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Our sixth combat is with what the Greeks call ακηδια, which we may term weariness or distress of heart. This is akin to dejection, and is especially trying to solitaries, and dangerous and frequent foe to the dwellers in the desert… (Cassian circa 416 CE)


Ajax, in Sophocles’ play, after slaughtering cattle believing that they were human captives regained his senses but then fell into melancholia. Tecmessa said of him


He broke into such piteous cries of anguish

As I had never heard him use before;

For he had always taught me that loud crying

Was only fit for cowards and mollycoddles;

If he lamented it was with low moans,

A bull’s deep groaning – never a shrill complaint.

And so he still sits, utterly dejected;

Will take no food nor drink, but only sits

Still where he fell among the slaughtered beasts.

He clearly means to do some dreadful thing,

If there is any meaning in his words,

His bitter cries…


So, what is this feeling that is so dreadful that it is a ‘deep groan’? How to describe a feeling that Alberto Moravia’s  (1907-1990) protagonist in Boredom describes as follows

…It resembles a repeated and mysterious interruption of the electric current inside a house: at one moment everything is clear and obvious – here are armchairs, over there are sofas, beyond are cupboards, side tables, pictures, curtains, carpets, windows, doors, a moment later there is nothing but darkness and an empty void…[it] might be described as a malady affecting external objects and consisting of a withering process, an almost instantaneous loss of vitality – just as though one saw a flower change in a few seconds from a bud to decay and dust


The challenge is to find the words to do justice to an experience, a profoundly incommunicable experience that is outside of the ordinary, but that is misunderstood as the same as ordinary sadness. William Styron (1925-2006) made this point in Darkness Visible


Depression is a disorder of mood, so mysteriously painful and elusive in the way it becomes known to the self – to the mediating intellect – as to verge close to being beyond description. It thus remains nearly incomprehensible to those who have not experienced it in its severe form


And, Styron is a wordsmith, a man not readily prone to failing to find the right word!


All we have is language, words, to express how we feel, to say what things are like for us, and when languages fails us, then there is that peculiar sensation of being cut off from others, from the common weald. And, since we are social animals. To be cut off is tantamount to death. It is clear then that there is a burden, an obligation on others, doctors included, to reach out across this abstract chasm, to make contact, to indicate understanding and solidarity in the face of the unutterable.


To return to Moravia’s protagonist


What struck me above all was that I did not want to do simply anything, although I desired eagerly to do something. Anything I might wish to do presented itself to me like a Siamese twin joined inseparably to some opposite thing which I equally did not wish to do. Thus I felt that I did not want to see people nor yet to be alone; that I did not want to stay at home nor yet to go out; that I did not want to travel nor yet to go on living in Rome; that I did not want to paint nor yet not to paint; that I did not want to stay awake nor yet to go to sleep; that I did not want to make love nor yet not to do so; and so. When I say “felt” I ought rather to say that I was filled with repugnance, with disgust, with horror. I used to ask myself, between these frenzied bouts of boredom, whether perhaps I did not want to die; it was a reasonable question, seeing that I disliked living so much. But then, to my surprise, I realised that although I did not like living, I yet did not want to die.


My aim is merely to find the myriad ways, the analogies and metaphors, the words and ideas that have come down to us, always attempting to tie down what is amorphous yet toxic, what is dreadful and un-nameable but that yet has to be given breath, tongue, lips and sound. So, that this inner canker can be communicated and therefore understood if not expunged.


This is Ivor Gurney (1890-1937) crying out to us from the City of London Mental Hospital


To God

Why have you made life so intolerable

And set me between four walls, where I am able

Not to escape meals without prayer, for that is possible

Only by annoying an attendant. And tonight a sensual

Hell has been put upon me, so that all has deserted me

And I am merely crying and trembling heart

For Death, and cannot get it. And gone out is part

Of sanity. And there is dreadful hell within me.

And nothing helps. Forced meals there have been and electricity

And weakening of sanity by influence

That’s dreadful to endure. And there is Orders

And I am praying for death, death, death.

And dreadful is the indrawing or out-breathing of breath,

Because of the intolerable insults put on my whole soul,

Of the soul loathed, loathed, loathed of the soul.

