Delusions of grandeur

"Madness," declared Socrates, "is a nobler thing than sober sense. Madness comes from God, whereas sober sense is merely human." The ancient notion that insanity might be a form of inspiration has persisted into modern times. During the early Christian period it produced the Holy Fool, blessed by visionary craziness. Shakespeare's King Lear, a secular metamorphosis of that figure, similarly attained a state of higher sanity through going mad. Two hundred years later, the Romantic generation of writers and painters (themselves captivated by Shakespeare's conjuring of extreme mental and emotional states) sought to induce a species of inspired irrationality in themselves by taking opiates. This Romantic transvaluation of insanity reached a peek in the later 19th century, and it is to that period that the origins of a certain modern cult of the lunatic as genius or prophet may be traced.

No one developed that cult more systematically and determinedly than Hans Prinzhorn (1866-1933), assistant director of the psychiatric clinic of Heidelberg University, self-styled "Revolutionary on Behalf of Things Eternal" and author of a briefly celebrated book, published in 1922, Artistry of the Mentally Ill. It was Prinzhorn's somewhat grandiose belief that, by studying the art of those suffering from severe mental disturbance, he might gain "a universal overview of all artistic manifestations on this minute terrestrial globe of ours". In his quest to discover the Psychological Foundations of Pictorial Configuration (his capitalisation), he amassed a collection of more than 5,000 paintings, drawings and other objects created by patients from psychiatric hospitals across Europe. That collection still survives, and a selection of some 200 works from it forms "Beyond Reason: Art and Psychosis", currently at the Hayward Gallery.

The experience of contemplating a pencil drawing such as Water Spirits, by Arthur F Becker, or Arthur F Buhr (no one can quite decipher the signature at the bottom of the sheet of paper in question), is not an entirely comfortable one. A group of ghostly white shapes have been teased into existence, presumably using an eraser, from a ground of dark scribble. Their forms are indeterminate and they are perhaps meant to evoke something like the otherworldly ectoplasm described by that army of spiritualists, mediums and other quacks, like Madame Blavatsky, who enjoyed a vogue in the early years of this century. A certain undeniable virtuosity went into the making of this image. Perhaps realising that those inspecting it might need interpretative assistance, or perhaps to prompt his own memory should he happen to forget its subject himself, its creator has added a short inscription:

"I was sitting in bed, then out of the water came just sort of - how shall I say? - sort of beasties, and my mother was one of them. They were half humans, half animals; I saw that quite clearly. There was some witchcraft in it. I think my mother was trying to pull me into the water; and perhaps that way I would have been taken out of this world - when I lie still, it still happens now and then. In the air I see it. It's best in twilight."

To all of which it seems impossible to add much in the way of constructive comment. Those who suffer as Mr Becker (or Mr Buhr) did are remote from most of us. The white ghosts on a dark ground are the mute phantasms of an affliction that (and this was his tragedy) could not truly be shared. The function of the images that he created while in the grip of schizophrenia or psychosis is also unclear. Did he make them to explain himself to others, or were they meant as a form of exorcism?

Such distinctions, it seems, did not much concern Hans Prinzhorn when he set about forming his collection of art by psychiatric patients. It was his belief that the insane (all of them) were more fully in touch with the deep, primal wellsprings of creation than the rest of us. The differences in their creative work - the difference, say, between Becker or Buhr's slight apparitions and the meticulous drawing of the groundplan of the lunatic asylum created by another inmate, Hans Kleber - did not interest Prinzhorn at all. He thought that the contemplation and analysis of all such art work was equally enlightening, and always enlightening in essentially the same way - each picture leading him, inch by inch, towards his personal alchemist's stone, namely a full understanding of the primordial (das Ursprunglich) in art.

He was of course quite wrong in all of this, but wrong in a way that makes him very much a man of his time. Prinzhorn pursued, albeit to unusual lengths, one of the characteristic fallacies of the first half of the 20th century. It was shared, for example, by many of the Expressionists, Dadaists and Surrealists, who similarly believed that the art of the mad, like the art of children, was more nakedly true to some unspecified core of humanity than the more tutored work of professional artists.

One of the several shortcomings of this view lies in its dependence on the idea that all such work is necessarily "spontaneous": the product of nature, rather than culture; the pure expression of the deepest human needs, fears and feelings. (Much the same used to be thought, just as misguidedly, about so-called "primitive" African art; and it is no coincidence that among the comparative materials gathered by Prinzhorn for his collection were several African tribal carvings.) But the fact is that mentally disturbed people are quite capable of considerable calculation and elaboration - some of the myriad forms of mania, indeed, resulting in forms of art (not quite the right word for it, if truth be told) that are characterised, precisely, by an appalling over-elaboration. In the present show, the various therapeutic exercises gone through by a meticulous but psychotic businessman called Josef Heinrich Grebing testify more than adequately to this, depressingly minute diagrams, maps and charts, drawn in a fine, fine hand, but utterly indecipherable in their meanings.

At the other extreme, when the work of a patient does seem less manically calculated than that of Grebing - the precise truth in such matters being somewhat hard to establish, given Prinzhorn's habit of bribing and rewarding patients to produce art "spontaneously" - there is nothing especially enlightening about it. A patient called Emma Hauck is represented by a series of "works" to which the title Letter to Husband is affixed. These are very painful to behold, tangible pieces of the desperation that once made up a wasted life. The phrase "Sweetheart please come", written out in pencil hundreds upon hundreds of times on a single sheet of paper, builds to a dark cloud of yearning and depression. But to be shown such a thing as if it were art - an exquisite prefiguration of the scrawls of Joseph Beuys, or some such, which is the inevitable implication of showing it in a modern art gallery such as the Hayward - seems terribly inappropriate. There is a profound difference between form, shaped consciously and deliberately by someone who has chosen the vocation of the artist, and the patterns which pain and mental anguish may happen to take as an illness runs its course.

To be fair to those who now care for the Prinzhorn Collection, some of whom have contributed essays to the catalogue of this exhibition, they themselves appear to feel many such qualms about the status and raison d'etre of the works in question. But to recognise a problem is not to solve it. This exhibition, hedged around with caveats as it is - defined by those who have put it on as an attempt to raise questions rather than provide answers - still seems fundamentally lacking in direction. The art of the psychiatric patient is rarely engaging as art because it is insufficiently artful. Furthermore, it is apparently (according to those whose business it is to know about such things) almost invariably unhelpful as a means of furthering psychiatric or psychoanalytical knowledge, because it is so fundamentally uncommunicative. The links between the patient August Natterer's vaguely Arcimboldo-esque pictures of faces configured to resemble landscapes, for example, and the mental disorder that plagued him, have never been established and probably never will be. Natterer's pictures are as strange as the delusions from which he suffered (which apparently included the conviction that "the cracking of his knees are telephone calls by which the devil is always notified of his whereabouts"); but that is all that can be said.

What we are left with is a collection of disparate material, gathered together for a purpose long since discredited, which amounts to little more than an archive of impenetrable oddities. An additional pathos clings to much of the material, because we know that many of those who created it were later to be murdered, as "genetic aberrations", by the Nazis. But this only adds to the atmosphere of slightly dirty voyeurism that hangs over the exhibitionn

`Beyond Reason: Art and Psychosis' is at the Hayward Gallery, SBC, London SE1 (0171-960 4242), to 23 Feb