The following paper is a case analysis of Ernest Hemingway’s bipolar disorder. The paper uses a psychodynamic model to discuss treatment, symptoms, and diagnosis. The case study uses the concepts of abnormal psychology to trace the etiology of a mood disorder beyond just the vestiges of uncommon behavior. The paper argues that he suffered from a mood disorder. His problems were exacerbated by alcoholism and a tendency to exhibit bipolar mood swings that contributed to his suicide. He was most likely motivated to rescue himself from an overprotective mother and a cold and disciplinarian father.
The task of the psychoanalyst is to help the patient uncover their unconscious desires by analyzing their dream content, or what they say in free association in the therapy context. Freud teamed up with Josef Breuer to develop a variation of the hypnosis treatment that Mesmer and Charcot had developed, but they devised a way to have a patient talk about their problems while in a highly agitated hypnotic state (Barlow, 2013, p. 17). Using the method of free association, Freud had discovered “the unconscious mind and its apparent influence on the production of psychological disorders” (p. 17). The second discovery of Freud is the realization that reliving past trauma in the safe environment of the therapeutic environment can be helpful for patients. In therapy, the patient releases emotional tension and experiences catharsis.Freud took these basic observations and construed a psychoanalytic model to treat disorders and to speculate on the etiology of dysfunction.
Hemingway had a conflicted relationship with his mother. She showered affection on him when he was young, which formed a close, codependent bond. As Hemingway grew older he desired to emulate his father who was more masculine and independent. Coupled with the fact that he was twinned with his sister, He struggled throughout his life to become free of his mother’s influence and to embrace an ersatz machismo that covered up his tendency to depression. When his father committed suicide, this must have been a devastating event in the life of Hemingway which forever marked his psyche and his mental health.
Since there are no extant scripts of Hemingway in therapy, nor is there any evidence that he went to a therapist, the task of this paper is to draw up an as-close-to realistic psychodynamic portrayal of Hemingway using knowledge of his life, written examples, and interpretation drawn from what he wrote, the events of his life, and his behaviors.
Ernest Hemingway was born in 1899 in Oak Park, Illinois, and he died of suicide on July 2, 1961. He had four wives and sired three children in total: Jack Hemingway, Gregory Hemingway, Patrick Hemingway. He wrote seven novels and a series of non-fiction collections and many collections of short stories. He was a prolific writer, and he won the Nobel Prize for Literature in 1954 for his contribution to literary excellence. He grew up in Oak Park, Illinois. He grew up in a fairly conservative upper middle-class environment. His father was a physician, and his mother taught music. Ernest excelled in his school studies and was also musically inclined. His mother dressed him and his sister Marcelline to look like twins (Wagner-Martin, 2007, p. 14.) The siblings were not twins, but the two were only a year apart in age. Since Marcelline started school later, Ernest and Marcelline entered school together as if they were twins (Wagner-Martin, 2007, p. 1).
When young Ernest was not in school, he and his family vacationed in the Summer in a cottage they owned on Lake Walloon in Michigan. Since Marcelline was not into sports, the young Hemingway enjoyed the private time he was able to spend with his father who taught him how to use firearms responsibly and to hunt and fish. Hemingway would carry with him throughout his life a constructed masculinity with other men, and a sensuousness with women, while in public life constantly seeking the attention of the media (Wagner-Martin, 2007, p. 10). Hemingway also befriended an older, more liberal couple at their family Summer location. They taught him about art and letters. He cherished the time he spends on the lake. He was introduced to arts, literary life, and intellectual conversation early on in life.
He served as a Red Cross volunteer during the First World War in Italy, driving an ambulance, and he worked in a canteen, all of which would become the source material for his novel Farewell to Arms (Kramer 2007). He injured himself in Italy, which would change his life forever. He often referred to his time in Italy in his writings. Upon returning home, he refused therapy to rehabilitate his injuries, and insisted on partying to the dismay of his father who called him a wastrel (Wagner-Martin, 2007, p. 18). Hemingway broke away from his family’s expectation to go to college. Hemingway eschewed college life to become a writer, and he and his first wife Hadley, moved to Europe, and lived the life of an ex-patriot. His life as an ex-pat is the source material for his novel The Sun Also Rises. Hemingway returned to the United States in 1927. As an adult, Hemingway became more and more distanced from his family. His father committed suicide in 1928 when Hemingway was in his early 30s. He travelled extensively throughout his life. In the 1930s he returned to Europe and covered the events of the Spanish Civil War as a reporter. He used his experiences to write the novel For Whom the Bell Tolls. In the 1940s, Hemingway had become an American celebrity; he was known for his colorful lifestyle and enjoyed presenting a machismo self-image. In The Old Man and the Sea, Hemingway writes about an old fisherman who tries to catch a marlin. The story is about getting older and accepting one’s fate. The fish is eaten by sharks. In the 1950s Hemingway suffered health problems, and he committed suicide on July 2, 1961 (Kramer 2007).
