Reading · Rat Park with Carl Erik Fisher

Recently, a lot of people have been asking me how to write a book. More than usual—I wonder why? (Wanting to make something enduring in a moment of uncertainty? Seeking to influence the popular discourse about health and behavior? Who knows?) Anyway, for a long time, it’s been one of the most frequent questions I get.

So, I wanted to write a post about how I wrote my first book, somewhat selfishly, so I could point people to it in the future rather than firing off inadequate thoughts in the moment. But also, I wanted to share my experience because publishing is opaque—I got to write (and finish, and publicize, etc.) a book in large part because of a combination of luck, privilege, connections, help from many others, and good timing. Some of those we can’t change, but I do think bringing a little more transparency to the process serves the world of writing well. (I’ll also link to some starter resources at the end of this post.) Some people shroud these topics in unnecessary secrecy or indirection; instead, I just want to write simply and directly, as if to someone who knows very little about the process.

Sometimes, very accomplished people ask me how to write a book, but they could probably write a book—sometimes they have already written academic ones. What they’re really asking is how to get to get the opportunity to write a book in the first place.

Early in my recovery, I hit upon an idea about the history of addiction that I wanted to pursue for my own sake. I described this fairly clearly in the opening of The Urge, but the upshot is: after my own addiction crisis and recovery, I was frustrated by the mess of oversimplified, incomplete explanations of addiction I found. I was especially frustrated by some viewpoints that argued for an overly reductionistic and medicalized perspective on addiction. I felt a more historically and humanistically grounded exploration of addiction would help. Simply put, I looked around for the book I wanted to read, and I felt like it didn’t exist, so I set out to write it.

Let me emphasize that I didn’t really know what I was doing, and many early conceptions of the book made basically no sense. I thought I had the germ of a good idea, but it had to go through many iterations, and I didn’t realize how important it was to test those ideas.

I remember meeting Elyn Saks early in the process—she is the author of The Center Cannot Hold: My Journey Through Madness, which is a wonderful memoir of her struggles with schizophrenia and the way she crafted a deeply meaningful life. Through a mutual connection I arranged a brief chat with her during an APA meeting in Los Angeles. I described to her, overconfident and a bit tone-deaf, how unique my story was. How even upon admission to the psychiatric ward at Bellevue, the NYU physicians didn’t know what to make of the unusual presentation of my manic episode. How I was unlucky enough to be caught up in the net of a physician health program and treated like a garden-variety alcoholic, but my real issue wasn’t quite addiction—sure I had drinking problems, but it was deeper and more sophisticated than that. I wanted to bring in all sorts of orthogonal and ornate ideas, like folie à deux, the borderlands between psychosis and everyday experience, and the nature of spirituality. She listened to me, very patiently, then suggested, essentially, that perhaps my story had more to do with addiction than I was giving it credit.

If you don’t know Elyn Saks you should read her book. One of the many remarkable things about her story was the importance of psychoanalysis in her own treatment, even when struggling with significant psychotic symptoms, to the point that she herself pursued psychoanalytic training later in life. This training must have helped her to become a great listener, and perhaps it informed the way she responded to me. Or, maybe she was just bored by me. Regardless, this was a turning point, an important critique that helped me to cut through my distorted sense of specialness to get to a more authentic version of my story.

Don’t get me wrong, there were plenty of useful ideas in those early days: our models of addiction create an exaggerated binary between “normal” and “hijacked,” neglecting important shades of grey and heterogeneity. Drug use by itself is not a pathology and systems of care unwittingly replicate prohibitionist logics. The definition of addiction is not “owned” by medicine but is necessarily influenced by culture, history, and values.

Nevertheless, I think it was during this conversation that I really began to take seriously that my fundamental conception for the book was not clear, and that I would need a lot more help from other people to get this done. I realized that I wouldn’t burst out of nowhere with a great book—that it would be better to be embedded in a community and a process for writing, sharing, and testing my ideas.

