Art and “Insanity”

Started: 1922
No matter how hard you may try to imagine fantastic and impossible things, or the most bizarre images, you will never succeed in conceiving of the type of insane image which presents itself on canvas at the hand of a madman, those nightmare creations which make you dizzy.
Ambroise-Auguste Tardieu

Summary of Art and “Insanity”

The assumption that artistic genius and "insanity" are somehow linked is a very common one. For example, it is behind the cliched image many of us still have of artists and writers as necessarily troubled, isolated, or lost in their own minds. But the relationship between art and "insanity" - a term used here for its historical relevance but now considered out-of-date - has changed over time in the minds of artists, critics, medical professionals and the general public. From the Enlightenment, when the creative activities of asylum patients were taken as proof of their mental incapacity, to Romantic-era idolization of madness as a source of inspiration, to the Surrealist and Art Brut movements which held up certain "patient artists" as exemplars of creative purity, the relationship between art and cultural concepts of "insanity" has shifted in fascinating and often troubling ways.

Key Ideas & Accomplishments

Progression of Art


Great Great God Father Rooseli and St. Adolf

Artist: Adolf Wölfli

This detailed colored pencil drawing on newsprint is an example of the meticulous and intricate practice of Adolf Wölfli, perhaps the best-known of the "insane" artists lionized by modern art movements such as Surrealism and Art Brut. As writer John Maizels explains, Wölfli's "detailed and near-symmetrical compositions....introduced a rich visual vocabulary [including] highly repetitive and detailed decorative borders and bands which sweep around each composition, the use of musical manuscript fragments..., the introduction of lettering and word forms, the inclusion of small self-portrait heads and distinctive 'bird' motifs, even the introduction of collage." Wölfli drew obsessively and his total output was astounding. His most significant work, which he began in 1908 and worked on until his death in 1930, was an illustrated, semi-autobiographical, semi-fictional epic of 45 volumes, comprising about 25,000 pages, 1600 drawings, and 1500 collages.

Wölfli suffered abuse and abandonment as a child and was arrested a number of times as a young adult for attempted sexual assaults on very young girls. In 1895, when he was probably 31, he was admitted to the Waldau Clinic near Berne, Switzerland. There, after a year of isolation and silent introspection, he began to draw. Wölfli's art eventually caught the attention of Walter Morgenthaler, a psychiatrist who began working at Waldau in 1908, and who published the first monograph on an "insane" artist, about Wölfli and his art, in 1921. This book, titled Ein Geistekranker als Künstler (A Mental Patient as an Artist), marked one of the earliest moments when a medical professional took an interest in "insane" art as art, rather than as mere proof of insanity. Morgenthaler wrote of Wölfli that "new life may emerge from despair, strengths may develop after a crisis, forms may emerge from such chaos. Wölfli has truly passed through such a crisis....The instinctual energy of the first stage now gave way little by little to something new. This new element no longer showed itself in a disorderly, chance fashion, but took a very defined form. It was not an occupation which he found but an activity which he created in the solitude of his cell and which took on all the value of authentic work. It is precisely thanks to this work that he has, to some degree, freed himself."

While it seems poetic that Morganthaler believed Wölfli was able to "free himself" from his isolated circumstances through his art, we do not know if the artist felt the same. Thus Morgenthaler's comments exemplify the greatest problem with the category of "insane" art: that it has historically prompted people other than the artists to draw conclusions about the importance of "insane" artists and their work with little regard for the artist's own perspective. We also do not know if Wölfli saw the narrative presented in his work as fact, fiction, or somewhere in-between, nor do we know how much of his creativity stemmed from his mental illness as opposed to the "healthy" portion of his brain.

Wölfli's work formed the core of the collection that Morgenthalaer began amassing of "insane" art. This, along with a similar collection from the Swiss Psychiatric Society, later became the Waldau Museum collection. Morgenthaler's "discovery" of Wölfli influenced psychiatrist Hans Prinzhorn, who included Wölfli's work in his 1922 book Bildnerei der Geistekranken (The Artistry of the Insane). He also acquired works by Wölfli for his own collection of work by "insane" artists. The Prinzhorn collection was exhibited widely, and it was through these exhibitions, as well as the international dissemination of Prinzhorn's book, that many modern artists, such as Jean Dubuffet first encountered the work of Wölfli and other "insane" artists.

Colored pencil on newsprint - Kunstmuseum Bern, Switzerland


Witch's Head Landscape

Artist: August Natterer (Neter)

This work is an example of the many created by August Natterer which process his visions of the last judgement, and of various creation myths involving God and other characters, including "the witch," depicted here. The maker of this stunning image was born in Ravensburg, Germany, in 1868, and worked as an electrical engineer before suffering from severe delusions in his later adult life. On April 1, 1907, his most significant series of hallucinations occurred, during which, over the course of one hour he experienced 10,000 visions of the last judgment. He later described the experience which led to works such as Witch's Head Landscape: "I saw a white spot in the clouds absolutely close - all the clouds paused - then the white spot departed and stood all the time like a board in the sky. On the same board or the screen or stage now images as quick as a flash followed each other...God himself occurred, the witch, who created the world - in between worldly visions: images of war, continents, memorials, castles, beautiful castles, just the glory of the world - but all of this to see in supernal images. They were at least twenty meters big, clear to observe, almost without color like photographs....The images were epiphanies of the Last Judgment. Christ couldn't fulfill the salvation because he was crucified early... God revealed them to me to accomplish the salvation."

Following this episode, Natterer attempted suicide, and was subsequently institutionalized for the remainder of his life. He began drawing and painting avidly to represent the terrifying visions of that day - just as many mainstream artists use their work to process visions and hallucinations, including Sigmar Polke, Joan Miró, and Yayoi Kusama. Natterer's work was included in Hans Prinzhorn's Bildnerei der Geistekranken (The Artistry of the Insane) (1922), and was thus seen by modern artists around the world. The Surrealists were particularly fascinated by the images in Prinzhorn's book, as they believed that altered mental states, including those caused by psychiatric illnesses like schizophrenia, granted access to higher psychic realms.

Although the Surrealists objectified "insane artists" in the very process of holding them up as examples, other critics have written about Natterer with greater awareness of his individual traits and skills. Jenifer P. Borum writes: "Natterer's works conjure unsettling, quasi-religious avatars in a precise style that draws the viewer into his visionary experience with haunting conviction. His lack of academic art training allowed for the evolution of an oeuvre singularly devoted to an elaborate universe populated by shape-shifting witches and otherworldly, unstable landscapes. The artist's belief that he would be a divine player in an endtimes event charges his works with a palpable urgency. It is not surprising that Natterer inspired Surrealists, including Salvador Dali, who emulated his visual strategies, but could never rival his achievement."

