PERSPECTIVES

Writer’s Block In academia, the notion of writer’s block is disdained by younger

members but seems to gain respect at higher levels where it occurs
M. Castillo, Editor-in-Chief more commonly.4
Writer’s block is better termed “creative inhibition” or “cre-

A fter writing nearly 70 Perspectives, it was bound to happen; it

seems I have hit “writer’s block.” This is the first time I sat
down to write my monthly essay in over 8 months and I decided to
ative block.”5 It is becoming more prominent: it was little known
by the early Romantic writers, became more prominent during
the epoch of the French Symbolists, and last, was rampant (and
use the occasion to familiarize myself with this condition (and try became a recognized entity) during the period of the great Amer-
to liberate myself from it). Writer’s block varies in intensity from ican novel. Today, in a manner similar to attention-deficit disor-
extreme (abandoning one’s career as an author—think Harper der, writer’s block is a nearly unique American affliction (though
Lee and Ralph Ellison) to trivial and temporary (which I hope it occasionally happens in other countries, vide infra).6
mine is). Why worry? Most writers have it at one time or another. Agraphia is the ultimate writer’s block because it refers to the
The most common causes cited for writer’s block are lack of in- physiologic inability to write, but, in this case, lesions in the brain,
spiration, illness, depression, financial pressure, and a sense of such as those induced by trauma or stroke, are present and explain
failure. None of these apply to me. In my case, maybe it is just it. Agraphia results from damage to the Wernicke area and is
good old academic pressure. With increasing frequency, I hear nearly always accompanied by other language disabilities. In some
that the only part of AJNR that our subscribers read is my Perspec- cases, the inability to write may be physical, such as so-called
tives, to which I say: What about the rest of the Journal? That is “writer’s cramp.” This is a muscle dystonia, and DTI has shown
where most of my energy and time are spent! And, if our readers fractional anisotropy changes in the fibers connecting the primary
are paying that much attention to my short essays, should each sensorimotor areas with subcortical structures in individuals who
one be better than the last? Writer’s block sounds like the ideal suffer from it.7 In such individuals, fMRI has also shown abnor-
excuse to avoid thinking about what to write (just look at the title mally low activation of the sensorimotor cortex and supplemen-
of my first reference: “Writer’s Block as an Instrument for Re-
tary motor areas.8 The findings of these studies imply that both
maining in Paradise”).1
inhibitory and excitatory mechanisms play a role in writer’s
Writer’s block is a modern notion, and the term was coined in
cramp and that the pain it causes prevents writing by hand. Writ-
1947 by Dr Edmund Bergler, a famous Austrian psychiatrist living
er’s cramp can also develop during typing and other activities
in New York City.2 Today, it is well accepted that the notion of
such as using a screwdriver. Compared with men, women are
writer’s block arose in conjunction with the sudden prestige of
thought to be better writers; however fMRI does not show signif-
psychiatry in the United States after World War II. Dr Bergler, a
icant differences in brain activation for either sex while writing.9
follower of Freud, blamed writer’s block on oral masochism and a
The same study found significant differences between good and
milk-denying mother (that gives me something to think about
poor writers while handwriting, mostly in brain regions involved
because I know that I was bottle-fed!), in addition to other “phal-
with planning for serial finger movements.
lic and anal” explanations along Freudian lines. Stress leads to
The opposite of writer’s block is also known to occur, and it
panic, and some scientists believe that the reticular activating sys-
can be temporary or affect an individual all of his or her life.
tem in the brain stem will shift higher functions associated with
Balzac, Hugo, and Dickens probably had “graphorrhea.” The
writing from the cortex to the limbic system under duress.3 Oth-
problem with calling the obsession to write “graphorrhea” is that
ers disagree and think that the creative writing process starts at the
this term is also used for manic patients who compose long lists,
level of the limbic system, whereas more technical writing is ini-
tially fueled by the frontal cortex. If both were true, all writing many times containing only meaningless words, which is not the
would stop as functions shift from one location to the other. How- same as writing many great novels. As psychiatry evolved from an
ever, writer’s block can be selective, as it is in my case. That is, I analytic discipline to a chemical science, writer’s block came to be
continue to write other articles, chapters, and books, but writing blamed on abnormal brain chemistry. More seriously, writer’s
this specific series of essays is my problem. Writer’s block is com- block can be a manifestation of a dangerous underlying psychiat-
monly seen in college and university students who consistently ric disease such as schizophrenia, obsessive compulsive disorder,
fail to turn in their written assignments. In them, procrastination or substance abuse (think Scott Fitzgerald).
(a behavior specifically called “academic trait procrastination”) is Writer’s block has been assessed in individuals who speak lan-
a major component of writer’s block. Procrastination is learned, guages other than English. Two studies addressed it in Chinese
so education specialists claim that it can be unlearned.1 Perfec- and Spanish native speakers and found that it occurs in those
tionism is also blamed for the block; it seems to motivate some languages as it does in English.10-12 In other languages, as in Eng-
procrastination, and together these both promote writer’s block.1 lish, writer’s block appears to be related to premature editing and
to a lack of strategies for dealing with complex writing tasks. De-
veloping a strategy before the actual writing helps some individ-
http://dx.doi.org/10.3174/ajnr.A3729 uals. Princeton Professor and author John McPhee tells a related

AJNR Am J Neuroradiol 35:1043– 44 Jun 2014 www.ajnr.org 1043

story in his essay “Structure.”13 For 2 weeks he lay down on a fMRI has proved (many times) that ideomotor effects originate in
picnic table under the trees looking at them and wondering how the brain and not outside of it.19
to start a piece on pines. After 8 months of work, he was finally At this point, I must say that having finished this Perspectives,
able to turn it in. He suggests that having a preplanned structure I feel somewhat liberated. Whether that feeling will be short-lived
eases the stress of writing and results in a better organized and or last and allow me to write next month’s piece, you, kind reader,
flowing article. The ease of cutting and pasting makes attaining must wait and see.
the desired structure easier today than in the past.
The use of a computer with word-processing capabilities re- REFERENCES
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2. http://en.wikipedia.org/wiki/Edmund_Bergler#cite_note-Akhtar2009 –
ability to write. In one study, disabled spellers showed signifi- 11. Accessed July 24, 2013
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4. Gumz A, Brahler E, Erices R. Burnout experience and work disrup-
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Strategies for coping with (and curing) writer’s block include January 14, 2013, pp 46 –55
group discussions, brainstorming (I wrote an essay against this), 14. Richards TL, Berninger V, Winn W, et al. Differences in fMRI acti-
vation between children with and without spelling disability on
list-making (I have a long list of topics that I have considered, but 2-back/0-back working memory contrast. J Writing Res 2009;
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1044 Editorials Jun 2014 www.ajnr.org