ART AND IMAGES IN PSYCHIATRY SECTION EDITOR: JAMES C. HARRIS, MD Anxiety (Angst) Sickness, insanity and death were the dark angels standing guard at my cradle and they have followed me throughout my life. Edvard Munch, age 70 years1(p31) ORN IN LØTEN,NORWAY,EDVARD MUNCH Munch began painting at age 17 years in Christiania (1863-1944) was the first Scandinavian (now Oslo). A state grant awarded in 1885 enabled him to painter to establish an international reputa- study in Paris, France. For 20 years thereafter, Munch tion. His artistic creativity spanned more than worked chiefly in Paris and Berlin, Germany. Initially in- 6 decades. During those years, he estab- fluenced by Impressionism and Postimpressionism, he later Blished his reputation as a portraitist and landscape painter developed his highly personal Expressionistic style and con- and painstakingly explored the human passions. Munch tent that emphasized images of illness, anxiety, and death. strongly influenced the development of German Expres- In 1892, an exhibition of his paintings in Berlin so shocked sionism. His life was filled with separation and loss, and the authorities that the show was closed. these experiences are reflected in his art. The second of His painting The Scream carefully reconstructs a 5 children, he was traumatized by the death of his mother moment of anxiety in which he stood alone and trem- when he was 5 years of age and that of his 15-year-old sis- bling.4 The Scream shows the panic experienced when ter, Sophie, at age 14 years. Both died of tuberculosis, a one individual feels totally isolated. Anxiety depicts the disease he contracted as a teenager but survived.2 Despite collective despair and desperation of a group of people, being descended from a prominent Norwegian lineage, his yet it is based on his own anxiety in viewing them. family was relatively impoverished and lived in tenement Munch writes of the silence he experienced when his houses in the workers’ suburb of Oslo, where they were anxiety peaked and he became dissociated from his exposed to tuberculosis. emotions. He watched a crowd pass by like ghosts, but Unable to accept the loss of his wife and daughter, his he saw through their masks and there was suffering in father, Christian Munch, an army medical corps physician, all of them: “[P]ale corpses—who restlessly hurry— became depressed and had episodic outbursts of temper. rush hither and thither along a tortuous path whose end An extreme religious fundamentalist, he believed that these was the grave.”1(p107) Anxiety represents the failure of deaths represented divine punishment; he had frightening love and how it leads to alienation from others. visions of his own and his surviving children’s eternal dam- Throughout the 1890s, he depicted variations on nation and sought solace in penitential prayer.2 These ex- these themes of anxiety in both prints and paintings. These periences fundamentally shaped Munch’s character and his paintings were displayed in his Frieze of Life exhibit on work. His most significant early painting, The Sick Child, 4 walls in the Berlin Secession Exhibition in 1902, with depicts his sister’s terminal illness. It shows a teenaged girl the title A Series of Pictures From Life. According to Munch, propped up against a pillow in a large armchair next to an the paintings represent moods. They are impressions of olderwoman,whobowsherheadindespairandgrief.Munch the life of the soul, and taken together they portray one completed many versions of this painting, and all of the es- aspect of the battle between man and woman called love. sential elements of his future style appear in it. The paintings were organized into 4 themes: Love’s Awak- Munch felt that God should have averted these fam- ening, Love Blossoms and Dies, Life Anxiety (Fear of Life), ily disasters. He ultimately rejected traditional religion, ini- and Death. The Scream and Anxiety (Angst) were in- tially adopting a philosophical view of life based on the cluded in the Life Anxiety section. Norwegian writer Hans Jaeger’s dictum of the primacy of Of The Scream, Munch wrote, personal experience. Jaeger was an anarchist who advo- cated an antibourgeois lifestyle of emancipation and free- I was walking along the road with two friends. The sun set. dom focused on sexual liberation, social equality, and the I felt a tinge of melancholy. Suddenly the sky became a bloody red. I stopped, leaned against a railing, dead tired (my friends rejection of Christianity. Subsequently Munch, like Søren looked at me and walked on), and I looked at the flaming clouds Kierkegaard (The Concept of Anxiety; Fear and Trembling) that hung like blood and a sword...over the