This essay argues that Ralph Ellison's Invisible Man (1952) provides promising ground and a certain imperative to investigate the underexamined intersections between literature and the history of psychiatry. Especially where African American literature is concerned, there has been a general reluctance to approach these categories together, even while anecdotally history records numerous engagements between the two. Ellison, for example, worked closely with Richard Wright and Dr. Fredric Wertham to establish Harlem's LaFargue Clinic, the first and, in its time, only such institution committed to providing modern psychiatric services to any and all who needed them. Ellison found in the clinic's practices a model of social psychiatry that did much to address the shortcomings he observed in Freud's psychoanalytic paradigm, but not enough to fully shake his deep suspicions of the medical establishment's interests in black minds and bodies. Focusing on Invisible Man and an early excised chapter titled “Out of the Hospital and under the Bar,” this essay proposes that Ellison rewrites the terms of psychiatric discourse, embracing a dialectical understanding of neurosis that figures it as both disabling and enabling and deploys it as a claim to modernity and a rejection of and retreat from the modern world. The essay argues that the novel is prescient in its postmodern playfulness, offering a representation of mental illness detached from its specifically psychiatric or broadly medical moorings that anticipates by more than a decade the radical revisions of thinkers like Foucault and Szasz.