2012 Sacks Hall 

Oliver Sacks Hallucinations Knopf: New York, 2012, 326 pp.


[p. 90] 6 Altered States

     Humans share much with other animals--the basic needs of food and drink or sleep, for example--but there are additional mental and emotional needs and desires which are perhaps unique to us . . . we need meaning, understanding, and explanation . . . And we need freedom (or at least the illusion of freedom) to get beyond ourselves . . . to transcend our immediate surroundings. We need detachment of this sort as much as we need engagement . . .

     We may search, too, for a relaxing of inhibitions that makes it easier to bond with one another, or for transports that make [p. 91] our consciousness of time and mortality easier to bear. We need a holiday from our inner and outer restrictions, a more intense sense of the here and now, the beauty and value of the world we live in. 

     William James was deeply interested, throughout his life, in the mystagogic powers of alcohol and other intoxicants, and he wrote about this in his 1902 book The Varieties of Religious Experiences. He described, too, his own transcendent experiences with nitrous oxide:

     "Our normal waking consciousness, rational consciousness, as we call it, is but one special type of consciousness, whilst all about it, parted from it by the filmiest of screens, there lie potential forms of consciousness entirely different . . . Looking back on my own experiences, they all converge towards a kind of insight to which I cannot help ascribing some mystical significance. The keynote of it is invariably a reconciliation. It is as if the opposites of the world, whose contradictions and conflicts make all our difficulties and troubles, were melted into unity . . . To me [this sense] only comes in the artificial mystic state of mind."

     Many of us find the reconciliation that James speaks of and even Wordsworthian "intimations of immortality" in nature, art, creative thinking or religion, some people can reach transcendent states through meditation or similar trance-inducing techniques or through prayer and spiritual exercises. But drugs offer a short cut, they promise transcendence on demand. These shortcuts are possible because certain chemicals can directly stimulate many complex brain functions. 

     [p. 92] Every culture has found chemical means of transcendence and at some point the use of such intoxicants becomes institutionalized at a magical or sacramental level, the sacramental use of psychoactive plant substances has a long history and continues to the present day in various shamanic and religious rites around the world. 

     At a humbler level, drugs are used not so much to illuminate or expand or concentrate the mind, to "cleanse the doors of perception," but for the sense of pleasure and euphoria they can provide. 

     All of these cravings, high or low, are nicely met by the plant kingdom, which has various psychoactive agents that seem almost tailored to the neurotransmitter systems and receptor sites in our brains. [They are not, of course; they have evolved to deter predators or sometimes to attract other animals to eat a plant's fruit and disseminate its seeds. Nevertheless, one cannot repress a feeling of wonder that there should be so many plants capable of inducing hallucinations or altered brain states of many kinds. [1] 

     [p. 92] Ft. note 1. Curiously, lower plants--cycads, confers, ferns, mosses, and sea weeds--lack hallucinogenic substances. 

     Some nonflowering plants, however, contain stimulants, as the Mormons, among others, discovered. Mormons are forbidden to use tea or coffee. But on their long march along the Mormon Trail to Utah, the pioneers who were to found Salt Lake City, the new Zion, noticed a simple herb by the roadside, an infusion of which ["Mormon tea"] refreshed  and stimulated the weary pilgrims. The herb was ephedra, which contains ephedrine, chemically and pharmacologically akin to the amphetamines. 

     Richard Evans Shultes, an ethnobotanist, devoted much of his life to the discovery and description of these plants and their uses, and Albert Hofmann was the Swiss chemist who first synthesized LSD-25 in a Sandoz lab in 1938. Togther [p. 93] Schultes and Hofmann described nearly a hundred plants containing psychoactive substances in their Plants of the Gods, and new ones continue to say nothing of new compounds synthesized in the lab.) [2]

     [Ft. note 2] Quite by accident Hofmann discovered the hallucinogenic power of LSD when he synthesized a new batch of the chemical in 1943. He must have absorbed some through his fingertips, for later that day he began to feel cold and went home, thinking he had a cold. As he lay in bed, he experienced "an uninterrupted stream of fantastic images of extraordinary plasticity and vividness and accompanied by an intense kaleidoscopic play of colors." Jay Stevens in his book Storming Heaven LSD and the American Dream, recounted what came next. He must have absorbed some through his fingertips, for later that day he began to feel odd and went home, thinking he had a cold. As he lay in bed, he experienced "an uninterrupted stream of fantastic images of extraordinary plasticity and vividness, and accompanied by an intense kaleidoscopic play of color, Jay Stevens, in his book Storming Heaven: LSD and the American Dream, recounted what came next: Suspecting that LSD-25 had caused these fireworks, Hofmann decided to test this hypothesis . . . [A few days later] he dissolved what he thought was a prudently infinitesimal  amount  of the drug--250 millionths of a gram--in a glass of water and drank it down. [Forty minutes later he recorded a growing dizziness, some visual disturbance, and a marked desire to laugh. Forty-two words later he stopped writing altogether and asked one of his lab assistants  to call a doctor before accompanying him home. Then he climbed onto his bicycle--wartime shortages having made automobiles impractical--and pedaled off into a suddenly anarchic universe. 

