Kay Redfield Jamison, celebrated researcher and hero to the bipolar
community, uses her own experiences with mania, psychosis, and suicidal
depression to enrich research into the historical and cultural roots of
psychotherapy and other curative practices in her new book Fires in the Dark: Healing the Mind, the Oldest Branch of Medicine.
Kay Redfield Jamison, PhD, had no intention of getting personal when she began working on her latest book.
Dr. Jamison had been there, done that with her bestselling memoirs An Unquiet Mind: A Memoir of Moods and Madness, a raw reflection on living with bipolar mood swings since her teens, and Nothing Was the Same, a look back at her relationship with her first husband, Richard Wyatt, a fellow mental health researcher who died of cancer.
Her new work, (released May 23) titled Fires in the Dark: Healing the Mind, the Oldest Branch of Medicine, is
a multibranched exploration into the roots of what we now call
psychotherapy. The book offers historical and cultural perspective on
how we humans have sought to “cure” mental distress before, and
alongside, pharmaceutical methods.
With subject matter so relevant to her own life, it’s perhaps
inevitable that she ends up touching on her own search for healing as
she circles from the ancient Egyptians and Greeks to “shell-shocked”
soldiers in World War I. Along the way, she branches out to look at
sometimes troubling physical interventions for mood symptoms and
psychosis as well as how religion, ritual, and myth contribute to mental
wellness.
Fires in the Dark also looks at what makes a good healer and why that’s so important. “I was unbelievably lucky that the doctor who I had was a healer,” says Jamison, 76.
Psychologist, Heal Thyself
So what makes a good healer? For starters, Jamison explains, she
benefited from her psychiatrist’s skill and insight early on in
treatment. He had a thorough knowledge of depression, mania, and the medications
used to treat mood disorders. He asked all the right questions,
listened in all the right ways, and educated Jamison about bipolar
disorder at a time when it was rarely discussed publicly.
“This type of competence doesn’t get emphasized as much as it should,” she reflects. The vital complement to his competence was compassion, empathy, an understanding of how bipolar disorder
affected Jamison as a person: “He understood what my illness meant to
me in terms of a sense of failure and terror about losing my job or my
life,” she says.
Perhaps most importantly, he buffered harsh reality with a strong dose of optimism. On
the one hand, “He made it clear that this wasn’t going away, and this
was going to be hard,” says Jamison. On the other hand, “He always
believed I would get better even when I had no belief that I would.”
She adds: “Healing … is the intelligent extension of hope with belief, and this is really important at the early stages.”
From Breakdown to Diagnosis: The Unfolding of a Mood Disorder
Jamison’s own early stages in her bipolar journey include what she
describes as a “breakdown” at age 17. Despite periods of depression and
mild mania, she didn’t get her diagnosis of manic- depressive illness —
as bipolar disorder was then known — for another decade.
In 1974, she experienced severe psychotic mania. At the time, she was
a new faculty member at the University of California in Los Angeles,
having completed her PhD in clinical psychology. A friend and colleague
pointed out the likelihood that Jamison was having an episode of
manic-depressive illness.
Once the diagnosis was confirmed, she kept it mostly private to protect her professional reputation and career aspirations. And it has proved to be quite a career.
Her impact on the field of bipolar research began when she helped
found what is now the Mood Disorders Clinic at UCLA in 1978. With the
benefit of years of clinical practice at her back and her own insider
knowledge, she cowrote the influential and groundbreaking textbook Manic-Depressive Illness with prominent researcher Frederick K. Goodwin. (The first edition came out in 1990.)
Jamison went on to become a professor of psychiatry and behavioral
sciences and co-director of the Mood Disorders Center at Johns Hopkins
University, where she has been since 1987. She is also the university’s
Dalio Professor in Mood Disorders (in academia, a named position
reflects respect and prestige). And that’s just one of the many honors
and awards to her name. Here’s another: In 2001, she received a
MacArthur Fellowship (commonly known as the “genius grant.”)
Bringing Bipolar Disorder Out of the Shadows
In addition to her straight-up memoirs, Jamison has written a number of scholarly inquiries:
a couple of works on bipolar and creativity, one on the power of
exuberance, another on suicide. Arguably, however, it was the
publication of An Unquiet Mind in 1995 that carried her influence to a wider audience.
Jamison’s difficult decision to disclose that she has bipolar 1
disorder — although she continues to prefer the term manic-depression
for its descriptive accuracy — made her one of the early heroes of the
bipolar community. Like the actress Patty Duke,
another pioneer in public disclosure, Jamison became a role model at a
time when psychiatric conditions were shrouded in secrecy and shame. Not
only was she sharing her truth, but she was successful in her field and
settled in her personal life to boot.
Even today, she says, she encounters individuals at her readings or
lectures who tell her she has given them hope that they can not only
survive but thrive in the face of their mental health challenges.
Beyond Lithium: The Importance of Psychotherapy in Healing
Jamison was also a pioneer in terms of treatment. According to a paper published in 2009,
lithium was approved to treat mania in the United States in 1970 and as
a preventive treatment for manic-depression in 1974, the year she
received her diagnosis. She thus was among the earliest cohorts with
access to a truly effective mood stabilizer.
“I am a big believer in medication,” she says. “There is no question
if I weren’t on lithium and didn’t respond well, I would be dead.”
