Brain shrinking drugs cause many of the problems usually attributed to “schizophrenia”
February 19, 2011Is it “psychosis” or just “maladaptive daydreaming?”
March 3, 2011Not too long ago I finished reading Making Sense of Madness by Jim Geekie and John Read. A central idea in the book was that “madness,” or “schizophrenia” are “essentially contested concepts” which means that like other terms such as “beauty” we can expect that there will always be controversy about their meaning, that different groups will see the meaning differently, etc.
This led me to think about how when a person is in the states we call madness, just about everything can become an “essentially contested concept” – the nature of self, of the world, of good and evil, of the meaning of words or a glance or anything at all. Or at other times, a person will accept the most incredible ideas without contesting them in the least. What’s that about? I thought I would share my thoughts.
I have heard more than one person say that they traced to origins of their psychosis to a time period when they were “asking too many questions at the same time.” And yet, we also know from research that a common behavior in psychosis is asking too few questions, of jumping to conclusions off very little evidence, and then holding onto those conclusions without allowing them to be questioned. How could “asking too many questions” and “questioning too little” both be a part of what we call psychosis, or madness?
In brain research, it is known that adolescence and young adulthood is a time when the number of connections in the brain is “pruned” or dramatically cut back. There is some evidence to suggest that in the brains of people headed for psychosis, this pruning is much greater than normal. Brain researchers often make this sound like it is some kind of strictly physical or biological process, but another possibility is that is just the way the process of “questioning things,” a process which is part of growing up, looks if you watch it inside the brain. We form lots of associations while we are children, but then have to question them in order to form our own identity and point of view. (Breaking associations is also, I’m sure, in some ways a dissociative process.)
From some perspectives, those who question what they learn more deeply have an advantage, because they are more likely to discover a truly independent point of view. On the other hand, the risk is that a person who questions more undermines the foundation of learning that the person grew up with, and becomes more uncertain than the person is willing to tolerate.
How, exactly, do we know that the world as we know it is not some kind of dream, from which we might wake up at any moment into an entirely different sort of world? How do we know that those who seem friendly might not be appearing so just so they can later betray us in some horrible way? Children turn to their caretakers to get reassurance that such things can’t be so, but as we grow up, we must find our own basis for judgment – and sometimes such a basis is difficult to find, especially for those who question previous “knowledge” too intensely.
The process of questioning is often more intense for young people who have grown up experiencing major interpersonal stress, trauma, and betrayal. Their world has been less reliable, and so any sense of direction is less certain. On the other hand, uncertainty is even harder to tolerate for those who know just how dangerous the world can be; they may feel unable to rest till they can have some certainty regarding what is happening.
When people feel they can’t tolerate uncertainty, they are likely to attempt to resolve the uncertainty by jumping to conclusions, and identifying with radical views. So what we see are cases where people flip from being what seems to them to be too uncertain, to being what seems to us to be too certain – too certain that the mafia is spying on them, that God is speaking to them or that the CIA has an implant in their brain. The person may now be afraid to question those beliefs, for fear of becoming, again, too lost in uncertainty.
Professionals themselves are often afraid of uncertainty, since they feel their claim to professional expertise would be undermined by being uncertain. Also, people in general are upset by the way “mad” people point out that all of our beliefs are in some respects questionable – it is often much more comfortable to see one’s cultural assumptions as necessarily true. These factors often lead professionals and others to clash with the “mad” person, or to dismiss the “mad” point of view as completely wrong. This only results in further alienating the “mad” person, or leaving that person feeling disqualified from any right to create his or her own independent view of the world, in other words, hopelessly “mentally ill.”
The route to recovery is often found when the helper instead is willing to acknowledge uncertainty themselves, which allows the “mad” person to first see the helper model being uncertain in a safe way, which then might be followed by a relationship where both learn to be uncertain together. Out of that process and that sort of relationship, the “mad” person can develop his or her own way of understanding what has happened, which is both independent and yet more related to the world of others.
9 Comments
Ron,
Another great post! I really appreciate your ability to offer such well thought out explanations with examples. It is truly heartening to have ideas and opinions offered by professionals like yourself which validate experiences my son and I have had.
This particular post is relevant to parenting teenagers in general, in my opinion. Traditionally, this is a time to question and rebel against “parental authority”—and those who do so without the understanding and/or support of parents are often then labeled and perceived as “dysfunctional” “troubled” or diagnosed and targeted for ‘treatment” far too hastily.
Ordinary people can only guess about madness because most of them are behind at least three walls in my conceptualization.
first they are behind a social illusion. They have a rigid well defined idea of who they are and what their society is. It is very limited, they hardly see themselves and live mainly in lies in deceits. In modern times the ante is upped , in olden days it was mostly the peer group that helped maintain the illusion. Nowadays technological wizardry deluges the common person 24/7, they cannot escape even five minutes someone defining them and invading their mindspace presenting what to think about.
