BOOK REVIEW: The Collected Schizophrenias by Esmé Weijun Wang

The Collected Schizophrenias: EssaysThe Collected Schizophrenias: Essays by Esmé Weijun Wang
My rating: 5 of 5 stars

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Schizophrenia is ill-understood, and that’s just by psychiatrists and psychologists, the rest of us tend to downright misunderstand the condition. Wang’s book collects thirteen essays on her experience of living with schizo-affective disorder. I found Wang’s prose to be clever and engaging, though she does get into the weeds of technicality a bit in some of the early chapters. The book is not only well-written, it’s also brutally forthright. We hear a lot of how the author uses her alma mater (Yale) as a combination of sword and shield to combat the ever-present assumption she will be a stark-raving – not to mention dangerous — lunatic.

The book begins with discussion of diagnosis, but it doesn’t begin with her being diagnosed as Schizo-affective, but rather as Bipolar [formerly know as, manic-depressive.] There’s a great deal of discussion of the inexactitude of psychiatric science, and the fact that — to be fair — it’s not like every case is presents the same. The set of symptoms seen may create the potential to classify the same individual in different ways; hence, psychiatric diagnosis is often a long and winding road.

To list the essays with descriptions wouldn’t do them justice, so, instead, I’ll present some of the highlights. There’re a couple of chapters that look at how Wang tried to cope with, or counteract, the impression of people finding out she had schizophrenia. One of these involved the aforementioned repeated references to the Ivy-league institution that ultimately kicked her out and wouldn’t let her back in once she’d been treated and stabilized. Another was attachment to the label — and the idea — of “high-functioning,” which can be a hard sell for a condition like Schizophrenia. (Though not uniquely so. I once had a conversation with friend who didn’t understand that there could be such a thing as a “mild stroke.” This person believed that if one had any stroke one would surely be unable to talk correctly or have adult cognitive functioning. Though it occurs to me that my analogy is not entirely apt because anyone with a diagnosis of Schizophrenia will at some point experience severe symptoms – e.g. hallucination, delusion, etc. – otherwise they would be unlikely to be [rightly or wrongly] so diagnosed.)

There’s a chapter that deals with the question of having children. This brings up the twin questions of whether the schizophrenic can be a good parent throughout the development of the child, as well as how likely they are to pass on the trait through genes. [Those who’ve watched “A Beautiful Mind” will remember a scene in which the bathwater is rising on the baby because Nash is having an episode.]

Wang uses a number of sensationalist cases – e.g. murders – both to counteract the notion that all Schizophrenics are dangerous by contrasting with her own [more typical] experience, but also to let the reader know such extremes do exist. It should also be pointed out that one of these cases was the murder of a Schizophrenic by a family member who was living in terror that said schizophrenic (her brother) would ultimate kill her and her daughter, given the things he said and the auditory hallucinations he was said to have had.

One of the most interesting discussions for me was Wang’s description of leaving the Scarlett Johansson film “Lucy” asking her boyfriend whether what she saw was real. Everybody has that situation of being drawn into a film in an edge-of-the-seat fashion, but is fascinating to imagine a person who can’t disentangle from that state.

Chapter ten talks about the author’s experience with Cotard’s Syndrome. Cotard’s is a condition in which the individual believes they are deceased. I’ve read of Cotard’s in popular neuroscience books, but Wang’s first-hand account provides an extra level of connection to it.

The last essay discusses Wang’s pursuit of spirituality. It should be noted that in many tribal societies, Schizophrenics have been made shamans and are seen as having special powers. Wang doesn’t talk about this in great detail though she does a little [it is the premise of the series “Undone” on Amazon Prime], but it’s interesting to consider how religion and spirituality might influence the Schizophrenic mind.

I found this book fascinating and the writing to be elegant. I would highly recommend it for anyone with interests in the mind, mental illness, or just the experiences of other people.

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5 Psychological Concepts Psychologists Disagree About [or Just Plain Get Wrong]

Every academic discipline has a concept or two that its scholars disagree upon. In the social sciences, these can even be the fundamentals of the subject, and, sadly, they aren’t always so much disagreements of definition as concepts the experts don’t grasp. In Economics [the discipline I was educated in], there is a famous war over whether economists understand “opportunity cost” — a concept that is raised not only in undergraduate texts but even in high school classes.

