For my patients, madness is not a political statement. More important, it is something by which hardly any of my patients would choose to be burdened. For those of us who are fortunate enough to be comparatively sane, it is abhorrent to stand in celebration of Woolf’s madness. It did, after all, cost her her life. It is audacious and self-serving o

it is scarier to face a threat alone, without someone there to see what you are experiencing, to comfort, to understand.

Being married to another writer is wonderful. Being married to another writer whose strengths compensate for your deficiencies is miraculous.

Most of us cannot exist over time in a sustained state of exultation. More often a high is a sign of a crash to come.

Self-injury is even less comprehensible to us than suicide. Suicide at least can be cast as a desperate attempt to end torment and pain. How do we make sense of behavior whose very intention is to bring about damage and pain and yet survive?

Obsessions are involuntary, upsetting, persistent thoughts that cannot be reasoned away. Hallucinations are false sensory perceptions.

I have found that one of the gifts of medicine is that it allows those who practice it to participate in the purest and most vulnerable moments of human life.

Woolf, they said, Dante, Sexton, Lowell. With each pronouncement the group seemed to gain confidence and momentum: Shelley, Plath, van Gogh. It struck me as a marching song. A cadence by which the Mad Pride parade could rally and process: Handel, Hemingway, Munch!

If I am to abide with these patients, then I must accompany them to that place among the rocks, to the sweating wall. I must face with them the uncertainty of what lies beyond. I must stand at the edge with them and peer over into the fathomless depths. If I tell my patients, as I do, that this life can be a tolerable one, that they can face their