Sunday, July 01, 2001

The Psychedelic Pharmacy Without—and Within

The Dream Drugstore

By: Leslie L. IversenPh.D.

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What do dreams and nightmares, hypnosis and psychoanalysis, LSD and Valium have in common? According to neuroscientist Allan Hobson, M.D., who has written much over the years about sleep, dreaming, and consciousness, all of them can alter our state of consciousness by causing subtle shifts in our brain’s chemical balance.

His new book, The Dream Drugstore, once more conveys Hobson’s fascination with dreams and other altered states of consciousness. He pays particular attention to how changes in the balance of activity of chemical messengers in the brain underlie these different states, and how psychoactive drugs interact with the brain’s own consciousness-altering chemicals. Each of us possesses within our head our own “dream drugstore,” says Hobson; and shifts in the balance of chemical mediators from this drugstore can cause remarkable alterations in our consciousness. Even more dramatic changes in consciousness, sometimes resembling states of madness, are produced by psychedelic drugs, while therapeutic drugs can correct chemical imbalances in those suffering mental illness. Ultimately, says Hobson, we can learn to use psychological means to control our own dream drugstore. 

Neuroscientists and philosophers have long been intrigued by the nature of consciousness. Many scientists have tried to pinpoint the exact site in the brain where consciousness resides; Francis Crick suggests, for example, that rhythmic activity in the thalamus casts a “searchlight” on dark and otherwise unconscious regions of the cerebral cortex. Brain-imaging techniques have been used to detect the differing patterns of brain activity in sleep and waking, but so far no “consciousness center” in the brain has been located. The best we can conclude is that consciousness results when particular parts of the brain are active, and when the right balance exists in the brain’s chemical soup. 

Hobson rightly reminds us that there are different states that we call conscious, and that people seem to have an irresistible desire to modify these states. As he puts it: 

Normal human consciousness is so rich and so naturally variegated that any willful efforts to alter it artificially may seem, at first glance, perverse. But human beings are never satisfied with things as they are. People are always pushing the envelope of conscious experience. 

DREAMING: PERPLEXING, PARALYZING, AND LUCID

The first sections of The Dream Drugstore review brain anatomy and functioning. Hobson explains his “AIM” schema in three dimensions of moment-to-moment brain activity. “A” refers to the state of activation of the cortical neuronal circuits (a certain minimum level of activation is needed for consciousness to occur). “I” refers to the state of openness or closure of input (sensory) and output (motor) neural gateways to and from the brain: Is the brain open to incoming sensory information, and is it capable of controlling actions? “M” refers to monoamine tone, the balance among the various monoamine chemical modulators released from the brain stem. Any brain state, he argues, should be explainable by reference to different combinations along these dimensions of activity, input, and chemical modulation. 

Given his own interests, it is not surprising that Hobson emphasizes sleep and dreams. The occurrence of sleep is fairly easy to understand in evolutionary terms. Most animals cannot remain active during the night, and sleep provides an efficient and economic method of resting the body during an otherwise unproductive time. Why dreams evolved is much more difficult to explain. 

The occurrence of sleep is fairly easy to understand in evolutionary terms...Why dreams evolved is much more difficult to explain.

Humans experience four or more periods of dreaming every night, with each becoming longer as the night wears on, eventually lasting an hour or more. Whereas during nondreaming sleep, neural activity in most regions of the brain is very subdued, this is far from the case in dreaming sleep. Hobson’s earlier research helped pinpoint regions of the cortex and subcortical structures that become active during dreaming, including the paroxysmal bursts of neural activity that rise as electrical waves and more from the brain stem, to the thalamus, to the occipital cortex. During dreaming sleep, the brain is cut off from its normal sensory inputs; the gateways to motor output are also shut, with the exception of outputs to the muscles controlling the movements of the eye, which become very active—hence the term Rapid Eye Movement, or REM sleep. In a nightmare, as in other dreams, the dreamer is literally paralyzed and unable to escape.

