The Stress Doc Letter
Cybernotes from the Online Psychohumorist (tm)
January 1999, No. 3
Dear Readers. By popular demand, here is your gumbo of the sublime, the spicy and the
ridiculous: a tasty mix of my writings along with humor jokes, lists and other sparkling
entities that have descended from cyberspace.
While sitting in Teaism, my tea and ginger scones haven, a young man one seat over
began eyeing my hardcopy of "Van Gogh, Prozac and Creativity." (The main article
below.) I asked if he'd like to take a look. Sheepishly, he passed: "I'm not an
artist and I'm not on Prozac." Too bad.
Let me assure you this two-part essay -- a labor of love, obsession and redemption --
is for anyone grappling with emotional and existential vulnerability and performance
pressure. Hopefully, the piece will both challenge and support a quest to be your most
authentic and productive self. Enjoy!
A provocative lunchtime question concerning the impact of psychotropic medication on
creative genius triggers a thought-provoking two-part essay on medication and mood
disorder, artistic personality and productivity. The Stress Doc ebbs and flows between his
study of Van Gogh and personal reflection on depression-driven creativity -- pre-and
Van Gogh, Prozac and Creativity: A Mere Pigment of the Imagination? -- Part I
Two recent communications - one real, the other virtual - have been hyperactively
percolating in my primal wellspring. The first occurred over lunch with a soulful and
insightful seventy-year-old grandmother and friend. I mentioned seeing the movie, Vincent
and Theo, about the Van Gogh brothers. Just before or after my statement, I also shared a
recent discovery: a series on my own depressive condition and medication
trial-transformation has been indexed by the Yahoo Search Directory under "Rapid
Responders" (to Prozac). (Email firstname.lastname@example.org for the series.)
Ernestine, who has a daughter successfully taking medication for manic- depression,
raised a provocatively poignant question, highlighted by the recent National Gallery Van
Gogh exhibit. (An exhibition that had allowed both DC residents and tourists some
distraction from the insufferable and omnipresent Clinton Impeachment process.) As for
Ernie's enigma: "Would Van Gogh have been as creative if he had taken Prozac?"
Actually, a number of psychohistorians suspect the artistic giant of having a bipolar
condition. So, more accurately, Lithium would be the damnable drug in question. (For a
thought-provoking work on a link between creativity and moderate to serious mental
illness, try Kay Redfield Jamison's, Touched with Fire: Manic- Depressive Illness and the
The second communicational catalyst was an email in 18 point bold type: "What if
you're taking 150mgs of Zoloft (an antidepressant first cousin of Prozac) and you're still
not happy?" (My instinctive response here is get a second psychiatric opinion, find a
good psychotherapist and start a regular exercise regimen, for starters.)
And both queries raise two fundamental issues: what are the purposes for and outcomes
of psychotropic mood medication? Actually, we have a mirror image conundrum. Ernestine
asks about the potential negative consequences of too much happiness through chemistry.
The emailer's question laments her lack thereof despite chemical intervention.
Stress Doc's Van Gogh Mania
This has been "My Fall of Van Gogh's Genius and Discontent." In addition to
catching the awe-inspiring exhibit, I've seen two movies about Vincent Van Gogh, (the
other, the compelling Lust for Life, with a youthful-looking Kirk Douglas). Also, I'm
currently reading a collection of the voluminous, impassioned letters to his brother
titled, Dear Theo.
Now I must declare a number of people have commented on a likeness with Van Gogh,
especially when wearing my New Orleans brim. (For the pic, check out my homepage:
www.stressdoc.com .) It's probably the shape and rust coloring of my trimmed beard. But I
will recognize some affinities: a passion for creative expression and a predisposition to
depression. Though not manic- depressive, some cyclothymia (a tendency toward moderate
mood swinging) is a diagnostic possibility. (And certainly, various depressive/psychiatric
labels, like Christmas ornaments, have been strewn on the family tree.)
While Van Gogh committed suicide at 37 years of age, my self-destructive musings
remained mostly hypothetical. Though I did commit academic suicide -- self-immolating and
burning out of a doctoral program over a wildly creative and off the academic wall
dissertation project at age 33. Twelve years later, after a rapid series of personal and
professional upheavals (and a history of overt and covert depression denied), I
reluctantly started taking a clinical baseline dosage - 20 mgs - of Prozac. Over a
two-year period, I've reduced my intake to 1/3 of a 10mg capsule, twice/day. Basically,
it's my daily serotonin supplement. ;-)
So dispassionate lunchtime listening was hardly possible. When Ernie pondered about Van
Gogh and Prozac, as a patient, therapist, writer and performer, a heartfelt protest jumped
from my guts and throat. The issue of medication drying up or blocking a creative
wellspring defies simplistic speculation.
Has being on Prozac affected my creative process and product? Surely there's been an
impact. (Which I will reflect upon shortly.) Still, I do know agitated depression and
emptiness. It just doesn't take as long to mourn, crawl around, reach out for support or
to massage the obsessive thoughts and piercing emotions, and to muster, finally, the
energy to get back on my feet. And I still grapple with my creative muse and self-doubts
on a near daily basis.
