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Psychotic indigenous painters from new guinea†
Art Psychotherapy,
Vol. 1. pp. 316-328.
PSYCHOTIC
Pergamon
Pram. 1973.
INDIGENOUS
Printed in the U.S.A.
PAINTERS
FROM NEW GUINEA*?
OTTO BILLIG Vanderbilt
University
School of Medicine, Nashville, Tennessee and
B. G. BURTON-BRADLEY Department
of Mental Health, Port Moresby, Papua-New
Guinea
Cultural attitudes strongly affected the daily life of the group and its individual members. Their magico-religious beliefs were a mixture of animism and ancestor worship. Every man was considered a potential sorcerer. The isolating conditions of terrain and custom have slowed Western influences. Ceremonial, rather than kinship groups within a given locality, formed the social unit. The absence of strong authority figures within the family influenced the social structures. The focal points in their lives were the men’s houses from which women were excluded. All spiritual activities were group activities. Contacts, even between neighboring groups, are still limited and often a few hundred people form their own “social universe of unique culture and language” (Maher, 1961). Two million people speak seven hundred different languages and dialects, mostly not understood outside each linguistic unit. The vast variety of local languages increases the great difficulties in verbal communications even among neighboring groups. Interpreters who are fluent in the local dialect are necessary to bridge the language gap. Psychiatric evaluations often require translations by non-psychiatric personnel which may lead to a considerable loss of the original content. Often more than one interpreter may be necessary in order to communicate in the local
THE setting of our study is New Guinea, the second largest island of the world; even today, it is relatively isolated. Some areas were not known to the outside world until forty years ago. There are still very few roads connecting the various towns. The highways out of Port Moresby, the capital, end about forty to fifty miles away. The existing connections are by air or pathways. One of my first contacts in the Western Highlands was a Mount Hagener dressed in his traditional costume, boarding the plane on which I had arrived. He carried a leather suitcase. This brief encounter may not be important by itself but it illustrates the impact of the past on the present. New Guinea is meeting the 20th century head-on with its stone age civilization. “As consequence of this interaction of conditions and influences, the human situation involves a wide variety of cultures in many stages of change” (Maher, 1961). The cultural isolation is impressive; tribal warfare still takes place periodically, in spite controls. Cultural interchange of governmental between groups is limited. “The territory is one of the most forbidding and unprepossessing parts of the tropics. Coastal swamps, dense inland jungles and mountains abound . . travel is often necessary by (small) aircraft or on foot . . .” (Burton-Bradley, 1970).
lAJthough the editor intends to devote this Journal to art psychotherapy, there may be occasion where it may be beneficial to the readers to overstep this frame. There may come to our attention valuable descriptive and diagnostic material in support of our therapeutic interest. The paper offered here seems to be of such unusually important character that we felt we ought to present it to our readers-Ernest Hurms. iRequest for reprints should be sent to Dr. Otto Billig, 2011 Ashwood Avenue, Nashville, Tennessee 37212 or Dr. B. G. Burton-Bradley, Department of Mental Health, Port Moresby, Papua-New Guinea.
315
BILLIG
316
AND
BURTON-BRADLEY
language. Moreover. the schizophrenic’s inherent language difficulties with the neologisms and vague verbal expressions increase the already existing communication problems, eventually leading to regressions on a nonverbal level (Ruesch, 1955). Schizophrenic patients. regardless of cultural backgrounds, often begin to draw SpontaneousIy during their psychosis (Billig, 1970). Non-Westernized patients who had neither drawn or painted previously nor had ever seen graphic material made surprisingly good use of the art supplies placed at their disposal (Biilig, 1966). The psychiatric diagnosis in transcultural settings is prone to be complex and cannot be based on the content of delusions but on the structure of the disorder. Magic concepts such as *‘bone pointing” may be either a paranoid delusion or part of a cultural belief. Magico-religious content may reflect
supernatural and ancestral culrs among psy~hotr~s and non-psychotics. In addition. the possibility ot different diagnostic sriterta being used must always be considered when clinical material is collected by, different investigators even where the same culture is examined. Since “present-day methods of detecting and diagnosing mental disorders are largeI> based on culturaily deviant behavior” (Zubm. 1966). it is essential that patients are diagnosed or classified by local mental health workers who have intimate knowledge and experience with the culture and mental illnesses which pertain to that area. In our study, the diagnosis was made by local medical practitioners who were sophisticated in disorders of tropical New Guinea. The criteria for diagnosing psychiatric disorders had been established previously (Burton-Bradley, 197 1).
