Essay on Psychiatrists
I. Invocation
It's crazy to think one could describe them—
Calling on reason, fantasy, memory, eyes and ears—
As though they were all alike any more
Than sweeps, opticians, poets or masseurs.
Moreover, they are for more than one reason
Difficult to speak of seriously and freely,
And I have never (even this is difficult to say
Plainly, without foolishness or irony)
Consulted one for professional help, though it happens
Many or most of my friends have—and that,
Perhaps, is why it seems urgent to try to speak
Sensibly about them, about the psychiatrists.
II. Some Terms
“Shrink” is a misnomer. The religious
Analogy is all wrong, too, and the old,
Half-forgotten jokes about Viennese accents
And beards hardly apply to the good-looking woman
In boots and a knit dress, or the man
Seen buying the Sunday Times in mutton-chop
Whiskers and expensive running shoes.
In a way I suspect that even the terms “doctor”
And “therapist” are misnomers; the patient
Is not necessarily “sick.” And one assumes
That no small part of the psychiatrist’s
Role is just that: to point out misnomers.
III. Proposition
These are the first citizens of contingency.
Far from the doctrinaire past of the old ones,
They think in their prudent meditations
Not about ecstasy (the soul leaving the body)
Nor enthusiasm (the god entering one’s person)
Nor even about sanity (which means
Health, an impossible perfection)
But ponder instead relative truth and the warm
Dusk of amelioration. The cautious
Young augurs with their family-life, good books
And records and foreign cars believe
In amelioration—in that, and in suffering.
IV. A Lakeside Identification
Yes, crazy to suppose one could describe them—
And yet, there was this incident: at the local beach
Clouds of professors and the husbands of professors
Swam, dabbled, or stood to talk with arms folded
Gazing at the lake ... and one of the few townsfolk there,
With no faculty status—a matter-of-fact, competent,
Catholic woman of twenty-seven with five children
And a first-rate body—pointed her finger
At the back of one certain man and asked me,
“Is that guy a psychiatrist?” and by god he was! “Yes,”
She said, “He looks like a psychiatrist.”
Grown quiet, I looked at his pink back, and thought.
V. Physical Comparison With Professors And Others
Pink and a bit soft-bodied, with a somewhat jazzy
Middle-class bathing suit and sandy sideburns, to me
He looked from the back like one more professor.
And from the front, too—the boyish, unformed carriage
Which foreigners always note in American men, combined
As in a professor with that liberal, quizzical,
Articulate gaze so unlike the more focused, more
Tolerant expression worn by a man of action (surgeon,
Salesman, athlete). On closer inspection was there,
Perhaps, a self-satisfied benign air, a too studied
Gentleness toward the child whose hand he held loosely?
Absurd to speculate; but then—the woman saw something.
VI. Their Seriousness, With Further Comparisons
In a certain sense, they are not serious.
That is, they are serious—useful, deeply helpful,
Concerned—only in the way that the pilots of huge
Planes, radiologists, and master mechanics can,
At their best, be serious. But however profound
The psychiatrists may be, they are not serious the way
A painter may be serious beyond pictures, or a businessman
May be serious beyond property and cash—or even
The way scholars and surgeons are serious, each rapt
In his work’s final cause, contingent upon nothing:
Beyond work; persons; recoveries. And this is fitting:
Who would want to fly with a pilot who was serious
About getting to the destination safely? Terrifying idea—
That a pilot could over-extend, perhaps try to fly
Too well, or suffer from Pilot’s Block; of course,
It may be that (just as they must not drink liquor
Before a flight) they undergo regular, required check-ups
With a psychiatrist, to prevent such things from happening.
VII. Historical (The Bacchae)
Madness itself, as an idea, leaves us confused—
Incredulous that it exists, or cruelly facetious,
Or stricken with a superstitious awe as if bound
By the lost cults of Trebizond and Pergamum ...
The most profound study of madness is found
In the Bacchae of Euripides, so deeply disturbing
That in Cambridge, Massachusetts the players
Evaded some of the strongest unsettling material
By portraying poor sincere, fuddled, decent Pentheus
As a sort of fascistic bureaucrat—but it is Dionysus
Who holds rallies, instills exaltations of violence,
With his leopards and atavistic troops above law,
Reason and the good sense and reflective dignity
Of Pentheus—Pentheus, humiliated, addled, made to suffer
Atrocity as a minor jest of the smirking God.
