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Writing Like Crazy: a Word on the Brain

Publication Date: 2003-11-21

Scientific and literary evidence suggests
that the drive to write is often more emotional than cognitive, more primal than intellectual, writes Alice Weaver Flaherty, a staff neurologist at Massachusetts General Hospital and a
neurology instructor at Harvard Medical School.

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, but want, even need, to write? How can we understand the outpouring of authors like 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 (As William Pritchard said of him, "He must have had an unpublished thought, but you couldn't tell it.")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 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 of these conditions arise from complicated abnormalities of the basic biological drive to communicate. 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 have included a neuroscientific perspective have neglected crucial brain regions such as the temporal lobe and limbic system in favor of a still-popular -- but oversimplified -- emphasis on a right brain-left brain dichotomy.

The temporal lobes have been somewhat neglected by neurologists, in part because damage to the temporal lobes does not produce glaring motor or cognitive problems. But the temporal lobes are important for producing literature, in part because they are necessary for understanding semantic meaning and also Meaning in its philosophical senses, as in the Meaning of Life. And changes in the temporal lobes can produce hypergraphia. One example of these changes is temporal-lobe epilepsy. Some people with epilepsy stemming from temporal-lobe damage have hypergraphia so strong that they will write on toilet paper or use their own blood for ink if nothing else is at hand. Their hypergraphia is usually linked to other personality traits, including unstable mood and motivation, and a tendency to ruminate on the philosophical or religious Big Questions. Similar traits are often seen in people with manic-depression during their manic periods. And there is evidence for selective changes in the temporal lobes of people with mania.

The temporal lobes appear to be important for the drive to seek beauty and meaning in nonliterary art forms as well. When Pick's disease, a rare form of dementia, selectively affects the temporal lobes, its victims may gain breathtaking artistic or musical drive, even as their ability to take part in other activities disintegrates. The same brain changes that drove the epileptic Vincent van Gogh's hypergraphic letters to his brother Theo seem also to have driven his frenetic painting -- at his peak he produced a new canvas every 36 hours. In some respects, hypergraphia and compulsive art-making 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 joy of work, the terrors of work.

A second region critical for creative writing is the limbic system, the seat of emotion and drive. It gets its name from the fact that it forms a limbus or ring deep under the cortex. It drives many functions we wish we had conscious control over, but don't: for instance, hunger and sexual desire, and the experience of inspiration. The limbic system connects more strongly to the temporal lobes than to any other region of the cortex. This strong connection 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 importance of mood swings in driving creativity.

Although -- at least in principle -- everyone approves of creativity, many have been skeptical of attempts to study or enhance it. The artist's view of creativity is often that it should be left alone, that looking too closely could endanger it. Often, the basic scientist's view is also that creativity should be left alone, that it is by definition too anomalous for controlled study. That has left the study of creativity enhancement to New Age practitioners, inspirational-business seminar leaders, and a few brave social scientists. Even social scientists have been hesitant. Freud, in his essay on Dostoyevsky, wrote that "before the problem of the creative artist, analysis must, alas, lay down its arms." (To be fair, though, psychoanalysts have struggled more valiantly with the problem than have other clinicians. Psychopharmacologists have a tendency to dismiss creativity as a reason patients make up to excuse not taking their pills.) Some social scientists believe that enterprises as diverse as scientific discovery, literature, dancing, and successful business decisions should not all be lumped under the single concept of creativity. Howard Gardner, for instance, has argued that different intelligences are needed for different domains such as language and mathematics, and that creativity in one domain does not necessarily extend into another.

Nonetheless, researchers on creativity have begun to combine information from a number of different disciplines, and argue persuasively that it is such an important phenomenon that we cannot afford not to study it. Most researchers agree that a useful definition of creative work is that it includes a combination of novelty and value. Creativity requires novelty because tried-and-true solutions are not creative, even if they are ingenious and useful. And creative works must be valuable (useful or illuminating to at least some members of the population) because a work that is merely odd is not creative. This two-factor definition of creativity also provides an explanation of why the creative can lie close to the crazy (unusual but valueless behavior).

