Ivan Tyrrell talks with Daniel Nettle about the far closer than expected connection between psychosis and creative thinking.

Tyrrell: What were you trying to do in your marvelous book, Strong Imagination: madness, creativity and human nature? I read it on holiday this summer and I couldn't put it down. It really is brilliant.

Nettle: Oh, thank you. It's a book with an odd history. I started out aiming to synthesise a biological, more phenomenological understanding of mental disorder. However, I hit upon this link between creativity and the predisposition to psychotic conditions and that became the central argument of the book. It seemed to tie in so much about the way that the mental resources we use to generate many of the symptoms found in mental illnesses, including hallucinations, obsessions and so on, are the very same resources which the human mind uses when it is being most creative and producing what is generally regarded as the most healthy and elevated human activities. So the book became an opportunity to really look at how the biology and psychology link up psychotic conditions in a continuum with the healthy mind.

Tyrrell: Yes, that's one of the reasons I was so taken with it, and because this links in with our work. It seems to us, looking at the fossil record, that the ancestors of modern humans at some point made some sort of psychological breakthrough and began to use the imagination in new ways. There was an explosion in different types of tools and inventions, beautiful carvings appeared, etc. This must have had something to do with the discovery that we could focus our attention in a new way — daydreaming — and ask new types of questions and problem solve much more efficiently. However, with this powerful new mental tool came a vulnerability — as well as focusing our attention outwards imaginatively, to ask questions and solve problems, it meant we could also focus our attention back in on our own emotional responses and obsess about them in a way no animal before us could do.

Nettle: Absolutely. This capacity that humanity has to make representations of our own representations, is enormously powerful because it allows us to talk to each other about the future, the past, the absent and the mythological and the imaginary. But we can also hallucinate and obsess and become diverted into mental loops that are unhealthy for us. Clearly the psychological power of human imagination, when harnessed to a mammalian set of moods, needs and rhythms, can be wonderfully productive — and it also can go wrong. Both potentials are there.

Tyrrell: It seems to be on a continuum and that comes across in Strong Imagination. You wrote that "Any psychosis is a physical process. Thus it can be caused by any other physical process or event, be it a fencing foil, a hallucinogenic drug, or a prior brain state. The earlier brain state might, in turn, be caused by something in the social environment, since the activity of the brain is constantly changing in response to input from the senses and the body."

Nettle: Yes. That's right ...

Tyrrell: And that's a brilliant point because the genetic templates that are laid down have to seek their fulfilment in the environment. You call these genetic templates, or patterns, 'archetypal needs', and if they aren't being met in people's lives, for whatever reason — social disruption, brain damage, loneliness, etc — there's a strong likelihood that those disposed to psychosis are going to have breakdowns.

Nettle: That's right. I'm very keen, as I think many people are these days, to go beyond the 'biological' versus 'social causes' dichotomy. Of course, in one sense, every depression, for instance, is biological because one level of analysis of the phenomenon is that neural transmitters fire off stress hormones. We are biological creatures which means that, however we react, it will involve our biochemistry. Each person has a social history and a way of interpreting life events, which, in turn, affects their biology. There are just different layers of the same phenomenon that can all be investigated, rather than putting some depressions into one category and some into another.

Tyrrell: Yes, that's very clear. Can we talk about how mainstream psychiatric opinion describes, or categorises, schizophrenia?

Nettle: There have been many attempts to split schizophrenia into several subtypes, along the lines of symptom clusters, course of illness, or treatment response; these have not proved predictively valid.

The mainstream of psychiatric opinion would say that schizophrenia is a heterogeneous but none the less valid category of severe mental illness. The core features of it can be divided into three main types. First, there are the so-called positive symptoms. These are the bizarre beliefs, delusions, and hallucinations which popular imagination most often associates with schizophrenia. Typical features of positive symptoms include hearing alien voices in one's head, feeling that one's thoughts or speech are being controlled or manipulated by an outside force, or believing that neutral, outside events have a special significance referring to oneself (these are called ideas of reference).

In contrast to the positive symptoms are the negative symptoms, so called because they involve a diminution of emotion and motivation. The schizophrenic is often withdrawn, indifferent, and seems emotionally cold. He may be a loner. His range of interpersonal responses is much restricted. He has a reduced sense of purpose, and has difficulty setting himself goals and going about achieving them. In short, the schizophrenic's ability to perform acts of volition seems impaired.

The third category of symptoms involves subtle changes in patterns of perception or cognition. The effects of these changes are sometimes collectively known as 'divergent thinking' or 'loosening of associations'. Schizophrenic thought has a surreal feel about it, as connections are made which are quite bizarre from the normal point of view. When asked to sort pictures of objects into classes, schizophrenics often depart from those categories most intuitively accessible to the rest of us, such as 'tools' or 'fruit'. One research subject put together a bath plug, a padlock, and a circle of red paper "because all three stop flows or processes". Another put together a trumpet, an umbrella, and a whistle because all of them are, in some way, "noise-producing objects". Schizophrenic responses can be either abnormally concrete, as when a spanner and a screwdriver are put together because they are silver rather than because they are tools, or abnormally abstract, as when a coat and a dress are put together because they both "maintain human modesty", or air and water are put together because they are "states of molecular density". Either way, the perspective is unconventional.

Tyrrell: Was there any reason why you list the positive symptoms of schizophrenia first?

