A book on hallucinations which are not caused by schizophrenia and other psychotic disorders. (It also doesn’t deal much with culturally normal hallucinations, which is too bad.) Hallucinations – sensory perceptions which occur during waking and are not based on consensus reality - are surprisingly common, and include many experiences which probably most people don’t think to define as hallucinatory.

While drifting off to sleep, with my eyes closed, I often see kaleidoscope-like geometric patterns, faces (often grotesque or witch-like), and occasionally swarming insects. They are not dreams, are not perceived as being part of reality or projected into the real visual field, and do not have emotional connotations. I always assumed they were caused by going from visual perception to blank darkness while drifting toward sleep: a sort of meditative optical illusion/visual imagination.

They are called hypnogogic hallucinations and are extremely common, and the particular things I see are commonly seen, along with other stereotyped visuals. (“Stereotyped” as in common to people who experience the phenomenon, as opposed to “unique.”) They are caused, in simple terms, by the visual centers of the brain “idling” before sleep.

Hypnopompic hallucinations are less common, and are more vivid, often briefly perceived as real, often frightening illusions which occur upon waking from sleep. I've had those too, thankfully only a few times; mine were quite unpleasant, full-sensory illusions of being entombed in stone. They were not nightmares, though; I could also see my real surroundings. Once someone in the room with me verified that I had my eyes wide open and could track movement and respond to voices.

I have also sometimes, while wide awake, heard my name being called, when no one is there or when nobody called it. This is also extremely common. People in dangerous situations often hear voices giving helpful commands or suggestions; grieving people often see or hear their loved ones. These phenomena are common and “normal.”

I wish Sacks had analyzed those situations more in neurological terms, because I find that fascinating. The main theory he suggests, regarding auditory hallucinations in general, is that they’re a glitch caused by the brain failing to recognize its own thoughts. Another possibility is that people become consciously aware of the non-verbal stream of consciousness beneath their articulated thoughts, and perceive it as coming from the outside.

Sacks covers a number of hallucinatory experiences caused by neurological conditions, such as Charles Bonnet Syndrome, in which blind people hallucinate certain types of sights. Also, in a fairly funny chapter, his own youthful drug use.

The non-psychotic hallucinations are typically either never experienced as “real,” or are easily believed to be unreal once someone explains that they aren’t real, or are understood to not be real once they’re over. This is quite different from psychotic disorder-type hallucinations, which are often believed to be real, even when they end. (A person with PTSD may hallucinate, but they typically either always know the hallucination isn’t real, or, as in the case with flashbacks, figure it out in retrospect.) Regarding culturally normal hallucinations like ghosts, people may believe that they did literally see a spirit, but they also regard it as a spirit – a visitor from another realm. That’s a different experience from literally believing that Abraham Lincoln is living in your guest bedroom. (To avoid wank, let’s assume that I am only discussing those perceptions of spirits, God, etc, when they really are hallucinated and not objectively real.)

Hallucinations without accompanying delusions don’t usually cause major life problems for people. They are not “crazy,” though they might worry that they are. Delusions seem to be what cause the life problems.

The book is well-written and intriguing, as one would expect from Sacks, but more descriptive than analytical. Some types of hallucinations, particularly visual ones with a clear-cut neurological basis such as migraine auras, are explained in neurological terms, but others are simply described. The descriptions are quite evocative and the material is fascinating, but I would have liked more neurological speculation, especially on why certain situations or conditions create certain types of hallucinations, like fever deliriums causing distorted perceptions of size, which are almost invariably perceived as unpleasant or threatening.

I also wish he’d covered auditory hallucinations in more depth. At times he speculated on historical figures who might have heard voices. The problem is, many people write about the simple perception of their own thoughts in voice-like terms, so it’s very hard to tell whether someone literally meant they heard a voice, or only that their thoughts were so vivid that they seemed voice-like. It seems entirely possible, too, that two different people might have a neurologically identical experience, but one might attribute it to an outside voice and one to distinctive inner thoughts.

Please discuss your own experiences of and theories on hallucinations, if you wish.

Hallucinations

Recced by rydra_wong. Great rec, thanks!

Excellent, clearly written, honest memoir about the mind-body connection. My description is going to sound straightforward, but you really have to read the book to get what I got out of it. I've read a fair amount of memoirs and nonfiction about physical disability, mind-body issues, and even the type of paralysis Sanford has, and thought I understood much of what he discusses, at least on an intellectual level. After reading this book, I feel like I have a far, far better and more visceral understanding.

At age thirteen, Sanford was in a car accident which killed his father and sister, and paralyzed him from the chest down. He goes through puberty while still recovering from his injuries, which was fairly traumatic all by itself, and grows up seemingly doing fine, but inwardly suffering from being disconnected from his body. Well-meaning doctors told him that the sensations he had in the paralyzed parts were meaningless "phantom pains," and Sanford learned to dissociate himself from his body as a survival mechanism, to be able to endure otherwise unbearable pain.

