Phantoms in the Brain: A Review

At this stage you must admit that whatever is seen to be sentient is nevertheless composed of atoms that are insentient. The phenomena open to our observation do not contradict this conclusion or conflict with it. Rather they lead us by the hand and compel us to believe that the animate is born, as I maintain, of the insentient.

– Lucretius

A complete opposite of a dry, technical writing, V.S. Ramachandran has run with Lucretius and his idea that universe depends on the study of our brain, in ways no other writer ever has.

‘Phantoms in the Brain’ is probably the first book on neuropsychology I’ve read, and it’s been a completely new experience. It is probably one of the few books that made me take notes while reading. Such a shame I did not get to know about V.S. Ramachandran and his works much earlier. As a writer he prides himself, and rightfully so, on being able to explain the most technical of the concepts to a layperson.

The book’s most intriguing aspect is not necessarily its encyclopedic selection of strange cases. I would give that prize to the philosophical undertones that accompany each examination. These musings range from discussions on free will (the brain seems to do a lot of thinking and acting on its own), to pondering the nature of self (questioning the idea of the “ghost in the machine” and whether we should even be talking about souls anymore).

The author has steered clear from presenting his findings from various experiments, as an overly serious thesis. His work has culled some of the most intriguing cases available across medical literature. One of the most peculiar cases I read about, was the woman who ‘thought she was pregnant’. She spent nine months believing she was pregnant and when she finally started experiencing contractions, she went to a doctor for delivery. An experienced man, he sensed something was wrong, gave the lady an anaesthetic and examined her. As he suspected from her down tuned belly button, the lady was experiencing a case of ‘Phantom pregnancy’. Pseudocyesis – a condition where women who desperately want to be pregnant, experience all signs and symptoms of a true pregnancy. They stop menstruating, lactate, have morning sickness and have even been reported to sense fetal movements. In this case, the doctor informed the lady of a miscarriage once she woke up. Couple of days later, the lady turned up at the hospital, again, with a pregnant belly gain and told the doctor he forgot to deliver the twin!

Ramachandran meditates, 

If the human mind can conjure up something as complex as pregnancy, what else can the brain do to or for the body? What are the limits to mind−body interactions and what pathways mediate these strange phenomena? And assures us that, contrary to what many of my colleagues believe, the message preached by physicians like Deepak Chopra and Andrew Weil is not just New Age psychobabble. It contains important insights into the human organism— ones that deserve serious scientific scrutiny.

The chapter on Capgras Syndrome ( where the patients see familiar and loved figures as impostors ) was one of my favorites in the book. Below is an extended excerpt from the chapter:

I’ll never forget the frustration and despair in the voice at the other end of the telephone. The call came early one afternoon as I stood over my desk, riffling through papers looking for a misplaced letter, and it took me a few seconds to register what this man was saying. He introduced himself as a former diplomat from Venezuela whose son was suffering from a terrible, cruel delusion. Could I help?

“What sort of delusion?” I asked.

His reply and the emotional strain in his voice caught me by surprise. “My thirty−year−old son thinks that I am not his father, that I am an impostor. He says the same thing about his mother, that we are not his real parents.” He paused to let this sink in. “We just don’t know what to do or where to go for help. Your name was given to us by a psychiatrist in Boston. So far no one has been able to help us, to find a way to make

Arthur better.” He was almost in tears. “Dr. Ramachandran, we love our son and would go to the ends of the earth to help him. Is there any way you could see him?”

“Of course, I’ll see him,” I said. “When can you bring him in?”

Two days later, Arthur came to our laboratory for the first time in what would turn into a yearlong study of his condition. He was a good−looking fellow, dressed in jeans, a white T−shirt and moccasins. In his mannerisms, he was shy and almost childlike, often whispering his answers to questions or looking wide−eyed at us.

The parents explained that Arthur had been in a near−fatal automobile accident while he was attending school in Santa Barbara. His head hit the windshield with such crushing force that he lay in a coma for three weeks, his survival by no means assured. But when he finally awoke and began intensive rehabilitative therapy, everyone’s hopes soared. Arthur gradually learned to talk and walk, recalled the past and seemed, to all outward appearances, to be back to normal. He just had this one incredible delusion about his parents—that they were impostors—and nothing could convince him otherwise.

After a brief conversation to warm things up and put Arthur at ease, I asked, “Arthur, who brought you to the hospital?”

“That guy in the waiting room,” Arthur replied. “He’s the old gentleman who’s been taking care of me.”

“You mean your father?”

“No, no, doctor. That guy isn’t my father. He just looks like him. He’s—what do you call it?—an impostor, I guess. But I don’t think he means any harm.”

“Arthur, why do you think he’s an impostor? What gives you that impression?”

He gave me a patient look—as if to say, how could I not see the obvious—and said, “Yes, he looks exactly like my father but he really isn’t. He’s a nice guy, doctor, but he certainly isn’t my father!”

“But, Arthur, why is this man pretending to be your father?”

Arthur seemed sad and resigned when he said, “That is what is so surprising, doctor. Why should anyone want to pretend to be my father?” He looked confused as he searched for a plausible explanation.

Maybe my real father employed him to take care of me, paid him some money so that he could pay my bills.”

Later, in my office, Arthur’s parents added another twist to the mystery. Apparently, their son did not treat either of them as impostors when they spoke to him over the telephone. He only claimed they were impostors when they met and spoke face−to−face. This implied that Arthur did not have amnesia with regard to his parents and that he was not simply “crazy.” For, if that were true, why would he be normal when listening to them on the telephone and delusional regarding his parents’ identities only when he looked at them?

“It’s so upsetting,” Arthur’s father said. “He recognizes all sorts of people he knew in the past, including his college roommates, his best friend from childhood and his former girlfriends. He doesn’t say that any of them is an impostor. He seems to have some gripe against his mother and me.”

Arthur was suffering from Capgras’ delusion, one of the rarest and most colorful syndromes in neurology.1 The patient, who is often mentally quite lucid, comes to regard close acquaintances—usually his parents, children, spouse or siblings—as impostors. As Arthur said over and over, “That man looks identical to my father but he really isn’t my father. That woman who claims to be my mother? She’s lying. She looks just like my mom but it isn’t her.” Although such bizarre delusions can crop up in psychotic states, over a third of the documented cases of Capgras’ syndrome have occurred in conjunction with traumatic brain lesions, like the head injury that Arthur suffered in his automobile accident. This suggests to me that the syndrome has an organic basis. But because a majority of Capgras’ patients appear to develop this delusion “spontaneously,” they are usually dispatched to psychiatrists, who tend to favor a Freudian explanation of the disorder.

Anyone out there interested in the least bit in knowing about the strange workings of human brain, I’d highly recommend this book! And if not for anything else, the author’s findings on the Capgras syndrome and phantom limb experiments amongst others (the results of which have been conclusively proven by various research groups, over the years) are worth reading.

This TED talk will give you a good impression of what this book is all about.

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