- Split Model of Reality.
The chapter starts with a history of views on the condition that we now call autistic spectrum disorders (ASD). Most of the approaches focus on the apparent set of external symptoms that can be described in one word: dissociation. Hence the name of the condition ‘autism,’ meaning withdrawal into oneself. But dissociative withdrawal is not a pathological condition per se. It is one of the three natural reactions of any living system to danger: fight, flight, and freeze. We all dissociate if the environment brings an overload of numerous signals with many parameters and complex dynamics of these parameters so that the brain cannot cope with integration and limits the flow of incoming signals. But in ASD this ‘frozen’ state is chronic. What is the reason?
From the Teleological Transduction Theory (TTT) perspective, the mind is the process of encoding environmental signals and creating their representations to form a coherent and adaptive reality model. The logical conclusion is that any maladaptive state of the mind is some kind of disturbance in this process and ensuing incoherence of the model. It is not the world that is dangerous for autistic people; it is the picture of the world that their mind creates that causes fear and dissociative reaction. The world model is split internally and a person is split from the world. This simple and not new assumption leads to further questions about the nature of the violation that creates the splitting of the model, which are still unresolved.
The chapter offers a solution based on the TTT concept of the physical mechanism that creates the harmonious structure of the reality model and algorithm that the brain employs to produce the coherent flow of the mind. If we have an understanding of the norm, then the hypotheses about pathology are only opposites of the hypotheses about the harmonious state of the system.
- The Chaotic World Syndrome.
The environment is complex and potentially dangerous for anyone. However, we make sense of the world and, in the usual course of events, consider it quite coherent. But for an autistic person, the world is an intolerable, incomprehensible and terrifying cacophony full of dissonances. The chapter continues to explore the nature of the disturbance of the physical mechanism that usually binds the model into a coherent structure. It also offers a clear hypothesis at what stage there is a break of the mind’s algorithm in ASD and what brain structures are involved.
- Kaleidoscope of Reality.
We can use a metaphor of a constantly rotating kaleidoscope to describe the autistic condition. To stop the senseless rotation of bits and pieces, an autistic person either shuts off from the world or tries to compensate by focusing on specific details. The chapter looks at behavioral and physiological markers of the autistic condition from the point of view of the proposed hypotheses about the nature of the brain’s internal state. Thus, the bits and pieces that have been rotating in models of autism when theorists were trying to focus on one or another symptom start to fall into place. The new model shows how to get out of the autistic position of science on the issue of autism.
The chapter also offers a new name for the condition, and it reflects the internal problem. We begin to move away from the standard symptomatic diagnostic classification in psychiatry by seeing that many diseases that are now put on different ‘shelves’ in the manuals result from the same internal state of the nervous system. They may have various etiology, and differ in some details of the pathogenesis and clinical picture, but the essence of the violation of the normal brain work is the same. ASD becomes a clinical subclass of a new general diagnostic category based on a clear definition of the state of the organ performing a specific function.
- Collapse of the Integrative Function.
This chapter focuses on the function violated in states of the split model of reality: the integration of various representations into a coherent picture of the world. When we say ‘picture,’ we mean not only visual modality. But for the sake of illustrative power, this chapter deals mainly with how people with such a model actually see the world. Taking the examples of visual arts created by people with a formal diagnosis and without it, the chapter shows the inside-out view of what their mind’s ‘eye’ produces. We begin to understand why the world is scary for them.
- Reality Model Assembly Line.
The normal and smooth production of reality model involves well-coordinated processes both at the stages of preparation of parts (primary signal conversion), adjusting them to the standards of the entire system (modulation), assembly into system blocks (primary integration), and at the stage of final assembly (higher integration). The whole system is set up to ensure that the product goes out in a working state and can perform its inherent functions efficiently and reliably.
There may be failures at any stage of the process. Failures in modalities of perception and even complete loss of one modality can be compensated. Failure at the stage of higher integration leads to the impossibility of creating the final product — a comprehensive, effective, reliable, coherent and working model of reality. To fix the breakdown, we need to understand what is physically happening at this stage of the process. Only in this case, there is hope for minimizing losses and even for a complete restoration of the reality model ‘assembly line.’ The chapter shows at what stage the collapse of the integrative function happens and describes what is going on with the physical activity of the higher integrators of the brain.
- Technological Jams of the Mind.
By taking examples of pathological states with different etiology, this chapter illustrates how the collapse of the higher integrative function causes various clinically observed behavioral symptoms and physiological markers of the split model of reality.
- Building Bridges.
When constructing the model of any pathology, we need to build a bridge between the internal physiological phenomena and psychological symptoms. The major problem with many mental disorders is that they are not detected by the methods of conventional neurological diagnostics aimed at gross violations of the spatial structure of the neural network. This problem led to such pathologies being simply attributed to the ‘riddles of the soul.’ But a violation of the integrative function means a change in the spatial and temporal organization of the neural network. Assessing the state of the system (diagnostics) requires determining the condition of both aspects. It is necessary to go deep into the network topology details and the details of the fine temporal regulation of oscillatory processes of the brain.
Unfortunately, when it comes to mental disorders, the second option is almost never considered in conventional neurology and psychiatry. It is not only due to the deficiency of current diagnostic technologies but is the result of the conceptual gap. The chapter goes back to the hypothesis about the binding mechanism that was worked out in the previous volumes and suggests the way out of the dead-end. Once again, the model of how the mind works normally helps in understanding the malfunction.
- The Puzzle of Life.
This chapter takes some clinical cases of ASD with various levels of disruption and shows that, despite significant functionality differences, they all have similar markers of core deficiency. The degree of severity depends on the level of violation of the normal integration processes. In some cases, compensation is possible, but it requires high computational costs, and the speed and efficiency of the process suffer. In other cases, the system cannot complete the ‘puzzle’ from pieces even at the expense of great effort.
