Pageii

AlsobyJ.AllanHobson
TheDreamingBrainSleep

Pageiii

DreamingasDelirium
HowtheBrainGoesOutofItsMind
J.AllanHobson,M.D.
ABradfordBook
TheMITPress
Cambridge,Massachusetts
London,England

Pageiv

FirstMITPressedition,1999
1994byJ.AllanHobson.OriginallypublishedbyLittle,Brownin1994asTheChemistryofConsciousStates:HowtheBrainChangesItsMind.
Allrightsreserved.Nopartofthisbookmaybereproducedinanyformbyanyelectronicormechanicalmeans(includingphotocopying,recording,orinformation
storageandretrieval)withoutpermissioninwritingfromthepublisher.
LibraryofCongressCataloginginPublicationData
Hobson,J.Allan,1933
[Chemistryofconsciousstates]
Dreamingasdelirium:howthebraingoesoutofitsmind/J.Allan
Hobson.1stMITPressed.
p.cm.
"ABradfordBook."
Originallypublished:Thechemistryofconsciousstates.Boston:Little,
Brown,c1994.
Includesindex.
ISBN0262581795(pbk.:alk.paper)
1.Dreams.2.Consciousness.3.Neuropsychology.I.Title.
QP426.H6291999612.82dc219925728
CIP
ThisbookwasprintedandboundintheUnitedStatesofAmerica.

Pagev

Toallthosepatients,students,andcolleagues
whohavesogreatlyenrichedmyscientificlife
bybecomingmycollaboratorsinbrainmind
research

Pagevii
TheBrainiswiderthantheSky
Forputthemsidebyside
Theonetheotherwillcontain
WitheaseandYoubeside
TheBrainisdeeperthanthesea
ForholdthemBluetoBlue
Theonetheotherwillabsorb
AsSpongesBucketsdo
TheBrainisjusttheweightofGod
ForHeftthemPoundforPound
Andtheywilldifferiftheydo
AsSyllablefromSound
EmilyDickinson

Pageix

CONTENTS
xi

PrefacetotheMITPressedition

xiii

Acknowledgments
PartOne:DefiningtheBrainMind

1
TheBrainIsInsane

2
BrainMindSchizophrenia

18

3
Delia'sDreamDelirium

31

4
TheCauseofDelia'sDelirium

46

5
TravelinginBrainMindSpace

64

PartTwo:AnalyzingtheBrainMind

6
LostandFound:OrientationandDisorientation

81

7
TheStoryofOurLives:MemoryandConfabulation

102

8
SeeingIsBelieving:PerceptionandHallucination

126

9
TheHeartoftheBrainMind:EmotionandInstinct

147

10
Stop,Look,andListen:AttentionandDistraction

165

11
UpsandDowns:Energy,Mood,andHealth

182

12
WhatIsConsciousness?WhatIstheMind?

202

PartThree:ChangingtheBrainMind

13
HowtheBrainMindHealsItself

223

14
ChangingBrainMindStatestoImproveYourHealth

242

15
TheLastResort:UsingDrugstoChangeYourState

262

Index

287

Pagexi

PREFACETOTHEMITPRESSEDITION
Theideathatdreamingisanormalkindofmadnessisnotnew.Throughtheagesmanyphilosophersandpoetshavecelebratedakinshipbetweenournocturnal
visionsandthehallucinationsanddelusionsthatdistortthewakingconsciousnessofthefortunatelymuchsmallernumberofuswhobecomepsychoticbyday.
Whatisnewisthespecificationofthehypothesisthatdreamingisformallymoresimilartodeliriumthantoanyotherkindofpsychosis.Thisnovelformulationhas
emergedonlyrecentlyfromthecasestudyofdreamreports,usingmeasuringtoolsthatquantifythecategoriesofthementalstatusexambywhichneurologistsand
psychiatristsclassifyanddiagnosesuchconsciousstatesasdeliriumintheirpatients.
GiventheconvictionofHelmholtz,Wundt,andmanyothernineteenthcenturyscientiststhatdreamingreflectedachangeinbrainphysiology,itissurprisingthatthe
DreamingasDeliriumhypothesiswasneverclearlyenunciatedbeforenow.Afterall,itisthoseorganicchangesthatupsetthephysiologicalbalanceofthebrainthat
causesthedeliriumsyndromeofvisualhallucinations,disorientation,recentmemoryloss,andconfabulation.Allfourof

Pagexii

thesementalstatefeaturesclearlycharacterizedreaming.Andallfourofthemhavealwayscharacterizeddreaming.
SowhydidittakeussolongCorecognizethatthosedreamfeaturesprobablywerecausedbyorganicchangesinthebrain?
Therearetwoanswerstothisquestion,andbothrevealthemselvesinthepivotalworkofSigmundFreud.Theyarethepaucityofdataandthesuperabundanceof
speculation.
Freud,adirectintellectualdescendantofWundtandHelmholtz,didhisbesttospecifytheneuronalbasisofdreaming,neurosis,andpsychosisinhisProjectfora
ScientificPsychology(1895).Lackingthenecessarytheoreticalneurobiologicalbuildingblocks,Freudrecognizedhisfailureandturnedhisbottomupconceptson
theirhead.Thenheelaboratedhisnowfamouspsychoanalyticdreamtheory.
Soseductivewas(andstillis)TheInterpretationofDreamsandsoemphaticwasFreud'sdenialofneurologyasrelevanttohistheorythatmosttwentiethcentury
thinkers(myselfincluded)werelonginthethrallofoneofthemostextravagantversionsofmindbodydualismthathaseverbeenpromulgated.
Evenwhenmodernsleepresearchbeganinearnest(afterAserinskyandKleitman'sdiscoveryofREMsleepanditsassociationwithdreamingin1953),thedominant
integrativeparadigmwasanattempttofitpsychoanalyticnotionsdownuponthenascentphysiology.Thismisguidedandillfatedeffortcharacterizedboththeearly
psychophysiologyera(19531975)andthemorerecentcognitivepsychologyera(19751999)ofsleepanddreamresearch.
AlmostnoonenoticedthatthetoolsneededbyFreudforhisintegrativeprojectwereslowlybutsurelybeingsuppliedbycellularandmolecularneuroscienceofthe
wakingandsleepingbrainstem.By1975,itwaspossibletoproposeaspecificneurobiologicalmodelofREMsleepcontrolandby1977toconstructabottomup
dreamtheoryuponitsfoundation.AsIhaverecountedinTheDreamingBrain(1988)thisparadigmshiftcaughtevenusitsauthorsbysurprise.
Thenandonlythendidwehavethewittobegintoanalyzedreamsfromtheformalmentalstatusperspective.Thisapproach,whichisdeterminedlydescriptive,
eschewsglobalinterpretationof

Pagexiii

particulardreamsintheinterestofmappingsuchgenericanduniversaldreamfeaturesasvisualhallucinosis,disorientation,andrecentmemorylossdownontoits
neurobiologicalsubstrate,thedifferentialplayofneuromodulatorysystemsthroughoutthebrainthatdistinguishREMsleepfromwaking.
Thisbookrecountsourefforttobuildthisnewapproachtothepsychologyofdreamingandtellshowitcametosuggestusingtheresultingdreamneuropsychologyas
aspringboardforstudyingotherconsciousstates.Theformalapproachisameansofintegratingourunderstandingofnormalprocesseslikedreamingwiththe
psychosesof(socalled)mentalillnesslikedelirium.
SincethisbookwasfirstpublishedbyLittleBrownin1994asTheChemistryofConsciousStates,theintegrativeeffortdescribedherehasbeengivenanenormous
boostbytheapplicationofbrainimagingtothestudyofREMsleepdreaming.Thesenewmethodsprovidethefirstdirectapproachtotheactivationanddeactivation
ofmeasuringthespecifichumanbrainregionsinREMsleep.
Complementingtheexcitingimagingstudies,therehasatlonglastappearedastudyofdreamneuropsychologythatcorrelatespatients'reportsoftheloss,changein
character,orintensificationofdreamingfollowingstrokesandseizures.Thebrainareaswhosedestructionleadstoalossofdreamingarethesameasthosethatthe
PETstudiesshowtobeselectivelyactivatedinREM.Ofcourse,thislastapproachcouldhavebeentakenbyFreudhimself(whowasaneurologistandanexperton
aphasia).Butitcertainlyhelpstobeabletoquantifythelocationandextentofthebrainlesionsquantifiedinvivo.
Theneteffectofallthisprogressistovindicatetheconcomitantstudyofbrainstatesandtheircorrelatedstatesofconsciousness,andtoshowthatsubjective
experienceisbothscientificallyessentialandscientificallytractableinthisendeavor.
WhateverthefateoftheparticulartheoriesthatIadvancehere,itismyfondhopethattheverywelcomerepublicationofthisbookbytheMITPresswillencourage
studentsofmindbrainunitytopursuethemanyimportantimplicationsofthisstoryforscience,forphilosophy,andforthehumanitiesingeneral.Iamgratefulto
MichaelRutterandJeremyGraingeroftheMITPressfortheirenthusiasmandeffectiveness.

Pagexiv

AndIlookforwardtolearningmorefromthoselayandprofessionalreaderswhosharemyinterestinselfobservationandtakethetroubletorecordthemany
fascinatingvicissitudesofconsciousnessthatwestillcannotexplain.Thankstoallofyouwhorespondedtomyinitialappealformorebroadbasedparticipationin
whatmustbethemostexcitingandfarreachingscientificadventureofthemall,theanalysisoftheformandoriginsofhumanconsciousness.Pleasetellmemore!

Pagexv

ACKNOWLEDGMENTS
TheChemistryofConsciousStatesbuildsuponthescienceoutlinedinTheDreamingBrainandSleepbutisdifferentfromthosebooksinthreemajorrespects.
Thefirstisitsemphasisuponourrecentandsystematicresearchondreaming.Thesecondisitsuseofexperientialdetailsfrommyownlifeandthelivesofmypatients.
Andthethirdisitsgreatlyenlargedscopethatnowincludesspeculationsaboutconsciousnessitself.
Exceptforcoworkersandcolleaguesoftheauthor,pseudonymshavebeenusedtoprotecttheprivacyofcertainindividuals,and,insomecases,compositeshave
beendrawnfromseveralindividualsforbrevityandclarity.
ThenewresearchondreamingwascarriedoutbyateamofcoworkersmostofwhomwerestudentsinthecourseWaking,SleepingandDreamingthatIhavetaught
intheHarvardExtensionSchoolsince1989.Thisteam,whichhasmetastheWednesdayDreamSeminarforthepastfiveyears,includesDavidKahn,JaneMerritt,
EdwardPaceSchott,JeffSutton,RichieDavidson,JodyResnick,CindyRittenhouse,andBobStickgold.Ourmostgloriousjointachievementhasbeenthe
publicationofeightarticleson

Pagexvi

dreamingthatfilledanentireissueofthejournalConsciousnessandCognitionearlierthisyear.
ForoverthirtyyearsIhavebeen.privilegedtoworkattheMassachusettsMentalHealthCenter,wherethepersonalexperiencesofpatientswereourmosthighly
valueddata.Fromthetimeofmyresidencytraininginpsychiatrythroughmyquartercenturyasclinicianandscientist,Ihavebeenabletoelicitandattendto
descriptionsofconsciousstatesinalltheirgloriousvarietyanddetailfromaveritablelegionofinformants.Icannotnametheindividualpatientswhohelpedmegetthe
senseoftheneuropathologyofeverydaylifethatItrytoconveyinthisbook.Manyofthemwillrecognizetheircontributions,andIhopeallofthemwillacceptmy
respectfulthanks.
ThecouragetotacklethedauntinglybroadanddeepsubjectofconsciousnessgrewoutofmyparticipationintheMindBodyNetworkoftheJohnD.andCatherine
T.MacArthurFoundation.Thisnetwork(whichwasthebrainchildofJonasSalk,MurrayGillMann,PeterNathan,andDenisPrager)hasbeenoneofthemost
stimulatingintellectualexperiencesofmylife.FromsuchbrightandcreativethinkersasKenHugdahl,DavidSpiegel,AnnHarrington,EveVanCauter,PhilGold,
MardiHorowitz,StevenKosslyn,andBobRose,Ihavelearnedmanyofthefactsandconceptsthatarethefabricofthemiddleofthebook.Theresourcesofthe
foundationhavealsomateriallyaidedmyresearchbycomplementingmysupportfromtheNIMHinanencouragingway.
ConsciousStateshasbeeninthemakingsince1991.JillKneerimandIkeWilliamsofthePalmerandDodgeAgencyhelpedmegettheprojectrollingandoffered
theirwisecounselwhenroadblocksappeared.IwrotethefirstdraftwhileservingasavisitingprofessorintheNeurologyDepartmentoftheUniversityofMessinain
Sicily.MyhostsRaouldiPerriandLiaSylvestrihelpedmeinthreeways:theymadesuremyformalacademicresponsibilitieswerelighttheylentmetheirbeachfront
condominiumnearTaorminaandtheyofferedmetheirgraciousgoodcompanyonmanymemorablesocialoccasions.Learningtocookrisottowasanunanticipated
fringebenefitofmySiciliansojourn.
Translatingmyabstruseandjargonfilledprosewasthejoint

Pagexvii

effortofJordanPavlinandBillPhillips,myeditorsatLittle,Brown,andofMarkFischetti,ajournalistwhoknowshowtoturnthedensestsciencewritingintolucid
narrative.Anyopacitythatstillcloudsthisbook'smessagesismyresponsibility,nottheirs.
Inpreparingthemanuscript,IhadtheassistanceofJaneMerritt,whotypedthefirstdraftfrommy450pagelonghandjournal,andDollyAbbott,whoorganizedthe
manyrevisionsthathavesincebeennecessary.
NowIcanonlyhopethatyouwillbeanactiveandcriticalreader.Pleasesendmeanyquestions,ideas,oraccountsofyourownconsciousstatesthatthisbookmay
inspire.
ALLANHOBSON
BOSTON,MASSACHUSETTS

Page1

PARTONE
DEFININGTHEBRAINMIND

Page3

Chapter1
TheBrainIsInsane
Imuchpreferoldhotelstomodernones,andonelookaroundthecharminglobbyIwasnowstandinginmademeIhappy.MyNewOrleanshosthadheededmy
requesttobebilletedsimplyduringtheimportantscientificmeetingIwastoattendhere.ButasIsteppedintoanadjoiningroom,IsuddenlyrealizedthatIhad
stumbleduponacrimeinprogress.Theeasycomfortofmyexploratoryprowlturnedtodreadpanic.Myheartpoundedinmychest,andmystomachchurnedinfear.
Myfirstimpulsewastorunforit,butsincethesecurityguardacrosstheroomwasaiminghisshotguninmydirection,Ifroze.ThenIwatchedinfearfulfascinationas
heslowlyturnedhisweaponupwardtowardtheceiling,zeroinginonunseenintruders.Iwasrelievedtorealizethatatleasttheguardhadnotmistakenmeforoneof
them.Beckoningmenottomoveandtokeepsilent,theguardadvancedtothecenteroftheroomandtrainedhisgazebackontheceilingabovethedoorIhadjust
entered.Whatishenoticing?Iwonderedasmyeyesandearsatfirstdetectednoevidenceofatarget.
Thenitallbecamequiteclear.TheweaponIhadmistakenforashotgunwasactuallyaningeniouselectronicdetectiondevice

Page4

thatwaspickingupandamplifyingvoicesemanatingfromtheroomabove.Astheguardswepthisinvisibleelectronicbeambackandforthalongtheceiling,he
focusedontwoclearlyaudiblevoicesaboutsixfeetapart.Eachvoicewasthatofaman,speakingasthoughhehadnoideahecouldbeoverheardanddiscussing
detailsofthehotelbreakinheandhisaccomplicehadengineered.Althoughthevoiceswereeasilyunderstood,andalthoughthelanguagespecificallydescribedthe
criminals'strategy,Icouldnotmakeanysenseofwhatwassaid.Itwasalmostasifthemeaningofthesentences,iftherewasany,dissolvedimmediatelyupontheir
utterance.
NomatterthatIcan'tcomprehendtheirdialogue,Ithought,thekeyistolocalizetheculpritssothattheycanbeapprehended.Toaccomplishthisgoal,theguard
mountedastepladderanddrewtwocirclesontheceilingwithalargefelttippedmarker.That'sexactlywheretheyare,Irealized,asifthecircleswouldfacilitatethe
thieves'arrestbypolice,whoIimaginedmustbeclosinginonthemintheroomabove.
Withinwhatmusthavebeenconsiderablylessthanasecond,thisgrippingmysterythrillergavewaytoquiteadifferentscenario:thegraydawnofafoggy,rainy
MondaymorninginOgunquit,Maine,thetailendofalongandrestfulFourthofJulyweekend.IchuckledasIrolledoverbeneathmyblanketbecausetheplotofmy
littledreamhadbeensobeguilingandbecause,onceagain,Ihadbeensocompletelyfooledbyit.
Youneedquiteagoodsenseofhumortodealwiththerealityofdreaming,Ithought,becauseitisclearthatyouareascrazyasaloonwhenyouareinthegripsofa
dream.Thereisnomadnessmoredeliriousthandreaming,Irealizedonceagainfortheumpteenthtime.
OnlysecondsbeforeIawakenedtothepitterpatteroftheraindropsoutsidemywindow,Ihadbeencompletelyconvincedoftherealityofawildworldofimpossibly
fluidvisualimagery(inwhichagunbecameavoicedetector),ofimpossiblykeenauditoryanalysis(inwhichvoiceswereheardbutspeechwasnotrecognized),of
inconsistentanduncannylogic(inwhichunseenintruderswereremotelylocalizedandencircled),andofparalyticanxiety(inwhichnomatterhowscaredIwasIcould
notrun).Ihavehadeven

Page5

moreimpossibledreams,buteventhenIusuallyhaven'tcaughtontothefactthatIwasdreaming.
Whatisthedifferencebetweenmydreamsandmadness?Whatisthedifferencebetweenmydreamexperienceandthewakingexperienceofsomeonewhois
psychotic,demented,orjustplaincrazy?Intermsofthenatureoftheexperience,thereisnone.InmyNewOrleansdreamIhallucinated:Isawandheardthingsthat
weren'tinmybedroom.Iwasdeluded:Ibelievedthatthedreamactionswererealdespitegrossinternalinconsistencies.Iwasdisoriented:IbelievedthatIwasinan
oldhotelinNewOrleanswhenIwasactuallyinahouseinOgunquit.Iwasillogical:Ibelievedthatdrawingcirclesonaceilingwouldhelppolicelocalizeindividualsin
aroomabove.Iwasemotionallyseized:Iwassodominatedbymysuddenfearthatmygutswereconvulsedandmysensesdriventoinsanecontrivance.AndIwas
confabulating:Iwastellingmyselfastoryinordertointegratemyhallucinations,mydelusions,myemotions,andmyderangedanalyticalpowers.
OnceIwokeup,Iwasnotworriedaboutmytemporaryinsanity.MydreamwasnomoreludicrousthananyotherdreamIhavehad.AndI'llbetyou'vehadsome
yourselfthatweremuchmorebizarre.Wealltakecomfortinourconvictionthatournightlymadnessisanimportantfunctionofthatincrediblehandfulofjellythatlies
behindoureyesandbetweenourears.Iamtalking,ofcourse,aboutourbrains.
Ihavebeenthinkingaboutmybrainforsometimenow,andI'mbeginningtorealizesomethingthatseemstometobequitestartlingandimportant.AndthatisthatI
cannolongermakeanymeaningfuldistinctionbetweenthestateofmybrainandthestateofmymind.EspeciallywhenIconsiderdreaming.
DreamingasDelirium
AsIlayinmyOgunquitbeddreamingaboutthedetectionofcriminalsinahotelinNewOrleans,IwassoconvincedbytherealityofmysubjectiveexperiencethatI
believedmyselftobeawake.Thus,Iwasinnopositiontodeduceanythingvalidaboutthestateofmyconsciousness.

Page6

Withinaninstant,however,mybrainstatechangedfromdreamingtowaking.IimmediatelyknewthatitwasMonday,July5,1992(notOctober10,1991,thetime
ofthedream)andthatIwasinOgunquit,Maine,notNewOrleans,Louisiana.Awake,Iwasoriented,notdisoriented.Awake,myplanforthedaywaslogicaland
clear,notconfusedandcloudy.Andyetthedreamstateaffectedmywakingstate.Mymemoryofthedream,althoughfragmented,wasvividanddetailedafterIhad
awakened,andIcanrecallitjustasclearlynow,sometwentyfourhourslater,asclearlyasIcanallmysubsequentactionsofyesterday,whenIdrovewithmyson
fromOgunquittomyfarmhousehereinthehillsofnorthernVermont.Thisisodd,becausealltheotherdreamsIhadhadthatSundaynight,andtheninetythousand
othersIhavehadduringthenights'sleepofmylife,areutterlylosttoamassiveandeverlastingamnesia.
Itseemsindubitablethatthesharpanddramaticchangeinmymentalstatewascausedbyanequallysharpanddramaticchangeinmybrainstate,fromsleepto
awake.Itisthisperfectmatchofbrainstatetomindstatethatgivesmethecouragetoproposethatitisanerrortousetwodifferentsetsofwords,concepts,and
feelingswhenconsideringourbrains(ontheonehand)andourminds(ontheother).Ibelievethatthebrainandthemindareinextricablybound.Thereisnodifference
betweenthephysicalbraininmyskullandtheallegedlyetherealmindthatfloatsaboutmeinsomefifthdimensionnoneofuscanobserve.Thebrainandmind
constituteaninseparableunity.
MyconvictionthatthebrainandmindareonespringsfromtherecognitionthatthenatureofeachstateofconsciousnessthatIexperiencesubjectivelyisdetermined
bythestateofmybrain.Idreambecausesomethingspecificishappeningamongtheneuronsinmybrain.Iwakeupbecausethatactivitysuddenlychangesagainina
specificmanner.ThereforeIproposethatwecallthisunitythebrainmindandthatwerefertoitsmajormodesofoperationlikedreamingandwakingasbrain
mindstates.
Althoughthisideamayseemlogicalandharmlessenough,itisnolessthanheresytobothscienceandthehumanities.Manyscientistsdescribethebrainasabiological
centralprocessoranddeny

Page7

theexistenceofmind.Andmanyhumanistsdescribethemindassomegloriousentityabeinguntoitself,aselfawarespiritthattranscendsanyphysical
embodiment.Thusweareportrayedasmindlessbrainsorbrainlessminds,andneverthetwainshallmeet.Thebrainrunsthebodyitenablesustosee,towalk,to
digestourfood.Themindrunsourthoughtsandpersonalitiesitenablesustothink,tofeel,tojudgeoursurroundingsandthepeopleinthem.
ButIhavecometobelievethatthebrainandthemindarenottwoentitieslinkedinsomeluckycosmicway.Theyareoneentity.Andthenormalmodesofexperience
thatmakeupourlives,likewakinganddreaming,andthoseabnormalmodessufferedbysomeofus,likeschizophreniaandtheDTs,aresimplydifferentstatesofthe
brainmind,whetherhealthyornot.
ThishypothesisisnotsomethingIhavepulledfromthinair.Trainedinbothneurology(the''braincamp")andpsychiatry(the"mindcamp"),Ihavestudiedpeoplefor
morethanthirtyyearswithadualinsight.Recentyearshavebroughtgreatadvancesinbothfields,thankstonewdiagnostictechnologysuchasmagneticresonance
imaging(MRI),thegatheringofempiricaldataonwhatgoesoninourheadswhenwesleepanddream,andmedicaldiscoveriesaboutsuchdiseasesasAlzheimer's.
Thenewideascomingfromtheseadvancesareallconvergingtoonecommonunderstanding:thatthereisaunifiedbrainmind.
Icallthisnewwayoflookingatthingsthebrainmindparadigm.Iusethehyphenatedterm"brainmind"todenoteunity.AndIusetheword"paradigm"todenotea
newandexplicitmodelofthatunity.AsThomasKuhnhaspointedout,aparadigmshiftismorethananincrementalchangeinthestatusofascientifictheoryitisa
revolutionarychangeinourwayofseeingandunderstandingourworldand,inthiscase,itisarevolutionarywayofunderstandingourselves.
InPartOne,Iintendtolaythistheoryoutforyouindetail.Wheredoesitcomefrom?Whyisitsocompelling?Whyisitsoexciting?Andsoshocking?WhydoIsay
thatthereisnotsimplyananalogybetween,say,dreamingandpsychosis,butthatdreamingandpsychosisarethesamekindsofthingssimilarvariantsofbrain
mindstate?Toyou,a"normal"person,adreamisregular

Page8

behavior.Toapsychotic,anepisodeofhallucinationisjustasroutine.Thenewbrainmindtheoryisnotcomplete,butitisbeingfinetunedeverydayinlabsand
hospitalswherenormalandabnormalpeoplegotobestudiedandcured.
Thisbookisnotaboutthestrangeexperiencesofafewpeople.Itisaboutthestrangenessoftheexperienceofallpeople,soitisabookaboutyou.AndwhileIdo
notintendtotakeawayanyreverentsenseyoumayhaveaboutyourowndreams,oryourspirit,oryoursoul,Idointendtohelpyouunderstandallyourexperiences
intermsofbrainmindstates.
PartTwointroducesthemajorfacultiesofthemindorientation,memory,perception,emotion,attention,andmoodandshowshowtheseareallafunctionof,
andarealldependenton,thestateofthebrainmind.Itdiscusseshowbrainmindstatesfunction,howtheychange,andwhatmakesthemchange.Whyyoumaybe
confusedwhenyouwakeupfromsleep.WhyyouragingparentwithAlzheimer'soryoursonwithattentiondeficitdisordermaysuddenlyswitchfromlucid
conversationtoanaloofstare.
Andhere'sthepowerfulpunchlinethepayofftoyou,tome,andtothosemisunderstoodmenandwomeninmentalinstitutionsaroundtheworld:ifwecan
explainhowthebrainmindcontrolsthesefaculties,thenwecanimproveourownlivesandthoseofothers.YouwillseeinPartThreethatyoucanimproveyour
health,yoursleep,yourmemory,andyourabilitytolearn,byvoluntarilycontrollingyourbrainmindstate.Youwillalsobegintounderstandthefrightfulbehaviorof
peoplewith"mentalproblems"andwillseethattherearesoundwaystohelpthemrectifytheirownmixedupbrainmindstates.Ihope,too,youwillcometoagree
thatitisextremelyimportanttobringbacktogethertheneurologistsandthepsychiatriststhescientistsandthehumaniststoasharedvisionandthusashared
pursuitofbettermentalandphysicalwellbeingforallofus.
Socomewithmeonthisbrainmindodyssey.
<><><><><><><><><><><><>
ThefirsttimeIbegantothinkthattheremightbeawayofscientificallyestablishingbrainmindunitywasduringmymedical

Page9

internshipatBellevueHospitalinNewYorkCity,in1960.InthatyearIsawhundredsofcasesofsocalledmentalillnessthatwereactuallycausedbybraindisease.
AsanyonewhogrewupintheNewYorkareaknows,thenameBellevueissynonymouswithnuthouse,loonybin,andmentalhospital.SomepeoplejustcallitThe
Psycho.Kidssaytoeachother"Stopbeinggoofyorthey'llsendyoutoBellevue."WhenIwasthere,Bellevuewasthetriagecenterforeveryman,woman,andchild
whoactedcrazyonthestreetsofManhattansouthofFortysecondStreetandeastofFifthAvenue.That'snuttyterritoryonthebestofdays.
IfapersonwaswildlypsychoticandoutofcontrolwhenheenteredtheBellevuePsychoadmissionsunit,hewouldbelabeledschizophrenicandsentuptotheninth
floorofthepsychiatrybuildingforconfinementandobservation.Asoneofthemedicalinternsassignedtocoverthatfloor,Iwascalledintoexaminepatientswhohad
afeverandanyotherbodilysymptoms.
IrememberoneDutchsailorwhowasso"schizophrenic"thatIcouldn'thavegottenhimtotellmehismedicalhistoryevenifIhadspokenDutch.Butsomethingabout
hiswildramblingsandhisbodytemperatureof106Fsaid"delirium"tome,anddeliriuminturnsaid"brainproblem,possibleinfection."Thestiffnessofhisneck
andspinethatIobservedastwoheftyorderlies''persuaded"himtoliecurleduponhissideforaspinaltaphadalreadysuggestedmeningitis,butIwasnonetheless
shockedwhenageyserofpussprayedout,justmissingmyleftear,asIprickedhisspinewithaneedle.
MicroscopicexaminationofthespinalfluidrevealedthatthecauseoftheDutchsailor'spsychosiswasamicroorganism,abacterium,a"bug."Andbecausethe
bacteriumsuccumbedtopenicillin,hewasquicklyanddramaticallycuredofbothhismeningitisandhisdelirium.Duringthebalanceofthatmad,madyear,Isawmany
otherpatientswhosebrainswerebugged,includingonepatientwhose"paranoia"wascausedbyatuberculosisabscessofhisbrain,andanotherwhose"mania"was
causedbyabacterialblockageofhisbloodvesselsduetoaheartinfection.
Therewerescoresofotherpatients,allofwhomweresaidto

Page10

havementalillnessesthat,whenunmasked,weretheresultofbraindiseases.Manyhumanproblemsarecausedbybrainabnormalitiesmasqueradingasmentalillness.
Anyabnormalorexceptionalmentalstateisareflectionofanabnormalorexceptionalbrainstate.Thisbooktakesthatideaveryseriously.
Stoptoconsidertheideaforjustasecond.Itseemsobvious,inretrospect,thatmyDutchsailor'srantingandravingwascausedbyabraindisease(in1960physicians
simplylabeledhim"crazy").Buttherearethousandsofothermentalpatientswhorantandravewhohavenoknowndisease.Therearehundredsofthousandsmore
whohavelessdramaticbuttroublesomeproblemslikeanxiety,depression,andneurosis.Societyreadilyassumesthatallthesepeoplemusthavesomehistoryof
psychologicalstressortraumathathascausedthemtobethisway.Isayno.Theyrantandrave,orflitaboutnervously,orfailtoshowupforwork,orcarryValiumin
theirpursesbecausethereisafunctionaldisorderofthestateoftheirbrainmind.Theymaywellhavebeenabusedaschildren,orhavelosttheirselfesteem,andthis
cancauserealemotionalstress.Butitdoesnotcausetheactualanxiety,depression,neurosis,oranyotherofalonglistofproblems.Theseproblemsareallcausedby
subtlephysiologicalchangesinthestateofthebrainmind.
Theideaworksinreverse,too.Thereisnomysteryaboutpeoplewhocanhypnotizethemselves,enteratrance,ormeditate.Whiletheymayascribetheirabilityto
Buddhism,tomindcontrol,ortoconcentrationontheenergyofthespiritsaroundthem,noneofthesepracticesactuallycausesthemtoshiftgearsunlesstheyeffecta
changeinbrainmindstate.Youcandoallthesethings,too,withouteverreadingawordofEasternphilosophyorbelievinginmagicorwitchcraft.
WhatIstheMind?
Untilthenineteenthcenturymostdefinitionsofthemindwerecomfortablyrestrictedtoselfawareness.Formosttheorists,"consciousness"wasakintotheancient
conceptofspiritasentientformofenergythatvitalizedthebodyandmovedit.Becauseofits

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linktothenotionofasoul,thisconceptconceivedthemindtobequitedifferentfromthebrainandevenseparablefromit.
Separabilityofmindfrombrainhasalsobeenanimportantaspectofreligiousphilosophiesthatholdthatthespiritmaybothantedatethebodyandsurviveitafter
death.ForearlyChristianphilosophersthedoctrineofseparabilitywastiedtotheprimacyofGod'swillasthefirst,last,andultimatecauseofallthings.
EvenwiththeriseofmechanisticthinkingintheRenaissance,theseparabilityofbrainandmindwasmaintained.InonevariationoftheFrenchphilosopherRen
Descartes'sdualistictheory,separabilitywasachievedbyassumingthatthebrainandthemindweretwoperfectlysynchronizedmechanisms.AccordingtoDescartes,
myawakeninginOgunquitinvolvedsimultaneousstatechangesofmybrainandmymind,whichreflectedaperfectpreordinationoftwoparallelclocklikeprocesses
thatweredesigned,woundup,andsettickingbyGodbeforeIwasborn!Todaythiselaborateintellectualcontrivanceseemssostrainedastobeuntenabletomost
modernthinkers.Andyet,manyofusstillremainsubtlybutstronglycommittedtooneoranotherformofdualism.Howcanweexplainthisparadox?Whatisthe
sourceofourdeepresistancetothecompellingideaofbrainmindunity?
Thedeliriumofmydreammayofferaclue,sinceitindicatesthatconsciousness,invaluableandpreciousatoolthoughitmaybe,isaverypoorjudgeofitself.Itis
oftenhopelessincorrectlyidentifyingitsownstate.Towit:IwasdreamingbutwasconvincedIwasawake.EvenwhenIamawake,itisdifficultformetoimagine
thatmyconsciousnessisaphysicalstateofmybrain.
Thefactisthatthehugeknotofnervesinourheadshasnonervedevotedtomonitoringitself.Wethushavenodirectsensationofactuallypossessingabrain.We
havetotakeitonfaith.Andwhileitisanideathatweallacceptasanatomicaltruth,italmostneverentersourconsciousnessaswethink.Thusourphilosophieshave
almostentirelyignoredourbrains.
Youmightsupposethattheexistenceofheadachesprovesthisideatobewrong,butthenervefibersthatconveythesepainfulimpulsesareinthewallsoftheblood
vesselsthatsupplythebrain

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withitscriticalquotientofoxygentheyarenotsensitivetothestateofthebrainitself.
Onlysomeotherpartofconsciousness,thefacultythatwecallselfawareness,iscapableofobservingourbrainstates.Wesay,"I'mgettingquiteforgetfulinmyold
age,"implyingsenility,or"Myattentionisflagging.Imustneedagoodnight'ssleep,"implyingbrainfatigue.
Vernacularexpressionsregardingincompetenceormentalillnessalsorefertothebrainmindconnection.Consider:"peabrain"forsomeonewhoisnottoobright
"batsinthebelfry"forsomeonewhoisbehavingoddly''brainwashed"forthevictimsofcultconversion.Butmostlywejustdon'tthinkofourselves,ourthoughts,and
ourfeelingsasbrainfunctions.Itrequirestoomuchofaleap.Andthereissomuchridingonit.Whowantstogambleandlosehisimmortality?ButifIamrightabout
brainmindunity,thenmymind,mybeing,willdiewithmybrain.Itwillnotflyoffsomewheretoanotherdimensioninspaceandtime.
Mymainpointhere,however,isnottochallengeyourbeliefaboutGodoryoursoul.Iamattemptingtodescribewithscientificrigorhowthebrainmindworkswhile
youareonthisearth,regardlessofwhetheryouthinkaGodputyouhereorthatyouhaveasoulthatwillcarryonafteryouaredead.
BrainMindUnity
Theexplosionofknowledgeaboutphysiologythatbeganinthelatenineteenthcenturyfirstpromptedtheconvictionofmanyscientiststhatbrainandmindareone.
That'swhysomanyturnofthecenturypsychologists,includingSigmundFreudandWilliamJames,triedtoformulateaunifiedbrainmindtheory.Thefailureofthese
earlyeffortsstemmedfromtheinabilityofthescientiststofitnew,objectiveinformationaboutthebraintothesubjectiveexperienceofthemind.Howeverclearly
relevantwerethediscoveriesofbrainelectricalactivitybraincells,andbrainmolecules,itwasimpossibletoseehowthegrandmentalwholeemergedfromthesetiny
physicalparts.

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AlthoughthisdifficultyledFreudandotherstoabandonthesearchforabrainmindconnection,evidencehassteadilymountedovertimetosupportit.Thefirstmajor
insightwastherecognitionthatchangesintheelectricalactivityofthebraincorrelatedwithsleepandawakestates.Thisimpliedthatconsciousnesshadadefiniteand
essentialphysicalbasis.Today,withsophisticatedimagingtechnology,itispossibletoobservetheseelectricalchangesinrealtime.Researcherscannowprojectan
imageofmybrainontoacomputerscreenasIsleepandshowthechangingelectricalactivitythatoccurswhileIdreamandwhenIwakeup.
Asecondimportantinsightwasthediscoverythateachnervecellinthebraineachneuronisanindependentelectricsignalgenerator.Eachneuroniscapableof
convertingthemetabolicenergyderivedfromsugarandoxygenintoelectricalenergyandofdeployinganelectricalchargetosignalitsownstateofexcitementtoits
neighbors.Thisgaverisetotheideathatthebraincouldnotonlyproduceitsownelectricalenergybutcouldusetherapidchangesinenergyleveltoencode
information.ThepatternofelectricalsignalsarisinginneuronscouldthusbeconceivedofasasortofMorsecodethatcouldrepresenttheexternalworldwithinthe
brain(perception)andcouldgoontoperformcalculationsonthoserepresentations(thinking,orcognition).Oncetheideaofrepresentationviaelectricallycoded
signalswasaccepted,emotions,memories,andalltheexquisiteandtorturedstatesofourconsciousexistencecouldbegintobemodeledinphysicalterms.
Athirdseminalrevelationwastheappreciationthatneuronalsignalingwaschemicalaswellaselectrical.Atthejunction(orsynapse)betweenanytwoneurons,the
electricalstateofoneiscommunicatedtotheotherviathereleaseofchemicalmoleculescalledneurotransmitters.Thesechemicalsaremanufacturedbytheneurons
themselves.
InolongerhaveanydoubtthateverydetailofmyOgunquitdreamcanbeaccountedforintermsofneuronalsignalpatterns.Mydreamwasjustoneofaninfinite
numberofpossiblesetsofselfgeneratedbrainsignals.Mybraingeneratedtheimages,then

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concoctedastorylinetolinkthem.Ofcourse,therepresentationsofthephysicalworldstoredinmygraymatter,mypersonalhistory,andmyemotionalmakeupall
playedanimportantroleinthecreationofthedreamplot.Forme,reducingthecontentofthedreamtoitsrepresentationinneuronsignalsrobsthedreamofnoneof
itsdramaorsignificance.Buteventhedramaanditssignificancearephysicallyinstantiatedprocesses.
Utilizingthebuildingblocksnowavailableinthebrainsciences,itispossibleforustounderstandhowourconsciousstatesareelaborated.Thought,memory,and
emotionarerealizedinbraincellactivitypatterns.Andthebraincellsareorganizedinsuchawayastocontinuouslyshiftfromoneactivitypatterntoanother.The
mostdramaticandglobalshiftsoccurwhenwefallasleep,dream,andwakeup.Inthesemajorstates,andattheinterfacesbetweenthem,theunityofthebrainmind
revealsitselfwithstartlingclarity.Thatiswhythestatesarethefoundationoftheunifiedtheory.
FromWakingtoDreaming...AndBackAgain
Thestrongestevidenceofbrainmindunityemergesdaybydayandnightbynightfromthescientificstudyofwaking,dreaming,andthestretchesofsleepduringwhich
wemaythinkorimaginebutdon'tvividlydream.Overthepastfortyyears,ithasbecomeclearthatourbrainmindsregularlyalternatebetweentwoextremeswhen
consciousnessisatapeakwakinganddreaming.Whenweareawakeourbrainmindsareinthegripofonechemicalsystem,andwhenwearedreamingour
brainmindsareinthegripofacompletelydifferentchemicalsystem.Whenbothsystemsareathalfthrottle,wesleepdeeplywithnodreamsandlittleornoconscious
mentalactivity.
Thebrain'schemicalsystemthatmediatesourwakingstateiscalledtheaminergicsystem.Themoleculesthatdotheworkareamines.Thechemicalsystemthat
mediatesdreamingiscalledthecholinergicsystem.Itsmoleculeisacetylcholine.Thetwochemical

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systemsareindynamicequilibrium.Thismeansaswealreadyknowthatourconsciousstatesfluctuateconstantlyandgraduallybetweentheextremesofwaking
anddreaming.Evenattheextremes,boththeaminergic(waking)andthecholinergic(dreaming)systemsareactive.Theirpredominanceisonlyrelative,notabsolute.
Thus,thetwoextremestateshavesharedaswellasdifferentiatedproperties,atboththecellularmolecularandtheexperimentallevels.Betweentheextremesisarich
continuumofaminergiccholinergicinteractionsandanequallyrichcontinuumofbrainmindstates.
Someofthemostinterestingpointsalongthecontinuum,suchasfantasy,hypnosis,andmeditation,havealreadybeguntobeelucidatedintermsoftheunifiedbrain
mindstatetheory.Thetheoryalsoenablesustounderstandlessappealingalteredstatessuchasdelirium,dementia,depression,andcomainanewandintegrated
way.Andsinceourbrainmindtheoryisspecifiedatthemolecularlevel,chemicaltreatmentoftheseunwantedstatescanberationallyprescribed.Iwillexploreall
thesestatesandthemeansforalteringthemasthisbookmovesahead.
Thegreatestvalueofthebrainmindstateconceptisthatitaddressestheexperienceofwaking,sleeping,anddreaminginaholisticway.Giventhemanymicroscopic
detailsofbrainscience,itispossibleforourconsciousstatestobeintegralonlyifthebrainmindoperatesaccordingtoasetofglobalphysicalchemicalconditions.
Andthis,asyouwillsee,isexactlywhattheaminergiccholinergiccontrolsystemguaranteesviaitswidespreadconnectionsthroughoutthenervoussystem.
Weneedalsotobeabletoaccountforthealmostinstantaneouschangesfromoneconsciousstatetoanother.How,forexample,ismyconversionfromthewild
worldofmyNewOrleanshoteldreamtomyawarenessofarainyMondayOgunquitmorningaccomplishedsoseamlesslyandefficiently?Withinsmallpartsofa
secondmybrainmindshiftsfromoneselfconsistentstate(dreaming)toanother(waking).Toaccountforsuchadramatictransition,wemustdiscoverastrongly
centralizedandhighlyhierarchicalcontrolsystemwithinthebrain.Theaminergiccholinergic

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systemisjustthat.Fromitsstrategicpositionatthebaseofthebrain,itcancommandthestateoftheupperbrain(whereourthoughtsandfeelingsarerepresented)at
thesametimethatitcontrolsthelowerbrain(whichconveyssensationsfromourbodiesandenactsourvolitionthroughmuscularaction).Thisswitchingsystemisas
reliableasitisflexible.ItisaboutasrareformetogainawarenessthatIamdreamingwhenIamdreamingasitisformetobegintohallucinatewhenIamawake.
Thediscretenessofconsciousstatessoextremeaswakinganddreamingmustthereforebedeterminedbythecapacityoftheaminergiccholinergiccontrolsystemto
undergoveryrapidswitching.WhenIwokeupinOgunquit,thehoteldreamscenariowasimmediatelycanceledasmyaminergicwakestatesystemquenchedmy
cholinergicdreamstatesystem.Thisispossiblebecausethebraincellsdelivertheirelectrochemicalmessagessoquickly.
Thebrainmindstatesareallthemorewondrouswhenweappreciatejusthowdifferenttheyare.InmydreamIwasentirelyinthethrallofaninternallygenerated
scenarioasecondlatermystatewasreplacedbyafaithfulrepresentationoftheexternalworld.Inaflashmyfeelingsswitchedfromacutepanictoamusedcalm.
Oneinescapableupshotisthatallthefacultiesofwhatwehaveheretoforecalledthemind(suchasperception,orientation,emotion,andmemory)operateina
consistentandunifiedwaywithineachstate.Theotheristhattheinstantiationofallthosefacultiesinbrainsignalprocessesislikewiseconsistentandunified.The
conclusionisthatbrainmindstatesareeverybitasmuchfunctionalunitsasaretheneuronsandneurotransmittersthatmediatethem.Andlikewise,ourbrainmind
statesareencodedandcanbeaccessedjustlikethephonenumbersthatareencodedasmemories,ortheterrorandblissthatareencodedasemotions.
Brainmindstatesareunitsofreality.Ifwecanunderstandhowtheyworkwewillbeenormouslyempowered,becausebrainmindstatesarenotalwaysadaptiveor
pleasant,andtheknowledgewillenableustodesignmoreeffectiveinterventionsforwhatwehavealwayscalled"mentalillness."Itmightwellbemore

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appropriatetolabelsuchunwantedconditionsdysfunctionalbrainmindstates.
ACalmintheStorm
Oneofthemostobviousapplicationsforournewunderstandingofbrainmindstatesisinsleepscience,whichisexpandingrapidly.Sleepdisorders,sleeplabs,and
sleepcentersarespringingupeverywhere.Goneforeveristhemythofsleepassimple,benign,anduneventful.Atlastthereissomebalmfortheanguishofthenight.
Everyday,newphenomenaaredescribed:adultsstopbreathingonlytogaspforairbabiesstopbreathingintheircribsanddiemendiveoffbedsintodream
swimmingpoolsortacklebureaudrawersindreamfootballgamesothersshake,rattle,androll(andevenkick)theirsweetwives.Depressivesawakenunrefreshed
andaregivendrugstopreventthemfromdreamingthentheywakeupwithrenewedvigor.
Whatisgoingonhere?Whatcanthebrainmindparadigmtellusaboutallofthis?Forstarters,ittellsusthatweareluckythereisnotmoredisorderinourlives.Ata
deeperlevel,ittellsusthatmuchofthedisorderisunderstandableandcontrollableusingthesimplifyingassumptionsofthebrainmindtheory.

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Chapter2
BrainMindSchizophrenia
Iwasangry.IknewIhadtogothere,butIdidnotwantto.Iwalkeddownthelongwhitehallway,slowly,untilIreachedtheopendoorwayonmyright.Ilookedinto
theoffice.Hewasthere.Themaninthewhitecoat.WasheJesusChrist?OrGod?Ihadbeeninthisbuildingbefore.Itwasahouseofpeaceandrest.ButIknew
betterthantogointohisoffice.Ikneltatthedoorway,genuflected,andsaid,"IamagoodCatholic."Themaninsidetheofficewalkedtowardme.Ilookedupathim
asheapproached.Iwastense.Ilungedathim,myfistsclenched,butheslippedoutoftheway.Iturnedandstaredangrilyathim.Hesaid,"Yourfeelingsarenormal
andhealthy,eventhoughtheyareconfusedandoutofcontrol."
Anotheroneofmyodddreams?Notatall.IthappenedtoamanIknownamedBertal.Butforhimitwasn'tadream.Hewaswideawakewhenhehallucinateditand
acteditout.ThebuildinghewasinwasamentalhospitalinBoston.Hewasapatient.Iwashisdoctorthemaninthewhitecoat.Andhelungedatmewithso
muchforceIwasonlyluckytododgehisassault.

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Bertal'swakingexperiencecertainlyseemslikeadreamexperience,doesn'tit?Anditis,inanimportantway:theimageofthehouseofpeace,andofJesus,wasas
realtoBertalastheNewOrleanshotelandguntotingguardhadbeentome.ThreeminutesbeforeIwokeupfrommydreaminOgunquit,IwasascrazyasBertal.
Mydreamingwasaconsciousbrainmindstate.Bertal'shallucinationsanddelusionswereaconsciousbrainmindstate.Onlyforme,thestateoccurredwhenIwas
asleep,asitshouldhave.ForBertal,itoccurredwhenhewasawake,whenitshouldn'thave.Mentalillnesses,Imaintain,aredisorderedbrainmindstates.
IvividlyrememberthedayImetBertal.HewasthefirstpatientofmyresidencyinpsychiatryattheMassachusettsMentalHealthCenterinBoston.LikeBellevuein
NewYorkCity,theplacehadinformallybeendubbedThePsycho.Itseemsthatpeopleeverywherecallmentalhospitalsbynicknamesthatcaptureourcollective
ignoranceandfearofbeingoutofourminds.
IwasrelievedtohavecompletedmyBellevueinternshipwithoutcontractingtuberculosis,asthreeofmyelevencolleagueshad,withoutbeingassaultedoreven
murderedbyapsychoticpatient,asalsosometimeshappened,andwithoutsufferingfromthatmostperniciousdiseaseofdoctorscynicaldetachment.Instead,I
wasfullofhopeandexcitementasIdrovetoBostonintheearlymorninglightofJuly1,1960.IwasstillinmyhospitalwhitesbecauseIhadstayedupallnight
successfullytreatingayoungwomanindiabeticcoma.Itseemedlikeafittingandsatisfyingendtoonechapterofmylife,andIwaseagertobeginthenewone:my
educationinrealpsychiatry,realmentalillness,notjustthebraindiseaseIhadseenatBellevue.
Mass.Mentalwasindeedatempleofhope.Itwasthedawnofthe1960s,andnotjustpsychosisandneurosisbutallthesocialproblemsofmankindweredeemed
mentalillnessesinthesensethattheywereviewedaslearnedbehaviorsthatcouldbeunlearnedandreversedviapsychoanalysis.Likemanyotheryoungpeople,Iwas
outtosavetheworld.
Bertalwasatwentythreeyearoldelectronicsworkerwhohadbeenadmittedaboutthistimeofyearduringeachofthepriortwo

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years.Hismotherbroughthimineachtime,andthissummershehadtoldthestaffthatBertalhadbeenunderpressurefollowingarecentjobpromotion.Hehadfully
withdrawnfromcommunicatinginthelasttwodays.DoctorsatThePsychothoughtBertal'smentalillnesswascausedbyhismother'soverprotectivebehavior.They
thoughtshewassopsychologicallytoxicthattheylabeledher"schizophrenogenic."Bertal'spsychoticconfusion,theysaid,wasareactiontohismother'smixedsignals.
ImustconfessthatalthoughIwonderedabitabouttheplausibilityofthisnotion,Itendedtoacceptitbecausemyaugustmentorssaiditwasso.AndIsupposesome
partofmewantedtobelieveit,too.Becauseifthis"badmother"theorywascorrect,allwewouldneedtodowasseparateBertalfromhistoxicparentandcurehim
withclearcommunicationsignals.Atourplanningmeeting,notonewordwasmentionedtomeaboutthebrain,aboutneurotransmitters,oraboutthepossibilityofa
chemicalgenesisorremedyforBertal'sproblem.
WhenIfirstmetBertal(afewweeksbeforethelungingincident),helookedphysicallyhealthy,wellbuilt,andneatlydressed.Buthewasincrediblyanxious,shifting
fromonefoottotheother,wringinghishands,andstaringattheceilingofmyoffice.Hisvocabularywasusuallylimitedtogutturalgrunts,sohesurprisedmewhenhe
oncesuddenlysaid,"Ishouldhavewentswimming."
ThenextdaytheorderlieshadtoforciblyrestrainBertaltokeephimintheward.Hewasextremelywithdrawnandangry.Wetelephonedhismotherandshecamein.
Inseemingconfirmationofthebadmotheridea,shewasveryprotectiveanddominanttowardhim.Inherpresence,Bertalbecametearfulandclinging,andhebegged
hertotakehimhome.
MyconversationswithBertalinsubsequentsessionswentnowhere.Hefluctuatedfrombeingalooforapologetictobeingangryorviolent.Aseniorpsychoanalystat
ThePsychotoldmeIshouldnotgivemedicationtoBertalevenduringhisworstepisodes.HesaidthateventhoughBertalwasamassivelyanxiousandgrossly
psychoticyoungman,medicationconstitutedachemicalstraitjacketthatwoulddamagehisabilitytoenterintoapsychotherapeuticrelationshipwithme.Our
"relationship"soonbecameri

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diculous.AsBertalhallucinatedanendoftheworldbombingandstrafingraid,Iwastryingtocoaxhimtoentermyofficetodiscusshisfeelingsabouthismother.
When,inmortalterrorofthedivebombers,heranoutofthehospitalandcrawledunderaparkedcar,Iranafterhim,laydownonthecurbstone,andperformeda
wildsortofsidewalkpsychoanalysis.Later,whenBertalwasinthegripsofanevenmoreterrifyingwakingnightmare,mypsychoanalystsupervisormadethemistake
ofenteringtheseclusionroomwheretheorderlieshadputBertalforhisownprotection.Bertalmistookhimfortheenemyandbeathimup.Theorderlieswrestled
Bertaltothegroundandputhimonheavydosesofchlorpromazineatranquilizer.
WithinafewdaysBertalwassittinginmyoffice,calmandcollected,talkingabouthismother.Heremainedthiswayaslongashewasonthemedication.
Bertal'spsychosiswastheresultofaspontaneousandcataclysmicbrainmindstatechange.Althoughwebrainresearchersdon'tyetknowwheresuchpsychoses
originate,wedoknowthatBertal'sbrainmindstatewasconvertedfrompsychotictononpsychoticbyachemicalprocess.Whatwealsoknownow(butdidnot
knowthen,unfortunately)isthatchlorpromazineinteractswithbrainneurotransmitterssostronglythatitwasabletobamboozleBertal'sneuronsintomorestable
behavior.
MyexperiencewithpatientslikeBertalforcedmetobemoreskepticaloftheadequacyofpsychoanalysis.Second,itforcedmetoconsiderhowthosetwomost
difficultofmedicalschoolsubjects,physiologyandbiochemistry,mightbehelpfulinconstructingamoreadequatetheoryofmentalstatechangethanwaspossible
usingpsychologyalone.ThisisbecauseBertal'spsychosiswasundoubtedlymediatedbychemicalswithinthebrain,regardlessofwhetherithadanythingtodowith
hispsychologicalconflictwithhismother.EvenifpsychoanalysisultimatelyprovedusefulinunderstandingBertal,itwasclearlynotasgoodaschemistryinrestoring
normalfunctioningtohispsychoticbrainmind.
Buthowintheworldwerewetoaccountfortheefficacyofachemical?Atthetime,weknewthatchlorpromazinewasanantihistamine.Itstranquilizingeffectshad
beendiscoveredbyaccident

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asitwasbeingtriedoutasacoldremedy!Wedidnotknow,however,whyitclearedBertal'smindofdivebomberhallucinations.
Todayweknowthatchlorpromazineblockstheactionofatleastoneneurotransmitter.Butwedonotunderstandexactlywhythathelps.Intheabsenceofafull
explanationwearestillinthedarkaboutpsychosis.Eventhoughwemaytakesomesatisfactioninbeingabletoaltersuchstateschemically,wecan'tbecontent
withoutamoreadequatetheoryofnormalandabnormalmentalstates,onethatisbuiltupfromthephysiologyofthebrain.Thattheorythebrainmindstate
theoryisthecentralsubjectofthisbook.Becausethetheorysetsforthaspecificmodelofhowconsciousstatesdevelop,Icallthatmodelthebrainmind
paradigm.
Thereisanimportantexperimentalpointtorealizehere,too.Justasthevisualimagesofmyhoteldreamwereentirelyfabricatedbymybrain,soBertal'sreligious
delusionswerefabricatedbyhisbrain.Thisrecognitionradicallyaltersourunderstandingofpsychosis.ThereisnowayforustoregardBertal'sdivebomber
hallucinationsasessentiallydifferentfromourowndreamprojections.Wecanthereforeregardourowndreamsasaproperbasisforstudyinganormalprocessthat
becomesexaggeratedinpsychosisprojectiveperceptionescapesitsconfinementtoonestatedreamingandinvadesanotherwaking.ThisiswhyIbasethe
brainmindparadigmonthestudyofstatesandespeciallyconsciousstateslikedreaming.
FreudversusSkinner:They'reBothWrong
Beforediscussingthebrainmindparadigm,itwillhelpustorecognizetheconflictthathasragedforninetyyearsbetweenneurology(thestudyofthebrain)and
psychology(thestudyofthemind),forthecontextandfoundationofthenewparadigmspringsfromthisconflict.Inspiredbytherapidgrowthofneuroscience,these
twofieldshaverecentlyevolvedinthedirectionofbrainmindintegration.Thereisfinallyagroundswell,acoalescingofideas.

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In1890aclearconceptofbrainmindunitywaslaidoutbyAmericanphilosopherandpsychologistWilliamJamesinThePrinciplesofPsychology.Jamescarefully
presentedacomprehensivevisionofwhathappensinsideourheads.Hetriedtointegratethethencurrenttheoriesaboutthebrainwiththoseemergingfrom
observationsofpeoplemadeduringpsychologyexperiments.InVienna,SigmundFreudwastryingtodoexactlythesamethingatexactlythesametime.ButJames
andFreudsimplydidnotknowenoughaboutthephysicalbraintomakeitwork.AlthoughJamesstuckwithit,Freudabandonedthisearlygoalofbuildingupclinical
psychologyfrombrainscience.
By1920neurologyhadbeguntofadeintothebackground,whilepsychologyhadgrown.Butpsychologyitselfwasundergoingacivilwar,ledbytwoofthegreatest
intellectualadventurersofthetwentiethcentury:SigmundFreud,thefatherofpsychoanalysis,andB.F.Skinner,thefatherofbehaviorism.Freudheldthatouractions
wererootedindeepdarkimpulses,particularlythosethathadtodowithsex,whichwerestoredinourunconsciousminds.Thesemotivatedourconsciousbehavior.
Hemaintainedthattheseimpulses''gotout"oftheunconsciouswhenwewereasleep,andcauseddreams.Thus,thestudyofdreamingbecametheprovinceof
psychoanalysts.ToFreud,neurologywasgoodonlyforexplainingbodyprocesses,suchaseatingorwalking.(Freudalsofearedthatlendinganycredenceto
neurologywouldweakenhisnewtheoryandhisburgeoningpsychoanalyticmovement.)
Skinnerandthebehavioristswentevenfurther.They,too,ignoredthebrain,callingita"blackbox."Buttheywerealsodisdainfuloftheintrospectiveexperiencethat
interestedFreudandthepsychoanalyststothebehaviorists,onlyoutwardlyobservablemotoractsweresuitabledataforascientificpsychology.Allbehaviorwas
learned,andallactionswerereactionstostimuli.
Asaconsequence,neurologyandpsychologyproceededalongtwoparallelbutcompletelyseparatepathsforwelloverhalfacentury.Amongthemanyvictimsofthe
divergencewasmedicine,andespeciallypsychiatry.Althoughpsychiatrywasbornahybridofneurologyandpsychology,itvacillatedbetweenthetwo(asmy

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experiencewithBertalproved)andledyoungdoctorslikemetotrytotalktopatientsundercarsonedayandinjectthemwithchlorpromazinethenext.Ironicallyand
sadly,psychiatryhadbecomeincreasinglydistantfrombrainscienceatpreciselythetimewhenpsychiatryhadsomuchtogainfromit.Withinpsychiatry,confusion
reignedsupremethereweretherapistswhoweresensitivetopatients'psychologicalconflictsandreluctanttoprescribepills,andotherswhoprescribedmedication
freelybutwereofteninsensitivetothepersonalconcernsoftheirpatients.
TheNewNeuroscience
Thisclinicalturmoilstillpersiststoday,andclearlyitisstillasundesirableasifisunacceptable.Psychoanalystsandbehavioristshaveallfailedtoofferdefinitiveor
lastingsolutionstotheproblemofpsychosis.Andmanyofthedrugsofpsychiatrists,suchasValium,Tegretol,andClozaril,whiledramaticallypowerful,arestill
problematicbecausetheycannotbetargetedtospecificbrainsystemsinmostcaseswedon'tevenknowwhichbrainsystemstotarget!Allthismakesthe
conscientiousphysicianunhappy.Weneedtheconceptualandexperimentaltoolswithwhichtodobetter.Thankfully,theyarenowbeingforgedinthebrainmind
workshopsoftheworld.
Abasicconceptweneedisonethatexplainsthenaturalrelationshipbetweenbrainminddisorderandorder.Forthisweturntotheemergingtheoriesaboutchaos.
Mathematiciansandphysicists,likemycolleagueDavidKahn,tellusthatallcomplexsystemsandthebrainmindisaverycomplexsystemhaveintrinsically
chaoticproperties.Thebrainmindisthusliketheweatherknowingitsstatetodaydoesnotallowuspreciselytopredictitsstatetomorrow.Thuswemustaccept
ourselvesas,toadegree,unpredictable.
Chaostheorymaintains,however,thattheunpredictabilityisbalancedbyanequallyintrinsiccapacityforselforganization.Fromselforganizationarisesanemergent
orderthatmaybeasunanticipatedasthechaosthatgaverisetoit.Humancreativity

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dependsonanaturaltensionbetweenthechaosandtheselforganizationofbrainmindstates.Dreamingisindeedachaoticbrainmindstate,yetithaslongbeen
celebratedbymanyartistswhotaptheirdreamsassourcesofinspiration,suchastheEnglishpoetSamuelTaylorColeridge,whowrote"KublaKhan,"theSpanish
surrealistSalvadorDali,whopaintedThePersistenceofMemory,andRobertLouisStevenson,authorofTheStrangeCaseofDr.Jekyll(order)andMr.Hyde
(chaos).
Butmathematicalmodelsarenotenough.Peoplewanttoseephysicalevidencethatthereisorderinthechaosofthebrain.Theevidenceisfoundintheneuroscience
labsoftheworld,whicharemonitoringthebrainactivityofeveryonefromsleepingcollegestudentstoAlzheimer'spatients.ItisnowpossibleinthesleeplabthatIrun
forHarvardMedicalSchoolattheMassachusettsMentalHealthCenter,forexample,towatchthebrainatworkeachnight.Andbyusingnewimagingtechnology
thattransmitsimagesofthebrain'selectricalactivityontoacomputerscreen,wemayseethatthesamevisualareaofmybrainlightsupwhenIseearealgunpointed
atmeorwhenIdreamofasecurityguarddrawingabeadonmyheadorevenwhenIvoluntarilyconjureupanimageofaguninmymind'seye.Itwouldalsobe
possible,today,toseeifBertal'sdivebombersarehisexperienceofhotspotsinthevisualpartofhisbrain.Ifyouliveanotherdecade,youyourselfmaywellseeall
thesethingsonthelocalnewsshowsandinmagazines,asmoreliving,thinking,feeling,anddreamingbrainsareplacedunderpositronemissiontomographyscanners,
magneticresonanceimagers,andmagnetoencephalograms.
Thisnewfieldofbrainmindstudy,calledcognitiveneuroscience,isthejoyoussecondmarriageofneurologyandpsychologyafternearlyacenturyofcold
estrangement.Rejuvenatedpsychologistshavefoundtheirwaybacktothestudyofconsciousnessbyapplyingbehavioristmethodstothestudyofsuchmental
facultiesasperception,memory,andemotion(insteadoflimitingthemselvestoFreud'sscandalousunconscious).Andtoday'sneurologistsarelikechildrenat
Christmaswithsomanynewtoysforplayingbraingames,they'reliningupawaitingtheirturns.The

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kidswhogettoplayfirstarethecognitiveneuroscientists,thebrainmindpeople.Thankstotheirefforts,wecanbegintosketchthenewbrainmindparadigm.
PrinciplesoftheBrainMindParadigm
Threefundamentalprinciplesmakeupthebrainmindparadigm.Thefirstisthatthebrainmindisaunifiedsystem.Thebrainandmindareinextricablylinked:nobrain,
nomind.Furthermore,whenIdreamofcriminalsinahotelandwhenBertalhallucinatesdivebombers,ourrespectivebrainmindshaveenteredstatesthathave
commonphysiologicalandpsychologicaltraits.Wecanusephysiologytopredictpsychology,andpsychologytopredictphysiology.Thatis,ifweare"seeingthings,"
itislikelythatourvisualbrainisactivated.Conversely,ifourvisualbrainisactivated,itislikelyweare"seeingthings."Threeboldcorollariesofthisunificationprinciple
hold:thatconsciousnessisthebrain'sawarenessofitsownphysicalstatethatconsciousnessisatoolforstudyingthebrainandthatconsciousnessisatoolfor
changingbrainactivityinstrategicandhealthfulways.
Thesecondfundamentalprincipleofthebrainmindparadigmisthattherearethreecardinalbrainmindstates:waking,sleeping,anddreaming.Thesearethe
fundamentalorganizationalunitsofthebrainmind.Itmayevenbeassertedthattheyarethehighestleveloforganizationofthebrainmindbecausetheydetermine,ina
powerfulandreliableway,thequalityandquantityofourexperience.Therearemanyotherbrainmindstates,suchasdrunkenness,sleepwalking,andcoma,butin
comparisontheseprevailduringonlyshortintervals.Itfollowsthatthemorewecanlearnabouthowthethreecardinalbrainmindstatesareorganized,themorewe
canunderstandconsciousexperienceandthewayinwhichconsciousnesscanalter,forgoodorbad,brainmindstates.MyhoteldreamandBertal'swarpsychosis
arevariantsofthesameorganizationalunit:Idon'tknowI'mdreaming,andhedoesn'tknowheispsychotic.Bothofusarecompletelyconvincedthatweareawake,
seeingtherealworld,andfeelingthreatened.

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Thethirdprincipleisthatbrainmindstatescanbemeasuredandmanipulated,andthusunderstood.Wehavealreadyseenthatbrainmindstatesarecontrolledbya
brainwithinthebrain,theaminergiccholinergicsystem.Thischemicalsystemprovidesasolidlinkbetweenneurology,psychology,andthepsychiatricuseofdrugs.
Andresearchersarelearningsomuchmoreeachdaythatwecanalreadyperceiveanextensionofourknowledgeintolessunderstoodbutimportantbrainmind
states,suchaspsychosis,depression,andhypnosis.
ForBertaltohallucinatewhileawakeandformetohallucinatewhileasleep,somecommonshiftinthebalanceofourbrainchemicalstatecontrolsystemsmustoccur.
Bylearningwhathappensinmybrainmind,wecangaininsightintowhathappensinhis.Byilluminatingthespecificchemistryofshiftsinthecontrolsystem,wecan
thenfullyunderstandthefavorableeffectofchemicalsonBertal'shallucinations,therebynotmerelyrelievinghimofhisfear,butenlighteninghimtohisproblemand
howtocontrolit.
Iftheseclaimsareevenpartiallytrue,thenthenewparadigmisworthyofourrespectfulandexcitedattention.Isuspectthatitisfartruereventhanitnowappears.
Computers,Galaxies,andtheBuddha
Aswemoveaheadonthisjourneyofdiscovery,itiscomfortingtoknowwedon'tgoitalone.Newideasbearingfruitinotherareasofscienceandthehumanitiesare
helpingusrefineourmodel.Computerscientists,forexample,havesuccessfullybuiltcomputersthatexhibitsocalledartificialintelligence.Thesearesystemsthat
processdataoverandover,andastheydoso,theydiscernpatternswithinthedata.Thepatternsareautomaticallyenteredintothesoftwarethatrunsthecomputer,
whichaltershowthecomputerrespondstonewdata.Thecomputerrefinesitsresponsesbyrunningsmalltestprogramsonitself.Thisisausefulwaytothinkabout
howweourselveslearn.Theneuronsinourheadsstoredataandperceivepatterns.Onetheoryaboutdreamsistheyarethetestprograms,whichweinitiateduring
oursleeptotest

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ourresponses.Inthecomputersciencemodel,ourdreamsarediagnosticsthatwecreateduringsleeptomakesureourprocessorsstaysharp.
Fromsleepresearchwelearnthatourbrainscontinuouslyprocessinformation,evenwhileweareinthedeepestsleep.Untilrecentlyitwasthoughtthatthebrainmind
requiredexternalstimulitokeepitgoing.Bignamesinpsychology,includingIvanPavlov,whotaughtdogstosalivateattheringingofabell,mistakenlybelievedthat
ourbrainsshutoffatnightlikethelightsinourbedrooms.Eventodaytherearepopularnotionsthatthestimulusthattriggersadreamwhenweareasleepisexternal,
beitatruckdrivingpastourwindow,anexperiencewehadduringtheday,orevenindigestion.Butwenowseeinsleeplabsthatnoexternalstimulusisnecessaryor
evensufficienttoinducedreaming.Mostnervecellsinthebrainfireallthetime,alldayandallnight.Ourbrainmindsdonotmerelyreact.Theyanticipate.They
generatetheirownimages.Andtheydosospontaneously,continuously,andautomatically.
Thisisfortunate!Supposewehadtoremembertobreathe?Onemomentofforgetfulnessandwe'dallbedead.Wearenot,however,onlyautomatawhosecentral
processorskeepclickingaway.Whilewedoenjoysomeofthereliabilityofarobot,wealsoarefreetochoosewhatgoesintoourmindsandbodies.Theinformation
wechoosetoprocess,andthefoodanddrugswechoose(ornot)totake,influenceourbrainmindstates.Assuch,thebrainmindparadigmgivesusnotonlythe
freedomofchoicebutalsotheburdenofresponsibility.
Wehavemoretolearn.Brainscientistsnowtellusthereareontheorderof100billionneuronsinourbrains,thateachonemaycontact10,000others,andthateach
cansendupto100messagesasecond.Modestestimatesofthetotalinformationprocessingareupwardof1027bitsofdataasecond.That's
1,000,000,000,000,000,000,000,000,000bits.Itiseasytovisualizethebrainmindasaroilingcauldronofwitch'sbrewabouttoboilover.Itseemsboundtogo
haywire.Andattimes,forpeoplelikeBertal,itdoes.
Whydon'tweallhaveflightsofmanicpsychosisorepisodesof

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epilepsy?We'renotcertain.Butwedoknowthatamajorresultofthetensionbetweentheaminergicandcholinergicsystemsisthechemicalrestraintofourcomplex
brainmindsystem.Galaxieshaveorderlysolarsystems,oceanshavedependablecurrents,weatherhasthesteadytradewinds.Brainmindstatesselforganize,too,
andarehelpedtodosobytheaminergiccholinergicsystem.Ourbrainmindscananddooccasionallyjumpoutofthisequilibrium.Somepeoplegoinsane.Therest
ofusjustdreamorchangeourminds.Theseeventsarethesupernovas,tidalwaves,andthunderstormsofourlives.
WelearnevenfromEasternphilosophy.Buddhistsviewconsciousnessascausal,eveninaphysiologicalsense.Theypracticemeditationnotonlyforpeaceofmind
butalsotohealthebody.Changethestateofthemindandyoucanchangethestateofthebody.WeintheWestarebeginningtoembracethisidea,asmorestories
surfaceofpeoplewhohavestavedoffcancerorotherillsbypositivethinkingandsheerwilltosurvive.
WhyaNewParadigm?
AsIadvancethenewbrainmindtheoryhere,Iwilltrytoshedlightonsomeofthemostperplexingquestionsofourexistence.Whydoweneedsleep?Howdowe
learn?Whathappenstoourbrainmindsasweage?Sinceweallseemtostrugglewithanattentiondeficitdisorderafterpoorsleep,Ihintthatonefunctionofsleep
maybetoreducetheprobabilityofdisorderinherentinsuchaspringloadedmachineasourbrainmind.
Anotherthornyissuetoconfrontisthatolddemondeterminism.ItledFreudtoerroneouslyassumethatthebrainmindwasdoomedtofatallyreenactconflicted
scenarios.Thebrainmindparadigmrecognizestherealityofdeterminism,butitmaintainsthatthesystemistoonoisysimplytorepeatitself.Itisconstantlybeing
jostledintonewstates.Certainlythestatescanrecur,astheydoduringtherecurringdreamssufferedbyVietnamvets.ButIwillgosofarastosuggestthatnotwo
brainmindstatesareeverperfectlyidentical.
Oneguaranteeofstatediversityisthepassageoftime.Because

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ourbrainsandpersonalhistoriesarechangingateverysecond,weareneverinexactlythesameinformationalstatetwice.Forbetterorworse,weneedconstantlyto
updateourinternalstoreofrepresentations(callthemmemoriesifyoulike)tokeeparunningaccountofwhatis,afterall,theperpetualnoveltyoftheoutsideworld.
Howdowedoit?Ifyouaregettingmymessage,youwillhavealreadyguessedtheanswer:bytheconstantcyclingofourbrainmindstates,fromwakingtosleeping
todreaming.Thereisatimetocollectdataandatimetoprocessit.Thisinformationalcycleisasautomaticasbreathingitself.Wedon'thavetoremembertodoit.It
justhappens.Experimentstodeterminewhat,electricallyandchemically,isoccurringwhenwestorenewdataandlearnfromit,evenduringsleep,arealreadyinthe
works.
Psychiatryisindeepcrisis.Psychoanalysisisclearlyacureallthathasfailed,anddrugdependentpsychiatryjustasclearlyhasfailedtobecomeacureall.Intothe
breachwemarch.Wedesperatelyneedanewbrainmindparadigmthatwillallowustorescuethenoblegoalsofpsychoanalysis,tietheminameaningfulwaytothe
strengthsofpharmacology,andintegratethewholepackagewiththeburgeoningsciencesofthebrainandcognition.
Thisbookattemptsnothinglessthansuchanintegration.Itdoessobybringingtogetherthemostrecentfindingsofmodernresearchonwaking,sleeping,and
dreaming.Thenewbrainmindparadigmisasboldasitismodest.Itisboldinthatitaspirestocomprehensiveness.Anditismodestinrecognizingthatitisstill
incomplete.Ifyoucanstandsuchambitionofendsinthefaceofsuchhumilityofmeans,Iwelcomeyoutogiveyourselftothisendeavor.

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Chapter3
Delia'sDreamDelirium
Toprovideadeeperdescriptionofwhatbrainmindstatesare,Iwillexamineoneexceptionalexamplethathappenstobewellknowntousall:dreaming.Dreamingis
thestatescientistscanbestanalyzeanddiagnosetoday.Oddlyenough,scientistshavespentlittletimeactuallyanalyzingourbrainactivitywhenweareawake,but
thereisavolumeofdataondreaming.Oncemyanalysisisdone,dreamingwillbecomeatouchstonefortheotherbrainmindstatesthatIwilldiscussasthisbook
progresses.
Mentalstateshavetraditionallybeenassessedbyneurologistsandpsychiatristsusingaquestionandanswerformatcalledthementalstatusexam.Thementalstatus
examwasconceivedinthelate1800sandwasanintegralpartoftheclinicalexaminationofanewpatient.Thecentralideaoftheexamwasthatorganicdiseaseofthe
braincouldberevealedthroughnoticeabledefectsinmemory,orientation,perception,andlanguage,whetherornotthepatientshowedanyspecificsignsof
neurologicaldamageinthephysicalexam.Inparticular,someformsofpsychosiscouldbeshowntobeorganicusingonlythementalstatusexam.
Thisusefultoolfellthroughtheclinicalcrackswhenpsychology

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andneurologydivergedearlyinthiscentury.Psychologistsconcentratedonapatient'semotionalpastwhileneurologistsbecamepreoccupiedwithhardwarethat
couldtweakthebrain.Bothneglectedthementalstatusexam.Todaywecanresurrectandamplifytheusefulnessofthementalstatusexamusingthetoolsofmodern
cognitivescience.
Scientistsinterestedinnormalandabnormalstatesofthebrainmindhavelongfocusedondreamingbecauseitsharessomanyoftheformalfeaturesofwhatwecall
mentalillness.TheintensevisualimagesofourdreamsarelikethevisualhallucinationsthatfrequentlyoccurintoxicstatesliketheDTs.Ourconvictionaswedream
thatthephysicallyimpossibleeventsweexperiencearerealislikethedelusionalbeliefthatisthehallmarkofpsychosis.Thestoriesthatweconcocttoexplain
improbableandimpossibledreameventsareliketheconfabulationsofdelirium.Theintenseanxietywesufferduringnightmaresapproachesthatexperiencedby
peoplewithpanicdisorder.AndthepoormemorywehaveofdreamsonceweawakenfromthemissimilartothememorylapsesexperiencedbyAlzheimer'spatients
andpeoplewithothertragicformsofdementia.
AlmostacenturyagotheSwisspsychiatristCarlJungsaid,"Letthedreamerawakeandyouwillseepsychosis."ButwhatkindofpsychosisdidJungexpecttosee
whenheexamineddreaming?Heneveransweredthatquestion.Couldournightlymadnessbelikenedtothebizarrethinkingandemotionaldullingofschizophrenia?
Ordoweseethewildflightsofmaniaorencounterthedolorousdelusionsofdepression?Isdreamingmostlikethedeliriumoforganicbrainrotthespoilagethat
occurswhenpeoplepersistentlypickletheirbraincellsinbeer,wine,andpot?Ordoesdreamingresemblethedementiathatoccursinolderpeopleastheirneurons
dieaway?
OnereasonthatJungneverconsideredthesequestionsisthathecameundertheinfluenceofFreud,whowasconvincedthatdreamingwas"theroyalroadtothe
unconscious."FreudmadehismovetodraftJungintothepsychoanalyticarmyjustwhenJungwasmakingquantitativestudiesthatshowedthatalooseningof
associationswasnotonlythemostessentialcharacteristicof

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dreams,butalsothatitwasakeysymptomofschizophrenia.NeitherJungnorFreudmadetheobviousmoveofperformingamentalstatusexamondreaming,their
ownmodelofmentalillness.Ithinkthereasoniscleartheybecamesocaughtupintheanalysisofthecontentofparticulardreamsthattheylostsightoftheform
ofalldreaming.
Havingcometothisconclusionseveralyearsago,Idecidedtofindoutformyself:Whatkindofmadnessisdreaming?Whatsortofunconsciousmentalprocessesare
revealed?Andwhatisthepointofgoingnutsfourorfivetimeseverynightofmylife?
Let'sanalyzesomedreams.
Oneofthegreatpleasuresofworkingonsleepanddreamingisthateveryoneyoumeethassomethinginterestingtotellyouabouthisorherexperience.Farfrom
dreadingbeingoffendedbytheseoftenwildandwoollydreamreports,Irelishthem.Andtheycomenotonlyfromfriends,students,andfamilymembersbutfrom
dreamerstheworldover,manyofwhomsharetheirremarkabledreamdiarieswithmeandmycolleagues.
Onesuchcorrespondent,astudentofminenamedDelia,wasaparticularlyprolificdreamerandremarkablydiligentdreamjournalist.Shekindlylentmeacopyofher
dreammanuscriptsrecordedbetweenNovember29,1988,andJune30,1992,atreasuretroveof1,001nights.FromthisIhaveselectedseveraltypicalexamples
forthisbook.Theyaregivenverbatim,withDelia'spermission,onconditiononlythatIconcealtheidentitiesofthecharacters.Indiscussingthepersonalaspectsof
Delia'sdreamsIdrawinferencesfromthereportsthemselvesandfromwhatIhavelearnedfrommyrelationshipwithDeliaandotherslikeher.
OnApril19,1989,DeliaawakenedandreporteddreamingofbeinginaballoonoverParisandstayingneartheAlAqsaMosque.
IwaswithmysistersandfatherinaballoonoverthecityofParis.Therewereotherballoonistsintheairaswell.Theviewofthecitywasspectacular,andwewerewatchingagolf
tournamentgoingonbelow.Wewerehavingaproblemkeepingtheballoonsteadyinthewind,andkeptbobbingupanddownandwereevencomingclosetosomepowerlines.
Somyfatherandsistersdecidedto

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changeourplanswhichcalledforourarrivingbackintheUnitedStateslaterthatsamedayinfavoroflandingandspendingthenightinParis.
Sowelanded.AsIgotoutofthebasket,Ithoughttomyself,Well,hereIamstandinginParisforthefirsttime!Ifollowedmyfamilythroughabeautifulpublicgardenanddownto
theseashore(PariswasontheNorthSeainmydream).Therewetookourshoesofftowadeoutintothewater.Inoticed,however,alargetankeroffshore,andsawayoungboy
peeinginthewater,soIwonderedhowbadlythewaterwaspollutedasIsteppedbackout.
Wewalkedtoalarge,oldhotelnexttothegardentogetaroom.Iassumeditwouldberatherexpensivesinceitwassuchafancyplace.IcaughtaglimpseofAlAqsaMosque
acrossthestreetfromthehotel,soIaskedthewomanbehindthedeskaboutit.Shepointeditoutonamap.Themosqueandconnectedbuildings(some28innumber)tookupa
fullblockinthecity.IaskediftheotherbuildingscomprisedanIslamicuniversity,butshecouldn'tanswermesincenoonehadaskedaboutthemosquebefore.
AsIlookedatthemap,itseemedtobecomealiveaerialviewoftheproperty.Thereweremattressesallaroundtheopenspacesbetweenthebuildingsfortherefugees.Thelady
behindthedeskpointedouttheentrancetothemosqueonthemap.Ibegantomakeplanstogetupearlytosaymymorningprayersthere.

