Why has a box, displayed at the Kochi-Muziris Biennale, left visitors perplexed?

The mirror box at Kochi-Muziris Biennale. (Photo: Rohini Mohan)

In one of the episodes of the popular American medical drama television series House (2004-12), Hugh Laurie as Dr House wheels a captive to a small box on a table. “This mirror box is neurological trickery,” he says. And that’s still proving to be true at the Kochi Biennale this year. A mirror box is playing tricks with the visitors as they wonder if "it’s an art installation" or some kind of "vaudeville equipment".

But what exactly is it and why is it displayed in an art show? The prototype mirror box, similar to what is seen at the Biennale, is the invention of Dr Vilyanur S Ramachandran, an American neurologist and distinguished professor at the University of California, San Diego.

By creating a visual illusion of two "intact" limbs, the mirror box allows the patient to "move" the phantom limb (which is actually the reflection of the intact limb) and to unclench it from potentially painful positions. The Mirror Visual Feedback (MVF) was so ingenious that it was quickly used to treat other disorders and disabilities like hemiplegia or cerebral palsy. Dr Ramachandran’s work was pioneering.

In 1995, at the second annual meeting of the Cognitive Neuroscience Society, he spoke of Steen, a 28-year-old worker whose phantom arm still felt paralysed, pressed against his body and aching terribly for 10 years.

Before the amputation, Steen’s brain constantly got information that his arm was not moving even though it was still there. After the amputation, he still felt the arm was there. Dr Ramachandran wondered that if it’s true that paralysis can be learned (by the brain) then how does one unlearn it especially when the arm isn’t there?

He constructed a simple box without a lid and placed a vertical mirror in the middle. When Steen placed his only arm into the box, he could see the mirror image of his missing arm. He was instructed to make symmetric movements with "both" hands and voila! his phantom limb was unfrozen. A relieved Steen took the $5 box home. After three weeks of the therapy, Dr Ramachandran received an ecstatic call from Steen. The phantom arm had finally gone!

What happened was that the mirror box told Steen that his arm was back and obeying his commands. But he was not getting feedback from the muscles in his "phantom" arm. Faced with tremendous sensory conflict over a period of time, the brain may simply ward off the signals saying "this doesn’t make sense" and stop.

Dr Ramachandran later went on to write, Phantoms in the Brain: Probing the Mysteries of the Human Mind (1998), where he described his findings with patients whose clinical experiences shed light on the working of the human brain. There are fascinating descriptions of human behaviour and the perceptions that seem mystical, magical or crazy and could arise from particular failures in parts of the brain. The mystical experience of seeing or even believing God? Well, the doctor calls it the fault of lesions in the temporal lobe of the brain.

His other book, The Tell-Tale Brain: A neuroscientist’s Quest For What Makes Us Human (2010), continued with instances of the strange malfunctions of the brain. He wrote about a man who, after a head injury, cannot recognise or respond to people when he sees them but can chat with them on phone, a woman who laughed instead of crying when in pain, about people with Capgras syndrome wherein they believe the others are imposters, and even about the unfortunate ones who desire to amputate their own limbs or, contrarily about those who refuse to acknowledge their limb is paralysed.

Dr Ramachandran’s narrative is rather spellbinding as he explains, in his books, several speculations about the working of the brain and neuroscience in general. His scientific lectures, available on the Internet, are equally interesting, especially the seven approaches on the belief in God.

Some of his speculations, like the "mirror neurons" or what he calls the "Gandhi neurons"  were rejected by the scientific community but Dr Ramachandran's name is synonymous with MVF.

But the mirror box became an art installation when artist Jitish Kallat curated a show late last year called "Tangled Hierarchy" in which various interrelated themes and ideas were woven together. The exhibition moved to the Kochi Biennale in December.

The mirror box sits along an axis that runs between the box of envelopes handed by MK Gandhi to Lord Mountbatten, and the trunks, which were essentially boxes carried by families as they moved borders between Pakistan and India. One of the tropes within the exhibition is the theme of amputation and phantom pain. “There is an analogy drawn between the severing of limbs and the drawing of borders that petitions the land, producing lingering phantom pain on either side. It is within this interlacing of body and border that lead to my placing the mirror box within the exhibition,” Kallat said. Dr Ramachandran was very helpful during the making of the exhibition copy of the first mirror box he had made but they have never met.

“Somehow, despite the fact that VS Ramachandran and I share a few common friends we never met in person. That said, we had a few long conversations over the phone and email, and he was very helpful during the making of the exhibition. I was keen to have one of the earliest versions of the mirror box and, with his help, we did.”

At the biennale, visitors have been spending time watching the reflection of their arm. “The mirror box looks like a magic box,” one visitor gushed. That it surely is!