In 1905, the French psychiatrist Gabriel Revault d’Allonnes published a scientific essay on the subject of a patient at Sainte-Anne psychiatric hospital in Paris: Rôle des sensations internes dans les émotions et dans la perception de la durée [The role of internal sensory perceptions in the emotions and perception of duration].1 In the essay’s very title Revault d’Allonnes interweaves “internal sensory perceptions” with the “emotions” and the “perception of duration.” In the case of the patient, Alexandrine, these three mental functions have been impaired. The 53-year-old hospital patient—she is married and has a son—complains that for about a year she has had hardly any physical sensations, experiences no emotions, and no longer senses the passing of time. Revault d’Allonnes records his conversations with the patient Alexandrine in great detail in order to explore this strange case in depth. Although she cries frequently—tears well up if she has to think about a personal misfortune, and even during her conversation with the doctor—in doing so Alexandrine experiences no emotions. This means that the physiological reactions to and the cognitive understanding of a situation appear intact, but the subjective side of the affective experience is disturbed:
—Alexandrine: You see, Sir, I can cry! But it doesn’t affect me, I feel nothing. …
—Revault: But you are sad.
—Doubtless, as I am indeed crying. I have reasons to be sad, my illness, being separated from my poor husband, and from my son, he is in such poor health! No, I do not lack reasons to be sad. I am crying but it doesn’t affect me, I can no longer feel anything.
Physical sensations are also affected. Alexandrine has certain physical perceptions, but is not particularly affected, for example in the case of feeling cold:
—You are shivering.
—Perhaps my feet are cold, but that doesn’t bother me; I feel the cold a little, but it doesn’t affect me. In the sun I feel the warmth a little, but it doesn’t affect me.
Equally, Alexandrine is never hungry, and never senses when she is full. She reports that she has to manage her food intake using her experience, since after all she knows approximately how much a person eats. She is seldom thirsty, is never tired, and also does not feel rested. The urge to visit the toilet is absent. Revault d’Allonnes finds that her descriptions fully correspond to reality through a series of tests, in which for example he pours ice-cold water on sensitive parts of Alexandrine’s body, provoking no increased sensory perceptions in the patient.
In his essay, Revault d’Allonnes discusses the possible causes of the disorder. He wonders whether perhaps hysteria, a psychiatric diagnosis common at the time, would be applicable. In hysteria symptoms, a lack of physical sensation could also present. Tests in which the skin on Alexandrine’s body is systematically pricked by a needle show an extensive absence of skin sensitivity. Revault d’Allonnes contends, albeit rather weakly, that the illness must have an organic cause, provoked multicausally by several factors. In particular, he cites a serious case of influenza and complications during the menopause. Today, from a psychiatric point of view, we would probably talk about a case of depersonalization.2 Incorporated in this diagnosis, he says, are two episodes of depression lasting several months, which occurred well before the beginning of the present disorder. However, one would, he says, have to determine neurological causes as well. For example, the patient reports serious headaches, possibly symptoms of a brain illness that directly preceded this puzzling condition.
Independent of the medical causes of the illness, there are symptoms that may be somewhat surprising, but which are crucial for Alexandrine, and which are questioned intensively by Revault d’Allonnes: problems with the perception of time. Since the start of the illness a year earlier, Alexandrine can no longer sense the passing of time. This is the immediate feeling of time. She can, of course, name the date correctly by looking at the daily newspaper, and she can tell the time on a clock, so she does not arrive late for her hospital appointments. She understands the abstract concept of time. But without the help of the clock she is far from being able to judge temporal duration. If we have to estimate a period of hours without using the clock, almost everyone will get it wrong by many minutes. But we have an approximate sense of the time that has elapsed, even if we make a clear error of estimation. However, this patient has absolutely no sense of how much time might have passed. Interestingly, it is Alexandrine herself who makes the connection between the loss of her subjective time and the disappearance of her bodily feelings. For example, she realizes that in the past she was able to judge the time by her rising feeling of hunger, her urge to urinate, or her tiredness. She herself infers from the situation that, because she no longer has any physical sensations, as a result she can also no longer sense time. Revault d’Allonnes summarizes his investigations thus, that “the duration perceived by consciousness is nothing less than visceral sensibility.” He writes that we have something resembling internal clocks made up of various physical rhythms, supplied by signals from our gut, bladder, lungs, arteries, and heart. Consequently, physical perception is the necessary and sufficient condition for the immediate temporal consciousness of “medium-sized duration,” as Revault d’Allonnes puts it. Longer periods of time he considers to be a day, a week, or a year; that is, intervals that cannot be experienced immediately by means of their duration. Medium-sized durations of time, by contrast, are seconds and minutes, up to perhaps a few hours—periods of time that are accompanied by physical reactions.
With the aid of a metronome, Revault d’Allonnes also conducts tests on the experience of rhythm. Quite short durations, of one second at most (at a frequency of 1 Hz), are employed. In several sequences, he sets the metronome beats at various frequencies between 1 and 3 Hz. After performing a specific sequence of 10 metronome beats at speed A, he presents, for example, a second sequence of 10 metronome beats with a different speed B. Alexandrine has to say whether she can hear the difference in temporal intervals. It is a proper experimental setup. And by comparison with healthy control subjects, the patient turns out to be impaired in the case of these short temporal intervals; she needs greater differences in pace in order to recognize them. But, Revault d’Allonnes explains, the impairment is not as serious as in the case of medium-sized durations of time, where a complete failure in the sense of time occurs. In a further test, Alexandrine is asked to match the rhythm of her breathing to the slower metronome beats; she fails in this simple task as well.
At the end of the nineteenth century, William James and Carl Lange were already arguing that emotions were based on physical reactions. The extreme interpretation of this posited connection—“I perceive certain physical reactions and only because of this do I have a certain emotion”—is incorrect, but all our emotions are underpinned by physical movements (arousal versus relaxation), which feed into the context of the situation and participate in the expression and strength of the emotion. Externally, this is apparent in an altered physical posture, a high flush to the face, a strained voice, breaking out in a sweat, and flashing eyes. We ourselves experience our accelerated heartbeat, an uneasiness in the pit of the stomach, and butterflies in the belly—or, as Chuck Berry sang, “I got lumps in my throat when I saw her comin’ down the aisle, I got the wiggles in my knees when she looked at me and sweetly smiled.”3 Emotions are physical. But these bodily reactions do not have to be conscious. Our emotions are quite directly what they are—joy or anger, desire or torment. For example, we do not have to feel physical sensations first, from which we then derive emotions.4 The sympathetic (arousing, activating) and parasympathetic (relaxing, inhibiting) autonomous nervous system regulates the body’s organs and its functions—the vital functions, heartbeat and breathing, blood pressure, metabolism and digestion, and of course, sexuality. The physical processes are to a certain extent integrated into complex situation-dependent emotions; as physiological reactions they are part of the emotions. The subjective experience of emotion can include the bodily experience, but not necessarily so. Physical processes, however, are always part of the emotions.
