Study on the Impact of FOCUS-PDCA Management Model on the Disinfection Qualit...
Metaphrenia part 2
1. 10. THE ONSET OF PSYCHOSIS
As with depressive, post-traumatic stress and bipolar disorders, psychosis too involves a
failure of the dreaming function to cope with whatever may be the specific burden – of nature,
nurture and circumstance – which may overtax it and trigger a psychotic break.
In depression, the dream generator is under-active and inadequate; in post-traumatic stress
disorder it is over-active, distressed and agitated; in psychosis it is both: perpetually switched
on – even in waking hours – yet unable effectively to complete its nightly psychic house-
cleaning.
The actual lived subjective experience of psychosis feels very much like that of dreaming
whilst awake. As if in a dream, rebellious and the reach of voluntary control. This is the
psychoanalyst’s “irruption of unconscious content into consciousness.” It is quite natural to
look to the biological basis of sleep, and dreaming in particular, when probing the nature and
causation of psychosis.
Underlying the psychotic condition, like the quake-prone and volcanic seabed the oceans, is
a perturbation of the whole wake/sleep/dream cycle and its various stages, and eventually our
dream generator takes over even in waking consciousness. Typically our first warning of the
onset of psychosis – whether reactive, bipolar or schizophrenic – is the increasingly delayed
nightly onset of sleep, and/or the early-morning waking that daily puts a premature end to our
dreaming cycle at its most critical stage of resolution. Sleep deprivation suppresses the REM-
dreaming stage of hippocampal stem cell neurogenesis, already genetically compromised in the
schizophrenic’s brain, essential for efficacious memory processing. Following its loss of sleep,
the schizophrenic brain is denied the usual relief of rebound REM sleep. In addition, the dreams
of the ‘stabilized’ unmedicated schizophrenic are puny and ordinary and ineffectual in
comparison with those of ‘normal’ college students.
These are not so much unrelated symptoms as glimpses of the underlying cause at work.
Something has gone awry with our sleep cycle at its very root, and for those of us endowed with
a genetically susceptible dream generator, until it is reversed with post-synaptic dopamine-
blocking medicine it will continue progressively to deteriorate until we are living a constant
waking-dream. At which stage, the ‘waking’ anatomical state of the schizophrenic brain shows
a neural activation pattern remarkably similar to that of the ‘normal’ brain’s REM-dreaming
state. “Psychosis as waking dream” happens to be harsh corpuscular fMRI- and PET scan-
evidenced fact, not just some quaint poetical metaphor…
(An objection arises here, an apparent contradiction. If psychosis truly is a waking dream
state – indeed, the anatomical equivalent of the normal REM state, how can it possibly be
hypothesised that psychosis is caused by a dreaming deficiency? Surely it is rather a case of
excessive dreaming? He or she surely needs a shot of adrenaline to wake them up rather than
even more sleep? A good kick in the pants, no less, to brighten up their ideas?
This objection addresses the very nub of the problem: it’s not so much a case of needing
more sleep but better quality sleep. To revisit Philip Adams’ insightful metaphor, it‘s rather like
2. someone whose bowel for some reason is battered and incompetent: the otherwise nourishing
aliment passes through it largely undigested, unprocessed and unabsorbed. You can actually see
bits of raw food in those loose and unformed pastel-coloured foul-smelling faeces.
The normal bowel hosts a wide variety of metabolic activities. Inter multa alia, a healthy
bowel is an integral component in the body’s systemic biochemical factory – in vitamin B and
serotonin production. By taking measures we can vastly improve the situation: masticating our
food more thoroughly thus saturating it with salivary amylase at the same time making it easier
for the gastric enzymes to do their work; avoiding gluten and other irritants in our diet if that is a
factor; a seven day water fast or two; drastically reducing our drug intake, medicinal and
recreational; cleaning up our gut biota with antibiotics and then benign flora supplements, with
its totally unexpected ameliorating spin-off on our allergies; exercising our body with yoga,
weight-lifting and jogging, and other athletic activities; increasing the proportion of roughage in
our diet – long & slow-cooked beans, whole-grains & vegetables; and so on. And if we are
very lucky – Voila! With problems like these, just taking in more food is only going to make
them worse.
Although some of the parallels may immediately be apparent, the precisely corresponding
analogues in the developmental dreaming process are at this stage largely unknown, like life-
forms on other planets, awaiting discovery. Already it is known they probably involve
genetic, developmental and abuse-induced brain variations including deficiencies in memory
processing by hippocampal adult stem cell neurogenesis, and the hallucinatory aberrations
elicited by hair-trigger basal forebrain nuclei.)
These sleep loss effects are interactive, reciprocal and cumulative. If a disturbance of the
dream generator doesn’t initiate the early wakings, those early wakings and other sleep
deprivations will most surely play havoc with the whole wake/sleep/dream cycle, and so
ultimately with a genetically delicate dream generator. And so it goes…
This can happen spontaneously. Or be brought on by overwork or chronic anxiety or burning
the candle at both ends and from its middle. Attend the meetings of Alcoholics Anonymous or
Narcotics Anonymous and quite soon it becomes obvious from the shared testimonies that an
early casualty of any neurochemical addiction is sleep loss and its inevitably disturbed sleep
cycle.
We underestimate the aetiological role of sleep loss in serious disease precisely because we
undervalue sleep as being when everything is switched ‘off’, rather than when essential
alternative cognitive modalities are switched ‘on’. For many, “Sleep is like a temporary death”
rather than our nightly resurrection. (Robert Zimmerman) We have come so to hallow our
waking rational conscious state and its civilised and interstellar achievements that Chuang Tzu’s
koan seems merely witty sophistry rather than the cognitive scientist’s point of embarkation:
“Last night I dreamed I was a butterfly. Or am I now a butterfly dreaming I am a man?”
Our consciousness does not cut out when we fall asleep nor come online again with waking.
It simply changes gear. Asleep or awake, the human brain is forever actively processing
information and solving its problems. Even in reverie and daydreaming, the frontal cortex is
3. highly activated as it plays around with various options.
Whatever its cause, sleep deprivation will generally be the first recognisable step of a descent
into psychosis. Not just a symptom, but an early step along the way for those of us with a
susceptible dream generator; indeed, in many if not most cases, the initiating and precipitating
cause of the whole psychotic process, the underlying cause at work…
Of course, schizophrenia involves global brain-wide neural deficits and impoverishment,
evident when construing the emotional intent behind facial expressions and tones of voice,
paraphrasing proverbial wisdom, interpreting the revolving ‘hollow mask’ illusion and so forth.
