Touched With Fire

Kay Redfield Jamison

• Publisher: Free Press
• Year: 1996
• ISBN:
  9781439106631
• Topic: Psicologia
• Subtopic: Psicologia anormale

The definitive work on the profound and surprising links between manic-depression and creativity, from the bestselling psychologist of bipolar disorders who wrote An Unquiet Mind. One of the foremost psychologists in America, "Kay Jamison is plainly among the few who have a profound understanding of the relationship that exists between art and madness" (William Styron).The anguished and volatile intensity associated with the artistic temperament was once thought to be a symptom of genius or eccentricity peculiar to artists, writers, and musicians. Her work, based on her study as a clinical psychologist and researcher in mood disorders, reveals that many artists subject to exalted highs and despairing lows were in fact engaged in a struggle with clinically identifiable manic-depressive illness.Jamison presents proof of the biological foundations of this disease and applies what is known about the illness to the lives and works of some of the world's greatest artists including Lord Byron, Vincent Van Gogh, and Virginia Woolf.

1. THAT FINE MADNESS

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Introduction

. . . his raptures were,

All air, and fire, which made his verses clear,

For that fine madness still he did retain,

Which rightly should possess a poet’s brain.

—MICHAEL DRAYTON¹

An Angel Descending: Dante’s Divine Comedy. William Blake, c. 1826 (The Pierpont Morgan Library, New York)

“We of the craft are all crazy,” remarked Lord Byron about himself and his fellow poets. “Some are affected by gaiety, others by melancholy, but all are more or less touched.”² This book is about being “more or less touched”; specifically, it is about manic-depressive illness—a disease of perturbed gaieties, melancholy, and tumultuous temperaments—and its relationship to the artistic temperament and imagination. It is also a book about artists and their voyages, moods as their ships of passage, and the ancient, persistent belief that there exists such a thing as a “fine madness.”

The fiery aspects of thought and feeling that initially compel the artistic voyage—fierce energy, high mood, and quick intelligence; a sense of the visionary and the grand; a restless and feverish temperament—commonly carry with them the capacity for vastly darker moods, grimmer energies, and, occasionally, bouts of “madness.” These opposite moods and energies, often interlaced, can appear to the world as mercurial, intemperate, volatile, brooding, troubled, or stormy. In short, they form the common view of the artistic temperament, and, as we shall see, they also form the basis of the manic-depressive temperament. Poetic or artistic genius, when infused with these fitful and inconstant moods, can become a powerful crucible for imagination and experience.

That impassioned moods, shattered reason, and the artistic temperament can be welded into a “fine madness” remains a fiercely controversial belief. Most people find the thought that a destructive, often psychotic, and frequently lethal disease such as manic-depressive illness might convey certain advantages (such as heightened imaginative powers, intensified emotional responses, and increased energy) counterintuitive. For others it is a troubling or unlikely association that conjures up simplistic notions of the “mad genius,” bringing with it images of mindless and unaesthetic reductionism as well as concerns about making into disease something that subsumes vital human differences in style, perception, and temperament. Indeed, labeling as manic-depressive anyone who is unusually creative, accomplished, energetic, intense, moody, or eccentric both diminishes the notion of individuality within the arts and trivializes a very serious, often deadly illness. There are other reasons for such concerns. Excesses of psychoanalytic speculation, along with other abuses of psychobiography, have invited well-deserved ridicule. Due to the extraordinary advances in genetics, neuroscience, and psychopharmacology, much of modern psychiatric thought and clinical practice has moved away from the earlier influences of psychoanalysis and toward a more biological perspective. Some fear that the marked swing from psychoanalysis to psychopharmacology is too much, too soon, and that there exists the risk of a similar entrenchment of ideas and perspectives. The erosion of romantic and expressive language into the standardization of words and phrases necessary for a scientific psychiatry has tempted many to dismiss out of hand much of modern biological psychiatry. Almost by definition, the idea of using formal psychiatric diagnostic criteria in the arts has been anathema, and, in any event, biological psychiatrists have displayed relatively little interest in studying mood disorders in artists, writers, or musicians. Certainly those in the arts have been less than enthusiastic about being seen through a biological or diagnostic grid. Those in the best position to link the two worlds—scholars of creativity—only recently have begun to address the problem. Having previously focused on the relationship between creativity and “schizophrenia” (often misdiagnosed manic-depressive illness) or diffuse notions of psychopathology, these researchers have left largely unexamined the specific role of mood disorders in creative work.

