The Shifting Realities of PK Dick

"Drugs, Hallucinations, and the Quest for Reality" (1964)

One long-past innocent day, in my prefolly youth, I came upon a statement in an undistinguished textbook on psychiatry that, as when Kant read Hume, woke me forever from my garden-of-eden slumber. "The psychotic does not merely think he sees four blue bivalves with floppy wings wandering up the wall; he does see them. An hallucination is not, strictly speaking, manufactured in the brain; it is received by the brain, like any 'real' sense datum, and the patient acts in response to this to-him-very-real perception of reality in as logical a way as we do to our sense data. In any way to suppose he only 'thinks he sees it' is to misunderstand totally the experience of psychosis."

Well, I have pondered this over the dreary years, while meantime the drug industry, psychiatrists, and certain naughty persons of dubious repute have done much to validate -- and further explore -- this topic, so that now we are faced with a psychiatric establishment little related to the simple good old days (circa 1900) when mental patients fell into one of two rigid classes: the insane, which meant simply that they were too ill to function in society, to wash and wax their car, pay their utility bills, drink one martini and still utter pleasant conversation, and hence had to be institutionalized... and the neurotic, which included all those wise enough to seek out psychiatric help, and for merely "hysterical" complaints, such as feeling a compulsion to untie everybody's shoes or count the number of small boys on tricycles passing their houses or offices, or for "neurotic" disorders that boiled down to anxiety felt out of proportion to the "reality situation," in particular specialized phobias such as a morbid, senseless dread that an unmanned space missile supposed to land in the Atlantic would instead strike dead-center in the patio on Sunday afternoon while the person in question was fixing charcoal-broiled hamburgers. No real relationship was seen between the "insane" who were -- or should have been -- in institutions and "neurotics" or "hysterical" individuals showing up for one hour of free-association a week; in fact, the belief that the insane (or as we would say now, the psychotic) had an ailment of a physical, rather than psychogenic, origin and the neurotic felt unnatural fears because of a traumatic event in his early childhood was so established that Freud's initial discovery had to do with creating a diagnostic basis upon which the doctor could decide into which group the ill person fell. If he proved psychotic, then depth psychology, psychoanalysis, was not for him -- if neurotic, all that was needed was to bring the long-forgotten repressed traumatic sexual material out of the subconscious and into the light of day... whereupon the phobias and compulsions would vanish.

This looked to be a good thing, until Jung showed up and proved:

1. That hospitalized, full psychotics responded to psychotherapy as rapidly as neurotics, once the psychotic's private language had been comprehended, communication thereby being established. And

2. Many "neurotics," who were ambulatory, who held jobs, raised families, brushed their teeth regularly, were not what he had designated as "introverted neurotics" but in fact psychotics -- specifically schizophrenics -- in an early stage of a lifelong illness career. And they responded less well to psychoanalysis than anyone else.

This meant something. (A) Perhaps all mental illness, no matter how severe, might be psychogenic in origin. (B) A neurosis might not be an illness at all or even an illness symptom, but a construct of the brain to achieve stasis and avoid a far more serious breakdown; hence it might well be risky to tinker with someone's neurosis because under it might lie a full-blown psychosis -- which would emerge at the point where the happy psychiatrist sits back and says, "See? You're no longer afraid of buses." Whereupon the patient then discovers that he is now afraid of everything, including life itself. And can no longer function at all.

So out went the whole great scheme of things, the subconscious, the repressed childhood sexual trauma -- like a medieval flat-world map it referred to nothing, and was, possibly, even harmful to what are now designated as "borderline psychotics," which is a way of saying, "Those who can't function in society but do. I guess." How cloudy can an issue become? All theories, one by one, broke down; there were "rational" psychotics, whom we in our amusing way call paranoids, and there were -- but enough. Because now we are at what I regard the crucial issue: that of the presence in the psychotic of not only delusions ("They're conspiring against me," etc.) but of hallucinations, which neurotics do not have. So perhaps in this regard we have a diagnostic basis, if not of the nature of the illness then at least of its severity. But one item crops up, here, that is rather unnerving. There is such a thing as negative hallucination -- that is, instead of seeing what is not there, the patient cannot see what is. (Jung gives, I think, the most extraordinary example of this: a patient who saw people minus their heads -- he saw them up to the neck only, and then nothing.) But what is even more scary is that this patient was not psychotic; he was absolutely for sure merely hysterical -- as any stage hypnotist can testify, since such malperception can be induced in distinctly nonill people... as well as a good deal more, including that which when it occurs without the influence of the hypnotist is considered the sine qua non of psychosis, the positive hallucination.

