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Reflections on Creativity and Madness*

ARNOLD M. LUDWIG, M.D.f Lexington, KY

The author reflects on the long-assumed relationship between creativity

and madness. He comes to the conclusion that, while not a prerequisite, a
touch of madness could enhance creativity. He attempts to define creativ-
ity and breaks it down into the basic elements of creative person, creative
process, and creative product. He touches on the influence of a particular
culture on the emergence of creative works.

I n his Metaphysics, Aristotle holds that the creative act is a natural event
and, as such, conforms to natural law. For Plato, this poses a paradox. I f
the poet knows what he wants to say beforehand, then he cannot be creative
since, by definition, creativity must go beyond the bounds of what already is
known or deducible by reason; if the poet does not know what he wants to say,
then he cannot compose his poem since he is ignorant of what information he
is searching for and, consequently, cannot expect to find it. This logical
paradox can be resolved, Plato holds, by assuming that the poet, as the
wellspring for his genius, must have access to remembrances from past
incarnations, which come to him during moments of "divine madness."
For the early Greeks, the concept of "madness" had a different meaning
than it does today. Aside from the madness caused by human infirmity,
other forms of madness were assumed to be inspired by the gods. Prophetic
madness, induced by Apollo, provided revelation and knowledge of the
future. Ritual madness, instigated by Dionysus, allowed emotional tran-
scendence and liberation from the self. Erotic madness, inspired by Aphro-
dite or Eros, stimulated rapture and love. And poetic madness, inspired by a
Muse, offered the power of song and rhyme. Almost any extraordinary
performance or creative achievement, then—whether it be in writing, music,
poetry, philosophy, dance, art, sculpture or intellectual discovery—could be
said to derive from one or another of these divine sources of inspiration.
Variants of the belief that there can be "no great genius without some
touch of madness" continue to persist. References to famous, emotionally
disturbed artists, writers, poets, composers, scientists, and philosophers—
Vincent Van Gogh, Franz Kafka, Edvard Munch, Ezra Pound, Delmore

* Based on the Atwood Lecture, delivered at Salve Regina College, Newport, Rhode Island,
October 20, 1988.
fEvalyn A. Edwards Professor, Department of Psychiatry, A. B. Chandler Medical Center,
University of Kentucky, Lexington, Kentucky 40536.

A M E R I C A N J O U R N A L O F P S Y C H O T H E R A P Y , Vol. XLIII, No. 1, January 1989

Reflections on Creativity and Madness 5
Schwartz, W i l l i a m Cowper, Ernest Hemingway, Friedrich Nietzsche,
Eugene O'Neill, Charles Darwin, Fyodor Dostoievsky, Robert Lowell,
Sylvia Plath, and others—are cited widely i n the literature. Likewise,
results of various studies and anecdotal reports suggest an increased rate of
schizophrenia, manic-depressive disorder, depression, personality disorder or
alcoholism in creative individuals. I n a recent, highly publicized, long-
term study of 30 writers at the University of Iowa Writers' Workshop, for
instance, 80 percent, compared to 30 percent of a control group, reported that
they had been treated for mood disorders; they displayed, among more
specific findings, about four times as much manic-depressive illness and/or
Despite the intriguing nature of such reports, the relationship between
creativity and insanity may be apocryphal. M a n y other artists, writers,
poets, composers and scientists presumably have led reasonably "sane,"
emotionally stable lives—William Shakespeare, Albert Einstein, Jules Henri
Poincaré, Walt Whitman, W i l l i a m James, Aldous Huxley, Carl Jung,
Camille Pissarro, Niels Bohr, Duke Ellington, and the like. Reports, such as
the Stanford 35-year follow-up study of over 1,000 "geniuses," Havelock
Ellis's psychobiographical study of eminent men, the MacKinnon study of
creativity in architects, and others, suggest a connection between creativity
and mental health rather than mental illness.
These conflicting results leave many key questions unanswered. Is
mental illness essential or merely incidental to the creative process? Do
psychoses, mood disturbances, intoxications or severe characterological
defects serve as sources of inspiration, allowing innovators to perceive reality
in novel ways, or do they inhibit creativity? Do mental symptoms or
emotional distress represent the consequence of creative activity—the price to
be extracted for relentlessly pursuing the unknown as Carl Jung might
claim —or the impetus for discovery and innovation? Are many artists and
writers apt to rely on alcohol and drugs to still their overactive minds or to
fuel their imaginations when they are feeling emotionally blocked and
intellectually inhibited? Even more to the point, are certain types of
individuals, with certain kinds of psychopathology, in combination with
certain other talents and abilities, and under certain circumstances more
likely than other types of individuals to make scientific breakthroughs or
create important works of art?
Unfortunately, these matters are not so easily settled. A basic difficulty
is that no scientific consensus exists on the nature of creativity. As a result, it
is not known whether studies that compare the attributes of writers, artists,
poets, and composers to those of presumably noncreative individuals are
measuring anything distinctive of creativity at all. Because individuals are
engaged in the "creative arts" or drawn to the artistic lifestyle does not
necessarily mean that they are creative thinkers or that the works they