That said, Psychology appears to take the cake for being the most internally confused academic discipline. Ever. I first became aware of this problem with respect to a subject I have great personal experience with (by virtue of  being firmly lodged in said category), and that’s introversion.

Recently, this psycho-confusion has come up again as I’ve been reading two books that have major discussions around psychological definitions. One is Dean Haycock’s Murderous Minds, which devotes a whole chapter to the fight over how psychopathy is defined and differentiated from other conditions (in part, because another term — Sociopath — exists to spur confusion, but even without that term [which some psychologists think of as a synonym and others think of existing in another ballpark] there would be a huge gulf in expert opinion.)

The second book is Julia Shaw’s The Memory Illusion, which is a fascinating and generally thought-provoking book. In it, Shaw claims that hypnotism doesn’t exist.  I found this difficult to believe (both because I’ve been in a hypnotic trance state and because there is a well-established literature on the subject [i.e. it’s not like parapsychology concepts, e.g. clairvoyance, which are highly controversial]) until I realized that Shaw’s definition of hypnosis was filled with all the misconceptions that one would expect of an individual entirely unfamiliar with a hypnotic trance — except maybe having seen a stage hypnotist once or twice.

5.) Introversion: Introverts are often confused with those who have social anxiety disorder(severe shyness) — which an introvert may or may not have, but which an extrovert also may or may not have. (While it’s probably true that introverts experience social anxiety disorder at a higher rate than extroverts, there is a big problem with equating the two — not the least of which is that one can beat one’s social anxiety and still be an introvert.) It should be pointed out that Susan Cain’s excellent book Quiet (among others) has done a lot to bring a consensus view to the subject, but one still hears people — even experts — equating shyness and introversion.


4.) Psychopathy: Like many confused topics (including introversion and hypnosis), part of the problem is that everybody has a mental construct of what psychopathy is before they learn anything formally about it, and sometimes those preconceptions survive the presentation of formal knowledge — even, apparently, for the experts.  Maybe a person has read American Psycho or maybe they’ve seen Dexter or the movie Psycho, and so they know very well that a psychopath is a murderous maniac, and, therefore, they may not swallow the information that most psychopaths function just fine in society and aren’t even considered inherently mentally ill.


3.) Schizophrenia (v Split Personality): This is probably one of the most discussed of the confusions in the field. To be fair, this may be largely ironed out these days, but it certainly took long enough. Multiple Personality Disorder (commonly called Split Personality but today called Dissociated Identity Disorder [DID]) is usually a trauma-based disorder that results in schisming of personhood. Whereas, Schizophrenia is a genetically transmitted disorder that involves a disconnect with reality, but not necessarily a separation of personalities.


“Hypnotisk” by Richard Bergh (1887)

2.) Hypnosis: I mentioned Julia Shaw’s statement that hypnosis doesn’t exist. In her book, she mentions several preconceptions about hypnosis that are quite different from my limited (but existent) experience with hypnosis. To be fair, many hypnotists would tell you that the term hypnosis (coined by Scottish surgeon James Braid) is a confusing choice because “hypno” suggests the state is like sleep — which, not so much. First, Shaw calls the hypnotic trance state a non-attentive state. (This comes up because she is making the point that attention is critical to memory formation, which is probably entirely true and I don’t have any dog in the fight of whether hypnosis can help memory.) What I am arguing is that hypnosis is not a non-attentive state. It’s a highly relaxed state, but might be more accurately called a hyper-attentive state. Maybe the confusion is because stage hypnotists frequently successfully suggest participants temporarily forget things in deep trance, but keeping one’s attention focused  (on what may vary, though it’s usually voice) is critical to the hypnotic trance state. Second, she suggests that hypnosis is an act that must hinge on the activities of the hypnotist — i.e. the hypnotist as sine qua non.  I think many, if not all, hypnotists would admit (often begrudgingly) that the hypnotist is the most dispensable element of the process — or, as it’s more commonly phrased, “all hypnosis is self-hypnosis.” Third, she seems to have problem with hypnosis being considered an altered state of consciousness. To my mind, everything but ordinary waking consciousness is an altered state of consciousness. I don’t know of any way in which a hypnotic trance state could be confused with ordinary waking consciousness. (If you’re sure of it, go to a dentist who uses hypnotism for pain reduction and have them yank your tooth in a state of ordinary waking consciousness, and then compare your experience to the individuals who had it done under hypnosis. See here for a related BBC special on the Science of Hypnosis.)


