Dr. Kay Redfield Jamison believes that medication is an overused option and that many people can make great strides recovering from “mental suffering” using therapy, art, and meaningful hobbies. She also shares that we can learn a lot by understanding the lessons learned from resilient people who came before us. Using numerous historical examples, Dr. Jamison takes us on a journey of understanding our present mental health states by using the past.
What do soldiers who suffer from PTSD, mourners after a death, and people with mental illness all have in common? According to New York Times’ best selling author and Johns Hopkins professor Dr. Jamison, they all have an unquiet mind they need to heal.
Kay Redfield Jamison is 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. She is the coauthor of the standard medical text on bipolar disorder and author of An Unquiet Mind, Night Falls Fast, Exuberance, and Touched with Fire. Her most recent book, Robert Lowell: Setting the River on Fire, was a Pulitzer Prize finalist. Dr. Jamison is a Fellow of the American Academy of Arts and Sciences and of the Royal Society of Edinburgh. She is a recipient of the Lewis Thomas Prize, the Sarnat Prize from the National Academy of Medicine, and a John D. and Catherine T. MacArthur Fellowship.
Gabe Howard is an award-winning writer and speaker who lives with bipolar disorder. He is the author of the popular book, “Mental Illness is an Asshole and other Observations,” available from Amazon; signed copies are also available directly from the author.
Gabe makes his home in the suburbs of Columbus, Ohio. He lives with his supportive wife, Kendall, and a Miniature Schnauzer dog that he never wanted, but now can’t imagine life without.
To book Gabe for your next event or learn more about him, please visit gabehoward.com.
Producer’s Note: Please be mindful that this transcript has been computer generated and therefore may contain inaccuracies and grammar errors. Thank you.
Announcer: You’re listening to Inside Mental Health: A Psych Central Podcast where experts share experiences and the latest thinking on mental health and psychology. Here’s your host, Gabe Howard.
Gabe Howard: Welcome to the show, everyone. I’m your host, Gabe Howard, and calling in today, we have Kay Redfield Jamison. Dr. Jamison is perhaps best known as the author of “An Unquiet Mind.” She’s also a professor of psychiatry at the Johns Hopkins University School of Medicine and coauthor of the standard medical text on bipolar disorder. Also, she’s written many other books, including the Pulitzer Prize nominated “Robert Lowell, Setting the River on Fire.” Her latest book, “Fires in the Dark: Healing the Unquiet Mind,” is out now. Dr. Jamison, welcome to the podcast.
Kay Redfield Jamison: Well, thank you. Delighted to be here.
Gabe Howard: It is truly my pleasure to have you here. In the description of your new book, you say that this book is partly “a cultural history of the treatment and healing” of mental illness. Now, your book focuses a lot on war and the experiences of soldiers in war. And specifically, you write a lot about World War I and you write about post-traumatic stress disorder, the PTSD of those soldiers who fought. Is there a reason that you put so much attention in that direction?
Kay Redfield Jamison: Um. I would say I chose World War I for a couple of reasons. One is I think the kind of trauma and suffering is much clearer to people than if you if you describe try to describe the suffering of depression. So, I wanted to start my book with something that was obviously, you know, the trauma of a really awful trench war. Um, I also one of the things I wanted to do with my book was to incorporate the people who over the years and the writers and clinicians whom I’ve admired and drawn from and put them together in one book to sort of, kind of pull from what I what I’ve learned from them. I hope and I would say with the First World War, there are two people when I was a high school student and I was recovering from a breakdown, my high school English teacher gave me a couple of books, the poetry of Robert Lowell, and some books about King Arthur, because I was interested in in King Arthur and tragedy. But he also gave me the diaries of Siegfried Sassoon, the Great World War I poet, and in his writings about the First World War, which were brilliant, he wrote about his relationship with his psychiatrist, W.H.R Rivers, who was an anthropologist, a medical psychologist, a psychiatrist, deeply broad, broad minded and well-educated and empathetic man.
Kay Redfield Jamison: And he actually was very instrumental in changing attitudes or trying to change attitudes about shell shock, which was kind of the earlier version of PTSD, because people thought it was malingering. People thought people were just making it up. Just trying to get out of the war. And he was very importantly involved in that. But I have been a fan of W.H.R Rivers since I was 17, and then in briefly again in graduate school when it came up. And so, I was intrigued by of all the kind of archetypal relationships, psychotherapeutic relationships, if you had to describe. You would take Siegfried Sassoon’s description of his relationship with W.H.R. Rivers and how he helped him heal. And it’s a deeply moving relationship and a profound relationship. And Sassoon, being a great poet, was able to put that into words, actually quite simple, beautiful words. So, I wanted to start off with that, but also from a history of psychotherapy point of view, even though its roots are ancient, the immediate, more immediate origins of formal psychotherapy were right around the time just before the First World War, the time of Jung and Freud and so forth. So, it’s a very important time. But I was very interested in the healer Rivers.
