*

Stars
 LIVENFUUL IROTTTUIE UE DUULATIUW

UNIVERSITY
OF
LIVERPOOL

INSTITUTE
OF
EDUCATION

jucation Library

oe:
012951418
Po G. OF Te Coa Ra
 Digitized by the Internet Archive
in 2022 with funding from
Kahle/Austin Foundation:

https://archive.org/details/psychoticart000Ofran
See Text Chapter 2

[Frontispiece
 PSYC HOTLC IUART

by
FRANCIS REITMAN
M.D., D.P.M.

ROUTLEDGE & KEGAN PAUL LTD

Broadway House, 68-74 Carter Lane
London
 First published by
ROUTLEDGE & KEGAN PAUL LTD.
Broadway House, 68-74 Carter Lane,
London, E.C.4
1950

TO
SUSAN

Printed in Great Britain by William Clowes and Sons, Limited

London and Beccles
 CONTENTS
FOREWORD page ix

. DEFINITIONS AND APPROACH I

FORM IN PSYCHOTIC ART 21

- THE CONTENT OF PSYCHOTIC ART 4!

. AN ILLUSTRATIVE CASE OF SCHIZOPHRENIA 64

THE NATURE OF PSYCHOTIC ART

AN ILLUSTRATIVE CASE

. INTERPRETATION “OF PSYCHOTIC ART

« Ed
CULTURAL INFLUENCES

SUMMARY

BIBLIOGRAPHY

INDEX 175
 2

|ae kh
ie AK
ls tnt
Rea)ru
ee of
 ILLUSTRATIONS
FRONTISPIECE

1. ““A MOST IMPORTANT COMPOSITION” _—_facing page 6

2. FIGURES 7
3. ““ PRAYER OF LOVE” 22

4. ““THOUGHT
ee 23
23
5. ““A MAN GOING OVER A HILL” 38

6. ““THE REVERSAL OF PERSPECTIVE” 39

CAT : @ 54
“ # ;
8. PAINTING UNDER MESCALIN 55

g. ““HYACINTH
ce 99 a
70
10. DOODLE aT
II. ““DERBY” 86
12. “THE OLD RIVER” 87

13. ‘““ HORSES AND FLOODING”’ 118

I4. GOYA: SOPLA 11g

I5. GOYA: PLATE 26 OF THE CAPRICHOS 150
16.“ GOYA? PLATE 7 OF THE CAPRICHOS 15!
 FOREWORD
THE PSYCHIATRIST, by dealing with the total personality,
tends to become a Jack-of-all trades; he measures his
patients’ body-configuration and their mental abilities;
he assesses his patients’ electro-encephalographic records
and their paintings; he interferes with his patients’ cere-
bral structure and with their set of values, and so forth.
Furthermore, psychiatrists assume the right to generalize
and give opinions on brain functions in general, on
politics and sociology, on art and religion. These aspects,
enumerated at random, require highly specialized know-
ledge, and psychiatrists cannot deal with them ex-
haustively ;they can manipulate with them only in order
to attempt some synthesis of their patients’ personality.
As to the generaliz&tiorf, this is only permissible if the
psychiatrist maintains throughout that he does so from
his own limited viewpoint.
With these tendencies and criticism of them in my
mind I set out to examine psychotic art from one of the
psychiatric viewpoints. Though necessarily this study is
a psychiatric one, it was intended for interested non-
psychiatric research workers as well, and in consequence
the description of some phenomena had to be out of
proportion to others.
On the other hand, problems in writing this study were
created not only by the diversity of possible readers, but
also by the diversity of the various approaches to be
synthetized, such as neurology, psychometrics, psychology,
sociology, aesthetics, etc. I had the advantage of co-opera-
tion from experts in these various fields, and had the help
ix
x FOREWORD

of Mr. J. P. S. Robertson, who offered valuable criticism

and advised me on several relevant points. I wish to
express my gratitude to him and to others for their help,
viz. Dr. E. C. Dax for giving me facilities for this study
and permitting me the use of his case material; the Hon.
W. 58. Maclay for advice and permission to publish some
pictures from his collection; to several of my colleagues
whose cases I investigated; to Mr. E. Adamson, art
therapist. I am grateful to Mr. Herbert Read and Mr.
Geoffrey Grigson for their encouragement. I would also
like to acknowledge the help of my secretary, Miss A. M.
Silkstone. I could not have completed this study without
the encouragement of my maior to whom this book is
dedicated.

Sussex, 1950.
 DEFINITIONS AND APPROACH

Employment of terms “‘psychotic’? and ‘‘art’? in the present

study — Former studies of psychotic art— Art as a result of
human cerebral function can be viewed biologically — Description
of the present biological approach, termed the psycho-phystological.

THE PRESENT INQUIRY is concerned with the pictorial art

of psychotics. Before this subject can be examined it is
necessary to clarify one’s terms, and in particular to discuss
the sense in which the words “psychotic” and “‘art”’ will
be employed.
The term “psychosis”’ will accord with the description
of Henderson and Gillespie: they state that psychosis
involves a change in the whole personality of the indi-
vidual in whom it appears, his apprehension of reality
changes qualitatively and his behaviour alters in conse-
quence. So far as the various forms of psychosis are con-
cerned, in this investigation the schizophrenias will
feature predominantly; descriptions of this class of dis-
order, leading to a definition of it, will be given subse-
quently at a relevant point. The paintings and other
artistic products of neurotics have been deliberately ex-
cluded from consideration here. The differences between
neurotics and those conventionally called “normal” by
some criterion or other are so finely graduated that a sharp
P4 PSY GUO TI CEARA

delineation is almost impossible. If one judges neuroses by

criteria that are purely sociological, it is possible to argue
(as several writers have done) that creative artists in any
medium are almost bound to be categorized as neurotic.
Many investigators now consider that there is no sharp
break at any point between the normal and the psychotic;
instead there is a succession of graded differences from the
normal through the neurotic and the severely neurotic to
the psychotic. Even if one grants this proposition, the first
and last categories are so far from each other on the scale
of differences that they contrast sharply. Thus one can
support a quantitative theory of psychosis and still be
justified in dealing with psychotic art in contradistinction
to normal art. :
The concept “‘art”’ presents much greater difficulties and
demands fuller discussion. This investigation is limited to
“pictorial art”, which is meant in most cases throughout
the study (according to a common usage), whenever the
term ‘‘art” is employed. Brief references, however, will
be necessary to analogies presented by other forms of art
and to art as a general concept irrespective of its medium.
The definition of art has always been elusive for art
critics and art historians, aestheticians, philosophers and
psychologists. Dictionaries define art in terms of a synonym
“skill” or as “application of skill”’. While this corresponds
to certain established usages it is too wide for aesthetic
purposes. As a working hypothesis E. Newton defined art
as ‘‘an original human conception, made manifest by the
skilful use of a medium”. Herbert Read in his earlier
works seems largely to agree with this definition :as when
he declared art to be ‘‘the technical skill’? required ‘‘to
transform mental images into linear signs”. He added
that the artist is capable of allowing ‘‘the personality to
express itself in the craftsmanship”. All such descriptions
as these offer a useful point of departure for the art-
historian who, having done with the definition, turns to
his main subject; but they do not entirely clarify the
meaning of “art”. Read has developed the various ap-
proaches to art that have been developed to further our
 DEFINITIONS AND APPROACH 3

understanding of its nature. He has described genetic,

metaphysical, aesthetic, phylogenetic, sociological and
other approaches. These give information about the
possible moral function of art, about the interrelation
between art and society and about the motifs of artistic
developments in savage communities, but they do not
satisfactorily demarcate art from other human activities.
Read, in his important work Education through Art, to
which further reference will be made, has added his own
definition, which is in terms of receptive and expressive
phenomena. According to this, art has two basic principles
—the principle of form, which is a function of perception,
and the principle of organization, which is a function of
imagination. On ‘the expressive side Read mentions
“bodily action”. The neuro-psychiatric objection to a
formulation in these terms will be mentioned below. Here
I need only say that the modern psycho-physiological con-
ception of the working of the brain is contrary to the
proposition that cerebral functions at the higher levels are
receptive or expressive and hence ultimately reflex in
nature. That Read’s definition is based on the reflex
character of functions at the higher levels is indicated by
his description of the mind: ‘“‘mind is like an automatic
telephone exchange ‘with’ senses ringing up every second
asking to be connected in every direction”’, and “‘mind is
the reservoir of all senses”. Another shortcoming of Read’s
formulation lies in the principle of origination, which is
explained by means of ‘“‘imagination”’. For imagination,
in turn, the hypothesis ‘‘the subconscious” is utilized.
Thus the hypothesis of the definition rests on yet another
hypothetical concept (see also Chapter 7). These objec-
tions are not aimed at criticizing the thesis to which Read’s
definition leads; they show only that such a definition
does not allow the application of the technical tools of a
psycho-physiological approach.
The problem stands thus: how are we to differentiate
certain human activities, or the products of certain human
activities which we call art, from all other human activi-
ties? In accordance with modern theories of definition and
4 PSYCHOTIC ART

method, many difficulties can be avoided if we make our

point of departure from the concrete and the readily
verifiable and thence lead up to what is abstract and not
easily confirmed. The theory developed in the following |
paragraphs has been suggested to me by Mr. J. P. S.
Robertson.
The first verifiable fact with which we are concerned is
that there are objects called paintings in art galleries, art
exhibitions, on the walls of private houses and elsewhere.
The overt activity by which these are produced may be
observed by going to the studios of artists or by watching
them at work in the open air. Activity of this kind has been
going on for a number of centuries. The paintings are in
the first place smears of paint on surfaces such as panel,
canvas or paper. There are closely similar objects in
which lines are drawn on surfaces with pen and ink, char-
coal, or in many other ways, but everything that will be
said of paintings can be applied to these with only slight
modification ;for simplicity the discussion will be confined
at this stage to painting. The next verifiable fact is that
these objects are not usually apprehended by the onlooker
as smears of paint; the great majority of them by far make
us think, or give us the semi-illusion, that we are seeing an
actual situation (the difficulties raised by the term “‘actual
situation”? will be discussed shortly). This fact can be
readily confirmed in particular instances: for example
Chagall’s “Sleeping Poet” in the Tate Gallery makes us
think that we are looking at a man asleep in a field with
farm buildings in the background, farm animals, trees and
so on. It would be possible to value paintings according
to the fidelity or accuracy with which they present this
appearance of an actual situation which the spectator can
perceive visually. Such a criterion is applied by many
spectators at art galleries and art exhibitions, as anyone
who listens to their comments will soon discover. It is not,
however, the criterion applied by art critics or by those
spectators who derive certain feelings of intense satis-
faction from looking at the paintings. Nor do the painters
themselves usually conform to any such system of valuation.
 DEFINITIONS AND APPROACH 5

This leads to the next verifiable fact. These situations

which the paintings make us think we are perceiving
visually are deliberately “‘structured” in a way that
actual situations in visual perception are not. Their rela-
tions have been ordered so that a pattern of form, shading
and colour is produced. Consideration of painters at work
indicates that this ordering into a pattern is usually a
“re-structuring” of an actual situation visually perceived
by the artist. The re-structuring is carried out by selection,
rearrangement and qualitative alteration of form, shading
and colour. Memories of other actual situations may be
involved in various complex ways. The product may
sometimes be based entirely on a re-structuring of re-
membered situations. Everything that has been said of
painting is applicable to pictorial art in other media, such
as pen-and-ink drawings, except that patterns of shading
or colour may be absent in them. It must be noted that
the re-structuring into a pattern is a phenomenon quite
distinct from the fact that the perceived situation is repre-
sented in a two-dimensional and static medium, though it
has a relation to it.
It is now possible to define pictorial art as a sub-class of
pictorial products, the latter being’ defined ostensively.
Pictorial products which are not pictorial art will be dis-
cussed shortly. Pictorial products can be called pictorial
art when the situation which they make us think we are
perceiving visually is structured into a deliberate pattern.
This definition accords with the usual intention of the
artists and the criteria by which modern art critics
evaluate the art product; it is on the fact of structuring
into a pattern that the feelings of satisfaction experienced
by trained spectators depend when they view certain
pictorial products. Differences in the effectiveness of the
structuring constitute the scale of aesthetic values. The
criteria by which these differences are judged show
historical and geographical variation which will be dis-
cussed in a subsequent chapter. It is merely necessary to
note here that art products differ in aesthetic value and
that we are concerned, as so very often is the case, with a
6 PSYCHOTIC ART
graded phenomenon. In the effectiveness with which the
process of re-structuring is carried out there are two inter-
related but separable kinds of skill: there is the executive
skill involved in the manipulation of the medium and the
intellectual skill involved in thinking out the pattern.
This matter will also be discussed later on.
Besides differing in the effectiveness, according to
certain criteria, with which they structure into a pattern
the appearance “er semi-illusion of an actual situation,
paintings differ also in the extent to which a re-structuring ~
has taken place. In some instances, notably in what is
called ‘“‘abstract”’ art, in the work of Cubist painters, in
certain paintings of Picasso and others, the re-structuring
is carried so far that the appearance or semi-illusion of
viewing an actual situation is lost and the work becomes
a pure study in design, in relations of form, shading and
colour. While such work is certainly visual art, it is ques-
tionable whether it can still legitimately be termed “pic-
torial”? art. In most cases, however high the degree of
re-structuring, the appearance of an actual situation or
some reference to perceived actuality is usually retained.
The extent to which a variety of aesthetic satisfactions can
be given by paintings which are pure design seems
limited. Most spectators seem to need for their satis-
faction this appearance of viewing an actual situation;
and most “‘abstract”’ painters return periodically to some
reference to actual perception in order that they may
enrich and vary their performance. However that may be,
it is certainly a fact that the great majority of paintings
combine two characteristics: they give to the spectator
the appearance, or semi-illusion, that he is beholding an
actual situation, and they structure this situation into a
pattern. ‘
Paintings and drawings may contain a narrative com-
ponent; they may tell or illustrate a story. An obvious
example is Hogarth’s “‘Marriage a la Mode’’. They may
contain a propositional component: they may advance
some contention or exhortation that could also be ex-
pressed in words. There are many examples of this in
 1 , 4 | 4y | f :i | s {

— a E Oo e)
Fig.
0
ze n ~Y
—
d ie
= fon)
j=
~
is jorie)
1tion
mz)
>

face p. 6
 DEFINITIONS AND APPROACH 7

poster painting—for instance, the war-time poster of a

man with his hand on his lips to express what could be
verbalized as “‘Be silent’? or ‘Discretion is desirable”
They may contain components that evoke feelings other
than the aesthetic satisfaction arising from the pattern;
they may depict a situation that arouses tenderness, pity,
indignation, reverence, horror, disgust or other emotions.
The subject depicted may have associations which are
pleasurable in a particular cultural group, at a particular
time or place; this applies to religious and erotic subjects,
subjects having a mythological, historical or literary
allusion, and so on. Other additional components are
possible in paintings. But no such additional component—
narrative, propositional, emotional, allusive or of any
other kind—is either needed or enough to make a pic-
torial product into “pictorial art” as the term will be
used in this inquiry. Such components are neither needed
nor enough, because they do not in themselves arouse the
feeling of satisfaction which is based on structuring into a
pattern. Whether they actually impede the stimulation of
such a feeling or diminish it, is an arguable question. It
will be assumed here that they do not necessarily have
these effects, but are variables completely independent of
artistic value. This is not to deny that such matters of
content in pictorial art are of great interest and importance
and that the satisfaction from them may mingle in a com-
plex way with the satisfaction arising from the struc-
turing into a pattern of form, shading and colour. What
is affirmed is that only the last-named characteristic
is necessary and sufficient to make a pictorial product
“pictorial art”, as the term will be used in this study.
Matters of content are, of course, especially important in
psychotic paintings and will need to be examined in due
course.
The description of situations as ‘‘actual”’ or “real” and
the references to a process of the re-structuring of actuality
raise certain difficulties where psychotics are involved.
By an “‘actual” or “‘real”’ situation is meant what one
visually perceives when one looks at houses, streets, people
2
8 PSYCHOTIC ART
about their business, stretches of countryside, animals and ||
so on. It is not necessary in an empirical investigation to |
consider metaphysical problems or to go beyond the|
assumptions of everyday life and biological science. Thus |
one ignores the question whether such perception gives
true knowledge, and assumes that when two normal indi-
viduals look at the same object or situation their visual
perception will be closely similar and for practical pur-
poses may be considered the same. The difficulty arises in
distinguishing aesthetic re- structuring of actuality from —
the re-structuring that occurs in the phantasies of normal
individuals, both artistic and non-artistic, and from the
qualitative alteration in the apprehension of reality that
is taken as a defining characteristic of psychosis. So far as
the phantasies of normal individuals are concerned—day-
dreams, night-dreams and allied processes—it is almost
certainly true that they are composed entirely of elements
from the remembered perceptual experience of the indi-
vidual and that the remembered perceptual experience
is re-structured in various ways, as a rule much more
radically in the case of night-dreams than of day-dreams.
This re-structuring differs from the re-structuring of art.
First it is not expressed in a relatively-:permanent medium,
and secondly (the important difference) it is usually a re-
structuring of events in accordance with wishes and fears,
and never a re-structuring into a pattern that accords
with certain widely held criteria. When it is said that
psychotics show an altered apprehension of reality, it
means obviously that reality becomes re-structured for
them. The psychotic re-structuring differs from the
artistic re-structuring because it is not into a pattern that
accords with certain criteria and because the psychotic
accepts his re-structuring as being reality—which is one
of the chief reasons why he finds his way into a mental
hospital. The normal artist remains aware of reality as it
is and knows that he has deliberately re-structured it in
his art product. So does the spectator who looks at the
product. The difference between the various ways of re-
structuring have deliberately been formulated in the
 DEFINITIONS AND APPROACH 9

sharpest manner possible in order to show the general

tendencies; in point of fact, the differences need not be
so absolute, and there do exist intermediate states.
The subject-matter of pictorial art may derive wholly or
partly from day-dreams and similar phantasies or from
recollection of night-dreams. Surrealist painters acknow-
ledge that night-dreams have given rise to many of their
pictures; asimilar source for other pictures may be inferred.
All this is interesting as a matter of content and may give
certain adventitious satisfactions to the spectator; but it is
quite irrelevant to the status of the product as art, which
still depends on the extent to which its pattern of form,
shading and colour accords with the criteria by which art
products are estimated. The extension of the subject-matter
of pictorial art to such fields as night-dreams opens up, of
course, many new possibilities of patterning.
One or two other points should be briefly mentioned in
connection with reality and art. Sometimes it is argued
that the artist “‘really sees” the situation as he paints it;
this can be true only if “‘see’’ is used metaphorically.
Some commentators would emphasize abstraction and
selection from what is given in visual perception rather
than re- arrangement and qualitative alteration of it; the
evidence is strong that all these processes co-_exist. In
regard to reality, the appreciation of natural beauty—for
example, of landscapes or mountains—is sometimes raised
as a problem. This lies outside our scope, but it may be
noted that such appreciation is probably for the most part
consequent on the work of pictorial artists and other
artists, such as poets, rather than antecedent to it.
The complex motivations that lead the normal artist to
produce his work will not be directly considered in this
inquiry, but they may be illuminated indirectly in dealing
with the motivations that lead psychotic patients to pro-
duce paintings. At this point it can merely be left as an
-unanalysed fact that the artist finds great satisfaction in
his achievement. The satisfaction found by trained
spectators in their apprehension of the structuring of a
pictorial art-product will also be left as an unanalysed
10 PSYCHOTIC ART

fact ;its biological history and sources will not be investi-

gated. The structural relations that are necessary to pro-
duce it and the historical or geographical differences in
regard to these, that is to say, historical or geographical
differences in aesthetic criteria, will be given some con-
sideration in the next chapter.
One should now refer briefly to art as a general concept.
To ask, What is art as a general concept? is to ask, What
have pictorial art, sculpture, architecture, music and
literature in common?
Restriction of the term to these general media is purely
arbitrary and many aestheticians would extend it much
further, for example, to ceramics, the ballet, and so on.
It is, however, historically true that up to the present most
individuals capable of producing aesthetically satisfying
work have chosen one of the five media named. These
media at present offer to those trained to appreciate them
the greatest possibilities of varied and intense aesthetic
satisfactions. How far the limitation depends on biological,
how far on sociological factors, will not be discussed here.
If one disregards all the important differences between
these five art-forms and asks what remains in common,
one quickly sees that it is the structuring of perceptual
material into a pattern which is satisfying by recognized
criteria—in sculpture and architecture a pattern of three-
dimensional form, in music a pattern of sound relations,
in poetry usually a pattern of sounds and images, in prose
literature a pattern of described human events or be-
haviour, and so on. In so far as products in any other
media become art, it is because they are structured into
a pattern. These remarks will be sufficient, for our pur-
pose, to relate pictorial art to other forms of art.
How far to this concept of structuring into a pattern
can the notion of “configuration” be applied? In recent
years the term “‘Gestalt” or “‘configuration” has become
the cloak for much loose and vague thinking and evasion
of careful analysis. It is used to denote a number of
distinct phenomena, all more or less involving the notion
“‘wholeness”’ or “unity of parts”. But how far is it true
 DEFINITIONS AND APPROACH If

to say that a painting or other pictorial art-product must

constitute a whole? Certainly a painting is a self-sufficient
and self-contained system in relation to its actual sur-
roundings, the frame, the wall, other paintings and so on.
It is also true that the various relations constituting its
pattern are usually all consonant with each other accord-
ing to the criteria of art. In these senses a painting is a
“whole”. The subject-matter often, though not always,
has a unity irrespective of the design, but the content is
irrelevant to the status of the painting as art, in the way
in which we have defined art. The relation of wholeness
exists in the painting, but it is only one of many relations
and it can easily be too much emphasized. In particular
it is almost certainly wrong to argue that a painting can
only be apprehended as a whole and still more wrong to
say that it can be apprehended as a whole in one imme-
diate swoop. All the testimony from artists and the
aesthetically appreciative indicates that an artistically
satisfactory painting has manifold relations in its struc-
turing. Now one of these comes to the forefront of the
spectator’s awareness, now another. When he returns to
the painting on a different occasion he is aware of still
others. The relation of the whole is usually present only
in the background of awarenéss as a schema. A similar
contention applies to the effect of music, literature and
the other arts. The facts seem to be best described by say-
ing that a work of art is a more or less complex isolated
system of relations of various kinds. If that is what is
meant by a configuration, then a work of art is a con-
figuration.
Pictorial art has already been related to other forms of
art. It is desirable to relate it to pictorial products which
are not art. The basic biological fact leading to all
pictorial activity is that some objects make it appear to
the spectator in a more or less illusory way that he is
visually perceiving other objects. Such objects may occur
naturally :they may be rocks, dead trees and clouds. They
may also be produced by human activity in making
smears or marks on a surface, which is the starting
12 PSYCHOTIC ART

point of pictorial production. How and when early man

discovered this fact and began to act upon it can be treated
only speculatively. The drawings of young children ex- .
plain the matter as little as their acquisition of speech
explains the kindred problem of linguistic origins ; children
are born and grow up in communities where pictorial
production is already an established, many-sided activity;
the means of drawing are placed in their hands and they
arrive at drawing with the encouragement and instruction
of those about them. Once smears or marks make it appear
that we are looking at other objects, we may develop in
our picture-making in various directions. We may struc-
ture our representations into a pattern so that they
become pictorial art. On the contrary we may make the
representations more and more closely faithful to the
appearance of the object or situation which they resemble.
Pictorial products then become a tool of practical and
scientific activities; examples are anatomical or botanical
drawings. In this development the skills of close observa-
tion of what is drawn and effective manipulation of the
medium are involved ;the more complex skill of thinking
out a pattern is absent. How far this development has now
been rendered obsolete by photographic techniques is a
debatable question. Another development is in the direc-
tion of schematization so that the product finally ceases to
be a representation; this leads to diagrams, alphabets,
conventional signs and so on. A quite different develop-
ment is that of expressing or communicating situations
which the individual cannot, or for some reason does not
wish to, verbalize—situations he fears or desires. This is an
especially important development with psychotic patients
and must be dealt with more fully as the study proceeds.
Products of this kind may or may not be pictorial art
according to the presence or absence of deliberate struc-
turing. Such a motivation may sometimes be present in
the work of normal artists, but consideration of exhibited
works suggests that it is very uncommon. The foregoing
remarks will be sufficient to establish the status of pictorial
art in relation to other pictorial products. Once again the
 DEFINITIONS AND APPROACH 13

distinctions have been made sharp for the sake of clarity;

once again there are intermediate possibilities. The im-
portant fact is that, while pictorial art-products may be
valued as aesthetically satisfying or not in various degrees,
there are pictorial products which are neither good art
nor bad art by any criteria—they are not art at all.
This leads to the problem of how far pictorial art and
other pictorial products may be regarded as symbols.
The theory of signs and symbols is complicated and has
many aspects; the terms “‘sign” and ‘‘symbol” are em-
ployed by various writers in different ways. There is
general agreement that an object may be termed a sign or
symbol if it is attended to not for its own sake but for the
sake of something else to which it refers. In pure cognition
one may follow G. F. Stout in differentiating expressive
signs which are attended to through a series of activities
with continuous reference to what they signify, suggestive
signs in which attention immediately passes from the sign
to what is signified, and substitute signs which are attended
to through a series of activities with reference to what is
signified only at the beginning and end of the process.
Examples of expressive signs are words, of suggestive signs
traffic lights, and of substitute signs most mathematical
symbols. When orectic and sociological factors are taken
into account many other classes of sign or symbol may be
distinguished. There are symbols used for concealment
except from the initiated, such as codes; symbols used to
denote occupational class, such as uniforms, or relative
status, such as badges of rank; symbols designed not only
to denote group membership but to promote group
solidarity, for example flags and political emblems;
symbols used allusively to evoke feelings or for pure
ornamentation, of which there are religious or literary
examples. There are also the Freudian dream symbols,
which, in so far as they are a fact, may be regarded as a
variety of the symbols used for concealment, the conceal-
ment being from the dreamer himself. Sometimes objects
are attended to partly for their own sake and partly with
symbolic reference. There are many further ramifications
14 PSYCHOTIC ART

in the theory of signs and symbols with which we need not

be concerned. The question is, at what points do pictorial
products fit into the schema we have outlined?
As the smears and marks on a surface are not attended ©
to for their own sake, pictorial products might be sub-
sumed under the class of signs and symbols. They differ,
however, from all the varieties of symbol we have con-
sidered in that they make it appear to us that we are per-
ceiving the object or situation to which they refer. This
difference is so great that it seems best not to treat them
as symbols but to class them as a different phenomenon,
as “representations”, just as stage-plays are representa-
tions. Only when the component of representation is quite
lost while at the same time external reference remains, as
in diagrams, do pictorial products develop into real signs
of the expressive variety. Another important point must
be noted. Pictorial art products are attended to for their
own sake so far as the essential structuring into a pattern
is concerned ; they may be said to combine two aspects—
an external reference to what they represent and an
intrinsic value as a structuring into a pattern. When
pictorial art products develop into art products that are
pure design they lose all exterior reference and are
attended to entirely for their own sake. For these reasons
it seems inappropriate to call pictorial art per se symbolic.
It is another matter that the content of pictorial art may
sometimes be wholly or in part deliberately symbolic in
that objects depicted may signify something other than
themselves. An obvious example is afforded by the objects
in Holbein’s “‘Ambassadors”. This may occur for orna-
mentation and evocativeness, or because the painting
advances some proposition. Anyway, it is a matter of con-
tent and neither necessary nor enough to make the paint-
ing art, within our definition. Such deliberate symboliza-
tion, however, is of some importance, as we shall see, in
discussing the pictorial products of psychotics, especially
those which express or communicate what the patient
cannot verbalize.
A number of writers have argued that the subjects or
 DEFINITIONS AND APPROACH 15

situations depicted by artists have a symbolic meaning for

them of which they are unaware, either of the sexua
Freudian or the mystical Jungian variety. Leaving this for
a time, it may be said that while such unconscious symbol-
ization may perhaps have been satisfactorily demon-
strated in particular normal or abnormal painters, its
general occurrence has never been empirically shown and
a priort is exceedingly improbable.
The use of the terms “‘psychotic”’ and “‘art” has now
been elucidated. Psychotic patients make pictorial pro-
ducts, some, but not all, of which are pictorial art. In so
far as such products are pictorial art they may be estimated
and enjoyed in precisely the same way as the productions
of normal artists. The methods of patterning, however
that are_chosen by psychotics are of special interest in
connexion both with the theory of psychosis and the
theory of art. The content or subject-matter of psychotic
pictorial products is irrelevant to their status as art but
is of great intrinsic interest in relation to general psy-
chology and in relation to the theory of psychosis. Before
coming to the special characteristics of psychotics both in
patterning and in subject-matter, it remains in the second
section of this first chapter to describe previous work in
the study of psychotic pictorial activities, to discuss in
general the applicability of scientific method to aesthetic
questions, and to set out in particular what is meant by
the psycho-physiological approach.

The subject of ‘‘ psychotic art”? has been admirably re-

viewed by Anastasi and Foley (1940) and an extensive
survey of the literature on it up to 1946 is given in the
works of Pappenheim and Kris. The various approaches
to psychotic art have been grouped by Maclay and Gutt-
mann into three categories. First the clinical approach,
which attempts to ascertain how far his psychotic drawings
are typical (symptomatic) of the mental disease of the
patient. Such studies were the outcome of the static
16 PSYCHOTIC ART
psychiatric theories originated by Kraepelin. With the
introduction of dynamic concepts into psychiatry, the
interest was focused on parallels between personality
changes and stylistic alterations. Experimental work
utilizing this approach began as far back as 1906, when
Mohr attempted to investigate the personality structure
of schizophrenics by letting them copy figures. Similar
techniques were reported by me in 1939, leading to the
conclusion that psychotics, especially schizophrenics, fail
to appreciate and are unable to reproduce facial expres-
sion in drawings; sometimes only the latter incapacity is
evident. The second category of approach in the study of
psychotic drawings is the psychological one ; these methods
have been dynamic and interpretative and ultimately
speculative about the genesis of pictorial art. The most
outstanding psychological work is that of Prinzhorn, who
studied the art products and life-histories of psychotics,
correlated them, and attempted general conclusions on
the nature of art. His explanations, however, such as ‘‘the
universal urge for expression... manifested in form
tendencies” are merely substitutes for such concepts as
“‘inspiration”’, and they fail to answer the genetic pro-
blems of art. Furthermore, Prinzhorn maintained that
ethical values are essential factors jn psychotherapy and
he introduced such valuation when assessing the art pro-
ducts of his patients; he thus became frankly subjective.
The last factor leads us to the third category of approach
to psychotic art: the aesthetic approach, that of some
psychiatrists, who have attempted to compare psychotic
art with recent developments in non-psychotic painting.
What, we have to ask at this point, is the relationship of
scientific to aesthetic valuation? A value may be regarded
as a fundamental dimension of differences. In.a crude
form it is a dichotomous classification :in ethical valuation
into good and bad, in scientific valuation into true and
false, in aesthetic valuation into artistically satisfying and
artistically unsatisfying. In its more developed form valua-
tion is graded and relativist; in ethical valuation actions
become more or less desirable according to certain
 DEFINITIONS AND APPROACH 17

principles or standards; in scientific valuation theories

become more or less credible as approximations to the
truth, in aesthetic valuation products become more or
less artistically satisfying. In both the crude and the de-
veloped forms scientific and aesthetic valuation are basic-
ally different dimensions. Scientific valuation rests on the
“quite-so” feeling of conviction; aesthetic valuation rests
on the satisfaction produced by apprehension of struc-
turing into a pattern. The sharp difference is shown by the
fact that scientific products such as Newton’s Theory of
Light are rated as more or less probable in the existing
state of knowledge, but aesthetic products such as Botti-
celli’s ‘Birth of Venus” or Beethoven’s “Emperor Con-
certo”’ have no relation to probability whatsoever. A
scientific valuation can be altered by the adducing of
fresh facts or consideration; aesthetic valuations do not
alter in this way at all—they alter when for historical and
sociological reasons there are changes in the criteria by
which a patterning is judged to be artistically satisfying.
If, then, the two dimensions are fundamentally different,
how can aesthetic products be studied scientifically? The
answer is that in the Jast analysis one cannot produce
scientifically the feeling of aesthetic satisfaction in those
that do not experience it, nor can one adduce reasons why
an individual ought to prefer one set of aesthetic criteria
to another. In the same way we cannot in the last analysis
adduce reasons why people should be humanitarian or
prefer one ethical code to another. One can, however,
attempt to study scientifically the biological origins of the
feeling of aesthetic satisfaction. One can study how far the
criteria of aesthetic value are biological and innate, how
far they are sociological and acquired. One can also
attempt to correlate differences and changes in aesthetic
valuation with cultural and social differences or changes.
The aims of this book are more modest than that. They
are to study the special characteristics in form and content
of psychotic pictorial activity and to investigate its motiva-
tion. A psychiatric estimation of art thus aims to remain
a scientific approach and must concern itself with truth
18 PSYCHOTIC ART
only. Below, I shall inquire into problems of psychotic art
from a psychiatric standpoint. I shall examine data col-
lected hitherto, and criticize them. I shall attempt to show .
the biologically determined dynamics of this human
characteristic: art. ‘‘ Biologically determined dynamics”’,
however, is a phrase which calls for more detailed descrip-
tion, all the more as this is my own basic attitude in
treating the material. . -
The specific characteristics of man distinguishing him
from the sub-human species lie in his capacity of con-
ceptual thinking. This capacity enabled man to alter and
re-create his environment, to create in general, and, znter
alia, to create art. The capacity of conceptual thinking is
basically related to the brain. Here some explanations are
necessary. The mental functions have been for long looked
upon as reflex in their nature, having been conveniently
subdivided into receptive and expressive functions. It was
imagined that an initiation from outside, that is to say, a
sensory stimulus, arrives at the brain, is relayed and de-
layed, initiating an expressive phenomenon which is
manifested in motor action. Thus the cortical cells were
looked upon as a kind of inter-nuncial (connector) system
and their functional entirety was imagined to rest upon
an afferent and efferent branch of a reflex arc. Sher-
rington, however, clearly refuted this out-moded con-
ception of mental functions in his Gifford lectures, when
he argued that the cortical cells of the roof brain act
spontaneously and not as a result of sensory activation.
He rightly pointed out, that as the cells of the stomach do
not rest between meals but prepare themselves for the
next feeding time, similarly the cortical cells remain active
even during sleep. They are, as Sherrington emphasized,
self-activating. Support for this comes from eléctro-en-
cephalographic (E.E.G.) studies; these have shown that
the so-called “alpha waves”’ are, as Gray Walter termed
them, inaction potentials; they are records of cellular
activities in rest, without an initiation from outside. Sleep
also has a typical E.E.G. record, and is not an abolition
of the waves. These findings support Sherrington’s thesis,
 DEFINITIONS AND APPROACH 19

that the cortex is a self-activating structure ;hence cortical

function should be assessed on a different basis from that
of the reflex phenomenon. Thus the study of psychotic art
on a neuro-physiological basis must, since psychotic art
is a phenomenon of dysfunction, be related in some way
to the brain. Upon that level cerebral physiology needs to
be considered in terms of psychology and psychiatry, in
other words, psychiatry and psychology must be, physio-
logically, the technical tools of our approach.
To give an example, Greek is a conglomerate of sounds
which is perceived as such, if you cannot speak the
language; but the same conglomerate of sounds becomes
meaningful if you do speak that language. This does not
mean that the physiological processes in the second
example are different, but that they become broadened
and integrated in such a way that they have to be assessed
on the highest cerebral physiological level. To continue
the analogy or verbalization, an aphasic disturbance (in-
ability to speak or to understand speech without damage
to the motor or sensory system proper) might be comparable
with psychotic art. Aphasias are dysfunctions on the highest
physiological level, and the analysis of these dysfunctions
helped greatly to the understanding of the physiologica
functions of speech. Upofi this‘analogy one might ask:
could not the analysis of psychotic art, viewed as a dys-
function, throw light on the physiological, namely, on
non-psychotic art?
It was said that the technical tools of assessment on a
high physiological level were psychiatry and psychology.
The next problem arising is this: through what psychiatric
approach should the results we obtain be assessed? In
studying brain functions and mental life three types of
approaches have been developed. First the neuro-
psychiatric approach, which correlates mental life with
cerebral structure; second, the psychosomatic approach,
which interrelates structural and psychological factors as
correspondent to each other; and thirdly, the psycho-
physiological, which correlates mind and mental life not
to structure but to the function of that structure. Head
20 PSYCHOTIC ART

instanced the psycho-physiological views on walking,

which is a group function. Now a lesion anywhere local-
ized disturbs the smoothness of this combined function,
resulting in an alteration of the function as a whole. Thus
Head not only stressed the correlation of dysfunction to
function, but also the significance of group function, the
wholeness of function, and that a dysfunction should not
be correlated to structure but to the original function of
that structure. *
To sum up: art is a mental manifestation based on
human cerebral function. Such a conception allows
formulation in such a manner that the problems can be
assessed in terms of functions, that is, physiologically or
else psychiatrically and psychologically. This might lead
to recognition of biologically determined factors in
psychotic art: if then the findings are related to function
and not to structure of the brain, one might, to a limited
extent, generalize from the psychotic to the non-psychotic
art.
 Dl

FORM IN PSYCHOTIC ART

The formal elements of schizophrenic paintings—The réle of

colour— Tendency to ornamentation—Mescaltn drawings and the
schizophrenic type of ‘‘ doodle’.