Inthislongdreamsequencetherearefourdistinctscenes:(1)flyingintheballoon,(2)landinginParis,(3)walkingtothehotel,and(4)lookingatthemap.
NoticethatDeliaindulgesheradventurouswanderlustinthecompanyofimportantfamilymembers.Herfatherandtwosistersarewithherintheballoon.Despitethe
exhilarationofflyingandthespectacularvantagepoint,thereisobviousanxietyaboutthesafetyofthecraftandtheyalldecideagainstcrossingtheoceanintheballoon
thatnight.
DecidingtolandinParisputsthehighanxietyofsceneoneontheterrafirmaofscenestwoandthreewithoutgivingupalltheexoticismofsceneone.Deliahasnever
beentoParisbefore.And

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thisParisisveryspecialindeed.Itisontheseaside,andtheNorthSeaatthat,anditharborstheAlAqsaMosque(whichisactuallyinJerusalem).
NowtheFreudianinusmightsaythatthisone,likeallflyingdreams,isathinlyconcealedsexualwish.Deliahasanincestuousdesireforherfatherand''flying"with
himallowsthisunacceptablewishtobefirstsymbolizedandthen,ultimately,grounded.Shewillthensublimatehersexualdesiresinvoyeuristictourism.Seeingtheboy
urinatingisevidenceofthisprogressivedisplacementprocessandillustratesherguiltandfearofcontaminationbyheruncleandesires.Notyetcleanenough,sheends
upinchurch.
ImustadmitthattheseOedipalspeculationsseemfarfetchedandsilly.Andevenifwewereconvincedthat,throughpsychoanalysis,Deliacoulddredgeupa
forgottentraumawithherfather,oruncoverarepressedfearaboutapunitivemother,resultinginhelpfulclarificationofsexualidentityandchoiceofmanissues,this
interpretiveapproachoverlookssomethingcrucial.Whatisoverlooked,andwhatisthewindowtoanalyzingDelia'sdreamstate,istheformofherdreams.Studying
themanyformalfeaturesofherdreamsequencecouldhelpusunderstandalldreamsandthecommonbrainmindstatethatproducestheminallofus.
ThereforeIwillperformamentalstatusexam.Iwillfirstlookatthecognitiveaspectsofthedreamawareness,memory,sensoryperception,andsoon.ThenIwill
examinetheemotionalaspectsofthedream,suchasangerorsorrow.OnceIhaveperformedthementalstatusexamonDelia'sdreamingIcandrawsomestrong
conclusionsaboutherbrainmindstateandthekindofmadnessherdreamingrepresents.Herewego.
MentalStatusExam
GeneralAppearanceandBehavior
Deliaisanattractiveblondeinherearlythirties,neatlyandfashionablydressed,withashy,winsomesmile,whospeaksopenlyaboutherrichmentallife.Althoughshe
isemployedinabank,she

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ispsychologicallymindedanddescribesherphilosophyas"definitelyNewAge?"Sheisintelligent,curious,andseemstobeanextremelyreliableinformantbecause
thereportsofherdreammadnesshavegreatinternalconsistency.Deliasaysthatdreamingoccurseverynightandalthoughsheisnotalwaysawareofit,sheusually
remembersatleasttwoepisodes,especiallysinceshebegankeepingherbedsidejournal.Inshort,thereisnothinginherwakingappearanceorbehaviorthatwould
evenfaintlysuggestpsychosis.
Sensorium
Deliasaysthatherconsciousnessduringdreamingisusuallyunclouded:"assharplyclearasaDalipainting"isoneofherphrases,"andequallystrange."Shesays,for
example,"Theviewofthecitywasspectacular,andwewerewatchingagolftournamentgoingonbelow."Shefeelssomewhatconfusedwhenshefirstsnapsoutof
herdreamstate,butwheninit,hermindisveryattentive,althoughsheusuallyhasnoawarenesssheisdreaming.Forexample,thefourdreamscenessherecorded
flowedseamlesslyinasinglestream.Soweconcludethathersensoriumisclear.
Orientation
Deliaisoftenabitdisorientedinherdreamssometimesquitealot.Thepeopleinherdreamsareparticularlyfluid.Sometimestheydon'tlookliketheonestheyare
supposedtobe,andsometimestheyseemliketwopeople,orevenahybridofthetwosexes.Sometimescharactersappearoutofnowhereawomansuddenly
becomesaman.Veryoftentheidentityofpeopleisvagueoruncertain.
Despitethisuncertaintyaboutothercharacters,Deliaissuresheisherselfandnotsomeoneelse(liketheVirginMary,JoanofArc,orJosephineBonaparte).Very
rarelysheseesherselfasanactressonthestageofherdreams.Butshealmostalwaysviewstheactionfromthecenterofherbrainmind.(Manypeople,myself
included,neverseethemselvesasathirdpersonintheirdreams.)Herfirstperson,her"I,"isalwaysthesameandisusuallyintegral,

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whilethirdpersons,"they,"areverycommonlyincongruous,ephemeral,orstrangelyconstructed.Butsurprisingly,thisorientationrarelyseemsbothersometoher.
DreamplacesareparticularlylikelytoviolateAristotelianunity.
Dreamobjectsareeitheroutofplace(liketheAlAqsaMosqueandtheseashore)orareinternallyinconsistent(likethemosqueanditstwentyeightinterconnected
buildings).Andwedonotexpecttoseeaboyurinatingopenly,eveninParis!
Timeoftenjumpsforwardandbackward,oriscompressedorexpanded.WhocouldexpecttoflyfromParistotheUSAinonedayinaballoon?
So,weneedtounderlinedisorientation,becauseDeliaisobviouslyseverelydisorientedinherdreams.
Attention
Whenseizedbyadream,thedreamerpaysnoattentiontotheoutsideworldandmakesnoconsciousselectionoftheinternaldataeither.Deliadidn'tselectwhatto
lookatthescenesjustappeared.Anotherthingshehasalsonoticedisthatshecan'tdirectherthoughtsasshenormallycan.
SowecanconcludethatDelia'sbrainmindstateofdreamingischaracterizedbyahighdegreeofbothdistractibilityandabsorption.Thisdreamfeatureisso
commonandsooverwhelminglystrongthatweusuallydon'tevenmentionit.Itcombineswiththedisorientationofdreaminginaninterestingway:wecannowsaythat
thisparticularbrainmindstateischaracterizedbyconstantshiftsinboththeorientationsense(time,place,andperson)andtheorientingsense(attentionaldirection).
Memory
Deliasayshermemoryofherdreamsisusuallyquitegood.Comparedwithherfriends,shehastwoorthreetimesasmuchrecall.Theoriginalreport,356words,is
notexceptionallylongforher,butitisfarabovethefiftywordaverageofmostpeople!Evenso,Deliasayssheissurethatthereareoftenmanydetailsshecan't
remember.Sometimessheissuretherehavebeenpreviousepisodes

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thatcannotberecalled.Andmoreoftenthannotshewillawakenunabletorecallanythingatall.
Sheissometimesstruckthatsurprisinglyremotememoriescomebacktoherinherdreams.EquallystrikingarewhatDeliacallspseudomemories,thingsthatreally
neverhappenedinreallife.Shesaysitisalmostasifshefillsintheblanks,makesitallupasshegoesalong.Deliaknowsquiteabitaboutthiscapacityofherbrain
mindtoconfabulate.Whenmemoryfailsher,shemakesupforitwithimagination.
And,indeed,thesedreamystatesofbrainminddohaveafabulousaspect.Theyarelikefables,fullofmystery,withmismatchingfeaturesthatnonethelessseemtofit.
Sowehaveathirdandfourthimportantfindingtoaddtodisorientationandattentiondeficit:spottyrecentmemoryanditspartner,confabulation(whichpatchesup
thestorybyfillingintheholes).DeliaalreadysoundsabitlikemyauntAgatha,whogotlostmoreandmorefrequentlyassheagedandthenmadeupincrediblestories
tocoverhertracks.Shewasn'tlying,shewasjustconfabulating.
IntellectualFunctions
Deliaisanavidreader,butsheshunsmathandscience.Interestingly,sherarelyimaginesreadinganyofthesesubjectswhensheisdreaming.Shemayspendherentire
workdayporingoverpapersortablesofnumbers,butneithertextsnortablesofanykindmakeanappearanceinherdreams.Wedon'tknowwhethershecanread
duringherdreamsorunderstandwhatshehasread,whethershecansubtract7from100,ornamethepresidentsbacktoJFK.Itmaynotseemimportant,butthe
lackofthiskindofcontentisalsostrikingevidenceofadifferenceinbrainmindstatesbecauseitsuggestsalossofthatwholesetofhigherbrainmindskillswecall
rationalanalysis.Evenprofessors,likeme,neverdreamofreadingorwriting.
LanguageandStreamofTalk
Delia'sdreamlacksdialogueinsituationsthatwouldseemtocallforit.Nowhereinherreportofthreehighlysocialscenariosis

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therean"Isaid"/"Hesaid"sequence.Infact,thereisnoquotablelanguageatall.Shedoesnotreportthenervousconversationthatwouldhavebeennaturalamong
herself,herfather,andhersisterswhentheballoonwasbobbingupanddownnearthepowerlines.Theyjustdecidedtochangetheirplanswithoutdiscussingit.This
isatypicaldreamfeature:whenconversationseemsindicated,itisoftenonlyimplied.
Uponlanding,Deliadoeshaveabitofaconversationwithherselfwhenshethinks,Well,hereIamstandinginParisforthefirsttime.Butthisisn'tmuchofa
conversationanditisn'tevenmuchofathought,sinceitisaconclusionnotsupportedbythedata(witnessthebeach,thetanker,thepeeingboy,andthemosque).
MentalContent
Thiscategoryofthementalstatusexamhasalwaysstruckmeasillnamedbecauseitdoesn'tdealwiththecontentatall.Instead,itemphasizestheforminwhich
activityispresented.ThecontentofDelia'sdreamisexpressedintheformofhallucinations(falseperceptions)anddelusions(falsebeliefs).Thewholedreamscenario,
forthatmatter,isfictive.
Thefirstaspectofthedream'smentalformtoconsideristherichnessofthevisualandmotorperceptionsthatarethemaingroundofDelia'sdreamexperience.The
people,places,andactionsinherdreamareallfullyrealizedtheyarenotamorphousimagesorvoicesthatcomefromoffstage.Shehallucinatesthem.Deliaactually
seesherfatherandtwosistersintheballoonbasket.Sheseesthegolftournament,thepowerlines,thebeautifulpublicgarden,theseashore,thetanker,thepeeing
boy,theAlAqsaMosque,andthemattresseslaidoutfortherefugees.
Twothingsaresoobviousaboutallofthisthattheymightescapenotice.Oneisthatthesceneofthedreamisconstantandvividsoishersenseofbeinginthescene
andmovingthroughit.Themainhallucinatoryaspectofthebrainmindstatemightthenbecharacterizedasvisuomotorratherthanassimplyvisual.(Theterm
visuomotorcapturesthecinematicaspectofdreamingtheconstantlychangingsceneandourperpetualmovementthroughit.)

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AlthoughDali'spaintingsareasuitablemetaphorforthestrangesurrealisticqualityofDelia'sdreamexperience,theyarestatic,whereasDelia'svisionsarenot.Dali's
famoussurrealistfilmTheAndalusianDogisamoreadequatemetaphor,becausebothitsvisionanditsmotionarecontinuous.Thesilenceofthatfilmisalsoaccurate
inmimickingtherelativeweaknessoftheauditorysenseduringdreams,whichIhavealreadynotedasthelackofclearspeech.Weakerstillarethesensationsof
touch,temperature,taste,andsmellnoneofthesearepresentinDelia'saccount.
IemphasizethealmostconstantmotionofDelia'sdreambecausetheillusionofmovementiscommontoalldreams.InsceneoneDeliaisstrugglingtosteadythe
bobbingballoon.Inscenetwo,shewalksthroughthegarden,takesoffhershoes,andwadesinthewaterbeforewalkingontothehotel.Theseareallactive,transitive
movementsofthedreambodythroughthedreamspace.
Let'snowconsiderthepsychologicalaspectsofthedream.Itcould,certainly,promptpsychoanalyticspeculation.IhavealreadypointedoutthepossiblyOedipal
meaningofthisballoonjauntwithdaddyandshownhowDelia'sanxietyatbeingaloftwithhimmightleadtothesafetyoftheirgrounding.Wehaveevenadmittedthe
possibleimportoftheurinationpollutionvisionandconcern.Nothinginmyformalanalysiscontradictsthesespeculativeideas.Iunderstandandacknowledgethat
parentsareimportant,thattheydopowerfullyshapepsychosexualattitudesandbehaviors.Andwithoutendorsingthemastruth,Isimplypointoutthatallthese
"interpretations"reveal"meanings"thatarealreadyblatantandtransparentinthedream.
Whenitcomestodelusions,Delia'scasebecomesmuchmoresubtle.Arethemisidentifications,suchasthisParisbythesea,thePariswithamosque,really
delusions?Theyareindeed.AndtheabilityofDelia'sfatherandsisterstochangetheirmindandsodescendtheballoonisverymuchlikethethoughtprojectionand
relatedfeelingsofbeingmentallytransparentthatbothermanypeoplesufferingfrompsychosis.Thereisnodiscussionamongthem,butitisasifherfatherandsisters
knewshewantedtostop.Sowecansay,yes,therearedelusions,andquitemagicalones

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atthat,butwenotethatthedelusionsarebenign,notmenacing.DeliadoesnotimagineherselftobepersecutedbytheFBI,theKuKluxKlan,orthemafia,those
reallifedemonsthatthreatenourmostpsychoticbrethren.Sothereisnoparanoia,acrucialnegativefinding,sinceschizophreniaandbipolaraffectivedisorder(two
ofthemajorbrainmindstatesthatcausepsychosis)areoftenloadedwithparanoia.
InsightandJudgment
Let'sconsiderinsightfirst.It'sjustnotthere.Deliathinkssheisawakeeventhoughtheactionthatisgoingoncouldneveroccurinthewakingstate.Howcanshebe
sowrongaboutsomethingsoobvious?Wemarvelwhenweheardescriptionsofwhatpeoplebothsaneandinsaneardentlybelieve.Butisn'tittrulymind
bogglingthatwiththemanystrikinganddistinctivesignsofpsychosisthatarealwayspresentinthedreamstate,wealmostneverrecognizeitforwhatitis?
JeanPaulSartre,theFrenchexistentialistphilosopher,assertedthatlackofinsightwasthemostdistinctivefeatureofdreaming.Hecalledita"lackofselfreflective
awareness."Ilikehispoint.Thelackofselfmonitoring,orwhatSartrecallsselfconsciousness,preventsusfromcallingourselvesfoolwhenwearecaught,againand
again,inamadhouseofourowndevising.
Inwaking,wepossessanalmostuncannycapacitytotrackourthoughtsandourbehaviorastheyunfold.Bymeansofselfmonitoringweconductacontinuous
negotiationbetweenourowngoalsandsocialconstraints,betweenourhereandnowideasandourthereandthenhopes,betweenourcognitionsandourfeelings.
Deliadoesmaintainasocialconscience.Noticeheraccommodationofherfamily'sconcernsaboutdangerinorchestratingtheballoon'slanding,herwithdrawalfrom
theurinecontaminatedwater,andherconcernabouttheluxuriousexpenseofthehotel.
Butevenwiththisabilitytojudge,Deliaisnotawareofhertruestateofconsciousness.Whensheisawakeshemightsayofhersuspicions,"IwonderifIam
gettingparanoid,"orofhermomen

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tarylapseswhenshemaybeabsorbedinfantasy,"Imusthavebeendaydreaming."ButalmostneverisDeliaabletonoticethatsheisdreamingwhilesheisdreaming.
Andevenif,forafleetinginstant,sheweretosaytoherself,"Thisissocrazythatitmustbeadream,"herinsightimmediatelyleavesherandsheispulledbackinto
delusion.
Emotion
Thereismoretodreamingthanthevariouscognitivequalitieschartedabove.Thereisthewholedomainoffeelings.Ourfeelingsserveasawaytoknowtheworldthat
iscompletelydifferentfromthinking.Feelingscantellusaboutourstatesandthoseofothers.Wehavepowerful"firstimpressions"andoftenbaseimportantdecisions
onour"gutfeeling."YetintheWest,emotioniscontrastedwithrationalknowingitisalmosttreatedasacognitivenuisance.Itisasifwedidn'twanttoacknowledge
thatemotionsarejustasvalidawaytoperceivetheworldaroundusasthatprovidedbyoursensesandourthoughts.
Delia'sfeelingsmovefromexcitement,elation,andanxiety(intheballoon)tosurpriseandpleasure(inParis)todisgust(inthepissywater).Thusthereisatransition
fromhottocoolfeelingsinthefirsthalfofthedream.
SothispartofDelia'smentalstatusexamdoesnotindicateanypredominantemotionortypeofemotions.Typically,thebrainmindstateofdreaminghasamajorityof
hot,orhighside,emotions(likeanxiety,anger,orjoy)andaminorityofcool,orlowside,emotions(likesadness,shame,orremorse).Notonlydothehighside
emotionstendtooccurmorefrequently,theyareoftenmoreintense.Thisisespeciallytrueoffearandanxiety.Butitisnotuncommontohavebalance,asDeliadoes.
Inaddition,Delia'sdreamemotionsarealwaysappropriatelytiedtohercognitiveexperiences.Thereisnoseparationofthoughtsandfeelingsindreaming,asoccursin
schizophrenia.Herbrainmindstateofdreaming,unlikeschizophrenia,isnotcharacterizedbyattenuatedorsuppressedfeelings,anditisnotcharacterizedbyeither
intolerablystrongdepressivefeelingsorbythegiddyelationthatdisruptscognitionandjudgmentinmania.

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Inshort,theemotionalaspectofDelia'sdreamisnaturalandhealthy.
DiagnosingDelia'sDream:ACaseofDelirium
ThisexaminationofthecognitivedomainsofDelia'sdreamingbrainmindhasrevealedseveralstrikingfeatures:disorientationdistractibilityspottymemoryand
confabulationsvisuomotorhallucinationsanddelusionsandalackofinsightthatappearstoberelatedtoalossofselfconsciousness.Heremotionsarefine.
IhavecharacterizedDelia'sdreamstate.Ihavedescribeditsqualitiesandnotedwhichofthemaretypicalandwhicharesignificantlyoutoftheordinary.SonowIwill
diagnoseDelia'sbrainmindstate.
Deliahasatypicalcaseofdreaming.Thatseemsquitecertain:herbrainmindstateisconsciousandoccursinsleepitisepisodicandithasconsistentfeatures.But
whatkindofpsychosisdoesherdreamrepresent?ThatisthequestionIwantedtoanswer,thequestionJungandFreudnevergotto.
IhavealreadypointedoutthatthereisacleardissimilaritybetweenDelia'sstateandthosewithwhichdreaminghasbeencommonlycompared,namelyschizophrenia
andaffectivedisorder.Thereisaclearsimilarity,however,betweenthemainfeaturesofherdreamstateandthoseofanorganicmentalsyndrome.
Asyndromeisacollectionofsymptomsthatcropuptogetherinresponsetosomepathologicalprocess.Anorganicbrainsyndromeisonethatiscausedbyan
anatomicalorphysiologicalalterationofthebrain.Peoplewhoareintoxicatedwithdrugsoralcohol,havebraintumors,orhaveAlzheimer'sdiseasehaveanorganic
mentalsyndrome.Thesethreegroups,bytheway,oftendisplaypartsofthefollowingsyndromeoffeaturesonthementalstatusexam:
1.Disorientationtotime,place,andpersons
2.Visualhallucinations
3.Distractibilityandattentiondeficits

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4.Recentmemoryloss
5.Lossofinsight
ThesearetheverycharacteristicsofDelia'sdreamstatethatwefoundtobeunusual!Thisleadsustotheinescapableconclusionthatdreamingisanorganicmental
syndrome!
Amongtheleadingtypesoforganicmentalsyndromesitismorelikedeliriumthandementia.Deliriumiscommonlycausedbysuddendisruptionsofbrainfunctions,
suchasintoxicationbyimpulsiveoverdosingofdrugs,orasuddenstoppageintheuseofdrugs.Asareotherdeliria,thevisualhallucinationsandtheshortlivednature
ofthedreamscenessuggestthattheunderlyingcauseofthedreamstateisatemporaryinstabilityorimbalanceofphysiology,ratherthanapermanentstructuraldeficit.
WhatamIsaying?DoesDeliahaveabraindisease?Issheaclosetjunkie,analcoholic?No.Sheisperfectlyhealthyandwelladjusted.Butherdreamstatematches
thewakingstateofsomeonewhohasoneoftheseproblems.UnliketheanecdotalcomparisonofmyowndreamswiththepsychoticepisodesofBertal,Ihavejust
performedadetailedclinicalexercisetoshowthatDelia'sbrainminddreamstatematchesexactlythebrainmindwakingstateofsomeonewhosuffersfroman
organicmentalsyndrome.
Dreaming,then,isnotlikedelirium.Itisdelirium.Dreamingisnotamodelofapsychosis.Itisapsychosis.It'sjustahealthyone.
Nowwebegintoseehowthebrainmindparadigmcanpayoff.Wecanstudydreaming,wecanmanipulateit,andwecancontrolititisasimplematterinasleep
lab.Indoingso,wearestudying,manipulating,andcontrollingapsychosis.Ifwecanunveiltherootcauseofdreaming,wewillhavefoundthegenesisofthis
psychosis.
Oncewearepoweredwiththisknowledge,wecanuseitonthemanyotherunhealthypsychosesthatstalkpeopleallaroundtheglobe.Byunderstandinghowthe
brainmindproducesa"normal"psychosisdreamingwemaybeabletounderstandhowthebrainmindgoesawrytoproduceapathologicalpsychosis.More
broadly,ifwecandiscernasetofprinciplesandrulesdescribinganormalconsciousstateandcanalterthatstateexperimentally,we

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candeduceasetofprinciplesandrulesforalteringabnormalconsciousstateslikeBertal'spsychosis.Ourultimategoalismoreambitiousthansolvingthe
philosophicalbrainmindproblemwewouldliketosolvethepracticalproblemsthatdamagethebrainmind.

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Chapter4
TheCauseofDelia'sDelirium
Everynightintheemergencywardsofhospitalsincitiesaroundtheworldambulancesbringinpatientswhoaredisoriented.Somearedisheveledoldbagladies
obsessedwiththeLastJudgmentsomeareramblingwinosenvisioningbugsclimbingthewallssomeareconfusedyoungmenwhojust''wokeup"inthecity,having
noideahowtheygotthereorwheretheycamefromandsomearegiddyyounggirlswhodon'tevenknowtheirownnames.Intrepidinternsquicklyassessthebrain
mindstatesofthesepeoplebylistingsymptoms,insearchofrecognizablesyndromes.
Whenasyndromeincludesrecentmemorylossandconfabulation,thedoctorsbegintoconstructmenusofpossibleunderlyingorganicdiseasesofthebrain.Since
thesemenusoftengetverylongandthedoctorsdon'twanttomissanythingeasilytreatable,theyorderbasiclabtests:XraysandCATscansofthehead,which
couldrevealmajorstructuralalterationsofthebraincausedbytumorsorbleedingelectroencephalograms(EEGs),whichcouldrevealfunctionalalterationsinthebrain
causedbyepilepticseizuresandspinalfluidanalyses,whichcouldrevealinfectionortheingestionoftoxicchemicalsubstances.

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SinceDelia'sdreamisapsychosis,similartestsperformedwhilesheisasleepcouldgiveuscluestothephysiologicalcauseofhernocturnalmadness.AndsinceDelia
wassoeagertolearnmoreaboutherdreaming,Iaskedherifshewouldvolunteertoundergotestinginmysleeplab.Shesaidyes.
ItoldDeliaIcertainlydidn'texpecttoobservestructuralproblemsinherhead(whichwasarelieftoher)andthatmystaffwouldthereforenottakeXraysorCAT
scans.Buttheywouldlookforchangesinbrainelectricalandchemicalactivity.
ItwouldbeaneasyandpainlessmattertorecordtheelectricalactivityofDelia'sbrainmystaffwouldhookhertoanEEGmachinewhilesheslept.Buthowwould
theyassessDelia'sbrainchemistry?Surelynotbytakingbrainbiopsiesorwithdrawingspinalfluidduringhersleep.Whattheywoulddoinsteadisapplywhatthey
alreadyknewaboutbrainchemistryastheyobservedherelectricalactivityandthebodyandeyemovementsshemadewhilesheslept.Theyhadagoodhandleon
brainchemistrythankstoscoresofscientistswhohavestudiedextensivelytwoofourfellowmammalsthecatandtheratbothofwhichhavethesamebasic
brainactivityduringsleepthathumansdo.
Animalmodelsareusedtostudythebiologicalunderpinningsofallhumanbraindysfunctions.Theyhavebeencrucialtothesuccessthatphysicianshaveachievedso
farinrelievingthesufferingassociatedwithnumerousneurologicaldiseases.Polio,anervediseaseandtheterrorofmyyouth,islonggonebecausethevirusthat
causeditandthevaccinethatcureditwereworkedoutonmonkeys.TherootcausesofParkinson'sdisease,whichaffectsthesameneuronsinthebrainstemthat
controltheaminergiccholinergicsystem,werefoundinrats.Thepharmacologythatledtothedrugtreatmentnowusedwasworkedoutonrats,too.
Thesamestrategyisalreadyprovingessentialinstudyingotherbrainminddiseases,suchasschizophreniaandAlzheimer's.Inthisregard,thebasicscienceofthe
sleepresearchlaboratorypromisestoplayakeyroleinmedicalresearch.
AsDeliaslept,mystaffandIwouldapplycellularandmolecularevidencetoexplainthemechanismsofherpsychosis.Howwouldweknowwhattolookfor?To
answerthiscrucialquestion

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wehadtothinkabitmorecriticallyandcreativelyaboutthesyndromewewouldtrytoexplain.
ReducingDelia'sPsychosis
ThegreatBritishneurologistJohnHughlingsJackson,physiciantotheNationalHospitalfortheParalysedandEpilepticinLondonfrom1862to1906,astutely
observedthatthelossofonebrainmindfunctioninhispatientswasinvariablyassociatedwithareciprocalgaininanother.JacksonlinkedthisobservationtoDarwin's
theoryofevolutionashigherbrainfunctionswereaddedinevolution,lowerfunctionsweresuppressed(butnotlost).Jacksonshowedthatwhenhigherfunctionswere
lostindisease,lowerfunctionsreemergedtotaketheirplace.
InDelia'scase,thementalstatusexamofherdreamstateindicatedshehaddeficitsinorientation,attention,memory,andinsightthereciprocalgainswerein
perception(thevividhallucinations)andemotions(whichwereplentiful).TheHughlingsJacksonwithinusmightsaythatDelia'scapacitytoorganizecognitive
information(orientation,attention,memory,andinsight)sufferedattheexpenseofheightenedsensations(perceptionandemotion).
Delia'sfourdeficitfunctionshadinterlockingfeatures,whichsuggestedtheymightsharesomeunderlyingbrainmechanism.Ifso,thefourcognitivelossescouldbe
reducedtoonecause,asinglecellularprocess.Whatcouldthatprocessbe?Wedidn'tknow,butintuitivelywethoughtthatwhatwasmissingwasrestraint,control,
andstability.Thebasicrestrainingprocessofthebrainiscalledinhibition.
ToexplaintheenhancedsensationsofDelia'spsychosisthehallucinationsandemotionswesupposedthatjustassomethinghadbeensubtractedfromthe
systemrestraintsomethingelsehadbeenaddedebulliententhusiasm.Thebrainlevelprocessthatrevealsitselfasenthusiasmisexcitation.
Ifthelossofrestraintiscausedbyafailureofinhibition,thatsamefailurewouldallowanincreaseinexcitation.Comparingthefunctionallossesandgainsinthisway
suggeststhepossibilitythatallsixunusualfactorsinDelia'sdreampsychosiscouldbereduced

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toone,asinglelossthatwouldbeaprimemoverofacomplexbutinterlockingsetofprocesses.ThatiswhatwewouldlookforasDeliasleptinourlab.
AGroggyNight
Deliaarrivedabout10:00P.M.thenextevening,abitwearyfromalongday.Thoughshehadseenasleeplabbrieflyincollege,shelookedaroundagainwithanew
curiosity,sinceshewouldactuallybesleepinghereandwewouldbewatchingher.Thelabconsistsofthreeroomsinarow,eachopeningoffacommonhallway.
Thereisabedroomatthefarend,arecordingroominthemiddle,andasecondbedroomatthenearend.Fromtherecordingroom,mystaffcanobserveavolunteer
ineitherbedroomthroughonewayglassinwindowsinthewalls.
Eachbedroomiscomfortablyfurnishedwithadoublebed,asmallbedsidebureau,andanadjoiningbathroom.IbroughtDelia,ouronlysleeperthisevening,to
Bedroom1,whereshemetSandy,oneofmytechnicians.SandywouldbemonitoringDeliathroughoutthenightfromtherecordingroom.
OnceDeliahadgottensettledinbed,Sandybegantofixsilverelectrodestoherskinwithasimpleconductivepasteandgauzepads.Sandyplacedoneelectrodejust
tothesideofeachofDelia'seyelids,whichwouldrecordeyemovements,fouronvariouspointsonherscalp,whichwouldrecordbrainactivity,andtwounderher
chin,whichwouldrecordmusclesignals.Theeightelectrodespluggedintojacksintheheadboard,andwiresranfromtheretoanEEGmachineintherecordingroom
(thatway,shouldDelianeedtousethebathroomduringthenight,shecouldsimplypulltheleadsfromthejacksandwalkwiththem,likepullingthejackfromastereo
whilewearingheadphones).
TheEEGmachine,orpolygraph,wouldrecordthedataonsevenofitschannels,plusaneighthchannelfortimeapenforeachdatachannelwouldquiverbackand
forthasareelofpapercontinuallyrolledthroughthemachine,producingaperpetualgraphthatlookssomewhatsimilartoastripchartfromaseismographthat
monitorsearthquakeactivity.

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DelialaydowntorelaxwhileSandywenttotherecordingroomtotestthesetup."Moveyoureyesfromsidetoside,"saidSandy,talkingintoamicrophoneasshe
watchedDeliathroughtheglass.ThetwopenslinkedtothetwoelectrodesnexttoDelia'seyesjumped."Moveyoureyesleft,"Sandysaid,andasDeliacompliedthe
twopensjumpedapart."Nowright."Thetwopensconverged.
WhilethiswashappeningthefourpensrecordingDelia'selectricalbrainactivityweresketchingaway.SandytoldDeliatoclosehereyesandrelax,butevenafter
Deliahaddonesothefourpenskeptatit.Delia'shead,justlikeB.F.Skinner's,wasnotablackboxafterall.Whileshelayquietlywithhereyesclosed,herrelaxed
stateproducedapowerfulalpharhythmontheEEG.
SandytoldDeliatheinstrumentswereworkingfineandthatshecouldgotosleep.Beingadevoteeofmeditation,Deliawaspracticedatinducingastateofrelaxed
waking.Sheoftenusedtherelaxationtechniquetoreleasestressthatbuiltupduringthedayfromthehustleandbustleofherlifeasadataanalystinthebanking
industry.Toinitiatetheprocess,Deliasometimessaidamantraorjustlethermindgoblank.EnteringthisrelaxationstatewouldhelpDeliafallasleepinthelab,
becauseasyoucanimagine,itisnoteasytonodoffwithabunchofwiresgluedtoyourhead.
AnotherimportantrelaxationtrickthatDeliahadlearnedwastoreducethetensioninhermuscles.Inthelabbedroom,shecouldactuallyhearthefaintchatterofthe
recordingpenswhensheclenchedherteethorstretched,becausethetwoelectrodesplacedonherchinpickeduptheelectricalsignalsthatthemusclestheregenerate
duringcontraction.Soifshewasevergoingtogettosleepundertheseconditions,shewouldhavetokeephermusclechannelquiet,andthebestwaytodothat,she
quicklylearned,wastoletthetensionflowfromherbody.
WhenSandywaspreppingDeliaafewminutesearlier,shehadexplainedtheawakeningprotocolforthenight."Doyourbesttosleepnaturally,"Sandytoldher,"and
whenyouhearyournamecalled,wakeupaspromptlybutpeacefullyasyoucanandgiveusareportofanythingthatwasgoingoninyourmindbeforeyouwere
awakened."
Despitebeingkeyedupandabitselfconscious,Deliahadsim

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plytoldherself,"Okay,I'mgoingtofallasleepandshowthesesciencetypeswhataNewAgercandreamupwhensleepingundertheridiculousconditionsofthese
experiments."Aftertenminutes,shewasout.
Meanwhile,intherecordingroom,Ali,anundergraduatestudentincognitivesciencewhowasservinganapprenticeshipinthelab,hadentered.Sandyexplainedthe
strategyoftheexperimenttohim.Shesaidthatthefourbrainchannelsthatgeneratetheactualelectroencephalogram(EEG)readingswouldtellthemaboutthe
activationstateoftheupperbrain,wherethedataprocessinginvolvedinmemory(amnesia),thinking(delusion),seeing(hallucination),andstorytelling(confabulation)
takesplace.Thetwochannelsoftheelectrooculogram(EOG)wouldtellthemaboutthetiming,direction,andspeedofeyemovements.Thechannelshowingthe
electromyogram(EMG)wouldrecordmusclesignalsthatresultedfrommovementcommandsthebrainwouldgivethebodysomeofthemusclesunderthechin
mediatethefacialexpressionsthatresultfromdreamemotions,andotherstwitchduringintenselyimagineddreammovementsofthetrunkandlimbs.Theeighth
channelwouldbeusedtodisplaytimeandtorecordsuchexperimentaleventsasawakenings.
FranticPens,aMilitaryInstallation,andElectricCurrents
OnceDeliafellasleepherbrainmindwasputonautomaticpilot,firstwindingdownquicklyintoadeep,utterlyunconscioustrough,thenclimbingupagaintoapeak
ofwildinternalexcitement.ThiscycleoffallingandrisingbrainmindactivationwouldrepeatitselfthroughthenightasSandyandAliwatchedinfascination.
Allpeoplehaveasleepcycle,andpeopleofthesamegeneralagehaveasimilarone.Formostteenagersandadults,thesleepcyclerepeatsevery90to100minutes.
Ifyousleepfromsixtoeighthours,youwillgothroughfourorfivecycles.
Withineachcycletherearefourpossibletypesofsleep.Stage1

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isalightsleep,Stage2deeper,Stage3deeperstill,andStage4thedeepest.EachcycleusuallybeginswithaquickdescentthroughStage1intoStage2,then3or4,
andendsafteranascentbackup,followedbyastretchofStage1sleep.Picturesteppingdownashortflightofstairs,stoppingatthebottom,steppingbackup,and
stoppingatthetop.
ThedeepestsleepisinStage4.Whenwefirstfallasleep,weusuallyproceedrapidlythroughotherstagestoStage4.Duringthisstage,brainactivityisseverely
limited,heartrateandrespirationandbodytemperatureareattheirlowest,andwedonotdream.Stage3andStage2havesimilarcharacteristicstheyarejustless
extreme.Stage1iswhenwearemostlikelytodream.Thebrainisveryactive,andheartandrespirationratesincreasesignificantly.Oureyesalsodartbackandforth
behindourclosedeyelidsastheytracktheimageswe"see"aswedream.Theserapideyemovements(REMs)arethewellknownsignatureofdreaming.Stage1
sleepisthereforecalledREMsleep,whiletheotherstagesaregroupedintononREMsleep.Asweendeach90minutecycleinStage1REMsleep,wedream,with
apossibleexceptioninthefinalcycle,whenweoftenawakeinstead.Ifyoupassthroughfive90minutecyclesinanight,youwillhavefourorfivedreamepisodes.
Consideringthat,it'samazinghowfewweremember.
SandyandAliletDeliasleepthroughthefirsttwocycles,readilyrecognizableontheEEGchart,becausenonREMsleepisprevalentanddreamsarescantandshort.
AsDeliaascendedhersilentstaircaseinthethirdcycleofthenight,however,shehadaprolonged,intenseREMperiod."It'saclassic,"Sandysaidasthethirdriseof
activityneareditspeak.TheEEGpensjumpedfranticallyacrossthestripchart,theeyeandmusclepensfollowedinsync.
"Lookatthoseeyemovements!"Aliexclaimed."Herbrainmustbebuzzing."
"Thisisthekindofbrainwavepatternthatoccurswhenpeoplearestartledorfrightened,"saidSandy,whohadstudiedtheoutcomeofmanysleeplabnights."And
eventhoughhermuscletoneiscompletelysuppressednow,therearespikesintheEMG,whichindicatetwitchesintheface,arms,andlegs.Let'swakeherupand
askherwhat'sgoingoninherhead."

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Sandygrabbedthemicrophonerightinthemiddleofaflurryofrapideyemovements."Delia!...Delia!"shecalledinastrongbutcalmtone."Delia,pleasewakeup.
Wakeupandtelluswhatyousee."Deliawasgroggy,butsinceshehadalreadybeenasleepformorethanfourhoursshecamearound."What?"sheasked.
"Delia,it'sSandy.Telluswhatyouweredreaming."AlthoughDeliaappearedabitlethargicanddisoriented,shequicklyregainedhercognitivebearings.Sheclosed
hereyesasiftoreplaythedreamanddescribedwhatsheexperienced.
Iwasinatallbuildinginamilitaryinstallationwherepeoplewereworkingonweaponry.Anelectricaldevicewasfiredfromanairplaneatthebuilding.Electriccurrentstraveled
downthemetalframeofthebuilding,withtheeffectthattheexternalshellofthebuildingbecamehardenedsothatpeoplecouldnoteasilyescape.
Anotherweaponwasusedagainstthepeopleofthebuilding,withtheeffectthatimagesofpeoplewalkingthroughthehallswerecreatedsothatrealpeoplemightfallinline
behindthemandbethwartedfromtryingtoescape.Iwasinagroupofpeoplewhowerestilltryingtoescape.Oneofthemtoldmetofollowthepeopleinthehalls,sincetheywere
primarilyillusory.
Webrokethroughawindowandgotoutbeforeitwastoolate.Itwasduskout.Wewonderedhowdangerousitwasoutsidethebuildingwewereafraidpeoplemightbe
waitingoutsidetopickusoffaswecameout.
Wemadeourwaytoahouse.AmanIwaswithcapturedsomeweaponsfromthehouse.Hethrewahandgunthroughawindowofthehousetome.Weescapeddownarailroad
track,andthemantoldmetoshootwhoevercameafterus.Ifumbledwiththeweapon,sothemanexchangedtheriflehehadforthehandgunhehadgivenme,sincehethoughtit
mightimprovemyaim.

Thatwasit.AtypicalsleeplabspecimeninthatDeliafeltmenacedbyelectricaltechnology!"Okay,Delia,"Sandysaid."Thanks.Youcangobacktosleep."Delia
hadalreadysunkherheadbackintothepillow.Thenoisychatterofthemuscleandeyepolygraphpenswentmutethemomentshewentbacktosleep.TheEEGpens

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quieteddowntoo,resumingthetypicalpatternofthenextnonREMsleeptrough.
SandyandAlitookaquietlookatthereadingsonthestripchartfromthelastfewminutes.ThedifferenceinactivitythatcorrelatedwithDelia'sdream,hernonREM
sleep,herwaking,andhersubsequentsleepwasstriking.Theregular,uneventfulEEGpatternofthenonREMsleepindicatedalowlevelofbrainmindactivation.
TheperiodwassuddenlypunctuatedbythesharplydefinedanddistinctiveplotoftheREMdreamingstage.Delia'sdescriptionofherdreamcorrelatedwellwiththe
EEG,eye,andmusclereadingsduringherREMsleep.Inherdreamthereweremanypeopleandobjects,conversations,andchangingscenestotrack,bothmentally
andwithhereyes.Sheexperiencedseveralstrongemotionsfrustration,resistance,fearwhichcorrelatedwithfacialmotionsandmusclecontraction.
ItoldSandyandAlithatthetraitsofDelia'sdreamalsomatchednicelythoseIhadobservedwhendoingthementalstatusexamonherearlierdreamreportthatwe
hadexaminedintheclass.Delia'sdreampsychosisonthisnightinthelabhadthesamenoticeabledeficitsinorientation(shefindstheAlAqsaMosqueinParis),
attention(shecannotfocusonanypersonorobjecttheimagessimplystreampasther),memory(shecan'trecognizepeoplealthoughsheknowssheworkswith
them),andinsight(shedoesn'trealizesheisdreaming).Shealsohadthesamereciprocalgainsinperception(thevividhallucinations)andemotions(whichpervaded
bothscenes).Delia'sdescriptionofherownREMsleepwasfullofevidenceofthenegativeandpositiveaspectsofherpsychosis.
WhattheSleepLabFindingsMean
Deliacontinuedtosleep.ShewasenteringthenonREMportionofherfourthsleepcycle.SandyandAlitookapreliminarylookatthedata.Theysawthatduring
REM,Delia'sbrainmindwasinvolvedinaverydynamicprocess.HerEEGwasstronglyactivatedduringherdream,evidenceoftherichandvividmentalactivityin
herdreamreport.Theinternalmotorsignalsthatwere

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beinggeneratedandreadoutasrapideyemovementsandmuscletwitchesonthepolygraphmatchedthevisuomotorintensityofDelia'sdreamexperience.The
absenceofsignalsfromDelia'schinmuscles,however,indicatedasuppressionofovertmotoractivity,andindeedDelia'sphysicalbehaviorwassuppressed.She
wasn't,infact,standingupinbedasshetriedtobreakthewindowsandfleethemilitaryinstallation.Shewaslyingquitestillbecausehermuscleswereparalyzedby
thespinalinhibitionofREMsleep.HadSandyandAlirecordedheartrateandrespirationtheyundoubtedlywouldhaveseentherapidriseandfallofpulseand
breathingduringthatscenewhichtypifyanxietystates.
InnonREMsleep,Delia'sbrainmindwasinastateoflessintenseactivation.SandyandAlihadawakenedDeliatwiceduringnonREMsleepandaskedfora
report.Delia'sreportswereshortandconfusedtherewerenovividimages,noDalilikevisions,noscurryingabout,noelaborateandimprobablebuildings,andno
flying.Justpriortotheawakenings,herbrainwave(EEG)patternwasslow.Therewasnoevidenceofvisuomotorstimulationonthepolygrapheither,noeye
movements,nomuscletwitches,andnosuppressionofmotoroutput.
HavingstudiedtheoutcomeofthousandsofsleeplabexperimentsatHarvardandotherinstitutions,Sandyhascometothefollowingconclusions:WhenthereisEEG
evidenceofbrainactivationinsleep,thepersonsleepingexperiencesavividformofconsciousness.Whenthebrainactivationisassociatedwitheyemovements,the
personperceivesimagesclearly.Whenmostmuscleactivityissuppressedbutsmalltwitchesoftheface,fingers,head,andlimbsappear,thepersonimagineshimself
toberunning,flying,orswimming.Whentheheartbeatsrapidlyandbreathingrateincreasessharply,thepersonexperiencespanicanxiety.
Allthesedetailedcorrelations,ItoldSandyandAli,haveledustoconsiderthepossibilitythatdreamsaresimplythebrainmind'sawarenessofitsownfullyautomatic,
selfactivatedstate.Thereisnodreamspiritthatinvadesthebodyduringsleepandleavesitagaincomemorning(astheGreekssupposed).Thereisnodreamsoul
thatdescendsanangelicladderduringsleepandclimbsitagainbeforedawn(asthemedievalChristianshypothesized).But

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thereisthewondrousbrainmindwithallofitscreativepower,whichrendersatotallyconvincinganddramaticallypowerfulconsciousexperienceusingonlyitsown
energyandinformation.Justfliptheswitchandwatchtheshow.
Itoldthem,too,however,thatthesleeplabfindingshavetoldustoolittleaboutwhatishappeningwithinthebrainitself.Weneededtouncoversomephysicalchanges
withinthebrainthatcorrelatedwiththecognitivedeficitsofdisorientation,attentionfailure,andlossofinsight,andtheenhancementsofperceptionandemotion.We
hadtouncoverwhatwassubtractedfromthewakingmixinDelia'sbrainthatwouldaccountforthenegativefeaturesofherpsychosis,andweneededtoknowwhat
wasaddedthatwouldaccountfortheenhancedfeatures.
ALookInsidetheDreamingBrain
Seatedintherecordingroom,Sandy,Ali,andIbegantodiscusswhatwashappeningatthemolecularlevelinDelia'sbrain,asshepeacefullyslepttherestofthenight
awaynextdoor.Luckilyforus,acolleagueofmine,Roberto,wasaroundconductingsomeexperimentsintheanimallabdownstairs,andhejoinedus.
Robertoisoneofthebestbrainmarksmenintheworld.Hehasmorethanadecadeofexperienceinplacingminuterecordingprobesanddrugdeliverydevicesdeep
intobraintissue.Healwaysseemstohithistargets,nomatterhowdeeplyburiedinthebraintheylieandnomatterhowsmalltheyare.Andtheelectricalrecordings
thatresultfromhisprobingsareimpeccable.
Asyoumightguess,Robertodoesnotplaceprobesinthebrainsofpeople.Eventhoughthebrainhasnonervesofitsowntosignalpain,andeventhoughitisnot
likelythataprobewouldcauseanydamage,neitherRobertonorIbelievewewillmeetsomeonesoonwhowillbewillingtohaveaprobeinsertedintohisbrain.
Enteroneofourfavoritehouseholdpets,thecat,toasuitableroundofapplause.Thecat'ssleeppatternisstrikinglysimilartoourown.Cats'brainwaves,eye
movements,andmuscletwitchesclearlydifferentiatewaking,nonREM,andREMsleepinaman

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nerthatisparalleltowhatpeopleexperience.Thecat'ssleepcyclealsohasaclocklikeregularity,exceptthatitisaboutthirtyminuteslonginsteadofninety.Thecat's
brainhasnosensorynervesofitsown,either,andaspetloversknow,catsarebrilliantatfallingasleepandstayingthatway.
TheprobesRobertoinsertsintothebrainsofsleepingcatsaresothintheycaneavesdroponthesignalsofindividualcellsandrecordtheconversationformany
minutesorevenhours.Theelectricalactivityissentdirectlytoanoscilloscope,anditisanamazingsight.Thetraceontheoscilloscopejumpsinstaccatofashion,and
theclicksofthesignalscomingthroughthescope'sspeakerschatterawaylikethesoundofahighspeedtelegraph.
Roberto'srecordingofindividualcellswouldbekeytoourdiscussion,becausehisworkandthatofothershasshownthatwitheachsignal,specificchemicalsare
liberatedfromthecells.Ifenoughbrainstemcellsofaparticularchemicaltypeincreasedordecreasedtheirsignalinginunison,thewholebrainmightundergoa
majorchangeinitschemicalstate.SuchamajorchangeinchemicalstatecouldhelpusexplainwhyDelia'sbrainisswitchedfromwakingtodreaming,justasBertal's
brainisswitchedfromsanetocrazy.Itwasthebrainstem,too,thatwewouldfocuson,becausewealreadyknewthatthecellsinthebrainstemthatemitthe
neurotransmittersnorepinephrineandserotoninshutoffduringdreaming,whilethebrainstemcellsthatsignalwithacetylcholinedischargewildly.Wealreadyhada
strongsuspicionaboutwhatwasbeingsubtractedandaddedtoDelia'sbraintocreateherdreamdelirium.
Thebrainstemliesatthebaseofthebackofthehead,justabovethetopoftheneck,andextendsinward.Deepinthecenterofthebrainstemisaregioncalledthe
pons.Cognitivefunctionsinthecortex,theupperpartofthebrain,areturnedonbyasustainedactivationprocessthatarisesinthepons.Somerepetitivemotor
functionslikewalkingandrunningalsobeginwithsignalssentfromtheponsdownthespinalcord.Withhisprobes,Robertohasfoundthatthemotormessagesare
actuallyblockedduringREMthemotoroutputisturnedoff.Onlytheeyesarefreeto

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flyaroundintheirsockets,hesaid,inpartbecausethesemovementsaresoimperceptibletheydon'twakecatsorpeople.Sleep,itseems,isprotectedfromdisruption
bymotorinhibition.
TheEEGwavesthatariseintheponsarecalledPGOwaves,becausetheyradiatefromthepons(P)tothegeniculate(visual)body(G)andtheoccipital(visual)
cortex(0).Duringdreams,theshapeofthesewavesresemblesthatofwavesrecordedduringepilepticseizures.Byunderstandinghowthebrainnormallyproduces
andcontrolsthisseizurelikeactivity,somebrainresearchershopetolearnnewwaystoreducethesufferingofpeoplewithepilepsy.
Researchintoepilepsy,RobertotoldSandyandAli,offeredusanotherclue.Thetemporallobes(hiddenbehindthetemplesnexttoourears)areonepartofthebrain
thatisparticularlypronetoseizures.Theyarealsotheseatofemotion.IftherewasawaytofigureouthowthePGOwavesareturnedoninREMandturnedoffin
theotherbrainmindstateswewouldnotonlyhaveastrongclueastothecauseofthevisuomotorhallucinations,butalsoaleguponhowtheemotionalbraingets
intoseizurelikestatesthatcausethewildanxietyofsomeofourdreamsandthedreamlikestatesofsomepsychoticpatients.
Robertowasleadingthemon,Iknew,becauseheandcolleagueshadalreadyconductedexperimentsoncatsthatwouldfurnishananswer.Theyhadselecteda
syntheticmoleculecalledcarbachol,whichresemblesacetylcholine.TheytheninjecteditintotheponsofcatsthatwereawakeorinnonREMsleep,andthecats
suddenlyswitchedtoREMsleepand(wemightsuppose)begantodream.ThecarbacholsettheREMprocessinmotionthroughouttherestofthebrain.
Sincecarbacholmimicstheactionofacetylcholine,theyconcluded,itisacetylcholinethattriggersthePGOwaves.Thesewaves,inturn,initiatethevisual
hallucinationsandemotionsofdreams.Althoughtheproofwasindirect,itwascompellingabuildupofacetylcholine,whichwoulddevelopprogressivelyinDelia's
brainstemduringnonREMsleep,wouldinitiateREMsleep.Thewholedreamexperiencemightthusbetriggeredbyasinglemolecule.
Couldthisreallybe?SandyandAliwondered.Robertore

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countedtheexperimentalevidencebrainscientistshadfoundinrecentyearsthatsupportedtheidea.First,henoted,theponsisacrucialpartofthevisualsystemthe
cellsthatexecutealloureyemovementsarelocatedthere.Soarethecellsthatturnmuscletoneonandoffandprogramourgaitslikewalkingandrunning,and
acetylcholineisinvolvedinmediatingsomeoftheseactionsinfact,researcherscanturnwalkingorrunningonandoffbystimulatingthepans.ThePGOsystemalso
tellsthesensorypartofthevisualbrainwhatthemotorpartisdoing,anditusesacetylcholinetorelaythatinformation.Whatthevisualbraindoeswiththe
acetylcholinesignalsduringREMsleepishallucinatethat'swhatwethinkhappenstothecatswhencarbacholissquirtedintotheirpons.
AChemicalBalancingAct
Thestepthatremainedwastofigureoutwhatturnedontheacetylcholinesystemintheponsinthefirstplace.Coulditbethattheacetylcholinenetworkwasalways
readytotakeoverbutwasheldinrestraintbyinhibitorysignalsfromsomeothernetwork?Theanswerisaresoundingyes.
Itisonlyrecentlythatscientistswerestunnedtodiscoverhowmuchisactuallygoingoninsidethebrainduringsleep.Oncescientistshadgottenusedtotheir
counterintuitivediscoverythatinternalbrainfunctionspersistathighlevelsinsleep,theygaveuptheideathatthebrainitselfeverreallyrests.Thensomecellswere
discoveredintheponswhoseactivitydecreasedtoabouthalfduringnonREMsleepandwasvirtuallyarrestedduringREMsleepwhiletherestofthebrainwas
activeatnearseizurelevels.Whatdidthecellscontain?Norepinephrineandserotonintheamines.
Theamines'roleintheponsistodecidewhattodowithmessagesthataregeneratedwithinthecellsthere.Theydecidetorespondornotrespond,torecordornot
record,tostoreornotstore.Whenweareawake,thesecellsfireandsecreteaminescontinuously,whichamongotherthingsrestrainsthecholinergicsystem.The
biggestclustersofserotonincellslierightdownthemiddleofthepons,andthenorepinephrinecellslieoneithersideofthem.

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Fromthesesitestheyallprojectgreatdistancesallthewayuptothecortexanddowntothespinalcord.Thisreachismuchmorewidespreadthanthatofthe
acetylcholinesystem.
OnceDeliabegantorelaxinBedroom1waybackaround10:30orso,theneuronsinherponsthatcontainaminesquieteddownenoughforhertoenternonREM
sleep.Thecellsfiredmoreandmoreslowly.Fewerandfeweroftheaminesweresecretedintoherbrain.Theelectricaldriveonhercortexfell.Therelativestrengthof
theacetylcholinesystem,thoughstillinabeyanceduringnonREMsleep,wasbuilding.
After70or80minutessomethingfunnyhappened.Thesystemswitched.Activityinthecellscontainingtheamines,whichhadbeendriftingamiablydownward,
plungedtoitslowestlevelofthedaythesecretionofaminesplungedwithit.Asthenosediveensued,theactivityofneighboringcellscontainingacetylcholinesoared
toapeakrarelyexperiencedevenunderintensestimulationduringwaking.Acetylcholinewassecretedinabundance.Delia'sbrainhadchangeditschemicalmind.
Nooneyetknowsexactlyhowtheamineneuronsaresilenced,butthelackofrestraintonDelia'scholinergicsystembynorepinephrineandserotoninwasnearlytotal.
Delia'sbrainmindcameunderthecompletedominationofthecholinergicsystem.Fueledbyacetylcholine,hervisuomotorcircuitsbuzzedaway.Itwasanythinggoes
intheimage,idea,andfeelingfactory.Herbrainmindwaslikeapinballmachinewithallitslightsflashing.
WhenDeliaenteredREMsleepandbegantodream,themotorpatterngeneratorsofherbrainstemandupperbrainwereturnedon.Motorcommandslike''run"or
"breakthewindows"wereemittedandDeliafeltasifshewerereallyrunningortryingtogetawayinahurry.FortunatelyforDelia,however,thosesamecommands
werenotrelayedtohermusclesbecauseherspinalmotornerveswereparalyzedbyinhibition.
Delia'sbrainmindcalledupscenestofittheemotionoffear.Thesceneswerepeopledwithdramatispersonaefromherfearfantasyfile.Becauseofthelackof
restraintonhercortex,Delia'scapacitytoconfabulatewasenhanced.Anonymouscharacterswith

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gunswoulddoforthestory.Thislooseningofassociationswasnotentirelywithoutrhymeorreason,howevertherewasanunderlyingsetofrulesconstrainingthe
scenariostructureofthedream,becauseitdidmakealotofsensegiventhefactthatshewaswireduptoanEEGmachine!
Givenallthathasbeensaidsofar,itisnothardtoseewhyDelia'sattentionfailedinherdreampsychosis.Therewasnowayforhertofocusononeofthemultiple
competingstreamsofinternallygeneratedimageryarisinginresponsetoheroveractivebrainstem.Firstoneperceptgainedcenterstage,thenanother,inchaotic
fashion.
Whenshewasdreaming,Delia'sbrainmindalsoswitchedfromtopdowncontrol,wherevolitionhasanimportantsayinwhathappens,tobottomupcontrol,where
volitionissweptaway.Thereforeherlossofcontroloverthoughtisunderstandable.Thinkingislikeamotoractinthatitrequirestopdowncontrol.ButthosePGO
wavesrollingoverherbrainandthoseshowersofacetylcholinedampenanysparkthatpersistsofthe"I"thatwatches,weighs,andwillsheractionswhensheis
awake.InREMsleepDeliaisstillsureofherownidentity,butsheisnotatallincommandofheracts.Thingsjusthappentoherandshetries,invain,tofigurethem
out.Thisdissolutionofwillindreamshasalwaysposedaseverethreattomanyethicists,whoaredisturbedtothinkthatsuchaprecioushumantraitasconscienceis
sofragileastobedissolvedbyachangeinstate.
Thescientificevidencenowseemsclearlyinfavorofanevenmoreradicalconclusion.Notonlyisvolitiondependentuponthestateofthebrainmind,volitionisa
stateofthebrainmind.Thegoodnewsisthat,toadegree,wecanmakeupourminds.Thebadnewsisthat,toadegree,wecannot.Itisoursometimespsychotic
mindsthatmakeusup.
WhydidDelia'sdreamend?Becausethefloodofacetylcholinewasturnedoffimmediatelywhenherserotoninandnorepinephrineneuronsturnedbackon.Asthe
twoaminesflowedbacktowardhercortex,Delia'scapacitytofocus,recall,andremembercamebacktoo.WhyDeliaissogoodatrememberingthecontent

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ofherdreamstate,whenothersaresobad,however,isstillacompletemystery.
Bynowitwasnearly6:00A.M.andDeliabegantowakeup.Sandy,Ali,Roberto,andI,however,werereadyforsomesleepofourown.Sandyremovedthe
electrodesfromDelia,andweallinvitedhertovisitourscientifichotelagain.Shewentoffforashowerandbreakfast.Wewentoffforourbedsathome.
LearningfromPsychosis
NowwefinallyhaveacompleteanswertothetwokeyquestionsposedearlieraboutDelia:Whatkindofpsychosisisherdreaming?Andwhatcausesit?Themental
statusexamshowedusthatDelia'sdreampsychosisisadelirium.Thesleeplabexperimentinformedusthatitiscausedbyashiftinthechemicalbalancewithinher
brain.Thereisindeed,asIhadhypothesizedalongwithHughlingsJacksonattheoutsetofthischapter,asingleprocessthatcausedthesixcognitivelossesandgains
ofDelia'sdeliriumitisthelossofaminergicinhibitionandthereciprocalgainincholinergicexcitation.
Themostimportantimplicationoftheseconclusionsisthatalterationsoftheconsciousstatesofthebrainmindobeyreliableandspecifiablerules.Whetherthestates
areanormaldelirium,likedreaming,oranabnormaldelirium,likealcoholwithdrawal,theyalwayshavethesameformalfeaturesandthesamekindofcause.The
commonfeaturesofnormalandabnormaldeliriumaredisorientation,inattention,impoverishedmemory,confabulation,visualhallucinations,andabundantemotions.
Thecommoncauseofnormalandabnormaldeliriumisasuddenshiftinthebalanceofbrainchemicals.Ifnorepinephrine,serotonin,oracetylcholinelevelschange
suddenly,allhellbreaksloose.
Knowingthesharedfeaturesofallkindsofdeliriumandtheircommonunderlyingcauseisahugepayofffromthebrainmindparadigm.Theparadigmunitesasetof
normalanduniversalphenomena,thoseseenindreaming,withapathologicalandexceptionalsetofphenomena,thoseseeninorganicpsychosis.Thistourdeforce
notonlybuildsthepiersofthebrainmindbridgebutit

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allowsnormalandabnormalconsciousstatestomarchacrossithandinhand.Thepromisedlandthatcanbereachedbycrossingthebrainmindbridgeisaspacein
whichallthemyriadvariationsofourconsciousexperiencecouldbedefinedandexplained.
Inchapter5,wewillexplorethatspace.

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Chapter5
TravelinginBrainMindSpace
Inthe1960swhenMercurycapsulesandSputnikswerehurlinghumansintoearthorbit,thehipcultureexperimentedwithwhatcametobecalledheadtrips.Instead
ofrocketfuel,thesepsychedelicvoyagesintoinnerspacewerepropelledbydrugslikeLSDandmescaline,whichalterbrainmindstateschemically.Wenowknow
thatstreetdrugssuchasacidandangeldustcausehallucinationsbecausetheyarechemicallysimilartothenaturalmoleculesthatinitiatedreaming,andtheyinteract
withtheneuronsthatcontrolthestatesofwakingandREMsleep.
Itisnoaccidentthatthedruginducedvisionsofpsychedelicfamearesodreamlike.Norcanweresistdescribingourdreamsaspsychedelic.Promptedbythese
compellinganalogieswewanttocreateaunifiedframeworkforthinkingaboutourinnerspace.Howdowetravelfromwakingtosleeptodreamingduringthecourse
ofeachdayandnight?Whatholdsusonanormalcourse?Andwhatcausessomeofustogoofftrackintotheforbiddenzonesofdelirium,psychosis,orcoma?
InthischapterI'lldevelopathreedimensionalmodelofbrainmindspacetoanswerthesequestions.ThenI'llusethemodelto

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integratewhatIhavelearnedaboutDelia'sdreampsychosiswithBertal'swakingpsychosis.Theresultwillbetheoutlineofamodelofallbrainmindstates.
WhatMadeDeliaDream?
Alistofallthepossibleconsciousandunconsciousstateswouldbequitelengthy.Let'sconsiderwhatthekeyfactorsarethatdriveallthebrainmindstates.Ifthereis
onlyone,thenalinearmodel,likethespectrumofcolorsofvisiblelight,mightdoiftherearetwo,thenatwodimensionalgraphwilldoiftherearethree,thena
threedimensionalmodel,likeasphereorcube,isneeded.
WhenSandyandAlihadfinishedrecordingDelia'ssleeponthatlongnightinthesleeplab,theytrudgedwearilydownstairscarryingaboxoffoldedchartpaper
weighingabouttenpoundsandextendingwhenlaidoutendtoendaboutathousandfeet.EightpenshadcontinuouslytracedvariousaspectsofDelia'sbrain
mindstateoverthesevenandahalfhoursshewasinthelab:herbrainwaves,hermuscletone,hereyemovements.Therewereseventhousandfeetofdataamile
andathirdofittoanalyze.
OnceSandyandAlihadthemselvessleptandwereagainalertenoughtothinkstraight,theybegantoscoreDelia'srecord,pagebypage.TheyretracedDelia'snight
lifetoseewhatthefundamentalfactorswerethatcorrelatedwithherperiodsofnonREMsleep,REMsleep,andwaking.
OnefundamentalfactorwastheelectricalactivitywithinDelia'sbrain.Astheelectricalpowerinherbraindeclined,herconsciousnessfaded,justlikethelightofa
chandelierwhensomeoneslowlyturnsdownadimmerswitch.Whentheelectricalpowerwasturnedbackup,thelightscameon,andDeliawasinREMsleep.One
keyfactor,then,iselectricalactivation.
Butwhydoesn'tDeliawakeuptotheoutsideworldwhenthepowercomesbackon?Andwhycan'tshecontrolthethoughts,feelings,andmemoriesofherdreamsin
REM?BecauseasthebrainisinternallyreactivatedinREM,sensoryinputfromtheout

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sideworldisactivelyblockedherbraincan'treceiveandprocessexternaldata.Hermotoroutputalsoisheldincheck,soshecan'tactoutherdreamsshedidn't
actuallymoveherlegsasshefledthemilitaryinstallationandshedidn'tactuallymoveherarmsasshecaughtthehandgunthatwastossedtoher.
However,byanalyzingthelongstripchart,SandyandAlisawthatDelia'seyesmovedbackandforthassheenvisionedtheaspectsofherdreams.Soherbrainmind
wasindeedseeingtheobjectsofherdreams,ashereyesmovedautomatically.WhathappenedwasthatDeliaswitchedfromanexternalsourceofvisualdatatoan
internallygeneratedsource.Shechangedfromexternalinputstointernalinputs.Asecondkeyfactor,then,istheinputsource.
TherewasstillaproblemthechangesinelectricalactivationandtheinputsourcecouldnotaccountforwhyDeliawasnotabletothinkstraightduringherdreams,
whyshedidn'trealizeshewasdreamingwhenshewasdreaming,andwhyshecouldn'trememberallherdreams.Apparently,hermodeofinformationprocessinghad
changedwhenshedreamed.Itchangedfromrational,logical,andselfaware(thetraitsofbeingawake),todelusional,illogical,andunreflective(thetraitsof
dreaming).Thethirdcriticalfactor,then,ismode.Themodeofthebrainminddependsontheaminergiccholinergiccontrolsystemonwhethertheaminesarein
power,thecholinesareinpower,orthetwoaredeadlocked.
SandyandAlifoundthatthesethreefactorsactivationenergy,inputsource,andmodeofprocessingcouldaccountforalltheexperiencesDeliahadduringher
nightinthelabandforallthevariantsinthereadingstheyanalyzedonthestripchart.Abrieflookattheclockoncetheyhadfinishedthisexercise,however,reminded
themtherewasafourthfactor:time.Thedegreetowhichthethreekeyfactorsareineffectchangescontinuallyovertime.
Nowthatwerecognizethattherearethreefactorsthatmediatethevariousstatesweexperienceduringsleepandthatthesevaryovertime,wecancreateamodelthat
describesourbrainmindspace.Thismodelistheessenceofthebrainmindparadigm.

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TheThreeDimensionsofBrainMindSpace
Let'scallthekeyfactorsforourmodelAforactivationenergy,Iforinformationsource,andMformode.Let'sputtimeonthebackburnerforthemoment.Thelabels
ofthethreedimensionsreadAIM,afortuitousacronym.
Sincetherearethreefactors,wecanpickanythreedimensionalshapewewantforourmodel.ThesimplestisacubeadietoplayMonopoly,aRubixCube
game,aracquetballcourt,anemptybox.
Sincewe'remakingallthisup,wecanputthethreedimensionsalonganyoftheedgesofthecube.ImagineholdingaboxinfrontofyouateyelevelletArepresent
thewidth,Ithedepth,andMtheheightofthebox.Ifyouwereinaschoolauditoriumlookingheadonatthestage,Awouldrunfromlefttoright,Ifromfronttorear,
Mfromthefloortotheceiling.
Itisimportanttorecognizethatthestatespacemodelwehavejustconstructedisentirelyartificial.Likeotherscientificmodels,itisamodel,builttohelpusrepresent
andtestatheory.Italsowillhelpusvisualizehowthebrainmindchangesstate.
Let'scheckthatthemodelmakessense.Isitrealistic?Yesthedimensionsandvaluesaredrawnfromspecificdatatakeninthesleeplab.Isitdynamic?Yesit
recognizesthecontinuouslyshiftingnatureofbrainmindstates.Isitcomprehensive?Yesthespacehasaninfinitenumberofpointsorpositionswithinit,soall
possiblestatesofthesystemcanbeaccommodated.Isitcontinuous?Yestherearenoqualitativeboundariesseparatingthenormalfromtheabnormalinthethree
dimensionalspace.Isitpredictive?Yesifwechangeonefactor,wecanseehowthatwillaffecttheothertwo.
Let'svisualizehowthismodelcanrepresentafewofthebasicbrainmindstates.Takeaseatintheauditoriumandlookattheemptystage.
Nowimagineadothoveringinthecubicspace.Placeit,say,intheright,back,uppercornerofthespace.Coloritredjusttoliventhingsupabit.Aslongasthedot
hoversmoreorlessinthissector

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itrepresentsastablestate,becauseitspositionrepresentingthethreepropertiesofactivation,informationsource,andmodeofprocessingdoesn'tchangevery
much.
Whichstateisthedotin?Thelefttorightaxisisactivationactivationislowtotheleft,hightotheright.Sotheactivationenergyishigh.Thefronttobackaxisis
informationsourcefrontistheinternalsource,backistheexternal.Sotheinformationsourceisexternal.Thefloortoceilingaxisismodewhenacetylcholineisin
power,themodeisatthefloorandwhentheaminesareinpower,themodeisattheceiling(whenthetwoaredeadlocked,themodeishalfwayup).Sothemodeis
aminergic.Thus,whenthedotisintheright,back,uppercorner,thebrainmindstateishighlyactivated,informationiscomingfromtheoutsideworld,andtheamines
areclickingaway.Weareawake!
Gettingtiredofthis?Sotiredyouwantanap?Thenmovethedot.Asyougetsleepytheactivationofyourbraindecreasesthedotmovesfromtherightsideofthe
stagetowardtheleft.Youcloseyoureyes,decreasingtheexternalinputsthedotmovesfromtherearofthestageforward.Youdozeoff,losingrationalthoughtas
acetylcholinebattlestoretakecontrolfromtheaminesthedotmovesfromtheceilingofthestagedowntowardthefloor.Thedotisnowinthecenterofthecubeyou
areinnonREMsleep.
Wherewouldthedotbeifyouweretoreallyzonkoutforawhileandbegintodream?Onthefloor,inthefront,righthandcorner.Duringdreaming,acetylcholineisin
control,soyourmodewouldbeallthewaydownonthefloor.Theinputsarefullyinternal,whichcorrelateswiththeveryfrontofthestage.Butrecallthatbrain
activityincreasesgreatlyduringREMtheactivationenergyishighagain,placingthedotallthewaytotheright,asitwasduringwaking.
Wecanmovethedottoanyregionofthecubeandimaginetheconsequences.WherewouldBertal'sdotbewhenhewasrunningfromthedivebombers?Intheright,
top,frontcorner,asopposedtotheright,top,backcornerthatisnormalwaking.Bertal'sactivationishigh(theright),theaminesareinpower(top),buthis
processingmodehasswitcheditsattentionfromthenormalexternal

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inputs(back)givenbyhiseyesandearstoanabnormalinternalsource(front)thatisgeneratinghallucinations.
Wheredoesthedotlieforahospitalpatientincoma?Attheleft,bottom,frontcorner.Itisattheleftbecausethereisvirtuallynobrainactivation,atthebottom
becauseacetylcholineisindomination,andatthefrontbecausethereisnorecognitionofexternalsensations,meaningthebrainisprocessingonlyinternalinformation.
Amotherandfatherwillsitendlesslyatthebedsideoftheirdaughterwhohaslapsedintocomafollowingatragicaccidentandtalktoherandrubherhandsina
desperateattemptto"getthrough"toher.Inrarecasesthechild'seyesmayflickerorherhandmaytwitchtheparent'swellknownvoiceortouchisanexternal
sourceofinformationthatmayactivatethebrain,foronlyaninstant,inavainattempttojoltthedotofthecomatosechildfromitsdepthatthefrontleftcornerofthe
stagefloor.Asanyonewhohaswitnessedprolongedcomaknows,thebrainmindofthepoorchildhasbecomestuckinthecornerandwillnevergetout.Andshould
theactivationvaluegotozero,it'sallover.Braindeathhasoccurred.
FineTuningtheAimModel
NowthatwehaveabasicunderstandingoftheAIMmodel,let'slookatthethreedimensionsmoreclosely,toseehowtheycontributetomovingusfromonebrain
mindstatetoanother.
Activation(A)
Theactivationfunctionrepresentstheamountofelectricalactivitygoingoninthebrain.ItcanbeestimatedfromthefrequencyofanEEG.Itisalsoameasureofthe
rateatwhichmostneuronsarefiringinthebrain.
Theconceptofactivationhasstrongrootsinthebrainmindsciences.Inneurology,itaccountsfortheswitchingonoftheupperbraininbothwakingandREMsleep.
Inpsychology,itisusedtointerpretresultsofmemorystudiesinordertoremembersomething,wehavetoactivateasetofconnectedcellsthatencodethedata.

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Theideaofactivationalsohasbecomethecentralconceptofneuralnetworks,thesoftwarethatrunsthesocalledartificialintelligencecomputers.Whetherornot
neuralnetworkscanlearnbychangingtheirpropertiesovertime,theprobabilityofgettinganyoutputfromaninputintoacomputer,orourbrains,isafunctionofthe
levelofactivation(or''drive"or"power").Noactivation,noprocessing.Lotsofactivation,lotsofprocessing.
Again,lowvaluesofactivationaretotheleftintheAIMcube,highvaluestotheright.Asweraisethelevelofactivationthedotmovesfromlefttoright,nomatter
howhigh,low,deep,orshallowitisinthebrainmindspace.Wecanrunthedotfromsidetosideatwill,thusactivatingordeactivatingthesystem.
InformationSource(I)
Thisfactortellsuswhetherthedataweareprocessingcomesmainlyfromtheoutsideworld(asitdoeswhenweareawakeandattentive)orfrominsideourheads(as
itdoeswhenwelapseintofantasyorwhenwedream).
Thereisconsiderableevidencefrombothexperimentalpsychologyandneurologythatperceptionisacollaborationbetweenrepresentationsbroughttoourbrainsby
oursensesandinformationalreadyencodedthereinmemory.Considerhowweidentifyanimage.WhenIcomeoutofmyofficeandheadformyconferenceroom,I
oftenseethecoatrackinthehallway.Inthesummer,whentherearenocoatsorhatsonit,itisjustacoatrack.ButlettheweatherchangeandIbegintohavetrouble
seeingitonlyforwhatitis.Inwinter,whenthereisbothacoatandahatontherack,Ioftencatchtheimageoutofthecornerofmyeyeandamstartled,becauseI
thinkforaninstantitisapersonstandingthere.Myheadandeyesaredrawntothisimaginarypersonfrequently,eventhoughIknowbetter.
Youprobablyhavehadsimilarexperiences,especiallyinthedark,whenyouarealoneandanticipatingdanger.Everythingthatrustles,glitters,ormovesisuntil
provenotherwiseanattacker.Youhavetotalktoyourselfsoastonotoverreact.Inpsychology,thisiscalledprojection,anditalwaysoccurswhenthebalanceof
inputstrengthshiftsfromexternaltointernal.

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Thereisaconstantinterplaybetweeninformationcominginfromtheexternalworldandourinternallystoredimages.Aslongasourexpectanciesandobservations
match,wearecomfortable.Butlettheinternalimagery(ourimagination)becometoostrongandweeithermisperceivetheoutsideworld,orbecomeanxious,orboth.
Herewerecognizethatemotionandperceptionareinconstantinteraction.Misperceptionsincreaseouranxiety,andanxietyincreasesourmisperceptions.Thisvicious
cyclecanleadtoneurosisandeventopsychosis.
Duringwakingtherelativestrengthofexternaltointernalstimulationishighand,aswiththecoatrack,issubjecttoimmediatecorrectionviafocusedattention.But
funnythingsbegintohappenasthestrengthoftheexternalstimulidiminish,eitherduetodarknessorbecauseourbrainsarenotsohighlyactivatedwhenweare
gettingsleepy.Itisinthedarkandattheedgesofsleepthatmicrohallucinationsmostcommonlyarise.
ThustheAIMvariableI,theinformationorinputsource,existsalongacontinuum,justlikethelevelofactivation.IntheAIMcube,theinformationlevelrunsfrom
purelyinternal,atthefrontofthestage,topurelyexternal,atthebackofthestage.
Note,now,thatwhenthedotisattherightfrontofthestage,ithashighactivationandstronginternalinput,regardlessofwhetheritisneartheceilingorthefloor.This
isthecolumnofhallucination,ifyouwill.WhenDeliaisdreaming,herdotisattherightfront,onthefloorherbrainactivationishigh,andthevisualinformationis
generatedinternally,butthecholinergicsystemhascontrol,keepingherasleep.WhenBertalseesdivebombers,hetooisattherightfront,butisupattheceilinghis
brainactivationishigh,andthevisualinformationisgeneratedinternally,buttheaminergicsystemhascontrol,meaningthatheisawake.Andsincethecolumnhasa
midsectionitallowsustoaccountforrandomimagesthatsometimesariseinnonREMsleep.
Mode(M)
Whethertheaminergicorcholinergicsystemisinpowerisdescribedasthemodeofthebrainmindstate.Theaminergiccholinergicsystemmodulatescognition
attention,volition,in

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sight,andsoon,allofwhichdiffersoradicallybetweenwakinganddreaming.
ItistheMfunctionthatenablestheactivatedbrainmindtoselect,hold,andevaluateitsrepresentationswhenweareawake.Wecallthisthinkingoranalytic
reasoning.Indreaming,wecan'tthinkinthisway.RecallthatboththeaminergicandcholinergicsystemsarealwaysactiveMistheratiooftherelativepowerof
aminestocholines.AhighvalueofMrepresentstherelativedominanceofamineswhenweareawake.AlowvalueofMmeansthattheaminesarerepressedand
acetylcholineisdominant.Wearedreaming.Wehavenovolition(wecan'tstopthedream).Wehavenocontroloverourattention(wecan'ttakeacloserlookata
passingflowerorapizzashop).Moreover,agreatparadoxensueswhenwewakeup:althoughourmemoriesarereleasedduringdreams,weusuallycannot
rememberthedream.
Asisthecasewiththeothertwovariables,theratioofaminestoacetylcholineexistsalongacontinuum.IntheAIMmodel,thehighestvalueoftheratioisatthe
ceiling,thelowestvalueisatthefloor.
Brainresearchshowsthatthereisadirectlinkbetweencellmetabolismandtheaminergiccholinergicratio.Recallthatthetwoamineneuromodulatorsare
norepinephnineandserotonin.Theymayinhibitorexcitetheneurons.Buttheyalsoredirectthemetabolicactivityoftheneuroncellstheycontact.Thuswhenacellis
contacted,say,bynorepinephrine,itsfiringmaybeinhibited,butitalsomaysimultaneouslybeinstructedtoincreaseordecreaseitsmetabolicactivity,forexample,or
tosynthesizeacertainprotein.Oncethisisdone,thenatureofthecellhaschanged.Thisisoneproposedmechanismforthewayinwhichbraincells"store"memories.
Thesameactivitymayberesponsibleforlearning,forlockingintrauma,orforliberatingapsychosis.
Becauseitcanaffectcellmetabolism,thispoweroftheaminergiccholinergicsystemtocontrolthemodeofthebrainisalsocrucialtothefundamentalbodily
phenomenonwecallourhealth.Thisisbecausetheaminergicandcholinergicsystemsofthebrainstemhavedirectconnectionsdownwardtothebody.Iwillexplore
thisfurtherinlaterchapters.