Pencil, pen and water colours on varnished card - Prinzhorn Collection, University of Heidelberg, Germany

с. 1935-1949


Artist: August Forestier

Auguste Forestier's sculptural assemblages, like this bird-man hybrid statue from the 1930s-40s, were made at the St. Alban psychiatric hospital in Lozère, France. They often resemble monstrous, semi-anthropomorphic figures. He also frequently depicted boats. Forestier's practice exemplifies the way in which many "insane" artists, due to their isolated circumstances, operate entirely within the limited economy of the institution in which they are housed. Not only was Forestier restricted to using materials that could be salvaged from the property of St.Alban, and to creating his artworks inside the hospital (where staff helped him set up a makeshift studio), he also disseminated these works within the hospital, selling or gifting them to employees as toys for their children.

The sculptor was born on a farm in Southern France in 1887. When he was 27 his curiosity and fascination with trains led him to place some pebbles on a train track to see how they would be crushed. However, the next train that passed by ended up derailing, and the incident led to Forestier being incarcerated until his passing 44 years later. In St. Alban, Forestier began drawing and creating sculptural assemblages to occupy his time. As resources were limited, he used whatever scrap materials he could find to make his art, such as animal bones and teeth from the trash bin of the hospital's butcher, as well as buttons, fabric, wood, and whatever else he could get his hands on.

Many art historians see Forestier's artworks as offering the artist a means to "travel" (at least in his imagination) despite the tragic circumstances of his confinement. For instance, Savine Faupin writes that "Forestier's wanderlust was unbroken: he ran away [from the psychiatric hospital] a total of five times between 1914 and 1923, yet he gradually began substituting his real travels with other forms of departure. His drawings and sculptures took him on fictitious journeys through history...Because he no longer ventured outside the hospital walls, Forestier, the stationary traveller, invented imaginary means of travel."

Wood and mixed media - Collection de l'Art Brut, Lausanne, Switzerland


Mythe Atalante Lance des Pommes d'Or,

Artist: Aloïse Corbaz

Aloïse Corbaz was born in Lausanne, Switzerland, in 1886. She was well-educated and worked as a dressmaker, teacher, and governess, but was institutionalized in 1918 after developing a delusional obsession with Kaiser Wilhelm II. Diagnosed as schizophrenic, she remained in hospital until her death in 1964. While hospitalized, Corbaz scavenged materials with which to make art, even mixing toothpaste and crushed flower petals into brilliant pigments of various colors. Most of her works are romantic, even sensuous, scenes, with voluptuous female figures accompanied by regal-looking men in military uniform. She always used vivid colors, and filled every inch of the pages on which she worked, front and back.

French artist Jean Dubuffet, who developed the category of Art Brut, met with Corbaz several times during her hospitalization at La Rosiére de Gimel. He wrote of her: "I fear that to begin with she had to suffer from dreadful disturbances, but it seems to me just as likely that her fabulating system, which was seen as the germ of her delirium, and which gave her such great pleasure, consoled her and gave her a reason for being....If we must talk of madness in Aloïse's case (I'm not sure of it), we are at all events witnessing a sort of cure not prompted by therapies blocking the delirium, but on the contrary through the free movement given to it and its fortunate flourishing." We have here, therefore, an example of the way in which many modern artists, like Dubuffet, romanticized "madness" and understood it as a conduit to creative genius.

Colored pencil on cardboard - Collection de l'Art Brut, Lausanne, Switzerland


I Spit on Life

Artist: William Kurelek

The Canadian painter William Kurelek created powerful autobiographical murals while hospitalized in England with a (probably incorrect) diagnosis of schizophrenia. I Spit on Life presents several vignettes of the artist's life, including episodes from his difficult Depression-era upbringing in rural Canada - where he toiled on his family's farms and was bullied in school - and scenes inspired by his time in psychiatric hospitals in England. Psychologist Fiona Birkbeck asserts: "[t]here is a theatrical and dynamic sense about Kurelek's work which transforms us from passive viewers into an engaged audience." Birkbeck identifies one vignette from I Spit on Life as particularly significant. In this vignette, a patient is receiving a lecture from a psychiatrist while lying in a coffin, while a nurse uses her entire body weight to push down the lid of the coffin. According to Birkbeck, the image shows how "institutions desensitize individual practitioners until they no longer respond with recognizable humanity in the face of the suffering of their 'clients'."

William Kurelek was born near Willingdon, Alberta in 1927 to Ukrainian immigrant parents. He grew up on farms in the Canadian prairies but discovered a love for art at an early age, something that was not encouraged by his parents. Nevertheless, after high school he committed to studying art, attending the University of Manitoba, the Ontario College of Art, and the School of Fine Arts in San Miguel de Allende, Mexico. He also read widely, and became particularly enamored with the Mexican Muralists. In his mid-20s, Kurelek moved to England. It was around this time that he began suffering from severe psychological problems, including depression, social anxiety, and a lack of a sense of self, something he called "depersonalization." In 1952 he admitted himself to London's Maudsley Psychiatric Hospital and was treated for schizophrenia (though it is now believed this diagnosis was wrong). In hospital he became a devout Catholic and set himself to producing artwork that dealt with the traumas he experienced during his youth. The next year, he was transferred to the nearby Netherne Hospital where he spent another 13 months. There, he worked with art-therapy pioneer Edward Adamson.

Unlike many "insane" artists, who experienced institutionalization for many years and often died in confinement, Kurelek seemingly recovered and led a fairly happy and successful life after leaving Netherne in January 1955. He remained in London for four years before settling in Toronto in 1959. He continued to produce and exhibit art for the rest of his life, travelling extensively. He also married, and had several children before his death in 1977. Importantly, Kurelek's extensive art education, as well as his encounters with significant mainstream artists and artworks during his worldwide travels, make him an excellent example of an "insane" artist who cannot also be classified as an "outsider" artist, highlighting the slipperiness of these terms.

Watercolour on board - Adamson Collection, Wellcome Library, University College London, England

с. 1910-73


Artist: Henry Darger

After the death of hospital janitor Henry Darger in Chicago in 1973, his landlord made an incredible discovery in his apartment: tens of thousands of drawings, paintings, and collages, all created by his unremarkable-seeming tenant. Most notably, Darger produced a 15,145-page illustrated book, In the Realms of the Unreal, containing stories about a group of young adventurers, the "Vivian girls," who battle the malevolent "Glandelinians." Gruesome battles, violent torture, and grisly executions, all involving children, saturate the text. Darger had found much of his inspiration in local newspapers, including the tragic 1911 story of five-year-old murder victim Elsie Paroubek. He was also influenced by advertising images, such as the "Coppertone Girl," and by comic strips. Art historian Annemarie Iker asserts that, "Though living and working in isolation, Darger intuited many strategies of 20th-century avant-gardes. Like Dada and Surrealist artists, for instance, he appropriated found images and produced startling compositions by juxtaposing unrelated found and made images."

