Hazel McHaffie

From the Edge of the Couch

When I was a student I made a conscious decision not to do a stint in psychiatry. Why? I was acutely conscious of the fine dividing line between what’s ‘normal’ and what’s ‘abnormal’, and had a sneaking suspicion I was too close to the edge for comfort myself at times. Decades on, I’m more sanguine about my own mental resilience, and more sympathetic to others’ strengths and weaknesses, and I guess, more curious about how the mind works.

Why am I re-living this decision now? Let me explain.

I was at a bit of a loss as to what book to take for eight hours sitting on a train with weighty matters on my mind. I needed something that I could dip in and out of, but something sufficiently absorbing to hold my interest. Ahah! Time maybe to tackle From the Edge of the Couch: Bizarre psychiatric cases and what they teach us about ourselves. The author: Dr Raj Persaud, a consultant psychiatrist, writer and TV personality.

It’s disturbing (as expected) and raises all sorts of questions about the way the mind functions, the variety of delusions and distorted beliefs that can lurk in its hinterland, and the cracks and flaws that can derail the psyche. More than that, it shows how delusions are far more common than we might imagine, and probing them can reveal much more understanding of how the ‘normal’ mind works.

From werewolves and vampires, to phantom lovers and stalkers, to Munchausens and gender issues, to various distorted perceptions relating to parts of the body, Dr Persaud unravels the problems, the possible causes, and the treatments, through the lives of real people amassed from reported cases over many countries, many years, and from many clinicians. It’s detailed, it’s research based, and it corroborates my remembered feeling that the line between the healthy and the disordered can indeed be thin.

Which of us doesn’t feel unworthy at times?
But most of us don’t resort to eating animal faeces as penitence, or slicing off a hand with a chain saw.

Which of us has not at times disliked a part of our appearance, or experienced anxiety about something untoward happening to cause us acute embarrassment or public humiliation?
But most of us don’t shut ourselves away from society altogether, or deliberately inflict injuries to ourselves and then infect them in order to get a limb amputated.

Which of us has not at some stage tried to alter their body image by something like dieting or exercise?
But most of us don’t eat industrial quantities of toilet paper or our own hair.

Which of us does not have some an experience in our childhood that was fairly traumatic?
But most of us don’t deliberately mutilate our face, amputate limbs, castrate ourselves or enucleate our eyes.

Which of us has not worried about body odour of some kind?
But most of us don’t opt our of work/school to obsessively wash our clothes, and avoid all social and domestic excursions out of the house.

Which of us has not known someone who had a stroke?
But most of us don’t react by becoming pathologically obsessed with eating fine haute cuisine food ourselves.

The list goes on and on. Puts our normal little anxieties into perspective, doesn’t it?

Dr Persaud takes delusions very seriously – sometimes indeed more seriously that the disturbed patient! Furthermore, for him, anything we can learn from them is valuable, as he points out in the postscript:
… dialogue with the delusional has much to offer us. It will not only assist in the specialized scientific enterprise of understanding the brain and mind, but such people’s experience should inform our personal understanding of what it is to be human … If we can grope towards some understanding of the most bizarre and incomprehensible ideas of all, then surely there is more hope for us to understand what each other thinks.
Many have said the most complex entity in the known universe is the human brain, but in fact there is something much more intricate and elaborate: human society – or groups of brains interacting. What is produced when minds try to understand and manipulate each other is where the real mystery and excitement of the human sciences lie.

From the Edge of the Couch is a lengthy tome, and holds a wealth of information – 59 pages of footnotes alone! All made viable by the bringing together of cases from so many sources, enabling deductions to be generated which would not be possible from the occasional single example that comes the way of any specific clinician. It’s perhaps small comfort that, as Dr Persaud admits, psychiatry is far from being an exact science, and relies heavily on objective interpretation of symptoms. That’s part of my worry!

Yep, I’ve no regrets at bypassing psychiatry! But after finishing this book, I’ve got the gratitude-for-what-life-has-dealt-me T-shirt and the mug.

 

 

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