On religion and mental illness

Karl Marx, a 19th century philosopher, told us that religion “is the opium of the people”. He meant not that it makes you believe things that aren’t real and see things that aren’t there, but that it has the soothing and calming effects opium has on the human mind in amongst the turbulence of what goes on in the real world. So then the question becomes, what is real? Is God real? Actually, it’s not what I intend on discussing here, but rather an anecdotal relationship I have noted between those with mental illness and their religious beliefs.

I may have discussed it earlier, but there was the story that was told to me by a neuroscience professor: There was once a very devout Christian religious minister who developed a brain tumour. The tumour affected this man’s thinking capacity, his cognitive function, and interestingly it made him unable to understand or believe in a non-physical, abstract, concept such as God. He lost his faith not because he was disappointed in God, but because the part of his brain related to religious faith was damaged! My professor took this as hard evidence that God and religious faith is nothing more than a human cognitive construct and in fact there is no God out there in wherever a person believes he is. Now, that is a pretty good deduction, but perhaps a bit premature. For example, if the antenna broke on my TV and I could no longer receive the signals that transmit my favourite shows, would I be right in concluding that in fact the television channels never existed in the first place or even that they have stopped transmitting the moment my antenna broke?

The opposite to the scenario proposed by my university professor could also happen. Some people with epilepsy and even those with migraines can experience an “aura” before an attack. The aura is different for everyone and some will suddenly experience a particular taste on their tongue, a music in their ears, a vision in their sight, a smell in their nose, etc. – yet these sensations are all originating from brain activity, not the organs they appear to be coming from. There are the rare people who experience very complex auras, things like seeing a halo-like figure of a person who resembles how a religious figure is depicted in art, or who hear a voice like that of a relative who is now dead. Of course, in the medical world we may call them auras or a sign of temporal lobe epilepsy or aberrant brain activity, but then other people may call them religious experiences. I won’t even try to conclude anything from that for anyone, but it is an interesting thought.

A quote often attributed to Robert M. Pirsig, a writer and philosopher, is “When one person suffers from a delusion it is called insanity. When many people suffer from a delusion it is called Religion”. As a medical student doing a post in a psychiatric ward, I first started to notice how a large number of patients’ delusions revolved around God and other religious concepts. As an example, a person might believe that electricity is controlled by the devil and every time you plug in an appliance to a powerpoint then that lets the devil into your house. Or she may be obsessed with keeping her clothes clean all the time and protects them from being invaded by others and germs and other such things because she has read some scripture in the bible about guarding your heart and wearing the armour (of faith) and has taken her armour to be her clothes and she guards it by standing in the same spot for hours on end watching out that no one or nothing gets to it. Others have believed they are carrying the devil’s child in their pregnant bellies as foretold by some scripture they have read/misread somewhere. Or that the people putting thoughts in their heads are either angels or demons or God himself and that they must heed their ministry of whatever they’re been instructed to do… These people, however, have ended up in mental hospitals because what they’ve done or attempted to do has posed a threat of physical damage to themselves or others. Generally that is why they’re considered “crazy” and not just a founder (or follower) of a religion with those beliefs.

Now, I will very openly admit to being a Christian; one who believes things about God and other divine creatures that neither I or anyone anywhere on Earth currently has ever seen with human eyes. Yet I also remain curious about the relationship between religious belief and mental illness, especially when it comes to psychosis. Consider a person who has never had any religious inclination at all; perhaps someone the opposite of the religious minister of my neuroscience professor’s story. Suddenly, and I mean within a space of a few days, this person starts to believe that he can speak in a language new to him but that isn’t a language of this world or of a fictional book or film and can be understood by no one of this world. To all human ears he appears to just be making sounds with his mouth. Along with this “speaking in tongues”, he believes that God is giving him dreams that have special meaning about the past, present, and future. He also believes that he has been chosen by God and can exert God’s will of healing by merely touching the infirm of body and/or spirit. Unfortunately, due to his unique position before God, he believes that the devil (God’s enemy) is trying to hurt him. To minimize the hurt from the devil, he may engage in ritualistic behaviours such as rocking back and forth in his chair, hitting his head against the wall, or cutting himself to let out the bad energies. His new life revolves around speaking and singing about God and his newfound faith whenever he can and to whomever is around, sometimes even when no one is around… A psychiatrist may diagnose this man with a delusional disorder. Someone else may say ‘here’s a new member of the Pentecostal church who has reached enlightenment’.

Lastly, I will leave you with a comical quote by George Carlin that I found amusing:

“Religion has convinced people that there's an invisible man living in the sky, who watches everything you do every minute of every day. And the invisible man has a list of ten specific things he doesn't want you to do. And if you do any of these things, he will send you to a special place, of burning and fire and smoke and torture and anguish for you to live forever, and suffer, and suffer, and burn, and scream, until the end of time. But he loves you. He loves you. He loves you and he needs money.” 

On "the Jews"

I'm on holidays at the moment so here's just a few lines on things I've been thinking about recently.

