[AppinIsobel]

Keynote lecture by Professor Elyn R Saks, her diagnosis -- schizophrenia, stays on medication, married in her 40's
　
Lecturing in Florence, Italy, April 2010

http://www.schizophreniaforum.org/fo.../swf/0001.html

The Professor's husband travels with her and prepares the Power Point slides. A great love story.

Over 10 more slidecasts are available online from this meeting. Watch the presentations by clicking on the speaker names at the Schizophrenia International Research Society website.

http://www.schizophreniaforum.org/fo...010/index.html

[spiritual_emergency]

I've not yet read Ms. Saks book although I remain intrigued by her experience. As a word of forewarning, AppinIsobel, my comments will run in a Jungian vein. I'm left with the impression this is not a perspective you appreciate, nonetheless, it's the perspective I speak from.

When I first heard of Ms. Saks, what initially caught my interest was the fact that she had made such a significant recovery and had opened up publicly about her experience as a means of helping others. What also caught my interest was the title of her book: The Center Cannot Hold.

Within Jungian psychology, it is acknowledged that there are two centers -- the first is the center of consciousness, known as the Ego. Psychotic episodes seem to be very hard on the ego, literally assaulting it until it collapses, splinters, fragments or shatters under the strain. With the protective boundaries of the ego out of the picture, the border between inner and outer realities blur, the unconscious rushes forth and intense fear is common as one experiences what feels like an invasionary force. A great deal of recovery seems, of necessity, to be involved in rebuilding the egoic identity and thus, re-ordering and re-structuring the contents of the psyche.

Beyond the ego however, there is a second center. This is referred to as the Self. If the Ego is the king of consciousness, the Self is the Ruler Supreme of the unconscious. According to Jungian thought, it is always expressed in numinous terms -- the figure of a deity or a sacred geometric pattern. I've addressed this issue before via this article: Visions of the Center in Accounts of Schizophrenic Disintegration. That article contains an account of Jung's own experience of what is considered by many to be evidence of a psychotic episode, which is to say, an experience of ego collapse.

At any rate, this is what draws me to Ms. Saks story and for that reason, I began slowly making my way through the presentation above. Admittedly, I prefer to read because I can read rather quickly. Videos on the other hand, move slowly. Still, it's occasionally worth my while to hang out with one and this has been one that I'm enjoying.

One factor that intially took me off guard was Ms. Saks voice -- initially, I thought I was hearing a male who might be introducing her but it turns out that Ms. Saks has a very deep and masculine voice. The following notes were taken from the first eight minutes of the 45 minute presentation during which Ms. Saks shares the love she found in Philosophy during her time at university...

I discovered Philosophy and fell in love with it...

Philosophy and psychosis have more in common than many people -- philosophers especially -- might care to admit. The similarity is not what you might imagine -- that philosophy and psychoisis and don't have rules and you're tossed around the universe willy-nilly. On the contrary, each is governed by very strict rules. The trick is to discover what the rules are and in both cases, that inquiry takes place almost solely inside one's head. And while the line between creativity and madness can be razor-thin -- a fact that's been widely romanticized -- examining and experiencing the world in a different way can lead to sharp and fruitful insights.

Not only did this work give me a surprising joy, it also imposed a structure on both my mind and routine that I'd been unable to provide myself... the repoire of the material, the lively give and take of the students and faculty in the department, imposed a kind of order to my days. Suddenly I had attainable goals, a sense of productivity and purpose, and tangible results against which I could measure my progress. ...

While I would eventually leave philosophy -- too many bad memories associated with my time at Oxford -- the joys of thinking have remained with me providing a sense of focus, structure and well-being. Intellectual work is clearly one of the stalwarts of my recovery and I was lucky to discover the pleasures of that work early.

