Schizophrenia
The Doors Swung Open
We have seen how migraine opens up the ‘doors of perception’ slightly, but only during the aura states preceding a classic migraine. The opening becomes wider for those who experience temporal lobe epilepsy. Again these glimpses are of a short duration and are related to an aura state. However, there is another group of individuals, those who can be found at the extreme end of my Huxleyan spectrum, who receive the full force of the universe as it really is: the Pleroma blasts through their meagre defences. These people experience what modern neurology hubristically calls schizophrenia.
In the early 1980s the American periodical Schizophrenia Bulletin published a request that individuals suffering schizophrenic episodes should write in and describe their experiences. In a 1984 edition some of these responses were published.1 Some were surprisingly positive. For example:
Should I let anyone know that there are moments, just moments, in the schizophrenia that are ‘special’? When I feel I am traveling to someplace I can’t go normally? Where there is an awareness, a different sort of vision allowed me? Moments which I can’t make myself believe are just symptoms of craziness and nothing more.2
This is not what the layperson would expect from a schizophrenic. However, experiencers of this peculiar ‘illness’ have no doubts about its conflicting nature. Later in the 1984 edition another correspondent, a 37-year-old female artist attempts to describe the sensory overdrive that she experiences when in such ‘altered states’:
What’s so special? Well, the times when colors appear brighter, alluring almost, and my attention is drawn to the shadows, the lights, the intricate patterns and textures, the bold outlines of objects around me. It’s as if all things have more of an existence than I do, that I have gone around the corner of humanity to witness another world where my seeing, hearing and touching are intensified, and everything is wonder.3
A few years earlier another young woman attempts to explain what may be taking place at such times. She believes that her ‘doors of perception’ had been flung wide open at the onset of her schizophrenia-facilitated experiences, making her suddenly able to perceive ‘reality’ in all its terrifying power. Over many years of such experiences she had come to a profound conclusion:
Each of us is capable of coping with a large number of stimuli, invading our being through any one of the senses. We could hear every sound within earshot and see every object, line and colour within the field of vision, and so on. It’s obvious that we would be incapable of carrying on any of our daily activities if even one-hundredth of all the available stimuli invaded us at once. So the mind must have a filter which functions without our conscious thought, sorting stimuli and allowing only those which are relevant to the situation in hand to disturb consciousness.4
In a similar way physicist Raynor Johnson created this wonderful analogy to describe what it is like to have the ‘doors’ open fully:
We are each rather like a prisoner in a round tower permitted to look out through five slits in the wall at the landscape outside. It is presumptuous to suppose that we can perceive the whole of the landscape through these slits – although I think there is good evidence that the prisoner can sometimes have a glimpse out the top!5
The aura ‘breeze’ that is experienced by migraineurs and temporal lobe epileptics is as nothing to the hurricane that is schizophrenia. Schizophrenics are within the storm at all times. The doors are not opened, they are blown off, leaving the schizophrenic Eidolon faced directly with the awe-inspiring power of the Pleroma as perceived by the Daemon. With no protection from the hurricane’s forces, the schizophrenic recedes into behaviours that seem, to neurotypicals, to be totally irrational and insane.
The story of schizophrenia as a psychiatric illness began in the early 20th century when Emil Kraepelin, a German psychiatrist, proposed that most mental illnesses could be categorized as one or other of two major disorders: manic-depressive insanity and dementia praecox. Kraepelin believed that all forms of mental illness that showed signs of improvement over time should be defined as manic-depressive insanity. These illnesses may involve hospitalization, but given systematic care and professional assistance the prognosis is promising. He had no such optimism for dementia praecox. He considered this to be a progressive illness that started in adolescence or early adulthood and followed an inexorable downhill course. Recovery, if it ever occurred, was usually short-term, and afterwards the patient would continue their decline. Note the use of the word ‘dementia’. It was argued that schizophrenia, as it was later to be defined by Eugen Bleuler, was simply a form of dementia that is experienced by the young.
