In our daily interactions with intimate others we look into their eyes and may feel responsiveness, a steadiness and presence in their eyes as they look at us. We have a sense that we are in ‘eye contact.’ Yet for most of us there are limitations in our ability to make satisfying eye contact. If we extend our circle out from intimates we might notice how difficult it is for people to look with a steady gaze or to have clear eyes that are readable. Some ocular holding is common, meaning that our eyes, including our ability to see clearly, perceive reality, sense reality through our physical sensations, tolerate eye contact from others and come forward through one’s eyes, have been compromised. We count on the integration of the ocular segment with our other capacities of sensing, perceiving, feeling and thinking to give us a clear grasp of reality.
Reich stated that a serious eye block starts in the first ten days of life. He was referring to the mother-infant dyad and how the eye contact evolved between the two. Did the infant look into warm eyes that enveloped with safety or was the caretaker distressed, distracted or expressing meanness in his eyes? The absence of early attachment synchrony is a factor in the development of an ocular block.
The ocular segment (see prior post) is critical to our functioning after birth and is the earliest way we begin to orient along with our oral needs. And so an ocular block would result in our first developmental difficulty. As we develop toward latency and puberty, our biophysical characteristics mature. As in other character types, puberty is when the character type is fixed and symptoms solidify for the most part. The eye block does not necessarily inhibit development to a higher level of functioning (phallic level) but will color the functional capacity depending on how serious the ocular segment block is. Individuals with an ocular block do not retreat to that level (as does the anal character), but rather keep developing with those limitations. More severe types may retreat to some extent to the ocular level and have psychotic symptoms along with more extreme withdrawal and shutting off from the real world as we know it.
The term Schizophrenia has a long history in medical nomenclature and is a current medical diagnostic category in the Manual of Mental Disorders DSM-5 that defines a severe brain disorder in which people interpret reality abnormally. Classic Schizophrenia may result in a combination of hallucinations, delusions, disordered thinking and behavior. Research has discovered a strong genetic component in the development of Schizophrenia. Classic Schizophrenia defines a disorder that seriously effects normal functioning, is chronic and stabilized, according to current guidelines, with massive doses of medications. Many Schizophrenics with heightened symptoms can live with either low dosage medications or none at all and benefit from psychotherapy. (see Bollas, C. (2015, October 17) A Conversation on the Edge of Human Perception, NY Times, Retrieved from http://opinionator.blogs.nytimes.com/?s=schizophrenia )
I was finishing a final edit to this blog post when I woke up to the NY Times, front-page article, titled Talk Therapy Found to Ease Schizophrenia, “…study advises therapy and reduced drugs…” (Carey, B. (2015, October 20) Talk Therapy Found to Ease Schizophrenia, NY Times, Retrieved from http://www.nytimes.com/2015/10/20/health/talk-therapy-found-to-ease-schizophrenia.html?smid=fb-nytimes&smtyp=cur ). This research published in the American Journal of Psychiatry, and funded by NIMH is a rare, exciting turnaround in clinical practice guidelines. The study found statistical effectiveness in the trial with: low dosage medications (20%-50% lower), early intervention at first episode— usually in late teens, with talk therapy, family education and help with education and work. The article affirms the importance of a holistic approach that views pathology through the lens of the personal rather than throwing massive drugs at a problem in a generalized way.
Reich utilized the term Schizophrenia differently— to define a character type distinguished by the stage of the developmental difficulty, the severity of the block in the ocular segment and a preponderance of fear. Reich discussed this type as reaching the phallic level albeit with early developmental arrest in the ocular segment. This comprehensive understanding of the components of the Schizophrenic character type can give direction to treatment.
Don’t be alarmed by the term Schizophrenic Character Type or think it is an unusual type with which you rarely interact. There are many extremely successful Schizophrenic types in business and technology, for example, or in artistic realms. This type can be nerdy, extremely intelligent, creative, with heightened capacity for imaginative thinking. They can be dogged, industrious and work compulsively; and can be driven to accomplish and work on a project for long hours until it is completed in a way that suits the Schizophrenic’s their high standards. Yet, they exhibit oddness at times, a contactless quality, as if they are often lost in thought. In the social area, they are less confident and tend to be introverted. They can seem ungrounded, confused and lack relational skills as they have difficulty reading social cues. The Schizophrenic Type has minimal interest in his appearance and grooming and is less interested in the physical aspects of his life. He can seem idiosyncratic and it seems you can’t quite pin him down.
The most significant area of armoring for this character type is in the brain as the occipital region connects through the optic nerves to the eyes. The schizophrenic has a brain contraction and therefore retains high-energy charge in the head and withdrawal in the eyes. The energy flow does not circulate down toward the chest, organs and limbs therefore creating an implosion in the cranial area. Schizophrenics often feel tightness in their head muscles and occipital regions and those areas are painful to the touch.
One of the major symptoms of Schizophrenia is the split between perception and sensation. Thus excitation, which normally leads to sensation with perception is disrupted and split apart. If there is a malfunction in self-perception then consciousness is limited. Consciousness includes our capacity to orient and engage in social reality. If the dysfunction is severe then thoughts and perceptions are separated off from the body. This results in confusion, disorientation and projections on to others and a lack of clarity in all areas.
Thus their communication about things can seem odd or disconnected from what others generally perceive.
The Schizophrenic cannot ‘see clearly’ and integrate the rainbow of feelings: fear, love, anxiety or anger due to chronic misperception of reality. As they exist more in the thinking function, cut off from their body, they don’t have sufficient access to emotions. In order to feel, we need an organized, integrated perception-sensation function.