To briefly return to the concepts of Ego and Self. Ego-consciousness arises out of the relationship with the mother, or rather -- the feminine. The feminine, is associated with darkness, night, chaos and possibilities pregnant with potential. The masculine on the other hand is associated with light, day, structure and order. The act of structuring a self-identity is a masculine act. Ego consciousness arises from the mother; the feminine.

If all goes well, the child learns to define the borders of the self/ego (note the lower case "self" as a means of differentiating it from the Self) and to go out into the world and make their mark upon it. This involves leaving the mother's lap, the mother's hearth, the mother's home. Creating structure and order is a masculine principle which Ms. Saks gives nod to: Not only did this work give me a surprising joy, it also imposed a structure on both my mind and routine that I'd been unable to provide myself.

I think it would be true to say of myself that I found the model of Jung's psyche worked in similar fashion. I've also encouraged others to make use of a timeline which seems to serve a similar purpose. Both provided a template of structure around which I could organize my experience of fragmentation -- a means of imposing linearity upon a non-linear experience which can never be entirely contained by the material viewpoint. It also provided intellectual challenges I could pit myself against and via this process, re-introduce an organizational structure into the experience of fluidity, non-linearity, and boundlessness.

This is an area where I'm currently watching my own child struggle -- they can function reasonably well at home and even within the complex world of social relationship but they continually falter when they attempt to find success for themselves outside of those boundaries. Their struggle centers around creating structure and order for themselves in the outside world by being capable of finding success or stability in work or school. I sometimes think they are attempting to force the issue too early in the recovery process. They keep wanting to dive where I implore them to wade.

To return to Ms. Saks earlier account... she notes that she fell in love with Philosophy. The word itself is from the Greek: philo meaning lover and Sophos, which means wisdom. Thus, a philosopher is a lover of wisdom. And what do we find when we turn our attention to this love of Sophos...

"I am black but comely, O ye daughters of Jerusalem."

- The Song of Songs (1:5)

Perhaps it is not at all unusual that Ms. Saks, in describing her fall into psychosis, would find herself back in the realm of the mothers; a psychological space of profound chaos, rich in meaning and possibility. According to Jung, this "fall" is actually an attempt at self-healing; a means of "re-birthing" the egoic identity following a period of crisis which has caused it to collapse.

It would seem that Ms. Saks has managed to rebuild her egoic identity although I remain curious to know if she has come into a harmonious relationship between Ego (masculine/light/consciousness) and Self (feminine/dark/unconsciousness).

Thanks for sharing AppinIsobel.

~ Namaste

See also:
- Masculine, Feminine and Schizophrenia
- The Inner Apocalypse
- Archetypes & The Individuation Process

Music of the Hour: Death Cab for Cutie ~ I'll Follow You Into the Dark

[spiritual_emergency]

Additional musings on The Center...

Up until then, my life, like the Story itself, had moved in two veins. I "lived" in reality some of the time and I "lived" in the imaginary setting of my Story some of the time. But once I surrendered to the process, I let go of reality. I entered the Story. It became my only reality.

From that point forward the process moved very quickly. I immersed myself completely in the experience. I stopped eating or sleeping. Every moment of every hour was spent writing, reading over my words, listening to the music, and experiencing what was rising to the surface. It was akin to a highly concentrated form of non-stop therapy. My writing output at that time was about 5,500 words a day. I know because I later went back and counted.

Every frozen piece of grief and trauma within me came forward. Every loss. Every fear. Every failure. Every bit of heartbreak. As I opened myself more and more to the process, as I dropped every possible defense or barrier, it became quite painful, not only emotionally but also physically. My chest felt as if it were being crushed. My throat felt like it was in a vice. My limbs and joints ached and felt disconnected. I hyperventilated. I shook and trembled. I vomited terror and grief. I could feel strange sensations within my body, as if places within me were opening. I smelled perfume. I slipped the bonds of time and into the black womb of the Universe.


. . . I am dancing with God . . .

