Wednesday, 14 June 2017

hallucination as unrelinquished anticipation

notes for talk this week: a phenomenological theory of hallucination 

Posted here to supersede and collate previous musings on hallucination.

1. ontological question of hallucination

What is it to hallucinate? What is the being of hallucination? This not an empirical question about psychological precipitants or associated neurological events.

2. against dualistic answers to the ontological question

If you espouse dualism of inner (mind/brain) and outer (world/body), then you hardly need a theory of the being of hallucination. Your conception of perception will likely already reference an inner mental item of some sort ('inner representation'/'percept'/'sense datum'/'idea'), so: hallucination becomes simply the inner item in absence of outer stimulus. (You'll also be likely to: take seriously the problem of constancy, be drawn to Helmholtzian theorising, talk of unconscious inferences etc; Gibson won't speak to you.)

But perception and experience are not just caused by their worldly objects; they take them in. Not hybrids of i) non-mental causal outer interactions with a world (the mechanics of vision and audition etc) plus ii) mental upshots of 'loud and glowing sense data' in an internal world. Instead perceptual experience is our openness to the world; it is originary transcendence. In this sense of 'perceptual experience' a hallucination is precisely not a perception or experience; paradoxical to talk of 'an experience of a horse in the absence of a horse'.

'Inner representation', 'sense datum', 'inner image' etc are simply philosophical inventions which themselves cry out for explication before they themselves can feature in explanations. What use is a visual representation if one can't see it? Doesn't the concept of a 'representation' - e.g. of a picture - presuppose rather than explain the capacity to see what is thereby pictured? Such notions need explaining before being put to use to 'explain' perception. But why do we even need an explanation? The felt need had better not be a result of a theoretically contrived dualism between mind and world (the unnecessary explanation being of how it is possible for such an alienated subject to reach the world; ... dude, we're not world-alienated subjects, it's ok).

Non-disjunctivism says: the visual perception of a horse, and a hallucination of a horse, have something psychological/inner in common. 'Psychological': not just that they have in common the atemporal fact that the right way to describe their content is 'a horse'. Instead: they (allegedly) have in common something experiential and episodic. They are not just both experiences of horses; they are both - some or other allegedly illuminating sense - experiences of horses. 

Disjunctivism: it is no more illuminating to say this than to say that a real horse and a plastic horse are both horses, or that a standing bridge and a bombed out bridge are both bridges. We can say that a hallucination is a perceptual experience, just as we can also say that a bombed-out bridge is yet a bridge. But in both cases what is essential to the being of the perceptual experience (openness to the world) and the bridge (forging a connection between two sides of a river) has been lost. The reason why we identify the broken bridge as a bridge, the plastic horse as a horse, the hallucination as an experience, has to do with their ontological dependence on real bridges, horses, perceptions. We can call both veridical perceptions and hallucinations 'experiences', but this is not because they share something episodic in common, but instead because additive mention of all such phenomena gives us the extension of one concept of 'experience'. 

3. differences to hallucinators of hallucinations and perceptions

Not elucidatory to say that in both real and hallucinatory cases it seems to us that there is a horse in front of us. For it may not seem to the hallucinator that there's a horse in front of her. Perhaps it seems to her that she's hallucinating a horse. 

Merleau-Ponty: examples of hallucinators being able to tell the difference between hallucinations and his perceptions. Early 20thC French and German psychiatrists playing tricks on psychotic patients with mock-ups of hallucinations, and reporting how taken aback the patients were, and how differently they related to their real and hallucinatory experiences with the same object.

Also: unclear what it means to say of someone who clearly sees a horse that it seems to him that he sees a horse. This because part of the work that the concept of 'seeming' does is to distinguish between, for example, when something 'really is' the case and when something 'just seems' to be the case. To say that there is a 'seeming' alive in both cases sublimes the logic of 'seems'.

4. existential phenomenology - thinking form and content together

Value of existential-phenomenological theory is that it thinks hallucinatory form and content together. Dualistic theories, by contrast, typically chalk up form to neurological factors alone, and view content as epiphenomenal or to do with psychologically intelligible preoccupations, traumas, complexes, self-esteem, etc.

In thinking form and content together we also aid rapprochement of psychiatric understanding of form with psychoanalytic understanding of content.  (Thinking them together: we can ask: why would that be the content of a hallucination? The form of our embodiment is central to answering this.)

I will call hallucination: an embodied expectation of hearing (or seeing, being touched, etc.) uncancelled by (unrelinquished despite) the absence of a stimulus; a 'negative' (quasi-photographic) or 'anti-'experience, an ungraspable absence registered as a presence. This an existential-phenomenological characterisation, not a reductive explanation. Merleau-Ponty: We need to understand - to 'live' - hallucination without reductively 'explaining' or psychologically reducing it. 

