Original Paper
Psychopathology
DOI: 10.1159/000479883
Bipolar Disorder and/or Creative Bipolarity:
Robert Schumann’s Exemplary Psychopathology –
Combining Symptomatological and Psychosocial
Perspectives with Creativity Research
Rainer Matthias Holm-Hadulla a, b Asimina Koutsoukou-Argyraki a
a
Psychosoziales Zentrum, Universität Heidelberg, Heidelberg, Germany; b Facultad de Medicina,
Universidad Diego Portales, Santiago de Chile, Chile
Keywords
Psychopathology · Bipolar disorder · Creative bipolarity ·
Creativity · Psychotherapy · Robert Schumann
Abstract
The psychopathological condition of Robert Schumann has
been a prominent object of study in psychiatry since his hos-
pitalization in 1854. Renowned psychiatrists have diagnosed
Schumann with syphilis, schizophrenia, and bipolar and per-
sonality disorders. Until today, these analyses of his symp-
tomatology have led to contradictory results. Recent discus-
sion has suggested that his hospitalization was due to pro-
fessional failure and separation wishes on the part of his wife,
her family, and her friends. In line with this hypothesis is the
opinion that the separation insisted upon by Clara Schumann
was reinforced by the economic interests of the psychiatrist
who kept Schumann in custody for 2 years until his death in
1856. In this article, we trace the complex interaction of bi-
polar vulnerability and pathogenic life events with hyper-
sensitive talent and “creative bipolarity,” defined as the ca-
pacity, motivation, and resilience to transform emotional
© 2017 S. Karger AG, Basel
E-Mail karger@karger.com
www.karger.com/psp
Received: December 2, 2016
Accepted after revision: August 1, 2017
Published online: October 11, 2017
stress and cognitive inconsistency into coherent artistic
products. Finally, we present our conclusions about compre-
hensive psychiatric and psychotherapeutic treatment with
respect to “creative bipolarity.” © 2017 S. Karger AG, Basel
Introduction
Many renowned psychiatrists have commented on
the psychopathology of Robert Schumann since his
death in 1856 [1–3]. The comments are great not only in
number but also in diversity [4]. Also, the relationship
between creativity and psychopathology in general re-
mains a controversial issue. Asked to treat the supposed
mental illness of Democritus, Hippocrates referred to
melancholia as a special state of the soul affecting ex-
traordinary people. Melancholic ecstasy, he said, in-
creased creativity and enabled the “highest concentra-
tion of the spirit.” Hippocrates distinguished this form
of melancholia from melancholia as a disease [5]. Today
we are still struggling with the question of to what extent
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Asimina Koutsoukou-Argyraki
Psychosoziales Zentrum, Universität Heidelberg
Gartenstrasse 2
Göteborgs Universitet
DE–69115 Heidelberg (Germany)
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E-Mail asimina.koutsoukou @ stw.uni-heidelberg.de
melancholic and manic ecstasy lead to extraordinary
achievements or turn into mental disorders. Aristotle
[6] stated in the famous Fragmentum XXX,1, which was
also thought to have been written by Theophrastus [see
7], that all great men are melancholic. Like Plato, he also
saw manic ecstasy as a precondition for achievements of
genius. But, some lines later in the Fragmentum, the au-
thor concludes that melancholia and mania can become
so severe that some of these extraordinary persons fall
sick.
In other words, according to the ancient Greek phi-
losophers, melancholia and mania were not necessarily
diseases but special states of mind that can lead to ex-
traordinary creativity. In this sense, Plato described 4
types of mania (μανία): prophetic, mystic, poetic, and
erotic. In Plato’s understanding, individuals in general
are cast into a struggle between order and chaos, and it
depends on the intensity of this struggle whether melan-
cholic and manic ecstasy favours creativity or results in
depression and madness [8, 9].
Later, Shakespeare expressed similar insights in A
Midsummer Night’s Dream: “Lovers and madmen have
such seething brains/Such shaping fantasies, that appre-
hend/More than cool reason ever comprehends. …/And
as imagination bodies forth/The forms of things un-
known, the poet’s pen/Turns them to shapes and gives
to airy nothing/A local habitation and a name” [10]. To-
day we still have an ongoing discussion on the extent to
which emotional instability favours creativity and the
point at which it associates with depressive or bipolar
disorders leading to a loss of creativity.
A potential link between creativity and psychopa-
thology and, more recently, bipolar disorders has also
been discussed throughout cultural history [11] and is
supported by the findings of modern neurobiological re-
search [12]. Doerr-Zegers [13] and Doerr-Zegers et al.
[14] have addressed the relationship between genius and
melancholy with phenomenological analyses of the cre-
ative struggles of Sören Kierkegaard, Alexander von
Humboldt, and Rainer Maria Rilke. Holm-Hadulla [15,
16], Holm-Hadulla et al. [17], and Holm-Hadulla and
Bertolino [18] provide insights into extraordinary cre-
ativity associated with dysthymia and melancholia in the
cases of Johann Wolfgang von Goethe and Jim Morri-
son. A comprehensive survey on this issue is provided
by creativity researcher Marc Runco [19].
