Friday, March 30, 2007

Hearing Voices

An interesting article in the New York Times questioned the unquestionable assumption that a person hearing voices in their head is pathological, mentally ill, in need of immediate treatment (Smith, D.B.: Can you live with the voices in your head? March 25, 2007). Auditory hallucination is the hallmark of schizophrenia, although some schizophrenics do not have auditory hallucinations, and they also occur in other psychoses as well, but generally, if you are hearing voices, you want to get rid of them – right away, by taking one of the antipsychotic medications that suppress or eliminate the voices (with substantial side-effects).

(Pic from

According to the NYT article, there is a group based in Manchester, England, the “Hearing Voices Network (HVN), that advocates making friends with the voices instead of trying to get rid of them ( In group sessions, participants talk about their voices and how they relate to them. The goal is to accept the voices as part of “normal” consciousness.

Hearing voices is not fun, according to what we read in the psychiatric literature. It is extremely frightening, like having an alien within your body. Hearing voices is not like talking to yourself, because it is not your voice. The voice typically comments, often sarcastically and critically, on what you are doing and thinking. The voice is intrusive. You can’t read, can’t think. It won’t shut up. Often, according to patients, the voice urges you to commit suicide. Sometimes it is two different voices talking to each other, commenting on and criticizing the patient’s thoughts and actions in the third person. I’ve never read about a friendly, encouraging, helpful auditory hallucination. They’re always bad news.

The article describes a typical incident:

Angelo was walking home from the laboratory when, all of a sudden, he heard two voices in his head. “It was like hearing thoughts in my mind that were not mine,” he explained recently. “They identified themselves as Andrew and Oliver, two angels. In my mind’s eye, I could see an image of a bald, middle-aged man dressed in white against a white background. This, I was told, was Oliver.” What the angels said, to Angelo’s horror, was that in the coming days, he would die of a brain hemorrhage. Terrified, Angelo hurried home and locked himself into his apartment. For three long days he waited out his fate, at which time his supervisor drove him to a local hospital, where Angelo was admitted to the psychiatric ward. It was his first time under psychiatric care. He had never heard voices before. His diagnosis was schizophrenia with depressive overtones.

HVN disputes the assumption that hearing voices always indicates psychosis. They claim that many ostensibly normal people hear voices and live with them. Some interpret the voices as messages from a spirit world, some as thoughts from their own unconscious mind. The article did not present any evidence that normal people hear voices, or if they do, how prevalent that might be. It’s an interesting and plausible idea however that should be investigated.

I have heard a voice in my head that did not seem to be my own, when falling asleep, where the boundary between dreaming and wakefulness is not clear. It’s rare, but I have “heard” my name being called loudly and clearly, and was startled, only to realize “it was only a dream.” But what does that mean, “It was only a dream?” I heard a voice in my head; It was not my own voice; It called my name.” Why is that not an auditory hallucination? I can well imagine that some people might experience similar events throughout the day. There is wide variation in the quality of normal human consciousness.

When you have a tune in your head that keeps repeating, against your will, and you can’t get rid of it, isn’t that an auditory hallucination? It is, but it is so common that we accept it as a normal, albeit annoying part of life. But voices speaking sentences are not common so we pathologize that.

This is an amazing idea, that otherwise normal people might routinely hear voices. Julian Jaynes, in his weird book, The Origins of Consciousness in the Breakdown of the Bicameral Mind (1976) claimed that humans enjoyed two distinct, parallel conscious experiences, one in each hemisphere of the brain, until recently in evolution. His evidence ranged from none to sketchy, and I wasn’t convinced. But there may well be brain-based structural or biochemical factors behind hearing voices.

The idea promoted by HVN is that a person should accept the voices as meaningful and try to understand them, much as we try to interpret the meaning of dreams. I think that is a good idea. The brain does not manufacture sentences. Only a socialized mind can do that. So whatever the brain basis might be of the voices, their manifestation as language statements is an ego phenomenon and subject to meaningful interpretation.

I don’t think there is any reason to think that the voices are from angels, spirits, or aliens, although I can appreciate why sufferers might believe that. The voices are dissociative, that is, they seem ego-alien, or “not-self,” but they do come from within the psyche of the person and should be interpreted as clues to how that psyche operates.

