- Email: [email protected]
Voices and the imaginative ear
Perspectives
The art of medicine Voices and the imaginative ear See Perspectives page e54 See Comment Lancet 2015; 386: 2124–25 See Perspectives Lancet 2015; 386: 2136–37
“Jesters”, says Regan in King Lear, “do oft prove prophets”. Perhaps so. Try this one: “In everyday life, talking about imaginary people as though they were real is known as psychosis; in universities, it is known as literary criticism.” The jester here is the cultural critic Terry Eagleton, explaining the nature of the imagination in his book How to Read A Poem. It’s a typical Eagleton gag: arch, irreverent, crafted, and probably designed to ruffle the feathers of English professors (or to indulge them). Yet it feels also unusually callous: is it possible, in good taste, to liken an episode such as psychosis to the feeling of involvement in a work of literature, one being a form of adversity and the other a pleasure? Actually, the joke works in precisely the opposite direction, trading on the surprise that comes from mentioning psychosis and literary criticism in the same breath. Its effect really insists on the established truth of their unlikeness. But in turning away from whatever connection it intuits, could we be missing something more serious? What if we were to think in more subtle and sustained ways, assisted by literature, about the complexity of unusual or aberrant mental episodes and why they might be regarded as meaningful to the person who experiences them? Hearing voices, for example, while typically associated with severe mental disorders such as schizophrenia, happens to resonate strongly in literary tradition. This is not just because literary critics have a habit of talking about the “voice” of a writer or a particular work. In a more profound way, being receptive to voices is a recurring demand of the literary. These lines from a poem by William Blake help to establish the idea: Hear the voice of the bard, Who present, past and future sees, Whose ears have heard The Holy Word, That walked among the ancient trees
Blake’s opening to the introductory poem of his Songs of Innocence and Experience (1794) discloses a model of poetry based upon voice-hearing: whoever is called to the occasion of the poet’s words must take up a relation to a speaking voice, they insist, a voice invested with mystical authority (the Bard of oral tradition, inspired and prophetic). This command-like voice speaks of itself and its own creative necessity. But the lines also reveal Blake’s bard to be first an auditor, a listener who becomes a voice, “Whose ears have heard / The Holy Word”. The poet harnesses the power of speech from some primary ability to hear. From the start, his voice mingles with a greater originating power. Blake is extending a long tradition of associating literary inspiration with the accommodation of strange voices, a view stretching from Plato’s theory of divine madness to the Romantic period’s discovery of the creative 2248
imagination and beyond. To be inspired means giving oneself over to compelling forces at the fringes of being. In a poetic fragment by William Wordsworth, the poet describes hearing the river Derwent as a voice of inspiration: Standing beneath these elms, I hear thy voice, Beloved Derwent, that peculiar voice Heard in the stillness of the evening air, Half-heard and half-created.
What, and where, is the “voice” of Wordsworth’s river? Its noise occurs outside and inside the head, conjured in some strange act of hearing in which world and mind collaborate and conspire. Its “peculiar voice” is not so much out there, wholly alien, as already known, distinctive, joined to memory. We’re assured of the poet’s physical presence and yet the lines suggest that the Derwent’s burbling is, in part, internally derived. And as the river’s voice merges into, or emerges as, the verbal performance of the poem, it becomes difficult to tell apart his acts of hearing, remembering, imagining, and writing. But, again, what is this voice? At once, it is and isn’t Wordsworth’s voice. It could be that he hears his own creative inner speech somehow afresh, reinvigorated, in the sound of rushing water, since it offers an acoustic context happily conducive to poetry. Or is it that in the poet’s ear some less easily identified voice makes itself heard? Important later poets, after Romantics such as Blake and Wordsworth, would continue to regard poetry as heightened audition. “Its first pleasure is in the fact of the voice”, observed the modern American poet Robert Frost. But thinking about creativity as a voice coming to the inner ear shouldn’t be restricted to poets. Novelists, too, have described their complex construction of fictional worlds as a process linked to voice-hearing. Charles Dickens thought he heard the voices of some of his characters involuntarily, as if writing them down had been more a matter of transcribing their words than consciously inventing them. By the end of his career, Dickens was earning huge sums for giving celebrated recitals of his work in lyceums and literary institutions. These were in effect solo stage performances of his various characters’ voices, which exhaustingly Dickens acted and impersonated night after night on his reading tours—in fact, he seemed to channel the voices in a manner not unlike that of a Victorian spiritual medium. There was something darker, more privately turbulent in this: it is common to hear that the strain of his performances contributed to Dickens’ death at the age of 58 years in 1870, after a stroke. In a sense, voices took him over. And Victorian literature responds more widely to the threat posed by unusual or unbidden voices. Here is Alfred Tennyson in The Two Voices (1833–34), a poem that stages a dialogue with an intrusive voice: www.thelancet.com Vol 386 December 5, 2015
Perspectives
A still small voice spake unto me, “Thou art so full of misery, Were it not better not to be?”
