Avances en Salud Mental Relacional / Advances in relational mental health
Vol.4, núm.3 - Noviembre 2005
Órgano Oficial de expresión de la Fundación OMIE
Revista Internacional On-line / An International On-line Journal
SHAMELESNESS AND CREATIVITY
Asunción Gonzalez Pinto, Ph.D., Verónica Sanmartín, Virginia Guillén, Ph.D;
Carlota Las Hayas, B.A; José.Guimón, M.D. PhD;
Shameless attitudes can appear in the course of neuropsychiatric illnesses and
specific perversions, under the form of disinhibition and exhibitionism. In other cases,
shamelessness is a stance with creative connotations, or, alternatively, alienating, taking
the form of obscenity and pornography, which we have also dealt with recently
(Guimón, 2005)
The word shamelessness is most often used in the negative sense as with no
sense of shame, immodest, impertinent, insolent, immoral, immodest. However, most
dictionaries also accredit the noun with a number of positive connotations by relating it
to audacity, daring and "having the nerve to" as an equivalent to surmounting cowardice
and shyness.
1. A pilot study
In a recent pilot study, we compared normal subjects versus psychiatric
patients (60) and artists (16 plastic young women) and we found some differences in the
TOSCA (1989) and in the Sensation Seeking Scale (1986).
On the one hand artists [X(dt)= 39,38(7,16)] were closer to severe
psychiatric patients [38,57(9,88)] in the Shame items of the TOSCA. The difference
between normal subjects [43,44(8,75)]and patients was statistically significant although
the difference between artists and normal population was not. (Table.1: Means,
Standard Desviations (SD) and means comparisons between groups (ANOVA) in the
Shame domain of the TOSCA).
On the other hand women artists differed
significantly in Zuckerman´s
Experience seeking (ES), Desinhibition Score (DIS), Boredom Susceptibility (BS) and
Total Score of the Sensation Seeeking Scale (Table 2).
Finally there were significant differences between artists who use drugs with the
purpose of enhancing creation when compared to those who did not. Artists who used
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Avances en Salud Mental Relacional / Advances in relational mental health
Vol.4, núm.3 - Noviembre 2005
Órgano Oficial de expresión de la Fundación OMIE
Revista Internacional On-line / An International On-line Journal
drugs showed higher score in Susceptibility to Boredom than the rest of the groups (
artists who never consumed and artists who consumed regularly).
These are, of course, preliminary findings of a pilot study, which have to be
considered provisional, which encourage us to continue in future research.
2. The Disinhibition in Organic brain damage
Creativity frequently arises when the artist is disinhibited. Inhibition is a
generally reversible active functional process, which suspends or reduces the
manifestation of another physiological mechanism enacted. Its intervention explains
many biological phenomena such as blocking some dangerous reflexes (death by
inhibition, psychic sexual impotence etc.)
Disinhibition is a particular feature of organic brain disorders, occasionally a
sign revealing the onset of a disorder. However, it is significantly more common in
fronto-temporal dementia than in Alzheimer's disease and sometimes is on the basis of
increased creativity . This was the case of the well know increase of prductivity of De
Kooning (Guimón, 2003)after several years of evolution of his dementia (Pictures 1,2
and 3)
A number of studies have shown an increase in artistic creativity in patients with
focal or generalised injuries and this has been interpreted as a phenomenon of
« liberating » complex visual-spatial skills.
In the years following the Second World War, some avant-garde artists carried
out experiments with psychodelic drugs, and these have been documented in some
scientific works
3. Social phobia spectrum
A number of recent studies confirm suspicions of a hereditary tendency in
shyness, shame and inhibition. Low levels of serotonin are related to submissive
behaviour. Dopamine hyperactivity has been associated with social phobia and with
deficiencies in the prize and incentive functions. On the contrary a group of males with
a high score in a factor made up of "search for experiences", disinhibition and tendency
to boredom showed significantly higher levels of testosterone and free androgens.
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Avances en Salud Mental Relacional / Advances in relational mental health
Vol.4, núm.3 - Noviembre 2005
Órgano Oficial de expresión de la Fundación OMIE
Revista Internacional On-line / An International On-line Journal
3.Endogenous psychoses
In endogenous psychoses, shamelessness has been described with schizophrenic
disorder and in the manic stages of bipolar disorder, especially during the excitomotor
crisis, in the context of other unconnected behaviour (gluttony, exhibition, turbulence,
violence).
