Good morning, Hickits Tuesday. So three and a half years ago, I was diagnosed with a disease called labyrinthitis, where in part of my inner ear became inflamed due to a viral infection. All at once I went from feeling like I had a bit of a head cold to being completely incapacitated by vertigo. I fell over, began vomiting, and was rushed to the hospital. And in the years since, I've had a lot of treatment for labyrinthitis, and I've started to wonder, is this disease mental or physical? Let me begin by noting just how profoundly we stigmatized mental illness. When I was in the hospital, there was initially some thought that my vertigo might be psychosomatic, that the dizziness could be caused by my chronic anxiety. And I have to confess, once they found an ostensibly physiological cause for the vertigo, I was a little relieved, because suddenly everyone was acting as if, and I started feeling as if, my illness was really real. But of course, mental illness is also really real, and often has a physiological cause, like the brains of many people who have OCD, as I do, look different in FMRI scans than the brains of other people. We just don't really understand those differences very well yet. And illnesses that are poorly understood, or lack-effective treatments tend to be heavily stigmatized, see also endometriosis, and irritable bowel syndrome, and many pain disorders, and leprosy. Rarely do I need a footnote in a video, but I do need one here. The category of mental illness is just that, a category it has uses, and it has limitations, and remembering that categories are often useful, but almost always limited, seems to me one of the big challenges of life right now. Like the extremely silly discourse around whether a hotdog is a sandwich is of course very silly, but underneath it lies something important, which is that we want categories to be strict and inviolable when in fact they are messy and constructed. But right, so I got Labrind Thitis, which is not a psychological illness, or at least I'm told it's not. I went home from the hospital with two medications, one a central nervous depressant called mechaline, and the other an anti-anxiety medication called diazepam that also lessons vertigo. Both these medications were psychotropic in the sense that they affected the way I experienced consciousness, and both of them are sometimes prescribed as psychiatric medications, but in my case they weren't psychiatric medications because in my case my illness was not considered psychiatric. Both these medications reduced my symptoms while I recovered, but I eventually found that even after I was mostly better and the virus was gone, I still had some sort of long-term problems with my vestibular system, so my doctor sent me for therapy at a balance institute. So I went to this place to retrain my brain's balance system, and while I was there, the therapist said to me, we're just trying to rewire your brain, and in that moment I realized this is just like the other therapy I go to. Like in regular therapy, I'm trying to get my brain to respond differently to unreliable anxious thoughts, and in this therapy I'm trying to get my brain to respond differently to unreliable inner ear information. Now the exercises and medicines used to treat OCD are very different from those to treat Labrind Thitis, but the underlying idea is similar medication and therapy. And so is it a mental or physical illness? Yeah, yeah, yes, it is. I find myself going back again and again to Elaine Scarie's observation in the body in pain. To have great pain is to have certainty and to hear that another person has pain is to have doubt. I think that doubt compounds the suffering of people in pain, and I think it is further compounded when we imagine that someone's illness or pain is less real because it involves the mind or because an observer can't see it. The truth is the mind-body dichotomy is as insufficient as the category of sandwiches. Our minds are made out of body and our bodies think. In fact, on Earth at least, bodies are the only things that think. Whether we call it mental or physical, other people's pain is as real as our own. Hank, I'll see you on Friday.