Touched With Fire

Jamison, Kay Redfield. Touched with Fire: Manic-Depressive Illness and the Artistic Temperament. New York: Free Press Paperback, 1994.

Robert Burton wrote in the seventeenth century that “all poets are mad.” Many people have long shared Burton’s suspicion that genius and insanity are entwined. Kay Redfield Jamison is a psychologist and a highly regarded researcher of bipolar disorder (also known as manic-depressive illness) and has been eloquently open about her own struggles with the illness in her memoir, An Unquiet Mind: A Memoir of Moods and Madness. In Touched with Fire: Manic-Depressive Illness and the Artistic Temperament, she turns her attention to the specific relationship between creativity and bipolar disorder. Jamison uses a blend of modern psychiatric diagnostic criteria, illness-outcome data and research, and genetics to examine the lives of writers, artists, poets, and composers for evidence of bipolar disorder all the while speculating about the possible ties between the disease and success in the arts. Touched with Fire is a beautifully written book that poetically weaves the strong links between psychopathology and creativity with first-hand accounts about their mental illness from famous artists, writers, poets, and composers. Because Jamison so skillfully illustrates the psychopathology of bipolar disorder by discussing specific creative individuals, often presenting quotations from them or their work, the book is interesting to read and gives the reader a concrete feel for the ideas presented.

Jamison provides a thorough and accurate description of bipolar disorder and cyclothymia. A full description of the types of mood swings that can occur, from depression to normal functioning to hypomania (a milder form of mania) and manic states is given. Mild mood elevations are thought to be the most facilitative for creative thinking therefore hypomania is thought to be the most useful state for creative work because it is characterized by mild mood elevations, risk taking, and fluency of thought. Hypomanic or manic individuals “usually have an inflated self-esteem, as well as a certainty of conviction of correctness and importance of their ideas” (p. 13). After defining mood disorders, Jamison reviews the research and biographical literature that finds an association between creativity and mood disorders.

For years, scientists have documented some kind of connection between mania, depression, and creative output. In the late nineteenth and early twentieth centuries, researchers turned to accounts of mood disorders written by prominent artists, their doctors, and friends. This research is largely anecdotal and is thus not representative of a scientific study, but it strongly suggests that artists and writers and their first-degree relatives are far more likely to experience mood disorders and to commit suicide than the general population. Jamison reviews empirical studies on the incidence of mood disorders among living writers and artists. She also reviews the historical records of numerous deceased artists and writers using information from their medical records, their personal letters, their art, and from their biographers. She makes a compelling case that the incidence of bipolar illness in these groups of artists is staggeringly high, especially for poets, in comparison with the rates in the general population. Judging by current diagnostic criteria, it seems that many famous artists suffered from one of the major affective (mood) disorders, namely, bipolar disorder or major depression. Major depression includes intense melancholic phases, whereas bipolar disorder, a strongly genetic disease, cycles between depression and hyperactivity, euphoria, or intensely irritable states (also known as mania). In its milder form, cyclothymia, bipolar disorder causes changes in mood, behavior, sleep, thought patterns, and energy levels that are not completely debilitating. People who suffer from bipolar disorder and those who are creative appear to share certain features: the ability to function well on a few hours of sleep, the focus needed to work intensely, bold and restless attitudes, and an ability to experience a profound depth and variety of emotions. The review of biographical research indicates that there is a higher rate of mood disorders in artistic populations than would be expected by chance. Jamison then introduces her own study of British and Irish poets born between 1705 and 1805 and she finds that this population was thirty times more likely to have symptoms of bipolar disorder, ten to twenty times more likely to have milder forms of bipolar disorder, more than five times as likely to commit suicide, and twenty times more likely to have been committed to an asylum than the general population.

Jamison builds the link between bipolar disorder and creativity with biographical details about the gifted as well as evidence culled from life-study investigations conducted over the last century and a half and some recent diagnostic and psychological examinations of living artists and writers. While most of the studies being cited suffer from a variety of problems—questionable selection of subject populations, inadequate sample size, lack of meaningful control groups, and ambiguous diagnostic methods—two conclusions emerge: (1) the symptoms of bipolar disorder are disproportionately encountered in higher socio-economic classes and upper levels of educational achievement and (2) poets, writers, artists, and composers give evidence of higher rates of mood disorders than the general population.

