I'm going to talk about writing by talking about Video Games.
I feel that most games do not understand how to create drama. The primary problem seems that most game writers don't understand what drama is vs. a series of problems.
There was a mod to Return to Castle Wolfenstien called "Gold Rush" and it had perfect drama:
Two teams starting opposite bases with gold scattered through out the location. You need to pick up gold and bring it back home. The more gold you pick up, you get exponentially more gold; however, the more gold you pick up, you move exponentially slower... increasing your chances of getting shot. That's the perfect dilemma. It seems so simple, but most games never think of dilemma's, they think of obstacles and there is an enormous difference between the two.
An obstacle is one dimensional:
You need to get through a room, the room has a monster in it - you need to get past the monster to the door. This is the structure of 99% of games on both meta (overall story) and micro (individual building blocks of a story) level. In order for an obstacle to become a dilemma, the player must be forced to equivocate. "Equivocate" means they must weigh two options of equal value. I don't say "good options" because sometimes great drama comes from both options being lousy - but with an obligation to choose (a ticking clock or a sniper helps)?
Lord of the Rings at it's core contains a great set-up for a dilemma. The ring makes you invisible, but the more you wear it - it sucks your life away and makes you evil. This alone, however, isn't a dilemma until you are face to face with a situation where the sucking away of your life might be better than being visible.
There are a couple things which make dilemma's more interesting.
1) The more hope there is for a potential outcome (this is why people fall for get-rich-quick schemes, just like people always try to pick up so much gold that they can't make it back to base before they get shot.)
2) The equal value of both choices. The more the user is oscillating between which is the better option, the more the dilemma.
3) The fact that one option must be chosen. "I really want to eat chocolate, but I don't want to get fat." - This is not a dilemma. You can not eat chocolate, it's a choice.
"Only two people will fit in the life boat and there are three of us and the main ship is sinking and the water is filled with piranhas." - This is a dilemma.
When writing, if you can start thinking in terms of dilemmas vs. obstacles, you will increase the interest in your story exponentially because a good dilemma automatically raises the curiosity factor: "How will they decide who goes into the life boat?"