Psychic Punctuation

Ms. Nilofer Kaul

How do our patients talk to us? In the language of embedded punctuation marks may lie a story the patient is trying to tell us.


Punctuation /n. 
1. The system or arrangement of marks used to punctuate a written passage.
2. the practice or skill of punctuating. From med. Latin punctuatio from latin punctum POINT

Oxford Reference Dictionary

The ragtag bits on which Emily Dickinson scribbled were gathered posthumously into a gigantic corpus of nearly 1,800 poems. Bemused editors noticed that these busy little poems seemed to run mostly unconcerned with regular punctuation. Full stops, commas and colons were conspicuously absent; instead there were these strange, ubiquitous dashes. This scandalous punctuation was immediately ‘rectified’. Infamously the trademark dashes were replaced with commas, question marks, colons and exclamation marks. Fortunately, her readers soon saw the erroneousness of that exercise. They could see that the abundant dashes that connected as much as interrupted, invited as much as they excluded, were very much the furniture of these poems:

After great pain, a formal feeling comes —
The Nerves sit ceremonious, like Tombs —


This is the Hour of Lead —
Remembered, if outlived,
As Freezing persons, recollect the snow —
First — Chill — then stupor — then the letting go —

This poem (written c. 1862, published in 1929) intuitively captures the rhythm of loss. In the lines quoted here, a leaden numbness follows intense pain — and if you survive this crucible, the memory of it will change from ‘Chill’, to ‘stupor’ and ‘then the letting go’. Each dash here, arrow-like, transports us from one state to another. The poem ends on a cliff, with a dash, highlighting the ‘process’ of writing and feeling, rather than the stasis of arriving at a destination or creating a perfect sculpture. The flow here matches the quicksilver nature of emotions. This is why Mark Ford describes her oeuvre as ‘conjugations of interiority’; or else it is only too easy to mis-read her as a melancholic figure. Dickinson’s ability to communicate her vision and her multitasking with the dashes brings me to the idea of how, like other components of language, our idiosyncratic punctuation too may reveal the relationship to the invisible constituencies in our minds.

Unlike the dashes, the hyphen is a break followed quickly by a related word. The pause is a friendlier, usually a less surprising one. ‘How wonderful the English language is!’ Ms. M exclaims. ‘What other language would allow, me to describe the colour of ‘not-quite-plum-red-aubergine-purple-satin pyjamas’?!’ Ever sensitive to language, she alerts me to links that the hyphen enables between several unrelated and even incongruous words. She senses my enjoyment in her discovery. Later I wonder if she also meant the uniqueness of our link which was a peculiar set of attributes; and that is the very specific conjunction possible in this analytic relationship alone.

Sometimes the exuberance of too many exclamation marks in speech can feel noisy, as though exerting a pressure to join in. Mr B begins his session with a long series of exclamations: He passed his driving test! His daughter got chosen for basketball! His friends loved the photos he posted! Unwittingly, I find myself retreating, withdrawing into a silence that he experiences as icy. This is the place we often find ourselves in. Perhaps a recreation of the world he inhabits where he and I are in a frieze — him pleading with me to join in — while I watch enviously his capacity to extract the last ounce of joy possible. 

The question mark carries an innocent air of eager curiosity. But it may be used excessively by the doubtful, the curious and the querulous.  Ms S for instance is always full of questions: ‘Why do I feel so angry? But why should it matter? And why is that so?...?’ It can just carry on, till I feel depleted while she is still piling them on remorselessly. This questioning feels like a constant gnawing at an empty vessel, where she is only receiving mouthfuls of air. We become the mismatch she needs to tell me about urgently. Ms S’s jumpy music is different from Mr K’s choppy speech.

Mr K’s bursts are punctuated by constant full stops: ‘Strange weekend. Girl from office came home. Big house. So you live alone?’ I struggle to make contact. The staccato rhythm leaves me outside a locked door. Sometimes I feel so lost, I find myself asking too many questions to hunt for the connectives. Like coaxing him to unfold his psychic limbs. I might insert a question mark, where there was a full stop. The assumed tone of ‘you know what I mean’ would then be met with ‘No I don’t but please tell me.’ Sometimes we manage to link the little bursts of speech like the one above:  A colleague dropped in and Mr K was excited to have a visitor, even if it was for work. But her look at his home made him feel accused of being extravagant. He also felt exposed in all his littleness. 

Mr K’s associations lead us to a magical belief in omniscience. It had never occurred to him to speak up in order to communicate. In the enchanted world he believes in, the membrane of his mind is diaphanous, and everyone can see through it. The unresponsiveness of the world feels deliberate and he is embittered by it.

