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Strengths rising from dementia Scientist finding links between illness, skills

THE BALTIMORE SUN

The wealthy California stockbroker had never cared about art.

Then, when he was 56, things inside him began to change.

He would glimpse a color or a beam of light, and he would find himself suffused with pleasure. And there were times when a color or a light would seem almost unbearable, and he would feel unwell.

For the first time in his life, he began to paint. His early attempts were nothing remarkable - elliptical patterns in purples and yellows. Still, he quit his job to concentrate on being an artist.

It was as if a door were opening in his mind. But it became clear that another door was closing. The stockbroker began to have trouble speaking and remembering. He developed odd compulsions, such as searching the streets for coins. He insisted upon wearing purple shirts and yellow pants.

He was diagnosed as suffering from frontotemporal dementia, a tragic wasting disease of the brain. After about 10 years, the illness brought him to Dr. Bruce Miller, a California neurologist.

When Miller learned of the stockbroker's paintings, he was surprised. "I had never thought," he says, "of a patient with dementia as simultaneously developing strengths."

The man's original ellipses had grown into flowers, which had the fantastic symmetry of mandalas. These progressed into birds, fastidiously detailed. And the birds evolved into animals, intensely imagined and powerfully realized.

"Oh, my goodness," thought Miller, pondering the pictures. "He's actually gotten better."

Miller, who is now director of the Alzheimer's disease center at the University of California, San Francisco, published the story of the stockbroker and other patients with similar experiences in a recent issue of the journal Neurology.

Some of Miller's patients started their art in the early stages of their dementia and kept working while the disease progressed. Others continued creative work that they had been pursuing in spite of the disease.

Miller finds hope in these rare cases, in the way the disease - which typically destroys creativity, energy and interest in the world - has left, perhaps even opened, pockets of skill.

"It suggests these dementias are not monolithic entities," he says. He hopes such discoveries help lead to therapies that will slow the disease.

Several hundred thousand Americans suffer from frontotemporal dementia, part of a group of disorders that includes Alzheimer's disease.

The cases Miller has documented are rare in the realm of these diseases, says Robert Friedland, a neurologist at Case Western Reserve University in Cleveland.

In general, says Friedland, "Neurological diseases do not enhance anything. The same is true of psychiatric diseases."

True, he says, Dostoevski suffered from epilepsy, another neurological disorder.

Willem de Kooning, the abstract expressionist painter, is said to have had Alzheimer's. "It's difficult to think their creativity was enhanced by these diseases," says Friedland. If anything, he believes, they probably created in spite of illness.

Creativity's source

Experts are far from knowing where creativity comes from, and how it might or might not coexist with illnesses of the brain, be they neurological or psychiatric in origin.

Some eminently sound minds have produced great art, they agree. Yet illness and art are also "closely linked," says Emanuel Hammer, a New York-based psychologist and psychoanalyst who has written extensively on creativity.

The best work, he says, is created on the borderline between illness and health. It might drink of the well of madness but is shaped in sanity.

"It has to communicate to the non-insane," says Hammer. "Otherwise, it becomes a delusion. Illness gives the content, but the ability to shape your art is a function of keeping a foot in the realm of reality.

"A borderline psychosis has the ability to shape the creativity that pours out."

It calls to mind Vincent van Gogh. During the final 10 years of the artist's life, he was struggling with hallucinations, paranoia and suicidal urges, and scaring his neighbors with his bizarre behavior. Yet he was experiencing periods of calm lucidity, and completing some of the most electrifying and unforgettable paintings ever seen.

Experts have suggested he might have suffered from epilepsy, schizophrenia or alcoholism. Miller wonders if Van Gogh had a kind of temporal lobe disorder. No one knows. But the terrible beauty of the gift is plain in the paintings he completed just

before he ended his own life, such as the one of the crows whirling in a sky ablaze with two suns.

Identifying with Van Gogh

At Creedmoor Psychiatric Center, a New York state facility in Queens, the patients have an art studio and gallery called the Living Museum. "Van Gogh is a very popular artist around here," says the museum's director, psychologist Janos Marton, "probably because people identify with him."

Marton has never worked with a patient who has frontotemporal dementia. But he says people with all kinds of illnesses turn to art at Creedmoor, taking to it "like fish to water."

When it comes to losing one's mind, he says, art "is the only advantage to it, the only perk that comes with it."

Miller believes that, for his patients, art became "the major focus, the one source of pleasure in life."

As the progress of their disease destroyed the left side of the brain - the center of language and social skills - it spared the right, which is responsible for visual skills.

Perhaps, Miller suggests, the destruction of the verbal processes allowed for a more visual kind of thinking. He's not sure.

Left brain vs. right brain

"The pictures are pretty. They tend to do realistic, non- symbolic scenes," he says. "Symbolism probably comes from the left side, the language side, which is being affected. The right side of the brain, involved in copying what you see, is spared."

Some of Miller's artists have died. The stockbroker no longer cares what he is wearing.

"He is pretty sick," says Miller. Still, the man paints, although the animals he painted at the peak of his powers have degenerated into oddly shaped, doll-like figures. He is almost back to where he began. But his colors, purple and yellow, remain.

This article was distributed by Knight Ridder/Tribune Information Services.

Pub Date: 12/13/98

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