TABLE REGRESSIVE
Clinical
Oceanic
Feelings
Severe
Repression
LEVELS
I
OF DISINTEGRATION
Condition
Spatial
Multidirectional of Reality
Relations
Baseline
with
Geometric
Appearance
of Giobal
More Advanced
inadequate
Concepts
Disintegration
Balance
Between
of the Ego Boundaries
Outer
and Inner
Reality
“Horror
Disintegration
Bepinnmg
Withdrawal
of Object
Cathexis
Direction
(Illustration
15)
Structures
and Condensed
Design
Mixing
of Planes
(IlIustrations
“X-ray
Pictures”
(Transparencies)
Projection
Perseveration
of Ego Boundaries
Vertical
Vacui”
impoverished
Vertical
(Illustration
IIllustration
Spatial
Relations
Cosmic
Destruction
Emptying
13)
Space
Designs
Inarticulated
Structure
(Illustrations
6, 7)
61
4)
Destroyed
(IIiustration
3)
Space
Shadowy Figures. Elongation. (Illustrations 2. 101
and Distortions
1,
5)
PSYCHOTIC
INDIGENOUS
STRUCTURAL D~S~NTEGRAT~UN Previous publications discussed the progressive levels of spatial disintegration (Bihig, 1970) and the changes in the perception of motion (Billig, I97 t f in Western schizophrenics. An illustrative table (Table 1) shows the summary of such changes. We based our theories on the withdrawal of cathexis which plays a major role in the schizophrenics’ disintegration. It leads to changes in reality concepts (Federn, 1952) which are reflected in the structuralization of their graphics. Reality dppears fiat and empty (Sechehaye, I95 I f. eventualty limitless; concepts become at first fragmented and secondarily fused. Since the cathexis is not evenly withdrawn and since attempts of secondary restitution or “redefinition” (Bumham, 1969) are being made continuously, different stages of regression in the concept of reality and its spatial structures may be manifested in the same graphic.
SCHIZOPHRENIC GRAPHICS OF PAPUA AND NEW GUINEA Previously, comparative cross-cultural studies of schizophrenic “art” (Biilig, i 966) included material from Kenya, Hong Kong, Japan and Lebanon. The present material deals with psychotic “painters” from New Guinea and Papua. Cultural beliefs influence the content of the psychosis depending on the Ievel of personality disintegration. As the patients become more disintegrated, abstract designs appear but they still include several basic elements found in indigenous art (Mead, 1963). In contrast to the tribal artist, schizophrenic patients use bright colors such as v&id red, green, or purple. These are completely foreign to the local culture and their use meets with severe disapproval from the local community (Mead. 1963, p.16). The traditional colors are “low toned’ earth colors: mostly red and yellow ochre, white and black. One of our patients came from Ihu in the Cuff of Papua. He was a fifty-year-old male who was admitted to the hospital after having broken into the house of a man whom he had accused of sorcery. The patient was convinced that “this sorcerer” was responsible for a crocodile3 having killed the patient’s wife. Since two other women had accompanied his wife at the time of her death, the patient had given each of them one hundred dollars to help him find the sorcerer and the crocodile. The women accused a man living in the village of the act. The distressed husband was going lo kill the accused
PAINTERS
317
FROM NEW GUINEA
man, but was restrained by the men of the community; he was considered mentaliy iif and was hospitalized. While in the hospital he showed delusions of persecution, appeared confused and hallucinated. These symptoms were considered beyond any cus-
Illustration
1
318
BILLIG
AND BURTON-BRADLEY
tomary cultural patterns but characteristic of psychotic personality disintegration. His drawings are highly influenced by the traditional designs of the region. Not markedly disintegrated, his first drawings show a great similarity to
Illustration
Papuan memorial plaques. The original plaques are diamond shaped (Illustration I): the face shows prominent eyes surrounded by chevrons, with the nose a long central axis ending at the mouth. whrch is usually open, displaying two rows of shark teeth.
2
PSYCHOTIC
INDIGENOUS PAINTERS
The face is topped by a large headdress. The body is often incomplete, disproportionately small and contains geometric designs. The patient’s drawing preserves the basic structure of the conventional design, but the principal characteristics are over-
Illustration
FROM NEW GUINEA
319
emphasized and distorted (Illustration 2). The headdress is elongated; the chevrons around the eyes have become diamond-shaped figures drawn rigidly; the traditionally small body is absent. The customary geometric symmetry is maintained but overempha-
3
320
BILLIG
AND BURTON-BR.iDLE\r’
sized. The colors, as in all his draivings. are bri@tr yellow, red, blue, and some purpie. They &Care earth colors considerably from Ihe traditional (Mead. 1963). The severe constriction of this figure suggests an attempt to control the rhreatening
prrsondlty dIsiltI~~i-a(i(~it. iSpace Intuits msh~2 it WxessaI~ t!, iim1t ;I rluntbel- Of the pat1i”nt’s cttlt<1waret-colors.) The design ot‘ ;f Later graphic (Iii~~~t~xs~ tion 3) is dissolved to ;1 ionaderabls degree: the central axis is preserved: the eyes ~tppesr prominent.
