A neuroscientist’s story about her stroke, recovery, and the insight she gained.
My Stroke of Insight is a book written a decade ago by brain scientist Jill Bolte Taylor. I just recently learned about the Jill Bolte Taylor story when I caught the tail end of a radio program. What piqued my attention was the association between stroke, insight, and something about a brain scientist/neuroanatomist whose sibling was diagnosed with schizophrenia. That led to me viewing the Ted Talk video.
Why is this particular story relevant to a website about criminalization of serious neuropsychiatric illness? The point of this blog post is to continue expounding upon the foundational concept of the Due Justice Project mission – that the world needs to remodel how it thinks about what it calls serious ‘mental illness’ and redesign our criminal justice and social policies accordingly.
We will continue to be primitives living within the trappings of modernity until we evolve and mature our system of justice to reconcile with medical science. For 170 years of justice by the standard of M’Naghten’s Rule, this definition of ‘insanity’ has trampled upon the testimony of competent medical doctors, under the mocking name of a philosophically innocent man. Western culture and its imitators have condemned hundreds of thousands of people to unjust punishment under a defective definition of ‘insanity’ under the law. The only exit from this misguided path is for human beings to be instilled with insight into what serious ‘mental illness’ really is and how it robs an individual of the capacity to conform their behaviors to the law. The story of this brain scientist will not achieve that goal but it does have the potential to augment our understanding of what it means to be neurologically in touch with reality – the oppose of the state of psychosis.
I had anticipated that the brain scientist would somehow relate her compelling experience to what had sparked her interest in neuroscience of the brain in the first place, i.e. growing up with a brother who displayed signs of brain function disorder. Watching the TED Talk video, I observed a captivated audience respond to this charismatic neuroscientist with fascination, amusement, and esteem. This was not a talk intended to subdue the audience with a story about the horror of what a traumatic brain injury or serious ‘mental illness’ can do to a human being. This was a motivational speech of sorts, a narrative about recovery after crisis, a message of transcendence and hope.
The insight that Bolte Taylor’s seemed to sharing with the world was multi-faceted:
…That our sense of our embodied selves and the semblance of mind is a neurological construct.
(excerpting from the book)
“I learned the hard way that my ability to be in the world is completely dependent on the integrity of my neurocircuitry”.
In chapter 4, she writes, following commentary about the disintegration of her brain’s semblance of mind and the physical sense of self (even describing aspects of this experience as a delusion):
“And when the systems functioned properly, they naturally manifested a consciousness capable of perceiving a normal reality”
…That we human beings are empowered with an untapped capability to become consciously attuned to the inner-workings of our neurocircuitry, enabling us to achieve inner peace and self-actualizing power to become the best versions of ourselves.
(excerpting again, from the book)
“Ultimately, it’s about my brain’s journey into my right hemisphere’s consciousness, where I became enveloped in a deep inner peace.”
The neurological phenomenon that she experienced during the stroke, during hospitalization, and recovery that seemed to have the most impactful effect on her consciousness. In one passage she describes…
“…feelings of tranquility, safety, blessedness, euphoria, and omniscience”.
The potential that this remarkable story had to change the way people think about neuropsychiatric illness lie within the first of these facets. Serious neuropsychiatric illness is not an affliction of a disembodied abstract of “mind” – it is not a defect of character, it is not a psychological weakness, it is not a psychosocial disorder, – it is a severe malfunction of the circuitry that creates our semblance of mind. Just as serious neuropsychiatric illness is a disordered state of brain function, so was the euphoric state that lingers on in the memory of the book’s writer.
Some of the neuropsychiatric phenomenon Bolte Taylor describes in the Ted Talk and the book are similar to those experienced in individuals afflicted with attenuated or full-blown psychosis.
Yet, the significance of the first facet was probably lost on the audience to the degree that it mostly served as the speaker’s kernel of truth for the more compelling, might I say, populist message of self-empowerment, the triumph of recovery, and the beauty of the brain. I was struck by although not critical of the laughter in the audience as the charismatic scientist described the mystical neurological disturbances that enveloped her on the morning of the stroke, through her hospitalization, and years of recovery.
I was left wondering if there was a more expansive meaning to Bolte Taylor’s acquired insight. I would need to read the book to explore this question.
