If the Illness Creates Art, Why Do We Need the Cure?

E. Timuçin Oral

Transcultural Dialogues in Medical Humanities Nov 25th 2016

Agenda

• Creativity & Psychopathology

• Origins

• Studies, “Case reports”

• Do they really correlate?

• Focusing on bipolar illness

• Creative patients and is it limited to art?

• What about the treatment?

Creativity & Mental Ilness

• The link —-— between creativity and mental illness is one of the most controversial topics in modern creativity research.

• Trying to link creativity to mental illness is too broad to be productive. More focused questions, (specific disorders, domains, developmental periods, and levels) may help more.

if any

Vincent van Gogh 1883, Art Institute of Chicago

Weeping Woman

Salvador Dali Lobster Telephone, 1936

The only difference between myself and a madman is that I am not mad.

The only difference between me and the Surrealists is that I am a Surrealist.

I don't do drugs - I am drugs.

Every morning when I awake, the greatest of joys is mine: that of being Salvador Dalí.

Salvador Dali (1904 –1989)

The Swallow's Tail — Series on Catastrophes (1983)

Origins of the relationshipPlato: All the good poets are not in their right mind when they make their beautiful songs. This is divine madness.

Seneca: There is no great genius without some touch of madness

Shakespeare: The lunatic, the lover and the poet /Are of imagination all compact (A Midsummer Night's Dream)

Dryden: Great wits are to madness near allied / And thin partitions do their bounds divide. (Absalom and Achitophel 1681)

Lamartine: Genius carries in itself a principle of destruction of death, of madness, as the fruit carries in itself the worm

“Nullum magnum ingenium sine mixtura dementiae"

1. Most prominent in the order of frequency is an early death 2. He may help swell the criminal ranks 3. Ultimately find his way into a hospital for the insane 4. Least frequently, he startles the world by an invention or

discovery in science or by an original composition of great merit in art, music or literature

Conceptions of the Mad Genius

1895

“Genius is one percent inspiration, ninety-nine percent perspiration”

Thomas Alva Edison, 1903

Psychiatric studies

• The rate and intensity of symptoms appear to be higher among eminent creators (vs gen. population)

• The more eminent the creator, the higher is the expected rate and intensity of the symptom.

• Te rate and intensity of symptoms varies according to the specific domain of creativity.

• Eminent creators’ families also have a higher rate and intensity of symptoms

K.R. Jamison, Scientific American, Feb 1995

Psychiatric studies

! Ludwig spent 10 years laboring over biographies that were reviewed in the NYT between 1960-90; gathered 1,005 and distributed them to 18 professions. ! He applied Creative Achievement Scale (CAS) &

ICD-9 criteria of WHO ! Creative people had higher psychopathological values

! He found an over-representation of bipolar disorder, schizophrenia-like psychosis and depression in the creative arts group

! Symptoms had to appear earlier and life-time depression scores were predicting their cretaivity

Creative Achievement and Psychopathology: Comparison Among Professions Arnold Ludwig (1992)

Creative Achievement and Psychopathology: Comparison Among Professions

Arnold Ludwig (1992)

Alfred Lord Tennyson 1809-1892

Tennyson’s Pedigree

Emilie, 37y

Robert, 41y

Ludwig

Schumann’s Pedigree

Domschke K BJP 2010;196:325-325

The British Journal of Psychiatry 199, 373–379 (2011)

Karolinska Institutet, Stocholm

Sch

BP

UP

Psychometric studies

• Highly creative individuals score above normal level on several dimensions associated with psychopathology. (e.g., creativity is positively correlated with psychoticism scores).

• The higher the level of creativity displayed, the higher the scores tend to be on the clinical scales.

• Artistic creators still have more elevated scores than do scientific creators.

