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Book Forum: Mind, Brain, and Imagination   |    
The Midnight Disease: The Drive to Write, Writer’s Block, and the Creative Brain
DAVID L. NATHAN, M.D.
Am J Psychiatry 2004;161:1937-a-1938. doi:10.1176/appi.ajp.161.10.1937-a
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Princeton, N.J.

By Alice Weaver Flaherty, M.D. Boston, Houghton Mifflin, 2004, 266 pp., $24.00.

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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 a sense of fragility in the writer’s craft. She draws on 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 the work of some writers and poets 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 these phenomena 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. Flaherty uses vocabulary that would send both Funk and Wagnall running for their dictionaries. Nonetheless, the author’s principal target audience appears to be dedicated scientists and wordsmiths, and The Midnight Disease may find a place on their bookshelves.

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