My Stroke of Insight, The Book
To the audience in the TED Talk video, Bolte Taylor’s description of her experiences was fascinating yet beyond their power to imagine. What I do find intriguing is the implication that she formulated the concept that…our ability to be in the world is completely dependent on the integrity of our neurocircuitry…as experiential insight rather than a dimension of her expert insight as a brain scientist prior to the stroke.
Restating what was said earlier, much of the neurological phenomenon that she described is very similar to how some people describe what it’s like to experience so-called primary psychosis:
- Disintegration of the integrity of mind and body and the sense of agency
(She describes “feeling detached from normal reality, I seemed to be witnessing my activity as opposed to feeling like the active participant performing the action”).
- Experiencing a spiritual awakening or enlightenment
- Acute sensitivities to external and internal stimuli
- Feelings of grandiosity or invincibility
- Proprioception disturbances similar to Alice in Wonderland syndrome.
(She describes losing the sense of having a solid body and the ability to sense the boundary between the external environment and her own body…her body felt like a liquid)
- Alterations in the sense of time or strange sensory experiences such as difficulty identifying tastes and smells…water might taste like a chemical, a food no longer tastes as it used to
- Becoming fixated on certain ideas, words, objects
(in increasingly disturbing ways with schizophrenia)
- Depersonalization and Derealization (in the neurological sense, not the psychoanalytic sense of defense mechanism which is rubbish)
- Dysphoric and Euphoric states (The book does describes some dysphoric feelings but it mostly emphasizes the euphoric state which she describes as nirvana)
As Jill Bolte Taylor said in an interview with Brain World Magazine:
“Euphoria is a state of being, not an emotion. I think a lot of people confuse the experience I call nirvana with an emotional state of happiness. If anything, it was the state of a lack of emotion that was bliss. The absence of experience was one of bliss.”
As Due Justice Project has asserted before, this widespread confusion about what euphoria and dysphoria means is the fault of the medical profession ( specifically psychiatry) and the pharmaceutical industry with their sanitized depictions of bipolar in visual media ads. Terms like “Depression” and “Mood Disorders” are misleading.
It is important to recognize that the psychosis of schizophrenia in particular can impair the state of waking consciousness and autonomic thought generation in ways that can submerge a person into a dark unreality of horror. Euphoria can be woven into the fabric of this altered neuropsychiatric state. Some of the most horrific crimes result from this gravely abnormal status of brain functioning…beyond the person’s control I should add. Unlike the writer of this book who appears to have retained awareness of her impaired condition, people experiencing so-called primary psychosis and sometimes delirium or other brain function disorders may be unaware that they are gravely impaired.
Can the brain be trusted to recall what it was like to be ‘in the moment’ of neurological distortion of reality?
There are parts of the narrative early in the book where I wondered how it was possible for her to have given such vividly textured descriptions of what she was thinking and reasoning and feeling while her brain was in such a catastrophic state of malfunction. In chapter 14, she writes:
“Post-stroke year two was spent reconstructing, as best I could recall, the morning of the stroke. I worked with a Gestalt therapist who helped me verbalize my right hemisphere experience of that morning.”
Learning about her working with a gestalt therapist for said purpose did give me pause. I wondered how much of what was written might have been influenced by left/right brain theories or the gestalt therapist’s theory of mind (if you will).
Drawn To Brain Science, A Quest for Answers to a Mystery
Jill Bolte Taylor was attracted to the study of neuroscience, in the late 70s when it was (as she describes) a young science, in a quest to understand “what was “normal” at a neurological level. Her brother received a formal diagnosis of Schizophrenia at the age of 31 while she was pursuing studies and working at a branch of Indiana University School of Medicine. However, he was displaying signs of psychosis for many years prior to diagnosis.
Without venturing into the quagmire of trying to define what represents “normal”, what Dr. Bolte Taylor is speaking to is optimal functioning of the human brain’s semblance of mind as it was engineered to allow us to function as human social beings. It is the neuro-diversity in our brain functioning that creates a broad spectrum of differences in our personalities, talents, cognitive capacities, perceptions, and a host of other human characteristics. Yet within our respective subjective realities, most of us with relatively healthy brain functioning have a general sense of “normality” and a collective, shared sense of what is real in our shared reality. Generally, we have some sense of the strange or “abnormal” in a social sense although cultural influences, religious beliefs, or other environmental factors can have a powerful influence on our perceptions.
