Gemma Anderson

June 21, 2010

7 July 2010 – 22 August 2010

Gemma Anderson

Patients; Portraits and Psychiatrists

Patients, Portraits and Psychiatrists is a series of portraits of psychiatric patients and their doctors. The exhibition forms the culmination of a Wellcome Trust Arts Award winning collaboration between artist Gemma Anderson and forensic psychiatrist Dr Tim McInerny, and is touring various venues in summer 2010 following a launch in June at the Bethlem Archives.

Throughout the development of psychiatry there has always been an association with the arts. It could be argued that the most fundamental creative relationship has been with the visual arts as a means of understanding mental disorder, as a representation of the social and morale decline that is associated with it, as a form of treatment and as a means of expression for the patient.

Gemma Anderson and Dr McInerny wanted to explore this relationship in a manner that related to the story of mental disorder and its historical representation that also was a visual metaphor for the therapeutic alliances that run between doctors and patients in mental health settings.

In psychiatry/psychotherapy the stories that patients carry with them are often distressing and violent. How does the psychiatrist hear such tragedies and how can they process them into meaningful therapy?

The 20th Century led to the development of the creative therapies as a form of expression and a path towards recovery. In its turn outsider art has become a representation of the psychiatric patient’s role in society and in the mid-20th Century a representation of the anti-psychiatry movement as championed by Foucault and R D Laing.

Hear Gemma in interview with BBC Radio 4’s All in the Mindprogramme from 15 June 2010.

Bethlem Gallery

June 21, 2010

Bethlem Gallery.


and INTERVIEW the curator and workers.

Insomnia and its Effect on Art and Creativity

A Debilitating Affliction or a Priceless Gift?

Feb 28th 2010 by Robert Lester
Many sufferers of insomnia, especially those with artistic tendencies, credit the inability to sleep as one of the main sources of their creativity.

We have all been there at some point in our lives. After a busy day of working, playing, travelling or whatever else we choose to do, absorbing all the words, sounds, visions, tastes and smells that the day brought, it is no surprise that we require a good night’s sleep to recover and refresh.

A Good Night’s Sleep

But when that sleep is not forthcoming, one has to find alternative methods of filtering out all the above stimuli, something that a good night’s sleep would usually do.

As Griff Niblack once said, “If a man had as many ideas during the day as he does when he has insomnia, he’d make a fortune.” (

Learning to embrace insomnia is the only way to ever be able to control it. Worrying about not getting to sleep exacerbates the problem; worrying simply makes it even more difficult to drop off.

Counting Sheep

Having counted a whole flock of sheep, drunk no end of hot milky drinks and even after attempting deep-breathing techniques, we roll are heads from one side of the pillow to the other.

The ability to sleep is usually not even present in our conscious thought; it is something that is automatic. But in this time of desperation, it is far from automatic.

As we sink further into the ugly abyss of insomnia, there comes a time when we decide to throw the towel in and get out of bed.

At this point the brain craves stimulation and we must feed it. Some choose to watch television, read a book or even do the ironing. But for some this is when creativity takes hold and they must vent this in an artistic manner; whether this is by writing, painting, drawing or playing music.

Writers, Artists and Politicians

Alexandre Dumas, the famous French historical novelist, suffered with terrible insomnia. After being advised to simply get out of bed when struggling to sleep, he went on to use his sleep deprived state to write many of his works. It is widely considered that “He produced enough words to fill 1,200 volumes and claimed to have fathered 500 children.” (

Vincent Van Gogh believed that his insomnia was his very own problem and that only he could help to make it bearable. He resorted to dabbing some camphor oil on his pillow and mattress every night. This did in fact help the artist to have a good night’s sleep, but tragically this oil was believed to have slowly poisoned him up until his eventual death in 1890.

The most famous insomniac of recent years is Winston Churchill. He blamed his nocturnal wakefullness on the bed in which he lay; he had twin beds and would switch between the two if one failed to advocate sleep. Despite the terrible torture this lack of sleep must have inflicted on the great politician, he used these hours in the depths of the night to think and plan.