You have some schizophrenia and some psychological

depressions and much more sir

Shrink

ShrinkYihhouuou I’ll become an artist. I’ll paint, carve, write poems, novels now

D Hs Hy Ma Pa Pd Pt ScSCALE

30

40

50

60

70

80

90

SCORE

PSYCHOTICWRITERS1WRITERS2NORMALNormal? Writers2 Writers1 Psyhotics1 Highly creative 2 Successful

Barron FX (1963), Creativity and Psychological Health: Origins of Personal Vitality and Creative Freedom. Princeton, Van Nostrand

“First, contrary to popular as well as professional belief, there is no specific personality type associated with outstanding creativity. Creative people are not necessarily childish or erratic in human relationships, as is often thought, nor are they necessarily extraordinarily egotistic or rebellious or eccentric.

… Only one characteristic of personality and orientation to life and work is absolutely, across the board, present in all creative people: motivation… they want specifically to create and to be creative, not merely to be successful or effective or competent”

Albert Rothenberg

! In their study of over 800 people regarded as geniuses Lange-Eichbaum & Paul argued that it is within the group of individuals with exceptional gifts and a concomitant psychopathology that history’s greatest geniuses are found; (e.g. Michelangelo, Luther, Napoleon, Beethoven, Schopenhauer and Strindberg)

! They stated that ‘it cannot simply be a chance matter that among geniuses the healthy constitute only a small minority’

Lange-Eichbaum & Paul, 1931

Studies in creative people

! Adele Juda investigated 294 highly gifted artists and scientists born in German-speaking countries between 1650–1900 during 1927-1943

! No relationship between highest mental capacity and psychic illness, highly gifted individuals had increased rates of psychopathology.

! Schizophrenia and psychopathy was higher among artists while there were more bipolar scientists.

• Painters 27% • Poets 50% • Architects 17% • Scientists 19% • General population 10-12%

Juda A (1949). The relationship between highest mental capacity and psychic abnormalities. Am J Psychiatry; 106: 296–307

! During 1970-80’s 30 creative writers at the University of Iowa Writers’ Workshop, compared with healthy controls (K. Vonnegut, J. Irving, R. Lowell, T. Williams worked)

! Hypothesis: Cretativity-Psychosis are related. ! Evidence: James Joyce was schizotypal, daughter

was schizophrenic; Einstein’s son is physicist ! Result: In creative writers and in their first degree

relatives there were no schizophrenia but mood disorders.

Andreasen NC (1987). Creativity and mental illness: Prevalance rates in writers and their first degree relatives. Am J Psychiat 144:1288-92.

affective disorderbipolar disorderbipolar Ibipolar IImajor depressionschizophreniaalcoholismsubstance abusesuicide

x3

x4x4,5

Andreasen NC (1987). Creativity and mental illness: Prevalance rates in writers and their first degree relatives. Am J Psychiat 144:1288-92.

At least one “Serious Depressive” Episode

poetwriterpaintercomposersportsmensoldierexplorer

The Price of Greatness Arnold Ludwig (1995)

We poets in our youth begin in gladness;

But thereof comes in the end despondency and madness.”

William Wordsworth 1770-1850

Jamison “Touched with Fire” (1993)

Schizophrenia and Creativity

• Isaac Newton • Guy De Maupassant • Robert Schumann • Copernicus • Descartes • John Forbes Nash

(Prentky, 1989)

• Andy Warhol • Anne Sexton • Rodin • Charlie Parker • John Forbes Nash • Rene Magritte • Salvador Dali • Van Gogh • Virginia Woolf • Mozart

Psychosis?

• Andy Warhol • Anne Sexton • Rodin • Charlie Parker • John Forbes Nash • Rene Magritte • Salvador Dali • Van Gogh • Virginia Woolf • Mozart

• Isaac Newton • Guy De Maupassant • Robert Schumann • Copernicus • Descartes • John Forbes Nash

Schizophrenia?

“We of the craft are all crazy. Some are affected by gaiety, others by melancholy, but all are more or less touched.”