IN THIS CHAPTER, certain formal elements of psychotic

paintings, and schizophrenic paintings in particular, will
be examined. The early studies recognized that a painting
by a manic-depressive, for instance, reflects the patient’s
excitement, in wild choicé of colour, and in restless, dis-
ordered, incoherent lines. Mild depressives choose sombre
colours; their pictures exhibit in their themes the poverty
of their ideas. Severely depressed patients do not produce
pictures at all, because of the inhibitory effect of their ill-
ness. Drawings of patients suffering from general paralysis
of the insane are ataxic, vulgar and deteriorate to childish-
ness. Senile drawings exemplify the ataxia of the
patients; epileptics are the most willing dilettantes with a
great gusto for pedantic detail. But, in general, it has been
found that the total of paintings from all other groups of
mental disease does not equal the wealth of painting pro-
duced by schizophrenic patients. The reason for this,
which I shall discuss eventually, has been investigated by
later workers. At present, as I have said, I shall deal only
with the formal elements of schizophrenic paintings,
Pa PSYCHOTIC ART

though the subdivision is artificial, necessitating a reference

from the one aspect of form to the other aspect of content.
Schizophrenic reactivity may be insidious in onset or it
may take an acute form. A wide variety of schizophrenic
symptoms may then be manifested. There may be ex-
treme confusion of thinking and turmoil of emotion.
These may be accompanied by states of perplexity or fear.
The patient may exist.in a state akin to that of a dream.
He may show the phenomena called “dissociative ’’—his
personality disintegrates into unconnected separate
systems. He often exhibits “ideas of reference”; he
believes that quite extraneous events have a special appli-
cation to himself or that people are talking about him.
These symptoms usually appear suddenly, often without
any apparent precipitating stress. Inquiry, however,
generally reveals historical evidence of preliminary symp-
toms. The acute schizophrenic reactivity is often accom-
panied by a pronounced effective tincture of either excite-
ment or depression. The symptoms frequently clear up ina
matter of weeks, but there is a tendency for them to recur.
The schizophrenic reaction may pass into a chronic form
in which varying mixtures of symptoms are exhibited.
Many of the various subtypes of schizophrenia have
hallucinations of hearing as one of the typical symptoms;
and the pictorial reproduction of hallucinations is a fre-
quent characteristic of schizophrenic art. Visual hallucina-
tions may also be elaborated pictorially and some ex-
amples of such work readily convey to the physician the
ghastliness of hallucinatory experience. On the other
hand, in the rapidly progressing types of schizophrenia
the personality disintegrates and so do the artistic pro-
ducts, as one would expect. Such a rapid deterioration is
well illustrated in Figs. 1-3. The patient had been an art-
student before her illness began: her first drawing is
technically skilful, but as a picture, meaningless. It is
lacking in composition and the figures are merely pieced
together without having any connexion with one another.
The patient wanted to do “‘an important composition”’,
but when asked what the picture meant she was unable
‘Bry*& Jokvig,
Jo PAOT
| aysnoy, “VY sty
 FORM IN PSYCHOTIC ART 23

to say; she could not even give a title to it. This is not a
frequent occurrence in schizophrenics, since they seldom
become alienated from their own work. The second
picture, painted a couple of months later, completely
lacks any cohesion or composition; technically it is in-
ferior to the first one, hardly indicating that its creator
was an artist. The third picture was the last one she
painted; at one time she called it ‘‘Prayer of Love”’, a
bizarre expression without meaning—at least in relation
to the picture itself. The outline of some figures can still be
detected in the drawing, but it demonstrates that not only
content but technique has deteriorated. The personality
of the patient became fragmented and so did her draw-
ings. The three paintings chosen as landmarks in the
history of her illness were selected from a larger set of
pictures ;it should be mentioned that between the second
and third pictures she created a few ‘“‘ornamental”’ draw-
ings. These are not reproduced because the progressive
disintegration of her personality is better demonstrated by
the paintings depicting figures.
Schizophrenic behaviour is unpredictable, and is often
characterized by stereotypy, actions monotonously re-
peated by perseveration, repetition of an action after a
stimulus, by mannerisms and bizarre actions. Such be-
haviour disturbances may first be “‘complex-determined”’
in the Freudian phrase, but become later a habit, from
which meaning has completely departed. Those symptoms
are readily detectable in schizophrenic paintings. One
patient painted cubes in the same arrangement (in one
corner of the sheet of paper) all the time. The cubes were
always open. The meaning of this for the patient lay in its
expression of the fact that a cube, though well defined
towards the surrounding space, becomes absorbed in this
surrounding space by being left open. In a few years this
meaning disappeared and he kept on drawing the pictures
in a mechanical and stereotyped way. Yet another patient
used to start on a picture and then at one point, like a
broken gramophone record, he would go on and on re-
peating the same motif in the picture (perseveration).
3
24 PSYCHOTIC ART
Bizarre reactions are expressed in the choice of content as
well as in the style of the picture; such bizarre reactivity
is shown in the next three reproductions (Figs. 4-6). They
are paintings of a young man, who, before his admission,
did not paint at all; he had no knowledge of pictorial art
or of painters. He had never been to an exhibition and
had never seen any work of ‘‘modern”’ art. This patient
suffered from a schizophrenic type of thought disturbance
and from bouts of depersonalization, that is to say, of
sudden losses of belief in his own existence, an experience
suggesting that he is no longer himself. Sometimes this
experience was accompanied by the feeling that his sur-
roundings were dream-like, distant and not real (de-
realization). Fig. 4 is the first picture he painted, and he
called it ‘‘'Thought” ; according to him the picture is self-
explanatory. The development of a thought is shown as a
fragment of a pensive black figure, which successively
becomes more complete and ultimately flies away into
space. The pensive figure originates from the big skull; it
has no head, as if to illustrate that it is part of that skull.
At this point it is not only the bizarre notion to which
attention must be drawn, but the dominance of symbols
as well. The hypertrophy or enlargement of symbols is a
usual phenomenon in schizophrenic paintings, and
psychiatrists have explained it in terms of schizophrenic
thought disturbances. It has been said, that in schizo-
phrenic thinking the symbol becomes identical with the
meaning and is then experienced as the meaning. In
other words, it is a kind of short-circuiting between con-
cepts and their “‘concretistic’’ equivalents. More will be
said about this later; here an example should suffice to
illustrate what is meant. A patient of mine thought that
as a private in the Army he had a dog’s life; whilst on
par ade he suddenly went on all fours and started bark-
ing. This was the manifest outbreak of his schizophrenia.
In his disordered thinking, instead of ‘‘I am treated like a
dog’’, he thought in a concretistic way, “‘I am a dog”’, and
acted accordingly. To return to the picture; a thought
arising in the skull is actually experienced as a fact arising
 FORM IN PSYCHOTIC ART 25

from the skull. This is not an abstract symbolization of the

knowledge that it arose as a cerebral function within the
body; it is a concrete mode of thinking. Hypertrophy of
symbols will be detected in several other schizophrenic
paintings reproduced in this study.
The second picture produced by the patient was ‘‘The
Man Goes over the Hill” (Fig. 5). Each hill stands for a
stage in the man’s life on which he leaves his mark; this
is symbolically represented by his shadow, and in the fore-
ground the rest of his shadow is visible. The shadow is
flanked by two classical pillars, which are symbolic of the
man’s past. This picture in its structure is well balanced
and well delineated in relation to the surrounding space;
the system of patterning as a whole is pleasing and so is
the choice of colour.
The third picture (Fig. 6) is less satisfactory, when com-
pared with “‘ Thought” or “‘The Man Goes over the Hill”’.
It is not well balanced, its spatial organization is disturb-
ing, and so is its system of relations as a whole. Its choice
of colour is strikingly displeasing; here one should point
to the curious effects in the painting of the use of red, as
for instance the red which contrasts with the blue of the
stairs in the foreground. Such red effects are favoured by
schizophrenics, a fact fo which W. S. Maclay drew my
attention. It will be convenient now to discuss the rdle of
colour in schizophrenic painting.
Schizophrenic patients, especially those who are chronic
or deteriorated, are much bolder in their use of colour
than normal individuals. Besides this, an unpleasing
choice of colour is fairly typical of schizophrenic paintings
in general. This is manifest in various ways. One aspect
is a preference for colours not often employed by the
normal and distasteful to them, such as the curious tone
of red already described and certain other tones. Another
aspect is seen in unsatisfactory interrelationships of
colours, seldom favoured by normals. A third aspect is a
tendency to depict objects in colours markedly at variance
with those they possess in real perception. Empirical in-
vestigations into the colour-behaviour of schizophrenics
26 PSYCHOTIC ART
have been chiefly concerned with their passive preference
for colours and their relative tendency to react to form or
to colour; there has been little experimental work to
elucidate their active use of colour in painting. So any
tentative explanations must be largely hypothetical.
It may be that in schizophrenic painting there exists a
schism of a kind between form and colour; colour is em-
ployed as an element quite independently of form. This
in turn may depend“upon a disintegration of conceptual
categories in relation to the outer environment. Again
the schizophrenic treatment of colour may be a return to
more primitive modes of reaction. A quite different possi-
bility is that the schizophrenic has a special affective
relation to particular colours and uses them merely
because of their intrinsic appeal to him. Or the schizo-
phrenic may feel a need to modify the colours of his
environment in the most radical way that he can. Still
another possibility is that parallel with the disintegration
of the personality in schizophrenia the technique involved
in painting the colour of light deteriorates; this would
apply principally to changes in the use of colour by
trained artists who have become schizophrenic. Evidence
from diverse sources supports each possibility.
The responses of deteriorated.schizophrenics to the
Rorschach Ink Blot tests, in which coloured blots are used
instead of blots of plain ink upon white, show a heightened
reactivity to colour together with an inability to integrate
the blots (which is the point of the test) into meaningful
shapes. This would favour the possibility that in schizo-
phrenic painting colour is divorced from form on the
basis of a dissolution of clear-cut concepts about the
external world. The evidence of the Rorschach test also
supports the possibility of a special emotional relation to
particular colours.
In brain lesions perception of form may be impaired or
lost while perception of colour remains normal. Schilder
described a case of carbon-monoxide poisoning where the
patient was suffering from visual agnosia or inadequacy
of perception, but his perception of colour he retained
 FORM IN PSYCHOTIC ART 27

almost intact. I. Wechsler observed a similar case. These

findings show the relative independence of the two per-
ceptive functions and suggest that possibly in the schizo-
phrenic process perception of form becomes weakened
while perception of colour becomes heightened and at the
same time modified by its separation from form.
Von Senden’s studies of congenitally blind patients
cured by operation indicate that colour is often perceived
before form after vision is acquired. This fact hints that
perception of colour may be more primitive than per-
ception of form. The evidence, however, from the animal
series and from child development is fairly conclusive that
perception of form is the more basic and biologically the
more important function. It seems that in the normal
individual reactivity to colour is slight in very early
childhooa, rises rapidly to a peak in middle childhood,
and diminishes steadily from adolescence onwards. It may
be that the colour preferences and reactions of schizo-
phrenics are a regression to those of middle childhood.
For the normal individual, in conceiving and manipu-
lating his environment, categories of form predominate,
categories of colour are definitely subordinate. In other
words, our orientatiom towards our environment is de-
pendent on sorting out shapes and attributing colour to
them rather than vice versa. Schizophrenia is marked by a
disintegration of categories in relation to the outer en-
vironment; one effect of this may well be the divorce of
colour from shape. On the other hand, Goldstein found
that schizophrenics tend to group shapes not by abstract
criteria, but on an anthropomorphic basis, by attributing
to them human qualities and relationships; perhaps
schizophrenics in a similar way attribute human qualities
to colours also and their odd colour-behaviour springs
from such an attitude.
As for the disintegration of technique, treating the
matter on the executive side, one must remember that a
painter has to learn to see the colour of light instead of the
colour of objects ;he has to learn to see “‘picture colours”’.
D. Katz has emphasized the part colour, or more
28 PSYCHOTIC ART
particularly illumination, plays in the structuring of a work
of art. If there are no special colour differences to dis-
tinguish the illumination within the picture from that out-
side it, the opposition between picture and reality dis-
appears. “‘True art”, adds Katz, “‘never seeks to destroy
the dividing line between what is presented and what is
real.” Thus the painter who has become schizophrenic
may refuse to work with “picture colours”? and may revert
to “‘object colours”; 4s a consequence of his altered
relation to reality (see Chapter 3).
The altered relation to reality leads to attempts of
various sorts to reverse presented situations in some way.
Examples are well-known in schizophrenic symptom-
atology; for instance, one schizophrenic insisted on
beginning his dinner with coffee, then having his sweet,
then meat and then soup. This reaction is specifically
shown in regard to colour in response to the Kohs Block
Design test. Schizophrenics sometimes arrange the blocks
in a correct design with the colours changed or reversed.
Schizophrenic painting of objects in colours markedly at
variance with their colours in real perception may be due
to a similar reactivity.
All these possibilities still need to be verified. Further-
more, the cerebral basis of colour perception is far from
being settled, though it appears that fibres transmitting
specific colour vision are ultimately relayed to the
calcarine cortex, where the receptive, analytic part of
colour vision ends. There is every reason to suppose that
a synthesis of impulses is elaborated in neighbouring
centres, but there is no record of an isolated disturbance
of cortical colour synthesis. The patients investigated by
Kleist and P6étzl who suffered from colour agnosia were
also word-blind and thus fundamentally aphasic. Gelb
and Goldstein relate colour agnosia to amnesic aphasic
disturbances and evaluate it as a failure in categorical
thinking. Thus, owing to lack of psycho-pathological and
neuro-physiological studies, no further discussion is
possible, but the importance of colour disturbances is
considerable and attention must be drawn to them
 FORM IN PSYCHOTIC ART 29

when the formal elements of schizophrenic paintings are

considered.
It should be noted that the trained artist is essentially
relational in his approach to colour in his painting,
whether he formulates this clearly in a verbal statement
or is only half-aware of it in an unverbalized way. This
may be well illustrated by a quotation from Matisse. He
describes his process of painting in the following manner:
“If, on a clean canvas, I put at intervals patches of blue,
green and red, with every touch that I put on, each of those
previously laid on loses in importance. Say I have to paint
an interior; I see before me a wardrobe. It gives me a
vivid sensation of red; I put on the canvas the particular
red that satisfies me. A relation is now established between
this red and the paleness of the canvas. When I put on
besides a green, and also a yellow to represent the floor,
between this green and the yellow and the colour of the
canvas there will be still further relations. But these
different tones diminish one another. It is necessary that
the different tones I use be balanced in such a way that
they do not destroy one another. To secure that, I have to
put my ideas in order; the relationships between tones
must be instituted in Such a way that they are built up
instead of being kndécked’ down. A new combination of
colours will succeed the first one and will give the whole-
ness of my conception.”’* Similar accounts of the painter’s
approach to form have been given by Braque and
Metzinger, to mention only two of modern artists. Clearly,
the impairment of conceptual thinking in the schizo-
phrenic patient makes it difficult or impossible for him to
apply such a relational approach either to colour or toform.
The patient who created the painting in Fig. 6 wished
to solve the problem of the “Reversal of Perspective”’
which is the title he gave to the picture. He indicated that
the reversal of perspective is “‘the philosopher’s problem”’,
and that he is going to solve it pictorially, by lines and
colour, and by a human figure, with a child’s feet, to
indicate the reversal of accustomed visual relations, When
* From Notes d’un Peintre, published in 1908,
30 PSYCHOTIC ART

his picture was completed he announced with satisfaction

that “‘the problem is solved’’. The picture presents a man
whose head is up in the sky and whose feet are in the fore-
ground; though one would expect the shapes in the fore-_
ground to be larger, the proportions are in the reversed
direction. This same reversal is emphasized in the steps,
which narrow as they approach the onlooker and contrast
with some very large steps, to reinforce the effect. Simi-
larly, the most disturbing factor in the picture, the white
road and the reversedly smaller trees flanking it, empha-
size the inverted proportions of the perspective. The red
and green lines of the background give the picture a more
restless effect.
The choice of such bizarre content might legitimately
suggest that it reflects his own difficulties, and that the
distorted body, in a disordered spatial relation, is a reflec-
tion of his feelings of depersonalization and derealization.
In other words, the picture might express his distorted
experiences of his own body. Moreover, it raises the im-
portant question of whether the underlying factors in
schizophrenic depersonalization and derealization are
primarily experienced in distortion of the body or in
distortion of the spatial surroundings. To this problem I
shall return. It seems to be significant that at first glance
this third painting appears to be the worst : we experience
in it an inverted configuration or system of relations. It is
not the new or unexpected re-structuring of reality which
disturbs us, but its destructiveness. This destruction is not
only achieved through linear representations but through
colour as well.
The bad configuration of the picture “Reversal of Per-
spective’? we must consider at more length chiefly to
clarify the sense in which the term configuration or
‘“‘gestaltung”’ is used. Visual reduplication is a sub-
division of space and corresponds to rhythm in music,
which is a subdivision of time. Both are the most elemen-
tary factors in art, elementary because their relationship
to the physiological is nearest. The pictorial artist brings
elementary visual reduplications into relationships of
 FORM IN PSYCHOTIC ART 31

varying degrees of complexity. He begins with a vague

concept or schema of his picture and organizes the various
reduplications into a pattern of relations to each other.
If configuration or “‘gestaltung”’ is taken to mean this
process of organization or its result, then it involves con-
ceptual activity to a great degree. In schizophrenics a
conceptual deterioration takes place and the organization
of pattern disintegrates. The picture loses its unity and
gives the impression of a bad configuration or a discordant
system of relations. This phenomenon is also illustrated in
the series of pictures of a cat reproduced in the frontispiece
and Fig. 7. In the former, though ornamentation pre-
dominates, the picture is well organized as a whole; the
cat’s paw, its eyes, nose and ears, and the filling up of the
space between them organize the factors in a pleasing
unity. Fig. 7, however, does not show any organization;
the cat is lost in a maze of parts. The picture has no de-
lineation in relation to the surrounding space; if it were
twice the size it would demand still more space. It is not
a “‘restructuring”’, because it possesses virtually no struc-
ture. The parts do not hold together; what has taken
place can be described as a refragmentation. Thus instead
of configuration, “structuring” seems a more satisfactory
term; the part colour pl4ys iri structuring has already
been mentioned.
Spearman has drawn attention to the confusingly
double meaning of this concept of “configuration”. He
emphasized that configuration not only concerns objective
form, but also denotes a subjective grouping; the latter
signifies the manner in which the form is regarded.
Structuring, on the other hand, denotes a frankly con-
ceptual activity or its product. The principles of this
activity may be ascertained empirically, but it does not
necessarily depend on any a priori laws of “‘gestalt”. As
McDougall pointed out, the laws of configuration can be
easily fitted to facts which were known beforehand, but
they are unsatisfactory means to use for prediction of un-
known facts. Throughout the present study, the term
**configuration”’ will always be used to denote conceptual
32 PSYCHOTIG ART

activity or its product; for instance, when it is said that

the body image is a gestalt or a configuration, this refers
to its conceptual component. It is intended to denote a
grouping and elaboration of various sensory impulses into
a system of relations.
But to return to the frontispiece, the picture might also
illustrate other points raised in the first chapter, such as
the schizophrenic apprehension of reality. A ““modern”
artist’s reconstruction might be unexpected, might appeal
only to a few, whose perceptual and conceptual training
allows them to follow the artist’s problem and its solution;
but the schizophrenic “reconstruction” is rejected, not
merely unappreciated, because his “‘reality”’ is a dis-
torted, an abnormal one. It can be estimated psychiatric-
ally, but hardly appreciated aesthetically.
Mannerisms are often expressed in so far that alien
elements may appear suddenly in the picture, which are
not inter-connected in any way with its form or content.
Alternatively, they may be expressed in a needlessly over-
elaborated picture, often filling in every square milli-
metre of the available space. It seems that to such over-
elaboration and ornamental stylization abstract forms
lend themselves more suitably than attempts at repre-
sentation. Indeed, pattern of form frequently pre-
dominates in schizophrenic paintings and the tendency to
produce geometric forms instead of representative ones
may accord with the alteration of reality for schizo-
phrenics. Stylization as a result of the altered experience
of reality in schizophrenics was first emphasized by
adherents of the psychoanalytical school. They considered
it to be a result of changed logical activity owing to
emotional causes, and looked upon it as a magic means of
altering and influencing reality. The principles governing
stylization have been well summarized by Kretschmer.
They are: emphasis of the essentials, simplification and
the repetition of forms; the latter is achieved by bilateral
symmetry and by multiplication of a single pattern.
It has been shown, however, that there is a strong
physiological element responsible for the appearance of
 FORM IN PSYCHOTIC ART 33

the ornamental in schizophrenic paintings. Kanner’s

experiments on optic imagery indicate a tendency to
multiplication of the image itself. ‘“‘The tendency to
multiply perception is probably a primitive tendency con-
nected with the optic-perception as such, which finds
increased expression in optic imagination”. Thus there
seems to be a tendency to spontaneous multiplication of
the images. The investigations of Kluever also support
these observations: he studied the process of reproducing
eidetic images and found fragmentation of the images,
which at times are cut to pieces. Schilder argued that the
mechanisms of this fragmentation are based on primitive
optic experiences, in which simplified figures (spirals,
waves and vortices) are important. Bender also observed
that after injury to the brain complex figures revert to
more primitive levels, and that again simplified patterns
and reduplications make their appearance. These observa-
tions suggest a perceptual conditioning for stylization.
However, the use of simplified patterns on more primitive
levels, such as follows after injury to the brain, strongly
supports the theory of the phylogenetic development of
artistic configuration. Visual reduplication or repetition,
as already stated, is the subdivision of space, just as
rhythm is the subdivisioré of time. Both are the simplest
forms of configurational activities; they are phylogenetic-
ally the first to appear in artistic creations, and when
deterioration takes place they are the last to disappear.
Stereotyped repetitions often accompany disintegration ot
the central nervous system, as in senility, following en-
cephalitis, etc. Thus it seems that the appearance of a
strong stylistic element in the sense of excessive ornamenta-
tion in the art products of a patient indicates that he is
deteriorating. Schilder and Levine, on the other hand,
investigated geometric patterns in drawings, from a
psycho-pathological point of view. Patients who were
receiving group treatment were encouraged to draw.
When “primitive, instinctual drives” became evident in
the course of the group analysis, geometric stylization
showed in the drawings of the patients. This group
34 PSYCHOTIC ART
analysis was conducted entirely on psycho-analytic lines,
and since they are related in terminology and evaluation
exclusively to the Freudian school of thought, it is difficult
to generalize from Schilder and Levine’s conclusions.
The two pictures reproduced in Figs. 7 and 8, which
have already been discussed in connection with the
problems of configuration, also illustrate in dynamic
fashion the tendency to stylization. They were painted by
a professional artist who was ill; the choice of theme, the
stereotyped cat, may be ‘‘complex determined’’, but this
matters little in relation to the questions raised in this
chapter. Before his illness, this artist’s drawings of cats—
impressionistic studies of cat’s heads—were well known.
I have not reproduced any of these more normal draw-
ings. But as his illness gradually progressed, so his style
altered, and as the years went by he tended more and
more to ornamentalization. In the end he produced an
over-elaborated, bizarre, ornamental pattern, which sug-
gests a cat at all only in connection with the earlier
drawings.
Support for the theory of a close link between per-
ceptual reduplications and optic imagery comes from
experiments with mescalin. Mescalin is an alkaloid pro-
duced from a Mexican plant; the natives of Mexico used
it for its intoxicating effects and attributed demoniacal
and supernatural powers to it. Experiments since the
early nineteenth century have confirmed that mescalin
produces a toxic state, accompanied by a transient
mental derangement, not unlike schizophrenia. The
experience itself is partly characterized by visual halluci-
nations of a very pleasant character, which change like
the patterns of a kaleidoscope. No other drugs such as
hashish or marihuana, induce visual hallucinations which
are so intense. The drug is excreted through the urinary
system within 24 hours. In some cases there is a slight
after-affect accompanied by inco-ordination (ataxia).
The power of this drug to induce a transient schizo-
phrenia-like psychosis has been utilized by several psychia-
trists, some of whom have taken mescalin themselves to
 FORM IN PSYCHOTIC ART 85

be able to judge of the experience personally. I myself,

when I was under mescalin, was fully aware of my sur-
roundings, but I asked people irritably to leave me in
peace, so that I could enjoy my hallucinations undis-
turbed. This increased introspective tendency is one of the
characteristics of mescalin experience, and more will be
said about it in Chapter 3 in dealing with schizophrenic
disturbance of thought. Let us confine ourselves at the
moment to the visual effects. Maclay studied the mescalin
hallucinations of subjects able to draw. He asked them to
sketch their hallucinations instead of giving a verbal
account of them. They appeared fleeting in shape, position
and colour, and all the shapes tended to elongation and
reduplication. Reduplicated zig-zag lines were frequent.
Another fairly common character of the visual hallucina-
tions was a “‘tapestry pattern”. Knauer and Maloney’s
subjects reported mosaics and ornaments, spiral and
windmill and carpet patterns; other workers have found
that colour in mescalin hallucinations becomes dissociated
from form. When Maclay studied the drawings of his
subjects, he observed that the “tapestry”? pattern was
probably the reproduction of the choroid or intermediate
coat of the subject’ S eyeball which was perceived and then
painted. Fig. 8 is a painting by one of Maclay’s mescalin
subjects, representing the choroid in an artistic elaboration.
Fig. 9 is an interesting parallel. This picture was painted
by a schizophrenic patient under the following con-
ditions : she was gazing out of the window absentmindedly,
when she started to sketch the background, and the flower
pot was elaborated later. Probably she experienced her
choroid as an after-sensation and incorporated it into the
picture which, with some phantasy, represents her two
eyes and her nose. The point to emphasize, however, in
both examples is the strongly physiological perceptual
impetus which moulds the “‘artistic” expression. Maclay
speculated on the psychological versus the physiological
theories of hallucinations and concluded that at least in
mescalin the hallucinations are physiological in origin,
but that their content is determined psychologically.
36 PSYCHOTIC ART
Most probably, all experiences of the kind are interwoven
in a similar way. The examples reproduced were chosen to show
the interrelation between perceptual pattern and optic imagery. In
an artistic sense the same interrelation was consciously
utilized by Leonardo, who remarked that when con-
templating a damp spot one may see chimeras and other
phantastic figures in it: ‘“‘this method of looking at
fortuitous shapes may stir the mind to inventing things
and can be, therefore, of importance for creative work. ...
it is a good education for the fancy”’.
One of the early symptoms of schizophrenia is the
alteration of verbal expression. There seem to be odd
sequences and inconsequences of ideas; associations seem
to be directed by alliteration, instead of logical relation-
ships. Speech becomes incoherent, fragmented and ap-
parently meaningless. Various words are condensed into
new words (neologisms): ‘“‘convertical’’, “‘needies’’, are
examples of the neologisms used by a patient of whom a
fuller account is given in Chapter 4. But ultimately the
lack of logical relationships, the quantity of neologisms,
etc., make schizophrenic language unintelligible. Such
nonsense language (‘‘word salad’’) in schizophrenics
sounds like a proposition, but it is not. It has speech value,
by its perceptual merit only. Thus, actually it becomes a
substitute for a communication: as Noyes puts it, it is a
“* self-meaningful’? communication, which amounts to the
same thing—it is no real communication at all. This
tendency of words to lose their true content value and
retain only a perceptual existence exemplifies the schizo-
phrenic tendency to “perceptual” or ‘“‘concretistic”
thinking. As a result, a schizophrenic communication
becomes a mixture of conceptual and perceptual factors;
of pictures and words; of “‘self-meaningful’’ symbols and
meaningful concepts. Such are—for want of a better ex-
pression—the schizophrenic ‘“‘doodles”. Several psychia-
trists look upon such doodles as being primarily pictorial
propositions mixed with “writing in” or the naming of
what is drawn, the latter being a schizophrenic symptom.
It is, however, futile to search for the primary factor in
 FORM IN PSYCHOTIC ART 37

these products. As far as doodles have a meaning, they

have it only in being a unity of drawing and writing; the
lack of one of these components destroys the whole meaning
or “‘self-meaning”’ of the doodle.
Before attempting further analysis of this schizophrenic
type of doodle, some remarks on non-schizophrenic
doodles seem to be necessary. Maclay and his collabor-
ators studied doodles sampled from the “‘normal” popula-
tion. They defined them as “graphic results of playful
activity done without purpose, in a state of divided and/or
diminished attention”. They found that out of 500
specimens only 139 were devoid of “‘writing in”’. In form,
these doodles exhibited stereotypy, ornamental details,
movements, figures, faces and animals; they depicted
scenes, medley, “‘mixtures’? and ornaments. Maclay con-
cluded that as far as the uniformity of doodles goes, they
express physiological and psychological uniformity of
human reactions. Though noticing similarities between
doodles and certain schizophrenic drawings, Maclay care-
fully avoided any conclusions based on analogies alone.
Doodles, he emphasized, are not communications and
their meaning is only apparent in individual analysis;
thus again they are only “‘self-meaningful’’. In this respect
they have the most intimate relationship with the schizo-
phrenic ‘‘doodle’’, described in this chapter.
Nonsense poetry is an artistic elaboration of verbal
doodling; actually it is, as in the schizophrenic doodles,
always a mixture of writing and drawing, both being
closely interrelated, and only in conjunction making a
proposition of some kind. The classical example of this is
Edward Lear’s nonsense. Carroll’s nonsense is probably a
conscious imitation of such doodling, of neologisms, etc.
How far nonsense poetry is symptomatological is a specula-
tion not within the problems of this present chapter.
Enough is said if it is recalled that both the authors named
have been subject to the curiosity of psychiatrists and that
schizoid inclinations have been noted in each of them.
In considering the schizophrenic type of doodle, Fig. 10
should now be examined more closely. The circumstances
38 PSYCHOTIC ART
in which the patient came to draw it were these: she
possessed a copy book and pencils and after one of her
former doodles had been seen she was encouraged to go on
drawing. Thus she was not doing it as a message or for
some purpose, but merely as a playful activity for no
ulterior reason at all. The picture has no content and the
patient’s explanations, so far as she was capable of these,
were a secondary paraphrase. Because of the meaning-
lessness or purposelessness of the picture, I am inclined to
classify it as a doodling type of drawing. Its creator is a
schizophrenic woman 30 years of age, with much dis-
integration of personality. Her illness was chronic and did
not seem to respond to treatment. Only a few remarks
from her explanatory attempts are given here. First, she
remarked on the fact that she was related to an Earl of
Shrewsbury. Then she emphasized that the picture should
be viewed as history repeating itself. She drew attention
to the centre of the composite figure. On the top of the
picture are stars, and a key of hope. The central figure is
“‘a man in woman, the woman in man”’. The fingers are
Finland; this is evident just as much as Warsaw means
“saw war’’. There are two lips on the figure which are
tulips; Denmark is shaped geographically like a tulip.
So, for instance, from the “‘past time’? came Palestine.
The picture is in a way a plan of the universe, and a plan
of the globe. She also explained that the top figure is the
male, God the Father; the duplication of this figure is
God the Son and the female means three in one. She
reverted to geographical explanations. There are three
fatherlands in the drawing, Japan, China and Indonesia.
Indonesia comes from the Danes, Daniel in the lion’s den.
Religion and Denmark stand for a “‘father-country”’.
Then she turned the picture upside down. There is a
female figure now. Her umbilicus is a cherub; the um-
bilicus is the navel, which is nose. Then the tubes are
there, and the two lips which are the chamber of the
womb. The writings on the picture denote the evil spirit
of conduct being set aside for 3,000 years. The key of love
is: hope. She went on in the same manner, “‘explaining”’
 ¥ #go 8 ee y coe Ge

Fig. 5. ‘A Man Going Over a Hill’

face p. 38
Fig. 6. “The Reversal of Perspective’
 FORM IN PSYCHOTIC ART 39

the picture. All her explanations are illustrative of a

“‘word salad”’ and of the schizophrenic type of association
on a perceptual basis. They also illustrate the conceptual
(structural) weakening shown in sentence formation.
They really do not explain the drawing.
The composite figure in the picture is not dissimilar to
neologisms: it is condensed from various parts, just as
neologisms are formed from various words. In the same
way as neologisms, such pictorial condensations are self-
meaningful, comprehensible, that is, to the patients alone.
Fig. 16, one of Goya’s engravings, exhibits such pictorial
condensation elaborated artistically ;but as a picture it is
also self-meaningful only. Among ‘“‘modern”’ works,
Picasso’s ‘‘ Minotauromachia”’ illustrates the same phe-
nomenon, re-emphasizing the pictorial condensation with
an artificial neologism. The psychoanalytical school has
given much thought to the underlying mechanisms of
such pictorial condensation, all the more as similarities
have been found in them to dream mechanisms. More-
over, because of similarities between such drawings, and
those of totemistic civilizations, conclusions have been
drawn on the basis of superficial appearance—a character-
istic heritage of nineteerith-century psychiatric reasoning.
It also deserves merttion’that several details of Fig. 10
refer evidentially to sex and many more would invite a
psychoanalytical interpretation. Some of the sexual repre-
sentations in the picture are almost obscene, a not in-
frequent feature of schizophrenic drawings. On the other
hand, the appearance of Father, God, “‘the Woman in
the Man”, etc., are pleasing pictorial expressions of
Jungian concepts. I shall come later to ask whether the
Freudian and Jungian symbols are valid; but here, we
seem to have a striking pictorial illustration of the
relativity of such interpretative approaches.
Yet another type of “‘composite figure” often found in
schizophrenic drawings is the Cephalopode. The appear-
ance of such figures in children’s drawings, amongst
others, is probably indicative of the child’s incomplete
orientation towards his own body. I found that several of
4
40 PSYCHOTIC ART
my schizophrenic painters were motivated in a similar
way, and I shall have more to say about this, mentioning
here only one of my patients, who had greatly disturbed
notions about the trunk of his body, which he wrapped up:
day and night in cotton-wool. In his drawings, not only
Cephalopodes, but their symbolic equivalents appeared
repeatedly ;for instance, Humpty-Dumpty, or kites which
possess head and tail but no trunk.
,=
tal
~~

The various formal factors I have enumerated are not

exhaustive; there are several others which have been left
out and there may be still others which have not, as yet,
been recognized. The presence or absence of one of these
characteristics, however, does not alter the “diagnosis”
of a schizophrenic picture. Such a diagnosis can only be
made in any event, if one compares a series of pictures
from the same patient, that is to say, if one views these
pictures dynamically. Alternatively, one may relate the
pictures to the patient and correlate the two together.
Decisive, therefore, are the mental mechanisms behind
the picture: it is which of these will determine whether
one should view a picture as schizophrenic or not. No
“diagnosis” can be made by Studying one isolated
painting.
 III

THE CONTENT OF PSYCHOTIC

ART

The schizophrenic reactions; their similarities to psychological

dynamics in “‘ primitives”—Disturbed ego demarcations of schizo-
phrenics—The body image; its neurological and psychological
aspects; its relation to schizophrenia.
THE PROBLEM THAT I now intend to examine is why schizo-
phrenics are almost the only contributors to psychotic art.
This entails an inquiry into the motivations impelling
schizophrenics to paint. ~*
First of all we must state the grounds of behaviour on
which a patient is regarded as schizophrenic. In recent
usage ‘‘schizophrenic illness” has been taken to represent
a group of psychotic disorders characterized by funda-
mental disturbance in the relationship of the patient to
reality and in his conceptual thinking or “‘concept-
formation”. These basic disturbances lead to further
affective and intellectual disturbances in varying degrees
and mixtures. The disorders are marked by a strong
tendency to retreat from reality and by emotional dis-
harmony. There are unpredictable interferences from
within the patient with the sequence of his expressed
thought. His emotional expression inclines to be “flattened
out’’. His conative behaviour, in particular his reaction
to biological drives, inclines to be altered. All these changes
42 PSYCHOTIC ART

give an appearance of deterioration. The expectation that

the patient will deteriorate still further may not be ful-
filled. But he may progress to a stage of childishness called _
‘schizophrenic dementia”
Important diagnostic evidence of schizophrenic re-
activity, especially of disordered conceptual or ‘“‘categoric”
thinking, is afforded by special tests such as the Rorschach
Ink Blots; the Vigotsky: classification test and develop-
ments from it such as.the Hanfman—Kasanin test; the
sorting tests of Goldstein-Scherer, Rapaport and Hal-
stead ; tests based on proverbs and problems like those of
Benjamin and Cameron; and Murray’s Thematic Apper-
ception test. The use of some such tests will be described
more specifically in the next chapter, and the whole
problem of conceptual thinking and its experimental
investigation will be discussed in Chapter 5.
Schizophrenic reactivity may occur in a mild form
which is revealed only by special procedures such as the
tests I have named. Such cases rarely need admission to
a mental hospital. The reactivity may, however, take an
acute form.
The fundamental symptoms, then, in the schizophrenic
process may best be regarded as the schizophrenic’s
peculiar ways of thinking or thought disturbances. His
world seems organized into categories of time, space and
logical relation quite different from those of the world of
the normal individual. This is more evident as the illness
progresses but the beginnings of the phenomenon can be
detected in the earlier stages. Cameron found when he
applied problem-tests and sorting tests to schizophrenics
that they exhibited an allied phenomenon of “over-
inclusion” ; they could not eliminate from the problem
environmental and imaginal material only remotely re-
lated to it. Another allied phenomenon, occurring in
everyday talk but particularly elicited by special tests, is
that of contamination, a form of that condensation already
discussed. ‘T'wo separate notions,occur simultaneously to
the patient and he fuses them incongruously into one. A
pin-man drawing was shown to a schizophrenic patient.
 THE CONTENT OF PSYCHOTIC ART 43

