The Chronicle Review

Madness and the Muse

We’re captivated by the idea of the troubled genius. But is it a fiction?

Illustration of Beethoven, Virginia Woolf, and Kurt Cobain by Meen Choi for The Chronicle Review

September 19, 2014

Nancy Andreasen is not a smooth performer-of-ideas in the TED vein, the sort who roams the stage wirelessly mic’d, dispensing wisdom with Broadway-caliber aplomb. She does it old school, podium and PowerPoint, describing her research as she clicks through slides. The 400 or so people gathered for a midafternoon session of this summer's Aspen Ideas Festival were drawn by the promise of learning "The Secrets of the Creative Brain" from Andreasen, a literary scholar turned psychiatrist and neuroscientist, winner of the National Science Medal, and author of a landmark study that found that eight out of 10 writers had experienced some form of mental illness during their lives. When the study was published in 1987, it was taken as scientific confirmation that there is indeed a link between creativity and mental illness, that most of our geniuses are fragile, moody, and perhaps a bit mad.

Her presentation concluded with a flourish as photographs of famous and famously troubled artists like Hemingway, Beethoven, and Kurt Cobain flashed on the screen to the strains of Don McLean’s "Vincent," as in van Gogh, the ear-carving archetype of suffering for your art. McLean’s most memorable line could serve as a kind of musical epigraph for Andreasen’s research: "This world was never meant for one as beautiful as you."

The song ended. Applause.

I sat in the very back row of the crowded room, squinting at the screen and scribbling notes. Afterward I ran into a couple of creativity researchers, Keith Sawyer and Scott Barry Kaufman, and asked them, casually, what they thought of Andreasen’s talk. While I can’t swear they rolled their eyes simultaneously, I can’t swear they didn’t.

"Let me think how to put this," said Kaufman, trying to be polite.

"I stayed for as much as I could take," said Sawyer, not trying as hard.

Both admitted to walking out before Andreasen was finished.

Though you’d never know it from Andreasen’s lecture, or from the article she wrote recently for The Atlantic, the notion that there is an established connection between mental illness and creativity is far from undisputed. A new generation of researchers, who came of age in the era of positive psychology, frame creativity in terms of flow states and mindfulness; in other words, not as symptoms of disease but as evidence of human flourishing. Theirs is a nicer, more democratic view, one that sees creativity as a capacity to be nurtured and developed, something all of us possess, perhaps to varying degrees, rather than a rarefied ability tragically paired with affliction.

So is there really a link? Or is Andreasen peddling a morbid, shopworn theory? Moving closer to an answer requires first untangling the question.

Back in 1972, when Andreasen began her research into creativity and mental illness, what she assumed she’d prove is that there is a relationship between creativity and schizophrenia. John Nash, the brilliant mathematician and game-theory pioneer, with whom Andreasen is friendly, battled the condition; Nash’s story was the basis for the movie A Beautiful Mind. James Joyce’s daughter was diagnosed with schizophrenia and Carl Jung believed the writer himself had it. Perhaps the off-kilter vision of the world in the mind of the schizophrenic is not unlike the celebrated imagination of the genius.

For more than a decade, Andreasen interviewed and tracked 30 faculty members from the renowned writing workshop at the University of Iowa, where she is a professor of psychiatry. She also interviewed and tracked 30 control subjects of similar age and IQ who worked as administrators, lawyers, social workers, and so on. She questioned and diagnosed subjects using a methodology she devised. Instead of identifying a passel of schizophrenic novelists, Andreasen stumbled on extremely high rates of mood disorders like depression and mania among the writers. The gap between the writers and the control subjects was huge: Eighty percent of writers reported some mental illness compared with 30 percent of nonwriters. Andreasen also found that writers' families were "riddled with both creativity and mental illness," much more so than the families of the control subjects. Her conclusion: "affective disorder may produce some cultural advantages for society as a whole, in spite of the individual pain and suffering it also causes."

Andreasen’s findings lent empirical heft to popular books like Touched With Fire: Manic-Depressive Illness and the Artistic Temperament, by Kay Redfield Jamison, a professor of psychiatry and behavioral sciences who has written about her own struggles with depression, and A Brilliant Madness: Living With Manic Depressive Illness, by the actress Patty Duke. Forty years later, Andreasen’s study continues to be cited, nearly 700 times to date, according to Google Scholar, and it still attracts mainstream interest. Just this summer, a film crew from PBS NewsHour visited Andreasen at her lab and on her 40-acre ranch in Iowa to pick her brain on, among other topics, whether creative people with mental illness should be treated for their conditions. (She said she wasn’t sure.)

The depressed writer is a stock character, like the ditzy cheerleader or the slick salesman. It’s something we believe almost without thinking about it, in part because that pathetic figure so frequently appears in books and movies, and because we can point to historical examples of artists plagued by mental illness. John Berryman leapt from a bridge. Virginia Woolf walked into a river. David Foster Wallace, a fairly new addition to this sad list, hung himself. We mull the meaning of their deaths, divine clues from the works they left behind.

