Schizophrenia

When innate emotional needs – human givens – are not being met well,
people start to worry excessively and are then prone to becoming
depressed. Our observations of hundreds of depressed patients had
confirmed that excessive worry puts huge stress on the REM sleep
mechanism. (Stop them worrying and the depression lift.) This led us to
hypothesise that schizophrenia develops in those particularly imaginative,
highly sensitive people who become so stressed that the REM sleep
discharge mechanism cannot take the strain, and so their ability to
separate waking reality from the metaphorical reality of the dream world
(where the metaphors themselves seem totally real), becomes impaired. When
they wake up, they cannot properly switch out of the REM state and become
stuck in it.

Naturally their thinking is then predominantly driven from the right
hemisphere, the part of the brain most active in metaphorical pattern
matching and dreaming. Many of their bodily behaviours could be expected
to derive from those found in normal dreaming. In other words, the left
hemisphere’s role, which is normally to analyse and organise reality in a
rational way, and is predominantly in charge during wakefulness, has been
usurped. The delicate working partnership of the brain’s hemispheres has
shattered.

This, to our minds, provides a plausible way of explaining the wide
variety of psychotic symptoms. The phenomenon of ‘word salad’ – the
loosening of meaningful associations between words and phrases that
results in people talking in a stream of apparent nonsense – is just what
one might expect if the left hemisphere of the brain were to be out of
sync with the metaphorical mind of the right hemisphere, as the latter
would continue to generate associations without waiting for the left
hemisphere to check them out and articulate them.

Catatonia, where patients can stand, sit or lie motionless for long
periods in strange postures, oblivious to pain, is what the body also does
during REM state dreaming, when the anti-gravity muscles are paralysed.
Indeed, resistance to pain is often observed among schizophrenic patients
and is even more marked during severe episodes. This is easily understood
when we realise that, in dreaming also, cut off from all sensation, we
experience no physical pain. That, too, is a REM state phenomenon (and is
why hypnotised people can have major surgery painlessly without
anaesthetic, as we have discussed).

Hearing voices is entirely predictable from our theory too. Talking
is primarily a left hemisphere activity, whereas right hemisphere activity
is mainly concerned with processing pattern matching and tagging emotions
to those patterns to prompt action. We don’t talk when the right
hemisphere is dominant during dreaming in REM sleep, although talking
whilst in slow-wave sleep is common (but the content rarely seems to make
sense to the awake mind.) However, during a psychotic episode, if the
person were in the REM state awake, there would still be some logical
activity and thinking taking place in the left hemisphere.

But, because the REM state is not anticipating any input from the
left hemisphere, it has to interpret those thoughts metaphorically and
comes up with the image of alien voices, which can seem to be commenting
on the person’s every move, or haranguing them or giving ‘instructions’.
(It might be expected that such thoughts would often be critical because
the left hemisphere would, to some degree, still be able to analyse what
was going on and ‘logically’ know that the behaviour is not normal.) This
could further be interpreted metaphorically by the right hemisphere as
being spied upon, or being persecuted, or that aliens are inside their
head or that they are being followed everywhere by strange ‘rays’ that
know everything they are doing. (Neurophysiological evidence confirms
that, when schizophrenic people are hearing voices, the speech centres in
the left neocortex are activated. And other researchers have observed and
filmed REM activity when patients hear voices.)

The visual hallucinations or delusions associated with psychosis are
also totally characteristic of the dream state, the function of which is
to generate such hallucinatory realities. Neuroscientists have shown the
same neuronal pathways are activated in psychotic episodes. Whilst
dreaming we all believe completely in the reality of our dreams, just as
the schizophrenic person believes in their reality.

It has long been suggested that there is a connection between
creativity and mental illness. Certainly, people prone to schizophrenia
tend to come from creative families. And even if they themselves are not
productively creative, then high rates of creativity are found among their
siblings and other relatives.

Furthermore, creative people tend to be more sensitive to the
emotional environment around them and are less robust in withstanding
hostility, intolerance or criticism. Indeed, the higher the level of
emotional criticism within the family context, the higher the rate of
schizophrenic and depressive relapses. When people go into a psychotic REM
trance due to emotional arousal any criticism may well be acting like a
post-hypnotic suggestion, compounding the condition.

When treatment for people suffering psychotic breakdowns concentrates
on getting the patient's innate emotional needs met, a much higher rate of
recovery is seen.

Ivan Tyrrell and Joe Griffin

Competing interests:
None declared