When Bacchus’s Chorus (who call him “most gentle”!) observe:
“Ten thousand men have ten thousand hopes; some fail,
Some come to fruit, but the happiest man is he
Who gathers the good of life day by day”—as though
Life itself were enough—does that mean, to leave ambition?
And is it a kind of therapy, or truth? Or both?
VIII. A Question
On the subject of madness the Bacchae seems,
On the whole, more pro than contra. The Chorus
Says of wine, “There is no other medicine for misery”;
When the Queen in her ecstasy—or her enthusiasm?—
Tears her terrified son’s arm from his body, or bears
His head on her spear, she remains happy so long
As she remains crazy; the God himself (who bound fawnskin
To the women’s flesh, armed them with ivy arrows
And his orgies’ livery) debases poor Pentheus first,
Then leads him to mince capering towards female Death
And dismemberment: flushed, grinning, the grave young
King of Thebes pulls at a slipping bra-strap, simpers
Down at his turned ankle. Pentheus: “Should I lift up
Mount Cithæron—Bacchae, mother and all?”
Dionysus: “Do what you want to do. Your mind
Was unstable once, but now you sound more sane,
You are on your way to great things.”
The question is, Which is the psychiatrist: Pentheus, or Dionysus?
IX. Pentheus As Psychiatrist
With his reasonable questions Pentheus tries
To throw light on the old customs of savagery.
Like a brave doctor, he asks about it all,
He hears everything, “Weird, fantastic things”
The Messenger calls them: with their breasts
Swollen, their new babies abandoned, mothers
Among the Bacchantes nestled gazelles
And young wolves in their arms, and suckled them;
You might see a single one of them tear a fat calf
In two, still bellowing with fright, while others
Clawed heifers to pieces; ribs and hooves
Were strewn everywhere; blood-smeared scraps
Hung from the fir trees; furious bulls
Charged and then fell stumbling, pulled down
To be stripped of skin and flesh by screaming women ...
And Pentheus listened. Flames burned in their hair,
Unnoticed; thick honey spurted from their wands;
And the snakes they wore like ribbons licked
Hot blood from their flushed necks: Pentheus
Was the man the people told ... “weird things,” like
A middle-class fantasy of release; and when even
The old men—bent Cadmus and Tiresias—dress up
In fawnskin and ivy, beating their wands on the ground,
Trying to carouse, it is Pentheus—down-to-earth,
Sober—who raises his voice in the name of dignity.
Being a psychiatrist, how could he attend to the Chorus’s warning
Against “those who aspire” and “a tongue without reins”?
X. Dionysus As Psychiatrist
In a more hostile view, the psychiatrists
Are like Bacchus—the knowing smirk of his mask,
His patients, his confident guidance of passion,
And even his little jokes, as when the great palace
Is hit by lightning which blazes and stays,
Bouncing among the crumpled stone walls ...
And through the burning rubble he comes,
With his soft ways picking along lightly
With a calm smile for the trembling Chorus
Who have fallen to the ground, bowing
In the un-Greek, Eastern way—What, Asian women,
He asks, Were you disturbed just now when Bacchus
Jostled the palace? He warns Pentheus to adjust,
To learn the ordinary man’s humble sense of limits,
Violent limits, to the rational world. He cures
Pentheus of the grand delusion that the dark
Urgencies can be governed simply by the mind,
And the mind’s will. He teaches Queen Agave to look
Up from her loom, up at the light, at her tall
Son’s head impaled on the stiff spear clutched
In her own hand soiled with dirt and blood.
XI. Their Philistinism Considered
“Greek Tragedy” of course is the sort of thing
They like and like the idea of ... though not “tragedy”
In the sense of newspapers. When a patient shot one of them,
People phoned in, many upset as though a deep,
Special rule had been abrogated, someone had gone too far.
The poor doctor, as described by the evening Globe,
Turned out to be a decent, conventional man (Doctors
For Peace, B’Nai Brith, numerous articles), almost
Carefully so, like Paul Valéry—or like Rex Morgan, M.D., who,
In the same Globe, attends a concert with a longjawed woman.
First Panel: “We’re a little early for the concert!
