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CREATIVITY AND LIABILITY FOR SCHIZOPHRENIA

A variety of observations and studies link creativity with another mental illness, schizophrenia. Two of the twentieth century’s most creative figures in their fields, Albert Einstein (science) and James Joyce (literature), both had children who were treated for schizophrenia, while John Nash, a Nobel laureate in economics, was diagnosed with schizophrenia after he had completed his most creative work. A 1992 study reviewing the biographies of many of the twentieth century’s most influential avant-garde writers and artists concluded that many had a type of personality disorder that may be genetically related to schizophrenia. Such studies have led to the suggestion that a tendency toward psychoticism, when present to a milder degree, might actually be conducive to creativity. In a recent study testing these predictions, a questionnaire measuring proneness to psychosis was filled out by professional artists and control subjects, nonartists similar in age and education. The artists scored significantly higher. Another study had college students take personality tests as well as paper-and-pencil tests of creativity. This study found that the students who appeared to be more creative by paper-and-pencil measures scored significantly higher on scales of proneness to psychosis.

Several other studies compared the creativity of biological relatives of people with schizophrenia with that of control subjects, as measured by third-party judgments of how creative the individuals had been in their jobs and hobbies. For example, a study in Iceland found that the biological relatives of those with schizophrenia were significantly more likely than other people to be listed in Who’s Who as having distinguished themselves in a creative profession. A meticulously designed study examined the creativity of the work and hobbies of Danish adoptees who were born to either parents with schizophrenia or control parents with no history of psychiatric hospitalization. Both groups of adoptees were placed with adoptive parents at an early age. In the study, evaluators, who were not told the adoptees’ personal and family histories of psychopathology, assessed the creativity of the adoptees’ activities. The scales used to rate creativity were designed to reflect creativity not just in the fine arts or sciences, but in a wide variety of job and hobby activities. The hypothesis was that the greatest creativity would be found in individuals who had schizotypal traits because, while not psychotic, they would be more likely to carry genes for schizophrenia. These genes would tend to predispose them to unusual styles of thinking and perceiving, which in turn would be conducive to creative ideas. As predicted, adoptees who did not have full-blown schizophrenia but did have multiple schizotypal signs (such as odd speech, recurrent illusions, or magical thinking) were rated as showing greater creativity in their jobs or hobbies than adoptees who had one or none of these signs.

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Creativity, Talents, and Skills — The Dana Guide

By Dennis K. Kinney, Steven R. Pritzker, and Ruth Louise Richards
November 2007

Sections include: the brain basis of talents and skillscreativitycreativity and mood disorderscreativity and psychopathology: some practical implications 

For years, Einstein’s brain has been a prized object of research that only a few scientists have been allowed to study, so it was national news in1999 when some of those researchers reported finding a physical difference between the great physicist’s brain and others. The difference was the absence of a particular groove (a “sulcus”) in the cortex in an area of the brain that we generally use in mathematical thinking. The finding suggested that lacking the groove probably allowed Einstein’s brain to devote more neuronal connections to his mathematical abilities.

Einstein’s brain seems remarkable to us because of the way we think about creativity, talents, and skills. Most of us consider ourselves fortunate to have one or two of these attributes, and we believe that only a few lucky people have all three in combination, which adds up to fame. The good news is that this popular belief is wrong. Our brains are  constructed for creativity, talents, and skills; some combination of all three is the rule, not the exception.

The Brain Basis of Talents and Skills

Looking at the brain allows us to appreciate the subtle differences among creativity, talents, and skills, as well as the way in which these attributes both overlap and stand apart.

Skills

Skills—the things we learn to do well—may be the most thoroughly studied, partly because they present a high profile in the brain and partly because a variety of disorders can impair them. Brain imaging studies in particular have shown that the development of a skill leads to differences in either brain anatomy, neural processing, or both. These differences  have been observed, for example, in the way a highly skilled person uses memory. Brain imaging studies  comparing expert chess players with amateur players recently confirmed a longtime theory that expert players are able to “chunk” complex configurations into quickly discernible amounts of information for easy retrieval from memory. Researchers estimate that it takes 50,000 chunks (patterns of information) and approximately ten years to make an expert. Studies of people with professional-level skill on a stringed musical instrument showed that, in the motor cortex, which is responsible for movement, the areas devoted to finger movement had grown larger than in people who did not play. Other data analyzed in the study showed that this difference was greater the younger the musicians had been when they started their studies.