We are now getting somewhere, and it is a frightening where. Because we have entered the landscape depicted by Richard Condon in his terrific novel The Manchurian Candidate: Not only can delusions and hallucinations be induced in virtually any person, but the added horror of "posthypnotic suggestion" gets thrown in for good measure... and, by the Pavlov Institute, all this for clearly worked-out political purposes. I don't think I'm wandering into fantasy here, because recall: Freud originally became involved in a form of psychotherapy that utilized hypnosis as its cardinal tool. In other words, all modern depth psychology -- that which postulates some region of the mind unavailable to the person's conscious self, and which, on many an occasion, can preempt the self -- grows from the observation of individuals acting out of complete convictions and perceptions and motivations implanted by "suggestion" during the hypnotic state. Suggestion? How weak a word; how little it conveys, compared to the experience itself. (I've undergone it and it is, beyond doubt, the most extraordinary thing that ever happened to me.) What the body of "suggestions" add up to for the hypnotized subject is nothing less than a new worldview superimposed on the subject's customary one; there is no limit to the extent of this induced new view or gestalt of data perceptions and organizing ideas within the mentational processes of the brain -- no limit to its extent, its duration, or its departure not only from what we quaintly call "reality." And -- this simply can't be, logically, but it is so -- the subject can be altered physically, in terms of what he is able to do; he can lie rigid between two chairs and be stood on, so even the somatic portion of him is new... sometimes even to the point of contradicting what we know to be anatomically possible, as relating to the circulatory system, etc. (e.g., holding his arm extended for a considerable time); the time limit is imposed by purely physiological factors, and there simply can be no psychogenic explanation as to such a phenomenon, unless we wish to posit yoga or Psionic or -- let's face it -- magical powers. But powers of this sort by whom? The patient? The hypnotist? It makes no sense either way, unless we restore the seventeenth-century notion of wizards and those who are victims of wizardly spells... and where does this take us? I doubt if even John W. Campbell, Jr. [influential SF editor of Astounding magazine, whose rigid approach to SF plotting was disapproved of by Dick] would want to venture along this path.

However, perhaps we can construct something comprehensible out of this by recalling that there now appears some validation of extrasensory perceptions -- and abilities. There is a relationship; as far back as 1900 Freud himself noted palpable evidence, during free association by his patients, of telepathic ability. (I really hate to have learned this, having jeered at ESP for years; but Freud's documentation alone -- and he was an incredibly scrupulous observer -- tends to strengthen the case for ESP.) And, recently, in absolutely reputable psychiatric journals, trained M.D. psychiatrists have given us the news that telepathic perceptions by their patients occur so frequently as to be beyond dispute. Ehrenwald, published by W. W. Norton, which is reputable, with a foreword by Gardner Murphy, goes so far as to construct an entire theory of mental illness based on firsthand observation of his severely disturbed patients that they are experiencing involuntary telepathic linkage; the paranoids, for example, receive as sense data the marginal, repressed, unspoken hostile thoughts and feelings of those around them; he declares that again and again, while passing through hospital wards, paranoid patients quoted to him word for word hostile thoughts that he was entertaining toward them -- and, of course, concealing such thoughts, as we all do, in order to keep our interpersonal relationships functioning. So now, in my prolix, rambling way, I have gotten to my Big Scoop. Taking Ehrenwald's utterances at face value (that is, accepting them as true and using them as a postulate), we are faced with the clear and evident possibility that at least in the case of paranoids -- or, anyhow, some paranoids -- the "delusions" are not delusions at all, but are, on the contrary, accurate perceptions of an area of reality that the rest of us cannot (thank the Lord) reach. All right; now let's return to and reexamine the entire topic of mental illness, hallucinations both negative and positive, the hypnotic experience, pseudoschizophrenic sensory distortions brought about by chemicals such as LSD and organic toxins such as are found in some mushrooms, etc., and, to be absolutely certain that I make a fool of myself, I'll add mysticism, the mystical event called "conversion," such as happened to St. Paul. Ready? Okay.

Can a person be psychotic without hallucinating? Yes. The paranoids merely have "delusional ideas"; they see the same reality that we do, but interpret it differently, work it into their system.

Can a person hallucinate without being psychotic? Yes, as for example during the hypnotic state, under drugs, when ill with a high fever, poisoned -- for many reasons.

What is the relationship between hallucination and worldview? The German psychological notion (more accurately Swiss) is that each individual has a structured, idiosyncratic, and in some regards unique way of picturing or experiencing -- or whatever it is one does with -- reality. It now is universally accepted that reality "in itself," as Kant put it, is really unknown to any sentient organism; the categories of organization, time, and space are mechanisms by which the living percept-systems, including the portions of the brain that receive the "raw" sense data, require the imposition of a subjective framework in order to turn what would otherwise be chaotic into an environment that is relatively constant, with enough abiding aspects so that the organism can imagine, on the basis of memory (the past) and observing (the present), what the future probably will be. Continuity is essential; one must be able to recognize a good deal of the external world in order to function (this, of course, is why the name problem is real and not a figment of medieval imagination; the logos, the word, turns chaos into separate and different objects).

