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The belief that the highest forms of human achievement, now termed “creativity”, were invariably associated with “madness” goes back to Aristotle, and can easily be found in Shakespeare. People famous for their outstanding ability and originality came to be called geniuses, although this still leaves undecided the perennial argument of the Mad Genius Controversy, (1) whether “genius” is the highest expression of human worth or a form of mental abnormality, is a subject recently evaluated by Kessel (2). In 1867, Henry Maudsley (3) judged that there was altered neurophysiology both in geniuses and in the insane but to Francis Galton (4), two years later, genius was not a special quality but something biological stemming from, natural ability. Galton observed that “those who are over eager and extremely active in mind must often possess brains that are excitable and peculiar... They are likely to become crazy at times, perhaps to break down altogether” (4).
Reviewing the evidence in 1948, Brain (5) concluded that, although geniuses were probably not specially prone to insanity, they were certainly more “nervous”, and that when insanity occurred the commonest kind was “cyclothymia, the manic-depressive state”. This was before the seminal work of Adele Juda (6) (7) who studied the records of 294 male geniuses, in two groups consisting of 113 artists and 181 scientists and statesmen, from German speaking countries. 4.8% of the artists and 40% of the scientists and statesmen suffered from functional psychoses - all schizophrenic or indeterminate in the artists, all manic-depressive in the scientists. These figures are not much higher than those expected in the general population. The great majority of the distinguished figures were mentally normal, and had suffered neither mental illness or any morbid or antisocial deviation of personality. Neurosis and personality disorder were found in 27% of the artists and 19% of the scientists and statesmen, against a claimed expected general rate of 10 - 12%. However, these rates for the geniuses were not higher than an intermediate comparison group of mainly professional people. Juda concluded that genius and insanity are not correlated.
The so-far unexplored importance of minor psychiatric disorders was emphasised by Slater and Meyer, (8) others, working mainly with living creative people, have found a higher incidence of psychiatric abnormality, (9)(10)(11) particularly of depressions and alcoholism, in writers and artists. Consequently, a link between creativity and a tendency to affective disorders has been firmly suggested (12) Jamison (13) lately reported a specific relation between creativity and bipolar manic-depressive disorders. Slater (14) on the other side of the controversy, concluded that “creative work is done out of the vigorous and healthy elements of the personality. Psycopathic features may give a slant to the work....But the creative work itself proceeds from strength and not weakness”, and Kessel (2) supported this pathographical conclusion.
The controversy led Felix Post (15) to read 250 biographies over ten years to determine the prevalence of psychopathology in creative world-famous figures, and to test whether the high prevalence of “psychic abnormalities” reported in living creative persons was present in those who had achieved world status. Data were obtained from 291 biographies of 48 visual artists, 50 scholars and thinkers, 45 scientists, 46 statesmen and national leaders, 52 composers, and novelists and dramatists arbitrarily restricted to 50. The search depended on the availability of adequate biographies and could not be random. Women were excluded because Post discovered only five adequate biographies of writers and one for a female scientist. In view of the differences in prevalence of psychological abnormalities in women, their inclusion among male subjects was unacceptable, and all of them (Charlotte Bronte, Colette, George Eliot, George Sand, Virginia Woolf, and Marie Curie) had serious psychiatric and/or psychosexual problems. Only factual material and any medical opinions found in these biographies was transformed into diagnoses of persistent psychopathology and episodic illnesses. There were five suicides - Hemingway, Van Gogh, Hitler, the physicist Boltzmann, and Tchaikovsky, yielding a suicide rate that was not regarded as unduly high. 22 male suicidal bids.
Besides their ability and originality Post (15) noted, as Galton (16) had done earlier, the remarkable energy showed by gifted men, in whom, as well, he found unusual personality characteristics and minor ‘neurotic’ abnormalities that were probably more common than in the general population. In contrast to the scientists, who also showed the lowest prevalence of psychological abnormalities, the group of novelists and dramatists had family histories of psychiatric disorder, and the groups of writers, artists and intellectuals had psychosexual difficulties. Severe personality deviations were unduly frequent in visual artists and writers, and perhaps scholars and thinkers. Functional psychoses were probably less frequent than expected from population studies, and were entirely restricted to the affective varieties. Depressive conditions were particularly prevalent in writers. Alcoholism was a problem - strikingly in writers, artists and composers, less so in politicians and intellectuals, and not at all in scientists. Reasons for the greater mental stability of the scientists, and differences in kinds and severity of psychopathology between the other groups, were not examined.
Post (15) concluded that certain pathological personality characteristics, as well as tendencies towards depression and alcoholism, are causally linked to some kinds of valuable creativity. This is unlikely to be the last word on the subject.
References
1. Becker, G. The Mad Genius Controversy: A Study in the Sociology of Deviance. Beverly Hills: Sage Productions, 1978.
2. Kessel, N. Genius and mental disorder; a history of ideas concerning their conjunction. In Murray, P. ed. Genius, the History of an Idea. Oxford: Blackwell, 1989.
3. Maudsley, H. The Pathology of Mind. London: Macmillan, 1867, p. 297.
4. Galton, F. Hereditary Genius. 1st ed. London: Macmillan, 1869; 2nd ed. 1892, p.33.
5. Brain, W.R. Diagnosis of Genius. Brit. J. Aesthetics 1963; April; pp. 114-28; In: Doctors Past and Present. London: Pitman, 1964.
6. Juda, A. The relationship between highest mental capacity and psychic abnormalities. Amer. J. Psychiatry 1949; 106: 296-304.
7. Juda, A Hoechstbegabung: Ihre Erbverhaeltnisse sowie ihre Beziehungeg zu psychischen Anomalien. Munchen: Urban & Schwarzenberg, 1953.
8. Slater, E. and Meyer, A. A Contribution to a pathography of the musicians: 1. Robert Schumann. Confinia Psychiastricia 1959; 2: 65-94.
9. Eysenck, H.J. The roots of creativity: cognitive ability or personality trait? Roeper Review 1983; May: pp. 10-12.
10. Andreasen, E.W. Creativity and mental illness: prevalence rates in writers and their first-degree relatives. Amer. J. Psychiatry 1987; 224: 67-71.
11. Jamison, K.R. Mood disorders and patterns of creativity in British writers and artists. Psychiatry 1989; 32: 125-34.
12. Hare, E. Creativity and mental illness. Brit Med J. 1987; 295: 1587-89.
13. Jamison, K.R. Touched with fire: manic-depressive illness and the artistic temperament. New York: Free Press, 1993.
14. Slater, E. The problems of pathography. Acta Psychiatricia Scandinavica 1970: 219 (Suppl): pp. 209-15.
15. Post, F. Creativity and psychopathology; a study of 291 world-famous men. Brit J Psychiatry 1994; 165: 22-34.
16. Galton, F. Inquiries into human faculty and in its development. London: Macmillan, 1883.
Reprinted by permission from The Lancet