Present study

In the present study I have not been as ambitious as Jamison, Post and Ludwig in terms of the size of the sample. I have targeted a particular period of jazz, which it is possible to refer to as the classic era of American modern jazz, that lasted from about 1945 to about 1960. Bebop, the first manifestation of modern jazz, ‘Lies at the midpoint of what has become known as the jazz tradition... bebop is the point at which our contemporary ideas of jazz come into focus’ (Reference DeVeauxDeVeaux, 1997). By the early 1960s, the music was changing again, largely as a result of what was known as The New Thing, The New Wave, or Free Jazz. In targeting a particular era of jazz, I am nevertheless mindful of the words of Harrison et al (Reference Harrison, Thacker and Nicholson2000) when they say that ‘In reality, the parameters according to which periods are demarcated are so manifold and overlapping that valid periodization may be almost impossible to achieve’. Still, the period 1945–1960 gave prominence to a large group of innovative and virtuosic jazz musicians who form a convenient and compelling group for study. Jazz musicians from other eras will form comparison groups who may or may not reveal similar personal characteristics.

Sampling

Forty jazz musicians who are regarded generally as having emerged as innovators on their instrument and often regarded in other ways, for instance as composers or arrangers, in the period 1945–1960 were selected using the standard jazz texts The Encyclopaedia of Jazz (Giants of Jazz section) (Reference FeatherFeather, 1960), Jazz Masters of the Forties (Reference GitlerGitler, 1966) and Jazz Masters of the Fifties (Reference GoldbergGoldberg, 1965). Twenty-six (65%) of the musicians were African American and 14 (35%) were Caucasian American. All were born in the period 1912–1936 and all were deceased. The sample (Table 1) consisted of six trumpeters, three trombonists, four alto saxophonists, one alto doubling tenor saxophonist, five tenor saxophonists, three baritone saxophonists, five pianists, five bassists, four drummers, one guitarist, one vibraphonist and two arrangers.

Table 1 Forty eminent modern jazz musicians and their instruments

Trumpet	Trombone	Alto saxophone
Dizzy Gillespie	J. J. Johnson	Charlie Parker
Fats Navarro	Frank Rosolino	Art Pepper
Clifford Brown	Bill Harris	Paul Desmond
Chet Baker		Eric Dolphy
Miles Davis		Alto/tenor saxophone
Howard McGhee		Sonny Stitt
Tenor saxophone	Baritone saxophone	Piano
Wardell Gray	Serge Chaloff	Bud Powell
Dexter Gordon	Gerry Mulligan	Thelonious Monk
Stan Getz	Pepper Adams	Erroll Garner
Hank Mobley		Lennie Tristano
John Coltrane		Bill Evans
Bass	Drums	Guitar
Ray Brown	Kenny Clarke	Charlie Christian
Oscar Pettiford	Art Blakey	Vibraphone
Charles Mingus	Philly Joe Jones	Milt Jackson
Paul Chambers	Shelly Manne	Arranger
Scott La Faro		John Lewis
		Gil Evans

Following the approach of previous researchers, biographical material was reviewed. Twenty-two musicians had biographies devoted to them, in some cases more than one. Where biographies per se did not exist, whole chapters devoted to individual musicians in jazz histories and reference works were referred to, supplemented by jazz magazine interviews and articles, providing extensive information on personality, health and other details.

Ratings

Where possible, I attempted to transform the biographical data into psychiatric diagnoses by using classifications and criteria from DSM–IV (American Psychiatric Association, 1994). The categories used were: heroin-related disorder, disorder, alcohol-related disorder, cocaine-related disorder, schizophrenia and other psychotic disorders, mood disorders and anxiety disorders. The categories of family background, sensation-seeking, late-life deteriorations and suicides also were added. Although the use of cannabis by jazz musicians has been a topic for discussion (e.g. Reference ShapiroShapiro, 1988), the category of cannabis-related disorder was omitted owing to a lack of information in the biographical material.

