& Nervous System Dysregulation
The title of my academic paper describing a new model of lived experience.
Its August 2014: As my journey of self-exploration, in order to understand and articulate the experience of psychosis from the inside-out continues. With this paper representing a synthesis of all the experiential reseach I've done in the past 7 years. Which has culminated in a model of experience articulated in the spirit of Wilhem Reich's "everyone is right in some way," it is merely a matter of knowing "how."Hence, I present a model of psychotic and mental illness experience, that explores the taken for grantedness of our normal, adult, analogous sense of self, whereby we interpret our lived experience with reference to the external world.
Hence, the biomedical model of psychosis and mental illness is based on the analogous assumption of a "fever-type" infectious disease, in my experience. While my lived experience explored the nature of my primary process affective states of being, and the contagion of innate affects. Hence, "everyone is right in some way, its merely a matter of "how." With my transformational journey from chronic mental illness victim to this, from the inside out articulation of my actual experience, raising serious questions of our current consensus on mental health. And while its unusaul to post an academic paper on a blog post like this, the whole point of my experiential journey, was a need to go beyond the taken for granted, rank & status norm's that thwart our human potential. Please consider:
Psychosis: Affective States of Consciousness & Nervous System Dysregulation
ABSTRACT: With 34 years of lived experience, I present a middle path bridging psychology and psychiatry, based on research and discoveries in developmental science. An experiential understanding of psychosis, as a thermodynamic, psychosomatic process. Enabled by developing an embodied awareness of the “affect” driven nature of nervous system activity and the “role of visceral state and visceral afferent feedback on the global functioning of the brain,” (Porges, 2011) during episodes of affective psychosis. Since 2007, my normal and abnormal states of mind have been explored with an improving sense of the “bidirectional influences between peripheral physiological state and the brain circuits related to affective processes.” (Porges, 2009) A model of experience based on: The Polyvagal Theory (Porges, 2011) and the discovery of “an integrated social engagement system,” (Porges 2001) vulnerable to “affect dysregulation.” (Schore, 2003) A phylogenetic perspective on “A Traumagenic Neurodevelopmental Model,” (Read et al, 2001) with an understanding of traumatic experience and “the mis-attuning social environment that triggers an intense arousal dysregulation.” (Schore, 2003) With 7 years of experiential research focusing on “the primacy of affect” (McGilchrist, 2010) and the “primary process emotional/affective states,” (Panksepp, 2004) of my “innate affect” (Tomkins, 1995) driven imagery of consciousness, during episodes of “affective psychosis.” (McGorry et al, 2012)
All life is “affective life,” all behavior, thought, planning, wishing, doing . . .
There is no moment when we are free from affect,
no situation in which affect is unimportant. -Silvan Tomkins.
Introduction: In April 2007, in Sydney Australia, I was scheduled in St George hospital’s acute care ward for psychiatric patients. Scheduled because I’d been assessed and diagnosed hypo-manic and likely to become hyper-manic without medical intervention. Scheduled despite my claim, that with 27 years experience, I knew the hyper-manic phase of my emotional dysregulation had peaked the previous week and the internal energies involved were waning. My experiential understanding vindicated a week later when I was released with a letter of apology after successfully questioning the medical assessment and diagnosis before a magistrate. Thus, I began a seven year journey to understand my spontaneous psychoses from the inside-out, particularly the visceral meaning of the terms “affect” and “affective,” during my varied states of consciousness. With my experiential journey driven by a need to understand “how” my birth trauma experience and my phylogenetic predisposition to “intense arousal dysregulation,” (Schore, 2003) confirms an increasingly accepted “stress/vulnerability model, highlighting the interaction between biological predisposition and environmental influences. Particularly the role of stress in lowering the threshold to psychosis,” (McGorry, et al, 2002) while my self-exploration brought a “sensate” (Levine, 2010) awareness of my innate “affect-system” (Nathanson, 2008) to current formulations of a “diathesis-stress paradigm.” (Read et al, 2001) With my existential challenge exploring the paradox of a taken for granted sense-of-self lacking knowledge of internal structure and brain-nervous system function. Lacking knowledge of the thermodynamic nature of organism organization, and the level of dissociation involved in a mind-body split in functional awareness. With an experiential focus on how: The attempt to regulate affect - to minimize unpleasant feelings and to maximize pleasant ones - is the driving force in human motivation. (Schore, 2003) A self-exploration of my affective states of consciousness creating a “sensate” (Levine, 2010) awareness of the “thermodynamic,” (Schore, 2003) “primary process” (Panksepp, 2004) nature of dissociation, compared to secondary process conceptualizations stating: Dissociation can be understood as a psychological survival strategy that enables us to endure overwhelming pain and fear. (Longden, 2013) While my experiential research has been conducted in the spirit of "everyone is right in some way," it is merely a matter of knowing "how." (Reich, 1973) Hence, my need to understand my first episode of psychosis, acknowledges a consensus view of “brain regions that are changing dynamically during adolescence and early adulthood,” (McGorry et al, 2012) which postulates that “neural mechanisms are accepted as underlying mental disorder.” (McGorry et al, 2012) While a “polyvagal perspective” (Porges, 2006) on “three neural circuits that regulate reactivity,” (Porges, 2004) enabled a physiological awareness of “primary process emotional/affective states,” (Panksepp, 2004) and a psychological understanding: that physiological states support different classes of behavior. (Porges, 2007) With knowledge of the experience dependant maturation of my brain-nervous system, enabling the experience dependant transformation of three affective psychoses in 2010-11-12, to deliver this, nervous system dysregulation perspective on psychotic experience. While presenting a middle path narrative between psychiatry and psychology’s current formulations on the nature of psychosis, requires extensive excerpts from my reading education, to give readers a congruent sense of my experiential integration of developmental science knowledge with other psychosocial observations on human motivation. Particularly a synthesis of neuroscience knowledge and discovery with Silvan Tomkins profound observation that: there is no moment when we are free from affect, no situation in which affect is unimportant. A physiological perspective on human motivation which I hope to show readers, transcends the taken for granted perceptions of an attachment driven, consensus normality. More specifically, to show how “a phylogenetic interpretation of the neural mechanisms mediating the behavioral and physiological features associated with stress and several psychiatric disorders,” (Porges, 2004) brought me "a genuine integration of psychosocial and biological research." (Read et al, 2008) Particularly, how “The Polyvagal Theory” (Porges, 1995, 1997, 1998, 2001a, 2003, 2007, 2011) transformed my previous treatment oriented perspective on mental illness, into an embodied awareness of the hierarchical function of my autonomic nervous system. Hence, I describe how through the development of an increasing capacity for “introception,” (Schore, 2003) I have gained an physiological awareness of how my evolved “social engagement system” (Porges, 2001) is vulnerable to “affect dysregulation,” (Schore, 2003) after being primed by early life, traumatic experience. With my improved self-regulation resulting from an experiential integration of this phylogenetic model of organism function, enabling me to understand how “the mis-attuning social environment that triggers an intense arousal dysregulation,” (Schore, 2003) through a nervous system “neurorception,” (Porges, 2004) of both my internal environment and the external environment:
The model emphasizes phylogeny as an organizing principle and includes the following points: (1) there are well defined neural circuits to support social engagement behaviors and the defensive strategies of fight, flight, and freeze, (2) these neural circuits form a phylogenetically organized hierarchy, (3) without being dependent on conscious awareness the nervous system evaluates risk in the environment (i.e., neuroception) and regulates visceral state to support the expression of adaptive behavior to match a neuroception of safety, danger, or life threat. (Porges, 2004)
Hence I present a middle path psychophysiological understanding of how, “heightened vulnerability to stress is not, as often wrongly assumed, necessarily genetically inherited, but can be acquired via adverse life events,” (Read et al, 2008) which in my case created an internal sense of life threat. Thus, after almost three decades of being a chronic treatment resistant mental illness sufferer, due to a lack of knowledge about the internal structure and function of my nervous system. An experience dependant integration of “the polyvagal theory” (Porges, 2011) resolved the habituated muscular/vascular tension and pressure of a trauma entrained, internalized sense of life threat. While an improving awareness of affective states of consciousness, also required exploring the development of my sense of reason, as an instinctive identification process leading to a reliance on the limited utility of descriptive language, and creating a deceiving self-interpretation, by way of analogy, with the objective environment beyond my skin. Although for the past decade I have been increasingly mindful of a wise injunction: The great danger of thinking about man by means of analogy is that analogy comes to be put forward as a homology. (Laing, 1990) Which has guided my self-exploration of a socialized suppression of “the primacy of affect” (McGilchrist, 2010) and the “primary process emotional/affective states,” (Panksepp, 2004) of my “innate affect” (Tomkins, 1995) driven images of consciousness. Uncommon language that will require extensive excerpts from the sources of my self-education drive, in order to deliver a convincing argument for this understanding of psychotic experience, as a hierarchical process of “disorganization, and reorganization,” (Schore, 2003) or “dissolution.” (Porges, 2011). Hence, crucial to this phylogenetic perspective of my medically diagnosed bipolar type 1 disorder, was developing a “felt-sense” (Gendlin, 1982) of my normal cognitive function and how it dampens the raw “physiological states” (Porges, 2008) of non-conscious “implicit functions that occur beneath levels of awareness not because they are repressed but because they are too rapid to reach consciousness.” (Schore, 2012) While my previous acceptance of medical diagnoses, despite an unresolved treatment resistance, was stimulated by non-conscious attachment processes, in a crucially important existential context, of how: The attempt to regulate affect - to minimize unpleasant feelings and to maximize pleasant ones - is the driving force in human motivation. (Schore, 2003) Hence, my self-exploration of motion, emotion and cognition, during psychotic experiences, was guided by a synthesis of developmental science literature and other extensive observations of the human condition.
While, developing an embodied awareness of how “there is no moment when we are free from affect, no situation in which affect is unimportant,” (Nathanson, 2008) led me to ponder how a cultural history of the suppression of an innate “affect system,“ (Nathanson, 2008) has lead to routine distortion of research papers, like: "Vulnerability: a new view of schizophrenia" (Zubin & Spring, 1977) and their "stress-vulnerability model." (Read et al, 2008) Specifically, how a "gross distortion of what had actually been said produced an illusion of integration." (Read et al, 2008) Suggesting to me, that a history of cultural denial towards our evolved nature is based on an implicit fear of the “contagion” (Brennan, 2004) of “innate affect,” (Tomkins, 1995) which underlies an analogous “fever-type,” (Porges, 2013) medical perception of psychotic experience. While my need to gain an accurate physiological sense of the psychological terms “affect” and “affective,” explored my taken for granted illusions of self-awareness and the self-defensive cognitive processes leading to formulations of affective and non-affective psychosis. While a recent critically acclaimed publication explains our normally taken for granted cognitive processes, in more eloquent way: This processing eventually becomes so automatic [autonomic] that we do not so much experience the world as experience our representation of the world. The world is no longer ‘present’ to us, but ‘re-presented’, a virtual world, a copy that exists in conceptual form in the mind. (McGilchrist, 2010) [In brackets mine] Hence, my experiential journey to develop a deeper, embodied awareness of my nervous system structure and function, steadily improved my “self-regulation.” (Schore, 2012) Enabling a growing cognitive understanding of the reciprocal-influences between body and brain, during episodes of what academic literature describes as affective psychoses. A growing understanding, within a human organism regulation context of how: Thermodynamics are not only the essence of biodynamic, they are also the essence of neurodynamics, and therefore of psychodynamics. (Schore, 2003) Specifically, in an experience-dependant acceptance of “the primacy of affect” (McGilchrist, 2010) and the “primary process emotional/affective states,” (Panksepp, 2004) underpinning my higher cognitive processes. Primary processes, which, in my opinion, create a subconscious self-preservation bias, in our categorizing, “treatment-oriented approach to diagnosis” (McGorry et al, 2012) of a continuum of human experience. An innate bias, understandable from McGilchrist‘s “virtual world…conceptual form in the mind” perspective, and a leading psychiatrist’s confession that: Psychiatric diagnosis is seeing something that exists, but with a pattern shaped by what we expect to see. (Frances, 2013) While Allen Frances confession about psychiatric diagnosis and current literature explaining how: Many of our psychiatric diagnoses beyond the schizophrenia spectrum are based on chronic patient populations, and this is an example of the clinician’s illusion. (McGorry et al, 2012) May be understood from a phylogenetic perspective on our innate susceptibility to nervous system dysregulation, through “three principal defense strategies—fight, flight, and freeze,” (Porges, 2004) and their self-deceiving cognitive rationalization. With the clinician’s illusion of expectation finding a lived-experience context in understanding the “freeze” functionality of the nervous system and how: When victims of trauma and abuse try to explain these features to many clinicians, there is a disconnect between the personal experience and the clinicians expectations. Functionally, the clinicians, with the model that trauma and abuse provoke a state of stress, aren’t listening. This is why people who have experienced severe abuse, physical trauma often are at a loss, are really panicked when they have difficulties explaining their experiences, because the clinical world did not have the vocabulary to describe immobilization as a defensive system. (Porges, 2012) While our “experience dependant” (Schore, 2003) cognitive modulation of “the attempt to regulate affect - to minimize unpleasant feelings and to maximize pleasant ones,” (Schore, 2003) creates, in my opinion, a taken for granted paradox in our perceptions of mental health. Due, in my opinion, to a taken for granted self-ignorance of non-conscious: Affect Regulation & the Origins of the Self, (Schore, 1995) and how:
A deep concern with either mind or body or both, appears historically
to lead to concern with affect. -Silvan Tomkins.
From Normal Self-Ignorance to Embodiment & Affect-Regulation
For twenty seven years, an acceptance of the “treatment-oriented approach to diagnosis,” (McGorry et al, 2012) of mental disorders, guided a limited understanding of my experience of affective psychoses. My spontaneous episodes of mania and depression. My vigilance towards signs of relapse, predominately based on “a helpful rationale for treatment,” (Smith et al, 2003) involving a “basic assumption” (Bion, 1961) that “the patient has a biological, often genetic predisposition that interacts with stress to cause illness (EPPIC, 1997, p. 13.),” (Smith et al, 2003) also known as “a diathesis-stress paradigm.” (Read et al, 2001) With various categorized images of my experience gained through a diagnosis of schizophrenia in 1980 and a diagnosis of bipolar disorder type 1, in 1988, along with other comorbid diagnoses during my decades of lived experience. Yet no treating psychiatrist mentioned the descriptive terms, affective and psychosis, or mentioned my body and the “role of visceral state and visceral afferent feedback on the global functioning of the brain,” (Porges, 2011) while explaining their treatment oriented need, to focus on signs of pathological disorder. Only when I read psychiatry’s academic literature, did the terms affective and psychosis come to my attention, while searching for information on the public rhetoric of early intervention for psychosis, and exactly how my experience was a similar disease process to cancer or diabetes. Searching for information about why, despite “the powerful new tools of molecular biology, genetics, and imaging have not yet led to laboratory tests for dementia or depression or schizophrenia or bipolar or obsessive-compulsive disorder or for any other mental disorders.” (Frances, 2013) While reading the literature of “The International Society for Psychological and Social approaches to Psychosis,” (IPSP) oriented my attention towards “A Traumagenic Neurodevelopmental Model” (Read et al, 2001) of my psychotic experience. Hence a search for relevant information led me to compare treatment oriented literature with “developmental science” (Schore, 2012) explanations on how, “the sympathetic and parasympathetic components of the autonomic nervous system, important elements of the affect-transacting attachment mechanism, are centrally involved in the child’s developing coping capacities.” (Schore, 2003) Which brought a psychosomatic, developmental context to the social distress triggers, of my spontaneous “affective psychoses” (McGorry et al, 2012) and my “felt-sense” (Gendlin, 1982) of an e-motive development issue, with Schore‘s “affect-transacting attachment mechanism” leading to an existential exploration of “expressed emotion” (McGorry et al, 2012) and Teresa Brennan‘s formulations on The Transmission of Affect. While this research explained my previous urge to accept a biomedical model of my lived-experience, from the attachment driven perspective of: Affect Regulation & the Origins of the Self. (Schore, 1995) A psychosomatic perspective which shifted attention towards the hidden thermodynamic nature of my “primary-process affective consciousness,” (Panksepp, 2004) with a growing awareness of the limits of treatment oriented language, in the interpretation of primary processes, assumed to be signs of pathology, analogous to a “fever-type model” (Porges, 2013) of infectious disease. While my experiential journey was guided by a previous injunction: The great danger of thinking about man by means of analogy is that analogy comes to be put forward as a homology. (Laing, 1990) Hence my experiential approach to understanding psychotic experience involved a process of “living sensory attention” or “discernment,” (Brennan, 2004) towards internal sensations and the “common cores that seem to transcend diagnostic categories.” (Porges, 2013) A sensory attention during episodes of psychosis, which explored the experiential meaning of the terms “affect” and “affective,” in my moment to moment, lived-experience. Hence my self-exploration challenged my “basic assumptions” (Bion, 1961) about my psychosomatic experience, and the internal thermodynamic nature of my instinctive, identifying, attention processes. The roots of my intelligence and my “affect” driven images of consciousness, so aptly expressed in Allen Frances statement: MAN IS THE naming animal— we can’t stop ourselves from putting a label on everything in sight. Hence, my sensory approach, explored a non-conscious sense of “affective states,” (Schore, 2003) and my life history of self-objectifying, subjective interpretations of lived experience, in a need to gain an embodied awareness of:
The Limits of Language: At present we only have a rudimentary language for connecting sensations, affects, and words, for connecting bodily processes and a conceptual understanding of them. The further development of such language requires an attention to the pathways of sensation in the body. We need to formulate bodily knowledge more accurately and increase the rapidity of human understanding. Extending knowledge in this way is the reverse of gathering it by “objectification,” or studying bodily processes disconnected from living sensory attention. (Brennan, 2004)
Thus, in 2007, I began a self-education process to understand the structure and thermodynamic functioning of my nervous system processes, and the non-conscious stimulation of my manic-depressive experiences. Including a continuous reading and re-reading of relevant literature like “The Polyvagal Theory” (Porges, 1995, 1997, 1998, 2001a, 2003, 2007, 2011) which articulates the discovery of “an integrated social engagement system,” (Porges 2001) and an adaptive perspective on psychiatric disorders:
The Polyvagal Theory provides a perspective to demystify features of clinical disorders. The theory provides principles to organize previously assumed disparate symptoms observed in several psychiatric disorders (i.e., a compromise in the function of the Social Engagement System). Moreover, by explaining features of disorders from an adaptive perspective, interventions may be designed that trigger the neural circuits that will promote spontaneous social engagement behaviors and dampen the expression of defensive strategies that disrupt social interactions. (Porges, 2009)
Leading me towards an experiential integration of developmental science knowledge, which has changed a self-defensive, treatment oriented perception of my genetic predisposition to experiencing manic-depression. Towards “a phylogenetic interpretation of the neural mechanisms mediating the behavioral and physiological features associated with stress and several psychiatric disorders.” (Porges, 2004) A shift in personal focus, towards understanding the “phylogeny of the autonomic nervous system,” (Porges, 2004) which brought a non-pathologic context to why “despite family, twin and adoption studies revealing a high genetic liability, with a point estimation of 81%, single major-effect genes have not been detected and the precise molecular aetiology of psychosis currently remains unknown.” (McGorry et al, 2012) Hence, my experiential research, has explored a dichotomy in the descriptive language used to define assumptions of brain pathology, and the nervous ease and “dis-ease” (Frances, 2013) of my lived-experience. A dichotomy evidenced by my pharmacological treatment resistance, with a long history of delusional experience, occurring both on and off antipsychotic medications. A long history of various medical diagnoses, hospitalizations, intolerable medication side-effects and no breakthroughs in the promise of genetic research, so painfully frustrating to my quality of life aspirations. A dichotomy of lived experience and diagnostic definition, which persisted until appropriate education enabled an awareness of my nervous system function, and the psycho-physiological content & context of an experience, historically labelled psychotic. Which, in the phenomenology of non-conscious organism function, and how “thermodynamics are not only the essence of biodynamic, they are also the essence of neurodynamics, and therefore of psychodynamics,” (Schore, 2003) views all descriptive language terms as the insubstantial labels, of our “affect” driven images of consciousness. An existential dilemma summed up long ago with advice that: Words do not describe reality, only experience shows us true face. -Buddha. While my social stress vulnerability to experiencing episodes of spontaneous nervous system dysregulation, became understood as a non-conscious “neuroception” (Porges, 2004) of “the mis-attuning social environment that triggers an intense arousal dysregulation.” (Schore, 2003) With current diagnostic formulations of “cognitive–perceptive basic symptoms of ‘information processing disturbances,” (McGorry et al, 2012) becoming understood from a psycho-physiological perspective on “the organizational competence of the nervous system.” (Porges, 2011) Hence professor Stephen Porges research and the polyvagal theory brought a phylogentic perspective to psychological formulations that: brain research that points the way to a genuine integration of the biological, the social, and the psychological in understanding how childhood trauma can lead to psychosis. The Traumagenic Neurodevelopmental (TN) model of psychosis is based on research demonstrating that the biological differences traditionally cited as evidence that schizophrenia is a brain disease are also found in the brains of abused children. (Read et al, 2008) Helping me resolve the trauma conditioned internal sense of life threat and the limited development of my prepsychotic personality, in the physiological context of nonconscious affect regulation. With spontaneous episodes of mania becoming understood through a developmental lens of transitional affective states, after my first reading of “Affect Dysregulation & Disorders of the Self” (Schore, 2003) in 2007. My experience dependant resolution beginning by acquiring such relevant developmental science knowledge as:
During transitions between later developmental stages, the individual is presented with the challenge of retaining continuity while changing in response to environmental pressures. These challenges are associated with positive and negative affective states, and they call for a resilient right orbito-frontal regulated capacity that can read the facially expressed states of others, access a theory of mind, as well as cope with, regulate, and thereby tolerate the uncertainty and stress that are inherent in the attachment-separation and exploratory dynamics of these transitional periods.
