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The Quintessential Rational Mind

The day of Vaisakh Purnima (May 27 this year), is significant for three reasons. It was on this day that Gautama Buddha was born as Prince Siddhartha at Lumbini in Nepal in 560 B.C; the day when he attained enlightenment at Gaya in India; and the day he attained Nirvana (Unity with the Absolute) in 480 B.C. It is, therefore, observed as Buddha Purnima, worldwide. To mark this day in 2010, we examine the rational mind, as conceived by Buddha.

It has become fashionable and commonplace to associate Buddhism with the metaphysical. This is in stark contrast with Buddha’s emphasis on rational thought and insistence on empirical verification. He encouraged the development of theories that were verifiable and was strongly opposed to dogma, which he viewed as an impediment to the truth. To him the truth was supreme, and ideas that hinder the discovery of truth best avoided. He believed in full freedom in thought and action; “the gates of freedom will cease to be gates, if people start clinging to the gates.”

Buddha also had very interesting, remarkably contemporary views on the mind and some of these are enumerated below.

On Thoughts and Ideas: The very first verse of the Dhammapada translates as“you are nothing but your mind”, based on which, “Sarvam Buddhimayam Jagat” has been proposed. The word used by Buddha ‘ mana’ translates both as thoughts and as mind, and can be interpreted to mean the brain. Buddha’s emphasis is on the flow of thoughts and the continuous change in the thinking process. In his concept, ideas are not constant, they change all the time. Ideas have no independent origination; they have ideas preceding and following them. Consequently, all ideas are interrelated and there are no stand alone or absolute ideas. The thinker, the thought and the concepts therein cannot be separated. Interestingly, this concept has parallels in modern psychiatry. A primary delusion, a first rank symptom of Schizophrenia is said to arise when the person, following a “delusional mood” has a thought “out of the blue” and “without antecedents”. To have such a thought that has no thoughts preceding it, and possibly therefore no basis in fact, was abnormal to the Buddha, and remains so in modern concept.

On Perception: Both the Surangama Sutra and the Lankavatra Sutra attribute perception, physical and emotional, to the mind. “Both delusion and enlightenment originate within the mind and every existence or phenomenon arise from the functions of the mind.” The Surangama Sutra poses an interesting question: “A man opens his hand and the mind perceives it; but what is it that moves? Is it the mind, or is it the hand? Or is it neither of them? If the hand moves then the mind moves accordingly, and vice versa; but the moving mind is only a superficial appearance of mind”. According to the Buddha, all perception had basis within oneself. This concept of the Buddha has neuro-scientific underpinnings. If one were to replace the “mind” as Buddha called it, with “brain” as he probably meant, and is contemporary concept; that all our perception and action has basis in the brain, is truism. Prof. VS Ramachandran has described in his book Phantoms in the Brain, novel representation areas for human body parts that have been amputated, developing in the brain.

This illustration leads to another important question, namely, what is ‘me’ and what is ‘mine’? Buddha, through fables, encourages us to think about this existential dilemma. The parable is about a man who takes shelter in an abandoned structure on a stormy night. Sitting in a corner of a dilapidated room he sees around midnight, a demon enter, with a corpse. The demon leaves the corpse on the floor; suddenly another demon appears and claims the corpse. Both demons turn to the man and ask him to decide on the ownership of the corpse. Being truthful, he indicates he saw the first demon bring in the corpse. On hearing this, the second demon is enraged, tears away and eats the hand of the unfortunate man, which the first demon, immediately replaces with the one taken from the corpse. After the demons leave, the man wonders and thinks aloud, “the replaced hand is ‘mine’ but is it ‘me’?

Again, the questions raised have neuro-scientific relevance. After damaging physical trauma, and transplants, it is well reported that people sometimes feel dissociated from their new organs. Indeed, having an organ replaced can be a life-changing experience. At another level, damage to the brain, the parietal lobe in particular, can result in the sufferer neglecting his body parts, as he does not recognise them as his own. The phenomenon of anosognosia, leading to neglect of one half of the body (hemi-neglect), is a well described phenomenon after a stroke. Here, the person sees the paralysed limb lying beside him on the bed, but is unable to recognise it as his own.

Buddha did, therefore, begin the mind-matter debate much before it became fashionable in contemporary philosophy. He placed human emotion firmly within the organ he referred to as the mind, which we now understand to be the brain. His statement – “If we learn that there is no world of delusion outside the mind, the bewildered mind becomes clear” – is remarkably accurate.