It seemed to her like a rope and also like a man; thereupon

she described it as a ‘‘man-rope”’.
Besides the disturbances of thinking the other important
feature of the schizophrenic reaction is an apparently
complete apathy or loss of emotional response. Frequently
also the patient seems “‘ambivalent”’ in his emotions; he
expresses contradictory feelings, say love or hate, towards
the same person or object, and these appear either to co-
exist or to alternate very rapidly. This attitude occurs in
the normal man, but to nothing like the same degree.
A resemblance has been argued between the thinking
of schizophrenics and the thinking of pre-literate peoples,
particularly by the French school of sociologists founded
by Durkheim. These views have been particularly de-
veloped by Lévy-Bruhl in relation to primitive peoples.
He has described the thinking of primitive tribes as “‘pre-
logical” and accounts in these terms for such phenomena
as magical practices and beliefs. The concepts of the
primitive are vague, incoherent and ill-defined. The well-
known notion of mana is a good example of such an ill-.
defined concept. Primitives are held not to proceed
rationally from premise to conclusion but to jump illicitly
and impressionistically'in a manner similar to that which
Piaget, in the field’of ¢hild-psychology, calls ‘‘trans-
ductive reasoning’. Resemblance is taken to mean
identity. A person or object can be regarded as being
simultaneously two different things: thus a leopard may
be both a leopard and a man at one and the same time.
This Lévy-Bruhl calls duality. Conversely they regard it
as possible for one and the same person or thing to be in
two different places at the same time; a man may be
lying asleep and simultaneously may be hunting a
hundred miles away. Lévy-Bruhl’s term for this is bi-
presence. Everything is looked upon as homogeneous in
essence—people, animals, plants and stones. The boun-
daries of the self are not clearly defined. Most especially
the real unit is the group, not the individual, as it is in
advanced communities. A physiological, almost organic,
solidarity exists between members of the same social
44 PSYCHOTIC ART
group; individuality is almost completely submerged in
this solidarity. The boundaries of the self are weak also in
relation to component parts and property. The indi-
vidual’s secretions, excretions, footprints, the remains of |
his food, the objects he makes or handles, his personal
property, his reflection or shadow—all are regarded as the
man himself. It is this attitude that makes possible the
practices of sympathetic magic. The resemblance between
such notions ascribed -to primitive men and some of the
disorders in the thought of schizophrenics already
described will be quickly apparent.
The psycho-analysts, notably Freud himself, Roheim
and Money-Kyrle, have developed allied but somewhat
different theories about primitive psychology which
would also resemble schizophrenic reactions. They state
that at an early period in cultural development the
emotional life predominates over logical thinking; things
or events are interconnected by their emotional impor-
tance, not their spatial or temporal coincidence. This
emotional life of fears and desires is characterized by
ambivalence, here taken to mean contradictory feelings
towards the same object; these may be reverence and
horror, or, as with schizophrenics, love and hate. The
conflicting emotional experiences are apprehended as
“good”? and “bad” respectively, have to be accepted or
rejected; they are projected outwards and constitute the
basis of the notion of tabu, its sanctions, the constructs of
demons and spirits and all the beliefs of animism. Such a
system of emotional thinking Bleuler termed “‘dereistic”’;
it is also called ‘‘magic thinking’. The practice of magic
itself, according to this school of writers, is an attempt to
resolve ambivalence of feeling by apparently meaningless
behaviour, either active as in the development of rituals
or passive as in the use of amulets. The apparently mean-
ingless behaviour symbolizes the rejected part of the ambi-
valent feelings and leaves the savage free to experience
the aspect that he wishes to accept. Money-Kyrle de-
velops this theory further by considering magical fluids
and substances (of which he regards mana as an example)
 THE CONTENT OF PSYCHOTIC ART 45

to be projections outside the self of the body fluids and

substances such as breath, urine or excrement; he treats
supernatural creatures as similar projections outside the
self of parts of the human body, for example, the breasts,
the nipple or the penis, which are apprehended as either
‘““good”’ or “bad” objects, or ambivalently as both.
The theories of the psycho-analysts are, to say the
least, highly speculative. The views of Lévy-Bruhl and
the French sociologists have also not found much favour
with anthropologists working in the field. Anthropological
objections were ably summarized by F. C. Bartlett some
twenty-five years ago in a series of arguments which still
remain valid. He notes that much of Lévy-Bruhl’s evidence
rests upon the ‘“‘traveller’s tales’ of missionaries and
traders rather than upon the observations of the trained
investigator. Pre-logical thinking, he points out, is incom-
patible with the practical inventiveness of primitive man
in the search for food, the provision of dwellings, and the
development of material arts, crafts and techniques; all
the evidence obtained in the field indicates that in such
activities the pre-literate employ the same psychological
processes of learning and reasoning as civilized man. This
criticism would also apply to the theories of the pre-
dominance of emotional thinking, advanced by the
psycho-analysts. Bartlett remarks that even in the realms
chiefly dealt with by Lévy-Bruhl—those of death, disease,
dreams, omens, wounds, war, desire and the like—pre-
logical thinking is not absolute; Lévy-Bruhl’s own illus-
trations contain examples where logical thinking is
evident. Moreover, Lévy-Bruhl has made an antithesis not
between the primitive man and the ordinary member of
a modern social group but between primitive man and
the scientific expert. Pre-logical thinking in the form of
relating surprising and sudden events to remote and re-
condite agencies can be observed by anyone who cares to
look for it in modern life almost any day he wishes; Lévy-
Bruhl has almost completely neglected to observe the
modern and normal.
Malinowski by implication assailed Lévy-Bruhl’s theory
46 PSYCHOTIC ART
that in the primitive the boundaries of the self are not
clearly defined and that individuality is almost com-
pletely submerged in solidarity with the group. In dis-_
cussing the factors of social cohesion in the primitive
tribes of the Trobriand Islands he demonstrates that the
contention of clan-unity is only partly true. Those who
have insisted upon clan-unity have tended to be duped by
mistaking a legal idea for-the sociological realities of tribal
life. At certain times, especially in the ceremonial phases
of native life, clan-unity does dominate everything, but in
general the clan is homogeneous only with regard to other
clans. Within the clan or sub-clan there is a strict watch
over particular self-interest; a thoroughly business-like
spirit prevails and it is not devoid of suspicion, jealousy
and mean practices ; strained relations between individuals
are not infrequent, and strong hatreds, acts of violence
and hostility, occur between them. Other anthropologists
have advanced like considerations with regard to different
primitive communities.
The arguments of Bartlett and Malinowski have very
considerable weight. Nevertheless one cannot set aside
completely the evidence marshalled by Lévy-Bruhl. One
must avoid sharp, artificial antitheses and the pressing
of speculations too far beyond ascertained facts. One must
recognize that practices and beliefs realistically deter-
mined and those determined by phantasy or emotion co-
exist in all communities and all individuals, but that the
relative emphasis varies. It does seem to be true that the
modes of thinking, named ‘‘pre-logical’’? by Lévy-Bruhl,
are commoner in primitive than in advanced communi-
ties. One might here note the point long ago made by
G. F. Stout that since conceptual thinking chiefly depends
on language as a tool, the differences between the syn-
tactical usage of the flexional Indo-Germanic languages
and of those languages which employ such devices as
syncretism and incapsulation necessarily imply differences
in mode of thinking. These differences tend to be obliter-
ated by the spread of West-European culture to com-
munities not speaking an Indo-Germanic language, but
 THE CONTENT OF PSYCHOTIC ART 47

they remain in full force in the more primitive communi-

ties. It also seems to be true that the feeling of individu-
ality is more sharply defined in modern industrial
civilization than among primitives, though it is far from
absent among them.
Returning again to the resemblance between schizo-
phrenic thinking and that ascribed to pre-literate man,
one should note the point that well attested cases of
schizophrenia have been found in several primitive
societies—Asiatic, American—Indian, Eskimo and Poly-
nesian. This speaks strongly against any simple identifica-
tion of schizophrenic thought processes with those normal
in a non-technical or pre-literate community. Whatever
may be the truth in the controversial matter of primitive
thinking, it is the case that schizophrenic behaviour often
closely corresponds to the modes of thought ascribed by
Lévy-Bruhl and the Freudian anthropologists to the un-
civilized. Transductive reasoning, notions of duality or
bipresence of the individual, ambivalence of feeling,
magical practices and ideas, rituals, beliefs of an animistic
nature, can frequently be demonstrated in clinical ex-
amination or by special tests. The parallel of schizophrenic
to primitive beliefs is somgtimes extraordinarily close, as
I shall show later in a special instance. One must, how-
ever, take great care in establishing that such beliefs are
not current in the milieu from which the patient derives
and are therefore unrelated to his illness. One must also re-
member that there is no sharp contrast between primitive
and advanced communities in the matters of magic,
animism and related phenomena: there is merely a
gradation in their incidence and in the emphasis laid upon
them, from pre-technological societies through agri-
cultural communities down to the communities of modern
industrialism. The apparent return of the schizophrenic
to ways of thinking more magical and animistic than
those current in our society is best regarded as a weaken-
ing in his conceptual or categorical thinking so that it
approximates to the level of conceptual or categorical
thinking standard in the pre-literate communities,
48 PSYCHOTIC ART
About the causes of schizophrenia there are many
hypotheses. No single one is sufficient to account for all
the factors of so complex and many-sided a phenomenon; .
most of the explanations put forward are only part of the
truth. It is not my intention to add to their number. I
wish rather to start from the most comprehensive general-
ization possible about the symptomatology of schizo-
phrenia ; to relate this to facts from certain other biological
fields—neurological, psychological, psycho-pathological
and pharmacological ;and to see what light can be thrown
in this way on the phenomenon of schizophrenic painting
and its motivation. Such a generalization can be found in
Magnan’s description of schizophrenia. He states that in
schizophrenia a noxious agent erodes the personality and
that the demarcation between ego and non-ego begins to
disappear, and is finally dissolved as the disease pro-
gresses. This generalization subsumes many, though not
all, of the symptoms of schizophrenia described at the
beginning of the chapter; it would be difficult to find any
generalization subsuming more of the symptoms, except
the bare statement that they are all of queer or eccentric
behaviour. Magnan’s generalization describes, and does
no more than describe. It does not imply that the noxious
agent is either physiogenic or psychogenic in kind. The
nature of “ego” and ‘‘non-ego”’ is left unspecified, but
““ego”’ can be taken to denote something having clearly
marked boundaries in spatial and temporal reality. If the
‘““ego” boundaries are eroded, the ‘‘ego” is no longer
distinct from its spatial and temporal surroundings;
reality for the ego is changed. Under such conditions
thinking, which is a functional relation between the ego
and the non-ego, can hardly remain realistic.
The concept “ego”, however, is exceedingly unsatis-
factory; furthermore, the use of ‘“‘ego” leads to a bio-
logical impasse. It denotes something imaginary like the
mathematical point. To substitute ‘‘body” for the con-
struct “ego” provides a suitable operational term, capable
of biological treatment; it can be observed and verified.
As Sherrington emphasized, the ‘‘I” is aware of itself as
 THE CONTENT OF PSYCHOTIC ART 49

an embodied “I”, but the feeling of “I” or “‘self”’ is

usually wider than the body, sometimes narrower, more
rarely co-extensive with it, but through all transforma-
tions of this feeling the body remains as the one constant
factor. The feeling is wider when ‘“‘self” is extended to
include clothes, implements such as a pen or weapons such
as a gun, vehicles such as a bicycle, dependents and sub-
ordinates, or friends and comrades; it will be noted that
the ease and security with which these can be included in
the “‘ego” vary in degree. The feeling of “‘self’’ becomes
narrower than the body when the individual is engaged
in thinking or intellectual activity or appraisement of his
own deeds and qualities; this retraction of the self would
appear to be uncommon except in the highly intelligent
or intellectually sophisticated. The feeling of ‘‘self”? may
perhaps become co-extensive with the body when the
individual is lying in a hot bath. All such statements rest
solely on introspective evidence in a matter where intro-
spection is extremely difficult; there are great individual
differences. Certain psychologists have attempted by
introspection to localize the feeling of ‘‘self”’ in the body.
E. Claparede placed it between the two eyes; others have
placed it in the thorax. Here, too, individual differences
come into play. Moréover; much depends on the activity
in which the organism is engaged. The feeling of “‘self”
may well be located between the two eyes when the indi-
vidual is busied upon an intellectual activity with the body
relatively passive—for example, playing chess or reading
a book. If the whole body is in motion as in swimming or
playing tennis, the feeling of “‘self’? could hardly be
located in so limited a spot. It will now be quite plain that
this shifting point (or region) whose locality rests on such
tenuous and variable introspective evidence is something
quite unsuitable for objective scientific treatment. Instead
one must make use of the constant component, the verifi-
able and observable fact; that is, the body itself.
I am now led to the neuro-physiological concept of the
“‘body-image’’. This phenomenon was first demonstrated
by Sir Henry Head on the basis of his work with brain-
50 PSYCHOTIC ART

injured patients. From studying certain effects of lesions

of the brain—impairment in voluntary movement, im-
pairment in knowledge of the spatial position of the limbs,
loss of touch- localization—Head concluded that the
human organism has two “models” or “‘schemata” of
itself, the postural model based on kinaesthetic sensation
and the surface model based on cutaneous sensation.
These two models are closely interconnected but the
surface one is the less transient. The postural model is
always being built up and constantly changing by means
of perpetual alterations in position. Head also distin-
guished the ‘“‘schema-building” which is an activity in
progress from the “‘schema-built”’ which is a state result-
ing from the activity. Other néurologists have added to
these propositions and modified them. Lhermitte empha-
sized that vestibular and particularly visual sensations
together with the kinaesthetic and tactile ones were the
raw material of a synthesis which constituted the ““body-
image”. Pétzl, Gerstmann and others, by observing
patients with vascular catastrophes of the temporo-
parietal part of the cerebral cortex, demonstrated that the
nervous integration of the “‘body-image” lies in that
region. Unawareness of parts of the body occurs without
loss of sensation (anaesthesia); these investigators took
this fact as demonstrating that the disturbance in the
*““body-image”’ is not sensory in nature but is a specific
symptomatology due to a lesion of a specific area. Those
findings about the localization of the “‘body-image”’ were
also supported by Hoff’s experiments; he was able by
freezing the temporo-parietal region through a skull-
defect to demonstrate unawareness of the opposite body
side (autotopagnosia). Bychowsky stated that the ‘‘ body-
image” alters not only with body movements and body
positions but also through acquired skill. Neurologists
classify the ““body-image”’ disturbances as positive and
negative. Positive disturbances occur when a patient
apprehends as still present a part of the body that has
been removed. The chief phenomenon here is that of
“phantom-limbs”’, exhaustively studied by Head and G.
 THE CONTENT OF PSYCHOTIC ART 5!

Riddoch; when a limb is amputated the patient has for a

long time a sensation that it is still there. Allied to this is
the more general phenomenon called anosognosia, or
rejection of the evidence of bodily disease. Thus the
patient with hemiplegia or paralysis on one side of the
body may deny that he is paralysed, the blind man may
deny his loss of vision, and so on. Negative disturbances
occur when the patient apprehends part of his body as not
belonging to him. When the patient suffering in this way
is shown an arm he may deny that it belongs to him.
Disturbances of this kind occur after lesions of the
temporo-parietal region and refer to the opposite side of
the body. Purden Martin raises the question, ‘‘What
would happen if following an extensive bilateral lesion a
patient lost the awareness of both halves of his body?” He
goes on that the patient “‘would then be to himself a dis-
embodied spirit. Gan you imagine yourself without any
body-consciousness? To yourself you could be a disem-
bodied spirit, entirely devoid of body. I find that I am quite
unable to imagine myself as such. I can imagine myself
possessed of a body of which I was unaware of bodily
sensation, and then I would, I suppose, if I remained con-
scious at all, still be aware of my environment—through
eyes and ears of which I Was unaware—and I might see
my body as I see that of another person. But could I
remain conscious if I had no awareness of my body as me?
Certainly a large part of consciousness would be lost”.
Lesions of the left parietal region in right-handed persons
occasion finger agnosia, an inability to select and recognize
the fingers of either the patient’s own hand or of the
examining physician’s; this is associated with loss of
ability to write, to calculate sums and to discriminate
between right and left. The foregoing account sketches
very briefly the main findings of pure neurology upon
awareness of the body and its parts, their existence, spatial
position and relations.
The neurological findings clearly raise a number of
psychological considerations to which I must now turn.
The psychologists of two generations ago, in England
52 PSYCHOTIC ART

notably James Ward and G. F. Stout, devoted some

attention to awareness of the body, to the way in which it
was singled out as a separate thing from the environment,
to its importance as the spatial centre from which the
position, distance and direction of other perceived objects
are reckoned, and so on. Since that time, however, the
whole subject has been largely disregarded in theoretical
psychology. The main ,development and elaboration of
psychology in relation to the ‘‘body-image”’ can be found
in a series of brilliant studies by the neuro-psychiatrist
P. Schilder and his co-workers. He concluded that the
‘“‘body-image” is a configuration or “Gestalt”. He in-
vestigated the building up of the “‘body-image”’ in chil-
dren and noted the importance of socialization or identifi-
cation with others in this regard. He studied the réle of
mirrors in connection with the body-image; he also
studied ‘‘body-image”’ experiences in dancing and when
travelling in lifts or aeroplanes. He noted that the “‘body-
image’? extends in space and implies space perception;
he studied its time-relations. He was the first to raise the
problem of the perception of internal body-parts, and of
feelings of heaviness and lightness. He advanced a theory
that primitive space-perception originates in connection
with the body openings, the mouth, the anus and the
others. His co-worker, L. Bender, affirmed that the occur-
rence of phantom limbs was a configurational activity.
Schilder’s view that the “‘body-image”’ is a “‘Gestalt”’ led
to the proposition, obvious enough and yet ignored by the
purely neurological investigators, that what goes on in
the body is always part of a total situation in which the
outer world as well as the body itself is involved.
Fundamental and seemingly exhaustive as the work of
Schilder is, much in it is yet obscure and confused. His
experimental findings are never presented in an explicit
and verifiable form. He depended largely on introspective
data with all the pitfalls that such dependence implies.
He ignored the relevance of individual differences and
seems to have applied inadequate control or systematic
variation of conditions. If, however, the criticism in the
 THE CONTENT OF PSYCHOTIC ART 53

following paragraph appears to reflect mainly on his work,

it is because he opened up paths which others have not
ventured to tread.
It must first be noted that though the term “ body-
image” is now well established, it is a very unfortunate
one and Head’s original term “‘ body schema”’ would have
been much more appropriate. Except in relation to optics
and the theory of vision the term ‘‘image”’ has for many
decades in psychology had one meaning only, that is, an
experience which reproduces or copies in part with some
degree of sensory realism a previous perceptual experience
in the absence of the original sensory stimulation. Alterna-
tively it is an element of experience which is centrally
aroused and which possesses all the attributes of sensation.
These definitions might be taken to apply to the phenome-
non of the phantom limb; they certainly do not apply to
most of the phenomena comprised in the term ‘body-
image’’. The chief psychological categories involved in
this matter are not images but percepts and concepts. _
A second and more important criticism of the term
*“body-image’’, advanced by Mr. J. P. S. Robertson, is—
and I agree—that in the discussion of Schilder and others
it is used to denote a number of quite distinct though con-
nected psychologicale phenomena. It is often not clear
which of these is meant; arguments and demonstrations
appropriate to one are quite unwarrantably transferred to
another. A clear distinction of these phenomena is of the
utmost importance in discussing schizophrenic symptom-
atology and schizophrenic painting. They are the follow-
ing:
I. The total complex of sensations or percepts from
the body and concerning it at a given moment. Any or
all of the sense-modalities may be involved. In the
waking organism sensations of touch and proprioceptive
and vestibular sensations are always involved; and also
sensations of sight, except when the organism is awake
with eyes closed. Sensations of hearing are included if
the organism is itself uttering sounds and in various
other circumstances. Interoceptive sensations of heat
54 PSYCHOTIC ART
and cold and pain are often concerned. In special
though rare circumstances even sensations of smell and
taste may be included. This complex, if one likes, may
be called a configuration. It is in continual change and
the emphasis falls now on one sense-modality, now on
the other.
II. The individual’s feeling of ‘‘me, here, now”.
This depends in part on the sensation-complex just
described; it can..bé shaken seriously or otherwise by
disturbances in that complex or contradictory testimony
from different modalities. It also depends on factors
independent of the sensation-complex; memory, per-
ception and knowledge of the immediate environment;
and awareness of the immediate goals toward which the
organism is striving.
III. The individual’s relatively permanent and
static concept or schema of his own body and its parts,
their spatial relations and proportions, their qualities,
their abilities, disabilities and inabilities. Changes in the
sensation-complex can affect this concept only in excep-
tional or pathological circumstances. The schema has a
number of aspects and emphases which differ from
time to time and individual to individual, but for the
most part it remains clearly defined and static for each
normal individual from the end’of the period of physical
growth. It changes slowly in response to the changes of
senescence, perhaps lagging behind them. In special
circumstances, particularly with the maimed, disabled
and handicapped, there may be two such concepts, one
realistic and one idealized, closely similar but differing
in the presence or absence of the disability.
IV. The individual’s concept or schema of the
human body in general, that is, the bodies of other
people, their spatial proportions, qualities and so on.
This is particularly brought to light in drawings. The
concept seems to be completely formed by the end of
the period of physical growth, if not somewhat before.
It is even more permanent and static than the indi-
vidual’s concept of his own body and is realistic except
Jace p. 54
Fig. 8. Painting Under Mescalin
 THE CONTENT OF PSYCHOTIC ART 55

in pathological cases. There is, of course, a separate

though similar schema for each sex. This concept seems
to be less detailed than the individual’s concept of his
own body and for the most part it is based on visual
sensation alone. It has not received as much attention
from other investigators as it deserves.
One must here point out that in the everyday goal-
seeking activities of the normal individual these four
phenomena are always in the background of the organ-
ism’s effort, never in the centre. They come to the front
only when there is a dysfunction in some part (or the
whole), mild or serious, or when the individual for some
reason or other adopts a special introspective attitude.
To show the importance of distinguishing the phe-
nomena just enumerated, one may first refer to one of
Schilder’s investigations. In considering ‘‘body-image’
experiences when going up or down in lifts he noted that
the body in stopping after going down tends to be tele-
scoped and in stopping after ascending, elongated; the
feet vary in relation to the head; there are differences in
the feelings of lightness or heaviness. One can call these
changes in the ‘‘body-image” if one likes. They are
certainly changes in the sensation-complex of the given
moment ; they are unlikely fo affect the individual’s feeling
of identity and still less likely to affect his concept of his
own body. While such changes can be discriminated by
the careful introspective observer they are completely dis-
regarded by the millions who go up and down in lifts
every day, busy about their immediate goals; they have
no effect, it is all but certain, on the concept those people
hold about their own bodies, any more than the optical
phenomena discriminated by the careful introspectionist
affect the visual perception of his environment.
It should be noted that the sensation-complex, the
schema of the individual’s own body and the schema of
the human body in general, may all refer to the body as a
whole or to any of its principal parts. A special réle in
regard to body-parts in the body-schemata is played by
the sex organs, because, as many writers have noted, the
5
56 PSYCHOTIC ART
social ban on their mention or exposure co-exists with a
strong interest in them. One must observe the importance
of the fact without discussing the many theories of the
cause of the ban.
Light on the various “‘body-image’”’ phenomena is
thrown by the cases of deaf-blind individuals such as
Helen Keller. Her account of the way in which she appre-
hends the bodies of others and the human body in general
makes it quite clear’ that her concept is very different
from that of persons with an intact sensorium. Her concept
is one built upon kinaesthetic data and data of touch, of
the sensation of heat and cold, and of smell. She has
related this as nearly as she can to the terms in which the
normal apprehension of the bodies of others is described,
but the final product is something quite different. Her
schema of her own body too, it would appear, with its
absence of the components of sight and hearing, differs
basically from the schema which normal individuals have
of their own bodies.
Distinguishing the four “‘body-image”’ phenomena I
have enumerated is important chiefly in relation to schizo-
phrenia, as I have already indicated. In cases of demon-
strable organic lesion, it is the changes ‘in the perceptual
complex which are mainly emphasized; the changes in
the body concept are not so prominent. Moreover, the
emphasis lies on changes in parts of the body and not the
body as a whole. A special manifestation of schizophrenic
“‘body-image”’ disturbance should be noted at this point;
schizophrenic patients are frequently observed to pinch
themselves in the face or elsewhere to assure themselves
that they really are there, as substantial beings. In schizo-
phrenic symptomatology, however, while there may be
quite often a disturbance of the feeling of identity, of the
concepts of the individual’s own body, and of the concept
of the human body in general, a disturbance in the
sensation-complex is less readily demonstrable. But that
such a disturbance is likely to exist is suggested by certain
psycho-physiological experiments, using a pharmaco-
logical technique which I am about to describe.
 THE CONTENT OF PSYCHOTIC ART 57
Before doing so I wish to summarize the ground we have
covered so far: schizophrenic symptoms may be character-
ized in the most general way by saying that the boundaries
of the ego are eroded by a noxious agent; the ego is for
empirical treatment equated to the body or rather the
‘““body-image”’; this concept includes three phenomena
which frequently show manifest disturbance in schizo-
phrenia; these three phenomena are distinct from but
dependent on a fourth phenomenon which does not show
manifest disturbance in schizophrenia; it will be demon-
trated now that disturbances artificially induced in this
fourth phenomenon can lead to disturbance in the other
three.
In relating schizophrenic symptomatology to ‘‘body-
image”’ disturbance some aspects may seem excluded.
The motor-symptoms, mannerisms and postures would
appear to have a fairly close relation, at any rate for the
most part. The loss of affect, the somatic delusions, the
feelings of depersonalization, have an obvious close con-
nection. Certain of the other thinking disorders may seem
less obviously included. Here a brief account of the build-
ing up of the ‘‘body-image”’ in the child is appropriate.
The child builds up its concept of itself on the basis of the
sensory data already notéd as constituting the body
sensation-complex; these are conjoined with ceaseless
motor activity and experimentation. The child’s own
name becomes a fixating point. A continual process of
comparison of itself with other selves reinforces the child’s
concept of itself and builds up its concept of the human
body in general. The segregation of its own body from the
spatial environment is usually accomplished before the
second year, according to Koffka; knowledge of spatial
and temporal relations is built up slowly but nearly
reaches maturity by about the tenth year, as noted by
Sturt and others. A distinction between the animate and
inanimate environment is learnt securely only in late
childhood; it is easily lost in the adult. This is important
in relation to acquiring the knowledge that thoughts and
feelings can be private to oneself. There seems to be no
58 PSYCHOTIC ART
satisfactory evidence of when children learn that their
thoughts cannot be read, but can at the most be guessed;
but accounts of the study of lies at different ages suggest
that the knowledge comes late in childhood. The notion
that feelings are not private persists beyond childhood
and is never entirely lost by the adult; the ready com-
municability of feeling to the human environment gives it
some semblance of truth. Most adults are at times guilty
of Ruskin’s “pathetic fallacy”, that the inanimate en-
vironment, the plants and the animals, participate in our
feelings of the moment. The notion is stronger in child-
hood. All this suggests that the weakness of the boundaries
of the self in the schizophrenic, shown in ideas of reference
and influence, and in other symptoms, may plausibly be
treated as a weakening of the “‘body-image”’ so that its
contours are no stronger than in early childhood; ‘‘ body-
image” can here be taken to denote both the feeling of
identity, “‘me-here-now’’, and the concept of the body.
To state this is not necessarily to imply a regressive theory
of schizophrenia.
Evidence on the effect of disturbance in the sensation
complex upon the feeling of identity, the individual body-
concept, and the general concept of others’ bodies will
now be offered. It has to do chiefly with the use of mescalin
once more. Mescalin was employed by Guttmann on
60 normal subjects in order to induce what could be re-
garded as an experimental psychosis. Producing as it does
an introspective and hallucinatory state, mescalin intoxi-
cation most characteristically results in altered visual per-
ception, in “‘body-image”’ disturbances, and in disturbed
spatial and temporal experiences. The visual hallucina-
tions are of both a simple and a composite kind. The
hallucinatory pictures change constantly and fluctuate;
and they have been clearly described by one of Gutt-
mann’s subjects, who said, ‘‘When I happened to look at
a burning cigarette it started sparkling like fireworks; the
whole room was filled with small fiery stars. If the cigarette
was moved, circles, oblongs and other shapes appeared”’.
Other subjects reported that perception of their own
 THE CONTENT OF PSYCHOTIC ART 59
bodies became altered; they noticed that their limbs
changed size and shape independently of visual per-
ception and uninfluenced by it. One said that he had a
numb feeling of the mouth as if there were a swelling of
his lips; ‘‘the skin was unusually vivid’’. Another said, “‘I
lost control of the position of my face . . . I pulled faces.”
Alterations in experiences of space and time may be
illustrated by further statements. One subject had a feeling
that his body was inseparable from the surrounding
space: another reported that gradually the feeling of body
vanished and the position of the limbs could not be local-
ized: “‘The posture of the body could hardly be deter-
mined, it could scarcely be separated from its surround-
ings.’ Space for these subjects had new dimensions, new
qualities. Time also became altered. One subject reports:
““I drank a spoonful of soup and looked around me and
looked down again at my plate. It had been in front of me
for hundreds of years, but my movements and conversa-
tion at the table were no slower than in ordinary life;
indeed they appeared somewhat accelerated. I must have
kept everyone waiting.” The breakdown of the boun-
daries between the self and the environment is also well
described by the subject who said, ‘“‘all demarcation melts
away ; one feels lost in fhe cosmos”. Derealization is illus-
trated by the observation that ‘‘all doings and sayings of
the people around me were absolutely unintelligible to
me, like the rules of a strange game”. A disturbance of
conceptual thinking was experienced in some mescalin-
intoxicated subjects in a direct and simple form. One
reported: “‘Each word I thought was connected with a
picture. This hindered me thinking, as the concrete
picture held me.”
Such experiences have been reproduced by other
experimenters with mescalin. Hashish and marihuana
have been used to produce experiences of a similar nature.
This strongly suggests that the noxious agent in schizo-
phrenia first operates on the complex of body sensations
and from there affects the other ‘“‘body-image”’ phe-
nomena.
60 PSYCHOTIC ART
Several other features of the mescalin experiments are
of importance, namely:
I. The disturbed perception of space and time. It
will have been evident at many points in the account of
the ‘‘body-image”’ phenomena, especially the “me-
here-now” feeling, that they depend upon a clear per-
ception of space and time. These experiments lead one
to believe that adequate perception of space and time
depends also upon’ an unimpaired complex of body
sensations.
II. The impairment of ordered conceptual thinking:
verbal symbols were replaced by visual images.
III. The fact that the visual hallucinations might be
regarded as creative experiences of an unusually intense
kind.
These last two features make it necessary to set out
some views upon “‘visualistic” thinking. In early child-
hood, thinking tends to be in terms mainly of visual
images. For the child there are, to begin with, no true
symbols but only imaginal representations of meaning.
Gradually the child learns to think in terms of verbal
symbols devoid of intrinsic meaning. The visual symbols
themselves tend to be altered in quality as the child grows
older, so that they become schematic or conceptual. A
process of condensation and stylization takes place, which
is analogous in a certain degree to the development of
hieroglyphics from picture-writing. According to Gold-
stein and his followers the development of pictorial part-
images into abstract concepts is one which is not complete
until the onset of puberty, and which shows parallelism to
the development of the ego. Most psychologists would
regard this as rather over-simplified and lacking in experi-
mental demonstration ; in some children visualistic think-
ing disappears long before puberty; on the other hand,
some adults show it in a marked degree. Apparently, how-
ever, the more concretistic elements of thinking tend to
disappear at puberty. Visualistic thinking is clearly related
to the eidetic imagery found by Jaensch to be prevalent in
 THE CONTENT OF PSYCHOTIC ART 61

children and to disappear, save in a minority of cases, at

puberty. Jaensch postulated three genetic levels or stages
of imagery—the after-sensation, the eidetic image and
finally the true memory image which is the basis of con-
ceptual thinking. This suggests that visual imagery fades
with the development of conceptional thinking. Con-
versely perhaps alterations in conceptual thinking due to
pathology may show a return to predominantly visualistic
thinking.
An interesting contribution of electro-physiology to
eidetic studies and mescalin intoxication is worth con-
sidering. Electro-encephalographic records show altera-
tion in the resting alpha rhythm of the visual cortex when
the eidetic subject experiences eidetic images. Chweitzer
and his colleagues found that the onset of the effect of the
mescalin flattens the alpha rhythm; this flattening coin-
cides with altered time-space perception and with the
onset of visual hallucinations. These findings underline
the markedly physiological character of what in psycho-
logical terms was called ‘‘visualistic” thinking.
In schizophrenics it would appear that some concepts
disintegrate into pictorial part-images again as if under
the influence of mescalin; there is an increased emphasis
on the perceptual as opposéd to the conceptual elements
in thinking. It seems reasonable to believe also that in
primitives there is a similar emphasis on the perceptual,
though in the absence of empirical evidence one hesitates
to affirm it. This disintegration of concepts appears to be
accompanied by a weakening of conceptual time and
space relation (possibly of perceptual time and space
experiences as well), of the feeling of identity and of the
schemata of the individual’s own body and of the bodies
of others. Possibly all these phenomena depend on altera-
tion in the complex of body-sensations. At any rate,
reality is altered for the schizophrenic. The weakening in
his conceptual and categorical mode of thought brings it
about that for the most part he does not think realistically
but in a way that appears magical or animistic. Perhaps
it would be truer to the facts to say that realistic thinking
62 PSYCHOTIC ART
becomes relatively weakened and non-categorical think-
ing, giving an appearance of magic or animism, relatively
strengthened. The increased tendency to non-categorical
thinking is itself dependent on body-image disturbance,
loss of boundaries between the body and its outer en-
vironment, and distorted time-space relations.
Schizophrenic paintings can now be presented as active
rituals of a creative sort.. They are outcomes of a mode of
thinking that is predominantly non-categorical. The
schizophrenic paints to adjust himself to his altered
reality. He recreates the world so that it shall harmonize
with his experience. He has no message about the real
world, directed to its inhabitants; he is trying to express
an altered world. Not only have his concepts broken up
into pictorial fragments; his total personality has done so
too. The content of his pictures is determined by his
thought disturbances. The fragmentation of the person-
ality directly depends on the disordered “‘body-image”’,
the disordering of the concept of his own body and of the
bodies of others. This is depicted in amputated limbs,
mutilated bodies, detached heads, fusion of parts and the
like. The weakening in the concept of space-relations (and
possibly in their perception) is revealed in a poor presenta-
tion of perspective and a general lack of spatial unity—
the picture is not clearly defined and set off from the
space surrounding it. The disturbance in conceptual (and
perhaps perceptual) time is shown in the depiction of
successive temporal events as simultaneous, and in allied
phenomena; this resembles what we see, for example, in
pre-renaissance painting but, whereas in the latter it de-
pends on a difference of aim and an absence of knowledge
which was to be acquired later (a lack of skill), in the
schizophrenic it is primarily dependent on disorder of
thinking. It would be naive, however, to expect to find
each single symptom neatly expressed in schizophrenic
pictures. They are a general representation of the patient’s
disturbed thinking. They often have a peculiar appeal
through their mixture of drawing with ‘“‘writing in”, that
is, naming what is drawn. This may be regarded as a
 THE CONTENT OF PSYCHOTIC ART 63
mixture of elements primarily conceptual (writing) with
elements primarily perceptual (drawing).
The previous chapter and the present one have both
tended to show that in all human activity, normal or
abnormal, the psychological and the physiological are
closely intermingled. Psychotic art should be evaluated as
an expression of such psycho-physiological unity. Per-
ception is inseparable from motivity, as demonstrated in
*“body-image” formation by Schilder and elsewhere by
others; no strict delineation can be drawn between re-
ception of stimuli and expression. This proposition must
be applied to the art products of the psychotic. A purely
psychological description is insufficient; they must be
appraised physiologically as well. It is not enough to treat
them only as reactions in the form of expressive pheno-
mena; nor is it enough to treat them only as receptive
reflexions of a new experience of the world. Schizophrenic
art contains both expressive and receptive, both motor
and sensory, phenomena. These are essentially biological
because they can be considered not only in terms of
psychology but also in those of physiology.
The advantage of taking an aspect of psychotic art
which can be formulated in biological terms is that it
more easily allows for experimental research both into the
nature of psychosis and into the nature of art either by
means of psycho-physiological investigation as in the
mescalin experiments or by means (which we shall come
to) of psychometric studies. This is the scientific justifica-
tion of such a method.
 “f1V
AN ILLUSTRATIVE CASE OF
SCHIZOPHRENIA
I

