Psychology, Psychiatry and Writers Groups

The relationship between creativity and madness has long been studied, and creative writing is frequently used for therapeutic purposes. Both institutional and open-access writers groups offer further opportunities for patients and for researchers. An awareness of literary fashions and the current role of writers groups will help maximise the benefits.

Writers and the Self

Subconsciously or otherwise, people may read literature for psychological benefits. Zunshine (2006), Mar, Oatley, Djikic, etc suggest that reading fiction is a kind of simulation of social interactions. "After being given either fiction or non-fiction from the New Yorker, those who read the fiction piece scored higher on a test of social reasoning" ("The Psychologist", V21 No12, p.1030-1). Compared to the general reading public and even to other creative people, writers might have more need of these benefits

• "Nancy Andreasen has tracked 30 students from the University of Iowa Writer's Workshop. 80% had mood disorders (30% is average amongst similar people who are non-writers). 43% had some degree of manic-depressive illness (10% is average). 2 committed suicide over the 15 years of the study" ("Psychology Today", April 1987)
• "A great many writers find relating both painfully difficult and beside the point. The same qualities that make them writers - self-direction, independence, intelligence, skepticism, a love of solitude - also incline them in the direction of isolation, alienation and a carelessness about relating." (Maisel, 1999)

Writing may be a more useful form of simulation than passive reading, helping practitioners to

• analyse, prepare and anticipate human responses
• see other points of view
• create retrospective autobiographical narratives to analyse their past and plan behavioural reprogramming. Some writers create online personas, especially in the "fanfic" world - Fan fiction and its communities have long been of interest to academic researchers - see Henry Jenkins (1992)

Schizophrenia and depression are the mental illnesses most linked to creativity in the historical context (Schuldberg, 2001). He suggests that most often,

• artists who focus on emotions and feelings in their work are manic-depressive. Sass writes that poets like William Blake, Lord Byron, Shelley and Keats all suffered from manic-depressive illness
• artists who remove themselves from the world are more often associated with schizophrenia. Creative people with schizophrenia often experience a sense of alienation from the self, from their bodies and from the world. They become hyper-self-conscious but are able to step outside themselves, allowing a more cerebral form of creativity.

Some symptomatic mental traits could be seen as useful to writers, though the benefits tend to be specialised.

• Obsession - writers need to be determined and focussed
• Detachment; asocial distancing - writers need to be observers ("a poet even as falling down the stairs, will observe his fall" - Holub). A lack of empathy may assist observation. Also, staying away from people frees up more time for writing. Awareness of a lack of social empathy may result in compensating strategies - increased observation, etc.
• Asocial self-revelation/freedom - freed from the constraints of politeness and political correctness, writers might produce more interesting (or at least provocative) work. This could be another compensating strategy, hoping to encourage a response.
• Decontextualised (field-independent) thinking - randomness, chaotic/original thinking "outside the box", and finding unusual connections between things may help with creativity.
• Multi-level thinking - a characteristic of some schizoid thinking is the ability to see the underlying media without inferring meaning, seeing pattern as well as plot; noticing fonts, wordplay.
• Sensitivity - Highly Sensitive Persons and "neurotic" people might see things that others miss.
• Inhibition - excessive control may lead to an interest in Formalism and Oulipo
• Private language - Unusual forms of expression may result in interesting (albeit intractable) work.

The Writer in Society

"There have always been people in societies and cultures who have different experiences of reality compared with the majority, and there's always been an overlap between people who have those gifts, or insights, and people who are identified as suffering from mental illnesses" (Thomas, 2007). Social acceptance depends on the literary trends of the period. Some literary styles align with particular mental problems.

• Romanticism - trying to be at one with nature presupposes a split between the mind and the world
• Modernism - reading Sass's "Madness and Modernism" one might easily believe that modernism is dominated by schizoids
• Nouveau Roman - might suit the mind-blind
• Confessionalism - a school of poetry that merges well with therapy - easier to do if you don't care what others think of you, or the effects on family and friends
• Surrealism/Dada - these schools are based on random or subconscious images
• Ermetismo (Hermeticism) - a school whose poems were characterized by unorthodox structure, illogical sequences, and highly subjective language.
• Elliptical poetry (a term coined in 1998 by Stephen Burt) - "Full of illogic, of associative leaps, their poems resembled dreams, performances, speeches, or pieces of music"

Patients might consider themselves lucky if they're born into a era whose literary style matches their symptoms. Currently there's no dominant literary mode. The Web has helped like-minded people keep in touch, leading to a more fragmented literary scene where minority genres more easily survive.

Social Integration

If writers are going to support themselves by writing nowadays, they will need to teach, so social adaption is useful. It may also improve the chances of wider publication. The risk from the writer's viewpoint is that if (as Freud believed) their writing's a symptom, then it might disappear as they become more "healthy". Several normalisation options are on offer

• "Asylum" - rather than change the writer to fit society, new surroundings can be found to suit the writer. Some art colonies (and academic settings) are big enough to be self-contained worlds within which eccentricities are tolerated, even encouraged, creating their own norms that visitors adapt to.
• Borderline cases - those with borderline symptoms may be more strongly encouraged to tweak their style rather than adopt wholesale changes - e.g. writing a narratively normal piece with a mad person safely compartmentalised as the main character; normalising the appearance of their manuscripts and cover letters.
• Drugs - These may be offered to make life easier, but they may dull writing. Schuldberg suggests that drugs blunt the creativity of patients with manic-depressive illness more than that of schizophrenic patients.
• CBT - behaviour change (e.g. being encouraged to meet people) may take the edge off writing or use up time.