Here, Robert Schumann serves as a prominent ex-
ample of the complex interactions between psycho-
pathological vulnerability, psychosocial stress, and cre-
ativity.
2 Psychopathology
DOI: 10.1159/000479883
Methods
Biographical information about the life and work of Robert
Schumann, letters and diary notes written both by himself and
closely related persons are analysed ideographically and with phe-
nomenological and hermeneutic methods. Given the limitations
imposed on ideographic and phenomenological analysis as well as
hermeneutic understanding [20–22], this approach suggests itself
for the analysis of Robert Schumann’s psychopathology and cre-
ativity. Generally, narrative analyses serve to contextualize empir-
ical findings, combining scientific evidence with hermeneutic
plausibility [23, 24]. Narrative analysis offers the advantage of con-
sidering the empirical findings in their contextualized framework
of emergence, adding valuable meaning to the description and
evaluation of symptoms and remaining sensitive to significant di-
agnostic and clinical implications. A hermeneutic framework of
human understanding and communication, as well as modern di-
agnostic classifications of mental diseases (DSM-V-R, ICD-10),
have been applied to the analysis of the biographical data available.
Furthermore, findings from creativity research [19, 25] and psy-
chotherapy research [26] are used to cast light on Robert
Schumann’s existential and creative struggles.
Results
Symptomatological Perspectives
The analysis of Robert Schumann’s psychopathologi-
cal condition by a former chair of psychiatry at a German
university, Theo R. Payk [1], is paradigmatic for a strictly
symptomatological approach. In his book Robert Schu-
mann, he comes to the conclusion that Schuman was in-
fected with syphilis when he was a student and considers
this an explanation for many of his symptoms. Likewise,
he considers statements by Robert Schumann, his wife,
Clara Schumann, his friends and doctors to be evidence
supporting this assumption. He concludes that Robert
Schumann’s creative work was a constant fight against
fear, melancholy, and pain, ending in the mental decline
caused by syphilis [1].
However, a closer look at the diagnostic criteria shows
that the syphilis diagnosis is highly uncertain. As another
chair of psychiatry, Uwe H. Peters [2] argues, on the basis
of historical documents, the genital affection described by
Robert Schumann when he was 20 years old could also
have been genital herpes or gonorrhoea. Even more im-
portant is the fact that the psychopathological symptoms
thought to be caused by syphilis do not appear until years
or even decades after the infection with Treponema pal-
lidum. For this reason, it cannot have been syphilis that
caused the anxieties and the disgruntled moods described
by Robert Schumann in his diaries as a young student.
The most essential symptom of progressive paralysis is
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dementia [27]. In the case of Robert Schumann, no clues
for symptoms of dementia were documented by the doc-
tors that treated him at the mental asylum in Endenich
near Bonn, where he was hospitalized during the last 2
years of his life. In fact, Robert Schumann was playing the
piano and writing finely worded letters at that time. No
atactic distortions or signs of dementia became apparent
until the last month of his life, when he literally starved to
death. Nevertheless, Payk [1] is convinced that the diag-
nosis of syphilis explains Schumann’s strange behaviour
and eccentricities.
In addition to the organic brain diseases, Payk [1] as-
sumes that Schumann suffered from all 3 aspects of the
triadic system. This model was developed by Emil Krae-
pelin [28], Eugen Bleuler [29], and Karl Jaspers [30], and
systematically described by Kurt Schneider [31]. It con-
sists of the triad of exogenic psychosis, endogenic psycho-
sis, and the “abnormal variations of the psychological be-
ing,” i.e., adjustment and personality disorders.
Besides syphilitic symptoms, Payk finds indications of
schizophrenia. However, no key symptoms for either of
these diagnoses can be found in authentic biographical
documents from or about Robert Schumann. Schizo-
phrenia is very unlikely, because delusions, disordered
thoughts and speech, or hallucinations have to appear
continuously for more than 1 month for this diagnosis to
be convincing. Robert Schumann did indeed experience
auditory hallucinations once or twice for some days when
he was facing an intense workload and was under the in-
fluence of high doses of alcohol. But Robert Schumann’s
“auditory hallucinations” were mood congruent, and
they were musical, not verbal. They resemble experiences
that most musically gifted people can report.
A manic-depressive disorder, nowadays termed bipo-
lar disorder, seems to be more probable in Robert
Schumann’s case [3, 4]. He himself described melanchol-
ic moods since the age of 17 years at times of extraordi-
nary creative tension and productivity. For him, like
Goethe [16, 32], melancholia and extraordinary creativity
were closely related.