produce are inspired, extraordinary or original. I t is also not settled whether

there are many different kinds of creativity, whether creativity is a special
mental faculty that is distinct from general intelligence and reasoning
abilities, whether it is confined to a specific field and not generalizable to
others, whether it is an unique aptitude possessed by only an elite few or a
quality democratically distributed to different degrees among all individuals
and present in all ages, whether it can exist independently of social
affirmation, and whether it can be expressed in noncustomary and perhaps
unrecognized ways.
Some progress has been made in resolving conceptual confusion by the
growing recognition that a distinction needs to be made among three
dimensions of creativity: as an attribute of the person, as a process, and as a
property of the product. Creativity as an attribute of persons or their minds
cannot be regarded as equivalent to creativity as a property of a given work of
art. What pertains to one may have little bearing on the other. For
instance, individuals ordinarily regarded as creative in the way they think or
act may lack the motivation, opportunity, resources, talent or other 'x' factors
to produce a major work of art; others, who by any objective standards,
appear unexceptional or ordinary beforehand, may be capable of monumen-
tal achievements. Some individuals may be inspired but not produce
anything of note; in contrast, geniuses, like Edgar Allan Poe, may deny that
their writings are inspired.
I n what ways, then, are these three dimensions of creativity independent
of or related to each other, and how does this bear on the presumed
relationship of creativity to mental illness?

The first dimension—creativity as attribute of the person—involves

the potential interplay of motivation, talent, personality, and cognitive
processes. W i t h regard to motivation, there is no evidence to prove that it is
different for creative persons than for anyone involved in any ambitious
undertaking, but a mystique to that effect exists. Anecdotal accounts are
common of geniuses who claim to be obsessed with their works, unable to
attend to little else, or who come to believe their works control them.
Faulkner, for instance, reputedly wondered whether it was he who created all
the characters who peopled Yoknapatawpha County or they who created
him. Also, for many, their very existence takes on meaning by virtue of their
art. The wife of Eugene O'Neill claimed that her real husband died when
his tremor kept him from writing even though he continued to live on for
many years. Kafka commented that i f a writer wants to escape madness,
he must never leave his desk: he must cling to it with his teeth. Graham
Greene also regarded writing as vital for living. "Sometimes I wonder," he
wrote, "how all those who do not write, compose or paint can manage to
escape the madness, the melancholia, the panic fear, which is inherent in the
Reflections on Creativity and Madness 1
human situation." Whatever this monomania for expression in one or
another medium, whether it simply reflects a mundane drive for riches,
power, and fame, a quest for immortality, an overvalued therapeutic outlet or
an unique motive force, it certainly needs to be better understood.
Then there is the matter of talent and whether it is a necessary and/or
sufficient condition for creativity. The evidence to date is confusing. Not all
creative geniuses have the capacity of a Mozart to compose entire symphonies
in their heads, of an Einstein to visualize themselves riding on a wave of light
at a speed of 186,000 miles/second, of a Michelangelo to imagine human
forms imprisoned within amorphous blocks of marble, of a Robert Frost to
capture with words vivid recollections of the past, or of a Dostoievsky to
intuitively understand the complexities of human nature. Nor, for that
matter, are all individuals who possess these remarkable faculties or facilities
always able to use them to produce scientific breakthroughs or impressive
works of art, as evidenced, for example, by the lack of substantive achieve-
ments by most former child prodigies or virtually all idiot savants.
Even i f one is to assume that talent is necessary for true creative
expression, the extent to which it can be cultivated and developed is still
unknown. What is also unknown is the degree of its specificity. W i l l a
particular talent manifest itself in other ways i f its direct expression is
thwarted or inhibited, or does it operate on an all-or-none basis? What
form, i f any, for instance, would Picasso's incredible skill at drawing have
taken i f he had developed a paralysis of his arms early in life or even, for that
matter, i f his father had discouraged his art?
Then there is the notion that certain kinds of personality attributes tend to
be associated with or contribute to creativity. Among those attributes
commonly cited in the literature are unconventionality, egocentrism, flexibili-
17 19
ty, tolerance for ambiguity, and a preference for complexity. " I n certain
studies, psychological testing reveals that creative individuals tend to be more
troubled emotionally than "noncreative" controls but, interestingly enough,
have greater internal resources (i.e., "ego strength") for dealing with their
problems. This could account for the potential ability of many geniuses to
use their psychopathology in the service of their art. Perhaps that is what
G. B. Shaw meant when he wrote that i f you cannot get rid of the family
skeleton, you may as well make it dance.
Of the many personality traits or cognitive styles presumed to be
characteristic of creative persons, one of the most fascinating is that of
"oppositional t h i n k i n g , " the almost automatic tendency to adopt a contrary
or opposite response. That this response style can play an important role in
creative activity is illustrated, for example, in the compositions of Duke
Ellington. Knowlingly or not, Ellington exploited traditional musical rules
as inspiration for his jazz. I f he learned that he was not supposed to use
parallel fifths, he immediately would find a way to do so; i f told that major