There’s an art museum we can stroll through!” “I’d like
That, Dr. Morgan!” Second Panel: “Outside the hospital,
There’s no need for such formality, Karen! Call me
By my first name!” “I’ll feel a little awkward!”
Final Panel: “Meanwhile ...” a black car pulls up
To City Hospital .... By the next day’s Globe, the real
Doctor has died of gunshot wounds, while for smiling, wooden,
Masklike Rex and his companion the concert has passed,
Painlessly, offstage: “This was a beautiful experience, Rex!”
“I’m glad you enjoyed it! I have season tickets
And you’re welcome to use them! I don’t have
The opportunity to go to many of the concerts!”
Second Panel: “You must be famished!” And so Rex
And Karen go off to smile over a meal which will pass
Like music offstage, off to the mysterious pathos
Of their exclamation marks, while in the final panel
“Meanwhile, In The Lobby At City Hospital”
A longjawed man paces furiously among
The lamps, magazines, tables and tubular chairs.
XII. Their Philistinism Dismissed
But after all—what “cultural life” and what
Furniture, what set of the face, would seem adequate
For those who supply medicine for misery?
After all, what they do is in a way a kind of art,
And what writers have to say about music, or painters’
Views about poetry, musicians’ taste in pictures, all
Often are similarly hoked-up, dutiful, vulgar. After all,
They are not gods or heroes, nor even priests chosen
Apart from their own powers, but like artists are mere
Experts dependent on their own wisdom, their own arts:
Pilgrims in the world, journeymen, bourgeois savants,
Gallant seekers and persistent sons, doomed
To their cruel furniture and their season tickets
As to skimped meditations and waxen odes.
At first, Rex Morgan seems a perfect Pentheus—
But he smirks, he is imperturbable, he understates;
Understatement is the privilege of a god, we must
Choose, we must find out which way to see them:
Either the bland arrogance of the abrupt mountain god
Or the man of the town doing his best, we must not
Complain both that they are inhuman and too human.
XIII. Their Despair
I am quite sure that I have read somewhere
That the rate of suicide among psychiatrists
Is far higher than for any other profession.
There are many myths to explain such things, things
Which one reads and believes without believing
Any one significance for them—as in this case,
Which again reminds me of writers, who, I have read,
Drink and become alcoholics and die of alcoholism
In far greater numbers than other people.
Symmetry suggests one myth, or significance: the drinking
Of writers coming from too much concentration,
In solitude, upon feelings expressed
For or even about possibly indifferent people, people
Who are absent or perhaps dead, or unborn; the suicide
Of psychiatrists coming from too much attention,
In most intimate contact, concentrated upon the feelings
Of people toward whom one may feel indifferent,
People who are certain, sooner or later, to die ...
Or people about whom they care too much, after all?
The significance of any life, of its misery and its end,
Is not absolute—that is the despair which
Underlies their good sense, recycling their garbage,
Voting, attending town-meetings, synagogues, churches,
Weddings, contingent gatherings of all kinds.
XIV. Their Speech, Compared With Wisdom And Poetry
Terms of all kinds mellow with time, growing
Arbitrary and rich as we call this man “neurotic”
Or that man “a peacock.” The lore of psychiatrists—
“Paranoid,” “Anal” and so on, if they still use
Such terms—also passes into the status of old sayings:
Water thinner than blood or under bridges; bridges
Crossed in the future or burnt in the past. Or the terms
Of myth, the phrases that well up in my mind:
Two blind women and a blind little boy, running—
Easier to cut thin air into planks with a saw
And then drive nails into those planks of air,
Than to evade those three, the blind harriers,
The tireless blind women and the blind boy, pursuing
For long years of my life, for long centuries of time.
Concerning Justice, Fortune and Love I believe
That there may be wisdom, but no science and few terms:
Blind, and blinding, too. Hot in pursuit and flight,
Justice, Fortune and Love demand the arts
Of knowing and naming: and, yes, the psychiatrists, too,
Patiently naming them. But all in pursuit and flight, two
Blind women, tireless, and the blind little boy.
XV. A Footnote Concerning Psychiatry Itself
Having mentioned it, though it is not
My subject here, I will say only that one
Hopes it is good, and hopes that practicing it
The psychiatrists who are my subject here
Will respect the means, however pathetic,
That precede them; that they respect the patient’s
Own previous efforts, strategies, civilizations—
Not only whatever it is that lets a man consciously
Desire girls of sixteen (or less) on the street,
And not embrace them, et cetera, but everything that was
There already: the restraints, and the other lawful
Old culture of wine, women, et cetera.
