|
||||||||
|
NEUROLOGY
Brain Regions May Sap or Spur CreativityThe deadline is only two hours away. Do you know where your muse is?It may be flitting back and forth between your brain's frontal lobe, the harsh inner critic located behind your brow, and your temporal lobe, the compelling creative force arising behind your ear, says Alice Flaherty, HMS instructor in neurology at Massachusetts General Hospital.
Looking at the neurological basis of creativity disorders opens up new treatments for writer's block, says neurologist Alice Flaherty. (Photo by Graham Ramsay) Students of popular culture know the left brain-right brain theory of creativity, but Flaherty turns it sideways in a new hypothesis blending the seemingly opposite problems of hypergraphia, the overpowering desire to write, and writer's block, a more common and painful quandary. Frontal vs. Temporal Lobe"It is likely that writing and other creative work occur, in part, through a push-pull interaction between the frontal and temporal lobes, which have very strong anatomical connections," Flaherty told her colleagues at a recent grand rounds titled "(Grant) Writing as Disease."
Central to Flaherty's thinking is the role of the temporal lobe in hypergraphia. Temporal lobe epilepsy, mania, and even senile degeneration confined to the temporal lobe can cause compulsive nonliterary creativity, she said. Flaherty herself had two bouts of postpartum hypergraphia, possibly triggered by hormones acting on the temporal lobe--one after the premature birth of twin boys who died and the other after the premature birth of twin girls who lived. At McLean Hospital, Flaherty often sees college students at the opposite end of the spectrum, whose biologically based mental illness was detected only after they stopped doing their schoolwork. A common cause--and a possible consequence--of writer's block may be depression, which can sap energy and motivation, Flaherty said. The author William Styron described his depression as "an abyss of sorrow, a noncommunicable grief that at times ... lays claim upon us to the extent of having us lose all interest in words." Depression can mimic mild frontal lobe damage, said Flaherty. Depressed people can have trouble making decisions. They appear emotionally flat. They get stuck in cognitive ruts and try to apply the same, often useless, solution. "An interruption can help," she said. "So forcing yourself to stay at your desk too long is counterproductive, but it is just the sort of thing that depressed and blocked people do." Anxiety or too much frantic energy can also thwart the creative drive by a kind of stage fright. "Techniques often tried to break writer's block--black coffee, whipping yourself with guilt--can make it worse," Flaherty said. Medical interventions such as psychotherapy and drugs may be helpful. Procrastination may figure in here as a way to avoid confronting the core angst, but cognitive therapy that teaches timelines can miss the point. A Creative TouchIn late October at the Deep Brain Stimulator Consortium meeting at the National Institutes of Health, Flaherty presented the case of a high-functioning woman, 37, an Ivy-league graduate and medical editor with Tourette's syndrome, whose uncontrollable tics had broken her limbs and blinded her in one eye. After neurosurgeon Emad Eskandar, HMS assistant professor of surgery, and Rees Cosgrove, HMS associate professor of surgery, both at MGH, implanted a wire that ends in the nucleus accumbens of each frontal lobe, the woman's tics decreased slightly.The mood changes, on the other hand, were profound. Deeper settings produced mild depression, but "on the upper settings she was more productive and creative on work and personal projects. Her work supervisors independently noted her increased creativity, asking 'What was it they put in your head, and can other people get one?' The possibility that stimulating the accumbens, a dopamine-rich region involved in drives, can increase creativity fits with studies showing that creativity correlates much better with motivation than IQ." Flaherty has reviewed current theories, illustrated them with literary cases, and outlined tests of her hypotheses in a new book called The Midnight Disease (Houghton Mifflin, 2004). With the help of a Scholars in Medicine fellowship, one of the Claflin Distinguished Scholar Awards (see page 5), she has begun working with Shelley Carson, lecturer in the Harvard Psychology Department, to test these ideas. --Carol Cruzan Morton |
