The phenomenon of dissociations appears more complex than it seems at first. It is very simple to attribute the dissociations to psychiatric pathologies, however, in certain cases it has been seen that the brain organization works in a very different way from what could be expected.
These two studies bring us closer to a strange reality.
NEUROIMAGEN DURING THE STATE OF TRANCE: A CONTRIBUTION TO THE DISSOCIATION STUDY
Julio Fernando Peres, Alexander Moreira-Almeida, Leonardo Caixeta, Frederico Leao, Andrew Newberg. Published: November 16, 2012
Summary
Despite the growing interest in pathological and non-pathological dissociation, few researchers have focused on spiritual experiences involving dissociative states such as mediumship, in which an individual (the medium) claims to be in communication or under the control of the mind of a deceased person Our preliminary study investigated psychography, in which supposedly «the spirit writes through the hand of the medium», in search of possible associations with specific alterations in brain activity.
We examined ten healthy psychologists: five less experienced mediums and five with substantial experience, ranging from 15 to 47 years of automatic writing and from 2 to 18 psychographs per month, using computed tomography to emit individual photons to scan the activity while the subjects wrote , both in dissociation states of trance and non-trance. The complexity of the original written content they produced was analyzed for each individual and for the sample as a whole. Experienced psychologists showed lower levels of activity in the left culm, left hippocampus, left lower occipital gyrus, left anterior cingulate, right superior temporal gyrus, and right precentral gyrus during psychography compared to their normal (non-trance) writing.
The mean scores of complexity for the psychographed content were superior to those of the control writing, both for the complete sample and for the experienced mediums.
The fact that the subjects produced complex content in a state of trance dissociation suggests that they were not simply relaxed, and relaxation seems an unlikely explanation for the activation of brain areas specifically related to the cognitive processing that takes place.
Introduction
Dissociation is typically defined as the lack of normal integration of thoughts, feelings and experiences in consciousness and memory. The idea that traumatic experiences cause dissociative symptoms is a recurrent theme in the clinical and neuroimaging literature, and some of the cognitive phenomena associated with dissociation seem to depend on the emotional context or attention. Although non-pathological dissociation is quite common in the general population, dissociative experiences are mainly studied as a risk factor for dissociative pathology.
It has been shown that spirituality and religiosity are highly prevalent in patients with schizophrenia and dissociative symptoms. However, the various methodological issues and discrepancies between the studies developed so far make it difficult to articulate a comprehensive framework for brain activity and cognitive mechanisms in pathological and nonpathological dissociation.
Although the nature of the mind and its relation to the brain remains one of the most challenging topics for science, the assumptions made in this regard are the cornerstones that guide therapeutic interventions. This study addresses important theories that support creativity and includes religious and spiritual experiences.The American Psychiatric Association noted the need to conduct more research in this field by recognizing the non-diagnostic (non-pathological) category of «spiritual and religious problems» in the DSM-IV, therefore, healthy forms of dissociation can be distinguished from those pathological
The medium, a spiritual phenomenon that has often been reported throughout the history of mankind, is defined as an experience in which an individual (the medium) claims to be in communication or under the control of a person’s mind. deceased or another non-material being. The mediumistic experiences are usually dissociative, such as motor, sensory or cognitive automatisms (for example, hearing spirits or reports of bodily movements or thoughts caused by spirits) and an identity or alternative possession. Therefore, it is not surprising that the study of mediumistic experiences was crucial for the development of ideas concerning unconscious and dissociative processes.
Pierre Janet’s classic dissociation study of 1889 examined several mediums; Carl Jung’s doctoral thesis was a case study, and William James conducted a meticulous research on the medium Leonore Piper. There has been a tendency to divide dissociation into two broad categories: detachment (a sense of separation from self or world) and compartmentalisation (inability to deliberately control actions or cognitive processes that would normally be susceptible to such control). Although sometimes also involves detachment, mediumship is generally related to the subtype of compartmentalization.
Psychography is one of the many possible dissociative forms of mediumistic expression. The «mediums of writing» or the psicógrafos affirm that they write under the influence of the spirits, and some psychographed writings have had a great impact in different communities around the world. The most important and prolific psychographic medium in Brazil, Chico Xavier, whose education ended in elementary school, produced more than 400 automatic writing books covering a wide range of styles and themes, selling several million copies, and all the profits of Copyright donated to charities.
A study on the mental health of 115 spiritual mediums found that the subjects had high socio-educational levels, showed a low prevalence of psychiatric disorders and were well adjusted socially compared to the general population.
His experience of mediumship was different from dissociative identity disorder.However, few studies have investigated the neural substrates underlying the dissociative states of consciousness related to religious experiences. In a previous study of glossolalia neuroimages, a trance-like state with vocalizations that sound like language but lacking a clear linguistic structure, the subjects were found to have reduced activity in the left caudate nucleus and the right prefrontal cortex, along with an increase in activity in the upper core. parietal lobes. Neurofunctional research on sensitive experiences, such as religious ones, requires specific methods that do not adversely affect the performance of volunteers.
As in the study of glossolalia, the present study used single photon emission computed tomography (SPECT) to measure regional cerebral blood flow (rCBF), which is closely related to brain activity. We use the SPECT neuroimaging method for this study because it allows researchers to maintain an adequate environment without distracting / anxiogenic effects for subjects who perform complex tasks that require silence and concentration. As far as we know, there have been no previous studies on the association between the claimed dissociative media states and the specific alterations of BCF.
