The Molecule of More

Before the psychiatrist met his patient, a twenty-year-old college student 
named May, her father came in to prepare the doctor for his first appoint-
ment with her. “She has never given us any trouble before,” he said. “She’s 
a good girl.” May had been the perfect student. She was valedictorian of her 
high school class and had been admitted to a prestigious program of study at 
a nearby university. She had never gotten into trouble of any kind: no drugs, 
no alcohol, no staying out late. She had always been respectful toward her 
immigrant parents and had lived up to every expectation they had for her. 
Now she was being discharged from the hospital after a suicide attempt that 
had put her in the intensive care unit for a week.
When May came in for her initial visit, she was 30 minutes early 
and waited patiently in the reception area for her turn to see the doctor. She 

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CREATIVITY AND MADNESS
was slender, dressed as if she were going to a job interview. Her voice was 
hushed. Sometimes it was hard to hear what she was saying. It was as if
she didn’t believe the things she had to say were important enough to be 
spoken aloud.
May told the doctor that she couldn’t concentrate, couldn’t sleep, and 
sometimes cried for hours at a time. She had stopped going to class, and 
spent all day in her bedroom with the shades pulled down. It was clear that 
she couldn’t function in the high-stress environment of the intensive course 
of study she had signed up for, and she had taken a leave of absence. More 
than anything else, she felt guilt. Always the perfect daughter, she now 
believed she was a source of shame to her family.
When May’s family had first come to the United States she was just 
a girl, but she learned to speak English quickly, and became responsible for 
taking care of the entire family. She made sure the utility bills got paid. She 
called a plumber when the sink backed up. And when her parents fought, she 
was the referee. She believed that the happiness and success of her family lay 
on her shoulders. She had to be a straight-A student. She had to be thin and 
well-dressed. She wasn’t allowed to rebel like other adolescents. She always 
had to do what she was told and was never allowed to disagree.
Her doctor expected her to respond well to treatment. She was cooper-
ative and smart. But no matter what he did, nothing changed. Her depres-
sion wouldn’t go away. When her leave of absence came to an end, May 
withdrew from school.
It was a long time before May revealed her secret. She was abus-
ing amphetamines. It was the only way she could keep up with her stud-
ies, maintain a weight that was acceptable to her mother, and manage all 
the chores associated with the family responsibilities she had taken on. It 
worked for a while, but it was a coping mechanism that was destined to fail. 
There were emotional problems, too. Having missed out on normal teenage 
rebellion, a confusion of anger and resentment swirled inside her, and she 
didn’t know what to do with those frightening feelings. Ultimately, the only 
possible treatment for her was moving to a different city. She needed to put 
many miles of distance between herself and her family before she could 
begin to figure out who she was.

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THE MOLECULE OF MORE
How well our models fit the real world is of great importance. If our 
models are poor, we will make bad predictions about the future and 
subsequently bad choices. Poor models of reality may be caused by 
many things: not having enough information, difficulty with abstract 
thinking, or the stubborn persistence of wrong assumptions. Such 
bad assumptions may be so harmful that they lead to psychiatric ill-
nesses such as anxiety and depression. For example, if a child grows 
up with critical parents, she may develop the conviction that she is an 
incompetent person, and this belief will shape the models of the world 
that she creates all her life. Therapists can address these faulty, often 
unconscious assumptions through psychotherapy, which may include 
insight-oriented psychotherapy, in which the patient and the thera-
pist work to uncover suppressed memories that locked in the negative 
assumptions. Another helpful technique is CBT, which addresses the 
assumptions head on, and teaches the patient practical strategies for 
changing them.
As we gain experience with the world, we develop better and better 
models, and this is the basis of wisdom. We embrace models that work 
well, and discard the ones that fail to take us where we want to go. 
Knowledge passed on from previous generations can help us improve 
our models in a different way than direct experience. We have folk wis-
dom that tells us “a stitch in time saves nine,” as well as the inherited 
knowledge of the great scientists and philosophers.
BREAKING MODELS: STARTING DOWN 
THE PATH OF CREATIVITY