The Lathe of Heaven
Page 6
One patient, however, he did keep. He was a psychiatrist, after all. He had gone into sleep research and oneirology in the first place to find therapeutic applications. He was not interested in detached knowledge, science for science' sake: there was no use learning anything if it was of no use. Relevance was his touchstone. He would always keep one patient of his own, to remind him of that fundamental commitment, to keep him in contact with the human reality of his research in terms of the disturbed personality structure of individual people. For there is nothing important except people. A person is defined solely by the extent of his influence over other people, by the sphere of his interrelationships; and morality is an utterly meaningless term unless defined as the good one does to others, the fulfilling of one's function in the sociopolitical whole.
His current patient, Orr, was coming in at four this afternoon, for they had given up the attempt at night sessions; and, as Miss Crouch reminded him at lunch tune, an HEW inspector was going to observe today's session, making sure there was nothing illegal, immoral, unsafe, unkind, unetc., about the operation of the Augmentor. God damn Government prying.
That was the trouble with success, and its concomitants of publicity, public curiosity, professional envy, peer-group rivalry. If he'd still been a private researcher, plugging along in the sleep lab at P.S.U. and a
second-rate office in Willamette East Tower, chances were that nobody would have taken any notice of his Augmentor until he decided it was ready to market, and he would have been let alone to refine and perfect the device and its applications. Now here he was doing the most private and delicate part of his business, psychotherapy with a disturbed patient, so the Government had to send a lawyer barging in not understanding half of what went on and misunderstanding the rest.
The lawyer arrived at 3:45, and Haber came striding into the outer office to greet him—her, it turned out— and to get a friendly warm impression established right away. It went better if they saw you were unafraid, cooperative, and personally cordial. A lot of doctors let their resentment show when they had an HEW inspector; and those doctors did not get many Government grants.
It was not altogether easy to be cordial and warm with this lawyer. She snapped and clicked. Heavy brass snap catch on handbag, heavy copper and brass jewelry that clattered, clump-heel shoes, and a huge silver ring with a horribly ugly African mask design, frowning eyebrows, hard voice: clack, clash, snap.... In the second ten seconds, Haber suspected that the whole affair was indeed a mask, as the ring said: a lot of sound and fury signifying timidity. That, however, was none of his business. He would never know the woman behind the mask, and she did not matter, so long as he could make the right impression on Miss Lelache the lawyer.
If it didn't go cordially, at least it didn't go badly; she was competent, had done this kind of thing before, and had done her homework for this particular job. She knew what to ask and how to listen.
"This patient, George Orr," she said, "he's not an addict, correct? Is he diagnosed as psychotic or disturbed, after three weeks' therapy?"
"Disturbed, as the Health Office defines the word. Deeply disturbed and with artificial reality-orientations, but improving under current therapy."
She had a pocket recorder and was taking all this down: every five seconds, as the law required, the thing went teep.
"Will you describe the therapy you're employing please, teep and explain the role this device plays in it?
Don't tell me how it teep works, that's in your report, but what it does. Teep for instance, how does its use differ from the Elektroson or the trancap?"
"Well, those devices, as you know, generate various low-frequency pulses which stimulate nerve cells in the cerebral cortex. Those signals are what you might call generalized; their effect on the brain is obtained in a manner basically similar to that of strobe lights at a critical rhythm, or an aural stimulus like a drumbeat. The Augmentor delivers a specific signal which can be picked up by a specific area. For instance, a subject can be trained to produce alpha rhythm at will, as you know; but the Augmentor can induce it without any training, and even when he's in a condition not normally conducive to the alpha rhythm. It feeds a 9-cycle alpha rhythm through appropriately placed electrodes, and within seconds the brain can accept that rhythm and begin producing alpha waves as steadily as a Zen Buddhist in trance.
Similarly, and more usefully, any stage of sleep can be induced, with its typical cycles and regional activities."
"Will it stimulate the pleasure center, or the speech center?"
Oh, the moralistic gleam in an ACLU eye, whenever that pleasure-center bit came up! Haber concealed all irony and irritation, and answered with friendly sincerity, "No. It's not like ESB, you see. It's not like electrical stimulation, or chemical stimulation, of any center; it involves no intrusion on special areas of the brain. It simply induces the entire brain activity to change, to shift into another of its own, natural states.
It's a bit like a catchy tune that sets your feet tapping. So the brain enters and maintains the condition desired for study or therapy, as long as need be I called it the Augmentor to point up its noncreative function. Nothing is imposed from outside. Sleep induced by the Augmentor is precisely, literally, the kind and quality of sleep normal to that particular brain. The difference between it and the electrosleep machines is like a personal tailor compared to mass-produced suits. The difference between it and electrode implantation is—oh, hell—a scalpel to a sledgehammer!"
"But how do you make up the stimuli you use? Do you teep record an alpha rhythm, for instance, from one subject to use on another teep?"