Talk of 'embodied and cancelled expectations' is not straightforwardly perspicuous. We instead arrive at sense through analogies, disanalogies and examples. (Similarly for perception - to say it is our 'originary openness to the world', that it 'takes us out to the objects', that it involves an 'originary transcendence', hardly conveys positive information. Instead: reminders not to make a travesty of our concept of perception by espousing dualism of inner mental domain enjoying merely external relation to an external world.) Of course one can have unrelinquished anticipations which do not constitute or coincide with hallucinations! I am truly aiming at an identity claim, but the particular meaning of 'unrelinquished' and 'anticipation' will emerge as we proceed.

5. hallucination as uncancelled anticipation

Hallucination: an embodied expectation of hearing, seeing, being touched, etc., uncancelled by the absence of a stimulus; a (quasi-photographic) 'negative' or 'anti-' experience; an ungraspable absence registered as a presence.

Anticipation: Merleau-Ponty follows Husserl in describing how perception has built into its structure a large array of 'promises' - if I move over there, and my vantage changes, or if I pick this up and turn it over, that I will encounter this or that. An interconnected protentive structure of experience constituting our normal perceptual world. Objects offer what Gibson calls sensori-motor affordances. M-P: 'I can feel swarming beneath my gaze, the countless mass of more detailed perceptions that I anticipate, and upon which I already have a hold'.

Merleau-Ponty on hallucination: 'The illusion of seeing is ... much less the presentation of an illusory object than the spread and, so to speak, running wild of a visual power which has lost any sensory counterpart. There are hallucinations because through the phenomenal body we are in constant relationship with an environment into which that body is projected, and because, when divorced from its actual environment, the body remains able to summon up, by means of its own settings, the pseudo-presence of that environment.'

Walk along - expect the floor to stay still. Get onto an escalator, expect it to move thus and so. Turn an object over in your hand: expect it to appear thus and so. Self usually rapidly and automatically adjust to various environmental changes. 

Selfhood and perceived object are two correlative moments in perception. What belongs to whom - this is what must be divvied up by the intentional arc which subtends and (at the 'chiasm') divides the two subject and object poles: I've moved further away? Or: it's got smaller / moved away?

Spinning: spin around a lot - then stop - the world appears to spin. You've set up certain expectations of self/world movement in your lived body. These expectations are not visually met with (because you stopped spinning). They're not immediately relinquished/cancelled. So then, instead, the world appears to move. In intoxication we have the same difficulty. Expectation and world are not so tightly coupled. Maximal grip is degraded.

Broken escalator: your body carries expectations of movement even if you can see escalator is static. Get on the escalator - it appears to lurch in the opposite direction. Your body stumbles. Why isn't it like getting on a normal staircase?

Jewellery removed: take off a watch or bracelet before swimming or before doing the washing up. Normally you don't feel it. But now you feel an anti-bracelet around your wrist!

Sensory deprivation: nothing to entrain the web of anticipations; nothing to cancel them (no staircase fully visible where a person would otherwise occlude it). Hallucinations spring up from fleeting unrelinquished sensory anticipations.

Phantom limb: the expectations that constitute the body schema can't be readily relinquished. 'Knowing that your limb is gone' is not a neurological unity - various disjunctive criteria for that, some of them verbal and some motor-habitual. (Harder to adjust if unconscious when amputation happened.) 

Rubber hand illusion: disturbance of sensory integration. Tickling of feather is not where body expects it when body takes rubber hand for own hand. So position of hand in body schema is adjusted. (Can cause OBEs in schizophrenics.)

Ghosts: my beloved has died but this understanding has not propagated through my set of reactive dispositions. That is: I still expect her to come through the door. She does not. Yet the expectation does not immediately relinquish: instead I 'see' a 'negative' of her.

Succubi, incubi, old hags, alien visitors: sleep paralysis undermines ability to update the body schema. Corollary discharge of the motor intention plus no change of retinal stimulation due to paralysis naturally gives rise to hallucinatory experience - projection of body image. Sense of evil - self-disintegration (terror - see below) and hallucinated body shape combine in the night terror. 

AVHs: perhaps not so easy to generalise to 'hearing voices'? The model would be: I have a latent anticipation of hearing my name being called. And in cases of mental illness, a latent anticipation (in the complexes) of receiving hostile criticism, of being talked about, etc. I do not manage to experience silence - in other words my latent anticipation is not relinquished. I then 'hear' an 'anti-voice' saying what I expect to hear. AVHs are auditory ghosts. Why expect criticism? This is the 'introjection of the bad object' to form persecutory superego.