Tennyson’s “still small voice” is not one of calm, as in John Greenleaf Whittier’s hymn Dear Lord and Father of Mankind (1884), which alludes to Elijah hearing the persistent voice of God through the trials of wind, earthquake, and fire. Rather it is a voice that calls for suicide. It tempts and torments with reasoned arguments about the pointlessness of human existence and physical life in general. Surely it would seem better “not to be” than to put up with life’s unedifying disappointments (that “to be” recalling a kindred tormented soul, Hamlet). In the end, the poem reaches for a kind of accommodation with the oppressor urging suicide, by deciding to “commune with that barren voice” rather than opting for an alternative “sweet” one, almost as if to say that even the most difficult inner voices belong to the person and must at all costs be heard. Tennyson, himself prone to depressive states and delusory experiences, saw dialogue with voices as the only course open to the perturbed mind. Intrusive voices in Victorian fiction can be equally troubling. George Eliot’s novella The Lifted Veil (1859) imagines a man cursed by the ability to see into the future and to read other people’s minds. He is a notable example of a fictional voice-hearer from the 19th century: his narrative characterises these strange mental gifts as symptoms of an unfathomed illness, and the language of the story borrows repeatedly from Victorian medical science. With a nod to psychologists of the 1850s, such as Henry Holland and William Carpenter, the narrator couches his supernatural powers as a form of “double consciousness”. Being able to host multiple experiences within a single personality was of course a distinctively Victorian anxiety, most famously explored in Robert Louis Stevenson’s The Strange Case of Dr Jekyll and Mr Hyde (1886). But a somewhat milder experience of hearing a voice, again a dialogic encounter, turns up at the end of Charlotte Brontë’s Jane Eyre (1847), when Jane overhears the geographically distant Rochester evoking her name, calling her to return to him. In her autobiographical narrative, Jane consciously chooses to describe it using the poetic language of “inspiration” rather than the psychiatric terminology of “a mere nervous impression—a delusion”, yet it remains uncertain what has occurred: “I recalled the voice I had heard; again I questioned whence it came, as vainly as before: it seemed in me—not in the external world”. Disembodied speech held a new fascination for writers in the late 19th century, who were the first generation to hear technological recordings of the human voice after Thomas Edison’s invention of the phonograph in 1877. It is not inconsequential that Joseph Conrad’s antihero in www.thelancet.com Vol 386 December 5, 2015
Yale Center for British Art, Paul Mellon Collection, USA/Bridgeman Images
Then to the still small voice I said; “Let me not cast in endless shade What is so wonderfully made.”
“Introduction” from William Blake’s Songs of Innocence and of Experience
Heart of Darkness (1899), the existentially hollow man Kurtz, is repeatedly reduced to vocal timbre (“A voice! A voice! It was grave, profound, vibrating”). Conrad, like so many writers and poets before him, was interested in the power of utterance and in the voices that cut into one’s own language and thought—and also in their frail authority and complicity. While casual quips about psychosis and literary experience are certainly best avoided, it’s worth underlining how literature supplies a rich understanding of voices and their work in the head—their texture, feel, and mental orchestration. Novels and poems from the 19th century, a period that was yet to neatly categorise voice-hearing as a feature of psychosis, can yield new perspectives—historical and creative—that assist with revising standard models of auditory verbal hallucination, not least by helping us to recognise the manifold ways in which voices enter human experience and, like a text, bear interpretable meaning. Now, that would be prophetic.