illustrati~)rt 4
PS’YCNOTIC
rN~IGE~~~S
PAINTERS
larger than usual; the circles around them are perseverated and the chevrons are stereotyped; the teeth in the mouth are missing. The tower part of the face has a somewhat vacant appearance. Other drawings show distortions and destruction of spatial relationships. Two pairs of eyes are displaced both upwards and down (Illustration 4). Ornamental curlicues are emphasized and perseverated, filling the space between the two sets of eyes. The next graphic (illustration 5) shows a further impoverished and condensed design. The horizontal axis (which originally presented the nose) is maintained and a horizontal line is added, thereby forming a cross, Curlicues originate from the center and retain the barest suggestion of the original diamond-shaped face and headdress. Another of our psychotic painters comes from Buka, a small island at the extreme northern tip of the Solomon group. The thirty-mile-long island has an indigenous population af about ten thousand
illustration
FROM NEW GUfNEA
321
people. Their myths are colorful and they developed distinctive cults: the Hahahs Welfare Society {a communal economic and sexual organization), the Baby Garden (where women are housed to make them freely available to all men) and cargo cults (see below). The patient was admitted to the hospital at Port Moresby after having sacrificially killed his sister’s daughter’s son whom he had “marked” for the purpose. Following the sacrifice, he attempted suicide. The patient belonged to the “welfare society”: he had prophesized the coming of a new millennium of everfasting wealth. Ancestors would return with cargoes of building materials, food, axes and other goods. The patient considered himself to have unusual powers while thinking that only a small number of his people were endowed with such superior abilities. As a result of the sacrifice, he became God. He developed a slowly progressive paranoid system which was rather well organized. His delusions remained unshakably fixed. Such
S
112 __
BILLIG AND BURTON-BR.4DLEY
cargo cults have sprung up periodically during the last fifty years and espress the contlict arising from the impact of Western culture on tribal tradition (Burton-Bradley, 197 I ). Sacrifice and suicidal attempts are part of the cult. However. the patlent’s
delusional system is outside the customary cult and his own community considered him mentally ill. The patient’s first drawing shows a rudimentark human figure with ten to twelve layers of various colors (red. yellow. green and black) indicating perseveration. Only three layers of colors would be used in traditional art. Arms snd legs are highly stylized; the face shows the emptiness of the schirophrenic graphic and is not a local charxterlstic. One drawing (Illustration 6) is somewhat unusual for the patients of these islands. It shows
unexpected activitk. The objects are built up on ;I baseline which depicts the ground. .A trntllke stnlctul-e is on the left while the c‘rnter IS built up CIII S-like curves. the space being filled in \<~th >hoIt strokes. In the upper part of the drawing. there seems to be a boat on which some tlees are placed: above it lies a long figure suggesting ;I snake. wlih
its upper body raised as if ready’ to strike. Its head IS directed against a male figure In motion whose body is rudimentary “perspective tordue”
and deplcted In the posltion of (Billig. lQ70). Thus drawing
410~s a limited cohesiveness and vertical projectlon.’ disproportionately sized objects and distortions appear. .A somewhat crayon another
similar drawing
arrangement by the
II1 appears same patlent
PSYCHOTIC
INDIGENOUS
PAINTERS FROM
(Illustration 7). The various layers are separated from one another. Geometric designs appear. A tree and a bird are disproportionate in size. On top is again a snake-like figure; however, its end seems to be split, appearing as if it had two legs. Other objects are vague and difficult to identify. The deterioration of cultural influences can be traced in the drawings of another indigenous schizophrenic who was admitted after developing delusions of persecution. The psychiatric evaluation revealed additional dissociation of affect and affective withdrawal as well as some incoherence. His adjustment showed considerable fluctuations during his hospitalization and some of his persecutor-y ideas remained. His first drawing has a hardly recognizable central figure with a large head which is slanted to the left. The head has concentric blue lines
Illustration
NEW GUINEA
323
separated by a narrow space from the outside contour. The contour line is covered by alternating blue and red spines (a cultural characteristic). The total form is distorted. The same patient made another crayon drawing (Illustration 8) with separate objects, each fairly cohesive but apparently unrelated to each other: two plants with exposed roots, the tops of which consist of concentric rings and some curlicues. On the right appear three birds in various sizes; similarly shaped birds are found among early cultural groups (as in Byzantine cave paintings in Turkey, etc.). The relatively cohesive but separate designs indicate a marked improvement over the abstract forms of the first drawing by this patient. Paintings and drawings done by patients from more isolated areas of New Guinea, where tribal
7
324
BILLIG
AND BURTON-BRADLE1
customs and traditions play an even more significant role. show more pronounced spatial disintegration than do similar productions from the coastal cities such as Port Moresby. Fewer clinical data are known about these patients. One patient from the Highlands came from the
Illustration
Mount Hagn regon. HIS behavior was considered to be “abnormal” by members of his communitv; ;I marked personality change had taken place. C‘ontrary to his usual custom. he started to steal and collect things for which he had no use. He began to wear grass skirts, which are only worn by women In
8
PSYCHOTIC
INDIGENOUS
PAINTERS
that region. One of the watercolors shows a traditional hut built on stilts; ladders lead up to it. The hut and the bare outlines of several disproportionately sized people are placed on a baseline (Billig, 1970). Objects are all two-dimensional; therefore
Illustration
FROM NEW GUINEA
325
depth is lacking. One crayon drawing filled the paper almost completely (“horror vacui”). It is drawn in extremely bright reds, blues and orange with a green spot suggestive of a flower pot. The design is rigid, consists only of broad lines or simple
9
326
BItLIG
AND BURTON-BRADLEY
Againa three-dimensiona aspect is missing. A patient from Goroka had supposedly committed several murders. He was considered mentally ill when he had necrophilic relations with his dead wife. This act, considered campietely unacceptable
spikes.
by his peopie, led to several manda~a-lake originate (Illustration green and blue. were choice of colors.
his hospitalization, He painted circles from which chevrons 91. Bright colors, mostly red. used in contrast to the usuai
327
In another watercolor (Illustration 10) two animals show marked elongation, with the arms and legs depicted in a culturally characteristic &XXition.. The two centered animals and the shadowhke figure on the left lack depth (Billig, 1970). As regression advances in any cultural setting, fewer of the specific elements of that particular culture remain, while apparently universal elements emerge. Regressive characteristics such as elongation, emptying space, distortion, transparencies, mixing of planes, vertical projection and the “baseline” appear (See Table 1) (Bilfig, 2970). As the regression becomes very advanced, patients design patterns very similar to those by Western patients of corresponding levels of personality disintegration. Flowers in simple shapes, houses or huts in a child-like flatness, stars and the like are drawn, These characteristics appear regardless of any artistic experience and dexterity or cultural level.
