Thursday, 4 August 2016

hallucination, cracked

In recent-ish posts I've been stumbling piecemeal towards an existential-phenomenological theory of hallucination. What I'm looking for is what I take to be the holy grail of psychopathology (alongside, you know, cracking das Wahnproblem; oh, and properly theorising thought disorder as dissociality). This is a theory which reveals the of-a-piece-ness of the form and the content of schizophrenic hallucination. Of course it's just a supposition of mine - a 'hope' if you like - that they are indeed of a piece. Most psychologists and psychiatrists think otherwise: they go all weakly bio-psycho-social on us before we've even got our existential investigations off the ground, parcelling off content to the psychological and form to the biological level of explanation. (En passant it seems to me that an existential-phenomenological investigation of the structuration of the mind operates at a different 'level' altogether than the three in the b-p-s scheme.)

Let me be clearer about what I'm (not) after. The kind of theory which posits a merely external relation between hallucinatory form and hallucinatory content might say: well, the content of hallucinations (excoriating voices, say) reflects the low self-esteem and the self-abasement, the personal preoccupations, the past traumas, the shadow or the harsh superego (take your pick), of the patient. Yes, but: why hallucinate? Why do such preoccupations take this form? Well, the standard b-p-s theory now flips to a different level of explanation to provide this, with a concept like 'anxiety' or 'stress' or 'dissociation' mediating between the levels. Basically: hallucinatory form is said to be a function of neurological overwhelm. The overwhelm may have happened because of those psychologically intelligible reactions documented above. But what it does to the brain is, as it were, accidental: it just happens that the associated stress put the brain into a state which couldn't support normal functioning. Hence hallucination. Accident. Punkt.

There is in fact a rather lazy further answer to our question which transcends the biopsychosocial mishmash - it's taken from psychoanalytic psychiatry. This is that the hallucinatory form is a function of the relations amongst intrapsychic agencies. You get hallucination because, say, the superego is directly addressing the ego. Or something like that. Now I don't disagree with this, I just think it's not yet ascended to the status of a real explanation. So far it's little more than redescription. This largely because, as yet, we don't have a clearer idea of what it is for the superego to address the ego than we do of what it is for the patient to hallucinate. Talk of 'superegos' possesses explanatory force when we're thinking about matters of the origin of the self-hating disposition, the form it takes, etc. (developmental 'internalising of the bad object' being the idea here). But it doesn't possess - so far as I can tell - explanatory force in relation to the hallucinatory form. We carry over, in our explanations, in only an impressionistic way from the externality of the superego and ego to the externality of the voice and the subject. So, well, I'm going to leave such talk behind here (also I find the metapsychology too arcane and self-satisfied).

Another answer will not appeal to pre-existing intrapsychic agencies, but will instead focus on dissociation into separate agencies. (Such approaches stem from Pierre Janet, the master of dissociation-based psychology.) Under conditions of stress the mind pulls apart. Such conditions might include the nastiness of certain thoughts. So: I think a terrible traumatic-abuse-induced thought ('I am worthless') but the associated affect overwhelms me and so I dissociate - now my thought is ego-alien - it's what we call 'a hallucination'. Again, this answer is not at all implausible, but it still leaves the content and the form externally related - even though now at least they both form part of a purely psychological explanation. The holy grail I'm seeking instead aims to help us 'think both form and content together', understanding them in terms of one another. ... Furthermore the dissociation-based explanation is still a little lazy in that it simply helps itself to the intuition that internal dissociation gives rise to hallucination. (You defensively split off from the thought, so now it appears ego-alien.) My concern is once more that this is non-explanatory redescription dressed up as explanatory redescription. For we still want to know, like: how does it actually happen?

Here's part of an answer - inspired by Dreyfus in turn inspired by Merleau-Ponty - that I find endlessly intriguing. It's that of the 'breadth unconscious'. The idea is that significant aspects of what we can call 'unconscious' (but bear in mind that this term is here as yet a placeholder) are not hidden unobserved in the back of the mind. Rather they form part of the structure of the 'clearing' (Heidegger) itself, or they permeate the 'atmosphere' (Merleau-Ponty). I am unconscious of my anger towards my father because I am so supersaturated by it that it is not graspable by me. It has defined and informed my measuring sticks and so cannot itself be measured. It is an automatically adopted window from which I look out at the world without realising it, a lens I don't - can't - notice I'm looking through. ... It forms part of the structure of the seeing eye, rather than itself being seen. ... I can't get my head around it because it is completely around my head. (The super-important point here is - whatever you do - not to assimilate the breadth to the depth unconscious - not to imagine that here we meet with a thought or feeling simply un-noticed or un-recognised...)