Today we talk about “embodiment”—the embodiment of the mind. The brain does not simply represent the world in a disembodied way as an intellectual construct, but rather the organism interacts as a whole with the environment. In this notion, a mind separate from the body (which according to René Descartes would be an autonomous world) does not exist, but rather our mind is body-bound. We think, feel, and act with our body in the world.5 All experience is embedded in this body-related being-in-the-world. Or, to put it another way, subjective experience means living that is embodied in the environment and social interaction with other people.
As psychological and neuroscientific studies of the last decade as well Gabriel Revault d’Allonnes’s individual case study confirm, temporal experience alters according to the intensity of emotions and is linked to the accompanying physical processes. In this, the experience of self and the sense of time fluctuate in their intensity. In periods of boredom, the perception of self and the sense of time (which is ticking away all too slowly) are both intensified. Before the climax of ecstasy, temporal experience expands and the sense of self is heightened in the extreme. In an extreme experience of flow or even in mind wandering, by contrast, we perceive ourselves and time less intensively. Individual cases such as that of the patient Alexandrine are not representative. But they are the source of new findings about relationships, which must then be systematically tested. In the case of Revault d’Allonnes’s work, it took a hundred years before basic psychological and neuroscientific research was able to catch up with the description of Alexandrine’s particular case.6
In 2009, the brain researcher A. D. (Bud) Craig of the Barrow Neurological Institute in Phoenix, asserted that temporal experience was dependent on body signals.7 According to Craig, the sense of time passing arises from the continuous construction of representations of the body in the brain. The autonomic neural pathways that connect body and brain run from the lateral gray column of the spinal cord to the brain stem and then via specific thalamic nuclei to the posterior insular cortex, which is part of the cerebral cortex. Through a gradual processing and integration of these body signals with other sense impressions and thought processes and with motivational and situational conditions, an all-encompassing representation of the present condition is created in the anterior insular cortex. This is what Bud Craig calls a “global emotional moment,” and it represents the self, updated from moment to moment, as “how I feel now.” Consequently, the concept of self is based on physical conditions that alter with time; in this way the sense of time arises as a perception of self through time.
My own research at the University of California in San Diego using functional magnetic resonance imaging (fMRI) generated the first explicitly discussed empirical findings that indicated the involvement of the insula in temporal perception.8 In this fMRI study, activity in the posterior insular cortex in particular demonstrated a steady climb over time, finishing only at the end of the 9- or 18-second temporal intervals to be estimated by the subjects. During the phase when the test subjects had to press a button to indicate that a certain period of time was now just as long as a previously perceived interval, the anterior insular cortex and sections of the frontal cortex showed this rise in activity; it declined only shortly before the button press. Following Bud Craig’s thesis, these results can be interpreted in the following way: through the activity in the insula, the passage of time is coded as an increase in body signals, initially in the posterior insular cortex. When comparing the time interval that is just being perceived with the one presented earlier, the anterior insular cortex, together with sections of the frontal cortex, is particularly active as a conscious temporal comparison is taking place that increasingly involves thought processes, which include working memory and decision-making.
The bodily feelings that are linked to the insula—body temperature, pain, muscular contractions, physical contact, and signals from the gut—are also an integral component of emotions and trigger positive or negative feelings. Short-term affects as well as longer-lasting moods are essential for the modulation of the sense of time. Consequently, physical sensations, emotions, and time consciousness are closely interconnected. As in the case of Alexandrine, these areas can be jointly impaired—whatever the psychiatric or neurological causes may have been. The consciousness of self, as a physical and emotional self, as well as time consciousness, are inextricably linked.
Today’s discussion9 of the connection between self, body, emotion, and time was already advanced in the mid-twentieth century by the French philosopher Maurice Merleau-Ponty in his Phenomenology of Perception: “We must understand time as the subject and the subject as time” (p. 490).10 Merleau-Ponty equated time as a mental entity with a body:
It is as much of my essence to have a body as it is the future’s to be the future of a certain present. So that neither scientific thematization nor objective thought can discover a single bodily function strictly independent of existential structures, or conversely a single “spiritual” act which does not rest on a bodily infrastructure. (p. 501)
This refers to all mental functions. In addition, the sense of time is “embodied” in a more all-encompassing way than the other senses. Ultimately, time perception is not mediated by a specific sense organ, as happens in the case of the senses of sight, hearing, taste, smell, or touch. There is no sense organ for time. Subjective time as a sense of self is a physically and emotionally felt wholeness of our entire self through time.
Time and self are one: this is a powerful hypothesis put forward by phenomenology and the neurosciences. If it is correct, then perception of self and time perception would have to be interchangeable. To put it another way, the concept of self and the experience of time should display a high correlation. As became clear in chapter 1, extraordinary states of consciousness entail precisely this. But even in everyday states of consciousness the relationship is clear to see. In situations we find boring, we are forced back on ourselves and feel ourselves in an unpleasantly intensive way. On a boring Sunday afternoon, time spent alone passes only too slowly. Psychological studies show that people who are prone to feeling bored experience time passing more slowly when engaged in monotonous activities than do people who are seldom bored.11 Boredom actually means that we find ourselves boring. It’s the intensive self-reference: we are bored with ourselves. We are tired of ourselves.
In his discussion of the philosophy of Martin Heidegger, Rüdiger Safranski provided an incisive description of boredom:
Pure time, its pure presence. Boredom—that is, the moment when no one notices that time is passing because it will not just then pass, when one cannot drive it away, make it pass, or, as the saying goes, fill it meaningfully. … It refuses to pass, it stands still, it holds one in inert immobility, it “thralls.” This comprehensive paralysis reveals that time is not simply a medium in which we move, but that it is something that we produce out of ourselves.12
According to Heidegger, boredom leads crucially to the problem of time, and thus to ourselves, “to an understanding of how time resonates in the ground of Da-sein.”13 As unpleasant as it may be, in a state of boredom and the extreme experience of time associated with it we come closest to ourselves. We are completely ourselves without distraction, in Heidegger’s words: “This peculiar impoverishment which sets in with respect to ourselves in this ‘it is boring for one’ first brings the self in all its nakedness to itself as the self that is there and has taken over the being-there of its Da-sein.”14 In boredom we are completely time and completely self—inner emptiness. Now I am I and nothing else—a surfeit of being oneself, in most cases when one is alone, but sometimes also being lonely when being with others.15
Depressives complain that time passes terribly slowly and hours can sometimes feel like whole days. “It’s only five o’clock and the day is still not over. I wait and wait for evening, and must constantly look at the clock,” as one 37-year-old man suffering from depression said.16 A US study in the 1960s looking at 50 patients with different psychiatric diagnoses, including 20 depressives, who were admitted to the emergency department of a hospital and were tested again on average nine days later as patients in the hospital, showed how emotional symptoms and temporal experience correlate. The greater the improvement in emotional symptoms (fear, aggression, depression) during their hospitalization, the more accurate their estimation of time became, moving in the direction of a relative acceleration.17
People suffering from depression are temporally desynchronized; their internal speed does not match the speed of the social environment.18 Depressiveness and sadness, expressed in a negative self-image, self-blaming, and a feeling of worthlessness, among other things, go hand in hand with the intensified, unpleasant sensation of time passing more slowly.19 In the absence of a positive future perspective, one’s personal situation is experienced as imprisonment in the now of slowly passing time.
