Empathy as the Basis of Delusion, and Yagé as a Potential Treatment
By Brendan Bombaci
Copyright Brendan Bombaci 2016
As indicated by the behaviors of mammals in contrast to non-mammalian animals, neocortex size evidently relates to capacities of empathy and organization. Dunbar’s Social Brain Hypothesis notes that, in primates, bigger neocortices are correlated to humanlike friendship relations rather than solely mating or hierarchy relations seen in other animals; and, Dunbar's Number rationally relates sizes of neocortices to those of social networks (Dunbar 2009, Dunbar 1992). This may be due to the fact that more memories can be stored about individuals, allowing for more individuals to be well known. For humans, the theory holds that we can each relate well to nearly 150 other humans (Gonçalves, Perra, and Vespigniani 2011; Hernando et al. 2010; MacCarron, Kaski, and Dunbar 2016). Such “others” do not have to be known to be considered: to know 150 other individuals fairly well is to be able to predictively assess or even imaginatively synthesize unknown people – by calculating potential personality trait permutations of known individuals who share certain recognizable traits with them – hence, “social intuition.”
It may be that quantity increases and/or amplified transmission efficiency of dopamine and serotonin neurotransmitters, caused by monoamine oxidase inhibitor chemicals (MAOIs), mostly known for their use as antidepressant drugs in the West, promotes broadened and intensified access to and mentation upon interpersonal memories. Hyperactivation of such neurotransmitters seems to lead to an uncontrollable, unhampered, and sometimes delusional consideration (or auditory hallucination) of others, as seen in bipolar and schizophrenic psychoses. Underactivation seems to lead to social withdrawal. The unique activities of antidepressant MAOIs and antipsychotic drugs, respectively, corroborate this psychiatric polarity. In as much, empathy appears on the same spectrum as delusion, but is simply lower in intensity, incidentally controllable, and, in effect, more accurate.
Differences in culture appear to be the foundational factors behind whether or not delusions are detrimental, and this is partly due to the contrasting effects of prohibition to embrace and expertise with certain plant chemicals that alter consciousness in various ways. These are MAOIs, and also various “psychedelic” or “entheogenic” serotonin agonists – I prefer Winkelman’s (1996) term psychointegrator for this latter chemical class because of the way that such substances unify and awaken brain areas for heightened learning and performance (Carhart-Harris et al. 2016), nonlinear thought processes (Petri et al. 2014), and the promotion of neurogenesis as well as resolution of fear conditioning (Catlow et al. 2013). The two-fold combination of these chemical classes (MAOI + psychointegrator), such as found in the sacred medicinal Amazonian tea Yagé (also and most popularly called Ayahuasca, though that is actually just the name of the MAOI-bearing liana ingredient alone) can make visually tangible the afflictions that are otherwise internalized or invisible yet auditory in psychotic episodes. Given the profound worldview modifications that can be made with the utilization of such substances (Bombaci 2012), it may be that the generally implicit or subconscious neurological mechanism by which the human brain learns and enacts social intuition (Lieberman 2000) shares an equal impact with the typically less effective explicit or intentional mode as well, during such ASC. In a scientific clinical set and setting, this can be leveraged to potentially ameliorate feelings of guilt, self-loathing, and paranoia in such sufferers, by way of persuading patients via logic and manipulation of hallucinations, to recognize the actually subconscious and transmutable rather than typically static and spuriously perceived supernatural or extraterrestrial origins (APA 1994:273-317) of such delusions. Such a Westernized form of Yagé therapy (with either organic or pharmaceutical compounds) would be a major step forward for the field of psychiatry.
