Table of Contents
HALLUCINATION, DREAMS, AND REALITY
THE sense of reality and the belief in the external existence of the hallucinatory objects are quite strong in hallucinations and in some of the more vivid and intense dream states.
In order to explain this seemingly anomalous sense of reality, it may be well to revert to our general principle of subsuming both the normal and the abnormal under the same general laws and processes.
Although the abnormal is of the highest importance in revealing new relations which the customary and habitual normal seems to hide, as found, for instance, in the growth and development of physiology, largely due to pathological research, still we must clearly remember that from a strictly scientific standpoint the normal and abnormal are but teleological concepts which are of importance for the practical purposes of our habitual life activity and possibly for classification of various types of phenomena, but which science is to reduce to the same laws and processes. The abnormal is the normal out of place.
In mental life as in the phenomena of life in general the atypical, or the variation, helps to explain the typical, the normal, and the latter in its turn explains the atypical, the abnormal. We may therefore turn to the criterion of the normal sense of reality and validity of experience as explaining the same relations in abnormal mental life and the latter in its turn may throw light on the “reality and validity” of “normal” experience. A brief review will suffice for our purpose. It may look as if we attempt to make an excursion into a domain not belonging to normal or abnormal psychology proper, but to epistemology. This may be so, but the nature of our subject brings us so closely to this problem that a brief discussion may help us to see the facts in a clearer light.
Abnormal psychology with its various forms of mental aberration, such as are to be found in the phenomena of insanity, functional psychosis, hallucination, delusion, somnambulic states, hypnoidic states, is so intimately connected with aberrations of the ‘sense of reality and validity’ of experience that not only the abnormal psychologist, but also the clinician must take it into account from a purely practical standpoint. We shall view the problem only in so far as it directly concerns and illustrates the general subject of our discussion, namely hallucination and illusion, or fallacious perception.
The objective reality of the physical world is sometimes defined, and apparently with best of reasons, as social experience, as experience common to ourselves and our fellow men, as experience which men share in common. This view, however, of ‘external reality’ seems in contradistinction to the psychic experience which is essentially of an individual character. The tree yonder can be seen by everyone who possesses eyes, but my perception of the tree, or my idea of it, can only be experienced by myself. It may be said that this difference between the physical object and psychic state is a valid and valuable one. It is, however, neither general enough, nor specific enough.
For on the one hand it may be claimed that from a more general philosophical standpoint even the physical object belongs ultimately to the individual only, and on the other hand, it may be claimed that psychic experience is communicated to our fellow men not only in terms of the physical object, but far more often in terms drawn directly from our mental life. Neither the physicist nor the psychologist will be quite satisfied with this point of view as both physical objects and psychic objects are entirely emptied of their specific contents and must remain at best in the dubious regions of epistemology.
Still this social aspect of the physical object is significant and valid and is even used by the psychiatric clinician as a practical standard in the valuation of abnormal mental life in general and of insanity in particular. It may, therefore, be of value even if we do not agree with the extreme way in which this view is sometimes put.
It is true that at the first glance we cannot help being struck by the import of the common or social aspect of external reality. We are well assured of the existence and presence of an external object, if we have the assurance of our fellow-beings, and what is accepted by our fellow men assumes the dignity and authority of actuality. A fact is regarded as existing beyond the shadow of any dispute, if every one can verify it in his own experience. The categorical necessity or our modern science rests entirely on this principle of validity: The social object is the valid object.
This criterion of validity of the external object stands out specially clear and distinct in our standard of abnormal mental life. A belief is regarded as insane and delusional, if it is in opposition to social beliefs and experience, and is emphatically rejected by all other men. An object is regarded as illusory or hallucinatory, if it is treated as non-existent by other people; a desire, an action is considered immoral, if it is spurned by our neighbors. The real object is the social object, the valid belief is the social belief, and the social will is the moral will. The individual object, the individual belief, the individual will are treated as insane.
One can not help noticing the semblance of truth in the assertions of those pathological anthropologists who put genius in the same category with insanity. What is social is alone true, valid and real, the individual is false, non-existent. The individual can buy the reality and truth of his being on condition of becoming social. Sociality is verity.
