The Nobel Prize Winner
Another example of schizophrenia in the absence of evidence for neurological impairments is the case study of John Nash, the Nobel Prize winner (Nasar, 1998). Not only do medical models have no evidence that Nash suffered from brain disease, but it is difficult to see how such evidence could help us to understand the specific symptoms which he developed and why these were so different from those of the Unabomber. Moreover, there is no need to assume that Nash suffered from brain damage as PBT's simple concepts can adequately account for this case similar to the Unabomber.
First, Nash's schizophrenia meets PBT's five criteria of madness. The symptoms preoccupied his attention and severely affected his daily activities (criterion 1); The onset of his symptoms were not linked to a specific event that could account for the behavioral changes (criterion 2); He was unaware of the underlying cause of his behavior (criterion 3); His bizarre behaviors were extremely rare (criterion 4), and; His behaviors were stigmatized as the reflection of an illness (criterion 5).
Second, like the Unabomber, his schizophrenic symptoms were a response to an extreme level of stress. Thus, despite differences in their schizophrenic symptoms, Nash was in many respects similar to the Unabomber. He too skipped grades, developed poor social skills and felt extremely lonely during childhood, adolescence, and throughout his academic career (Nasar, 1998). While years of social rejection must have caused severe feelings of inferiority, negatively affecting his self-esteem, this was not substantial enough to motivate the adoption of deviant behaviors. Two women loved Nash, which helped boost his self-esteem. For Nash, "Who had never even known a woman other than his mother and sister" (Nasar, 1998, p. 174), his secret liaison with Eleanor [his mistress] was not only a pleasant sexual experience, but also a highly ego enhancing affair. His wife, Alicia, "A beautiful young physics student who adored him" (Nasar, 1998, p. 15), and of whom he was proud, surely contributed to raising his confidence as well.
Nevertheless, eventually, Nash developed schizophrenia, not because of his poor social skills, though this factor no doubt played a significant role in precipitating his disorder. His breakdown was the consequence of an accumulation of stressors that aggravated a self-loathing he had established earlier, and which had overtime grown to reach an unbearable level. Nasar (1998) noted that schizophrenia might not be the result of a single stressor but rather the consequences of an accumulative effects number of stressors. "Rather than a single trauma, a string of events from childhood through young adulthood produces strains that mount like straws on the proverbial camel's back" (Nasar, 1998, p. 188). Three specific personal stressors dramatically aggravated his already present self-loathing and left him with almost no choice but to adopt schizophrenia as a coping mechanism or, as he sometimes contemplated, to commit suicide (Nasar, 1998, p. 308).
The first stressor concerned Nash's extremely ambitious personality, which was affected by his strong feelings of inferiority resulting from years of social rejection. As noted by Nasar (1998), although "he was told that he had a brilliant future in mathematics…for a teenager who had endured a lifetime of rejection by peers, the warm praise of such professors…was too little…Nash craved a more universal form of recognition…" (p. 44). "Nash was interested that everyone would recognize how smart he was, not because he needed this admiration, but anybody who didn't recognize it wasn't on top of things… He seized opportunities to boast his accomplishments" (p. 67). However, Nash's self-esteem further deteriorated when his need for superiority was denied primarily due to two events.
1) Nash hoped to get an appointment at Princeton University, but, the members of the mathematics faculty rejected his nomination primarily because of his personality traits. "The thought must have occurred to Nash that he was being rejected less on the basis of his work than on the basis of his personality. It was an even greater blow [to his self-esteem] because the same faculty made it clear that John Milnor, only a junior by this time, would one day become part of the Princeton faculty" (p. 132). His expectation of receiving a promotion and tenure at MIT was not fulfilled, since faculty members felt he was a poor teacher and an even worse colleague. MIT promised to reconsider his promotion once his new article was published. "Nash, however, was furious" (p. 224).
2) Nash was extremely disappointed when he did not receive the Fields Medal, the mathematics' equivalent of the Nobel Prize, or the Bôcher Prize, the only award remotely comparable in terms of prestige to the Fields Medal. Perhaps the best indication of his disappointment in himself regarding his academic achievements can be seen in his statement, "What, thirty already, and still no prize, no offer from Harvard, no tenure even? And you thought you were such a great mathematician? A genius? Ha, ha, ha!" (p. 229).
