The American photographer Nan Goldin has not had an easy life. Growing up in 1950s suburbia, she was a witness to her sister Barbara’s severe mental health struggle, her brutal institutionalisation, and eventual suicide at the age of eighteen. Goldin took up drugs and began dating a much older man. She left home at merely fourteen and after a spell in foster care, became a regular on Boston’s underground scene of homosexuals and drag queens. 

In the Goldin legend, it was a camera that saved the sixteen-year-old artist from her own depressive tendencies. Many a moody teenage girl has experimented with photography and Goldin could take some credit for this trope. But her seductive depiction of her dysfunctional relationships and the narrated importance of art to her very survival have had a profound influence on visual culture’s mediation of addiction and mental strife. Even today, plenty of Instagram selfies, television shows, and arthouse films follow the aesthetics Goldin pioneered. Yet like her work, these artefacts often fail to challenge their authors’ moral standing.

Goldin moved to New York after graduating from art school, she fell in with the post-punk music subculture and soon became a fixture on the Bowery’s hard drug circuit. In her seminal photographic cycle The Ballad of Sexual Dependency produced in the 1980s, Goldin captured her subjects and herself in the spasms of suffering and anguish. Goldin herself, often seen in mirrors, appears slightly older than her subjects. When she isn’t showing off the wounds on her body, she pouts melancholy at her camera lens. Bruises and burns are a frequent feature of her oeuvre. By the time they healed, AIDS started wreaking havoc on the artist’s community.

Everyone in front of Goldin’s lens projects a state of heightened vulnerability. Looking at her confessional works, one might wonder how her generation survived at all. The slide-and-tape project Sisters, Saints, Sibyls on show at Soho’s Welsh Chapel makes for harrowing viewing. This three-screen installation assembled over nearly twenty years narrates Goldin’s childhood, dwells on the sorest points of her adolescence, and graphically shows the struggles of her later life. 

This struggle is real. There is no doubt that the artist and her friends experienced some of life’s most profound lows. Losing a sibling could crush anyone for life. In Sisters, Goldin is haunted by the repressive actions of her parents which, in her view, led to Barbara’s downfall. “The wrong things are kept secret, and that destroys people.” Goldin lionises Barbara’s “rebellion”. “She showed me the way.”

Childhood trauma neatly maps onto adult addiction and dependency. But there is a deep dissonance between these formative events and the high price Goldin pays trying to overcome them. Drug overdoses, self-harm, and domestic and sex-work abuse are the everyday in the artist’s images. Such violence, she claims, is the means of liberation, not a barrier to it. But already a few pictures in, it is unclear whether the addictively self-destructive behaviours are the result of suffering or its cause.

Many claims have been made of art’s effects on both the artist’s and audience’s emotions. That poetry heals the soul has been a cliché since Aristotle. Pottery and poetry workshops were the bread and butter of the community arts movement of the 1980s and are today available on the NHS. The biographies of Virginia Woolf or Sylvia Plath confirm that such practices can be life-sustaining. Anguish also makes for great art. Artistic expressions of illness, like the compulsive polka-dot installations of the occasional mental ward inmate Yayoi Kusama, sell for millions and are praised for combating social stigma. At another end of the scale, art can become indistinguishable from addiction. The writing of William S. Burroughs, which documents and promotes the methodical destruction of the author’s psyche, is a prime exponent of this genre.

Art is no longer a sure route to relief. Indeed, it is often the cause of anguish

Goldin’s work brings these forms together and turns them into a social phenomenon. Her artefact isn’t merely the product of illness or an illustration of recovery. In this, the most harrowing form of mental strife, the work of art is the addiction itself. The resulting pictures find their way into galleries and onto cinema screens. They inspire mimicry, not least by Goldin’s already suffering friends. They fuel the production of addictive art which destroys its creators. 

Today’s mass adoption of vulnerability in response to stress has undeniably aesthetic roots. Art is no longer a sure route to relief. Indeed, it is often the cause of anguish. The recent craze of prepubescent teens diagnosing themselves with dissociative identity disorder or autism on TikTok is a prime example. This phenomenon may have passed its peak but the “mental health crisis” has not lost its appeal: it looks “artistic” to be unwell. 