Excerpting from the opening paragraphs of chapter 1 of the book:
During our childhood, he was very different from me in the way he experienced reality and chose to behave. As a result, I became fascinated with the human brain at an early age…”. In 1988 during her university studies, her brother was officially diagnosed with schizophrenia.
“I wanted to understand why I could take my dreams and connect them to reality and make my dreams come true. What was different about my brother’s brain such that he could not connect his dreams to a common reality and they instead became delusions? I was eager to pursue research in schizophrenia.
Frankly, I found this way of defining the difference between normal brain functioning and psychosis to be a little strange. I wondered if the brain scientist was just waxing poetic. I certainly would not describe the normal human stream of consciousness as connecting dreams to reality and making them come true, nor would I describe a delusion as an inability to connect dreams to reality.
I paused for a moment after reading that passage continuing to wonder what more I would learn in this book about what she meant by insight and if it had much to do with how we should conceptualize “mental illness”. It seemed to be important to keep in mind why the brain scientist pursued the field of study in the first place – to gain understanding of impaired mental functioning. Some of us are lead to become fervent advocates because of the insights acquired from familial exposures to neuropsychiatric illness; others are attracted to the study of psychology or psychiatry in search of insight – unfortunately, native cognitive incapacities prevent some people entering these fields of study from ever understanding the biological nature of neuropsychiatric illness.
The writer’s raison d’etre for pursuing studies in neuroscience of the brain was to search for answers to the question of why her brother’s mind worked so differently. This is why it is such a curious thing that Bolte Taylor’s central thesis of her enlightenment seems to be that we all have an untapped potential to become cognitively and physically attuned to our neurocircuitry, to achieve tranquility and regulatory control over our thoughts and behaviors – the beauty of the brain. This capacity, if it were achievable, would be the pursuit of the relatively healthy brain, not one disordered by severe neuropsychiatric illness – as was the case with her sibling.
To this point, she does address the sobering reality that people afflicted with serious “mental illness” are stripped of these purported capacities to override neurocircuitry-driven thoughts, feelings, and behaviors. It would be detrimental to the well-being of people afflicted with so-called primary psychiatric illness for the general public to be led to believe that severe “mental illness” can be overcome by tapping into these self-deterministic capacities. Yet, the euphoric quietude she experienced was symptomatic of severe brain dysfunction. It is difficult to understand how this very personal subjective facet of insight applies to others.
There is a school of thought in the psychotherapeutic and psychoanalytic fields that severe ‘mental illness’ lies along continuum or a spectrum of normal mental states representative of the human race. Some people deny the notion of serious ‘mental illness’. For the sake of understanding the potentially catastrophic ramifications of a neurological state like psychosis, a rational model would have separate coexisting spectrums, one of the typical or ‘normal’ (representing the range of relatively healthy brain functioning) and another representing neuropsychiatric/neurocognitive illness, TBI, seizure disorders, etc. (representing grossly atypical brain functioning).
There is a reason why severe ‘mental illnesses’ overlap with the symptomology of strokes, traumatic brain injuries, seizure disorders and other brain function disorders – It is because illnesses like “schizophrenia” are neurological illnesses that lie far outside the spectrum of ‘normal’ brain functioning. To say that SNI lies along a continuum of normal brain function would be to say that stroke symptoms lie along a continuum of normal brain function.
Anosognosia is one of the neurological conditions that is seen in both strokes and serious neuropsychiatric illness. Anosognosia is a neurocognitive blockade that prevents people with SNI from recognizing their impairments. There is no evidence in the book that the writer experienced this rare symptom of strokes but she does describe the phenomenon of loss of insight in serious ‘mental illness’ without describing this disability as anosognosia
The phenomenon of loss of insight in strokes was named anosognosia in 1914 by neurologist Joseph Babinsky, however, it was not recognized as a neurological symptom of serious ‘mental illness’ until the 1990s as a consequence of the misguided belief systems of the psychoanalytical era…which persists to this day in some factions.
Bolte Taylor describes the role that loss of insight plays in incapacitating people for self-directed engagement with treatment (the credo of the “recovery movement” that has operationalized into failed social policies).
