Creativity, the arts, and madness
Neihart, M.
Roeper Revew
Vol. 21, No. 1, pp. 47-50
September 1998

This article by Maureen Neihart explores studies on the link between creativity and madness. It explains that there definitely is a more frequent occurrence of certain types of mental problems in those who are exceptionally creative. It also brings up questions such as whether the creativity causes the higher incidence of mental illness or visa versa.

A brief, historical review of the alleged association between creativity and madness is followed by highlights from recent research in psychiatry and clinical psychology that address this relationship. The precise nature of this link is explored from the perspectives of several disciplines, and implications for the creative process in gifted education are discussed. Creativity is defined as the production of something both new and valued. Madness is defined as self destructive deviant behavior.

Maureen Neihart is a clinical psychologist in Billings, Montana. She is a Board member of the National Association of Gifted Children (NAGC) and an Editor of the Roeper Review.

Men have called me mad; but the question is not yet settled, whether madness is or is not the loftiest intelligence-whether much that is glorious-whether all that is profound-does not spring from disease of thought-from moods of mind exalted at the expense of the general intellect. They who dream by day are cognizant of many things which escape those who dream only by night. In their grey vision they obtain glimpses of eternity....They penetrate, however rudderless or compassless, into the vast ocean of the light affable (Edgar Allan Poe, cited in Galloway, 1986, p. 243).

The belief that madness is linked with creative thinking has been held since ancient times. It is a widely popular notion. "Deviant behavior, whether in the form of eccentricity or worse, is not only associated with persons of genius or high-level creativity, but it is frequently expected of them." (Rothenberg, 1990, p.149). Since the time of the Greek philosophers, those who wrote about the creative process emphasized that creativity involves a regression to more primitive mental processes, that to be creative requires a willingness to cross and recross the lines between rational and irrational thought.

What is the evidence that there is a link between creativity and madness? What account can be given for this link, biologically and psychologically? And what does this association suggest for related research and our understanding of creative people? The aim of this article is to describe what creativity and madness have in common and to discuss implications for creative thinking in gifted education. The article begins with a brief, historical overview of the topic, followed by some highlights of studies on creativity and mental illness. Explanations for the possible link between creativity and madness are then addressed. Creativity is defined as the production of something that is both new and valued and madness is defined as a self destructive deviation in behavior. The article concludes with a discussion of implications for the creative process in gifted education and questions for further research.

Historical Overview
The notion that inspiration requires regression and dipping into irrationality in order to access unconscious symbols and thought has been popular across disciplines for hundreds of years. Plato said that creativity is a "divine madness...a gift from the gods." Seneca recorded Aristotle as having said, "No great genius was without a mixture of insanity" (Langsdorf, 1900, pp. 90-91). One of Shakespeare's characters says, "The lunatic, the lover and the poet are of imagination all compact," and Marcel Proust said, "Everything great in the world is created by neurotics. They have composed our masterpieces, but we don't consider what they have cost their creators in sleepless nights, and worst of all, fear of death."

More recently, at the end of the last century, physicians were very interested in the physical causes of mental illness as well as in the genetic causes of genius. The physician, Lombroso (1889), wrote about the connections he believed to exist between genius and madness. Acceptance of his ideas persisted well into the 20th century until Lewis Terman's (1925) data suggested that people of high ability exhibited less incidence of mental illness and adjustment problems than average. But at the same time that Terman was beginning to publish the first round of his results, Freud was formulating his psychoanalytic concepts in Vienna. Freud analyzed literary works and the lives of eminent creative people because, "He believed that great works of art and literature contained universal psychological truths and that the study of artists' and writers' lives would reveal basic psychological truths in persons of heightened sensibility and talent." (Rothenberg, 1990, p. 80). Since the time of Freud's analysis, other psychoanalysts and psychologists have continued to conduct scores of pathographies, diagnostic analysis of the works or lives of eminent creative people in an effort to improve our understanding of the relationship between creativity and madness (Jamison, 1993; Panter, et. al, 1995).

In this century the clinical literature, particularly the psychoanalytic writing, is full of theories about the relationship between creativity and emotional illness (Feldman, 1989; Greenacre, 1957; Jamison, 1993; Lowenfeld, 1941; Niederland, 1976; Panter, Panter, Virshup and Virshup, 1995; Pickford, 1981; Richards, 1981; Rothenberg, 1990). A long-held view in psychiatry is that artistic endeavors heal the artist, whose work is then healing to others. It is important to note that the studies tend to focus on a subpopulation of artists in particular: writers, poets, and visual artists.