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MovinginAimSpace
IhavespentconsiderabletimedescribingtheAIMmodelbecauseitcanbeusedtoexplainhowwehumansmovefromonebrainmindstatetoanother.Itcanexplain
howwefallasleep,howinoursleepwealternatebetweennonREMandREMsleep,andhowwewakeupagainthenextmorning.Italsogivesusstrongcluesasto
whatgoesawrywhenpeoplelikeBertal"gocrazy."
Let'svisualizeonceagainthedot,whichrepresentsthebrainmindstate.Sinceyouarenowawake,yourdotishoveringintheupper,back,righthandcornerofthe
cube,thedomainofnormalwaking.Youractivationlevelishigh,youareprocessingexternalinputs,andthestrengthofyouraminergicmodulatingsystemishigh.
Ifyourdotwandersawayfromthecorneralonganyofthethreeaxes,however,youwilldriftawayfromwaking.Onepointisclear:normalwakingisstatistically
improbable!Ifitwerelefttochance,youwouldbeinthispartofthecubeonlyasmallfractionofthetime,yetyouare"there"moreliketwothirdsofthetime.
Ifyoumoveyourawakedotfromtheupper,back,righthandcornertowardtheverymiddleofthecube,youaresimulatingtheprocessoffallingasleep.Asthe
activationlevelfalls,theabilityofexternaldatatocontrolyourthoughtsalsofalls,andthepoweroftheaminergicsystemweakens.Whenyouarefirmlyinthecenterof
thecube,youareindeepnonREMsleep.Allsystemsareathalfthrottle,andnoneoverpowerstheother.However,youremaininthisstablestateforonlyawhile.
Acetylcholine,havingweakenedthepoweroftheamines,startstotakeover,draggingyourdottowardthefloor.Yourcapacitytoprocessexternaldatafalls
precipitouslyasitweakens,theinternaldatainyourcognitiveunconsciousbecomespowerfulenoughtocreateimagery(hallucination)andnarrative(confabulation).
Andtheacetylcholinereactivatesyourbrain.Yourdot,alreadysinkingtothefloor,isthereforepulledforwardbytherelativestrengthofinternalinformationandtothe
rightbytheincreasingactivation.Itstopsinthebottom,front,righthandcornerofthecube.Youareindreamland.
Howdoyouwakeup?Theaminesnevergiveup.Thereisa

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buildupoftensionbetweentheaminesandtheacetylcholineremember,theircontrolisrelative.Atsomepointthetensionsnaps,andtheaminesleapbacktopower,
whichalsochangesyourfocustoexternalinformation.Youhavejumpedtotheupper,back,righthandcorneroftheAIMcube.
Let'stestthisexplanationforwakinginanotherway.Supposeyouaredreaming,andyourgoodfriendsneaksuptoyouandclapshishandsloudlyrightnexttoyour
ears.Youjumptoattention(andproceedtothrottlehimforhiskindness).ButwhathappensintheAIMmodel?Theexternalinputissostrongitinterruptstheinternal
inputitthrustsyoufromthefronttothebackofthestage.Thisshockalertstheamines(likeanyanimal,wesuddenly"powerup"whenweareshockedor
threatened)theyleaptopowerandthrustyoufromthefloortotheceiling.Youareawake.Wideawake.
Inthiswaywecanexplainthepharmacologyofoureverydaylives.Formanyofus,it'shardto"getup"oncewewakeup,especiallyifwehaveawakenedtoanalarm
clockinsteadofournaturalrhythms.Andwhatdomanyofuslookfortohelpusgetittogether?Acupofcoffee.Coffeecontainscaffeine,achemicalstimulant.
Caffeineaffectsusinthesamewaythataminesdoitraisestheactivationlevelofourbrains.Bydrinkingcoffeeinthemorning,wearetryingtoaidourbodiesin
shiftingfromonebrainmindstatetoanother.Note,too,thatwhenwedrinkcoffeeatnightweareartificiallytryingtopreventourbodiesfromshiftingbackfromthe
awakestatetothesleepingstate,againbyraisingouractivationlevelandstavingofftherisingtideofacetylcholine.
Whathappenswhenwearesuddenlythreatened?Wefocusintently.Oursensespeak.Wereadyourbodiesforfightorflight.Weareinastateofsuperactivation.
Why?Theadrenalglandreleasesadrenaline,ahormoneadrenalineisanaminergicmolecule,anditheightensouractivationasitsimultaneouslyraisesbloodsugarand
stimulatestheheart.Atthesametime,aminergicmoleculesarereleasedthroughoutthebrain,andtheneuralcircuitsthatcontrolattention,anxietyanalysis,anddecision
makingarerevveduptopeaklevels.
Inanimalsleeplabs,researcherscancausecatsthatareawake

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tosuddenlydreambygivingthemasmallshotofcarbachol,achemicalsimilartoacetylcholineitshiftsthemodetothecholinergicfloorandmovesthecatsquickly
intoREMsleep.Obviously,wecan'tshootcarbacholintothehumanbrain.Butwecaninjectsimilarcompoundsintotheveinsofsleepingpeoplewhenwedo,they
slipmorerapidlyintoREMsleep,staytherelonger,havemanymoreeyemovements,anddreamintensely.
AndwhathappenedtomyfriendBertal?Whenhebeatupmysupervisor,weinjectedhimwithchlorpromazine.Suddenlyhewascalmandwouldsittoactuallytalk
abouthismother.Hishallucinationsstopped.WhenBertalsawthedivebombers,twoofhisthreeAIMfactorswerefinehisamineswereincontrol(hewasawake),
andhisactivationwashigh(hecouldyellandrun).Butthepartofhisbrainthatprocessesvisualimageryswitchedfrommonitoringthenormalexternalinputstothe
abnormalinternalinputs.Wenowknowthatchlorpromazineaffectsanothermodulatorychemicaldopamine(anamine)thatwehaven'tyetbeenableto
incorporateintoourAIMmodel,butwhichweknowinteractswiththeotheramineandcholinemodulators.OnceBertalhadthehelpofthisdrug,hisinputfunction
wasshiftedfrominternaltoexternalandhereturnedtonormalwaking.
Wemusttieuponelooseend:time.Timewasthefourthfactorcriticaltoourbrainmindstates.ThethreeAIMfactorsallchangecontinuouslyovertime.Timeis
representedsimplybythemovementofourdotastimemarcheson,ourdotmovesbackandforthbetweenbrainmindstatesintheAIMmodel.
Whenwelookatourdailytrajectorythroughthestatespace,wecannothelpbutbeimpressedwiththereliabilityoftherestrictedpaththatwenormallyfollow.It
resemblestheshapeofaboomerang,withonetipintheupper,back,righthandcorner(waking),themidsectioninthecenterofthecube(nonREMsleep),andthe
othertipinthelower,front,righthandcorner(REM).Thatwedonotnormallyentermostsectorsofthecubeisanotherwayofsayingthatthesystemisselflimiting.
Forthiswecanbegratefulintwoways.First,mostofusaresparedtheindignitiesthatbesetpatientslikeBertal.Andsecond,wehaveabetterchanceof
understandingandinfluencingourmovementthrough

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thestatespacebecauseitoccursalongasomewhatnarrowandwellboundedcorridor.
CuringPsychoses
UsingtheAIMmodel,wenowhaveawaytounderstandhowthethreekeyfactorscontrolallbrainmindstates.Thesethreeforcesactivationenergy,information
source,andmodulationdictatethestateweareinateverymomentinourlives.Theyaresimple,butpowerful.
Knowingthis,wefinallyhaveawaytodefineindetailthemanybrainmindstates.Reachingthiscapabilityhasbeenthegoalofthefirstpartofthisbook.Thebrain
andthemindarenotseparateentitieslinkedinsomewelltunedway.Theyareoneentity.Thatentityexistsinvariousstates.Thestatesarecontrolledbythreekey
variables,andastheyvary,ourbrainmindsmovefromonestatetoanother.
YoucanusetheAIMmodeltothinkaboutyourownbrainmindstates.Inpresentingthemodel,Iamnotattemptingtotakeawaythewonderful,cozyfeelingyoumay
haveaboutyourdreamstheyarenolessmagicaljustbecauseyouunderstandhowtheyarecreated.Iamnotattempting,either,tochallengeyourbeliefsabouteternal
lifeIamattemptingtodescribewithscientificrigorhowthebrainmindworkswhileyouareonthisearth,regardlessofwhetheryouthinkyouarereincarnatedor
haveasoulthatwillcarryonafteryouaredead.
Theminordiscomfortsofthebrainmindthatweexperience,fromfatiguetoanxietytooccasionalsleeplessness,occurwhenoneofthethreekeydriversisoffabitfor
somereason.MajormentalillnessessuchasschizophreniaandAlzheimer's,however,occurwhenthereisaproblemwithoneormoreofthemajorfacultieswe
possess,regardlessofwhetherthecauseisphysicalorpsychological.Thesefacultiesareorientation,memory,perception,emotion,attention,andenergy.InPartTwo,
Iwillexamineeachfacultyandshowhowitisaffectedbythebrainmindstates,andthushowthestatescanbeusedtocorrectthementalillnesses.
Ifwecanfigureouthoweachfacultyworksinahealthystate,

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wehaveagoodchanceoffiguringhowtofixitinanunhealthystate.Thebrainmindstatewebestunderstandtodayisdreaming.Dreamingisnotlikeapsychosis,itis
apsychosis.It'sjustahealthyone.IfwecanmonitorandexperimentonthefacultiesduringthehealthydreampsychosesofpeoplelikeDelia,wecanthenfindthe
causeandperhapstreatthefacultyproblemsthatcausetheunhealthypsychosesofpeoplelikeBertal.

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PARTTWO
ANALYZINGTHEBRAINMIND

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Chapter6
LostandFound:OrientationandDisorientation
MybedroominBostonfacessouth,asdoesmybed,whichhugsthenorthwalloftheroom.Therearewindowstotheeast,whichareonmyleftasIsleep,andtothe
south,beyondthefootofthebed.Beyondthedoorinthewalltomyright(thewest)isthatimportantantechambertothegreathallofsleep,thebathroom.
OnerecentmorningIwasawakenedbyafaintbutdefiniteclinkingsoundinthebathroom.Twoyearsago,beforemydaughterleftforcollege,Iwouldhavesleptright
throughthisgentlenoise,becauseherbedroomhasadoortothebathroomfromtheotherside.ButIknewthereshouldbenosuchsoundtomyrightnow,andI
respondedwithalarm.Mydaughterwasgoneandtherewasnoguestusingherroom.
HowquicklythiscomputationwasmadeIcan'taccuratelysay,butIwouldguessittookallofabouttwoseconds.Myorientationprocesswasasfollows:(1)The
placeismybedroomthereisnodoubtaboutthatbecauseIamme,wakingupinbed.(2)It'searlymorningbecauseIcanseeafaintlightthroughthedrapescovering
theeastwindowandIamalreadyawareofhavinggottenupduringthenighttousethebathroom.

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Nowthatmybrainmindwasmorefullyactivated,Iwonderedwhocouldpossiblybemakingthesoundinthebathroom.Myorientationalsearchforacandidatewas
powerfullydrivenbyanxiety,anemotionthathadbeenimmediatelyactivatedbymynotknowingwho.
Inthatinstantofwaking,Iwentthroughalikelypersonschecklist.Wasthewho:(1)Mydaughter?No,shewasawayatcollege.(2)Myliveinhousekeeper?No,
sheneverusedthatbathroombecausethereisanotheroneimmediatelyadjacenttoherownquartersinthebackofthehouse.(3)Anovernightguest?No,Iknew
therewasnone.(4)Myfather?Impossible,hisapartmentisevenmoreremotethanmyhousekeeper'sandatageninetyhedoesn'twander.
SinceIhadeliminatedalltheinnocentsuspects,myanxietyroseanothernotchandImovedintothedomainofmenace.HadsomeonecomeinofftheStreet?Unlikely,
sinceIhadlockedthegroundfloordoorsandwindowsbeforeretiring,asIdoeverynight.Still,wehadtwobreakinsandonewasbyasecondstoryspecialist.Soit
couldbeacrook.Iimagineditwasaman,becausehousebreakersareusuallymen,andbecausetherehadbeenarecentupsurgeinneighborhoodviolence.Iwasby
thistimeaplusfiveonthefivepointanxietyscale.
AlthoughIwasawake,IwasasdisorientedasIaminadream.ExceptthatmycriticallogicwasworkingquitewellinadreamIdon'trejectthecandidatesthatIcall
uptoplayarole.Theysimplypassbyme.Ievenaskedmyself,Nowwhywouldanyhousebreakerbeinmybathroom?There'snothingtostealinabathroom.
Thelightswerecomingupabit,butnotenoughtoprotectmefromawildprojectionwhenIheardafaintlyaudiblefemalevoiceinthebathroom.Itmustbethe
housebreaker'sgirlfriendandshe'sbrushingherteeth,Ithought.
Seriously!AprofessorattheHarvardMedicalSchoolcameupwiththisnuttyconclusion.ButimaginativethoughImaysometimesbe,Icouldn'tbuyit.SoIfigured,I
mustbewrongaboutmywhereaboutsI'mlostinthemaproomofmymind.MyselfreflectiveawarenesswastellingmethatIwasbarkingupthewrong

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treeandthattherewassomethingwrongwithmybasicassumptionsaboutspace.Irealized,stilldimly,thatImightbedisoriented.
MyanxietyleveldroppedtothreeandIbegantoregroup.Waitasecond,Ithought,mybedroomisalmostneverthisdarkandthereshouldbelightthroughthesouth
windows,too.AndthenIheardtwofemalevoices.Nohousebreakerwouldtaketwogirlfriendsonthesamejob,Ideduced,clinchingthecase:Imustbeinsome
otherbedroom.
Sureenough,Iwasinanotherbedroom.IhadjustawakenedinahotelinColumbus,Ohio.Outinthehallway,justbeyondthebathroom,weretwochambermaids
clearingtheroomoppositeofaroomservicetrayandclinkingtheglassesonit.ItisimportanttonotethatthebathofthehotelroomwasonmyrightasIlayinthat
bed,whichdidhugthebedroom'snorthwallIwaslyinginthesamerelativepositionwithrespecttotheeastwindowofthehotel,throughwhichthesunriselightreally
didfilterasIwokeup.Inmyterror,however,IwasroughlysixhundredmilestothewestofmyBostonbedroom.
Thereareseveralpointstothisstory.Thefirstisthatoursenseoforientationisaconstructionthatwehavetofabricateuponawakeningeveryday.Thesecondisthat
ifwehaveevenoneimportantdetailwrong,orientationisdifficultorevenimpossible.Thethirdisthatotheraspectsofourconsciousness,suchasourabilitytothink
straightandtofeelcalm,aredependentuponourbeingoriented.Thefourthisthatourabilitytoorientisstronglystatedependentiffiveminutesratherthanfive
secondshadelapsedbetweenmyawakeningandmyhearinganoise,Iwouldhavehadnotroubleknowingwhatwasgoingon.Finally,thisvignetteillustratesthat
thereisatightlinkbetweenthinkingandfeelingandthereisaverystronganddecidedlycounterproductivefeedbackloopbetweenanxietyanddisorientation.The
moreanxiousIbecame,themoreoutlandishweretheideasIentertainedtoexplainthenoisesinwhatImistakenlytooktobemyBostonbathroom.
Mysmallcaseofmentalillnessquicklycorrecteditself.Indeed,soquicklydidIgetmybearingsthatIwouldneverhavetakenanynoticeoftheepisodemymind
jumpedthroughallthosehoopsinwhatwasprobablylessthantwominuteshadInotprimed

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myselfduringtheprecedingmonthstotrytopayattentiontotheprocessofwakingup.How,Iwondered,couldasystemsobadlyoutofwhackinonestate
(dreaming)rightitselfsoquicklyandsothoroughlyinanewstate(waking)?
Thisstoryalsoillustratesthatbrainmindstatetransitions,whilerapidenoughtofoolus,arecertainlynotinstantaneous.Theyarehybridstateswithqualitiesofboth
sleepingandwakingthatoperatesimultaneously.WhenIusethevernacularterm''halfawake,"youknowwhatImean.Butwhichpartofthebrainmindisawake?
Whichpartislaggingbehindstillinsleep?Andhowlongdoesitreallytakeforthelagginghalftocatchup?
Althoughtheyconcernthemostcommonplaceeventsinourdailylives,thesefascinatinganddifficultquestionsareofmomentouspracticalimportance.Considera
doctoronnightcallintheemergencyroomofabusyhospital,oranairtrafficcontrollerinalargehubairport,oraradaroperatoronanuclearsubmarine.Howmuch
disorientationcananyofthesepeopleaffordwhenmanyotherpeople'slivesdependupontheirbeingattheirverybest?
Thesecondpartofthisbookexaminesthemajorfacultiesofthebrainmindthatwedependonforlife:orientation,memory,perception,emotion,attention,and
energy.Eachofthemdependsonthestatethebrainmindisin.Mymaingoalinthissectionistousethebrainmindparadigmtoexplainhowitisthatthesefaculties
worknormally,andhowachangeinstateisresponsiblefortheirgoingawry.Allmentalillnessesresultfromthefailureofoneormoreofthesefaculties.Forthosewho
areill,orientationgiveswaytodisorientation,memorytoconfabulation,perceptiontohallucination,reasonableemotiontoextremism,attentiontodistraction,and
energytodespair.Ifachangeinthestateofthebrainmindcancauseafacultytofail,thereishopethatwecancountermentalillnessbychangingthestatebacktoits
rightfulplace(howtodosoisthesubjectofPartThree).
Eachofthenextsixchaptersaddressesoneofthemajorfacultiesineach,Iintendtoshowhowtheconceptofstates,theAIMmodel,andtheaminergiccholinergic
systemcanexplainboththenormalandabnormalfunctioningofthatfaculty.Oneoftheways

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todothatistoexaminesomeoftheexperienceswe"normal"peoplehave.ManyofusexperiencethesymptomsofabnormalstatesDelia'sdreams,andmineforthat
matter,sharemanyoftheformalfeaturesinBertal'spsychosis.Analysisoftheseexperiencesoffersstrongcluestowhatcausesanillpersontopermanentlyharborthe
symptomsthatareonlyfleetingforus"normal"people.Inchapter12,Iwillthentieallthesefacultiestogether,andcombinethemwiththeparadigmdevelopedinPart
One,tocreateanewexplanationofconsciousness,unconsciousness,andthemind.
Orientation:ANecessaryTrick
"WhereamI?"isaquestionthatwemustbeabletoanswerateveryinstantintime.Whenweareawake,wedothissoeffortlesslyandsounconsciouslythatwefailto
noticehowimportantandhowactivethisorientationfunctionisinestablishingourplaceintheworld.Thefactthatwearesooftenlostinourdreamshelpsus
appreciatethefrailtyoftheorientationfunctionandexplainswhydeepstudyofthebraininREMsleepcouldgiveussurecluesastohowoursenseofplaceis
achieved.Otherexperimentsofnaturethatresultinseveredisorientation,suchasAlzheimer'sdisease,arealsoinstructive,howevercruel.Howdoweorient?And
whatstatechangescauseusandotherstobecometemporarilyorpermanentlydisoriented?Letusgritourteethandanswerthesequestions.
Locatingourselvesinspaceisonlypartoftheorientationfunction.Wealsohavetoknowwhoweareandwhattimeitis.
Knowing"whoweare"isnotalwayssimple.Oursenseofselfisacombinationofinternalandexternalmonitoring,bothofwhicharesubjecttofailureasourbrain
mindchangesstateoverthecourseofeachdayandoveralifetime.
Inmanydreamsneitherthedreamernorotherdreamcharactersareexactlyastheyshouldbe.IoftenidentifydreamcharactersaspersonsIknowonlytonoticethat
theirphysicalfeaturesinthedreamdon'tmatchupwithreality.Forolderpeople,accurateidentificationofthirdpersonsstartstofailasmemorybeginstofalter.This
tellsusthatourabilitytoorientdeteriorateswitheachnew

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day,iffornootherreasonthanthatourbraincellsdieatanapproximaterateof50,000perday.Weneednootherillnessbutlifeitselftoaccountforalossin
orientation.Ourrelationshipsalsohelpdefinewhoweare,andweallknowhowrelationshipscanchange.Thisisnotafrivolousthoughtanagingmanbeginstolose
sightofwhoheisashefailstorecognizehisownfamilymembers.Awomanwhomarrieshappilycanloseherentiresenseofselfwhenheroncetrustedhusband
startstobeather.
Knowingthetimeisnoteasy.Agreatpartoftheproblemstemsfromthefactthatoursocialworldisregulatedbyschedulesandthatinfernalinvention,theclock.Our
mindsandbodiesareregulatedbyanentirelydifferenttimer.Toorientproperly,weneedtomakeasharpdistinctionbetweenexternal,societaltimeandinternal,brain
time.Societaltimeisentirelyarbitrary.Ourinternaltimeisinnatewhenwe"takeourtime,"weproceedatapacesetbyaclockinsideourheads.Thatsameclock
timesourmoods,ourdrive,andourfertility.
Therepresentationsofplace,time,andactioninourbrainmindsdependabsolutelyonthestateourbrainmindsarein.Maintainingthedramaticunitiesisthusmuch
morethanatheatricalnicety.Inprovidinguswithorientation,thebrainmindgiveseveryaspectofourconsciousnessandourbehaviortheirmostcrucialcontextual
dimensions.Wecannotbegintoevaluateanythingwithoutfirstcorrectlyidentifyingitandlocatingitinplaceandtime.
OrientationandtheOrientingResponse
Therearetwopartstoourorientationfaculty:anorientingresponse,whichisourimmediatereactiontoanunexpectedsignal,andasenseoforientation,whichisour
ongoingassessmentofplace,person,andtime.AquicklookatwhathappenedtomewhenIawoketotinklingglassesillustrateshowthesetwopartsdiffer,yetwork
together.
WhenwearearousedfromREMsleepandregaintheorientationalparametersofwaking,thebrainmindmustmovealongdis

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tanceinthethreedimensionalstatespacethatIsketchedastheAIMcube.Thelittledotdoesn'tjustleapinstantaneouslyfromthelower,front,righthandcornerof
dreamingtotheupper,back,righthandcornerofbeingawake.Itmovestheregradually,althoughquickly.Sincetheactivationlevel(A)isalreadyhighandstaysthat
way,anydrag(orinertia)thatthesystemmustovercomeduringtheactofwaking(whenwedragourselvesoutofbed)mustbeduetoeithertheinformationsource
(I)orthemodulator(M).NotethatduringmyawakeninginColumbusmysenseswereinstantlykeenmycapacitytoperceivethetinklingglasseswas,ifanything,
enhanced.Thusmyinformationprocessingchannelswerewideopen.
Themostlikelyculpritoftheinertiawemustovercomeduringwaking,then,isthemodulator,theaminergiccholinergicsystem.Duringwaking,theaminergicneurons
inmybrainstemareresurgingtotakebackcontrolfromthecholinergicneurons.Whyshouldthisrisebeplaguedbyinertia?Becauseweneednotonlytogetthe
electricalsignalingofthesecellsuptospeed(andthatdoeshappenveryfast),butalsoweneedtoraisetheconcentrationoftheirchemicalproducts(norepinephrine
andserotonin)throughoutthebrain.Itisthiswethormonalaspectofthemodulatorysystemthatlags.Likefillingatankwithfluid,ittakessometimetoregainfullbrain
modulation.
MyColumbusawakeningstorydemonstratesthattheorientingresponsehappensastonishinglyquicklyandaccurately,eventhoughthesenseoforientationtakes
longertorectify.Eveninmyhalfsleep,Icouldaccuratelylocalizethequestionablestimulustomyright,aboutfifteendegreessouthwestandabouttwentyfeetaway.
Theorientingresponseisarapidreflexwithlittleornocognitivecomponent.Itreadiesourmusclesforthedreadedchoice:fightorflight.Ifthestimulusthatexcites
suchalarmlaterprovestobeinnocuous,wecansimplyrelaxbettertosupposeanunknownpersonisafoeandlaterrealizemymistakethanignorethispossible
dangerandbedonein.
Orientation,ontheotherhand,isanenduringconditionandisalmostwhollycognitive.Onceweorient,thenwebegintoevaluate.Thisprocesscanbecomplicatedby
emotionbecauseIcould

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notquicklysettlethequestion"who,"anxietysoundedanalarmandsetmyfancifulthoughtsinmotion.
Theorientingresponseisareflexthathasevolvedtofavorthefastestpossiblecollectionofthemostcriticalexternalinformation.Itismediatedbythesame
acetylcholineneuronsofthebrainstemthattriggerREMsleep.Thequickestwaytoactivate"eyesright"istobuzzthenervecellsontherightsideofyourpons.You
can'tdoitvoluntarilyasrapidlyasyouwouldifIweretoclapmyhandsbehindtherightsideofyourheadwhenyouwerenotexpectingaloudnoise.
Theorientingresponseiscompletelyautomatic,involuntary,andprecognitive.Asfarasweknow,itisalldoneunconsciously.Orientationoccursmoreslowly,hasat
leastsomevoluntaryaspects,andiscognitive.Butittooishighlyautomaticand,atsomelevel,Idaresay,isalsoaquantitativecomputation.Thecomputationis
performedintheupperbraininresponsetocuesperceivedbythebrainstemandyieldsanswersthatgroundournarrativeandcanberetrievedinourverbalreports.
Butnoticehowcloselythesetwoprocessesarerelated:theyaresequentialandserial,butalsosimultaneousandparallel.Sincebothorientingandorientationdepend
onthebrainstemandsincethebrainstemischemicallyreorganizedaswemakethetransitionfromdreamingtowaking,orfromanyonestatetoanother,theywill
bothchangeasafunctionofbrainmindstate,withmanydramaticconsequencesinadditiontothosewehavealreadyexplored.
TheMapRoomoftheBrain
Howthebrainactuallycomputesourlocationinspaceisstillunknown.Evidenceisaccumulatingtosuggestthatthesignalsderivedfromtheorientingresponsemaybe
integratedwithmapsthatarestoredinmemorybyaspecializedbrainregioncalledthehippocampus.Thismaproomisaspecializedpartofourmemorybankwhose
contentsarestoredinintimateproximitytoemotioncentral,locatedbesidethehippocampus.Thenetresultisthatoursenseofplaceistiedtoourrecollectionsofearly
experienceandoursenseofcomfortoruneaseintheworld.

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Noticethatthecombinationofspatialorientation,memory,andemotionthatwasevidentinmyColumbusawakeninghasacorrespondingconjunctionatthe
neurologicallevel.Thetyingtogetheroforientingresponsedata(atinklingsoundtomyright)withspacemapsstoredinmemory(thelayoutofmyBostonbedroom
andbathroom)andinthepresenceofaninternaldistresssignal(anxiety)requiresalocalizedbrainregionthatisspecializedtoperformthisthreewaycomparison.
Ifyoumakeafistwithyourrighthandandtucktheendofyourthumbundertheforefinger,theresultingimageofyourhandresemblestheappearanceofyourbrain
seenfromaboveandtotheleft.Thebackofyourhandandforefingerrepresentthecortexatthetopofyourbrain,andyourthumbrepresentsthetemporallobeat
yourleftear.(Thebrainstemwouldextenddirectlydownbelowthebaseofthepalmofyourhand.)Thehippocampusliesapproximatelyatyourthumbnail.Alongside
itinyourthumbisthealmondshapedemotionfactorywhichLatinlovinganatomistscalledtheamygdala.
ThehippocampusasmaproomideahasgainedgreatercredibilitythroughtherecentworkofneurophysiologistsFrankKeefeandLynnNadel,whohavefoundthata
specificcellofthehippocampussignalsmoststronglyasaratmovesfromonespecificspatiallocationtoanother.These"placecells"mustbethesameonesthatget
turnedoninourbrainsduringREMsleepaswewanderaimlesslyaroundthelandscapeofourdreams.
Theadjacencyofourspatialmemorybank(thehippocampus)andouremotionregister(theamygdala)isimportantforbothsurvivalandprocreation.Evidenceis
readilyseenintheanimalworld,whereknowingwhoelseisinone'sterritory(friend?foe?mate?)andknowingwhatbehaviorisappropriate(fightorflight?approach
oravoid?)reallymatters.
Thequestion,then,iswhetherourownalteredbrainmindstates,andespeciallyourdreams,aren'tremindingusofjusthowimportantallofthisplace,person,and
timeknowledgereallyis.Whyelsewouldthebrainmindexpendsomuchofitscognitiveeffortattrying,invain,tosettleonareliabledreamlocale,toestablisha
consistentcastofdreamcharacters,andtosituatethe

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actioninaparticulartimeperiod.Inthissense,Freudwasright:dreamsaretryingtotellussomethingimportantaboutourinstincts(sex,aggression),ourfeelings(fear,
anger,affection),andourlives(places,persons,andtimes).Fromstudyingwaking,sleeping,anddreaming,wecan,therefore,deriveatheoryofhowthesecruciallife
dataareprogrammed,integrated,andmaintainedusingoneofourmostfundamentalfacultiesorientation.Acloserlookatsomeoftheorientationalfactorsof
Delia'sdreamswillshowhowtheycoincidewithinstinctandemotion.
CreatingtheBizarrenessofDreams
Throughanextensivesetofobservationsofmanyreports,mysleeplabgrouphasestablishedthesurprisingandpreviouslyunrecognizedfactthatmostofwhatwe
considertobethestrangenessofdreamsderivesfromtheirorientationalinstability.Aswehaveseen,dreamswithalltheirwonderfullycatharticdramasnotonly
flagrantlyviolateAristotle'scanonicalunitiesoftime,placeandactionbutalsooftenconfoundtheidentitiesoftheactors.
Toillustrateorientationalinstabilitylet'slookagainatDelia'sfirstdream,theoneinwhichshewasflyingintheballoonwithherfatherandsisters,thenlandedinParis
bythesea,sawtheboypissinginthewater,andendedupplanninghervisittotheAlAqsaMosque.Thewaythatwescorethedreamistounderlinethephrasesin
Delia'sdreamreportthatportrayinstancesof"bizarreness."Bizarrenessisdefinedasimprobabledetailsofeitherthedreamplotorthedreamer'sthoughtsandfeelings.
Foreachbizarreitemthatisidentifiedinareport,wenexttrytosituatetheitemwasitintheplotitselforinthedreamer'sthoughtsorfeelings?Finally,we
determinewhetherthebizarrenessqualityoftheitemstemmedfromdiscontinuity,incongruity,oruncertainty.
Whatresultsisatablelistingtherelativefrequencyofeachbizarrenesscategory.Delia'sballoondreamwastypicalinthatthethreeleadingbizarrenessesidentified
wereplotincongruity,plotdiscontinuity,andcognitiveuncertainty.Youtoocouldreturnto

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myhoteldreamormysummaryofDelia'sballoondreamreportandscoreitforyourselftogetthehangofityoumayevenwanttorecordsomedreamsofyourown
andscorethemusingthetechnique.Whatyouwillendupwithisalistthatisstructuredlikethis:
Bizarreitem

Situated

Quality

Itseemedtobecomealiveaerialview

Plot

Discontinuity

Downtotheseashore(PariswasontheNorthSea)

Plot

Incongruity

Isawayoungboypeeinginthewater

Plot

Incongruity

PlotIncongruity
FarandawaythemostcommonpeculiarityofDelia'sdream,andalldreams,isthatthecharacters,settings,andactionshavemismatchedorotherwiseinappropriate
features.Sometimestheserepresentphysicalimpossibilitieslikethemapthatsuddenlybecomesanaerialview,butusuallytheyaremoresubtle,suchaswhenshesaid
thatshewalkeddowntotheseashoreorsawtheAlAqsaMosque.Thisclassofitemsseemstoreflectakindofoverinclusiveness,asifthereferencefilesforagiven
itemsuchas"Delia'stourism"weremorewideopenthanispermittedinwaking.Theassociativerulesaresoloosenedthatalmostanythingfitsintoadream
scenario.
PlotDiscontinuity
Lesscommon,butnolessdistinctive,isasuddenchangeintheidentityorcharacteristicsofaperson,aplace,oranaction.ThePariscitymapthatmetamorphoses
intoaliveaerialviewisastrikingcaseinpoint.Moredramaticdiscontinuitiescansegmenttheplotintoentirelyseparatescenesbychangingallfacetsoforientationat
once.Thisclassofitemwouldseemtoreflecttheactivationofcognitiveschemataandtheirneuronalnetworkinfrastructure.Thenewschematicnetworksmightor
mightnotbeassociatedwiththeonestheyhavereplaced.Whileitisgenerallyassumedthatthesuccessivescenesofadreamdealwithasingle,unifyingtheme,

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wewilllaterconsiderpersuasiveevidencethateventhematicunityissometimesflagrantlyviolated.
CognitiveUncertainty
Thesecondmostcommonitemtobescoredasbizarrebywakingstandardsisexplicitvaguenessregardingorientationaldetailssuchvaguenessmaybeexpressed
whetherornottheitemsthemselvesarebizarre.Delia'sballoondreamdoesnotillustratethisfeaturedramatically,butheruseofthephrase"seemedto"indescribing
thetransmogrificationofthePariscitymapintotheliveaerialviewcomesclosetoit.Whetherthisclassofitemisconvincinglybizarreisdebatable.Iincludeitbecause
itissoprevalentinmanydreamreportsandbecauseIfinditoddthatinmyowndreamsIcan'teithercoherentlyimaginewellknowncharactersorbesureofthe
identityofsomecharactersthatareclearlyimagined.Boththeperceptualassemblies(theimages)andtheirnominalattributes(theirnames)tendtobeunaccountably
peculiar.IfIhadthesetwodifficultiesinmywakinglife,myorientationalcapabilitywouldbegrosslydefective.
MicroBizarreness,MacroStability
Alltheitemsdescribedinthebizarrenessinventoryarerelativelydetailed.Atahigherlevelofdreamorganization,thespatiallocationsarestableforeachofthefour
scenes.Indeed,itisthisstabilitythatdefineswhatwemeanbya"scene."Furthermore,thedreamlociarestableinwaysthatwemustconsidertobesignificantwith
respecttothedreamer'sgoalsandlifehistory.
Scene1takesplaceintheballoon,anexoticsettingreflectingDelia'slifelongdesiretotranscendmundanereality.Butherfatherandsistersarealsointhisperilous
craftwithher.Something(fear?)ispullingthemdown,butthisinturnobviatestheneedtoendthetrip.
HereweseethewayinwhichDelia'sorientationalinstabilityinteractswithherdeepmotivationaldrives.Intotheholesand

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spacesofherdefectivedreamcognitionflowthehopes,wishes,andfearsthataretiedtothekeydrivesinherlife.Thesenseandthenonsenseofherdreamaretwo
sidesofthesamecoin.ItisthisreciprocalaspectthathasledmetocalldreamingaphysiologicalRorschachtest.LikethemeaninglessinkblotsthatHermann
Rorschachaskedhispatientstoidentify,theREMsleepbrainsendsitselfsenselesselectricalmessagesandsays,"Tellmewhatyousee!"Theresultingdreamreflects
ourinnatetendencytoprojectmeaningontostimuli.Whatwesee,feel,anddoinourdreamsrevealsourspecificandpersonalpredilections.Ishouldpointout,
however,thatbyusingthisanalogy,IdonotscientificallyendorsethepracticeortheinterpretiveaccuracyofeithertheRorschachtestoranyparticularsortofdream
analysis.Interpretationisalwaysarisky,speculativeenterprise.
Deliadoesn'thavetogohome,afterall.ShecanstayinParisandcontinueherquestforexoticadventuresonfirmground.Sothebeatgoeson,atleastforDelia,and
inScene2sheexploresthecityandfindstheseashoretovisit,whereshegoeswading.Weassumeherfatherandsistersarestilltherebuttheyarenotmentioned
again.Butagainsheisblocked.Deliaislikethenurseryrhymegirlwhoaskshermotherifshecangoouttoswimandistold,"Yes,mydarlingdaughter.Hangyour
clothesonahickorylimbbutdon'tgonearthewater!"Aboyisurinatingandsopollutingherbathingplace.
InScenes3and4sheisstillquesting,butnowhergoalistheAlAqsaMosque.Thisisexoticenough,surely,butnoticethatherplantovisitthisholyplaceofIslamis
nowsanctifiedbyprayer,byworship.Herquestforadventurehasnowbeentamed,neutralized,andsocialized.Sheisagoodgirlafterall.Onlyinseekingdirections
tothemosquefromtheladybehindthehoteldeskdoessheonceagain"takeoff,"butthistimeitisentirelyviathevisualizationoftheaerialviewofParis,whichserves
herneedtofindthemosqueentrancesoshecansayhermorningprayers.
Lookingatthedreaminthiswayemphasizestheclarityandcoherenceofitsstructure.Overridingthemicroscopicbizarreness,whichIaminclinedtodiscountas
meaninglessbrainmindnoise,

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isthemanifestlycoherentnarrativethatdisplays,withlimpidclarity,manyofDelia'spsychologicalconcerns.Bydiscountingdreambizarrenessasnoise,wearefreed
fromanyinterpretiveobligationtoitandcaninsteadfocusourattentiononthedirectlyrelevantnatureofthisdream'scontent.
Thiswayofsortingdreamwheatfromchaffrunscountertoclassicalpsychoanalyticpractice.BecauseFreudthoughtthatdreamsweremostmeaningfulwhenthey
appearedmostcrazy,hewasinspiredtopositacensorthatdisguisedthedreamdatasothatitcouldnotpossiblybeunderstoodwithoutinterpretationviafree
association.OurnewtheoryallowsustodispensewithFreud'sdistinctionbetweenthemanifestcontent(whichhedemeanedandweconsidervaluable)andthelatent
content(whichheextolledandweconsidernoise).
Therelateddreamcharacters,settings,andemotionsarereadoutasDelia'shippocampusandamygdalaarestimulatedbyherbrainstem.Ontopofthesestableplots
isajumbleofcognitiveoddities,whichimpliesthatthebrainmindcannotachievefullcoherenceofdreamplotdetailbecausetherearetoomanyunpredictableand
irrelevantstimuliemanatingfromDelia'sbrainstem.ThefailuretoachievetightcoherenceofdreamplotmayalsobeduetochemicaldemodulationofDelia'scortex,
whichcontainstheinformationneededtoroundoutthedreamscenarioinaninternallyconsistentway.
Putanotherway,Delia'sbrainmindcallsuponitsownrecordsofsignificantplaces,people,relationships,andfeelingstoachievesuchorderasispossibleunderthe
curiouslyalteredconditionsofthedreamstate.Whilethiscouldbetakentomeanthatdreamsrevealunconsciousmentalstructuresnototherwiseavailabletothe
subject,thatisnotnecessarilyso.Aswehavejustseeninthelastfewparagraphs,thesameinformationisreadilyavailablefromDeliaduringherwakingstate.There
wasnoneedforaFreudianexplorationintoherunconsciousalltheinformationwaseasilyaccessiblewhensimplytalkingtoDelia.
Whatismostdreamyaboutdreams?Whatismoststrange?Discontinuity,incongruity,anduncertainty.Thesearealldisruptions

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inorientation.Theyareallproblemsofplace,person,andtime.OfalltheimpressivefeaturesofDelia'sdreams,andmineandyoursandeveryone's,orientational
instabilityisthemostfundamental.Thereasonforthisisthatthedreamstateisdifferentfromthewakingstate.Dreamingisanorganicpsychosis,andtheother
instanceswhenweseeorientationasaproblemaretheotherorganicpsychoseswhenthebraincellsofanAlzheimer'spatientaredying,orthebraincellsofan
alcoholicarepickled.Duringdreamingthereisnodeathofcells,nodrug,butthereisaphysicalcauseforthedisorientationtheaminesthenorepinephrineor
serotoninarenowheretobefound.Acetylcholinehassweptthemout.Andsoweseehowthebrainmindparadigmexplainsorientationduringwaking,and
disorientationduringdreaming,thathealthypsychosis.
ButwhatofBertal?Ifthebrainmindparadigmholdstrue,thenasimilarexplanationshouldholdforBertal'sepisodesofhallucination.Andindeeditdoes.
AsitisforDelia'sdreams,disorientationisafundamentaltraitofBertal'spsychoticepisodes.Clearly,hewasdisorientedwhenheenvisioneddivebomberscomingat
himatThePsycho.Hismindcouldnotevenbegintojustifydivebombersasrealunlesshewasseverelydisoriented,becausehewasinsideabuildingatthetimeof
the''raid."Disorientationalsoledtohisattackonmeinmyoffice.Hethoughthewasina"houseofpeaceandrest"becausehesawwhitewalls,heardasolemnquiet,
felthardfloorsbeneathhisfeetthat'swhyhekneltatmyofficedoorandgenuflected.Thenhesawmestandingthere,inawhitedoctor'scoat,whichbythispoint,to
hismind,couldbereadilymistakenforaholyrobe,andhethereforemistookmeforJesusorGod.HismindwasdoingtheexactsamethingthatDelia'swas:receiving
imagesandimposingascenariothat"madesense"outofthem,inordertotrytoorienthimtotellhimwherehewasandwhothepeoplewerearoundhim.The
difference,sincehewasawake,wasthathismotorimpulseswerenotinhibitedandhewasindeedabletokneelandlungeatme.Whyhelungedisanotherquestion,
butwhyhethoughtIwasaholymaninthefirstplacewastheresultofdisorientation.

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DisorientationinDifferentStates
Wecanbetterunderstandthefacultyoforientationbylookingattheorientingresponseanditscounterpart,habituation.Liketheboywhocriedwolftoooften,
handclapseventhunderclapslosetheirpowertomakeusjumpiftheyoccurfrequentlyenough.
Sincetheorientingreaction,withitsrapidredirectionofoureyesandourheads,isareflex,thecapacitytodiminishtheorientingresponseisalsoautomatic.Buthow
cananautomaticsystem"know"howtorecognizeastimulusasfamiliar?Whenasurprisingsignal,likethesharpreportofafirecracker,entersthebrainstem,it
catchestheneuronsnapping.Asamotorresponseisbeingprepared,the"Whereisit?"orientingsignalsaresentintotheupperbraintopreparethosenetworksforthe
analytictaskofdeterminingthesignificanceofthestimulus.
Underconditionsofsustainedthreat,theorientationsystemconsiderseverysoundasdangerous.DuringthebombingofLondoninWorldWarII,Britishcitizens
hidinginundergroundsheltersconsideredeveryenginelikesoundtobethatofaGermanairplane.WhenKhrushchevwasfoundtohaveinstalledmissilesinCuba
andKennedylearnedthatmorewereonthewayweAmericanswerefacedwiththerealisticthreatofbeingbombardedforthefirsttimesinceWorldWarII.I
vividlyrememberthemassstartleresponseofthirtyscientistsin1962whenaloudexplosionsuddenlyinterruptedournightcourseincalculusattheNationalInstitutes
ofHealthnearWashington.Wewereallunderourdesksbeforeourorientationsystemrecognizedthatthesourceofthesoundwasacarbackfiring,andnotoneof
Castro'smissilesblowingupthePentagon!
Thebrainstemsignalsthatpreparetheupperbrainnetworksfortheiranalytictaskofasking"Whatisit?"includemessagesfromtheacetylcholineneurons.These
brainstemsignalsaresostrongtheycanactuallyberecordedasprominentwavesintheEEG,called"evokedpotentials,"ofananimalthatisstartledduringwaking.
Thisinternalcommunicationsystemutilizesacetyl

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choline,andalthoughitisnotyetexactlyclearwhy,thecurrentthinkingisthatacetylcholinemayactasachemicalexclamationpoint.Itreinforcesthesignificanceof
othersignalscomingintothevisualbrainbysaying,"Hey,you'dbettersitupandtakenoticeofthisimage!"
Thefirstwaveofanyseriesofextremestimulicausesthereleaseofalargeamountofacetylcholine.Italsoexcitestheserotoninneurons,which,aswealreadyknow,
putadamperonthecholinergicsystem.Buttheserotonineffectisdelayedandprolonged.Itdoesnotdiminishthefirstresponse,butitdoessuppresstheresponseto
subsequentstimuli,eachofwhichkeepsthedamperonaslongastheyarerepeatedfrequentlyenoughtoguaranteetheirfamiliarity.IfIentertheroomwhenmy
partnerisworkingintently,hewilljumpandadmitseverefrightdespitehispromptrecognitionthatitisonlyme.Butoncestartled,hisvulnerabilitytoarepeat
performanceismarkedlydiminished.Icouldn'tscarehimifItried.Hebecomeshabituated.
Itwouldthusseemthatourstatecontrolsystemisalsoanelementallearningmachine,sinceitknowshowtochangeitsresponsesbasedonitsexperience.Butnow
weneedtoask,"Supposeitchangesstate.Whathappenstoitsknowledgethen?"
BecausethemotoraspectsofthestartlereflexaresuppressedinREM,ourbrainmindneedssomeotheroutletforreactionstostimuli.Duringourdreamswe
constantlyinventimaginaryinterlopersinresponsetotheacetylcholineandelectricalstimulienteringourcortex.Bertaldoesthesame.
Itisinthissensethatwearerepeatedlysurprisedbyunexpectedevents,bystrangepeople,byfeelingsofalarm,andbythefullbagoforientationaltricksthatour
brainmindemployswhenitlacksexternalspacetimecues.Ourcapacitytogetusedtobeinglostisitselflost.Soeverythingseemsnovel,seizesourinterest,absorbs
ustotally,andmakesusfeelwhollyengagedinthefool'serrandoffindingoutwhereweare,whoelseisthere,andwhatisgoingon.Indreamland,itisablindman's
bluff,itishideandseekfromstarttofinish.And,asinthesechildren'sgames,wearealways"it."

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MyLostMother
Inourdreams,weexperiencethebrainmindstateofsomanyofourfellowhumanswhosufferfrommentalillness,thoseunfortunateswhoarealways"it,"always
lookingforsomethingthatisnotthereandoftenunawarethattheyarecaughtinaviciousgameofhideandseek.Putmoreharshly,whenwedreamwearebeing
treatedtoapreviewofcomingdistractions,thosethatageanddegenerationofourownbrainmindsmaybring.Nowthatweknowthechemistryofhowthebrain
mindbecomesdisoriented,however,wemaybeabletoapplyittomentalillness.
Whenmymotherbecamelostduringagameofbridge,Ishouldhavecaughton.ShehadalwaysbeensuchagoodbridgeplayerthatIfailedtounderstandherstrange
behavioronenightwhenIfirstnoticedherspatialdisorientation.ItwasinJuly1977,andwehadtakenasmallhouseinanabandonedItalianvillagenearPisain
Tuscany.EveryMondayIdroveaperilousmuletraildowntoBagnidiLuccaandthenontoPisatocollectatrunkfulofbooksformyresearchonTheDreaming
Brain.TherestoftheweekIworkedinthemorning,enjoyedexploratorytripswithmyfamilyintheafternoon,andintheevening,afterdinner,satwiththemallinthe
kitchentoplaybridge.
Mymother,whowasthenseventythree,andIwereononeteam,andmywifeandsonwereontheother.Ihadfirstbidspades,andmymotherandItookthe
contractatfour.Asisusual,Iinvitedmymothertodisplayhertrumpcards,thespades,beforemysonledthefirstcardofthehand.Shelaiddownaverynicesetof
spades,buttomyastonishmentsheplacedtheminacolumntoherleftandnottoherright,asconventiondictates.
WhenIthoughtlesslyblurtedoutmyobjectionshewasquiteinsistent.Withhercharacteristicdeferenceandsweetnessshesaid,"Ialwaysputthemdownonthisside."
Istilldidn'tgetit.Asaresultofmyincreasingobstinacy,shefinallygavein,saying,"Oh,haveityourway,"andchangedthetrumpfilefromherlefttoherright.We
wentontowintherubberassheplayedhersubsequenthandwithherusualskill.
Butthen,whenwewereonanoutinginFlorence,mymother

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hadtroublerememberingwhereshehadparkedthecar.Thiswaseasyenoughtodismissonahotsummerdayinaforeigncityfullofshorttemperedtouristslike
ourselves.Anddismissitwedid.ItwasnotuntilthenextfallwhenapolicemanfoundherconfusedandutterlylostonabackroadnearherownhouseinNew
Hampshirethatthelightsfinallywentoninourheadsandwerealizedtherewassomethingsadlyamissinthemaproomofhermind.
Inretrospect,I'mgladittookussolongtorealizethatshehadbeguntoundergothatinexorabledegenerationofbraincellsnamedaftertheMunichpsychiatristAlois
Alzheimer.Asaresult,shehadhalfayearoffreedomandwehadsixmoremonthsofenjoymentofhercompanywithoutanycontemplationofthepainthatlayahead.
ThemostconfoundingfeatureofAlzheimer'sisdisorientation.Andalthoughbrainscientistsdon'tyetknowhowtofitallthepiecestogether,itisbecomingclearthat
Alzheimer'sisalmostentirelytheresultofaprobleminbrainchemistry.Thebrainmindparadigmoffersussomehope.
ItseemsquitelikelythatinAlzheimer'sdiseaseboththeacetylcholineandserotoninsystemssufferfromthewidespreadlossofcells.Thesleeparchitectureof
Alzheimer'spatientsisastopsyturvyastheirmemorywhentheyareawake.Alzheimer'sisadiseaseofstructurethataffectsallthestatesofthebrainmind.
Thoseofuswithahealthycomplementofbraincellsaremorelikelytobecomedisorientedaroundtheedgesofsleep.OnewaytogaininsightintoAlzheimer's,then,is
tofurtherstudywhathappenstousaswemakethetransitionfromwakingtosleepingandbackagain.Thecapacityofourbrainmindtoattend,toremember,andto
controlemotionisdecidedlydiminishedattheedgesofsleep.Idaresaytheseimportantfunctionsslideimperceptiblybutsignificantlyalldaylong,Whyelsedomostof
usworkmosteffectivelyinthemorning?Themostlogicalanswerisbecausewe'vejustsleptandthesefunctionshavehadachancetorestorethemselves.
Thecurrenttheoryisthatourfacultiesfunctionbestinthemorningbecausetheratioofaminergictocholinergicneurotransmissionismaximalatthattime.Putanother
way,weareatthe

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topofthemodulatory(M)axisintheAIMmodel.Wearesharp,interested,attentive,andeffectiveatourdataprocessingtasks.Asthedaymoveson,theaminergic
systemlosesitsedgeandthecholinergicsystemescapestightcontrol.Ourmentallapsesfirstincreaseinfrequencyandfinallybecomecontinuouswhenitistimefor
lightsout.
Insleep,whathadbeenaslowdeclinebecomesaslipperyslope.Asaminergicactivityplummets,cholinergicactivitysurges.Now,inourdreams,wecanseethings
thataren'tthere,believethingsthataren'ttrue,becomecompletelydisoriented,explainawayourdementedstatebyconcoctingwildstories,andthenconveniently
perhapsforgetournocturnalmadness.
Asforthepurposeofthisflimflam,weimaginethatouraminergicbraincellsmightbenefitfromtheirtimeoff.Perhapstheyareabletorestoretheirchemicalpowerby
buildingnewmoleculesandnothavingtousethem.Atthesametime,ourcholinergicneuronsarehavingafieldday,sotheybecometamedandmoreeasilymanaged
bythetimewewakeupinthemorning.What'smore,theirrambunctiousactivityovernightcouldhavetunedourbraincircuitsbyrunningtheminthedark,inessence
usingourdreamsastestprograms.Totakebutoneexamplethatoforientationitseemspossiblethatwegetlostindreamsinordertostayfoundinwaking.
Thechangesinourfacultiesthatsocloselyparallelchangesinourbrainstateshouldconvinceusallofthevirtuesofthebrainmindparadigm.Whetheritbeoverthe
courseofadayoroverthecourseofalifetime,itisinthestructureandfunctionofourneuronsthatwefindthemostfundamentalwaysofunderstandingour
extraordinarytalentfororientation(andaswewillseeinsubsequentchapters,formemory,andattention,andotherfacultiesaswell).
Infact,wecannowseewhywecalledthebrighteststudentsinourhighschoolandcollegeclasses"brains."Theirprodigiousfeatsofmemorization,theirspeedin
perceivingthelogicofageometrytheoremortheallegoricalsignificanceofashortstory,theiruncannyabilitytoconcentrateontheirhomeworkallthesemental
skillsweremanifestationsofoptimalbrainmindstatecontrol.

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Thesebrainykidsweretheparagonsofthebrainmindparadigm.Theirsuperbcerebralhardwarewasafortuitousgeneticaccident.Theirversatilementalsoftware
wasagreatprogrammingjobdoneinthechildhoodandteenageenvironmentsoftheirlives,whichloadedandfinetunedtheircerebralcircuitsforefficientand
accurateprocessingbothonlineandoff.

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Chapter7
TheStoryofOurLives:MemoryandConfabulation
Inthe1960s,manypeopleinthepsychoanalyticcommunitybelievedthatourlivesweretheenactmentofscriptsprewrittenintoourminds.Nowmostpsychoanalysts
contendthatwewriteourownscriptsaswegoalong,pullingupoldscenestohelpusnavigatethroughnewones.Thoseoldscenesareourmemories.AndasFreud
himselfinsisted,it'snotwhatreallyhashappenedtousthatmattersit'sourrecollectionofwhathashappenedthatmatters.
Anyparentknowswhatthismeans.Asparentstrytoadvancearelationshipwiththeirchild,theylookbacktohowtheirownparentsinteractedwiththem.Whatthey
arecallingup,however,isnotwhatactuallyhappened,buttheirrecollectionofwhathappened.
Wealldothis.Thereisnoalternative.DuringChristmasIamalwaysremindedofhow,whenIwasasmallboy,IlookedupthechimneytoseeifSantaClauswas
real.WhetherIactuallyrememberdoingthat,atsuchayoungage,oramrememberingthestorymyparentsalwaystoldmeofmydoingit,Ican'tsay.It'sour
reconstructionofearlyevents,ourfantasyaboutthem,thatoperatesinourmindstoday.

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MySantaClausmythconnotesprecociousscientificskepticism.Weallmanageourdailylives,ourimportantrelationships,andouremotionalupheavalsbymeansof
storiesthatwetellourselvesaboutourselves.WeareallourownPRagents.Atthehighestlevelofourconsciousness,thereisasetofprecepts,explanations,and
ruleswithoutwhichwewouldbeunabletocopewithlife.Weconstantlytrytoclarifyandarticulatewhattheseimportantrepresentationsactuallyare,andthenwe
makeadeliberateefforttocreatealternativedescriptionsofourselvessothatwecanliveourlivesmorehappily.Weallconstantlyelaboratenarrativestructuresto
explainandguideourbehavior.Someofthematerialishistoricaltruth,andsomeofitispurefiction.Andsomeofitmayjustbemadeuponthespottosuittheneed
ofourcurrentscript.
Whatarememories?Therearenowords,nosentences,nopictures,nostoriesinourheads,anymorethantherearesentencesinthewordprocessorthatrecordsthis
manuscript,flashesituponascreen,andthenprintsitoutonpaper.Thereareonlybitsofdata.Ourmemoriesexistasgroupingsofdataintheactivatedneuronal
networksofourbrainmind.Visualimages,mapsofspace,andmotorprogramsareallproducedwhenweactivatetheappropriatenetwork.
Memoryitselfisnotathing.Itisaprocessofneuronalnetworkactivation.Sometimesweareimmediatelyabletoactivatethenetwork,say,torecallthenameofa
personweknowweshouldknow,andsometimeswecan't.Somememorynetworksselfactivateinperpetuity,nomatterhowuselesstheinformation.Thetelephone
numberofmychildhoodhome,whichIleftoverfortyyearsago,is2320043onthelastdayofthebaseballseasonin1944,SnuffyStirnweissoftheNewYork
YankeeslosttheAmericanLeaguebattingchampionshiptoLukeApplingoftheChicagoWhiteSoxbyafewthousandthsofapercentagepoint.Istillremember
cryingasIdidthelongdivisiontofigureouttheresult(IwasaYankeefan).Othernetworkslastonlyafewdaysandaregone:whatdidyoueatfordinnerlast
Monday?
Memoriesarestronglydependentonthestateofthebrainmind.WhenIenterREMsleepeachnightandthemodulatorychemistryofmybrainchangesitsstate,Iam
liabletorecallex

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traordinarilyremotememories.RecentlymysixthgradeclassmateDickTinguelysuddenlypoppedintooneofmydreamsafterafiftytwoyearabsencefromany
otheraspectofmyconsciousexperience.FunnytothinkofDicklyingquietlyinafurrowofmybrainforallthoseyears.JustasDickTinguelypopsupduringmy
dream,acquaintanceslongforgottenpopupduringyours.Yet,aswehavealreadyseen,werarelyrememberadreamwehadjustafewhours,orevenminutes,
earlier.Peoplewhocanputthemselvesinatrancecansuddenlyhearthevoiceoftheirmotherorfather,deceasedforyears.Themorningafteranightofdrunkenness,
theycan'trememberwhattheydid.
Alltheseoddtraitsofmemoryareonlybeginningtobeunderstood.Howdoesmemorywork?Whydoesitchangewithstate?Howcanitleaveus,andthosewith
mentalillnesses,temporarilyorpermanently?Letususethebrainmindmodeltoworkoutsomepreliminaryanswers.
ThatCarLooksLikeIt'sBeeninanAccident
IwasstandingonthesidewalkinfrontofanineteenthcenturyapartmenthouseontheQuaiAristideBriandinLyon,France,whenthenarrativenetworksofmybrain
emittedanominousannouncement:Thatcarlookslikeit'sbeeninanaccident.Andindeed,therearendoftheEnglishRiley1.5parkednexttothecurbwasa
messasifsomeothercarhaddrivenintoitatconsiderablespeed.Thecrowdofpassersbythathadgatheredtosurveythewreck,anddiscussitspossiblecausein
heatedGallicdebate,indicatedthattheaccidentmusthavebeenrecent.Itwashardformetotell,exactly,becauseIhadtroubleunderstandingtheirFrench.ThenI
hadaveryalarmingthought.
Howeverdamaged,thatlookslikemycar.Butitcouldn'tbe,Itoldmyself.Thereisnothingwrongwithmycar.ThenInoticedthatdowntheroadaboutahundred
yardswasasmallblueFrenchRenaultwithabridgeabutmentstickingupthroughitshoodliketheEiffelTower.Anothercrowdofgarrulousandgesticulating

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Frenchmenwastryingtoextricatethedriverfromthecrumpledfrontseatofthatvehicle.
Iwonderhowthedriverofthiscar[referringtotheonethatlookedlikemine]isdoing?Iaskedmyself.Hemustbeokay,becausethereisnooneinthecarandthere
isnoonelyingonthesidewalk.
AmemberoftheargumentativecrowdthathadgatheredaroundthecarbeforemethenaskedmesomequestionsthatIcouldn'tunderstandwellenoughtorespond.I
justsmiledhelplesslyasIusuallydowhenatalossinaforeigncountryorastrangesituationandthatseemedtosatisfythegroup.Theywentbackto
gesticulatingand,asIgatheredfromtheirgestures,toarguingaboutwhathadhappenedandwhomighthavebeenatfault.Bythistimeapolicemanhadarrived,as
wellasanambulancethatemittedaterrifyinghonkinsteadofasiren.
Ilookedatthecaragain.
Practicallytotaled,Iconcluded.I'mgladitjustlookslikemine.Amazingcoincidence.Black(justlikemine),cutelittleEnglishfourseater(justlikemine),redleather
bucketseats(justlikemine),walnutdashboard(justlikemine),Riley1.5,raremake(justlikemine).Extremelydifficulttorepair,saidmynarrativenetwork.
Allthefeaturesofthewreckmatchedthoseofmyowncar.Eventhelicenseplate,RhodeIsland,MD353,whichcouldbeseeninthecrumpledfoldsofthebashed
trunk,matchedthoseofmyvehicle.Iwassurprisedbyallthesedetailsbutwasatsomethingofalosstounderstandhowsuchcoincidencescouldbeexplained.
YetIwasn'tdisoriented.IknewwhoIwas.IknewitwasSaturday,October9,1963.AndIevenknewthatIwasstandingonthesidewalkoftheQuaiAristide
Briand,whichrunsalongsidetheRhneRiver.Ipromptlyrecognizedmywife,Joan,whensheshoulderedherwaythroughthecrowdandaskedme,''Areyouokay?"
"Okay?OfcourseI'mokay.Butlookatthatcar.Whatamess!Gladit'snotours.Itjustlookslikeours,"Ireassuredher.

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"Butitisourcar,"sheasserted,"andwhenIwentintothehousetopickupthebabysitter,youweresittinginthedriver'sseat."
"Ohyes,"Isaid,withoutanyrealconvictionandpromptlyforgotwhatIhadjustbeentold.
"Fromthebabysitter'sapartmentaboveIheardthecrash,"shecontinued."Somedrunkranintoyoufrombehind.Bothhislegsarebroken!"
"Howdreadful"wasthebestIcoulddoforhim.Icouldseethathehadbeenextricatedfromhiscarandwasabouttobewhiskedofftothehospitalbythemournfully
honkingambulance.
SincemywifehadidentifiedmeasthedriverofthestoveinRiley,thepolicemanwasnowaskingmealotofquestions.ButIwasnotgivinghimwhathewanted."Too
badhedoesn'tspeakFrenchaswellasyou,madame,"hesaidtomywife(inFrench,ofcourse).
"ButhisFrenchisusuallyfluent,"Joantoldhim."Theremustbesomethingwrongwithhishead.Hecan'tseemtorememberanything."
Joan'sdiagnosisdidn'tslowthegendarmedownany.HeandthesidewalkjuryallagreedwithmethatIwasfine."N'inquietezvous,"hesaid,meaning,"Notto
worry."
ButIdidhavesomeconcernaboutouroneyearoldson."HowisIan?"Iasked.
"Fine,"Joansaid."Heisathome."
IstillhadenoughselfreflectiveawarenesstorealizeIcouldnotformarecordofmyfrighteningexperience.Ididnothaveenoughmemorytomakealasting,usefulset
ofrepresentationsofmyextremelyperilousstateoreventocreateastoryexplainingwhathadcausedmetobesodim.AndinmyinsistencethatIwasfine,Ireally
thoughtIwasfine.Iwasn'tdeliberatelyconfabulatingeither.
Meanwhile,thegendarmewasbehavingwithabureaucraticthoroughnessthatmatchedhismedicalincompetence.Wewouldbewelladvisedtocallahuissier,the
gendarmekeptsaying.NeitherJoannorI,atourbest,knewthathuissierwastheFrenchequivalentof"justiceofthepeace,"apublicofficialwhosedocumentationof
aseriousaccidentisrequiredbyinsurancecompanies,especiallywhentherehasbeenseverebodilyinjury.Thebabysitter's

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mothernotonlytranslatedthisrareFrenchwordbutcalledupaliveoneonthetelephone.
Beforethisworthy'sarrivalandnomorethantenminutesaftermymemoryhadbeenblastedoutofthatbucketseatIbegantofeeldistinctlywoozy.Idon't
recallwhetherthelightswentallthewayout,butIwassuddenlyonmybackonthesidewalk.
Beforelong,Itoowaslaidoutinanambulance.WithJoanridingshotgun,theambulancehonkedandcareenedalongthequaitowardtheemergencyroomofthe
GrangeBlancheHospital.ThehospitalactuallysitsrightacrosstheBoulevardRockefellerfromthemedicalschoolinLyonwhereIhadbeenstudyingthecontrolof
consciousstatesbythebrainstem.Iwasscared.IknewIhadamnesiaandIknewIwasinshock.The"onkonk"oftheambulanceseemedtogostraighttothe
anxietycenterinmybrain,whichrespondedbysendingbackrhythmicwavesofpanic.
YetIwasnotdisoriented.IcouldmoreorlessvisualizethewholeambulancetriponthemapofLyoninmymind.Andintheemergencyward,whenIfoundthatI
couldsitifnotstand,IwasevenabletohelpJoanandtheinterngetthroughthementalstatusexam!ButIstillcouldn'tgivethemahistoryoftheaccident.Ihadno
recentmemory.Icouldformulatenopropositionsabouttherecentpast.AndeventhoughIwasadoctorandabrainspecialist,Icouldoffernoexplanationaboutwhy
Iwasamnesic.Althoughthehonkinghadstopped,Istillfeltscared.
Despitemyobjections,thedoctorsdecidedtoadmitmeforobservation.Ihatehospitals,atleastwhenI'mthepatient.AndIfeltprettysurethatIwasalreadygetting
better.MyFrenchwascomingback.IevenrememberedgoingouttodinnerthenightbeforeandthatwewereheadedforarugbygamewhenIgotclobberedoutside
thebabysitter'shouse.AndlastofallIrememberedthatmycousinGeorgewascomingthenexteveningwithapromisetotakeustodinneratFernandPoint's
LaPyramideRestaurantinnearbyVienne.Iwasn'tgoingtomissthatoneevenifIwasdelirious.
ButIhadtoadmitthatIstillcouldn'tremembertheaccidentatall.JoanhadtokeeptellingmeaboutitandreassuringmeaboutIan.Sobeforeshelefttogohometo
takecareofhim,shewroteme

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anarrativescriptthatcouldserveasastandinformylostmemory.
TheobservationwardinwhichIlaywasnotcomforting.Themaninthebednexttominewascomatoseandgurgling.ToruleoutthesuppositionthatItoomightbe
dying,Ireadmyscript,whichsaid:"You'vebeeninanaccident."
"Thecarisbadlydamaged."
"Ianisfine."
"Iamfine[meaningJoan]."
"Theguyinthenextbedisinmuchworseshapethanyouare!"
Itworkedforlongenoughtoletmedoze.ThenIwasawakenedbythegurglingfromthenextbed.AndagainIreadthescript.AndagainIslept.
ThiscyclerepeateditselfthroughouttheeveninguntilIfinallyfellintoalonganddeepsleep.Bymorning,whentheneurologistsmadetheirrounds,Ireallywasfine.
Mymentalstatusexamwasnormal:Iwasorientedtotime,place,andpersonmyrecentmemorywasintactandmyemotionswerestable.Mybloodpressurewas
normal.Theformulationoftheeventsoftheaccident,anditseffectonmybrainmind,whichtheFrenchdoctorsandImadetogetherinFrenchwascrystal
clear.Hereistheformulationweelaborated:
Iwassittinginthedriver'sseatofmyRiley1.5waitingformywifetocomedownstairswiththebabysitterwewerepickinguptotakecareofIan,sowecouldgoto
arugbygame.
Iwasdoubleparkedonaroadonwhichpeopleoftenspeed,andIcouldremembernervouslyeyeingtherearviewmirror.Althoughthereweretwootherfreelanes
betweenmeandtheRhneRiver,IwasastonishedtoseetheeverenlargingimageofaRenaultweavingitswaytowardme.Paralyzedwithfear,andhaving
inadequatetimetomovemycarorjumpoutofit,Iwasstruckfrombehindandmycarwasviolentlyacceleratedforward.Butsinceinertiaheldmostofmestill,my
headsnappedbackwardasthebucketseatshotforwardagainstmyback.Itwaswhiplashatitsworst.
ThementalimageofasnappingwhiphelpedthedoctorsandmevisualizethesuddenSshapeddeformationmybrainstemun

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derwentwhenmyheadfirstsnappedbackawayfrommybodywhenthecarwashit,thenreboundedforwardagainasthecarrapidlydeceleratedandstopped.My
headprobablydidn'tmovefartherthanafootandahalfoffitsusualverticalalignmentwithmybody,andsincetherewasnoevidenceofanyimpacttomyheadon
eitheritsbackwardorforwardflight,weassumed,simply,thatmybrainstem,thesoftspongybitoftissuethatmakesmebreatheanddream,wasjusttwistedand
tuggedawholelotmorethanitlikestobe.
IfIhadhitmyheadonthesteeringwheel,theamnesiathatIsufferedwouldhavebeeneasytoexplain.Insuchacasethetemporallobesarejostledbyaneffectcalled
contrecoup(meaning"againsttheblow").Thisiswhathappenstoaboxerwhoseheadisrockedbacksofastbyaknockoutpunchthatitleaveshisbrainbehindhis
braincrashesintothefrontwallofhisskull.Aftertoomanysuchboutsaboxer'smemorymayleavehimforgood.
Eventhoughmyheadhitnothing,mybrainmayhavecrashedagainstthefrontwallofmyskullasthecarrapidlydecelerated.Thatentirelyinternalimpactmayhave
addedtheinsultoftemporallobeconcussiontotheinjuryofbrainstemwhiplash.
ConsideringthatIwasabletorecoversoquickly,mybrainwasprobablynotevenbruised.WhatreallyhappenedtomybrainthatdayIwillneverknow,whichistoo
badbecauseitcouldtellmealot.Inadditiontothesuddenanddramaticamnesiaabouttheaccident,Ihadapartiallossofmanyrepresentationsoftheprevious
months.Moststrikingly,myhardearnedfluencyinFrenchhadtemporarilydisappeared.
Untilmybloodpressuretookadiveonthesidewalk,andIwithit,weassumedthatwhateverwentwrongwasmainlyneuronal.Isupposedthatthetugcausedsome
localchangesinbloodsupplysothattheneuronsweretemporarilyshortofoxygenorwereperhapsbathedinaslightbutsuddenlyquitedifferentconcentrationofsalt.
IalsowonderedifthemodulatoryneuronsonwhichIdependedtoholddatainworkingmemorymighthavedecreasedtheiroutputbelowacriticallevel.Toanyone
whowantedtoknowwhatwasgoingon,Iwassuddenlyaboutasusefulasacabbage.

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Therestofmybrainwasactuallyfine,however,soIhadgottenoutofthecar,walkedaroundtowhatusedtobeitsrearend,andsaidtomyself,Thatcarlookslike
it'sbeeninanaccident.
TheGrangeBlancheneurologistsagreedwithmytheoryaboutmystate,buttheyweren'tabouttoletmeleavethehospitaluntiltheyhadrunalotoftests.They
naturallywantedtoprotectthemselvesandmeIsupposefromtheoversightofsomealternativeexplanation.ButIstillwantedout.SoIsaidthatsincemylab
colleaguesatthemedicalschoolwereallneurologists,Iwouldbeunderconstantsurveillance.AndIagreedtosignareleaseandtogetallthetestsdoneasan
outpatient.
Theystilldidn'tlookhappy.SoIplayedmytrumpcard,mycousin'sdinnerinvitation.WhentheyheardIwasgoingtoLaPyramideandthatsomeoneelsewasgoing
tobepayingthebill,theyallsmiledateachotherwithgastronomicgleeandsaid,"Vaton,"meaning,"Beatit."Ishallneverforgetthatdinner!
Memory,Remembering,andLearning
Amemoryitselfisunobservable.Itisstoredasapatternofelectricalsequencesinthebrain.Rememberingisanacttheactivationofthatelectricalsequence.When
weremember,wecallupaword,aphonenumber,orarecipeandholditinconsciousness,orprojectitasavisualimageonthescreenthatwecallourmind'seye.
Memoriescanbeimplicitorexplicit.Implicitmemoryinvolvesonlyrecognitionanagingwomancanshowthroughemotionsthatsheknowssomeoneeventhoughshe
cannotrecalltheirname.Explicitmemoryinvolvesactiverecall.Almostallmemoryiscompletelyunconsciousalmostallthetime.Memoryisunconsciousevenwhenit
isrevealingitselfclearlyinelaborateandoverlearnedbehaviors,likeplayingthepianoorspeaking.Whenweperformsuchacts,wearenotawareofaccessing
memoryatallhowtomoveourfingersorourtongues.Theyjustmove.Wemaybecomeconsciousoftheroleofmemory,butonlyafterthefact.Thisso

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calledproceduralmemoryisrelativelyautomatic,likemotorpatterns.
Sowherearememoriesstoredwhenwearenotrememberingthem?Notinsomeneatlylocalizedfile.Veryrecentresearchindicatestheyarerepresentedinneuronal
activitypatternsthatarewidelydistributedthroughoutthebrainonepieceofevidencetosupportthisnotionisthatproceduralmemoryinpeopleandanimalsisnot
eliminatedwhendamageoccurstoanyparticularpartofthebrain.
Whenwewanttoretrieveanamefrommemory,then,thetaskisnotamatteroffindingitslocation.Itisamatterofturningonitsrepresentation.Weknowthis
intuitivelyifwetrytoohardtosearchforalostname,wemayactuallyimpedeitsretrieval.Wesay,ironically,"IfIforgetaboutit,itwillcometome."Andloand
beholditdoes.Whynotstoreamemoryinjustoneplace?Oneanswermayberedundancy.Justasmostofuskeepcopiesofthecomputerprogramsonourhard
drivesonafloppydisk,incaseanelectricalmisadventurecausesourcomputertocrash,ourbraindoesthesame.Youcanhaveasmalllocalizedstrokeandnotlose
yourmemory.
Thereisamorepositivereasonforstoringmemoriesinadistributedway,too.Itmakesusmoreversatileinassociatingdatawithasmanycontextsandskillsas
possible.Sinceitisnotalwaysobviouswhatcontextsarelikelytoberelevantinthefuture,itisusefultoassociatesomenewpieceofdatawithallthepossible
contextsofitsrelevance.
WhenIfirstboughtmyolddairyfarminVermont,Iwasappalledatallthejunkthepreviousownershadaccumulated.Cursingtheirlaziness,Itoreintotheunsightly
scrapmetalheapsthatclutteredtheshedandfieldsalike.You'veprobablyseenthoseoldautomobilecarcassessproutingpetunias,wagonsdisguisedbyweeds,
ancienthayrakesenmeshedinburdock,andtangledfencerollstrailingmorningglory.Suchrubbishwasthebaneofacitybredfixerupper.Grunting,sweating,and
selfsatisfied,Ithrewthemallout.
ThenItackledthedrainageproblembehindthebarn.My

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fifteenyearoldfarmboyhelperandIdugaditch,lineditwithstone,andinstalledaporousrunoffpipetocarrytheexcesswaterdownandawayfromthebarn's
alreadywobblybackwall.Weextendedthepipetoadrywell,whichwehadhackeddeepintosemisolidclayandwalledupwithcinderblock.Itremainedonlyto
putatoponthewell,atopstrongenoughtosupporttheweightofacoworatractor.
"Whatdoweuse?"Iasked.
"Whereareyouroldwagonaxles?"theboyanswered.
Isuddenlylongedforamorewidelyconnectedmemorysystem,onethatunderstoodthatalong,thin,rigidwagonaxlewasnotonlyrefuseinafield,butapotential
carryingbeamfortheroofofadrywell!Themeaningofthewordsjunkpile,dump,andstorageareatookonnewlifeinaflash.
IhadthrownthewagonaxlesawaybecauseIhadnowagons.Butamoreformalanalysisofwagonaxlesasweightbearingbeamswouldhavearguedforstoringthem
(especiallysinceIhadplentyofstoragespace).Inthesamemanner,Imayretainmyproceduralmemoryofhowtocatchabaseball,notsomuchbecauseofthe
likelihoodthatIwilleveragainplaycenterfield,butbecausethecomponentskillscanbeusedinawidevarietyofhandeyepractices,likecatchingabookasit
tumblesfromahighshelfinmylibrarybeforeitbonksmeonmybrainmind.
Thepointhereisthatourmostpreciousskillsashumans,fromourrepetitivenessasraconteurs,writers,musicians,andpublicperformers,toourmorepersonalsetsof
souvenirsandsensibilities,areallelaborationsofsimpleneuralassociations.Whatwecallmemoryhumanmemorydependsonwhatneurobiologistscall
learning,andanimallearningatthat.
HowLearningWorks
Simpleformsoflearning,likethehabituationthatmediatesthestartleresponse,occurautomaticallyandwithoutourawarenessofthem.Buthigherordersoflearning
requireustoconsciouslyattempttokeeprecords,say,ofwhere,when,andwithwhomwehaveathreateningexperienceoragratifyingone,sothatinthe

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futurewecanavoidthreatandincreasepleasure.Toaccomplishthis,weneedtoassociatetwoormorestimuliinmemory,bymakingarepresentationoftheir
relationshiptoeachother.Thusinthebarnyardofmybrain,Imightassociateaxles(metal)withbeams(wood)throughtheirsharedpropertyofweightbearing.By
associating,Ibegintoputaxlesinvariouscategoriesthatcouldlaterproveuseful:long,hard,strongIcouldevenusethemtotieupmytomatoes.Thesekindsof
logicalconnectionsaremadeviatightassociationsandaretypicalofcertainbrainmindstates.Otherstates,likedreamingandschizophrenia,arecharacterizedby
muchlooserassociations.
Thebrainaccomplishesanyinstantaneousassociationbyrelayingtheexcitationfromtwobraincellsonathirdbraincell,therebysensitizinganetwork.Butassociative
learningrequiresthecoactivationofstillanotherbraincellthatisnotdirectlyconcernedwiththeinformationbeinginstantaneouslyassociated,whichsoldersor
cementstheinstantaneousassociationinmemory.Tobemarried,abrideandagroomneedaminister.Theministersofthebrainarethemodulatoryneurons,andthey
areaidedbytheneuronaltransmitters.Whenthemarriageceremonyentailslearning,theministersareaidedbytheaminesnorepinephrineandserotonin.
NeuronAcansensitizeneuronB,butunlessneuronCiscoactivatedneuronBwillhabituate.Inthecourtshipanalogy,AandBcanhaveanaffairandbecome
mutuallyexcited,butwithoutanyinputfromC,AandBwillgrowtiredofeachotherandgoontothenextsensitization.Theeventislost.Thereisnomemory.
DreamingisawildsequenceofABexcitations,buttheCneurons,themodulators,arenottheretotakepart.Thereisnoassociation,nomarriage,andnorecent
memoryfordreamsbecausenorepinephrineandserotoninarenotavailable.
DreamsarestringsofmemoriesthatarenotthemselvesrememberedbecausetheCcellsarenotavailabletomaketheirrelationshippermanent.Thereisconverging
evidencenowthat,inorderforaBneurontotracebackthepaththatexcitedit,ithastohavebeencontactedbyAviaC,insteadofdirectly.Ifcontactisdirect,B
cannottellwherethemessagecamefromitdoesn'tremember.