But being completely present in the “here and now,” as in experiences described in chapter 2, is also the desired condition in meditation. Whereas boredom can creep up on us and take over almost imperceptibly, contemplation in meditation entails the positive will to transcend self and time. However, beginning meditators, in particular, often have to struggle with feelings of boredom as they focus on themselves.
In order to describe situational boredom, we do not need to invoke the notion of existential ennui, the inner emptiness of a Sunday afternoon, as actually we could do anything we wanted to. In fact, personally and professionally, we are fine, but nevertheless we feel listless. Our joie de vivre evaporates for hours on end. Already in the mundane activity of waiting for the train or bus, or sitting in a traffic jam, we are constantly confronted with ourselves. This is why so many people reach for their smartphones while waiting on the platform or on a five-minute commuter journey. Happily, there’s always the radio, if you are stuck in the car in a traffic jam. Psychologists are researching these everyday situations and have discovered that if people have to spend just 6 to 15 minutes alone in a room with themselves and their thoughts, many judge this period of time to be totally unpleasant and are grateful for any diversion, even mildly painful stimuli, just to be distracted.20 And this applies not only to impulsive young people and adults, but to a representative selection of adults of all ages.
This feeling of an intensified and particularly negative sense of self-awareness goes hand in hand with a specific activation of emotional networks in the brain, as was shown in an fMRI study21 using test subjects who experienced situations of relative boredom for short periods during a first-person shooter video game. Depending on the extent of decrease in positive emotions, the anterior insular cortex was bilaterally active, along with other important areas that regulate the emotions. In addition, an increase in negative affect was associated with activation of bilateral anterior cingulate cortex. This area is closely linked functionally with the anterior insula. According to Bud Craig’s model, the organism’s actual state in the moment is generated by the integrated processing of all available information in the anterior insula. This is how I feel now. The regulation of behavior, caused by the deviation of an actual state from a target state, is initiated by activity in the anterior cingulate cortex. When it gets too hot (actual state), we look for a shady spot in order to restore the target state of relative coolness. When we are thirsty, we drink. When we are bored, we look for another, more inspiring situation—or take out our smartphone.
Other areas involved in modulating the experience of self and time have also been explored using fMRI studies. As we saw in chapter 2, in mindfulness meditation our attention is focused on the experience of the “here and now”; every moment should be perceived in a concentrated way. To maintain the experience of the present, one directs one’s focus toward specific areas of the body; for example, attentively monitoring regular inhalation and exhalation—this is intended to help avoid mind wandering. This procedure leads to an increase in the experience of bodily presence, and thus directly to the experience of time expansion. For example, fMRI studies using trained meditators show how the induced feeling of presence is linked to greater activation of the insular cortex.22 Research by Ulrich Ott and Britta Hölzel at Gießen University’s Bender Institute of Neuroimaging, conducted with the participation of long-term meditators, also showed an increase in insular cortex volume, compared with people who did not meditate.23 This suggests that experience of the body self, intensified over the years, leads to an enhancement in the formation of connections between the nerve cells in this area of the brain—yet more powerful proof of the brain’s plasticity. Other brain areas are active in meditators and are larger in experienced meditators: for example, the hippocampus, which bears a key responsibility for the storage of new experience; and the frontal cortex, which is linked to the executive functions of attention and working memory.24 As became clear in chapter 2, an increase in mindfulness is linked to a greater capacity for attention regulation; in addition, the working memory is essential for the maintenance of mental presence. Mindfulness means that events are experienced more consciously, leading to increased and more detailed storage of events.
While activity in the insular cortex increases during meditation as a correlate to the increase in physical awareness, at the same time activity in the midline region of the brain decreases.25 This corresponds very well with the concept of the so-called default mode network, the cortical midline structures. When fMRI was first used to examine brain activity, it came as a complete surprise to some researchers that during the breaks between tasks, when apparently nothing was happening, powerful neuronal activity was registered in the cortical midline structures. To any test subject who has ever been in the fMRI scanner, however, this will not be particularly surprising. It is precisely during these quiet break periods when mind wandering begins: “What am I doing here?”; “I hope it’s over soon”; “What a boring job!” In the absence of stimulation and tasks, test subjects give their thoughts free rein, reviewing past events or looking forward to an evening with friends. And this mind wandering is associated with activity in the default mode network.26 These are thoughts related to the self—the imagined self of past, future, and possibility. The studies conducted by the medical scientist and philosopher Georg Northoff in particular have shown how this kind of narrative self-referentiality is linked to the cortical midline.27 For Northoff, the default mode network is the neuronal basis for what William James called the “stream of consciousness,” the constant flow of perceptions, thoughts, and fantasies. Many studies using imaging techniques show that the self-referential imagination, producing scenes from the past as well as in the future, is linked to the default mode network.28
Of course involuntary mind wandering happens not only while lying in the scanner, but in all periods of waiting. Even during meditation, thoughts slip in unbidden and we lose focus on the present experience. Experienced meditators have demonstrably less activity in the default mode network during a session of mindfulness meditation.29 This means their heightened mindfulness correlates with a decrease in activity in the neuronal networks linked to mind wandering. Thus we might say that changing between conscious experience of our self in the present moment and having a wandering mind goes hand in hand with a change in predominant activation between the two brain networks of the insular cortex and the cortical midline. In heightened states of presence—associated with insular activity—time slows down, and the felt “now” expands. By contrast, when our mind wanders more—correlating with activity in the cortical midline—time accelerates.30
Time passes quickly when we are feeling entertained and when we are absorbed in various kinds of activity. In common parlance we even say we are “lost in our work.” We don’t quite perceive ourselves; all our attention is directed outward. This extreme loss of self is the experience of flow, which can occur during activity that is particularly intensive but comes easily and smoothly—while writing this book, while playing music, while practicing a hobby. We are totally engrossed, and attention is focused effortlessly on the performance of the activity. We do not perceive ourselves, and as a result subjective time accelerates. Typically, as soon as we become aware of ourselves and of the time, we are astonished at how much time has elapsed. In the flow of intensive activity, the perception of self is reduced and the feeling of time disappears. This is a paradoxical situation. On the one hand we have achieved something that will be permanent—writing this text, solving a syntax problem in programming—but our life as a whole has almost disappeared for minutes or even hours. We were concentrating fully and completely on the matter at hand, but in doing so we did not notice ourselves: a loss of the experience of both self and time. Expressing it negatively this way also shows how the perception of self and that of time are jointly modulated.