Whereas psychotic activity itself is not so much a whole-brain condition as it is a more localised
condition confined to the dream generator (scilicet its basal forebrain nuclei in particular) which
can strike almost any brain given sufficient stress and sleep deprivation.
Deprive pretty well anyone of sufficient sleep, and they will go crazy. Eventually they’ll
die. The annals of our race are replete with many such anecdotes. Guantanamo Bay was based
in no small way upon this inflexible law. During a controlled experiment in 1959, seven healthy
medical students who kept awake for 72 hours – just three days – developed a variety of ego
disturbances including feelings of depersonalisation, confusion, hallucinations, paresthesias,
motor incoordination and various subtle psychological changes. That none developed florid
psychosis was attributed largely to their benign, socially supported surroundings at the time –
the experiment was conducted in the safety of a fully staffed hospital ward.
Nor is the psychotic experience always bad news. It can be a neurological odyssey of growth
and development, a psychological perestroika that taps into previously inaccessible wellsprings
of creativity. Witness for example the radical difference in the paintings executed by
internationally renown Scottish-Australian artist Ian Fairweather after his lone eighteen day-and-
night voyage, 900 kilometres as the tern flies, across Timor Sea from Darwin to the
Indonesian island of Roti in 1952 at the age of 61; adrift on his crude makeshift raft, during
which he experienced a full-blown but fortunately brief psychotic episode punctuated with
bizarre delusions and phantasmagoric hallucinations. A cursory glance at an atlas reveals that he
made landfall at all, and was not swept out past that final insular outpost into the vast Indian
Ocean to shrivel and die and feed sharks, was in itself seemingly miraculous. “Those whom the
Gods love, they send crazy.” (John Steinbeck)
From which “act of symbolic suicide” (Christopher Allen) he emerged ultimately to settle
on a Bribie Island beach, accomplishing in his bark hut innovative paintings characterised by a
startling degree of imaginative symbolism and unfathomable abstraction until his death in 1974.
Noticeably absent from his post-crisis work are the subtle sensuality and haunting beauty of his
earlier art.
But psychosis can be a harsh mistress: if you haven’t got what it takes, it can take what
you’ve got. “He who has not, even what he has will be taken.” (Jesus of Nazareth)
4. 11._ THE WAKING DREAM STATE OF PSYCHOSIS
Unlike many paranoid psychotics, rather than religious, my delusions appeared to me strictly
political in character. I felt that novels like Brave New World and 1984 hinted at the ‘real’
story. All history was a created phantasy. Shakespeare – all published writers – were either
fictions created by Big Brother and the politicians, or an integral part of ‘the plot’. I was the
reincarnation of Ned Kelly, and Prime Minister Malcolm Fraser was my chief adversary. Our
main issues concerned aboriginal land rights and uranium mining. The all-consuming
responsibilities of these onerous tasks exhausted me daily.
Delusions about my parents surfaced mainly as members of the medical profession. My
father was a tragic hero. During the war, he was an army pathologist who inter alia treated the
afflicted soldiers. The world was one big brothel, so he was pretty damn busy. Our street was
home to many retired prostitutes, whom it was my mother’s job to nurse. Reproduction was
different from what was commonly thought – women were impregnated by powerful men, and
their husbands were the ‘patsies’ who, for suitable favours and appropriate compensation,
looked after the wife and her offspring.
My father had been an outcast in his profession, and the death-dealing melanoma on his nose
was caused not by the sun, but by radioactive nose-pads installed on his spectacles by his
colleagues, enraged at his unimpeachable integrity. It was beyond belief that I was son & heir to
the noble Dr Jakananda. My biological father was his younger brother, my much-loved Unca
Bill.
Distant wars and international events did not really happen, but were a vast sideshow
improvised by the powers-that-be to divert & enthral & control the multitudes. Photographic
evidence of the Holocaust was not real, but an artefact of some ministry of propaganda. World
War Two did not really happen; no one died in battle. Only from venereal disease.
Chance coincidences seemed particularly real and meaningful because statistically the
mathematics were so against them happening. I was acutely conscious of the unelected kingship
of me, the underdog. Eventually my wake/sleep cycle reversed so that I was awake all night and
asleep all day. There was a video camera concealed in my bedroom’s ceiling relaying my every
move to Command Central, and wherever that was, it was everyone, apparently. My life was a
public document. Nothing was private: The Truman Show as a matter of daily reality. That’s
exactly how paranoid psychosis appears to the subject.
On a small portable typewriter, a sturdy little German Adler Tippa, I regularly found
temporary relief committing acts of rhyming doggerel to paper, of which the following is a
representative sample:
PEACE! (Circa 1977)
For thirty odd years
We’ve had pax pepsicola
Succeeding the tears
5. Of pax toga and bowler
Bringing nuclear fears
And unfreezing packs polar.
My life overflowed with meaning. Everything had its own special significance. Just for me.
Especially words and songs and music. A signpost reading “Napperby 6 Kilometres” became an
ominous “Six kill, or meet her.“ (If I do not meet her train, somewhere six people will die as a
result.) In its 364 words, Samuel Taylor Coleridge’s opium dream-transcribed Kubla Khan
conjured up an erotically charged alternative universe.
As my condition deteriorated, I developed a strong anger toward my longsuffering mother,
who I felt was intentionally frustrating my ‘development’. Weeks before my inevitable total
collapse, precipitated finally and suddenly by the abject terror a dose of non-specific urethritis
gave rise to, I insisted that my mother leave the family home. She did.
Subsequent to my eventual hospitalisation, and an atypical feverish reaction to chlorpro-
mazine in my testicles due to the NSU, I thought that the antibiotic a GP had injected was really
radioactive testosterone, designed to produce testicular cancer. Like father, like son. Death.
This nightmare mostly cleared up within a few months of commencing chemotherapy,
although thioridazine made me feel dreamy, and I thought it might be marihuana. Till the daily
panic attacks started again, that is, successfully distracting me from that surely waning fantasy
world.
There were, of course, the more usual delusions such as coded messages just for me from
radio, television and newspapers; people reading my thoughts, and hypnotising me; infantilism
and megalo-mania. And violent mood fluctuations, which had raised a possible diagnosis of
manic-depressive psychosis. But fortunately, no voices or hallucinations. Morbid fears that I
had been infected with syphilis, and of a slow lingering death from general paralysis of the
insane, continued to haunt me for several years.