The definition of creative work as novel and valuable also captures the societal aspect of what gets called creative work. Creativity is not the property of a work in isolation: Novelty and value have to be defined in relation to a social context. When I use a lever and fulcrum to move a rock in my garden, I don't get the creativity points that I would have if I were Cro-Magnon. Sometimes the social context is not clear, however. Who should judge whether a work such as Finnegans Wake is creative? The general public is generally neither skilled nor interested enough, whereas specialists in a field are sometimes so invested in the status quo that they resist innovation. The role of social context in determining value also underlies the process whereby the geniuses of one generation are hacks the next, while people dismissed as mad are rehabilitated as geniuses.

Sometimes the social context is all too clear; the notion of creative freedom becomes so rigidly codified that it is paradoxically restrictive. A good friend, a wonderfully inventive storyteller and decorator, nonetheless feels uncreative because she does not Paint or Write. Another recalls arguments with a high-school art teacher who insisted that he stop "limiting" his painting to black and white, and freely use color like the rest of the class. And a preschool teacher gently expressed concern about one of my daughters' enjoyment of precisely coloring within the lines of her coloring book (the other scribbles wildly). These examples also raise the issue of whether creativity can be taught, a thorny subject that I will now sidestep.

Just as creative work requires novelty and value, the creative thinker who produces it requires both talent and drive. Here I'll lay down my arms before the question of talent, and take up a different set of weapons to shoot the easier target, drive. Hypergraphia is a window onto the nature of creative drive, and its neurological underpinnings are better understood than those of talent. Drives are largely controlled by the limbic system.

The consensus seems to be that drive is surprisingly more important than talent in producing creative work. Researchers find that above an IQ of 115, there is essentially no correlation between creativity and intelligence. Rather, in Thomas A. Edison's words, "Genius is 1 percent inspiration and 99 percent perspiration." The argument that creativity is proportional to total output, is 99 percent perspiration, does not completely let us escape that problem of the remaining 1 percent, the sliver that separates the workaholic genius from the merely workaholic. Generating reams of text without some talent is not enough. As Eyler Coates put it, "We've all heard that a million monkeys banging on a million typewriters will eventually produce a masterpiece. Now, thanks to the Internet, we know this is not true."

How, specifically, does motivation affect creativity, both the generation and editing of ideas? Hypergraphia doesn't guarantee writing skill; its products can range from the simple (for instance, an epileptic patient whose copious journal was endless repetition of the thought "Thank GOD, no seizures" in variously colored ink) to the sublime (the novels of Dostoevsky or Flaubert, also temporal-lobe epileptics). But a compulsive need to write may indirectly make good writing more likely by increasing the time the writer spends practicing. This may be one factor in the very high incidence of manic-depressive writers. Kay Redfield Jamison calculates that poets are up to 40 times more likely than the general population to have had manic episodes.

It turns out to matter where the drive to write comes from. All driven writers focus on their work. But people driven by intrinsic motivations such as curiosity and enjoyment have a different relationship to the product of their work from those moved by extrinsic motivations including praise, money, and the constantly varying world of punishments. Someone who is fascinated by language attends to details and to the overall texture of a writing project more than she will if she is writing simply to satisfy the public. While strong intrinsic motivation increases creativity, surprisingly, adding extrinsic motivations -- even positive ones -- can actually decrease creativity. If that is true, paying a writer may paradoxically make him write less well. (As you might guess, I do not think this means you should not pay writers.) Reward may encourage the writer to stop work as soon as she has completed the minimal amount of work necessary for the reward, resulting in what Herbert Simon called "satisficing." Extrinsic motivation may also have a negative effect on creativity by distracting the subject's attention from the task to thoughts of reward or punishment.

This implies that the best way to foster creative writing is to give the writer freedom to work on a subject he loves. But the motivation to write may also be infectious, as Plato described in the Ion. "[The Muse] first makes man inspired, and then through these inspired ones others share in the enthusiasm, and a chain is formed, for the epic poets, all the good ones, have their excellence, not from art, but are inspired, possessed, and thus they utter all these admirable poems." There is actually some scientific evidence for Plato's position: Children shown videos of other children enjoying their work not only enjoy their work more, but seem to escape the negative effect of extrinsic rewards. Reward makes them perform even better.