sevenths must always rise, he would write a tune in which the line descended
from the major seventh; and i f the tritone was forbidden, he would find the
earliest opportunity to use it and, to emphasize the point, would let it stand
alone and exposed. I t is probably a variant of this same tendency that could
prompt Sigmund Freud, despite his own Jewish heritage, to declare Moses
an Egyptian.
What are the actual cognitive processes or mental operations that
presumably underlie creative thought? Whether these processes or opera-
tions should be conceptualized as distinct from or as a special aspect of
general intelligence is still open to debate. What is known is that above
intelligence quotients of 120, there does not seem to be any significant
correlation between increasing levels of intelligence and creative ability,
usually measured by the capacity for divergent thinking. I n contrast to
convergent thinking, which represents the type of single-answer, right-
or-wrong thinking usually measured in general intelligence tests, divergent
thinking tends to be characterized by a fluency and abundance of verbal
associations, flexibility, and originality. Other promising measures, such as
the capacity for analogical thought and the ability to form remote associa-
tions, also have been proposed as distinctive of creativity.
A n important issue is whether psychoses or mental aberrations confer any
advantage for this kind of thinking. Despite certain intriguing conceptual-
izations, the limited research findings on this matter are inconclusive.
Earlier studies note certain similarities between presumably creative indi-
viduals and certain subgroups of schizophrenics; more recent studies note
similarities with manics. Unfortunately, formidable methodological and
conceptual issues, such as the importance of controlling for general intelli-
gence, medications, the stage of illness when disturbed individuals are tested,
and other variables, make the prospects of any definitive studies i n this area
As interesting as such studies may be, they unfortunately seem moot.
That is because there is no way to prove that these personality traits or ways
of thinking have anything to do with actual creative achievement. Aside
from the possibility that the mental attributes commonly regarded as
indicative of creativity may simply reflect a bias about what most researchers
consider to be desirable human qualities—i.e., the kinds of attributes they
consider themselves to have or would like in friends—the logical fallacy of
post hoc ergo propter hoc is apt to be involved in any retrospective attempt to
explain or infer anything about the predisposing personality attributes or
thought processes of individuals from an anlysis of the creative product itself
or, conversely, in any prospective attempt to predict how a work or art w i l l
turn out from prior knowledge of these personal attributes or thought
Reflections on Creativity and Madness 9