All traumatized patients seem to have the evolution of their lives checked; they are attached to an insurmountable object. Unable to integrate traumatic memories, they seem to have lost their capacity to assimilate new experiences as well. It is as if their personality development has stopped at a certain point and cannot enlarge any more by the addition of new elements. (Schore, 2003)
While my shift away from a treatment oriented perspective of pathology and disease, brought new context to why I was one of a significant number of people, worldwide, for whom a pharmacological intervention had provided neither long term relief, or significant understanding of my actual experience of psychosis. Although such context forming information did not come to my attention until professional training, and a burgeoning information age, contributed to my intuitive sense of a paradox, concerning the pragmatic, “treatment dependant” approach to the experience and understanding of mental illness. While my long frustration at the limited of understanding of pharmacological interventions, is perhaps best evidenced by a current longitudinal study on the efficiency of antipsychotic medications. “More than 70% of SZ continuously prescribed antipsychotics experienced psychotic activity at four or more of six follow-up assessments over 20 years. The 20-year data indicate that, longitudinally, after the first few years, antipsychotic medications do not eliminate or reduce the frequency of psychosis in schizophrenia, or reduce the severity of post-acute psychosis.” (Harrow et al, 2014) With this comprehensive study on lived-experience and my own experience and frustration with treatment-oriented definitions of psychosis, also acknowledged in a current medical publication, explaining how: One of the barriers to effective early intervention in patients with treatment resistance is that definitions of such resistance for affective and non-affective psychoses do not exist, are not updated or remain controversial. (McGorry et al, 2012) Thus, it is in the context of descriptive language definitions and the non-conscious stimulation of my actual experience, that I present a nervous system oriented understanding of “affective psychosis,” (McGorry et al, 2012) as a, non-pathological and adaptive need of our “primary-process affective consciousness.” (Panksepp, 2004) An experiential understanding which highlights the illusion of self-awareness, involved in the nature of our descriptive languages:
The delusion is extraordinary by which we exalt language above nature:-
making language the expositor of nature,
instead of making nature the expositor of language. -Alexander B Johnson
Hence, it was through a determined self-education process, that my history of resistance to pharmacology interventions found a middle path context, when reading such salient comments as “Unfortunately most researchers in psychiatry and psychology express little interest in mapping autonomic regulation as a “vulnerability” dimension for various psychiatric disorders and behavioral problems, even though visceral features are often symptoms of the disorders they are treating. Clinical disciplines rarely acknowledge the proximal functions of the visceral state. (Porges, 2009) While understanding the non-conscious stimulation of my self-referential delusions, within the “psychophysiological” (Porges, 2011) context of an “attempt to regulate affect,” (Schore, 2003) became a life goal after proving my lived-experienced assessment of my bio-energetic state, was more accurate than a disease oriented, biomedical expectation in April 2007. With even my normal experience of mind and common language definitions of lived experience, moving from an attachment driven, taken for granted acceptance, to an increasing awareness of inner sensations, as the tensions and pressures, of hierarchically organized nervous system activity. Leading to an embodied sense of my “primary process emotional/affective states,” (Panksepp, 2004) as “innate affect” (Tomkins, 1995) driven imagery and consciousness. Since 2007, both my normal and abnormal states of mind have been explored with an improving sense of the “bidirectional influences between peripheral physiological state and the brain circuits related to affective processes.” (Porges, 2009) Leading to an embodied “appreciation of the autonomic nervous system as a “system,” with the identification of neural circuits involved in the regulation of autonomic state, and an interpretation of autonomic reactivity as adaptive within the context of the phylogeny of the vertebrate autonomic nervous system.” (Porges, 2006) With my “psychosomatic disturbances,” (Porges, 1995) described in medical literature as, “state-related abnormalities or changes that occur dynamically over the course of the illness,” (McGorry et al, 2012) finding more accurate definition, from knowledge of how “the polyvagal theory emphasizes that physiological states support different classes of behavior.” (Porges, 2007) Hence, my experience of delusion has become understood from a “phylogenetic perspective,” (Porges, 2004) as a function of adaptive, bio-energetic, “primary process emotional/affective states,” (Panksepp, 2004) rather than a primary symptom of psychosis, and a treatment oriented sign of “psychopathology.” (McGorry et al, 2012)
Before 2007 and my efforts to acquire relevant scientific knowledge, I was profoundly self-ignorant about my own human nature, particularly the structure and function of my nervous system and the role traumatic experience had played in my “prepsychotic personality.” (Perry, 1998) Profoundly ignorant of birth trauma, as a casual factor in my vulnerability to psychotic experience. A vulnerability faxtor which is also a focus of research in: Early Intervention in Psychiatry: Over the last 10 years, it has become increasingly apparent from well-conducted research studies that childhood trauma is a risk factor for psychosis. (Bendall, Alvarez-Jimenez, Nelson, McGorry, 2013) With a traumagenic perspective on psychotic experience, articulated in a recent paper, “The traumagenic neurodevelopmental model of psychosis revisited: Evidence that childhood adversities are risk factors for psychosis has accumulated rapidly. Research into the mechanisms underlying these relationships has focused, productively, on psychological processes, including cognition, attachment and dissociation. In 2001, the traumagenic neurodevelopmental model sought to integrate biological and psychological research by highlighting the similarities between the structural and functional abnormalities in the brains of abused children and adults diagnosed with ‘schizophrenia.’” (Read et al, 2014) Furthermore, my experiential understanding of nervous system processes in a lived-experience of mental illness and psychosis, reflects psychophysiological research into a “fundamental order in heart-brain interactions and a harmonious synchronization of physiological systems.” (McCarty et al, 2009) In which, "the central role of the heart is explored in terms of biochemical, biophysical and energetic interactions." (McCarty et al , 2009) Energetic interactions, “dependent on the dynamic bidirectional communication between peripheral organs and the central nervous system connecting the brain with these organs.” (Porges, 2009) Thus, my intolerance of a pharmacology intervention approach to symptomatic behaviours labelled psychotic, prompted me to develop a “sensate” (Levine, 2010) awareness of the body-brain-mind connection in my actual experience of psychosis. Developing an embodied awareness of the physiological impulses of manic-depression and the escape-impulse motivation of my suicidal ideation. While my improved impulse control or “affect-regulation,” (Schore, 1995) also involves an epiphany moment of visceral impact, in digesting a concise statement about the internal creation of my mind: “the motor act is the cradle of the mind.” (Sherington, 1951) An important shift in self-awareness in developing an embodied sense of how: The attempt to regulate affect - to minimize unpleasant feelings and to maximize pleasant ones - is the driving force in human motivation. (Schore, 2003) A shift towards understanding my subconscious primary processes, which explored "nine innate affects, this universal set of prewritten instructions," (Nathanson, 2008) through which we are, "motivated to accept, savor, and seek out the two positive affects because they are “inherently rewarding,” and motivated to avoid, quash, and rebel against the six negative affects because they are “inherently punishing.” (Nathason, 2008) Hence my self-exploration of the phenomenology of “affective psychosis” (McGorry et al, 2012) has led to a synthesis of developmental science research and discovery, with Silvan Tomkins: Affect Theory. With its articulation of a from birth understanding of human development, described in, A PRIMER OF AFFECT PSYCHOLOGY:
When those of us who work with affect psychology say someone has a feeling, we mean that person has become aware of the biologic state that has been triggered in them, in other words they have become aware of their affect. Affects and the resulting feelings are inborn parts of our biology. We all have the same nine affects. We all “know” what fear, shame, joy, and anger feel like because we have all experienced the same thing when any of these affects is triggered. From the time we are born, however, our innate affective responses begin to be altered into emotions. Every family in every culture handles affect differently. Anger in one family will be encouraged and in another suppressed. The more vulnerable affects like fear, shame, or distress are treated with compassion in some families and are scorned as weakness in others with responses like “big boys don’t cry” or “if you don’t stop crying, I’ll give you something to really cry about.”
Emotion, therefore, is not innate like affect, it is learned. (Tomkins used the term script to describe the complex things that happen during learning.) Emotion is the result of our affective biography. It develops uniquely in each of us, scripted from our life experience with our affects, the responses of others to our affects, and our observations of the affects of those around us. As a result, we are all different emotionally. One person’s anger scripts may involve ranting, raving, and cursing like a sailor. While another person, just as angry, might simply raise an eyebrow. The bottom line is that affect = biology while emotion = biology + biography. (One aspect of Tomkins’s genius was that he was able to unpack the unbelievable complexity and diversity of human emotion and unearth the nine building blocks of affect that are its foundation.) (Kelly, 2009)
While uncovering or unearthing the building blocks of my affective states of consciousness, during episodes of euphoric mania, required developing a “sensate” (Levine, 2010) awareness of primary and secondary processes, involved my “affect” driven images of consciousness. A self-exploration of the paradox involved in a “normal” sense-of-self, historically defined by way of analogy with the external environment. With this taken for grantedness of analogous self-interpretation crucial to my argument here, that a “treatment oriented approach” (McGorry et al, 2012) to psychosis is based on a “fever-type” (Porges, 2013) model of infectious disease, and the historical accidents that led to our current era of pharmacology intervention and homeostatic maintenance. An analogous perception of mental suffering well illustrated in such evocative book titles as: Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in America. Wherein the author writes, “Thorazine, wrote University of Toronto professor Edward Shorter, in his 1997 book, A History of Psychiatry, “initiated a revolution in psychiatry, comparable to the introduction of penicillin in general medicine.” (Whitaker, 2010) Yet despite the obvious rationale in comparing mental suffering with illnesses like cancer and diabetes, “the powerful new tools of molecular biology, genetics, and imaging have not yet led to laboratory tests for dementia or depression or schizophrenia or bipolar or obsessive-compulsive disorder or for any other mental disorders.” (Frances, 2013) While a deeper self-awareness exploring innate affect and the millisecond function of “three principal defense strategies—fight, flight, and freeze,” (Porges, 2004) and their self-deceiving cognitive rationalizations. Suggests a primary process motivation of avoidance underpins our analogous assumptions, in the existential context of Schore’s powerful statement that: The attempt to regulate affect - to minimize unpleasant feelings and to maximize pleasant ones - is the driving force in human motivation. (Schore, 2003) Specifically, a paradoxical avoidance of internal awareness underpinning the sense of reason in modernity’s veneration of: Descartes Error: “I think therefore I am.” (Damasio, 2008) While my experiential integration of the polyvagal theory has brought an updated, phylogenetic perspective to Silvan Tomkins original observations of an innate affect system and his analogous articulation, crucial to a coherent sense of my argument here. While Dr Kelly’s primer of affect psychology provides a perfect example of our normally taken for granted analogous illusions of self-awareness, and just how much we misperceive our evolved, organic nature: It is not uncommon today to compare our brains to computers. From a functional standpoint, our brain is a “device” that gathers, analyzes, and stores information. While my experiential journey was tempered by an earlier lived wisdom injunction: The great danger of thinking about man by means of analogy is that analogy comes to be put forward as a homology. (Laing, 1990) With another example of this paradoxical, analogous sense-of-self, witnessed in a recent publication on mental illness recovery: So, if normal memory is like a filing cabinet, then traumatic memory (mediated by dissociation) has files that are missing, scattered, and which come tumbling out at unexpected times. (Longden, 2013) While my self-exploration of a “fundamental order in heart-brain interactions and a harmonious synchronization of physiological systems.” (McCarty et al, 2009) In which, "the central role of the heart is explored in terms of biochemical, biophysical and energetic interactions." (McCarty et al , 2009) Brought an understanding of how these bioenergetic interactions, are “dependent on the dynamic bidirectional communication between peripheral organs and the central nervous system connecting the brain with these organs.” (Porges, 2009) Enabling an embodied sense of how: In mechanistic observations of objective thought, the heart has become sealed off, as a sense organ. The heart as an affective receptor-organ is impaired by our lost ability to understand ourselves organically, at the level of both internal and external sensory awareness. (Brennan, 2004) Hence, my resolution journey involved a need to ignore the common psychology of my previously taken for granted sense-of-self, and regain my: Infants Sixth Sense: Awareness and Regulation of Bodily Processes, (Porges, 2011) to resolve the non-conscious paradox of a heightened mind-body split, orchestrated by: Three Neural Circuits That Regulate Reactivity (Porges, 2004) in the self-protective, millisecond functioning of: three principal defense strategies—fight, flight, and freeze. (Porges, 2004) With a crucial a need to leave my own culture for a period of three years, in order to develop a mind-less awareness of the internal pressures and tensions, of my affect driven primary processes of consciousness, which actively explored Sir Charles Sherington’s concise statement: the motor act is the cradle of the mind. While experientially integrating relevant developmental science research and psycho-physiological discovery, which brought an updated perspective to a somatic creation of primary process consciousness:
Somatomotor and Visceromotor: Coupled systems
In mammals, we observe two evolutionary strategies that link autonomic function with somatic muscle activity. First, there is an anatomical linkage between the segmentation of the spinal nerves and the sympathetic chain. This linkage is reflected in the motor-related increases in sympathetic tone that have dogged psychophysiologists by confounding motor and autonomic responses. The evolution of the segmented sympathetic nervous system parallels the evolution of voluntary motor activities. The sympathetic nervous system regulates vasomotor tone to direct blood flow, and thus, oxygen, to the specific muscles being challenged. Additionally, there are sudomotor links to hydrate and protect the skin from tearing. This link between sympathetic activity and movement has been the cornerstone of arousal theory and hypotheses linking autonomic function to temperament and psychopathologies. It was not many years ago that Obrist challenged the Lacey notion that autonomic state was independent of motor activity (i.e., metabolic demands). There is no doubt that the effects of motor activity are profound on the autonomic nervous system. Yet, this profound effect does not mitigate the importance of other relationships that may be sensitive to specific psychological processes, independent of movement.
To foster motor movement, visceromotor (i.e., autonomic) processes are associated with somatomotor activities. In the periphery this is done primarily by the sympathetic chain and in special cases, such as those related to reproduction and elimination, the sacral branch of the parasympathetic nervous system contributes. However, in the rostral part of mammalian anatomy (i.e., the head) the somatic muscles that regulate facial expression, mastication, vocalization, swallowing, and sucking are matched with general visceral efferents, projecting from the ventral portion of NA, that exert potent influences on the heart and the bronchi. These motor fibers effectively slow heart rate and increase respiratory resistance to conserve oxygen exchange. Neuroanatomical studies performed on human embryos and fetuses suggest that these visceromotor neurons may have migrated from DMNX (Brown, 1990).
As observed through both embryological research and phylogenetic comparisons, in mammals, the primitive gill arches evolve into muscles and nerves controlling the face, bones of the mouth, jaw, pharynx, larynx, softplate, esophagus, and trachea. The nerves innervating these muscles uniquely arise, not from the anterior horns of the spinal cord, but from the source nuclei of five cranial nerves referred to above (trigeminal, facial, glosso-pharyngeal, vagus and accessory). Because of their uniqueness, these motor systems are known as special visceral efferents. And, because of their voluntary aspects, these pathways have been excluded from traditional concepts of the autonomic nervous system. Facial expressions, sucking, swallowing, and vocalizations, characteristic of mammals, reflect the unique mammalian adaptation of special visceral efferent control of the visceral muscles evolving from the branchial arches. However, similar to the synergistic relationship between the sympathetic nervous system and skeletal muscles of the extremities, there is a synergistic relationship between the traditional general visceral efferents of the vagus and the somatic muscles controlled by these cranial nerves. Thus, increased outflow of these somatic muscles produce specific visceral shifts. For example, chewing will produce salivation in the absence of food. Additionally, head rotation, via accessory special visceral efferents, will impact on cardiovascular action via the vagus. (Porges, 1995)
Hence, my experiential integration brought a phylogenetic perspective to “A Traumagenic Neurodevelopmental Model,” (Read et al, 2001) with a deeper understanding of traumatic experience and “the mis-attuning social environment that triggers an intense arousal dysregulation.” (Schore, 2003) Furthermore, the above excerpt from The Polyvagal Theory enabled a congruent sense of the habituated muscular/vascular constriction, of my post traumatic stress defence, my PTSD. With an increased understanding of how my premorbid, (McGorry et al, 2012) pre-psychotic personality, was stimulated by the subconscious activity of my autonomic nervous system. While a fearful inability to surrender to the sensations of my body, ensured that the vital need of “feeling” safe, depressed the activity of my “social engagement system.” (Porges, 2011) Yet only a “sensate” (Levine, 2010) awareness of the thermodynamic activity of this phylogenetic perspective, brings a coherent sense of a “dissolution-dysregulation” model of the lived-experience of psychosis. Which for me, brought an increasing sense of cognitive dissonance towards the descriptive language of the biomedical diagnosis, of mental suffering. With my constant reading and re-reading of research literature bringing further context to my earlier, mainstream definitions of mental illness experience: Clinical research often focuses on studying aberrant psychological processes in clinical populations. When neurophysiological systems are studied with clinical populations, the research designs focus on establishing correlations with the disorders and, in general, preclude the possibility of distinguishing whether the physiological correlates are causes or effects of the disorder. (Porges, 2004) While, prior to reading neuroscience comments like Sherington’s and Schore’s above, years of psychotherapy training and practice had undermined a taken for granted acceptance of normal cognitive function, raising concern about self-awareness and the depth of my own self-ignorance. Prior to my reading of affective neuroscience literature, no thought or awareness of the primary role of motion and emotion in the experience dependant maturation of my subjective experience, had existed for me. Like all normal people, I reached early adulthood taking the functioning of my mind completely for granted, having long forgotten how I learned to think by mimicking others, after I’d learned to crawl. My taken for granted, self-objectifying, normal adult functioning, which was so eloquently expressed by the existential psychiatrist R. D. Laing:
As adults, we have forgotten most of our childhood, not only its contents but its flavour; as men of the world, we hardly know of the existence of the inner world: we barely remember our dreams, and make little sense of them when we do; as for our bodies, we retain just sufficient proprioceptive sensations to coordinate our movements and to ensure the minimal requirements for biosocial survival – to register fatigue, signals for food, sex, defaecation, sleep; beyond that, little or nothing. Our capacity to think, except in the service of what we are dangerously deluded in supposing is our self-interest, and in conformity with common sense, is pitifully limited: our capacity even to see, hear, touch, taste and smell is so shrouded in veils of mystification that an intensive discipline of un-learning is necessary for anyone before one can begin to experience the world afresh, with innocence, truth and love. (Laing, 1990)
An existential perspective also described by Roland Fischer in his research on perception and hallucination, along a continuum of nervous system, hypo and hyper arousal: Space and Increasing Hyper and Hypoarousal: “Although the newborn infant’s only reality, in the beginning, is his CNS activity, he soon learns, by bumping into things, to erect a corresponding model “out there.” Ultimately, his forgetting that his CNS activity had been the only reality will be taken by society as proof of his maturity, and he will be ready to conduct his life “out there” in (container) space and (chronological) time.” (Fischer, 1971) A nervous system mediated arousal perspective which gives an existential context to my 2007 experience in St George hospital, Sydney. With an assessment that I was hypo-manic and would become hyper-manic without medical intervention. Although by the time I was released, I had been medication free for four days, at my request, after arguing my emotional development perspective with the hospital’s head of psychiatry. Therefore, considering my lived experience of mental illness and how my acquired knowledge of neuroscience research has enabled an improved self-regulation without using any medications at all. Seems to suggest that our mainstream public rhetoric concerning mental illnesses is enmeshed in existential paradox. With my own sense of such a paradox first raised by my professional training, which exposed me to alternative explanations for our “inherent susceptibility to emotional illness.” (Nathanson, 2008) Alternative views which embrace a continuum view of psychosomatic experience, rather than a perception of pathology and disease. With an intuitive sense of paradoxical rhetoric finding an increasing coherence through my experiential integration of “The Polyvagal Perspective,” (Porges, 2006) on my non-conscious, autonomic functioning. Specifically, my vagus nerve and the “role of visceral state and visceral afferent feedback on the global functioning of the brain,” (Porges, 2011) so concisely illustrated in the contents section of a paper from: The National Institute for the Clinical Application of Behavioral Medicine: How We Use Others To Feel Safe, Three Hierarchical Systems for How We Respond to the World, How The Vagus Nerve Is a Paradox, The Vagus: A Conduit of Motor and Sensory Pathways, and The Connection between Trauma and Social Engagement. (Buczynski & Porges, 2012) Illustrating my own internal paradox, and the paradox of how so many concise depictions of the human condition, seem to be so religiously ignored by the basic human needs of self-interest and self-preservation. An example of which is the discovery and articulation of an internal process relevant to my lived-experience of mania.