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InREMsleep,theamines,whichfunctionastheCneurons,haveretreated.Butwhenwewakeuptheyreturn.EveryABexcitationisagainassociatedwithaninput
fromtheCcells.Sonowtheinformationismorelikelytoberetainedinmemory.Whydowerememberanydreamsatall?Becausetheactivatedneuronsthat
representthedreamplotareonlyrelativelydemodulated(theyarenotgone),andbecauseuponourwakingtheirinfluencemayriserapidlyenoughtocementthe
otherwisetransitorydreamexcitationintotheformofamemory.Manyneurobiologistsnowbelievethatthemodulatoryneuronsconfersomepermanentstructural
changeonthebraincellsthattheycontactandthatthischangeconstitutesthesamefundamentalmechanismoflearningandmemoryatalllevelsoftheanimalkingdom,
fromsnailstohumans.
ManagingMemory
Ifwehavetobeawaketoremember,whatcouldbethememoryfunctionofdreaming?Dowedreamtosomehowstrengthenmemory?Dowedreaminorderto
forget?We'renotsure,buttheonepsychologicalqualitythatismaintainedineverydefinitionofdreamingoverthecenturiesisthatitishyperassociativethecategories
thatwelinkwhenwedreamaresobroadtheybecomeoverinclusive.
AllofwhichimpliesthatIdon'tdreamofaxlesbecausetheysymbolicallyrepresentbeams,orphallusesforthatmatter.Idreamofaxles,beams,phalluses,and
whateverelsebecausetheyareassociatedinsome(orseveral)broadcategories.Onefunctionofmydreammightthusbetoassociatemymemoriesandsoincrease
theirversatilityandredundancy.Awagonaxleisalsoaprobe,abatteringram,acrowbar,andadrillitcanpoke,hit,pry,andscrew.Tobeusable,its
representationshouldbestoredinallthosecategoriessoastobeeasilyaccessiblefromallofthem.
Ibelieve,thoughIcan'tyetproveit,thatthebrainmindtraversesthestatesofnonREMandREMsleepinparttoreinforceandreorganizememory.Reinforcement
occursviaconsolidation:anexperiencethatwehadduringthedayisrepresentedasanABconnectiontemporarilyenhancedbyaCchemical(likenorepi

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nephrineorserotonin).InsleepthebrainchangesthestatusofthatsensitizedconnectionfromtemporarytopermanentbyremovingtheCchemicalandaddingaD
chemical(likeacetylcholine).
Thoughstillspeculation,thereismountingevidencethatoneofthereasonsweneedsleepatallistopermanentlyencodeourmemories.Wesleep,andthepastday's
memoriesarereactivatedaswedream,whichchangestheirstatusitadvancesthemfromshorttermmemoryintolongtermmemory,perhapsbyimpositionof
acetylcholine,whichisomnipresentduringsleep.
Acolleagueofminerelatedastoryabouthiscollegehousemate'speculiarstudyhabit.Thehousematewasanaccountingmajorandthereforehadtocommitto
memorylargestoresofnumbers,formulas,andcasestudieseachday.Whenitcametimetostudyhewouldretreattohissparselyfurnishedbedroomandreclineon
hisbed,proppinghisheadupwithapillowagainstthewall.Hewouldopenanaccountingbookandreadintentlyforfortyfiveminutestoanhour,scribblinginthe
marginswhennecessary.Hewouldthendozeoff,fornomorethanfifteenminutesbutnolessthanfive.Hewouldawake,resumeanotherhourofwork,thendozeoff
again.Thepatternrepeateditselfthreeorfourtimeseachevening(unlesstherewasagoodparty,ofcourse).Hisnocturnalsleepschedulewasnodifferentfromthatof
anyothercollegestudent.Heneverexpressedmentalfatigue,yetwasusuallyunawarethathewasdozingoff,retortingtomycolleague'stauntsthathehadjustclosed
hiseyesforaminute.
Wasthehousemate'sbrainshuttingdowntosiftinformationoncethefunnelwasfull,tostorewhatwasusefulanddrainofftherest,emptyingthefunnelforthenext
load?Thisisjustconjecture,butitispossible.Thehousematewasabrilliantstudentanddidn'tnapunderanyothercircumstances.ThomasEdison,whomwewill
meetagainlaterinthisbook,glorifiedthe''powernap"anditscapacitytofuelinventiveness.BynoddingoffforaquickfiveunderthestairsofhisMenloPark
laboratory,EdisonmayhavebeenusinghisREMsleepnotonlytostorebuttorecombinecreativelyhisideationaldata.
Theinstancesoflettingthebrainshutdowninordertoprocessinformationareallaroundus.Whenwehaveavexingproblem,

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ourfriendstellustosleeponit,andthematterdoesseemsimplercomemorning.Writerswhohavewrittenthemselvesintodeadendsaretoldbytheireditorstoput
thedraftinadrawerfortheweekend,andapathwayoutusuallydoespresentitselfcomeMondaymorning.Children,whentheymustmemorizealistoffactsfor
school,areoftenfoundwiththeireyesclosedrepeatingthelisttothemselvesoverandover.Thoughitisnotsleep,ithassomeofthesameeffectstheyareputting
themselvesintoamildtrancewiththemnemonicmantraandrelievingthebrainofexternalstimulisoitcanencodethedevilishlist.
Inadditiontoconsolidation,changingthestatusofwhatisrememberedduringsleepcouldhavethreeotherpurposes.Therepresentationofthememoryinneuronal
networkscouldbemademoresecurebyitssimultaneousdistributiontoothernetworks.Itcouldbemademoreversatilebylinkingitinhyperassociativefashionto
everynetworkwithwhichitsharesformalfeatures(suchasaxleswithlongthings,hardthings,strongthings).Itcouldbemademoreusefulifitwerelinkedto
proceduresthatitserved(suchasweightbearing,prying).Icallthesethreeadditionalmemoryprocessesdistribution,hyperassociation,andproceduralization.WhenI
thinkaboutmyownimaginaryexperienceswhileIamdreaming,theseideastakeonastrongcommonsenseappeal.
Dreaminghasseveralfeaturesthatcouldenhanceallfourofthesefunctions.Forthefunctionofmemoryconsolidation,REMsleepprovidesatimewhenthebrain
minddoesnothavetoacceptnewdata.Italsoprovidesanalteredchemistryaneuromodulationofthecircuitrywiththehelpofacetylcholinethatmaypermit
theconversionofshorttermmemoryintolongtermmemory.Forthememorydistributionfunction,REMsleepprovidesamassive,widespreadactivationwithintense
reiterativestimulationofallthecorticalcircuitsofthebrain.Forthehyperassociationfunction,REMsleepprovidesthecoactivationofnewlysensitizedcircuitsandall
thosecircuitspreviouslyendowedwiththemultipleinterconnectionsnecessaryforcategoryoverinclusiveness.Fortheproceduralizationfunction,REMsleepprovides
theautomaticrunningofmotorprogramsthatgivethedataaccesstoexistingactionfiles.

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Inshort,dreamscenesarerandomandweimposeaplot.Indoingso,wearecementingmemoriesandlinkingthemtoactionprograms.Thisisonemajorreasonwhy
wemustsleep.Onesurprisingimplicationofthistheoryisthattheoutwardcalmofsleepisentirelymisleading.Themotorprogramsinthebrainarenevermoreactive
thanduringREMsleep!Asourdreamsmakeclear,REMsleepentailsafrenzyofactionwerun,wedrive,wefly,weswim.ThereisnorestinREMsleepforthe
centralprogramsthatmoveusaboutbyday.Onthecontrary,theyaresoupedup,andweassumeforgoodreason:topreventtheirdecayfromdisuse,torehearsefor
theirfutureactionswhencalledonduringwaking,andtoembedthemselvesinarichmatrixofmeaning.
WemustthereforepayhomagetobehavorismandB.ESkinner,eventhoughthisnotionwouldmakehimturnoverinhisgrave.Isuggestthatmemoryisorganized
withinaframeworkofmotorprogramswithinthebrain.Farfrombeingablackboxofnorelevancetobehavoristpsychology,thebrainisajackinthebox,filledto
thebrimwithspringloadedplansofaction.Assuchitistheverywellspringofallbehavior.Thesebrainmindbehaviorprograms,likesensoryrepresentations,are
virtualandtheyhaveevenbeencalled"fictive"tocapturetheirpromissoryaspectbuttheyarenolessreal.Inourbeingandinourbecoming,theyareusandwe
arethey.
ConfabulationinWaking,Dreaming,andFantasy
Thebrainmindisastorytellerinallitsstates.Afterthealarmclockrings,itentersitsnonfictionmodeandsays:"Timetogetup.It'sWednesday.Don'tforgettostop
bythebank.Youhaveaconsultationdowntownthismorning.Youhaveanappointmentat2:00P.M.atthehospital.Your5:00P.M.seminartopicisDreamsand
Fantasies.RemembertomakeasupperreservationatCiaoBella."
Thislevelofplotoutliningisfamiliartoallofus.Everydaywewriteoutthesequenceofscenariosthatconstitutetheactionprogramsforourlives.Todothisweneed
accesstorecentmemory,

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toremotememory,andtoorientationaldata.Andweneedtobeabletotietheplantoourmotorprogramsandrunthem.Thisprocessissoroutinethatwetendto
takeitforgranted.
Theforegroundlevelofnarrationisnotthewholestory,however.Assoonaswegetmoving,perhapsevenwhenwelookinthemirrorwhilestillbrushingourteeth,a
parallelnarrativekicksin."Youlooktiredtoday,"yousaytoyourimage.Oryousay,"Youareirresistiblewhenyousmile."LikeJamesThurber'sWalterMitty,some
ofuscanbecomesototallyabsorbedintheseprivatefictionsthatwemissthechangeofthetrafficlights.Untilsomeonebeeps!
Thestorylikestrainofmentalactivitythatproceedsinparallelwithourminutetominuteperceptions,thoughts,andactionshasbeencalledreflection,daydreaming,
woolgathering,andfantasy(thetermIprefer).Formanypeople,fantasyissomuchinthebackgroundthatitisscarcelyconsciousatall.Butifwepayalittleattention,
wecanseethatitoccursatsomelevelallthetime.Thebackgroundfantasyprocessissocloselyconnectedtotherealityprogramintheforegroundofconsciousness
thatitofteninitiatesrehearsalsforupcomingsocialencounters.Fantasyalsoservestoreviewourrecentlycompletedinteractionswithothers.Wesaytoourselves,"I
wishIhadsaidsuchandsuch"or"Thatwentsurprisinglywell."
Theselittlefictionsalsoofferusthecomfortofhumorousselfreflection,aswhenweimagineourselvesasWoodyAllenplayingthebrilliantfoolorAlbertEinstein
playingthespontaneousgenius.ForeroticconsolationwemightbecomeHenryMillerorJosephineBakerandplaythecompulsivelover,irresistibleandinsatiable.In
thissensefantasyisourartworld,ourprivatetheaterwithitsendlessopportunitytoescapefromthebanalityoftheeverydayintotheexoticlandofimaginationand
creativity.
Yearsago,whileIwasincollege,afriendofminereportedhisextremeanxietyathavingtocarrysteelsuppliesacrossthegirdersofskyscraperskeletonsduringa
summerjobhehadinNewYorkCity.Thepaywasgreat,buttheemotionalcostwasexorbitant.Theworstofit,hesaid,wasthathecouldn'treallytalktohisfellow
workersheneededtheirsupportandcomradeshiptohelphim

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copewhilepassingrivets.Oneafternoon,ontheveryhighestfloor,andonitsoutergirderedge,hetriedtoengageaunionwelderindivertingsmalltalk.
"Quiet!"demandedthepro."I'mhavingamental."''Mental"wasthewelder'swordforfantasy.
Later,inthelockerroomatgroundlevel,thewelderexplained."Iwasrightinthemiddleofahotsexscenewithmygirlfriend,"hesaid."Youdon'tliketobe
interruptedwhenyouaremakinglove,doyou?"
Whatarewetomakeofthiscuriousstory?Thatwecanavoidanxietybyescapefantasy?Thatthebrain,unlikethedupeofabadjoke,candomorethanonejobata
time?Orthatfantasyrepresentsacontinuous,ongoingstreamofsubconsciousimpulsesthatconstituteourinstructionalprogramsorsurvivalstrategies?
Inthepsychoanalyticera,itwascommontoassumethatblatantwishfulfillmentofsexualdesiresinfantasieslikethoseofthewelderprovedtherewasadeeplink
betweenfantasizinganddreaming.Dreamingwasabreakthrough,madewhenthewakinggatekeeperofoursociallyunacceptableurgeswasoffduty.Thesourceof
bothfantasyanddreamswastherepressedunconscious.AndmanymodernpsychologistswhohavewashedtheirhandsofFreudstillassumethatfantasyanddreams
arequalitativelysimilar,thattheyreflecttheundifferentiatedactivationofnetworkswhoseconnectionscodethedataofoursecretandforbiddenfables.
Ifthiswereso,wewouldexpectthereportsoffantasiesanddreamsfromthesameindividualstobeformallyindistinguishable.Andwewouldexpecttoseeinboththe
samequantitativescoresofsuchformalpropertiesasorientationalinstability.
HereisatranscriptofoneofDelia'sfantasyreports.
Whiledrivingtoschoolafterafrustratingandstressfuldayatwork,IimaginedthatIgototalktoaprofessoraboutdoingworkforhiminprimateresearchinAfrica.Heisthrilled
tohaveme,andItalkitoverwithmyfamilywhothinkit'sagreatopportunity.I'llbegoneforacoupleofmonths.IplantheshotsandclothesI'llneed.NextIseemyselfwalkingin
thejungletryingtofollowsomeorangutans.Ithinktomyselfthattheyaremoreunpredictablethan

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gorillasandfeeluneasy.Iseemyselfatnightwritinginmynotebookinatent.I'mmadatmyselfbecauseI'mworryingaboutbeingawayfrommyfamily.IrealizeIdon'tfeelfreeto
goonsuchanadventure,whichmakesmedeterminethatifIevergetsuchanopportunityI'lltakeit.

ThefantasycertainlyseemsdifferentfromDelia'sdreamsinseveralways.Buthowso,exactly?Idecidedtotestwhetherthereportsoffantasiesanddreamsfromthe
sameindividualscouldbedistinguishedandifso,whatfundamentalqualitiesweredifferent.Iappealedtoanotheroneofmyclasses,thisoneacollectionofHarvard
Universitypsychologystudents.Althoughthetestrevealedalargeareaofoverlapindicatingthatdreamsandfantasiesdosharemanybrainmindstatefeatures
therewerealsomarkeddifferences,indicatingthateachbrainmindstateisunique,withitsowndistinctivesignature.
Dreamsturnedouttobeabouttwoandonehalftimesas"crowded"asfantasies.Thatis,thereweremanymorecharactersindreams.Therewerealsomoresettings
indreams,andthosesettingsweregenerallymorerichlydetailedandmoreexotic.Theywerealsomoreremote,lesslikelytoreflectwherethedreamerhadbeen
todayorcouldgoinaday'sdrive.Whentimewasspecified(anditusuallywasn't)dreamsalsotendedtobemoredisplacedfrom"thepresent"thanfantasies.
AquickcomparisonofDelia'sfantasywithherlongdreamreportaboutbeingintheballoonaboveParisshowsallthesedistinctionswell.Thereisonlyone
characterinDelia'sfantasy,herprofessor,whoisawelldefined,realpersoninherlife.Inherdream,therearefour,andoneofthem(thehotelclerk)isnotwell
defined.AlthoughthesettingschangeinDelia'sfantasy,theyarecommonplaceandliteral,notextraordinary(likeflyinginaballoon)orimprobable(theAlAqsa
MosqueinParis).Delia'sfantasytookplaceataspecifictime,evenlinkedtoacalendar,whileherdreamscenestookplaceinsomeweirddistortionsofthedistant
pastandthefuture.
Someofthedifferencesinplaces,persons,andtimescouldbeduetothefactthatwhilewethinkweareawakeindreams,in

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fantasy,wereallyareawake.Thismeansthatfantasyalwayshasadooropentothehereandnowthroughwhichlocalplaces,characters,andeventimereferences
caneasilypass.Butindreamsthedoortothehereandnowisslammedshutalongwithoureyesandothersensoryportals.
Dreamcharactersarenotonlymorenumerous,theyhavelessdefiniteidentities.EventhepeoplethedreamerknowswelllikeDelia'sfatherhavepeculiar
characteristicsindreams,butnotinfantasies.Onedistinctlydreamlikefeatureofpersonstheirtendencytochangeintosomeoneelseisneverseeninfantasy.
Thisidentityswitchingindreamshasbeencalledtransmogrification.Now,Ihavenodoubtthatsomeofuscouldgetupafantasyand,byautosuggestion,inducea
characterswitchortwo,butitdoesnotoccurwhensubjectsleavetheirbrainmindstotheirowndevices.
Whatdoesallthishavetodowithmemoryanditsbedpartner,confabulation?Itmeansthatbothprocessesareconstrainedbythebrainmindstatesinwhichthey
occur.Wecanconfabulatewhenweareawakeorwhenweareinadream.Butthefactthattheproductwillbedifferentimpliesthattheproductionprocessisalso
quitedifferent.
Thelinebetweenourforegroundproblemsolvingcognitionandourbackgroundimpulsestreamoffantasy,whileusuallyclear,canbecomeuncomfortablyfuzzy.Inno
caseisthefuzzinessmoredistressingthaninpsychosis.Herethedistinctionbreaksdownentirely.Exoticmythcanreplaceconventionalthinking.
That'swhathappenedjustbeforeBertal'smotherbroughthimtoThePsycho.AprovocativetelevisionscenariotookoverBertal'snarrationgenerator.Theresultwas
apsychoticfictionofclassicOedipalproportions.
TwonightsbeforehisadmissiontoThePsycho,BertalandhismotherhadwatchedaTVshowaboutawomanhavingababy.OverthenextfortyeighthoursBertal
becamemoreandmorepreoccupiedwithbirthandbecameconvincedthathismother,whohadrecentlygainedweight,wasgoingtohaveanotherchild.Whenhis
motherdecidedtobringBertalin,shetoldhimtogetintothecarandthattheywere"justgoingforaride."Whentheyreached

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ThePsycho,whichBertalofcourserecognizedsincehehadbeenthereforastayontwopreviousoccasions,henonethelesstoldthestaffintheadmissionsroomthat
hewastherebecausehismotherwaspregnantandhecouldn'tdeliverthebaby.Whenhewasaskedtosignin,hesignedhisfather'sname,because,hesaid,hisfather
"couldn'tmakeit."
JustasfrustrationatworkmovedDeliatofantasizeaboutprimateresearchinAfrica,theTVshowlaunchedBertalintohismotherpregnancypsychosis.Inbothcases,
arealstimuluswasthetriggerforafictiveandelaborateconfabulation.Andintheirconfabulations,bothDeliaandBertalfocusedonrelationshipswithoppositesex
parentalfigures.InDelia'scase,theimageryismorerealizablethaninBertal's,andthisreliabilitymeasuresthedifferencebetweenfantasyandpsychosis.Furthermore,
althoughbothDelia'sfantasyandBertal'spsychosisaredreamlike,theyareclearlydifferentiatedfromdreaminginthattheyhavehighlyfocused,persistentthemes
involvingrelativelyfew,realisticcharacters.Thissuggeststhatamajordifferencebetweendreamingandfantasyorpsychosisistheversatilityoftheconfabulation.
DreamSplicing
OneofthemostpreciousmythsaboutdreamsandonethatImyselfwasalwayssurewastrueisthat,inspiteoftheirmicroscopicchaos,theiroverallplot
designisunified.Ithasevenbeenmaintainedthatthesuccessionofdreamsduringasinglenightislikethechaptersofabook.Thatisaveryflatteringconcept:inside
ourheadsisalittlescenariowriterwhoissouncannilyorganizedhecankeepthebigpictureclearevenwhentheindividualimagesarefuzzy!
IwassoconvincedofthishighleveldreamplotcoherencethatIwasextollingwhatItooktobeanindubitableexampleofitataseminar.Althoughthedreamer
jumpedaroundfromplacetoplaceandevenfromonecontinenttoanotherinthedreamreportIwasdiscussing,thewholedreamseemedtometobetightlyheld
togetherbythecontinuingtwineoffamilialrelationship.Theset

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tings,characters,andactionswerewildlydisparate,butthedreamseemedtobetellingthestoryofthedreamer'slife.Sohavingdazzledmyselfandthegroupwith
whatIcalledmy"framesequencemethod"(nowintheashbin),Isaid,"Despitethegibberishyoucanseethatitallhangstogether.It'sastory."
"Howcanyoubesosure?"askedmycoworkerBobStickgold."I'mnotconvincedatall."Havingsleptonthequestionhimselfforafewnights,Bobhadcomeup
withaverysimplebutheretoforeunimaginedexperimentalapproachtotestforcohesiveness.Hecalleditdreamsplicing.Hereishowweusedit.
Wetooktwentyrandomdreamreportsfromtwentypeople,eachofwhichwereofaboutequallengthandeachofwhichcontainedonesceneshift.Wecuttenofthe
reportsinhalfwithapairofscissorsatthepointwherethesceneshifted.Thatleftuswithtendreamheadsandtendreamtails.Wethentransposedthesepieces:
headsontails,headsonheads,tailsonheads,tailsontails.
Wethengavethetenspliceddreamsandthetenunspliceddreamstomembersoftheseminarandaskedthemtodistinguishwhichreportsweresplicedcrossovers
andwhichwerenot.Ifdreamsaretellingstoriesandeachdreamerhasaparticularstorytotell,itoughttobeeasyonanyoneofanumberofgroundstosay,"Yes,
thatoneisanintactstory"and"No,thatonesurelyisspliced!"
ThatnightIsatdownmyselfwithmyownsetofreportsandtriedtosortthemout.BythetimeIgottothethirdreport,Ihadspentoverthirtyminutesinobsessive
agonyandallIhadtoshowforitwasasplittingheadache,soIputthetaskasideforawhile.Humiliation,shame,andguiltgoadedme.Ispentthreemorehoursonthe
taskandkeptchangingmyjudgmentsbackandforth.Myeffortsweretonoavail.Icouldnottellaspliceddreamfromanintactone.Andnooneinthegroupdid
muchbetterthanchance.
Thesignificanceofthisisthat,althougheachsubplotmaybeastorylikeunit,thereisnostorylineconnectingonesubplottothenext.Dreamcoherencemaybeinthe
eyeofthebeholder,butitisnotinthetextofthereports.Thereisdramaticsegmentationwithindreams.Eachstoryisgottenupunderlocalconstraints.The

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brainisjumpingaround.Whenweareawakewecanconcentrateonasubjectforhours,butwhenweareasleepwecan'tfocusformorethanafewminutes.Freud
thought,andothersstillmaintain,thatthedreamswehaveoverthecourseofanentirenightareintegral.Itcannotbe.Theevidencesimplydoesnotsubstantiateit.
WhoseDreamsAreYouDreaming?
Areourdreamsthesameasthoseofeveryoneelse?Ibelievethatthedreamsplicingevidenceforcesustoconsiderthepossibilitythattheyare,thattheformal
aspectsofdreamingresultfromachangeinbrainmindstatethatisuniversal,impersonal,andimperative.
Whilemuchmoreinvestigationremainstobedone,itwouldappearthatourdreamamnesiaandourdreamconfabulationsaretheimpersonalnecessitiesofabrain
statethatisforcedonusbyournature.Wecanromanticizeaboutdreams,tellourselveswearereceivingmessagesfromthegods,orbelievethatsomesecretcodeis
beingbrokentounveilanessentialtruthwhoserevelationwillchangeourlives.ButIhonestlythinkthatinentertainingsuchconceitswearebeinghadbythedream
romancersevenmoreflagrantlythanwearebeinghadbythedreamsthemselves.Atleastthedreamisfree.Thedreamromancerschargeusmoneyfortheircode
breakingservices.
Inanycase,itwouldappearthatwearealleasilyfooledintothinkingthatdreamsareintactstorieswhentheyarenot.Thisseemstomeanthatoneofthemain
predispositionsoftheintegratedbrainmindistodiscernintegrity,unity,andsinglenessofpurposeinanytextthatappearstobeintegral.Andwhenintegritydoesnot
resideinthetext,weimputeit.Thisrecognitionrendersnotjustdreaminterpretation,butthewholeinterpretativeexerciseofhumanisticcriticismandscholarship,
extremelyproblematic.
Nowwecansee,evenmoreclearly,whyFreudandJungwerebothrightandwrongwhentheysaid,"Letthedreamerawakeandyouwillseepsychosis."Yes,
Delia'sdreamsandfantasiesandBertal'spsychosisareallalikeinthattheyareconfabulatory.Butthedreamingconfabulationissolushandlavishitisdistinctlydiffer

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entfromtheothertwostates.Onlyinaflagrantorganicpsychosis,liketheDTsofalcoholwithdrawal,doesconfabulationassumetrulydreamlikeproportions.This
mustmeanthatfantasy,dreaming,andpsychosisareonthesamecontinuumofstatesbutthateachstateonthecontinuumhasitsowndistinctivecharacterreflectingits
ownspecificbrainactivationpattern.

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Chapter8
SeeingIsBelieving:PerceptionandHallucination
Ican'tbelievemyeyes"isanexpressionweoftenusewhenwewitnessanunusualevent.IsaiditjusttheotherdaywhenIwasstandingontheterraceofa
condominiumandIsawaflockofgoatswalkingalongthesandybeachbeforeme.ItwaslikeascenefromaBuuelmovietherewasevenascragglylooking
shepherdwithacrook,acloak,andanenergeticmutttokeeptheflockinorder.Butthiswasnotafilm.Whatwastheexplanationforgoatsonthebeach?Imust
havebeenoutofmymind.
Turnsouttheexplanationwassimple.ThetowntowhichIhadrepairedtothinkandwritepartofthisbookwasinSicily,wheretheagrarianpastandtheurban
presentareseamlesslymerged.Thespatialincongruityofgoatsinfrontofacondoonthebeachwasnormalinviewofthelocalsocioeconomicsituation.
BecauseIwasanoutsider,Iwastheonlyonewhowassurprisedbythegoatparade.ThenativepasserbywhomIquestionedaboutitcalmlyexplainedthatthegoats
weresimplyontheirwaytothehighmountainpasturesthatsurroundTaormina.
Thefactis,wehavetobelieveoureyes.It'souronlyhope.Ifwewentaroundthinkingourvisionwassuspect,wewoulddrownin

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aseaofselfdoubt.Mostofthetime,wearerighttobelieveoureyes.Imean,therereallyweregoatsonthatbeach.
Buthowcanwebesurethatitisoureyesthataredoingtheseeing?Theanswerisalreadyclearfromourdreamexperience:wecan't.Thevisualsystemofourbrain
mindiscompletelycapableofsimulatingtheworldwithsuchskillthatitfoolsuseverytimewegotosleepanddream.Itfoolsme.AndDelia.AndBertal.Allthatis
neededtogetusintobigtroubleisashiftinthebalancebetweenexternalstimuliandinternalstimuli.Thisisbecausevisionactuallytakesplacewithinthebrainmind.
Ourconvictionthatwhatweseeis"outthere"isadeepdelusion.
Theimageswe"see"areonlyrepresentationsoftherealworld.Whenwepointourheadsatatree,oureyesreceivelightwavesthatarebouncingoffthattree.The
lightinputiscomputedbyourbrains,thecomputationischeckedagainstdatastoredinourneurons,andtheresultingmatchtellsusthelightsignalswehavereceived
constituteatree.Toaflywithitscompoundeyes,thesamelightsignalsproduceaverydifferentpicture.Bynowwe'veallseenthoseinfraredimagesofahouseora
person'sbodythatshowwithcomputerenhancedcolorwhichareasarehotandwhicharecool.Theobjectsproducethesamelightwaves,butthereceiver,inthis
caseaninstrument,"sees"thedatadifferently.
Hearingalsoworksthisway.Thinkaboutthedogwhistle,whichemitsaveryhighpitch.Wecan'thearit,butFidocomesrunning.Whycan'twehearit?Afterall,the
soundwaveshittingoureardrumsarethesameonesasthosehittingFido's.Buthisbraincanprocessthem,andourscan't.
Seeingandhearingareperceptions.Oureyesandearssurveytheworld,constantly,toletusknowwhat'sgoingon.Consideringthatwedonotperceiveanything
directly,butonlyafterourbrainhasprocessedtheincomingsignal,itwouldseemthatweareontherazor'sedgeofmadnessallthetime.Whyisthebrainmind
designedinsuchariskyway?Howisthedelicatebalancemaintained?Couldthechangesinbrainmindstatesbetweenwakinganddreamingactuallyservetoprotect
usfrommadness?Andcanthebrainmindstatetheoryhelpexplainhowweperceiveandhow

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ourperceptionscangowrong?Let'strytoanswersomeofthesequestions.
HowWeSee
Inorderfortheeyetoseeitmustbemoving.Infact,theeyesareinmotionevenwhenwefixthemonanobjectofinterest.Soundsincredible,doesn'tit?Youcan't
feelthemovement.Youcan'tevenseeittryit,bylookingintoamirror,ortheeyesofalovedone.Andsoyoutendtodoubtthiswholestory.Buttheevidenceis
overwhelming.
Evenwhentheobjectyouarelookingatismotionless,youreyesmoveimperceptiblyallthetime.Scientistswhostudyvisioninthelabuseeyetrackingmachinesthat
cangaugethemovements.Itistheeyeballitselfthatmoves,intiny,fast,flickingmotions.Partofthereasonyoucan'tseeitisbecausethebraincancelsouttiny
movementsinalltheimagesyouperceive,inordertokeepthemfromjumpingorblurring,justasthetrackingcontrolbuttononyourVCRkeepsthevideoimagefrom
flickering.Iftheeyemusclesareparalyzed,visionceases.Noeyemovement,novision.
Theconverseisalsotrue.Whenscientistsshinelightontheretinaandrecordtheelectricalsignalssentintothebrain,theyfindtheycanexcitetheretinalneuronsonly
bymovingorflashingthelightsource.Thecellsoftheretinaareinterestedonlyinchangesinthepropertiesofthelight,notinthefixedproperties.
Paralyzingtheeyemusclesisnottheonlywaytoimpairvision.Thebrainstemnervecellsthatcommandtheeyescanbedamagedsothatcertaineyemovements
becomeimpossible.Theastonishingfactisthatwhenapersonwhohasbeeninjuredinthiswaytries,unsuccessfully,tomovetheeyes,theworlditselfseemstoflicker.
Thereasonforthisillusionisthatwhenthebrainstemsendsmotorcommandstotheeyemuscles,itsendssimultaneousmessagestothevisualprocessingregionsof
thecortex,tohelpitpredictthechangingscenetocome.Thebrainmindusesthesesignalstopreventthevisualimagefromblurringorjumpingwhiletheeyesare
actuallymoving.Thevisualbrainmindisconstantlyadjustingitsownimagebyconvertingmovementcommandsfromthebrain

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stemintosensorypositiondatainthecortex.Sothebrainmindoftheinjuredpersonismakingadjustmentsforeyemovement,butthereisnoactualeyemovement
goingon.Theresultisaninternallygeneratedflicker.
Sinceeyemovementscanberecordedinwakingaswellassleep,thetestforthistheoryissimplytoattachelectrodestotheskinaroundaperson'seyesandaskhim
tofixuponastationarytargetandfollowitwhenitmoves.Electricalrecordingsinwakingsubjectsrevealthattheeyesmakeupwardoftwentysmall,rapidmovements
persecond.Animalexperimentsshowthatthisconstantagitationishighlyorganizedwithmany,manybrainstemcellscontributingtoitsadministration.Eventhough
theyaresmall,themicromovementsresultinasignificantandconstantchangeinthepropertiesoflightfallingontheretinaofeacheye,enablingthebraintoprocess
images.
Thusvisionisadoubleillusion:theworldisstable,butIcan'tseeitunlessmyeyesmove,yetbymovingmyeyes,Imaketheimagesjump,whichmybrainthen
correctsagainsothatthefinalillusionisstable!
Ifyouarestillinanydoubtwhatsoever,thinkaboutthisone.IfIweretohookyouuptoaneyemovementrecorderanddisplayyoureyepositionasadotoflighton
ascreenacrosstheroom,suchthateacheyemovementyoumadecausedthedottomove,whatdoyouthinkyouwouldsee?Adotmovingaroundthescreenisthe
obviousanswer.Butyouwon'tseethedotmoveatall.Allyouwillseeisasequenceofstationarydots.Everyoneelseintheroomwillseethedotsactuallymovefrom
onepositiontoanother.Thiseffectiscalled''visualblanking,"implyingthatduringtheeyemovements,visionisactuallysuppressed.
Onewaytoappreciatethisprocessistorecognizehowamoviereelworks.Thereisablackbandseparatingeachframeofthemovie,butiftheprojectormovesthe
reelatfasterthantwelveframesasecond,youreyeswillnotperceivetheblacklineasitzipsupacrossthescreenitgoesbytoofast.Thisisaresultofvisualblanking
youbelievethatthemovementoftheobjectsdepictedonthescreeniscontinuousratherthanintermittent.Theblackbarthatyouseehoveringonyourtelevision
screenwhenthevertical

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controlisnotsetproperlyistheresultofthesamephenomenoninfact,engineerscallittheverticalblankinginterval.
SleepDeprivationandHallucination
Onceweappreciatethefactthatour"normal"visionisareproductionofreality,itshouldbeeasierforustounderstandhowthebrainmindcreatesentirelyartificial
visions.Aswewillsee,wecanshiftourbrainmindstatesvoluntarilytoimproveourhealthinthesameway,shiftscanbemadeintheinterestsofhavingareligious
experienceifwewanttohaveavision,thereisaneasyway.
Visions,hallucinations,dreamscallthemwhatyouwillareallactivelyinvitedbyseekersofspiritualtruth.Theperceptionsareoftenachievedbyenteringan
uncommonstate,beittrance,meditation,orotherritualpractice.AverycuriousandinformativecaseisthatofEmanuelSwedenborg,theseventeenthcentury
Swedishbotanistturnedevangelist.Onthebasisofhisvisions,hecreatedtheChurchoftheNewJerusalem,abranchofProtestantreligion.Heusedaparticularly
interestingtechniqueforinducingthevisionsthatinformedhisreligiousdoctrines:sleepdeprivation.
Swedenborgworkedinanerawhen"science"simplymeantknowledge,allknowledge,andascientistwasmeasuredasmuchbythebreadthasbythedepthofhis
intellect.Swedenborg'sknowledgewassobroadthathewrotetreatisesonbotany,zoology,geology,andastronomy.Healsowassurethatsciencewouldultimately
leadhimtoadirectencounterwithGod.ButtheheavenlyFatherfailedtoappearinthelensesofhismicroscopesortelescopes.
Disappointedbutundaunted,Swedenborgsetouttosharpenhispowersofinternalobservation,hisinsight,ifyouwill.Resuscitatingthemedievalists'useofdreamsas
avehicleofrevelation,hesystematicallyundertookaprogramofdreamsensitizationanddreamenhancement.HismethodisclassicalandeffectiveIhavelearnedto
useitinmyownselfexperiments.Whetheroneisbentonanasyetunfulfilledcareerasacharismaticorsimplyinterestedtoseeifdreamsareasfrequentandlongas
scientistssaytheyare,itispossibleforanyonetorepeatSwedenborg'sprocedures.

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Therulesaresimple:(1)keepadreamjournal,(2)keepirregularhours,(3)getupbeforeyouhavesatiatedyourneedforsleep.That'sallthereistoit.
AsSwedenborgdiscovered,bypayingattentiontodreamshenoticedthemmore,andbywritingthemdowninhisjournal,hepaidmoreattentiontothem.Thisinturn
causedhimtonoticedreamsevenmore.Andsoon.Thejournalisallyoureallyneed.Butifyouthrowinirregularhours,youwillincreaseyouryieldappreciably
becauseyouwillhaveamuchgreatertendencytowakeupatunexpectedtimes,therebyincreasingyourchancesofwakingupjustafter,orevenduring,adream.
Ihavesaidnothingaboutthecontentoftheambusheddreams.Andindeeditdoesn'tmatter.Ifyouwantreligiousvisions,youcanprobablyinducethem.Ifyouwant
FreudianorJungiandreams,youcaninducethemtoo.Dreamcontentisheavilycontextdependent,whichiswhyweignoreitinscientificendeavorsandconcentrate
ondreamform.Dreamformisuniversal,sowefeeljustifiedinassumingthatitfaithfullyreflectsbrainactivity.
Sofarwehavetalkedonlyaboutincreasingthefrequencyofrecallingyourdreams.Butifyouaddsleepdeprivationyoucanalsoincreasetheintensityofyourdreams,
asSwedenborgknewandeveryothervisionarywannabehasdiscovered.Ourdrivetodreamislikeotherinstinctssuchashunger,thirst,andsex.Stopdoinganyof
thesethingsforawhileandyourappetiteincreases,andsodoesyoursatisfactionwhenyouarefinallyfulfilled.Swedenborgfoundthatbykeepinghimselfawakeall
nightandthenlettinghimselfsleepfitfullybydayhisdreamsweremoreintense.Forhim,thatmeantthatGodappearedmoreoftenandwithmorecogentandurgent
instructionsaboutwhatneededtobedonetoproperlyreformthereligioustheoryandpracticeoftheday.
MyRedEyeVision
Ourneedtodream,or,Ishouldsay,toperceiveinternallygeneratedstimuli,isastrongerdrivethanwemightwanttobelieve.Ilearnedthatformyselfonedaysome
yearsago.IhadbeenatabusyscientificmeetinginAnaheim,California,forfivedays,andI

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wastoflybacktoBostonononeofthosewellnamedredeyeflights.OnthisparticularflightIgotevenlesssleepthanusualbecauseIwasseatednexttoanintriguing
femalecolleagueourconversationwassoscintillatingwedidn'tsleepawink.
ThedawnoverLakeEriewasglorious,andwelandedinBostoninthemiddleofoneofthosehighpressureweathersystemsthatmakestheNewEnglandfallso
exhilarating.Highanddrywithablue,bluesky.AttheairportIwasmetbymyfamilyforournottobemissedannualoutinginVermont.Knowingmysleeplessstate,
Ididnotdrive,buttriedtonapinthebackofourstationwagon.Arousedbytheroad'sbumps,mykids'jumps,andmyencounterintheairplane,Ididn'tsucceed.
Havingarrivedatmyfarm,Iwantedtobegintogetmywinterwoodinorder.Wewouldprobablyneedafirethatnight.AndthedaywassogloriouslyclearthatI
decidedtoforgosleepandgetthechoresdone.Ifeltfine.Evenabitelated.Iwasnottired.Notgroggy.Notdreamyorevendaydreamy.Iwaslucidandenergetic.
Sharp.
Afteraquicklunch(atabout8:00A.M.Anaheimtime)Iwasstackingkindlinginneatpilesunderthetinroofofmyleantowoodshed.Itissomewhatdarkunderthe
roof,buttherewasstillplentyoflighttoseeby.Suddenly,Ihadanunexpectedhelper.Hewasstandingbehindmyrightshoulder.Atfirst,Icouldn'treallyseehim,but
Icoulddefinitelysensehispresence.WhenIturnedmyheadandeyestothelight,sureenough,therehewas.TheonlyproblemwasthatIhadn'thiredahelper.And
Vermonters,asfriendlyastheyare,don'tusuallyjustturnuplikethat,especiallytotalstrangersandthisguywasutterlyunknowntome.Myheartstartedpounding
likealogsplitterandIwasovercomewithterror.
ThoughImusthaverunfromtheshedIonlyrememberreelingwithvertigo,nausea,andpanicasIspunandfelltothegroundaboutfifteenfeetfromwhereIhadseen
him.WhenIstoodupintheclear,coolairIwasrelievedtodiscoverthattherewasn'treallyanyoneelsebythewoodshedafterall.AfterIregainedmycomposureI
wentbacktosortingkindlingandgotthejobdonebeforerecountingmyadventuretomyfamilyoverdinner.
MysonChriswantedtoknowhowlongthestrangeepisode

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hadlasted.Iguessedabouttwoseconds,certainlynomorethanfive.WhenheaskedmewhatIthoughthadhappened,allIcouldsaywasthatIhadavisual
hallucinationaccompaniedbyintensepanicandanxiety.Itwashardinretrospecttosaywhichcamefirst,thevisionorthefear.Iguessedthattheyweresimultaneous.
Atfirstbothelementswerequitemild,buttheyseemedtogrow,togetheritwaslikeanightmareandaseizureallrolledintoone.Therewasastrangeauraatthe
beginningthevaguesenseofapresence.IturnedtolookandthenIsawhim.IfeltscaredandthenIlostconsciousnessforaninstant.ThenIreeled,spun,andfell
asifdrivendowntotheground.
I'mhappytoreportit'stheonlyfrankhallucinationIhaveeverhadandthatmyEEGisnormal.Ihavehadnoseizuresbeforeorsince.SomepeoplethinkI'mabit
eccentric,maybebizarre,butnotevenmyseverestcriticsusetheword"psychotic."Sohowdoweexplainthis?
Oneanswerspringsimmediatelytomind.ThedeprivationofsleepthatIincurredduringmyredeyeflightfromLosAngelestoBostoncausedmybraintobe
hyperexcitable.Visionneuronsthatwouldnormallyrespondonlytoexternalstimuliwerenowpronetofireimpulsivelyontheirown,asiftheyhadlostanimportant
restrainingforce.
Recallthatwhenweareawaketheamineskeepacetylcholineincheck.WhenweareinREMsleep,theaminescannolongerrestraintheacetylcholinemolecules,
whichtriggerthehallucinationsweseeasdreams.CoulditbethatbyrestinginREMsleeptheaminesarebetterabletodotheirrestrainingjobonacetylcholineduring
thenextday?Andcoulditbe,then,thatsincemyamineshadnothadarestoftheirown,theyfinallycrumbledundertheexcessivepressureofacetylcholinewhileI
wasstandingatthewoodshed?Wemusttaketheseideasseriouslybecausetheypromisenotonlytoexplainthedeleteriouseffectsofsleepdeprivationbuttotellus
aboutthebeneficialeffectsofsleepitself.
PuttingSwedenborg'sstoryandminetogethersuggestsatheory:thatthebalanceofourinternalelectricalexcitationandinhibitionissofinelytunedthatthebrainmind
isalwaysontheedgeofseizurelikehallucinations.Inthistheory,thejobofsleepisto

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protectorstabilizethatbalance,sothatperceptioncanbecreativeenoughtoreproducetheworldbutnotsocreativethatitproducesentirelyartificialworlds.What
wouldhappentous,then,ifweweretosuddenlyandviolentlyshiftthebalanceinfavorofelectricalexcitation?
DreamsAsSeizure
Ihavealwaysbeenastonishedandhorrifiedbythecrudenessofelectroshocktreatment.Basically,thebrainmindispluggedintotheEdisoncompany.The
electriccurrentcausessuchamassiveoverdriveofthebraincellsthataseizureistriggered.Thisisfollowedbyaperiodofunconsciousness.WhenIwasintrainingto
beapsychiatrist,Ifoundshocktherapytobemorallyandintellectuallyunacceptablebecauseitwasnotonlycrudebutinexplicable.Toreducethechanceofinjury
thattheintensemusclecontractionsassociatedwiththeseizuremightcause,patientswhoaretoundergoshocktreatmentaregivenacurarelikedrugthatpartially
paralyzestheirmuscles,addingtheriskofrespiratoryarresttoanalreadyfrighteningprocedure.
YoucanthusimaginemyamazementandconsternationwhenadepressedmancameintoThePsycho'soutpatientcliniconedayanddemandedelectroshocktherapy.
Iadvisedhimthatwehaddrugsthatweremuchsaferandeverybitaseffectiveintreatingdepressions.Butthefactis,shocktherapyisoftendramaticallyeffective,and
thisparticularpatienthadtriedboththerapiesandfoundthattheshocktreatmentswerenotonlyquicker,butenabledhimtoavoidthesideeffectshegotfromthe
drugs.Heclaimedthatthreeorfourshockswereallthatheneededtoavertthehorriblesinkingholeofdepressionthathewasfallinginto.Hewasafraidthathis
depressionwouldlastsixmonthsifwedidn'tactfast.
Icheckedouthischart,consultedwidely,andthendidashehadasked.Andashehadpredicted,hismoodbouncedrightback.Iwillspareyouadescriptionofthe
seizuresheunderwent,whichstillhauntmymemory.Atthetime,Ihadn'theardofREMsleep,butIrecallwonderinghowandwhysuchamassiveoverdrivingof

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thebraincouldhavesuchpromptandlastingeffectsonaperson'smood.
Mytheorynowisthattheartificiallyinducedstateofbrainmindhyperexcitability,inwhichthemotoroutputisblockedbyadrug,issomethinglikeREMsleep,and
thatit'spossibletolookatREMsleepasamodifiedseizure.Inotherwords,mytheoryishomeopathic:wehaveasleepseizureinordertoavoidawakingseizure.
Wedreamsoasnottohallucinate.
IfyouweretolookattheEEGofapatientduringaseizure,youwouldseethattheominouslyspikedtracesthatarediagnosticofepilepsylookjustlikethePGO
wavesinREMsleep.Thedifferenceisinthesourceinanepilepticfit,thesourceofthewavesisusuallyhighupinthecortex,butduringREMsleepthesourceis
deepdowninthebaseofthebrainstem.Asweknow,thatisthecenterofstatecontrolit'sthebattlegroundfortheaminergiccholinergicsystem.
ThePGOwavesrepresentunbridledbraincellelectricity."Brainstemlightningbolts"ishyperbolicbuttothepoint.Theyspreadlikeflashfiretoareasofthebrain,
excitingthemwildly.TheelectricalfireofREMsleepflashesinthesameway,upwardtothevisualbrain(whichsees),sidewaystothemovementandbalancesystem
(whichflickstheeyes),anddowntobodymovementcommandcells.
AlookattheEEGindicatesthatthedreamystatesofepilepticsmaynotbeallthatdifferentfromthoseweexperienceduringdreaming.Andthemodifiedseizuresthat
weinducebyelectroshockmaynotbeallthatdifferentfromthephysiologicalexperiencewehaveduringdreams.Furthermore,theeaseofexperimentallyinducinga
seizureisincreasedwhenthesubjecthashadsleepdeprivation.Sleephastheeffectofrestoringtheusualprotectionagainstseizuresthatmostofusenjoyallofour
lives.ThereisalsoreasontobelievethatREMsleepoffersinsuranceofanotherkinditmayhelppreventpsychosis,astatewhich,wearelearning,maydependin
partonashiftinthebalanceofexcitationwithinthebrain.
Ifthistheoryiscorrect,thereoughttoariseasacruelexperi

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mentofnaturecasesinwhichREMsleep'scapacitytopreventnaturalseizuresismissing.DuringREMsleepthebrainstemblocksthemotorcommands,socertain
damagetothebrainstemoughttonegatethisaction,allowingthosecommandstoreachmusclesduringadreamscenario.Itnowseemsthismaybesorecently,
scientistshaveuncoveredcasesinwhichdreamsareactedoutowingtoafailureininhibitionofmotorcommands.
TheManWhoMistookHisWifeforaBendintheRoad
Joswassixtythreeyearsoldwhenheandhiswife,Giovanna,cametoseemeintheearly1980sabouttheirsleepproblem.Iaskedthembothtokeeprecordsof
whathappened.HerearetwoofJos'sjournalentries:
1.Iwasdreaming.Iwasinthemidstofdrivingonanextremecurvetotheleft.Itriedtomaneuver.MywifewokemeupIhadhitheronthearm(nothard)withmyelbow.
2.Iwasdreaming.Thisguyusedtobeafootballstarquarterback.They'rehavinghimdothismoviestunt.Idon'tknowwhathehadtodo,buttherewasthisbigsphere(wayupin
thesky).Iwasuptheretooandthemetalobjectwasspinning.ItwascomingatmeandIwasducking.Whenmywifeawakenedme,Iwassittingupinbedholdingmyarmsup
thinking,Ifthishitsme,it'sallover.

ManyyearsearlierithadbeenclearlyshownthatsleepwalkingoccursinnonREMsleepandisnotassociatedwithdreaming.Peoplewhosleepwalkarenotacting
outadream.DuringnonREMsleep,motoractivityisnotblocked,soourbodiesarefreetomoveabout.Werarelydomorethanrolloverinbed,though,because
thereislittlebrainactivityduringnonREMperiods(sleepwalkingisdiscussedfurtherinchapter14).Theoccasionalreportsfrompatientsandtheirbedpartnersof
dramaticandoftenfearsomedreamenactmentswerethereforeperplexing,becausewebrainmindscientistshadassumedthattheinhibitionofmotoroutputinREM
sleepwasalmostalwayseffective.Ourassumptions

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overlookedtwopoints.First,evenstronginhibitionisonlyrelativealthoughthespinalnervesthatnormallycommandmovementaredampened,theycanbeturnedon
iftheexcitationisstrongenough.Theotherpointisthatthedegreeofinhibitionmayvaryfromtimetotimeandpersontoperson,especiallyiftheinhibitorynervesin
thebrainstemarelostduetodiseaseoraging.
Inretrospect,it'sprettyobviousthatJoswashavingvisuomotorhallucinationsofthesortthataretypicalofdreamsandthathewasactuallymovingexactlyashe
imaginedhimselftobemovinginthedream.Itisalsoobviousfromtheexamplesaboveandothersinhisjournalthatthedreamsinwhichmovementactuallybroke
throughtheinhibitorybarrierwerethoseinwhichhefeltastrongsenseofthreatordanger.Joswastryingtoavertdisasteronthehairpincurve(butindoingso
whackedhiswife)next,hewasdesperatelytryingtoavoidaspinningmetalobjectcomingtowardhim(andfoundhimselfstretchingouthisarmsinselfdefense).
Otherdreamsdrovehimrightoutofbed,facefirstonthefloor,causingsignificantpainandinjury.
WeknewfromGiovanna'snotesandtaperecordingsthatJos'sdreamenactmentswereoccurringinREMsleep,becauseshecouldseethateyemovementsand
facialgrimacesusuallyprecededthethrashingandtwistingofJos'strunkandlimbs,whichshesaidwere"likehewashavingafit."Sleeplabrecordingsofpatientslike
Joshavenowconfirmedthat,indeed,thedreamedmotoractsaresomehowbreakingthroughthenormallyprotectivebarrierofinhibition.WecanlikenREMsleep
motorinhibitiontotheclutchinanautomobile.Duringinhibitiontheclutchisdisengagedtheengineishummingalongbutnopowerreachesthewheels.Wereitnotfor
thisphysiologicalclutch,allourdreammotorswouldbeconnectedtoourwheelsandwewouldbethrashingabouteverynightofourlives!
We'relucky.AndsowasJos,whoseworstfearwasactuallyhurtinghiswife,Giovanna,whomhedeeplyloved.Thatneverhappened.Becauseshewasalight
sleeper,GiovannawasabletododgeJos'sdreamdrivenflailingandawakenhimtostoptheprocess.Havingsuccessfullydefeatedanalcoholproblemearlierinhis
life,Joswasreluctanttotakethemedicationthatwasnewlyavail

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ableandeffectiveintreatinghiscondition,whichiscalledREMsleepbehaviordisorder.Asissooftenthecase,Joswashelpedmostbyhavingthreestrong
pillarsofnaturalsupport:increasedunderstandingofthenatureoftheproblem,acceptanceoftheproblemasavariationonanormalprocess,andasignificantdegree
ofcontroloverhissleepthatheachievedwithmeditationandrelaxation.JustasJoshadearlierrecognizedtheneedtostopdrinking,henowrecognizedtheneedto
giveuphislatenights,hishighstrunglifestyle,andhisirregularsleepschedule.
MotorPatternGenerators
WhatcausesREMsleepbehaviordisorder?Canitbecuredorjustsymptomaticallyrelieved?Itisstilltooearlytoknow.Inalllikelihoodthisunusualbrainmindstate
hasdifferentcauses.Anyprocessthataffectsthebrainstemmotorinhibitorycenter,orthepathwaysfromittothemuscles,couldweakentherestraintonunwarranted
movement.Andanyprocessthatoverdrivesthemotorpatterngeneratorsofthebrainstemandthusincreasestheexcitationofmovementneuronsinthespinalcord
couldcausethedisorder.
Thisdisorderisamongthestrongestevidencethatdreamsarelinked,andevendriven,bymotorprogramsinthebrainstem.Whenhe'sawake,Jos'svisualworld,
likeallofours,isdrivenbymotorinputsthetinymotionsofoureyes.Whenhe'sdreaming,however,Jos'sclutchsometimesdoesnotdisengage,andthemotorin
hisbrain,idlingawayattopspeed,runshisdreamaroundthebedroom!
Bertalalsohadaproblemwithhismotorprograms.Hisepisodesofstronghallucinationoftenmadehimcatatonic.Hisposturebecamerigidandheassumedbizarre
statuesqueposes.Therewassomethingwrongwithhismotorsystem,justastherewaswithhisvisualexcitation.AfteroneepisodeatThePsycho,IfoundBertal
squattinginthekitchenstaringatthewall.Ispoketohimforanhourwhileheremainedmotionless,tuckedinanawkwardball.Hegavenoreply,exceptforone
instantwhenheasked,"WhydoIdothefoolishthingsIdo?"

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Bertal'smotorandvisualsystemsalsowereoutofkilterwhenmysupervisorhadenteredtheseclusionroomwheretheorderlieshadputBertalafteroneofhis
terrifyingwarhallucinations.Bertalfirstmistookhimasthe''enemy,"thenbeganflailingawayathim.
TheevidencefrombothJosandBertalseemstoindicateclearlythatbizarremovementandbizarreperceptionsarelinkedinmanyalteredbrainmindstates.The
sensorysystemdoesn'tworkproperlywhenthemotorsystemprogramsarerunningafoul,andviceversa.Thebrainmindisaunifiedsystemand,forbetterorworse,
itisunifiedbyitsstates.
Whenwedecidewewanttogosomewhere,wevoluntarilyinitiatemovementsequences.Oncetheybegin,though,thesequencesaresoautomaticthattheynolonger
requireourconscioussupervision.Walking,jogging,evensprintingaregaitscontrolledbybrainstemmotorpatterngenerators.Allwehavetodoisflipacommand
switchinourcortexandourlowerbraincoordinatesthemotion.Becausethatcommandcenterisinthecortex,andthecentersforgaitcontrolareinthebrainstem
andspinalcord,ourdecisiontowalkisoneofmanyexamplesofwhatscientistscallatopdownprocess.
Therearesituationsinwhichitisadvantageoustoshortcircuitthecortexandactivateamotorpatterngeneratordirectlyfromthebrainstem.Ifwesuddenlyseeacar
careeningtowardus,weinstantlyturnourcarawaywereactautomatically,andonlylater(evenifitisonlyasplitsecondlater)dowerealizethereisdangerandfeel
afraid.Thestartleresponseandtheorientingresponsearealsogoodexamplesofshortcircuitprocesses.Becauseinthesecasesthebrainstemsignalsprecede
thought,theyarecalledbottomupprocesses.
Whetherornotthemotorpatterngeneratorsareundervoluntary(topdown)orautomatic(bottomup)controldependsonourstate.Thegaitcontrolcircuitsarein
thebrainstem,intertwinedwiththesamenetworksthatgovernbrainmindstates.Wecanseethisinthelabwecanstimulateandchangethegaitcontrolcircuitsin
thebrainstemelectricallyorwithchemicals.
Wecanalsoseethisanecdotally.Jos'sefforttocorrectthecourseofhisdreamcarwasavoluntaryefforttoregaincontrol.

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Itwastopdown.Itinterruptedthenormalbottomupprocessofdreaming,whichinhibitsmotoroutput.Wecertainlyfeelwearemakingvoluntarymotionswhenwe
areinfearinourowndreams.Wetrytorunfromimaginaryassailants,andwetoowouldfeelwewerethrowingourarmsupinselfdefenseifweweretosuddenly
turnaroundinadreamandseeahugemetalspherescreamingtowardourheads.Insuchperilousmomentsweactuallywillourselvestorunaway,toblockthe
sphere.ItisthenthattheREMsleepdreamstateismostlikelytobreak.Thesetopdownmovementcommandsfromthecortexoverridethesignalsfromthebrain
stemtheybreakthroughthemotorinhibition,andwewakeup,ofteninterror,andinacoldsweat.
ThePrimacyofMovement
Whydosuchmotorprogramsruninoursleep,andaren'ttheresomedangersintheirdoingso?Whatiftheboundariesbecomeblurred?WhatreallystopsJosfrom
assaultinghiswifeifhesupposessheisanintruder?Andwhatdoesallthishavetodowiththerelationshipbetweenbrainmindstatesandthefacultyofperception?By
theendofthischapter,Ihopetooffersomeanswers.
Tothispoint,Ihavediscussedhowexternalandinternalvisionworkandhowvisionisintegratedwithmovement,andindeedhowmovementitselfisanactive
organizerofsensoryexperience.Alookathowwedevelopinourearlyembryoniclifewillleadustoanevendeeperpropositionthatmotorpatternsareelemental
buildingblocksofthebrain.Iwillsuggestthatinnatemotorprogramsarefunctionalblueprintsforbehaviorsthatarerunbyourbrainsinutero.Thehumanfetusspends
mostofitslastuterinedaysinaREMlikestatethatlongantedatestheemergenceofconsciousexperience.
Thequestionof"whichcomesfirst,brainormind?"isavariationonthetheme"whichcomesfirst,thechickenortheegg?"Speakingdevelopmentally,most
neuroscientistswouldsaythatthebrainprecedesthemind.Thedevelopingbrainisdynamic,and

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thereisanorderedmovementateverylevel,fromtherollingoftheDNAprintingpresstotheceaselessfluxofactivityofcellmembranesfromtheserpentinetwistsof
theembryototheagitateddanceofthefetusonthesonarscreensofobstetricalofficesaroundtheworld.Weareforcedbytheevidencetoconsidermotoractsas
primaryandformativeaswellassecondaryandreactive.
Alloflifeisflux.Alloflifeismotion.Motionisperpetual.Broadeningthedefinitionofbehaviortoincludeeventhemicroscopicmovementsthatoccurcontinuously
withinalllivingcellsmakesitclearthataveryearlyorganizationalstateofourexistenceislikeREMsleep.Ourprimordialselvesaretwitching,writhing,andmoving,
andoureyesarewandering,inauterinehottub.Noonecandenythatthisismotorbehavior.Whetherthereisanypsychologyattheseearlystagesisamatterof
heavymoralweightthatwecannotassessatthisstageofourknowledge.Butevenifthereissomeprimordialconsciousexperiencesuchassensoryprocessingthat
couldbefeltatsomelevelthereiscertainlynoevidencewhatsoeverthatwehavetheselfreflectiveawarenessthatistheessenceofwhatweimplybytheterm
consciousness.
Wecanavoidthephilosophicalquicksandoftryingtodecidepreciselywhenconsciousnessbeginsbysayingsimplythatweallspentaverysignificantamountoftime
inaveryREMlikestatebeforewewereborn.Withnewtechnology,embryologistscanseeeyemovementsinfetusesonlytwentyweeksold.Andtheearliera
prematurebabyisborn,themoretimeitspendsinREMsleep.Thatstate,withorwithoutconsciousness,ischaracterizedbyautomaticactivationandmotility.Thisset
ofobservationshasledmanyresearcherstoproposethatREMsleepisafunctionalblueprintforhumanbehavior.Onthedrawingboardsofthewomb,braincircuits
arelaidoutandtestedbyanautomaticprocessthatprobablyarisesassoonasthenetworksofnervecellsarefirstformed.Primordialmovementisabuildingblockof
behavior.Ithelpsthebrainandthecentralnervoussystemcompleteandcorrectitswiring.
Thisisaclassicexampleofselforganization,thatamazingpropertyofallcomplexsystemstocreateorderoutofchaos.Our

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brainsareprogrammedbyperiodicactivationthatbeginsinuteroandresumeseverynightofourlives.Andoncewehavesetthebrainmindinmotion,allwehaveto
doisshapeandmodifyitbyexperience.Thisiswhatitmeanstolearn.Wethusbuildwhatwehavelearnedintothedynamicstructureofanautomaticallyactive
system.Atsomepointearlyinlife,thesystemacquiresarichenoughstockofimagesandthoughtstohaveconsciousawareness.Addafewmoreandithasenoughto
beawarethatitisaware.Oncewehaveselfreflectiveawareness,wearefullyconscious.
Insketchingthisdevelopmentalmodel,severalimportantnewconceptshavesurfacedthatwillrequirecontinuedattention.Tothenotionthatbrainmindstatesare
organizationalunitsofenormousimportance,wehaveaddedtheideathatelementalbuildingblocksofsuchstatesaremotorpatterns.InREMsleep,theautomatic
activationofmotorpatternsgetsaselforganizingprocessgoingthatgivesthesystemthecapacityforcontinuousandprogressivechange.Thatchangeiswhatwecall
maturation.
Nowwecanaddstillanothernewconceptthatofproceduralknowledge.GiventhatthefetusknowshowtoenteraREMlikestate,italreadypossesses
proceduralknowledge.Thefetuscan'tgiveanaccountofhowitdoesthisbecauseitdoesn'tyethavenarrativeorimplicitknowledgebutitdoesknowhowtodo
it.
Evenlater,whenwearefullymature,mostofourknowledgeisprocedural.Weknowhowtotieourshoes.Andweprobablycouldwriteafiveorsixpagepaper
explainingexactlyhow.Butitisinfinitelysimplertodemonstratethebehavior.Thatiswhywewouldrathershowsomeonehowtotiehisshoesthantotrytodescribe
howtodoit.
Whenitcomestoswallowing,wedon'tevenconsiderdemonstratinghowtodoit.Wejustdoit.Thisimportantbehavioriscompletelyselftaught,completely
unconscious,andcompletelyprocedural.Wecan'trememberlearningtoswallowbecausenooneevertaughtustodoit.Wealwaysknewhowtoswallow,long
beforethetimeofourearliestmemory,longbefore,indeed,wewereborn.Whenfetusessucktheirthumbstheymaybefinetuningthecrucialactofswallowing.

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MovementIstheKeytoLearning
Forbabiestosurviveintheworld,theyneedtobebornknowinghowtodocertainthings.Becauseitissocrucialtofeeding,swallowingisclearlyoneofthem.This
exampleshowsthatinstinctsaremoreorlesscollectionsofprocedures.Thetechnicaltermforsuchautomaticallyprogrammedbehaviorsis"fixedacts."Ifwe
extendedthelistfromfeedingto,say,sex,wewouldagainagreethatmanyelementsofeventhatbehaviorarepresentatbirth.Theerectionofthephallusisonesuch
behaviorthatbeginsinthewombandoccursduringREMsleepforlife.
Whendidyou,asababy,emityourfirstsmile?Doyourememberthosebabypicturesofyougrinning,givingyourmotherevidencethatshewasdoingherjob
effectively?Chancesarethatneitherthecameranoryourmother'seyecaughtyourfirstsmilebecauseitmightwellhaveoccurredbeforeyouwereborn.Andit
certainlydidoccur,often,whenyouwereREMingawayinyourbassinet,unseenbyanymemberofyourlovingfamily.
Smilesofhappiness,frownsofdispleasure,andgrimacesofpainareamongthemanymotoractsthathaveatrulyinstinctualcharacter.Asanyparentofademanding
infantcanattest,babiesarebornwithanimpressiverepertoireofemotionaldisplays,includingthatsleepshatteringscreamthatcallsforfeedingstwiceanight.These
behaviorsarepreprogrammedbytheselfactivatedbrain,inREM,longbeforetheyareputtotheserviceofsurvival.
Nowthatwerecognizethisselforganizingcapacityofthebrainmindanditsstates,ourwholeconceptofwhatFreudcalledinfantilesexualitycanchange.Weno
longerneedtoendowsuchactswithintentionortoprojectadultideasofsexualityuponthenewborn.Wecanabandonthisforcedexplanationnowthatwe
understandtheprogrammedautomaticityofbrainmindstatesthatextendsintosomanyaspectsofourmentallife.
Thischangeinviewpointdoesnotimplythatsexisanylessimportant,nordoesitignorethefactthatsexualbehaviorcanbemessedupbysocietalpressuresand
prohibitions.Theselforganizationconceptmerelyrelegatessextooneofanequallyim

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portantnumberofproceduresthatisactivelyandautomaticallydevelopedovermanyyearssothatwe,asbabies,canbesuccessfulashumanbeings.Knowingabout
selforganization,wecannowconfidentlysaytoparents,"Look,yourjobismucheasierthanyousupposedbecausesomuchofthesculptingofallsociallycritical
behaviorisinternal.Youdon'thavetoteachyourchildmostproceduralknowledge.Intime,itwillemergespontaneouslyandnaturally,especiallyiflefttoitsown
devices."
Thepurposeoflayingsuchheavyemphasisonthemotorsideofthedevelopmentstoryistopreparethewayfortheideathatproceduresmaywellbethenucleifor
muchofwhatseemstobepurelysensory(asinmywoodpilehallucination)orpurelycognitive(asinBertal'sdelusionaboutwhyhewascomingtoThePsycho).
Everysensoryexperience,beitveridicalorillusory,involvesbothactionandbelief,bothmovementandconcept.Inthecaseofvision,thecrucialandfundamentalrole
ofeyemovementisclear.Eyemovementislikewisecentraltotheorientingresponse.And,assuch,itinteractswithorientation,thatvitalfacultythatweexamined
earlier.Throughmotion,wetrainourbrain.
WeDreamsothatWeMayLearn
Whenwefindourselvesinanewplace,weatoncebegintodeveloporientationalschemas.Webuildupourbrainmindmapsbyincorporatingtheresultsofexploring
theenvironmentandmovingthroughit,whileatthesametimesniffingit,hearingit,andfeelingitstextures.Thisleadsustoanimportantquestionthatistougherthanit
looks:Howcanwemostefficientlyandeffectivelyassurethattheorientationalexperienceweperceivegetsbuiltintooursystem?Inaddition,howcanwebesurethat
ifabuiltinprocedureisn'tused,itdoesn'tgetlost?
Onewaywouldbetohaveastate(waking)inwhichweareexposedtonewinformationandanotherstate(REMsleep)inwhichthenewdataisintegratedwiththe
wholesetofexistingprogramsinthesystem.Forthattohappen,wewouldneedtorunthesystemautomaticallyforaconsiderablelengthoftimeeachday(sayone
andahalfhours,theusualgrandtotalofREMsleepfor

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anight)wewouldwanttorunitfast(saysixproceduresasecond,theusualrateofPGOwavesignals)wewouldwanttorunitwiththeclutchdisengaged(sothe
systemdoesnothavetooutput)andwewouldwanttorunitinanalteredchemicalclimate(tofavorasetofmolecularoperationsthatdiffersfromthatinwaking,to
encodelongtermmemory).That'satallorder.Butit'salldonereliably,efficiently,andunconsciouslyinREMsleep,themotherofallprocedures!Weareperforming
mentalgymnastics,usingmotorprogramstotrainourbraineachtimewedream.
Thatthisprocessdoesnotalwaysoccurperfectlywehavealreadyseen.Partsofitcangetoutofcontrol.Ifwedon'tgetenoughsleep,visuomotorhallucinationsmay
breakthroughrightintothelightofday,astheydidformeatthewoodshed.Ifthereareevensmallshiftsofbalanceintheaminergiccholinergiccontrolsystem,motor
actsmaybreakthroughtheinhibitionofREMsleep,astheydidforJos.Andifthereareevenmoremassiveshiftsinoursensorimotormodulators,wemightallsee
divebombersandcurlupinatightballasBertaldidthatdayatThePsycho.
WecanevenimaginesomebehaviorsthathavethepropertiesofbothREMsleepandseizuredrivenfugues,inwhichelaborateviolentactscouldoccur.Infact,the
courtshaverecentlyconsideredseveralcasesofnocturnalmurder,inwhichtheperpetratorswillinglyconfessedandconvincedjuriesoftheirpeersthattheiractswere
automaticandinvoluntary.
Thesestartlingdreamenactmentsonlyemphasizewhatwealreadyknowifwehavepaidevenpassingattentiontoourowndreams.Theyaresofullofimaginings
fromthievesbreakingintohotels,toflyinghighinaballoonoverParis,toveeringoffasharpcurvethatREMsleepmustbepreparingandequippingusforalmost
anypossiblewakingeventuality.Theprogramsareallthere.Life'seventscallthemforth.And,mostofthetime,theyotherwisestayput.
Wehaveourwelltemperedsequenceofbrainmindstatestothankforthat.Thelessonsofthischapterteachusthatinordertosee,weneedtorecreatethevisual
worldinourbrainmind.Thisdeeplyartisticactrequiresthatwescantheworldbytheperceptualjitterofoureyeballs,whichmeansthatourvisions,betheyveridi

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calorfanciful,arealltightlytiedtobrainstemmotorpatterngenerators.Nowonder,then,thatthesemotormainspringsareputinactionearlyinthelonggameoflife,
inwhichwewinourhighestnaturalprivilegeourconsciousness.Andnowonderthatthisvisionmakingprocessrequiresconstantupdatingwithrealityinputsand
frequentrebalancingintherepairshopofourdreams.

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Chapters9
TheHeartoftheBrainMind:EmotionandInstinct
AyoungwomannamedSally,wholivedinBoston,toldmeaboutadreamshehadrecentlyhad.
Iamonabusinalargemetropolis,andalthoughitisdaytime,Iamuneasyandafraidofmysurroundings.Thepeopleonthebusareallstrangers,andIknowthattheydonot
noticemeandwouldnotlikemeorhelpmeifIneededthem.Iamsittinginthefrontofthebus,ontherightside,facingtheaisle.Apersoninawheelchairisinfrontofme,andI
feelthatheiscrowdingme.Althoughthebusisfull,Inoticeamaninthebackwhofrightensme.HelookslikeCharlesManson[thepsychopathwhouseddrugsandsexto
enslave,torture,andmaimyoungwomen].Althoughthemandoesnotlookatme,Iknowthatheisawareofme.
Whenthebusstopstoletofftheguyinthewheelchair,Ilookaway,andwhenIlookback,themanhasmovedforwardoneortwoseats.Heisreadinganewspaper,andhe
doesn'tmove.WhenIlookagain,heisevencloser,althoughIamnotawareofhimmoving.Ibegintopanic.Whenheistwoseatsaway,Itrytogetoffthebus,butthedriverwill
notopenthedoor.Ibegintocryinfeartoanolderwomaninanotherseat,butsheisannoyedand

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doesn'tanswerme.Iamafraidtolookathim,forfearhewilllookback.Iscreamandstarttobeatonthedoorofthebus,butnobodyseemstobelieveme,andwithmybackturned
Iwaitfortheinevitablecoldtouchofhishandonmyshoulder.

Sally'sdreamsuggeststhatlifeinamodernmetropolismightnotbeallthatmuchsaferthanintheprimitivejungleofourreputedlysavageforebears.ThenItoldSallya
storyofmyown.
Iwaswalkinginaresidential,downtownsectionofBostonintheweehoursofthemorning,whenthreedrugcrazedmensuddenlyappearedatmyside.Oncemyassailantshad
corneredme,mysenseofthreatwasofnightmarishintensity.Feardominatedmythinking.ThemostagonizingaspectofmydreadwasthesensethatIwashelplessandalone,
eventhoughIwassurroundedbypeople.Iknewthateyewitnessestoanurbanassaultwoulddonothingtohelp.Oneofthementappedmyshouldertodistractmyattention,
settingupacripplingcrosschopthatknockedmedowntothepavementandtemporarilyout.WhenIregainedconsciousnessandlookedupatmythreeassailantsstompingme
withtheirfeet,IscreamedasloudlyintheBostondawnasIcould,butitwastonoavail.Noonebotheredtogetoutofbedonthatearlyspringmorning,muchlessopena
window,toverballydriveoffmyattackersoraskifIneededhelp.

Sallyreactedknowinglytomyaccount,untilItoldherthatitwasn'tadream.Iwasthereallifevictimofabrutalurbanassault.Iwasbeatenandbloodiedandhad
screamedouttosavemyverylife.
Itisnotsurprisingthatyoungwomenwholiveinbigcitieshavedreamanxietythatmatchestherealthing.Sallydidn'thavemyexperience,shejustanticipatedit.But
noticehowwellsheanticipatedit.Heremotionsoffear,dread,anxiety,andpanic,andherscreamingoutincompleteterror,matchedmineexactly.Wecouldnothave
beenintwomoredifferentstatesshewasinREMsleep,underdominationofhercholinergicsystemandperceivingnothingfromtheoutsideworld,andIwasas
awakeandhyper

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awareofrealityasmyaminergicsystemcouldpossiblymakemeyetouremotionswereidentical.
Itisclearfromthiscomparisonthatemotionisnotjustawayofreactingtolife'sevents.Itisalsocreatedfromwithin,andwithjustasmuchintensitywhenitis
spontaneous(asinSally'sdream)aswhenitarisesinresponsetoarealthreat.Emotionisaconstant,afundamentalpartofallourbrainmindstates.ForSally,itisas
ifshecameintotheworldequippedwiththecapacitytoanticipatetheworstandrehearseforitinthethroesofherCharlesMansondream.
Anxietyisnaturalandhealthy.Andthereisnothingnecessarilyneuroticaboutit.Anxiety,howeverunpleasant,oftenservesuswell.Myintuitivereflectiononthis
recognitionisthatthebrainisananxietyemitter.Liketheheart,itbeatsconstantly.Asouremotionalheartbeats,itemitsjustenoughuneasetokeepuswary.Afterall,
itisoftenwisetobewary.Thebrainmindalsoemitsjustenoughoftheothercolorsoftheemotionalrainbowtokeepusjoyfulenough,angryenough,sadenough,
guiltyenough,andashamedenoughtoliveourliveswithsafety,gusto,andresponsibility.
Whatareemotions?Wheredotheycomefrom?Whataretheygoodfor?AndhowcanitbethatSallyandI,insuchdifferentstates,canhavetheexactsame
emotionalexperience?
WhyScienceHasShunnedEmotion
Whenwesaythatouremotionsare''primitive,"werecognizetheirlongandimportanthistoryinourrisefromtheevolutionaryswamp.Butbycallingemotions
"primitive"wealsotendtodevaluetheirutility.Asrationalistsmostofusarealmostembarrassedbyemotion.LikeStarTrek'sMr.Spock,wesupposethatifwe
werereallysensiblewewouldn'thavetohaveanyfeelingsatall.Itisnosurprise,then,tofindthatscience,beingrational,hashadaverydifficulttimedealingwiththe
subjectofemotion.Whyisitsoimportantforsciencetofacethefactsofourpassions?Becausetheynotonlyinfluenceourthoughts,theyalsoconstituteanim

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portantwayofknowingtheworldthatisindependentofourintellect.
Thepsychoanalystsmustbegivenenduringcreditforalwaysgivingemotiontheirhighestpriority.Butthatadmirablegroupofcaretakershashadlittlemoresuccessin
formulatingascientificallyvalidtheoryofemotionsthanthehardheadedexperimentalists.Asinsomanyotherareas,theinfluenceofFreudhasheldthefieldback
intellectually.Freud'smistakennotionofhowdreamsareactuallyconstructedcontaminatestherestofhistheoryofmentallife.ForFreud,dreamingwasa
fundamentallyneuroticprocessandathreattoourmentalhealth.Censorshipwasneededtoprotectourpristineconsciousnessfromthevillainous,instinctualforcesof
theunconscious.Andourdreamemotionsespeciallyanxietywereasuresignoftheinadequacyofourdefensesagainstourinstinctualselves.
Weneednowtofindanewwayoflookingatemotion,thisancestral,important,andessentialpartofourselves.Weneedtorecognizethatemotionisitselfaninstinct
and,assuch,iscrucialtooursurvival.
Aslongasallformsofspontaneousactivityofthebrainmindwentunrecognizedbyscience,emotioncouldhardlyhavebeenexpectedtobeseenforwhatitis:a
constantflowofvitaldatafromdeepwithinourselves.Onceweadopttheideathatthebrainmindisaunified,dynamicsystemthatmanifestsitselfinacontinuously
variedsequenceofactivationstates,wehavenoproblemwiththeconceptofemotionasoneofitsmostreliableandusefulproducts.Thenounemotionstemsfrom
theverbemote,whichmeans"tomoveawayfromtomove."Justasperception,whichisdrivenbymotorprograms,isspontaneousaswellasreactive,sotoois
emotion.
Anothermajorobstacletoprogressinunderstandingemotionhasbeenthescientifictabooonsubjectiveexperience.Althoughmanyscientistshadnodifficultywith
documentingbehavioralaspectsofemotionalexpressionlikesmilingorfrowningandfindingoutwhatstimuliproducedtheseresponses,theideaofusingthe
attendantfeelingsthemselvesasdatawasanathema.Thefamiliarobjectionsincluded"can'tbeverified"and"tooliableto

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distortionbysuggestionorconcealment."Thesecomplicationsmaymakeexperimentationdifficult,buttheycertainlycanbereducedtotolerablelevelsbysmart
collectionandanalysisofdata.
Theothermainobstacletoseeingemotionasanessentialbuildingblockofourconsciousstateswassimplyignorance.Untilwewerewellintothetwentiethcenturywe
simplydidn'tknowenoughaboutthebraintospeculateabouthowitmightgeneratetheemotionalaspectsofallourstates.Nowthatwedo,wecandevelopatestable
theoryofemotion.Wemustexpectsomesurpriseswhenthedatastartstorollin,butifwedon'thaveatheorythatrecognizestheubiquityandspontaneityofemotion,
wewon'tknowwhattolookfor.Iwillarguethatsubjectivedataisnotonlyadmissiblebutpositivelyindispensableinexploringbrainmindstates.
OnewaytogettothesourceandnatureofemotionsisthroughacarefulstudyofREMsleep.Dreamingshowsusthatemotionisnotjustawayofreactingtolife's
events,butalsoanintegralandusefulpartofourbrainmindstates.Anddreamingisperhapsmoreusefulinitslucidrevelationofemotionasacentralbuildingblockof
consciousnessthanitisforanyotherfaculty.Preciselybecauseitoccurswhenwearenotreactingtotheoutsideworld,dreamemotionprovidesthescientistwitha
powerfulinvestigativetoolforbetterunderstandingitsmechanismsandfunctions.
WhatIsEmotion?
We'reallfamiliarwiththepainfulexperienceoffearthatwehaveinournightmares.Butjustflipaswitchsomewhereinourbrainmindandadreambecomesa
completelydifferentemotionalscenario:
IamwalkingdowntoabeachfrontwhereinashortperiodoftimeIamflying(onmyownaccord)highinthesky,dippingdownto"Nantucket,"whichisclearinmyvisionfrom
above.ThisplaceIcallNantucketisasmallisland.IamfeelingelatedandfreeasItakehighdives,circlingupanddown.AwomanisremindingmetohurrysothatIcancatchthe
ferryback(backtowhere?).IminimizeherconcernasInoticehowaquaandshimmerythewateris

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asIfly.ThisfeelingisonethatIdonotwanttoend.Ifinallygetbacktolandhowever,Idon'trecalllanding.Ireadtheferryschedule,whichindicatesa7:31P.M.departure.My
watchshows7:25P.M.Ihaveawaytowalkanddon'tthinkIcanmakeitontime.Iamwalkingthroughlocalstoresonmyway,onlybecausetheyareinmypath.Igothrougha
Mexicanstorewhichhashomefurnishingsonsaleupto50percentoff.Itakenoteofthemanyrugshungoveroneanother.Ifinallyreachtheferrylandingbutseetheferrytaking
offinthedistance.Iamnotconcerned,eventhoughitisthelastferryoftheevening.