Talents

Talents, by contrast, and despite Einstein, are harder to pick out in the brain. The evidence of the brain’s role, while intriguing, is indirect and warmly debated among researchers. For example, another study that looked at musicians found that the auditory association cortex (a left-hemisphere area of the brain that recognizes sound) was larger in musicians with absolute pitch than in musicians without it and in nonmusicians. But it was impossible to say if this difference was inborn or a result of the way they listen. Because results like these run head-on into the argument over nature versus nurture, a more promising way to explore talents may be studies that focus on two types of children—gifted children and savants, both very different from other children at unusually young ages. Gifted children are striking for developing adult-level skills, often in music or language, but also in mathematics and spatial interests, such as geography, and frequently in more than one domain. They reach impressive levels of achievement rapidly, almost spontaneously, beginning as early as preschool. Savants, too, show unusual musical, linguistic, or artistic gifts as small children, but their talents dwell side by side with profound mental retardation or, sometimes, autism. One of the key insights that child savants offer is how little general intelligence has to do with talent.

One interesting study of gifted individuals suggested that unusual talents in one area might represent the brain’s response to problems in another. In this study, the researchers noticed that the personal histories of their subjects who were gifted in right hemisphere domains had more than the expected number of instances of dyslexia and other language difficulties, which are considered to be related to the left hemisphere. This led the investigators to ask if the right-hemisphere-oriented gifts could represent a compensatory development. Somewhat similarly, a recent study that looked at visual performance after one-sided brain damage offered the idea that weakness in one hemisphere could reduce the competition for the other. In other words, the hemispheres might typically be in a kind of tension or equilibrium that, if disturbed, can free the unaffected side to act more vigorously, with better results.

The nature-nurture debate over talents won’t be settled anytime soon, but an area of research that seems to tip the scales slightly in favor of nature is behavioral genetics, particularly the findings of twin studies. The high heritability of certain talents is suggested by the findings that identical twins who were reared apart tend to be remarkably similar in their talents.

The main point brought home by studies of skills and talents in the brain is that we can set out to develop these attributes with confidence that our brains will cooperate, at least in the mechanical sense. Whether we end up satisfied with our efforts, however, may depend more on bringing a positive attitude and temperament, especially as we age. In general, the skills we use to develop our talents may work better if they are trained in youth (for more, see our section on brain development in childhood).

Creativity

Creativity may be notable for how often people deny having it. We tend to say, “I’m not creative; I can’t write (or paint, or sing).” We may further limit our view of creativity to that which achieves formal recognition: for example, painting well enough to be shown in a gallery, or winning prizes for writing. But this common view, giving creativity a capital C, owes more to social or perhaps economic perspectives. From the standpoint of the brain, creativity is not only a distinct form of mental activity, it is also ubiquitous in human beings.

Everyday Creativity

Psychologists studying creativity put it in two categories, everyday creativity and eminent creativity. Everyday creativity is defined in terms of two criteria only—originality (something new) and meaningfulness (communicates something to others). Such creativity occurs widely across the activities of daily life, at work and at leisure. Everyday creativity can, of course, involve producing something “from scratch,” such as writing or drawing, but it also includes accomplishments that use clever and original ideas to deal with tasks such as settling a problem at work, handling a difficult child, getting out of the woods when lost, starting a stalled car, or producing a meal from a skimpy larder. In other words, it’s not what you do, it’s how you do it, whether you’re an entrepreneur, a parent, a home hobbyist, or a gourmet cook.

We tend not to realize that this is creativity; we may call it coping, making do, know-how, or savvy. Creativity, however, is a particularly human capability and perhaps a cognitive style. It is one that may be seen as essential to life, a  fundamental survival capacity. Everyday creativity involves the suppleness of thinking that allows us to adjust to changing circumstances or to alter those circumstances when necessary. Research has suggested that everyday creativity is not only necessary in our response to our environment but also has an ongoing role in our health. Numerous studies of aging identify flexibility, improvisation, and the ability to take new perspectives and think for oneself— all characteristics of everyday creativity—as qualities associated with longevity. Other research has found that creative activity improves health. Hundreds of studies show successful healing provided by art therapy, music therapy, drama therapy, dance therapy, and writing therapy. For example, in one set of studies subjects who wrote about their traumatic experiences made fewer doctor’s visits, reported increased feelings of wellbeing, and had elevated levels of two biological markers of immune function. By contrast, feelings of helplessness, an inability to think of a “way out,” and paralysis of action—the loss of everyday creativity—are the hallmarks of depression and its debilitating effects on mental and physical health.