And here's another part of an answer - inspired by Freudian psychoanalysis (especially Anna Freud and W R D Fairbairn). It is that of introjective identification. When an object relation is not manageable I may instead identify with the bad object. (Think Stockholm syndrome.) If you can't beat them, join them... but join them in my bones: no calculated truce this. I don't feel your lack of love towards me if I join you in your values. That way I stay close to you. I become just like you - or, better perhaps, I become you. If I fear you will punch me I hug you: that way there's no distance between us for your fist to travel and gain momentum. The idea is that this is automatic: the identification becomes so entrenched that fear now doesn't even arise. Or you die and to avoid the pain of mourning I become you; this way I haven't lost you.

Let's now put those two parts together: I identify with you, and in doing that the feelings which I thereby avoid become part of the clearing/atmosphere/perceptual apparatus.

Here is the third part of my answer - inspired in some ways by Kleinian psychoanalysis but developed in my own vein. This is that there is yet a basic counter-identificatory, individuating, force in human life. This force is sometimes called 'symbolisation' or 'dreaming' or 'thinking' (I mean these terms in distinctive psychoanalytic senses - please don't read them with all their everyday connotations!). In (let's call it) 'thinking' what happens is I become able to separate from something with which I'm bound up. In so doing I have that comprehending affective experience which we call 'a thought'. I now enjoy a comprehending experiential relation to the object of the thought (I am no longer sunk into it in the identification: I can see it as itself). Because of the space that opens between me and the fist, once I stop embracing this opponent it can once again hurt me. But now I am at least free from my unwitting embrace of it; I can think what to do. I can express myself. I may take steps to get out of there, I may grieve, I may punch back or otherwise assert myself.

The fourth part: When I hallucinate what I am 'experiencing' is a 'negative' of an experience of something or someone. We don't have to do with 'seeing/hearing what we expect to see/hear' or with an 'inner image' of the thing hallucinated. (Let's leave such simplistic mentalistic and psychologistic notions aside... and instead plumb the existential-phenomenological depths...) Here I want to understand hallucination along the lines of a certain understanding of illusion. Like our lurch on the static escalator, like the ghostly watch around your wrist when you've finished the washing up (i.e. before you put it back on): the hallucination is an absence experienced as a presence.

Why is the absence experienced as a ghostly presence? Because the lived-body is still, in its identification with the object, partly readied for non-experience of it. The lived body still has the identified-with object/person sedimented in its background/clearing/atmosphere. It's only as yet on-the-way-to relinquishing it. I move from identification to relation and, then, whilst the move happens, I hallucinate. (The hallucination is the subjective experience of the disidentification.) I hallucinate the object the identification with which I am currently relinquishing: I experience what I'm here calling 'the negative of' this object as it 'leaves' me. (Now we can see more clearly how readily ideas of spirit possession spontaneously come about!)

It's like this (analogy:). You are utterly habituated to a certain sound. But then it stops. Now you hear a negative of it. (We might even try to do something with this by saying 'the silence seems really loud'.)

What is thinking? (I'm thinking of that kind of thinking which is mulling in foro interno.) It is, I imagine, rehearsal for conversation (which by definition is not currently happening) or it is, when we meet with creative thought, the disidentification from presupposition. (Presupposition is an enmeshment with (an identification with) an aspect of the world, a blindness to what may be.) If I fully take for granted, utterly automatically, that I'm a shithead, then I won't be able to hallucinate anyone telling me that. (Perhaps I totally internalised this message as a verbally abused child.) But imagine that I now achieve hallucination of that 'You're a shithead Richard'. Great! Individuation is underway. How do we get to full relinquishment? (I'm assuming that someone will only keep hallucinating if they don't fully relinquish the identification.) Well, understanding that the voice is something which was previously unconsciously believed by oneself would be a good place to start! (I hope it's clear how the existential-phenomenological perspective affords us rather more therapeutic subtly here than a more ontically grasped voice-dialogue approach.) It's not a matter of standing up to the voice - we don't need new enemies. It's a matter of furthering the standing up to the content of the voice which the very having of hallucination has already begun. (The voice is already not us.) For hearing voices already provides an entry point to not believing what they tell us. The super-saturated atmosphere - the breadth unconscious containing the toxic identifications - is starting to crystallise out a distinct content, freeing up the form of the clearing for more open world-relations.

Why are we more likely to see ghosts of the departed? Because, I suggest, it is when they are gone that we can begin to safely disidentify from them. Before then there's too much pressure to be them. Later on, though, we can achieve release.

Hallucination may be frightening. But when you think about it, it's pretty hard to see how living disidentification could obtain without it. Can we embrace it, then, as the form taken by that madness which itself is disidentificatory healing spontaneously at work?