Thisflyingdreamthatwassoenjoyedbymyecstaticinformant,Carol,couldrightlybecalledasensationalhigh.JustasSallywantsdesperatelytogetoffherdream
bus,Carolwantstostayonherdreamflight.SheisasinvulnerableasahawkasshesoarsaboveNantucket.Andinthesamewaythatourunpleasantlyanxious
dreamsprepareusforthreateningsituations,ourecstaticdreamsequipusfortheelationandjoyoflife.Thevisual,motor,andemotionaldomainsareastightlylinked
inCarol'sdreamastheyareinSally's.
Sally'sandCarol'sdreamsaretwofromalargesamplecollectedinanexperimentIdesignedwithmycolleagueJaneMerritttoidentifyandmeasuredreamemotion.
Wefoundthatnegativeandpositiveemotionscanbeequallystrongindreams,butthatnegativeemotionsarefarmorefrequent.Onceeachsubjecthadwrittenouta
dreamreport,weaskedhimorhertoidentifytheemotionspresentineachlineofthereportandtoestimatethestrengthoftheemotionsonascaleofonetothree.
Sallyratedtheemotion"fearanxiety"as3+forthelinesduringwhichCharlesMansonismovingtowardherandforthelineduringwhichsheisbeatingonthedoorof
thebusandscreaming.Likewise,thescoreCarolgaveherselffor"joyelation"was3+forthelineduringwhichshewasdippinganddivingandforthelineduring
whichshewashavingherpsychedelicvisionofthewater.
Indesigningthestudy,wehadtoaddressseveralhotlydebatedquestions,whichIwilltrytoanswerhere.Thefirstis:Whatisemotion?

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Everyoneknowsthatemotioniswhatwefeel.Itisfirstandforemostaselfsignal:acommunicationfromonepartofourbrainmindtoanother.Emotionhelpsus
answerthebanalquestion"Howareyou?"withmorehonestytoourselvesthanisusuallysociallyacceptableinourdiscoursewithothers.Mostofusanswer"Fine"
whenafriendasks"Howareyou?"evenifwewouldreallyrathersay"Downrightdepressed''(ifwearesadorguilty)or"Ontopoftheworld"(ifwearehappyor
elated).
Twootherpowerfulemotionsthatweusuallydonotacknowledgeopenlyareanxietyandanger.Itisnotoftenthatafriendwillreplytoyour"Howareyou?"with
"Intolerablyanxious,thankyou."Anxietyissuchaconstantaspectofwakingconsciousnessthatweusuallysay"Fine"ifouranxietylevelisanythinglessthan
overwhelmingpanic.Wedon'tliketocommunicateanger,either,becausewedon'twanttooffendasolicitousfriendandbecauseweareloathtoadmitthatweharbor
suchpotentiallyhurtfulfeelings.Wealsooftenprefertoconcealevenstronglypositivefeelingslikeaffectionandsexualattraction.Mostpeoplearen'tpreparedfora
responselike"Extremelycuddly"or"Hornyasagoat"whentheyaskcasually,"Howareyou?"
Sometimes,however,wecannotconcealourfeelings,nomatterhowhardwetry.Evenwhenwefailtogetthemessagesourselves,otherpeoplecanoftenpickthem
up."What'sbuggingyoutoday?"afriendwillaskyou."Oh,nothing,"youreply,thinkingtoyourself,"Itisthatobvious?"
Thusweseethatemotionisnotonlyasignaltoourselves.Itisabehaviorallycodedmessagetoothersaboutourbrainmindstates.Emotionscommunicateour
availability,ourapproachability,andouraffabilityinalanguagethatisoftenmoreclearanddirectthanourwords.Inintimaterelationshipsthereisnoplacetohide
fromemotion.Emotionisthestuffthatintimaterelationshipsaremadeof.
Seenthisway,emotionisaveryimportantaspectofourbrainmindstate.Itdeterminesoursociallyandbiologicallycriticalconjunctionsanddisjunctions.Our
spectrumofemotionsthestrengthofthesignalsweemitinthevariouskeysofourfeelingsisnothinglessthanwhatwecallpersonality.Ifwewanttounder

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standanythingimportantaboutourselves,wesimplymusttakeouremotionsseriously.
Howmanydifferentemotionsarethere?Mostscholarsusuallycomeupwithalistofsixtotwelve.Whenweaskedthepeopleinourdreamemotionstudytoidentify
emotions,wehadthemchoosefromalistofseven:anger,anxietyfear,shameguilt,sadness,joyelation,affectioneros,andsurprise.
Anyemotioninventoryisliabletobeincomplete.Forexample,weleft"disgust"offourlistbecausethereisdisagreementoverwhetheritisindeedanemotion.Disgust
iseasilyidentifiablebysomeone'sfacialexpression,oneofthekeysignalsofouremotionalstate.Butothersarguethatdisgustisareflexresponsethatrequiresa
specificstimuluslikeabadsmell.Andatthehigherlevelof,forexample,displeasurewithbadfactionsofsociety,disgustappearstorequiremoreconsciencethan
mostofuscaneasilymusterinourdreams.
Wedidinclude"surprise,"whichisalsoadebatedcategory.TomesurprisehasmoretodowiththeorientingresponsethanwithemotionIseeitasarecognitionof
thenoveltyof,orinconsistencyin,theflowofdatawe'rereceiving,ratherthananevaluationofthedata.Onceweevaluateasurprise,ouremotionalreactiontoitfalls
intooneoftheothercategories,say,offearorjoy.
WhereDoEmotionsComeFrom?
Facialexpressions,bodylanguage,andmoredramaticactionssuchasthepoundingheartandsweatypalmsofanxietyclearlyindicatethatemotionalstatesare
conveyedtoandthroughthebody.Butarethesebodilychangesnecessaryforustofeelouremotions?Ifso,doesemotionactuallyresideinourbodies?Or
doesithaveacentralaspectthatisindependentofourbodies?
WilliamJames,theAmericanphilosopherwhotriedinthe1890stoformulateanintegratedtheoryofthebrainandmind,thoughtthatmanyofthebodilyeventsthat
weremediatedbyourautonomicnervoussystemwerereadbyourbrainmindasemotion.Theautonomicnervoussystemcontrolsourheart,bloodvessels,stomach,
andotherorgans(butnotourmuscles).Whileitis

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certainlytruethatstomachcontractionsandrapidheartbeatoftensignalanxiety,itnowseemsclearthatthesebodilysensationsareneithernecessarynorsufficientfor
ustofeelanxious.Thinkforamomentaboutyourmostterrifyingdreamsandaskyourselfif,inthegripofanightmare,youareawareofyourheart,stomach,orany
othervisceralorgan.Iamnot.
Ofcourse,apolygraphicrecordingofSally'sCharlesMansondreammighthaveshownanincreasedheartrate,ariseinbloodpressure,andrespiratoryirregularity.
ButSallydidn'tfeeltheseperipheralexpressionsofheremotionbecauseallbodilysensationsareactivelyblockedduringREMsleep.Shemightalsohavehadexactly
thesamebodilychangesduringquiteadifferentdream.
Whenwedream,thebrainstemsendstwoparallelmessagestothespinalcord:onesaysnooutput(youcan'tmove),andtheothersaysnoinput(youcan'tfeel).
Furtherevidencethatdreamemotiondoesnotdependonthebodycomesfromdreamreports.Inthesereportsthereisalwaysadramaticandtotalabsenceof
descriptionsofthebodilysensationsofemotion.InherdescriptionofherterrorduringtheMansondream,Sallydoesnotsaythatshewassuddenlyawareofbreathing
rapidly,feelingpalpitations,orsweatingasMansonedgednearerandnearer.Whynot?Becauseshedidn'tsensethosesignals.Shefeltterror,asanemotion,inside
herownbrainmind,andwascompletelyunawareofherbody.
PhysiologyfinallydidinJames'stheoryofemotion.CharlesSherrington,thechampionofthereflexdoctrine,andWalterCannonbothshowedthatanimalswerefully
capableofemotionalbehaviorafterthenervestoandfromthebodywerecut.Emotionscouldbetriggeredsimplybystimulatingthebrain.
OnceCannonhadsatisfiedhimselfandthescientificworldthatsignalsfromthebodywerenotnecessaryforspontaneousemotion,heandPhilipBardsetoutto
localizethecentralsiteofemotioninthebrain.Theyshowedtheycouldinduceemotionslikefearandrageinanimalsbystimulatingeitherthehypothalamusorthe
amygdala.Andwhentheamygdalawasremoved,theanimalswererenderedtame,placid,andevendocile.
Wehavesincecometothesameconclusionusingmoremodernresearchthattheamygdalaisanimportantbraincenterofemo

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tion.Notonlythat,theneuronsoftheamygdalabeatconstantly:thusweproduceemotionsinallstates,nomatterhownormalorbizarre.
Geneticsprobablysetsanindividualrangeofemotionswithinus,justasitsetstherangeofourpulsesandbloodpressures.Wearetheparticularpeoplethatwearein
largepartbecauseofthewayourbrain'semotionregistersareset.Wecantunethisregistertoadegreeaswematurefromchildhood,buttheemotionalmusicthatis
playedoutofusaspersonalityisasdistinctiveasourfingerprints.Whenthevolumeislow,wearetheonlyoneswhohearthismusic.Butturnthevolumeupandthe
wholeworldknowswhatstatewearein.Theamygdalaisalsolikeaplayerpianointhatitrunsthroughitsownscoreseveryday.Dreamingisanemotionalrecital:all
stopsareoutandthekeysarehammeringaway.
Itissadthatsolittlescientificworkonemotionisbeingdonetoday.ThislamentiswellsungbyJosephLeDouxatCornellMedicalSchool,oneofthefewbrave
scientistswhohasstayedwiththiscriticalscientificproblem.LeDouxpointsoutthattherecentgrowthofcognitivescience,whilerestoringconsciousnesstoitsrightful
placewithinpsychology,hastendedtoexplainawayemotionasamerelycognitiveprocess.
Whileitiscertainlytruethatemotionandcognitionareintegrated,theyarenotoneandthesame.SallyfeelsCharlesMansoncomingclosetoherbeforesheseeshim.
Inherdream,itseemspossiblethatthecognitiveperceptionstheimagesofMansonsheseeswhenshedoeslookbackmayhavebeengeneratedbyherbrain
toaccountforhermountingsenseofdread.Onceagain,thebrainisconcoctingastorytolinktherandomfiringofthebrain'sneurons,inthiscasenottomakesenseof
images,buttocreateimagestomakesenseofemotions.EvidencethatemotionandcognitionarenotonewasalsoapparentduringmyawakeningattheColumbus
hotel,whenmymisperceptionoftheclinkingsoundoutsidemybedroomcausedanxiety,whichinturncausedmetohaveevenmoreradicalmisperceptions.
Thestudyofdreamemotionhasalreadyallowedustoconcludethatthebrainisanemitteroffeelings.Whetherwearescientificrationaliststryingtotuneoutemotion
inordertofreeourcogni

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tionfromthebiasofsentiment,orromanticartiststryingtotuneupouremotionstodrownoutthenaggingvoiceofrationality,thefundamentalrealityofemotionisthe
same.Emotionisnotjustareactiontotheworld,itisaspontaneousandconstantlypresentcomponentofoursubjectiveexperience,andofourselves,thatotherspick
up,read,anddescribeasourpersonalities.Thebodyconveysemotionasitamplifiesandchannelsthesignalsofouremotionalstates,butemotionisanintegraland
independentaspectofallactivatedbrainmindstates.Bylookingmorecloselyatdreamemotionwecanexpecttogreatlyadvanceourunderstandingofthisbasic
aspectofhumannature.
FearMoreThanJoy
Whatisthenatureofourspontaneousemotionspectrumasitisrevealedindreaming?Itwillcomeasnosurprisetomostdreamersthatanxietyistheleadingbatterin
thelineupofdreamemotions.Thesubjectsofourdreamemotionexperimentproduced200dreamreports,andafterwehadaskedthemtoidentifythetypesof
emotionstheyfelt,ifany,lineforlineinthereports,wecomputedtheaverageincidenceofthevariousemotionsindicated.Anxietyhadthehighestbattingaverage
of.321ofthe809incidencesofemotionindicatedinthereports,260ofthemwerenotationsofanxietyorfear.Joyelationwassolidlyinsecondplacewithan
averageof.255.Thismeansthatwelloverhalfofalldreamemotions(57percent)areextremeouremotionalstatetendstotiltonewayortheothersothatdreams
areeitherpleasantorunpleasant.
Thistiltismuchmorefrequentlytowardtheunpleasant,however,becauseangerisstronglyinthirdplaceonthelist.Whenaddingupalltheincidencesofemotion,the
totalproportionofunpleasantemotionscomesto68.1percentalittlemorethantwothirds.Whenafriendwishesus"pleasantdreams,"weshouldbeawarethat
wehave,onaverage,onlyaoneinthreechanceofhavingone.SurelythisfindingnegatesFreud'sideathatdreamsareafulfillmentofwishes.
Theweakesthitteronthedreamteamisaffectioneros,whose

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averagewasalowly.064.AbatterwiththiskindofperformancerisksbeingtradedtothePonyLeague!Andtakentogether,thepositiveemotionsjoy,elation,
affection,anderoscompriseonly31.9percentoftheentirespectrum.
Wewerenotthefirstdreamscientiststocomeupwiththisimportantinformation.Threepreviousstudieshadshownthesamegeneralprofile.Whatwasnewly
revealingaboutourstudy,however,wasthequantityofemotions.Byaskingsubjectstoscoretheirownreports,weobtainedanincidenceofemotionthatwasten
timeshigherthanthatreportedinpreviousstudies.Thatisbecausewhenpeoplearesimplyaskedtogivedreamreports,theyspendaninordinateamountoftime
describingtheplotandthevisions,nottheemotions.Butwhenyouaskthemtogobackandponderwhattheywerefeelingastheyexperiencedthoseevents,then
theynotetheiremotionsinmuchmoredetail.Clearly,ourbrainmindisemittingsomeemotionalmostallthetimeinthisstate.
Theincreaseinthesensitivityofourdreamemotionmeasuringtechnique,whileencouraging,givesuspausebecausewedon'treallyhaveanydirectwayofknowing
howmuchemotioniswithusinthedreamstate,orinthewakingstateforthatmatter.Howmuchofwhatkindofemotionareyoufeelingrightnow?Wesimplydonot
yethaveenoughvaliddataabouthowouremotionsareactuallyperceivedinanyofourconsciousstates.Morecarefulexaminationoftheissueisneeded.
Wealsoneedmorepreciseandobjectivemeasures.Atpresent,wehavenoideahowtheamygdalaoritsrelatedtemporallobestructuresmediatethedifferent
emotions.LeDoux'sanimalworksuggeststhatfearismediatedbythenucleusoftheamygdala,butneitherhenoranyoneelsehaslookedatanyoftheotheremotions
withthepowerfulanatomicalandphysiologicaltechniquesthatarenowavailable.Andemotionmaybeonefundamentalfacultythatistootoughtosolveusingonly
animalmodels.
Nowthatwehavethenewimagingmethodsformappingbrainactivationinhumanswecanbeginthiswork.Theimagingmachinesorscannersarefamiliartomostof
uswhohavehadcomputerizedXraypicturestakenfordiagnosticpurposes.SupposethatSallyhadherCharlesMansonnightmare,orthatCarolhadher

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Nantucketflyingdream,whilesleepingwithherheadinabrainimagingmachine.It'salmostaseasytofallasleepinsometypesofbrainscannerasitistonodoffin
oneofthosemetalbeehivesatthehairdresser's.Suppose,forthatmatter,thatwecouldcaptureandcompareBertal'sfearandflightfromthedivebomberswithmy
fearandflightfrommywoodshedhelper.Myquestionisthis:WouldtheemotionalbrainactivityassociatedwiththedreamsofSallyandCarol(whichhadopposite
butextremeemotions),orthestatesofBertalandme(whichhadthesameemotionsbutindifferentstates),besimilarordifferent?Andcouldscannerssensea
differenceiftherewasone?Wewillsoonknow.Indeed,acolleagueofmineatHarvardhashimselfsleptinabrainscanner,andtheemotioncenterinhisbrain,his
amygdala,litupthenightduringREMsleep.Nowwemustfindwaystousethisandotherpowerfulnewtoolsanalytically.
AhMen!AhWomen!
Ioccasionallyappearasaguestontalkshows,andcallersfrequentlyask:"Arethedreamsofmendifferentfromthoseofwomen?"Theywouldlikemetocomeup
withsomethingthatwillfittheirwidelyheldstereotypesaboutgenderdifference:Weallknowthatwomenaremoreemotionalthanmen,don'twe?Andbeing
maternal,theyexpressaffectionmorefreely,don'tthey?Theyarealessangrylotthanhypercompetitivemales,right?
Wrong!Whenitcomestodreamemotion,theanswerstoallthesequestionsisno.Wefoundnosignificantdifferencebetweenmenandwomenonanymeasureof
dreamemotion.Theactualfiguresformenversuswomenweresosimilartheyarenotworthlisting.
Howdoweexplainthis?Theanswermaybethat,deepdown,we'renotallthatdifferentemotionally.IbelievethatDarwin'sconclusionthatouremotionalrepertoire
istheresultofouradaptivecapabilityshouldbetakenveryseriously.Thefullspectrumofemotionislikelytobesharedbyallmembersofaspeciesregardlessoftheir
sex.
Itisalsoclearthatmenandwomenhaveexactlythesamerange

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ofbrainmindstates,withtheexceptionofminorfluctuationsinassociationwiththemenstrualcycleandmajordisruptionsofsleepduringpregnancy.Nogender
differenceshavebeenreportedinthestudyofanymajorsleepwakevariable.ThisimpliesthattheREMsleepactivationmechanism,downtoitscellsandchemical
messages,isidenticalinbothsexes.Turnitonandoutcomethesameemotionsformenandwomen,inthesamerelativeproportions.
Willwehavethesamesurprisewhenmorescientistsbegintolookatemotionsinthewakingstate?Itseemslikelytome.Thatdoesn'tmeanthatbiologyhasnothingto
dowithsexroledifferentiation.Menarebiggerandstronger(onaverage)andwomenbearthechildren(wellabovetheaverage),soweneedtobecautiousabout
pushingtheconceptofgendersamenesstoofar.Nonetheless,itdoesappearthattheREMsleepstaterevealsaninternalsoundingboardwhoseemotionalnotes,
whenstruckbytheamygdalaintheplayerpianomode,makesstrikinglysimilarmusicinbothsexes.
Onestrongpartofthedreamemotionmessageisthatfeelingsareimportantcomponentsoftheactivatedbrainmindstatesofallpeople.Asecondisthatthespectrum
ofemotionisstronglyshiftedtothenegativesideandthisskewissharedbymenandwomen.Thepowerofpositivethinkingthushasalottocompetewith!Whyare
wesetupthisway?Whatarethebenefitsofexperiencinglifewithsuchworryandviolentfeelings?
WhatAreEmotionsGoodFor?
IfCharlesDarwinwerenotsowellknownastheauthorofOriginofSpecies,hisbookentitledTheExpressionofEmotionsinManandAnimalswouldprobably
bemuchmorewidelyrecognizedandappreciated.Darwinclearlyrecognizedthatemotionsareimportantsignalsthataccuratelycommunicatethebrainmindstateof
oneanimaltoanother.Whenconfrontedwithastranger,thefirstresponseisaninternalalertingthatsays,"Orient:stop,lookandlisten!"Thisisfollowedwithstrong
bodysignalsmadesothatanyintrudercanreadthem:hairsrise,earsgoup,eyes

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widen,andmovementisfrozen.Theintruderisputonnoticethathehasbeenidentifiedandisbeingcriticallyevaluated:Areyoufriendorfoe?
Thesebodilychangesarenotonlypreparationforfurtherevaluationofthreat(thesensoryaspectofemotion),buttheysimultaneouslyprepareusforanactivemotor
response.Themostconservativeresponseisflightescapewhichisservedbyincreasingbloodflowtothemuscles.Heartactionincreases,bloodpressurerises,
andrespiratoryrategoesup.Ifescapeisimpossibleandashowdownbecomesinevitable,thesamephysiologyservesthepreparationforafight.
ThisinitialreactioniswhatWalterCannonlatercalledthefightorflightresponse,andheshowedthatitsphysiologywasmediatedbythesympatheticnervoussystem,
thesubsetoftheautonomicnervoussystemthatcontrolstheheart,bloodvessels,andlungs.Wenowknowthatthissympatheticactivationincludesstrongsignals
carriedbytheaminergicsystemofthebrainstem,whichpreparethebrainmindforactionbyheighteningallthefunctionsnormallyassociatedwithwaking.
Norepinephrineandserotoninarethebellsofthebrain'sowninternalalarmsystem.
Aswebecomealertwecanprocessdatafasterandevaluateitmorecriticallybecauseourbrainmindsaremorehighlyactivated.Atthesametime,webecomemore
preciselyoriented.Notonlyarewebetteratanalysis,wearefarmorelikelytorememberthreateningencountersandalltheirassociatedparametersforfuture
reference.Thisisbecausewearenotonlysensitizedfortheshortterm,butinstructedforthelongterm.
Ourcapacitytodothisisbuiltin.Thatispreciselywhatwemeanbythewordinstinctual.Accordingtothebrainmindparadigm,anxiety,coupledwitharousal,isan
instinctualemotionalcapacitythatoperatesatsomefinitelevelallthetime.Anxietyistheleadingemotionbecauseitisthemostimportantemotionthereisnoway
thatanxietycanberegardedassecondaryorasderivedfromsexualandaggressiveinstincts,asFreudassumed.Anxietyishealthy,anditisanindispensabletoolof
oursurvival.
Whethertofleeortofightisadecisionthatfollows,perhapsautomatically.Anditisonethatourdreamshelpusrehearse.

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WhenCharlesMansonedgednearerandnearertoSally,shefrozeandpreparedtoflee,becauseshewastrappedandknewshecouldn'twinthefight.Ireactedinthe
samewaywhenIwascorneredbythejunkies,forthesamereasons.
Sally'snightmareendedasshepounded,screaming,onthebusdoor.ShemighthavepummeledMansonifherdreamstatehadnotbeeninterruptedbythemassive
arousalthatactivatedhercortexandwokeherup.Iwonderhowmanytimesmyownbrainmindhadbeenpreparingmewithnightmaresformyrealshowdowninthe
street.Inevertookboxinglessons,Inevertookjudo,butIknew,procedurally,howtofightwhenitbecameclearthatmylifedependedonit.
Fortunately,suchshowdownscanusuallybeavoided.Butwhentheybecomeinevitable,itisimportanttoknowwhattodototrytomitigatethem.AsDarwin
recognized,twothingsservetoreducetheoccurrenceofdamaginginteraction.Oneisthesignalingoffearandappeasementorsubmissionbyeitherpartythe
reciprocalisthesignalingofreadinesstofight,perhapsaccompaniedbyanadvisoryindicatingthetermsofapeacefulsettlement.
Wewouldallratherbecozy,warm,andsexuallygratifiedthanscaredstifforfightingmad.Andweknowhowtodothesethingstoo.Wejusthavetobecarefulabout
whomwedothemwith,andwhereandwhenwhichnarrowsthelistofprospectsconsiderably.Itseemsourbrainmindstatesaredesignedconservativelyinthis
crucialemotionalarea.Weapproachoneanotherwithacircumspectionandcautionthatisbornofourexistentialfearandanxiety,andbredinthebristlesofouranger
andaggression.Narrowisthegate.Maybeit'sbecauseitissoverysweet,sohardtoget,andsoveryhardtoholdontothatwekeepaffectionanderosinsuchhigh
esteem.
RehearsingOurLives
TheDarwinianrevolutioninbiologyhasbranchedintotwomainpathways.One,thebettertraveled,iscalledmoleculargenetics.Thispathwayisjustconvergingwith
brainmindtheory,intheideathatREMsleepprovidesatime,aplace,andtheappropriate

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chemistrytocombineourgeneticinstructionswithourexperientialdata.Theother,calledethology,looksatbehaviorintermsofthegoalsofsurvivalandprocreation.
Ethologyassumesthatmanybehaviors,suchasmatingrituals,nestbuilding,andterritorialdefense,haveageneticallybuiltinactionprogram.Whenactivatedbythe
appropriatestimulus,suchasanattractivefemale,ababy'scry,oracompetitivemale,theactionprogramthensetstheappropriatebehaviorsinmotion.Innate
behaviorshaveseveraldefiningproperties:theyoccurwithouttrainingtheyaremorelikelytooccuriftheintervalbetweenthelastoccurrencehasbeenlongandthey
haveanallornonequalityoncetheyhavecommencedtheytendtoruntocompletion.
Feedinganddrinkingareeasilyunderstoodexamples.Theybothhavehighsurvivalvalue.Theydon'thavetobelearned.Theyseemnevertobeforgotten,eveninthe
depthofdementia.Thelongerithasbeensincethelastconsumption,themorelikelytheyaretooccur.Feedinganddrinkingarealsostatedependent.Theyfrequently
occurtogetherinwakingbutaremarkedlyunderrepresentedindreaming.
Feedinganddrinkingandsleepanddreamingcouldthusbeviewedastwomutuallyexclusivesurvivalstrategies.Insteadofinvestingenergyinseekingwaterand
food,theorganismsleepstoconservebothwaterandcaloriesbyreducingactivityandexposure.Andconsiderthis:hungerandthirstarebothregulatedbythe
hypothalamus,theverysamepartofthebrainthattellsuswhentosleepandwhentowake.PerhapsthisiswhytheFrenchsay''Quidort,dine,"meaning,"Whenwe
sleep,weeat!"
Ethologistsnowtheorizethatthebrainstemistheseatoftheprogramsformanyofthesefixedacts.Wehavealreadyencounteredthisideainourconsiderationof
motorpatterngenerators.Weconcludethatsleepisitselfaninstinct.Anditcontainswithinittheoperationofthecentralprogramforthreeotherinstincts,namely:the
anxietyandorientingresponsesthatservesurvivalbyalertingustodangertheangerandaggressionthatreadyustorepelattackersandtofightforourlivesif
necessaryandthesexualarousalthatpromotesaffection,affiliations,andtheconsummationofdesirethatisessentialtoourfutureasaspecies.

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Ethologistswillhavenodifficultyinappreciatingthefunctionalimportanceofourdailyroundofbrainmindstates.REMsleepisappetitive:ifwearepreventedfrom
sleeping,weexperienceanincreaseddrivetosleepanylossesincurredarepromptlyandpreciselyrepaid.REMsleepisfixed:theautomaticactivationofthebrain
mindinREMsleepguaranteestherunningofinstinctprogramssothattheywillalwaysbepracticedandthusavailablewhenneeded.Furthermore,REMsleepallows
theseprogramstobeupdatedwithnewexperientialdata.Thisiswhydreamingsoclearlyreflectsthewhere,when,andwithwhomaspectsofourinstinctivelydriven
emotionalinteractions.
Emotioncomplementsourmemorybygivingitavalence:howwereallyfeelaboutthispersonorthat,thisexperienceorthat,thisplaceorthat.Emotionisawaynot
onlyofperceiving,butalsooforientingtotheworld.Itisawayofbeingstronglytiedtopurposessodarkanddeepthatwereitnotfortheirgloriousunveilinginour
dreamswemightgothroughlifepretendingtheywerenotthere.Indreamingthereisnoplacetohidefromourinstinctualselvesandfromourbiologicaldestinies.

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Chapter10
Stop,Look,andListen:AttentionandDistraction
MyfriendKajiAsisamanofmanytalents.BesidesbeingamasterofclassicalJapanesebrushpainting,hesingsItalianoperawithglassshatteringforceandheart
warmingbrio.Asifthisweren'tenough,heisalsoabletoentertainthechildineachofuswithhisparlormagic.EachtrickinKaji'srepertoiredependsonsleightof
handhepullsfromhisrightearthePingPongballthathehasjustputinhismouth,andmakesawhitenapkinmousejumpfromhispalmtohiselbow.Kajiisableto
performthesemagicactsbypurposefullymisdirectingtheviewer'sattentionandimplantingerroneousexpectationsintheviewer'sbrainmind.
NomatterhowmanytimesKajirepeatshistricks,theyfoolus.Tosaythat"thehandisquickerthantheeye"missesthepoint,however.Kaji'shandsdon'tmovethat
fast.Andtheyarealwaysoralmostalwaysinfullview.Kaji'smanualspeedisnottheessenceofhisdeception.Itistheprovisionoffalsecuesaboutwhatto
expectnextthatcatchesourattentionandcommitsustoanexpectationthatthemagiciancansneakbehind.WhenP.T.Barnumsaid,"There'sasuckerbornevery
minute,"hewasnotingthatourattentionalsystemisreadytobefooledbymisleadingcuesateveryminuteofourlives.

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Oneofthesurestwaysofknowingthatyouhavefreewillistonoticeyourabilitytoselectwhatyoupayattentionto,toselecttheinformationthatoccupiesyourmind.
Thisabilitytoselectivelyattend,however,iscomplicatedbythenoiseandturmoiloftheworldaroundusandbythesurgeofemotionsandthoughtsthatarise
continuouslyfromwithinus.Ourabilitytoattendortobedistracteddependsasmuchontheseinternalforcesasitdoesonoutsidestimuli.Thedecisiontofocus,to
concentrate,andtoselectanddirectourthoughtsrequiresanalmostherculeaneffort.Imaintainthatitistheveryessenceofwillpowertothinkalongcertainlinesand
toabandonothers.Allthatismostgloriouslyhumanisdependentuponourcapacitytodirectourconsciousness.Itisessentialtoart,science,learning,andthemoral
fabricofourlives.
Thiswillisnotalwayseasytoenact,however.IrelearnthiseveryautumnatmyfarminVermont.Whentheweathersuddenlychangesfromsultrytobrisk,thelocal
fliesmakeanaggressiveefforttoenterthewarmhouseandfeedonanypartofmyanatomythatisexposed.Justtheotherday,whileIwasputtingthefinishing
touchesonanoilpainting,theperniciouslittlemonstersbegantoattackmyankles.Theydestroyedmyeyehandcoordinationbysendingdistractingsignalstomy
brain.WhichshouldIattendto,thepaintbrushortheflies?NowayIcoulddealwithboth,andnowayIcoulddenytheexistenceofthedistraction.Perhapsa
practicedBuddhistmeditatorcouldhavemaintainedfocus,butnotI.MyWesternbrainisbestwhenitisattendingtoonechannelofdataatatime.Ihadtoputdown
thebrushandwhiskthemaway.Icouldn'tstandit.
Sohowdowenegotiatethetugofwarbetweenattentionanddistraction?Howdoweselectthesignalswewanttofocusonandexcludethedistracters?Whydowe
sometimesbecomeobsessedwithathoughtordeed,andhowdowelaterbreakfreefromit?Whyarewesofocusedinthemorning,butcontinuallymoreeasily
distractedasthedaywearson?Andhowisitthatwecanprocessinformationfromourenvironmentintheforegroundofourminds,whilealsoprocessingthe
memories,plans,andreferencesthat

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comprisethenecessarycontextinthebackground?LetususesomeofthebrainchemistryandtheAIMmodelpresentedinPartOnetoexplainourabilitytoattendor
tobedistractedandhowthisabilityvariesindifferentstates.
FocusingOutwardorInward
Weallknowhowfragileourabilitytopayattentioncanbe.Whenwehavelostevenalittlesleep,attentionisthefacultythatflagsfirst:wehavetroublestayingwith
ourtaskswearedistractedbyinsignificantstimuliandourmindswanderfromtopictotopicandfromfantasytoreality.Weloseourabilitytostayontrack,to
maintainourdirectiontowardagoal,andeventofeelcalm.
Inordertopayattention,wemustkeepaconstantfixonthebandwidthofdataweareprocessingandonitsexternalorinternalsource.Payingattentionnotonly
requiresstrongwill,butcommitsourbrainmind'sresourcestoarestrictedsetoftargets.Payingattentiontoonethingmeansnecessarilyignoringmanyothers.Itdrains
mentalenergyandentailsanexperientialsacrifice.
Theflipsideisthatattentioncanbecomeinvoluntarilylockedontoitstarget.Webecomeobsessedratherthandistracted,andourbehavioriscompulsiveratherthan
aimless.Uponleavingourhouseforatrip,theideathatwehaveleftourticketsbehindissostrongthatwehavetocheckagainandagainthatwehavethem.Ifweare
lucky,somepartofusnoticesthatweareoverlyconcernedandfreesusfromafruitlessreaffirmationoftheobvious.
Attention,then,mustremaincenteredindynamictensionbetweendistractionandobsessionifourbehavioristostayonamoderatecourse.
Thesensorydatathatcompeteforourattentionaremyriad,andourselectiontaskis,ateveryinstant,formidable.Wehaveeightmodalitiestochoosefrom:thefive
sensesvision,hearing,touch,taste,smellandthreedatachannelsthatcomefromwithinourbodiesposture,movement,andpain.That'sthebadnews.The
goodnewsisthatwecandoit.Firstweprioritizethemillionsofbitsofdatathatknockonthedoorsofourconscious

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nessfromdawnuntildusk,andthenwedecidewhattomakeofthebitsthatareadmitted.
Tobetterenjoyakisswecloseouteyes.Indoingso,weexcludethenormallyhugedemandthatvisionputsonourprocessingcapabilityanddevotemoreofour
resourcestothesubtle,tactileexperienceofkissing.Oncetheactisunderway,sensualpleasuremay,forsome,beenhancedbyreopeningtheeyesandadmitting
visionsthatenhancearousal.Thefirstprocessisoneoffinetuningtheinput,likezeroinginonaradiostationonyourstereo.Thesecondisoneofenhancingintensity,
likeaddingasecondpairofspeakerstoincreasethevolumeanddepthofthemusic.
Increasingpleasureanddecreasingpainareamongtheimmediatebenefitsofsensorychannelselection.IusedtodreadgoingtothedentistuntilIdiscoveredjusthow
wellIcouldtrainmyselftoselectthecontentsofconsciousness.NowIanticipatemytimeinthaterstwhiletorturechamberbyloadingupmyneuronalnetworkswith
alternativeinputs.Whenthedrillingstarts,Ineverclosemyeyesortensemymuscles,bothofwhicharesuretomakethepainandanxietyworse.InsteadIgazeupat
theskythroughthewindowandimaginethesunlitsceneonCrane'sBeachinIpswichorvisualizethefallpaintedwoodsbehindmyplaceinVermont.
Noticethatinthisactofdentaldissociation,Ihavedonemorethanjustselectthedatachannel.Ihaveswitchedinputsourcesfromexternaltointernal.AndIhave
shiftedawayfromtheforegroundofexternalsensorydataprocessingandtowardthebackgroundofinternalmentalactivitythatwecallfantasy.Iamwellonmyway
tothebrainmindstatecommonlyknownashypnosis,asubjecttowhichwewillreturninPartThree.
Thereisstillanotherkindofattentionalfreedomtoconsider.Icanchangethemodeandstrengthoftheinternalrepresentationsthatoccupymyconsciousness.The
qualityandintensityofthementalactivitythatwecallfantasycanvaryfromexclusivelyverbal,throughpartiallyvisual,tointenselyhallucinatory.Thedegreetowhich
myconsciousnessattendstodatafromtheoutsideworldorfrommyownthoughtsiswidelyvariable.

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Bychangingfocusfromexternaltointernal,wearemovingtowardthedomainofdreamingandpsychosis.Attention,likeallotherfacultiesofthebrainmind,isstate
dependent.Onekeyvariableisvolition.IcanvoluntarilyshiftattentiononlywhenIamawake.Insleepmyattentionisrivetedtointernallygenerateddata.Sincewe
nowknowthatthestateshiftfromwakingtosleepingisachievedbythebrainstem,wemightbetterunderstandattentionitselfbyexploringthosebottomupprocesses
thatshiftit.Becauseattentionhasastronglyvoluntaryaspect,wemightalsolearnhowtogainsometopdowncontroloverthebottomupprocessesthatgovernour
brainmindstates.Thepayoffwouldthencomefromfindingnaturalandscientificallyvalidwaystomanageourconsciousnessviatheselectiveactionofattention.Self
hypnosis,paincontrol,andtheplainoldpowerofpositivethinkingareamongtheprizesthatweseek.
MeasuringAttention
Thebehavioralsignsofattentionareeasilymeasured,andthedataconstitutesaleadingedgeoftherenaissanceincognitivescience.Onescientistwhohasbeen
particularlysuccessfulinanalyzingattentionisMichaelPosneroftheUniversityofOregon.
Inoneofhisschemes,Posnerusescarefulmeasurementsofreactiontimetoreconstructthesequenceofbrainmindeventsthatunderlieourattentivebehavior.A
personisaskedtofixhisgazeonaspotoflightinthecenterofacomputerscreen.(Electrodesplacedjustabovetheeyelidsdeterminecompliancewiththis
restriction.)Whilethesubject'sgazeisfixed,Posnerwillflashadotoflighttotherightorleftsideofthescreen.Thesubjectistoindicatehisrecognitionofthedot's
appearanceasquicklyaspossiblebypressingtheappropriatekeyonthecomputerkeyboard.Thecomputerthencalculatesthetimeelapsedbetweentheactivationof
thetargetonthescreenandthesubject'smanualresponse.
ImaginehowyouwouldfeelifyouwereseatedatPosner'scomputer.Nomatterhowlaidbackyoubelieveyourselftobe,somethinginyouwantstodothistaskwell.
Youwanttobequick.And

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youmayevenwanttofigureoutawaytobeatthesystem.Youarequitealert(andevenabitanxious)asyouawaitthedot.
Towhetyourappetite,Posnerwillsometimesprovideyouwithacueastowhichsideofthescreenthenextsignalwillappear.Othertimesthecuewillnotcontaina
directionalhint.Buttopreventyoufromjumpingthegun,theintervalsbetweentrialsareunpredictablyvaried.Butthat'snotall.Thetestisevenmorediabolicalinthat
only80percentofthedirectionalcuesPosnergivesyouwillbeaccurate20percentwillbemisleading.Whenthearrowpointstotheright,thetargetwillactually
appearontheleft,orviceversa.Finally,thesequenceofcuesvalid,invalid,ormissingwillberandomized.
Asyoucanimagine,yourreactiontimewillbefasterwhenyouaregivenavalidcuetothetarget'slocationthanwhenyouaregivenaneutralcue.Andofcourse,itwill
takeyoulongerstilltorecognizeatargetwhenitappearsintheunexpectedhalfofyourvisualspace,becauseyouwillwastetimesearchinginthewronghalfofthe
screenbeforeyouswitchovertotherighthalf.Thusthereactiontimeforacorrectlyguidedsearchisfasterthanthatforarandomsearch,whichisfasterthanthatfor
anincorrectlyguidedsearch.Asotherlifeendeavorshavetaughtus,awronghypothesisismorecostlythananopenmind.
Thedifferenceinresponsetimeunderthethreecueconditionsisconsiderable.Ifyouaregivenacorrectcue,yourreactiontimewillonaveragebe85milliseconds
fasterthanifyouaregivennocue.Thisdifferenceisreferredtoasthe"benefit"ofcorrectlyanticipatedattention.Ifyouaremisledbyaninvalidcue,yourreactiontime
willbe36millisecondsslowerthanifgivennocue.Thatisthe"cost"ofincorrectlyanticipatedattention.Therangeistherefore85+36=121milliseconds,or1.21
tenthsofasecond,whichcouldmeanthedifferencebetweenlifeanddeathifyouweredrivingacar.Ofcourse,therangewouldbemuchwiderifyouhadenjoyeda
twomartinilunchorifyouweresleepy.
Althoughthebasicreactiontimeexperimentisoldhatinpsychology,itgainsenhancedpowerwhenusedwithnewtechnology.ImagingtechniquesliketheCATscans
nowroutinelyusedinhospitals,andPETandMRIscansnowusedinresearch,aredramati

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callyrevolutionizingcognitivesciencebyshowingusinrealtimewhatishappeninginthebrain.Wearenowabletovisualizetheactivityofourbrainmindsasweseea
dogorsearchforrandomdotsonavideoscreen.ItisthistechnologythatpermitscognitivescientistslikePosnertotesttheirinferencesaboutthesequencesofbrain
activitythatunderlieattention.
Byplacingasubject'sheadinapositronemissiontomography(PET)scannerandinjectingaradioisotopeintothebloodstream,itispossibletoobtainpicturesofthe
brainmindatwork.Neuronsthatareactiveconsumemorebloodsugarandoxygenthanthosethatareinactive.Thegreatertheactivity,thegreatertheconsumption.
Thustheradioisotopescarriedbythebloodcongregateinareasofhighactivity.Theprotonsemittedbytheisotopesfromanyregionofthebrain,sensedbythe
scanner,accuratelyreflectthenetactivityoftheneuronsinthatregion.Thecomputerproducesabrightlycoloredpaintbynumberportraitofyourbrainmindasyou
trytobeatthesysteminthereactiontimegame.Theactivatedregionsofthebrain"lightup"onthescannersscreen.
UsingthePETscannerinconjunctionwiththereactiontimetestandothers,ithasbecomeclearthateachaspectofattentioninvolvesaspecificareaofthecortex.
WhenPosnerflashesadotonthescreen,theposterior(rear)regionofthecortex,wherevisionisprocessed,lightsupfirst,followedbythecentralregionofthe
cortex,wherespatialanalysesareformed.Theanterior(forward)regionofthecortex,whereidentificationoccurs,lightsupthird.Oncetheposteriorsystemhas
answeredthequestion"Whereisit?"(leftorright),theanteriorsystemaddressesthequestion"Whatisit?"(adot).
Thesetwoquestionshavelongbeenrecognizedaskeystagesintheprocessingofperceptualdata.Andwehavealreadyconsideredthemindiscussingtheorienting
response(whereisit?)andorientation(whatisit?).Orientationismediatedbythebrainstem,anditshouldcomeasnosurprisethatcognitivescientistshave
determinedthatthebrainstemalsomediatesattention.
Inorderforustoattendtoeitherexternalorinternalinformation,ourbrainmindsmustbesufficientlyactivated.Andinordertoholdanyexternalorinternaltargetin
mind,wemustbeableto

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maintainthatactivation.Aswenotedinchapter5,activation(A),inputsource(I),andmodulation(M)alldependonthebrainstemandtheaminergiccholinergic
system.
Posnerhasdevelopedananatomicalmodelofattention.Init,twoupperbraincomponents(theposteriorandtheanteriorcortex)areresponsiblefororientingtoa
signalandtheorientationneededtolocalizethatsignal,andonelowerbrainvigilancecomponent(thebrainstem)isresponsibleforactivatinganddirectingthetwo
upperbraincomponents.Soundfamiliar?Indeeditdoes,butnowthebrainstemisrunningattentionaroundourimagesoftheoutsideworldastheyarebeing
received,notlaterinadreamsimulationofexternalreality.Ofthethreemodulatory(M)chemicals,itisnorepinephrinethatismostessentialforattention,accordingto
Posner.
Wecantestthisconclusionwithselfobservation.Norepinephrinelevelsfallwheneverwebecomesleepy(orevenbored)inthesestateswehavedifficultyfocusing
ourattention.Welosesightofthewordsaswereadabookatbedtimeorlosesightoftheroadaswedrivelateatnight.Thecortexisnotgettingthejuiceitneedsto
stay"litup."Andrecallthatindreamsweareneverabletostoptheactiontofocusonsomedetailourabilitytoattendisdisabled.Asweknow,duringdreaming,the
cortexismissingnorepinephrineandthecontrolthatitconfers.
WatchingOurselvesDream...AndHallucinate
Withpractice,inourdreams,wecancallupjustenoughnorepinephrinetogiveussomecontrol.Atraretimesweexperiencewhatiscalledluciddreamingwhile
stillinadream,webecomeawarewearedreaming.Thisawarenessisusuallyfleetingandmoreoftenwakesusup.Butweknow,foraninstant,wearedreaming.
Certainindividuals,likemycolleagueEdPaceSchott,cansometimesmakethemselvesbecomelucidwhiledreaming.Whenhesucceeds,heregainscontrolofhis
attention.Hedoesthisintwoways.Oneistonoticeandpayattentiontothebizarrediscontinuitiesand

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incongruitiesthatlabeldreamingsoclearly,insteadofignoringtheseobviouscluesasweusuallydo.Thesecondistotellhimselftomakevoluntarymovements(thatis,
toseizecontrol)ofhiseyesinsteadoflettingthemflitbackandforthautomaticallyastheyusuallydo.
WithsomeencouragementfromEd,Ihaverenewedmyinterestinluciddreaming.AndIuseasimilaronetwopunch.FirstInoticetheobviousfactthatIam
dreaming,andthenIwillanactthatcorrespondstowhatIamseeinginmydreams.IfIamflying,Itellmyselftoflapmyarms.
Myarmsdon'tactuallymoveinbed,butwhatIamdoingisengaginginvolition.Iampurposelystartingamotorprogram.MytheoryisthatbydoingthisIam
engagingmyfrontalcortextocallforchemicalhelp.Mybrainstemrespondsbysendingupsomenorepinephrinejustenoughtoplacemeontheknife'sedge
betweenREMsleepandwaking.IfIpushthesystemtoohard,Iwillwakeup.IfIletupabit,Iwillbecomereabsorbedinthedream.
Wecouldprobablycapturethisonabrainscanner.Normally,thebrainstemhasthepoweroveradream,andthefrontalcortexistryingtocatchupbyimposinga
plot.Butduringluciddreaming,thecortexhascaughtupandcanbegintodirect,oratleastwatch,theactionfromadistance,likedirectingorwatchingamovie.
Duringluciddreamingthefrontalcortexshouldlightupfaintly,evenifnotenoughtooutshinethebrainstem.
Thefactthatluciddreamingispossibleisnotjustamusing.Itisextremelyimportant,becauseitgivesusacriticalkeytounlockingpsychosis.Wehavealready
concludedthatdreamingisapsychosis.It'sjustahealthyone.Iftheparallelholds,thenpeoplewhoarementallyillshouldhavelucidpsychoticepisodestoo.Andthey
do!Indeed,itisthefirststeptowardrecovery.Whenpatientsgainsuchinsight,theyfinallyrealizetheyarepsychotic.Althoughtheywillstillsuffertheeffectsoftheir
illness,theycanbegintotakecontrol.
EvenBertal,whoseepisodesweresometimesextreme,hadmomentsofinsight.RememberwhenIfoundhimsquattingonthefloor,inthekitchenofThePsycho,
crampedupinaball?Itwasafterhishallucinations,butbeforeheregainedcontrolofhispos

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ture,thathesaid,''WhydoIdothefoolishthingsIdo?"TherewereafewtimeswhenBertalseemedtorealizethathishallucinationsandactionswereunhealthyor
harmful.
ThepoweroflucidobservationwasdemonstratedtomebyHarrietNorth,apatientofmineatThePsychointhe1960s.Shetoowaspsychotic,buthadcometothe
realizationthatshehadaproblemandhadfoundawaytobegintocontrolit.Whenahallucinationbegan,shewouldtrytopictureherlibraryathome.Shewouldlook
attheimaginaryshelvesandstarttocountthebooks,focusingoneachoneasbestshecouldasshecounted.Soon,herhallucinationwouldstop.Harriet'sinsightdid
notstopthepsychosis,butthelibrarytrickdid.Thevisualizationandcountingwerevoluntarymotoractsshedirectedhereyesatthebooksandcarriedoutthe
rationalexerciseofcounting.Bydoingboththesethings,shewasimposingtopdowncontrol,whichquashedthebottomuphallucinationsignal.Shewaspurposefully
lightinguphercortexsothatitdrownedoutherlowerbrain,snappingheroutofherepisodejustascognitionwakesusupoutofadream.
ChangingFocusandPayingAttention
Whathappenswhenyoulookupfromyourbookinresponsetoapersonwhohasjustenteredtheroom?Youswitchyourattention.
Thatisnotasimplematterforpeoplewhohavehaddamagetotheparietallobeoftheircortex,ontherightsideoftheirbrains.Thesepatients,whosufferfromwhatis
calledhemineglect,havetroubledisengagingandshiftingtheirattention.Theytendtobecomefixedonthingsinonehalfofvisualspaceandtoignoretheotherhalf.
Forthemtheworldhasbeencutinhalf,buttheyarecompletelyunawareoftheirloss.
Engagementiscontrolledbythethalamus,adeepcentralstructureinthebrain.Itprojectsmessageswidelytoareasofthecortexandreceivespowerfulfeedbackfrom
eachofthem.Becauseofits

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centralpositionanditsreciprocalfiringpattern,thethalamusistheidealpointatwhichtointerceptunwantedorunexpecteddata.Selectiveattentiondependsasmuch
onthesuppressionofirrelevantdataasitdoesontheamplificationofrelevantdata,andthethalamusisgoodatsuppression.Byfeedingnogosignalsintothe
thalamus,hugeareasofthecortexcanbeeffectivelydeprivedofinput.Inananalogytoradio,thethalamusisaveryeffectivetuningfilterforthebrainmind.
Wecanseethisdirectlyinmonkeys,who,happily,areabletolearntoplayPosner'sreactiontimegame.Monkeysperformtheseroutineoperationsoverandoverfor
modestrewardssuchasasipofjuice.Astheyplaythegame,itispossibletorecordtheactivityintheirbraincellstodocumentthedramaticeffectsattentionhason
theneuronsthatprocessvisualdata.Oneofthemostsurprisingrevelationsisthatvisionis"builtup"withinthebrainassignalsareprocessedviatwodistinctpathways
fromtheposteriorcortexforwardtowardtheanteriorcortex.Howwelltheseimagesarebuiltupdependsstronglyonhowcloselythemonkeysarepayingattention.
Furthermore,whenthemonkeys(andwehumans)shiftattention,theircortexmustdisengagethecurrenttargetandcommunicatewiththethalamustoreengageona
newtarget.Thissequenceoccursflawlesslyandthoughtlesslyeighttotentimesasecond.Canyouimmediatelydisengageyourattentionfromthisbook?Ofcourse.
Canyoureengageonapersonenteringtheroom?Rapidly.
Whileweneedtobeabletoengageanddisengageourattention,wealsoneedtobeabletomaintainourattentiononcewehavefocusedonsomething.Asahigh
schoolorcollegestudentyouracademicsuccesswasrelatedtoyourabilitytoresistdistraction,topaysustainedattentiontoyourbooknomatterwhowalkedintothe
room,suchasthelibrary,whereyouwerestudying.Youhadbothasharpfocusandasustainedspanofattentionevenwhenfriendstemptedyoutotalkorflirtinstead
ofstudy.Whileyoumayhavetakenjustifiableprideinyourcapacitytopayattention,youmustadmitthatitwouldhavebeenconsiderablymoredifficulthadyoulived
inasocietywhereeverystrangermighthave

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beenamemberofthesecretpolice.Isupposethat'sonereasonitissohardtomakeeyecontactwithnativeridersontheMoscowsubway.Forthem,beingwatched
hasasinistersocialimplication.
Maintainingourattention,ordecidingtoswitchit,dependsontuninginandoutthemanychannelsofinputwereceiveandthemanychannelsofoutput,suchasmotor
commands,thatwehaveatourdisposal.Unnecessarynoiseineitherdirectionusesupthelimitedresourcesoftheattentionalsystem.
"Tuning"seemstobejusttherightwordtodescribehowthethalamussustainstheproperleveloftension.Electronicsengineerscallthisprocesssignalsharpening.
Severalindependentscientistsnowmaintainthatnorepinephrinecellsinthebrainstemplayacriticalroleinthetuningofattention.Norepinephrineincreasestheratioof
signaltonoise.
Thistheoryarosefromneurophysiologicalstudiesofthelisteningcapabilityofsquirrelmonkeys.Whenevertheanimalsbecameinattentiveordrowsy,therewasa
correspondingdropinactivityofnorepinephrinecellsandpresumablyofthenorepinephrinethatwasreleasedinthebrainstem,thalamus,andcortex.Whenweare
"outofit,"wearen'tpushingourbrainstem'snorepinephrinesupplierhardenoughwhenweareonthequivive,wehavethissystemworkingwellforusandwhenwe
arestressedout,wearepushingittoofar.
LossofVigilance
Webecomedrowsy,daydream,orbecomegenerallyinattentivebecauseourbrainsareproducinglessnorepinephrine.Thisoutputisreducedtoitslowestlevelduring
dreaming.Andwhathappenstoourcapacitytoattendindreaming:Isourinternalattentionselective?Dowefocus?Isourattentionalspanlong?Canwethink?Are
weabletoholdanideaorimageinmind?
Theanswertoallthesequestionsisno.Internalattentionislostduringdreaming.Icannotcontroltheimages,feelings,ideas,oractionsinmydreams.DuringmyNew
Orleanshoteldream,whenthesecurityguardwastryingtofindintrudersintheroomabove,Iwasfarfromfocusing,finetuning,orevaluating.Iwasdissolved

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inafloodofsensations,emotions,andactionsaboutwhichmyideasweredecidedlyflaky.
Ontheotherhand,myassociativecapacitiesarenevergreaterthaninmydreams.Iamawashinwildlyuncriticalandimaginativefabrications,whichimpliesthatthe
vastcapabilitiesofmy"whatisit?"systemarebeingbroughttobearonwhateverproblemissuggested.WhileIdon'tbelievethattheevidenceforreallifeproblem
solvingindreamsisverygood,Iamimpressedbythemotleyarrayoftricksthatmybrainmindtrotsout,asiftoshowthemofforgivethemtheirdailyexercise.
Therearetwogoodexperimentalwaystofindoutifmyattentivedifficultiesduringwakinganddreamingarerelatedtoalackofnorepinephrine.Oneistointerfere
withnorepinephrineduringwakingbygivingmeadrugandseeingwhathappenstomyperformanceonthePosnerreactiontimetask.Theotheristowakemeup
fromnonREMandREMsleep,putmeimmediatelyonPosner'smachine,andcomparemyperformancethentomyperformanceduringtheday.Bothtestshavebeen
done,andbothproducethesameresults:thespeedofdisengagementfromatargetisfasterwhenoneisawakenedfromsleepthanwhenoneisawakeduringtheday.
Subjectsdisengagetheirattentionunusuallyquicklywhennorepinephrinelevelsarelow,whichfitswithoursubjectiveexperienceofdreaming.
Rapiddisengagementisnotnecessarilygood,asshownbychildrenwhohaveattentiondeficitdisorder.Fordecadestheassumptionaboutkidswhodidn'tpay
attention,particularlywheninschool,wasthattheywere"hyperactive."Thiswastheconclusionbecausethesamekidswereusuallyfidgeting,movingaroundintheir
chairs,andtappingtheirfeetonthefloorinsteadofstaringinblurryeyedobedienceattheblackboard.Notethattheir"hyperactivity"consistsofmotoracts.Focusing
theireyesontheblackboardandmaintainingtheirconcentration(volition)alsodependonmotorprograms.Theproblemwithsuchchildrenisnotthattheycan'tpay
attentiontoanything,it'sthattheyarepayingattentiontoeverything.Theyrapidlydisengagefromagivensignalinordertoengagealltheothers.Theyfailtoinhibit
enoughmotorsignalssotheycanfocusonafew.

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Todaythesechildrenareputonaregimenofamildamphetamine,amoleculethatissimilartonorepinephrine(noticethatamphetamineisanamine).Thisboost
enablesthemtoinhibitsomeofthedistractingmotormovements,allowingthemtoconcentratebetter.Thereareadultswhohavethesameproblemandarehelped
withthesamedrugs.
Themainpointisthatimpairmentsinattention,whethertheyoccurintheREMsleepstateortheawakestateofpeoplewithattentiondeficitdisorder,shareacommon
chemicalcause:adecreaseinoutputfromthenorepinephrinesystem.Atleastwehaveanexperimentalhandleontheslipperyissuesofwhatsleepmaydotoand
forattention,andhowthoseeffectsmaybemediated.Thisisagoodcaseofhowthebrainmindparadigm,inexplainingafacultyofanormalstate,canbeusedto
findasolutiontoaproblemwiththesamefacultyinanabnormalstate.
Thereisalsoanethicalpointtobemadehere.Theinsightgainedwiththebrainmindparadigmisimportantbecauseitexplainswhyadrugtreatmentworks.Doctors
haveknownforsomeyearsnow,basedonclinicaltrials,thatamphetamineshelpmediateattentiondeficitdisorder,buttheyhaven'tknownwhy.Thisisdangerous.If
wedon'tknowtherootcauseofaproblem,wecan'tpredicttheeffectofatreatment.Itcouldwellhavebeenthattheamphetamineshelpedthechildrenintheshort
termbutaggravatedtheprobleminthelongterm.Wesimplycouldn'tpredictifthiswasso.Nowwecanbesurethatitisnotthecase.Furthermore,itishardtofind
alternativetreatmentsifwedon'tknowtherootcauseofaproblem.Somechildrencannottoleratethedrugs.Oncethebrainmindtheoryexplainswhythedisorder
occurs,wecanmethodicallyandsuccessfullyfindothertreatments.
Forexample,itwouldhavebeenveryusefultohavethisunderstandingwhenIwastryingtohelpBertal.Itisclear,now,thatBertalsharedsomeofthesame
symptomsaschildrenwhocan'tselectwhattoattendtoandwhattoignore.IngivinghischildhoodhistorytousatThePsycho,Bertal'smotherdescribedhimasa
"misfit."Hisschoolrecordwaspoor,andintheninthgradehewasdroppedfromschoolbecauseofinattentioninclassandsuspectedinvolvementinhomosexualand
firesettingactivities.Inattention

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inclass!Whataclue!Unfortunately,thiswasinthe1950s,longbeforeattentiondeficitdisorderwasrecognized.
ThebrainmindtheoryofinattentionalsocouldhavehelpedusunderstandwhychlorpromazineworkedonBertal.Wegavehimchlorpromazinetocalmhimdown
whenhewasreactingwildlytoeveryinputfromhisexternalandinternalsources.Weknewthenthatchlorpromazinesuppressedthecholinergicsystem,andwehave
learnedsincethatitalsointeractswithdopamine,anamineinthebrain.Althoughdopamineisnotdirectlyinvolvedinconsciousstatecontrol,itiscrucialinmediating
motivatedbehavioranditisachemicalcousinofnorepinephrine.ThusthesamegeneralprinciplemayuniteourmodelofdreampsychosiswithBertal'swaking
psychosisanditschemicalmanagement.Anycondition(ordrug)thataltersthebalanceoftheaminergicandcholinergicsystemsislikelytoalterforbetteror
worsebrainmindstate.
TheBenefitsofDistraction
Inordertoevaluateanattentiongettingsignalweneedtofreeourbrainmindfromitsrivetingcontrol.Thereflexiveanimalhasalimitedsetofoptionstobeonthe
safeside,itusuallyjustrunsaway.Thatmaybesafe,butitisneithereconomicalnorsupple.Tobediscriminating,weneedimmediateaccesstoaslargeandricha
storeofmemoryaspossible,guidedbyexperientiallydeterminedpriorities.Howdoourbrainmindssimultaneouslyaccomplishthetwintasksofsharpfocusandrich
analysis?Let'scirclebacktoourconsiderationofmemoryandemotion.
Whenweareawake,theaminergicsystemisdominant,butthecholinergicsystemstillplaysarole,whichincreasesasthedaywearson.Andrecallthat,whilethe
aminesarenecessaryforrecordinganexperience,itisacetylcholinethatconsolidatesmemory.Inthedynamicstrugglebetweentheaminergicandcholinergicsystems,
wearewitnessingastrategictradeoffbetweenattentionalselectivity(aminergic)andcontextualversatility(cholinergic).Thiscontrastfitswellwithournotionof
foregroundprocessing(oftheconstantflowofdatafromourimmediateenvironment)andback

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groundprocessing(ofplans,memories,andreferenceframes).Italsofitswellwiththedifferencesbetweenwakinganddreamingconsciousness.
Insharplyattentiveawareness,whentheaminergicsystemdominatesbrainmindoperations,theemphasisisonfocusandresponse.Inmorerelaxedwaking,whenthe
cholinergicsystemplaysamoreprominentrole,abroadersetofinternalconstructs(thoughts,memories,wishes,anddesires)isusedtoreflectonongoingevents.In
sleep,asboththeaminergicandcholinergicsystemsabate,bothfocusandrepertoirebecomesharplylimited.Indreaming,focusislostaltogetherastheaminergic
systemshutsoff,buttheresponserepertoireiscorrespondinglymorevastbecausethecholinergicsystemisgivenunbridledsway.
ThisdiurnalcontinuumofattentioncanbeexplainedbytheAIMmodel.Inthemorningourbrainmindsarewideawake.Ourattentionisclearandsharp.Wecan
focusandwecanswitchwithrelativeease.Ourmostsuccessfulcolleaguescanevenkeepseveraltasksontrackatonce.Todothis,theaminergicsystemmust
beatitspeak,andithasbenefitedfromcompleterestinREMsleep.Weareinthewakingsegment,theupper,back,righthandcornerofthestatespace.
Byafternoonoreveningourattentionisnotsotightlyconnectedtotheexternalandinternalinformationthatcompetesforourconsciousness.Ourmindswander.We
daydream.Wearemoreeasilydistracted.Ourfantasiesshiftfromthedressrehearsal,problemsolvingmodeofthemorning,tomoreexotic,escapist,andsensual
topics.Welongforourfamiliesandfriends,ourloversandourentertainment.Thisattentionaltransitioncorrespondstoagraduallossinaminergicpoweranda
correspondinggaininthecholinergicabilitytodilate,imagine,andfreelyassociate.Wehavemoveddowntowardthecenterofthestatespace.
Ourdailyglidedownthecurveispreparinguslittlebylittleforournightlylaunchintothecholinergicworldofourdreams.Logicisonhold,restoringitself,like
norepinephrine,forthenewspapersandspreadsheetsoftomorrow.OncewehavegonetobedandtraveledthenullzoneofnonREMsleep,weswitchtoan
uncriticalandwildreviewofourmemoriesandemotions.Wepopthecorks

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onourbrainmindstocksofacetylcholineandwearedrawndowntothelower,front,righthandcornerofthestatespace.Weindulgeourselvesindreaming.Our
inattentionfavorsourlookingateverything,imagingthingsweneversawbefore.Andastheversatilityofourassociativepowerisreassured,ourattentionalcapacityis
restored.Weawaken.

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Chapter11
UpsandDowns:Energy,Mood,andHealth
Youcangetawhoppingcaseofjetlagwithouteverleavinghome.Juststayupallnightandseewhathappensthenextday.Forevenmorefun,stayawakeforafew
nightsrunning,sleepabitduringthedays,andyouwillbegintoexperiencesomeverypeculiarshiftsinyourenergystateandyourconsciousexperience.Someareso
dramatictheywillputtheeffectsofjetlagtoshame.I'veexperiencedthismanytimes,afterspendingnightsintherecordingroomofmysleeplabwatchingotherssleep
andmonitoringtheirbrainwaves.
IdiscoveredtheseshiftsinenergyformyselfwhenIwasdoingallnightsleepstudiesattheNationalInstituteofMentalHealthinBethesda,Maryland,earlyinmy
career.Nightturnedintomyday,andeveningturnedintomymorning.Iwouldfinishmyexperimentsatabout7:00A.M.,makemyroundsatthehospital,discussthe
nextnight'sexperimentwithmymentor,anddrivebacktoWashington,D.C.,tomyapartmentneartheWashingtonCathedral.IwassotiredonceIgottherethat,
withtheshadesopen,trafficroaring,andfireenginesclanging,Icouldsleepwithoutdifficulty.By10:00A.M.Iwasout.Iwouldsetmyalarmfor4:00in

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theafternoon,soIcouldgetupintimetogreetmywife,Joan,whenshegotbackfromherteachingjobattheCathedralSchool.
Inordertomaintainourconnectionwiththesocialworld,wedecidedwewouldtrytogoouttogetherintheeveningasmuchaspossible.Anyway,itwastheearly
1960swelivedinJFK'sCamelotWashington,andasyoungBostoniantransplantswewerestarryeyedandeagertobeintheswim.Butitwasfrequentlypointless.
Mybodyyelled,"Hellno!Iwon'tgo!"
Mybodysaidnobecausemybrainmind(that'sme,afterall)wasinamorningmood,notaneveningmood.Itwasripeforaquietbreakfastandaleisurelyread
throughthenewspaper,andthenprimedforfocused,analyticalthinking.Theboisterous,scatteredenergyofacocktailpartywasnotsomethingmybrainmindcould
tolerate.Iwouldlookinstupefieddisdainatthefreneticguestsasiftheyweremanicpsychoticswhoneededlithiumtobringthembackdowntotheground.They
lookedatmeasifIwereadepressivewhoneededelectroshocktherapy.
Iwasn'tdepressedanymorethantheyweremanic.Ourenergylevelsweresimplyoutofphasewitheachother.Thesamethinghappensafteralongflightacross
severaltimezonesyourenergy,yourbodytemperature,andyoursleeprhythmsdon'tbeatinlocaltime.
Weallknowthatourenergyoscillatesbetweenupsanddowns.Whenwe'reup,theworldisouroyster.Wefeelasifwecandoanything.Whenwe'redown,allis
bleakanddismal.LikeBertal,wemaysaytoourselves,"Ishouldhavestayedinbed."Itseemsclear,too,thatwhenweareupwefeelmorehealthy,andwhenwe
aredownwefeelourresistancetoinfectionhasfallenaslowasourmood.
Canourknowledgeaboutthebrainmindbeextendedbeyondthebrainminditself,tothebodyatlarge?Indeeditcan,forthebrainmindcloselyregulatesour
energy,mood,andhealth.Buthowandwhydoesoursleepscheduleaffectourenergylevel?Isgoodsleeprequiredforgoodhealth?Arementalillnessesofenergy
andmood,suchasdepression,afunctionofbrainmindstates?Andcantheseillnessesbebeatenbyalteringthestates?Theanswer,aswewillsee,isthattheymost
certainlycan.

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LinkingMindtoBody
Thenervoussystemconnectsmindandbody.Onitsbroadestscale,ournervoussystemhastwodivisionsthecentralnervoussystemandtheperipheralnervous
system.Thecentralnervoussystemconsistsofthebrainandthespinalcorditreceivesimpulsesfromnervefibersintheskinandorgansandfiresmotorcommandsto
musclesandglands.Theperipheralnervoussystemconsistsofnervesthatcontroltheface,neck,andspineandthesocalledautonomicnerves,whichregulatethe
heart,lungs,stomach,andotherorgans.
Theautonomicnervoussystemisthekeytoenergy,mood,andhealth.Ithastwodivisionsofitsownthesympatheticnervoussystemandtheparasympathetic
nervoussystem.Thesympatheticnervoussystemkicksourcardiovascularsystemintohighergearwhenweasktheheartandlungstoresponditsinstructionsare
carriedbyaminemoleculeslikenorepinephrine.Theparasympatheticnervoussystemslowstheheartandlungs,usinginstructionscarriedbyacetylcholine.Our
understandingofthebrainmindcanthereforebedirectlyappliedtothebodyforonesignificantreason:thedivisionoflaborbetweentheaminergicandthecholinergic
systemsinourbrainsismirroredbyadivisionoflaborbetweenaminesandacetylcholineinthebody.
Byaskingourheartandlungstoincreasetheiroutput,thesympatheticnervoussystemrequiresustoexpendenergy.Itsactionisdescribedasergotropic,whichmeans
energygenerating.Andbyaskingtheseorganstoreducetheiroutput,theparasympatheticnervoussystemtellsustoconserveenergy.Itsactionisdescribedas
trophotropic,whichmeansenergyconserving.
So,inanutshell,herearetherelationshipsweneedtokeepinmind:
Waking

Sleeping

amines

acetylcholine

ergotropic

trophotropic

sympatheticnervoussystem

parasympatheticnervoussystem

highenergyoutput

lowenergyoutput

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Nowthatwecanspeakthelanguageofphysiology,wecanbegintodeterminewhyanyofthismatters.Inboththebrainandthebody,allstatesthathavehighenergy
demandsdependonthereleaseoftheaminenorepinephrinefromnervecells.Whennorepinephrinerisesafteranight'ssleep,wewakeup.Itremainshighduring
wakingandfallsindefeattoacetylcholinewhenwegotosleepagain.Sincenorepinephrineandacetylcholineregulatethemajorbrainmindstatesofwakingandsleep,
weseethatenergyflowmustbeanelementalaspectofthesestates.Initsfundamentalform,thisideastronglyparallelstheEasternnotionofyinandyang.
Intheearlyhalfofthiscentury,physiologistsassumedthattheautonomicnervoussystemwasconnectedtoandcontrolledbythebrain,buttheydidn'tknowthatthe
brainitselfcontainedcholinergicneurons.WhenIwenttomedicalschoolinthelate1950s,therewasstillnodirectevidencethatacetylcholinewasacentralbrain
neurotransmitter.NowweknowthatacetylcholinemediatesREMsleep,duringwhichenergyisconserved.Thereduceddemandforoutputenablesnorepinephrineto
bestockpiledagainstfutureenergydemands.
Physiologistsdidknowthatacetylcholineslowedheartaction.Infactthediscoveryofacetylcholine,byOttoLoewi,wasmadeduringresearchintoheartrate
regulation,whichcanbeamatteroflifeanddeath,forexample,duringcardiacarrest.Itwasspeculatedthatwhencarriedtoextremes,thecholinergicsystemcouldso
powerfullyslowtheheartthatheartbeatwouldstopaltogether,causingVoodooDeath.Althoughwe'vedroppedthemoniker,today'sphysiologistsstillbelievethat
mediationofcardiacarrhythmiabyacetylocholinecancausesuddendeath.
InthecentralpartsofThailandandCambodia,thereisasyndromeofsuddendeathinyoungmenthatoccursduringsleep.Asinotherillnesses,deathinsleepmaybe
relatedtothenormaltendencyofacetylcholinetoaltertherhythmoftheheart,whichismadeabnormallysensitivebyotherphysiologicalfactorssuchasgeneticsor
diet.SleepdeathiscalledLaiTaibytheThainatives,whobelieveitiscausedbythevengefulvisitofawidowghostwhoseducesmenintheirdreamsandkillsthemin
retributionfortheirinfidelity.

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Wecanthereforeconcludethattheyinandyangofthebrainandbodyaremaintainedbythereciprocityoftheaminergicandcholinergicsystems,whichspringfrom
nervecellsinthebrainstem.Theaminergiccholinergicsystemsinthebrainandbodyarealsodirectlylinkedbythenervesinthebrainstem,whichguaranteesthe
regularcyclingweundergofromtheenergyoutputtingwakingstateandtheenergyconservingsleepingstate.
Whilethissoundslikecommonsense,itactuallyisn't.Commonsensehasalwaysheldthatsleepconservedenergybecauseitensuredinactivityandrest.Afteragood
night'ssleepwewakeupfeelingmorealertandstronger.Butsleepiscommandedbythesurgeofthecholinergicsystem.Acetylcholineworksatleastashardatnight
asitdoesduringtheday.CholinergicbraincellsaremostactiveduringREMsleep,andalmostallthebrainneuronsareturnedon.Thisdiscoveryrunsdirectlycounter
tocommonsensebecauseitmeansthatourmentalrefreshmentmustbeachievedbyaspecialkindofbrainwork,ratherthanbrainrest.Thisshowsusjusthow
misleadingsubjectiveexperiencecanbe.Wesimplycannotintuitthewaythebrainfunctionsfromourpsychology.Wemusthaverecoursetophysiology.
RegulatingBodyTemperature
Oneenergyfunctionthatisparticularlysensitivetochangesinbrainmindstateisbodytemperature.Becauseitissoimportantitisappropriatelycalleda''vitalsign"by
doctors,whorecorditeveryfourhourswhenwearepatientsinahospital.Whenbodytemperaturerisesorfalls,wefeelintenselyuncomfortableandknowthatour
healthisthreatened.
Mammalszealouslymaintaintheirbodytemperaturewithinnarrowlimits.Withtheexceptionoftheremarkablestateofhibernation,bodytemperatureinmammals
normallyfluctuateswithintheverysmallrangeofabout1.5F.Bodytemperaturetypicallypeakswhenweareawakeandactive,anddipswhenweareasleepand
restful.Theergotropictrophotropicenergycycle,whichrisesduringwakingandfallsduringsleep,determinesthebody'stemperaturecurve.Asitshoulditcostsmore
energytokeepourbod

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ieswarmwhenweareoutandaboutthanwhenwearelyingstillandcoveredinourbeds.
Sinceourphysiologyissodependentontightregulationoftemperature,itcameasagreatsurprisetofindthatwhenmammalsareinREMsleep,temperaturecontrol
isessentiallyabandoned.ThisunexpectedfindingsuggeststhatduringREMsleepthebrainsthermostatistemporarilyturnedoff.Thereasonthatbodytemperature
doesnotfallduringthistimeisbecauseheatlossispreventedbysleepbehavior.Wesleepinwarmnestsorbeds.Andwedon'tsleepatallifwearecold.Explorers
whoareunexpectedlytrappedovernightinfrigidareasanddon'thaveadequateprotectiontrytostayawaketoomanyoftheirpredecessorshavefallenasleepunder
suchconditionsandfrozentodeath.Nowweknowwhy.
Temperatureregulationdependsontheactivityofthesympatheticnervoussystemtheergotropicsystemwhichismodulatedbynorepinephrine.Andweknow
whathappenstothecellsthatproducenorepinephrineduringREMsleep:theyareturneddowntoalmostzero.Soenergymobilizationandtemperaturecontrolare
twotightlylinkedprocesses,andthelinkbetweenthemisprovidedbytheaminergicsystem.Whenitison,weareawakeandourtemperatureisregulated.Whenitis
off,weareinREMsleepandourtemperatureisnotregulated.
Whenwearesickwiththefluandourbodyreactswithfever,oursleepmaybecomelightandfitful.Thisoccursinpartbecausetheelevatedtemperaturesuppresses
REMsleepandwithitdreams,leavingourmindsinthethrallofthepersistentobsessivethinkingofnonREMsleepandthemicrodreamsofrepeatedandunsuccessful
sleeponsets.Howevermuchweneedtosleep,wehavetroublegettingenoughoftherightkindbecauseouraminergicemergencydefensesystemistoobusywith
survivaltoallowtheluxuryofdeepcholinergicrecuperation.
IfREMsleepcausesustoabandontemperaturecontrol,thenwhydoourbrainmindseverallowourbodiestofallintosuchaprecariousposition?Oneideaisthat
REMsleepmayfunctionnotonlytoconserveenergy,butalsotoconservethecapacitytoregulateenergyflowproperly.ItisinREMsleepthatwemosteffectively
restoreouraminergicsystemandthereforeourabilityto

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maintainaconstantbodytemperature.Recallthatwecametoasimilarconclusionabouttheaminergiccholinergicsysteminthebraintheaminergicsystemis
suspendedduringREMsleepsothatitcanrestoreitselfandfunctionproperlywhenwemostneeditwhenweareawake.
IfREMsleepfunctionstorejuvenatetheenergyregulationsystem,thensleeplossoverthelongtermwouldhaveseveralpotentiallydamagingresults.One
wouldbealossofcontroloverbodytemperatureanotherwouldbealossofenergyavailabilityandathirdwouldbedepressionofbrainmindenergyfunctions.We
willseethat,toadegree,alltheseoutcomeshavebeenshowninlaboratoryanimalstudies,andthatillhealth,depression,andevendeathmaybetheconsequencesof
sleeploss.Recentexperimentshaverevealedthatlongtermsleeplossinvariablyleadstodeathinratsandthatthesleepdeprivedratsdiefrominfection.
SleepandtheImmuneSystem
Noneofthedeclarationsoffolkpsychologyismorewidelybelievedthanthatlinkinggoodsleepandgoodhealth.Mothershaveexhortedtheirchildrento"getagood
night'ssleep"sincetimebegan,itseems.Intheearly1970s,studiesconductedattheCaliforniaHumanPopulationLaboratoryidentifiedseveralbehaviorsthatwere
positivelycorrelatedwithlengthoflife.Sleepheadedthelist,followedbyexercise(whichisknowntopromotesleep),eatingbreakfast(commuterstakenote),andnot
snacking(iceboxraidersbeware).Weightwatching,notsmoking,andmoderatingalcoholintakewerealsopositivepredictorsofgoodhealth.
ThesubjectsintheCaliforniastudyhavebeenfollowedovertime,andthosewithsixofthesevenhealthbehaviorslistedabovehaveallenjoyedmuchlongerlivesthan
thosewhoviolatedtherules.Butlongevityisnottheonlyyardstickthatmeasuresthepayoff.Positivewellbeing,or"feelinggood,"hasbeenlinkedtoallsevenfactors.
Itthusappearsthatnotonlylifeitselfbutwellnessissomehowfosteredbygoodsleep.
Isay"somehow"toemphasizethattheencouragingresultsoftheseepidemiologicalstudiesdonotestablishcausality.Forex

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ample,itcouldbethatgoodsleepisnotlinkedtogoodhealthatall,butthatbotharesimplytheeffectsofexercise.Oritcouldbethathealthypeoplejusthappento
sleepwell.Itcertainlyseemsthatforustohaveasenseofwellbeing,enjoyment,andaccomplishmentweneedenergyandapositivemood.Anditseemsnaturalthat
peoplewhoaredepressedlackenergyandhaveproblemswithmood.Butwecannotfeelsecureinourwellbeingorhelpthosewhoaredepressedunlesswecan
uncoverthemechanismsthatdriveenergyandmood.Isgoodhealthmediatedbybrainmindstatesastheydictatetheflowofnorepinephrine,whichcontrolswaking
thesympatheticnervoussystem,andacetylcholine,whichcontrolssleepandtheparasympatheticnervoussystem?Let'sseewhatrecentresearchtellsus.
Weallshareacommonexperiencewhenwehavethefluwefeelbest(or,shouldIsay,leastbad)inthemorning,whenwehave"rested."Oursymptomsworsenby
afternoonandmoresobyevening.Butweimproveagainaftergoodsleep.Manypeople,includingme,willswearbysleepforthefluuntilsomethingbettercomes
along.Butcansleepactivelysuppressinfection?Canitactuallyboosttheimmunesystem?ThatisexactlytheconclusionreachedbyJamesKruegeroftheUniversity
ofTennesseeafterfifteenyearsofresearchontheeffectsofsleepdeprivationonrabbits,rats,mice,andbelieveitornotgoats.Goatswerechosenbecause
theyhadprovenusefulinstudiesofcerebrospinalfluid,arichsourceofsomeofthebrainchemicalsrelatedtosleep.
Tomakealongandfascinatingstoryshort,itturnsoutthatwhenanimalsaresleepdeprived,aproteinknownasdimuramylpeptideaccumulatesintheirspinalfluid.
Thepeptidesdonotoriginateinthebrain.Instead,theycomefrombacteriainthebody,suggestingthatsleepdeprivationmayenablebacterialgrowthandthat
sufficientsleepimpedesbacterialgrowth.
What'sevenmoreinterestingisthatthesedimuramylpeptidesenhancenonREMsleep(butnotREMsleep).Thepeptidesalsocausefever.Thetwoeffectsare
dissociable,howeverthesleepeffectisindependentofthefever.Moreinterestingstillisthefactthatthepeptidesstimulatecellsinthebrainandthebodytoproduce
interleukin1,apowerfulimmunesystemmoleculethatpromotes

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thedestructionofbothbacteriaandtumorcells.Highlysignificantanddesirablehealtheffectsaremediatedbyinterleukin'sabilitytoencouragetheBlymphocytesto
produceantibodies,whichkillviruses,andtotriggertheproliferationofTlymphocytes,whichattackmicrobialinvaders.Theneteffectistomobilizethebody's
defensiveforces.
Itlooksasifsleepresearchhasinadvertentlystumbledonsomethingofcapitalimportance.Bydeprivinghisanimalsofsleep,Kruegermadethemmorevulnerableto
infection,whichstimulatedtheirimmunesystem,whichmadethemmoresleepy.Havingnoticedthis,itwasthenpossibletoshowthatmanyimmuneproteinsdo,in
fact,promotesleep.Takingashotofsleepforyourfluissoundingbetterandbetter,isn'tit?Noneedles.Nopills.Sleepaloneisenoughtochangethestateofthe
immunesystem.
Nowwereturntoourfirstquestion.Whydowefeelsleepywhenwehaveaninfection?Perhapsbecauseinterleukin1,aproteinthatispartofthenormalbodily
responsetoinfection,isalsoaneffectivesedative.Likethepeptides,interleukin1enhancesnonREMsleep.ItalsoincreasesthesizeoftheEEGwavesassociated
withnonREMsleep.Thusboththelengthanddepthofsleepareincreasedasanintegralpartofthebody'sattempttorepulsemicrobialinvaders.Theupshotisthat
thereisapositive,circularinteractionbetweentheimmuneresponseandsleep.Sleepenhancestheimmunesystem,andtheimmunesystemenhancessleep.
Invadersareassaultingourbody'sportalsatalltimes,notjustduringwinter,whenwetendtogetsickmore,andnotjustduringlocaloutbreaksofviruses.Thismeans
thatthemarginofsafetyofourhealththedegreetowhichweareresistanttoinfection,andperhapsevencancermaybedeterminedbyhowwelloursleepstate
enhancesourimmunesystem.Thedailysequencingofnormalbrainmindstates,therefore,mediatesourhealth.
ItisnonREMsleepthatisenhancedbythechemicalsourbodiesproducetofightinfection.WhyisREMsleepabsentfromtheimmuneresponsepicture?We'renot
sure,butitseemslikelyitisbecauseREMsleepinvolvesalossoftemperaturecontrol.Whenwearesick,ourbodytemperaturesoarsanddrops,andwecannotrisk
enteringREMsleepandabandoningtemperaturecontrol.