The evidence is plentiful that creative work can contribute to the healing of psychological problems. For many years research has found that creative people tend to have a number of positive characteristics for mental health, including a high level of autonomy, motivated goal setting, a wide range of interests, and originality. Creativity may be used as a way to help resolve internal conflicts or as protection against the disorganizing and immobilizing potential of such conflicts. Creative capabilities can help individuals tolerate ambiguity and uncertainty and enable them to reshape their world at a higher level of organization.

Eminent Creativity

In contrast to the importance to individuals of everyday creativity, eminent creativity is activity that a culture elevates as meaningful, formally recognizing it through monetary reward, prizes, and honors. We can say an eminent creator is an everyday creator who is a special case because his or her creativity has achieved social recognition and serves a wider social purpose. Eminent creativity also offers many ways for researchers to explore the underlying features of creative mental activity.

A longtime question in this regard has been about the significance to creativity of the brain’s distribution of processing to either the left hemisphere or the right hemisphere. Starting in the 1960s, when this distribution was first recognized, researchers theorized that the right side of the brain was primarily responsible for creative activity, whereas the left side was more linear and mathematical. This led to a popular stereotype of people being right-brained or left-brained. However, improved electroencephalographic (EEG) measurements and functional brain imaging technology subsequently showed this division to be much too simplistic. For example, EEG studies clearly indicate that solving complicated creative verbal tasks involves both the left and right sides of the brain. Other research using brain scanning has found that when we listen to music, which is supposedly a right-brain activity, our auditory association cortex and language areas, both usually located mainly in the left hemisphere, are highly active.

Another way to get at creativity is through the study of intelligence. Neuropsychological studies may indicate that intellectually advanced individuals are mentally less active during problem solving than average individuals. (This is still speculative but is interesting and important in exploring the way the brain functions during the process of problem solving.) Two possibilities may explain why this occurs. Some researchers propose an “efficiency” hypothesis, suggesting that irrelevant areas of the brain aren’t used during problem solving. Use of task-relevant areas may cause this. Another possibility is that the lower mental activity may define the ability of good problem solvers to bring order into their thoughts and operations.

Although expertise may fit more into the category of skill than creativity, experts and eminent creators appear to share a common specialty in their use of memory. A good example in experts is the chess master’s facility in “chunking” some 50,000 patterns in memory, mentioned earlier. In highly creative people, memory also probably differs from the norm, storing information in patterns that more easily allow insight, analogical transfer of knowledge, and access to unusual, remote associations. Experts also develop protocols, which have been studied by having them think aloud. For example, a chess expert recalls potential moves and then plays them out mentally, making adjustments as necessary. Eminent creators may also make use of such tailored rules for their actions. Once expertise is achieved, however, highly creative individuals will carry their involvement a step further and attempt to make a novel  ontribution to their area by studying and analyzing the work of masters in their field.

Eminent creativity is not just a matter of the brain’s ability to manage a prodigious amount of the information related to a particular art or science. Other requirements, such as flexible thinking and originality, are also required for creativity. From these requirements, research has found, emerges an unusual connection, the only one of its kind that seems to apply to mental life: an advantage for creativity from the presence of mental illness.

Creativity and Mood Disorder

The popular belief in a connection between creativity and psychological disorder may indeed have a basis in truth—but it may be a little more complicated than Dryden said in Absalom  and Achitophel: “Great wits are sure to madness near allied/And thin partitions do their bounds divide.” Eminent artists show very high rates of mood disorders, particularly bipolar disorder, or manic-depressive illness. For example, in one set of studies of eminent writers, as many as 80 percent had experienced at least one episode of clinical depression, and more than half had bipolar disorder. Eminent nonartists (such as social scientists and physicists, for example) present a healthier profile.

Efforts to understand this phenomenon go back more than a century. Freud saw creativity as a way of solving the basic conflict involving sex and aggression. The struggle to solve these conflicts, if unconscious material is not disguised and transformed through creative activity, may emerge as neurosis. One difficulty with this was always that, as friends and family of mood-disordered artists can testify, neurosis may continue despite creative activity.

Jung saw less abnormality in the manifestations of mood disorders by highly creative people, maintaining that we are all born with a collective unconscious that includes dreams, visions, religious experiences, and myths. Still another perspective, Janusian theory, proposes that creativity consists of holding two opposite thoughts simultaneously so that something new is conceived—a use of mind perhaps made easier by the help of a disorder.

