Mood disorders and creativity
Your editor has been an advocate of using mandatory medical withdrawal procedures sparingly, if at all. In the unlikely event a student with a serious mental disorder won’t accept a voluntary leave of absence, our advice is to “focus on the conduct.” Dangerous or disruptive behavior (including acts and threats of self-harm) can be immediately addressed by interim suspension policies, followed by appropriate due process proceedings. In less serious cases progressive discipline can be employed to induce students to obtain necessary professional help as an alternative to dismissal. And penalties can always be fine-tuned to encompass dismissal from housing but not dismissal from college altogether. Whether this process should be undertaken administratively (e.g. with a committee including mental health professionals) or by existing disciplinary panels is a matter of discretion. We note, however, that students eighteen years and older can sit on juries deciding equally weighty issues in the larger society. Finally, if deficient academic performance is the only behavioral manifestation of a mental disorder, “focusing on the conduct” means invoking an academic dismissal policy when student performance reaches unacceptably low levels. The “right to fail” in this regard is preferable to the longer term stigma associated with being removed from college due to a real or presumed mental disorder.
What are the policy reasons for a “focus on the conduct” approach? We’ve discussed several over the years, including the inability to predict future behavior, the therapeutic benefits of holding students accountable for their misconduct, and the due process required in disciplinary proceedings (contrasted with the unchecked paternalism usually seen in mandatory medical withdrawal policies). Our focus in this edition of SWR, however, is on a different factor: the risk that hair trigger policies designed to dismiss individuals at risk of suicide will remove some of the most thoughtful and creative students at the school. Exploring the topic requires entering into a long-standing debate among mental health professionals about a possible connection between mood disorders (e.g. bipolar disorder) and creativity.
This topic was explored long ago by Plato —in the dialogue Phaedrus— when he had Socrates say that “[t]there is also a madness which is a divine gift, and the source of the chiefest blessings granted to men.” This kind of “madness,” Plato says, is “of those who are possessed by the Muses; which taking hold of a delicate and virgin soul, and there inspiring frenzy, awakens lyrical and all other numbers . . .”
The humanistic psychoanalyst Erik Erickson said something similar in Young Man Luther (1962):
[R]eligiously and artistically creative men often seem to be suffering from a barely compensated psychosis, and yet later prove superhumanly gifted in conveying a total meaning for man's life . . . [There are also instances when] malignant disturbances in late adolescence often display precocious wisdom . . . The chosen [youth] extends the problem of his identity to the borders of existence in the known universe [while] other human beings . . . adopt and fulfill the departmentalized identities which they find prepared in their communities . . .
More recently, a leading protagonist on the side of an association between mood disorders and creativity is John’s Hopkins University psychiatry professor Kay Redfield Jamison, author of An Unquiet Mind: A Memoir of Moods and Madness (1996) and the medical text Manic-Depressive Illness (1990). In her book Touched by Fire: Manic Depressive Illness and Artistic Temperament (1998) she reviewed a broad range of studies and concluded that there is a “literary, biographical, and scientific argument for a compelling association, not to say actual overlap, between two temperaments—the artistic and the manic-depressive.” Her view is consistent with an editorial in the April 1994 issue of the American Journal of Psychiatry which concluded that “[t]he association between [creativity and affective illness] seems to be real, particularly for depression and bipolar disease, and especially among writers and those in the creative arts.” That view was bolstered last year by research at Stanford University finding “an association between BD [bipolar disorder] and creativity” based on a comparison between bipolar parents and their offspring with “healthy control adults and their children.” (Simeonova, D.I.; Chang, K.D.; Strong, C.; Ketter, T.A., “Creativity in familial bipolar disorder, “ Journal of Psychiatric Research, November 2005).
Mental health professionals, however, sometimes disagree. In his book Against Depression (2005) Brown University psychiatry professor Peter D. Kramer wrote that:"Jamison's book [Touched by Fire] considers the narrow version of heroic melancholy—that it leads to lyric verse—and centers the relevant pathology in bipolar affective disorder, not major depression." Kramer observed that even if depression is associated with creativity (an assertion for which "objective evidence is lacking") "[i]t is true that difference helps in the creative process, and depression is a form of difference." Kramer’s perspective is broadly endorsed by Harvard University psychiatry professor George E. Vaillant. In his book The Wisdom of the Ego (1993) he wrote that “[t]he sources of creativity are multiple, complex and fascinating, and they will probably never be fully understood . . . but inner torment is by no means a necessary or sufficient cause for creativity.”
There’s less disagreement between Jamison and Karmer/Vaillant than meets the eye. Kramer wrote that “there may be something there” in the suggestion of a frequent connection between mania and poetry. One of his primary goals is to show that severe mental illness (e.g. major depression) is more likely to inhibit than promote the creative process. And Vaillant cites research showing that “depressive disorder” is “roughly three times more common in . . . writers [poets and playwrights] and their relatives than in the controls and their relatives,” leading to the possibility that “it may be only the poets and the playwrights, among artists in general, that make us equate creativity with mental illness.”
Jamison’s views on the mood disorder/creativity debate are equally nuanced. In a March 3,1998 PBS interview (“Live from Lincoln Center”) she said that:
[Y] ou don't have to be sad in order to write sad music any more than you have to be ecstatic to write ecstatic music. You don't have to have a mental illness to write about anguish. There is a huge body of scientific evidence now, that if you look at the most creative composers and writers and artists, they in fact suffer disproportionately from depression and manic depression, but it certainly doesn't mean that you have to have depression or manic depression to be enormously creative . . .
It may also be that the struggle to adapt to a mood disorder helps explain the insights some artists can express. Jamison observed in this regard that:
I think it's also that people with manic depressive illness who have a particular temperament live a life of almost seemingly irreconcilable differences and opposite states that they somehow, on a day to day basis, have to reconcile. So that people who have very disciplined and interesting and strong and creative minds, who also have this temperament, spend their lives having to make some order out of chaos and reconcile these opposite states. I think that a lot of what we ask from our artists really is to experience extreme mood states, experience the extremes of human nature and experience, but also to put some new meaning and redemptive value.
A variation of this experience may be found in people who struggle with physical disabilities. In a review of John Hull's book Touching the Rock (New York Review of Books, April 11, 1991) Psychiatrist Oliver Sacks wrote that Hull— who was totally blind—was able to find:
a new organization and depth and identity. After sinking hopelessly into a bottomless ocean, he discover[ed], in his deepest depths, his anchor and soul: this, for [him], [was] 'touching the rock.'"
Students with the most serious mood disorders will probably lack the energy or mental focus to do significant creative work. Others with artistic temperaments and milder conditions may find moments of heightened creativity, especially during times of mania. But each student struggling with a mental disorder, including those at risk of suicide, will be facing a challenge that may open a pathway to profound insight. This phenomenon—the potential of “touching the rock”—can be tempered and guided by educators, not eliminated altogether. Respecting the process of adaptation, within reasonable bounds of safety, entails erring on the side of helping troubled students stay enrolled, both for their benefit and the benefit of those around them.