Addendum: Charles Bonnet Syndrome visual hallucinations - in some of those with significant retinal damage - i.e. with partial blindness. Standard theory: impairment of normal visual stimulation unconstrains the brain from producing 'images' (of little people, of objects, landscapes, and repeating visual patterns). Alternative: hallucination here too is result of 'anticipations' uncancelled by normal sensory input. Question remains: why does person have such anticipations - of encountering people etc.? Well: of course we have expectations of encountering people, objects, landscapes, etc. And if we experience a little bit of a pattern it may be natural to expect this to continue as well (in the absence of the cancelling effect of regular visual input). Elaboration of a partial visual stimulus into a face, person, object, pattern ought to happen, and is what subtends normal protentive dimension of visual experience.

6. hallucination as failed grieving 

Failing to smoothly update body schema: caused by identificatory failures of mourning, by intoxication, by tricking the body (psychologist's rubber hand illusion etc), by schizophrenic fragility.

Easy to update, to 'grieve', when the lost phenomenon not really a part of who one is. 

Grieving: not an emotional experience that sits on top of the letting go of reactive dispositions to encounter the departed other / the amputated limb. Grieving is the embodied relinquishing of these expectations. Grieving tears at the fabric of our self, allowing it to adjust to new situation without the lost object. (You can't ask: 'why does mourning (letting go) involve feelings like that (grief)?' because the feeling is the experience of the adjustments within the mourning process.) 

Ghosts: intrinsically mournful phenomena. Beckon to the living from 'another world'. They still have something they want to say. They can 'haunt' - won't leave you or this world alone, trapped between the worlds. All of these properties in fact belong to the bereaved: it is we who can't let go of the beloved, we who want to say something to her, we who can't relinquish our expectations. The ghost is the reverse of these - rather than grieve we hallucinate. Ghosts - so-called presences - are, in fact, unmanageable absences.

This is not wish-fulfilment. It is a direct product of the non-relinquishment of the anticipations. It is no more wish-fulfilment than our lurch on the static escalator. 'Ghosts' are lurches on the static escalators of our animal souls.

7. hallucination, terror and self-dissolution in schizophrenia

Self and perceptual object are correlatively enacted structures.

If we can't achieve self-world stability - grip (as in maximal grip) - then disintegrative terror looms. Not being able to attain object-stability is also disturbing. Because of their correlative enactment, not two alternative scenarios.

Schizophrenia - especially coenaesthopathic schizophrenia - involves a fragility to slippage of body schema - and by implication a vulnerability to disturbed self-world enactments (hallucinations, autoscopies, passivity experiences, coenaesthopathies, OBEs).

Parts of body schema become sheared off. Transitivism, appersonation, passivity experiences, alien hand, coenaesthopathies develop as body is no longer 'lived', alien invasions, electrical experiences, kundalini, etc.  Or displacement of point of perception - autoscopies, OBEs.

Terror is the experience (the undergoing - i.e. non-transitive experience) of self-dissolution. (The identity claim matters - now you can't say 'but Richard why is that so scary?') 

Delusionality: the relinquishing of the attempt to solve for self-world discrepancies, the retreat into autism / detachment from reality / disconnection of sensori-motor feedback cycles / diminished fonction du reél. Delusion is a way to not experience terror of self-dissolution (persecution is better than disintegration).

8. hallucination and therapy: between identification and grief

Compared to perception (reality contact) and self-world adjustment, hallucination is failure.

Compared to introjective identification with bad object, hallucination is a success!

That is: the hallucinator who 'hears' a persecutory voice is at least now not completely identified with it.

Hallucination can be seen like psychoanalytic symbolism (in dreams, images, preoccupations, obsessions, delusion-like ideas, etc): as a stage between illness and health. Both regressive and progressive moments possible. Recognition and encouragement of it's progressive dimension is the therapeutic task.

Therapeutic task is: relinquishing the anticipation! This may be updating the body schema with mirror boxes etc for phantom limb sufferer. It may be grieving the beloved, realising what one oneself wants to say to him or her, in those who see ghosts. It may be taking care to stabilise body schema, and sharing understanding about this, in schizophrenia.  

This contrasts with a conception of hallucinations as 'inner images'. On that conception we're likely to see them as psychologically unmotivated brain events, or as wishfully motivated (since imagination is often under control of the will). By contrast the anticipation account provides a clearer therapeutic direction.