Technology has evolved considerably since my first years in the Medical Center and, as we all know, the speed of that evolution is itself increasing. Today any reasonable 10-year-old can remember a time before the first iPhone. I can myself recall an even worse epoch when there were no cell phones at all, not even flip phones. In those days, I knew the location of every single telephone booth there was along the corridor between my house and the hospital—and along both sides of the road–because when my beeper went off, I had to find a pay phone in a big hurry to call in. This made for skittish driving when I was on call. And not just me: I know of accidents–one of them grimly fatal–that occurred when a colleague’s beeper went off on the drive home, or on the drive into work, and good road safety was challenged by the programmed, urgent need to find a telephone. Continue reading “Handguns”
My Girl Wears Long Skirts
When I met her, she had just been admitted onto the unit, and was being watched 24/7 by an aide hovering nearby, but she nevertheless one afternoon, with no warning whatsoever, leapt out of her chair, sprinted as fast as she could run, and threw herself head-first through the window at the end of the second-floor hallway. However, because the window was fitted with unbreakable plexiglass, she didn’t go through it to plunge to her death, though she did break her nose and further bruise her poor face. Hospital staff got to be pretty twitchy around her, until the shit-load of Haldol she was given began to have an effect, and she was sedated enough to allow less impulsive people to keep up with her.
She was serious about her self-harm. From her own point of view, she felt she had reason to be so deadly in her attempted suicide: she had caused the Second World War, and she was simply unable to bear the excruciating pain of her grief and guilt. Those terrible years of wartime anguish and physical suffering were entirely her fault: 60 million soldiers killed, 4.5 million Jewish people—and uncounted gypsies—sent to the death camps, Japan bombed with nuclear warheads. Most of the northern hemisphere ran thick with blood, and fried in a radioactive fire because of her.
Her diagnosis was schizoaffective disorder, and she was heart-breaking to be with, when she didn’t terrify you with her potential for another lethal gesture, so staff bound up their anxieties as best they could and tried to alleviate, somehow, her mortal sorrow. In 1991 she was 22 years old, having been born in 1969, which—if you do the math—was 24 years after the conclusion of the war in 1945, and 30 years before it began in 1939. The favorite strategy among us, therefore, was to choose a time when she seemed receptive, and point out in a kindly way that, since she wasn’t yet alive when the war began, she could not have been the origin of it. This seemed to be an unanswerable refutation to the basis of her emotional torment. She could not possibly have caused the war, so be of good cheer.
Although I don’t know that any of us actually thought about it this way, we all in fact shared a two-fold assumption common to well-meaning people the world over: a. that emotional turmoil was refutable (i.e. that we could talk Wanda out of it); and that, b. common sense would be the source by which the refutation prevailed. Neither assumption proved to be true. Despite her long stay on the inpatient unit, Wanda never was reconciled to happiness, but simply became less violent in trying to relieve herself of her psychic pain. She became more stoical, or at least became used to living with her sense of personal responsibility, and inured to everyone else trying to cheer her up.
Our argument was never persuasive either. I was, of course, one of those compulsive explainers trying to set her right. I was fully committed, I admit it: her passion was supported by no more than the merest bubble, it seemed to me, just the frailest sense drifting away from humane connection, and so I talked with her. I listened as hard as I could when she tried to convey her deep conviction of her causal guilt. She had started walking, she told me, on Church Street when she saw the foil wrapper of a piece of gum, and she knew that the foil was reflecting God’s thoughts to her about cast off people because the wrapper was in the gutter near a mailbox with the American eagle on it which meant war, and war was WWII, and so she caused it because there she was.
Actually she said a considerable amount more than this, but I couldn’t follow it all. I was in truth able to follow hardly any of it. What I have represented here are only the few details I could remember long enough to write them down, and I remembered them that long chiefly because, out of the welter of things she said, these items were those that I could make sense of for her. That is, because I thought I saw coherence in the sea of verbal production, I was able to remember these details, but not any of the others.
