Indigo is my favorite hallucination: Oliver Sacks on altered states of consciousness

© Charles Avery

The eminent British neuropsychologist Oliver Sacks, who has worked all his life on the problems of perception, memory and consciousness, in his latest book explores the question that has occupied him all his life - the comprehensive and transcendental concept of hallucination. In one chapter, he describes his own experiments with drugs in the sixties, and in an interview with NPR radio, he cites interest in the effects of psychoactive substances on the brain as one of the reasons he wanted to become a scientist.

- In your book The Mind’s Eye, in a small footnote, you mentioned that in the sixties, during the period of experimentation with large doses of amphetamine, you experienced a number of vivid mental images. Now, your entire book is about hallucinations, and it has a whole chapter about the hallucinogenic drugs you took when you were young. Did you think it would be a book when you wrote it?

- No way. I knew I would have a book about hallucinations, but this personal chapter appeared relatively late in the manuscript. Then it kind of woke up in me. I was in the hospital with a broken hip and I was very bored. And my friend said, "You talk about the 60s sometimes." “Can you tell me more?” So I started telling him stories, and he wrote them down and brought them to me. That's how these stories got into the book.

I'm talking about what happened in the distant past. I view myself as a subject of medical history, as I would treat anyone else. Thankfully I survived it and I'm still here to tell the story 45 years later.

- Why did you decide to write about hallucinations caused by various diseases, drugs, neurological disorders?

- I have been interested in hallucinations for most of my life. I was thrilled to read about the hallucination of Ms. Havisham seen by Pip in Dickens' Great Expectations. Many of Dickens’ books raise the subject of haunting hallucinations. And later, as a medical student and a doctor, I saw hallucinations of all kinds. My brother was schizophrenic, and he communicated with his hallucinations. It was a completely different experience. I covered hallucinations in most of my early work, but I thought it was time to put it all together. Especially since we now have ways to study the brain and see everything that happens when people have hallucinations.

- Are you talking about functional magnetic resonance imaging?

- Yeah.

- At the beginning of the chapter on your own experiments with altered states of consciousness, you write that every culture has discovered the chemical means of transcendence. At some point, the use of such substances is fixed on the level of magic or sacred.

“Someone once offered me some weed. I took two puffs and looked at my hand. It seemed to me that the hand had detached itself from my body, but at the same time it was getting bigger and bigger until it became a cosmic hand for the whole universe. I thought it was just amazing. I was thinking about peyote ceremonies in Native Americans, similar ceremonies in Mexico to the seeds of the "Morning Glory" (this is a plant of the genus Ipomea of the family of bunny), as well as rituals in Central America with hallucinogenic mushrooms and rites in South America from ayahuasca. It seems that at some point it happens in every culture.

- You write that some drugs, such as hallucinogenic drugs, promise transcendence on demand. So you wanted to experiment with them?

- Well, I think that's one reason. It's probably too pompous. I think sometimes I just wanted to have fun. I wanted to see a visually and musically expanded world. I wanted to know what it was like. But I have always been partly an observer as well as a participant. I often took notes when I was high.

- And you didn't find it absurd to take notes of this experience, because it's too vivid and overwhelming to document. And in doing so, do you have to come out of that experience while still remaining in it?

- Yeah, but I didn't always take notes. Normally I would take notes if I got scared during the trip, then my notes would help me get out of the situation.

- When was the first time you tried a perceptual distortion drug?

- I think it was 1963 in Los Angeles. I did a residency in neurology at UCLA at the time, but spent the whole time at Venice Beach and Muscle Beach. There was a culture of drugs there, just like in Topanga Canyon, where I lived at the time. Someone once offered me some weed. I took two puffs and looked at my hand. It seemed to me that the hand had detached itself from my body, but at the same time it was getting bigger and bigger until it became a cosmic hand for the whole universe. I thought it was just amazing.

- And what did you find most interesting, enjoyable, or difficult that time that made you look for more of this experience?

- It struck me that such perceptual changes were possible and that they occurred with a certain sense of importance, an infinite supernatural feeling. I’m a staunch atheist, but when it happened, I couldn’t help thinking that it must be the hand of God, or at least that’s how it could be felt.

- Did you study neuroscience at the time?

- Yes, I was already a resident neurologist, and there were discoveries and conversations in the air about neurotransmitters and the effects of drugs, and how people with psychosis or Parkinson's could be helped. The "chemistry" of the nervous system was a very hot topic and seemed quite appealing to try it all out for yourself.

- So you started taking LSD in 1964, and you also took mind-altering drugs every weekend for a while. Could you describe your feelings?

- The perception of color seemed special to me. I read about the color of indigo, how Newton added it to the spectrum quite late, and it turned out that there are no two people on earth who can agree on what indigo is. I thought I would like to experience indigo.

