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The Royal College of Psychiatrists Improving the lives of people with mental illness

Creativity and Mental health - Professor Rob Poole

Professor Rob Poole

"...Monk is interesting in lots of ways.... there are wildly differing accounts of him, even amongst people who knew him well. This illustrates why I don't think you can do proper empirical work on the most interesting figures - the information is just too unreliable."


Professor Rob Poole

Professor Rob Poole is Professor of Social Psychiatry, School of Social Sciences at Bangor University. He describes himself as ‘fundamentally a clinical psychiatrist’ but with an academic interest in clinical skills and issues of clinical importance that affect deprived and marginalised people. This is reflected in his published work, including a new book on poverty and mental health published by Cambridge University Press.

Professor Poole is also a musician and is interested in the relationship between creativity and mental health. This gave him a platform for his brilliantly witty article on musicians with ‘day jobs’ published in the Psychiatric Bulletin in 1997. It also led to an invitation to write an insightful commentary1 in response to a very interesting paper2 on mental illness in the lives of jazz musicians in the British Journal of Psychiatry in 2003.

Since this time, he has further pursued his interest in this topic and he has plans to write a book about music and mental health. I spoke to him about a range of issues and found his considered and sometimes unexpected answers to be particularly thought-provoking, at times challenging some widely accepted beliefs about the relationship between creativity and mental health. I hope you enjoy this text based on our conversations. Although he is reticent about publicity for his music, I am also providing this link to some of his own material, which illustrates his love of Delta blues.

In your BJPsych article, you made some interesting points about cause and effect of mental health problems in jazz musicians. Where did the opportunity come about to write the piece? Have you further explored the ideas you wrote about in your work since?'
The BJPsych article came about because the editor at the time, Greg Wilkinson, knew that I was an active musician and he invited me to write a commentary on Geoffrey Will's paper. I had done no primary empirical research on the subject whatsoever.

However, the paper led to a lot of invitations to talk on the subject, some of them involving international travel! I've been slowly working on a book for about 8 years, most recently with John Bailey, who is a research psychologist who works with me. I've read lots of biographies of musicians, and had many discussions with mental health professionals who are musicians. My ideas have developed a fair bit, and I've become interested in some new angles, such as the motif of self-destruction and self-loathing in the images of iconic musicians. John has made me think afresh, although he is totally obsessed with Bob Dylan. We are writing (yet another) synopsis at the moment.

If anything, I'm even more impressed with the stressful awfulness of most musicians' lives than I was 10 years ago, and I do think that causality is likely to run in that direction. I have had discussions with very successful musicians, who have to keep working forever, endlessly touring, with no pension, unstable relationships and other problems. I just don't accept the romantic/biogenetic idea that musical brilliance is the upside of a psychotic/affective/substance misuse downside. I'm also interested that the link between jazz, drugs and early death seems to have been broken. But then the age of iconic musicians has long passed- it was an artefact of the vinyl era, in my opinion.

I'm particularly interested in what you make of difficulties Thelonious Monk experienced. There is a strikingly wide range of opinion on this point. The documentary 'Straight, No Chaser' suggests to me that his behaviour through most of his life can be accounted for by an eccentric personality influenced by substance misuse. But there does seem to have been a dramatic functional decline in his later years. Have you any strong views on this matter?'
Monk is interesting in lots of ways. As you suggest, there are wildly differing accounts of him, even amongst people who knew him well. This illustrates why I don't think you can do proper empirical work on the most interesting figures- the information is just too unreliable. His son claims that he never took drugs, saying that people just assumed that he did because he behaved so oddly.  It does seem clear that the peculiarities of his speech were permanent and not an affectation, but who knows? He did set out the model of a cool jazz dude and is probably responsible for the pork pie hat's enduring popularity, although I think he got the whole hat thing from Lester Young.

There are two things about his music. Firstly, it was radically strange, with a violent approach to time signatures, bar length and chord structures. But it was always melodic. Although he's been so influential, no one remotely achieves the same effect. The other thing is that the music rapidly became static, with little or no development after the mid-fifties, and eventually he simply re-recorded his old tunes. He sounded very outdated by the mid-sixties, when Miles [Davis] was about to invent jazz-rock and jazz-funk.

