Sarah Raphael, Migraine and Me

By Debbie Ayles and Klaus Podoll

"I first came across the artist Sarah Raphael", remembered Debbie Ayles, "when I went to London to see the NatWest Art competition in 1996. Sarah Raphael had won the £36,000 first Prize that year with a painting from her Desert series, inspired by her travels in the Australian outback. I was overwhelmed by the hypnotic nature of the work, its colour and intensity.

Sarah Raphael, Sometimes a River (1), 1995. © 2007 Agnew's Gallery

The next time I noticed her name was two years later, when I saw the remarkable 'Strip Page 3' painting, advertising the 'Strip!' exhibition at Marlborough Fine Art (London). The work had changed into a fantastic comic-strip format of hundreds of tiny squares, rectangles, stars and triangles filled with brightly coloured patterns, shapes, empty speech bubbles questioning meaning and narrative.

Sarah Raphael, Strip Page 3, 1996. © 2007 Estate of Sarah Raphael, Courtesy of Marlborough Fine Art (London) Ltd.

Coincidentally that October I read an article in the Weekend Telegraph entitled 'My eighteen-month migraine', describing her horrendous pain and suffering due to migraine and how it influenced her work (Gregson, 1998). Suddenly my interest in her and her work became more significant. Being a migraine sufferer myself for many years it had become a terrible affliction about that time affecting my own life and painting, so I was naturally fascinated to learn how another migraineur was coping.

Having embarked upon a fine art degree in 1999 I began an investigation into something called Migraine Art which I had discovered by chance when I joined the Migraine Action Association in an attempt to get some support for the fortnightly migraines that were flooring me for three days at a time. This led to my meeting Dr Klaus Podoll, a neurologist interested and knowledgeable in the subject. Dr Podoll has found and suggested many links between migraine and creative genius in other artists such as de Chirico, publishing many papers and recently, jointly with Ubaldo Nicola, a book 'The aura of Giorgio de Chirico mdash; Migraine Art and metaphysical painting' on the subject. Realising that my own work and working practices were immensely influenced by migraine, I decided to research further into Sarah Raphael, her images and comments on migraine to see how its symptoms and the paintings were linked. And then, in January 2001, came the shock news that she had died.

Dr Podoll and I have since collaborated on many papers for medical journals regarding artists influenced by migraine. With the new exhibition of Raphael's work, 'A Survey of Work from 1994-2001' at Marlborough Fine Art (London), and another opportunity for the public to enjoy the colours, patterns and enigma of her images, here is an expanded version of a paper published in the Journal of the Royal Society of Medicine in 2002. This gathers together various sources of information and investigates a potential link between migraine and Raphael's inspiration endeavouring to show another aspect of this artist who so sadly was unable to continue along the path she had begun."

Several art critics have noted the similarity between the imagery of the 'Strip!' paintings and certain types of universal visual perceptual experiences, the so-called phosphenes which can occur in a great variety of conditions and are hence known, potentially, to everyone (for example from hallucinations seen in the twilight periods of approaching or ending sleep). According to Jennifer Hall, the 'Strip!' paintings "in vivid technicolour" are "Reminiscent of Hergé on acid", suggesting a resemblance between Raphael's comic-strip patterns (her work being likened to Hergé's Adventures of Tintin) and psychedelic hallucinations such as those induced by lysergic acid diethylamide (LSD). According to Andrew Motion, their "unrecognisable shapes" are "like the shapes which appear when you rub your eyes too hard", the so-called pressure-induced phosphenes ("seeing stars"). "Or maybe", the Poet Laureate continued, "like the start of a headache, before the pain starts" mdash; a clear reference to the so-called migraine aura, characterised by a variety of neurological symptoms (mostly visual disturbances) which can herald the headache of a migraine attack. Similarly, Geordie Greig noted that "There is a blurring, a dizziness, an intensity, but no one single focus" in Raphael's 'Strip!' images, suggesting that "This all brings us back to her migraine" (or more precisely, her visual migraine aura). We now know that migraine experiences have acted as a source of artistic inspiration not only in the past but also in contemporary artists, so the notion of a possible impact of Raphael's migraine on her art merits further consideration.

