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Skip to 0 minutes and 9 seconds So, I’m here in the studio with Finuala and Sean, with an opportunity to unpack some of the issues with regards to the role of the arts in mental health, specifically the role of poetry and music and imagery in understanding some of the issues from a different perspective. So, Finuala, I’m particularly interested in how poetry unlocks, as it were, some of the subjective or inside experiences of serious mental illness. I’m glad you used the word unlocks, because my experience, when I was initially left at home with my mother and I had a young child on the other side, those sort of sandwich years, was a feeling of being trapped and looking for a key.

Skip to 0 minutes and 55 seconds And staying at home with a mad person, is completely different from your previous experience, if you’ve had any, of encountering a mad person. I remember, as a child, a mad woman walked into our house and thought that I was the dentist and sat and opened her mouth, wanting dentistry, and that recoil, you know, that feeling of,I mean, I think we need to be honest about it, that feeling of repulsion you feel towards someone who is so other than you. And now, much later on, then, in my 40s, I was experiencing something quite else, somebody I loved and thought that I understood completely, unravelling and thinking that this was the dentist or this was a place that it was not.

Skip to 1 minute and 43 seconds So I think that poetry became, for me, the only place I could go to, because one of the things that happens when you care for the mad is that other people start to treat you as a pariah, so you start to feel what it’s like to be mad because people don’t want to visit you because they’re going to have to engage in this conversation with someone who’s dementing, people… They can invite you out but you can’t go, because you have to stay at home, you’ve got duties, this person is a danger to themselves.

Skip to 2 minutes and 14 seconds So my world began to join up with my mother’s world, and I initially started writing the poetry as a way of expressing that feeling of entrapment, but when I read the poetry now, I see my mother’s voice coming out. It seems to demand extraordinary levels of imagination and, hopefully, empathy, to get that inside perspective. Yes, and I think that, it’s interesting for me that the key for empathy is listening, which is very much what a doctor does, and observing, and then repeating what that person has said. It’s almost only -‘Does this make sense? - it’s almost only once you’ve written down on the page the words of the mad person that you truly experience what their world is like.

Skip to 3 minutes and 10 seconds So it’s almost an empathy after that fact. Your first response is how am I going to deal with this, this situation is difficult, this situation is beyond my comprehension, but once I had taken down, in the daily-diary format that I follow as a way of taking notes towards whatever future poem is coming, I had those direct words and I saw the extraordinary beauty, the aesthetic qualities of what she had said, and this alternative, imaginative, as you say, reality. You spoke of that, Sean, as well, and you used, obviously, all of the verbatim quotes from your patients. How important were those?

Skip to 3 minutes and 55 seconds I think it’s critically important, just as Finuala said, that it’s authentic, that we are in some way trying to show respect and pay tribute, in a way, to sometimes curiously beautiful alternative ways of making sense of that particular reality. Just with regard to this earlier issue, Steve, about insider, outsider, I do, one way of trying to, I suppose, diminish the sense of otherness of the outsider is to, first of all, at one level, to recognise that these extraordinary psychotic, strange symptoms are curiously prevalent in the general population, we don’t necessarily have to link a psychotic symptom with madness. It’s one way, possibly, of diminishing the otherness.

Skip to 4 minutes and 52 seconds Another way to try and make sense of it is that these phenomena, these strange beliefs, these strange ideas, these phenomena voices are, in themselves, on the part of our patients, my patients’, possibly idiosyncratic ways of trying to make sense of their experience, some experience that’s profoundly anomalous, maybe just on a biological level of noise. So it’s an act on their own part, an act of imagination to try and restore some sense of harmony and order and meaningfulness. And maybe just to take that a little bit further, that’s what we all do anyway. I think we all in order to make sense of our world, it’s an act of imagination to create meaning in our worlds.

Skip to 5 minutes and 39 seconds If art allows madness to come through, and gives it to us in a way that is accessible and, particularly in Sean’s case, in those beautiful voices. I mean, that chorus, that chorus of concerned voices, I identified with very much, but I also came away and I spoke to other people who came away from your opera, just feeling that that is me, that in fact the hero, the mad person at the centre of the drama, is also me. And how does that happen? How does that happen? Because you didn’t write the script knowing that I was going to come and… Absolutely. I’m very grateful to hear you say that Finuala because, in a way, it was trying to, again, diminish inside-outside.

Skip to 6 minutes and 21 seconds This is, in a way, a universal issue. It’s a plea, it’s a call, who am I, how am I making sense of this experience? Which hopefully goes beyond simply being identified as mad or being the patient.

In dialogue about mental illness

I wanted to know why Finuala and Sean decided to use poetry and music to understand and talk about mental illness.

We went on to talk about the insider-outsider view of mental illness, the strange beauty in how the world is viewed from a psychotic state, the role of the imagination, empathy, and the importance of listening closely to the original words spoken by people undergoing mental illness.

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Medicine and the Arts: Humanising Healthcare

University of Cape Town