There are numerous examples of artists who used their work to save their minds. For example, Anne Sexton, who was institutionalized for her psychosis wrote, "Poetry led me by the hand out of madness" (cited in Jamison, 1993, p. 122) and Jackson Pollock's large canvas drippings have been viewed by several investigators as an attempt to organize his chaotic inner life (Feldman, 1989; Virshup, 1995; Wyshup, 1970). A basic premise of the expressive therapies (e.g. art, music, and dance therapy, etc.) is that writing, composing, or drawing, etc., is a means to self-understanding, emotional stability and resolution of conflict. Creativity provides a way to structure or reframe pain. This, perhaps, is what much good comedy is about.

Findings From Studies on Creativity and Mental Illness
In the last two decades there have been numerous systematic investigations into the alleged relationship between creativity and madness. Albert Rothenberg, Kay Jamison, and Nancy Andreasen are a sample of investigators who have explored this topic. What do creativity and madness have in common? Observations from psychiatric studies suggest that there are three characteristics common to both high creative production and madness. These are disturbance of mood, certain types of thinking processes, and tolerance for irrationality.

Eminent Creative People

with Probable Mood Disorders

John Berryman Honore De Balzac
Hans Christian Andersen Robert Burns
Samuel Clemens Lord Byron
Charles Dickens Samuel Taylor Coleridge
Isak Dinesen Emily Dickenson
Ralph Waldo Emerson T.S. Eliot
William Faulkner Victor Hugo
F. Scott Fitzgerald John Keats
Ernest Hemingway Edna St. Vincent Millay
Henry James Sylvia Plath
Eugene O'Neill Edgar Allan Poe
Leo Tolstoy Anne Sexton
Tennessee Williams Ezra Pound
Virginia Woolf Alfred Lord Tennyson
Emile Zola Dylan Thomas
Walt Whitman Michelangelo
Irving Berlin Jackson Pollock
Noel Coward Vincent Van Gogh
Stephen Foster Edvard Munch
Cole Porter Mark Rothko
Paul Gauguin Georgia O'Keeffe
Adapted from Jamison, 1993; Panter et al., 1995; and Rothenberg, 1990.

Disturbance of mood appears to be present in a high percentage of talented visual artists (Andreasen, 1988; Jamison, 1989; 1993; Richards, 1981). Mental disorders in which the primary feature is a mood disturbance include major depression, dysthymia and bipolar disorder (also popularly known as manic-depressive illness). There seems to be a greatly increased rate of depression, manic-depressive illness, and suicide in eminent creative people, writers and artists especially. The incidence of mental illness among creative artists is higher than in the population at large. Some studies link creativity with bipolar disorders specifically (Andreasen, 1988; Jamison, 1989; Richards; 1989), and within the field of academic psychiatry, there has recently been serious acceptance of the association between creativity and the mood disturbance, hypomania (Jamison, 1993). Table 1 lists a sample of eminent persons who are believed to have had a mood disorder. Many of them committed suicide.

It is well recognized that moods do have an impact on personality. Bipolar disorder is a recurrent mood disturbance characterized by cyclical, extreme mood swings that include manic states. Mania is a distinct period (at least a week) during which the individual demonstrates a euphoric high or irritable mood. "The expansive quality of the mood is characterized by unceasing and indiscriminate enthusiasm for interpersonal, sexual, or occupational interactions" (APA, 1994, p. 328). Grandiosity or uncritical self confidence is often observed. During a manic state, thoughts race, sometimes faster than can be articulated. There is a great increase in goal-directed activity. Manic individuals may write volumes, paint numerous canvases, or engage in multiple activities simultaneously. The level of activity is so high that it results in impairment of functioning, or hospitalization may be necessary to protect the individual.

Jamison's (1993) work suggests that periods of creative productivity are preceded by an elevated mood. It is as if certain types of moods open up thought, allowing for greater creativity. She (1993) stated that depressions may have an important cognitive influence on the creative process. Depression may slow the pace, put thoughts and feelings into perspective; and eliminate excess or irrelevant ideas, increasing focus and allowing structuring of new ideas. In other words, it may be that the cognitive processes associated with certain moods are the link between creativity and madness.

