Book Review

Here’s the problem with mental illness: what we know about it is far surpassed by what we don’t. This, of course, should be unsurprising. After all, the human brain remains one of the most complex things in the known universe. We’ve figured out black holes, developed vaccines for novel coronaviruses in unprecedented record time, and catalogued nearly the entirety of flora and fauna underneath the ever warming sun, but when it comes to the five-pound piece of meat and electricity between our ears, we know admittedly very little, especially when things go awry. Cognition, emotion, behavior: when these go miraculously as expected and fail to disrupt our lives in irrevocable ways, we take them for granted; it’s only when they fall apart that we are forced to reckon with just how much we don’t know about the hows, the whats, and most devastatingly—the whys.

The why question stands at the center of Grace M. Cho’s autobiographical treatise on schizophrenia in Tastes Like War. Part memoir, part historiography of the enduring ravages of the American military presence in Korea, part sociological expose on many varietals of racism growing up in Chehalis, Washington, Cho’s book defies category, genre, and quite possibly entire subfields of social science. In her singular account of growing up as the daughter of an American marine stationed in Seoul and the South Korean “cocktail waitress”/single mother he rescues from the naval base (where she presumably sold more than just drinks), Cho catalogues her own traumas with an academic precision and speculates about her schizophrenic mother’s with the kind of storytelling normally reserved for fiction writers, with no shortage of literary finesse. But like any good storyteller, her sleight of hand in blending the known with the unknown, the facts of her own lived existence and observations as a sociologist with the speculation of her family’s untold history, is so seamless, so adept, that figuring out what her book means for our modern understanding of mental illness and its origins requires nothing less than a total autopsy.

To be fair, Cho, in many ways, was faced with an impossible task as a memoirist: to piece together the past of a mentally ill woman who birthed and defined her but refused to talk about her own history. There is a reason that, as I tell my undergrads, schizophrenia is one of the most devastating mental illnesses: it strikes people when they’re young and takes away, oftentimes forever, everything, including reality itself. In this case, the mother started her psychosis when Cho was just fifteen. The so-called “positive” symptoms of schizophrenia—the hallucinations, delusions, paranoia—consumed both their lives until they gave away to the “negative” symptoms. Because if you think hearing voices and believing that you are the target of perpetual persecution is bad, consider the alternative that awaits: anhedonia, avolition, asociality, alogia—in other words, loss of pleasure, will, relationships, speech. As Cho tells it:

My socially dead mother sat on the couch for years on end with the curtains closed, completely cut off from the outside world. This was the mother whose voices told her to make herself invisible and small, to sit in the dark, eat as little as possible, and let no one from the outside see her. This was the mother of my coming-of-age, the one around which my adult psyche formed, the one I could not let disappear, but could not yet fully embrace.

But what makes Cho’s story divergent even in a year where a strikingly similar memoir—Michelle Zauner’s Crying in H-Mart—became a critically-acclaimed bestseller as the debut book by a singer-songwriter of a once-obscure indie rock band (Japanese Breakfast) who was also mourning her long-suffering, difficult, recently deceased Korean mother, is Cho’s unique academic pedigree. Many a book has been inspired by dead parents, but leave it to Cho to turn her loss into a thesis that challenges the empiricists’ understanding of schizophrenia and its causes. Because Tastes Like War is not your typical memoir; if anything, it’s a manifesto, a dressing-down of the problematic history of how psychologists have understood—and failed to understand—illnesses like schizophrenia. As her evidence, Cho liberally cites cross-cultural findings from anthropologist T.M. Luhrmann’s case studies showing that if there’s one thing the Third World does better, it’s giving schizophrenic individuals a better prognosis. Throughout Luhrmann’s works, she makes the case that our current biomedical understanding of the disease—which chalks it up to primarily a matter of genetics and neurochemistry gone awry—is Eurocentric and flat-out wrong. She points out that in this country, immigrants, people of color, and the poor are more likely to develop psychosis; in other countries, those with one psychotic episode are less likely to have another one. As Cho sums it up, “this is the story of being on the wrong side of power.”

Of course, neither Cho nor Luhrmann are the first to consider the psychosocial causes of schizophrenia. Just about every Introductory Psychology instructor—myself included—will tell you that poverty, immigration status, and urbanity are all risk factors. So is drug use and your mother getting the flu during her first trimester. As the empiricists are quick to point out, though, these risk factors, however established, are tiny compared to the statistical likelihood of you developing schizophrenia if a first-degree relative—or god forbid, a monozygotic twin—has it.

But here’s the other thing: Dan Gilbert, illustrious Harvard psychologist, die-hard empiricist, author of his own narrative non-fiction Stumbling On Happiness, and one of the masterminds behind the Psych 1 textbook I use, once famously said to his incoming class of introductory psychology students (for which I was once a TA): “You must understand that at least half of what I’m going to teach you this semester is wrong. We just don’t know which half.” He was couching that in the context of psychology being a baby discipline that has only been around for about a century, but I suspect the same may be true of all of science. If we weren’t interested in proving ourselves wrong, we wouldn’t need case studies, surveys, controlled clinical trials. But we do. The entire enterprise of science rests upon the conviction—the hope—that in time, with enough experimentation and observation and challenge, our wrong ideas can and will be replaced by right ideas, or at least less wrong ones.

Whether Tastes Like War is completely right about the origins of schizophrenia remains an open empirical question, but one thing is clear: we need stories like Cho’s, like her mother’s, because no problem big or small was ever solved by being invisible. In shedding light on a life and an illness too often relegated to the dark corners of rooms where no one dares to visit, Cho demonstrates the fragile miracle that is an ordinary day devoid of voices.