This conflated 1975/1977 episode was the penultimate in a series of five psychotic reactions
in a paranoid direction between 1969 and 1990. Like any cognitive-emotional process, the
psychotic journey is driven by its own internal logic with a life of its own. As a spontaneous
product of the unconscious via the dream generator, the psychotic odyssey is as amenable to
analytical interpretation as any daydream, fantasy or big dream. Whilst such an enterprise is
beyond the scope of this monograph, the work of Dr John Weir Perry maps out how one may go
about navigating that bedevilled archipelago under one‘s own canvas.
6. 12. RECOVERY
“Before the medication,” as my Uncle Bill bluntly reported, “people either stayed mad, got
better, or killed themselves.” The first antipsychotic drug was discovered in 1952 in Vietnam by
a French doctor trialing the synthetic dye chlorpromazine as a treatment for hay-fever. He noted
its tranquillising effect, and five years later Largactil began changing lives and clearing out
mental hospitals and saving governments billions of dollars. Basically, a major tranquilliser
takes the edge off and resets an uber-active dream generator.
The remedy for psychosis is the maximal normalisation of the wake/sleep/dream cycle. This
translates into titrating the optimal dosage of the appropriate dopamine blocker, together with a
determined cultivation of an active, vigorous and energetic waking conscious life. The
normalising of the dream function that accompanies chemotherapy’s recovery is usually seen as
a symptom of stability, a result of recovery rather than an underlying cause. It is both.
Antipsychotic medicine works by blockading the psychotic dream generator’s excessive
dopaminergic activity, thus ending the waking dream phenomenon, at the same time as it
restores acetylcholine activity and thus full-potency REM-sleep. There is a reciprocal
relationship between these two neurotransmitters: “Dopamine normally suppresses acetylcholine
activity.” (Associate Professor Stephen Stahl) The schizophrenic brain’s excessive
dopaminergy dampens its cholinergic activity, thus dampening REM-stage sleep’s dreaming
activity. Neuroleptic medicine removes this brake.
In the former circuits, the medicine acts as a chemical straitjacket on the dopaminergic dream
generator but unlike leucotomy, achieves this in a measured reversible fashion, controllable by
dosage, without at the same time destroying entirely and irreversibly the dreaming function. In
the latter circuits it brings on the lengthy sleeping often associated in the early stages with these
medicines. The former effect is the central therapeutic agent of recovery, the latter a side effect
which can be both help and hindrance in recovery.
For therapeutic REM-dreaming sleep to occur requires, like micturition, defecation or
orgasm, a subtle balance of normally antagonistic neurotransmitter activity. In general, too
much aminergic activity precludes the onset of REM-sleep dreaming. An overstimulated dream
generator suppresses sleep, REM-stage sleep in particular. An under-stimulated generator
cannot muster sufficient dopaminergic intensity to stage normal developmental REM-dreaming.
Too much dopamine-blocking medicine may inhibit the fullest expansion of the dream generator,
risking an adynamia almost as severe as leucotomy’s, though not as permanent; not enough can
lead to relapse.
In the research literature, the effects of antipsychotic medicine on REM sleep are as yet
sketchy and inconclusive. Evidence suggests that in healthy volunteers, these effects vary with
the subject’s capacity for rebound REM sleep, and are dosage-dependent. Subjects with the
smallest REM sleep rebound following REM sleep deprivation experienced a reduction of REM
sleep after antipsychotic medicine administration, while those with longest rebound REM spans
experienced an increase. (The reader may recall that schizophrenics have not only shorter, but
no rebound REM.) Again in healthy volunteers, a lower dosage of the medicine increased REM
7. sleep, whereas a higher dosage decreased REM sleep.
These cryptic results suggest tentatively that for the schizophrenic brain, the lower the
effective medicinal dosage, the better for REM sleep and thus for REM-dreaming. Fortuitously,
for lasting compliance, this also coincides with the compelling need to minimise the medicine’s
often drastic side effects.
It is crucial we get the dosage right: so often, the only difference between a tonic and a toxin
is purely a matter of dose. Some toxins – lead, mercury, asbestos or tobacco – the only safe
dosage is zero. The fullest benefits of neuroleptic medication are locked into just the right
amount of it, and everything else. “All things in moderation.” (Audine Adelaide Andrews)
The subsequent research and development of a later ‘generation’ of improved antipsychotic
medicines regulating serotonin activity as well as dopamine’s may well reflect the schizophrenic
brain’s recusant tendency to involve non-REM sleep stages in its elucidation of developmental
dreams, as well as the more normal REM stage. In NREM sleep, some level of serotonergic
activity still continues to subsist, which ex hypothesi also requires medicinal modulation if our
dreaming is to be restored as much as possible to full vitality.
13. PRACTICALITIES
The trajectory of our recovery will largely be determined by, and either be limited or
liberated by our attitude. In my final high school year, our English teacher commenced with the
disconcerting announcement that he wasn’t going to teach us to get a good examination mark,
but rather to enjoy our reading and to think intuitively about it. If we did that, he assured us,
the good mark may well follow. But that wasn’t the point of the exercise. Mark ‘Roo’ Ricciuto
‘s coach once commented that the former Adelaide Crows star’s crucial talent was the way he
coped with injury. Setbacks are inevitable. They are part of life for everyone. It’s not our
neurophysiological peculiarity that defines us, so much as how we respond to it. It has been
found that “spontaneous remitters from cancer almost invariably say they weren’t shooting so
much for a cure, but rather to live congruently at last with their inner values“. It helps if we see
our own setback as no different from Barack Obama’s African skin colour in a racist world, or
Helen Keller’s blindness in a seeing world. The same program applies to everyone: “When
you’re going through Hell, keep going.” (Winston Spencer Churchill)
We may be assured of the broad compass of our recovery when regularly we go to bed each
evening, not too early, not too late, and fall soon fast asleep pleasantly wearied from our
eventful day, waking not less than six hours thereafter. Ideally, between seven and eight hours.
Whether we choose then to wander along quiet suburban tree-lined avenues, or go walkabout
through parklands and along deserted bush fire tracks, or explore the main roads and fly-overs
of a buzzing global metropolis depends entirely upon our own predilections. But our overriding
concern must be to maintain this hard-won and ever vulnerable circadian rhythm: to keep the
night shift obliviously busy at its indispensable duties.