On Perception and Memory

Buddha made a distinction between the flow of thoughts and the stock of memory influencing our perception. In his view our perceptions are influenced by our memory. Thus we view the present through the coloured glass of past experience and do not see things as they exist or as they are constituted. When a person perceives an object, both the memory of the same or similar object and the feelings the person had on the earlier occasion are rekindled. Moreover, comparisons are made between imaginary constructions of the object and the object itself. However, this distinction between stock and flow is more analytical than exclusive. Indeed, stock and flow interact all the time.

This view mirrors our current understanding of how the limbic system in the brain works. It has been proposed that the hippocampus is the storehouse of memories. Adjacent and connected to it by a chemical rich neural network is the amygdala, an organ deeply concerned with human emotion.

Any external stimulus results in activation of both organs; thus when a person sees a snake, his memory (and learning) tell him that it could be dangerous, and he experiences fear as a consequence. Memory and emotion are therefore in continuous interplay, as conceived by Buddha.

The Rational Mind

Buddha’s understanding of the human mind (and brain) was unique; both rational and contemporary. He encouraged debate and discourse; raised questions more often than he provided answers; encouraging his followers to think like him, with freedom. He recognised the pitfalls of blind faith, unquestioning belief and intolerance of contradictory ideas. He laid emphasis on empirical verification and on understanding the world, as it is and as it is constituted. Indeed, through his radical empiricism, he laid the foundations of scientific spirit and enquiry 2500 years ago. His was the quintessential rational mind.

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Temperamental, Indeed

Life with my pet canines is not just joyful and entertaining; it reveals to me each day, profound neuro-scientific insights. Carlo, my German Shepherd, is a classic example of his breed; in looks and temperament. A “Master’s” dog, his life revolves around my routines. A glance in his direction, slight change in tone, low whistle, all will ensure his immediate compliance with “his Master’s” desires. Obedient and devoted to a fault, Carlo is also extremely high strung and anxious, alert to every change in his environment, and protective of it; so much so that I rarely catch him in fitful slumber. Blessed with an uncanny sixth sense for “his Master”, a trait that his breed is famous for, Carlo actually heads for the gate, minutes before my arrival at home from work. Not one to break rules, he will not enter a room or defile a piece of furniture, once forbidden. Natty and fastidious about his appearance, he remains shiny coated through the week, not an ounce of dirt on him, nor a doggy odour.

Unpredictable and Wilful: Contrast this with my later acquisition Coco, a Basset Hound. A handsome specimen with the classic sad and droopy face, jowls et al, Coco suffers from both occasional seizures and frequent mood swings. An approach in his direction, with best intentions, can evoke dramatically different responses: from a friendly, excited, tail-wagging welcome, to total loss of control; sometimes a resentful, even angry growl, bark or snap in the general direction of approach. Unpredictable mood swings from hypomania and hyperactivity to depression and profound apathy characterise his eventful existence. Disobedient, wilful and obstinate, he can be depended on to do exactly the opposite of what is intended, oblivious to “his Master’s” pleas, commands and threats. Indeed so agnostic is Coco of his surroundings that he can collapse like a sac, his numerous folds spread around him, in fitful slumber, no matter what the circumstances are. House rules mean little to this brat! Stride he will into any room at will, climb on any piece of furniture that strikes his fancy; and somehow manage at least once in each week to manifest for our benefit the pinnacle of filth; no part of the garden, however muddy, having been spared during his meanderings.

Not surprisingly, he emits a profound doggy odour so striking that dog lovers claim it should be bottled and sold (Chanel by Coco is our private joke). Guests without a fondness for canines, beat a hasty retreat from our abode when he decides to bless our company with his presence.

The contrasts in doggy behaviour become most apparent in our morning walk together. Carlo, the German Shepherd, needs no leash, walking three to four kilometres on the footpath that runs alongside arterial roads near our home. Rarely straying more than 10 feet from “his Master”, purposeful in his stride, nary a glance asunder, whatever the provocation, Carlo is the epitome of walking propriety, even his ablutions being timed for completion at a certain discreet spot.

Coco, the Basset Hound, on the other hand, treats the walk as a grand exploration of sorts; an opportunity to experience for himself this beautiful world that the good God has created. Constantly tugging at his leash in an angle perpendicular to the general direction of travel; sparing no human, animal or plant form en route from his nasal excursions, Coco is anything but purposeful about his morning constitutional, his ablutions being intermittent and erratic, intruding into the well directed journey of his fellow canine and Master, much to their combined annoyance. No order is heard, let alone obeyed; no single purpose complied with, other than that, which his doggie mind is set on.

My clinical experience in brain and mind matters has led me to conclude that Carlo, my German Shepherd, is left-brained and Coco, my Basset Hound, right-brained. The concept of hemispheric dominance, i.e. which side of the brain has a more dominant effect in the concerned individual, is one example of how brain function may influence behaviour and temperament.

