‘Sin your way to heaven and get slaughtered: A byzantine general problem of the self’ (part twenty-three)
Having presented two voice-works using at least some of Freud’s techniques,
I think it is important to then look at some distinctions between ‘voice-hearing’
and dreams. In a paper looking at the phenomenology of voice hearing Rojcewicz
Jr. and Rojcewicz (Journal of Phenomenological Psychology, 28, No.1, 1997) they
distinguish between voice hearing and dreams. Starting with Jean-Paul Sartre’s
distinction between hypnagogic images and dreams, they note that hallucinations
are “an isolated experience, shut off from other images, whilst the dream is ‘a
world.’ Despite any seeming nonsensicality, the dream images appear in a rich
spatial world. The dream action contains references to a temporal before and
after. The dream so carries us into a world that every dream appears to us as a
story… The hallucination is limited, fragmented, impoverished, more furtive
than a dream. Only a few words occur, not a full narrative or an introduction to
a world, however imaginary. The image in a dream may have multiple facets and
occur In relation to many images. The auditory hallucination is isolated, has
few if any spatial connections, and is experienced as detachment from other
sensory modalities… auditory hallucinations lack not only the fullness of
normal perception but also the richness, nuances, and multiple facets of the
dream.†(p.18). They consider this distinction to be a necessary component of
why auditory hallucinations appear as ‘voices’. Before we follow Rojcewicz, Jr.
and Rojcewicz’s argument about voices, it might be worth familiarising
ourselves with their view of other distinctive aspects of auditory
hallucinations. Firstly, they note that they contrast with everyday sensory
experiences, for a start the duration of hallucinations is quite limited, “what
the patient usually hears is not a sustained argument or a full discussion but
a only few words; the patient experiences fragments or sentences, not pages or
even paragraphs… as contrasted to everyday sensory experience, hallucinations
do not display multiple facets; they are disjointed, fragmented. Normally, an
object is perceived from several different perspectives and in multiple facets.
In auditory hallucinations, these varied perspectives of normal perception are
absent. Instead of a whole object being perceived a voice is heard. This voice,
disembodied, is heard in isolation from other sensory phenomena. In normal experience,
a person is perceived; the person is seen, experienced, through multiple sense
as well as heard. The direct, immediate words of patients are instructive here.
These patients do not hear persons, they hear voices. Although the
hallucinations are in harmony with the totality of the patient’s psychological
life, the hallucinated voice is in isolation: in isolation from the other
senses and from the full experience of the sensation of hearing. There is no
interplay or variation with other sounds and phenomena.†(p. 17). They quote A.
Kraus, stating, “a missing worldly background of the ‘perceived,’ and therefore
a missing continuity in space and time, as well as monomodality of perception,
all lead to the fact that the hallucinatory perceived world… is not perceived
from varied perspectives. As Husserl… has shown, it is precisely the endless
shadings of a perceived perspective, possible in normal perception, that
provide the surest conviction of its reality.†(p.17-18). They follow up with a
statement by Merleau-Ponty saying “If the hallucination does not occur in the
stable and intersubjective world, it is because it lacks the fullness, the internal
articulation that makes a true thing repose ‘in-itself,’ act and exist by
itself. The hallucinatory thing is not, like a true thing, a being with depth,
which contracts within itself a density of duration; and a hallucination is
not, like perception, my concrete purchase on time in a living present. It glides
over time, just as it glides over the world.†(p.18).