Maybe some people can live fast and loose, ignoring the insistent demands of their body
8. clock. Not us. Judy Garland, Howard Hughes, Marilyn Monroe, Elvis Presley, Heath
Ledger, Michael Jackson and countless others have perished in a sad and futile quest for what
we now have. It is a precious gift we cannot afford to take for granted. Our freedom, our sanity,
even our very life depend upon it. We learn to paraphrase the words of Nicholas Copernicus: If
we face facts with both eyes open, finally we will place sleep at the centre of our psychic
universe.
There are various practical measures we can take, both to establish this auspicious rhythm,
and to maintain it into the future. First and foremost, we take our antipsychotic medicine.
Religiously. Every night at the same time. Without exception. A medicine like haloperidol does
have a long half-life, but depends for its efficacy on nightly topping up. Over the months and
years and decades, assiduously we work away at finding our own effective minimum
maintenance dosage, which can change with our years and their habits. For haloperidol, the
generally recommended minimum maintenance dosage seems to be 2 mg nocte. (For me
personally, less than 3 mg and symptoms begin to re-emerge; a dose of 5 mg or more and the
imploding excitation/panic attacks return as surely as the monsoon rains in June.) We should be
no more self-conscious or ashamed of this dependence than any kidney patient who needs their
regular dialysis.
Next, physical exercise. People on antipsychotic medicine tend to put on weight. And it can
contribute to the onset of type 2 diabetes. Cogent reasons in themselves to make exercise a
necessary part of our day. But these aside, there is nothing like tiring out Brother Ass with
plenty of exercise to ensure he then seeks plenty of sleep. We inherit our bodies from organisms
who evolved by running to catch the food which then grew their brains. Not sitting around all
day and night at a computer keyboard, or reading books, or watching telly. If at the same time
we learn new motor skills, or simply follow a different route for our geoneurographical morning
foray, giving thereby our dreaming memory circuits the satisfying connatural work they thrive
and grow on, we quadruple the benefit.
Giving our mind regular memory work does have a flow-on stimulatory REM-dreaming
effect. Our REM-dreaming sleep tends to expand, both quantitatively and qualitatively, to
embrace the increased demands of our memory and learning work. Acquiring a second
language, learning the periodic table, to touch type or to play a musical instrument – the range
of possibilities is limited only by our imagination, our curiosity and our willingness.
The simple daily and costless exercise of memorising key paragraphs from our favourite
books is immensely enriching and rewarding, in so many ways. Of necessity this elementary
exercise engages not only our conscious mental processes in a most intricate fashion, but also
our REM dreaming circuits as the night shift then integrates our work. As our dreaming brain
makes these different and novel connections, and we subsequently refresh our memory, we
come to appreciate previously hidden and unseen depths in our most cherished texts. Like our
uncles and grandfathers, we become a living book, an anthology of textual prime cuts with two
legs and a heart beat, and discover for ourselves that “Memory is the treasure house of the
mind.” (Buckminster Fuller) “A good memory is surely a compost heap that converts
experience to wisdom, creativity, or dottiness…” (Michael Leunig) Our sleep can play a vital
part in this organic process, but like damsel fair, it often needs attentive wooing.
9. It is perhaps in our relationship sphere that our daytime work shows up most in our dreams.
We discover fresh angles and new dimensions that fill out, recast and renew the way we view
and relate to our loved ones. And even, God bless ’em, to our enemies.
As our schizophrenic brain gears up to live a more intense and complete life, the nocturnal
dreaming component of its equipment also gears up a notch or three. We discover a new world,
initiate new dimensions of consciousness. All we have to do is “Keep busy!” as a local
octogenarian GP keeps telling me. Just how we achieve that end really doesn’t matter. That is a
matter for our legitimate passions and ambitions. According to our own conscience and its
values.
We shouldn’t be too surprised to discover that the dream generator responds developmentally
to our critical needs of the moment, and equally to our passage through broader life transitions.
Nor that it is embedded in the rhythmic world of Nature, tied to the phases of the Moon, to the
four Seasons, to Equinox and Solstice. (They don’t call us “lunatics” for nothing.)
Apart from a very occasional one-off emergency benzodiazepine, the only drugs we need to
experiment with are valerian capsules for episodic insomnia and maybe now and then a sporadic
tablet of homeopathic melatonin 6x just before bedtime, to ginger things up a wee bit. The
neurogenerative and educational benefits of cannabis are dangerously outweighed by its longer-
term and typically disturbing effect on our thinking, our mood, and above all on our sleep cycle.
We think before we drink. We take respectful care of a brain that doesn’t need such drugs, at the
same time ever mindful that “A little bit of what you fancy does you good; and half as much as
you get older.” (Phyllis Irene Tehan) Unless of course we are an alcoholic or an addict, when
usually our only remedy is total abstinence consequent normally upon “an entire psychic
change.” (William D. Silkworth, M.D.)
Psychologists generally recommend the practice of ‘sleep hygiene’ for people with a sleep
problem: our bed is reserved for nighttime sleeping only. No cola or coffee, or any caffeine,
after 6 pm. Some say a brief burst of vigorous exercise or a hot bath ninety minutes before lights
out helps to ensure our body’s temperature is dipping appropriate to induce sleep by that time.
Others say to wind down and relax...
14. HOOPTEDOODLE: AN EVOLUTIONARY DANGLER?
These days dreams seem to play a much less important role than for our evolutionary
ancestors. We have our science, technology and industry to solve our survival problems – and
create even more. We have our organised religions to give us our ready-made myths to live by,
pre-digested by the Rishis, Moses, The Buddha, Confucius and Lao Tse, Christ, and
Mohammed, and by our local preacher’s weeklysermon. We have Johann Gutenberg’s
marvellous invention, and the Holly/Bollywood dream factories, to educate and entertain us.
Thanks to William Gates, anyone can now publish and disseminate their work, like this,
straight from their own desk. We have turned our nights into day with electricity, making eight
hours’ sleep an optional choice rather than our ordinary course, obscuring with street-lighting in
our ever-encroaching cities the nightly empire of the stars.
10. Indeed, it could well be argued that our dreamlife has outlived its evolutionary role, of
relevance only when it malfunctions in depression and post-traumatic stress disorder and
psychosis and so on: that our dreams, like our appendix and our wisdom teeth, are mere
evolutionary danglers. But for vast aeons of our history, when our brains were being evolved, it
was not like this.
