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Pink Floyd's ‘Comfortably Numb’: a clinical reflection – Psychiatry in music

Published online by Cambridge University Press:  01 September 2023

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Abstract

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Extra
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Copyright © The Author(s), 2023. Published by Cambridge University Press on behalf of the Royal College of Psychiatrists

‘Comfortably Numb’ is one of the most famous tracks from Pink Floyd's masterpiece album The Wall. The song is conceived as a dialogue between a patient, afflicted by a deep and intolerable pain, and a doctor, who offers him an anaesthetic to soothe his inner suffering.

The patient's pain is so severe that it isolates him and does not allow him to communicate (‘Just nod if you can hear me/Is there anyone home?’). The doctor attempts to calm him, asking ‘Can you show me where it hurts?’. Incommunicability and emotional isolation are pivotal themes, to the point where the patient claims ‘I can't explain, you would not understand/This is not how I am’. The only response to this dull, loud and incommunicable pain is to become ‘comfortably numb’. The numbness is emotional: the pain is intolerable to such an extent that it prevents the patient from ‘seeing’ reality, from perceiving his own emotions. The emotional isolation brings to mind the isolation that can occur during a delusional experience or in substance misuse, both defences against an intolerable reality.

On the journey to ‘comfortable numbness’, the protagonist perceives himself as immersed in the sea, and sees the doctor like ‘a distant ship smoke on the horizon’: the sea and the water, in literature and philosophy, are often juxtaposed with the unconscious. On the inner journey, the protagonist partially comes into contact with his suffering core, which seems to be associated with adverse experiences during childhood (‘When I was a child I had a fever/My hands felt just like two balloons’), leading him back to his current state of suffering (‘Now I've got that feeling once again’).

However, the doctor is unable to see the deep core of the suffering, limiting himself to treating the symptom. In the scene from the movie The Wall, when ‘Comfortably Numb’ is played, the protagonist Pink is a performer before a concert, and he's found unconscious by the doctors (probably, in an overdose). He is then administered the ‘little pin prick’, which the doctor claims will make him feel better. The possible contents of the injection have been argued at length: many claim it was naloxone, for a heroin overdose, but others argue that it was a mixture of amphetamines, to increase wakefulness, or corticosteroids, for stress management.

Broadening the reflection, the meaning of the song can be extended to what usually happens in mental health contexts, where the patient manifests a symptom (a delusion, a depression, an addiction), which cannot be traced back to inner suffering and which stems from experiences that they have repressed, such as childhood trauma and abuse. The task of the therapist is not only to treat the symptom, but to really get to ‘where it hurts’. Only in this way will the suffering be cured.

It may be worth questioning, as mental health practitioners, how often we try to get to the core of the inner suffering, with a longer and emotionally intense pathway, or how often we simply treat the symptom with a ‘little pin prick’, as in the passage described.

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