I have wondered if this was a consequence of his failure to absorb external influences, which I suppose feeds into the idea that he might have been on the autistic spectrum. His final slow decline stumps me, but I don't believe it was due to drugs, because I've known hundreds of drug users and none of them have just stopped talking and died. So I think he must have had a dementia, because if he'd had something like GPI [General Paresis of the Insane], it would have been diagnosed (he certainly had psychiatric treatment).  The other amazing thing is that Thelonious Monk was his real name.


Which musicians have interested you most in your work to date? Have any been particularly inspiring to you, either directly or indirectly?

Obviously, like anyone else, I'm most interested in the music that has been important to me. But you can only really explore the interface between a musician's life and their music if there is very good biographical material (which is rare) or lots of it. So you are bound to look at really well known musicians, who have been written about regularly.

Music and musicians had a special salience for people who were young between 1950 and 1980 and musicians from this period had a big impact on the public discourse on mental illness and substance misuse. As a social scientist, I'm interested in this. So it's the usual suspects: Jaco Pastorious, Thelonious Monk, Joey Ramone, Iggy Pop, John Ogden, Miles Davies, Jimi Hendrix, Charlie Parker, Nick Drake, Jim Morrison, Warren Zevon, Captain Beefheart. Bob Dylan is of interest because he was amongst a small group of persistently productive, massively influential, musicians of the 20th century, and he had a huge, charismatic presence, but he appears to be incredibly ordinary as a person, if not actually dull.

A couple of people stand out though. First of all, there's Syd Barrett. David Gilmour said that there was obviously something wrong with Syd as early as the recording of 'See Emily Play' in May 1967. Everything in his life disintegrated over the next few years, and his mental health problem is evident in his solo recordings. However, what interests me is the 'Crazy Diamond' mythology around him. This was kicked off by a misleading/mythologising article by Nick Kent in the NME in about 1974, which infuriated me at the time. It suggested that Syd had gone to a creative place so far out, he couldn't find his way back. It's a version of the 'Acid Casualty' narrative, and I think it's extremely unhelpful, because it denies that rock stars can develop mental illnesses just like anyone else. Creative burnout for the famous, mental illness for ordinary people. The myth was certainly unhelpful to Syd, who was pestered by unwelcome visitors for the rest of his life. There are loads of photos on the internet of him in his later years, taken while he tried to go about his business in Cambridge. Presumably photographers jumped out from behind vans and hedges. He doesn't look like a crazy diamond or a wreck. He looks like an ordinary older man. He reverted to the name Roger, and when people knocked at his door and asked him if he was Syd, he'd say “Syd doesn't live here anymore”.

Another is Peter Green, a stunningly great guitarist and songwriter. What's interesting is the way his anguish got into his not just into the lyrics but also into the structure of the music. Just listen to 'The Green Manalishi'. As he became unwell, he produced the best music of his career. And then he stopped. I saw him play a couple of times after his 'comeback', and there was this extraordinary thing where he would suddenly show a burst of his old brilliance, and then it had gone again. This might be down to age though. I saw a frail Clark Terry at the Village Vanguard 10 years ago. No one has ever suggested he had a mental health problem, as far as I know, but he showed something similar to Peter Green's intermittent flair, if more extreme. At first he was horribly all over the place, out of tune and out of time, then it all suddenly came together and he was great. Creaky inter-phalangeal joints, in all probability. The lesson here is that it is easy to attribute far too much to a mental health problem, when there may be a more mundane cause. Clark Terry is still alive, but very unwell. According to his website, arthritis in his fingers now makes it very difficult for him to play.

Eric Clapton is really interesting. I don't like his music much, apart from the Bluesbreakers album, but no one can deny he's a talented player. I'm not suggesting he has a mental illness, but it is uncontroversial to say that he's had problems with substance misuse. What's interesting is the way that he has tracked his own misery in his music, like a really wealthy, famous version of Son House or Charley Patton. And the extreme variability of the quality of his music over the years. At his best when he sticks to imitating blues greats, in my opinion. Like many serious musicians, he doesn't seem able to judge the quality of his own work.

