Metaphrenia part 2


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Metaphrenia part 2

  1. 1. 10. THE ONSET OF PSYCHOSIS As with depressive, post-traumatic stress and bipolar disorders, psychosis too involves afailure of the dreaming function to cope with whatever may be the specific burden – of nature,nurture and circumstance – which may overtax it and trigger a psychotic break. In depression, the dream generator is under-active and inadequate; in post-traumatic stressdisorder it is over-active, distressed and agitated; in psychosis it is both: perpetually switchedon – even in waking hours – yet unable effectively to complete its nightly psychic house-cleaning. The actual lived subjective experience of psychosis feels very much like that of dreamingwhilst awake. As if in a dream, rebellious and the reach of voluntary control. This is thepsychoanalyst’s “irruption of unconscious content into consciousness.” It is quite natural tolook to the biological basis of sleep, and dreaming in particular, when probing the nature andcausation of psychosis. Underlying the psychotic condition, like the quake-prone and volcanic seabed the oceans, isa perturbation of the whole wake/sleep/dream cycle and its various stages, and eventually ourdream generator takes over even in waking consciousness. Typically our first warning of theonset of psychosis – whether reactive, bipolar or schizophrenic – is the increasingly delayednightly onset of sleep, and/or the early-morning waking that daily puts a premature end to ourdreaming cycle at its most critical stage of resolution. Sleep deprivation suppresses the REM-dreaming stage of hippocampal stem cell neurogenesis, already genetically compromised in theschizophrenic’s brain, essential for efficacious memory processing. Following its loss of sleep,the schizophrenic brain is denied the usual relief of rebound REM sleep. In addition, the dreamsof the ‘stabilized’ unmedicated schizophrenic are puny and ordinary and ineffectual incomparison with those of ‘normal’ college students. These are not so much unrelated symptoms as glimpses of the underlying cause at work.Something has gone awry with our sleep cycle at its very root, and for those of us endowed witha genetically susceptible dream generator, until it is reversed with post-synaptic dopamine-blocking medicine it will continue progressively to deteriorate until we are living a constantwaking-dream. At which stage, the ‘waking’ anatomical state of the schizophrenic brain showsa neural activation pattern remarkably similar to that of the ‘normal’ brain’s REM-dreamingstate. “Psychosis as waking dream” happens to be harsh corpuscular fMRI- and PET scan-evidenced fact, not just some quaint poetical metaphor… (An objection arises here, an apparent contradiction. If psychosis truly is a waking dreamstate – indeed, the anatomical equivalent of the normal REM state, how can it possibly behypothesised that psychosis is caused by a dreaming deficiency? Surely it is rather a case ofexcessive dreaming? He or she surely needs a shot of adrenaline to wake them up rather thaneven more sleep? A good kick in the pants, no less, to brighten up their ideas? This objection addresses the very nub of the problem: it’s not so much a case of needingmore sleep but better quality sleep. To revisit Philip Adams’ insightful metaphor, it‘s rather like
  2. 2. someone whose bowel for some reason is battered and incompetent: the otherwise nourishingaliment passes through it largely undigested, unprocessed and unabsorbed. You can actually seebits of raw food in those loose and unformed pastel-coloured foul-smelling faeces. The normal bowel hosts a wide variety of metabolic activities. Inter multa alia, a healthybowel is an integral component in the body’s systemic biochemical factory – in vitamin B andserotonin production. By taking measures we can vastly improve the situation: masticating ourfood more thoroughly thus saturating it with salivary amylase at the same time making it easierfor the gastric enzymes to do their work; avoiding gluten and other irritants in our diet if that is afactor; a seven day water fast or two; drastically reducing our drug intake, medicinal andrecreational; cleaning up our gut biota with antibiotics and then benign flora supplements, withits totally unexpected ameliorating spin-off on our allergies; exercising our body with yoga,weight-lifting and jogging, and other athletic activities; increasing the proportion of roughage inour diet – long & slow-cooked beans, whole-grains & vegetables; and so on. And if we arevery lucky – Voila! With problems like these, just taking in more food is only going to makethem worse. Although some of the parallels may immediately be apparent, the precisely correspondinganalogues in the developmental dreaming process are at this stage largely unknown, like life-forms on other planets, awaiting discovery. Already it is known they probably involvegenetic, developmental and abuse-induced brain variations including deficiencies in memoryprocessing by hippocampal adult stem cell neurogenesis, and the hallucinatory aberrationselicited by hair-trigger basal forebrain nuclei.) These sleep loss effects are interactive, reciprocal and cumulative. If a disturbance of thedream generator doesn’t initiate the early wakings, those early wakings and other sleepdeprivations will most surely play havoc with the whole wake/sleep/dream cycle, and soultimately with a genetically delicate dream generator. And so it goes… This can happen spontaneously. Or be brought on by overwork or chronic anxiety or burningthe candle at both ends and from its middle. Attend the meetings of Alcoholics Anonymous orNarcotics Anonymous and quite soon it becomes obvious from the shared testimonies that anearly casualty of any neurochemical addiction is sleep loss and its inevitably disturbed sleepcycle. We underestimate the aetiological role of sleep loss in serious disease precisely because weundervalue sleep as being when everything is switched ‘off’, rather than when essentialalternative cognitive modalities are switched ‘on’. For many, “Sleep is like a temporary death”rather than our nightly resurrection. (Robert Zimmerman) We have come so to hallow ourwaking rational conscious state and its civilised and interstellar achievements that Chuang Tzu’skoan seems merely witty sophistry rather than the cognitive scientist’s point of embarkation:“Last night I dreamed I was a butterfly. Or am I now a butterfly dreaming I am a man?” Our consciousness does not cut out when we fall asleep nor come online again with waking.It simply changes gear. Asleep or awake, the human brain is forever actively processinginformation and solving its problems. Even in reverie and daydreaming, the frontal cortex is
