Andy Warhol Was a Hoarder (40 page)

When possible, I also visited places where these historical figures live on in tangible ways. In Pittsburgh, I studied Warhol's silk screens and “oxidation” paintings at the Andy Warhol Museum; in Alexandria, Virginia, I toured the Pope-Leighey House, one of Frank Lloyd Wright's Usonian homes; in Philadelphia, I stared with disbelief at slices of Einstein's brain—Einstein's brain!—at the Mütter Museum.

I do not presume to know everything about these 12 minds and the infinite thoughts, fears, and desires that swirled through them. Far from it. But I learned enough to appreciate, more deeply than ever, the disparity that often exists between our inner and outer selves—despite their inseparable connection.

Science is doing its best to unravel the mysteries that drive the interaction between inner and outer—why we feel and act the way we do, what happens when something goes wrong. This is a tough and valiant effort. Mental health research is often overlooked, underfunded, and stigmatized. The scientists I interviewed impressed me deeply with their commitments to better understanding the brain so that they can help people emerge from the depths of depression, stop injuring themselves, or quit their addictions to drugs and alcohol. As they continue to sort out the entanglement of genes, life experiences, and environmental risk factors that contribute to mental health conditions, some torment may be alleviated, and some lives bolstered and rejuvenated.

My research has also made clear that there are no absolutes when it comes to behaviors, diagnoses, and treatments. In some cases, shyness may just be shyness, not a symptom of an illness that needs to be treated. In other situations, a mental health diagnosis will be warranted so that therapy can make life more purposeful and satisfying. Medication may be enormously helpful
for certain patients; others might do as well or even better with psychotherapy, support groups, lifestyle changes (more exercise, better sleep, relaxation techniques), or a combination. Probing the biology of the brain is critical—but so is a more holistic approach that explores a person's experiences, feelings, and motivations. There are valid concerns about overtreating human behavior, and equally important worries about undertreating serious disorders. Patient privacy is important, as is an openness that will help reduce stigma. Language and terminology are shifting, and fresh concepts are emerging. Distinct diagnoses are giving way to an understanding of the similarities that underlie many mental health conditions, which is in turn driving research in new directions.

All of these intricacies have made writing this book equal parts daunting, challenging, and fascinating. I view my exploration of these 12 historical figures and their minds as an entrée into this complex world, not a journey that has ended. I hope the hypotheses I've explored and the questions I've raised will lead to a better appreciation of the many tangled forces that make up our collective minds—and a greater empathy for the trials we all face.

It seems fitting to end this book with a reflection on Charles Darwin, whose 19th-century pilgrimage into nature resonates with a 21st-century expedition of the mind. In early 1832, while traveling aboard the
Beagle
, Darwin wrote in his journal about the “transports of pleasure” he encountered while exploring the landscapes and forests of Brazil. He described an abundance of nature's splendor—“the elegance of the grasses, the novelty of the parasitical plants, the beauty of the flowers” and the “paradoxical mixture of sound & silence.” This intoxicating jumble, with its butterflies and fruits and soft air, brought him enormous joy.
It was a place of beauty and bewilderment. In describing his reaction to all that he was seeing, Darwin wrote that “the mind is a chaos of delight.”

Simple words for the vast enigmas of the mind. A chaos of delight it is.

—Claudia Kalb

May 2015

Throughout the course of my research, I conducted dozens of interviews with mental health professionals, scientists, and academic researchers. A wide variety of source materials informed my biographical research, including diaries, letters, newspaper and magazine articles, autobiographies, and biographies. In my analysis of mental health conditions, I consulted medical and scientific journals and books, as well as content published by mental health associations, medical associations, and government health organizations. These included the American Academy of Pediatrics, American Psychiatric Association, American Psychological Association, Centers for Disease Control and Prevention, Harvard Health Publications, National Alliance on Mental Illness, and National Institute of Mental Health. For each chapter, I consulted the American Psychiatric Association's
Diagnostic and Statistical Manual of Mental Disorders
, fifth edition (
DSM-5
, 2013), as well as fact sheets on the APA's website.

In my notes below, I have highlighted materials mentioned within each chapter's text as well as additional sources that helped inform my understanding of the historical figures and the mental health conditions presented.

Conversations with experts in the field provided me with invaluable insights into the state of mental health research as well as the value and challenge of evaluating historical figures and the mind. These individuals include Dr. Jeffrey Borenstein, Brain and Behavior Research Foundation; Dr. David Kupfer, University of Pittsburgh School of Medicine; Dr. Philip Mackowiak and Dr. David Mallott, University of Maryland School of Medicine; Dr. Michael Miller, Harvard Medical School; Dr. Osamu
Muramoto, Center for Ethics in Health Care, Oregon Health and Science University; Dr. David Rettew, University of Vermont College of Medicine; and Mark Smaller, president, American Psychoanalytic Association.