One of the most fascinating and well-known "insane" artists, Darger also serves as an example of the historical specificity and potential cruelty of the category of "insanity." Darger was born in Chicago on April 12, 1892. His mother passed away when he was four and, as his disabled father could not care for him, he was put into an orphanage. There he exhibited "troubling" behavior, namely "self-abuse," the pathological term for masturbation, which was then seen as aberrant and immoral. Henry was placed in the Illinois Asylum for Feeble-Minded Children, from which he attempted to escape several times, eventually succeeding in 1909. He settled back in Chicago and found work as a hospital janitor. A passionate advocate for the protection of children against exploitation - which he had experienced frequently growing up - Darger attempted unsuccessfully to adopt a child of his own.

Unsurprisingly, Darger's drawings of nude children have invited psychoanalytical interpretation. For instance, he often drew young girls with penises, which has been understood as stemming from sexual confusion (he is believed to have been gay, which no doubt conflicted with his devout Catholicism). The frequency of child nudity in his work, and its many scenes of violence against children, are also (mis)understood as evidence of the artist being a pedophile, a deranged criminal, or even a serial killer. The extreme and bizarre nature of his artworks has made him one of the most famous "insane" outsider artists. As artist and writer David Maclagan asserts, Darger's "queasy scenes of child massacre," which seem "to ignore or defy social or moral conventions," can make "the artist seem an Outsider in more ways than one." Maclagan continues: "despite the poignancy of his life history, the juxtaposition in Henry Darger's work of clichéd images of innocent childhood with sadistic scenes of the same children being mutilated and massacred is uncomfortable to witness. Sometimes the appeal is of something barely imaginable, at the very edge of empathy, and this could be called psychological Outsiderness; but at other times it's something we can recognize in ourselves, even if we may prefer not to admit it."

Watercolor and pencil on paper - Museum of Modern Art, New York, New York

Beginnings of Art and “Insanity”

Earliest Artistic Depictions of “Insane” Artists

The idea that mental illness or "insanity" allowed unique kinds of creative insight only took hold after the Romantic era. But artists have been interested in exploring the outer realms of human consciousness and behavior for a longer period, with varying degrees of creative and ethical justification.

In 1735, English artist William Hogarth published a series of eight engravings titled The Rake's Progress, depicting the gradual downfall of a young man "of weak moral principles" named Tom Rakewell. Tom begins gambling, drinking, and cavorting with prostitutes until he is placed in Fleet Debtor's Prison and, eventually, in the eighth and final plate, reduced to madness and confined in the Bethlem Mental Hospital. The series conveyed a cautionary tale that equated immorality, criminality, and mental incapacity. This cluster of connections continued to pervade general thought for the next several centuries.

What is unique about Hogarth's final plate is that it shows an "insane" artist, that is, an inmate, drawing on a wall of the asylum. As far as we know, this is the first depiction in art of an "insane" artist at work. While it remains unknown whether the subject-matter is something that Hogarth actually witnessed, as it seems more likely that Hogarth selected it as an appropriate image for an "insane" artist to be creating. In fact, the diagram refers to a scheme that English theologian, historian, and mathematician William Whiston put forth for determining the longitude of the earth. The scheme was considered "mad" and it is likely that eighteenth-century audiences would have recognized the reference.

It seems that Hogarth and his contemporaries were less concerned with the content of "insane" artists' drawings and more with the activity itself. It is possible that eighteenth-century artists believed that, as MacGregor writes, "because [the drawing] was supposed to be the idea of a madman, [it] did not matter" what the content was. According to MacGregor, the images these artists invented as imaginary themes for their "insane" creators served as generalized representations of madness, whether by including scientific or mathematical diagrams (likely symbolizing the "melancholy of the scholar"), disheveled and/or devilish figures (meant as self-portraits of the insane artist), or childlike sketches, upholding the common belief in similarities between the mind of the child and the "madman's" mind.

A century later, German historical painter Wilhelm von Kaulbach produced another engraving that aimed to depict the interior of a madhouse, titled Das Narrenhaus (1836), which was directly inspired by Hogarth's work. Of interest is Kaulbach's inclusion of an inmate drawing on the rear wall. The crude sketch strongly resembles an idea of the art of children, and appears to show the asylum's keeper (a portly man with keys in his pocket) in the process of beating a helpless inmate. As MacGregor notes, "once again, it seems unlikely that this drawing is an accurate reflection of an actual piece of 'insane' art. It is put there to tell a story, as in Hogarth, and to represent the artist's idea of what patient art would look like."

First Physicians to Take an Interest in “Insane” Art

During the nineteenth century, a number of physicians and "alienists" (an early term for psychiatrists) worked with "insane" asylum inmates and began to take an interest in the artistic activities of their patients. However, these physicians were not in the least concerned with the artistic merit of these images. Instead, they believed the patients' artworks could be used as evidence of insanity, and that specific artistic styles could be associated with particular diagnoses. Nonetheless, these accounts represent the first instances of the idea of the "patient artist."

The earliest scientific account of "insane" art-making can be found in French physician Phillipe Pinel's Medical-Philosophic Treatise on Mental Disturbance or Mania (1809). However, he focused only on cases in which the "insane" individual had worked as a professional artist prior to the onset of insanity, to the exclusion of untrained individuals who began creating images after the onset of insanity. Pinel understood art-making behavior as "belonging to a surviving healthy portion of the patient's personality," and thus encouraged their interest in returning to this activity. Around the same time, American Dr. Benjamin Rush, credited as "the father of psychology" in North America, developed an interest in "insane" patients who, with no past experience in art-making, displayed significant interest in and talent for art having become "insane." He wrote in his book Medical Inquiries and Observations upon the Diseases of the Mind (1812) that: "[t]he records of the wit and cunning of madmen are numerous in every country. Talents for eloquence, poetry, music and painting, and uncommon ingenuity in several of the mechanical arts, are often evolved in this state of madness."

The first person to reproduce "insane" art in a publication was John Haslam, an apothecary at Bethlem Hospital who was charged with conducting autopsies. He wrote an 1810 report entitled Illustrations of Madness about a diagnosed "madman" named James Tilly Matthews who was admitted to the asylum in 1797. Matthews's family was attempting to have him pronounced sane so that he could leave the asylum and arranged for other medical experts to testify to his sanity. Haslam was recruited to prove the other experts wrong by demonstrating definitively that Matthews was in fact "insane," and possibly even dangerous. In his report, Haslam recounted the details of Matthews's delusions of persecution by an international gang of criminals and members of the government, who he believed had already killed his family members and were now conspiring to torment him with a mechanical device he called an "air-loom" and a magnet in his brain. The important thing to note is that, although Haslam is significant as being the first to reproduce patient art in a publication, he only included the image as further evidence of the patient's poor mental state and not because he recognized any artistic value in the image.