  3. 3. highly activated as it plays around with various options. Whatever its cause, sleep deprivation will generally be the first recognisable step of a descentinto psychosis. Not just a symptom, but an early step along the way for those of us with asusceptible dream generator; indeed, in many if not most cases, the initiating and precipitatingcause of the whole psychotic process, the underlying cause at work… Of course, schizophrenia involves global brain-wide neural deficits and impoverishment,evident when construing the emotional intent behind facial expressions and tones of voice,paraphrasing proverbial wisdom, interpreting the revolving ‘hollow mask’ illusion and so forth.Whereas psychotic activity itself is not so much a whole-brain condition as it is a more localisedcondition confined to the dream generator (scilicet its basal forebrain nuclei in particular) whichcan strike almost any brain given sufficient stress and sleep deprivation. Deprive pretty well anyone of sufficient sleep, and they will go crazy. Eventually they’lldie. The annals of our race are replete with many such anecdotes. Guantanamo Bay was basedin no small way upon this inflexible law. During a controlled experiment in 1959, seven healthymedical students who kept awake for 72 hours – just three days – developed a variety of egodisturbances including feelings of depersonalisation, confusion, hallucinations, paresthesias,motor incoordination and various subtle psychological changes. That none developed floridpsychosis was attributed largely to their benign, socially supported surroundings at the time –the experiment was conducted in the safety of a fully staffed hospital ward. Nor is the psychotic experience always bad news. It can be a neurological odyssey of growthand development, a psychological perestroika that taps into previously inaccessible wellspringsof creativity. Witness for example the radical difference in the paintings executed byinternationally renown Scottish-Australian artist Ian Fairweather after his lone eighteen day-and-night voyage, 900 kilometres as the tern flies, across Timor Sea from Darwin to theIndonesian island of Roti in 1952 at the age of 61; adrift on his crude makeshift raft, duringwhich he experienced a full-blown but fortunately brief psychotic episode punctuated withbizarre delusions and phantasmagoric hallucinations. A cursory glance at an atlas reveals that hemade landfall at all, and was not swept out past that final insular outpost into the vast IndianOcean to shrivel and die and feed sharks, was in itself seemingly miraculous. “Those whom theGods love, they send crazy.” (John Steinbeck) From which “act of symbolic suicide” (Christopher Allen) he emerged ultimately to settleon a Bribie Island beach, accomplishing in his bark hut innovative paintings characterised by astartling degree of imaginative symbolism and unfathomable abstraction until his death in 1974.Noticeably absent from his post-crisis work are the subtle sensuality and haunting beauty of hisearlier art. But psychosis can be a harsh mistress: if you haven’t got what it takes, it can take whatyou’ve got. “He who has not, even what he has will be taken.” (Jesus of Nazareth)
  4. 4. 11._ THE WAKING DREAM STATE OF PSYCHOSIS Unlike many paranoid psychotics, rather than religious, my delusions appeared to me strictlypolitical in character. I felt that novels like Brave New World and 1984 hinted at the ‘real’story. All history was a created phantasy. Shakespeare – all published writers – were eitherfictions created by Big Brother and the politicians, or an integral part of ‘the plot’. I was thereincarnation of Ned Kelly, and Prime Minister Malcolm Fraser was my chief adversary. Ourmain issues concerned aboriginal land rights and uranium mining. The all-consumingresponsibilities of these onerous tasks exhausted me daily. Delusions about my parents surfaced mainly as members of the medical profession. Myfather was a tragic hero. During the war, he was an army pathologist who inter alia treated theafflicted soldiers. The world was one big brothel, so he was pretty damn busy. Our street washome to many retired prostitutes, whom it was my mother’s job to nurse. Reproduction wasdifferent from what was commonly thought – women were impregnated by powerful men, andtheir husbands were the ‘patsies’ who, for suitable favours and appropriate compensation,looked after the wife and her offspring. My father had been an outcast in his profession, and the death-dealing melanoma on his nosewas caused not by the sun, but by radioactive nose-pads installed on his spectacles by hiscolleagues, enraged at his unimpeachable integrity. It was beyond belief that I was son & heir tothe noble Dr Jakananda. My biological father was his younger brother, my much-loved UncaBill. Distant wars and international events did not really happen, but were a vast sideshowimprovised by the powers-that-be to divert & enthral & control the multitudes. Photographicevidence of the Holocaust was not real, but an artefact of some ministry of propaganda. WorldWar Two did not really happen; no one died in battle. Only from venereal disease. Chance coincidences seemed particularly real and meaningful because statistically themathematics were so against them happening. I was acutely conscious of the unelected kingshipof me, the underdog. Eventually my wake/sleep cycle reversed so that I was awake all night andasleep all day. There was a video camera concealed in my bedroom’s ceiling relaying my everymove to Command Central, and wherever that was, it was everyone, apparently. My life was apublic document. Nothing was private: The Truman Show as a matter of daily reality. That’sexactly how paranoid psychosis appears to the subject. On a small portable typewriter, a sturdy little German Adler Tippa, I regularly foundtemporary relief committing acts of rhyming doggerel to paper, of which the following is arepresentative sample: PEACE! (Circa 1977) For thirty odd years We’ve had pax pepsicola Succeeding the tears
  5. 5. Of pax toga and bowler Bringing nuclear fears And unfreezing packs polar. My life overflowed with meaning. Everything had its own special significance. Just for me.Especially words and songs and music. A signpost reading “Napperby 6 Kilometres” became anominous “Six kill, or meet her.“ (If I do not meet her train, somewhere six people will die as aresult.) In its 364 words, Samuel Taylor Coleridge’s opium dream-transcribed Kubla Khanconjured up an erotically charged alternative universe. As my condition deteriorated, I developed a strong anger toward my longsuffering mother,who I felt was intentionally frustrating my ‘development’. Weeks before my inevitable totalcollapse, precipitated finally and suddenly by the abject terror a dose of non-specific urethritisgave rise to, I insisted that my mother leave the family home. She did. Subsequent to my eventual hospitalisation, and an atypical feverish reaction to chlorpro-mazine in my testicles due to the NSU, I thought that the antibiotic a GP had injected was reallyradioactive testosterone, designed to produce testicular cancer. Like father, like son. Death. This nightmare mostly cleared up within a few months of commencing chemotherapy,although thioridazine made me feel dreamy, and I thought it might be marihuana. Till the dailypanic attacks started again, that is, successfully distracting me from that surely waning fantasyworld. There were, of course, the more usual delusions such as coded messages just for me fromradio, television and newspapers; people reading my thoughts, and hypnotising me; infantilismand megalo-mania. And violent mood fluctuations, which had raised a possible diagnosis ofmanic-depressive psychosis. But fortunately, no voices or hallucinations. Morbid fears that Ihad been infected with syphilis, and of a slow lingering death from general paralysis of theinsane, continued to haunt me for several years. This conflated 1975/1977 episode was the penultimate in a series of five psychotic reactionsin a paranoid direction between 1969 and 1990. Like any cognitive-emotional process, thepsychotic journey is driven by its own internal logic with a life of its own. As a spontaneousproduct of the unconscious via the dream generator, the psychotic odyssey is as amenable toanalytical interpretation as any daydream, fantasy or big dream. Whilst such an enterprise isbeyond the scope of this monograph, the work of Dr John Weir Perry maps out how one may goabout navigating that bedevilled archipelago under one‘s own canvas.
