Wednesday, August 22, 2007

News Flash!

It is the first anniversary of this blog at the end of the month, and with that in mind I have a new and exciting development to announce.

I am very pleased to announce that this blog now has an official illustrator – Philippa King.

Philippa is an extremely gifted individual who writes and paints about her experiences with Schizoaffective Disorder. Having suffered from mental illness for 19 years of her life, Philippa has found solace in her art explaining “I live to paint and paint to live. Time spent not painting is time spent not breathing”.

Philippa’s art is a very powerful tool in portraying how it feels to suffer mental illness, which is precisely the reason why I contacted her to ask if I could use some of her art on my blog. What happened next can only be described as having a whirlwind romance with her art, as I quickly went from falling in love to owning a piece of my own within days.

I was blown away when Philippa agreed to actually illustrate my blog, and her first piece “Because I Love You” (for this post), sold within two days, really demonstrating just how moving her art is.

I don’t recall ever being affected by art in this way before. Philippa’s paintings really provoke an emotional response in me, and it is a privilege to have her illustrate my experiences with Mr Man.

Thank you Philippa.

When I looked at this beautiful piece close up it provoked a very strong emotional response in me. If you look closely you can see a girl standing behind the glass wall.

"Behind a Glass Wall" by Philippa King

Philippa displays her art in her blog Loaded Brush. Not all of her art relates to mental health, and some of her pieces are playful and funny. For a person who is knowledgeable about art it is easy to see who her influences are, including Van Gogh, Lucian Freud, and Francis Bacon. There really is something for everyone.

Tuesday, August 14, 2007

Genius or Madness? The Connection between Psychosis and Creativity

Part Three – To Treat or Not To Treat

We’ve already seen how psychosis can often be a positive experience for some people, and can contribute to creativity in various ways. We’ve also seen the enormous sense of loss that one feels when it has gone. Bearing this in mind, is it necessary to treat it?

For Mr Man it seems that it was; those friendly voices had long been replaced by the threats and demands of the unfriendly, which is what led to the discovery of his illness. Instead of telling him the next best possible move in a Chess game, or the solution to a programming dilemma, they would tell him he was stupid and worthless. Instead of helping him to be creative, he believed they were stealing his ideas. The voices demanded he continued to “work” for them, or they would kill his wife. Mr Man became more and more paranoid, depressed, and suicidal, and his illness became unmanageable.

So why is psychosis a pleasant experience for some, and an unpleasant experience for others? Why does that pleasant experience sometimes change, as it did for Mr Man?

I have no idea if there is currently any research into this area, but in my opinion there should be. It would seem that some people are predisposed to certain mental illnesses. This could be for a variety of reasons, including genetics or problems during pregnancy which effect the development of the brain. However, some people will not develop mental illness until a second trigger comes into play. That second trigger could be stress, trauma, or drugs.*

My theory is that some people who are predisposed to mental illness will go on to develop a “happy” kind of psychosis, but those who do not develop psychosis until a second trigger comes into play will develop a more “depressive” kind of psychosis. For those people who previously experienced “happy” psychosis; stress, trauma, or drugs could also cause them to develop a more “depressive” psychosis later on. Of course this is only a theory, and like all theories, needs adequate research to prove or disprove its accuracy.

“Taunting voices they are, never kind any more. When did that change?” - Catherine

Mr Man experienced “happy” psychosis since his teens, and thus was able to keep it to himself for over 10 years. In his late twenties he experienced the physical stress of suffering from Epstein Barr, and the emotional stress of trying to hold down a job while he was suffering from this virus, as well as extra burdens placed on him by his manager. It would seem that it was at this time that the nature of his psychosis changed and the voices became more threatening.

Hearing voices is often a traumatic experience for the sufferer

"The Words of my Voices" by Philippa King

There is evidence** to suggest that the longer psychosis is left untreated, the harder it is to treat. Bearing this in mind, and also the changeable nature of psychosis, should all those who experience psychosis be treated, even if it is a positive experience for them? I really feel that this is a moral question which I have no answer to.


Earlier this year I received the following comment by Doctor Goober Modesty:
“There is a fine line between genius and psychosis. It is never spoken about in a clinical setting, seems like only on the Internet. From my view point, the Mental Health System does not know how to handle the genius in us persons with Schizophrenia. Here in Canada, namely Montreal, the Hospital started to invest in my genius slant through the arts... times do slowly change for the better!” – Doctor Goober Modesty
I have to agree that mental health staff often do not know how to handle genius. I suspect part of the problem is their inability to recognise it due to their own limitations, but if what is produced is linked to the psychosis then they may wonder if it is a good thing to encourage it.

