Language is the key tool in psychiatric practice, and we routinely attend to its disorders as well as those of thought. Less so to its ordinary workings and their clinical importance. This is akin to attending to pathophysiology while neglecting normal physiology in neurobiology. Healing and the Invention of Metaphor directly addresses this gap. ‘Situations that are emotionally charged… tend to have… higher rates of metaphor use. In psychotherapy, patients may produce about six metaphors a minute’ (p 5). Drawing a distinction between cure and healing, Kirmayer examines not the technical use of language in psychotherapy but, more broadly, ‘the place of language in illness experience and healing’ (p. ix).

Language, here, is not confined to words but understood more broadly as the biologically evolved psychological foundation of human connection, expressed through speech, gestures, acts, images, art, culture and mass media. The scope of reference is wide, extending from psycho-neurophysiology and predictive processing to meaning, justice and healthcare. These sit alongside discussions of relationships, trauma, madness, genocide, alterity (Emmanuel Levinas), ‘I–Thou’ relationships (Martin Buber) and elements of aesthetics and poetics. Although informed by philosophy, linguistics and literary theory, this is not a book about abstractions. Chapter titles such as ‘The Body’s Insistence on Meaning’, ‘Animal Powers’, ‘The Texture of Time’ and ‘Asklepian Dreams’ signal a sustained focus on lived experience. The author draws on his own professional formation and experience as a healer and emphasises the poetic essence of human beings – our capacity to make and to make sense of things – presenting metaphor as central to this species-defining characteristic.

A carefully revised and edited collection of previously published papers, Healing and the Invention of Metaphor achieves a high degree of cohesion, even if occasionally the origins of some chapters as stand-alone pieces remain somewhat perceptible as the reader moves on from one to the next. It is clearly written with a didactic and systematic intent, supported by a number of diagrams, clinical cases and discussions of communal responses to grief and trauma. The fruit of a lifetime’s dedicated practice and research, it suggests the need for a review of the psychiatric curriculum and makes a claim for a place as a groundbreaking first edition of an introductory clinical textbook on what we may call psychiatric poetics, in a similar way that other key textbooks do for psychopathology, history taking and the mental state examination. It should become, therefore, an essential early addition to psychiatric trainees’ bookshelves, to be returned to throughout training. A wide range of experienced clinical supervisors and practitioners will also find it helpful in systematising their thoughts. Readers primarily interested in narrowly operationalised clinical techniques will have to attune to it being more reflective than prescriptive.