Visual art - Ravaged by alcoholism, mutilated in a lovers' spat, Edvard Munch nevertheless had an instinct for survival

Ever since his childhood, Edvard Munch had been confronted by the trauma of fatal illness. His mother died of tuberculosis when he was five. Nine years later, his favourite sister, Sophie, succumbed to the same disease aged 15. The double loss left him exposed to the oppressive influence of his father, a neurotic military surgeon obsessed with discipline, religion and the need to destroy his son's unholy paintings of nude figures. Death haunted Munch's vulnerable mind, even though he lived to 80.

The painter's earliest self-portraits at the Royal Academy's revelatory show have a haunted air. Painted in 1882 at the age of 19, they are not yet handled with the bold gestural freedom that marks his later work. However, the frowning adolescent already looks tense, staring out from the darkness with a defensive expression. By 1886, when he painted a far freer and more broken image of his handsome, melancholy features, Munch had become an avant-garde force.

His work became preoccupied with images of bones beneath flesh, fatal stabbings and severed heads. His celebrated Self-Portrait With Cigarette may look the quintessence of cool - the 31-year- old Munch lets tobacco smoke float up towards his face like a matinee idol - but he is surrounded by shadows, and the lower part of his torso is so insubstantial it looks like a ghost.

Such alcohol-fuelled fantasies exhausted him and exacerbated the weakness of his lungs. He spent several months in the Kornhaug sanatorium in Faberg around 1900. A bleak photograph survives of Munch standing in the snow, buttoned up against the cold and his own agora-phobia. He seems resolute, yet the truth is that his fears were accelerating. And then, quite suddenly, they were transformed into a brutal reality.

His relationship with the heiress Tulla Larsen, who supported him financially, deteriorated when she announced their engagement without consulting him. Munch, who never married and had a horror of monogamy, severed the union, but she stalked him, accusing him of exploiting her. Finally, a female friend of Larsen's wrote him an urgent message in 1902, claiming that she had just saved Larsen from an overdose of morphine.

As Sue Prideaux warns in her excellent new biography, we have only his writings to reconstruct the order of events. Munch certainly left his cottage, made the boat trip to Larsen's house and found her laid out like a corpse on a bier. Candles were placed around her head, illuminating the red-gold tresses Munch had painted in some of his most impassioned canvases.

We do not know who had the gun, nor indeed who fired it. But a bullet smashed into his left hand, injuring it and shattering the middle finger. Munch claimed that, while he bled, Larsen rose from her bier and simply walked up and down, before mopping the floor with a cloth. A doctor was eventually summoned and the woun-ded artist despatched to hospital.

Because Munch refused chloroform, he was able to witness the entire operation. Soon afterwards he painted a gruesome canvas, On the Operating Table, in which he lies naked on a white sheet smeared with an alarming amount of blood. After the operation was over, Munch asked if he would be able to use his hand again. "Yes, we hope so," came the doctors' answer, but when the bandages were removed the hand was "deformed, disgus-ting and useless".

Within a year he painted the flame-like Self-Portrait in Hell, showing an agonised man unable to put the disastrous affair behind him. The discovery that she had been involved with another painter made him apoplectic with rage. At the very time that he began to be hailed as a pioneer, Munch found his mental condition was deteriorating fast.

In 1908, alarmed by increasing attacks of numbness and paralysis, Munch travelled to Copenhagen in search of a "nerve sanatorium". He went to a clinic run by Dr Daniel Jacobson, who correctly decided that his patient was suffering from a manic-depressive psychosis caused by the poisonous effects of acute alcoholism. As well as heart massage and pine-needle baths, the clinic's staff applied electrical currents to Munch's brain. The voltage was weak, so he reacted well and drew a lively ink caricature of Jacobson and an elegant young nurse administering treatment. While she manipulates a wire attached to an appliance on a nearby table, Munch leans back gratefully and allows the doctor to mop his sweaty brow. An inscription proves that he still retained a self-mocking sense of satire: "Professor Jacobson passing electricity through the famous painter Edvard Munch, changing his crazy brain with the positive power of masculinity and the negative power of femininity."

In May 1909 he at last felt able to return home, after making a lithograph self- portrait celebrating his decision to give up smoking. Clutching his final cigar, he stares defiantly through the smoke like a man on the edge of regaining his lost charisma.

Although Munch continued to find life a struggle, he painted incessantly. The most moving images in this show are his self-portraits in old age. The brush strokes are spare and decisive. They are the work of a man who has no wish to waste energy, yet who remains more determined than ever to convey the truth about his own "inner turmoil".

"Edvard Munch by Himself" is at the Royal Academy, London W1, until 11 December. For more information call 020 7300 8000

Sue Prideaux's biography, Edvard Munch: behind the scream, is published by Yale University Press (£25)

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