How do you deal with a man who thinks he’s a tiger? Katie Jarvis talks to the author and neuroscientist about the workings of the human brain
So what was it like…” I ask Helen Thomson, “talking to a man who thought he was a tiger?” I don’t mean that this man – Matar, a villager from the United Arab Emirates – is prone to imagining what it might be like to be a tiger. Or that he particularly admires or feels an affinity with large cats.
Nothing fanciful. Nothing metaphorical.
This is a man who, whenever in the grip of his idiosyncratic delusion, looks in the mirror and sees reflected there – without a
shadow of a doubt – orange fur struck through with black stripes. Who feels his fingers stretching and bending into razor-sharp claws. Who is so terrified of attacking someone – in his tiger state – that he locks his door and binds his limbs tightly in a sheet. Once, he weighted his shoes with concrete blocks. “I just want to stop myself from hurting anyone,” he says, with unbearable poignancy.
There he is, in Al Ain Hospital, where he’s agreed to meet Helen: his thick black beard slightly greying; heavily lined chubby cheeks; long white kandura swathing his unmistakably human form, topped with white headdress.
“I don’t know why I’m a tiger,” he explains, sadly. “I just know I am.”
There are some moments you always remember because (rare as they are) they changed your world-view. On first reading Oliver Sacks’s 1985 masterpiece, The Man Who Mistook His Wife for a Hat, was one such for me. Here was a world of wonders. True wonders. Patients whom Sacks had treated – as an innovative neurologist – whose brain conditions rendered them alien beings. Twins whose low IQ meant they could neither read, nor perform multiplication; yet they could pluck prime numbers out of the air like swifts snatching at beetles. A young man who believed his own leg was a severed ‘other’, cruelly placed in his bed as a prank. And, of course, the eponymous man who couldn’t visually distinguish his wife from his hat.
Journalist Helen Thomson also read this book with fascination. With a degree in neuroscience and an award-winning career writing about the brain (and other cutting-edge science subjects), she felt it was time to revisit Sacks’s idea: the idea that abnormal brains tell us something particular of what it is to be human.
But her newly-published book – Unthinkable: An Extraordinary Journey Through the World’s Strangest Brains – does something a little different. Her bizarre thinkers (including Graham, who believed himself to be dead; Sharon who can’t find her way around the most familiar of rooms; and Joel, a doctor, whose extreme empathy means he physically feels the pain of his every patient) are not looked at in any clinical setting. Helen wanted to see them in their own world; to ask: What is it like? What is it like to be you? The seeds of the idea were sown, Helen Thomson tells me, when she came across an extreme case of face-blindness a decade ago. It was in a journal-paper – scientific and anonymous – describing a woman who not only could not recognise famous people; she couldn’t even identify members
of her own family by sight.
As Helen read through, questions popped into her head that the scientists simply didn’t address.
Like, I suggest, similarly intrigued: What happened when this woman bumped into someone she knew in the street?
“Exactly! I wanted to know: What happens when you wake up next to your husband? Does he look like a stranger to you?”
The upshot is, Helen tracked this woman down (I’m so taken with the story that I forget to enquire how) and asked her all those naturally fascinating questions. The kind of questions you’d ask someone in the pub volunteering a bizarre nugget about themselves. Or that you’d mention, yourself, in the midst of describing your own idiosyncrasies.
How does someone who can’t recognise ANY faces cope? What strategies do they use? What embarrassing situations has it led to? Is it best to ‘fess up or would that risk offending people who just don’t get it? So?
“She said she doesn’t recognise her husband as such, but she’s not stupid. So she knows that’s her husband for every other reason you know that the person next to you is your husband.
“But when the two of them started dating, he would come into a restaurant and she wouldn’t know who he was; she hadn’t learned to recognise his clothes or gait or hairstyle. In fact, she almost kissed another person because she thought that was her date.”
Those sorts of questions might seem a bit lightweight, “But, actually, they’re the ones that have these great stories attached to them. The things that tie us all together are stories. They’re the kind of things that make our lives special.”
She’s absolutely right, of course. Which is what makes Unthinkable unputdownable. So when Helen meets 57-year-old Graham in his tiny, smoky mobile home, she finds out the things we’d all be wondering. This poor chap was going through his second divorce when, in a fit of severe depression, he climbed into a bath holding a plugged in hairdryer. When he came to (miraculously, he survived), he knew he was dead.
“I just had this blank mind and I knew – I couldn’t say why – I just knew that I didn’t have a brain no more.”
Helen considers this, as she sits opposite him in his living room. “And at no point did you think, ‘Okay, I know I must have a brain because I am sitting here breathing?’”
“No. I didn’t know what to make of it. I didn’t know how I could breathe or talk when my brain was dead. I just knew it was.”
What is so fascinating, as she runs through her stories, is the way the people in question are so convinced – beyond doubt
– by their fantastical illusions. Graham’s is a rare but known condition, Cotard’s, that was first documented (as Helen discovered, while nervously leafing through a fragile, leather-bound book at Cambridge University) back in the 16th century by another science writer, Levinus Lemnius. He told the story of a man who, like Graham, was so convinced by his own ‘death’ that he refused to eat or drink. As he lay dying – from real starvation, by this point – his inventive friends hatched a plot. They dressed up in shrouds – as if they, too, were dead – and sat themselves round the table in his parlour, eating and drinking. Reassured, the man-whomistook-himself-for-a corpse joined them for a meal.