We do the same with other artists. After Robin Williams's recent suicide came the predictable musings about whether his comedic brilliance was fueled by his apparent depression. Was his manic humor a tool to keep the darkness at bay?

Our readiness to accept the connection between mental illness and creativity makes Andreasen’s research all the more palatable: It is approval from on high of what we already feel in our guts. Perhaps it's perversely comforting to us nongeniuses that artists, in a sense, pay dearly for their cultural accomplishments. Maybe you'll never produce a great American anything but at least you're not nuts. At the same time, it's nice to think that the mentally ill harbor some special skill, and to argue otherwise seems unkind.

And that’s part of the problem, according to Judith Schlesinger, who is probably Andreasen’s most vociferous critic and author of The Insanity Hoax, a 2012 book devoted to skewering the supposed link. "The mad genius is a beloved cultural artifact," Schlesinger writes. "It provides the perfect container for every romantic fantasy about both madness and genius—and doesn't have to be any more precise than that to be useful." She accuses society of "chasing its geniuses with a butterfly net and demeaning their work as the product of a disordered mind."

Schlesinger dissects Andreasen’s study, finding it wanting at every turn. The study was not double blind, so Andreasen knew which of her subjects were writers, potentially compromising her sample from the outset. Not that Andreasen was out to fool anyone, only that she might subconsciously emphasize the mental illness of writers over nonwriters. The sample size, Schlesinger contends, was too small to make any generalizations. The writers were mostly middle-aged, mostly male (27 of the 30) and entirely white, so not terribly representative. In order to qualify as mentally ill, the subjects needed only to have experienced "an episode of affective illness at some point in their lives." As Schlesinger highlights, Andreasen didn’t publish her methodology, nor did she keep records of her interviews, making independent analysis of her results next to impossible.

Schlesinger, a psychologist and jazz critic, reserves special scorn for one sentence in particular. Andreasen notes that two of the 30 writers she studied killed themselves. "Issues of statistical significance pale before the clinical implications of this fact." For Schlesinger, this is emblematic of Andreasen’s emotion-over-data approach, breezing past doubt with anecdotal assertion. "She says, ‘Forget the math, guys, this is serious stuff! These guys killed themselves!’" Schlesinger told me. "How is that science?"

The Insanity Hoax wasn’t the first book to cast a critical eye on Andreasen’s results. In Creativity and Madness: New Findings and Old Stereotypes, published in 1990, three years after the publication of Andreasen’s study, Arnold Rothenberg wrote that while Andreasen’s discovery "might seem striking, and even impressive, we must hesitate to accept it." Rothenberg studies highly creative people too; his forthcoming book is based on interviews with Nobel laureates. What bothers Rothenberg, among other issues, is that Andreasen drew her sample entirely from Iowa’s workshop. "The quality of the workshop has been known to vary widely and some of the writers may have been there because they had either never been successful or else were no longer successful and were seeking a refuge—important considerations for assessing depressive illness," he writes.

In a 2000 paper that serves as a kind of mission statement for positive psychology, Martin E.P. Seligman and Mihaly Csik­szentmihalyi, the field’s two heaviest hitters, wrote that its goals included understanding "how optimism and hope affect health, what constitutes wisdom, and how talent and creativity come to fruition." Optimism, wisdom, creativity: These are all good things. Following in that tradition, Keith Sawyer, a psychologist at the University of North Carolina at Chapel Hill and author of Zig Zag: The Surprising Path to Greater Creativity, talks about creativity as a muscle to be flexed, a skill to be acquired and improved. Down with the unbathed, unhinged artiste; up with the cooperative, creative contributor. Like Schlesinger, Sawyer insists that the science shows no link between creativity and mental illness, that in reality the information points in the other direction, that creativity is associated with psychological stability. And a few studies have found, for instance, that workers in positive moods are more creative, though whether that translates to making art is unclear.

Given that, it makes sense that Sawyer might be annoyed, even apoplectic, that Andreasen’s research findings once again dominate the national conversation on creativity and mental illness. "Deeply unscientific" is how he describes her Atlantic piece. "She’s a nice woman and I’m sure she’s having fun doing what she’s doing," he says, "but the link just isn’t there."

Here’s where it gets complicated. You will have a hard time finding a creativity researcher willing to offer a full-throated defense of Andreasen’s 80-percent-of-writers-are-depressed-or-manic verdict. But that doesn’t mean they completely rule out the possibility of a more subtle connection. It depends on how you ask the question. When it comes to everyday artistic expression, what some call little "c" creativity, the consensus seems to be that playing banjo with your buddies or making decorative coffee mugs in your backyard kiln doesn’t mean you’re more likely to need professional help. But when it comes to genius-level creativity, the truly groundbreaking stuff, there is much more doubt.