Social Pressures

With the constant reminder that we must get seven hours sleep a night and with the necessity to function at work the next day, it is of no surprise that we suffer with such anxiety when we can’t sleep. But as the French novelist Sidonie-Gabrielle Colette so accurately said, “In its early stages, insomnia is almost an oasis in which those who have to think or suffer darkly take refuge.” (quotegarden)

The only way to cope with insomnia is to embrace it because eventually sleep will take it off your weary mind and nothing that is thought of, written or drawn during those dark hours will ever be wasted.

Movies to watch.

June 21, 2010



Lust for life (1956)

Call me Anna(1990)

My friend Paul (1999)

Intimate Portrait:Margot KIdder (2000)

The Devil and Daniel Johnston (2005)

Stephen Fry: The Secret Life of the Manic Depressive (2006) (TV)

A Fine Madness (1966)

Mr Jones (1993)

Blue Sky (1994)

Mad Love (1995)

Bulworth (1998)

Précis of The creative mind: Myths and mechanisms – Margaret A. Boden


What is creativity? One new idea may be creative, whereas another is merely new: What’s the difference? And how is creativity possible? These questions about human creativity can be answered, at least in outline, using computational concepts. There are two broad types of creativity, improbabilist and impossibilist. Improbabilist creativity involves (positively valued) novel combinations of familiar ideas. A deeper type involves METCS: the mapping, exploration, and transformation of conceptual spaces. It is impossibilist, in that ideas may be generated which – with respect to the particular conceptual space concerned – could not have been generated before. (They are made possible by some transformation of the space.) The more clearly conceptual spaces can be defined, the better we can identify creative ideas. Defining conceptual spaces is done by musicologists, literary critics, and historians of art and science. Humanist studies, rich in intuitive subtleties, can be complemented by the comparative rigour of a computational approach. Computational modelling can help to define a space, and to show how it may be mapped, explored, and transformed. Impossibilist creativity can be thought of in “classical” Al terms, whereas connectionism illuminates improbabilist creativity. Most Al models of creativity can only explore spaces, not transform them, because they have no self-reflexive maps enabling them to change their own rules. A few, however, can do so. A scientific understanding of creativity does not destroy our wonder at it, nor does it make creative ideas predictable. Demystification does not imply dehumanization.

Creativity and Mental Illness

Laura Gosselink

Men have called me mad, but the question is not yet settled, whether madness is or is not the loftiest intelligence–whether much that is glorious–whether all that is profound–does not spring from disease of thought–from moods of mind exalted at the expense of the general intellect. Those who dream by day are cognizant of many things which escape those who dream only by night – Edgar Allen Poe

When you are insane, you are busy being insane – all the time… When I was crazy, that’s all I was. – Sylvia Plath

Is creative genius somehow woven together with “madness”? According to the dictionary, “to create” is “to bring into being or form out of nothing.” Such a powerful, mysterious, and even impossible act must surely be beyond the scope of scientific inquiry! No wonder creativity has for so long been “explained” as the expression of an irrational, intuitive psychic “underground” teaming with forces (perhaps divine) that are unknown and unknowable (at least to the “sane,” conventional mind). The ancient Greeks believed creative inspiration was achieved through altered states of mind such as “divine madness.” Socrates said: “If a man comes to the door of poetry untouched by the madness of the muses, believing that technique alone will make him a good poet, he and his sane compositions never reach perfection, but are utterly eclipsed by the inspired madman” (8). Creative inspiration – particularly artistic inspiration — has often been thought to require the sampling of dark “depths” of irrationality while maintaining at least some connection to everyday reality. This dive into underground forces “reminds one of a skin-diver with a breathing tube” wrote Arthur Koestler in his influential book, The act of creation (8). According to Koestler, “the creative act always involves a regression to earlier, more primitive levels on the mental hierarchy, while other processes continue simultaneously on the rational surface.” Using similar themes, the great scientific figure, Kekule described a visionary moment leading to his groundbreaking discovery that the benzene molecule is a ring. His creative break with the prevailing assumption that all molecules were based on two-ended strings of atoms came in a blazing flash of insight:

“I turned my chair to the fire and dozed. Again the atoms were gamboling before my eyes…. [My mental eye] could distinguish larger structures, of manifold conformation; long rows, sometimes more closely fitted together; all twining and twisting in snakelike motion. But look! What was that? One of the snakes had seized hold of its own tail, and the form whirled mockingly before my eyes. As if by a flash of lightning I awoke.” (2).