A layer of aesthetic camouflage hides that the performance of suffering can induce real strife. Today’s Insta model patients are acting out on impulses which they cannot resist. The mental health advocate’s claim that giving into them leads to freedom, pioneered for the masses by Goldin’s beautiful junkies, is perverse. 

The German artist Melanie Manchot’s film Stephen released this summer unravels the constructive relationship of art to addiction. Stephen is a multi-tiered crime reconstruction, based on the world’s first-ever filmed crime staging of the arrest of the Liverpool bank fraudster and addict gambler Thomas Goudie in 1901. Goudie is portrayed by Stephen Giddings, himself an addict in recovery with whom Manchot worked on an earlier film about addiction and whom she encouraged to take up acting. 

The story in which the character’s debts escalate and in which the hopes of paying them off diminish with every impulse is familiar. Yet the film proceeds in a closed circuit in which it is never clear whether Giddings is portraying Goudie, reconstructing his own experience, or if he isn’t acting at all. To unsettle any certainties, Manchot mixed in numerous “behind the scenes” shots in which the apparatus of the cinema such as the lights, cameras, directors, and acting coaches join in on the action. Like the rest of the film, these scenes are scripted. 

The whole film was written specifically so that Giddings could test and prove himself as an actor. The result of Manchot’s manipulation is that Giddings’ experience of addiction is made ungraspable, perhaps even to himself, without the mediation of a camera, or an intermediary like his character Goudie. To act, Giddings must embody addiction. To overcome it, he must act.

Like Goldin’s photographs, Manchot’s film is at once an artwork made by a recovering addict, a sober voyeuristic study of addiction, and raw fire for the illness. It is unlikely, however, that the latter element was planned. In the Q&A at the film’s premiere, the director brimmed with pride at her protégé’s success in the challenge of her making. 

That Giddings didn’t succumb to a new addiction — to acting, for example — might be to Stephen’s artistic failing. A contrast is found in the fate of Richard Gadd, the author and star of the recent hit series Baby Reindeer. This supposedly true story follows the relationship between Donny Dunn (a character who is indistinguishable from Gadd himself) and a relentless female stalker. Dunn’s key strategy for coping with the strain is to fall deep into self-loathing and succumb to addiction. Judging by Dunn’s talentless and humourless character bent on finding success as a stand-up comic and the ad-hominem gossip which surrounded the Netflix production of Baby Reindeer, Gadd’s compulsion to act — to act out uncontainably — fell right in step with his stalker’s.

It took many years for Goldin to break away from an all-consuming addiction. Today, the pioneer of the vulnerability selfie is better known as an art activist who campaigns against the Sackler family. The Sacklers whose fortune is derived from marketing Oxycontin are patrons of numerous arts institutions. The drug has been the cause of addiction and death of countless Americans and continues the kinds of devastation which made Goldin’s career.

Goldin’s transition from the underworld’s diarist to a powerful political heroine is too simple a story, however. The 2022 film hagiography of the artist All the Beauty and the Bloodshed made by Laura Poitras remixes the photographic material of Sisters, traces Goldin’s work with her campaign P.A.I.N. (Prescription Addiction Intervention Now), and laments the plight of Oxycontin victims. Yet in the film’s nearly two hours, Goldin doesn’t consider whether her depiction of addiction as freeing might have contributed to today’s resigned moral acceptance of deadly drug use. Instead, she lays the blame on her parents, while curiously refusing to contend with her mother’s mental health struggles.

Goldin’s work inspired generations of artists, promising that the fleeting beauty of abandonment might set off the devastation it causes. In a sense, it is a testament to the power of art over an artist whom it commits to the service of seductive, even addictive images. In another light, however, Goldin’s legacy propagates addiction and encourages forms of self-pity that look good on camera but are devastating in life.

Sisters, Saints, Sibyls by Nan Goldin is on at Gagosian Open, Soho, until 23 June. 

Stephen by Melanie Manchot is on in selected cinemas.