Later in life, he begins studying yoga and learns that his entire body is still a part of him, and he does still have a perception of it and feelings from it. I already knew that people with spinal injuries do still have sensations below the point where the nerves are severed, but they're, essentially, transferred by indirect means and may be felt in other parts of the body or in different ways. Sanford explains not only what this actually feels like, but how important it is not only physically, but emotionally and even spiritually.

He is now a yoga teacher.

Fantastic book. Read it if you have any interest whatsoever in the subject matter, and by that I mean mind-body issues, not just physical disability or yoga.

Note that while Sanford doesn't get into tons of graphic details, there are fairly harrowing descriptions of injuries, medical procedures, and pain. The one that got to me the most was when he broke his neck a second time after the car crash, by tipping out of his wheelchair, and someone insisted on moving him despite his protests.

Waking: A Memoir of Trauma and Transcendence

Craziness also runs in the family. I can trace manic depression back several generations. We have episodes of hearing voices, delusions, hyper-religiosity, and periods of not being able to eat or sleep. These episodes are remarkably similar across generations and between individuals. It's like an apocalyptic disintegration sequence that might be useful if the world really is ending, but if the world is not ending, you just end up in a nuthouse. If we're lucky enough to get better, we have to deal with people who seem unaware of our heroism and who treat us as if we are just mentally ill.

This is Mark Vonnegut's second memoir. (Kurt Vonnegut's son.) The first one explains how he had a psychotic break while a young man living on a commune. Due to the circumstances, everyone at the commune just thought he'd become spiritually advanced. Eventually, his parents stepped in to rescue him. It concluded with the note that he was diagnosed with schizophrenia but apparently "recovered," which is unusual, especially given that it all went down in the 1960s. I had wondered if he'd been misdiagnosed.

His second memoir picks up many years later. He became a successful doctor... who periodically had psychotic breaks, to go with his drinking problem and falling-apart family life. But it's not primarily a story about pain and problems, but about one man's particular life. Every life has problems. Usually they don't involve being put in a straightjacket every ten years or so. But that's Mark Vonnegut's particular issue, or one of them, anyway, and he treats it very much in the manner of "everyone's got problems."

The memoir is at least as much about being a doctor as it is about having a mental illness of a somewhat mysterious nature. (He gets diagnosed with bipolar disorder later, but that might not be it either. Whatever he has, it's atypical.) It's also about life, and art, and being a misfit in a screwed-up society, and also about being his father's son (Chapter title: "There is Nothing Quite So Final As A Dead Father"). And accidentally poisoning himself with his shiny new hobby of mushroom hunting.

It's all over the place and hard to describe, but enormously funny, enjoyable, quotable, and wise. Its humane, humorous, epigrammatic tone reminded me a bit of James Herriot, and I love James Herriot. Unless you're really squicked by medical stuff or triggered by mental illness, this is the sort of book I'd recommend to just about anyone.

Just Like Someone Without Mental Illness Only More So: A Memoir

Brief notes on books I read a while back but never got around to writing up.

A Taste of China: The Definitive Guide to Regional Cooking (Pavilion Classic Cookery), by Ken Hom. An evocative, hunger-inducing travelogue/memoir/cookbook/food history by a Chinese-American author. A bit of a period piece now, but much of it is historical anyway, and it's well worth reading if you have an interest in the topic.

The Gift of Fear, by Gavin de Becker. The classic nonfiction book on the value of intuition: specifically, that fear - especially women's fear of men - is often based on having subconsciously picked up subtle signals of very real danger. I've re-read this book a couple times before, and it continues to be valuable: honest, easy to read, thoughtful, and very usable. One thing I'd forgotten was that de Becker himself was a survivor of childhood abuse and trauma, and is writing not only from his experience as a security expert but from his experience as a scared little kid.

This would make an excellent paired reading with Malcolm Gladwell's Blink: The Power of Thinking Without Thinking, which is also about how intuition works, but approached from completely different angles. Both books discuss false intuition based on prejudice or pre-conceived ideas versus true intuition based on the situation at hand, and how to tell the difference. Gladwell's book is more sociological, and de Becker's is more of a how-to.

Let's Take the Long Way Home: A Memoir of Friendship. It's an old story: I had a friend and we shared everything, and then she died and we shared that, too.