Around that point, I started taking seriously the idea of learning how to write, meaning approaching writing as a skill that could be learned and practiced rather than something that would naturally flow out of me via divine inspiration. I was lucky that Columbia University had an active writing group called Neuwrite: a group of writers and neuroscience-adjacent folks who workshopped their work together. The scientists helped writers be less wrong about science; the writers helped scientists write. It was a fantastic group: the scientists brought skepticism and rigor, and the writers talked about craft, pitching, books, the media landscape, and everything else. There was a culture of helping one another, and I received tremendous assistance from some fantastic people.

I’m going to plug a few of them here, which will also illustrate the range of interests (buy their books! Subscribe to their stuff!): Jamie Green (astronomy and aliens), Ferris Jabr (the earth as an interconnected living system), Meehan Crist (lots of writing, including “Is it OK to have a child?”), Marin Sardy (a family memoir of schizophrenia, excerpted in the New Yorker), Susannah Cahalan (several books, including Brain on Fire, a memoir of anti-NMDA receptor encephalitis), Stuart Firestein (ignorance), Hannah Furfaro (great mental health journalism), Ben Ehrlich (a biography of Ramón y Cajal), Michele Lent Hirsch (young women with serious health issues), and Casey Schwartz (attention). These are just some of the people who were most active at the time I was going, and I’m sure I’ve forgotten a lot.

(Special shout out to Tim Requarth, who just launched a new Substack about what AI is doing to our brains.)

Through that group, but also by asking around and watching for opportunities, I pitched shorter, then longer media pieces. I wanted to meet editors, sharpen my writing for the public, and get some “clips” to show future book editors that I was serious. NOTE: I’m not sure exactly how replicable this strategy is today! The freelancing and magazine writing landscape has changed a lot even in the last 10 years. But I do think the general principles are still intact. I think if your end goal is to publish a nonfiction book, from what I gather, you’re best served by getting shorter work out there, as best you can, as frequently you can.

Notice that I didn’t start with the proposal! Yes, you need a book proposal to sell a book, and maybe to get an agent, but I started with testing ideas, connection, practice, and publishing shorter work for a reason.

Eventually, I did start working on a book proposal. There’s a lot of material out there that can help you do this—books, blogs, etc—so I won’t linger on the basics (again, I’ll link to some starter resources at the end of this post). If you want to write a book, it helps to go do a lot of research. This is an entirely new line of work, after all.

To get started, I asked others, and that helped; I got at least half-a-dozen examples of book proposals from people I knew relatively well and who generously shared their work. I also found other books about nonfiction publishing and chased down other proposal examples online. Many of the examples were profoundly different.

From there, I started from a rough outline based on my favorite template, wrote, rewrote, went through many iterations. I researched and wrote a sample chapter about a character I found interesting, Lawrence Kolb (senior), the director of the first federal “narcotic hospital” — later known as the U.S. Narcotic Farm, or Narco, in Lexington, Kentucky. I spent a lot of time on this and even did some archival work to round out his story. It’s shocking how little of Larry there is in the final version of The Urge. So it goes.

I did workshop this proposal at least one time with my writing group, but it was in rough shape. I started doing a little research on the agents and agencies I’d like to query—mostly just by looking at the acknowledgements sections of the books I loved. I imagined over the course of a few more months or even years I would tighten up the proposal and then start pitching. But then chance took a totally unexpected course. I got lucky, but I was also somewhat prepared.

Around this time an opportunity for a magazine pitch came across my desk. I wrote a piece on willpower in a relatively small science magazine, where I got to work with an editor I really liked. The piece got a little attention, and I was thrilled when a few agents and editors reached out to me.

That’s the lucky part. I got to have informal chats with some agents, and they asked whether I’d thought about writing a book about addiction. I told them, yes, as a matter of fact, I had a whole rough draft of a proposal. I now know that it’s not uncommon for agents to be on the lookout for new writers in smaller publications, so I’d suggest you not underestimate who might be out there reading your work.

At this point I worked very hard to get my proposal in as good shape as possible and sent it to the agents I had met. I also used this momentum to get other agents to read my work. In the end, I was lucky to sign with the superb Libby McGuire at the superb Gernert Company, and we tightened up the book proposal, sent it out, and got a book deal.