Numerous books informed my understanding of mental health and historical diagnosis. These include Philip Marshall Dale,
Medical Biographies: The Ailments of Thirty-Three Famous Persons
(Norman, OK: University of Oklahoma Press, 1952); Brian Dillon,
The Hypochondriacs: Nine Tormented Lives
(New York: Faber and Faber, 2010); Douglas Goldman et al.,
Retrospective Diagnoses of Historical Personalities as Viewed by Leading Contemporary Psychiatrists
(Bloomfield, NJ: Schering Corporation, 1958); Kay Redfield Jamison,
Touched with Fire: Manic-Depressive Illness and the Artistic Temperament
(New York: Free Press, 1993); Jeffrey A. Kottler,
Divine Madness: Ten Stories of Creative Struggle
(San Francisco: Jossey-Bass, 2006); Philip Mackowiak,
Post-Mortem: Solving History's Great Medical Mysteries
(Philadelphia: American College of Physicians, 2007); Roy Porter,
Madness: A Brief History
(New York: Oxford University Press, 2002); David Rettew,
Child Temperament: New Thinking About the Boundary Between Traits and Illness
(New York: W. W. Norton, 2013).

Articles include: Nancy C. Andreasen et al., “Relapse Duration, Treatment Intensity, and Brain Tissue Loss in Schizophrenia: A Prospective Longitudinal MRI Study,”
American Journal of Psychiatry
170, No. 6 (June 1, 2013), 609–15; Milton Cameron, “Albert Einstein, Frank Lloyd Wright, Le Corbusier, and the Future of the American City,” Institute for Advanced Study,
Institute Letter
(Spring 2014), 8–9; D. S. Carson et al., “Cerebrospinal Fluid and Plasma Oxytocin Concentrations Are Positively Correlated and Negatively Predict Anxiety in Children,”
Molecular Psychiatry
(online ed.; November 4, 2014), doi: 10.1038/mp.2014.132; Cross-Disorder Group of the Psychiatric Genomics Consortium, “Identification of Risk Loci With Shared Effects on Five Major Psychiatric Disorders: A Genome-Wide Analysis,”
Lancet
381, No. 9875 (April 2013), 1371–79; Eric Kandel, “The New Science of Mind,”
New York Times
, December 6, 2013; Callie L. McGrath et al., “Toward a Neuroimaging Treatment Selection Biomarker for Major Depressive Disorder,”
JAMA Psychiatry
70, No. 8 (August 2013), 821–29; Richard Milner, “Darwin's Shrink,”
Natural History
114, No. 9 (November 2005), 42–44.

A note about the increase in mental disorders in the
DSM
(from 80 in the first edition to 157 in the fifth edition): These numbers were provided by the American Psychiatric Association and refer to the total number of distinct disorders contained in the manual. They do not include subtypes of disorders, variation in severity within disorders (mild, moderate, or severe, for example), or “unspecified” disorders. I chose to cite the APA's tally of distinct diagnoses, but it should be noted that the number of possible diagnoses contained in the
DSM
is higher.

Lois Banner,
Marilyn: The Passion and the Paradox
(New York: Bloomsbury, 2012); Arnold M. Ludwig,
How Do We Know Who We Are? A Biography of the Self
(New York: Oxford University Press, 1997); Arthur Miller,
Timebends: A Life
(New York: Grove Press, 1987); Marilyn Monroe,
Fragments: Poems, Intimate Notes, Letters
(New York: Farrar, Straus and Giroux, 2010); Marilyn Monroe,
My Story
(New York: Cooper Square Press, 2000); Sarah K. Reynolds and Marsha M. Linehan, “Dialectical Behavior Therapy,” in
Encyclopedia of Psychotherapy
1, eds. Michel Hersen and William H. Sledge (Academic Press, 2002), 621–28; Donald Spoto,
Marilyn Monroe: The Biography
(New York: HarperCollins, 1993); Gloria Steinem and George Barris,
Marilyn: Norma Jeane
(New York: East Toledo Productions, 1986); Anthony Summers,
Goddess: The Secret Lives of Marilyn Monroe
(New York: Macmillan, 1985); J. Randy Taraborrelli,
The Secret Life of Marilyn Monroe
(New York: Grand Central Publishing, 2009).

