Schizophrenia And Creativity: What Schizophrenia Research Suggests

Schizophrenia is a psychotic disorder listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM). This condition is usually considered a spectrum, with individuals experiencing unique symptoms and presentations. Some people may wonder whether schizophrenia and creativity are connected, as there are notable examples of creative production by people with schizophrenia. 

 Exploring the connection between this condition and artistic ability can be one way to learn more about the spectrum of abilities with which people with schizophrenia might identify. Those with schizophrenia may also consider asking the mental health professionals with whom they work if they could benefit from trying therapeutic art exercises to foster well-being through artistic expression. 

Understanding schizophrenia: DSM-5 diagnostic criteria 

In the fifth edition of the DSM, schizophrenia is classified under the “Schizophrenia Spectrum and Other Psychotic Disorders” category. According to the DSM-5, several symptoms must be present for this condition to be diagnosed, including two or more of the following: 

• Hallucinations, such as hearing voices or seeing shadows that others do not see
• Delusions, or firmly held false beliefs 
• Disorganized patterns of speech 
• Disorganized or catatonic behavior 
• Negative symptoms, such as diminished expression and lack of motivation
• Functional impairment in major areas of life, such as a person’s social and professional lives

How long should the symptoms last to be classified as schizophrenia?

In general, the above symptoms must last at least six months, including at least one month of symptoms in the “active phase.” In addition, other psychotic and psychological disorders usually must be ruled out. If the individual has been diagnosed with autism spectrum disorder (ASD), they must experience prominent delusions and hallucinations alongside other symptoms of schizophrenia for at least one month. 

In the prior edition of the DSM (the DSM-IV), schizophrenia was organized into categories, including:

• Paranoid schizophrenia
• Disorganized schizophrenia
• Catatonic schizophrenia
• Undifferentiated schizophrenia
• Residual schizophrenia. 

In the DSM-5, all schizophrenia presentations are labeled under the schizophrenia spectrum, showcasing the wide range of symptoms and experiences people with this condition can have. 

What research says about schizophrenia and creativity

Researchers may define creativity in different ways. For example, creativity may be defined as a combination of elements involving various factors, including openness to ideas and divergent thinking patterns. Formal analysis by the Department of Educational Psychology, Creativity Research & Programming, and Radical Creativity suggests that an individual’s context may inhibit or encourage creative production. For instance, a person may express creative ideas in one context but not in one where they experience pressure or stress.

Since art is often associated with originality and new ideas, some may find the artwork of people with schizophrenia to be creative, unique, and innovative. However, art and creativity tend to be subjective, and anyone can be an artist. Several studies have been done on whether schizophrenia and creativity are connected. Often, studies have led to mixed and contradictory findings, however. For example, recent meta-analyses of several studies suggest that creativity can be significantly impaired in those with schizophrenia. However, the same researchers noted that the standardized measures used to evaluate creativity may miss important elements of creativity, including lived experience and subjectivity. The researchers concluded that creativity in schizophrenia can be a “multidimensional phenomenon” that may not be adequately measured by tools that are less sensitive to the creativity potential in people with schizophrenia. 

In a 2018 study in the Schizophrenia Research Journal, researchers looked at 42 studies on schizophrenia and creativity, using variables like creativity measure, severity of schizophrenia symptoms, and patient status. The results of the study showed that people with schizophrenia usually had higher nonverbal creative skills than verbal creative skills. However, creativity was not highly associated with schizophrenia itself. The researchers concluded that people with psychotic episodes may have a small but positive correlation with creativity, but that not all people experiencing psychotic episodes may be living with schizophrenia. Instead, creativity may be a healthy coping behavior for individuals struggling with mental health challenges. 

Cognitive profile and creativity 

A person’s cognitive profile may affect creativity. For example, divergent thinking has been found to be more pronounced in those who experience psychosis. As a feature of creativity, divergent thinking and cognitive disorganization may enhance creativity in those with schizophrenia. 

While findings indicate that people with schizophrenia may show cognitive deficits and executive dysfunction when compared to the general population, studies also suggest that creativity may be related to neurological and social cognition in schizophrenia. Moreover, researchers have noted that a person’s global functioning may be tied not only to clinical symptoms and symptom severity but also to creative ability. These findings also suggest that creativity interventions were associated with fewer negative symptoms, enhanced creativity, and improved functioning. 

The “mad genius” myth 

The “mad genius” stereotype may be prevalent in society, with roots traced to antiquity. With numerous examples of highly creative individuals with mental health conditions throughout history, such as Vincent van Gogh and John Nash, many researchers have sought to study the possible link between creativity and mental illness from different angles. One study suggests that differences in schizophrenia diagnosis, such as schizotypal traits versus more severe schizophrenia, may be stronger predictors of creativity. The same findings note that relatives of people with schizophrenia often have creative careers or hobbies, and show higher levels of schizotypal traits and creativity than the general population. These findings also indicate that a creative person with psychosis-proneness and other mental health symptoms may experience stigmatization and ignore their symptoms, which can affect their creativity and well-being. 

The role of latent inhibition

Another key element of these findings points to the roles of latent inhibition versus reduced latent inhibition in creativity. Latent inhibition refers to the filtering of “irrelevant” information. Individuals with higher creativity may have reduced latent inhibition, possibly allowing them to generate more novel ideas. By focusing on both seemingly irrelevant and relevant ideas, they may create more creative associations. However, this ability is linked with creativity in general, regardless of one’s mental health condition or profile. 

