On Creativity and Pathological Processes

This panel focused on creativity and pathological processes. Henry Krystal explored creativity in alexithymia, and Althea Horner discussed the use of creativity in patients who create a “not-me” solution to deal with psychic conflict.

Creativity as defined by the panel is associated with a process that allows the individual to conceptualize new areas of psychic functioning. Creativity can be impaired and deny the individual opportunity to view new solutions, or it can be utilized by the patient to construct various solutions in order to survive and deal with trauma. These themes were compared in both papers.

Krystal hypothesized that we can learn about creativity from those people who are least creative, that is, alexithymic patients. The alexithymic patient seems unable to relate to emotions in any way that can be useful. Like the holocaust survivor, these patients present with emotional numbness and affective anesthesia. They seem to possess little differentiation of emotions and respond to interpretation with muted emotional responses. These patients are described as being “boring and unimaginative.” It is as if they have a cognitive disturbance that renders them incapable of responding to emotion. They ignore all signs and seem “shut down.” They are “thing oriented,” not people oriented. Their capacity for regression is evident by a tendency toward somatization and a retreat from the cognitive arena.

Krystal hypothesized that the cognitive disturbance in these unemotional patients was similar to patients whose corpus callosum had been severed neurosurgically. These patients have also demonstrated impaired imagination and an interrupted creative process.

To explain this phenomenon, Krystal suggested that alexithymic patients had been exposed to overwhelming psychic trauma at an early age. They had not been able to develop transitional phenomena and therefore had not developed an internalized