Left brain dominant individuals tend to be more ideological and philosophical in their approach; more motivated by social and pragmatic, rather than emotional concerns; more diligent, purposeful, capable of greater tenacity and driven more often by a sense of duty.

On the other hand, right brain dominant people have a better appreciation of the world around them, greater creative ability; a proclivity for the finer aspects of life; and tend to be more mood and emotion driven in making their choices; both day to day ones and those that are life-defining. Put simply, left brained individuals think with their heads, the right brained with their hearts; and can be quite a study in contrasts, experiencing great difficulty understanding one another. Little wonder then that many professional and personal relationships run into rough weather; the two parties failing to understand each other’s contrasting preferences and predilections.

Unique Temperamental Attributes

Carlo and Coco have taught me that brain dominance is not an exclusive prerogative of the human race. And love them as I do, equally, I have learnt through them to celebrate rather than despair in these unique temperamental attributes conferred on us by our brain, that marvellous wonder of creation. To understand my family and friends better by observing their brain dominance. To choose correctly my activity companions: left brained for the purposeful and right brained, the hedonistic; and to tailor my expectations of them, appropriately. Carlo and Coco have enhanced my understanding of human nature; and thanks in part to them, I find myself at peace with my fellow men; well most of the time. It is a dog’s life, indeed!

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In a New Light

An exploration of Jiddu Krishnamurti’s well-documented ‘transformational’ experience that lead him to a state of god-intoxication.

Jiddu Krishnamurti! The name conjures up many images: benevolent soul who dominated the spiritual world; silver-haired seer with unparalleled vision and verbal felicity; educationist and thinker par excellence; institution builder; diminutive gentle giant with the unique ability to usher peace and joy into troubled lives and minds. In Toto, an enlightened soul, supremely in touch with himself and the world.

How did he evolve to this enlightened state? Was he born with a special mind? Was he transformed by experience, education and mentorship? Or, did he have a moment of spiritual awakening that changed his life forever, as his associates and biographers say? Unlike many world seers whose transformational experiences are hearsay, JK’s was well documented by those close to him at that moment. It is the subject of this exploration.

Well known, but worth recapitulating. Born to a poor rural Brahmin family in the now famous Rishi Valley area in Andhra Pradesh, JK moved to Madras as a young boy. Frail and unremarkable, he was spotted playing on the banks of the Adyar River by C.W. Leadbeater, an associate of Annie Besant, founder of the Theosophical Society. He came under their combined influence. Identified as “the chosen one” by them, he was told he should await the emergence of the master. His transformational experience occurred soon after. Noteworthy that he awaited “the Master” living in a beautiful place, surrounded by mountains.

The Turning Point: Described by his brother Nithya, who was with him during this period, the transformation begins with JK feeling ill; the sequence of events leading to the turning point is summarised in the box titled “The Prelude”.The setting for the transformation is described, “We were a strange group on the verandah. The sun had set an hour ago and we sat facing far off hills, purple against the pale sky in the darkening twilight, speaking little, and a feeling came upon us of an impending climax; all our thoughts and emotions were tense with a strange peaceful expectation of some great event”.JK is described as sitting under a roof of delicate leaves, black in a starlit sky. He is heard murmuring “unconsciously”; then a sigh of relief. “Oh, why didn’t you send me out here before?” This is followed by the weary repetition of a daily “mantra”. Then, silence.JK on the transformed mind: “I was supremely happy for I had seen. Nothing could be the same again. I have drunk at the clear and pure waters at the source of the fountain of life and my thirst was appeased. Never could I be thirsty, never more could I be in utter darkness. I have seen the light. I have found compassion, which heals all sorrow and suffering; it is not for myself but for the world. I have stood in the mountain top and gazed at the mighty beings. Never can I be in utter darkness. I have seen the glorious and healing light. The fountain of truth has been revealed to me, the darkness has been dispersed. Love in all its glory has intoxicated my heart; my heart can never be closed. I have drunk at the fountain of joy and eternal beauty. I am god intoxicated!”In a letter to Leadbeater written two days later, he goes on to say… “After August 20th I know what I want to do and what lies before me – nothing but to serve the Masters and the Lord. Now I feel I am in the sunlight with the energy of many, not physical but mental and emotional. My whole life, now, is, consciously on the physical plane, devoted to the work and I am not likely to change.”His words were, as the world later discovered, remarkably prophetic.

