The Phenomenology of the Psychotic Break and Huxley’s Trip: Substance Use and the Onset of Psychosis

Abstract

Background: While considerable research attention has been devoted to the causal relationship between substance use and psychosis, the phenomenology of the association between the two has largely been ignored. This is a significant shortcoming, because it blinds researchers to the possibility that there may be elements of the subjective experience of substance use and psychosis that contribute to their apparent relationship in empirical studies. Sampling and Methods: The current paper examines the phenomenology of the onset of psychosis and the phenomenology of substance intoxication through consideration of two texts: Sass’s account of the phenomenology of psychosis onset and Huxley’s account of the experience of hallucinogenic intoxication. Sass’s account of psychosis onset includes four components: Unreality, Fragmentation, Mere Being, and Apophany. Results: The analysis reveals significant parallels – and also some differences – between this account and the phenomenology of substance intoxication. Conclusions: We discuss the implications of this for the causal relationship between psychosis and substance use and suggest several ways of understanding the overlapping phenomenologies. This includes the suggestion of a shared factor, perhaps best described as psychotic-like experience, which seems to involve a breakdown of the sign-referent relationship and relationship with the common-sense, practical world. However, in the onset of psychosis, this breakdown is primarily experienced as a sense of alienation from self and world, whereas in the hallucinogenic state a sense of mystical union and revelation seems predominant. Further research may extend this analysis by looking at experiences with other drugs, particularly cannabis, and by examining the phenomenology of psychotic disorder beyond the first episode.

Kafka, paranoic doubles and the brain: hypnagogic vs. hyper-reflexive models of disrupted self in neuropsychiatric disorders and anomalous conscious states

“…Sass (e.g., [90,98,99]) emphasizes that his own analysis based on Sechayes' [91] Autobiography of a Schizophrenic Girl is consistent with Conrad's [95] phenomenological approach. We have already noted that Sechehaye's book is central to Sass' own Apollonian hyper-reflexive account of schizophrenia.…”

“…However, Conrad [95] is very clear in his classic monograph in devoting over five pages (!) to refuting any effort to examine schizophrenia, which bases itself on Sechehaye's book, denouncing the very same passages which Sass [90,99] cites as evidence for the harmony between Conrad and his use of Sechehaye's work (for complete discussion, see [71]). In short, I maintain that Conrad's concepts do not support the Apollonian or "operative" versions of the hyper-reflexivity concept (as further documented in other publications, e.g., [71]).…”

Towards integrating phenomenology and neurocognition: Possible neurocognitive correlates of basic self-disturbance in schizophrenia

“…In many ways, this "directed" relationship to the world (the phenomenological concept of intentionality [144]) provides context and organises our multifarious experience of the world. The attenuation or loss of affordance value and its replacement with a sense of an object's crude physical presence (or "mere being" [9,145]) has been reported in psychotic states. A hammer, for example, is no longer a tool but is perceived simply as an object.…”

Severe Burns and Amputation of Both Arms in the First Psychotic Episode of a Schizophrenic Patient

“…The fact that positive symptoms are correlated with both hypo- and hyperalgesia in acute episodes of schizophrenia suggests that the characteristics of the cases associated with either finding have not been individualized [ 7 ]. Therefore, in the context of pain experience phenomenological scrutiny of acute-onset schizophrenia, with its presence of ecstasy, mysticism, and other disturbances of consciousness [ 26 , 27 ], is pending. So far, phenomenological assessment of corporeality in schizophrenic patients, in relation to their different pain experiences, has not been conducted, even when it is a perspective that could contribute to the complete understanding of this phenomenon [ 28 ].…”