1.) Delirium  (v. Dementia):  To be fair, by the time an individual is in a full-blown state of either, these conditions are nearly impossible to distinguish and have overlap. However, delirium has quick onset, involves severely impaired attention, and can fluctuate greatly from one day to the next. On the other hand, dementia often progresses slowly, begins with mild impairment of attention and focus, and is a far more consistent state.

BOOK REVIEW: Challenger Deep by Neal Shusterman

Challenger DeepChallenger Deep by Neal Shusterman
My rating: 5 of 5 stars

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“Challenger Deep” is the story of a smart and artistically talented young man, Caden Bosch, who is afflicted with Schizophrenia. There are essentially two story lines being told in parallel. One is the real world, and in the chapters in this line we see Caden’s descent as it takes place. From references to past events, we gain insight into how Caden was before the disease. In the early part of the book, these chapters are set at school and at home, and then later at the mental hospital at which he’s admitted as a patient.

In the other story, Caden is on a sailing ship headed to the Challenger Deep—the deepest portion of the Marianas Trench at almost 7 miles down, and—symbolically—Caden’s rock-bottom . Shipboard life is Caden’s hallucinated experience of the mental hospital. Over time the reader begins to match up characters from the real world with those from the delusion—both patients and staff members. This is a mutinous vessel, and the tension reflects the pull between Caden’s desire to be well and the appeal of the world of delusion.

Over time the author shows key events in both lines and the reader can connect them up to interpret how delusional Caden experiences the world. The story isn’t strictly told in a chronological order, though the broad sweep of it is. The bits of disjoint create no confusion while helping to convey the nature of a fractured mind. This works, in part, because the book is told over 161 short chapters, and, because the chapters are so short, a diversion doesn’t take one far and it’s easy to show the match up of events. The book artfully conveys the bizarreness of a dreamlike world of delusion while remaining clear and readable. Any confusion in the early chapters becomes rectified as the author reveals how the delusional world and the real world zip together.

This book was imaginative, enjoyable to read, as well as allowing the reader insight into the nature of mental illness. Atypical of a work of fiction, there is a resources section that provides contact information for organizations that support mental health.

I’d highly recommend this book for fiction readers.

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BOOK REVIEW: The Man Who Wasn’t There by Anil Ananthaswamy

The Man Who Wasn't There: Investigations into the Strange New Science of the SelfThe Man Who Wasn’t There: Investigations into the Strange New Science of the Self by Anil Ananthaswamy
My rating: 5 of 5 stars

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What is the self, and is the self a distinct entity as we feel it to be? Those are questions that philosophers and theologians have been debating for centuries, and they’re the questions at the heart of this book. Ananthaswamy takes a crack at answering by looking at several of the ailments and mental phenomena that seem to steal or morph what we think of as the self.


While there are many distinct views on the self, the predominant view has always been the one guided by the way it feels. And it feels like there is some non-material entity—call it a soul, a spirit, a consciousness—that resides in the body though is–in certain extraordinary circumstances–detachable from the body (e.g. death.) This gave rise to a widespread belief that while our physical bodies may have a shelf-life, this non-material bit is eternal—or at least not governed by physical laws.


However, as science has illuminated the workings of the brain, it looks more and more as though this “non-material entity” is, in fact, an emergent property or illusion that derives from the activity of our material brain / nervous system. One of the phenomena that a materialist explanation would have once had great difficulty in explaining is the out-of-body experience [OBE.] Historically some may have written these off as fraud, but the cases are common enough and described similarly enough that that strains credulity. However, we now have strong reason to believe that the OBE is a specific kind of hallucination, and that reason is that OBEs can now be consistently induced by neuroscientists applying an electrode to a specific point on the brain. As for the old schools of thought, it seems that the Buddhists were by far the closest when they suggested that there is no self—that it’s illusory.