The Clinical-Science Perspective: The spectrum of symptoms during the prelude: pain, increased temperature, altered consciousness, exaggerated response to sound and touch (“exaggerated startle”) and repeated episodes of shaking with teeth clenched and fists closed indicate a seizure syndrome — an electrical storm in the brain. There are unusual features: quiet when comforted; quiet during mealtimes; having memory of the event and the ability to describe it later. All these are not normally encountered in a seizure syndrome. Was JK then experiencing psychosomatic symptoms: physical symptoms that have no physical cause and are underpinned by severe psychological stress?In this particular situation one must not forget that he was a mere slip of a boy, aged 16. He had been told that he was the “chosen one” and that he was to await “the Master”, a much anticipated event, both for him and those around him. Were his experiences brought on by the weight of collective expectation?He has said himself, “I wanted to meet with the Master as soon as I could. I thought about it every day but this was done most casually and carelessly. I realised where I was wrong and thereafter meditation became easy. I realised that there was a need to harmonise all my other bodies with the Buddhic plane (highest plane of consciousness) by keeping them vibrating at the same rate as the Buddhic. The main interest was to see Lord Maithreya and the Master.”Freud proposed that the human tendency is to repress emotional conflicts that are anxiety provoking and so the conscious mind cannot possibly contemplate them. Emotional repression results in these conflicts remaining firmly rooted in the sub-conscious mind. Inevitably, there are times when repressed emotions transcend to the conscious, but given their unacceptable nature, manifest as a physical symptom. Medical men term this “hysterical conversion”. These and other explanations for the events leading to JK’s transformational experience are outlined in the box titled “Neuropsychiatric Interpretations of JK’s Turning Point”.

Trinity Talking Eureka Moments: Should the clinician hesitate to make a diagnosis here? JK’s experience was not followed by any decompensation in mental faculties. Indeed, they were enhanced! He underwent a positive transformation and went on to occupy a special place in the world, beginning his journey as a spiritual leader. Further, the experience was not repeated; and it was both shared and documented; all of which render it less likely to be “a figment of the imagination”. JK is described by his biographers as being reticent in describing and discussing his experience, for a number of reasons that people have thought fit to attribute.

I for one wonder if transformational experiences reflect unique moments when one is in touch with one’s soul, that undeterminable part of the human psyche. Perhaps they represent a union between the brain (cognition), mind (emotion) and soul (realisation): a trinity talking “eureka” moment. Moments in which there is sudden clarity, often following a period of confusion and turmoil. Moments of insight, decision, and action.

Interestingly, both functional Magnetic Resonance Imaging (fMRI) and electroencephalogram (EEG) studies in Carmelite nuns, when they were “in a perceived state of union with god” have revealed activation of several brain regions concerned with emotion, memory and judgment, the temporal and frontal lobes and the connections that link them. It has also been suggested in these studies that personality rather than personal orientation may have a significant role in determining such experiences. Of course, what we do not know is whether these brain changes precede and therefore are presumably responsible for transformational experiences; or indeed whether they are the result of such a transformational experience.

The Transformed Mind: Transformational, life-changing experiences are well described among many seers, and often are a defining part of their reaching enlightenment. Our look at JK’s turning point indicates that they defy conventional paradigms of understanding in clinical science. Positive transformation in the JK mould may well require a very special and unburdened mind: sans expectation, dogma, and prejudice; explaining perhaps the early age at which many seers attained realisation. Perhaps, too, it needs in some instances, preparation, opportunity, encouragement and mentorship, all of which JK enjoyed. Most importantly, perhaps, transformation requires that Eureka moment, when the brain, mind and soul trinity are talking to one another!

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The Entrepreneurial Mind

Many years ago, I remember watching a BBC program on the qualities of entrepreneurship. A diverse group of young individuals who did not know each other and had no knowledge of each other’s identity were being put through a series of tests, to identify secret entrepreneurs in their midst. One test stands out in my mind: the participants were asked to aim for and hit a target from a distance of their choice. Needless to say, the greater the distance from which one tried to accomplish the task, the more the rewards and indeed, the risks. Interestingly, the entrepreneurs in the group were the ones who chose to try from seemingly impossible distances. This appetite for risk is well recognized as being a quintessential entrepreneurial quality. But pray, what else characterizes the entrepreneurial mind? This is the subject of our exploration.

Five Minds!

Howard Gardner has described “the five minds” that are necessary for leadership. He begins with “the disciplined mind” acquired through years spent in scholarship, a craft or a profession, which he estimates takes the average person a decade to master. He prescribes that the disciplined mind emerges from consistent work done to develop skill sets and a knowledge base. This concept of “the disciplined mind” necessitates education and/or training, of course. But is education or training an essential pre-requisite for the entrepreneur? Many famous entrepreneurs have had very limited formal education, and in many instances have dropped out of the educational system, only to prosper. Famous examples of people who did not survive the educational system for a variety of reasons include Bill Gates, Richard Branson, Steve Jobs and our own Dhirubhai Ambani; all synonyms of successful entrepreneurship. So is education at all necessary for entrepreneurial excellence?