Self Stimulation:
It is remarkable how long it has taken psycho-biologists to begin to properly conceptualize the function of the self-stimulation system, in the governance of behavior. The history of this field highlights how an environmental-behavioral bias, with no conception of internal brain functions, has impeded the development of compelling psycho-behavioral conceptions of self-stimulation. One of the most fascinating phenomena ever discovered, yet still largely ignored by mainstream psychology.
The prevailing intellectual zeitgeist is not conducive to conceptualizing this process in psychological terms. This would involve discussion of the inner neurodynamic aspects of the “mind” and the nature of intentionality and subjective experience. A neurophysiological understanding of such brain systems can explain how we spontaneously generate solutions to environmental challenges. And how this type of spontaneous associative ability characterizes normal human thinking, as well as the delusional excesses of schizophrenic thinking. (Panksepp, 1998)
This affective neuroscience knowledge brought a congruent sense of “how” I self-stimulated my first experience of a profound shift in physiological state, into the driving affective images of mania, in 1980. Knowledge which allowed me to self-regulate spontaneous episodes of affective psychosis, during a three year sojourn in a less judgemental, non Western culture. While professional education, prior to 2007, had brought me an awareness of family therapy traditions which postulate a “multigenerational transmission process” (Bowen, 1985) for psychosis, involving a subconscious e-motive projection, which resonated with my lived-experience. A family experience which mirrored normal perceptive reactions of blaming and shaming the family, towards the psychological formulations of a “double-bind,” (Bateson, 1956) “family projection process.” (Bowen, 1985) While in 2007, it was through the perceptual lens of “Affect Dysregulation & Disorders of the Self,” (Schore, 2003) that my intuitive sense of an e-motive development problem, as the core issue in my experience of manic-depression, first began to discover the scientific information which enabled my transformational journey. Specifically, the experience dependant regulation of the innate affect, “interest - excitement,” (Tomkins, 1995) missing from my early life development, dominated as it was, by the prolonged experience of negative affect, as the primary affective process of innate “distress-anguish.” (Tomkins, 1995) With an affect theory perspective on our current conceptualizations of stress-vulnerability, suggesting an alternative view of stress-distress vulnerability. Hence my experiential understanding of manic emotionality in the development of an affective psychosis, describes a non-pathologic and adaptive “primary-process affective consciousness,” (Panksepp, 2004) prompted by reading such “developmental science” (Schore, 2012) knowledge as:
It is now established that emotion expression changes developmentally as a function of the experience-dependant maturation of neural inhibitory mechanisms, and that the maturation of the frontal region in the second year is responsible for affect regulation and the development of complex emotions. The emergence of the adaptive capacity to self-regulate affect is reflected in the appearance of more complex emotions which result from the simultaneous blending of different affects, and in an expansion of the “affect array.” (Schore, 2003)
Schore’s developmental lens on experience-dependent affect regulation, and affective neuroscience literature explaining how; “The extent to which emotional operating systems exhibit neural plasticity--changes in the efficiency of synaptic connections and dendritic arborization as a function of experience--is becoming an increasingly important avenue of empirical enquiry.” (Panksepp, 2004) Brought my previous acceptance of pathological disease and “psychopathology” (McGorry et al, 2012) into serious question, and was my first clue towards understanding my experience of “severe psychotic mood disorder,” (McGorry et al, 2012) in terms of neural adaptation and the hierarchical structure of nervous system function. This was my “way in” (Smith et al, 2003) to an adaptive capacity to self-regulate “innate-affect,” (Tomkins, 1995) by improving my awareness of “physiological state.” (Porges, 2009) Thus, after decades of accepting brain pathology as causal, in my spontaneous psychoses, I began to re-orientate from a “symptom based formulation,” (Smith et al, 2003) towards a “sensate” (Levine, 2010) awareness of my body and the non-conscious activity of my autonomic nervous system. Hence, a growing awareness of physiological state, in my constant “attempt to regulate affect,” (Schore, 2003) involving an innate “cardiac orienting response,” (Porges, 1995) of “brain-heart communication,” (Porges, 1995) has reframed a limited conceptual sense of “stress vulnerability.” (McGorry et al, 2012) Towards a physiological sense of innate and adaptive autonomic function. Thereby adding a depth of embodied awareness to psychiatry and psychology, group “basic assumptions” (Bion, 1961) that “the patient has a biological, often genetic predisposition that interacts with stress to cause illness (EPPIC, 1997, p. 13.).” (Smith et al, 2003) While my ability to transform a intellectual sense of the latest neuroscience literature and psychophysiological discoveries, along with Silvan Tomkins affect theory, into embodied awareness was made possible by learning “how” to be aware of the “Unspoken Voice” (Levine, 2010) of my body:
The conscious containment and reflection upon our wild and primal urges enlivens us and keeps us focused on actively pursuing our needs and desires. It is the basis for reflective self-awareness. To be “embodied” means that we are guided by our instincts, while simultaneously having the opportunity to be self-aware of that guidance. This self-awareness requires us to recognize and track our sensations and feelings.
“Embodiment” is a personal-evolutionary solution to the tyranny of the yapping “monkey mind.” It paradoxically allows instinct and reason to be held together, fused in joyful participation and flow. Embodiment is about gaining, through the vehicle of sensate awareness, the capacity to feel the ambient physical sensations of unfettered energy and aliveness as they pulse through our bodies. It is here that mind and body, thought and feeling, psyche and spirit, are held together, welded in an undifferentiated unity of experience.
Through embodiment we gain a unique way to touch into our darkest primitive instincts and to experience them as they play into the daylight dance of consciousness; and in so doing to know ourselves as though for the first time - in a way that imparts vitality, flow, color, hue and creativity to our lives. The age of embodiment in the West peaked around the late Egyptian and early Cycladic period of Greece, some five thousand years ago. (Levine, 2010)
An excerpt included in hope of giving readers a congruent sense of my sub-heading suggestion: From Normal Self-Ignorance to Embodiment & Affect-Regulation. Furthermore, “the polyvagal theory: phylogenetic substrates of a social nervous system,” (Porges, 2001) has served as a template to experientially identify “the neural mechanisms available to regulate neurobehavioral state, to deal with challenges along a continuum.” (Porges, 2001) Hence, my education and experiential integration of the latest “developmental science” knowledge, questions a “treatment-oriented” (McGorry et al, 2012) consensus of pathology and disease, within the context of my improved self-regulation, of a psychosomatic experience labelled psychotic. While in: Normal vs abnormal thinking: There is a grey area to protect. There can be no clear defining rules for what we call 'normal' - and there can't be. What one man calls normal differs from another's concept. The not-normal, the abnormal or ill are those considered to interfere with the group's ability to maintain the conditions which they value most highly: for example, health, work and social potential. (Cullberg, 2014) With my lived-experience understanding of; Affect Dysregulation & Disorders of The Self, (Schore, 2003) questioning a biomedical consensus, in terms of a dichotomy created when one reads the latest medical literature concerning: The Recognition and Management of Early Psychosis. (McGorry et al, 2012) Which while stating, “Although there has been an explosion of research into identifying potential biological markers of psychotic illness, and aberrant neural mechanisms are accepted as underlying mental disorder, to date scientists have been unable to identify a specific gene, gene combination or specific brain pathology that is a unique marker of illness (Andreasen, 1997; Patel et al., 2007). At present, the underlying biological substrates and causal risk factors for psychotic disorder remain unknown.” (McGorry et al, 2012) Compared to reading the kind of developmental science literature, which explains how: important discoveries emphasize cortical and sub-cortical structures in the emergence of the complex affective repertoire of humans and their contribution to social relationships (e.g., Schore, 1994, 2003a; Siegel, 2007). However, underlying these contributions are details of an important and often overlooked neurobiological substrate: the neural circuits mediating the reciprocal communication between body states and brainstem structures, which have an impact on the availability of these affective circuits. These underlying circuits not only promote feelings (e.g., Damasio, 1999), but also form a bidirectional circuit (e.g., Darwin, 1872/1965) that enables mental and psychological processes to influence body state, and to color and, at times, to distort our perception of the world. (Porges, 2009) Developmental science literature which, in my opinion provides a middle path understanding of the development of psychosis, and why professor Patrick McGorry writes in the forward to the book, Psychoses: An Integrative Perspective:
Understanding and treating psychotic disorders, particularly schizophrenia, presents a major challenge. Despite significant advances in treatment and liberal reforms to the structure of mental health services, in most parts of the world, including affluent developed countries, the personal experience and quality of life of those affected and their relatives has not improved very much. Indeed the neglect is palpable in North America and other English-speaking countries, and also in the developing world where the fate of people with schizophrenia tends to be idealized. Psychiatry itself has contributed to this problem by lurching from one reductionist extreme to another.
For decades all psychiatric disorders were fully explained on a narrow psychological basis. More recently brain dysfunction and a narrow disease model has taken over. Psychiatry among the medical disciplines truly aspires to an integrative, bio-psycho-social approach, yet this is eschewed in centres of research, elusive in the real world and increasingly lacking in the training of mental health professionals and psychiatrists. (McGorry, 2005)
While the need for an elusive, real world understanding of the actual experience of psychosis. In order to further illuminate our idealized models of care, seems well summed up in excerpts from the same forward section to this universally respected book on the psychoses:
Working in medical care has an almost irresistible tendency to numb practitioners to the realisation that they are treating and tending individuals who are just like themselves. Many claim that they have to dissociate themselves from their feelings if they are to function in the wards.
There is more to good care than ethical principles and staff training. It also requires an organization that accords priority to and accordingly finds room for empathy and humanity without loss of professional standards. An organization in which truly humane care is not feasible is a bad organization, In other words, this has to do with the politics of care in the widest sense. (Cullberg, 2014)
Therefore, in my experience developed opinion, it was this politics of care and diagnostic observation, by way of dissociation which ensured that my first episode of affective psychosis (FEP) or mania became a bipolar experience, after my first hospitalization in 1980. While from a hierarchical phylogenetic perspective on our non-conscious thermodynamic motivation, the above excerpt: Working in medical care has an almost irresistible tendency to numb practitioners to the realisation that they are treating and tending individuals who are just like themselves. Many claim that they have to dissociate themselves from their feelings if they are to function in the wards. (Cullberg, 2014) May be understood in the context of “a more helpful emphasis on the dimensionality and continuum of human experience.” (Longden, 2013) With an acceptance that dissociation is primary process human phenomena, while developing a focused “introception” (Schore, 2003) may explain more perceptively, most of the various signs and symptoms, biomedically categorized as disease and pathology. With my first episode of psychosis in 1980, viewed in the context of our tendency towards a labelling categorization of the human experience, and the publication of DSM III. Which the leading psychiatrist David Healy mentions in his book: The Creation of Psychopharmacology:
The rhetoric of modern drug development is powerful enough to blind clinicians to preventable deaths and obscure the fact that the life expectancies of their patients are falling rather than rising. Despite this, there is a perception that psychiatry has put its house in order. The very visible process of agreeing and publishing successive versions of the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders underpins this perception. The year in which DSM-III, the third edition of this manual, was published, 1980, is another key year, a year in which a new biomedical self was effectively born.
The story of psychiatry is a story of tensions that have not yet played out. It is a history where what we decide is the truth regarding our past has immediate and profound implications for how we view ourselves and our futures and how we treat others when they are at their most vulnerable. It is a history that affects all of us, whatever our ethnic group, gender, class, or religion. It is a history of the intersection of drugs, madness, social order, and the experience of the self. (Healy, 2002)
An excerpt from my reading education which brings an historical context to my thirty four years of lived-experience, and a self-preservation, self-interest context to the dichotomy of descriptive language definitions of human experience. While my experience of the self during states of euphoric mania, defy description with our thus far evolved descriptive languages, based overwhelmingly on object oriented visions of the external environment. While essentially: Language functions by giving us a place in relation to others, so enabling us to overcome the subject-centred illusions that plague each of us, and it also gives a voice to the affective blocks and feelings that otherwise stand in the way of rejoining enough of the flow of life to survive. (Brennan, 2004) With my experiential journey based on my need to understand the “flow of life” within, beneath a self-deception of analogous self-interpretations. My existential need to understand a treatment oriented diagnosis and of my lived-experience which occurred some two weeks after I experienced a profound shift in physiological state, which my subjective interpretation mystified through the process referred to above as “self-stimulation.” (Panksepp, 1998) While decades later, reading R. D. Laing brought an insightful context to this period of confusion and its subjective diagnosis:
The Mystification of Experience:
We must repudiate a positivism that achieves its “reliability” by a successful masking of what is and what is not, by a serialization of the world of the observer by turning the truly given into capta which are taken as given, by the denuding of the world of being and regulating the ghost of being to a shadow land of subjective “values.”
The theoretical and descriptive idiom of much research in social science adopts a stance of apparent “objective” neutrality. But we have seen how deceptive this can be. The choice of syntax and vocabulary are political acts that define and circumscribe the manner in which “facts” are to be experienced. Indeed, in a sense they go further and even create the facts that are studied.
The “data” (given) of research are not so much given as taken out of a constantly elusive matrix of happenings. We should speak of capta rather than data. The quantitatively interchangeable grist that goes into the mills of reliability studies and rating scales is the expression of a processing that we do on reality, which is not the expression of the process of reality. (Laing, 1990)
While Laing’s eloquent articulation of the politics of our lived-experience and illusions of neutrality and objectivity, seem to be validated by recent psychiatry and psychology publications: It seems the case that DSM has reified ‘syndromes’ that naturally may be poorly defined at the boundaries and early in the course of the disorder where they can merge or overlap with other syndromes. It appears that we have shored up reliability without impacting on validity (Andreasen, 2007; McGorry, Copolov & Singh, 1989), and: Psychosis is a phenomenological-psychological concept. There is neither a biological definition covering the term, nor is there a specific biological ‘marker’ for psychosis. Every attempt to find a neurophysiological correlate has been unsuccessful. (Cullberg, 2014) While resolving my personal dichotomy of self-ignorance and improving affect-regulation has involved a self-exploration of the diagnostically overlooked, reciprocal influences between body and brain. Bringing a middle path "phylogenetic perspective" (Porges, 2004) to the development of psychosis and diagnostic perceptions of a disease process. With a developmental science perspective on why: Many of our psychiatric diagnoses beyond the schizophrenia spectrum are based on chronic patient populations, and this is an example of the clinician’s illusion. (McGorry et al, 2012) An illusion based on “clear cut diagnostic categories, because diagnostic categories are totally resultant of a consensus of a series of behavioural and psychological features; so basically, a fever-type model.” (Porges, 2013) The “basic-assumption” (Bion, 1961) of an analogous fever-type model of illness, which perceives behavioural “syndromes” in order to create a group consensus on medical diagnoses, in the: diagnostic and statistical manual (DSM). (McGorry et al, 2012) A group consensus stemming from what some describe as: The Kraepelinian dichotomy: Emil Kraepelin’s view that psychotic disorders could be conceptualized as naturally-occurring disease entities which could largely be differentiated into dementia praecox and manic-depressive psychosis, has had a huge impact on twentieth-century psychiatry. The rise of neo-Kraepelinian psychiatry in the 1960s and 1970s contributed to the construction of DSM-III, in which the Kraepelinian dichotomy between schizophrenia and psychotic affective disorders became embedded in psychiatric classification. (Greene, 2007) An essay which points out how the attachment driven urge of group behaviour tends to be self-citing: The neo-Kraeplinians, although not connected in any official way, worked together to promote their approach. Blashfield (1982) described this informal network with their common beliefs, methodologies and research interests as an ‘invisible college’: there was a tendency among this group to produce papers which actively reinforced one another’s findings. (Greene, 2007) A vision of group behaviour, which resonates with Bion's earlier work on the psychological group's, basic assumptions:
Bion on Groups: Bion’s major work, “Experiences in Groups,” was published in 1961. His starting point in groups, was the work of Melanie Klein and the mechanisms she ascribed to the earliest phases of mental life, mechanisms that involve psychotic defences. These psychotic defences persist in the life of all normal individuals to a greater or lesser extent, but they are especially characteristic of groups, and revealed in the “basic assumption” that binds the group together. As in psychosis, and for that matter the unconscious, time plays no part in basic-assumption activity. “The basic-assumption group does not disperse or meet.” If the awareness of time is forced on a group in basic-assumption mode (as with the unconscious), it tends to arouse feelings of persecution. At some level the group is always in its basic-assumption, which means no member of the group can cease to be in it, even when the group is not gathered. The group remains a group through its basic-assumptions, by the resonances they trigger, and the positions they assign.
Bion did not believe that basic-assumptions are all there is to group behaviour though. He believed that there is a work aspect to groups, which does the job for which the group is formed, and the basic-assumption aspect, which acts on the basis of unconscious affect. The same group is simultaneously a work group and a basic-assumption group; and one or other of these aspects will dominate from time to time. The group can be apparently sane (a university department for instance) and yet occasionally irrational or persecutory in its dynamics. For the group can and usually is, organized around its work function. But, as it is also bound together by its basic-assumption, it is stressed that organization and basic-assumption bondage are radically different. As Bion articulates; “In contrast with work-group function basic-assumption activity makes no demands on the individual for a capacity to cooperate but depends on the individuals possession of “valence,” a term borrowed from physicists for “instantaneous” involuntary combination of one individual with another, for sharing and acting on a basic-assumption.” (Brennan, 2004)
Hence, an understanding of unconscious affect and the resonant, bioenergetic dynamics of our taken for granted group behaviour, in my opinion, points to a dichotomy in mental illness categorization, which fearfully resists a deeper understanding of a continuum of human experience. While Bion’s formulations on the bonding phenomena of group basic assumptions, may be contemplated from the perspective of a bioenergetic resonance, in the nature of human ideology. A resonance “affect” which Silvan Tomkins described thus: Ideo-affective resonance to ideology is a love affair of a loosely organized set of feelings and ideas about feelings with a highly organized and articulate set of ideas about anything. As in the case of a love affair the fit need not be perfect, so long as there is sufficient similarity between what the individual thinks and feels is desirable, to set the vibrations between the two entities into sympathetic resonance. (Tomkins, 1995) Which, in my opinion brings the need of self-doubt to biomedical expectations, of an analogous “fever-type” perception of psychosis. Resulting, in my opinion, from a history of cultural denial about the human body and the structure and function of our phylogenetic, biological nature. Particularly our instinctive, self-protective and self-preserving processes of selective attention and memory, so aptly described by McGilchrist as: It might turn out that for some purposes, those that involve making use of the world and manipulating it for our benefit, we need, in fact, to be quite selective about what we see. In other words we might need to know what is of use to us – but this might be very different from understanding in a broader sense, and certainly might require filtering out some aspects of experience. (McGilchrist, 2010) With my argument for a clearer perception of non-conscious innate affect, involved the primary processes of our human consciousness. Particularly how professor Stephen Porges phylogenetic perspective and the polyvagal theory guided my resolution journey, finds support from a leading expert on PTSD.
