Greetings to all SOPH members,

In this edition we have a leading article by the award-winning poet and child psychiatrist Dr Jennifer Harrison on the role of art and psychiatry. The article also contains information on a new exhibition at the Dax Gallery, The Anxiety Project.

We have also included a poem by Dr Harrison from her latest publication wOmen’s wOrk, which is currently shortlisted for the 2024 Alastair Reid Pamphlet Prize, UK.

We have a book review to inspire your reading. Dr Thinh Nguyen has reviewed The Rigors of Angels by William Egginton.

To discover what one of your colleagues was stimulated to reflect upon in films we have an article by Dr Lieu Chi Nguyen on the series Family Law.

Continue reading and you will find our chosen art image and reflection.

With regards,

Dr Robert Kaplan         
Chair Bi-national Section of Philosophy and Humanities in Psychiatry Committee

Dr Susan Lutton, Member, WA Representative
Editor

Art and Psychiatry

Dr Jennifer Harrison, child psychiatrist, award winning poet and chair of the World Psychiatry Association’s Section for Art and Psychiatry. Alfred Infant Child and Youth Area Mental Health and Wellbeing Service, Melbourne;

My interest in psychiatry and the arts reflects my practice as an Australian child psychiatrist but also considers my interest in poetry itself. As an Australian poet with eight collections, I began writing and publishing poetry at the age of eight and have never stopped. When I studied medicine at the University of NSW, I also undertook creative writing studies. In 2011, I was awarded the Christopher Brennan Award for sustained contribution to Australian poetry and in 2021 became Chair of the World Psychiatry Association’s Section for Art and Psychiatry. My interest in the arts and psychiatry extends from poetry and literature to include all arts: cinema, visual art, sculpture, music, theatre, dance, just to name a few.

The recognition of the importance of art therapy is well established in Australia, but understanding of the value of the arts more generally in psychiatry has been underdeveloped in so far as there is currently no binational Section for the Arts within the Royal Australian and New Zealand College of Psychiatrists (RANZCP). This is not to say that art is not important for the mental health of Australians, including psychiatrists. Many Australian and New Zealand psychiatrists incorporate the arts into their practice, either through their own artistic interests, their work with art therapists, or their pursuit of other activities such as supporting group arts projects or art-related conference presentations. For example, the arts made an important contribution to the 2000 RANZCP annual congress, ‘Culture & Creativity’, which included music performed by psychiatrists, presentations by First Nations holistic healers, as well as poetry readings. Film presentations, too, have been a popular feature of the annual congress, and remain an excellent conduit for psychiatric teaching.

Dr Toby Davidson from Macquarie University, in 2011, edited the Collected Poems of the Australian poet Francis Webb (1925-1973), and noted that Webb spent many years institutionalised for a variety of diagnoses from ‘persecution mania’ to schizophrenia. He was one of the first poets of the postwar era to openly write about his experiences in mental hospitals in Australia and the UK. Webb himself referred to mental illness as ‘that nameless knowledge in my soul.’ Art has just that nameless, sublimely expressive quality. The insights are often humorous, life affirming, dark and resilient. There is rebellion, refusal, irreverence and a coming together to articulate the individuality that lies between silence and language.

In 2011, I was invited to establish The Dax Poetry Collection (TDPC) as an important adjunct to the Cunningham Dax Collection of art works created by people with experience of mental illness. The launch of the took place in August 2013, the launch brochure featuring a poem by TDPC poet Petra White (her published books include The Incoming Tide, 2007, The Simplified World 2010 – which won the 2010 Grace Leven Prize – A Hunger, 2014, and Reading for a Quiet Morning, 2017), and visual art from The Cunningham Dax Collection by artist Susan Donato.

