Writing and the Creative Life: “The incurable disease of writing”

Another in my series on the nexus between writing and creativity.

This is one of the most fascinating interviews I’ve read in a long time. It’s subtitled “A neurologist considers the compulsions and frustrations of literary creativity.” The neurologist in question is Dr. Alice Flaherty, director of the movement disorders fellowship at Massachusetts General Hospital and an assistant professor of neurology at Harvard Medical School. And her story is quite a personal as well as professional one:

In 1998, a month after completing her residency, Alice Flaherty ’94 gave premature birth to twin boys. One baby did not survive the complicated delivery and the other died soon after, clutching his mother with a hand so tiny it barely encircled her finger. For ten days, Flaherty grieved. But then suddenly, she says, “The sun and the moon switched positions.” For the next four months, in a rare postpartum mania, Flaherty experienced her first episode of hypergraphia — the medical term for an overpowering desire to write. She wrote everywhere, all the time: on her left arm as she gripped the steering wheel of her car, on squares of toilet paper in public bathrooms, on Post-it notes in the middle of the night.

As a neurologist at Massachusetts General Hospital, Flaherty was able to diagnose herself — and to put her symptoms to good use. Within a year she had completed her first book, “The Massachusetts General Hospital Handbook of Neurology,” which has since been translated into three languages. And in “The Midnight Disease: The Drive to Write, Writer’s Block, and the Creative Brain” (Houghton Mifflin, 2004), Flaherty explores both hypergraphia and its seeming antithesis, writer’s block.

Here are some excerpts from the interview Flaherty did with the Harvard Medicine journal:

One morning, exactly ten days after my babies died, I woke up feeling as if a switch had been thrown and a thousand volts were flowing through me. It was like in Hamlet, when “the sheeted dead / Did squeak and gibber in the Roman streets.” I was filled with an overwhelming compulsion to write. That’s all I was conscious of — I had important ideas that I needed to write down because otherwise I would forget them.

Everyone kept saying, “It’s a grief reaction,” or “She’s depressed.” But I liked my sorrow. I was wallowing in it — I think that would be the appropriate clinical term. Depressed people don’t enjoy being depressed; I vaguely remembered that from medical school. I was full of grief, but I was euphoric too, and I had no intention of getting better, even though there were days that I felt that my brain was going to explode, or that I was like a balloon attached to the earth by a single frayed thread.

So I wrote all the time. In the middle of the night, I’d write on a PalmPilot or on tiny Post-it notes. I would stick the Post-its on the wall, collect them the next morning, then type my scribbles into the computer. My husband, Andy, who was incredibly supportive through all this, told me, “That’s when I knew you were sick. The smallest Post-its — why not even the medium-sized ones?” I don’t know why — it just had to be the tiny ones.

About some of my behavior, I’d think, well, doesn’t everybody do that? Many people write on their hands; I just extended that up my arm while driving across the Longfellow Bridge. And everyone will suddenly jot something down — but maybe not on toilet paper in the public bathroom, and not for half an hour.

— —

Then, after four months of mad scribbling, another switch was thrown, and I became completely torpid, with no impulse to write — or even to move. It was peaceful, unless I tried to write or speak. Then I felt as though my lungs were full of water. That lasted about six weeks.

The following year, by a strange symmetry, I gave birth to premature — but healthy — twin girls, my wonderful daughters Katerina and Elizabeth. Again, I experienced four months of hypergraphia followed by a short period of semi-catatonia.

Whatever brain-hormonal interactions caused hypergraphia in me might have caused more traditional postpartum psychosis in someone with a different premorbid personality. The truth is that, even before the pregnancies, I’d always been inclined to write a bit more than normal. When my attention wandered during medical school lectures, for example, I would furiously write whatever thoughts came into my head. Then my classmates would get mad because they assumed I had taken great notes that I just wasn’t willing to share. And this past summer I tried hard not to start a new book — the result was an oratorio libretto about Jacob wrestling with the angel, a 165-page biographical sketch, and a children’s book on the adventures of a picky eater and the Loch Ness monster.

