INTRODUCTION TO ‘SCRIPTIONS

One sketches for many reasons. Some sketches are done as ends in themselves for pure delight. Some are drawn to work out some problem such as a study for a larger work. Others are drawn to share some concept or idea. These poetic sketches have served all these purposes. They are presented here to convey different dimensions of the usage of poetry in psychiatry.

Some of these sketches were drawn to help patients see themselves and the process of insight-oriented psychotherapy more clearly. The sketches are not complete renderings; their elaboration occurs in the rest of the therapy process.

There were several considerations that evolved in the writing of these poems. Since many were intended primarily didactically, that is, to instruct, there was in these poems more extensive use of simile with its one to one correlation rather than metaphor with its multi-level suggestiveness. I chose the form of the poem rather than prose because it seemed to come more naturally and because of poetry's terseness, expressiveness and directness and the overtones which foster remembrance and impact.

This use of poetry didactically rather than expressively is different from other uses of poetry in psychiatry. Schloss encourages patients to write poems generally in a stream of consciousness to help patients get in touch with their feelings and then elaborate on them in a group. (1) Others assign published poems to be read by patients and then discuss them with the therapists. Many of my poems evolved out of going over certain recurrent themes with patients and finding that the themes integrated into a poem. These were then shared with the patients and used for discussion or interpretation. I found the sketches helped me to put the abstract constructs of psychodynamics into direct, concrete terms for the purpose of education, confrontation, and interpretation.

Rollo May points out that the dilemma of man is that he is both a subject and an object of his own subjectivity.(2) One of the purposes of therapy is to help a person integrate subjective and objective points of view of himself and his world. Some patients have an inability to look objectively at their problems because their feelings cloud their vision. Other patients have been so strongly taught to look at themselves and the world objectively, they have lost touch with their own feelings and their subjectivity. They begin to think of themselves as the problem and begin to lose sight of their subjectivity. The missing "I’s" in the tear-drop-shaped poem, "On the Need for Biofeedback Therapy," and the looking to stone in the "Mood Rings" poem suggest the missing sense of being a subject in one’s own life, one’s sense of "I," as patients and therapists try to objectify everything, including themselves, reflecting the scientific bent of our society. Science hopes to discover laws to establish uniformities in nature so that man might control his environment.

Science seeks commonalities.

It is abstract,

Though specific

In its generalities.

But when the focus of science turns to man as its object, man as a subject tends to be lost. The art of psychiatry in part is an attempt to restore some balance, to find again that lost sense of man as a subject.

Art seeks uniqueness.

It is personal,

Yet universal

In its concreteness.

The art of psychiatry is finding anew that uniqueness, authenticating its being and encouraging its growth. Thus some of the poems present the dual perspective of the psychiatrist as he views the patient alternating from the objective or analytic point of view to the empathic, feeling point of view. In these poems what the therapist is thinking is on the left, and the patient’s remarks are indented and italicized. This continuous alternation is almost like a duet going on in the mind of the therapist. The patient who can begin to identify with these two points of view develops an "observing ego" and can begin to objectify his problems, when feelings threaten to overwhelm the patient and then they can begin to approach them more realistically.

Finally, poetry tries to integrate concepts meaningfully on several levels. It frequently suggests more than it states often because the subject matter cannot be precisely defined or delimited. Thus, poetry often focuses more on the connotative rather than the denotative meaning of words. Insight therapy also tries to integrate various aspects of oneself into a focused, flexible, autonomous whole yet allowing for the acceptance of uncertainty, ambiguity, and paradox. Consequently, poetry often seems more descriptive of the personality and its dynamics than the usual narrative found in most psychiatric texts.

Thus, this sketchbook. These are personal drawings of my experience with my patients and with the art of psychiatry.

Some lines are poetry,

Some lines are verse,

Some are doggerel,

And some are worse.

But I hope they communicate and give some sense of the use of art in psychiatry and the art of psychiatry.

1. Schloss, Gilbert A. Psychopoetry. New York: Grosset and Dunlap, 1976.

2. May, Rollo. Psychology and the Human Dilemma. New York: D. Van Nostrand

Company, 1976, p. 8.