The history of Sarah Raphael's migraine can be reconstructed from a number of articles based on interviews given by the artist on the occasion of her said 'Strip!' exhibition. Aged 15 or 16, she "began to get unusually bad headaches, but it wasn't until she was 21 that she experienced her first full-blown migraine. 'I remember this friend coming round to see me, and, while she was talking, feeling myself close down, and this incredible pain take over', she says. 'After she'd gone, I lay on the ground in floods of tears banging my head on the floor. I phoned Paul, my brother, who came round with codeine, and eventually it went away.' Over the next 15 years, she began to learn what triggered the headaches, although headache is too genial a word for the 'absolute revolt of the nervous system' she feels during an attack. In her case, she had to cut alcohol, coffee, wheat and cheese out of her diet. She tried 'every kind of alternative therapy: acupuncture, osteopathy, Chinese herbs, yoga'. Some eased the situation, but none cured her" (Gregson, 1998). "At Camberwell her terrible headaches were first diagnosed as migraine, a complaint that dogged her life as an artist, causing her such pain that she had to give up work for a couple of years both then, and later with the birth of her third daughter, Rebecca" (Barnes, 2001). "It was when she was pregnant with... Rebecca, in 1996, that the full force of the condition struck and Sarah experienced a terrifying continuous migraine" (Gregson, 1998). "I basically had them non-stop", she told, "which made me insane. I couldn't see properly, couldn't stand noise, bright lights or any kinds of movement. I didn't stop painting straight away, but it slowed down till I was in bed in a blacked-out room, taking large amounts of Pethidine [a narcotic painkiller] and not having a life" (Petrovic, 1998). Thus, "A blinding migraine meant Sarah Raphael could barely leave her sick bed for almost eighteen months" (Greig, 1998). In summary, the available information strongly suggests a diagnosis of migraine with aura, although there is a sad lack of description of the visual aura phenomena experienced by the artist during her attacks of a "blinding migraine".

According to John Russell Taylor's obituary of Sarah Raphael, "Her struggles with ill-health of various kinds, all of them rooted in migraine, inevitably led to speculation about a connection between her artistic obsessiveness and her malady. Curiously, though, knowledge of her illness throws very little light on her painting itself". However, Julia Gregson made a general claim that "The story of Sarah Raphael's pain, and her addiction to pethidine, is told in her painting", but she remained vague as to how exactly migraine was assumed to have influenced Raphael's 'Strip!' images. In more detail, Geordie Greig suggested that "Courageously and cleverly, she turned this [i.e. her blinding migraine] to her professional advantage by making comic-strip paintings on which she could work just a little bit at a time. She could manage only short periods of work before the pain became too much. This meant that large single-image pictures were too demanding. Her new, detailed and painstakingly constructed works constitute 'Strip!', her first exhibition at Marlborough Fine Art". Rada Petrovic provided further information confirming that "Raphael devised a migraine-friendly working method. The hundreds of tiny, individual pictures that comprise these paintings lent themselves perfectly to working in staccato fashion mdash; her only real option. 'I was only able to do bite-sized sections, because I could do them one at a time.' Raphael also had to give up her favourite medium, oil paint, as the smell of linseed and turps became a relentless trigger for new migraine attacks. In came flat, harsh but mercifully fragrance-free acrylic paints (some would say a much more appropriate medium for the pop-artish flavour of the new works, anyway)".

These accounts emphasize the impact of migraine on Raphael's art by means of the restrictions the illness may have imposed upon her choice of art media and art-making practices. Similarly, a Migraine Masterpieces competition organized in 1997 by the National Headache Foundation in the USA provided evidence to the effect that migraine patients/artists often manage their pain by changing art materials and methods mdash; e.g. "switching from techniques that require high levels of precision and avoiding materials with noxious fumes" (Vick and Sexton-Radek, 1999).

Sarah Raphael, Strip Page 5, 1997. © 2007 Estate of Sarah Raphael, Courtesy of Marlborough Fine Art (London) Ltd.