Schizophrenia is a surprisingly common ‘illness’. Across the world it affects, at any one time, around 1 per cent of the population. It occurs in all cultures and across all geographic areas. This suggests some very intriguing implications with regard to its causes and its function.
If genetically transmitted, it must have ‘evolved’ using classic evolutionary (that is, Darwinian) processes. If this is the case, then why has such a debilitating and socially problematic condition not been eradicated from the gene pool? If the role of Darwinian selection is to create efficiency through adaption to social and environmental conditions, why is it that schizophrenia did not disappear millennia ago? For example, it is known that schizophrenia normally manifests itself around the time of maximum sexual proclivity – the time when seeking out and finding a mate is at its most important. Schizophrenics are known for being loners, and would clearly not be an ideal target for those seeking out (overtly or unconsciously) the best possible gene carrier for the next generation. It is reasonable to conclude that such individuals would be actively ignored. But this has clearly not been the case.
The dispersal of human populations across the globe has taken approximately 100,000 years. The consistency of the incidence of schizophrenia across geographically spread populations suggests that the illness existed within the human gene pool at that time. So across countless generations the schizophrenic gene has managed to carry through. This can only be because those showing schizophrenic tendencies managed to reproduce and ensure that the gene continued to the next generation – time and time again. So there has to be some kind of evolutionary purpose for what seems a totally debilitating illness. What can this be?
Schizophrenia and Perception
Experimental psychologist Charles McCreery, whose work with Celia Green we have already discussed in detail, has suggested that schizophrenic perceptions may be brought about by a phenomenon known as ‘micro-sleeps’. Curiously enough, these are brought about by hyperarousal rather than under-arousal.6
To appreciate why this is so strange we need to understand how brain cells (neurons) communicate. We have already discovered how neurochemicals modulate the messages being sent from neuron to neuron. But within each neuron itself the actual message is transferred using electrical impulses. In effect, millions of neurons working together create waves of electrical activity that move across the brain. These ‘brain waves’ can be measured using devices such as an EEG. It has been discovered that there are four different types of brain waves. These are identified by a particular Greek letter. Beta brain waves, in terms of the Hertz scale used to describe such frequencies, have a frequency of 13 to 60 Hz; they are found in people who are consciously alert. The frequency rises as the person becomes agitated or afraid. Alpha waves, with a frequency of 7 to 13 Hz, occur in someone who is relaxed but aware of what is going on around them. Theta waves, at 4 to 7 Hz, occur when the person is asleep and dreaming. Anything lower than 4 Hz is called the Delta state and is found in individuals who are in a very deep sleep and therefore unconscious.
It has long been noted that levels of brain activity related to dreams and schizophrenic states, specifically those involving psychotic behaviours, are similar. When we dream, we enter a very curious world in which events and circumstances are beyond our control. We are acted upon rather than taking action. Dreams also seem to have an air of significance that is absent in the non-dream state. In dreams we also take for granted seemingly impossible situations. We suddenly can fly, or we are somebody famous. In most cases, such impossible circumstances do not lead us to realize that we are dreaming: we simply accept the situation. All these circumstances are experienced by schizophrenics within consensual reality.
McCreery argues that schizophrenics, when experiencing a psychotic state, are actually asleep. In effect, perceptions encountered within the Pleroma carry over into consensual reality.
When neurotypicals dream, they usually enter a state characterized by something known as ‘rapid eye movement’ (REM). This is reflected in Beta brainwave activity, reflective of a fully wakened state. However, studies have shown that schizophrenic patients, when in psychotic states, do not show the REM activity that is characteristic of dreaming.7 McCreery suggests that the reason for this is that schizophrenics are in a state of high arousal when they micro-sleep, rather than the low arousal associated with sleep states in neurotypicals. He cites the work of psychiatrist Ian Oswald, who considered that sleep was a ‘provoked reaction’, as exemplified by soldiers who have fallen asleep while waiting to go into battle. It is regularly recorded that in times of extreme stress individuals experience out-of-the-body states. The standard explanation for such events is that they demonstrate depersonalization, whereby the experiencer is trying to mentally escape from a dangerous, painful or unpleasant situation. This makes a degree of sense but totally fails to explain the regularly recorded veridical aspects of such experiences, and is not consistent with examples taking place during childbirth where the expectant mother has every incentive to remain, as it were, embodied.