The historical documents prove that Robert Schumann
was affectively depressed from time to time but never for
longer than 2 weeks, the minimum time required for a
diagnosis of major depression. In fact, Robert Schumann
documented his fear of mental breakdown, illness, and
death from his 17th year onwards in his diaries and his
letters. Payk [1] interprets this and his fear of lunatic asy-
lums and funerals as “self-protection or dismal anticipa-
tion.” Schumann may well have had an idée fixe that he
would become mentally sick. However, many people ex-
Bipolar Disorder and/or Creative
Bipolarity: Robert Schumann
perience this kind of preoccupation and then never suffer
mental illness, while patients with psychological disor-
ders often do not feel sick at all. Schumann could even
take a critical and distant view on that issue, writing:
“Even back then, in 1833, certain feelings of sadness came
upon me … they were disappointments that every artist
experiences when things do not proceed as fast as one
would like …” [1, p. 163].
After the death of his brother, the 22-year-old Robert
Schumann lapsed into a state of crisis. He described him-
self as falling victim to “the worst melancholia from Oc-
tober till December – An idée fixe about going insane has
seized me” [1, p. 163]. But this period of gloom must not
be confused with major depression. It is rather a state of
profound mourning caused by the loss of a close relative
and should therefore be classified as an adjustment disor-
der (situational depression). In addition, more symptoms
are needed to diagnose a depression, such as the loss of
interest and energy. But even in periods of severe gloom,
Schumann devoted himself intensively to his work. Ac-
cordingly, the evidence based on the documents available
to us today is not sufficient to diagnose Schumann with
severe major depression. In his diaries and letters,
Schumann presents himself as a sensitive, reflective, and
creative mind ruminating about life and death with an
intensity comparable to Goethe, who strongly influenced
Robert Schumann’s feelings, thoughts, and creative
achievements. Like Goethe, he considered affective and
cognitive “polarity” to be essential for creative human ex-
istence. Goethe believed that creative individuals often
suffer affective turmoil and cognitive dissonances. For
Goethe, human beings in general are a mixture of light
and dark, good and evil [15–17]. In creative moments, the
artist can resolve the sufferings stemming from emotion-
al and intellectual chaos by creative work [16, 25, 33]. Like
Goethe, Robert Schumann struggled with affective disso-
nances, but – with the exception of his last 2 years in the
mental asylum – was not inhibited in his creative energy.
It is also unlikely that Robert Schumann had manic
episodes, since he never experienced elevated moods, ag-
itation, sleeplessness, and unrealistic behaviour for more
than 1 or 2 days in sequence. Schumann’s enhanced pro-
ductivity can also be explained by other circumstances.
For instance, 1840 (referred to as the “Liederjahr” or “year
of songs”) was one of the most productive periods of the
artist’s life and also the year when he was finally in a posi-
tion to marry Clara Wieck. Interestingly, at this time of
joy and happiness, his music engages with profoundly
melancholic feelings, for example in “A Poet’s Love” after
poems of Heinrich Heine [33]. Furthermore, in manic
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Psychopathology 3
DOI: 10.1159/000479883
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episodes, patients act aimlessly and are easily distracted.
Neither of these symptoms are compatible with Robert
Schumann’s productivity and creativity.
On a more critical note, we might however inquire
whether Schumann’s mood swings and emotional and
cognitive dissonances were associated solely with creative
bipolarity. In his family, there are some genetic indica-
tions of bipolar disorder and alcohol abuse, suicidal lean-
ings, and impulsiveness, all of which are closely related to
the bipolar disorder spectrum [11]. Perhaps Robert
Schumann was able to transform the melancholic moods
assailing individuals of genius and analysed phenomeno-
logically by Tellenbach [34, 35] into creative bipolarity
until his breakdown in early 1854 (see below).
Besides endogenous and exogenous psychoses, Payk
[1] also ascribes the third aspect of the triadic system to
Robert Schumann’s mental condition, i.e., adjustment
and personality disorders. He argues that Robert Schu-
mann’s irrational fear of funerals and fascination with the
magical aura of brilliant and outstanding personalities in-
dicate a personality in which mystic and occult ideas are
frequent and “spirits, angels and demons were not only
figures in his work, but also hallucinatory, dangerous
companions of the last years of his life” [1, p. 16]. Payk
argues that alongside megalomania Schumann rapidly
developed feelings of inferiority that could be attributed
to a narcissistic personality. He reiterates the opinion that
Schumann’s mental disorders increased in his last years
of life and finally led to his demise. However, he ignores
important psychosocial circumstances that can also ex-
plain this disastrous process, such as the separation from
his wife and his humiliating dismissal as musical director
(see below).
In summary, Payk presents a descriptive, psycho-
pathological examination of Robert Schumann’s case
from a symptomatological point of view. Seen from this
perspective, Robert Schumann was infected with syphilis
when he was a student, which serves as an explanation for
many of his symptoms. In addition, various other kinds
of psychological disorders are ascribed to him, such as
schizophrenia, manic depression, and personality disor-
der. After discussing the limitations of these statements,
our conclusion is that there are insufficient historical data
to bear out these diagnoses and that the diagnoses pro-
posed cannot adequately explain the development of
Schumann’s complex psychopathological condition.