CROSS-CULTURAL ART Cultural influences determine the symbolization in tribal art. Stylistic characteristics fulfill sociocultural needs; they are continued as long as the spiritual and social system continues (Billig, 1966). Tribal thinking builds defenses against reality threats. The defenses are imposed by a societal order to protect it against unknown and potentially threatening powers. They lead to a relentless desire for omnipotent control of the surrounding danger. Only an integrated ego can fend the inner cohesiveness to magical concepts which can satisfy the societal needs. The motivating force of tribal art is based an the anxieties which attempt to control the threatening unknown by the magic of imagery. The tribal artist uses his insight into an inner reality (i.e., X-ray pictures in Australian bark paintings) as a response to societal needs. In contrast, psychotic disintegration leads to distortians and regression characteristic of earlier patterns of personality organization. While the tribal artist shapes his images as responses to societal needs which have important meaning to the group, the psychotic imagery is sofipsistic and it is not intended to meet societal needs. Jt is based on a need to be understood (Bihig, 1970). The psychotic,
with his reduced ability to test reality, sacrifices external reality. As the illness progresses, environ. mental, cultural influences lose their significance. The conception of reality becomes unstable, existing social demands less consequential. Thought pro. cesses are interrupted and fragmented (Bill&, 197 1). The newly formed structures are controlled by inner needs, rather than their being adapted to societal reality. The disintegrated ego is no longer capable of interrelating ‘&the multiple dete~inants to mental functions” ~H~~owel~, 1965) and it regresses to ~~~sychob~o~ogi~al, possibfe hereditary structures common to ail . s . (nameiy) to universals” {DeVos, 1965). The psychotic process modifies the “simple universals” through distortions and by a lack of cohesiveness. The universals are originally based on psychobiological structures. They can be observed in the morphological development of embryos of all vertebrate classes (Iiooker, 1958). They appear first as a vertical bending of the head, and, somewhat later, a horizontal movement (“avoidance reflex”) appears [Hooker, 1958). Similarly, the first movements of the infant, which are related to feeding mechanisms (Spitz, 1957), lead to a horizontal rotation of the head, to which nodding in a vertical direction is later imposed. These two directions have become selected from a number of possibilities as “success-specific movements,” while the unsuccessful ones become eliminated (Billig, 1970). Such “simple movements form the building stones of behavior . . addition of one ‘simple movement* to another leading to the characteristic behavior of the organism” (Hooker, 1958). This early space conception becomes repeated in the first attempts to represent space in children’s drawings, After the first unorganized scribbfings, the basefine “represents the earhest schematic representation of objective space” (Loewenfeld, I.939). Other dimensions of space are added and form “subjective spatial patterns”: transparencies, mixing of planes, etc. Children”s drawings from different parts of the world may vary as to content; however, the structure of “these drawings is identical with those produced by young children everywhere” (Read, 1961). As “socialization practices” (DeVos, 1965) gain influence, the originaf universal designs become modified into cultural specifics ~ountford, 1961). Similar developments of the spatial structure have been described in primeval art and in early high civilization (Giedion, I962).
328
BILLIG
AND BURTON-BRADLEY
DISCUSSION AND SUMMARY Spontaneous graphics obtained from psychotic patients who five in areas of comparatively marked cultural isoiation, such as New Guinea. show regressive patterns not unlike those of Western civilization. The content of the drawings is culturally influenced as long as the patient remains relatively well integrated. Enculturation, which has a strong impact on the individual and his society, resists the psychotic personality disintegration to considerable degree. But as the psychotic process advances, a regression to universal factors of the spatial structure can be seen and cultural differences recede. “Sociahzation practices” lose more and more significance. The psychotic process adds to the simple regression pathological distortions. elaborations. condensations and lack of cohesiveness, The regression observed in schizophrenic productions seems to support theories of “universal” factors of human behavior (DeVos, 196.5; Hallowell, 1965). These form the building stones from which socialization practices lead to differential branching off to various cultures. REFERENCES BILLIG, OTTO. (1966) Cross-cultural factors in schizophrenic art. Proceedings of the IV World Congress of Psychiatry, Madrid. Excerpta Medica International Congress Series No. 150, 600-612. BILLIG, OTTO. (1970) StructureS of schizophrenic forms of expression. Psychiat. Quart. 44, 187 -- 222. BILLIG, OTTO. (1971) Is schizophrenic expression art’? J. nerv. ment. Dis. 153, 149-164. BILLIG, OTTO. (1971) Representation of motion in schizophrenic “art”. V World Congress of Psychiatry, Mexico City. To be published in Confinia Psychiatrica. BURNHAM, D. L. and A. L. (1969) Schizophrenia and the Near-Fear Dilemma. pp: 282-305. International University Press, New York. BURTON-BRADLEY, B. G. (1969) Papua and New Guinea. trsnscultural psychiatry II. Aust. New Zeal. J. Psychiat. 3% 130-136.