  6. 6. 12. RECOVERY “Before the medication,” as my Uncle Bill bluntly reported, “people either stayed mad, gotbetter, or killed themselves.” The first antipsychotic drug was discovered in 1952 in Vietnam bya French doctor trialing the synthetic dye chlorpromazine as a treatment for hay-fever. He notedits tranquillising effect, and five years later Largactil began changing lives and clearing outmental hospitals and saving governments billions of dollars. Basically, a major tranquillisertakes the edge off and resets an uber-active dream generator. The remedy for psychosis is the maximal normalisation of the wake/sleep/dream cycle. Thistranslates into titrating the optimal dosage of the appropriate dopamine blocker, together with adetermined cultivation of an active, vigorous and energetic waking conscious life. Thenormalising of the dream function that accompanies chemotherapy’s recovery is usually seen asa symptom of stability, a result of recovery rather than an underlying cause. It is both. Antipsychotic medicine works by blockading the psychotic dream generator’s excessivedopaminergic activity, thus ending the waking dream phenomenon, at the same time as itrestores acetylcholine activity and thus full-potency REM-sleep. There is a reciprocalrelationship between these two neurotransmitters: “Dopamine normally suppresses acetylcholineactivity.” (Associate Professor Stephen Stahl) The schizophrenic brain’s excessivedopaminergy dampens its cholinergic activity, thus dampening REM-stage sleep’s dreamingactivity. Neuroleptic medicine removes this brake. In the former circuits, the medicine acts as a chemical straitjacket on the dopaminergic dreamgenerator but unlike leucotomy, achieves this in a measured reversible fashion, controllable bydosage, without at the same time destroying entirely and irreversibly the dreaming function. Inthe latter circuits it brings on the lengthy sleeping often associated in the early stages with thesemedicines. The former effect is the central therapeutic agent of recovery, the latter a side effectwhich can be both help and hindrance in recovery. For therapeutic REM-dreaming sleep to occur requires, like micturition, defecation ororgasm, a subtle balance of normally antagonistic neurotransmitter activity. In general, toomuch aminergic activity precludes the onset of REM-sleep dreaming. An overstimulated dreamgenerator suppresses sleep, REM-stage sleep in particular. An under-stimulated generatorcannot muster sufficient dopaminergic intensity to stage normal developmental REM-dreaming.Too much dopamine-blocking medicine may inhibit the fullest expansion of the dream generator,risking an adynamia almost as severe as leucotomy’s, though not as permanent; not enough canlead to relapse. In the research literature, the effects of antipsychotic medicine on REM sleep are as yetsketchy and inconclusive. Evidence suggests that in healthy volunteers, these effects vary withthe subject’s capacity for rebound REM sleep, and are dosage-dependent. Subjects with thesmallest REM sleep rebound following REM sleep deprivation experienced a reduction of REMsleep after antipsychotic medicine administration, while those with longest rebound REM spansexperienced an increase. (The reader may recall that schizophrenics have not only shorter, butno rebound REM.) Again in healthy volunteers, a lower dosage of the medicine increased REM
  7. 7. sleep, whereas a higher dosage decreased REM sleep. These cryptic results suggest tentatively that for the schizophrenic brain, the lower theeffective medicinal dosage, the better for REM sleep and thus for REM-dreaming. Fortuitously,for lasting compliance, this also coincides with the compelling need to minimise the medicine’soften drastic side effects. It is crucial we get the dosage right: so often, the only difference between a tonic and a toxinis purely a matter of dose. Some toxins – lead, mercury, asbestos or tobacco – the only safedosage is zero. The fullest benefits of neuroleptic medication are locked into just the rightamount of it, and everything else. “All things in moderation.” (Audine Adelaide Andrews) The subsequent research and development of a later ‘generation’ of improved antipsychoticmedicines regulating serotonin activity as well as dopamine’s may well reflect the schizophrenicbrain’s recusant tendency to involve non-REM sleep stages in its elucidation of developmentaldreams, as well as the more normal REM stage. In NREM sleep, some level of serotonergicactivity still continues to subsist, which ex hypothesi also requires medicinal modulation if ourdreaming is to be restored as much as possible to full vitality.13. PRACTICALITIES The trajectory of our recovery will largely be determined by, and either be limited orliberated by our attitude. In my final high school year, our English teacher commenced with thedisconcerting announcement that he wasn’t going to teach us to get a good examination mark,but rather to enjoy our reading and to think intuitively about it. If we did that, he assured us,the good mark may well follow. But that wasn’t the point of the exercise. Mark ‘Roo’ Ricciuto‘s coach once commented that the former Adelaide Crows star’s crucial talent was the way hecoped with injury. Setbacks are inevitable. They are part of life for everyone. It’s not ourneurophysiological peculiarity that defines us, so much as how we respond to it. It has beenfound that “spontaneous remitters from cancer almost invariably say they weren’t shooting somuch for a cure, but rather to live congruently at last with their inner values“. It helps if we seeour own setback as no different from Barack Obama’s African skin colour in a racist world, orHelen Keller’s blindness in a seeing world. The same program applies to everyone: “Whenyou’re going through Hell, keep going.” (Winston Spencer Churchill) We may be assured of the broad compass of our recovery when regularly we go to bed eachevening, not too early, not too late, and fall soon fast asleep pleasantly wearied from oureventful day, waking not less than six hours thereafter. Ideally, between seven and eight hours.Whether we choose then to wander along quiet suburban tree-lined avenues, or go walkaboutthrough parklands and along deserted bush fire tracks, or explore the main roads and fly-oversof a buzzing global metropolis depends entirely upon our own predilections. But our overridingconcern must be to maintain this hard-won and ever vulnerable circadian rhythm: to keep thenight shift obliviously busy at its indispensable duties. Maybe some people can live fast and loose, ignoring the insistent demands of their body