A closer phenomenological look at the typology of
Robert Schumann’s mood disorder shows signs that can
be ascribed to the species of depression that Tellenbach
[34, 35] calls “Schwermut.” This type of depression is
4 Psychopathology
DOI: 10.1159/000479883
characterized by episodic and/or chronic ill humour
connected with extraordinary inspiration and productiv-
ity. J.W. von Goethe is one prominent example [15, 16]
of an artistic personality experiencing feelings of vanity,
futility, and despair so intense as to lead to death wishes.
When these states cannot be transformed into creative
achievements, clinically significant major depression
materializes. This was most probably the case shortly
before Schumann’s hospitalization in March 1954. He
could no longer transcend his mood swings by creative
activity and was also unable to fight for his rights (see
below). But up to this time, he suffered and enjoyed states
that can legitimately be referred to as “creative bipolar-
ity.” Creative bipolarity is characterized by the ability to
withstand affective dissonances, contradictory feelings,
and mood swings on the one hand, and at the same time
transform cognitive inconsistencies and unusual – and
often disturbing – inspirations into extraordinary cre-
ative achievements [8, 25]. Unlike severe major depres-
sion, “creative bipolarity” is not associated with a crip-
pling lack of drive or serious disruptions of biological
rhythms [see 36, 37].
Psychosocial Perspectives
Another renowned psychiatrist, psychotherapist, and
neurologist, Uwe Henrik Peters, also investigated the case
of Robert Schumann in detail. Like Payk, Peters was a full
professor of psychiatry and director of a German univer-
sity hospital. He also worked at much the same time as
Payk. Interestingly, he comes to totally different psycho-
pathological results. We maintain that this is due to the
fact that he looked at Robert Schumann’s case primarily
from a psychosocial perspective.
In his book Imprisoned in a Lunatic Asylum: Robert
Schumann [2], Peters comes to the conclusion that Robert
Schumann’s downfall was occasioned by the treatment at
the hands of his wife Clara Schumann and a number of
severe professional setbacks. At the time of the psychic
crisis that began in autumn 1853 and led to his hospital-
ization in February 1854, Robert Schumann was dis-
missed as a musical director, while Clara Schumann, an
energetic and highly ambitious pianist, began a romantic
relationship with Johannes Brahms, similar to the ideal-
istic “poet’s love” uniting her with Robert Schumann
nearly 2 decades before. Peters argues that Clara’s inten-
tion to keep her husband out of the house was assisted by
an incompetent psychiatrist, Dr. Richarz, who held
Schumann in custody for over 2 years, mainly for finan-
cial reasons.
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 After Robert Schumann’s acute psychic crisis in late
February 1854 and his transfer to a private psychiatric
hospital on March 4, Clara Schumann quickly spread the
news that her husband was chronically ill. Her mother
wrote in her letters that she has “little hope for Robert …
you can tell everyone quite openly that Robert is men-
tally ill…” [2, p. 36]. On March 2, Clara Schumann had
already informed the newspapers about her husband’s
mental illness. In addition, the violinist Joseph Joachim,
a close friend of theirs, informed the public and the court
that Robert Schumann was mentally ill. On April 9, 1854,
Otto Grimm, another close friend of Clara Schumann,
wrote that “Schumann’s mental death” had occurred [2,
p. 130]. On March 15, 1854, Clara Schumann wrote a re-
port with public appeal which Peters calls a “horror story”
because it massively exaggerates Robert’s symptoms and
reads like an attempt to justify her separation from her
husband. One year later, she wrote to the doctors in En-
denich that Robert had always been ill: “I also have to tell
you that I think that you will find some signs of disease
in my husband that have never been any different…” [2,
p. 120].
Two months after Schumann’s hospitalization, 35-
year-old Clara Schumann celebrated Johannes Brahms
21st birthday at her house. The next day, she wrote: “I love
to see him play! His face has such a noble appearance but
when he plays it becomes even nobler… His movements
are always beautiful” [2, p. 178]. Clara Schumann also
planned new concert trips and travelled to see a friend in
Ostende, Belgium. Johannes Brahms wrote jealously:
“Her vivid and stimulating company … how can I do
without it … I so dreadfully long to see her again” [2,
p. 190].
There are documents indicating that Schumann want-
ed to leave the hospital after some months. Joseph Joachim
wrote in November 1854 that Robert Schumann’s spirit
“grows noticeably better! I have just had letters from him
from Endenich. He described precisely some of our expe-
riences with his friendly, mild expressions … he asks
about compositions, about friends: we can indeed hope
for the best” [2, p. 262]. No psychopathological abnor-
malities can be found in Robert Schumann’s letters.
Joachim notes: “Isn’t this letter from Robert Schumann
wonderful: how fine and how similar to the usual charac-
teristics the drawings appear! What a joy to see such
handwritten refutation of the doctor’s last report” [2,
p. 263].
As of October 14, 1854, Clara Schumann resumed her
extensive concert activities, travelling to Hamburg, Lü-
beck, Bremen, Berlin, Breslau, and Frankfurt/Oder. She
Bipolar Disorder and/or Creative
Bipolarity: Robert Schumann
was often in the company of Johannes Brahms, who wrote
to Robert Schumann on December 2, 1854: “Since spring
I have been spending the year in Düsseldorf (with Clara);
it will be unforgettable, I adore and love you and your
wonderful wife. I have never looked to the future and nev-
er believed in a marvellous future until now” [2, p. 285].
