Are Artists Really Mad?

A poet is an unhappy being whose heart is torn by secret suffering, but whose lips are so strangely formed that when the sighs and cries escape, they sound like beautiful music.
-- Soren Kierkegaard

The idea that creativity and insanity are inter-related is not new, although it has been transformed over the centuries depending upon our understanding of both processes and their dynamics. The ancient Greeks had a concept of "divine madness" wherein madness meant not only mental illness but also a state of mind in which human beings were possessed with spirits and inspired by gods. Certain gods offered different kinds of inspiration: Apollo for knowledge of the future, Eros for love and the muses for song and poetry. They also had a word for that process, enthusiasm meaning “god within.” (Ref 2)

Socrates declared, "If a man comes to the door of poetry untouched by the madness of the Muses, believing that technique alone will make him a good poet, he and his sane compositions never reach perfection, but are utterly eclipsed by the performances of the inspired madman." Aristotle asked, "Why is it that all men who are outstanding in philosophy, poetry or the arts are melancholic?"
The notion that creativity and insanity are interconnected have been reflected in the writings of many writers, artists and philosophers over the centuries. Robert Burton in the seventeenth century noted, "All poets are mad." (Ref 3)

Some artists observed that insanity ran in families. Van Gogh in one of his letters wrote, "The root of the evil lies in the constitution itself, in the fatal weakening of families from generation to generation....the root of the evil certainly lies there, and there is no cure for it." (Ref 4)

In the nineteenth century psychologists and psychiatrists began to study the families of artists and psychotics more seriously. Italian psychiatrist Cesare Lombrosa was the first scientist to make an association of mental illness with creativity, but he was overenthusiastic in his conclusions. He believed that all creative people were mentally ill. He gave examples of Schopenhauer, Beethoven, Dostoevsky and many others to prove his hypothesis. (Ref 5) But it was only in the twentieth century that the research methodology became sophisticated enough and the studies of families of psychotic and creative people became extensive enough to provide reliable results. In the second half of the twentieth century, scientists proved that not only did insanity and creativity run in the families but the two could also be found in the same families.

Family studies of people suffering from schizophrenia and manic depressive illnesses (which affect about one per cent of the population) show that both illnesses are far more present in the first-degree relatives of patients. A number of studies clearly show that both forms of mental illness are genetically transmitted and family members of those mentally ill people are more at risk to suffer from mental illness than the general population.

Other family studies in Europe and North America have shown that creative people and their relatives are more at risk to suffer from mental illness than the general population and that creativity and insanity are genetically transmitted in the same families. It is also important to note that the expression of creativity is generalized and not specific to the form. Creative people could be writers, artists, musicians or dancers. (Ref 6)

What is common to creative people and psychotics? It is generally accepted that both groups perform outside the range of normal behaviour with their non-traditional thinking and unconventional lifestyles, both deal with the unconscious mind and both transform the world around them. The difference in them according to American psychiatrist Salvano Arieti is, "Both the creative person and the psychotic want to transform the world but…their transformations are quite different. The creative person wants to change reality to beautify it or enlarge the field of human knowledge or experience in order to provide usefulness, understanding and predictability or to evoke a universal response. The psychotic instead wants to transform reality in a way that fits his private ways of feeding his delusional thinking and does so in ways which do not evoke consensus but often remain strictly individualistic, bizarre, strange, incommunicable and even destructive to self and others." (Ref 7)

One of the important questions mental health professionals face is how to deal with a creative person who has a psychotic episode and suffers from schizophrenia, depression or some other form of mental illness. Artists also wonder about the relationship between the periods of creative expression and psychotic regression.

Some creative people when faced with emotional suffering and mental illness are quite willing to receive treatment, whether medications or psychotherapy or a combination of both, to control their symptoms; but others feel that the medications will interfere with their creativity. They believe that creativity and insanity are part of a package deal. Rather than having none of them they prefer to have both.

Edvard Munch, who had been hospitalized on a number of occasions for his depressive episodes, said, "A German once said to me, ’But you could rid yourself of many of your troubles.’ To which I replied, ‘They are part of me and my art. They are indistinguishable from me and it would destroy my art. I want to keep my sufferings.’" (Ref 1)

In the last few decades there has been a wide range of medications discovered that control many symptoms of mental illness. The medications range from antipsychotics to antidepressants to Lithium Carbonate which has been found quite effective in controlling the symptoms of manic depressive illness.

