Ink and inspiration: Exploring the interaction between psychiatry and literature

Examples of people with mental illness who were also great artists abound, leading many to speculate that there is a special relationship between mental illness and creativity. This leads to what we might call the ‘Van Gogh effect’ — the belief, based on a small but significant number of exceptional cases, that psychiatric illness predisposes a person to greater creativity in the arts. Is it true?

This interesting idea is not, for the most part, based on systematic surveys of persons with mental illness to determine average levels of creativity, but is based rather on the individual stories of accomplished artists, writers and composers who were also diagnosed with psychiatric disorders or psychological problems, or spent time in psychiatric hospitals. The story of Ezra Pound, ably told in this book, The Bughouse: The Poetry, Politics and Madness of Ezra Pound, is a good case in point.

Pound (1885-1972) was an American poet and critic and a major figure in the early modernist movement. In 1945, however, Pound was due to stand trial for treason for his broadcasts in Fascist Italy during the Second World War and was declared insane. He escaped a possible death sentence by being sent to St Elizabeth’s Hospital near Washington DC, where he stayed for more than 10 years. St Elizabeth’s was, famously, the first federally-operated psychiatric hospital in the US, with over 8,000 patients at its peak in the 1950s. It was, therefore, bigger than any of the psychiatric hospitals in Ireland during this period.

Pound’s time at St Elizabeth’s was somewhat atypical: In his room on Chestnut Ward and in the elegant grounds, he was visited by the major writers and poets, including TS Eliot, John Berryman, Elizabeth Bishop, Charles Olson, Frederick Seidel and Robert Lowell. Lowell, interestingly, is also the subject of a recent biography which details his bipolar disorder, titled Robert Lowell, Setting the River on Fire: A Study of Genius, Mania and Character by Kay Redfield Jamison (Alfred A Knopf, 2017). Jamison has written extensively and impressively on these topics, especially bipolar disorder and creativity, in the past.

Returning to Pound, Daniel Swift’s book does a fine job of exploring the differing perspectives of doctors and visitors in relation to the troubled poet, each struggling to make sense of his mental state. Swift records and discusses the diagnoses applied to Pound, including depression and bipolar disorder, and explores the unclearness about therapies provided, including the issue of whether or not Pound received ECT (which remains uncertain). Swift also makes reference to E Fuller Torrey’s previous treatment of some of these themes in his fascinating The Roots of Treason: Ezra Pound and the Secret of St Elizabeth’s (Sidgwick and Jackson Ltd, 1984), which remains a key text.

While there are no firm conclusions to be drawn about Pound’s mental state in Swift’s book, it is still a very useful exploration of the interaction between two worlds — psychiatry and literature — and the ways in which one man found himself at a peculiar intersection of both. Swift’s book also presents a very useful timeline of Pound’s years at St Elizabeth’s and an interesting ‘essay on sources’ towards the end.

Swift’s writing is fluent and clear, just as one would expect from a contributor of the New York Times, New Statesman and Harper’s. He tells his story with some flair and with considerable focus on Pound’s literary work, as well as his mental state. In the end, Pound was released from the St Elizabeth’s in 1958 but was deeply depressed by December of the following year. He died in October 1972 in Venice.

So, what can we conclude about the relationship between mental illness and creativity? Pound’s story, although interesting, does not add to the understanding of this relationship any more than do other, analogous life stories, such as those of Robert Lowell, Van Gogh and various others. But taken together, these biographies do provide a clear demonstration that mental illness can certainly coexist with extraordinary artistic achievement in the same individual, although it might well be the case that periods of greatest creativity occur between episodes of illness.

Perhaps the best and most reasonable exploration of these themes has already been provided by Kay Redfield Jamison in Touched With Fire: Manic-Depressive Illness and the Artistic Temperament (Free Press, 1993), which received the Lewis Thomas Prize for Writing about Science in 2012. Jamison’s book is balanced and insightful, recognising the suffering of mental illness, as well as the possibilities for creative expression.

This is a complex area. Anyone who has experienced severe depression will be aware of the difficulties of doing anything while depressed, although insights stemming from depressive experiences may well motivate artistic endeavour later on, when well. Similarly, with mania, many people who are elated are filled with expansive visions and ideas but lack the focus to organise them while unwell. A minority, however, find a way to balance their increased energy with application to specific artistic projects, sometimes to dramatic effect.

John Dryden, in the language of his times, might well have been correct about the relationship between mental illness and genius, but that does not mean that mental illness should be romanticised. Treatments are needed, in addition to understanding, compassion, respect, and, of course, an acknowledgement of the key role of artistic expression for many people who are recovering.

Prof Brendan Kelly is Professor of Psychiatry at TCD and author of Hearing Voices: The History of Psychiatry in Ireland (Irish Academic Press, 2016)