Based on previous research on related practices, such as meditation and prayer, we focus primarily on the prefrontal cortex and anterior cingulate gyrus, since both are known to be involved in the brain’s attention network. In addition, these areas are involved, together with Broca’s area, in the production of speech. We also find evidence of changes in thalamic activity in limbic structures such as the hippocampus, and the upper temporal region is involved in several processes, including language reception. The precentral gyration may be involved in motor function related to writing. Therefore, our hypothesis-based analysis focused on these regions.
We study the neurophysiological nature of dissociative mediumship in psychography, as measured by changes in rCBF. During psychography, individuals write legible structured narratives, but often claim not to know the content or grammar of the written text. The present study aims to determine if this type of dissociative trance state is associated with specific alterations in brain activity that differ from those found when writing normally, that is, not in a state of dissociative trance. Given that the psychographed contents present complexity and planning, our a priori hypothesis was that the areas involved in the cognitive processes when writing consciously, such as the reasoning and the content of the planning, would show a similar activation during the medium trance.
Methods
We examined 10 Brazilian psychologists who had been writing automatically for 15 to 47 years, producing 2 to 18 psychographies per month, who we divided into 5 «less expert mediums» and 5 with «substantial experience». All were white, right-handed, with good mental health, and currently do not use psychiatric drugs. The criteria used to describe the mediums as ‘experienced’ consisted in having practiced mediumship for at least 20 years and produced at least 10 psychographs per month at the beginning of the study.
The 10 mediums adjusted well in terms of their family, social and professional life, and regularly helped people who had lost loved ones. None of them were paid for their mediumistic activity, which they consider part of their mission to help people. They all reported spiritual experiences in childhood or adolescence. Both groups had the same average age: experienced (48 + -9.8 years) and less experienced (48.6 + -6.7). The mediums ‘experienced’ had practiced mediumship for 37.4 + -8.8 years with an average of 15.6 + -2.2 experiences of psychography per month, against the records of ‘less experts’ of 22.4 + -14.8 years and 4.8 + -3.0 times respectively .
The number of participants needed to determine the statistical power of the study was based on previous research related to glossolalia. Several mental health inventories and qualitative assessments of subjective experience were administered. Depressive symptoms were assessed using the Beck Depression Inventory (BDI), anxiety symptoms using the Beck Anxiety Inventory (BAI), current and past mental disorders using the Appendices for Clinical Evaluation in Neuropsychiatry (SCAN) ). Borderline personality disorder and history of child abuse were based on data from the Dissociative Disorder Interview Program (DDIS) and psychiatric morbidities were evaluated using the Psychiatric Self-Reporting Questionnaire (SRQ).
The local Human Research Ethics Committee in Brazil and the Institutional Review Board of the University of Pennsylvania authorized the study, and all participants signed informed consent forms.
Neuroimaging procedures
RCBF was measured using SPECT during psychography (writing in a dissociative trance state) and the data were compared with those collected during normal conscious or non-trance writing (the control task). Both writing assignments were carried out in a quiet and low light environment. Volunteers were asked to do psychography in the same way as in their regular activity as mediums. They all followed the same procedure: they sat in the chair where they would perform their tasks, prayed, closed their eyes and concentrated. Usually, they were in a trance state a few minutes later, they took a pencil and began to write. The mediums reported entering into a trance state very easily and silently. For non-trance writing, in the same place,
After the task of psychography, all subjects were asked if they had reached the mediumistic state (contact with a deceased person), and they were also asked to rate their level of mediumistic experience from 1 «poorly achieved» to 4 «successfully. accomplished». The order of tasks was random among the subjects to avoid the sequence effect and the controlled interval between tasks ensured the distinction between trance and non-trance states for psychography and control writing, respectively.
The use of SPECT images for the purposes of this study allowed the evaluation of the trance state itself. The rCBF SPECT studies are performed in such a way that the scans reflect what is happening at the time of the radioactive marker injection, which was during control writing tasks or psychography instead of after. The subjects are scanned afterwards, but the distribution of the marker is not reversible once it is injected and collected in the brain. This allows you to obtain images of your own trance state.
The subjects began writing in the room and wrote for 10 minutes, at which time they were injected through the IV cannulas (inserted in their left arms) with 7 mCi of 99m Tc-ECD. After writing for another 15 minutes, an investigator instructed him to stop writing and they were taken to the SPECT scanner for a 40-minute scan.
The images were acquired in a triple-head scanner (Trionix Research Laboratory) using high-resolution fan beam collimators. The projection images were obtained at three-degree angle intervals in a 128 × 128 matrix (3.56 mm × 3.56 mm pixel size) at 360 °. The SPECT images were reconstructed using the filtered back projection, followed by a low pass filter and a 1st order Chang attenuation correction.
After the first exploration of the writing task, the subjects returned to the room to perform the second task (psychography or control). After observing that they performed the second task for 10 minutes, they were injected in the same way with 25 mCi of 99m Tc-ECD, without disturbing them. Then, the subjects continued to perform the second task for 15 minutes, and the session ended. Each subject was scanned (second scan of writing tasks) for 40 minutes using the same image parameters as above. The phenomenological experience of the mediums during the task of control and psychography was evaluated through a semi-structured interview just after the acquisitions of image scanning.
Analysis of complexity of written content.
