Prose from Poetry Magazine

Four Walls

A psychiatrist’s view of poetry and poets.

When I left the world of academic English literature it was not because I was any less passionate about poetry, but because I did not want to spend my life operating on my friends. I thought I might kill them. Later I learned of Ted Hughes’s dream about the fox that came to him, singed and smelling of burnt hair, put its paw on the essay he was writing, leaving a bloody mark, and said, “You are destroying us.”

Poetry engraves itself in the brain: it doesn’t just slip smoothly over the cortex as language normally does. It has all the graininess of life, as it rips into being from deep within the limbic system, the ancient seat of awareness and affective meaning. Sometimes this is most obvious in a foreign language, because there the smooth, familiar words recede, and the sheer awesomeness of what is meant comes refreshed by the new encounter. As a child I was bewitched by the poems of Heine that my father would recite to me while shaving. Im Abendsonnenschein . . . I remember thinking then that the real word for sunshine was Sonnenschein. So, too, something seemed missing when things disappeared: they only truly disappeared when they were verschwunden. This is odd because my father was a Scot and my mother English. It seems like a sort of latent knowledge.

Although I have favorite periods for music and painting, I do not for poetry. Poetry can occur anywhere there are words, even in daily life. After twenty years I still remember the response of a psychotic patient of mine when asked to distinguish between a river and a canal. Without hesitation he responded: “A River is Peace, a Canal is Torment,” a line worthy of Blake. The forging of unusual links—metaphor—in which poetry resides depends on the right hemisphere of the brain, where the overall meaning of language, rather than mere syntax and semantics, is appreciated. It is here, too, in the right hemisphere, that experience is fresh, truly present, not pre-digested into re-presentation.

In adulthood I have found that many of my favorite male poets had a history of mental illness—Blake, Hölderlin, Smart, Cowper, Clare, Hopkins; and, interestingly, each of my favorite female poets—Dickinson, Plath, Charlotte Mew, Stevie Smith—had a history of either mental illness or ambivalent sexuality, or both. Quite apart from the fact that such experience may prove fertile ground for poetry, I wonder if this—and the astonishing prevalence of depression in general amongst poets—points to an anomalous lateralization of brain function, with a right hemisphere bias at the phenomenological level.

In practice as a psychiatrist, listening to the voice of suffering, I find myself often recurring to certain specific lines. Hardly a day goes by when I do not think of Wilfrid Gibson’s “the heart-break in the heart of things.” And how Larkin understood regret:

Truly, though our element is time,
We are not suited to the long perspectives
Open at each instant of our lives.
They link us to our losses.

But the sheer terror of depression is for me embodied in the last stanza of Cowper’s “The Castaway”—“No voice divine the storm allayed, / No light propitious shone”—or his half-crazed

Me miserable! how could I escape
Infinite wrath and infinite despair!
Whom Death, Earth, Heaven, and Hell consigned to ruin,
Whose friend was God, but God swore not to aid me!

I myself have suffered with depression, and I remember feeling that the only way I could convey how I felt was through some lines by Hölderlin, who spent the last years of his life in an insane asylum. After two stanzas in which he recounts the blissful eternal life of the gods in Elysium, the poem turns:

But to us who suffer,
       to mankind, it is given
             to have no place to rest,
                 blindly we falter and fall
                        from one hour to the next,
                           like water that’s tossed
                                  from cliff to cliff, down
                                        the years into the unknown.

Ivor Gurney’s searing poem “To God” was a later discovery, which should be compulsory reading for every psychiatrist. It seems to me to have everything there is to say about psychotic depression, and the utter powerlessness in the face of some brutal force that such patients experience. It is a salutary reminder never to play into that feeling by attempts to help, however well-meaning:

Why have you made life so intolerable
And set me between four walls.

His last words send a chill down my spine, passing, like my father’s German verses, Housman’s shaving test:

Gone out every bright thing from my mind.
All lost that ever God himself designed.
Not half can be written of cruelty of man, on man.
Not often such evil guessed as between Man and Man.

Originally Published: July 1st, 2010

Iain McGilchrist is a Quondam Fell of All Souls College, Oxford, where he researched and taught English literature, and a former consultant psychiatrist and clinical director at the Bethlem Royal and Maudley Hospital, London. He works privately in London.

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  1. July 7, 2010
     ray gibbs

    Thoughtful article, thank you for printing same. One more (mine) expression, McGilchrist's "terror of depression": For why such wound was I born?

