Insight 330 www.thelancet.com/psychiatry Vol 3 April 2016 As he recounts the story of a plague ravaging an Algerian city, Albert Camus explores our ultimate lack of control and the essential and fundamental irrationality of life. The title is bleak, and the topic could be misinterpreted as bleak. Yet, what I take from the book—what has both changed my life and changed my approach to mental health—is that we all nevertheless act, take decisions, and exert moral influence on an absurd and unfair world. It’s a message of perverse optimism. The hero of the novel, Dr Rieux, battles to provide medical care in a futile struggle. At one point, he is challenged as to why he continues to work so hard in the face of no success in practice and in the absence of religious faith to motivate him. “His face still in shadow, Rieux said that he’d already Books on the brain Perverse optimism: how The Plague changed my life His story takes the side of the Capgras sufferer, imagining that they are not delusional, but instead lonely witnesses to a horror of which the wider world is oblivious: humans are being cloned by aliens. They look and sound like themselves, but are little more than husks, pod people with a collective consciousness and chilling lack of affect. If Finney’s prose style has often been criticised, his idea has been shown to have an evolutionary strategy every bit as robust as his aliens, growing into five film adaptations. Philip Kaufman’s 1978 Invasion of the Body Snatchers finds San Francisco scientist Elizabeth Driscoll (Brooke Adams) showing Capgras symptoms. Why is her partner, Geoffrey, acting so strangely? He seems cold, disconnected, not himself. She confides in colleague Matthew Bennell (Donald Sutherland) but his response (though kindly) is disbelieving. He suggests that she seek the counsel of psychiatrist David Kibner (Leonard Nimoy), who overrules Elizabeth’s fears. She’s not the first patient he’s seen with these symptoms, and he insists that the root of the problem is a breakdown in commitment—Elizabeth and people like her are seeking an exit from tired relationships. Kaufman is said to have offered Nimoy the role of Kibner because he felt he’d been typecast as Star Trek’s Mr Spock. Here, Spock’s rather loveable insistence on reason and logic are rendered oppressive, patriarchal. Kibner is probably the kind of psychiatrist R D Laing disliked, always insisting on empirical fact over lived experience. Psychiatry is part of the conspiracy: nothing to see here, back to your unhappy relationship. Soon, the pod people control the police, the civil service, even the taxis. There’s something elliptical and mysterious about Invasion of the Body Snatchers that makes it ripe for topical reworking. To some extent, what’s bothering Kaufman is what’s bothering the makers of all the great conspiracy thrillers of the 1970s, from Serpico to The Conversation to The Parallax View: government, corruption, surveillance, a sense of the odds being stacked against the individual. It is no coincidence that the pod people get you while you’re sleeping. Kaufman told Film Comment: “We were all asleep in a lot of ways in the 50s, living, conforming, other-directed types of lives. Maybe we woke up a little in the 60s, but now we’ve gone back to sleep again.” Yet what makes Kaufman’s Body Snatchers compelling is the personal. Elizabeth and Matthew are clearly in love, but he can only tell her his true feelings when it looks as though all hope is lost. As the film nears its end, the question that Capgras delusion poses—do you recognise the one you love?— becomes a kind of philosophical challenge, even an act of resistance. Love might not be enough to defeat the pod people, the conformists, Kaufman seems to suggest, but it’s all we’ve got. Laura Thomas United Artists/Sunset Boulevard/Corbis