At the same time, Robert Schumann lived isolated in En-
denich, “plays the piano … reads much … reads and
writes … very happy with the catalogue of his composi-
tions … was friendly … pretty cheerful …” [2, p. 287]. But
he wept when he was told about a concert in Bonn that he
was not allowed to attend. On December 15, he wrote to
his wife: “… Couldn’t I come to you for Christmas…?” [2,
p. 290]. But Clara spent Christmas with Brahms, whom
she was “endlessly longing for,” while Robert Schumann
informed his doctors in “well-tempered” terms that he
wished to “return to Düsseldorf soon” [2, p. 292].
What were the reasons for Clara Schumann’s separa-
tion from her husband and why was he confined to the
psychiatric hospital? After long and exhausting confron-
tations, Schumann had resigned from his position as
Düsseldorf’s Director of Music on November 7, 1853
[38]. But until the end of 1853 he remained highly cre-
ative, composing the famous Violin Concerto in D minor
and the third Violin Sonata in A minor. After the humil-
iating and demeaning ejection from his prominent posi-
tion in Düsseldorf, he embarked on a concert tour from
November 23 to December 22. He was very well received
by the public, both as composer and conductor. Clara
Schumann noted that in fact he almost forgot his humili-
ating dismissal during those weeks. After this trip, he de-
voted himself to the “Dichtergarten” and to another con-
cert trip together with Clara Schumann from January 17
to 30, 1854. During that period, no indications of organic
brain disease, schizophrenia, depression, or manic disor-
der are discernible in any of the pertinent documents.
Symptoms of an illness seem to have evolved in mid-
February 1854. On February 10, Clara Schumann de-
scribes “very intense and distressing auditory affections”
and “painful earache and headache” [2, p. 294]. Peters
suggests that these symptoms could be signs of severe tin-
nitus or an inflammation and sees no indications of
schizophrenic hallucinations or bipolar disorder. What
Clara Schumann noted in the following days is very inter-
esting: “Friday the 17th, at night, not long after we went
to bed, Robert got up and wrote down a musical piece,
which, and this is how he put it, the angels sang to him;
after he finished it, he lay down and fantasized the whole
night with open eyes, staring at heaven; he strongly be-
lieved that angels were around him making revelations,
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all in marvellous music, they welcomed us, we would be
united before the end of this year […] Morning arrived
and with it a terrible change! The voices of the angels
changed into voices of demons with horrible music, they
told him he was a sinner and they made to cast him into
hell. In short, his condition developed into a nervous par-
oxysm; he cried out in pain (because, as he described to
me later on, they pounced on him as tigers and hyenas)
and two doctors who luckily came quickly enough could
hardly hold him still. Never again I will forget that sight,
I suffered the greatest anguish. After about half an hour
he calmed down a little and said that he was hearing
friendly voices again that encouraged him. The doctors
put him to bed, where he held out for some hours before
getting up again and making some corrections to his Vio-
lin Concerto. He said that this would relieve him of the
never-ending din of the voices. On Monday, the 20th,
Robert spent the whole day at his desk, paper, nib, ink in
front of him, listening to the voices of the angels, then
writing down some words, not many, and listening again.
[…] The next few days he stayed much the same, good
and bad spirits surrounding him in constant change, but
not always in music, often only talking to him. During
that time, he was so clear in his mind that he wrote this
marvellously touching, indeed devout theme on the night
of the 10th and then similarly moving and touching vari-
ations” [2, p. 297].
Robert Schumann finished his Variations in E-flat ma-
jor on February 25, shortly before jumping from a bridge
into the river Rhine. After his rescue, he was isolated from
Clara Schumann, who moved in with a close friend. On
February 28, Robert Schumann sent her the finished set
of variations. The work itself and the notes he made show
that Robert Schumann’s cognitive functions were intact
[2, 38]. In addition, there is no reference to depressive
symptoms with severe loss of drive or manic symptoms
with elevated energetic levels or self-overestimation. The
musicologist Joachim Draheim describes the “Geister-
variationen” (Ghost Variations) or Variations in E-flat
major as first-rate Schumann: “They do not show any
sign of flagging powers of invention” [39, p. 282].
Which diagnosis fits with Robert Schumann’s crisis?
Apparently, he was in a state of high emotional distress
and intellectual tension. Auditory impairments in com-
bination with pain are not typical of paranoid schizophre-
nia. Like many musicians, Robert Schumann heard music
inside his head, and like many artists he fought with an-
gels and demons. This is not a symptom of mental disor-
der but an omnipresent feature throughout cultural his-
tory. Moreover, it is a theme in the Bible, for instance in
6 Psychopathology
DOI: 10.1159/000479883
the Book of Job, or later in Rilke’s Duino Elegies: “Who, if
I cried out, would hear me among the angelic orders? And
even if one were to suddenly/take me to its heart, I would
vanish into its stronger existence. For beauty is nothing
but the beginning of terror that we are still able to bear…”
[40, 41]. Goethe, so greatly admired by Schumann, also
used the motive of angels and demons in various works,
for instance in the “Prologue in Heaven” section of Faust
I. For this reason, Schumann may well have been ac-
quainted with the idea that angels and devils are creative
stimuli.