I SHALL NOW illustrate the theoretical conclusions of the

previous chapter by means of the case of a 55-year-old
labourer suffering from chronic schizophrenia.
Mr. A. was admitted 14 years ago to a psychiatric
institution. He then was solitary, self-absorbed, reluctant
to answer questions, or to enter into any conversation. He
thought that he was “‘done in” many years ago, and that
if he went home he would be killed. Later his delusions
became more bizarre; he believed that he was in the
secret service, that he understood all the languages of the
world. His periods of quiet solitariness alternated with
periods of slight excitement. The diagnosis established was
schizophrenia. There was no physical abnormality detect-
able except in his right arm and hand; this arm had been
injured in the 1914-1918 war. The power of the right
hand was diminished; abduction of the thumb was lost
and the thenar eminence was flattened. There was some
diminution in sensation over the radial part of his hand.
(The physical findings are identical to-day.) He settled
down ultimately and partook in the regulated life of a
psychiatric institution. A short while ago, however, it was
discovered that he made a fair number of rather interest-
ing drawings, which he used to hide from the medical and
 AN ILLUSTRATIVE CASE OF SCHIZOPHRENIA 65

nursing staff. The case was re-investigated, and I give a

summary of these investigations.
The previous history, secured by the Psychiatric Social
Worker, has been pieced together from information given
by his wife, two of his sisters and three elderly inhabitants
of his birthplace, one of whom taught him in the infant
school. :
Until he was mobilized in 1914, Mr. A. lived in N., a
village a few miles from Maidstone and about one mile
from a railway station. The family consisted of his father,
who was a foreman bricklayer, his mother, two brothers,
three sisters and himself; their standard of living was not
above, and may have been somewhat below, that of the
village in general. His father, now dead, drank to excess,
and the home possibly was not a particularly satisfactory
one; nevertheless, the father and one of the brothers were
steady workers who kept their jobs for a lifetime. The
sisters, who entered domestic service at 14, later married
and are now leading settled, reasonably comfortable lives.
The third brother, said to have been the one with whom
Mr. A. was most friendly, is popularly, though not
officially, believed to have committed suicide at the age
of 27; he was burnt to death in somewhat mysterious
circumstances on the eve’ of his wedding. The mother
never recovered from the shock and died within a year,
following a breakdown that caused her to be sent to a
home.
At school none of the A. family did very well, and Mr.
A. was remarkable only for his cruelty to other children
when he was himself quite young, and for his interest in
drawing. He was quite often in trouble, and was not
regarded as one of the “‘nice boys” of the village, but he
mixed with other children and was not considered by
himself, his family or the villagers to be outstandingly
different from others.
Mr. A.’s work-record differs markedly from that of his
father and surviving brother; he began by being appren-
ticed under his father as a bricklayer, but he never com-
pleted the apprenticeship. Instead he made an abortive
66 PSYCHOTIC ART
attempt to join the Army; on his return home he learned
hedge-cutting and fencing. Later he set up on his own
account in this trade, with six men under him and his
wife dealing with the paper work. Before this there had ~
been his army service from 1914 to 1918, an attempt at
running his own fried-fish business, and a spell, it seems,
of helping with a travelling show.
Mr. A.’s capacity for forming social relationships seems
to have diminished as the grew older; as a young man he
had no particular friend of his own sex, and he came to
mix more and more exclusively with show-people, until
after his marriage to one of them he neither had nor
wanted any company other than his wife and her family.
(He had previously been courtihg a respectable young
domestic servant.) His own family were outraged by his
marrying a woman who had no settled home (to make it
worse she was a widow with a small daughter) and by his
leading a kind of semi-nomadic existence. After his
marriage, he had little contact with his family, although
his mother became at least partly reconciled to his wife.
His last two visits to his old home were made after the
deaths of his brother and of his mother. He was greatly
distressed at the brother’s fate, and was the only one of the
family to see his very badly burned remains.
Mr. A. became the father of four sons. One died a few
years after Mr. A. was admitted to hospital. Of the others
the eldest is married and working on a farm, the second is
in the army, and the youngest lives with Mrs. A. and the
step-daughter, spending the summer picking fruit in
rural Kent and the winter in chopping wood and similar
occupations.
The village offered nothing in the way of cultural pur-
suits and Mr. A.’s interests were very limited. Before his
marriage he worked enthusiastically at the family allot-
ment, but he did no gardening afterwards. He was not
religious and never went to church after he grew up; he
was married in a registry office. He was not concerned
with magic or the supernatural, except that at one time
he learnt water-divining from the old man who taught
 AN ILLUSTRATIVE CASE OF SCHIZOPHRENIA 67

him hedge-cutting. He did not show any body-preoccupa-

tion and he was right-handed. He never read, nor did he
belong to any kind of club or association. He always
maintained his liking for drawing apparently, but un-
fortunately none of his early drawings are now available.
As was mentioned, the neurological condition of his
right hand has not changed since the original examina-
tion. His general physical health is satisfactory and his
appearance is that of a well-nourished elderly man.
The psychiatric and psychometric investigations were
conducted simultaneously for reasons which will be self-
evident in the description below. The psychological in-
vestigations were conducted in a masterly fashion by Mr.
J. P. S. Robertson.
The standard tests applied to Mr. A. were the Wechsler-
Bellevue Intelligence Scale, the Rorschach Ink-Blot Test,
the Thematic Apperception Test, the Group Werd-
Association Test, the Visual-Motor Gestalt Test and the
Pin-Man Test. The Wechsler-Bellevue Scale is a well-
known American system of tests for the assessment of adult
intelligence, now widely employed in this country as well.
The Rorschach and Thematic Apperception Tests are
likewise well-known 4nd extensively used in psycho-
logical practice; in tHe first of these the form-perception
and phantasies of the patient are examined by showing
him a series of ink-blots and asking him to say what they
look like or can represent; in the second the patient’s
phantasies are investigated by showing him a number of
pictures depicting ambiguous human situations and asking
him to tell a story about each of them. The other three
standard tests are less well-known. The Group Word-
Association Test has been much used during the last few
years in the selection of personnel and is now being applied
also in abnormal psychology; the patient in company
with others is shown a series of words on cards and asked
to write down what each word brings to his mind, a time-
limit of fifteen or thirty seconds being imposed. The
Visual-Motor Gestalt Test has been developed by L.
Bender from the Gestalt Figures of Wertheimer; the
68 PSYCHOTIC ART
patient is shown these figures drawn on small cards and
asked either to copy them or to reproduce them from
memory; the test discloses various pathological pheno-
mena, especially disturbance in apprehending configura-
tions and in the perception of size. The Pin-Man Test was
devised by Reitman and standardized by Robertson; the
patient is shown a number of schematized drawings
strongly suggesting the expression of different emotional
states and is asked to say what feelings they represent or
show; the test reveals disturbances in abstract thinking,
especially in the conceptualization of emotion, and dis-
orders of body-imagery.
An indication of Mr. A.’s performance on the standard
tests will be given in this account. In general his perform-
ance in the Wechsler, the Rorschach, the Word-Association
and the Pin-Man Test was typically that of a deteriorated
schizophrenic; Thematic Apperception was beyond his
capacity.
Besides being subjected to the six standard tests Mr. A.
was examined to discover how he would judge length of
lines, size of squares and circles and duration of empty
and filled intervals. The psycho-physical methods of pro-
duction and single stimuli were used. His memory for the
time-order of events was tested in a similar way. The
occurrence in him of space and time disturbances sug-
gested the desirability of these investigations. It was
apparent, however, that whether or not those disturbances
had a perceptual component they were mainly conceptual
in character. So special questionnaires had to be designed
to elicit his general notions of space, time, cosmology,
causality and body-structure and parts. In addition to
this an attempt was made to get him to produce drawings
under standard conditions. 4
First of all we must describe his intellectual and educa-
tional status, as disclosed by the tests and other examina-
tions. On the Wechsler-Bellevue Scale he rated an intelli-
gence quotient of seventy-eight; that is the level of a
border-line mental defective. It is possible by means of
this test-scale to estimate the original intelligence-level of
 AN ILLUSTRATIVE CASE OF SCHIZOPHRENIA 69

demented patients and the extent to which they have

deteriorated intellectually. The suggestion here was that
Mr. A. was originally of dull normal intelligence, not a
mental defective, and that he now shows a pathological
degree of intellectual deterioration. In this test-scale his
efficiency of performance fluctuated from one sub-test to
the other in a manner characteristic of schizophrenics.
His educational status is low. He reads laboriously, having
much trouble over comparatively simple words; most
words longer than a monosyllable he spells out letter by
letter; he cannot read to himself silently but articulates
each word aloud. His spelling is approximate and marked
by frequent omissions of letters and whole syllables. So
far as arithmetic is concerned he can carry out sums on
the four rules and money calculations with creditable
speed ana accuracy, but beyond that he can do nothing.
He left school at thirteen and a half; his attendance had
been somewhat irregular. Taken as a whole, his educa-
tional attainment is more or less what would be expected
in a person of his background and history. In discussing
the oddity of some of his notions one must at all times bear
in mind the extent to which sane individuals of similar
intelligence, background and education would express
beliefs equally at variance ~vith modern knowledge.
Throughout the tests modes of behaviour recurred
again and again and certain beliefs were repeatedly
stated. The first general feature of his behaviour was that
he was almost completely unable to consider any question
except in direct relation to himself and his past experi-
ences. He could view nothing in a detached manner.
The dull and the ignorant not infrequently show this
characteristic in a mild form but as will shortly be evident
in Mr. A. the tendency becomes extreme. To the question
in the Wechsler test: ‘‘Why does the state require people
to sign a register when they get married?” his reply was:
*‘T write a form out for them to show they’re legally
married.”’ To another question: “‘Why are laws neces-
sary?” he responded: ‘‘Because my work has to be paid
for.’ When asked what he would do if he were the first
70 PSYCHOTIC ART

person to discover an outbreak of fire in a cinema, he

said, ‘“‘I don’t go to the pictures!” and could not be
persuaded to consider the question further. Again, when
asked to find something similar about a coat and a dress
he replied: “‘I was always well-dressed. I always used to
wear a coat’”’; and would add nothing more. Three con-
structed accounts of incidents were read to him, re-
sembling real incidents in his life-history but having also
a number of distinguished characteristics ;one concerned
a bicycle-accident, one a fire and one a chase by a bull.
He was able to deal with them only in terms of the true
autobiographical occurrence and could not introduce the
modifications or incorporate the divergent details required
by the constructed story. Such inability to detach the self
from a presented situation is noted by Goldstein as a
principal manifestation of pathological concreteness of
attitude. It is especially characteristic of organic cases but
is also frequent in deteriorated schizophrenics.
The same tendency was shown in the Pin-Man Test
where he apprehended the figures as pictures of himself in
different postures, in the Rorschach where most of the
blots became objects or incidents in his past history, and
in the Thematic Apperception Test so far as he was able
to do it.
A somewhat different but allied tendency was his habit
of identifying himself with every réle or function of im-
portance that was mentioned. Thus he claimed at different
times to have fulfilled almost every possible occupation.
Thus when asked about marriage in the registry office he
had replied “I write out a form for them.” At another
point he claimed to be a doctor: “‘I know all about
diseases and can cure them all. I know what’s wrong with
everybody.” Again he asserted that he was a clergyman:
“T can make any child into a priest or a vicar by christen-
ing him.” At other points he claimed to be a lawyer, a
judge, to know all about weaving and textiles, all about
explosives and chemicals, all about colours and painting,
about building and road-making. When asked, ‘‘ Who is
the present king of England?” he answered, ‘‘ Well, ’'m
Fig.
‘Hyac
9.
Fig. 10. Doodle
 AN ILLUSTRATIVE CASE OF SCHIZOPHRENIA 7I

one of them’’; when asked, “‘How long ago did Christ

live?” he replied, with apparent astonishment, ‘‘He’s
still alive. I’m Christ and I’m here.” The shifting and un-
stable character of these grandiose notions will be ap-
parent. They were expressed side by side with his more
stabilized conception of himself as a farmer, producing
food for the whole world, which will shortly be described.
Together with this identification of himself with occupa-
tions or offices of importance there ran a continual
tendency to compare himself with the examiner, mainly
so far as physique or dress was concerned, in a way quite
irrelevant to the matter under discussion. Several times
he remarked, ‘“‘Here we are sitting side by side, you
sitting there, me sitting here.’’ Once he added to this,
‘““You’ve got a strong constitution. I got a strong constitu-
tion.” Another time he added, “Some people have got
more hair than others, on their body and all. Me and you
are not baldheaded, are we?” On still another occasion
he said, “‘ You got your hat off. I take my hat off”’, suiting
the action to the word. He persisted in regarding all the
test-material, the Wechsler drawings, the Rorschach Ink
Blots, the Thematic Apperception pictures, the Pin-Man
figures, as art products-of the examiner; he expressed his
contempt for them in no .ainmeasured terms! “That’s a
useless drawing, that is. Is that all you can do? I can do
better than that any day.” His main grounds of criticism
were that these drawings were not of living people—
“They’re all dead, all lifeless’ —whereas his drawings
were drawings of people “with life in ’em, like you and me
sitting here. We’re alive.” He also criticized the Thematic
Apperception drawings and a map of the hospital as
being “‘placed”’ or ‘‘hung round” “the wrong way”’; it
was not possible to clarify what he meant by this.
Another form of identification along apparently distinct
lines was the identification of himself with inanimate
objects depicted on the cards. In the Wechsler scale there
is a picture-completion test in which the patient is shown
drawings of objects or situations where something is miss-
ing and is required to say what it is. One of these is of a
6
72 PSYCHOTIC ART

watch where the second hand is absent; the patient looked

at it and remarked “‘There’s a dent in its side where an
artery has been opened up and is bleeding and the doctor
has tried to stop the bleeding with a pebble.’’ Much later
in the examination he narrated an incident during the
First World War when he had been wounded in the arm,
an artery had been ruptured and the army-surgeon,
according to his account, had arrested the bleeding with
a pebble. Another of these pictures represents a door with-
out a handle; here he answered, ‘‘ The keyhole is there, but
my posterior is missing; there is no human posterior on
it.” His preoccupation with the posterior we shall come
to presently. There were several other less clear examples
of identification with inanimate, objects.
His verbal behaviour showed some characteristic
features. There was an extreme repetition of certain auto-
matic phrases appropriately and inappropriately, especi-
ally: ‘All different answers to that”, “‘ITll prove it to
you”’, and “‘I proved it to you when I was a baby”. He
made great use of a neologism, “‘convertical’’, of variable
and vague meaning but usually denoting some sort of
spatial, temporal or causal relation: ‘‘The apple-tree was
convertical to the glass-house’’,.‘‘ The motor-car moves
because the petrol is convertical in the engine”, “‘It
must be Tuesday because my pension is convertical on
Wednesday”. He exhibited the phenomenon of associating
his thoughts by means of homonyms; this might be con-
sidered a form of confusion between words and things. It
gives the appearance of paronomasia, but his attitude was
not that of someone making a pun. Examples of this are
the following: when asked to say what “‘fur’? meant, he
said, “Fur is fur because it goes fur”’ (i.e. far) ; he described
people in the world as “‘needies’” because they ‘‘need
everything, clothes, food and all what you eat, same as
you need plant to make the things, and don’t you knead
bread?”
Besides the repetition of automatic phrases he showed
other forms of perseveration. Notions and words from
an answer to one question often intruded with marked
 AN ILLUSTRATIVE CASE OF SCHIZOPHRENIA 73

inappropriateness into the next answer or the next answer

but one. Several times there was a failure to answer a
question correctly and then at a later point he offered the
right answer to that question but in response to quite a
different one. There was also periodically a perseverative
return to matters raised by the examiner in the early part
of the testing. This was quite distinct from the persevera-
tion of his special pre-occupations. Some of these perse-
verative phenomena are more commonly seen in organic
than schizophrenic cases.
He was not infrequently unable to find words for the
meaning he wanted to express and he indicated it by some
form of concrete representation. Thus when asked to say
what “diamond” meant he could not define it in words
but demonstrated the shape by an ingenious interdigita-
tion of his fingers. Similarly he attempted to express the
meaning of the word microscope (misconceived as tele-
scope) by a miming representation of someone looking out
to sea through a spy-glass. There were a number of such
gestural or miming representations. This method of ex-
pressing meanings by using gesture or concrete representa-
tion in substitution for or supplementation of verbal
statement is not at all uncommon in people of Mr. A.’s
background and cultural status. Nevertheless in his case
it appeared to go beyond the usual and to reach patho-
logical proportions. Several times in the early stages of the
testing he appeared to be in need of paper and pencil to
show pictorially what he wanted to say. Accordingly,
paper and pencil were placed in front of him to use when
he felt it necessary. This technique, however, was not so
successful as might be expected. There was extreme difh-
culty in distracting his attention from a drawing once he
had begun on it; once started he would continue a process
of painstaking elaboration which impeded the general
application of the tests.
Mr. A. exhibited several preoccupations: the most out-
standing of these, both by reason of its unusual character
and its frequent repetition, was the delusion that he was
right outside the world, though apparently spatially in it.
74 PSYCHOTIC ART

Most people were in the world; in particular the examiner

and the hospital authorities were very definitely there;
but besides Mr. A. miners and quarrymen and fishermen
were also outside the world. The birds of the air were out-
side the world and so were sea-fish and river-fish. This
notion invited further investigation; it raised interesting
problems about Mr. A.’s ideas of cosmology and his
orientation in conceptual space.
In so strange a situdtion, apparently in the world and
yet in fact outside it, Mr. A. had a very important task to
perform. Most usually he described it as that of growing
or producing food to maintain all the people in the world.
Food, he insisted, came from outside the world. Some-
times he associated ‘‘ other farmers, all the farmers in the
world”’ with himself in the execution of this task; most
usually he presented it as incumbent on himself alone.
Other forms that the task assumed were that of “making
everybody in the world wise”’’, that of “‘curing all the
diseases in the world’’, and that of “‘mending all the roads
and repairing all the buildings in the world”’. These were
not treated as parallel activities; each was presented at a
given moment as the entire and sole nature of the task.
Further aspects of this task will be described in discussing
Mr. A.’s notions of cosmology. In order to complete the
task he was compelled to live for “twenty hundred years” ;
he never varied this number, however often he mentioned
it. He spoke of the task at all times with great feeling and
conviction. All attempts to ascertain who had imposed
the task were quite unsuccessful; it was clear, however,
that no theological component was involved in the
idea.
A second, apparently quite distinct, preoccupation,
already referred to, was with body-parts, more_ precisely
with the posterior and the anus. This found expression on
a number of occasions though not nearly so frequently or
insistently as the preoccupation just described. His remark
when identifying himself with a picture of a door on one
of the Wechsler cards has already been noted. In doing
the Group Word-Association Test his response to the
 AN ILLUSTRATIVE CASE OF SCHIZOPHRENIA 75

word “alcohol” was “‘Kee-hole, a... hole”’ (ste) and to

the word “body” it was simply “‘hole’’. On the Rorschach
Test he saw in the blots on four separate occasions “‘the
human posterior” or ‘‘organs in the human posterior”;
the nature of these “organs” was vague and he could not
specify them—they were neither the bowels nor the sex
organs, he stated. The oddest example of this preoccupa-
tion emerged when he was asked which season of the year
it was. He replied, “It’s the corn season. I sow all the
corn this month. That’s why I got all the land in the
world ready this month. I did it together with all the
farmers in the world. The corn what we put in this month,
I'll prove it to you.” Here he unexpectedly turned a most
agile somersault and landed on his hands and feet with
his bottom prominently turned upwards. Supported on
his right hand and toes he pointed with his left hand
repeatedly to his anus and said, “‘That’s the way we do
it. We put it in that way. I’ll prove it to you. I proved it
when I was a baby. This is what you do. Farmers and
blacksmiths and all do it.” A number of possible explana-
tions of the meaning of this performance will suggest
themselves; he would not elucidate his meaning any
further himself. In particular he denied that he intended
any reference to the mianufing of the soil.
The marked disordering in conceptual space and time,
alike evident in his drawings and his curious delusions,
suggested an investigation of his judgments of perceptual
space and time and of his concept of the lengths of short
distances and intervals. Nothing outside normal limits
was revealed here. His verbalized judgments of length of
lines, his production of lines or figures equal in length or
size to a given line or figure, were both accurate to an
extent beyond the average. His reproduction of the
Bender-Gestalt figures was better than the average. His
verbalized judgment of filled and unfilled intervals of
time and his production of intervals equal to a given
interval showed a pronounced tendency to over-estima-
tion, especially in the verbalized judgments; this over-
estimation was considerably greater than is usual, but one
76 PSYCHOTIC ART
could not say that it was definitely outside normal limits.
So far as his memory for time-order was concerned he
was tested on his capacity to reproduce a succession of
taps on different coloured blocks, some circular and some
square. He first began to fail when there was a succession
of six taps and he was quite unable to reproduce accurately
a succession of more than seven taps. This, however, is a
creditable performance for one of his intelligence-level
and age. me
It will now be of value to describe his general orienta-
tion in conceptual space and time. He knew the hour of
the day, the day of the week and the month of the year,
though he was unable to give any satisfactory ground for
his statements. He was out by ten days in stating the day
of the month. In explanation of this he said: “I must have
missed the days in talking to you.” He believed that the
year was 1968 and over-estimated his own age by four
years. As to the season he could not name it ‘“‘autumn”’,
but he knew it was the corn season. He was vague about
recurring dates such as Armistice Day, Easter and
Christmas. He found it easier to regard these in terms of
a particular occasion rather than generally; thus when
asked in what month Armistice Day falls he replied, “‘It
was in 1918”, and in what month Christmas falls he said,
‘Last Christmas was in December”. Later he maintained
that there were “‘two Christmases in the year, one last
December and one this”. He was sure that the day of the
week would be the same in different parts of England.
His estimates of how long it would take him to walk or to
go by motor-vehicle to different places in the locality or
to go by train to places further afield were reasonable. He
was able to state his age at leading events in his life, such
as leaving school, marriage and the like, with plausible
accuracy, though he could not give the year. The only
historical events prior to his own life of which he showed
any cognizance were the Crimean War and the Indian
Mutiny. He could not say when Queen Elizabeth or
Napoleon lived. He thought his grandfather would prob-
ably have been alive at the same time as Henry VIII.
 AN ILLUSTRATIVE CASE OF SCHIZOPHRENIA 77

Such ignorance of historical matters is no more than

would be expected in a man so educated and of such
origins. More unusual was his insistence that there had
been no Second World War: “‘There ain’t been no other
war except the one that started in 1914. We know all
about that. It’s no good keep on saying that. There’s only
one war and that’s outside the world. You can have a
million other wars, but only one on the outside of the
world.” He insisted that a war was going on outside the
world, ‘“‘and all the other wars come in the middle of it’’,
but it was impossible to elucidate any other details about
it. When asked how long ago the world began he would
only reply: “I go on a-making it.” When asked if any-
thing existed before the world began he inquired:
“Would there have been fishes and the sea then? That
were all, the fishes in the sea.”’ As to the end of the world
he observed, “‘It will never end because I will go on
a-making it. I’ve over twenty hundred years to do on
public work.”
So far as his orientation in conceptual space was con-
cerned, he was able to describe the relative position of
prominent landmarks in the hospital and its grounds with
considerable accuracy.*He also described accurately the
relative positions of sample towns and villages in East
Surrey and Kent. He was asked to draw a map of the
British Isles; all considered, this was a fair approximation
and he was able to point out the position of towns such as
London, Canterbury, Manchester and Birmingham with
reasonable correctness. There were certain gross errors in
the position of the Isle of Man, Ireland and Newhaven
(where he had once worked). At a subsequent point he
voluntarily corrected all these errors. It should be noted
that in referring to the scenes of his earlier life and to the
present location of his family he was always curiously
vague and spoke of ‘‘back there”’ ; it was difficult to make
him talk precisely on this matter. About the positions of
countries other than the British Isles his knowledge was
mixed, in some respects amazingly accurate, in others
very inexact. He knew the location of countries in the
78 PSYCHOTIC ART
Near East very well; he said that he had been there
during the 1914-1918 war. He was vague about the
position of Russia, ‘“‘Somewhere near Salonika”, and
thought that Australia was just beyond Canada and New
Zealand just beyond that. Such ignorance of geography
is quite in accordance with his educational status ;never-
theless it should be remarked that he has at times pored
over maps and copied them. These questions were pre-
sented by asking to what countries he would come if he
flew in an aeroplane north, south, east and west respec-
tively. He denied that it is possible for aeroplanes to fly:
‘It is all labour in vain,” he said, ‘‘they fall back to the
ground.” So the form of the question had to be modified
by adding the supposition, ‘‘if+it were possible to fly’’,
which he accepted. He stated that if anyone went due
east or west he would come to the sea and after that there
would be nothing but more sea.
Such remarks suggested that Mr. A. did not conceive
the world as round. This question was posed to him direct
by asking what was the shape of the world. He answered,
‘It’s supposed to be round and I go by the circumference
of the world. I believe the world is round meself. All the
things you look at is round. Well, the world must be round.
You put water into a vessel, well, it’s round what it holds!
There’s all different ways with water.” It would appear
that he knows it to be commonly accepted as a fact that
the world is round and that he has seen geographical
globes. Nevertheless his own private concept is of a flat
earth surrounded by sea. He is in a pit underneath this
flat earth “outside the world’. Food is underneath the
world, that is, “outside it”, but comes into it by pushing
up as corn and vegetables to feed animal and man. The
fish which are in the sea “‘outside the world” are also
brought into it to feed people. His task in his pit or quarry
“outside the world” is to force the corn and vegetables
to push their way up through the ground. He is similarly
able to influence from his pit the catching of the fish. He
is also able to affect from his pit ‘‘outside the world” the
minds of men and to make them wise; he can also affect
 AN ILLUSTRATIVE CASE OF SCHIZOPHRENIA 79

diseases. This account, of course, renders precise what is

in its essence vague and fluid.
With regard to his general cosmology he believes that
the sun goes round the earth; he could not at first say
what happens to it at night, but afterwords, using a piece
of knowledge separate from his private construct of the
world, he said it must warm other countries. He stated
that the sun, the moon and the stars were all the same
distance from the earth and no one knew how far that
was. About the sun he observed: “The sun is glory!” He
expressed some very interesting notions about the moon:
**Each moon gives birth to another moon. The moon
~wasteth away every month and another one has to grow
next month. It’s like everybody; it dies and is reborn.”
These notions of the world suggested an inquiry into
his theological ideas. Already when he had declared, “I
am outside the world and all the millions of others are in
the world’’, he had been asked ‘‘ What about God?” He
replied: “‘That’s only a name for a village, that’s all that
means; Godstone and places like that.’? When pressed on
the point: ‘‘Don’t you think there is a God, then?” he
reiterated : ‘‘ No, no, that’s only a name. That’s all named
on the map. Godstone is the name of a village.” At a
later point he answered in similar fashion. He entertains
no notions of immortality, apart from his idea that he
must live for twenty hundred years. When asked what
happens to people after they die, he answered in terms
of burial, the graveyard and decay.
In order to elucidate the strong element in his cognitive
processes of what some investigators have termed “‘ magical
thinking”? and others would interpret as “conceptual
weakening”’ he was asked a number of questions about
causality. He accounted for the movement of trains,
motor-cars, lifts, threshing machines, animals and human
beings all in the same manner: “they’re started up and
once they’re started they’ve just got to go; they keep on
going and going.” With regard to weather-phenomena,
rain, wind, thunder and lightning, he gave an account
not meteorologically correct but reasonable for one of his
80 PSYCHOTIC ART
education; thus of lightning he said, ‘“‘The clouds go
together with a bang and that makes lightning.” The
winds, he said, ‘“‘come from across the sea outside the
world’’. He rejected most of the common superstitions— °
the number thirteen, spilling salt, black cats, robins as
signs of death and others; but stated, however, that it
was bad to walk under ladders. He had already claimed
that he could read all the examiner’s thoughts and knew
in advance every questidn that he was going to be asked.
He now stated that he could read “‘everybody’s thoughts,
builders and all’. He also stated that he could put
thoughts into people’s minds because “‘most people are
not thinking about anything at all’’; he could influence
them to do anything that he wanted and make them die
or live, but “‘I like to keep them alive. If they do what
they’re told they keep alive.” He would not expatiate
upon how it was possible to achieve these things. With
regard to number, I have mentioned the twenty hundred
years that he is going to live. The number forty-two also
had a special attraction for him. Thus he described a
soldier injured in the First World War as having forty-
two wounds between his legs; he could not describe how
this number was counted. At a later point he stated that
a milk separator had forty-two cups to it. He declared
that he understood all about people’s dreams, “‘just like
a doctor”, but he denied that he had any dreams himself.
His notions of birth and sex betrayed interesting
features. Early in the testing he stated: “‘I understand a
lot, cripples, ruptures and all that. If a baby is born
crippled it came out of a crippled womb.” Later he
observed that he and the examiner were born different
ways: he was born inside out but the examiner and all
the other people in the world were born outside out;
afterwards he modified this by saying that everybody was
born inside out. These remarks were spontaneous. When
questioned about conception, he denied that the male
played any part in it. Women just became pregnant; he
could not say why. He was asked to draw a figure of a
man; then he was asked to draw the sex organs. He
 AN ILLUSTRATIVE CASE OF SCHIZOPHRENIA 81

refused to do this, then and subsequently: ‘‘That would

take too long to do. That takes a lot of time to do. I
haven’t time enough to think about that.”
His concept of internal body-parts was investigated by
getting him to draw a human figure and then insert the
chief internal organs. No feature of special interest
occurred in this performance. He was also asked a number
of questions about inner organs. The curious answers here
seemed to depend for the most part on ignorance rather
than disturbance. He stated that the brain was in the back
but not the front of the skull; under pressure as to what
was behind the front of the skull he agreed that the brain
must be there too. He declared that the lungs were con-
cerned with chewing food, the kidneys with digestion, the
liver with breathing. A matter of greater interest was his
insistence that there were organs “‘in your posterior” other
than the bowels or the sex organs; under pressure to
explain what these were he withdrew the statement.
Asked to say what there was behind the eyes he said,
“There’s danger behind them eyes more than what you
understand. There’s dark nights and other nights behind
the eyes. Your head’s not built the same as what mine is.
There’s a lot of difference. Your head’s not been hurt at
all. Mine’s had moré hufts than you’d ever understand.
I’ve had the feeling of it and you’ve not.” He stated that
people were blue inside because their eyes were blue;
people were not red inside like animals; if they were red
inside there was something wrong with them and they
would die.
With regard to external body-parts one or two points
emerged in his sketches. The left ear was consistently
drawn larger than the right; there was no such dys-
symmetry in the other bilateral organs. In drawing a face
he increased the size of the nostrils, with the observation,
‘“must make the holes larger”. He also spent some time
elaborating the eyelashes, saying, “give him plenty of
hair”.
His Rorschach and Word-Association responses sug-
gested an inquiry into his attitudes to colour. On the
82 PSYCHOTIC ART
Rorschach he exhibited the phenomenon of several pure
colour responses, a characteristic behaviour of deteriorated
schizophrenics. In the Word-Association there were some
odd colour answers: thus to Blood he responded “‘Black”’, ©
to Heart ‘‘ Black” and to Death “‘Yellow”’. He was asked
his preferences about the various colours; he stated that
he liked blue and purple, greatly disliked yellow; about
all other colours he merely said, ‘‘ All right in its place”.
A number of colours-.were named to him and he was
asked to exemplify each of them; his answers were:
green for “‘beans”’, blue for “lilac”, red for “‘paint”’,
yellow for ‘‘a ruler”, brown for “‘fruit”, black for “‘a
horse”, grey for “‘wool”, and white for “‘paper”. A
number of objects were named td him and he was asked
to say what colour they were. Most of his answers were
correct. One or two were remarkable: thus of blood he
said, ‘‘it is all colours but generally it is black”; coal he
said was blue: “‘if a coal marked your skin it would be a
blue mark”; milk he also said was blue. His statement
that people are blue inside has already been noted. These
attitudes in relation to colour are of interest in connection
with his refusal to do any painting. It may be added here
that his. colour-vision as tested by the Ishihara Test is
completely normal. ‘
Attempts to investigate his drawing under standard
conditions were not successful, chiefly because he cannot
sketch rapidly but elaborates his work slowly and with
much effort. When he does a drawing he continues to fill
in the whole sheet with matter irrelevant to the original
subject but expressing his thought of the moment or the
topic recently mentioned by the examiner. Mostly he
talks as he works, less often he is silent. He finds it neces-
sary to label with a written word many of the, objects
drawn. As I have said, three incidents were read to him
which he was asked to illustrate. In two of these drawings
he exhibited the phenomenon of spatial superposition of
temporally successive events; in one of them he actually
carried out the drawing, in the other a critical attitude
emerged spontaneously and he stopped in the middle.
 AN ILLUSTRATIVE CASE OF SCHIZOPHRENIA 83

It will be evident that most of his behaviour when

examined psychometrically can be described as demon-
strating either inability to think conceptually or marked
weakening in his capacity to do so. The purely perceptual
continually invades the conceptual.

II

The psychiatric and psychometric study summarized

above reveals a chronic schizophrenic, who exhibits some
special features, which were discussed theoretically in the
third chapter. To Freudian analysts the case seems to
offer self-evident explanations. His meticulousness in
drawing and his definite preoccupation with his posterior,
his talk about it as soon as sex matters are mentioned, his
constant worry about money, all invite the ‘‘anal erotic”
commentary. His magic ceremonies carried out by pro-
ducing the drawings fit in well with Freudian principles.
On the other hand, the archaic appearance of his work
would invite a Jungian analysis. Such interpretations,
however, are lacking in sufficient proof, as I shall argue
later.
One of the striking’features of the patient’s behaviour
was the relation of everything to himself, and his constant
comparison of himself to the examiner. This is a feature
seen In some organic conditions as well as in children. It
appears that the basic psychophysiological mechanism of
it lies in the patient’s attempt to experiment with his body-
image, integrating it in comparison with the examiner.
Such attempts are a normal phenomenon in children,
because they are constantly shaping and re-building
their body-image. Schizophrenics, however, are losing it,
hence the patient’s compensatory attempt to integrate his
body-image through identification. His pre-occupation
with his body-parts refers straightforwardly to body-
image disturbances through which the outside world
intrudes into the body. The disturbance is partly ex-
pressed in shift of the body-image in the anterior-posterior
direction. Schilder found that in general the image of the
84 PSYCHOTIC ART
brain is of something heavy in the region of the frontal
bones. Mr. A.’s brain-image is at the occipital region, and
so is his image of his testes. The disproportional repre-
sentation of his left side appears to be dependent on the —
injury to his right arm and the fact that he has taught
himself to make drawings with his left hand; because of
this his left is over-emphasized and made dominant. Why
this newly acquired leading hand shifted the body-image
in a posterior direction’ could not be elucidated. His
identifications with pictures in the test were similar to
those of brain-injured cases; as Goldstein emphasized,
such cases show a tendency to “‘physiognomic concrete-
ness’’. One of Goldstein’s patients described going through
the door as ‘‘the door swallows me’’. Mr. A. shows similar
tendencies as we saw in his responses to the picture-
completion test and in the “‘keyhole”’ association response.
Such concreteness, which I shall treat more fully in
Chapter 5, means that the function of abstract thinking
is impaired. This is supported by further observations
such as his association on ‘‘fur’’. As was said, it was not
punning; it was due to the fact that at any moment words
lose their conceptual value for such patients in a manner
unsuspected by the hearer; they suddenly acquire a funda-
mentally purely perceptual value, or a mixture of per-
ceptual and conceptual qualities. It might well be that
his perseveration is another expression of a merely per-
ceptual value of words, which are just nee
repeated.
Animism as an expression of disturbed body-imagery
and impaired conceptual thinking is well instanced by
Mr. A.’s remarks on movement, when he indicated that
all movements, human or mechanical, have the same
motivation behind them.
All those evaluations, however, become more evident
when studied in connection with his drawings, of which
only three will be reproduced here. The first one is ‘‘ The
Derby”, the second ‘“‘The Old River” and the third
“The Horses and Flooding” (Figs. 11, 12 and 13). In
general they show the typical schizophrenic features;
 AN ILLUSTRATIVE CASE OF SCHIZOPHRENIA 85

meticulous over-elaboration of details, playful irre-

levancies such as the butterfly in “‘The Horses and
Flooding”’, “‘writing in”, etc., with mannerisms in the
lettering. “‘The Derby” is interesting because its content
demands a spatial representation of a temporal event.
His technique in solving this is twofold. The horses, when
lined up, are superimposed on one another as if each
were transparent, so that the whole line can be seen.
After the start he represents them twice again, when
running and at the finish. These three representations of
the runners are deliberate, because at the start there is no
hot air steaming from the horses’ nostrils, but later this is
carefully represented to indicate that the course is coming
to a finish, Thus, it appears, spatial representation of
duration presented little that is problematic to Mr. A.;
this might point to the fact that his time-space system has
lost its proper interrelation. In the “Old River” all
figures are himself; when it was pointed out to him that
he could not be eight times in the same landscape at a
given moment, he argued that he could. He also argued
that the rider on horseback was himself too, but ‘“‘that
happened at another time’. He was asked why then it
should be put into the-same picture; he stated that “all
things happen all the time’. It appeared that in dis-
cussing his pictures his idea of time somewhat contra-
dicted the psychometric findings; it was a time relation
of spatial character. The difference here probably de-
pends on the fact that the psychometric examination
pinned Mr. A. down to precise statements and induced
critical realistic attitudes, whereas in discussing the draw-
ings he was free to follow his preferred phantastic modes
of thought. The disturbed spatial experience is also ex-
pressed in faulty configuration (Gestaltung) ; these pic-
tures have no delineation in relation to the surrounding
space—they are completely lacking in spatial unity. Even
in ‘The Derby’’, where the oval shape of the race-course
would have automatically given a closed shape, it re-
mained open; questions about this only led to long,
irrelevant discussions with Mr. A.
86 PSYCHOTIC ART
As it was emphasized, disturbed time-space relations
are interconnected with disturbances of conceptual think-
ing. These disturbances are well exemplified in the pic-
tures. The mixture of conceptual elements, the “writing:
in’’, is one of them. More striking are these mixtures of
conceptual and concretistic representation in the figures
themselves. For instance, ‘‘The Horses” is primarily
representation ; two horses actually were in a field. The
River Medway had flooded the field and the horses had
nothing to eat. Hence Mr. A. (in the top corner of the
picture) brought them hay to feed them. But to give more
food to them he drew a milk bottle between the heads of
the two horses, so that for certain they should not starve.
The horses, however, are not produced only as he saw
them existing; though they are standing on all four limbs,
the horse-shoes are drawn in on each hoof with nails and
all, because he knows they had shoes—horses in general
are shod. Similarly in the case of the trees, though their
appearance is only trunk and crown, he always draws
the roots as well, because root, trunk and crown are
essential parts of a tree. Aestheticians have drawn atten-
tion to the fact that oriental artists do not paint the actual
appearance only but the essence of the thing as well;
consequently in most of their pictures it is not a tree
depicted but the tree. Similarly Mr. A.’s pictures show a
mixture of reproduction of the existent and the essential,
the reproduction of perceptual reality and also of its
abstracted concept. These types of symbol are the ones
which have induced Jung’s adherents to assume a uni-
versality of symbols. In some primitive cultures the
“skeleton drawing”’, or “X-ray drawing”’, is a frequent
way of pictorial representation. In fact, Mr. A.’s fish, as in
“The Old River”’, is almost identical with drawings of the
Kakadu tribe as reproduced in B. Spencer’s book. As I have
said, primitives are in process of conceptualizing, whereas
schizophrenics are deteriorating from abstract thinking to
a level which issimilar to some pre-literate thinking, since it
is a mixture of concepts and concretistic elements. Hence
the similarity between the pictorial expressions.
face p 86
AIATY PIO PUL, “1 SL
 AN ILLUSTRATIVE CASE OF SCHIZOPHRENIA 87

The body-image disturbances are well appreciated

when one compares “The Old River” with ‘‘The
Derby”’. In the latter all figures, including the barmaids
in the beer-tent, fill their clothes well; they all have sub-
stantial bodies. Mr. A. himself, however, in ‘‘The Old
River” is merely a faint skeleton held together only by
clothing. When, after fishing, he undresses, the clothing,
like a live thing, lies on the ground leaving him a pathetic
lemur, shivering; and in the water his arms become dis-
solved. When discussing this picture, as I have indicated,
he admitted that all the figures were himself, and he
stated that he was thin, adding that the little figure in the
circle “‘is me outside the world”. After much discussion
he spontaneously returned to this picture and said that
he could be himself and everything else as well, and that
the picture started by himself being outside the world.
This seems to be an attempt to demarcate himself some-
how, as otherwise he would be one with the whole world,
thus developing an animistic belief. He not only stated
that he was every figure in the picture, but that he was the
whole world and the tree in the picture as well. He com-
mented on this, saying: “‘I am the tree as well; you can be
all these things. You eat yeast, which comes from the tree,
so you become a tree. I am a tree and I am all the people
‘in the world.” He re-emphasized that he was a tree and a
person and all the world. This short quotation might have
come from a pre-literate native, the animism is so marked.
It strikingly expressed the loss of body demarcations and
dissolution of the body in the temporal and spatial sur-
roundings. One should regard this as chiefly a cognitive
phenomenon. The outlook of the schizophrenic patient
approximates in this respect to what has often been
observed in very young children. The spatial boundaries
between the body and the outside world are extremely
tenuous; there is deficiency in the conceptual ordering of
space. The conceptual ordering of time is also deficient;
there is no schema of past events; the distinction between
what is past and what is present loses its sharpness.
It seems that when he was confronted with his pictures
7
88 PSYCHOTIC ART
relevant material was easily obtained. This brings me to
the final question, what function these pictures had for
him, whether they had magic value? When asked why he
did them, he gave on various occasions identical answers.
He said that those pictures ‘‘prove that I am here”’, Le.
that he exists at present. All the things in the pictures did
happen, and by depicting his past life he feels assured of
his existence in the present—and as it was made certain,
present was literally meant and not future or eternity.
Thus those pictures fulfilled for him an absolutely vital
function ; they kept him, so to say, alive. I have remarked
schizophrenics often pinch themselves or ‘inflict other
injuries to themselves, such as pulling out their hair,
actions which make them experience the reality of their
body. Schizophrenic paintings are similar actions in a
creative sense; Mr. A. confirmed that through drawing
he could experience and maintain his existence.
To sum it up, the motivating factors in his drawings
were: weakening of his conceptual thinking, which was
also ascertained psychometrically; disturbance of his
body-image, which was also evident clinically; and dis-
turbance of time-space relations, evidenced in the pictures
and supported clinically. His. “‘animism” was inter-
connected with those factors; the interpretative concept
of “‘magic” was not necessary ‘for elucidation of his
actions. It should be re-emphasized that the evaluation
outlined is descriptive and not speculative. One is aware,
however, that these biological factors are not the total
motivation of schizophrenic art; neither do they answer
the problem of why Mr. A. is creative and other schizo-
phrenic patients are not.
 V

THE NATURE OF PSYCHOTIC

ART

The cognitive aspect—Spearman’s theory and criticism of it—

Goldstein's approach—Similarities between psychotic and non-
psychotic art products.
THE PRECEDING CHAPTERS have argued that the peculiari-
ties and special features of schizophrenic painting depend
primarily on cognitive abnormalities in the patient. One
basic motivation leading to the spontaneous and abundant
production of pictures by schizophrenics is, according to
the evidence I have adduced, their attempt to adjust
themselves to an altered apprehension of reality. The
disturbances of thinking in schizophrenia have been
viewed from a psycho-physiological standpoint with par-
ticular attention to the phenomenon of the body-image,
an approach which I believe to be well founded in biology.
In analysing the body-image as a conceptual schema we
have seen how closely it is linked with the concepts of
space and time; and we have seen that disturbances in
the concepts of space and time can be induced experi-
mentally by the administration of mescalin and that the
disturbances so occasioned are accompanied by visual
hallucinations. I also pointed out that disordering in the
conceptual systems of space and time leads inevitably to
a general disorganization of conceptual thinking.
gO PSYCHOTIC ART