Based at the Dax Centre, the collection now holds 500 poems from 60 authors, and we have a waiting list of 30 authors keen to submit their poems to the database. The Dax Centre, situated in the Kenneth Meyer Building on the University of Melbourne campus in Parkville, has been part of the SANE Australia group since 2018. The collection is overseen by a trust board (The Cunningham Dax Collection Trust Pty Ltd.) and The Dax Centre, currently managed by Eliza Murley, is a Collection facility, a gallery space and a multifaceted not-for-profit organisation that explores the fascinating interface between art and the mind.

More specifically, The Dax Centre’s mission is to promote mental health and wellbeing by fostering a greater understanding of the mind, mental illness and

trauma through art and creativity. The gallery’s exhibitions regularly change, and students frequently tour through the space with the aim of education towards mental wellbeing.

A new exhibition The Anxiety Project opened at the Dax Galley on 11 September 2024.

‍Artwork: Jacqui Stockdale, Finished, 2006, oil on linen, 35 x 41cm, courtesy of the artist (exhibiting artists: Betra Fraval, Erika Gofton, Ilona Nelson, Jacqui Stockdale, Sarah Tomasetti).

The exhibition brings together five Melbourne-based professional artists with an interest in how art practice interacts with a lived experience of anxiety. Initially displayed at The Art Room in Footscray, The Dax Centre is honoured to present the second iteration of the exhibition to further explore how anxiety manifests and operates within the creative process. Within this exhibition, the artists illuminate the complexities of anxiety, from its unrecognized presence to its management and ongoing impact on artistic practice. The artists invite viewers to traverse the emotional landscape they've crafted, prompting reflection on the role of art in both healing and as a source of anxiety itself. 

I’m delighted that the Binational Section for Philosophy and Humanities in Psychiatry has embraced the work of art and psychiatry, and I look forward to a wonderful collaboration with the Section well into the future, including our proposed conjoint symposium as part of the RANZCP’s annual congress at the Gold Coast, 4th-8th May, in 2025. 

In the Park

by Jennifer Harrison

her daughter loves to swing in the park     swing me mother

swing me higher than you     and her mother swings her across

the mown grass     the swing slap-slapping her hands

in the park Larkin’s women are not pushed to the side

of their lives     they cup shoulders and hips in hard enamelled

hands     their thick arms working in the rhythm of the sea

and the blood they once fed to their wombed young     washed

washed     they are the symmetry of all holding

the realm of the swing     colours washing through the sun

from michelangelo’s prisoners (Australian Scholarly Publishing, Melbourne, 1995), recollected into the author’s new book, wOmen’s wOrk, poems from which are currently shortlisted for the 2024 Alastair Reid Pamphlet Prize, UK.

Book Review

                         The Rigor of Angels by William Egginton.                        

Dr Thinh Nguyen, Psychiatrist, Rockingham, WA.

On a wall in my outer suburban office, hangs a print of Durer’s Rhinoceros.

It is a beautiful but wildly inaccurate woodcut of a rhinoceros, made by a master renaissance artist from secondhand depictions of the same animal, that was a gift from the sultan of Gujarat to the king of Portugal. Although the animal arrived in Portugal in 1515, it never made its tour around Europe, as the ship carrying it sank off the coast of Italy. What remained was a “poster” done by Albrecht Durer, and for many years until another rhino arrived in Europe, the woodcut represented the rhinoceros. While actual rhinos roamed in India in the 16^th century, many Europeans came to know this animal as having armoured skin, with splayed hooves, and a horn sprouting from its torso. I use the print, and the story in Neil McGregor’s History of the World in 100 Objects, to discuss with students about the real and the imagined, a fundamental dialectic of psychotherapy. For patients with borderline personality disorder for instance, it’s less important what reality is, but rather what the patient imagines it to be.

In an apartment in Buenos Aires, late one evening, a solitary man encountered a door-to-door bible salesman. The old man’s failing eyesight made the exchange stilted and dream-like and by the end, he had purchased a cloth bound book with an infinite number of pages. “Look at the illustration closely. You’ll never see it again.” The salesman told the old man that the book is called the “Book of Sand”, because neither the book nor the sand has any beginning or end. His elation of possessing the “Book of books”, evolved to the “the fear of having it stolen, and then the misgiving that it might not truly be infinite”. But more than that, despite a lifetime of erudition, he came face to face with the infinitude of knowledge, and with the despair that at the end of his life, that he knew next to nothing.