I just finished reading a book called "Outliers" by Malcolm Gladwell, which I at first thought was about the absolute opposite of what my core beliefs about success are: that everyone has the same innate capacity. And, yes, at first glance it appears to be saying that you can expect to be in low-skill service jobs if you're Latino, you can expect to be good at maths if you're Asian, and you'll probably be a doctor or a lawyer if you're Jewish. And if you're of African descent you'll probably want to kill and physically hurt others for minor slights. Generalizations? Stereotypes? Actually, it deals more on examining the roots of why people turn out to be the way they are based on specific things that happened to the ancestors of their culture, and that for the most part continue to imprint on their futures. An interesting note was made of New York's Jewish community.

In the last week I made my mum visit the Museum of Jewish Heritage in New York with me. Now, she's a very humble woman with a primary school education who can barely pick out the location of countries on a map of the world (e.g. not long ago she was surprised to find out that Spain is in Europe and not in South America like she assumed for a long time). You get my point: she's a humble woman with not a lot of knowledge of what is not essential to her survival. At the Jewish museum while we were looking at concentration camp uniforms and learning about the disgusting things that happened to so many people during WW2, mum asked me, "why did all this happen to the Jews?" I thought it was an excellent question! There's probably no single answer why that did, and there's definitely nothing in this universe to justify it.

What I find even more fascinating, though, is how a great majority of the Jewish community post-WW2 became so prosperous. They were always an oppressed and abused people. They were workers and they had to learn skills. Since thousands of years they've been working (even under slavery conditions) - they had to learn! So the theory goes that around the time of WW2 when dislike of the Jews was quite overt and common, even in the new lands they settled in they were discriminated against for many reasons. So to escape this oppressive environment, Jews after some time used the skills hey had learnt previously, textile and garment industry, for example, and started up their own operations. They hired other Jews. They taught their children the importance of work to better yourself and aiming to equalize opportunity (I maintain that this is the true value of education). The story goes that the children of garment workers went on to become lawyers and doctors and business people at the insistence of their parents - but after they became lawyers (for example) their gentile counterparts still discriminated against them. They ended up working the legal cases nobody wanted, working the medical fields nobody else considered worthy at the time (things like psychiatry and neuroscience, for example). And then, something happened: the Jews had created niches of industry for themselves - which as fate or history would have it, soon became the most sought out niches in industry.

Why did the holocaust happen? I guess there's no valid or all-exhaustive answer to that. But you know what, I believe the best thing the Jewish people ever did was 1) acknowledge their position as others viewed them, and 2) used it not as an excuse to become victims of oppression but to motivate forward action. They were people who once they left the concentration camps, they left the concentration camps. They didn't sit down and feel sorry for themselves for their dreadful pasts and suffering. They began to build instead their prosperous futures. Can't we all learn from that? Once the suffering is done with, let's stop suffering and start building a future we desire.

On memory

I came across an email I wrote a few years ago and it was about something that happened to me in 2007. In 2006 I took some time out of medical school for reasons I’ve discussed many times in this blog. The thing is that in 2007 I returned to finish off my medical degree and I kept running into people I’d known previously from medical school – and they were all surprised that I had returned! The only person, it seems, who wasn’t surprised that I returned to my studies was myself. And yet I struggled to understand why people were surprised given that I never once considered it a possibility of not returning.

Here’s part of the email I wrote to my friend (and, yes, I do write very long emails):

Being back at the hospital I am often running into guys who knew me from a few years ago, and its so weird. Some of them (I guess the ones who knew me a little) tell me that they’re glad to see I came back into it, back to med. This girl even gave me a hug the other day and said exactly that! Now, in my mind I can’t remember ever being as unsure as these people seem to be that I would return. When I decided to take leave, I knew it was just a break, that’s what I wanted, and I don’t remember doubting that I would return, only doubting that if it was to be one rotation off or the rest of the year (that’s all the options the school offered me). But maybe I was projecting something different. I don’t know now, I’m confused. Maybe other people were projecting onto me and doubting my commitment or abilities more than I was. It’s so strange; I don’t recall being that unsure.

I remember feeling empty and alone and overwhelmed - and the insomnia- but it wasn’t even the lowest I have ever been. By comparison that period wasn’t even that bad or even that long-lasting. And I remember a few months after I stopped doing med in 2006, a friend of mine (and I mean a friend not an acquaintance) said to me “you’re not going back, right?” I thought that comment came out of nowhere and I was a little offended, because even at the time of that question I was very convinced that I would – and actually looking forward to returning to med the following year. 

My family also had countless talks to me telling me that I should return to med. I felt it was so pointless because they spoke to me as if trying to convince me of something that was against my will, whereas I felt ‘of course I won’t counter-argue because we both are thinking the same thing’. It was absurd. But of course, I knew that some of them were telling other members of my family that I was a loser who was incapable of finishing a real uni degree. 

And then there was my therapist, who probably knows me better than most of the people in my life and is familiar with most fragments of who I am. She also asked me before I started back, if I actually wanted to go back. Returning to med was never an issue as far as I was concerned; when I would was the only issue present at the time I decided to take time off. And she had known me since before I started to feel all the negative stuff that made me want to take the time off. 

