Psychopathology and Creative Cognition A Comparison of Hospitalized Patients, Nobel Laureates, and Controls Albert Rothenberg, MD \s=b\ To assess a tendency to rapid opposite responding asso- ciated with the type of creative cognition called janusian thinking, timed word association tests were administered to 12 creative scientists who were Nobel laureates, 18 hospi- talized patients, and 113 college students divided as controls into high and low creative groups. Nobel laureates gave the highest proportion of opposite responses at the fastest rate of all groups, whereas patients gave the lowest proportion of opposite responses at the slowest rate. Both Nobel laureates and high creative students gave opposite responses at a significantly faster rate than they gave common, popular (nonopposite) responses, and their average speed of opposite response was fast enough to indicate that conceptualizing opposites could have been simultaneous. The results support the connection between janusian thinking and creativity and indicate a distinction between creative and psychopathologic cognitive modes. (Arch Gen Psychiatry 1983;40:937-942) Genius, creativity, and psychopathology have long been connected in both the popular and the professional mind. A wide spectrum of deviant behavior, ranging from mild eccentricity to overt psychosis, is not merely accepted but frequently is expected from persons of genius or of high- level creativity. Scores of anecdotes abound about the strange actions of the great, and popular literature is replete with images of mad scientists, artists, and poets. Plato described poetic inspiration as a form of divine madness,1 and Aristotle reportedly said that "no great genius was without a mixture of insanity."2 Shakespeare, too, had one of his characters state, "the lunatic, the lover, and the poet/Are of imagination all compact."3 At the beginning of this century, important psychiatrists, the most famous of whom is Cesare Lombroso,4 wrote extensive treatises connecting genius and creativity with insanity. While tradition and anecdotal information point to a connection, few empirical studies have been carried out. Retrospective studies of documented evidence of mental illness among persons of eminence have been uncontrolled and equivocal in results,5"8 whereas the rare controlled studies9 " have indicated the presence of mental illness or psychopathologic styles of thinking12 among subjects whose creative accomplishments are uncertain. Barron13 found evidence of mental illness as measured by the Minnesota Multiphasic Personality Inventory in a group of highly creative writers, but he also reported the paradoxical finding of a high degree of ego strength in the same group. A persistent methodological problem in empirical studies that have been done is that they have assessed general per¬ sonality characteristics and symptoms rather than specific creative functions. They have either been focused on whether creative persons manifest psychiatric symptoms, or on whether persons with psychiatric illness and symp¬ toms manifest creativity.1415 Even if creativity and illness can be shown to coexist in the same person, or in a group of persons, it does not thereby follow that the two factors are specifically interdependent or causally connected. Unless particular factors in the creative process or in resulting created products can be plausibly accounted for by the presence of psychopathologic symptoms, the presence of creativity together with mental disorder could be either adventitious or mediated by other factors. Artistic styles, technological procedures, occupational factors of isolation or competitive stress, social and cultural recognition, de¬ gree of success, and political and economic climate may all be related to either or both creative achievement and mental illness at any given time or place. Deviation from overriding social norms of thought or behavior involved in certain types of creative work and activities may influence psychiatric assessments and measurements to show an apparent overlap. However, because creative achievements are highly valued and unique, and psychopathologic symp¬ toms are banal and stereotyped, a direct causal connection is not plausible at all. To assess the relationship between mental illness and creativity, therefore, specific factors connected with creative results need to be measured. This study is focused on a particular type of cognition previously identified as a factor in the creative process in diverse types of fields, including literature, visual art, Accepted for publication Dec 27,1982. From the Austen Riggs Center, Stockbridge, Mass. Reprint requests to Austen Riggs Center, Stockbridge, MA 01262 (Dr Rothenberg). Downloaded From: http://archpsyc.jamanetwork.com/ by a STANFORD Univ Med Center User on 06/23/2014