At the “age of the brain,” one would expect the public to view psychiatric disorders as “diseases like all others.” But mental illness still carries a significant social stigma that deprives them of employment, housing, and social opportunities. Invoking the brain as the source of disease helps reduce stigma, but it elicits curious fatalistic reactions. People believe that if the disease is “in the brain,” then it is more severe, incurable, and resistant to psychotherapy. And it is not only the general public that is taken by such misconceptions. Patients believe the same, and so do even trained clinicians. Why do psychiatric disorders elicit such persistent misconceptions? No one would shun a cancer patient because she has a tumor in her breast. Why shun the sufferer of a disorder that ravages the brain? And why believe brain diseases are incurable?
This chapter traces the misconceptions of brain disorders to the core knowledge of Dualism and Essentialism. Dualism prompts us to presume that the mind and matter don’t mix and match; if the disease is “in your brain matter,” then, in our intuitive psychology, ephemeral “talk therapy” won’t do. Essentialism further compels us to believe that what’s “in” our material body is innate, hence, immutable, so biology is truly destiny. Thus, the same core knowledge principles that plague our self-understanding in health also derail our reasoning about psychiatric disease.