In its actual presentation, none of her thinking was coherent. She was far less organized than what I have represented in her tangential logic because I cannot disorganize my mind enough to reconstruct the brute chaos of hers. She could not sequence her thoughts, could not put them in an order that made sense, even to her. She was over whelmed, prostrate before fragments and huge ungated emotions, and therefore she was terrified: there were no conventions of meaning, all mental structure was sundered, she had no fundamental recognition of cause and effect, or even temporal series. She couldn’t tie her shoes, couldn’t manage her hygiene, would eat only sometimes if food happened to be placed in front of her. Like I said, she was heart-breaking.
Lately among scientists studying the human mind, there is a temptation to see in this mental place of Wanda’s a freedom from conventional restraints of thought that is promoted as a model of the creative process. Dr. Nancy Andreasen’s article in the current July/August Atlantic Monthly is a case in point. Science is always interested in isolating the important variables (and as a corollary, ignoring those that it construes as unimportant to its theory), and in studies of creativity, the favored candidate is a concept of freedom, an escape from conventional thought, the ability to avoid the usual grind of daily associations, to make something new, and thereby elude the standard conclusions of a “average mind—with one thought less each year,” as Ezra Pound imagined it. From this point of view, Wanda represents a class of people who are about as free from conventional standards of thought as anyone science could hope for. If you want a group of people whose thought lacks customary, middle-class organization, then schizophrenia will do.
Accordingly, once exemplars of freedom have thus been identified, the interest then is to discover whether creative people have a higher incidence of mental illness among their families than the average banker has occurring in his. The general logic is that creative people find their creativity because they are just a little mentally ill–not entirely whacked out like Wanda, but just weird, a-typical, eccentric, flaky but not funky. They “think different”, like Steve Jobs. They had rather spend their time playing with words, or drawing pictures, or like Georgia O’Keeffe painting large images of flowers that look like female genitalia—all instead of making money the way rational, non-weird people prefer to do. This theory works best if you do not really know the details of psychotic life–which science gets around nicely by preferring to ignore individuals, and instead to look at the class as a whole to isolate apparent similarities among them as a group. It is easier to construe mental illness as a model for imaginative freedom if you do not actually listen to individuals like Wanda, do not spend time with them to uncover how their minds are actually working, or failing to work–and do not bother much with empathy.
It is also easier to generalize across individuals to reach group commonalities if you do not have a concept for creativity itself. Why bother to define creativity, Dr. Andreasen reasons, if you can just look instead at people who are supposed to embody creativity, whatever that is? As she points out, “If it walks like a duck and quacks like a duck, it must be a duck.” And besides, if you accept analogies about ducks in place of logical argument, then her problem is now much easier: she just needs to identify who the creative people are among us. Fortunately for Dr. Andreasen, there are various literary awards that do this work for her. Creative people, she tells us, are those whom academic professors have given prizes to.
I am going to assume that the naiveté of this reasoning is self-evident to everyone who is not a tone-deaf neuroscientist–though I will permit myself to point out, irritably, how this ceremonial process has somehow failed to recognize the likes of Emily Dickinson, Marcel Proust, Virginia Woolf, James Joyce, and virtually every person of color writing before 1993–none of whom were awarded anything, certainly nothing like what Pearl S. Buck received (Nobel Prize), or even Antonio Egas Moniz (another Nobel laureate), who ‘invented’ lobotomy, which was understood to cure mental illness. Dickinson, of course, couldn’t even manage to get published in her lifetime.