  8. 8. clock. Not us. Judy Garland, Howard Hughes, Marilyn Monroe, Elvis Presley, HeathLedger, Michael Jackson and countless others have perished in a sad and futile quest for whatwe now have. It is a precious gift we cannot afford to take for granted. Our freedom, our sanity,even our very life depend upon it. We learn to paraphrase the words of Nicholas Copernicus: Ifwe face facts with both eyes open, finally we will place sleep at the centre of our psychicuniverse. There are various practical measures we can take, both to establish this auspicious rhythm,and to maintain it into the future. First and foremost, we take our antipsychotic medicine.Religiously. Every night at the same time. Without exception. A medicine like haloperidol doeshave a long half-life, but depends for its efficacy on nightly topping up. Over the months andyears and decades, assiduously we work away at finding our own effective minimummaintenance dosage, which can change with our years and their habits. For haloperidol, thegenerally recommended minimum maintenance dosage seems to be 2 mg nocte. (For mepersonally, less than 3 mg and symptoms begin to re-emerge; a dose of 5 mg or more and theimploding excitation/panic attacks return as surely as the monsoon rains in June.) We should beno more self-conscious or ashamed of this dependence than any kidney patient who needs theirregular dialysis. Next, physical exercise. People on antipsychotic medicine tend to put on weight. And it cancontribute to the onset of type 2 diabetes. Cogent reasons in themselves to make exercise anecessary part of our day. But these aside, there is nothing like tiring out Brother Ass withplenty of exercise to ensure he then seeks plenty of sleep. We inherit our bodies from organismswho evolved by running to catch the food which then grew their brains. Not sitting around allday and night at a computer keyboard, or reading books, or watching telly. If at the same timewe learn new motor skills, or simply follow a different route for our geoneurographical morningforay, giving thereby our dreaming memory circuits the satisfying connatural work they thriveand grow on, we quadruple the benefit. Giving our mind regular memory work does have a flow-on stimulatory REM-dreamingeffect. Our REM-dreaming sleep tends to expand, both quantitatively and qualitatively, toembrace the increased demands of our memory and learning work. Acquiring a secondlanguage, learning the periodic table, to touch type or to play a musical instrument – the rangeof possibilities is limited only by our imagination, our curiosity and our willingness. The simple daily and costless exercise of memorising key paragraphs from our favouritebooks is immensely enriching and rewarding, in so many ways. Of necessity this elementaryexercise engages not only our conscious mental processes in a most intricate fashion, but alsoour REM dreaming circuits as the night shift then integrates our work. As our dreaming brainmakes these different and novel connections, and we subsequently refresh our memory, wecome to appreciate previously hidden and unseen depths in our most cherished texts. Like ouruncles and grandfathers, we become a living book, an anthology of textual prime cuts with twolegs and a heart beat, and discover for ourselves that “Memory is the treasure house of themind.” (Buckminster Fuller) “A good memory is surely a compost heap that convertsexperience to wisdom, creativity, or dottiness…” (Michael Leunig) Our sleep can play a vitalpart in this organic process, but like damsel fair, it often needs attentive wooing.
  9. 9. It is perhaps in our relationship sphere that our daytime work shows up most in our dreams.We discover fresh angles and new dimensions that fill out, recast and renew the way we viewand relate to our loved ones. And even, God bless ’em, to our enemies. As our schizophrenic brain gears up to live a more intense and complete life, the nocturnaldreaming component of its equipment also gears up a notch or three. We discover a new world,initiate new dimensions of consciousness. All we have to do is “Keep busy!” as a localoctogenarian GP keeps telling me. Just how we achieve that end really doesn’t matter. That is amatter for our legitimate passions and ambitions. According to our own conscience and itsvalues. We shouldn’t be too surprised to discover that the dream generator responds developmentallyto our critical needs of the moment, and equally to our passage through broader life transitions.Nor that it is embedded in the rhythmic world of Nature, tied to the phases of the Moon, to thefour Seasons, to Equinox and Solstice. (They don’t call us “lunatics” for nothing.) Apart from a very occasional one-off emergency benzodiazepine, the only drugs we need toexperiment with are valerian capsules for episodic insomnia and maybe now and then a sporadictablet of homeopathic melatonin 6x just before bedtime, to ginger things up a wee bit. Theneurogenerative and educational benefits of cannabis are dangerously outweighed by its longer-term and typically disturbing effect on our thinking, our mood, and above all on our sleep cycle.We think before we drink. We take respectful care of a brain that doesn’t need such drugs, at thesame time ever mindful that “A little bit of what you fancy does you good; and half as much asyou get older.” (Phyllis Irene Tehan) Unless of course we are an alcoholic or an addict, whenusually our only remedy is total abstinence consequent normally upon “an entire psychicchange.” (William D. Silkworth, M.D.) Psychologists generally recommend the practice of ‘sleep hygiene’ for people with a sleepproblem: our bed is reserved for nighttime sleeping only. No cola or coffee, or any caffeine,after 6 pm. Some say a brief burst of vigorous exercise or a hot bath ninety minutes before lightsout helps to ensure our body’s temperature is dipping appropriate to induce sleep by that time.Others say to wind down and relax...14. HOOPTEDOODLE: AN EVOLUTIONARY DANGLER? These days dreams seem to play a much less important role than for our evolutionaryancestors. We have our science, technology and industry to solve our survival problems – andcreate even more. We have our organised religions to give us our ready-made myths to live by,pre-digested by the Rishis, Moses, The Buddha, Confucius and Lao Tse, Christ, andMohammed, and by our local preacher’s weeklysermon. We have Johann Gutenberg’smarvellous invention, and the Holly/Bollywood dream factories, to educate and entertain us.Thanks to William Gates, anyone can now publish and disseminate their work, like this,straight from their own desk. We have turned our nights into day with electricity, making eighthours’ sleep an optional choice rather than our ordinary course, obscuring with street-lighting inour ever-encroaching cities the nightly empire of the stars.