But now let me conjure up Van Gogh's response to biochemical intervention. This mind
game may not be possible if a person has been medicated for a lengthy duration in early
childhood. Such intervention in the formative years may well change a person's
biochemistry and subsequent maturational development. It may also impede an uncommon
biological and psychological sensitivity to and acuity with certain types of information
processing and experience. So I will not ponder a hyperactive Baby Van Gogh getting
Ritalin. Though I do agree this is a legitimate area of professional and ethical concern.
The Van Gogh/Prozac Hypothetical
So which scenario are we contemplating? Van Gogh, struggling with a career identity in
his 20's, not fitting in as an art seller or as a "man of the pulpit," seeking
therapy and medication instead of following his love of art and his intuitive sense of
himself as an artist? Or Van Gogh the struggling artist, almost always on the financial
edge (despite his brother's support), with little recognition, few friends, fewer sales.
Would he have short- circuited a full-blown psychotic break along with his full
development as an artist by opting for some peace through Prozac or lightness with
Drawing on my various explorations of Van Gogh, along with personal and professional
experience, here are my premises along with hypotheses about the interaction effects
between this manic-depressive artist and medication usage on his creative processing.
1. The Essence of the Man. Van Gogh's biochemical imbalance is definitely an intrinsic
part of his being and likely a family predisposition. It's a component that would
predictably and, at times, scarily and uncontrollably, excite, exhaust or flatten mood and
energy levels and cognitive processing abilities. However, his essence was also forged by
overall genetic predisposition, family dynamics, including being raised in a clerical
family, and an upbringing that placed high value on the beauty and aesthetic appreciation
of nature. And he was fortunate to have the financial and emotional backing of a brother
with both an aesthetic sensibility and a capacity for resonating with a family
predisposition for psychiatric instability.
Clearly, he also had creative genius: a compelling need and ability to look behind and
beyond the superficial, to capture, unmask and transform the obvious. He was driven to
distill and achieve both a universal and an uncommon synthesis - an elegant simplicity -
in his understanding and representation of humanity. Van Gogh was compelled to experiment
with varying modes of seeing, methods of applying color and, in general, designing new
relationships among the flora and fauna of his artistic world.
2. Impact and Use of Medication. I will allow myself the conceit of contemplating how
Van Gogh would use medication. A bias may be present. Based on my readings of his letters
he would take the least amount of medication possible and would experiment with lowering
the dosage. Or, he would obsessively study the impact of medication on his perceptual
faculties. He'd probably do the same sketch multiple times at different dosages. In other
words, medication would as likely be subsumed by art as art by medication. Important to
Van Gogh would not be emotional equilibrium or contentment, but the incessant drive to
develop his mind and his heart, his eye and his hand
to strive endlessly to absorb
and depict the essentials of nature and human nature in a fresh and idiosyncratic manner.
Medication would not have changed a tenaciously reflective student of his own history
and the work of other artists. In addition to his paintings, he wrote unceasingly,
poignantly and analytically to Theo on all facets - high and low - of his art, philosophy
and life -- sixteen hundred pages worth of letters. Van Gogh's genius was a mix of gifts
combined with a personal quest to find difficult and wonderful artistic problems to work
on rather than "saleable" solutions to gain favor with family, other artists or
Whether on medication or not, the reality of limited sales would have been a perennial
source of frustration, isolation and disappointment. And what makes him a personal and
powerful role model, stronger than Prozac, is a conviction that he would always revere and
pursue the most demanding aesthetic -- not commercial -- standard. Medication might smooth
out some of the mood swings, but it would not change the basically precarious and heroic
course of history for an individual who was destined to be cutting edge!
Of course, one may ask whether he would have rejecteded medication even if it was
available. Van Gogh often noted that his work, and its contribution to society, was more
important than his life which he believed, because of exhaustion and his enigmatic medical
condition, was likely to be short-lived. Nonetheless, if only to appease his brother, I
believe Van Gogh would have done a meds trial. (He did voluntarily commit himself to a
sanitarium and, as a patient, produced some major works.) Medication may well have
extended both his longevity and his productivity.
3. The Essence of a Work-Life. Van Gogh never fit into the bourgeois world of his
upbringing. He was not suited for the logical or conventional career choices that appeared
along his path. Certainly, a depressive or bipolar condition when combined with an
artistic temperament heightens the sensitivity to and sense of a poor fit between the
environment and the individual. It's why depressive-creative people can appear inflexible;
they have great difficulty accommodating an environment that leaves little room for
individual expression, the workings of their inner clock or the passionate pursuit of
their mission. (Of course, some folks shroud themselves in this tortured mantle and are
basically just spoiled prima donnas or narcissistic legends in their own minds.)