But how to explain -- and help -- people who know how to write, seem to want desperately to write, and yet do not? This question is, of course, a special case of what to do with creative block in all fields. The scourge of block, and its handmaid procrastination, have been documented since the ancient Egyptians, who had two separate hieroglyphs for the latter. Does writer's block have a neurological basis that is the opposite of hypergraphia? Yes -- in certain respects. Block is highly associated with depression, just as hypergraphia is with mania. And block shares with depression some features of frontal-lobe alteration, including lack of initiative and excessive self-criticism. There is evidence for a push-pull interaction between temporal and frontal lobes in creativity, an axis that turns sideways the 1970s theory of right brain-left brain interactions. While a link between block and depression seems to fly in the face of the conventional wisdom that professional writers often suffer from depression, the fact is that talented writers are actually more likely to be blocked than poor writers. (This is true outside of literature as well. The tremendous outpouring of Leonardo da Vinci's ideas, for instance, was matched only by his long list of giant unfinished projects.) Most writers with depression do their writing not while depressed, but while on the edge of a mood change, or in a rebound euphoria. Indeed, many writers who carry the diagnosis of depression actually have mild bipolar disorder. This in part explains why writers can have odd combinations of block and hypergraphia simultaneously. For instance, the modern equivalent of Eliot's Mr. Casaubon, blocked on his grand Key to All Mythologies, may instead turn out megabytes of e-mail messages and blogs a day.

Such genre specificity in block is more evidence that block is not a problem with cortical writing skills but with limbic drives. Yet many college programs fight block with cognitive strategies, such as making an outline and brainstorming, or with cognitive-behavioral therapy. While these are often appropriate, remembering that block is a brain state as well as a mental state can provide alternate approaches -- and not necessarily involving drugs such as antidepressants or stimulants. For instance, a writer who finds that his creativity and productivity plummet around Thanksgiving and Christmas every year may blame his lack of motivation, or wonder if the stress of seeing his dysfunctional family twice in two months is what is doing it. Yet a significant winter dip in creative output has been documented by researchers for artists in general. It is most likely due to shorter day length, which triggers an unpleasant hibernation instinct even in those of us who don't have full-blown seasonal affective disorder. The writer described here may therefore find setting a small light box on the table next to his breakfast cereal would have a more immediate benefit to his productivity than would working through issues with his mother -- although the latter option, of course, may have other benefits.

The urge to write is a secondary drive that grows out of a more fundamental drive, the drive to communicate. But how fundamental is the drive to communicate? The behaviorists argued that it, too, is secondary, that we are conditioned to use language because it gets us things we want: food, sex, permission to use the bathroom when we are in elementary school. More recent researchers propose that communicating is something hardwired into us, that we have, in Steven Pinker's term, a language instinct. This position does not deny that language is useful for getting things; indeed, it argues that language has been hardwired just because it is so useful.

The way emotion drives language becomes clearer when we look at the evolutionary origins of speech. Until recently nearly everything that was said about language origins proceeded from a certain smugness about our role as the only species with true language, with grammar. It is true that nonhuman primate communication contains only a limited number of signals (sounds or gestures with innate meaning, such as laughing or screaming) and even fewer symbols (items whose meaning must be learned, as in the snake- and eagle-alarm calls of vervet monkeys). And there is little interchange in primate communication -- primates make pronouncements rather than conversation. Finally, and crucially for followers of Noam Chomsky, primates have no grammar. But there is still important information to be gained from studying nonhuman primates.

Linguists tend to focus on semantics and syntax, on sentences as vehicles that transmit solely a logical proposition. In practice, however, we often interpret sentences more "primitively," looking for the emotional or limbic aspects of speech, even before we bother with the semantic aspects. When a colleague bursts into your office with a rant about some departmental policy, you are likely to store the entire 15-minute tirade as a judgment about emotion -- "Anne is angry" -- and dispense with the cognitive aspects of her argument. Traditional linguists may argue that the emotional aspect of language, transmitted as much by tone as by words, does not separate it from primitive nonlinguistic gestures such as giving someone the finger, and thus is not a fit subject for linguists. It is nonetheless an essential subject for understanding what drives us to speak and write.

