The art of the mentally ill is the focus of great interest. There have been many books on the subject, the emergence of specialized journals, international exhibitions, and the sale of work at ever-increasing prices. The creations of mentally ill patients have been given various names, such as ‘outsider art’, ‘psychotic art’, ‘art brut’ and ‘art extraordinary’. The area has attracted psychiatrists, artists and historians.
Psychiatrists have been interested in what such art reveals about the mental state of the artist; such as, Sims1 used a picture by a psychotic patient to illustrate the cover of his textbook on psychopathology. Here art is being used as a visual demonstration of mental illness. Artists have claimed to find in the pictures of the psychotic a liberating disregard for cultural convention and orthodoxy, and have hailed these patient—artists as intrepid explorers of new artistic landscapes. Historians have been interested in several aspects of the art of asylum patients. Why was such work produced in the first place? What can it tell us about the asylum world? And, finally, why is such patient-work, which was initially considered to be artistically worthless, now held to have significant aesthetic value—a process that MacGregor2 has called ‘the discovery of the art of the insane’. These disciplines bring with them contrasting perspectives, but at the core of these discussions are two questions: Is there anything distinctive about the art created by those deemed mad? If so, is it possible to recognize and describe its distinctive features?
At the beginning of the nineteenth century, two major factors contributed to the awakening interest in the art of the insane—the Romantic movement, which identified madness as an exalted state allowing access to hidden realms; and the emergence of the asylum, which provided a place for the production of patient-art. Romanticism saw madness as a privileged condition: the madman, unrestrained by reason or by social convention, was perceived as having access to profound truths. The Romantics emphasized subjectivity and individualism, and hailed the madman as a hero, voyaging to new planes of reality. Although the equation of madness and genius originated with Plato, it was only in the nineteenth century that it became an important feature of cultural discourse3. From the proposition that the genius was a kind of madman it was logical to ask whether the mad themselves create works of genius.
The growth of the asylum and attendant rise of the psychiatric profession has been the subject of intense debate, stimulated by Michel Foucault‘s ground-breaking Madness and Civilization4. While recent scholarship has painted a complex picture, which finds evidence not only of oppression but also of humanity, it is undeniable that the asylum era witnessed the creation of large, captive and often long-term populations of the mentally disturbed. It also saw the emergence of asylum doctors, some of whom began to take an interest in the artistic productions of their patients.
Pinel, the pioneering French alienist, appears to have been the first to write about the art of the mentally ill. In his Medical Treatise on Mental Disorder or Mania, published in 1801, he made mention of two patients who drew and painted. A little later, the American Benjamin Rush wrote that the development of insanity could sometimes unearth hidden artistic talents: it could throw ‘upon its surface precious and splendid fossils, the existence of which was unknown to the proprietors of the soil in which they were buried’5. Rush was articulating what was to become a common perception—that madness carried the promise of artistic achievement. John Haslam, apothecary at the Bethlem Hospital, was probably the first clinician to reproduce patient work in his Illustrations of Madness6, which featured a drawing by James Tilly Matthews. However, Haslam reproduced the drawing to show that Matthews was mad, rather than from any aesthetic considerations.
W A F Browne, the first Superintendent of the Crichton Royal Asylum in Dumfries, was another clinician who took an interest in the art of inmates, and in 1880 he wrote an article entitled ‘Mad Artists’7. However, Browne was interested in proving his thesis that the art of the mentally disturbed was no different from that of healthy people, and he seems to have selected the more conventional pictures and ignored the stranger creations—more specifically the type of work that would nowadays be called ‘outsider art’. Browne’s emphasis on the essential normality of patients’ art addresses one of the fundamental questions in this area—namely, is there anything distinctive about the work of the mentally ill? For Browne, the answer was no.
Another nineteenth century alienist who took an interest in the art of the insane was the Italian clinician Cesare Lombroso, who collected a large amount of patient work. He outlined his views in his book The Man of Genius8. Lombroso subscribed to the theory of degeneration and saw insanity as representing an atavistic regression to an earlier more savage stage of human development. He believed that genius and insanity were closely related, and that genius was in fact a type of insanity, more specifically ‘a degenerative psychosis of the epileptoid group’. Lombroso thus approached the mad-genius controversy from the opposite side to the Romantics. Yes there was a link, he agreed, but it was not one to extol: both the madman and the genius were types of degenerate.
For his book Lombroso collected 108 patients whom he considered to show artistic tendencies. Like Benjamin Rush he noted that insanity was able ‘to transform into painters persons who have never been accustomed to handle a brush’. Lombroso examined the work of the mad, looking for distinctive features, and concluded that there were certain recognizable characteristics of insane art. These included such features as ‘eccentricity’, ‘symbolism’, ‘minuteness of detail’, ‘obscenity’, ‘uniformity’ and ‘absurdity’. Although Lombroso has often been condemned as an aesthetically blinkered clinician who embraced a now discredited theory of degeneration, his writing does suggest that, at some level, he was alive to the strange power of his patients’ art.
The first book to address the art of mental patients from an aesthetic rather than a clinical point of view was Art by the Mad9, which was published in Paris in 1907 by Paul Meunier, a psychiatrist, who wrote under the pseudonym, Marcel Reja. He saw the art of the insane as primitive in character, but unlike Lombroso he did not think the work was pathological in itself. Rather he felt that a study of such work might yield an understanding of artistic creativity in general.