Gabe Howard: Dr. Jamison, I was really surprised to learn that at any point in history, shell shock, post-traumatic stress disorder was ever looked down upon. And
Kay Redfield Jamison: Oh, yeah.
Gabe Howard: You know, the soldiers were looked at as malingerers and cowards.
Kay Redfield Jamison: Yes. And they were shot.
Gabe Howard: Why cowards? Is it because their minds couldn’t handle it?
Kay Redfield Jamison: Uh, well, because in the middle of a war, there’s the practical aspect. If you need men to fight and the people are saying showing symptoms of shocks, in this case, shell shock. You lose fighting men. So, I think some people would say from a cynical point of view, the Army point of view, that’s one perspective. Another perspective is that all sorts of people were going out and dying. It was an incredibly ghastly war in terms of death. And, you know, the assumption was you would you would do your bit and that if you didn’t, you were a coward. I think that was not that far from, you know, general social beliefs. And so, what the psychiatrists were forced to do, I mean, by virtue of their job. And Rivers was no exception. He had to get them well enough to go back and fight. I mean, Rivers was an Army officer as well as a doctor and as an Army officer, his obligation was to get his patients, in his case officers, because he was treating officers, well enough to go back to fight. So, it was a particularly brutal aspect of things. And then there were people who were shot for cowardice and their doctors, some of their doctors had to put like a white cloth over their heart to make it easier to find for the firing squad to shoot them. PTSD has not, and to this day, I mean, I was at UCLA after the Vietnam War. You know, those soldiers went through an incredible amount of stigma and they still do. You know, I think people are much, much, much better informed now than they used to be. But they still go through, you know, awful shame.
Gabe Howard: I appreciate the fact that you said it’s improving. And obviously, if there were firing squads literally murdering people who are suffering from post-traumatic stress disorder, it’s a vast improvement that we’re no longer doing that. But as far as society is concerned and even the medical community is concerned, how is the treatment and acceptance of PTSD changed from World War I to now?
Kay Redfield Jamison: First of all, I think people just know a lot more about it. They know about the symptoms. They know the kind of natural course of the symptoms. They know the lingering trauma that can go on for years. There’s much more medical knowledge, treatment with medications and group therapies and so forth. So, it’s still incredibly painful for people coming back from war zones to try and get well. But I do think society has a better understanding. Some of it is you know, we actually are very isolated from the military. You know, most people don’t aren’t in proximity to veterans’ hospitals or to army posts. So that, you know, I know that when I was in my father was in the Air Force, you know, all my life, the people, the Post, the Air Force and Army posts were just away from places, you know. So, there was there was a pretty isolated war or world there. I think one of the other things that’s changed is just the level of expertise. You know, if you look at the doctors at Walter Reed and, you know, all the army posts around, you know, they just have more training, more caring. You know, I think the military has tried extremely hard to understand this. It’s still a huge problem.
Gabe Howard: It is still a huge problem. And I’m glad that more and more people are becoming aware of it and talking out about it. Now, moving on, your book also contains a lot of stories and histories of people who you feel demonstrated “great healing and courage.” And you call these people “exemplary figures.” One of the people that you talk about is Paul Robeson, and he was a great black singer and activist. And he’s just done so many incredible things. But of all the available folks, what made you choose him?
Kay Redfield Jamison: Um, partly because I think quite a few people I was sort of I was brought up on his music. My father loved Paul Robeson and, you know, had his music going a lot. It was sort of a background to my childhood in many respects. And my father, who was an Air Force pilot, was always intrigued and interested in the idea of what is courage? And what does courage allow you to do? You know, why is it necessary in some circumstances? And he used to say that Paul Robeson, from his point of view, was the most courageous man in America. And I didn’t quite understand that at the time because I didn’t know all that Paul Robeson had been through. But, you know, as time goes by and you return to people you’ve admired or loved their work, loved their art, and you see them in different ways, you can sort of draw upon the strength. He went through in just terrible things from the government for his political activism. And he paid a terrible cost for it. And he was deeply principled man. And he just never buckled. He never gave in to the horrendous life that was given to him in many respects. And he was someone who sang from that and cared about other people and extended his musical genius to the lives of other people. And he worked for the lives of people who had it far worse than he did. You know, the miners and the unionists and everybody. But he really cared. And he did something about it. And I find that incredibly admirable. And, you know, I’ve gone back to his music in different ways at different times as I think people do. And, you know, one of the things that I think just becoming aware of the things that mean so much to you at different points in your life and going back and kind of stitching them together and making something beautiful and meaningful and consoling out of them.