In the extreme case of extraordinary alterations in consciousness, dramatic modulations take place in self-awareness and in the sense of the body and time. A feeling of spatial unity of the body and self with the surrounding space can occur—oceanic boundlessness—or a sense of timelessness can be experienced, as a unity of past and future in the present. Such alterations in consciousness are described in neurology too, for example in the case of certain forms of epilepsy. In these instances, there is initially an excessive feeling of presence. What ultimately occurs is the borderline experience of alteration in physical image and in spatial and temporal experience. In this context, we speak of epileptic auras, which can be tracked using hospital measuring equipment. Studying this neurologic condition, one sees what happens in the brain while extreme alterations in consciousness take place.
During an epileptic seizure, clusters of neurons discharge simultaneously. A characteristic of such focal seizures is that these discharges are confined to particular brain structures. Just before they lose consciousness—which does not necessarily happen; in the case of consciousness disorders and absence seizures, consciousness is sometimes maintained—affected individuals experience special perceptual impressions. These impressions are linked to the mental functions located in the affected regions. For example, in occipital lobe seizures, visual hallucinations can occur if the seizure remains confined to that area, or before the seizure spreads.
The Russian writer Fyodor Mikhailovich Dostoyevsky, who suffered from epilepsy, provided precise descriptions of his ecstatic auras in his novels and letters. Moreover, his wife, Anna Grigoryevna, wrote about her recollections of her observations and conversations with him. For example, the seconds preceding a seizure were often associated with incredible feelings of happiness and of meaning in life which—typically for mystical experiences—were indescribable.31 After such a seizure, Dostoyevsky’s suffering resembled the physical after-effects of drug intoxication, while mentally he lost the ecstatic state of happiness. Besides these feelings of depression, his memory and attention were functionally impaired for days. In his novel The Idiot, Dostoyevsky writes about Prince Myshkin’s ecstatic state during auras that lasted for seconds:
The sense of life, of self-awareness, increased nearly tenfold in these moments, which flashed by like lightning. His mind, his heart were lit up with an extraordinary light; all his agitation, all his doubts, all his worries were as if placated at once, resolved in a sort of sublime tranquillity, filled with serene, harmonious joy, and hope, filled with reason and ultimate cause.32
Finally, Dostoyevsky, alias Prince Myshkin, describes the ecstatic auras as an extraordinary state of consciousness:
Those moments were precisely only an extraordinary intensification of self-awareness—if there was a need to express this condition in a single word—self-awareness and at the same time a self-sense immediate in the highest degree.
By using such terminology, Dostoyevsky describes an extraordinarily intensified feeling of presence.
In the last few years, neurologists have been looking more and more at such experiences. An increasing number of patients have been examined in hospitals using imaging technology in order to locate the area of the brain with the most activity during a seizure. Studies available so far from Geneva and Linköping indicate that the anterior and central insular cortex is particularly activated during ecstatic auras.33 The patients in these studies convincingly report feelings of being powerfully physically and mentally present and aware of themselves (this recalls states of meditation); how the sense impressions are intensified and that the physical feeling can be compared with an unprecedentedly intense orgasm (this reminds us of accounts of drug intoxication); how they are in harmonious unity with themselves and the world; and that time and space no longer have any meaning (akin to mystical experiences or the effects of hallucinogens). Some patients talk about a transcendent force, sometimes about feeling the presence of a divine power.
First of all, these accounts correlate with observed brain events that indicate the involvement of the insula in the creation of a sentient self. In addition, the phenomena of extraordinary states of consciousness seem to be linked to an uncontrolled overactivation of the insular cortex. A heightened feeling of presence is produced, and this can ultimately result in a dissolution of the boundaries of the bodily self in space and also a dissolution of the sense of time. If confirmed, these findings illuminate how the physical sense of self is modulated by processes taking place at a neuronal level. A sensual exaggeration of the self goes hand in hand with an increase in the activity of the insular cortex. Beyond a certain threshold, if the activity becomes too strong, the senses tip over, leading to the disappearance of the feeling of self.
A study published recently by a group of French researchers has added to the data with the case of a patient presenting epileptic seizures in the right anterior insula.34 Uncontrollable with medication, these seizures were caused by a slow-growing tumor (astrocytoma) that had been surgically removed. The anterior insula had been damaged by repeated seizures before the patient could undergo an operation. Striking difficulties were observed in the temporal estimation of intervals on the scale of seconds—difficulties not displayed by patients with epileptic seizures in other areas of the brain. Of course, disorders in time perception can initially be regarded as merely secondary when linked to a patient’s neurological illness. But in the context of the data, which supports a comprehensive alteration in consciousness in this kind of epilepsy, this record of the experience of time acquires significance as an important marker for self-consciousness.
The psychiatric illness of schizophrenia is a disorder in which the experience of the self is massively impaired. Typical symptoms are delusional mental disturbances (sufferers feel they are being watched and followed) as well as auditory hallucinations (they hear voices making comments). Schizophrenia is primarily a disturbance of the “self,” as described by psychiatrists since the beginning of the twentieth century.35 In cases of schizophrenic psychoses, the phenomenon of self-alienation occurs: the sufferer feels threatened by the dissolution of the self. The “self” is experienced as permeable, the ego boundaries merge with the world, and a terrifying dissolution of the self results—a state that can also be induced by ingesting hallucinogens such as LSD. In addition, emotions, thoughts, and actions are experienced as alien or unreal. The “self” is no longer understood as a unity—it fragments, as it were. This is the account of one female patient:
I think I am dissolving. I feel—my mind feels—like a sand castle with all the sand sliding away in the receding surf. … Consciousness gradually loses its coherence. One’s center gives way. The center cannot hold. The “me” becomes a haze, and the solid center from which one experiences reality breaks up. … There is no longer a sturdy vantage point from which to look out, take things in, assess what’s happening. No core holds things together, providing the lens through which to see the world.36
This description clearly shows how the observer’s perception is pathologically impaired. It addresses the subject of perception, or, to put it another way, the processes generated by the subjectivity of experience. In normal circumstances, these processes create a unity of experience that underpins a unitary sense of the self as a spatial and temporal presence in the stream of consciousness.37 The unity of the self—at the phenomenal level, the self-consciousness—is on the one hand linked to the body as its frame of reference. My perception is perspectival, that is, related to the location of my body with its particular characteristics. On the other hand, I experience myself as someone who is perceiving both now and through time.