"Porges helped us understand how dynamic our biological systems are and gave us an explanation why a kind face and a soothing tone of voice can dramatically alter the entire organization of the human organism— that is, how being seen and understood can help shift people out of disorganized and fearful states. We had long realized that psychopathological states rarely are static and tend to fluctuate greatly depending on the safety of the environment and the physiological state in which people find themselves. The proposal that our physiological states are flexible, and depend on both our relationship to our visceral experiences and the state of our relationships promises to decrease our dependence on drug treatment alone to shift people into a different psychological organization. Recognizing the critical role of visceral afferent feedback on the global functioning of the brain inevitably leads to curiosity about the nonpharmacological treatments that have so long been practiced outside of Western medical approaches: age-old traditions of changing mental states with specific breath exercises, body movements (chi qong, tai chi, tae kwon do, and yoga) and rhythmical activities (such as kendo drumming and davening).
If physiological mind– brain –viscera communication is the royal road to affect regulation, this invites a radical shift in our therapeutic approaches to a number of psychopathological states, such as anxiety, attention deficit/ hyperactivity disorder, autism, and trauma-related psychopathology." (Van der Kolk, 2011)
While important to a coherent sense of the illusions predicated on our instinctive identification of words, with too little simultaneous internal awareness, may be contemplated with a comparison of psychological formulations. “We had long realized that psychopathological states rarely are static," which may be compared with Teresa Brennan's formulation of a foundational fantasy, suggesting a non-conscious, crucial need for safety creates a psychological desire for certainty and a tendency to interpret our free flowing bioenergetic experience in fixed, rather mechanistic ways that fearfully cuts us off from the reality of our evolved nature:
The foundational fantasy removes us from the sphere of more rapid understanding, just as it slows us down in relation to the freely mobile energy into which we are born. In Exhausting Modernity I proposed that humans slow down natural, energetic time by constructing inertia--an artificial time of fantasies and fixed commodities. This notion is here linked to language and the severance of thought and feeling by the affects of self-interest, which make us pause to take stock of how a given situation does or does not advantage us. This calculation severs links with the other, including the other that is one’s flesh, links that can be re-established by a different kind of reflection as a means for reconnection and reflection as the calculation of advantage is tied, in the concluding section, to the two forms of science or knowledge (logical, and that based on subject/object thought). Understanding fleshy languages as language-structured systems of intelligent communication whose matter is intrinsic to their form--enhances the likelihood that science will identify more of them. (Brennan, 2004)
Reflecting on the millisecond nature of my own affective judgements of “otherness,” and the construction of an egoic sense of “I am,” brought me an embodied awareness of dissociation, as the foundation of my experience of mind. With a heightened sense of paradox towards psychological formulations of dissociation as a symptom of psychopathology. With my exploration of non-conscious millisecond nervous system activity, suggesting that the “freeze” functionality of our autonomic nervous system, is responsible for perceiving “psychopathological states” in a static, categorizing way. While my experiential resolution of psychotic experience, challenges our normal illusions of self-awareness, in our affective states of consciousness, whereby:
The delusion is extraordinary by which we exalt language above nature:-
making language the expositor of nature,
instead of making nature the expositor of language. -Alexander B Johnson
My Transformative Psychoses: Psychological Content & Physiological Context
After twenty seven years of medicating my bipolar type 1 disorder mood swings, doing my best to avoid the delusional highs of mania, the despairing desolation of clinical depression, and the powerful escape impulse of suicidal ideation. I found myself confronting the depth of my self-ignorance about my human nature, in a desire to improve my capacity for self regulation. Since stumbling on Allan N Schore’s book: Affect Dysregulation & Disorders of the Self, in late 2007 and reading the constant references to the autonomic nervous system and its role in psychiatric disorders. Hence, developing a mind-body awareness of nervous system activity and “innate affects” (Tomkins, 1995) to improve my capacity to regulate affect, has been the driving force in my personal motivation. After twenty seven years of experiencing affective psychoses, whether on or off antipsychotic medications, I have not used any form of medication since late 2007. Particularly while experiencing three uninterrupted episodes of affective psychosis or euphoric mania, over a three year period of self-exploration in 2010-2011-2012, while residing in the Buddhist culture of Thailand. Where, after reaching a point in my life, when I could afford to indulge my self-exploration need, beyond the economic necessities of normal self-preservation. Experientially exploring all the relevant developmental science knowledge I had acquired, from the Buddhist perspective that: words do not describe reality, only experience shows us true face. -Buddha. A three year period of self-experimentation allowing me to explore an earlier observation that: psychosis is natures way of setting things right. (Perry, 1998) With a wide ranging inter-disciplinary education process, culminating in the use of “the polyvagal theory” (Porges, 2011) as a guiding concept and Peter Levine’s “somatic-experiencing” methods as a tool for internal self-revelation. I have steadily improved my need to regulate the expression of what Silvan Tomkins described as: “the affect system,” a specialized neuromuscular system responsible for some of the most important functions in human life. (Nathanson, 2008) Specifically, innate “interest - excitement” (Tomkins, 1995) which seems to be the expressed innate affect, in my experience of mania, while the innate affect mechanisms of “fear - terror,” “distress - anguish,” (Tomkins, 1995) were the core affects involved in the developmental dis-ease of my “prepsychotic personality.” (Perry, 1998) Hence, since that fateful scheduling in St George hospital in April 2007, towards the end of a six week period of unrestricted psychotic experience, I have acted on the desire to find developmental science explanations of Dr John Weir Perry’s earlier observation that:
In speaking of the acute episode as a self-healing process, we are confronted with what at first appears to be a paradox for those who think in terms of psychopathology. If the acute episode is a psychosis, then it must by definition, be a disorder, and how can a disorder be healing? In my view the "disorder" lies in the so-called prepsychotic personality, that is, in the insufficient emotional life of the individual up to the time of the first break, the emotional aspect of development having been severely limited and inhibited. For these individuals the interchange of feeling has been considered unsafe and intimacy seen as threatening. In many ways their experience has shown that feelings cannot be afforded because of the danger of being hurt. (Perry, 1998)
While my “trance-like” post traumatic stress defence, the PTSD of my prepsychotic personality, needing a “felt-sense” (Gendlin, 1982) resolution. Found a coherent sense of Perry’s observations, in professor Stephen Porges conception of: NEUROCEPTION: A Subconscious System for Detecting Threats and Safety. What determines how two human beings will act toward each other when they meet? Is this initial response a product of learning from culture, family experiences, and other socialization processes? Or is the response the expression of a neurobiological process that is programmed into the very DNA of our species? (Porges,2011) Bringing a phylogenetic perspective to my own experience of a first episode psychosis, triggered by attachment loss and a “neurorception” of safety, described below. An adaptive view of nervous system function increasing my intuitive sense of a “self-nurturing” context to my experiences of delusional mania. Experiences like the first of four full-blown and uninterrupted affective psychoses, as a neural potentiation need to reorganize three levels of autonomic nervous system activity, in order to resolve my approach/avoidance and proximity needs, in a defensively oriented social world. With a need to develop an embodied understanding of an innate stimulus to the dissolution of a pain/fear potentiated neural orientation to “internal-external” environmental challenges. Hence, my non-intervention need to explore my delusional experiences, was documented as best I could for future analysis, with the help of relevant information. Documented from a traditional behavioural therapy re-frame perspective, that beneath our conscious illusions of image labelling words, all behaviour is communication. Hence I made daily journal entries of my lived experience leading up to my scheduling in St George hospital on April 12th 2007:
Monday March 19th 2007 5am. Day One. I think I’m fully realized now, my resurrection is complete, I am David, I am Jesus, I am prophet, I am hero. Walking down the street I can feel the oneness call in every fibre of my being, my senses are heightened, expanded well beyond the boundary of my skin, I am energy, I am nature, I am element, I do not walk down this street just feeling the breeze on my skin, hearing the birds in the trees, the rustling of the leave’s, the smell of jasmine, I am the street, the wind, the leaves, the birds, I am dissolved of all sense of separation, I am one.
“No! This can’t be fucking real, I’m losing my mind again, I’m falling, falling into the same old madness, what is dissolving here is my sanity, my connection to objective reality, this is no ascent into a higher oneness state, it’s a decent into dream and I’am awake not freaking asleep!” I was trying to resist the temptation, trying to hang on to my perception of who, what and where I was on that Monday morning as my connection to objective reality deserted me. I turned a street corner as daylight thickened around me and hoped that it would bring clarity and end this nonsense. The sun was rising above the tree line as I entered the park area and stopped to catch my breath, bending over to touch the grass wanting to ground my senses, as I straightened I saw it, a single white cloud in a perfectly clear sky. “Shit! This can’t be real.” It was not exactly like that morning a decade before, when a single black cloud sat on the horizon of an azure blue sky. I winced at the memory of that day and all it’s consequences.
“This is not a bloody sign! The universe is not talking to me!” I was trying hard to remain aware of changes in physiology and the effect it was having on my perception, and these self-referential illusions. Six hours before I had taken the King James bible into my bedroom and read again the passage in Revelation 19.16 “On his robe and on his thigh he has a name inscribed, king of kings and Lord of Lords,” and asked myself why I didn’t die in 1981, when my leg should have been ripped off, and this deep scar on my thigh marked me for life? (Bates, 2008)
IF ALL BEHAVIOUR IS COMMUNICATION: What was this delusional perception of everyday normality trying to communicate to my own cognitive processing and to others, who quiet reasonably, view such self-referential ideation as a clear sign of madness or a discreet category of mental illness. An image of mental illness most commonly understood as the hyper-manic phase of “bipolar-affective disorder.” (Smith et al, 2003) While from my experiential perspective, self-referential ideation involves a need for the bioenergetic feedback upon which all biological systems maintain homeostasis, while immersed in existential challenges. The psychological content representing a metaphorical need to interpret the physiological context of the existential nature of the challenge. With the delusional association of being Jesus (the psychological content) now understood as a reaction to existential isolation, with a deep need for love that cannot be consciously requested due to an experience conditioned expectation of rejection, of abandonment. With delusional ideation, my self-referential identification with the spiritual heroes of my childhood, now understood in the context of existential metaphors and personification stories about the human condition. With the phylogenetic nature of cognitive processes, metaphorically described as an “immaculate conception,” in this life-defining story of Christian culture. While in physiological terms, the identification represents the need to “affect” positive “primary process emotional/affective states,” (Panksepp, 2004) to overcome the “density” of my negative affective states, experienced in attachment relationships. A need to invoke a felt-sense of invincibility, in order to cope with the ego shattering sense of existential isolation and the dread of approaching others. In existential terms, the phantasy of delusional ideation was a metaphorical interpretation of the non-conscious activity of my nervous systems: three principle defence strategies—fight, flight, and freeze. (Porges, 2004) With existential metaphor like "Yea, though I walk through the valley of the shadow of death, I will fear no evil: for thou art with me; thy rod and thy staff they comfort me." -Psalms 23:4, referring to the most primitive of three neural circuits that regulate reactivity, retaining a capacity for “death-feigning behaviors,” (Porges, 2008) and the rod or staff referring to the spinal chord, in my opinion. While as Peter Levine points out: In the reciprocal enervation discovered by Sherrington, the nervous system operates primarily as a negative feedback system, much like a house thermostat. Self regulation of the complex nervous system exhibits what are called emergent properties, which are often somewhat unpredictable and rich in nuance. While the nervous system operates under the principle of self-regulation, the psyche operates under the emergent properties of creative self-regulation. We might say that as the nervous system self-regulates, the psyche engages with these emergent properties: that is, to creative self-regulation. (Levine, 2010) A view of nervous system regulation which brings a physiological context to my life-long need to “self-nurture” my nature by using phantasy to self-stimulate primary process affective states. While my subjective interpretation of the heightened sensory awareness, which followed a sudden shift in physiological state, and the dissolution of my life long post traumatic defence of constricted sensory awareness, needs to be taken into account in my delusional experiences. While crucial to my argument here, is “how” my delusional experiences where met with subconscious “affective-judgements” (Brennan, 2004) by others (family members) immersed in a consensus normality, which lacks knowledge of internal structure and function. Which readers may contemplate from the perspective of: NEUROCEPTION: A Subconscious System for Detecting Threats and Safety. While a: A Traumagenic Neurodevelopmental Model, (Read et al, 2001) of psychosis may be contemplated from the perspective of one of the world’s leading experts on PTSD and a strong advocate of a trauma informed treatment approach.
"People with impaired social engagement systems are prone to misinterpret safety as a threat and objective danger as safety. Their visceral feedback system fails to protect them, or prevents them from engaging in the fullness of what life has to offer. People who are chronically traumatized have a tendency to become overwhelmed and triggered by their seemingly unmanageable visceral feedback systems that cannot be modified by a functional social engagement system. Consequently they try to inhibit sensory feedback from their bodies and experience the feedback from both their bodies and the world around them as bland and meaningless. Our observation that traumatized individuals habitually engage in body-based defensive maneuvers led us to incorporate the work of such body-based therapists as Peter Levine and Pat Ogden into our treatment armamentarium." -Bessel A. van der Kolk. Forword: The Polyvagal Theory: Neurophysiological Foundations of Emotions, Attachment, Communication, and Self-regulation.
While through improved knowledge of my internal structure and function, I was able to “feel” my way out of the trance like states of a post traumatic stress defence. After decades of self-ignorance and reliance on a biomedical approach to my experience. While my experiential interpretation of my delusional, self-nurturing phantasies, may be contemplated with earlier formulations about the nature of phantasy and experience:
As domains of experience become more alien to us, we need greater and greater open-mindedness even to conceive of their existence. Many of us do not know, or even believe, that every night we enter zones of reality in which we forget our waking life as regularly as we forget our dreams when we awake. Not all psychologists know of phantasy as a modality of experience, and the, as it were, contrapuntal interweaving of the different experiential modes.
Many who are aware of phantasy believe that phantasy is the farthest that experience goes under ‘normal’ circumstances. Beyond that are simply ‘pathological’ zones of hallucinations, phantasmagoric mirages, delusions. This state of affairs represents an almost unbelievable devastation of our experience. Then there is empty chatter about maturity, love, joy, peace. This is itself a consequence of and further occasion for the divorce of our experience, such as is left of it, from our behaviour. (Laing, 1990)
With Laing’s intuitive sense of a “devastation of our experience” perhaps more effectively described by McGilchrist’s: It might turn out that for some purposes, those that involve making use of the world and manipulating it for our benefit, we need, in fact, to be quite selective about what we see. In other words we might need to know what is of use to us – but this might be very different from understanding in a broader sense, and certainly might require filtering out some aspects of experience. (McGilchrist, 2010) While my resolution of spontaneous episodes of psychosis, and re-frame understanding of delusions, in the self-nurturing context of affect-regulation, in the physiological context of motion, emotion and cognition. Questions psychological formulations that may unwittingly be quite selective and “be very different from understanding in a broader sense.” Psychological formulations like: Without delusions one cannot or should not speak in terms of psychosis. Perceptions are often correct in psychosis, but it is the interpretations of the perceptions which are mistaken. This differs from delirium where it is primarily the perceptions that are disturbed. A psychosis can be more or less influenced by the following phenomena, which however cannot be called psychotic in themselves: hallucinations disturbed behaviour confusion or delirium. (Cullberg, 2014) Which may be perceived as a treatment oriented perspective which creates theories and hypotheses “that involve making use of the world and manipulating it for our benefit,” (McGilchrist, 2010) by a process of inclusion and exclusion, which fails to take account of broader perspectives. Perspectives like the common occurrence of hypnagogic hallucinations, reported in Oliver Sacks book Hallucinations:
On the Threshold of Sleep: Images and their subsequent changes appear and fade without my control. The experience is fugitive, sometimes lasting a few seconds, sometimes minutes. I cannot predict their appearance. They appear to take place not in my eye, but in some dimension of space before me. The strength of the imagery varies from barely perceptible to vivid, like a dream image. But unlike dreams, there are absolutely no emotional overtones. Though they are fascinating, I do not feel moved by them. . . . The whole experience seems to be devoid of meaning.
He wondered whether this imagery represented a sort of “idling” in the visual part of the brain, in the absence of perception. What Mr. Utter described so vividly are not dreams but involuntary images or quasi-hallucinations appearing just before sleep— hypnagogic hallucinations, to use the term coined by the French psychologist Alfred Maury in 1848. They are estimated to occur in a majority of people, at least occasionally, although they may be so subtle as to go unnoticed. While Maury’s original observations were all of his own imagery, Francis Galton provided one of the first systematic investigations of hypnagogic hallucinations, gathering information from a number of subjects. In his 1883 book Inquiries into Human Faculty, he observed that very few people might at first admit to having such imagery. It was only when he sent out questionnaires stressing the common and benign qualities of these hallucinations that some of his subjects felt free to speak about them.
Peter McKellar and his colleagues started what was to be a decades-long investigation of near-sleep hallucinations, making detailed observations of their content and prevalence in a large population (the student body at the University of Aberdeen) and comparing them with other forms of hallucination, especially those induced by mescaline. In the 1960s, they were able to complement their phenomenological observations with EEG studies as their subjects passed from full wakefulness to a hypnagogic state.
More than half of McKellar’s subjects reported hypnagogic imagery, and auditory hallucinations (of voices, bells, or animal or other noises) were just as common as visual ones. Many of my own correspondents also describe simple auditory hallucinations: dogs barking, telephones ringing, a name being called. (Sacks, 2012)
While in my own phenomenological observations of psychotic experience, it is worth noting that I only experienced one auditory and one visual hallucination, both occurring on high dose antipsychotic medications. With my need to find a broader science based understanding of my actual experience, involving a less fearful sense of delusions and hallucinations during waking states, after experientially digesting such knowledge as:
Some people have also thought that dreaming is the crucible of madness. Many have suggested that schizophrenia reflects the release of dreaming processes into the waking state. Schizophrenics do not exhibit any more REM than normal folks, except during the evening before a “schizophrenic break,” when REM is in fact elevated. There seem to be two distinct worlds within our minds, like matter and antimatter, worlds that are often 180 degrees out of phase with each other. The electrical activity in the brain stem during dreaming is the mirror image of waking--the ability of certain brain areas to modulate the activity of others during waking changes from excitation to inhibition during REM. In other words, areas of the brain that facilitate behaviors in waking now inhibit those same behaviors.
Many believe that if we understand this topsy-turvy reversal of the ruling potentials in the brain, we will better understand the nature of everyday mental realities, as well as the nature of minds that are overcome by madness. Perhaps what is now the REM state was the original form of waking consciousness in early brain evolution, when “emotionality” was more important than reason in the competition for resources. (Panksepp, 1998)
This was the kind of reading education which helped me to steadily develop an embodied sense of the phylogenetic perspective on human development, and transform my earlier commonsense acceptance of disease and psychopathology, into one of a continuum of human experience. While my seven year journey to this experiential articulation of affective psychoses, as an adaptive neural potentiation need, was documented in journal form in 2007 and then online in various forums, from October 2010 to June 2012. Hence, over a three year period, three affective psychoses were experienced with a steady improvement in awareness of internal affective processes. Steadily improving my understanding of the psychological content and physiological context of my affective psychoses, with no intervening episodes of depression. With a birth trauma induced proximity dichotomy steadily resolved as I learned to sense the non-conscious activity of my “cardiac orienting response,” (Porges, 1995) involving my hearts: intrinsic nervous system, (McCarty et al, 2009) and its role in creating my “primary process emotional/affective states.” (Panksepp, 2004) My traumatic, experience dependant proximity dichotomy, of a muscular, vascular constriction within, directly reflected in my life long social proximity difficulties without. A trauma induced non-conscious flight from sensations of physical pain within my body, mediated by the involuntary reactivity of my self-protective nervous system.