My previous discussion has touched on the number of

apparent resemblances between schizophrenic painting
and modern pictorial art. This apparent similarity has
been seized on by many commentators on modern art
who do not sympathize with its development. It is fre-
quently mentioned by visitors to art exhibitions, who have
not trained themselves to appreciate the work of modern
painters or who are deficient in the capacity for aesthetic
enjoyment. But sometimes the similarity is also accepted
by present-day artists and those who are in sympathy
with modern painting. Schizophrenic art products are
then regarded as having aesthetic status equivalent to
that of paintings by normal artists; the fact of mental ill-
ness is considered either to be irrelevant or else as a
stimulus to satisfactory work. Those who take the latter
view have usually had little opportunity of examining
much psychotic painting; moreover, they have probably
not formulated at all clearly for themselves the character-
istics which distinguish pictorial production as an
aesthetic activity. It must be emphasized very strongly
that when large numbers of art products by normal
modern artists and by schizophrenic patients are carefully
scrutinized and compared, the resemblances are found to
be apparent and superficial, the differences fundamental
and profound. The work of nornial artists reveals a de-
liberate re-structuring of presented reality into complex
patterns or relations of form and colour. The work of
schizophrenics reveals no such deliberate and complex re-
structuring but on the contrary a general lack of structure,
a disintegration of perceptual relations and a dissolution
of concepts. The apparent similarity is due to the fact
that both in modern and in schizophrenic pictorial
activity the relations of presented reality are radically
altered ;in normal painting before the modern epoch the
alterations were usually less radical. In the painting of
modern artists—this is the basic, all-important difference
—the radical alteration is one of re-organization, in the
work of schizophrenics it is one of disorganization. The
patterning of normal artists is complex, many-sided and
 THE NATURE OF PSYCHOTIC ART gI

systematic; the patterning of schizophrenics is chiefly

disorganized and unsystematic.
I have purposely set out the difference once more, in
sharply opposed terms, whereas in fact there exist inter-
mediate cases in which schizophrenic illness interacts
with artistic ability and training. Such cases as these have
reinforced the supposition that trends in modern art are
related to the phenomena of mental illness. A few normal
artists develop an overt schizophrenic disorder and under
its influence their work steadily disintegrates; I have dis-
cussed one such instance in Chapter 2. No doubt, too, a
certain number of apparently normal artists, like some
apparently normal individuals in other professions, have
latent schizophrenic tendencies and exhibit underlying
schizophrenic modes of thought; such tendencies can be
detected in their work by the observer skilled enough in
discrimination. This is true only of a small minority of
artists. It also happens that some schizophrenic patients
have high innate artistic abilities and sufficient training
to give their work a genuine artistic character, though not
sufficient to constitute them artists. The work of such
patients has, besides its psychotic features, real aesthetic
value of greater or less-degree and can be appreciated in
the same manner as normal art.. Despite all intermediate
possibilities, however, the general distinction between
normal modern art and the pictorial activity of the
mentally diseased is clear and outstanding.
This stress on the relational character of normal art and
on thinking disorders as the primary determinant of schizo-
phrenic pictorial production demands a more extended
discussion of art as a cognitive phenomenon. My view
implies a close interconnection between art and con-
.ceptional thinking. Both may be described as human
peculiarities. Man’s capacity for conceptual thinking
must be regarded as the capacity which most distinguishes
him from the lower animals and the one on which his
mastery of his environment essentially depends. The
barest rudiments of conceptual thinking can be detected
below the human level in the recognition of similarities,
92 PSYCHOTIC ART
in the isolation of aspects and in other behaviours shown
in problem-solving situations by animals which possess a
well-defined cortex, but it does not require demonstration
that man possesses these capacities in a measure far tran-
scending that of any other animal and that he alone is
capable of dealing with the possible as well as the actual.
Artistic production in any degree of development is like-
wise an exclusively human characteristic. Nothing parallel
to it is evident in the infra-human mammalian series.
Certain activities in birds, it is true, such as the displays
associated with mating and the rituals which go with a
change of duties in the care of the young, may be a
parallel specialized development of the same basic ten-
dency in animal nature which is latent in the infra-human
mammals; artistic development then, like colour-dis-
crimination, paternal care and quasi-permanent mating,
might be considered as a concealed possibility in the
animal organism which evolutionary processes bring to
the surface in widely separated zoological classes. The
complex, relational character of artistic production in
man, however, makes it quite distinctive of the human
species and at the same time indicates how closely it is
involved with conceptional thinking.
Consideration of art as a cognitive phenomenon at once
raises the problem of why certain individuals are able to
produce pictorial art while others are not. In dealing with
psychotic art it raises the problem of why only some
schizophrenics paint or draw. These matters are not, of
course, purely cognitive; orectic questions of drive and
motivations are likewise concerned. But here, I believe,
the cognitive aspect is the more important. One is led to
inquire what cognitive difference can be found between
the artistic and the non-artistic in pictorial art, First it is
necessary to make a general analysis of the cognitive
activities and capacities involved in aesthetic drawing or
painting. Four independent aspects can be distinguished:
unlearned motor and perceptual aptitudes, learned skills
of craftsmanship and technique, relational thinking and
aesthetic creativity. As a basis for this discussion, especially
 THE NATURE OF PSYCHOTIC ART 93

of the motor and perceptual skills, it will be desirable to

outline the ontogenetic development of drawing in the
child. This has been investigated chiefly in America, but Sir
Cyril Burt, who has ably summarized the American con-
clusions, has verified that in general they can be applied
also to children in Great Britain. Essentially similar
accounts have been given by Lowenfeld and many others.
Burt notes that the development of drawing in children
is a matter of spasmodic growth with unexpected meta-
morphoses. The progression shows changes in kind as
well as in degree; there is a movement from one unique
phase to another through a series of transformations. He
distinguishes seven main stages, each of which glides im-
perceptibly into the next; within several of these stages he
distinguishes sub-stages. In the early stages up to the age
of 5 the-interest is motor rather than visual; there is
little control by sight. To begin with, movements of the
arm are dominant; gradually movements of the wrist
come to dominate movements of the arm and in turn are
dominated by finger-movements. The earliest stage is that
of scribble; the child begins with purposeless pencillings
enjoyed for the sake of movement and passes through
phases of purposive. pencilling, imitative pencilling and
localized pencilling tg a point where activity is limited to
a single movement instead of rhythmic oscillations. The
rate and succession of development is modified by instruc-
tion at home or at school. The child names his products
in various ways, but his interest tends to focus more and
more exclusively on representing the human form. This
fact is clearly correlated with that building up of the body-
schema to which I have referred in Chapter 4. The human
form is first represented with juxtaposition rather than
synthesis of parts and then at the stage of descriptive
symbolism develops into a crude symbolic schema. The
schema varies from child to child but each child sticks to
the same schema for man and woman and for animals,
if he represents them. Both at this stage and at the subse-
quent one, which Burt calls descriptive realism, the child
is thinking of the generic type, not the model. Perceptual
94 PSYCHOTIC ART
interest is in the background; most children do not look
at the model they are drawing, a few look at it once only.
At this stage, of course, the process of concept formation
is still in full swing. During this period, about the age of
seven, the important change from full-face to profile
representation occurs; some children go through a phase
in which they produce hybrids between the two incom-
patible aspects. Round about the ages of g to 10 there
occurs a sharp metamorphosis. Motor skill and repre-
sentative technique improve immensely and interest shifts
to detailed perceptual observation. The child traces the
drawings of others and draws spontaneously from nature.
He begins to represent landscapes and particular indi-
viduals. Representation moves from a two-dimensional to
a three-dimensional sub-phase. In the pre-pubertal period,
usually about the age of 13, there ensues a stage of re-
pression, in which drawings often show an apparent
deterioration or regression. Conventional designs are pro-
duced but the human figure is avoided. Burt remarks that
obscure intellectual and emotional factors underlie this
repression but suggests that increased self-criticism, more
careful perceptual observation, and a transference of
interest to expression through language. may be the chief
determinants. After this phase of repression the majority
of children never draw again. In a few, however, there is
an artistic revival in early adolescence when for the first
time genuine aesthetic activity appears. Drawings tell a
story, or, if instruction has favoured it, demonstrate
principles of formal design; when human figures are
represented they approximate to the portraits of the pro-
fessional artist.
As already noted, teaching considerably modifies the
progression of stages I have just described. It has tradition-
ally been the endeavour of teachers to develop the child’s
perceptual observations as early and fully as possible and
to encourage the drawings of various objects in addition
to the human figure. Modern teachers of art have empha-
sized and encouraged creative ability rather than motor
and perceptual skills. They believe that the phase of pre-
 THE NATURE OF PSYCHOTIC ART 95

pubertal repression need not inevitably ensue and have

done everything to tide it over or eliminate it. It is their
contention that the motor and perceptual capacities and
the creative ability on which the production of aesthetic-
ally satisfying art depends are latent in every human being
and can be made manifest by skilful instruction and en-
couragement. There is no doubt that this is true. But it
is also true that great individual differences exist and that
some persons have potentialities much in excess of the
majority.
So far as motor capacities are concerned the existence
of marked individual differences among children in the
efficiency of their performance is implied at a number of
points in Burt’s account. He does not, however, discuss
them very explicitly except in connection with mental
deficiency. The fact of considerable individual differences
in sheer motor capacity to draw can easily be verified by
asking a number of adults who have had no training to
sketch a man or a cat or to copy some form or figure.
Quite independently of perceptual and conceptual aspects
the results vary from the highly effective to the grossly
inadequate. In fact, one can say that a fair number of
individuals have a-distinct disability in this direction.
Teachers of drawing likewise agree that both children and
adults vary markedly in the speed with which they acquire
the necessary motor skills and in the level they finally
reach. The variation almost certainly depends on innate
differences in motor aptitude. It shows some relationship
to general intelligence, but as Burt indicates not a single
or linear one. That the relationship is not very close is
suggested by fairly numerous cases in which motor dis-
ability in drawing co-exists with high efficiency in dealing
with abstract verbal or numerical material. Possession of
this innate motor aptitude in a considerable degree is
without doubt an essential component in pictorial pro-
duction, aesthetic and non-aesthetic. It is a necessary
condition of the fact that some people become pictorial
artists while others do not. Its occurrence in low or high
degree would also appear to be a determinant of the fact
96 PSYCHOTIC ART
that only some schizophrenics draw or paint. While, how-
ever, it is a necessary condition of pictorial production it is
very far from being a sufficient one, as I shall shortly argue.
Most artists and persons who display artistic talents are
found to have drawn well in childhood, that is to say, they
possessed in high measure the motor aptitude necessary
for effective representation on paper. There appear to be
some exceptions, however, and the converse is not true;
many people who draw well in childhood show no artistic
abilities in later life ard in certain cases are even not very
effective in the motor skills of drawing. These circum-
stances, as Burt indicates, make it extremely difficult to
diagnose special artistic powers before puberty; the fact
that motor skill is only one component of artistic ability
complicates the situation still more. Even in the most
precocious, Burt states it is not possible to predict artistic
talent before the calendar age of eleven. Nevertheless,
examination of the life-history of professional artists indi-
cates that their steps were first set in this direction by the
realization that they possessed in an unusual degree the
motor skill for pictorial representation, the satisfaction
this gave them and the approbation it won from others.
That some possessing this skill never become artists de-
pends partly on environmental factors, lack of oppor-
tunity and encouragement or the like, but mainly on
deficiency in other components of artistic ability, relational
thinking and creativity.
The conditions underlying differences in the motor
aptitude for drawing have not been very satisfactorily
analysed or investigated. Educational psychologists have
inquired into the cognate problem of the movements em-
ployed in handwriting, but so far as drawing is concerned
their interest has lain principally in the training of per-
ceptual observation and in the encouragement of creative
activity. In the vocational guidance of adolescents no
elaborate analysis of what is involved by the ability to
draw has been required, since an individual’s success in
an artistic career can be most easily and reliably pre-
dicted by examining his actual products.
 THE NATURE OF PSYCHOTIC ART 97

It is evident that the motor aptitude for drawing

belongs to the class of manual dexterities. The general
characteristics of these have been investigated by a number
of workers, especially in this country, by F. M. Earle,
F. Gaw and J. Cox; their results agree more or less com-
pletely. All investigators concur that manual dexterity
is quite distinct from mechanical aptitude and nearly all
that manual dexterity is specific to a particular task, that
is, that there are manual dexterities and not a general
capacity of manual dexterity. Earle and Gaw analyse any
given manual dexterity into two components—first, a co-
ordination of the separate activities of different muscle
systems, brought about by the subordination of these
separate movements to the purpose of the activity as a
whole, and secondly, a general bodily “‘set”’, peculiar to
the person carrying out the movement. The first com-
ponent they regard as having its physical basis in the
connections of the nervous system; it is influenced by
practice, fatigue, drugs, emotional excitement and the
like. The second component depends on structure, length
of limbs, muscular development and so on; this factor of
““ set’ varies from one process to the other and is prob-
ably responsible for thé high independence of the abilities
involved in manual dextérities. Earle and Gaw discuss
classes of purposive manual movements; drawing is
nearest to their third class, those movements in which
accuracy is the chief factor and rate of movement is
comparatively unimportant.
The studies of F. N. Freeman on the manual dexterities
in handwriting help to explain those involved in drawing.
The writing and drawing dexterities both centre on
directing with the hand the movements of an implement
such as a pencil or pen. Both are complex organizations
of many elementary or simple movements. The most basic
dexterity of all is that of separating the first and second
fingers in their action from the third and fourth so that the
implement is grasped between the thumb and first two
fingers while the third and fourth support the weight of
the hand. It is a familiar fact that the capacity to place
98 PSYCHOTIC ART
the thumb against the tip of the fingers in grasping an
object is one of those distinctive of man. The more primi-
tive form of grasping, which appears first in the child and
is the only form seen in the other primates, is that of fold-
ing the four fingers about the object without using the
thumb. Besides the dexterity of grasping, other important
dexterities involved in the process of writing and drawing
are various movements of the arm joints, especially
shoulder, fore-arm and wrist movements. As already
noted, the progression is from emphasis on arm-move-
ments to emphasis on wrist-movements and from the
latter to emphasis on finger-movements. Sometimes it is
stated that the progression is from fundamental or phylo-
genetically old movements to accessory or phylogenetic-
ally recent movements; the fundamental movements are
sometimes identified with movements of the large muscles
and sometimes with movements concerned with the trunk
or parts of limbs next to the trunk. The empirical in-
vestigations, however, indicate that the progression cannot
be satisfactorily described in these terms. As the child
advances in its capacity to write or draw, the basic com-
ponent dexterities are built up into a total large move-
ment which is rhythmical and regular. Besides the manual
dexterities, adjustments of the eye and of the body posture
are integrated into the total movement. The process of
learning to write or draw in its motor aspect is one of
selecting appropriate movements, inhibiting contrary
movements, and co-ordinating those selected into a
rhythmical chronological system. Both in writing and
drawing the movements improve markedly from the age
of six to that of sixteen in rapidity, steadiness and pre-
cision; the improvement takes place in irregular phases.
At all ages of childhood there are striking individual
differences in the capacity to execute the movements
dexterously, and these differences are also strikingly
evident in adults.
Although in the first stage of learning to draw the
emphasis is chiefly motor, this shifts at a fairly early point
to emphasis on the perceptual and conceptual aspects of
 THE NATURE OF PSYCHOTIC ART 99

what is represented. All three aspects are, of course, inter-

woven in the mature performance; their separation is
artificial and usually only of theoretical interest. Never-
theless cases of discrepancy where motor skills are of high
degree but accompanied by no aesthetic creativity and
vice versa indicate that the aspects are separable at times.
The perceptual aspects of drawing do not require an
extended discussion. Innate differences in this regard are
overlaid by the effects of training at various levels. The
essential perceptual element in drawing is the recognition
of form, gained through active exploration, and inter-
acting at all times with the motor representation of form.
This recognition is closely linked with symbolic and
generalizing behaviour. Perception develops as an organ-
ization of impression and includes processes of analysis
and synthesis. For the most part accurate and detailed
observation of perceptual relationships is a function of
intellectual capacity in conjunction with training, but
there are individual differences of general intelligence.
Besides specific differences in sensory acuity some persons
observe concrete details better than they observe emotional
states and reactions, some the reverse. Some individuals
introduce interpretation into their perceptual observa-
tions much more thar others. A few people of very high
ability are astonishingly weak in their observation of
concrete spatial relationships.
The teaching of craftsmanship in drawing is essentially
the same process at all levels. It differs chiefly in com-
plexity from the early efforts with young children to the
advanced instruction at the school of art. The emphasis,
of course, may vary between accuracy of representation
and the production of satisfying formal relations; as I
have already argued, the latter is the necessary condition
of art and in recent decades has mainly been stressed.
The acquisition of craftsmanship is principally a question
of mastering effective representative and suggestive tech-
niques—perspective, black and white shading, use of
shadows, recession of masses, employment of colour in
terms of light, and so on—and of learning the processes
100 PSYCHOTIC ART

of formal design—composition, selection, elimination,

modification. The representative and suggestive tech-
niques can probably be taught to anyone, though persons
with a high motor aptitude for drawing and with a good
capacity for accurate perceptual observation are likely to
master them more quickly and effectively than those who
are deficient in these respects. The processes of formal
design can be taught only in part; they are too much
involved with relational thinking and aesthetic creativity
to be mastered in any effective degree except by a gifted
minority. It is not difficult to find individuals who have
marked skill so far as the representative and suggestive
techniques are concerned and even in the principles of
formal design, inasmuch as these can be reduced to rule
of thumb, but who are exceedingly deficient in aesthetic
creativity. Such people may be called craftsmen as opposed
to creative artists. '
At this point it will be useful to interpolate a neuro-
logical discussion of the bases of motor aptitude in drawing
and the higher capacities which are necessary in the con-
stitution of an artist. It has been found that slight damage
to the motor cortical area is followed on the opposite side
of the body by clumsiness of finger-movements, leading to
a disturbed performance. Such a disturbance is essentially
a motor phenomenon with little relevance to higher per-
formances. Differences in motor aptitude for drawing can
plausibly be related to structure or functional difference
in this cortical area. They may also be related to another
phenomenon which seems especially applicable to
instances of people possessing high capacity for perceptual
observation, relational thinking, and aesthetic creativity
but grossly deficient in the capacity to express pictorially
their creative schemata. This condition is that of ideo-
motor apraxia, which appears without involvement of the
motor system proper. The patient loses his ability to per-
form intended movements but spontaneously or by re-
flexes can carry out old habitual motor patterns, often
with perseveration. Ideomotor apraxia depends on a
lesion in the region of the brain where the temporal,
 THE NATURE OF PSYCHOTIC ART IO!

parietal and occipital lobes meet. In this region of the

leading hemisphere, especially in the supramarginal and
angular gyrus, the most refined functions appear to be
located. Visual agnosia, body-image disturbances, aphasia,
loss of orientation in space, and ideomotor apraxia result
from lesions of these centres. Furthermore, Schilder has
reported that lesions of the dominant supramarginal gyrus
result in an asymbolia for pain; the patients feel pain but
are unable to symbolize their experience of it. Another
neurological observation is that lesions of the angular
gyrus not only result in aphasia but produce a situation
in which the patient can draw from memory but cannot
draw present complex objects. I do not propose to
enumerate more fully the symptomatology of this region
of the brain which in phylogenetic perspective is more
unique than the so-called frontal lobes, but the few
examples that I have quoted demonstrate convincingly
that symbolic formation should be correlated with this
area.
From the physiological viewpoint, as expected, these
observations contradict a dichotomy of reception and
expression. One cannot state when symbolic formation
ends and symbolic expression begins. The idea of per-
formance can only be divorced theoretically from the
performance itself. In other words, the artist’s ability to
re-structure reality cannot be analysed into two distinct
processes of symbolic formulation and expression, since
both are highly interwoven. Artistic creation is more than
motor and perceptual skills; it has always an ideational
component as well. If such a comparison might be per-
missible, the difference between the artist and the non-
artist who is appreciative of art lies in an ideational
apraxia of the non-artist. Another interesting reflection on
the structural and functional link just mentioned is that
the body-image, spatial orientation, symbolic formulation,
plans of skilled movements, etc., are all condensed in this
area. At this point, it will be convenient to discuss more
fully the relation between artistic production on the one
hand and cerebral structure and functioning on the other.
102 PSYCHOTIC ART

Interest in the problems of brain injury has been re-

newed since the operation of leucotomy has been used in
the treatment of mental disorders. This operation aims at
inflicting bilateral symmetrical injury to the prefrontal
lobes, by undercutting fibres which constitute the white
matter of the prefrontal part of the brain. Opinions on the
advisability, technique, indications and evaluations of this
treatment vary, but there seems to be a fair agreement on
its action in a broad-sense. By this induced injury a new
symptomatology is produced, which balances with the
pre-existing mental symptoms, and brings about a social
adjustment in the patient. We need not discuss in detail
all the problems of this empirical treatment, which prob-
ably induces cognitive, conative and affective changes in
the patient’s personality, but a few points are of interest
because they are relevant to artistic creativity.
Previously I have quoted Schilder’s work, pointing out
that the posterior part of the brain might be responsible
for the symbolic formulation of pain; it has been found,
however, that a similar event takes place after leucotomy. I
have also pointed to the fact that the idea of an action corre-
sponds to the functions of the posterior part of the brain;
on the other hand, the symptoms arising from prefrontal
leucotomy have been evaluated as a loss of foresight, a
loss of the ultimate weighing of actions. Apathy has been
looked upon as a symptom of various diseased brain
centres, yet diminished conation and emotional blunting
have been described as typical sequels of bilateral pre-
frontal leucotomy. These and several other symptoms
might support the hypothesis, suggested on other grounds
as well, that the localization of function to a certain part
of the brain is only more or less correct, and that a function
is always a result of the inter-action of several ‘‘centres’’.
Nevertheless, a fairly well controlled interference with a
certain part of the brain allows observation of the induced
symptoms, even if the explanations may differ. It also
gives an opportunity of correlating structural alterations
to psychophysiological events and so ultimately of study-
ing injury to the brain in relation to artistic activity.
 THE NATURE OF PSYCHOTIC ART 103

Of the large number of studies of leucotomy, only a few

deal with leucotomy and artistic activity. Professor Free-
man had a patient who painted pictures of real merit, yet
after leucotomy he ‘‘came down to earth and his creative
urge was soon extinguished’’.* Later, in a paper given
together with Watts, Freeman speculated on the factors
which might affect creativity. Creative work, he con-
cluded, is based on phantasy, which demands foresight:
“no work of art can be created without visualizing the
effect before it is undertaken”. In leucotomized patients
the structure mediating phantasy is destroyed; hence
creativity proper is lost for them. Apart from the attempt
to localize phantasy in the prefrontal lobe, the short-
coming of this speculation lies in the fact that creativity
involves very many more factors than those singled out by
Freeman. E. Hutton and M. Bassett corrected this short-
coming; they recognized four factors in creative activity:
(1) imagination; (2) emotional motives and associated
judgements of value; (3) technical knowledge and practi-
cal activity; (4) sustained effort and persistent applica-
tion. They found that leucotomy in the first six weeks
after the operation alters these factors: creative imagina-
tion is much reduced and made almost non-existent;
emotional motives and associated judgements of value are
weakened and there is a decrease in effort and application.
Thus they concluded, like Freeman, that there is a
decrease in creativity following bilateral prefrontal leu-
cotomy. Although these authors themselves criticized the
psychometric methods which they employed to verify
their statements, their argument was to a certain degree
based on a case that exhibited creativity prior to operation.
Alas! the patient was a Hungarian poet and this makes
their conclusion the less applicable when discussing
pictorial art.
My own investigations, before those of the authors I
have quoted, posed the problems differently. In the first
place, 8 per cent. of my operated case material took
to drawing shortly after the operation, but the urge to
* Personally communicated.
8
104 PSYCHOTIC ART

continue disappeared at the time when definite improve-

ment became manifest. Previous investigators found, how-
ever, that only 2 per cent. of schizophrenics produce
spontaneous drawings; thus I am inclined to think that.
there zs a creative spell following the operation, though
my speculations on the psycho-pathological nature of this
induced creativity may be controversial. Secondly, my
observations were related to schizophrenics who showed
peculiarities in their mental life and in their pictorial
activities, as described in previous chapters. Now it has
been observed that the artistic products of patients with
brain injury of various localizations exhibit a certain
orderliness, a tendency to avoid empty spaces, and a
perseverative trend, together with a disordered choice of
colour. There are changes of configuration: there is a
tendency to curves instead of angles, figures may be con-
tracted or expanded and elongated. Thus the pictorial
activity of patients with brain injury resembles in some
respects schizophrenic pictorial activity. The differences,
however, I found in a more marked disturbance of the
figure-background relation, in more pronounced dis-
integration in the system of relations and in a very
apparent horror vacuz. On the-.other hand, the post-
operative appearances were more often as follows: the
patient painted in one corner of the sheet of paper objects
without any relation to one another: a dress, birds flying,
a bell, four dots. As the post-operative period progressed,
the paintings moved more imto the centre of the paper.
Two weeks after operation the same patient made a
drawing of a woman jumping from a jumping board; in
the sky were some birds and beneath some blue dots; thus
the discrete parts became interrelated one with another;
the picture became an organized whole. This is a more
striking example, since at other times the picture appeared
as chaotic conglomerates of schizophrenic and _brain-
injured expressions.
The tmportance of these observations in relation to
formal appearances is that fundamentally they are
similar to the results of less specified brain injuries. They
 THE NATURE OF PSYCHOTIC ART 105

indicate that any cerebral catastrophe results in a uni-

versal reaction, as seen in pictorial expression; thus
they give yet another indication of the importance of
the structural relations of functional integrity. They
also indicate that to search for a cerebral centre of
artistic talent is useless and that it is the total brain, in
particular its function, which has to be studied in this
connection.
To return to the psychological problems, the whole
burden of my discussion so far has been to emphasize the
components of relational and conceptual thinking in-
volved in aesthetic pictorial activity. The classic analysis
of the cognitive processes concerned in the production
and enjoyment of pictorial art is that of C. Spearman. He
distinguishes five aspects in pictorial art—truth, beauty,
emotionality, exaggeration and self-expression—and re-
lates all these primarily to his third neogenetic principle,
the creation of correlative fundaments. More remotely
they depend on his other principles of experience and
relations, and most basically of all, he states, probably on
emotion and sub-conscious activity. He decisively rejects
the view that to explain aesthetic creativity one must
assume the existence af supernatural powers in the artist.
Besides relating the five aspects of art to his qualitative
principles of neogenesis, Spearman also relates them to
his quantitative principles—constancy of output, reten-
tivity, fatigue, conative control and primordial potencies.
The aspect of truth he views as a relation of likeness
between the painting and what is represented. So far as
the aspect of beauty is concerned Spearman notes that
marked divergences of view exist on what is meant by
beauty, and he then analyses the variable carefully in
terms of energy and his five quantitative principles. Con-
stancy of output implies that everything irrelevant to the
aim must be abandoned; energy tends to adopt a unified
mode of distribution and the aesthetic interest of the
picture must be adopted to such a unifocal distribution
of energy. Retentivity demands that there should be
repetition in the painting, patterns and relational systems
106 PSYCHOTIC ART
of varying complexity, built up into general structures
whose form may be that of the circle, the ellipse, the
pyramid, parallel lines and so on. Fatigue on the contrary
demands that there should be variety besides repetition,
difference as well as likeness, multiplicity in unity, leading
to harmony, rhythm and balance. Conative control
functions in art by indicating how far the flow of energy
is perfect ;the individual enjoying art bases his evaluation
not on the absolute amount of the stream of energy but on
the ratio of this to the effort he makes. By primordial
potencies Spearman denotes irregularities between the
mental powers of different individuals; in pictorial art
these are displayed in the fact that a product which leads
to perfect energizing in the sophisticated expert may
occasion only confusion and pain in others. Spearman
touches on the cultural, historical and geographical
differences in the production and appreciation of pictorial
art by noting that if a person has adopted a particular
view and finds paintings done otherwise he will be
thwarted in his conation and his energizing will be
vitiated because the system of relations does not accord
with expectation. He also follows Sir Charles Myers in
distinguishing different attitudes in the appreciation of
art, a passive attitude of contemplation and an active
pursuit of similarities and other relations. Spear-
man believes that pleasure is obtained chiefly by the
active perception of relations, but Myers holds the view
that both the active and passive attitudes have their
rewards,
The aspect of emotionality Spearman relates to his
principle of retentivity ;the principle of fatigue is involved
only to a slight extent. The emotions evoked are make-
believe ones which come by association. The other aspects
of exaggeration and self-expression he does not so closely
link to the distribution of energy. He notes that when the
natural appearance is transcended it is usually a process
of exaggeration ; this process has limits and if carried far
becomes caricature. Self-expression is largely a question
of individual differences and personal style. Spearman
 THE NATURE OF PSYCHOTIC ART 107

distinguishes four sub-aspects here; technical differences

in the use and application of implements and materials;
differences in breadth—a tendency to multiplication
of details is characteristic of some artists, a general
simplifying tendency is characteristic of others; in-
dividual stylization; and personal phantasies which in
an extreme form find their match in those of the schizo-
phrenic.
There can be no doubt that Spearman’s analysis is
searching and illuminating. I am in thorough agreement
with his treatment of artistic production and appreciation
as being chiefly cognitive, relational activities. I would
incline to attach less importance than he does to the
aspects of truth and emotionality and much more to the
aspects of exaggeration, regarded rather as re-structuring,
and beauty, regarded as a patterning of relations. The
latter two aspects seem to me the necessary constituents
of aesthetic activity; the others are merely possible con-
comitants. While Spearman’s account is so fundamental,
it still needs to be amplified and verified by empirical
inquiries, particularly in regard to its biological founda-
tions and the impact upon it of cultural factors. Spearman
seems to have relied almost exclusively on introspective
analysis in this mattér without’experimental checks. His
explanation in terms of the distribution of energy is
entirely speculative. By energy, of course, he denotes his
concept of ‘“‘mental energy”; it has been abundantly
demonstrated by a number of writers, notably Burt and
Godfrey Thomson, that the concept of mental energy is
either meaningless or a deceptive metaphor. His principle
of fatigue is contrary to several findings in experimental
psychology. While Spearman touches on cultural factors
in relation to art he gives them inadequate weight; and
one may note that few individuals trained in the apprecia-
tion of pictorial art during the past half century or more
would agree that many of the examples chosen by Spear-
man are aesthetically satisfying ;his standards seem to be
those of a period rather distant in the nineteenth century.
The most important deficiency in Spearman’s account,
108 PSYCHOTIC ART
however, is that it does not adequately explain why some
individuals are aesthetically creative and others are not.
Besides the instances of people intellectually able to
re-structure presented reality into a pattern and disposed
to do so but unable to express their re-structuring effec-
tively owing to weakness in motor aptitude, there are also
individuals with high ability in relational thinking and a
high degree of motor aptitude for drawing who despite
this cannot produce’ -aesthetically creative work. Such
persons are usually excellent photographic copyists and
can produce highly effective anatomical and botanical
drawings and so on. Spearman would seem to imply that
aesthetic creativity depends solely on high ability in
relational thinking and that difference in this regard
between individuals of apparently equivalent intellectual
capacity springs entirely from environmental conditioning
or temperamental tendencies. Undoubtedly the chances
of environmental stimulation and such orectic factors as
emotional responsiveness and expressivity are important
determinants here. I am strongly of the opinion, however,
that a part equally important is played by basic, innate
differences in cognitive attitude and approach which
bring it about that people deal with relations in different
ways and vary considerably in theyr capacity to deal with
different kinds of relations. Spearman suggests differences
in conative attitudes so far as appreciation is concerned
and differences in breadth of approach so far as execution
is concerned. These attitudinal differences, especially the
cognitive ones, seem to me to require much more extended
investigation and analysis.
A noteworthy extension of Spearman’s aesthetic theory
has been made by H. J. Eysenck, who has endeavoured
to remove some of its weaknesses and to relate it to the
concept of Good Gestalt. He emphasizes that the problems
of aesthetics are essentially problems of perceptual pro-
cesses and that the laws of beauty can be reduced to
problems of perception. So he defines the beautiful in
its formal aspect in terms of “‘order multiplied by com-
plexity”, where order is a simplifying and complexity a
 THE NATURE OF PSYCHOTIC ART 10g

differentiating principle. Dealing with aesthetic apprecia-

tion he states that intercorrelational analysis has demon-
strated the existence of a general component so that
persons aesthetically appreciative of visual stimuli are
also aesthetically appreciative of auditory stimuli, per-
formance and so on. This general component, named the
T-factor, is correlated with intelligence to a small but
statistically significant extent. Analysis of correlations also
shows the existence of a bipolar group factor in aesthetic
appreciation related to introversion and extraversion, and
of specific factors related to individual peculiarities.
Eysenck formulates a general law of aesthetic apprecia-
tion, with three corollaries, in terms of the distribution
of energy in the nervous system. He abandons Spear-
man’s principle of fatigue and attempts to avoid the
difficulties occasioned by the concept “‘mental energy”’
by equating it with neural energy. There can be no
doubt that Eysenck is right in insisting that aesthetic
appreciation (and by implication aesthetic creativity) is
closely involved with the basic laws of perception, but it
is going too far to say that aesthetic appreciation is com-
pletely reducible to these laws; this would ignore the
active striving and relational thinking which does at any
rate very frequently go wrth aesthetic satisfaction. If it is
true there is a general component in all varieties of
aesthetic appreciation, its presence in low degree may
account for the lack of artistic creativity in some able
individuals well able to draw. Conclusive evidence on
such matters cannot, however, be obtained from inter-
correlational analysis, as the long and unresolved con-
troversy about the existence of a general factor in intelli-
gence clearly indicates; only neurophysiological experi-
mentation in conjunction with behavioural analysis can
settle these questions. The biological foundation of
Eysenck’s law of aesthetic appreciation and its corollaries
is very insecure. It is entirely speculative and without
warrant in experimental neurophysiology to say that
nervous energy is decreased or drawn off in the manner
he suggests during perception, simple or aesthetic, nor is.
110 PSYCHOTIC ART

there any evidence that changes of energy are related to

feelings of pleasure in so simple a fashion. Furthermore,
‘‘nervous energy”’’ in connection with aesthetic enjoyment
has never been estimated chemically and biologists have
merely been able to note increased blood flow when
a group of nerve cells are particularly active. Creative
and aesthetic activity requires a wide distribution of
nerve-cell activity, and no measurements’ have been
attempted yet. Electro-physiologically, V. J. and W. G.
Walter recently (1949) made some interesting observa-
tions on the interrelation of mental and emotional
changes and electro-encephalographic recording. They
found that after a variety of photic stimulations, mental
and emotional changes can be induced together with
subjective visual sensations as indicated in E.E.G. records.
They speculate that with appropriate psychological
analysis some correlation could be found between E.E.G.
features, the evoked responses and some such character
as originality or creative imagination. But, rightly, they
emphasize the speculative nature of this conclusion, and
put the emphasis on the interrelations. So this pioneer
work in the study of electro-physiologic expression of
discrete mental mechanisms is far from offering a tool by
which the “‘nervous energy”? which Eysenck postulates
may be measured quantitatively. ~
From the sociological point of view it is noteworthy that
Eysenck ignores the relativity of aesthetic appreciation to
cultural conditions in space and time. The history of art
makes it clear that culturally acquired values have a com-
plex interaction with simple unlearned preferences which
rest on an innate physiological basis.
Nearly all experimental investigations into aesthetics
have been concerned, like those of Eysenck, with apprecia-
tion rather than artistic expression and creativity. A
notable exception is the work of C. Patrick (1933). She
studied the creative process itself under standard con-
ditions in 50 artists of some degree of eminence and in
50 non-artists by reading to them a poem and asking
them to paint what it suggested to them, subsequently
 THE NATURE OF PSYCHOTIC ART Tit

obtaining their introspections. She had previously com-

pared the creative process in poets and non-poets by
showing them a painting and asking them to write a
poem suggested by it. Patrick described the psychological
phases of the creative process in the terminology intro-
duced by Graham Wallas: Preparation, Incubation,
Illumination, Verification (or Revision). She modified his
concept of incubation, however, by establishing that the
incubated idea or mood is not entirely absent from aware-
ness during that phase but recurs intermittently. Patrick’s
work confirms the essential importance of cognitive pro-
cesses in aesthetic creativity. Her central finding was that
the cognitive method of working was the same in all four
groups, artists and non-artists, poets and non-poets. The
trained individuals differed from the untrained in the
effectiveness of their product, not in their manner of
creating it. There were no cognitive differences in mode
of work between artists and poets (they were, of course,
carrying out different tasks), but certain conative differ-
ences impinged upon their working; the artists were
better disciplined and more systematic owing to their
formal training and were more inclined to seek the
opinion of others owing to their more sociable mode of
life. Patrick noted some differences in manner of intel-
lectual approach within her groups but as her purpose
was primarily to investigate general laws she did not
pursue these.
That a thorough empirical investigation of pictorial
art must deal both with aesthetic appreciation and with
aesthetic expression or production is sufficiently plain.
Such an investigation must consider both questions of
neurophysiology and questions of sociology or cultural
anthropology. Aesthetic preferences that depend on
acquired training or cultural conditioning must be dis-
tinguished by careful experimentation from preferences
that are characteristic of all human beings, irrespective of
their training and background. The diffusion and inter-
relationships of the preferences dependent upon training
and culture must be traced, and the neurophysiological
I12 PSYCHOTIC ART

basis of the universal preferences must be discovered.

The differences in cognitive attitude and approach,
such as Spearman’s distinction of differences in breadth,
must be analysed and their relationships and variations
investigated. Such an ambitious programme would
occupy several years, even taking into account the
sporadic previous work done in the field of aesthetic
appreciation. I cannot. pretend in this study to be con-
tributing substantiallyto this programme. But I wish
to describe one difference of cognitive attitude which
I believe to exist between pictorial artists and non-artists
of equivalent intellectual ability, although I am aware
that it needs empirical verification.
It is my belief that the rekations in terms of which
creative pictorial artists think tend much more to be
those of situational conjunction * and much less those of
classification than is the case with non-artists. I have been
led to this view by clinical observations of the thinking
processes in creative artists. It has also been suggested to
me by the fact that pictorial activity is more prevalent
among children and primitive peoples than among the
ordinary adults in our society and that in those same
groups thinking tends to be in terms of situational con-
junction rather than classification. The enhanced pic-
torial activity of schizophrenic patients seems to me to
depend in part on a shift of emphasis from classification
to situational thinking. I do not intend by this to imply
that the thinking of creative artists is abnormal; in the
first place, I regard situational thinking as an entirely
normal process, and secondly, in creative artists it is a
question not of inability to think in classificatory terms,
but merely of a preference for thinking situationally. The
phenomena of dreams also suggest this possibility ;dreams
may be regarded as a sort of pictorial activity with certain
obvious resemblances to painting and in dreams situa-
* By situational conjunction I mean relating objects according to
their association in space or time as opposed to classifying them by
the abstraction of common components. The difference between the
two modes of thinking emerges with especial clarity on sorting tests,
but is generally applicable.
 THE NATURE OF PSYCHOTIC ART I13

tional thinking predominates over classificatory thinking.