That is from the account of my own experience which included an "encounter with the Self". I can tell you with pinpoint accuracy when that occurred because, to the best of my ability, I was writing that experience down, logging it. The timestamp on that entry reads as: February 14, 2002 00:00:00. This is the space I refer to as Kali, Silence, The Place Where Time Melts. There is Nothing there and yet, it contains Everything.

Kali's blackness symbolizes her all-embracing, comprehensive nature, because black is the color in which all other colors merge; black absorbs and dissolves them. 'Just as all colors disappear in black, so all names and forms disappear in her' (Mahanirvana Tantra). Or black is said to represent the total absence of color, again signifying the nature of Kali as ultimate reality. This in Sanskrit is named as nirguna (beyond all quality and form). Either way, Kali's black color symbolizes her transcendence of all form.

Source: Kali ~ The Divine Mother

I keep coming back around to that space. There are some answers there that I'm seeking for myself. Nonetheless, my point is, it is the realm of the dark feminine; the realm of the mothers; the realm of Sophia.

[spiritual_emergency]

... I discovered that my castles stand
upon pillars of salt and pillars of sand ...

Viva Le Vida ~ Coldplay

Psychotic Episodes

I spent some more time last night hanging out with Ms. Saks words and again today. I viewed the presentation in its entirety and then went back to review key portions. In this instance, what I was interested in was her personal history -- some clue that might have pointed to a psychological factor that served as a predecessor to her first break, for there is nearly always one.

Ms. Saks doesn't offer up much information in that regard. According to her, she spent her early childhood in a suburb of Florida as the oldest child and only daughter in a family of three. She describes her parents as caring and attentive -- "my father could be critical, my mother dependant" -- but there is no indication that any of the horrific events that can occur in some families occurred in hers.

However, not all was trouble-free. She notes that by the age of 5 she had developed some phobias and obsessions. Most 5 year olds probably have some things they are frightened of, some things they are keenly interested in, so even that doesn't necessarily bode ill. She does describe some night terrors. Again, depending on the circumstances, that might not be unusual. We are all vulnerable to a certain extent, children even more so.

In her adolescence she notes that she had difficulties with anorexia and briefly flirted with some recreational drug use. I don't have any real knowledge of anorexia aside from knowing it's related to self-image. Nonetheless, it doesn't seem a stretch to acknowledge that she was undergoing some difficulties as related to her concept of her self. Meantime, recreational drug use does seem to play a role in triggering psychotic episodes in some individuals but Ms. Saks does not associate its use with any psychotic episodes she experienced. Rather, she notes that her first real experience of psychosis was triggered in response to a conversation with her father...

... The first time it happened I kept bugging my dad about going to the beach and he finally snapped at me. It felt in that moment as if my self were losing its coherence; it's as if my mind were a sandcastle with all the sand sliding away in the receding surf and no center to take things in, put them together, and make sense of them. Hence, following Yeats, the title of my book, The Center Cannot Hold.

Bear in mind that the impact of an individual's words are related to not only what was said and how it was said, but how what was said was interpreted. For some reason, Ms. Saks seemed to internalize her father's response in a very personal way.

This is something I would call an ego blow; it's not enough to collapse the ego but maybe it produces a little crack -- just enough that everything that the boundary between the ego and the unconscious had held at bay begins to leak through. In my own case, this occurred in November, 2000, when my mother died. From that point forward, life began to get a little odd and this was noticed by some of the people around me. In Ms. Saks case, we know she already had some difficulties as related to her self-image and self-worth. Presumably, this is what began to bleed through from the unconscious into consciousness...

My first frankly psychotic experience happened when I was 15 or 16 and I was in the drug rehab. I had read Sylvia Plath's The Bell Jar and like many teenage girls, it spoke to me. One day, in the middle of school, without any warning, I simply stood up and started walking several miles home.

As I walked along I began to notice that the colors and shapes of everything around me were becoming very intense. And at some point I began to realize that the houses I was passing were sending messages to me: They said: Look closely. You are special. You are especially bad. Look closely and ye shall find. There are many things you must see... see... see...

