Siri Hustvedt’s The Shaking Woman, or a History of My Nerves, is a genre-bending memoir that calls itself an essay and manages somehow to read like a mystery novel.

The mystery plot is driven by Hustvedt’s search for the roots of her body’s startling behavior: the sudden onset of a condition that caused her to convulse when she spoke in public (which she did often).

The first incident occurred at a memorial service for her father:

Read more:

http://californica.net/2011/10/14/the-shaking-woman-or-a-history-of-my-nerves-by-siri-hustvedt/

Article:
http://www.3sat.de/page/?source=/scobel/156253/index.html

The Prix Femina is a French literary prize created in 1904 by 22 writers for the magazine La Vie heureuse (today known as Femina). The prize is decided each year by an exclusively female jury, although the authors of the winning works do not have to be women. The winner is announced on the first Wednesday of November each year.” – Wikipedia

Romans étrangers

Siri Hustvedt, Un été sans les hommes (Actes Sud)
Eleanor Catton, La répétition (Denöel)
Jonathan Franzen, Freedom (L’Olivier)
Francisco Goldman, Dire son nom (Belfond)
Jean-Christian Grondahl, Quatre jours en mars (Gallimard)
David Grossman, Une femme fuyant l’annonce (Seuil)
Laura Kasischke, Les Revenants (Bourgois)
Joseph O’Connor, Muse (Phébus)
Alessandro Piperno, Persécution (Liana Levi)
Ursula Priess, A travers tous les miroirs (Editions Zoé)
Jon Kalman Stefansson, La tristesse des anges (Gallimard)
Duong Thu Huong, Sanctuaire du Coeur (Sabine Wespieser)

Continue reading at the New York Times.

Continue reading this post at PsychologyToday.com.

2. Cognitive scientists have repeatedly conducted the following experiment and, without fail, they come up with same results. An audience is asked to watch a film of two teams playing basketball. They are given a job to count the number of times the ball changes hands. I have done this, and one has to be very attentive to follow the motion of the ball. In the middle of the game, a man wearing a gorilla suit walks onto the court, turns to the camera, thumps his chest and leaves. Half the people do not see the great ape. They do not believe that he was actually there until the film is replayed and, indeed, a gorilla strolls in and out of the game. Nearly everyone sees the gorilla if he is not given the assignment. This has been named inattentional blindness.

3. Writing at my desk now, I see the screen but this sentence dominates my attention. In fact, my momentary awareness that there is much around the words distracts me: the blue screen of the computer beyond the white edge of the page; various icons above and below; the surface of my desk cluttered with small Post-it squares which, when I turn my head, I can read, “Habermas 254-55”, “Meany et. al, implications for andrenocortical responses to stress” scrawled on pink paper (residue of arcane research); a black stapler; and countless other objects that enter my awareness the moment I turn to them. What is crucial is that I don’t turn to them. For hours every day, I have little, if any, consciousness of them. I live in a circumscribed phenomenal world. An internal narrator speaks words and dictates to my fingers that type automatically. There is no need to think about the connection between head and hands. I am subsumed by the link. Were another object suddenly to materialize on my desk and then vanish, I might well have no knowledge of either its appearance or disappearance.

4. Once, in an unfamiliar hallway, I mistook myself for a stranger because I did not understand I was looking in a mirror. My own form took me by surprise because I was not oriented in space. Expectation is powerful.

5. There are days when I think I see an old friend in the street, but it is a stranger. The recognition ignites like a match and then is instantly extinguished when I understand I am wrong. The recognition is felt, not thought. I can’t trace what created the error, can’t tell you why one person reminded me of another.  Was the old friend a subliminal presence in my mind on that particular day or was the confusion purely external—a jut of the chin or slope of the shoulders or rhythm of a walk?

6. We do not become anesthetized to horrible photographs of death or suffering. We may choose to avoid them. When I see a gruesome image in the newspaper in the morning, I sometimes turn away, registering in seconds that looking too long will hurt me. People who gorge on horror films and violent thrillers do it, not because they have learned to feel too little, but because they indulge in the limbic rush that floods their systems as they safely witness exploding bodies. It seems that these viewers are mostly men.

7. We feel colors before we can name them.  Colors act on us pre-reflectively. A part of me feels red before I can name red. My cognitive faculties lag behind the color’s impact. Standing in a room my eyes go first to the vase of red tulips because they are red and because they are alive.

