Genius, Disease and Art therapy

Danguole Survilaite, psychiatrist

All children draw. There is some doubt whether they feel any especial impulse to create and set to paint by themselves. At school and at pre-school everyone is stimulated to take a pencil or a brush and so is encouraged to draw. Traditionally teachers correct child’s chosen colour: the sun is yellow, the sky is blue, and trees are green. Unfortunately, later on just a very few children become artists. One patient of mine, a graphic artist, coming from countryside and with no artists in his family, and so having no possibilities to learn painting, has told he has, as far as he remembers, drawn everywhere: in small stick on sand, in coal on walls, and on various pieces of paper.

It is obvious genius must be born, but it seems to me, that every grown up person might be taught to paint well, and even to create original art-works. Meanwhile music needs innate abilities (ear, voice, sense of rhythm, etc.), which are not possible to learn. Usually grown-ups are shy to draw insisting they are incompetent, though somehow they do not avoid singing.

It is much more easily to persuade to draw a person suffering from mental disease. What happens? Probably the public “censorship” stops functioning: “one cannot draw – one should not draw”? The opinion, that artists and other people having non-verbal contacts with their environment are kind of mad, is now dominating. And when one falls ill, one thinks “why can’t I become an artist if I am the God”.

Artist – oddity – mental patient?

It is such a common myth in the society that all the artists and creative persons are oddities, or said even stricter, “abnormal”, i.e. mentally ill. I am not going to analyse in this article an especially complicated problem concerning psychology, psychiatry, and philosophy, what it means to be normal and pathologic. As far back as Plato distinguished clinical and creative madness.
In the work of Siegmund Freud, published in 1910, it was psychoanalytically examined a biography of the famous Leonardo da Vinci. S. Freud, referring to quite meagre facts of L.da Vinci’s biography (an imagination about a hawk from his childhood, and a funeral list made by Katherine, who probably was his mother or his nurse), made a conclusion that the artist was homosexual. This work laid the foundations for a new genre – pathography. Pathography is a determination of pathology, referring to personal biography, letters, creative works, and so on.

It is known surely, that such artists as Vincent van Gogh, Michail Vrubel, Eduard Munch, Mikalojus Konstantinas Èiurlionis had been hospitalised in the mental clinics due to mental disturbances. It may be interesting to psychiatrists but in no case should be important to those fond of their works. I am very displeased when patients having red books start naming famous people with mental disorders. Not every mental user might be Èiurlionis, and the disease certainly does not make equal different personalities. I do not agree that disease helps a person to become a genius. Disease, especially a mental one, is medically negative factor. A person is more likely to be talented before the disease; just he most probably has been censored by society as well as by himself. The disease has enabled to get free. Sometimes I see that most of us are too much sound and limit our abilities too long. Otherwise, as my other patient says: “I would prefer being an unknown worker to mad genius”.

Does it exist “the art of mental patients”?

More than 100 years it has been interested in the art of mental patients in the world. In 1870 in Paris there was organized the first world exhibition of works of mental users. The art works exposed in the exhibition shocked the society. Such creativity held people in contempt and fear (by the way, the first exhibition of impressionism was held in 1874 in Paris as well). In 1921 Walter Morgenthaler, a Swiss psychiatrist, published a monograph titled A Mentally Ill Person as Artist about his patient Adolf Wölfli, where his creative personality was held in respect. One of the most famous book on the art of mental users until now is Artistry of the Mentally Ill (1922) by German Hans Prinzhorn. The other book, Artistry of the Prisoners is less known. Hans Prinzhorn was an opera artist, later he studied medicine, become a psychiatrist and collected a rich collection of mental patients’ works.

There is a question mark about the correctness to discern a concept of “mental patients drawings”. Very often it is very hard to describe creative abilities of a person with mental disorders; and to distinguish them from criteria of contemporary arts. Not all famous psychiatrists recognized modern arts. In 1922 famous German psychiatrist Ernst Kretschmer equated the arts of those suffering form schizophrenia to crude drawings and expressionism. In 1932, Karl Gustav Jung published an article about Pablo Picasso where he had declared that painter’s reaction to a deep brainstorm was a complex of schizoid symptoms.

Art could hardly be divided into the art of mental patients and non-patients. It would be the same to discern the art according to gender or initial profession of the artist. It is known that Vasily Kandinski was a lawyer, Henry Rousseau was a customs officer, Andre Breton was a doctor, and Henry de Toulouse-Lautreck’s leg was paralysed. Thus their works could be divided into the categories of “lawyers’ art”, “doctors’ art”, “art of paralytics” and so on. But nevertheless it is stressed that only a part of creative works of patients could be considered an art.

What features of drawings are characteristic for a person suffering from schizophrenia or epilepsy?

There are a lot of creative differences between patients and true artists described in the literature. Drawings of patients with schizophrenia are primitive and childish. Such patients draw like pre-schoolers, their drawings are transparent (“roentgen” paintings). There is no perspective; various elements of paintings are ignored. It is hard to understand whether a thing is here or there. Sometimes drawings seem to be drawn looking down from upstairs or look like maps. It is painted up to the very border. Authors seem to fear of emptiness and try to fill their drawing with ornaments and colours; various written elements (explanations, numbers, separate letters, foreign words, etc.) are inserted into the pictures. People with schizophrenia due to the way of thinking often use symbols in their drawings, but the symbols are neither usual nor understandable to everyone. Most often they might be explained only by the authors themselves. The drawings of mental patients link to be comic and grotesque. Figures in their drawings are disproportional (abnormal limbs, too small head, too big body, it may be many heads, breasts, hands, or legs). Separate body parts, ugly faces and disgusting grimaces are depicted in their drawings. People or separate human body parts are combined with things, i.e. stones have eyes, plants are drawn with ears, or human faces are painted to various things. Sexual and sadistic scenes are often repeated in the pictures. It is stressed that people suffering from schizophrenia usually link to draw portraits, but during my practice I have met many patients never painting human beings. One of my patients is fond of drawing busses, trains, and planes. He often goes to an airport to look at the newest models of foreign planes in order to depict them later on the sheet of paper. It is interesting I have seen a very similar work of planes in one patient’s exhibition in Germany.