I did not hear these words as literal sounds as though the houses were talking and I were hearing them. Instead, the words just came into my head. They were ideas I was having. I instinctively knew they were not my ideas. They belonged to the houses and the houses had put them in my head.

By the time I walked through my parents' front door -- two maybe three hours later -- I was tired, hot and very frightened. I told my parents about my experience. My parents drove me to the drug rehab program I was in and nothing ever again was said about the episode.

It's in this scenario that we see some of the same type of content that people report when taking psychoactive drugs -- the colors and details of the world deepen and sharpen. We then begin to see a form of projection and reflection come into play wherein the houses "begin to speak" to her. Occasionally this projection speaks in very powerful, almost biblical language: Look closely and ye shall find.... We also see a degree of inflation: [You are special as coupled with a critical and harshly judgemental "voice": You are especially bad. The contents of the deeper psyche is breaking through into consciousness and, as to be expected, the majority of the material breaking through is related to the Shadow.

She goes on to describe her transition to college with a few repeated episodes that, like her experience above appear to have been relatively short-lived, as interspersed by periods of stability...

I went to college at Vanderbilt University in Nashville, Tennessee. I did extremely well, I got straight A's, I graduated first in my class and I was able to make one of my closest friends. ... But there were portents of my illness even then. For example, my personal hygiene my first year was truly appalling and I had several out of control episodes in my first and senior year which were scary but I was able to bring to a close.

This brings us up to Ms. Saks love affair with Philosophy. After her experience at Vanderbilt she further notes...

I eventually won a scholarship to study at Oxford and it was there that my world began to really fall apart; I became officially mentally ill. It started out as depression coupled with episodes of paranoia but over time developed into a thought order as opposed to a mood disorder.

She goes on to detail what appears to be a recurrence of depression and anorexia -- at 5'10" she weighed less than 100 pounds. There appears to have been a further collapse into psychosis for she notes that she withdrew into isolation and began to feel that others were laughing at her and talking about her behind her back. She adds this may have been no paranoia on her part since she feels she did look quite odd, "walking around the campus, gesiticulating and talking to myself. During this time she began to have vivid fantasies of killing herself because she believed she was such a bad person. She found herself unable to work and a period of hospitalization followed...

I was not getting better. I was also very resistant to the idea of taking drugs. ... But then one day something happened that changed my way of thinking; that changed everything. I looked into a mirror. 'Good god,' I thought, 'who is that?' I was emaciated and hunched over like someone three or even, four times my age. My face was gone. My eyes were simultaneously vacant and full of terror. My hair was wild and filthy. My clothes wrinkled and stained. It was the visage of a crazy person on the long-forgotten backward of a hospital for lunatics. ... The woman looking back at me was in some kind of terrible, terrible trouble. I vowed that I would do whatever I needed to do to get her out of this place in any way I possibly could. The choice seemed clear, drugs or death. I said, "Okay, I'll take your drugs." ...

In my fog of isolation and silence I began to feel I was receiving commands to do things, such as walk all by myself through the old abandoned tunnels that lay underneath the hospital. The origin of the commands was unclear. In my mind, they were issued by some sort of beings. Not real people with names or faces but shapeless powerful beings that controlled me with thoughts, not voices, that had been placed in my head. So they said walk through the tunnel and repent. Now lie down and don't move. You must be still. You are evil.

The effects of those commands on me during these nights and days was powerful. It never occurred to me that disobedience was an option. It was never clear to me what might happen if I disobeyed, I do not make the rules, I simply follow them...

... Nearly four months in the hospital passed like this and I wasn't getting any better, I was only getting worse.

Within Jungian psychology, spaces underground are associated with the unconscious. Meantime, what Ms. Saks seems to be describing as 'some sort of beings" are what a Jungian might call an archetype.

