What to Write When You Don’t Know What to Write

This week, I’m taking a break from The Psych Writer to discuss writing.

Writing is my bread and butter. I have some posts I’ve written about writer’s block, and facing the terror of the blank page. In fact, I’ve written about the blank page twice, at least. But writer’s block still seems to be one of the biggest complaints I’ve seen among young writers or writers who are just starting out.

Recently, I got this in the form of a question. “What am I supposed to write when I don’t know what to write?”

Since I am trained as a therapist, I tend to want to pick apart problems and either reframe them or otherwise deconstruct them in order to help.

So when you don’t know what to write, it could be for a variety of reasons.

  • You may be afraid of failing and not completing a project.
  • You may be afraid of succeeding and not knowing what to do next.
  • You may think your writing will never be good enough, so part of you feels it’s not even worth starting.

There are obviously many more reasons for keeping that page blank, but for this post, let’s just focus on these three. If you have one or two you’d like me to address, please shoot me a message on Facebook if you’d like, and I’ll address them in future posts.

  1. You’re afraid of failing and not completing a project.
    It happens. I have a few manuscripts I’ve abandoned about 3/4 of the way through because the idea wasn’t panning out, I couldn’t write the characters in a way that satisfied me, or a variety of other reasons. It happens to everyone. Think of your favorite writer, living or dead, and I could almost guarantee you they have abandoned and unfinished work.

    The best way to get around this is the “fuck it” philosophy. Say to yourself that you’re going to start a project and if it doesn’t pan out, fuck it. Start over, change direction, whatever. You can also just keep going even if you know it sucks, because the first draft of everything sucks. So go until you’re finished. Write until there’s no story left. You can revise it later.

  2. You may be afraid of succeeding and not knowing what to do next.
    This is one I’ve heard a few times now, so it’s not terribly uncommon. In this case, you’re fortune-telling. Can you really see the future and know you’ll be devoid of further ideas? Well, so what? One book that’s finished beats the hell out of one half-finished story that never got off the ground. Preventing yourself from succeeding because of what might be next cheats you out of the satisfaction of a finished project.
  3. You may think your writing will never be good enough, so part of you feels it’s not even worth starting.
    There’s one thing I’ve learned, and I’ve said it above–the first draft of everything is a steaming pile of crap. Some of it has potential, but every first draft needs to be reworked. You will learn to kill your darling manuscript with a hatchet at first, then come back with fine, surgical editing tools to improve it. Tell the part of you that tells you it’s not worth starting to shut up,  because that part of you cannot know what it feels like to finish a project. You have to get to the end to know what that’s like.

When you sit down to the keyboard, or sit with a pen and paper, block out the future. Block out expectations. Block out everything but you and that page, and tell it your passions, your fears, your world.

Get writing.


I am Anne Hogue-Boucher, and I write books. You can read them here.

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The Psych Writer on Major Depressive Disorder, Part Three – MDD with Psychotic Features

This is the final installment of The Psych Writer series on Major Depressive Disorder. This week, we turn our focus on MDD with Psychotic Features.

Of course, when writing any disorder, focus on showing rather than telling, and remember, your character is human. Give them more dimensions than their disorder.

What’s tricky about writing MDD with psychotic features is not making it look like schizophrenia or bipolar with psychotic features. You will need to make sure that the depressive features are most prominent, otherwise the reader isn’t going to get it.

Naturally our writings are always open to interpretation by the reader–that’s what makes it such an enriching experience. It’s not the focus on the symptoms that makes the writing interesting, anyway. It’s the expression of the character and their life that makes the reading compelling.

So, we’ve already reviewed what MDD is all about, but what about psychotic features? Psychotic is a word that’s used in lay terms that tends to get confused with other terms (hell, even I’ve confused the terms when I was exhausted at one point). Psychotic is a term for losing touch with external reality.

The patient who is psychotic can experience any of the following, with some examples for illustrative purposes:

  • delusions – believing someone has bugged their home, is being gang stalked, they have a terrible disease, or that they’re the Archduke Ferdinand.
  • hallucinations – seeing, hearing, tasting, or smelling things that aren’t there, such as seeing a person that no one else can see.
  • anxiety – the person may seem anxious and restless.
  • withdrawal from family and friends – sometimes due to the delusions and hallucinations, the patient withdraws from social interactions. This is not just an “oh, I don’t want to go to the mall.” This is more like they don’t answer any of their phone calls and they stop talking to people entirely. Think the most extreme form of withdrawal possible.
  • suicidal ideation and actions – they may attempt to kill themselves or think about it all the time.
  • disorganized speech – this isn’t your average non-sequitur. Disorganized speech is often completely incoherent. There are several types of DS:
    • word salad – seemingly random words put together in a sentence. “My pants raisin toggle the burp slurped in a cat.”
    • derailment – completely unrelated or tenuously related ideas put together as if they were related. “I have to pick up my dry cleaning. There’s a bar in the street that keeps me from walking to the park.”
    • neologisms – words that are made up. “I took my wife to the helgistahooven for a new haircut.”
    • perseveration – a response repeated uncontrollably (this can be verbal or gestural). “Did you pack a pair of socks?” “Socks, socks, socks, socks, socks, socks, socks…”
    • thought blocking – when a person stops talking abruptly in the middle of a sentence without any explanation. “I went to the store and-” *silence*
    • pressured speech – rapid speech that sometimes is incoherent.
  • difficulty concentrating – this is pretty self-explanatory.
  • hypersomnia or insomnia – sleeping too much or not enough.
  • suspicion of others and situations – this is usually due to delusions.

Keep in mind that the person with psychosis is typically unaware of these symptoms and signs. They are often so out of touch with external reality that they have no idea that their delusions or hallucinations aren’t real, and that their behavior has changed to be out of the ordinary.

Here you see there are some things that crossover with depression, such as suicidal thoughts or actions, anxiety, and withdrawal. Knowing this, it’s easy to understand how difficult differential diagnosis can be.

The standard treatment for MDD with psychotic features is antidepressants and antipsychotics. If that doesn’t bring relief, ECT (electroconvulsive therapy) is another common method.

Overall, when writing a character with this disorder, there’s an opportunity to do a little reality bending. Just don’t make it too much of a trope.

Coming up for The Psych Writer, we’ll tackle some of the following subjects (not necessarily in this order):

  • Bipolar Disorder I and II
  • Munchausen Syndrome
  • Munchausen-By-Proxy Syndrome
  • Anxiety Disorders – Generalized Anxiety Disorders, Panic Disorder, PTSD
  • Schizophrenia
  • Autism Spectrum Disorder
  • Personality Disorders: Exploring the three clusters of the ten disorders.

I also take requests. Any disorder you’d like me to explore? Contact me via Facebook.


Anne is a former supervised therapist at the Master’s level who abandoned it all to become a writer. Visit her shiny Author Page to learn more about her and read some of her more macabre thoughts on paper (or eBook).

The Psych Writer on Major Depressive Disorder, Part One

Disclaimer: This is not a substitute for medical advice and is for educational purposes only. If you read this and any of the below sounds like you, seek the help of a licensed professional in your area.

Depression is a big topic. There are different types of depressive disorders, but for the purposes of this post, I’m going to focus on Major Depressive Disorder (MDD), which affects about 6.7% of the US population. That’s around 15 million adults.

Last week, we reviewed an introduction to MDD, and I still didn’t even get into all of it. So I’ll do that here, briefly. Because of the many sufferers of MDD, there get to be a whole slew of levels of severity and specifiers. While you’re writing about these characters who have these disorders, don’t forget they are a person and they are not their pathology.

Nothing is worse than a character whose only interesting thing about them is their disorder. Remember Forgetful Jones from Sesame Street? Even he had more than one dimension. He was a cowboy. So if a cowboy Muppet with amnestic disorder can be more than just a one-dimensional character, Depressive Jones can, too.

When you decide to write from a place where your character has MDD, decide what type they have. This can be mild, moderate, or severe. They can have psychotic features (delusions, hallucinations, etc.). They can have partial or full remission as well. (Partial remission is having some of the symptoms but not meeting the full criteria for MDD for a period of less than two months. Full remission is an absence of symptoms for more than two months.)

MDD also can come with certain specifiers, such as with anxious distress or with catatonia, but there are too many specifiers to go into without scaring you away from the subject forever. I could likely write a book on each of the specifiers. So, in the interest of time and space constraints (which I will now call space-time constraints to either irritate or amuse mathematicians and physicists), I won’t list them all here. You may wish to skip over certain specifiers, but with psychotic features you can often cross it over with supernatural fiction. This should be handled carefully, though, because otherwise you risk it becoming a trope.

Another important thing to remember is that MDD distorts a person’s perceptions. I used to tell patients that their brains were trolling them. This troll brain is part of the illness. It is best expressed through Beck’s cognitive triad. The person with depression has a negative view of themselves, of the future, and of the world. They often don’t believe they’ll ever get better, this is the way it is, and that there is no one or nothing that can help them. This triad does not necessarily apply to all people with depression all of the time, but there tends to be more leaning towards negative and pessimism during the course of a depressive episode.