There are those too who say our complicated cultivated minds are a beautiful exotic mate-
attracting efflorescence, but an incident on a sub-antarctic rock in 1875 suggests that our
primordial ancestors developed our complicated neural networks for more prosaic, more heroic
reasons: the grim ingenious task of eking out a basic diet in an uncertain, often bleak and hostile
environment. Hundreds of thousands of years before homo sapiens applied their brain’s
imagination circuits to creating religious art in the caves of Lascaux or their sculpted ikon of the
Goddess of Willendorf in Europe’s lush green valleys, these neural circuits were being sculpted
as he and she struggled ingeniously to eke out an existence on the oft drought-blasted African
savanna.
The good ship Strathmore set sail from London on April 17 1875, bound for New Zealand,
bearing 88 passengers and crew. At 4.30 am on June 13th, the ship struck and was wedged
between two rocks outlying the Crozet Islands group, in sub-antarctic waters almost 2,000
kilometres South South-East of the Cape of Good Hope. Forty nine survivors made it in two
boats to a nearby ‘island’ - a large high extensive inhospitable and barren rock, half a mile long,
bearing but little soil, growing only sparse grass and weeds, affording absolutely no firewood
for warmth and cooking, inhabited only be various seabirds. Among the survivors were 49 year-
old widow Fanny Wordsworth, and her son Charles.
For the next seven months, life for these people was a daily struggle for bare survival as they
eked out a basic diet of grasses, and birds and their eggs, and strove to cook and make edible
their simple hard-won fare. They were living an experiment of nature, living the very same life
their primordial ancestors had lived, daily facing many of those same basic survival threats,
with but a few basic implements to assist them, one box of safety matches and some wood, and
only their nightly dreams to sustain them, apart from a copy of the Bible and a set of
Rosary beads. Diarrhea and dysentery were their constant companion. Indeed, their waking
lives were nasty and brutish and – without the hoped-for rescue – likely to be short indeed.
They must have been made of stern stuff. The way survivor-descendant Sophie Haisman tells
the story from extant records, mainly the writings of her Wordsworth forebears, there were two
crucial turning points. Each day, according to the annual migration cycle, albatross and
stinkpots, then molly mawks and finally penguins were clubbed, skinned and cooked as their
main diet. When they ran out of firewood from the ship to cook them, by a happy experiment
they
discovered the fatty bird skins made good fuel. Good enough for cooking and a little warmth,
leastaways. And bird wing fat was good for light at night, too. When the supply of albatross
ran out, and things looked grim, one morning Charlie Wordsworth discovered the molly mawks
were laying enough eggs in their nests to feed them. Whether these life-saving inventions were
prefigured in dreams is an unknown detail.
11. What is known is that in an almost total absence, apart from fond nostalgic memories, of
their former nurturing domestic culture, their nightly dream life took up the slack and filled the
gap, softening their otherwise unrelenting hardship. Their sojourn began in mid-winter, with
icy nights fifteen hours long at that latitude. In the absence of alternative entertainment, there
was plenty of opportunity to dream. And dream they did.
Ably their dreams took over the former place of art and literature, church, newspapers,
music hall and theatre, guild meeting and their other wonted sources of entertainment,
education and edification. Deprived of these resources, simply for lack of anything else, their
dreams came to serve as their de facto culture, along with their food-gathering, cooking
etcetera. It is easy now to see how dreaming became so central to the community life of the
nomadic hunter-gathering Australian Aborigine.
It is fitting tribute to their psychological health and pioneering hardiness that their reported
dreams at least were clearly a successful compensatory mechanism which balanced the gruelling
circumstances of their waking lives, so that they faced their days mentally fresh and in a good
frame of mind for the day’s struggle.
Early in Charlie’s daily schedule was a visit to the other shanties “and getting the latest news
such as a new yarn or a dream. Any interesting ones were retold to my mother.” (Charles
Wordsworth) “We all had the most vivid dreams of home or things to eat or ships come to rescue
us. When we awoke in the night we invariably asked each other what we dreamt.” (Fanny
Wordsworth) “Our dreams were generally of food in some shape, but there was always a feeling
in the background that spoiled these dream feasts.” “Having dreams was quite like a letter by
post, for they took our minds off the island enabling us to forget our miserable circumstances for
a time. Dreaming was by far the pleasantest part of our existence on that miserable island.”
(Charles Wordsworth)
15. ‘THE DELUSIONAL CONFABULATOR’
Much of our ‘normal’ everyday thinking and interior conversation doesn’t stand up to the
scrutiny of an objective observer. Our workaday minds are not the infallible soothsayers we take
them to be. So often, we all confuse the eclectic whimsy of our personal culture-driven
preferences for moral absolutes. It’s the human condition. To the traditional Christian, the
fundamentalist atheistic scientist is delusional, and to the atheistic scientist fundamentalist
Christianity is a pernicious sub-species of wilfully blind fanaticism. The personalist bhakti is at
odds with the impersonalist jnani, and vice versa. The mind-set of a Liberal party voter and a
Labour party voter are mutually alien, both agreeing however that any minor party is their
common enemy. “Two men say they’re Jesus – one of them must be wrong.“ (Mark Knopfler)
And so it goes…
From someone else’s antagonistic viewpoint, each and every one of us is irredeemably
wacko. Who’s to say who – if anyone – is ultimately right? There are those armed with a
coercive power to enforce their viewpoint, but that doesn’t necessarily make them right. Or
wrong, for that matter. “It tain’t necessarily so...” (George Gershwin)
12. If our neighbour – in Lord Atkins’ usage of that word – happens to be obtrusively ‘different’
in some way – say muslim, or mentally ill, or gay, depending upon the peculiar bent or latest
fashion of our endogenous xenophobia – we are even more likely to jump even more quickly to
our erroneous conclusions. Once our brain has affixed to someone or some viewpoint its
preferential status diagnosis, whether laudatory or denigratory, it tends thereafter intransigently
to constellate all subsequent data about that person or viewpoint so as only to confirm its initial
all-or-nothing one-dimensional kafkaesque textbook caricature, rather than a more complex and
fluid balancing model appropriate to the usually confusingly ambiguous reality. We misinterpret
all they say and do… Life becomes a conversation in an old Ealing Studios’ farce where two
people converse completely at odds, from different planetary systems, whatever either
innocently may say only amplifying the other’s direst fears.