Mental illness and creativity

The relationship between mental illness and creativity is often a debated topic in the psychological research community. Some studies have found that schizophrenia may be connected to an impairment in performance, whereas others show a higher amount of creativity and openness to new ideas when compared to “normal” control subjects. A 2020 study on white matter in the brain suggests that a lack of verbal creativity in individuals with schizophrenia may be due to impairment in white matter regions. However, further study may be needed to examine this link. 

Art activities for schizophrenia 

Despite schizophrenia not necessarily being connected to a higher creative ability, anyone can create art, and art can take any form. You do not have to have a mental illness or a lack of mental illness to partake in creative pursuits. If you enjoy art, you may still benefit, as studies show that art can be a healthy coping mechanism for improving mental health. Below are a few art activities people with schizophrenia can try as at-home “art therapy.” 

Painting

Painting can be a way to put colors on canvas and create a scene of any type. Painting can be a way to express yourself with patterns, designs, images, or memories. Consider looking at other artists' paintings to find inspiration for the type of painting you might create. Below are a few prompts you can also consider for inspiration: 

• A happy memory
• Colors that remind you of someone in your life 
• An abstract rendition of the word “love” 
• Golden hour 
• Birds
• Your favorite memory 
• A fictional setting
• A location you like to go to when you’re stressed
• A celebrity or public figure
• A self-portrait
• An underwater scene 
• A city skyline 
• Shapes, patterns, and colors you enjoy
• Repetitive designs, like a mandala or bouquet
• A complex memory you’d like to process 

No matter what you create, painting doesn’t have to be structured. The canvas is yours to use, and being creative can mean being open to whatever ideas come to mind while you paint. 

Improvising music

Even if you don’t know how to play an instrument or sing, music improvisation can be a way to connect with the healing power of sound. Studies show that making and listening to music can improve well-being. Being spontaneous and creative in real-time may be one way to reap this benefit. If you’re interested in playing instruments and exploring sounds, consider looking for a music therapist in your area. 

Mandalas

The benefits of art therapy for schizophrenia 

According to the American Art Therapy Association (AATA), art therapy is a therapeutic modality used to “improve cognitive and sensorimotor functions, foster self-esteem and self-awareness, cultivate emotional resilience, promote insight, enhance social skills, reduce and resolve conflicts and distress, and advance societal and ecological change.” 

In art therapy, a therapist typically guides clients in creating art in a curated environment where they can let their imagination roam. You don’t have to have creative experience or skills to participate in art therapy, as it is focused more on artistic expression than on the quality of the finished product. Art therapy can be done in individual, couples, family, and group settings. 

A 2018 study in the Archives of Psychiatric Nursing on schizophrenia and art therapy found that an art therapy intervention often reduced negative symptoms and increased motivation and pleasure in participants with schizophrenia. In addition, interpersonal relationships, personal hygiene, and hospital program attendance were usually increased. 

Further research outside of an inpatient setting may be beneficial, but these initial studies tend to show promise in art therapy as a treatment for schizophrenia. You can use AATA’s art therapist locator tool to find an art therapist near you and gain access to therapy options.  

Creativity can exist without romanticizing illness

When considering the possibility of enhanced creativity in schizophrenia spectrum disorders, there may be a risk of romanticizing psychiatric disorders. To prevent this, it can be important to separate creativity from the distress that often accompanies symptoms of schizophrenia. There might also be a risk of misinformation in asserting that those with schizophrenia may be more creative—an assertion that is often debated and is still being studied. An open-access article distributed under the terms of the Creative Commons Attribution License stresses the complex relationship between creativity and schizophrenia, and the present lack of tools to measure the possible link. 

The role of cognitive training

Interventions may foster creativity, improve well-being, and global functioning in people with schizophrenia spectrum disorder. For example, a cognitive remediation program has been shown to improve neurocognition, social cognition, clinical symptoms, and creativity in people with schizophrenia. The integrative remediation programs that combine training in various skills, such as social skills and neurocognition, may reduce negative symptoms as well as promote creativity. Creativity, for its part, has been shown to improve functional outcomes, so addressing factors that can impair creativity may be beneficial. 

Art-making as a coping tool and part of care

Creative production may also be a tool for emotional processing, possibly helping a person with daily functioning. Findings also indicate the role of creativity in positive outcomes, such as improving daily functioning and well-being. 

Support Options

Therapy and psychosocial supports can be a helpful option for schizophrenia, helping individuals manage daily life and functional difficulties through evidence-based techniques and modalities. With a therapist, a client can work to gain independence, improve daily living, practice self-care, and explore their creative potential. However, seeking in-person therapy and treatment support may be difficult for someone living with psychotic episodes or negative symptoms. 

In these cases, online therapy through a platform like BetterHelp may be more convenient. With an online platform, clients can talk to a provider from home at a time that fits their schedule. In addition, online platforms normally provide the option to choose between phone, video, or live chat sessions, giving clients control over the way they receive support. 

Studies show that online therapy can be effective in supporting individuals with schizophrenia and other psychotic disorders. A recent study found that online therapy typically reduced symptoms in those experiencing first-episode psychosis, with results similar to studies on face-to-face treatment. Please note that, in some cases, individuals experiencing acute psychosis may require in-person care.