Family background

Information on family psychiatric history was rather patchy. It was ascertained that four subjects (i.e. 10% of the sample) had problems in this regard: Art Pepper's parents, Stan Getz's maternal uncles and Bill Evans's father had alcohol-related disorders, whereas Stan Getz's mother had depression and Bill Evans's brother died by suicide. Erroll Garner's twin brother had severe learning difficulties. Seven subjects (17.5%) experienced an unhappy or unstable early life: for instance, Dizzy Gillespie and Charles Mingus remembered being beaten by their father, and Charlie Parker's father deserted the family when Parker was 10 years old. Miles Davis had an acrimonious relationship with his mother, who whipped him when he was young. On the other hand, he was one of five subjects (12.5%) who came from well-to-do or middle-class backgrounds. Davis's father was a wealthy dentist and ranch owner. Serge Chaloff's father was a symphony orchestra pianist and his mother was a music conservatory teacher.

Heroin-related disorder

Twenty-one subjects (52.5% of the sample) were addicted to heroin at some time during their lives. It must be noted that heroin use was widespread among modern jazz musicians in the period after the Second World War and there were a number of reasons for this. After the war there was a dramatic increase in the availability of heroin because supply routes from the Far East and Turkey were re-opened by the Mafia. Heroin travelled via Marseilles directly to New York and was made easily accessible (Reference ShapiroShapiro, 1988). It ‘flooded urban black neighbourhoods to plague the lives of average working-class African-Americans’ (Reference DeVeauxDeVeaux, 1997). Modern jazz was a revolutionary music that was rejected by the general public, and heroin, like the music, was defiantly anti-establishment (Reference HentoffHentoff, 1978). It thus tended to be adopted by disaffected musicians.

Heroin addiction was felt to be a contributing factor to early death in five of the subjects. A further subject, Chet Baker, lived until the age of 58 years but remained a lifelong addict. Fourteen subjects overcame their addiction but five relied on other substances, such as alcohol, cocaine and methadone, to sustain them.

Alcohol-related disorder

Eleven subjects (27.5%) were dependent on alcohol and six (15%) abused alcohol at some stage during their lives. Eleven subjects (27.5%) were comorbid for other disorders, such as heroin and/or cocaine dependence at certain times in their lives. Five of the alcohol-dependent subjects eventually overcame their dependence.

Cocaine-related disorder

Three musicians (Miles Davis, Art Pepper and Bill Evans) developed a dependence on cocaine. In each case it followed the cessation of heroin use. In the case of Bill Evans, there was a 10-year abstinence before the commencement of cocaine use. Other musicians known to use cocaine were Thelonious Monk and Chet Baker.

Schizophrenia and other psychotic disorders

Three subjects (7.5%) had psychotic disorders.

Mood disorders

Eleven subjects (28.5%) definitely or probably fell into this category (Table 2). Four subjects received in-patient treatment for a depressive disorder and one subject, Frank Rosolino, although not diagnosed as having depression, died by suicide after attempting (successfully, in one case) to kill his two sons.

Table 2 Mood disorders

Musicians	Diagnosis
Miles Davis	Mood disorder due to sickle-cell anaemia, with depressive features
Paul Desmond	Dysthymic disorder
Bill Evans	Dysthymic disorder
Gil Evans	Major depressive episode
Stan Getz	Major depressive disorder, recurrent1
Charles Mingus	Major depressive disorder, recurrent, superimposed on cyclothymic disorder1
Gerry Mulligan	Mood disorder due to hypoglycaemia with mixed features
Charlie Parker	Major depressive episode1
Art Pepper	Substance-induced mood disorder with depressive features1
Oscar Pettiford	Cyclothymic disorder (?)
Frank Rosolino	Major depressive episode (?)