He had been evading this point. He did not intend to lie, of course, but there was simply no use talking about uncompleted research till it was done and tested; it might give a quite wrong impression to a nonspecialist. He launched into an answer easily, glad to hear his own voice instead of her snapping and bangle-clattering and teeping; it was curious how he only heard the annoying little sound when she was talking. "At first I used a generalized set of stimuli, averaged out from records of many subjects. The depressive patient mentioned in the report was treated successfully thus. But I felt the effects were more random and erratic than I liked. I began to experiment. On animals, of course. Cats. We sleep researchers like cats, you know; they sleep a lot! Well, with animal subjects I found that the most promising line was to use rhythms previously recorded from the subject's own brain. A kind of autostimulation via recordings. Specificity is what I'm after, you see. A brain will respond to its own alpha rhythm at once, and spontaneously. Now of course there are therapeutic vistas opened up along the other line of research. It might be possible to impose a slightly different pattern gradually upon the patient's own: a healthier or completer pattern. One recorded previously from that subject, possibly, or from a different subject. This could prove tremendously helpful in cases of brain damage, lesion, trauma; it might aid a damaged brain to re-establish its old habits in new channels—something which the brain struggles long and hard to do by itself. It might be used to 'teach' an abnormally functioning brain new habits, and so forth. However, that's all speculative, at this point, and if and when I return to research on that line I will of course reregister with HEW." That was quite true. There was no need to mention that he was doing research along that line, since so far it was quite inconclusive and would merely be misunderstood.
"The form of autostimulation by recording that I'm using in this therapy may be described as having no effect on the patient beyond that exerted during the period of the machine's functioning: five to ten minutes." He knew more of any HEW lawyer's specialty than she knew of his; he saw her nodding slightly at that last sentence, it was right down her alley.
But then she said, "What does it do, then?" "Yes, I was coming to that," Haber said, and quickly readjusted his tone, since the irritation was showing through. "What we have in this case is a subject who is afraid to dream: an oneirophobe. My treatment is basically a simple conditioning
treatment in the classic tradition of modern psychology. The patient is induced to dream here, under controlled conditions; dream content and emotional affect are manipulated by hypnotic suggestion. The subject is being taught that he can dream safely, pleasantly, et cetera, a positive conditioning which will leave him free of his phobia. The Augmentor is an ideal instrument for this purpose. It ensures that he will dream, by instigating and then reinforcing his own typical d-state activity. It might take a subject up to an hour and a half to go through the various stages of s-sleep and reach the d-state on his own, an impractical length for daytime therapy sessions, and moreover during deep sleep the force of hypnotic suggestions concerning dream content might be partly lost. This is undesirable; while he's in conditioning, it's essential that he have no bad dreams, no nightmares. Therefore the Augmentor provides me with both a timesaving device and a safety factor. The therapy could be achieved without it; but it would probably take months; with it, I except to take a few weeks. It may prove to be as great a timesaver, in appropriate cases, as hypnosis itself has proved to be in psychoanalysis and in conditioning therapy."
Teep,said the lawyer's recorder, and Bong said his own desk communicator in a soft, rich, authoritative voice. Thank God. "Here's our patient now. Now I suggest, Miss Lelache, that you meet him, and we may chat a bit if you like; then perhaps you can fade off to that leather chair in the corner, right? Your presence shouldn't make any real difference to the patient, but if he's constantly reminded of it, it could slow things down badly. He's a person in a fairly severe anxiety state, you see, with a tendency to interpret events as personally threatening, and a set of protective delusions built up—as you'll see. Oh yes, and the recorder off, that's right, a therapy session's not for the record. Right? O.K., good. Yes, hello, George, come on in! This is Miss Lelache, the participant from HEW. She's here to see the Augmentor in use." The two were shaking hands in the most ridiculously stiff way. Crash clank! went the lawyer's bracelets. The contrast amused Haber: the harsh fierce woman, the meek characterless man.
They had nothing in common at all.
"Now," he said, enjoying running the show, "I suggest that we get on with business, unless there's anything special on your mind, George, that you want to talk about first?" He was, by his own apparently unassertive movements, sorting them out: the Lelache to the chair in the far corner, Orr to the couch.
"O.K., then, good. Let's run off a dream. Which will incidentally constitute a record for HEW of the fact that the Augmentor doesn't loosen your toenails, or harden your arteries, or blow your mind, or indeed have any side effects whatsoever except perhaps a slight compensatory decrease in dreaming sleep tonight." As he finished the sentence he reached out and placed his right hand on Orr's throat, almost casually.
Orr flinched from the contact as if he had never been hypnotized.
Then he apologized. "Sorry. You come at me so suddenly."
