Mixed Bag #9: John Z. Sadler on Creativity

“Mixed Bag” is a series where I ask an expert to select 5 items to explore a particular topic: a book, a concept, a person, an article, and a surprise item (at the expert’s discretion). For each item, they have to explain why they selected it and what it signifies. — Awais Aftab

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John Z. Sadler, MD is a Professor of Psychiatry and the Daniel W. Foster, M.D. Professor of Medical Ethics at the University of Texas Southwestern Medical Center. He directs the Division of Ethics in the Department of Psychiatry and is the institution-wide Director of the Program in Ethics in Science & Medicine at UT Southwestern. Sadler is one of the founders of the Association for the Advancement of Philosophy and Psychiatry, as well as the International Network of Philosophy and Psychiatry. He maintains a video archive of philosophers of psychiatry, www.psagacity.org, which offers in-depth high-definition video interviews of notable scholars in this field.

He is Editor-In-Chief of the Johns Hopkins University Press journal, Philosophy, Psychiatry, and Psychology, celebrating its 30^th year in 2023, and is a co-editor of the Oxford University Press book series, “International Perspectives on Philosophy and Psychiatry” the latter currently spanning over 50 volumes. In addition to numerous books he has edited or co-edited, Sadler is the author of the comprehensive and seminal monograph, Values and Psychiatric Diagnosis (Oxford University Press, 2005). A collaboration with philosopher Jennifer Radden, The Virtuous Psychiatrist: Character Ethics in Psychiatric Practice was published by Oxford University Press in 2010. His follow-up to Values and Psychiatric Diagnosis, Vice and Psychiatric Diagnosis, is in production with OUP in 2023.

Person — Ornette Coleman

Sadler: Creativity is, of course, embodied in people. Ornette Coleman, historically credited as the developer of ‘free jazz’, has been an inspirational figure for my entire adult life. Born in Fort Worth, Texas in 1930, his willingness to strike out in new directions is exemplified by the legend of him getting kicked out of high school band because of improvising on his sax in response to the band’s standard repertoire. His willingness to break out of the mold followed him throughout his career, leading him to be decried as a noisemaker by many, yet recognized with a MacArthur Fellowship, praise from Leonard Bernstein, a Pulitzer Prize, among many other honors and honorary degrees. Defining creativity is difficult, and given my interest in virtues and virtue theory, I might talk about creativity in terms of Ornette’s habits of character. I’ve already noted his willingness, as an adolescent — that developmental stage where conformity is so powerful — to be his own man, and pursue his own vision. That independence of spirit has to be a part of creativity. The structural elements of his music — collaborative with skilled musician/improvisers, but holding no rigid key, rhythm, tempo, harmony, is also a microcosm of his character, which is egalitarian, interactive, respectful, yet ‘led’ through his singular vision. That’s another thing about creativity, one needs constraints to be creative. The paradox with Ornette was he dispensed with many of the standard constraints of Western music, yet the ‘constraints’ in his improvisations were all about being attuned, empathic, and responsive to his fellow musicians. That attunement to interactivity is a profound constraint. Musicians who were to become jazz legends in their own right were attracted to him, and worked with him for long periods, much like his contemporary, but more troubled, peer Miles Davis. Ornette’s free jazz was all about listening to the collective others, not simply call-and-response, but evolving the musical work as a unit in real time. Ornette’s response to the standard accusation that “there’s no melody in your music” was “It’s all melody.” This reveals another feature of creativity, context-shifting: taking ideas and practices and placing them into different contexts, including turning them upside down. Ornette’s convention-shaking, however, was rooted in the raw emotions of the blues, the latter vivid in his own playing. Another element of creativity from Ornette was his constant development, from small-group acoustic bands in the 1950's and 1960's, moving to electric funk-inspired grooves in the 1970's forward, and culminating in symphonic music and film soundtracks in his later life.  Ornette was a notorious collaborator over his career, working with diverse individuals including Yoko Ono, Pat Metheny, Joachim Kuhn, Howard Shore, and the Grateful Dead, among others. Moving forward, not looking back — that’s Ornette, and that’s creativity too. 

Concept — Free Will

Sadler: I’m still working out what I think about free will, but respect it’s persistence in broad culture as well as in philosophy.  In my new book, Vice and Psychiatric Diagnosis (Oxford University Press, forthcoming 2023) it’s a significant part of what psychiatry, psychology, and criminology get wrong about the relationship between mental illness and wrongful or criminal conduct e.g. ‘vice’. Instead of thinking about how vice and mental illness are conjoined by undesirable, problematic thoughts and behaviors, and situating these thoughts and behaviors in scientific complex multicausal accounts, our culture is dominated by blame and ‘responsibility’ for one’s actions. In the book I argue that ‘responsibility’ and ‘free will’ are historical/cultural tropes embedded in law and religion on the one hand, while practiced in quite confusing ways by medicine/psychiatry on the other. Think about the weirdness of holding people with some disorders criminally responsible (e.g., personality disorders and victimizing paraphilias), while others are not (like psychoses), when at base all of these human conditions are situated in complex multicausal networks which constrain thought and behavior. What I can say about free will is that I don’t accept determinism as a foundation of most all philosophical treatments of the concept. The reason for this is strong and weak accounts of determinism both ignore the relevance of entropy, e.g. the tendency toward randomness, which physics and biology have well established as a natural, ubiquitous feature of complex systems (like us). What I think ‘free will’ is at base, with details yet to be worked out, is a manifestation of negentropically complex multicausal systems operating with various structural constraints (biogenetic, material, historical, situational, cultural) with entropy (randomness) inserting itself within and outside the structural constraints leading to surprising behavior that we happen to attribute to ‘free will’. It’s weird to me that free will is a thing rather than a structural and emergent property of complex systems. I call this response to the ‘free will problem’ this: ‘complex multicausal constraintism’. Needless to say that entropy interacting with complex multicausal, structurally constrained systems like us results in some categories of thought and behavior that we call ‘creativity’.  From a psychiatric perspective, vice and psychopathology are manifestations of various multilevel structural constraint failures, and I would guess, a dollop of entropy thrown in as well. Looking at creativity from the vantage of art and artists, randomness as a facet of creativity is evident. 