Complicating matters further, certain life-styles provide cover for deviant and bizarre behavior. The arts have long given latitude to extremes in behavior and mood; indeed, George Becker has observed that the Romantic artists used the notion of mad genius to “provide recognition of special status and the freedom from conventional restraints that attended it.”³:

The aura of “mania” endowed the genius with a mystical and inexplicable quality that served to differentiate him from the typical man, the bourgeois, the philistine, and, quite importantly, the “mere” man of talent; it established him as the modern heir of the ancient Greek poet and seer and, like his classical counterpart, enabled him to claim some of the powers and privileges granted to the “divinely possessed” and “inspired.”⁴

Robert Burton wrote in the seventeenth century that “all poets are mad,” a view shared by many since. Such a view—however appealing to some, and whatever its accuracy—tends to equate psychopathology with artistic expression. A common assumption, for example, is that within artistic circles madness is somehow normal. This is well illustrated by an episode described by Ian Hamilton in his biography of the poet Robert Lowell; it illustrates the reactions of Lowell’s colleagues to one of his many escalations into mania:

Lowell had announced to all his Cincinnati acquaintances that he was determined to remarry, and had persuaded them to stand with him on the side of passion. Some members of the faculty found him excitable and talkative during this period, but since the talk was always brilliant and very often flattering to them, they could see no reason to think of Lowell as “ill,” indeed, he was behaving just as some of them hoped a famous poet would behave. They undertook to protect this unique flame against any dampening intrusions from New York. Thus, when Hardwick [Lowell’s wife] became convinced that Lowell was indeed sick—over a period of two weeks his telephone calls to New York became more and more confused, lengthy and abusive—she ran up against a wall of kindly meant hostility from Lowell’s campus allies. Her version of Lowell was not theirs, even when they were discussing the same symptoms; what to her was “mad” was to them another mark of Lowell’s genius.⁵

The main purpose of this book is to make a literary, biographical, and scientific argument for a compelling association, not to say actual overlap, between two temperaments—the artistic and the manic-depressive—and their relationship to the rhythms and cycles, or temperament, of the natural world. The emphasis will be on understanding the relationship between moods and imagination, the nature of moods—their variety, their contrary and oppositional qualities, their flux, their extremes (causing, in some individuals, occasional episodes of “madness”)—and the importance of moods in igniting thought, changing perceptions, creating chaos, forcing order upon that chaos, and enabling transformation.

The book begins with a general overview of manic-depressive illness: what it is, whom it affects, and how it shows itself. Mania, depression, mixed manic and depressive states, and suicide are described both from a clinical perspective and through the words and experiences of artists, musicians, and writers who have suffered from severe mood disorders. The biographical and scientific evidence for a relationship between manic-depressive illness and artistic creativity is given in chapter 3. Recent research strongly suggests that, compared with the general population, writers and artists show a vastly disproportionate rate of manic-depressive or depressive illness; clearly, however, not all (not even most) writers and artists suffer from major mood disorders. There remains skepticism and resistance to the idea of any such association, however—some of it stemming understandably from the excesses of psychobiography alluded to earlier (especially those of a highly speculative and interpretive nature), but much of it arising from a lack of understanding of the nature of manic-depressive illness itself. Many are unaware of the milder, temperamental expressions of the disease or do not know that most people who have manic-depressive illness are, in fact, without symptoms (that is, they are psychologically normal) most of the time. When many individuals—even those who are generally well versed in psychology and medicine—think of manic-depressive illness, they tend to imagine the back wards of insane asylums and unremitting mental illness or madness, and rightly conclude that no meaningful or sustained creative work can occur under such circumstances. Madness, or psychosis, represents only one end of the manic-depressive continuum, however; most people who have the illness, in fact, never become insane. Likewise, work that may be inspired by, or partially executed in, a mild or even psychotically manic state may be significantly shaped or partially edited while its creator is depressed and put into final order when he or she is normal. It is the interaction, tension, and transition between changing mood states, as well as the sustenance and discipline drawn from periods of health, that is critically important; and it is these same tensions and transitions that ultimately give such power to the art that is born in this way.

