Then melancholy, now depression: a modern interpretation of Rembrandt's mental state in midlife

The authors identify two Rembrandt etchings of 1642, Saint Jerome in a Dark Chamber and A Scholar at a Table by Candlelight, as self-portraits. Considered with biographical data, the prints suggest that Rembrandt suffered from a bipolar personality disorder, manifest in exuberance and lavish spending in the 1630s, and then, after the death of the artist's wife, in clinical depression in the early 1640s. Depression is depicted in the prints by their dark ambiance, and the figure's pose is traditional in art to represent melancholia, one of the four classical humors conventionally ascribed to artistic genius. In addition, the authors identify as a portrait of his wife the object at which the "scholar" is looking. Although the panel is turned away from the viewer of the etching, its size, shape, and material suggest that it is a painting that survives in Kassel, Germany.     

Recurrent depressive disorder in Caspar David Friedrich. A pathographical approach with operationalized diagnosis

Caspar David Friedrich (1774 - 1840) is one of the most important German Romantic painters. In his paintings, he prototypically represents the melancholy, which has been mentioned by his contemporaries and later biographers. Art scientists have also referred to his melancholy for the interpretation of his work. From a medical point of view, there are only two pathographies which remain inconclusive. Having applied diagnostic criteria for psychiatric disorders to his letters and publications, to statements of his contemporaries and to his art, we propose that he had suffered from a recurrent major depression which occurred in 1799 for the first time. At least three depressive episodes followed before he was struck by a stroke in 1835. There are epidemiological, psychodynamic and personality-typological reasons supporting our diagnostic assumption. The course of his depression corresponds to phases of reduced creativity, to the chosen techniques and motives. Finally we discuss the implications of our approach for the pathographical method in general.     

"I am rather satisfied with this interpretation of my dreams." -- real-life and work-related encounters between psychiatrist Johann Christian August Heinroth and poet Johann Wolfgang von Goethe

Apart from being a major pioneer of modern psychiatry, Johann Christian August Heinroth (1773 - 1843) is foremost famous as the first academic teacher, professor of this subject at Leipzig University. Despite his theoretical concepts being thoroughly investigated by medical historians, the fact that his scientific work also brought him in contact with Weimar poet and scientist Johann Wolfgang von Goethe (1749 - 1832) has up to now not been acknowledged. This paper analyses for the first time the manifold points of contact between the two geniuses. Starting off with a retrospective on Goethe's relationship towards psychiatry in his day, this paper investigates the mutual interconnections and influences between the two. This is achieved by an analysis of yet unknown primary sources as well as Goethe's literary and scientific works. A main emphasis is also placed on Heinroth's Textbook of Anthropology of 1822 in which the psychiatrist laid out his understanding of 'relational thinking' (gegenst?ndliches Denken), a key concept for both. This theory developed from Heinroth's dealing with Goethe's concept of "anschauung" and was to gain major importance not only for his way of gaining knowledge in general but also for his psychiatric concept. Goethe's influence on Heinroth is particularly revealed in the latter's holistic views on mental illnesses. Heinroth's visit to Goethe on 15 September 1827 can be earmarked as a sign of their mutual esteem.     

Cesare Lombroso: an anthropologist between evolution and degeneration

Cesare Lombroso (1835-1909) was a prominent Italian medical doctor and intellectual in the second half of the nineteenth century. He became world famous for his theory that criminality, madness and genius were all sides of the same psychobiological condition: an expression of degeneration, a sort of regression along the phylogenetic scale, and an arrest at an early stage of evolution. Degeneration affected criminals especially, in particular the "born delinquent" whose development had stopped at an early stage, making them the most "atavistic" types of human being. Lombroso also advocated the theory that genius was closely linked with madness. A man of genius was a degenerate, an example of retrograde evolution in whom madness was a form of "biological compensation" for excessive intellectual development. To confirm this theory, in August 1897, Lombroso, while attending the Twelfth International Medical Congress in Moscow, decided to meet the great Russian writer Lev Tolstoy in order to directly verify, in him, his theory of degeneration in the genius. Lombroso's anthropological ideas fuelled a heated debate on the biological determinism of human behaviour.     