Similarly, French physician Ambroise-Auguste Tardieu (son of engraver Ambroise Tardieu, who had been commissioned by French psychiatrist Jean Étienne Dominique Esquirol to execute illustrations of "idiot" and "insane" patients) published a brief discussion, based on observation of two "insane" artists, including a reproduction of one of their images, in his book Etudes Médico-Légales sur la Folie (1872). He wrote that "[n]o matter how hard you may try to imagine fantastic and impossible things, or the most bizarre images, you will never succeed in conceiving of the type of insane image which presents itself on canvas at the hand of a madman, those nightmare creations which make you dizzy." His main motivation for the publication came from his simultaneous interests in psychiatry and law, and his desire to "establish objective criteria for a legally acceptable diagnosis of insanity." He thus saw "insane" art as offering potential evidence for such a diagnosis.

Romanticism and the Genius-Insanity Theory

In and around the Romantic era (approximately 1780-1830) artists and other thinkers were deeply curious about, and preoccupied with, exploration of the individual mind, including altered mental states and "insanity." As MacGregor writes, "[t]he Romantic artist worshipped at the altar of emotion. Throughout the period one encounters a deep, almost unappeasable hunger for emotional experience, for new intensities of feeling at whatever cost. It is as if reality could only be experienced in situations of violence, or ecstasy, or madness. Insanity is understood, perhaps naively, as a form of heightened existence, as a state of pure emotion free of the restraints imposed by the mind, the polar opposite of the mind governed by intellect and reason.

Artists and poets during this period developed a great interest in things like dreams and the supernatural, as they believed these offered opportunities to access raw emotion. It is perhaps no coincidence that this artistic attitude flourished at the same time that psychiatry, and later psychology, were emerging as specialized fields of expertise. The madhouse became a popular place for tourists, including Romantic artists, to visit (in Europe and North America). There, they could witness "insane" individuals in the throes of profound psychological and emotional experiences "like exotic animals in a menagerie," recording their observations as notes and sketches for later use in their art.

Francisco Goya was one such artist, representing madhouse scenes in several of his works, most notably in the paintings Corral de Locos (1794) and Casa de Locos (1812-19). In both of these works, Goya depicted pitiable groups of asylum inmates, many of them naked, often engaged in bizarre, even "animalistic" behavior such as fighting, orating to empty spaces, or sitting alone in withdrawn positions. He used light and darkness in suggestive ways in both works, with inmates lurking in shadows, indicating their lack of mental clarity, while bright light can be seen shining over the madhouse wall or coming through the window, perhaps suggesting the sanity, morality, and order that exists outside the institution.

The Romantic artist's interest in insanity was closely linked to the Romantic obsession with nature, as "lunatics" were understood as "primitives" or "savages" more closely related to animals than humans, and somehow in closer touch with "natural" forces. The Romantic preoccupation with insanity was also closely linked to the growing belief in what is commonly referred to as the "Genius-Insanity" theory: that is, the belief that (creative) genius is directly linked to "madness." French philosopher Denis Diderot wrote "[o]h, how close the insane and men of genius touch! They are chained, or statues are raised to them." German philosopher Immanuel Kant wrote in his Anthropology from a Pragmatic Point of View (1800) that "when insanity is accompanied by emotional agitation it is frenzy, whose seizures, though involuntary, can often be original, in which case, like poetic rapture, it borders on genius," and French psychiatrist Jean-Étienne Dominique Esquirol wrote: "the delirium of the maniac has certain connections with the high excitement of the genius." In fact, the Genius-Insanity theory has its roots in much earlier philosophy, such as that of Ancient Greek philosophers Plato and Aristotle.

Though highly contested, these ideas have formed a truism that has continued to pervade much common thought throughout the history of madness and remains intact even today. As MacGregor notes, "[t]he Romantic view of madness was seldom based on any real experience of the insane. It was a fantasy, a dream of madness as a treasure trove of the imagination free of reason and constraint. Madness held within it the promise of new and unexplored realms of the imagination, and the Romantic artist constantly seems to have felt that another world lay just inches away, that he was separated from it by the thinnest of membranes, and that some sudden turn of the mind could lead him, all unresisting, into this unexplored, and vastly more real, reality."

Many Romantic-era thinkers and artists soon turned to the madhouse, not only to witness the general insane population, but also to seek out "insane" artists and discover what sorts of images they were creating. For instance, in 1838, French sculptor Pierre-Jean David d'Angers wrote in his diary of a visit to the insane asylum at Saint-Rémy in Provence, where he had met a young lovesick artist. His diary entry indicates a desire to be able to express himself in the same way as the "disturbed" artist. The French poet Arthur Rimbaud similarly expressed a desire to enter the mental state of the madman, in order to elevate himself from a "poet" to a "visionary." He explained that "[t]o arrive at the unknown through the disordering of all the senses, that's the point. The sufferings will be tremendous, but one must be strong." As the nineteenth century turned to the twentieth, more artists (most notably the Surrealists) would attempt to simulate altered mental states, including insanity, in order to access what they viewed as a "more genuine and non-alienated experience of human life."

In 1864, Italian anthropologist, criminologist, and psychiatrist Cesare Lombroso, published L'Uomo di Genio ("The Man of Genius") (originally published under the title Genio e Folia ["Genius and Madness"]). As MacGregor notes, "no single publication has contributed more toward shaping the popular conception of artistic genius." The book was extremely popular, with six editions published in a span of 30 years and translations into French, English, and German published in 1889, 1891, and 1894 respectively. One chapter (added in the fourth edition of the book in 1880), titled "Art in the Insane," was devoted entirely to discussing the "artistic tendencies" of 108 case studies of "insane" artists. Lombroso sought to prove that genius was a form of "moral insanity," that is, that "all geniuses should be diagnosed as suffering from a degenerative psychosis." The collection of "insane" art that Lombroso amassed for this undertaking survives today as part of the Museum of Criminal Anthropology in Turin, Italy, and "represents the earliest surviving example of a nineteenth-century collection of the art of the insane."


In his chapter "Art in the Insane," Lombroso described what he saw as the 13 unique characteristics of the art of the insane. One of these he called Atavism, meaning "references to stylistic features belonging to earlier periods in history" and "primitive mental states." Lombroso's notion of atavism stated that "insane artists" experienced these "primitive mental states" due to "arrested development of some one organ, and a corresponding backwardness in the products of that organ." As a result, he argued, these artists produced images that more closely resembled the images produced by less developed cultures such as "China or ancient Egypt." He offered the examples of "a French captain, suffering from paralysis, [who] drew figures stiff as Egyptian profiles," and "another patient, at Genoa, [who] carved bas-reliefs on pipes and on vases, exactly similar to those of the Neolithic Age." This belief that "idiot" and "insane" individuals had automatic access to more basic, primitive "psychical conditions" would come to be an important factor in the way that the art-world of the twentieth century would understand and value "insane" artists.