After writing for 25 minutes without interruption, the written content was evaluated by a PhD in Brazilian Language and Literature with extensive experience in the qualification of essays sent for the entrance exams to the university using the Analytical Evaluation, which weighs several characteristics or components. of effective writing to provide a deep quality rating and writing skills. The writing evaluated involved approximately 350 words related to the period in which the brain was impregnated with a marker. This analysis was masked (blind) so that the analyst did not know to which group each volunteer belonged. The following criteria were used to analyze the written content: (i) punctuation, (ii) selection of lexical elements and spelling, (iii) concordance of verbs and names, and placement of pronouns, (iv) development of the subject, (v) structure of prayer and articulation between parties, and (vi) consistency. Scores varied from 1 to 4 for each criterion as follows: (1) poor, (2) regular, (3) good, and (4) very good. The content scores for the two groups were compared using the Wilcoxon Signal Classification Test.
Results
Although the subjects studied reported apparent delusions, auditory hallucinations, personality changes and other dissociative behaviors, they did not present mental disorders and were able to use their mediumistic experiences to help others. The structured clinical interviews exclude the current psychiatric illness.
None of the subjects, except one with previous signs of borderline personality disorders, showed clear signs of current mental disorders of Axis I or II. All the subjects stated that they felt very comfortable during the study and that they had successfully reached their usual trance state during the psychographic task (4 ‘successfully achieved’), and this evaluation was made shortly after the task of psychography. All reported being in their regular / wakefulness state during the control task. Seven found that writing for the control task was easy, and the three who mentioned some difficulty reported that, in general, it was difficult for them to write written texts in their daily lives.
During psychography, all mediums reported altered states of consciousness, but to different degrees. Experienced mediums spoke of a deeper trance, with a clouded consciousness, often reporting that they were outside the body and that they had little or no awareness of the content of what they were writing.
The groups were assigned randomly, so there were no significant differences in the mean time between the scans. When using a t test analysis of the regions according to the voxel counts, there were no significant differences when the whole group was analyzed. However, subjects experienced during the control condition showed significantly greater activity in these regions (p <0.001 for all regions) than less experienced mediums. Significantly higher rCBF (p <0.01 for all regions) was shown in several areas of the brain by less experienced psychologists, particularly in the left culm, left hippocampus, left inferior occipital gyrus, left anterior cingulate, right superior temporal gyrus and right precentral gyrus during psychography compared to normal writing (without trance). The precentral gyro approach actually covers the precentral gyrus and the medial frontal gyrus, but we report the region as a function of the MNI coordinates. Experienced mediums of writing in a trance state showed rCBF consistently lower in these regions than when writing in the control condition.
The difference was significant in comparison with the less experienced (p <0.05).
The written content produced by the subjects during both types of tasks, with or without medium trance, had never been written before. The level of complexity of both types of written content (psychographed and control-task) was analyzed individually for each topic. The content produced during media writing and control usually involved ethical principles, the importance of spirituality and the union of science and spirituality. The mean scores of complexity for the psychographed content were higher than those of the control writing, both for the complete sample [16.8 (SD 3.33) vs 14.4 (SD 2.95) – p = 0.007] and for the experienced mediums [18.4 ( SD 2.30) 3.36) – p = 0.041]. For less experienced mediums, the difference was almost significant [15.2 (SD 3.63) versus 13.4 (SD 2.41) – p = 0.066].
Finally, a linear correlation analysis was performed that compared the change in the global complexity score so that the written content changed in CBF in the six regions identified as being significantly associated with the state of psychography.In general, there was a trend towards an inverse correlation between the change in complexity and the change in the CBF in each region. The correlation coefficients varied from 0.59 to 0.74 for p values from 0.03 to 0.12. All correlations were reversed, so that the greatest increases in complexity were associated with a progressive decrease in HR in each region.
Discussion
Our hypothesis was not confirmed for less expert psychologists, since the results showed significant changes in the rCBF in several areas of the brain during psychography compared to writing without trance. In addition, contrary to our hypothesis, experienced mediums who write dissociatively in a trance state showed a consistently lower rCBF in these regions than when writing in the control condition.
In relation to the hypnotic suggestion, some studies showed prefrontal activation, but not others, while our subjects showed lower levels of activity in the frontal care system. Although reduced frontal-parietal connectivity and frontal deactivations are observed after a hypnotic induction in highly suggestive individuals, hypnosis is phenomenologically distinct from mediumistic expressions, therefore, the two conditions are not directly comparable. In addition, the idea that hypnosis reflects dissociative states remains controversial.
Brain scanning studies of meditation have generally found an increase in frontal lobe activity and a related care network, unlike our findings for experienced mediums. Although meditative states do not necessarily involve dissociation and phenomenological expressions are very different from psychography, a recent study suggested that meditation improves the efficiency of brain functioning, so that experts’ brain activation levels are lower than those of less experienced meditators, pattern similar to that reported in the present study.
Previous research in neuroimaging has shown that writing is a complex process that requires synchronized cognitive, language and perceptual-motor skills. The complexity of the written content reflects the creativity of the author and the planning work that underlies the underlying activity in the precentral gyrus, the right superior temporal gyrus, the left anterior cingulate, the hippocampus, the culm and the occipital lobes. Damage or hypoperfusion in these regions has been correlated with severely damaged writing.
In particular, experienced mediums showed higher complexity scores, suggesting that planning for psychographed content was more sophisticated than for written content when it was not in a dissociative mediumistic trance. The greater complexity of the text that involves more creativity and planning work during psychography would presumably require more activity in the central precentral gyrus, the right superior temporal gyrus, the left anterior cingulate, the left hippocampus, the left culm, and the left inferior occipital gyrus that the task of control less complex, but this was not the case, especially for experienced mediums.