  2. July 13, 2010
     Michael Brown

    I believe that, while he did suffer a final
    relapse into "insanity" in 1807, for
    which he was initially placed in an
    asylum in Tübingen, Hölderlin rather
    famously lived out the rest of his life
    (1808-43) there entrusted to the care
    of a local carpenter (Ernst Zimmer),
    making his residence in what is now
    known as the "Hölderlinturm," right on
    the Neckar. He became a kind of proto-
    Poundian figure, with young poets and
    admirers paying him visits. Poems
    about him and his sequestering have
    also been famously written by such
    poets as Paul Celan and Johannes
    Bobrowski - at least those are the two
    that come to mind. At any rate, this is
    important insofar as Hölderlin wasn't
    interred behind the above article's
    suggestive "four walls" as much as he
    continued living, albeit incapacitated by
    the very experience of being alive, of
    his failure, his loss, and what he
    perceived as the farcical procession of
    worldly, human affairs (Cf. Celan's
    poem "Tübingen, Jänner").

  3. July 15, 2010
     Barbara Wright

    Yes, the overall meaning of language,
    and its function as "link" to instants,
    suffering, loss. Loss above and inside
    the words. Suffering expressed in the
    space between the words "so" and
    "intolerable". A most delicate manner of
    conveyance, language, forced to
    become the most indelicate of all things.
    Caregivers plead, "I have never been
    psychotic, have not felt each patient's
    particular pain. You must tell me; that's
    how I can know." So we tell them, and
    we tell others, and the words tell and
    don't tell the terror. Vehicle and
    boomerang.

  4. July 21, 2010
     leah

    Great article. For those interested in the connection between mental illness and creativity, I highly recommend Kay Redfield Jamison's "Touched with Fire: Manic-Depressive Illness and the Artistic Temperament."

  5. August 6, 2010
     Robert

    I think the Michel Foucault "The History of Madness" is also a worthy read in this regard. Reason and Madness are co-dependent.

  6. August 8, 2010
     Marina Rios

    Thank you for this wonderful article.
    Rarely do I see the connection between
    psychological suffering and creativity
    treated with, on the one hand,
    intelligence and even-headedness, and
    on the other, such a delicate and artful
    sensibility. I myself suffered terribly
    and only became well after being
    medicated at age 28. Now I am able to
    function enough to be an artist, which
    brings me immeasurable joy.
    However, I always go, for my
    inspiration and the words needed to
    describe the pieces, into the mental
    areas that I discovered/explored/lived
    in before I was well. It's very difficult
    to articulate why this should be, but you
    do so here quite nicely.

  7. August 9, 2010
     Stephen Parker

    Speaking as a psychologist -- this is a very poignant and meaningful article about the intersection of poetry and mental illness... I think Theodore Roethke also captures difficult mental states, as in "In a Dark Time" In a dark time, the eye begins to see, I meet my shadow in the deepening shade....

  8. August 14, 2010
     M.D.L.

    I am curious about the phrase "Housman's
    shaving test." Can anyone clarify this
    phrase?

  9. August 26, 2010
     Teuta Abazi

    Four walls is an desperate poem that obviously is an out call to escape the isolation. Author clarifies his momentum with boring God, in accordance of the lines that shows limit to human being. Of course is like that if we refer to the situation, but in time like this is better of not to write rather than becoming more ill by thinking what to release instead of releasing one's self. Teuta Abazi albanian poet arts council england london group surrealist birthday feb 22. 197...

  10. August 29, 2010
     Daniel Thomas Moran

    It has always been a provocative subject, the frail separation between insanity and the creative mind. It is entirely possible that the definition which separates these two, the poet and the madman, is purely academic. I might suggest that a poet is someone who lives in a tiny house with the windows and doors thrown wide open. In such a place, the madness of the world and the turmoil of the inner self are hopelessly and entirely intermingled. Perhaps the way in which a person responds is the nature and the mystery of art.

  11. January 2, 2011
     Barbara Baldwin

    Re:line "A River is Peace, a Canal
    is Torment."
    I once made a poem out of similar
    speech, listening to a patient
    answer a question,replying:"There
    are only two shades of lipstick.
    There are one hundred shades of
    blood." She spoke like that,
    beautifully. However, she had no
    apparent access to joy.

  12. February 18, 2011
     Lou Pomeroy

    Yeats' "Terrible Beauty" rings in our ears
    as music makers.... Finding a balance on
    the way invents who we are.... Damn I'm
    enchanted by his text The Master and His
    Emissary!
    here we go loop-di-lee....
    He makes for a fine guide in the magic of
    exploring the embodied mind

  13. December 6, 2015
     Reza Mahani

    Your post reminded me of this part of D.W.Winnicott's article, ``Fear of
    Breakdown'':

    "Naturally, if what I say has truth in it, this will already have been dealt
    with by the world's poets, but the flashes of insight that come in poetry
    cannot absolve us from our painful task of getting step by step away
    from ignorance torvards our goal."