As numerous accounts of schizophrenic patients’ experiences record,38 self disorders in schizophrenia are accompanied by disorders in time consciousness. The temporal modes of past, present, and future shift in emphasis. The relationship with the future is experienced as unreal, and as a result the past becomes more intensely present. In a scientific paper published in 1929,39 the psychiatrist Franz Fischer reproduces the following account by a female patient (case history 7, patient Ku):
I stand still; I am cast back into the past by the words spoken in the room. … The present no longer exists, only a backwards reference. … Does the future exist at all? Earlier I had a future, now it dwindles increasingly. The past is so intrusive, it throws itself across me, dragging me back. … All this to say that the future does not exist and that I will be cast backwards.
Others among Fischer’s female patients emphasize the loss of the passage of time, and their feeling that time is standing still (case history 6, patient Ze):
The others walk to and fro in the room, but for me time does not pass. The clock works exactly as it did before. … Time passing and the clock hands turning are things I can no longer quite imagine. … What does the future mean to me? One cannot reach it. … Time stands still; … this is boring, extended time without end.
Objective time passes, as the patient can see by looking at the clock. But she can no longer feel the passing of time. If time stands still, equally the future can no longer exist.
Another patient, an eloquent philosophy student, also reports feeling that time is standing still. He clearly articulates how difficult it is for him to capture the subjective sense of time in words (case history 8, patient Ge):
Time broke down and stood still. In fact it happened differently, as time appeared as immediately as it disappeared. This new time was infinitely multi-form and intercalated, and in fact hardly to be compared even distantly with what we otherwise call “time.” … Thinking stood still, indeed everything stood still as if nothing existed any more. I seemed to myself to be a timeless creature, extremely clear and transparent in my psychic connections, as if I could see into the very heart of myself.
This patient even tries to override the temporal standstill using rhythmical movements, to produce a continuation of time, as it were:
It was a standstill, a freezing of the inner oscillation that otherwise permeates us psychically and physically and that can be called the “feeling of life.” In a nervous rush I attempted to help myself get over this by drumming my fingers on the edge of the bed, but without success. In doing this I attempted to beat out a rhythm, and I still well remember how important the very creation of a rhythmic beat seemed to me. Why, I can no longer recall.
It is striking—and this recalls the similar expansion of time and space in Walter Benjamin’s experience of hashish—that even the perception of space has changed markedly. The patient (Ge, case history 8) describes it as follows:
The space seemed to expand, to grow infinitely, and at the same time was as if emptied out, such as the time when I walked across the fields one evening. I felt incomparably alone and abandoned, powerless to fulfill myself and exposed to the infinitely broad space, which despite its emptiness stood threateningly before me. For me it was the immediate extension of my own emptiness and my psychic collapse.
Here the patient experiences the threatening ego disorder in relation to the space around him as isolation. Small and empty, the self faces the great surrounding world.
In schizophrenia, the continuity of temporal experience and with it the continuity of the self are disturbed.40 It is as if the “self” is stuck in the present. Time no longer moves on, and seems to stand still. Temporal standstill means the standstill of the subject. Normally we experience ourselves as a unity of our self. Our focus on anticipated events kick-starts our preparations for action. Mental presence means that we integrate past, present, and anticipated experience into a whole that is our self. As conscious beings we are constituted through self-experience in the three temporal modes. As the Heidelberg psychiatrist Thomas Fuchs puts it,41 in schizophrenia the “intentional arc” of our self-consciousness is disordered across the three temporal perspectives. The dynamic of the passing of time, which underlies the subjectivity of all our experience, no longer functions. Because subjective time “gets stuck,” the experience of the self that depends on the underlying dynamic temporal structure is impaired. Without the dynamic of this temporal flow, the “self” collapses into fragments of now.
Of course, in such a complex syndrome as schizophrenia, many areas and neuronal networks are affected.42 In particular, the connections between the brain areas seem to be disturbed. fMRI studies carried out by researchers at Munich’s Technical University were able to establish in detail the altered functional connectivity between three areas in the brains of schizophrenic patients:43 (1) the default mode network in the midline of the cortex, which—as previously described—is linked to mental “time travel” into the past and the future; (2) the dorsolateral frontal cortex, which is associated with the executive functions of attention and working memory; and (3) the so-called salience network, consisting of the anterior insular cortex and the anterior cingulate cortex. “Salience network” means that these areas are involved in the detection of external, but also and in particular, internal (i.e., emotional and bodily) states.44 In psychotic patients, the anterior insular cortex showed a conspicuous decrease in activity and in connectivity with other areas. This can be interpreted as an indication that decreased and disturbed bodily perception forms a basis for psychotic illness—with an impact on the immediate experience of the self and of time.
Some researchers, such as Sanneke de Haan and Thomas Fuchs, assume that the main disturbance in the case of schizophrenia lies in the lack of “embodiment,” as if the mind is not correctly anchored in the body.45 They claim that, phenomenologically speaking, the “self” lacks sufficient contact with physical processes, leading to disturbances in awareness of the body and of the emotions, and in temporal experience. This analysis might also explain the disorder presented in the case of Alexandrine, the patient whose story opened this chapter. Further fMRI anomalies in midline activity are highly consistent with the reported disturbances in temporal perspective. In addition, mental presence is dependent on the functioning of attention and working memory processes, which in turn are closely linked to activity in the frontal cortex. While exercising all due care not to overinterpret such results using imaging technology—which can only give an indication of possible associations—the researchers at Munich’s Technical University have identified their patients’ altered brain function in structures that are also closely associated with time consciousness.46
When schizophrenia patients are asked to estimate periods of time in the range of seconds, they indeed present as impaired. Studies carried out over the last few decades show that they frequently overestimate a period of time of several seconds.47 Short time periods of less than one second, by contrast, are if anything underestimated or temporally discriminated less accurately, probably because attention and short-term memory are not functioning optimally, i.e., the memory traces disappear more quickly.48 Consistent with the Munich fMRI study, the results of these studies on time perception using short duration indicate an impairment of the executive functions, as has been well documented in the pathology of schizophrenia.49
Correspondingly, many patients report time coming to a standstill and the simultaneous loss of the future perspective. These sensations are connected: because the relationship to the anticipated future has been lost, the feeling of time at a standstill arises. Can this subjective experience be recorded experimentally? Can we show at a behavioral level that schizophrenic patients get stuck in the present moment and their relationship to the future is limited? For a long time, subjective experiences of patients were recorded by psychiatrists who were actually interested in people’s lived experiences. They were, in particular, psychiatrists who had a philosophical education and were interested in phenomenology, and who wanted to understand the conscious experiences of their patients beyond a purely scientific worldview.50 To date, however, these reports have hardly ever been used to understand the illness and possible therapeutic approaches. Their shortcoming is that they were at most descriptive, and by no means all patients are eloquent enough to be able to express their complex experiences in words. If there were an objective method of recording subjective time consciousness, one could then examine patients purposefully, follow the course of the illness, and assess the success of therapy.51
Perhaps the most promising approach to the objective recording of time consciousness in schizophrenic patients is currently being pursued by Anne Giersch and her team in the psychiatric department at Strasbourg University Hospital. A computerized procedure is used there, which examines the ability to recognize the temporal sequence of visual stimuli. For a test subject the task is notionally simple. On a screen, two squares appear in two locations, on the left and on the right. However, most of the time the squares are shown not simultaneously, but with a short time interval in between.
