Category: Human Brain

The human mind is a complex phenomenon, which continues to be investigated through neuroscience in great detail (Bassett & Gazzaniga, 2011). The structure of the brain is an intricate temporal and spatial multiscale, which composes molecular, cellular and neural phenomena, which together produce the physical and biological base for cognition (Bassett & Gazzaniga, 2011). Furthermore, each structure is organized into modules, such as anatomical or functional cortical areas, which form the foundation for cognitive functions that are adaptable to any commotions in the external environment (Bassett & Gazzaniga, 2011).

Much study has gone into behavioural science regarding the manner in which the nervous system can change its organization and eventually, its functions throughout an individual’s lifetime, an ability which is referred to as plasticity (Kolb, Gibb & Robinson, 2003). The functional and physical change in response to an environmental stimulus, behavioural experience or cognitive demand allow us to recognize the exceptional plasticity the brain has (Li, Legault & Litcofsky, 2014). Consequently, brain plasticity is of considerable interest, as it allows us to understand its sensitivity to experience, as well as the development of the brain and its behaviour to a new learning (Kolb et al., 2003). On the whole, experience can change the brains plasticity, in both the structure and the function (Osterhout et al., 2008). Like many other experiences, such as riding a bike or doing mathematics, the experience of learning a second language will induce changes in the brain (Osterhout et al., 2008).

Humans have a unique ability to learn more than one language and this is a skill which is considered a favourable asset, both educationally and cognitively (Osterhout et al., 2008). Today, more than half of the world’s population are learning a second language which came about as a result of globalisation, cross- cultural communication, increase in popular culture or simply, for requirements in a job (Li, Legault & Litcofsky, 2014). This experience will have an impact on the human brain, which has been proven by cognitive and brain studies, along with studies of memory, perception and attention (Abutalebi & Green 2007; Li et al., 2014; Mechelli et al., 2004). Through my own previous study with bilingualism, I believe that changes will occur in the mind or brain as a result of a second language learning. Subsequently, this paper will explore the neuroplasticity in second language learning with discussing changes in the electrophysiology response, brain sources and the brain structure.

The electrophysiological changes in the brain during L2 acquisition demonstrate the qualitative changes in the neural substrates of L2 learning, that can be recorded using the event- related brain potentials (ERPs) (Osterhout et al., 2008). The ERPs can reflect synchronized postsynaptic activity in cortical pyramidal neurons, which can, subsequently, be used to support the neural changes second language learning can induce in the brain and show new insights into L2 learning.

A large body of research has been conducted on the electrophysiological changes in the brain during L2 acquisition, including that of McLaughlin, Osterhout & Kim (2004). They examined the rate at which L2 is integrated into the learner’s language comprehension through recording their ERPs while they read or listen to L2 phrases. Their findings suggested that there are separate semantic and syntactic processes in a L2 learning context, with a presence of negative waves at 400ms and positive waves at 500ms (McLaughlin et al., 2004). These findings suggest distinct temporal properties as well as a developing linguistic competence of second language learners, which is evident through scalp recordings of the brains electrical activity. (McLaughlin et al., 2004).

Furthermore, grammaticalization during L2 learning is also assessed, where the acquisition of grammatical features and their morphological rules are examined. Osterhout et al., (2008) investigated 14 novice French learners who were required to read 30 sentences and recorded them using EEG. Their results showed a N400 effect which was replaced by N600 after 4 months of learning (Osterhout et al., 2008). As a result, it can be concluded that the brain will produce a striking difference in electrophysiological activity after consistent L2 learning, which can be evident through ERP and EEG recordings. These findings can be further supported by White, Genesee & Steinhauer (2012), who investigated Korean- Chinese late L2 learners of English. Using ERPs, their findings showed significant P600 after the end of instruction which came about as a result of online grammaticality judgement task and behavioural responses (White et al., 2012).

Overall, these studies lead us to infer that the neuro- cognitive processes underlying in the brain will be modified through second language learning and electrophysiological changes in the brain will occur during the learning of a second or foreign language, which is supported by a range of cognitive and brain studies.

Many researchers today have investigated how the brain supports more than one language (Liu & Cao, 2016). Brain sources refers to the neural sources of the language- effect ERP effects, which allow to convey the changes in the current density and which areas of the brain are activated during second language learning (Osterhout et al., 2008). Measuring the brain source can reflect the changes in the source distribution, as a result of the processing of the second language (Osterhout et al., 2008). The brains source is measured simultaneously with ERPs to determine the distribution and which brain area is activated.

Due to the advancements in technology, superior temporal resolution and reduced spatial resolution can be measured through tomographic analysis analogous, provided by neuroimaging methods (Osterhout et al., 2008). In a study by Osterhout et al., (2008), a low-resolution electromagnetic tomography (LORETA) was used to measure the sources associated with processing sentences in L1 and L2. As a result, it is demonstrated that the L1 distributions were in the posterior parts of the brain, including the temporoparietal and extrastriate regions. The L2, on the other hand, has the greatest current in the medial dorsal frontal lobe. Furthermore, it has been suggested that bilinguals will have distinct advantages when it comes to cognitive control, which leads to better executive functions such as inhibiting, updating and switching. Previous studies, such as Bialystok (2009) and Mechelli (2004) have found an increase in neural activities in several cognitive controlled areas in the brain, which form an integrated network for bilingual control (Bialystok, 2009). This, subsequently, results in better conflict monitoring abilities and attention.

In general, L2 processing involves more regions than L1 (Liu & Cao, 2016), and the processing is particularly more demanding in late bilinguals. The proficiency in L2 is a major factor in determining the peak and extent of activations in the brain, along with the neurophysiological mechanisms, as a function of learning (Kotz, 2009). However, in general, L2 has a more widespread cortical activity, as it is described as less automated and more effortful, thus, more brain activity (Wattendorf & Festman, 2008). Subsequently, the brain activation or distribution will change as we learn a second language and it will be highly influenced by the age of acquisition of L2.

The points discussed above have explored the specific brain function patterns when learning a second language, but moreover, these neural changes are often followed by anatomical changes in the brain structure (Li et al., 2014). Second language learning can influence changes in the brains grey matter, white matter and cortical thickness (Li et al., 2014; Mechelli et al., 2004).

The brain is the most complex organ in the human organ which is highly adaptable to bilingualism and multiple language experiences, that responds both functionally and structurally to any brain changes (Li et al., 2014). Today, the changes in the brain structure in response to L2 learning can be measured precisely through neuroimaging methods, such as fMRI (Li et al., 2014). In terms of the organizing principles of the brain, both grey matter and white matter are made of neurons, in which grey matter mostly consists of neuronal cell bodies, while white matter consists of axons and support cells (Li et al., 2014). Cortical thickness refers to the thickness of the grey matter, which is primarily a direct measure of cortical morphology (Li et al., 2014).

Subsequently, studies have found that bilinguals would have a greater grey matter density in the left inferior parietal lobule than monolinguals (Li et al., 2014; Mechelli et al., 2004). This measurement, however, is highly influenced by the age of acquisition of the second language, as Li et al. (2014), has shown that the effect was greater in early bilinguals compared to late bilinguals. Other studies such as Mechelli et al. (2004) have also found that bilinguals had a greater density in the left inferior parietal cortex, compared to monolingual speakers and it is more pronounced in early bilinguals. The changes in the grey matter density suggest a change in cell size when learning a second language, which often involves both neurons and glial cells (Li et al., 2014, Mechelli et al., 2004).

The white matter integrity can further be used to assess the anatomical changes in the brain in response to second language learning (Li et al., 2014). This is because second language learning can modify white matter integrity quite early on in the experience, where several areas of the brain showed a greater white matter density in bilinguals (Mechelli et al., 2004). The cortical thickness and grey matter share an inverse relationship (Li et al., 2014), due to the cortical folding patterns. As previously mentioned, the grey matter volume changes in response to bilingual experience and the white matter density also differs between monolinguals and bilinguals, however, the cortical thickness correlates with the learners age of acquisition for L2 (Li et al., 2014). Hence, a later learning of L2 is equivalent to a greater cortical thickness (Li et al., 2014).

Taking these points into consideration, second language learning will stimulate changes in the brains structure, which can be observed through the changes in grey matter and white matter densities, as well as the cortical thickness.

In conclusion, the brain will change in response to second language learning, which can be seen through electrophysiological changes, changes in brain sources and changes in the brains structure. The electrophysiological changes demonstrate the qualitative changes in the neural substrates of L2 learning. Furthermore, the changes in brain sources describe the changes in the current density and which areas of the brain are activated during second language learning. Second language learning will also induce anatomical changes in the brains structure.

The study of neuroplasticity has become a growing interest among researchers, particularly due to the ability of the human brain to adapt in response to environmental stimulus, cognitive demand or behavioural experience (Li et al., 2014). An individual’s linguistic experience has led to significant findings regarding the changes in the brain and how it adapts itself with the introduction of a new language. Moreover, each research article has also emphasized the importance of age of acquisition, proficiency or performance level, language specific characteristics, individual differences as well as other environmental properties which greatly influence the type and extent of change in the brain during second language learning.

Future studies should consider more systematic investigations into the complex function- structure interactions. Through reviewing a number of research articles and their studies on plasticity, most neuroimaging and their correlations were opaque, without any clear reasons as to why the results are sometimes positive or negative. Also, a number of studies have called out for a more definite analysis to identify the cellular and molecular mechanisms underlying language- related changes in the brain (Li et al, 2014; Osterhout et al., 2008; Mechelli et al., 2004; Abutalebi & Green 2007)

This paper has discussed how neural and structural plasticity occurs as a result of second language learning, which is supported by several empirical findings. Therefore, it is appropriate to say that the linguistic brain is very plastic, where second language learning can induce electrophysiological, distributional and structural changes.

