Philip Larkin - A Psychiatric Appraisal

Patient Name: Larkin, Philip

DoB: 09/08/1922

Symptoms: Has written poem, Aubade, see below with doctor's responses and recommendations.

Aubade

I work all day, and get half-drunk at night.     I suggest patient should drink rather more; it will help him sleep better.

Waking at four to soundless dark, I stare.     Lucky him - AGES till the alarm goes off.

In time the curtain-edges will grow light.     Dawn! Don't knock it, friend. A lovely time of day.

Till then I see what's really always there:

Unresting death, a whole day nearer now,     Oh come now old chap. Lighten up!

Making all thought impossible but how     All thought? really? What about "UGH NO - Monday again"?  

And where and when I shall myself die.     Don't dwell on it so. It does no-one any good.

Arid interrogation: yet the dread

Of dying, and being dead,

Flashes afresh to hold and horrify.     Golly. He must have been VERY BAD.

The mind blanks at the glare. Not in remorse     Perhaps if he did express a little remorse he might feel less doomed.

- The good not done, the love not given, time

Torn off unused - nor wretchedly because

An only life can take so long to climb

Clear of its wrong beginnings, and may never;

But at the total emptiness for ever,

The sure extinction that we travel to     You're jumping to conclusions here. The Pope of Rome (God bless him) disagrees with you.

And shall be lost in always. Not to be here,     I'm not sure many of us are going to mind terribly much if you aren't here, you old misery.

Not to be anywhere,

And soon; nothing more terrible, nothing more true.

This is a special way of being afraid

No trick dispels. Religion used to try,     Yes it still does, and succeeds quite well in many cases.

That vast, moth-eaten musical brocade

Created to pretend we never die,     "Pretend"? Dear me you are going to find the doorkeepers at the Gates of Pearl don't take kindly to that sort of talk.

And specious stuff that says No rational being

Can fear a thing it will not feel, not seeing

That this is what we fear - no sight, no sound,

No touch or taste or smell, nothing to think with,     Well I do think you are worrying unnecessarily here. If there aint nothing there it aint nasty is it?

Nothing to love or link with,

The anaesthetic from which none come round.    Nice. Sleep after toil doth greatly please and death after life likewise. 

And so it stays just on the edge of vision,

A small, unfocused blur, a standing chill

That slows each impulse down to indecision.     Come on, man. Get a grip.

Most things may never happen: this one will,     That's the first thing he's said which I can't argue with.

And realisation of it rages out

In furnace-fear when we are caught without     Steady now! Calm down.

People or drink. Courage is no good:

It means not scaring others. Being brave 

Lets no one off the grave.

Death is no different whined at than withstood.     Death may be no different, but you'd find life more agreeable if you would just RELAX about it a bit. Ignore it, do. Stop paying it so much attention.

Slowly light strengthens, and the room takes shape.    OK; that's true.

It stands plain as a wardrobe, what we know,

Have always known, know that we can't escape,

Yet can't accept. One side will have to go.     Eh? He'd feel a lot more composed if he would accept it, as everyone else does and gets on with living.

Meanwhile telephones crouch, getting ready to ring

In locked-up offices, and all the uncaring

Intricate rented world begins to rouse.     Yes well I admit that is a bit grim.

The sky is white as clay, with no sun.

Work has to be done.    Yes, in fact, very grim, specially if it's Monday.

Postmen like doctors go from house to house.     "like doctors" : this simile reveals a preoccupation with matters of illness and mortality.

Conclusions:

This patient is morbidly obsessed with death, and it is making him miserable. It interferes with his ability to engage socially in a normal way and is affecting all areas of his life. 

Diagnosis: possibly Thanatophobia, but probably merely Existential Death Anxiety which the patient has failed to address by the normal mechanisms i.e. denial, religious faith, or blindly ignoring it.

Patient needs to be encouraged to think about other things and other people. Keep the fellow busy, and tire him out physically. He might benefit from reading Friends Beyond by Thomas Hardy who, despite being another old misery himself, here presented a more cheerful view, with the dead obedient to their fate and perhaps even grateful for some of Death's peculiar mercies.

Suggested treatment: 

?Confirmation Classes. I can refer him to Fr O'Hanrahan.

Dose of Voluntary Work.

Spell in the army (a tough regiment would be best).




A sensible well-adjusted person, unlike P Larkin, enjoying a pleasant chat with the Reaper.