Anxiety disorders

Two subjects (5%), Art Pepper and John Coltrane, appeared to have anxiety disorders. Art Pepper carried out obsessive–compulsive washing rituals and had phobic anxiety regarding the sight of blood, hospital operations and answering the telephone. John Coltrane exhibited obsessive–compulsive features related to excessive practising, consumption of sweet foods, dieting, searching for the perfect mouthpiece and constantly exploring various religions. In relation to Coltrane, it is interesting to note that obsessionality can have an adaptive function in creativity, and Storr (Reference Storr1972) discusses the use of ritual to induce a suitable state of mind.

Sensation-seeking

Zuckerman (Reference Zuckerman1994) has described sensation seeking as ‘the tendency to seek novel, varied, complex, and intense sensations and experiences and the willingness to take risks for the sake of such experience’. It ‘seems to be a necessary but not sufficient ingredient of an antisocial personality’ (Reference ZuckermanZuckerman, 1994) and has been linked to borderline personality disorder (Reference Reist, Haier and DeMetReist et al, 1990). It seems possible, therefore, that sensation-seeking is a characteristic of all DSM cluster B (dramatic type) personality disorders. Sensation-seeking also has been linked to creativity, in the form of divergent thinking (Reference McCraeMcCrae, 1987), and to a preference for complexity and abstraction in art (Reference Furnham and BunyanFurnham & Bunyan, 1988).

In terms of the sample as a whole being rated as exceptionally creative, I felt that it would be interesting to look at the documentation of sensation-seeking tendencies in biographical material.

Late-life deteriorations and suicides

It was felt that from the age of 54 years Thelonious Monk had a dementing process caused by excessive drug usage. He died from a cerebral aneurysm, aged 64 years.

At the age of 52 years Frank Rosolino shot his two sons (killing one and seriously wounding the other) and then killed himself. J. J. Johnson, having been ill for a number of months, died by suicide at the age of 77 years.

Shortcomings of the study

Ludwig (Reference Ludwig1995) and Post (Reference Post1994) discuss the shortcomings in their studies and the same criticisms can be levelled at the present one. Information was taken from soft biographical data and interpreted as facts. A single investigator attempting to translate descriptions of subjects in biographies into specific DSM diagnoses cannot achieve high levels of validity and reliability. Biographers may be biased in the way that they select and interpret facts, and information is retrospective. Ideally, the subjects should have been selected from a list provided by a group of experts. The present sample of 40 subjects is small and rose to prominence in a very specific era that had a strong influence on them as individuals. Nevertheless, objective data were available in the form of documented behaviours, such as medical or psychiatric illnesses. Often there were several biographies of one subject, each written from a different standpoint and providing cross-corroboration of data.

Statistical comparisons with other studies

It was interesting to compare and contrast rates and types of mental health problems in the sample of jazz musicians with those of previously documented creative groups.

Overall, the statistics for jazz musicians were comparable with those of composers and musical performers provided by Post (Reference Post1994) and Ludwig (Reference Ludwig1995). For instance, 28.5% of jazz musicians had mood disorders compared with 41% of musical performers (Ludwig) and 34.6% of composers (Post); and 10% of Ludwig's and 1% of Post's composers had a psychotic illness compared with 7.5% of jazz musicians. Figures for alcohol problems were similar, with 40% of Ludwig's musical performers, 21.2% of Post's composers and 27.5% of jazz musicians. Thus, the present study tended to confirm previous findings regarding mood disorders and alcohol problems in creative persons. Comparable statistics for the general population during the time period studied are not easily available. The Midtown Manhattan Study (Reference Srole, Langer and MichaelSrole et al, 1962) did not determine the presence of specific mental disorders, stating only that 23% of the sample population had significant psychiatric impairment. The Epidemiologic Catchment Area Study (Reference Robins and RegierRobins & Regier, 1991) found incidences of 6.8% for mood disorders, 1.5% for schizophrenia, 14% for alcohol dependence and misuse and 6% for drug dependence and misuse.