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REMasSupersleep
WehaveseenhownonREMsleephelpsusbattleinfection.Oncewearehealthy,however,itseemsthatREMsleepisthekeytostayingontopofourgame.We
havenotedthusfarthatREMsleepservestorestoreourenergysystem.Recall,too,fromourdiscussionofmemory,thatduringREMsleepourmemoryis
consolidatedandmadepermanent.DuringthisuniquebrainmindstateofREMsleep,then,ourcircuitsarebeingclearedandourbatteryisbeingrecharged.Wewake
upwiththeinsightandenergyneededtotackleproblemsthatseemedinsolublethenightbefore.
Astheconservatoroftheaminergicsystem,REMsleepismorethantwiceaseffectiveasnonREMsleep.Thefiringratesofneuronscontainingnorepinephrineand
serotonindroptohalftheirwakinglevelsinnonREMsleep,buttheoutputdropsbyfarmorethanhalfagaininREMsleep.ThusREMsleepisatleastfivetimesmore
conservativeoftheaminesthannonREMsleepandtentimesmoreconservativethanwaking.
Thesecalculationsarebasedontheassumptionsthatthereleaseofthechemicalmodulatorsisdirectlyproportionaltothefiringrateoftheneuronsandthatthereisno
releasewhenthecellsdon'tfireatall.Bothassumptionshavenotbeenprovendirectly,butthegeneralconclusionthatfarfeweraminesarereleasedinREMsleepthan
ineithernonREMsleeporwakinghasbeenprovenbyexperimentsthatmeasuretheirconcentrationinthebrain.Thesamemethodshavealsoshownreciprocal
increasesinacetylcholine.
REM,itseems,issomesortofsupersleep.Thefirstreasonforaccordingitthisstatusisthat,althoughitnormallyoccupiesonlyabout20percentofthetotaltimewe
sleepeachnight,ittakesonlysixweeksofdeprivationofREMsleepalonetokillratscomparedwithfourweeksforcompletesleepdeprivation.Basedonitsrelative
durationofonly20percentofsleeptime,wewouldpredictthatfivetimesaslongadeprivationperiodwouldberequiredifbothstateswereequallylifeenhancing.On
theseterms,oneminuteofREMsleepisworthfiveminutesofnonREMsleep.
ThesecondreasonsupportingtheideaofREMassupersleepisonethatisattractiveforthenappersoftheworld:thereisasurpris

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inglybeneficialnatureofshortnapsiftheyoccurattimesinthedaywhenREMsleepprobabilityishigh.Daytimenapsaredifferentfromnightsleepinthatwemayfall
directlyintoaREMperiodandstaythereforthedurationofthenap.SincethetimeofpeakREMprobabilityisgreatestinthelatemorning,thetendencyofnapstobe
composedofREMsleepishighestthenandfallsthereaftertilltheonsetofnightsleep(abouttwelvehourslater).Theimplicationisthatalittlebitofsleep,attheright
timeofday,maybemoreusefulthanthesameamountlateron.
Thethirdreasonisthat,followingthedeprivationofevensmallamountsofREMsleep,thereisapromptandcompleterepayment.Thesubjectwhohasbeendenied
REMsleeplaunchesintoextendedREMperiodsassoonasheisallowedtosleepnormally.Inrecentdrugstudies,whenREMsleepwaspreventedthepayback
seemedtobemadewithinterest.MoreREMsleepwaspaidbackthanwaslost.
Ofcourse,alltheseconsiderationshaveignoredtheprospectthatwemightderivebenefitsfromtheriseofacetylcholineduringREMsleeptoo.Unfortunately,how
acetylcholinemightconferitspositivetrophotropicbenefitsisasyetobscure.Onepossibilityisthatexposuretohighlevelsofacetylcholinemightaffectcell
metabolism.Ifso,thiswouldindicatealinkbetweenbrainmindstatesandgenetics,anexcitingscientificprospect.
Thefieldofbrainmindresearchisonthethresholdofaninevitableunionwithmolecularbiology.SincebothREMsleepandDNAwerediscoveredin1953,thisisa
ratherlatemarriage.Theneuromodulatormoleculesnorepinephrine,serotonin,andacetylcholineoperateonthemembranesurfaceofcells.Genesarelarge
moleculesthatliedeepinthenucleusofthecell.Genescommunicateviamessengermoleculesthatferryinformationfromcellmembranestothenucleus.Thereis
evidencethattheneuromodulatorsmayaffectthiscommunication.Ifthisisthecase,thennorepinephrine,serotonin,andacetylcholinemayaffectthecommunication
betweengenes.Andsincetheyaffectthebrainmindstates,theywouldprovidealinkbetweenourgenesandourstates.
Thuswecancontemplateaveryintimateconjunctioninbiol

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ogy:thecouplingofsleeptoourgenes.FromsuchaunionthefathersofDNAandREMsleep,FrancisCrick,JamesWatson,EugeneAserinsky,andNathaniel
Kleitman,couldexpectabevyofbeautifulscientificgrandchildren.
Myhypothesis,andthatofmanysleepscientists,isthateachofthethreemajorbrainmindstateswaking,sleeping,anddreamingwillprovetobequitedifferent
statesataverydeeplevel,thatofgeneexpression.Genesoperatebymakingenzymes,andenzymesareessentialtosynthesizingnorepinephrine,serotonin,and
acetylcholine.Wemightexpect,then,thatinREMsleepthegeneticmanufactureofenzymesthatsynthesizethenorepinephrinemoleculewouldbeturnedonwhen
acetylcholineinteractswiththemessengercellscommunicatingwiththegenes.ArelatedconceptwouldbethatthedisappearanceofnorepinephrineduringREMsleep
mightsignalgenestocrankoutmoreoftheenzymesthatmakeit.Eitherway,bythetimewewakeupenoughnorepinephrinewillhavebeenmanufacturedsothatthe
aminergicsystemisreadytogo.Whatscientistsneed,now,arewaystostudythegeneticbiologyofsleep.Asgeneticsandbrainmindtheorycometogether,wewill
findbetterexplanationsofhowstatesaffectenergy,mood,andhealth.
TheStateofDepression
Meanwhile,wearemakinggreatprogressinunderstandingsomementalillnessesthatwouldseemtobedirectlylinkedtoenergylevel.Peoplewhoaredepressed,for
example,sleeppoorlyandoftencomplainoffeelingtired.Theywanttosleepallthetime,yettheirsleepdoesnotrejuvenatethem.Theirbodiesfeel"heavy,"and
alertnessisreplacedbyakindofdazedsemiconsciousness.Exercise,whichmostpatientswithdepressionknowwouldhelpbreaktheforceofthisviciousdownward
spiral,isnotinitiatedbecausepeoplesufferingfromdepressiondon'tfeellikeexercising.Theycan'tgetupenoughenergytodoitinthefirstplace.Thetrophotropic
systemseemstoactwithoutopposition,pullingthesepeopledown,down,downintothesloughofdespondencyand

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lethargy.Foodbecomesunappealing,soenergysuppliesdecreasefurther.Weightlossthenoccurs.Sexualenergyandlibidoaregone.Thesepeopleareontheirway
toavegetativedeath.
Whatisgoingoninthestatecontrolcentersofthebrainstemduringdepression?Howarethebrainmindstatesaffected?Andhowcantheviciouscyclebereversed?
Peoplewhosufferfromdepressionexhibittwosignificantshiftsinsleeprhythm:oneaffectsthetimingofrestandactivityacrossatwentyfourhourdaytheother
affectsthetimingofthefirstREMperiodduringsleep.Bothmayhaveacommoncausetheloweredefficacyoftheaminergicsystem,whichrevsupthebrainduring
wakingandmediatesthestormofacetylcholinereleaseduringsleeping.Peoplewhoaredepressedaredirectlyexperiencinglowebbsofchemicalpowerintheirbrains
andbodies.
Thefirstproblem,thatofthetimingofsleepandwaking,arisesbecauseournaturalsleepwakecycleisnottwentyfourhours.Scientistsknowthisbystudyingpeople
whoareisolatedfromtimecuesexperimentsperformedonpeoplewhoaresequesteredinundergroundbunkersshowthatournaturalcycleisfrom24.3to25.0
hours.Therefore,iflefttoourowndevices,wewouldgotosleepabitlatereverynightandwakeupabitlatereverymorning.
Wedon'tfollowthissleepphasedelay,though,becauseourbrainmindsusesocialcues,clocks,adherencetoworkhours,andsuchtoresetoursleepcycleviaour
behaviorsothatitfallsintoatwentyfourhourphase.Ourphysiologyhashelpedusadaptalsotheinternalclockthatcontrolsourdailycycleisinthehypothalamus,
justabovethepituitarygland.Itislocatedjustbehindthecrossingpointofthetwoeyenerves.Theeyenervessendfibersdirectlyintothehypothalamus.Scientists
assumethesefibersconveyinformationaboutdaylengthtohelpthebrainclockresetitselfeachday.
Thepropercareandmanagementofourbrainmindstatesthusinvolvestherewindingofourbrainclocks.Peoplewhosuccumbtodepressionfailtoresettheirclocks
properly.Ithasbeenshownthatuseofartificiallight,andevensleepdeprivation,canhavebeneficialeffectsondepressedmood,byhelpingthebrainandbodyget
themselvesbackintophase.

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ThesecondproblemfordepressivesisthetimingofREMsleep.Ironically,eventhoughdepressivesarealwaystiredandalwayswanttosleep,moresleepistheirown
worstenemy.REMsleepmakesdepressionworse,andREMdeprivationmakesdepressionbetter.Howcanthisbe?
Depressedsubjectswhoarestudiedinthesleeplabexhibittwounusualcharacteristics.First,theyareunlikelytohaveanydeepnonREMsleep.Althoughwearenot
surewhythisisso,theoutcomesuggeststhatthedepthofsleepislessened,accountingforitsunrefreshingquality.SomorenonREMsleepwillnothelpthe
depressive.
ThesecondoddcharacteristicisthatthefirstREMsleepperiodoccursearlier,lastslonger,andismoreintensethanusual.Itisasiftheprocessthatnormallyrestrains
REMsleepisweakened,whiletheprocessthatnormallydrivesitisintensified.REMsleepisnormallyrestrainedbynorepinephrineandserotoninalthoughtheyare
down,theyarenotoutduringdreamingandputatleastsomereinonthecholinergicsystemthatcausesREMsleep.Itisnosurprise,though,thatthestrengthofthe
aminergicsystemwouldbediminishedindepression.Thecauseofenergylossinthebodyresultsfromadepressedsympatheticnervoussystem,thatis,adepressed
aminergicsystem.Aparallelweaknessappearsinthebrain'saminergicsystem.Thebodyandthebrainmindsufferfromaminergicinefficacy.Failureoftheaminergic
systemcouldbeduetoseveralthings:thebrainstemisn'tmakingenoughnorepinephrineorserotoninorthebrainstemisnotdeliveringthechemicalsfastenoughto
theirtargetsorthosetargetsarenotreceptivetothechemicalswhentheyarrive.
Thisreducedabilitytoreceivetheaminesmaybeaconsequenceofanxiety.Anxietycausesexcessivetransmissionofamines,whichdemandsexcessivereceptionof
amines.Overtime,ourcellssimplycan'tkeepuptheirabilitytocontinuallyacceptaminesbecomesexhausted.
Whateverthecause,weneedtogivetheaminergicsystemajumpstart.Itneedsajoltsothatitwillkickoverandsquirtoutsomeofthathighenergyjuice.Perhaps
that'swhythetreatmentofdepressionbyelectroshockissometimessoeffective,orwhya

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goodgameofsquashoragoodaerobicworkouthelpsusfeel''up."Whenweexercise,weforceouraminergicsystemtoincreaseoutputmorenorepinephrineis
neededtorevupourheartrateandbreathing.Aparallelheighteningofnorepinephrineoccursinthebrain.Withregularexercise,theaminergicsystembecomesmore
robustandisbetterabletocontrolREMsleep,bringingthedepressivebackintothepropersleepcycleandslowlyliftinghimoutoftheabyss.Joltingoftheaminergic
systembystimulantdrugsisalmostcertainlythereasonthattheyworktootheymimictheactionofnorepinephrineandenergizeus.Theyaren'tcalled"uppers"for
nothing.
CouldREMsleepdeprivationbeanotherwayofstrengtheningtheneuronsthatproduceamines?Atfirstglance,itmayseemso.PreventingREMsleepwoulddepress
thecholinergicsystem,allowingtheaminergicsystemtogainbacksomeground.Butthiswillneverworkforthelongtermbecausetensionwillbuildupinthe
cholinergicsystem,andatsomepointitwillovertakethebrainmindinadangerousway.Remember,that'swhatcausedmetohallucinatemysuddenhelperatthe
woodshed.AndrememberthatREMsleepdeprivationinlabanimalsleadstodeath.That'salltoodefinitiveacure!
HowaboutmoreREMsleep,say,bynapping?Nohelp.Depressedpeoplewhonapwakeupevenworsethantheywerebefore.Weird.Shouldn'ttheyhavesaved
someenergyifREMsleepissupersleep?No,becausethedepressedperson'ssystemisalreadyhypersensitivetoacetylcholine.Thelastthingadepressive'sbraincells
needisarisingfloodofacetylcholineduringREMsleep.
Wecantestthisinthelabwithacholinergicdrugcalledarecoline.Whenadministeredtoanormalpersonwhoissleeping,ittriggersadreamepochduringnonREM
sleep.This"cholinergicdreaming"isanalteredbrainmindstatecausedbydeliberatechemicalintervention.Itmightbe,then,thatbyusingthisdrugtotriggerdreaming
duringnonREM,adepressive'saminergicsystemcouldrecuperateduringtheseepochs.ButtheplanbackfiresbecausetheinducedREMsleepturnsontheperson's
cholinergicbraincells,whichproducemoreacetylcholine,towhichtheyare

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alreadyhypersensitive.Heretheviciouscycleofdepressionrevealsitselfatthecellularmolecularlevel.
AntidepressantDrugs
Somethingmoredefinitivemustoccurifariseinthepoweroftheaminergicsystemistobesustained.Recentdiscoveriesindicatetheplacetolookiswithinourown
DNAourgenes.Thismaybeaclueastohowtheantidepressantdrugsreallyworkandwhytheyoftentakesolongtopeppatientsup.
Untilwefindtheexactmechanism,peoplewhosufferfromdepressioncantakesolaceinknowingthatantidepressantdrugsdowork.Allthedrugsofthenowlegion
classofantidepressantshavethedesirablepropertyofincreasingthepoweroftheaminergicbraincells.
Manyoftheantidepressantsarenotonlyproaminergicbutalsoanticholinergic.Theyinterferewiththeabilityofcellstoproduceacetylcholine,whichisdesirable
becausethedepressivepersonishypersensitivetoacetylcholine.Thisaidisnotwithoutabadside,though.Acetylcholinemediatesmanymechanismsinthebrainand
body,andthedrugsarenotselective.Theyacteverywhereinthebodythatacetylcholineacts.Thiscausesmanysideeffects,suchasdrymouthandfainting.Sointhe
longrunknowingthespecific,cellularmechanismofdepressionwillserveuswell.
Immediately,whenadepressedpersonstartstotakeoneofthesedrugs,hisdistinctivesleepabnormalitiesarereversed.Butthechangesinbraincellchemistrydonot
immediatelyanddirectlyaltermood.Somelater,longertermprocessisinvolved.
Topicturethislongtermprocess,considerthetimeittakesforacountrytomobilizedefenseforces.Whenwarisdeclared,thecitizensareinalarm.Theyimmediately
initiatestrategieslikerunningthemunitionsfactoriestwentyfourhoursadayandconvertingchemicalplantsfromthemanufactureofnitratefertilizertothemakingof
nitroglycerine.Weturnplowsharesintoswords,butitmaytakemonths,oryears,toreachpeakproduction.Inthebrain,ittakestwotothreeweeks.

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RestoringEnergy,Mood,andHealth
Sleepandtheantidepressantdrugsbothappeartobekeystothesamelocks.Thewaysleepbeatstheflumayhavemuchincommonwiththewaythat
antidepressantsaltermood.Thebrainandtheimmunesystemarehomologousinrequiringanappreciabletimetomobilizetheforcesthatgiveusenergyhealth,andour
senseofwellbeing.
Inthecaseoftheimmunesystem,itisnothardforustoimaginewhyittakessometimetodefeatamicrobialinvader.Theantibodyfactoryhastobeturnedonand
mustproduceenoughmoleculestoslowthegrowthoftherapidlymultiplyingbacteriaorvirus.Inthetimeittakestogetthedefensesystemmovingtheinfectious
agentsmaynotonlybeproliferatingbutdigginginandlikeaninvadingarmymakingthemselvesmoredifficulttodislodge.Infections,likewars,cangoonand
on.
Peoplewhoaredepressedareoftennotonlylowinenergybutsostuckintheirthoughtsthattheycan'tgetgoinginanydirection.Theirideasbecomesoblackand
theiroutlooksobleakthattheydon'tevenseethepointoftryingtogetgoing,orconsultingadoctor,ortakingthepillshemayprescribe.Andjustastheydonot
usuallyfallintothesloughofdespondencyovernight,theyrarelypulloutofitinaday.Theselongtermeffects,Ipropose,canworkonlybychangingthemetabolism
ofourbraincells.Thesecellsareslowtofallandslowtoriseagainevenwhenpushedbythehelpinghandofadrug.IwillreturntothistopicinPartThree.
DeliaandBertal
Depressionisadisorderofenergy.Thefirststeptowarddepression,ageneralfeelingofbeingdown,maybebroughtonbyanumberofcauses.Itcanariseduetoa
senseoflossfollowinganythingfromdeathofalovedonetobankruptcy.Itcanalsobebroughtonbyanxiety.Peoplewhoallowthemselvestobeovercomewith
anxietystarttofeeltheyaretrapped,theycan'twintheyarealreadyslidingdowntheslipperyslopeintodepression.

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Theirmindsays,"Ican'tdoit,"andtheirbodysays,"Ihavenoenergyforit."Thereisaparallelpsychologicalandphysiologicalresponse.Thisisnosurprise,sincethe
aminergicsystemsofthebrainandbodyarelinked.
Ifthisistrue,andtheunderlyingpremiseofthisbookthatnormalandabnormalstatesarevariantsofthesamethingholds,thenasimilartriggerfordepression
shouldcausesimilarsymptomsinsomeonewhoisemotionallystableandsomeonewhoispsychotic.Wehavetworeadysubjectstocompare:DeliaandBertal.
DuringthetimeDeliawaskeepingherjournal,thereweredayswhenshe,likeeveryoneelse,didappeartobeanxious.AfterIgottoknowherabitbetter,itbecame
clearthatherownanxietywasrelatedinparttolivingalone.Generally,Deliacouldhandlethisanxiety.Butonceinawhile,whenshewasstarklyremindedofher
difficulties,shewouldfeelsodowntroddenthatshewantedtostayinbedinsteadofgettingupandgoingtowork.
Thislocalizeddepressionthepsychologicalfeelingofbeingdownandthephysicalfeelingofbeingtiredappearednotonlyinherwakingstatebutinher
dreamingstateaswell.Thisindicatesthatalthoughdreamemotionhasaconsistentprofilethatiswidelysharedbymostpeople,therestillmightbeimportantshiftsin
thatprofileasindividualsundergolifestress.Inthecaseofthelossofalovedone,forexample,wemightexpectboththedreamcontentandthedreamemotionto
reflectourpain.
Delia's"Animation"Dream
IwaswatchingwhatItooktobeapieceofanimation.Theviewpointoftheobserverwasfloatingintoanelaboratewatergardenlikesceneoftrees,sky,andstillwater.Thepiece
impressedmebecauseitwasallapparentlydonewithwatercolors,adifficultmedium,andsincetheviewpointwassweepingintothepiece,noloopscouldbeusedinanimating
thesequenceeachpanelhadtohavebeenpaintedseparately.Thiswouldhavemeantanimmenseamountofworktoproduceevenashortpiece.
Thesceneshiftedtoasceneofanoldworldcitystreet,likean

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alleyway,surroundedbythebrickwallsofbuildingsandwithpeoplewalkingonthesidewalks.Again,Iwasamazedbythedetail.Thepeoplelookedreal,butIknewthescene
wasnotrealandIcouldn'tfigureouthowitwasdone.Itlookedlikeitmighthavebeendonewithstillmotionphotography.Islappedabrickwallandpoppedmylipswithmyhand
toseeifthesoundcoincidedwiththescenery.Itdid.Idecideditmusthavebeendonewithcomputeranimation.
Thedreamagainshifted,thistimeintoanoperaperformedbymyfatherandmother.Anothermanwastryingtostealmymotheraway.Myfatherintervenedtotakemymother
back,butmymotherranbacktotheotherman.Myfatherthenpulledherawayandlookedlikehemighthither.AtthatpointIintervenedmyselftopreventthis.Myfather
stompedofftoamen'sroomandmymotherescapedtoalady'sroom.IcommentedtoLarry,whowasthereandwithwhomIwasgoingtoseeamovie,thatnomatterwhat
everyonewassaying(sincetheoperawasinanotherlanguage)theactionhadputmeinafoulmood.

Thedayfollowingthedream,Deliawasverydepressed,notonlybecauseofthedream,butalsobecausementallyandphysicallyshefeltdefeated.Feelingsofanxiety
hadmountedtoapointthattheytriggeredapsychoticeventadreamaboutherparents'marriage.Andafterthedream,Deliafeltmoredepressedthanbeforeit.
ThisisexactlythesamepatternBertalexperienced.HismotherbroughthimtoThePsychoashorttimeafterhehadreceivedapromotionathiselectronicsjob.He
couldn'thandletheincreasedresponsibility.Hefeltlikeafailure,andhisselfesteemplummeted.Theanxietybuiltinsidehim.Duringthetwoweekspriortothedayhis
motherconvincedhimtogetintothecar(soshecoulddrivehimtoThePsycho),hehadwithdrawnmoreandmorefromhouseguests,hissiblings,andevenhis
mother.Heatepoorlyandbegantoloseweight.OncehegottoThePsychohebecamestillmoreanxiousandbegantohavepsychoticepisodeshallucinations.
Aftereachepisode,hewasintractable.RememberwhenIfoundhimonthekitchenfloorafterahallucination?Hestayed

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theremotionlessforanhourhecouldnotmoveevenifhehadwantedto.
Whenhewasattheheightofhispanic,hespokeonlyinshort,crypticphrases,indicatingastrongpreoccupationwithsexandviolence,suchasthefollowing:
"S.O.S."
"Theresaishavingababy."
"Communists."
"Shocktreatmentdestroysthebrain."
"Violencedestroysthebody."
"Kotex."
Followingthatscenehewasseverelydepressedforseveraldayshestayedinbedmuchofthetime,didnotcometohisscheduledsessionswithme,andatelittle.
Bertal'ssymptomsweremuchmoreextremethanDelia's,buttheyarosefromthesamepsychologicalsource,followedthesamesequence,andhadthesameeffects
onmindandbody.AndneitherDelianorBertal,intheseinstances,gotoutofthedepressionuntiltheygotoutoftheirbedsandgotbackintotheirroutines,which
raisednewbutmanageableandfamiliarchallengesthatgottheiraminergicsystemsgoingagain.
Wenowknowthatjumpstartingourenergysystemscanoftenbeachievedmoreeasilybygivingtheaminergicsystemachemicalkick.Inthelastchapterofthisbook
Iwillexaminetheprosandconsofexercisingthisoption.Althoughtherearesomeproblemsassociatedwithanydrug,thenewantidepressantsareparticularly
attractivebecausetheydoincreasethepowerofthebrain'saminergicenergysystem.

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Chapter12
WhatIsConsciousness?WhatIstheMind?
Inpartone,Idescribedthebasicchemistryofthebrain(theaminergiccholinergicsystem)anddefinedthreeoftheforces(activationenergy,informationsource,and
modulation)thatdictatethestateweareinateverymomentofourlives.Ourmanybrainmindstatesarecontrolledbythesevariables,andasthevariableschange,
ourbrainmindsmovefromonestatetoanother.
InthelastsixchaptersIhaveshownthatthemajorfacultieswepossessashumanbeingsdependonthestateofthebrainmind.Whenweareawake,"perception"
meansonethingwhenweareasleeporpsychoticordaydreamingorpanickedperceptionmeanssomethingquitedifferent.
Nowthatitispossibletodescribehowourstatesaregeneratedandhowtheyaffectallthatweexperience,Iproposetoanswertwoofthemostfundamental
questionsinpsychologyandneurology:Whatisconsciousness?Andwhatisthemind?
Ifmysenseofidentity,location,andtime(orientation),myrepresentationsoftheworld(perception),mystoriesandbeliefsaboutmylife(memory),myemotional
statesandinclinations(emotionandinstinct),mycapacitytodirectmyperceptionsandthoughts

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(attention),andmywellbeingandzestforlife(energy)allarisefrombrainmindstates,thenIposittwotheorems:(1)Themindisalltheinformationinthebrain.(2)
Consciousnessisthebrainsawarenessofsomeofthatinformation.
ANewDefinitionofConsciousness
Onthefaceofit,thesetwostatementsmayseeminnocuousenough.Butifyouthinkaboutthemclosely,youwillseethatIprobablyhavejustdiscardedyourvery
senseofwhoyouare,andIhavecertainlyforsakenthedefinitionsofmindandconsciousnessusedbymostpsychologists,psychiatrists,neurologists,and
philosophers.Foronething,itappearsthatIhaveputthecartbeforethehorse.
Mostpeople,andmostscientists,shareacommonnotionthatthemindspringsfromconsciousness.Whenwesleep,wesayourmindsareatrestsinceour
consciousnesshasbeen"turnedoff."Wesaysomeonewhoispsychoticis"outofhismind,"meaningthathehaslostanawarenessofhimselfandtheworldaround
him.
Weevengosofarastobelievethatthereisa"seatofconsciousness"inourbrainssomewhere.ThisideagoeswaybacktoRenDescartes.Hedesignatedthepineal
glandastheseatofawareness,theseatofthesoul,becauseofitsbudlikestructureanditspositioninthemiddlebrain.Wewouldbeequallymistakentodayifwe
designatedtheponsastheseatofconsciousnessbecauseitregulatesthechemistrythatcontrolsourbrainmindstates.Consciousnesscannotbelocalizedinanypart
ofthebrain,noteventhecortex.Itisdistributedinmanypartsofthebrainandbeyond.
Whydoesthisseemtooffendus?Isitanylesssatisfyingtosaythatconsciousnessiseverywhereinourbrainmindsandeveninourbodies?Ifwebrushagainstahot
stove,ournerveendingssendmessagesthatindicate,"Wow,that'shotbetterstayawayfromit.Andifourhandhappenstotouchtheburner,itisjerkedawaybya
reflexactionthatbypassesthebrainaltogether.Inbothcases,weareawareoftheworldandarereactingtoit.Isthisnotconscious

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ness?Isayemphatically,yes!Althoughmysensorynervesarenot,themselves,capableofrepresentingtheworld,theinterconnectedcellsthatreceivetheirsensory
messagesare.Theactivationstateofeventheselowlynervefibersisanessentialcomponentofmyconsciousness.Thelevelandkindofconsciousnessthatanybrain
mindwillhaveisafunctionofthenumberofneuronsitpossesses,thenumberofinterconnectionsbetweenthem,thelevelofcomputationthattheycansupport,and
thenatureofthestatesduringwhichthesecomputationstakeplace.
Withinanygivenindividual,likemeoryouorDeliaorBertal,consciousnessvaries,continuouslyandgradually,throughaninfiniterangeoflevelsfromcomato
enlightenment,frompsychosistopoetry,fromopensuggestibilitytorigidbigotryasthesimpleresultoftheprocessingthatisgoingoninourbrainsandthedatathat
isbeingoutwardlysensedandtappedfromwithin.Withthisview,wecanbegintoconsiderhowconsciousnessdevelopswithinmembersofaspeciesandacross
species.WhenmydaughterJuliawasababy,shecouldfeelrageaspartofaprimordialconsciousstatelongbeforeshecouldname,tame,orexplainit.Bothmydog
andcatcanfeelshameandcanrecognizemeastheirfriend,withoutknowingwhatshameisorthatIamanentityknownasaperson.
Allowingthatconsciousnessdevelopsgraduallywithinandacrosscreatureshasthegreatadvantageoffreeingtheconceptfromthestraitjacketoflanguage,inwhichit
hasoftenbeencorseted.Tobesure,languagedoesconferaspecialqualitytotheconsciousnessofthosecreatureswhocanspeak,becausetheirinternal
representations,aswellastheircommunicationswithothers,canbebothpropositionalandabstract.Forhumans,possessinglanguagethrustsconsciousnessupto
suchalevelofrichness,complexity,andinventivenessthatithaspromptedustodrawaselfcongratulatorylinebetweenourownspeciesandallothers.ButIdefyyou
tofindasinglepetownerwhowouldsayhisanimalfriendisdevoidofconsciousnessorevenaconscience.Furthermore,hewouldcertainlysayhispetissometimes
happyandothertimessad.Thelinebetweenusand"therestoftheanimalworld"hasbeensharplydrawnonlybecauseitreinforcesthe

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dogmaticviewoftheuniquenessofhumanityanditsplaceinthegrandschemeofthings.
Thisviewisflawed,nottomentionconceited.Consciousnessvarieswitheachstate,withinaspecies,andbetweenspecies.Andaswehaveseen,thebrainisnever
"turnedoff"orevenrestingitisprocessinginformationallthetime.
ANewDefinitionoftheMind
Ifconsciousnessisthebrain'sawarenessofsomeofitsinformation,thenwhatisthemind?Itissimplyalltheinformationinthebrain.Inthisdefinition,mindismore
fundamentalthanconsciousnessbecausemostoftheinformationthatisinthebrainatanypointintimeisnotconscious.Wecannotsensetheprogramsthattellushow
tobreathe,whentosleep,howtoremember,andevenhowtothink.Italljusthappens.Thebestwecandoisfigureouthowtousethesecapabilitiestoour
advantage.
Thiswillbeastickyplaceformanyreaders.Itishardtoacceptthat"themind"includessuchbasicactivityastheroutinefiringofneuronsthatkeepsusbreathing.ButI
hopetoconvinceyouthatbyacceptingthemodestproposalthatthemindincludesnonconsciousbrainactivity,youwillgainimportantintellectualfreedomandpower
atthecostofonlyhubrisandselfglorification.
Broadeningthedefinitionofmindtoincludethegeneticallydeterminedinformationthatisinthebrain,aswellasthatwhichisacquiredor"learned,"willalsostrike
manyreadersasnotonlydegradingbutdownrightdangerous.Doesn'tthismaketheword"mind"almostmeaningless,sincepracticallyeverythingaboutthebrainis,in
asense,storedinformation?Inthisview,theword"mental"alsoseemstobedowngraded.Weconsiderourselvesmentalandotheranimalsnot.Weequatemental
functionwiththinking,butinsidethebrain,performingamathexerciseorarguingoverFreudisnodifferentfromkeepingtheheartgoing.Ineachoperation,neurons
arecommunicatingwithotherneuronsinexactlythesamewaytheyarejustdifferentneuronsfiringindifferentplacesinthebrain.
Whatweareafterhereisamoreaccurateandusefulviewof

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theconceptofthemindthantheoneaffordedbytheanthropocentricviewthatmindentailsconsciousness,andthatconsciousness,inturn,entailslanguage.
Supposeasnaillearnstoassociateashockstimulustoitstailwithapainfulpricktoitssnout.Intimeitwillwithdrawitssnoutwhenitstailisshockedwhetherornotits
snoutissubsequentlypricked.Thisisclassicalconditioning,thefundamentalparadigmoflearning,andithasprovenimmenselyusefulinoureffortstounderstandthe
cellularandmolecularbasisofhowourownthoughts,feelings,andactionsareshapedbyexperience.Sodoyousaythatthisisnotmentalactivitybecausesnailsdon't
haveconsciousnessandthereforetheydon'thaveminds?Ordoyousaythatanylearningismentalbecauseitchangesthestatusofinformationinthesnail'sbrain?
Mentalityistheprocessingofinformation,whetherornotitisdoneconsciously.
Let'sreconsiderDelia'sdreams.DreamingisaconsciousstateofDelia'sbrainmind,despitethefactthatshedoesnotexperienceitinthesamewayshewouldif
awake.Thismeansthereisacontinuityofthemindintheabsenceofwakingconsciousnessthepeople,plots,andemotionsofDelia'sdreamscarryoverdirectlyfrom
thepeople,plots,andemotionsinherwakinglife.Hermindthesamemindthatoperateswhensheisawakeisoperatingwhensheisdreaming.
AndwhendidDeliastartexperiencingthisbrainmindstatecalleddreaming?Didshebegintohavedreamsbeforeshelearnedtospeakoronlyafterherspeechhad
developed?Inotherwords,dobabieshaveminds?Almosteveryonewouldsayyes,theydo,eventhoughitisimpossibletoknowforcertainwhetherornottheyare
consciousinanywaythatresemblestheadultsenseoftheword.Andtheycertainlydon'thavelanguageattheirdisposal.When,then,didDelia'smentallifereally
begin?DidDeliaalreadyhaveamindandsomesortofdreamexperiencebeforeshewasborn?WeknowshehadlotsofREMsleepwhenshewasfloatinginher
mother'suterus.WhendidDelia'sdreamingbegin?Canwedrawasharpline?Idon'tthinkso.
Aswiththesnail,thequestionbecomesthis:Atwhatlevelofbraindevelopmentdowesay''themindbeginsnow."Thereis

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none.Themindisnothingbuttheinformationinthebrain,anddreamingisnothingbuttheactivationofthatinformation.Assuch,allbrainactivationisdeeplyand
essentiallymental.
Iamquiteawareofthepotentialforabusethatthislineofreasoningofferstothosewhoholdthatabortionshouldbebannedbecausethehumanmindbeginsatthe
momentofconception.TothemIwouldsaythatsuchdecisionsmustbelefttoprospectiveparentswithoutregardtothescientificallyunresolvableissueofwhen
consciousnessormindbegins.Wecanneversayconclusively.Furthermore,atnopointinmytheoryisthereanyplaceforaseparateentity,whetheritbecalledmind
orsoul,thatcouldeitherantedateorsurvivethebrain.Whatevermindorsoulthereis,itisborn,lives,anddieswiththebrain.Infact,therearecaseswhenthemind
dieswhilethebrainisstillalive,butisnolongercapableofselfactivation.Technicallyandlegally,werefertothispermanentstateofinactivationas"braindeath."
ConsciousandNonconscious
Ihavesaidthatconsciousnessisthebrainmind'sawarenessofsomeofitsowninformation.Thisbearsfurtherexplanation.Butfirstletmebeclearonterminology.
Muchoftheconfusionaboutwhatconsciousnessis(orisn't)andaboutwhatmentalactivityis(orisn't)stemsfromthewelterofcontradictorytermsusedtodescribe
thesupposedstrataofthemind.
Wehaveallheardoftheconscious,thesubconscious,theunconscious,thenonconscious,thepreconscious,therepressedunconscious,andsoon.Whatamess!All
weneedaretwoterms:consciousandnonconscious.
Historically,psychologistsandwritershavereferredtotheunconsciousandsubconsciousmindsassynonymousyetdifferent."Subconscious"istakentomeanjust
belowconscious,whileunconsciousimpliesanegative,thatis,noconsciousness.Sure,ifyou'rehitovertheheadwithabrickyou'llfalltothegroundandbe
unconscious.Asamedicaltermthishassomeusefulness,butthatisall.Freudcomplicatedmattersfurtherbydividingtheunorsubconsciousintoasegmentthathas
accesstoconsciousness

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(the"preconscious")andonethatdoesnot(the"dynamicallyrepressedunconscious").Freudbasedhiswholetheoryofmentallife,includingdreamsandpsychosis,on
thisconception.Allthesecategoriesarejustthatartificialconstructs.
Giventhemonumentalsizeofourcurrentignoranceofthesematters,itseemswisesttonotesimplythatmostoftheinformationinthebrainisnonconsciousandto
keepanopenmindaboutwhatdatacanbeadmittedorexcludedfromconsciousness.Italsoseemswisestforasimpleandobviousreason:ifourmindisallthe
informationinourbrain,thentheinformationiseitheraccessible(conscious)orinaccessible(nonconscious).Itcannotexistinanyothermode.
Thisisnotarigidsegmentation.Datacanmovefromonemodetotheother.RemembermylonglostchildhoodfriendDickTinguely,whopoppedintomydreamone
nightafterafiftytwoyearabsencefrommythoughts?Hewasburiedinmynonconsciousmindallthattime,yetonenightcrossedoverintoconsciousness.Allour
thoughtsandwilledactionsareconscious.Themotorprogramsthatcontrolourthinkingandmovingarenonconscious.Andyet,peoplewhoaresupposedlyparalyzed
sometimes,somehow,canbegintogetmovementbackbysheerwill.Peoplewhoputthemselvesintoadeeptrancecansometimes,somehow,slowtheirown
heartbeats.We"crosstheline"ourselvesinlessmysteriousbutnolessimpressivewayseveryday,whenwedaydreamandwhenwehaveournightlyREMsleep
dreams.
Acorollary,boldbutsimple,isthatalltheinformationinthebrain,whetherconsciousornonconscious,ismentalinthatitcanservetosolvetheorganism'sadaptive
problemsandaidinachievingthetwolifegoalsofsurvivalandprocreation.
Theinformationthatcanmovefromthenonconsciousintoconsciousnessincludesmuchofwhatwecallmemory.Memoryconsistsofperceptionsthatwecancall
forthasimagery,mostofouremotions,mostofourinstincts,andavastsetofproceduraltalents.Manyofthebrainprocessesthatarerequiredtorepresentthese
kindsofdataarethemselvesbelowthereachofconsciousness.Iproposecallingtheaggregateofthesebraininformationstatesthenonconsciousmind.Wecannot
intuitivelyknowour

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nonconsciousminds.Onlyobservation,inference,andexperimenthelpusrealizeitsexistence.
Thedivisionofmindintoconsciousandnonconsciouscomponentshasmanyimportantadvantagesovertheoutmodedbutstillpopularmodelofpsychoanalysis.The
mostimportantadvantageanddifferenceofthenewmodelisthatitaccomplishespreciselywhatFreudwantedtoachievewhenhesetout,in1890,tocreatea
scientificpsychology,aprojectthathelaterabandoned.Insteadofcreatingaburdenbyinsistingthatahiddencausefordreams,hallucinations,anddelusionsexistsin
someinteractionbetweensupposedlayersofthemind,thenewmodeloffersasimpleexplanation:theimageryandemotionsofdreamsarealwayswithus,ridingin
ournonconscious,andwhenwechangestatefromwakingtodreamingthisinformationisabletocrossintoconsciousness.Ourdreamsarenotmysteriousphenomena,
theyareconsciousevents.Here'sthesimplesttest:Areweawareofwhathappensinourdreams?Ofcourse.Therefore,dreamingisaconsciousexperience.
Notethatthebrainmindoffersamechanismforthisfreeflowofinformationitscontinuouslychangingstatesenableinformationtoflowfromnonconsciousto
conscious.Thephenomenonisinextricablytiedtobrainprocess.Whathappenswithinformationintheconsciousandnonconsciouscompartmentsofthemind
dependsonthestateofthebrain.
ThusIstronglyagreewithFreud'sassertionthatallmentaldataandallpsychologicalconceptsmustultimatelyfindtheirrootsinthephysicsandchemistryofthebrain.
Toomanyprofessionalcaretakerstodayhidebehindthehocuspocusofconfusedterminologyandunprovableassertionsinjustifyingthehighratestheychargetheir
patientsortheunfoundedtheoriestheyusetoobtaingrantmoney.
Thesefolkswillprovefataltopsychology.Asscientificfactreplacespsychologicalconjecture,theyarehidingbehindanewshieldcalledhermeneuticsthestudyof
texts.Ratherthanprovetheirassertionsanddiagnoses,theyarenowassertingthattheyneverclaimedtobescientific,thattheywereonlystudyingthetextsofFreud,
orstudyingtheutteringsofpsychotics,andinterpreting

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them,asifthisinsomepredictablewaywouldresultinhelptothosepeoplewithmentalillnesses.Itisbothlogicallyunjustifiedandethicallywrongtoarguethat
hermeneuticscanproceedindependentoftestingorproofbyanyothermeans.Itisalsowrongwhenpeoplewhopurporttobehelpingtheillpurelybystudying
textsmostlyreligiousscholars,universityprofessors,andpsychologistsclaimtopossesssomesortofhigherknowledgethatisaboveorbeyondexperimental
verification.Ournewmodelofconsciousandnonconsciousisentirelycompatiblewiththeburgeoningsciencesofthebrain(neurobiology),themind(cognitive
science),andtheintegrationofthetwo(cognitiveneuroscience).Itcanbetested,anditcanbeverified.
IstheMindCausal?
Itisimportanttotestournewviewofthemindagainstafundamentalrequirementofscienceandphilosophy:causality.Noexplanationofthephysicalormetaphysical
worldpassesmusterifitcannotbeexplainedintermsofcauseandeffect.AsSirIsaacNewtonfoundoutthehardway,applesfallfromtreesbecauseofgravity.
Gravityexistsbecausemassesattracteachother.Massesattracteachotherbecauseofforcesbetweenprotons,neutrons,andelectrons.Andsoitgoes.
Inournewviewofthemind,causalityisguaranteed.Thisissobecausetheworkingsofthebrainmindarerootedinthelawsofphysicsandchemistry,whichare
themselvescausal.Ariseoftheaminescauseswakingbeingawakefortheentiredayweakenstheamines,whichenablesacetylcholinetosurgethisbringsonnon
REMsleep,whichcausesaminestodroplowerandacetylcholinetorisesohighthatdreamingoccursthisenablestheaminestorestandregroup,whichcauses
wakingagain.Likewise,wakingenablesustoacceptnewinformationintoourconsciousminds,sleepingenablesustoetchthisinformationintothepermanent
memoriesofournonconsciousminds,andREMdreaminganddaydreamingandotherchangesinstateenablethatinformationtotravelbetweenthetwomodes.
Abolderview,whichsomewoulddebate,isthattheREMsleep

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statecaninitiateupwardcausationfromthenonconscioustotheconsciousmind.Inotherwords,aneventatthenonconsciouslevelthefiringofcholinergic
neuronscouldbesaidtocausethevisionsofourdreams.
Asacorollary,dreamforgettingiscausedbytheunavailabilityofnorepinephrineandserotonintothecellsofthebrainthatstorerecentmemories.
Theboldestandmostdifficultargumenttosustainisthatthereisdownwardcausationfromtheconscioustothenonconsciousmindluciddreaming,forexample.
SupposeIwanttonoticemydreams.Todoso,Iprimemybrainmind,beforeIgotosleep,torecognizelaterduringREMthatIamdreaming.Thistakessome
persistence,butitusuallyworks.SupposeInowdecidetowakeupfromadream.Icandosobyaneffortofwill.Thismeansthatmyconsciousintent,instantiatedas
aspecificchemicalprocess,hasactuallycausedtheREMstatetoabatesothatIcanawakenwithsharpandextensiverecallofmydream.
RealigningPsychologyandNeurology
Ifwecannot,exceptunderthemostunusualcircumstances,willinglyaccessourownnonconsciousmind,thenhowcanitbestudied?Thebestwecandoisto
objectivelyandexperimentallystudythenonconsciousmindinothersubjectsandapplythefindingstoourselves.Thereisnowayformetointuitdirectlytheneuronal
activationpatternsofmybrainstem.Icanconstructamodelonlybyobservingtheactivityofneuronsinsomeotherbrainandhypothesizethatmybrainobeysthe
samerules.IimaginethatItoopossessabrainstem.IassumethatmybrainstemcontainsaminergicneuronsthatstopfiringinREMsleep.Ifurtherassumethatwhen
mycholinergicneuronsbecomeenthusiasticallyactivetheyspritzmythalamuswithjetsofacetylcholineandIdream.Buteventhearticulationofsuchclearandspecific
ideascannotleadmetodirectlyperceivetheirreality.Icanperceiveonlytheireffectsonmyownconsciousstates.
Thenonconsciousmindisforeverclosedtoinvestigationvia

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introspection.ThisprinciplecastsfurtherlightonthefollyoftheFreudianenterprise.Freudbelievedthatthe"unconscious"couldbeinvestigatedviaintrospection.With
theassistanceofapsychoanalystversedinthemethodoffreeassociation,apersoncouldtracetheoriginsofbizarredreamcontentbacktorepressedinstinctual
wishes.Freudconcoctedawildpanoplyoffarfetchedexplanations,mostofthemsexual,fordreamstimuli,whenweknowtodaythatdreamsriseoutofsimplebrain
chemistry.WhenFreudsaidthatdreamingwasthe"royalroadtotheunconscious,"hefailedtorecognizethatonlyaverysmallpartofwhatactuallydetermines
dreamingiseveraccessibletoconsciousness.Tomakehisprogramworkhewasthereforeobligedtobendhisinterpretativeschemetothebreakingpoint.AsI
pointedoutindetailinmyfirstbook,TheDreamingBrain,practicallyeveryaspectofdreamingismoreclearly,moreeconomically,andmoreprofoundlyunderstood
bypassingthedetourtoFreud'sroyalroadandtakingthemainavenuetothenonconsciousmindaffordedbyneurobiology.
Animportantimplicationofthisargumentisthatconsciousness,howeverelegantandelevatedaphenomenonitmaybe,isextremelylimitedinunderstandingitself.
Scientistshaverepeatedlypointedouthowmisleadingandthereforeunreliableintrospectioncanbe.Ifweacceptthis,wecanlearntouseitbetterforthefew
thingsitcandowellsuchasdescribethesubjectiveaspectsofourbrainmindstateswithoutforcingittoexplaineveryfacetofourlives.
Thebrainmindparadigmthusunburdensconsciousnessfromaresponsibilityitcannevermeet.Itbringsaidintheformofchemicalexplanationsthatcanbetestedand
verifiedwiththeinvestigativetoolsofmoderntechnology.Indoingsoitshowswhynotonlypsychoanalysis,butallofspeculativephilosophy,isseverelylimitedinwhat
itcanhopetounderstandaboutthemind.Themindisnotonlyelusivebyvirtueofitsbeinghiddenfromitself,itisliterallyembodiedinthedepthsofbraincellsand
brainmindstatesthatcannotbeilluminatedbyintrospection.
Thislimitationisexactlywhymodernanalyticalphilosophers,ledbyBertrandRussellandAlfredNorthWhitehead,havetalkedthemselvesoutofalmostallclaims
regardingthemindandhave

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settledinsteadforthelogicofmathematics.Itisalsothereasonpsychoanalystshaveincreasinglyrestrictedthemselvestohermeneutics.Althoughthesestrategic
retreatsmaybeintellectuallyinteresting,theyaredisappointingtopeoplelivingintherealworld,becauseitseemstousasiftheanalyticalphilosophersand
psychoanalystshaveabandonedtheverypurposetheirdisciplineswerecreatedtoserve:tounderstandhowthemindworksinhealthandhowitmalfunctionsin
disease.
Bydefiningthoseaspectsofbrainmindstatesthatareinaccessibletointrospectionasnonconscious,ahugeareaofpsychology,philosophy,andpsychoanalysis
suddenlybecomesamenabletounifiedscientificinvestigation.Today,ascientificpsychology,ascientificphilosophy,andascientificpsychoanalysiscanallbesolidly
groundedinneurobiology.
Thisdeclarationwillsendshockwavesthroughmanyinstitutionallyembeddedpractitionersofpsychology,philosophy,andpsychoanalysis.Theywillseeitasathreat,
asareductionoftheirfieldtoneurobiology.Individualjobsareatstake,andinsomecasesuniversitydepartmentsmightbereplaced.Iwouldcounselagainstsuch
panicontwocounts.Oneistheconvictionthateachofthesethreefieldswillbestrengthenedbyembracingthescienceofthenonconsciousmind.Twoisthatthe
subsequentredefinitionofeachfieldisliberating,notenslaving,asmanyfrightenedpractitionerswouldbelieve.
Myvisionoftheredefinitionofpsychology,philosophy,andpsychoanalysishastwoaspectsthatshouldbequiteattractivetothosewhodonotwanttogobackto
schooltolearnneurobiology.Thefirstisthatagreatamountofworkstillneedstobedonetodevelopascientificallyrespectablephenomenologyofthemind.We
needmorecarefuldescriptionsofmentalprocessesviatheproperlylimiteduseofintrospection.Weneedcataloguesofmaterialdescribingnormalandabnormal
mentalstatesthatconformtothestructureandgoalsofthementalstatusexambutwhichgobeyonditbothindetailandintimespan.Weneed,forexample,dream
journalscollectedoveralifetime,andanalysisoftheminallofmysixtyyears,Ihavenotyetfoundonesuchjournal.Psychologythatis,introspectioncanbea
powerfultoolifitis

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usedproperlyandwithinitsownlimits.Butitmustberecognizedaspartofalargerprocess,andnotanendinitself.
Thesecondattraction,andneed,istoapplythepropertoolsofeachfieldtoaconstructivecritiqueofthenewbrainmindparadigm.Whatdoesitmeantoequatethe
nonconsciousmindwiththeactivationofbraincells?Howmustthebrainscienceschangetomeettheopportunitiesandresponsibilitiesofsuchaparadigmshift?What
arethemoralandethicalimplicationsofrecognizingthatmentalprocessesarematerialtransactionsbetweenneurons?Whataretheproperhumanisticframesofeach
viewpoint?
LeavingSomeofOurLivestoChance
Whyshouldpsychology,philosophy,andpsychoanalysiswanttomakecommoncausewiththebrainsciences?Becauseallthesefieldshaveasharedinterestinthe
samedeepquestionsabouthumanexistence.Towhatextentarewepartofacosmicmasterplan?Towhatextentcanourfuturebepredictedbyknowingourpast?
Towhatextentisthecontentofourthoughtatanymomentderivedfromantecedentmentalactivity?AndifwearegoingtogiveupthesecurityofBiblicalcosmology,
Newtonianmechanics,andFreudianpsychodynamicsallofwhichadheretosomeformofstrictdeterminismwhatintheworldarewetoputintheirplace?The
shortansweristhatourcreativityandourfreedombothdependuponrandomness.Andrandomnessappearstobeanintrinsicaspectofbrainfunction.
Indeed,oneofthemostdistastefulideasassociatedwithmodernscienceisthatrandomnessisamajordeterminantofeventsinthecosmos,includingtheoriginoflife.
Tothehorrorofthetheologians,itisassertedthatlifearoseoutofchaosbychance,withoutanysupervisorydirection.Inthebeginning,therewasnoWord,only
cosmicnoise.Weallshareadeepfearofbelievingthatanypartofourlife,andespeciallyourmentallife,issubjecttothewhimofchance.
Weprefertothinkthatallsuchprocessesobeystrict,causalrulesthataresetbysomearchitectwhoisasrationalbut

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wiserthanourselves.Onereasonforthesurprisingpopularityofpsychoanalysisisthatitprovidesasenseofcertaintyandclosure.Playingthegameoflife
accordingtodeterministicrulesguaranteessafetyfromtheunexpectedandtheuncontrollable.Everydreamisawishwhosefundamentalimpulsecanbeidentified,
understood,andcontrolled.
Butwhatiftheworldhasnobeginningandnoend?Whatifourmindsarenotdirectlyknowable?Howarewetolivecomfortablywithsuchuncertainty?Whoisin
chargeifnotweorHim?Mustwetrustanit,amechanismthatismentalbutnotconscious?Webalkatsuchanidea.
Itisironicthatsomanyofuswhoprofesstolovefreedomhavesoblindlyembracedapsychologythatoffersthesecurityofpsychicdeterminismatthecostofthe
freedomthatchanceandonlychanceguarantees.Thebrainmindparadigmoffersussecurityviathereliabilityofourowncellularprocesses,yetguaranteesus
freedomthroughtheunpredictabilitythattheseprocessescanbring.Yes,thereisalwaysthechancethatwewilldieinoursleepbecauseourbreathingprogramwillget
stuckandjuststop.Yes,thereisalwaysthechancethatwewillbewalkingdownthestreetonedayandjustflipourlid.Buttheprobabilityisextremelylow.
Althoughthesepossibilitiesmaybeunnerving,theyaregoodandquitenecessary.Supposeallmentaleventswerethepredictableworkingofamachinesowell
engineeredthatitalwaysfunctionedperfectly.Howcouldcreativityarisefromsuchanautomaton?Howcouldnoveltyeveroccur?Itcouldnot.Naturetinkers
creativelyviageneticmutation.Mutation,achanceevent,isthemostcreativeforceinnature.Yetitisahorriblycruelforce,sincemostmutations,likemostofour
ideas,arefatallyflawed.
Nowhereistheroleofchancemoreevidentinourmentallifethanindreams.Byrecognizingthistruth,weacknowledgethatdreamingoccurswithpredictable
unpredictability.Thenonconsciousbrainmindisbothhighlyreliableinitsoveralldesignandhighlyunpredictableinthedetailsofitsnighttonightoperation.
Sinceeachdreamiscreatedbytheactivationof100billionneuronsinourbrains,eachconnectedtoatleast10,000others,and

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allchatterawayatratesofupto100messagespersecond,howcouldweexpectanyotheroutcomethanunpredictabilityofdetail?Aremarkablepointisthatsome
dreamsdotakeuprecurrentthemesofundoubtedsignificancetothelifeofthedreamer.Someseemtorepeatalmostexactly.Howdowesquarethisparadox?What
partofdreamingisdeterminedandwhatpartisnot?
Theonlyanswerwehaveischaos.Allcomplexsystemsandthebrainmindiscertainlyacomplexsystemarecharacterizedbyaconstant,dynamicinterplay
betweenchaos(unpredictability)andselforganization(orderliness).Whenweseeorderliness,wetendtoassumethatitcouldbebegottenonlyoforderliness
henceournaiveacceptanceofdeterminism.
Observeastreamofwaterortheflamesaboveafireandwatchasorderlyflowgiveswaytoturbulenceandthenreturnstoorderlinessagain.Inlikefashion,our
streamofconsciousnessflows,breaks,eddies,andreconvenes.Inourinnocence,wehavetendedtobelievethatallthebreaksinthestreamofourconsciousness,
whetherduringwakingordreaming,aremeaningful.Wemustnowadmitthatthisisasunlikelyanassumptionasitisunproven.Wemustrealizethatdissociationisas
muchtheruleofthebrainmindasassociation.Andweshouldbethankfulforit.Creativityseparatesusfrommostotheranimals,andithasitsdeeprootsinthe
dissociative,chaoticnatureofournonconsciousbrainminds.
AssociationandDissociation
Itisnormal,evendesirable,thatourbrainmindstatesdissociatenaturally.Withinanystatetheprocessingofinformationislikelytobedissociatedbecausethe
informationisinherentlyjumpy,noisy,anddiscontinuous.Thefacultiesthatmakeupourstates,suchasmemoryorperception,maythemselvesbesubjecttothesame
kindsofinconsistenciesandunpredictablechanges.Withoutwarningandwithoutanyidentifiablestimulus,ImaysuddenlythinkofthenameofapersonIhaven'tseen
ortalkedtoinyears.AndImayimaginethatperson'sfacequiteclearly.
Wehavealreadyseenhowourwakingconsciouscanbedissociatedintoforegroundandbackgroundprocesses.Icanconcentrate

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simultaneouslyonthemechanicalactofshavingandtheintellectualactofrunningthroughtheday'supcomingevents,intheforeground,whiletellingmyselfIlookgood
inthatmirrorandplayingoutthedialoguethatmightunfoldduringanyofmyday'smeetings,inthebackground.Theforegroundconsistsofperceptualdataprocessing
thebackgroundconsistsoffantasyproduction.Thefantasyitselfrangesincontentfromliteralness(thedialogueforthemeetings)toabstractness(myselfimage).The
multipleandmodularnatureofthebrainmindcontributestoalltheselevelsofdissociation.Onlytheunityandconstancyofthestatecontrolsystemtheaminergic
cholinergicsystempreventsthisanarchicprocessfrombeingmoretroublesomethanitalreadyis.
Weknow,too,thatthebrainmindcanbe''split."Therighthemisphereprocessesanalogicallyandemotionallywhilethelefthemispheregivesspeechandnarrative
theirlogicalform.Thetwohemispheresusuallyproceedharmoniously.Buttheycanbedissociatedfromoneanotherbycuttingthecorpuscallosum,thelargefiber
bundlethatconnectsthetwohemispheres.Whenthisisdone,thesubject'sleftbraincannotnametheobjectthatisseenbyhisrightbrain.Thebrainmindcanalsobe
splitsothatthetopisdissociatedfromthebottom.Whenapersonsleepwalks,thecortextofhisupperbrainremainsasleepwhilethelowerbrainisawake.
Thesedissociativeexperiencesborderonthemaladaptive,andwethereforechoosetocallthemdisorders.Butweshouldnolongerregarddissociationasabnormal.
Justasweshouldcheerchaosasessentialtocognitivefreedomandcreativity,weshoulduseourcapacitytodissociateforhealthsupportingpurposes.Hypnosisand
meditation,forexample,areeffectivebecauseofdissociationtheyenableapersonto"tuneout"theoutsidewhileremainingawake,thusreducingstress.Theseare
voluntarychangesofstatethatrelyondissociationtobringbenefits.
Wheneverwegotosleepweclearlyabandonconsciouscontrolandletthenonconscioussystemsofourbrainminddotheirautomaticwork.Whatthenonconscious
brainmind"decides"todowitheachopportunitywecannotknow.Hereagain,weneedtoabandontheideathatwecandeduceanonconsciouscausefor

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theinformationcontentofconsciousness.Theymaybeentirelydissociatedphenomena.
AtthesametimethatwerecognizetheshortcomingsofthekindofpsychologicalreductionismthatwasattemptedbyFreud,ourscientificstrategyofmethodically
studyingthebrainmindonemoduleatatime,orevenoneneuronatatime,isenormouslyenrichedbyrealizingthatineachinvestigationwehaveagoodchanceof
learningsomethingsurprising,essential,andknowableinnootherway.Thebrainmindparadigmencouragesanintegrationofpsychology,psychoanalysis,and
neurobiology.Weshouldallbeabitmorerelaxedaboutdemandingthatthepiecesfittogetherrightaway.Infact,attherateweareprogressing,wecanexpecttobe
inforalonghaul.WehavehadaccesstowhatIamcallingthenonconsciousmindforonlyfortyyears.Wehavestudied,atmost,onlyafewthousandofthose100
billionneurons,anincrediblyminusculefraction.Andveryfewofthesewerestudiedinalivinghumanbrain.Wehavealongwaytogo,butweareontherighttrack.
AConsciousDecisiontoAlterConsciousness
Nonetheless,thereisjustcauseforcelebration.Wearefinallybeginningtogetaglimpseofwhatisreallygoingoninsideourheads.Wehaveonlyrecentlynoticedthat
wearetheembodimentofbrainmindstatesandthatbrainmindstatesareallthatweare.Ourstatescontrolourfaculties,yetwithconsciousnesswecancontrolour
states.
Havingcutconsciousnessdowntosize,letusendthisdiscussionwithenthusiasmforjusthowsuccessfullyitcanstillserveus.Wecandecidetopursueornotpursue
thescientificstudyofourdeepselves.Wecandecidetoadoptornotadoptthebrainmindparadigm.Ifindtheinvitation,andmyfreedomtoacceptorrefuseit,
equallyexciting.
Ifyoudecidetoadoptthebrainmindparadigm,youhaveapowerfultoolatyourdisposal,whichyoucanusetoimproveyourmentalhealth.Youcandecidehow
besttoconditionyournoncon

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sciousandconsciousbrainmindsothatyourvegetativelifeandyourcognitivelifecanthriveandflourish.Youcanaccomplishthisbychoosingwhichstatesyour
brainmindmayoccupyandhowlongitmayresideinanyonestate.Shouldyousleepmoreorless?Shouldyouengageinmeditation,hypnosis,ortrance?Ina
parallelstrategy,theminddoctorsamonguscandecidehowtomanipulatethestatesofothers,inordertohelpthem.WhatisthebestwaytosolveBertal'sproblem
andthatofpeoplewhosleepwalk,oraredepressed,orareaddicts,andsoon?TheseissuesformthefocusforPartThree.

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PARTTHREE
CHANGINGTHEBRAINMIND

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Chapter13
HowtheBrainMindHealsItself
Nowthatyouhaveafullunderstandingofhowbrainmindstatechangesaffectyourfaculties,andhowsubtlechangesdeterminethedifferencesbetweennormaland
abnormalstates,itistimetousethispowerfulknowledgetoyouradvantage.Thefinalsectionofthisbookwillshowyouhowtobegin.
Thischapterexplainshowthebrainmindhelpsitself.Thesystemhasitsownbuiltinhealingpower.Iflefttoitsowndevices,thebrainmindisquitecapableof
correctingitself.Unfortunately,untilyouhaveagraspofhowitdoesso,youareaslikelytointerferewiththeprocessasyouaretohelpit.
Thebasicactionthatthebrainmindtakestokeepitselffitistochangeitsstate.Youcanimproveyourhealthbothmentalandphysicalbyjostlingthesystema
little,byvoluntarilychangingstatestoachievecertaineffects.Techniquessuchasmeditation,hypnosis,trance,andtheplaceboeffectareamongtheactsofvolition
usedbymany"normal"peopletochangestatesandthushealth.Thesearethesubjectsofchapter14.
Ofcoursesomepeopleareunabletoexertsuchcontrol.Otherssuccumbtoanyoneofanumberofdebilitatingfactorspsychologicalstress,addiction,chemical
breakdown,disease,andthe

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simplelongtermdeathofcells.Inthesecasesthesystemhastobejostledalot.Drugsareoftenhelpfulinchangingthebrainmindstatesofthe"abnormal"people
whofallintothesesituations.Onlychemicallyinducedchangesinstatescanpermanentlyhealthem.However,asyouwillseeinchapter15,drugsalonearenotthe
answer.
ScientificHumanism
Thepowerweallhavetoaffectourownhealthisdemonstratedbyourcollectiveresponsetooneofourmostfamiliarenemies:thecommoncold.Asktenpeoplehow
tobeatanaggingcoldandyou'llprobablygettendifferentanswers:fruitjuices,steambaths,chickensoup,vaporrubsnottomentionanyoneofanarmfulofover
thecounternostrumsavailableatthelocalpharmacy.Butthereisoneremedyeveryoneagreeson:moresleep.
Ifyoutakesleepseriouslyenough,ithelpsmorethananypotionfromtherefrigeratororthedrugstore.Ihavelearnedthatformyselfoverthepasttwowinters.
ThreeyearsagoapersistentcoldturnednastywhenIwasinSicilybeginningtowritethisbook.Butsincemytimewasmyown,Iwasfreetoexperimentwiththe
sleepcure.Withinafewdaysofgoingtobedat10:00P.M.andsleepinguntil9:00A.M.(insteadof12:00till7:00),myfatigue,lassitude,andeveningcoughwere
gone.WithinaweekIwascompletelywell.
Thispastwinter,bycontrast,Iwasstatesideandwasstrugglingtosqueezemywritingintoanalreadybusyschedule.Aseachhecticweekevolved,Icouldfeelmy
chestcoldworsen.Ontheweekends,mySicilianstylesleepinsstrengthenedmeenoughsothatonMondayIwasclosetobeingcomfortable.Threeextrahoursof
sleepwereenoughtoknockthebugdown,butnotout.Finallythebuggotthebetterofme,andoffIwenttothreedaysofbedrestandsleep.OnlythendidIreally
begintorecover.
What'sgoingon?Whyissleeptheonlycurethatultimatelyworks?Bysleepingsomuch,Iamconsciouslyshiftingthebalanceoftimemybrainmindandbodyspend
intheenergyexpensive

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ergotropicawakemodetowardthemoreenergyconservative,andhealing,trophotropicsleepmode.Iamvoluntarilymanipulatingmybrainmindstates.AndfinallyI
getwell.
Thelessonhereisthatthebrainmindisgoodathealingitself,andthatwecandirectthishealingbychangingourbrainmindstates.Furthermore,asweallknow,the
keytogoodhealthisnottogetsick!Thebestwaytoincreasetheprobabilityofstayingwellistoelectbehaviorsassociatedwithhealth.Thebestdoctor,then,isthe
self,theonlyagentwhocanengineersoundhealthpractices.
Thisview,anditsapplicationtoourmentalandphysicalhealth,issomethingIcall"scientifichumanism."Itrecognizesapowerfultopdowninfluenceofcognitionover
thenonconsciousstates.Withoutappealingtoforcesoutsidetheself,scientifichumanismincorporatesthepowerofpositivethinkingthatisextolledbysomany
religions.
Scientifichumanismismodestinitsgoals.Itcan'tcureeverything,anditislessgrandioseinitscosmology.IthasnoGod,nofoundingfather(ormother),andno
officialhealers.Asadiscipline,itplacesitshighestrelianceontheselfashealerandviewsthestatesofthebrainmindasinherentlyhealthpromoting.Itsaysthatthe
self(definedasanactivatedstateofthebrainmind)extendstothewholebody.Tounderstandtheselfthoroughlyrequiresanactiveinterestinbothtraditional
psychologyandmodernneurobiology.
Scientifichumanismseesknowledgeasmoreimportantthantexts,ritualpractice,ordivinelyinspiredgurus,althoughitrecognizesthatmuchcanbelearnedfromthe
conceptsandexperiencesofmanycharismatics,fromWilliamJamestotheDalaiLama.Itassumesthatmanyimportanttruthsarealreadyknownbutlieoutsidethe
usualrealmofscience,andthatmanymoreimportanttruthsremaintobeestablishedbytheapplicationofsciencetohealthpractices.
Likewise,scientifichumanismviewstheoriginalgoalofSigmundFreudtoforgeascientificpsychologyasentirelylaudable.Itseesneurobiologyasa
fundamentalelementinanyreconstructionofpsychoanalysisitdoesnotsupposethatneurobiology

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wouldentirelyreplaceorswallowuppsychoanalysis.Scientifichumanismalsodoesnotseektodisenfranchisephysicians:abrokenlegstillrequiresagoodorthopedic
surgeonpneumoniastillrequiresaninfectiousdiseasespecialistandpsychosisstillrequiresthemostsophisticatedbrainmindpsychiatrists.Butscientifichumanism
doesenfranchise,empower,andenjoinindividualstoknowmoreandtoactmoreintheinterestoftheirownhealth.Itassumes,asmanyscientificepidemiologic
studieshaveproven,thathealthiseitherthestrongcorrelateorthedirectcausalconsequenceofpracticesthatcanbeinfluencedandcontrolledbyconsciousdecision
making.
Ofallthepracticesknowntobeassociatedwithgoodhealth,sleepisthemostfundamental.Themostbasicstepyoucantaketoimproveyourhealthistofigureout
howmuchsleepyouneedandtoseethatyougetit.Aswehaveseenineverychapterofthisbook,thebrainmindseekstoregulateitself,andthebestyoucandois
toletitdoso.Youhavetodiscoveryourtruesleeprequirement,thenhelpyourselftogetit.Laterinthischapteryouwillreadaboutseveralcasesthatshowthatthe
brainmindregulatesitselfbychangingstates,andthatthemostfundamentalstatechangeisfromwakingtosleeping.Thecasesshowhowsomepeopleneedonlya
littlesleep,somealotandhowweallrunintotroublewhenwetrytoalterournaturaltendency.Theyalsoshowhow,throughsimpleevaluationandcommonsense
practices,youcanovercomesleepproblemstoimproveyourhealth.
Therearethreeimportantreasonsforfocusingonsleepasthebrainmind'sownresidentphysician.First,itisresidentinthatitisabuiltinstatechange,andaphysician
inthatitsintrinsichealingmechanismhasbeendetailedatthelevelofbraincellsandmolecules.Thesecondisthatitscurativefunctionisbeginningtobespecifiedasan
enhancementtotheimmunesystem.Andthethirdisthatthemechanisticandfunctionalrulesthatareemergingfromsleepresearchcanbeextendedtoothercurative
conditionsthatarestillonthefringeofscience.Sincethepowerofsuggestionisnotoriouslystrong,wecannolongeraffordtomarginalizeitashystericalhocuspocus.
Instead,wemustbegintoharnessitspower.

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FindingYourSleepNiche
"HowmuchsleepdoIneed?"isaquestionIamaskedallthetime.Doyouexpectmetosay7.5hours?Ican'tanswerinthatway.Icansaythat7.5hoursisabout
average,butthatisapurelystatisticalanswer.Itdoesn'ttellyouifyouare"average"orevenifaveragefolkarehealthy.Thereisnoquickanswer.Onlyamonthorso
ofcarefulselfobservationcantellyouconvincinglywhetherornotyouaregettingenoughsleep.Bearinmind,too,thattheamountyouneedcanchangewithage,
lifestyle,andillness.
TheclinicalapproachtosleepevaluationandoneI'veadoptedpersonallybeginswithasimplechart.I'lldescribehowthemethodtracksboththequantityand
qualityofsleep,andyoucanadaptitforyourself.
What'sneededisagridonawidepieceofpaper.Inumberdaysfrom1to30downthelefthandedgeofthepaper.Eachdaygetsitsownrowrunningacrossthe
pagefromlefttoright.AcrossthetopofthepageIlisteachhouroftheday,from12:00noononeday(attheleft)to12:00noonthenextday(attheright).Eachhour
getsitsowncolumnrunningdownthepagefromthetoptobottom.WithalightpencilmarkIdivideeachhourintoquarters.
EachdayImarkthetimeIwenttobed(tothenearestquarterhour),thetimeIactuallyfellasleep,thetimesduringthenightIgotup,andthetimeIwokeupinthe
morning.UsingafelttippenIdrawalineconnectingthetimeIfellasleepwiththetimeIwokeup.Asthedaysprogressdownthepage,abarchartemerges
indicatingthenumberofhoursIsleep.
Duringthewakinghoursofeachday,Iuseaseriesofcodestonoteanyunpleasantchangesinmylevelofattention(A)orinmyenergyflow(F),andtonotethetime
ofoccurrenceofmeals(M),exercise(E),sexualactivity(S),alcoholintake(I),andtobaccouse(T).InparallelwiththisratherdullandquantitativeprocedureIkeep
anarrativejournalinwhichIrecordmydreams(becausetheyinterestandamuseme),aswellasqualitativenotesabouthowIfelteachday,whomIspenttimewith,
andwhateverphilosophicalorquasiartisticinspirationsImighthavehad.
Takentogether,mysleepchartandjournalgivemeadetailed

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pictureofmynonconsciousandconsciousstates.SometimesitisdifficulttosaywhetherIsleptwellbecauseIfeltgoodorwhetherIfeltgoodbecauseIsleptwell.
Butitreallydoesn'tmatter.WhatisclearisthatwhenIdon'tsleepwellIdon'tfeelgood.WhatismostusefulaboutdocumentingthedetailsisthatIcanlookbackto
seewhatmybehaviorwasbeforemybadnightsandwhatkindofnightsprecededbaddays.
Inordertofeelhealthy,Ineedatotalofseventoninehoursofsleepanightapromptsleeponsetofnomorethanthirtyandusuallylessthantenminutesnomore
thanthreeawakeningsofnomorethanfiveminuteseacharegulartimeofgoingtobed(between10:30and11:30P.M.)andaregulartimeofrising(between6:30
and7:00A.M.).Youmayneedmoreorless.Youhaveonlytobehonestwithyourselfandexertsomemodestdisciplinetofindout.
Inaddition,severalfactorsconspiretoconfoundmysleep.Alcoholintakeandovereating,especiallywhentheyoccurtogether,delaytheonsetofmysleep,causeme
tosleepfitfully,andresultinpooralertnessthenextmorning.Afailuretoexercise,whichinmycaseisoftenrelatedtoanoverabsorptioninwork,hasthesameeffect.
FromthisstraightforwardsetofobservationsitisobviouswhatIneedtodotogetandstayonthehealthtrack:eatbreakfast,besuretotakeadailyswimorrun,
avoidmorethanaglassofwineortwo,andgetthefullseventoninehoursofsleep.
ThisexerciseinselfobservationandthechangesImakeasaresulttogetherconstituteasimpleexampleofhowanindividualcanimproveandcontrolhishealthusing
thebrainmindparadigm.Bycommittingmyselftotheselfobservationpractice,Ifocusmyattentionontheaspectsofmybehaviorthatimprovemysleepstateand
thereforeimproveoneofmyfacultiesmyattentionduringmywakingstate.Byengaginginthisprocess,Iamengagingmyconsciousmindtobecausalonmy
health,viaitseffectsonmynonconsciousmind(thesleepstate).Hereweseethatthisgrandparadigmandallitsseemingcomplexitiescanbequiteobviousandsimple
touse.

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It'sNormaltoBeAbnormal
ThesleepprescriptionIhavegivenmyselfworksonlyforme.Youwillhavetodoyourownanalysistofindaprescriptionforyourself.Asyouplottheoutcome,don't
besurprisedbyextremes.Thereisgreatvariationinournonconsciousstatessomepeopleneedverylittlesleep,othersneedagreatdeal,andmanypeoplerequire
more(evenifjustalittlebitmore)thanthesocialworldallows.Whichmeanswemusteitherchangethesocialworld,investmoreheartilyingeneticengineering,or
changeourownconsciousapproachtocontrollingourstates.Obviously,onlythelastoptionisrealistic,solet'stakeit.
Theuniquenessofeachindividual'sstateswasmadecleartomerecently,asIwasbeginningtoyawnattheendofanelaborateandendlessdinnermeeting.My
colleagueLiaSylvestri,whousuallyhasmorespunkthanIdoatsuchalatejunctureintheday,seemedtolackherusualbrillianceonthisparticularoccasion.Ialready
knewLiawasashortsleepershewasoftenabletofunctionimpressivelywithasfewasoneandahalftothreehoursofsleep.
''Howmuchsleepdidyougetlastnight?"Iaskedher.
"Thirtyminutes,"shesaid.
WhenIaskedherifshewastirednow,sheadmittedthatshewas."Howmuchsleepwillyougettonight?"Iasked.
"Threetofivehours,"shereplied,makingmefeelabitmorelikeIwastalkingtosomeonefrommyownplanetandnotabionicsuperwomandesignedbyagenetic
engineer.
Liaisatypicalshortsleeper.Sheisactiveandproductiveinhercareerasaneurologistspecializinginsleepandmovementdisorders,andasawomanwhoisraising
twoyoungchildrenwithherpresentspouseandfourolderonesfromapreviousmarriage.Sheiscompetent,happy,andwelllikedinbothroles.Sheexhibitsno
evidenceofbeingpathologicallyanxiousorhypomanic,asonemightexpectofevenshortsleeperswithsuchademandinglife.
"Couldyousleeplongerifyoutried?"Iasked.
"Ohsure,"sheasserted."WheneverIlike."
Andindeed,thescientificevidenceiswithheronthatpoint.