     [p. 93] Many people experiment with drugs, hallucinogenic and otherwise, in their teenage or college years. I did not try them myself until I was thirty and a neurology resident. This long virginity was not due to lack of interest. 

     I had read the great classics--De Quincey's Confessions of an English Opium-Eater and Baudelaire's Artificial Paradises, among others--at school. I had read about the French novelist Theophile Gautier, who in 1844 paid a visit to the recently founded Club des Hashischins, in a quiet corner of the Ile Saint-Louis. Hashish, in the form of a greenish paste, [p. 94] had recently been introduced from Algeria and was all the rage in Paris. At the salon, Gautier consumed a substantial piece of hash ("about as large as a thumb"). At first he felt nothing out of the ordinary, but soon, he wrote, "everything seemed larger, richer, more splendid," and then more specific changes occurred. 

     . . .

     By the 1890s, Westerners were also beginning to sample mescal, or peyote, previously used only a sacrament  in certain Native American traditions.  

     [p. 95] As a freshman at Oxford, free to roam the shelves and stacks of the Radcliffe Science Library, I read the first published accounts of mescal, including ones by Havelock Ellis and Silas Weir Mitchell. They were primarily medical men, not just literary men, and this seemed to lend an extra weight and credibility to their descriptions.  . . . 

    [p. 96] [Mitchell] found he had no power to influence his visions voluntarily; they seemed to come at  random or to follow some logic of their own.

     Just as the introduction of hashish in the 1840s had led to a vogue for it, so these first descriptions of mescal's effects by Weir Mitchell and others in the 1890s and the ready availability of mescaline led to another vogue--for mescal promised  an experience not only richer, longer-lasting, and more coherent than that induced by hashish but one with the added promise of transporting one to mystical realms of unearthly beauty and significance. 

     Unlike Mitchell, who had focused on the colored, mostly geometric hallucinations that he compared in part to those of migraine, Aldous Huxley writing of mescaline in the 1950s focused on the transfiguration of the visual world, its investment with luminous, divine beauty and significance. He compared such drug experiences to those of the great visionaries and artists, though also to the psychotic experiences of some [p. 97] schizophrenics. Both genius and madness, Huxley hinted, lay in these extreme states of mind--a thought not so different from those expressed by De Quincey, Coleridge, Baudelaire, and Poe in relation to their own ambiguous experiences with opium and hashish (and explored at length in Jaques Joseph Moreau's 1845 book Hashish and Mental Illness.) I read Huxley's Doors of Perception and Heaven and Hell when they came out in the 1950s, and I was especially excited by his speaking of the "geography" of the imagination and its ultimate realm--the "Antipodes of the mind." (5)

[p. 97] Ft. note 5: Benny Shanon . . . The Antipodes of the Mind . . .  "When one thinks about it," Shanon writes, "the discovery of Ayahuasca is indeed amazing. The number of plants in the rain forest is enormous, the number of their possible pairings is astronomical. The common sense method of trial and error would not seem to apply."

     [Ft. note KR] Colieme Rentmeister [most recently of Topanga] reconstructs, rehabilitates her hip surgeries, recollects for my benefit some of her connections to Ocean Park, photography, the Santa Monica Pier, Carousel, Carousel Apartment House, contemporary art, Aldous Huxley, Big Sur, San Francisco houseboats . . . ]

     [p. 97] Around the same time, I came across a pair of books by the physiologist and psychologist Heinrich Kluver. In the first one, Mescal, he reviewed the world literature on the effects of mescal  and described his own experiences with it. Keeping his eyes closed, as Weir Mitchell had done, he saw complex geometrical patterns:

     ". . .