Book — David Graeber & David Wengrow- The Dawn of Everything: A new history of humanity.  New York: Farrar, Strous, & Giroux, 2021

Sadler: This new book of ‘world history’ has blown me away. Graeber and Wengrow are an archeologist/anthropologist team who have co-authored a 692-page tome that has shaken and stirred what I thought I knew about world history. Reading this is to have the experience of entire worlds of experience open up, whether in philosophy, government, ethics, the arts, you name it. Unimaginable that a nearly 700 page heady tome is a page turner, but for the curious of mind it’s irresistible. It’s a great example of another feature of creativity: shifting a context of inquiry or activity to make discoveries. So the context-shift in this case is the drawing upon a vast archeological and cultural anthropology literature to not only rethink world history as a whole, but also dismantle, with evidence, standard historical-cultural tropes. Just one example, for instance: Drawing from worldwide archeological studies, Hobbes’ view of the dire predictions of humans ‘in the state of nature’, is dismantled by revealing, in prehistory, the diversity of peaceful co-existence of native peoples without a ‘State’. The whole book opens up cause for optimism as we have our assumptions undermined through the resourcefulness of many ancestors contributing to living together peacefully. Regarding resourcefulness: that’s a part of creativity too.

Article — Nancy Andreasen’s “Secrets of the Creative Brain,” in The Atlantic, 2014

Sadler: My choice would be this lay article, in which the world-class schizophrenia researcher, Editor of the American Journal of Psychiatry, and PhD in Literature summarizes her lifetime work on the understanding of creativity. In telling a damn good story about scientific discoveries, she also reveals a lifetime of enormous creativity herself. She finds in her earlier studies that creativity, at least as measured in outputs (number of works, recognition, praise), tends to run in families and tends to be associated with mood disorders. She notes that later studies of ‘genius’ found that a high IQ was not equivalent to high creativity. So if not (super) smart, then what?  Creative individuals exhibit ‘divergent thinking’ where ambiguous probes result in a panoply of responses (recall Ornette), compared to ‘convergent’ thinkers who narrow responses to a few to one. Her neuroimaging studies of creatives supplemented the linguistic studies, finding that temporal-lobe language/association cortices lit up in creatives compared to controls. Big vocabularies count for at least many cases of creative individuals. (Pre-Med students, those vocabulary flash cards for the MCAT really count.) She found that creatives tended to engage more in random episodic silent thought (REST), where free association — letting one’s mind wander — was a finding Freudians could appreciate. One has to wonder if our era of info-noise is dampening REST and creativity! These findings were replicated in similar studies with scientific creatives, thus showing the importance of creativity in science too.  Both kinds of creatives found great joy in their creative activity too. Andreasen discusses much more, but I’ll let readers seek the rest out for themselves. Andreasen’s paper leads me to mention my own interest in creativity: I believe that skilled clinicians are also high in creativity, and a new book project just begun with my colleague Michael Laney seeks to sketch out ‘diagnostic virtues’ where ‘creativity’ is a habit of character surely exemplified by skilled, virtuous clinicians.

Surprise item — Marvel Comics

Sadler: Given the current cinematic overkill of corporate Marvel, it’s easy to trivialize Marvel Comics as well as the whole superhero genre. That would be a creativity mistake. Call me biased because I’ve read Marvel stories since 1963! Back in the Stan Lee-Steve Ditko era of Spider-Man, there was this character Otto Octavius a.k.a Doctor Octopus, who developed mechanical arms connected to his spinal cord, enabling him to control them with his consciousness. It wasn’t until later — much later — that this precision digital-neural interface seemed possible, until I saw the Keene, et al. Stanford group’s paper on the development of a digitally-responsive artificial synapse. Stan Lee was onto something 57 years earlier! Since then Marvel has been a go-to for unleashing my imagination. Science fiction has always drawn from this ‘what-if’ mode of thinking as a creative resource. However, other elements of Marvel comics teach us about creativity. When the story of a Marvel hero(ine) is retold and reworked, it provokes us to consider how small changes in thinking or in character can result in expansive effects for both storytelling as well as problem-solving. When I teach psychiatric ethics to our residents, I encourage a ‘theme-and-variations’ approach to stock ethics cases; changing one detail, whether age, gender, social status, (and potentially any other variable in the case) can result in a different ethical outcome. That’s creativity at work in teaching, and creativity at work in anticipatory problem-solving. My oldest son Evan noted at the conclusion of Avengers Endgame that this film corpus was the biggest and most expansive metanarrative in the history of cinema, through tying together about two dozen films into a final, inclusive, act. This was not a surprise to comics readers, as the narratives of Marvel characters had been developing for as long as 80 years, often in monthly and at-minimum annual installments. That’s a lot of stories to draw from! Considering phenomena from multiple levels of description, from molecular on up to societies and even ‘multiverses’, is the stuff of creative problem-solving, encoded in clinical models like the ‘biopsychosocial’. In practice, multilevel thinking is used by creative clinicians when they ‘think outside of the box.’

See previous posts in the “Mixed Bag” series

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