One day I went to a museum to look at azurite, a copper mineral perhaps closest to indigo, but I was very disappointed. I actually repeated the experience, but the second time I didn't do drugs, I listened to music. It seems to me that music can help achieve states commensurate with drugs. So I made a cocktail of amphetamines, LSD and cannabis, and I took it and I said, "Now I want to see indigo." And, as if under the stroke of a brush, a huge pear-shaped spot of the purest indigo appeared on the wall.

Again, there was a luminous, supernatural sensation. I leaned over to him in ecstasy and thought, "This is the color of paradise or the color that Giotto has sought all his life, but never found." It seemed to me that this color did not actually exist on Earth, or maybe it existed before, but it disappeared.

It all swept through my head in four to five seconds, and the spot immediately disappeared, leaving me feeling lost and heartbroken. When I was released, I was still concerned about whether indigo existed in the real world.

One day, I went to a museum to look at azurite, a copper mineral perhaps closest to indigo, but was very disappointed. I actually repeated the experience, but the second time I didn't do drugs, I listened to music. It seems to me that music can help achieve states commensurate with drugs. But I think indigo is my favorite hallucination.

- Could you give us an example of a really bad experience with hallucinogenic drugs?

- Perhaps the worst case was the most mysterious. In 1965, I had just moved to New York. I had trouble sleeping. I was constantly increasing the dosage of sleeping pills - chloral hydrate. And one day the medicine ran out. I didn't give it any importance, although when I got to work I noticed a slight tremor. I was doing neuropathology at the time, and it was my turn to cut the brain and describe all its structures, which I always found easy and enjoyable.

But this time it was difficult for me, I doubted and felt the tremors were becoming more apparent. When class was over, I went across the street for a coffee, and suddenly my coffee turned green and immediately purple. I looked at the cashier and he had a huge head with an elephant seal trunk.

I was in a panic, I didn’t know what was going on. I ran across the street and got on the bus, but the passengers terrified me. Each had huge egg-shaped heads with insect-like eyes, strange eyes that moved quickly.

I wrote it all down in my journal. It felt like I was getting out of control one way or another, either in panic or in catatonia if I didn't make my notes. I somehow managed to get off the bus, take the subway, get off at the right station — I lived in the East Village then, as I do now — at home, buildings fluttered like flags in the wind.

When I got to my apartment, I called a friend I was interning with, her name was Carroll Burnett, and I said, "Carroll, I want to say goodbye." I'm crazy. And she said, "Oliver, what did you take?" I told her I didn't take anything. She thought for a moment and asked, “What have you stopped taking?” ?

"That's it!" Chloral! This was the beginning of attacks of white fever, caused not by abstinence from alcohol, but by abstinence from chloral. Very dangerous condition. I really should have gone to the hospital, but I didn't. A lot, a lot of horrible things happened.

- While you were having these nightmarish hallucinations caused by the withdrawal of a drug you were taking, did it help you somehow to realize that it was because of the drugs, that you were not losing your mind and that it would end at some point?

- Yeah, yeah, absolutely. When I realized it was a drug, not a madness, I felt so relieved that I was able to endure it to the end.

- What has this situation taught you as a neurologist?

- I learned that you can't be stupid. But this time I remembered a peculiar, strange visual perception. Sometimes I didn’t perceive continuous motion, I just saw a series of frozen images. It shocked me and made me seriously wonder if the sense of visual movement was an illusion, and if we were actually seeing a series of stop frames.

I don't remember that coming to my mind before. I felt that almost every possible sensory combination was within my control, every fantasy, every unreal distortion. Unlike dreams, people remember hallucinations. In general, they are different from dreams because you sleep when you dream, whereas here you are conscious and watching yourself.

- You write that your parents were medics, and when they were out of town, you went through their drawers and injected yourself with morphine to see what it was like. I wonder if they found out.

- I think they never found out, and if they did, they didn't say anything. That was the only time I ever climbed their drawers and took morphine intravenously. It was fascinating, but to my surprise it lasted thirteen hours, even though I only counted on twenty minutes. Then I realized how dangerous opiates are.

“I am intrigued by the relationship between drugs and religion and hallucinations and religion. I have a big chapter on epilepsy, which at one time was called a sacred disease, even though Hippocrates said there was nothing sacred about it. Despite this, he admitted that the symptoms of epilepsy could be visionary. Does that play a role when you prescribe morphine as a doctor?

- I don't prescribe morphine too often. I usually act as a consultant and can only suggest different drugs rather than prescribe them. But I believe that morphine is indispensable in cases of severe pain. In England, heroin is used in such cases. It seems to me that denying morphine to terminally ill patients because they may be addicted to it is the height of cruelty. There are times when morphine is needed.