BURTON-BRADLEY, B. G. t 1970) Tran\
Vol. 1. pp. 316-328.
PSYCHOTIC
Pergamon
Pram. 1973.
INDIGENOUS
Printed in the U.S.A.
PAINTERS
FROM NEW GUINEA*?
OTTO BILLIG Vanderbilt
University
School of Medicine, Nashville, Tennessee and
B. G. BURTON-BRADLEY Department
of Mental Health, Port Moresby, Papua-New
Guinea
Cultural attitudes strongly affected the daily life of the group and its individual members. Their magico-religious beliefs were a mixture of animism and ancestor worship. Every man was considered a potential sorcerer. The isolating conditions of terrain and custom have slowed Western influences. Ceremonial, rather than kinship groups within a given locality, formed the social unit. The absence of strong authority figures within the family influenced the social structures. The focal points in their lives were the men’s houses from which women were excluded. All spiritual activities were group activities. Contacts, even between neighboring groups, are still limited and often a few hundred people form their own “social universe of unique culture and language” (Maher, 1961). Two million people speak seven hundred different languages and dialects, mostly not understood outside each linguistic unit. The vast variety of local languages increases the great difficulties in verbal communications even among neighboring groups. Interpreters who are fluent in the local dialect are necessary to bridge the language gap. Psychiatric evaluations often require translations by non-psychiatric personnel which may lead to a considerable loss of the original content. Often more than one interpreter may be necessary in order to communicate in the local
THE setting of our study is New Guinea, the second largest island of the world; even today, it is relatively isolated. Some areas were not known to the outside world until forty years ago. There are still very few roads connecting the various towns. The highways out of Port Moresby, the capital, end about forty to fifty miles away. The existing connections are by air or pathways. One of my first contacts in the Western Highlands was a Mount Hagener dressed in his traditional costume, boarding the plane on which I had arrived. He carried a leather suitcase. This brief encounter may not be important by itself but it illustrates the impact of the past on the present. New Guinea is meeting the 20th century head-on with its stone age civilization. “As consequence of this interaction of conditions and influences, the human situation involves a wide variety of cultures in many stages of change” (Maher, 1961). The cultural isolation is impressive; tribal warfare still takes place periodically, in spite controls. Cultural interchange of governmental between groups is limited. “The territory is one of the most forbidding and unprepossessing parts of the tropics. Coastal swamps, dense inland jungles and mountains abound . . travel is often necessary by (small) aircraft or on foot . . .” (Burton-Bradley, 1970).
lAJthough the editor intends to devote this Journal to art psychotherapy, there may be occasion where it may be beneficial to the readers to overstep this frame. There may come to our attention valuable descriptive and diagnostic material in support of our therapeutic interest. The paper offered here seems to be of such unusually important character that we felt we ought to present it to our readers-Ernest Hurms. iRequest for reprints should be sent to Dr. Otto Billig, 2011 Ashwood Avenue, Nashville, Tennessee 37212 or Dr. B. G. Burton-Bradley, Department of Mental Health, Port Moresby, Papua-New Guinea.
315
BILLIG
316
AND
BURTON-BRADLEY
language. Moreover. the schizophrenic’s inherent language difficulties with the neologisms and vague verbal expressions increase the already existing communication problems, eventually leading to regressions on a nonverbal level (Ruesch, 1955). Schizophrenic patients. regardless of cultural backgrounds, often begin to draw SpontaneousIy during their psychosis (Billig, 1970). Non-Westernized patients who had neither drawn or painted previously nor had ever seen graphic material made surprisingly good use of the art supplies placed at their disposal (Biilig, 1966). The psychiatric diagnosis in transcultural settings is prone to be complex and cannot be based on the content of delusions but on the structure of the disorder. Magic concepts such as *‘bone pointing” may be either a paranoid delusion or part of a cultural belief. Magico-religious content may reflect
supernatural and ancestral culrs among psy~hotr~s and non-psychotics. In addition. the possibility ot different diagnostic sriterta being used must always be considered when clinical material is collected by, different investigators even where the same culture is examined. Since “present-day methods of detecting and diagnosing mental disorders are largeI> based on culturaily deviant behavior” (Zubm. 1966). it is essential that patients are diagnosed or classified by local mental health workers who have intimate knowledge and experience with the culture and mental illnesses which pertain to that area. In our study, the diagnosis was made by local medical practitioners who were sophisticated in disorders of tropical New Guinea. The criteria for diagnosing psychiatric disorders had been established previously (Burton-Bradley, 197 1).
