The term "mental illness" is synonymous with madness in most cultures. People who are suffering are stigmatised the world over, and India is no exception. A person with cancer will garner sympathy while someone with a so-called mental illness will most likely engender fear in others. It's hard to be sympathetic when you are afraid.
Partly, this fear comes about because we perceive the mind as superior to the body. We owe some of this fear to Rene Descartes' "I think therefore I am" philosophy, which gave us a form of dualism, separating the body from the mind. And it's not just Descartes. We all have this intuition that the mind is apart from the body, and that it's the mind that controls the body. So, it's not hard to see why we fear illnesses that seem to be of the mind, not the body.
"[I]n just about every condition, aspects of our sense of self that we would normally attribute to the brain and by extension to the mind turn out to be inextricably linked to the body."
But if there's one thing I learned while writing The Man Who Wasn't There: Investigations into the Strange New Science of the Self, it's that this dichotomy between the body and the mind is false and misleading. In the book, I examine a range of neuropsychological conditions -- from autism and Alzheimer's disease to ecstatic epilepsy and out-of-body experiences -- that change or perturb one's sense of self, or how one feels about oneself. By understanding what aspect of the self goes awry in each of these conditions, we can get a glimpse of how the brain and body work in concert to create our sense of self.
And in just about every condition, aspects of our sense of self that we would normally attribute to the brain and by extension to the mind turn out to be inextricably linked to the body.
Take autism. Children suffering from autism are often diagnosed based on certain behaviours. For instance, they have trouble relating socially to others, trouble forming bonds with other children. Such children are said to have problems with something called theory of mind, which refers to an instinctive ability we all have of being able to infer what someone else may be thinking based on cues we pick up from their actions, body posture, behaviour and the like. It's not difficult to see why an impaired theory of mind can lead to difficulties with social relationships.
Turns out that the autism affects not just the ability to infer what might be in others' minds, but also the ability to sense one's own body and body states. In one study I write about in the book, three adults with Asperger's were asked to carry a beeper that would beep at random. When it beeped, the study subjects had to introspect and write down the contents of their mind. The study showed that their reports lacked, for example, perceptions of feelings, something that would nearly always be found in similar reports by neurotypicals.
There's preliminary evidence that autism involves a disturbance of the bodily self: the perception we have of our own body and its states. Something that is often thought of as a behavioural and hence mental problem may have its roots in a perturbed bodily self. In fact, psychiatrists in France have shown -- albeit using a controversial technique -- that helping children with autism feel their bodies intensely, thus potentially helping them form a clearer perception of the body, has behavioural consequences, such as reducing aggression.
This idea that the brain, body and mind are a seamless continuum plays out in other conditions too. For example, depersonalisation disorder, a condition in which people feel estranged from their own body and emotions, can sometimes be alleviated by engaging in tasks that demand sustained attention of the body, such as playing tennis or playing jazz drums. More evidence that something "mental" like depersonalisation is intimately tied to the body.
"[I]nstead of referring to someone as a schizophrenic, it's important to appreciate that there's a person experiencing schizophrenia. It's a subtle distinction, but it makes all the difference..."
By eschewing Cartesian dualism, I'm not suggesting that the mental can be ultimately reduced to the material. Neuroscience is a long way off from explaining how the mental arises from the material. But what is clear is that if we understand that the mental and the physical are not as distinct as our intuition leads us to believe, and especially understand that the mental is not lording over the physical, and that the body may underpin our sense of self (and hence any disturbances of the self), then we can start to destigmatise mental illnesses. They are illnesses like all else.
And more than anything else, the writing of The Man Who Wasn't There brought in me an understanding that no matter how severe the condition, there is always an "I" experiencing the condition. So, instead of referring to someone as a schizophrenic, it's important to appreciate that there's a person experiencing schizophrenia. It's a subtle distinction, but it makes all the difference when relating to, and treating, those suffering.