by Dr. Jacques Barber
There is a first time for everything. This will be the first time that I blend my interest in psychology with my interest in a TV series. The series Homeland, which just won several Emmys awards, has many interesting aspects, including many psychological ones. In fact, there are so many psychological angles to focus on that I will have to be selective. I will focus on Carrie and her psychological struggles. At the end of the first season, her bipolar disorder is exacerbated by the stress and complexity of the situation that she is trying to solve. Solving complex problems is stressful; stress and lack of sleep are detrimental to individuals with a tendency to have difficulties maintaining a stable state of mind and emotional balance. My focus on this blog is to discuss her “disease,” how her disease leads Carrie to be mistrusted, and how it is easy for “normal” people to dismiss the views of individuals different from themselves. Furthermore, I will touch on the topic what is “truth” and how do we know it.
The viewer knows that Carrie is onto something when she is suspicious of Brody. Because her behavior is somewhat erratic and her theories are quite unusual if not “crazy,” her colleagues begin to distrust her. In fact, it is heartbreaking to see how easily dismissed somebody who sounds crazy can be. It is easier for those around her to distrust her and to dismiss her Ideas or “hypotheses” than to take them seriously, or even ponder, what she was suggesting. How can an American hero, a Marine, who has survived hardship during years of captivity, betray his country? How could he really plan to murder the Vice President of the USA and his entourage (e.g., the defense secretary)?
Many psychologists and psychiatrists have tried to find deep meaning in human behavior, including abnormal behavior. One of the first was Freud, the father of psychoanalysis, who attempted to explain hysterical symptoms (e.g., hysterical hand paralysis which is a phenomenon that is not consistent with what we know about the neurology of hand function) with a far-reaching theory of the mind. His psychoanalytic theory of the mind, which some people consider quite farfetched, has recently received some support from neuroscience findings. This is happening at a time when the popularity of Freudian therapy is declining around the world. Watching “Homeland” the viewers, however, do not need to understand the deep causes of Carrie’s delusions. This is not necessary as we know that her views are not delusional. This is reminiscent of the non trivial saying “Just because someone is paranoid, it doesn’t mean he’s not being followed.” The viewer knows enough to understand that Carrie’s theories are not off the wall; they are close to reality. Keep in mind also that the reality is evolving as Brody becomes more involved in what could be called anti-American activities (e.g., collecting secret information from the CIA) than he actually planned initially.
If we stick with what is known, are Carrie’s hypotheses farfetched? Is she delusional? Delusions are not a typical feature of bipolar disorder. Systematic delusions like Carrie’s are more a characteristic of paranoia (now called delusional disorders) or to a lesser extent of schizophrenia. But we do not need to be too technical here; after all, it is a TV series. So let’s discuss delusions. Following the work of Fried and Agassi (1976), I will surmise that in paranoia the delusion is very systematic. How do we know when a systematic delusion is true or when is it false? Can we even know when a scientific theory is delusional, or when it is true, for that matter? For example Copernicus was initially dismissed as irrational. Although much has been written about how, and whether, the validity and truth value of scientific theories can be corroborated, there is little work that takes seriously the question, how do we decide that a delusion is indeed delusional? Is it when it does not correspond to reality or to the facts? Do we ever have all the facts? These are very basic questions that mental health experts and epistemologists should grapple with but, for the most part, they have not (exception includes Fried and Agassi). Early in my life these questions occupied much of my thinking, and intellectual energy. The question is: What distinguishes a delusional theory from any kind of theory, including a scientific one? How do we know that a scientific theory is valid while Carrie’s is not?
She is dismissed. It is also interesting that when, as she is going to receive her first ECT, she remembers that Brody knew Abu Nazir’s son and she asks her sister and the nurse to remind her of that after the ECT. However, the nurse dismissed her. Yes, it is common for patients under anesthesia to say things that make no sense. And even if what they express is logical and sensible, how can a nurse or doctor hearing those fragments of thoughts understand them without the context? Furthermore, the anesthesia nurse has heard many depressed patients (depression is one pole of the bipolar disorder spectrum) saying all kinds of things related to their own lives. Likely she long ago stopped trying understanding what the patients are saying, or meaning.
I will bet that most viewers feel sympathy towards Carrie; she cares about her country, and she is extremely dedicated. In fact, she is willing to follow her views in the face of ridicule and adversity. But in the end she gives up. She comes to believe she is wrong, and she feels badly (depressed) about having caused harm to Brody and his family. Is it a coincidence that she is a woman, and that as a woman with mental health issues she is dismissed?
How do we increase tolerance and respect for people who are different from us? I think the first step is to listen to them and not dismiss them automatically. I know that this is hard; it’s hard to listen to somebody from the extreme right, or the left, etc. But one message I take away from the show , even if the writers didn’t intend it, is that it is worth listening to people like Carrie and perhaps even to Brody (note that how his daughter listens to him and the impact it had on him when he decides not to detonate the explosive vest in the bomb shelter). If we listen, we open up the possibility of learning something new.
Fried, Y. & Agassi, J. (1976) Paranoia: a study in diagnosis. Boston Studies in Philosophy of Science, Volume 50. Dordrecht: D. Reidel Publishing Company
Jacques P. Barber, Ph.D., ABPP is the dean of the Derner Institute of Advanced Psychological Studies at Adelphi University and Emeritus Professor, Perelman School of Medicine, University of Pennsylvania and Adjunct Professor of Psychiatry, New York University Medical School.
