Suspicious Minds: How Culture Shapes Madness

Brothers Joel (of the NYU School of Medicine) and Ian Gold (of McGill University) combine their knowledge and experience as psychiatrists to shed light on the history and future of the study of mental disorders, focusing on what is called the “Truman Show delusion.” They reject the idea that neuroscience and the brain are the determinants in the emergence of delusions—”what sorts of pills to prescribe and which kind of misfiring neurons the pills are meant to target”—and instead attempt to link social life changes to psychosis: “What this pill-and-neuron story misses is the larger narrative of social and cultural life going on around every patient, around every neuron.” Changes in social life like bullying, immigration, and even urban living are presented as potential factors in the emergence of schizophrenia, but the Golds do not provide enough convincing evidence to support their position. They also discuss how a faulty Theory of Mind—“the ability human beings have to think about the thoughts and feelings of others”—or “suspicion system,” a “special purpose” mechanism that helps individuals navigate through social situations, can result in signs of schizophrenia. The link between both concepts and environmental factors is weak; readers are left to assume they are neurological issues. What the Gold brothers end up demonstrating is that no simple answer can fully explain what happens when a person has “faulty reasoning.” Figs. & illus. Agent: Max Brockman, Brockman, Inc. (July)