Nor can a severe depressive episode be diagnosed,
since gloomy moods, the inability to experience pleasure,
and loss of interest have to last at least 14 days for this di-
agnosis, and none of these criteria are met in Schumann’s
case. A manic episode can also be ruled out, since Schu-
mann’s behaviour was not characterized by elevated
moods, unusual drive, or frequent unmotivated decisions
with no regard to the consequences. In fact, he was pro-
ductive during that period and the symptoms faded away
quickly. Probably his ability to cope with emotional dis-
tress was weakened by high alcohol intake or possibly
even alcohol withdrawal delirium [2]. But this could have
been only for a short period because concert master Beck-
er noted that he had had a “pretty reasonable” conversa-
tion with Robert on 24 February. He is on record as saying
that Schumann told him that the figure of Franz Schubert
had appeared to him and given him a wonderful melody
that he used for the Variations in E-flat Major. His audi-
tory sensations seem to have been mood-congruent mu-
sical fantasies and not the acoustical hallucinations typi-
cal of schizophrenia.
After his isolation from friends and family, Schumann
was visited by Joseph Joachim on December 24, 1854,
after over 9 months of hospitalization. Clara Schumann
commented on this visit: “Dear Joachim visited my Rob-
ert on Christmas Eve … He found him very well and as
he has always been … I believe that he mustn’t see me
before he has fully recovered! …” [2, p. 298]. At the same
time, Johannes Brahms wrote Robert a New Year’s letter:
“I arrived here the evening before Christmas Eve. How
long the separation from your wife appeared to me! I have
grown accustomed to her stimulating company, I have
lived marvellously close to her and appreciate and love
her deeply. Everything appeared so barren to me that I
only longed to see her again…” [2, p. 302].
On New Year’s Day, Clara Schumann made just one
entry in her diary: “Alone with Johannes” [2, p. 304]. Dur-
ing that time, Schumann was unhappy in Endenich, re-
fused medication in his food and water and complained
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that he was not allowed to attend Wagner’s Lohengrin in
Cologne. His letters to Clara were still tender, he wrote
about his musical ideas and gave no evidence of psycho-
pathological abnormalities. Clara wrote in her diary: “…
His letters are so wonderfully nice, he couldn’t have been
more affectionate in his healthy days” [2, p. 308]. It is not
surprising that Schumann was not only “calm and good-
tempered” but also occasionally “agitated and fearful.”
More and more often he said that he wanted to leave
Endenich. He began to take long walks with a personal
orderly, played the piano and worked, for example, on
his Paganini sonatas [2, p. 352].
His last letter to Clara, on May 5, 1855, is both com-
pletely lucid and full of poignant resignation. He wrote
about Johannes Brahms, for whom Clara Schumann has
arranged another major celebration. She notes in her di-
ary: “He (Brahms) enjoyed it (the birthday) with great joy
that also made me feel younger…” [2, p. 388]. One day
after Schumann’s last letter and the birthday celebra-
tions, Dr. Richarz wrote about his patient: “Today he
talked about the bad women” [2, p. 389]. Three days lat-
er he notes: “During the visit he was nostalgic, we shall
send him home.” Meanwhile, Brahms wrote to Schumann:
“Your dearest wife knows how to make one feel joyful”
[2, p. 392] and to Joachim: “I am in love with her […] I
could no longer love a young girl […]” [2, p. 412]. Mean-
while, Clara Schumann noted that she did not want to see
her husband again. She met his doctor Dr. Richarz out-
side the hospital and signed a document consenting to
her husband’s permanent confinement. After Christmas
1855, which she celebrated with Brahms, she set off on a
lengthy concert tour, visiting Prague, Vienna, Pest (Hun-
gary), and England. During this tour Brahms became
Clara’s constant partner. He did the bookkeeping and
took care of the children. Temporary separations from
“her dearest friend Brahms” were “endlessly heartbreak-
ing” for her [2, p. 491]. Robert Schumann continued to
write “well-structured” and “fine” letters (e.g., April 29,
1856) but appeared to be a broken man. Dr. Richarz did
not allow him to play the piano for months. His already
fragile self-esteem finally faded away altogether, he re-
signed himself to his fate and had to be force-fed. Finally,
he died of severe malnutrition eventually compounded
with bronchopneumonia [2, 4]. At the last, Clara Schu-
mann paid her dying husband a visit: “I had to beg God
to release him (from this life), as I loved him so.” [2, p.
552]. When he drew his final breath, Clara Schumann
was sitting at the dinner table in a nearby hotel with
Brahms and Joachim.
