Book Review

The Creating Brain: The Neuroscience of Genius

N Engl J Med 2006; 354:1539-1540April 6, 2006

Article

The Creating Brain: The Neuroscience of Genius
By Nancy C. Andreasen. 197 pp., illustrated. New York, Dana Press, 2005. $23.95. ISBN: 1-932594-07-8

How do we fathom the extraordinary musical outpourings of Mozart? Or the paintings of Michelangelo? In a word, what makes for “genius”? How often is creativity linked to mental illness, as in the case of van Gogh? Can one identify brain circuits that underlie uniquely creative activity? Can one train for creativity? The public has long been fascinated by the accomplishments of the most gifted people. Much has been written, but little has been clarified.

Wolfgang Amadeus Mozart at the Age of Six Years.

Nancy Andreasen's book comes closer to providing solid insight into all of these questions than anything else I have read. Although numerous authors have attacked individual components of the creative process, this book, to my knowledge, is the first to take an in-depth look at all the major elements. It begins by clarifying definitions regarding what constitutes creativity and genius and then reviews the literature on efforts to quantify IQ and elements of creativity. Recent research that monitors the activity of various regions of the brain during the creative process is presented, along with what is known of the relationship between various forms of creativity and psychiatric disturbance. The book explores the diverse environments that have given rise to explosions of creative enterprise, such as the Renaissance, and even offers suggestions for mental exercises and training programs for young children that may enhance creativity.

Andreasen is uniquely qualified for her task. At the age of five, she was declared a genius, on the basis of IQ tests. She subsequently earned a Ph.D. in English literature and taught at various universities before entering medical school and later training as a psychiatrist. Her research has focused on brain-imaging studies of people in diverse mental states, including those that are critical for creative activity. She has also conducted investigations of the relationship between various forms of psychiatric disturbance and creative efforts. For her accomplishments, Andreasen received the National Medal of Science in 2000.

Insights into creativity can emerge when one permits the great geniuses to describe the process in their own words. Mozart once commented, “When I am, as it were, completely in myself, entirely alone, and of good cheer . . . my ideas flow best and most abundantly. Whence and how they come, I know not; nor can I force them.” Here Mozart describes what one hears repeatedly — namely, that the greatest insights seem to arise spontaneously “out of the ether.” The playwright Neil Simon described the process succinctly: “I slip into a state that is apart from reality. I don't write consciously — it is as if the muse sits on my shoulder.” Tchaikovsky described his conception of a new composition by saying that “it takes root with extraordinary force and rapidity, shoots up through the earth, puts forth branches, leaves, and, finally, blossoms. I cannot define the creative process in any other way than by this simile.”

In order to clarify brain processes that may occur during bursts of creativity, Andreasen used positron-emission tomography to study the brains of people engaged in free-floating and uncensored thought and observed the dynamic interaction of multiple areas of the cerebral cortex. Another of her investigations showed a high prevalence of mood disorders among professional writers, with an incidence of up to 80 percent. Other studies have broken down the prevalence among various types of writers. Poets seem to display the greatest incidence of manic–depressive illness, with almost one in five having bipolar illness requiring hospitalization. The general public has often regarded the bizarre, otherworldly mental processes of schizophrenia as fertile ground for the type of “out-of-the-box” thinking that characterizes the most creative thought. However, creative accomplishment is “1 percent inspiration and 99 percent perspiration,” and schizophrenia is so disruptive to everyday functioning that productivity is impaired.

How can creativity be encouraged? For children, Andreasen recommends turning off the television, which promotes passivity, and encouraging interactive processes, such as reading aloud or listening to music. For adults, she emphasizes practice in imaging and observing, as well as spending time “just thinking.”

In sum, Andreasen packs a rich abundance of facts and ideas into a surprisingly brief book. Her literary talents are evident throughout, since the book is remarkably lucid and flows like a novel. The Creating Brain may not confer creativity on the reader, but it is an important contribution worth the attention of anyone who cares about the creative process.

Solomon H. Snyder, M.D.
Johns Hopkins University, Baltimore, MD 21205