Rojcewicz Jr. and Rojcewicz also contrast auditory hallucinations to other
symptoms, these include what are often classified as positive symptoms such as visual
hallucinations or hallucinations of smell and touch, as well as delusions, paranoia,
ideas of reference and bizarre behaviours, and negative symptoms such as
emotional withdrawal and inappropriateness of affect. As observed in both the
DSM and ISD classification systems auditory hallucinations without other
pathological manifestations are considered more benign. They argue that “the
significance of hallucinations in pathological conditions is that they are
symptomatic of a pathological way of relating to the world, an abnormal way of
being†(p.16). They point out that Bleuler saw hallucinations as an accessory
symptom of schizophrenia and not a fundamental aspect of the condition. Freud
in his study of Schreber saw hallucinations as a secondary symptom, “an attempt
at some sort of restitution following the primary symptom of severe emotional
withdrawal. The patient initially withdraws his emotional attachment from
person and things in the world; this is the primary pathology, the most
fundamental symptom. Subsequently in many cases, the patient develops hallucinations
or delusions. These symptoms attempt to bring back, to reconstitute in an
idiosyncratic way, the emotional attachment to persons and things in the world.â€
(p.16). Rojcewicz Jr., and Rojcewicz argue that these manifestations of
emotional withdrawal can become self-justifying; the phrase ‘J. Edgar Hoover,
proving the FBI are after the voice hearer, “derogatory hallucinations, which
may occur following some blow to self-esteem, help to reinforce a distorted
view of low self-worth… command hallucinations precede acts of violent
acting-out.†(p.16). However, they also point out that the negative symptoms
are of equal importance, “a hallucinating patient may have little social interaction,
speak to few other persons, and spend his time in profound emotional withdrawal.
At times the only interaction seems to be talking back to the hallucinations.â€
(p.17).
To understand this phenomenology of voices, Rojcewicz Jr., and Rojcewicz create
a typology of the phenomena associated with voice hearing. After acknowledging
benign types of auditory hallucination such as hearing a loved one who recently
died, or a solo round the world sailor hearing voices after long time at sea,
which we won’t explore further here, they point out that whilst other forms of voice
hearing are possible such as whistles, machinery noises, animal noises, even
musical sounds, the sound of a voice is the most common. People may attribute
the source to all kinds such as God or angels, spirits of the dead, telepathy,
AI or aliens, the voice still takes the form of human speech. However, in
addition to the type of sound, hallucinations have significant characteristics
that follow certain parameters: “extent (frequency, duration), location, degree
of reality, sensory intensity, constancy, overt behaviour, control time, cause,
experience shared, affect, and content†(p. 12). Rojcewicz Jr. and Rojcewicz
investigated each in turn.
1. Type of Speech. As observed earlier it is rare to get a ‘whole sermon of
speech’, rather “usually each episode of a hallucinated voice is usually
relatively short-lived, but there may be many episodes in the course of one
day. Nevertheless, there is often a very complex structure to some auditory hallucinations.
The patient may here several distinct voices, the voices may engage in dialogue
or debate with the patient or with each other, the voices may offer a running
commentary on the patient’s activities, and so forth. At times the auditory
hallucinations are associated with visual or other hallucinations, with
paranoid ideas of reference or with delusions.†(p.13.)
2. Constancy. “In this context ‘constancy’ refers to a global measure of
overall variability, not to minor changes on a given hallucination. While some
patients have rapidly changing hallucinations in reference to content or to
intensity, other patients may have the same hallucination at the same level of
intensity over and over.†(p.13).
3. Duration. Rojcewicz Jr. and Rojcewicz quote Minkowski who points out that “hallucinations
tend to be more or less ephemeral; to come into existence and then vanish
suddenly; to succeed one another rapidly, without crystallizing into something
stable or unchangeable. In general, each episode of a hallucination is
relatively short-lived.†(p.13). As noted before Bleuler observed that “the usual
occurrence is in short sentences or abrupt words, nor paragraphs or long
speeches. These occur intermittently, even if in rapid sequence; it is rare
that the voices are constant or continuous.†(p.13).
4. Content. According to Rojcewicz Jr. and Rojcewicz, “the usual emotional
content, especially in the early stages of schizophrenia, is critical,
threatening, or otherwise negative. As the illness progresses, the
hallucinations can become less negative… Often the content ids of the patient’s
own thoughts, acknowledged by the patient as such, but now audible.†(p.13-14).
They continue “the precise, word-by-word verbal content has been studied in a
few patients… over a period of time, the words were found to be non-random. Semantically
related themes tend to recur, such as the same adjective or verb in different
contexts every day, or the recurrence of words all related to food.†(p.14).
