“Mirrors and Prisms”: An Interview with Dennis Palumbo About Art, Life, and Psychotherapy – Part I

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SECOND THOUGHTS

Introducing Dennis Palumbo – Psychotherapist and Writer

It is a pleasure to introduce Dennis Palumbo, MA, MFT, to the readers of Psychiatric Times. Dennis is a licensed psychotherapist in Los Angeles, CA, where he specializes in treating individuals in the creative arts community of Hollywood. He is uniquely well-suited for this specialized work given his double, even triple, skill sets as a former Hollywood scriptwriter and current detective fiction novelist,¹ teacher of creative writing,² and his work with Robert Stolorow, MD, incorporating intersubjectivity theory in his psychotherapeutic work. Dennis will soon be addressing readers of Psychiatric Times in a monthly column of his own, “Creative Minds: Psychotherapeutic Approaches and Insights.” His latest essay is about his role as Consulting Producer on the recent Hulu TV series, “The Patient.”³

We have had an enriching exchange about art, life, and psychotherapy for several years. Dennis was our invited guest for the inaugural meeting of American Psychiatric Association Caucus on Medical Humanities in Psychiatry in New Orleans, LA, in 2022. Dennis’ uniquely diverse and specialized skill sets allow me to explore the question of the relationship between the psy disciplines and detective fiction. More generally, I wanted to explore the roots of creativity and empathy in creative writing and clinical work and connect it to therapy.

Besides international literary fiction and poetry, detective novels and murder mysteries have been my great avocational passion, something that Dennis and I share with such serious thinkers as Austrian-British philosopher Ludwig Wittgenstein and British social psychiatrist Sir Michael Shepherd, MD, who wrote an insightful little book about Sherlock Holmes and Freud. And literary greats from Jorge Luis Borges to TS Eliot chimed in on what makes great detective fiction, not to mention pliers of the trade, especially British detective fiction writer PD James.⁴

Mirrors and Prisms

In this interview, Dennis Palumbo talks about the classical notion of “art imitating life” and something more intriguing, more crucial where “the arts inform life.” The first formulation sees art as a passive mirror, whereas the second one sees the arts are a transformative prism. This was brilliantly expressed in the “Ultra Manifesto,” an “iconoclast ideology” whose bold credo was “not to have a credo,” by a group of Spanish writers including Jorge Luis Borges⁵:

Two aesthetics exist: the passive aesthetic of mirrors and the active aesthetic of prisms. Guided by the former, art turns into a copy of the environment’s objectivity or the individual’s psychic history. Guided by the latter, art is redeemed, makes the world into its instrument, and forges—beyond spatial and temporal prisons—a personal vision.

With his dual careers as a writer and a psychotherapist, Dennis Palumbo offers his insights into how art imitates life imitates art.

Vincenzo Di Nicola, MPhil, MD, PhD, FCAHS, DLFAPA, DFCPA: You have been in private practice as a psychotherapist for over 30 years and prior to that you were a Hollywood screenwriter, working in both TV and film. Can you talk about that experience?

Dennis Palumbo, MA, MFT: Looking back on my career in Hollywood, what springs most to mind is how lucky I was. Yes, I was a good writer and a hard worker, and subscribe to Louis Pasteur’s belief that “chance favors the prepared mind.” But I knew many others starting out when I did who were even better writers and worked harder, yet they never achieved their career goals.

In both TV and film, I was fortunate to work with many people I admired. But, as any Hollywood scribe will tell you, it is a brutal industry, and can be quite unkind to writers. The cliched narrative of having to appease diva-like stars, dictatorial directors, and illiterate studio and network executives is no cliché for those toiling in the screen trade. And while my experience in show business was overwhelmingly positive, I found the constant hustling and struggle to maintain creative integrity taking a considerable toll over the years. In fact, once my screenwriting career had been established, my concurrent turn to prose writing was a counterpoint to some of my frustrations with the limits of Hollywood storytelling. I was also frustrated by the way TV and film writers are routinely treated; unlike the theater and with books, Hollywood writers do not own copyright on their material, so it can be rewritten, edited, or discarded by producers, directors, and studio execs at their discretion. In retrospect, I see my turning occasionally to prose writing during this period as an example of what a self-psychologist might term an “antidote function” or a Freudian “reaction formation.”