8. My mother once told me about coming home to find our cat dead on the lawn. She saw the poor animal from many yards away, but she said she knew with absolute assurance that it was dead.  An inert thing. An it.

9. Photographs of the beloved dead draw me in. I am fascinated. There is the good, dear face, one that changed over time.  It is the picture that preserves the face, not my memory, which is befogged by the many faces he had over the years. Or is it the single face that grew old?  Sometimes I cannot bear to look. The image has become a token of grief. And yet, there is nothing so banal as the pictures of strange families.  After my father died, I found Christmas cards with photographs of unknown people among his papers—happy families—grinning into an invisible lens. I threw them away.

10. Galvanic skin response registers a change in the heat and electricity passed through the skin by nerves and sweat during emotional states.  People in white coats attach electrodes to your hands and track what happens. When they show you a picture of your mother, your GSR goes up. Meaning.in the body.

11. Is our visual world rich or poor? There are fights about this. People do not agree. Philosophers and scientists and other academics ponder this richness and poverty question in papers and books and lectures. Human beings have very limited peripheral vision, but we can turn our heads and take in more of the world. When I’m writing, my vision is severely limited by my attention, but sometimes when I let my eyes roam in a space, I discover its density of light and color and feel surprised by what I find. When I focus, say, just on the shadows here on my desk, they become remarkable. My small round clock casts a double shadow from either side of its circular base, one darker than the other, a gray and a paler gray. There is a spot of brilliant light at the edge of the darker oval. As I look, this sight has become beautiful.

12. Why is a face beautiful?

13. If an image is flashed too quickly to be perceived consciously, we take it in unconsciously and we respond to it without knowing what is happening. A picture of a scowling face I can’t say I’ve seen affects me anyway. Scientists call this masking. Blindsight patients have cortical blindness. They lose visual consciousness but not visual unconsciousness. They see but don’t know they are seeing. If you ask them to guess what you’re holding (a pencil) they will guess far better than people who are truly blind. Words and consciousness are connected. How much do I see of the world that never registers in my awareness? When I walk in the street, I sometimes glimpse a scene for just an instant but I cannot tell you what I have witnessed until a fraction of a second later when the puzzling image falls into place: that furry thing was a stuffed animal and a little boy was dangling it from his stroller. The lag again.

14. We are picture-making creatures. We scribble and draw and paint. When I draw what I see, I touch the thing I am looking at it with my mind, but it is as if my hand is caressing its outline. People who stopped drawing as children continue to make pictures in their dreams or in the hallucinations that arrive just before they go to sleep. Where do those images come from?  I dreamed grass and brush and sticks were growing out of my arm, and I got to work busily trimming myself with a scissors. I wasn’t alarmed; it was a job handled in a matter-of-fact way. If I painted a self portrait  with bushy arms, I would be called a surrealist.

15. Some people who go blind see vivid images and colors. Some people who are losing their vision hallucinate while awake. An old man saw cows grazing in his living room, and a woman saw cartoon characters running up and down her doctor’s arm.  Charles Bonnet syndrome. Just before I fell asleep, I saw a little man speeding over pink and violet cliffs. Once I saw an explosion of melting colors—green, blues, reds, and then a great flash of light that devoured them all. Hypnogogic hallucinations. Freud said dreams protect sleep. At night the world is taken from us and we make up our own scenes and stories. When you wake up slowly, you will remember more of that human underground.

16. Deprived of sight, we make visions. Seeing is also creating.

17. There are things in the world to see. Do I see what you see? We can talk about it and verify the facts. Through my window is the back of a house. One of its windows is completely covered by a blue shade. But if I tell you I see a flying zebra you will say, Siri, you are hallucinating. You are dreaming while awake.

18. Sometimes artists can make a hallucination real. A painting of a flying zebra is a real thing in the world, a real thing to see.

19. Why do I not like the word “taste” when applied to art? Because it has lost its connection to the mouth and food and chewing. I don’t like the way this picture tastes. It’s bitter. If we thought about actual tastes, the word would still work. It would be a form of synesthesia, a crossing of our senses: seeing as tasting. But usually it is not used like that anymore so I avoid it entirely when I talk about art.