Superficially, the link between creativity and mood disorders may appear to be one of style: a depressed poet writes sad sonnets; a manic playwright gives the world a slapstick comedy. Indeed, the experience of a mood disorder may provide rich material for the artist. But at the level of the brain, the link is much more basic. A disorder’s possible effects involve thought, affect, and motivation— or, to put it another way, creativity and these disorders share similarities in how the mind works.

Modern cognitive science has sorted out several characteristic features of creativity: the bringing together of unusual material or connections through intersecting frames of reference, discrete remote associations, a more generally “overinclusive” cognitive style that allows richer associative networks in the brain, and chance configurations in creativity, in interaction with social and historical forces. Another feature, which researchers have called flow, or being in the moment, is considered the creative brain’s facilitator for creative activity including analogies, metaphors, dreams, visualization, and meditation.

Some of these characteristic features of creativity are reminiscent of the mind in a hypomanac (or mildly mood-elevated) phase of bipolar illness, particularly overinclusiveness, extremely rapid thought, and a sense of great and profound insight. Both eminent creators and everyday creators suffering with these disorders report to researchers that they can receive benefits from their disorder in three areas: thought (freer associative process), affect (richer experience), and motivation (confidence and energy)—up to a point. These reports are so common that the phenomenon has come to be called the creative advantage. Many studies have tried to pin down exactly where, along the spectrum of mental states, a disorder’s effects may serve a creator’s goals. The evidence seems to show that, within varied mood states, a state of mild mood elevation is particularly conducive to varied phenomena, including unusual associations, overinclusion, and creative problem solving.

Studies of noneminent creators that investigated the occurrences of creativity and mood disorders among those with manic-depression and their biological relatives have turned up very interesting findings. The creative advantage has also been seen with psychiatrically normal relatives of patients with bipolar disorder, suggesting that suffering the pain of the disorder may not be necessary to have the effect. In addition, depressive persons with a family history of bipolar disorder may also show the effect, compared with people with depression without a bipolar family history. This is important, because creative people who have bipolar disorder have more relatives with unipolar depression or milder dysthymias than relatives with bipolar disorder.

The field of genetics may one day make a contribution to this issue: the question is why these mood disorders are so prevalent and so persistent down through the generations. The fact that family members who do not have bipolar disorder enjoy the creative advantage suggests that understanding the genetics of the disorder offers the possibility of protecting and fostering the cognitive style involving features such as “overinclusion.” Thus the openness to the outside world and one’s inner states that are typical of this style—and are physically as well as psychologically healthy— could be sustained while treating the harmful and debilitating effects of the disorder. It is critically important that mood disorders not be romanticized: the rate of suicide for untreated persons with bipolar disorder is 20 percent.

Moreover, the disorder in its full-blown state is not conducive to creativity but detrimental to it. Only along the road to that misery, when the disorder passes through the stage of mild mood elevation, do creators report any benefit. Most important, not only are these disorders highly treatable, but treatment appears to enhance rather than detract from creativity. (Remember, family members who are not ill also demonstrate the creative advantage, so it must not be necessary to be ill first.)

Creativity and Psychopathology: Some Practical Implications

Findings linking creativity to psychopathology have potential practical implications for fostering both mental health and creativity. First of all, the associations between creativity and liability for schizophrenia or bipolar disorder may apply not simply to a few psychotic geniuses in the fine arts, but also to noneminent or “everyday,” levels of creativity in a wide variety of fields of endeavor in the general population. The results suggest that the association may also extend, not only to the millions of individuals who have a diagnosis of outright schizophrenia or bipolar disorder, but also to the much larger group of individuals who carry genes that predispose them to the disorders. Knowing that the genes that carry  risk for these disorders may actually have a beneficial aspect, or “silver lining,” could help boost the morale of patients and their families, as well as combat the stigma that is often associated with these illnesses.

Finally, it bears repeating that the studies have found the greatest creativity, on average, not in individuals who suffered from full-blown forms of these disorders, but rather in individuals who had mild psychiatric symptoms—or even none—but who were biologically related to a patient with bipolar disorder or schizophrenia. That underscores the importance of treatment: to realize the potential creative advantages that may be associated with genetic liability for these disorders, one need not pay the price of the suffering that is often associated with them.

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