Reprinted from the American Journal of Psychiatry, October 2004
Blessing and Curse
The Midnight Disease: The Drive to Write, Writer’s
Block, and the Creative Brain,
Alice W. Flaherty, M.D., Boston, MA, Houghton Mifflin Company, 2004,
266 pp., $24.00.
Reviewed by David L. Nathan, MD
Do you believe in the mind-body connection? Before you answer
this trendy question, there are two things you might recall from
your training: The experience of the mind emanates mainly from the
head, and the head is firmly attached to the rest of the body by
a structure we doctors call the “neck”. Thus, one might
as well ask if there is a knee-body connection.
In her new book, The Midnight Disease, Alice Flaherty entwines mind
and brain as she contemplates influences on the process of writing.
Flaherty, a neurologist who experienced postpartum manic and depressive
episodes, outlines similarities between bipolar disorder and the
strange but fascinating seizure disorder known as temporal lobe
epilepsy. She considers how the mind and brain contribute to the
phenomena of hypergraphia (the pathological tendency to write a
lot) and writer’s block. She applies traditional scientific
methods to examine human thought and behavior, looking at what happens
when the psychological and biological components of writing are
hampered. In the case of an ailing brain or a broken heart, we can
see what effect intrusion on a writer’s life can have on his
or her productivity. The sophisticated language and focused subject
matter of the book will not appeal to a wide readership, but may
hold interest for writers as well as scientists.
The author looks at writing as a highly advanced and culturally
dependent outgrowth of language, and she conveys to the reader a
sense of fragility in the writer’s craft. She draws upon her
professional background and personal difficulties to explain what
can make someone write at a pace so fast that it seems almost involuntary.
She also examines how other factors, such as depression or brain
injuries, can prevent a writer from producing at all. Speaking with
confidence and balance about biological and emotional influences,
Flaherty challenges the stigma of psychiatric and neurological disorders.
She also dispels a number of myths, for example that treating a
mood disorder will invariably reduce a writer’s capacity to
create. A caged bird may sing a pretty song, but not if its head
gets stuck between the bars of its cage.
Flaherty defines creativity as a union of novelty and value. Some
examples of writing, such as refrigerator warranties and certain
book reviews, lack novelty even if they are of value. On the other
hand, the incoherent hypergraphia of one who suffers from mania
may be original but devoid of meaning. She describes how some writers’
and poets’ work is fueled by pathological psychiatric and
neurological states. Paradoxically, the same or similar conditions
can lead to the evaporation of creativity and to the loss of the
ability to write at all.
As an extraordinarily literate scientist and author, Flaherty taps
into widely diverse perspectives on writing. Integrating thought,
emotion and biology is a monumental and perhaps impossible task,
so I should not have been surprised when I completed the book without
knowing how to put it all together. Flaherty herself appears to
concede the point, using Albert Einstein’s assertion that
“a chemical analysis of a cup of soup shouldn’t be expected
to taste like the soup.”
Still, I wished that there had been a more coherent thesis permeating
the many interesting anecdotes and explanations. The chapters on
hypergraphia, writer’s block and creativity describe without
fully assimilating all the descriptions. Flaherty entices the reader
with ideas to help with writer’s block, although most solutions
are familiar behavioral strategies. On the other hand, the chapters
on how and why people write are delightful and skillfully address
the biology and psychology of writing.
I would propose that the best part of this work is the wit of its
author, who is a remarkably bright and creative woman. Her stories
about personal experiences as a neurologist and mother are most
entertaining. But be warned: High verbal SAT scores are a must for
those who wish to read this book, as Flaherty uses vocabulary that
would send both Funk and Wagnall running for their dictionaries.
Nonetheless, the author’s principle target audience appears
to be dedicated scientists and wordsmiths, and The Midnight Disease may find a place on their bookshelves.