Like Kekule, people recognized for their creative genius often depict moments of inspiration as an electrifying convergence of rational and irrational thought. If there is an edge to be found between the rational and the irrational; between the known and the unknown; between the conventional and the innovative, and if this edge is where creativity takes place, it makes sense that a creative mind runs the risk of going “too far.” As Koestler has put it, “skin-divers are prone to fall victim to “the rapture of the deep” and tear their breathing tubes off”(8). Artists Ernest Hemmingway, Virginia Woolf, Charles Parker, and John Berryman would appear to have torn away their breathing tubes when they entered psychiatric hospitals and eventually committed suicide (1). Further reinforcing the association of creativity with illogical, disruptive psychic forces are great numbers of influential 18th and 19th century poets, including William Blake, Lord Byron and Alfred, Lord Tennyson, who wrote about their emotional extremes of experience. For example, George Edward Woodberry wrote of poets: ” Emotion is the condition of their existence; passion is the element of their being.” (1). And the turbulent lives of high profile musicians and artists such as Charles Mingus, Georgia O’Keefe, Jackson Pollack, and Sylvia Plath also seem to testify to a link between creativity and psychic instability. But can a connection between mental disorder and enhanced creativity be identified by the methods of science? Is there really a connection, and if so how does it work?

“When a superior intellect and a psychopathic temperament coalesce,” wrote psychologist William James as the twentieth century began, “we have the best possible condition for the kind of effective genius that gets into the biographical dictionaries. Such men do not remain mere critics and understanders with their intellect. Their ideas posses them, they inflict them, for better or worse, upon their companions of their age” (8). James and contemporary scientists such as psychiatrist Emil Kraepelin emphasized the positive aspects of certain psychological disorders, and speculated that other talents could combine with them to produce extraordinary creativity. But James also stressed the debilitating extremes of psychiatric illness(8). This moderate view, underscoring the need for balance in an effectively creative person, has since characterized much thinking on the subject of creativity and mental disturbance. As Sylvia Plath later said, “When you are insane, you are busy being insane – all the time… When I was crazy, that’s all I was”(5). Against this background, some current research into the interaction between creativity and psychiatric disorders such as bipolar disorder and depression suggests that their may indeed be a vital connection between “genius” and “insanity” in some instances.

Kay Redfield Jamison is a professor of psychiatry at the Johns Hopkins University School of Medicine who has talked openly and honestly about her own manic depressive emotional instability. Her review of current research leads her to conclude that a large number of established artists – “far more than could be expected by chance” – can be diagnosed with bipolar disorder or major depression (4). Jamison believes that several corroborating diagnostic and psychological analyses of living artistic populations provide meaningful evidence that highly creative people experience major mood disorders more often than do other groups in the general population. So for her there is a clear link between psychic instability and creativity. But Jamison warns against simplistic notions of the “mad genius.” She points out that most emotionally unstable people are not extraordinarily creative, and most extraordinarily creative people are not emotionally unstable. She then asks the question: how might mania or depression contribute to creative accomplishment?

The characteristics of milder forms of mania are very similar to creative thought, Jamison asserts. Acutely tuned senses, restlessness, irritability, grandiosity, thought diversity, and the ability to associate divergent ideas and thoughts rapidly are all hallmarks of both the creative and mildly manic (or “hypomanic”) individual. Jamison describes two features central to both creative and hypomanic thought. First, thought is fluid, rapid, and flexible. In addition, there is heightened ability to merge ideas and thoughts that have no conventional connection. (4). Many psychologists, Jamison points out, have emphasized the importance of fluid, quick, and divergent thinking in producing new, original, and “creative” ideas. Rapidity of thought itself spurs creativity. “Because of the more rapid flow of ideas,” Psychologist Eugene Bleuler explains, “and especially because of the falling off of inhibitions, artistic activities are facilitated even though something worth while is produced only in very mild cases and when the patient is otherwise talented in this direction. The heightened senses naturally have the effect of furthering this.” (8). Observing an incredible outpouring of uncensored mental activity by his manic friend Lord Byron, Sir Walter Scott said: “The wheels of a machine to play rapidly must not fit with the utmost exactness else the attrition diminish the Impetus.” (8). But the sheer volume or density of ideas spewing from a manic person’s mind increases the likelihood that at least some of those ideas will be creative ones. A person who goes to bat a million times is more likely to get a hit than someone who only steps to the plate a few hundred times.

