Annotate this!

Woolf walked into a river, Joyce went blind, and Yeats lived to a ripe old age, muttering about Irish politics and Rosicrucians and the great unrequited love of his life, Maud Gonne. But what did they eat for breakfast? What went on in their busy little brains in between masterpieces? And what the hell was the deal with Finnegans Wake? Questions only blogs could have answered. And o, how prolific they might have been.

You're too thin, Hemingway

Hemingway didn't just write about fishing and bullfighting and war. He also wrote about what he ate and what he drank and what he didn't eat and what he very much wanted to drink because it was so cold and so good. But there's one thing that all writers come back to... other than alcohol... (from "A Moveable Feast")

"I'm sorry, Sylvia. Forgive me for speaking about it."
"Forgive you for what? Always talk about it or about anything. Don't you know all writers ever talk about is their troubles? But promise me you won't worry and that you'll eat enough."
"I promise."
"Then get home now and have lunch."
Outside on the Rue de l'Odeon I was disgusted with myself for having complained about things...

No question. I love "A Moveable Feast." But just think how it would've been if Hemingway had kept a blog! Your head spins to imagine what ramblings we've missed out on because the writers and philosophers of yesteryear had to wait around for a publisher and printing press. Here's a few speculations... with portraits in lieu of those horrible emoticons.

On Anagrammatology

I’ve been into anagrams ever since high school chemistry. In between memorizing atomic weights and scribbling teenage death poems on the inside of my notebook, I found that a mere rearrangement of letters could take me very quickly from FUNERAL to REAL FUN. Charmed, I flipped through my poems and tried out the trick with other favorite words and phrases. When I got to DESPERATION = A ROPE ENDS IT, I knew I was hooked. What surprised me was how quickly the most morbid of ideas could be suddenly transformed into something else entirely. Something strangely diverting and, what the hell, therapeutic.

An accidental anagram may not solve your problems, but it gets you thinking. It’s not long before you realize your artfully written “suicide note” is nothing but a “nice, tedious” bore. But the larger question raised is this: what power do words really have? What, after all, is in a name?

To answer this question, I consulted Dr. Caleb Dorado Hydes: psychologist, cognitive scientist, and… anagrammatologist. When confronted with the mysteries of the human mind, what are we to think of a guy who plays with the alphabet – and calls it science?

“Oh, I’ve heard it before,” says Dr. Hydes. “People say to me, your profession doesn’t exist! I’ve got nothing but a crappy HMO that doesn’t even cover a trip to a real shrink! What the hell is an anagrammatologist going to do for me? There are so many misconceptions about what anagrammatology is all about, and I’m sick to death of people confusing me with those damned scientologists.”

Dr. Hydes explains: “It’s simple. Rearranging letters of the alphabet is the quickest way to transform a negative thought form into a positive one.” He’s created dozens of anagrams for the depressed and sometimes suicidal patients he sees in his private practice, words which he keeps on index cards for handy reference. His favorite therapeutic anagram comes from a conversation he had once with a patient on a suicide hotline. When the patient cried out, “I want to die,” Dr. Hydes exclaimed, “Wait! Die not!” and quickly realized what had happened.

“I couldn’t believe how easily it occurred to me,” Hydes recalls. “I thought if I could help one depressed patient cope by giving a couple letters the old switcheroo, why not help them all?” Shortly thereafter, Dr. Caleb Hydes then began writing his Psychiatric Anagram Reference Guide, which provides doctors with dozens of ways of scrambling the alphabet for the patients who need it most. (Further information on the guide forthcoming. - Dr. Iritano)

Anagrammatology works particularly well with certain groups, including those with borderline personality disorder (“Nerds, reorder libido!” he wisecracks) and patients struggling with self-injury. “That’s a big one,” Hydes says. “It’s just a matter of getting patients to make the leap from self-mutilation to lame, unfit toils.” He continues: “They say, Swiss Army knife! I say, swanky misfires. They say, My razor blades! And I tell them they’re talking to Abysmal Dr. Zero.” He says that some patients don’t like to hear it, but by teaching them how to shift letters, he’s teaching them a valuable lesson about life and healing.

He adds that he doesn’t like to use therapeutic anagrammatology with his paranoid patients, complaining that he couldn’t even get through a sentence without the patient desperately trying to rearrange letters. “They think everything’s a secret code. Sometimes a cigar is just a cigar.”

Thanks to the poetical wrath dupery of Dr. Hydes, therapeutic wordplay has enjoyed a wretched popularity. Of course, the knife cuts both ways. Doctors opposed to Dr. Hyde’s practice have turned the very same tool back on the anagrammatologist. “Sure, I’ve been accused of creating an anagram stigma tool. Some have even gone so far as to claim I’m nothing but an alarming gas tomato.” Hydes shakes his head sadly. “That one really got to me,” he adds.