When I was approached to do a book review for the newsletter for the Section of Philosophy and Humanities in Psychiatry, I thought, this is a big ask. What book? A classic or a modern one? Fiction or nonfiction? One that is widely read but not praised? Or widely praised but not read? Am I to write a general book review or to draw a specific relationship with Psychiatry?

But I did give it some thought. What about the one I’m currently reading – Septology by Jon Fosse, or the one I recently read – Eve, How the Female Body Drove 200 Million Years of Human Evolution, by Cat Bohanon, or the one next on my list, The Rigor of Angels: Borges, Heisenberg, Kant and the Ultimate Nature of Reality. by William Egginton?

Does it matter?

I decided to leave the snow of Septology, and embark on The Rigor of Angels by William Egginton. I was naturally drawn to the book because of the inclusion of Borges, who wrote one of my favourite short stories, The Book of Sand, alluded to in the previous section. Then there was Heisenberg, who has been trending from the movie Oppenheimer and the best-selling books: When We Cease to Understand the World by Benjamin Labatut and Helgoland by Carlo Rovelli. I didn’t know anything about Kant, so it seemed like a good opportunity to learn.

Egginton, who is a professor of humanities and literature at Johns Hopkins University, continues the tradition of finding a meeting point or convergence in the works of intellectuals from different disciplines.  In this case, the trinity is of the Argentinian, Jorge Luis Borges, and two Germans, Immanuel Kant, and Werner Heisenberg. Jorge Luis Borges (1899-1986), was blind for most of his writing life. An erudite, solitary man who grew up surrounded by books and cross-cultural dialogues, Borges had brief, and somewhat controversial marriages, and despite his enormous influence on literature, was “snubbed” by the gentlemen of the Swedish Academy. He was a writer who was described by James Marcus as “A lyrical miniaturist who could pose the great questions of existence on the head of a pin”, - and posed them he did. He left behind a lyrical and metaphysical body of short works including The Garden of Forking Paths, Circular Ruins and The Aleph that are eerily prescient of our modern day, grappling with the nature of reality – such as the multiverse theory, and the birth of the internet and virtual reality. The idiosyncratic 17^th century philosopher, Immanuel Kant (1724-1804), was never married, suffered from gastrointestinal problems, and was so rigid in his routines that others could set their clocks by him. He wrote a number cutting treatises, the most famous of which, was Critique of Pure Reason, which earned him the title of the most important modern philosopher, even if his works are inaccessible to many. He wrote a number of cutting treatises, the most famous of which was Critique of Pure Reason, which earned him the title of the most important modern philosopher. Even if his works remain inaccessible to many. The third of the trinity is the Breaking Bad of the physics world, Werner Heisenberg (1901-1976), who challenged the God of relativity, and formulated the principle of uncertainty, the deciphering of which, still ruins many great minds.

From the outset, Rigor is not the light escapist reading fare that you may have promised yourself. Even the title seems a little difficult to roll off the tongue. Is it “rigor” as in the disciplined, unwavering pursuit of something or the shivering at the height of a fever? It can be helpful to know that the title came from another short story by Borges called Tlon, Uqbar and Orbis Tertius (we are now down the rabbit hole of cryptic titles) in which the writer commented that

“Enchanted by its rigor, humanity has forgotten, and continues to forget that it is the rigor (discipline) of chess masters, not of angels”,

“In other words, we can detect order, but only within the parameters of the games that we invent; we cannot and should not aspire to the understanding of (transcendent) angels” (Lorraine Daston TLS 2024).

But let’s face it, other than Borges getting a look in for his Labyrinths in British Professor of Psychiatry Femi Oyebode’s Ten Books in literature and psychiatry, his writing isn’t your usual psychiatric reading prerequisite, even if such things exist these days. Nor is it likely that quantum theory and Kantian philosophy would be standing items for discussion at CPD meetings.