Di Nicola: British physician and author Arthur Conan Doyle, MD, was inspired by the clinical reasoning of his medical professor at Edinburgh to portray the famous deductions of his character Sherlock Holmes. Another Brit, Sir Michael Shepherd, MD, wrote a little book on Sherlock Holmes and The Case of Dr Freud⁶ and your friend Nicholas Meyer wrote the best Sherlock Holmes pastiche about a fictional encounter between Holmes and Freud in The Seven-Per-Cent Solution.⁷ Can you explain the enduring appeal of crime and detective stories, from both a writing and a psychological viewpoint?

Palumbo: From a psychological point of view, the standard response to this question is that the detective brings order to a disordered world; when the guilty person whose crime has torn the fabric of civilized society is exposed and caught, that fabric is mended.

I also think the character of the detective (whether male or female, private or an amateur, or a member of the official police) speaks to our yearning for a parent figure who is smart, compassionate, and dogged in their pursuit of the truth. As children, we need the security of knowing where things stand; what can and cannot be relied on. In most crime fiction, we can rely on the protagonist to share that need with us and, like a good parent, in the end provide it.

In my own crime fiction, my psychologist hero/amateur sleuth serves this purpose in spades.1 In fact, as clinicians sift through facts, emotions, and patterns of behavior in search of illuminating a patient’s core issues, so does the hero in crime fiction. Both therapists and detectives look for “clues,” and then are tasked with finding out what truths they may point to.

I say this with a caveat: I am not totally comfortable with the notion that clinical treatment is primarily some kind of detective work. Just as I have always been uneasy with it described as archeological work, “digging” for the truth underlying a patient’s issues. For one thing, it implies that unearthing such material helps “cure” the patient; ie, helps the patient return to a “normal” level of functioning. Once again tasking (approvingly) the therapist with being an agent of the dominant culture.

That said, the psychological appeal of the protagonist in crime fiction is undoubtably bound up in our need for a hero/parent/restorer of order. At the most basic level, while we readers are often thrilled or titillated by the crimes depicted, we want good to triumph over evil. We want justice to prevail. Again, a somewhat regressed need, frequently seen in a young child’s firm belief in the rightness and necessity of rules (before adolescence comes along and shreds that belief).

In looking at the popularity of crime fiction in terms of writing, I think you have to go back to the Greeks. Unlike other fiction, particularly what we call “literary fiction,” most crime fiction is plot-driven. No matter how well-written, no matter how multidimensional the characters may be, no matter how grounded in psychological sophistication the narrative is, crime and detective fiction is built on plot. The crime, the suspects, the clues, the hero or heroine’s missteps until glimpsing the truth—these elements make for a satisfying mystery story. This does not always mean a “happy ending,” but readers expect (and deserve) a structure built along these lines.

Drama has its demands, and crime fiction has even more. Nowhere outside of children’s fiction is the requirement for a beginning, middle, and end so stringent. The point is, life does not make sense. Much “literary” fiction reaffirms this. Crime fiction—for all its violence, disturbing psychological themes, and often bizarre plot—is popular because, in the end, the story satisfies. The pieces all come together and make sense. Unlike the ragged edges of life, the solution of a crime novel or short story completes a narrative Gestalt that satisfies the reader.

Di Nicola: Can you address the mirror issues of empathy (psychotherapy) vs cruelty (psychopathy) that detective fiction deals with?

Palumbo: In most crime or detective fiction, a duality within the human personality is a given. Reminiscent of Robert Louis Stevenson’s theme in his Strange Case of Jekyll and Hyde, in which he posits a simple internal struggle between good and evil in each person, today’s crime fiction tends toward a more sophisticated approach, which indeed mirrors the psychological concept of empathy vs sociopathy.