The second stressor was his bisexual tendencies. Capps (2003, 2004), thoroughly reviewed evidence indicating that Nash had homosexual desires. Based on Erikson and Freud's theories, Capps suggested that Nash's paranoid delusions were mainly the result of acute identity confusion and his efforts to repress his homosexual desires after his marriage to Alicia. It seems that these desires aggravated his negative self-loathing particularly due to his "merciless superego" (Nash's own term, Nasar, 1998, p. 317) and his guilt, which was "directly connected, but not limited, to his feelings about homosexuality" (Nasar, 1998, p. 327). Nash imagined himself as "a religious figure of great, but secret importance" (Nasrar, 1998, p. 275) destined to replace the Pope (see Capps, 2004). It seems this delusion is associated with Nash's desire to gain a “gay liberation” and compensate for his unbearable guilt. As noted by Capps (2004) in regards to Nash's homosexual desires, Nash was seeking "some sort of vindication as a man who had suffered far too much at the hands of his "merciless superego" (p. 211).
The third stressor, perhaps even worse than the previous two, concerned his wife's pregnancy and the death of his father. Nash's breakdown and his hospitalization occurred when his wife, Alicia, was giving birth to their son, John Charles Nash. It seems unlikely that his wife's pregnancy and the birth of his child constituted stressful events, as Nash expressed satisfaction when his mistress, Eleanor, announced her pregnancy five years earlier (Naser, 1998, pp. 175, 235). Moreover, he reminded Alicia when she had suggested waiting a few years before having children, "that the whole purpose of marriage, in his view, was to produce children" (p. 235). Therefore, it seems the expected birth precipitated Nash's psychological breakdown for other reasons. First, the birth reminded him of the trauma associated with his first son's birth and his parent's subsequent discovery of his mistress and son. The shock to his parents was enormous. His father contacted him via a long-distance call, an unusual occurrence as they communicated exclusively by letters, and told him sternly "don't come home… Go right to Boston and make this right. Marry the girl" (Nasar, 208). Soon afterward, his father suffered from a massive heart attack and died. The death shocked Nash, and the possibility that he hastened his father's death bothered him greatly. His mother accused Eleanor of causing her husband's death, and "it is quite possible that she said something similar to her son, or implied as much" (Nasar, 1998, p. 209). Second, Capps (2003) noted that the expected birth was traumatic because it "confronted him with a crisis of commitment… The archaic voice of his father, saying perhaps, 'You are not man enough to assume responsibility for the consequences of your actions" (p. 378). Thus, like the Unabomber, it makes more sense to attribute Nash's schizophrenic disorder to psychological factors than brain damage. Self-loathing, where he perceived himself as the only one responsible for his inability to cope, motivated the adoption of his schizophrenic disorder.
Third, as with other bizarre behaviors, the major psychological function of Nash's schizophrenic symptoms was repression—they intensively preoccupied his mind so that the unbearably stressful thoughts became inaccessible. Thus, contrary to claims of the psychoanalytic theorists, such as Capps (2003, 2004), repression did not cause Nash's paranoid symptoms, but vice versa: the paranoid symptoms blocked the accessibility of stress-related thoughts. Further support for PBT’s theoretical paradigm is found in the fact that Nash's repressive efforts were aimed not only towards homosexual desires but also towards other stressful areas, such as the disappointment of his academic achievements, his image as a father and the pain he caused his parents, especially his father.
Fourth, Nash's symptoms also served his need of controllability. His symptoms boosted his self-esteem and projected his devastating stressors on to external sources. While it is beyond the scope of this book to analyze all of Nash's delusions, which are discussed by both Nasar (1998) and Capps (2003, 2004), a number of examples may be sufficient to illustrate these claims. Before relating to these examples, it is worth noting that the symbolic and complex meanings of these delusions, as well as the clever way by which these meanings were encoded, preclude the possibility that Nash's symptoms were the consequence of brain disease and strengthen PBT's position that these were the result of psychological processes
One example is when Nash slouched into the common room of Hartley Rodgers, announcing, while pointing to the story on the front page of The New York Times, that
"Abstract powers from outer space, or perhaps it was foreign governments, were communicating with him through The New York Times. The messages, which were meant only for him, were encrypted and required close analysis. Others couldn't decode the messages. He was being allowed to share the secrets of the world" (Nasar, 1998, pp. 241-242).