Lombroso concluded his chapter by stating: "[p]erhaps the study of these peculiarities of art in the insane, besides showing us a new phase in this mysterious disease, might be useful in aesthetics, or at any rate in art-criticism, by showing that an exaggerated predilection for symbols, and for minuteness of detail (however accurate), the complication of inscriptions, the excessive prominence given to any one colour (it is well known that some of our foremost painters are great sinners in this respect), the choice of licentious subjects, and even an exaggerated degree of originality, are points which belong to the pathology of art." Little did he know that less than a century later, exactly such a project would be undertaken by Hitler and the Nazis, who would attempt to demonstrate that the formal similarities between "insane" art and modern art indicated that they were both forms of Degenerate Art.

“Insane” Art as “Art Properly Speaking”

While the desire to use "insane" art as a diagnostic tool would continue well into the twentieth century, a handful of uniquely situated physicians who had significant training and/or interest in art history or criticism as well as psychiatry or psychology would play a key role in a new era wherein "insane" art would come to public attention and have a strong influence on modern artists. These physicians were not only wrote about "insane" art as art (through the lens of art criticism), they also reproduced many images of "insane" art in their publications, and organized exhibitions of "insane" art where, for the first time, laypeople and mainstream artists could view these works for themselves. They were the first to properly embrace the idea of the "patient artist," therefore, but their definitions were often problematic. They viewed "insane" art as equivalent to the art of children and "primitive" peoples, representing an early stage in the evolutionary development of artistic expression, thus perpetuating Lombroso's theories regarding "atavism."

In 1907, Marcel Réja (pseudonym of Dr. Paul Gaston Meunier, a psychiatrist who worked at the psychiatric hospital at Villejuif, and was also an art critic, writer, playwright, and poet) published a text on the "art of the insane," titled L'Art Chez les Fous, which included black-and-white reproductions of images from Auguste Marie's collection of "insane" art. As MacGregor notes, the book was "[i]ntended for artists and the general public,...the first full-length book devoted to a study of the spontaneous image-making activity of patients considered from the standpoint of art criticism." Réja asserted: "[i]t no doubt appears excessive to utilize the word 'art' in speaking of such productions. But, to appreciate so unique a genre, it is indispensable that we lay aside the conventional ideas we may possess about beauty." His decision to publish this work under a pseudonym further indicates his desire to distance the work from a medical or psychiatric framework, as does his decision to only occasionally mention an artist's psychiatric diagnosis.

Réja was clearly aware of what was in the process of becoming a widespread and intense interest in "primitive" art, noting, for instance, that both "insane" and "primitive" artists at times created "hieroglyphic drawings which make use of bold distortions to express their ideas. There is a curious symbolism at work in them which can be varied in an infinite number of ways." He also remarked upon the way that one "insane" artist's wooden sculptures "bear an astonishing resemblance to the fetishes created by primitive people," and how another "insane" artist's embroidery work contained "violent colors which provide a sensation of savagery which is closely related to the rudimentary execution of the drawing." However, it remains unclear whether his work had a direct influence on modern artists, or whether he was only picking up on modes of thinking that were already gaining momentum. Réja described "insane" art as "the more or less embryonic form of art," and asserted that "[t]here is no human science which has not obtained indispensable clarification and affirmation of its central principles from the study of more elementary phenomena...If art criticism intends to teach us something of the nature of beauty, it is necessary that it turn to the study of simpler forms. Art was not born a masterpiece. Beside the work of art, which represents, by definition, the perfectly realized formula, there are a number of products of a more or less elementary kind; the work of children, of savages, of prisoners, and the insane."

In 1921, Swiss psychiatrist Walter Morgenthaler published the first monograph on a "psychotic" artist (Adolf Wölfli), titled Ein Geistekranker als Künstler (A Mental Patient as an Artist). Morgenthaler worked at the Waldau Psychiatric Hospital in Bern from 1908-10, where he took an interest in the collection of "insane" art, crafts, and writings that Waldau doctors had begun collecting in the late nineteenth century. Morgenthaler presented this collection by creating a small museum at the hospital, and reached out to doctors at other psychiatric institutions across Switzerland to ask them to contribute more works to the Waldau collection. It was at Waldau that Morgenthaler became acquainted with Wölfli, and his monograph on the artist was, as curator Michel Thévoz asserts, "remarkable in many ways, but especially for the primacy of aesthetic over clinical emphasis."

In 1922, Dr. Hans Prinzhorn (1886-1933) of the Heidelberg Psychiatric Clinic in Germany published Bildnerei der Geistekranken ("The Artistry of the Insane"), based on a collection of "insane" art he had amassed from various institutions. Prinzhorn was trained in aesthetics and art history as well as psychiatry. He went on to work at the Heidelberg Psychiatric Clinic in 1919, which put him in a unique position to begin, according to MacGregor, "to envisage the productions of his patients from an aesthetic angle. He tried to see the creative process from the inside by considering each style as the overall expression of the life experience of its maker." A small collection of "insane" art had been started at Heidelberg, prior to Prinzhorn's arrival, by Dr. Karl Wilmanns, who wished to see the collection further developed, studied, and published. Prinzhorn's unique academic and professional background made him the ideal candidate for the job. By the time of his book's publication, the Heidelberg collection had grown to include some 5000 works by 500 "insane" artists active from about 1890 to 1920, at Heidelberg and at other institutions in Germany, Austria, Switzerland, Italy, the Netherlands, Japan, and the United States. Prinzhorn included 187 reproductions of patients' artworks in his books, and for many readers, particularly those who did not speak German, it was likely through these images that the book gained its greatest influence.

On the first page of his book, Prinzhorn wrote that "most of the reports published to date about the works of the insane were intended only for psychiatrists." He, instead, sought to write for a much broader audience, including "the lay public and the art lover." He also wanted to explore a "basic, universal, human process behind the aesthetic and cultural surface of the configurative process [which] would be essentially the same in the most sovereign drawing by Rembrandt as in the most miserable daubing by a paralytic: both would be expressions of the psyche." He, like Réja, explicitly rejected the word "art," not because he didn't view "insane" art as art, but because "the word 'art' includes a value judgment within its fixed emotional connotations. It sets up a distinction between one class of created objects and another very similar one which is dismissed as 'non-art'." He opted instead to use the term Bildnerei ("image-making" or "artistry"). Prinzhorn's book was widely read, including by modern artists such as Paul Klee, Max Ernst, and Jean Dubuffet, who were, as arts writer and educator John Maizels notes, "fascinated by an art that was without any influence from the modern art world yet was highly original, compelling, and contemporary." In 1922, Ernst travelled to Paris, bringing a copy of Prinzhorn's book along with him, which he shared with the Surrealists. The influence of Prinzhorn's book upon the group, as well as on Jean Dubuffet and his conception of Art Brut, was profound.