John Warrilow in a recent article identifies some reasons why an MBA may be bad for entrepreneurship.

1. Causal rather than Effectual Reasoning:

Entrepreneurs use effectual reasoning (they assess what resources they have and ask themselves what can be created) while conventional CEO’s use causal reasoning (they set goals and develop systematic plans to achieve those goals). MBA programs teach causal rather than effectual reasoning.

2. Adaptive rather than Innovative Thinking:

Adaptors are cautious and pragmatic. They take others ideas and try to innovate them, incrementally. On the other hand innovators overturn other ideas, challenge conventional concepts and are into big-bang thinking. MBA programs teach adaptive thinking rather than innovation, which is an entrepreneurial quality.

The advantages of the disciplined mind notwithstanding, one must address the question therefore, whether formal education is necessary for entrepreneurship, or whether indeed it is an impediment for success. John Warrilow points out that an MBA is bad for entrepreneurs also because “your classmates will not be entrepreneurs” and “you will waste 40% of your risk free years in a classroom”. It is a truism that the higher one climbs on the academic ladder, the more one usually has by way of formal employment opportunities, and the greater are the risks when one chooses to pursue an entrepreneurial venture in favor of well paid employment. Thus, too many years spent in education maybe a disincentive for risk, that important entrepreneurial quality. On the other hand it has to be acknowledged that formal education such as an MBA does bestow on one credibility, a critical element for entrepreneurial progress, at least in the early years. A doctor turned entrepreneur recently remarked to me, rather ruefully, that it took an ivy league MBA for people to be convinced about the seriousness of his entrepreneurial intent and ability.

Howard Gardner goes on to describe “the synthesizing mind” as learning to integrate disparate sources of information, identifying the links between them. Synthesis he says is identifying the jobs that need to be done and the people available to do those jobs. Synthesis is the identification of priorities and the way forward, balancing past visions with future aspirations. Synthesis enables one to examine new ideas in the light of one’s knowledge base. In this concept one needs the discipline of education combined with the ability to integrate disparate sources of information, an ability that usually comes with work experience.

Gardner then describes “the creating mind”, more a function of the leader than of the manager. Entrepreneurs are leaders and are generally bestowed with a strong sense of creativity, the ability to innovate and think out of the box. In general, the leadership of organizations require the development of compelling narrative, which then gets embodied in the leaders life. Good leaders (and entrepreneurs) are therefore expected to live by the principle “my life is my work; my work is my life” and to bring about changes to the lives of those

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The Stranger In The Mirror

Mad Tales looks at the way Hindi cinema has portrayed human emotions, madness in particular, down the decades and what these caricatures tell us about ourselves as a society.In a country like India, where people idolise film stars and are influenced greatly by cinema, it is very important that issues like human emotion and mental illness are portrayed accurately and responsibly.

Mad tales from Bollywood, Professor Dinesh Bhugra, Maudsley Monographs number Forty-eight, Psychology Press, U.K.Art is often viewed as a caricature of society — an exaggerated portrayal of the life and times it evolves in. In no art form perhaps is this a greater truism than the world of cinema. Human emotion takes the centre-stage in most cinematic endeavour: from romance to war, epics, social drama and magical realism. Indeed, even the most Kafkaesque (or for that matter, Tarantinoesque) contribution, is fashioned around bedrock of human emotion.

Mad Tales from Bollywood (2006: Psychological Press, Hove, U.K.) is a unique effort by a London based academic psychiatrist of Indian origin, Professor Dinesh Bhugra. In this work he analyses from a cultural viewpoint the portrayal of human emotions and mental illness in Indian Cinema.

The book begins on a technical note, defining and introducing some basic terms and concepts. One of these, “The Other”, an individual who stands for something quite opposite to what we stand for, is of interest from the perspective of how mental illness and villainy are portrayed. How this other gets defined, vilified, criticised, made fun of, or rejected outright is crucial, as mental illness may be then viewed as a visitation, mitigating one’s responsibility for it and engendering greater acceptance of the sufferer.

The author explores the socio-cultural underpinnings of Indian cinema, paying attention to the extended family in Indian society with its attendant religious undertones. The use of song and dance in Indian movies, to convey emotions of love, passion, anger and hatred, with the protagonists often being far apart from one another, is dealt with in some detail. The roles of gender, social and class factors, besides that of patriarchal hierarchy, dictate how songs are used in Indian society. The new boldness that has swept Indian cinema halls, particularly in how sexual emotions are dealt with, is discussed here.