When writing from a therapist’s point of view, your character would see the person as ill. They would note things such as poor attention to personal hygiene, being tearful, and a depressed affect (they look “sad” or “down”). It’s an ethical therapist’s job to help a patient process their thoughts and reframe things that happen to them–to teach them how to rethink things. They also do things such as medication education and other interventions. Treatment often consists of Cognitive Behavioral Therapy (CBT).

An unethical therapist would do things such as foster dependency, and interventions that keep the patient depressed and vulnerable to manipulate them into doing things the patient would not normally do. People with depression can be quite vulnerable, and so open to suggestion in order to find relief, a therapist without ethics could possibly ruin the patient’s life further.

I’m not sure if it’s as interesting to write about a therapist treating someone with depression as it is to write about someone who has depression, but even then, it’s important to give your characters full dimensions.

No matter what, though, write your character as a person first, and their condition second. Otherwise, you risk making a flat character that’s nothing more than a stereotype.

If you came here looking for help with depression, please seek the help of a licensed professional in your area. Depression is a horrible, soul-sucking disorder that takes your life piece-by-piece. Don’t let it take control over you. Call for help. It’s out there.


There is little more horrific than what lies in our own imaginations. If you love reading about nightmare worlds and strange happenings, check out my author page. You can also follow me on Twitter or Facebook.

On Writing Reviews – The Dude

Have any of you read Food with the Dude? Well, it’s not your average food critic site, where someone who’s all stuck up their own ass gives a review/critique of the service in relation to their own personal snobbery.

If you want to become a reviewer and food critic, I think you need to follow The Dude. His unique approach is fair and covers multifaceted aspects of a restaurant, including accessibility, sanitation, food quality, and service. What I like most about it is that he keeps it fair.

Take a look at one of the more negative reviews about a restaurant that couldn’t quite get his mother’s steak right. Now, some of these food snobs who call themselves “foodies” because they’re too afraid of the word gourmand and couldn’t spell it if they tried could really afford to take a lesson from The Dude. He uses tact and thoughtfulness to express why service was not up to par, or why the food wasn’t as tasty as it could have been. Blame isn’t assessed, it’s analyzed.

The Dude keeps a rule of “Be Nice, Be Respectful,” and it works. When I read his reviews, I feel like I know exactly what to expect when I visit the restaurant he’s reviewing. He follows ethical critique which is a refreshing break from the bombastic style of “food critics” who just want to be crabby, snobbish bitches.

I suppose I could take a lesson from The Dude, myself, as I’m a bit crabby. But in all seriousness, I enjoy reading his reviews and am looking forward to a road trip to try out some of these places. If The Dude ever comes to Atlanta, I’ll be pleased as a pig at the trough.

This review style is the kind of succinct, straightforward writing I enjoy seeing in a review. He cuts out the nonsense and presents you with the real experience.

It’s a great example if you’re looking for inspiration on how to write your own reviews.

Nicely done, Dude.


I like to write about writing, and I do a little writing, myself. If you’re looking for something to read that’s a fun scare and enjoy Lovecraftian nightmares, check out my author page on Amazon. You can also follow me on Twitter and Facebook.

The Psych Writer: Seven Stages of Grief

By popular demand (with only one detractor and over 50 votes total), and a burning desire to put my graduate studies to good use, I’ve decided to combine two things I love and am good at by starting something that may help other writers. I’m putting together a series called The Psych Writer.

This series will consist of different psychological problems and mental illnesses. I will explore them with some level of depth for the following purposes:

  • To give readers and writers a clearer understanding of the psychopathology behind particular mental illnesses and life problems.
  • To give writers who are writing from a therapist’s perspective a better understanding of how a trained therapist would work with such psychopathology.

Granted, you will want to take poetic license at some point to make your work fit your world. The purpose is not so that you write a counselor, therapist, or psychologist perfectly, but that you have a better understanding of how they’ve been trained. That way, you might avoid writing some cringe-worthy material for the in-the-know audience, and make it far more believable and less distracting when read.

This installment deals with the seven stages (or phases) of grief. It’s a brief overview, as I intend to go in-depth on each phase in the following seven installments of The Psych Writer.

Grief is not a mental illness unless it becomes complicated (and even then it’s not truly a mental disorder yet according to the DSM-V, but we’ll discuss that in a later installment), but it is considered a life problem that can interfere with functioning. This is normal and it happens to virtually everyone.

Because we’ll be exploring these seven stages in-depth, I will refrain from delving into the writer’s and therapist’s perspectives. For this installment, we’ll go over a quick outlook at the stages.