First Exhibitions of “Insane” Art

Around the same time as images and analyses of "insane" art were being made available to the general public, some physicians were beginning to mount exhibitions of "insane" artworks. In 1900, the first exhibition of "insane" artworks was held at the Bethlem Royal Hospital in London. A second exhibition was held at the same venue in August 1913, organized by Sir George Savage, to coincide with an international medical congress. The exhibition was extremely popular, visited by many artists and laypeople in addition to physicians. Other such exhibitions were held during international congresses in Berlin in 1913 and in Moscow in 1914.

In 1905, Dr. Auguste-Armand Marie, student of the renowned French neurologist Jean-Martin Charcot, held an exhibition titled Musée de la Folie ("Museum of Madness") at the Villejuif asylum near Paris, where he was chief physician. Inspired by the 1900 exhibition at Bethlem, Marie (who himself drew and painted) began collecting "insane" art that same year. His collection became the primary source of information and images of "insane" art, at least until the development of Prinzhorn's collection some two decades later. Works from Marie's collection were put on display at Villejuif (alongside artifacts from the history of psychiatry) and he welcomed visitors to the collection for many years, including artists and laymen. Works from his collection also went on to be shown elsewhere, including at the Galerie Vavin in Paris in 1928, an exhibition which was well-attended, particularly by the Surrealists. Works from Marie's collection were also reproduced and discussed in Réja's influential 1907 book. In 1966, Marie's widow donated what remained of the collection to the Compagnie de l'Art Brut.

A significant motivation behind Marie's desire to bring "insane" art to public view was his hope of making the idea of the "madman" less alien and alarming in the public imagination, thereby promoting asylum reform. He envisioned, as art historian Allison Morehead writes, "a reformed institution whose walls would be more porous and whose patients would be seen as human beings." He said of the art in his collection, "[m]ost of the works were made by very simple people who had never learned any art technique. Their spontaneity is further proof of their 'originality,' for the influence of no master is discernible in them....Many of the paintings were made on newspapers or even toilet paper, with a vehemence clearly showing a real need for self-expression. These people contrive to procure all the necessary materials when the storm of creation is upon them."

Marie's collection was brought to public attention primarily through media exposure. In October 1905, Marie published an article titled "Le Musée de la Folie" in the Paris periodical Je Sais Tout, which, according to its editors, presented articles "encompassing the whole of human knowledge and universal events." Marie argued that "[t]he brain of the insane man is not that different from ours! The only difference between him and us are exaggerations, and sometimes these are only partial. It is an all too common error to consider the insane as beings outside of humanity, to believe that their mental incoherence and disordered imagination are part of a world foreign to us." He also, like Réja, noted that in-depth study of "insane" art would allow researchers "to glean precious information on the psychology of normal artists, even the painter of genius." Marie's article, however, did not appear in the journal's "Arts and Literature" section but rather in the "Curiosities" section, which included what Morehead calls a "mish-mash of the miscellaneous and somewhat strange." Thus, the media's presentation of Marie's collection distorted his original vision of presenting asylum inmates as "human beings," instead titillating readers by presenting patient artworks, and their creators, as freakish "curiosities."

A November 1905 article titled "A Mad Museum: The Insane as Artists," which contained an English-language summary of the Je Sais Tout article, appeared in the London journal The Sketch, and also framed Marie's collection and its contents in an exoticizing manner. The text was accompanied by a double-page spread which featured black-and-white reproductions of several "insane" artworks from Marie's collection. These images were not presented on their own, however. Rather, the journal editors filled in the space around the images with fantastical drawings of bizarre and frightening creatures, real and imaginary, which no doubt evoked in the minds of the readers a link between "insane" artworks and notions of madness and otherness. As Critical Disability Studies (CDS) scholar Geoffrey Reaume asserts, "the animalistic image of a mad person as someone to fear has remained the most powerful of these stereotypes, stereotypes that have survived in popular media representations and the public mind and that people have been fighting against for literally generations."

Over the next few decades, several more exhibitions featured "insane" art. In 1921, the same year that Morgenthaler published his monograph on Wölfli, an exhibition of "insane" art was held in Frankfurt. In 1923, Prinzhorn's collection of patient art was shown at the Kunsthalle, Mannheim. In 1925, Dr. Charles Ladame (Director of the Bel-Air clinic in Geneva) opened a museum of "insane" art. In 1929, a show of "insane" art, titled Exposition des Artistes Malades, opened at the Galerie Max Bine in Paris. The same year, the Prinzhorn collection was shown at the Gewerbemuseum in Basle, Switzerland. Some exhibitions during this time featured "insane" art alongside the works of other groups of people believed to also be producing more "elementary" forms of art, including children and "primitive" peoples. For instance, in 1919, artist Max Ernst curated an exhibition in Cologne of avant-garde art, "tribal art," children's art, and "insane" art. In 1930, works by Adolf Wölfli, as well as several children artists, were shown at the Gewerbemuseum Winterthur in Switzerland. In 1933, another exhibition, organized by Brazilian doctor Cesar Osorio in São Paulo, placed "insane" art alongside works by children. In 1936, North-American art historian and the first director of the Museum of Modern Art (MoMA) in New York, Alfred Barr, curated an exhibition at the MoMA called Fantastic Art, Dada, Surrealism, which included children's art, folk art, and "insane" art.

Influence of “Insane” Art on Modern Artists

Avant-garde artists of the twentieth century saw "insane" art (as well as "primitive," mediumistic, and children's art) as possessing what MacGregor calls a "purer and more intense reality." As Thévoz notes, "[f]rom the Symbolists to the Surrealists, there is no counting the artists who, more or less deliberately, and more or less successfully, have capitalized on the disordered working of their mind and senses and dabbled in clairvoyance and psychic phenomena. The art of the insane has had an abiding fascination for them, and they themselves have sought to cross the threshold of that visionary world, even by the artificial means of hallucinogenic drugs." Modern artists like Matisse, Picasso, Miró, and Braque rejected traditional notions of beauty, and were drawn to "insane," "primitive," and children's art specifically because they offered alternative conceptions of beauty.

Many modern artists continued to view "insane" artists as possessing a unique ability to express purer, more primal mental states. As artist and writer David Maclagan notes, "[a]rtists, particularly in Expressionism and Surrealism, were also fascinated by the psychological and social alienation that might have been responsible for these extraordinary works, and by the resulting intensity of their expression, and sometimes christened them 'Expressionist' or 'Surrealist' in retrospect." For instance, one sculptural work, Objet d'Aliené, by an unnamed "insane" artist, was lent out from Dr. Marie's collection to the Surrealists and shown at several of their exhibitions, including the Exposition des Objets Surréalistes at the Galerie Charles Ratton in 1936, and the Fantastic Art, Dada, Surrealism exhibition at the Museum of Modern Art in New York in 1937.