Probably the best memoir I've read all year. I read it when it first came out, and then re-read it several months later. Though Knapp's death frames the memoir, it's not primarily about that, but about the intimate, twin-like friendship between two women. Writers Gail Caldwell and Caroline Knapp bonded over their careers, their alcoholism and sobriety, and most of all, their beloved dogs. The structure is complex but seamless. Caldwell traces her own life story and how it paralleled and diverged from Knapp's, weaves it back into the story of their friendship, and then continues her story without Knapp, but always with her memory. It's extremely well-written, intense, and engaging, and reminded me quite a bit of another favorite memoir of mine... Caroline Knapp's Drinking: A Love Story.

It also reminded me of Ann Patchett's Truth & Beauty: A Friendship, another intense and well-written memoir about female friendship, in this case with troubled author and cancer survivor Lucy Grealy. Though Let's Take the Long Way Home, despite Knapp's early death, is a lot less tragic, since Caroline Knapp sounds like she had a lot more happiness and satisfaction in her life than poor Lucy Grealy ever did. It's also got way more dogs. In fact, it has enough dog content that I would especially recommend it to anyone who loves dogs. it contains dog death by old age, but is much more about what it's like to live with and love and train dogs.

You can click on the author tags to get reviews of the books I mentioned in comparison.

Another school book, this one for Personality 1.

A manual for accessing one’s unconscious via dreams and “active imagination.” Johnson is a Jungian and discusses archetypes, but emphasizes that most dream symbolism is highly personal. Whether one believes that dreams are literal messages from the unconscious, or that one’s interpretation of the largely random matter of dreams is a method for accessing unexplored areas of the psyche, if one has any interest in exploring dreams and the unconscious, Johnson’s methods seem likely to be helpful.

He outlines detailed steps for dream interpretation, as follows:

Associations: Write down all the associations for each element of the dream, one at a time, not censoring oneself. That is, if the dream involves a blue car, all the associations for “blue.” Then all the associations for “car.” Etc.

Dynamics: Connect the images and associations with one’s inner life. Which associations seem intuitively valid? What in one’s inner life might relate to them? He suggests that real people in dreams typically don’t represent the actual people, but characteristics one associates with them.

Interpretations: Search for the central message that seems to be communicated.

Rituals: Do a small but concrete ritual action to cement the meaning of the dream and its message.

He also explains and gives steps for “active imagination.” Basically, this is doing somewhat directed daydreaming while writing down the daydream as it occurs. This sounds potentially interesting, and I will try it. (There’s way too much involved to try to summarize it here, but the book is easily available in the US, if you’re curious.)

Caveat: some mild gender stereotyping, and romanticizing of the past and non-western cultures.

Last night I dreamed that Anthony Bourdain and I were strolling around an indoor-outdoor food court somewhere in Asia, sampling and discussing all the food. We each tried a lamb skewer with different seasonings, his tandoori, mine spice-rubbed, then took a bite of the one we didn't get. He deemed mine "tough but good." I also recall ramen, donburi, and some very fancy wagashi.

Inner Work: Using Dreams and Active Imagination for Personal Growth

Summary: Lots of parents were the victims of child abuse and parents who crushed and denied their feelings; they then abuse, or deny and crush the feelings of their own children. It takes lots of therapy to overcome this. Many patients come in claiming that their childhoods were just fine, but after a bunch of sessions, they realize that actually, their childhood feelings were denied and crushed.

Moms! The first few weeks of infancy are crucial, and if you aren’t perfectly sensitive and loving (while you’re sleep-deprived, exhausted, and overwhelmed) you will cause enormous trauma to your child, which will persist throughout their entire life unless they do intensive therapy.

My feelings: Meh. I agree with what she says when it comes to actual abuse, of course. But a lot of what she talks about sounds a lot more like “failure to be perfectly sensitive and caring 24-7.” I bet Miller hates the idea of “good enough parenting,” but it came to my mind a lot while reading. It takes a lot to make me to think, “You’re being awfully hard on parents,” but I did. Not to mention, “Parents could often stand to be more sensitive, but kids are probably not going to be OMG traumatized for life because their parents let them have bites of ice cream but wouldn’t buy them their own cones,” and “Stop insisting that people are in denial just because they aren’t saying what you think is the truth.”

The Drama of the Gifted Child: The Search for the True Self

Getting a jump on some school reading for next quarter.

I have only just started this, but... is it just me, or is she annoyingly prone to assuming that everyone experiences similar things in the same way and has the same reactions, and so insisting that anyone who says they feel differently from what she expects is denying or repressing the ONE TRUTH?

Drama of the Gifted Child

To celebrate 11/11/11, I bring you brief notes on books which I read but, resignedly, realize I will never get around to writing up in full.

Glitter Rose, by Marianne de Pierres. A beautifully designed small hardcover from Twelfth Planet Press of connected short stories about a little Australian island, mostly populated by the decadent and desperate rich, which is infected by spores which mutate the population in strange, subtle ways. Wispy, atmospheric, delicate, like spare prose poems. A bit reminiscent of Lee Killough's Aventine stories, and, in themes but not style, of Tanith Lee. A World Fantasy Con giveaway.