Bipolar Disorder and/or Creative
Bipolarity: Robert Schumann
The Interplay between Symptomatological and
Psychosocial Perspectives
Chilean psychiatrist Andrés Heerlein [3] has investi-
gated the interplay between Robert Schumann’s psycho-
social circumstances and his personality traits and psy-
chopathological symptoms. He starts his analysis with the
close relationship between the young Robert Schumann
and his parents. At the age of 3 years, Robert Schumann
was separated from his family because of his mother’s
typhus disease and/or depression. This separation lasted
for 2 years and a certain emotional instability was notice-
able in the aftermath. Heerlein suggests that Robert Schu-
mann’s fear of abandonment may be traceable to those
experiences. His parents, and particularly his father, real-
ized that their son was an extraordinarily gifted musician
and also linguistically talented. Beyond these obvious
gifts, he was particularly curious, diligent, and ambitious.
He read “difficult” literature, studied Latin, French, and
Greek, and in his adolescence was already very aware of
his talents. But he also sensed that these gifts were not only
a blessing but also a potential source of distress.
From the age of 14 onwards, there are documents in-
dicating marked erotic interests. Schumann continued to
be an excellent student, and he was inspired by the works
of Schiller, E.T.A. Hoffmann, Hölderlin, and notably Jean
Paul and Goethe. Apart from the separation from his par-
ents in his early childhood, his sister’s death when he was
15 years old may have been another decisive turning
point in his life. Emilie has been described as reclusive
and melancholic and her fall from the second floor of her
parents’ home has been interpreted as suicide. The par-
ents never fully recovered from this loss, and Heerlein
suspects that Robert’s fear of heights and his apprehen-
sions about falling mentally ill himself are closely con-
nected to this incident.
One year after Emilie’s death, fate struck again when
Schumann’s beloved father died. This tragic loss in Au-
gust 1826 had a strong impact on Schumann’s character.
He was no longer as cheerful and sociable as he had been
in his childhood [3]. In his diary, he noted that he had lost
all his energy and that he often felt himself to be on the
verge of insanity. However, the notion that he was suffer-
ing from acoustical hallucinations seems to be incorrect.
He did indeed note that he sometimes heard “eternal mel-
odies” at night, but this has happened to many sensitive
musicians. There are no indications of voices talking to
him or commenting on his thoughts.
According to Heerlein, Robert Schumann’s increasing
consumption of alcohol, which started at the beginning
of his studies in March 1828, can be explained by his de-
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Psychopathology 7
DOI: 10.1159/000479883
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sire to forget unpleasant experiences and to overcome his
social inhibitions [3, p. 99]. Despite his alcohol consump-
tion, Schumann tackled a remarkable work load and there
are no signs of him composing or writing in an intoxi-
cated state. Heerlein emphasizes that Schumann pos-
sessed the following character traits: highly intelligent,
extremely imaginative, hard-working, introverted, emo-
tionally vulnerable, sensitive, restless, and curious. All of
them are characteristic of many artists [19].
Schumann’s tendency to avoid interpersonal conflicts
and his longing for secure bonding becomes apparent by
comparison with his successful contemporary Richard
Wagner. Where Robert Schumann was introverted, cau-
tious, and shy, Wagner was extroverted, audacious, and
aggressive [42]. The difference is especially conspicuous
in their relationship with women. Schumann was a ro-
mantically devoted lover. His idealization of the love of
his life, Clara Schumann, was passionate and single-
minded. This bond was his main emotional anchor, but
it also made him dependent. Wagner, too, idealized his
lovers but he also exploited his relationships to achieve
his aims. In his erotic involvements, he remained inde-
pendent and less vulnerable. He took advantage of his
partners to achieve not only his erotic and artistic, but
also his economic, social, and political goals. Robert
Schumann, however, was so closely attached to Clara that
at least at the end of his life he was no longer able to assert
his own interests. Wagner never avoided conflicts with
rivals, in fact he actively sought such altercations. By con-
trast, Schumann avoided disagreements, for example
with Clara or Brahms, and was unable to assert his inter-
ests as Wagner could. That is also one of the reasons for
his failure as a musical director.
In his last years, Robert Schumann’s anxiously avoidant
and dependent personality traits became increasingly dys-
functional. After bearing 8 children, Clara Schumann went
on exhausting tours as a pianist and energetically pursued
her musical and social ambitions. She was better focused,
more realistic and robust than Robert Schumann, who was
dreamy and vulnerable, and seldom able to express aggres-
sive affects. Too often he suppressed them with the aid of
alcohol consumption. When Robert Schumann failed in
his position as a musical director in Düsseldorf, a post he
had really longed for, his general disability to cope with
conflicts and emotions led to his breakdown. Clara was
disappointed and possibly even contemptuous. In this dif-
ficult situation, Schumann’s covert despair, his increasing
disappointment, and the loss of his wife’s support together
with substantial alcohol consumption led to a loss of emo-
tional control and a suicide attempt.