To anyone free from similar delusions, these experiences defy belief (to use oxymoronic terms).
“But having had hallucinations myself, I know how realistic they can be,” Helen explains. “I used to have hypnopompic hallucinations [hallucinations experienced while awakening] when I was lacking sleep and going through a stressful period.”
For a couple of years, she’d often wake to ‘see’ people in her bedroom.
“The first few times, it was absolutely terrifying. I don’t think anybody who hasn’t experienced a hallucination of one kind or another can ever understand how real it is; there is seemingly no difference between it and somebody really being there.
“But as I began to learn about these hallucinations and understand them, I got some control over them. I remember Oliver Sacks saying similar things when I once interviewed him [lucky her!]: that when he started having hallucinations as he lost his sight, he actually began to enjoy looking at what he called the ‘theatre of his mind’.”
Indeed: with her degree in neuroscience, Helen is well placed to explore the origins of some of these brain anomalies – and fascinating they are, too. Take the case of Joel, the doctor, whose empathy is so extreme, he feels other people’s pain, emotions and even touchsensations. Once, in a lecture theatre, he felt a hand closing round his throat. Taken by surprise, he soon realised that no one was touching him; but his lecturer, speaking at the front, had his hand round his own throat.
Helen’s questions – as always – are spot on. Can Joel use his hyper-empathy to help his patients? Can he ever turn it off? And what’s it like when he sees a patient die? (‘“To put it simply,’ he says, ‘it’s as if I’m dying as well. There’s this very powerful moment just before death of letting go.’”)
But she’s also excellent at explaining – as far as scientists can – how these conditions can occur. In Joel’s case, most people are programmed, from newborn onwards, to mimic others: accents, facial expressions, body language. Yet, at the same time, most of us can maintain a sense of separation. With Joel – and people like him – neuroscientists have discovered less brain matter in their temporoparietal junction: the area of the brain that helps distinguish where our bodies end and others begin.
The more you read of Helen’s
‘How does someone who can’t recognise ANY faces cope?’
book, I suggest to her, the more you wonder not so much ‘How can brains go wrong?’ but ‘How can they go right?’ This seemingly endless complexity of 100 billion neurons, acting and interacting in perfect balance.
“Yes, that is something I was constantly aware of, meeting these people. But I guess that also led me on to thinking: What is normal? Because – and I hope this comes across in the book – by looking at the extremes of how brains can be different, you realise these are skills and abilities that we all possess; it’s to do with where we all sit on that spectrum of ‘normality’.
“And I hope this all adds to that conversation of how we define mental health.”
So let’s finish by returning to Matar, the man who believes himself to be a tiger. Because his story – told by Helen with her constant sense of compassion and understanding – grabbed me for several reasons.
Often – it seems to me (though I’m no neuroscientist) – we believe people not because they’re logical but because they themselves are convinced. Tony Blair (arguably) on the need for the Iraq War; preachers, with claims for religion; alternative healers whose ‘powers’ have nevertheless been thwarted by double-blind experiments. A part of us seems compelled, against logic, to believe in their belief. (And you can see in that all sorts of phenomena, from witches to ghost stories.)
Because there’s no doubt, from her description, that part of Helen, sitting listening to Matar, felt she was in the presence of a wild animal.
She nods. She’s careful to point out that - despite the stigma - aggression and violence are not always linked to schizophrenia in the way the press would often have us believe.
“I did know that, at some time in the past, Matar had tried to attack a barber, so there was an element of danger, I guess. But he had been well for a while; he’d come to the hospital of his own free will for an interview and was happy to be interviewed. There was no reason to suspect he would have a relapse.” So it came as a complete surprise – to Helen and to the two physicians with them – that Matar began to experience his delusion as he spoke with her.
“It was a terrifying experience,” she tells me. “It was very quiet and you could see he was having this internal struggle. His hands were stretched and his fingers were bending in this really realistic claw-like manner; and these growls were coming from him. It’s hard to explain without sounding like he’s acting.
“There was a silence while this was going on and none of us moved. I did genuinely feel – I was sitting right next to the door – that, if I tried to make any movement, he might actually attack me. So I did think to myself: What would a preying predator do? Obviously, that’s ridiculous because he’s a human being having a severe health issue; but it was so realistic that that’s how I was feeling: Don’t make any sudden movements.”
It was a brief experience and Matar soon became lucid again.
But it gave Helen an insight into other such documented conditions. A 34-year-old woman who arrived, agitated, at an A&E department, before suddenly jumping around like a frog, darting out her tongue to catch flies. Or another who felt she was getting smaller and smaller and turning into a bee.
Were there any strange conditions Helen couldn’t track down?
“A few. There is an entire community of people in Africa who cannot feel fear; they are all very closely related, which is why the condition has persisted. At the time [of researching], it was impossible to get to them, but it’s one I’d love to look into.
“A really interesting aspect of not feeling fear is that you rarely tell lies. If you think about it, it makes sense: We lie because we are fearful of the consequences of truth.”
But for all those waiting for the next instalment, there’s a rather different new brain Helen Thomson needs to explore: She’s expecting a baby in the summer.
She laughs. “A first challenge. And then I might think about the next book.”
‘It was a terrifying experience. His hands were stretched and his fingers were bending in this really realistic clawlike manner’