References

1. Abutalebi, J., & Green, D. (2007). Bilingual language production: The neurocognition of language representation and control. Journal of neurolinguistics, 20(3), 242-275. doi: https://doi.org/10.1016/j.jneuroling.2006.10.003
2. Bassett, D. S., & Gazzaniga, M. S. (2011). Understanding complexity in the human brain. Trends in cognitive sciences, 15(5), 200-209. doi: https://doi.org/10.1016/j.tics.2011.03.006
3. Bialystok, E. (2009). Bilingualism: The good, the bad, and the indifferent. Bilingualism: Language and cognition, 12(1), 3-11. doi: https://doi.org/10.1017/S1366728908003477
4. Kolb, B., Gibb, R., & Robinson, T. E. (2003). Brain plasticity and behavior. Current directions in psychological science, 12(1), 1-5. doi: https://doi.org/10.1111/1467-8721.01210
5. Kotz, S. A. (2009). A critical review of ERP and fMRI evidence on L2 syntactic processing. Brain and Language, 109(2-3), 68-74. doi: https://doi.org/10.1016/j.bandl.2008.06.002
6. Li, P., Legault, J., & Litcofsky, K. A. (2014). Neuroplasticity as a function of second language learning: anatomical changes in the human brain. Cortex, 58, 301-324. doi: https://doi.org/10.1016/j.cortex.2014.05.001
7. Liu, H., & Cao, F. (2016). L1 and L2 processing in the bilingual brain: A meta-analysis of neuroimaging studies. Brain and language, 159, 60-73. doi: https://doi.org/10.1016/j.bandl.2016.05.013
8. Mechelli, A., Crinion, J. T., Noppeney, U., O’Doherty, J., Ashburner, J., Frackowiak, R. S., & Price, C. J. (2004). Neurolinguistics: structural plasticity in the bilingual brain. Nature, 431(7010), 757. doi:10.1038/431757a
9. Osterhout, L., Poliakov, A., Inoue, K., McLaughlin, J., Valentine, G., Pitkanen, I., … & Hirschensohn, J. (2008). Second-language learning and changes in the brain. Journal of neurolinguistics, 21(6), 509-521. doi: https://doi.org/10.1016/j.jneuroling.2008.01.001
10. Wattendorf, E., & Festman, J. (2008). Images of the multilingual brain: the effect of age of second language acquisition. Annual Review of Applied Linguistics, 28, 3-24. doi: https://doi.org/10.1017/S0267190508080033
11. White, E. J., Genesee, F., & Steinhauer, K. (2012). Brain responses before and after intensive second language learning: proficiency based changes and first language background effects in adult learners. PloS one, 7(12), e52318. doi: 10.1371/journal.pone.0052318

It is unlikely a person would ever recall the moment of their very first utterance. After months of crying and cooing, the baby’s speech would start to resemble a form of mama, or dada as it starts to produce preliminary syllables in the early stages of linguistic development (Parker & Riley, 2010). Before you know it, the baby is able to comprehend words and even form basic sentences on their own. During this process no proper education is involved. Just like our instinct to use our feet to stand up and walk, it is as if we had it all along in our mental system how to manipulate our vocal apparatus to produce certain noises to communicate with our fellow humans. It does not end there. Not only do we communicate with this unique noise, but we are able to express our thoughts by connecting certain sounds with certain ideas (Darwin, 1981). Through this we are able to handle abstract concepts like time and space. We then figure out ways to convey these ideas through forms of writing. We record, contemplate and evolve. From what was a mere utterance have become the foundation of our civilization. We have separated ourselves from any other species alive through the use of language. The mechanism in which this intricate ability is created is through the interaction of multiple cognitive abilities with our brain serving as a hub. Therefore, without the study of the brain we cannot fully explain linguistic concepts like the language instinct, the theory of an innate human ability to use language (Pinker, 2000). Linguistics cannot hold its theoretical credentials without understanding how the brain has specifically evolved for this competence. This paper will explore how incorporating a neuroscientific approach in linguistics can help us better understand the mysteries of language.

Linguistics and Evolution

To distinguish humans from apes—our closest relatives—in their methods of communication we must approach linguistics from an evolutionary perspective. Although apes can verbally communicate by producing a form of speech, the evolutionary difference in the anatomy of the vocal tract gives humans the advantage in complex articulatory range. For instance, one of the most notable physical differences between the vocal apparatus of humans and apes is that the human larynx is located lower than that of the ape’s. This makes room for a larger pharynx and gives more control over intricate phonological articulation for the humans to utilize (Ghazanfar & Rendall, 2008) (Stebbins, 2007).

The evolutionary difference is also apparent in the brain. Animals are still able to communicate through speech, but there is a distinction between their communication methods and what we define as language in that the latter requires higher mental capabilities (Darwin, 1981). In the early stages of evolution, humans shared with the apes the same primitive ability to speak and hear. However, at some point in the evolutionary process, humans distinguished themselves by developing more complex use of sound with the use of phonology, semantics, morphology and syntax (Stebbins, 2007). This complex skill became an exclusive trait involves multiple brain activities simultaneously taking place at a highly intellectual level. Take reading ability for example. illustrates how interpreting the written text requires a combination of linguistic abilities and other neurological functions like the working memory, permanent memory, and visual processing (Vellutino, Fletcher, Snowling, & Scanlon, 2004). In this sense language is an innately human characteristic evolved exclusively for the brain with high cognitive capabilities.

Linguistics and the Brain

Since the evolution of the brain played a major role in human communication, language cannot be studied without it. However, early 20th century linguistics was approached predominantly from a behavioristic psychological perspective without much observation of the brain structure (Small, 2008). In the behaviorist perspective, language is acquired through stimulus and response, just like learning sports, disregarding the mental process playing a role in language acquisition (Skinner, 1957). Linguist Noam Chomsky (1965) argued otherwise, claiming the innateness of language instinct using the concept of Generative Grammar. Since then linguists’ main concern was how this language competence developed in the human brain (Pinker, 2000). However, the theoretic contemplations within the faculty of language were faced with the problem of not being able to provide tangible evidence for their arguments. It was not until the late 20th century that linguists were able to expand their understanding of the linguistic system in relation to the physiology of the brain with the advance of brain imaging technology (Small, 2008). This shift in paradigm coincided with the shift in the academics’ attitude of approaching language from a broader perspective that encompasses other cognitive faculties. For this purpose, linguists who study language from a biological point of view—biolinguists—coined the term of faculty of language in the broader sense (FLB) to take into account elements from the cognitive realm into linguistic territory (Boeckx, 2005). The idea is that the development of language can be deduced from the study of the evolutionary process of human’s brain. The linguists’ change in attitude in combination with brain imaging techniques opened brand new possibilities.

When Hurst, Baraister, Auger, Graham and Norell (1990) discovered that a similar type of language deficiency is apparent within 16 members of 3 generations of the KE family, they concluded that the phenomenon was related to a flaw in chromosome 7. This established ground for the correlation of language with genetics and therefore evolution. The use of fMRI took this a step further by observing defection in the Broca’s area within the family members and people who are not family members but share similar language deficiency (Vargha-Khadem, Gadian, Copp, & Mishkin, 2005). This research implies 1: The link between specific brain regions and language functions 2: The biological background of language development. This type of research would never have been possible without brain imaging technology.

Is Neuroscience Necessary For Linguistics?

The hazard linguistics could face without the presence of neuroscience is that linguistic theory lack the scientific ground it needs to establish credibility. Chomsky’s Generative Grammar was ground-breaking, but when examined from a non-linguistic perspective, it was a mere contemplation that the brain functions within the unconscious level in an unexplainable way that inexplicably generates grammar. As such, when confined within the area of linguistics, the academics could not offer the scientific explanation to back their argument. The evidence is merely empirical. This is similar to how Freudian psychology is criticized for the absence of scientific value. As we have established earlier that language is a result of multiple cognitive faculties interacting, it is inevitable to study the process of language production in relation to neuroscience.

Research Question

What are the advantages and disadvantages of utilizing Nuclear radiation for the treatment of a brain tumor?

Background Information About Brain Tumors

A brain tumor is a group of abnormal cells that grow in or around the brain. Tumors can directly destroy healthy brain cells. They can also indirectly damage healthy cells by crowding other parts of the brain and cause inflammation, brain swelling and pressure within the skull.

Brain tumors are either malignant or benign. A malignant tumor, also called brain cancer, grows rapidly and often invades or crowd’s healthy areas of the brain. Benign brain tumors do not contain cancer cells and are usually slow-growing.

I chose to look further into brain tumor treatment through nuclear radiation because one of my relative’s suffered from it and decided not to get treatment.

Rationale

The claim I have chosen “The Benefits Of Using Nuclear Radiation In Medicine Outweigh The Risks” has many areas that can be investigated such as what type of radiation we’re talking about? what are we trying to treat? what risk may occur when in use and many more. When it comes to treating brain tumors there is a variety of treatment choices. These vary due to the size of the tumor, type of tumor, growth rate, location on the brain and the overall health of the patient. Treatment options include radiation therapy, chemotherapy (the use of anticancer drugs to destroy cancer cells), all these together and a few more options. When talking about the claim we are trying to figure out the advantages and disadvantages of the use of nuclear radiation for the treatment of brain tumors. So, we must discuss the multiple types of treatment weighing them against each other to find out if nuclear radiation in medicine is worth it.

Analysis

Diagnostic information uses radiation to give analytic data about the functioning of an individual’s organs or to treat them. Diagnostic techniques utilizing radioisotopes are now normal in today’s world. Radioisotopes are radioactive isotopes of an element. They can also be defined as atoms that contain an unstable combination of neutrons and protons (www.ansto.gov.au). Over 40 million nuclear medicine operations are performed each year whilst the demand for radioisotopes increases by 5% every year. This is a sign of nuclear radiation medicine being the future of medicine but behind the scenes, there are a lot of disadvantages that come with using nuclear radiation in medicine.

Nuclear medicine provides functional and anatomic information about the anatomy of the patient’s body. It offers the doctor the most useful diagnostic information to help determine the course the patient is taking and with the information received is so detailed it can also help the medical provider determine the state which the tumor is at. Nuclear medicine can also detect and determine the status of cancer letting the medical provider know if cancer has metastasized (spread to other places in the body) or remissioned (it’s manageable and is not getting any worse). This technology can also provide doctors reasons for unclear or abnormal lab results using a 3-phase body scan including MRI scan, x- rays and tomography. Which can evaluate were the bone pain is for patients, it can also detect cancer in bones which is helpful for older patients when they need help finding signs of osteoporosis. And there are many more advantages that I could list.

But of course, there always are some disadvantages. One is that the use of nuclear radiation medicine may badly affect any women who are in the phase of pregnancy or breastfeeding which will have a bad effect on the child the woman is carrying or feeding. There is also a threat of a severe allergic reaction that might have the patient experiencing dizziness, abnormal heart rhythms, dip in blood pressure and severe headaches. Although the odds of this happening are quite slim with 1 in every 40,000 patients reacting, it is still something to look out for. Another major downfall of using nuclear medicine is that it is very expensive without insurance or subsidies and because most of the patients aren’t in a financial position to afford it. The main reason for nuclear medicine being so expensive is what it takes for the assembly, operations, and maintenance of the equipment being used. When medical facilities spend millions of dollars on these products, they are expecting some sort of way to recover that money and that’s when they charge patients a lot to money to conduct procedures with the equipment. I believe there is significant evidence to show that the advantages of using nuclear radiation in medicine outweigh the disadvantages. Although there are a few flaws when it comes to using nuclear radiation in medicine it can clearly be seen that the flaws listed aren’t as bad as the media portrays them to be while the advantages are clearly paving the way for the future of medicine. Going back to the claim “the benefits of using nuclear radiation in medicine outweigh the risks”. It is now clear that the benefits do outweigh the risks in most circumstances which helps justify the claim.