While in the yesteryears the coming together of flowers or butterflies would convey erotica, or indeed, such portrayal will be relegated to the vamp or coquettish mistress, there is today a sexual brazenness sweeping Indian cinema, reflecting the changing sexual mores of Indian society. The fact that the character played by Amitabh Bachchan in “Hum” could sing, “Jumma, chumma de de (kiss me…)” and the heroine in “Khalnayak” asked, “What is under your blouse?” reflects the social shift towards a more open acknowledgement of sexual desire and erotic thoughts.

Changing Landscape: The author traces the history of Indian cinema against the background of the changing political, economic, cultural and social landscape of the country, the hero being the focus of this exploration. In the 1950s and 1960s, several Muslim socials (as films with Muslim stories and characters were often called) of the time represented the zenith of that culture in Indian cinema. After the initial shock of the Partition, these films were placed very much in the Islamic context, and they exploited the culture of a bygone and much-mourned era. There was also a post-independence idealism that marked this period, many films with patriotic fervour being released at that time. The 1960s, widely regarded as the golden era, was characterised by a certain romanticism, with family and social melodramas, excellent lyrics and good songs that had wholesome family appeal. The hero was our aspirational ideal: good looking, vibrant and romantic. In the 1970s, the euphoria of independence had disappeared. The protagonist is shown as a marginalised individual whom the audience can identify with. He is much wronged and exploited, and has suffered physically, emotionally and psychologically. He does what we would like to do, but are prevented from doing because of social mores and our own private morals. Interestingly, this change coincided with the imposition of the “Emergency” in India and the widespread social disaffection this provoked in Indian society. This theme continued well into the next decade, with the portrayal becoming more prominent, aggressive and violent.

The dominance of the angry young man continued in the 1990s. However, his anger was no longer directed against society. Instead, it became a symbol of love. The roles of Shah Rukh Khan as the love-obsessed stalker in films like “Deewana”, “Darr”, “Baazigar” and “Anjaam” heralded the arrival of a psychopath who feels no remorse or guilt. Another theme that emerged in this period, which has continued in this millennium, is a new idealism involving young people with high aspirations and dreams, either in urban India, or often living abroad, but culturally conscious of their “Indian-ness”. This evolution, which coincided with economic liberalisation and globalisation, appeals both to the younger audience of Indians and to the Indian Diaspora. Family dramas and romance have made their reappearance reflecting also an interesting coexistence of tradition and modernity. Interestingly, the psychopath who engages in mindless violence (“Abhay” in Hindi, “Alavandan” in Tamil); the person with an explosive impulsive personality (Shah Rukh Khan in many films); the multiple personality disorder sufferer (“Manichitratazhe” in Malayalam; “Chandramukhi” in Tamil); all continue to engage our cinematic cultural consciousness, as do themes of marital jealousy and infidelity (“Astitva”), unusual relationships that transgress social class and mores (“Chandni Bar”, “Ek Chalis ki Local”); differences in age (“Jogger’s Park”, “Nishabdh”, “Cheeni Kum”) and other conventional barriers. Indeed, it could be said that Indian cinema has demonstrated the maturity to explore many an unconventional emotive theme, while continuing to remain curiously infantile in Toto, largely reflecting a male dominated parochial society.

Appalling Portrayal: The portrayal of madness in Indian cinema is appalling. Those with mental illness are clowns, feeble and weak. Those treating them are caricatures, all in white coats and, absurdly enough, they get the hero to face the truth by setting up situations, as a detective might. Prof. Bhugra reviews several Indian (mainly Hindi) movies to make this point. As in “Khamoshi”, the senior psychiatrist chairs a meeting with at least 10 other psychiatrists to decide whether the protagonist is insane or not. They take turns in asking questions to assess his mental state; with one psychiatrist (unusually) instructing him to keep his answers short and to the point. The interview is more like an inquisition with rapid fire questioning.

Illogical and unrealistic portrayals of mental illness in Indian cinema are highlighted here. The heroine, usually a nurse or, more recently, doctor, makes it her life’s mission to “cure” the mentally ill protagonist, often going far beyond the call of her profession; more alarmingly, often breaching clinical ethics by falling in love; the submission of the heroine to many a risky assignation in order to diagnose or identify the cause of the protagonists madness; the explosive climax which puts all including the protagonist at risk of losing life, limb and sanity; the ward filled with several mentally ill people, most engaged in some ridiculous form of repetitive activity (running around, body rocking, asking the same comical question repeatedly, staring into space) all of which reduce mental illness to a caricature; the delivery of treatment in a most unethical, unacceptable and unrealistic manner etc. without discussion or consent, etc. The common thread that binds these cinematic situations together is that they are designed to shock the viewer and dissociate him from mental illness, making the mentally ill person the classic “other”. Indeed, Western films too share the tendency to portray mental illness and its treatment unrealistically, resulting in worldwide misconceptions about the role of the psychiatrist and psychiatric treatments. Electroconvulsive Therapy (ECT) or shock treatment as it is popularly referred to, has suffered and been demonised in particular due to its unrealistic portrayal in cinema. People are often given ECTs when fully conscious and sitting up, a most unusual practice, not in the armamentarium of any right thinking psychiatrist.