Perhaps the most interesting finding from clinical studies is that there are similarities in the thought processes of manic, psychotic, and highly creative people (Prentky, 1980; Rothenberg, 1990; Rothenberg & Burkhardt, 1984). Psychotic thinking rarely turns into creative production without some abatement of the psychosis, but there is evidence that creative processes sometimes turn into psychotic ones. Albert Rothenberg, clinical professor of psychiatry at Harvard, has served for the past twenty-five years as principal investigator of the Studies in the Creative Process. One focus of his research has been the relationship of creativity to psychosis. "I was at one time extraordinarily puzzled and piqued about the fact that so many outstanding persons also suffered from some form of psychosis (1990, p. 6).

The major findings to come out of my research are that there are particular and specific thought processes used by creative people during the process of creation; this applies to the entire spectrum of disciplines, areas and media. These special thought processes are the features that distinguish creative people from the rest of us. Although very complicated in structure and in psychological function, there is little doubt that these particular processes are crucial to outstanding creative attainment (1990, p. 11)

Specifically, Rothenberg's research concludes that translogical types of thinking characterize both psychotics and highly creatives. Translogical thinking, he explains, is a type of conceptualizing in which the thinking processes transcend the common modes of ordinary logical thinking. It involves what Rothenberg calls janusian and homospatial processes. Janu-sian thinking is a conscious process of combining paradoxical or antagonistic objects into a single entity. Homospatial process is the essence of good metaphor. It means to superimpose or bring together multiple, discrete objects. Rothenberg states that janusian thinking tends to occur in the beginning stages of creative work when ideas are generated, and homospatial thinking characterizes the development of the creative ideas.

He acknowledges that there are similarities between the primary process thinking of psychotics and translogical thinking, and that there are some subtle distinctions. "There is thus a thin but definite borderline between the most advanced and healthy type of thinking creative thinking -- and the most impoverished and pathological types of thinking -- psychotic processes" (p. 12).

Other researchers have noted cognitive similarities. Drs. Andreasen, Stevens, and Powers (1975) investigated conceptual overinclusiveness (i.e. the tendency to combine things into categories that blur conceptual boundaries) in a sample of writers, manic depressives and schizophrenics. They found that the conceptual styles of only the first two groups were similar, with a difference being that the writers had more control over their thought processes than did the manic-depressives.

Kay Jamison's research (1989; 1993) also supports the idea that there is a cognitive link between creativity and madness. She notes that many of the cognitive changes that characterize mania and hypomania are also typical of creativity: restlessness, grandiosity, irritability, intensified sensory systems, quickening of thought processes, and intense feeling. "Two aspects of thinking in particular are pronounced in both creative and hypomanic thought: fluency, rapidity, and flexibility of thought on the one hand, and the ability to combine ideas or categories of thought in order to form new and original connections on the other" (1993, p. 05). It appears that the potential for creativity is enhanced by the cognitive changes that occur within some mental states. However, we don't as yet understand the chemical and anatomical pathways responsible for the cognitive changes that take place during creative and manic states.

Finally, insights concerning the relationship between creativity and madness come also from artists themselves. Their reflections and observations about themselves and their work suggest that they have a very high tolerance for irrationality or deviance. In life, creation and destruction are closely related.

Many artists report that their motivation for engaging in their creative endeavors is to work through, release, or better understand their own destructive urges. The life and suicides of Sylvia Plath and Jackson Pollock exemplify how thin the line can be between destruction and creation. Rothenberg (1990) hypothesizes that this line is crossed, from creativity to madness, when the creative expression is used primarily to control hostility rather than to create. "Just as a need to control interferes with turning destructiveness into creation in art, so it interferes with turning self-destructive feelings into a process of self-creation in life" (p. 73).

Additionally, many artists personally attest to one of the most widely accepted associations between creativity and madness — the connection between what is learned from personal suffering to round out meaning and depth in the creative work. The poet, John Berryman for example, described the role of pain in his work.

I do strongly feel that among the greatest pieces of luck for high achievement is ordeal. Certain great artists can make out without it..., but mostly you need ordeal—My idea is this: The artist is extremely lucky who is presented with the worst possible ordeal which will not actually kill him. At that point, he's in business. Beethoven's deafness, Goya's deafness, Milton's blindness, that kind of thing. And I think that what happens in my poetic work in the future will probably largely depend not on my sitting calmly on my ass as I think, 'Hmm, hmm, a long poem again? Hmm', but on kinds of other things short of senile dementia. At that point, I'm out, but short of that, I don't know, I hope to be nearly crucified, (cited in Plimpton, 1976, p. 322)

Discussion
In summary, there is evidence of a link between creativity and madness, especially within the subpopulation of writers, poets, and visual artists. There is a higher incidence of creatively gifted people among certain mental disorders than in the general population (Andreasen 1988; Jamison, 1989; 1993; Richards, 1989). There seems to be an increased rate of suicide in eminent creative people. Many of the cognitive processes that characterize creative writing also characterize certain mood disorders. The conceptual style of writers and manic-depressives has been found to be similar. And the personal accounts of many creative writers and visual artists testify to their struggle with psychological problems. These findings suggest that the line between creativity and madness is a fine one, and probably permeable.

