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Song of the Third Floor 

A new gallery in UNC Hospitals' neuroscience ward raises a question about the connection between mental illness and creativity

The UNC hospital campus is a vast canvas of asphalt, buildings, cars and construction--a surprising gray expanse in the otherwise green landscape of Chapel Hill. In the midst rises the N.C. Neurosciences Hospital. To the casual observer, it is monolithic, but to many patients and families who spend time within its walls, it is protean, a kind of fluid world where every day the human drama of the damaged mind unfolds--its ineffable sounds, colors, corners and labyrinthine passages.

On the third floor, in the hallways outside the wing housing the inpatient Schizophrenia Treatment and Evaluation Program (STEP), an array of artwork hangs as testimony to the mind's tenacity--a splash of color in answer to the monochromatic scene outside. This is a new gallery for art and healing where artists, who also happen to be outpatients and inpatients in STEP, will exhibit their work on a biannual basis.

Brushes with Life: Art, Artists, & Mental Illness is the inspiration of Wen Crenshaw, a senior recreational therapist in STEP. Disturbed by the long, barren white hallways that ushered patients and visitors to the inpatient STEP unit, and noting that many of his patients had been or were practicing artists, Crenshaw imagined transforming these blank walls into a gallery for his patients' paintings, drawings, musical compositions and poems. The cool, clinical hallways could become a warmer place--where art greeted and engaged the people who found themselves there.

This past spring, Crenshaw shared his idea with his colleagues. They soon formed a committee of doctors, nurses, therapists, designers and patient-artists, logging many on- and off-the-clock hours to make the gallery happen. Working within a tight budget, the committee members even undertook matting, framing and hanging the artwork themselves, explains Dr. Nancy Clayton, director of the inpatient STEP unit. The result is Brushes with Life, an exhibit that opened Tuesday, Jan. 9, with a reception sponsored by Pfizer, Inc. and the UNC department of psychiatry.

The range of artwork in the gallery is stunning--from medium to subject matter to sophistication. A few pieces are untutored; many are skillful, nuanced and complicated. All are compelling.

Some of the art seems a window into the interior lives of those with mental illness. An anonymous acrylic of vibrant color depicts a pile of wingless birds in the grass, with other wingless birds falling dead from the sky. A haunting epigraph appears in the sky: "It just isn't the same without my wings." In seeming counterpoint, Cliff Poole's pastel and crayon hangs in an adjacent hallway: a jack-o-lantern that leans gleefully forward on a brown background with the words, "Yes! Even Pumpkins Can Fly!" Despair and hope--these twin emotions bind us all together yet are experienced perhaps more acutely, and with more consequence, in these artists.

Most of the patients exhibiting in Brushes with Life live with either schizophrenia or manic-depressive illness, brain disorders that are largely misunderstood by the general public. Both usually surface in adolescence or early adulthood, both place patients at higher risk for suicide, and both are now believed to be biologically based and genetic.

In the popular imagination, schizophrenia is considered a multiple personality disorder, but in fact, it's a different condition entirely. In essence, it is a brain disorder that impedes perception and processing ability. A person with schizophrenia experiences a separation of emotion and response, of perception and rationality, and may suffer hallucinations, delusions or other distortions of reality, decreased expression of emotions, and disorganized speech, thoughts or behavior.

In schizophrenia, some neural circuits--the routes of travel in the brain's vast and byzantine road system--don't work properly. The result is reflected in the derivation of the Greek name of the disease--schizo meaning split and phrenia meaning mind. Persons with the disease often appear emotionally disconnected from the world around them. At its worst, the disease can bring on psychosis, turning the mind into a terrifying place of unfiltered sights, sounds and feelings.

Manic-depressive illness, a range of disorders popularly known as manic depression or bipolar disorder, involves extreme mood swings between mania and depression, although persons with the disease often experience long stretches of normal moods. Kay Redfield Jamison, a Johns Hopkins professor of psychiatry who herself has manic-depression, is a leading researcher of the disorder. "When you're high it's tremendous," she explains in her memoir An Unquiet Mind (Knopf). "The ideas and feelings are fast and frequent like shooting stars ... but, somewhere, this changes. The fast ideas are far too fast, and there are far too many; overwhelming confusion replaces clarity."

