Wednesday, June 21, 2023

Review of "Bizarre: The Most Peculiar Cases of Human Behavior and What They Tell Us about How the Brain Works" by Marc Dingman



Marc Dingman has a Ph.D. in Neuroscience and is a faculty member in the Department of Biobehavioral Health at Pennsylvania State University. In this book Dingman discusses the human brain, and disorders that result when the brain malfunctions.



Author Marc Dingman

Scientists generally acknowledge that our brain determines who we are at the most fundamental level, and disruptions to our brain function can drastically change our behavior and personality. Dingman uses specific examples to illustrate this, and writes, 'In this book, we'll examine cases of people who, because of some deleterious influence on their brain, had their typical experience with the world categorically transformed.' Dingman goes on to explain, 'While most of the unusual phenomena I'll discuss in this book are brought about by some adverse effect on the brain - such as trauma, a tumor, infection, stroke, or psychiatric condition - others are curious manifestations of an otherwise normal brain, the far end of the spectrum of human behavior.'


The human brain

Some of the examples Dingman discusses seem bizarre, perhaps even funny, but the author emphasizes that these are real people who experienced considerable suffering, and they deserve respect.

For every patient Dingman cites, he describes the person's aberrant behavior or problem; depicts the parts of the brain involved (with illustrations); and offers some hypothesis about what might be going on in the brain to cause the symptoms. The book is accessible to the layperson, and doesn't require advanced knowledge of neurobiology.

Each chapter covers a different aspect of brain malfunction, including: Identification, Physicality, Obsessions, Exceptionalism, Intimacy, Personality, Belief, Communication, Suggestibility, Absence, Disconnection and Reality.

I'll provide some examples, to give a feel for the book.

🧠🧠 Cotard's syndrome is a rare mental disorder in which the affected person holds the delusional belief that they are dead; are decaying; are empty inside; don't exist; etc. Dingman describes several people with this affliction, one of whom he calls Will.


Distorted self-image of a person with Cotard's Syndrome

Following a motorcycle accident, Will - a 28-year-old stockbroker - fell into a coma. Will woke up several days later, and spent months in the hospital recovering from his injuries. Will had ongoing problems like a stiff right leg and partial blindness, but most serious of all, Will thought he was dead.

Will's mother took him on a trip to South Africa, to help him recover, but the heat convinced Will he was in hell.....further proof that he was dead. Will speculated that his cause of death might be a blood infection; a vaccination for yellow fever; or AIDS (which he didn't have).



Dingman explains that Cotard's Syndrom starts with a brain dysfunction, such as a trauma or tumor. This malfunction causes symptoms of derealization (a sense that your environment and the events happening around you seem to be part of another world) and depersonalization (a feeling of disconnection from yourself and your surroundings). The author observes, Cotard's syndrome patients tend to assume that if there is something wrong with their experience, the problem likely originates with them, and "the explanation their brain lands on is that they are dead, decaying, possessed, or something else along those strange existential lines."

Dingman writes that these kinds of delusions result from damage to the 'plausibility-checking mechanism' in the right side of the brain, and he discusses the disorder in detail.



*****

🧠🧠 Lycanthropy is a condition in which people with brain malfunctions have the highly unusual belief that they are not human. Dingman explains that a search of the medical literature turns up descriptions of people who believed they could change into a cat, dog, wolf, cow, horse, frog, bee, snake, wild boar, goose, bird, and even a gerbil.


A person with lycanthropy might think they're a wolf

The author writes about several cases of lycanthropy in detail, including a woman he calls Aleyna. Aleyna was a 47-year-old female who suffered from depression. After several weeks of taking anti-depression medicine, Aleyna started sticking out her tongue for no reason, then quickly retracting it back into her mouth. Aleyna then said she had transformed into a snake....or rather that Aleyna was dead, and the devil had replaced her with a snake.



When Aleyna was brought to the hospital, she was tempted to bite (and kill) members of the hospital staff....and she did try to bite the hands of several hospital workers. Medication normally used for schizophrenic patients helped Aleyna, and she was released from the hospital.

Once again, Dingman notes that these kinds of symptoms demonstrate failure in the 'plausibility-checking mechanism' of the brain. In addition, these patients experience a problem with the 'mental representation of the body and its parts', which scientists call the body schema. Neurological disorders can generate an inaccurate body schema.

Researchers have identified several brain areas that may work together to form the body schema, including different parts of the cerebral cortex, or outer layer of the brain.



Dingman provides additional examples of lycanthropy, along with illustrations of the brain parts thought to be responsible.

*****

🧠🧠 In some people, brain dysfunction results in improvements in certain skills, or even savant-like talents. In fact, it's been suggested that people in general may possess latent unusual abilities. Dingman describes several 'sudden' savants, including a man called Derek Amato.

Derek was 40-years-old and at loose ends, without a permanent profession. Derek had owned a pressure-washing business; sold cars; did public relations for a non-profit organization; taught karate; delivered mail; and more. Then, on a visit to his home town, Derek hit his head while diving and suffered a serious concussion.

From then on Derek suffered from headaches, memory problems, and extreme sensitivity to light. He also developed a new talent. On seeing a keyboard in his friend's house, Derek was drawn to the instrument, and - though Derek never had piano lessons - he began to play with "the fluidity of a professional pianist." Derek "composed a new piece of music on the spot, smoothly interweaving chords and notes that had - up until that moment - been unknown to him." After that, Derek devoted his life to music.



Derek had 'acquired savant syndrome', defined as the sudden development of exceptional skills, usually after brain injury or disease. This condition is so rare that scientists have no real explanation for the syndrome.

The author describes various savants, such as people with extraordinary mathematical abilities; calendar skills (given a date, they immediately know the day of the week); artistic talents; and more.

****

Dingman did a deep dive into the neurological literature and describes a wide array of symptoms that might result from brain injuries or brain malfunctions. These encompass things like: people who think their loved ones have been replaced by lookalikes; people who can only see things on one side (right or left); people who feel their limbs don't belong to them and want them amputated; people with a compulsion to eat things that aren't food (hair, cigarette ashes, matches, etc.); people who fall in love with inanimate objects (such as the Eiffel Tower or safety pins); people who suddenly lose an ability, like reading or writing; people who abruptly start speaking with a foreign accent; and much more.



For each phenomenon Dingman describes, he gives the current thinking about the parts of the brain involved (with illustrations), how these parts of the brain interact with each other, and how the symptoms arise.

In his conclusion, Dingman points out that anyone, at any time, might suffer an accident or health crisis that damages the brain, or experience neurological changes associated with aging. In an interview, Dingman noted, "One of the things that writing this book really impressed upon me is that the sense of self – that we feel is immutable and is part of us throughout our entire lives – can be changed pretty easily through an event like a traumatic brain injury or a stroke. Many of the patients I talk about in the book had one event and the next day they were completely different for the rest of their lives."



Thus Dingman advises: "Take advantage of the functionality of your brain while you can: create memories, experience emotion, indulge in pleasure (and practice restraint), think deeply, engage your body - do all those things your brain permits you to do, and do them with great gusto."



The book is interesting and enlightening, and would appeal to a wide array of people interested in science and the brain.

Thanks to Netgalley, Marc Dingman, and Nicholas Brealey Publishing for a copy of the manuscript.

Rating: 4 stars

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