On the afternoon of Tuesday, September 11, 2001, a British boy who had been diagnosed with Obsessive Compulsive Disorder – a form of anxiety which is only relieved by performing certain repetitive actions – was walking home, while engaging in one of his compulsive rituals. This one made him step on specific white markings on the street, but that day he accidentally missed one. Shortly after, when news of the atrocities from the US reached him, he became convinced that he was the cause of the attacks, because he did not step on that particular white mark. The boy thought he was to blame for 9/11.
Consumed with guilt, he behaved erratically for days – he also had Tourette’s – and had to be persuaded by his therapists that the time difference between the UK and the US meant he had missed his ritual after the attacks happened, so he wasn’t responsible.
People who suffer from OCD often believe that missing their rituals might cause terrible harm, to themselves or others. But it was the first time an OCD patient thought he had caused a terrorist attack. The fear can take many forms and can even be externalized on various objects, like in the curious case of a patient who freaked out whenever he saw a particular type of car in the street, an El Camino.
A malfunctioning brain can create very powerful delusions: Capgras Syndrome is a rare condition – only about one hundred accounts exist – in which a person believes that their spouse, friend, parent or other family member has been replaced by an identical looking impostor. A similar condition, the Fregoli delusion, named after an Italian quick-change artist, has patients think that different people are in fact a single person who keeps changing appearance to torment them.
They both originate from a problem with face recognition, often due to illness or brain damage. The brain can no longer recognize familiar faces, and while attempting to make sense of them, it produces what psychologists call a confabulation, an unintentional lie that rings true to no one but the person who creates it.
This sort of mental short-circuit can unfortunately apply to one’s own body as well. BIID, or Body Integrity Identity Disorder, is a neurological failing that brings patients to think that a limb in their body no longer belongs to them: they want it gone, and strongly desire to become amputees. They start to behave like amputees, and will often gruesomely attempt to get rid of the alien body part.
The cause of this condition is unknown, but it is often associated with apothemnophilia, a form of sexual arousal based on one’s image as an amputee. The list of peculiar sexual preferences connected to mental illness is a long one, but I’ve always been particularly struck by Object Sexuality, by which people become affectionate to things rather than persons.
One American woman, Erika Eiffel, is an advocate for this very persuasion: she has been in love with the Berlin Wall for over twenty years. We’re not talking about architectural interest or a passion for aesthetics, but feelings of true love: she even slept with a miniature portion of the wall, cuddling it and treating it as her boyfriend. In 2004, she fell in love with the Eiffel Tower, which she famously “married” in a ceremony in 2007, hence her name (she was born Erika LaBrie). She received significant media attention and she is the subject of a book and a musical theatre production.
What I find fascinating about mental disorders is that they almost always abide by our need for a narrative. All brains, including healthy ones, prefer to receive information in the form of a story: it’s called narrative bias. We often use narrative to make sense of what happens to us, finding connections between events even if there are none. A damaged brain will not stop doing so, and will happily take the narrative to grotesque extremes. That is why, at times, the only way to “cure” a patient is to operate inside their own narrative. Philosopher Alain de Botton, in this almost certainly apocryphal tale, beautifully captures this:
“Medical history tells us of the case of a man living under the peculiar delusion that he was a fried egg. Quite how or when this idea had entered his head, no one knew, but he now refused to sit down anywhere for fear that he would “break himself” and “spill the yolk.” His doctors tried sedatives and other drugs to appease his fears, but nothing seemed to work. Finally, one of them made the effort to enter the mind of the deluded patient and suggested he should carry a piece of toast with him at all times, which he could place on any chair he wished to sit on, and hence protect himself from spillage. From then on, the deluded man was never seen without a piece of toast handy and was able to continue a more or less normal existence.”
(From Essays In Love, by Alain de Botton)