Imagine that someone has received a blow to the head somehow – an accident at work, a fall at home, perhaps – somehow the person’s head was struck hard enough to injure the brain. Now consider what would happen if this injury affected the person’s behavior, causing him to act in a bizarre or irrational manner. Those who knew of the injury would feel compassion. Poor guy, he can’t help it, he has an injury to his brain that causes him to act that way.
Most of us understand that people whose behavior is erratic because of an injury or illness in the brain aren’t responsible for their actions. They’ve been hurt. What they’re doing is a symptom of a problem, not something they’ve chosen. They need to be treated with respect and compassion, not ridicule.
All of this applies to the mentally ill. We’ve also received an injury to the brain. How it happened, what exactly the injury was, what might be done about it – these questions usually remain unanswered. We rarely have a blow to the head to point to as an explanation for our misery, no obvious wound or physical damage. Most of the time, highly sophisticated and complex devices such as the fMRI or the PET scan are required to identify differences between a normal brain and one that is malfunctioning. The differences are real and they are significant. They can mean the difference between a normal life and one of unending suffering; or between life and death.