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Dear Sir,
Salman Akhtar's thoughtful and provocative paper, ‘Mental pain and the cultural ointment of poetry’ (IJP, 81: 229-44) raises several questions.
One has to do with the problem of finding adequate terms to convey what mental pain is all about. So much of such affect being aroused by degrees of loss, producing inner voids of varying intensity, I wonder if we have within the context or confines of secondary-process thinking, especially in English, the wherewithal to capture these states, or in some cases non-states, of mind with any clinical precision. William Styron, a remarkably articulate individual, tried to make this point in Darkness Visible, the account of his struggle with severe depression, which he referred to as ‘the despair beyond despair’ (1990, p. 84), concluding that it was ‘close to being beyond description’ (p. 7). Might an important reason for this semantic impasse be the part played in current intrapsychic conflict by psychological trauma secondary to deficiencies in caretaking during the pre-verbal phase?
With regard to the poem Akhtar wrote in response to countertransference issues, assuming the shift from passivity to activity with the implication of mastery to have been a crucial dynamic element, I would be curious about his choice of this modality to attempt to resolve the matter, quite apart from the fact that he is also a poet, as opposed to other means like self-analysis or discussing the situation with the patient where appropriate. In other words, what exactly determined his decision to proceed in this matter? How did the ensuing disappointment with his friend influence the course of events? Had that incident not occurred, would he have taken the same tack? If the poem hadn't provided the necessary insight or relief, would he have persisted along that line of enquiry or perhaps selected another format?
Lastly, at this stage in the psychoanalytic understanding of the creative act can we say with reasonable certainty that the pleasure or