‘I’.
Sometimes, for example, there is what is called the “I am”
symptom. The patient in trying to keep some control over his behavior repeats over and over to himself “I am,” or “I am the one present in everything,” or “I am the mind, not the body.” Another patient may use only single words like “strength” or “life” to try to anchor himself against the dissolution of his consciousness.27
The Dissolution of Mind-Space
A schizophrenic not only begins to lose his ‘I’ but also his mind-space, the pure paraphrand that we have of the world and its objects that is made to seem like a space when we introspect. To the patient it feels like losing his thoughts, or “thought deprivation,” a phrase which elicits immediate recognition from the schizophrenic. The effect of this is so bound up with the erosion 27 Carney Landis, Varieties of Psychopathological Experience (New York: Holt, Rinehart and Winston, 1964).
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of the analog ‘I’ as to be inseparable from it. Patients cannot easily think of themselves in the places that they are in and so they are unable to utilize information to prepare in advance for things that may happen to them.
One way this can be experimentally observed is in reaction-time studies. All schizophrenics of every type are much less capable than normally conscious people when they attempt to respond to stimuli presented to them at intervals of varying lengths. The schizophrenic, lacking an intact analog ‘I’ and a mind-space in which to picture himself doing something, is unable to “get ready” to respond, and, once responding, is unable to vary the response as the task demands.28 A patient who has been sorting blocks on the basis of form may be unable to shift to sorting them for color when instructed to sort in a different way.
Similarly, the loss of the analog ‘I’ and its mind-space results in the loss of as-if behaviors. Because he cannot imagine in the usual conscious way, he cannot play-act, or engage in make-believe actions, or speak of make-believe events. He cannot, for example, pretend to drink water out of a glass if there is no water in it. Or asked what he would do if he were the doctor, he might reply that he is not a doctor. Or if an unmarried patient is asked what he would do if he were married, he might answer that he is not married. And hence his difficulty with the as-if behavior of hypnosis, as I mentioned at the end of the previous chapter.
Another way the dissolving of mind-space shows itself is in the disorientation in respect to time so common in the schizophrenic.
We can only be conscious of time as we can arrange it into a spatial succession, and the diminishing of mind-space in schizophrenia makes this difficult or impossible. For example, patients may complain that “time has stopped,” or that everything seems to be “slowed down” or “suspended,” or more simply that they 28 This is an interpretation of a widely held theory of David Shakow, “Segrnental Set,” Archives of General Psychiatry, 1962, 6: 1-17.
422 Vestiges of the Bicameral Mind in the Modern World have “trouble with time.” As one former patient remembered it after he was welclass="underline"
For a long time no days seemed to me like a day and no night seemed like a night. But this in particular has no shape in my memory. I used to tell time by my meals, but as I believed we were served sets of meals in each real day — about half a dozen sets of breakfast, lunch, tea, and dinner in each twelve hours —
this was not much help.28
On the face of it, this may seem inconsistent with the hypothesis that schizophrenia is a partial relapse to the bicameral mind.
For bicameral man certainly knew the hours of the day and the seasons of the year. But this knowing was, I suggest, a very different knowing from the narratization in a spatially successive time which we who are conscious are constantly doing. Bicameral man had behavioral knowing, responding to the cues for rising and sleeping, for planting and harvesting, cues so important that they were worshiped, as at Stonehenge, and were probably hallucinogenic in themselves. For someone coming from a culture where attention to such cues has been superseded by a different sense of time, the loss of that spatial successiveness leaves the patient in a relatively timeless world. It is interesting in this connection that when it is suggested to normal hypnotic subjects that time does not exist, a schizophrenic form reaction results.30
The Failure of Narratization
With the erosion of the analog and its mind-space, narratization becomes impossible. It is as if all that was narratized in the normal state shatters into associations subordinated to some gen-29 M. Harrison, Spinners Lake (London: Lane, 1941), p. 32.
30 Bernard S. Aaronson, “Hypnosis, responsibility, and the boundaries of self,”
American Journal of Clinical Hypnosisy 1967, 9: 229-246.
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eral thing perhaps, but unrelated to any unifying conceptive purpose or goal, as occurs in normal narratization. Logical reasons cannot be given for behaviors, and verbal answers to questions do not originate in any interior mind-space, but in simple associations or in the external circumstances of a conversation. The whole idea that a person can explain himself, something which in the bicameral era was distinctly the function of gods, can no longer occur.
With the loss of the analog ‘I’, its mind-space, and the ability to narratize, behavior is either responding to hallucinated directions, or continues on by habit. The remnant of the self feels like a commanded automaton, as if someone else were moving the body about. Even without hallucinated orders, a patient may have the feeling of being commanded in ways in which he must obey. He may shake hands normally with a visitor, but, asked about this, reply, “I don’t do it, the hand proffers itself.” Or a patient may feel that somebody else is moving his tongue in speech, particularly as in coprolalia, when scatalogical or obscene words are substituted for others. Even in early stages of schizophrenia, the patient feels memories, music, or emotions, either pleasant or unpleasant, which seem to be forced upon him from some alien source, and, therefore, over which ‘he‘ has no control.
This symptom is extremely common and diagnostic. And these alien influences often then develop into the full-blown hallucinations I have discussed earlier.
According to Bleuler, “conscious feelings rarely accompany the automatisms which are psychic manifestations split off from the personality. The patients can dance and laugh without feeling happy; can commit murder without hating; do away with themselves without being disappointed with life . . . the patients realize that they are not their own masters.”31
Many patients simply allow such automatisms to take place.
Others, still able to narratize marginally, invent protective de-31 Bleuler, p. 204.
424 Vestiges of the Bicameral Mind in the Modern World vices against such foreign control of their actions. Negativism itself, even, I think, in neurotics, is such. One of Bleuler’s patients, for example, who was inwardly driven to sing, managed to get hold of a small block of wood which he would cram into his mouth in order to stop his mouth from singing. At present we do not know whether such automatisms and inner commands are always the result of articulate voices directing the patient in his actions, as a relapse to the bicameral mind would suggest. It may indeed be impossible to know, since the split-off fragment of the personality that is still responding to the physician may have suppressed the bicameral commands which are being ‘heard’ by other parts of the nervous system.