Unfortunately, it seems like there is usually more than one brain malfunction going on – more than whatever cause the voices. Angelo, for example, was diagnosed also with depression, which may arise from another brain dysfunction, or maybe another aspect of the same one – who knows. In schizophrenia, there is a broad range of clinical symptoms, not just voices. So it may be next to impossible, in practice, to find much sense in the hallucinatory voices, since they may also be manifestations of other problems in the brain. It might nevertheless be possible to disentangle these multiple strands by careful analysis, the way a skilled mechanic can identify multiple problems in your car’s engine by isolating one thing at a time.

Friday, March 02, 2007

Did Egyptian Pharaohs Seek Immortality?

On a recent visit to the Portland, Oregon art museum, I saw an exhibit called “Egyptians: the Quest for Immortality.” It was a Disneyesque crowd-pleaser including a dimly lit mockup of a pyramid tomb room where you could see the writing on the wall. Despite the show-biz tone and the oxygen-deficient tomb room, I enjoyed studying the hieroglyphics, mummies, and other displays.

However, in examining the exhibit, it occurred to me that the Pharaohs were not questing for immortality at all. They simply assumed it, for everyone. The idea of personal nonexistence was probably inconceivable to them.

Why would you assume that at death you ceased to exist? You have never ceased before, despite having gone through innumerable transformations, from infant to adult. Always, you continued on. And so why would death be any different? Obviously, you would continue on as you always have, albeit in some other form. That would make perfect sense and would be beyond question for any normal ancient Egyptian.

When you think about it, the idea that death is oblivion only makes sense if “the person” is identical with the physical body. That view is recommended by modern science, but is far from being a fact. Intuitively, we feel there is more to a person than meat. Prescientific Egyptians would have no reason to doubt it.

It is more consistent with common sense and life’s experience to assume that one continues indefinitely. The ancient Egyptians were NOT on a quest for immortality because they knew they were immortal.

However, they did seem confused about what “the person” is. They put an enormous amount of resource into retarding the decay of the physical body. Why? They were unclear on the concept of immortality if they thought the physical body would continue after death, but they probably had not conceived of a physically transcendent soul or spirit yet. That would be for later monotheists to invent. So the Egyptians made do with what they could understand.

Nevertheless, if you assume immortality of “the person” (however that is defined), then the question would be, what can I do now to make my continued existence in the next world go better? For a pharaoh, the answer would be obvious.

A pharaoh would need the trappings of wealth and power, because that is the only way to distinguish a pharaoh from anybody else after death. Even the humblest farmer has the same number of fingers and toes as Pharaoh. Only wealth and social status make the difference, and if you’re leaving this social world for another, you are leaving your social status behind.

Therefore, the grand pyramids and their tombs are necessary for preserving one’s social status in the coming realm. For a big dude like a pharaoh, social status must be preserved at all costs, because that’s all you have, all you are. That IS your personhood. If you expect to have any clout with the gods on the other side, you will need credentials. The funerary art and treasure are the perfect calling cards (overlooking the awkward fact that they will remain tangibly located in this world).

Building a pyramid tomb is not a denial of death and it’s not a quest for immortality, it is like pressing your good suit in preparation for a party.

On the other hand, if you are a farmer in this life, and you have no social status, you don’t need a fancy tomb. You have nothing to lose and nothing to prove.

Early Neandertal or Pleistocene graves might have had a different purpose. Those people probably just accepted the evidence of the senses: at some point a person stops moving and someone declares, “He daid!” (That’s how early people talked).

They might put a few flowers in the grave out of respect for the memory of the living, a gesture of remembrance, without any thought of transition into another world. If people had little self-consciousness, the idea of personal continuation would not come up, and the idea of immortality would not come up.

It was the intellectual achievement of the Egyptians (or their forebears), to conceive continuous personal self-identity, and its corollary, immortality.

Today, we have lost that pharaonic certainty. Scientific naturalism tells us death is the end, the total, absolute, permanent, irredeemable end of everything you are. Religion assures us there is an escape valve: only the body dies, not the soul. We are not sure who to believe. It was easier for the Egyptians. They knew.

So I think the curators of the Egyptian show at the PAM misunderstood the meaning of the Egyptian tombs. Billing the exhibit as a “quest for immortality,” they projected their own existential uncertainty onto the pharaohs.

Of course, since we don’t really know what the pharaohs were thinking, it is all a mystery.