Manic people also have demonstrably increased ability to form new and different associations between words. In laboratory tests, the number of “statistically common” responses to tested words fell by one-third and the number of “original” responses increased three-fold(8). This qualitative change in mental processing “may well facilitate the formation of unique ideas and associations,” Jamison asserts.

In contrast to the fiery energy with which mania infuses creativity, is the cold, ruminative, introspection of depression. It is widely accepted that insight gained through intense, extreme, even painful experiences can add depth and meaning to creative work. Poet Anne Sexton explained how she used pain in her work: “I, myself, alternate between hiding behind my own hands, protecting myself anyway possible, and this other, this seeing ouching other. I guess I mean that creative people must not avoid the pain that they get dealt…. Hurt must be examined like a plague.” (8).

The creative person who suffers from manic-depression also has what Jamison calls “a built-in editing process” for the excesses and sometime lunacies expressed during manic episodes. Mild depression can actually put into perspective what had seemed, in a manic-state, to be brilliant. One is better suited to truly discover what ideas may be brilliant or creative out of the hodge-podge of ideas spewed from the manic mind. In fact, research has shown that people in mildly depressed states are more “realistic” than people in “normal” states of mind(8). Observations and beliefs produced during mild depression are closer to “reality” than those produced in “normal” states of mind. This supports T.S. Eliots’ observation that “human kind cannot bear much reality” (8).

In the face of too much reality, creative work can be turned to as a solace and a means of working out of a depressive episode, Jamison says. George Bernard Shaw wrote that if you can’t get rid of the family skeleton, you might as well make it dance “(5). And T.S. Eliot, working through a bout of depression, wrote: “Poetry is not a turning loose of emotions, but an escape from emotions, it is not the expression of personality, but an escape from personality. But, of course, only those who have personality and emotion, know what it means to want to escape from those things” (8). By this reasoning, if you routinely keep an even emotional “keel,” there’s not much impetus to behave creatively.

Thus, although it is certainly not the case that all creative individuals suffer from manic depression, it seems that characteristics of mania and depression aid the development and expression of creative thought and action. Mania combines new and heretofore unconnected ideas at a rapid pace and has even been shown to elevate IQ scores(8). Mania also imbues the individual with relentless drive and confidence that can, very often, lead to creative output. Balancing mania, depression not only can serve as a “reality-check” to manic excesses of thought and action, but also can itself provide fuel for creativity.

What does this mean for treatment? “I want to keep those sufferings,” said artist Edvard Munch. When told he could end his cycle of psychiatric hospitalizations with available treatment, he replied that emotional torments “are part of me and my art. They are indistinguishable from me, and it would destroy my art” (8). As Jamison points out, many creative people are reluctant to be transformed by psychiatric treatment into “normal, well-adjusted, dampened, and bloodless souls” no longer moved to create(8). And their fears may not be unfounded. Current psychotropic drug therapies can offer some relief from the painful, destructive features of mania and depression. But according to Jamison, there is a price to pay — these drugs can “dampen a person’s general intellect and limit his or her emotional and perceptual range”(8). As a result, many people with mood disorders stop taking these medications. The tragic consequences include emotional extremes that intensify over time and can lead to psychosis or death. These consequences should not be romanticized.

Jamison argued that the methods of science identify, in the case of bipolar and depressive disorders, some truth behind the persistent cultural notion of a vital link between genius and insanity. Clearly our existence as a human community would be diminished without the “genius” responsible for scientific breakthrough or for what we respond to as great musical, literary, and visual works of art. If this genius sometimes grows up in suffering, it seems that the pain of a few of us benefits all of us. If we appreciate the gifts these creative people have given us, they deserve our understanding and careful consideration. Treatment should seek to find a balance preserving crucial human emotions and experiences while alleviating destructive extremes.