The common ground between creativity and mental illness appears to be intrapsychic conflict. Noting a few exceptions (e.g., Peter Paul Rubens), most creative people produce less during calm times in their lives (Berman, 1995). Artists themselves argue that they strive to keep contact with their primitive selves because it is from their core self that they draw the energy and inspiration needed to do their best work. But many mental health professionals would propose that to wrestle often with the primitive self is like walking the edge between sanity and insanity. What implications does the research have for educational practices?

There do appear to be psychological risks associated with creative giftedness and with the pursuit of exceptional creative achievement. Teachers and counselors should be aware of the vulnerability that can be associated with creative talent. They can help students and parents guard against a too ready acceptance of the popular notion that deviant or destructive behaviors are the sine qua non of outstanding creative achievement. Suffering, or mental breakdown, should not be accepted as a likely consequence for creative production. Neither research or history supports that view. At the same time, it is probably important that those working with the creatively gifted be willing to tolerate a higher degree of irrationality or deviance since such behaviors are more common among these individuals. Although we should not ignore the strong association of certain types of psychological problems with creative production, neither should we ignore the observation that for every disturbed creative individual noted there are many more healthy creative individuals.

Educators need to understand and accept that the creative process does often arouse considerable anxiety, which may interfere with production. The teacher who can anticipate this possibility and who can make accommodations that support the student in reducing anxiety will promote the student's achievement. It would also be helpful if school personnel were at least aware that the thought processes of high creatives and those of manics or psychotics are similar on the surface, but very different foundationally. Teachers and parents might advocate for acceptance of translogical modes of thinking, but not encourage the widely popular pairing of creative achievement with destructive deviant behaviors.

The research also suggests that differentiated emotional support should be available to students who are in pursuit of superior creative achievement. Educators should increase awareness among students and their parents of the psychological risks common to the pursuit of superior creative achievement and assist them in developing strategies to minimize or prevent harm (Jamison, 1993; 1995; Markova, 1994; Rothenberg, 1990). Both by their nature and by their identification with eminent artists, creatively gifted individuals may put themselves at risk for serious emotional disturbance. Specific assistance in managing mood vacillations may be helpful. Self-care strategies designed for the artistic temperament may be beneficial in minimizing the damage that can occur when the line between rationality and irrationality is crossed and recrossed.

There are several resources that describe strategies for self-care. For example, David Wexler's Program for Innovative Self-Management (PRISM) is described in his text, The Adolescent Self: Strategies for Self-management, Self-soothing, and Self-esteem in Adolescents (Wexler, 1991). In addition, he has written two workbooks of exercises designed to help adolescents who are having problems with self-destructive behaviors, anxiety, mood swings, aggression, substance abuse, and eating disorders (Wexler, 1991; 1993).

Several resources exist that describe exercises that could be used by experienced teachers or school guidance personnel to promote emotional health and prevent more serious problems among creatively gifted youth (Davis, McKay, & Eshelman, 1982; Ilardo, 1992; McMahon, 1992). There are also resources describing exercises that might be especially relevant to students who are aspiring writers, actors, dancers and musicians (Heckler, 1985; Markova, 1994; Progoff, 1975). In addition, those training and teaching creatively gifted students should have in their referral network mental health professionals who can distinguish superior creative thinking from crazy, psychotic thinking and who can identify serious mood disturbances.

The creative process is a mystery. We can know about pieces of it, but we are unlikely to unravel all of it. Many questions remain unanswered. If there is a significant correlation between creative genius and mental disorders, how do we explain it? Do mood disorders lead to creativity? Is there something about wrestling with the primitive core or with our moods, that facilitates the creative process? Or is there a vulnerability that accompanies creative thought? How do we explain the exceptions — those who achieve greatness and lead healthy lives? Are people with certain types of difficulties (e.g., mood disorders, substance abuse) more attracted to the creative fields than are people without such difficulties? Is there something about the creative process itself that over time, contributes to disintegration? Or are the struggles for health the result of the cumulative effects of repeated interactions with others who lack understanding or tolerance?

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