Review: Doctor Pluss
& Collected Poems

However, turning to his book of essays, poems, reviews and interviews, Collected Couteau, though it, too, contains no authorial information, one begins to see that he is a well-informed layman, who has thought deeply about psychological issues. Not only has he thought, but he has also forged a coherent philosophy through both the direct study of the subject and a close reading of literature.

Part of his philosophy is revealed in the interpretation of schizophrenia in a review of a book by John Perry. He notes that “Perry’s work in traditional psychiatric settings led him to conclude that those in the thrall of an acute psychotic episode are rarely listened to or met on the level of their visionary state of consciousness.” If care providers paid heed to what the patients were trying to show in their symptoms and musings, they would often find that “forced to live an emotionally impoverished life, the psyche had reacted by forcing a transformation in the form of a ‘compensating’ psychosis, during which a drama in depth was enacted, forcing the initiate to undergo certain developmental processes.” Couteau quotes Perry concerning this state: “The individual [patient] finds himself living in a psychic modality quite different from his surroundings. He is immersed in a myth world.” This modality may seem to be regressive, but it is far from unfruitful. “Although the [myth] imagery is of a general archetypal nature … it also symbolizes the key issues of the individual undergoing the crisis. Therefore, once lived through on this mythic plane, and once the process of withdrawal nears its end, the images must be linked to specific problems of daily life.” This leads, in the best cases, to a healing whereby the patient is now able to face and cope with problems that caused the flight into illness.

Perry’s work is not that well known, but readers may be more familiar with the once-celebrated theories of R.D. Laing. While not finding archetypes in his patients’ thoughts, Laing agreed with Perry in treating the schizophrenics’ attempts to communicate as valid efforts to reach out, and in finding that that their psychological difficulties were often rooted in their untenable lives.

This is not to say that Couteau wholeheartedly endorses these ideas of Perry’s. That’s not the point. Rather, Dr. Pluss, the staff psychiatrist in the novel named after him, does. Instead of coldly and clinically assessing his schizophrenic patients (as dominant psychiatric norms dictate he should), Pluss befriends them, sharing his own passions, such as his love of modernist art, particularly of Paul Klee, in a workshop where the inmates learn to appreciate art as a form of therapy. Further, he listens carefully to them as they exhaustively recount their life views. He may criticize these patients’ sometimes outrageous ideas, but he takes them seriously.

The description on the back of the novel states that the book is “based on actual dialogues with schizophrenic patients,” something evident from the stories told to Pluss. With a fantasy akin to Freud’s famous Rat Man case, one woman thinks a ravenous cat lives in her midsection. That’s why she constantly has to eat. Otherwise, the beast, in its craving for food, will begin consuming her internal organs. (In Freud’s story, the patient imagines rats gnawing on his friends’ buttocks.)

The most significant patient is Jonah, who believes his own mental problems are so tremendously fascinating that when he engages in a self analysis (talking to himself), somehow the Viennese master himself comes back to life to eavesdrop. As Jonah tells Dr. Pluss, “And Freud listened to the analysis, glued to his television set. He [Freud] wouldn’t eat; he wouldn’t sleep; he wouldn’t anything.” Ironically enough, Jonah’s psychoanalysis simply consists of enumerating, without explaining, his own situation. “I’m a patient; this is a hospital. Why am I in a cage?” While this fantasy may not seem terrifically engaging, when not raving Jonah presents thoughtful and provocative comments on religion, other patients and even on Dr. Pluss, who is himself undergoing a nervous breakdown.

Pluss had been a painter but gave up the arts to devote himself to helping people. Now, as he is increasingly enthralled by some of his patients’ mythic visions, he begins painting again. Using notes of his talks with schizophrenics, he recasts their ideas as art. He creates, for instance, a series of paintings on Jonah, who sometimes thinks of his mind as a clockwork. Pluss depicts “Jonah being cured of paranoia at the Bulova Watch Repair School, and leaving behind the persecution complex in the grim milieu of the Bulova assembly line.”

Couteau has some misgivings about the sympathetic ear approach of Perry. This is suggested by the fact that Pluss goes beyond listening to his patients’ stores, gets caught up by them, and eventually seems to go a little mad himself when he quits the sanitarium and disappears. I say “seems” because, mirroring Pluss’s dissolution, the narrative strands of the book, which had been tightly wound in the first section that focused closely on Pluss, begin to unravel, with Jonah taking over much of the narrative and becoming a new focal point. This shift of gears can be a bit disorienting as the realism of the opening is partially abandoned, but it does give the reader a chance to see the schizophrenia developing as it gains hold of Pluss’s thought processes. Pluss is like the psychiatrist Dr. Dysart in Peter Shaffer’s play Equus, who begins to doubt his profession, since when a cure succeeded, it often converted a passionate, inspired, if addled person into a normal, but dull zombie. Pluss is attracted by the crazed creativity of so many of his charges. Unlike Dysart, though, who confines his admiration to rueful ruminations, Pluss mimics his patients, becoming schizophrenic in the process.

I mentioned previously that Couteau obtained psychological knowledge not only from studying and thinking about books on the mind, but by reading literature. Indeed, it is important to note that while Pluss took the ultimately dangerous path of learning from his patients, Couteau has deepened his insights by interviewing great writers, such as Ray Bradbury and Hubert Selby Jr.

These interviews are not simple Q&A’s but interactions with a lot of give and take. The interview with Selby (done for Rain Taxi) delves deeply into spirituality and ethics. In a notable passage, Selby remarks, “What we seem to be taught, at least in the Western world [is]: we’re born with a blank slate and we have to learn how to get and get. … But no one ever seems to train us in methods of finding out that we already have within us all the things that are valuable: all the treasures. But it’s only in the process of giving them away to somebody else, that we become aware of having them.”

This thought seems to follow up on insights brought to bear in Dr. Pluss. One reason for the immobilization of so many in psychiatric offices or institutions (according to Couteau and the Shaffer of Equus) is that conventional education does not provide tools for people to deal with stress or act in a humanitarian, giving manner, only instructing them on how to get ahead.

I can’t help, though, by noting that Selby, like Couteau, suggests he has learned from unique individuals, pointing to none other than Evergreen Review’s own editor, Barney Rosset, for special commendation. In discussing his first novel, Last Exit to Brooklyn, which Rosset published, Selby engages in an interchange, beginning with Couteau’s question:

Why was Last Exit allowed to be published in the United States in 1964, while Tropic of Cancer, which was a much less obscene book – by the classical definition – was banned until just a few years before that?

Selby: I think because … it [Tropic] had been banned for many years. … You could only smuggle it in and all that sort of stuff. So, it had a different resistance and a different procedure to go through.

Couteau: It had already an established weight, a history that it had to deal with.

Selby: Right. Yeah. And, of course, Barney Rosset took care of business and made it possible for a lot of things to happen.

It is nice to see that old debts: Rosset’s discovery and championing of Selby’s work, are here being repaid, but this also brings me to a final thought on history. Some readers may find Couteau out of date, in that Laing and the anti-psychiatry movement to which he belonged are not the household names they were in the 1960s, but they (as represented by Perry) seem to orient and spur the author’s fictional and nonfictional excursions. While some may say this current of psychology has been superseded, Couteau has a gone a long way toward showing that it still possesses validity and staying power. How else account for the intellectual freshness, richness and potency of his novel and essays?