In 1921, a Swiss psychiatrist Walter Morgenthaler published A Mental Patient as Artist10, about the patient, Adolf Wolfli, who has become the most cele
ted outsider artist and whose work now hangs in public galleries. Morgenthaler became acquainted with Wolfli when employed as a psychiatrist at Waldau Asylum, near Bern. Morgenthaler arranged for Wolfli to be supplied with materials such as pencils and paper, and over the years he spent long periods with Wolfli, talking to him as he worked on his pictures in his single asylum cell. Morgenthaler’s book was borne of a deep knowledge of his subject, and he made the case for taking the work of psychotic patients seriously.
Morgenthaler was influenced by the psychiatric schools of Kraepelin and Bleuler, but also by the psychiatrist-philosopher Jaspers and the art historian Worringer. Morgenthaler wished to study the origins of artistic creativity in an individual whose insanity, he contended, made these origins more visible than they would have been in a sane person.
The following year, Hans Prinzhorn, a German psychiatrist working at the Heidelberg Hospital, published the classic Artistry of the Mentally Ill11, in which he derided attempts, as exemplified by Lombroso, to search for diagnostic clues in the creations of the mad, arguing that such art should be approached as the work of individuals rather than inspected for signs of insanity. Prinzhorn’s book contained the work of ten ‘schizophrenic masters’. The use of this term signified that Prinzhorn felt that such work had aesthetic value. The ‘schizophrenic masters’, include such patient—artists as Karl Brendel, Peter Moog and August Neter (Figure 1). Having rejected an inventory of the superficial traits of insane art, Prinzhorn judged that the work of patients with schizophrenia was best characterized by a ‘disquieting feeling of strangeness’. Further, he argued that ‘We sense in our pictures the complete autistic isolation and the gruesome solipsism which far exceeds the limits of psychopathic alienation, and believe that in it we have found the essence of schizophrenic configuration.’
August Neter. Witch’s Head (Prinzhorn Collection)
Subsequent research has revealed some discrepancies in Prinzhorn’s work12. First, Prinzhorn presented a rather Romantic picture of the asylum artist, who was held to be untutored and uneducated. In fact several of the patient—artists in his collection were knowledgeable about culture and had painted before admission to the asylum. Secondly, although Prinzhorn hailed the patients with schizophrenia as the most profound and creative group, not all of the ‘masters’ were actually schizophrenic. Prinzhorn also ignored the social context in which the work was produced. By doing so, he neglected the effects of incarceration on the creation of patient-art. In addition, the view that patient—artists were indifferent to the reception of their work has proved to have been unfounded. For example, Wolfli was aware of the market for his work and produced pictures on commission13.
In 1965, Leo Navratil, an Austrian psychiatrist, published Schizophrenia and Art. Navratil held that artistic expression was a symptom of schizophrenia, and that this expression could bring about a healing process. Navratil described four main features—formalization; deformation; use of symbols; and a tendency to impose facial interpretations on shapes14. Subsequently, Navratil set up an Artists’ House in the grounds of the psychiatric hospital at Gugging, near Vienna. This venture has given rise to several patient—artists, such as Johann Hauser and August Walla.
ARTISTS AND ART CRITICS
Before the twentieth century, several artists such as Hogarth, Goya, Géricault and Fuseli had taken an interest in the insane, though mainly as subject matter for their painting. It was really in the early 1900s that the art of the mentally ill began to attract the artistic community. This interest should be seen in the general context of a dissaffection with established western culture and a search for new modes of expression. Artists looked to so-called primitive cultures, to the art of children, and, of course, to the art of the mad. For example, Paul Klee, like many Expressionists, was greatly influenced by Prinzhorn’s book. He wrote:
‘In our own time worlds have opened up which not everybody can see into, although they too are part of nature. Perhaps it’s really true that only children, madmen and savages see into them’2.
Max Ernst was also intrigued by the art of the insane, and his work clearly reflects its influence. Ernst was probably responsible for introducing Prinzhorn’s book into French Surrealist circles, where it created a profound impression. Inspired by the writings of Sigmund Freud, the Surrealists wished to explore the unconscious, and saw dreams, automatic writing and madness as a means of entering this dark and disturbing territory. They regarded madness as a state of absolute freedom—a state in which bourgeois law had no jurisdiction. Madmen were perceived to have broken free from the cage of reason and logic. As the poet, Paul Éluard wrote:
‘We who love them understand that the insane refuse to be cured. We know well that it is we who are locked up when the asylum door is shut: the prison is outside the asylum, liberty is to be found inside’2.
In the first Surrealist Manifesto, André Breton, the leading theorist of the movement, wrote:
‘The confidences of madmen: I would spend my life in provoking them. They are people of a scrupulous honesty, and whose innocence is equalled only by mine. Columbus had to sail with madmen to discover America’15.
A few years later, Breton published an autobiographical novel, Nadja, in which he described his real-life encounter with a young woman who was descending into psychosis. Here he did indeed provoke the confidences of the mad. The young woman, the eponymous Nadja, formed a relationship with Breton during which she became mentally more disturbed, ultimately being admitted to an asylum. In her last weeks with Breton she completed a series of drawings, some of which were reproduced in the novel. Breton acknowledged that he may have played a part in precipitating Nadja’s breakdown. He did not visit her in the asylum, and instead railed against the psychiatric system. Polizzotti16 is surely right when he suggests that Breton’s anger was fuelled by his personal guilt over Nadja’s predicament. Breton’s novel can be read as a collision between an intellectual theory of madness and the actual experience of the sufferer.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1282252/
My friend and co-editor here on Beyond Meds, Will Hall, spoke at the American Psychiatric Association a day or two ago. I just listened to this talk and was moved very deeply. Imagine — he just said all this stuff in front of a room filled with psychiatrists!!
jessicawritesnow 
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