The relationship between psychosis and creative activity has been frequently
observed in the scientific field (de Rivera, 1993), and in the artistic field in particular.
This was the case in artists such as Antonin Artaud (Picture 4).
The sadness caused by key events (grieving, loss) can occasionally further
artistic creativity. However, where this is extremely intense it tends to inhibit work,
particularly when it is accompanied by symptoms such as psycho-motor inhibition, as
occurs in what are known as major depressions, whether these are isolated or recurrent,
and in some chronic forms of depression. An examination of the biography and work of
Mark Rothko will serve to show the evolution of creativity within disorder characterised
by recurrent major depressions (Guimón, 2003)(Picture 5).
Several authors (Hershman & Lieb, 1998) have found a high prevalence of
major depression or manic-depressive psychosis in studying the turbulent and
frequently shameless lives of certain celebrated people (such as van Gogh). Studies
include the detection of cyclotymic disorders in some interesting sample groups such as
jazz musicians (Akiskal, AkisKal, & 1993). In this sense, Richards (Richards, 1993,
1994) Kay Jamison (Jamison, 1993) and Andreasen (Andreasen, 1987, 1996) conducted
elegant research on this topic carrying out « structured interviews » with conclusive
results.
Personally, we tend to agree with Jonathan Miller, who claimed, in connection with the
relationship between mental illness, art and science is that art and science are produced
despite the illness, not because of it. Some artists were depressed or manic, and were
still geniuses, but their genius was not caused by their disorder. They managed to live
and work with their illness. It makes no sense to speculate that one must be ill to
produce, or that mental alterations are to be advised to this end. Along the same lines,
Storr (Storr, 1983) summarised a certain amount of research in this field by claiming
that creativity is a means whereby the creative retain their health and not vice-versa, and
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Avances en Salud Mental Relacional / Advances in relational mental health
Vol.4, núm.3 - Noviembre 2005
Órgano Oficial de expresión de la Fundación OMIE
Revista Internacional On-line / An International On-line Journal
that madness is the force leading to creative orgies. It would appear that when creative
people succumb to mental illness their creative moments come to an end.
4. Exhibitionism / voyeurism
In recent works we have stressed that shamelessness includes the attitudes of
disinhibition, unintentional exhibition and exhibitionism (Guimón, 2005).
There are acts offensive to modesty brought about by disinhibition, without deliberate
attempts to arouse or corrupt the spectators. This is the case of the exhibition of genitals
by the mentally retarded, or in senile dementia, or by patients affected by generalised
cortical damage. It is common to observe similar shameless acts in manic patients or in
schizophrenics, usually without the intent to scandalise.
On the other hand, exhibitionism can be a sexual perversion, a psychological
disposition which colours some clinical symptoms or a consciously chosen behaviour
pattern for publicity purposes. Distinction can be made between exhibitionist attitudes
which colour the behaviour patterns of many normal people (with neurosis and slight
personality disorders), and exhibitionist perversion, which makes this the only activity
which enables the individual to have an orgasm. Many artists, politicians and public
personages in general have marked exhibitionist characteristics (pictures 6 and 7 and
Warhol). Others show, at certain times in their lives, denial or compensatory behaviour
patterns which are exhibitionistic.
Patients with narcissistic and theatrical personality disorders (according to
classification DSM IV-TR of the American Psychiatry Association) frequently show
more marked and persistent attitudes of shame and exhibitionism.
5. Shmelesness and avant-gardey
Discreet ("modest") people in our societies cover themselves up, they retire
elsewhere to make love, to defecate, to sleep, to suffer, to pray, and also occasionally to
eat, since otherwise they would be considered as shameless and obscene. There are also
cases of "obscene" births, which became a craze among progressive types in the 1970s,
who showed lunch-time films of their wives giving birth, and also "obscene" deaths, in
which live therapy exposed a deplorable spectacle of human functions ebbing away.
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Avances en Salud Mental Relacional / Advances in relational mental health
Vol.4, núm.3 - Noviembre 2005
Órgano Oficial de expresión de la Fundación OMIE
Revista Internacional On-line / An International On-line Journal
We have seen that shameless activities also have positive social implications as the
driving force behind avant-garde art movements, dominated by the exhibitionist desire
to "épater les bourgeois": surrealist opposition to the bourgeois took on a more
ideological and political character, but exhibitionism and shamelessness coloured the
public activities of many of their number. Hippies and yuppies also created unconvent.
ional modes of Counterculture life. Postmodernist artists adapt to a globalising society,
but also express their opposition to it using resources such as uglyism.