20. Looking at a human being or even a picture of a human being is different from looking at an object. Newborn babies, only hours old, copy the expressions of adults. They pucker up, try to grin, look surprised, and stick out their tongues. The photographs of imitating infants are both funny and touching. They do not know they are doing it; this response is in them from the beginning. Later, people learn to suppress the imitation mechanism; it would not be good if we went on forever copying every facial expression. Nevertheless, we human beings love to look at faces because we find ourselves there. When you smile at me, I feel a smile form on my own face before I am aware it is happening, and I smile because I am seeing me in your eyes and know that you like what you see.

21. I am looking at a small reproduction of Johannes Vermeer’s Study of a Young Woman, which hangs in a room at The Metropolitan Museum here in New York.  It is a girl’s head and face. I say girl because she is very young. From her face I would guess she is no more than ten years old. When I look up the picture in one of my books on Vermeer, I see that there it is called Portrait of a Young Girl, a far better title. We should not turn girls into women too soon. She is smiling, but not a wide smile. Her lips are sealed. My impression is that she is looking at me, but I cannot quite catch her eye. What is certain is that she is answering someone else’s gaze. Someone has made her smile. She is not a beautiful child; it is her looking that is beautiful, her connection to the invisible person. There is shyness in her expression, reserve, maybe a hint of hesitancy. I think she is looking at an adult, probably the artist, because she has not let herself go. She looks over her shoulder at him. I have great affection for this girl. That is the magic of the painting; it is not that I have affection for a representation of a child’s head that was painted some time between 1665 and 1667. No, I feel I have actually fallen for her, the way I fall for a child who looks up at me on the street and smiles, perhaps a homely child, who with a single look calls forth a burst of maternal feeling and sympathy. But my emotion is made of something more; I remember my own girlhood and my shyness with grownups I didn’t know well. I was not a bold child and in her face I see myself at the same age.

22. In some of Gerhard Richter’s painted-over photographs, he painted over his wife’s face and parts of her body. He covered the bodies of his children, too, in snapshots of them as babies and growing children. In these gestures, I felt he was keeping them for himself, keeping the private hidden. Other times, he framed them with swaths of color, turning them into featured subjects. I love those pictures.

23. Mothers have a need to look at their children. We cannot help it.

24. Lovers have a need to look at each other. They cannot help it.

25. Several years ago a friend sent me a paper on mirror neurons. They were found in the brains of macaque monkeys. When one monkey makes a gesture, grabs a banana, neurons in his premotor cortex are activated. When another monkey watches the gesture, but doesn’t make it, the same neurons are activated in his brain. Human beings have them, too. We reflect each other.

26. Looking at pornography is exciting but loses its interest after orgasm.

27. Reading the end of James Joyce’s Ulysses when Molly Bloom is remembering is erotic because she gives permission, gives up and gives way, and this is always exciting and interesting because it is personal not impersonal. Isn’t it strange that looking at little abstract symbols on a white page can make a person feel such things? I see her in his arms. I am in his arms. I remember your arms.

28. When I read stories, I see them. I make pictures and often they remain in my mind after I have finished a novel, along with some phrases or sentences. I ground the characters in places, real and imagined. But I always remember the feeling of a book best, unless I have forgotten it altogether.

29. I do not usually see philosophy with some exceptions: Plato, Pascal, Kierkegaard, and Nietzsche because they are also storytellers.

30. Some people cannot make visual imagery. They do not see pictures in their minds. They do not turn words into images. I didn’t know such a thing was possible until a short time ago. They see abstractly. They remember the symbols on the page.

31. “I see” can also mean “I understand.”

32. There is a small part of the brain called the fusiform gyrus that is crucial for recognizing faces. If you lose this ability your deficit is called prosopagnosia.  It happens that a person with brain damage looks at herself in the mirror, and believes she is seeing, not herself, but a double. It seems that what has vanished is not reason, but that special feeling we get when we look at our reflections, that warm sense of ownership. When that disappears, the image of one’s self becomes alien.

33. I look and sometimes I see.

Siri Hustvedt

Psychoanalysis proposes that we are strangers to ourselves. There were precursors to Freud’s idea of a psychic unconscious in both philosophy and science. Schopenhauer and Nietzsche each had a version of it, as did the scientists, William Benjamin Carpenter in nineteenth century England and Gustav Fechner and Hermann von Helmholtz in Germany. All of them believed that much of what we are is hidden from us, not only our automatic biological processes but also memories, thoughts, and ideas. Pierre Janet, Jean Martin Charcot’s younger colleague at the Salpêtrière Hospital in Paris, pursued a psychobiological notion of the self. Ideas, he argued, can split off from consciousness, travel elsewhere, and appear as hysterical symptoms. Theories never bloom in nothingness. What is certain is that Sigmund Freud and his followers, both the faithful and the revisionist, have altered the way we think of ourselves. But the question here is about the novel. Has psychoanalysis changed the novel? Does putting a psychoanalyst in a novel affect its form, its sense of time, its essence?

