There is nothing we take for granted as much as sanity. No matter what “crazy” unexpected thing might happen at the office tomorrow, you still know that you’re not going to show up and find, say, your boss replaced by a talking guitar.
But as we have explored before, there are mental disorders that can mess with your perception of reality in unimaginable ways, while often leaving the rest of your mind untouched.
Imagine you get into an argument with your asshole roommate about the unpaid rent. You need to let off some steam, so you call your girlfriend to see if she wants to go for a nice burrito somewhere, but for some reason it’s your asshole roommate on the end of the line and he’s calling you “honey.” So you hang up and go outside, but your asshole roommate is waving at you from the neighbor’s yard.
Apparently Mr. Moneybags has enough cash for two rents.
Furious, you go to the local bar, only to find that your asshole roommate is the one pouring the drinks. Ten minutes and two black eyes later, you find yourself getting arrested by your asshole roommate.
Fregoli syndrome is the delusion that some or all of the people you meet during the course of a day are actually the same person. It’s named after a famous actor who was able to change costumes rapidly onstage. As you would expect, Fregoli sufferers are frequently paranoid, as they reasonably assume that some master of disguise is fucking with them. Or maybe some kind of shape-shifting wizard.
Keep practicing, buddy. You can be James Hetfield, but you can’t be all of Metallica.
The disorder comes with different degrees of severity, though. Sometimes, sufferers don’t know exactly who is stalking them, but everybody looks really familiar somehow. It’s like waking up to find your town populated entirely by people who went to your high school that you never spoke to much. One guy was known to just walk up to everybody and ask where they’d met before.
Fregoli syndrome also makes for an interesting insanity stew when it tag-teams with other disorders. For instance, a woman who was diagnosed with the condition also suffered from schizophrenia and something called erotomania, the belief that someone is in love with you when they aren’t. She believed that actor Erik Estrada was in love with her, communicated with her telepathically and disguised himself to show up in her daily life in the form of her acquaintances and current boyfriend.
This is someone’s fantasy.
It’s such a sad story that we’re hoping someday it will turn out she was right all along, and Mr. Estrada will be arrested.
You wake up in the middle of the night and shuffle down the hall to the bathroom. You stumble in and flick on the light, and look up at the mirror on the medicine cabinet over your sink.
A stranger is standing there. He’s staring right at you, as surprised to see you as you are to see him. You scream, “Get the hell out of my bathroom, you pervert! Go look at someone else’s dick!” but the man only screams your own words back at you.
“Bring it on, buddy, I can do this all day.”
People suffering from a disorder called mirrored-self misidentification have a breakdown with the part of their brain that understands how reflections work, so when they look at a mirror, their brain tells them they’re looking at a stranger through a window. On a rational level, they understand what mirrors are and what they do, but they maintain the strong impression that their reflection is some nefarious doppelganger. It shows up mostly in Alzheimer’s patients, but even then it’s rare.
Scientists study the disorder by presenting subjects with a mirror, then holding up an object behind them and asking them to grab it. People without the disorder will turn around and reach for the object behind them, but someone who suffers from the condition tries to reach through the mirror, providing hours of quality entertainment for the researchers.
“You guys are DICKS!
One patient known as TH described the man in his mirror as “a dead ringer” for himself. He would even try to talk to his reflection, though their conversations were a little one-sided. TH did not particularly dislike this person, saying he had no reason to be suspicious of him. He believed that this man lived in the apartment adjoining his own. (There was no apartment adjoining his own.)
And they liked to look at each other while masturbating.
You go to the grocery store to pick up your weekly supply of Red Bull and Febreeze, but you quickly realize that something is a little off. Specifically, all of the products you pick up scream and fight back when you try to shove them into your cart. Worse, when you finally get to the register, a potted fern asks if you’re paying by cash or charge.
“Hey, asshole, my fronds are up here.”
Visual agnosia is caused by a dysfunction in some of the brain’s visual processing areas, the result of which is that you’re unable to correctly identify things for what they are. And we’re not talking about confusing a dog with a cat from a distance; we’re talking about looking at your brother and trying to cram bread into his hair because you think he’s the toaster.
If you think we made up that example to be funny, the neurologist Oliver Sacks described a patient in the book The Man Who Mistook His Wife for a Hat who, at the end of an interview, grabbed his wife’s head and tried to put it on his own head. According to the wife, this was the kind of bullshit she had to put up with every day.
“Sick bastard just walked up and started dry-humpin’ my head.”
People suffering from visual agnosia are stuck seeing the world kind of the way a space rover on Mars does. When a person with a normally functioning brain looks at something familiar, like a rose, she sees a bunch of shapes and colors and her brain automatically tells her what that thing is. The process is so lightning fast that you aren’t even aware of it.
But it is a process and it can break down. Agnosia sufferers are permanently trapped in the shapes-and-colors stage. Sacks’ patient looked at a rose and described it literally as “a convoluted red form with a linear green attachment.” It’s kind of like being blind, except you have some jackass following you around describing things to you and making you figure out what those things are on your own. For the rest of your life.
“Convoluted red form with a linear green attachment … Rose McGowan?”
Mercifully, visual agnosia is just that — a visual disorder. Sufferers retain the ability to identify things by using their other senses. Sacks’ patient was able to recognize the rose when he smelled it.
Pause here and take a moment to thank your brain for all of the shit it does in the background just so you can get around every day.
“I sure hope none of those convoluted gray shapes are people!”
You sit down in the morning to a cup of coffee, and to work the maze on the back of the Lucky Charms box. Your nose itches, and suddenly somebody else reaches over to scratch it.