In a series of experiments Oswald was able to evoke sleep onset by administering painful electric shocks at 10-second intervals to the wrist or ankle of the subject.8 With this in mind, McCreery suggests that the relationship between sleep and high arousal – in effect, mania – should not be considered as linear, as it normally is, but instead as circular.
Imagine this to be like a clock face. At the 12 o’clock point we find the normal waking state. Increasing arousal is monitored by a movement following the arc of the clock face from 12 o’clock down through the 3 o’clock point and ending up at the 6 o’clock point in a fully aroused state of consciousness. Conversely, increasing drowsiness can be shown by an anti-clockwise movement from the normal waking state at 12 o’clock to drowsy at around 9 o’clock and fully asleep at 6 o’clock. From this it will be noted that both increasing and decreasing arousal meet at the same point, where sleep and high arousal share the same state.
McCreery gives us an example of how high and low arousal states are related by citing catatonia, a condition observed regularly in schizophrenia. Catatonia involves the schizophrenic adopting a position of immobility for extended periods of time. Much to the surprise of researchers, individuals in this state could be brought out of it by the administration of amobarbitol, a sedative. This makes no sense if catatonia is a state of low arousal: to give a catatonic person a sedative should place them in an even deeper state of arousal, not wake them up from it. McCreery cites the work of Stevens and Darbyshire, who concluded from their research that the ‘psychic state in catatonic schizophrenia can be one described as great excitement’.9
It has been discovered that one of the EEG markers of schizophrenia is a lack of alpha rhythms within the brain. Alpha rhythms are large, slow waves of electrical activity that are registered by an EEG and are associated with a state of total rest. They disappear as soon as the subject starts to think about anything or experiences pain. These waves are usually centred on the occipital lobes. They are particularly active during REM sleep. Conversely beta waves are suggestive of a full waking state. Some studies have shown that delta rhythms show higher than average levels of activity in fully awake schizophrenics. These are extremely slow waves with a frequency of less than four pulses per second. In neurotypicals this is associated with very deep sleep states in which REM activity ceases altogether. McCreery considers this to be strong evidence that, even though seemingly awake, schizophrenics are, in fact, in a deep sleep state.
I would like to add that in my opinion it is in such states of high arousal that the doors of perception are flung open for schizophrenics. The delta activity allows the Pleroma to leak over into waking life and causes massive cognitive confusion. As we have already discovered, McCreery and his associate Celia Green have proposed a mechanism by which one reality can overlay another, and in doing so they suggest an explanation for many altered states of consciousness such as the out-of-body experience and the near-death experience.
McCreery’s model does seem to offer an explanation as to how schizophrenics’ ‘hallucinations’ seem to be a regular part of their waking life. Schizophrenics are continually in a state of semi-sleep and at any moment can fall into a very deep sleep state whereby the images usually associated with dreaming break through to manifest in the everyday world.
Of course, a central feature of schizophrenia is a subject we have touched with regard to various other elements of the Huxleyan spectrum: namely, the hearing of voices. This is probably the dominant factor in the general public’s image of schizophrenia. The voices are usually not supportive of subjects and, in some cases, incite them to terrible acts. It is as if the schizophrenic’s reducing engine has wound down too far and all kinds of negative impulses seep through. There is a total loss of control, and the person is simply overpowered by the sensory inputs.