- I want to quote something you wrote when you stopped taking amphetamines. You wrote, After taking amphetamines, I felt as if I had made a crazy ascent into the stratosphere, but I came back empty-handed and couldn’t prove it. The experience was as empty and empty as it was intense.”

- I believe I took drugs in part to regain the sense of intellectual energy, pleasure, and perhaps creativity that I had as a young boy and loved chemistry, and that seemed to have left me.

That amphetamine trip happened to me while I was treating migraine patients I was very worried about. I had a beautiful old book about migraines written in the 1860s. I felt like it was the 1960s and we needed a book like this again. But who will write it? And a very loud voice said, "You're an idiot, you should write it." And then something switched in my brain, and I never used drugs again.

- There is a view that the human brain was created for a certain perception of God and religion. What do you think of that?

- I am intrigued by the relationship between drugs and religion and between hallucinations and religion. I have a big chapter on epilepsy, which at one time was called a sacred disease - even though Hippocrates said there was nothing sacred about it. Despite this, he admitted that epilepsy symptoms could be visionary. In particular, there is a kind of seizure, which some call an ecstatic seizure, accompanied by a feeling of bliss and delight, as if you were transported to heaven, visions of angels or communication with God.

This can happen to seemingly non-religious people—not one iota religious—but it can be overwhelming and can lead to conversion.

- It's interesting how often these visions, let's call them that, are born out of what we would now diagnose as abnormalities, and are actually abnormalities like epilepsy and schizophrenia.

- Absolutely. I think there have always been visions and voices attributed to the divine or the demonic or the muses. I think many poets still feel that they are dependent on an inner voice or a voice telling them what to do.

The medicalization of hallucinations actually took place only in the nineteenth century, and after that people became much more concerned with hallucinations, began to hide them and become ashamed of them. Therefore, this topic was discussed less and less. I think hallucinations should be discussed. There are different kinds of hallucinations, and there are even normal hallucinations like the ones most of us experience at night in bed before falling asleep, when we can see all sorts of patterns, or faces, or scenes.

- In your book, you talk about both hallucinations caused by various drugs and natural hallucinations - as, for example, in the transition from wakefulness to sleep.

- Can I complete this list? There are also hallucinations caused by serious life experiences, such as bereavement.

- I'm glad you touched on the loss. After all, this is such a common form of hallucination, when a person who has lost a loved one seems to see or hear him. How would you describe this phenomenon?

- Someone dies, a hole appears in your life, and that hole may be briefly filled with hallucinations. Hallucinations of loss are quite common, they occur periodically in 40-50% of widows. They are usually seen as comforting, helping in the process of grief. They disappear when the mourning process is complete.

“I tore off my hip muscles and dislocated my knee. At one point I went into a state of shock and wanted to fall asleep. And the voice said to me, "No, that means imminent death." Keep moving. You have to keep going. Choose a rhythm in which you can move and keep going.” It was a clear commanding voice, a kind of voice of life that cannot be disobeyed. How do you interpret these hallucinations as a neurologist?

- With any hallucinations, you can assign a functional brain tomogram in the active phase. You will be able to see how the parts of the brain normally involved in vision and hearing — perception — become superactive on their own. Autonomous activity. That doesn't happen with imagination. But hallucination in some sense simulates perception, and the perceptual parts of the brain are activated. You know what else is going on? Obviously, we are dealing with hallucinations of loss with a very strong, passionate sense of love and loss. I am convinced that any intense emotion can cause hallucinations.

- Imagine that a person actually sees that he is visited by someone for whom he is mourning. What happens in the brain compared to what it describes in a hallucination? In other words, does functional MRI prove that it was just a chemical reaction in the brain, not a visit from the deceased?

- You will see an exact coincidence between the “session” and rather serious changes in the brain, to which one cannot reduce the “session” alone, nor discuss these changes without mentioning that they were experienced as a visit to the deceased. The whole complexity of neuroscience or science or philosophy is how to connect brain activity with experience and consciousness. All we can say is that these processes are parallel.

- I'm curious, how do you take brain pictures of someone who's hallucinated? They are not attached to the scanner at the moment when it seems that their deceased loved one is visiting them.

- This, of course, is not easy, hallucinations of this type are rare, isolated and unpredictable. But there's another category of my patients -- and this is particularly interesting to me, because I've worked in nursing homes for the last 40 years of my practice. I have met a large number of elderly people whose intellectual abilities have remained unaffected, but whose hearing and vision have been impaired. They had visual and auditory hallucinations about it.