Then this person grabs your coffee mug and brings it to your lips. You’re starting to wonder who this is and why he’s being so helpful, considering that you live alone. It’s then that you realize, to your horror, that you’ve actually had someone else’s arm grafted onto your shoulder and the goddamn thing is acting all innocent about it.
And the thing is really good with kids, too!
People with somatoparaphrenia suffer damage to the brain’s homunculus region or “body map.” That’s the part of your brain that catalogs all the parts of your body and keeps track of them so you know where all your limbs are without actually looking at them. If you have a stroke or something that messes with your brain, however, it can actually lose track of one of your limbs. And this really, really messes with your head. It makes it so that you can still move the limb and still register feeling — you just don’t recognize it as yours.
In one documented case, a man denied ownership of an arm and a foot, and while he didn’t know where the foot came from (it was a “big foot only suited for work”), he figured for some reason that the arm belonged to a woman he knew named Maria.
She did have some guns, though.
In some cases, the experience of having someone else’s body parts attached to you is so stressful that people will actually try to get the foreign limbs chopped off. In 1997, a man approached surgeon Robert Smith and asked him to amputate his left leg, which he believed wasn’t his. Apparently shooting for the title of World’s Most Unethical Surgeon, Smith granted the request, and was immediately swamped by people wanting him to cut off their alien limbs. He actually made a decent living cutting off people’s healthy body parts until the hospital ordered him to stop, for some reason.
“Yeah, that feels much better. Thanks, Doc.”
Imagine you’re in an accident that lands you in the hospital. You’re clearly fine, but you know how doctors are, it’s all about precaution (or padding the bill). So, the doctor asks if you can move your legs. It’s the tenth time he’s asked you to do this today, even though you clearly can. This doctor, who is clearly the worst doctor in the world, just shakes his head sadly and tells you he doesn’t think you’ll ever walk again.
It’s at this point when you start wondering if this is in fact a real doctor, or if a janitor is just impersonating one like in that episode of Scrubs.
Though we’d probably go to that hospital because he’s awesome.
Anosognosia is a delusion suffered by paralyzed people that they are not, in fact, paralyzed. And it’s incredibly common — according to some studies, over half of people with hemiplegia (stroke-induced paralysis on one side) will have anosognosia for at least some amount of time. And to be clear, we’re not talking about people who are in denial, or just too stubborn or proud to admit they’re disabled. They have damage to their right parietal cortex, the area responsible for drawing conscious attention to body perception, movement and sensation.
Patients with anosognosia wind up with the bizarre delusion that their inability to move their limbs is not because they can’t, but because they don’t want to. When prompted to move a paralyzed limb, patients will make up excuses to convince the doctor (and themselves) that their noncompliance is actually a conscious choice, like their arm hurts from arthritis, or that they don’t move their limb just because the man tells them to.
Incidentally, it’s the same excuse used in many 3 a.m. sobriety tests.
However, some people, like neurologist Vilayanur Ramachandran, believe that, while the patients aren’t lying per se, there might be some subconscious knowledge of their condition. When Ramachandran asked a woman to touch her nose with her paralyzed left hand, she didn’t just make up excuses not to do so; eventually, she just grabbed her left arm with her working right arm and guided it to her nose, like, “Oh, yeah, I always do it this way.”
“See, I can sit up on my own just fine.”
Imagine you walk downstairs one morning to find someone cooking scrambled eggs. The person smiles at you, but you don’t go in for a kiss because you’re not sure if it’s your wife, or your son, or your uncle Joe who is staying for the weekend. Later you’re at work, and someone asks you to do something, but you don’t know if it’s your boss (in which case you should comply) or that jackass from two cubicles down trying to get you to do his work so he can go back to linking all of his paper clips together in one huge chain.
Every person you run into is a total stranger … even though you’ve seen them every day, for years.
You must have a conversation with Criss Angel, REO Speedwagon or Carrot Top. Distinguish.
What we’re describing is prosopagnosia, the inability to recognize faces. There are different levels of this — whenever you hear someone say they are “bad with faces,” chances are they suffer from some form of prosopagnosia. About 2 percent of the population has a mild case of it, and it’s more pronounced in people with conditions along the autism spectrum.
But then you have the severe cases, the people who can’t tell even their family and friends apart from total strangers. Sometimes, they can’t even recognize themselves.
“Frankly, I don’t see the resemblance.”
To understand what it’s like, imagine trying to distinguish one dolphin from another, or trying to pick one chicken out of a police lineup. You couldn’t, unless one had some distinguishing feature, like say if the chicken was wearing a tiny beret or if the dolphin had a swastika tattoo. The only reason that humans can tell other humans apart is that we have a specially developed area of the brain just for that. Back in the Stone Age, it became evolutionarily advantageous to know your bros from the total douchebags who steal your scraps of meat. Being able to greet your favorite chicken by name before you kill and eat it? Slightly less important.
“I dub thee … Beakface Squeakything!”
Granted, everyone has had that awkward moment when they’re shaking hands with someone they know at a party but can’t place their face and can’t quite remember their name. For people with prosopagnosia, this is almost every encounter they have. Enjoying a movie? Impossible — they can’t tell who any of the characters are unless they say their names at the beginning of each line of dialogue.
However, people with prosopagnosia can become ingenious in their techniques for recognizing people, identifying them by memorizing their distinctive features. It works perfectly as long as nobody you know ever gets a haircut.
“OH, I recognize you! You’re the guy who has the beer!”
People with brain disorders get by in much the same way as people with other illnesses or disabilities. For instance, Oliver Sacks, the neurologist we mentioned earlier, has prosopagnosia himself, and once preened his beard using what he thought was his reflection, but was in fact a stranger on the other side of a window. And he did well enough for himself that he got quoted as an expert in a Cracked article.