Curiously, however, there is also a humanism that is often conveyed through this bizarre portrayal. The nurse is often portrayed as having genuine empathy for her patients while remaining fiercely loyal towards the doctor, resulting in an emotional conflict (for her). The patients appear to form a closer network and, to their minds, “the other” is obviously the hierarchy and the establishment.The chronological approach adopted in this book enables the reader to study the evolution of Indian cinema over time, to comprehend the change in perception and portrayal of various subjects including mental illness over the decades and how the changes in politics, economics, culture and society affect changes in cinema, ensuring that he leaves no ambiguity in conveying his findings.

The films that Dr. Bhugra has made references to are popular, decade-specific contributions that attracted large audiences in their respective times, were influenced by the social climate of the country, and in turn influenced society as well. The cumulative effect of viewing film after film is the creation of a mental warehouse full of internal stereotypes stored in the preconscious and unconscious memory banks. He calls for more studies on the influence of external factors on the way films are conceived and made, so that a more accurate picture of mental illness can be projected by cinema, which is a rather powerful medium influencing public opinion.

Deceptive Title: The title of the book and of its many constituent chapters is deceptively light hearted and in some ways does not do justice to it. This book is a comprehensive and scholarly analysis of the gamut of philosophical, psychological, social and cultural issues associated with human emotion (including mental illness) in Indian cinema, dealt with in a serious, theoretical manner. The book does largely limit itself to Hindi cinema save a few references to regional contributions. The author draws on a vast theoretical and academic base to convey his point authentically. The wide array of references ensure that the book is a storehouse of information not only for cinema buffs and mental health professionals, but also students across the spectrum of humanities.In a country like India, where people idolise film stars and are influenced greatly by cinema, it is very important that issues like human emotion and mental illness are portrayed accurately and responsibly. With the great mass of Indian cinema audiences being highly vulnerable to the influences of this medium, accurate and responsible attempts at portraying human emotion and mental illness are necessary, as also avoiding portrayals that trivialise and dehumanise important disorders of the mind. However, as the author has pointed out rather eloquently, the trivialisation of madness in India cinema may in itself be a reflection of the liberal, forgiving and largely tolerant society that we are!

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The Mind in Modern Medicine

The view that it is not enough to heal the body of the affected person, that we must also heal the mind, is gaining credence.It is curious that the mind, so important at the turn of the 20th century, is experiencing today a reawakening in scientific and societal consciousness. The founders of modern medical science in the 18th and 19th centuries had clearly conceived the mind to be a representation of the brain; people like Alois Alzheimer demonstrated pathological abnormalities in the brain of people affected with dementia. Indeed, centuries earlier, the father of modern medicine, Hippocrates, had firmly placed “our joys, sorrows, desires and feelings” in the brain.Sigmund Freud, who started his career as a neurologist, developed an interest in the mind while a student of the legendary neurologist Charcot in Paris. Charcot was deeply interested in hysteria, that condition where physical symptoms like fainting, seizures and paralysis are expressed due to an abnormal emotional state, rather than an abnormal physical state.

Many aspiring neurologists of the time including Freud were attracted to Paris by Charcot’s knowledge and erudition.Sigmund Freud, however, branched off from Charcot to develop his own hypothesis of the human mind, in what famously became the school of psychoanalysis. Freud took the exploration of the mind in hysterical states deeper, into areas that few physicians before him had dared to tread. His theory of “consciousness” attempted to explain the role of deep-rooted emotional conflicts originating in early life, in developing symptoms of the mind later on. Freudian thought is complex, requiring many hours of concerted study. In a nutshell, Freud proposed that the human tendency was to repress anxiety provoking emotional conflicts that the conscious mind could not possibly contemplate.

While these thoughts were confined to the unconscious mind, there were, inevitably, times when they emerged into the conscious, and given their unacceptable nature manifested (were converted into) a physical symptom, instead. Freudian thought spawned a school of psychoanalysis which dominated the practice of “psychological medicine” for over a century. However, his all-pervasive view of sexual underpinnings for all manner of emotional conflict, for example the Oedipus complex where the mother is the inappropriate object of sexual attention of the male child, was not accepted in its totality by his contemporaries.Two milestones in the latter half of the twentieth century brought the mind firmly back into the realm of brain science. The first, the discovery of the neuroleptic drug chlorpromazine that could control effectively the symptoms of serious mental illness like schizophrenia, followed on by a range of psychotropic drugs with potential to address a range of other emotional symptoms, provided indirect evidence that the brain had a role in the development and manifestation of human emotions. The second, the development of several dynamic brain-imaging tools in the last two decades of the twentieth century and the first decade of the twenty-first, has transformed our understanding of the human brain and mind, permitting us to visualise live, brain activity during a psychological task.

