Psychology Physician Psychiatrists and the Clinical Association of Genius and Madness

The romantic redefinition of genius in terms of the imagination reigning supreme satisfied two goals simultaneously. Through its stress on the spontaneous and irrational imagination, it made possible the appropriation of 'mania' from the past, but it did so while insuring intellectual independence in the present. There was, however, a critical byproduct: while the new definition liberated the romantics from the past, it also disassociated them from the very qualities that previously had been seen as establishing and safeguarding sanity. Given the commonality of the belief concerning the relation of sanity to the balance of mental faculties, the romantic reformulation of genius, which removed this balance, established a logical foundation for the association of genius and madness. And, most ironically, perhaps, the romantics, trapped by their premises and system of logic, began to suspect that clinical madness is indeed a likely if not inevitable end of the condition of genius.

The need of the romantics, then, for a sense of identity and for their own intellectual and artistic independence, led them to adopt a system of premises that left them defenseless against the label of madness. Trapped by their own logic, they came to see their madness as inevitable. Accordingly, the romantic men of genius were among the first to suggest (e.g., Lamartine, Schopenhauer, Wieland, Poe, and others), in reference to themselves and other eminent individuals, that the ancients were indeed correct in their assessment: the 'demon of madness' was more than just a stranger among their ranks. Although many of these confessions or pronouncements on the nature of genius were expressed in more general than specific terms, and referred to the 'inspired' madness of the ancients, some testified, quite clearly, to the fear of clinical insanity. Coleridge, for example, commented specifically on the dire consequences of a suspended judgment or reason:

The reason may resist for a long time ... but too often, at length, it yields for a moment, and the man is mad forever. ... I think it was Bishop Butler who said that he was all his life struggling against the devilish suggestions on his senses, which would have maddened him if he had relaxed the stern wakefulness of his reason for a single moment.

Similarly, Byron, although often appearing to revel in a professed madness, nevertheless spoke with considerable apprehension about his future: "I picture myself slowly expiring on a bed of torture, or terminating my days like [Jonathan] Swift - a grinning idiot."

It would be erroneous to assume, however, that such trepidations and self-admissions on the part of geniuses were sufficient to establish as a medical fact the connection between genius and madness. For such to occur there had to exist a close correspondence between the intellectual grounds on which these trepidations were based and the specialized knowledge claims associated with the rising fields of psychology and the medical-psychiatric profession. It should be noted in passing that at least one dominant philosophical-psychological tradition was unfavorably disposed and frequently hostile to the romantic conception of the extraordinary individual. The psychological empiricism of Hobbes, Locke, and Hume (which, in the hands of Hartley, Bentham, James and John Stuart Mill, was transformed into psychological asso-ciationism) was unalterably opposed to the view that knowledge is in some way innate to humans or the result of inherent dispositions. Instead, these empiricists stressed the extrinsic nature of all human knowledge. The support the romantics needed to help articulate and legitimate their view of the extraordinary individual and the workings of his mind was

Imagination - it is this dominant part in man, this mistress of error and falsity, and more often trickster than not. ... But being most often false, it gives no mark of its quality, marking the true and the false with the same nature.

It is not well in works of creation that reason should too closely challenge the ideas that come thronging to the doors. Taken by itself, an idea may be highly unsuitable, even venturesome, and yet in conjunction with others, themselves equally absurd alone, it may furnish a suitable link in the chain of thought. Reason can not see this. ... In a creative brain reason has withdrawn her watch at the doors, and ideas crowd in pell-mell.

located in a highly speculative psychological tradition which predated the critical empiricism of Locke and Hume.

Before 1700, Western scholars attempted to understand the nature of the mind, learning and creativity from a modified Aristotelian position. This position recognized the existence of some half-dozen more or less distinct mental components or 'faculties,' which, to some degree, were subject to improvement through their exercise. The belief in mental faculties was gradually expanded and formalized during the eighteenth and nineteenth centuries and, through the writings of Wolff, Reid, Sully, and others, became established as a school of thought known as faculty psychology. In Reid's reformulation of this perspective, for example, the number of components of the mind was expanded to 24 but retained such traditionally recognized intellectual powers as perception, judgment, memory, and moral taste. Although Reid and other faculty psychologists concurred that the mental powers could be improved through training, they believed that a pronounced display of strength in any faculty is rooted, overwhelmingly, in a powerfully endowed instinct or native disposition. Accordingly, an individual distinguished by an extraordinary ability to memorize facts was seen to possess an unusually vigorous instinct or faculty of memory. The belief in inherent mental dispositions supported not only the inception of the genius ideal but its subsequent romantic reformulation.

Unlike the school of psychological empiricism, therefore, the faculty psychology of Reid, Wolff, and others, with its stress on innate powers and inherent mental dispositions, was sufficiently vague and mystical to accommodate most of the romantics' assertions regarding the transcendental nature of profound creativity. Importantly, also, faculty psychology even concurred with the romantics' position that the genius's dependence on an 'overcharged' and highly impulsive imagination constitutes a form of madness, divine or otherwise. It had long been an established principle, particularly for faculty psychologists, that an excessive stimulation of any faculty of mind is incompatible with perfect health and mental adjustment.

Whether or not, however, the supposed infirmities of genius constitute clinical pathology rather than a divine gift or mania remained, until the middle of the nineteenth century, a matter more of philosophical speculation than of supposedly scientific fact. The individuals, overwhelmingly, who were to establish the verdict of clinical madness as a medical fact were those who had earned a medical degree and are classifiable under the general category of physician-psychiatrist. These specialists, although they embraced many of the assumptions of faculty psychology and brought to bear what then were regarded as the latest clinical concepts and diagnostic categories, relied quite heavily in their determination of genius as clinically mad on the self-admissions of illness on the part of the 'gifted.' And while many of these self-admissions were expressed in terms of the inspired madness of the ancients, these physician-psychiatrists took the men of genius at their words, they decidedly were not like ordinary, healthy humans.

The first examination of genius as a purely medical problem may be dated to Lelut, a French psychiatrist, who in 1836 scandalized the world of letters with the first clinical history of genius in which he claimed that Socrates's inclination "to take the inspirations of his conscience for the voice of a supernatural agent [his demon]" was evidence of a

"most undeniable form of madness." Other psychiatrists and scholars soon followed suit with their own views and analyses of other 'gifted' persons (e.g., Galton, Lombroso, Maudsley, Moreau, Stekel), with the result that within a century such works numbered in the hundreds. Importantly, the judgment of genius as pathological was the dominant position on the issue, one that derived its overwhelming support from members of the medical and the developing psychiatric professions. Those who projected the image of sickness distinguished themselves from each other by identification of different types of mental illness largely in step with the rise and fall of diagnostic categories in psychiatry then currently in favor. Whereas diagnostic labels such as psycho-physical disequilibrium, monomania, degeneracy, neurasthenia, and neurosis prevailed in the years up to 1950, the disease categories that have gained ascendency since that time are those, such as schizophrenia and manic-depressive illness, that figure prominently in the contemporary lexicon of psychiatry.

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