Research with split-brain folk suggests that much of our self-talk is generated by what might
more appropriately be called ‘the delusional confabulator.’ When the left split-brain hemisphere
is isolated and asked the reason for an assessment the right brain made, which may well be an
appropriate one, it comes up with something it may find plausible and even invincible, but
which to an informed observer is clearly spurious.
To a reassuring extent, this is largely an artefact of the split-brain condition: the brain’s
bicamerality is severed when a cut is made through its corpus callosum in an operation to relieve
epilepsy. And with it go the copious connections between the two cerebral hemispheres and their
contrasting, complementary capacities.
Which defect is largely irrelevant to an intact brain. But not entirely irrelevant. More recent
research on otherwise normal people suggests that their brain arrives at its subterranean choices
and emotional opinions, and then milliseconds later, quite unwittingly it fabricates their
unassailable rationalisations justifying these otherwise inscrutable behaviours. This is Blaise
Pascal’s mind which wots not of the heart’s true reasons, Freud & Jung‘s distant but immanent
unconscious.
Clearly, there is more going on here than meets the eye. As the birds are not conscious of the
air that supports them in their flight. Nor fish of the water in which they live and move and have
their being. For lack of a closer, more explicit knowledge, homo sapiens often falls back on
stock shorthand terms like ‘Soul’ & ‘Spirit,’ ‘Being,’ ’Self,’ ‘psi phenomena‘ & ‘the collective
unconscious,’ ‘Tao,’ ‘Brahman’ & ‘Atman,’ ’Suchness’ & ‘Buddha nature’ and so forth…
As yet our scientific method cannot even be sure of the extent to which REM sleep is
necessary for memory consolidation. Or elucidate as yet the underlying mechanisms whereby
this might be accomplished. There are enough unanswered questions here to keep researchers
busy for the next five hundred years, and still no guaranteed agreement on anything basic.
About as promising as dissecting out a collection of Basho’s haiku with a microtome.
Like Charles Darwin, “I see no good reason why the views given in this volume should
shock the religious feelings of anyone,” be those sensibilities devoutly agnostic or traditionally
Christian. Like the composer of Origin’s concluding thirteenth canto, I take for granted a
“Creator” behind it all. This brief excursion is quite consistent with the words of Pope Pius XII:
13. “If the human body takes its origin from pre-existing living matter, the spiritual soul is
immediately created by God.”
What this inquiry daffynitely does assert, however, is that the true nature of whatever
‘energy’ it is may survive bodily death – what His Holiness terms “the spiritual soul” - and its
relationship with the living body and in particular the conscious brain, is quite quite different
from anything that homo sapiens can possibly conceive of, by the lights of any extant
cosmology, be he or she Angelic Doctor or the discoverer of evolution through natural selection.
Nor upon their return are those subjects who have temporarily left behind their lifeless cadaver
and actually experienced “the spiritual soul” (whatever it is) at first hand in near death able to
explain it any better, secundum humanum nostrum modum concipiendi.
The use of words like ‘soul’ or ‘atman’ can only feed the comforting delusion that an earth-
bound human brain has even an inchoate understanding of a mystery that is as yet totally beyond
its ken. “The Tao that can be named is not the constant Tao.“ (Lao Tse) Equally sad is the
delusion of those who dismiss out of hand the now well-attested phenomenon of the near death
experience and its life-changing reverberations.
The upshot is that homo sapiens is left free to roam parliament and the courts, newspaper
editorial offices and television newsrooms, our homes and the streets, with these cavalier spin-
doctoring circuits in our left cortex determined by evolution not to let the facts get in the way of
a good story, of a convincing narrative. Especially when powerfully motivated by survival and
self-interest and personal advancement. (In a Freudian framework, the confabulator becomes
the enthusiastic script-writer to a hungry inflated self-aggrandising ego, which the evolutionary
psychologists tell us is driven by the territorial imperative‘s expansionist agenda.)
Thus presidents declare war, popes pronounce against contraception and condoms, physicists
postulate an ultimate anarchic chaos, orthopaedic surgeons decide to operate, magistrates
decline bail, and “wretches hang, that jurymen may dine.“ (Oscar Fingall O’Flahertie Wills
Wilde) All the while sincerely believing we are impeccably right and acting with the highest
intentions; any lingering self-doubt constrained by a necessity that knows not law.
Between our lunar dreaming and our solar confabulations plunges a bottomless chasm,
affording only vaporous foundations to foot an invulnerable meaning to life. At its very best,
our metaphysic will amount to no more than “whistling in the dark.” (Soren Kierkegaard) The
greatest courage is the courage to be happy. (A saying in Ladakh)
All of us, every single one, each in our own way, is mad. Not certifiably so. In a world of
equally insane persons, our everyday delusions routinely pass muster as common sense. Only
the symptoms vary, some more common than others. We are all too inherently noble, equally
capable of arousing that true grit our destiny may require of us at any moment.
If “humility is endless,” it’s because so too is our limitless capacity for delusion, and
accepting this stark reality requires the utmost humility. (Thomas Stearns Eliot) A good sense of
humour doesn’t go astray either – the ability to chuckle at our own ridiculosity. To paraphrase
and misapply some words of Rabindranath Tagore: “This truth comes as a conqueror only to
14. those who have lost the art of receiving it as a friend.”
It scarcely needs to be mentioned in passing that it is obviously a routine matter of the
operation of the immutable axioms of ordinary logic that the foregoing monitory paragraphs of
this Section 15 herein apply as much to the entire contents of this periphrastic pot-pourri as to
any other verbal perambulations of homo sapiens. Indeed, with my erratic history, doubtless
they apply here more than to most...
16. ARIADNE’S THREAD: PERHAPS AN ANTIDOTE?
Zen Buddhism wisely advises against us holding too many opinions.
“Transformations going on in an empty world which confronts us
Appear real all because of Ignorance: (our delusional confabulator)
Try not to seek after the true,
Only cease to cherish opinions.” (Seng-t’san)
But this doesn’t mean the way of zen is in any way nay-saying or life-denying. Rather, zen
affirms living life instead of merely thinking and talking about it, as Edward Jenner and his
antecedent mentors advise us: “Don’t think – Experiment!”
Zen gracefully sidesteps our deceiving confabulator by bringing us directly to our senses.
“The most important point is to own your own physical body. If you slump, you will lose
yourself. Your mind will be wandering about somewhere else; you will not be in your body.