Hence, my resolution journey has involved a need to give up my previous attempts to regulate innate affect by thinking and accept the essence of motion and emotion and how: the motor act is the cradle of the mind. (Sherington, 1951) Accept how my previous, narrative of an “objective” sense-of-self, was based on the “illusions of a self-contained subject negotiating a world of objects.” (Brennan, 2004) With my previous illusion of self-awareness based on splitting my mind from my body, in a thought-narrative avoidance of the sensations of negative affect. Such was the post trauma, pain-fear driven avoidance motivation of my, “premorbid,” (McGorry et al, 20120 “pre-psychotic personality,” (Perry, 1998) masked by mimicked behaviour or what Tomkins described as simulated affect. Hence my need to transform my pre-psychotic personality from a withdrawn and depressive primary process motivation of fear and avoidance, and understand the spontaneous dissolution of an internalized sense of “life threat,” (Porges, 2004) which led to my first experience of psychosis in 1980. A need to understand how my post traumatic stress defence was an internal “double-bind” (Bateson et al, 1956) energized by my hearts "orienting and defensive responses," (Bernston et al, 1991) and how a non-conscious “neuroception” (Porges, 2004) enabled a sudden rise in the functional activity, of my “social engagement system.” (Porges, 2011) Hence, I note formulations about psychotic experience suggest: A period of marked depressive or hypomanic symptoms can herald both brief psychoses, schizophreniform and schizophrenic psychoses. In an affective psychosis the underlying disorder is depression or a bipolar illness, where the person, during a period of their illness, develops a clear psychosis. In affective psychoses the preceding deterioration in mood may act as a trigger for the psychosis. This would support the idea that there is not necessarily a categorical distinction between affective and non-affective psychoses. (Cullberg, 2014) While my experiential journey sought to “sense” the thermodynamic nature of my psychotic experience, beneath the modulation of physiological states, by cognitive processes. Developing a felt awareness of how: Emotions organize behavior along a basic appetitive-aversive dimension associated with either a “behavioral set involving approach and attachment,” or a set “disposing avoidance, escape, and defense.” (Schore, 2003) An understanding which helped me to heal the mind-body split of my prepsychostic personality, and gain a deeper understanding of my innate affect regulating, phantasies of mind. In a self-exploration of my mind’s “foundational fantasy,” (Brennan, 2004) which lacked awareness of how: bodily physiological and chemical processes themselves push for admission to consciousness past blocks of self-absorption via a slow linguistic gateway. (Brennan, 2004) While it is no coincidence that my transformative psychoses, were experienced in a Buddhist culture with an implicit understanding that: Presence in reality is not possible if your mind is overwhelmed by thoughts. When the mind is emptied, it is possible to turn your attention spontaneously to reality. (Giacobbe, 2005) A Buddhist perspective on mental suffering, which brings an existential context to the profound shift in perceptual awareness, mediated by three neural circuits that regulate reactivity, (Porges, 2004) which led to my first episode psychosis and a life-defining medical diagnosis. While my extensive reading education and experiential integration, led to the discovery of books like “Psychosis and Emotion: The Role of Emotions in Understanding Psychosis, Therapy and Recovery,” which explores our perceptions of motion and emotion:
Movement and emotion: In the objective world, movement is the basis of life. No one has promulgated this idea more than Maxine Sheets-Johnstone, who in her ground-breaking work The Primacy of Movement (1999a) has collated massive amounts of evidence from anthropology, biology, psychology and evolution to support this thesis. Aristotle, she notes, “states in unmistakable terms that to understand nature is to understand motion, for nature— by its very nature— everywhere articulates a principle of motion.
Going back to Aristotle, she notes that his was an “essentially experiential, kinetic and qualitative explication of perception” which is drawn on an understanding of perception as sensorially localized. “We perceive at the site of our senses.” That sensation is “a change of quality, and of change of quality as a matter of movement” (1999b, pp. 259– 277). Sheets-Johnstone goes on to establish the fact that language and all it achieves is post-kinetic. The newborn moves, cries but does not speak like an adult. All its efforts are movements. The first breath, the first cry, the first gulp of milk, the first caress it enjoys are all movements. The emotions exhibited by the baby and the affection showered on the baby is through motion. As a newborn grows, motion or movement is the basis for perceiving and understanding the world around it. Sheets -Johnstone asserts that these behaviors form the underpinning of emotions and further the evolution of language. (Gumley et al, 2013)
An articulation of motion, emotion and the evolution of language, which I found more concisely stated in Sir Charles Sherrington’s “the motor act is the cradle of the mind.” With my constant reading and re-reading of relevant knowledge leading to an epiphany moment, on my journey towards resolving the trauma affected nature of my thermodynamic, internal organization. Fulfilling my decade long desire to understand the experience of mental illness from the inside-out, and articulate a deeper awareness of actual experience to myself and others. Thereby developing an understanding of my first experience of mania as an innate need to dissolve a pain/fear potentiated neural orientation to “internal-external” environmental challenge. An understanding of my affective psychoses as a need to resolve the approach/avoidance dichotomy, of post traumatic experience, in our “inherent susceptibility to emotional illness.” (Nathanson, 2008) An subconscious approach/avoidance dichotomy which in my opinion is intimately involved in the assessment and diagnosis of this profound experience, our “affect” driven images of consciousness, label’s a psychosis. While the experiential challenge I faced in redressing the self-ignorance of my own “thermodynamic” functioning, in the subconscious processes of “affect regulation,” is summarized by professor Stephen Porges:
At present, there are only a few easily understood descriptors that characterize internal senses and states— for example, pain, nausea, and arousal. Yet in spite of this linguistic handicap, our experiences provide us with an awareness of bodily sensations and an appreciation of how these sensations can contribute to mood state and psychological feelings. Missing from our language and our science is the ability to describe internal states. In our day-to-day interactions we choose vague terms, such as “feelings,” to describe the psychological consequences of bodily changes. Behavioral scientists often attempt to objectify these terms by operationalizing concepts such as state, mood, and emotion with verbal reports and elaborate coding systems. Clinical practitioners infer these feelings and use terms descriptive of emotional tone. However, whether we are talking about feelings, emotions, states, or moods, we are always attempting to describe the internal states that are continuously being monitored and regulated by the nervous system. Classic physiology describes this sensory system as interoception. Interoception is a global concept which includes both our conscious feelings of and unconscious monitoring of bodily processes. (Porges, 2011)
An excerpt from the book The Polyvagal Theory which uses the term “tone,” which was crucial to my acceptance of the motor act as the cradle of the mind and therefore my mental illness experience. With my mind-less self-regulation of affective psychoses, based on an improving awareness of the “cerebral tones” (cognitive processing) created by “primary process emotional/affective states.” (Panksepp, 2004) With an appreciation of how the innate affects amplify their stimulus, bringing a growing awareness that my thoughts were amplifying energized internal states, in the constant reciprocal feedback between my body and brain. My self-experimentation during normal periods and during active psychoses, exploring an: often overlooked neurobiological substrate: the neural circuits mediating the reciprocal communication between body states and brainstem structures, which have an impact on the availability of these affective circuits. These underlying circuits not only promote feelings (e.g., Damasio, 1999), but also form a bidirectional circuit (e.g., Darwin, 1872/1965) that enables mental and psychological processes to influence body state, and to color and, at times, to distort our perception of the world. (Porges, 2009) Hence, from my lived-experience perspective, psychosis is as an adaptive process thwarted by the subjective state interference with an innate process seeking to return the organism to appropriate nervous system function. A need of appropriate stimulus response to both internal and external challenges. Therefore, my resolution experience of adaptive psychoses is so well described by the Buddhist conception that: The attribution of reality to the mental objects of our mind, is the cause of mental suffering. We suffer because of the “fantasies” in our mind. (Giacobbe, 2005) Thus, I present this articulation of my unconscious motivation, involving an innate affect system as the wellsprings of my mind’s-eye. While understanding “innate affects” (Tomkins, 1995) as the “neuronal pools” (Sherington, 1951) involved in how: the motor act is the cradle of the mind, (Sherington, 1951) and the degree to which I function with a non-conscious nervous system expectation, and constant environmental “neuroception.” (Porges, 2004) An understanding of the wellsprings of my human consciousness described in the book: The Private Life of the Brain: Emotions, Consciousness, and the Secret of the Self, as “fountains,” in a hypothesis of how “distinct chemical systems are responsible for energizing, alerting, and modulating the brain in different ways under different conditions of biorhythms and arousal.” (Greenfield, 2000) With a depth of embodied awareness enabling a cognitive understanding of my innate affect-system and how the: Feedback processes in “affective cognitive systems” are capable of “provoking sudden nonlinear jumps, far away from equilibrium, leading to chaotic conditions or to the formation of new “dissipative structures.” (Schore, 2003) While understanding how birth trauma and subsequent life experience, dominated by the activity of an innate “distress - anguish” (Tomkins, 1995) mechanism, may be considered from a stress (distress) accumulation perspective. “The accumulation of stress, defined in terms of the autonomic nervous system, influences many, if not all, other systems.” (Levine, 1976) While my acceptance of a pre-wired affect-system involving heart-brain communication suggests that accumulated stress, may be a predominate expression of innate “distress - anguish,” blended with innate “fear - terror” and driven by an innate pain system. With my “sensate” (Levine, 2010) awareness of nervous system activity and the “role of visceral state and visceral afferent feedback on the global functioning of the brain,” (Porges, 2011) suggesting that “the motor act is the cradle of the mind and “innate-affects” are “analogical-amplifiers” of stimulus response systems, involving feedback processes within and without the human organism. After digesting affective neuroscience knowledge of how:
1, The underlying circuits are genetically pre-wired and designed to respond unconditionally to stimuli arising from major life-challenging circumstances. 2, The circuits organize behavior by activating or inhibiting motor sub-routines (and concurrent autonomic-hormonal changes) that have proved adaptive in the face of life-challenging circumstances during the evolutionary history of our species. 3, Emotive circuits change the sensitivities of sensory systems relevant for the behavior sequences that have been aroused. 4, Neural activity of emotive systems outlasts the precipitating circumstances. 5, Emotive circuits come under the control of neutral environmental stimuli. 6, Emotional circuits have reciprocal interactions with brain mechanisms that elaborate higher decision-making processes and consciousness.
While the superficial layers of the superior colliculi flexibly harvest information about the location of visual stimuli, the underlying motor system generates orienting movements using a remarkably stable set of action coordinates. This stability of the somatomotor system indicates that it has primacy in the evolution of the psycho behavioral coherence, which this system spontaneously generates. Underlying PAG tissues, which contain representations of all emotional processes, may constitute an even deeper and more primitive visceral-SELF.
Even though the extroceptive contents of consciousness are obviously created by sensory zones, these zones must send massive outputs into motor areas in order for coherent behavior to occur. I suspect this has led many thinkers to mistake sensory awareness for consciousness itself, as opposed to the toolbox of consciousness that sensory awareness really is. In sum, a careful consideration of underlying issues, indicates that primary-process and intentional consciousness is more critically linked to motor than to sensory cortices. (Panksepp, 1998)
While my experiential research drive was stimulated by a “differentiation of self" (Bowen, 1985) need, based on Murray Bowen’s conception that, “A person can have a well functioning intellect but intellect is intimately fused with his emotional system, and a relatively small part of his intellect is operationally differentiated.” (Bowen, 1985) An “intimate fusion” which affective neuroscience investigates as cortical and sub-cortical processes within the brain. Hidden processes, described as seven "affective systems, SEEKING, RAGE, FEAR, LUST, CARE, PANIC/GRIEF, and PLAY.” (Panksepp, 1998) With my carefully documented separation distress triggers to nervous system dysregulation, finding relevant affective neuroscience explanations, when reading: In the coarse of brain evolution, the systems that mediate separation distress emerged, in part, from preexisting pain circuits. It is now widely accepted that all mammals inherit psycho-behavioral systems to mediate social bonding as well as various other social emotions, ranging from intense attraction to separation induced despair. There is good reason to believe that neurochemistry’s that specifically inhibit the separation-distress or panic system also contribute substantially to the processes which create social attachments and dependencies--processes that tonically sustain emotional equilibrium and promote mental and physical health. (Panksepp, 1998) Hence my experiential suggestion that my acceptance of a pre-wired affect-system involving heart-brain communication suggests that accumulated stress, may be the predominate expression of innate “distress - anguish,” blended with innate “fear - terror” and driven by an innate pain system. With my synthesis of relevant knowledge enabling me to explore my lived-experience of psychoses, in order to understand, from the “inside-out,” the nature of my own affect driven images of consciousness. Thereby steadily improving my voluntary regulation of my innate affect system through a growing appreciation of the polyvagal perspective. Thus developing an experiential understanding of how socially suppressed innate-affect was involved in my “primary-process affective consciousness,” (Panksepp, 2004) through a synthesis of broad ranging observations on the human condition and the evolving nature of my human consciousness:
"Consciousness is a report about affect-driven imagery. Since affect in our view amplifies varying rates of change (its innate activities), the images within the control assembly represent only such information as is urgent that reports significant, vital, new changing information" (p. 353). The six basic innate affects (interest-excitement, enjoyment-joy, surprise-startle, fear-terror, distress-anguish, anger-rage) are evolved, programed responses to stimuli with highly specific qualities. They are triggered when the flow of data rises or falls over one or another gradient, or remains steady at one or another non-optimal level. The contour in time of each type of stimulus is mimicked by the contour in time of the affect it triggers, thus drawing our attention to the specific kind of importance associated with that stimulus. Affect is vitality; affect occurs only when something is significant; affect is about changing information. "Stability is that very rare special case of a rate of change which is extremely slow compared with the totality of the environment" (p. 354). Boredom is not triggered by lack of change, but by a steady-state non-optimal stimulus; boredom is an adult form of distress rather than an innate response to understimulation (which can only exist in death.) We have evolved to "know" that some stimulus needs the highest level of neocortical cognition (accessible only through the gateway of consciousness) because an affect has told us so. (Nathanson, 2008)
Thus, my once taken for granted adult cognition, my “cognitive constructs” (Williams, 2012) of a “subject-object orientation,” (Brennan, 2004) in my instinctive identification of words as symbolic “re-presentations” (McGilchrist, 2010) of my lived-experience, and my mainstream image of reason, is now understood on a visceral level of experiencing “affect” driven imagery. With the subject-object orientation of my experience created by my hearts "orienting and defensive responses," (Bernston et al, 1991) produced by my hearts: intrinsic nervous system, (McCarty et al, 2009) and its role in creating my “primary-process affective consciousness.” (Panksepp, 2004) With the “primary process emotional/affective states,” (Panksepp, 2004) of my spontaneous psychoses, now understood as behavioural expressions of positive and negative affect, in a bioenergetic explanation of my medical diagnoses of schizophrenia and bipolar affective disorder. My disorder or dyregulation of affect/emotion becoming more realistically understood through my seven year process of experientially integrating relevant developmental science knowledge and other observations on human motivation. Knowledge that enabled a deeper appreciation for the metabolic energy processes involved in maintaining organism homeostasis, while experiencing internal/external environmental challenges. My differentiation of self assignment, involving a determined search for knowledge of the complex issues involved in differentiating homeostasis, emotion and cognition:
Once deemed not respectable as a scientific domain, when behaviourist doctrine held sway, emotion is now an exploding subject of compelling attraction to a wide range of disciplines in psychology and neuroscience. Recent work suggests that the concept of ‘affective regulation’ has become a buzzword in these areas. Disciplines involved include not only affective neuroscience, but also cognitive neuroscience, developmental psychology, clinical psychiatric studies into syndromes of emotion dys-regulation (such as borderline personality, PTSD, mood disorders, and many other syndromes), various psychotherapy approaches, and several others, e.g. the increasingly popular fields of meditation and relaxation training. However, the overall conceptualization of emotion and its close ties to cognitive processes continues to befuddle many theorists and researchers, for various reasons. I would suggest that these complex issues around emotion and cognition can be understood heuristically with a simple graphic:
HOMEOSTASIS <-> EMOTION <-> COGNITION
In essence, this framework emphasizes a basic propensity of evolution — keep what works and then tinker with it to make it work even better, under the pressure of adaptive selection. This argues that emotion is an evolutionary extension of homeostasis, and likewise that cognition is an extension of emotion, not something that sits fundamentally counterposed to it, in contrast to the simplistic ‘emotion vs. cognition’ debates that dominated psychology for decades. One could argue that the brain’s entire complex connectivity and functional operation is organized to achieve just such an adaptive and seamless integration of homeostasis, emotion, and cognition, through a vertical integration of systems from top to bottom of the neuroaxis. This is biologically instantiated in rich neural connectivities between thalamocortical brain systems and many subcortical (basal forebrain, diencephalic, and midbrain-reticular) systems (see Watt and Pincus, 2004 for details).
From this perspective, emotion is an ‘evolved supervisor’ sitting over homeostatic routines, just as cognition performs a similar function for emotion, while still being fundamentally at the service of homeostatic and affective mandates. Emotion provides basic behavioural and body tuning paradigms to help maintain homeostasis in the context of adaptive challenges, such as dealing with predators, securing food/ territory, structuring fundamental relationships with conspecifics, including the nurturing and protecting of young, selection of mates, and maintenance of intimate social connections and dominance hierarchies. Cognition can be understood as an evolutionary refinement of our ability to deal with prototypic adaptive challenges that are fundamentally affective.
These cognitive tool-kits potentially allow increasingly subtle and adaptive fine-tuning of behaviour and subjective state consonant with basic emotional pushes and pulls. Much of the content of human consciousness once past early infancy consists of complex and highly variable even idiosyncratic emotion-and-cognition amalgams in which almost any version of a primary emotion (at almost any level of intensity) can be linked with almost any version of a perceptual or cognitive/conceptual attractor. (Watt, 2004)
Hence, while it may contravene normal practice in essay writing to include such extensive excerpts from my self-education process, I feel a strong need to show readers the kind of knowledge which raises reasonable questions of the public rhetoric, of our treatment oriented approach to a continuum of human experience. Particularly, given the “autonomic” nature of affect regulation, and the growing taken for grantedness of our increasingly self-objectifying, analogous self-interpretations. With my journey to understand my own affect driven images of consciousness, with my attachment driven acceptance of an “objective” consensus normality, more eloquently described by McGilchrist:
The nature of the attention one brings to bear on anything alters what one finds; what we aim to understand changes its nature with the context in which it lies; and we can only ever understand anything as a something. There is no way round these problems – if they are problems. To attempt to detach oneself entirely is just to bring a special kind of attention to bear which will have important consequences for what we find. Similarly we cannot see something without there being a context, even if the context appears to be that of ‘no context’, a thing ripped free of its moorings in the lived world. That is just a special, highly value-laden kind of context in itself, and it certainly alters what we find, too. Nor can we say that we do not see things as anything at all – that we just see them, full stop. There is always a model by which we are understanding, an exemplar with which we are comparing, what we see, and where it is not identified it usually means that we have tacitly adopted the model of the machine. (McGilchrist, 2010)
An excerpt included to draw the readers attention towards this “paradoxical” notion that we see with an expectation created by the millisecond, subconscious activity of the autonomic nervous system. The constant dilemma of maintaining an experience established homeostasis in face of existential challenge. The dilemma of learned behaviours and cognitively constructed, autonomic expectations of reality, lacking awareness of the stimulus processes within. While my journey of self-revelation and transformation from chronic mental health patient, to this experiential articulation of psychotic experience, is witnessed by a trail of documented episodes, between October 2010 and June 2012. Online documentation made with a genuine desire to honestly and authentically describe my experience of psychosis as it happened, with a trust in my human nature, by which a heart-felt intuition, along with patience and perseverance would lead to a coherent resolution. Thus, in June 2012 I wrote, in part two of an analysis of my psychotic experiences:
Just as my public "coming out" was a series of posts on TheIcarusProject.net in October 2010 and again on facebook.com in 2011. My fourth full term psychosis included a series of posts made on MadinAmerica.com, about alternative views of psychosis suggesting a natural metamorphosis which requires safety, time, patience, support and understanding guidance. My own guidance came from finding my way to the right books and articles to read, and a faith in something deeper within me than can be consciously recognized. These online posts are an attempt to document my own process and show that psychosis is not a brain disease, but a natural healing process, much misunderstood. With the rise into another manic euphoria beginning to escalate in late May, although with a noticeable difference in impulse control and clarity of thought, as my fourth full term manic psychosis in five years begins to bare the fruits of a personal metamorphosis. From all my online posts readers can judge the content and gauge the benefits of a five year self education drive.
While a few days later, some five weeks into an uninterrupted episode of euphoric mania, I wrote this post on MadinAmerica.com:
Madness: An attachment awareness of the divine, a sense of eternity in a single moment. Mania: I fall out of my braced muscular defence which habitually miss-regulated and thwarted my need of human attachment, and in the spontaneous shift in physiological state, sensory freedom reigns. I’m suddenly born again to an awareness of so much, as if all five senses have come back online, after being stuck in the freeze mode of the post trauma trap. In my body, I’m suddenly so alive.