Near infrared spectroscopy brain scans of schizotypes, schizophrenics and normal controls during creative thinking tasks. Credit: Vanderbilt University

Fine Line Revealed Between Creativity and Insanity

History suggests that the line between creativity and madness is a fine one, but a small group of people known as schizotypes are able to walk it with few problems and even benefit from it.

A new study confirms that their enhanced creativity may come from using more of the right side of the brain than the rest of us.

In the spectrum between normal and insane, schizotypes generally fall somewhere in the middle. While they do not suffer many of the symptoms affecting schizophrenics, including paranoia, hallucinations and incoherent thoughts, schizotypes often exhibit their own eccentricities.

“They may dress or carry themselves in a strange way,” says Bradley Folley, a graduate student in clinical psychology at Vanderbilt University in Tennessee and the lead author of the study. “They’re not abnormal, they live normal lives but they often have idiosyncratic ways of thinking. Certain things may have special meaning for them or they may be more spiritually attuned.”

Problem solving

The link between creativity and psychosis has largely been based on anecdotal evidence and correlation studies. The Vanderbilt study is the first to investigate the creative process experimentally using brain-imaging techniques.

The researchers defined creativity as the ability to generate something new and useful from existing products or ideas.

“Creativity at its base is associative,” Folley toldLiveScience. “It’s taking things that you might see and pass by everyday and using them in a novel way to solve a new problem.”

The researchers conducted two experiments to compare the creative thinking processes of schizotypes, schizophrenics and normal control subjects.

In the first experiment, subjects were shown a variety of household objects and asked to come up with new functions for them.

For example, all three groups would be asked to come up with possible uses for a needle and thread. While the normal and schizophrenic controls came up with pretty typical responses like sewing or stitching, one schizotype said that if a person was poor but wanted to get engaged, he could use the thread to make a ring and use the needle to write “I Love You,” in the sand.

Picture this

In the second experiment, the three groups were again asked to come up with creative uses for everyday objects, but this time their brains were monitored using a brain-imaging technique called near-infrared optical spectroscopy.

The scans showed that both sides of the brain in all three groups were active when making novel associations. However, in the brains of schizotypes, the activation of the right hemisphere was much higher compared to brains of the control subjects.

Folley speculates that what may be happening is that schizotypes may either have more access to the right hemisphere than the average population or there may be more efficient communication between the two hemispheres.

The finding is detailed online in the journal Schizophrenia Research.

Creativity and Insanity More Alike Than You Think

Genius and MadnessThere is a common notion that there is only a fine line between creativity and insanity. A small group of people known as schizotypes may essentially live on that line.

Between Genius and Madness

Schizotypes fall in the midpoint between sanity and insanity. They do not suffer most of the symptoms of schizophrenia, such as paranoia and hallucinations, but they often exhibit both eccentricities and enhanced creativity. A new study confirms that both may come from their using more of the right side of the brain than the rest of us.

Scanning  Your Brain

The link between creativity and aberrant behavior has generally been based on anecdotal evidence. The new study used brain-imaging techniques to investigate the creative process in an experimental manner, with “creativity” being defined as the ability to generate something new and useful from pre-existing materials or ideas.

The researchers compared the creative thinking processes of schizotypes, schizophrenics, and normal control subjects.

Schizotypes Used Their Right Brain More

Scans showed that both sides of the brain in all three types were active when making novel associations. But in schizotypes, the activity in the right hemisphere was much higher when compared to the control subjects, and they also came up with a wider variety of creative ideas.

It was theorized that schizotypes may have more access to the right hemisphere of the brain, or that they may exhibit more efficient communication between the two hemispheres.

Live Science September 7, 2005

Is there a link between madness and creativity?

Many illustrious thinkers and poets, including Shakespeare, have believed that genius is only a step away from insanity. John Walsh goes in search of evidence in our contemporary culture

“The only performance that makes it,” Mick Jagger’s rock star advises James Fox’s gangster in Performance, “is the one that achieves madness.” This embracing of derangement has been a debating-point in our experience of art for centuries, and is found everywhere today. In Peter Shaffer’s Equus, recently revived in London’s West End, a psychiatrist called Martin Dysart wrestles with the problem of “curing” the mad-but-ecstatic teenager Alan Strang: how can he force Strang to relinquish his communion with a horse God and return to an “utterly worshipless” normality? Shouldn’t the boy be “allowed” to be insane, when it gives him something to worship?