This is not the way. We must exist right here, right now! This is the key point. You must have
your own body and mind. Everything else should exist in the right place, in the right way. Then
there is no problem.” (Shunryu Suzuki Roshi, emphasis added)
Zazen practice, bare mindfulness of the aesthetic delight within the ever-present breath, is
zen’s recommended methodology. “When we practice zazen our mind always follows our
breathing. When we inhale, the air comes into the inner world. When we exhale, the air goes
out to the outer world. The inner world is limitless, and the outer world is also limitless. We say
“inner world” or “outer world,” but actually there is just one whole world. In this limitless
world, our throat is like a swinging door. The air comes in and goes out like someone passing
through a swinging door. If you think “I breathe,” the “I” is extra. There is no you to say “I.”
What we call “I” is just a swinging door which moves when we inhale and when we exhale. It
just moves; that is all. When your mind is pure and calm enough to follow this movement,
there is nothing: no “I,” no world, no mind nor body; just a swinging door.
“So when we practice zazen, all that exists is the movement of the breathing, but we are
aware of this movement. You should not be absent-minded. But when we follow this
movement, we are not aware of our small self, but rather of our universal nature… This kind of
awareness is very important, because we are usually so one-sided. Our usual understanding of
life is dualistic: you and I, this and that, good and bad. But these discriminations are
themselves the awareness of the universal existence: “you” means to be aware of the universe in
the form of you, and “I” means to be aware of it in the form of I. “You” and “I” are just
15. swinging doors. This kind of understanding is necessary. This should not even be called
understanding: it is actually the true experience of life through Zen practice.” (Shunryu Suzuki
Roshi) Traditionally in zazen practice, this “swinging door” effect centres on the hara in the
soft floating belly, just below the navel, as gently it rises and falls while we breathe in and out.
What can be simpler than this? Try it, though, and soon we discover how the confabulator,
our own Lone Deranger, as if true to our simian origins, continues to leap and swing like an
orang-utan from synapse to synapse, as it ranges restlessly through its dendrite jungle home of
grey matter and supporting glial cells, no matter our vain attempts to leash it. Small wonder in
the East, they call this “monkey mind.”
Perhaps Suzuki Roshi’s truly great contribution is his restatement of the idea that
enlightenment is not some elevated state we might or might not one day attain to if only we
meditate long enough and hard. Enlightenment is what we experience here and now in our
ordinary everyday zazen practice. Which will be both different and similar for each of us, at our
own individual stage and rate of ‘development.’ The goal is not enlightenment. The goal is
simply more zazen, for its own sake. “We practice zazen to express our true nature.” (Suzuki)
Should we persevere in this edifying pursuit, we may well be taken in surprise by
unforeseeable illuminations from this simple mindfulness pranayama. At very least, we may
confirm the truth of William James’ observation: “The faculty of voluntarily bringing back a
wandering attention, over and over again, is the very root of judgment, character and will.” On
another level, zazen transforms the simple process of respiration into a high-grade aesthetic
experience.
When we become established in our meditation practice – and it has many possible forms
besides zazen, at least 108 according to the Hindus – it makes its havening abode alongside our
dream life and our intimate relationships as a ‘safe place’ to process our emotional life and
dissolve our resurgent inner conflicts, also largely ex opere operato. In an ever-changing world,
our meditation practice comes to be a rock of stability. One we can access on our own accord, at
any moment.
Time and again, we come home to soft belly, just letting it all go… Always gently,
effortlessly. Never forceful or insistent, for instead of dissolving them, we may repress the
conflicts, only to have them come back stronger and brand us on the bum. Or bite our loved
ones on theirs.
One thing is certain: if you do the meditation, the meditation will do you. We come to see
through this delusional confabulator as the transparent imposter it truly is, in ourselves and in
everyone. We recognise the need to respond to this universal and uniquely human condition with
an endless compassion. Everyone has their own story, and it drives the plot-line of their life
“with the inexorable inevitability of a dream.” (Joan Didion) In hoc est mysterium humanae
vitae. So begins our real work: Just listening... And echoing with an unblocked heart... One
swinging door to another…
As an elderly Canadian sadhu from Shivananda Ashram up on the hill by Laxmanjoola Bridge
16. said to me in the Railway Road, Rishikesh branch of the State Bank of India one sunny October
morn in 1991, while we were waiting to cash our traveller’s cheques: “Maybe the
purpose of meditation is to help us live with the Mystery.” Or as Lex Luthor says: “Another
man can pick up a chewing gum wrapper from the sidewalk and find the secret of the universe.”
“Once a certain degree of insight has been reached,” said Wylie, “all men talk, when talk they
must, the same tripe.” (Samuel Beckett)
17. CONCLUSION
The ongoing psychosis of schizophrenia is a catastrophic psychiatric condition that afflicts
1% of the world’s population, some sixty million global citizens, equivalent to the total
population of a world power such as Great Britain or France or Italy. Its onset typically occurs
during late adolescence and early adulthood. It does not discriminate in favour of or against any
of the traditional biases – gender, race, religion etcetera. It is characterised by delusions,
hallucinations, cognitive deficits, angry or apathetic reactions and intense and changeable
moods. The emotional and cognitive life of the psychotic individual is totally overwhelmed, and
before the accidental discovery of chlorpromazine’s tranquillising properties, there was no
reliable antidote.
Along with sleep apnea, nightmares, teeth-grinding, sleep walking, restless legs syndrome
and the adynamia and total loss of dreaming experienced by the vast majority of prefrontal
leucotomy patients, psychosis can most helpfully be regarded as another sleep disorder,
specifically a misapplication of the dreaming function. The primary task for the psychotic brain
is to reactivate and normalise its night-time REM-dreaming sleep, even as it resuscitates its
daytime rational consciousness. These are but two sides of the same coin: profligate
diurnal stimulation of the schizophrenic brain’s dreaming function dampens its full nocturnal
therapeutic REM-operation; conversely, one sure way for a schizophrenic genotype brain to
dream whilst awake is to suppress its nocturnal REM-dreaming activity.
Symptomatically, psychosis may well be a thought disorder or a mood disorder, but
essentially its aetiology is a sleep disorder. Not just in some crass, blatant, obvious, clumsy
and trivial sense with all its echoes of mere insomnia and utter fatigue, but more profoundly of a
nocturnal mode of consciousness extruding itself queerly into the harsh alien light of day. Yin
energy where there should be Yang. Water where there should be fire. Poetry where should be
prosody. Dreaming when we should be vigilant and rational and decisive.