Peter Garratt Department of English Studies, Durham University, Durham DH1 3AY, UK [email protected]
Further reading Blake W. Selected poetry and prose. Fuller D, ed. London: Longman-Pearson, 2000 Eagleton T. How to read a poem. Oxford: Wiley-Blackwell, 2006 Gill S, ed. William Wordsworth: 21st century authors. Oxford: Oxford University Press, 2010 Matus J. Shock, memory and the unconscious in Victorian fiction. Cambridge: Cambridge University Press, 2009 Tennyson A. Selected poems. Ricks C, ed. London: Penguin, 2007 Wood J. Passion and pathology in Victorian fiction. Oxford: Oxford University Press, 2001
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The art of medicine Voices and the imaginative ear See Perspectives page e54 See Comment Lancet 2015; 386: 2124–25 See Perspectives Lancet 2015; 386: 2136–37
“Jesters”, says Regan in King Lear, “do oft prove prophets”. Perhaps so. Try this one: “In everyday life, talking about imaginary people as though they were real is known as psychosis; in universities, it is known as literary criticism.” The jester here is the cultural critic Terry Eagleton, explaining the nature of the imagination in his book How to Read A Poem. It’s a typical Eagleton gag: arch, irreverent, crafted, and probably designed to ruffle the feathers of English professors (or to indulge them). Yet it feels also unusually callous: is it possible, in good taste, to liken an episode such as psychosis to the feeling of involvement in a work of literature, one being a form of adversity and the other a pleasure? Actually, the joke works in precisely the opposite direction, trading on the surprise that comes from mentioning psychosis and literary criticism in the same breath. Its effect really insists on the established truth of their unlikeness. But in turning away from whatever connection it intuits, could we be missing something more serious? What if we were to think in more subtle and sustained ways, assisted by literature, about the complexity of unusual or aberrant mental episodes and why they might be regarded as meaningful to the person who experiences them? Hearing voices, for example, while typically associated with severe mental disorders such as schizophrenia, happens to resonate strongly in literary tradition. This is not just because literary critics have a habit of talking about the “voice” of a writer or a particular work. In a more profound way, being receptive to voices is a recurring demand of the literary. These lines from a poem by William Blake help to establish the idea: Hear the voice of the bard, Who present, past and future sees, Whose ears have heard The Holy Word, That walked among the ancient trees
Blake’s opening to the introductory poem of his Songs of Innocence and Experience (1794) discloses a model of poetry based upon voice-hearing: whoever is called to the occasion of the poet’s words must take up a relation to a speaking voice, they insist, a voice invested with mystical authority (the Bard of oral tradition, inspired and prophetic). This command-like voice speaks of itself and its own creative necessity. But the lines also reveal Blake’s bard to be first an auditor, a listener who becomes a voice, “Whose ears have heard / The Holy Word”. The poet harnesses the power of speech from some primary ability to hear. From the start, his voice mingles with a greater originating power. Blake is extending a long tradition of associating literary inspiration with the accommodation of strange voices, a view stretching from Plato’s theory of divine madness to the Romantic period’s discovery of the creative 2248
imagination and beyond. To be inspired means giving oneself over to compelling forces at the fringes of being. In a poetic fragment by William Wordsworth, the poet describes hearing the river Derwent as a voice of inspiration: Standing beneath these elms, I hear thy voice, Beloved Derwent, that peculiar voice Heard in the stillness of the evening air, Half-heard and half-created.
What, and where, is the “voice” of Wordsworth’s river? Its noise occurs outside and inside the head, conjured in some strange act of hearing in which world and mind collaborate and conspire. Its “peculiar voice” is not so much out there, wholly alien, as already known, distinctive, joined to memory. We’re assured of the poet’s physical presence and yet the lines suggest that the Derwent’s burbling is, in part, internally derived. And as the river’s voice merges into, or emerges as, the verbal performance of the poem, it becomes difficult to tell apart his acts of hearing, remembering, imagining, and writing. But, again, what is this voice? At once, it is and isn’t Wordsworth’s voice. It could be that he hears his own creative inner speech somehow afresh, reinvigorated, in the sound of rushing water, since it offers an acoustic context happily conducive to poetry. Or is it that in the poet’s ear some less easily identified voice makes itself heard? Important later poets, after Romantics such as Blake and Wordsworth, would continue to regard poetry as heightened audition. “Its first pleasure is in the fact of the voice”, observed the modern American poet Robert Frost. But thinking about creativity as a voice coming to the inner ear shouldn’t be restricted to poets. Novelists, too, have described their complex construction of fictional worlds as a process linked to voice-hearing. Charles Dickens thought he heard the voices of some of his characters involuntarily, as if writing them down had been more a matter of transcribing their words than consciously inventing them. By the end of his career, Dickens was earning huge sums for giving celebrated recitals of his work in lyceums and literary institutions. These were in effect solo stage performances of his various characters’ voices, which exhaustingly Dickens acted and impersonated night after night on his reading tours—in fact, he seemed to channel the voices in a manner not unlike that of a Victorian spiritual medium. There was something darker, more privately turbulent in this: it is common to hear that the strain of his performances contributed to Dickens’ death at the age of 58 years in 1870, after a stroke. In a sense, voices took him over. And Victorian literature responds more widely to the threat posed by unusual or unbidden voices. Here is Alfred Tennyson in The Two Voices (1833–34), a poem that stages a dialogue with an intrusive voice: www.thelancet.com Vol 386 December 5, 2015
Perspectives
A still small voice spake unto me, “Thou art so full of misery, Were it not better not to be?”
