The Association Between Creativity and Psychopathology: Part II

On “Creative Mythconceptions: A Closer Look at the Evidence for the ‘Mad Genius’ Hypothesis” by Schlesinger (2009)

            Most people believe that the link between creativity and mental illness has been scientifically “proven,” but this belief is unfounded, according to Schlesinger (2009), who says that the issue is by no means settled, and may never be settled due to the difficulties of conducting research on the topic. Schlesinger (2009) critically reviews the work of the three biggest names in the field and argues that their “landmark” studies contain serious methodological flaws that have, until now, been overlooked or underemphasized by the scientific community. She states:

Many people—including too many mental health professionals and textbook writers—continue to assume that an invariable connection between great creativity and pathology has already been proven. This conviction draws its primary strength from two sources: (a) the influential claims of psychiatrists Nancy Andreasen and Arnold Ludwig and psychologist Kay Redfield Jamison, and (b) the lack of equally strong, visible, and recurring professional statements to the contrary. (p. 62)

            Schlesinger (2009) condemns modern researchers for citing the seminal works of Andreasen (1987), Jamison (1989; 1993), and Ludwig (1995) without critically analyzing their methodologies, and she rather pointedly insinuates that the prominent trio is often cited by researchers who haven’t actually read the original publications. Schlesinger expresses her disappointment that many authors trumpet the words of Andreasen, Jamison, and Ludwig as if their suppositions are verified facts rather than tenuous speculations. She wryly alleges that one text had to borrow a quote from Nietzsche in order to “compensate for its lack of hard data” (p. 63). After relaying the quote—‘One must harbor chaos within oneself to give birth to a dancing star’—Schlesinger condenses the sentiments of her entire thesis into a single, sarcastic question: “Who needs science when we have such compelling poetry to make the case?” (p. 63).

When the “scientific” evidence of Andreasen, Jamison, and Ludwig is scrutinized, it becomes clear that Schlesinger’s critiques—blunt and facetious though they may be—deserve serious consideration. According to Schlesinger, Andreasen’s famous study began in 1972 but was not published until 1987. After fifteen years of data collection, Andreasen only managed to amass a whopping N of 30 (27 of these were male). All experimental participants were faculty members from the Iowa Writers’ Workshop, and Andreasen herself interviewed them about their own mental health histories as well as the pathologies of their closest relatives. Andreasen’s interview was self-constructed and lacked empirical validation, and her diagnostic criteria were only available for review upon request. Participants in the non-writer control group worked in areas such as law, administration, and social work—professions that Andreasen personally believed did not require high levels of creativity (Schlesinger, 2009).

Despite the clear flaws of this design—questionable validity of measures/constructs, high risk of experimenter bias, small sample size, and low external validity, to name a few—Andreasen’s ‘stunning’ report that 80% of the writers in her study suffered from mood disorders, compared to only 30% of the non-writers, spread quickly and soon became fodder for news stories and media dramatizations (Schlesinger, 2009). While Andreasen later acknowledged a few limitations of her study, she attempted to divert further criticism by reporting that 2 of her 30 writers eventually committed suicide. In Andreasen’s words: ‘the issues of statistical significance pale before the clinical implications of this fact’ (p. 64). Schlesinger, however, seems to think that the myriad of methodological weaknesses and dearth of significant results in Andreasen’s (1987) study have remained the key areas of concern (Schlesinger, 2009).

Similar methodological criticisms apply to the works of Kay Jamison, who has also been a great champion of the link between creativity and psychopathology, specifically focusing on mood disorders. Schlesinger (2009) notes that Jamison’s (1989) study used a small, handpicked sample; there was no control group; and all conclusions were based on self-report data, which was collected during interviews by Jamison, who apparently utilized unofficial diagnostic criteria. Despite these weaknesses, Jamison’s findings were, at first glance, even more remarkable than Andreasen’s: Jamison reported that her creative participants sought treatment for affective illness at a rate 30x greater than that of the general population. However, it does not take long for Schlesinger to add, “The 50% figure for disordered poets is equally astonishing, unless you know that it represents only nine people, news that tends to disappear when the study is quoted—along with the fact that her 12.5% total for depression-medicated visual artists refers to just one person” (Schlesinger, 2009, p. 65). Clearly, sample size was as much of a problem for Jamison as it was for Andreasen.

