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

Mental illness pierces the veil, and those who suffer from it dwell with their fragility in plain view. My role as a psychiatrist is not to try to repair the veil but to strengthen my patients so that they can live, so that they can suffer less, so that they can hope.

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?”

it is scarier to face a threat alone, without someone there to see what you are experiencing, to comfort, to understand.

It is hard to be empathetic and helpful to a patient if you see her as a threat to your credibility.

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

But even if it is madness that makes possible extraordinary creation, how much ingenuity and productivity are short-circuited by that same madness? How much potential greatness is lost in insanity’s dark corners?

That too much elation is a chimera.

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?

Woolf, they said, Dante, Sexton, Lowell. With each pronouncement the group seemed to gain confidence and momentum: Shelley, Plath, van Gogh. It struck me as a marching song. A cadence by which the Mad Pride parade could rally and process: Handel, Hemingway, Munch!