Major Depressive Disorder (MDD) and Social Anxiety Disorder (SAD) have been linked to decreased capacities for comprehension, and even negative perceptions, of emotional tone in others (Emerson et al. 1999, Kan et al. 2004, Murphy and Cutting 1990, Perón et al. 2011, Uekermann et al. 2008, Quadflieg et al. 2008, Quadflieg et al. 2007) – an ability that is normally acculturated by a young age, and key to empathetic socialization (Kirmayer 2008:459). In that social engagement declines with increases in symptom severity in these disorders, which can create recursive attentional, emotional, and attributional symptom amplification or looping (Kirmayer and Sartorius 2007:836), such a connection highlights the fact that humans are still socially dependent primates, and tend to pine for recognition of worth when under duress. MAOI-A chemicals (different from MAOI-Bs), whose effective pharmaceutical effects are classified as “antidepressant,” boost levels of endogenous and dietarily active serotonin, dopamine, and epinephrine. It can be inferred that depression is the chemical and social-engagement opposite of an MAOI-altered state when experienced by a psychiatrically normal person, being that for them it is a literally sensational, socially sensitizing experience, made apparent by the original name for the plant-sourced MAOI harmine alone, that is, “telepathine." Hence, MAOIs can facilitate approximations of psychiatric baseline for depressed people. However, it can precipitate or exacerbate mania and delusions, as well as auditory hallucinations, in sufferers of bipolar disorder and schizophrenia both, because these people already have either an active overabundance of those neurotransmitters and/or malfunctioning receptor sites (Howes and Kapur 2009, López-Figueroa et al. 2004, Mueller 2007, Preisig 2000). This is suggestive that those detrimental mental states are merely amplified versions of what stable people experience with MAOIs. In as much, there would appear to be a sort of threshold where MAOI-enhanced empathy, energy levels, euphoria, and saturated imagination become delusions, mania, and auditory hallucinations.
In some cultures, these extremes, seeming on first objective glance to arrest or overtake a person’s self-control, are not frightful conditions for the experiencer or those around them, but are rather accepted because they occur at a frequency of and to a degree of social manageability, and are even informative for the collective. This cultural difference likely has to do with a variety of factors including societal power hierarchies and acceptable levels of individualism in contrast to collectivism (Johnson and Johnson 2014:1114-5), less dramatizing family relations (Watters 2010:152-153), and an absence of iatrogenic “looping” (amplifying) effects caused by both societal stigmas and the limitations of caregiving service and political-economic treatment options (Kirmayer and Sartorius 2007:836). Complex shamanic practices, in all likelihood the origin of medical systems worldwide, stem from such extreme altered states of consciousness (ASC) or the reverent mimicry thereof, i.e., actual mania and psychotic episodes (Polimeni and Reiss 2002:246), similar experiences evoked by carefully considered endogenous or exogenous overdose of psychoactive substances (Dobkin de Rios et al. 1974:152, Rätsch 2005), or even the ritual act of performing tasks under such influences by a sane person in an unaltered state (Lewis 2003:161-172, Vitebsky 2001:52-92). Cultures that appreciate and explore the deep relationship between both the ASC below and above the control threshold may be those best able to handle them. For them, externalized voices that are given to Westerners’ familiar “angels and demons” within may instead be perceived as benevolent environmental spirits or ancestors who comment on or guide us through activities and decisions. To see those entities as “beyond the veil,” potentially being in control of our interpersonal charisma, care, and scrutinizations, is fundamental to both animism and concepts of the soul, which led many societies from animistic belief to theistic religion (Winkelman and Baker 2010:135-148), and then, for some, to the scientific method.
The MAOI-bearing plants known as Ayahuasca (“vine of souls”), caltrops (“goatheads”), mimosa hostilis, malabarica (found in the Tibetan and Nepalese incense Nag Champa), and Syrian Rue (a royal red fabric dye and medicine), are all originally sourced from disparate locations in the world and have historical and modern use. It is not a leap between associating such potently psychoactive plants with spirits, and, in consistency, associating all natural beings and objects with spirits as well. Importantly, the difference between MAOI and psychointegrator experiences may be the difference between speaking with angels and demons and actually bringing their realms visually to our own. This resonates with the proclamation by many Amazonian Yagé shamans (ayahuasqueros) that, in the psychoactive beverage Yagé (actually containing an admixture of various plant extracts), the MAOI-bearing liana ingredient Ayahuasca, Banisteriopsis caapi, is “the power” (providing access to the spirit realm), while one of the DMT-bearing leaf ingredients Chacruna, or Psychotria viridis, is “the light” (providing the ability to see said realm). This relationship may have been recognized in Mesopotamia during Biblical times as existing in a similar way between Syrian Rue and Acacia (Shanon 2008) – the latter being a common architectural and craft wood, but incidentally the “burning bush” that spoke on behalf of Jehovah to Moses – revealing the known utility of a Yagé analogue half a world away. This is quite possible, given strong arguments for an as-yet unadmitted but evidenced use of other psychointegrators in the spatiotemporality of Biblical accounts (Irvin and Herer 2009; Irvin, Rutajit, and Zervos 2009; Moleiro 2005).