     [p. 98] For Kluver, these hallucinations represented an abnormal activity in the visual system, and he observed that similar hallucinations could occur in a variety of other conditions--migraine, sensory deprivation, hypoglycemia, fever, delirium, or the hypnagogic and hypnopompic states that come immediately before and after sleep. In Mechanisms of Hallucinations, published in 1942, Kluver spoke of the tendency to "geometrization" in the brain's visual system, and he regarded all such geometrical hallucinations as a permutation of four fundamental "form constants" (he identified these as lattices, spirals, cobwebs,  and tunnels.) He implied that such constants must reflect something about the organization, the functional architecture of the visual cortex--but there was little more to be said about this in the 1940s.   

     . . .

     [p. 100] [David Breslaw describes his experiences under supervised trials with psycilocibin.] Animation and intentionality appeared everywhere as did relationship and meaning . . . one sees every relationship it has to the rest of the universe, it possesses, therefore, an endless variety of meanings, and one proceeds to entertain every possible thought there is to think about it . . .

     And when the effects were most intense, there came a rich synesthesia--a mingling of all the senses, and of sensation and concepts. Breslaw noted, "Interchanges between the senses are frequent and astonishing. One knows the smell of low B  [p. 101] flat, the sound of green, the taste of the categorical imperative [which is something like veal.] 

     . . .

     [p. 102] The effects of cannabis, mescaline, LSD, and other hallucinogenic drugs have an immense range and variety. Yet certain categories of perceptual distortion and hallucinatory  experiences may, to some extent be regarded as typical of the brain's responses to such drugs. 

     The experience of color is often heightened, sometimes to an unearthly level . . . There may be sudden changes in orientation and striking alternations  of apparent size. There may be micropsia  . . . or there may be gigantism (macropsia).

     There may be exaggeration or diminution of depth and perspective or exaggeration of stereo vision--or even stereo hallucinations, seeing three dimensional depth and solidity in a flat picture. 

     [p. 103] . . . There may be enhancements or distortions or hallucinations of taste and smell, touch and hearing, or there may be fusions of the senses--a sort of temporary synesthesia . . .

     [p. 104] I had done a great deal of reading, but had no experiences of my own with such drugs until 1953, when my childhood friend Eric Korn came up to Oxford. We read excitedly about Albert Hofmann's discovery of LSD,  [and ordered some still legally from Switzerland but at such a low dose it had little or no effect.]

     . . .

     By the time I qualified as a doctor, at the end of 1958, I knew I wanted to be a neurologist, to study how the brain embodies consciousness and self and to understand its amazing powers of perception, imagery, memory, and hallucinations. A new orientation was entering neurology and psychiatry at that time; it was the opening of the neurochemical age, with a glimpse of the range of chemical agents, neurotransmitters, which allow nerve cells and different parts of the nervous system  to communicate with one another. In the 1950s and 1960s, discoveries were coming from all directions, though it was far from clear how they fit together. It had been found, for instance, that the parkinsonian brain  was low in dopamine, and that giving a dopamine precursor, L-dopa, could alleviate the symptoms of Parkinson's disease, while tranquilizers, introduced in the early 1950s, could depress dopamine and cause a sort of chemical parkinsonism. For about a century, the staple medication for parkinsonianism had been anticholinergic drugs. How did the dopamine and cholinergic systems interact? Why did opiates --or cannabis--have such strong effects? Did the brain have special opiate receptors and make opioids of its own? Was there a similar mechanisms for cannabis receptors and [p. 105] cannabinoids? Why was LSD so enormously potent? Were all its effects explicable in terms of altering the serotonin in the brain? What transmitter systems governed wake-sleep cycles, and what might be the nurochemical background of dreams or hallucinations? 

     Starting a neurology residency in 1962, I found the atmosphere heady with such questions. Neurochemistry was plainly "in" and so--dangerously, seductively, especially in California where I was studying--were the drugs themselves. 

     While Kluver had little idea of what the neural basis os his hallucinatory constants might be, rereading his book in the early 1960s was especially exciting to me in light of the ground-breaking experiments on visual perception that David Hubel and Torsten Wiesel were performing at the time, recording from neurons in the visual cortex in animals. They described neurons specialize  for the detection of lines, orientations, edges, corners, etc., and these, it seemed to me, if stimulated by a drug or a migraine or a fever might well produce  just what geometrical hallucinations as Kluver had described. 

