When you question how the world functions, or why the world behaves the way it does, you run the risk of sending your life into complete mayhem. Like a small fish trying to comprehend the existence of water and the pond it lives in, a human can't possibly comprehend and add up the world that formed it?
That's the responsibility of philosophers, Lishan Chan will tell you. But what she won't tell you, however, is how the pursuit for a logical explanation to the world might push you down the path schizophrenia.
Chan started early with philosophy. As a teenager, she was already scribbling in her diary, sentences pertaining to self-deception and reality like, 'The realistic people are the depressed ones.' Later she majored in philosophy in the UK and enrolled herself in a graduate philosophy course in the National University of Singapore.
It was there in 2007 that Chan tried to make sense of the world – with logic. She told the supervisor her intention and he asked, "Have you heard of the logician Raymond Smullyan?"
Chan didn't. Her supervisor then posed this logic riddle to her:
‘I wish to prove to you that there exists a unicorn. To do this, it obviously suffices to prove the (possibly) stronger statement that there exists an existing unicorn. (By an existing unicorn I, of course, mean a unicorn which exists.) Surely if there exists an existing unicorn, then there must exist a unicorn. So all I have to do is prove that an existing unicorn exists. Well, there are exactly two possibilities:
(1) An existing unicorn exists.
(2) An existing unicorn does not exist.'
It seems very much that Smullyan's unicorn puzzle is a fact statement explaining two sides of a coin. The riddle is not a question, but a play on logic and possibilities. It's quite like the chicken and egg conundrum or the thought experiment, Shrödinger's cat.
You won't know your mental limitations as a young philosopher. A simple, cursory contact with this existential unicorn puzzle threw Chan into a wealth of confusion.
"You must get through this," her supervisor said. "I have another one after this. You want to be good at this or not? How strong is your desire?"
He turned on the heat, saying, "If you can't solve this problem, there's no hope for any other problem in philosophy. Drop everything and nail this bastard. Then you'll learn something about what a solution to a philosophy problem looks like."
There was immense pressure on Chan. "I would work all day and night on. I was sucked into it." At the sixth or eighth month mark – Chan wasn't certain, for she had completely lost track of time, "I hadn't spoken to my family in months. I hadn't spoken to anyone other than [the lecturer] in months... I began to see frog faces in bed sheet creases. It might not be frog faces but only faces. Faces with large mouths and tiny eyes."
By now, Chan had slipped into schizophrenia. She would lapse into episodes of what she called "blank stares", where she abruptly tuned out of her surroundings and gazed into space. They would last for seconds or minutes, and in her mind was frenzied confusion.
Later in October 2008, she was enraptured by the number '298142'. "I made some connection between the numbers – the post code and a place that I had to go... I was going to find that address which had that post code." It was a seemingly logical connection to her, but they were in fact delusions – or what Chan describes as false beliefs.
She was in search of a church so she could be a nun, hoping that spirituality would lend her clarity. It made logical sense to her.
But when Chan arrived at the postal code 298142, it was the Orange Valley Nursing Home. The staff offered her food and drinks. "[They] were so friendly to me," Chan adds.
She was sent into rude shock when the police arrived and arrested her on grounds of trespassing. "I was very shocked. In hindsight, maybe they did that because they didn't know what to do with me. And they thought maybe the police could help."
The police escorted her to the station and locked up her overnight. The next morning Chan was sent to the Institute of Mental Health, where she stayed for six weeks. She couldn't comprehend what she did wrong, for her actions were fully sound and rational to her back then. She wasn't trying to trespass. All she wanted was a clear mind.
"The cause of schizophrenia is multifactorial and it arises from a combination of risk factors [which] includes both environmental and genetic vulnerability," Dr Sutapa Basu at the Institute of Mental Health explains. In Chan's case, the cause remains unknown. It would have been either of the two possible causes. Her pursuit for logic led her down the steps of schizophrenia, and she was eventually dismissed from school.
"A person who is suffering from schizophrenia may [be] present with all or some of the symptoms," Dr Sutapa states. The symptoms are hallucinations, delusions, disorganised speech, thinking, and extreme social withdrawal. "There may also be a decline in the person's social, occupational or academic functioning."
Later in the hospital, she was formally diagnosed with schizophrenia. "Contrary to common misconceptions, schizophrenia is not a disorder of 'split personality', but rather a disorder of fragmented mental processes," Dr Sutapa explains.
Speaking to Chan now, ten years from her diagnosis, it seems that her descent into and ascent out of schizophrenia was governed by one thing – logic. She sees recovery in a logical – almost mathematical – system.
"The story is usually – it's not that there is a template, there's no template – but it just somehow naturally falls into a structure." Chan picks up a notebook and draws a V-shaped graph. "You start with a certain point and you fall into the... worst point of the mental health story," Chan explains as she circles the bottom of the graph. The left-hand side is, therefore, the descent into schizophrenia. And when one is at the bottom, "it's the lowest point so you just have to climb".
She perhaps modelled her own trajectory in the form of the graph. "The way I see it is that... you have to accept that there is a gritty reality. You have to accept the fall, in order to accept that you can go up... You have to accept that things will go bad in order for them to go well afterwards."
In her upward climb back to a normal life, Chan is methodical about recovery. She took a few months to accept help in the form of medication, but she did eventually with the guidance of a good doctor. Throughout the past ten years, she's been habitually writing diary entries and logs her thought process in a "Cognitive Behavioural Therapy app to guide my thinking". The app takes her through a series of questions and mood ratings. It serves to highlight cognitive distortions – unhealthy thought habits – in the user.
Stress and emotional management aside, she keeps her diet healthy and exercises. She recommends too, that schizophrenia patients write a relapse plan and disseminate it to family and friends – symptoms that lead up to a psychotic attack, symptoms during a psychotic attack. "They can help you to observe, that's helpful too."
Not everyone has the capability to be as rational as Chan about schizophrenia and recovery. "Schizophrenia is usually a chronic illness. Treatment helps relieve many symptoms of schizophrenia. And in some instances there is remission," Dr Sutapa adds. A case of remission is Chan, for she has devoted the past ten years to keeping schizophrenia at bay.
Does that mean that Chan is leaving some existential and philosophical questions unanswered? It definitely seems so.
She was debating her identity post-schizophrenia. "The question is a philosophical question. Can I still be me?", she asked. This is the surprising part – for someone who spent a year of her life trying to solve a philosophy-related logic riddle, she concluded, "It's a philosophical question and I don't know whether you need an answer to it. But it's fun to think about."
Lishan Chan is the author of 'A Philosopher's Madness'. Dr Sutapa Basu is the Assistant Professor and Consultant at the Department of Early Psychosis Intervention of the Institute of Mental Health. Dr Sutapa is not commenting on Chan's case, but on the condition in general.
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