In the 1980s Hughes worked with the mentally ill in hospitals in Glasgow and Edinburgh. This experience powerfully affected his work which often evokes despair, agony and pain. Hughes has described ‘Apperception I’ as showing “… a deeply introverted head, symbolic of a state of mind that is completely self-obsessed, cut off from the rest of the world, balancing on a tightrope over a void, the tightrope that divides sanity from sanity… The red line (tightrope) can also be seen to represent literally the top of a sheet… so all we see is the patient’s head”.