This all falls apart for most madpersons. It’s part of the package – a world of lies collapses, the threats and betrayals are real – distorted but real.
The second wall is social identity. All this too, all of them shatters. It’s the Steppenwolf! What does the mirror reflect , o more the hockey player, the wife, the nationalism person with all the accompanying agendas and manipulations of each identity disease. Already in a world of fear and to become identity-less.
The third wall is the spiritual wall the direct perception of matter , of nature of self come slamming in. What yogis meditate for decades to realize comes uninvited along with fleeting moments of joy transcendence bliss and nightmare. Nightmare – because there is no base -it’s all mixed up.
All these things can and are obtained by the normal through mindfulness and direction but for the madpersons it is uninvited an they can not use it.
Only later if they recover or are genuinely cured, when they are well then they can understand past mad experiences and make use of those experiences to go weller than well or peak experiences or states.
Once been mad and experienced passing through those walls the madperson has forever a foot in both worlds of the normal and the meta-normal as it were. They can make use of it , ignore it or smother it but they have absorbed it.
Based on my own experiences – some developed thought.
Madness is not fun – Don’t try it at home!
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People cured of DSM-V type conditions will probably have the nature of radicals , troublemakers, rebels etc – because they become the combination of a caring self-loving person (as the healed are) and having experienced extreme negativity and social abuse (if it wasn’t, it usually will be – just the way it goes) these combos often directs such proactive paths.
The Stepford people and the Stepford parents with the madchildren screaming obscenities at them.
The uncured in an uncured world. Perhaps madness is social evolution at work. nature abhors a vacuum and abhors vacant lives and vacant purposes.
But Personkind defeats nature. Personkind invents Soma – the Pill!
With great Meds come great responsibility!
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But seriously…
Hi Max, I think you are onto something with your notion that madness has something to do with social evolution.
As far as your contention that people can only understand their “breakthrough” experiences once they have recovered, I think that is only partly true. Or, another way of putting it is that people are often (or always) just partly mad, so at any point they probably have a partial understanding of what they are going through.
I wrote down the other day that one way to describe the difference between a psychotic perspective and a mystical perspective is that the person with the mystical perspective gently questions everything and drops categorical thinking, then gently picking it up again when/if it seems helpful – while the person with the psychotic perspective questions accepted truth more aggressively than he or she is really prepared for, and then when a void and insecurity is experienced as a result, the person becomes too grasping in attempting to find a solid truth, and grasps onto perspectives that aren’t helpful. But of course, none of us fit completely into either category.
James Joyce once asked Carl Jung why his daughter was schizophrenic. Joyce said he certainly worked and wrote in a psychotic fashion. How did he escape the ravages of psychosis?? Jung replied to him: “You jumped; she was pushed”.
Hi Pam, interesting exchange you quote!
Alan Watts used to always point out that when skidding on ice, it can be helpful to turn one’s wheels in the direction of the skid, this helps one regain control. I think even when one is “pushed” into a mad experience, one can possibly get more control by deliberately going with it. For example, a lot of people feel that their voices (or memories) are pushing a point of view or direction on them. If the person, instead of resisting, actively tries to explore that perspective or point of view, they are doing something like “turning the wheels in the direction of the skid.” The person is then more likely to identify themselves as having or understanding the point of view the voice or memory is pushing, and then will have more of a sense of being able to start modifying or changing it. Kind of like the person who turns the wheels in the direction of the skid can then start altering the direction of the skid, unlike the person who is totally resisting, turning the wheels sideways.
I have observed that in the psychotic state there is an ungluing of these beliefs and concepts and that the psychotic individual in that state is susceptible to incorporating disjointed sound bytes into his or her logic and the formulation of some new belief.
For example a psychotic individual had a conversation with a social worker who explained to him that she enterered her field of work because she wanted to help children who were affected by homeless mothers who had a crack dependancy. The individual shortly afterward had an overpowering and unsettling delusional belief that his home was a crack house occupied by vagrants. It seems in this unglued state that anything can stick and be formulated into some irrational story or belief. The indiviudual appears to only recognize when the psychosis has abated that his or her belief at the time was absurd.
Hi Alan,
When I was young and intent on questioning all established beliefs, I noticed that once one questioned everything, that all beliefs could be seen as equivalently absurd. There was no basis for any of them, and so, really, no basis for not believing any of them. This is the “cloud of unknowing” that can lead to mystical states, but of course it’s also easy to slip from profound mystical insight into various sorts of irrational fanatacism.
