In the early 1960s, JFK promised that science would take us to the moon, and, just weeks before his death, he declared that science would make “the remote reaches of the mind accessible” and cure psychiatric disorders with breakthrough medications. We were on the moon within the decade. But today, psychiatric cures continue to elude us—as does the mind itself. Leading neuroscientists have told me that we’ve made no true progress in medicating mental illness in half a century. Why? And what alternative approaches to understanding and treatment might we take? My book is an exploration of these questions through three personal stories, one of them the story of my little brother, who was put on a locked ward when we were in our early 20s.

By the early 80s, the idea that the brain and the mind are synonymous took full hold. Psychiatric troubles were purely a matter of neurology; if we could just adjust and fix the physical stuff of the brain we would fix our depressions, our anxieties, our manias, our breaks from shared reality into the hallucinations of psychosis. This was the so-called “third revolution.” It was defined by a kind of triumphal rationalism. This is the source of the common wisdom that mental illness is like diabetes; you take psychiatric drugs like you take insulin—straightforward as that. But it’s not even remotely as straightforward as that. The brain and the mind, neurology and consciousness, wiring and emotion, are vastly, perhaps infinitely divergent things. Science may well never take us from one to the other. And this is where, though I’m a fairly rational person, the book takes a slow spiritual turn. 

Maybe the quickest way to answer this infinitely complex question is to think about Abraham. He hears God telling him to sacrifice his son. If I told a psychiatrist that God was commanding me to bind my son on an altar of stone and slaughter him, I'd be rushed to a locked ward. But the authors of Genesis thought completely differently. And even without the distances of millennia, divergent cultures can have dramatically different perspectives on the mind and mental health. One of my main characters, Chacku, learns to live with his voices and value his unshared realities through the lens of Buddhist and Hindu perspective. That last sentence might sound impossibly romantic, given that we're talking about psychosis. But stories like Chacku's have a lot to teach all of us about existing in our subjective, private realities, and about what it means to be human. If that doesn't come through in the book, then I've failed as a writer.