The Psychotic Brain

The Psychotic Brain.

Each of the following scenarios is factually plausible. The are placed together to demonstrate the conundrum psychiatry continually faces in pursuing its idiosyncratic and idiotic model.

1 Eric is a middle manager in a drug company who lives alone in his bachelor apartment. He is usually well disposed towards his peers and friends, well liked and enjoys his job.
One day when answering the phone he hears a series of clicks he has not heard before. He pays no attention but then he hears the same clicks when answering the phone at work. Sometimes when he answers the phone there is no one there. “Funny thing that’ he says to himself and pays no attention. “Anyone else hear funny noises?” he asks at work. “Nope” they say, “You must have a faulty phone”.
Eric calls security and they check out the phone. Nothing wrong. Then he notices that a particular green car seems to be following him. He happens to look out the apartment window and notices that same green car parked a little way off outside his apartment. Just for the hell of it he walks outside along the path and notices a man in it he doesn’t know reading a newspaper. “Coincidence!” he says to himself.
A few weeks pass and he notices another car parked unusually outside his apartment. He again goes down to look. This time he sees the same man as before still reading a newspaper. The unusual clicks on the phone persist.
Then he notices that when he comes home at night his papers and things on his desk seems to have been rearranged. Nothing has been taken but he becomes suspicious. He says to himself that he must be getting paranoid and tried to put it out of his mind. He asks his workmates about it but they reassure him and say not to worry and say that he is just getting a bit paranoid. He tries to put it out of his mind but it just won’t go away. Finally although he knows he is being silly he places fine threads over his desk and hairs in strategic places on the doors in his house.
Astoundingly when he come home they have been displaced. Not only once but on many different occasions but nothing has been taken. His friends do not believe him and attempt to reassure him. This being the case and not wanting to be seen as stupid or paranoid he stops talking about it to anyone. Inside himself however he becomes more and more suspicious and more and more paranoid. He finds himself scared to go to work, wanting to stay home to see if he can catch them red handed.
Finally after he fails to go to work his friends knock on his door to see what has happened. Eventually the Police are called and when they gain entry they find him cowering under the bed in terror of unnamed people who are after him.

The Police take him to the local Mental Health services where he has a psychiatric assessment and he is given a diagnosis of Paranoid Psychosis (Not otherwise specified) and he is commenced on antipsychotic treatment.


Dr. Oakshott is a research biological psychiatrist specializing in the brain alterations in psychosis. Currently his project is in the particular lesions he avows, that mark the paranoid brain and is very keen to get some case material. Someone suggests he might wish to interview Eric who could be a good candidate for his research. Dr Oakshott is very keen and interviews Eric who’s ‘uncontaminated’ paranoid ideation would, Dr Oakshott considers, make him an ideal subject to include in his project. Eric agrees to be a subject, having been convinced that he is in fact ‘mentally ill’ by his key workers.
Eric consents to having an MRI scan of his brain as well as an fMRI scan, having little else to occupy his time.
Dr Oakshott is pleased when he view’s Erics scan because he can identify specific lesions and alterations that he is convinced distinguish the paranoid brain (namely Eric’s) from the normal brain.
In his study of the paranoid brain versus the normal brain Dr Oakshott has taken the liberty of including his own brain scan as being one of the normal controls.
Finally Dr Oakshott’s study of the normal versus the paranoid brain is completed and published to great acclaim.
He is sought after for seminars and lectures.
Dr Oakshott publishes a textbook entitled “Neurobiological Psychiatry” complete with visual scans of the lesions that distinguish the paranoid brain from the normal brain. The textbook is a resounding success in the psychiatric literature.
The years pass and a Nobel prize is mentioned.

3 Some twenty years pass, and Dr Oakshott now in a position of authority in psychiatry happens to be reading his newspaper.
The newspaper carries the headlines that the FBI is now able to release files that had hitherto been classified.
These files related to the surveillance of individuals that had been considered threats to national security because of their drug business affiliations or suspicions about them that had prompted ‘red flags’ for intensive surveillance.

Horror struck, Dr Oakshott realized that Eric, one of the subjects on whom his whole thesis rested, was in fact on of those whose life had been under intensive surveillance. Furthermore, he realized that Eric must not have been psychotic or deluded at all, but simply reacting as anyone might to such intense surveillance.
His whole theory, in fact his whole reputation and his textbook became at stake for him as he realized that he did not really know whose brain was the psychotic brain.
His own brain.
Or Eric’s.