Mr Man was often treated with little or no respect whilst on the ward, and yet he was undoubtedly more intelligent than the staff treating him that way. If they had looked into his little note book that he carried around with him, they would have seen a long list of zero’s and one’s and no doubt would have concluded that it was part of his “madness”, and yet a math professor would have instantly recognised that he was forming a code with the use of binary.

On the other hand, even if they had recognised the complexity of the code and understood the mathematical side of it, would it be right for them to encourage Mr Man to develop it, knowing that he was writing a code so that we could communicate without the “company” understanding us? Surely that would reinforce his delusional thoughts? Yet, isn’t art therapy encouraged in psychiatric hospitals? Isn’t that also reinforcing delusional thoughts for those who feel that they are “instructed” to paint or draw through psychosis?

It seems that the topic of creativity and psychosis is a complicated one with many more questions than answers.

Finally we arrive back at the original question: Genius or Madness?

You decide.

Special thanks to Seaneen, Doctor Goober Modesty, Philippa King, and Catherine

The mental health charity, MIND, is celebrating 60 years with the “Art - Making a Difference” or M.A.D Art Installation. It is a collection of work by mental health users and survivors and will be open to the public from Saturday 1st - Sunday 9th September 2007 at Draywalk Gallery, Truman Brewery, Draywalk off Brick Lane, London, from 11.30am - 7.30pm. Entry is free, and the nearest tube station is Liverpool Street. Click here for more information.

The “Frame of Mind” Art Exhibition will be displaying artwork of people managing a serious mental illness or brain disorder. It will be held on Monday 22nd October - Sunday 4th November 2007 at Wycombe Swan, High Wycombe, Buckinghamshire.

Philippa King will have pieces of art on display at both of these exhibitions.

*The Causes of Schizophrenia

**Wyatt RJ. Neuroleptics and the natural course of Schizophrenia. Schizophr Bull 1991; 17:325-351.

Genius or Madness? The Connection between Psychosis and Creativity

Part Two – Just Where Do You Come From?

As mentioned previously, psychosis and mania are not always bad experiences for people. Many people actually welcome these experiences, feeling that they are a source of inspiration.

Of course, feeling inspired by psychosis can mean different things to different people. For some it will literally mean that they feel that their hallucinations are informative in some way; for example, they may feel that their hallucinations are a form of apparition or vision; a religious experience. They may feel that they are being instructed on how to carry out a certain task. Others feel that their psychosis merely provides a “subject” for their creativity.

Hallucination or Vision?

"The Vision of Time" by Doctor Goober Modesty

Where does this creativity really come from?

Since hallucinations are a product of the persons own mind, the knowledge and the abilities must be their own. Mr Man believed that the voices instructed him on how to play Chess, compose music and how to solve programming dilemmas, but a hallucination can’t tell a person how to do something they don’t already know how to do, because it doesn’t really exist. To suggest otherwise would be to suggest that the voice is from a real outside source and not a hallucination after all. Although auditory hallucinations appear to the hearer to be from an outside source, it is merely a symptom of psychosis.

Some artists use their experiences of psychosis as a subject for creativity, and this can be a beneficial form of therapy

"Medication" by Philippa King

So what role, if any, does psychosis play in creativity?

Psychosis can aid creativity in two ways. As previously mentioned, psychosis can often provide a subject for creativity. The subject is compelling, and as Philippa explains regarding her own art “I could be creative without psychosis but it would not have the same edge to it”. Conversely, creativity itself can be an important outlet for those suffering from psychosis, and can be a beneficial form of therapy.

Also, delusional thinking often gives people confidence. The person could genuinely be a genius, and their delusional thinking could give them the confidence that they would usually lack to believe in themselves; or they could be lacking in talent, and suffering from delusions of grandeur which gives them false confidence. Either way, whether the ability in itself is real or imagined the delusional aspect of phychosis can aid self belief.

“I don’t know if my writing is any good at all and in normal circumstances I don’t believe it is, but I miss that manic self-belief.” - Seaneen

As mentioned previously, Mr Man also gained confidence through his psychosis, and felt that the voices were helping him with various tasks. It’s been a slow process, but Mr Man is starting to believe in himself now, and to find his own identity. I’ve already mentioned how he is becoming more involved in Table Tennis, and that he will be redesigning the website for his club. Having access to the internet means that he can share the computer programs he has written with others, and he has quite a little “fan club” of users who regularly ask him for the latest updates, so he is learning that his abilities are appreciated by real people. His music is something that has taken him a little longer to get back to, but recently he has started experimenting with that also.