When it came to conducting research I easily found evidence to support my claim. With all the resources the internet I had a lot to choose from. Many resources resulted in many different points of view which made it harder for me to find the best possible opinion from a trusted source. But the more I looked the more reliable the sources would get resulting in me finding the information I have presented to you already. I know the sources I’ve used are reliable because the information is coming from professionals in their selected fields such as doctors, radiologists, and brain surgeons. Unfortunately, the only type of source I used for this assignment was websites limiting the information that I could have collected. If I had used books and other sources of information my view on this topic could have been changed.

A few things could’ve been improved to make the assessment better. Including a broader range of claims to suit everyone’s liking instead of a small group of choices that minimise the potential of different types of research investigations. I could have made this investigation more insightful by looking at more sources and looking more into the negatives of using nuclear medicine so my report wouldn’t seem as biased.

The research question “What are the advantages and disadvantages of utilizing Nuclear radiation for the treatment of brain tumor?” could have been extended by taking a look into long term effects, how old are the people who use these resources, what health conditions do the patients have and many other factors could’ve been discussed to make the report more detailed and thorough.

Did you know that there are syndromes that can cause you to think things are real when actually they are not? Dr. Ramachandran’s presentation in his ted talk video reviews three types of brain syndromes what they do to a person and research on what might help the people suffering from these illnesses. One is Capgras syndrome, two is phantom limb syndrome, and three is synesthesia syndrome. These conditions are known as a type of brain syndromes and can affect the way people perceive what is real and what is not. Here is an outlook on these three syndromes what they do, what we can do to help people with dealing with their illness and other solutions to try and help reverse the outcomes of their illness.

The first syndrome is called Capgras. This syndrome occurs when there is an accident that causes damage to the fusiform gyrus. Symptoms of this syndrome involve not being able to tell who someone is when they are standing in front of you. To you, they may look just like your mother, son, or dad but your brain tells you they are an impostor. In Dr. Ramachandran’s video, he tells how the person they think is an imposter could walk out of the room and call the patient and they would think it was their mother the hearing does not change in this condition (3 clues to understanding your brain). You can test this by what is called galvanic skin response. Most people when they see a picture of their mother would sweat a person with this condition would have no response.

The second syndrome is called phantom limb. This is a condition where the patient has suffered some kind of accident or illness and loses their limb but to them, it’s still there but paralyzed and causes them pain. This causes paralyzed peripheral nerve injury. One treatment for this is what Dr. Ramachandran invented and it’s called ‘mirror box’ (3 clues to understanding the brain). The mirror box helps to reflect that the patient’s phantom is moving again. The mirror box can help change this learned paralyzes and help the patients not have pain and help with their body image or depression.

The third syndrome is called synesthesia. It is known as a mingling of the senses. “For example, someone with synesthesia may hear color or see sound” (Giles). This syndrome is genetic basis and normally found in creative people. Why is this you may ask it might be because some artist use recreational drugs. It also could be a result of cross-wiring in the brain or an abnormal gene. They way to test if you have this syndrome and are just not making it up is by a questionnaire test.

My thoughts on the presentation given by Dr. Ramachandran is that is was very informative, interesting and educational. He explained each syndrome, to where the listener could comprehend and he gave good examples. His research and knowledge about each condition were very interesting. This information about the three syndromes was very informative and educational to learn about.

I do feel we need this type of research. Here are three reasons why. One to educate people of these conditions. Two so we can look into further treatments for people suffering from these conditions. Three to help follow-through with treatment or a cure.

The syndrome I found the most interesting was the Phantom limb. The reason I picked this one is because I have known people that have experienced this condition. It was always interesting yet confusing when they would say my foot is hurting but there is no foot there. I always figured it was the mind playing tricks on them. This presentation helped me to understand this syndrome a little bit better. I was not really sure of anything I could suggest on research for these syndromes.

Works Cited

1. Ramachandran, Dr. Vilayanur. 3 Cluesthesederstanding Your Brain, Ted talks, 2007, Https://Www.ted.com/Talks/vs_ramachandran_3_clues_to_understanding_your_brain/Transcript#t-31754
2. Giles, Chrissie. “What It’s like to Have Synesthesia: Meet the Man Who Can Taste Sounds.” The Independent, Independent Digital News and Media, 16 Oct. 2017, https://www.independent.co.uk/news/long_reads/synaesthesia-sound-taste-health-science-brain-a7996766.html

When you put on headphones or listen to music sometimes you can’t help but get up and dance around. It’s obvious that listening to music can make you lose control of your body but, not many people really know what music does to your brain. The amount of control music has over you and your brain is shocking. Music can easily affect your brain development, learning, daily moods, and even your health.

When we hear music we enjoy your brain releases a chemical called dopamine. Dopamine is what makes you feel happy and euphoric.It’s a natural response your body has and happens almost instantly. This is the reason you might find yourself playing your favorite song over and over after you had a terrible day. Just hearing it can improve your mood. After hearing the song many times and experiencing the feeling you start to expect it. So, once you press play your brain is already working on sending that dopamine and giving you that good feeling. Everyone’s opinion of music is different so a song that makes you happy within a second might not work for someone else.

On the complete opposite hand a song you hate might give you a negative feeling and make your mood worse. If you associate a song with sadness or a bad event, your brain will begin to release a chemical called serotonin. The increase of serotonin will make you feel sad or even depressed.

Most people in the world feel something when they hear different types of music. Only about 3-5 percent of the world’s population feels absolutely nothing with music in their ears. This condition is called musical anhedonia. People who suffer from musical anhedonia live completely normal lives but can never understand why people enjoy music and love it so much.

Most people experience an increase in heart rate and skin conductance. People who have musical anhedonia don’t experience this at all. Their brains have zero response to music regardless of the type or genre. Their brains still produce dopamine and serotonin regularly when it comes to other types of events, but they don’t have any reaction to music.

Music isn’t only used to boost happiness, it can also be used by people like writers and artists to help boost creativity. The right side of your brain is responsible for everything creativity related, including music. Listening to music stimulates the right side of your brain and gets the creative juices flowing. This is why people find themselves throwing in the headphones when it’s time to get their assignments done. Something as simple as music you like can help increase your productivity, and pleasure from your work.

Different types of music might produce different feelings. For example you wouldn’t listen to classical music while you’re going on a ten mile run. Studies around the world have shown listening slow light classical music can help with your focus and keep you nice and calm. Its would be good to listen to this in the classroom when you’re reading a book or writing an essay. When you’re going for a run you would listen to faster music with a clear beat. Athletes can listen to faster music when their just getting started to help get their heart rates going and get them pumped up. In the end they slow down the beats per minute of the type of music so they can begin to calm down.

Music can even encourage brain growth and improve functions such as auditory processing, learning, and memory. The auditory cortex is one part of the temporal lobe. Without the auditory cortex we wouldn’t have the ability to understand music. Not only does it help with understanding music but it helps with understanding spoken phrases. Listening to music often helps make these abilities your brain gives you stronger. Since music helps increases your focus and ability to understand it makes taking in information much easier. In other words, music can help you learn. Finally music promotes good memory. Sometimes it’s hard to remember what we ate for breakfast yesterday but once that song comes on we know all the lyrics. You may also recall a specific even much easier if you knew the song that was playing in the background. Not only if music fun to hear but it also serves as a form of brain food.

Different genres of music have different impacts on our brains and our bodies. Pop and rock music are known for pushing physical endurance and physical performance. Rap music music stimulates a person’s emotions. Whatever the artist is rapping about and feeling the audience will feel as well. Rap music also helps with your language skills and increases your knowledge of different words. Not many people listen to nature music but it still has its own affects on our brains. The sounds of nature such as waves crashing or rain hitting the ground automatically calms us down. This type of music can be played when you’re trying to fall asleep or even in a babies nursery to keep them calm and sleeping peacefully.

I’m sure everyone has seen a movie that had them sitting on the edge of their seat. Of course the movie itself was probably great but, music actually plays an enormous roll on how the movie goes. Since movies have been a thing music was included. When old silent movies were shown an orchestra would be sat right to the side of below the screen. They would play the necessary music. Today we don’t need an orchestra but we still need to music. An epic fight scene wouldn’t be accompanied by a classical slow song. The music playing also gets your brain ready for what to expect. When you’re watching a horror movie the music playing is what tells your brain to be afraid and bury your head in the blanket.

Unfortunately music isn’t always something so fun like participating in a choir or watching your favorite movie. Music is also used for numerous kinds of therapy. From depression, anxiety and ptsd to head injuries, deafness and even alzheimer’s disease. Everyone’s music therapy is unique and has to be designed based on health factors, emotional state, cognitive skills, and interests. Music therapy can differ from patient to patient. SOme might benefit from hearing different types of music while some would benefit more from composing their very own songs.

Music is something that has been around for thousands and thousands of years. Over time it has evolved and changed completely but humans love for it has never faded away. There’s numerous types of music and millions of songs available for us. The possible combinations of notes and songs are endless. Right now we know music is not only a form of entertainment but a form of medicine. Music affects our brains and the way we think way more greatly than people realize. The impact of music has been climbing since it was first ever made and will only continue to climb as time goes on.

Abstract

“The Brain that Changes Itself” is an informative book about neuropsychology but specifically i have focused on Chapter six that discusses Obsessive-Compulsive Disorder. This mental illness is incurable and the people that suffer from this disease have a lot to overcome but with the help of Norman Doidge and Dr. Schwartz people with OCD can calm their anxieties down with the treatment that Dr.Schwartz has developed. Plasticity-based treatment has helped not only with OCD but people who have regular day worries to relabel their thoughts to teach their brains that they can fight their obsessions and compulsions so that they can learn to live a better happier life with OCD.