Findings about the lower activity levels of the left hemisphere and the higher activity of the right hemisphere have been reported in pathological expressions of dissociative and psychotic experiences. Unlike our volunteers, patients with schizophrenia had lower blood flow levels in the left hemisphere regions, while areas of higher flow may reflect the need to turn to the right hemisphere to compensate for deficits in the left hemisphere networks . In addition, BCS abnormalities in the anterior, precentral, temporal, and culminating cingulate could predict the development of psychosis in high-risk subjects with a subsequent transition to psychosis. The anterior cingulate is involved in the attention system along with emotional regulation, learning, memory, error detection, conflict monitoring, strategy planning and empathy. The decrease in the activity of the anterior cingulate, the precentral gyrus, the superior temporal gyrus and the hippocampus in experienced mediums may partly explain the absence of focus, self-consciousness and consciousness during the dissociative state observed in psychography. Despite several similarities with brain activation related to schizophrenic patients, the subjects who participated in the present study did not present schizophrenia or any other mental illness. This finding underscores the importance of further research on the differential diagnosis between pathological and nonpathological dissociation.
We try to maintain the greatest possible similarity between the groups in order to better compare their brain functions. The differences observed in CBF may be related to their different levels of experience, but may also reflect differences in anxiety, effort or efficiency. For example, studies have shown that anxiety is associated with increased uptake in the right ventral frontal cortex and the insula / left area. Therefore, some of the changes we observed may have reflected anxiety, although none of the subjects reported particularly high levels of anxiety or stress.
Studies of cognitive skills have revealed two general patterns of changes in brain activity. Several studies have found that experts and non-experts show greater activity in different regions. The level of activity in the area of the fusiform face (FFA) when experts identify objects such as cars or birds, predicts performance in a measure of behavior of the experience performed outside the scanner. However, studies have found that some regions of the brain show increases while others show decreases during the task performed by experts.
Observations of the calculations made by experts have reported an increase in activity in the medial frontal gyrus, the parahippocampal gyrus, the anterior cingulate gyrus and the right-middle occipito-temporal junction, as well as the left paracentral lobe
Other studies of arithmetic expertise have shown larger regions of greater activity.These results suggest that experts use different or more extensive brain pathways.However, other studies suggest that more skilled subjects make more efficient use of regions and brain activity. Under these circumstances, less brain activity is observed in cognitive tasks. On the other hand, those who struggle to perform cognitive tasks often have to recruit more areas of the brain as a compensatory mechanism.
The results of the present study suggest that the level of experience may have an important effect on brain function. There was a tendency towards an inverse correlation between the change in complexity and the alteration of the CBF in each region. Given that these correlations were reversed, the implication is that greater increases in complexity were associated with a progressive decrease in HR in each region. This interesting finding that takes into account the complexity of psychographed texts deserves future research and elucidative hypotheses. It could be speculated that these findings were related to improvisation musical performances, in which the activity decreased in some areas of attention has been involved in a change induced by training to the inhibition of attention driven by stimuli.
In addition, a recent study showed that alcohol consumption, which decreases frontal lobe activity, seems to improve creativity. However, the states of musical improvisation and alcohol consumption are quite peculiar and different from psychography. Future research is needed to thoroughly compare psychography with other similar states and to clarify more precisely the relationship between frontal lobe function and the depth, intensity and complexity of the written content produced in this interesting mediumistic state.
In general, the fact that experienced mediums had less rCBF than less experienced mediums may be due to having more years of practice and doing more psychographs per month. However, considering the high complexity scores of the experts for their psychographed content, it is not clear whether the decrease in brain activity is related to a more efficient brain function during the task, or the influence of other variables.
Although we know the problems to conceptualize the trance, for the purpose of this study we use a more consensual and phenomenological definition of the trance proposed by Cardeña: a temporary alteration of consciousness, identity and / or behavior evidenced by at least two of the following :
(1) marked alteration of consciousness;
(2) reduced knowledge of the immediate surroundings;
(3) Experienced movements that are beyond one’s control.
In qualitative terms, given that there is not a single expression of mediumship, but rather important differences between people and occasions, our subjects reported on various types of «spiritual contact». The less experienced mediums were emotionally affected and reported that they felt inspired during the psychography, and that they were in a semi-conscious state (the sentences arrived as if they were dictated) in relation to the written content, while the experienced mediums said that they were «Out of their bodies» and had no control over the content «elaborated by the spirit».
The superior temporal gyrus, which contains the auditory cortex, was activated during psychography for the less experienced mediums, who listened to sentences as if they were dictated, but were deactivated in the experienced subjects, who had no conscious control over the psychographed content. The superior temporal gyrus is also involved in linguistic comprehension and is a key area related to auditory hallucination in psychotic patients.
The decrease in activity of the left prefrontal cortex, which is involved in the classification and classification of the experience may be related in part to the subjective description of the dissociative trance as reported by experienced mediums, and is consistent with the notion of writing automatic Instead of planning the written content. Language processing studies consistently show that the superior temporal cortex and the precentral gyrus are crucial for word processing and its hypoperfusion results in the selective deterioration of written work. Constant activation is expected in these areas during writing in healthy subjects. These regions were hypoactivated in the brain of the subjects experienced during psychography, and did not show the deteriorated written text that we would expect with the hypoactivation presented.
The lowest level of activity in the temporal cortex and the precentral gyrus, as well as the hippocampus and the anterior cingulate in experienced mediums, supports their subjective reports of ignorance of the written content during psychography. It should be noted that no changes were observed in the CBF in the caudate nuclei described above in the glossolalia. The subjects also showed a reduced CBF in the right prefrontal cortex, and these discrepancies may be related to different tasks related to language processing during these trance-like states.
