Sarah Fawn Montgomery

“Narrative is its own kind of medicine.”

Sarah Fawn Montgomery

Regenerate: Poems of Mad Women (Dancing Girl Press, 2017)

You open the poem “After Electric I” with the lines, “After the electricity / her mouth slipped open / and her tongue loosened / all over—spilled out / what doctors wanted.” Similarly, in your essay “My Voice for their Drugs,” you create striking images of the inhibition of speech: “There is a salamander in my throat, his black body slimy with regret, his claws piercing my words.” How does this theme of the inability to articulate experiences characterize your work?

I’m interested in the inability to articulate experiences as it is related to silence. There is a long history of silencing medical patients, for we tend to value medical authority rather than patient perspective. Those with mental illnesses have the added difficulty of “proving” they can be trusted and being required to tell their stories within a framework of reality they may not occupy. It is hard to describe the outrageous fears of anxiety, the compulsions of OCD, or the truth of hallucination to those for whom they are not a reality. The burden falls on patients to frame their stories in a way the healthy world understands or is willing to accept. Silence, then, becomes a powerful tool by those in power to regulate which narratives are privileged and which are stigmatized.

At the same time, however, silence can be an active, purposeful rhetorical move, a choice that grants power by way of its agency. Patients can choose what to reveal and to whom. Those who feel forced into certain narrative pathways or coerced into certain power dynamics can employ silence as a strategy. They can voice their stories within their communities, resisting dominant narratives to share with audiences that are willing to accept diverse ways of knowing, being, and telling in the world. My work is interested in both these forms of silence and tries to tease out the implications, pitfalls, and possibilities of articulating the inexpressible. I want to fill imposed silence with narratives that complicate our understandings of mental illness, but also employ silence as a strategy through white space, time shifts, and experimental form.

In “Bloom,” you describe a pit – “dense walnut wrinkle” – that transforms by the end of the poem into a “pearl / luminescent.” Is this conversion analogous to the process of embracing mental illness as a part of identity? How does that journey inform your poetry?

Absolutely—we often rely on the narrative that mental illness is wrong and that patients must “fight,” branding them a “failure” if they somehow do not succeed in ridding themselves of their diagnosis. But for many, mental illness is the lens through which we view the world. It is an embodied, lived reality that cannot and should not be separated from the individual. Accepting my anxiety, OCD, and PTSD as inherent parts of my identity rather than deficits or embarrassments was crucial to my understanding of self and mental diversity. Over time, I’ve come to appreciate these qualities about myself, for though they can pose challenges, they enrich my understanding of the world, my engagements with others, and my ability to be a writer, editor, and teacher. I am far better because of them, a narrative that flies in the face of what we are often taught to believe about mental illness—and something I examine in my forthcoming memoir, Quite Mad: An American Pharma Memoir.

“Prescription Doll” seems to take a harsh or perhaps contemptuous view of prescription medication for mental illness. “Prescription dolls simply need a windup,” the poem opens, “pinprick pills to turn keys.” It ends with the line, “Wind yourself up, rosebud mouth. Smile.” Do contempt and sympathy both play a role in this poem, and if so, how?

Medications help millions of people with mental illnesses survive—for many, a prescription is the difference between life and death. One of the worst criticisms of mental health care is that people are weak for taking medications. So I’m not critical of prescription medications as much as the rhetoric surrounding them, particularly in wellness marketing. This poem responds to a series of print and commercial Pristiq ads that depict depressed patients as windup dolls slowed to a stop—or “broken”—because of their illness. When medicated, the dolls are suddenly “fixed,” reenergized and productive. What is problematic about this narrative is that it dehumanizes patients and oversimplifies mental illness, making it a mechanical malfunction with an easy fix—even though medications do not always work for patients and certainly not as quickly as the advertisement makes it appear, and many patients manage symptoms with multiple approaches. The ads also imply patients must perform certain tasks or roles to be considered “well” or “productive,” which becomes a means to police behavior and emotion.

More problematic, however, is the fact that nearly all of the dolls are women, as though only women need to be medicated, or worse still, as though mental illness is a woman’s illness. When “wound down,” the dolls each wear drab, ill-fitting clothing, their hair hanging limply about their expressionless faces. They are overwhelmingly depicted alone.  Dolls who take the medication wear bright, formfitting clothes and perform gendered tasks like hosting parties, cooking for families, and doing yoga. The narrative constructed in the ad is that mentally ill women are unattractive, unfashionable, and unlovable. Even the use of dolls to replace women is suspect, shaping our cultural expectations about gender roles and responsibilities and our ideas about what constitutes a “normal” or “sane” woman.

Does composing poetry energize or exhaust you? What about writing nonfiction?

I derive energy from writing each genre but find poetry to be a welcome respite from the personal reflection required of me in nonfiction writing. Writing memoir in particular requires me to dig through my past, focus on myself, and in the case of Quite Mad, spend long moments with painful memories and occupy unhealthy or unhappy mental spaces in order to more effectively write about them. While I’m immensely proud of this book, the writing was long, emotional, and anxiety-producing. Not all of my nonfiction requires this—I enjoy place-based writing, science writing, and the intellectual movement afforded by the personal essay—but my memoir certainly proved taxing.

I began writing poetry as distraction or palate cleanser from my memoir. In poems I can write about anything—strange science facts, historical tidbits, a rainy day. I can occupy other voices, which was a kind of freedom when memoir required me to stick closely to my experiences and my family’s history. I examined space exploration in my first poetry chapbook and living on the Great Plains in my second. And Regenerate, while inspired by my own experiences with mental illness, is largely a collection of persona poems from historical and literary madwomen. Along the way, I discovered that I enjoy writing both and now write the two genres simultaneously—working on particular elements of craft in one genre (voice or image or rhythm) invariably leads to discoveries in the other.