Identity: Unknown (Tall, Dark and Dangerous), by Suzanne Brockmann. Amazon has Brockmann's short Navy SEAL romances listed quite cheaply, so I snagged a couple. Navy SEAL Mitchell Shaw is shot and hit over the head while deep undercover, and ends up amnesiac on a horse ranch and convinced that he's a hit man! This doesn't live up to its delicious premise, and suffers enormously from its short length. The romance starts too soon and seems way more about physical chemistry than real interaction, and the heroine seems like a nitwit to be convinced based solely on intuition that he's not a villain. There is missing plutonium that gets mentioned a few times, then forgotten. Read Frisco's Kid (Tall, Dark and Dangerous) or Harvard's Education (Tall, Dark and Dangerous) instead.

The Gift of Therapy , by Irwin Yalom. Brief notes and tips for new therapists, concentrating on the therapist-client relationship, the here-and-now (what's going on in the present moment during therapy), and dreams. Yalom is an existential therapist, and delves into the big questions about fear of death, existential anxiety, the meaning of life, etc. I got a lot out of this, and will undoubtedly refer back to it when I start seeing clients.

Crazy Like Us: The Globalization of the American Psyche, by Ethan Watters. How American concepts of mental illness and its treatment are exported worldwide, causing changes in how mental illness is perceived, manifests, and is treated. A mixed bag, but very much worth reading. Watters theorizes that symptoms of emotional distress manifest in a manner which one's culture recognizes as messages that something is wrong. In Freud's time, distressed people fainted and had mysterious physical symptoms, and that was culturally recognized as a signal of distress. In our time in the USA, those people would be more likely to complain solely of anxiety and depression.

Watters has some great and little-addressed points which are very much worth taking seriously. However, he has a bias toward the idea that Western therapy and psychiatric medication is overrated and often useless, that it should not be exported to other countries, and that looking at mental illness as biologically-based and treatable by biological means is at best only good for Americans (to whom it's at least culturally appropriate) and even then is stigmatizing.

To bolster these opinions, he makes extensive use of selective evidence. For example, he quotes people with mental illnesses who think that looking at it as a matter of brain chemistry is degrading and erasing, and then suggests that all people with mental illnesses feel that way and it's only the drug manufacturers and the medical establishment who think that the medical/chemical viewpoint can be empowering. This is flat-out untrue, as is his claim that no one ever manifested the current DSM-IV symptoms of PTSD before WWI. (It's true that earlier reports tended to be more somatic, but there are descriptions that do sound very similar to modern Western understandings of PTSD which go back at least to Shakespeare's time. It's a pretty well-researched area.) This makes me wonder how much other parts of the book are similarly carefully selected to make his point, and equally misleading. It's too bad, because his overall thesis has a lot of merit.

Note to commenters: If you want to discuss Watters' book or the ideas therein, please be aware that it's a hot-button topic, and be courteous and sensitive to the different experiences of others.

The heartbreaking final book in Barker’s WWI trilogy.

Prior returns to the front by his own choice, where he joins Wilfred Owen, while Rivers continues treating mentally and physically brutalized soldiers at home. Meanwhile, Rivers remembers his time spent doing anthropological research on a Melanesian island, where the British ban on head-hunting had destroyed the local way of life. That part of the book steers neatly between the Scylla of Look At Those Wacky Primitives and the Charybdis of They Are Simpler Yet Wiser Than Us; the similarities and differences between their ways and the British ones, and between Rivers and a Melanesian healer, are complex, not easily summarized, and lead to the novel’s powerful conclusion.

The “eye” motif of the last book is replaced with a “head” motif in this one. I know that sounds a bit silly, but it plays out with wrenching elegance. The heads and skulls on the island are sometimes the product of violence, sometimes attached to captives who may live out their natural lifespans in comfort (so long as their head isn’t needed), and sometimes represent a deep respect for the process of life and death: the stacks of skulls are the link to their pasts and ancestors and families, the essential element of their culture without which it may not survive, and the product of the deepseated human urge to kill. Rivers repeatedly deals with horrific head injuries occurred in a war that makes pointless all his efforts to heal and to understand, the war without which he would never have done his best work.

Everything we are, everything which makes us special and unique, is in a ball of grey-pink gelatin protected by a helmet of flesh and bone: a prize, a lover’s face, a surgical problem, a link to the holy, an object of horror, the source of poetry.

The Ghost Road (William Abrahams)

I will make a filter for this shortly. Until then, cut to spare you, and also for sexual content including some hilarious romance novel excerpts. These are my brief notes, for my own benefit with the exception of the throbbing pistons which are for yours, on today's reading.

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