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Imagination and Madness

Tyrrell: Well, we've published information on the connection between dreams and depression which, when applied in psychotherapy and counselling, massively improves the speed with which one can lift depression.

Depressed people, as you know, dream a lot more than non-depressed people. We know this from work in sleep laboratories. They have disturbed sleep patterns and wake up exhausted because they have been dreaming for far more than the normal two hours a night. Depressed people get little recuperative slow wave sleep. Also, when the brain is dreaming, it uses an enormous amount of energy. Just before dreaming starts, there is a massive firing of the orientation response, known as the PGO wave, which is what draws our attention to things, like loud bangs, when we are awake, and activates the fight or flight response. In depressed people, it is firing off all night, creating dreams that metaphorically act out all the unresolved emotional arousals from the previous day, brought on by excessive negative introspection.

If the reasons for the excessive introspections don't go away — and one reason can be the attributional style of overly negative thinking about the ordinary ups and downs of life — long term depression sets in. It is this exhaustion of the orientation response, night after night, which creates the depression.

And this is the same orientation response that we need in the daytime to motivate action and purposeful thought, which provides the meaning for our lives. If the dreaming process is exhausted, life does seem mean-
ingless. And that's how depressed people feel — even to the point where some of them kill themselves. All successful therapies, including antidepressant drugs, reduce dream sleep. That, we would say, is why they work.

Nettle: This is very interesting.

Tyrrell: We're coming to realise that stress, anxiety and depression seem to be on a continuum. Just as excessive environmental pressure can lead to depression, it can go on to trigger psychosis in those predisposed to it. Perhaps psychosis is the dreaming brain, not just exhausted as it is in depression, but so overloaded it invades daytime thoughts and activity to the point when the person can no longer tell the difference between a dream and waking reality. And so they have waking dreams — actually living and experiencing their dream metaphors.

I was speaking about this at a seminar recently, and a woman in the audience said, with tears in her eyes, that it made perfect sense to her because 17 years ago she had got extremely stressed and depressed about things going on in her life, and then collapsed into a psychotic breakdown which felt totally dreamlike. "I'm dreaming in the daytime," she kept saying to people, including her psychiatrist, but nobody took any notice of her! They just thought it was her madness talking.

Nettle: Yes, this is very interesting. And you do get this phenomenon, that I've seen clinically described, of people in psychotic states experiencing life in the way that we do in a dream where everything feels absolutely normal, but we also know is also very strange.

Tyrrell: Yes. While we're dreaming, it seems normal, doesn't it? The dreaming brain is a kind of reality simulator and we totally accept its reality while we are in it.

Nettle: Yes, and yet at the same time you are aware that this is something deeply unusual.

Tyrrell: Well, in lucid dreaming, for example, we can suddenly realise we are dreaming because a part of our mind knows that, say, we can't fly — so this must be a dream, and we become aware that it is.

Nettle: And exactly that ambiguity has often been reported in people's descriptions of the early stages of a breakdown. They are quite convinced that their hallucinations are real and normal, and indeed are part of everyday life, but they are also aware that they are not normal, and they really shouldn't tell other people about them because —

Tyrrell: Yes, it's as if part of the brain is still —

Nettle: — is still hanging in there. Yes!

Tyrrell: Not all of their mind goes into the waking dream.

Nettle: I certainly think that a lot of the content of hallucination and delusion may come not so much from the pathological response itself, but rather from our conscious mind's attempt to say, "Well, look, you've got all this chaotic, unreleased cortical limbic activity going on; how can we give it narrative meaning?" The conscious mind is, in a sense, a narrator, I think.

Tyrrell: And that narrative has to be metaphorical. Dreams themselves, the narrative and the individual elements of them, are always metaphorical resolutions. And if it's the case that metaphorical dreaming plays such an important role in the brain, it follows that paranoiac and other hallucinations would also be metaphors for what's disturbing and stressing a person. Just as dream metaphors are wacky, and therefore seem absurd to the waking mind and other people, they are not absurd to the metaphorical mind.

Nettle: Now, that's what's so interesting. They are simultaneously metaphorical and also extremely concrete, and I think that's the paradox of the condition. Symptoms are metaphorical and represent, no doubt, tensions that are being worked through, yet the narrator has to apply a concrete substantiation. This means literally believing in the metaphor, as in the case of someone I knew who totally believed that there were white vans waiting round the corner with certain men in them. So, whilst the symptoms are metaphorical, I have no doubt that, at the same time, our conscious mind is thorough enough an interpreter and narrator to give them an extremely specific localisation in space and time — so that the person is not aware of their metaphorical nature and experiences them as entirely concrete.