blue-black fjord and Henrik Ibsen, acknowledged anxiety as an existen- and the city. My friends walked on. I stood there trembling with tial problem. In later life, he carefully read Kierkegaard and fright. And I felt a loud unending scream piercing nature.1(p90) spoke of the similarities in their views. Munch never mocked religion and strove, as had Vincent van Gogh and Munch wrote that he painted the sky like real blood, Paul Gauguin before him, to make his personal experi- with the colors screaming. The universal appeal of this ences and spiritual longing the focus of his art.3 work may lie in its synesthetic effect linking the visual (REPRINTED) ARCH GEN PSYCHIATRY/ VOL 61, JAN 2004 WWW.ARCHGENPSYCHIATRY.COM 15 ©2004 American Medical Association. All rights reserved. Downloaded From: https://jamanetwork.com/ on 09/29/2021 image, emotion, and hearing; the colors spread out on by looked so strange and odd, and he felt they were all staring the canvas like sound waves. The viewer is drawn to the at him, all these faces pale in the evening light.5(p40) expression of anguish in the face of the central figure, and likewise, in Munch’s description of the painting, the Munch was prone to emotional instability and ago- 6 reader to his refrain: “My friends walked on.” Munch is raphobia, describing himself at the breaking point at the referring to a dramatic sunset along the Oslo fjord that time he painted The Scream. He worried about his fa- often occurs in late autumn after heavy rains, when the ther’s nervousness and religious melancholia and his sis- sun shines on the clouds and mist, producing stripes and ter’s mental health. Her mental illness was diagnosed while tongues of intense reds in a blue sky. He experienced panic he was working on his Frieze of Life; she, like his grand- when the red color reminded him of coagulated blood. father, died in a mental institution. Despite Munch’s symp- Subsequently he told a patron that at the time he had “a toms of anxiety and psychodynamic speculation about 7 great fear of open spaces, found it difficult to cross a street his life story, his creativity allowed him to transform these and felt great dizziness at the slightest height.”4(p67) experiences into art and become one of the best-known Painted a year later, Anxiety depicts the same land- painters of his time. scape, style, and colors. The same 2 ships are shown in In the immediacy of his imagery, Munch vivifies perspective, suggesting that the figures are standing those moments of existence when we are confronted by farther down on the same bridge. An advancing crowd indifferent forces of nature at times of separation or loss. of people dressed in black have replaced the screaming Ultimately his art focuses on an individual’s confronta- figure. The wide-eyed, green-faced, anonymous crowd tion with his or her own natural limitations. How does is like that shown in an earlier painting, Evening on Karl one face love and death while maintaining a sense of in- Johan Street (1892). Anxiety is a composite of that paint- tegrity? He sees sexuality and death as encroachments ing and The Scream, but now Munch shortens the view- on self-conscious identity and a threat to the coherence 8 er’s perspective, lowering the point of view so that the of the self. For Munch, dignity could be maintained with viewer is face to face with the crowd. an acknowledgment of life’s uncertainty when lacking the In his autobiographical St Cloud Manifesto5 (1892), capacity to master its demands. Munch links his anxiety to the pains of love as he de- James C. Harris, MD scribes a fleeting encounter with his estranged married lover, Milly Thaulow, whom he refers to as “Mrs Heiberg.” The narrative is directly relevant to Anxiety, in which REFERENCES the woman in the foreground with the bonnet and fac- ing the viewer is probably Mrs Heiberg. What is striking 1. Stang R. Edvard Munch: The Man and His Art. New York, NY: Abbeville Press; 1977. 2. Heller R. Edvard Munch. The Grove Dictionary of Art Online [Oxford University is the silence he feels as he is seemingly dissociated from Press]. Available at: http://www.groveart.com. Accessed October 30, 2003. his emotions, as these haunted faces pass by and stare: 3. Howe J. Munch in context. In: Edvard Munch: Psyche, Symbol and Expression. Boston, Mass: Boston College, McMullen Museum of Art; 2001:11-19. Never before had he seen her so beautiful. She greeted him with 4. Heller R. Munch, The Scream. New York, NY: Viking Press; 1972. a weak smile and went on....Hefelt so empty and alone. Why 5. Nahum K. In wild embrace: attachment and loss in Edvard Munch. In: Howe J, did he not stop and tell her that she was the only one...that ed.