If the interval lasts for a sufficient length of time, let’s say a quarter of a second, a person can easily recognize the temporal order: first right, then left. Eventually, however, as the intervals become increasingly shorter, the ability to recognize the temporal order suddenly and consistently decreases. That is, from a certain interval onward, the accuracy rate becomes increasingly worse. Nevertheless, the person can clearly see that the squares do not appear at the same time. Even if one can no longer clearly make out the exact temporal sequence, one can still see that the squares did not appear simultaneously; one has the impression of visual asynchrony.
In the experiments carried out by Anne Giersch and her colleagues, test subjects were asked to press one of two keys, positioned left and right, to say whether the two squares appeared simultaneously or asynchronously.52 For example, the left key was to be pressed if the stimuli were simultaneous, and the right key if they were asynchronous. At some point, when the temporal difference between the squares was between 20 and 40 milliseconds, the response was almost exclusively “simultaneous.” This temporal fusion of the two events, one could say, represents the functional moment discussed in chapter 2. Under these circumstances, the test subjects could no longer recognize the temporal asynchrony. An initial result from a sequence of tests is that schizophrenic patients answered “simultaneous” even in the case of longer time intervals between the stimuli, where healthy participants in the experiment could still clearly recognize “one after the other.” From these and many similar experiments, for example using auditory or complex visual/auditory stimuli, the researchers concluded that schizophrenic patients have an extended “now” moment.53 They need longer intervals between two stimuli in order to experience them as temporally distinct. We can interpret this as the objective correlative of the altered “now” perception in the case of schizophrenic patients—the feeling of time at a standstill and of expanded moments.
But this is not all. In the aforementioned analysis, the issue is the conscious perception of temporal asynchrony, of the explicit indication of temporal sequence. As Anne Giersch’s team of researchers in Strasbourg went on to discover, the patients’ implicit temporal processing is also striking. This was revealed through the unconscious behavior of the test subjects in the case of very short time intervals. When the temporal distance between the two stimuli is less than 20 milliseconds, it is impossible to consciously perceive the asynchrony. Test participants in that case pressed noticeably more often, although not always, on the “simultaneous” key. But an important effect distinguished between the two groups, even in the case of these short intervals. Healthy people demonstrated an unconscious motor “tendency” to press more frequently on the key that appears on the side of the second stimulus. Even if the test subject perceives the two stimuli as “simultaneous” he or she still shows a higher probability of pressing on the key that is on the side of the second stimulus. This means that in our system of perception, temporal sequence is processed unconsciously, and we just don’t notice it.
By contrast, schizophrenic patients displayed the tendency to press more frequently on the key located on the side of the first stimulus.54 This led to the interpretation that the patients—like the subjective reports—have become stuck in the “now,” and that they cannot follow the temporal sequence of the visual stimuli even unconsciously. Consequently, patients with schizophrenia process the stimuli in isolation, and not in a temporal sequence. The astonishing result is that at an implicit level the patients cannot look “forward” into the future, but get stuck in individual moments. This work potentially represents the discovery of an experimental paradigm that records an implicit behavioral disorder, corresponding to the subjective experience of the patients. It is surely only a first step in developing, at an objective level, a measuring procedure that can be used in future studies. It will, of course, be a question of assessing such abnormal timing behaviors in the context of clinical parameters; this is extremely important for the patients’ diagnostic and therapeutic support. Nevertheless it is possible that, through these results, research has taken an important step. It has been a long journey from the purely phenomenological recording of subjective symptoms in the disintegration of the self and the altered perception of time to the development of an experimental paradigm.
How should we evaluate hallucinogens? Are LSD, psilocybin, mescaline, ayahuasca, and all related substances dangerous intoxicants? Or do these substances provide us with access to another reality, like a vision of the divine? Highly diverse stories are in circulation on this subject, and each in its context identifies at least one aspect of reality. This is the case with alcohol, too. It is the means of overcoming social inhibitions, a brain poison that creates dependence in millions of people, an indispensable cultural asset, or even the blood of Christ.55
In the 1950s and 1960s, well over 1,000 clinical studies on the effects of LSD and psilocybin were amassed in medical and psychological journals.56 For example, psychodynamic experiments were conducted in order to reach the hidden layers of the unconscious by using hallucinogens. Another approach pursued the recording of mystical experiences induced by drugs. The “Good Friday Experiment” of 1962 became legendary.57 Twenty theology students attended Mass on Good Friday in a separate room in a church. Ninety minutes before the Mass, ten of the students were given psilocybin, and the other ten received a control compound with no hallucinogenic effects. Using a lege artis approach, the experiment was administered double blind. Double blind means that when the substances were given, neither the researchers nor the students knew who received psilocybin and who an inactive capsule.
The two-and-a-half-hour-long Mass then began, with organ music, singing, and contemplative prayers. It soon became apparent who had taken psilocybin and who had not. Ten students sat devoutly, but ten students left their seats, lay on the floor, and walked around in wonder, mumbling prayers. One played strange music on the organ, another adopted the position of Christ on the cross.58 Immediately after the Mass, the theology students were interviewed about their experiences during the Mass. When the data were deanonymized, it was confirmed that those who had received psilocybin had had significantly more powerful mystical experiences during the Mass.
In the rebellious 1960s, a crazy blending of science and cult occurred: we might remember the psychologist Timothy Leary, who started as a researcher at Harvard but was soon relieved of his teaching duties by the university, gaining the status of the LSD guru of a spiritual liberation movement. The narrative of the era alternated between mystical and psychotherapeutic promises of salvation and the condemnation of highly dangerous substances that might be ingested by anti-establishment hippies.