But what really hurt was when the rogue letter-scramblers turned their talents on the actual Caleb Dorado Hydes. A rival doctor set up a Web site calling for the best, most scathing anagrams to lash back at its most famous promoter. This competition led to the unfortunate moniker that haunts him. To this day, many prominent psychologists refuse to call him anything but “Dr. Bloody Headcase.” All things considered, he takes it in good stride.

“At the end of the day, would you rather say to yourself, all is nothing? Or would you rather say,” Dr. Hynes pauses to deliver the anagram with relish, “I still hang on? I STILL HANG ON!"

Call me a histrionic tirana, but I’d still prefer fun rhyming kicks.

The Three-Body Problem

"The Three-Body Problem" by J. Doherty. Razor on scratchboard. Image taken from The Illustrated Guide to Borderline Disorders, Copyright 2005, Perish or Publish Press

A striking example of illustrated autopathography. The artist (a sufferer of an Axis II disorder) created the image on black scratchboard using nothing but a boxcutter. In it we see a complex narrative: a picture worth, I would estimate, approximately 150,000 words.

Several hallmarks of borderline logic prevail in the image: black-and-white thinking; recurrent suicidal behavior, gestures, or threats; self-mutilating behavior. I'm also sensing an affective instability here: an intense episodic dysphoria. The simplistic, graphic rendering of the subject suggests a fluctuation between idealization and devaluation of the subject's relationship to both the razor blade and, by association, to death itself.

Against autopathography?

The search for suitably unhappy volumes of books to add to my bibliotherapy list has kept me well occupied in past weeks. I had to be coaxed from my office with a stack of absurd pop-psychology books in order to refuel my sense of indignance at the current sorry state of public discourse on depression. Fortunately, or unfortunately as the case may be, the old trick worked.

After slogging my way through the latest hardcover psychiatric polemic, Against Depression, I was interested, though hardly surprised, to hear that author Peter D. Kramer ("Listening to Prozac") has not only called for the eradication of depression as we know it, but also for the eradication of the depression memoir. The jury is still out on which of these cries deserves more hearty scoffs of ridicule, though I'm voting for the axing of the depression memoir - "autopathography" as Kramer describes it. Self-pity, self-analysis, and the tangle of hypergraphia these states inspire in the bewildered sufferers: where would our profession be without it? Burton's "Anatomy of Melancholy"? Schreber's "Memoirs of My Nervous Illness"? The canon of Wurtzel? We can't get these people to shut up anyway, Dr. Kramer. Let's stop trying.

Personally, I'm all for autopathography. The more, the better, I say. Kramer bemoans finding himself buried under a stack of heart-wrenching, gut-cringing manuscripts from all over the world, finding such depth and breadth of expression baffling. How is it possible that so many people should feel so unhappy? And more importantly, why won't they stop grousing about it? I suppose we all have our nights when we'd rather listen to Prozac, or Schumann, than listen to another writer struggle to make depression, if not literary, then at least explicable.

Far be it for me to deny depressed patients their antidepressants. But to take away their pens, their laptops, their little scraps of paper stuffed anxiously into pockets on the way to and from the shrink's office? Come on, doctor. Have a heart.

If it's literary worth you're after, by all means. Have a look around: they're there. We wouldn't be reading the Viennese quack after all these years if he wasn't such a good writer. What if the Wolf Man would have taken Prozac? Van Gogh? Kierkegaard? Yes, I'll agree with Kramer: that's a tired question. But let's not go so far as to take Soren away from his quill and scroll. As Adam Phillips writes, "You can teach poetry, but you cannot teach someone to be a poet. The same is true of psychoanalysis. More people are harmed, though, by bad psychoanalysis than by bad poetry."

Frankly, I'd prescribe Nietzsche

Bibliotherapy is news? British scientists seem to think so. Apparently, they have uncovered the radical notion that there may be more to helping patients feel better than drugs. An excerpt:

"The programs, called "bibliotherapy" or "guided self-help," were endorsed by the National Institute for Clinical Excellence, a British health agency, in December. The agency warned of "overuse" of antidepressants in patients with mild depression and recommended that doctors try guided self-help or other kinds of counseling before medication.

"Bibliotherapy raises some concerns. Some patients fail to check out or read the books and fall through the cracks. And, in a few cases, severely depressed people have been directed to the self- help program when more serious treatment was needed, counselors say."