5. Identification. Rojcewicz Jr. and Rojcewicz state
that “in a pseudo-hallucination [a voice considered to be more internal rather
than external], the patient has some insight into the fact that the
hallucination is not real or is created by the self (“my mind is playing tricks
with meâ€), while in a true hallucination the experience is attributed to a real
outside the self. Many individuals with schizophrenia retain a high level of
conviction in the reality for this external source of their voices… At times,
the hallucination is specifically identified with certainty (as the voice of
God, of an FBI agent, etc.), at times it is identified in a vague way (as the
voice of some unknown enemy), at a times it is not identified at all. Patients
may identify the voices as coming from parts of their body, from their clothing,
from material surroundings, or from persons, agents, or technical equipment
that cannot be seen.†(p.14).
6. Intelligibility. Rojcewicz Jr. and Rojcewicz point out that “the voices can
be mumbling, can be clear and distinct, or can be a changing combination of
these features… the voices can be so loudness of the voices can vary, more or
less independently of the other features listed… The voices can be so loud that
other sounds are drowned out, or they can barely be perceived at all. Several
voices may talk at once, so the intelligibility is diminished, or the words
themselves may be fragments or neologisms without an overall sentence structure.â€
(p.14).
7. Spatial localisation. “The voices may occupy an indeterminate position
without special localisation, or they may be more precisely situated. Patients
may localise the source to a considerable distance away, to a relatively far
but still within ordinary sensory range, to a distance relatively close to their
body (sometimes at the same constant distance), or to a space inside the body.
The voices may move between one location and another; in individual patients
the change in location may have some considerable significance†(p.15) It has
been noted that closer voices are sometimes more comforting and supportive.
Other patients are able to describe different spatial localisations that may,
say, be divided as ‘left’ good and ‘right’ bad.
8. Control. “Patients have greater or lesser degrees of control over the occurrence
and effects of their hallucinations… The most extreme issue of control consists
in the obeying of command hallucinations… An individual patient may be able to
resist commands at one time, yet, act out on them at another time. Some
patients continue to have command hallucinations without ever obeying them.â€
(p.15).
With regards my own voices I have had at least a few similar experiences from each
parameter in the list. But with regards the examples from the last two posts
then it might be a good idea to explore some. The first example was clearly in
line with the argument around duration, the second was slightly different in
that a narrative arc was formed. It is here that Rojcewicz Jr. and Rojcewicz’s
distinction between dreams and auditory hallucinations may seem to differ.
There are different arguments for this, one is that the voices occur in tandem
with other symptoms. But is it right to call it purely delusional or paranoid?
One way to look at this is the point made about content, in that semantically
they are non-random and there is a recurrence of themes, and words, or signifiers.
I use the term signifier here rather than word, as the term indicates that the ‘words’
can change their relation to signified or even referent, I would argue in much
the same way that Freud interprets dreams. This though still leaves the
question of the difference between manifest and latent content and whether,
there are what are called ‘wish fulfilments’ (although this can, although not
always necessarily, be related to past traumas, something that is acknowledged
by Freud but has been further explored by people such as Romme and Escher) that
cause a latent content of the duration of the ‘illness’. The relation to
emotional withdrawal is related to an idea in phenomenology that Rojcewicz Jr.
and Rojcewicz call the intentional arc, and I will be coming back to this, and
then looking at an issue neglected by Rojcewicz Jr. and Rojcewicz which is what
leads to the slackening of the intentional arc, where I will be returning to
Bateson’s cybernetics. Before that in the next post I will look at a similar typology
of features identified by Lisa Blackman and will be briefly acknowledging her
work on what I have written about in this post, which she calls the ‘problem of
hallucination’ and its place in the history of psychiatry. Before returning to
the problem of the ‘slackening of the intentional arc’. And then I will return to
Freud’s dream interpretations and then back to Deleuze and Gauttari on machines.