Hobson asks the obvious question, What are dreams for? All mammals experience REM sleep, which seems biologically essential. Experimental animals deprived of REM sleep become distressed and unable to function normally; after some weeks of REM deprivation, they may die. Is dreaming a way of rehearsing skills learned during the day? Or is it, as Crick suggested, a way of clearing the cerebral computer of useless memories—dreaming in order to forget? There is no answer to this conundrum, as yet, but Hobson gives an admirable review of the brain mechanisms that underlie this curious state. 

Hobson is a devoted observer of his own dreams, regularly going to sleep wearing a “night-cap” with multiple electrodes to record the electrical activity of his brain, and holding a tape recorder in his hand to permit the instant recording of dreams each time he wakes up. Most of us cannot remember our dreams, but Hobson can provide many detailed accounts. He even has learned the technique of “lucid dreaming,” in which one preprograms a particular dream and when dreaming can participate in it. The author’s account of lucid dreaming, which encapsulates much of the thesis he expounds in this book, is presented in the excerpt at the end of this review. 

Lucid dreaming is a significant departure from the lack of self-awareness that characterizes normal states of consciousness during dreaming. It is but one of several varieties of consciousness that can exist in the dreaming state. In some people, for example, shutdown of the motor system gateways is incomplete, and they may enact their dreams by sleepwalking, talking, and other activities of which they are unaware. 

As a psychiatrist trained during the era of Freudian psychoanalysis, Hobson also has much to say about Freud’s views on dreams. He delights in contrasting his own “neurodynamic” view of dreaming as a particular state of brain activity with the Freudian view of dreams as psychodynamic experiences in which the ego translates thwarted instinctual drives into dream symbolism that the analyst helps the patient to decode. Whereas psychoanalysis sees the unconscious mind as the enemy within, filled with primitive impulses that need to be suppressed, Hobson on the whole is grateful that so many functions of the body can be taken care of without the need for conscious intervention. 

Whereas psychoanalysis sees the unconscious mind as the enemy within, filled with primitive impulses that need to be suppressed, Hobson on the whole is grateful that so many functions of the body can be taken care of without the need for conscious intervention.

In our era of biological psychiatry and the common treatment of mental illness with drugs, it is hard to recall just what a powerful and pervasive influence psychoanalytical thinking had in the first half of the twentieth century. Hobson cites the example of narcolepsy, a condition that makes people fall into sudden, short, unpredictable periods of sleep during the normal daytime waking period. In the 1950s, Freudian-trained psychoanalysts explained this organic brain disorder in terms of “repressed sexuality and guilt” and “anxiety about sex.” Nowadays, brain scientists believe that narcolepsy may be due to a disturbance of brain chemicals, the orexins, that regulate sleep, and new medicines are available to treat the disorder. 

PSYCHOACTIVE DRUGS: PLEASURE AND PERIL

Dreams are spontaneous and often bizarre experiences of altered consciousness; psychoactive drugs are a means of producing such altered states at will. Much of The Dream Drugstore is devoted to analyzing these drugs, both those used recreationally to induce an altered brain/mind state and those used medically to correct some chemical imbalance in the brain. 

Dreams are spontaneous and often bizarre experiences of altered consciousness; psychoactive drugs are a means of producing such altered states at will.

Hobson tries to explain how drugs can induce a dreamlike state of consciousness, or mimic some features of psychotic illness, through their effects on brain chemistry. By contrast, he says, drugs used to treat mental illness act by correcting imbalances in this chemistry. Hobson rightly acknowledges the radical improvements in the treatment of mental illnesses made possible by these drugs, but he views the current fashion for Prozac and related serotonin selective reuptake inhibitors with some concern, worried about their overuse and the disruptive effects that these drugs can have on REM sleep. 

The discovery of powerful psychedelic drugs during the 1960s and 1970s helped launch a drug culture among young people. Despite all attempts to outlaw psychedelic drugs, they continue to be popular, particularly among the young, with Ecstasy the latest fashion in designer drugs. Hobson likes to compare the state of consciousness induced by drugs such as LSD with dreaming, and there are parallels: LSD causes heightened visual imagery, bizarre mental thought processes, and impaired memory, just what we experience in REM sleep. Indeed, these similarities led to the brief popularity in U.S. psychiatry of using LSD to induce a dreamlike state in patients with mental illnesses, in the hope that this might facilitate a Freudian insight into their condition. Between 1950 and 1965, more than a thousand scientific papers were published on such uses of LSD, in studies that involved more than 40,000 patients. 

