12 - 10. States and levels of awareness

10. States and levels of awareness

© SPMM Course 10. States and levels of awareness Consciousness is defined loosely as human awareness of stimuli. There are many theories of consciousness, e.g. Sigmund Freud’s Topographical model of the mind. The topographical model was elaborated in The Interpretation of Dreams in 1900. Here, the mind is divided into three systems: the conscious system, the preconscious system, and the unconscious system. The conscious system  Receives and process information from the outside world.  Its contents are communicated via speech and behaviour.  Attention cathexis refers to the investment of psychic energy on a particular idea or feeling to process it consciously. Cathexis is ‘stable’ in the conscious mind.  Operates secondary process thinking mainly. The unconscious system:  Contains the contents of censored or repressed wishes.  Characterized by primary-process thinking, and is governed by the pleasure principle.  Shift of cathexis happens very often and quickly  Evident via parapraxes (Freudian slips) and dreams. The preconscious system:  As and when needed service  Interfaces with both unconscious and conscious - contents of unconscious become conscious by ‘squeezing’ through the preconscious  Maintains the ‘repressive barrier’ to censor unacceptable wishes and desires (not the repressed contents). Problems with a topographic theory: When someone employs defense mechanisms such as displacement, repression etc., he or she is not aware of the process of this defense. Hence, these cannot be represented by preconscious as Freud originally proposed – as preconscious is available to the conscious ‘as and when’ needed. Further, an ‘unconscious need for punishment’ was frequently noted among Freud’s patients – topographical theory fails to explain this. The role of the unconscious mind in decision-making is still greatly debated. Unconscious cognition is processing of memory, thought, learning and perception without awareness. Freud believed the unconscious stored memories and desires that influenced an individual's thought process. Freud believed the unconscious could be accessed through dream analysis and random association. Carl Jung categorised the unconscious into personal unconscious (holding individual memories/experiences) and collective unconscious (holding memories/experiences of a species passed down through generations). Arousal: physiological and psychological state of being awake/reactive to stimuli. Activation of the reticular activating system in the brain stem, along with the autonomic nervous system leads to an ‘alert

© SPMM Course state’ – raised blood pressure and heart rate, alertness and readiness to respond. Arousal regulates consciousness and attention, important for fight-or-flight response and sexual activity. Arousal is also crucial for the appraisal of emotion (see notes for emotion theory) and motivation (see notes for motivation). Alertness is a state of heightened awareness of environmental stimuli resulting in ability to act promptly to danger. Biorhythms: Chronobiology refers to the study of biological rhythms. Various biological processes of the human body repeat themselves in a cyclical fashion indicating the presence of a biorhythm. Processes repeating approximately every 24 h are considered to have a daily rhythm (circadian e.g. sleep-wake cycle); those with cycles lasting less than a day are called ultradian (e.g. daily arousal levels, phased brain activity patterns during sleep) while those lasting more than a day are called infradian (e.g. menstrual cycles last 28-30 days). Infradian rhythms may also occur as a result of seasonal changes in animals e.g. migration cycles in birds and hibernation in some mammals - these are called circannual rhythms. Biorhythms are driven mostly by endogenous factors but are entrained by external time cues (called ‘zeitgebers’ or time givers). For example, light is an important zeitgeber without which the sleep-wake circadian cycle may indeed be a 25h cycle instead of the entrained 24h cycle that we have. Social zeitgebers are external social cues that function to entrain biological rhythms, e.g. the need to go to work by 8AM, etc. Life events that disrupt social zeitgebers can increase one’s vulnerability to depression/manic episodes. The suprachiasmatic nucleus is an internal pacemaker located in the anterior hypothalamus that regulates many biorhythms. More details on this neuroendocrine system are given in the Neuroscience section along with details regarding sleep structure and parasomnias. Sleep deprivation: Most cognitive processes cope surprisingly well despite sleep deprivation. In early stages, sleep deprived individuals show reduced arousal and perform poorly on monotonous tasks, but optimally on interesting tasks, indicating that the motivation to perform is more affected than one’s performance capacity. With further deprivation, 2-3 second periods of micro-sleep (wherein the individual is unresponsive) are noted. The individual also complains of ‘hat phenomenon’ a feeling that “something is gripping one’s forehead and temples”. Further deprivation results in delusional ideations, paranoia, loss of sense of identity and difficulty in social interaction including disorganized speech; this syndrome is termed sleep-deprivation psychosis. Upon deprivation, sleep debt accumulates over time, some of which is ‘paid back’ when an individual resumes sleep after the period of deprivation. REM sleep deprivation has profound effects on concentration and other psychological functions. REM phases of sleep recover better than NREM sleep, a phenomenon known as REM rebound. Hypnosis: the state of consciousness involving focused attention and reduced peripheral awareness. There are two theories about what occurs – altered state: hypnosis is an altered state of mind with a level of awareness different from normal; non-state: hypnosis is a form of imaginative role-enactment.

© SPMM Course Normally preceded by ‘hypnotic induction’, non-state theory suggests the client becomes more focused, heightens expectation.

The term suggestion (instruction or suggestion of subject into the hypnotic state) was not used in the initial description of hypnotism, but suggestion now forms part of the language associated with hypnosis. Some state that ‘suggestion’ is communication directed at the conscious mind whereas others believe it is communication with the unconscious. Braid defined hypnotism as focused (conscious) attention upon a dominant idea (or suggestion). Other hypnotists (e.g. Erickson) who believed that responses are mediated through an ‘unconscious mind’, employed indirect suggestions such as metaphors.

Meditation is defined the practice of training one’s mind or inducing a mode of consciousness for the benefit or as an end itself. It often involves self-regulation and clearing the mind. It can help reduce blood pressure, help with anxiety and depression. Mindfulness-based therapy is about increasing awareness of emotions/cognitions in order to address them. Trance is a state of consciousness other than normal waking consciousness. It can be associated with hypnosis meditation, prayer and illicit substances. It denotes any state of awareness or consciousness other than normal waking consciousness.