Poets on Prozac: Mental Illness, Treatment, and the Creative Process

Introduction

introduction richard m. berlin, md 1 Poets are damned but they are not blind, they see with the eyes of angels. —william carlos williams Everywhere I go I find that a poet has been there before me. —sigmund freud throughout my career as a psychiatrist, I have treated creative people from many disciplines—poets, writers, artists, professors, scientists, entrepreneurs—and have been privileged to witness the growth in creativity that accompanied e¤ective treatment. Yet as I shared my patients’ satisfaction with their progress, I wondered how psychotherapy, psychoactive medications, and other forms of psychiatric treatment might free us to work at our highest creative levels. This collection of essays allows creative people—in this case, poets—to reveal the inner workings of how psychiatric treatment a¤ected their creativity. Because creativity is not limited to poets, the reader may ask why I have focused my inquiry on this highly select group. My reasoning is simple: in addition to my work as a physician, I am also a poet, and I know from experience that poets are among the most fearless of writers when it comes to self-revelation. In this collection of essays, a number of our finest contemporary poets write about their experiences with psychiatric treatment. To be considered as essayists for this book, poets had to demonstrate a high level of creativity based on publication of at least one book of poetry as well as a publication in literary journals. My strategy for finding poet-essayists began with scanning my bookshelf and writing to all the poets whose work I love. My cover letter explained that I had no idea about whether they had ever received any type of psychiatric treatment (though there was an occasional exception, when I knew the psychiatric history from a poet’s published work). I asked the poets for an essay that would explore the influence of psychiatric treatment on their creative process, including examples of poems that would give the reader a sense of how their poetry had changed after treatment. I also ran two advertisements in Poets and Writers magazine. In addition, poets contacted me after learning about the project from other contributors . About one-third of the essays came from each of the three groups. The essays address many of the key questions about psychiatric treatment and creativity. Do poets need to be mentally ill to produce great work? Does mental illness enhance or diminish creativity? What is the influence of substance use/abuse? What are the benefits and risks of prescribed psychoactive medications? Is creativity heightened by treatment, or does treatment reduce emotional pain to the extent that the poet no longer has anything to say? Does a person have to be “crazy” to write good poetry? What do poets themselves define as crucial elements in their creative process? Poets are also an obvious group to ask about psychiatric treatment because, as a group, poets may have a high incidence of psychiatric disorders . Popular culture has reinforced this idea: Shakespeare wrote, “The lunatic, the lover, and the poet are of one imagination all compact ,” and Robert Burton was even more direct when he wrote, “All poets are mad.” In our own era, depression in poets has been called “the Sylvia Plath e¤ect,” named for the poet who committed suicide when she was thirty-one years old. Current psychiatric research suggests that poets have a high rate of depression and suicide. In a study of thirty poets at the prestigious Iowa Writer’s Workshop, Nancy Andreasen , MD, the former editor of the American Journal of Psychiatry, reported that 80 percent had a mood disorder. Poets also tend to die at a younger age than other writers: sixty-two years for poets; sixty-eight years for nonfiction writers. An entire generation of poets, including Plath, Anne Sexton, Robert Lowell, and Dylan Thomas, became famous for the dramatic excesses of their psychiatric disorders and substance abuse. I have often wondered whether our current treatment options would have altered the lives of these poets and enhanced their work and also whether some poets avoided any psychiatric treatment, fearing that treatment might have deleterious e¤ects on their creativity. For example, consider poet-physician William Carlos Williams’s assessment of the psychiatric care he received fifty years ago when he richard m. berlin 2 became depressed following a stroke. At that time, psychoanalytic psychotherapy (described by one...