The discussion on the limits between obscenity and progressive political action
has now come to the fore since the Nobel Prize for Literature 2004 was awarded to the
writer Jelinek.
Over the last 10 or 15 years, however, shamelessness has not been found in the
ugly or in the uncanny in veiled format, or as a means of wakening aesthetic enjoyment
by contrast. A wave of bad taste and coarseness has invaded the media, which offers
"trash" lapped up avidly by a thirsty public.
6. The risk of "inhibitionism"
Shamelesness
and
Exhibitionism
are
frequently
socially
and
ethically
reprehensible, and legal sanctions are justified to halt behaviour which can be harmful to
the victims, and children in particular. Insufficient importance is attached, for example, to
the need to legally combat Internet child pornography. Despite favourable results in
inhibiting exhibitionism, some practices are ethically questionable, based on behaviour
therapy. They suggest, for example, exposing the exhibitionist to the mocking gaze of
therapists to bring about an extinction phenomenon of the reprehensible impulses.
Analytic psychotherapy shows us that many of these patients do not feel guilt after
their outrages. But one must also take into account the shameful suffering which many of
these patients have experienced throughout their lives. Many of them would not dare to
act, and they will avoid guilt and public dishonour.
There are many individuals who could stand out in relation to their contemporaries,
but they inhibit the genital exhibitionist desires which would be observed if they dared to
be brilliant in public. All human beings want to have a moment of glory in their lives, but
we often receive the success of others badly because it brings about unbearable envy.
Many creative beings suppress showing their talent in fear of the sea of mediocrity which
wishes to destroy them. It is important to avoid excessively attacking the tendency to
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Revista Internacional On-line / An International On-line Journal
exhibit creativity, or we can produce what Kahr (2001) calls "psychological
inhibitionism", which hampers the lives of many frustrated artists.
Table 2. Means, Standard deviations (SD) and means comparisons between groups
(ANOVA) in the domains of the TOSCA.
N
TOSCA
SHAME *
Score range: 1575
DETACHED
Score range: 1050
GUILT
Score range: 1575
Mild severity patientsa
(0,1,2)
Controlb
c
Artists
High severity patientsd
(4,5,6)
Total
Mild severity patientsa
(0,1,2)
Controlb
Artistsc
High severity patientsd
(4,5,6)
Total
Mild severity patientsa
(0,1,2)
Controlb
Artistsc
High severity patientsd
(4,5,6)
Total
EXTERNALIZAT Mild severity patientsa
ION
(0,1,2)
Score range: 15- Controlb
75
Artistsc
High severity patientsd
(4,5,6)
Total
ALPHA PRIDE
Mild severity patientsa
(0,1,2)
Score range: 5-25 Controlb
Artistsc
Mean
SD
22 40.3636 7.20149
93
43.4409
d
8.74949
21 39.3810 7.15874
38.5714
35
b 9.87655
171 41.5497 8.82721
22 41.2273 5.03258
93 39.4086 5.57408
22 41.6818 7.60568
35 38.9429 6.94492
172 39.8372 6.12131
22 55.6818 5.92321
93 57.0108 6.84533
22 57.4545 9.01178
35 56.6857 8.50180
172 56.8314 7.35567
22 37.8182 6.04457
93 36.4516 6.58146
21 38.5238 7.70467
35 36.9143 8.63771
171 36.9766 7.09926
22 17.3182 3.34360
93 17.7097 3.36084
21 17.8571 2.43487
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Avances en Salud Mental Relacional / Advances in relational mental health
Vol.4, núm.3 - Noviembre 2005
Órgano Oficial de expresión de la Fundación OMIE
Revista Internacional On-line / An International On-line Journal
High severity patientsd
(4,5,6)
Total
BETA PRIDE
Mild severity patientsa
(0,1,2)
Score range: 5-25 Controlb
Artistsc
High severity patientsd
(4,5,6)
Total
35 16.6857 4.75748
171 17.4678 3.59131
22 19.3636 3.53951
93 18.7097 3.06658
22 17.0000 3.02372
35 18.0000 3.88057
172 18.4302 3.34224
* ANOVA showed significant differences in means between groups, at p < 0.05.
(0,1,2) = Clinicians rated the severity of the patient in the Clinical Global Index as 0, 1
or 2.
(4,5,6) = Clinicians rated the severity of the patient in the Clinical Global Index as 4, 5
or 6.
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