Friday, April 13, 2012

Suffering for art is still suffering

Edvard Munch, Self-Portrait in Hell (1903)

"I inherited two of mankind's most frightful enemies — the inheritance of consumption and insanity — disease and madness and death were the black angels that stood at my cradle." 1

-Edvard Munch

Many contemporary observers believe that Edvard Munch, the brilliant Norwegian artist best known for The Scream, had bipolar disorder. According to Rothenberg (2001):
A diagnosis of bipolar disorder with psychosis is based on his own diary descriptions of visual and auditory hallucinations, a multiply documented instance of his travelling throughout Europe manifesting manic disrupted behavior that culminated in his shooting two joints off the ring finger of his left hand, and his psychiatric hospitalization in 1908 for an intensification of auditory hallucinations, depression, and suicidal urges. He also suffered from bouts of alcoholism.
In the same article, the abstract expressionist painter Jackson Pollock was raised as another example of the innovative, tortured, bipolar artist. This might be taken as support for the view that creative individuals are more likely be bipolar than those in the general population. Clinical psychologist Kay Redfield Jamison, herself a prolific and talented person with bipolar disorder, has written extensively on this topic (Jamison, 1989, 1993). However, Rothenberg is actually critical of this general notion: has been alleged that the illness makes creative persons more sensitive because of depressive diatheses and more productive while undergoing manic episodes. These allegations represent a romantic notion about creativity—the saga of the suffering artist—with little evidence to support them. Only comedians such as Jackie Gleason and Dick Van Dyke have seemed to derive direct benefit in their work from manic and hypomanic tendencies. Artistic products containing depressive or manic flight of ideas content have, only at particular times in history, been of social and aesthetic interest.
He continues with specific critiques of the methods used by Andreasen (1987) and Jamison (1989). In her sample, Andreasen found that 43% of writers attending the prestigious University of Iowa Creative Writing Program were bipolar, but only 10% of the controls (who included “hospital administrators, businessmen, social workers, lawyers, medical and computer science students”). The groups were not matched for socioeconomic status, peer recognition, intelligence, or success. Finally, Rothenberg notes that "the Iowa Program has long served as a retreat for writers at times of career shifts or setbacks" -- when they might be more likely to be depressed or otherwise affected by a mental illness.

He's even more scathing about Jamison's study of 47 prizewinning British artists and writers:
Stating that the design of the study could not allow for systematic diagnostic inquiry regarding mania and hypomania, Jamison reported that 38% of the sample had been treated for an “affective” illness. No controls, however, were used in the study. Investigator interviews here also were not “blind” and no attempt at differential diagnosis was made. Subjects were asked only “whether or not they had received treatment, and the nature of that treatment, for a mood disorder” (p. 126), and no further diagnostic assessment was reported. This problem was compounded by the fact that subjects were self-selected which, in the absence of controls, introduces the possibility of an overrepresentation of psychiatric illness in the group.

In the last few days, author and blogger David Dobbs (whom I respect and admire) has written about mental illness and creativity. In Jonah Lehrer Meets Stephen Fry – The Paradoxes of Bipolar and Creativity, he discussed Andreasen's work and the third chapter of Lehrer’s new book Imagine:

...[Andreasen] adds that the ideas one comes up with during such phases tend to be quite original, as the manic person, in a set of long-distance synaptic leaps that Lehrer explains earlier, draws associations that lie beyond the reach of more ordinary modes of thought. (NB: Not everyone with bipolar gets these manic “highs.”)* 2 The ideas they come up with, in short, can be a bit crazy. If they spit them out then and published them, they’d likely be of little worth. But, as Lehrer explains,

then the mania ebbs. The extravagant high descends into a profound low. While this volatility is horribly painful, it can also enable creativity, since the exuberant ideas of the manic period are refined during the depression.

In other words, the emotional extremes of the illness reflect the extremes of the creative process: there is the ecstatic generation phase, full of divergent thoughts, and the attentive editing phase, in which all those ideas are made to converge. This doesn’t take away, of course, from the agony of the mental illness, and it doesn’t mean that people can create only when they’re horribly sad or manic. But it does begin to explain the significant correlations that have been repeatedly observed between depressive syndromes and artistic achievement.

A new idea is borne during mania, refined when it subsides. If you read only that, you can mistakenly think bipolar disorder is a good thing to have, to let run amok. Lehrer is quick to note that but fairly quickly to move on — he’s writing a book about creativity, not depression.

These ideas sparked a discussion and a follow-up post at Neuron Culture, Madness Ain’t All It’s Cracked Up to Be: A Corrective.3 David graciously included an update, saying that "These links between madness and creativity don’t make the more severe manifestations of depression or bipolar disorder any less destructive or painful." Then he quoted me:

Sometimes I think those who talk about bipolar and creativity haven’t been around many severely manic individuals. There’s overspending, lying, cheating, alienating friends, paranoia, psychosis, taking off and abandoning family, etc. I don’t think there’s anything especially creative about that.

Here’s another idea about bipolar and creativity: the percentage of manic people who engage in creative pursuits exceeds that in the general population. However, much of the output is incoherent. Some small percentage might be brilliant (either during or in between episodes), but then how many people are Kay Redfield Jamison or Stephen Fry (collapsing across bipolar subtypes)?

At any rate, bipolar can be a very destructive illness, and I hope those that romanticize it (or are viewed as romanticizing it) truly understand that. End of rant.

Kay Redfield Jamison is an extremely impressive woman, and a wonderful writer and speaker. I don't mean to detract from all she's done in her professional and personal lives to advance understanding of manic-depressive illness. But how many others (with or without bipolar) are as accomplished? You might as well ask, how many of us will win an Oscar or a Nobel Prize? Not many. Expecting that severe mental illness should confer special creativity is a mistake.