James C. Kaufman—no relation to the aforementioned Scott Barry Kaufman—is a longtime creativity researcher and editor of a collection of essays on mental health and creativity that will be published this fall by Cambridge University Press. He did not ask Andreasen to contribute an essay, and he told me that her research was "certainly interesting and likely completely meaningless." So while he doesn’t think much of Andreasen’s work, he doesn’t entirely dismiss the idea that there is a link, at least for certain, high-level artists. "Are you talking about everyday creative people, or are you talking about Mozart?" Kaufman, a professor of psychology at the University of Connecticut at Storrs, asks. "When it comes to genius, there’s been more work done and, whether or not you want to say it’s compelling, there’s enough to say that there’s a debate."

Kaufman’s own work has fueled that debate. In a 2001 study, he examined the biographical information of 1,629 writers and found that female poets were more likely than any other kind of writer (female novelists, male poets, etc.) to suffer from mental illness. Kaufman called this phenomenon, memorably, the Sylvia Plath Effect. Since its publication he has had misgivings about the message that study sent. Kaufman only looked at very famous writers and his method was historiometric—that is, he mined writers' biographies, from which, he concedes, "it’s possible to extrapolate too much." Kaufman worries that his study and others that rely on this method get interpreted as confirmation that writers are necessarily unbalanced. "Give me a minute and I’ll send you a list of 200 wonderfully creative people who are very mentally stable and lead boring lives," he says.

Like Kaufman, Dean Keith Simonton doesn’t rule out a connection. Simonton, a professor of psychology at the University of California at Davis, has staked a nuanced middle ground between the link and the no-link crowds. He argues not just for a distinction between everyday creativity and genius, but between run-of-the-mill genius and super genius. Simonton cites a list of the 150 greatest operas performed by the Metropolitan Opera, in New York. Those 150 operas were written by 72 composers. Most of those composers contributed one or two operas to the list, which is obviously impressive. But on that list of 72, there are two composers—Richard Wagner and Giuseppi Verdi—who each composed more than 10. If you compose one great opera, you’re amazing. If you compose 12 great operas, you’re so amazing, the idea goes, that maybe something is wrong with you. (As it happens, Wagner showed signs of borderline personality disorder.)

In a forthcoming paper, Simonton argues that everyday creative people are probably more mentally healthy than noncreative people, but among the highly creative, the so-called super geniuses, perhaps pushing the boundaries comes at a price. He calls this the mad-genius paradox. "That connection is not tantamount to saying that genius is necessarily insane, like was so popular in 19th-century psychiatry. But there is a shared vulnerability," he writes in an email. As for Andreasen’s much-talked-about study, Simonton doesn’t mock her findings, as some researchers do, though he doesn’t exactly embrace them, either: "It’s easy to criticize any one study as having too many flaws to make a convincing case." When you add everything up, Simonton thinks, there is a link, just not the big, clear link that Andreasen thinks she found.

I wanted to see what Andreasen thought of the criticism. Judging by her public pronouncements, it appears that she doesn’t have much to do with the rest of the field of creativity studies. By phone, she allowed that her study—which, in fairness, began more than 40 years ago—may be imperfect. She regrets not recording interviews and that her handwritten notes no longer exist. "It would be interesting to have them preserved so I could go through and apply more stringent criteria, and I think if I did that they would be lower in each of the two groups," she says, meaning writers and nonwriters. "But I think the important thing is that there’s a difference between the two."

She does not concede that the original study was fatally flawed. Not in the least. In fact, she says her follow-up study, years in the making and apparently far from finished, will support those original findings and makes use of tools like neuroimaging to understand what separates creative people from noncreative people (she’s recording her interviews, too, this time). In the first study, two subjects took their own lives and in the current study two subjects have parents who committed suicide. Andreasen’s thesis is that mental illness and creativity run in families, so novelists and filmmakers and poets are more likely to have fathers, sisters, aunts, and so on who themselves are creative and likewise must cope with psychological problems. She stays in touch with her former subjects, and some of them, she says, are "really struggling," an observation that further bolsters her confidence in the results.

Andreasen has zero patience for those who doubt a link she believes has been scientifically established. Researchers who raise questions about her work are either ignoring reality or worse. "Is somebody like Keith Sawyer going to say they’re not mentally ill? That it doesn’t run in families? That it’s not associated with being creative? It seems like people who want to ignore this association are just burying their heads in the sand, or they are showing the typical hostile reaction toward the mentally ill," she told me.

It’s hard to take seriously Andreasen’s assertion that those who question a link are ignoring facts or somehow stigmatizing the mentally ill. At the same time, Sawyer and Schlesinger probably go too far when they say there’s no serious debate. The discussion too often gets derailed by wildly varying definitions of creativity and mental illness, terms that are so hopelessly broad that simply asking if there is a link between the two is unlikely to ever lead to a satisfying answer. The research that appears most promising takes a narrow look at particular fields and distinguishes between everyday creativity and bleeding-edge genius.

It remains a bewildering puzzle, one hampered by our still-evolving knowledge of neurological differences, the challenge of categorizing creativity, and the cultural biases that can’t help but influence our conclusions. It’s enough to drive anyone crazy.

Tom Bartlett is a senior writer at The Chronicle.