Social monkeys are much more likely to make expressions of pain than are solitary species, because for the latter, wincing does not get them any aid; it merely attracts predators. Is it too reductionist to suggest that a major reason for creative writing is an abstracted version of the same biological urge that causes you to cry out in sorrow or anger? Let us call it the need theory of self-expression. It is perhaps a more inclusive formulation of Freud's description of literature, which he believed was driven only by unexpressed sexual needs. It also has a dollop of more modern neuroanatomy and evolutionary biology thrown in. There is admittedly a big step between nonlinguistic expressions of emotion and semantic propositions. Such an explanation need not fit all writing. It would not cover technical or impersonal writing -- the medical journal Prostate, or the book How to Talk to Your Cat come to mind. It would include most autobiographical writing, most fiction, most poetry, and most nonfiction in which the author had a strong personal stake in the subject. I was going to include my previous book, an apparently dry handbook of neurology, along with Prostate and How to Talk to Your Cat, but I realized that it secretly was a record of three very happy years as a neurology resident, under the tutelage of two wonderful mentors -- that's why I enjoyed writing it so much. Maybe the Cat guy had similar personal motives.

If language and writing grow out of a biological system for attempting to fill needs, then the notion of self-expression, so often invoked vaguely to explain the artistic urge, can be better understood. Self-expression is not simply a broadcasting of personal characteristics or tastes. It is generally, if subliminally, much more goal-directed than that. Educators often justify art and creative-writing courses on the grounds that self-expression can teach the student more about himself or herself. This may be true to some extent, but many creative writers have been quite capable of powerfully emotive writing while lacking insight into the internal conflicts that drive their suffering. Nonetheless, while they may not gain insight, they may gain a sense of relief, and a sympathetic audience.

Yet to the extent that self-expression does broadcast and reinforce a person's character, it makes clearer one more link between art and, if not mental illness, eccentricity. Because the more like ourselves we become, the odder we become. Insanity is like sanity, only much, much more so. This is most obvious in situations where society no longer keeps us in line: the eccentricity of the very rich, or of castaways.

Can any of this need theory of self-expression be tested? One group of studies by Alice Brand provides evidence that writing, at least on personally chosen subjects, has measurable mood effects. In both students and professional writers, the act of writing both intensified positive emotions and blunted negative ones. This was somewhat of a surprise to researchers in the field of composition studies, as the standard view of writing emphasized the anxiety induced in students by writing assignments. The findings were consistent with what has been described by many writers, from hypergraphic patients to Joyce Carol Oates when she said, "I have forced myself to begin writing when I've been utterly exhausted, when I've felt my soul as thin as a playing card ... and somehow the activity of writing changes everything." Ernest Hemingway saw Oates's half-full glass as half-empty: "When I don't write, I feel like shit." Some writers, such as the poet Tina Kelley, describe a physical sensation of unease or restlessness that torments them if they haven't written for a few days. For others, it is a sort of headache, a stuffy, swollen brain. Milton described feeling like a cow that needs to be milked. And for many, there is the primal conviction that they should not do anything but write because it is their vocation, in a nearly religious sense. Writing is what they are meant to do, and the headaches and the restlessness are their body rebelling when it is kept from fulfilling its destiny.

Reuniting language with the screams and cries of animal communication, looking at it not as vibrations in the ether but as a secretion of one of the spongiest organs in the body, goes against most of traditional linguistics' stress on language as semantics, as a way of making statements about truth. But the huge popularity of fiction, in which the majority of the "events" are not true, tells us that there is something more going on with language than the symbolization of truth, at least truth narrowly defined. If chimpanzees use utterances for emotional expression, if toddlers compulsively narrate events as they happen, it may be that these are merely the most primitive facets of language. But that is not a reason to neglect them. Their very primitiveness fits with what we feel about language and writing, that it is fundamental to our nature. Emotional meaning is deeper than cognitive meaning, both literarily and literally, anatomically in the heart of the brain. In thinking about language we need to broaden our scope from mastering syntax and constructing tight paragraphs, to look also at gains and losses of significance, the afflictions of writers who write too much or hold back from writing, and our primal desire for our words to mean something to someone else, somewhere.

Alice Weaver Flaherty is a staff neurologist at Massachusetts General Hospital and a neurology instructor at Harvard Medical School. This essay is excerpted from The Midnight Disease: The Drive to Write, Writer's Block, and the Creative Brain, to be published in January by Houghton Mifflin. Copyright 2004 ? by Alice Weaver Flaherty.

This excerpt was printed in The Chronicle of Higher Education, November 21, 2003

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