“Stain” evokes a dark image of an abusive partner in a relationship: “his hand patting / her hindquarters / insistent then, as now / as he pulls her / towards his eager body.” Has the subject of abuse impacted your writing? Could you tell us a little about this?

The link between trauma and mental illness cannot be understated, and my discussions of mental illness invariably involve discussions of abuse—violence leading to diagnosis, violence in the treatment of mental illness patients in this country, the violence we erroneously label as a symptom of mental illness. Mental illness rates have historically been much higher for women, and much of this can be attributed both to the ways we treat the female body and mind and to the violence that so often accompanies the female experience. When we look at rates of sexual assault, domestic violence, harassment and stalking, unpaid and underpaid labor, the burden of invisible domestic labor, and other factors, it can come as no surprise that so many women experience depression, anxiety, OCD, and PTSD. When it is reinforced daily that women are less than, are wrong, are not worthy, are disposable, are broken, it is no wonder bodies and brains react with pain, fear, dissociation, and confusion. It is not just my writing about mental illness that is fueled by explorations and critiques of cultures of abuse, however. My previous books and current projects about the history of the Great Plains, representations of wicked women, and the cultural expectations of motherhood all require an acknowledgement and an interrogation of the roles of systemic abuse.

In your nonfiction essay “My Voice for their Drugs,” you discuss the inherent incommunicability of pain. Citing Elaine Scarry, you write, “Sufferers cannot articulate their truths and those without pain cannot begin to comprehend. What exists for those in pain is simply unreal to those without it.” However, you have also commented on the relief that can come from sharing struggles with friends and being part of community. How, if at all, has this redemptive aspect of community influenced your writing?

While it is difficult to share the experience of pain with those who have no context for the reality of chronic mental and physical ache, there is a wonderful relief, a joy even, in recognizing your lived experience in others. I’ve received far more nurturing from the stories of other patients than I have from medical writing, and the vibrancy of the community has reframed the way I view my illnesses—mental illness is an inherent identity I claim proudly, a benefit that allows me to see the world more richly and to live in it more fully. Erasure occurs when patients are met with disbelief time and again, so to have someone see you—to not only accept, but to validate and value your story—is incredibly healing. Narrative is its own kind of medicine.

A theme that emerges from “My Voice for their Drugs” is the overwhelming inability to speak up about mental illness, the kind of seizing that occurs when trying to articulate such confusing and complicated emotions. However, you write so eloquently and with such vivid imagery: “Shortness of breath like the time I blew up too many balloons, like falling into the deep end of a pool as a child, like running in the humid south, like breathing through gauze, through purple velvet, like eating too much shortbread or chewing on a cotton ball.” Could this irony be seen as a statement about the empowering nature of writing?

First, thank you! And yes, writing opens up both literal and metaphorical spaces for narratives often overlooked or ignored in favor of medical texts and perspectives. Part of what we require from patients is a reliance on symptoms, medical terms, the power structure of physician and patient, and a particular narrative arc that requires patients to translate or edit their narratives for the healthy world. These requirements can be incredibly limiting for patients who may have other ways of articulating their pain, but creative writing and narrative medicine empower patients to craft narratives on their own terms, to determine what is important, to establish and enforce the tools they believe necessary to the tale, and most important, to take ownership of the narrative with a kind of agency and action a ten-minute doctor’s visit simply can’t accommodate.

In “Marguerite,” the voice in the poem seems to be collective first person: “She paused by the door as if to speak, / and how we wished she’d used that mouth.” Who are the speakers in this poem, and how does your poetry represent the voices of those other than yourself?

This is one of the few poems in the book directly inspired by my own life—the poem describes a girl bullied by boys on the school bus each day. I distinctly recall riding the bus: many girls confined to a few seats in the front while a few young male students occupied much of the rear, antagonizing female students and threatening them with bodily injury if they entered male-claimed space or even so much as spoke back. Marguerite was one of the last to get on the bus each day so she had to sit in dangerous territory and experience daily harassment, which she did stoically and silently. The “we” in this poem are the girls who witnessed as Marguerite claimed space from those that sought to deny it to her. We were both proud of her efforts—we never ventured to the rear—and simultaneously wished she were braver, as she never spoke back and was clearly made miserable by the taunts. In many ways, Marguerite was scapegoat and saint, someone we hoped we’d never become yet also desperately wished to emulate. Stories like this are hardly new, so this poem and others in the collection voice a collective “we” that silently witnesses harassment, abuse, and violence and occupies poetic space in order to challenge culpable silence.

Do you prefer writing nonfiction or poetry? What about an idea indicates to you that it would be better expressed in nonfiction or in poetry?

I enjoy writing both and tend to work on projects in two genres simultaneously. For example, right now I’m hard at work on a collection of poems and a collection of essays. Certainly length and space play a role in determining the genre of each project—the scope and subject of my current nonfiction project requires the length and narrative space of the genre. But the creative processes each genre affords also influence my decisions—I tend to be more playful with poetry and more reflective in prose—so the project usually determines the genre. And the flexibility and freedom to move between genres—and in many cases to break the arbitrary borders between them—is something I derive energy from as a writer.


Sarah Fawn Montgomery is the author of the forthcoming nonfiction book, Quite Mad: An American Pharma Memoir, as well as three poetry chapbooks, including Regenerate: Poems of Mad Women. Her work has been notable in Best American Essays and her poetry and prose have appeared in The Normal School, Passages North, The Rumpus, Los Angeles Review, DIAGRAM, Terrain, and others. She has been the Nonfiction Editor for Prairie Schooner since 2011, and is an Assistant Professor at Bridgewater State University, where she teaches creative writing, disability studies, and women’s literature.



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