“Unfortunately, 60% of people diagnosed with schizophrenia do not recognize that they are ill. As a result, they do not seek or value treatment and often engage in self-medication throught the abuse of drugs or alcohol. Even the recreational use of these substances (by anyone) decreases our ability to share a common reality,…”
Self-medicate, does not suggest recognition of illness. Many people are unaware that the baseline state of consciousness that is powered up upon wakening is not within a healthy spectrum of brain function. Although there are certainly deleterious consequences of substance abuse, these chemicals might capacitate certain impaired electro-chemically modulated functionalities or relieve some symptoms in people afflicted with severe neuropsychiatric illness.
Most advocates for the mentally ill do a disservice to those for which they advocate by failing to put into concrete terms how anosognosia impairs its victims. Simply describing loss of insight in the abstract as “not knowing one is sick” or “being so severely ill as to not know one is mentally ill” does not challenge head on what is problematic with the law’s concept of legal insanity.
In chapter 14, she recounts how she responded to the drug Dilantin, which doctors had prescribed to prevent seizures…”a common practice when the temporal region of the brain has been surgically violated”.
“My biggest complaint, however, was that the medicine masked my ability to know what it felt like to be me anymore. I was already a stranger to myself because of the stroke, but mix in some medication and I was even more disoriented. Because of this experience, I find that I am much more sensitive to why some people would choose insanity over the side effects of their antipsychotic medications.”
(note that she does not subscribe to the right to remain psychotic…see comment at the end of this blog post).
Figments of Our Own Imaginations
On the back cover there is this quote:
“I was, by anyone’s standard, no longer normal. In my own unique way, I had become severely mentally ill. And I must say, there was both freedom and challenge for me in recognizing that our perceptions of the external world, and our relationship to it, is a product of our neurological circuitry. For all those years of my life, I really had been a figment of my own imagination”.
The misguided beliefs that human beings have about ourselves…the lack of insight into what forms our sense of self, our consciousness, our sense of agency, what drives our feelings, thoughts, reasoning, emotions, impulses, decisioning, and motor activities make us figments of our own imaginations.
Most of us can only relate to altered states of consciousness via the experience of dreaming. A person who can imagine what it is like to experience psychosis or dysphoria or euphoria probably has a brain that is not functioning properly. However, someone with cognitive depth perception can acquire a conceptual understanding of these altered states. Someone who has experienced a loss of agency or a command hallucination automism can no longer go on believing in simplistic notions of free will as it relates to criminal responsibility and serious ‘mental’ illness.
The lifting of “barriers” that kept Bolte Taylor from experiencing a sense of oneness with the energy of the universe, creativity, intuition, and “spiritual” peace was a function of catastrophic injury to the brain. We were not engineered to be able to “rerun the circuitry that creates a neuropsychiatric sense of peace” on demand.
To some degree, if cognitive behavioral therapy (psychotherapy) or even counseling has any legitimate application, then it would be to help people with relatively healthy brain function to gain some insight into their mental and behavioral functioning with the goal of being better human beings. The seemingly miraculous recovery and physical rehabilitation of stroke survivors has also taught medical science about neuroplasticity of the brain and the enormous benefits that can be achieved from exploiting this capacity of the human body.
The enduring value of the Jill Bolte Taylor’s story for anyone faced with the adversity of serious illness or injury.
The narrative of how Jill Bolte Taylor struggled through the dense fog of cognitive and neuromotor crisis to save herself is remarkable. She was operating on a reservoir of her professional knowledge, the power of intellect, and the force of an indomitable will. Those powers carried her through eight arduous years of recovery. Her story is truly one of triumph over tragedy. Her mother was an extraordinary woman of exceptional intuition and vision who walked side by side with her daughter guiding her through a journey to recovery and independence from a baseline state of functional infancy.
A Word to the ‘Mental Illness’ Advocacy Community
Bolte Taylor was active in the National Alliance on Mental Illness (NAMI) before she suffered the stroke and continues to support the mission of the organization.
At the close of chapter 18, Jill Bolte Taylor speaks powerfully to the advocacy community and one faction of that community needs to heed her gentle admonition:
“Although some individuals advocate for the right to be insane, I am of the opinion that it is everyone’s civil right to experience sanity and share in a common reality – whatever the cause of their brain illness or trauma”
Commentaries and Critiques from other sources concerning controversial left-right brain theories: