Ellen Storm

Writing the White and Purple Coats

Misdiagnosis

Sylvia Plath, Giftedness and Existential Depression

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[N.B. Please note that this is a re-write of an article I first wrote in November 2012, that was partially lost when this site was hacked.]

It’s very hard to keep your spirits up. You’ve got to keep selling yourself a bill of goods, and some people are better at lying to themselves than others. If you face reality too much, it kills you. [Woody Allen]

Today is the 50th anniversary of the death of Sylvia Plath by suicide, and everyone is talking about her prodigious talent, her mental health, her two young children and her absent husband. Carol Ann Duffy has edited a new selection of her poems to mark the occasion, and wrote an article in the Guardian Review in November 2012 in which she described Plath’s language as manifesting her “tangible joy in the unflowering of her genius“.

It is possible that Plath experienced joy as a direct result of her intellectual abilities, but perhaps it was that very genius itself – not the snow or the loneliness or motherhood or marriage; not even the rejection – that was the reason for her suicide. In her final poem, Edge, written on 5th February 1963, Plath describes a very different kind of “unflowering”: She [dead woman] has folded/Them [dead children] back into her body as petals/Of a rose close when the garden/Stiffens and odors bleed/From the sweet, deep throats of the night flower.

We have a tendency to romanticise genius, and to set those touched by it apart from ourselves. We separate genius from mental illness, too, as mutually exclusive entities. We understand that these entities can co-exist in the same person, but if that person produces works of great talent it is because of their genius. If they kill themselves, it is because they are mentally ill. This dichotomy of thinking is wrong, just as it is probably wrong to blame external factors for the actions taken by someone whose internal workings were so complex and so intense as to be largely incomprehensible to even those who knew her well. Plath’s poetry gives us a glimpse into that inner world. No more.

For myself, writing functions mainly to relieve the pressure caused by the build-up of thoughts inside my head. Once a train of thought has been made concrete and can be read back and reviewed, there is a sense of release. Ideas no longer need to be held, contained and remembered: all things that require effort and energy. Not writing is exhausting. Writing brings clarity and relaxation. Communication is important, but is secondary to this compulsion. Approval would be nice, but isn’t necessary for this purpose. Writing is like mental spring cleaning – like organising the spice cupboard – and it’s best to spend some time every day doing it.

The reality of motherhood however, is that looking after children is a full-time job with little respite. Bedtime arrives and mothers everywhere collapse in dribbling heaps, incapable of intelligent thought. It isn’t that intelligent mothers do not love or enjoy their children, but there remains a psychological necessity for an active engagement with the world: for its processing and for feeling part of something larger than oneself. Without this one begins to contemplate one’s smallness, one’s inability to effect significant change in the world, the pointlessness of it all…

During 2011-12 I spent a year working in a community paediatric department, seeing children with “behavioural problems”. This extremely broad umbrella term encompasses a wide variety of social, emotional, learning and communication difficulties. During this time I became increasingly aware of a distinct subset of my patients for whom giftedness, or high intelligence, appeared to be a major, but largely unrecognised, contributor to their problems. Many of these children already had a diagnostic label attached to them when I met them, most commonly Asperger’s Syndrome or ADHD (Attention Deficit Hyperactivity Disorder).

I discovered an organization in the US called SENG (Supporting the Emotional Needs of the Gifted (1)) which provides extensive online resources on the subject, and read their book Misdiagnosis and Dual Diagnoses of Gifted Children and Adults: ADHD, Bipolar, OCD, Asperger’s, Depression, and Other Disorders (James T. Webb et al., Great Potential Press Inc. 2005). The basic premise of this book is that many of the features of giftedness (see Characteristics of Giftedness, below) are frequently mistaken for pathology by those who are unaware of the particular characteristics of this group. Simply knowing their IQ (and other measures of personality type and learning preference), and knowing that certain characteristics and experiences, while not common in the general population, are common amongst those of similar ability, can be very helpful for gifted young people struggling with feelings of difference and social isolation.

Not all diagnoses in gifted individuals are wrong however. In fact, giftedness, far from being a universal positive, may be a predisposing factor for certain types of psychological distress. One such type is existential depression. Writing of this in his book, James T. Webb (et al.) states:

“There is relatively little inherent in being a gifted child or adult that makes them more prone to depression than others. Most often, it is a poor fit between the gifted person and the environment that creates the problems. A lack of understanding and support from teachers, peers, or family can precipitate very real problems of various kinds, including depression.