The positive states of interest, excitement & joy resume their biological process and begin to reorganize my brain stem neural networks to mediate a free and full engagement with the experience of life. So enraptured by this spontaneous shift towards positive affect/emotion experience, I subjectively feed this new physiological state of being with emotive scenarios of passion, glory and wonder. I’m so overjoyed I can’t still my mind, and its role in my self-nurture during long periods of isolation, automatically continues and I overshoot the runway of my new physiological approach to the experience of life. Its natural intent, as the non-linear biological system, which is the organism known as David Bates, is miss-perceived by subjectivity, and the physiological need to BE in the here and now moment, is thwarted. Thwarted because I confuse my minds sense of “I” with the deeper consciousness of the sensate experience of the body. The subtle sensations, sensory vibrations and arising images that resonate in an attunement/attachment connection, as that oceanic feeling of oneness, so common to the manic/mystic experience. Attachment, Separation & Loss, is perhaps the ultimate challenge to deepening awareness, for a sentient species.
If I’d known what I’ve learned in the past five years, back in 1980 when I had my first experience of mania, I would have understood that the shift in state had gifted me the powers of “approach” and resolved the fearful “tonic immobility” which had haunted my life from birth and kept me in habitual avoidance patterns, no matter how much I learned to simulate the behaviours of approach. Inside, unconsciously my nervous system was always screaming “get me out of here," to the safety of isolation. Understanding that physiological state and the motor act is the pre-conscious awareness of being, I would not have poured my “subjective” sensations of mind, into the pure reality of being in the lived moment. These days, when I still the mind and feel for those subtle sensations of being, I suddenly realize I’m in heaven.
I understand my sense of “I” as a survival mode of being, while my sense of self, my soul, is a manifestation of the eternal now. How else would the Universe become eternal, if not by evolving into a form which can act upon itself? When we fall for this obvious perception of “us vs them” survival, are we really sure we understand the difference between “I” & Self? (Bates, 2012)
A post which speaks to the debate about whether mania or affective psychosis can be understood as an existential crisis with a well documented spiritual history in both Western and Eastern literature. While my self-education and self-exploration process enabled an understanding of the foundations of my subjective experience, while also bringing a thermodynamic resonance context to my experience of mania in 2007. A lived-experience which involved episodes of synchronicity, suggesting a resonance between the bio-energetic self-organizing system of the human organism and the background nature from which we emerged. Which may be less defensively approached by developing an embodied sense of systems theory, and how: a property of resonance is sympathetic vibration, which is the tendency of one resonance system to enlarge and augment through matching the resonance frequency pattern of another resonance system. (Schore, 2003) While an excerpt from my own self-analysis illustrates how I found alternative explanations to a limited biomedical model of my spontaneous episodes of affective psychosis, and lends more existential context to my “sentient species explanation of attachment, separation and loss,” comment above:
What Are Hallucinations and How Can They Be Measured:
The hallucinatory or waking-dream states along the perception-hallucination continuum can best be described as experiences of intense sensations that cannot be verified through voluntary motor activity. Along the perception-hallucination continuum of increasing arousal of the sympathetic nervous system (ergotropic arousal), man–the self-referential system–perceptually-behaviorally (cortically) interprets the change (drug-induced or “natural”) in his subcortical activity as creative, psychotic, and ecstatic experiences. These states are marked by a gradual turning inward toward a mental dimension at the expense of the physical. We can describe verifiable perceptions, therefore, by assigning to them low sensory-to-motor (S/M) ratios, while non-verifiable hallucinations and dreams can be characterized by increasing S/M ratios as one moves along the perception-hallucination continuum toward ecstasy or samadhi, the two most hallucinatory states. Moderate doses of the hallucinogenic drugs LSD, psilocybin, and mescaline can get one "moving" along the perception-hallucination continuum, whereas minor tranquilizers and some muscle relaxants may initiate travel along the perception-meditation continuum. The components of a psychomotor performance, specifically, handwriting area and handwriting pressure (20), in volunteers during a psilocybin induced wakingdream state. The techniques for measuring handwriting area (S) (in square centimeters), as well as for obtaining handwriting pressure (M) (in 104dynes averaged over time), with an indicator that operates on a pressure-voltage- to frequency basis. Using these two parameters prior to (T1) and at the peak,(T2) of a psilocybin-induced experience [160 to 250 micrograms of psilocybin per kilogram of body weight], we found in a sample of 47 college-age volunteers a 31 percent (T1 -T2) increase in mean S/M ratio. Moreover, subjects with a large standard deviation on handwriting area at T1 (that is, "variable" subjects), tend to be "perceivers," whereas volunteers with a small standard deviation at T1 ("stable" subjects) tend to be "judgers," in terms of the Myers-Briggs Type Indicator. This self-reporting, Jungian-type personality indicator yields simple, continuous scores on four dichotomous scales: extroversion-introversion, sensation-intuition, thinking-feeling, and judging-perceiving. The perceivers also overestimate or contract time more than judgers do at the peak of a psilocybin-induced experience: this implies that perceivers move faster and farther along the perception-hallucination continuum than do judgers, who apparently require a larger dose for a comparable experience.
“Self”: The Knower and Image-Maker; and “I”: The Known and Imagined:
We have seen that the departure from the physical dimension during a voyage on the perception-meditation continuum is accompanied by a gradual loss of freedom, which is manifested in the increasing inability to verify the experience through voluntary motor activity. At the peak of trophotropic arousal, in samadhi, the meditating subject experiences nothing but his own self-referential nature, void of compelling contents. It is not difficult to see a similarity between the meditative experience of pure self-reference and St. Teresa’s description of her ecstasy: in both timeless and spaceless experiences the mundane world is virtually excluded. Of course, the converge is true of the mundane state of daily routine, in which the oceanic unity with the universe, in ecstasy and samadhi, is virtually absent. Thus, the mutual exclusiveness of the “normal” and the exalted states, both ecstasy and samadhi, allows us to postulate that man, the self-referential system, exists on two levels: as “Self” in the mental dimension of exalted states; and as “I” in the objective world, where he is able and willing to change the physical dimension “out there.”
In fact, the “I” and the “Self” can be postulated on purely logical grounds. See, for instance, Brown’s reasoning that the universe is apparently … “constructed in order (and thus in such a way as to be able) to see itself. But in order to do so, evidently it must first cut itself up into at least one state which sees, and at least one other state which is seen. In this severed and mutilated condition, whatever it sees is only partially itself… but, in any attempt to see itself as an object, it must, equally undoubtedly, act so as to make itself distinct from, and therefore, false to, itself. In this condition it will always partially elude itself.”
In our terminology, the “Self” of exalted states is that which sees and, knows, while the “I” is the interpretation, that which is seen and known in the physical space-time of the world “out there.” The mutually exclusive relation between the “seer” and the “seen,” or the elusiveness of the “Self” and the “I” may have its physiological basis in the mutual exclusiveness of the ergotropic and trophotropic systems. A discernible communication between the “Self” and the “I” is only possible during the dreaming and hallucinatory states, whether drug-induced or “natural.” During the ”I”-state of daily routine, the outside world is experienced as separate from oneself, and this may be a reflection of the greater freedom (that is, separateness or independence) of cortical interpretation from subcortical activity.
With increasing ergo tropic [sympathetic nervous system] and trophotropic [parasympathetic nervous system] arousal, however, this separateness gradually disappears, apparently because in the “Self”-state of ecstasy and samadhi, cortical and subcortical activity are indistinguishably integrated. This unity is reflected in the experience of Oneness with everything, a Oneness with the universe that is oneself. (Fischer, 1971) [in brackets mine]
Roland Fischer’s paper on a continuum of perceptual experience helped explain my own exalted states of mania, in a more perceptive rather than fearfully judgemental way. With so many spontaneous episodes occurring over a three decade long experience, raising a mounting challenge to explore my human nature within, rather than dismiss my lived-experience for the sake of appeasing consensus normality, and satisfying my attachment drive. While for the past seven years I have been driven to understand Allan N Schore’s salient comment on human motivation, as a constant need to regulate affect, from an inside-out perspective, which integrates a phylogenetic perspective with the innate affect system described by Silvan Tomkins. Hence thirty four years on from my first episode of affective psychosis, my attempt here to articulate its adaptive need from a non-conscious, millisecond nervous system activity perspective, on how:
All life is “affective life,” all behavior, thought, planning, wishing, doing . . .
There is no moment when we are free from affect,
no situation in which affect is unimportant. -Silvan Tomkins
My First Episode Psychosis & Nervous System Dysregulation
The long journey towards this articulation of my lived-experience, has culminated in a hierarchical, thermodynamic, dysregulation model of psychosis. A model which brings a phylogenetic context to a “Traumagenic Neurodevelopmental Model,” (Read et al, 2001) of psychosis, and the widely held view of underlying neural mechanisms involved in psychotic experience. A phylogenetic perspective which also brings a sense of how “everyone is right in some way," it is merely a matter of knowing "how," (Reich, 1973) in my opinion. While the sudden shift in physiological state which precipitated my first episode psychosis, involved the three neural circuits that regulate reactivity “consistent with the Jacksonian principle of dissolution.” (Porges, 1995) A dissolution/dysregulation perspective of how, in February 1980 a sudden attachment loss triggered my first episode of mania and set me off on a three decade long struggle to understand the hidden nature of my abnormal experiences. I still remember those very first moments that led me into mania, the unusual body sensations and the shift in perceptive awareness that overcame me. I was in the bedroom of our first home in the Sydney suburb of West Ryde, sitting on the end of our double bed on the morning after my wife had left me. Although at that time, like normal people everywhere, I had no knowledge or awareness of my internal structure and function to understand and accept immediate experience. No knowledge of nervous system function to understand how that spontaneous shift in physiological state, was a spontaneous resolution of my trauma entrained, avoidance orientation to environmental challenge. The sudden dissolution of "three principal defense strategies—fight, flight, and freeze," (Porges, 2004) and the muscular, vascular constriction of an internalized life threat, precipitated by attachment loss and the need to face the challenge of existential isolation. A nervous system reaction to an existential crisis, that may be considered “natures way of setting things right.” (Perry, 1998) Although it would be decades before a determined self-education drive, would bring me knowledge of the phylogenetic nature of my nervous system, and the Jacksonian principle of dissolution:
Jackson proposed that in the brain, higher (ie, phylogenetically newer) neural circuits inhibit lower (ie, phylogenetically older) neural circuits and ‘‘when the higher are suddenly rendered functionless, the lower rise in activity.’’ Although Jackson proposed dissolution to explain changes in brain function due to damage and illness, the polyvagal theory proposes a similar phylogenetically ordered hierarchical model to describe the sequence of autonomic response strategies to challenges. (Porges, 1995)
Knowledge which allowed me to understand my inherent susceptibility to nervous system dysregulation, or dissolution, during life challenges, and the paradox of cognitive processes which can actively thwart autonomic nervous system activity, and an innate healing response to traumatic experience. While an experiential integration of the polyvagal theory, enabled by using Peter Levine’s methods of developing sensate awareness, allowed an experience dependant healing response to unfold, despite decades of treatment resistance and chronic mental illness experience. Thus by embracing the reality of my evolved nature, by surrendering to non-conscious and socially denied autonomic processes, my lived-experience resonates with an eloquent articulation of how “the human animal is a unique being … endowed with an instinctual capacity to heal, as well as an intellectual spirit to harness this innate capacity.” (Levine, 1997) While the underlying mechanism of the vagal system, at the heart of my innate negative/positive reactivity, is perhaps best evidenced with an excerpt from the transcript of a conversation entitled: Beyond the Brain: How the Vagal System Holds the Secret to Treating Trauma:
Dr. Buczynski : Why is your theory called polyvagal theory?
Dr. Porges: It is called polyvagal theory because there is an underlying principle here, and that is the principle of evolution in our phylogenetic history – where mammals come from. Mammals came from reptiles and we have literally a family heritage of neural circuits, and those neural circuits, as they evolve, change and start doing different things. With the mammal – and we are mammals – the polyvagal theory identifies a uniquely mammalian vagal pathway, and that vagal pathway is myelinated and goes to the heart and bronchi – the organs above the diaphragm.
But that is not the interesting part or the critical part of the theory; the critical part of the theory is that it is linked to the nerves that regulate the striated muscles of the face and head. Facial expressions literally become a portal that tells you exactly how the vagus is influencing your heart and bronchi. When people are stressed out, how do their faces look? The muscle tone gets flat, especially the neural tone to the orbital muscle called the orbicularis oculi, which gets flat. All clinicians know that when people have flat affect, there is something to be concerned about. The window to our autonomic state becomes our face. That is one of the primary principles of the polyvagal theory.
The other primary principle is that we functionally have three autonomic nervous systems or circuits that follow a phylogenetic or evolutionary history, and these circuits provide a response hierarchy. When we’re challenged, we use new circuits, and when they don’t help us get into safe and appropriate situations, we regress – we use older and older circuits. Our newest uniquely mammalian circuit is that face-heart connection, and we use this to literally convey to others that we’re safe to come close to. When people convey to us that they are safe, we feel comfortable – social support has literally a polyvagal correlate.
However, when we’re challenged, which can be due to normal life demands or threat, we can mobilize. To mobilize we need our parasympathetic nervous system and we have to turn off the vagus because the vagus is a calming circuit. But fight/flight doesn’t always work for us – and this is the whole story underlying trauma. Trauma is normally associated with unsuccessful attempts to get away. When we can’t get away, we can’t use fight/flight; we resort to our most primitive neural circuit, and that, functionally, is a shutdown circuit.
That shutdown circuit is also vagal, but it’s the old vagus; it’s the vagus that we share with reptiles, like turtles. When this circuit goes, we just reduce our cardiac output and we reduce our mobilization. Again, one of the critical things that we find when we talk to clients who have experienced trauma is this immobilization feature. (Buczynski, Porges, 2013)
Hence, understanding, on a visceral level, the orienting activity of my vagal system was crucial to my transformative psychoses and a psycho-physiological understanding of “what happened” (Dillon, 2013) to me in 1980. Understanding how it was a spontaneous resolution to early life traumatic experience, subsequently self-stimulated into delusional mania, through a lack of embodied awareness. With my recent awareness of “this immobilization feature” of my autonomic nervous system, explaining the existential paradox of my life-long quest to feel secure, and the relative “isolation” need that followed a negative experience of attachment, early in my life. The birth trauma of a protracted and brutal delivery, plus the subsequent life experience of being a unwanted child. Meant that life was dominated by relative existential isolation, resulting in a self-protective “cardiac orienting response” (Porges, 1995) to experiential challenge. An experience dependant habituation of heart-brain communication, mediated by three neural circuits that regulate reactivity, in response to a neuroception of "whether situations or people are safe, dangerous, or life threatening. Because of our heritage as a species, neuroception takes place in primitive parts of the brain, without our conscious awareness." (Porges, 2004) The too defensive orientation to life, which was my premorbid, (McGorry et al, 2012) prepsychotic personality (Perry, 1998) prior to that spontaneous switch in the: Three Neural Circuits That Regulate Reactivity. (Porges, 2004) A sudden switch which entrained a sustained experience of positive affect with a “simultaneous blending of different affects, an expansion of the “affect array,” (Schore, 2003) and my subsequent self-nurturing, “self-stimulation” (Panksepp, 1998) into euphoric mania:
I sat looking into the mirror, yearning for a new direction, something I could feed with a sense of dedication. I prayed sincerely, promising I'd do whatever was required if he’d just show me the way, give me a sign, help me please! Nothing happened for what felt like minutes as I sat there in hopeful expectation while looking at my own reflection, looking into my face. Then it began, a new sensation, a feeling at the top of my head which flowed down slowly, down through my face, into my shoulders and down through my chest, down into my pelvic area. I sat with a sense of "what is it” wonder, although more felt than in any thinking sense. A sense of wonder that was similar to the out of body experience when I was fourteen, except this slowly descending calm was the polar opposite of the sudden sharp elevation, when I'd seemly left my body. It felt like I'd been sitting in a bath of water that was over my head and someone had pulled the plug. I sat there as calm descended slowly from head to toe, as if a mind numbing tension were being drained out of me, like waste water flowing down and out through my toes. Next came a mindful realization of the experience in a pleasant and very welcomed surprise. I felt unburdened somehow, refreshed and excited, happy and new. "Wow! Wow! Wow! Has God just touched me on the shoulder? Is this a religious experience? Or am I just relieved by a sense of being free, free from demanding attachment, not needing anyone but myself?" (Bates, 2012)
Hence, the hierarchical switch in neural circuits that regulate the autonomic reactivity of my internal environment, was mediated by a non-conscious “neurorception” of safety, as I sat looking into a mirror at my own face, while simultaneously aware of a more complete “image” of the external environment. With the spontaneous dissolution/dysregulation action of the "three principal defense strategies—fight, flight, and freeze," (Porges, 2004) suddenly dissolving the muscular/vascular constriction of an internalized life threat, through a spontaneous rise in the activity of my “integrated social engagement system.” (Porges 2001) Bringing a middle path psychophysiological perspective to how: “heightened vulnerability to stress is not, as often wrongly assumed, necessarily genetically inherited, but can be acquired via adverse life events,” (Read et al, 2008) Which in my case was early life experience, whereby my pre-wired “social engagement system” was never activated by the vital “proximity” (Porges, 2011) of a:
Mother’s right cortex as a template for the imprinting, the hard wiring of circuits in his own right cortex that will come to mediate his expanding cognitive-affective capacities to adaptively attend to, appraise, and regulate variations in both external and internal information. It is important to note that these dyadically synchronized affectively charged transactions elicit high levels of metabolic energy for the tuning of developing right-brain circuits involved in processing socioemotional information. Psychobiologists emphasize the importance of “hidden” regulatory processes by which the caregiver’s more mature and differentiated nervous system regulates the infant’s “open” immature, internal homeostatic systems. These body-to-body communications also involve right-brain-to-right-brain interactions. (Schore, 2003)
Hence my life-long dichotomy of fear and avoidance stemmed from an habituated internal constriction, which actively depressed my evolved social engagement system. With my spontaneous episodes of manic euphoria understandable in a neural mechanism context of how: the system is capable of dampening activation of the sympathetic nervous system and HPA-axis activity. By calming the viscera and regulating facial muscles, this system enables and promotes positive social interactions in safe contexts. (Porges, 2011) While my argument here seeks to contribute to a widely held view that: Any meaningful theory about how early abuse or trauma leads, years later, to psychotic symptoms must integrate biological and psychological paradigms. A number of theories have been developed. At the psychological level of analysis the focus has been on cognitive and attributional processes, dissociation and, to lesser extent, attachment theory. At the biological level the focus has been the recently discovered neurodevelopmental effects of trauma on children’s brains, particularly damage to the stress regulation mechanisms in the hypothalamic–pituitary–adrenal (HPA) axis. (Read et al, 2005) With my experiential understanding of “hidden” regulatory processes, questioning psychological formulations about dissociation and the power of our non-conscious attachment drive, which is generally denied in our Western world’s defence of an egoic sense of “I.” With this primary process view of motivation suggesting that basic assumptions of “damage to stress regulation mechanisms” in our “treatment oriented” (McGorry, et al, 2012) perception of psychotic experience, may be better understood in the context of an internal “environment of adaptedness” (Schore, 2012) and a phylogenetic perspective on nervous system function. With my own life experience becoming better understood from neuroscience perspectives on John Bowlby’s earlier formulations of attachment theory. Hence my ability to sense an internal nervous system environment with “three neural circuits that regulate reactivity,” (Porges, 2011) comes from an experiential integration of the neurobiology of attachment processes:
At 2 months of age, “Typically developing children can rely upon a right hemisphere– mirroring neural mechanism— interfacing with the limbic system via the insula— whereby the meaning of imitated (or observed) emotion is directly felt and hence understood” (p. 30). Attachment studies thus strongly support Panksepp’s (2008) bold assertion of the primacy of affective neuroscience: “Now cognitive science must re-learn that ancient emotional systems have a power that is quite independent of neocortical cognitive processes” (p. 51). In addition, prenatal and postnatal interpersonal events also wire the connectivity of structures in the developing central nervous system (CNS) with energy-expending sympathetic and energy-conserving parasympathetic branches of the evolving autonomic nervous system (ANS). (Schore, 2012)
While the mind-less, felt-sense of muscular-vascular tensions and pressures which enabled my experience dependant transformative psychoses, was based on knowledge of my “face-heart connection” (Porges, 1995) and an embodied acceptance that “the motor act is the cradle of the mind.” (Sherington, 1951) Resolving a “traumagenic” (Read et al, 2001) genesis to my spontaneous psychoses. A birth trauma event affecting sub-cortical neural processes, which occurred long before the development of my higher cognitive processes. Thus, my experience dependant metamorphosis from chronic mental illness victim, to this articulation of adaptive nervous system function, may be read in the context of Bowlby’s immense contribution to attachment theory, in which he states: Not a single feature of a species morphology, physiology, and behaviour can be understood or even discussed intelligently except in relation to that species environment of evolutionary adaptedness. (Bowlby, 1969) With this phylogenetic perspective on the structure and function of our evolved nature, infusing my online documented comment above. “The subtle sensations, sensory vibrations and arising images that resonate in an attunement/attachment connection, as that oceanic feeling of oneness, so common to the manic/mystic experience. Attachment, Separation & Loss, is perhaps the ultimate challenge to deepening awareness, for a sentient species.” While it was the experiential integration of relevant knowledge that allowed me to self-regulate episodes of mania with a steady increase in conscious control, thereby gaining a depth of understanding and ability to articulate my experience from the inside-out. Articulated within the existential context of psychotic experience as a challenge to develop a deeper understanding of a continuum of human experience. A challenge to go beyond a treatment oriented reaction to abnormal “physiological states,” so routinely misunderstood by the subjective interpretation, of our “affect” driven images of consciousness. While only a felt-sense and acceptance of how: All life is “affective life,” all behavior, thought, planning, wishing, doing . . . There is no moment when we are free from affect, no situation in which affect is unimportant. (Nathanson, 2008) Brings an embodied awareness of the limits of our thus far evolved, descriptive languages and a need to develop a sensate awareness of how: The attempt to regulate affect - to minimize unpleasant feelings and to maximize pleasant ones - is the driving force in human motivation. (Schore, 2003) While a wide ranging interdisciplinary search for relative information, can orient attention to other formulations on the nature of our innate affect, motivation:
Cognitive theorists have also studied the role of affect. The amount of distress when first having a psychotic experience is determined by one’s attributions about the experience, and these attributions are predicted by the presence of earlier trauma. There is good evidence to support a “catastrophic interaction hypothesis” whereby the cognitive dificulties of traumatized people exacerbate their distress when they later encounter normal stressful events, and that this exaggerated distress reciprocally exacerbates the cognitive problems. (Read et al, 2008)
An excerpt from my reading education, which I include to raise a question about our understanding of stress reactivity, when “exaggerated distress” is viewed from the perspective of an innate “distress - anguish” (Tomkins, 1995) mechanism. While knowledge of an innate affect-system, combined with knowledge of how: Feedback processes in “affective cognitive systems” are capable of “provoking sudden nonlinear jumps, far away from equilibrium, leading to chaotic conditions or to the formation of new “dissipative structures.” (Schore, 2003) May suggest that: The accumulation of stress, defined in terms of the autonomic nervous system, influences many, if not all, other systems. (Levine, 1976) Thereby directing attention towards: common cores that seem to transcend diagnostic categories, (Porges, 2013) with an “introception” (Schore, 2003) of “innate-affects” as “analogical-amplifiers” of stimulus response systems. Knowledge of which allowed me to experience successive psychoses, in order to understand, from the “inside-out,” the nature of my affect driven images of consciousness. Thus developing an experiential understanding of how denied “innate-affect” is involved in my affective states of consciousness:
"Consciousness is a report about affect-driven imagery. Since affect in our view amplifies varying rates of change (its innate activities), the images within the control assembly represent only such information as is urgent that reports significant, vital, new changing information" (p. 353). The six basic innate affects (interest-excitement, enjoyment-joy, surprise-startle, fear-terror, distress-anguish, anger-rage) are evolved, programed responses to stimuli with highly specific qualities. They are triggered when the flow of data rises or falls over one or another gradient, or remains steady at one or another non-optimal level. The contour in time of each type of stimulus is mimicked by the contour in time of the affect it triggers, thus drawing our attention to the specific kind of importance associated with that stimulus. Affect is vitality; affect occurs only when something is significant; affect is about changing information. "Stability is that very rare special case of a rate of change which is extremely slow compared with the totality of the environment" (p. 354). Boredom is not triggered by lack of change, but by a steady-state non-optimal stimulus; boredom is an adult form of distress rather than an innate response to understimulation (which can only exist in death.) We have evolved to "know" that some stimulus needs the highest level of neocortical cognition (accessible only through the gateway of consciousness) because an affect has told us so. (Nathanson, 2008)
While reading the above excerpt from the prologue to: Affect Imagery and Consciousness, written in a period when the rising tide of technology was in its infancy. The taken for granted spectre of self-definition by way of analogy may be borne in mind when reading an excerpt from: The Coherent Heart Heart–Brain Interactions, Psychophysiological Coherence, and the Emergence of System-Wide Order:
Research at the Institute of HeartMath has identified six distinct patterns of physiological activity generated during different emotional states. We call these psychophysiological modes. Each of these is described in detail in Appendix A. Of particular significance is the psychophysiological coherence mode, which is characterized by ordered, harmonious patterns of physiological activity. This mode has been found to be generated during the experience of sustained positive emotions. The psychophysiological coherence mode has numerous physiological and psychological benefits, which can profoundly impact health, performance, and quality of life.