Schlesinger was not the first to comment upon these deficiencies. In his book, Creativity and Madness: New Findings and Old Stereotypes, Albert Rothenberg (1990) states:

Two presumably objective studies by Drs. Kay Jamison and Nancy Andreason…have been consistently discussed in popular as well as professional publications as having proven a connection between affective illness—depression, mania, or both together—and creativity, despite the fact that the first had not been published or reviewed in a scientific journal until quite recently, and the other had a flawed research methodology. The need to believe in a connection between creativity and madness appears to be so strong that affirmations are welcomed and quoted rather uncritically. (p. 150)

            Rothenberg (1990) later asserts that creative eminence is in no way associated with a particular personality type or disposition; rather, he reports that, in his own research, the only trait present in creative individuals across the board was motivation. Still, Rothenberg’s (1990) criticisms did not sway popular opinion, and, four years after Jamison’s initial study, she published a book entitled, Touched with Fire: Manic Depression and the Artistic Temperament, which became, in Schlesinger’s (2009) words, the “proverbial bible” in the creativity and mental illness debate (p. 63). Of course, the majority of evidence in Jamison’s book is anecdotal, and some of the claims are simply educated guesswork. For example, Jamison includes a table entitled ‘Probable Cyclothymia, Major Depression, or Manic-Depressive Illness’ that lists the names of 166 dead writers, artists, and composers, whom Jamison personally “diagnosed.” Never mind that archive-based, retrospective diagnoses should be viewed with caution on principle alone—the lack of a bibliography completely precludes any attempt for readers to assess the validity of Jamison’s sources and diagnostic criteria. Most concerning is that the word ‘Probable’ tends to disappear whenever the list is referenced (Schlesinger, 2009), and thus Touched with Fire only added fuel to a flame that was already spreading too quickly.

Finally, Arnold Ludwig, the author of a (1995) book entitled The Price of Greatness: Resolving the Creativity and Madness Controversy, was heavily influenced by the writings of Jamison, and his support for the link between creativity and mental illness is no less questionable, again due to methodological flaws. Ludwig read the New York Times biographies of 1,004 famous individuals in an attempt to identify psychological commonalities that might have contributed to their achievements. Yet he treated the biographies as if they were objective sources, rather than acknowledging that the biographers must have had their own personal and professional agendas at the time of composition. In addition, he lumped military, scientific, social, and political eminence in the same category as artistic eminence; his evaluations were based upon variables that were largely undefined and subjective (e.g. ‘oddness’); he contradicted himself throughout the text regarding whether or not he actually supported a link between affective disorders and creativity; and, like Jamison, he failed to include a bibliography (Schlesinger, 2009).

Given that Andreasen, Jamison, and Ludwig’s investigations all contained substantial flaws and limitations, Schlesinger concludes that “there is still no clear, convincing, scientific proof that artists do, in fact, suffer more psychological problems than any other vocational group” (p. 69). We should therefore find it troublesome that our culture’s endorsement of the “mad genius” hypothesis has been based almost exclusively on the claims of Andreasen, Jamison, and Ludwig—claims that do not hold up well under scientific scrutiny. These three figures have had an enormous influence on the rest of the field, and this reality must be acknowledged as we evaluate and interpret the findings of more recent publications.

(Search “Psychopathology” at the top of the page to find the other posts in this series!)

References:

Schlesinger, J. (2009). Creative mythconceptions: A closer look at the evidence for the “mad genius” hypothesis. Psychology of Aesthetics, Creativity, and the Arts, 3(2), 62-72.

Rothenberg, A. (1990). Creativity and madness: New findings and old stereotypes. Baltimore: The John’s Hopkins University Press.

 

Also see:

Andreasen, N. C. (1987).  Creativity and mental illness: Prevalence rates in writers and their first-degree relatives. American Journal of Psychiatry, 144, 1288-1292.

Jamison, K. R. (1989). Mood disorders and patterns of creativity in British writers and artists. Psychiatry, 52, 125-134.

Jamison, K. R. (1993). Touched with fire: Manic-depressive illness and the artistic temperament. New York: Free Press.

Ludwig, A. M. (1995). The price of greatness: Resolving the creativity and madness Controversy. New York: The Guilford Press.

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