And though I am sorely tempted, I do not want to spend too much time here with the weaseling details of Dr. Andreasen’s peculiar argument. I am after much bigger game: the impulse itself to romanticize mental illness as a prodromal feature of creativity–which is at once an unfeeling injustice to people suffering with psychotic spectrum psychosis, and a cynical misunderstanding of the nature of creative activity. Wanda’s mental flights out of organized thinking were not redeemed by imaginative insight into the nature of war, nor into the trauma of violent death, nor the social tragedy of senseless slaughter. Nor was there insight into her own mental processes, no exposure of underlying psychic conflicts, no understanding regarding the nature of her sense of guilt and responsibility. Nor did she produce anything that an outside audience might find edifying. She was, in short, not creative. She was psychotic. Big difference.
I suppose it could be argued that we should not be too hard on Wanda for failing to create anything memorable since she was not an artist to begin with. But I want to mention an occasion I had to study the transcript of a Rorschach that had been given to a famous writer (whom I shall not name) when The Famous Writer (TFW) had been hospitalized psychiatrically in an institution that I shall also avoid naming. (I do not want to be publishing protected medical information). Unlike Wanda, who was not and never will be considered a creative person by Dr Andreasen’s standards, TFW would fit her definition. So I read the Rorschach transcript with fascination. The Rorschach is a test designed something like Georgia O’Keeffe’s paintings: the ambiguous image encourages the subject to project whatever structures are inside his or her mind to organize that visual ambiguity into a coherent percept. Some things may be more common than others to see.
There are ten cards, and to my surprise at the time, there was nothing in any of TFW’s responses that was artistic: no startling imagery, nothing of intelligent word magic, little that was coherent, and even less that was memorable–apart from the one line that I happen to recall, with which I have titled this article: My girl wears long skirts. And in its context, that one sentence wasn’t even a pertinent response, but represented a moment of tangential thinking–the mind drifting away from its subject. Upon recovery, TFW also said the same thing that I am saying: there was nothing redemptive about the episodes of mental disorganization that was suffered, no depths plumbed that were useful to subsequent creative projects, no lines resurrected from the chaos that were ever used in subsequent written products. The periods of illness were life wasted. What TFW created when he wrote was of an order entirely different than what his mind did when it disintegrated. There was no lesson to be learned from his own mental illness, certainly no general theme to be promoted about creativity at large.
The creative act does not arise out of a freedom from restraint, or an escape per se from conventions. As my instance of Wanda can attest, psychotic escape both throws away conventional meaning, and in fact destroys the principles of meaning itself. Creativity, on the other hand, is better understood as a freedom to perform among a multiplicity of choices. It is the mental compass to digest the whole range of worldly features, the discretion to select among the play of cultural, social, and natural fragments, the comfort with randomness within shapeless substances. Creativity invents out of chaos, not out of the void–as Mary Shelley noticed in her Introduction to Frankenstein: Invention, she writes, does not consist in creating out of void, but out of chaos; the materials must, in the first place, be afforded: it can give form to dark, shapeless substances, but cannot bring into being the substance itself.
Creativity is no more associated with psychotic illness than it is with alcoholism (which also disinhibits the mind), or personality disorders (which filter social data through a non-standard perspective) or lung cancer (because creative people smoke) or congestive heart failure (because writers, at least, sit at their desks all day and get fat). There may be correlations among all these things, but of course correlations are cheap. Did you know, for example, that when I was born, there were earthquakes in Chile and 40 people died in China?—which, sad to say, do not attest to the worldwide influence of my birth. Three things (my birth, earthquakes, the death of 40 people) just happened somewhere at the same time. But there is nothing causative here.
The impulse to pathologize creativity is part of the present cultural drive to find pathology everywhere within our daily, usual, precious mental life–so that sorrow is now depression, physical energy is now hyperactivity, mental energy is now mania, flights of imagination are now psychoses, shyness is now social anxiety, individual differences are now personality disorders. The collusion between science, medicine, and money makes a compelling horror story, but that narrative is beyond the scope of my work here. Let me suggest that, if you want to be frightened, don’t watch Shark Week, but instead read Blaming the Brain, by Elliot Valenstein, or Anatomy of an Epidemic, by Robert Whitaker. Both will disturb your sleep.