Let us now, however, try to break through, if for a moment only, the traditions of social régime with its criteria of social reality and validity. When being pricked or getting a blow, or when cut or scratched, along with the experience of the sensation, the experience of the external stimulus is also given. In looking out of the window and seeing the tree with its green leaves moving in the wind, along with the perception of sensory elements, primary and secondary, the external existence of the object tree is also given. Similarly in listening to the sounds of a familiar and dear voice and listening to the words as they form into phrases and sentences is not the sense of reality of the external object given along with the series of sound sensations? Sensation carries along with it the sense, the reality of its stimulus. It is not that the sense of reality is different from the sensation, it is given in the sensation itself. Similarly the percept and the sense of reality of the external object are not two different things; they are given together in the same process of perception and are identical. The percept tree is the perception of the reality of the objective tree yonder. The sensory process is also the process of the sense of reality. As Spinoza puts it in his Ethics: “If the human body is affected in a manner which involves the nature of any external body, the human mind will regard the said external body as actually existing.” In seeing or perceiving the chair yonder we do not perceive it as real, because of its social or common aspect-the reality of its existence is given directly in the sensory processes of the percept itself. Sensory elements involve the reality and existence of their stimuli; the percept involves the existence of the perceived objective content.
The sense of reality of the external stimulus or object is strengthened by association of the original sensory systems with other sensory systems, and the intensity rises in proportion to the number of systems of sensory elements, brought into relation with the functioning sensory system. If on perceiving an object, we wish still further to assure ourselves of its reality, we verify it by means of other sense organs. If one sees an apple and wishes still further to assure himself of the real presence of the object, he goes to it and examines it with his other sense organs, he touches it, presses it, bites it, tastes it.
Kinaesthetic elements, being the most important in adaptations and reactions to the stimuli coming from the external environment, are possibly of all sensory elements the ones that give the keenest and most intense form of sense reality. Facts warrant us to assert with some show of probability that the sense of reality is chiefly centered in the sensori-motor or kinaesthetic elements which serve as nuclei for other sensory elements.
Whether this be correct or not, it remains true that the sense of reality is given directly by sensory elements and their combinations and organizations. The more systems of sensory elements are pressed into service, the stronger is the sense of reality and the more assured is the reaction to the stimuli of the external environment.
In the evolutionary process of man's adaptation to his environment he becomes extended in being and grows more developed, because of his social relations with other men. Man presses into active service the systems of sensory elements of his fellow beings. Adaptations and hence successful reactions to the external environment are now more assured, and the sense of reality is still further emphasized and intensified.
Throughout the course of intensification of the sense of reality the principle remains unchanged in nature. The sense of reality is given by and consists in nothing else but the sensory elements.
Social experience may be regarded as more real or as giving a more intense sense of reality, because of the greater number of sensory systems involved, but an object is not felt as external and real, because of its social aspect merely, the sensory aspect is by far the more fundamental. If one's perception of the house yonder is of a purely “individual” character, not shared by his fellow men and even emphatically denied by them, the visual perception, as such, still directly perceives it as real, external, and physical.
Should furthermore this experience be intensified or confirmed by all the other senses-should he be able to touch it, to press it and feel its resistance, knock against it and feel concussion and pain, and have a series of tactual and muscular sensations by walking into the perceived house and around it, and should he further have this purely ‘individual’ experience of all the senses each time he comes to the same spot, the perceived object would then be a real, external, physical object, and no amount of social contradiction and lack of the ear marks of community could make it less real, objective, and physical.
Epistemologically regarded, community may be sufficient for the purpose of reality; psychologically regarded, the real, existent physical object is essentially the perceived sensory object given by the ‘community’ of sensory elements. Sensory elements give the objective “reals.”
From this digression we may turn again to the question: “What is it that makes hallucinations in general and dream hallucinations in particular appear real, objective?” The solution is given in the question itself. We have shown in our analysis that hallucinations are essentially peripheral and sensory in character and do not differ in their make-up from sensation and perception in general which furnish the very foundations of our sense of reality. Hence hallucinations are real and objective, because of the constituent sensory elements.
Strictly psychologically considered, percepts do not differ from hallucinations as far as process is concerned. Normal percepts differ from hallucinations mainly by the fact that the former are the habitual, the customary, confirmed by other systems of sensory elements, and that in the struggle for life, they proved the fittest to call forth the best adapted reaction.