In a much-discussed TV documentary last year, The Secret Life of the Manic Depressive, Stephen Fry explained that hundreds of highly intelligent, creative people have been diagnosed with the condition, before telling the world (with a hint of pride) “I have extremes of moods that are greater than just about anybody else I know.” He revealed that many victims of “bipolar disorder” preferred to endure the aching chasms of depression without therapy or drugs, because of the creative high they experienced in the manic stage. “I wouldn’t be without it,” he said “for all the tea in China.” The former pop star Adam Ant (Stuart Goddard) and the glamour model Sophie Anderton have also revealed themselves to be sufferers, as have Robbie Williams and Caroline Aherne.

At Tate Britain, where the paintings of the homicidally mad Richard Dadd are on display, we can inspect Dadd’s mysterious The Fairy Feller’s Master-Stroke, which he painted while in Bethlem Hospital, sent there after stabbing his father to death in 1843, thinking him the devil in disguise (he thought he was personally under the power of the Egyptian god, Osiris). Many art lovers have looked at his fairy paintings, at the microscopic exactness of his tiny figures, human and grotesque, and concluded that no sane person could have managed such intricacy. They are, it’s been said, “positive symptoms of insanity.”

Do the mad have access to hidden worlds of imagination, denied to the sane? Is madness the final frontier of art and science? Is genius only a step away from insanity? Many artists and writers, scientists, philosophers and intellectuals have thought so in the past. “Great wits are sure to madness near allied/ And thin partitions do their bounds divide” wrote John Dryden in 1681. The idea of creativity as divine afflatus, the breath of God, turns easily into the divine fire, that ignites the imagination but consumes the thinker. Inspiration may suffice for the minor thinker, writer or inventor; but only the divine furor will do for the world-changing genius.

In the 20th century, as quantum mechanics made the world of physics increasingly unknowable, the “mad scientist” and Einstein-haired boffin became comic figures, men deranged by their excessive devotion to the not-yet-known. In past centuries, poets gave themselves airs as divinely maddened. Celebrating Christopher Marlowe in 1627, the poet Michael Drayton approved “that fine madness still he did retain/ Which rightly should possess a poet’s brain.” It should? William Wordsworth, never himself a candidate for the funny farm, averred, “We Poets in our youth begin in gladness/ But thereof come in the end despondency and madness.” The first line was adapted by Eileen Simpson for her book Poets in Their Youth, a memoir of the poetic circle that surrounded Robert (“Cal”) Lowell and John Berryman in the 1950s and 1960s, when they were contenders for the title of America’s Top Poet. Lowell suffered frequent bouts of mental illness; Berryman killed himself and left a note that read, “Your move, Cal.”

Shakespeare himself identified the connection in A Midsummer Night’s Dream, when Theseus reflects on the creative act of turning unknown and unearthly things into words:

“The lunatic, the lover and the poet/ Are of imagination all compact./ One sees more devils than vast hell can hold,/ That is, the madman…/ The poet’s eye, in a fine frenzy rolling,/ Doth glance from heaven to earth, from earth to heaven/ And, as imagination bodies forth/ The forms of things unknown, the poet’s pen/ Turns them to shape, and gives to airy nothing/ A local habitation and a name.”

But what do we make, today, of lunatics and poets, scientists and fruitcakes? Do we still see a link between creativity and madness? For Professor Philip Thomas, of Lancaster University’s psychology department, the answer is a qualified yes: “It’s certainly interpreted that way. There have always been people in societies and cultures who have different experiences of reality compared with the majority, and there’s always been an overlap between people who have those gifts, or insights, and people who are identified as suffering from mental illnesses.”

What’s the distinguishing factor about the mentally ill writer or scientist? “Strangeness,” he says firmly. “It’s the strangeness of people’s experience, and what they try to communicate about it, that’s dangerous, threatening, anxiety-provoking to those of us who have conventional rationalities, if I can put it that way. Those people often seem to be visionaries, shamans, people with privileged access to a world which ordinary mortals don’t have access to – either that or they’re seen as brilliantly creative. In the past 400 years, there’s been a tendency to see certain people, from our own time as well as retrospectively, as great minds, geniuses and brilliant thinkers but also as people who showed signs of mental instability.”