The subjects attributed their writing in trance to «spirits». Compared to normal writing, less experienced media showed greater activation in the same areas of cognitive processing during psychography, whereas experienced media showed a significantly lower level of activation.
The less experienced had to «work harder,» as evidenced by their relatively high levels of activation of the area of cognitive processing during psychography.Experienced media showed a significant reduction in rCBF changes during psychography, which is consistent with the notion of automatic (non-conscious) writing and their claims that an «external source» was planning written content.The brain regions that are known to be involved in writing planning were activated less, although the content was more elaborate than their writing without trance.
These findings are not consistent with falsification or role play, which have been offered as explanations for psychography. Neural circuits related to planning would probably be recruited to compose more elaborate texts if the subjects were faking trance states.
Conversely, studies of regions of cognitive processing involved in reasoning and written content planning showed a decrease in activity in experienced mediums, who reported that they were not aware of the psychographed content and that they had no control over it.
The subjects reported that their trance state implied a «relaxed state of mind». The state of relaxation could only explain the lower overall activity of the brain, but the fact that the subjects produced complex content in a state of trance dissociation suggests that they were not simply relaxed. In addition, relaxation seems an unlikely explanation for the activation of brain areas specifically related to the cognitive processing that takes place. As a first step toward understanding the neuronal mechanisms involved in non-pathological dissociation, we emphasize that this finding deserves further investigation in terms of both replication and explanatory hypotheses.
In non-pathological conditions, a person may benefit from these dissociative abilities, although such a disposition may become dissociative pathology after adverse / traumatic events. The absence of current mental disorders of Axis I or II in the groups is in line with current evidence that dissociative experiences are common in the general population and not necessarily related to mental disorders, especially in religious / spiritual groups. Alterations in medium blood flow differed between experienced and less experienced subjects, highlighting the diversity of the dissociative phenomenon in healthy subjects and suggest that additional research should address the criteria for distinguishing between healthy and pathological dissociative expressions in the field of mediumship.
A limitation of this study arises from the small sample size, which obviated the detailed analysis that a larger sample could support. We only use a threshold for the groups as a correction of importance, since the correction for multiple comparisons would be too conservative for this exploratory study. However, in a larger study, we could perform a more robust analysis to correct multiple comparisons, as well as correction of small volumes. Nor do we perform a single subject analysis since we consider this study as exploratory, and therefore we simplify the analysis to random effects in an attempt to determine the basic differences between the groups.
Different lines of research come together in a promising development that points to a deeper understanding of consciousness and dissociation. Although the study of spiritual experiences such as mediumship is fundamental to the development of our current understanding of the mind, researchers neglected its relevance in the last century. The present study provides useful preliminary data and points to the potential usefulness of deep, epistemologically informed studies of dissociative states of consciousness and spiritual experiences to improve our understanding of the mind and its relation to the brain.
DIFFERENCES BETWEEN TRANQUILIZATION OF TRANCE AND MULTIPLE PERSONALITY DISORDER IN STRUCTURED INTERVIEW
Dureen J. Hughes Los Angeles, California
Trance channeling and multiple personality disorder seem to be based on the basic mental process of dissociation. Dissociation has been defined, very simply, as the opposite of association. The elements of the psyche can be in a dynamic relationship with each other, in which case the thoughts, feelings, experiences, etc.they are integrated into consciousness and memory (association). Or these same elements of the psyche may be relatively isolated and separate, in which case they dissociate (Ross, 1989, p.87). This concept goes back to Janet (1977). While dissociation itself is a «normal human ability» (Richards, 1990), it is generally accepted that there is a continuum of dissociative phenomena (Bernstein and Putnam, 1986). Bernstein and Putnam have characterized this continuum as «from the minor dissociations of everyday life to the main forms of psychopathology such as multiple personality disorder» (1986, p.728), whereas Richards (1990) has characterized it as from automations . from routine behaviors in one extreme to «co-consciousness» in the other. While Prince defined «co-consciousness» as simply the simultaneous but separate presence of two streams of consciousness (1978), Richards uses the definition of Beahrs, Le, «the existence within a single human organism of more than one that experiences consciously a psychological entity, each with a certain sense of its own identity or sameness, relatively separate and discrete from other similar entities «(1982, p, 182). The phenomena in the far end of the dissociative continuum are the objective of this study.
Dissociation in the form of, or accompanied by, co-consciousness is currently found in at least two forms in our own culture: trance channeling and multiple personality disorder. Klimo (1987, p.2) has defined trance channeling as «the communication of information through a human being embodied physically from a source that is said to exist in some other level or dimension of reality than the physical as we know . that, and that’s not from the normal mind (or me) of the channel. « While this activity could be classified as a type of «possession» according to Winkelman’s definition, that is, «a trance state interpreted by culture as a condition during which the personality of the practitioner is temporarily displaced by the personality of another entity (1986, p.194), it should be noted that the trance channels that participated in this research prefer the term «mixture» to describe their trance state.
The term «mixture» connotes harmony and mutual cooperation between the channel and the entity rather than the dominance of the channel by the entity (Hughes, 1991). Finally, some authors have chosen to include classical «mediumship» within the scope of trance channeling (Hastings, 1991; Klima, 1987).D. Scott Raga has stated that «communication is the art of bringing through the spirits of the dead specifically to communicate with their relatives. The channeling that I define is to carry through some kind of intelligence, the indefinite nature, whose purpose is to promote spiritual teachings and philosophical discussions «(cited in Klima, 1987, pp. 5-6). It is this latter definition that describes in more detail the activities of the subjects who participated in this investigation.