The novel is a chameleon. That is its glory as a genre. It can be an enormous waddling monster or a fast, lean sprite. It can take everything in or leave most things out. It is Tolstoy and Beckett. There are no rules for writing novels. Those who believe there are rules are pedants and poseurs and do not deserve a minute of our time. Modes of writing and various schools come and go: Grub Street, Naturalism, the nouveau roman, magical realism. The novel remains. The modern novel was born a hybrid, to borrow the Russian theorist M.M. Bakhtin’s word for the genre’s mingling, contradictory voices that shout and murmur from every level and corner of society. When psychoanalysis appeared on the horizon, the novel welcomed it into itself as it welcomes all discourses. “I am the doctor occasionally mentioned in this story, in unflattering terms,” Italo Svevo’s mind doctor tells the reader in his “preface” to Zeno’s Conscience. “Anyone familiar with psychoanalysis knows how to assess the patient’s obvious hostility to me.” The book was published in 1923. Since then, fictional analysts have played their roles, large and small, as villains and heroes and anti-heroes. They have been charlatans, seducers, weaklings, pretentious twits, saviors, and healers. Some, like Philip Roth’s Viennese doctor in Portnoy’s Complaint, are merely sounding boards for a narrator’s fulminations, characters that remain mostly off-stage.

And when the “I” of the book is an analyst, does it fundamentally alter the way the novel works? Laurence Sterne’s Tristram Shandy (1759) has a structure far more radical and, I would say, more akin to the associative workings of the human mind and memory, than Simone de Beauvoir’s far more conventional book The Mandarins (1954), which has a narrating analyst, Anne. But to address this question, I cannot remain outside it, looking down at it from a third-person view. In life there is no omniscient narrator. Making a work of fiction is playing, playing in deadly earnest perhaps, but playing nevertheless. D.W. Winnicott, the English psychoanalyst and pediatrician, argued that play is universal, part of every human being’s creativity and the source of a meaningful life. Sometimes people go to psychoanalysis because they can’t play. They have to learn through the back and forth that goes on in a room where trust is possible, because, as Winnicott says, play is “neither inside nor outside” a person; it happens in “a potential space” between a person and the environment. Making art is a form of play, and it, too, takes place in the Land of Between.

I have discovered that a novel can be written only in play: an open, relaxed, responsive, permissive state of being that allows a work to grow in potential space. The Sorrows of an American was generated by an unbidden mental image that came to me while I was daydreaming. In a room that looked very much like the tiny living room in my grandparents’ farmhouse, I saw a table. On the table was an open coffin, and in the coffin lay a girl. Then, as I watched, she sat up. My father was dying then, and despite the familiar setting—my father grew up in that house—and the undisguised wish to wake the dead that must have been at the heart of the fantasy, I did not interpret it. Not long afterwards, my father died. There are no miracles in the book, but the farmhouse is there, and a girl child who wakes up, and all through it, the dead return to the living. Sections of the book came directly from a memoir my father had written at the end of his life for his family and friends. I now know I used those passages as a way to revive him, if only as a ghost.

And where did my storyteller come from, my forty-seven year old, divorced, lonely, grieving psychiatrist/psychoanalyst, Erik Davidsen? Sometime in the early eighties, I saw a drawing by Willem de Kooning called “Self-Portrait with Imaginary Brother” at the Whitney Museum in New York. I love de Kooning’s work, but in this case it was the artist’s title, the idea of an imaginary brother, that hit me. When I was a child I used to wonder what it would be like to have a brother in my family. I had three sisters. Later, I wondered what it would have been like to be a son, not a daughter, to be a man, not a woman. After I finished my PhD in 1986, I considered training to earn my living as an analyst, but I was too poor for more schooling. Nevertheless, when I began writing the story, my imaginary brother-self was waiting for me. And I began to play.