Again, I hasten to add that I just don’t know how replicable this exact path is today. I’m also conscious that I’m exceptionally privileged in certain respects. But rest assured there is not just one path to writing a nonfiction book, and the core principles are meaningful, if not timeless. I found opportunities to workshop my work and, in the process, help others and make meaningful connections. I got my work out there. Through it all, I tested and retested my ideas about the book and why it mattered to me.

This is a big topic. I’ll just briefly mention that it’s very useful to clarify why, exactly, you want to write a book. When I started, my motivations were fundamentally selfish—I had things I needed to work out for myself. I wanted deep engagement with questions that mattered to me: what is addiction? Why is treatment so moralized and one-size-fits-all—how did we get here? How do we move beyond a hyperindividualized frame?

Later, I made more peace with being someone in recovery—partly through the writing process, partly through recovery itself. I needed a new motivation, so it was a sort of Buddha and the raft situation. Deep in the early days of COVID lockdowns, it became simpler: to help one person.

There’s more I could say about that process, but I’m already going on too long. Let me think about some other questions I get…

What about retreats and residencies? A lot has been written about this. Check out this post by Rebecca Makkai as a starting point.

Do I need a “platform?” Should I start my own Substack/podcast/etc? I don’t have great answers for navigating the attention economy in 2025 without becoming miserable. But what helped me was to hear that “platform,” defined broadly, is simply how you reach potential readers. This means if you care enough about something to write a book, you must already have some sort of platform—connections, expertise, a field you work in—even if you hate social media, as I do.

In the run-up to publication, I started a podcast and an email list, simply because I didn’t want to do publicity for its own sake; I wanted something of value to offer readers and to share material similar to what I had already been collecting, individually, to write the book. One of the most enjoyable parts of doing research for the book was getting on the phone to experts in the field, and I thought that’d be easily shared. Those activities eventually morphed into this Substack. Do you need a way to reach people? I suppose so. But I think it’s best to find something you’re genuinely interested in, not just what you think you’re supposed to do.

Is it appropriate to ask friends / colleagues / friends-of-friends-of-friends to pass along my work to their agent as a referral? This is a really tough one and I know the etiquette is hazy from the outside, so I sympathize with people who find themselves in this position. The answer is, unfortunately, it depends. Do you know who their agent is? Are they actually the right fit? Does this person know you well? Do they know your writing really well—can they vouch for you? Ideally the answer would be yes to all of the above. If not, it’s complicated, and you should read a bunch about the agenting and querying process.

How exactly do I write a book proposal? A lot has been written about this. Here are some starting resources:

one classic is How to Write a Book Proposal. it’s not the only way, but it provides a very clear template.
Jane Friedman has a very active blog and newsletter that I found useful when starting out.
My current agent, Alia Hanna Habib, has a Substack and a new book on writing, publishing, and proposals coming out soon. I read an advance copy and it’s a banger. Her advice, and her writing about the proposal, completely changed my approach, and now that I’m a few months into writing my second book, I feel immensely clear on the project and how to execute it, in no small part because of that process. That’s the real work of the proposal—clarifying the book you actually want to write, and that people actually want to read.

Let me end by coming back to ideas. One of my favorite craft books is Zinssner’s classic On Writing Well. He says: “Ultimately the product that any writer has to sell is not the subject being written about, but who he or she is.” Forgive the commodified language. This is good advice.

In other words, ideas are cheap. I sometimes get emails from people protective of what they consider an original, revolutionary angle or topic. “I’m sharing this with you, but please don’t talk to anyone about it,” they say. I get it—I had those thoughts writing The Urge. With all kindness, I’d like to gently suggest that this is not as big a concern as people make it out to be. A book proposal is 60-plus pages because publishers want to know how you will tell the story, who you are, whether you can actually do it.

I have to believe that writing a book is like any other uncertain, serious, solitary task worth doing—potentially futile, but worthwhile regardless of outcome. It’s not about having the cleverest idea, but who you are and what you care about. Work on that, and no matter how it goes, it’s worthwhile.

I’d be happy to take any questions or criticisms on all this.

How to write a book

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