Hamlet's Madness

Yesterday, I wrote on the madness of Lear. This inspired me to dig out two pieces on Hamlet I did for HealthCentral back in early 2007. Following is a reworked version:

I have of late - but wherefore I know not - lost all my mirth, forgone all custom of exercises; and indeed it goes so heavily with my disposition that this goodly frame, the earth seems to me a sterile promontory …

The speaker is Hamlet, of course, and he is either severely depressed or doing a damn good job faking it:

What a piece of work is man!
How noble in reason!
how infinite in faculties!
in form and moving, how express and admirable!
in action how like an angel!
in apprehension, how like a god!
the beauty of the world!
the paragon of animals!
And yet, to me,
what is this quintessence of dust?

Somehow, our hero has to get over his grief and harness his anger long enough to elicit the facts, figure out who his enemies are, then lie low and bide his time for the right opportunity to strike, assuming he can summon up the nerve to act against his true nature. 

Shakespeare wastes no time in introducing his madness theme. In the first scene of the first act, sentinels Barnardo and Marcello assume their night watch with extreme caution. Their conversation reveals that they have had two close encounters with a ghost. Are they hallucinating? Hamlet’s buddy Horatio definitely thinks so, but then …

Enter the Ghost in complete armour, holding a truncheon, with his beaver up.

Suddenly, Horatio is a believer. But Marcello needs confirmation that he is not losing his marbles. “How now,” he implores Horatio. “Is not this something more than fantasy? What think you on’t?”

This is Horatio’s cue to deliver his own prognosis: “This bodes some strange eruption to our state.”

Hamlet has yet to make his entrance, and already mad is the new normal.

Now we learn that no sooner have they buried Hamlet’s father than his uncle (Claudius) has married his mother (Gertrude) and assumed the throne. Perfect sociopaths that the new love couple are, neither parent can fathom why Hamlet is so upset.

“How is it that the clouds still hang on you?” enquires Claudius, apparently noticing that his newly adopted son is not exactly acting like the life of the party.

Gertrude gets straight to the point: “Good Hamlet, cast thy nightly colour off.”

In other words, snap out of it, get over it. What’s the big deal? So what that your mother is shtupping the guy who murdered your father?

Clearly Hamlet is becoming unhinged, but if his new father and all his retainers think he’s crazy (as in resolving to exact his revenge on them) then it's curtains for Hamlet. (Actually it turned out to be curtains for Polonius – yuk-yuk.)

We are talking about a normal reaction to a crazy situation, especially in a culture that gave birth to the terms anger and berserk, not to mention the name of the weapon of choice, the knife. This is what everyone around him is expecting, for Hamlet to act as they would, were they in his shoes. The catch is that they are bound to display their understanding in a preemptory outpouring of unsheathed steel.

One slight misstep for Hamlet, then, one indiscreet glance the wrong way, one blown syllable in one soliloquy, and cue up the grave diggers for the first act.

So - was Hamlet mad or was he just faking it? That is the question. Scholars pose this as an either-or “to be or not to be” riddle when reality (keeping in mind our hero is fictional) suggests a far more nuanced “to be AND not to be.”

Hamlet clearly knows he cannot hide his perfectly logical and dangerous madness. No, his survival depends on showing the Danish court a different kind of crazy, a harmless crazy, a crazy so crazy that even fair Ophelia is confused.

At one point in the play, Ophelia advises her father Polonius of Hamlet's interest in her:

He hath, my lord, of late made many tenders
Of his affection to me.

But later on, our title character abuses the object of his affections:

Get thee to a nunnery: why wouldst thou be a
breeder of sinners?

Ophelia has bought in to Hamlet's madness:

O, what a noble mind is here o'erthrown!

And so has Claudius, who has overheard everything:

Madness in great ones must not unwatch'd go.

Hamlet has bought himself time. He is mad, faking mad, going mad. Then there is the not-so-small matter of his force nine depression, introduced at the beginning of the play. As we know, any decent red-blooded male of Viking descent would have been hell-bent on revenge. But no, Hamlet can barely summon up the motivation to get out of bed, and Prozac is eight hundred or so years from being invented.

Someone needs to pull our melancholy Dane out of it. Enter Horatio and Marcellus and Barnardo with a very strange sighting to report, an apparition armed and with his beaver up – Hamlet’s father!

The life and death battle of wits is on.

Madness and Creativity - What's the Connection?

Back in 2003, I had one of those breakthrough moments, the type you associate with light bulbs switching on. I was at the American Psychiatric Association's annual meeting attending a symposium on genetics. Robert Freedman MD of the University of Colorado started explaining his research into schizophrenia.

"The DSM-IV was not designed with human gene function in mind and genes do not encode for psychopathology," he said. Instead, "genes encode simple molecules in cells that alter cell function and brain information processing."

I had kind of been aware of this, but this time I went, "Aha!"