Gabe Howard: Is Paul Robeson’s life an example of resiliency towards the goal? I think this applies very well to mental suffering or managing mental illness because it’s so difficult. Healing the mind is difficult and we have this goal to heal ourselves. And Paul Robeson’s life, he had a goal. It was a difficult goal, but he was resilient. Does that encapsulate one of the reasons that people should be so intrigued by his story so that they can apply it to their own lives?
Kay Redfield Jamison: I think some of it is much of it is his art is he had an extraordinary voice that had great beauty, great pathos. And it was a voice that had a kind of sorrow and that is just inexpressible. And so, I think, you know, I would say first and foremost is his art, but also his courage in taking on what he saw as the injustices in the world and which were very clearly injustices. And he didn’t give up despite. For the problems that he encountered. I think that if you can admire somebody and even if you can’t be that admirable and if even if you can’t be that courageous and certainly even if you can’t sing like that to have that person in your life is a gift. And I think that, you know, in many respects, artists and writers give us this incredible gift of the experience of their lives and the ability to put the experience and the pain and suffering of their lives into a form that we can learn from it.
Gabe Howard: And we’re back with Dr. Kay Redfield Jamison, author of the new book “Fires in the Dark: Healing the Unquiet Mind.” I noticed that you talk a lot about heroes and artists and explorers, them being a critical part of the notion of healing the mind. Why are you so attracted to that?
Kay Redfield Jamison: Um. Partly, again, because this is interesting and because people who have done brave things, explorers or some artists, you know, people who’ve been out in the world and taken real risks, have very genuine things to teach. And I think exemplars are very important that when we grow up, we have heroes. I had Billy Mitchell, I had King Arthur, you know, a lot of people. And I think that if you lose that capacity to believe in heroes, it’s sort of a deadening effect and you can bring them into your lives. One of the things I try to emphasize is really that you’ve got to create your own world. You can’t just passively receive treatment and care. You can, but it’s not going to be work as well or be as meaningful as if you bring something to it. If you bring, if you make your own islands of things that sustain you. Artists and writers and heroes and memories and music and, you know, all the things that keep people going. Nature. Those things are important to begin to fill out your life so that you can draw upon it. You can’t do that when you’re morbidly depressed, of course, I mean, you don’t feel like doing anything. But when you begin to get better, when you begin to heal, those things can put the pain and the suffering in perspective and give some moment to it.
Gabe Howard: I think it’s lost on our society that creativity, things like singing, painting, performing, it can just be a hobby. You don’t have to have a desire to be famous or to monetize it or to do it for a living in order to enjoy it and get benefit from it. Are you saying that? Are you saying that doing something creative or artistic can help you heal from mental suffering or mental illness?
Kay Redfield Jamison: Absolutely. But I would also say it’s not even that you have to be so creative yourself, though that may help. It’s drawing upon the creativity of others, drawing upon the long history of our species, of how people have dealt with pain and suffering. You know, the one of the great things about writers, I mean, it’s not great for them, but it’s great for other people, is that so many of them have been depressed. So, when you begin to get better, you can bridge things over and make things more meaningful and put yourself in the company of people you admire by listening to their music or reading their books, realizing that not only are you not alone, but that people have given purpose to their lives. Because I think that one of the hardest things to do is to make that art. Step from being sick, psychotic, severely depressed, whatever, to feeling like you can take something from the awfulness and give back to society. And there’s just a huge literature, clinical literature on the importance of purpose, of having something that is larger than you are, that contributes to the greater good.
Gabe Howard: So, talking about healing for mental suffering, you say that in recent years psychotherapy has been relegated to the sidelines in favor of medication when it comes to the treatment of mental illness. Now, I personally don’t think that’s a good thing. In your opinion, why has this happened?
Kay Redfield Jamison: Um, I think it’s the main reason it’s happened is financial. Economic. We don’t, as a society, I think put the same kind of money and time and effort and caring into treating psychiatric illnesses as perhaps we do other illnesses. And there aren’t enough psychiatrists, there aren’t enough psychologists, there aren’t enough nurse practitioners or social workers. There just aren’t enough people. And I think one of the things that’s been very clear as a result of COVID is how stressed the system is. So, people don’t even have enough time and resources to see somebody for medication. Psychotherapy can be expensive and it’s time consuming. So, it’s just not something that has a high priority. And I think for a long time when people pressed only psychotherapy for illnesses like bipolar illness or depression, you know, that wasn’t enough. It didn’t work. And so, psychotherapy got relegated to the sidelines for perhaps for good cause because it was being prescribed for the wrong illnesses at the wrong time and the wrong point in the illness. But I think now the evidence is quite clear that people respond better for depression and bipolar with adjunctive psychotherapy in addition to medication. So, does this mean everybody needs it? But it’s a tremendously powerful treatment when it’s done well, when it’s done right.