The TPM (multiple personality disorder) and the trance channeling may seem very similar to those of a casual observer, since there are at least two different personalities that inhabit or control the same body in each case. In addition, it seems that the trance channels conform to the criteria OSM-III-R for MPO, that is: «the existence within the person of two or more personalities or different personality states (each with its own perception pattern). relatively durable, related to, and thinking about the environment and the self) «and» at least two of these personalities or personality states take full control of the person’s behavior «(American Psychiatric Association [APA], 1987, p 272). Previous ethnographic and EEG investigations with trance channels (Hughes, 1991, Hughes and Melville, 1990) raised questions about whether «channeling» phenomena could be understood in terms of multiple personality disorder.
Consequently, structured interviews with ten trance channels were conducted using the Dissociative Disorder Interview Program (OOlS), developed by Ross and Heber (Ross, 1989, pp. 314-30) to determine the degree of overlap between the complex of symptoms that characterize the MPO. And the phenomenological experience of the trance channels. These results were compared with DDlS scores of twenty subjects with TPM as reported by Ross, Heber, Norton and Anderson in their 1989 article comparing patients diagnosed with MPD, schizophrenia, panic disorder and eating disorder. In his 1989 book on TPM. Ross further stated that these results (pp. 330-34 in that publication) are typical of TPM as it occurs throughout North America.
All subjects also completed the Dissociative Experiences Scale (EED), developed by Bernstein and Putnam (1986), to measure the frequency and number of different types of dissociative experiences among trance channels. The mean EED scores and the median of the supported items were compared for the group of trance channels and two groups of subjects whose scores were reported by Bernstein and Putnam (1986). These last two groups consisted of twenty subjects with TPM and thirty-four normal adults.
METHOD
The programming of interviews of dissociative disorders
The DDIS is a structured 131-item interview that differentiates TPM from several other psychiatric disorders, as well as normal ones, using diagnostic criteria DSM-IIl (American Psychiatric Association [APA], 1980). It has a global reliability of 0.76, a sensitivity of 90% and a specificity of 100% for the diagnosis of MPR (Ross, et al., 1989). Instead of giving a total overall score, it provides a profile of scores in several areas that can then be compared with a typical profile for a patient with TPM (Ross, 1989).
The Scale of Dissociative Experiences.
The EED is a 28-item self-report instrument with a reliability of .84. Although the EED is a screening test, rather than a diagnostic instrument, it generally distinguishes between subjects who have a dissociative disorder and those who do not (Bernstein and Putnam, 1986, Ross, 1989).
Subjects
The ten trance channels that participated in this study are the same subjects who participated in a study that measured the brainwave activity of trance channels, both in and out of trance (Hughes and Melville, 1990). All had been channeling for more than a year, two had been channeling up to seven years, and the modal experience was 3 years.
None of the subjects had currently active psychiatric diagnoses. Two subjects had previous diagnoses of anxiety disorder, one subject had a previous diagnosis of depression and one subject had previous diagnoses of depression and obsessive-compulsive disorder. Seven of the ten had no active physical diagnoses. Of the rest, a 74-year-old man had cardiac dysrhythmia, a 64-year-old man had high cholesterol and bladder problems, and a 35-year-old male had rheumatoid arthritis, lupus, autoimmune disease, and migraine headaches.
Ethical approval (in the form of an Exemption Statement) to interview the subjects was obtained from the Committee for the Protection of Human Subjects at the University of California, Los Angeles.
Interview management
Nine of the subjects were interviewed by the author. Each interview (DDIS and EED) lasted approximately forty-five minutes. A subject had moved out of the area and, therefore, a modified DDIS was mailed, that is, all subject headings and «notes» were deleted that may have biased the subject against positive responses (due to the implications of psychopathology). The real questions of the interview remained unchanged. The unmodified EED was also completed by the subject through the mails.
The data were analyzed by t tests for continuous data, Fisher’s exact test for dichotomous data and comparison of EED medians.
RESULTS
Demographic characteristics of the subjects
The ten subjects were divided equally in terms of sex. Their age ranged between 31 and 74 years, with an average age of 47.6 (SD = 13.17). Four were married and, as a group, had an average of 0.6 children (SD = 1.07). All, except one of the subjects, had some post-secondary education; four had obtained baccalaureate degrees, two had master’s degrees and two had doctorates, occupations varied widely, but all were employed and all could be classified as middle-to-upper-middle class. Eight had never been imprisoned; the other two each spent a few hours in jail for minor infractions.
Clinical characteristics of the subjects
The trance channels differed from the TPM subjects in all the DSM-III diagnoses performed by the DDIS. Although the differences between the trance channels and subjects with TPM were not significant at the .05 level with respect to the DSM-III diagnoses of psychogenic leakage and somatization disorder, it should be taken into account that this is due to the percentage (relatively) small of the subjects with positive TPM for these diagnoses, since none of the trance channels was positive for these diagnoses. The average number of somatic symptoms (used in the diagnosis of somatization disorder) for subjects with TPM in 13.5 (Ross, 1989, p.331), which is compared with an average number of somatic symptoms for trance channels of 1.8 (p <.0001). The average number of positive limit criteria for subjects with TPM is 5.3 (Ross, 1989, page 332), which is compared with an average number of positive limit criteria for trance channels of 0.3 (p <.0001).