Keywords: Obsessive-Compulsive Disorder, Therapy, Plasticity, Treatment

How to unlock the brain

Obsessive-Compulsive Disorder is one of the most tormenting mental health diseases that plague so many people. This mental health illness makes patients who suffer have uncontrollable thoughts that then create behaviors that cause patients to desire to repeat those behaviors or compulsions constantly. The people who suffer from OCD are the people that get affected the most from the worries that constantly run through their minds. Norman Doidge, author of “The Brain That Changes Itself” explores OCD and how it can affect patients and discovery of new treatments for OCD. This condition worsens over time because people who suffer from OCD focus solely on their worries. Often times there is a deeper significance that can be emotional when a patient with OCD has their first attack. Many obsessions often have things in common to one another such as fear of being tainted with germs, needing things to be kept tidy and put together, violent thoughts about self-harm or torture others, etc.

The same theme is applied when it comes with compulsions. Some patients create imaginary rules and protocols to follow the obsessive behavior because they feel it helps control their anxiety when obsessive thoughts occur. Although everyone sometimes has worries or doubts it is completely different for patients with obsessive-compulsive disorder because they spend so much time going over these thoughts throughout their day, they do not get any sort of relief from taking part in the behaviors because they only feel slight relief. The compulsions are usually superfluous and most of the time are not related to the problem they are intending to fix. Some patients with the obsessive-compulsive disorder also have tic disorder. These tic’s come through out of the blue and involves repetitive movements such as eye blinking and other movements with the eye, shoulder shrugging, and head jerking.

There are also vocal tics that include repetitive throat clearing, sniffing, or grunting sounds. There are a few causes for OCD including biology, which would be due to changes in your body’s natural chemistry or brain functions. Genetics could be a portion but the specific genes have not been identified yet. Mr.Doidge discusses in the chapter the treatments that Dr.Jeffrey Schwartz has initiated. It is an effective plasticity-based treatment that helps patients with OCD, people who suffer from strong everyday worries, helps us when we get mentally “sticky”, and helps us overcome bad habits.

Dr.Schwartz created a new psychotherapy treatment by studying the brain scans of patients with OCD and those without it. He also took brain scans on patients before therapy sessions began and after therapy was finished and found that the brain normalizes when treatment. This demonstrated how talking communication-based therapy could change the brain. Normally when a person does something wrong three things happen in the following order. First, we get the “mistake feeling” following after that we get anxiety and feel the need to correct our mistake. Finally, once the wrong is corrected we “turn the page” or move on from the situation. The brains of patients that have OCD do not move on even when the mistake they made is corrected. There are three parts of the brain that are involved in obsessions.

Once the mistake made is detected our orbital frontal lobe (part of the frontal lobe) is signaled. Once the mistake feeling arises the orbital frontal cortex sends signals to the cingulate gyrus located in the deepest part of the cortex. The “automatic gear shift” that helps us to move on is the caudate nucleus that is located deep in the center of the brain which allows our thoughts to flow smoothly from one to the other but the patient’s caudate nucleus is extremely “sticky” which causes the lock in their brain. Brain scans reveal that all three parts of OCD brains are hyperactive. The treatment that Dr.Schwartz developed has two major components. The first is the person going through an attack needs to reidentify what is happening to him/her so they or realize they are having an OCD episode. Dr.Schwartz is coaching patients to recognize the difference between the general form of OCD and that of an obsession (i.e. the dangerous germs, fear of loved ones being harmed, etc).

The second component is response prevention which is suppressing the patient from acting on his/her compulsion. By changing the focus of the patient they are learning not to get drawn into the obsession but to work around it. The more you partake in the acts OCD is urging you to do the more you want to do it but, once you start learning to control your obsessions the less you will want to act on them. According to “BMC Psychiatry” although treatment guidelines recommend both pharmacological and psychological treatments, research has shown that people prefer psychological therapies rather than medication. Even with the existence of effective treatments, many patients are stopped by a few issues such as lack of trained practitioners, and the cost of these treatments.

The therapy generally lasts twelve to sixteen sessions beginning with an entire assessment of the patient and ends with a series of therapy techniques that are carefully planned through partnership between the therapist and the client that gets implemented during therapy sessions and while the patient is doing their day to day activities. The BMJ journals also say that cognitive-behavioral therapy put together with medication is the best treatment option. They also discuss EPR (exposure and response prevention therapy) which involves a controlled exposure to situations that cause mild levels of anxiety. Over time exposure to obsessional triggers helps the patient to slowly get used to them, leading to a reduction in anxiety. The International OCD Foundation discusses deep brain stimulation that has been used since the 1980s.

Statistics for treatment using deep brain stimulation show that for twenty-six patients with treatment-resistant OCD described in the Greenberg manuscript, 61.5% were considered responders to deep brain stimulation. They have concluded that with the treatment in neurosurgery for the obsessive-compulsive disorder has progressed very much over the years there is still continuing research that is needed to optimize deep brain stimulation treatment and to better understand how deep brain stimulation functions. Obsessive-compulsive disorder along with all mental health issues are a huge problem that are not taken seriously, in fact, many people are often belittled and made fun of for being mentally ill. There is no cure for OCD but there are many things that sufferers of this illness can do to help themselves for the future to come.

References

1. Gellatly1, J., Pedley1, R., Molloy1, C., Butler2, J., & Bee1, P. (2017, February 22). Low-intensity interventions for Obsessive-Compulsive Disorder (OCD): a qualitative study of mental health practitioner experiences. Retrieved from https://bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-017-1238-x.
2. Pietrabissa, G., Manzoni, G. M., Gibson, P., Boardman, D., Gori, A., & Castelnuovo, G. (2016, March 1). Brief strategic therapobsessive-compulsive disorder: a clinical and research protocol of a one-group observational study. Retrieved from https://bmjopen.bmj.com/content/6/3/e009118.
3. The Past and Future of Brain Circuit-Based Therapies for OCD. (n.d.). Retrieved from https://iocdf.org/expert-opinions/the-past-and-future-of-brain-circuit-based-therapies-for-ocd/.
4. Obsessive-compulsive disorder (OCD). (2016, September 17). Retrieved from https://www.mayoclinic.org/diseases-conditions/obsessive-compulsive-disorder/diagnosis-treatment/drc-20354438.
5. Obsessive-Compulsive Disorder. (n.d.). Retrieved from https://www.nimh.nih.gov/health/topics/obsessive-compulsive-disorder-ocd/index.shtml#part_145346.

Mental health is a person’s Psychological and emotional well-being, it affects how we think, feel, and act. It included how we handle pressure, identify with others, and settle on decisions (Anne, 2014). We all experience fluctuations in our emotional state or mood but for many of us, at certain periods in our lives, this can be to such an extent that it a person suffering from these conditions can be diagnosed with mental illness (Claire, 2012; Fernando and Keating, 2008). The majority of us who experience mental health problems can get over them or learn to live with them, especially if we get help early on (Henderson et al, 2013).

Most mental illness symptoms have traditionally been divided into groups of either ‘neurotic’ or ‘psychotic’ symptoms (Anne, 2014; Mind.Org.UK, 2013). ‘Neurotic’ covers those symptoms which can be regarded as severe forms of normal emotional experiences, such as depression, anxiety, or panic (Claire,2012). These conditions are now more frequently referred to as ‘common mental health problems’ or ‘common mental illnesses’ (CMI). Less common are ‘psychotic’ symptoms, which interfere with a person’s perception of reality, and may include hallucinations such as seeing, hearing, smelling, or feeling things that no one else can (Anne,2014). These types of conditions are referred to as severe mental illness (SMI).

Since the early 1980’s issues around race and culture in mental health services in the UK have been highlighted, mainly based on ethnic differences in admission to psychiatric institutes and compulsory detention under the mental health act (Fernando, 2010).

Many people who live with a mental health problem, or are developing one, try to keep their feelings hidden because they are afraid of other people’s reactions – stigma is still a reality for many (Sabry and Vohra, 2013).

Globally, 70% of young people and adults with mental illness do not receive any mental health treatment from healthcare staff (Mind.Org.UK, 2013).

According to Karasz (2005) comparing illness presentation between South Asians and White Americans, found that the South Asians interpreted the symptoms of depression in situational terms – as an emotional reaction as opposed to a pathogenic state – and were unable to label the illness. The aspect of concept of depression may be unique to Western cultures (Tsai & Chentsova-Dutton, 2002). However, other cultures do appear to differ in such expectations (Greenwood et al, 2014). Modern definitions of South Asian countries are Afghanistan, India, Pakistan, Sri Lanka, Nepal, Bhutan, Maldives, and Bangladesh (Bhui and Bhugra, 2002).

This assignment will look carefully at differences in the way mental illness is seen in the Bangladeshi Muslim (cultural) tradition that compromises British society.

The vast majority of the Bangladeshi community came from the rural area of Sylhet region, which lies in the northeastern part of Bangladesh. Sylheti is the main dialect spoken throughout Sylhet and has no written form. Around 90% of the population are Muslims (Kapasi, 2000).

Sylhetis are largely Sufi-influenced Sunni Muslims (but 10% are Hindu) who follow an Islamic path that is depicted by ‘purist’ (clerical, scripturalist) Islam as contaminated with Hinduism culture in its reverence for, if not actual worship of, saintly pirs (religious spiritual leader), a more thaumaturgical (magical or black magic) approach to the problems of social and religious life, and with local practices of oblations, music, and dancing (Hinduism) (Dein et al, 2008). While the earlier migrants originated from rural and non-literate backgrounds, some of the most recent Sylheti migrants derived from towns, and some have university degrees obtained before coming to the UK (Gardener, 2002). Bangladeshi families are characterized by a patrilineal kinship system, male authority over women, which includes restrictions on women when outside the household, and an emphasis on family honor (Hussain and Cochrane, 2004). This paper will demonstrate the attitudes toward mental illness in the Bangladeshi Muslim community and how their beliefs lead them to seek help from spiritual leaders before seeking medical help. Followed by an analysis of the findings, then a critical discussion and debate on the emerging themes and limitations of engaging the Bangladeshi community about mental health services, emphasizing the importance of cultural understanding and better treatment/s for individuals suffering from mental illness, following this, a conclusion will be drawn.

Literature review

Cultural beliefs often affect people’s attitudes toward mental illness and their help-seeking behavior ( ).

The aim of this paper is to:

1. Explore the attitudes towards mental illness in the Bangladeshi Muslim community. Traditional methods used to treat mental illness and how it can be addressed by professionals, engaging them in Mental health services

The objective of this paper is to:

1. What are the attitudes of Bangladeshi people towards mental illness?
2. How professionals working with service users can have a better understanding of different cultures and religions.
3. How cultural and religious beliefs contribute to the treatment gap and assesses the evidence that public health approaches to different cultures and traditional beliefs can facilitate access to mental health care and the stigmatization attached to mental illness in the Bangladeshi community.