Jungian archetypes

The concept of psychological archetypes was advanced by the Swiss psychiatrist Carl Jung, c. 1919. In Jung's psychological framework archetypes are innate, universal prototypes for ideas and may be used to interpret observations. A group of memories and interpretations associated with an archetype is a complex, e.g. a mother complex associated with the mother archetype. Jung treated the archetypes as psychological organs, analogous to physical ones in that both are morphological constructs that arose through evolution.[3]


Jung outlined five main archetypes;

• The Self, the regulating center of the psyche and facilitator of individuation
• The Shadow, the opposite of the ego image, often containing qualities that the ego does not identify with but possesses nonetheless
• The Anima, the feminine image in a man's psyche; or:
• The Animus, the masculine image in a woman's psyche
• The Persona, how we present to the world, usually protects the Ego from negative images (acts like a mask)

Although the number of archetypes is limitless, there are a few particularly notable, recurring archetypal images:

• The Child
• The Hero
• The Great Mother
• The Wise old man or Sage
• The Trickster or Fox
• The Devil or Lucifer
• The Scarecrow
• The Mentor

Source: Wikipedia ~ Archetypes

Ms. Saks then goes on to describe her experience with psychoanalysis -- not Jungian based but helpful to her. Nonetheless, that's all I have time for at the moment.

Music of the Hour: Coldplay ~ Viva La Vida

[spiritual_emergency]

The subject of mechanical restraints is something Ms. Saks discusses in her video presentation but this excerpt is taken from an online essay I found in a format that's easier to share.

Freedom of Motion - Elyn Saks

... He immediately called for security. Another attendant came in, this one not so nice. And once he'd pried the nail from my fingers, I knew I was done for. Within seconds, the doctor and his whole team of goons swooped down, grabbed me, lifted me out of the chair and slammed me down on a nearby bed with such force that I saw stars. Then they bound both my legs and arms to the metal bed, with thick leather straps.

A sound came out of my mouth that I'd never heard before. Half-groan, half-scream, barely human, and pure terror. Then the sound came again, forced from somewhere deep inside my belly and scraping my throat raw. "Noooooo," I shouted. "Stop this, don't do this to me!" I glanced up to see a face watching the entire scene through the window in the steel door. Why was she watching me? Who was she? I was an exhibit, a specimen, a bug impaled on a pin and helpless to escape. "Please," I begged. "Please, this is like something from the Middle Ages. Please, no!"

For years after the several-week period that followed, in which I was restrained sometimes for very long periods (as many as twenty hours) and sometimes for shorter periods (an hour or so), I had nightmares. Often in my dreams I would get a measure of revenge: I would seclude and mechanically restrain the entire staff of the hospital, leaving them there for long stretches. (I would also open the hospital doors so people could leave. Interestingly, in my fantasy, a significant percentage of patients chose not to leave.) The dreams were a way for me to try to process and come to terms with the experience.

It is impossible to overstate how horrible it is to be in restraints, especially long term. There is considerable pain: try not moving your arms or legs even a bit for a long period of time. It hurts like hell. Then there is the indignity and degradation. There's also a terrible sense of helplessness that is compounded by not knowing when you will be released. Last but not least, patients are often restrained by being tied spread-eagle to a bed. I believe that people who have been sexually abused will be retraumatized by being held in this position. (Even someone who has not been sexually abused — as I have not been — may feel in a compromised sexual position.)
The prime benefit cited for mechanical restraints is that they prevent patients from harming themselves, even killing themselves at times. Yet, a series run in the Hartford Courant uncovered many restraint deaths in psychiatric hospitals. Many of these were covered up. Based on what we do know, a Harvard statistician estimated that there are 50 to 150 restraints deaths a year. It's hard to estimate how many deaths restraints prevent that wouldn't be preventable in other ways (e.g. "staff specialing" the patient). But the number of deaths per week is at the least noteworthy...

Source: Freedom of Motion