Gabe Howard: I’m really surprised that there is a pushback against the idea that psychotherapy would be helpful just given the fact that we know that it can be helpful in managing things like grief. So why couldn’t it be helpful in managing things like the aftermath of a bipolar diagnosis? Do you think we are getting better at understanding that we need multiple pathways to recovery and multiple treatment options available? Or are we still just very, very stuck on this concept of, again, these are my words, the magic pill?
Kay Redfield Jamison: I think I think things have changed a lot. I think I think most people in clinical psychiatrist clinical psychology would absolutely say psychotherapy is often not only recommended but necessary. It’s more that there was a phase when only psychotherapy was being used to treat basically pretty biologically based illnesses, that psychotherapy overpromised what it could do. And as a result, there was kind of a swing back. And I think what happened was then there was too much of a swing toward medication alone. And now I think most people, most people who treat these illnesses would say, no, you need both. These are illnesses that are devastating in terms of people’s notions of themselves. As you say, what people have done to themselves or done to other people, what they’ve left undone. And, you know, these are illnesses that may be genetic in their basis, but they the manifestation of them is behavioral. I mean, people do things and don’t do things that lead them down very, very traumatic paths. And so, I think the major consideration now in psychotherapy is cost. The health care system is a mess.
Gabe Howard: I could not agree more, Dr. Jamison. The health care system is absolutely a mess, especially when it comes to mental health. But there are some people that they could afford it. They do have the insurance, the resources, even in some cases, the time, and they just choose not to in lieu of programs that they find online or apps that they download or even supplements that they’re buying in gas stations because. They just have this idea of alternative medicine for mental health works. And that is the setup for my question. Psychotherapy has ancient roots in both medicine and religion. So, I would think that more people would be on board of this idea of healing yourself. Now, how does it show itself in our current times? How is that all fitting together for folks today?
Kay Redfield Jamison: Well, I think there are a couple of things. One thing is that psychotherapy, in ways completely unfathomable to me has made itself relatively boring and passé. And my hope with my book is that is to make it as interesting or at least aspire to make it as interesting as it is. I mean, psychotherapy is a fascinating, fascinating sort of thing. And I think in this day and age, people kind of have either a notion of a very structured psychotherapy, which certainly could be effective at times, but it’s not everybody’s cup of tea and people don’t talk about it in the same way that they used to. I mean, we used to be, you know, people who talked about their therapists, perhaps to a nauseating degree. But I think what’s happened is that there are just so many alternatives out there that people don’t really fully appreciate what psychotherapy is when it’s done well and the questions that addresses in your commenting on the on the ancient roots, one of the things I hope to convey was this is a part of human nature, this need for healing, this need for understanding where we’ve been, where we’re going, why we’re doing what we’re doing, how we can heal the pain that we’ve been through. And this goes back to, you know, religious roots. It goes back to the most ancient times. And that’s to me, what makes it interesting. It’s not I mean, psychotherapy, types of psychotherapies and medication, particularly medications come and go. What doesn’t come and go is that very human need to heal suffering, to make some sense of suffering, to bring some purpose from the suffering.
Gabe Howard: I’ve been curious, Dr. Jamison, I noticed that in your book and even throughout this interview, when you talk about healing, you say mental suffering rather than mental illness. May I ask why that is?
Kay Redfield Jamison: Because people suffer, you know, grief is not a mental illness, but it’s certainly profoundly a kind of suffering. And I think that the roots of from religion and medicine into psychotherapy are again, they’re human roots. And the human suffering is certainly mental illness is terrible suffering. But people suffer from all sorts of things. And I didn’t want to limit the book to just discussing mental illness, although obviously mental illness is close to my heart.
Gabe Howard: Dr. Jamison, thank you so much for being here.
Kay Redfield Jamison: Well, thank you for having me. Nice to talk with you.
Gabe Howard: It was nice to speak with you as well. And I want to give a big thank you to all of our listeners. Remember Kay Redfield Jamison’s new book, “Fires in the Dark: Healing the Unquiet Mind,” is available now. My name is Gabe Howard and I’m an award-winning public speaker, and I could be available for your next event. I also wrote the book “Mental Illness Is an Asshole and Other Observations.” which you can get on Amazon. However, you can get a signed copy with free show swag or learn more about me just by heading over to gabehoward.com. Wherever you downloaded this episode, please follow subscribe to the show. It is 100% free and hey, can you do me a favor? Recommend the show, send a text message, an email, put it on social media, talk about it around the water cooler mention in a support group. Because sharing this show is how we grow. I will see everybody next Thursday on Inside Mental Health.
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