Furthermore, as Hobson points out, Harvard professor Timothy Leary and his followers claimed that LSD was a chemical means of inducing a state akin to religious enlightenment. It remains a fascinating feature of many drug-induced experiences that the user becomes convinced that he or she has experienced profound philosophical or metaphysical insights. This feature is not unique to LSD, although this drug more than any other is claimed to mimic the mystical experience. Take the vividly described experience of the novelist Aldous Huxley in The Doors of Perception of taking the psychedelic drug mescaline: 

I took my pill at eleven. An hour and a half later I was sitting in my study, looking at a small glass vase. The case contained only three flowers—a full-blown Belle of Portugal rose, shell pink with a hint at every petal’s base of a hotter flamier hue; a large magenta and cream-coloured carnation; and, pale purple at the end of its broken stalk, the bold heraldic blossom of an iris. At breakfast that morning I had been struck by the lively dissonance of its colours. But that was no longer the point. I was not looking now at an unusual flower arrangement. I was seeing what Adam had seen on the morning of his creation—the miracle, moment by moment, of naked existence…a bunch of flowers shining with their own inner light and all but quivering under the pressure of the significance with which they were charged. 

This kind of experience does not come only from the so-called psychedelic drugs. I think that Hobson would enjoy the following episode related by Mike Jay, in his entertaining account of the social history of psychoactive drugs in the nineteenth century, Emperors of Dreams. In 1799, the young British chemist Humphry Davy, in the heroic tradition of self-experimentation, tested the effects of the newly discovered gas nitrous oxide by inhaling several liters of it. Jay relates what happened next:

 It became clear that Davy’s only analogy for this type of chemical intoxication—alcohol —would be of no help at all in understanding what was happening to him. Far from dulling his senses, the gas was elevating them to levels which he had never imagined possible. His hearing became fantastically acute: he could hear every sound in the room and, as he concentrated on the echoing babble, he began to sense that he was hearing sounds from far beyond the room— a vast and distant cosmic hum, the vibration of the universe itself…He was rising effortlessly into new worlds, worlds which had perhaps—until this moment—been the provenance of the Gods. Somehow the whole experience was irresistibly funny. 

Nitrous oxide, more commonly known as laughing gas, had a brief period of popularity in the nineteenth century as a recreational drug, and it later gained a genuine place in medicine as the first effective dental anesthetic. Users of marijuana and opiates have reported similar transcendental experiences. 

Hobson points out, though, that psychoactive drug experiences are not always pleasurable or revealing. Huxley wrote another book about his experiences of LSD as Heaven and Hell, describing the nightmarish experience of the bad trip in contrast to the mystic enlightenment of drug-induced heaven. Hobson likens the bad trip with LSD to psychotic illness, although here even he admits that the dream analogy may be stretched too far. The experience of the schizophrenic patient is characterized by auditory hallucinations— often hearing voices talking about the patient in the third person—and by delusional thoughts and feelings of persecution. None of these features resembles very closely the psychedelic drug experience, although some other psychoactive drugs, notably the amphetamines and phencyclidine (angel dust) do provide more accurate models of psychosis. 

THE PHARMACY WITHIN

There are inevitably some disappointments. Hobson seems to place too much emphasis on the monoamines as chemical regulators of consciousness. Although these substances do play key roles, many other chemical messengers modulate neuronal circuits; the large family of neuropeptides, for example, is barely mentioned. 

I also find it odd that Hobson has little to say about language as a unique feature of the human brain, and how the evolution of language has led to extreme specialization of our left and right hemispheres. Julian Jaynes, in The Origin of Consciousness in the Breakdown of the Bicameral Mind, argues provocatively that consciousness, as we know it, did not exist until this specialization occurred. The British psychiatrist Timothy Crow has suggested that schizophrenia represents the evolutionary price we paid for development of language. He views schizophrenia as a disorder caused by an incorrect development of the nerve fiber tracts between the two hemispheres of the brain that connect the brain regions related to language. 

He has his own pharmacy within: the consciousness-altering chemicals in his brain and the psychedelic experiences in his dreams.