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


Photo by Jan Oyebode


Poems of disquiet




Sabi is the color of the poem. It does not necessarily refer to the poem that describes a lonely scene. If a man goes to war wearing stout armor or to a party dressed up in gay clothes, and if this man happens to be an old man, there is something lonely about him. Sabi is something like that. Bashō (1644-1694)


There is something “lonely” about human existence that poetry, poets capture well. This is not despair, desperation, gloom, or even melancholia. Often these other emotions are in the territory of psychiatry. But, there is an ambiguous zone, maybe a transept where communion is possible, a passage way that words travel through to express sorrow, regret, ultimately loneliness. I am not sure how words manage this. Victor Segalen (1878-1919) in Paintings hints at how words come to have this power:

‘Behind the words I am about to pronounce, there have been objects from time to time; symbols sometimes; often historical ghosts…And even if one did not find any images really painted on them, so much the better, the words would create an image, more freely! And I am unable to dissimulate any longer: I call on you as indispensable helpers in this substitution…This is a shared task: on my side, a kind of parade, a display, a patter…But totally useless, out of place and completely absurd, if it did not find in you its echo and its value. Hence, a certain attention, a certain acceptance on your part, and, on mine, a certain cadence, an abundance, an emphasis, an eloquence are equally necessary’.


There is collaboration between the reader and the writer in the making of whatever it is that poetry does to the internal world to both signal and induce that feeling of loneliness. This collaboration also takes place in clinical encounters. Ordinary language, the patient’s parade, her display or his patter find their echo and value in the clinician.




Issa (1763-1827) one of the canonical Haiku poets was particularly masterly in catching sight of Sabi in nature. Perhaps this was because he had experienced much tragedy, much reason to feel lonely and sorrowful. His mother died when he was 2 years old. His grandmother who had raised him died when he was 16 years old. He had a poor relationship with his stepmother and this strained relationship continued past his father’s death and cause Issa’s father’s will to be contested. He married aged 51 years. His wife Kiku had 4 children all of whom died and she died at the birth of the fifth baby who also died. Issa remarried at age 63 and again in 1825. His third wife survived him and gave birth to his only surviving child after Issa’s death in 1827. It is unsurprising given his personal history that his poems had a special quality of emotional depth:


We humans –

squirming around

among the blossoming flowers.


One human being,

one fly,

in a large room.




Another poet, Primo Levi (1919-1987), who understood this dark undertow in human affairs wrote in the poem ‘Monday’


Is anything sadder than a train

That leaves when it’s supposed to,

That has only one voice,

Only one route?

There’s nothing sadder…


And in another poem ‘Shemà’, he wrote



Consider whether this is a man,

Who labors in the mud

Who knows no peace

Who fights for a crust of bread

Who dies at a yes or a no.

Consider whether this is a woman,

Without hair or name

With no more strength to remember

Eyes empty and womb cold

As a frog in winter.



William Carlos William, a doctor poet said of poetry

“There’s nothing sentimental about a machine, and: A poem is a small (or large) machine made of words. When I say there’s nothing sentimental about a poem I mean that there can be no part, as in any other machine, that is redundant”.

I think here Williams is arguing for concision and economy, but also saying that poems like machines are well oiled for a purpose. That they have a function. To say what that purpose is, is not my aim. Rather it is to say that poems are like machines in how they are constructed and in the fact they work towards a purpose. For example, Haiku is a way of sharing a sensory experience with other people. If whilst walking home by Hebden Water I were to see a dragonfly with crimson wings and looking up I found myself in the presence of a young woman wearing a lace blouse and pale shoes with a red bow, a sight resonating with the dragonfly and the moment, I might want to tell other people about that chance encounter.


César Vallejo (1892-1938) wrote a prose poem ‘There is a man mutilated…”, and the tone is in a conspiratorial voice sharing information with the reader:

‘There is a man mutilated not from combat but from an embrace, not from war but from peace. He lost his face through love and not through hate. He lost it in the normal course of life and not in an accident. Lost it in the order of nature and not in the disorder of men…As his face is stiff and dead, all his psychic life, all the animal expression of this man, takes refuge, to translate itself outwardly, in his hairy skull, in his thorax and in his extremities…I know the man whose mutilation left him organless, who sees without eyes and hears without ears”.




Vallejo is the master of  corrupted spaces, the interstices between the groan and moan, where pain and human suffering resides. He understood what was “between pain and pleasure”. His life was lived on the edge, without material comfort and always grasping for how far we can exist in the margins of organized society and yet be profitable in our quest for the ineffable something that defines being human.




Finally, Eugenio Montale (1896-1981) in ‘Sorapis, 40 years ago’



And then I led you by the hand to the summit,

to an empty hut. That was our Lake,

a few spans of water, two lives

too young to be old, and too old

to feel themselves young.

It was then that we discovered what age

means; it has nothing to do with time,

it is something which makes us say

we are here, a miracle that

cannot be repeated. By contrast

youth is the vilest of all illusions.


Yes, everything is evanescent and within this reality life is conducted like a dance to music that will last only the briefest of moments. That is what Sabi is, knowing the fragility of existence yet dressing gaily, and dancing.




Photos by Jan Oyebode

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