According to Sheikh and Furnham (2000) regardless of whether the individual has experienced mental illness or communicated in enthusiastic, emotional, or physical terms is probably going to be an impression of the social foundation of the person. Individuals from ethnic minorities, especially Bangladeshis, generally possibly use psychological well-being care services when they believe that their modified condition of working is identified with their physical well-being (Bhui & Bhugra, 2002).

Although the general health indicators for this population are not good (National Statistics 2004). Yet South Asians, including Bangladeshis in Britain are generally noted for having lower reported rates of psychiatric hospital admissions and minor psychological symptoms than most other ethnic groups (Littlewood, R. and Dein, S., 2016).

For Bangladeshi service users, the fear of being unwell played an important role in consolidating beliefs in religious and cultural explanations of illness (McClelland et al, 2014). Religion gave them a sense of structure and purpose and a framework within which to understand emerging symptoms (Dein et al, 2008).

Weatherhead and Daiches (2010) state there is a significant stigma in the Bangladeshi community around mental health. They go on to state that sometimes, Bangladeshi people who suffer from mental illness simply stay at home.

The popular image of Bangladeshi families is that they provide unquestioning care and support to elders (Gardner 2002). Dein et al (2008) claim the main carers for Bangladeshi patients were generally close family members and some reluctance was expressed when needing professional carers instead of them. Littlewood and Dein (2016) agree and state a strong sense of moral duty was expressed by spouses toward their husbands or wife when they became sick.

If their condition gets worse, they may be taken to Bangladesh for treatment, rather than being treated in the UK (Dein et al, 2008).

Hussain & Cochrane (2004) state, the South Asian people group appears to connect more prominent shame to psychological instability than that of their British White partners.

Dysfunctional behavior may likewise be seen as a test or discipline from God (Mental health stigma in the Muslim Community, 2012). For instance, illness may be seen as an opportunity to remedy disconnection from Allah or a lack of faith through regular prayer and a sense of self-responsibility. Imams (traditional spiritual leaders) are often seen as indirect agents of Allah’s will and facilitators of the healing process (McClelland, 2014). Imams may also play central roles in shaping family and community attitudes and responses to illness (Mental health stigma in the Muslim Community, 2012).

Cultural influences on the presentation of symptoms and mental health problems also need to be considered (Sheikh and Furnham, 2000). In addition, normative cultural beliefs in the existence of jinn (evil spirits) may be confused with delusions of possession and control and may prevent patients and family members from recognizing medical or psychiatric problems (Islam et al, 2015; Dein, 2008). Significant cultural differences with respect to gender may also put women at especially high risk of diagnosis (Hussain and Cochrane, 2004) and treatment of mental health problems in Muslim communities.

According to (Littlewood and Dein, 2016) it was additionally anticipated that Older British Bangladeshis will be progressively disposed to look for assistance from their family and to make utilization of ‘lay referral frameworks’ solidarity than British Whites (It is an illness referral system through which a person passes from the first recognition of an abnormality to an announcement to the family, to members of the community, to traditional or culturally recognized healers, and then to the regular medical system that includes nurses and physicians), furthermore, that British Bangladeshis will have more superstitious convictions about despondency than the British Whites (McClelland et al, 2014). Research shows Bangladeshis in the UK are hesitant to disclose mental issues to well-being experts (Dein et al, 2008). Religious and cultural beliefs in supernatural causes such as possessions by evil spirits and evil eyes often lead people to faith healers and religious advisors before seeking medical help (Islam et al, 2015; McClelland et al, 2014). Stigma and shame have been heavily implicated in poor help-seeking behavior (Mental health stigma in the Muslim community, 2012), and profoundly stigmatizing community attitudes about mental illness can determine religious rather than psychiatric help-seeking for such cases.

Belief in superstitious causes of mental illness can lead to seeking help from non-medical practitioners, which might hinder treatment. Lack of education and information has also been considered to be an attributing factor in such explanations of mental illness in the United Kingdom and in developing countries (Islam et al, 2015; Greenwood et al, 2014). According to Greenwood et al (2014), voluntary and community organization representatives stated that the stigma about mental illness was a factor for South Asian communities not attending local mental health awareness-related events. people who needed the support of services were failing to reach services until the crisis.

Furthermore, Bangladeshi carers may be less likely to seek out information about services, which may then result in them being less likely to be aware of services (McClelland et al, 2014). Reasons for not seeking out services include: a perception that care for kin is the family’s responsibility, the information may not be provided in a culturally appropriate way or, because of the stigma associated with illness and disability or asking for help for themselves, they avoid admitting needing it (Mental health stigma in the Muslim community, 2012).

Methodology

This research is a desk-based research that involves an analytical review of existing research. The research subject is Mental illness and the group of people that this research is based on are the adults in the Bangladeshi Muslim community. This study will focus on and explore the attitudes toward mental illness in the Bangladeshi community and engage the Bangladeshi community about mental health services. The research will be obtained from journals, books, and electronic databases. Searches were also made in the A-Z database in the library catalog. The database used was CINHAL, google scholar, and SocIndex. Books on mental illness in the Bangladeshi community were difficult to find. However, books on mental illness and ethnic minorities were plenty. Four books from the University library were used for my research and study. When searching in the A-Z database, the SocIndex database was used. The word search used was ‘Mental illness and stigmatization’ 335 journal articles were found. However, when the search word was changed to ‘Mental illness in the Bangladeshi community, only two journal articles were found. When the search was made in google scholar, the search word used was ‘Attitudes towards mental illness in the Bangladeshi community’, but only three journal articles were found. I later typed the search word ‘Mental illness in the Muslim community’, as 90% of Bangladeshis were Muslims and they followed the Islamic religious tradition as well as their cultural tradition. I found plenty of information and journal articles on mental illness and Islam. So, a decision was made to use these journals and websites for my study. Instead of just writing about Bangladeshi culture, it was decided to go for religion also, as that has a big impact on ones thinking. Therefore, this paper is about the Bangladeshi Muslim community. All journals and researches are in full text, from the UK, and in the English language, and ethical principles such as consent, privacy, and confidentiality were followed in all the research used. Analysis was based on the principles of thematic analysis. Research from outside the United Kingdom and languages other than English were excluded. Only the most recent and relevant data for my subject were collated. Key search terms used for my study are:

• Mental health problems
• Mental illness
• South Asians and mental illness
• Bangladeshis and mental illness
• Muslims and mental health
• Mental illness and culture
• Mental illness stigma
• Care and mental illness
• Attitudes toward mental illness
• Multiculturalism.

Findings

The Bangladeshi population in the UK has grown rapidly, from 6,000 in 1961 to 162,835 in 1991 (Eade and Garbin, 2002), and is now estimated to be over double that figure. According to the 2001 Census, there were 275,395 Bangladeshis living in England of which 254,704 reported their religion as Muslim, 17 percent of England’s Muslim population (Gardner, 2002). The Bangladeshi Muslim community is the most concentrated and ethnically segregated Muslim community in England with 24 percent of the absolute Bangladeshi Muslim populace living in the London Borough of Tower Hamlets and a further 19 percent of the total population living in surrounding boroughs (Gardner, 2002).

Despite the growing size of the Islamic community in Western countries, most Western practitioners appear not to have been very well exposed to Islamic values and teachings during their educational careers (Sabry and Vohra, 2013). Researchers found that many Bangladeshi Muslims are hesitant to seek help from mental health professionals in Western countries due to the differences in their beliefs and lack of understating of the helping professionals about Islamic values in their treatment modalities (Mental health stigma in the Muslim community, 2012). Consequently, Muslims might feel uncomfortable in seeking psychiatric help to avoid being in conflict with their religious beliefs (Sabry and Vohra, 2013).

As indicated by the Mental Health Survey (2013), a network study found that there was an under-portrayal of British Asians in mental measurements, especially for full of feeling issues, for example, depression. Research demonstrated that there were lower rates of depression among South Asians (Karasz, 2005), including British Bangladeshis, compared to their British White partners (McClelland et al, 2014).    

Mental illness has the right to live with dignity

Introduction

People with serious mental illnesses are at a substantial disadvantage in defending themselves when they face criminal charges, and those difficulties are compounded when the charges are so serious that the death penalty is sought. Stigma and fear are significant factors in jury verdicts in such cases, and the criminal justice system too often fails to do justice. As a result, people with mental illness are at heightened risk of losing their lives to unfair and capricious application of the death penalty.

Executing a mentally ill person is condemned widely by international law – the UN Commission on Human Rights urged all states “not to impose it on a person suffering from any mental disorder” and it has repeatedly urged India to enact domestic legislation that brings the practice in line with international legal standards. The UN ECOSOC, Implementation of Safeguards Guaranteeing Protection of the Rights of those Facing the Death Penalty, requires the elimination of the death penalty for “persons suffering from mental retardation or extremely limited mental competence, whether at the stage of sentence of execution.”

In the case of Accused X vs State of Maharashtra, [footnoteRef:2]Justice NV Ramana, Justice Mohan M. Shantanagoudar, and Justice Indira Banerjee held that ‘every person with mental illness shall have a right to live with dignity’. In this case, the accused was sentenced to a death sentence due to the charge of the offense of rape and murder of two girls. In this case, Court justified the post-conviction mental illness as a mitigating factor for converting a death sentence to life imprisonment. In this case, the question before the Court to find out answers about [2: REVIEW PETITION (CRIMINAL) NO. 301 OF 2008]

1. What is the relationship between mental illness and crime?
2. How can culpability be assessed for sentencing those with mental illness?
3. Is treatment better suited than punishment?