What is taking place in the schizophrenic state with regard to clearly destructive voices is, I admit, a major issue regarding the Huxleyan spectrum. If these ‘voices’ are simply those of the Daemon, why do they sometimes seem to do harm to an already confused and defenceless Eidolon? A partial answer may be that the wavelength of signal being received may be much broader, allowing other elements of the Pleroma in some way to tune in. What these are is open to conjecture, but history is full of examples of demonic possession and attacks from other negative forces. This may or may not be the explanation, but it is an area of important research that needs to be pursued.
However, as we have seen, the majority of voices, even in schizophrenia, are in general supportive or, at worst, indifferent. Even so, it must be accepted that, in general, schizophrenia is a far from pleasant experience. Indeed, one of the associations made by the original researchers into the condition, Kraepelin and Bleuler, may be of huge significance in this regard. This is to do with how schizophrenia mirrors another very upsetting and disturbing illness, at least to those who have to witness it: the illness we call dementia or, as it is now becoming known, Alzheimer’s disease.
Schizophrenia and Alzheimer’s: A hidden relationship?
On 9 December 2014 a paper was published in the prestigious Proceedings of the National Academy of Sciences (PNAS) journal.10 It linked an illness that seems to occur early in life with one that seems to occur late in life. A team at Oxford University led by Gwenaëlle Douaud examined the brains of 484 subjects ranging in age from eight to 85 using magnetic resonance imaging (MRI) scans. They were looking to discover how the human brain changes over time. It seems that the areas that develop latest deteriorate earliest. In other words, as we get older our brain seems to go backwards in time. For example, high-level processing of visual, auditory and sensory information do not fully develop until late adolescence or early adulthood. However, as we age, these are the first faculties to deteriorate. They are particularly susceptible to the damage brought about by schizophrenia and Alzheimer’s disease.
This may be of huge significance with regard to the central thesis of this book. For many years the similarities between schizophrenia and dementia have been noted by neurologists, psychiatrists and psychologists. Indeed, as we have already seen, schizophrenia was originally called dementia praecox, which is Latin for ‘premature dementia’ or ‘precocious madness’. It was noted by Kraepelin that this early-onset form of dementia manifested in the early teens, usually around puberty.
Douaud and her team discovered that the lateral part of the primary motor cortex and a small section of the lingual gyrus were areas that showed the delayed development and the earliest deterioration. These areas are known to be the ones most affected by schizophrenia and Alzheimer’s, specifically in the bottom of the folds on the surface of the brain in that area. It is exactly here, as we shall discover later, that higher levels of a protein called ß-amyloid (beta amyloid) have been discovered in individuals suffering from Alzheimer’s.
In effect this discovery reinvigorates a long-neglected scientific idea known as ‘retrogenesis’ which was popular in the 1880s; in simple terms, this proposed that mental abilities decline with age in the same way that they develop with age and through evolution. It may be significant that chimpanzees and our other close primate relatives do not have the neural centre identified in the study. This gives them a seeming immunity to naturally occurring schizophrenia and Alzheimer’s. In turn this suggests that these two diseases may be what makes us human. We will be discussing some controversial observations later regarding this intriguing concept.
Birth and death are the two states that bracket our lives. One thrusts us crying into consensual reality from the Pleroma and the other ushers us back there at the end of life. If we are lucky and manage to avoid dying in accidents, by illness or by the hands of our fellow human beings, we will eventually shuffle off this mortal coil with the assistance of Alzheimer’s disease. Indeed, as our medical technology manages to control the major killing diseases of the past, enabling us to live longer, more and more of us will succumb to this disease. It relates directly to an ageing brain and, it is reaching epidemic proportions, particularly in the developed world. It has been calculated that every 67 seconds somebody in the United States develops the disease. Worldwide around 35.6 million people have the disease, and by 2050 this number is expected to have tripled. It mirrors a related epidemic, on which we will focus later.
So why does an illness that differentiates us from all other animals work as the last resort in making sure that we move on, stepping aside for the younger generation? Let us now spend some time looking more closely at this condition that many of us will one day face.