But is it necessary to challenge the delusions of an individual? Is it necessary to treat someone experiencing psychosis? Why do some people have a pleasant experience with psychosis while others do not? These questions will be discussed in part three.

Next: Part Three

Genius or Madness? The Connection between Psychosis and Creativity


For some people, psychosis or mania isn’t actually an unpleasant experience at all, and many people feel that it is a positive source of inspiration for creativity. I first came across this thought when I was emailed by an administrator for the 1 in 4 Forum about the website Intervoice. On the website reads the statement: “Many voices can be unthreatening and even positive” and Professor Marius Romme is quoted as saying “It’s wrong to turn this into a shameful problem that people either feel they have to deny or to take medication to suppress.”

The connection between psychosis and creativity is something I have been meaning to write about for quite some time. Here follows a series of three articles, covering topics relating to psychosis and creativity, such as the loss one feels when recovering from psychosis, identifying the true source of creativity, and covering questions such as: is treatment really necessary? And why do people experience psychosis in different ways?

Part One – When the Madness has Gone

Even for one whom psychosis has been a bad experience, the fact is that the process of recovery is a difficult one with many losses. The recovering person may experience feelings similar to those of grieving, and it can leave them feeling confused about their identity and their role in society. This is an important point to acknowledge when helping someone through this recovery process. For a creative person, the process of recovery can strip them of their confidence and leave them feeling insecure about their abilities.

Consider for example this interesting article written by Seaneen on “Pole to Polar – The Secret Life of a Manic Depressive”

As a creative individual recovering from mental health problems, Seaneen asks some very poignant questions: “Who am I now?” and “How much of my creativity is me, and how much is the illness?”

For Mr Man, the question “Who am I?” has also been a poignant one during his recovery.

Like Seaneen, Mr Man was more intelligent than his peers at school. His mother was told that he was “university material” when he was about 5 years old. Also, like Seaneen, he is a very creative individual; over the years he has composed hundreds of pieces of music. Amazingly though, he suffers from low self esteem.

“I love writing, but I have no idea if I am talented or if I am only any good when I’ve got that manic energy” - Seaneen

Just as manic episodes gave Seaneen the confidence to believe in her own abilities, psychosis gave Mr Man the confidence to believe in his abilities also. Through the whole of his adult life Mr Man has believed that he was specially selected to work for a “company” because of his level of intellect, and yet he believed that much of his knowledge and creativity actually came from this same company through the voices. He believed that he and they were working in partnership with each other, composing music and writing computer programs. He believed that there were others like him, and that his identification number was 4064. This belief has given him a sense of belonging, given him a purpose, and made him feel valued and appreciated. He has felt supported, almost nurtured, and felt that the “company” recognised his potential without him having to sell himself, which isn’t in his nature. It gave him confidence in his abilities, as he received confirmation that he was doing things the right way.

It’s been difficult for him to accept that there is no “company” after all. In accepting that the company isn’t real, he has also had to accept that what he believed to be the very reason for his existence isn’t real either. If there is no company, no special selection, then who is he? What is his worth? Does this mean that his creative work has no value?

This realisation has left him feeling confused and alone; how could he achieve all those things that he once did without the “company” to help him? Just as a creative person with Bipolar Disorder may wonder if they can be creative without mania, Mr Man was left wondering if he had the intellect and creativity to continue with his music and programming without the voices. Just how much was due to his own abilities, and how much was due to the “illness”?

Mr Man has suffered many losses during his recovery, but was it really necessary for him to be treated for psychosis and to suffer those losses? Just how much of his creativity could be attributed to his voices? These are questions that will be discussed in the following articles.

Next: Part Two

Wednesday, August 08, 2007

The First Three Weeks

Continued from “First Hospital Admission
May 2002 – June 2002

There was nothing major to report during the first three weeks of Mr Mans first hospital stay. No one had any idea what Mr Man was experiencing and it was thought that he was suffering from severe depression. Mr Man did everything that he was asked to do; behaving as the model patient and joining in with all of the ward activities, but during the limited time that I spent with him I could see that really nothing had changed. My husband still wasn’t there, and it seemed that everything he did in the company of others was an act.

"Not as it Seems"

I cannot bear the silence
or the poorly held disguise
or all of this pretending
or the distance in your eyes

by Philippa King

Visiting times produced extremely mixed emotions for me; I missed Mr Man so much and I couldn’t wait to see him, but at the same time I hated seeing him so down and withdrawn. While I was there I couldn’t wait to leave, and yet every time I left it tore me apart to leave him behind. I just wanted everything to be back to normal again.