“Insane” Art and Expressionism

German Expressionism, which held a "radical conception of the origin and function of human expression, [a] rejection of academic and bourgeois artistic ideals, and [an] openness to man-made images of the most primitive kind," was highly receptive to "insane" art. German artist John Heartfield praised "insane" artists in a 1914 essay published in the leading Expressionist periodical Aktion, in which he wrote that "[t]he mentally ill are artistically gifted. Their works show a more or less unexplained, but honest sense for the beautiful and the appropriate. But since their sensibility differs from ours, the forms, colours and relationships of their works appear to us as strange, bizarre and grotesque: crazy. Nevertheless the fact remains that the possessed can work creatively and with devotion."

Prinzhorn's book, and the images of "insane" art it held, was particularly influential on modern artists like Kubin, Max Ernst, and Paul Klee. After reading Prinzhorn's book, Klee exclaimed: [i]n our own time worlds have opened up which not everybody can see into, although they too are part of nature. Perhaps it's really true that only children, madmen and savages see into them." The works of Max Ernst, who had studied psychology at university and was responsible for introducing Prinzhorn's book to the Surrealists in 1922, bear the influence of "insane" art. For example, his sculpture Der Schwachsinnige (The Imbecile) is nearly identical to "insane" artist Karl Brendel's Der Teufel (The Devil), which is part of the Prinzhorn collection.

As cultural and literary historian Sander Gilman notes, "[d]uring the opening decades of the twentieth century, German Expressionism revelled in the exotic. The 'discovery' of African art by Carl Einstein very much paralleled the 'discovery' of the insane by such diverse writers and poets as Ernst Stadler, Georg Trakl, Carl Einstein, Alfred Doblin and the Dadaist Richard Huelsenbeck. This discovery was precipitated as much by the need to define the avant-garde as the antithesis of the established order....If the state found it necessary to isolate the insane, the avant-garde would integrate them, or at least the myth of insanity, into their image of their ideal world." German expressionists like Alfred Kubin, Erich Heckel, and Otto Dix turned to the madhouse for inspiration, not only depicting the scenes they witnessed there, but also adopting the emotive, often frenzied aesthetic style of many "insane" German artists like Paul Goesch and Franz Karl Buhler.

“Insane” Art and Surrealism

André Breton, founder of the Surrealist movement, wrote in the first Surrealist Manifesto: "[t]he confidence of madmen: I would spend my life in provoking them. They are people of a scrupulous honesty." As Maclagan notes, "There was much emphasis in Futurist and Dadaist manifestos on the necessity to sweep away the old order and to replace it with something fresher and more vigorous. But it was in Surrealism that alternative forms of creativity - naif art, eccentric art and the art of madmen - was most systematically promoted." Indeed, it is not an exaggeration to say that the Surrealists celebrated madness.

Breton had studied medicine from 1913 to 1920, during which time he developed a strong interest in psychiatry, mental illness, and psychoanalysis. He subsequently had psychiatric training, and worked with shell-shocked soldiers in Saint-Dizier, which led him to experiment with automatic writing. Breton's classmate, physician and author Théodore Fraenkel, stated that "Breton was deeply disturbed to see that the inmates [at Saint-Dizier] were greater poets than he." Breton referred to hysteria and psychosis as a "kind of bodily speech emanating from the unconscious," "the greatest poetic discovery of the latter part of the century," and "a supreme vehicle of expression." "Psychic automatism," as seen in automatic writing and drawing, word games like "the exquisite corpse," the recording of dreams, and the cultivation of dreamlike states in "séance-like sessions" went on to become a central Surrealist technique, as it was believed to be a useful exercise for tapping into the unconscious and exposing the "actual functioning of thought." Breton insisted that these activities were not simply "regrouping of words or a capricious redistribution of visual images, but....the recreation of a state which can only be fairly compared to that of madness."

According to cultural studies scholar Natalya Lusty, the Surrealist Leonora Carrington also "realized one of the greatest desires of the surrealists - 'the voyage down into madness'," as she was diagnosed "incurably insane" by the British consul and was committed to a psychiatric hospital in Santander, Spain. Upon escaping and rejoining the Surrealists in New York, she was encouraged by her peers to write about her experience of madness. She narrated this in Down Below (1944), in which she attempted to recreate, as Lusty puts it, "the paranoid and psychotic voice and experience [of hallucination]" in a diary format. As Lusty explains, Carrington's text presents this experience as "a godsend" and "an embryo of knowledge" by which she came to a greater understanding of herself. Yet at the same time the book presents "her own psychic drama as part of the traumatic and chaotic atmosphere of war" (Lusty). Carrington's mental deterioration was provoked, after all, at least in part, by the politically-motivated incarceration of her lover and artistic collaborator Max Ernst.

Art Brut and Outsider Art

Modern artist Jean Dubuffet was immediately taken with "insane" art when he first encountered it in Prinzhorn's Bildnerei der Geistekranken, admiring what he saw as its isolation from mainstream cultural paradigms. He grouped "patient art" together with the art of prisoners, children, spiritualist mediums, and non-Western (or "primitive") cultures under the label of Art Brut, a category which was later termed "Outsider Art" in English by literary and visual studies professor Roger Cardinal. Dubuffet was driven to articulate the category of Art Brut by his disillusionment with the exclusionary institutions of art.

Dubuffet first developed an interest in patient art after receiving Prinzhorn's book in 1923 as a gift from the Swiss art critic Paul Budry. Dubuffet didn't speak German so we can assume the book's main influence on him was through the images themselves. He later said: "[t]he pictures in Prinzhorn's book struck me very strongly when I was young. They showed me the way and were a liberating experience. I realized that everything was permitted, everything was possible. Millions of possibilities of expression existed outside of the accepted cultural avenues." Dubuffet subsequently travelled to Switzerland in 1945 with the French writer Jean Paulhan, painter René Auberjonois, and architect Le Corbusier. There he visited the Waldau Collection and saw the work of Wölfli (among others) first-hand. Dubuffet came to realize that various sorts of untrained artists were producing art "compulsively, entirely for individual satisfaction and inner need with no regard to exhibition, fame, reward or even audience." Dubuffet's fame and success after 1945 - although he did not, strictly speaking, consider his own work Art Brut - meant that his new category of "Art Brut" became extremely influential. From that point until around the 1980s, art created by people experiencing mental illness or otherwise significantly impacted by mental health issues was almost exclusively referred to as Art Brut.