Artists, he says, do not have it all to themselves; scientists suffer just as much from “manic creativity”. He instances John Nash, as played by Russell Crowe in A Beautiful Mind – a great mathematician who watched himself gradually losing his reason. “He was seeing something denied to the rest of us,” says Professor Thomas. “The trouble is, such people are trying to put the unspeakable into words. But since the time of Plato and Aristotle, we’ve been preoccupied with the idea of the rational, self-aware, speaking self, using language understandable by (omega) others. Those who experience madness are cut off from the mainstream of western thought and society.”

How does it feel from the point of view of the sufferer? Sara Maitland, 56, is a prize-winning novelist and short-story writer, the author of several works of theology and gardening, and a teacher in creative writing. She has also, since her teens, suffered from visitations of mental disarray. “I was very young in the late 1960s, and there was a glamour about madness, in those Laingian days. I wasn’t eating or looking after myself or ‘conducting myself in a proper manner’,” she says, emphasising the last words with bolshy-schoolgirl scorn. “I used to react excessively to things. I’d lie down in the street and weep and wail.” She went to a mental hospital. “I wasn’t sectioned, I took myself there, though I didn’t have a lot of choice. I was on drugs off and on. Of course, this was some time before the voices.”

It’s piquant to listen to this charming, ferociously gifted woman chatting about the voices which settled in her head over the years. “I’ve never believed it’s a completely external, fully embodied voice,” she says. “Some people do. I always know that they’re something to do with my imagination. I tend to record them, write what they say in notebooks.” What do they say? “It tends to be pretty hyper; they talk in fairly Biblical language.” Are they male or female? “I’ve a set of voices and they’re very different. I give them names to make them more manageable. Not personal names, but descriptions – the Dwarf, the Angel, the Little Girl. They have vocal timbres to go with their names.” Was her writing improved by the voices? “Yes, I think they give me better insights. In my second novel, Virgin Territory, I tried to use the voices directly, to incorporate them. It was exhausting. Once is quite enough for that.”

She concedes that some mentally ill people revel in performance. “Patients get into a state where they say, ‘I’m more anorexic than you, I’m suffering more, I’m madder than anyone else.’ And writers do that too. All artists are show-offs.” Did she think mentally disturbed people produced valuable work as a result of their disability? “I don’t want to say that evil psychiatrists and the Government are trying to stop the production of wonderful artworks, because it’s more complicated than that. But I’d say there’s a connection between those kinds of excitements and imaginative excitements. Which doesn’t mean every artist has to be psychotic, nor that every psychotic is an artist.”

What is Sara suffering from? Don’t, if you know what’s good for you, mention the S-word near Ms Maitland. “I don’t think schizophrenia exists, although there’s a long list of symptoms associated with it. I’ve a friend who was interviewed by a nurse looking for symptoms of schizophrenia. She asked such stupid questions that my friend laughed – and the nurse ticked another box, because ‘inappropriate laughter’ is another symptom.” She whinnies with indignation. “If you sent a supposed schizophrenic to different psychiatric consultants around the country, no two people would come up with the same diagnosis. Well, you wouldn’t go to hospital to have your appendix out if they’d given you five different diagnoses, would you?” She sees the word as “a put-down word, that makes you lose your fundamental human rights, makes you have compulsory treatment, makes you take medicine which no one says will make you better and often makes you worse.”

What really annoys her is the way that psychiatrists lump different altered states under the same umbrella. “I said to a psychiatrist that there must be something wrong, when people are unable to distinguish between Peter Sutcliffe [the Yorkshire Ripper] and William Blake [who as a boy saw angels sitting in a tree on Peckham Rye, ‘bright wings bespangling every bough like stars’] and he said, ‘There’s no difference.’ I said, ‘Excuse me, there’s a massive difference between writing a lot of beautiful but rather strange poetry and going out and murdering a lot of women.” She wants to establish a respectable pedigree for hearing voices. “In the days of Joan of Arc, a whole range of options were advanced about why she was afflicted by voices. That range is dead. Now, if you hear voices, you’re a loony. That’s what I want to challenge.”