How to get the patients to actually read the books the doctors prescribe? NICE may want to reconsider the reading list. While I can't count the number of times I've seen an endorsement for "The Feeling Good Handbook," it's probably just as well. To me, this is the therapeutic equivalent of telling a patient with a broken leg to take a quick jog around the block. For years I've been waiting for someone to come out with "The Feeling Bad Handbook." Let's stop patronizing our patients, please.

Remember "Final Exit?" The book on the art of dying for those who didn't naturally do it exceptionally well. Despite some uneasiness over the book's popularity - it spent weeks on The New York Times bestseller list - there were no immediate repercussions: no Werther-like death cults, no spike in national suicides. Perhaps it is as Nietzsche once said, "The thought of suicide is a powerful solace; by means of it, one gets through many a dark night."

Until "The Feeling Bad Handbook" comes out, a few selections from my personal reading list:

E.M. Cioran, "On the Heights of Despair." With chapter titles such as "Weariness and Agony," "All is Dust," and "Total Dissatisfaction," this book is as comforting as it is apocalyptic.

Friedrich Nietzsche, "Ecce Homo." Yes to cruel fate! Yes to the absurdity of suffering! Add your own Nietzschean chapter title: "Why I Am So Good at Feeling Bad." Nietzsche probably just never got around to it.

Fernando Pessoa, "The Book of Disquiet." A humble paean to one's own total meaninglessness. "Since we can't extract beauty from life, let's extract beauty from not being able to extract beauty from life."

Take two and call me in the morning. Or better yet, don't call.

Mersault Steps Down

I found this in Tuesday’s Tribune and found it highly amusing. - C.I.

In Surprise Move, Mersault Steps Down, Appoints New Director

After a colorful career that has spanned nearly half a decade, Dr. Maurice Mersault, the controversial psychoanalyst whose theories of transference and countertransference sparked an internal debate about the role of patient-doctor relations in the psychiatric community, has announced he is stepping down from his position as director of the Psychiatric Institute of Arts & Letters. Mersault’s announcement comes at a time of renewed interest in the direction of the institute and raised immediate concerns about the institute’s future - or if, in fact, the small institute can survive such a crushing departure.

The Psychiatric Institute of Arts & Letters has seen its share of controversies and nadirs since its inception thirty years ago, but its curious blend of highbrow academia and ardent, from-the-trenches mental illness narratives (what some dub "autopathography") have kept the institute at the helm of alternative psychiatric thought - a trend which, according to its supporters, isn't going away.

Dr. M. Roodhouse Gloyne, Mersault’s longtime colleague and co-founder the institute, expressed a staunch, even indignant optimism at the announcement of Mersault's departure. Gloyne, a bookish, almost emaciated figure with large, bespectacled eyes and signature white lab coat, cuts an interesting contrast to the boisterous, bearded Mersault, who smoked Cuban cigars and whose antics at parties and medical conferences earned him a reputation as a brilliant thinker but gregarious hedonist. The two befriended one another while students at the Royal College of Charlatans in Cambridge, forging an unlikely personal and professional friendship that would span decades.

"The cross-contextualization of leitmotifs of suffering in art, psychology, and literature?" Gloyne asked, perhaps rhetorically. "Not the sort of thing one would call a ‘passing trend,' would one? Mersault's vision will live on."

That may be, but what's next? Dr. Gloyne offered some of his thoughts at his cramped research office. Gazing over his pristeen desk at a portrait of Mersault, Gloyne fondly recalled his colleague's peculiar research methods. Maurice Mersault was an obsessive note-taker who claimed his best ideas came to him away from his desk. Hence, he accumulated quite a collection of scraps over the years, detritus which nevertheless gave birth to some of his most complex theories.

“You name it, he wrote on it," Gloyne said. "Napkins, ticket stubs, racing forms. Once I saw him carve notes to himself into the wood pulp of a pencil. Carved into a pencil - with another pencil,” Gloyne marveled. As to the content of the spontaneous criteria? Were they merely daydreams, the musings of a man too distracted to bother with formal writing implements? “That,” Gloyne said, leaning forward in his chair as though he were sharing with me a private joke, “Was the inception of MPD.”

Megalomaniac Personality Disorder, known also by its acronym MPD, first appeared in the Paradiagnostic and Statistical Manual of Mental Disorders in 1972. The PSM (an alternate volume to the better-known and more widely accepted Diagnostic and Statistical Manual of Mental Disorders) was another of Mersault’s brainchildren. In it, Mersault and a small research team working out of a basement apartment collected the data and clinical criteria either discarded, disproved, or disowned by the larger psychiatric community.