The excerpts of personal letters and original work of great writers, composers, poets, and artists of the past are enlightening, inspiring, and often devastating to read. For example, the suicide letter by Virginia Woolf is heart wrenching:

Dearest,

I feel certain I am going mad again. I feel we can’t go through another of those terrible times. And I shan’t recover this time. I begin to hear voices, and I can’t concentrate. So I am doing what seems the best thing to do. You have given me the greatest possible happiness. You have been in every way all that anyone could be. I don’t think two people could have been happier till this terrible disease came. I can’t fight any longer.

–Virginia Woolf

Another telling example is a suicide note written by American artist Ralph Barton detailing the plights of his life and why he can no longer bear to go on living is heartbreaking:

Everyone who has known me and who hears of this will have a different hypothesis to offer to explain why I did it. Practically all of these hypotheses will be dramatic—and completely wrong. Any sane doctor knows that the reasons for suicide are invariably psychopathological. Difficulties in life merely precipitate the event—and the true suicide type manufactures his own difficulties. I have had few real difficulties. I have had, on the contrary, an exceptionally glamorous life—as lives go. And I have had more than my share of affection and appreciation. The most charming, intelligent, and important people I have known have liked me—and the list of my enemies is flattering to me. I have always had excellent health. But, since my early childhood, I have suffered with a melancholia, which, in the past five years, has begun to show definite symptoms of manic depressive insanity. It has prevented me from getting anything like the full value out of my talents, and, for the past three years, has made work a torture to do at all. It has made it impossible for me to enjoy the simple pleasures in life that seem to get other people through. I have run from wife to wife, from house to house, and from country to country, in a ridiculous effort to escape from myself. In doing so, I am very much afraid I have spread a good deal of unhappiness among the people who have loved me.

Barton’s letter exhibits things most people fail to understand about the seriously mentally ill. Despite increased awareness, there is still a need for empathy among much of the world’s population. This book is a contribution to raising awareness and erasing stigma associated with mental illness, supplying vital details of the lives of the creatively revered that carry over to the lives of millions enduring similar situations today.

Jamison devotes an entire chapter to Lord Byron as an example of an intense, changeable, and complex temperament. In another chapter, Jamison intimately presents short biographical overviews of a number of creative individuals including Alfred Lord Tennyson, Robert Schumann, Herman Melville, Ernest Hemingway, and Vincent van Gogh. Through a thorough examination of artists’ famous writings, diary entries, medical records, family trees, and personal writings, she dissects the history of the disease. This interweaving of quantitative research and case study illustrations is the most compelling part of the book and is surely a major contribution to the fields of both psychology and creativity.

This book concludes with a discussion of the medical and ethical concerns raised by the study of bipolar disorder. For example, Jamison asks us to consider the potential consequences of effective treatment of bipolar disorder on the quality of literary and artistic production from those who suffer from it. Moreover, with the prospect of identification of the gene(s) responsible for bipolar disorder, the question is posed about what to do with those who test positive for this disorder. The question is likely to impact medical intervention in the form of gene therapy, prenatal testing, voluntary abortion, and sterilization.

Jamison’s review of the research literature that supports a link between bipolar disorder and artistic creativity is comprehensive although she does not go into much detail regarding the methodology of past studies or possible methodological flaws that come with studying a deceased population for a mood disorder that is conceptualized completely differently today than it was in the day of these artists. The fact that the subjects of this study are all dead invites certain difficulties. It means that most of what can be said about the lives of these people has come from secondary sources and what are often fragmentary and passing observations made by the subjects themselves and their family and friends. The fact remains that the pronouncements of the famous dead were made in a context of cultural assumptions that were quite different from those of our contemporary society.

As a psychologist and an authority on mood disorders, Jamison identifies bipolar disorder as the clinical label best suited to the explanation of the afflictions and erratic behaviors commonly associated with artistic and literary creativity. Jamison succeeds in making a strong argument for this association. For those suffering with bipolar disorder, the book is both disturbing and strangely comforting. Knowing that many of the world’s greatest artists and writers suffered from debilitating conditions, yet were able to contribute immortal novels, poems, paintings, and symphonies to the world provides a sense of great hope. Anyone loving or living with a person coping with a mental disorder such as bipolar disorder often finds the emotions and experiences of the sufferer difficult to handle and impossible to comprehend. Jamison clarifies what it means to feel something one cannot control.