Classic and Contemporary Poetry: Explained

Anne Sexton’s poem "What Has It Come To, Dr. Y, Fr. Letters to Dr. Y" is an intense and introspective exploration of the relationship between the speaker and their therapist, Dr. Y. Through vivid and often stark imagery, the poem delves into themes of dependency, vulnerability, and the desperate need for guidance and salvation. The speaker’s relationship with Dr. Y is portrayed as both vital and troubling, as they navigate the complex terrain of their psyche, with Dr. Y serving as both a savior and a source of existential anxiety.

The poem opens with a direct and almost plaintive question: "What has it come to, Dr. Y. / my needing you?" This sets the tone for the entire piece, where the speaker grapples with the discomfort and vulnerability that comes from relying so heavily on another person. The speaker’s need for Dr. Y is not just physical or emotional but existential, as they describe their daily life as being "stuffed into a pine-paneled box," evoking a sense of confinement and suffocation. This imagery suggests that the speaker feels trapped in their own life, reduced to a mere object or a shell of their true self.

Dr. Y’s office is depicted with clinical detachment: "You work days / with your air conditioner gasping / like a tube-fed woman." The air conditioner, a symbol of the sterile environment of the therapist’s office, is anthropomorphized, likened to a woman dependent on life support. This comparison highlights the artificiality and fragility of the environment in which the speaker seeks help, further underscoring the sense of desperation that pervades the poem.

As the speaker enters Dr. Y’s office, they describe the therapy session as working "over the cadaver of my soul." This powerful image suggests that the speaker feels spiritually or emotionally dead, as if their soul is something to be dissected and examined, rather than something alive and vibrant. The therapy process is likened to creating a "stage set out of my past," where "painted puppets" are stuffed into place, emphasizing the performative and constructed nature of memory and identity. The speaker’s past is something that can be manipulated and controlled, yet it remains distant and artificial, much like the puppets.

The speaker expresses a desire for strength and self-sufficiency, crying out, "I will be steel! / I will build a steel bridge over my need! / I will build a bomb shelter over my heart!" These declarations reveal the speaker’s yearning to protect themselves from vulnerability and pain, to become impervious to the emotional turmoil that necessitates their sessions with Dr. Y. However, the speaker quickly acknowledges that "my future is a secret. / It is as shy as a mole," suggesting that despite their bravado, the future remains uncertain and elusive, burrowed deep within the subconscious.

The metaphor of the "irritating pearl" and the "necessary shell" encapsulates the dynamic between the speaker and Dr. Y. The speaker sees themselves as the "irritating pearl," a source of discomfort and challenge, while Dr. Y is the "necessary shell," providing protection and structure. This dynamic reflects the speaker’s recognition of their own neediness and the essential role that Dr. Y plays in their life, despite the discomfort it causes.

The speaker’s dependency is further explored through a series of metaphors that emphasize their reliance on Dr. Y: "You are the twelve faces of the Atlantic / and I am the rowboat. I am the burden." Here, the speaker likens themselves to a small, vulnerable vessel adrift in a vast and powerful ocean, with Dr. Y embodying the multiple and ever-changing faces of the sea. The question, "How dependent, the fox asks? / Why so needy, the snake sings?" introduces a sense of internal conflict, as if the speaker is aware of the potentially unhealthy level of their dependency, yet feels powerless to change it.

The poem reaches a crescendo of vulnerability and gratitude as the speaker describes Dr. Y’s efforts to rescue them: "Time after time I fall down into the well / and you dig a tunnel in the dangerous sand." Dr. Y is portrayed as a tireless and brave savior, risking their own safety to rescue the speaker from the depths of despair. The image of Dr. Y taking "the altar from a church and shore[ing] it up" suggests a spiritual dimension to their role, as if Dr. Y is not just a therapist but a quasi-religious figure, providing the speaker with a sense of purpose and redemption.

The speaker’s dependency is further highlighted by the metaphorical gifts Dr. Y provides: "You give me hoses so I can breathe. / You make me a skull to hold the worms / of my brains. You give me hot chocolate / although I am known to have no belly." These lines underscore the deep, almost parental care that Dr. Y offers, tending to the speaker’s most basic needs, even as the speaker feels themselves to be hollow or lacking in essential qualities. The mention of "hot chocolate," a symbol of comfort and warmth, contrasts sharply with the earlier image of the sterile air conditioner, suggesting that Dr. Y provides both emotional and physical sustenance.

Despite this deep dependency, the speaker also expresses a sense of defiance: "What has it come to / that I should defy you?" This line introduces an element of rebellion, as if the speaker resents their own need for Dr. Y and wishes to break free from this dependency. The subsequent metaphors—being "a copper wire / without electricity," "a Beacon Hill dowager / without her hat," "a surgeon / who cut with his own nails"—all convey a sense of incompleteness and inadequacy without the essential counterpart that Dr. Y represents.

The poem concludes with two striking metaphors: "I would be God / without Jesus to speak for me. / I would be Jesus / without a cross to prove me." These lines encapsulate the speaker’s existential crisis, where they see themselves as fundamentally incomplete or ineffective without the necessary counterpart—be it Dr. Y, Jesus, or the cross. The speaker’s identity and purpose are inextricably tied to their relationship with Dr. Y, much as Jesus’ identity is tied to his crucifixion. Without this relationship, the speaker feels they would lack the proof or validation of their own existence.

In "What Has It Come To, Dr. Y, Fr. Letters to Dr. Y," Anne Sexton explores the complex and often contradictory nature of the therapeutic relationship. The poem delves into the deep dependency and vulnerability that comes with seeking help, while also acknowledging the discomfort and defiance that such dependency can provoke. Through rich, metaphorical language and a confessional tone, Sexton captures the intensity of the speaker’s relationship with Dr. Y, portraying it as both life-saving and deeply unsettling. The poem ultimately reflects on the human need for connection and validation, even as it grapples with the existential questions of identity and purpose.

Copyright (c) 2025 PoetryExplorer

Discover our Poem Explanations and Poet Analyses!

Other Poems of Interest...