Portrait of My Father: Frida Kahlo’s Intimate Relation to Epilepsy

The art of Frida Kahlo (1907–1954) tells a story of a woman who excelled despite the sorrows in her life. Many of her paintings speak boldly of her own medical struggles with poliomyelitis, accidental severe trauma to the spine and pelvis, numerous orthopedic operations in attempts to alleviate her chronic pain, miscarriages, therapeutic abortion, and amputation, in addition to her tumultuous relationship with the notable Mexican painter Diego Rivera [1, 2]. One of her paintings, Portrait of My Father (1951), touches upon a lesser known fact about Frida Kahlo as a care partner to a person with epilepsy.

In 1951, confined in a wheelchair, Frida painted a portrait of her father, Guillermo Kahlo (1871–1941), 10 years after his death [3] (shown in Fig. 1). He is portrayed younger and in a photographic manner, reflecting his trade. Frida’s composition for the portrait may have been inspired by a photographic self-portrait that Guillermo made in 1907 (shown in Fig. 2). The dedication text at the bottom of the retablo reads: “I painted my father Wilhelm Kahlo, of Hungarian-German origin, artist-photographer by profession, in character generous, intelligent and fine, valiant because he suffered for sixty years with epilepsy, but never gave up working and fought against Hitler, with adoration, His daughter Frida Kahlo” (author’s translation).

Guillermo Kahlo (1871–1941) was born in Pforzheim, Germany, and immigrated to Mexico at the age of 19 in search of new opportunities. A tense relationship with his stepmother might have been one of the motives behind his move to Mexico [3-5]. At the time of his arrival, there were around 500 German nationals living in Mexico City. He was intent to rapidly assimilate into the Mexican society. He changed his name from Wilhelm to its Spanish version, “Guillermo,” adapted the prevailing Catholicism over his Protestant formation, married a Mexican woman, and within 4 years became a Mexican citizen [3-5].

Guillermo Kahlo married Matilde Calderón y González, after the death of his first wife in 1898. From that marriage, Frida was born in 1907 [4]. He is described as a stoic, proud, chronically depressed, and fastidious man of regular habits and intellectual pursuits from daily playing classical music at his piano, reading from his large library, painting, to spending hours carefully labeling and arranging his photographic work [3, 5, 6].

He took photography as a profession late into his twenties. The origin of his photographic career may have been motivated by his father-in-law (Frida’s maternal grandfather) who was a photographer. Given that 3 of his grandchildren also dedicated themselves to the photographic trade that has a certain logic [4]. His career took a turn to success when the German-owned Boker Trading House commissioned Guillermo with a photographic documentation of their new headquarters in the center of Mexico City in 1899. His photograph for the Boker Announcer brochure had a massive circulation of 40,000 copies. Governmental commissions soon followed [5]. He considered himself a documentary photographer, specializing in architecture and industrial plants. His photographic work was characterized by the analytical look at architecture and its precision without picturesque deviations, along with an obsession with the technical innovations of the time [5].

Guillermo favored Frida among all his daughters [3, 6]. Their close relationship was developed early as Gui-llermo took an active role in Frida’s recovery from poliomyelitis at the age of 6 years. He instilled in Frida a positive outlook so that her disability was not an impediment to a childhood full of games and sports. Frida claimed that it was her father who gave her a “marvelous childhood” [6]. As Frida recovered and grew into adolescence, the role of care partner reversed. She took on the task of keeping him cheerful, luring him out of depression, and working as his assistant to protect him should he have an epileptic seizure [7]. She provided first-aid and guarded his photographic equipment from getting stolen [3, 8]. These early and intense medical experiences inspired Frida to embark on a course of study leading to medical school, only to be derailed by a tragic tram accident at the age of 18 years [1, 2]. She was impaled with a steel bar which fractured her pelvis and spine, injuries that they kept her confined to bed for several months and left her painful footprints for life. This second convalescence further cemented the father-daughter relationship, as Guillermo once again took on the role of a primary care partner. It was with his support that she began to paint, opening a new field to express her emotions and talent [1, 2].

Frida Kahlo presented herself through her paintings and writings as a woman who was constantly in a struggle against physical and psychological pain, sexism’s disfranchisement of women, and the rise of fascism during her lifetime. In that context, she distorted both her father and her life story. Frida often mentioned that her father was a German-born Jew of Hungarian descent, eager to identify herself with marginalized groups in alignment with her anti-fascist political views [4]. However, the family origins dating to the sixteenth century only support a German and Protestant origin [4]. Furthermore, her father was apolitical, and letters from Kahlo to his daughter never took political overtones despite both Frida and Diego Rivera’s involvement with leftist causes [3]. The dedication in the lower panel of Portrait of My Father has contributed to perpetuate the chain of misinterpretations regarding the Kahlo family’s origin [4, 9]. Biographical distortions are not uncommon in patients with chronic pain [10, 11]. The experience of chronic pain involves both unpleasant sensory and affective experiences which have a debilitating effect on the patient’s sense of self. The unbearable experience of daily chronic pain forces major changes in all aspects of life, de facto stealing the patient’s life [10, 11]. Biographical distortions could be a coping mechanism for the patients to reclaim some control over their existence.