Freud and the mighty warrior

This essay traces a prominent facet of Freud's personality, his being a "mighty warrior" throughout his life. This aspect of his character evolved as a reaction formation against his submissive father and as an identification with his more aggressive mother. He first tried it out in his highly ambivalent relationship to his nephew John, who was one year older. In his childhood play, Freud identified with certain military heroes, such mighty warriors as Napoleon, Hannibal, Alexander the Great, and Massena. As he grew older he shifted from military heroes to other great men including Goethe, Shakespeare, and finally Moses. He substituted these men as ego ideals in place of his father about whose stature he felt disillusioned. He far surpassed his father in his life achievements and yet managed to maintain an even-handed, respectable relationship with him until he died in 1896. His mother all but worshipped Sigmund but also demanded that he achieved the maximum in whatever he did. He had to earn her love by an outstanding performance but always wanted to feel unconditionally loved. His mighty warrior attitude developed into an important part of its personality. It protected him from feelings of helplessness and inadequacy and made him into an outstanding leader of the psychoanalytic movement.     

Charcot and art: from a hobby to science

Jean-Martin Charcot not only was one of the founders of modern neurology, but he displayed an exceptionally developed visual perception and memory, with special artistic gifts, which he used first as a hobby and subsequently as a tool in his profession. Previously unpublished drawings emphasize Charcot's talents in caricature, including autoderision. One of the best achievements of Charcot in correlating the clinic with art includes his thorough study of artistic representations of "possessed states", which allowed him to refine his work on hysteria. The artist and the scientist are two unique facets of Charcot, whose permanent coexistence help to understand his legacy.     

The consequences of stroke for the artist Lovis Corinth

The artist Lovis Corinth suffered a right-hemispheric stroke at the age of 53 years but only died 14 years later. The huge amount of work he produced after this life threatening disease allows detailed analysis of his post-stroke artwork in comparison to pre-stroke. When performing this analysis as a neurologist, an enormous diversity of subtle stroke sequelae can be discovered that are mostly explained by left-sided hemi-neglect. These findings clearly go far beyond pure psychological processes. Moreover, Corinth is a motivating example for disabled patients because he was able to produce great artwork after his stroke. He was struggling against a motor disability admittedly not severely affecting his artistic production, but also against severe neuropsychological deficits that did have clear consequences. Lovis Corinth left us the credo "True art means to use unreality". Taken together with the often cited phrase "Drawing means to leave out (details)", a clear-cut interpretation for neurologists can be derived from the understanding of right-hemisphere lesions and subsequent left-sided neglect.     

Machado de Assis's epilepsy.

Machado de Assis (1839-1908) is considered the most important Brazilian writer and a great universal literary figure. Little is know about his medical, personal and family history. He hid his "disease" as much as possible. Machado referred to "strange things" having happened to him in his childhood. He described seizures as "nervous phenomena", "absenses", "my illness". Laet observed a seizure and described it as: "... when Machado approached us and spoke to me in disconnected words. I looked at him in surprise and found his features altered. Knowing that from time to time he had nervous problems, ... and only permitted Machado take the Laranjeiras Street car, when I saw that he was completely well". A photographically documented seizure is shown. Alencar wrote, "The preoccupation with health was frequent: either he was having the consequences of a fit or was foreboding one". It is clear that Machado presented localized symptomatic epilepsy with complex partial seizures secondarily generalized of unknown etiology. The seizures which began in infancy or childhood had remission in adolescence and then recurred in his thirties and became more frequent in his later years. His depression got markedly worse with age. In our opinion, the greatest consequence of Machado's epilepsy, was his psychological suffering due to the prejudice of the times. Despite this Machado showed all his genius, which is still actual and universal.     

