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J R Soc Med. 2002 August; 95(8): 417–419.
PMCID: PMC1279971

Inspired by migraine: Sarah Raphael's ‘Strip!’ paintings

Sarah Raphael (1960-2001), who during her short career made her name as one of the leading British artists of her generation, first became known during the 1980s as a figurative and portrait painter, but from the mid 1990s her artistic development moved from naturalism towards abstraction. This change in her work started with her Desert paintings series, inspired by her travels in the Australian outback, for which she won the £36 000 NatWest 90s Prize For Art in 1996. It culminated in her series of ‘Strip!’ paintings presented in her 1998 exhibition at Marlborough Fine Art Gallery, London, featuring a comic-strip format with hundreds of tiny images of brightly coloured shapes devoid of meaning and narrative.

Several art critics have noted the similarity between the imagery of the ‘Strip!’ paintings and the phenomenon of phosphenes1. According to Jennifer Hall2, the ‘Strip!’ paintings ‘in vivid technicolour’ are ‘Reminiscent of Hergé on acid’ (LSD-induced visual hallucinations). According to Andrew Motion3, their ‘unrecognisable shapes’ are ‘like the shapes which appear when you rub your eyes too hard’ (pressure-induced phosphenes). ‘Or maybe like the start of a headache, before the pain starts’ (the aura heralding a migraine attack). Similarly, Geordie Greig4 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’. We now know that migraine experiences have acted as a source of artistic inspiration not only in the past5,6 but also in contemporary artists7,8, 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 several non-medical articles3,4,9,10,11,12 based on interviews given by the artist on the occasion of her ‘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... 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’9. ‘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’10. ‘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’9. ‘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 kind of movement’11. Thus, ‘A blinding migraine meant Sarah Raphael could barely leave her sick bed for almost eighteen months’3. ‘During her illness, the nausea and pain were so tyrannical that she relied heavily upon the painkiller pethidine’4, which led to an addiction9 that in turn had to be treated. In summary, the available information strongly suggests a diagnosis of migraine with aura13, 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's13 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’. Julia Gregson9 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 Greig4 suggested that ‘Courageously and cleverly, she turned this [i.e. her blinding headache] 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 Petrovic11 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—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...’

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—e.g. ‘switching from techniques that require high levels of precision and avoiding materials with noxious fumes’14.

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. In four ‘Strip!’ pictures, the regular grids arranged by tiny boxes (Strip Pages 5, 7 and 9) or repetitive images of unrecognizable objects (Strip Page 8) are superimposed by large zigzags enclosing an oval-shaped area displaying some obscuration (Figure 1) or alterations of colour (Figure 2), reminiscent of the form and other phenomenal features of Gowers'15 fortification spectra (Figure 3) which represent a common and almost pathognomonic type of visual aura symptom in migraine. We suggest that such visual aura symptoms of Raphael's ‘blinding migraine’ were exploited as a source of artistic inspiration in the ‘Strip!’ paintings produced during her eighteen-month migraine. That such action is by no means uncommon in migraine patients/artists can be seen from the Migraine Masterpieces competition14 where about one-quarter of those sufferers who experienced visual aura said they deliberately depicted these phenomena in their art.

Figure 1
Sarah Raphael, Strip Page 5 (Detail), 1997/98, acrylic on canvas with papier maché collage
Figure 2
Sarah Raphael, Strip Page 8 (Detail), 1998, acrylic on canvas with papier maché collage
Figure 3
Zigzag fortification spectrum illustrated in an entry in the national Migraine Art competition

In 1998, Sarah Raphael recorded, ‘I came to abstraction reluctantly. It was never my intention’4. 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’16. The present study suggests that such synthesis can also be found at the heart of ‘Strip!’, 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’3, 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’4.

Acknowledgments

Figures Figures11 and and22 are reproduced by permission of Marlborough Fine Art (London) Limited. Figure 3 is reproduced by courtesy of the Migraine Action Association and Boehringer Ingelheim UK Ltd.

References

1. Oster G. Phosphenes. Sci Am 1970;222: 82-7 [PubMed]
2. Hall J. Artist of the month: Sarah Raphael. Tatler 1998;293(No. 10): 70
3. Motion A. Introduction. In: Raphael S, Strip! London: Marlborough Fine Art (London) Ltd, 1998
4. 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): 82-4
5. Fuller GN, Gale MV. Migraine aura as artistic inspiration. BMJ 1988;297: 1670-2 [PMC free article] [PubMed]
6. Podoll K, Robinson D, Nicola U. The migraine of Giorgio de Chirico—Part I: History of illness. Neurol Psychiat Brain Res 2001;9: 139-56
7. Podoll K, Robinson D. Migraine experiences as artistic inspiration in a contemporary artist. J R Soc Med 2000;93: 263-5 [PMC free article] [PubMed]
8. Podoll K, Robinson D. Visual migraine aura as source of artistic inspiration in professional painters. Neurol Psychiat Brain Res 2001;9: 81-94
9. 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 31 October 1998: 3
10. Barnes R. Sarah Raphael. Guardian 8 January 2001
11. Petrovic R. Painting a picture of my pain. When agonising illness struck artist Sarah Raphael, it wreaked havoc on her life, but it also transformed her work. Independent on Sunday 18 October 1998
12. Taylor JR. Sarah Raphael. Talented painter whose restless urge to experiment took her from portraits and landscapes to patchworks of pure colour in an all too short career. Times 17 January 2001: 23
13. International Headache Society. Classification and diagnostic criteria for headache disorders, cranial neuralgias and facial pain. Cephalalgia 1988;8(suppl 7): 1-96 [PubMed]
14. Vick RM, Sexton-Radek K. Interplay of art making practices and migraine headache pain experience. Headache Quart 1999;10: 287-91
15. Gowers WR. Subjective visual sensations. Trans Ophthalmol Soc UK 1895;15: 1-38
16. Boyd W. Sarah Raphael. In: Raphael S, Desert Paintings and other Recent Work. London and Cambridge: Agnew's and the Fitzwilliam Museum, 1995

Articles from Journal of the Royal Society of Medicine are provided here courtesy of Royal Society of Medicine Press