Crossroads

The brain and mind interface is therefore at an interesting crossroads in modern medicine. There is a growing understanding in medical science of the role our brains play in determining what are predominantly emotional symptoms. Research, for example, has shown that people with psychopathic personalities, hitherto considered to suffer from a disorder of the mind, have a poor perception of others’ facial emotions, and experience difficulties in affect recognition (that is, gauging the other person’s mood). These abnormalities in perception have been linked to abnormalities in brain function, the amygdala, part of the emotional brain, being implicated in many instances. Clearly, as our ability to image the mind expands, so will our understanding of brain-mind relationships and knowledge of “how the mind works!”From a social and health policy perspective, the mind has assumed considerable importance. In a seminal paper, “The Mental Wealth of Nations,” published in Nature (Volume 455; October 23, 2008), Beddington and colleagues emphasise that countries must learn to capitalise on their citizens’ cognitive resources if they are to prosper, both economically and socially, and that early interventions for emotional health and cognition will be the key to prosperity. Reporting the Foresight Project on Mental Capital and Wellbeing commissioned by the U.K. Government Office for Science, they introduce two important concepts.

Mental capital encompasses both cognitive and emotional resources. It includes people’s cognitive ability; their flexibility and efficiency at learning; and their emotional intelligence, or social skills and resilience in the face of stress. Mental well-being, on the other hand, refers to individuals’ ability to develop their potential, work productively and creatively, build strong and positive relationships with others and contribute to their community. The importance of detecting mental disorders early, the role of science, for example neural markers for childhood learning disability; the development of early interventions that enhance mental capital and mental well-being, boosting brain power through the lifespan; and encouragement for processes that will help people adapt well to the changing needs of the workplace, as also engage in life-long learning, are highlighted here.From a clinical practice perspective, the importance of mental health, wellness and health-related quality of life as outcome indicators of both physical and mental disorders is becoming widely accepted.

The view is that it is not enough to heal the body of a person affected with physical disease; it is also crucial that we heal the mind, enhancing wellness, is gaining credence in modern medicine, quality of life having become established as the best outcome of treatment. Indeed, the reintegration of people into society as they recover from illness requires as an imperative the restoration of both their mental capital and mental well-being. Pray, what is the status of hysteria, that original symptom of the mind, in this era of modern medicine, you may well ask. It is noteworthy that a whole range of bodily symptoms that have no physical basis — tension headache and chronic fatigue, atypical facial pain, atypical chest pain, irritable bowels and bladder, fibromyalgia, burning in the private parts, to name just a few — all have their putative origins in the theory of hysterical conversion. It is estimated that between 20 per cent and 35 per cent of all primary care consultations and about a fifth of all emergency room visits are for physical symptoms such as these, that do not have a physical basis. They are also responsible for the loss of many patient and caregiver workdays; untold suffering and burdensome expense, both personal and social; and unnecessary investigations in pursuit of that elusive diagnosis.Physicians who frequently encounter these symptoms have learnt to spot the telltale signs that are their forerunner: multiple consultations (doctor shopping); the large bag filled with a variety of investigation reports that have mysteriously failed to identify “anything wrong”; the constant need for reassurance, combined curiously with disbelief in the doctor’s opinion, notwithstanding his erudition; the development of new symptoms, without any apparent physical basis, soon after old ones disappear; disenchantment with the medical profession for failing to diagnose, sometimes even subtle pride in being “such a difficult diagnostic dilemma”; as indeed the failure of any serious setback to manifest itself despite months, sometimes years, of ongoing symptoms… the list of diagnostic clues is endless.

The French physician Briquet described this syndrome which for many years carried his name. In modern medicine this ailment goes by the name “Somatisation Disorder.” And in the clinic setting, in an era of advancing diagnostic technology, it has become the most common manifestation of hysteria. Indeed, somatisation, thought to be more common in non-western cultures with traditionally limited verbal expression of emotions, is almost becoming fashionable, akin to “swooning” (another hysterical symptom) in the Victorian era.Hysteria does therefore exemplify the importance of the mind in modern medicine. It may well have origins in the brain, which future research may reveal: it clearly is a significant public health problem that does affect mental capital and well-being; it does pose a tremendous drain on the public exchequer and private resources; it has potential for cure through early diagnosis and intervention; and interestingly, may well be the last frontier to traverse at the interface between the brain and mind.

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