Literature Review
The Literature on Ernest Hemingway’s mental health tends to focus on his struggle with depression, his alcoholism, and his prevalence for mood disorders. Literary biographers like Lynn and Wagner-Martin stress Hemingway novels of similar Hemingway characteristics and link his traumatic life in wartime with his fiction. Farewell to Arms is a cover for a man dealing with the trauma of war, while Sun Also Rises, deals with the transition of leaving one’s bourgeoisie lifestyle. Old Man and the Sea is prescient because it deals with Hemingway’s impending death and how he views fate as the final determine factor on what constitutes life. Kramer gives a decent timeline of Hemingway’s life. Moddelmog’s helps link Hemingway’s bouts with anger to depression.
Freud developed a psychodynamic model of the mind that is useful to explore the etiology of mental disorders. The superego, the id, and the ego is helpful to form a basis for interpretation (Barlow, 2013, p. 18). Freud’s tripartite theory of the mind is based on the fact that the mind is not a unity that works in harmony. The psychic life is made up of deep instinctual desires and passions. However, since we live in a society with its norms for behavior, we as human beings are forced to negotiate and compromise our desires. As a child, Hemingway was given unfettered access to his mother’s “pillowy breasts” (Lynn, 2002, p. 43). He fed whenever he wanted and slept in the same bed as she for six months.The weaning process was perhaps very difficult for him, and this separation from the mother made it more difficult for him to create a balanced impulse control. In Freud’s theory, the id is the basic drives. The Ego is what we call the conscious mind; it is what we think of when we think of the self. In Freud’s theory, the ego is always in conflict with the superego and the id. This is a normative model for human development; all of us are faced with conflict. In the mentally ill mind, there is a tendency for the tripartite model of the psyche to collapse. It does not work as it should.
Hemingway constantly dealt with the solitude required to be a writer, and the rich social life he desired. His fiction is often written in spare prose, which some commentators have suggested is his tendency to remove details from his writing. Even though commentators have suggested that Ernest Hemingway is the main protagonist in all of his writing, it is ironic that Hemingway wrote in such a way to eliminate details about setting, family background, and such on his characters. It is possible to interpret this as his way to escape the conservative provincialism of Oak Park with its strict Protestant Conservative values. Clarence, his father, was a disciplinarian and used corporal punishment, while his mother was not loath to punish her children and often found their indiscretions amusing.
Coupled with his alcoholism, Hemingway’s life was marked by a bevy of risk-taking endeavors. Moreover, he, of course, took on the dangerous job of driving an ambulance in war-torn Italy and ended up injuring himself. In fact, if you look carefully at his life, he was often getting injured. From a psychodynamic approach, one ought not to overlook these “minor accidents” but to look at deeper unconscious motivation. He injured his eye when his son poked him, and in an unusual accident the glass of the skylight broke when he opened it causing him to have a major cut (Wagner-Wartin, p. 33).
Symptoms and Diagnosis
Symptoms of his mental health issues can be traced back to his childhood and adolescent in Oak Park, Illinois. The life in Oak Park with its strict governance and rules of decorum shaped Ernest’s superego. The superego is the section of the brain responsible for morality and following social decorum. In abnormal psychology, usually breaking social conventions are considered breaches of the superego. While not all unconventional behavior is abnormal, it is certainly cogent in Hemingway’s case that he sought to find a way to escape from what he perceived to be an oppressive life of upper-middle class bourgeois values. He chose the life of the artist-cum-writer. However, one symptom of an overactive id is lack of impulse control.
Hemingway was irritable and often had loud outburst (Moddelmog, 2013, p. 212). He lashed out at friends and loved ones. While we do not have a record of his dreams, Hemingway suffered from insomnia and had frightful nightmare — due to the trauma he experienced during the war (Moddelmog, 2013, p. 209).but also due to his underlying lack of ego-control, to balance the oppressive superego on the one hand and the id on the other. The superego is supposed to counteract the violent nature of the id, but in Hemingway’s case it did not mediate successfully (Barlow, p. 18-19).
Hemingway undertook risk-taking behavior, some not very subtle, and other more subtle. Ernest drank a range of alcohol, everything from absinthe to liquor (Wagner-Martin, 2007, p. 87-88). As Martin has disclosed, Late in life, “Hemingway also developed symptoms of psychosis likely related to his underlying affective illness and superimposed alcoholism and traumatic brain injury” (2006, p. 351). But even before his psychotic breakdown due to the comorbidity of alcohol consumption, Hemingway had a heightened sense of masculinity is closely associated with aggression, and he may have had a low serotonin activity which could explain the predisposition to suicide in his family (Barlow, p. 48). Hemingway’s alcoholism would take a toll on him, and he was most likely an alcoholic. His body was undergoing the debilitation of alcoholism (Wagner-Martin, 2007, p. 155). According to Barlow, he probably has a tendency to vulnerability that caused an uptick in his drinking (p. 37). Moreover, Barlow also links depression to alcoholism.
