The Midnight Disease: The Drive to Write, Writer's Block, and the Creative Brain

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9780618230655: The Midnight Disease: The Drive to Write, Writer's Block, and the Creative Brain

What underlies the human ability, desire, and even compulsion to write? Alice Flaherty first explores the brain state called hypergraphia - the overwhelming desire to write - and the science behind its antithesis, writer's block. As a leading neurologist at a major research hospital, Flaherty writes from the front lines of brain research. Her voice, driven and surprisingly original, has its roots in her own experiences of hypergraphia, triggered by a postpartum mood disorder. Both qualifications lend power to Flaherty's riveting connection between the biology of human longing and the drive to communicate.
The Midnight Disease charts exciting new territory concerning the roles of mind and body in the creative process. Flaherty - whose engagement with her patients and lifelong passion for literature enrich each page - argues for the importance of emotion in writing, illuminates the role that mood disorders play in the lives of many writers, and explores with profound insight the experience of being "visited by the muse." Her understanding of the role of the brain's temporal lobes and limbic system in the drive to write challenges the popular idea that creativity emerges solely from the right side of the brain. Finally, The Midnight Disease casts lights on the methods and madness of writers past and present, from Dostoevsky to Conrad, from Sylvia Plath to Stephen King.
The Midnight Disease brings the very latest brain science to bear on the most compelling questions surrounding human creativity.

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About the Author:

A. W. Flaherty is a neurologist at Massachusetts General Hospital who also teaches at Harvard Medical School. She is the author of The Midnight Disease: The Drive to Write, Writer’s Block, and the Creative Brain. A. W. lives with her husband and twin daughters near Boston.

Excerpt. Reprinted by permission. All rights reserved.:


Writing is one of the supreme human achievements. No, why should I be
reasonable? Writing is the supreme achievement. It is by turns exhilarating
and arduous, and trying to write obsesses and distresses students,
professional writers, and diarists alike. Writers explain why they write (and
have trouble writing) one way; freshman composition teachers, another;
literary critics and psychiatrists and neurologists have increasingly foreign
explanations. These modes of thinking about the emotions that surround
writing do not easily translate into one another. But one fact is always true:
the mind that writes is also the brain that writes. And the existence of brain
states that affect our creativity raises questions that make us uneasy. What
is the relation between mind and body? What are the sources of imagination?
How can both neuroscience and literature bear on the question of
what makes writers not only able to, but want to, even need to, write? How
can we understand the outpouring of authors such as Joyce Carol Oates or
Stephen King? Why does John Updike see a blank sheet of paper as radiant,
the sun rising in the morning? (As William Pritchard said of him, "He must
have had an unpublished thought, but you couldn"t tell it.") This compulsion
seems—and is—an unbelievably complex psychological trait.
Yet it is not so complex that it cannot be studied. Neurologists
have found that changes in a specific area of the brain can produce
hypergraphia—the medical term for an overpowering desire to write. Thinking
in a counterintuitive, neurological way about what drives and frustrates literary
creation can suggest new treatments for hypergraphia"s more common and
tormenting opposite, writer"s block. Both conditions arise from complicated
abnormalities of the basic biological drive to communicate. Whereas linguists
and most scientists have focused primarily on writing"s cognitive aspects,
this book spends more time exploring the complex relationship between
writing and emotion. It draws examples from literature, from my patients, and
from some of my own experiences.
Evidence that ranges from Nabokov to neurochemistry, Faulkner
to functional brain imaging, shows that thinking about excesses and dearths
of writing can also clarify normal literary output and the mechanisms of
creativity. The few current books on creativity that include a neuroscientific
perspective have neglected crucial brain regions such as the temporal lobe
and limbic system in favor of a still popular —but arguably oversimplified—
emphasis on the role of the right side of the brain.
Focusing on the importance of the brain in the drive to write helps
suggest treatments for disorders of creativity that are sometimes medical. It
should do so, though, without ignoring the fact that most innovative people,
and most people struggling with blocks, are not mentally ill. Concentrating on
the brain structures underlying creativity provides surprising answers to such
diverse questions as how we learn to write, the nature of metaphor, and even
what causes the strange sensation of being visited by the muse.
Although The Midnight Disease attempts to be a scientifically
accurate book, it is far from a dispassionate one. How could I speak dryly on
a subject as charged as the origin of literature? I am infatuated with writing,
and this emotional engagement shapes the book. Writing can do
extraordinary things. One night when I was a child, I read a passage in C. S.
Lewis"s autobiography, Surprised by Joy, which described one of his own
reading experiences as a child. He had been reading Longfellow"s
poem "Tegner"s Drapa," when a line jumped out at him: "I heard a voice that
cried / Balder the beautiful / Is dead, is dead. . . ."The beauty of that line, the
way it tore at him, drove him to become permanently addicted to reading and
writing. Strangely, even out of context, the line stirred me as well. Something
swept me out of his book high into the cold air above the northern wastes.
What was it that was transmitted from the writer of "Tegner"s Drapa" to the
writer of The Allegory of Love to me, possibly even to you?
In her book On Beauty and Being Just, Elaine Scarry imagines
Leonardo da Vinci seeing a woman with a face so beautiful that he tries over
and over to capture it in different drawings. Later artists are moved by his
copies, which they then try to copy themselves. Eventually the critic Walter
Pater writes his famous essay on Leonardo, and the copies of the woman"s
face spread from one art form into another. Beauty drives copies of itself,
whether in art, or when we want to make children with someone we love.
Great scientific ideas drive their own transmission in the same way—it is not
a metaphor when researchers refer to an elegant theorem as beautiful.
In another sense, though, it is the brain, not beauty, that drives
those copies. Many parts of the brain play a role: Leonardo"s exquisite motor
cortical control of his pen, the way his visual cortex perceived shape from
shadow, his face recognition area. Yet some parts of the brain may be more
crucial than others for the emotional aspect of the drive toward beauty or
One of these regions is the pair of temporal lobes, located in the
cerebral cortex roughly behind the ears. The temporal lobes have been
somewhat neglected by neurologists, in part because damage to them does
not produce glaring motor or cognitive problems. Still, the temporal lobes are
important for producing literature, in part because they are necessary for
understanding word meaning—and also Meaning in its philosophical senses.
In addition, changes in the temporal lobes can produce hypergraphia.
A second region of the brain that is surprisingly relevant to
creative writing is the limbic system, the seat of emotion and drive and, I"ll
argue, some aspects of the feeling of being inspired (a feeling, alas, that
does not always coincide with producing great work). It gets its name from
the fact that it forms a limbus, or ring, deep under the cortex. The limbic
system connects more strongly to the temporal lobes than to any other
region of the cortex. This strong link underlies the importance of emotion and
drive to creativity—factors that are anatomically as well as conceptually
distinct from the cognitive contributions of the rest of the cerebral cortex. The
limbic system also reflects the way mood swings can drive creativity.
The temporal lobes and the limbic system appear to underlie the
drive to seek beauty and meaning in nonliterary forms of artistic achievement
as well. The temporal lobes" role in hypergraphia, for instance, may parallel
their role in intense drives to paint and to compose music. The same brain
changes that drove Vincent van Gogh"s frenzied painting (at his peak he
produced a new canvas every thirty-six hours) seem to have driven his
hypergraphic letters to his brother, Theo. Further, to the extent that
hypergraphia and frenetic artistic achievement are special cases of the more
general phenomenon of a sense of vocation, or of workaholism, they can
shed light on how or whether to control these double-edged states. Nearly all
of us, artists or not, feel the terror of work as well as the joy of work.
Along with my fascination with writing, my work as a physician
shapes the book. I am obsessed with illness and how it changes my
patients. Moreover, like many doctors, I have acquired the occupational
illness of seeing disease everywhere. During dull conferences, my colleagues
and I amuse ourselves by diagnosing one another: Horner"s syndrome, swan-