A good deal of this organization is done within the percept system itself; that is, by less-than-conscious portions of the neurological apparatus, so by the time the "self" receives the sense data it has so to speak been automatically structured into the idiosyncratic worldview. The self (or ego or some damn fool thing) is therefore presented with material a good deal of which originated within its own being, at one level or another. In the light of this, the idea of hallucinating takes on a very different character; hallucinations, whether induced by psychosis, hypnosis, drugs, toxins, etc., may be merely quantitatively different from what we see, not qualitatively so. In other words, too much is emanating from the neurological apparatus of the organism, over and beyond the structural, organizing necessity. The percept system in a sense is overperceiving, is presenting the self portion of the brain too much. The cognitive processes, then, in particular the judging, reflecting frontal lobe, cannot encompass what it has been given, and for it -- for the person -- the world begins to become mysterious. No-name entities or aspects begin to appear, and, since the person does not know what they are -- that is, what they're called or what they mean -- he cannot communicate with other persons about them. This breakdown of verbal communication is the fatal index that somewhere along the line the person is experiencing reality in a way too altered to fit into his or her own prior worldview and too radical to allow empathic linkage with other persons.

But the crucial question as to where, at what stage, these perplexing aspects, augmentations, or warpages away from the commonly shared view begin, is not answered by any of this. We are aware today that a good deal of what we call "external reality" consists of a subjective framework by the percept system itself, and that there are probably as many different worldviews as individuals... but how do unwanted, even frightening, and certainly not commonly shared "hallucinations" creep in? Up until the last three or four years it would have been generally agreed that these invasions of the orderly continuity of world experience beyond doubt originate in the person, at some level of the neurological structure, but now, for the first time, really, the body of evidence has begun to swing the other way. Entirely new terms such as "expanded consciousness" are heard, terms indicating that research, especially with hallucinatory drugs, points to the probability, whether we like it or not, that, as in the case of Jan Ehrenwald's paranoids, the percept system of the organism is overperceiving, all right, and undoubtedly presenting the judging centers of the frontal lobe with data they can't handle, and this is bad because there can be no judgment under such circumstances, and no interpersonal life, due to the breakdown of the shared language -- but the overperception emanates from outside the organism; the percept system of the organism is perceiving what is actually there, and it should not be doing so, because to do so is to make the cognitive process impossible, however real the entities perceived are. The problem actually seems to be that rather than "seeing what isn't there" the organism is seeing what is there -- but no one else does, hence no semantic sign exists to depict the entity and therefore the organism cannot continue an empathic relationship with the members of his society. And this breakdown of empathy is double; they can't empathize his "world," and he can't theirs.

Hallucination, mental illness, drug experiences of "expanded consciousness" are menacing to the organism because of the social results. It is obvious, then, what role language plays in human life: It is the cardinal instrument by which the individual worldviews are linked so that a shared, for all intents and purposes common reality is constructed. What is actually subjective becomes objective -- agreed on. So, viewed this way, sociologically and anthropologically, it does not matter where the hallucinations originate or even whether they are accurate -- but unique and hence unshared -- perceptions of "higher levels of reality unglimpsed ordinarily," even by the person himself.

Real or unreal, originating within the percept system or received validly by the percept system because, say, of some chemical agent not normally present and active in the brain's metabolism, the unshared world that we call "hallucinatory" is destructive: Alienation, isolation, a sense of everything being strange, of things altering and bending -- all this is the logical result, until the individual, formerly a part of human culture, becomes an organic "windowless monad" [a description utilized by Leibnitz]. It does not matter that his reasoning faculties are unimpaired; it does not matter whether or not he feels "adequate emotion," those being the two classic criteria by which schizophrenia was diagnosed. Actually it seems to be that neither is impaired; faced with the sense data presented him, the individual does as well with it as we do with ours, and the same goes for his emotional life -- he may display moods and feelings that to us can't be accounted for. But we are not perceiving what he is; the emotions are almost certainly appropriate in relation to what he perceives, i.e. experiences.

My own feeling, especially in view of the very recent laboratory findings that some connection exists between schizophrenia and subsecretions of the adrenal gland, is this: "The sane man does not know that everything is possible." In other words, the mentally ill person at one time or another knew too much. And, as a result, so to speak, his head shut down. A little knowledge may be a dangerous thing, but gadzooks -- what about too much knowledge? Death, as a factor of reality, perhaps should not be known about at all, or, if that's impossible, then as little as one can manage. James Stephens, in his poem "The Whisperer" (from Insurrections, Dublin, 1912), informs us of something I distinctly am not glad to know, but now I know it, and I guess one finds it out sooner or later. Ironically, it is that God Himself feels this:

I fashion you,

and then for weal or woe,

By business through,

I care not how ye go,

Or struggle, win or lose, nor do

I want to know.

One doesn't have to depend on hallucinations; one can unhinge oneself by many other roads.