Dream hallucinations, like hallucinations in general, are initiated by peripheral stimulations; even the so-called “central” hallucinations are really peripheral in origin, the dream hallucinations naturally falling under the same category. The entrance of external peripheral stimulations being difficult in proportion to the depth of sleep and extent of hallucinatory dissociation, the internal sensations predominate in the functioning systems of dream life. For in sleep the activity of the internal organs, though depressed, still goes on uninterruptedly; the glands continue their function of secretion and excretion, the heart continues to contract and dilate, the blood goes on circulating through arteries and veins; the liver, the spleen, the stomach, the intestines, the lungs and other organs carry on their functions without a moment’s arrest; the whole sympathetic nervous system, the vasomotor, the spinal cord, the medulla and other basal ganglia, all, contributing to the vast mass of internal sensations, can hardly be regarded as being asleep.
All these peripheral internal sensations go to form nuclei of primary sensations around which secondary sensory elements become crystallized and organized, and give rise to hallucinatory percepts—to dreams. To these must be added the external peripheral sensations coming from touch and pressure of bed clothes, from changes in the muscles, joints, ligaments, and synovial surfaces, from changes in the superficial temperature of the extremities, from chemical changes in the olfactory and gustatory organs, from summation of minimal acoustic stimulations, and above all from changes in the visual apparatus, and especially from the masses of light in the retina and macula lutea.
With the obscuration and dissociation of the mind the internal sensations along with the external peripheral minimal sensations come to the foreground of mental life. The dreaming consciousness stands in closer relation to the bodily functions than the waking consciousness, absorbed as the latter is with the intense stimulations coming from the external environment. The intense, external, peripheral sensations of waking consciousness obscures the weaker, but more constant internal sensations, as Hobbes puts it, much “as the light of the sun obscureth the light of the stars.”
This intimate relation between internal sensations and dreams was clearly seen and pointed out by Aristotle: “For the movements which occur in the daytime (within the body) are, unless very great and violent, lost sight of in contrast with the waking movements, which are more impressive. In sleep the opposite takes place, for then even trifling movements seem considerable." Similarly Hobbes says: “and because the brain and nerves which are the necessary organs of sense, are so benumbed in sleep as not easily to be moved by the action of external objects, there can happen in sleep no imagination and therefore no dream, but what proceeds from the agitation of the inward parts of man’s body; which inward parts for the connection they have with the brain and other organs, when they be distempered, do keep the same in motion.”
Dreams sometimes reveal in phantastic and grotesque images the conditions of bodily function, conditions which the waking consciousness cannot detect, because they lie in the subconsciousness and cannot overstep the threshold of waking consciousness. It is here in the deeper regions of co-anaesthesis, that we have to look for those “prophetic” dreams which seem to foretell some future event, some future state of the organism.
An incipient irritation of the nerve endings in the teeth, an irritation not yet felt in the waking consciousness, may become the nucleus of a dream and give rise to a dramatic vision of sitting in a dentist’s chair and being operated upon, a prevision that may actually become fulfilled soon after. Incipient organic affections, not yet felt in the waking consciousness, may become the starting point of a highly dramatic prophetic dream. Dreams of such a “veridical” character often appear highly mysterious and their fulfilled prophecy seems nothing short of the miraculous and supernatural. There are many such cases on record, but the following may be regarded as typical:
A lady, a relative of mine, had a vivid vision which proved “veridical,” and seemingly could only be accounted for on supernatural grounds. One evening, on being left in a room all alone, she suddenly saw the apparitions of her deceased parents. The lady became much frightened, but the parents quieted her and told her not to be afraid as they came to bring her good tidings. “You will give birth to twins, a girl and boy, name them after us, they will be strong and healthy.” With this the apparitions vanished.
The lady became greatly agitated and, although she did not suspect to become a mother, still, being religious and a firm believer in spirits, she had implicit faith in the actual presence of her parents, who appeared to her in order to bring her glad tidings from another world, and naturally she even began to prepare clothes for the promised twins. As this happened in a remote country place the news of this vision soon circulated among all the neighbors, and expectations were aroused as to the fulfillment of the prophecy. It soon became apparent that at least a portion of the prophecy was being fulfilled. The lady soon discovered that she was going to become a mother—the sceptics were somewhat confused, still they maintained their front, but they were completely silenced, when after a few months the lady gave birth to twins and that a boy and girl. The vision then did prove to be of supernatural origin.