In An Unquiet Mind, Jamison said: “I have often asked myself whether given the choice, I would choose to have manic depressive illness…..strangely enough I think I would” (pp 217–218).

Not everyone feels this way, and the title of this post is taken from the quote below (from an anonymous person with Bipolar I disorder):
"...I've read a fair bit about bipolar disorders and creativity, some interesting theories, and have analyzed my own cycles.

But, this disorder destroyed my life and whatever moments of brilliance I may have had during episodes were not at all worth it. Suffering for art is still suffering.

A few people have found good outlets and moods enhance their work. Good for them. Kay Redfield Jamison is an example. Various famous people. Hemingway. Kurt Cobain. Wonder what they'd say about the mad pride movement?"


1 Translations are by Bente Torjusen, Words and Images of Edvard Munch.

2 David kindly added some of my cranky suggestions:
*Added 4/10/12, 6:13 a.m. EDT. Thanks to a friend for a prod on this. Fry addresses it in the film, but I forgot to include that definitional wrinkle in my post the first time through.
3 NOTE: I found the Rothenberg critique after our exchange, while writing the present post. One thing we did discuss was the difference between Stephen Fry's cyclothymia (Fry has called it "bipolar lite") and the full-blown mania of Bipolar I reflected in my quote.


Andreasen NC. (1987). Creativity and mental illness: Prevalence rates in writers and their first degree relatives. American Journal of Psychiatry 144:1288–1292.

Jamison KR. (1989). Mood disorders and patterns of creativity in British writers and artists. Psychiatry 52:125-34.

Jamison KR (1993). Touched With Fire: Manic-Depressive Illness and the Artistic Temperament. New York: Free Press (Macmillan).

Jamison KR (1996). An Unquiet Mind. Crown Publishing Group/Random House, New York, NY.

Rothenberg, A. (2001). Bipolar Illness, Creativity, and Treatment. Psychiatric Quarterly, 72 (2), 131-147 DOI: 10.1023/A:1010367525951

Edvard Munch, Self-Portrait with Skeleton Arm (1895)

What is art -
Art grows from joy and
sorrow - but mostly
from sorrow -
It grows from man's life -
Is art a description of
this life this movement -
Shall one depict the different
pleasures - the different

misfortunes - or shall one

only see the flower - whose
nature substance and vibration
are determined by
the joy and the pain -

I do not believe in an art which
has not forced its way out through
man's need to open his heart -

All art literature as well as
music must be brought out
with one's heart blood -

-E.M., Words and Images of Edvard Munch

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At April 13, 2012 4:09 AM, Anonymous Michelle Dawson 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 think that's a quote from Munch, from *Edvard Munch, the man and the artist*. I haven't read that book but long ago looked up that quote. Not sure where I ran into it first--possibly via Jamison?--or how accurate it is.

I know almost nothing about Munch, but in 2003 looked around a bit (that was before I had a computer), because of something the late Ivar Lovaas said when I spoke with him. He identifed Munch (fellow Norwegian) as his favourite historical autistic.

I have no opinion on Lovaas' diagnosis (he thought Van Gogh was autistic too), but that quote stuck in my head.

At April 13, 2012 10:45 AM, Blogger Ryan Stuart Lowe said...

I remember reading a NYTimes op-ed piece about a research scientist who would give talks on anti-depressants and psychology. He said that without fail, one of the questions in the Q&A would be akin to:

"What if Van Gogh had taken Prozac?"

It's telling that our culture so emphasizes the link between psychological illness and creativity. It might be a matter of analogy: people who are creative/radical often feel marginalized in a more pragmatic society; so do people with psychological illnesses.

At April 13, 2012 2:05 PM, Anonymous creative type said...

Surely great works like these amigurumi happy pills are worth it?

At April 13, 2012 2:18 PM, Blogger The Neurocritic said...

Worth it to whom, creative type?

At April 15, 2012 12:58 AM, Blogger The Neurocritic said...

Thanks, David. It's definitely a multifaceted issue with no simple bottom line.

At April 18, 2012 8:18 AM, Blogger Lonestarslp said...

As someone with BP, I am heartened to see that someone has critiqued Jamison's book. I don't feel it is productive to diagnose someone from history. So many of the symptoms can be used to "prove" many different types of disorders: BP, schizophrenia, anxiety, autism, or OCD. It all depends on your interest. When you have a hammer, everything looks like a nail.

Most of this research looks at artists and their mental status.
It is also important to remember that most people with BP are not highly creative artists. They are people from every walk of life, every socioeconomic level, and every IQ level. We are tired of being criticized for choosing to treat our illness the best way we know how which most of the time does include some type of medication. We are tired of being patronized as if our illness doesn't exist and that we are making it up. So when others treat it as a special opportunity to gain insight, we are appalled.

Personally, I may have gained insight from my illness. Would I give it up? In a heartbeat.

At April 19, 2012 12:26 AM, Blogger The Neurocritic said...

Lonestarslp - Thanks for commenting about your experiences.

At May 04, 2012 8:18 PM, Anonymous Candida Abrahamson said...

Wonderful--couldn't have said it better myself. I find the argument that creativity comes from illness, andn thus justifies the pain that also comes from it, specious--and callous. Busy sending this around to all my favorite social media!

At June 02, 2012 9:45 AM, Anonymous Anonymous said...

Whoa! hold on here--no need to pop this balloon on my account! my brain's been pickled black and blue with depression since junior high school--and it's still okay by me if you keep this one afloat--In fact, let her soar-- Pure puffery but--I gotta admit--flaky romanticism, all right, but really flattering flaky romanticism. Looking at me--you might think I'm mopey and sullen, but you'd be wrong--I'm deep and sensitive. An artist. Given to spells. Got it? It's like a consolation prize.


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