TABLE REGRESSIVE
Clinical
Oceanic
Feelings
Severe
Repression
LEVELS
I
OF DISINTEGRATION
Condition
Spatial
Multidirectional of Reality
Relations
Baseline
with
Geometric
Appearance
of Giobal
More Advanced
inadequate
Concepts
Disintegration
Balance
Between
of the Ego Boundaries
Outer
and Inner
Reality
“Horror
Disintegration
Bepinnmg
Withdrawal
of Object
Cathexis
Direction
(Illustration
15)
Structures
and Condensed
Design
Mixing
of Planes
(IlIustrations
“X-ray
Pictures”
(Transparencies)
Projection
Perseveration
of Ego Boundaries
Vertical
Vacui”
impoverished
Vertical
(Illustration
IIllustration
Spatial
Relations
Cosmic
Destruction
Emptying
13)
Space
Designs
Inarticulated
Structure
(Illustrations
6, 7)
61
4)
Destroyed
(IIiustration
3)
Space
Shadowy Figures. Elongation. (Illustrations 2. 101
and Distortions
1,
5)
PSYCHOTIC
INDIGENOUS
STRUCTURAL D~S~NTEGRAT~UN Previous publications discussed the progressive levels of spatial disintegration (Bihig, 1970) and the changes in the perception of motion (Billig, I97 t f in Western schizophrenics. An illustrative table (Table 1) shows the summary of such changes. We based our theories on the withdrawal of cathexis which plays a major role in the schizophrenics’ disintegration. It leads to changes in reality concepts (Federn, 1952) which are reflected in the structuralization of their graphics. Reality dppears fiat and empty (Sechehaye, I95 I f. eventualty limitless; concepts become at first fragmented and secondarily fused. Since the cathexis is not evenly withdrawn and since attempts of secondary restitution or “redefinition” (Bumham, 1969) are being made continuously, different stages of regression in the concept of reality and its spatial structures may be manifested in the same graphic.
SCHIZOPHRENIC GRAPHICS OF PAPUA AND NEW GUINEA Previously, comparative cross-cultural studies of schizophrenic “art” (Biilig, i 966) included material from Kenya, Hong Kong, Japan and Lebanon. The present material deals with psychotic “painters” from New Guinea and Papua. Cultural beliefs influence the content of the psychosis depending on the Ievel of personality disintegration. As the patients become more disintegrated, abstract designs appear but they still include several basic elements found in indigenous art (Mead, 1963). In contrast to the tribal artist, schizophrenic patients use bright colors such as v&id red, green, or purple. These are completely foreign to the local culture and their use meets with severe disapproval from the local community (Mead. 1963, p.16). The traditional colors are “low toned’ earth colors: mostly red and yellow ochre, white and black. One of our patients came from Ihu in the Cuff of Papua. He was a fifty-year-old male who was admitted to the hospital after having broken into the house of a man whom he had accused of sorcery. The patient was convinced that “this sorcerer” was responsible for a crocodile3 having killed the patient’s wife. Since two other women had accompanied his wife at the time of her death, the patient had given each of them one hundred dollars to help him find the sorcerer and the crocodile. The women accused a man living in the village of the act. The distressed husband was going lo kill the accused
PAINTERS
317
FROM NEW GUINEA
man, but was restrained by the men of the community; he was considered mentaliy iif and was hospitalized. While in the hospital he showed delusions of persecution, appeared confused and hallucinated. These symptoms were considered beyond any cus-
Illustration
1
318
BILLIG
AND BURTON-BRADLEY
tomary cultural patterns but characteristic of psychotic personality disintegration. His drawings are highly influenced by the traditional designs of the region. Not markedly disintegrated, his first drawings show a great similarity to
Illustration
Papuan memorial plaques. The original plaques are diamond shaped (Illustration I): the face shows prominent eyes surrounded by chevrons, with the nose a long central axis ending at the mouth. whrch is usually open, displaying two rows of shark teeth.
2
PSYCHOTIC
INDIGENOUS PAINTERS
The face is topped by a large headdress. The body is often incomplete, disproportionately small and contains geometric designs. The patient’s drawing preserves the basic structure of the conventional design, but the principal characteristics are over-
Illustration
FROM NEW GUINEA
319
emphasized and distorted (Illustration 2). The headdress is elongated; the chevrons around the eyes have become diamond-shaped figures drawn rigidly; the traditionally small body is absent. The customary geometric symmetry is maintained but overempha-
3
320
BILLIG
AND BURTON-BR.iDLE\r’
sized. The colors, as in all his draivings. are bri@tr yellow, red, blue, and some purpie. They &Care earth colors considerably from Ihe traditional (Mead. 1963). The severe constriction of this figure suggests an attempt to control the rhreatening
prrsondlty dIsiltI~~i-a(i(~it. iSpace Intuits msh~2 it WxessaI~ t!, iim1t ;I rluntbel- Of the pat1i”nt’s cttlt<1waret-colors.) The design ot‘ ;f Later graphic (Iii~~~t~xs~ tion 3) is dissolved to ;1 ionaderabls degree: the central axis is preserved: the eyes ~tppesr prominent.