  10. 10. Indeed, it could well be argued that our dreamlife has outlived its evolutionary role, ofrelevance only when it malfunctions in depression and post-traumatic stress disorder andpsychosis and so on: that our dreams, like our appendix and our wisdom teeth, are mereevolutionary danglers. But for vast aeons of our history, when our brains were being evolved, itwas not like this. There are those too who say our complicated cultivated minds are a beautiful exotic mate-attracting efflorescence, but an incident on a sub-antarctic rock in 1875 suggests that ourprimordial ancestors developed our complicated neural networks for more prosaic, more heroicreasons: the grim ingenious task of eking out a basic diet in an uncertain, often bleak and hostileenvironment. Hundreds of thousands of years before homo sapiens applied their brain’simagination circuits to creating religious art in the caves of Lascaux or their sculpted ikon of theGoddess of Willendorf in Europe’s lush green valleys, these neural circuits were being sculptedas he and she struggled ingeniously to eke out an existence on the oft drought-blasted Africansavanna. The good ship Strathmore set sail from London on April 17 1875, bound for New Zealand,bearing 88 passengers and crew. At 4.30 am on June 13th, the ship struck and was wedgedbetween two rocks outlying the Crozet Islands group, in sub-antarctic waters almost 2,000kilometres South South-East of the Cape of Good Hope. Forty nine survivors made it in twoboats to a nearby ‘island’ - a large high extensive inhospitable and barren rock, half a mile long,bearing but little soil, growing only sparse grass and weeds, affording absolutely no firewoodfor warmth and cooking, inhabited only be various seabirds. Among the survivors were 49 year-old widow Fanny Wordsworth, and her son Charles. For the next seven months, life for these people was a daily struggle for bare survival as theyeked out a basic diet of grasses, and birds and their eggs, and strove to cook and make edibletheir simple hard-won fare. They were living an experiment of nature, living the very same lifetheir primordial ancestors had lived, daily facing many of those same basic survival threats,with but a few basic implements to assist them, one box of safety matches and some wood, andonly their nightly dreams to sustain them, apart from a copy of the Bible and a set ofRosary beads. Diarrhea and dysentery were their constant companion. Indeed, their wakinglives were nasty and brutish and – without the hoped-for rescue – likely to be short indeed. They must have been made of stern stuff. The way survivor-descendant Sophie Haisman tellsthe story from extant records, mainly the writings of her Wordsworth forebears, there were twocrucial turning points. Each day, according to the annual migration cycle, albatross andstinkpots, then molly mawks and finally penguins were clubbed, skinned and cooked as theirmain diet. When they ran out of firewood from the ship to cook them, by a happy experimenttheydiscovered the fatty bird skins made good fuel. Good enough for cooking and a little warmth,leastaways. And bird wing fat was good for light at night, too. When the supply of albatrossran out, and things looked grim, one morning Charlie Wordsworth discovered the molly mawkswere laying enough eggs in their nests to feed them. Whether these life-saving inventions wereprefigured in dreams is an unknown detail.
  11. 11. What is known is that in an almost total absence, apart from fond nostalgic memories, oftheir former nurturing domestic culture, their nightly dream life took up the slack and filled thegap, softening their otherwise unrelenting hardship. Their sojourn began in mid-winter, withicy nights fifteen hours long at that latitude. In the absence of alternative entertainment, therewas plenty of opportunity to dream. And dream they did. Ably their dreams took over the former place of art and literature, church, newspapers,music hall and theatre, guild meeting and their other wonted sources of entertainment,education and edification. Deprived of these resources, simply for lack of anything else, theirdreams came to serve as their de facto culture, along with their food-gathering, cookingetcetera. It is easy now to see how dreaming became so central to the community life of thenomadic hunter-gathering Australian Aborigine. It is fitting tribute to their psychological health and pioneering hardiness that their reporteddreams at least were clearly a successful compensatory mechanism which balanced the gruellingcircumstances of their waking lives, so that they faced their days mentally fresh and in a goodframe of mind for the day’s struggle. Early in Charlie’s daily schedule was a visit to the other shanties “and getting the latest newssuch as a new yarn or a dream. Any interesting ones were retold to my mother.” (CharlesWordsworth) “We all had the most vivid dreams of home or things to eat or ships come to rescueus. When we awoke in the night we invariably asked each other what we dreamt.” (FannyWordsworth) “Our dreams were generally of food in some shape, but there was always a feelingin the background that spoiled these dream feasts.” “Having dreams was quite like a letter bypost, for they took our minds off the island enabling us to forget our miserable circumstances fora time. Dreaming was by far the pleasantest part of our existence on that miserable island.”(Charles Wordsworth)15. ‘THE DELUSIONAL CONFABULATOR’ Much of our ‘normal’ everyday thinking and interior conversation doesn’t stand up to thescrutiny of an objective observer. Our workaday minds are not the infallible soothsayers we takethem to be. So often, we all confuse the eclectic whimsy of our personal culture-drivenpreferences for moral absolutes. It’s the human condition. To the traditional Christian, thefundamentalist atheistic scientist is delusional, and to the atheistic scientist fundamentalistChristianity is a pernicious sub-species of wilfully blind fanaticism. The personalist bhakti is atodds with the impersonalist jnani, and vice versa. The mind-set of a Liberal party voter and aLabour party voter are mutually alien, both agreeing however that any minor party is theircommon enemy. “Two men say they’re Jesus – one of them must be wrong.“ (Mark Knopfler)And so it goes… From someone else’s antagonistic viewpoint, each and every one of us is irredeemablywacko. Who’s to say who – if anyone – is ultimately right? There are those armed with acoercive power to enforce their viewpoint, but that doesn’t necessarily make them right. Orwrong, for that matter. “It tain’t necessarily so...” (George Gershwin)