The truth about unconscious processes is that the book can know more than the writer knows, a knowing that comes in part from the body, rising up from a preverbal, rhythmic, motor place in the self, what Maurice Merleau-Ponty called schema corporel. When I cannot find words, a walk helps. My feet jog the sentence loose from that secret underground. Images lurk in that cellar, too, along with half-formed phrases, and whole sentences that belong to no one. Wilfred Bion, the English psychoanalyst, said, “If a thought without a thinker comes along, it may be what is a stray thought, or it could be a thought with the owner’s name and address upon it, or it could be a ‘wild thought.’” Sometimes when I’m writing, wild thoughts appear. They fly ahead of me. I have to run after them to understand what is happening. It became clear after a while that Erik and I were writing a fugue, themes chasing themes: telling and not telling, hearing and deafness, wholes and fragments, present and absent fathers, burial and resurrection.

I discovered the novel’s music as I went along, as well as its gaps and silences. There are always things that are unsaid—significant holes. I was aware that I was writing about memory. Freud’s notion of Nachträglichkeit haunted the book. We remember, and we tell ourselves a story, but the meanings of what we remember are reconfigured over time. Memory and imagination cannot be separated. Remembering is always also a form of imagining. And yet some memories remain outside sequence, story, and felt human time: the involuntary flashbacks of trauma. These timeless bits and pieces of images and sensory shocks subvert and interrupt narration. They resist plot. The real secrets of this particular novel are not revealed through the plot. Many of them never come to light at all.
Surely, what I have learned about psychoanalysis over the years has shaped my work because it has altered my thoughts, both wild and tame. But so have philosophy, linguistics, neurobiology, paintings, poems, and other novels, not to speak of my lived experiences, both remembered and forgotten. As Winnicott knew, long before there was psychoanalysis, there was play.

Siri Hustvedt

There is a distance to fatherhood that isn’t part of motherhood. In our earliest days, fathers are necessarily a step away. We don’t have an inter-uterine life with our fathers, aren’t expelled from their bodies in birth, don’t nurse at their breasts. Even though our infancies are forgotten, the stamp of those days remains in us, the first exchanges between mother and baby, the back and forth, the rocking, soothing, the holding and looking. Fathers, on the other hand, enter the stage from elsewhere. More exciting than pacifying, they often bring with them rousing games and rough and tumble play. I vividly recall my own baby’s joyous face as she straddled her father’s jumping knee. He regularly turned her into ‘Sophie Cowgirl’, and the two took wild rides together as my husband provided the shoot-’em-up sound effects.

While she meditates on this philosophical conundrum, her body changes again. The girl shrinks. I have asked myself the same question many times, often in relation to the perceptual alterations, peculiar feelings, and exquisite sensitivities of the migraine state. Who in the world am I? Am “I” merely malfunctioning brain meat? In “The Astonishing Hypothesis” Francis Crick (famous for his discovery of the DNA double helix with James Watson) wrote, “You, your joys and your sorrows, your memories and ambitions, your sense of personal identity and free will, are, in fact, no more than the behavior of a vast assembly of nerve cells and their associated molecules.” Mind is matter, Crick argued. All of human life can be reduced to neurons.

There is a migraine aura phenomenon named after Charles Lutwidge Dodgson’s (Lewis Caroll’s) story of myriad transformations: Alice in Wonderland syndrome. The afflicted person perceives herself, or parts of herself, ballooning or diminishing in size. The neurological terms for the peculiar sensations of growing and shrinking are macroscopy and microscopy. Dodgson was a migraineur. He was also known to take laudanum. It seems more than possible that he had experienced at least some of the somatic oddities that he visited upon his young heroine.

These experiences are not unique to migraine. They are also seen in people who have suffered neurological damage. In “The Man with a Shattered World,” A. R. Luria, the Russian neurologist, recorded the case of a patient, Zazetsky, who suffered a terrible head injury during World War II. “Sometimes,” Zazetsky wrote, “when I’m sitting down I suddenly feel as though my head is the size of a table — every bit as big — while my hands, feet, and torso become very small.” Body-image is a complex, fragile phenomenon. The changes in the nervous system wrought by an oncoming headache, the lesions caused by a stroke or a bullet, can affect the brain’s internal corporeal map, and we metamorphose.