Inspiring? Brian Wilson. Another massive individual talent, with an awful and well documented history of mental health problems. He endured and recovered. I saw him at Liverpool Philharmonic Hall a few years ago. His touring band is considerably better live than the Beach Boys ever were. His voice is cracked (well, he's over 70) and he's a bit wonky these days, but the sound of that soaring, sunny music, full of optimism- I wept. 'In My Room' was particularly moving.

Have you learned anything from your research in this area that has been especially useful to your clinical practice?

I can honestly say that this area of interest has been of no usefulness in my clinical practice whatsoever. My habitual scepticism means that I don't feel that everything I like doing makes me a better psychiatrist. It's just really interesting, and to me its relevance is in the arena of the public understanding of mental disorders.

What impact do you think being a musician has on your working life? Does it help or hinder you in any way?

This is difficult for me to judge. Music has been my over-riding passion since long before I went to medical school. I did my first gig in 1971, aged 15. I drive my car in silence, working out arrangements in my head, or learning music by mentally practising. I go to sleep thinking about music, and often pick up the guitar before my morning cup of tea. I'm more interested in playing than listening, but then playing well is less about technical ability and more about knowing what music idea you're trying to get across, so playing and listening aren't really separate things.

I've just asked my wife. She says that music has meant that I'm never at home in the evenings and that I blow money that I don't have at Frailer's Guitars in Runcorn. I have two electric guitars and a small amp in my office at work, and I practice licks while I read emails. As you see, I am somewhat verbose but my lead guitar playing is economical and succinct. Music gives me a place where I can escape from words and where no one really cares what I do for a living. It probably has hindered my career, a bit. Golf would have been more career-enhancing. Football would have given me friends and a sense of belonging. Instead I have had the social promiscuity of band membership and a surprisingly large group of ex-band mates who blank me.

Who could take a senior clinician seriously when he has an unrestrained admiration for both the MC5 and Alvin Youngblood Hart? And who, indeed, cares if it has set me back? I have been incredibly fortunate to be able to pursue both psychiatry and music to my own satisfaction. If only I'd known at 18 that that was possible. I'd have done exactly the same things again.

Hmmm, this is turning into a book chapter...



1. Wills, Geoffrey I. "Forty lives in the bebop business: mental health in a group of eminent jazz musicians." The British Journal of Psychiatry 183, no. 3 (2003): 255-259.

2. Poole, Rob.. "‘Kind of Blue’: creativity, mental disorder and jazz." The British Journal of Psychiatry 183, no. 3 (2003): 193-194.


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Re: Creativity and Mental heal
Very interesting article. I am only just appreciating jazz so can not comment too much on Thelonius Monk yet. I do know a little about Syd Barrett, Peter Green, Eric Clapton and Brian Wilson. Professor Poole seems to be spot on with his comments. I may have been at the same Brian Wilson concert in Liverpool. I didn't cry but his music always moves me. The same with Peter Green including the glimpses of genius.
Re: Creativity and Mental heal
Not so nice article about John Ogden (no relative, sadly) below:

Funny how people can't see that good mental health means good brain function, including creative. Duh..

...after John had cut three crosses into his forehead and each cheek (father, son and holy ghost?). As they drove around to find a hospital, John, in the back seat, took his clothes off, mumbling incoherently.

With three doctors bullying Brenda into submission, to give John Electro-Convulsive Therapy, she bowed to the pressure and it went ahead. She has been blamed for letting him down but at her wits end, she had little choice. After John’s breakdown it was thought giving a concert would be a good remedy. In hindsight John was lost; his brilliance failed him due to the ECT – a treatment that destroys brain cells. So he forgot bad things but also the good things.

Two days after the concert he attempted suicide. He cut himself with a razor blade and his tendons were hanging out of his neck. Brenda took him to the old University College Hospital where a surgeon screamed at John that he was wasting their time when other people were sick and how dare he try to commit suicide! Luckily, time has moved on from this kind of abuse.
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Minds in Music

Minds in Music

  John Tully  


Dr John Tully is a forensic psychiatrist and researcher at the Institute of Psychiatry, Psychology and Neuroscience, London. He is also a musician and is interested in the role of the arts in mental health.