Professor Thomas shares her views. He doesn’t believe in schizophrenia either, labelling it “a made-up 19th-century-Greek word which has no meaning and no longer has any useful value.” He talks instead about “states of mind in intense distress, that exist in a form of psychosis” but is wary of recommending standard treatments. “Some patients find psychiatric treatment helpful, and if they want that, fine. Many find it harmful, in which case they shouldn’t be forced to have it. I think psychiatry should spend more time developing ways of helping people make sense of their distressing experiences because, in a way, that’s what creativity is about. If we did, we wouldn’t get into such hassles over the need to impose treatment and lock people up.”

Like a man regretting the decline of novel reading and the rise of the DVD, Thomas sees a lack of curiosity in human psychology. “These days, as part of the wider changes in our culture, we’re less interested in ways of understanding the human condition that rely on detailed analyses of people’s inner worlds. We’re more interested in ourselves as neurochemical beings. Thirty years ago, if you were in a bar in New York at weekends, they’d be talking about what their analyst said the other day. Today, they’ll be talking about Prozac and its effects. We’re interested in more superficial, glib, easy-fit narratives as ways of understanding ourselves.”

Maitland, meanwhile, doesn’t want to lose the noisy companions in her head. “The point is not to drug the voices out of existence, but to negotiate with them. Really, it’s just the same as having a lot of ill-behaved toddlers in the house. You tell your health visitor, ‘My toddlers are driving me round the bend,’ and she says, ‘Oh, hit them over the head and drown them.’ But you don’t want to kill them. You just want them to behave.”

Ages of the mind A brief history of treatments for mental illness – from witch-burning to electroconvulsive therapy


Cave paintings from the Stone Age seem to show trepanning – drilling a hole into the skull, and suggest that people thought it would cure mental disorders.


At Memphis, the temple of Imhotep (below), became a medical school. Successful psychiatric treatment was attributed to amulets or gods.

After 460BC

Hippocrates wrote 76 treatises which are still the foundations of modern medicine and psychiatry. He described melancholia, postpartum psychosis, mania, phobias and paranoia.

After 400BC

Plato (above right) proposed a view of the soul (psyche) as a charioteer driving two horses, one noble, the other driven by base desires. The charioteer struggles to balance their conflicting impulses.

9th century

Rhazes (865-925), later called the Persian Galen, was chief physician at Baghdad hospital where there was a psychiatric ward. The Arabs had no fear of demons, so patients were treated kindly.

11th century

In Salerno university Constantinus Africanus, a Jew who became a Christian, translated Hippocrates from Arabic into Latin. The nervous system was examined and the brain seen as the seat of mental illness.

Middle Ages

In the early days of the Bethlem hospital (Bedlam), which began to care for people with mental health problems in the 12th century, patients were treated with concern and issued with arm badges to wear so that they could be returned to hospital if their symptoms recurred.

14th century

People with mental health problems were considered to be witches (above) and were the victims of persecution rather than treatment.

16th century

Johann Weyer (1515-1588) emphasised that illnesses attributed to witches came from natural causes, and made the revolutionary demand that witches should themselves be sent to physicians for treatment.

17th century

There was a belief that if people behaved like animals, they should be treated like animals. Thomas Willis, a neuroanatomist and doctor, said: “The primary object is naturally curative discipline, threats, fetters and blows are needed as much as medical treatment.”

18th century

Asylums were built to house people with mental health problems separately from houses of correction and poor houses. The wealthy could become a private patient of a doctor or clergyman. The beginnings of psychology as a separate discipline.

19th century

Several psychologists developed theories concerning neuroses. Sigmund Freud’s ideas are the basis for psychoanalytic theory today. Intravenous injections of morphine began.

20th century

Gestalt theory and behaviourism, or stimulus-response, began to merge in the techniques of cognitive behavioural therapy, which is popular today. Chemicals were used to induce deep sleep treatment. Insulin coma therapy saw patients given insulin to induce a coma and convulsions. Camphor injections were also used to induce fits. Electroconvulsive therapy (above) was introduced as a treatment for schizophrenia and soon became widespread. Various antipsychotic and antidepressant drugs were introduced in the 1950s and 1960s. Psychosurgery was used with considerable enthusiasm in the middle of the century.