A second proposition is that the heart plays a central role in the generation and transmission of system-wide information essential to the body’s function as a coherent whole. There are multiple lines of evidence to support this proposition: The heart is the most consistent and dynamic generator of rhythmic information patterns in the body; its intrinsic nervous system is a sophisticated information encoding and processing center that operates independently of the brain; the heart functions in multiple body systems and is thus uniquely positioned to integrate and communicate information across systems and throughout the body; and, of all the bodily organs, the heart possesses by far the most extensive communication network with the brain. As described subsequently, afferent input from the heart not only affects the homeostatic regulatory centers in the brain, but also influences the activity of higher brain centers involved in perceptual, cognitive, and emotional processing, thus in turn affecting many and diverse aspects of our experience and behavior. (McCarty et al, 2009)
With this “systems” approach to the human organism, bringing a thermodynamic perspective to non-conscious motivation and a nervous system dissolution model of psychotic experience. While our conception of “a diathesis-stress paradigm,” (Read et al, 2001) and historical descriptions of manic-depression, may be reframed with sensate awareness of how “six innate affects (interest-excitement, enjoyment-joy, surprise-startle, fear-terror, distress-anguish, anger-rage) are evolved, programed responses to stimuli with highly specific qualities.” (Nathanson, 2008) Particularly when compared with, “research at the Institute of HeartMath has identified six distinct patterns of physiological activity generated during different emotional states. We call these psychophysiological modes.” (McCarty et al, 2009) While my own experience of manic-depression as a disorder of affect, was resolved with an integration of psychological observations and formulations on:
Affect, Feeling, Emotion, Mood, Disorders of Mood
The affects are physiological mechanisms easily visible on the face of the newborn and although muted through the process of maturation, can be easily identified throughout life into senescence. The reader may find helpful the following terminology of affect-related experiences, all of which will be explained in greater detail below:
1) By the terms “affect” or “innate affect,” we reference a group of nine highly specific unmodulated physiological reactions present from birth.
2) We use the term “feeling” to describe our awareness that an affect has been triggered.
3) The formal term “emotion” describes the combination of whatever affect has just been triggered as it is coassembled with our memory of previous experiences of that affect. Tomkins eventually dropped the term “emotion” in favor of the much larger category of these coassemblies that he called “scripts.”
4) In general, the term “mood” or “normal mood” refers to a state in which some immediate experience has triggered an affect in such a way that the combination reminds us of an analogous historical experience, the memory of which re-triggers that affect. Such sequences may go on in the form of reminiscences that maintain the more-or-less steady experience of any affect. This kind of normal mood will vanish the moment some new stimulus triggers another affect and terminates the loop.
5) By “disorders of mood” we refer to biological glitches that produce the relatively steady experience of any positive or negative affect, affects that share neither the triggers nor the time constants typical of normal affective experience.
A good way to conceptualize this system of nine quite different alerting mechanisms is to view them as a bank of spotlights, each of a different color, each flicked on by its own quite individual switch, each illuminating whatever triggered it in a way highly specific to that light. We don’t “see” any stimulus unless and until it is brought into our field of awareness as colored by affect.(Nathanson, 2008)
With my three year sojourn in a Buddhist culture, which promotes embodied awareness as a way of life, vital in helping me develop a sensate awareness of my wired from birth, innate affect-system. My daily mind-less meditation routine exploring “how” muscle tone creates cerebral tone, in affective states of motion, emotion and mood. With the above affect theory description of how "we don’t “see” any stimulus unless and until it is brought into our field of awareness as colored by affect." Finding a relevant correlation in Allan Frances book "Saving Normal: An Insider's Revolt against Out-of-Control Psychiatric Diagnosis, DSM-5, Big Pharma, and the Medicalization of Ordinary Life." In his salient comment that: Psychiatric diagnosis is seeing something that exists, but with a pattern shaped by what we expect to see. While in my self-exploration of the primary processes of my states of mind, a “pattern of what we expect to see,” found an embodied sense of being shaped by an innate "affect-system." (Nathanson, 2008) Hence this presentation calls for a willingness to be flexible about our current beliefs in the primacy of cognitive function, in order to accept this articulation of first episode psychosis, as a hierarchical process of “disorganization, and reorganization,” (Schore, 2003) or phylogenetic “dysregulation-dissolution.” (Porges, 2011) For as Dr Vernon Kelly points out in A PRIMER OF AFFECT PSYCHOLOGY: It is important to keep in mind that affect psychology contains very different ideas about the origins of emotion and how you usually think of them. What you were taught either formally or informally by word-of-mouth are the current culturally determined beliefs about human emotion and motivation. The current set of beliefs is missing some vital components and wrong about some others. (Kelly, 2009) Hence I include an excerpt from: The polyvagal theory: New insights into adaptive reactions of the autonomic nervous system:
Emotion, defined by shifts in the regulation of facial expressions and vocalizations, will produce changes in RSA and bronchomotor tone mediated by NA. As a construct, emotion is heterogeneous. Therefore, correlations between specific emotions and physiological states may be a function of the type of emotion. Even Darwin (1872) distinguished between primary or neurally based emotions and social or culturally based emotions. Darwin (1872) suggested that certain emotions have as their substrate an innate neural basis and, because these emotions are neurally based, they are universally expressed and understood across cultures. These primary emotions include anger, fear, panic, sadness, surprise, interest, happiness (ecstasy), and disgust (Ross, Homan, & Buck, 1994). Since the prevalent hypotheses suggest a strong physiological basis for primary emotions, we will focus here on relating primary emotions to the PolyVagal Theory. (Porges, 1995)
To highlight my synthesis of “the polyvagal theory” (Porges, 2011) with “affect theory,” (Tomkins, 1995) in my physiological awareness and psychological reframe of my treatment oriented diagnoses of schizophrenia and “bipolar affective disorder.” (Smith et al, 2003) An experiential journey exploring the affect driven images of my human consciousness, with a “sensate” (Levine, 2010) awareness of how: To try to understand human beings without knowing about the biologic roots of affect and how affect is triggered is like trying to build a house without knowing the fundamentals of creating a strong foundation. Your house may stand for awhile, but when it is stressed, it will fall apart. (Kelly, 2009) Therefore this thermodynamic, nervous system dissolution, model of my first episode of psychosis, questions current conceptualizations of “a diathesis-stress paradigm,” (Read et al, 2001) and historical definitions of psychotic experience with analogous interpretations. Specifically, the existential context of our personal self-definitions, by way of analogy with what we see in the external environment, while remaining predominately non-conscious of our thermodynamic, internal environment. Hence, my articulation of the lived experience of psychosis, and my synthesis of developmental science and earlier observations about our innate nature, may be read in light of R. D. Laing’s wise injunction: The great danger of thinking about man by means of analogy is that analogy comes to be put forward as a homology. While my own innate healing of an innate response to traumatic experience, required letting go of my analogy of mental illness experience, with the infectious disease process of “a fever-type model,” (Porges, 2013) and developing a “felt-sense” (Gendlin 1982) of organism “common cores that seem to transcend diagnostic categories.” (Porges, 2013)
Hence, in transcending my history of innate pain/fear entrained avoidance motivation and experience dependant subconscious expectation of “distress - anguish,” energized the self-protective bias of my cardiac orienting and defensive responses. I came to a deeper understanding of how a profound shift in physiological state in February 1980, led to a two to three week long progressive experience which induced “distress and disturbance” (Smith et al, 2003) within the “emotional system” (Bowen, 1985) of family and friends, observing my abnormal expression of innate “interest - excitement.” (Tomkins, 1995) An experience of interest-excitement, as an “analogical amplifier,” (Tomkins, 1995) of an innate “seeking system,“ (Panksepp, 1998) defensively diagnosed as a sign of schizophrenia in 1980, and the manic phase of bipolar type 1 disorder several years later. While the challenge of self-regulating innate interest-excitement had been the bane of my life, prior to 1980. Because I’d always found it very difficult and psychically painful, to engage in spontaneous expressions of excitement and joy in the physiological context of group interaction. Far to sensitive to the emotional expressions of others (the transmission of affect) and too painfully, psychologically self-conscious for the free expression of my own innate “affect-system.” (Nathanson, 1995) With my experience-dependant life history creating a confusing, embarrassing, involuntary “freeze” reaction, whenever I approached a social group. Whenever I needed to maintain “affect regulating proximity,” within a group or with non intimate others, because I was unconsciously oriented by an “immobilization with fear,” (Porges, 2004) with every fibre of my being screaming, “get me out of here.” An inner life experience defined by lack, a lack of capacity for the subconscious, thermodynamic regulation of “primary process emotional/affective states.” (Panksepp, 2004) A capacity dependent on early life attachment experience and the crucial role of dyadic “inter-regulation” (Schore, 2003) in the post-natal maturation of my brain and nervous system. A subconscious capacity which is taken for granted in normal behaviour, and in my experience, profoundly misunderstood in abnormal behaviours. Hence, my experience of delusional mania may be understood from the psycho-physiological perspective of thermodynamic processes, wherein “the mind” is trying to “affect” coherent physiological states, in the face of “internal/external” environmental challenges, along an approach/avoidance axis. Whereby, traumatic experience and the induced “fear - terror” (Tomkins, 1995) involved in the existential isolation of being a demonstrably unwanted child, combined to create my involuntary “freeze” reaction, upon approach towards all but one, intimate other. An approach/avoidance axis which applied equally to my internal environment and the “mis-attuning social environment that triggers an intense arousal dysregulation,” (Schore, 2003) created by, “three principle defence strategies—fight, flight, and freeze.” (Porges, 2004) In fact, my relationship with others in the social environment is now understood in the context of: Orienting in a defensive world: Mammalian modifications of our evolutionary heritage, (Porges, 1995) clearly reflecting the psycho-physiological relationship, within myself. While this model of a hierarchical-thermodynamic self-regulation of psychotic experience and a “A Traumagenic Neurodevelopmental Model” (Read et al, 2001) of psychosis, may be understood from the perspective of systems theory and nature’s bioenergetics. With a post made on MadinAmerica.com in the fifth week of an active psychosis, in June 2012, illustrating my growing transformation in self-awareness. While suggesting a need to redefine our increasingly self-objectifying sense-of-self, in the way that we instinctively identify words and objects in the external world, with no existential pause for deeper self-awareness:
SYSTEMS THEORY is now being used to understand the complex non-linear feedback systems which integrate our human experience, particularly the early maturation of brain and nervous systems, via environmental feedback. It is becoming increasingly clear that human inter-subjectivity, is more resonant affect/emotion than left-brained linguistics and dialogue. Consider Allan Schore’s understanding of our non-linear bio-metabolic-energy transformations, which turn matter into “meta” within the human mind; “In physics a property of resonance is sympathetic vibration, the tendency of one resonance system to enlarge & augment through matching the resonance frequency pattern of another resonance system.
“In contemporary bioenergetic theory, information is conceived of as ’a special kind of energy required for the work of establishing biological order’. The processing of all forms of information by the brain, including that embedded in internal representations, occur through transformations of metabolic energy. The extraordinary power of the concept of energy transformations derives from the fact that these fundamental phenomena occur on each and every level of living systems, from the molecular to the societal.