It is well acknowledged fact throughout the world that, prisons are difficult places to be in.[footnoteRef:3] The World Health Organization and the International Red Cross, identify multiple circumstances such as overcrowding, various forms of violence, enforced solitude, lack of privacy, inadequate health care facilities, concerns about family etc, can take a toll on the mental health of the prisoners. Due to the prevailing lack of awareness about such issues, the prisoners have no recourse and their mental health keeps on degrading day by day[footnoteRef:4]. [3: REVIEW PETITION (CRIMINAL) NO. 301 OF 2008] [4: Ibidi ]

Mental illness/ Mental   disorder

“Mental illness” means a substantial disorder of thinking, mood, perception, orientation, or memory that grossly impairs judgment, behavior, capacity to recognize reality or ability to meet the ordinary demands of life, mental conditions associated with the abuse of alcohol and drugs, but does not include mental retardation which is a condition of arrested or incomplete development of mind of a person, especially characterized by subnormality of intelligence.[footnoteRef:5] [5: section 2(s), Mental Healthcare Act, 2017 ]

“ Prisoner with mental illness” means a person with mental illness who is an under-trial or convicted of an offense and detained in a jail or prison.[footnoteRef:6] [6: Section 2(w) Mental Healthcare Act, 2017 ]

‘Mental disorder’ is a syndrome characterized by clinically significant disturbance in an individual’s cognition,     emotion regulation, or behavior that reflects a dysfunction in the psychological, biological, or developmental processes underlying mental functioning. Mental disorders are usually associated with significant distress in social, occupational, or other important activities. [footnoteRef:7] [7: The Diagnostic and Statistical Manual of Mental   Disorders  (DSM), 5th edition (DSM5), 2013]

‘Severe Mental Illness’ under the ‘International Classification of Diseases (ICD)’, which is accepted under Section 3 of the Mental Health Care Act, 2017, generally include­

1. schizophrenic and delusional disorders
2. mood (affective) disorders, including depressive, manic, and bipolar forms
3. neuroses, including phobic, panic, and obsessive-compulsive disorders
4. behavioral disorders, including eating, sleep, and stress disorders
5. personality disorders of different kinds.

Capital Punishment to Mentally ill prisoners –

Now the question arises whether the imposition of the death penalty upon such Mentally Ill prisoners is justified, who has clearly impaired their abilities to even understand the nature and purpose of such punishment and the reasons for such imposition.

Because means ‘a mad man is like one who is absent’[footnoteRef:8] and punished by his own madness[footnoteRef:9]. [8: ‘Furious absentis law est’] [9: Furious furore sui punier]

It is the well-settled principle of law that Sentencing is the appropriate allocation of criminal sanctions, which is mostly given by the judicial branch[footnoteRef:10]. [10: Nicola Padfield, Rod Morgan, and Mike Maguire, ‘Out of Court, out of sight? Criminal sanctions and no­judicial decision making’, The Oxford Handbook of Criminology (5th Ed.).]

This process occurring at the end of a trial still has a large impact on the efficacy of a Criminal Justice System and sentencing is a socio­legal process, wherein a judge finds an appropriate punishment for the accused considering factual circumstances and equities. In light of the fact that the legislature provided discretion to the judges to give punishment, it becomes important to exercise the same in a principled manner. We need to appreciate that a strict fixed punishment approach in sentencing cannot be acceptable, as the judge needs to have sufficient discretion as well. it is a fundamental principle of natural justice that the adjudicators must provide reasons for reaching the decision and secondly, the reasons assume more importance as the liberty of the accused is subject to the aforesaid reasoning.

Further, the Appellate Court[footnoteRef:11] is better enabled to assess the correctness of the quantum of punishment challenged, if the trial court has justified the same with reasons. Any reasoning dependent on the moral and personal opinion/notion of a Judge about an offense needs to be avoided at all costs. [11: Accused X vs State of Maharashtra]

In Atkins v. Virginia, the U.S. Supreme Court prohibited the use of the death penalty for persons who had intellectual disabilities at the time of the offense.[footnoteRef:12] The Court recognized that sentencing individuals with intellectual disabilities to death fails to serve any of the three main rationales for punishment: [12: 536 U.S. 304 (2002)]

1. rehabilitation (which is inapplicable to the death penalty),
2. deterrence (such individuals have a “diminished ability to process information, to learn from experience, to engage in logical reasoning, or to control impulses,” and thus are “likely unable to make the calculated judgments that are the premise for the deterrence rationale”), and
3. retribution the diminished capacity of the intellectually disabled lessen moral culpability and hence the retributive value of the punishment”).[footnoteRef:13] [13: Hall v. Florida, 134 S. Ct. 1986 (2014)]

Sentencing in India is midway between judicial intuition and strict application of the rule of law. As much as we value the rule of law, the process of sentencing needs to preserve principled discretion for a judge. In India, sentencing is mostly led by ‘guideline judgments’ in the death penalty context, while many other countries like the United Kingdom and the United States of America, provide a basic framework in sentencing guidelines.[footnoteRef:14] [14: REVIEW PETITION (CRIMINAL) NO. 301 OF 2008, Para 49 ]

On the dangers of sentencing discretion, Justice Krishna Iyer held that “Guided missiles with lethal potential, in unguided hands, even judicial, is a grave risk where the peril is mortal though tempered by the appellate process.”[footnoteRef:15] [15: Rajendra Prasad v. State of Uttar Pradesh (1979) 3 SCC 646]]

In any case, considering that a large part of the exercise of sentencing discretion is principled, a Judge in India needs to keep in mind broad purposes of punishment, which are deterrence,   incapacitation, rehabilitation,   retribution, and reparation (wherever applicable), unless particularly specified by the legislature as to the choice. The purposes identified above mark a shift in law from crime-oriented sentencing to a holistic approach wherein the crime, criminal, and victim have to be taken into consideration collectively. [footnoteRef:16] [16: Accused X vs the State of Maharashtra]

Legal Insanity and Mental Illness

Test for recognizing that an accused is eligible for such mitigating factor. It must be recognized that insanity is recognized under IPC and the mental illness Supreme Court Accused X vs the State of Maharashtra case considering the present case arises at a different stage and time.

Under IPC, Section 84 recognizes the plea of legal insanity as a defense against criminal prosecution.[footnoteRef:17] This defense is restricted in its application and is made relatable to the moment when the crime is committed. Therefore, Section 84 of IPC relates to the men’s rea at the time of the commission of the crime, whereas the plea of post­conviction mental illness is based on the appreciation of punishment and the right to dignity.[footnoteRef:18] [17: Surendra Mishra v. State of Jharkhand, (2011) 3 SCC (Cri.) 232] [18: Amrit Bhushan   Gupta   v.   Union   of   India,  AIR   1977   SC   608]

The doctrine of rarest of the rare’ –   It is necessary to consider the aspect of post-conviction mental illness as a mitigating factor in the analysis of ‘Rarest of the rare doctrine which has come into force post-Bachan Singh Case [footnoteRef:19] [19: Bachan Singh V. State of Punjab, AIR 1980 SC 898]

The case of Piare Dusadh v. King Emperor[footnoteRef:20], has already recognized post­ conviction mental illness as a mitigating factor although no proper guideline regarding this was made. Usually, mitigating factors are associated with the criminal, and aggravating factors are relatable to the commission of the crime. These mitigating factors include considerations such as the accused’ s age, socio­economic condition, etc. [20: AIR 1944 FC 1]

In the case of Accused X vs. State of Maharashtra SC held that the ground claimed by ‘accused x’ is arising after a long­time gap after the crime and conviction. Therefore, the justification to include the same as a mitigating factor does not tie in with the equities of the case, rather the normative justification is founded in the Constitution as well as the jurisprudence of the ‘rarest of the rare’ doctrine. It is now settled that the death penalty can only be imposed in the rarest of the rare case which requires a consideration of the totality of circumstances. Supreme Court concluded that we have to assess the inclusion of post­ conviction mental illness as a determining factor to disqualify as a ‘rarest of the rare’ case.

Liberty and freedom for the accused

Sentencing generally involves curtailment of liberty and freedom for the accused. Under Article 21 of the Constitution, the right to life and liberty cannot be impaired unless taken by just laws. In the case of Accused X vs the State of Maharashtra Supreme Court has concerned with the death penalty, which inevitably affects the right to life, and is subjected to various substantive and procedural protections under our criminal justice system. An irreducible core of the right to life is ‘dignity’.[footnoteRef:21] Right to human dignity comes in different shades and colors. [footnoteRef:22] [21: Navtej  Singh Johar v. Union of India, AIR 2018 SC 4321] [22:  Common Cause v. Union of India, AIR 2018 SC 1665]

Mental illness has the right to live with dignity –

The dignity of human beings inheres to a capacity for understanding, rational choice, and free will inherent in human nature, etc. The right to dignity of an accused does not dry out with the judges’ ink, rather, it subsists well beyond the prison gates and operates until his last breath.[footnoteRef:23] Section 20 (1) of the Mental Health Care Act, 2017, Act No. 10 of 2017, explicitly provides that ‘every person with mental illness shall have a right to live with dignity’. All human beings possess the capacities inherent in their nature even though, because of infancy, disability, or senility, they may not yet, not now, or no longer have the ability to exercise them. [23: Accused X vs State of Maharashtra]

When such a disability occurs, a person may not be in a position to understand the implications of his actions and the consequence it entails. In this situation, the execution of such a person would lower the majesty of the law.

Article 20, Constitution of India

Article 20 (1) of the Indian Constitution imbibes the idea of communication/knowledge for the accused about the crime and its punishment. It is this communicative element, which is ingrained in the sentence (death penalty), that gives meaning to the punishments in a criminal proceeding. The notion of the death penalty and the sufferance it brings along causes incapacitation and is idealized to invoke a sense of deterrence. If the accused is not able to understand the impact and purpose of his execution, because of his disability, then the raison d’être for the execution itself collapses.

Article 20 of the Constitution guarantees individuals the right not to be subjected to excessive criminal penalties. The right flows from the basic tenet of proportionality. By protecting even those convicted of heinous crimes, this right reaffirms the duty to respect the dignity of all persons. Therefore, our Constitution embodies broad and idealistic concepts of dignity, civilized standards, humanity, and decency against which penal measures have to be evaluated. In recognizing these civilized standards, we may refer to the aspirations of India in being a signatory to the Convention on Rights of Persons with Disabilities, which endorses the ‘prohibition of cruel, inhuman or degrading punishments’ with respect to disabled persons.

In England, there was a common law right barring the execution of death sentences for lunatic prisoners.[footnoteRef:24] [24: Hale’s Pleas of the Crown Vol. I ­ p. 33; Coke’s Institutes, Vol. III, pg. 6; Black­stone’s Commentaries on the Laws of England Vol. IV, pages 18 and 19;, ‘An Introduction to Criminal Law’, by Rupert Cross, (1959), p. 67.]

International Consensus

There is a strong international consensus against the execution of individuals with mental illness.[footnoteRef:25] Convention on Rights of Persons with Disabilities and its Optional Protocol was adopted on the 13th of December 2006 at United Nations Headquarters in New York and came into force on the 3rd of May 2008. India has signed and ratified the said Convention on the 1st day of October 2007. [25: Commission on Human Rights Resolution 2000/65 The question of the death penalty, UN Commission on Human Rights (Apr. 27, 2000)]

Declaration on the Rights of Mentally Retarded Persons(1971) and the Declaration on the Rights Of The Disabled Persons(1975) are International Conventions related to the protection of the Human Rights of the mentally ill accused.