If, however, we analyze the vision somewhat more closely, we find that it can easily be resolved into elements which admit of a perfectly natural explanation. The vision first of all occurred during the state of repose and was really a dream hallucination. Still this does not explain the fact that the hallucination appeared in such a dramatic form which turned out to be so strikingly prophetic.
On further examination of the lady's history it was found that she lost both her parents but a few months before the occurrence of the hallucination and that this loss deeply affected her. This mental system was an important factor in shaping the course and development of the hallucination. At the same time there was another factor at work in the elaboration of the dramatically effective dream hallucination. The lady before she gave birth to the twins was already a mother of fourteen children. It is quite possible that, although in her waking state she did not suspect of being pregnant, still in her dream state, being cut off from the intense external stimulations, she could more easily realize her condition from symptoms and changes in the internal organic sensations which now alone reigned supreme, These symptoms and changes in the organic sensations during the incipient stages of pregnancy could all the more be easily appreciated by the lady as she had ample experience of them before. Some special changes in the organic sensations such as the arrest of the menses, changes in the circulation, in the metabolism of the generative organs, and other changes of similar nature served as so many peripheral stimulations which, in states of dissociation, such as occur in the light states of sleep, favored the occurrence of a dream hallucination that took the form of apparitions of the deceased parents, because of the subexcitement of this particular system, and because for the time being, the system played a dominant rôle in consciousness.
Moreover, the organic changes differed greatly from the previous experiences of similar kind, and it was therefore quite natural that the dreaming consciousness should suspect the coming of twins, a circumstance which connected itself all the more closely with the formation of the dream and was no doubt a factor in the determination of the appearance of the apparitions of the parents, which in turn, helped her further to confirm the intuition that she was to be a mother of twins. All this was represented in that vivid way characteristic of dissociated states in general.*
*Another theory, based on subconscious wishes, symbolism, and on a fancifully elaborate mechanism of condensation, displacement dramatization, and secondary elaboration, finally reduces dreams to the sexual wish, dating as far back as the sexual or “bisexual” life, as the school terms it, of early childhood and infancy. Of course, this theory is not psychological, but rather teleological and metaphysical, inasmuch as the whole of psychic life activity is reduced to wish and desire of which the sexual instinct is supposed to play the sole role.
There is the manifest content of the dream which is directly given by the dream and the latent content which underlines the dream activity. The four factors of the dream activity distort the dream so that the latent content cannot be recognized in the manifest content. This distortion is done by the “censor” who for the protection or self-defense of the person does not permit the subconscious latent content to come forward in dream.
As I shall discuss dreams more in detail in my forthcoming volume on the causation of mental diseases I limit myself here with a few remarks on the subject. The ‘psychoanalytic’ theory is unpsychological and arbitrary as it introduces a process of symbolism which by sufficient distortion and suggestion leads the whole investigation astray and puts it on the same basis with the Oneirology of ancient times and the middle ages.
Professor William James, whose introspective powers no one can call in question, in speaking to me about this theory told me that he could not find anything of this kind claimed by the theory in his own dream experience. I myself have dealt with dream experiences in my own case as well as m the case of subjects and most of my patients for about fifteen years at least and I could not find any-thing that should in the least substantiate this fanciful theory of what may be termed symbolic psychology.
There is no doubt that with sufficient distortion, twisting and suggestion one can get anything out of a dream. By a series of associations and suggestions long continued, aided by ingenious symbolic interpretation there is no difficulty in arriving at “sexual complexes,” and then fix the subject's or patient's attention on them. It is the easiest thing to do with suggestible people.
I may add that the view of “dream symbolism” is a psychological fallacy. The fallacy is the confusion of what is understood by symbolism with the associative activity of the dream consciousness.
Thus one writer tells us there is no doubt of the presence of symbolism in dreams. When we hear in our sleep the singing of birds we may dream of hearing an orchestra. Now an orchestra is not at al1 a symbol of birds. A symbol is the use of a certain definite image indicating the essence and meaning of a complicated psychic activity coming from another sphere of mental life. Even the psycho-analytic enthusiasts would hardly regard the above example as one of symbolism. Still fundamentally there is the same fallacy present in all the works on psycho-analysis and, that is, the identification and confusion of the associative image activity characteristic of the dream consciousness with the widely different mental activity of symbolization which is essentially universal and abstract, and utilizes the object or the percept as the embodiment of its highly abstract meaning.