  12. 12. If our neighbour – in Lord Atkins’ usage of that word – happens to be obtrusively ‘different’in some way – say muslim, or mentally ill, or gay, depending upon the peculiar bent or latestfashion of our endogenous xenophobia – we are even more likely to jump even more quickly toour erroneous conclusions. Once our brain has affixed to someone or some viewpoint itspreferential status diagnosis, whether laudatory or denigratory, it tends thereafter intransigentlyto constellate all subsequent data about that person or viewpoint so as only to confirm its initialall-or-nothing one-dimensional kafkaesque textbook caricature, rather than a more complex andfluid balancing model appropriate to the usually confusingly ambiguous reality. We misinterpretall they say and do… Life becomes a conversation in an old Ealing Studios’ farce where twopeople converse completely at odds, from different planetary systems, whatever eitherinnocently may say only amplifying the other’s direst fears. Research with split-brain folk suggests that much of our self-talk is generated by what mightmore appropriately be called ‘the delusional confabulator.’ When the left split-brain hemisphereis isolated and asked the reason for an assessment the right brain made, which may well be anappropriate one, it comes up with something it may find plausible and even invincible, butwhich to an informed observer is clearly spurious. To a reassuring extent, this is largely an artefact of the split-brain condition: the brain’sbicamerality is severed when a cut is made through its corpus callosum in an operation to relieveepilepsy. And with it go the copious connections between the two cerebral hemispheres and theircontrasting, complementary capacities. Which defect is largely irrelevant to an intact brain. But not entirely irrelevant. More recentresearch on otherwise normal people suggests that their brain arrives at its subterranean choicesand emotional opinions, and then milliseconds later, quite unwittingly it fabricates theirunassailable rationalisations justifying these otherwise inscrutable behaviours. This is BlaisePascal’s mind which wots not of the heart’s true reasons, Freud & Jung‘s distant but immanentunconscious. Clearly, there is more going on here than meets the eye. As the birds are not conscious of theair that supports them in their flight. Nor fish of the water in which they live and move and havetheir being. For lack of a closer, more explicit knowledge, homo sapiens often falls back onstock shorthand terms like ‘Soul’ & ‘Spirit,’ ‘Being,’ ’Self,’ ‘psi phenomena‘ & ‘the collectiveunconscious,’ ‘Tao,’ ‘Brahman’ & ‘Atman,’ ’Suchness’ & ‘Buddha nature’ and so forth… As yet our scientific method cannot even be sure of the extent to which REM sleep isnecessary for memory consolidation. Or elucidate as yet the underlying mechanisms wherebythis might be accomplished. There are enough unanswered questions here to keep researchersbusy for the next five hundred years, and still no guaranteed agreement on anything basic.About as promising as dissecting out a collection of Basho’s haiku with a microtome. Like Charles Darwin, “I see no good reason why the views given in this volume shouldshock the religious feelings of anyone,” be those sensibilities devoutly agnostic or traditionallyChristian. Like the composer of Origin’s concluding thirteenth canto, I take for granted a“Creator” behind it all. This brief excursion is quite consistent with the words of Pope Pius XII:
  13. 13. “If the human body takes its origin from pre-existing living matter, the spiritual soul isimmediately created by God.” What this inquiry daffynitely does assert, however, is that the true nature of whatever‘energy’ it is may survive bodily death – what His Holiness terms “the spiritual soul” - and itsrelationship with the living body and in particular the conscious brain, is quite quite differentfrom anything that homo sapiens can possibly conceive of, by the lights of any extantcosmology, be he or she Angelic Doctor or the discoverer of evolution through natural selection.Nor upon their return are those subjects who have temporarily left behind their lifeless cadaverand actually experienced “the spiritual soul” (whatever it is) at first hand in near death able toexplain it any better, secundum humanum nostrum modum concipiendi. The use of words like ‘soul’ or ‘atman’ can only feed the comforting delusion that an earth-bound human brain has even an inchoate understanding of a mystery that is as yet totally beyondits ken. “The Tao that can be named is not the constant Tao.“ (Lao Tse) Equally sad is thedelusion of those who dismiss out of hand the now well-attested phenomenon of the near deathexperience and its life-changing reverberations. The upshot is that homo sapiens is left free to roam parliament and the courts, newspapereditorial offices and television newsrooms, our homes and the streets, with these cavalier spin-doctoring circuits in our left cortex determined by evolution not to let the facts get in the way ofa good story, of a convincing narrative. Especially when powerfully motivated by survival andself-interest and personal advancement. (In a Freudian framework, the confabulator becomesthe enthusiastic script-writer to a hungry inflated self-aggrandising ego, which the evolutionarypsychologists tell us is driven by the territorial imperative‘s expansionist agenda.) Thus presidents declare war, popes pronounce against contraception and condoms, physicistspostulate an ultimate anarchic chaos, orthopaedic surgeons decide to operate, magistratesdecline bail, and “wretches hang, that jurymen may dine.“ (Oscar Fingall O’Flahertie WillsWilde) All the while sincerely believing we are impeccably right and acting with the highestintentions; any lingering self-doubt constrained by a necessity that knows not law. Between our lunar dreaming and our solar confabulations plunges a bottomless chasm,affording only vaporous foundations to foot an invulnerable meaning to life. At its very best,our metaphysic will amount to no more than “whistling in the dark.” (Soren Kierkegaard) Thegreatest courage is the courage to be happy. (A saying in Ladakh) All of us, every single one, each in our own way, is mad. Not certifiably so. In a world ofequally insane persons, our everyday delusions routinely pass muster as common sense. Onlythe symptoms vary, some more common than others. We are all too inherently noble, equallycapable of arousing that true grit our destiny may require of us at any moment. If “humility is endless,” it’s because so too is our limitless capacity for delusion, andaccepting this stark reality requires the utmost humility. (Thomas Stearns Eliot) A good sense ofhumour doesn’t go astray either – the ability to chuckle at our own ridiculosity. To paraphraseand misapply some words of Rabindranath Tagore: “This truth comes as a conqueror only to
  14. 14. those who have lost the art of receiving it as a friend.” It scarcely needs to be mentioned in passing that it is obviously a routine matter of theoperation of the immutable axioms of ordinary logic that the foregoing monitory paragraphs ofthis Section 15 herein apply as much to the entire contents of this periphrastic pot-pourri as toany other verbal perambulations of homo sapiens. Indeed, with my erratic history, doubtlessthey apply here more than to most...16. ARIADNE’S THREAD: PERHAPS AN ANTIDOTE? Zen Buddhism wisely advises against us holding too many opinions. “Transformations going on in an empty world which confronts us Appear real all because of Ignorance: (our delusional confabulator) Try not to seek after the true, Only cease to cherish opinions.” (Seng-t’san) But this doesn’t mean the way of zen is in any way nay-saying or life-denying. Rather, zenaffirms living life instead of merely thinking and talking about it, as Edward Jenner and hisantecedent mentors advise us: “Don’t think – Experiment!” Zen gracefully sidesteps our deceiving confabulator by bringing us directly to our senses.