Today there is a veritable renaissance in hallucinogen research, free from the ideological skirmishing of the 1960s. For example, psilocybin is administered in schizophrenia research, in order to create in healthy participants short-term states resembling acute psychotic phases.59 Besides this, psilocybin is used in medically controlled sessions, because in the correct setting it can provoke mystical experiences that are potentially capable of altering the personality.60 In general, a person’s characteristics change only moderately once they have reached adulthood.61 A study led by Roland Griffiths of Johns Hopkins University in Baltimore showed that even a year after the supervised administration of psilocybin, positive changes in the personality trait of “openness” could be seen. The more powerful the mystical experience had been, the stronger the characteristic of “openness to new experiences.” In further studies with terminally ill patients, it could be shown that administration of psilocybin alleviated the fear of death.62 High doses of psilocybin led to marked decreases in depressed mood and death anxiety. At the same time optimism and the sense of life’s meaning increased considerably. Since participants of the study reported typical mystical-type experiences, these positive changes may be attributable to a stronger feeling of connection with the world and with the people around them. Even today, the cultural significance of hallucinogens varies according to the different scientific perspectives and stories that circulate about them. Narratives range widely, from the biological reductionist approach of the neurosciences, via holistic approaches (in psychotherapy and palliative medicine), to emphasis on spirituality and mysticism in descriptions of the immediate experience and the associated interpretations.63 For example, psilocybin-containing mushrooms, which occur throughout the world, or ayahuasca, a brew derived from a variety of Amazonian plants, are taken during shamanistic and religious ceremonies.
Scientific research on the effects of LSD and psilocybin has shown clearly that the states of consciousness involve striking changes in perception, emotions, and ideas, and also in the ways they are described: time, space, and the experience of self are dramatically altered. These changes are comparable only with other extreme states of consciousness such as occur in dreams, in mystical and religious ecstasy, or in acute psychotic phases in the early stage of schizophrenia.64 The dimensions of mystical experience include oneness of the self with the universe, the feeling of timelessness and spacelessness, the most intense feelings of happiness, and the certainty of experiencing a sacred truth which is, however, indescribable.65 The latter is the feeling of looking behind the veil of reality and seeing the immutable (that is, timeless and spaceless) truth of the world in its entirety. This experience also came to Tilmann Lhündrup Borghardt over many years of meditation.
Zurich has seen large-scale pharmacological, neuroscientific, and psychological research into psychoactive substances such as psilocybin, ketamine, and MDMA (Ecstasy) since the 1990s. The doctor who has for decades been leading this research at Zurich University’s psychiatric hospital, the Burghölzli, is Franz Vollenweider. Based on a questionnaire devised in the 1970s by Adolf Dittrich in Zurich and developed over the decades to record “abnormal states in waking consciousness,” tools were developed that can capture the extraordinary experiences that take place under the influence of psilocybin. Once the effects of the substances have largely abated, study participants are asked appropriate questions. The items on questionnaire 5D-ABZ (“five dimensions of extraordinary states of consciousness”) are organized according to the following factors: (1) oceanic boundlessness, (2) dread of ego dissolution, (3) visionary restructuralization (4) auditory alterations, and (5) vigilance reduction.66 Altered states of consciousness can be described as individual expressions of these dimensions. Factor 3 comprises visual hallucinations, a heightened visual imagination, and vivid memories; in factor 4, changes in auditory experiences are recorded; and factor 5 refers to reduced alertness and a heightened feeling of drowsiness.
In the context of this book, the first two factors, comprising the principal positively and negatively experienced aspects, are particularly important. Over the course of several questions, the “oceanic boundlessness” segment records alterations in the personal experience of self, a perception that is accompanied by an excessively euphoric feeling of elation. One question in particular addresses alterations in the experience of time. This set of questions generally depict the typical, mystical experience in positive terms. But it can be otherwise; the other side of the experience is addressed by factor 2, the dread of ego dissolution. Questions on this topic cover the feeling of losing control over events and the body, the angst-ridden sense that everything is completely unreal, violent thought disturbances, and the nightmarish version of a loss of boundaries between the self and the world. This is a “bad trip.” These two factors are experienced in similar ways, though one is perceived as ecstatic and heavenly, while the other is hell.
Over the decades, Franz Vollenweider and his colleagues have only rarely monitored people who had exceptionally unpleasant psilocybin experiences. This could be because prospective test subjects are questioned intensively as to whether they themselves or their relatives have psychiatric disorders or are conspicuously excessive consumers of drugs. Only if there is no personal or family history of psychiatric complications are people allowed to take part in a study. In addition, research participants are monitored the entire time. In an extensive, retrospective study by Erich Studerus, Michael Kometer, Felix Hasler, and Frank Vollenweider, researchers analyzed the experiences of all 110 of their test subjects, who had been tested with different doses of psilocybin in Zurich between 1999 and 2008.67 The “dread of ego dissolution” factor presented strongly only with the two highest doses of psilocybin used, that is, in around 6.5% of participants who received these highest doses. In the case of one participant, a 23-year-old medical student, longer-term disturbances of some weeks occurred, combined with anxiety and depression that had to be treated with psychotherapy sessions. The test subject reported having been overwhelmed with intensely negative memories while under the influence of psilocybin. In psychodynamic terms, hidden layers had been released, which rose to the surface of consciousness. Indeed, the administration of psilocybin intensifies the vividness of memories and visual images,68 a fact that could be used under certain circumstances in controlled psychotherapy sessions in the future. However, this particular case also demonstrates that hallucinogens can produce effects that require medical and psychological supervision.
Since the experience of time can be modulated powerfully under the influence of hallucinogens, it makes sense to study the phenomenon in more detail. After taking hallucinogens, people often report extraordinary states of consciousness, strongly resembling phenomena by now familiar to us, such as time appearing to stand still or minutes seeming to last for hours.69 Can these alterations in subjective time perception also be analyzed objectively as deviations from normal estimations of specified time intervals? In 2003, I was working in the Generation Research Program at Munich’s Ludwig-Maximilian University in Bad Tölz. My team, had developed a battery of computerized time perception tasks, which we applied to different groups of subjects. With a computer loaded with these tests I drove to see Franz Vollenweider and his colleagues at the Burghölzli in Zurich, where a major new study was in the process of being designed.70 A range of procedures for measuring time perception and the temporal control of motor skills was being integrated into the study. It was the first-ever systematic attempt to describe time perception under the influence of psilocybin using objective measuring devices.71
The test subjects, who attended the university hospital’s consulting rooms on three different days at intervals of two weeks, were given a placebo, a medium dose of psilocybin, and a high dose of psilocybin, in random order.72 Each day, they were subjected to time tests before the substance took effect, at the peak of its impact after 90 minutes, and as the impact diminished after 4 hours. Those taking the stronger dose presented stronger effects, and at peak impact the effects were greatest: when asked to temporally reproduce specified sound intervals, the test subjects who had been given the high dose produced a shorter temporal duration, deviated more markedly from the objective time, and were less precise. This effect was, however, only evident in the case of temporal durations longer than 4 seconds; shorter durations were not affected. When subjects were asked to rhythmically accompany a regular sequence of sounds, more mistakes and discrepancies crept in with intervals of 4 seconds, but not in the case of shorter intervals. The individual tapping tempo, wherein a self-selected tempo was to be tapped on a button repeatedly and at an equal rate, was also slowed down. This was, however, not as a result of a general deceleration of motor skills, as the test subjects were not slower when tapping a maximum tempo. This suggests that the conscious control of the self-selected tapping tempo was affected.