Tyrrell: Yes, but I suppose that would happen if they were constantly slipping in and out of the REM state. When something is breaking up, you get bits, don't you?

Nettle: Yes, well, that's right. I've no doubt that the dreaming mind makes use of perceptual and memory resources. So, if it's dealing with memories of threatening-looking people, for example, it's going to give them a specificity drawn from the person's own memory and own perceptual maps and so on. And so it will put them in, for example, white Ford transits.

Tyrrell: Well, white van man can be pretty threatening!

Nettle: Ah, well, yes. In the beginning of my book I offered a case study of a Victorian gentleman, Mr Matthews, who had hallucinations. They are exactly the kind of thing a science fiction writer of those days would have written about. Back then, people thought that the future of technology was all pneumatic — all big looms with pedals and people in stovepipe hats leaning over them. And this is precisely what this man hallucinated because he was using the representations available in his culture, which the dreaming brain would make use of. So there is a link between creative culture, the creative process and the hallucinatory one. You have unresolved emotional activity and you attempt to give that a concreteness in the representations available in your culture and experience. Hallucination is a biological function and a cultural one.

Tyrrell: Your book is very convincing about the high degree of depression and mental instability in creative people — writers, poets, artists, pure mathematicians — people who are doing a lot of introspecting in their work. It seems as if introspection itself, which is necessary for creativity, is also a vulnerability. Could you talk a bit about what you discovered about the connection between creativity and mental illness?

Nettle: When I started out researching this area I was aware that there is a stereotype linking creative people with psychiatric symptoms, particularly of depression. I began to wonder if I would find anything beyond that stereotype. Now, I think the evidence is pretty good that groups of people involved in creative activity are very vulnerable and, in general, the more solitary and the more open-ended the creative process they are involved in, the more vulnerable they seem to be. While creative people in chemistry and the biological sciences obviously have moments of extreme theoretical abstraction, mostly they are working empirically in groups, solving problems which are well defined. So they have a slightly lower level of vulnerability.

By contrast, people in pure maths, and in poetry and in music composition, seem to have high levels of vulnerability. I think this is because, if you're a poet, a mathematician or a composer, the field is wide open. There are not many parameters when you sit down to work. It's not a case of, "Well,
I've got to do this experiment and then count the numbers that come out of it". It's just me and the structures, the representations that I can create.

And that of course is incredibly pure and incredibly exciting but, as you say, it's deeply introspective, and the introspection need never terminate. Poetry, or making music, or doing pure mathematics, is never finished. There is always going to be something else to solve or express. There's always more you could do —

Tyrrell: — and more divergent possibilities.

Nettle: So it does seem that there's a particular linkage between the most open-ended realms where you could speculate, or, as you say, introspect, in
a non-terminating way, and those realms where the outcomes are more constrained and practical.

But is it the creativity that's making these people depressed or the depression that's making them creative? I suggest a third alternative — that the types of people who, by virtue of both their nature and nurture, are drawn to creative work are also likely to be vulnerable to depression. So, if you like, I'm taking the person's disposition as the unifying factor of the two.

Tyrrell: That's interesting. The vulnerability of the more creative person is that their disposition is not to hold on to rigid structures in their minds. Creativity only happens if you can let go of old thoughts and rituals and conditioning. I would expect that you're not going to get many sufferers of, for example, obsessive compulsive disorders having psychotic breakdowns because they would be so obsessively controlling. But when nature seems almost to be pushing some people to be less dogmatic, more creative, to let go, the risk is they become more flaky in their creativity, and eventually this can lead to schizophrenia.

Nettle: That's true. Though I think that, when we do more research on the creative personality, we will find it is actually a very paradoxical disposition.
What some studies have reported is that successful creative people — those we know and talk about in our cultures and disciplines as being creative — somehow combine apparently conflicting characteristics of openness but also strong control. And I think that typically the creative process involves a phase of openness and then a phase of doing the 99 per cent perspiration. They work in a way that's more convergent. When they have conceived of something they then have to get it down, get the details right, work in a more constrained, practical way towards the realisation of their vision — the creative outcome.

And I wonder if one difference between people who ultimately have psychotic breakdowns and people who have some of those same tendencies, but become very creative, is the degree to which they are able to perform that second phase. Lots of creative people report spending a very

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© 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