illustrati~)rt 4
PS’YCNOTIC
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PAINTERS
larger than usual; the circles around them are perseverated and the chevrons are stereotyped; the teeth in the mouth are missing. The tower part of the face has a somewhat vacant appearance. Other drawings show distortions and destruction of spatial relationships. Two pairs of eyes are displaced both upwards and down (Illustration 4). Ornamental curlicues are emphasized and perseverated, filling the space between the two sets of eyes. The next graphic (illustration 5) shows a further impoverished and condensed design. The horizontal axis (which originally presented the nose) is maintained and a horizontal line is added, thereby forming a cross, Curlicues originate from the center and retain the barest suggestion of the original diamond-shaped face and headdress. Another of our psychotic painters comes from Buka, a small island at the extreme northern tip of the Solomon group. The thirty-mile-long island has an indigenous population af about ten thousand
illustration
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people. Their myths are colorful and they developed distinctive cults: the Hahahs Welfare Society {a communal economic and sexual organization), the Baby Garden (where women are housed to make them freely available to all men) and cargo cults (see below). The patient was admitted to the hospital at Port Moresby after having sacrificially killed his sister’s daughter’s son whom he had “marked” for the purpose. Following the sacrifice, he attempted suicide. The patient belonged to the “welfare society”: he had prophesized the coming of a new millennium of everfasting wealth. Ancestors would return with cargoes of building materials, food, axes and other goods. The patient considered himself to have unusual powers while thinking that only a small number of his people were endowed with such superior abilities. As a result of the sacrifice, he became God. He developed a slowly progressive paranoid system which was rather well organized. His delusions remained unshakably fixed. Such
S
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cargo cults have sprung up periodically during the last fifty years and espress the contlict arising from the impact of Western culture on tribal tradition (Burton-Bradley, 197 I ). Sacrifice and suicidal attempts are part of the cult. However. the patlent’s
delusional system is outside the customary cult and his own community considered him mentally ill. The patient’s first drawing shows a rudimentark human figure with ten to twelve layers of various colors (red. yellow. green and black) indicating perseveration. Only three layers of colors would be used in traditional art. Arms snd legs are highly stylized; the face shows the emptiness of the schirophrenic graphic and is not a local charxterlstic. One drawing (Illustration 6) is somewhat unusual for the patients of these islands. It shows
unexpected activitk. The objects are built up on ;I baseline which depicts the ground. .A trntllke stnlctul-e is on the left while the c‘rnter IS built up CIII S-like curves. the space being filled in \<~th >hoIt strokes. In the upper part of the drawing. there seems to be a boat on which some tlees are placed: above it lies a long figure suggesting ;I snake. wlih
its upper body raised as if ready’ to strike. Its head IS directed against a male figure In motion whose body is rudimentary “perspective tordue”
and deplcted In the posltion of (Billig. lQ70). Thus drawing
410~s a limited cohesiveness and vertical projectlon.’ disproportionately sized objects and distortions appear. .A somewhat crayon another
similar drawing
arrangement by the
II1 appears same patlent
PSYCHOTIC
INDIGENOUS
PAINTERS FROM
(Illustration 7). The various layers are separated from one another. Geometric designs appear. A tree and a bird are disproportionate in size. On top is again a snake-like figure; however, its end seems to be split, appearing as if it had two legs. Other objects are vague and difficult to identify. The deterioration of cultural influences can be traced in the drawings of another indigenous schizophrenic who was admitted after developing delusions of persecution. The psychiatric evaluation revealed additional dissociation of affect and affective withdrawal as well as some incoherence. His adjustment showed considerable fluctuations during his hospitalization and some of his persecutor-y ideas remained. His first drawing has a hardly recognizable central figure with a large head which is slanted to the left. The head has concentric blue lines
Illustration
NEW GUINEA
323
separated by a narrow space from the outside contour. The contour line is covered by alternating blue and red spines (a cultural characteristic). The total form is distorted. The same patient made another crayon drawing (Illustration 8) with separate objects, each fairly cohesive but apparently unrelated to each other: two plants with exposed roots, the tops of which consist of concentric rings and some curlicues. On the right appear three birds in various sizes; similarly shaped birds are found among early cultural groups (as in Byzantine cave paintings in Turkey, etc.). The relatively cohesive but separate designs indicate a marked improvement over the abstract forms of the first drawing by this patient. Paintings and drawings done by patients from more isolated areas of New Guinea, where tribal
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customs and traditions play an even more significant role. show more pronounced spatial disintegration than do similar productions from the coastal cities such as Port Moresby. Fewer clinical data are known about these patients. One patient from the Highlands came from the
Illustration
Mount Hagn regon. HIS behavior was considered to be “abnormal” by members of his communitv; ;I marked personality change had taken place. C‘ontrary to his usual custom. he started to steal and collect things for which he had no use. He began to wear grass skirts, which are only worn by women In
8
PSYCHOTIC
INDIGENOUS
PAINTERS
that region. One of the watercolors shows a traditional hut built on stilts; ladders lead up to it. The hut and the bare outlines of several disproportionately sized people are placed on a baseline (Billig, 1970). Objects are all two-dimensional; therefore
Illustration
FROM NEW GUINEA
325
depth is lacking. One crayon drawing filled the paper almost completely (“horror vacui”). It is drawn in extremely bright reds, blues and orange with a green spot suggestive of a flower pot. The design is rigid, consists only of broad lines or simple
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Againa three-dimensiona aspect is missing. A patient from Goroka had supposedly committed several murders. He was considered mentally ill when he had necrophilic relations with his dead wife. This act, considered campietely unacceptable
spikes.
by his peopie, led to several manda~a-lake originate (Illustration green and blue. were choice of colors.
his hospitalization, He painted circles from which chevrons 91. Bright colors, mostly red. used in contrast to the usuai
327
In another watercolor (Illustration 10) two animals show marked elongation, with the arms and legs depicted in a culturally characteristic &XXition.. The two centered animals and the shadowhke figure on the left lack depth (Billig, 1970). As regression advances in any cultural setting, fewer of the specific elements of that particular culture remain, while apparently universal elements emerge. Regressive characteristics such as elongation, emptying space, distortion, transparencies, mixing of planes, vertical projection and the “baseline” appear (See Table 1) (Bilfig, 2970). As the regression becomes very advanced, patients design patterns very similar to those by Western patients of corresponding levels of personality disintegration. Flowers in simple shapes, houses or huts in a child-like flatness, stars and the like are drawn, These characteristics appear regardless of any artistic experience and dexterity or cultural level.