Recently the magazine Picture Post published an account
by seven modern artists of their reasons for painting.
There were certain differences in formulation but all said
substantially the same thing. It was evident that all
viewed their activity in painting as essentially relational,
a task of discovering and expressing formal relationships
in design. It was equally evident that their tendency was
to think in terms of situational rather than classificatory
relationships.
My hypothesis that pictorial artists tend to think situa-
tionally rather than in terms of classification has obvious
affinities to the theory of K. Goldstein on abstract and
concrete behaviour. On the basis of his work with brain-
injured patients during and after the First World War
and of more recent work by himself and his followers with
brain-diseased, schizophrenic and oligophrenic patients,
Goldstein distinguishes two fundamental capacity levels
of the total personality, two modes of behaviour which he
calls the abstract and the concrete attitudes. The normal
person is capable of assuming both, whereas the abnormal
individual tends to be confined to the concrete attitude.
The concrete attitude*is realistic, immediate and un-
reflecting. The abstract Attitude embraces more than
merely the “‘real” stimulus in its scope; it implies con-
scious activity in the sense of reasoning, awareness and
self-account of one’s doing. The abstract attitude is
marked by the presence and the concrete attitude by the
absence of eight capacities. These are: (1) To detach our
ego from the outer world or from inner experiences ; (2) to
assume a mental “‘set”’; * (3) to account for acts to one-
self and to verbalize the account; (4) to shift reflectively
from one aspect of the situation to another; (5) to hold in
mind simultaneously various aspects; (6) to grasp the
essential of a given whole, to break up a given whole into
parts, to isolate and to synthesize them; (7) to abstract
common properties reflectively and to form hierarchic
* By “set”? I mean a temporary condition of the organism which
facilitates a certain specific type of activity.
I14 PSYCHOTIC ART

concepts; (8) to plan ideationally, to assume an attitude

towards the ‘“‘more possible’, and to think or perform
symbolically.
Goldstein notes that normal individuals differ both in
the ease with which they can adopt the abstract attitude
and in their preference for doing so. He strongly main-
tains that there is a pronounced line of demarcation
between the two attitudes which does not represent a
gradual ascent from more simple to more complex mental
sets. The abstract attitude demands the behaviour of a
new energent quality, generically different from the con-
crete. From the evolutionary point of view this behavioural
quality represents a recent achievement, a new functional
level connected with the intact working of the cerebral
cortex, especially the frontal lobes.
I am well aware of the damaging criticism to which
Goldstein’s theory has been subjected by many psycholo-
gists. J. McV. Hunt and others have pointed out that
Goldstein’s emphasis on the intensive study of individual
cases and passionate rejection of statistical validation
imports many sources of error and leads to a gross over-
generalization. Halstead, following Forster and von
Monakow, observes that the brain-injured patients of the
First World War were unsatisfactory material for investi-
gating the problems which Goldstein poses. N. Cameron
argues that Goldstein’s eight criteria of the abstract are
merely those customarily employed in demonstrating the
intervention of consciousness and have no more valid
application than in normal behaviour. Most psychologists
feel that Goldstein paid inadequate attention to the intelli-
gence level of his patients before the brain lesion; he
ignores the approximately Gaussian distribution of intelli-
gence and seems oblivious to the cognitive characteristics
of dull normal and low average individuals. He also
ignores the interaction with concrete and abstract think-
ing of special abilities and disabilities in dealing with
verbal, spatial and mechanical relations. The most im-
portant criticism, however, is that of Hunt and Cameron,
with which nearly all psychologists would agree; there is
 THE NATURE OF PSYCHOTIC ART IT5

good reason to doubt the usefulness and validity of an

effort to maintain separate categories of abstract and
concrete behaviour, which seems to be a heritage of the
Cartesian dichotomy between human and animal think-
ing. The assertion that abstract and concrete thinking are
not acquired mental sets but fundamental capacity levels
is more than dubious. Both require high levels of funda-
mental capacity, but neither arises automatically by
maturation; both represent a complex accumulation of
habits successively acquired.
If one cannot, however, accept without question Gold-
stein’s assertion that abstract and concrete thinking repre-
sent fundamental capacity levels of the organism, one can
agree that many aspects of abstract thinking are impaired
in the brain-injured and also that normal individuals
differ, probably to some extent independently of general
intelligence, in the ease with which they think abstractly
and in their preference for doing so.
Whether situational or categorical, the cognitive aspect
seems a dominant factor in art. To-day’s artists con-
sciously analyse the total system of relations. This analysis
has led them invariably to employ techniques which led
to similarities between the schizophrenic and their own
art products. In content the surrealists have explored
“‘the subconscious” instead of external reality; schizo-
phrenics reproduce their hallucinations and the world of
their own. The cubists have analysed reality in terms of
geometric interrelations; schizophrenics show a tendency
for geometric ornamentation in the course of their disease.
Chagall painted a man walking in the clouds, depicting
an exalted feeling, and so experimented with the mean-
ing of symbols; in schizophrenics the symbol becomes
identical with the meaning and is reproduced as such.
This experimentation of the moderns with form and
content is naturally based to a greater extent on con-
scious intellectual activity than was, for instance, the
work of the Renaissance artists. The emphasis is on
conscious analysis which in its turn always makes the
components more obvious, so that modern art products ©
116 PSYCHOTIC ART
appear to present some degree of fragmentation. It was
shown previously that in schizophrenics the basic dis-
integration is cognitive, leading also to fragmentation.
Hence, the apparent similarities between modern and
schizophrenic art.
 VI

AN ILLUSTRATIVE CASE

WE HAVE DISCUSSED how far structural alterations in the

brain and their subsequent functional manifestations in
such activities as art, are rélated to one another. I have
mentioned that the operation of leucotomy induces a
bilateral and more or less symmetrical injury to the pre-
frontal lobes of the brain, and that after leucotomy, or,
for that matter, closed head injuries, executive skill
becomes altered, and the criteria of creativeness, so
various authors have elainred, become altered as well.
Whereas the observation that brain injury alters executive
skill is fairly well established and has been demonstrated
psychometrically, its results have not been studied in
creative artists. Furthermore, observations in linking
artistic creativeness and leucotomy still need to bé verified :
the investigations hitherto published concern a poet and
not a painter.
As this study was being written a unique opportunity
occurred: a creative artist was undergoing prefrontal
leucotomy. The problems presented by such a case are
these: first, does executive skill alter as it alters in non-
artists; and secondly, does creative capacity alter? This
was all the more suitable a case for special investigation
because the illness of the patient altered the style of her
pictorial éxpression. So a third problem is involved: an
118 PSYCHOTIC ART
improvement of the psychosis raises the possibility of a
renewed alteration in the patient’s artistic style, which
might be related to functional and structural changes.
The account given below is a synthesis based on the
reports of the psychiatrist in charge of the case and on
special psychological investigations.
Only a brief account of the patient’s history can be
given, to avoid any possibility of recognition ;for the same
reason, none of her.’;dtawings or paintings can be repro-
duced here.
The patient was an only child. There was a history of
mental illness in her family on her mother’s side. She was ~
a normal baby, had a happy childhood and uneventful
early schooldays. Her talent for painting very soon became
apparent, and with the encouragement of teachers and
artists who saw her work, she began a career as an artist.
Her personality, however, altered at the onset of puberty;
she became self-absorbed and moody. At the art school
changes in her personality progressed till she broke down
completely. She suffered from auditory hallucinations ;
the imaginary voices told her to commit suicide and she
felt unable to resist. She was admitted to a psychiatric
institute as an impulsive and suicidal patient.
In hospital, she received up-to-date physical methods
of treatment and she improved slowly. She started paint-
ing again, but her work remained very restricted and
academic. She could not express herself freely in painting
because she felt she had to keep strictly to concrete objects
in order to remain sane; abstract painting reminded her
of the onset of her illness.
After discharge, she started life anew, went to a cele-
brated art school, but kept in close contact with her
psychiatrist. About six months after her discharge, how-
ever, she relapsed again, heard imaginary voices, ex-
pressed delusions of persecution and became suicidal. She
agreed to come back to the hospital; now she no longer
cared what happened to her because she felt she could no
longer paint.
After re-admission, she failed to respond to the normal
grr *g anf
Surpooyy puy sesiopy, “1 “Sty
©
Fig. 14. Goya: Sopla
 AN ILLUSTRATIVE CASE I1g

therapeutic procedures, so at last, with her consent, it

was decided to perform an operation of leucotomy on her
brain; the so-called lower quadrants of the prefrontal
lobes were sectioned with a blunt instrument, according
to the method described by W. Freeman. There were no
complications, and the patient had an uneventful conva-
lescence. Three weeks after the operation, she was more
cheerful and communicative, and she worked almost
daily on some picture. Her attitude towards her psychotic
symptoms was fairly objective; she observed that they
were present, but that they appeared somewhat diminished
in intensity. She took an interest in her appearance, began
to go out to visit her home, and made friendly contact
with her parents and with her fellow patients. She was
delighted to find that her creative capacity remained
intact. At the time of writing (five weeks after the opera-
tion) she continues to make satisfactory progress as far as
her personality is concerned.
As to the psychometric assessment of her case, after she
was first admitted to hospital she was not in a suitable
state for testing until several weeks had gone by. When it
was judged that she was at last able to co-operate fruit-
fully in a psychometrie investigation, she was tested with
the Rorschach Ink Blots and also with Word-Association
Responses. She was still vague, preoccupied and detached
from her immediate environment. All the same, she
grasped the nature of the Rorschach task immediately and
settled down to it quite happily, perhaps because she was
prepared for it by hearing other patients discuss it or
perhaps because of her strong visual-mindedness. There
was considerable difficulty in getting her to grasp the
nature of the Word-Association task, either because she
was unprepared for it or because of its verbal character.
Her treatment of the Ink Blots showed many distinctive
features, schizophrenic in quality and especially interest-
ing in one who was an artist. The forms she perceived
were for the most part not clearly outlined, and were
poorly integrated into meaningful structures. There was
a curious disturbance in her perception of space relations
9
120 PSYCHOTIC ART

and relations of bodily parts. Thus in one blot she per-

ceived a moth with its body, nose, wings and antennae
distributed over the card in a quite unnatural way. In
another she saw a volcano, presented in spatially incon-
gruous sections; in still another she perceived a series of
pelvises of increasingly poor form and constructed in a
way suggestive of disordered spatial relations. She was
incapable of any three-dimensional perceptions, which
was unusual in an artist, and movement was almost com-
pletely absent in the forms she apprehended. She re-
sponded strongly to colour in the blots, but could not
integrate the colours into meaningful shapes; thus she
gave several pure colour responses, a schizophrenic re-
action especially noteworthy invan artist. She made much
use of black as a colour, an exceptional behaviour, which
is generally a sign of affective disturbance. The content
of her perceptions displayed little creativity ;most of them
were maps or anatomical representations; none were
human beings. When she saw a map she was often con-
fused and uncertain whether it was a real object she
perceived or merely a conventional sign; thus in what she
described as a map of Ireland she perceived at the same
time pictures of real lakes and trees. When the matter was
pursued, she declared that they were only conventional
signs for lakes and trees, but her reaction suggested a dis-
ordered visual perception of her environment. Throughout
her performance she tended to think in visualistic rather
than conceptual terms. Her control over her reactions was
considerably impaired, but she retained some degree of
control.
She was asked to write her responses to the Word-
Association test. They chiefly consisted of one word,
empty of imaginative or emotional content. She appeared
to be helpless when not confronted with matter which
was concrete and presented visually. There were some odd
defects in her reading and spelling. She showed consider-
able affective disturbance at the words ‘‘ Mother” and
‘““Father”. The word “‘mother” led to a curious motor
expression of this disturbance: she wrote “Mummy” with
 AN ILLUSTRATIVE CASE Tei

a proliferation of m’s—Mummmmy. Some of her re-

sponses were suggestive of body-image disorder, for
example: Month, space; Stomach, small intestine; organ,
lives.
In both tests she gave the impression of an evasive,
withdrawn personality, apparently lacking inner rich-
ness ;she did not at this time express any paranoid feelings
of suspicion or being wronged, nor did she indicate that
apparently environmental events were specially significant
for her.
After she had undergone treatment and just before she
was discharged from hospital she was re-examined with
the same tests. She had, according to her own account, no
recollection of the previous testing. Her manner was still
vague, but she was less preoccupied; her social behaviour
was superticially more pleasant and she expressed greater
interest in the tests. Her performance showed a consider-
ably increased degree of control, but was no richer, no
more imaginative. Her perceptions on the Rorschach Ink
Blots were all reasonably good in form, clear in outline and
meaningfully integrated. There was no evidence of a dis-
turbance in spatial perceptions; although suggestions of
disordered body imagéry remained. Three-dimensional
perceptions, movement and human figures appeared this
time. There were many fewer maps and anatomical
responses; concrete, inanimate objects and animals took
their place. Her colour reactivity was less marked, less
schizophrenic in quality, more controlled; the colour
percepts were all organized into meaningful shapes. This
time she made no use of black as a colour. In the Word-
Association test she showed no affective disturbances. Her
responses consisted of several words, but they were all
definitions without imaginative or emotional content.
She expressed no attitudes of being wronged nor did her
manner show any suspicion or distrust. In comparison
with her previous performance, both tests indicated that
she had adjusted herself superficially and had mastered
for the time being an underlying schizophrenic reactivity.
After she returned to hospital she was tested with the
122 PSYCHOTIC ART

Behn Ink Blots, a series parallel to the Rorschach Ink

Blots. She was also tested with these again under the
influence of methedrine. In comparison with her earlier
performances, what was most marked on both occasions
was the emergence of suspicions, of distrustful behaviour
and the expression of feelings that she had been wronged
and ill-treated. She believed also that events had special
reference to herself. This corresponded to changes which
had been observed -in her clinically. There were several
other differences. Her reactivity to colour was much less
marked and she showed some tendency to avoid it. She
made use of the white spaces in the ink-blots to construct
percepts, a behaviour entirely absent in her earlier per-
formances; this is usually interpreted as a sign of opposi-
tion, contrary reaction or negativism. Queer forms of
verbalization, a trend only hinted at in the previous test-
ing, appeared explicitly. Thus she modified her descrip-
tion of a cat she had perceived to: It’s rather the desire to
wanting to catch a bird. When the Word-Association test
was re-administered to her, such verbalizations were
several times evident; examples are: Disease, Something,
germ, that makes your health wll; and Kiss: Mouth to mouth and
face to face—a conveyance of thought and love. Her Word-
Association responses once more were chiefly definitions,
but they had now a distinct emotional component in
them, an expression of paranoid or wronged feeling.
When she was tested with the Behn Ink Blots under
the influence of methedrine, some of these trends dis-
appeared, others were more explicitly revealed. There
were no odd verbalizations, and she organized the different
parts of the blots into more competent and imaginative
percepts than she had ever done previously. She avoided
colour in a more marked degree; there was an increase in
her perceptions of movement and a marked increase in
her use of white spaces. Another interesting change was
the emergence of a content in her responses which was
menacing or provocative of fear; for example, what she
perceived originally as a barn-owl, became under the
influence of methedrine ‘“‘a terrifying winged skull”.
 AN ILLUSTRATIVE CASE 123

Probably this content had previously been suppressed

rather than not experienced. Body-image disturbance was
not apparent in these performances.
After leucotomy she was once more tested with the
Rorschach Ink Blots. Her manner at the beginning was
still distrustful and full of suspicion, but afterwards she
relaxed and became more co-operative. The disturbance
in spatial perception, shown in her very first performance,
was again evident, but not in so clear-cut a form. There
was also a renewed suggestion of disordered body-
imagery; the injury to her head appeared to be a com-
ponent in this disturbance. Avoidance of colour-responses
was more marked than ever before; she openly expressed
her dislike of the colours. In her sparing use of them she
was much affected emotionally, as if they represented a
potential danger to her. The outline, structuring and
organization of her responses were poorer than at any
time except in the first performance of all. There were
again some queer verbalizations.
The general impression of her final performance was
that her fundamental schizophrenic reactivity was un-
altered, but that her concern, self-criticism and control
were diminished. The suggestion was that her contact
with her human environment was improved.

II

Her paintings before her illness had shown great origin-

ality, an imaginative perceptual treatment and courageous
handling of colours and of structural relations. She had
inclined towards ornamentation and strongly marked
patterning; by choice, her paintings had always been of
small size. Whilst her illness developed, her drawings were
not altered by her early psychotic experiences; the first
influence of which occurred the night before she came into
the hospital. She had been working during the afternoon
on a design of two horses, grazing: black horses on a green
background, executed in green and black Indian ink. In
the night she suddenly jumped out of bed, took a pen and,
124 PSYCHOTIC ART

apparently under the influence of auditory hallucinations,

felt compelled to finish the drawing. She drew five shields
in the background, with a different crest on each of them.
These have no meaning and are not originally connected
with the picture; superficially they might be looked upon
as expressions of bizarre reactivity. Her own account of
this drawing, of the adding of symbols to “‘real things”’,
has been mentioned in her case history above. Whilst in
hospital and under tréatment she did not paint. Between
her discharge and re-admission, when her psychosis
became active again, she reproduced her hallucinatory
experiences. At that time she worked with pencil only.
After she was re-admitted she could not work at all. She
was given methedrine injections and while the action of
this sympathetico-mimetic drug lasted, she worked in un-
inhibited fashion; but as soon as the effect of the drug
wore off, she relapsed into her self-absorbed, depressed
and hallucinatory state. The four pictures she painted
under methedrine were: ‘‘The Tiger, from the Tiger’s
Point of View’’, ‘‘A Washstand and a Bed”’, ‘‘A Chair”
and “‘A Cart”. All were of large size, were disproportionate
to the space, and were drawn—studies in sepia and white
—with very heavy contours; they retained artistic value.
Then came the operation. Before this she had just begun
to outline a horse; six days after her operation she began
to paint again. Once more she used monochrome tech-
nique and drew the outline of a nude. The picture was
completely out of proportion to the space provided; she
worked happily on it, but did not like anyone to see it.
One day she asked for vinegar, to make the flesh of the
nude more human (sic!), then suddenly she tore it up.
When I asked her about her painting, she said that she
could use her old technique now, but she did not want to
do so. At present she is interested only in the actual
relation of shapes, which is “‘reality’’. She is no longer
afraid of non-reality, but is not interested in it. She tore
up her nude because it was not what she wanted, and she
had no more use for it. Apparently her painting was an
experience of her own and not intended to afford aesthetic
 AN ILLUSTRATIVE CASE 125

satisfaction to others. In her third post-operative week

she remembered that before the operation she had begun
to draw a horse; she said that she knew exactly what she
wanted to do about it, and wanted to work on it again.
Once more the picture started as a monochrome, though
now and then she put white patches on the sepia. Again
the spatial relations were out of proportion. The horse
occupied the whole of the paper, so she pinned another
piece of paper to it, and painted a cart behind the horse.
A week later she added another piece of paper to the
picture and drew a man standing in the cart. Thus the
picture became L-shaped. Whilst working she wished
that she had a very large canvas because she wanted to do
paintings that were greater than life-size.
To investigate changes in her executive skill induced
by the cperation special tests were administered to her
three days before the operation; the same tests were
repeated at three and at twenty-four days after the opera-
tion. The tests used were mainly based on the perception,
analysis and reproduction of spatial relations. Besides
these the Reitman Pin-Man test was applied on each
eccasion. The spatial tests consisted of Kohs’ Blocks, the
Bender Visual-Motor Gestalt test, and four tests of draw-
ing ability adapted frony Clark L. Hull—Memory for
Designs, Circle Completion, Angle Copying and Size
Copying. It has been established that after leucotomy
patients tend to show an impaired performance on the
first two of these spatial tests. The last four tests were
included among those employed by Hull in investigating
the ability to execute freehand drawing; he did not find
them all of utility in this matter but to my particular
purpose they seemed relevant. In the Kohs’ test the
subject is given cubes coloured differently on each side
and is required to construct patterns with them in imita-
tion of patterns shown to him on cards; as the test pro-
ceeds, the number of blocks and the complexity of the
patterns are both increased. The Bender test is widely
recognized as a delicate indicator of impaired capacity
owing to organic cerebral damage. It presents to the
126 PSYCHOTIC ART
subject a number of rather unusual designs, deriving from
the Gestalt figures of Wertheiner, and requires him either
to copy them or to reproduce them from memory; in this
case reproduction from memory was required. Hull’s
Memory for Designs resembles the Bender test, but the
figures are somewhat easier to remember and reproduce.
In the Circle Completion test, the subject is given arcs of
circles and required to complete them by freehand draw-
ing; in Angle Copying*he has to reproduce various angles
as closely as possible; in Size Copying he is shown a
square, a circle, a triangle and a Latin cross and required
to copy each so that it is as near in size to the original as
possible.
Before the operation the patient’s performance on all
these tests was highly competent. Contrary to expectation
little or no impairment was evident three days after the
operation. On the twenty-fourth day, however, changes
were more apparent. She found it more difficult to analyse
some of the Kohs’ Block designs. The Bender figures were
much less satisfactorily reproduced; there were reversals
of direction and displacements of parts, simplifications of
the design, changes in length and relative size, flattening
of curves and similar changes. None: of these features
appeared in her two previous testings. The lines were
notably thicker than before. Andther important change
was that on the first two occasions the separate figures
were systematically and effectively arranged on the page;
on the third occasion they were scattered over the page
haphazardly and ineffectively. The Memory for Designs
test showed on the third occasion simplification of the
figures, increase in size and thicker lines; on the first two
occasions the reproduction was all but perfect. Neither in
the Bender test nor in Memory for Designs did she show
any change in purely motor execution; the change was
in the spatial relations of the design. The Circle Com-
pletion test showed no change even at the third testing,
except for some thickening of the lines. In the Angle
Copying test the reproductions were increased in size and
thickness on the twenty-fourth day. So far as Size Copying
 AN ILLUSTRATIVE CASE 127

was concerned, the reproductions were always exceed-

ingly close but they were more exact on the first two
occasions; there was a slight tendency to increase of size
the third time. In the Pin-man test the verbal responses
were substantially the same on all three occasions. The
Pin-man drawing, however, showed some changes. On
the first and second occasions it was exceedingly good,
worthy of an artist. On the third occasion the drawing
was mediocre; it would have been passable in a non-
artist, but was well below the level of an artist. There was
a perceptible weakening in the suggestive character of
the figure. In particular the arms were poorly drawn;
they were mere empty copying. Besides this, the figure
was disposed in the available space very ineffectively; it
was displaced into a corner of the sheet. This would have
meant nothing in a non-artist, but was significant in a
patient of high aesthetic ability in pictorial art.
Only a few conclusions can be drawn with any degree
of certainty from her immediate post-operative condition.
The style, which had begun to alter just before the opera-
tion, continued to alter in a more marked way. The pre-
operative alteration of her style was ascertainable only
under the influence of methedrine. So far as I have been
able to observe, the paintings of patients under the
influence of methedrine show a marked fragmentation,
whereas her pictures under the drug were large and well-
balanced structyres. Thus it may be that the methedrine
treatment did no more than mobilize her new style which
was maintained by the post-operative personality. In this
sense, the alteration of her style has probably little to do
with the operation.
She did not lose her executive skill, a fact also evidenced
by the Bender test. This might be expected, in that an
artist’s executive skill is such an established behaviour
that relatively restricted damage to the prefrontal lobes
might leave it unaltered. It should, however, be recalled
that neurological observations suggest that after cerebral
damage the loss of skills precedes the loss of more ele-
mentary functions.
128 PSYCHOTIC ART
On the other hand, the changes registered by the
Bender test confirmed that there were alterations in her
treatment of spatial relations, just as her drawings had
indicated. This might quite easily be a sequel to her brain
injury, but other explanations are possible. It may well
be that her perception of space was altered as a result
of the operation. The post-operative responses to the
Rorschach test might be taken to support this explanation.
Another interpretation of this fact might be based on
post-operative changes in personality, the existence of
which is widely recognized. An artist must have a pre-
liminary concept of the structural relations he is going to
paint; the concept and the canvas together shape the
unity of the finished work. In her case, it seems that the
preliminary schema is somehow only vaguely organized
and remains fluid, so that the canvas has to be addition-
ally enlarged according to changes in her visual con-
ception. Now, as I have already noted, it is said that after
leucotomy the ultimate evaluation of planned action, or
foresight in general, becomes affected. Thus it may be
that what is expressed in her bad structural unity is a
disturbed capacity for planning, which leads to an un-
satisfactory manifestation of spatial relations. The evalua-
tion of planned action, or “foresight”, however, is a
complex activity comprising several components, one of
which is motivation. Assuming her psychosis to be included
among the motivating forces, one can state that her
motivations did alter, as judged by favourable changes as
far as her behaviour in the hospital was concerned and
also in her activities outside the hospital. On the other
hand, this hardly explains the alterations in spatial per-
ception. Furthermore, A. F. Tredgold has described a
mental defective who was cared for during a period of
many years in an institution and who showed 4a highly
developed capacity for planning, as evidenced by the
construction of model ships, some of which were exhibited
with great success. After this patient’s death, the examina-
tion of the brain demonstrated, amongst other anomalies,
badly underdeveloped prefrontal and temporal lobes.
 AN ILLUSTRATIVE CASE 129

Thus structural deficiencies in the cortex and artistic

foresight do not seem to be in close correlation with one
another.
Apart from the fact that the patient’s pictorial expres-
sion altered, the conclusions to be drawn are tentative
and none gives a direct answer to the problems which
were raised in the introduction. The study of one case
cannot offer a secure basis for generalization on such
matters, for instance, as whether leucotomy is likely to
influence artistic production favourably or unfavourably.
It certainly affects non-artists differently, as I indicated
in the previous chapter. To a certain degree it is entirely
specific to the individual how much of the prefrontal lobes
can be damaged without causing marked deficit in the
patient’s artistic capacity. All one can state is that the study
of one artist showed that a special cerebral injury caused
alteration in the personality, but affected creation only
superficially and not fundamentally up to the beginning
of the fifth post-operative week. A more decisive answer
could be given only if such a case were followed up and
studied over a period of three or four years.
 >.
cave

INTERPRETATION OF
PSYGH O TiC wate

Sublimation and the functional significance of art (Freud)—

Criticism of the psycho-analytical approach—Fung’s concept of
symbols and criticism of 1t—Typology, another aspect of the
motivation of art—Application of the interpretative approaches in
the pathographies—Pathographic sketch of Goya—Problems
arising from pathographies.

WE HAVE NOW examined the manner in which the

_ psychotic picture has been regarded in its form or its
content as symptomatic of a special illness, and we have
discussed attempts to relate form and content to the
dynamics of the patient’s illness, that is to say, to the basic
motivations and needs on which his illness depends and
to his particular way of responding to such fundamental
drives. Dynamic views in relation to psychotic art led to
interpretative speculations on the motivation of art pro-
ducts in general and also in the case of individual artists.
These interpretative attempts should now be more closely
scrutinized,
The first attempt to solve the problems of art by an
interpretation in dynamic terms was the contribution of
Freud to the understanding of aesthetic creativity. Freud
first posed the question, What function has creativity for
 INTERPRETATION OF PSYCHOTIC ART 131

the artist himself? In his study of Leonardo da Vinci and

elsewhere he demonstrated the symbolic expression in the
artist’s works of subconscious conflicts. Put in another
way, he introduced the notion of the subconscious as a
motivating force in creative activity. At the same time he
argued about the cathartic function of art. This last con-
cept was presented in especially clear form by Baudouin,
who maintained that art represents a relief from tension
and that as such it can be a therapeutic agent in nervous
diseases. Release from tension by means of creativity is an
application of the well-known psychoanalytical concept
of sublimation which is regarded as a symbolic expression
of subconscious conflicts. For the pictorial artist the
symbols are non-verbal substitutes for something meaning-
ful. The function of the symbol is equated to the role of
symbols in dreams; that is to say, it conceals the real
meaning from the artist as from the dreamer, and it
graduates and reduces emotions which in direct, non-
symbolic expression would arouse disturbance, stress or
extreme unhappiness. In non-symbolic expression such
emotions would be chaotic: they would not be co-
ordinated. By reducing their objects to symbolic form the
emotions are rendered orderly and tolerable. This process
of symbol formatien is one of Freud’s well-known
mechanisms, together with displacement and condensa-
tion, the function of which in psychotic art I have already
discussed.
In this approach the interpretation of the symbols is
entirely based on Freud’s theory of the libzdo. It is assumed
that the fundamental conflicts of the artist and the notions
most disturbing to him must necessarily lie in the sexual
sphere. The fact that in many instances there are more
urgent and immediate sources of conflict is disregarded.
The psycho-analytic investigators describe a legion of
phallic symbols. There is no independent evidence that
the majority of these are in fact symbols for the male organ.
A similar criticism applies to the other Freudian symbols.
In the case of one individual it may sometimes be satis-
factorily demonstrated that a particular object symbolizes
132 PSYCHOTIC ART

a given meaning. To extend this fact to an assertion that

the object symbolizes the same meaning for all other indi-
viduals is quite unwarrantable. Nevertheless it has been
a common procedure among psycho-analytic investigators.
It may also be noted that in symbolic interpretations along
these lines there is marked disagreement between one
psycho-analyst and another about the meaning to be
attached to a given symbol in an art product. The sub-
jectivity of this approach condemns it as a scientific
method of attack. fi
The concept of the functional significance of art for the
psychotic artist has been further elaborated by Kris, who
has argued that the art of psychotics is a means of adjust-
ment to reality. Other psycho-analysts have demon-
strated in specific instances that the choice of theme in
art is dependent on conflicts within the artist. These
studies have succeeded in showing that the motivations
leading to the production of art by the artist may be
highly significant in his life-history. They have also shown
(see Chapter 8) that such motivations may correspond to
general needs and drives in the community; it is upon
this fact that appreciation and enjoyment of art by the
general public depends, at any rate, in part. These
accounts in terms of motivation, however, fail to give a
satisfactory description and evaluation of art as a function
of the human organism specific to it.
Another psycho-analytic explanation of the pheno-
menon of art, only seemingly different from the one just
considered, is that it is closely allied to play. The slow
maturation of the human infant makes it necessary that
the parents should provide protection for it and satis-
faction for its oral needs. The child, identifying himself
with his parents, engages in mock activities of protection
and the provision of oral satisfaction. These activities give
him pleasure and constitute what is ordinarily called
play. Because play has a pleasure value it helps the child
to tolerate the difficulties and frustrations of things as
they are, called by Freud “‘the reality principle’. By
means of play the child learns to postpone satisfactions, a
 INTERPRETATION OF PSYCHOTIC ART 133

capability essential to ordered social life. At a later stage

of cultural development the play of the child evolves into
rituals and art with an accompanying process of rational-
ization. It will be evident that this explanation overlooks
many aspects both of play and of art. In particular it
neglects the conceptual qualities of art, which I have
already considered. The theory of the evolution of art
from play will be seen to rest on the Freudian pleasure-
principle and ultimately on the theory of sexual libido. It
is, therefore, vulnerable to all the criticism directed
against these hypotheses.
Clearly the psycho-analytical evaluation of art is
closely interwoven with Freudian doctrines in general.
It could hardly be otherwise. For this reason we must re-
state, as briefly as possible, the objections to the Freudian
theories trom the standpoint of general scientific know-
ledge. In a grossly over-simplified manner, psycho-
analysis treats psychological processes and reactions as
causally determined. Human behaviour is linked up into
a rigid system of cause and effect with a concept of cause
which is not only fallaciously narrow but is for the most
part purely hypothetical. One might mention here the
interesting contradiction, noted by K. Young, that the
technical tool of so ultraxdeterministic a system of psy-
chology is “‘free association”. In relating each item of
human behaviour to an over-simplified determinant or
system of determinants psycho-analysis ignores the great
differences in the strength of the motivating drives leading
to people’s actions and the enormous variation that exists
in the meaningfulness of actions to the individual. Thus
a patient’s delusions that his testes are being snipped off
by an hallucinatory pair of scissors and some individual’s
habit of pulling leaves from trees are treated on the same
level as consequences of a castration complex. The
Freudian psychology neglects the fact that large numbers
of human actions are merely habitual or, to use Goldstein’s
term, “‘preferred’’ positions or modes of response, having
no meaningful relation to the individual’s basic motiva-
ting drives. So far as the fundamental drives themselves
134 PSYCHOTIC ART

are concerned, by centring all attention on reproduc-

tive behaviour psycho-analysis gives wholly insufficient
weight to the importance for the organism of what E. 8.
Russell calls its ‘maintenance activities”, its endeavour
to preserve its integrity against its inanimate and animate
environment, its behaviour in relation to nutrition and to
enemies and the like. Rather similarly by centring atten-
tion on the affective aspect of human psychological
deficiencies and disabilities the psycho-analytic approach
underrates the importance of purely cognitive factors,
resting on neural structure and function, in such in-
adequacies; this is especially shown in the Freudian treat-
ment of the phenomena of memory, difficulties in re-
membering names or facts, slips of the tongue or pen, and
such matters.
From a biological point of view the Freudian theory is
one-sided. Considered sociologically its weaknesses are
even more striking. Freud based his system of psychology
on his theory of the development of personality. The child
begins as a polymorph pervert. Then it becomes sexually
attracted to the mother ;an accompanying sexual jealousy
of the father leads in the male child to the formation of
the Oedipus complex. The succession of events in the
female child is more complicated and obscure. From the
moment that the mother-fixation and the Oedipus com-
plex are formed the whole structure becomes one of
accumulated complexes. This leads almost naturally to
the conclusion of Roheim that civilization and culture are
basically pathological in nature; they are a compensatory
reaction to infantile conflicts. Here it must be observed
that there is no satisfactory proof of the existence of the
Oedipus situation. On the contrary the careful investiga-
tion of C. W. Valentine with the children of English
professional workers suggests that it is a quite erroneous
description of the true state of affairs. Field research in
societies and cultures other than our own, notably the
work of B. Malinowski and the anthropologists of the
school of F. Boas, has shown the existence of systems of
values and attitudes wholly incompatible with Freud’s
 INTERPRETATION OF PSYCHOTIC ART 135

hypothesis. It is unnecessary to stress the extreme im-

probability of Freud’s theory that there was a primal
horde in which the dominating father was slain and that
the feelings of guilt aroused by this murder were the
starting-point of civilization; recent attempts to treat this
theory as untrue historically but true ‘‘endopsychically”’
have made it no more plausible. Considered sociologically
and anthropologically the whole psycho-analytic theory
is deficient because it neglects the differential effects of
culture and the social environment on the child’s de-
velopment. It is true that in the majority of cases the most
influential persons in shaping the child’s attitudes, values
and standards are its parents, especially its mother; but
those parents are themselves part of a more or less complex
social pattern in relation to which the values that they
instil into the child vary in nature or emphasis. Besides
this, the individual’s personality and strivings cannot be
said to be rigidly determined in early infancy. The
human organism carries a number of inherited psycho-
logical tendencies, but it is especially characterized by
its plasticity of behaviour. This plasticity is greater
in childhood than later and becomes progressively less;
even so it remains throughout life, save in patholo-
gical cases. The plasticyhuman organism from early
infancy onwards is in continual functional relationship
with a complex social structure; all the time it is
being modified in its strivings and its attitudes by that
relationship. The Freudian psychologists grossly over-
simplify this social structure and give little attention to its
importance.
The relevance of this criticism to psycho-analytical
interpretations of art products, pictorial and otherwise,
will be readily apparent. The great service of the psycho-
analysts in showing that art has a dynamic motivation
must be recognized; their over-simplified and one-sided
account of that motivation must be rejected. It should be
noted here that a Freudian formulation may at times be
found to give the most adequate description of a par-
ticular psychopathological case. The essential criticism
10
136 PSYCHOTIC ART
of the psycho-analysts is not that they state what is untrue
in a particular individual but that they fallaciously extend
into general laws what has been demonstrated only in a
special instance. For further basic criticisms of Freud’s
teaching I would refer the reader to the works of Sturt,
Wohlgemuth and Jastrow.
Systems of psychology which have developed out of
psycho-analysis have taken their point of departure from
a keen feeling of the.sHortcomings of the Freudian theory
in one field or another of psychopathology. They have
attempted to correct these shortcomings. Jung’s revision
of the psycho-analytical approach began on biological
lines by endeavouring to broaden the narrow concept of
the libido. This he did by calling all the strivings of the
organism “‘libido” and by postulating a system of
multiple and deepening psychological layers in the indi-
vidual such as the “‘persona”’, the “‘anima”’, “‘the personal
unconscious” and the “racial and collective uncon-
scious”. Jung found that in the course of analysis the
symbols became universal and expressed collective images
such as Good and Evil, instead of Mother and Father.
He maintains that these symbols originate from that part
of the unconscious which is primordial; furthermore,
these symbols have never been conscious and never
personal. They represent some kind of pre-thought, an
experience partly emotional and partly cognitive, which
has been handed down to the individual through genera-
tions from the dim past. These pre-thoughts or symbols
cannot be verbalized; they can only be experienced as
an urge for the universal, for the spiritual; they are the
“creative urge’’. It is possible that phantasy will express
those pre-thoughts in an adequate way. Hence the study
of phantasy-products, such as the drawings of patients,
can give direct access to the deepest layers of the person-
ality and so the therapist is enabled to help the patient to
achieve a moral balance.
These Jungian symbols are looked upon as the right
and only way to express the universal, so naturally the
“analytical”, that is, the Jungian psychologists, have
 INTERPRETATION OF PSYCHOTIC ART 137

collected an immense wealth of paintings from psycho-

neurotic and psychotic patients during the course of
treatment. In the Jungian analysis, by means of painting
the mandala, a symbol of concentric structure, makes its
repeated appearance. This contrasts with the drawings
obtained from their patients by non-Jungian psycho-
therapists, in which the mandala does not appear. One of
the best known works which thoroughly illustrates the
Jungian approach is Baynes’s Mythology of the Soul; I may
note that the far-reaching conclusions reached by this
author are based on the study of only two cases. Another
example of recent works written under Jung’s influence,
which I choose at random, is M. Petrie’s Art and Regenera-
tion (1946). This author has attempted a comprehensive
survey of art from a Jungian viewpoint, including the
mandalas and all Jung’s theoretical constructs. There is
little originality in the formulae of her work, but it is a
representative sample of the approach to art problems
made by this school. The methodological freedom that
she permits herself leaves small room for objectivity. ‘““The
existence of the unconscious is now regarded as an estab-
lished fact’’, she writes; this would be more accurate
scientifically if ‘‘ working hypothesis”’ were substituted for
‘*fact”’. The number’ of other art books, written in terms
of the Jungian theory, is enormous. For the understanding
of art, it would be less valuable to discuss all this literature
than to discuss the general scientific objections to Jung’s
concepts.
It is highly questionable whether the Jungian symbols
actually “‘express”’ collective images or whether they are
merely so interpreted. The chief proof offered that they
are such an expression is the introspective account of the
patient;alternatively the Jungian interpretation itself may
be presented as evidence. In either case the argument
rests on entirely subjective grounds, and in the second
eventuality is circular. The Jungian method of approach
is a priori and not empirical. Furthermore, as Boas and his
collaborators have repeatedly pointed out, anthropological
evidence indicates the relativity of all symbols and the
138 PSYCHOTIC ART
universality of none. Ruth Bunzel has fully demonstrated
this relativity of symbols in a number of diverse cultural
patterns. If it is shown empirically that there is no univer-
sality of symbols, then the central pillar of the Jungian
system falls to the ground. Another objection to this
symbolic theory is grounded in Jung’s conception, already
mentioned, that the symbols have never been conscious or
personal and cannot be verbalized. If they cannot be
verbalized then they cannot be apprehended rationally,
and they are insusceptible of scientific treatment. The
whole Jungian theory then becomes antithetical to a
scientific approach. One must here remark that medical
psychology, which is a branch of biology, cannot operate
with valuative concepts such ds “‘good”’ and “‘evil’’; its
sole value as a theoretical science is truth and as an
applied science the adjustment of patients, and not their
moral balance. The introduction of other values shifts
psychology from the empirical sciences into the fold of
metaphysical, ethical and normative inquiry. Nicole has
already raised the question: Is Jung a scientist or is he a
prophet?
Whilst certain paintings clearly suggest to the Jungian
psychologist the rudiments of the mandala, the same paint-
ings with equal clarity suggest phallic symbols to the
psycho-analytical spectator. It seems probable that the
contradictory interpretations depend on the projective
processes of the onlooker; he sees what he expects or is
predisposed to see. On the other hand, it is certainly a
fact that pictures produced by patients do actually reflect
in a clear manner the viewpoint of their particular
therapist. There is nothing surprising about this. The
analyst interprets the picture to the patient according to
his own enlightenment. Thus he influences him in the
production of the next one. So it proceeds. Ultimately the
pictures are diagnostic only for the therapist’s creed.
Whether art is interpreted from one viewpoint or the
other, each school offers merely a subjective basis for its
estimation. The problem of art is fitted into a pre-existing
theory; such fitting of problems to prior theories was a
 INTERPRETATION OF PSYCHOTIC ART 139

typical feature of continental psychological work in the

early twentieth century.
Other investigators have inquired into the motivation
of artistic creativity from a different standpoint. These
workers, though their aims have varied, may be grouped
as Typologists. It is difficult, when surveying this vast
field of typology, to present it systematically, and only a
few representative theories can be considered. Jaensch,
whose work I have mentioned, extended his theory of
eidetic imagery to artistic productions; he recognized
different styles of work corresponding to his classification
of types based on the presence or absence of eidetic
phenomena, that is, corresponding to his tetanoid, base-
dowoid, epileptoid and other types. Lowenfeld, studying
the artistic productions of blind artists, distinguished two
types on another perceptual basis, a visual and a haptic
type or type dependent on the sense of touch. Jung built
up a quite different typology, not on the basis of per-
ception but on that of fundamental attitude (introvert
and extravert) modified by the four mental functions into
which he analysed mind, namely, Thinking, Feeling,
Intuition and Sensation. He applied this typology in
evaluating art, a procedure pushed ad absurdum by Evans.
Like the whole of Jung’s system, this typology rests on
prior and not empirical grounds. The basic attitudes of
introversion and extraversion are not defined in precise
and verifiable terms. They comprise a number of distinct
psychological variables, such as degree of responsiveness
to inner mental constructions rather than outer presenta-
tions, degree of introspectiveness and self-analysis, degree
of emotional expressiveness, degree of sociability, degree
of conformity to social norms, and other tendencies.
Common observation and experimental studies, such as
those of J. P. Guildford, alike indicate that the con-
comitant variation of such tendencies is never more than
moderately high. Still more important, there is no break
in their occurrence sharply dividing those individuals who
show them from those who do not. On the contrary they
are distributed, when any population is surveyed, in a
140 PSYCHOTIC ART

graduated form from minimal to maximal incidence with

the great majority of individuals showing a given tendency
to more or less the same extent; their distribution usually
approximates to a Gaussian curve. Moreover, in different
situations an individual shows a given tendency to varying
extents. The type concept distorts the facts. As for the
four mental functions, it may be said that no psychologist
outside the Jungian school accepts this analysis as either
true or convenient. Most British, as opposed to American
and Continental, psychologists still find it useful to dis-
tinguish the traditional three processes or aspects of human
behaviour and experience, namely, Thinking, Feeling and
Striving, but these processes are regarded as interlocked
and always present in a psychological phenomenon in
greater or less degree. One of these aspects may be more
marked in a certain individual’s behaviour than in the
behaviour of others, but there is no warrant for believing
that any individual operates chiefly by one process to the
exclusion of the others. The Jungian analysis ignores the
conative aspect, but adds the new functions of intuition
and sensation. This addition is pointless; the processes
called intuition and sensation can be satisfactorily
described as special forms of thinking in-:conjunction with
feeling. If one is to discriminate such special forms one
could make a much larger number than four. The exist-
ence of types of individuals using one (or two) of these
functions to the exclusion of the others has not been con-
firmed by empirical researches.
The introvert-extravert dichotomy of Jung is akin to
that of Kretschmer, based upon structure of the body.
Kretschmer’s typology is the best known and most widely
employed of all which rest on a distinction between consti-
tutional characteristics. It may be regarded as funda-
mental to all subsequent work along those lines.
Kretschmer calls constitution “the totality of inborn
peculiarities”; all the affective and voluntary reaction
of the individual he names character; and he applies the
term temperament to the psychic tempo or the “‘tempo of
performance”. These terms have been employed with
 INTERPRETATION OF PSYCHOTIC ART I4!