In 1979 Drs. Polatin and Fieve wrote, "In the creative individual who does his best work in the course of a hypomanic period the complaint regarding the continued use of Lithium Carbonate is that it acts like a ’brake’. These patients report that Lithium Carbonate inhibits creativity so that the individual is unable to express himself, drive is diminished, and there is no incentive. These patients also indicate that when they are depressed, the symptoms are so demoralizing and so uncomfortable they welcome the ’mild high’ when depression disappears and prefer to settle for a cyclothymic’s life of highs and lows rather than an empathic middle of the road mood state achieved through the use of Lithium Carbonate." (Ref 4)

But when such a concern was put to the test and creative people were assessed regarding their creative expression following treatment with Lithium Carbonate, most of them agreed that their creativity had actually increased. They admitted that the control of symptoms with medications had actually improved their concentration. Only a small number stopped medications because of adverse side effects.

There are also mixed feelings expressed by writers as well as therapists on the role of psychotherapy in dealing with artists’ unresolved conflicts. On one extreme are the writers like Virginia Woolf who considered psychotherapy as ’the rape of the mind’ (Ref 8) and on the other there are therapists who feel that artists can enrich their personal and creative lives through therapy. Myron Marshall wrote, "Some creative artists seek psychotherapy because they wish to overcome inhibitions that interfere with the free exercise of their talents." (Ref 9)

Some therapists see psychotherapy in itself as a creative process that enhances growth in the patient as well as the therapist. Albert Rothenburg in his article “Creativity and Psychotherapy” writes, "In other words, both patients and therapists are oriented to, and engaged in, facilitating creation. Both are focused on the patient’s creation of aspects of his or her personality, and both are engaged in an ongoing mutual creative process that involves the patient’s personality, attributes and structure. (Rothenburg and Hausman, 1976). In psychotherapy there is the production of both the new and the valuable. The patient develops better personality attributes and structure. These are valuable both to the patient and society at large." (Ref 10)

Many experts believe that the future of humanity depends upon the insights of creative people, whether scientists, artists, mystics or social reformers, who guide us to the next step of human evolution. Even when they suffer, they suffer on behalf of all of us, so it behooves us to cherish and celebrate their achievements. Kay Jamison wrote, "The great imaginative artists have always sailed ’in the wind’s eye’ and brought back with them the words or sounds or images to ’counter balance human woes.’ That they themselves were subject to more than their fair share of these woes deserves our appreciation, understanding and careful thought." (Ref 4)

Art is a form of therapy. Sometimes I wonder how all those who do not write, compose or paint can escape the madness, the melancholia, the panic-fair inherent in the human situation.
-- Graham Greene


References

1. Panter, Barry. Creativity and Madness, Aimed Press, USA, 1995.
2. Ludwig, Arnold, MD. "Reflections On Creativity and Madness", American Journal of Psychotherapy, USA, January 1989.
3. Burton, Robert. Anatomy of Melancholia, ed. Floyd Dell and Pane Jordon Smith, Tudor, New York, 1948.
4. Jamison, Kay. Touched With Fire - Manic Depressive Illness and the Artistic Temperament , The Free Press, Canada, 1994.
5. Arieti, Silvano. "From Primary Process To Creativity", Journal of Creative Behaviour, Vol. 12, No. 4
6. Anderson, Nancy, MD, Ph.D. "Creativity and Mental Illness: Prevalence Rates in Writers and Their First Degree Relatives", American Journal of Psychiatry, USA, Oct. 1987.
7. Arieti, Silvano. Creativity - The Magic Synthesis, Basic Books Inc. Publisher, New York, 1976.
8. Monore, Russell. Creative Brainstorms, Irvington Publishers Inc., New York, USA, 1992,
9. Marshall, Myron. "Lithium,Creativity and Manic Depressive Illness", Academy of Psychosomatic Medicine, Oct. 1970.
10. Rothenberg, Albert. "Creativity and Psychotherapy", Psychoanalysis and Contemporary Thought, Vol. 7 #2, 1984.