“The most important point is to own your own physical body. If you slump, you will loseyourself. Your mind will be wandering about somewhere else; you will not be in your body.This is not the way. We must exist right here, right now! This is the key point. You must haveyour own body and mind. Everything else should exist in the right place, in the right way. Thenthere is no problem.” (Shunryu Suzuki Roshi, emphasis added) Zazen practice, bare mindfulness of the aesthetic delight within the ever-present breath, iszen’s recommended methodology. “When we practice zazen our mind always follows ourbreathing. When we inhale, the air comes into the inner world. When we exhale, the air goesout to the outer world. The inner world is limitless, and the outer world is also limitless. We say“inner world” or “outer world,” but actually there is just one whole world. In this limitlessworld, our throat is like a swinging door. The air comes in and goes out like someone passingthrough a swinging door. If you think “I breathe,” the “I” is extra. There is no you to say “I.”What we call “I” is just a swinging door which moves when we inhale and when we exhale. Itjust moves; that is all. When your mind is pure and calm enough to follow this movement,there is nothing: no “I,” no world, no mind nor body; just a swinging door. “So when we practice zazen, all that exists is the movement of the breathing, but we areaware of this movement. You should not be absent-minded. But when we follow thismovement, we are not aware of our small self, but rather of our universal nature… This kind ofawareness is very important, because we are usually so one-sided. Our usual understanding oflife is dualistic: you and I, this and that, good and bad. But these discriminations arethemselves the awareness of the universal existence: “you” means to be aware of the universe inthe form of you, and “I” means to be aware of it in the form of I. “You” and “I” are just
  15. 15. swinging doors. This kind of understanding is necessary. This should not even be calledunderstanding: it is actually the true experience of life through Zen practice.” (Shunryu SuzukiRoshi) Traditionally in zazen practice, this “swinging door” effect centres on the hara in thesoft floating belly, just below the navel, as gently it rises and falls while we breathe in and out. What can be simpler than this? Try it, though, and soon we discover how the confabulator,our own Lone Deranger, as if true to our simian origins, continues to leap and swing like anorang-utan from synapse to synapse, as it ranges restlessly through its dendrite jungle home ofgrey matter and supporting glial cells, no matter our vain attempts to leash it. Small wonder inthe East, they call this “monkey mind.” Perhaps Suzuki Roshi’s truly great contribution is his restatement of the idea thatenlightenment is not some elevated state we might or might not one day attain to if only wemeditate long enough and hard. Enlightenment is what we experience here and now in ourordinary everyday zazen practice. Which will be both different and similar for each of us, at ourown individual stage and rate of ‘development.’ The goal is not enlightenment. The goal issimply more zazen, for its own sake. “We practice zazen to express our true nature.” (Suzuki) Should we persevere in this edifying pursuit, we may well be taken in surprise byunforeseeable illuminations from this simple mindfulness pranayama. At very least, we mayconfirm the truth of William James’ observation: “The faculty of voluntarily bringing back awandering attention, over and over again, is the very root of judgment, character and will.” Onanother level, zazen transforms the simple process of respiration into a high-grade aestheticexperience. When we become established in our meditation practice – and it has many possible formsbesides zazen, at least 108 according to the Hindus – it makes its havening abode alongside ourdream life and our intimate relationships as a ‘safe place’ to process our emotional life anddissolve our resurgent inner conflicts, also largely ex opere operato. In an ever-changing world,our meditation practice comes to be a rock of stability. One we can access on our own accord, atany moment. Time and again, we come home to soft belly, just letting it all go… Always gently,effortlessly. Never forceful or insistent, for instead of dissolving them, we may repress theconflicts, only to have them come back stronger and brand us on the bum. Or bite our lovedones on theirs. One thing is certain: if you do the meditation, the meditation will do you. We come to seethrough this delusional confabulator as the transparent imposter it truly is, in ourselves and ineveryone. We recognise the need to respond to this universal and uniquely human condition withan endless compassion. Everyone has their own story, and it drives the plot-line of their life“with the inexorable inevitability of a dream.” (Joan Didion) In hoc est mysterium humanaevitae. So begins our real work: Just listening... And echoing with an unblocked heart... Oneswinging door to another… As an elderly Canadian sadhu from Shivananda Ashram up on the hill by Laxmanjoola Bridge
  16. 16. said to me in the Railway Road, Rishikesh branch of the State Bank of India one sunny Octobermorn in 1991, while we were waiting to cash our traveller’s cheques: “Maybe thepurpose of meditation is to help us live with the Mystery.” Or as Lex Luthor says: “Anotherman can pick up a chewing gum wrapper from the sidewalk and find the secret of the universe.”“Once a certain degree of insight has been reached,” said Wylie, “all men talk, when talk theymust, the same tripe.” (Samuel Beckett)17. CONCLUSION The ongoing psychosis of schizophrenia is a catastrophic psychiatric condition that afflicts1% of the world’s population, some sixty million global citizens, equivalent to the totalpopulation of a world power such as Great Britain or France or Italy. Its onset typically occursduring late adolescence and early adulthood. It does not discriminate in favour of or against anyof the traditional biases – gender, race, religion etcetera. It is characterised by delusions,hallucinations, cognitive deficits, angry or apathetic reactions and intense and changeablemoods. The emotional and cognitive life of the psychotic individual is totally overwhelmed, andbefore the accidental discovery of chlorpromazine’s tranquillising properties, there was noreliable antidote. Along with sleep apnea, nightmares, teeth-grinding, sleep walking, restless legs syndromeand the adynamia and total loss of dreaming experienced by the vast majority of prefrontalleucotomy patients, psychosis can most helpfully be regarded as another sleep disorder,specifically a misapplication of the dreaming function. The primary task for the psychotic brainis to reactivate and normalise its night-time REM-dreaming sleep, even as it resuscitates itsdaytime rational consciousness. These are but two sides of the same coin: profligatediurnal stimulation of the schizophrenic brain’s dreaming function dampens its full nocturnaltherapeutic REM-operation; conversely, one sure way for a schizophrenic genotype brain todream whilst awake is to suppress its nocturnal REM-dreaming activity. Symptomatically, psychosis may well be a thought disorder or a mood disorder, butessentially its aetiology is a sleep disorder. Not just in some crass, blatant, obvious, clumsyand trivial sense with all its echoes of mere insomnia and utter fatigue, but more profoundly of anocturnal mode of consciousness extruding itself queerly into the harsh alien light of day. Yinenergy where there should be Yang. Water where there should be fire. Poetry where should beprosody. Dreaming when we should be vigilant and rational and decisive. This is a change of emphasis away from the usual focus on building up our rationalconsciousness. As well, we concentrate on reconditioning our dream generator and the qualityof its products. After all, the problem is largely located there, and that‘s largely where thesolution lies. It’s a question of rebalancing our over-active dream generator with our anorexicand frazzled story-telling circuits. The key to recovery from psychosis is to return and confineour truant dreaming activity to nocturnal sleep. This is basically how antipsychotic medicineworks, by restoring our dysfunctional dream generator. That is what constitutes recovery frompsychosis.
