On Dementia and Truth
In one of the most memorable scenes of Georgios Vizyinos’ story “The Only Journey of His Life,” the young narrator reunites with his grandfather after a long absence. They embrace, weep, kiss with emotion. The grandfather begins telling the boy his stories: about Dog-Headed creatures, about the land where the sun bakes bread, about the navel of the sea where the water spins in circles and ships sink; about the place where people are turned to marble; about the witch with the water of immortality. He speaks of all these things with great precision, reverence and gravity. The grandson has plenty of his own stories to tell, but doesn’t dare: the grandfather’s words seem more imposing, his vivid descriptions unmatched in the boy’s eyes. And he does not doubt their truth for a single moment.
Sometimes, in people living with dementia, we encounter something of this same inventiveness. There are those who, upon seeing any shiny or striking object, claim it as their own creation — and proceed without hesitation to construct entire stories with a beginning, middle and end: proud accounts of how they made it, how they use it, and to whom they plan to give it as a gift. Because for some people living with dementia, everything beautiful is destined to be given away.
“She’s making it all up, don’t listen to her,” warns a fellow resident. “All lies, every bit of it.”
In the dining room, among the other residents, we encounter another woman who every afternoon, at mealtime, cries out in alarm with dramatic urgency: “Did you hear? There’s been an earthquake! A big earthquake in Attica!” She calms down quickly, once someone reassures her — every time — that the earthquake caused no major damage, that it happened far away, that it’s over now, it’s passed.
Are the dramatic announcements lies? Are the proud narratives lies? Are the grandfather’s stories lies?
Freud, in his own search for truth, proposed two kinds of reality: “material” and “psychical.” The first concerns what is concrete, objective, measurable. The second, which Freud called “psychical,” has more to do with the representations that accompany each person’s subjective experience. Things certainly exist around us, but so does the way each person perceives and feels them. This psychical reality cannot be quantified or predicted.
If we try to approach these situations through the lens of psychical reality, truth and falsehood become relative. The claims of one person cannot be considered more true or more valid than those of another. Each person carries their own truth, and one does not cancel out the other.
We could, of course, say to all of them: “It’s all in your head.” We could call them fantasists or dismiss them outright. That would be the thankless role of “reality guard,” fighting at all costs to bring the person with dementia back to logic, to a commonly accepted reality. We could easily dismiss their words, attributing them to the dark progress of some cognitive deficit.
But that would not make the experience of those people any less real. One person genuinely believes that everything shiny and beautiful around her is something she herself has made. The anxiety and distress about the earthquake every afternoon is real. The grandfather’s convictions about all the terrible creatures lurking beyond the boundaries of the small village he never actually crossed are real.
Writers seem to speak to this same subjective truth. Isabel Allende, in her own way, says that “it is through the lie of fiction that the deepest truths are told.”
If truth is also the truth of the subject — unique and unassailable for each person — then who better to teach us about it than the person we call a dementia patient? Here is a clue for anyone wishing to avoid the easy solutions of dogmatism. Listen to the words of people living with dementia. Believe them, trust them. Ask not whether they are true or false, but how they function for the person who articulates them, what relationship they have to that person’s story.
Perhaps this is where the inexhaustible worldly wisdom of Vizyinos’ grandfather ultimately lies: subjective truth is always a search. It manifests only in fragments, remains permanently open, always under investigation — in a path that is humble, uncertain, complex.
And to those who never sat down to listen to the strange stories of their grandparents, or even their nonsense, hearing their truth with humility, perhaps we too might cry out:
“Oh, my soul! You have seen nothing in this life, nothing!”