Introduction: commentaries and author's response to "The rise and fall of the autochthonous self: from Italian Renaissance Art and Shakespeare to Hediegger, Lacan, and Intersubjectivism" by Richard D. Chessick

This article addresses the unresolved question of the existence of a private core autochthonous self, as it has been described by Winnicott, Modell, and others. The postmodern version of the self has eliminated this concept entirely, relegating the self to a changing and unstable display, or regarding it as totally chaotic, or even an illusion. The question is raised whether by returning to the origins of this notion of a private self and then tracing its apparent dissolution it might be possible to discover some evidence that it still exists. The methodology used is that of obtaining knowledge directly through the arts and the claim is made that because empirical science has clamored to be the only source of knowledge, we have lost what could be obtained by direct intuitive seeing and experiencing the works of creative geniuses. To explore the rise of the autochthonous self this article provides an examination of the shift from Gothic art to Italian Renaissance art, a time which engendered the origin of "man" with his or her elusive private individual self that then became expressed in changing works of art. As this spread north, Shakespeare appeared and similarly invented and illustrated in his characters the private individual self, a concept not appreciated or recognized before the Renaissance. But as science arose and Western civilization began to decline, a corresponding disillusionment with "man" took place. The self began to be viewed as solely a social construction with no core except perhaps a genetic endowment. This was accompanied by a reduction in the concept of the human as a valuable and precious living being and was replaced by regarding the human as an object of control and exploitation. After the Second World War a movement in contemporary United States psychoanalysis gradually replaced the ideas of Freud and his emphasis on the "I" in the psychoanalytic process, with forms of relational therapy, assuming that the self was ab initio intersubjectively formed and could be altered fundamentally by focus on intersubjective processes. The author contends that this attitude makes it less likely for the psychoanalyst to focus on the regressive transferences from which derivatives of the private self arise and to grasp the phenomenological whole of the patient (p. 625).     

The rise and fall of the autochthonous self: from Italian Renaissance art and Shakespeare to Heidegger, Lacan, and intersubjectivism

This article addresses the unresolved question of the existence of a private core autochthonous self, as it has been described by Winnicott, Modell, and others. The postmodern version of the self has eliminated this concept entirely, relegating the self to a changing and unstable display, or regarding it as totally chaotic, or even an illusion. The question is raised whether by returning to the origins of this notion of a private self and then tracing its apparent dissolution it might be possible to discover some evidence that it still exists. The methodology used is that of obtaining knowledge directly through the arts and the claim is made that because empirical science has clamored to be the only source of knowledge, we have lost what could be obtained by direct intuitive seeing and experiencing the works of creative geniuses. To explore the rise of the autochthonous self this article provides an examination of the shift from Gothic art to Italian Renaissance art, a time which engendered the origin of "man" with his or her elusive private individual self that then became expressed in changing works of art. As this spread north, Shakespeare appeared and similarly invented and illustrated in his characters the private individual self, a concept not appreciated or recognized before the renaissance. But as science arose and Western civilization began to decline, a corresponding disillusionment with "man" took place. The self began to be viewed as solely a social construction with no core except perhaps a genetic endowment. This was accompanied by a reduction in the concept of the human as a valuable and precious living being and was replaced by regarding the human as an object of control and exploitation. After the Second World War a movement in contemporary United States psychoanalysis gradually replaced the ideas of Freud and his emphasis on the "I" in the psychoanalytic process, with forms of relational therapy, assuming that the self was ab initio intersubjectively formed and could be altered fundamentally by focus on intersubjective processes. The author contends that this attitude makes it less likely for the psychoanalyst to focus on the regressive transferences from which derivatives of the private self arise and to grasp the phenomenological whole of the patient.     