Psychotherapy is based on an assumption of a clinician’s empathy, whether using Carl Rogers’ proposal of “unconditional positive regard” or else some more contemporary understanding of the intersubjectivity inherent in the therapeutic dyad. Despite what personal issues and preferences the clinician brings to the treatment room, and the ways these interact with those of the patient, the given is that the therapist cares. In crime fiction, as in life, the sociopath does not.

In most crime and detective fiction, especially in recent years, the protagonist “cares” in a similar way, often expressed as “the victim in this case deserves justice,” or—again, a more modern narrative device—the detective or police officer relates personally to the victim’s history or circumstance. Seeing him- or herself in the victim’s shoes often aids in understanding the cause of the crime or points to the motives of possible suspects.

Conversely, the cruelty of the villain is implied by a lack of such empathy, or even a clearly determined stance against the notion of relating in any way to his/her victim. This can be bluntly stated by the villain (things he/she says to the victim or evidenced by such dramatic device as letters sent to the media or messages left at the crime scene. The other evidence of the antagonist’s sociopathy is the heightened brutality of the crime, in which the murders are noteworthy for their excessive violence or degradation of the victim.

Regardless of approach or level of psychological sophistication, this good/evil duality within each of us is assumed in crime fiction as a given. Perhaps reflecting the notion that the reader sees the human condition in these same terms.

Di Nicola: That’s an intriguing take! We are both fans of Film Noir, in which the detective protagonist crosses the line and is often as transgressive as the criminal.⁸ How do you account for that?

Palumbo: Because the line between empathy and cruelty is thin and even porous. One of the reasons we love Film Noir is that the ostensible protagonist often crosses that line, either for a woman or out of greed, and our own desires resonate with his choices, even as we fear the eventual (and usually inevitable) outcome.

Di Nicola: What prompted your career change from screenwriter to psychotherapist? And what were the challenges involved?

Palumbo: Ironically, the year I retired from screenwriting was one of the most financially successful in my career. I had attained my graduate degree and completed the required 3000 intern hours to sit for the clinical exam while still working as a Hollywood writer, with only my wife and a few close friends knowing about my studies and shift in career goals. But as to what had prompted this decision, one that was viewed as either brave or crazy by those who knew (most falling into the latter camp), my reason was twofold: firstly, I had always been interested in psychology and philosophy, and had read widely in both subjects since college. This interest was intensified by the 3 months I spent in Nepal. Ostensibly there to research the life of a famous mountain climber for a proposed film, I instead lived, studied, and meditated at altitude in the Himalayas. During this period of intense reflection—and living far away from the distractions and obligations of my Hollywood career—I began to feel a need to change the course of my life. But more importantly, it was my many years as a patient in therapy (prior to and following my Nepal sojourn) that ultimately prompted the decision. The therapeutic dyad had become—and remains—the most emotionally and intellectually challenging experience of my life. It speaks to a core preoccupation of mine with the varieties of subjective perception, including my own. An interest I had explored, to the limited extent allowed in a commercial marketplace, as a screenwriter. But now I no longer wanted to be merely a curious and empathic witness to what was going on in the pool—I wanted to jump into the water myself.

The biggest challenge in changing careers was to convince myself that I was allowed to do it. Coming from a hard-working, blue-collar background, the thought of walking away from a successful, high-paying job to venture into the uncharted territory of a clinical practice often felt like a rebuke to my more pragmatic, “common sense” self-concept. Yet as the years of study and practical experience as an intern at a low-fee family clinic and a psychiatric facility went on, I was more and more convinced that this new path was the right one for me. In the 3 decades since, I have never once regretted that decision.

Di Nicola: You specialize in treating creative people, primarily in the entertainment industry. Besides drawing on your own experiences, was there some specific reason that you chose to specialize in this area?