Tennyson’s “still small voice” is not one of calm, as in John Greenleaf Whittier’s hymn Dear Lord and Father of Mankind (1884), which alludes to Elijah hearing the persistent voice of God through the trials of wind, earthquake, and fire. Rather it is a voice that calls for suicide. It tempts and torments with reasoned arguments about the pointlessness of human existence and physical life in general. Surely it would seem better “not to be” than to put up with life’s unedifying disappointments (that “to be” recalling a kindred tormented soul, Hamlet). In the end, the poem reaches for a kind of accommodation with the oppressor urging suicide, by deciding to “commune with that barren voice” rather than opting for an alternative “sweet” one, almost as if to say that even the most difficult inner voices belong to the person and must at all costs be heard. Tennyson, himself prone to depressive states and delusory experiences, saw dialogue with voices as the only course open to the perturbed mind. Intrusive voices in Victorian fiction can be equally troubling. George Eliot’s novella The Lifted Veil (1859) imagines a man cursed by the ability to see into the future and to read other people’s minds. He is a notable example of a fictional voice-hearer from the 19th century: his narrative characterises these strange mental gifts as symptoms of an unfathomed illness, and the language of the story borrows repeatedly from Victorian medical science. With a nod to psychologists of the 1850s, such as Henry Holland and William Carpenter, the narrator couches his supernatural powers as a form of “double consciousness”. Being able to host multiple experiences within a single personality was of course a distinctively Victorian anxiety, most famously explored in Robert Louis Stevenson’s The Strange Case of Dr Jekyll and Mr Hyde (1886). But a somewhat milder experience of hearing a voice, again a dialogic encounter, turns up at the end of Charlotte Brontë’s Jane Eyre (1847), when Jane overhears the geographically distant Rochester evoking her name, calling her to return to him. In her autobiographical narrative, Jane consciously chooses to describe it using the poetic language of “inspiration” rather than the psychiatric terminology of “a mere nervous impression—a delusion”, yet it remains uncertain what has occurred: “I recalled the voice I had heard; again I questioned whence it came, as vainly as before: it seemed in me—not in the external world”. Disembodied speech held a new fascination for writers in the late 19th century, who were the first generation to hear technological recordings of the human voice after Thomas Edison’s invention of the phonograph in 1877. It is not inconsequential that Joseph Conrad’s antihero in www.thelancet.com Vol 386 December 5, 2015
Yale Center for British Art, Paul Mellon Collection, USA/Bridgeman Images
Then to the still small voice I said; “Let me not cast in endless shade What is so wonderfully made.”
“Introduction” from William Blake’s Songs of Innocence and of Experience
Heart of Darkness (1899), the existentially hollow man Kurtz, is repeatedly reduced to vocal timbre (“A voice! A voice! It was grave, profound, vibrating”). Conrad, like so many writers and poets before him, was interested in the power of utterance and in the voices that cut into one’s own language and thought—and also in their frail authority and complicity. While casual quips about psychosis and literary experience are certainly best avoided, it’s worth underlining how literature supplies a rich understanding of voices and their work in the head—their texture, feel, and mental orchestration. Novels and poems from the 19th century, a period that was yet to neatly categorise voice-hearing as a feature of psychosis, can yield new perspectives—historical and creative—that assist with revising standard models of auditory verbal hallucination, not least by helping us to recognise the manifold ways in which voices enter human experience and, like a text, bear interpretable meaning. Now, that would be prophetic.
Peter Garratt Department of English Studies, Durham University, Durham DH1 3AY, UK [email protected]
Further reading Blake W. Selected poetry and prose. Fuller D, ed. London: Longman-Pearson, 2000 Eagleton T. How to read a poem. Oxford: Wiley-Blackwell, 2006 Gill S, ed. William Wordsworth: 21st century authors. Oxford: Oxford University Press, 2010 Matus J. Shock, memory and the unconscious in Victorian fiction. Cambridge: Cambridge University Press, 2009 Tennyson A. Selected poems. Ricks C, ed. London: Penguin, 2007 Wood J. Passion and pathology in Victorian fiction. Oxford: Oxford University Press, 2001
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