     But mescal hallucinations did not stop with geometrical designs. What was happening in the brain when one hallucinated more complex things: objects, places, figures, faces--let alone in the heaven and hell that Huxley had described? Did they have their own basis in the brain? [8]

     [p. 105, Ft. note 8] Very little was known in the early 1960s about how psychoactive drugs worked, and early research by Timothy Leary and others at Harvard, as well as the work of L. Jolyn West and Ronald K. Siegel at UCLA in the 1970's, focussed mostly on the experiences of hallucinogens rather than their mechanisms. In 1975, Siegel and West published a wide-ranging collection of essays in their book Hallucinations: Behavior, Experience, and Theory. Here West set out [as he had in previous work] his release theory of hallucination. It is now known that stimulants like cocaine and the amphetamines [p. 106] stimulate the "reward system" of the brain, which are largely mediated by the neurotransmitter dopamine; this is also the case with opiates and alcohol. The classical hallucinogens--mescaline, psilocybin, LSD, and probably DMT--act by boosting serotonin in the brain.  

     [California, Los Angeles and UCLA also drew students from Michigan, ones who had worked with Dr. James Olds, on reward systems in the brain, Dr. Ina Samuels, with Robert McCleary on brain structure, John Liebeskind, Jackson and Kathy Beatty, on EEG activation, (and curiously, with Dr. Danny Kahnemann, who came to Michigan after receiving his PhD from Berkeley who would receive the Nobel prize in behavioral economics and others . . . ] Dr. Domino, neuropharmacology; Dr. Bart Myers, Raymond Riciputti, Larry and Cheryl Butcher; Dr. Ernie Rothschild; Some Michigan names, some names from Michigan who came to UCLA.

     [p. 106] Thoughts like this tipped the balance for me, along with the feeling that I would never really know what hallucinogenic drugs were like unless I tried them. 

     I started with cannabis. A friend in Topanga Canyon, where I lived at the time, offered me a joint; I took two puffs and was transfixed by what happened then. I gazed at my  hand, and it seemed to fill my visual field, getting larger and larger while at the same time moving away from me. Finally, it seemed to me I could see a hand stretched across the universe, light-years or parsecs in length. It still looked like a living, human hand, yet this cosmic hand  somehow also seemed like the hand of God.  My first pot experience was marked by a mix of the neurological and the divine.

     . . .

     [From the viewpoints of a naive observer/participant of the effects of psychoactive drugs on consciousness and behavior there was a great deal to learn, not the least of which was the banal, the ordinary, the expected.]

     [p. 113] The summer of 1965 was a sort of in-between time: I had completed my residency at UCLA and had left California, but I had three months ahead . . . I tried intravenous injection [at my parent's house] . . .

     [p. 115] At the end of that summer of 1965, I moved to New York ti begin a postgraduate fellowship in neuropathology and neurochemistry. 

     [p. 116]  . . . I realized that I was hallucinating or experiencing some bizarre perceptual disorder that I could not stop what was happening in my brain, and that I had to maintain at least an external control and not panic or scream or become catatonic, faced by the bug-eyed monsters around me. The best way of doing this, I found, was to write, to describe the hallucination in clear, almost clinical detail, and in so doing, become an observer, even an explorer, not a helpless victim of the craziness inside me . . .

     [A parallel question to "What have you just taken?" is "What have you just stopped taking?" or as it is classically termed "delirium tremens," the DT's: confusion, disorientation, hallucination, delusions, dehydration, fever, rapid heartbeat, exhaustion, seizures, death.] 

     . . . 

Charles Baudelaire Artificial Paradises, 1860/1995, New York, Citadel.

Thomas De Quincey Confessions of an English Opium-Eater, London: Taylor and Hessey. 1822. 

Aldous Huxley Doors of Perception, New York: Harper and Row, 1954.

Aldous Huxley Heaven and Hell, New York: Harper and Row, 1954.

William James The Varieties of Religious Experiences, A study in Human Nature, London: Longmans, Green, 1902.

Heinrich Kluver, Mescal, London: Keegan, Paul, Trench, Truboff,  1928.

Heinrich Kluver, Mechanisms of Hallucinations, Studies in Personality, (ed.) Q. McNemar and M.A. Merrill, pp. 175-207, New York: McGraw-Hill, 1942. 

Jaques Joseph Moreau Hashish and Mental Illness, New York: Raven Press, 1845/ 1973.

Benny Shanon The Antipodes of the Mind, Oxford: Oxford University Press,  2002 

Richard Evans Shultes and Albert Hofmann Plants of the Gods, Their Sacred, Healing and Hallucinogenic Powers, Rochester, VT: Healing Arts Press, 1992.

Ronald K. Siegel and Louis Jolyon West Hallucinations: Behavior, Experience, and Theory, New York: John Wiley & Sons, 1975

Jay Stevens Storming Heaven: LSD and the American Dream, New York: Grove, 1998.

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 Kelyn Roberts 2017