Creativity & Schizophrenia
Antonio Preti
FAITH
OF OUR FATHERS
The
Italian psychiatrist and anthropologist Cesare Lombroso was in Nineteenth
century’s most fervent defender of the idea of an intrinsic link between
genius and madness. Lombroso was among the first to apply a less anedoctal
method to the study of the correlates of deviant behaviour (Preti, 1997a). Using
methods derived from anthropometry and the newborn science of statistics,
Lombroso investigated abnormal behaviour in its different manifestations:
madness, criminality, eccentricity, genius. Lombroso’s main idea concerns the
shared heredity of both somatic and psychic traits common to all individuals
expressing behaviour deviant from the norm. For Lombroso genius also had to be
considered an abnormal condition, alongside psychosis. The Italian researcher
did not merely consider the biographies of eminent people or their works, but
exposed artists and writers to experimental investigations, comparing their
reactions to those of mentally ill patients. Even acknowledging differences and
exceptions, he arrived at the conclusion that «between the physiology of the
man of genius and the pathology of the insane there are many points of
coincidence» (Lombroso, 1891). This opinion acquired such a value of absolute
truth that Wilhelm Lange-Eichbaum could affirm in his monumental study “Genie,
Irrsinn und Ruhm” that «the great majority of geniuses were abnormal
psychopaths, and many were also neurotics» (Wittkower and Wittkower, 1963). The
improper use of statistical methods occasionally led to grotesque results, like
the attempt of the Pannenborg brothers, in the 1920’s, to establish a
psychopathological typology of the artistic character. Even scrupulous
researchers, like Ernst Kretschmer, tended towards exaggeration in his attempts
to apply the biological laws of personality to interpretations of the works of
artists and scientists (Wittkower and Wittkower, 1963).
Most
studies performed in the positivistic era in order to either confirm or refute
Lombroso’s hypothesis rest on
biographical evidence (Richards, 1981). This raises the suspicion that these
studies claiming a higher prevalence of psychopathologies among creative or
eminent people, were biased by overexposure. For individuals, such as artists in
the public eye more information is available about their private lives: this
could determine an apparently higher prevalence of disorders that normally tend,
as a result of negative stigma, to
be hidden whenever possible. In addition, some temperamental traits widespread
among creative people, like eccentricity, uneasiness, propensity to excess and
experimentation, could be a reflection not of an underlying mental disorder, but
above all of the tolerance by society of the behaviour of individuals who obtain
achievement. In some way this behaviour is a secondary product of the
achievement, rewarded since it permits the expression of dissenting demands
which by the majority of people are not able to express and which are not
directly linked to the creative utterance. But negative result were also reached
contrary to the hypotheses of Lombroso and his followers: among others is a huge
study by psychiatrist and sexuologist Havelock Ellis (1904), who demonstrated a
clear link between good mental health and creativity among eminent British
people.
Despite
these reservations, even later studies, performed using methods applying
specific nosographic categories and direct confrontation with the candidate
through interviews and inventories, yielded similar results, with a higher
prevalence of mental disorders among gifted people than among the general
population (Preti and Miotto, 1997b; Lauronen et al., 2004). The two principal
studies performed in the era preceding the systematic ordering of the more
recent classifications (DSM III, and now IV, and ICD 9, and now 10), show among
both artists and scientists a prevalence of severe mental disorders
significantly higher than among the general population, with a strong familial
association between creativity, psychopathology, and higher suicide rates (Preti
and Miotto, 1999) . In a study performed in
Some
decades later JL Karlsson (1978), in a study of
The
introduction of drugs with a proved efficacy in the treatment of psychoses, like
neuroleptics for schizophrenia and litium for manic-depression, together with
the use of less empirically based criteria for diagnosis, in the mid 1970s
allowed investigations with more reliable methods, less subject to the
discretion of the researcher. In particular, better recognition of the less
typical forms of manic-depression, now called bipolar disorder according to the
nosographic changes introduced by the ICD and DSM, lead to the observation that
most creative individuals suffer from a mood disorder, just as the author of the
“Problemata XXX” stated (Andreasen and Glick, 1988; Jamison, 1993; Preti and
Miotto, 1997b). The scientists Boltzmann and Babbage (the father of modern
computer science); the composers Rossini and Tchaikovsky (who commited suicide
drinking a cup of water contaminated with vibrio colerae); the statesmen
Churchill and Lincoln; the painters van Gogh and Pollock; the philosophers
Wittgenstein and Kierkegaard; the writers Pavese and Hemingway (both of whom
committed suicide): all suffered from bipolar
disorders. Poets and writers seem to be particularly prone to developing mental
problems, generally of a depressive type, leading to assertions that one cannot
write with success without being “exposed to the Dark Sun of Melancholy”.
Nancy
C. Andreasen performed an extensive study in the mid 1970s on the qualities
which characterized the styles of thought of a group of writers who were
participating in the annual Writer’s Workshop of Iowa University, and, using
the criteria of the rising DSM-III, found a high prevalence among them of mood
disorders, mostly of a bipolar type (Andreasen and Powers, 1975; Andreasen,
1987; Andreasen and Glick, 1988). A clear prevalence of psychopathologies from
the affective spectrum among creatively talented people was later
reported by KJ Jamison (1989) in a study dedicated to 20th Century
English poets; by JJ Schildkraut and coworkers (1994) among American Abstract
Expressionist painters; and by AM Ludwig (1994) among 30 American female writers.
Kay Jamison (1993), in a study covering three centuries, reported similar
results limited to writers and poets, with high rates of mood disorders, in most
cases of a bipolar type. In the Jamison study, suicide and alcoholism rates were
also very high: as was the familial transmission of both psychopathological risk
and creativity.
Several
aspects characteristic of manic-depression may offer a basis for the higher
prevalence of mood disorders among creative people. During euphoric phases, for
example, cyclothymic individuals exhibit greater
energy which can favour their involvement in productive activities and their
ability to put up with fatigue. In addition, increased fluency of mental
associations, which in mania is expressed in the dramatic experience of
“flight of ideas”, allows a greater processing of information and a greater
articulation of ideas, favouring original or unusual associations. This is often
accompanied by improvements in both memory and concentration, which render even
more productive the hightened imaginative potential of these individuals. People
with recurrent mood disorders also tend to be more emotionally reactive, which
gives them greater sensitivity and sharpness. The lack of inhibitions permits
them unrestrained and unconventional
expression, less limited by accepted norms and customs: this makes them more
open to experimentation and risk-taking behaviour, and, as a consequence, more
assertive and resourceful than the mean. Even the depressive phases can favour
abilities contributing to achievement. Meditation, introspection and reasoning
are favoured during depressive withdrawn phases. Depressive episodes, in
addition, give access to “inner dimensions” of life,
allowing considerations of themes linked to guilt, sorrow and death. The
elaboration of these feelings can offer subject matter for creative expression
in many fields, but particularly in literature, as demonstrated by the high
prevalence of depressive disorders among poets and writers.
A
smaller group of studies, however, indicate that the style of thought which is
typical of schizophrenics can also contribute to the expression of a creative
talent (Arieti, 1976).