Frida Kahlo’s numerous emotional and physical life traumas led her to bouts of depression, alcohol, and pain medication abuse and numerous romantic affairs [1, 2, 6, 7]. There is no biographical evidence to suggest that she experienced epileptic seizures or psychogenic nonepileptic seizures, despite the respective risk factors of a positive family history of epilepsy and sexual abuse among the constellation of her life traumas. While the pathophysiology of psychogenic nonepileptic seizures is poorly understood, it has been speculated that observation of epileptic seizures might contribute to its development through model learning behavior [12, 13]. However, a recent retrospective study on 350 patients with psychogenic nonepileptic seizures did not demonstrate a significant role for family history of epilepsy and model learning [13].

The clinical information regarding Guillermo Kahlo’s seizures is fragmentary and limited. His seizures started in adolescence, coinciding with the death of his mother in 1890. There was mention of an episode of head trauma that anteceded the seizures [5]. Biographical accounts of both Guillermo and Frida Kahlo describe him as suffering from both sporadic grand and petit mal seizures, without providing much detail on the semiology [5, 8]. Frida described the most severe seizures as explosive – starting suddenly without warning [6, 8]. His death certificate lists the cause of his death as “epilepsia esencial” (idiopathic epilepsy) [5]. His seizures have been mentioned to possibly influence his photographic subject preference for nonmobile objects, which allowed him to work calmly, although this conjecture might be based on biographers’ biases about living with epilepsy [14].

Generalized seizures along with absence seizures with onset in adolescence are strongly suggestive of a diagnosis of juvenile absence epilepsy [15]. On the other hand, given the mention of head trauma by his biographers [5], consideration should be given to the possibility of posttraumatic epilepsy. Posttraumatic epilepsy accounts for around 4% of focal epilepsy in the general population and is the leading cause of epilepsy with onset in young adults between the ages of 15 and 24 years [16, 17]. Posttraumatic epilepsy commonly arises from mesial temporal lobe areas, followed by the frontal lobe and rarely from the parietal and occipital lobes [18]. Seizures characterized by impaired awareness and motor automatisms can arise from mesial frontal lobe areas, as well as the anterior cingulate gyrus and the orbitofrontal cortex [18]. These frontal seizures are often undistinguishable from the absence seizures seen in generalized epilepsy, particularly when short in duration (<10 s), that is, speech and behavioral arrest, starring, and simple automatisms. Like their generalized absence counterparts, these are not preceded by an aura. In contrast, frontal seizures impaired awareness may progress further into secondary generalized convulsive seizures [18]. Seizures with impaired awareness and motor automatisms are also one of the least common seizure types of frontal lobe origin [18]; furthermore, mesial frontal and orbitofrontal ictal foci also manifest frequent nocturnal seizures [19]. In the case of Gui-llermo Kahlo’s seizures, the brief descriptions of his seizures suggest that the convulsive seizures (grand mal) occurred suddenly and without warning and not preceded by other symptoms suggestive of an aura or absence (petit mal); also, there is no mention of nocturnal seizures during sleep. Moreover, mild head trauma rarely leads to posttraumatic epilepsy with an occurrence of about 2% in such mild cases [16].

Juvenile absence epilepsy is characterized by the appearance of absence seizures during adolescence, where the absences are less frequent than in childhood absence epilepsy [15]. The presence of generalized tonic-clonic seizures is quite common, and these can occur at an earlier age than absence seizures. The presence of generalized tonic-clonic seizures in juvenile absence epilepsy is associated with a worse prognosis, and only a third of patients achieve seizure freedom with antiseizure drug regimens [15]. Persons with juvenile absence epilepsy often have a family history of epilepsy [15]. During one of her failed pregnancies, Frida penned concerns of passing the genetic traits of epilepsy to her child in a letter to one of her physicians [3]. Panayiotopoulus and colleagues [20] described a series of idiopathic generalized epilepsy patients who in addition to generalized tonic-clonic seizures experience “phantom” absences of 3- to 4-s duration. These absences did not interfere with the patients’ daily life, despite mild cognitive impairment during these events. Some of the patients were aware of absences such as momentary loss of concentration and forgetfulness which they did not feel were of relevance. Like Guillermo Kahlo, the patients had demanding professions, for example, civil engineering and computer programming. Depressive mood disorders and other psychiatric comorbidities are also common in persons with juvenile absence epilepsy [21].

With the death of her father in 1941, Frida was emotionally overwhelmed. In a letter to her doctor, Leo Eloesser, she confided: “The death of my father has been something horrible for me. I think that’s the reason for my deterioration and weight loss. You remember how cute and nice he was?” [3]. Portrait of My Father, painted in the simple manner of the traditional Mexican religious ex-votos, was the way Frida reached closure with her loss. Her personal experiences with chronic illnesses, in this case, her father’s epilepsy, served as the impetus for another of her powerful works of art.

The author extends his gratitude to Dr. Kore Liow for his kind review of the manuscript.

Ethics statement is not applicable.

There are no conflicts of interest.

The author did not receive any funding.