Although this delusion appears insane and irrational, in fact, it is exceptionally clever, both in its symbolic meanings and in its psychological repressive and controllability functions. The abstract powers represent his "merciless super-ego," which coerced him to repress his stressful thoughts. These thoughts were labeled as "the secrets of the world" to further distance himself from them, thereby preventing their access. Nash encrypted his anxiety-provoking thoughts the same way a mathematician would encode his knowledge. This delusion also inflated Nash's self-esteem since the "abstract powers" or "foreign government" shared the secrets of the world" with him alone.
Often, his schizophrenic symptoms were insufficient in blocking the stress-related thoughts from his attention. Nash noted, despite the "horror of hospital and illness, these ideas keep coming into my head and I can't prevent it" (p. Nasar, 1998, p. 258). Therefore, he utilized his brilliant mind to create various tricks as additional barriers to prevent him from accessing his "secrets" -- the stress-related thoughts. One example of an ingenious method of distraction is Nash’s decision to focus on Alicia's secrets in an attempt to further distance himself from his own repressed stressors. "He behaved as if she knew some secret but wouldn't share it with him" (Nasar, 1998, p. 248). Nash became so persistent in the delusion that "he threatened to hit her" if she did not tell him (p. 249). As noted by Capps (2003), Alicia suspected that Nash's inquiries into her secrets "were an act designed to deflect attention from himself" (p. 367), to further repress his anxiety-provoking thoughts. He made Alicia part of the conspiracy plot against him, in an attempt to externalize the underlying causes of his psychological difficulties.
Nash was so distressed by his stressful thoughts and his constant battle to repress them that he felt as though his head was "as a bloated windbag, with Voices which dispute within" (Nasar, 1998. P. 328). He invested a vast amount of time and energy in attempts to form a world government (e.g., sending letters to all embassies in Washington, Nasar, 1998, p. 244), seeing himself as the leader of a great movement for world peace, and referring to himself "the prince of peace" (p. 255) or "a religious figure of great, but secret importance" (Nasrar, 1998, p. 275). While these delusions aimed to inflate Nash's self-esteem, they also held significant symbolic meanings. "The prince of peace" may symbolize his wish to establish peace within his psychic by resolving his unbearable psychological conflicts. Similarly, he wished to be "a religious figure" because he was concerned about his bisexuality and believed he could change the laws that forbid such behaviors if he possessed religious authority.
The conflicting symbolic meanings of Nash's delusions are also reflected in Nash's rejection of a prestigious offer from the University of Chicago to be a chair of the mathematic department, stating that he was scheduled to become "Emperor Antarctica." This statement represents his failure to gain the world's respect: Although Emperor is a highly respected position, serving as "emperor of Antarctica," a barren and empty place, is not the most impressive role he could have created for himself, indicating that he did not believe himself worthy of more. In addition, Nash told a student that he was on the cover of Life magazine but that his photograph had been disguised to make him look like Pope John the Twenty-third. He mentioned two signs proving the photograph was of him and not of the Pope: 1) As opposed to Nash, John was not the Pope's given name, but rather a name that he had chosen for himself; 2) The number 23 was Nash's favorite prime number. While this delusion boosted his self-esteem allowing for both comparison between himself and the leader of the Catholic world and the belief that his photograph had been publicized by a well-known magazine, it also reflects Nash’s negative perception of himself that the magazine had to “disguise” his real face due to his disgraceful behaviors and pictures.
In analyzing Nash's delusional perception of himself as the Pope, Capps (2003) claims that this reflects feelings of guilt and rage over his function as "papa" and his failure "to live up to his obligations as a father to Eleanor's son" (p. 383). However, while delusions may have negative messages, it seems that their central function, which is overlooked by psychoanalytic advocates, is to increase the schizophrenic's self-esteem. In the absence of this idea, it would be difficult to understand not only Nash's case, but also other cases, such as those of the Unabomber and Charles Cullen, which will be discussed later. This claim is also consistent with many studies showing that awareness of the positive symptoms (i.e., hallucinations and delusions) leads to depression, low self-esteem, hopelessness, and suicidal behavior (e.g., Acosta, Aquilar, Ceias & Gracia, 2013; Balhara & Verma, 2012; Crumlish, Whitty, Kamali, Clarke, Browne et al., 2005; Ekinici, Gorkem, Albayrak, Arslan et al., 2012; Lysaker et al., 2007; Melle & Barrett, 2012; Yu-Chen & Yia-Ping, 2011). Accordingly, Nash's positive symptoms were so important to him because of their repressive and controllability values that he believed that "taking away his delusions and hallucinations would be taking away his genius, his most treasured gift (Weuden, 2002).