Une folle de Dieu : sainte Catherine de Sienne ou la passion du sang du Christ

The issue of “passion” or “passions”, which has been of great interest to philosophers, goes far beyond the definitions and clinical categories of classical psychiatric studies. Among the countless human passions (love, art, politics, science, crime, etc.), the extreme passion for God in Christianity, i.e. that of holiness, has always intrigued psychiatrists owing to the extraordinary nature of its psychological and physical manifestations. Catherine of Siena (1347–1380) was one of the greatest Catholic mystics and her extraordinary life has given rise to various hagiographical and critical accounts. The author proposes his personal thoughts on this saint with regard to the following themes: her religious vocation so early in life; her holiness recognized by others; her refusal of food (severe anorexia nervosa); her passion for the blood of men and Christ; her mystical eroticism; her states of anguish and ecstasy; her complex private and social personality; the expressions of her holiness and her boundless love for God, and how they are related to mental disorders. The author concludes that he is unable to form a definitive opinion about the nature and cause of the extraordinary mystic phenomena that inhabited Catherine of Siena.     

Espace et temps des corps chez Samuel Beckett

What are we subject of? This major question works the work of Beckett in such a stubborn way that the reader, witnessing a vital fight of which he does not perceive the challenge, is embarrassed. If the desire to rise the subject is the cause, how to localize it? Mindful not to deflect Beckett from his own personal approach, we will examine him through his reading of Proust. Whereas Proust purports to save love, Beckett saves the body. From this perspective, we will read Watt, Molloy and The Unnamable, focusing closely on the bodies and the way the objects, which will direct them in the space that they will define, are chosen. Becket does not deduce that these objects are assumed by a subject, or even that these objects imply a subject; he supposes a body which assumes a topological subject. Thus, by tracking the objects provided by the body, Beckett gets the subject's saying. In doing so, one wonders if the subject of the science with Proust is not replaced by the body of the science with Beckett. Thus, Proust did not affect Beckett; his analysis has determined his ethical stance as shown. Yet, in writing, Beckett keeps on a subject still possible.     

The veiled intimacy between neurology and Vincent van Gogh

Vincent van Gogh (1853–1890) is one of the most important painters of our history. Celebrating 130 years since the death of this genius, this article unveils the surprising relationship between van Gogh and neurology. Besides all his eternal artistic output, Vincent also suffered all his life from a neurological disease. Many articles have already investigated his illness and epilepsy appears to be one of the most reasonable diagnosis. There is much evidence that van Gogh's work was influenced by his neurological condition in several ways. Besides, the analysis of Vincent's life can provide several valuable teachings to neurologists.     

Issues Relevant to a Consumer Art Show

Abstract

The exhibiting of fine art created by persons living with mental illness has become widespread in recent years, with several associations collecting and showing pieces at national venues, including the National Alliance for the Mentally Ill, The National Mental Health Association, National Artists for Mental Health, and the Very Special Arts Gallery. Some researchers who have examined the works of scores of eminent artists, writers and musicians have found a positive relationship between affective disorders and creative genius. The first author of this paper, who describes his work with a consumer art show in Illinois, questions whether this apparent abundance of creative aptitude translates from elite populations of artists to the general population of persons with mental illness. Experts in the field differ as to whether there is any greater incidence of talent among the general population of artists who are mentally ill and the general population of artists.     

Robert Schumann

Robert Schumann, one of the giants of early romantic music, was born in Saxony in 1810 and died in an asylum shortly after his 46th birthday. Early in life, he demonstrated extraordinary skills in both music and journalism; he remained active in both areas until his final illness. His marriage to the remarkable pianist, Clara Wieck, provided him with both much-needed emotional support and a highly effective champion of his music throughout her lengthy career. Schumann's plans to be a concert pianist were thwarted at least partially by an injury to his right hand, the nature of which has been the subject of much speculation. After considering what few facts are available, the author concludes that this may have represented focal dystonia. His compositional output waxed and waned dramatically over his professional life, reflecting to some degree his emotional state. It is considered most likely that he suffered from a major affective disorder, bipolar type. This ultimately led to a suicide attempt in February 1854, and to his eventual death in July 1856. Despite wide-spread and reasonable suspicion that he may have died from neurosyphilis, severe malnutrition from self-starvation seems more likely.     