Though dubbed “sensational” by its critics at its inception (a kind of “self-indulgent, self-serving, and medically irresponsible” encyclopedia, according to one famous comment by the head of the American Psychiatric Association), the manual surprised everyone by not just interesting a few specialists but by becoming a national bestseller, rising as high as number twenty-three on The New York Times bestseller list. This feat would be impressive for any book of psychology, let alone an obscure, 878 page clinical psychiatric manual written by a man some people called “the most narcissistic man since Narcissus.”

Far from a one-off, the PSM rose in stature and is now begrudgingly accepted as a companion text to the DSM. None of this would have been possible without the tireless vision and aggressive ad campaigns of Dr. Maurice Mersault, who stated from the beginning that, “like the famous assertion that we only use 10% of our brain capacity, the psychiatric community is only using 10% of its diagnostic and treatment capabilities - and I am out to change that. Singlehandedly,” he chuckled at a press conference, before downing a full glass of Shiraz and tossing the glass at the feet of reporters.

Mersault later added that the “bit about using 10% of the brain” was “bunco,” but stated he liked the sound of it and that it proved his point.

Dissatisfied by what he called the “scientific snobbery” of the psychopharmaceutical movement of the seventies, Mersault had conceived the institute as a forum to bridge the gulf between literature and psychology, his two loves. (A previous effort to bridge the gulf between psychology and sexuality, Mersault’s other two loves, was personally satisfying but professionally disastrous, and led to Mersault’s expulsion from the APA, an event he now jokingly refers to as the “excommunication.”)

The Psychiatric Institute of Arts & Letters was the crowning achievement in Mersault’s long career, and Gloyne had long had a hand in the institute’s operations - editing, compiling, and collating articles and submissions contributed by professionals and patients alike. Dr. Mersault and Dr. Gloyne’s longtime friendship made Gloyne the obvious successor to Mersault. And so it was an unexpected announcement when, at Mersault’s resignation last week, he dubbed as his successor - not his faithful, bookish colleague he laughingly referred to as “Ichabod Crane” - but a young, unknown, and some say “mindbogglingly underqualified” psychologist called Christina Iritano.

The announcement came as a shock to the psychiatric community, not the least of which was Dr. M. Roodhouse Gloyne himself, who appeared pale and ill when asked for his perspective on Mersault’s surprise appointment. “Mersault appointed who?” Gloyne said, and after asking me to repeat myself several times, Gloyne stood up and left the room. He never returned.

The mystique surrounding Mersault’s youthful successor was only compounded when, two days after the announcement, Dr. Iritano refused an interview with The Metapsychiatric Herald, a well-known journal founded by Mersault himself (Mersault’s resume of self-started psychiatric and psychoanalytic journals totals a staggering forty-seven publications). Phone calls and attempts to contact Christina Iritano went unreturned. In fact, Iritano did not even have an answering machine.

A listing in the “Who’s Who in American Psychiatry” had only one entry under Iritano, and the profile was starkly utilitarian, stating only the briefest of educational credentials. Christina Iritano graduated in 1997 with a Bachelor of Science (B.S.) from the School of Transcedental Linguistics, an M.A. from the Transient Research Society, and a Ph.D. from the Royal College of Charlatans, the same institute where Dr. Mersault and Dr. Gloyne forged their professional friendship. No other information on the young psychologist was made readily available, though Mersault had hinted that Dr. Iritano’s primary research interest was borderline personality disorder.

Mersault, in his drunken press conference, also hinted that his successor was not only “totally qualified for the job,” but was also “beautiful, a Siren, a Circe. You’ll love her. She’s perfect for Psych Inst. She’s got an interest in abnormal psychology - some of it empirical, if you know what I mean.” After listing several more of Dr. Iritano’s talents (writing, art, French philosophy), Mersault took an expansive breath and regained his composure. “God, she’s brilliant. You’ll find her (expletive) breathtaking.”

So who is Dr. Christina Iritano? And what makes her qualified to take on the direction of The Psychiatric Institute of Arts & Letters? Opinion in the psychiatric community ranges from the disinterested to the outraged to the frankly fascinated.

“This is a highly interesting appointment,” opined Dr. Phillip Hughes, one of Dr. Mersault’s former colleagues, who now oversees the Program for Megalomaniacal Personality Disorders at Cornell University in Ithaca, New York. “On the one hand, Mersault’s appointment comes as a surprise. Who is this girl? Is this a qualified intellectual or some former patient Mersault slept with? You never know with Maurice. But I think it only makes sense that a man who many saw as an enigma should appoint, as his successor, an enigma. A younger, prettier, perhaps even smarter enigma. It just makes sense.” Hughes stopped to examine his pager, sighed, and excused himself to make an important telephone call. “You didn’t get Iritano’s phone number, did you?” he asked at the end of our interview. “Damn. Damn.”