One major indicator of suicide in men is hopelessness (Barlow p. 60). Hemingway killed himself most likely because he believed that his body had been beleaguered, and he had no more hope for living a healthy prolonged life. Perhaps he felt he had to punish himself for the “sins of his father,” and he may have had lingering guilt about his father’s suicide. Hemingway’s proclivity to risk-taking behavior, his habitual drinking, his frenetic unstable lifestyle choices, and his underlying depression caught up with him. As he grew older he was unable to stave off his mental illness, and eventually the depressive symptoms overtook him and he was longer able to find coping mechanisms.
Application
It is hard to know whether Hemingway suffered from a Major Depressive disorder or an underlying dysthymia that was exacerbated by life events. He may have suffered from double depression, which means he underwent major depression and dysthymia during alternating periods. Another possible diagnosis is bipolar, which more accurately depicts the life of Hemingway. According to the Diagnostic Statistical Manual of Mental Disorders (DSM), Hemingway is typical of bipolar, offset by severe mood swings. Bipolar is characterized by severe mood swings of depression coupled with manic episodes. In the depressive stage, the person is wrought with the desire to take on risky behavior while in the depressive stage they have difficulty getting out of bed (Barlow, 2013, p. 209-210).
The DSM breaks bipolar into two types: type one and type two (p. 209). Type one bipolar His life is one emotional roller coaster that he tried to use defense mechanisms of excessive masculinity to hide. In fact, defense mechanisms are a common way people fight their inner, unconscious impulses (Barlow, 2013, p. 19). While a psychodynamic approach, when applied, could probably give Hemingway some insight into his behavior, people with bipolar are difficult to treat in traditional psychoanalytic sessions. The most common treatment for mood disorders is medication, and cognitive-behavior therapy has been shown to help people develop coping mechanism to deal with the disease.
However, a psychodynamic application could have helped Hemingway during two critical junctures of his life. First, he could have sought treatment with an analyst when he returned home from the war. His father Clarence noticed that he was not coping well with his return, but he refused to get help. Psychodynamic treatment could have helped him to free associate and to unlock the deep stressors that the war had caused. By not dealing with his underlying issues. he bottled it up inside and resorted to risk-taking behaviors that ended up doing more harm than good.
Second, he could have benefited from therapy when his father committed suicide. The life-shattering event could have helped Hemingway process through some of his emotions. Talk therapy could have helped him shake off the guilt he may have felt about his father’s death. It also could have reduced the need to undertake very risky behaviors, or to experience the hopelessness he felt like an older man. By the time alcoholism had infected his body, a psychodynamic treatment would probably not have been as effective because the degenerating effects of over-consumption of alcohol would have taken its course on his body. The earlier intervention methods would have been better treated early on. If Hemingway's parent had sent him treatment him as an adolescent, he would have been able to see what his true desires were, and not have been so stricken with wanderlust as an adult. If Hemingway had received treatment as a child he might have been able to help himself not demonize his parents, or to help him see that his parents had completely different personalities.
Conclusion
In conclusion, it is difficult to determine how much a psychodynamic psychotherapy would have benefited Ernest Hemingway. On the one hand, he was an artist and a writer, and he sublimated his mental health issues and funneled otherwise negative energy into creating beautiful literary works of art. Hemingway would probably be horrified by the suggestion that his work is due to his unresolved psychic issue. At the heart of his problems seems to be the unresolved issues with his mother and his inability to fully process the untimely suicide of his father.
However, examining his life shows that he suffered from a mood disorder. Part of his mood disorder is most likely biological in nature. He was genetically prone to addiction to alcohol, and his tendency toward bipolar equivocated his desires and sent him on endless searches for the next exciting adventure. In a way, his life was one emotional roller coaster after another. The problem is that there was probably not much happiness in the fulfillment of one activity from the next for Hemingway. Ernest Hemingway was driven by a repetition to repeat past traumas, both in his writing, his personal life, and in his travels.
References
American Psychiatric Association., & American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders: DSM-IV-TR. Washington, DC: American Psychiatric Association.
Barlow, D. H., & Durand, V. M. (2014). Abnormal psychology: An integrative approach. Seventh Edition.
Kramer, Victor Ph.D., Professor of English, Georgia State University (2007). Ernest Hemingway (1899-1961). World Book Encyclopedia. World Book, Inc. Retrieved online from PBS: The American Novel.
Lynn, K. S. (2002). Hemingway. Cambridge, Mass. [u.a.: Harvard University Press.
Martin, C. D. (2006). Ernest Hemingway: A psychological autopsy of a suicide. Psychiatry: Interpersonal and Biological Processes, 69(4), 351-361.
Wagner-Martin, Linda (2007). Ernest Hemingway: A Literary Life. New York: Palgrave Macmillan.
Moddelmog, D., & Del, G. S. (2013). Ernest Hemingway in context. New York: Cambridge University Press.