Another baseline of international law for the treatment of mentally ill prisoners, in general, can be found in the United Nations Standard Minimum Rules for the Treatment of Prisoners.[footnoteRef:26]These baseline rules were adopted sixty years ago by the First U.N. Congress on the Prevention of Crime and the Treatment of Prisoners, held in 1995, and were subsequently approved by the U.N. Economic and Social Council (“ECOSOC”) in 1957 and again, with revisions, in 1977. Of particular relevance is Standard 22(1), which recommends that every prison “include a psychiatric service for the diagnosis and, in proper cases, the treatment of states of mental abnormality.” Standards 24 and 25 govern the examination, treatment, and rehabilitation of mentally impaired individuals. [26: Economic and Social Council Res. 663 C (XXIV) (July 31, 1957)]

In the case of Shatrughan Chauhan[footnoteRef:27] Supreme Court held that “the directions of the United Nations international conventions, of which India is a party, clearly show that insanity/mental illness/schizophrenia is a crucial supervening circumstance, which should be considered by this Court in deciding whether in the facts and circumstances of the case death sentence could be commuted to life imprisonment. To put it clearly, “insanity” is a relevant supervening factor for consideration by this Court.”[footnoteRef:28]

Prison Rules Consensus [27: Shatrughan Chauhan v. Union of India, (2014) 3 SCC 1] [28: (2014) 3 SCC 1]

Various prison rules in India also recognize that generally, the Government has the duty to pass appropriate orders on execution if a person is found to be a lunatic.

1. Andhra Pradesh Prison Rules, 1979[footnoteRef:29] [29: Rule 796]
2. Gujarat Prisons (Lunatics) Rules, 1983
3. Delhi Prison Rules, 2018[footnoteRef:30] [30: Rule 824]
4. Tamil Nadu Prison Rules, 1983[footnoteRef:31] [31: Rule 923]
5. Maharashtra Prison Manual, 1979[footnoteRef:32] [32: Chapter XLII (Government Notification, Home department, No.RJM­1058 (XLVI)/12,495­XVI, dated 18.01.1971)]
6. Model Prison Manual by Ministry of Home Affairs (2016)[footnoteRef:33] [33: Rule 12.36]

Above are some of the examples of legal instruments in India which have already recognized post­ conviction mental illness as a relevant factor for Government to consider under its clemency jurisdiction.

Considering facts by Court when giving Death Sentence – In the case of the Accused X vs State of Maharashtra Supreme Court held that in any case, considering India has taken an obligation at an international forum to not punish mental patients with cruel and unusual punishments, it would be necessary for Court to provide for a test wherein only extreme cases of convicts being mentally ill are not executed. Moreover, Apex Court cautions against the utilization of this dicta as a ruse to escape the gallows by pleading such defense even if such aliment is not of grave severity.

• Grounds for Precluding Execution of Capital Punishment Mentally ill
• American Bar Association, by its Resolution[footnoteRef:34] notes as under ­ [34: 122A passed on August 2006]
• Grounds for Precluding Execution.

A sentence of death should not be carried out if the prisoner has a mental disorder or disability that significantly impairs his or her capacity

• to make a rational decision to forgo or terminate post­ conviction proceedings available to challenge the validity of the conviction or sentence;
• to understand or communicate pertinent information, or otherwise assist counsel, in relation to specific claims bearing on the validity of the conviction or sentence that cannot be fairly resolved without the prisoner’s participation; or
• to understand the nature and purpose of the punishment, or to appreciate the reason for its imposition in the prisoner’s own case.

Directions

Sentencing the mentally ill accused ‘test of severity’ can be a guiding factor for recognizing those mental illnesses that qualify for an exemption.

Therefore, the test envisaged herein predicates that the offender needs to have a severe mental illness or disability, which simply means that a medical professional would objectively consider the illness to be most serious so that he cannot understand or comprehend the nature and purpose behind the imposition of such punishment. These disorders generally include schizophrenia, other serious psychotic disorders, and dissociative disorders­ with schizophrenia.

In the case of Accused X vs the State of Maharashtra, following directions need to be followed in future cases.

1. That the post­conviction severe mental illness will be a mitigating factor that the appellate Court, in appropriate cases, needs to consider while sentencing an accused to the death penalty.
2. The assessment of such disability should be conducted by a multi­disciplinary team of qualified professionals (experienced medical practitioners, criminologists, etc), including professionals with expertise in the accused’s particular mental illness.
3. The burden is on the accused to prove by a preponderance of clear evidence that he is suffering from severe mental illness. The accused has to demonstrate active, residual, or prodromal symptoms, that the severe mental disability was manifesting.
4. The State may offer evidence to rebut such claim.
5. A court in appropriate cases could set up a panel to submit an expert report.
6. ‘Test of severity’ envisaged herein predicates that the offender needs to have a severe mental illness or disability, which simply means that objectively the illness needs to be most serious that the accused cannot understand or comprehend the nature and purpose behind the imposition of such punishment.

Generally, it needs to be understood that prisoners tend to have an increased affinity to mental illness.

Moreover, due to legal constraints on the recognition of broad­ spectrum mental illness within the Criminal Justice System, prisons inevitably become home for a greater number of mentally­ ill prisoners of various degrees. There is no overlooking the fact that the realities within the prison walls may well compound and complicate these problems.[footnoteRef:35] [35: Liebling, Maruna, and McAra et al., The Oxford Handbook of Criminology (6th Ed. (2017))]

Conclusion

In the late eighteenth century, Sir Edward Coke, the great English jurist, said that “by intendment of law the execution of the offender is for example . . . but so it is not when a mad man is executed, but should be a miserable spectacle, both against law, and of extreme inhumanity and cruelty, and can be no example to others.[footnoteRef:36] In the 1980s, the U.N. Economic and Social Council adopted safeguards concerning the application of the death penalty.[footnoteRef:37] The earliest version of the Safeguards called for the prohibition of the execution of “persons who have become insane,” [36: Ford v. Wainwright] [37: Economic and Social Council Res. 1984/50, Safeguards Guaranteeing Protection of the Rights of Those Facing the Death Penalty (1984) (providing the first iteration)]

The standard that the Court prescribes is one of execution and misapplied within both the sentencing paradigm as well as within the punishment paradigm. At the post-conviction stage, the “majesty of the law,” as referred to by the Court, is not lowered because the prisoner may not understand the nature and purpose of punishment but because the onset of mental illness in prison is an additional cost the prisoner bears which is not accounted for in the punishment imposed by the law.

Today, all of humanity has no qualms in exempting the insane from the death penalty; such has been the case in this country for the thirty years that have passed since the decision in Ford v. Wainwright. Yet the prohibition on cruel and unusual punishment also should bar the sentence of death for those who are “half-mad.” Surely the court can fashion a remedy that recognizes that class of offender.

The late 1980s and early 1990s were interesting times for America’s economy. Under President Ronald Reagan, a much larger emphasis was put on American capitalism. Taxes were dramatically cut, industries were deregulated, and GDP rose to an all-time high. Along with this extreme economic growth came scandals, thievery, and a decline in morality with sex and drugs being intertwined with multi-billion dollar companies. A lot of this mentality came from “yuppie” investors, a term that was coined in the 1980s that referred to young and highly educated working professionals on Wall Street and in other financial markets. As W. Scott Poole puts it, “…the Reagan Revolution came to fruition in the rise of the yuppie mentality, a vision of youthful experience in which brutally ambitious MBAs fought their way to the top of corporate America… The yuppie worldview saw American life as a wild frontier and men in Brooks Brothers suits as the new Davy Crocketts… Increasingly, the monster wore the mask of success, American style.” (160). And with that, audience members were greeted with Patrick Batman and the 2000 cult classic American Psycho, a film obsessed with the ramifications that this period had on society as a whole.

The mid-1990s is a period littered with a new fascination for Americans: serial murder. Movies, T.V. shows, and novels featuring dark and gruesome stories filled with murder flooded the marketplace and found their way into the homes of Americans. This dark obsession for Americans grew rapidly into the bloodstream of contemporary culture, as fascinations with killers such as Ted Bundy, “whose crimes brought him enormous media attention while he waited for execution on Florida’s death row… gaining a romantic following [from Americans]” (161). The film explores a multitude of different areas, but the concept of image over induvial stands out most prominently. Similarly, American Psycho’s Patrick Bateman’s deeply American psychosis mirrored this fascination with similar serial killers that intertwined with the American culture of celebrity (noting the tongue-in-cheek scene later in the film in which Bateman asks his assistant Jean about Bundy’s dog).

The film explores a multitude of different areas regarding fear and paranoia of the corporate-ladder-climbing male in the 1990s, but the concept of image over induvial comes most prominently. From the very first scene, it becomes clear that Patrick Bateman is obsessed with how others view him. Going off of just this scene alone, it’s unclear who our protagonist is, or even if any of these characters are important to the plot. Bateman is just another yuppie conforming to everything that those around him do. The group is all wearing similar attire and even whip out the same credit cards to pay for their meals and drinks. However, as the audience discovers in the following nightclub scene, Bateman has a dark and violent side hidden below the surface as he yells at the female bartender “I wanna stab you to death and play around with your blood.” It’s now revealed that Bateman just pretends to be normal when in reality, his true self is a cold-blooded killer. Oh course, this isn’t what society expects from him, so he hides behind a mask as he attempts to conform to those around him.

Bateman is obsessed with what others do and tries to mold himself to be more like them. Once the exclusive restaurant “Dorsia” is mentioned, Bateman does everything in his power to get reservations. He mimics those around him, trying to be just like them and to fit in. For example, the famous and iconic business card scene features Bateman obsessively panicking over the little details of his co-worker’s business cards. There is no significant or discernible difference between the cards; yet to him, it means everything. Instead of working, he gets upset over the smallest things. The lack of work is a defining feature of the film as well. Bateman’s limited time at the office is spent listening to music and worrying about where he’ll have dinner that night. In essence, he’s not worried about advancing his career or company but instead stays worried only about how others view him. This paranoia embodies the darkest elements of the modern male’s psyche, both in the 1980s and 1990s, but also today in 2019.

In addition to worrying about this, Bateman is also interested in his self-perception. I noticed while watching this movie (for the 20th time) that director Mary Harron uses reflection symbolism brilliantly in this film. Throughout the entire movie, Bateman is constantly looking at his reflection and always has to try and improve until he is at the standard that everyone holds him to. The first reflection in the movie isn’t actually in a mirror, but instead in the poster of the Broadway musical Les Misérables. This musical is mentioned throughout American Psycho by Bateman and his friends, showing the disconnect the yuppie brokers have from reality. They see the play as a status symbol and a sign of wealth since they can afford the tickets. Meanwhile, the story is about the exact opposite, focusing on class tension and how excess and wealth found in the upper class cause angst and rebellion in the lower one (and how this causes a collapse in society). Similar to Victor Hugo’s work, American Psycho finds a way to make the behavior of the upper class glamorize the lower class without any of its members realizing it.

