Schizophrenia – waking reality

processed through the dreaming brain

www.hgi.org.uk

For further information about schizophrenia, psychosis and the dreaming brain read: Dreaming
Reality: How dreaming keeps us sane or can drive us mad
You can find out more about psychosis and schizophrenia at the following MindFields College
events:
 Understanding the mental health continuum seminar
 Psychosis: and positive strategies for recovery workshop

One curious research finding, which has been confirmed by several major studies in five-year
follow ups, shows that about 64 per cent of people in third world countries recover fully after a first
schizophrenic breakdown. Yet the comparative figures for the developed world show that only
about 18 per cent recover fully.
By looking at these findings from the human givens perspective, however, we can deduce some
very significant things from them.

For example, in third world countries, there is a much stronger tradition of emotional and family
support and greater tolerance for personal psychological crisis, which may therefore be less likely to
spiral out of control. There are also more low-stress manual and handicraft jobs, and more
meaningful tasks that people need to perform for their subsistence, that facilitate recovery in a
close-knit community.
It is much easier, therefore, for people to meet their emotional needs for intimacy, support, status
and validation in these situations, than in the culture we have made for ourselves. Clearly, an
environment where emotional needs are met is a potent aid for helping people recover from
psychological disorders, even ones as seriously incapacitating as schizophrenia.

An additional factor is that, in third world countries, the use of modern neuroleptic drugs to treat
psychosis is minimal, whereas in the Western world they are the main treatment offered by the
psychiatric profession, despite the strong evidence that these heavily promoted drugs hinder
recovery, increase the rate of relapse and have a significant risk of causing severe brain damage.

Psychiatric theorists are at a loss to explain schizophrenia. The various simplistic ideas that it was
caused by specific deficiencies in brain chemistry, such as ‘overactive dopamine systems’, have not
been supported by research, despite the strident and misleading claims of some drug companies to
the contrary.

In our book, Human Givens: A new approach to emotional health and clear thinking, we described
how the REM brain state, which underlies dreaming, is separate from the process of dreaming and
dream content. It is also clear that the healthy brain is organised to keep the dream process separate
from the waking state, which is why we find it so difficult to remember dreams. We have shown
how the behaviour of a person in a hypnotic state clearly mirrors phenomena of the REM state, such
as muscle paralysis, dissociation, imperviousness to pain, and amnesia for the event after ‘waking’.
A psychotic breakdown is almost always preceded by an overload of stress and severe depression in
a person’s life, which, as we know, results in excessive REM sleep. We are now convinced that,
when people are in psychosis, they are in fact trapped in the REM state, a separate state of
consciousness with dreamlike qualities. In other words, schizophrenia is waking reality processed
through the dreaming brain.

To illustrate this, we only have to look at a number of typical schizophrenic behaviours and
experiences and see how they relate to the REM state.
Patients in a psychotic state often describe weird relationships with bodily feelings. One said that
her legs felt empty: another that her arms didn’t belong to her. This is a well-known REM state
phenomenon and is also noted in hypnosis: patients may feel that their bodies are dissolving
because, in the dream state, most sensory perceptions about the body are shut out.

It is also known that people with schizophrenia are unusually resistant to pain: even more so during
severe psychotic episodes. One patient jumped out of a second storey window of a hospital, broke
both his ankles, and walked to the shops oblivious of the damage he had done — damage that
would have caused excruciating pain for any person in a normal state of mind.
Again, this imperviousness to pain occurs in the REM state while dreaming, as we are cut off from
sensory information. (Anyone who has woken up in agony because a limb, or ear, has been lain on
in an unnatural way for a long period during dreaming will recognise this. The pain this causes is
only noticed after you wake up.) It is this fact that is exploited when hypnosis is used for pain
control or anaesthesia during surgery.

Psychotic patients may also talk about hearing voices. In the dream state, which is the province of
the right hemisphere of the brain, people are not usually capable of independent thought, the
province of the left hemisphere, because the mind is ‘locked’ into the metaphorical script of the
dream. But if an individual is trapped in a waking REM state, with waking reality happening around
them, there is still likely to be activity in the left hemisphere of the brain.
We suggest that, because the REM state operates through metaphor, the only way it could make
sense of these independent left brain thoughts would be to create the metaphor of hearing voices, or
being watched, or spied upon by aliens — which easily becomes paranoia.