Is “Alice in Wonderland” a pathological product, the result of a single man’s “nerve cells and associated molecules” run amock? The tendency to reduce artistic, religious, or philosophical achievements to bodily ailment was aptly named by William James in “The Varieties of Religious Experience.” “Medical materialism,” he wrote, “finishes up Saint Paul by calling his vision on the road to Damascus a discharging lesion of the occipital cortex, he being an epileptic. It snuffs out Saint Teresa as an hysteric, Saint Francis of Assisi as a hereditary degenerate.” And, I might add, Lewis Carroll as an addict or migraineur.

We continue to live in a world of medical materialism. People pay thousands of dollars to get a peek at their genetic map, hoping to ward off disease early. They rush to embrace the latest, often contradictory, news on longevity. One study reports it’s good to be chubby. Another insists that when underfed, our close relatives chimpanzees live longer, and we would do well to follow suit. Republicans and Democrats are subject to brain scans to see what neural networks are affected when they think about politics. The media announces that researchers have found the “God spot” in the brain. Before the genome was decoded and scientists discovered that human beings have only a few more genes than fruit flies, there were innumerable articles in the popular press speculating that a gene would be found for alcoholism, obsessive-compulsive disorder, an affection for purple ties — in short, for everything.

It is human to clutch at simple answers and shunt aside ambiguous, shifting realities. The fact that genes are expressed through environment, that however vital they may be in determining vulnerability to an illness, they cannot predict it, except in rare cases, such as Huntington’s disease; that the brain is not a static but a plastic organ, which forms itself long after birth through our interactions with others; that any passionate feeling, whether it’s about politics or tuna fish, will appear on scans as activated emotional circuits in the brain; that scientific studies on weight and longevity tell us mostly about correlations, not causes; that the feelings evoked by the so-called “God spot” may be interpreted by the person having them as religious or as something entirely different — all this is forgotten or misunderstood.

The man who gave us “Alice in Wonderland” suffered from migraine. He was also a mathematician, a clergyman, a photographer, and a wit. He was self conscious about a stammer and may have had sexual proclivities for young girls. It is impossible to know exactly what role migraine played in his creative work. My own experience of the illness — scotomas, euphorias, odd feelings of being pulled upward, Lilliputian hallucination — figure in the story of myself, a story that in the end can’t be divided into nature or nurture. Migraine runs in families, so I probably have a hereditary predisposition to headaches, but the way the illness developed, and its subsequent meaning for me are dependent on countless factors, both internal and external, many of which I will never penetrate. Who in the world am I? is an unsolved question, but we do have some pieces to the puzzle.
Alice growingIllustration by John Tenniel, 1865. Images courtesy of Lenny’s Alice in Wonderland Site.

As Freud argued over a century ago, most of what our brains do is unconscious, beneath or beyond our understanding. No one disputes this anymore. The human infant is born immature, and in the first six years of its life, the front part of its brain (the prefrontal cortex) develops enormously. It develops through experience and continues to do so, although not as dramatically. Our early life, much of which never becomes part of our conscious memory because it’s lost to infantile amnesia (our brains cannot consolidate conscious memories until later), is nevertheless vital to who we become.

A child who has good parental care — is stimulated, talked to, held, whose needs are answered — is materially affected by that contact, as is, conversely, the child who suffers shocks and deprivations. What happens to you is decisive in determining which neural networks are activated and kept. Since we are born with far too many neurons, the ones that aren’t used are “pruned”; they wither away. This explains why so-called “wild children” are unable to acquire anything but the most primitive form of language. It’s too late. It also demonstrates how nurture becomes nature and to make simple distinctions between them is absurd. A baby with a hypersensitive genetic makeup that predisposes him to anxiety can end up as a reasonably calm adult if he grows up in a soothing environment.

So Crick was technically right. What seem to be the ineffable riches of human mental life do depend on “an assembly of nerve cells.” And yet, Crick’s reductionism does not provide an adequate answer to Alice’s question. It’s rather like saying that Vermeer’s “Girl (or Woman or Maidservant) Pouring Milk” is a canvas with paint on it or that Alice herself is words on a page. These are facts, but they don’t explain my subjective experience of either of them or what the two girls mean to me. Science proceeds by testing and retesting its findings. It relies on many peoples’ work, not just a few. Its “objectivity” rests upon consensus, the shared presuppositions, principles, and methods from which it arrives at its “truths,” truths, which are then modified or even revolutionized over time.
Originally posted at the New York Times Migraine Blog.