The trance channels differed from the TPM subjects in four of the six historical elements that are known to be associated with TPM
The trance channels differed from the TPM subjects in sixteen secondary characteristics of TPM. These include objects that are missing or present where the person lives, changes in handwriting, strangers who know it, do or say things that can not be remembered, missing periods of time, «reach» in an unknown place, amnesia in much of childhood after five years, flashbacks, depersonalization, auditory hallucinations, speaking of oneself in the plural, and feeling that there is another person inside someone who has a name and takes control of the body. The trance channels also differed from the TPM subjects with respect to sixteen types of supernatural experiences that included things like mental telepathy, clairvoyance, telekinesis, clairvoyant dreams, deja vu, feeling possessed, having contact with ghosts, poltergeists or spirits, know something about past lives, and be involved in worship activities. Finally, the two groups differed with respect to eleven symptoms of Schneider’s first-ranking schizophrenia.
While Ross, et al. do not provide data regarding the average number of previous psychiatric diagnoses for the twenty subjects with MPD, two large series of patients with MPD have shown averages of 3.6 and 2.74 (Putnam, et al., 1986, Ross, Norton and Wozney, 1989) . The average for the trance channels was 0.5, and when compared to 2.74 (the average of the large series of Ross, et al.), It is significant at the level of .0001.
EED scores of the subjects
The trance channels differed from subjects with TPM with respect to the frequency of dissociative experiences (average EDS score) and the number of different types of dissociative experiences (median number of endorsed EED items). There were no differences between trance channels and normal subjects with respect to these elements.
Although Bernstein and Putnam (1986) do not provide data regarding the average EED score of the twenty subjects with TPM, a separate study comparing TPM and complex partial seizures (Ross, Heber, Anderson, et al., 1989) does provide said data. for a separate group of twenty TPM subjects. The average EED score for those subjects with TPM is 38.3 (SD = 20.9) which is compared with an average EED score for trance channels of 6.28 (SD 4.78).
This is significant at the level of .0001 (t = -21.18). When the average EED score of the trance channels is compared to the average EED score of twenty-eight neurological controls (5.2) (SD = 6.6) as reported in the complex study of partial attacks (Ross, Heber, Anderson, et al., 1989) there is no significant difference (t = .71).
DISCUSSION
The results presented above indicate that trance channels can not be characterized as suffering from psychogenic amnesia, psychogenic leak, depersonalization disorder, somatization disorder, depression, borderline personality disorder or schizophrenia (Tables 1 and 3). They rarely have histories of substance abuse, physical abuse or sexual abuse (Table 2).
Despite the fact that three of the ten channels had complied with the strict DSM-III criteria for TPM (Table 1), I believe that none of them can be validly diagnosed as multiples according to the lack of secondary characteristics of TPM (Table 3) as well as the general profile.
The TPM has been characterized as «the great imitator in psychiatry» (Ross, 1989, p, 94) because patients are polysymptomatic and often have numerous previous diagnoses, as well as a long history of mental health. The subjects of this study did not fit this general profile, either individually or collectively.
It should be noted that three of the ten subjects responded negatively to the question «trance states» (Table 2), even though they all identified themselves as «trance channels». Question # 69 asks: «Have you ever had an episode similar to a trance in which you stare into space, lose awareness of what is happening around you and lose track of time?» (Ross, 1989, p 322). The three channels that responded negatively to this question objected to several aspects of the wording of the question, since it did not accurately describe their experience.
It is also interesting to note that trance channels averaged almost twice the number of supernatural experiences than subjects with TPM (Table 3) because the presence of these experiences differentiates TPM from other diagnostic groups (Ross, 1989, pp 108). , 332).
When the data were examined more closely, it was found that responses to this section of the DDIS were grouped as follows. All the subjects had experienced mental telepathy, deja vu, contact with spirits, knew something about past lives and additional supernatural experiences not specified in the DDIS. Eight of the ten had experienced clairvoyance, and six had experienced the dreams of clairvoyance.On the other hand, none had experienced telekinesis or had been involved in cult activities. Half had experienced contact with ghosts, with three of them having experienced contact with poltergeists. Finally, regarding the question about possession, one felt possessed by a demon, one felt possessed by a dead person, two felt possessed by some other power or force, and none felt possessed by a living person.
Ross has suggested that ESP experiences are a non-clinical form of dissociation that can occur in healthy, highly functioning individuals (1989, p, 184). This suggestion is based on the results of an unpublished study in which eleven non-traditional therapists and seventeen residents of psychiatry were interviewed with DDIS and EED. According to Ross (1989, p.184) «None of the groups exhibited a notable degree of psychopathology … The element that most clearly differentiated non-traditional healers from the residents of psychiatry was the PES experiences, which were very common in the group based on the community. Both groups had low rates of child abuse. «
It would seem that, although supernatural / ESP experiences can actually differentiate TPM from other diagnostic groups, they are found in a variety of other (non-pathological) contexts and, therefore, should not be considered inherently symptomatic of mental pathology.
With respect to the EED scores (Table 4), it seems that while these subjects are clearly involved in the dissociative behavior at the far end of the dissociative continuum (Le. «Co-consciousness»), as a group they do not experience the types of dissociative phenomena. He talked about the EED more often than the normal ones. This suggests that quite dramatic forms of dissociation (co-consciousness) can exist independently not only from other types of dissociative experiences, but also from a high degree of general dissociation. This may call into question the concept of a single dissociative continuum that occurs naturally, without denying the fact that people who have experienced severe trauma (such as those with TPM) tend to a large number of different types of dissociative experiences, and have these experiences with some frequency.