So, my question is: why did everyone doubt that I would return to med; what have I forgotten from that time? Why do I forget? And what else am I forgetting? It’s scary, you know.
The only explanation I can think of for my old acquaintances saying they’re ‘relieved’ to see I came back into med is based on another theory of mine. After I’d already been on leave a few months 

I told two acquaintances of mine from medical school that I was on medical leave. So, my theory is that these two boys must have told a pretty drastic story of how I was and why I’d had the time off. I figured this after I ran into some people and to catch them up on my story I’d tell them that I was a year below them because I’d had some time off – and yet most people already knew that even though I’d only told two people in my course.  They all added that they were glad I had decided to come back. What decision to come back?! I had never doubted whether I would or not. Unless I am forgetting something. Am I forgetting something? 

It’s pretty confusing. I am scared of becoming convinced of something like 2+2=5 if you tell a person enough times, like in that book 1984. Maybe the whole world is really like that, and the world trade centre really just fell accidentally and there were weapons of mass destruction in Iraq and you can convince a person that the world has always been the way it is and nothing of the past atrocities brought us to this “progress”. But then what do memories serve us for? To confuse us? To make us suffer because of the incongruences?...

What I’ve come to realize since the time I wrote that email is that in this world it is dangerous to believe what others tell you about yourself. Hitler, for example, surrounded himself with yes-men, people who agreed with his every word and told him his every idea was genius. Isn’t the same equally true if others are constantly beating us down and telling us what a failure we are and how unlikely we are to succeed? We need not surround ourselves with only our worshippers and we don’t have to believe our oppressors, but the truest stories are sometimes those we write ourselves. The story of Vanessa is best written by Vanessa; and if I want to describe a positive person, then I have to build my story to allow myself to become that positive person. It’s taken me a while to figure that out, but my story is a work in progress.

On job satisfaction

Just in the last week I’ve had a few people tell me about how dissatisfied they are because they’re working in a big corporation and a few others have told me that they are dissatisfied because they’re working in a small business. There are plenty of things that can make you dissatisfied at work or about work, but it got me thinking a bit about whether the size of a company really does influence our general satisfaction levels and mood. Industrial and organizational psychologists will tell us that, yes, it can and there are some people who will thrive in one industry model and others in an alternative one. Anecdotally, I can attest to that statement based on the people I’ve met at work either as patients or colleagues. I can also tell you my own personal experiences.

What’s the good thing about working about for a big company? As an employee, the budget seems endless. You need what you need to do your job and you can access it reasonably easy. What’s the bad thing about it? If you need things other than those that relate to your job, especially that stuff of being human (e.g. holidays, time to recuperate from illness, or even just to be given a little slack when your personal life isn’t going so well), it is hard for a corporate machine to accommodate. Most companies will have a policy, but unfortunately that policy also tends to be quite strict. For example, bereavement leave may be just 2 days and turns out you may not be a human being that can get back to being your old productive self after the death of your parent after just 2 days. Then there’s also usually a hierarchy and a certain type of anonymity amongst very many employees. Yet both of those things can be positives: the hierarchy can give you motivation to progress; and the anonymity can afford you the space to work with less interruption. On the other hand, the hierarchy can lead to frustration when someone very distant from the sphere you work in makes decisions that affect you at your level without the direct knowledge of what things are like there. There is no perfect big company, and most try very hard to be, but there’s no escaping the fact that we are all human first and workers second.

Is small business, then, the answer to overcoming that barrier between being a worker and also being human? I don’t believe so either. The positives boasted about it are a much smaller hierarchy, often having direct communication with the big-decision makers, and much greater flexibility in work because you can discuss it directly with another human being. Then what’s so bad about it? Been wary of the much smaller budget at all times, and more human-human interaction and therefore greater possibility for human conflict with other workers.

Is there a perfect system? No, and there probably never will be a model that is right for everyone. As an employee all you can do is try to find that model that is best suited to your interpersonal and working style (and tools like the Myers-Briggs questionnaire can help).

In the last few months I’ve come to realize certain things about myself, and certain things about industry - and yet this is unfortunately knowledge that I have only gained through experience. I’ve noted that the greatest teams, the most successful companies, the greatest productivity out of a group of people is achieved when every member of that team feels useful, appreciated, and proud of achieving. In a working environment the reward for achievement is money: our salaries. Even a person who is not someone you’d call material and superficial engages in paid employment for exactly the reason of getting paid; after all, money pays for our daily necessities of life. One thing I’ve noted is that the more a person is paid, the more aware they become of the emphasis his company has for his role – in turn he becomes aware of his responsibility to represent his company in the best light he can. Pride. Pride in our work and feeling useful: tick. And if you feel a person does a good job, isn’t paying them their worth a good way to show your appreciation? I’ve also noted that when an employee stops feeling appreciated in his workplace, despite acknowledging his usefulness, he cannot maintain his pride and enthusiasm. I’ve seen it too often. And, I have to confess, I’ve felt it too.