The visual illusions or delusions associated with schizophrenia are totally characteristic of the
dream state, which generates hallucinatory realities that we believe in unquestioningly for the
duration of the dream. Stage hypnotists make use of this when they put subjects into what is in
effect a psychotic state, and induce them to believe that they are someone else or that non-existent
people and objects exist.

Rapid eye movements are often seen to occur in psychotic states, which, of course, are the defining
sign of the REM state. Psychotic patients also very quickly convert thought into sensory experience,
with the result that they can become highly emotional almost instantly. When recalling a distressing
memory, for example, they can be instantly transported right back into that memory and re-
experience the emotions connected with it. That phenomenon, too, is a characteristic of the dream
state, when arousals from the emotional brain trigger a thought pattern, in the cortex, which is
immediately converted into a sensory metaphor — the dream.
It is not surprising, then, that psychotic patients not only talk in metaphors but live them out, which
explains their often bizarre speech and behaviour.

The REM state, as we have explained, is in effect a reality generator. It creates all kinds of
perceptions in our dreams, but these are illusory perceptions — vivid metaphors. One psychotic
patient actually described herself as “being trapped in the land of illusion”. Indeed, we know from
talking to psychotic patients in their saner moments that they readily recognise that they are trapped
in a dreaming state.

We suggest that we can use this insight to help people make sense of their psychotic experience.
Ordinarily, there is ongoing interplay between the left and right hemispheres of the brain.
We can help psychotic patients dip out of the dream state into the more analytical side of their
brains by the type of questions we ask them and by talking about what is concerning them; and by
connecting with their metaphors and attempting to change the meanings these have for them. They
can then start to better understand what is happening to them and spend more time in normal,
waking reality.

When we have made these sorts of observations about psychosis at MindFields College seminars,
they have on occasion been heard by people who themselves have had a psychotic breakdown and
recovered. These people have all responded extremely positively, even thankfully, to this
understanding of their experience. (Indeed, we published a remarkable letter, sent to us by someone
who had had a psychotic breakdown and heard of this explanation in our book, Human Givens.)

In our preliminary investigations, using these concepts, we have found that psychotic patients calm
down when they realise there is an explanation for what is happening to them. When calm, the
psychotic phenomena become less threatening and less intense. Then we can start doing what many
traditional third world countries seem to do so much better — re-orientating people towards getting
their emotional needs met and creating strong support structures for them.

Being unhappy, stressed and depressed is a strong predictor of later mental illness. This new
understanding of what psychosis is, means we can set out practical guidelines for treating it and
thereby reduce the prevalence of severe breakdowns and increase the recovery rate dramatically
when they do occur.

We are saying, then, that extreme stress, anxiety and depression lead to psychosis, where the
patient’s brain can no longer distinguish between the metaphorical reality of the dreaming process
and the way a brain normally manages to order reality. If we are right, it follows that, if people were
treated more effectively for stress overload and depression by psychotherapists trained to be
effective using the human givens approach, the depression would lift in most cases and not
degenerate into psychosis.

Because psychotic people are so hypersensitive to metaphor, health workers need to know when
working with them how to use metaphorical language that encourages left hemisphere activity.
They need to know how to reduce their patients’ arousal levels with calming metaphors.
Conversely, they need to consciously avoid metaphors that may remind patients of their
predicament, flipping them back into their right neocortex and psychosis. This is a specialist skill
that can be taught. They also need to consider that their psychotic patients’ metaphorical language
and behaviour represent emotional needs not being met, or that they are attempts to express what it
feels like to process waking reality directly through the REM state.

In addition, the skills of occupational therapists need to be given much greater prominence in the
treatment of these patients, who need to connect to reality in disciplined, concrete, purposeful ways:
by gardening, cooking, making things, doing craftwork etc. Their daily routine also needs a clear
structure and discipline.

But, above all, as a society we need to ensure these vulnerable people receive effective
psychotherapy more quickly — before stress, anxiety and depression completely overload their
dreaming mechanism and too much damage is done. Prevention is the better course wherever
possible.

Enormous savings could be made if those using less effective counselling and psychotherapy
methodology were trained so that they could act quickly to stop stress, anxiety and depression
triggering major breakdowns in those genetically predisposed to developing psychosis. In other
words, therapists need to work with the givens of human nature, not ideology, profit motives (drugs
are not the only way to lower the arousal that puts pressure on the dreaming brain), or bureaucratic
convenience. We predict that, if such an approach were adopted, people in the West, as well as in
the East, could have fewer psychotic breakdowns and higher recovery rates from schizophrenia.
Click here to read 'A new look at psychosis' >>

© Human Givens Publishing (2009)