But these are minor quibbles. Overall, The Dream Drugstore is very readable and well-written, providing both a synthesis and an extension of Hobson’s earlier work. His writing about complex subjects is lucid and integrative. He gives a wide-ranging account of consciousness-altering drugs, but concludes that he has no need for any of them. He has his own pharmacy within: the consciousness-altering chemicals in his brain and the psychedelic experiences in his dreams.

EXCERPT

From The Dream Drugstore by J. Allan Hobson. © 2001 by J. Allan Hobson. Reprinted with permission of MIT Press. 

My dinner party hostess, who happened to be a descendent of Mary Arnold-Foster, sent me home with her copy of Studies in Dreams, where the technique of lucid dreaming and its psychedelic delights are described in detail. I was as attracted by the idea of flying in my dreams as I was by the power of self-hypnosis, so I followed Arnold-Foster’s prescription. I simply put a notebook by my bedside, so as to be able to record my dream recall, and told myself, before going to sleep, I’ll pay attention to my consciousness, which I would know to be dreaming because of the bizarre discontinuities and incongruities of time, place, and person. 

My response to this simple autosuggestion technique was typically three-tiered. First, I became much more aware of dreaming. Within a week I was flooded with more recall than I could record. Second, I was progressively more aware that I was dreaming while I was dreaming. At first this was simply a supposition, like “this is too weird to be waking reality, I wonder if I’m dreaming.” Then this doubt gave way to the conviction that, yes, this is a dream, and I’m watching it happen. Third, I became able to exert volitional control. This control could alter an ongoing plot like changing my movement from running to flying, interrupt the dream (so that I could briefly awaken, secure recall, and then return to the dream), or initiate a preordained plot (such as to induce the perception of brightly colored kaleidoscope-like imagery that was completely abstract). 

After a couple of weeks of practice I was flying hither and yon, meeting important people (like JFK!), and making love to all manner of oneiric bed partners in the safety and privacy of my bedroom and my dreams. The positive emotions—giddy elation, surprise, delight, humor, and erotic excitement—were all there in great abundance, even if they sometimes gave way to fear, anxiety, and doubt as non-lucid dreaming regained the upper hand. 

These self-observation experiments convinced me of the veracity of lucid dreaming as a robust and remarkable state of dissociated consciousness. What other conclusions can we draw from the experience of lucid dreaming? 

First (and foremost for this book), we can alter consciousness voluntarily and without the use of drugs to achieve many of the formal desiderata of the drug-induced psychedelic states. These include the simulation of psychosis, with exotic visual imagery; the simulation of magical behaviors worthy of Carlos Castenada’s imaginary Don Juan; the cultivation of ecstatic elation; and the experience of highly erotic sexual adventures. What else is there? Well, you might say, what about religious transports? Unification with the Godhead? “Why not?” I reply. If that’s what you want, you can probably get it, as did Emmanuel Swedenborg, whose induction procedure included intentional sleep deprivation to potentiate the REM process on which lucid dreaming rides. I’m not religious, but I bet I could hallucinate angels, saints, or even the Trinity if I tried! 

Second, it clearly demonstrates that we can master simple, safe, and economical self-hypnosis techniques. This observation has broad implications for psychiatry, for medicine, and for human behavior generally. That a voluntary practice can influence even so highly automatic and instinctual a state as REM sleep dreaming means that faith can indeed move mountains (physiological mountains, that is)... 

Third, it shows that a kind of psychic causality—or free will if you will–operates in conjunction with brain physiology. This last point illuminates the others and is so important as to deserve critical analysis. In the section that follows I consider the possible brain basis of lucid dreaming and develop a cognitive neuroscience theory applicable to all dissociative states where suggestion plays an important part.



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Scientific Advisory Board
Joseph T. Coyle, M.D., Harvard Medical School
Kay Redfield Jamison, Ph.D., The Johns Hopkins University School of Medicine
Pierre J. Magistretti, M.D., Ph.D., University of Lausanne Medical School and Hospital
Robert Malenka, M.D., Ph.D., Stanford University School of Medicine
Bruce S. McEwen, Ph.D., The Rockefeller University
Donald Price, M.D., The Johns Hopkins University School of Medicine

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