Healing goes far beyond getting the proper prescription, however. In Fires in the Dark, Jamison explores the synergistic benefits of medication plus psychotherapy.
Talk therapy “really saves people’s lives,” she says, with “the
capacity to help you understand what you have been through, learn from
it, and deal with it.”
The key is addressing the whole person, rather than simply ameliorating symptoms. “Psychotherapy is a deeply human experience and much different than a 10-minute medication check,” she notes.
In Jamison’s view, anything that soothes and enriches the soul can
contribute to healing the mind. For her, that includes leaning on loved
ones, looking to nature, listening to music, reading, and walking with
her basset hound, Muffin.
Happy memories also can be a life raft during turbulent times — for
example, looking back to childhood summers spent on Chesapeake Bay,
before she developed mood symptoms.
Unraveling Our Psyche Through the Great Works in Literature
Fires in the Dark shifts between a broad canvas and
individual portraits of healers Jamison regards as influential. In her
view, healers can be doctors, artists, musicians, clergy members, or any
kind, caring, and altruistic soul. Several of her examples illustrate
broader themes.
Sir William Osler, an influential figure in American medical
education, was the first physician-in-chief at Johns Hopkins University
Hospital, per the National Library of Medicine.
In addition to establishing extensive clinical practice for his
doctors-in-training, he strongly encouraged an enriching mental diet of
serious literature and history.
“He asked medical students to read deeply and profoundly in the
humanities, including books that got him through his own life,” Jamison
says.
Those books — including Plutarch’s Lives, a compilation of 48 biographies of famous men of ancient times, and Shakespeare’s plays Othello, A Midsummer Night’s Dream, and Hamlet
— served to remind students that people are more than bones and sinew.
Great works enhance our understanding of what drives and disturbs us.
Coping Better With Trauma: Jamison’s Call for Open Dialogues
W.H.R. Rivers was a British polymath who practiced medicine, made a
mark in anthropology, and went on to specialize in neurology and
experimental psychology. During World War I, he worked with soldiers
struggling with “shell shock,” the equivalent of today’s post-traumatic
stress disorder, per Everyday Health.
The backbone of his treatment approach was “the talking cure,” which
had taken root in Europe in the 1880s. At its core was the ancient Greek
idea of catharsis, a cleansing or purging of emotions. For Aristotle, a
great tragic performance stirred feelings of fear and pity in the
audience that could then be released. For Rivers, unearthing repressed
trauma and “unacceptable” emotions was the first step to moving past
them.
“The Greeks had temples where they talked about dreams and helped
each other heal,” Jamison notes. “We keep reinventing the wheel, but
other cultures have done better or as well as we have.”
Again, the healers around us don’t necessarily have to be
professional practitioners: “People can profit from the lives of others
much more than they do,” Jamison says. Her advice: Ask others for tips on coping better and getting through dark times. “Get into what people do to heal,” she suggests. “Ask others: ‘What have you found helpful or useless?’”
Paul Robeson: An Example of Courage in the Face of Racism
Jamison devotes a chapter to legendary singer and actor Paul Robeson,
an exemplar of courage. Although never formally diagnosed with bipolar
disorder, he experienced depressive episodes and manic symptoms and
spent time in psychiatric hospitals.
Robeson, a Black man, broke the color barrier to play on Rutgers
University’s football team. He played briefly in the National Football
League while earning a law degree from Columbia University, then moved
into the entertainment field.
He fought against racist acts — many of them very personal — and
systemic racism his whole life. He challenged injustice, including the
“red-baiting” of the U.S. House Un-American Activities Committee when he
was called to testify about his Communist affiliations.
His public stands and his art “showed conviction and courage, which helped to heal other people,” Jamison adds.
* * * * * *
What We Can Do to Heal
Jamison lists a few basic elements for healing:
Dig Into Your Diagnosis
Bipolar disorder is a chronic condition that requires active, ongoing
interventions. Or as Jamison says, “Don’t assume it is going to go
away.”
The first step toward healing is finding out as much as you can about symptoms, triggers,
and treatments — a “forewarned is forearmed” kind of thing. That’s a
lot easier now than when Jamison was grappling with her diagnosis in the
1970s.
“When I got sick, no one talked about it,” she recalls. These days,
people can find any number of resources in print or on the internet.
“Some [online] information is awful, but a lot is quite good,” she says.
Create a ‘Badger List’ for Your Doctor
When medications are prescribed, research what symptoms they are
supposed to address, how long before you can expect to see results, what
are the possible side effects, what time of day is best to take them,
and so on. Your practitioners are themselves a valuable resource, so
don’t be afraid to ask questions.
“Really badger your doctors with questions such as, ‘When do you
think I should be feeling better?’ Never forget that you have a right to
be actively involved in your own care,” Jamison says.
Find Humor Where You Can
Jamison often speaks on college campuses, which is apt since late
adolescence is the age of onset for many psychiatric illnesses.
“Kids go through an incredible amount of sheer hell with humor and
determination,” she says. “The fact that they are dealing with it and
that very often they have a lot of wit about it is transforming an awful
situation into one that is manageable.”
Cultivate ‘Islands’
Jamison describes “islands” as things you love and feel passionate about, things that add value to your life.
“Seek out the things you love and put them in front of you — even when you are depressed,” she says.
She recommends using imagination and tapping into the arts to create your own islands that no one else can infiltrate.
Posts
No comments:
Post a Comment