2006 : WHAT IS YOUR DANGEROUS IDEA?

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M.D. is Associate Professor of Neurology and Psychiatry at Albert Einstein College of Medicine and Chief of the Yarmon Neurobehavior and Alzheimer's Disease Center, Beth Israel Medical Center in New York City
Myths and fairy tales are not true

"Myths and fairy tales are not true." There is no Easter Bunny, there is no Santa Claus, and Moses may never have existed. Worse yet, I have increasing difficulty believing that there is a higher power ruling the universe. This is my dangerous idea. It is not a dangerous idea to those who do not share my particular world view or personal fears; to others it may seem trivially true. But for me, this idea is downright horrifying.

I came to ponder this idea through my neurological examination of patients with brain damage that causes a disturbance in their self concepts and ego functions.

Some of theses patients develop, in the course of their illness and recovery (or otherwise), disturbances of self and personal relatedness that create enduring delusions and metaphorical confabulations regarding their bodies, their relationships with loved ones, and their personal experiences. A patient I examined with a right hemisphere stroke and paralyzed left arm claimed that the arm was actually severed from his brother's body by gang members, thrown in the East river, and later attached to the patient's shoulder. Another patient with a ruptured brain aneurysm and amnesia who denied his disabilities claimed he was planning to adopt (a phantom) child who was in need of medical assistance.

These personal narratives, produced by patients in altered neurological states and therefore without the constraints imposed by a fully functioning consciousness, have a dream-like quality, and constitute "personal myths" that express the patient's beliefs about themselves. The patient creates a metaphor in which personal experiences are crystallized in a metaphor in the form of an external real or fictitious persons, objects, places, or events. When this occurs, the metaphor serves as a symbolic representation or externalization of the patient's feelings that the patient does not realize originate from within the self.

There is an intimate relationship between my patients' narratives and socially endorsed fairy tales and mythologies. This is particularly apparent when mythologies deal with themes relating to a loss of self, personal identity or death. For many people, the notion of personal death is extremely difficult to grasp and fully accommodate within one's self image. For many, in order to go on with life, death must be denied. Therefore, to help the individual deal with the prospect of the inevitability of personal death, cultural and religious institutions provide metaphors of everlasting life. Just as my patients adapt to difficult realities by creating metaphorical substitutes, it appears to me that beliefs in angels, deities and eternal souls can be understood in part as wish fulfilling metaphors for an unpleasant reality that most of us cannot fully comprehend and accept.

Unfortunately, just as my patients' myths are not true, neither are those that I was brought up to believe in.