Lord Byron 1788-1824

Mood score Creativity score

3.0

2.5

2.0

1.5

1.0

Mood vs Creativity Scores of Bipolar Patients

Jamison, Psychiatry 1989

54 artists and 33 healthy volunteers

• Mood Disorders in artists and in their relatives is significantly higher than the control group (p<0.001)

• A significant positive correlation was found between artistic creativity and mood episodes (p<0.001)

Mumcu, Ayla, Oral (1998) The Relationship Between Mood and Artistic Creativity

Robert Schumann

“There is a prevailing tendency to paint all of Schumann’s life with the same pathological brush. This approach is especially popular with those who use the “psychological autopsy” technique for diagnosing the deceased.”

John Worthen (2007)

I had promised myself: I wasn’t even going to write anything. What was writing but another ambition? I was going to await death here, amongst these decent people. What did I need ambition and exasperation for? I couldn’t do it. I ran to the tobacconist and bought pencil and paper. I sat down. I took out the pocketknife I had bought to whittle small sticks if I were to get bored whilst walking through the deserted streets of the island. I sharpened the pencil. After having sharpened it, I held and kissed it. I would have gone mad if I hadn’t written

• A 40-year study of 1.2 million Swedish people showed that (except bipolar disorder) those in scientific and artistic occupations were not more likely to suffer from psychiatric disorders.

• Full blown mental illness did not increase the probability of entering a creative profession (even in bipolar disorder it is 8%).

• What was striking, however, was that the siblings of patients with autism and the first degree relatives of patients with schizophrenia, bipolar disorder, and anorexia nervosa were significantly overrepresented in creative professions

Simon Kyaga et al (2012). Mental illness, suicide and creativity: 40-Year prospective total population study. Journal of Psychiatric Research, 1-8

Creativity and Bipolary

• “Manic depressive temperament is biologically “an alert and excitable system”, creating around itself “both the possibilities and chaos afforded by altered experiences and fluctuating tempos”. Kay Jamison

• “Bipolar illness augments the creative capacity that a person already has”. Neil Cole

“Creative” Patients

• Born in 1844, Agnes Richter, a seamstress, was admitted to a lunatic asylum in 1893 and spent the last 23 years of her life there.

• At some time, possibly around 1895, using the only materials available, Agnes made herself a jacket.

• Elegantly styled, it reflected her tiny, slightly deformed shape. All over, inside and outside, forwards and backwards, Agnes embroidered it.

Agnes’s Jacket

Agnes’s Jacket

Role of Treatment• 24 “manic depressive” artists, in whom prophylactic

lithium had attenuated or prevented recurrence of their mood swings, about their creative power on lithium.

• Twelve reported increased artistic productivity (judged as reflecting prevention of episodes and increased ability to maintain their artistic discipline).

• Six reported no change. • The six who reported decreased productivity tended

to require their highs to maintain productivity.

Mogen Schou, 1979

“I see clearly now that for the last few days I have been living in a state of increasing mania — almost off the rails at the end. It almost seems as if I couldn’t be with you any length of time without acting with abysmal myopia and lack of consideration. My disease, alas, gives one (during its seizures) a headless heart.”

Robert Lowell

Bryan Charnley• Bryan John Charnley was born on 1949 in Stockton. • At the age of 18, he suffered a nervous breakdown but

was able to study at Leicester School of Art. Diagnosed as schizophrenia. Between 1971-77 he lived with his parents between periods of hospitalisation.

• In 1978 he moved to Bedford and began painting. His work began to address his inner life, dreams and illness

• In 1984 his paintings were purchased by the Bethlem Royal Hospital. He had exhibitied at the Royal College of Art in 1990.

• In July 1991 Bryan Charnley committed suicide.

Results• Creativity requires the cognitive ability to be open to

serendipitous events and accidental results.

• Some psychopathological symptoms correlate with the creativity, moderate amounts of these symptoms may be positively associated

• Psychopathology is not the only possible source for the creativity.

• Relatives of the patients more likely have creativity comparing to patients

Thank you :)

etoral@superonline.com @timucinoral