Are these results explained by the fact that massive alterations in experience and behavior are observed under the influence of psychoactive substances? What conclusions can indeed be drawn if test subjects tap the button a little earlier during the temporal reproduction of intervals test? It could be argued that these are extremely artificial results. But that objection is countered by the continual increase in effects as the dose rises, as well as the decrease in impact between measurements taken at the peak of the effect (after 90 minutes) and measurements recorded as the effect dwindles (after 4 hours). However, the crucial indication of psilocybin’s specific effect on time perception was provided by a correlation between the objective measure of temporal reproduction and the questionnaire for recording the subjective state, the 5D-ABZ. Indeed, the item “change in subjective time” correlated with the impairment in the timing of the temporal intervals. This means that the subjective feeling of an alteration in the passing of time was modulated together with the ability to estimate duration.
How does psilocybin affect the brain? Psilocybin activates special receptors (called 5-HT2A) of nerve cells, which are normally activated by serotonin, a neurotransmitter that occurs naturally in the brain and is closely involved in the regulation of emotions. When hallucinogens are ingested, the activity of the 5-HT2A receptors is massively affected. Using positron emission tomography (PET scan), the research carried out in Zurich on the effects of psilocybin on the brain showed a considerable increase in activity in the frontal areas of the cerebral cortex, including the anterior cingulate cortex and the anterior insula.73 And what is the link between these alterations in metabolic activity in the brain and conscious experience? In a study carried out in Zurich, the feeling of oceanic boundlessness correlated with an increase in activity in the frontal cortex in subjects who had undergone a PET scan.74 As further investigations suggest, the powerful activity of the serotonin receptors activates nerve cells in the frontal lobe that release the neurotransmitter glutamate, which in turn activate NMDA receptors. This means that psilocybin has an effect on the glutamate system of the brain via serotonin receptors. These are interesting findings, and they can be related to an idea put forward by the neurobiologist Hans Flohr on the subject of phenomenal consciousness. The activity of the NMDA receptors in complex groups of nerve cells is modulated when certain anesthetics, such as ketamine, are administered: this effect is important for monitoring unconsciousness during operations, for example. Thus psilocybin indirectly influences the function of a neurotransmitter system that is closely linked to the modulation of consciousness.75 The massive hyperactivity in frontal areas of the cerebral cortex can be clearly linked to reports of sensory hyperstimulation—of a hyperpresent world in which the self (experienced negatively) threatens to disappear or (experienced positively) becomes one with the whole.
The effects on the brain’s neurotransmitters that we have described represent only a selection of all the alterations that have been recorded: for example, the dopamine system is also affected. More recent findings by researchers at Imperial College in London initially created some confusion: they were able to show using fMRI how a medium-sized dose of psilocybin, administered intravenously, led to an immediate reduction in activity in many areas of the brain. The research team, led by Robin Carhart-Harris, interprets their results to mean that psilocybin leads to a collapse of normally highly organized brain activity.76 This disintegration of activity across the brain thus coincides with the frequently experienced disintegration of the self. In particular, reduced activity in the cingulate cortex and a diminished functional connectivity between these regions (the default mode network of the cortical midline, an area discussed earlier in this chapter) and other areas of the brain were related to subjective alterations in the experience of the self. The default mode network is linked to mental “time travel” into the past and the future and is responsible for situating the self within time. Accordingly, disintegration of the self and time and the disintegration of the connections with the default mode network go hand in hand. This shows a correspondence, at least superficially, between conscious experience and underlying neuronal processes.
In these diverse findings, we can see that our knowledge about the effects of psilocybin is still inadequate. In addition, we can see how various methods lead to different results. For example, in the PET scan, the use of a radioactive sugar tracer is measured, while in fMRI the relative oxygen content of the blood is assessed. Also, the researchers in Zurich used capsules, which when taken orally produced their maximum effect only after about 90 minutes. The English researchers, by contrast, administered the substance intravenously, a procedure that is fully effective after just a few minutes. The discrepancy between the findings of the Zurich and London teams can probably be explained by the different means of psilocybin intake.77 It is also due to the mathematical methods used to derive meaningful results from the data. Using a special kind of data analysis, the London team recently showed that after the intravenous administration of psilocybin, lots of short-term functional connections between areas are established; these were not detected in the case of a placebo.78 This dramatic increase in fine, functional networks is highly consistent with the massive alterations in perception and mental associations that characterize the effects of psilocybin.
Hallucinogens have a profound effect on both the sense of self and the sense of time. Given the right context, these altered states of consciousness can be of the mystical kind. That’s why they are part of religious rituals for indigenous cultures but are also part of philosophical discourse in Western culture. In recent years they have also become a therapeutic means to treat depression and anxiety disorders—in patients with life-threatening cancer, but also in patients for whom standard pharmacological therapies failed. These drugs are also used to treat addiction to alcohol, cocaine, and tobacco.79 The available studies to date are still considered experimental, since large clinical trials have yet to be conducted. The first results are very promising and show impressively positive effects. In explaining the sometimes astounding transformation an individual goes through, the researchers suggest that the psychedelic “spiritual awakening” gives a person a different perspective on life and a sense of meaning. This could happen through the mystical connecting of the individual self with the world. Similar to what highly experienced meditators report, meaning and happiness grows through this spiritual connection with our fellow sentient beings.
Indeed, hallucinogens can be personality-changing and life-changing, as controlled studies have been able to show. However, as reports on psilocybin’s functional mechanisms make clear, the neurobiological mechanisms of psychedelic substances are poorly understood. While rare and spontaneously occurring mystical experiences are hard to explore scientifically, in hallucinogens we have a class of substances that can be used in a clinically controlled way. This opens a window for researchers to investigate extraordinary experiences that people throughout history have undergone. Research into the mystical experience of the disintegration of time and the self under the influence of hallucinogens is a way toward understanding human consciousness.