Etiology
It has been widely recognized that the TPM is a psychobiological response to overwhelming trauma during early childhood. The form this trauma takes is severe and repeated physical and sexual abuse. A 1986 survey by the National Institutes of Mental Health found that 97% of all patients with MPD reported having experienced significant trauma in childhood (Putnam, et al., 1986).
Dissociation seems to be an adaptive strategy used by these very young children to survive (Ludwig 1983, p.95). Ross has stated that, very simply, «TPM is a child who imagines that abuse is happening to another person» (1989, p.72). Therefore, according to Putnam, «repeated childhood traumas increase the normative dissociative capacities, which in turn provide the basis for the creation and elaboration of personality states altered over time» (1989, p.45).
The channeling of trance, on the other hand, is an activity that, according to its participants, promotes personal growth and development through the experience of altered states of consciousness. Very often it is learned as a skill that is routinely taught to adults with no history of physical or sexual abuse. The form taken by this training is of a meditative nature, using visualization techniques, and is often performed within the context of trance channeling classes (Hughes, 1991).
Function
TPM also differs from the trance channel with respect to the dissociation function.For multiples, dissociation is a defense mechanism, a way to block the conscious awareness of horrible emotional and physical pain. It is also its main coping mechanism: when things go wrong, they dissociate compulsively (Putnam, 1989, p.141).
For trance channels, dissociation is a method to achieve altered states of consciousness in a search for a sense of spiritual connection with something greater than oneself. In addition, there is a series of trance activities or exercises that entities (disembodied personalities) «do» with their channels while they are in a trance. These activities add to the feeling of not only having a spiritual life, but also of expanding or improving it (Hughes, 1991).
Control
There are also differences with respect to the control over the «switching process».The multiples are dissociated compulsively, and the change between different personalities is triggered by any number of environmental and internal stimuli (Putnam, 1989, p.117, Ross, 1989, p, 103). In contrast, the trance channels exert complete control over the «process of change». They consciously decide when, where and if they will go into a trance. There are specific contexts, somewhat stylized, culturally appropriate for the activity, and the «entities» are not fulfilled unless they are invited (Hughes, 1991).
Pathology
Finally there is the matter of pathology. The TPM is, above all, a dissociative disorder. Ross has compared patients with MPT to circumpolar shamans and has found that while «shamans were healthy and used their dissociation in a culturally integrated manner, the patient with MPD tends to be dysfunctional and socially isolated» (1989, page 13). .
Peters and Price-Williams have suggested that the cultural incorporation of an altered state of consciousness can be an important means of discriminating the pathological states of shamanism (1980, p 406). Bourguignon has pointed out that «the great difference between patients with TPM and the characteristic initiate of Haitian cult (or, for that matter, an agent of possession in any of our 251 sample societies and many others as well) is that they are (the personality multiple) the dissociations are purely idiosyncratic; behavior is not learned by following a cultural model «(1976, p.38).
Trance channeling is a form of dissociation that is not idiosyncratic, but is highly contextualized culturally through trance channeling classes, specific meditative techniques, etc. Trance channels also use dissociation in a culturally integrative manner, since they use their psychobiological capacity for dissociation in order to update, on a personal level, culturally relevant topics, such as personal growth, increased responsibility for their own lives , self-confidence and the empowerment of the individual (Hughes, 1991).
Although the absence or presence of cultural contextualization can be an indicator of whether a specific type of co-consciousness can be categorized as «pathological», I think it would be specious to suggest that the contextualization that explains the lack of psychopathology evidenced among the channels is cultural. of trance that participated in this study. Rather, I would suggest that it is the experience of trauma, to which dissociation is a reaction, that leads to the psychopathological aspects of the TPM, rather than the process of dissociation itself.
Furthermore, I would suggest that it is the lack of repetitive dissociation induced by trauma in early childhood that explains the lack of psychopathology evidenced among the trance channels that participated in this study despite the fact that they clearly evidence co-consciousness. In summary, it can not be assumed that extreme dissociative phenomena, ie, co-consciousness, are inherently pathological or automatically accompanied by psychopathology, nor can one form (for example, trance channeling) be equated with another (for example, TPM). ), even when they are within the same society.
CONCLUSIONS
These DDIS and EED data indicate that trance channels differ in a highly significant way from subjects with multiple personality disorder. It can not be presumed that the trance channels are multiples despite the fact that both groups exhibit co-consciousness (extreme dissociative behavior). The trance channels do not show a high degree of psychopathology (DDIS results), nor do they experience a high frequency or a large number of different types of dissociative experiences (EED results), but they do experience trance states and extra-sensory and supernatural experiences. Although both trance channeling and TPM are based on dissociation at the mental process level, they differ with respect to etiology, function, control and pathology.
For multiples, the dissociation with co-consciousness is idiosyncratic and compulsive, while for trance channels, the dissociative experience with the co-consciousness that accompanies it is culturally contextualized and under the conscious control of the practitioner. It is suggested that the independent variable with respect to the psychopathological aspects of dissociation is whether the dissociative activity is induced by trauma or not, rather than where the activity could be in a dissociative continuum.
In summary, we could say that, at least, there are three very different types of dissociation: the pathological, easily diagnosable, the false, of those who «strive» to look like it and the third group whose brains work unexpectedly.
Truth and usefulness, are the touchstones that validate this phenomenon.
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