Nettle: No. I'm not seeking to privilege the positive symptoms except that schizophrenia is not diagnosed in the absence of those. They are considered to be necessary but not sufficient. The positive symptoms are very remitting and often don't appear for a long time. When they become extremely severe for a period, that's when a label of schizophrenia tends to get applied. But then they may remit again.

But it's clear to me that those symptoms are just one possible manifestation of a kind of psychological process which is probably much more insidious and which involves, as it were, a disorder of the pathways of cognitive activity — and probably emotional activity too — which may rumble on in a way that's more quietly disabling. So, for example, it may very badly affect social relationships for years and years before anyone says, "Look, this is schizophrenia", because everyone thinks, "Ah, schizophrenia — that's hearing voices or seeing things".

Tyrrell: I see.

Nettle: I think the core of the impediment is likely to be a kind of processing mode, or set, which can manifest as these symptoms but may also be there in some people who don't necessarily have the very obvious positive symptoms. I think we've got to look at people's patterns of attribution, causal reasoning and so on, when they're not having frank hallucinations and delusions. And typically you find that, in people who have had schizophrenia and are now in remission or under treatment, those still remain odd, even if the worse sort of hallucinations and delusions are not currently active.

Tyrrell: When you say 'odd' would they be similar to attributional thinking styles that you find in depression, for example?

Nettle: Not necessarily. What you often find in depressed people is a feeling that particularly negatively weighted events are the product of the self. They catastrophise, "It was all my fault that such and such went wrong". They seem to see very starkly that they have caused a whole load of terrible failures or disasters in their life —

Tyrrell: The typical 'all or nothing', 'black or white' thinking style depressed people exhibit when their thinking is being heavily influenced by the emotional brain operating out of the 'fight or flight' response —

Nettle: But, with schizophrenia, more commonly there's a different kind of reference to self which is to do with thinking that events or objects refer to, or have significance for, one's decisions in ways that most other people would say were completely unrelated. Paranoia can be one manifestation of that. As can ideas of reference. They might say, if they saw three blue lorries together on a Friday, for example, that it was obviously a sign to them from someone.

Tyrrell: Yes. I've recently been talking to a woman whose ideas of reference include seeing intense, sinister occult meaning in the colour scheme of a particular television commercial which involves the journey of a mouse. She is convinced this is a personal message to her containing some evil significance.

Nettle: I think this area between a schizotypy and certain types of supernatural belief is an interesting area to explore. If people can feel that certain phenomena in the universe are telling them something significant, sending signs to them, that, say, natural phenomena like thunder and lightening refer to them personally, it seems to me that we're not a million miles from how certain cultish religious beliefs get established.

Tyrrell: Oh yes. You can see how superstitions and cult belief systems could take off when some people listen seriously to these sorts of ideas of reference!

Nettle: Absolutely! And clearly this comes back to our universal vulnerability to this kind of thing. In fact, it's a mode of talking which we find rather attractive. Hence the popularity of horoscopes and, if we see a black cat crossing our path, we might think that it refers to us when, in fact, a more rational analysis would be that the cat has nothing personally to do with us at all. This powerful inference-making apparatus we have is very good at detecting causal links, and perhaps a bit too good. Quite often, we're prepared to believe that this black cat crossing our path means that something bad will happen to us later, or something good. I think this stems from the development of the powerful mechanism for imagination that you describe — being able to go beyond the immediate — which our species obviously can do now.

Tyrrell: My colleagues and I are very interested in the role of dreams in distressed people. It comes up time and time again when you talk to them or read descriptions of how people feel when they are having breakdowns of various sorts — getting anxious, depressed or suffering in psychotic states. All these states seem to be connected to disturbances in the dreaming brain. Have you got any thoughts about that?

Nettle: Well, only that I think that it's an extremely interesting hypothesis. I've been around the schizophrenia literature for a while now and there is a kind of connection between hallucinations and dreams. One can't help but ask the question, are the voices and hallucinations that these people experience a kind of waking dream? But, as far as I can tell, it has never really been empirically investigated satisfactorily and it's something I'd be very, very interested in looking at further.

READ ON >>

© Human Givens Publishing Limited and Daniel Nettle (2001)

This article first appeared in Volume 8, No, 3 (2001) of the Human Givens journal.

DANIEL NETTLE is a lecturer in biological psychology at the Open University, in the Department of Psychology and Biological Sciences. He studied psychology at Oxford, before completing his PhD in anthropology at University College London. In 1996 he was elected a Junior Research Fellow at Merton College, Oxford. He has published many scholarly articles, as well as three books for Oxford Universiy Press: Linguistic Diversity (1999); Vanishing Voices (with Suzanne Romaine 2000); and the recent Strong Imagination: Madness, Creativity and Human Nature (£7.19)

> More information on the human givens approach and psychosis can be found in the following books both by Joe Griffin and Ivan Tyrrell

Dreaming Reality: How dreaming keeps us sane or can drive us mad

Human Givens: A new approach to emotional health and clear thinking

> You can find out more about psychosis and the new thinking on its causes at the following MindFields College events:

Understanding the mental health continuum Seminar

Psychosis: and positive strategies for Recovery Workshop

Return to top

> More information on the human givens approach and psychosis can be found in the following books both by Joe Griffin and Ivan Tyrrell

Dreaming Reality: How dreaming keeps us sane or can drive us mad

Human Givens: A new approach to emotional health and clear thinking

> You can find out more about psychosis and the new thinking on its causes at the following MindFields College events:

Understanding the mental health continuum Seminar

Psychosis: and positive strategies for Recovery Workshop

Return to top