Bear in mind that these phases are put in order for the convenience of the therapist, and that real human beings do not experience these stages in a nice, neat manner. Instead, they may experience them in order, out of order, or concurrently. All of that is considered normal and expected.

Additionally, these seven phases do not belong solely in the realm of death of a loved one. They can mark any kind of loss or end of most anything. Divorce, loss of a limb, end of a relationship, etc.

Phase One: Shock/Disbelief
“I can’t believe s/he’s gone.” This is probably the most uttered expression of disbelief and is the most well-known. The person in bereavement often describes feeling numb or nothing. No tears come even though they want them to or believe they should. They are so in shock sometimes that they faint upon hearing the news of a loss. Some feel like they’re on automatic pilot. This stage may last a few days, or a few weeks.

Phase Two: Denial
This used to be a part of shock and disbelief, but therapists tend to agree denial is a phase all of its own. Denial mimics shock at times in its lack of feelings, but it goes deeper than the initial shock of the news. It’s a full setting aside of one’s emotions so that they can carry on, which sounds great, right? Except inside, there’s an ugly storm brewing. Getting stuck in this phase can lead to substance abuse and other types of self-harm. This phase can go so far as the person pretending their loved one isn’t dead. They want to pretend it never happened or that there was some reversible mistake and any moment now, their loved one or whatever was lost will walk through the door or spontaneously regenerate. More on that later.

Phase Three: Bargaining
Some people plead to have their loved one back, even when they know it’s not possible. It’s been 20 years since my father died, and there are moments when I still hit that bargaining phase (I’d give away all my possessions to hear his voice again, or some variation of that phrase). This is something a therapist will hear in many terminally ill patients, but it happens to almost everyone. They want their losses returned. They may pray or bargain with God if they believe in the concept. They may just engage in wishful thinking.

Phase Four: Guilt
This phase comes in a variety of forms. A person feels guilty because they didn’t spend enough time with a loved one. They feel guilty because they had to make an end-of-life decision on the person’s behalf, and they question it–what if it was a mistake? They beat themselves up over having to make the decision, even though it was likely the best choice given their ugly situation. They are wracked with guilt about so many things they may not be able to put their finger on it.

Phase Five: Anger
“How dare he leave me?” “I hate him for dying!” This phase is self-explanatory, almost (but not quite). A person in bereavement is often furious at the loss, at the person, or the entity. They get angry with themselves, the person who ’caused’ the loss, the loss itself, and lash out at everyone in their way. I’ve noticed that with job loss, this phase tends to come earlier for people than it does in the case of death of a loved one. But it’s still there, and it’s still potent.

Phase Six: Depression
Here come the tears. In this phase (again, these phases are fluid and not concrete in any manner), the person is often crying and sad about the situation. They sleep too much or have difficulty sleeping. They don’t eat, or they overeat. It is what most people ‘see’ as being grief. Often, laypeople don’t realize that depression isn’t the only phase of grief and think that this is the only expression of the bereavement process. It isn’t, of course, but it’s usually the one that’s considered the most acceptable, or at least expected (depending upon cultural relevance).

Phase Seven: Acceptance
Oh, how some people think this is a happy time. It isn’t. Oh sure, in the case of job loss when you accept it and start pounding the pavement looking for something new, it brings peace that enables you to move on, but with death and dying? NO. This is not a happy time in the slightest. Acceptance can bring peace with the fact that you’re going to die, a loved one is going to die, or they have died, but by no means is this a cause for celebration.

I had a friend who was dying over a short period of time due to a rapidly developing terminal illness. We were sitting together on one of her final days and I asked, “are  you ready to die?” She turned her big blue-green eyes to me and gave me a small smile. “Sure. I mean, it’s not like there’s anything good on TV.” That was one of the best expressions of acceptance I’d ever heard. But it wasn’t happy for either of us. Humorous, yes, but not happy. She accepted her fate and died about a week later. This, my loving readers, is acceptance.

While I can hardly believe I got through that entire post without a single swear word, I can’t promise that for future posts. I hope that this series will prove to be fruitful for you as the reader or the writer.

If you came here to read and are in need of assistance getting through grief, please click this link to find hotlines in the US and Canada, and click here for a list of international hotlines. You can also search for local hospices, as they have a number of grief counseling resources.


Anne Hogue-Boucher isn’t always a horrible person who writes horror stories, but it’s fun when she does. You can follow her for more fun and entertaining content on Twitter and Facebook. Also, don’t put pennies on train tracks. It’s a waste of pennies.