All the while as Bateman loses his sanity and falls farther and farther away from reality, nothing begins meaning anything to him except for how others view him anymore. Unfortunately for Bateman, others view him as a nobody. Nobody is scared of Patrick Bateman. Patrick Bateman is indistinguishable from anybody else. He has shaped himself into the mold that others expect him to fit into, and in doing so, has taken away all individuality from himself. Bateman has been stripped down to his most animalistic instincts. He wants more, no matter the cost. What the audience discovers when there is no more for Bateman to take and nothing else matters to him, is his true self. The axe to Paul Allen’s face. The chainsaw is being dropped into the spine of a prostitute. The late-night murder spree. Finally, after no longer being able to maintain this mask, Bateman reveals who he really is under the surface: a terrifying psycho.

While Poole (and other critics) suggest that these murders cannot be verified as reality, I believe that Bret Easton Ellis made his answer clear. The expectation of image over individual brings out Bateman’s true self. More so, Bateman’s true self is a manifestation and a reflection of society in this era. He has been raised to conform to others and to value nothing. His actions are a byproduct of the world around him. This is such a world in which real estate agents cover murders so property values stay high. A world in which no care is given to those suffering (i.e. the homeless-man scene). A world where status is worth more than human life. A world like that is a world where Patrick Bateman, a psycho, is at home. In this world, these murders absolutely existed, and worse, were excepted by society due to the rampant self-absorption that the Reagan era of the late 1980s and early 1990s ushered in. 

Cinema shows us the fragility of masculinity

Cinema is a platform on which many subjects, emotions, problems, and eras can be displayed. It is a creative output and lets us have a glimpse into the minds of great film directors and has done so for many decades. One such director is Martin Scorsese who has graced the world with his cinematic creations for over five decades and is continuing to do so with his latest film, The Irishman only having been released in late 2019. Scorsese is from an Italian – American family and was born in Queens in New York City, but later moved to the area known as Little Italy. As a child, he was aware that there were some tough characters in his area and this obviously made an impression on him as he uses similar tough Italian – Americans in many of his films, some of which include: Goodfellas and Casino “This was a terrifying experience because I was old enough to realize that there were some tough guys around” ( Martin Scorsese, 1989 ). New York City is also a repetitive setting and theme in Scorsese’s films, he has depicted the city through many decades such as Taxi Driver and Goodfellas in the seventies, The King of Comedy in the eighties, and The Wolf of Wall Street running from the late eighties into the mid-nineteen 90s. Scorsese is also incredibly well renowned for having his lead characters and storylines about men, so I think he and his films are the perfect topic to write about in this essay about the fragility of masculinity in cinema.

The male characters portrayed in Scorsese’s films are flawed in many ways, but the ones I will be choosing to write about in this essay will be Scorsese’s various portrayals of mental illness in his characters. Mental illness/health is a subject that needs to be handled carefully, and if portrayed wrong it can misinform or offend the film’s audience, which can have dire effects. Scorsese handles the subject terrifically, however, by not only giving realistic depictions but also by “shining a light on issues which needed bringing to the fore.” ( Thom Denson, Dec 27, 2016 ). The idea of masculinity has evolved greatly in recent times and this along with other things could partly be to do with depictions of masculinity in films, such as Scorsese’s. His portrayals prove that even the smartest, most heroic, richest, everyday men can have mental health problems. The Films Scorsese I will be discussing in this essay, all of which have themes of mental illness, include The Aviator, Taxi Driver, Shutter Island, The Wolf of Wall Street, and The King of Comedy, all of which are some of my favorite films of his, that have all left a great impression on me. These films I am choosing to write about not only share similar themes but also two actors who repeatedly play lead roles in multiple of his films, but always individually. These actors are Robert De Niro and Leonardo DiCaprio “Scorsese’s timeline as a filmmaker can be defined by the two eras in which he found muses in Robert De Niro and Leonardo DiCaprio; two of the most skilled actors of the last 50 years, both instilled with the same commitment and delicacy to craft as their director” ( Thom Denson, Dec 2016 ). These two actors have yet to co-star in any of Scorsese’s films, but have starred together in the early nineteen 90s in a drama / coming-of-age film titled ‘This Boy’s Life’.

The first film of Scorsese’s I will be discussing is The Aviator. This was the first film of his I ever watched and it left a huge impact on me, due to me first watching it at a very young age. It also started my love for Scorsese’s filmography. The film is based on the life of Howard Hughes ( 1905 – 1976 ), who was an American aviator, film director, and much more, he was hugely successful in his life and set many aviation records, but also struggled with Obsessive-compulsive disorder ( OCD ) and other psychological issues throughout his lifetime. The story follows Hughes’s life from the late nineteen 20s until the mid-nineteen 40s and he is played by Leonardo DiCaprio. The film does a terrific job of letting us see through the eyes of Hughes and to help us to better understand his condition, instead of letting us watch from an outside perspective. Scorsese does this through his unique camera work techniques. One such example of this is in a scene about halfway through the film, where Hughes is washing his hands in a public restroom, which is a place of huge anxiety for him due to restrooms being hot spots for germs. In the scene, Hughes is aggressively washing his hands, with soap he brought himself. The camera is from his point of view so we feel like we are in his shoes and feeling what he is feeling. The scene cuts from Hughes’ hands to his face in fast, frequent shots. As these shots speed up we feel the panic and anxiety he is feeling build up until the scene reaches its climax when he cuts his finger “When he leaves the sink and approaches the door we feel the significance of that moment because we have been watching this chain of events through Howard’s eyes” ( Sean Maymon, Mar 2017 ). Hughes’ OCD only worsens throughout the film until he becomes a complete social recluse locking himself away in his mansion. As we know the circumstances behind Howard’s social reclusion, we understand it and sympathize with him instead of seeing him as crazy “Scorsese portrays mental illness and treats it not as a plot twist or a thing to fear but as something to be understood and explored ( Sean Maymon, Mar 2017 ). This film truly showcases that even the most successful, famous people can suffer from mental illness, but tragically in Howard Hughes’s case he went many years undiagnosed with his OCD and because of this he became the recluse he was due to the lack of treatment he received for his illness. Socially isolated and rejected characters are very common in Scorsese’s films and one such character is seen in his 1976 film Taxi Driver.

Taxi Driver is personally one of my all-time favorite movies, I think everything about it is hypnotizing especially the cinematography and the themes displayed in it. The film is about a man named Travis Bickle who is an honorably discharged ex–marine who served in Vietnam, he suffers from insomnia and decides to become a taxi driver in New York City “Exhausted, figuratively and literally, he rests his insomnia – riddled mind by taking up work as a taxi driver, working in the twilight of a city past midnight, bleary–eyed and disheveled, left in the maelstrom of his own reality.” ( Thom Denson, Dec 2017 ). Travis is played by Robert De Niro and he does a fantastic job of showcasing Travis’s mental state through his brilliant acting. Travis is isolated from society after coming back from Vietnam and this can be seen early on in the film in a scene where he is in a late-night diner with other taxi drivers. He is clearly physically and mentally distant from them and this can be seen through his body language, how he focuses on his drink instead of them, and through the camera work used in the scene. Scorsese shows this by focusing the camera on Travis’s point of view of his fizzing drink and slowly blocking out the conversation in the background, this is similar to the bathroom scene in The Aviator as we see Travis’s perspective of the world and feel like we are in his shoes, which helps us better understand him and empathize with him. Another common theme Taxi Driver has with The Aviator is Obsession. Howard Hughes was obsessed with things due to his OCD but Travis becomes obsessed and infatuated with two female characters in this film due to a need to try to fit in with society and to try to clear the streets of New York which he also becomes obsessed with. Travis hates and is disgusted by the people who are on the streets of New York and he wants to clear them “All the animals come out at night – whores, skunk pussies, buggers, queens, fairies, dopers, junkies. Sick, venal. Someday a real rain come and wash all this scum off the streets.” ( Taxi Driver, 1976 ). Travis thinks the people on the streets are scum, even though he frequently visits porn theatres and is constantly popping pills and drinking alcohol throughout the film. The two female characters Travis becomes obsessed with are Betsy, a woman he is attracted to who is involved with the campaign of presidential candidate Charles Palantine, and Iris who is a twelve-year-old prostitute. Travis at first starts watching Betsy from a distance, sitting in his Taxi outside where she works, just observing her live her everyday life. Eventually, he gets the courage to ask her out and she agrees, and she even comments on his odd personality saying “he’s a profit and a pusher, partly truth, partly fiction. A walking contradiction” ( Taxi Driver, 1976 ). Travis is first introduced to Iris when she gets into his taxi and is then pulled back out by a man forcefully, then the man throws money at Travis telling him to forget about what he just saw. This obviously left Travis concerned and it left a huge impression on him as he then decides he wants to free Iris from her pimp ‘Sport’. Both females are hugely influenced/controlled by males, in Iris’s case it’s her pimp, and in Betsy’s, it’s Charles Palantine. Travis then decides he wants to kill all the pimps and assassinate Charles Palantine, this is all caused by his worsening mental state throughout the film and how emotionally unstable he is. Even though Travis fails to assassinate Palantine and does murder all the pimps, his actions are almost dignified from a moral point of view. Some have even labeled him “The Perfect Anti–Hero” ( CinemaWizardBoy, Aug 2017 ) due to him seemingly doing the right thing from an outsider’s perspective and helping to free Iris and clear some of the streets of New York City. His actions are justified and he gets away with it even though he committed murder, he even gets Betsy’s approval at the end, in a scene where some believe it’s a dream sequence even though Scorsese himself says it is not and that it is real. Characters in a few of Scorsese’s films get away with crimes they committed at the end of the film, one such character is Rupert Pupkin from Scorsese’s 1982 film The King of Comedy.

The King of Comedy is an under-appreciated masterpiece in my opinion. The film is about a man named Rupert Pupkin ( played by Robert De Niro ), who has ambitions to become a stand-up comedian and is totally obsessed with a talk show host called Jerry Langford. Once again obsession is a key theme in this film just like the two I discussed above. At the start of the film, Pumpkin isn’t initially obsessed with Jerry Langford, he only starts to become obsessed after jumping into Jerry’s limousine and thinking that Jerry will be his shot to stardom.