A Dash of Madness
The Link Between Creativity and Psychosis
Alissa D'Gama
Dry leaves crackle underfoot as a man steps out of a black sedan. His hat pulled low over his face, he sneaks a furtive glance behind him and pulls out a thick manila envelope. He drops it into a mailbox.
Six months later, the same sedan drives up in broad daylight, and a pretty young woman gets out. She pulls a thick stack of manila envelopes out of the mailbox. With a pained expression on her face, she returns to her car and drives back to the mental hospital where her husband is institutionalized.
It is only when Alice shows the unopened envelopes to her husband that he realizes he has not been searching for Russian conspiracies under the commission of military officials at the Pentagon. John Nash, a brilliant mathematician and winner of the Nobel Prize in Economics for game theory, was also a schizophrenic who experienced auditory hallucinations that threatened to destroy his career and family.
A link between geniuses and madmen has been suggested since the time of Aristotle in the third century BC. In Problemata XXX, Aristotle observes that "men illustrious in politics, poetry, and art have often been melancholic and mad."
Biographical and scientific studies have revealed that many geniuses suffered from a mental disorder, and similarities can be drawn between the unusual ideas of the mentally ill and the truly original ideas of creative individuals.
Initially, psychologists postulated a link between schizophrenia and creativity, but this idea was then abandoned in favor of a theory linking the creative process with depression and other mood disorders. With a better understanding of the differing creative methods in the arts and the sciences as well as in the distinct affective and cognitive symptoms of schizophrenia and mood disorders, psychologists now believe that schizophrenia is associated with scientific genius and mood disorders with artistic creativity.
In order to understand the link between creativity and psychoses, we must first define these two terms.
Creativity is different from mere intelligence—it encompasses the ability to not just recognize and find solutions to problems, but also to discover the problems and find original solutions. While creativity can be studied by looking at the creative individual, the products they create, the conditions that foster their creativity, or their creative process, it is most commonly measured with divergent thinking tests. Creative individuals are presented with an open-ended problem with no single correct solution—for example, describe as many uses as you can for a common object such as a brick—and their creativity is scored based on how many meaningful solutions they can come up with and elaborate on.
Results from tests like these led psychologist Robert Sternberg to define creativity in his appropriately titled and definitive book Handbook of Creativity as "the ability to produce work that is both novel and appropriate." A creative individual is able to "oscillate back and forth on a cognitive continuum," from a defocused state where remote elements can be associated with each other to a focused state where these elements can be combined in a useful way.
Nash's game theory was so brilliant because it broadened previous work to include games that involved both competition and cooperation. This "opened the door to applications of game theory to economics, political science, sociology, and, ultimately, evolutionary biology" writes Sylvia Nasar in A Beautiful Mind. Nash's work was indeed novel and appropriate to many fields.
While psychosis is similarly easier to describe than to define, many psychologists now view mental disorders as the extreme end of a personality continuum. Some also argue that the two main "categories" of mental disorders—affective disorders, where patients shift between periods of depression, mania, and seemingly normal behavior; and the more pervasive schizophrenia that afflicted Nash—are more like dimensions. This dimensional view suggests that there might not be a link between psychotic states and creativity, but rather a link between the traits underlying both.
At the turn of the twentieth century, Italian psychiatrist Cesare Lomboro undertook a large biographical survey, initiating the scientific search for a link between creativity and psychosis. Lombroso studied the biographies of creative men and women across diverse fields—including Julius Ceaser, Isaac Newton, Petrarch, and Descartes—and reported his results in his book, The Men of Genius, published in 1896. Like those who conducted similar historical studies after him, the conclusion Lombroso reached was that, "Between the psychology of the man of genius and the pathology of the insane, there are many points of coincidence; there is even continuity."
The temporal relationship between psychotic episodes and creativity was studied in Lomboro's book The Problem with Genius, which concluded that those creative individuals tended not produce their creative work during times of psychosis, but often right after. As Sylvia Plath wrote, "When you are insane you are busy being insane—all the time."
With Mendel's discovery of genes and chromosomes, studying the link between creativity and madness shifted toward family studies in an effort to uncover whether creativity and psychoses were heritable.
These studies revealed that creativity results from a combination of other traits that are partially heritable. Creative individuals rank high on personality traits such as openness to experience and novelty seeking, leading to a decrease in latent inhibition and an increase in fantasy proneness. This lower threshold for screening irrelevant stimuli from conscious awareness is also a factor underlying vulnerability to psychosis. Similarly, while psychoses show modest heritability—relatives of schizophrenics having higher rates of mental disorders than the normal population—biological vulnerability to psychoses must be complemented by stress from the environment. Taken together, these results suggest an evolutionary hypothesis whereby genes that cause a predisposition to psychoses are kept in the gene pool because they also offer an advantage—in this case, creativity: the ability to paint Starry Night, compose Symphony No. 9, or calculate the laws of motion.
But do the same traits of creativity and psychoses underlie both eminent artists—Woolfe, Van Gogh, and Beethoven—and scientists—Einstein, Newton, and Nash?
In his book Madness and Modernism, Louis Sass argues that the symptoms characteristic of those with affective disorders map onto artists, while in The Dynamics of Creation, Anthony Storr argued that those symptoms characteristic of schizophrenia map onto scientists.
One can imagine Beethoven sitting at his piano, a romantic, emotional figure motivated to take pen to paper and compose an inspiring symphony. Many other artists, poets, and novelists display characteristics of this affective psychosis.
One can also imagine Nash sitting alone in his room, detached from the world, his abstract thinking manifested in the equations and patterns he circles and scribbles down on reams of paper. Many other scientists, philosophers, and mathematicians display characteristics of this schizotypic personality.
Recent studies have started to investigate the neurological mechanisms underlying creativity in these psychotic individuals. By using near-infrared optical spectroscopy while individuals were engaged in divergent thinking tests, Brandon Folley, a psychologist at Vanderbilt University, reported that creative thinking causes bilateral activation in the prefrontal cortex—the region of the brain associated with higher order, abstract thinking. Schizotypes, however, show an increase in only right prefrontal cortex activation—which is involved in forming unusual verbal associations—during divergent thinking.
Could this be the answer to the much sought after link between creativity and psychoses? Further studies using more advanced imaging techniques aim to discover whether neurotransmitter imbalances—especially serotonin and dopamine, which are hypothesized to play a role in many mental disorders—are the common factor.
John Nash, whose symptoms improved with shock therapy, medications and the passage of time, was eventually able to cope with the disorder, but he now hopes for a cure for the sake of someone else. His son, Johnny, a gifted student who used to spend time in the common room at Princeton where his father first came up with his ideas of game theory, developed the same mental illness that plagued his father. As Nasar writes at the end of A Beautiful Mind, "Johnny has been treated with the newest generation of drugs…these have enabled him, for the most part to stay out of the hospital, but they have not given him a life."
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