Schizophrenics go off in their eyes. Their eyes can appear receded, vacant, trance-like and are seemingly not connected. If he is overly stimulated, has more sensation than he can tolerate, he will immediately remove himself by going away in his eyes therefore losing further contact with reality. Sensations and stimulation may lead to distortions or delusions in their way of feeling. The ocular block results in disorientation, dissociation and withdrawal of interests.
The Schizophrenic breathes at a minimum due to lack of energy flow to the respiratory center of the brain. They keep their energy level down with their repressed breathing style. The lowered energy level, due to limited breathing, reduces sensation and stimulation so he doesn’t need muscular armoring to hold the excess energy. The lack of body armor permits heightened awareness as it is not bound in muscular holding throughout the body. So the Schizophrenic can be acutely alive and aware of his environment through one function like perception or another as in sensation – albeit with a limited movement of energy so he can feel more comfortable.
This type also has a tight throat and therefore can have a raspy voice or sound constricted when he speaks. He doesn’t express emotions easily as his throat is chronically, partially closed up inhibiting his ability to vocalize and emote. He can be shy and timid, withdrawing easily if threatened.
Due to the ocular block, the Schizophrenic has poor contact within himself, others and the external environment. He can project and misinterpret because his vision is compromised. With distorted awareness he misinterprets and lacks perspective. So he doesn’t read cues from others, doesn’t relate well in social situations and can be lost in his head thinking with distorted perceptions. He can lack a capacity for empathy.
The defining emotion for the Schizophrenic is fear. He is fearful about most things partly because he is out of contact, misinterprets and has sensations devoid of perceptions that ground him in reality. He can have an imagination that takes him to fearful places. He can be terrified of others, feel threatened and then feel hatred due to the threat he misperceives.
Let’s take a look at a fictional example:
Shana came to therapy at 19 with encouragement from her concerned parents. She was accepted to college but felt so much anxiety and fear that she ended up having to return home before the year ended. She collapsed at home in a depression. She was also smoking pot somewhat regularly. She felt lost and inadequate. Shana was consumed with circular thinking and fearful rumination as she surfed the internet daily. Other than that she was doing nothing. She had a muted, weak voice, a slender body and unfocused eyes. She looked disheveled when she came to her appointment. Therapy was about first unwinding her anxiety and fear to discover the contributing elements. First order of business was to stop her pot smoking that was a form of self-medication to numb her high anxiety. Stopping pot helped her to become more connected to reality and her feelings. As we unraveled her situation, she explored the disconnectedness she always felt with her parents who were aging hippies who still smoked pot and lead unconventional lives. Their lifestyle was difficult for her growing up as she felt ignored and was not helped to form regulated habits that would have contributed to her sense of confidence. Therapy helped her create form and substance in her self and her life that enabled her to become independent and return to college.
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The Schizophrenic can lack aggression due to his confusion and lack of strength both psychologically and physically. Confusion is a major characteristic. His confusion weakens his aggression, as he doesn’t know what he really thinks and feels. This confusion stems from his eye block as he is unable to define his reality. He suffers from an un-integrated quality and can seem disorganized. The interface with reality is less than orderly as his focus on the brain and thinking can predominate over a hands-on sense of reality.
A small portion of Schizophrenics can be prone to exaggerated paranoid thinking due to their lack of visual and perceptual clarity. Their paranoia can lead to an attitude of grandiosity and righteous indignation perpetuated by an inflated, all-knowing attitude. They project fear and anger outside themselves and on to others, including institutions. For the Schizophrenic with paranoia, he may have doomsday scenarios that result in paranoia in the financial realm. He can be fearful of conventional institutions or become vulnerable to hoarding and other schemes like stockpiling gold. Or, he can be mistrustful of the government, conventional medicine, educational authorities, and other institutions of authority; paranoid thinking can also manifest in political extremism.
These fears can lead, in an extreme form, to isolated, marginalized types who feel deeply inadequate and live in their mind with enhanced projections on the outside world. They long for power as they feel that they don’t fit in and feel rejected. Often they feel inadequate in love relationships as they do not extend themselves to create normal relationships due to their insecurity. They defend against their deeper pain by engaging in compulsive internet use and social media to compensate. Here they lose further contact with reality and dive deeper and deeper into delusions.
In the most impaired cases, we see the loner gunman acting out his paranoid, grandiose fantasy and distorted perceptions. Through mass shootings, he captures a sense of power and publicity that compels him beyond his small life and results in a suicidal mission, as well.
Some extreme political fanatics or zealots are Paranoid Schizophrenics— out of contact with reality, slaves to their ideological thinking that turns into religious fanaticism and bigotry. They can become righteous zealots that justify heinous actions for the sake of their cause. It is not only the Paranoid Schizophrenic that may act out in society. The Psychopathic Personality disorder, the Phallic Paranoid Character Type (Reich), the Paranoid Personality Disorder and the Devaluing Narcissist can also be implicated in these type of crimes against society.
Schizophrenics may be inclined to use marijuana but that is not a good idea. They are already out of contact in their eyes and pot makes it worse. Many ‘potheads’ are Schizophrenic, diffuse in their dealings in life, ‘spaced out’ and floating as if in a cloud above reality. Pot can encourage marginalization from society. Habitual pot use must be discouraged and particularly with this type.
Many of the character types can have an ocular block. If the eye segment is quite problematic then that defines more the character manifestations. For example, a Hysteric may have a significant eye block but retain her Hysteric qualities, but if the eye block and characteristics of the block dominate, than she might be labeled a Schizophrenic.
Therapy teaches the Schizophrenic to increase his capacity for contact and regulate his life better, enabling more grounding and confidence. Therapy can challenge the paranoid assumptions. Work on the relational deficiencies helps to unlock the buried pain. Treatment helps the Schizophrenic communicate better and feel more connected to others and that relieves symptoms.