Kay Redfield Jamison has written three books about bipolar disorder: one, a memoir about her own experience with the illness; another exploring the relationship between bipolar disorder and the “artistic temperament” of iconoclastic geniuses like Vincent van Gogh and Virginia Woolf. Her most recent work, Robert Lowell, Setting the River on Fire: A Study of Genius, Mania, and Character, is devoted to the great American poet who won the National Book Critics Circle Award, two Pulitzers, and a National Book Award, the latter for a collection, Life Studies, that delved into his mental illness, and for which he wrote some of the most celebrated poetry of his career during a prolonged manic episode.
But Jamison, a 70-year-old clinical psychologist and professor at Johns Hopkins University, doesn’t think having bipolar disorder is worth any amount of creativity or genius. “I really am wary of romanticizing this illness,” she says when we speak over the phone for an interview. “It’s very hard, but if you get through it, you can pull out something — you can make meaning out of what you’ve been through. That doesn’t mean it’s worth it to go through it.”
My opening question — whether Lowell’s symptoms could have been better managed in his youth if he had had more understanding of his illness — put Jamison on the defensive. Her exhaustive research into the poet’s family nets a rich and heartbreaking portrayal of cold New Englanders who couldn’t make room for any emotional expression. Jamison balked at this idea; as she noted at various points in the book during the conversation, “Psychiatry just went through a very long, unpleasant period of blaming parents for schizophrenia”; “I’m somebody who studies this disease and I believe that it’s a disease”; and that no matter the degree of kindness in a home, “that doesn’t cause mania, it doesn’t cause depression;” any more than it would, she says cause pancreatic cancer.
There was a lot happening in our conversation. It became a bit tense at times; I was asking questions that might imply I didn’t believe in mental illness, or considered it less serious than “physical” illness. Though I have a personal and extensive family history of debilitating mental illness, Jamison and I were speaking across a country — and to some extent, across cultural, professional, and diagnostic divides — about a topic that is so complex and clouded with misinformation that there is almost no way for anyone, scientist or layperson, believer or disbeliever, to talk about it with much nuance.
Moreover, Jamison is something of an absolutist. After I asked her — with the alternate philosophies of the “mad pride” movement and anti-psychiatry crusaders in mind — if there were any universe in which she could be supported off meds, she says, “Absolutely not. This illness has a really high suicide rate, a really high death rate. You can’t mess around with it.”
I believe her. I believe some psychotropic medications are important, just like polio vaccines and cholera rehydration salts. I know from personal experience that major depression causes major suffering, dangerous, life-threatening suffering. But I also believe disease can teach us something important, however far that view may veer into “anti-science.” “It can be meaningful, but not worth it,” Jamison says of living with major mental illness; personally, I’d prefer it to be both, or less black-and-white. It’s hard for me to square the idea that our suffering defines us with the notion that it eradicating mental illness would be a better goal. Writing about Jamison’s first book, 1993’s Touched With Fire: Manic-Depressive Illness and the Artistic Temperament, the late British novelist Jenny Diski asked, “Would [William] Blake on lithium have been Blake?” I also understand why Jamison’s response to my assertion is a big pause and an exasperated-sounding sigh: “I see people kill themselves and destroy other people. I don’t see anything romantic or extraordinary about that. This is a bad illness.”
Jamison’s views are nuanced too, of course. Mania is not purely psychological; current research suggests it’s primarily a genetic brain disease, and a restrictive environment like Lowell’s could have exacerbated his struggle. “I think you take a sensitive child like Lowell, who observes and expands and imagines, and put that child with somebody who’s not able to give affection or approval, then that’s gonna be very difficult,” says Jamison. “Clearly it can make somebody worse, but that’s not what makes the illness worse in general.” Because of his parents’ coldness, Lowell reached out to others for companionship and comfort, people who shared his passion for the written word and helped shape his work, which he considered the “solidness and solace” of his life. And while Jamison asserts that treatment for the illness is life-saving — “I have had those options [of being actively bipolar or not]; I’ve gone on and off lithium and it was nothing but a disaster and it nearly cost me my life” — living without treatment, with all its horrors, can inspire impressive art. “I think he would have had very different art,” Jamison says about a hypothetical non-bipolar Lowell. After all, she says of his poetry, “It’s a lot about madness.”
“I see that there’s a lot of scientific evidence of a disproportionate rate of bipolar illness in creative people,” says Jamison, who described her personal struggle in 1995’s An Unquiet Mind: A Memoir of Moods and Madness, though “I don’t go around saying I think that’s a great gift.” She says her dedication to writing about bipolar disorder is to “understand it. Describe it. Make some sense of it.” At the same time, “I would hope that I give some hope by showing that people can continue to live well with bad illnesses. With patients with all kinds of illnesses, not just mental illnesses, there’s different ways of handling it. Some people just move on; other people think about perhaps the human condition in a different sort of way, show perhaps more compassion to others who’ve gone through different kinds of suffering. They write from it. Like everything else in life, people just use what they are given in very different ways.”
As the author of this intimate portrait of Lowell and his symptoms — by turns debilitating, severe, violent, psychotic, and dangerous to himself and those around him — Jamison says her purpose was to study a man whose work she loved and show that despite how he suffered, “It isn’t all lost. And I think Lowell would be the first to say — and did say — the joy was the greater portion.” Whether or not it was worth it— the connections, the art, the lessons, the accolades — she says, “Just because you have suffering doesn’t mean you don’t have a great capacity to enjoy life as well.”
Robert Lowell, Setting the World on Fire
By Kay Redfield Jamison
Alfred A. Knopf