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M. A. Istvan Jr.'s avatar

"Clinical Excommunication" is a poem about the coercive grammar of therapeutic and institutional interpretation — the way certain professional frameworks demand a particular kind of self-disclosure, and penalize those who withhold it not by engaging with their refusal but by converting it into a diagnostic category. Its nine lines move through three tercets with comic precision, deploying two extended analogies before arriving at the clinical notation that retroactively names what the speaker's resistance has been classified as. The poem's argument is compressed into its title: excommunication is a religious act, the formal expulsion of a member who has failed to conform to doctrinal requirement. The clinical setting, the poem insists, performs the same operation under different vocabulary.

The governing analogy structure — psychoanalyst, Pentecostal revival, mall hypnotist — is the poem's central formal achievement. Each figure represents a system that requires the subject's surrender as proof of the system's validity. The psychoanalyst needs the mommy-daddy answers: the stock narrative of parental origination that confirms the theoretical framework before the session has properly begun. The Pentecostal reverend — "Reverend Sho'Nuff," whose name carries its own freight of performative authority — needs the congregant to fall under the holy-ghost hand, to drop as physical evidence of the spirit's presence. The mall hypnotist needs the subject to bark, to perform the loss of autonomous will that justifies the whole enterprise. In each case, the subject's non-compliance is not interpreted as evidence that the system may be limited or wrong. It is interpreted as evidence that the subject is deficient — a "spoilsport," a resistant case, a pathology.

"Reverend Sho'Nuff" is doing more than comic work. The name evokes the villain of the 1985 martial-arts film "The Last Dragon," a figure of theatrical self-proclaimed authority — "the master" — whose power depends entirely on others' willingness to recognize it. Applied to the Pentecostal revival context, the name quietly argues that the revival's spiritual authority and the villain's martial authority operate by the same logic: both require the crowd's performed submission to sustain the performance of power. The speaker who does not drop is not failing spiritually; they are declining to participate in a theater that requires their body as a prop.

The mall hypnotist comparison is the poem's most democratizing move. By placing the psychoanalyst in a sequence that runs through a Pentecostal revival to a mall hypnotist, the poem performs a deliberate bathos — a descent in cultural register that is also an argument about structural equivalence. The psychoanalyst operates in the most credentialed and theoretically elaborated of the three frameworks; the mall hypnotist operates in the least. But the demand each makes on the subject is identical: surrender your autonomous interpretive authority, perform the response the system requires, and thereby validate the system's power. The poem does not argue that psychoanalysis is as intellectually thin as mall hypnosis. It argues that the specific demand for compliance, and the specific penalty for non-compliance, are structurally the same across all three.

The poem's punchline — "and so / the notepad scribble: 'sev antisoc.'" — is where the argument lands with its full weight. The abbreviation performs the excommunication: "severe antisocial" rendered in the shorthand of clinical documentation, a notation made not because the speaker has displayed antisocial behavior in any meaningful sense but because they have declined to provide the responses that the framework requires. The "notepad scribble" is the clinical equivalent of the excommunication document — the formal record of failed compliance, converted into a diagnosis. That it is a scribble matters: this is not careful clinical observation but the quick notation of professional irritation, the diagnostic category deployed as punishment for the subject's refusal to be legible in the expected way.

The title's "excommunication" holds the poem's deepest irony. Excommunication is supposed to name a genuine breach — a heresy, a departure from the community's essential doctrine. What the poem exposes is that the breach here is not doctrinal but procedural: the speaker has not denied the validity of psychology or the existence of childhood influence, has simply declined to produce the expected narrative on demand. The clinical framework, like the religious one, cannot distinguish between genuine dissent and the refusal to perform. Both get the same notation.

Formally, the three tercets mirror the three analogies with elegant economy. Each tercet introduces a figure of institutional authority and the specific performance that figure demands, building a cumulative case before the final tercet delivers the verdict. The enjambment is precise — "and so" at the opening of the final tercet functions as a logical connective, the conclusion of an argument the poem has been building, before "the notepad scribble" arrives as the punchline that is also a diagnosis. The colon before the quoted notation gives it the weight of evidence — this is the record, the document, the excommunication made legible in four characters of clinical abbreviation.

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