Gradually, then steadily -- by his late 20s -- Van Gogh knew he would wholeheartedly
pursue the artistic life. And he pursued his calling despite a life of much deprivation
and near poverty. Actually, Van Gogh often noted that losing himself in his work was a
valuable distraction from material deprivation and melancholia. So would Lithium have
detracted from painting as a distracting and refocusing agent? While there is commonly a
period of adjustment to medication, and balance is more pronounced with effective chemical
intervention, the fire of compassion and vision, alienation and inspiration still rages
within. In other words, medication would not have motivated Van Gogh to take a day job. He
would have continued to accept financial support and live on the financial edge because of
his beliefs in a higher quest. Van Gogh would continue to empathize with and paint those
living a marginal existence. This man would not have become mainstream.
The Stress Doc Newsletter The Higher Power of Humor Section...
The second section will consist of humor material that filters down from cyberspace. To
counterbalance the creative side of obsession and passion, we'll feature a couple of
familiar addictions. Of course, there's often a fine line between innovation and
inebriation or cybervision and holistic hallucination. And I stand guilty as charged!
Cyberaddict...You Know Who You Are ;-) From: SWells1835
Yes, you. You, looking at this screen for hours on end, online. You, bleary- eyed. You,
an addict. Have you looked in the mirror lately? Been outside? Know what day of the week
Your name was given to us by a spouse or family member who is concerned about your
internet addiction. At Internetaholics Anonymous, we can help. We're a non-profit society
of recovering addicts that provides support and counseling through weekly meetings
designed to help WWWs - World Wide Wimps - like yourself you cope with your problem.
We feature a twelve-step recovery program and, in extreme cases, interventions.
Although it is our firm belief that you are never "cured," you most certainly
We have designed a brief checklist to determine if you are an addict. Do you: 1) Have
twitches of the hand when you walk by your terminal? 2) Check e-mail more than five times
a day? 3) Spend more time chatting than eating or sleeping? 4) Surf aimlessly with no
direction, if only to be online? 5) Leave your name and information at countless sites if
only to hope you'll receive a reply one day from a company you'll never do business with
anyway? 6) Log on before engaging important personal habits or tasks, such as meal
preparation, hygiene or bodily functions? 7) Have red, swollen eyes that hang halfway out
of your head? 8) Spend hours online on a holiday from work, where you'd usually be griping
about your carpal tunnel syndrome? 9) See smoke arising from your computer or WebTV box?
10) All of the above?
If you answered yes to four or more questions (or chose #10), you have a problem.
Please call us at Internetaholics Anonymous at: 1-800-LOGOFFNOWFORSWEETJESUSSAKES.
We're here, we're free, and we're confidential. The first step to recovery is admission
that you have a problem. Call us today. If you can power off to free up your phone line,
Five Stages of Drunkeness From: email@example.com
Stage 1 - SMART
This is when you suddenly become an expert on every subject in the known Universe. You
know you know everything and want to pass on your knowledge to anyone who will listen. At
this stage you are always RIGHT. And of course the person you are talking to is very
WRONG. This makes for an interesting argument when both parties are SMART.
Stage 2 - GOOD LOOKING
This is when you realise that you are the BEST LOOKING person in the entire bar and
that people want you. You can go up to a perfect stranger knowing they want you and really
want to talk to you. Bear in mind that you are still SMART, so you can talk to this person
about any subject under the sun.
Stage 3 - RICH
This is when you suddenly become the richest person in the world. You can buy drinks
for the entire bar because you have an armoured truck full of money parked behind the bar.
You can also make bets at this stage, because of course, you are still SMART, so naturally
you will win all your bets. It doesn't matter how much you bet 'cos you are RICH. You will
also buy drinks for everyone that you fancy, because now you are the BEST LOOKING person
in the world.
Stage 4 - BULLET PROOF
You are now ready to pick fights with anyone and everyone especially those with whom
you have been betting or arguing. This is because nothing can hurt you. At this point you
can also go up to the partners of the people who you fancy and challenge to a battle of
wits or money. You have no fear of losing this battle because you are SMART, you are RICH
and hell, you're BETTER LOOKING than they are anyway!
Stage 5 - INVISIBLE
This is the Final Stage of Drunkenness. At this point you can do anything because NO
ONE CAN SEE YOU. You dance on a table to impress the people who you fancy because the rest
of the people in the room cannot see you. You are also invisible to the person who wants
to fight you. You can walk through the street singing at the top of your lungs because no
one can see or hear you and because you're still SMART you know all the words.
Seek the higher power of humor...May the Farce Be with You!
And, of course...Practice Safe Stress!
Mark Gorkin, LICSW, the Stress Doc, a psychotherapist and nationally recognized
speaker, trainer, consultant and author, is also known as AOL's and the internet's
"Online Psychohumorist" . Check out his USA Today Online "Hot
Site" website - www.stressdoc.com and his page on
AOL/Online Psych, Keyword: Stress Doc
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(c) Mark Gorkin 1998 Shrink Rap Productions