The place of the patient or the misfortune of the institution

Changes in psychiatric practices derive from noticeable revision of conceptual framework and from the presence of different resources available to treat mental health problems. After an absolute priority given to the psychiatric hospital which in hand of an able doctor like Esquirol was certainly a splendid instrument of care, has followed the "Sector concept" (catchment area) which ideally insists on preventive and therapeutic measures directed toward the sick or presumably sick individual. But such evolutions are seldom linear and vicious genius tends to slow if not to reverse the process. The author retraces here the evolution of a psychiatric care system managed by himself for 25 years. Originally created by Sivadon in the context of relative freedom due to appurtenance to the private sector, this experience has been developed through addition of a variety of therapeutic structures to end up with a comprehensive System of social psychiatric deserving a catchment area. The author gives us his insights on the slowly made modifications to the functioning of this structure. He confirms the value of the catchment area framework but in the same time underlines his risks.     

Friedrich Mauz – T4-Gutachter und Milit?rpsychiater

Friedrich Mauz is one of the medical perpetrators of the second tier whose biography is difficult to comprehend. Autobiographies from three different political systems exist - Weimar Republic, the Third Reich, and postwar Germany in which he constantly reinvented himself. While after 1933 he suddenly emphasized his participation in the civil war turmoil during the early period of the Weimar Republic and his patriotism, he then depicted himself after 1945 as an apolitical person characterized by Württemberg pietism who inwardly rejected the Nazi State but had found himself prepared to accept "all sorts of humiliating concessions." He claimed that he had always remained true to his scientific code of conduct and had distanced himself from psychiatric genetics. In point of fact, Mauz was among those exonerated in the denazification trial in 1946 and was able to pursue his career in the Federal Republic of Germany. However, if the sources are read against the grain, a different picture emerges. Mauz's career stalled in the 1930s, not because he had been politically offensive, but because his scientific work was flimsy and considered lacking originality, particularly since he had chosen constitution research and psychotherapy as his main fields of interest, which were overshadowed by research in genetic psychiatry in the 1930s. Mauz tendered his services to the Nazi policy of genetic health, served as a medical assessor in proceedings based on the "Law for the Prevention of Genetically Diseased Offspring," permitted himself to be recruited for the T4 program as a medical expert, even participated in the deliberations on a future "Law on Euthanasia," and as a consulting psychiatrist for the German Armed Forces contributed to military medicine.     

What grounds creativity?

"Developmental or ordinary creativity" is distinguished from "genius creativity." The former offers pleasure or distraction. The latter sometimes offers this, but tarrying before the product of genius also brings a new understanding of one's culture, one's self, and even an experience of transcendence. The concepts of Heidegger and of Gadamer are applied to this distinction. All serious artists are seen as manifesting one or more of three aspects: (1) driven by creative genius from the biological furnace of the individual, (2) temporary regressions and exhaustion of ego function, and (3) an anxiety-driven process resting on a constitutional ability to shift levels of ego activities and compromise formations. Falling in love is discussed as another example of creative imagination based on the need to solve psychological discomfort either due to developmental or pathological problems. Creativity in psychoanalytic work is an important factor that needs to be explored in addition to the fact that every country seems to create the approach to psychoanalysis that it needs. Emotional illness is demonstrated as hindering and constricting creativity, not enhancing it as is the popular idea. Some seriously psychopathological artists are able to wall off the pathology and sublimate their conflicts into the production of art, but creativity requires a relatively intact ego; when the ego deteriorates, so does the creative product. An important spring to genius creativity is the nonrecognition of the extremely talented child, which leads to solitary activity and an immersion in ideas and fantasies that, if the person has the requisite talent, is manifested in the expression of truth and beauty through art.     

Emperor Napoleon Bonaparte: did he have seizures? Psychogenic or epileptic or both?

Napoleon Bonaparte was a general in the French army at 24 years of age, later conquering most of Europe. He was one of the greatest military geniuses the world has ever known, but also an extremely intelligent individual. Did he have seizures? The evidence shows that he had both psychogenic and epileptic attacks. The psychogenic attacks were likely related to the tremendous stress in his life, and the epileptic seizures were the result of chronic uremia from a severe urethral stricture caused by gonorrhea that was transmitted from his wife, Empress Josephine.