Palumbo: I knew from the start of my practice that I wanted to work with creative individuals, but not only because of my previous career. I have always been fascinated by the struggles that artists, including myself, deal with on a daily basis—issues both personal and professional. I also deeply revere artists and feel their contribution to society is at the same time profound, underrated and woefully misunderstood. Kierkegaard said that faith is a nonrational commitment; I think the same thing could be said of a commitment to a creative career. Or as one of my writer patients said of the desire to write: “It’s a blessing you’ve been cursed with, or else a curse you’ve been blessed with.” I could not put it any better myself.

Di Nicola: What are the most common issues your creative patients present?

Palumbo: Initially, most creative patients present with what I might call “the usual suspects”: writers’ block, procrastination, fear of rejection, etc, with the accompanying anxiety. There is also the depression that often predominates when creative aspirations go unfulfilled for a long period of time. And even for those artists who are in relationships, or enjoy the benefits of a strong social network, most creative endeavors—especially in their early stages—require a significant period of solitude, which for some is experienced as acute loneliness. Not to mention the financial issues, dealing with the politics of the marketplace, and a variety of other more pragmatic concerns.

Di Nicola: You have mentioned elsewhere that these creative issues are inextricably bound up patients’ personal issues. What do you mean?

Palumbo: I am referring to the fact that a patient’s particular set of issues, and especially the meanings they assign to them, are at the core of their creative struggles. For example, as painful and frustrating as it is to encounter a creative block, what makes navigating it so difficult is the meaning patients give to being blocked. What if it means the project they are working on is flawed? What if it means they are less talented than they had hoped? What if they are sure that (insert favorite artist here) never gets blocked? What if their parents were right and they should have gone to law school? These kinds of meanings need to be explored before the more pragmatic concerns that might underlie the block can be addressed. These concerns are usually (but not always) shame-based.

Let’s use writers’ block as an example: Perhaps the writer has never before written an explicit sex scene and so freezes at the thought. Perhaps the narrative involves characters that closely resemble or are even based on the writer’s family of origin. Maybe the writer has only done nonfiction and is trying fiction or poetry for the first time. Or maybe the writer has had success in one genre but is anxious to try another. Concerns such as these, usually involving a fear of shameful self-exposure, are often aspects of the writer’s creative roadblock that need to be investigated. 

Di Nicola: In his autobiography, The Magic Lantern, Swedish filmmaker Ingmar Bergman⁹ confessed that he turned himself into a liar: “I created an external person who had very little to do with the real me. As I didn’t know how to keep my creation and my person apart, the damage had consequences for my life and creativity far into adulthood. Sometimes I have to console myself with the fact that he who has lived a lie loves the truth.” In your clinical experience, what are the relational issues that creative people deal with, in particular with family members, romantic partners, and friends?

Palumbo: This is a huge issue, but to reduce it down to an appropriate explanatory length, in my experience most creative peoples’ intimate circle—family, romantic partners, and, to a lesser extent, friends—are a significant aspect of their lives, and not always in the best of ways. The financial struggles that often accompany a creative person’s career strivings can have a powerful impact on that person’s life partner, since their fortunes are, in a sense, combined. For an additional “turn of the screw”—crediting Henry James—this burden of financial troubles becomes even more impactful if the writer has children. In addition to money worries, the emotional toll that creative ambition takes on the artist can make him or her hard to live with. The ups and downs of a creative career, and their resultant stresses, are coexperienced by the life partner. I have had many romantic partners of creative people in my practice complain that they can no longer tolerate living with the uncertainty and “emotional roller-coaster” of their mates’ ambitions. Even quite successful artists find that their success can cause familial disharmony, due to a requirement to travel extensively, or to the stress of being in the public spotlight. As my patients who are themselves the adult children of famous artists regularly complain, growing up in that particular circumstance was not easy. 

I am often reminded of a quote by Robert Frost: “The one thing all nations of the earth share is a fear that a member of your family will want to be an artist.” As someone who left engineering school to seek my fortune as a Hollywood writer, I can certainly attest to that. Among others in my family, my grandmother routinely lit novena candles to save my soul. (This happened every Sunday at her Catholic church, named Our Lady of Perpetual Sorrow. I wish I were witty enough to have made that up.)