At the same time I was seeing all beliefs as absurd, I noticed that there were patterns to what I and others seemed to be more attracted to believing. For example, to some extent the individual in your example seemed to randomly pick up a belief from the social worker. But in a dream interpretation sense, one’s home can be seen as one’s self, and a crack house occupied by vagrants seems like a great metaphor for how one’s mind and self feels after getting caught up in extreme states and chaos. So maybe it wasn’t all random, that the belief seemed to make sense to the individual in that case. I think it helps preserve people’s self esteem, if they can look back and see that while in some sense their belief was absurd, in another sense it was meaningful.
Ron,
Without discounting the value in formulating an interpretation that is empowering to the individual as opposed to one that is disenfranchising I propose that when wecome to an awareness that all of our beliefs exist without basis and that life has no meaning nor purpose, other than those which we have consciously assigned to it, there is a freedom to life and to free thought.
The difficulty is we all have a fundamental need for belonging and this sense of belonging is derived by association and identification with people of similar cultural beliefs. (In this reference culture is meant to be viewed as people with common beliefs.)
The ego has a difficult time accepting that I am insignificant in the broader context of the universe and that my existence is limited in space and time. How significant I felt during my formative years, and the interpretation of my experiences then and now has an obvious influence on how accepting or unaccepting I am of the significance of my life in adulthood.
I suggest that the more oppressed and unworthy I feel the more I will be inclined to align with beliefs that advocate an afterlife, or that promote self sacrafice for a god, or that I will break with reality, feel depressed, or commit suicide.
At a fundamental level if we are to tear down the beliefs we have about ourselves we also need to tear down the beliefs we hold regarding our families, our friends, society, and the universe. As dysfunctional as the current state and context may be there is some comfort and security; a dependable familiarity derived from that dysfunctional identity.
Alan’s example of the SZ symptom makes perfect sense in taking into consideration the SZ basic state of fear. The SZ is reminded of yet another real type of threat. Accelerated fear simply leads to the delusional belief.
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Knowing this helpers can guide the SZ to accept , examine transform and claim their basic fear. People cannot possible be protected from every threat idea, hammer down one and another will emerge. Environmental stress reduction is a factor but concentrating on the internal – the fear process, rather than the external – the claiming or disowning of specific beliefs is a better approach Managing the internal can mean facilitating acceptance, helping the SZ .
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At higher levels the person can be helped to understand the nature of belief and knowledge – the old therapy technique of “How do you know this?”, “Do you think this is rational?” can be used – distinguishing between observations and conclusions and directing awareness to this process.
For both the afflicted and un-afflicted all beliefs are basically suspect and not good to be held unconditionally to understand anything. Belief is not knowledge or theory and understanding based on knowledge. Knowledge is modifiable and correctable. Belief is something like a temporary bandage place to model the world – because parents said so , or whatever – belief by definition is unsubstantiated.
As we emotionally mature it is only natural to examine our beliefs in the light of actual knowledge and direct experience.
It’s something to teach the afflicted and indeed their would be a better society if the difference between belief and knowledge was well understood and applied.
Unfortunately, in the society we live in much authority and power is maintained by inculcating belief and relying on belief in everything from politics and religion to the power dynamics in families from everything instead of encouraging knowing.
I believe in knowing, 🙂
Knowing is my way of self-actualization, not believing.
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Ron, as regards “understanding” breakthrough experiences , my sense is the idea of making use of it in an integrative way. But yes, probably some or a lot of it of it can be absorbed or made use of- or remembered and made use at a later time – it seems there is a large amount of hit and miss – basic anxiety ruining, the platform as it were.
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Here a helper or one who has been through it before can be of great assistance to someone going through those experiences for the first time.
“A single guide is worth 10,000 Meds” 🙂 (new aphorism)
I never had a guide, but now as I consider it, I might be able to do a lot in this regard – it’s a new line of thought for myself.
The essential difference you referred to defined and directed by is the emotional state. The mystical experience is calm and relaxed or exhilarating and joyful etc, the psychotic full of fear and anxiety (and even from nothing immediately identifiable in the experience – an underlying fear that already exists.)
As I look back on my own psychotic experiences – the actual perceptions and sensations are all , in memory, every one, quite beautiful – only fear and anxiety made them “reject-able” in the actual moment.
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Fear, it’s always fear – that can’t be ignored. The blunted aspect of the SZ is a facade or a bandage. Therein is the key those that don’t see that will treat the SZ as a collection of symptoms instead of an emotional being.
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Fear and anxiety cuts everything off at the knees in a practical way. Yes when a person calms down they can make use of their experience or use it. (Meds can help so long as they do not destroy
the fear which th person needs to make a transformation. ) The SZ is often in a great state of Chaos with so many real world emergencies – they often don’t have much space to make use of their understandings. The helper knowing this process and what is happening could be of great assistance.
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