In Touched with Fire: Manic-Depressive Illness and the Artistic Temperament (The Free Press), Jamison details the symptoms of the disease that has racked her own life. Elevated and expansive moods, decreased sleep, increased activity and energy levels, rapid and intrusive speech and thought, elevated self-esteem, a conviction about the importance of one's ideas, spending large amounts of money, engaging in risky behaviors such as reckless driving and sexual liaisons--these are the common features of mania. A depressive episode usually follows, Jamison explains, plunging its victim into a dark mood characterized by "apathy, lethargy, hopelessness, sleep disturbance ... slowed physical movement, slowed thinking, impaired memory and concentration, and a loss of pleasure in normally pleasurable events."

In the last 50 years, the growth of psychiatric knowledge has exploded, Dr. Clayton notes. Antipsychotic and mood-stabilizing medications have been discovered to help those with schizophrenia and manic-depression. Psychotherapy assists patients in coming to terms with their disease, understanding the importance of taking medication and learning skills for living with mental illness. These new medications and other treatments have dramatically improved the quality of life for those with schizophrenia and bipolar illness, allowing many to lead full and productive lives.

Darren Clark, a personable 24-year-old with a goatee and infectious smile, wrote a poem titled "Twenty-One" hanging in the Poet's Corner of the gallery. Several years ago, while a student at UNC-Chapel Hill, Clark found himself in the inpatient STEP unit, and his poem tells part of his story. He wrote the poem, he says, "to commemorate the good, honest people" who cared for him during this difficult episode of his life. While his lines suggest the pain and confusion of this period--"Untimely ripped/From a womb of warmth and half-light" and "Like a man broken in spirit,/Like a wanderer: exhausted and yearning"--it is, in the end, a poem that celebrates the people of STEP. "I sing of the third floor," Clark writes, a modern-day Whitman telling an essential American story of one young man's working his way through mental illness, and the doctors, nurses and staff who helped him find his way. Today, Clark is a part-time student at UNC-Chapel Hill pursuing his interest in poetry and fiction writing.

Brushes with Life intends to jumpstart a much-needed reform in the way we understand and treat those with mental illness. Neither manic depression nor schizophrenia is an uncommon disease. In its more severe form, manic depression affects one person in 100, and in its milder forms, it affects the same percentage again. Schizophrenia, too, occurs in one percent of the population. Given the incidence of the diseases, it's amazing that social stigmas continue to attach to both--and that public understanding is so limited. Organizers envision their gallery as a kind of advocacy. "The committee felt the art gallery would promote mental illness in a more positive light," Crenshaw explains, "thus decreasing the social stigmas surrounding such mental illnesses as schizophrenia and bipolar disorder."

A number of gifted artists are showing in this exhibit. Robert Longmire is one of the more prolific. A youngish man with a soft voice and solicitous manner, Robert is rarely without his wife, Ashley Longmire, at his side. Married for three years, the two are markedly devoted to one another. "He's truly an artist," Ashley says, her blue eyes filled with conviction. And he is. Although his oeuvre contains many wall-sized pieces, the gallery shows his smaller work--and a good bit of it. One of his favorites is "The Thing"--an abstract acrylic mixing grays and robust color to suggest, Robert says, what he was scared of under the bed as a boy. Step back from the piece and you might see an octopus, a squid, the sun, sunshine, an embryo, eyes, a watery place.

Just down the wall hangs Robert's "Sunshine Horse," another acrylic he painted this fall after he and Ashley returned from viewing the Van Gogh exhibit at the High Museum in Atlanta. Within two weeks, Robert had completed six paintings, his mood "sometimes melancholy, sometimes happy as a bee." In "Sunshine Horse," a fantastical blue horse head in the left foreground juxtaposes with a black house in the upper right background. Robert points out the paved road that leads to the house, "a fortress," he says, and the yellow sphere that hangs above it all.