  17. 17. There are further behavioural measures we ourselves can take to assist this process, byactively displacing the waking-dream activity of psychosis with strenuous, rewarding andenergetic rational daytime occupations which in their turn then provide solid food for the revivednightly developmental dreaming function to process and thus to thrive. It’s as simple – and aschallenging – as that. The healthy psyche is rooted deep in the humus of its rich nocturnaldreamlife, which is equally reliant upon at least a modicum of constructive daytime stimulus andemotional satisfaction. To comprehend psychosis for what it truly is – a chemically reversible brain state in which itdreams whilst we are yet awake – most effectively demystifies and destigmatizes this otherwisewithering condition. Even as when we awaken from the frightening thrall of some minor routinenightmare and are instantly relieved by that sudden hackneyed realisation: Ah – it was all just adream… It may well be true that “There is no cure for schizophrenia,” as Dr Simon Spedding soboldly proclaimed to the Paterson House day patients back in 1978. But there is now at leastmedicine and understanding that allows us to live out our days in peace. As to ‘normality’, asDavid Oliver Selznick observed: “I don’t want to be normal. Who wants to be normal?” And so we join ranks with Raymond Chandler’s nosy, irrepressible detective in a late nightblack-and-white movie from 1944: “I had a nightmare – a lot of crazy things. I slept. I woke upand the room was full of smoke. I was a sick man: instead of pink snakes, I got smoke. Well,here I am, all cured. What were you saying?” Maybe not cured, but enduring. Keeping out of trouble, one day at a time. With a little helpfrom our friends. “Restored to life.” (Charles Dickens)18. PHILOSOPHICAL POSTSCRIPT A passing allusion was made in the first paragraph herein to what some philosophers havecalled their “hard question”: how can a material brain ever give rise to our intangiblesubjectivity? How can matter – however complex and organised – produce this amazingly otherrealm of sensible interiority? One answer to this question is to deny its validity ab initio: in the words of philosopherOwen Flanagan, not to allow the “gee-whiz” bug to get a grip. Sometimes we let ourselves behypnotised by the way things seem to us, by their bedazzling appearances. On such an occasion,it makes eminent sense simply to say “I will not be put the question.” Is the glass half full orhalf empty? Either way, myopic monocularity. It is neither half full, nor half empty: IT ISBOTH, DAMN IT! And always will be. That’s just the way it is. It is never “All good,“ aspeople these days are so fond of saying. But then, neither is it ever all bad... As Francis Scott Fitzgerald put it: “The test of a first-rate intelligence is the ability to holdtwo opposed ideas in the mind at the same time, and still retain the ability to function. Oneshould, for example, be able to see that things are hopeless and yet be determined to make them
  18. 18. otherwise.“ Or as David Malouf so graciously puts it: “Our answer, on every occasion whenwe are offered the false choice between ‘this’ and ‘that,’ should be ‘Thankyou, I’ll takeboth.’” Does it make any more sense to ask how this sheet of paper, most of which is interstitialspace, can appear so solid? Or to ask how the amoeba’s agglomeration of inert nucleus, inertcytoplasm, inert organelles and inert membranes, collectively can give rise to the miracle ofLife? They just do. With greater understanding of atomic physics, biology and neuroscience,respectively in each case, these so-called ‘hard questions’ dissolve and disappear. And so weask no more that question about our own brains than we do concerning a steer’s brain, whosecasseroled blade steak we munched for lunch. Then come the really difficult ethical questions. If the rich inner life of homo sapiens is notgenerated by some species-specific immortal spiritual principle but simply by our prodigiouslyevolved neuronal complexity, what then, apart from a destructive overweening egocentricarrogance, is the basis for our unique and lordly legal status? And so it goes… Meanwhile, God is still in Her Heaven, as She is in Earth; and All is still as Well as Ever itwas. Some things better, others worse. “The horse leech’s daughter is a closed system. Herquantum of wantum does not vary.“ (Samuel Beckett) Always changing, ever evolving, everdevolving. “In times like these, it helps to recall that there have always been times like these.”(Paul Harvey) As to any Afterlife, there are many views, and much wise wrangling, but one thing is quitecertain: we will all find out for ourselves soon enough. The reports of their often life-transforming experience of some of those who have made their way back from near death readvery much like extended mythic dream journal entries. Yet at the time, there was apparently nildetectable brain activation… For now, enough the homespun idiographic phrases of Chuang Tzu: There is a globe, The foundation of my bodily existence. It wears me out with work and duties, It gives me rest in old age, It gives me peace in death. For the one who supplied me with what I needed in life Will also give me what I need in death.
  19. 19. SELECT BIBLIOGRAPHYAdelaide Advertiser, Melbourne Age and Weekend AustralianAustralian Broadcasting Corporation: Radio National and ABC1Rosalind Diamond Cartwright, Night Life Prentice Hall Inc. 1977Robert de Castella & Len Johnson, Jog with Deek – A guide to training for all runners Currey O’Neil Ross Pty Ltd, 1984Norman Doidge, The Brain That Changes Itself Scribe Publications Pty Ltd, 2007Ernest Hartmann, The Biology of Dreaming Charles C. Thomas, 1967J. Alan Hobson, The Chemistry of Conscious States Back Bay Books, 1994Thaddeus Kostrubla, The Joy of Running Pocket Books, 1977Christopher MacDougall, Born To Run Alfred A. Knopf, 2009Edited by Edward F. Pace-Schott et al, Sleep and Dreaming Cambridge University Press, 2003John Weir Perry, The Self in the Psychotic Process University of California Press, 1953Andrea Rock, The Mind at Night Basic Books, 2004Stephen M. Stahl, Psychopharmacology of Antipsychotics Martin Dunitz Ltd, 1999Shunryu Suzuki, Zen Mind, Beginner’s Mind John Weatherhill, Inc. 1970