However, a closer inspection of Sarah Raphael's 'Strip!' paintings indicates that her "blinding migraine" may have influenced her art also in a more direct way. "As 'Strip!' testifies", wrote Rada Petrovic, "migraines ain't all bad. 'This work should have been a lot more dark and interior than it is,' says Raphael. 'I painted these coming out of the most horrific period of my life, but ironically, they are more playful and effervescent than anything I've done before.''' In four 'Strip!' pictures, the regular grids arranged by tiny boxes (Strip Pages 5, 7 and 9) or repetitive images of unrecognisable objects (Strip Page 8) are superimposed by large zigzags enclosing an oval-shaped area displaying some obscuration or alterations of colour, reminiscent of the form and other phenomenal features of the so-called fortification spectra which represent a common type of visual aura symptom in migraine, so named after its similarity to the map of the bastions of a fortified town as viewed from above. Perhaps such symptoms of Raphael's "blinding migraine" were exploited as a source of artistic inspiration in her 'Strip!' paintings produced during her eighteen-month migraine. Such action is by no means uncommon in migraine patients/artists. It can be seen from the aforementioned Migraine Masterpieces competition where about one quarter of those sufferers who experienced visual aura symptoms said they deliberately depicted these phenomena in their art.

Sarah Raphael, Strip Page 9, 1998. © 2007 Estate of Sarah Raphael, Courtesy of Marlborough Fine Art (London) Ltd.

According to Andrew Motion, Sarah Raphael's development had taken her "from naturalism to abstraction, from outward looking to inward gazing". In 1998, the artist recorded, "I came to abstraction reluctantly. It was never my intention" (Greig, 1998). Indeed, critics of Raphael's Desert paintings series have noted that these achieved a provocative synthesis of figurative and abstract art. "They are, on one level, works of brilliant hyper-realism... And, on another level, the paintings take on the eerie and quasi-mystical properties of colour field abstraction" (Boyd, 1995). Our study suggests that such synthesis can also be found at the heart of 'Strip!' and her later groups of work, where figurative representations of geometric patterns of migrainous origin, subjected to the artist's practice to "gaze upon an object and paint it as truthfully as I can" (Motion, 1998), are amalgamated with the abstract imagery of "stripped-down forms, objects with just a hint of familiarity but from which any immediate identity has been pared away" (Greig, 1998).

Joost Haan on Migraine as a Muse

On September 12, 2009, in a lecture delivered at the 14th Congress of the International Headache Society in Philadelphia, Joost Haan, coauthor of a book on Migraine as a Muse (Haan and Meulenberg, 2009), suggested that "the works of ... artists, such as ... painter Sarah Raphael, have helped physicians experience illness through the eyes of migraineurs ... 'The visual aura of migraine is a subjective phenomenon mdash; what the migraineur experiences is necessarily inaccessible to others,' Haan said. 'By drawing, migraineurs can show us what they see and what they feel. Painting is useful in understanding and diagnosing migraine.'" (Partridge, 2009).

Identifying Sarah Raphael's migraine experiences as a source of her artistic inspiration does by no means demystify or etiolate her art in a reductionistic way, but rather enriches our appreciation of its complexities and beauty. "I loathe the idea of art being a vomiting forth of one's deepest miseries and neuroses" (Petrovic, 1998), she said in an interview, expressing a point of view which is not at all at variance with the notion that she has spiritually transformed her migraine experiences in her art. As Frederic Raphael has put it in a personal communication to Debbie Ayles dated 23 May 2002: "... while Sarah was indeed a migraine sufferer (so was I in my earlier years, and still very occasionally), I do not accept that her work was the consequence of migraine, more that it was, at times, accompanied by migraine. Sarah was an artist of some power and rare imagination before she suffered from migraine. There are, somewhere, some drawings she did literally of her headaches, but I do not see a causal relation between her pain and the beauty she created... I mention this not to be disagreeable, but to clarify a point which, in the present world, where everything tends to be deemed the result of some psychological wound, or a response to it, is often missed: art is not, in my view, explained by its 'sources', whatever they are. Many have migraine, not all turn into Sarah Raphael...", who will be remembered not for her migraines, but for her achievements as one of the outstanding artists of her generation.

First published on-line by NY Arts Magazine, July 30, 2003.

References

Barnes R. Sarah Raphael. The Guardian, 8th January 2001.
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Gregson J. My eighteen-month migraine. The story of Sarah Raphael's pain, and her addiction to pethidine, is told in her painting. Weekend Telegraph, 31st October 1998, 3.
Greig G. Empty speech bubbles. Sarah Raphael's surprising foray into abstraction marks an about-turn by an artist easily bored by standing still. Modern Painters 1998; 11 (no. 4): 82–84. (PDF see here)
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