Kaysen writes that no matter what they call it, most people like to think that they are in possession of something “greater than the sum of [their] neurons.” A lot of the “mind,” though, turns out to be brain. Memory and mood are both defined by cellular patterns and neurotransmitters, and thus are in the wheelhouse of the brain rather than the mind—but something must still interpret this “clatter of neurological activity.”
The distinction between the brain and the mind lies at the heart of much of what Susanna Kaysen has investigated throughout her memoir. Chemical imbalances and circuitry errors in the brain produce certain types of mental illness, and Susanna is envious of those who suffer from these disorders rather than a “character disorder” like she herself has had to negotiate.
Even though the mind is the “interpreter” of the brain, these interpretations must still be merely functions of the brain. The problem of interpreting the brain is an endless one, Kaysen says, as “each interpreter needs a boss to report to.” Something about this interpreter-boss model reflects “the essence of [the human] experience of consciousness,” she argues. Thoughts and thoughts about thoughts don’t feel the same—the brain talks to itself, and this conversation influences perception. The first interpreter reports to the second interpreter, who analyzes the information that comes in. The two interpreters—mind and brain—influence one another and go back and forth. One is not dominant over the other, and Susanna posits that mental illness occurs when a communication problem arises between the two interpreters.
As Susanna Kaysen attempts to understand how the brain and the mind work together to create consciousness—which can easily become fractured or disassembled completely—she relies on a model of two interpreters going back and forth with one another, each relying on the information the other provides. The mind—which many, as she stated earlier, hope is “greater than the sum of neurons”—is actually just the product and reflection of the firings or misfirings of those very neurons.
To illustrate her point, Susanna invokes the experience of being on a train, next to another train, in a train station. When the other train begins to move, one experiences the feeling of one’s own train moving, and it can take a while before the “second interpreter”—the brain—forces the mind to realize that it is in fact the other train moving. This process can take a long time, because it’s difficult to “counteract the validity of sensory impressions.”
By using an illustration which demonstrates a disconnect between the mind and the brain, Susanna sharpens even further the thesis she has been honing throughout her entire memoir: that the sensations, situations, or perceptions often described as “crazy” are separated by a very thin barrier from experiences which are widely accepted as “normal.”
The train conundrum is not an optical illusion, Kaysen notes, since an optical illusion contains two realities. The train conundrum allows one to suspend oneself between two different realms of consciousness—to suspend oneself in a place where “false impressions have all the hallmarks of reality.” Craziness, Kaysen argues, is simply the inability to get unstuck from this in-between space in which the mind’s perception overpowers the brain’s.
Kaysen helps her readers to understand that “craziness” is something most people have likely experienced on some level. The set of imbalances that, when pervasive, define mental illness, occur in all kinds of situations each and every day. Perception is everything, and the mark of mental illness is the inability to correct false perceptions that occur when the mind and the brain fall out of synch for a period of time.
Treating the psyche and treating the brain are two very different things. The mind has schematic issues, while the brain has chemical and electrical ones. Kaysen takes issue with this dichotomy, though. Rather than treating chemical-electrical problems with medicine, she argues, some “cooperative efforts,” such as sort the brain makes when dealing with situations such as the train conundrum, would be useful in treating mental illness. Analysts and neuroscientists, she argues, are like foreign reporters writing from two different countries and refusing to read one another’s work, refusing to see the similarities between the two realms they have chosen to explore.
After outlining the ways in which the mind and the brain communicate with one another and the consequences that occur when there is a fracture in that communication, Susanna Kaysen argues that mental health professionals should work with the mind and brain together rather than isolating them from one another, thus creating inconsistency and ineffectiveness in their patients’ treatments.
A scanned insert from Susanna’s case file reveals a “formal diagnosis” of “schizophrenic reaction, paranoid type (borderline)”. Her prognosis reveals her doctor’s belief that her “depressive affect and suicidal drive” will be resolved through her hospitalization, though how well Susanna will be able to achieve “personality integration and ego function” is “hard to predict.”
The term “personality integration” is a nebulous one. Using such a nebulous benchmark for “wellness” threatens to keep Susanna isolated within her disorder—and within McLean—for an indefinite period of time.