Resources

• For a superb, reassuring and therapeutic guide to writing, consult Dennis Palumbo’s Writing from the Inside Out. John Wiley & Sons; 2000.
• For his latest Daniel Rinaldi thriller, read Deniss Palumbo’s Panic Attack. Poisoned Pen Press; 2021.

Dr Di Nicola is a child psychiatrist, family psychotherapist, and philosopher in Montreal, Quebec, Canada, where he is professor of psychiatry & addiction medicine at the University of Montreal and President of the World Association of Social Psychiatry (WASP). He has been recognized with numerous national and international awards, honorary professorships, and fellowships, and was recently elected a Fellow of the Canadian Academy of Health Sciences and given the Distinguished Service Award of the American Psychiatric Association. Dr Di Nicola’s work straddles psychiatry and psychotherapy on one side and philosophy and poetry on the other. Dr Di Nicola’s writing includes: A Stranger in the Family: Culture, Families and Therapy (WW Norton, 1997), Letters to a Young Therapist (Atropos Press, 2011, winner of a prize from the Quebec Psychiatric Association), and Psychiatry in Crisis: At the Crossroads of Social Sciences, the Humanities, and Neuroscience (with D. Stoyanov; Springer Nature, 2021); and, in the arts, his “Slow Thought Manifesto” (Aeon Magazine, 2018) and Two Kinds of People: Poems from Mile End (Delere Press, 2023, nominated for The Pushcart Prize).

Dennis Palumbo is a licensed psychotherapist in private practice, specializing in working with creative patients. His award-winning series of mystery thrillers—the latest is Panic Attack—feature psychologist and trauma expert Daniel Rinaldi. He is also the author of Writing From the Inside Out, as well as a collection of mystery short stories, From Crime to Crime. Recently, he served as Consulting Producer on the Hulu limited series “The Patient.” Formerly a Hollywood screenwriter, Palumbo’s credits include the feature film “My Favorite Year,” for which he was nominated for a Writers Guild Award for Best Screenplay. He was also a writer for the ABC-TV series “Welcome Back, Kotter,” among numerous other series. His short fiction has appeared in Ellery Queen’s Mystery Magazine, The Strand, Mystery Weekly, and elsewhere. His work helping writers has been profiled in The New York Times, Premiere Magazine, GQ, The Los Angeles Times and other publications, as well as on NPR and CNN.

Acknowledgements

I wish to thank Dennis Palumbo for many hours of edifying exchanges on art, life, and psychotherapy. In the interest of full disclosure, Dennis provided a generous review of my last volume of poetry,¹⁰ which reminds me of a joke about a noted literary review as “The New York Review of Each Other’s Books.”

References

1. Palumbo D. Panic Attack. Poisoned Pen Press; 2021.
2. Palumbo D. Writing from the Inside Out. John Wiley & Sons; 2000.
3. Palumbo D. “The Patient” and my patients. Capital Psychiatry. 2024;5(3):41-43.
4. James PD. Talking About Detective Fiction. Knopf Doubleday; 2008.
5. Borges JL. Ultra Manifesto. In: SJ Levine, ed. On Writing. Penguin Books; 2010:4-5.
6. Shepherd M. Sherlock Holmes and the Case of Dr Freud. Routledge; 1985.
7. Meyer N. The Seven-Per-Cent Solution: Being a Reprint from the Reminiscences of John H. Watson, MD. E.P. Dutton; 1974.
8. Muller E. Dark City: The Lost World of Film Noir (Revised and Expanded Edition). Running Press Adult; 2021.
9. Bergman I. The Magic Lantern: An Autobiography by Ingmar Bergman. Tate J, trans. Hamish Hamilton; 1988.
10. Palumbo D. A Collection of Poems that Refutes the Binary in Favor of Imaginative Plurality. Review of Two Kinds of People: Poems from Mile End by Vincenzo Di Nicola. Capital Psychiatry. 2023;4(4):44-45.