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Youngstudentswhovolunteerformysleeplabcansleeplonger,bychoice,ifIoffertopay$5anhourforeachhourofbonafidesleeptheyexhibit.Somestudents,
somotivated,candoubletheirsleeptime.That'scertainlygoodnewsforinsomniacstheyjustneedtofindsomeonetopaythemforsleeping.(Actually,insomniacs
cansetupaSkinnerianrewardsystemforthemselvesitsometimesworks!)
ButLiareallythrewmeforaloopwhensheadded,"BeforeIhadchildren,Isleptasmuchasanyoneelse."
Lia'sideathathercurrentpatternwassimplyaproductofhabitseemedhighlyunlikelytomeandIstilldon'tbelieveit.Ithinksheis,andalwayswas,agenetically
determinedshortsleeperwhoincreasedhersleeplengthwhenshewasanadolescent,tofitinwithsocietalandfamilynorms.Lia'sspouse,RaouldiPerri,whois
everybitasfriendlyandhardworkingashiswife,agrees.Helivesinthesamehousehold,withthesamesixchildren,butsleepseighttoninehoursanight.Allattempts
todrasticallyshortenhissleephavefaileddismally.
Mostshortsleeperssaythattheyalwaysknewtheyneededlesssleepthantheirpeers.WhenLiagetsthreetofourhoursofsleep,sheisfineandcangoatitfulltiltfor
thetwentyortwentyonehourssheisawake.Whenshegetsless,shedoestire.Althoughshecansleeplonger,sheusuallydoesn'tLiahasagenuinecapacityto
significantlycurtailhersleepwithoutanynegativeeffect.Onarareweekendshemayindeedchoosetosleeplonger(relativelyspeaking).She'snot"catchingup"on
hersleepwhenshedoesso,howevershejustwantsabitofpeaceandquietawayfromherotherwisebusyworkandhomelife.
Liaistheonlychildofacouplewithsleeppropensitiesthatsuggestastronggeneticdeterminationofherownshortsleep.Hermotherhasalwaysbeenalight,fitful
sleeperandnow,atageseventyfive,stillsleepsonlyfivetosixhoursanight.Thisisnotterriblystriking.Butherfather,Enzo,isanotherstory.Aprofessorofreal
estatelaw,Enzoisstillvigorousandproductiveatageseventyeight,andfeelsrestedafteronlythreetofourhoursofsleep.Mostsignificantishiscapacitytoturn
sleeponandofflikeafaucet.Ifhefeelsabittired,hecanpromptlyfallasleepany

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whereandthenawakentwentyminuteslaterfullyrestoredandreadyforaction.
Asaculturethatstronglyvaluesactivityandaccomplishment,wenaturallyenvygeneticallyshortsleepers,whotypicallycanaccomplishmoreinadaythanthoseofus
whoneedmoresleep.Thisculturalbiasleadsustomakeseveralimportantmistakesthatneedtobemoreclearlyrecognizedanddealtwithbothbyindividualswho
needalotofsleepandbysocietyatlarge,whichtendstodevaluesleep.
SeveraltimesIhaveputadsintheBostonpaperslookingforpeoplewhosleeplessthanfiveormorethanninehourseveryday,andeachtimeIreceivednumerous
responses.ForeveryLiaandEnzointheworldthereisapersonwhoneedsmoresleepthanthe7.5houraverage.Buthisorherchancesofgettingit,orbeing
understood,areslim.OnesuchpersonwasRosa,amedicalstudentofmine,whoadmittedatagetwentyseventhatshefeltcompletelyrestedonlyafterfourteen
hoursofsleep.Youcanimaginehowmuchsheenjoyedherinternship.
InalllikelihoodRosadidnotactuallyneedfourteenhoursofsleepeverynight.Butshemightwellhaveneededninetoelevenhours,andcomplainedthatsheneeded
fourteenbecauseshewaschronicallysleepdeprivedbyalwayslimitinghersleeptomakeitmatchtheseventoeighthoursocietalnormandherowntoughmedical
schedule.Families,spouses,friends,andemployeesjustdonotaccepttherealityofalongsleeper'sneeds.Thelongsleepersoftheworldareeverybitasmuchsocial
pariahsastheLiasandEnzosareheroes.
Lazy,sleepyhead,andgoodfornothingareafewoftheunflatteringepithetsthatareheapedonthoseunfortunates.Thisreinforcementisreallyakindofpunishment.
Longsleeperswouldoftenprefertobecallednarcolepticsorevendepressivestohelpthemlegitimizetheirlegitimateneed.Longsleepersareasnaturalastallpeople.
Unfortunately,oursocietyhasnotcreatedasportasrespectedorwellpaidasbasketballforthosewhosleeptall.
Thesocialstigmaattachedtolongsleepersinworkethicculturesisnotsoftenedbythefactthatlongsleepersarenotparticularlyenergeticevenduringtheir
abbreviatedwakinghours.Many

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ofthemmaybelethargicandintroverted,whereasLiaandEnzoareenergeticandoutgoing.Totheirclosefriends,however,thelongsleepersmaybequiteappealing
becausetheytendtobemoresensitive,poetic,andreceptivethanthegogettershortsleepertypes.
Wheredoyoustandonthisspectrum,whichstretchesfromtwotofourteenhoursandclustersatabout7.5?Unlessyoumakeaconsciouseffort,you'llnevergeta
chancetofindout.AsWilliamWordsworthpointedout,"Theworldistoomuchwithuslateandsoon/Gettingandspendingwelaywasteourpowers:/Littleweseein
Naturethatisours."Asanintrinsicpartofscientifichumanism,weshouldconsiderbettertreatmentofourownbodiesanddevelopamorenaturalapproachtoour
nonconsciousbrainminds.Attaininggoodhealthisyourownresponsibility,andyoucancontrolittoagreatdegreebyconsciouslyinvestigatingandmanipulatingyour
brainmindstates.
TheThomasEdisonSyndrome
Whathappensifyoudon'ttakecontrol?Youinevitablyendupfightingthesystem.Asaresult,youmightsimplyfeeltiredallthetime.Butmuchmoredebilitatingand
obsessivefatescanbefallyou.
Thisconclusionnotonlyappliestosleep,itappliestoavastrangeofhumanbehaviors,dependentonbrainmindstates,thatmustmoveuneasilybetweenbiological
realityandegalitariandelusion.Longandshortsleepersareborn,notmade,buttheyhavetofittheirgeneticpredispositionintoonesocietalnicheoranother.Ifyou
aremiscast,youhavetofindawaytoreducethegapsbetweennativeconstitutionandsocialexpectation.Otherwise,youmightenduplikeEdwin.
Edwinisthefounder,owner,andpresidentofasmallelectronicscompanythatoperatesoutofhisgarageinthesuburbsofTurner'sFalls,Massachusetts,oncea
prosperousmilltownthatisfastfallingintopoverty.Despitepossessingtwentysixpatentsonprintedcircuitboardsandtherelatedentrailsofservogadgetsthat

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mightonedayallowhimtorockethiskitchentothemoon,Edwin'sbusinessisfoundering.
Heisconvincedthatamajorreasonforhisfailureasanentrepreneurishisexcessiveneedforsleep,andnotlongagoheconsultedmefortreatmentofwhathehimself
hadconfidentlydiagnosedasatypicalcaseofnarcolepsy.Notsurprisingly,EdwinreadstheWallStreetJournalandhadencounteredseveraldetaileddescriptions
thereinofsleepdisorders.Accordingtosomealarmistadvocatesofsleepdisordermedicine,almosthalfthecitizensoftheUnitedStatesaresufferingfromoneor
moreofthethreehundredsyndromesthathavebeenrecentlydescribedbysleeplaboratoryscientists.
Edwindoeshaveexcessivedaytimesleepiness,themostcommonandannoyingsymptomthatnarcolepticscomplainof,andheissometimesextremelysleepyat
meetingswithprospectivefinancialbackersandtechnicalcollaborators.Meticulous,welldressed,evendapper,EdwindescribedhissymptomsinminutedetailasifI
wereapatentexaminerinsteadofaphysician,andasifhewantedtoconvincemebothofthevalidityandoriginalityofhisclaim.
Infact,Edwinbelievedthatwiththepropermedicationhewouldbeabletoturnhiscompanyaroundandtakeadvantageoftheeconomicboomthatwas"justaround
thecorner."Furthermore,hehaddecidedthatthepropermedicationwasRitalin,anamphetaminelikedrugthatmimicstheactionofnorepinephrine(whichweknow
boostsouralertnessandenergyflow).Edwinhadreadthattheantidepressantsmightalsobeeffectiveintreatingnarcolepsy,but,becauseheclearlywasnot
depressed,hesaidhewouldpreferastimulantmedication.IagreedthatsuchadrugwouldprobablygiveEdwinquitealift,butatwhatcost?Iwasalsonotsosurehe
wasnotdepressed.Givenhisstoryitwouldcertainlybeunderstandable.
Iaskedifheeverfeltsoirresistiblysleepythatheliterallydroppedinhistracks?No,notreally,hesaid.Hecouldusuallyfightoffhissomnolencesothatnoone
noticedit,andhehadneversuddenlylostcontrolofhismusclesasoccursinthesocalledcatalepticattacksofnarcolepsy.Sincethesecollapsesofposturaltone

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areoftentriggeredbysurprise,laughter,orstrongpositiveemotions,suchasjoyoreroticexcitement,Iaskedifhissleepinesswaseverpromptedbyemotion.No,he.
said,andaddedthatherarelyexperiencedemotion.Hewastoorationalandtoobusyforthatsortoffoolishness.
Youcanimaginehowlittleweightheplacedonsuchawhimsicalphenomenonasdreaming.
"Can'trememberanydreamsever!"hesaid,whenIbeganalineofinquiryaboutbaddreamsatsleeponset,whicharepartofthenarcolepsypicture.Nordidheever
wakeupfromadreamunabletomove,sohehadnosleepparalysis.Quitethecontrary,heoftenawakenedquicklyandleapedoutofbedtojotdownapossible
patentableinventionidea.IaskedEdwinwhetherhethoughthisbrainmindeverreallyhadanytimeoff.Hesmiled,asifIwereontosomething,andsaid,"Youknow,
IreallyfeelthatsleepisawasteoftimeandthatIshouldn'tneeditatall."
"Whereverdidyougetthatidea?"Iasked.EdwinwasthelatestoffivesimilarcasesofselfdiagnosednarcolepsythatIhadseen.Isuddenlybegantowonderwhether
hemighthaveabsorbedhisviewsabouthisphysicalconditionfromthemedia,likemanyofmyfemalemedicalstudents,whohavebeentaughtbythemediathat
attractivenessisachievedonlybybeingthinandsohavestarvedandevenpurgedthemselvesinavainattempttolooklikeTwiggy.CoulditbethatEdwinwasona
selfimposeddietofsleepstarvation?Supposehewasacompletelynormalsleeperwhowastryingtoforcehimselftobeashortsleeper?
Tomyutteramazement,Edwinthentreatedmetoadetaileddescriptionofthesleephabitsofhishero,ThomasEdison,inventorentrepreneurparexcellence.Edison's
modestneedsforsleepandhisabilitytosleepanywhere,anytime(forexample,underthestairsofhisMenloParklaboratory)arelegendary,eveniftheyhavenever
beendocumented.ThenitsuddenlyoccurredtomethatwhetherthestoryislegendormythhardlymattersnowthatEdisonisgone.Hisimagelivesonandinspiresthe
EdwinsoftheworldtoemulateEdison'stalents,includinghisbriefandefficientsleep.

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WhenIsuggestedthisideatoEdwin,hereadilyconfirmedhisownconsciousadoptionofEdisonashisrolemodel.Atournextsessionhebroughtmeahugefileon
Edison,alongwithhisowncarefullydocumentedsleeplog.TherewasEdison,theinventorofthelightbulb,amanwhohardlyneededtosleepherewasEdwin,
limitinghissleeptoaslittleasfourhourspernight,thenfeelingtiredallday.Thecondensationofideasmademyheadswim.IrealizedthatEdwinwasnottheonlyone
sufferingfromtheEdisonsyndrome,asIcametocallthisseriesofcases:allofuswere.
Weallfeelinadequate(tovaryingdegrees)ifwearenotcreative,entrepreneurial,wealthy,andcontinuouslywakeful.Manyofusmaywishwecouldeliminatethe
needforsleepentirely.Indeed,whynotgiveEdwinthechemicalboosthisrelativelynormalbrainneededtorealizetheshortsleepprogramhehadimposedonit?It
certainlywouldhavebeenaneasiercoursethantheoneIembarkedon,whichwastotrytochangeEdwin'sbehaviorinamorenaturalisticwaybychangingbothhis
mindandhissleephabits.
PartofmyreasonforchoosingthisroutecamefromthebadexperiencesIhadencounteredinthepsychoactivemedicationcrazeIwasimmersedinduringitsheyday
inthe1960s.Andpartofitcamefrommyrevulsiontowardtheextensiverelianceontechnologythatseemedtometobealienatingthemedicalprofessionfromthe
mostpersonalaspectofitsobligationtopatientstodeeplycareaboutthequalityoftheirlives.
Wedonotneeddrugstosleepwell.Insmallfarmtowns,nooneismotivatedtocurtailtheirsleep.Thesimplemindednessofthefarmcommunityisrightontarget.If
someoneneedstosleepmore,theyshouldgotobedearlierandsleepmore.Period.Furthermore,farmfolksareabletosleepbetterbecauseboththeirmindsand
bodiesexistinamorenaturalenvironment.Citylifehasdrivenusawayfromthenaturalsleepenhancersphysicalwork,cleanair,andlowstress.Themodern
ethicthatsleepisawasteoftimeandshouldbeeliminatedbyscienceisclearlyabyproductofindustrializationandoftheelaborationofbehavioralnormsthat
serveitnotthatalongsleeperwouldbeapopularmemberofafarmfamily.Thereismuchhardworktobedone.

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Butthefamilywouldtoleratethedeviance,becausenaturalaberrationandevendisasteraremoreeasilyaccommodatedbyagrariansocieties.
AnotherimportantcontributiontomyownnaturalisticphilosophyofbrainmindstatemanagementcamefrommyserviceyearsagoonaNationalScienceFoundation
commissionformedbytheFoodandDrugAdministrationtoevaluatetheefficacyofelectrosleepmachines.Sovietscientistshadtheideathatsleepcouldbeinduced
andenhancedthroughelectriccurrentsandhaddesignedadevicetocarryoutthetask.
IfEdwinhadgottenhishandsononeofthesegizmos,hemighthavepatenteditandretiredrich.Theideawouldhaveappealedtohim.Thenotionwastocreatea
supersleepbyelectricallystimulatingthebrainwithadevicewornonthehead.Itwasassumedthatsleepefficiency,ordepth,orwhatevercouldbedoubled.
Clearly,boththecapitalistandcommunistphilosophiesareinfectedwiththesamevirus:thatweshouldnotneedtosleepor,attheveryleast,thatweshouldneedto
sleepless.FortheSoviets,thisengineeringwasnaturaltocentralplanners.TheirwillingnesstoabusescienceintheinterestofLeninlikeschemesforprogresswas
wellknown.OneobviousreasonforthefailureoftheSovietfiveyearplansforfactoryproductionwastheeighthourworkday.Whynotincreasetheenduranceof
theworkerstotwelvehoursbybuzzinghisbrainandtherebyreducinghissleepbythefourhoursneededtomakeupthedifference?
Fortunatelyforallofus,theelectrosleepmachinedidn'twork.Notonlydiditfailtoproducesupersleep,itdidn'tevenenhancenormalsleep.Wecannedtheideaas
unfeasibleandthecontraptionasunreliable.TheAmericanpeoplehadbeensparedatleastonebitofpseudoscientificgimmicky.Ifonlywecouldbeaseffectivein
rootingouttheantisleepsoftwareofoursociety!BythatImeanthehyperworkethic,thetypeApersonalitysyndrome,thewayofdailylifethatkeepssomanypeople
soturnedontheycan'tturnoffevenwhentheytry.Powerfullyvestedculturalandcommercialinterestsconspiretopromotetheinfectionofyourbrainmindjustas
theydidthatofEdwin.
Ididn'thavemuchluckinmyefforttoconvinceEdwinthat

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noamountofmodernbiochemicalingenuitycouldturnhimintoThomasEdison.ItriedtogethimtorealizethathewasnoEdison,atleastwhenitcametosleep
requirements.Itriedtopersuadehimtousehissleepchartasaguidetoincreasingthetimespentasleep.Heheard,buthedidn'tlisten.Hehadattachedhimselftoan
idealofachievementandhewouldn'treturntothesolidgroundofreality.AndsinceIwasunwillingtoturnEdwinintoanamphetamineaddict,heleftindisgust.I
suspect,Iamsorrytosay,thathehadnodifficultyconvincinganotherphysicianthathereallydidhavenarcolepsyandthathereallydidneeddrugs.
Physician,HealThyself!
MyresistancetoprescribingdrugsforEdwinspranginpartfrommyexperiencewithDr.GeorgeLowell,amedicalcolleagueofmineinthe1970swhohaddiagnosed
himselfasnarcolepticyearsearlierwhenhewasinmedicalschool,becausehewasoftensleepyduringlectures.Iffallingasleepinmedicalschoollectureswasan
adequatecriterionforthediagnosisofnarcolepsy,alldoctorswouldbepatients.TherewasnomoreconvincingevidencethatDr.Lowellwasnarcolepticthanthere
wasinEdwin'scase.Hewasalong,orevennormal,sleeperwhohadbeencastbyhischoiceofamedicalcareerinashortsleeper'srole.Butheprescribedhimself
stimulantsandantidepressantsandtookthemforyears.Hebecameaddicted.Overtimehebecameunmanageable.Hishospitalpositionwasputinjeopardy,andhis
marriagebecamerocky.
WatchingDr.LowelldisintegratehelpedconvincemethatIneededtodevelopanevenmoreaffirmativeeducationprogramformycolleaguesthantheoneIhad
designedformypatients.Ineededtobettereducatemyyoungstudentsaboutthebrainmindparadigmandthevirtuesofanaturalisticapproach.Ialsoneededto
warnmycolleaguesandstudentsagainstmistakingnaturalandnormalresponsestostressfordiseases(orevendisorders)and,whatevertheproblem,againstself
diagnosis,selftreatment,andselfprescription.
Sincethattime,Ihavealwaysacceptedinvitationstolecturetoyoungmedicalstudentstotrytobreakthisviciouscycleatitsin

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ception.Afteronesuchsession,inNorthCarolina,ayoungstudentwhohassincebecomeacolleagueaskedmeifIwouldseehisfather,aphysician,whohad
sufferedforyearsfromintractableinsomnia.Withmodestadmonishmentsagainstfalsehopes,Isaidyes.Thecasewasspecial,butitillustrateshowgenetics,life
events,culture,andpersonalityallconspiretomakeanaturalcourseofsleepimprobable.
Thestoryillustrateshoweducation,behaviormodification,persistence,andgoodwillcansuccessfullycounterthesepowerfulnegativeforces.Italsoillustrateshow,
throughsimpleevaluationandchange,anindividualcanalterhisbrainmindstatestoimprovehishealth.
ItwaseasytopersuadeDr.LarryRichbergthathisexcessivedaytimesleepinesswasnotduetonarcolepsy.Heknewthathewassleepdeprived,owingtoinsomnia,
andheknewthathisinsomniawascausedbyanxiety.OnethingthatstruckDr.Richbergasoddwasthatalthoughhehadalwaysbeenarelativelylightsleeper(a
geneticpredisposition),hecouldalwayssleepbetteronFridayandSaturdaynightsthanonweeknights(anenvironmentalfactor).HehadalsonoticedthatSunday
wastheworstnightoftheweek,especiallyifhewastoplayanactiverolethenextdayathishospital'sweeklymedicalboardmeeting(aspecificpsychologicalfactor).
Dr.Richberg'ssleepchartswereasmeticulousasEdwin's,buthisselfobservationjournalwashelpful,too.Dr.Richberghadtakencaretonotethepsychologically
idiosyncraticworkingsofhisownmind.Theparticularfactoraffectinghissleeppatternwashisfearofdefeat,failure,andrejectioninhisprofessionalwork.Earlierin
hiscareerhehadlosthispositionatamajorhospitalcenter.Thisblowtohisselfesteemwascounteredbyhissubsequentsuccessinaprivatehospitalnearby,buthis
senseofautonomyandsecuritywasconstantlyunderminedbyanuneasycompetitivenesswithDr.FrankCutter,asurgicalcolleaguebentupontakingDr.Richberg's
space,hisequipment,histrainees,andhisbillings.Sadtosay,thisisnotanuncommonscenario.
IsawDr.Richbergatotaloftwentytimesoverathreeyearperiodduringwhichhemademajorgainsinthemanagementofhisanxiety,hismaladaptivebehaviorat
work,andhissleep.The

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keystepsthathetookinvolvedallthewelldocumentednaturalaidstosleep,aswellassomespeciallytailoredmovesthatfithisparticularsituation.Together,heandI
cameupwiththefollowingprescription.
SleepWhenTired
OneoftheboldestmovesDr.Richbergmadewastoinstallacouchinhisofficeatthehospital.Heisnotapsychoanalyst.Buthecouldclosethedooreachdayafter
lunchandtakeanapifneeded.Inthiswayhegainedrelieffromandcontrolofhissleepiness.
GetUpWhenWakeful
Dr.Richberglovedclassicalmusic,soinsteadoflyinghopelesslyawakeinbedinthegripsoftense,ruminationanxiety,hewenttohisdenandlistenedtoasymphony.
Thisrelaxedhimenoughtogobacktosleepwithintwentytothirtyminutes.
PracticetheRelaxationResponse
Bothatworkandinbed,Dr.Richberglearnedtolistentohisbreathing,tocounthisslowdeepbreaths,andtoallowthemuscletensiontoflowfromhislimbs.In
doingso,heinterruptedtheflowofenergyfromhisbraintohisbody,whichreducedtheflowofenergyfromhisbodytohisbrain.
Exercise
BeforeconsultingmeDr.Richberghadsufferedaseriousheartattack,whichunderstandablyhadmadehimquitefrightenedofovertaxinghishealingheart.His
cardiologistandIagreed,however,thatbothhisheartandhissleepwouldbenefitfrommoderateexercise:atwomilewalkinthelateafternoonorearlyevening.
TobaccoandAlcohol
Neverasmokerandnotmuchofadrinker,Dr.Richberglearnedtoenjoyaglassofsherrywithhiswifebeforedinnerasanotherwayofbeingsuretoseparatehis
worklifefromhisrecreationandhisrest.

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Sex
ThisparticularlypleasurableformofexercisebroughtDr.Richbergandhiswifebothintimacyandanaturalsleepreadiness.Prostatesurgeryhadcausedhis
ejaculationstoflowbackwardintohisbladder,aconvenientandamusingcontraceptivetechniquethathelearnedtolaughabout.HiscardiologistandIbothendorsed
hisresumptionofthisinstinctiveandexcitingbehavior.
Breakfast
Takingtimeinthemorningtobeginhisdayatbreakfastwithhiswifewasanimportantwayofendinghisnightofsleeponapleasantandpositivenote.Insteadof
rushingofftothehospitalunreadied,malnourished,andtense,hebeganhisdaycalm,wellfed,andrefreshed.
StopTellingEthnicJokes
Dr.Richberg,whoisJewish,hadthehabitofregalingDr.Cutter,anIrishCatholic,withjokesaboutJesus,thePope,andRichardNixon.Dr.Cutterwasnotamused.
Bytellingthesejokesinpoortaste,Dr.Richbergwasvalidatinghisownsenseofhimselfasacompulsiveclown,borntolose,whichwasthemajorsubjectofhis
insomniacfantasies.Hepostedaninvisiblesignontheinsideofhisforeheadthatread:''Nojokes!"
Thereisnothingaphysicianwantsmorethananappropriatelygratefulpatient,someonewhogetswellwithalittlehelp,butmostlyonhisown.Whileitmightnothave
doneharmtoaddtemporaryuseofsleepmedicationtothenaturalregimen,itwasunnecessary,andbothDr.RichbergandIwereinterestedtoseehowfarwecould
gowithoutit.Ithinkwebothwantedhissontoseethat,too.
Today,Dr.Richbergsleepslikeababymostofthetime.Heisradiantlyhappywiththeresults.Heisclearandcalmandhismedicalpracticeisdoingquitewell.
Andhissleepproblemwassignificant.Ifhecouldcurehimself,thoseofuswhohaveoccasionalboutswithlessersleepproblemscansurelydothesame.

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Thepointis:Yes,asolutioncanbethatsimple.Dr.Richberghadtriedeveryconventionalcuremedication,psychoanalysis,andmoreandnothinghadworked.
Whenhesimplifiedhislife,hegotbetter.Therewasnogimmick,nomachine,nodeepsecret.
Thisisacuriousstatementformetomake,but:Manytimespeoplethinktoomuch.Theythinkthatproblemsmustrequirecomplexsolutions.Manytimes,areturnto
fundamentalsisallthat'sneeded.Dr.Richbergisnowfine.Dr.Lowellistakingeverypillinsightandislosinghismarriage,hiscareer,andhislife.Ishuddertothink
howfrazzledEdwinmustbebynow.Rosa,thelongsleepingmedicalstudent,isstillpersecutedbysociety,andshe'sstilltired.MycolleagueLia,theshortsleeper,is
sharpasever.Ifoundasleepcureformycoldsandhaveuseditsuccessfullyeversince,withoutwastingmymoneyatthedrugstore.
Onewaytosumupthemessageofallthesebedtimestoriesistosaythatthebrainknowsbest.Itknowswhatitneeds,itknowshowtogetit,anditknowswhatto
doonceitsneedsaremet.Sleepisofthebrain,bythebrain,forthebrain.Anditbenefitsthebodyaswell.Butthenaturallybeneficialeffectsofsleepcanoccuronlyif
weletthemoccur.Sometimesourmanagerialselveswon'tallowthemtohappen.Inthatevent,wemayneedtoconsultanothermanagertolearnthespecialstate
controltechniqueslikehypnosisthataredetailedinthenextchapter.Ifthatfails,wemayfinallyneedtoresorttothechemicalmanipulationofthebrainmindstate
controlsystemthatwewilllookintointhelastchapter.

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Chapter14
ChangingBrainMindStatestoImproveYourHealth
Dissociativebrainmindstatesthatrelyonthepowerofsuggestionareoftendismissedasasham.Hypnosisisridiculedasahoax,tranceasafake,meditationas
nothingmorethanrelaxation,multiplepersonalityasplayacting.Evenluciddreamingisindangerofbeingscuttledontheshoalsofscientificrespectability.Here'sthe
paradox,though:almosteverydoctorandscientistwouldagreethattheplaceboeffectworksonsomepeople.Well,whatistheplaceboeffect?Thepowerof
suggestion.
Takeninitsbroadestform,thepowerofsuggestionisindeedapowerfultoolthatweallcanusetoalterourbrainmindstatesandimproveourhealth.Whenwe
suggesttoourselves,weareactingoutoffreewill.Thevoluntarychangingofstateisanactofvolition,anactofselfsuggestion.Meditation,trance,andhypnosiscan
beinducedbyallofusifwebelieveitispossible.Wecanusethesethreealteredstatestochangeourhealth.
DentalSurgeryunderHypnosis
Lestyoudoubtit,considerthesuccessofDr.RobertDrury.ImetBobin1961,aftermydisillusionmentwithpsychoanalysisand

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myhorrorovertheKoreanWarpromptedmetomovefrommyresidencywithHarvardMedicalSchoolatThePsychototheNationalInstitutesofHealth,in
Bethesda,Maryland.ThereIwasabletopursueascientificeducationwhilefulfillingmymilitaryobligationasamemberoftheU.S.PublicHealthService
CommissionedCorps.Duringmyfirstyearmyresponsibilitiesweremainlyclinical:Itookmedicalcareofagroupofschizophrenicpatientswhowerethesubjectsof
anintensiveresearchprojectonbiochemicalcausesofmentaldisorders.IalsoprovidedpsychiatricconsultationtopatientsintheNationalCancerInstitute,manyof
whomweredyingandinextremephysiologicalandpsychologicalpain.
Bobwasayoungdentist,andhispracticeturnedouttobeextremelyinfluentialinmythinking.Hisjobwastoprovidedentalcarefortheresearchsubjectsinmy
schizophreniaunit.Iwasimpressedwithhoweasilyhewasabletoobtaincooperationforinvasivedentalproceduresfromtheseveryconfused,sometimesflagrantly
paranoid,andoftenstubbornlyresistantpatients.WhenIaskedhimhowhedidit,hetoldmehewasatrainedhypnotist.
Iwasasskepticalastheaveragephysician.IaskedBobplainlyifhethoughthypnosiswasreal."CometothedentalclinicandI'llshowyou,"hesuggested.
Beforethevisitcouldbearranged,wegottogetherforsupperand,atmysuggestion,Bobputseveraloftheguestsintoalighttrance.Heinducedtheirarmstofloatup
weightlesslyandpromptedthemtoenactsomeinnocentposthypnoticsuggestions,likegettingupandturningoffthelights.Ihadseenthissortof"stage"hypnosis
before,andIhaveseenitmanytimessince.Thehistrionicqualityoftheseperformancesonlymadememoreskeptical.Itisthisclearcollusionbetweenhypnotistand
subjectthathaspromptedcriticismofthevalidityofhypnosisasanauthenticmentalstate.And,indeed,thechargeoffakeryisdifficulttodismissinthesescenarios.
Inthedentalclinic,however,therewasamorescientificallycogentreasonforbelievingthatthehypnosisDr.Druryinducedwasreal.Heusedhypnosisinsteadof
anesthesiatohelppatientsblockpain.Thepatientscouldhavebeenfaking,butiftheywere,theirfakerywaseffectiveonthemselves.Iftheycouldfoolthemselves

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intothinkingtheydidn'tfeelpain,thenwhatkindofpaindidtheyhave?Hypnoticanesthesiaworked,anditworkedbydissociation.
OnthedayIattendedtheclinic,Dr.Drurywasperformingapainfulgumexcisiononapatientwithgingivitis.Anyonewhohasundergoneagingivectomywilltellyouit
isnotapleasantprocedure.Thepatientwasnotaschizophrenic,andhewasnottheusualstagetrancetypeeither.Hewasahealthynononsensesailorwhoworked
asamedicaltechnicianacrossWisconsinAvenueattheBethesdaNavalHospital.WithBob'sencouragement,hehadlearnedtopreferhypnosistoNovocainasa
wayofachievingdentalanesthesia.
Bob'sdemonstrationofhypnosiswasdramatic.Hefirstputthesailorintoamoderatelydeeptrance.Hethensuggestedthattherightsideofthesailor'smouth,butnot
theleft,wouldbeinsensitivetopain.WhenBobprobedtheleftgumwithhisneedlesharppick,thesailorjumpedandhowled.Butwhenhejabbedthegumonthe
rightside,thesailorgavenoresponse,eventhoughthepickdrewblood.Bobproceededtocutawaythecompromisedtissuewithhisscalpel.Hypnosis,Inoted,had
noeffectonhemorrhage:therewasplentyofbleeding.Yetthesailorsattherequietly.
Wasthispatientfaking?Didthesailorreallyfeelthepainbutsayhedidn't?Didonepartofthesailorfeelthepain(hisnonconsciousbrainmind)whileanotherpart
didn't(theconsciousbrainmind)?Orwasheabletoturnoffevenhisnonconsciousbrainmindsothatthestimuliwerenotevenprocessedaspain?Wedon'tyet
knowtheanswerstotheseimportantquestions.ButIcantellyouthis:thesailorwascalm,relaxed,andwideawakethroughoutapainfulprocedure.Somewherealong
thepathfromstimulustoresponse,theneuronsignalswereblocked.Itdidn'toccurinthetissue:thegumwasbleeding,soapainsignalwasheadedforthebrain.
Eitherthesignalwasn'tprocessed,orthemotorresponsetoitwasblocked.Weneedmoreresearchtofindout.Perhapshypnosisblockspainprocessinginthe
thalamus,arelaystationformessagesfromthebodytothebrain.Ifthiswerethecase,thehypnosisactionwouldresemblethatofluciddreaming,inwhichatopdown
signal(fromthecortex)overridesabottomupsignal(fromthebrainstem).

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Ifyoulendanycredencetothebrainmindparadigm(andIimaginethatifyoudon'tyouwillnothavereachedthispointinthebook),theideathatwecanvoluntarily
alterourphysiologicalresponsivenesstopainshouldnotseemthatoutlandish.Weknowfullwellthatwhenwedaydream,internallygeneratedvisionsreplace
externallygeneratedones.Withthissimpleactwearecontrollingperception.Why,then,shouldwenotbeabletoredirectattentionfromexternaltointernalsothat
painstimuliareeithercancelledordeniedaccesstothehigherlevelsofourconsciousness?Sure,itmightbeamoredifficulttaskignoringanexternalpainsignal
requiresmorevolitionthanignoringexternallightwavesbuttheprocessisexactlythesame.Weareshiftingstatestoalterafaculty.Weareshiftingtheinputsource
intheAIMmodelfromexternaltointernal.Andthatisall.Justbecauseitmightbehardertododoesn'tmeanitcan'tbedone.Thoseofuswithcommonsenseare
amazedattheresistanceputupbypsychologists,physiologists,andphilosopherstotheobviousrealityoffreewillandthevoluntarycontrolofourbodies.
Itch,BeGone!
Acriticmightsaythatthesailordidn'tfeelpaininhisgumbecauseitwasdiseased.Ilaterentertainedthisasapossibleobjection,aswellasothers,buttheprofuse
bleedingcouldn'tbeignored.Ididwonder,however,howfartheapproachcouldbetaken.Couldevenoutspokendisbelieversinhypnosisbeinducedtoignore
physicaldiscomfort?Isoonlearnedtheycould.
ThedoctorsoftheNationalCancerInstitutewereattheirwits'endformanyreasons,allrelatedtothedevastatingconsequencesofcancerontheirpatients.One
symptomthatwasparticularlyresistanttocontrolwasitchingoftheskincausedbytheinvasionofHodgkin'slymphomacells.Iwasaskedtoworkwiththepatients
whohadthisproblemsomeweredrivenalmosttoinsanitybytheitching,threateningtojumpoutofthewindowsofthecancerinstitute,whichwasontheeleventh
floor.
IquicklyrealizedthatwhatthesepatientsneededwasadentistnamedDrury,notapsychiatristnamedHobson,becausetheden

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tistwastrainedinhypnosisandthepsychiatristwasahypnophobe.Iaskedthepatients,onebyone,iftheythoughthypnosiswas"real."Alltensaidflatlythatitwas
not.OnetougholdcodgerfromtheDeepSouth,whohadaglareinhiseyeandapineydrawltomatchthebestofthem,wasliterallytearinghiscancerriddledskin
aparttryingtostoptheitching.Hewascoveredwithantibioticstopreventinfectionofhisbrokenskin."Lookhere,boy,"hetwangedatme,"youbetterputmeto
sleepbeforeIdoitmyself!"
Thatgavemeanidea.Whataboutplainoldsleep?Thenursessaidthatsomeofthepatientsdidstopscratchingatnight(implyingabatementoftheitch)butthatothers
wokeupmoreexcoriatedthanbeforetheywenttosleep(indicatingthatsleepscratchingisarealthreat).Thefactthatweallarenaturallyanestheticwhenwesleep,
andthatwealmostneverexperiencepaininourdreams,indicatesclearlythatanaturalchangeinbrainmindstatecouldchangetheperceptionofanunpleasant
stimulus(theitching)oreliminateadamagingresponsetoit(thescratching).
SoIaskedthepatients,"Iftherewasanychancethathypnosiswouldhelpyou,wouldyougiveitatry?"
"I'msureIcan'tbehypnotized,butI'lltryanything"wasthetypicalreply.
EnterBobDrury.Hecameatmyrequest,andonebyonehehypnotizedthetenpatientsandtoldthemtheywouldn'titchandshouldn'tscratch.Ididn'twitnessallten
attemptedhypnotisms,butIcantellyoutheoutcome.Fiveofthepatientshadverysignificantrelief.Theywerefreeofitchingandscratchingforthreeweeks,aftera
singlehypnoticsessionofabouttwentyminutes'duration.Oneofthosefivewasthetougholdcodger,andhewasassurprisedasI.
Whathappened?Werethesepeoplefaking?Hardly.Theywantedreliefbadly,badlyenoughtobelievethehypnosiscouldhelp.
Painanditchingarebothsubjectiveexperiences.Andhypnosisreliesonthepowerofsuggestion.Likebeing"undertheinfluence"ofalcohol,peoplecanbe"underthe
influence"ofsuggestion.Andastheydowithalcohol,theychangestateverysignificantlyundertheinfluenceofsuggestion.Ifwecouldjustfindthechemicalor

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electricalneuralmechanismsthataretriggeredwhenpeopleareundertheinfluenceofsuggestion,wecouldputthispowerfulandusefultechniqueonsolidscientific
ground.Asoneconsequence,hypnosiscouldbeintegratedwithmainstreammedicine.Wecouldthenhelpmanypatientswhoarehypnotizablebutdon'tknowit
becauseithasneverbeentriedonthem.Asanotherconsequence,wemightbeabletoinducethehypnoticstatephysiologically,andsohelpeventhosepatientswho
arenotsusceptibletosuggestion.
TheBrainMindinTrance
Throughouthistory,andinmanypartsoftheworldtoday,abrainmindstatecalledtranceplaysacentralroleinreligiousrituals.AmongtribalpeopleinMalaysia,for
example,thetrancestateiscalledLatah.
Becausetrancecanbeinducedbyhypnosis,IwilllookcloselyatLatah,andsomeotherexoticbehaviorsthatsharepropertieswithit,insearchofcommonunderlying
mechanismsthatwillhelpusbegintolinkthemtoourmodelofbrainmindstatecontrol.Iwillshowhowgenetics,braindisorder,andculturecanallconspireto
predisposepeopletoundergorapidanddramaticchangesinstate.Thefactthatsomanyculturesusetranceasanintegralpartofhealingpracticesgivesthis
comparativesurveyitsrelevancetoourquestforwaysinwhichhealthcanbeimprovedbyalteringstates.
LikeDrury'sdentaltrance,Latahseemstohaveananestheticeffect.Whensubjectshaveputthemselvesinasuitabletrancestate,theirnoses,ears,andcheeksare
piercedwithsharpskewers,whichmaythenremaininplaceforalifetime,astotemicinspirationtoothersinsearchofmoreintimatecontactwiththespiritworld.
Noteveryoneiscapableofthedeeptrancenecessarytobeartheritualortheheavyweightofornamentsthatarelateraddedtotheskewers.Buteveryoneindulgesin
longhoursofritualpractice.Ritualpreparation,includingintensedancingandsleepdeprivation,beginsmanydaysbeforethepublicexhibition.
SomeMalaysiansareparticularlysusceptibletotrance.Iftheyarestartledortickled,theyundergoadramaticstatechangethat

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isasrapidanddistinctiveasthecatalepticattacksofnarcolepsy.Butinsteadoftheirbodiesfallinglimpandtheirmindsfallingintothedreamstate,astheywouldin
REMsleep,theybecomehypnoticallydissociated.It'sasifsomeoneflippedaswitchandtheysuddenlylostcontactwithreality.Theymayutterunseemlystreamsof
invectivesorbecomesubmissivelyobedienttocommands.TheLatahtranceisahypersuggestiblestatethatisitselfsuggested.Butunlikehypnosis,itistriggeredbya
startlestimulus.
ThereisthusapotentiallyinformativesimilaritybetweentheuseofLatahtobearthepainofthepiercingritualandtheanalgesiaofhypnosis.Bothrequirepreparation
byanagent(thepriestorhypnotist).Botharestatesforwhichcertainindividualshaveaheightenedsusceptibility.Andbothareexperiencedasatemporary
abandonmentofvoluntarycontrolintheinterestofattainingastatethroughwhichpersonalorsocialwellbeingisenhanced.Itappearstherearetworoutestothe
alteredbrainmindstateoftrance.Oneistopdown,forwhichahypnotistorshamanandsomeritualisnecessary.Theotherisbottomup,requiringonlyasimplebut
suddenphysicalstimulus.
Byeitherroutethesubject'sbrainmindisseizedandhisperceptionsandmotorbehavioraredramaticallyaltered.Thesubject'sprivateexperience,especiallypain
perception,ischangeddrastically.Thesubject'scontrolofbothinternalandexternalattentionislost.Theseperceptualandattentionalfeaturesaresimilartoourown
normalexperienceinfantasyanddreaming.They'rejustmoredramatic.
Wehavealreadynotedthatwhenthehypnotistorpriestinducestrance,thesubject'svolitionissurrenderedintheinterestofapersonalorsocialgoal.Becausethe
processingofexternaldataandtheorientingresponsedependontheposterior(rear)regionofthecortex,wemightsupposethatduringhypnoticinductionthesubject
slowlybutsurelyallowstheactivitylevelofthatpartofthebraintofall.Ifthiswereso,thenotherpartsofthebrain,suchastheanterior(forward)region,which
directsattention,thought,andaction,mightgaintemporarydomination.Thesubject'sattention,nowpinchhittingforhiswill,canbeengagedbythehypno

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tist,whosesuggestionsareimplantedasplansforfutureaction.Later,thesecovertplansemergewhencued.
Reflextrancecouldworkviaasimilartakeoveroftheposteriorattentionalsystem,whichorientsustoexternalsignals.Astheunexpectedstimulusinvadesthe
abnormallyunprotectednetworksofthebrainstem,thesusceptiblesubject'sattentionisinstantly,unconsciously,andautomaticallydisengaged.Heloseshisabilityto
orienthelosescontactwithhissurroundings.Atthesametime,themotoraspectofhisstartleresponsealsoabnormallysensitiveistriggeredandhejumps.It
canhappentoallofus,althoughusuallytolesserdegreeswhensomeonestartlesus,we"jumps"asanintegralpartofoursurprisereaction.
Forcenturiesashiftinselectiveattentionhasbeenthoughttobethemechanismofhypnosis.Nowthatwehaveamoredetailedandbrainbasedtheoryofhow
selectiveattentionworks,itmaybepossibletospecifythemechanismsthatinducetrance.
AswesawinChapter10,whenwediscussedattentionindetail,itisalsolikelythatournewknowledgeofsleepstatecontrolwillhelptheefforttoputhypnosisona
moresolidscientificfooting.Forcenturiestheverytermhypnosis,memorializingtheGreekgodofsleep,Hypnos,hassignaledourawarenessofakinshipbetweenour
spontaneousandinducedbrainminddissociations.
Andindeed,sleepitselfcanbeviewedasanautomatismaninvoluntaryactionthatoccurswithoutvolitionorneuralstimulation.Becomingdrowsyisakinto
hypnosiswillandattentionbothfadeastheactivationlevelofthecortexfalls.Oncetheactivationfallsbelowacertainpoint,thethalamus,thatcentralfilterthatduring
wakingblocksthecortexfrombeingswampedwithrandomsignals,losescontrol,andthecortexisbombardedwithpowerfulinternalstimulithatfurtherdisorganizeits
activity.Nowwearetrulyentrancedbysleep.
ThebehaviorassociatedwithLatah,orstartletrance,isfascinatingforseveralotherreasons.ThestreamoffoulmouthedinvectivesutteredbytheMalaystrongly
parallelsthatwhichoccursinGillesdelaTourette'ssyndrome,inwhichcompulsiveswearingisoftenaccompaniedbyinvoluntaryarmflailing.Theseautomatisms

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haveakinshipwiththedissociationsofsleep:sleepwalking,sleeptalking,andtheREMsleepbehaviordisorderareallcharacterizedbyautomaticmotoracts.Allare
unwilledandallarenonconscious.
JumpingLumberjacks!
ThestartletranceofLatahisnotaquirkrestrictedtoaparticularAsiancommunity.Similartraitsaresharedbyanunusualgroupthatisclosertohome,the''Jumping
Frenchmen"ofnorthernMaine.TheseskittishlumberjacksarestrikinglyLatahlike,exceptthattheirstartlebehaviorhasnoreligiouscontextwhatever.Whetherthis
curioustraitisinheritedorlearnedisnotclearbutitappearstoprovidesocialentertainmentallweeklong.TicklingorsurpriseisagainthestimuluswhenaJumping
Frenchmanispokedorambushed,heimmediatelyrespondswithadramatic,almostconvulsivejump.Initsaftermathcomesastreamofgutterspeechandatrancelike
dissociationofconsciousnessthatpromotesautomaticobediencetothesuggestionsofonlookers.
LikereflexLatah,thebehavioroftheJumpingFrenchmenappearstoinvolveatakeoverofabrainmindstatethatcooptstheposteriorattentionsystem.Theorienting
functionofthebrainstemandposteriornetworkisjolted,causingthejump.Thenawaveofexcitationspreadsrapidlyupward,jammingthethalamusandmomentarily
disconnectingtheanteriorsystem.Thusreleasedfromvoluntarycontrol,restraintinthecortexislost.Thesubjectsbecomeslavishlyobedienttothesuggestionsof
onlookersandemitachorusoffoullanguageasifsomedeepswearingcenterhadbecomeautomaticallyactivated.
ThefactthattheJumpingFrenchmenknowtheyaresubjecttothisbehavioronlymakestheirreactionsworse.Ayoungboywhoknowsthathisolderbrotherwill
scarehimwhenhereachesthetopofadarkstaircaseisscaredevenmorewhenithappens.Theanticipationheightenshisresponse.
BoththeMalaysianLatahsandtheJumpingFrenchmenareisolatedculturalgroups,soitmaybethatreligiousbeliefsandgeneticinbreedingplayroles.Butthebrain
mindstatechangethatisseen

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inLatahs,JumpingFrenchmen,narcoleptics,andTourette'spatientsevidencesthecommonfeatureofincreasedsensitivitytostimuli.Sensorysignalscauseasudden
attentionalshift.Amotorautomatismresults.Theusualchainofcommandinvolvingconsciousness,volition,andactionisbroken.Likewise,highlyhypnotizable
subjectswhohavebeenstudiedinourcultureeasilyshiftattentionawayfromtheoutsideworld.Infact,thesesusceptibleindividualsareinclinedtoenterimaginative
trancelikestateswhetherornottheyareinthepresenceofahypnotist.Thisfrequentandfluidstatechangehasledtotheircharacterizationaslifelongfantasyaddicts.
Themostremarkabletalentofhighlyhypnotizablesubjectsistheirabilitytoperceiveselfgeneratedimageryofhallucinatorystrength.Forexample,insteadofcallingup
theoutlineorsilhouetteofananimal'shead,asweareallabletodo,theseexceptionalindividualscanseethewholeanimal,embeditinascene,andletthescene
developintoavividmovie.Thisnaturaltalentforscenarioprojectiononthehomemoviescreenoftheindividual'sbrainmindresultsinapseudorealitythat
mostofusexperienceonlywhenwedream.Fromaphysiologicalviewpoint,itseemsthathighlyhypnotizablepeopleliveclosertotheedgeofREMsleepthantherest
ofusdo.
Forobviousreasons,evolutionhasselectedindividualswhocanmaintainsharpboundariesbetweenbrainmindstatesthatinvolveshiftsfromexternaltointernal
attention.Ifoneistosurviveinanythreateningenvironment,itisimportanttomaintainalertnesstodanger.Andinataskrequiringsustainedvigilance,suchasstalking
preyorflyingahighspeedjet,thesuddenintrusionofdreamorfantasyimagesisextremelycounterproductive.
WecrosstheStage1boundaryrapidlyuponfallingasleepandwakingup.Duringthisfleetingstagedreamletsmayoccur.Wecrosstheboundarysoquicklyand
automaticallythatwehavelittleornoawarenessofthecuriousmixturesofwakinganddreamingconsciousnessthatcanoccur.Butwecanprimeourbrainminds,by
suggestion,toslowthisprocessdownandperceiveit,andwithpracticewecanevenachieveluciddreaming.Inbothsleeponsetandluciddreaming,someaspectsof
wakinghavebeendrawninto

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dreaming.Theresultinbothcasesisasimilarlydissociatedstateinwhichweregainsomeattentionalandvolitionalcontrolbutcontinuetohallucinate.Wecanenjoy
watchingourselvesdoingimpossiblethingssuchascarefreeflyingandjudgmentfreesex.Thesealteredstates,forus,closelyresemblethealteredstatesoftranceand
hypnosis.
Itshouldcomeasnosurprisetolearnthathighlyhypnotizablesubjects,whoflitaboutontheedgeofdreamingwhenawake,alsohaveanaturaltalentforlucid
dreaming.Theycanapproachthewakedreamstateinterfacefromeitherdirectionandhoverthere.Notsurprisingly,either,theseluciddreamerstendtobelieveinthe
supernatural.Itisaconvenientandintriguingexplanationfortheirstates,whicheventhemostcriticalbrainmindspecialistshavetroubleunderstanding.
Aseasilyastheycanenhancecertainstimuli,likeinnervision,peoplewhoarehighlyhypnotizablecansuppressothers,likepain.Thisanesthesiaswitchisobviously
usefulifitcanbecontrolledbythesubjectoratthesuggestionofahypnotist,aswasthecasewithDr.Drury'ssailorandtheHodgkin'sitchpatients.Mycolleague
DavidSpiegelhasintriguingpreliminaryevidencethattheelectricalandmetabolicactivityofthecortexcanbealteredatwillduringhallucination.Thispromisinglead
couldhelpprovidehypnosiswiththefoundationinphysiologythatitneedstoholditsafeintheharborofscience.
WhatcanthehousewifeinSheboyganhopetolearnfromtheLatahsofMalaysia,theJumpingFrenchmenofMaine,andtheneighborafflictedwithTourette's
syndromeornarcolepsy?Onlythatsheshareswithallofthembuiltinmechanismsforhypnosislikestateshifts,andthatthesemechanismscouldbeusefultoherin
aidingimportantfunctions(suchaschildbirth)ifshecouldonlylearntosummontheircommonanestheticproperties.Formostofusthemechanismsthattriggerthese
statesaresodifficulttoaccessthatwearetemptedtowriteoffourmoresusceptiblebrethrenasweirdoswhomwearehappynottoresemble.Butthisisasmugand
shortsightedstance.Aswenowturnourattentiontosomegardenvarietydissociations,letusthankourexceptionalfriends

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forhelpingusunderstandtheirtalentforchangingstatesandseewhatwecanlearnfromtheirexample.
SomnambulismandSleepwalking
Pronenesstohallucination,mildaddictiontofantasy,andtheanesthesiatriggeringabilityofhighlyhypnotizablesubjectsputthematsomeclinicalrisk.Whilesome
observersseethemastalented,othersseethemassobizarreastoinvitepsychiatricdiagnoses.Indeed,manycontroversiesinpsychiatryhavepivotedonthewaythat
thisexceptionalsetofmindbrainstatefeatureshasbeeninterpreted.Andthedebateisnotover.Ifanything,itseemstobeheatingupagain,soitmaybewiseto
quicklyreviewsomeoftherootsofthiscomplexstory.
Inthesecondhalfofthelastcentury,theneurologyclinicsofParisandVienna,aswellasthoseofMadridandMilan,werecrowdedwithwomenwhocomplainedof
amnesias,anesthesias,automatisms,anddreamystatesofconsciousness.ThemostfamouscenterforthestudyofwhatwascalledGrandHysteriawastheclinicof
JeanMartinCharcotattheSalptrirehospitalinParis.ThemostdramaticeventinCharcot'sclinicalrepertoirewastheinductionofhypnotictrance.
ThebrainmindstatechangesthatCharcotandhisillustriousteamwereabletoinduceincludedalterationsinposturaltone,reflexexcitability,andattentiveness.These
exoticphysiologicalchangesdidmuchtorescuethecuriousbehaviorfromthefringesofscience.Thefatherofhypnosis,theAustrianphysicianFranzAntonMesmer
(asin"mesmerized"),thoughtinthelate1700sthatthesestateshiftswereareflectionofanimalmagnetism.Thisconcept,whichhadalreadybeencastigatedbyan
officialcommissionthatincludedthelightningexpertBenjaminFranklin,wasreplacedbyCharcot'smorescientificvocabulary.
ButCharcothimselfcouldnotadvancehistheorybeyondtheimportantdistinctionthathedrew,whichwasthatabnormalfunction(whichwewouldnowseeasan
alteredbrainmindstate)wasnotnecessarilytheresultofananatomicallesion(fixeddamageto

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thebrain).Charcot'sinabilitytospecifyexactlywhathemeantby"functionalabnormality"leftthedooropentoawidevarietyofinterpretations.Themostfamousof
thesewasSigmundFreud'sdevelopmentofthepsychoanalytictheory.PsychoanalysiselaboratedCharcot'sownemphasisonthwartedsexualimpulses.Italso
allowedsomestrayMesmeriststosneakbackintothecenterring.Asacolleagueofminehaspointedout,magnets,batteries,andmetalplateswereonceagainin
vogue.
Charcotcoinedtheterm"somnambulism"todescribethepeculiarchangesinposture,reflexresponse,andattentivenessthathispatientsexhibited,sometimes
spontaneouslyandalwayswheninhypnoticallyinducedtrance.Charcot'ssomnambulistswereinadissociativestatewithsomefeaturesofwakingandsomefeatures
ofsleep.
Tohelpusunderstandthisoddstateweneedonlyexaminesomedetailsofmodernsomnambulismplainoldgardenvarietysleepwalking.Manyofushavedoneit,
andmostofushaveseenitoroneofitscloserelativesinourchildren.Today,themedicalcommunitycallssuchautomatismssleeptalking,bedwetting,tooth
grinding,andnightterrors"parasomnias,"tosignalthattheseunusualsensorimotorbehaviorsoccurwithinotherwisenormalsleep.Thetwoothermajorclassesof
sleepdisorderarecalledinsomnias(toolittlesleep)andhypersomnias(toomuchsleep).
Sleepwalkingisa"functional"problemifevertherewasone.LikeCharcot,wewouldexpecttoseenostructurallesionifwemicroscopicallyexaminedthebrainofa
sleepwalker.Andwewouldexpecttoseenosignificantpsychopathologyinamentalstatusexameither.Sleepwalkingisaslightbutsignificantvariationonaperfectly
normalprocessofbrainmindstatecontrol.
Whensleepwalkingoccursinthesleeplab,theelectroderecordingsrevealaprofounddissociation.Onepartofthesleepwalker'sbrainisasleep,anotherpartis
awake.Contrarytocommonsense,sleepwalkersarenotactingoutdreams.TheirepisodesdonotoccurduringREMsleep.Infact,theyoccurduringnonREM
sleep.SleepwalkingisphysiologicallyandbehaviorallydifferentfromtheREMsleepbehaviordisorderdemonstratedbyJos,the

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manwhoelbowedhiswifewhiledreamingofdrivinghiscar.Insteadofperformingmotoractsthatconformtothehallucinationsofadreamscenario,thesleepwalker
performsmotoractsthatareappropriatetosomerealistic,ifslightlymisguided,externalgoal.
PartoftheexplanationisthatduringnonREMsleep,motoractivityisnotshutoff.Itisonlyreduced.MotoractivityisnotfullyinhibiteduntilREMsleepbegins.In
nonREM,thereisstillalowlevelofdriveonthemotorsystem(howelsewouldwe"rollover"inbedwhileweareasleep?).Note,too,thatthereissomelevelof
brainactivityduringnonREMsleepaswellitisverydiminished,butnever"off."Thegoalthatsleepwalkersaretryingtoreachisnotfullyconscioustothem,butitis
powerfulenoughtodirectthebody.
Theamazingfactisthatasthesleepwalkerwanders,hiseyesopen,andsometimesheevenconverseswithwhoeverisintheroom.Parentsofyoungchildren
experiencethisfrequentlytheirlittlesonsordaughtersmayopentheireyesandevenreachforahugwhenparentswalkinduringthemiddleofthenight,yettheyare
stillsleeping.Inthelab,theEEGreadingsofsleepwalkerswhoareconversingwiththeattendantsexhibitthesameslowwavesofnormalStage4sleep.Thisfurther
supportsthediagnosisthattheupperpartofthesleepwalker'sbrain,thecognitivepart,isindeepsleep,whilethelowerpart,themotorpart,isawake.The
sleepwalkerisintwostatesatonce.
Insomecases,thesleepwalkerhasacompletelyunrealisticorpotentiallydangerousgoal,likeclimbingoutanupperstorywindowtoathinledge.Theoldwives'tale
thatyoushouldn'twakeasleepwalkerissilly.Youmightnotbeabletowakehimbecausehisupperbrainisindeepsleep.Buttheonlyreasonasleepwalkerseemsto
jumpinfrightwhenawakenedisbecausehehasbeenstartledfromhisstate.Theresponseisthesameasthatofsomeonewhoisseatedatadeskconcentrating,with
hisbacktoyou,whenyouwalkinandstartledhim:areflexivejump,perhapsaflailingofthearms,andamomentofangeratthejolt.Morecommonly,asleepwalker
issimplyheadedforthebathroom,butbecausehismapsaremixedup,heendsupinthelivingroomorthekitchen.I

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myselfwasquitecapable,whenayoungman,ofsleepwalkingdownafullflightofstairs,openingthefrontdoor,andurinatingintherosegarden.
Childrenareparticularlypronetothisformofdissociation,probablybecausetheysleepsomuchmoredeeply.Thishasledtothetheorythatalltheparasomniasare
"disordersofarousal."Astimuluslikeafullbladderissufficienttoarouseanolderpersonfromsleep.Whenwesaytotheparentofabedwetterorasleepwalker,
"Justbepatient,yourchildwillgrowoutofit,"it'strue.Maturation,inthiscase,isthelossofanentirelynormalbrainmindfunctionadissociation.
Weloseotherbrainmindfunctionsinmidlifeorlatelife,suchastheabilitytoenterStage4sleep.Manyolderfolksneversleepdeeply,andiftheywouldstop
worryingaboutit,itwouldhavenoaffectontheirhealth.Yetourcapacitytogrowoutofoneproblemismatchedorevenexceededbyourcapacitytogrow
intoanotherone.Oneelderlypatientofminesaidthat,forher,oldagewasaproblembecauseshehadmoretimeinwhichtodoless.Bythatshemeantthather
diminishedsleepneedreflectedinhershorterandshallowerepochsofsleepwasnotbalancedbyanincreaseinenergyorenthusiasmforworkorpleasuretofill
theextrawakinghours.Societyhadnotprovidedherwithdivertingorsatisfyingalternativestothesenseofuselessboredomthatwastherealpainofherinsomnia.In
thefaceofashrunkenandlesselasticbrain,theonlyadaptiveresponseolderpeoplecantakecomfortinistoalterthewaytheinformationintheirbrainmindis
processed.Thatkindofrefrainingofmentalcontentiscalledwisdom.
TheTapeRecorderCure
Sleeptalkingisanamusingvariationonthethemeofdissociation.Storiesaboutnocturnalmonologuesanddialoguesusuallyprovokemirthandmildembarrassment.
Notallisinnocentfun,howeverdamagingconfessionscanbeextractedbyspousessuspiciousofhankypanky,althoughtheseadmissionswouldneverholdupin
courtbecausetheyarecollectedwithoutthesubject'scon

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sciouscomplianceandbecausethesubjectistoopronetothesuggestionsmadebythemidnightinterviewer.
Untilrecently,itwascommonforpsychiatriststoassumethatallsleepdisordersweremanifestationsofunconsciousmotivation.And,indeed,amanwhofindshimself
snackingfromhisiceboxwhilehalfasleepat1:00A.M.maydowelltowonderwhatthisbehaviorsuggests.Forthevastmajorityofpeoplewithsleepdisorders,
however,thereisnopsychologicalundercurrent.Theireccentricitiesarepurelytheresultofdissociation.
ConsiderthecaseofFrankMorewill.Frankwasahardworkingandhandsomeapprenticeelectricianwhohadjustmarriedhishighschoolsweetheart.Heslept
enviablywellbutwashorrifiedtolearnfromhisyoungbridethatliketheLatahs,theJumpingFrenchmen,andtheTourette'spatientshehadafoultonguethat
ledalifeofitsownwhenhewasasleep.
Theyoungwifewasnotshocked.SheknewallthosewordsandacceptedtheobviousfactthatFrankknewthemtoo.Ifhissleepcursingawakenedher,allshe
neededtodowasgivehimapoketogethimtorollover,andpeacereignedagainintheirbedroom.ButFrankwasworriedabouthisgoingonaswearingbinge
duringanightwhenhisinlawswereguestsintheadjacentbedroom.Theywouldthinktheirdaughterhadmarriedamonster.
WhenImetFrank,IwasjustbeginningtorealizehowmuchIandmypatientscouldlearnaboutsleepbehaviorwithoutresortingtoasleeplab.SoIaskedFrank,
"Whynotsimplytaperecordtheswearingandhaveyourwifeenterthedateandtimeofeachoccurrence?"A$50handheldtaperecorderismuchcheaperthana
$10,000polygraphandhasamuchwidervarietyofuses.
SoFrankwenttothelocalgadgetshopandpickedupavoiceactivatedrecorderthatheplacedonhisbedsidetable.Onemonthlaterhereturnedtoseeme,clutching
histaperecorderandhissleepchart.Hewasbeaming.Ididn'tknowwhattoanticipatefromhisbroadsmile.
"Thistaperecorderiswonderful!"heexclaimed."Sinceyouprescribedit,Ihaven'tswornatall."
ImustconfessthatwhileIwaspleasedthathewaspleased,Iwasabitlost.Furthermore,Ihadn't"prescribed"anything.Then

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ithitme.IhadunwittinglyusedthepowerofsuggestiononFrank.Hehadrespondedpositivelytothesocialpressureofamonitoringdevice,andhisviewthatthiswas
my"prescription"addedlegitimacytothenotion.Ididn'twanttonegatethisdesirableplaceboeffect,soIsuggestedthat,justtobeonthesafeside,hekeepthetape
recorderathisbesideforanothermonthandcallmeifhehadanythingtoreport."I'mcured,"hesaidconfidently,andsureenough,henevercalledmeagain.
SincebeingeducatedbyFrank,Ihaveseenfourothercasesofparasomniathatwerecuredbythepresenceofamonitoringdevice.
ThePlaceboEffect
Weallexpecttobehelpedbyadoctor.Eventhemedicalprofession'scurrentfallfromgracedoesn'tseemtochangethedeepdrivetowardhealthandoptimismthat
promptsustoseekhelp.Itissostronginusthatevenadisenchantedpatientislikelytocomeawayfeelingbetter.
Thisperversebutwelcomephenomenoniscalledtheplaceboeffect."Placebo"inLatinmeans"Ishallplease."Itisaverypowerfulforceaccountingforbetweenone
thirdandtwothirdsoftheperceivedbenefitsofmedicalcare.Theeffectissopowerfulitnowformsthebasisfortestingnewtreatmentmodalities.Newdrugscannot
bepresentedtotheFDAforapprovaluntiltheyhavebeentestedagainstacontrolgrouppeoplewhoaregivenwhattheybelievetobeanewcurebutinrealityis
onlyasugarpill.Anynewtreatmentmustovercometheuphillbattleofprovingthatitprovidesasignificantimprovementinoutcomestatisticsoverthoseobtainedwith
sugartablets.
Howshouldwethinkaboutthisphenomenonandwhatshouldthedoctorandthepatientdoaboutit?OneresponsethatIwouldnotrecommendistodevalueitby
sayingit'snot"real"medicine.That'slikediscountinghypnosisbecauseitinvolvessuggestion.Theworstthingofallwouldbetosupposethattheplaceboeffectisno
effectatall.Weareindangerofthatscientificmistakewhenwecallit"nonspecific"oreven''psychological,"implyingitis"noth

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ingbut."Ifaplaceboworks,itworkssomehow.Andourjobasscientifichumanistsistofindouthow.Meanwhileletusprescribe,take,andenjoythebenefitsof
asmanyplacebosaswecanfind,whileadmittingourignoranceastohowsuchaharmlessandinexpensivemedicinecanbesoeffective.Anothermistakewouldbeto
trytogetridofit.Youcan'tkillhope.
LearningfromDelia
MyfriendDeliahastaughtmemorethanCharcot,Freud,andMesmerputtogetheraboutthenatureofbrainmindstatesandhowtheycanbeusedtobenefithealth
andthedeepenjoymentoflife.NothingisalientoDelia.Onthecontrary,sheseesevenhersometimesterrifyingdreamsandherpainfullydepressedstatesofwaking
asbothinstructiveandinspirational.AlthoughsheismorefatalisticthanIwouldcaretobe,sheisalsotruertoherselfthanIwoulddaretobe.Asaresult,sheisable
torespondpositivelytoawidevarietyofpsychological,physiological,andspiritualissues.
WehavealreadyseenhowDeliausesherrichandabundantdreamlifeasanexistentialtheatertobeenjoyedorsuffered,butinanycaseaccepted,attendedto,
andevencelebrated.Shegoestobedlookingforwardtodreamingandshewakesupthewiserforhavingdreamed.Herdreamjournalisatreasuretroveofher
psychicexperience,someofwhichshehasbeengoodenoughtosharewithus.WhilemostofuswillnevermatchDeliaonthescalesofdreamexoticismoramountof
recall,wecanalllearntoincreaseourawarenessofdreamingandtoincreasetheintensityandqualityofourdreamexperience.
Deliaisalsodaringlyexperimentalwhengiventhechancetoincreaseeitherherpsychicexperienceorherknowledgeaboutit.Shehassleptinthesleeplabandbeen
awakenedduringREMsleepfordreamreports.Shealsohasusedmylab'snewhomebasedREMdetector,theNightcap,whichenableshertocharthersleep
signalsonapersonalcomputerpositionedbesideherbed.DeliausestheNightcaptoincreaseheraccesstodreamsandhasdiscovered,justasSwedenborgdid,that
aftershehasbeensleepdeprivedherdreamsbecomemoreintenseandmoreinclusiveofthemesthat

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themesthatareimportanttoher,likerelationshipswithpeopleshelovesortheveneratedfiguresfromherreligiousworld.OneofDelia'smostexoticexperimentswith
dreamingisthecultivationoflucidityordreamconsciousness.Withpractice,shehasbeenabletogainawarenessthatsheisdreamingwhilesheisdreaming.Inso
doingshecanshapeherdreamlifeinformsthatsheseeks,likeflying(withoutaballoon)andenjoyingsex(evenwithforbiddenpartners).Thussheincorporatesthe
scienceofdreamingintoherintellectualgrowthandherownparticularviewoftheworldandthecosmos.DeliasaiditherselfsheisdefinitelyNewAge.
ButDeliaisnotimmunetothestressesofmodernlife.Farfromit.Sheistypicalofthe1990scitydweller,withahighpressurejobandlifestyle.ForDelia,theluxury
ofdroppingoutisjustnotanoption.Sowhenshegetsupearlyandcommutestoheroffice,sheplaysarelaxationinstructionaltapeonhercarstereo.Thisholdsher
brainmindinarelativelypeacefulstateasthetrafficwhizzes,honks,andhaltsaroundher.Andwhenherbossgiveshermoreworkthanthreeofhercouldcompletein
aday,shecallsonherinnervoicetoreassureherselfandherbossthatshewilldoherbestbutthatshecannotdotheimpossible.
Whenworkstressraisesitsvoicetoascreamingpitch,Deliadoesdropout,butonlybychangingstate.Notbyquitting.Shecanclosehereyes,sitstill,andentera
trancelikemeditativestateinseconds.Twentyminutesofemergencymeditationcanalsorescueherfromsocialembarrassmentwhenshefindsherselfwithpeoplewho
areinsensitiveorungiving.Insteadoflosinghertemperandherselfrespectshebeatsastrategicretreattohermeditativehaven,fromwhichsheemerges
refreshedandarmedwithbothdistanceandacalmerperspective.
Delia'shealthhasbeenplaguedbytheusualhostofminorproblems,andsomemajorones,too.Whensheneedstoconsultprofessionalslikedentistsand
doctorsshedoessocomfortably,knowingthatshecancontrolboththeinevitablediscomfortofdiagnosisandtreatment,andthesometimesalarmingmessages
theseencounterscandeliver.
Althoughaspronetoanxietyaboutherhealthasweallare,Deliamanagesheranxietyactivelybylettingherinsightaboutits

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natural,instinctualnaturehelpherfindequallynaturalchannelsofrelief.Oneisthemeditativepracticealreadymentioned.Anotherissleep.Andstillanotherisexercise.
Sofarshehasnotyetturnedtoformalhypnosis,butifsheneededit,shewouldnothesitatetotryit.Andbecausesheisalreadysotalentedandsopracticedatstate
change,shebelievesthatevendeeptrancewouldnotbebeyondherreach.
Andnoneofthesenostrumsprecludesheruseofdreamstocreateamodelofherlifehistory,hercurrentcrisis,andheroptionsforthefuture.Thesearetheconcerns
oftraditionalpsychotherapy,whichcanalsoflourishintherichatmosphereofthenewbrainmindparadigm.Delia'sconsciousstatesarethusbothablueprintanda
provinggroundforlifechange.

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Chapter15
TheLastResort:UsingDrugstoChangeYourState
Thebrainmindhastheabilitytohealitselfbychangingstates.Youcanharnessthispowertoimproveyourhealthbothmentalandphysicalbyvoluntarily
alteringyourstateofbeing.Somepeople,however,fallpreytoexcessivestress,addiction,disease,andthesimplelongtermdeathofbraincells.Drugsareoften
helpfulinchangingthebrainmindstatesofthesepeople,theBertalsoftheworld,whomwesoreadilylabelas"abnormal."Andwiththeadventofnewcureallslike
Prozac,evenverynormalfolkarelikelytobeofferedpotentstatealteringmedication.
Thereisnodoubtthatthedevelopmentofdrugsthatinteractwiththebrainmind'schemicalsystemisthemostimportantadvanceinthehistoryofmodernpsychiatry.
Drugsarefundamentaltoman'sattemptstocorrectsuchdebilitatingdisordersasschizophrenia,mania,anddepression,nottomentiondiseasesthatcanruinthebrain,
suchastumors,infections,diabetes,andmeningitis.Drugsmakeitpossibletoalterthealteredstatesofthementallyill.Ifweaddtothelistvitaminssuchasthiamine
andniacin,whichcanoftencuretheorganicpsychosesbroughtonbyalcoholand

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drugdependency,therecanbenodoubtthatchemistryhasrevolutionizedourunderstandingofmentalillnessandourcapacitytotreatit.
Why,then,wouldn'tanintelligentpersonconsiderpharmacologytobehisbesttreatmentoption?Shouldn'tthemostpowerfultoolforchangingthestateofthebrain
mindinadesirabledirectionbeadrug?Inmostcasestheansweris"Yes,but..."Theuseofadrugcanbeasproblematicasitispreemptive.ForthatreasonI
myselfprescribedrugsreluctantlyandpreferinasmanycasesaspossibletomanipulateapatient'schemistrybynaturalmeans.
Bywidelydeployingthesetofchemicalsthatregulateourbrainsandbodiesmostimportantly,norepinephrine,serotonin,andacetylcholinenaturehasmadeour
jobbothsimpleandimpossiblydifficult.Whenwegiveanydrugthatisaimedatthebrainmind,wecannotavoidhittingthewholebodyandallitsmanyphysiological
controlsystems.Wemustacknowledgetheriskofbothunspecificandundesirableconsequences"sideeffects"aswellasdynamicadaptationsoftheaffected
system:addictionandhabituation.
Wemustalsofacethefactthatalmostnoneofthechemicalsweusetodayasdrugsaremadebythebody.Forexample,thereisnoclearlyeffectivenaturalsedative.
Wealsoknowthatourdrugtreatmentsarenotonlyunnatural,theyarenotevenaimedatthedeepestlevelofbiologicalmechanism:thegene.Finallythereisahostof
drugabusestoconsider,rangingfromthepersonal,throughtheprofessionalandcommercial,tothemorebroadlysocial.
Drugsareapowerfulaidtochangingthebrainmindstatesofthementallyill,butwemustusethemwithappropriatecaution.
Oneafternoon,whenIwasathirdyearmedicalstudentandjustbeginningmyobstetricsrotationattheBostonLyingInHospital,Icamehomewithadreadfulhead
cold.MysinusesandupperrespiratorypassagesweresocongestedIfeltascloggedasastoppeddrain.Anysensiblepersonwouldhavethrowninthetowel,called
insick,andcrawledintobed.Butmycuriosityabout

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thebirthingprocessandasenseofresponsibilitytowardmyfellowstudentsandfuturepatientsurgedmenottomissadayofthisimportantlearningexperience.
Torelievemysymptoms,aroommaterecommendedthatItakeoneofhisantihistaminepills.Hesaidtheyhadworkedwondersonhisrecentcold.Inthemedicine
cabinetofthehousewesharedIfoundthebottlelabeledPhenergan,25mg.andpoppedapill.Withinafewhours,andbeforeIcouldreallysaywhethermy
coldsymptomswerebetterornot,Ibegantohaveastrangenewsetofsensationsthroughoutmybody.Theypersistedforthenexttwodays,duringwhichIassisted
infouruncomplicateddeliveries,onecesareansection,andoneemergencyoperationforanectopicpregnancy.
Ifounditamazingthatnoonenoticedanythingunusualaboutme.ApparentlyIlookedandactedsufficientlynormaltopassformewithaheadcold.Butfrommy
vantagepointIfeltremovedfromtheworldaroundme.Ifeltcutoff,sensoriallyandpsychicallyinsulatedinafuzzycocoonthathadspunitselfaroundme.Whatwas
goingon?
Theanswerwouldonlycomeayearorsolater,whenitwasshownthatPhenergan,inadditiontobeinganantihistamine,wasalsoamajortranquilizer,fromthesame
chemicalfamilyasthechlorpromazinewehadprescribedforBertalatThePsycho.Aswasthecasewithchlorpromazine,Phenergan'stranquilizingeffectswere
discoveredonlybyaccidentafterithadbeentriedoutasacoldremedy.Thesetwodrugs,itwasfound,hadawidevarietyofeffectsbecause,inadditiontoblocking
histamine,theyalsoblockedtheactionofdopamine,anotheraminethatplaysaroleinmodulatingthebrain.AdopaminedeficiencycausesParkinson'sdisease.When
dopamineisactivelyblockedinahealthyindividual,thatpersoncanactuallyundergoParkinsonlikeexperiences.Andbecausethedrugsalsointerferewiththeaction
ofacetylcholine,theymaycausedrynessofthemouth,blurredvision,anddizziness.ThesensationIfeltwasstrong,distinctive,andweird.IhavenodoubtthatI
changedstatebecauseIhadtakenapillthatalteredthebalanceofthenaturalstatecontrolchemicalsinmybrain.