neck deformity, congenital toe-walking, frontal release signs.
Can any good come from casting such a medicalized eye on the
world of writing? Medicalization tends to lead to pathographies of artists: El
Greco"s elongated figures are explained away as mere astigmatism,
Dostoevsky"s writing as nothing but epilepsy. Pathologizing the process of
writing could make us see creativity as abnormal or even dangerous. Yet
affliction is everywhere, perhaps especially in writing. Suffering has driven
great writing, and problems with writing, notably writer"s block, have caused
great suffering.
One of the most moving, and most readily helped, groups of
patients I see is college students admitted for their first psychiatric break.
Often what finally brings them to their university"s attention is that they can
no longer write and are beginning to get incompletes in their courses. These
are students with biologically based psychiatric problems that affect their
creativity and their ability to express themselves. Their treatment often
underestimates their problems with work as side effects of family issues.
Indeed, the two are hard to separate. But work—how we make things of and
do things to the external world—is nearly as basic, and primeval, a factor in
human happiness as family relations. The inability to write reflects the
sufferer"s feeling that he or she cannot contribute to the world, cannot
communicate with others in any meaningful way.
The medical model for fighting suffering, although it has distinct
limitations, is also immensely powerful. Bringing a doctor"s eye to writers"
own accounts of their creative process can lead to startling and useful
conclusions—ones that don"t necessarily involve prescribing pills. To give a
simple instance, many writers who hate themselves every winter for their
sluggishness and lack of productivity could be aided not by "more
motivation," but by bright full-spectrum light for a half an hour every morning
to treat their brain"s seasonal response to the shortened days.
Problems of motivation are not, of course, restricted to writers.
Some of my patients have severe movement disorders and, despite the best
intentions, from day to day their willpower is no longer enough to drive their
limbs. Yet someone with, say, Parkinson"s disease who has spent months in
a wheelchair will, if there is a fire, be able to leap from her chair and run. This
confusing inconsistency often convinces family members that their mother or
husband isn"t ill, but simply isn"t trying hard enough. Sometimes not even the
patient wants to give up that belief. To admit that your will is sometimes
ineffective is terrifying.
In place of the will, what do I offer my Parkinsonian patients? Pills,
of course, or permanently implanted electrodes in their brains to stimulate
them to move. I began to wonder if similar medical treatments might help
people with disorders of motivation not just in movement initiation abilities,
but also in cognitive skills such as writing. Motor-cognitive tasks are not
perfectly analogous. In simple movements, stronger motivation—the fire
under the wheelchair— is generally better. But in complicated tasks, if the
motivation is too strong, the adrenaline that usually helps movements can
cause the performer to freeze. This "stage fright" aspect to writer"s block is
often neglected. Another difference between "psychological states" such as
block and "neurological" states such as Parkinson"s disease is that relatively
subtle behavioral interventions (psychotherapy, for instance) can be
immensely helpful in the former, but not in the latter. Because of my biology-
based training, and because so many others have described the ways that
therapy can help writing problems, I sometimes neglect therapy and other
behavioral interventions in this book. Yet they are important, ultimately
biological, treatments. They work, in the end, by altering one"s brain
chemistry and neuroanatomy.
As a doctor, I hope I do not simply see normal problems as
illness; I want also to see that illness is often nearly normal. If we are all a
little bit sick, it is not all that sick to be sick. Illness is even sometimes
useful. It is easy to forget that whether a behavior is a disease or a gift may
depend on its context. The fallow periods that some writers call block are, for
others, a fermentation stage in the creative process.
Take the famous "little man with a perfect memory" so movingly
described by the Russian psychologist A. R. Luria in The Mind of a
Mnemonist. Although the man Luria studied had a photographic memory, he
was cursed rather than blessed by it. Reading and writing were among the
many activities his too-good memory made hard for him. Every word, even
every letter within a word, called up so many associations that it was nearly
impossible for him to concentrate on a chain of thought. His distracting
memory ended his writing career as a journalist, and he finished his life as a
circus performer doing memory tricks. (Or would only a writer say that this
career change was unfortunate?)
Other people who have near-perfect memories, but different social
and intellectual resources, have used them to great advantage in successful
writing careers. One instance is the prodigious memory of the prolific literary
scholar Harold Bloom, who has reportedly recited Paradise Lost backward.
The Midnight Disease is shaped not only by my work as a doctor
with people, but also by my work as a neuroscientist with brain imaging to
study neural activity. Is it therefore my goal to reduce the composition of
marvels like Dante"s Inferno to nothing more than electrical and
neurochemical patterns? Emphatically not. Do I want to say that talking of
the chemical states of our brains is more important than talking of experience
or the will? Emphatically not. We will always be talking about mental states,
too, because they are powerful, subtle, indispensable concepts. But when
Dante describes his writer"s block ("It seemed to me that I had undertaken
too lofty a theme for my powers, so much so that I was afraid to enter upon
it; and so I remained for several days desiring to write and afraid to begin"),
he is describing a brain state as well as a mental state.
Many readers, while granting that our minds are the products of
our brains, believe that there are some aspects of our thoughts—especially
during creative inspiration—that come from outside us. It would be a mistake
to dismiss this emotionally resonant position. In fact, I will show in the last
chapter that this position supports current scientific hypotheses of how our
brains handle creative, moral, and religious impulses.
While doctors care about disease because they want to cure it,
many neuroscientists care about disease as a scalpel with which to dissect
health. When something falls apart, you can see its pieces more clearly. In
this way, for instance, researchers learned about the role of the left and right
sides of the brain from split-brain patients. As a neuroscientist, I am
fascinated by hypergraphia and writer"s block because of what they tell us
about normal creativity. Most writing about creativity squares its shoulders
pluckily and stares the phenomenon in the face. The result is countless
biographies of uniquely Great Men, or statistical studies of one hundred
Nobel laureates. But staring creativity in the face has turned many writers to
stone. The Midnight Disease sneaks up on creativity from behind, by
considering its disorders.
As a researcher, I am obsessed with the powerful...

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