— —

Isaac Asimov, who wrote nearly 500 books, is a classic example [of hypergraphic]. He would sit down and compose 90 words a minute on his typewriter and reportedly never suffered a blocked moment. Everyone thinks of Proust as hypergraphic because he wrote such a long novel over such an extended time. Other writers often described as hypergraphic include Stephen King, Charles Dickens, Honoré de Balzac, Agatha Christie, Anthony Trollope, John Updike, Herman Melville, and Joyce Carol Oates.

— —

People don’t realize that not all aspects of mental illnesses are terrible, although most mental illnesses, of course, cause great suffering. Some of my patients have told me that, for them, a single episode of depression was far worse than living through World War II or cancer. But an obsessive-compulsive personality can be useful if you’re an engineer checking the Challenger for flaws. That’s going to be my next book: “Make Your Mental Illness Work for You.” If you have narcissistic personality disorder, become a dictator.

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Did you realize that writers are ten times more likely to be bipolar than the rest of the population, and poets are a remarkable forty times more likely? Which brings to mind the idea of the ‘tortured artist.’

With screenwriting or TV writing, there is — obviously — a premium on creativity, understanding of the craft, ability to communicate effectively, and so on. But it’s also important to hit deadlines. Mood swings would seem to work at cross-purposes with that specific concern, however Flaherty’s experience suggests that mania and depression can actually work together to help a writer write. And these issues seem to reside in one part of the brain:

There seems to be a frontal/temporal lobe interaction that is important for writing — and probably other creative endeavors — and if this interaction becomes imbalanced, problems arise. In people with injuries to the temporal lobe, you see disinhibitions and loquacious speech, as opposed to the laconic kind of speech typical of frontal lobe injuries. Wernicke’s aphasia, where you talk gibberish, and Broca’s aphasia, where you struggle to speak, are the classic examples. And there is evidence, although preliminary, that when your frontal judgment mechanism gets out of control, you can end up with creative block.

The frontal/temporal lobe axis turns the received view of creativity 90 degrees, because until recently, the only theories about the creative brain were ones that speculated that the right hemisphere is the seat of creativity and the left hemisphere just helps you do your taxes. I’m oversimplifying, but the picture is still much more complicated than even the best of those theories suggest — not only because of the way the temporal lobes on both sides may drive creative work, but also because of the role the frontal lobe may play in judging or editing the often over-exuberant products of temporal lobe changes.

— —

Roughly, the limbic system primarily controls emotion and drive and the cerebral cortex is more concerned with cognition. Yet the neurology of emotion and cognition are tightly intertwined. The cortical area that is the most connected to the limbic system is probably the temporal lobe. And the reason the temporal lobe can trigger hypergraphia is probably because the limbic system produces our strong biologic drive to communicate, which in turn drives the speech area of the temporal lobe.

In psychological terms, it seems that drive is more important than talent in producing creative work. The psychologist Dean Simonton has argued, for example, that the composers who produced the greatest music were simply the ones who wrote the most. Mozart and Beethoven composed all the time, whether walking down a street or attending a dinner party.

Finally this:

Clearly, though, you don’t have to be sick to be creative. It may be that engaging in creative work not only is a sign of health, but also makes you healthy. The relationship between illness and creativity doesn’t mean we should foster disease. Perhaps we should think of creativity as an adaptive response to difficult situations such as illness. Many plants won’t bother to flower unless they’re stressed just a little; people are like cyclamen.

Focusing on the relationship between illness and creativity is also useful because mental illnesses are often exaggerations of normal brain states that allow us to see more clearly how a mechanism works, even in healthy people. It would be tragic to go from there to pathologizing creativity, though. It makes more sense to go in the opposite direction and notice that everyone shares traits with the mentally ill.

Hence the title of the article: “The Incurable Disease of Writing.”

Does your writing feel like a ‘disease’ to you? How do you deal with your moods as they relate to writing? And do you feel like you have higher highs and lower lows than most people? I know I do. Frankly I see that as a plus to my writing as it helps me have more empathy for my characters as well as a broader range of emotional experiences to provide depth and texture to my stories.

How about you?

To read the entire interview, go here.

For more on Flaherty:

Identity Theory interview [March 10, 2004]

NYT [March 16, 2009]


Thanks to my wife Rebecca for this link (for anyone related in the science of brain studies, you should follow her Twitter feed as it’s extremely informative: @bf4tbrainy).

[Originally posted October 4, 2011]

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