Existential depression is an exception […] [it] is particularly likely among persons who are highly gifted, even though it is not a category of depression that is recognized in the DSM-IV-TR. […] In our experience, professionals generally overlook the gifted component, mistaking existential depression for depressions that arise from other causes.

The concept of existential depression has a strong connection to gifted characteristics; it arises from the ability to contemplate issues about existence and the asynchrony that is inherent in giftedness. Gifted children develop the capacity for metacognition – thinking about their thinking – early, in some cases even before they develop the emotional and experiential tools to deal with it successfully. They are able to see issues on a global scale, along with implications. Combined with their metacognition are their idealism, their intensity, and their sensitivity, which often result in feelings of alienation from the world around them. […]

Persons who suffer existential depressions are particularly at risk for suicide if they are rejected by the significant people in their lives. Often called “geeks” or “nerds”, they may feel alone in their peer group and in their family, as well as in society. They see how the world should be and despair of ever making a significant difference. […]

There are three key components in treating existential depression: (1) conveying a sense that someone else understands the feelings, (2) showing that the person’s ideals are shared by others and that he is not alone, and (3) pointing out that he can join common efforts with others and can make an impact.”

Perhaps had there been a greater understanding of all this during Sylvia Plath’s lifetime, she would have stayed around long enough to see her children grow up, and to produce the great works alluded to by Jeanette Winterson in this Saturday’s Guardian Review (9th February 2013, p. 3):

Plath was gifted. She could have been great. Wrong generation. Wrong medication.”

Sadly today there is still widespread reluctance to name or nurture our gifted and talented young people (this is particularly the case for those from poorer backgrounds or minority groups). Let’s not sacrifice any more lives because we, as a society, refuse to recognise high intelligence or acknowledge its implications.

[For more information about giftedness, depression and suicide, see the Hoagies Gifted Education website: http://www.hoagiesgifted.org/depression.htm]

Characteristics of Giftedness (developed by Linda Silverman (2)):

  • Reasons well (good thinker)
  • Learns rapidly
  • Has extensive vocabulary
  • Has an excellent memory
  • Has a long attention span (if interested)
  • Sensitive (feelings hurt easily)
  • Shows compassion
  • Perfectionistic
  • Intense
  • Morally sensitive
  • Has strong curiosity
  • Perseverant in their interests
  • Has high degree of energy
  • Prefers older companions or adults
  • Has a wide range of interests
  • Has a great sense of humor
  • Early or avid reader (if too young to read, loves being read to)
  • Concerned with justice, fairness
  • Judgment mature for age at times
  • Is a keen observer
  • Has a vivid imagination
  • Is highly creative
  • Tends to question authority
  • Has facility with numbers
  • Good at jigsaw puzzles

References:

1. SENG: http://www.sengifted.org/ Accessed on 10th February 2013.

2. Characteristics of Giftedness. Linda Silverman. Gifted Development Center: http://www.gifteddevelopment.com/What_is_Gifted/characgt.htm Accessed on 16th November 2012

 


3 Comments

  1. Interesting post. On a very shallow personal level I reckon my young-child self could have ticked about two thirds of the Silverman list…yet I did poorly at school, was always getting into detention for one thing or another, and left at 17 knowing that I was not that bright…yeas later I was given a battery of psychological, I Q and EQ tess for a job and was told I am in the top 25% of the general population for IQ and verbal reasoning. I was very lucky and went on to complete an MBA and other professional qualifications and am a passionate advocate of life-long learning.

    I beleive tht too many of our gifted children from less educated or poorer backgrounds are still being labelled as ‘difficult’ and failed by an over-stretched and commoditised education system.

  2. Thanks for your post!

    It’s exciting to see more medical doctors acknowledging the need to recognize the complexity of giftedness. Gifted children are being medically misdiagnosed. As you mentioned SENG, I don’t know if you were aware of SENG’s on-going public awareness effort to decrease medical misdiagnosis.

    Link to SENG Misdiagnosis Initiative:
    http://www.sengifted.org/programs/seng-misdiagnosis-initiative
    Link to SENG’s Misdiagnosis video:

  3. Thanks for the links Marianne. I have seen the film before, but not the brochure that is part of the misdiagnosis initiative. It looks like a helpful “at a glance” resource that I am sure lots of clinicians will find useful in their practice.

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