Now what about the matter of the creative process itself—namely, the
fortuitous conditions under which inspiration or discovery supposedly occur?
Because of formidable methodological problems, investigations in this area
understandably have been limited. I t is difficult to observe and record the
mental processes of individuals in the act of creating although, interestingly
31 32
enough, certain ambitious studies have attempted to do just this. " Most
students in the field have become familiar with the famous accounts of
Poincare's discovery of the Fuchsian functions, Kekule's of the benzene ring
or Archimedes' of the principle of bouyancy. Anecdotal accounts such as
these have usually served as the basis for conceptualizations of the creative
process as a series of stages, occurring consecutively but sometimes together.
One of the better known conceptualizations, for example, regards the initial
stage as one of preparation, during which the individual consciously but
unsuccessfully attempts to solve a seemingly unsolvable problem. Then,
when the problem is put aside, there is a stage of incubation, a period of
variable duration, during which ideas germinate at a subconscious level,
usually while the individual is engaged in other tasks. Then comes the stage
of insight, discovery or illumination, the "aha" or "eureka" experience,
mostly occurring when the critical faculties are suspended, such as during
relaxation or dreams—when supposedly the entire solution to the problem is
gleaned. But insight in itself is insufficient for discovery. The last stage
supposedly involves that of elaboration followed by verification, when the
idea is developed and tested against scientific, aesthetic or social standards.
This schema, though attractive, is probably more artificial than real.
Even should such insights emerge, they are not likely to follow this same
sequence of stages, in lock-step fashion, in all individuals. Moreover, for the
vast majority of individuals, the process of discovery or illumination likely
represents a consequence of many small hunches or glimmers of insight, as
exemplified by Charles Darwin's elaboration of the theory of evolution,
rather than one big flash or revelatory vision that encompasses the entire
creative work, as with Coleridge's inspiration for Kubla Khan during an
opium dream. There undoubtedly are many ways by which individuals
arrive at the solution to a problem, either reflecting the different ways they
think or the different nature of the problem. Koestler, seeking a common
basis for humor, scientific discovery, and aesthetics, conceived of the creative
act as due to the "bisociation" or intersection of two independent, seemingly
incompatible matrices of thought. This is not so different from the notion
of "Janusian" or "homospatial" thinking in which there is a temporal and
functional coexistence of opposites within a single framework or context,
such as with Frank Lloyd Wright's revolutionary design of Fallingwater in
which nature and interior space coexist.
But insight or unusual modes of thinking may not even be necessary.

Scientific or artistic discovery may gradually come about by the psychological

necessity to form a good gestalt, by the translation of an amorphous
cognition or "endoconcept" into an aesthetic unit, or by what has been
termed a "gradient of deepening coherence" that tells which direction the
work needs to go for completion. Einstein, for example, said that during
all his years of inquiry, even before he made his discovery, "There was a
feeling of direction, of going straight toward something definite."

Regardless of its validity, though, the notion that insight or inspiration is

essential for creativity is intriguing since it suggests why psychoses, mental
anguish and intoxication may sometimes confer an advantage over sanity.
" N o r m a l " writers, artists and composers may find it difficult to "regress i n
39 40
the service of the ego" in order to benefit from unconscious or preconscious
sources of inspiration. "Disturbed" individuals, because of insanity, drugs
or alcohol, may have more direct access to the subterranean regions of their
minds where unusual, novel or unconventional perspectives are apt to exist.
Of course, it should be apparent that the results of any brainstorms or
epiphanies, either by sane or insane individuals, need not always be
earth-shattering or meaningful. More often than not, they turn out to be
trivial, as in W i l l i a m James's famous revelatory dream of "Higamous,
hogamous; Woman monogamous. . .Hogamus, higamous; M a n is polyga-
mous." I f an insight or discovery is to be regarded as prophetic or
trail-breaking, it must withstand critical analysis. I n science, experimental
verification offers safeguards against false results; with aesthetics, validation
cannot always take place.
The notion that certain fortuitous states of mind, mental aberrations,
alterations in consciousness or "flow states" may predispose certain individu-
als to insights or revelations raises the intriguing issue of whether there may
be a distinctive neurochemical or neurophysiological basis for the creative
experience—a catecholamine/indoleamine imbalance, a predominant
alpha-rhythm state or right-brain dominance, for instance. Even more
fundamental and still unresolved issues pertain to potential genetic, congeni-
tal or sex-linked influences on creativity, as well as on special talents, and the
degree to which creativity is innate or learned.
Now to the matter of the creative product itself. The immediate issue
is how it is to be identified. What constitutes a beautiful work of art, an
imaginative composition or a brilliant discovery? What distinguishes such a
work from that which is simply trivial or bizarre? Such judgments are not
always easy, especially i n the realm of aesthetics.
It is often the case that works by insane, emotionally disturbed and
eccentric persons command attention by virtue of their unusualness or
unconventionality in presentation or theme. But it takes much more than
Reflections on Creativity and Madness 11
that for art, poetry, music or fiction to qualify as creative. Works that are
disorganized, lacking in technique or incomprehensible are unlikely to have
any redeeming social value. There must be a genius behind the vision, a
disciplined intelligence capable of transforming these private, primitive,
idiosyncratic or extraordinary perceptions into a language that is accessible
and coherent for others. Salvador Dali, an undisputed genius, professed to
be able to do this through the method of "paranoiac-critical" analysis, but just
what he meant by this is hard to decipher. "The only 'difference' between
me and a madman," he claimed, "is that I am not mad." This statement
may be prophetic. But the real question is, "What is the 'difference'?,"
especially as it pertains to others not so talented.
Immediately, it must be acknowledged that there are no objective or even
generally agreed-upon standards for evaluating creative works, whether
produced by individuals emotionally unbalanced or not. While qualities like
novelty, originality, simplicity, elegance and usefulness have traditionally
been attributed to creativeness, i ^ is also possible to characterize creative
works by the presence or absence of certain aesthetic responses. Surprise is
the aesthetic response to unusualness; satisfaction, the response of appropri-
ateness; stimulation, the response to transformation of the product; and
savoring, the response to condensation in the product, or its summary power.
There are yet other ways to judge creativity. A product or response is
creative, for example, not only to the extent that it is judged as novel,
appropriate and valuable to the task at hand, but also to the extent that it is
heuristic rather than algorithmic in nature. W i t h an algorithmic task, the
path to the solution is clear, logical, and straight-forward. W i t h a heuristic
task, new algorithms must be developed. Unfortunately, the difficulty with all
such criteria is how to apply them reliably to the fields of art, literature,
music, and aesthetics in which subjective experience is so important, fashion
is so apparent, and scientific validation so difficult. No wonder then that
historical forces and social currents have played so crucial a role in judgments
of "creativity."
What this indicates is the problem of establishing any absolute standards
for works of genius when judgments about their merit can only be made
within the social context of the times. The fields of art, literature, music,
aesthetics, and even science are replete with instances of works or ideas being
ridiculed at one point by the critics and then much later rediscovered and
praised—the works of the Impressionist, Abstract Expressionist, and Cubist
artists, the stream-of-consciousness writers, the free-verse poets, and scien-
tists who challenged established doctrines, such as Galileo, Copernicus, and
Darwin, to name but a few. The issue then is whether genius can exist
without a suitable following or notable authorities to proclaim it as such.
Certain authors claim not.