The growing postnatal brain, the physical matrix of the emerging human mind, is supplied with a continuous supply of energy from metabolic processes. A fundamental tenant of this theory states that the assembly of complex systems occurs under conditions of thermodynamic non-equilibrium (a directed flow of energy). This energy is utilized to facilitate the cooperativity of simpler sub-system components into a hierarchically-structured complex system that expresses the emergent functions of organizing and maintaining stability. Bioenergetic conceptualizations thus need to be implanted into the central core of psychoanalytic and psychological theory, a position they now occupy in physics, chemistry, and biology. Thermodynamics are not only the essence of biodynamic, they are also the essence of neurodynamics, and therefore of psychodynamics.” -Allan N Schore. (Bates, 2012)
A post made during self-regulated manic euphoria, as my third uninterrupted experience, in three years, of an affective psychosis, enabled more coherent psycho-physiological states of awareness. With this episode triggered once again by attachment loss, and vital need of the inter-regulating thermodynamic nature of dyadic relationships, for health and wellbeing. While this bioenergetic perspective on organism organization and function may bring a non “fever-type” disease analogy to an earlier experience in 2010:
It was the 8th October 2010, psychosis had peaked the day before, in a delusional state when I associated a passing Buddhist procession with Jesus entering Jerusalem. (There were palm leaves covering the road) As always in my 30 year experience of these altered states of awareness, I was extremely euphoric, spiritually enthused with intense feelings of universal oneness. Heightened senses with feelings of unusual calm, brought sensations of harmonic attunement with nature, the trees, birds, every wisp of wind on my skin and a eerie feeling that I was ‘affecting’ a resonant harmonic balance in the atmosphere surrounding me, or visa versa. It felt like, whenever I stilled my mind, and matched heart and breath with rhythmic nature, I could touch a oneness with all the usual sense of separation dissolved away. (Bates, 2011)
An excerpt I include to ask readers to feel your normal, subconscious “affective judgement,” at the instant you sight these words. While this experience of resonance with all nature may be viewed from the perspective of bioenergetics and our internal metabolic energy organization, mediated by the millisecond activity of the sympathetic and parasympathetic branches of our autonomic nervous system. Particularly within the bioenergetic context of how: a property of resonance is sympathetic vibration, the tendency of one resonance system to enlarge & augment through matching the resonance frequency pattern of another resonance system. (Schore, 1995) Furthermore, the waking dream or nightmare experience of psychosis, may be viewed through Silvan Tomkins observations of our evolved, pre-wired: “affect system,” a specialized neuromuscular system responsible for some of the most important functions in human life. Amplified by affect, anything becomes important. Affect, he said, “makes good things better and bad things worse.” Affect produces attention that brings its trigger into consciousness, and the world we know is a dream, a series of images colored by our life experience of whatever scenes affect brought to our attention and assembled as scripts.” Affect Imagery Consciousness is the label for a supraordinate concept. It fit his personality perfectly, this belief that something so complex as the person could only be encompassed by allusion and imagery no matter how many machines might be needed in order to prove individual ideas. (Nathanson, 2008) While the dream like quality of the subjective experience of psychosis, fit’s the evolution of brain structure and organization, wherein: Perhaps what is now the REM state was the original form of waking consciousness in early brain evolution, when “emotionality” was more important than reason in the competition for resources. (Panksepp, 1998) With my own need to accept the primary process functioning of my body in the psycho-physiological context of, “how” the polyvagal theory emphasizes that physiological states support different classes of behavior.” (Porges, 2007) Exploring Tomkins observations of his new born child’s crying, and an innate affect “distress - anguish” mechanism programmed prior to birth. Which he describes in, Exploring Affect:
I was struck with the massiveness of the crying response. It included not only very loud vocalization and facial muscular responses. But also large changes in blood flow to the face and engagement of all the striate musculature of the body. It was a massive total bodily response which, however seemed to centre on the face. (Tomkins, 1995)
An observation about our non-conscious motivation which speaks to the experience dependant conditioning of my pre-psychotic personality, prior to my early adult onset of psychosis. An important observation which helped me regulate the experience of affective psychosis, with a sensate awareness of the vascular sensations of driving elation, affected a change in blood pressure and temperature. Along with a sensate awareness of a distinct relaxation of the muscular contraction/constriction, that had defined my post trauma stress defence, mediated by “three principle defence strategies—fight, flight, and freeze. (Porges, 2004) While my experience-dependant self-exploration examined, “nine highly specific unmodulated physiological reactions present from birth,” (Nathanson, 2008) which seem highly descriptive of my lived-experience when seeking a synthesis of inter-disciplinary knowledge to understand the experience of first episode psychosis. Particularly, the dream-like quality of early-life experiences of motion-emotion and cognition, long forgotten in our taken for granted, sense of adult normality. Particularly, when focusing attention on the unspoken voice of the body, where the millisecond activity of the nervous system, and nine innate affect mechanisms, can be seen to underpin, an experience-dependant complex of behavioural responses. Enabling a sensory development of how, all behaviour is communication. While my psychosis resolution journey enabled the reframing of a conceptual sense of the “current diathesis-stress model” (Read et al, 2001) into a physiological sense of the primacy of innate affects, as “a predisposing vulnerability in the form of oversensitivity to stress.” (Read et al, 2001) Especially Tomkins very first observation that: It was a massive total bodily response which, however seemed to centre on the face, (Tomkins, 1995) when compared with:
Specifically, an integrated social engagement system emerged in mammals when the neural regulation of visceral states that promote growth and restoration (via the myelinated vagus) was linked neuroanatomically and neurophysiologically with the neural regulation of the muscles controlling eye gaze, facial expression, listening, and prosody. (Porges, 2008) Thus, the evolution of the nervous system determines the range of emotional expression, quality of communication, and the ability to regulate body and behavioral state including the expression and recovery of stress-related responses. Relevant to adaptive social and emotional behaviors, these phylogenetic principles illustrate the emergence of a brain-face-heart circuit and provide a basis for investigating the relation between several features of mental health and autonomic regulation. (Porges, 2009)
Most specifically, it was professor Porges discovery of our evolved “brain-face-heart” reciprocal feedback in generating self-protective orienting responses, that enabled me to trust in a mind-less daily meditation routine, to help dissolve the muscular-vascular constriction of my “traumagenic” (Read et al, 2001) internalized life threat. Maintained by my innate affect system and my nervous systems: three principle defence strategies—fight, flight, and freeze. (Porges, 2004) Hence, through a process of education and the experiential integration of relevant knowledge I came to experience an epiphany moment of visceral impact, in digesting a concise statement about the internal creation of my mind: “the motor act is the cradle of the mind.” (Sherington, 1951) Hence, my decades of trauma entrained internal conflict, as the “double-bind” (Bateson, 1995) of a non-consciously maintained sense of life threat, had begun to find more accurate understanding in comments like, “The bases of conflict are oppositional or incomplete motor patterns. The significance of this for therapy (and life) is monumental.” (Levine, 2010) While my improving “felt-sense” (Gendlin, 1982) of how I maintained the habituated muscular/vascular sense of life threat, as the genesis of my psychoses, found salient correlations in a recent medical publication:
Maintenance processes in delusions, hallucinations and emotion: Studies investigating the role and implications of emotional disorders in psychosis have also provided evidence regarding the impact of emotional processes and mechanisms on the formation and maintenance of delusions and hallucinations. Freeman and his colleagues (2001; Freeman, Garety & Phillips, 2000) have focused particularly on the role of anxiety in persecutory delusions, mainly because of the common themes that underlie the two (e.g. anticipation of danger or threat) and have demonstrated how cognitive distortions evident in individuals with anxiety disorders are also manifested in people with persecutory delusions. (McGorry et al, 2012)
Thus quickening my experiential movement away from the dissociated affective states of consciousness, in my culturally entrained sense of “I think therefore I am.” Towards a felt appreciation of my “primary-process affective consciousness,” (Panksepp, 2004) through a continuing experiential integration of relevant information. Relevant information, such as Peter Levine’s inclusion of Nina Bull’s work on the somatic correlations in our subjective experience. “Nina Bull discovered that the emotion of anger involves a fundamental split. There was, on the one hand, a primary compulsion to attack, as observed in tensing of the back, arms and fists (as if preparing to hit). However, there was also a strong secondary component of tensing the jaw, forearm and hand. This was self-reported by the subjects, and observed by the experimenters, as a way of controlling and inhibiting the primary impulse to strike.” (Levine, 2010) Which brought a physiological context to my family therapy training and earlier observations of a double-bind genesis in the aetiology of psychosis. While my self-exploration of the muscular/vascular foundations of my mood shifts and tones of thought, were guided by explanations and tributes to Bull’s work and her investigation of our common mind-body split. “Nina Bull is a significant albeit underappreciated figure in the history of body psychotherapy. She was a pioneer in the study of the mind/body relationship and the role of the musculature in subjective experience.” (Lewis, 2012) With an excerpt from this tribute to Bull, illustrating a perfect example of the mind-less meditation regime, which underpinned my experience dependant, transformational psychoses:
Clinical Application: Formative Differentiation of Bodily Attitude.
Once the motor pattern is recognized, one can increase its form (intensify the attitude) so that the pattern becomes vivified. Once it is vivified, it can be disorganized incrementally and with precision. Since, according to Bull, subjective states begin with a motor pattern (and not vice-versa), the Bodying Practice protocol provides a structure for nourishing self-regulation and working with one’s self and one’s subjective state. The Bodying Practice is a way to work with oneself by voluntarily differentiating motor attitude. A fixed pattern grows into a range of possibilities.
I offer the following account of how I have used the Bodying Practice to formatively differentiate my motor attitude of dense social defensiveness and in this way empower myself with a wider range of choice of social behavior and a subjective sense of confidence and self-esteem. I feel uncomfortable, “out of sorts”, awkward, nervous, not wanting to be seen, not wanting to reveal myself. This is familiar. It partakes of the feeling tone of much of my childhood and much of my present day social interaction. I pull in, just as I did in my childhood. Let me not be seen. Let me not embarrass myself. Let me not draw attention to myself. Let me not open myself to teasing and unkind words. I make myself smaller by pulling in my shoulders, hunching my back, and clenching my fists. This is the motor pattern that I recognize.
But I am no longer a child. Now, as an adult, I know what I am doing, and am doing it deliberately, precisely, and with intention. I start with my hands. With the tiniest of movements I make them solid, thick, dense, impenetrable. An observer might not even notice what I am doing, because my fingers and palms move only slightly. This is movement similar, in a way, to isometric exercises. Flexors and extensors are both activated, so there is no apparent external movement. But inside me, worlds build up, tear down, and build up again. I am voluntarily and deliberately invoking the self-protective pattern that I had formed in my childhood. (Lewis, 2012)
Daniel Lewis’s evocative articulation, is a brilliant example of the bodying practice which led me out of chronic mental illness experience, and into an embodied sense of the underlying mechanisms of my “primary process emotional/affective states,” (Panksepp, 2004) as the foundation of my subjective experience. While my epiphany moment of deeper self-realization was presumably a product of a bioenergetic process, synthesizing my constant reading and re-reading of relevant information, from scientific disciplines, such as affective neuroscience:
The Roots of Primary-Process Consciousness:
The massive and unparalleled convergence of information onto a simple and ancient body representation makes the centromedial areas of the midbrain an excellent candidate for the basic neural scaffolding for a primitive emotional self-awareness. This may have been achieved by the ability of a self-map to establish a characteristic resting tone within the somatic and visceral musculatures.
The establishment of such a “tone” throughout the body and brain, along with a variety of reafferent processes, may provide each organism with feelings of “I-ness” Upward influences into higher areas of the brain may have been achieved through the control of certain neural rhythms (delta, theta, alpha, beta, and gamma) which control information processing; such rhythmic systems of neural reverberations may generate intrinsic meaning structures within the organism.
For example; brain hormone detectors that instigate sexual urges may do so by promoting a natural lust-type neuronal rhythmic tone within a primitive motor-”I” Such a rhythm would reverberate throughout the body and at a cultural level, be expressed in actions like the varieties of dance, or simply felt as impulse to movement including emotional up-welling.
If various emotional and regulatory inputs modulate this primitive motor-”I” in distinct ways (each with a characteristic neurodynamic and neurochemical signature), the internal result may be a large number of subjectively experienced “feeling-states.” Obviously we can fault such a view of primitive consciousness in its failure to specify an exact manner of emerging subjective experience, yet shortcomings may reflect our human inability to verbally symbolize these intrinsic systems of a primary-process consciousness. (Panksepp, 1998)
Hence, I believe that in mental health research and psychological formulations about the experience of psychosis, there is growing need to adopt the approach of a recent paper: What is psychosis? A meta-synthesis of inductive qualitative studies exploring the experience of psychosis. (McCarthy-Jones et al, 2012) A need to contemplate anew, our taken for granted images of reason and our level of self-awareness, in the existential context of how: The range of what we think and do is limited by what we fail to notice. And because we fail to notice that we fail to notice, there is little we can do to change; until we notice how failing to notice shapes our thoughts and deeds. (Laing, 1990) With a need to accept our self-protective, self-interested motivation, by which: for some purposes, those that involve making use of the world and manipulating it for our benefit, we need, in fact, to be quite selective about what we see. (McGilchrist, 2010) Suggesting a need to follow a meta-synthesis example in which: A reflexive approach was taken throughout the study by considering how our own training, theoretical positions and personal beliefs were likely to impact our analyses. (McCarthy-Jones et al, 2012) While in the context of my personal history, it was my deep concern with the socialization of “innate affect,” (Tomkins, 1995) the existential meaning of the terms “affect” and “affective,” and the subconscious roots of my emotions, which motivated my self-education journey. An experiential process which involved giving up my self-objectifying identification with words, that form images of the external environment to explain by way of analogy, the internal experience of the self, or the ego, or the psyche. Three words that are used in communication between people with an illusionary sense of objective reality, particularly in the existential context of how we use words to enhance our survival, our status and our salary. Hence, I had to learn to sense within myself, the pseudo self illusion of the posthypnotic trance, induced by an over-identification with the word, which R. D. Laing had the courage to articulate. With Laing’s book “The Divided Self: An Existential Study in Sanity and Madness,” helping me to develop the courage to stand outside a consensus normality, in order to explore my non-conscious needs in the existential context of how: The attempt to regulate affect - to minimize unpleasant feelings and to maximize pleasant ones - is the driving force in human motivation. (Schore, 2003) Explore my hearts "orienting and defensive responses," (Bernston et al, 1991) as "affect responses," (Schore, 2003) and the “basic neural scaffolding for a primitive emotional self-awareness.” (Panksepp, 1998) Hence I present an excerpt from my own journal come memoir, of one of the defining, life “orienting” moments in my need to find the developmental science explanations, that would confirm my intuitive sense of an e-motive development issue, as the genesis of my psychotic experience:
Sectioned- On The Road to Redemption: April 12th 2012: Today is an anniversary of sorts, five years on from April 12th 2007. By the fate of the calendar’s cycle it’s the same day of the week too, it’s Thursday. The day I was sectioned for the first and only time, in my thirty two year experience with this profound dis-ease know as bipolar disorder. Confined within an acute care ward and then released with profuse apologies a week later.
The experience speaks volumes about our subjective states of mind, and the reality of mental health diagnosis. On that Thursday afternoon I’d sat opposite a young psychiatrist, as guilty of projecting a subjective state of mind onto immediate reality, as I was. I’d seen his involuntary reaction the previous Thursday while watching him read a young psych grad’s evaluation notes. Watched a whole body shift as his posture suddenly stiffened, and a pronounced look of concern transformed his face. His mind seemed to become fixated from that moment on, “this man is unstable and needs medication.” Over two brief sessions he repeated the same mantra some half a dozen times, “your in a hypo-manic state and without medication you will become hyper-manic.“
‘I’m coming out of the hyper-phase now, I’ve been in the hyper state for a couple of weeks.’
My explanations of emotional context and relevant developmental issues, like childhood trauma did not register at all with him. My twenty seven year history of bipolar only confirmed a rigid mindset, “unstable - medication.” I might as well have been experiencing my first episode of psychosis, same procedural approach, same firm belief in a disease of the brain. Discussing emotional context was counterproductive in his view, “loss of insight is a standard feature of this illness,” was his most empathic response during our first meeting.
We didn’t connect at all in the here and now reality of those face to face moments, divided by unconscious defensive reactions into which we each projected our subjective perception. His a brain disease of acute care need, of locked doors, sedating medications and strict policy procedures. A tough love perception of unfortunate souls, becoming increasingly defensive due to the rise in violence, from drug induced psychosis. All my training in the art of emotional healing, meant nothing to a paradigm of perception which views overt emotional expression as proof of a disease. His reactive judgment the same as in 1980 when I’d steamed open an M.D. referral letter to read, “exhibits schizophrenia like symptoms,” and been diagnosed schizophrenic within fifteen minutes, of my first contact with a psychiatrist. (Bates, 2012)
With the clash of ideology between myself and treating psychiatrist’s, finding real-life context in the view of one the world‘s leading psychiatrists. “Psychiatry among the medical disciplines truly aspires to an integrative, bio-psycho-social approach, yet this is eschewed in centres of research, elusive in the real world and increasingly lacking in the training of mental health professionals and psychiatrists.” (McGorry, 2005) While critical to accepting my argument here, is a cultural history of denial about our innate nature and the role our nervous system plays in the constant, non-conscious affective judgements of our lived-experience. Hence my seven year sojourn to articulate the existential meaning of the terms “affect” and “affective,” results in my suggestive title: Psychosis: Affective States of Consciousness & Nervous System Dysregulation. While my effort to articulate psychotic experience with an inside-out perspective, seeks to contribute to calls for a truly integrative approach to understanding psychosis as a continuum of human experience. In an “ideo-affective resonance” (Tomkins, 1995) with calls from the recovery oriented organization HVN: The Hearing Voices Network, alongside many of our professional allies in psychology and psychiatry, has serious concerns about the way we currently understand, categorise and respond to mental distress. We also recognise the confusion that can be caused when accepted facts, often presented to service users as truths, are challenged. We believe that people with lived experience of diagnosis must be at the heart of any discussions about alternatives to the current system. (Dillon, 2013) In consideration of a growing need to integrate historical, cultural definitions of our experience of affective states of consciousness. A need witnessed in a recent recovery publication: In many non-Western cultures, unusual experiences like voice hearing are often responded to within specified social or spiritual frameworks, which can promote hope, understanding, and reassurance for the voice hearer. In contrast, Western psychiatry and psychology generally couch the same experiences in a framework of fear and mental threat, which often marginalizes a distressed person even further. This is a position echoed by Simon McCarthy-Jones, who suggests that “hegemonic Western mind sciences would do well to look to theologians and individuals from other cultures to see what they can teach them about voices, and not just vice versa.” Interestingly, this viewpoint is congruent with research suggesting better outcomes for those designated schizophrenic in non-Western societies, compared with Western ones. (Longden, 2013) While here in 2014, the real-life outcomes produced by our Western mind sciences, is raising increasing concerns for all stakeholders in mental health. With my articulation of lived experience, questioning the public rhetoric of our analogous biomedical assumptions of a “fever-type” model of illness, and our historical denial of innate affect. Hence my description of how “I’d sat opposite a young psychiatrist, as guilty of projecting a subjective state of mind onto immediate reality, as I was.” Needs, in my opinion, to be read in contemplation of the existential meaning of the descriptive terms, “affect” and “affective,” with an excerpt from The Transmission of Affect, illustrating our common dilemma in self-awareness, and the real-life, bioenergetic nature of self-interest and the perceptual observations of our professional detachment:
To detach in accord with the procedure involved in comparing past and present affective states is to marshal and move attention toward a negative affect when one experiences it. The key to the nature of this real detachment (as distinct from a sadodispassionate projection of detachment) is that it is an exercise in feeling, but feeling of a calming and discerning variety.
Kant’s definition of passion (affect) as something like an obsession, was a perversion of the reasoning process, which is perverted when it is fixed on a self-absorbed direction. Psychoanalytically, the calculations characteristic of obsessionality derive from the ego’s initial formation in a game of comparitive advantage; only subsequently are these calculations given energy by the affects they help generate. One can think oneself detached from the passions and still be gripped by them, insofar as one calculates coldly. Regardless of whether this mistake was ever made by the ancients, it was made by those who think that coldness is equivalent to detachment, or worse, clear thinking.
Being coldly detached is being much too preoccupied with one’s own position, and it narrows one’s focus. It forecloses the feeling intelligence at work in “evenly suspended attention” in which one is open to new ideas about the other. And as that feeling intelligence works by making connections between new and existing ideas, any constraint on it, such as a preoccupation with prestige. (Brennan, 2004)
While it was my own dichotomy of maintaining a posture of professional detachment, while struggling to raise an “evenly suspended attention,” in real-life encounters with my clients, during therapy sessions, which was the genesis of my desire to understand the internal nature of “Affect Regulation & the Origins of the Self.” (Schore, 1995) With my narrative here, guided by the spirit of "everyone is right in some way," it is merely a matter of knowing "how," (Reich, 1973) seeking to articulate a “what happened inside,” perspective on trauma induced psychotic experience and recent calls suggesting that: Given the role of trauma and adversity, we need to start asking ‘what has happened to you?’ rather than ‘what is wrong with you?’ (Dillon, 2013) While my journey towards a dissolution of my self-objectifying illusions of self-awareness, with no simultaneous awareness of physiological state. Allowed an embodied sense of an ancient expression of human self-interpretation, in a bioenergetic reframing of my first experience of mania and its beyond descriptive language, oceanic sense of oneness:
The Body is the Shore on the Ocean of Being. -Sufi saying
Discussion: This paper has attempted to articulate the experience of psychosis, as the innate reactivity of my nervous system with the contagious capacity of innate affect, analogous to infectious diseases. An attempt to define the reciprocal influences between body and brain, in affective states of consciousness. Whereby, the modulation of primary process emotional-affective states, by higher cognitive processes, is understood as the “affect regulation,” of an established homeostasis. In which the “role of visceral state and visceral afferent feedback on the global functioning of the brain,” (Porges, 2011) is recognized in our experience dependant establishment and maintenance of organism homeostasis. Hence my self-exploration of the internal nature of my affect-driven images of consciousness, lead me to an embodied awareness of my, pre-wired at birth, affect-system. With this experiential perspective seeking to illuminate a sense of how: everyone is right in some way," it is merely a matter of knowing "how," (Reich, 1973) once we search beyond our immediate self-preservation motivation, in our attachment driven need to resonate with like-minded group behaviour. Thus, this paper seeks to influence discussion amongst mental health professionals and their perceptions of psychosis and categories of mental illness. Particularly in light of emerging concerns that mental illness is increasing amongst young people. An existential phenomena which from a phylogenetic perspective, may be psychologically re-framed, with a meditative contemplation of professor Stephen Porges life long interest:
The world we live in fosters so much cognitive functioning without the integration of our cognition with our bodily experience, and that dissociation is probably occupying a high percentage or a significant percentage of everyone’s lives. It is a product of a lack of integration – and this is the part I’m also getting very interested in – the communication between left and right hemispheres.
This is really Iain McGilchrist’s work – it’s quite amazing and interesting – the fact that as we mature, we spend more and more time in a sedentary position working on our cognitions and not on the neural regulation of our visceral state. Even our educational system is so poised to get people into that mode so early that they never even have the substrate of having a good biobehavioral state regulation system working. (Porges, 2013)
Hence, my lived-experience perspective seeks to stimulate discussion about the innate nature of psychosis, and the bio-psycho-social education required in the post first episode phase of psychotic experience. With an emphasise on the internal nature of our “social engagement system,” (Porges, 2011) whereby people may learn to improve their self-regulation, with an embodied return to their: Infants Sixth Sense: Awareness and Regulation of Bodily Processes. (Porges, 2011) With my mind-less meditation of the physiological states of psychotic experience, reflecting an increasing use of mindfulness in cognitive behavioural therapies for psychosis. While the “brain-face-heart” connection articulated by The Polyvagal Theory, explains, in my opinion, the implicit processes of a family therapy tradition, reflected in Finland’s “open-dialogue” approach to psychosis, and other empathy based approaches, accepting a continuum of human experience.
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