A Love Song to Psychotherapy and Coping During Turbulent Times
Steven J. Ceresnie, Ph.D.
Book Review: Kay Redfield Jamison. Fires in the Dark. Healing the Unquiet Mind.
New York: Alfred A. Knopf. 2023.
I think psychotherapy saves lives and is hugely meaningful and I think that one of the
unfortunate aspects of prescription drugs working well is that people tend to think that’s enough.
-- Kay Redfield Jamison
From Fires in the Dark
Kay Redfield Jamison is a psychologist and the Dalio Professor in Mood Disorders and a
Professor of Psychiatry at the Johns Hopkins University School of Medicine, as well as an
honorary professor of English at the University of St. Andrews in Scotland.
In 1995, as chair of the Michigan Psychological Association Program Committee, I
invited Dr. Jamison to speak to our association conference. It was same year her book, The
Unquiet Mind, was published. I called her at Johns Hopkins and was startled when she answered
the phone, and she was surprised when I invited her to present at our conference because she said
no other psychological association had yet ever asked her to speak. She agreed to speak and I had
the privilege of introducing her.
Her topic in her presentation that day was “A Clinical Overview of Manic-Depressive
Illness/Mood Disorders and Artistic Creativity.” I was able to point out in my introduction that
her new book, The Unquiet Mind, was currently on the New York Times best seller list.
About her book The Unquiet Mind, Dr. Jamison took a huge risk exposing her tumultuous
life struggling with bipolar disorder with the publication of her memoir. Before she went public
with her history of mental illness, Dr. Jamison consulted with her department chair who
encouraged her to publish The Unquiet Mind. The chair of her department said her book would
not jeopardize her academic career and would make a significant contribution to help people
understand mental illness and seek effective treatments.
Since 1995, Dr. Jamison has become an ambassador for mental health educating students
at college campuses around the country; giving lectures and interviews available on YouTube;
while writing many outstanding books such as Manic-Depressive Illness: Bipolar Disorders and
Recurrent Depression (coauthored with Frederick Goodwin), a 1,262-page bipolar disorder
Bible; Touched with Fire, a study of the relationship between creativity and bipolar disorder; and
Night Falls Fast, a title taken from a poem by Edna St. Vincent Millay, and a review of the
history and overview of suicide, the psychology and psychopathology, the biology, and the
prevention of suicide.
She took the title for Fires in the Dark, from the English writer Siegfried Sassoon’s poem
To a Very Wise Man, a tribute to W.H. Rivers, the psychiatrist who helped him cope with trauma
he sustained in World War I.
This is not a book about specific techniques and theories of psychotherapy. Rather, Dr.
Jamison reflects on the origins of healing, the underlying commonalities of psychological
treatments, and the work of extraordinary healers.
This love song is divided into three verses:
I: The Mind at War. Healing the Broken
II: Healers of the Mind. Priest, Physician and Psychotherapist.
III. The Healing Arts. Hero, Artist and Storyteller.
The emphasis of The Mind at War is on psychotherapy, “because in recent years
psychotherapy has been relegated to the sidelines.” This focus on psychotherapy is a theme that
runs throughout the book.
Dr. Jamison reviews the origins of psychotherapy, in ancient Roman and Greek cultures,
and as far back as our wide knowledge of the Neanderthals:
From earliest times to our own, in cave, village or consulting room, certain individuals –
healers – have stood out for being able to ease the suffering of the mourning, melancholic, or
mad. Long before we could treat diseases of the brain and afflictions of the mind, priests and
doctors laid on hands, listened, consoled, dispensed potions, and engaged the gods through
ritual and magic.
This chapter takes place in the “field and shell-shocked hospitals,” of the First World
War. Although the origins of healers of the mind dates back to the beginning of medicine and
religion, Dr. Jamison discusses what we have learned from nurses and doctors who treated
unimaginable psychic trauma and physical suffering during WWI. She notes:
Doctor, nurse and poet knew: Memory must be grappled with, death is a compelling tutor,
and adversity teaches.
Dr. Jamison tells the stories of nurses and doctors and the stories of those they tried to
heal. She discusses two extraordinary healers: Dr. W.H.R. Rivers, and Sir William Osler. Rivers
was a medical psychologist, physician and anthropologist. Rivers’ experiences as an
anthropologist familiar with a variety of cultures led him to “learn from healing rituals, ways of
death, from their gods and languages and arts, and from their ways of survival.” Rivers knew the
earliest ways of healing were psychotherapeutic.
Osler became the first physician in chief at Johns Hopkins Hospital. He was interested in
what makes a great healer. He recommended that young doctors read widely in the humanities
and make use of faith and suggestion. He was the first physician to insist that medical students
learn from seeing and talking with patients.
Exceptional healers such as Rivers and Osler knew the importance of memory was
crucial to healing, Dr. Jamison writes:
To remember the dead and the maimed, to know the faces of the insane, to bear witness to
the men they commanded or served with, was a start to heal.
In the second section, Healers of the Mind, Dr. Jamison talks about “the role that
psychotherapy plays in building walls to protect the mind, and in giving order to a chaotic
personal universe; to exploring the roots of suffering, and in pursuing meaning and the purpose
of life: all of these while edging the mind toward risk and quest…psychotherapy and medication
underpin the modern treatment of mental suffering…but to heal requires more active engagement
of the imagination, learning, and seeking…Healing is a journey.”
Osler knew that work was an important part of the healing journey and referred to work
as the “true balm of hurt minds.”
In The Healing Arts, Dr. Jamison addresses the role of imagination in psychological
healing and discusses the importance of art, adventure, adversity and courage. She writes that to
accompany and engage those who struggle and suffer, to let them know in words and actions,
that we will be with them, not for just a while, underlies our attempts to heal and goes on to say:
The active engagement of sufferer with healer is necessary to make sense of the
experience of suffering – grief, depression, trauma, madness, by learning how to navigate hard
psychological straits, to face painful memories, to gauge and harness painful memories, to gauge
and harness intense or erratic moods, and to find vitality when it has been depleted.
Dr. Jamison’s describes how some people harness the good that can come from facing
adversity and learn how to triumph over trauma. For example, she tells us about the life of Paul
Robeson, who was an American bass-baritone concert artist, lawyer, athlete, stage and film actor,
and professional football player who suffered from bipolar disorder, faced much adversity, and
led a life that inspired many.
Dr. Jamison tells us about the beginning of her treatment for mania, depression, and
suicide attempts – by a doctor and psychotherapist who accompanied her throughout the healing
journey. At the start of her psychotherapy, her psychotherapist asked her two questions: “What
matters to you?” and “How can I make a difference?”
Fires in the Dark sings a love song to psychotherapy as she advocates for moving
psychological healing from the sidelines to an essential part of treatment for mental illness.
Psychotherapy helps patients learn what matters to them and how to begin to triumph over life’s
inevitable struggles, and face the tragedies, mysteries, wonders, and bitter-sweet joys of being
alive.
This is a book to treasure.