What also becomes evident is that there seems to be a politics of creativity.

Different societies, at different times, have denounced or praised certain
works depending upon whether these works support or challenge prevalent
social mores. " A r t for art's sake," rather than art for the furtherance of some
social, political or religious ideology, is largely a relatively recent develop-
ment in Western society.

This leads naturally to a consideration of creativity from the cross-

cultural perspective. Unfortunately, little systematic information is avail-
able on the extent to which different cultures or subcultural groups foster or
suppress creativity or influence its particular means of expression. I n certain
non-Western societies, creative expression may become highly stylized and
ritualized and serve a predominantly stabilizing function; i n other societies, in
which the avant-garde is highly prized, it is more likely to have an
antibourgeois or antiestablishment emphasis. These cultural differences
may also pertain to expectations for behavior. H o w much of the publicized
drug use, unconventionality or angst of writers or artists is influenced by role
expectations and traditions within Western (as opposed to Eastern) society
rather than the manifestation of personal conflicts or basic personality flaws?
T o what extent is the flamboyant dress of an Ezra Pound, the drunken
excesses of a F. Scott Fitzgerald or the glamorous, rebellious, bohemian
lifestyle of a Left Bank expatriate reflective of the "true" artistic tempera-
ment or of a need to cultivate eccentricity and affectations within a society that
cherishes individualism and the flaunting of convention? Any judgment
about this matter must also be tempered by the realization that these
manifestations have not always been essential for creativity. Most classical
artists, composers, writers, and poets apparently respected both the "masters"
and tradition, yet still managed to produce great works of art.
While societal or cultural expectations undoubtedly account for much of
the behavior of artists, writers, musicians, and the like, they obviously cannot
account for all. What is the peculiar personality quirk, this oppositional
disposition, that drives so many creative persons to defy orthodoxy and
convention even in the face of social disapproval, ridicule, ostracism and, in
many instances, punishment? What is this dogged persistence, stubborn-
ness, and fixity of belief that fuels their perseverance, even when the prospects
of success are bleak? Is it a supreme confidence, an arrogance, a blinding
narcissism, that enables them to escape the strictures of conformity, the social
programming of a lifetime, or is it a blind, driven monomania, a conviction of
purpose that borders on delusion? Is this something a reasonably sane,
intelligent and emotionally well-adjusted individual would do? Madness, or
whatever this term connotes, may not be necessary for creative achievement,
but perhaps a touch of it may not hurt.
Reflections on Creativity and Madness 13

While it is quite clear that emotional instability is usually detrimental to
creativity, it also may be advantageous. I t may provide the intense motiva-
tion, the conviction, the egocentrism, the unconventionality, the imagination,
and the inspiration so necessary for new discoveries and breakthroughs. I t
may also allow the artist, writer, poet, composer and scientist to escape the
powerful social and cultural constraints that mostly favor conformity and
convention. What remains to be determind is just what types of psychopa-
thology inhibit or facilitate what types of creative activity.

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