somewhat different meanings by other workers such as

McDougall and Willemse. Kretschmer distinguishes four
chief typical types, the pyknic, the asthenic or lepto-
somatic, the athletic and the dysplastic, and he finds that
these are correlated to two main types of temperamental
reaction, the cyclothymic and the schizothymic. The
cyclothymes correspond to the pyknic physical type, the
schizothymes to the other three types of constitution. The
cyclothymes are in good harmony with their external
environment, the schizothymes opposed to or detached
from it. So far as artists are concerned he groups the
realists and humorists with the cyclothymes, as for
example Wilhelm Busch, and the “pathetics”, romantics
and formalists with the schizothymes, as for example
Griinewald.
A number of investigators have found confirmation for
Kretschmer’s correlation of body-type to psychological
characteristics ; a number have not. There tends to be an
increasing doubt of his thesis in its bare and simple form,
though not of the basic proposition that somatic structure
is a determinant of psychological and psychopathological
reaction. The chief difficulty in his theory, as in the
Jungian and all other typologies, is that the vast majority
of individuals are mixed in. type. It corresponds more
closely to the facts to think not of types but of factors or
components which exist in varying measure in each indi-
vidual. Nearly all investigators have found a quite con-
siderable number of cases in which the psychological
reaction of the individual, healthy or morbid, is in contra-
diction to what would be expected from his somatic
characteristics, if the Kretschmerian theory were true.
This may be in part accounted for in terms of the varying
mixture of components and in part due to the fact that
experience, learning and the influence of the environ-
ment can transform the basic mode of psychological
reaction. Kretschmer’s anthropometric techniques leave
much to be desired. Moreover, Eysenck has drawn atten-
tion to the dubious validity of many of the conclusions
drawn from the measurements; for instance, among
142 . PSYCHOTIC ART

Kretschmer’s pathological cases, the differences found

within the schizophrenic group are almost as great as the
differences between that group and the group of manic-
depressives. Sheldon has developed more exact anthropo-
metric techniques than Kretschmer and has modified
the over-simple notion of types into the more appropriate
one of varying components, for which he has evolved an
ingenious system of measurement. He has also en-
deavoured to correlate constitutional to psychological
differences, but his work in the latter regard is less satis-
factory than his anatomical results.
All these typological researches remain problematic but,
again, like the efforts of the great psycho-pathological
schools, they have led to attempts to interpret the
motivation of artistic activity.
A practical application of these motivational approaches
was found in the study of the life-histories of well-known
artists. Such work became an attractive sideline of
psychiatry; psychiatrists of various schools produced in
abundance pathographic studies. The earlier workers have
emphasized the psychopathological aspect only, but
pathographers of later date put the emphasis on the art
itself. Thus Schilder, when studying Alice in Wonderland,
drew conclusions about the nature of nonsense poetry.
Kris examined the nature of caricatures from a psycho-
analytical viewpoint. Non-psychiatric biographies of
morbid personalities have also helped to enrich our know-
ledge of psychotic art in relation to the artist. An example
is The Quest for Corvoe, Symon’s study of F. Rolfe. The
classical work on pathography, now somewhat outdated,
is that of Lange and Eichbaum. They define pathography
as a ‘demonstration of the markedly abnormal or pro-
nouncedly morbid aspects of an historic and famous
character”. These two authors went far enough by not
sparing anyone in their search for the pathological. To
elucidate, however, what is aesthetically incomprehen-
sible in an artist’s production by correlating it to his
psycho-neurotic illness is only possible if there is a positive
correlation between his illness and his art. Weygandt has
 INTERPRETATION OF PSYCHOTIC ART 143

described two negative and two positive relationships that

might subsist between mental illness and art. He suggests
that illness might not affect art or it might extinguish art
altogether; as a positive correlation he thinks that illness
might facilitate a dormant talent or it might cause a
change of style. It is this last possibility that has usually
given a working hypothesis to pathographers in their
examination of the art products of “morbid artists”’.
To demonstrate the pathographic technique it will be
of value to make use of this approach in outlining a sketch
of the life and works of a celebrated artist, who showed
psycho-pathological features. The artist I shall examine
is Goya.

II

Francisco Jose de Goya y Lucientes was born in 1746.

His grandfather on his mother’s side was mentally ill, but
there is no further record of illness in his heredity. As a
child he was brought up in the provinces; even there his
talent aroused attention, and as early as 1759 he began to
study in an art school in Zaragoza, where he remained
for six years, during Which time the awkward country boy
developed into a pugndcious, gay young man. The few
documents which refer to these school years are not
entirely reliable, and it is a difficulty in making this study
that very little of the evidence about Goya’s life is reliable.
Men were killed one night in a rowdy scuffle; apparently
Goya was implicated, and according to some authors was
suspected by the Inquisition; other writers attribute the
Inquisition’s interest to another affair. At all events,
Goya fled and appeared in Madrid in 1765. He involved
himself in amorous adventures; consequently his biogra-
phers consider it a matter of course that he should be
found stabbed on one occasion. Some authors hold that
it was not till this period that the Inquisition regarded
Goya as a suspicious character; others maintain that
information against him was laid with the police. Goya
fled once more. He left Spain with a troupe of toreadors,
144 PSYCHOTIC ART
and eventually arrived in Italy, alone, forsaken and with
little money. It is in Italy that he is first referred to as an
artist. His adventures multiplied in Rome, and he had to
flee for the third time. The most diverse reasons are given
for this, as, for example, that he was arrested when trying
to abduct a girl from a convent and was freed only by the
intervention of the Spanish ambassador, who thereupon
sent him home. This is no more reliable than the story
that he climbed the spire on the dome of St. Peter’s.
Whatever the truth may be, Goya by 1771 had returned
to Zaragoza, where he lived nearly two years in an abbey
for which he was painting frescoes. In 1775 we again find
him in Madrid. He was now a married man; his wife was
Josefa Bayeau, sister to the court painter, whose earnings,
by reason of his technical conservatism, were high. Goya’s
wife was extremely attached to her brother, and he played
a large part in the family quarrels. The marriage was
unhappy; suffering silently all the time from her husband’s
infidelity, his wife bore him twenty children and then
died.
From 1775 Goya’s position and income increased, and
he received commissions from the Court. At this time he
painted the cartoons for the carpets in the Prado. Delight-
ful colours, charming compositions, attractive choice of
theme characterize these genre pictures. The religious
pictures he was commissioned to paint are likewise full of
harmony. By 1780 he was a member of the Academy and
was beginning to paint portraits, being by this time a man
of wealth and consequence. In 1788 Charles IV ascended
the Spanish throne. The king was weak, the queen ruled
through her lovers, morality gradually disappeared from
the court and corruption was rife. Goya was appointed
court painter, and became acquainted with the Infanta
Alba. His legendary relationship with her has been
coloured by his biographers with many phantasies. For
some time he lived in retirement, according to some
biographers, with the Infanta; in this seclusion he began
the peculiar series of engravings known as ‘‘ Los Caprichos”
(1793).
 INTERPRETATION OF PSYCHOTIC ART 145

These were different from anything else he had pro-

duced. The engravings, according to their content, can be
divided into several groups. Each has a title chosen by the
artist, and on many there is a supplementary note which
he has engraved or written into the margin. In this series
there are groups with sexual content, as, for example, Bien
ttrada ésta (Stylish Dressing), in which the girl is dressing
up with the assistance of a bawd. In the ;Que Sacrificio!
(What a Sacrifice!) old roués in lascivious attitudes and
with lecherous glances surround a young girl. Another
group has themes which are social or political; donkeys
ride on poor Spaniards, for example, or a monkey and an
ass are doctor and patient. Finally, Goya included some
very strange designs of demons and witches collecting in
wild flight, killing their sacrifices, plucking out their
feathers and even their genitals. The title-engraving is
also phantastic: Goya is surrounded by spirits, one of
whom is handing him a pen so that he can draw them.
The title he has written is ““The sleep of reason produced
monsters.”
He emerged from his seclusion and later, in 1798, he
painted the frescoes for the chapel of Sta Antonia de la
Florida, finishing them in three months. In composition
they once more resemble the earlier and attractive genre-
pictures, but the choice of theme, and the half-decayed
corpse (St. Anthony reviving a dead man), are reminiscent
of the unpleasant experiences depicted in the “‘ Caprichos”.
Apparently Goya could not escape from these experiences,
or so, at least, it is suggested by his pictures of the year
1798; for example, “‘Carnival”, “‘The Procession of
Flagellants’’, “‘The Tribunal of the Inquisition”’, “‘The
Madhouse”’.
At this time he was becoming deaf, an affliction which
grew still worse later on. About this time, also, his one
great love, the Infanta Alba, died suddenly. Europe was
now in trouble, and in Spain, church, civic rights and
morality all showed signs of decay. In France, Napoleon’s
star was rising, and in 1808 the French seized the govern-
ment of Spain; the horrors of war began. Goya retreated
146 PSYCHOTIC ART
to his newly-built country house, living in the greatest
isolation. Here he worked at a fresh series of etchings,
‘Los desastres de la guerra” (‘““The Disasters of the
War”’), and adorned the walls of his room with frescoes,
from which ghosts, demons, witches, vampires and murder
all stared down at him. The new etchings are symbolic
compositions with strange animal shapes, and realistic
scenes of war. In the “With or without Reason”’, for
instance, an overwhelming French force is shooting down
a few poor Spanish peasants. In another the subject is
reversed; its title is “‘There is No Difference’’. In several
designs there are mangled corpses, or violated dead women
lie under the ruins of houses. Finally, in one design, a man
vomits over a heap of dead: ‘Para eso habets nacido? (Were
Ye Born For This?). “Los desastres de la guerra”’ were
succeeded by the series “Los Proverbios’’, designed
in 1814-1815. Other authors call the ‘“‘Proverbios”’:
*‘Suefios” or “Dreams”. Apart from one which is in-
scribed ‘‘Disparate Claro” (‘‘Clear Confusion’’), these
are not named, and for the most part the ‘‘ Proverbios”’
have been given inadequate titles by art critics whose
interpretations conflict. Some of the designs show more
comprehensible motifs, as, for example, the puppet-show;
others are full of ghost-shapes, beings with divided bodies,
legs, mixtures of men and women. The “Proverbios”
impress one as dark, dismal, repellent and incompre-
hensible.
About 1817 Goya left his isolation to travel to Seville;
at that time he completed his ‘‘Tauromachia”’ or bull-
fighting designs. Once more he worked on religious
pictures, portraits and the like, which betray a quiet
seriousness and a sincere belief; the colours are subdued.
His new genre pictures, such as the “Women at the
Fountain”, once again show beautiful form and colour-
ing. In 1824 the old man, now aged seventy-eight, was
again in flight; this time the reason is supposedly the
anger aroused by a drawing with political reference.
However, nothing certain is known, and Goya soon re-
turned to Spain. Then, in spite of being highly honoured
 INTERPRETATION OF PSYCHOTIC ART 147

both by the public and the king, he went back once more
to France, where he died in 1828 of apoplexy.
Several elements in Goya’s life-history may point to
pathological trends. First, his frequent flights, which con-
tinued till his old age. For these restless escapades the
documentary evidence is insufficient and contradictory.
His first flight has been explained as due to the attentions
of the Inquisition, the second as due to the attentions of
the police. Yet these reasons are frequently confused
chronologically. The flight from Italy was romantically
explained, but vaguely like the reasons (‘‘on political
grounds”’) given for his flight in 1824. We may note that
he returned direct from Rome to Zaragoza from which
he had had to flee, six years earlier, so we are told, from
the Inquisition. And one may legitimately wonder why a
man under the ban of the Inquisition and of the police
should be protected by the Spanish ambassador and
allowed to travel without fear of consequences from Italy
back to Spain. Goya soon returned from his political
flight—an indication of how much credence one may give
to the cause.
Secondly, Goya’s fairly sudden “retirements”. We
know little about them, but their motivation appears to
be psycho-pathological*Though his first withdrawal was
attributed by some biographers to his idyllic seclusion
with the Infanta Alba, Goya about this time wrote to one
of his friends saying: “‘ My health is just as it was. I am
frequently so excited that I cannot endure myself.”
Three months after this letter he wrote to Bernardo
Yriarte, on January 4, 1794, “*. . . to occupy the imagina-
tive power deadened by so much brooding over my
pain”. Such evidence suggests that his condition was one
in which periods of excitement alternated with morbid
brooding. His second “‘retirement”’ only appears to have
been caused by outside events; in fact, it had nothing to
do with politics, since both the Spanish and the French
esteemed him. He was so submissive to the French that,
as Calvert relates, he helped Napoli and Maella to select
the fifty best pictures from the royal gallery for dispatch
148 PSYCHOTIC ART
to the Louvre. It is hard to reconcile this with feelings of
patriotism. Moreover, his seclusion had nothing to do
with the war, the horrors of which began in 1808, whereas
it was not until 1811-12 that he withdrew into retire-
ment. No documents exist about this period of his life,
and consequently, his seclusion remains mysterious for
his biographers.
A third pathological.element in Goya’s life-history is
this: that, even if oné_ allows for the fact that Goya was
an artist of the Late Spanish Rococo and held standards
of conduct appropriate to the period, he behaved patho-
logically. His adventures appear to have been unscrupu-
lous, and his love, which he experienced only at a mature
period of his life, he took as a great opportunity for boast-
ing. He was querulous and belligerent. In a letter from
Zaragoza, dated March 18, 1781, he wrote at great length
to the Building Committee. Scornfully and insolently he
criticized the objections to his sketches, boasted repeatedly
that he was a member of the Royal Academy, that the
royal family was enchanted by him and that all his
pictures had been received with great acclamation. He
complained that intrigues were being conducted against
him, that his enemies were dragging his private life into a
blaze of publicity just to set the public against him. He
considered that the committee were biased, for they
mentioned only the faults in his work. Bayeau had already
seen his plans; why was it only now that he objected to
the pictures? Goya would not care to assert that it was
being done intentionally in order to ruin him as an artist,
for he had not sufficient proof—etc. Undoubtedly he
did have difficulties with the Building Committee, but
if one compares the way in -which other artists, for
example, those of the Renaissance, reacted in similar
circumstances, one will see that Goya’s reactions on what
was, after all, a comparatively trivial occasion, were
almost paranoid.
To sum up these indications, Goya’s life-history shows
flights of obscure motivation, when he is restless, bump-
tious and over-active; in contrast it shows at least two
 INTERPRETATION OF PSYCHOTIC ART 149

retirements of equally obscure motivation, when he is

deadened, withdrawn and full of pain. These swings of
mood can plausibly be evaluated as expression of an ill-
ness of the manic-depressive type. If one makes use of the
crude body-type theory of Kretschmer, Goya’s constitu-
tion—so far as can be judged from portraits, including
the one by himself—was of the pyknic variety, which
would also favour the diagnosis of a manic-depressive
psychosis. His death from apoplexy, a disease character-
istic both of pyknics and of manic-depressives, points in
the same direction. In accordance with this, in his elated
mood his pictures are of pleasant colouring and are
descriptive and realistic, features stated by Kretschmer to
be typical of the cyclothymes. .
Yet several aspects contradict this diagnosis. Goya’s
personality before his illness was querulous and _ bel-
ligerent ; his family life was unhappy and badly organized ;
he died in a foreign country. A cyclothyme would have
arranged all that far better and would have been able to
find more harmony in life. His unpatriotic act in helping
Napoli and Maella to send away the best pictures to
France suggests emotional detachment rather than de-
pression. Furthermofe, Goya’s prolific output is against
the diagnosis of depresston. In all, Goya produced about
seventeen hundred works of art, of which about six
hundred belong to the period of his illness. One-third of
all his production, therefore, was created during his ill-
ness; such a creative productivity is never seen in melan-
cholia. One could, moreover, consider his flights as
expressions of a psycho-pathological “‘wanderlust”’ or,
in other words, as expressions of a schizophrenic dromo-
mania and his retirements as autistic periods; this would
indicate the diagnosis of a schizophrenic reaction. Goya’s
pre-morbid personality and especially his paranoid trends
are well in accordance with this tentative diagnosis.
More decisive support is given to a diagnosis of schizo-
phrenia by the designs he made during his autistic periods.
A very brief indication of their appearance has already
been offered. So far as content is concerned it appears
150 PSYCHOTIC ART

that they are ‘‘romantic” or phantastic rather than

descriptive and realistic. But closer examination of these
etchings reveals some features of greater diagnostic im-
portance. The ‘‘Caprichos” and the “‘Suenos”’ have only
vague contact with external reality ;they depict the inner
experiences of Goya, and the engraving “‘Sopla”’ (Fig. 14)
indicates the kind of experiences they were. At this period
the belief in witches had disappeared from Spain and
witch-hunts no longer took place ;consequently the source
of the theme is endogenous to the artist. ‘Ya tienen
asiento” is almost vulgar and very crude in its sexuality;
the symbolic factors in it are dominant, just as they are
in the picture of the metamorphosed doctor and patient
and in all the others as well. The “Proverbios” show a
still more marked alienation from reality, representing a
world of pure phantasy. They depict disturbed spatial
relations and they show obvious displacement and pic-
torial condensation; in them body-parts are cut off,
multiplied and divided. In Fig. 15, for instance, detached
heads with chattering teeth give melody to the rhythm of
the castanets; the discrepancy in the size and grouping
of the figures suggests unreality. In Plate 16, instead of
detached body parts, multiplication: of body parts is
depicted: heads are doubled, the man in the foreground
seems to have four arms, and thére are displacements of
body-parts. Reality and unreality lose their boundaries.
Fig. 16 shows in abundance pictorial condensation of the
shapes of men and women or human and animal into one.
Compositions of such a kind, which I have already dis-
cussed in Chapter 3, are pathognomonic of schizophrenic
experiences.
Goya’s illness also finds expression in the titles of his
engravings and in his subsequent attitude towards them.
Each picture of the “Caprichos” has a title, which is
organically linked to the design in a way similar to that
“writing in” of schizophrenic drawings discussed in
Chapter 2. The inscription on the title page as originally
planned by Goya has been noted. Another etching Goya
merely called “Tooth Hunting” ; this depicts a disgusting
raI fa)
a! Ey
Ao 2& Id 18 909% J ua 3 @)
v yor
tad SO

~Q
g
GI
oS

anf
:¥A0yD
soystudery
jo
aieig
“By
‘QI
oui
£
 INTERPRETATION OF PSYCHOTIC ART I51

and fearful scene. When recovering from his illness,

however, Goya dallied over the publication of his
*““Caprichos”; and before they were published he made
alterations in the titles. On the title leaf he wrote ‘‘ Phan-
tasy without reason produces monstrosities; purified,
however, they bring forth true art and create wonder”’
Ultimately he replaced the title page with a rather un-
imaginative self-portrait. Under the ‘Tooth Hunting”
he wrote: “Is it not pitiful that people still believe in such
stupidities?”? The superficiality of those remarks in no
way harmonizes with the pictures and the original titles;
it is possible to explain this by the fact that after his illness
Goya no longer could understand them completely. They
were alien to him because their function was anchored in
his illness, which, when he had recovered from it, became
to him. incomprehensible; hence he tried to rationalize
the documents of his illness with titles, which would
restore contact with reality once more. Goya’s retro-
spective attitude to his engravings, this subsequent lack of
understanding, so it seems, of his own work, corresponds
more to what we see in schizophrenics than in manic-
depressives. Present-day developments in psychiatry have
blurred many of the, former diagnostic entities; often it
would be hair-splitting to t discuss whether a case should
be labelled recurrent schizophrenia or manic-depressive
psychosis with schizophrenic features. What seems to be
significant is that those aspects of Goya’s work which are
aesthetically incomprehensible can be readily understood
when psychiatric considerations are introduced. At that
point the interpretative and speculative work of the patho-
grapher is concluded. However, it would be alluring to
extend the ideas developed in the previous chapter to
this examination of Goya. Some of the designs, such as
Plate 5, of the ‘“‘Proverbios”’, deliberately convey loss of
boundaries between reality and unreality and alterations
in the temporal system; others depict marked disturb-
ances of the body image and the spatial system. But
because we lack an adequate clinical history such a
commentary must reluctantly be abandoned.
Li
152 PSYCHOTIC ART

Hil

The power of illness to modify art by causing altera-

tions in style and content is only one of the problems
arising from such studies as I have outlined above. The
psycho-pathological schools have been interested in ascer-
taining how far art products, modified through illness,
have a function for the artist himself. But so far, those
studies have led to conclusions applicable to anyone at
all who ever did some painting before his illness, that is
to say, to anyone who displayed some degree of craftsman-
ship. Quite another problem is posed when the individual
who maintained productivity throughout his illness was a
creative artist such as Goya.
To draw satisfactory inferente from a pathography one
must consider personality, art and illness as a whole. In
consequence the question arises, To what extent does an
illness in a creative artist become transformed, modified
or merely reduced in its severity by means of his art?
This is an interesting problem in research which calls for
special investigations outside the scope of my present
inquiry. Further problems, aesthetic and _ sociological,
arise out of the pathographies: how far have the art pro-
ducts of morbid artists furthered the development of art
and influenced cultural advancement? Maudsley formu-
lated his answer in a positive sense when he said, ‘“‘What
right have we to believe Nature under any sort of obliga-
tion to do her work by means of complete minds only?
She may find an incomplete mind a more suitable
instrument for a particular purpose.”
 VIII

CULTURAL INFLUENCES

Art as an expression of culture and its influence upon it—Art as a

means of psycho-therapy.

THE APPEARANCES, MECHANISMS, dynamics and motiva-

tions of schizophrenic paintings have been analysed, all,
so far, in relation to the endogenous, that is internal,
biological factors. Exogenous, that is to say, environ-
mental or cultural, anfluences should play an equally
important part in the analysis, Unfortunately, at present,
we lack comparative material. The paintings of Western
European schizophrenics do not show marked differences
as far as cultural influences are concerned, and schizo-
phrenic paintings from America as reproduced by A.
Rosanoff do not appear to be different from the European
paintings reproduced by Prinzhorn. If they were available,
schizophrenic paintings executed by patients of a more
markedly different cultural background, e.g. Indian or
Chinese, would offer the basis for a comparative analysis.
But there is another problem in this matter of environ-
mental influences. It has been mentioned that there exist
numerous similarities between schizophrenic and
‘*modern” art products, though these similarities are only -
apparent. The dynamics of modern painting can be shown
to be those of a conscious and deliberate analysis. The
154 PSYCHOTIC ART
question then arises: what are the cultural factors which
move the modern artist to produce paintings with re-
semblance at least to the work of the schizophrenic
patient? :
To apply to these cultural factors a psycho-physiologica
viewpoint does not help very much. Brickner, for instance,
emphasizes the cognitive aspect of culture. He calls atten-
tion to the concept of telencephalization, that is, the
functional dominance-of the roof brain over the rest of
the nervous system, and goes on to state that culture is
its expression. In his words, ‘“‘acculturation (in giving
form to telencephalization) operates in the service of
survival functions because the function of telencephaliza-
tion is to produce increasingly, elaborate means for their
expression”. As the cortex matures, the material for
learning becomes more abundant; this is essential for the
process of telencephalization. The material comes mainly
from cultural sources and is learned from the parents.
Masserman, on the other hand, does not restrict his
interest to the way in which culture expresses telencephal-
ization, but links the two systems more dynamically. He
emphasizes, in an over-simplified way, that all human
activity is directed towards the satisfaction of physio-
logical needs. He specifies the physiological viewpoint in
his “‘principle of substitutive adaptation”’, which states:
‘““When the direct satisfaction of some combination of
physiological needs becomes difficult or impossible, be-
haviour becomes deviated into indirect channels of goal-
seeking, or is diverted towards the satisfaction of other
combinations of need.” In such a system, art plays a dual
role: (a) it influences the various patterns of behaviour,
that is, signs acquire ““meaning”’ ;and (b) these meanings
can be drastically altered by subsequent experiences.
These biological aspects re-emphasize the cognitive and
biological nature of culture generally and of art par-
ticularly. They also demonstrate the significance of cog-
nitive factors in moulding our environment, and emphasize
the weakness of too sharp a dichotomy between the
intrinsic and the extrinsic determinants of behaviour.
 CULTURAL INFLUENCES 155

Thus in the analysis of cultural influences we have to

consider other ways of approach. The anthropological
method has often been used, but its scope is limited just as
the psychophysiological method is limited. Anthropo-
logical formulations refer only to the patterns of primitive
culture: they cannot be applied without considerable
modification to complex communities such as our own.
The misunderstandings that arise from applying anthropo-
logical concepts in too simple a form lead to such a con-
clusion for example as that ‘‘our whole way of life and
thought is breaking down”’, or, as the poet Robert Graves
has expanded it, that poets and artists become to some
extent dissociated from the social order in which they live,
and ‘exiled in the wilderness”. Thus in their work they
do not express any cultural values but experiment in
various ways with form devoid of content. Graves has
stated in The White Goddess: ‘It is not as though the so-
called surrealists, impressionists, expressionists and neo-
romantics were concealing a grand secret by pretended
folly . . . on the contrary, they are concealing their
unhappy lack of a secret.”? The critic Raymond Mortimer
also believes in a gulf between the public and the painter,
owing to the painter’s voluntary exile; he thinks that
to-day’s art contains no*-communication, and for the lack
of it, it has lost its raison d’étre. According to Mortimer, a
religious revival might stem this rapid decline in pictorial
art. Some of the modern artists themselves feel isolated.
Paul Klee exclaimed, “‘We still lack the ultimate power, .
for the people are not with us.”
So it appears necessary to apply sociological definitions
and in this manner to differentiate between “‘civilization”
which involves utilitarianism, and “‘culture”’ which is the
sum total of non-utilitarian activities. The interaction of
both has been subject to various investigations, but here
only a broad and necessarily brief outline will be given
in support of my main theme. It will be best to compare
two racially and geographically distinct cultures and
their artistic expression; for this reason the Chinese and
the Western European have been chosen.
156 PSYCHOTIC ART
Chinese painting in its origin was part of a religious
ritual and as such entirely of secondary value, but later
it became, through the needs and wishes of the court, of
primary value. Its subsequent history shows how various
military conquests, religious and political changes, altered
the pattern of Chinese painting. Up to this point, both
Eastern and Western art had shown a parallelism in their
development, but a few peculiarities of Chinese painting
may be noted. It wasmore or less a secret craft handed
down from father to son. Essentially it was a strongly
formal and traditional mode of expression; once a motif
had been established it was faithfully copied for centuries.
These motifs were of representational nature, but tended
strongly to develop a symbolic eontent as well. The picture
of a bird, for instance, a flower, or an animal, in Chinese
painting was used also to suggest another meaning; thus
the picture of a bat suggested also happiness and “‘ plum
flower” also represented female beauty. Hence, pictorial
combinations such as geese and bamboo acquired well-
established symbolic meanings which were always em-
ployed in the same context. But, as S. Yenyns has shown,
whereas the social environment underwent alterations the
pictorial motifs owing to the marked: traditionalism in
painting remained the same, and ultimately became signs
without content. This was so much the case that the
meaning of most of the motifs became incomprehensible
to scholars themselves. The symbols apparently became
conventionalized.
Nevertheless, if geese and bamboo stand for proverbial
religious and philosophical values, they cannot be a
special bamboo or the representation of some particular
goose, but they have to reproduce the bamboo and the
goose to fulfil their general symbolic role. E. Newton
expressed this by saying that the Chinese artist paints the
essence and not the existence; he paints what he knows
and not what he actually sees. When the Chinese paints
a landscape his attempt is not to give his personal per-
ception of the landscape, but the generalized conception,
the idea of that landscape. Whether traditionalism is an
 CULTURAL INFLUENCES 157
expression of this search for the universal, or whether the
detached search for truth is a factor moulding Chinese
culture in general, is less relevant than the fact that the
interaction has produced the peculiar pictorial art of
the Chinese.
The Western artist on the other hand, once he became
a creator of primary values, painted what he saw and not
what is known. Both in Western and in Eastern painting,
needless to say, the emergence of art as a primary value
entailed the development of pattern and formal restruc-
turing for their own sake. In both there was an interplay
between tendencies to exact representation and tendencies
to patterning, with the emphasis now going in one
direction and now in the other. In both the ways in
which artists formulate their aims and intentions cannot
always be accepted at their face value, but often require
interpretation or restatement in accordance with modern
psychological and aesthetic knowledge. The manner in
which pictorial art emerged as a primary value in the two
cultures, the detailed differences in the development of
structural principles, the dynamic interaction of tenden-
cies in the contrasted cultures are matters for the art
historian which I cannot pursue here. It will be sufficient
to note that in Western painting the artist concerned
himself with the re-structuring of a particular presented
situation, in Asiatic art as a rule he concerns himself with
the structuring of a generalized or conceptual situation.
The Western painter, then, interested himself in the
actual appearance of a particular thing, attempting to
give his own re-structured perception of it. His main
interest was the appearance of his surroundings and not
the essence of them. But this attitude does not imply, as
E. Newton assumes, that once artists achieved their
freedom from control by social forces such as the church,
the state, etc., they became individualistic to an extreme
degree. The products of the Western artist have always
expressed the cultural values of his time. For instance,
photography has taught us that when the galloping horse has
its fore legs extended, its hind legs are brought underneath
158 PSYCHOTIC ART
the body. Through this knowledge our perceptual apprecia-
tion of Georgian sporting prints with their long-drawn
horses has altered; the galloping horses in them do not
nowadays suggest speed to artists or to onlookers. A new
way of pictorial representation began through this know-
ledge, as R. Wilenski demonstrated.
An indirect interrelation between civilization and art
is the civilized creation of the machine. it is logical, as
H. Read has pointed out, that the art of the machine-age
should not be naturalistic, but is bound to become
‘abstract’, an art of geometrical proportions and purely
formal harmonies. Again, the twentieth century has seen
the popular rise of psycho-analytic doctrine. Its elabora-
tion into our cultural theme.became manifest in the
surrealist movement, which chose as its sole subject-
matter—the subconscious. The intellectual interest stimu-
lated by Freud’s teachings turned towards the art products
of psychotic artists; Goya was looked upon by art his-
torians as one who did not fit into the spirit of his period,
Blake as an isolated phenomenon, and Griinewald for
unknown reasons as a simultaneous mixture of the past
Gothic and of the coming Baroque; the work of these
artists became appreciated and- understood through the
stimulation of a new interest and they began to influence
modern painters. Such examples, ~chosen at random, all
reflect, as H. Read has emphasized, the various cultural
trends within our society. From another point of view
Waddington has drawn attention to the rapidity of
modern life, which does not allow enough time to assimi-
late problems and get an accepted artistic solution for
them. But in spite of the complexity of the appearances,
of the subject-matter chosen, the main Western cultural
tendency, that is, a subjective interest in life, has remained
the same. This common factor in Western art seems the
more important when it is contrasted with Eastern art
as outlined here. Furthermore, it appears that “‘modern”
artists display an analytical interest in life, becoming
more objective than subjective, or, as E. Newton calls it,
they become puritanistic. Thus the seeming similarities
 CULTURAL INFLUENCES 159
between schizophrenic and “‘modern” art in no way
indicate a dissolution of our culture, but reflect a phase
of dynamic cultural development.
Above, by treating culture in sociological terms, I have
indicated that an artist, even in our complex culture, is
never divorced from his background. McIver, on the
other hand, differentiates culture from civilization by
arguing that whilst the character of civilization is
standardization, that of culture is individualism, and the
active function of the latter lies in operating by its indi-
- vidualistic impact on the former. A similar viewpoint has
been emphasized by Lord Russell in his Reith Lectures.
Of the active functions of art in the community, a few
should be enumerated here. First, pictorial art can on
occasions be more effective than language, a fact which
has been analysed by Masserman. Pictorial representa-
tions in political or commercial propaganda or the
cartoons of our time would illustrate this. Secondly, art
is said to have the capacity of graduating emotions. In
this respect art functions in a utilitarian manner in relation
to society. The graduation of emotion is achieved through
the aesthetic experience, which according to Bullough is
based on the factor“of physical distance. Without this, art
would be too petsonal and the emotional release too
explosive. Thus, watching a drama, we identify ourselves
with the hero and work out our conflicts through this
identification, not being aware that it is our conflict we
are releasing. Identification is probably self-evident in
such an example as that which I have just given, but this
identification (empathy) is a less satisfactory postulate
when pictorial art has to be considered. For in what sense
can empathy explain the aesthetic enjoyment of a male
spectator looking at Giorgone’s “Venus”, if aphro-
disiacal components are evidently excluded? If the man
identifies himself with the figure, this makes sense only to
a psycho-analytic evaluator (hidden homosexuality) or to
an ‘‘analytical psychologist”? (anima projection). Clearly
empathy fails on many other occasions to explain
aesthetic responses. Nevertheless, Bullough’s theory is
160 PSYCHOTIC ART
still accepted by many investigators as a working hypo-
thesis in the study of the social aspects of art.
Aesthetic experience demands as a sine qua non that one
has to “‘understand the picture one looks at”. One
appreciates a picture; whether appreciation has an
emotional component or not, it can only be possible if
the formal pattern present in the picture is comprehended
by the onlooker. In a historical perspective one can safely
state that as far as art expresses dominant and prevalent
cultural factors, aesthetic appreciation is unhampered.
The incongruity arises when the artist, through his indi-
viduality, differs from the social background and employs
new and hitherto not accepted methods. With many of
the pictorial art products of present-day creative artists
the technique involved is such that the painting cannot
be understood by a large number of the onlookers. The
artists have attempted to visualize in a direction which is
not that of the established contemporary vision. Never-
theless, they have re-moulded our appreciation of patterns
in art. Contemporary art demands—according to its
nature—a more marked intellectual collaboration in
appreciating it. This intellectualization of aesthetic
experiences has allowed a perceptual -appreciation of
patterns suggestive of schizophrenia, especially when the
painting is in the form of posters, Advertisements, etc.—
Waddington expresses this wittily :““The man in the Tube
may never have seen a picture by Picasso, and if he did
might dislike it; but he would not regard it with quite
the same blank incomprehension or shocked hatred as
did his father, who had never sat opposite a watered-
down Picasso advising him to “‘Go By Underground—It’s
Quicker.”’ In such a sense, art exerts yet another active
function. e