XVI. Generalizing, Just And Unjust
As far as one can generalize, only a few
Are not Jewish. Many, I have heard, grew up
As an only child. Among many general charges
Brought against them (smugness, obfuscation)
Is a hard, venal quality. In truth, they do differ
From most people in the special, tax-deductible status
Of their services, an enviable privilege which brings
Venality to the eye of the beholder, who feels
With some justice that if to soothe misery
Is a tax-deductible medical cost, then the lute-player,
Waitress, and actor also deserve to offer
Their services as tax-deductible; movies and TV
Should be tax-deductible ... or nothing should;
Such cash matters perhaps lead psychiatrists
And others to buy what ought not to be sold: Seder
Services at hotels; skill at games from paid lessons;
Fast divorce; the winning side in a war seen
On TV like cowboys or football—that is how much
One can generalize: psychiatrists are as alike (and unlike)
As cowboys. In fact, they are stock characters like cowboys:
“Bette Davis, Claude Rains in Now, Voyager (1942),
A sheltered spinster is brought out of her shell
By her psychiatrist” and “Steven Boyd, Jack Hawkins
In The Third Secret (1964), a psychoanalyst’s
Daughter asks a patient to help her find her father’s
Murderer.” Like a cowboy, the only child roams
The lonely ranges and secret mesas of his genre.
XVII. Their Patients
As a rule, the patients I know do not pace
Furiously, nor scream, nor shoot doctors. For them,
To be a patient seems not altogether different
From one’s interest in Ann Landers and her clients:
Her virtue of taking it all on, answering
Any question (artificial insemination by grandpa;
The barracuda of a girl who says that your glasses
Make you look square) and her virtue of saying,
Buster (or Dearie) stop complaining and do
What you want ... and often that seems to be the point:
After the glassware from Design Research, after
A place on the Cape with Marimekko drapes,
The superlative radio and shoes, comes
The contingency tax—serious people, their capacity
For mere hedonism fills up, one seems to need
To perfect more complex ideas of desire,
To overcome altruism in the technical sense,
To learn to say no when you mean no and yes
When you mean yes, a standard of cui bono, a standard
Which, though it seems to be the inverse
Of more Spartan or Christian codes, is no less
Demanding in its call, inward in this case, to duty.
It suggests a kind of league of men and women dedicated
To their separate, inward duties, holding in common
Only the most general standard, or no standard
Other than valuing a sense of the conflict
Among standards, a league recalling in its mutual
Conflict and comfort the well-known fact that psychiatrists,
Too, are the patients of other psychiatrists,
Working dutifully—cui bono—at the inward standards.
XVIII. The Mad
Other patients are ill otherwise, and do
Scream and pace and kill or worse; and that
Should be recalled. Kit Smart, Hitler,
The contemporary poets of lunacy—none of them
Helps me to think of the mad otherwise
Than in clichés too broad, the maenads
And wild-eyed killers of the movies ...
But perhaps lunacy feels something like a cliché,
A desperate or sweet yielding to some broad,
Mechanical simplification, a dispersal
Of the unbearable into its crude fragments,
The distraction of a repeated gesture
Or a compulsively hummed tune. Maybe
It is not utterly different from chewing
At one’s fingernails. For the psychiatrists
It must come to seem ordinary, its causes
And the causes of its relief, after all,
No matter how remote and intricate, are no
Stranger than life itself, which was born or caused
Itself, once, as a kind of odor, a faint wreath
Brewing where the radiant light from billions
Of miles off strikes a faint broth from water
Standing in rock; life born from the egg
Of rock, and the egglike rock of death
Are no more strange than this other life
Which we name after the moon, lunatic
Other-life ... housed, for the lucky ones,
In McLean Hospital with its elegant,
Prep-school atmosphere. When my friend
Went in, we both tried to joke: “Karen,” I said,
“You must be crazy to spend money and time
In this place”—she gained weight,
Made a chess-board, had a roommate
Who introduced herself as the Virgin Mary,
Referred to another patient: “Well, she must
Be an interesting person, if she’s in here.”