Nash's contradicting messages are also reflected in his ongoing delusion that "he was the left foot of God and that God was walking on the earth" (Nasar, 1998, p. 258). While there seems to be no higher ranked position than closeness to God, this delusion also implies that he did not perceive himself as important enough to serve as God’s right foot, which indirectly refers to the perception of himself as a failure. Nash's psychological methods to reduce his intolerable level of depression not only included repression and grandiose delusions, but also delusions that aimed to project his failures and immoral behaviors to factors beyond the self. For example, in one of his letters, Nash wrote, "his career was being ruined by aliens from outer space" (Nasar, 1998, p. 243). Similarly, Nash accused one of the mathematical graduate students of MIT of searching through his trash to steal his ideas (p. 243).
Another delusion worth discussing is his belief that he could renounce his American citizenship and replace it with a universal identity card, "one that declared him to be a citizen of the world" (Nash, 1998, p. 271). Later, he also wished to obtain official refugee status. When his efforts failed, he destroyed or disposed of his American passport, so that "in his own mind, Nash was now stateless…” (Nasar, 1998, p. 276). He was so decisive in his efforts that he refused to return to the United States even when the Swiss authorities issued a deportation order and forced him to leave Geneva. His strong desire to disconnect himself from the United States was part of his repressive efforts to detach himself from anything that reminded him of his irreversible past. This may also account for the fact that in a conference at the College he insisted on giving his lecture in what he called "Pidgin French," even though most of the speakers delivered their talks in English. Nash's self-loathing was so painful that he wanted to escape from his own self by establishing a new identity completely detached from any memory of past experiences. This is consistent with Nasar's (1998) statement that Nash was:
"motivated by as much as by antagonism to his former existence as by an urge for self-expression, Nash particularly desired to supersede the old laws that governed his existence, and, quite literally, to substitute his own laws, and to escape, once and for all, from the jurisdiction under which he had once lived" (p. 271).
Capps (2005) noted that Nash's efforts to gain political asylum abroad might have been associated with his fear to be drafted during the Korean War. However, Nash continued his tremendous efforts to gain a refugee's status, for which he applied to many authorities, including the UN Commission for refugees, even when informed by the American authorities that he was beyond the draft age. Thus, it seems unlikely his insistence to obtain official refugee status had any connection to his fear of being drafted. It is more probable that Nash’s wish to renounce his American citizenship was part of his effort to disconnect himself from his earlier identity. The refugee delusion symbolically represented his attempts to escape from his own psychological battles, and thereby obtain "a psychological shelter" of serenity.
Nash’s case is also unique due to his relatively large number of symptoms. While this can be interpreted as an additional indication of his exceptional creative ability, it seems there were psychological reasons for this unusual abundance. Unlike the Unabomber and Charles Cullen, Nash did not develop schizophrenic symptoms that could intensively preoccupy his attention for a prolonged period. The mad behaviors of the former patients demanded a vast amount of cognitive and behavioral activity that effectively sealed their attention from infiltration of stress-related thoughts. In contrast, most of Nash’s delusions and hallucinations did not yield intensive behavior and cognitive actions, certainly not for a prolonged period. Moreover, since the symptoms were symbolically associated with his stressors, they could not serve as strong preventative barriers. As a result, he had to produce more symptoms that, together, could intensively occupy his attention. However, eventually, they became insufficient, which may explain his desperate efforts to gain a refugee status, to escape from his original environment that reminded him of his stressors.
Nash's refusal to take medications was interpreted by researchers as sign of irrationality. For example, in an article headed "Why Did John Nash Stop His Medications" Weiden (2002) noted, "Nash would have to be persuaded that his voices and strong beliefs (delusions) were harmful to his intelligence, and those medications, by reducing his preoccupations, would help his concentration and intellect" (p. 390). Not only did Weiden fail to realize the important psychological functions of Nash's schizophrenic symptoms, but recent studies also indicate how fortunate Nash was that he stubbornly refused medications. Research reveals that antipsychotics increase the risk for metabolic syndrome, cardiovascular disease, excessive mortality and significant cognitive damages (e.g., Casey, Haupt, Newcomer, Henderson et al., 2004; Scigliano & Ronchetti, 2013; Yogaratnam, Biswas, Vadivel & Jacob, 2013).