Lois Banner, “The Meaning of Marilyn,”
Women's Review of Books
28, No. 3 (May/June 2010), 3–4; Robert S. Biskin and Joel Paris, “Diagnosing Borderline Personality Disorder,”
Canadian Medical Association Journal
184, No. 16 (November 6, 2012), 1789–94; Benedict Carey, “Expert on Mental Illness Reveals Her Own Fight,”
New York Times
, June 23, 2011; Richard Ben Cramer, “The DiMaggio Nobody Knew,”
Newsweek
, March 22, 1999; John Gunderson, “Borderline Personality Disorder,”
New England Journal of Medicine
364, No. 21 (May 26, 2011), 2037–42; John Gunderson et al., “Borderline Personality Disorder,”
Focus
11, No. 2 (Spring 2013); John Gunderson et al., “Family Study of Borderline Personality Disorder and Its Sectors of Psychopathology,”
Archives of General Psychiatry
68, No. 7 (July 2011), 753–62; Barbara Grizzuti Harrison, “Vengeful Fantasies,”
New Republic
, February 28, 1991; James Harvey, “Marilyn Reconsidered,”
Threepenny Review
58 (Summer 1994), 35–37; Constance Holden, “Sex and the Suffering Brain,”
Science
308 (June 10, 2005), 1574–77; Sam Kashner, “The Things She Left Behind,”
Vanity Fair
, October 2008; Susan King, “Marilyn Monroe's Last Film Work Resurrected for New Documentary,”
Los Angeles Times
, May 28, 2001; Robert E. Litman, “Suicidology: A Look Backward and Ahead,”
Suicide and Life-Threatening Behavior
26, No. 1 (Spring 1996); Larry McMurtry, “Marilyn,”
New York Review of Books
, March 10, 2011; Daphne Merkin, “Platinum Pain,”
New Yorker
, February 8, 1999; Richard Meryman, “A Last Long Talk With a Lonely Girl,”
Life
, August 17, 1962; Richard Meryman, “Marilyn Monroe Lets Her Hair Down About Being Famous: ‘Fame Will Go By and—So Long, I've
Had You,' ”
Life
, August 3, 1962; Andrada D. Neacsiu et al., “Impact of Dialectical Behavior Therapy Versus Community Treatment by Experts on Emotional Experience, Expression, and Acceptance in Borderline Personality Disorder,”
Behaviour Research and Therapy
53 (2014), 47–54; Joel Paris, “Borderline Personality Disorder,”
Canadian Medical Association Journal
172, No. 12 (June 7, 2005), 1579–83; Patrick Perry, “Personality Disorders: Coping With the Borderline,”
Saturday Evening Post
, July/August 1997; Carl E. Rollyson, Jr., “Marilyn: Mailer's Novel Biography,”
Biography
1, No. 4 (Fall 1978), 49–67; William Todd Schultz, “How Do We Know Who We Are? A Biography of the Self,”
Biography
22, No. 3 (Summer 1999), 416–20; Lee Siegel, “Unsexing Marilyn,”
New York Review of Books
, NYR Blog, January 5, 2012; Diana Trilling, “The Death of Marilyn Monroe,”
Encounter
, August 1963; Diana Trilling, “ ‘Please Don't Make Me a Joke,' ”
New York Times
, December 21, 1986; Christopher Turner, “Marilyn Monroe on the Couch,”
Telegraph
, June 23, 2010.

Georges Belmont, interview with Marilyn Monroe, video,
Marie Claire
, April 1960,
https://​vimeo.​com/​76791522
; Jesse Greenspan, “ ‘Happy Birthday, Mr. President' Turns 50,”
History.​com
,
www.​history.​com/​news/​happy-​birthday-​mr-​president-​turns-​50
; John Gunderson, “A BPD Brief: An Introduction to Borderline Personality Disorder: Diagnosis, Origins, Course, and Treatment,”
www.​borderlinepersonalitydisorder.​com/​professionals/​a-​bpd-​brief/
.

Donald L. Barlett and James B. Steele,
Howard Hughes: His Life and Madness
(New York: W. W. Norton, 1979); Peter Harry Brown and Pat H. Broeske,
Howard Hughes: The Untold Story
(New York: Dutton, 1996); Richard Hack,
Hughes: The Private Diaries, Memos and Letters
(Beverly Hills: New Millennium Press, 2001); Jeffrey Schwartz with Beverly Beyette,
Brain Lock: Free Yourself From Obsessive-Compulsive Behavior
(New York: ReganBooks, 1996).