Concepts and Styles

“Insane” Art as Isolated

Enlightenment and post-enlightenment thought has, until relatively recently, tended to view mental health problems as purely biological in origin. As a result, control over the housing and treatment of "lunatics" or "the insane" was handed over to medical "experts". These early physicians proffered the idea of "lunatics" as criminals, and as threats to the moral order of society. The solution they devised for this perceived problem was to isolate "lunatics" in large-scale institutions. It was in these institutions, places in which patient inmates were typically completely cut off from the rest of society, that the "art of the insane" was produced and first "discovered." As such, it came to be seen as a product of isolation amongst other things.

“Insane” Art as Evidence of Immorality, Criminality, and Degeneracy

This conflation of "insanity" with criminality and immorality has its roots in the writings of eighteenth- and nineteenth-century physicians and alienists. Although many medical professionals of this time understood that "insanity" and "idiocy" could be caused by a range of factors, including illness, injury, and heredity, several influential physicians proposed links to contagion and moral weakness, including transgressions on the part of parents such as alcoholism, incest, masturbation, or "attempts to procure abortion." Likewise, it was theorized that the presence of the "insane" in wider society would lead to moral decline,: a major reason these individuals were generally confined to institutions. Over the coming centuries many "experts" would use the art produced by the patients (or inmates) of these institutions as (diagnostic) evidence of their insanity and sometimes even of particular psychiatric diagnoses.

“Insane” Art as Autobiographical

The "Art of the Insane" is a category that classifies artists and their works based on biography and the context of the work's creation. It generally pays little attention to the content or style of the work produced. As a result of this lack of interest in the theme and form of work, terms such as Art Brut and "insane art" have been used to refer a near-infinite variety of subject-matter and aesthetic styles. What connoisseurs of this type of art tend to focus on, however, is art in which the "insane" artist depicts traumatic scenes from their personal history and/or hallucinatory visions they experience as a result of their psychological abnormalities.

“Insane” Art as Atavistic/Primitive

From the eighteenth century onward, many medical professionals, artists, and laymen would come to believe in the erroneous and romanticized view of "insane" individuals and artists as having "atavistic" insights (linked to something ancient or ancestral), much like spiritual mediums, children, or people of so-called "primitive" cultures. In fact, art by members of these various groups has often been grouped together and exhibited, as they were all believed to represent a long-lost, perhaps "purer" phase in the evolution of creative expression. Curator Michel Thévoz writes that "the only common feature of [the art of children, madmen, and primitives] is the fact that they have been relegated to the same ghetto, on the same charge of illustrating a 'pre-logical mentality' formulated jointly by ethnologists..., child psychologists..., and psychiatrists." Such a view has long since been picked apart and proved incorrect in various respects, not least by querying the idea that non-western cultures ought to be seen as less "evolved" or "civilized."

Resourcefulness in “Insane” Art

Artists working within the confines of isolated institutions such as insane asylums have often had limited access to media and materials and have been inhibited in the scale of work they can create. At the same time, this means that many "insane" or patient artists have demonstrated astounding resourcefulness with regards to the materials they have incorporated into their work. For example, many sculptural works by "insane" artists are assemblage-based, made of a variety of found materials.

Later Developments - After Art and “Insanity”

Shifts in Terminology

Since the 1980s, many artists and scholars have come to understand the term "Art of the Insane," as well as Art Brut and Outsider Art, as reflecting problematic categories which do not respect the stylistic and aesthetic specificities of the artists and works in question. Instead, the inclusion of an artist in one of these categories is often based on biographical information, with isolation, either self-imposed or state-imposed, often seen as the crucial factor. "Insane art" and its related categories thus mark a sphere in which human beings (and their biographies and traumas) are commodified, similarly to how "insane" individuals have been commodified in various ways in the recent past and present (by serving as unpaid laborers, for example). These discourses thus result in what Maclagan refers to as "positive discrimination," wherein the greater the artist's suffering, trauma, illness, or "handicap," the more value is placed on the work.

The Rise of Disability Art

The disability arts movement, which began in the 1980s, seeks to frame artists with mental illnesses or otherwise disabled artists in a way that frames them as activists and self-advocates, often with political aims. With close ties to critical disability studies in the academy and wider disability activism, practitioners and proponents of disability arts are more conscientious of the ways in which art can be used to shift societal attitudes and assumptions about disability, perhaps even to influence policy and practices that affect disabled individuals and communities in tangible ways. At the very least, disability arts offers disabled creators the opportunity to reclaim representations of disability (challenging othering and exoticized representations by presenting more realistic representations of disability) and to have a voice after centuries of being silenced.

The Legacy of “Insane” Art

In spite of the problematic ethics of their support, that fact that influential artists such as Andre Breton and Jean Dubuffet championed the art of the "insane" meant that these people's work - often produced while confined in an institution, without any other avenue of presentation - came to have a significant impact on twentieth-century art. The Surrealists' use of automatic writing and other creative techniques designed to short-circuit the conscious mind, for example, were informed by Andre Breton's work with shell-shocked soldiers after the First World War at Saint-Dizier.

After the Second World War, during another period when "civilized society" seemed to have been exposed as an illusory idea, many artists and movements again turned to the mentally ill as a source of creative "purity." For example, the CoBrA movement, which sought to break from the academic constrains they felt had grown up around modern art, emulated the creative approaches of mental patients. The Abstract Expressionist movement, while not endorsing the same idea, was partly a product of the same underlying impulse: the idea that art reflecting intense and perhaps turbulent emotional experiences was able to escape the stifling influences of convention. The suicide of artist Mark Rothko reflects the influence of mental health and its exploration through instinctive expression on at least one canonical Abstract Expressionist artist.

Modern and Contemporary Artists and Mental Health

Partly as a result of the example of Insane Art, though perhaps also as a reaction against its shortcomings, many modern artists have come to define their practice in relation to their experiences of mental health. Yayoi Kusama, for example, has created art as a way of processing the hallucinations she has experienced since childhood. For other artists, mental illness has been an obstacle to work around. Agnes Martin, for example, was diagnosed as schizophrenic and suffered several psychotic breaks during her life. But she always defined these experiences as irrelevant to her work, thus working to counter the myth of mental illness as a creative source.

The fact that these two artists - neither of them defined as "insane" or "Outsiders" - have taken very different approaches to describing their work in relation to mental health suggests that it is not this choice that dictates whether an artist will be defined using such outmoded terms. The more relevant determining factor is whether or not they are treated first and foremost as an artist or as a "patient," and whether they or third parties such as doctors have control over how their work is presented. The demise of large-scale residential mental institutions across the west since the 1980s, while it has brought its own problems -leaving many people suffering from mental health problems to face a different kind of isolation - makes it less likely that artists will in future be pigeonholed as "patient artists," "insane artists" or outsider artists, and more likely that they will simply be considered as artists.

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