The simplistic conception of schizophrenia by medical models is evinced also by data indicating that Nash' choice of symptoms were affected by the principal of availability. For example, one of his prominent symptoms was associated with numerology (e.g., see Nasar, 1998, p. 281), and this symptom is unique to him because "Nash was the greatest numerologist the world has ever seen" (Nasar, 1998, p. 335). Similarly, the fact that mathematics constituted the major focuses of his life may explain why "Nash's delusions and hallucinations often involved mathematics, numbers, and other mathematicians opposing his ideas throughout the height of his illness" (Capps, 2005). Another example of availability concerns his delusion to establish a world government and his tremendous effort to renounce his American citizenship and replace it with a universal identity card, "one that declared him to be a citizen of the world" (Nash, 1998, p. 271). Nasar noted in this regard that
"Ideas of world government, and related concept of world citizenship, were at their heyday during Nash's Princeton graduate-school days and permeated the 1950’s science fiction that Nash devoured as a student….Princeton was the center of that movement, largely because of … Albert Einstein and John von Neumann… However, the one-worlder who fired Nash's imagination was a loner like himself, the Abbie Hoffman of the one-world movement. In 1948, Garry Davis, a leather-jacketed World War II bomber pilot, Broadway actor …had walked into the American embassy in Paris, turned in his U.S. passport, and renounced his American citizenship. He then tried to get the United Nations to declare him "the first citizen of the world" (pp. 270-271).
Nash's delusions were often associated with religious themes, and one was directly associated with the biblical story of Jacob and Esau (Nasar, 1998, p. 327). The availability of these ideas was partly due to his Sunday Bible classes (Nasar, 1998, p. 33), and partly to the fact that he was raised in a traditional religious family.
Traditional theories of psychopathology regard schizophrenic symptoms as extreme reflections of irrationality. Moreover, it is unanimously agreed that they are associated with severe neurological impairments. Professor George Mackey, from Harvard University, formulated this conventional conception in his first meeting with Nash after his remission:
"How could you, began Mackey, how could you, a mathematician, a man devoted to reason and logical proof…how could you believe that extraterrestrials are sending you messages? How could you believe that you are being recruited by aliens from outer space to save the world? How could you…? "(Nasar, 1998, p. 11)
Nash answered this question by saying, "The ideas I had about supernatural beings came to me the same way that my mathematical ideas did. So I took them seriously" (p. 11). Capps (2005) noted, in reference to this statement, that according to Nash, his schizophrenic symptoms "were just as reliable and real as the logic and math." In the absence of PBT, Nash's answer should have only intensified Mackey's confusion. Capps and researchers of rival theories would probably attribute Nash’s answer to irrational psychological processes, resulting from his madness.
However, Nash was correct in his answer, and moreover, his symptoms can be seen in terms of rationality as “a masterpiece of craziness.” As indicated above, schizophrenia is a rational coping mechanism, which provides a powerful repressive tool and decreases the patient’s sense of incompetence or self-loathing, thus alleviating an intolerable level of depression. In no other case did the schizophrenic symptoms reach as high a level of sophistication as those of Nash. Although Nash’s symptoms appear bizarre, careful examination reveals that they comprise a masterpiece of metaphors of his psychological condition, a masterpiece that only a genius such as Nash could invent.
Some examples of these beautiful metaphors are: 1) Nash’s perception of himself Emperor of Antarctica, which apparently represented both his aspiration to be famous and as the his feelings of failure; 2) His belief that he was the left foot of God, symbolizing his desire to be great, but also his image of himself as limited by his weaknesses; 3) His claim that extraterrestrials were sending him messages, which seems to refer to anxiety-provoking thoughts elicited by his merciless super-ego; 4) His conviction that the photograph of Pope John on the cover of Life magazine was actually a disguised photo of him, which again refers to his disappointment in himself for failing to earn recognition; 5) His reference to himself as "the prince of peace," which may reflect his wish to settle his psychological conflicts and thus live in peace; 6) The title of ABSOLUTE ZERO, on his notebook which he carried around, which may represent his perception of himself as a total failure. It is difficult to see how suggestions of brain impairments or other rival theories can explain these extraordinary metaphors.