- Bedlam of Psychiatry.
Undoubtedly, compared with the old notions of “demon possession” or “curse of god” we have advanced in our understanding of mental disorders. But in cases where the etiology and pathogenesis are not clear, there is a diagnostic failure. All diagnoses related to psychiatry say nothing about brain state. Thus, psychiatry substitutes the real diagnosis as an assessment of the state of the organ performing the mental function by syndromic pseudo-diagnosis as a label for a set of symptoms. As soon as the picture of the etiology, pathogenesis, and physiology of a particular condition becomes more or less clear, the diagnosis moves from the sphere of psychiatry to the sphere of neurology or other medical specialties.
But many pathologies stay stubbornly in the vague domain of psychosis (from ancient Greek ψύχωσις — disturbed soul). Schizophrenia is one of them. It is obviously a mental disorder in the sense that the normal functioning of the mind is disrupted. But what kind of disorder of the brain is it? So far, there is no understanding of the neural basis of pathology. There is no concept of the physical process violation which manifests itself in those symptoms that have been combined into the name of the syndrome ‘schizophrenia.’ The chapter starts to build bridges between the observed external pathological manifestations and their possible internal physical and technological reasons.
- Brain Integrators Dysfunction.
This chapter returns to the original description of schizophrenia by Eigen Bleuler, who coined the term in 1911. According to Bleuler, its main feature is the violation of the unity of the psyche. He singled out four A’s as diagnostic criteria: ambivalence (contradictory thoughts, feelings and desires), autism (avoiding contact), impaired associations and decreased affect. The word schizophrenia (from the Greek ‘split mind’) accurately described the symptomatology. It was an apt name for the syndrome, emphasizing the impairment of coordination between different mental functions (cognitive, emotional, motivational). Bleuler was perhaps the first to emphasize the secondary nature of the symptomatology that attracted the attention of other researchers (hallucinations, delirium, behavioral manifestations).
Schizophrenia is an integration disorder, just like autism. The schism between the reality model and the environment’s signals and the dissociative reaction as a defense against an incomprehensible environment is common in both conditions. Associative deficits (the problem of linking meanings into coherent patterns) are also a manifestation of the split model of reality. Violation of smooth regulation of the affective sphere with sharp swings or a decrease in the general motivational and emotional level result from the kaleidoscopic reality model in both conditions. Hallucinations and delusions may or may not happen, but they are not the specific symptoms of schizophrenia and manifest in many other states. The chapter proposes a hypothesis about the nature of the pathology and gives it a name within the proposed new classification. Thus, it becomes a subclass in a general diagnostic category that indicates the internal state of the substrate that leads to the externally observed symptoms.
- Evaluation Dysfunction.
There is one model of schizophrenia that can be called an attempt to take it out of the vague ‘disturbed soul’ domain — dopamine theory (DT). It is highly popular and has been the basis of treatment practice for many years. The major problem with this model is that it deals with only one side of the symptomatology (hallucinations and delusions). It is not about curing the core pathological state of cognitive function deterioration (four As). The chapter shows why the treatment practices that have been going on for dozens of years do not heal the fundamental problems inherent in the pathology. It is the result of the absence of a technological approach. That is why the reaction of the evaluative structures such as the dopamine system to the internal problem is taken for the problem itself. It is analogous to taking a fire alarm for the problem and extinguishing the alarm signal but not the fire. The chapter offers a hypothesis about the role of the dopamine system and the cause of its ‘fire alarm’ signal in schizophrenia. This assumption has non-trivial consequences: it means that the whole industry’s approach to the main systemic pathology of the mind should change.
- Delicate Strings of the Soul.
The integration mechanism proposed in TTT is a multiparameter process. There is no reason to associate the disintegration pathology with the dysfunction of only one type of neurotransmitter or receptor. The imbalance of the oscillatory process at the cellular and intercellular level leads to the observed phenomena of imbalances at the level of neuronal populations and general behavioral, cognitive and affective symptoms, which can be called in one word — disintegration. The chapter considers the details of this delicate process of tuning the ‘strings of the Soul’ and offers an explanation of the pathological state of chronic dissonance.
- When Strings of the Soul are out of Tune.
The modern methods of treating systemic disorders of the mind can be compared to trying to tune a violin with a hammer. It is no accident that among professionals, antipsychotics are called ‘chemical straitjacket.’ But the name ‘chemical lobotomy’ is more appropriate. The chapter describes some clinical cases as examples and takes meta-analytical longitudinal studies that show the dramatic adverse effects of antipsychotic drugs on brain tissue. The use of antipsychotics is aimed at extinguishing arousal and hallucinatory-delusional states, but negative symptoms increase and patients experience further decay of mental and motor activity. In short, current practice does not heal but cripple. This is the result of a conceptual error and lack of a clear model of the mind in the branch of medicine called ‘healing of the mind’ (psychiatry). The chapter offers a hypothesis on the nature of the underlying problem that causes the observed symptoms of schizophrenia. It gives a connecting thread on which individual aspects of internal and external manifestations of pathology can be strung. It gives hope for real diagnostics and therapy.
- A New Approach to the Diagnosis and Classification of Mind Pathologies.
This chapter summarizes the hypotheses proposed in this volume and places them within the general concept of the Teleological Transduction Theory. It offers a diagnostic class that is determined by the state of the organ that performs mental functions. This approach is new only to psychiatry. For the rest of medicine, it is a long-time standard. The shift from pseudo-diagnosing by calling sets of symptoms by various names in Old Greek to actual diagnoses is long overdue. If there is a new conceptual approach to diagnosis, then a new approach to treatment practice will arise. We will have hope that systemic pathologies of the mind, including autism and schizophrenia, will become curable.