History • 53Creativity and Madness
Another interdisciplinary series of conferences, all held in artistically rich settings, have
been sponsored since 1983 by the American Institute of Medical Education. The meet-
ings, occurring several times a year, were first organized by a multidisciplinary group that
included a psychiatrist, an internist, an artist, and an art therapist, Evelyn Virshup (1978,
1993). The same group also edited a book, Creativity & Madness: Psychological Studies of Art
& Artists (Panter et al., 1995) that was an outgrowth of those meetings.
Studies of the psychopathology of expression are intimately related to the ongoing debate
about the relationship between creativity and madness. The nature of the connection is, of
course, relevant for art therapy. It is now known statistically, as well as anecdotally, that the
incidence of bipolar (manic-depressive) disorder is significantly greater among creative art-
ists than in the population at large (Jamison, 1993). It is also known that some individuals
are more productive during episodes of illness, while the creative output of others suffers
in both quantity and quality. Did Van Gogh and Munch paint because of or in spite of their
ailments? The question is a complex one at best, and there is as yet no clear consensus.
What is less debatable and more relevant is that people suffering from acute mental dis-
tress are often better able to express themselves through the more direct language of paint,
clay, or pastels. When the verbal mode is absent (as in catatonia or mutism), or so confused
as to be largely indecipherable (as in the “word salad” and neologisms of some psychotic
states), “image-talk” can be a vital form of communication and a welcome release of tension.
Psychotic imagery is sometimes childish, primitive, and confused, but it can also be very
beautiful. Its aesthetic appeal is probably more significant than its symbolic meaning in its
persistent popularity.
Art Brut and Outsider Art
Since the turn of the century, artists and art critics have been intrigued with the art of
untutored individuals, including the spontaneous and lively work of young children. The
French Impressionists were fascinated by the creations of primitive tribes and exotic cul-
tures. Many artists and critics have valued work by those with no formal training—called
“naive” or “primitive”—from the Frenchman Henri Rousseau to the American Grandma
Moses (DVD 3.7).
In the late 1940s, painter Jean Dubuffet was drawn to what he named Art Brut (Thevoz,
1976) (A). This is a broad characterization covering all kinds of “raw” creations, including
artwork by those with mental illness. Also called Outsider Art (B) (Cardinal, 1972; Hall
& Metcalf, 1994; Trechsel, 1995; Yelen, 1995), both terms capture the sense of alienation
associated with untamed expressions of the human spirit, whether by indigenous peoples,
children, naive adults (C), or those with psychiatric disorders.
Art in Diagnosis and Therapy
A similar vein fertilizing the soil for the eventual emergence of the field of art therapy was the
growth of projective testing in the field of clinical psychology (DVD 3.8). Finger paint, from
the time of its invention by teacher Ruth Shaw (1938) in 1931, was thought to be potentially
diagnostic as well as therapeutic and was used in many treatment centers, including the
Menninger Clinic (A). My own first exposure to the idea that art could show something sig-
nificant about people was in a 1954 child psychology class, where my teacher, Thelma Alper,
shared her discovery that children from different socioeconomic milieus did very different
kinds of finger paintings. When she held up the pictures, her excitement was contagious.