Drug-related problems

There was a much higher rate of drug-related problems in the present sample than in those of Ludwig and Post, with 52.5% of jazz musicians having heroin addiction at some time during their lives. As has been noted previously, heroin use was widespread for a number of reasons among modern jazz musicians after the Second World War, but as modern jazz gradually became more accepted, and as younger musicians saw the harm caused to their older colleagues, usage began to fall off (Reference HentoffHentoff, 1978), so a more recent sample of jazz musicians undoubtedly would not show the same rate of addiction.

Consideration of occupational stress

In a previous large-scale study (Reference Wills and CooperWills & Cooper, 1988), the effects of occupational stress on mental health and substance misuse in popular musicians were explored. Arguably, the fullest picture is provided by using the diathesis–stress model (Reference MeehlMeehl, 1962). One may ask why Dizzy Gillespie survived to become an elder statesman but his fellow innovator Charlie Parker died aged 34 years. Research (see Reference LudwigLudwig, 1995) shows that, with regard to psychopathology in the arts, for substantial numbers the predisposition for mental disorder is established long before they launch their careers. There is also a greater tendency in their families for mental illness and they show more problems during childhood and adolescence than members of non-artistic professions.

Wider implications of sensation seeking

Despite the social reasons for drug usage, it is interesting to look at it in relation to the topic of sensation-seeking.

Sensation-seeking, mainly in the form of disinhibition and thrill- and adventure-seeking, was described in biographical material relating to many of the current sample, suggesting that their substance related problems were part of the wider spectrum of their appetites and not simply the result of the influence of their working environment.

The connection between sensation seeking and creativity is a topic worthy of further investigation. One may speculate that those high in creativity and sensation seeking may represent a subset of persons who are attracted to becoming performers in the field of popular music as a whole, when one also considers the biographies of a number of eminent deceased rock musicians. One can carry this speculation further, for instance when looking at the bohemian artistic world of fin-de-siècle Paris. Januszczak (Reference Januszczak2002) refers to the ether addiction of the poet Max Jacob, the absinthe addiction of the playwright Alfred Jarry, the opium smoking of Picasso and the alcoholism of Utrillo, Toulouse-Lautrec and Modigliani. The latter also used hashish and cocaine.

At the present time, of course, the connection is pure conjecture. Solely with regard to jazz musicians, there is a need to study larger samples and to make comparisons with groups from different eras of the music.

Non-pathological sample characteristics

To maintain a sense of perspective in the present study, it needs to be stated that many of the sample were exemplary, well-balanced human beings. For instance, Clifford Brown was regarded universally as being kind, generous, conscientious and highly intelligent. Eric Dolphy was known to be gentle, unassuming, helpful and considerate. John Coltrane, Thelonious Monk and Erroll Garner generally were liked very well. Pepper Adams was an exceptionally cultured person who was interested in art history and literature, and his friends regarded him as an excellent museum guide. Many musicians, such as Miles Davis, Art Blakey and J. J. Johnson, overcame early problems to become very successful and highly respected elder statesmen of jazz.

This study offers a further perspective on the link between psychopathology and creativity in the arts, and adds weight to the finding that outstanding workers in the arts can suffer from above-average levels of mental health problems but manage to produce exceptional work despite this. Connections with sensationseeking are highlighted, suggesting an avenue for further exploration.

CLINICAL IMPLICATIONS

1. ▪ Evidence of a link between psychopathology and creativity in the arts is given further support.

2. ▪ Further illumination of the creative process might be gained by an intensified study of its link with sensation-seeking.

3. ▪ Psychopathology is neither necessary nor sufficient for creativity.

LIMITATIONS

1. ▪ Information was taken from soft biographical data and interpreted as fact.

2. ▪ A single investigator attempting to translate descriptions in biographies into specific DSM diagnoses cannot achieve high levels of validity and reliability.

3. ▪ The present sample of 40 subjects is small and rose to prominence in a very specific era that had a strong influence on them as individuals.