Some neurotic people have a high tolerance for loneliness, and may find writing a useful way to gain esteem while being alone. Socialising may not "cure" writing, it may merely take away the opportunities for writing, leading eventually to lowered self-esteem. However, socialising with writers is less problematic.

Writers Groups

"Seizing on a traditional trope of the poet as exceptional individual, certain individuals receiving health-care who feel themselves to be exceptional apparently adopt poetic discourse as part of that role", (Fiona Sampson, in "Kicking Daffodils", 1997). Some writers groups exist solely for people with diagnosed mental problems (see Survivors Poetry, etc). These and private study can help a writer's inner development, but before the writer emerges fully into society they can join a halfway house - a more public writers' group. The semi-structured discourse within a restricted domain coupled with tolerance of quirks makes such groups a welcoming environment. They range from one-off events to Master's degrees.

• Amateur - Local writers groups are as popular as ever. Some focus more on literary appreciation than production. Their repetitive, undemanding format offers newcomers the chance to hone social and literary skills prepared in isolation. They usually have annual membership fees. In the bigger cities there are performance venues too, with open-mike sessions. Weekend and week-long residential courses are increasingly popular.
• Academic - There are creative writing evening classes in most towns. UK universities are slowly catching up with their US counterparts (over 800 degree programs in creative writing exist in the States). Some are part-time with low-residency options.

Technical competence, commercial success, emotional authority and educational status all contribute to a complex web of interaction in a group. In an educational context the tutors have a potential conflict between academic assessment and encouraging self-discovery. Autobiographical writing is an exploitable grey area, especially when authenticity is considered a positive literary feature. "Creative Non-fiction" (encompassing autobiography and personal essay) is on the increase.

How writers can use a public writers group as a support group

At one writers group I attended in the 80s, a subset huddled at the tea-break who seemed to have little in common. I later found out that they'd all been to the same local mental hospital. Therapy professionals who recommend patients to go to particular groups should perhaps attend one first - their atmosphere can vary a lot. Some groups offer tea, biscuits and companionship with a stable membership, others are competitive hot-houses. Some benefits of using writers groups are that they're cheaper than evening classes, casual, less committal, and (as opposed to self-help therapy groups) the person is not stigmatised as a patient. However, the writers need to be self-analytical enough to exploit the benefits, and meetings can be rather unstructured with difficult members. Advice includes

• trying an online group first.
• being prepared to face robust criticism that judges commercial potential more than depth of insight. Nervousness is common when presenting work, and crying's not unknown.
• looking upon all expression (comments as well as explicit self-analysis pieces) as revelation. The more gestures, the more that's said and written, the more there is to analyse.
• monitoring how much you speak in proportion to how much others speak, and checking the proportion of positive comments you make compared to negative ones.
• playing the game of wanting to be a writer, wanting to be published.
• studying theory in order to defend idiosyncrasies on theoretical grounds. Finding an appropriate style. Finding role models. Mixing theory with person-centred comments.
• going to the pub with members afterwards to get more varied feedback.

How psychologists can use writers groups

Less well covered than links between creativity and mental health is the group dynamics of writers groups. It's a mutually beneficial topic. A university creative writing course might welcome multi-disciplinary interest from a psychology department, hoping to improve students' ability to benefit from (and run) workshops. Topics could include studying

• how a writer's style influences the type of criticism they offer, and how influential their comments are.
• how a person's psychological type affects their chosen genre - is fragmented work a reflection of, or reaction to, personality?
• how genre affect happiness/survival statistics - are confessional poets happier than similar people who don't write?
• workshop dynamics (the different types of leadership and dissent) and how groups reach consensus on a text

The morality of using a writers group in this way needs to be addressed. There are precedents (in literature as well as psychology - in the US particularly, writing tutors use teaching contexts as subject matter for their poems and stories nowadays), and the group organisers are often willing to volunteer. The organisers of writers group who I've met are used to one-off visits and bouts of strange behaviour.

References

• Richard M. Berlin (ed) (2008), "Poets on Prozac: Mental Illness, Treatment and the Creative Process", John Hopkins University Press
• Vicki Betram (ed) (1997), "Kicking Daffodils", Edinburgh University Press p.261
• Stephen Burt (2009), "The Boston Review" May/June 2009
• Kay Redfield Jamison (1993), "Touched with Fire: Manic-Depressive Illness and the Artistic Temperament", Simon & Schuster Adult Publishing Group
• Henry Jenkins (1992), "Textual Poachers", Routledge
• J.C. Kaufman and S.B. Kaufman (2009), "The Psychology of Creative Writing", Cambridge University Press
• Eric Maisel (1999), "Living the Writer's Life", Watson-Guptill, p.125
• Louis A. Sass (1992), "Madness and Modernism", Harvard University Press
• David Schuldberg (2001) Infinite Mind: Art and Madness
• Philip Thomas (2007) The Independent, Sunday, 18 March 2007
• Lisa Zunshine (2006) "Why We Read Fiction: Theory of Mind and the Novel", Ohio State University Press
• The National Association for Poetry Therapy and the National Federation for Biblio/Poetry Therapy have information on training
• The UK's Poetry Society were/are involved with various projects - see their healthcare page.
• Survivor's poetry