We are all prisoners of our mortal minds and bodies, vulnerable to various kinds of perceptual transfigurations. At the same time, as embodied beings we live in a world that we explore, absorb, and remember — partially, of course. We can only find the out there through the in here. And yet, what the philosopher Sir Karl Popper called World 3, the knowledge we have inherited — the science, the philosophy, and the art — stored in our libraries and museums, the words, images, and music produced by people now dead, becomes part of us and may take on profound significance in our everyday lives. Our thinking, feeling minds are made not only by our genes, but through our language and culture.

I have been fond of Lewis Carroll’s Alice since childhood. She may have started out as words on a page, but now she inhabits my inner life. (One could also say her story has been consolidated in my memory through important work done by my hippocampus.) It is possible that my headache episodes have made me particularly sympathetic to the girl’s adventures and her metaphysical riddle, but I am hardly alone in my affection. I dare say countless people have lifted her from World 3, a kind of Wonderland in itself, and taken her into their own internal landscapes where she continues to grow and shrink and muse over who in the world she is.

Not every migraine has a prologue or “aura,” and not every aura is followed by a headache. Nevertheless, these overtures to pain or isolated events are the most peculiar aspect of the illness and may offer insights into the nature of perception itself. As a child I had what I called “lifting feelings.” Every once in a while, I had a powerful internal sensation of being pulled upward, as if my head were rising, even though I knew my feet hadn’t left the ground. This lift was accompanied by what can only be called awe — a feeling of transcendence.

I variously interpreted these elevations as divine (God was calling) or as an amazed connection to things in the world. Everything appeared strange and wondrous. The lights came later in my life — showers of stars that begin on one side, usually the right, sharp black points surrounded by shining light that cascade downward and then move toward the center of my vision or brilliant lights surrounded by black rings or just tiny black spots swimming in air. I’ve had fogs and gray spots that make it hard to see what’s in front of me, weird holes in my vision, and a sensation that there’s a heavy cloud in my head. I’ve had feelings of euphoria that are indescribably wonderful and supernatural exhaustion — a weariness unlike any other I’ve experienced, a pull toward sleep that is irresistible. Sometimes I have fits of yawning that I can’t stop. Also, often just before I wake up with a migraine, I have an aphasia dream. I am trying to speak, but my lips won’t form the words and every utterance is terribly distorted. But my most remarkable pre-migraine event was hallucinatory.

I was lying in bed reading a book by Italo Svevo, and for some reason, looked down, and there they were: a small pink man and his pink ox, perhaps six or seven inches high. They were perfectly made creatures and, except for their color, they looked very real. They didn’t speak to me, but they walked around, and I watched them with fascination and a kind of amiable tenderness. They stayed for some minutes and then disappeared. I have often wished they would return, but they never have.

Lilliputian hallucinations before migraine are rare. There are other documented cases, however. The neurologist Klaus Podoll, who will soon be contributing to this site, has written about a woman who during her migraine attacks sees amusing little beetles with faces that run across her floor and ceiling. Another reported case involved tiny Indians, and yet another, a dwarf. It wasn’t until after my duo had vanished that I understood I had seen a miniature version of two legendary, oversized characters from my childhood in Minnesota: Paul Bunyon and his blue ox, Babe. The giant man and his huge animal that I had read about in stories had shrunk dramatically and turned pink. It was then that I asked myself about the content of the hallucination. What did it mean that my aura took that form, rather than something else? Are these visions purely nonsensical? What memory traces are activated during these experiences?

A man I met in the hospital, where I teach a writing class to psychiatric inpatients, told me that he had hallucinated little green men getting into a space ship during a psychotic episode. This stereotypical vision of Martians appeared during his crisis, but unlike most of the migraineurs I’ve read about, he found his little aliens disturbing. Psychosis, alcoholism, dementia, epilepsy, and hallucinogens like LSD can all produce neurological disturbances that conjure tiny, life-size, or gigantic persons and animals, as can a disorder called Charles Bonnet syndrome, often but not always associated with deteriorating vision.

In his book “Phantoms in the Brain,” the neurologist V.S. Ramachandran reports that during a conversation he had with one of his patients, she told him that she saw little cartoon characters scooting up his arms. Why Paul Bunyan? Why Martians? Why cartoon characters? Oddly, all of these visions have a folkloric quality, more contemporary versions of the mythological little people around the world: leprachauns, brownies, fairies, gnomes, goblins, Nordic nisse and tomten, the Hawaian Menehune, the Greek kalikauzari, the Cherokee yumwi. Where did all these wee folk come from? The recognizable content of these hallucinations must surely be at once personal and cultural.