8 Psychopathology
DOI: 10.1159/000479883
Conclusion
Robert Schumann’s psychopathology can be explained
by the interplay of biological, psychological, and social
factors with creative bipolarity. On the biological plane,
his temperamental (hyper-)sensitivity and inclination to
mood swings that is characteristic of so many artists [11,
19] made him vulnerable for adjustment and bipolar II
disorders, but were also an important precondition for
extraordinary creative achievements. Creative bipolarity
can be found not only at the affective but also at the cog-
nitive level. Much like Goethe [15–17], whom he revered,
Schumann could constrain and transform mood swings
and ambivalent emotions as well as contradictory ideas
and extraordinary inspirations into works of art. But, in
his final years, alcohol abuse seems to have weakened his
creative coping abilities.
Psychologically relevant is the fact that Schumann had
already experienced painful losses in early childhood.
These possibly led to his anxious-ambivalent proximity-
seeking behaviour, which can be understood psycho-
dynamically [3]. His talent, diligence, and motivation en-
abled him to transform his anxieties and moderate de-
pressive moods into literature and music. Since childhood
he used music and literature as self-therapeutic resources
and as transitional spaces [43] where he could control his
emotions and mentalize his experiences. He found role
models in literature and music to work through psycho-
logical conflicts and a wife to live and shape the ups and
downs of “A Poet’s Love.” In his relationship with Clara,
both artists successfully fulfilled their erotic and artistic
desires, creating a relationship that was both romantic
and realistic.
However, psychosocial distress weakened Robert
Schumann’s sensitive equilibrium. His failure as a musi-
cal director in Düsseldorf foregrounded the discrepancies
between himself and Clara. Despite her 8th pregnancy,
Clara was an extroverted and realistic achiever, whereas
Robert Schumann had become more introverted, vulner-
able, and emotionally unstable. His anxiously preoccu-
pied attachment style, seeking high levels of intimacy, ap-
proval, and responsiveness from the object(s) of his at-
tachment, became dysfunctional. His overdependence on
Clara became stronger as he experienced professional dif-
ficulties. At a time of humiliating and devaluating social
rejection and professional failure, and reinforced by seri-
ous drinking, Robert’s emotional and cognitive coher-
ence were weakened together with his creative abilities.
Failure as a music director caused a gratification crisis
that punctured his already uncertain self-esteem. In addi-
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tion, his wife was disappointed and vexed by his career
setbacks. His presence became an inhibition to her musi-
cal and personal aspirations.
Clara Schumann energetically continued her musical
career and began a romantic and inspiring relationship
with the young Johannes Brahms, as she had once done
with the young Robert Schumann. Schumann was unable
to take arms against this relationship because of his fear
of loss and his inability to control his aggressions. In his
isolation at the psychiatric clinic in Endenich, his habitu-
ally submissive attitude prevented him from standing up
to the pseudoscientific authorities that kept him in cus-
tody much longer than necessary.
In the month before his hospitalization. Schumann’s
creative capacities were no longer sufficient to cope with
his mood swings. His substantial alcohol consumption
may also have vitiated his artistic powers. He may thus
have realized that he could not keep up with the expansive
vitality of his wife and saw how the young, successful
21-year-old Johannes Brahms took his place in the house-
hold and to all intents and purposes became his wife’s
partner. To compensate for these changes, he increased
both his workload and his intake of alcohol, thereby ag-
gravating his affective arousal and cognitive incoherence.
Some weeks before Schumann jumped into the Rhine,
numerous psychologically relevant factors explaining
this arguably suicidal attempt become apparent. His tem-
peramental vulnerability and other personality traits
could not be transformed into creativity as before. His
condition was exacerbated by social disregard, the emo-
tional separation from his wife and family, and the weak-
ening of physical vitality and coping strategies by exces-
sive drinking.
The analysis of Robert Schumann’s psychopathology
shows paradigmatically that a description of symptoms
that does not take into consideration the interplay be-
tween biological and psycho-social dimensions with cre-
ative bipolarity is bound to lead to contradictory results.
Schumann’s case demonstrates the necessity for a model
that combines biological, phenomenological, and psy-
chosocial perspectives with an awareness of “creative bi-
polarity,” defined as the capacity, motivation, and resil-
ience required to transform emotional stress, cognitive
inconsistency, and psychosocial conflict into coherent
artistic products. Psychotherapy should be seen as a
resource for balancing the sensitive interplay between
mood swings and extraordinary inspirations and creative
achievements. This can be achieved by integrating rela-
tional, cognitive-behavioural, and psychoanalytic-psy-
chodynamic strategies with existential creativity [26]. An
integrative psychotherapeutic approach is not an alterna-
tive to pharmacological treatment. It is a means of finding
the right course between the Scylla of severe depressive
and manic episodes that can destroy creativity and the
Charybdis of the pharmacological suppression of creative
bipolarity. Our hope is that today empathic and compe-
tent treatment will assist patients like Robert Schumann
to remain in their psychosocial environment and benefit
from therapeutic spaces in which creative bipolarity can
be sustained and even reinforced.
Acknowledgements
We thank Emile Wogram and Andrew Jenkins for their coop-
eration.

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