Essay: Creativity—the healthy muse

Not long ago, I decided to re-read a novel by Thomas Mann about the experience of chronic illness. I felt immersed in a sense of contemplation within seemingly endless time. Both moving and enlightening were the metaphorical power of this masterpiece, its insights about life and death, and its elegance of literary style. Other types of artistic productions—visual, musical, and dance—similarly draw us into meaningful looking, listening, and thought. All, together with outstanding scientifi c discoveries, enhance and change our lives, and are results of creativity, defi ned as the production of something both new and valuable. Given the magnitude of creative achievement, I am often perplexed about the recurring tendency in western history to connect creativity with mental disability and illness. It cannot be denied that a number of well-known creative people, primarily in the arts, have been mentally ill—for example, Vincent Van Gogh, Virginia Woolf, Robert Schumann, Robert Lowell, Sylvia Plath. The list has recently been made, in various ways, questionably large. Psychiatric diagnoses of eminent people have been derived not from clinical sources but from general and popular biographies revealing apparent clay feet of creative heroes, unproven gossip and hearsay, and a fi eld called pathography, in which both literary and psychological analysts describe correlations between artists’ psychological constitutions and pathological elements they see in subject matter or characters. Other studies have purportedly found psychopathology in people attending art or writing classes or achieving positive scores on various creativity measures. A factor in the conundrum, diffi cult to assess or measure, is the infl uence of the angst of modern times, the widespread social disruption and anxiety that became overt during the romantic period of the 19th century and continues today. This has cultivated an image of the suff ering artist and favoured artistic content—alienation, self-obsession, violence and sadism, extreme visual and sound imagery—seemingly connected with mental illness. Artistic expression has come to be considered therapeutic, a term that, though not always used rigorously, conjures up illness and its eff ects. Some mentally ill individuals have been attracted to the arts where themes and styles provide them with some experiential advantages. The confused beliefs and purported fi ndings have primarily arisen because both creativity and mental illness involve deviations, sometimes fairly extreme ones, from normative modes of thought. I am for the moment leaving aside people who perform creatively in everyday activities. Symptoms of mental illness diff er from normal thinking and behaviour, and creativity requires special or uncommon capacities. But there are sharp diff erences in eff ects; mental illness symptoms—compulsions, obsessions, delusions, panic attacks, depression, and personality disorders—deviate in stereotyped and frequently banal ways, whereas creativity involves novel and rich results. A common claim is that extreme euphoria and productivity are features of both creative work and bipolar illness. With the illness, however, these features are involuntary, devoid of judgment, and distorted, whereas creative artists’ productivity is purposeful, and euphoria results almost always from exceptional accomplishment. Suff ering is an intrinsic component of mental illness but, despite the traditional romantic belief, such disruption seldom contributes to creative inspiration. Suff ering for creative people generally comes from lack of recognition and its consequences, neither direct cause nor eff ect of mental illness. The list of successful mentally ill creators should induce hope but not treatment resistance in suff ering patients. Although the content of the list is dramatic, it is dwarfed by the number of highly creative people both in modern times and throughout history without evidence of disorder, including Czeslaw Milosz, Henry Moore, Sigrid Undset, Jane Austen, Anton Chekhov, George Eliot, John Milton, Johann Sebastian Bach, even William Shakespeare as much as we know of him, who have had problems like other human beings, but “here’s the rub”: was the author of Hamlet’s suicide-contemplating soliloquy depressed? As a matter of empathy, that is unlikely, as I shall explain. Studies using test or clinical assessments have not proven a connection between creativity and mental illness. Almost all have had methodological and conceptual inadequacies: absent or poor controls, investigator bias, unreliable testing tools. None have demonstrated validity with respect to actual creative performance. Shared deviations from the normative—unusual and remote associations or preferences, and divergent thinking (as opposed to convergent thinking toward a single correct solution)—perfuse the criteria used. The solution to the conundrum of mental illness in creative individuals lies, I believe, in the nature of the creative processes themselves. If the factors directly producing creations were in some way derived from, or even facilitated, by illness, there would be a necessary connection. I have, from many years of objectively controlled research interviews and controlled experiments, identifi ed three specifi c cognitive creative processes: articulation, janusian process, and homospatial process. I conducted individual interview series systematically focused on work in progress with a large number of outstanding creative people in the arts and sciences throughout Europe and the USA; the creative processes discovered are all healthy and adaptive. The process of articulation consists of concomitantly separating and connecting (as with the articulate speaker who keeps both words and ideas distinct and separate within a connected fl ow). One eff ect of this process is a Albert Rothenberg is Professor of Psychiatry at Harvard Medical School. Born in New York, he attended Harvard College, graduated in medicine at Tufts University School of Medicine, and received his psychiatric training at the Yale University Department of Psychiatry. He has been Principal Investigator of the research project “Studies in the Creative Process” since 1964.