Dr Freedman had been exploring the link between "sensory gating disturbance" and why people with schizophrenia crave nicotine. A normal person, for instance, can tune out the second of two repetitive sounds. Many people with schizophrenia, however, cannot, and so have great trouble concentrating.

It turns out that the alpha7 nicotinic receptor mediates sensory gating, and thanks to the work of Dr Freedman and others, drug manufacturers have a nicotinic agonist in development.

The upshot of my Aha! moment was the realization that to better understand my own illness (bipolar) I needed to research other illnesses as well, such as schizophrenia. The brain, after all, doesn't organize itself according to the DSM.

A couple of years ago, at the APA, I listened to various schizophrenia researchers talk about the thinking processes of the brain. To vastly oversimplify, individuals with schizophrenia have trouble tuning out distractions from competing neurons; yet what is also in play is the potential for novel neuronal alignments to generate novel thoughts.

At the same APA meeting, Nancy Andreasen MD, PhD of the University of Iowa discussed her research into creativity, which began with a hunch based on schizophrenia.

What we seem to be looking at is that fine edge where productive novel thinking ventures close to the precipice of pathologically delusional thinking. I raised this issue in an earlier blog about John Nash and in another blog about evolutionary psychiatry.

The other day, I came across a blog post on Psychology Today by author Scott Barry Kaufman PhD, entitled Schizophrenic Thought: Madness or Potential for Genius?

Eureka! Cue up the light bulbs.

Dr Kaufman talks about "latent inhibition" (LI), the brain's ability to unconsciously filter out information. High latent inhibition is conducive to rational thought. Low latent inhibition is associated with psychosis and schizophrenia.

But can there be an upside to low latent inhibition? Writes Dr Kaufman:

"Recently researchers have wondered whether a reduced latent inhibition can actually be beneficial for creativity. After all, decreased LI may make an individual more likely to see connections that others may not notice."

In support of this, Dr Kaufman cites research by Shelley Carson PhD of Harvard showing that those with a high IQ and decreased LI reported increased creative achievement. The key here appears to be adequate levels of executive function to ride herd on the stampede of incoming information. The catch is people with schizophrenia tend to score very low on measures of executive function.

Another point that Dr Kaufman raises is that people with schizophrenia have difficulty sorting out their emotions. Again, they are overwhelmed. Here's where it gets interesting: A lot of these emotions may be intuitions that are accurate, thus enhancing the potential for making a creative connection.

Dr Kaufman is engaged in research on subjects with normal levels of executive function. This involves measuring LI. In the first part of the task, subjects need to screen out certain irrelevant input to achieve success; in the second part, processing that same irrelevant information is vital to arriving at the right answer.

According to Dr Kaufman:

"I found that those who reported a higher faith in intuition displayed decreased latent inhibition. In other words, those who reported higher faith in their intuitions allowed the information that was tagged as irrelevant in the first phase to be treated as novel and interesting in the second phase, and by doing so were faster at figuring out the answer."

Alas, it seems, those with schizophrenia lack the necessary executive function to cope. Way too much information. "Indeed," says Dr Kaufman, "this idea of 'sensory gating' has been quite influential in the literature on schizophrenia."

Sensory gating! Where have I heard that before?

Much more research is needed, Dr Kaufman acknowledges. "Nonetheless, an understanding of the biological basis of individual differences in different forms of implicit processing and their relationship to openness to experience and intuition will surely increase our understanding of how certain individuals attain the highest levels of creative accomplishment."

And in conclusion: "Perhaps such research will even allow us to stop rehashing old ideas about the potential links between madness and creativity and re-conceptualize the thought processes that are prone to psychosis not as madness at all but as potential for creative greatness."

Further reading from mcmanweb:

The Thought Spectrum

If all that sounds way too simple, Dr Krystal rolled out a far more complicated scenario involving glutamate’s tag team partner, GABA (the main inhibitory neurotransmitter), in particular a group of GABA neurons referred to as chandelier cells. In this context, GABA helps prevent glutamate from running wild. When involved in working memory, GABA tunes out distractions from competing neurons, allowing the brain to focus. But a deficit in NMDA glutamate receptor function effectively disables GABA chandelier cells. ...

Trick Question: Vincent Van Gogh

Between Feb 1888 and May 1889, Vincent Van Gogh produced an incredible 187 paintings. How many did he produce from Aug 1890 to Sept 1891?

Answer: Zero. On a brilliant day in July 1890, Van Gogh aimed a pistol at his chest and fired. He died two days later. He was 37. The paintings would stop. There would be no more Van Goghs. No more Sunflowers, Irises, or Starry Nights.

Undoubtedly, Van Gogh's madness stoked his creativity. But it also stopped it dead in its tracks.

His last words were: "The sadness will live forever."

From mcmanweb: Vincent and Me

In May of 1889 he entered the asylum at Saint Remy de Provence. "As for me, my health is good," he wrote his brother Theo, "and as for my brain, that will be, let us hope, a matter of time and patience."

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What got me started on this quick blog was Therese Borchard's excellent video blog from earlier today:
On Creativity and Mood Disorders