The stress of the whole situation was starting to take its toll on me; I had started taking antidepressants in the April, and my anxiety levels were constantly high. I was becoming increasingly forgetful; leaving shopping bags in shops, leaving my handbag in cafĂ©’s, and leaving the car or house doors unlocked. I started going through a verbal ritual every time I left the house: “I have my purse, keys and phone. The windows are shut, I’ve locked the door. I have my purse, keys and phone. The windows are shut, I’ve locked the door” and I would repeat this to myself again and again as I drove away. Often I would doubt myself and I would have to turn around to make sure I had shut the house windows, or I would panic that I didn’t have my keys and then I would realise that if I didn’t have them I wouldn’t be able to drive the car! I was always able to produce a smile though, and not many people really knew what I was going through.

During this time the use of Monoamine Oxidase Inhibitors (MAOI’s) was introduced to Mr Mans treatment, which meant having to avoid certain foods such as cheese and other foods which contained Tyramine*. Mr Man wasn’t very happy about this; his diet was already restricted as it was believed that he was suffering from Coeliac disease at the time. Cheese is one of his favourite foods, and also he was unable to eat his favourite crisps because they contained cheese flavouring. The hospital was very good at catering for his dietary requirements though, and we were told that four weeks would be long enough to know whether it would be worth continuing this treatment or not.

Before his admission into hospital, I had always accompanied Mr Man on his appointments to see his Psychiatrist, and being in hospital proved to be no different. I was told by a nurse what day and time Mr Mans appointment would be, and was asked in the presence of Mr Man if I would be attending. We both agreed that I would.

They were very different to Mr Mans usual appointments, which were held in a small “office” type room at the local Community Mental Health Centre, and included only the Psychiatrist, Mr Man and myself. On the ward the “team meetings” as they were called, were held in a larger room, with armchairs and sofa’s, albeit scruffy ones. Several members of the ward “team” would be present, including nurses and Occupational Therapists. The atmosphere was an informal one with a strong sense of team work between the staff members present. In fact that sense of team work was so strong that to begin with I had no idea which one was the consultant. They would openly discuss treatment options between themselves, including various types of therapies, in front of Mr Man and I. They always asked how we felt about the treatments that were selected, and they made sure that we fully understood what each treatment entailed, providing information leaflets and often even suggesting that I do my own research on the internet, particularly when the MAOI’s were introduced and when the possibility of ECT** was discussed.

I have to say, the first 3 weeks of Mr Mans first admission was a very positive experience. The staff showed respect for the patients, and treated them the same as anyone else. Mr Man bonded with a couple of staff members there, and I really felt that if he could be “mended” it would be there.

Of course, this was a Psychiatric ward in a General Hospital, meant for short term stays. After a few weeks patients were usually sent home or moved on to the Psychiatric Hospital. The night before the team meetings we were approached by a nurse and told the “good news” that Mr Man would be discharged in the morning. Mr Man was obviously relieved, but I was very concerned; I knew nothing had changed.

That night as I drove out of the hospital grounds, distracted by my thoughts, I crashed into a plastic bollard. I had no idea what to do, but obviously I had to move it out of the road before it caused an accident. After moving it to the side of the road I parked my car again and then I went back for the bollard and carried it to the Hospital entrance. Just as I approached the main entrance one of the nurses from the Psychiatric ward was on his way out. As he smiled, curious to know what I was carrying, I burst into tears. I’m guessing he must have been used to emotional relatives as first admissions must be a traumatic time for any family, and he gently probed for the full explanation of my distress.

I explained to him how suicidal Mr Man had been and that I knew that nothing had changed. I explained how his involvement in ward activities was all an act, and that it was no indication of recovery. We must have talked in the car park for at least an hour, and by this time it was getting dark. He listened intently, asked questions, and took my concerns seriously.

The next day was the team meeting. The team actually asked to speak to me separately before Mr Man joined us, due to the report given by the nurse I had spoken to the night before. The Psychiatrist explained that she didn’t realise I had been on “suicide watch” for so long. It was obvious by what I had told them that Mr Man still had a long way to go in his recovery, but since the ward was for short stays only it had been decided that he would be moved on to the Psychiatric Hospital. I explained that I was supposed to be going away in a couple of days to one of our religious conventions, and I was strongly advised to still go. The Psychiatrist felt that I needed the break and the encouragement. Reluctantly I agreed.

*The combination of MAOI’s and food containing Tyramine can be dangerous as it can cause the persons blood pressure to rise suddenly.

**Electroconvulsive Therapy.

Next: "The Truth Revealed"