The psychological and biological arguments for a relationship between “madness” and artistic creativity are presented in chapter 4; the overlapping natures of the artistic and manic-depressive temperaments, as well as similarities in patterns of thought and behavior, are also explored. The importance to the creative process of certain types of experiences whose existence is due to extreme emotional states is discussed in some detail; however, the need for discipline, control, and highly reasoned thought is also stressed. The creative significance of the tension and reconciliation of naturally occurring, opposite emotional and cognitive states in artists with manic-depressive illness or cyclothymia (its milder temperamental variant), and the use of art by artists to heal themselves, are examined as well. The rhythms and cycles of manic-depressive illness, a singularly cyclic disease, are strikingly similar to those of the natural world, as well as to the death-and-regeneration and dark-and-light cycles so often captured in poetry, music, and painting. Seasonal cycles are particularly important, and these are discussed in the context of the scientific evidence for seasonal patterns in moods and psychosis, as well as illustrated by the seasonal patterns of artistic productivity evident in the lives of Robert Schumann, Vincent van Gogh, and others.

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Any discussion of temperament and art is best served by examining one life in some depth, and none better illustrates the complexity of overlap between heredity, individual will, circumstance, and poetic temperament than that of George Gordon, Lord Byron. Heir to madness, virulently melancholic, and in lifelong fear of going insane, Byron represents the fine edge of the fine madness—the often imperceptible line between poetic temperament and psychiatric illness. His terrible struggles with melancholy and his “savage moods,”⁶ yet his work’s indebtedness to them, bring up many of the medical, social, and ethical issues that are discussed in the final chapters. Manic-depressive illness is a genetic disease, and that fact is fundamental not only to understanding its origins but also to the many medical and ethical issues raised later in the book. The scientific arguments for the genetic basis of manic-depressive illness are presented in chapter 6, put into the context of the family psychiatric histories, or pedigrees, of several major literary and artistic families (including those of Byron, Tennyson, Melville, William and Henry James, Schumann, Coleridge, van Gogh, Hemingway, and Woolf).

Clearly, a close association between the artistic temperament and manic-depressive illness has many implications—for artists, medicine, and society. Modern psychopharmacology and genetic research raise almost endless possibilities, both liberating and disturbing, but the ethical waters remain disconcertingly uncharted. No psychiatric illness has been more profoundly affected by the advances in clinical and basic neuroscience research than manic-depressive illness. The efficacy of a wide range of medications has given clinicians unprecedented options and patients lifesaving choices. The fact that lithium, antidepressants, and anticonvulsants are now the standard of care for manic-depressive illness (and psychotherapy or psychoanalysis alone, without medication, is usually considered to be malpractice) raises particularly interesting questions about the treatment of writers and artists. Some artists resist entirely the idea of taking medication to control their mood swings and behaviors; interestingly, however, there is some evidence that, as a group, artists and writers disproportionately seek out psychiatric care; certainly many—including Byron, Schumann, Tennyson, van Gogh, Fitzgerald, and Lowell—repeatedly sought help from their physicians. Other writers and artists stop taking their medications because they miss the highs or the emotional intensity associated with their illness, or because they feel that drug side effects interfere with the clarity and rapidity of their thought or diminish their levels of enthusiasm, emotion, and energy.

Although manic-depressive illness has long been assumed to be genetic in origin, and its strong tendency to run in some families but not in others has been observed for well over a thousand years, only the recent radical advances in molecular biology have provided the techniques to enable highly sophisticated searches for the genes involved. Similarly, an almost unbelievable increase in the rate of study of brain structure and function has resulted in a level of biological knowledge about manic-depressive illness—this most humanly expressed, psychologically complicated, and moody of all diseases—that is without parallel in psychiatry. The ethical issues arising from such knowledge, and from the possibility that such a devastating illness can confer individual and societal advantage, are staggering: Would one want to get rid of this illness if one could? Sterilization of patients with hereditary psychoses, most directly applicable to those with manic-depressive illness, was once practiced in parts of the United States, and large numbers of individuals with manic-depressive illness were systematically killed in German concentration camps. Even today many provinces in China enforce mandatory sterilization and abortion policies for those with hereditary mental illness. What will be the roles of amniocentesis, other types of prenatal diagnosis, and abortion once the manic-depressive genes are found? What are the implications for society o...