CROSS-CULTURAL ART Cultural influences determine the symbolization in tribal art. Stylistic characteristics fulfill sociocultural needs; they are continued as long as the spiritual and social system continues (Billig, 1966). Tribal thinking builds defenses against reality threats. The defenses are imposed by a societal order to protect it against unknown and potentially threatening powers. They lead to a relentless desire for omnipotent control of the surrounding danger. Only an integrated ego can fend the inner cohesiveness to magical concepts which can satisfy the societal needs. The motivating force of tribal art is based an the anxieties which attempt to control the threatening unknown by the magic of imagery. The tribal artist uses his insight into an inner reality (i.e., X-ray pictures in Australian bark paintings) as a response to societal needs. In contrast, psychotic disintegration leads to distortians and regression characteristic of earlier patterns of personality organization. While the tribal artist shapes his images as responses to societal needs which have important meaning to the group, the psychotic imagery is sofipsistic and it is not intended to meet societal needs. Jt is based on a need to be understood (Bihig, 1970). The psychotic,
with his reduced ability to test reality, sacrifices external reality. As the illness progresses, environ. mental, cultural influences lose their significance. The conception of reality becomes unstable, existing social demands less consequential. Thought pro. cesses are interrupted and fragmented (Bill&, 197 1). The newly formed structures are controlled by inner needs, rather than their being adapted to societal reality. The disintegrated ego is no longer capable of interrelating ‘&the multiple dete~inants to mental functions” ~H~~owel~, 1965) and it regresses to ~~~sychob~o~ogi~al, possibfe hereditary structures common to ail . s . (nameiy) to universals” {DeVos, 1965). The psychotic process modifies the “simple universals” through distortions and by a lack of cohesiveness. The universals are originally based on psychobiological structures. They can be observed in the morphological development of embryos of all vertebrate classes (Iiooker, 1958). They appear first as a vertical bending of the head, and, somewhat later, a horizontal movement (“avoidance reflex”) appears [Hooker, 1958). Similarly, the first movements of the infant, which are related to feeding mechanisms (Spitz, 1957), lead to a horizontal rotation of the head, to which nodding in a vertical direction is later imposed. These two directions have become selected from a number of possibilities as “success-specific movements,” while the unsuccessful ones become eliminated (Billig, 1970). Such “simple movements form the building stones of behavior . . addition of one ‘simple movement* to another leading to the characteristic behavior of the organism” (Hooker, 1958). This early space conception becomes repeated in the first attempts to represent space in children’s drawings, After the first unorganized scribbfings, the basefine “represents the earhest schematic representation of objective space” (Loewenfeld, I.939). Other dimensions of space are added and form “subjective spatial patterns”: transparencies, mixing of planes, etc. Children”s drawings from different parts of the world may vary as to content; however, the structure of “these drawings is identical with those produced by young children everywhere” (Read, 1961). As “socialization practices” (DeVos, 1965) gain influence, the originaf universal designs become modified into cultural specifics ~ountford, 1961). Similar developments of the spatial structure have been described in primeval art and in early high civilization (Giedion, I962).
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DISCUSSION AND SUMMARY Spontaneous graphics obtained from psychotic patients who five in areas of comparatively marked cultural isoiation, such as New Guinea. show regressive patterns not unlike those of Western civilization. The content of the drawings is culturally influenced as long as the patient remains relatively well integrated. Enculturation, which has a strong impact on the individual and his society, resists the psychotic personality disintegration to considerable degree. But as the psychotic process advances, a regression to universal factors of the spatial structure can be seen and cultural differences recede. “Sociahzation practices” lose more and more significance. The psychotic process adds to the simple regression pathological distortions. elaborations. condensations and lack of cohesiveness, The regression observed in schizophrenic productions seems to support theories of “universal” factors of human behavior (DeVos, 196.5; Hallowell, 1965). These form the building stones from which socialization practices lead to differential branching off to various cultures. REFERENCES BILLIG, OTTO. (1966) Cross-cultural factors in schizophrenic art. Proceedings of the IV World Congress of Psychiatry, Madrid. Excerpta Medica International Congress Series No. 150, 600-612. BILLIG, OTTO. (1970) StructureS of schizophrenic forms of expression. Psychiat. Quart. 44, 187 -- 222. BILLIG, OTTO. (1971) Is schizophrenic expression art’? J. nerv. ment. Dis. 153, 149-164. BILLIG, OTTO. (1971) Representation of motion in schizophrenic “art”. V World Congress of Psychiatry, Mexico City. To be published in Confinia Psychiatrica. BURNHAM, D. L. and A. L. (1969) Schizophrenia and the Near-Fear Dilemma. pp: 282-305. International University Press, New York. BURTON-BRADLEY, B. G. (1969) Papua and New Guinea. trsnscultural psychiatry II. Aust. New Zeal. J. Psychiat. 3% 130-136.
BURTON-BRADLEY, B. G. t 1970) Tran\