The Man Who Wasn't There: Investigations into the Strange New Science of the Self (29 page)

Are there ways to test some of these linkages? Does an out-of-body experience influence perception and the construction of the narrative self?

Ehrsson’s team had people experience a full-body illusion in which they felt ownership of virtual bodies that were as small as Barbie dolls (about a foot high) or as big as a thirteen-foot-high giant. Then they were asked about the objects they were perceiving (cubes of different sizes, placed at a constant distance from the camera). The subjects were more likely to perceive objects as being larger and farther away when they identified with Barbie dolls, and smaller and nearer when they felt they were giants. “
One’s own body size serves as an approximate reference for the entire external world in view,” the team concluded. This is good evidence for the primacy of embodiment for our sense of self.

Ehrsson’s lab also tested the effects of an out-of-body experience on episodic memory with an elaborate setup. They induced full-body illusions in subjects using the usual complement of head-mounted displays and synchronous stroking. During the illusion, subjects felt like they were watching a scene in a room from a different location than the location of their physical body. In the scene, an actor played the part of a professor and interacted with the subjects (all of whom were university students). The actor used a script that had been adapted from a Harold Pinter play called
One for the Road
(the adapted script was “not so dark and heavy as the original,” said Ehrsson), and the interaction involved an oral examination, in which the student responded to questions. What Ehrsson’s team wanted to answer was this: did people remember the episodes any less when they were under the influence of an illusion of being outside their physical body? In other words, does the brain’s ability to encode episodic memory (which is essential to our narrative self, as we saw with Clare’s father and Allan in chapter 2) depend on our being embodied in the physical body?

The short answer is yes. Those subjects who were out-of-body
during the encounter with the professor
were less able to recall the episodes, compared to those who were in-body. “The out-of-body-created memories were significantly less structured in terms of temporal and spatial order of events, and less vivid,” Ehrsson told me in an email.

If this is so, how, then, does one make sense of the vivid recollections of people who have had out-of-body and heautoscopic experiences? “Those memories are probably less vivid and temporally structured (more fragmented and less coherent) than they would have been if the same event would have been experienced in-body,” said Ehrsson. At least initially. Then, by repeated retelling of their experience, people consolidate their fragmented memories and are eventually able to recall and narrate the experience with considerable vividness. It’s also possible that the dramatic and emotional nature of such experiences counters some of the out-of-body-induced memory impairment. Regardless, the basic embodied self seems fundamental to the more evolved, cognitive, narrative self in more ways than one.

However, in none of these conditions we have explored so far—whether in labs or in the subjective experiences of people—does the narrative self ever shut down fully. It does happen, sadly, in Alzheimer’s disease, but other cognitive abilities deteriorate too, debilitating the person in the process. But what if there were a way to be just the bodily self—just the organism living in the present moment, sensing, feeling, without the chatter of the narrative self? It almost sounds mystical, even New-Agey. But that’s where we are headed.

BEING NO ONE, HERE AND NOW

ECSTATIC EPILEPSY AND THE UNBOUNDED SELF

If the doors of perception were cleansed every thing would appear to man as it is, infinite.

—William Blake

I feel a happiness unthinkable in the normal state and unimaginable for anyone who hasn’t experienced it . . . I am then in perfect harmony with myself and the entire universe.

—Fyodor Dostoevsky

Z
achary Ernst was eighteen, in his second semester of college at Western Michigan University in Kalamazoo, when he had his first epileptic seizure. It was winter, a time when Kalamazoo is usually cold, dark, and cloudy. Zach and his girlfriend were sitting in his dorm room when he suddenly felt panicked. His mood darkened, suicidally so. He began hearing music that clearly wasn’t playing anywhere, except in his head. A terrified Zach made his girlfriend take him to her
parents’ place nearby, which she did reluctantly. The whole episode left him drained of energy. Convinced it was just a panic attack, Zach ignored it, hoping it wouldn’t happen again. It did, again and again, almost every day.

The seizures were so exhausting that Zach could not even summon the strength to see a doctor. Eventually, during a lull in the spate of seizures, he felt well enough to see a physician, who sent him to a psychiatrist, who immediately suggested he see a neurologist. When an EEG and an MRI revealed nothing, the neurologist started him on Tegretol, an anticonvulsant drug. But the seizures kept coming, sometimes two or three a day. The neurologist kept increasing the dosage, until Zach was taking 1,000 milligrams of Tegretol a day. “Years later I got a second opinion and they were horrified at what I was taking,” Zach told me. “And they actually hospitalized me to take me off the medication . . . slowly.”

But in the intervening years between the first diagnosis and the second opinion, Zach’s condition worsened. His short-term memory failed him badly (a side effect of the Tegretol, it would turn out). He had entered college to study math, but he could barely remember when or where his classes were. He had to carry a schedule with him at all times. Until the seizures began, he had been tackling upper-level calculus, non-Euclidean geometry, and group theory with relative ease. But he began to find the math tests increasingly difficult. Oddly, he was able to handle philosophy better—the grades were based not on classroom tests but papers, which he could write in his room while referring to his notes. He didn’t have to rely on his memory. “I was failing all my math classes and getting A’s in all my philosophy classes,” he said.