Visual is called Charles Bonnet syndrome. People can see faces, landscapes, patterns, music for several hours every day. In such a situation, we can place the patient inside a functional MRI, he can give a sign, for example, to raise a finger when the hallucinations begin. You can tell him or her, "You see faces," to which the patient may respond, "How do you know this?" This can be determined because the part of the brain responsible for facial recognition is suddenly activated.

In such cases, especially with Charles Bonnet syndrome, you can map the brain based on the hallucination the patient sees.

Morning Glory Plant of the genus Ipomeus of the family of buckwheat. The seeds of some varieties of Ipomoea violacea contain psychoactive substances and are traditionally used by Native Americans in magical rituals (usually in predictions of the future).

A small brown cactus, the botanical name is Lophophora williamsii. Since ancient times, it has been used by natives in northern Mexico and the southwestern United States as part of traditional religious rites, thanks to the fact that the mescaline contained in it causes rich visual hallucinations.

Used by the Indians of South America, a psychoactive mixture containing vegetative beta-carbolins and triptamines, giving unusually bright and strong flutters. Archaeological excavations have shown that the inhabitants of the Amazon basin consumed ayahuasca 5,000 years ago.

- You write about an auditory hallucination that may have saved your life. You were climbing and you hurt your leg, and part of you just wanted to stop, fall asleep. But then you heard a voice. What did he tell you?

- I tore off my hip muscles and dislocated my knee. At one point I went into a state of shock and wanted to fall asleep. And the voice said to me, "No, that means imminent death." Keep moving. You have to keep going. Choose a rhythm in which you can move and keep going.” It was a clear commanding voice, a kind of voice of life that cannot be disobeyed.

- And you kept walking despite the horrific condition of your leg.

- Yeah. I leaned on my hands. I secured my leg as best I could - with an umbrella and a jacket that tore in two. I thought it was going to be the last day of my life, and that's what it was all about until I was accidentally found by two hunters at sunset. It happened in Northern Norway.

But that voice was crucial to me, and I've heard many other similar stories. One of them happened to a young woman who was grieving a breakup with her beloved and decided to commit suicide. She had a bottle of sleeping pills and a glass of whiskey to drink. She put the pills to her mouth and heard a voice saying, “Don’t do that, I wouldn’t do that, you won’t always feel the way you do now.”

It was a male voice she didn't recognize. It scared her pretty much, and she said, "Who is this?" And she saw a silhouette opposite herself, a silhouette in an eighteenth-century suit, which disappeared in a moment. I think stories like this happen quite often. So is my story.

- Who did you hear? Was it your voice or that of a stranger?

- No, that wasn't my voice. I often hear myself, all the time swearing or muttering something to myself. But it was a very clear, confident voice. Not the one I learned, but the one I believed. I guess he came from the inside because he had nowhere else to go.

- What do you think happens neurologically in situations of great danger when a voice tells you what to do to save your life?

- I think it's akin to a primary defense mechanism. Some kind of power, a predisposition, built into the structure of consciousness and emotions. Perhaps most people live their lives without ever experiencing it. It only manifests itself in situations of extreme danger.

“We now look at the problem of consciousness as the key problem, whereas thirty years ago it was not regarded as a problem with a solution. There have been treatments that could not have been thought of a few years ago. In particular, the use of stem cells and other treatments for neurodegenerative diseases. You seem to have a neurologically busy life. You got migraines when you were 4 years old, you heard a voice when you almost died in the mountains. You had pain in your spine, and you wanted to understand what kind of nerves it was. You were visually impaired. You've been through so much that it may have been fruitful for you as a doctor, but I think it's a lot of trials for one person. You have lost sight in one eye due to cancer.

- It wasn’t easy, but I feel lucky. I am almost eighty years old and in good shape. Especially when I can swim. I'm a little limp on land, but I feel great in the water. It's true that I only have one eye working and the other requires surgery. But I do.

I suspect many people are not paying enough attention to their neurological problems. I think I’m different from the rest of us because I pay attention to things like that.

- What do you think has changed the most in your field since you became a resident in the '60s?

- Perhaps the possibility of brain imaging with MRI and PET scans. The brain can be viewed even at the cellular level. But there was a complete change of direction. For example, we view vision as something that is constructed. Once it reaches the back of the retina, the image is analyzed by 40 to 50 different brain systems.

Then they all work on creating the final image. There's an increased understanding of the complexity of the brain, this miracle. We now see the problem of consciousness as a key problem, whereas thirty years ago it was not a problem with a solution. There have been treatments that could not have been thought of a few years ago. In particular, the use of stem cells and other treatments for neurodegenerative diseases. It seems to me that neuroscience has grown stronger, and there is much more hope in it than when I first started doing it. Neurology has become more fun.

Source: theoryandpractice.ru