Egginton begins the book with the Borges’ short story called Funes the Memorious, (perhaps based on a real person, Solomon Shereshevsky) about a man named Ireneo Funes, who following a head injury, could remember everything and thereby forgot nothing. The redundancy here is necessary in order to emphasise that to forget nothing is a curse, in that one is tormented by details and cannot generalize and see things in context.

“It was not only difficult for him to understand that the generic term dog embraced so many unlike specimens of different sizes and different forms: he was disturbed by the fact that a dog at three-fourteen (seen in profile) should have the same (noun) as the dog seen at three-fifteen (seen from the front)"

Egginton went further.

“The more precisely you relive the past, the less it is a past you remember, and the more it becomes the present…A perfect memory is impossible because it destroys the very self who remembers it.”

This paragraph could easily have come from Bessel van der Kolk’s The Body Keeps the Score. Yet memory has an undeniably important role in the construction of the self:

“The soul or consciousness, in fact, is nothing but the unity of a sense of self over time, the bare fact that to perceive and then to articulate our perceptions something must connect from this very instant to another, and another after that. This connecting of disparate slices of space-time is a necessary condition of the possibility of knowing anything at all, but it is not itself a thing in space and time.”

The idea that memory glues us together but distorts our perception of reality is one of the many paradoxes examined in the book. How do relativity and quantum physics co-exist? Should we trust the world of ideas or that of the senses? Do we always have to swipe right or left on the free will/determinism Apps?

In a podcast with the renown physicist Sean Caroll, Egginton outlined the theory, propagated initially by the works of Kant, that existence means decoding the language of nature, but much of it remains undecipherable and we are not even sure that what we have deciphered is accurate, mostly because we are not “outside” observers (angels), but are wrapped up in the same space and time (chess masters). However, we are not passive objects, but active participants in defining reality, which is best defined as a dialectic between the universe as it is, and as what we think it ought to be.

Egginton outlined his theses via a journey through the short fictions of Borges, particularly his collections titled Ficciones, to Kant’s Critique of Pure Reason, and Heisenberg’s Principle of Uncertainty which states that at a quantum level, “the more precisely we determine the position (of the electron) the more imprecise is the determination of velocity”.

Kant’s great contribution to philosophy, was to highlight that “When we ask the most fundamental questions – what is the soul, what is the world in its totality, what is God? – our answers may be equally convincing even while opposed to one another (a concept he named antinomy). The only way this could be the case, Kant realized, was as if we were mistaken…”. Many years later, Heisenberg, coming from the quantum world, would conclude as “…we have to remember that what we observe is not nature itself, but nature exposed to our method of questioning”.

Whether it is within ourselves, or between us and others and the physical world, Rigor is about relational understanding:

“When we judge the actions or intentions of another person, we never have access to their thoughts, never actually see the world through their eyes. We construct an image of their intentions…But like an experimenter measuring an event, what we find pertains to us. It is the product of a relation, the way some part of nature manifests itself to us.”

For a phenomenologically determined discipline, we cannot undervalue these aspects in our work as psychiatrists.

Along the way, we encounter the four paradoxes of the ancient Greek philosopher Zeno, of Elea, quantum entanglement, and that old chestnut, free will, in an uncertain universe. All of this is done with humour and a light touch.

‘Entropy indicates a system’s disorder (which increases over time). An egg is highly ordered. An omelet less so. An omlet you have just chewed, swallowed, and digested, even less so. While it is relatively easy to turn that egg into a meal, it is far more difficult to reverse the process. That, in a nutshell is entropy.”

The tendency of the universe to have increasing entropy, according to our physicist Carlo Rovelli, indicates directionality, that is, the before and after, which is only a skip, hop and jump to cause and effect. Why does the patient present with these symptoms at this stage in time? But at least from a physics point of view, it is a big jump.