The seizures continued. When they came, they made him
lethargic; he found it difficult to speak or walk. He learned to recognize an imminent seizure. He’d walk over to the original part of campus, one of the few places in Kalamazoo with older buildings, to wait out the episode. “This very crushing feeling of sadness would wash over me, to the point where I’d have certainly tried to kill myself if I had the energy to do it,” he said. “It was very, very severe and very sudden. It would go away as quickly as it came.”

Given the overwhelmingly negative emotional tone of these seizures, it’s no wonder that Zach at first didn’t realize that he was having another type of seizure also. They were less frequent, but they too came unbidden. And they were pleasant. Very pleasant. He might have had them as a kid, but he can best remember the ones that happened during his college years. The world around him would turn sharp and vivid, as if until then he had been seeing everything on a flat screen and suddenly someone had taken the screen away to expose a 3-D world. He noticed details in ways that he wouldn’t otherwise. “If I saw a tree, it would be like seeing a real tree after you had only seen pictures of a tree,” he told me. “You could take in all of the details of the whole tree all at once and see the textures of everything. It was very, very beautiful.”

Time seemed to slow down. He would be walking down a city block at his normal pace and what normally would take a few minutes would feel like it had lasted an hour. “It felt like time was being stretched out,” he said. “Like you were experiencing more every second than you normally do.” Put another way, Zach was living in the moment. “There was certainly no place else to be at that time,” he said. “I was very focused on where I was [at] that exact time. That’s very pleasant. You don’t worry about things that are going to happen in an hour, a year.”

Was it an unusual state for him, living in the moment? I asked.

“Oh, it’s unusual for me,” he said, laughing. “I’m normally drifting around everywhere.”

Even more than the vividness and the slowing of time, the feeling that left the most indelible mark on Zach was a pervasive sense of certitude. “The world sort of looked like a very well composed photograph or a very well composed painting, where the objects are placed in just the right way that it brings out an aesthetic,” he recalled. “And Kalamazoo is not a pretty town. It’s very gray; it’s very depressing, in my opinion. That was certainly not how I normally thought about it.”

There was also the feeling of clarity, of knowing. “I felt like I knew everything about my environment so directly that there was no inference going on. It’s some strange feeling of certainty that the way the world is, is exactly how it should be, and how it was arranged to be,” he recalled. “It just cried out for an explanation. Very ordinary objects—tables, and chairs, and trees, everything—felt so powerfully like they are laid out with such precision and intentionality. I got an overwhelming feeling that there was an agency behind it.”

Listening to Zach, it was hard not to think of mystics and descriptions of their otherworldly experiences. I said so. He agreed. Having grown up an atheist, Zach didn’t equate his experiences with the existence of anything supernatural. “But it seems really clear to me that what mystics are describing is this,” he said.

As for himself, he remains an atheist. He became an associate professor of philosophy at the University of Missouri–Columbia—a profession that reinforced his skepticism. But he was at pains to point out that his post-seizure views cannot negate the “truth” of the seizures when he was in their throes. “During the seizures, it was
impossible to doubt that there was a kind of agency behind the world. That was not open to debate, so to speak,” he said. “It was such an immediate belief; there was no way to prevent myself from having it.”

Fyodor Dostoevsky would have agreed. The Russian novelist is one of the best-known literary figures who suffered from epilepsy. While his seizures often left him feeling a dark dread (“
as if I had lost the most precious being in the world, as if I had buried someone,” Dostoevsky told his wife, Anna), historians have identified instances when Dostoevsky talked of soaring high, just moments before being knocked unconscious by his seizure. “A happiness unthinkable in the normal state and unimaginable for anyone who hasn’t experienced it . . . I am then in perfect harmony with myself and the entire universe,” he told his biographer Nikolay Strakhov of those moments. “
The sensation is so strong and so pleasant that one would give ten years of life, perhaps even one’s whole life in exchange for a few seconds of such felicity.”

Many of Dostoevsky’s fictional characters suffered from epilepsy. Prince Myshkin, the protagonist in
The Idiot
, has ecstatic auras at the start of his fits: “
a moment or two when his whole heart, and mind, and body seemed to wake up to vigour and light; when he became filled with joy and hope, and all his anxieties seemed to be swept away for ever.” Myshkin even tells the novel’s villainous character Rogozhin, “
I feel then as if I understood those amazing words—‘There shall be no more time.’” But Myshkin is no fool. He realizes upon reflection that these unusual states are only due to his disease, a lower, not higher, form of existence. Still, he cannot shake off the truth of those moments. Why should it matter, Myshkin ponders, “
if when I recall and analyze the moment, it seems to have been one of harmony and beauty
in the highest degree—an instant of deepest sensation, overflowing with unbounded joy and rapture, ecstatic devotion, and completest life?”