My dear little creatures were migrainous figments, aura products similar to other experiences of complex visual hallucinations, which although they may have various medical causes, bear a resemblance to one another and no doubt have some neurobiological connection. As Oliver Sacks points out in his book, “Migraine,” we all hallucinate in our sleep. We generate dream images and stories that are often peculiar, violate the laws of physics, and are highly emotional. But why we dream remains a scientific mystery. Sigmund Freud proposed that dreams protect sleep. Mark Solms, a neurologist and sleep researcher, agrees. In a recent e-mail message to me, he wrote: “Patients who lose the ability to dream due to brain damage suffer from sleep-maintenance insomnia — they have difficulty staying asleep.” We human beings may have a need to create stimulating imagery that keeps us busy while we’re in that parallel state and the waking world has vanished.

Another ordinary form of spontaneous mental images are hypnogogic hallucinations, which appear on the threshold between sleeping and waking. I had always believed that the brilliant mutating images I see as I drift off every night are universal, but I have since discovered that while common, not everyone falls asleep to visions.

I am deeply attached to my pre-sleep cinema of ghouls and monsters, shifting faces and bodies that grow and shrink, to my own nameless cartoon characters who flee over mountain tops or jump into lakes, to the brilliant colors that explode or bleed into gorgeous geometries, to the gyrating dancers and erotic performers that entertain me while I am still conscious but falling toward Morpheus. Except as a spectator, I play no role in this lunatic borderland. It is a world distinct from that of my dreams, in which I am always an actor, and therefore it is more closely allied to my Lilliputian experience. I watched them, but I felt no need to interact with them. They were simply there for my viewing pleasure.

It is comforting to think that visual perception is a matter of taking in what’s out there, that a clear line exists between “seeing things” and the everyday experience of looking. In fact, this is not how normal vision works. Our minds are not passive containers of external reality or experience. Evidence suggests that what we see is a combination of sensory information coming in from the outside, which has been dynamically translated or decoded in our brains through both our expectations of what it is we are looking at and our human ability to create coherent images. We don’t just digest the world; we make it. For example we all have a blind spot in each eye at the place where the optic nerve enters the retina, but we don’t sense that hole because our minds automatically fill it in. As Dr. Ramachandran and the philosopher Patricia Churchland have argued, “filling in” isn’t always the covering over of a blank with more of the same; there are instances when the brain provides pictures — a normal form of hallucination.

Dr. Sacks points out in his earlier post that our perception relies on “the self-organizing activity” of huge numbers of neurons in the visual cortex. The patterns and geometric forms that recur in so many cultures may well be inherent to the human mind—a clue to how we parse the world of images. From this perspective, abstraction precedes figuration. More elaborate hallucinatory pictures of landscapes, people, and animals seem to call on both visual memories and interpretation (the language areas of the brain). Who are those guys? They must be Martians. What seems certain, however, is that, for the mind, absence can be a catalyst for presence.

In his beautiful memoir, “And There Was Light,” Jacques Lusseyran describes his experience of the world after he went blind at age eight: “Light threw its color on things and on people. My father and mother, the people I met or ran into in the street, all had their characteristic color which I had never seen before I went blind. Yet now this special attribute impressed itself on me as part of them as definitely as any impression created by a face.” For Lusseyran, losing his vision became an avenue to almost mystical insight. He found himself lifted up into a world of color and light drenched with meaning.

A lot of research had been done on visual perception. Scientists have isolated cells in particular areas of the seeing parts of the brain that serve special functions: the recognition of verticality, color, and motion, for example, but mysteries remain. Philosophers, neuroscientists, and cognitive scientists argue madly over “the binding problem” — how an object can appear whole and unified to us when each of its features is channeled through disparate networks in the brain. Qualia — the subjective experiences of things — are just as controversial.

I don’t see a consensus coming any time soon. Migraine auras of light, color, black holes and fogs, of high feeling and dread, and of peculiar little creatures that run or dance or just amble about occupy a special place in the medical literature. They are anomalies, no doubt, tics of the nervous system that affect some, not all, but they could well help explain more general human qualities — who we are, what we feel, and how we see. I suspect that everyone has a few Lilliputians in hiding. It may be just a question of whether they pop out or not.