Egginton does an excellent job of explaining quantum physics, but I for one, struggled with its many concepts. The chapter called “Visualize This” is like watching a Ninja Warrior obstacle course, where one cycles through feelings of frustration and triumph. Similarly, the discussion of Kantian epistemology is quite dense at times, mirroring Kant’s own writings.

Where Rigor became engrossing for me, was in the portrayals of Heisenberg, Kant, and Borges as intellectual giants with relational inadequacies. Borges has been described, perhaps unfairly, by the Uruguayan writer Eduardo Galeano as “a man with only a head. No heart, no sex, no stomach – just a head”. Egginton’s rebuttal was to construct a man with enormous passion, whose shyness and spurned love, led to a sublimation of his knowledge and feelings into the metaphysics of his fiction. Kant was a frustrated intellectual whose perfectionism and rigidity, found an outlet in challenging the established systems of thinking. Heisenberg was perceived as a man who thought his intellectual prowess and groundbreaking ideas would transcend politics (they didn’t).

Bubbling to the surface in this cloudy world of ideas, are also questionable ethical paths taken by these giants. Why did Borges accept an invitation to lunch with the dictator Pinochet? Why did Heisenberg work for the Nazis? (And perhaps less ethically challenging and more of eccentricity: why did Kant wear a sword everywhere he went?) Egginton hints at some answers. Perhaps Borges did not want to conform to the expectation that he would not have lunch with a dictator, thereby demonstrating free will. Perhaps Heisenberg just adopted the wait and see approach which aligned with his belief in uncertainty. Or perhaps both Borges and Heisenberg saw their ideas, and by extension themselves as being beyond good and evil. As Emily Wilson reconciled in translating the Greek word polytropos, to describe Odysseus, these men were complicated, they existed in a world of complications, and they made complicated choices.

Rigor is a wide-ranging book covering Greek philosophy to Dante to science fiction. Even Arundhati Roy gets a mention. Perhaps familiarity with the works of the three protagonists would be an advantage, but it is not necessary for Rigor is a book that stimulates thinking, one that leads to further reading.  Throughout, one can squint at parallels between what we know and what we don’t know about the quantum world and the function of the brain and mind, where uncertainty and discontinuity reign.

Does it matter what book to recommend for the Section of Philosophy and Humanities in Psychiatry? Probably not. In the age of specialisation, and compartmentalisation, it may be important for us psychiatrists to broaden our knowledge base and explore literature, physics and philosophy, the often-sidelined contributors to psychiatry.  As the Turkish writer Elif Shafak stated: “Everyone knows their own fields very well, in depth, but we don't necessarily connect the dots…We don't have enough conversations between disciplines, between cultures,…So when a novelist reads neuroscience, or when a neuroscientist loves poetry, or when a poet becomes interested in political philosophy, or when a political philosopher becomes interested in film theory, those are the conversations that are going to stimulate us.” (Podcast 2019)

Rigor is about our striving for the ultimate truths but also about accepting and embracing the limitations of our knowledge. It has a call to action: “Far from a weakness, this fundamental limitation on our knowledge empowers what we have come to call the scientific method”, with its core of active humility. Perhaps as psychiatrists we should spend less time doing and more time questioning what we do. Rigor is an erudite piece of writing by a scholar whose passion for the subject is infectious, and who writes with such zeal that one can’t help but be swept along.

Film/ TV Review Family Law (TV Series 2021- present)

A surprisingly realistic representation of addiction embedded in a fun legal drama

Dr Lieu-Chi Nguyen      Queensland Jurisdictional Committee Member

When I think of addictions depicted in film and television, I imagine the cliché of friends and family of the main character staging an intervention. This main character then goes away and comes back several scenes or episodes later, “recovered” and the addiction is never mentioned again. So, imagine my surprise when upon casually watching Family Law (2021 to present) that this show gets addictions right.