So it would appear that the Yagé users of the Amazon, and perhaps officially undisclosed users of Yagé analogues elsewhere, are in a unique position to differentiate between (1) the visual and euphoric effects of serotonin analogues such as DMT (aforementioned), psilocybin (found in certain mushrooms of Europe and the Americas), and lysergic acid (found in plants of Mexico and South America as well as in the chemically transformed beverage made from ergot used by the ancient Greek hierophants [Webster, Perrine, and Ruck 2000]); and (2) the reward-sensation increasing, empathy amplifying, and potential auditory hallucination inducing effects of dopamine and epinephrine flooding that occurs with consumption of plant-sourced (or synthetic antidepressant) MAOIs. They are also in a unique position to understand and navigate their combined effects. As noted already, the fact that ayahuasqueros are animistic rather than theistic may explain why instead of envisioning angels, demons, aliens, and multidimensional (rather than solely entoptic) geometric forms – all so ubiquitous in Western ideological, artistic, and technological undercurrents – they envision self-aware jaguars, serpents, birds, butterflies, people, plants, and elements. For them, these entities, in contrast, impose no pressure or moral judgment upon them, allowing them a bravery of the unknown that fosters learning and engagement rather than fear. For them, auditory hallucinations from MAOI overdose are learned to be associated with visual hallucinations as well. So, even when just using the MAOI-containing Yagé ingredient Ayahuasca, they are likely to be comfortable with and experientially analytical towards disembodied voices even without their associated visual representations. They are still recognized as tangible – people have a sense of knowing where they come from and are therefore on equal ground with them. If someone in a village experiences unwarranted and therefore confusing psychoses, ayahuasqueros are therefore in a great position to counsel them. However, their popularly acclaimed ability to successfully counsel those from other cultures (rather than administer a purely exotic catharsis or psychological placebo) is questionable, in that (1) tribal Amazonian culture is immensely distant from the West in norms, philosophies, linguistic devices, and archetypes, and (2) there doesn’t appear to be any literature on research that has controlled for psychiatrically normal versus delusion-prone people that have sought Yagé therapy and benefitted from it.
The everyday framework of culture is integral to both individual and group perceptions, feelings, and beliefs. Yagé could be powerfully therapeutic for mentally unstable Westerners prone to delusion and psychoses, in the right set and setting, and with logic-based cosmological counseling that decimates their subconsciously or intentionally acculturated notions of supernatural judgment or extraterrestrial intervention. Such suggestion should be familiar to them, because it has been promoted by many academic philosophers, lay skeptics, and now scientists, ever since The Enlightenment. DMT is a serotonin (5HT) analogue but is not serotonin itself, and there are very particular 5HT molecules that cause mania in some people but not in others (hence why one serotonin antagonist antipsychotic will work for one sufferer but not for another). As such, there are likely some sufferers of psychosis who can safely use DMT in a supervised and medical intervention-ready setting. This would have to be clinically confirmed, of course, with safety protocols such as dose-stepping experimentation for each potential Yagé therapy subject to ascertain the risk of and be aptly prepared for psychological crisis. The Ayahuasca vine or other MAOI source will likely cause delusion and/or auditory hallucinations, but the DMT, causal of general visual hallucinations, would potentially offer visual form to these as well, lending leverage to the counselor over both the subconscious and objectively conscious processes of the patient.
Acculturation mechanisms, and therefore the weavings of the subconscious – the schema with which we make associations between people, places, things – are a human universal even if particular symbolism, ideas, and knowledge classification systems are not (Bombaci 2012:3-8). Through suggestion and environmental alteration, that is, manipulation of the short term “set and setting” for familiar comfort, safety, and learning – known in the literature as integral to the quality of the psychointegrator experience (Bombaci 2012:19-22) – a psychointegrator therapist could intentionally transform Yagé-induced visual hallucinations; and, due to schematic relationships, there is great potential for such transformations to alter concomitant delusions and auditory hallucinations into visually tangible and familiar representations, and thereby into less mysterious and omnipotent or “stealthy” entities (traits that may be the root cause of their seeming malevolence). If the transformations are at least preferable to what the patient has experienced prior to psychointegrator therapy, rhetorical counseling would likely help them understand that such hallucinations are of subconscious rather than supernatural or alien nature, originating from a hyperactivation of empathy processes that under normal circumstances are meant to provide the predictable and useful mechanism of social intuition. They may thereby gain power over them, and recursively over delusional thoughts as well, increasingly softening their symptoms. Proven that such sessions are safe and effective, there is hope that they can affect remission, or at least self-control to the degree of functional self-sufficiency. In the process, the patient would necessarily gain a heightened capacity for empathy and become better equipped to assess others’ mental schema, capable of living a good social life, as well, and, in potential, as counselors or mediators, professional innovators, or community leaders.
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