With yet others, there is an absence of pauses or resting places, lines run on without pausing — and without any stillness one may be unable to focus the searchlights. The work with Ms L involves adding the punctuation, so that the work of interpretation is first in the inserting of the punctuation. She brings in a rush of words: ‘Sister won’t stop talking about her degrees cooking children eczema has been bad since we spoke had to rush to the school to pick up holiday homework for the class the brakes need to be fixed dentist has no time at all not till November busy guy’. The absence of punctuation invites me to insert the commas and ellipses. Later, I may piece this together as: Encounters with others leave her feeling unaccomplished and empty and her eczema flares up. She finds the gaps between our sessions very long and her thoughts become like a class of demanding children. She wants more sessions and finds me unavailable.

While Mr K assumes omniscience and speaks telegraphically, Ms L is overwhelmed by a feeling of invisibility and can’t bear to join the dots. When I am able to do that for her and it feels right to her, she is overwhelmed by the visibility. Her constant feeling of being invisible in plain sight is given shape in Margaret Atwood’s (1964) poem ‘This is a photograph of me’. As the title suggests, the poem promises to present the speaker’s photograph: ‘It was taken some time ago’ and then follows what looks like an apologetic prefixing, we are told it is a ‘smeared print’, and that there are ‘blurred lines’. She then speaks of the trees ‘(balsam or spruce)’. Beyond this, there is a lake and then the hills. This apparent background is presented quite deliberately as foreground. The second half of the poem is in parentheses:

‘(The photograph was taken/ the day after I drowned…’

She is located ‘in the lake’, ‘just under the surface’.

It ends:

‘but if you look long enough, eventually 
you will be able to see me.)’

The use of parentheses changes from enclosing obviously nonessential information ‘(balsam or spruce)’ to containing the most crucial information about the awaited subject of the photograph. By parenthesising this, the poem incarnates the invisibility of the speaker. Her experience of secondariness is symbolised triply in being a drowned object in the background of a faded photograph. The emotional heft is carried by the parentheses, rather than the words which are rather banal.  This poem’s use of parentheses embodies the shift that psychoanalysis makes with its attentiveness to the superfluous — the slips of tongue, jokes,  dreams — the unexamined idiosyncrasies that form the fabric of our experiences. 

The poem also signposts postmodern culture with its self-consciously ironic vision, its fondness for gesturing towards other, older practices and idioms. This is best exemplified by the style of informal dancing popular in India. At weddings and such, people break into steps that are obviously ironic — as they parody the style of movie dancing. The nudge-nudge wink-wink  is already inscribed in the body language and the space between quotation marks becomes the dance floor upon which an ironic relationship with life is performed, as revealed for instance, in the popular sitcom Friends

In this show Joey Tribbiani — the most unsophisticated of the six friends — articulates the position of the outsider (the lone Italian among the savvy New Yorkers). In one such moment he finds himself unable to comprehend the airy gesture indicating quotation marks, made by everyone around him. This corporeal punctuation mark is used so unselfconsciously most of the time, that we haven’t noticed the ironic stance that we have come to inhabit. He observes the others, as only the excluded can,  and then finally mimics it, hilariously illustrating his outside-ness again. For as an outsider he cannot inhabit this privileged position of airy, ironic distancing. This gesturally performed punctuation mark indicates a distance from what we are saying by disowning the words as someone else’s.  It marks one’s own position as being superior to, and different from, that of the person quoted. But when used as a tic, it may reveal a nervousness about inhabiting one’s own opinions. In writing it takes the form of quoting our predecessors excessively. Are we guarding against our arrogance? Or are we hiding our thoughts behind the old guard?

Sometimes this feels like a shrugging off of responsibility and at other times, it is like a crutch that allows one to enter speech. The overwhelming presence of powerful residents in our native land guards the thresholds of our mouths. It is with their permission alone that we can utter some words; albeit borrowed. We hear echoes of this in our patients when we ask them how they felt and are told the opinions of the Chorus. Sadly, they have not been able to wrest themselves away from the malignant superego figures, it seems. Insiders can use the ironic quotation marks, while the outsiders remain parenthetical. In the embedded punctuation marks, may lie a story the patient is trying to tell us.  We could think of these as notation symbols in music. Speaking of ‘the realm of emotional music of the voice’, Meltzer writes:

…it is my impression that I tend towards the centre, you might say. That is, if we envisage this emotional spectrum and the segment of it in which people actually operate, … I notice that I tend to talk a bit more loudly than the whisperer and more softly than the shouter, less minor-key than the depressed and less major- key-than the manic, more slowly than the galloper and faster than the tarrier, with less vibrato than the passionate… (pp. 379-380)

Atwood, M. (1964). ‘This is a photograph of me.’ Last accessed 23/8/2021.
Dickinson, E. ( 1929). ‘After great pain, a formal feeling comes.’ The Complete Poems of Emily Dickinson, ed. Thomas H. Johnson. Delhi: Kalyani, 1977.
Meltzer, D. (1976). Temperature and Distance. Sincerity and Other Works: Collected Papers of Donald Meltzer, ed. Alberto Hahn. London: Karnac,1994.
Oxford Reference Dictionary. Oxford: OUP, 1995, 1996.
Perry, S., Ford, M. & O’ Leary, J. (2021). London Review of Books. Last accessed 23/8/2021.


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