This is a change of emphasis away from the usual focus on building up our rational
consciousness. As well, we concentrate on reconditioning our dream generator and the quality
of its products. After all, the problem is largely located there, and that‘s largely where the
solution lies. It’s a question of rebalancing our over-active dream generator with our anorexic
and frazzled story-telling circuits. The key to recovery from psychosis is to return and confine
our truant dreaming activity to nocturnal sleep. This is basically how antipsychotic medicine
works, by restoring our dysfunctional dream generator. That is what constitutes recovery from
psychosis.
17. There are further behavioural measures we ourselves can take to assist this process, by
actively displacing the waking-dream activity of psychosis with strenuous, rewarding and
energetic rational daytime occupations which in their turn then provide solid food for the revived
nightly developmental dreaming function to process and thus to thrive. It’s as simple – and as
challenging – as that. The healthy psyche is rooted deep in the humus of its rich nocturnal
dreamlife, which is equally reliant upon at least a modicum of constructive daytime stimulus and
emotional satisfaction.
To comprehend psychosis for what it truly is – a chemically reversible brain state in which it
dreams whilst we are yet awake – most effectively demystifies and destigmatizes this otherwise
withering condition. Even as when we awaken from the frightening thrall of some minor routine
nightmare and are instantly relieved by that sudden hackneyed realisation: Ah – it was all just a
dream…
It may well be true that “There is no cure for schizophrenia,” as Dr Simon Spedding so
boldly proclaimed to the Paterson House day patients back in 1978. But there is now at least
medicine and understanding that allows us to live out our days in peace. As to ‘normality’, as
David Oliver Selznick observed: “I don’t want to be normal. Who wants to be normal?”
And so we join ranks with Raymond Chandler’s nosy, irrepressible detective in a late night
black-and-white movie from 1944: “I had a nightmare – a lot of crazy things. I slept. I woke up
and the room was full of smoke. I was a sick man: instead of pink snakes, I got smoke. Well,
here I am, all cured. What were you saying?”
Maybe not cured, but enduring. Keeping out of trouble, one day at a time. With a little help
from our friends. “Restored to life.” (Charles Dickens)
18. PHILOSOPHICAL POSTSCRIPT
A passing allusion was made in the first paragraph herein to what some philosophers have
called their “hard question”: how can a material brain ever give rise to our intangible
subjectivity? How can matter – however complex and organised – produce this amazingly other
realm of sensible interiority?
One answer to this question is to deny its validity ab initio: in the words of philosopher
Owen Flanagan, not to allow the “gee-whiz” bug to get a grip. Sometimes we let ourselves be
hypnotised by the way things seem to us, by their bedazzling appearances. On such an occasion,
it makes eminent sense simply to say “I will not be put the question.” Is the glass half full or
half empty? Either way, myopic monocularity. It is neither half full, nor half empty: IT IS
BOTH, DAMN IT! And always will be. That’s just the way it is. It is never “All good,“ as
people these days are so fond of saying. But then, neither is it ever all bad...
As Francis Scott Fitzgerald put it: “The test of a first-rate intelligence is the ability to hold
two opposed ideas in the mind at the same time, and still retain the ability to function. One
should, for example, be able to see that things are hopeless and yet be determined to make them
18. otherwise.“ Or as David Malouf so graciously puts it: “Our answer, on every occasion when
we are offered the false choice between ‘this’ and ‘that,’ should be ‘Thankyou, I’ll take
both.’”
Does it make any more sense to ask how this sheet of paper, most of which is interstitial
space, can appear so solid? Or to ask how the amoeba’s agglomeration of inert nucleus, inert
cytoplasm, inert organelles and inert membranes, collectively can give rise to the miracle of
Life? They just do. With greater understanding of atomic physics, biology and neuroscience,
respectively in each case, these so-called ‘hard questions’ dissolve and disappear. And so we
ask no more that question about our own brains than we do concerning a steer’s brain, whose
casseroled blade steak we munched for lunch.
Then come the really difficult ethical questions. If the rich inner life of homo sapiens is not
generated by some species-specific immortal spiritual principle but simply by our prodigiously
evolved neuronal complexity, what then, apart from a destructive overweening egocentric
arrogance, is the basis for our unique and lordly legal status? And so it goes…
Meanwhile, God is still in Her Heaven, as She is in Earth; and All is still as Well as Ever it
was. Some things better, others worse. “The horse leech’s daughter is a closed system. Her
quantum of wantum does not vary.“ (Samuel Beckett) Always changing, ever evolving, ever
devolving. “In times like these, it helps to recall that there have always been times like these.”
(Paul Harvey)
As to any Afterlife, there are many views, and much wise wrangling, but one thing is quite
certain: we will all find out for ourselves soon enough. The reports of their often life-
transforming experience of some of those who have made their way back from near death read
very much like extended mythic dream journal entries. Yet at the time, there was apparently nil
detectable brain activation…
For now, enough the homespun idiographic phrases of Chuang Tzu:
There is a globe,
The foundation of my bodily existence.
It wears me out with work and duties,
It gives me rest in old age,
It gives me peace in death.
For the one who supplied me with what I needed in life
Will also give me what I need in death.
19. SELECT BIBLIOGRAPHY
Adelaide Advertiser, Melbourne Age and Weekend Australian
Australian Broadcasting Corporation: Radio National and ABC1
Rosalind Diamond Cartwright, Night Life
Prentice Hall Inc. 1977
Robert de Castella & Len Johnson, Jog with Deek –
A guide to training for all runners
Currey O’Neil Ross Pty Ltd, 1984
Norman Doidge, The Brain That Changes Itself
Scribe Publications Pty Ltd, 2007
Ernest Hartmann, The Biology of Dreaming
Charles C. Thomas, 1967
J. Alan Hobson, The Chemistry of Conscious States
Back Bay Books, 1994
Thaddeus Kostrubla, The Joy of Running
Pocket Books, 1977
Christopher MacDougall, Born To Run
Alfred A. Knopf, 2009
Edited by Edward F. Pace-Schott et al, Sleep and Dreaming
Cambridge University Press, 2003
John Weir Perry, The Self in the Psychotic Process
University of California Press, 1953
Andrea Rock, The Mind at Night
Basic Books, 2004
Stephen M. Stahl, Psychopharmacology of Antipsychotics
Martin Dunitz Ltd, 1999
Shunryu Suzuki, Zen Mind, Beginner’s Mind
John Weatherhill, Inc. 1970