Falling Into the Fire: A Psychiatrist's Encounters with the Mind in Crisis

At what point can we know that ecstasy, or singular purpose, or religious fervor has become pathological, if we don’t wish to wait until obvious and irreversible damage has been done?

Does that mean that psychiatry leaves no room for divinity? That we’d medicate a person out of what could otherwise be a transformative and saintly life? That we’d subjugate—or, worse, block—some message from God?”

To acknowledge the reality of affliction means saying to oneself: “. . . There is nothing that I might not lose. It could happen at any moment that what I am might be abolished and be replaced by anything whatsoever of the filthiest and most contemptible sort.” To be aware of this in the depths of one’s soul is to experience non-being. It is the st

For my patients, madness is not a political statement. More important, it is something by which hardly any of my patients would choose to be burdened. For those of us who are fortunate enough to be comparatively sane, it is abhorrent to stand in celebration of Woolf’s madness. It did, after all, cost her her life. It is audacious and self-serving o

We all long, at some point, for a profound awakening. We travel with the expectation that the places we see and the encounters we have will transform us. We go to theaters and museums and holy sites in the hope of discovering something that will have a new and permanent resonance in our lives. It’s a human hunger. We want transformative things and

Standing on the edge with my patients—abiding with them—means that I must harbor a true awareness that I, too, could lose my child through the play of circumstance over which I have no control. I could lose my home, my financial security, my safety. I could lose my mind. Any of us could.

I adore this about her. The insistence upon beauty and awe being a daily part of her life. The fixed principle of the thing.

The body mystifies. The mind more so. Witnessing their complex intersections—and the unbidden ways in which the two can catastrophically fray—can unmoor us.

I believe that healing is a kind of holiness. But like any good religion, it leaves me with a fair number of huge and unanswerable questions.