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“The Man Who Mistook His Wife For a Hat” by Oliver Sacks

In this paper, a base concept is a lecture describing perception, and the book The Man Who Mistook His Wife for a Hat by Sacks (1987) is a target concept. To understand the target concept, it is necessary to apply the terms and theories discussed in the course of the lecture. In particular, a lacking element is the explanation of disorders presented by the author in his book, including their causes and effects.

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Oliver Sacks, an American neuropsychologist, focuses on his patients in a fascinating and accessible form by describing the stories of people who have encountered some mental damage, be it hallucinations or more complex disorders. On the pages of the mentioned book, there are several stories about those who suffer from a split personality, experience phantom pains, or do not feel connected with their body, but each of them may be engaged in creativity (Halliwell, 2016).

These pathologies are so strange for the human perception that they sometimes seem to be impossible. For example, the disappearance of joint-muscle feelings, when one of the patients does not feel his body may be noted. When she takes her eyes from her hand in which she holds the spoon, the latter immediately falls. The body is perceived as a foreign appendage.

Sacks (1987) writes not only about the diagnosis of patients but also about his thoughts, associations, and perceptions from the first meeting with a person as well as how the treatment worked on him or her. The author’s humanistic approach to patients plays an essential role as he does not consider them inferior due to the fact that they lack the functionality of some “mechanisms” in the brain, but treats them with deep interest (Halliwell, 2016).

He engages them in singing, playing the piano, or dancing. Here, for example, how does a blind from a birth woman suffering from cerebral palsy and not using her hands from birth perceives: “her first manual perception, and thus her birth as a complete ‘perceptual individual’” (Sacks, 1987, p. 35). Some patients have even adapted to their non-standard physiology: teak, twitching, and nervous excitement creates a virtuoso drummer; a patient who hardly perceives a sensual reality, who can confuse a wife and hat, becomes an abstractionist artist since he specifically perceives the shape of objects. In this regard, the doctor is seen as a physician, sincerely trying to help patients in any way to find a niche in society.

The collection of stories presented in this book makes one reconsider his or her view of mentally unhealthy people. Applying the lecture about perception, one may understand that perception consists of agents that organize sensations and produce a picture of the world. It occurs in the brain. The vivid examples show how physiology can take prevalence over a person when something in perception fails. According to El Haj, Moroni, Samson, Fasotti, and Allain (2013), the failure of one or another sensory modality explains where the voices in one’s head come from, how words can lose their importance, and persons confuse a human and an object.

Sensory integration is the correct interaction of all senses, of which the basic senses are touch, balance, and kinesthesia (Chuang, Ko, Jung, & Lin, 2014). The sensations of the latter are those that flow from the muscles allowing determining the position of one’s body without the control of vision. Therefore, the feeling of kinesthesia is called the sense of the position of the body. Due to the right sense of kinesthesia, people are able to perform expedient movements without looking at what they are doing (Chuang et al., 2014).

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Many of these movements people perform so quickly that even do not realize them. Lying in bed, one can feel his or her hands and feet; although he or she does not observe them or walking down the street or stairs, we do not look at feet. Without the correct treatment of tangent and equilibrium stimuli, the sensations that float from within the body and the sensation of the position may be disturbed. The level of muscle tension also matters since sensations of the body are broken if the muscle tension is too small or too large. The above explains why one of the patients was unable to hold a spoon without looking at it or why the other patient mistook his wife for a hat.

Sacks (1987) demonstrates the remarkable ability of the brain, and, therefore, of a person to overcompensate cognitive biases. As a result of the mentioned conditions, often frightening and infinitely convincing worlds of every individual manifest themselves in certain forms of activity and behavior, by which they are able to interact with objective reality. Examining various cognitive manifestations of patients, the author devotes a separate chapter to each of the cases, giving readers a feeling that they are absorbed in a series of fictional character studies, rather than by merely psychological guidance or superficial observations and blind assumptions made by a pompous intellectual (Hull, 2013).

In this connection, it is appropriate to mention neuroplasticity as one of the most amazing discoveries of recent years. It was considered that nerve cells are not restored. However, in 1998, a group of American scientists proved that neurogenesis occurs not only up to the age of 14 but also over one’s whole life and that new people can also develop new nerve cells (Hötting & Röder, 2013). They found that the reason for the reduction of mental abilities is not the death of nerve cells but the depletion of dendrites, the processes of the nerve cells through which impulses pass from one neuron to the other neuron. If dendrites are not constantly stimulated, then they atrophy, losing the ability to conduct like muscles without physical exertion (Hötting & Röder, 2013).

The same daily actions form a pattern behavior – habits – while using and strengthening the same neural connections. Thus, the brain is capable of changing the structure and function of gray matter through imagination and visualization. This can happen even without external influences.


To conclude, it is essential to emphasize that in psychology and cognitive science, it is accepted to consider the medical history separately from a patient’s personality as if the disease exists separately from him or her. On the examples of his patients, the author illustrates that it is necessary to treat the disease integrated with a person through perception. The same disease in different people may manifest itself in different ways.

For someone, his inferiority is tantamount to losing his own “Id,” for others – the way this “Id” provides a feeling of integrity. Sometimes a mental disorder reveals hidden opportunities in a person. Even though it seems to others that a person’s illness is tragic, a patient cannot feel it and be quite happy in his or her world inaccessible to others.


Chuang, C. H., Ko, L. W., Jung, T. P., & Lin, C. T. (2014). Kinesthesia is a sustained-attention driving task. Neuroimage, 91(1), 187-202.

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El Haj, M., Moroni, C., Samson, S., Fasotti, L., & Allain, P. (2013). Prospective and retrospective time perception are related to mental time travel: Evidence from Alzheimer’s disease. Brain and Cognition, 83(1), 45-51.

Halliwell, M. (2016). Romantic science and the experience of self: Transatlantic crosscurrents from William James to Oliver Sacks. New York, NY: Routledge.

Hötting, K., & Röder, B. (2013). Beneficial effects of physical exercise on neuroplasticity and cognition. Neuroscience & Biobehavioral Reviews, 37(9), 2243-2257.

Hull, A. J. (2013). Fictional father?: Oliver Sacks and the revalidation of pathography. Medical Humanities, 39(2), 105-114.

Sacks, O. (1987). The man who mistook his wife for a hat and other clinical tales. New York, NY: Touchstone.

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