Family Law is a Canadian legal drama set in Vancouver, Canada. It follows Abigail Bianchi (portrayed by Jewel Staite), a personal injury lawyer with an alcohol dependence syndrome. In the first episode, whilst supremely hungover, Abigail throws up on her client in court. This act is filmed and goes viral on the internet resulting in Abigail being put on probation by the law society. The only firm that will now take her on is run by her estranged father, Harry Svensson (Victor Garber) who heads a family law firm, and who is reflective of the stigma attached to substance misuse and dependence within highly competitive and visible professions such as law (and indeed medicine). Her colleagues are her estranged half-siblings, Daniel, another lawyer and Lucy, the firm psychologist, from her father’s second and third marriages respectively (Zach Samdu and Genelle Williams). Her relationship with her lawyer husband is also on the rocks.

What I love about Abigail’s depiction is that her dependence syndrome does not go away after she attends rehab in between scenes. It is a condition that she navigates alternatively begrudgingly, authentically and with vulnerability. She relapses when going through a stressful time whilst on probation (involving involuntary, random breath alcohol levels). Many episodes feature a close up shot of a glass of whiskey or champagne glasses at a law society event, indicating her ongoing cravings. Within her nuclear family unit, she is the scapegoat. Her husband is partially absolved from his infidelity because she is the “alcoholic” and her daughter wins an essay competition writing about how difficult it is to live with a mother with alcohol dependence, much to Abigail’s emotional pain.

She attends Alcoholics Anonymous because she has to and initially fobs off her psychologist, however, over the series seasons, she starts to engage meaningfully through journaling and having difficult conversations around her past trauma. The role of trauma, especially of a developmental and intergenerational nature, is a principal theme throughout Family Law and reflects the very significant comorbidity between substance dependence and stress-related disorders such as post-traumatic stress disorder. Complex, messy family systems is another key theme for both Abigail, her family and her clients and is reflective of the relationships that we see daily in the mental health profession.

Family Law is also diverse in racial and LGBTQIA+ representation in a way that is non-tokenistic. Jerri, the office manager and Abigail’s Alcoholics Anonymous sponsor, is trans. She is also most importantly the sensible and mature heart of the Svensson firm. Lucy is gay and black and navigates the challenges of planning to become a parent with her wife. Clients deal with issues such as capacity, sexuality and gender, metonymic to wider debates within Western Society and our own college.  

My only significant gripe about this show is that Lucy’s psychological interpretations can come across as overly earnest and ham-fisted. Nevertheless, Family Law is a great show, and much more fun and humorous that this review is making it sound. It also has interesting insight into many controversial topics that are important in contemporary Western psychiatry.

All three seasons are still available on the free-to-air 9now website and app. 

SOPH Photography/Image

The Section is keen to invite members to submit an image or a photo that has captured their attention or led to an introspection to share with us all.

Edward Hopper – Nighthawks

Comments: The Collector Mar 19, 2023, • By Deva Bhattacharyya, MA & BA English Literature

Edward Hopper’s paintings reflect the vacuity of human life and suffering in general and the listlessness of human existence by holding up a mirror to society. At first glance, Nighthawks depicts a small assortment of rather lonely individuals. What is intriguing, however, is the perspective: the viewer realizes that the loneliest thing in this context is indeed themselves, standing outside the bar, in the dark, staring at strangers from across the street

The surface of the painting is a screen that directs the view toward what the artist has placed at a distance from the spectator. The painting, therefore, becomes a screen that, in a mirror-like manner, becomes a placeless place that, according to Michel Foucault 

… enables me to see myself there where I am absent,” and yet from the standpoint of which “I discover my absence from the place where I am since I see myself over there. Starting from this gaze that is, as it were, directed toward me, from the ground of this virtual space that is on the other side of the glass, I come back toward myself; I begin again to direct my eyes toward myself and to reconstitute myself there where I am.

Next Edition

Keep in touch and any contributions to the newsletter (articles, news, reading, films or photographs) much appreciated and wanted!

Contact: Dr Sue Lutton
suelutton@iinet.net.au