XIX. Peroration, Defining Happiness
“I know not how it is, but certainly I
Have never been more tired with any reading
Than with dissertations upon happiness,
Which seems not only to elude inquiry,
But to cast unmerciful loads of clay
And sand and husks and stubble
Along the high-road of the inquirer.
Even sound writers talk mostly in a drawling
And dreaming way about it. He,
Who hath given the best definition
Of most things, hath given but an imperfect one,
Here, informing us that a happy life
Is one without impediment to virtue ....
In fact, hardly anything which we receive
For truth is really and entirely so,
Let it appear plain as it may, and let
Its appeal be not only to the understanding,
But to the senses; for our words do not follow
The senses exactly; and it is by words
We receive truth and express it.”
So says Walter Savage Landor in his Imaginary
Conversation between Sir Philip Sidney
And Fulke Greville, Lord Brooke, all three,
In a sense, my own psychiatrists, shrinking
The sense of contingency and confusion
Itself to a few terms I can quote, ponder
Or type: the idea of wisdom, itself, shrinks.
XX. Peroration, Concerning Genius
As to my own concerns, it seems odd, given
The ideas many of us have about art,
That so many writers, makers of films,
Artists, all suitors of excellence and their own
Genius, should consult psychiatrists, willing
To risk that the doctor in curing
The sickness should smooth away the cicatrice
Of genius, too. But it is all bosh, the false
Link between genius and sickness,
Except perhaps as they were linked
By the Old Man, addressing his class
On the first day: “I know why you are here.
You are here to laugh. You have heard of a crazy
Old man who believes that Robert Bridges
Was a good poet; who believes that Fulke
Greville was a great poet, greater than Philip
Sidney; who believes that Shakespeare’s Sonnets
Are not all that they are cracked up to be .... Well,
I will tell you something: I will tell you
What this course is about. Sometime in the middle
Of the Eighteenth Century, along with the rise
Of capitalism and scientific method, the logical
Foundations of Western thought decayed and fell apart.
When they fell apart, poets were left
With emotions and experiences, and with no way
To examine them. At this time, poets and men
Of genius began to go mad. Gray went mad. Collins
Went mad. Kit Smart was mad. William Blake surely
Was a madman. Coleridge was a drug addict, with severe
Depression. My friend Hart Crane died mad. My friend
Ezra Pound is mad. But you will not go mad; you will grow up
To become happy, sentimental old college professors,
Because they were men of genius, and you
Are not; and the ideas which were vital
To them are mere amusement to you. I will not
Go mad, because I have understood those ideas ....”
He drank wine and smoked his pipe more than he should;
In the end his doctors in order to prolong life
Were forced to cut away most of his tongue.
That was their business. As far as he was concerned
Suffering was life’s penalty; wisdom armed one
Against madness; speech was temporary; poetry was truth.
XXI. Conclusion
Essaying to distinguish these men and women,
Who try to give medicine for misery,
From the rest of us, I find I have failed
To discover what essential statement could be made
About psychiatrists that would not apply
To all human beings, or what statement
About all human beings would not apply
Equally to psychiatrists. They, too,
Consult psychiatrists. They try tentatively
To understand, to find healing speech. They work
For truth and for money. They are contingent ...
They talk and talk ... they are, in the words
Of a lute-player I met once who despised them,
“Into machines” ... all true of all, so that it seems
That “psychiatrist” is a synonym for “human being,”
Even in their prosperity which is perhaps
Like their contingency merely more vivid than that
Of lutanists, opticians, poets—all into
Truth, into music, into yearning, suffering,
Into elegant machines and luxuries, with caroling
And kisses, with soft rich cloth and polished
Substances, with cash, tennis and fine electronics,
Liberty of lush and reverend places—goods
And money in their contingency and spiritual
Grace evoke the way we are all psychiatrists,
All fumbling at so many millions of miles
Per minute and so many dollars per hour
Through the exploding or collapsing spaces
Between stars, saying what we can.
Copyright Credit: Robert Pinsky, "Essay on Psychiatrists" from Sadness and Happiness. Copyright © 1975 Princeton University Press, 2003 renewed PUP. Reprinted by permission of Princeton University Press.
Source: The Figured Wheel: New and Collected Poems 1966-1996 (Princeton University Press, 1996)