Ananthaswamy’s book consists of eight chapters. Each of the chapters addresses a particular ailment or phenomena of the mind that has something to tell us about what the self is and what it isn’t. If a specific injury, ailment, or consumption of a chemical cocktail makes one feel as though one has lost part of what it feels like to be a person—then we may get some idea where the self resides or where the series of neural activities that feels like a self resides. (Spoiler: There is no single spot in the brain where the self or sense of self resides.)


The first chapter gets straight to the heart of the matter by describing Cotard’s syndrome, a disease in which a person swears that he or she doesn’t exist or is dead. This affliction seems to attack the most fundamental sense of self—the gut feeling that one is a distinct living being. Another way that we think of ourselves as that distinct living being is through our life story. Chapter two looks at how diseases like Alzheimer’s shatter this sense of self-hood.


Another basic level at which we feel the self is in its correspondence to the confines of our body. However, not even this physically rooted approach to self is unassailable. One may be familiar with cases of phantom limb syndrome in which amputees feel a lost limb. Incidentally, this is another reason people have felt there was a soul—one that didn’t know the body was amputated and kept its original non-material shape, an idea that V.S. Ramachandran’s work showed was likely not the case. Ananthaswamy, however, focuses on an ailment that is the exact opposite of phantom limb syndrome, those who feel that one or more of their limbs are foreign entities. This is where the book’s reporting is at its most intriguing as the author manages to speak with a doctor who does amputations for such people at no small risk to his medical credentials.


In chapter two, the author investigated the self as a collection of memories—in other words, the things one has done. Chapter 4 explores people who don’t feel a connection between the actions they are performing and the self even as they are performing said actions. The cases discussed involve patients with schizophrenia.


Chapter five examines depersonalization syndrome. With this syndrome, there’s an emotional disconnect which people feel as being in a dream, but during the patients waking life. The chapter focuses on two cases which give different means by which this can occur. One was an individual who was abused as a child, and the ailment seems to have been a defense mechanism to disconnect from the trauma. The other was chemically induced—though, disconcertingly, the effects went on long after all of the drugs should have been out of the woman’s system. Chapter six explores another set of afflictions involving stunted emotional response, and those are the autistic syndromes. The principle case involves a high functioning Asperger who was intelligent enough to learn how to respond even though he had no emotional cues. A quote from that individual that sums up his experience of the world nicely is, “I love my sister, but it’s done purely at a cognitive level. I think love for her; I don’t feel love for her.”


The penultimate chapter is where the author describes case of OBE and other hallucinations in which the self seems to migrate, split, or wander. The final chapter continues examining the self free of the body by considering cases of epilepsy. Epilepsy can have many powerful mental effects. One may be familiar with the many cases of “spiritual awakening” that have been attributed to temporal lobe epilepsy. And some have speculated that Joan of Arc, St. Paul of Tarsus, and Mohammed all suffered from epilepsy. Ananthaswamy also presents cases of people on psychedelics—most famously Aldous Huxley.


There’s an epilogue that both tells us what the Buddha had to say about self during his first sermon at Sarnath, and sums up what’s been learned about what the self isn’t and what it seems to be. The book is annotated, but there are no graphics or other ancillary matter. It’s really not needed as the focus throughout is narrative, the telling of fascinating cases that illuminate the experience of the self. I appreciate that the author went out and sought some unique cases. I read a fair number of pop neuroscience books, and there are a few cases that get rehashed ad infinitum (Phineas Gage, H.M. etc.) It’s not that Ananthaswamy doesn’t go retell a few of the classics, but he also does some original investigation. The chapters on depersonalization disorder and amputation show this distinct touch.


I’d highly recommend this book for those who want insight into the nature of the self from a scientific perspective. I’ve read many books that touch upon the subject as part of a broader theme, but this is the first I’ve read that focuses entirely on this subject from a scientific rather than philosophical or spiritual perspective.

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