Did Dostoevsky fabricate the accounts of his ecstatic “auras,” genius novelist that he was? That’s exactly what French neurologist Henri Gastaut eloquently argued in 1977, after systematically analyzing the available evidence: “
I believe that the grand mal seizures of his epilepsy lacked any such ecstatic aura, but were preceded on rare occasions by mild alterations of consciousness which the author’s originality of thought and literary genius led him to describe as a feeling of bliss.”

It didn’t take long, however, for this view to be overturned. In 1980, Italian neurologists reported the story of a thirty-year-old man who had been having ecstatic seizures since he was thirteen. He didn’t see the need to go to a physician, but then he had a tonic-clonic, or grand mal, seizure; the physician referred him to the neurologists. Their account of his ecstatic seizures is edifying: “
He says that the pleasure he feels is so intense that he cannot find its match in reality. . . . All disagreeable feelings, emotions, and thoughts are absent during the attacks. His mind, his whole being is pervaded by a sense of total bliss. . . . He insists that the only comparable pleasure is that conveyed by music. Sexual pleasure is completely different: once he happened to have an attack during sexual intercourse, which he carried on mechanically, being totally absorbed in his utterly mental enjoyment. The neurological examination was negative.” The neurologists even managed to get an EEG recording while the young man was having a seizure, which he claimed created a feeling of ecstasy. Based on those recordings, the neurologists concluded that seizures in the temporal lobe can make people feel ecstatic.

That’s where things stood until recently. Fabienne Picard, a neurologist at the University Hospital Geneva in Switzerland, stumbled upon Dostoevsky’s writings on epilepsy and his epileptic characters while conceiving and producing her documentary
Art & Epilepsy
. Until then, her work had focused mainly on nocturnal frontal lobe epilepsy, which as the name suggests causes seizures mostly when the person is asleep. But after getting acquainted with Dostoevsky’s ecstatic auras, she began paying greater attention to some of her other patients. “When they really explained their feelings, it was incredible,” Picard told me. “It was very close to Dostoevsky’s descriptions.”

Epileptic seizures are broadly divided into two groups: generalized and focal. In generalized seizures, electrical discharges overwhelm the entire cortex, and can often lead to loss of consciousness. Ecstatic seizures are of the second kind: focal or partial, in which the electrical storm is confined to a small region of the brain, and the patient often remains conscious.

Detailed accounts of ecstatic seizures are scant in the medical literature. “These seizures are not so frequent, but I think that they are also probably underestimated, because people are sometimes reluctant to explain them,” said Picard. “Because the emotions are so strong and strange, maybe they feel embarrassed to speak about them; maybe they think the doctor will find them mad.” Also, given the blissful and pleasurable nature of such seizures, some patients may not even go to see a neurologist unless the seizures spread to other areas of the brain, causing loss of function or even loss of consciousness.

As Picard cajoled her patients to speak up about their ecstatic seizures, she found their sensations could be characterized using three broad categories of feelings. The first was
heightened self-awareness
. For example, a fifty-three-year-old female teacher told
Picard,
“During the seizure it is as if I were very, very conscious, more aware, and the sensations, everything, seems bigger, overwhelming me.” The second was a sense of
physical well-being
. A thirty-seven-year-old man described it as “
a sensation of velvet, as if I were sheltered from anything negative.” The third was
intense positive emotions
, best articulated by a sixty-four-year-old woman: “
The immense joy that fills me is above physical sensations. It is a feeling of total presence, an absolute integration of myself, a feeling of unbelievable harmony of my whole body and myself with life, with the world, with the ‘All,’” she said.

As far as Picard was concerned, these descriptions were pointing toward one brain region—the insular cortex—and to the work of Bud Craig, a neuroanatomist at the Barrow Neurological Institute in Phoenix, Arizona. In 2002, Craig published a remarkable paper in
Nature Reviews Neuroscience
, titled “How Do You Feel?” and followed it up with a paper in 2009 in the same journal, titled “How Do You Feel—Now?: The Anterior Insula and Human Awareness.” In these papers, Craig brought a body of experimental work—his own and that of others—to bear on his hypothesis that the anterior insula is key to human awareness, maybe even the seat of the “sentient self.”

We have seen the insula implicated in Cotard’s syndrome, depersonalization disorder, and the doppelgänger effect—all of which involve distortions in one’s perception of body states and emotions. The insula is deep in the brain, buried inside the lateral sulcus, the fissure that divides the frontal and parietal lobes from the temporal lobe. Its main function seems to be to integrate information about the internal state of the body with external sensations. There’s also evidence that the processing of these signals gets progressively more sophisticated as one moves from the posterior to the anterior part of the insula.
While the posterior insula represents objective properties, such as body temperature, the anterior insula produces subjective feelings of body states and emotions, both good and bad: the anterior insula could be responsible for creating the feeling of “being.”