II

When one is reviewing the social functions of art its

therapeutic and educative properties have to be con-
sidered as well. The utilization of art for educative pur-
poses has been attempted and advocated from various
 CULTURAL INFLUENCES 161

aspects. It is evident that as this study concerns itself with

psychotic art, a review of therapeutic attempts is more
justified than one of educative or ‘‘preventative”’ efforts.
On the other hand, some mention of the latter is indicated,
when the social ieipibations are discussed.
Educative problems are intimately connected with
children’s art. To treat the subject-matter appropriately
one should correlate the psycho-physiological develop-
ment of children with the nature of their particular
cultural background; one should relate development in
drawing to the special characteristics of the growing
mind; one should outline the special world of the child;
one should especially investigate children with ability in
craftsmanship, and one should take into account the pre-
existing trends of teaching in craftsmanship and so forth.
It is apparent that such a treatment demands a study of
its own. Herbert Read in his Education through Art has
attempted a synthesis of the various aspects of “‘children’s
* that I have enumerated. He has drawn attention to
the importance of sensation and built up a theory which
attempts to show that if in the upbringing of children the
vividness of their sensations is preserved by certain recom-
mended methods,“as a result more satisfactory human
interrelations may develop. “Idealism would then no
longer be an escape from reality; it would be a simple
human response to reality.” As Education through Art is one
of the most significant works of the past few years, it has
to be more closely examined. The synthesis and the
methods of education recommended by Read are based
on anatomical, physiological and psychological evidence,
much of which shows serious shortcomings. A few of these
should be enumerated here. Read accepts that “‘the
analysis of the structure of the brain suggests the possi-
bility of a physical location for the three levels into which
Freud divided the mental personality, the id, the ego and
the super-ego”’. Now, as I mentioned in the introduction,
mental manifestations have no direct relation to structure,
but to the function of that structure. Furthermore, the
terms, super-ego, ego and id denote hypothetical concepts
162 PSYCHOTIC ART
which may offer a working hypothesis for a dynamic
psychology; but to search for their cerebral location is
incorrect.
Psychologically, Education through Art accepts the ideas of |
the Gestalt school including that of isomorphism, which
correlates phenomenal experience with structural events.
This, from a psychophysiological viewpoint, may be
correct, but the anatomical and physiological basis of it
is outdated. Anatomically Kohler argued that configura-
tions are perceived as such in the calcarine part of the
cerebral cortex, whereas the evidence indicates that there
is a separate demonstrable centre with visuo-gnostic
function, that is, it enables what is seen to be understood.
In other words, this centre has synthetic or configurational
functions, elaborating the amorphous material that is
registered by the calcarine cortex. The ‘‘electrostatic
patterns” of the isomorphists cannot be confirmed by
electro-encephalographic studies. Furthermore, the formu-
lation that ‘“‘chemical reactions accompany nervous
activity” is incorrect ;nervous activity can be expressed in
biochemical terms, as Sir Henry Dale and his collaborators
have shown, or it can be expressed in electrophysiological
terms. ‘These two modes of approach are: complementary
to one another, and both are modes of evaluation of
nervous activity. On the purely psychological side B.
Peterman’s work still represents the basic critical survey
of Kohler’s ideas. Thus the theoretical background of
Read’s synthesis needs re-examination, but his statement
of problems should stimulate further investigations into
his very important inquiry—how far, that is, can art as an
educative means alter human behaviour?
As I have said, the therapeutic possibilities of art closely
concern this study of schizophrenic art. Art as a psycho-
therapeutic means has a long history; it has been em-
ployed from various viewpoints with various techniques.
Although every division is somewhat artificial, leaving out
one aspect or the other and simplifying unjustifiably, I
would be inclined for the sake of brevity to review in such
a simplified manner the various approaches to the
 CULTURAL INFLUENCES 163
therapeutic use of art. A detailed review would call for a
monograph of its own.
Art as a hobby was recommended by psycho-therapists
before the establishment of the current psychopathological
schools. Its subjects were mostly the neurotic type of
patients, only some of whom bordered on psychosis. Its
technique was the teaching of craftsmanship largely along
naturalistic lines. Sometimes it achieved its aim in helping
the patient to develop a certain degree of technique. But
it was seldom used for purposes of proper self-expression,
and it furthered an undesirable dilettantism. In fact, it
was a kind of occupational therapy: it had nothing to do
with art.
Art as a psycho-therapeutic auxiliary was introduced
by the pupils of Freud. Pictorial symbols were looked
upon ‘in the same way as dream products, namely, as the
disguised expression of thoughts which had to be inter-
preted and ultimately verbalized. It was to be expected,
verbalization being the ultimate aim, that the paintings
collected by Freudians would exclusively be children’s
paintings—Jung’s mystical approach was more successful
in furthering the pictorial expression of adults. Yet the
pictures so obtained have no originality, since both
their appearance and «ontent are of a suggested nature
(seep, 236).
The encouragement of spontaneous self-expression is
yet another organized method of art treatment, much
under discussion in England at the present time. Lectures
on art followed by the encouragement of spontaneous
drawings were originated during the war by the British
Red Cross, and the method found its way to the psychiatric
institutions. Fundamentally, the method is twofold; first
the lectures on pictorial art and then the formation of art
classes in which, under the direction of an art teacher, the
patients paint whatever they wish. The art teacher is
merely an expert who encourages, but does not éeach
technique. Two types of such art classes seem to emerge,
largely depending on the art masters. In the one type, the
art master is unable to suppress his own personality and
164 PSYCHOTIC ART
thus influences his class. This alters the class in that the
talented patients become active and their pictorial pro-
ducts improve in quality, though to a great degree they
reflect the art master’s personality and approach to art.
The other type of art class develops a less homogeneous
character in its product, owing to the fact that the master
successfully maintains a negative personality in the par-
ticular situation. The utility of art classes is partly
diagnostic, partly therapeutic by the encouragement of
self-expression ; they will be therapeutically useful only if
the art master refrains from teaching craftsmanship.
But they enjoy one more characteristic in contrast to
the more individual methods I have mentioned: the
classes give rise to more material than can be obtained
through individual encouragement. This provokes an
important question, namely, whether or no there are
some group dynamics present in those art classes, which
influence the superior quality and greater quantity of
the art products? I have raised this question in previous
publications and since made some observations on paint-
ing classes where male and female patients, hospitalized
neurotics and psychotics, worked together. The studio,
paints, brushes, stands, etc., were a change after the rest
of the hospital environment. The patients arrived indi-
vidually, and took generally a stereotyped choice of place,
e.g. the same corner in the studio; they talked now and
then to their neighbour or neighbours, but no further
intimacy with the rest of the class developed. They did not
show an interest in the drawings of others, nor in the fate
of their work when accomplished, that is, of their com-
pleted painting.
This short description would suggest that group
dynamics are only minimally present in the art classes of
psychiatric institutions. In a group, members enter into
distinct relations, into functional interconnections; they
develop common attitudes; they develop traditions and
so forth. None of these are present in the art classes; they
are merely classes or, in the sociological term, associa-
tions. Associations consist of interest-conscious units, with
 CULTURAL INFLUENCES 165
no definite organization, the emphasis being on the
“interest” in contradistinction to the “attitude” of a
group. As McIver puts it, ‘‘We cultivate an art . . . and
find it desirable to join with others in so doing.’ Thus
there is a tendency to form associations and the satis-
faction of this tendency may be the explanation of the
greater productivity of those art classes, reinforcing the
drive for spontaneous individual self-expression in paint-
ing. On the other hand, such art classes do not give an
impetus to modifying human interrelations within a
diagnostically inhomogeneous crowd of patients.
American experiments, however, have gone further,
though detailed reports are still not available. One group
therapist let his group become ‘“‘integrated’’. Once: his
crowd became a group, he gave them the task of painting
a mural together. Out of such a task two possibilities may
arise; first, a diagnostic one, namely, how far an inte-
grated group is able to organize a picture; or, in other
words, the mural becomes an objective measure of the
group integration. Secondly, it might well be that the
common task of painting a mural gives a further impetus
to group integration. If this can be shown affirmatively,
then the sociological, query of whether “‘art is an integra-
tive force” might be answered as well. Naturally, the first
control experiment “required iis to prove whether any other
task would integrate a group equally well; if it would
not, then it would seem more probable that art has a
positive integrative force within a group. The question of
the socially integrative force of art is the point where this
discussion of art as a therapeutic means links up with the
rest of the problem of the present chapter.
Before concluding, however, something needs to be
said about the value of all these art therapies. The
diagnostic value of spontaneous products is immense, and
any means (art classes, etc.) which encourages this is
welcome. So many latent schizophrenias, well controlled
by the personality, become unveiled through painting.
Thus it is, in a sense, a “projective technique” of the
diagnostic armory. It also offers possibilities for various
166 PSYCHOTIC ART
experimental investigations such as the investigation
reported by E. C. Dax at the meeting of the British
Council of Rehabilitation; Dax allowed his patients to
paint under controlled conditions whilst playing classical
music to them. The paintings show some uniformity, con-
ditioned by the stimulus rather than by the mental state
of the patients. It is too early, however, to comment on
his findings. T. Greene has reviewed similar investiga-
tions, and H. Sigerist has commented on these problems
from a therapeutic point of view as well.
As an occupational therapy at a higher level, art treat-
ment is to be encouraged, but as a treatment fer se it does
not seem to have much value. Whether a patient acts out
his ‘‘autistic phantasies” in artistic creation and gets
better by means of this, is highly questionable; the duty
of the psychiatrist is in the first instance to help and not
to rely on chance therapeutic results. Hence he will
reinforce his physical methods of treatment with en-
couragement to paint, and vice versa. No psychotic on
record has been cured by means of painting alone; this,
of course, excludes the true artists whose relationship
to their art, including the question of the healing value
of their art, has already been raised. But this specific
question at present has to remain unanswered.
 SUMMARY
THE JUSTIFICATION OF a survey of psychotic art lies in the
employment of a different viewpoint. This in the present
survey is the psycho-physiological viewpoint, from which
all mental manifestations are seen as related to cerebral
function ; cerebral function in its turn is related to struc-
ture. Such a viewpoint assesses art as a manifestation of
man’s cognitive capability.
Psychotic art, especially schizophrenic art, has been
studied as far as its appearance is concerned, and it has
been shown that severai of the schizophrenic patternings
are physiologically conditioned. Supporting evidence has
been sought not only through clinical observations but also
from experimental results, such as the mescalin investiga-
tions. rs i
The content of schizophrenic paintings is determined
by the peculiarities in the mental life of the schizophrenics.
Of these peculiarities, the body image disturbances seem
of crucial importance, as they reflect on disturbed cate-
gorical (time and space) experiences. Furthermore, the
body image is a better operational term than the hypo-
thetical ‘“‘ego”’. It has been shown how far schizophrenic
art is influenced through disturbances of the body image
on the basis of experimental and clinical evidence.
The disturbed categorical thinking of the schizophrenic
artists suggested the examination of the cognitive aspect
of art, which has been to a certain degree investigated by
several workers. It has been found that factors which
acutely alter the categorical thinking, such as an injury to
the brain, induce alterations in pictorial appearances
12
168 PSYCHOTIC ART
similar to those of schizophrenics. The nature of these
cognitive alterations has been more closely scrutinized
and it has been suggested that the so-called categorical
or abstract and situational or concrete attitudes are not
necessarily antagonistic, but that in artists they may be
simultaneously present. A hypothesis of such a simul-
taneous presence of the two “basic modes of psychological
existence” in artists has been expanded.
Of the dynamics of psychotic art, the explanations of
the various psychopathological schools (Freud and Jung)
and of typologists have been scrutinized.
Yet another aspect of the dynamics lies in environ-
mental factors. Cultural influences on schizophrenic
paintings are unexplored; an attempt has been made,
however, to examine cultural’ factors which influence
‘“‘modern” artists to paint schizophrenic-like pictures. It
has been emphasized that the similarities of schizophrenic
and modern art are only apparent because the attitude of
modern painters is deliberately analytical, which always
results in some seeming fragmentation, and because
modern art is a logical consequence of cultural events.
Psychotic art involves the question of art-therapy; a
review of this, however, offers little which would justify
an organization of it in a broader sense.
Throughout this study it has heen emphasized that
whilst the aspect employed is a specific one, the points
raised and the conclusions drawn do not claim to offer a
generalized theory. The cognitive components are merely
components of psychotic or non-psychotic art. But it is
better to arrive at some truth even if it represents only a
fraction of the vast problem of art. “‘The problem’’—to
use Sherrington’s words—‘‘has one virtue at least, it will
long offer to those who pursue it the comfort that to
journey is better than to arrive . . . and when that
arrival comes, there may be regret that the pursuit is
over.”
 BIBLIOGRAPHY
Adrian, E. D. The Basis of Sensation. Norton, New York,
1928. ;
Adrian, E.D. “Electrical Activities of the Nervous System.”
Arch. Neurol. Psych., vol. 38, p. 1125, 1934.
Anastasi, A., and Foley, T. ‘‘Survey of the Literature on
Artistic Behaviour of the Abnormal.” 7. Gen. Psychol.,
vol. 25, p. 187, 1940.
Anastasi, A., and Foley, T. ‘‘A Survey of the Literature on
Artistic Behaviour in the Abnormal.” Psychological
Monographs, vol. 52, 1940.
Bartlett, F. C. Psychology and Primitive Culture. Cambridge,
1923.
Baynes, H. G. Mythology of the Soul. London, 1923.
Bender, L. ‘‘Psychoses Associated with Somatic Diseases
that Distort Body Stfucture.”? Arch. Neurol. and Psych.,
vol. 32, p. 1000, 1934.
Bender, L. ‘‘ Visual Motor Gestalt Test and its Clinical Use.”
Res. Monogr. Amer. Orthopsych. New York, 1938.
Benedict, R. Patterns of Culture. Routledge, London, 1946.
Boas, F. General Anthropology. Heath, Boston, 1938.
Brain, W. R. ‘‘ Visual Disorientation with Special Reference
to Lesions of the Right Cerebral Hemisphere.” Brain,
vol. 44, Pp. 244, 1941.
Brickner, R. M. Telencephalization (in Frontal Lobes). Williams
and Wilkins, Baltimore, 1948.
Burt, Sir Cyril. Mental and Scholastic Tests. Staples Press,
Ltd., London, 2nd ed., 1947.
Bychowsky, G. ‘‘The Body Image.” Journ. Nerv. @ Mental
Disease, vol. 97, 1943.
Cameron, N. ‘‘Reasoning, Regression and Communication
in Schizophrenics.”? Psychol. Monograph., No. 50, 1938.
170 PSYCHOTIC ART

Cameron, N. ‘‘The Functional Psychosis,” Chapter 29, o1

Personality and Behaviour Disorders. Ronald Press, New
York, 1944.
Chweitzer, A., Geblewicz, E., and Liberson, W. “Action
of Mescaline on the Alpha Waves.” Compt. Rend. Soc.
Biol., vol. 124, p. 1206, 1937.
Cox, J. W. Mechanical Aptitude, its Existence, Nature and
Measurement. Methuen, London, 1928.
Dalbiez, E. Psychoanalytical Methods and the Doctrine of Freud.
Longmans, Londor, 1941.
Dali, Salvador. La Conquéte de Virrationel. Editions Sur-
réalistes, Paris, 1935.
Durkheim, E. The Rules of Sociologic Method. Chicago
University Press, 1938.
Earle, F. M., and Gaw, F. The Measurement of Manual Dexteri-
ties. Nat. Inst. of Ind. Psycho., London, 1930.
Evans, J. Taste and Temperament. Cape, London, 1939.
Eysenck, H. J. Dimensions of Personality. Kegan Paul,
London, 1947.
Eysenck, H. J. ‘‘ Experimental Study of the Good Gestalt.”
Psychol. Rev., No. 49, 1942.
Forster, E. ‘‘Selbstversuch mit Meskalin.” schr. ges.
Neurol. & Psych., vol. 46, 1919.
Freeman, F. N. “An PSRCETICHECN Biuay of Handwriting.”’
Psych. Mongr., 1914.
Freeman, F. N. Psychology of the Common Branches. Harrap,
London, 1916.
Freud, S. Collected Papers. Inter. Psychoanal. Library,
Hogarth, London, 1945.
Goldstein, K., and Gelb, A. ‘‘Psychologische Analysen
hirnpathologische Falle.” Zschr. f.d. ges. Neurol. v.
Psychiat., 41 Pl., 1918.
Goldstein, K., and Scherer, M. ‘‘ Abstract and Concrete
Behaviour.” Psych. Mongr., No. 239, 1941.
Graves, R. The White Goddess. Faber, London, 1947.
Greene, T. M. ‘The Problem of Meaning in Music and the
Other Arts.” Journ. Aesthetics and Art, vol. 308, 1947.
Guttmann, E., and Maclay, W. S. ‘“‘Clinical Observations
on Schizophrenic Drawings.”’ British J. Med. Psychology,
vol. 16, p. 184, 1937.
Guttmann, E. “Artificial Psychoses Produced by Mescalin,””
7 Mental Science, vol. 82, p. 204, 1936.
 BIBLIOGRAPHY ty

Halstead, W. C. Brain and Intelligence. Univ. Chicago Press,

1947.
Halstead, W. C. ‘‘Specialization of Behavioral Function and
the Frontal Lobes,’? Chapter 11 of The Frontal Lobes.
Williams and Wilkins, Baltimore, 1948.
Head, Sir Henry. Aphasia and Kindred Disorders of Speech.
Cambridge, 1926.
Henderson and Gillespie. Textbook of Psychiatry. Oxford,
1948.
Hull, C. L. Aptitude Testing. Harvey & Co., London, 1928.
Hunt, J. McV. “Psychological Experiments with Dis-
ordered Persons.”’ Psychol. Bulletin, No. 33, 1936.
Hunt, J. McV. Personality and the Behaviour Disorders (Chapter
32). Ronald Press, New York, 1944.
Hutton, E., and Bassett, H. ‘‘The Effect of Leucotomy on
Creative Personality.” 7. Mental Science, vol. 44, p. 332,
1448.
Jaensch, E.R. Eidetic Imagery. Kegan Paul, London, 1930.
Jastrow, J. The House that Freud Built. Rider, London, 1937.
Jung, C. F. Psychological Types. Kegan Paul, London, 1923.
Jung, C.F. “‘The Psychology of Dementia Praecox.”’ Nerv.
Ment. Dis. Mongr., No. 3, 1936.
Kanner, L., and Schilder, P. “‘Movements in Optic Images
and Optic Imagination of Movement.” 7. Nerv. @
Ment. Dis., vol.-72, p. 489, 1930.
Katz, D. The World of Colour. Kegan Paul, London, 1935.
Klee, P. On Modern Art. Faber, London, 1948.
Kleist, K. Storungen des Denkens und thre Hirnpathologischen
Grundlagen. Enke, Stuttgart, 1939.
Kluever, H. ‘‘ Visual Disturbances after Cerebral Lesions.”’
Psychol. Bulletin, vol. 24, p. 316, 1927.
Knauer, A., and Maloney, W. “A Preliminary Note on the
Psychic Action of Mescalin.” 7. Nerv. G Mental Dis.,
vol. 72, p. 397; 1930.
Koffka, K. Principles of Gestalt Psychology. Kegan Paul,
London, 1935.
Kretschmer, E. Medical Psychology. Kegan Paul, London,
1939.
Lange, J. E., and Eichbaum. Genie, Irrsinn und Ruhm, Berlin,
1928.
172 PSYCHOTIC ART

Lévy-Bruhl, L. The Soul of the Primitive. Allen and Unwin,

London, 1928.
Lhermitte, J. L’Image de Notre Corps. Paris, 1939.
Lowenfeld, V. Nature of Creative Activity. Kegan Paul,
London, 1939.
Maclay, W. S., and Guttmann, E. “Spontaneous Drawings
as an Approach to some Problems in Psychopathology.”
Proceed. Roy. Soc. Medicine, vol. 31, 1937.
Maclay, W. S.,and Guttmann, E. ‘“‘Mescalin Hallucinations
in Artists.” Archeof Neuro. G Psych., vol. 45, p. 130,
IQ4I. =
Malinowsky, B. Crime and Custom in Savage Society. Kegan
Paul, London, 1926.
Martin Purdon. ‘‘ Consciousness and its Disturbances.”
The Lancet, No. 654L—41, 1948-49.
Masserman, J. In—Modern Trends in Psychological Medicine.
Butterworth, London, 1948.
Masserman, J. Principles of Dynamic Psychiatry. Saunders,
Philadelphia, 1947.
Maudsley, H. Natural Causes and Supernaiural Seemings.
Thinkers Library, London, 1938.
Mclver, R. M. Society. Smith, New York, 1931.
Mohr, F. ‘Uber Zeichnungen von Geisteskranken und ihre
diagnostische Verwerbarkeit.”” 7. Psychol. Neurol., 1906.
Monakow von. Dzvze Lokalisation im Grosshirn und der Abbau der
Funktion durch kortikale Herde. Bergmann, Wiesbaden,
1914. :
Money-Kyrle, R. Superstition and Society. Hogarth Press,
London, 1939.
Myers, Sir Charles. ‘Individual Differences in Listening to
Music.” B. 7. Psych, vol. 13, 1923.
Newton, E. European Painting and Sculpture. Penguin Books,
1945.
Nicole, E. Psychopathology. Bailli¢re & Co., London, 1948.
Noyes, A. Modern Clinical Psychiatry. Saunders, Phila-
delphia, 1939.
Patrick, C. Archives of Psychology. New York, No. 178, 1935.
Patrick, C. Journal of Psychology. Provincetown, Mass.,
No. 4, 1937.
Petermann, B. The Gestalt Theory and the Problem of Con-
figuration. Kegan Paul, London, 1932.
Petrie, M. Art and Regeneration. Elek, London, 1946.
 BIBLIOGRAPHY 173
Pétzl, O. “Die optisch-agnostische Stérungen.”? Handbuch
d. Psychiatrie, Deuticke, Leipzig, 1928.
Prinzhorn, F. Buldneret Geisteskranken. Springer, Berlin,
1922.
Read, H. Art and Society. Faber, London, 1945.
Read, H. Education through Art. Faber, London, 1947.
Read, H. The Grass Roots of Art. Lindsey Drummond,
London, 1947.
Reitman, F. ‘Facial Expression in Schizophrenic Draw-
ings.” 7. Mental Sc., vol. 85, p. 264, 1939.
Reitman, F. “Lear’s Nonsense.” 7. of Clinical Psycho-
pathology, vol. 7, p. 671, 1946.
Reitman, F. ‘“‘Observations on Personality Changes after
Leucotomy.” Journ. Nerv. Ment. Dis., No. 6, 105, 1947.
Riddoch, G. “Phantom Limbs and Body Shape.” Brain,
P- 197; 1941.
Roheim, F. “Origin and Function of Culture.” Psycho.
Mono., 69, New York, 1946.
Rosanoff, A. J. Manual of Psychiatry. Wiley, New York,
1938.
Russell, E. S. Behaviour of Animals. E. Arnold, London,
1938.
Senden, M. von Raum u. Gestaltauffassung bei operierten
Blinderbornen. Fischer, Leipzig, 1932.
Schilder, P. Image aud Appearance of the Human Body. Kegan
Paul, London, 31925,
Schilder, P., and Stengel, E. “Asymbolia for Pain.” Arch.
Neurol. and Psychiat., vol. 25, p. 598, 1931.
Schilder, P. Mind Perception and Thought. Columbia Univ.
Press, New York, 1942.
Sheldon, W. H. The Varieties of Human Physique. Harper,
New York, 1940.
Sherrington, Sir Charles. Man on his Nature. Cambridge
Univ. Press, 1946.
Sigerist, H. E. Cizvilization and Disease. Cornell, New York,
1943.
Spearman, C. The Abilities of Man. MacMillan, New York,
1927.
Spearman, C. Create Mind. Nisbet, London, Contemp.
Library of Psych., 1930.
Spearman, C. Psychology down the Ages. MacMillan, New
York, 1937.
Symons, A. J. The Quest for Corvo, Penguin, England, 1934.
174 PSYCHOTIC ART
Thomson, G. The Factorial Analysis of Human Ability. Univ.
of London Press, 2nd ed., 1946.
Tredgold, A. F. Textbook of Mental Deficiency. Bailliére,
London, 1947.
Valentine, C. W. Psychology of Early Childhood. Methuen,
London, 1946.
Waddington, C. H. The Scientific Attitude. Penguin, 1941.
Wallas, G. The Art of Thought. Cape, London, 1926.
Walter, V. J., and Walter, W. G. ‘‘The Central Effects of
Rhythmic Sensory Stimulation.”’ Electroenc. and Clinical
Neurophys., vol. 1, p. 57, 1949.
Wechsler, J. ‘‘ Partial Cortical Blindness with Preservation
of Cortical Vision.” Arch. of Ophthalmology, 1933.
Weygandt, W. ‘‘Zur Frage der pathologischen Kunst.”
K. ges. Neuro. Psych., vol. 94, p. 421, 1925.
Wilenski, R. H. The Modern’ Movement in Art. Faber,
London, 1945.
Wohlgemuth, A. A Critical Examination of Psycho-analysis.
Allen and Unwin, London, 1923.
Yenyns, S. A Background to Chinese Painting. Sidgwick,
London, 1935.
Young, K. Personality and Problems of Adjustment. Kegan
Paul, London, 1947.
 INDEX
A B
Abstract attitudes, 112, 113, 114 Bartlett, F. C., 45, 46
Aesthetics, 16, 100, 109, III, 159, Bassett, H., 103
160 Baynes, H. G., 137
Agnosia, 26, 28, 50, 51, 101 Behaviour, conative, 41
Ambivalence, 43, 44, 47 Bender, L., 33, 52, 67
Analytical psychology (see Jung) Bizarre
Anastasi, A., 15 actions, 23
content, 30
Anima, 136
notions, 24
Animism, 44, 47, 62, 84, 87, 88
Bleuler, 44
Anthropology, 45, 111, 155
Boas, F., 134, 137
Aphasia, 19, 28, 101 Body image
Apraxia, 100, IOI criticism of, 53
Art dein neurology of, 51
definitions, 2
w
psychiatry of, 49, 53-57
expression, III psychology of, 51, 89
functions of, 131 Brain
modern, 9, 24, 32, 90, 91, 116, function, I, 19, 53, 81
153, 158, 159, 160, 168 injury, 100, 101, 102, 113
pictorial, 2, 6, 24, 92, 106, 107, structure of the, 20
LAs 157 Braque, 29
psychotic, 15, 90, 92, 131, 142, Brickner, R., 154
161, 167, 168 Bullough, 159
therapy, 162-166 Bunzel, R., 138
Artist, 2, 4, 5, 11, 23, 29, 30, 32, Burt, Sir Cyril, 93, 95, 96, 107
34,/90, 100, 107, Pil, w12, Busch, Wilhelm, 141
115, 120, 127, 128, 129, 131, Bychowsky, G., 50
132, 139, 141, 142, 143, 148,
157, 158, 160
Associations, 164, 165 C
Ataxia, 21, 34
Autism, 166 Cameron, N., 42, 114
Awareness, I1, 51, 54, 113 Cephalopode, 39, 40
176 INDEX

Chagal, 4, 115 Disintegration, 23, 26, 27, 33, 38,

Children’s
art, 93, 94, 95, 96; 97; 61, 104, 116
161 Doodles, 36, 37, 38, 39
Chinese painting, 156, 157 Drawings
Chweitzer, 61 of children, 39, (see also’
Claparede, E., 49 Children’s art)
Collective subconscious, 136 of psychotics, 15, 16
Colour of schizophrenics, 21 et
behaviour, 25, 27 passim
in carbon monoxide poisoning, Dreams
26 ke day,9
in schizophrenic painting, 25 mechanisms, 39
of light, 26 night, 9
of objects of light, 27, 28, 29 phenomena of, 112
perception, 28 symbols, 13
responses, 82 Drugs (see Mescalin)
space, 26, 27 Durkheim, E., 43
Complex,
5, 33, 48, 54, 56, 58,
59, 60, 61, 90, 92, 97, 101,
110, 114, 115, 128, 135, 155,
E
159
Complex determined, 23, 34
Earle, F., 97
Composite figures, 38, 39
Education, 69, 78, 80
Concrete attitudes, 112, 113
E.E.G., 18, 61, 110
Condensation, 39, 42, 60, 150
Configuration, 10, I1, 30, 31, 32, Ego, 48, 49, 57, 60, 113, 161, 167
Eichbaum, 142
34, 52, 54, 85, 104, 162 Eidetic images, 33, 61, 139
Confusion, 106
Empathy, 159
Cortex; 28; 92; 101, 109, 114,
Environment, 18, 26, 27, 51, 52,
129, 154, 162 54, 57, 58, 59, 91, 96, 119,
Cosmology, 68, 75, 79
120, 121, 123, 134, 135, 141,
Cox, F., 97
Creativity, 103, 104, 111 154, 156, 164
Culture, 46, 134,.135, Evans, F., 139
154, 155, Experiences, 44, 69, 85, 124, 136,
159
141, 150, 154, 160, 167
Extravert (see Typology)
Eysenck, H.J., 108, 109, 110, 141

Dale, Sir Henry, 162

Dax, E. C., pX, 166 Foley, T., 15
Delusions, 57, 64, 73, 75, 118 Form, 21
Depersonalization, 24, 30, 57 Forster, E., 114
Derealization, 24, 30, 59 Freeman, F. N., 97
Deterioration, 31, 33, 42, 69 Freeman, W., 103, 119
 INDEX 177
Freud, S., 15, 44, 130, 131, 132, Hunt, McV. J., 114
133, 134, 135, 136, 158, 163, Hutton, E., 103
168
Hypertrophy, 24, 25

Gaw, F., 97
Id, 161
Gelb, 28
Ideas of reference, 22, 58
General paralysis of insane, 21
Identification, 47, 71, 73, 83, 84,
Gerstmann, 50
Ne)
Gestalt Impressionists, 155
criticism of, 30, 51, 162 Individual, 43, 44, 46, 95, 99;
good, 108 106, 107, 108, 109, 113, 114,
psychology, 10, 11 130, 135, 1375 140, 141, 164,
Gillespie, R., 1 165
Giorgone, 159 Integration, 165
Goldstein, K., 27, 28, 60, 70, 84, Intelligence, 68, 76, 95, 99, 109,
89, 113, 114, 115, 133 114, 115
Goya, 39, 130, 143, 144) 145, Introvert (see Typology)
146, 147, 148, 149, 150, 151, Isomorphism, 162
152, 158
Graves, R., 155
Greene, T., 166
Group J
dynamics, 164 - ~
treatment, 165 Jaensch, E. R., 60, 61, 139
&
Guildford, J. P., 139 Jastrow, J., 136
Guttmann, E., 15, 58 Jung, C. F., 15, 39, 83, 86, 136-
140 et passim, 163, 168

H
K
Hallucinations, 35, 115
auditory, 118, 124 Kanner, 33
experimental, 34 Katz, D., 27, 28
schizophrenic, 118 Keller, Helen, 56
visual, 22, 34, 35, 58, 60, 61, 89 Klee, P., 155
Halstead, W., 114
Kleist, 28
Head, H., 19, 20, 49, 50, 54
Kluever, H., 33
Henderson, D., 1
Knauer, A., 35
Hoff, 50
Hogarth, 6 Koftka, K., 57
Horror vacui, 104 Kraepelin, 16
 178 INDEX

Kretschmer, E., 32, 140, 141, Methedrine, 122, 124, 127

142, 149 Metzinger, 29
INGaRs (Gy, TBP VU. Mind, 3, 19
_ Kyrle-Money, R., 44 Modern art (see Art)
Mohr, F., 16
Monakow, von, 114
Mortimer, R., 155
L Myers, C., 106

Lange, J., 142

Leptosomatic (see Typology).
Leucotomy, 102, 103, 1173~119, N
123, 125, 128, 129
Levine, 33, 34 Negativism, 122
Lévy-Bruhl, 43 et passim Neologisms, 36, 37, 39, 72
Lhermitte, J., 50 Neurology, 51
Libido, 131, 133, 136 Neuropsychiatry, 3
Localization, 104 Neurosis, I, 2, 56, 137, 163, 164
Lowenfeld, V., 93, 139 Newton, E., 2, 156, 157, 158
Nicole, E., 138
Nonsense poetry, 37
Noyes, A., 36
M

Maclay, W. S., pX, 15, 25, 35, 37

Magic, 44, 47, 88 O
Magnan, 48
Maintenance activities, 134 Object colours, 28
Malinowsky, B., 45, 46, 134 Occipital lobe, 162
Maloney, 35 Oedipus complex, 134
Mana, 43, 44 Optic imagery, 33, 34, 36
Manic depressive, 21, 142, 149, Orientation, 27, 29, 74, 77, 101
151 Ornamentation, 31, 33, 115, 123
Mannerisms, 23, 32, 57, 85
Martin, P., 51
Masserman, J., 154, 159
Matisse, 29 P
Maudsley, 152
McDougall, 31, 141 Pain, 101, 102, 106, 147, 149
Mclver, 159, 165 Patterns, patterning, 5, 6, 17,
Memory, 61, 68, 76 157, 160, 167 ‘
Mescalin, 34, 35, 58, 59, 60, 61, Pappenheim, 15
63, 89, 167 Pathographies, 130, 142, 143,
and optic experiences, 35 152
and body image, 58 Patrick, C., 110, 111
hallucinations, 35 Perseveration, 23, 73, 84, 100
pharmacology of, 34 Persona, 136
 INDEX 179
Personality, 2, 23, 26, 38, 48, 62, Rosanoff, A., 153
TO2;) 113, L1G, PIO. 127. Ruskin, 58
127, 128, 129, 135, 149, 163, Russell, E. S., 134
164, 165 Russell, B. Lord, 159
Peterman, B., 162
Petrie, M., 137
Phantasy, 35, 46, 67, 103, 136,
150, I51 S
Photography, 157, 158
Physiology, 19, 63 Schilder, P., 26, 33, 34, 52, 53,
Picasso, P., 6, 39, 160 55, 63, 83, 101, 102, 142
Picture colours, 27 Schizophrenia, 21, 22, 23, 24, 26,
Posters, 160 27, 48, 57, 58, 59, 64, 89,
Potzl, O., 28, 50 149, 151, 160, 165
Prinzhorn, F., 16, 153 Senden, von M., 27
Projective technique, 44, 45 Senile, 21
Psychiatric social worker, 65 Sensations, kinesthetic, 50
Psychiatry, 142, 151 Set, 97,113,
Psycho-analysis, (see Freud) Sex, 39, 55, 66, 80, 81, 83
Psychology, 44, 52, 53, 63, 67, Sheldon, W., 142
107, 133, 134, 138, 162 Sherrington, 16, 18, 48, 168
Psychosis, 1, 2, 8, 24, 58, 63, 118, Sigerist, H., 166
124, 128, 151, 163 Signs
expressive, 13
substitute, 4.
suggestive, 13
R ay
Skill, 97, 98, 99, 117, 125, 127
Sociology, 2, 3, 10, 13, 17, 46,
Read, H., 2, 3, 158, 161, 162 110, ITI, 134, 152, 155, 159,
Reality, 8, 32, 41, 48, 86, 88, 89, 165
QO, 115, 124, 150, 151, 161
Space, 33
Red Cross, 163 Spearman, C., 31, 89, 105, 106,
Reitman, F., 68, 125 107, 108
Renaissance, 62, 115, 148 Stereotypy, 23, 37
Repression, 94, 95 Stout, G. F., 13, 46, 52
Re-structuring, 30, 90, 101, 107, Sturt, 57, 136
108, 157 Super-ego (see Ego)
artistic, 5, 8
Surrealist paintings, 9
psychotic, 8
Structure, 31, 90, 100, 103, 106,
Rhythms, 30, 33, 106
134, 135, 161, 167
Riddoch, G., 51 Stylization, 32, 33, 34, 60
Robertson, J. P. S., p.X, 4, 53;
67, 68
Symbols, 13, 24, 25, 36, 39, 60,
86 (see also Freud and
Roheim, G., 44, 134 Jung), 115, 131, 136, 137,
Rolfe, F., 142 138, 163
Rorschach (see Tests) Synthesis, 28
180 INDEX
T True perception, 25, 28
Typology
Tate Gallery, 4 eidetic, 139
Technique, 23, 26, 27, 45, 92, extravert-introvert, 139
99, 100, 102, 115, 124, 143, haptic, 139
160, 163, 165 pyknic-leptosomic, 141
Telencephalization, 154
Tests
Behn Ink Blots, 122 : U
Bender-Gestalt, 75, 125,° r26,
127, 128 “ae Units and Gestalt, 10, 30, 31, 32,
Goldstein-Scherer, 42 52, 85, 108, 164
Hanfman-Kasanin, 42
Hull’s, 125, 126
Kohs’ Blocks, 28, 125, 126 V
Lowenfeld, 93, 139 :
Rapaport and Halstead, 42 Valentine, C. W., 134
Reitman’s Pin-Man, 67, 70, Values, 16, 17
125, 127 Verbalization, 122, 123
Rorschach, 26, 42, 67, 68, 70, Vestibular function, 50
71, 81, 82, 119, 121, 122, Wigotsky, 42
123, 128
Thematic Apperception, 42,
67, 68, 70, 71 W
Visual Motor Gestalt, 67 “
Wechsler-Bellevue, 67, 68, 69, Waddington, 158, 160
71, 74 Marri A
Word-Association, 67, 68, 74, As it
81, 82, 119, 120, a ne Wane ae 18, 110
Thinking Water VvT TIO
categorical, 47 pan ee
Watts, J., 103
conceptual (abstract), 29, 42, Wechsler, I., 26
84, 89, 91, 92, 112, 113, 114, Wetherimer, 67
to ; Weygangt, W., 143
concrete (situational), 112, Wilenski, R., 158
PAS DALES Willemse, 141
logical, 44, 45 Wohlgemuth, A., 136
magic, 44, 79 Word salad, 36, 39 y
primitive, 47 Writing-in, 36, 37, 62
relational, 96, 100, 105, 106,
107, 108, 109
visualistic, 60 Y
Thomson, G., 107
Tradition, 128 Yenyns, S., 156
‘Tredgold, A. F., 128 Young, K., 133
a KQ-876-853 _