"My artwork is a manifestation of how I perceive myself, society, and all creation," Robert explains. He cites his biggest artistic influence as Van Gogh, but also credits Klimt's reds and golds, Picasso's brilliant bright colors, and Monet's impressionism. You can see a variety of these influences at work in his painting "Park at Dusk," which depicts, in his trademark abstract style, a local park where he and Ashley spend a good deal of time. Robert and Ashley dream about one day running their own gallery and making a living from their work. (Ashley, too, is an artist.)

Not only the exhibit's name--Brushes with Life: Art, Artists, and Mental Illness--but also the simple existence of the gallery invites speculation about the connection between mental illness and creativity, a notion that has pervaded Western culture since ancient times. Both Socrates and Plato wrote of "divine madness," a channel of communication with the gods that allowed poets and priests access to heightened powers of perception, to an otherworldly genius. That "madness" inspires genius is a culturally entrenched notion--and it's a controversial one.

Kay Jamison has conducted extensive biographical studies of artists and writers, both present and past. What she has found supports and debunks the madness mythology at once. In highly creative groups, manic depression occurs at a rate 10 to 20 times that of the general population. Mania, Jamison argues in Touched with Fire, often inspires "increased fluency and frequency of ideas," leading to creative thought and productivity. Depression, on the other hand, "tends to force a slower pace, cools the ardor, and puts into perspective the thoughts, observations and feelings generated during more enthusiastic moments."

But Jamison is swift to qualify her argument. "It should be emphasized that many highly creative writers, artists and musicians have no significant psychopathology," she writes. "Conversely, most individuals with manic-depressive illness are not unusually creative. It is, rather, that a disproportionate rate of affective illness exists in the highly creative."

As Jamison emphasizes, there is little room for romanticizing the mood diseases responsible for 60 to 80 percent of all suicides. Not to take medications in order to encourage creativity is life-threatening. Manic depression is "occasionally an exhilarating and powerfully creative force, more often a destructive one." She further notes, "No one is creative when severely depressed, psychotic or dead from suicide."

Arnold Ludwig, professor of psychiatry at the University of Kentucky and author of The Price of Greatness: Resolving the Creativity and Madness Controversy (The Guilford Press), resolves the question differently. For over a decade, Ludwig conducted a scientific study of 1,004 men and women who achieved prominence in the arts in the 20th century. Like Jamison and others, he found that artists are much more likely to suffer from mental illness than those in other professions.

But the creativity does not necessarily stem from the mental illness, he claims. It may be that the artistic professions, in placing "a higher premium on the creative products of persons than on their personal behaviors," attract those with mental disturbances. And it may be that these professions encourage artists "to portray the image of the mad genius or at least to cultivate their eccentricities to increase their public appeal." Mental disturbance can either heighten or dampen creativity, Ludwig argues. And in some cases, creative activity can actually lead to mental disturbance.

Only in concert with particular social circumstances and personal attributes would mental illness actually enhance creativity, he emphasizes. And although he describes this "template for greatness," in the end, Ludwig's conclusions are frustrating in their ambiguity.

When you step off the main elevator on the third floor of the N.C. Neurosciences Hospital, the first art you see is the largest and perhaps most accomplished piece in the exhibit: Bill Wyatt's acrylic on canvas "Fat Man in a Fun House Mirror," on loan from a private collection. A squat, thick-waisted man in a suit and hat stands on pavement and leans forward to the right. Wyatt depicts him from an elevated and distorted perspective, as if he were painting the fat man's reflection in a tilted mirror. It's an image both playful and dark. We're viewing this man in a fun-house mirror, yet we see him entirely in grays, browns and blacks. A deep shadow falls beneath him. He stands over a crack in the pavement. We don't see him directly but through the filter of burlesque reflection. "Where is the man--the essential man?" the painting seems to ask us. We know he's there somewhere. We look for him in our own mirrors.

If you are interested in purchasing any of the artwork, please contact either Wen Crenshaw or Dr. Nancy Clayton (STEP, N.C. Neurosciences Hospital) to see whether the piece is available.

  • There's a new art gallery in UNC Hospitals' neuroscience ward--and the artists are the patients themselves.

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