People with epilepsy due to changed personality features – tenacity and pettiness usually paint very pedantic and business-like pictures. Movements of a hand while painting are impulsive. Hand is often strained as much as to pin a paper. Contrary movements, as up and down, are very characteristic. This is the way in which “space like” and “bas-relief like” pictures are created. The lines usually do not have any connection, are interrupted and dynamic. The subject of the painting is never static, but the principles of perspective are maintained. Every day’s life, daily routine and nature are most commonly depicted in their pictures. It has been noticed that during acute condition of the disease the paintings become much nicer; and they lose their richness when patient gets better. People suffering from epilepsy like bright and contrasting colours. There are a few very interesting drawings of house with all the things of daily routine and of forest full of snakes, lizards, moles, and birds in our collection.

All those mentioned details are portrayed in paintings of contemporary artists as well. So what is the difference between mental patients’ and non-patients’ art? The most important distinctive feature is the ability of real artist to manage his creativity or talent; and to choose various means of self-expression. Meanwhile patients are managed by strange experiences and emotions, which cause personal and archetypal symbols understood only by him. The artist creates as he wishes, and the patient draws, as he is not able to do this different way.

I think human creativity may be either artistic or not. The main distinctive feature is a fact of place and condition due to which the work has been created. The common characteristic for some creators spent some time in a mental hospital. Thus it may be works of patients of mental hospital as well as works of Vilnius painters.

Is it art for everyone but therapy for patients?

The term of “art therapy” was first used by Adrian Hill in 1938 describing his work with patients suffering from tuberculosis. These days art therapy means all kinds of occupation held in hospitals and mental health centres, although lots of professionals consider such a description incorrect and too wide. The question if art therapy (or treatment in art) could be considered a kind of psychotherapy or psychosocial rehabilitation causes lots of discussions between psychiatrists and psychoanalysts. Followers of S.Freud consider any art occupation a therapy. They refer to an idea of S.Freud stating primary thoughts and experiences raised in subconsciousness are rather expressed in symbols and images than in words.

There are opposite opinions as well. A creative action is a way of self-expression and existence. Creative activity is not treatment to an artist. Creative self-expression is characteristic both to patients and non-patients. Polish psychiatrist Naomi Madejska in her book “Painting and Schizophrenia” (1975) says “striving to create fairly good existential conditions for mental patients by compulsory long term hospitalisation must be based not only on the necessity for treatment but also on the human point of view. Why should an entertainment be just a pleasure to a sound person, and a therapy to a patient? If it is an effort to excuse oneself not to apply suitable treatment? It is not news that assurance of entertainment, work and possibilities to create obviously improves patients’ health. It would be expected to be the same if non-patients were deprived all those possibilities”. Patients think similar way. A member of the US NARPA (National Association for Rights Protection and Advocacy) organisation Rae Unzicker in her sarcastic essay (1984) on the feelings how it is to be a mental patient among other statements says also this: “to be a mental patient is to participate in stupid groups that call themselves therapy. Music is not music, it’s therapy; volleyball is not sport, it is therapy; sewing is therapy; washing dishes is therapy. Even the air you breathe is therapy and that is called “the milieu.”

Art therapy may be useful in the treatment of mental disorders for those reasons:

1. Gives a possibility to express aggressive feelings in a social acceptable form. Drawing, painting or modelling are not dangerous ways of aggressive expressions (abroad art therapy is widely applied in the treatment of compulsory hospitalised mental patients having committed crimes).
2. Fastens a process of therapy. Subconscious conflicts and inward feelings are easier expressed in images than during an interview. Improves interrelations inside the work-groups.
3. Creative output may be used for diagnostics and interpretation.
4. Enables the feelings of internal control and order to arise and to realise forms and colours.
5. Improves self-confidence and creative competence.

In Lithuania still there are not professional art therapists; no high school qualifies them. In some institutions this work is performed by self-educated pedagogues, and by social workers in others. All that related to art and performed in mental hospitals should be called an occupation therapy. The most it is done working with mentally retarded children. But in my work with grown up mental patients I see an obvious advantage of art therapy as well. Sometimes drawings reveal patient’s odd and secret emotions. They become more sincere and communicate among themselves easier. Sometimes they need a smaller doze of medicine to get quiet. But above all it is the fact that creation improves a self-evaluation, and an image of a mental patient in the society at the same time. Creative work often is a counterweight to a mental disease, which is not unfortunately tolerated by society. As patient S. says: “Earlier I had five professions and I was unknown. But after I have got ill and started drawing, my drawings are displayed in art exhibitions in Lithuania and abroad, I am interviewed by journalists”. And lots of people are sincerely jealous to him…

It was an idea to found a separate art gallery for mental patients, but the latest point of view to mental patients have made to refuse it. The foundation of separate gallery it would be a precondition to stigmatise (gr. Stigma “mark, sign”, it means a distinction of patients, marking in diagnosis) patients, a step behind. These days it sounds like a “chorus of blinds”. Creative works of mental patients must be exposed together with works of other artists. It is important what the creation says, not mental status of an author.