Psychiatrist as Flaneur?

Recent wanderings into and around speculation upon the places of the mind and feeling have encountered Sebald, Melville and the whole set of museum pieces such as “Debord”, “Benjamin”, “De Quincey”. This would be the Museum of Psychogeography, the latter word a meaningless catachresis that nevertheless circulates as does dust. Metaphors of mind and feeling, cities of God and Man, skies of gloom and dreadful nights are the “territory” of wandering, both an abstract fashion statement and the possibilities afforded by the power of a truly startling metaphor (which, after its birth can never be repeated to the same frame of experience: as Kierkegaard pointed out, the only true repetition possible is the repeated failure to repeat). Well, anyway.

Neil Scheurich has a post called…

The Psychiatrist as Flaneur

He refers to The New Yorker review of Teju Cole’s first novel, “Open City” (Random House), a novel that:

…. does move in the shadow of W. G. Sebald’s work. While “Open City” has nominally separate chapters, it has the form and atmosphere of a text written in a single, unbroken paragraph: though people speak and occasionally converse, this speech is not marked by quotation marks, dashes, or paragraph breaks and is formally indistinguishable from the narrator’s own language. As in Sebald, what moves the prose forward is not event or contrivance but a steady, accidental inquiry, a firm pressurelessness (which is to say, what moves the prose forward is the prose—the desire to write, to defeat solitude by writing). The first few pages of “Open City” are intensely Sebaldian, with something of his sly faux antiquarianism. On the first page, the narrator tells us that he started to go on evening walks “last fall,” and found his neighborhood, Morningside Heights, “an easy place from which to set out into the city”; indeed, these walks “steadily lengthened, taking me farther and farther afield each time, so that I often found myself at quite a distance from home late at night, and was compelled to return home by subway.”

The protagonist is a young psychiatrist, half-German and half-Nigerian, encountering multiracial New York. Scheurich, in his comment, says that while the novel is not about psychiatry per se (“convincing because he is first and foremost a human being, and only secondly a shrink;  he is not defined by his profession.  Indeed, he mentions his work only in passing, although with compelling insight.”), the straddling of the normal and abnormal, as Scheurich puts it, does throw light on psychiatric practice. Scheurich quotes:
On that day, with these thoughts of Signs and simpling in mind, I had tried to give my friend an account of my evolving view of psychiatric practice.  I told him that I viewed each patient as a dark room, and that, going into that room, in a session with the patient, I considered it essential to be slow and deliberate.  Doing no harm, the most ancient of medical tenets, was on my mind all the time.  There is more light to work with in externally visible illnesses; the Signs are more forcefully expressed, and therefore harder to miss.  For the troubles of the mind, diagnosis is a trickier art, because even the strongest symptoms are sometimes not visible.  It is especially elusive because the source of our information about the mind is itself the mind, and the mind is able to deceive itself.  As physicians, I said to my friend, we depend, to a much greater degree than is the case with nonmental conditions, on what the patient tells us.  But what are we to do when the lens through which the symptoms are viewed is often, itself, symptomatic: the mind is opaque to itself, and it’s hard to tell where, precisely, these areas of opacity are.  Ophthalmic science describes an area at the back of the bulb of the eye, the optic disk, where the million or so ganglia of the optic nerve exit the eye.  It is precisely there, where too many of the neurons associated with vision are clustered, that the vision goes dead.  For so long, I recall explaining to my friend that day, I have felt that most of the work of psychiatrists in particular, and mental health professionals in general, was a blind spot so broad that it had taken over most of the eye.  What we knew, I said to him, was so much less than what remained in darkness, and in this great limitation lay the appeal and frustration of the profession.

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