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TheBody'sDrugsandMan'sInterference
Tounderstandwhydrugsarebotheffectiveandproblematic,ithelpstoknowalittleabouthowthebody'skeychemicalscarryouttheirduties.Myownfavorite
molecule,acetylcholine,isresponsibleforanamazingarrayoffunctions.Itnotonlybattleswiththeaminesfordailycontrolovermybrainmindstates,itcanslowmy
heart,makeeverymuscleinmybodytwitch,constrictthepupilsofmyeyes,makemesalivate,orcausemetoblush.Thisonemoleculeisutilizedbypracticallyevery
cellinthebodyforonepurposeoranother.Ifitcouldonlyfinditswayintomybrainstem,whenadministeredfromoutside,withoutgoingeverywhereelsebutof
courseitcan't.
Ineachduty,acetylcholineworksbyconveyingmessagesbetweennervecells.Theendingsofadjacentnervecellsareseparatedbyatinyspacecalledthesynapse.
LiketheoutstretchedfingersofGodandManpaintedbyMichelangeloontheceilingoftheSistineChapel,thenerveendingsextendtomeeteachotherbutdon'tquite
touch.Whenonenervecellneedstocommunicatewiththenext,itsquirtsafewacetylcholinemoleculesoutoftheendofitsfingerandtheyferrytheinformation
acrossthesynapsetothetipofthesecondnervecell.
Whenthemoleculesreachtheotherside,theyarelockedintoplacebyreceptors,specialstructuresontheneuron'smembranethatdeformslightlyto"grasp"the
molecules.It'sasifaferryboatlefttheendofadockononesideofariver,crossedthewater,thenfoundanopensliponadockontheothersideifthereareno
suitableopeningswhentheshiparrives,thereceptorcellsshoveafewboatsapartfromeachothertomakeroom.Ornot.Thereceptorcellsmustdecidewhetherto
acceptthemessengerboatandlockitin,orrefuseitandkeepitadrift.
Becauseacetylcholineandotherkeychemicalsaffectsomanyfunctions,itisnearlyimpossibletolocalizetheiractiontoasinglesystem.ImaginethatIwantedto
increasetheamountofacetylcholineavailabletomymuscles(aswouldbethecaseifIhadthe

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muscleweaknessdiseasecalledmyastheniagravis).HowcouldIgetadrugtohelptheacetylcholineinmymuscleswithoutitalsogoingtomyheartormyeyes?I
couldn't.Oncethedrughasenteredmybloodstreamitcangoalmostanywhereinmybody.
The"almost"isimportantbecausetheoneplaceitmightactuallyhavethemosttroublereachingisthebrain.Thebrainissoimportantthatitisprotectedfrominvasion
bythesocalledbloodbrainbarrier.Thoughnotfullyunderstood,thebloodbrainbarrieriseffectivelyamembranethatsurroundsthebrain.Allbloodvesselsfeeding
thebrainmustpassthroughit,andateachcrossingpointunwantedmoleculesareturnedbackbyphysical,chemical,orelectricalmeans.Onlyafewmoleculesthat
circulateinthebloodareadmittedfreely,suchasoxygenandsugar.Mostmolecules,includingsomethatwewouldverymuchliketoseegettothebrain,are
excluded.
Thenetresultistroubleforpharmacologicalassaultsonthebrainmind.Mostmedicinaldrugsthatareingestedorinjectedwillgotovirtuallyeverycelloutsidethe
brainbutwillbepreventedfromreachingthebrain.Ifthebrainisourtarget,weareverylikelytomissitwhileinadvertentlyhittingeverythingelse.Notsurprisingly,
mostrecreationaldrugsgetthroughthebloodbrainbarriereasily.That'swhytheyaresopopularandsodangerous.
Becausethebodyusesacetylcholinetotransactsomuchofitsbusiness,ithasdevelopedsomechemicaltrickstoimproveandregulatethespecificityofitsaction.The
bodyregulatesacetylcholinewithanenzymecalledcholinesterase.Theenzyme,inthesynapse,chewsupacetylcholineandspitsitoutinlittlepiecesoncontact.Inthis
way,cholinesteraseinterruptsandshutsoffsignalsasrapidlyastheyaregenerated,whichisnormalandnecessary.Inthetimeithastakenmetowritethissentence,I
havemadethousandsofminutehandandfingermovements,eachofwhichdependedonthepromptreleaseandpromptbreakdownofmillionsofacetylcholine
moleculestocoordinatethetinymusclesinmyhand.
TheupshotisthatifIweretoinjectacetylcholineintomybloodstream(orintomybrainstem,ifthatweresomehowpossible)itwouldbeeffectiveforatmostone
second,afterwhich

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everyoneofthemillionsofmoleculesIinjectedwouldbechewedup!That'swhymycolleagueRobertoandhismates(Chapter4)injectedcarbachol,amanmade
chemical,intothebrainsofcatsthatwereawaketoswitchthemtoREMsleepandkeepthemthere.Carbacholmimicstheactionofacetylcholinebutcannotbe
chewedupbycholinesterase.
Theproblemwithusingsyntheticchemicalssuchascarbacholforclinicaltreatmentsisthattheyhaveavastsetofsideeffectsthatmaytakeyearstoemergeandfully
understand.That'swhypharmacologyis,forme,alastresort.Andthat'swhyIamareluctantchemist.Whenitcomestotreatingbrainmindstatedisorders,thebest
approachispreventivemaintenance.Thebestpersontocreateaneffectivepreventivemaintenanceprogramforyourbrainmindisyou.
Thebodyregulateschemicalsignalinginanotheringeniousway.Neuronsalwaystrytomaintainamoderatenumberofreceptorsitesopenslipsontheir
membranessothatwhenasignalfirstcomesinitcanquicklybereceived.Theincomingacetylcholinemoleculesfilltheemptyreceptorslips.If,astheslipsfill,the
dockscontinuetobebombardedwithmolecules,theneuronreconfiguresitselfsonomoreslipsareavailable.Itliterallychangestheshapeofthecellmembraneso
therearenomoreopenreceptorsites.Inthepresenceofahighconcentrationofanincomingmolecule,thereceptorsitesdecreaseinnumber.Thisprocessiscalled
"downregulation."Wemustadmirenature'seconomy:becausethereissomuchtransmitteravailable,thereisnoneedforsomanyreceptorstoensurethatmessages
willgetthrough.Eachneuronvariestheavailabilityofreceptorsaccordingtolocalconditions.
Thisprocessofadaptation,however,resultsinhabituation.Whenwecontinuallyusedrugsthataffectthebrainmind,theneuronsgetusedtohavingsomuchofthe
chemicalaround,andthereceptorsitesremainshutdown.Theneuronbecomesinsensitivetothemessengersthatareshoutingatdock'sedgetobeletin.Withinafew
days,mostdrugsbecomelesseffective,soweneedmoreofthemtoaccomplishthesameeffect.Noticethathabituationisthesamewordweusedtodescribethe
rapidadaptationofourbrainmindstorepeatedstimuliwhenwediscussedthestartle

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reflex.WhenItriedtoscaremyofficemateasecondtime,andathird,hedidn'tjumphelearnedcognitivelythattherewasnothreat.Hehadbecomehabituated?
Thesamelearningoccurswithdrugusage,albeitatthecellularlevel.
Ournonconsciousbrainmindsaremuchsmarterthanwethink.Ifwedouseamedicinalorrecreationaldrug,weshouldrespectthelongtermhabituationprocess.
Thesmartmoveisforconsciousnesstoorderfrequentabstentionfromdrugs,sothatthenonconsciousbrainmindcanrestoreitssensitivity.
Sensitivity,sotospeak,isrestoredbyanotheringeniousprocess.Whentheriverbecomesjammedwithacetylcholinemoleculesthatcannotfindreceptorsites,the
neuronsendingtheacetylcholineslowsdownitsoutputandeventuallystops.Thisisevidenceagainofnature'seconomywedon'tneedthestuff,sowedon'tmakeany
more.
Thereisonedrawbacktothisprocess.Iftheneuralnetworksuddenlydecidesitneedstoreceivemoremessages,theneuronsthathavestoppedproducing
acetylcholinewillnotbereadytoresupplythemolecules.Ittakestimetogettheacetylcholinefactorycrankeduptofullproduction.Dependingonthetypeofneurons
involved,thelagcanbeminutes,hours,days,orevenweeks.Asaresult,theneuronsonthereceivingendarecryingoutformessengersbutaren'tgettingany.Thisis
calledwithdrawal.It'sanormalandunnoticeablephenomenonthatoccursaftereverydayactions.Butitcanbemuchmoreextremewhenadrugisusedanddosage
andlengthofusereachexcessivelevels.
Thereisonewayfortheindividualinwithdrawaltostoptheanguish:givethedesperatereceptorcellsaquickshotofthechemicalthey'relookingfor.Takeanother
pill,swiganotherdrink,insertanothersyringe.Whathasbecomeofthepersoninthiscycle?Unbeknownsttohisconsciousbrainmind,theneuralnetworksinhis
nonconsciousbrainmindhaveundergoneamajorchangeinstate.Theironlydesireistostabilizetheirdistressbyfindingthemagicmissingmolecule:thedrug.
Adaptation,habituation,dependence,addiction,andwithdrawalasequencethat,inonewayoranother,istriggeredeverytimesomeonealtersthedynamicsofthe

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metabolismthatnormallyregulatestheneurotransmitterssendingmessagesbetweencells.ThisviciouscycleisyetanotherreasonwhyIamareluctantchemist.
Thereisnothingmoreunsatisfyingtomethantreating,withadrug,adisorderthathasbeencreatedbyanotherdrug.Butsocommonarethesideeffectsofbrainmind
chemicalsthatitistherule,ratherthantheexception,toneednotonedrugbuttwo,orthree,orevenfourtobalancethetiltedbrainmindandbody.Andsostrongis
theadaptationhabituatedaddictionsequencethatevendrugwithdrawalsoftenhavetobecoveredwithotherdrugs.
Thisdeleteriouscycleresultsinpartbecausebrainmindstatesreflectaconstantlynegotiatedsettlementbetweenopposingforces:wakingandREMsleepexcitation
andinhibitionergotropicandtrophotropicaminergicandcholinergic.Ifthebalanceofthesereciprocalsystemsistippedinonedirection,areactiveandcorrective
changetakesplaceintheoppositedirection.
Theproblemisthatachemicallyinducedcorrectioncanoftenleadtoabacklashthependulumisswungtoofarintheoppositedirection.Aclassicexampleisthe
overlyeffectivereversalofdepressionbyadrugthatthenlaunchesthepatientintomania.Anotheristhesuppressionofaggressivebehaviorwithdrugsthat,asaside
effect,turnoffREMsleepaswe'veseen,REMsleepfightsback,andinthiscasebreaksthroughasterrifyingnightmares.
Thepointisobvious:everyshiftinthebalanceofabrainmindsystemtriggersareactiveshift.It'satwistonNewton'ssecondlaw:everybrainmindactionhasan
equalandoppositereaction.Thegiveandtakeofergotropicandtrophotropicdrivesisanintegralpartofournonconsciousbrainminds.Itisthisabilitytooscillate
betweensuchdifferentstatesaswakinganddreamingthatconfersalargemeasureofouradaptiveflexibility,andassuchitistheveryfulcrumoftheleverofour
health.
Thewakedreamoscillationsarecontrolledbycatalysts.Vitaminsarethecatalystsofbrainmindchemistry.Catalystsareliketheactivitydirectorsoncruiseships
theyfacilitatetheactionbutdonotparticipate.Catalystsaremoleculesthatareessentialformetabolismtoproceedbutarenotthemselvesusedupinthe

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reactionstheyincite.Thiamine(vitaminB1)andriboflavin(vitaminB2)aretwoexamples.Theirpresenceisrequiredfortheenzymesinnervecellstocrankout
neurotransmitters.
Ourbodiescannotmakevitamins.Wemustconsumetheminourdiet.Andnowthattheirmolecularstructuresarewellknown,itisverydifficulttoavoidthem.They
areaddedtofoodduringthemanufacturingprocess.Justtakealookatacerealboxinyourkitchenandyouwillrealizethattheminimumdailyrequirementofmany
vitaminsisconsumedbymostofuslongbeforewereachforthatbottleofvitaminpills.
RecoveringfromSkidRow
Nowthatweunderstandhowthebody'skeychemicalscarryouttheirduties,andhowdrugscaninterruptortipthebalanceoftheseprocesses,wecanapplyour
knowledgetosolvingproblemsofbrainmindstates.Inkeepingwiththetenetsofscientifichumanism,Iwillpresentthreecasesthatshowhowdrugsaremost
effectivelyusedasbridgestomorenaturalandpermanentcures.Thethreecasespresentverydifferentdisordersofthebrainmindstatesystemandillustratetherange
ofmentalillnessesthatcanbefirstarrestedwithdrugs,thentreatedinthelongtermwithvoluntarycontrolofstates.
NewYorkCityisfamousformanylandmarks.Onesmallsectionoftown,TheBowery,hasbecomelegendaryasthegatheringplaceforthecity'swinos.Itisthe
prototypicalskidrow.OnthesouthsideofBoston,skidrowisfoundalongWashingtonStreet,underthe''el"(theelevatedsubway).That'swhereJerryGrossspent
muchofhistime.Jerryhadbouncedfromonejobtoanotherandcouldn'tseemtohangontohismoney.Solaceforhiswoestooktheformofadrink,whichserved
primarilytofurtherdepletehisalreadythinwallet.
JerrywokeuponemorningonthegrassofBostonCommon,wherehehadpassedoutindrunkenstuporthenightbeforewithotheralcoholaddictsofthecity.Jerry
hadbecomeadrunk.Itmadehimmad.Madattheworld.Somadhebegantomumbleaboutittotheimaginaryfriendwhotaggedalongbesidehimashewan

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deredupanddownWashingtonStreet.Somadherantedandravedaboutittopeoplewhohurriedlypassedhimby.Somadhetookadrink.Andanother.Untilhis
moneyranout,whichmadehimmadderstill.Heboldlyapproachedpeopleformoney,shoutingatwhoeverturnedhimdown.Henevergotmuch,perhapsarare
handfulofchange,sofoodbecameoutofthequestion.Whowantedfood?Whatheneededtofeelbetterwasadrink.Andthecheapertheboozethebetter.
Jerryroamedandravedandpanhandledanddrank,dayafterday,weekafterweek.Hesleptindoorways.Heurinatedinalleys.Hisarmsandlegsbegantoswell,
andsomenights,aftersleepingonthehardground,hecouldn'tmovehisbodytogetup.Whenhedidgetup,hewouldgetintopeople'sfaces,pressinghissmelly,
famishedbodyagainstthemuntiltheygavehimacoinorshovedhimaway.UntilthecopscaughtupwithhimandthrusthimintothemedicalwardofBostonCity
Hospital.
EveryoneinthehospitaladmittingroomcouldtellJerrywasanalcoholic.Butthedoctorsknewwhathismostimmediatemedicalproblemwas:beriberi.Thisdisease
wreakshavoconthenervoussystemandultimatelyresultsinparalysisandswellingofthebody.Itresultsfromthiaminedeficiency.Abouttheonlywaytobecome
thiaminedeficientinthemodernworldistobecomeadietarydropouttoabandonfoodinfavorofadrug,inJerry'scase,alcohol.Aftersixweeksorsoofthis
behavior,thebrainmindisnotonlypermanentlyintoxicated,itisontheedgeoforganicpsychosis.Whenawake,Jerrywouldrambleontohisimaginaryfriend.He
waslivinginadreamworld,quiteliterally.Hiswakingpsychosis,hisvisions,hisdisorientationandconfabulationandmemoryloss,weresimilartoDelia'sdream
visions,herdreampsychosis.AndthechemicalcausewasparallelDelia'ssleepingbrainisdeprivedofamines,enablingacetylcholinetotakeoverandcauseherto
dream.Jerry'svitaminstarvedbraincouldnolongerproduceanyamines,andsohisvisionswanderedwithhimupWashingtonStreet.
TheorganicmentalsyndromeofskidrowisoftencalledKorsakoff'spsychosis,notbecausethataugustRussianneurologistdranktoomuchvodka,butbecausehe
describedthesyndrome

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andrecognizedittobeaphysicalconsequenceofalcoholabuse.WhenKorsakoff'spsychosisisassociatedwithparalysisoftheeyemusclesandalimitationof
outwardgaze,thelargerandfargraverpictureiscalledWernicke'sencephalopathy.
Buddingneurologists(andyouqualifyifyou'vereadthisfar)willbeinterestedtonotethatthepartofthebrainthatismostsensitivetothiaminedeficiencyisthebrain
stem,whichcontrolsourstates.AsJerrymovedinexorablytowardKorsakoffWernickebedlam,hecouldnolongerenterREMsleepandhestoppeddreaming.In
attemptingacorrection,hiswakingbrainmindstatehadswungtoofarintheoppositedirection,anditassumedthepropertiesofdreamingaroundtheclock.What
Jerry'snonconsciousbrainmindneededI'msorrytosay,someweeksbeforethepolicedraggedhimintothehospitalwasshotsofvitaminB1insteadofthe
shotsofcheapwineheconsciouslycraved.
Surelyamoresignificanttriumphwouldbetopreventalcoholismaltogether.Aswecontemplatewhatisrequiredtoachievethatgoalwemaygainfurther
understandingofwhyitissoimportantandwhyitissodifficulttobeareluctantchemist.
Here,nonetheless,isarealcureforacurious,lifethreateningpsychiatricdisorder.NowonderLinusPaulingandothersophisticatedscientistshavepushedBvitamin
therapysohardagainstotherseriousdisorders,suchasschizophrenia.
Unfortunately,Jerryhadpassedthepointatwhichvitaminsandabstinencewouldhavecorrectedhisproblem.Aswewillseeshortly,hehadtoundergoamuch
morefrighteningbrainmindstatechangebeforehewasabletowanderontotheroadtorecovery.
Howisthebrainmindstatechangeaffectedbyalcohol?Whyisalcoholsoirresistible?Mostcasualdrinkerswouldarguethatalcoholpromotesrelaxation,
communication,andasenseofwellbeing.Alcoholdoessobyputtingjustenoughofourneuronsintojustenoughofaslumptoallowotherstoemergefromthe
shadowofinhibition.Intoxicationisdefinitelytherightwordforeventhemildesteffectsofalcohol.Weareactuallygivingourselvesadrugthatcould,ifthedosewere
increased,causesleep,stupor,coma,

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andevenanesthesiaasmoreandmoreneuronsareputoutofcommission.
Gettinghighonalcoholorotherrecreationalchemicalsoftenmeansfeelingelatedoratleastlessdepressedthanusual.Sowehavetheparadoxofachemicalthatis
justasmuchananxietybreaker(adepressant)asitisanenergizer(anantidepressant).Byreducingbehavioralinhibitions,alcoholpromotesemotionalexpression.The
personalinteractionatahighspiritedcocktailpartyoftenmovesfromjollity(andjoking)toelation(andselfrevelation)toaffection(andintimacy)toeroticstimulation
(andsexualattraction).
Ifwecouldkeepourconsciousbrainmindontrack,wecouldcontrolthedoseandkindofalcoholweusetogettheperceivedbenefitswithouttheliabilities.The
problemisthatwecannotcontrolourintakebecauseourgoodjudgmentisruinedasourinhibitionsarereleased.Inappropriatebehavior,gregariousness,evenanger
maysetinasourbodiestrytoridthemselvesoftheselfadministereddrug.
Alcoholisoneoftheworstdepressantdrugswecantakebecausethebodybreaksalcoholdownintobyproductsthataretoxic.Thatmiddleofthenightawakening
toasickfeelingoccursbecausetheliverisbusyknockinghydrogenofftheethanolmoleculesandturningthemintoformaldehydeasubstancecommonlyusedfor
embalming.Tosay"I'mpickled"isthusnotentirelymetaphorical.
By3:00A.M.afteraneveningofcarousing,theemployeesofyourbrainstemareawashintoxins.Theyaresounhappytheygoonsleepstrike.Theyrefusetocreate
REMsleepuntilmanagementimprovestheworkingconditions.Butmanagement,deprivedofREMsleep,isinnopositiontothinkclearly.Thealcoholanditsby
productspreventthecholinergicsystemfromdischargingacetylcholineintheuninhibitedwaythatitdoesduringREMsleep.AfteraprolongedperiodofREM
suppressionitseemsthatthecholinergicsystemisunderamarkedincreaseinpressure.
Theincreaseinpressurethrowsthebrainmindsystemoutofbalance.Itcan'tcontrolitselfanymore,andthependulumoscil

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lateswildly.Alcoholicsarebroughttothehospitalbecausetheirbrainmindsarenolongercapableofmanagingeventhealcoholseekingbehavior.LikeJerry,theyare
foundwanderingaimlesslyabout,confused,disoriented,unabletoremember,confabulating,andthelaststrawhallucinating.
TheseproblemsarisenotbecauseREMsleepislost,butbecauseitissuppressed.Researchershavebeenabletostudythedifferencethankstonewantidepressant
drugslikenialamide,whicheliminateREMsleepwithoutdireconsequence.ThefunctionofREMsleepistogivetheaminesarest,sotheycanrejuvenate.Thenew
drugsrejuvenatetheaminesdirectly,sothereisnoneedforREMsleep.ThefunctionofREMsleepisreplaced.AlcoholsuppressesREMsleepitdoesnotallow
theaminestorest,anditdoesnotboostthemeither.Recallthat,inahealthyperson,whenREMsleepislostforanightortwoitispaidbackwithintereston
subsequentnights.Inanalcoholic,constantsuppressionofREMsleepcausesthetensioninthecholinergicsystemtomountuntilREMsleepcomescrashingthrough,
intheformofhallucinations.
Thealcoholicwhohasreachedthisstageisinadangerousdownwardspiral.Theonlywaytobreakitistoabstainfromalcohol,sothebrainmindcanriditselfofthe
toxins.Duringwithdrawal,thebrainmindoscillatesoutofcontrol,andthespringloadedcholinergicsystem,aftersuchlongsuppression,takesover.Sleepis
completelydominatedbyREMperiods,andterrifyinghallucinationsoccuratrandom.Thisacutepayback,andthetremulousnessitcauses,areknownasdelirium
tremenstheDTs,theshakes,orrumfits.
Thefactthatthisdeliriumhasalltheformalfeaturesofnormaldreaming,togetherwiththeincreaseinREMsleepthatisobservedaswithdrawalproceeds,temptsusto
speculatethatthepsychosisitselfisaREMlikestate.UnlikeDelia'sdreamdeliriumaREMpsychosisconfinedtosleeptheDTpsychosisoccursina
dissociatedfashion,duringwaking.Thefactthatseizuresmayoccuralsoinvitescomparisonwiththenearlyepilepticnatureofneuronaldischargethatisnormally
confinedtoREMsleep.
TreatingapatientwhohasDTsisitselfaharrowingexperience.IknowbecauseIhadtoseeJerrythroughthistravail.Jerry'sepi

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sodesofDTmania,andthoseofothersIhavehelped,areamongthemostmemorableexperiencesofmymedicaladventures.Manyofthesepatientshadotherlife
threateningillness,too,includingragingcasesoftuberculosisacquiredduetoexposure,poordiet,andpoorsleep.
Itwasahot,humidmorninginAugustwhenthepolicebroughtJerryintoBostonCityHospital.Hisbrainmindcouldnolongerregulateevenhisbasicbodilyfunctions.
Rememberthoselabratswhich,aftersixweeksofREMdeprivation,werenolongerabletomaintainthemostfundamentalbodilyhousekeepingtasks,anddied?
Jerrywasclosetothesamedemise.Thenexttwodayswerescorchers.Jerryrantedaroundtheward,thenfellasleeponlytowakeupscreamingfromnightmares.In
thehotafternoonofthethirdday,hisbodyoscillatedoutofcontrol.Histemperaturesoaredto106F.At108Fbraincellsdieenmasse.Jerry'sbrainwasaboutto
fry.Weranfortheicepacksandthrusthimintoatuboffreezingwater.Histemperatureplummetedto88F,closetothepointoffatalhypothermia.Sowewarmed
him,andheimmediatelyoverheatedlikeacarengine.Backtotheice.
Eachcyclehisbloodpressureskyrocketed,thennosedived,atsomepointsbottomingoutinthe60satabloodpressureof60even,thebloodvesselscannolonger
diffuseenoughoxygenintothebrain,causingalossofconsciousnessandcoma.Theneurotransmittersthenorepinephrineandacetylcholinethatregulatethe
ergotropicandtrophotropicdivisionsoftheautonomicnervoussystemsthatcontrolbodytemperatureandbloodpressurecouldnotcoordinatethemselves.Andall
thewhileJerryhadhorrifyingwakingREMhallucinations:legionsofbugscrawledupthewallsinJerry'svisionsandalloverhisbody.Weknewwehadtostabilizethe
pendulumsoon,becauseaftertwentyfourhoursofthisautonomictornadoJerry'skidneyswouldshutdown,hisliverwouldfoldup,andhisheartwouldjuststop.He
woulddieofbrainmindstatecontrolfailure.Justlikearat.Wehadlostotherdrunksinthesameway.
Luckilyandluckdoesn'thurtinthesecasesJerry'smindandbodyrespondedtoourefforts,andhestabilized.Heremainedinthehospitalforthreeweeks.We
treatedhimwithvitaminsto

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restorehisbrainfunctionandwithtranquilizerstokeephisREMsleepreboundwithintolerablelimits.
Ashismindclearedandhebeganeatinganormaldiet,Jerryexpressedthebravadothatistypicaloftherecoveringalcoholic.Hehadseenthelight,hesaid.Hewould
neverdrinkagain.Hewascuredandhewasforevergratefultous.ButweknewthatonlyifhegothookedupwithAlcoholicsAnonymoustoassurehisabstinence
wouldhebeabletoavoidarelapsetothetoxicstateinwhichwehadfoundhim.AndonlyoncesolidlysobercouldJerrybegintobenefitfromthesortsofvoluntary
brainmindstatecontrolproceduresthatDeliahasusedsoeffectively.
BeatingInsomnia
ThephysiologicalchaosofDTsprovesthatabrainmindstatedisordercanbefatal,withouttherebeinganydiseaseinthebrain.JerryGross'sproblemwasanentirely
functionalorganicdisorder.Thereisnothingeitherimaginaryornonorganicaboutafunctionaldisorder.Asinsleepdeprivation,suddeninfantdeathsyndrome,and
VoodooDeath,vitalfunctionscanbesoderangedastoceasefunctioning.Indeed,perhapsalldeathistheresultofsomefunctionaldisorder.
Iemphasizethispointtocounterthepernicioustendencyofpsychoanalysistofosterthenotionof"functionalpsychoses,"implyingthatthesederangementsareonly
psychological,notorganic.ForFreud,theseincludeschizophreniaandmanicdepression.Formostofthiscentury,thisnotionledtoanexclusiveemphasison
psychodynamicfactorsascausalinschizophreniaandtothenowuniversallydiscreditednotionthatsuchmajordisturbancescanbereversedbypsychotherapyalone.
Farmoresubtleandfarmoredifficulttocorrecttoday,however,istheequallyfatuousideathatthesocalledpsychosomaticcomplaintsofmanypatientsinhospital
outpatientclinicsare"allinthemind"asifanythingcouldbeinthemindwithoutbeingeverybitasmuchinthebrain.
Evenatitslunaticpeakinthe1960s,psychoanalysisdidnotoffertotreattheDTswithconversation.However,onParkAvenue

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andinBeverlyHillssomeFreudianswerestillofferingdrunksthetalkingcure.
Likeabrainmindsystemthatovercorrectsitself,thepsychiatricpenduluminrecentyearshasswungtoofarintheoppositedirection,towardoveruseofdrugs.Often
whenIaddressalargemedicalaudience,Iamawareofanimpatienttolerationofmyviews.Thedoctorswaitoutmysermonaboutscientifichumanism,then,asifit
passedrightthroughtheirskulls,askwhichdrugsIprescribeforinsomnia,depression,andschizophrenia.MyansweristhatIhaveexperimentedwithpracticallyall
theusualagentsandhavehadmyshareofsuccessandproblemswitheachofthem.
Asmuchaspossible,Itrytousedrugsonlytohelpthepatientmoveasquicklyaspossibletoanewstateofmind.Withnewperspectiveandasenseofcontrol,he
canthenbegintobuilduphisultimaterelianceonphysiologyandpsychology,withoutchemicalaid.
Thisplanworksnotonlyforpeople,likeJerry,withextremeproblems,butforallofuswhohaveboutswithlessdramatic,butstilldebilitating,brainminddisorders.
Whichbringsustooursecondcase,thatofMirandaProspero.
MirandawasalovelyyoungwomanwhohadbeenunabletosleepsinceshehadarrivedinBostontoattendahighpoweredgraduateschool.Despiteherconstant
anxietyshehaddoneoutstandingacademicworkandhadmovedintoachallengingjob.Accordingtothepsychiatristwhoreferredhertome,allsheneededwasa
wellchosensedativeandshewouldbefine.Shewassaidtobehappilymarried.Shecamefromalarge,supportivefamily.Andshehadhercareerwagonhookedto
thestars.Unfortunately,sherarelystoppedworking,andwhenshedidshecouldn'tstopthinkingaboutwork,soshecouldn'tsleep.Onepartofhercortexwastelling
her"Youaretired,"butanotherpartwastellingher"You'vegottokeepprocessing,"anditcalledonthebrainstemtocontinuallysendupnorepinephrinetosupport
thecommand.Mirandawasvoluntarilydenyinghersleepstatebyconsciouslyremainingfixedonwork.Shewaspushinghersystembeyonditslimits,andsoonenough
shewouldcollapse.
Thisadvancebillingpreparedmeforaharddriving,unreflec

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tiveoverachiever,andbeforeourfirstmeetingIthoughttomyself,"IbetIwillnevergetanywherewiththislady."Myanticipationcouldnothavebeenmorewrong.
MycolleaguefailedtomentionthatMirandaProsperowasalsoverybeautiful,caring,andsensitive.Mirandawasabionicwomanallright,butonewhowhistledinthe
dark,andwhowasreadytoreflect,tolearnmoreaboutherself,andtochangeherbrainmindlittlebylittlesothat,ultimately,shewouldnotneedsleepingpills.
InthethreeyearssinceMirandafirstconsultedme,startlingrevelationshaveoccurredduringourdialogueanddramaticchangeshavetakenplaceinherlife.Shehas
rememberedscenesfromherchildhoodwhenherfather,anavalofficer,beatherandhersisters.Shehasgivenuptheentirelyirrationalideathathernose,brokenby
oneofherfather'sassaults,issouglythatonlyplasticsurgerycouldmakeherphysicallyacceptable.Shehasleftherhusband,atightlywiredbusinesscolleaguewith
whomnopsychologicaldialoguewaspossible.Shehasbegunanewrelationshipwithamanwhooffershermuchmoreintimacyandsupport.Andshehastakenan
extremelychallengingjobwithaconsultingfirmthatplacesheronthecuttingedgeofmanymajorpoliticalandeconomicissues.
Givenhernewresponsibilities,Mirandaisstillnotsleepingwell,butshecansleepwhensheneedstobecausesheusesherdrugsinanintelligentway.Shehasalong
actingsedativeforusethreetimesaweek,andashortactingsedativeforoccasionaluseifshewakesinthenightandcannotfallbackasleep.
MirandaisasfullyinformedasIamaboutthechemicalssheisusing.Andsheknowshowlittlewereallyknowabouthowandwhytheywork.Butherlifeisontrack.
Shedoesn'tsmoke,herdietisbalanced,sheexercisesvigorously,drinksmoderately,andenjoysbothhercasualandintimatepersonalrelationshipswithpassionate
enthusiasm.
Althoughsheisauniqueindividual,Miranda'splightislegion.Sheepitomizestheconflictsconfrontingmodernprofessionalwomen.Furthermore,assheracestoand
froherbiologicalclockistickingatthetopofherbrainstem.Soonerorlatershewill

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probablywantchildren.ToaccommodateafulldomesticagendainhercurrentlifewouldrequiremorechangethanallthepharmaceuticalsinNewJerseycould
catalyze.
Togetoffthedrugscompletely,Mirandaneedstolearntosayno.Shehasdifficultyinrefusingexcessiveandinappropriateresponsibility.Shealsoneedstoalterher
schedule,sacrificingsomeofheractivities.Mirandaisnotashortsleeper,butherscheduleoftenforceshertobecomeone.Shemustlearntoletherselfbethelonger
sleepershereallyis.Ittakessomeofusalongtimetofigureoutwherewebelongonthekeyspectrathatdetermineouroptimalbrainmindstates.Meanwhilewemay
needthehelpofareluctantchemist.
Somereadersmightsay,"SowhatifMirandahastotakethesedrugstherestofherlife.Diabeticstakeinsulineveryday."ThedifferenceisthatMiranda'ssleeplossis
notlifethreatening.Withoutdrugs,diabetesisfatal.ThereisacostforMiranda'sregularuseofdrugs:dependency.Shehasasubtleaddictiontothesedatives,and
shewillbecomehabituated.Shewillneedgreaterdosesforthedrugstoachievethesameeffect.Shewillhaveaproblemgreaterthaninsomnia.Tobereallycured,
Mirandahastotakefullvoluntarycontrolofherlife,andherbrainmindstates,andgetoffthedrugs.
NoDrugsorNewDrugs
Relieffromsymptomsisastrongmotivator,strongenoughattimesthatpeoplelikeMiranda,whoareinformed,consciouslychoosetoriskaddictionandhabituation.
Thereisanevenstrongerforceouttherethatmotivatestheuninformedtotakedrugs:profit.Thepharmaceuticalsbusinessisoneofthegreatestmoneymakersin
history.
Itishardforpeopletoresistadvertisingandtoresistrunningtothedrugstoreforanynumberofremedieswhentheyareinsearchofrelieffromacold,oranxiety,or
lackofsleep.Itishard,inpart,becausetheyareuninformedaboutwhattheyaretaking.Theplethoraofdrugsonanygivenshelfofadrugstoretofightany

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oneofthediscomfortsjustmentionedismindboggling.Aretheyallnecessary?Isonebetterthananother?Theanswertothesequestionsisoftenno.
Wedonotneeddrugstoovercomemanyillnesses,especiallymildmentalonessuchassleeplossoranxiety.Evenifwedecidewedoneedadrug,wedonotneeda
differentdrugforeachillness.ThismythisperpetuatedbytheFDA,whichapprovesdrugsinthisway,andthepharmaceuticalcompanies,whichmarketdrugsinthis
way.
Here'ssomeproof.Gotothedrugstoreandpluckfivemedicationsforcoldsofftheshelf,fiveforseasickness,andfiveforallergies.Readthelabels.You'llfindalong
anddifferinglistofsugarsandbindersandallsortsofnonsense.Buttheactiveingredientsarethesame.Theymayhavedifferenttradenames,butinfacttheyareall
antihistamines.Somearephenothiazines.AndrememberwhatweusedatThePsychotocalmBertal?Chlorpromazine,whichisnotonlyanantihistaminebutalsoa
phenothiazine.Thesamegroupofcompoundsisusedtorelievethedynamicallydifferentsymptomsofcold,flu,hayfever,seasickness,andwildpsychosis.One
drugandagenericoneforthatmatter,whichwouldbecheaperthanabrandnamecouldreplaceanentirethirtyfootshelfofproductsatthepharmacy.
Thesameinsidiousnessgoesoninpsychiatry.ThedoctorsonParkAvenuewhocounselthehighstrungelitewhocan'thandlethe''pressures"ofhighsocietyfilltheir
clients'medicinecabinetswithValiumtocontrolstress,Libriumtocontrolexcessivedrinking,andDalmanetocontrolsleeplessness.Theseareallbenzodiazepines.
Theyarethesamebasemolecule,eachwithalittletwistthatmakesaslightdifferencetothemolecularaction,andareprescribedindifferentdosages,colors,and
flavorstomakethewholeactseembrilliantlyselective.
Evenifyouacceptthisfolly,theworstabuseisthatdoctorscontinuetoprescribe,andpatientscontinuetotake,thesedrugsforyearsandyears.Smallwonderwhen
youseetheheadlinesintabloidsaboutaprominentpublicfigurewhohashadabreakdownoris"suddenly"admittedtoarehabclinic.
Eveniftheseindividualshaveseriousproblems,theirdoctors

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shouldprescribedrugsonlyasatemporarymeanstojoltthemoutoftheirstateandshouldthenturntoscientifichumanismforthelongtermcure.Theseindividuals
mayneedadrugforafewdaysorweekstobreaktheircycles,butthentheymustusevolitiontokeepthemselveshealthy.Onlyvolitioncancurethem.That'swhy
groupslikeAlcoholicsAnonymousworkthereisacollectionofpeoplewhomutuallysupporteachother.Thereisacollectivewill.Oncetheindividualsinthegroup
feelthepoweroftheirownvolition,theycancontroltheirstates,andthenaturalhealingpowerofthemindandbodywillkickin.
Virtuallyallthedrugsontoday'smarkethurtsomeofthebody'ssystemswhilehelpingothers.Valiummayreduceanxiety,butitalsoinducesanobstinatecaseofdrug
dependency.Antihistaminesmayreducesneezing,buttheyalsomakeyousleepy,andtheycanputyouintothekindoffunkIenteredwhenItookmyroommate's
coldpillsbeforeassistingindeliveringbabies.
Hopeisnearonthehorizon.Thereisagrowinglistofimpressivechemicalsintrialsthatwillnotcreatetheproblemofaddictionthatstimulantsanddepressantspresent
orthesideeffectsthatotherdrugspresent.Theyaccomplishthisbyworkinginafundamentallydifferentway.
Areplacementforamphetaminemaybeathand.Amphetamineisanaminemoleculethatlooksenoughlikenorepinephrinetofoolthereceptorsonnerveendings.The
receptorsopentheslipsandlockintheamphetaminemolecules.Indepressedpeople,toofewaminesarereachingthereceptorsites.Theamphetaminestandsinfor
norepinephrine,justascarbacholcanstandinforacetylcholine.Theproblemisthatamphetaminehitsfasterandharderanditsactionismoreshortlived.Furthermore,
itspresenceinhibitstheproductionofaminesevenfurther,makingtheusermorereliantonthedruginthefuture.Cocaineand"crack"arethecurrentstreetnamesfor
thiskindofdrug.Theyarepopularbecausetheyhavethepowertodrivepeopleskyhighintoenergeticelation,andtheyarecondemnedbecausetheycanenslave
theirvictimsbytheirverypower.
Thebettersolutionwouldbeeithertoincreasethenumberofaminesproducedortoextendtheirlifetimeswhiletheyarefloating

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inthesynapse,sotheirchancesoffindingavacantreceptorsiteareincreased.Recallthatacetylcholineischewedupbycholinesterasewhenitisleftinthesynapse.
Thebodyregulatesaminesinthesameway.Adrugthatcouldblockthenaturalbreakdownofamines,orcouldblocktheaminesfromreturningtotheirhomeports
whentheycan'tfindareceptor,wouldimprovethetransmittanceofsignalsbytheamines,energizingthedepressedpatient.
Thenewdrugsthatactbyblockingthereturnoftheaminesarecalledreuptakeblockers.TheyincludeProzac,theupstartdrugthathasreceivedsomuchrecent
attentionduetoitsgreatsuccessinrelievingobsessivethinkinganddepression.Forareluctantchemistlikemyself,thisisthesortofmedicineImightbeabletolive
with.Suchnewdrugspotentiatetheactionofnaturalneurotransmittersinsteadofreplacingthem.Becausetheydon'tturnoffthenormalrelease,theydonotinitiatethe
addictioncycle.
AnotherclassofthenewdrugsthatachievesthesameeffecthastheadditionalandsurprisingpropertyofsuppressingREMsleepwithoutcausingtheusualbuildupof
tension,paybackwithinterest,andbreakthroughintowakingthatisseeninalcoholwithdrawal.Thisremarkablefeaturewasfirstnotedduringthetreatmentof
narcolepsywithsocalledmonoamineoxidaseinhibitors.Thesedrugsincreasetheefficacyofnorepinephrineandserotoninbyblockingenzymaticbreakdown.Thenet
effectisthesame:eachaminergicmoleculeismoreeffectivebecauseitislongerlived.Andbecausetheaminergicsystemisthusstrengthened,thecholinergicsystemis
morestronglyinhibited.ThereislessREMsuppression.Foralcoholicsinwithdrawal,thesedrugsmightreducehallucinationsandnightmares.Forthosewhoare
depressed,thesedrugswouldgivethemaliftwhilealsoeliminatingdreaming.
Theabsenceofdreaming,withoutadecreaseinhealth,suggeststhatwemaynotneedthedreamsthemselvestoaccomplishthephysiologicalfunctionthatREMsleep
providesrestoringtheamines.Maybedreamsarereallyanepiphenomenon,asecondaryandunnecessaryoutcomeofanunderlyingprocess.Maybetheyarenot
importantpsychologicalexperiences.Thisconclusionisalreadysuggestedbytheneartotalamnesiathatweallnormallyhaveforourdreams.

Page283

ButiftheREMsleepisgonealongwiththedreamsdoesn'tthatmeanthatREMsleepisequallyuseless?Atfirstglanceitwouldseemso.Letusreflectonwhat
thedrugactuallydoes.Itincreasestheefficacyofnorepinephrineandserotonin,whichistheverypurposeweascribetoREMsleeptogivetheaminergicsystem
timeoffsoitcanrestoreitsefficacy.IfthereisplentyofdrugaroundsomuchthattheaminergicsystemisalwaysefficaciousthenREMsleepisnotneeded.Its
functionhasbeenreplacedbythedrug.
Nowthat,tome,isaninterestingidea.Therearenodreams,becausethereisnoREMsleep.ThereisnoREMsleepbecausethedrugkeepstheaminergicsystem
robust.Thedrugprotectstheaminergicsystemfromthelossofefficacythatwouldnormallyoccurduringwaking.ThedrugcantakethefunctionalplaceofbothREM
sleepanddreaming.
Thosereaderswhohavenotalreadygoneintorageatthisbarbarianassaultonthesacredmystiqueofthedreammayhaveacoolheadedfollowupquestion.What
aboutthecholinergicsystem?IfthereisnoREMsleep,isn'ttensionbuildinginthecholinergicsystem?Doesn'tthecholinergicsystemneedthereleaseitgetsduring
REMsleep?
Theanswertothisverygoodquestionappearstobethatmanyofthenewantidepressantdrugsareanticholinergicatthesametimethattheyareproaminergic.They
simultaneouslyquellthecholinergicsystem.Hereisacaseinwhichasocalledsideeffectofadrugmaybeahighlydesirablemaineffect.Whetherthissuppressionis
dangerousinthelongtermremainstobeseen.Butifthedrugsreplacetheneedforthecholinergicsystemtoreleaseitself,insteadofjustsuppressingtheaction,then
therewouldbenonegativeeffect.
Theimplicationsofthesespeculationsaremonumental.AndperhapsalargepartofthereasonIamareluctantchemististhatwhenIprescribemostdrugs,Idon't
reallyknowwhatIamdoing.Themorepowerfulandpotentiallyefficaciousthedrug,themoreIamintimidated,humbled,andcautiousaboutprescribingit.Iknow
toomuchnottorealizehowignorantIam,andhowmuchwestillhavetolearn.

Page284

Bertal'sWayOut
Thefactis,ourignoranceisdangeroustothepatientsweserve.Wephysicians,ofcourse,aretryingtodoourbest,butwhatwedon'tknowcanhurtourpatients.I
havecarriedadisturbingquestionaroundwithmeforthirtyyears,sinceIleftThePsycho.DidweactuallyhelpBertal?Orhurthim?Orboth?Andinwhatproportion
werehisbenefitandhisharm?
WealreadyknowhowBertalreachedhisstateofcrisis.Letmeproposehowwecouldhavehelpedhim,armedwithwhatwe'velearnedaboutthebrainmind
paradigminthedecadessinceIlastsawhim.
Firstandforemost,itiscleartomethatwemadethemistakeofputtingthepsychotherapeuticcartbeforethepharmacologicalhorse.InBertal'scase,weshouldnot
havebeensuchreluctantchemists.Assoonaswesawthathewasflagrantlypsychotic,weshouldhavetreatedhimwithadrugthatcouldhaveimmediatelystabilized
hisstate.
Chlorpromazineissuchadrug.Wejustusedtoolittle,toolate.Ifwehadadministeredarapidlyincreasingdoseschedulefromthefirstdayheenteredtheward,we
couldhaverepulsedhishallucinatorydivebomber,meltedhisstatuesqueposes,andreinedinhisgallopingsleepdeprivationwhichonlymadehispsychosisworse.
Idaresaywecouldhavesparedmysupervisorhisblackeyebutapartofmehastoadmitthathedeservedit.
Practicingpsychoanalysisonanuntreatedpsychoticpatientnowseemstometobeatoncetheheightofhubrisandthenadirofnavet.TheinsightBertalgainedatthe
handsofmyfreeassociativepsychotherapyseemedonlytomakehimmoreanxious,notless.InspiredbyFreud'stheorythatparanoidpsychosisiscausedby
repressedhomosexualimpulses,wedidourbesttomakeBertalawarethatwethoughthemighthaveaclosetgayspirit.Theresultwaspanicanddisasterfor
Bertalandeveryoneelseontheward,ashereactedwithrageandrampagetoprovehewasarealmachoman.
EvenishispsychoticconfusionBertalwastryinghisbesttotellustodroptheinterpretations."I'mlearningtoomuch,"hepro

Page285

testedonedaywhenheappearedonthewardwithlipscoatedwithhemorrhoidalcream.Andthen,prophetically,headded,"Ionlyneedonebrain!"Meaning,I
suppose,thathehadenoughtodealwithwithoutouraddingtohisanxiousburden.
Inowhavenodoubtthatifwehadimmediatelyenteredintoachemicaldialoguewithhisbrain,wecouldhaveobviatedthreemonthsofpainful,damaging,and
unnecessarypsychosis.SteponethenwouldbetoquicklyreestablishstatecontrolbyclampingdownonBertal'sbrainmind.Callitachemicalstraitjacketifyouwill,
butdonotwithholditsmercifulrestraintfromaravingcatatonic.ResettingthelevelofBertal'sbrainaminesandacetylcholinewithchlorpromazinecouldhavestopped
thepsychoticmusicplayinginBertal'sheadasquicklyaswakingarrestsourowndreamsandbyperhapsthesamemechanism:quenchingthecholinergicfire.
Then,andonlythen,couldherealisticallyandeffectivelyturnhisattentiontothebehavioralandpsychologicaldevicesthatwehavelearnedsomuchaboutfromDelia.
Couldhethentuneinonhisdreams?Whynot?EvenifwenolongercaretointerpretdreamsinFreudianterms,wesawthroughDeliahowdirectlyinformativethey
wereofhercontinuingconflicts.AsinDelia'scase,Bertalmighthavebeenabletofindhisownreasonsforwantingtodistancehimselffromhisoverprotectiveand
intrusivemother.Hemightthenhavebeenabletoleavehome,livealone,andseekamorematureloveforhimself.
Oncehispsychosiswasunderthecontrolofmedication,Bertalcouldhavebeguntofindothermeansofreducinghisanxiety.Hecouldhavelearnedtherelaxation
responseandcouldhaveenhancedhissleepwithexercise.HemightevenhavelearnedthehelpfultrickthatHarrietusedtonipherdelusionsandhallucinationsinthe
budbyenvisioningthebooksinherlibrary.Bertalcouldhaveincreasinglybroughthisownbrainmindstates,includinghispsychosis,underavoluntarycontrolthat
wasinformedbythebrainmindparadigm.Hewouldstillperhapsnotbefullyfreeofhisproblem.Buthewouldbewellenoughtofunctionpositively.Andhewould
bewellenoughtoseekthechemical,behavioral,andpsychologicalhelpheneededtopreventadisastrousrecurrenceofhispsychosis.

Page286

InthiswaywemighthaveavoidedthepoignantdialoguethatBertalandIhadthedaybeforehewastobetransferredtothat1960sgraveyardforfailedtreatments,
theBostonStateHospital."I'msorryIwasevercured,"Bertalsaidsadly,understandingsomehowthatwehadraisedhisawarenessofhisproblembutcouldofferhim
nosolution."Youshouldhaveleftmeinthedreamworld."

Page287

INDEX
A
abortion,207
absorption(asfactorindream),37
acetylcholine,14,62,264
inalcoholism,271
inAlzheimer'sdisease,99
amineratio,seeamines
caffeineand,74
carbacholmimics,58,75,267
andcardiacarrest,185
anddepression,196,197
dominanceof,57,68,69,73,95,133,181,185
functionsof,265,266,275
andmemory,115,116,179
inorientingresponse,88,9697
regulationof,266267,268,282
andREMsleep,58,5961,115,116,133,185,186,192196passim,211,273
Seealsochemicalsystems
activationenergy,6566
inbrainmindparadigmmodel(A),6770,71,73,76,172
conceptoffunction,6970
andhallucination,71
andsleep,73,249
andwaking,87
Seealsoenergyflow
adrenaline,74
affectivedisorder,bipolar,41,43
AIMmodel.Seebrainmindparadigm
AlcoholicsAnonymous,276,281
alcoholism,43,95,270276
andwithdrawal,62,125,274276,282
Alzheimer,Alois,99
Alzheimer'sdisease,25,76
disorientationin,85,95,99
memorylapsesin,32
andorganicmentalsyndrome,43
studiesof,7,47
aminergicsystem,aminergiccholinergicsystem.Seechemicalsystems
amines,14
acetylcholineratio,72,73,74,95,133,184
anxietyand,195
anddelirium,62
dopamine,75,179,264
duringdreams,57,60,95
drugregulationof,282
andmetabolism,72

Page288

roleof,5960,62,68
courtshipanalogy,113114
duringsleep,59,115,191
andwakingstate,61,7374,75,87
Seealsonorepinephrineserotonin
amphetamines.Seedrugs
amygdala,89,94
ascenterofemotions,155156,158,159,160
AndalusianDog,The(surrealistfilm),40
animalmodelsinstudyinghumanbraindysfunctions,47,155,158
attentiontested,175
sleeppatternsstudied,5659,7475,188191passim,196,267
animals,consciousnessorconscienceof,204
antihistamines.Seedrugs
anxiety.Seeemotion(s)
appearanceandbehavior(inDelia'smentalstatusexam),3536
arecoline,196.
Seealsodrugs
Aristotle,90
Aserinsky,Eugene,193
As,Kaji,165
association(andmemory),113114
free,Freudand,212
hyperassociation,114,116
Seealsodissociation
associativecapacitiesindreams,177,181
attention,165169
aminergiccholinergicsystemand,71
anatomicalmodelof,172
vs.benefitsofdistraction,179181
freewilland,166,167169
andhypnosis,168,249
measuring,169172
inmentalstatusexamofDelia'sdream,37,61
selective,166,175,249
shiftingfocusof,174179
"tuning"of,176
attentiondeficitdisorder
chemicaltreatmentof,178179
indelirium,62
"hyperactivity"in,177
lackofsleepand,29
organicmentalsyndromeand,43
automobileaccident,andmemoryloss,104110
autonomicnervoussystem,184,185
Seealsonervoussystem
B
bacteria
ascauseofdelirium,910
growthimpededbysleep,189190
Bard,Philip,155
Barnum,P.T,165
bedwetting,254,256
behavior
appearanceand,inDelia'smentalstatusexam,3536
attentionand,167,169172
definitionbroadened,141
innateorpreprogrammed("fixedacts"),143144,163
orientationand,86
REMsleepasblueprintfor,141142
behaviorism,19,24,25
and"blackbox"theory,23,50,117
BellevueHospital,NewYork,9,19
benzodiazepines,280.
Seealsodrugs
beriberi,271
Bertal(psychiatricpatient),28,77,85,286
AIMmodeland,68,73
confabulationby,121122,124
anddepression,200201
hallucinationsof,1819,25,2627,71,97,139,145,159
chemicaleffecton,2122,27,57,75,179,264,284285
disorientationand,95
hisinsightabout,138,173174
andinattention,178179
psychoanalytictheoryabout,20,24,284
Biblicalcosmology214
biochemistry,21.
Seealsodrugs
bipolaraffectivedisorder,41,43
bizarreperceptionsandmovement,9095,138139,172
"blackbox"theory.Seebehaviorism
bloodbrainbarrier,266.
Seealsodrugs

Page289

bodytemperature,186188,190
BostonCityHospital,275
BostonStateHospital,286
bottomupprocess,61,140,169,174,244
defined,139
andtrance,248
brain.Seebrainstemcortexhippocampushypothalamusthalamus
braindeath,69,207
brainmindparadigm,7
AIMmodelof,6677,87,100,172,180,245
andAlzheimer'sdisease,99
boldness/modestyof,30
andconsciousness,212
critiqueneeded,214
anddeterminism,29
anddisorderoflife,17(seealsochaostheory)
dreamingrelatedtoorganicpsychosis,6263
andholisticapproach,15,218
needfor,2930
physiologyand,10,1214,21(seealsochemicalsystemsdrugs)
separabilitydoctrinevs.,11
threefundamentalprinciples,2627
brainmindstate(s),7
"altered,""mentalillness"as,1617
consciousandnonconscious,207209
controlof
byaminergiccholinergicsystem,27(seealsochemicalsystems)
and"brainy"students,100101
dreamtheoriesregarding,8990
hyperexcitability,135
modeof(M),7172
physiologyand,10,253(seealsodrugs)
sleepingwakingtransition,6,1516,61,84,8688,99,173(seealsoorientation)
"split,"217
threecardinal,26
timeasfactorin,2930,66,67,75
uniquenessof,120
asunitsofreality,1617
unpredictabilityof,2425
visuomotoraspectof,39
volitionas,61
Seealsoconsciousnessdream(s)emotion(s)sleepvolitionwaking
brainmindunity,67,8,1214
FreudandJamesandtheoryof,12,23,154
resistancetoidea,11
brainstem
andaminergicsystem,195
andattention,169,171,172
anddreams,94,173,244
andfixedacts,163
gaitcontrolcircuitsin,139140
locationof,57,89
andorienting,orientation,88,96,171
inREMandnonREMsleep,5758,135,136,153
andREMsleepdisorder,138
vitamin(thiamine)deficiencyand,272
braintumor,43
Buddhism,10,29
C
caffeine,74
CaliforniaHumanPopulationLaboratory,188
Cambodia,185
Cannon,Walter,155,161
carbachol(syntheticmolecule),58,59,75,267
Carol'sdream,151152,158159.
Seealsodream(s)
Castro,Fidel,96
CAT(computerizedaxialtomography)scans,46,47,170
cats'sleeppatterns,5659,7475,267
causality,210211
centralnervoussystem,184.
Seealsonervoussystem
chance.Seechaostheory
chaostheory,2425,214216,217
Charcot,JeanMartin,253254,259
chemicals.Seedrugs
chemicalsystems,1416,2122,57,62,64,115,210,212
chemicalsystems(aminergic),1416,29,6874passim,87,179180,282

Page290

andbodytemperature,187
anddepression,194,195196,197,199,201
inREMsleep,188,191,196,211,283
timeofdayand,99100,180
chemicalsystems(aminergiccholinergic),1516,29,135,172,188
cognitionmodulatedby,7172
anddissociation,217
andenergy,186
andhallucinations,27
andmotorinhibition,145
inParkinson'sdisease,47
inwakingprocess(orientation),87(seealsowaking)
chemicalsystems(cholinergic),1416,29,179,185,187,282
alcoholand,273,274
anddepression,195,197
inREMsleep,60,71,75,180,186,196,211,283
restrainedbyamines,59,97,179
timeofdayand,99100,180
andVoodooDeath,185
children
baby'smind,206
baby'sREMsleep,141,143
''hyperactive,"177178
parasomniasof,254,255,256
chlorpromazine.Seedrugs
cholinergicsystem.Seechemicalsystems
cholinesterase,266267,282
Christianity
anddoctrineofseparability,11
and"dreamsoul,"55
Clozaril,24.
Seealsodrugs
cocaine,281.
Seealsodruguse/withdrawal
cognition,chemicalmodulationof,7172.
Seealsoattentioninsightandjudgmentorientationvolition
cognitiveneuroscience,2526,32,156,169,210
cognitiveuncertaintyindreams,92,156
Coleridge,SamuelTaylor,25
coma,15,26,69
compulsiveswearing,248,249,250
computersciencemodelofintelligence,2728,70
computertechnology,13,259
CAT,MRI,PETscans,7,46,47,170,171
inmeasuringattention,169171
conditioning,206,218
confabulation,117118
indream,32,38,6061,73,122,124
inpsychosis,46,62,121122,124,125
conscience
ofanimals,204
human,61(seealsovolition)
consciousness
ofanimals,204
andattentionalfreedom,168
beginningof,141,146,206207
inbrainmindparadigm,212
Buddhistviewof,29
cognitivescienceand,156
duringDelia'sdreams,36,41,206
andFreud'stheoryoftheunconscious,23,25,32,94,119,150,207208,212
languageand,204,206
newdefinitionof,203205
andnonconsciousactivity,205,207209,217218
orientationand,86
physicalbasisof,13
andselfawareness,10,12,141,142
duringsleep,EEGevidenceof,55
theoryof,1011
unificationprincipleand,26
Seealsobrainmindstate(s)thinkingwaking
CornellMedicalSchool,156
cortex,5758,89,135,162,217,248
andattention,171,172,174175,249
chemicaleffectson,60,61,94,97,116,173
andhallucination,252
andluciddreaming,173,244
andmotorpatterns,139,140
instartlereflex,97,250

Page291

"crack,"281.
Seealsodruguse/withdrawal
Crick,Francis,193
Cubanmissilecrisis,96
Cutter,Dr.Frank,238,240
D
Dali,Salvador,25,40
DalaiLama,225
Dalmane,280.
Seealsodrugs
Darwin,Charles,andDarwiniantheory,48,159,160,162
daydreaming.Seefantasy
Delia'sdreams,3345,71,85,206,259261,271,274
anddepression,199200,201
herfantasiescomparedto,119121,122,124
mentalstatusexamon,3543,48,54
sleeplabstudiesof,4762,6566,77,9095,259,285
delirium,15
causesof,44
dreamas,4,58,32,4344,62
normalandabnormal,commonfeaturesof,62
deliriumtremens(DTs).Seehallucinations
delusions(inDelia'sdream),4041
dementia,15,32,163.
SeealsoAlzheimer'sdisease
diPerri,Raoul,230
depression,15,27,193201
antidepressantdrugs,seedrugs
sleep/sleepdeprivationand,193196
Descartes,Ren,11,203
determinism,29,214215
diagnostictools,4647.
Seealsomentalstatusexam
disorientation.Seeorientation
dissociation,216218
inhypnosis/trance,248,250,252
insleepdisorders,254,256,257
distractibility
asfactorindream,37
organicmentalsyndromeand,43
distraction,benefitsof,179181.
Seealsoattention
distribution(asmemoryprocess),116
DNA,197
discoveryof,192,193
dopamine.Seeamines
downregulationprocess,267
DreamingBrain,The(Hobson),212
dream(s)
AIMmodelof,seebrainmindparadigm
associativecapacitiesin,177,181
attention/inattentionin,37,61,181
bizarrenessof,9095,139,172
ascardinalbrainmindstate,26
aschaoticstate,25,61,215216
chemicalsystemsand,1416,64,68
cognitiveuncertaintyin,92,156
confabulationin,32,38,6061,73,122,124
asconsciousexperience,209(seealsolucid,below)
asdelirium,9,58,32,4344,62
emotionduring,seeemotion(s)
enhancementofbysleepdeprivation,130131,259
fantasydistinguishedfrom,119122,124125
Freudiantheoryof,seeFreud,Sigmund
functionsof,114117
ashallucinations,32,39,58,73,137
hyperassociationin,114,116
insightandjudgmentduring,4142,44
intellectualfunctionsduring,38
interpretationof,35,40,90,9394,157,212,285
askeytobrainmindstates,8990
lackofinhibitionin,48(seealsoinhibition,motorinhibition,sensory)
language(conversation)during,3839
lucid,172173,211,242,244,251252,260
memoryinandof,seememory
mentalformof,3941
"mentalillness"comparedto,32
mentalstatusexamon,3543,48,54
narcolepsyand,234

Page292

neuronalactivityduring,seeneuronalsignaling
nightmares,32,269
asorganicmentalsyndrome,44
orientation/disorientationduring,3637,8283,8688,9095,100
PGOwavesduring,58,59,61
plotincongruity,discontinuity,incoherence,9192,94,122124
as"preview"ofdisorders,98
psychoanalysisand,23,94,119
aspsychosis,5,22,32,40,44,47,62,77,95,173
recurrent,29,216
asseizure,134136
sensoriumduring,36(seealsosensorysystem)
sleeplabstudiesof,4762,6566,77,9095
assourceofartisticinspiration,25
splicingof,122124
timeasfactorin,66,67
visuomotoraspectsof,39,55,58,60,137,138
volitionin,61,72,173
Seealsochemicalsystemssleep
dream"spirit"or"soul,"55
drugs,262286
amphetamines,178,281
animalresearchon,47
anticholinergic,283
antidepressant,196,197,198,201,233,274,282,283
antihistamine,21,264,280,281
andattentiondeficitdisorder,178179
andbloodbrainbarrier,266
chlorpromazine,2122,75,179,280,284
andhabituation/dependency,267268,279,281
implicationsoftherapy,283
placeboeffect,258259
psychiatricuseof,24,27,30,277,280281
disbeliefin,20
importanceof,262
reuptakeblockers,282
sideeffects,197,264,267,269
forsleepdisorders,233,235,237,240
druguse/withdrawal,43,44,64,263,268,281.
Seealsoalcoholism
drunkenness,26.
Seealsoalcoholism
Drury,Dr.Robert,242244,245246,247,252
DTs.Seehallucinations
dualism(brainmind),11
E
Easternphilosophy,10,29,185
Edison,Thomas,115
andEdisonsyndrome,232237
Edwin(psychiatricpatient),"narcolepsy"of,232237,241
EEG(electroencephalogram,polygraph),46,47,69
ofDelia'sdreams,4955passim,61
"evokedpotentials"(startlereflex)shownon,96
nonREMsleeppattern,52,54,190
seizuresindicatedby,58,135
ofsleepwalkers,255
electricalactivation.Seeactivationenergy
electroshocktherapy,134135,195
electrosleepmachine,236
embryology,140142
EMG(electromyogram),51,52
emotion(s),149151
anxiety
effectof,195,198
andsurvival,161(seealsodream,below)
ascommunication,153
defined,153154
dream,4243,54,62,150157passim,164
anxiety/fear,32,55,58,60,147152passim,155159passim,162
joy/elation,151152,157158,159
menvs.women,159160
fightorflight,74,161162
asfunctionalunit,16
functionof,160162
instinctual,161162
andmemory,164
negativevs.positive,157159,160

Page293

andorientation,87,164
andperception,71,164
sourceof,154157
temporallobes(amygdala)asseatof,58,89
duringwaking,8283,89
dreamcomparedto,148149
energyflow,182183,184186
andbodytemperature,186188
indepression,193194,195,198199,201
inhealing,224225
Seealsoactivationenergy
enzymes,193,266.
Seealsometabolicactivity
EOG(electrooculogram),51
epilepsy,58,135
ergotropicaction,187,225
defined,184
ergotropictrophotropiccycle,186,269,275
ethicalconcerns,61,178,207
ethology,163164.
Seealsobehavior
evolution,48,251.
SeealsoDarwin,Charles,andDarwiniantheory
excitation(indreams),48,113
exercise,261
anddepression,193,196
andsleep,228,239
ExpressionofEmotionsinManandAnimals,The(Darwin),160
eyemovement,144.
Seealsovision
F
fantasy(daydreaming),15,118122,124125,168,208,210
dissociationand,217
norepinephrinelevelsand,176
rememberedeventsand,102
FDA(FoodandDrugAdministration),U.S.,236,258,280
fear.Seeemotion(s)(anxiety/fear)
fightorflightresponse.Seeemotion(s)
"fixedacts."Seebehavior
Franklin,Benjamin,253
freewill.Seevolition
Freud,Sigmund,andFreudiantheory,102,214,218,225,259,277,284
anxietyasviewedby,161
brainmindtheory,1213,29,209
dreamtheory,33,35,43,90,94,124,150,157,212,285
andpsychoanalysis,23,32,212,254,276
andtheunconscious,23,25,32,94,119,150,207208,212
"functionalabnormality,"254
G
gaitcontrol,139140.
Seealsomotorprogram
galaxies,29
geneticstheory162163,192193,197
"GrandHysteria"clinic(Paris),253
Gross,Jerry,270276
H
habituation,96,97,112
todrugs,267268,279,281
hallucinations,174
activationenergyand,71
amineacetylcholineratioand,73,133
chemicaltreatmentof,2122,27,75
deliriumand,62
dreamsas,32,39,58,73,137
dreamspreventing,135
DTs,32,125,274276
hypnosisand,251
induced,130
bydrugsoralcohol,64,271
informationsourceand,69,71
andmetabolism,252
microhallucinations,71
organicmentalsyndromeand,43,44
PGOwavesand,58,59
proceduralknowledgeand,144
sleepdeprivationand,132133,145,196
visuomotorsystemin,138139,145
HarvardMedicalSchool,25,243
"headtrips,"64.
Seealsovisions,induced
healing,sleepand,224225,226,241,261
heartaction,acetylcholineand,185
hemineglect,174
hermeneutics,209210,213
hippocampus,8889,94

Page294

Hodgkin'sitch,245,252
holisticapproach,15,218
HughlingsJackson,John,48,62
"hyperactivity"(inattentiondeficitdisorder),177
hyperassociation.Seeassociation
hyperexcitability,135
hypersomnias,254.
Seealsosleep(disordersof)
hypnosis,15,27,168,217,242,261
asanesthesia,243247,248,252
self,10,169
andtrance,248249,251,253
Seealsotrance
hypothalamus,155,163,194
I
identityswitching(transmogrification),121
immunesystem,sleepand,188190,198,226
inattention.Seeattentiondeficitdisorder
information(input)source(I),inbrainmindparadigmmodel,66,6769,71,76,168,172
informationprocessing,115116
inhibition,behavioral
alcoholand,273
indreams,48
inhibition,motor,58
failureof,136140,145
and"hyperactivity"177
inREMsleep,55,60,66,97,136137,145,255
inhibition,sensors61,6566,155
insightandjudgment,7172
Bertal's,138,173174
inDelia'smentalstatusexam,4142,44
insomnia,238241,254,256.
Seealsosleep(disordersof)
instinctualemotion,161162.
Seealsoemotion(s)
intellectualfunctions(inDelia'smentalstatusexam),38
interleukin1,189190
intoxication.Seealcoholismdruguse/withdrawal
itching,hypnosisand,245246,252
J
James,William,155,225
andbrainmindunity,12,23,154
jetlag,182183
Jos'sdreams,136138,139,140,145,254.
Seealsodream(s)
joy.Seeemotion(s)(dream)
"JumpingFrenchmen,"250251,252,257
Jung,Carl,3233,43
K
Kahn,David,24
Keefe,Frank,89
Kennedy,JohnF.,96
Khrushchev,Nikita,96
Kleitman,Nathaniel,193
KoreanWar,243
Korsakoff'spsychosis,271272
Kreuger,James,189,190
Kuhn,Thomas,7
L
LaiTai(sleepdeath),185
language
andconsciousness,204,206
andstreamoftalk(inDelia'smentalstatusexam),3839
Latah(trancestate),247250,251,252,257.
Seealsotrance
LeDoux,Joseph,156,158
Librium,280.
Seealsodrugs
Loewi,Otto,185
Lowell,Dr.George,237,241
LSD(lysergicaciddiethylamide),64
M
Malaysia,247,249,250,252
mania,262,269
MassachusettsMentalHealthCenter(Boston),1921
sleeplabat,25
maturation,142,256
meditation,10,15,29,217,242,260,261
memory
acetycholineand,115,116,179
associationand,113114,116
ofautomobileaccident,104110
consciousnessand,208
indreams,103104
ofdreams,3738,114
vs.forgetting,32,44,104,113,211,282
emotionand,164

Page295

asfunctionalunit,16
andfunctionofdreams,114117
implicitorexplicit,110
learningand,112114
lossof(amnesia),32,46,62,107108,109
neuronalnetworkand,103,109,116
andorientation,85
procedural,111,116
psychologicalstudiesof,69
andrecollectionofpastevents,10
shortandlongterm,115,116
sleepand,103,114117,145,191,210
spottyrecent,38
"storage"of,72,88,89,111
mentalcontentofdream
ascategoryinmentalstatusexam,39
contextdependent,131
ofDelia'sdream,3941
"mentalillness,"1617
braindisordersseenas,10,19
dreamingcomparedto,32
failureoffacultiesas,84
aslearnedbehavior,19(seealsobehaviorism)
Seealsopsychosis
mentalstatusexam
beforeandaftersleep,107,108
conceptionof,3132
onDelia'sdream,3543,48,54
Merritt,Jane,152
mescaline,64.
Seealsodruguse/withdrawal
Mesmer,FranzAnton,andMesmerism,253,254,259.
Seealsohypnosis
metabolicactivity,72,192,193,198,252,269270
alterationof,andwithdrawal,268269
MichelangeloBuonarroti,265
microhallucinations,71.
Seealsohallucinations
mind,the
causalityand,210211
definitionsof,1012
newdefinition,203,205207
Seealsobrainmindparadigmbrainmindstate(s)brainmindunityconsciousnessthinking
mode/modulation(M),inbrainmindparadigmmodel,66,6769,7172,76,100,172
moleculargenetics,162163,192193
monkeys,attentionstudiesof,175
monoamineoxidaseinhibitors,282
Seealsodrugs
Morewill,Frank,257258
motorprogram
bizarreposesandmovement,138139
inhibitionof,seeinhibition,motor
motorbehaviorinembryo,140142,144
patternsactivatedinREMsleep,142
responsetothreat,74,161
andsleepwalking,255
volition(indream)and,173
Seealsovisuomotorsystem
MRI(magneticresonanceimaging)scans,7,170
mutation,215.
Seealsochaostheory
N
Nadel,Lynn,89
narcolepsy,233,234,237,238,248,252,282.
Seealsosleep(disordersof)
NationalCancerInstitute,243,245
NationalHospitalfortheParalysedandEpileptic(London),48
NationalInstitutesofHealth,182,243
NationalScienceFoundation,236
nervoussystem,15,184185,187,189
neurobiology,210,212,213,218,225
neurology
andactivationconcept,69
perceptionasseenby,70
psychologyopposedto,integratedwith,2224,25,3132,213,218,225226
ofwakingstate,89
neuronalsignaling,16,267
blockedbyhypnosis,244
computermeasurementof,171172

Page296

duringdream,1314,2728,57,113114,215216
druginduced,64
andmemory,103,109,116
andmetabolism,72
and"themind,"205
innonREMandREMsleep,60,64,89,191,211
sleepdeprivationand,133
atwaking,64,74,87,88
neuroscience,22
cognitive,2526,32,156,169,210
andsleepstudies,25(seealsosleep)
neurosis,misperceptionand,71
neurotransmitters,13,16,270
alcoholismand,275
chlorpromazineinteractionwith,2122,75,179
Seealsoacetylcholineamineschemicalsystems
Newton,SirIsaac,andNewtonianlaws,210,214,269
Nightcap(REMdetector),259
nonconsciousactivity.Seeconsciousness
nonREMsleep.Seesleep,nonREM
norepinephrine,62,114115,184,192
alcoholismand,275
amphetamineasstandinfor,281
andattention,172,176,177179
duringdream,57,59,60,95,113,211
drugsand,282
andenergy,185,187,233
andmetabolism,72
inorientation,87,95
andREMsleep,191,193,195,196,283
andwaking,61,173,189
Seealsoamines
North,Harriet,174,285
O
Oedipalspeculations(regardingDelia'sdream),35,40
organicmentalsyndrome,43
diagnosisof,4647
dreamingas,44
orientation,81101
brainstemasmediatorof,88,96,171
ascategoryinmentalstatusexam,3637,43
anddisorientation
indreams,3637,8283,8688,9095,100
assymptomofpsychosis,46,62,95,9899
emotionand,87,164
asenduringcognitivecondition,87,88
asfunctionalunit,16
importanceof,8586,90
memoryand,85
orientingresponse,8688,9697,139,144,160161,171
orientingsense,37(seealsoattention)
speedof,8788
OriginofSpecies(Darwin),160
oscilloscope,57
P
PaceSchott,Ed,172173
pain,245
indreams,246
hypnosis/tranceand,243247,248,252
panicdisorder,32
dreamanxiety,seeemotion(s)
paradigmshift,7.
Seealsobrainmindparadigm
paranoia
Freud'stheory,284
lackof,inDelia'sdream,41
parasomnias,254,256.
Seealsosleep(disordersof)
parasympatheticnervoussystem,184,189.
Seealsonervoussystem
Parkinson'sdisease,47,264
Pauling,Linus,272
Pavlov,Ivan,28
peptides,dimuramyl,189190
perception
bizarre,9095,139,172
emotionand,71,164
asfunctionalunit,16
andmisperception,7071
projective,22,70
wakingorsleeping,differencesin,202

Page297

peripheralnervoussystem,184.
Seealsonervoussystem
personality,153.
Seealsoemotion(s)
PET(positronemissiontomography)scans,170,171
PGOwaves,5859,61,135,145
pharmacology,30,47
ofwakingup,74
Seealsodrugs
phenothiazine,280.
Seealsodrugs
philosophy
analytical,212213
scientific,213
physiology,10,1214,21
andenergyflow,185188
andhypnosis,247,252,253
predictedby/predictorofpsychology,26
Seealsobacteriachemicalsystemsdrugs
placeboeffect,258259
"placecells,"89.
Seealsohippocampus
plotincongruity,discontinuity,incoherence,9192,94,122124.
Seealsofantasy
poliovirusandvaccine,47
polygraph.SeeEEG(electroencephalogram)
pons,5760,62,88.
SeealsoPGOwaves
Posner,Michael,169170,171,172,175,177
powerofsuggestion,226,242,246247,258.
Seealsohypnosis
PrinciplesofPsychology,The(James),23
proceduralknowledge,142,143144,162
proceduralmemory,111,116
projection(perceptionand),22,70
Prospero,Miranda,277279
Prozac,262,282.
Seealsodrugs
psychedelicvisions,64
psychiatry,23,30,226
controversiesin,253
drugsusedin,24,27,30,262,277,280281
disbeliefin,20
psychoanalysis,102,209,218,225226,242
behaviorismand,19
anddreams,23,94,119
andemotion,150
Freudand,23,32,212,254,276
inadequacyof,21,24,30,212213,276,284
scientific,213
psychology,10
andactivationconcept,69
andhermeneutics,209210,213
inadequacyof,186
neurologyopposedto,integratedwith,2224,25,3132,213,218,225226
perceptionasseenby,70
popularityof,215
predictedby/predictorofphysiology,26
andprojection,70
andpsychosomaticcomplaints,276
Seealsopsychiatrypsychoanalysis
psychosis
confabulationin,46,62,121122,124,125
diagnosisof(labtests),4648
disorientationassymptom,46,62,95,9899
dreamas,5,22,32,40,44,47,62,77,95,173
dreamasbasisforstudying,22,27
"functional,"276
lucid,173174
mentalstatusexamof,3132
misperceptionand,71
REMsleepaspreventerof,135
vitamindeficiencyand,271272,275
psychosomaticcomplaints,276
PublicHealthServiceCommissionedCorps,U.S.,243
R
randomness.Seechaostheory
reflexdoctrine,155.
Seealsostartlereflex
REM(rapideyemovement)sleep.Seesleep,REM
REM(rapideyemovement)sleepdisorder,138140,250,254.
Seealsosleep(disordersof)sleep,REM
Renaissance,the,11
Richberg,Dr.Larry,238241

Page298

Ritalin,233.
Seealsodrugs
Rorschach,Hermann,andRorschachtest,93
Rosa(insleepstudy),231,241
Russell,Bertrand,212
S
Sally'sdream,147149,152,155159passim,162.
Seealsodream(s)
Salptrirehospital(Paris),253
Sartre,JeanPaul,41
schizophrenia,9,4143passim,76,113,243,275
keysymptomof,33
studiesof,47
vitamintherapyfor,272
scientifichumanism,224226,259,277,281
sedative,interleukin1as,190
seizureandseizurelikestates,58,145
dreamas,134136
inDTs,274
selfawareness.Seeconsciousness
sensorium(inmentalstatusexam),36
sensoryinput.Seeinformation(input)source(I)
sensorysystem,139
activityinhibited,61,6566,155
selectionofdata,167169
sensoriuminDelia'smentalstatusexam,36
separabilityofmindfrombrain(asdoctrine),11
serotonin,62,115,192
duringdream,57,59,60,95,113,211
drugsand,282
andhabituation,97
andmetabolism,72
inorientation,87,95,99
andREMsleep,191,193,195,283
andwaking,61
Seealsoamines
Sherrington,Charles,155
shocktherapy.Seeelectroshocktherapy
Skinner,B.F.,23,50,117,230
sleep
Alzheimer'sdiseaseand,99
aminergiccholinergicactivityand,100(seealsochemicalsystems)
amountneeded,226,227237
animal,seestudiesof,below
andattention,29,167,169
ascardinalbrainmindstate,26
curativefunctionof,224225,226,241,261
cyclesof,5152,57,194,196
depressionand,193196
deprivationof,135,164,167
beneficialeffect(indepression),194,195,196
anddreamenhancement,130131,259
andhallucinations,132133,145,196
andhealth,188190,191,226
andpayback,192,274
disordersof,138140,233241,250,254258
electrosleepmachine,236
andtheimmunesystem,188190,198,226
asinstinct,163
andmemory,115,210
mentalstatusexambeforeandafter,107,108
motorinhibitionasprotectorof,58(seealsoinhibition,motor)
mythof,17,117
naturalaidsto,190,239240
stagesof,5152,251,255,256(seealsosleep,nonREMsleep,REM)
studiesof,17,25,28,137,182,226,231
animals,5659,7475,188191passim,196,267
Delia'sdreams,4762,6566,77,9095,259,285
valueof,85,151
transitiontowakingfrom,6,1516,61,84,8688,99,173
usefulnessof,timeofdayand,192
Seealsodream(s)
sleep,nonREM,58,71,75
"cholinergicdreaming"in,196
anddepression,195
andinfection,190
lowbrainactivityin,52,54,60,73,136,180
andmemory,114
motoractivityin,136

Page299

REMsleepcomparedto,191
sleepwalkingduring,254255
Seealsosleep
sleep,REM
acetylcholineand,seeacetylcholine
alcoholand,272,273275
ofbaby,141,143
asblueprintforbehavior,141142
andbodytemperature,187188,190
brainactivityincreased,68,69,89,117
ofcats,56,58,59,75
anddepression,194,195,196
discoveryof,192
anddreams,52,54,75,93,133,140,164,208
nightmares,269
druguseand,64,282
andemotions,159
fetusinstateresembling,140141
functionsof,144145,180,188,274,282283
andgenetictheory,162163,192193
inhypnotizablepeople,251
andmemory,103,114117,145,191
menvs.women,160
motoractivityinhibited,55,60,66,97,136137,145,255
motorpatternsactivated,142
"Nightcap"detectorof,259
paidback,192,274
PGOwaves,5859,61,135,145
aspreventerofpsychosis,135
REMsleepbehaviordisorder,138140,250,254
andseizures,134136
sensoryactivityinhibited,61,65,155
assupersleep,191193
assurvivalstrategy,163
valueofstudy,85,151
wakingfrom,86
Seealsodream(s)sleepsleep,nonREM
sleepdeath,185
sleeptalking,250,254,256258
sleepwalking(somnambulism),26,136,217,250,254256
SovietUnion,236
Spiegel,David,252
startlereflex,9697,112,139,247250,255,267268
StarTrek,149
Stevenson,RobertLouis,25
Stickgold,Bob,123
StrangeCaseofDr.JekyllandMr.Hyde,The(Stevenson),25
suddeninfantdeathsyndrome,276
Swedenborg,Emanuel,130131,133,259
Sylvestri,Enzo,230,231,232
Sylvestri,Lai,229231,232,241
sympatheticnervoussystem,184,187,189.
Seealsonervoussystem
syndromedefined,43
T
technology.SeecomputertechnologyXrays
Tegretol,24.
Seealsodrugs
temperature,body,186188,190
Thailand,185
thalamus,174175,176,211,244,249,250
thinking
feelinglinkedto,83
lackofcontrolof,61,6466,72,73
mentalfunctionequatedwith,205
positive,160,169,225
Seealsoconsciousnessvolition
Thurber,James,118
time
ofday
andaminergic/cholinergicsystems,99100,180
andusefulnessofsleep,192
asfactorinbrainmindstate,2930,66,67,75
andjetlag,182183
andorientation,86
Tinguely,Dick,104,208
topdownprocess,61,140,169,174,225
defined,139
andhypnosis,244,248
Tourette,Gillesdela,andTourette'ssyndrome,249,251,252,257

Page300

trance,104,116,208,242,247252,261
hypnotic,253
Seealsohypnosis
tranquilizer,antihistamineas,21,264.
Seealsodrugs
transmogrification,92,121
tropotrophicaction,186,192,225,269,275
defined,184
anddepression,193
U
unconscious,the,Freud'stheoryofSeeconsciousness
UniversityofOregon,164
UniversityofTennessee,189
V
Valium,10,24,280,281.
Seealsodrugs
Vietnamvets,recurrentdreamsof,29
vision,59,128130,135
eyemovement,144
''visualblanking,"129130
visions,induced,64,130133,271.
Seealsohallucinations
visuomotorsystem
indreams,39,55,58,60,137,138
inhallucinations,138139,145
Seealsomotorprogramvision
vitamins,262,269270
deficiencyof,andpsychosis,271272,275
volition(freewill),71
andattentionvs.distraction,166,167169(seealsoattention)
andcures,281
indreams,61,72,173
hypnosisand,248
Seealsopowerofsuggestionthinking
VoodooDeath,185,276
W
waking,144,210
aminergicsystemand,1416,68,71,7374,87(seealsochemicalsystems)
ascardinalbrainmindstate,26
dissociationduring,216217
emotionsduring,8283,89,148149
neuronalsignalingand,64,74,87,88
normal,statisticalimprobabilityof,73
transitionfromsleepto,6,1516,61,84,8688,99,173
WallStreetJournal,233
Watson,James,193
Wernicke'sencephalopathy,272
Whitehead,AlfredNorth,212
willpower.Seevolition
withdrawal,268.
Seealsoalcoholismdruguse/withdrawal
women
conflictsconfronting,278279
dreamemotionsof(comparedtomen),159160
Wordsworth,William,232
WorldWarIIbombingraids,96
X
Xrays,46,47
Y
yinandyang,185,186