It was necessary to rehypnotize him completely, employing the v-c induction method, which was perfectly legal of course but rather more dramatic than Haber liked to use in front of an observer from HEW; he was furious with Orr, in whom he had sensed growing resistance for the last five or six sessions. Once he had the man under, he put on a tape he had cut himself, of all the boring repetition of deepening trance and posthypnotic suggestion for rehypnotizing: "You are comfortable and relaxed now.
You are sinking deeper into trance," and so on and so on. While it played he went back to his desk and sorted through papers with a calm, serious face, ignoring the Lelache. She kept still, knowing the hypnotic routine must not be interrupted; she was looking out the window at the view, the towers of the city.
At last Haber stopped the tape and put the trancap on Orr's head. "Now, while I'm hooking you up let's talk about what kind of dream you're going to dream, George. You feel like talking about that, don't you?"
Slow nod from the patient.
"Last time you were here we were talking about some things that worry you. You said you like your work, but you don't like riding the subway to work. You keep feeling crowded in on, you said—squeezed, pressed together. You feel as if you had no elbow room, as if you weren't free."
He paused, and the patient, who was always taciturn in hypnosis, at last responded merely:
"Overpopulation."
"Mhm, that was the word you used. That's your word, your metaphor, for this feeling of unfreedom.
Well, now, let's discuss that word. You know that back in the eighteenth century Malthus was pressing the panic button about population growth; and there was another fit of panic about it thirty, forty years
ago. And sure enough population has gone up; but all the horrors they predicted just haven't come to pass. It's just not as bad as they said it would be. We all get by just fine here in America, and if our living standard has had to lower in some ways it's even higher in others than it was a generation ago. Now perhaps an excessive dread of overpopulation—overcrowding—reflects not an outward reality, but an inward state of mind. If you feel overcrowded when you're not, what does that mean? Maybe that you're afraid of human contact—of being close to people, of being touched. So you've found a kind of excuse for keeping reality at a distance." The EEG was running, and as he talked he made the connections to the Augmentor. "Now, George, we'll be talking a little longer and then when I say the key word 'Antwerp' you'll drop off to sleep; when you wake up you'll feel refreshed and alert. You won't recall what I'm saying now, but you will recall your dream. It'll be a vivid dream, vivid and pleasant, an effective dream. You'll dream about this thing that worries you, overpopulation: you'll have a dream where you find out that it isn't really that that worries you. People can't live alone, after all; to be put in solitary is the worst kind of confinement! We need people around us. To help us, to give help to, to compete with, to sharpen our wits against" And so on and so on. The lawyer's presence cramped his style badly; he had to put it all in abstract terms, instead of just telling Orr what to dream. Of course, he wasn't falsifying his method in order to deceive the observer; his method simply wasn't yet invariable. He varied it from session to session, seeking for the sure way to suggest the precise dream he wanted, and always coming up against the resistance that seemed to him sometimes to be the overliteralness of primary-process thinking, and sometimes to be a positive balkiness in Orr's mind. Whatever prevented it, the dream almost never came out the way Haber had intended; and this vague, abstract kind of suggestion might work as well as any. Perhaps it would rouse less unconscious resistance in Orr.
He gestured to the lawyer to come over and watch the EEG screen, at which she had been peering from her corner, and went on: "You're going to have a dream in which you feel uncrowded, unsqueezed. You'll dream about all the elbow room there is in the world, all the freedom you have to move around." And at last he said, "Antwerp!"—and pointed to the EEG traces so that the Lelache would see the almost instantaneous change. "Watch the slowing down all across the graph," he murmured. "There's a high-voltage peak, see, there's another. . . . Sleep spindles. He's already going into the second stage of orthodox sleep, s-sleep, whichever term you've run into, the kind of sleep without vivid dreams that occurs in between the d-states all night. But I'm not letting him go on down into deep fourth-stage, since he's here to dream. I'm turning on the Augmentor. Keep your eye on those traces. Do you see?"
"Looks like he was waking up again," she murmured doubtfully.
"Right! But it's not waking. Look at him." Orr lay supine, his head fallen back a little so that his short, fair beard jutted up; he was sound asleep, but there was a tension about his mouth; he sighed deeply.
"See his eyes move, under the lids? That's how they first caught this whole phenomenon of dreaming sleep, back in the 1930's; they called it rapid-eye-movement sleep, REM, for years. Ifs a hell of a lot more than that, though. It's a third state of being. His whole autonomic system is as fully mobilized as it might be in an exciting moment of waking life; but his muscle tone is nil, th
e large muscles are relaxed more deeply than in s-sleep. Cortical, subcortical, hippocampal, and midbrain areas all as active as in waking, whereas they're inactive in s-sleep. His respiration and blood pressure are up to waking levels or higher. Here, feel the pulse." He put her fingers against Orr's lax wrist. "Eighty or eighty-five, he's going.
He's having a humdinger, whatever it is. . . ."
"You mean he's dreaming?" She looked awed.
"Right."
"Are all these reactions normal?"
"Absolutely. We all go through this performance every night, four or five times, for at least ten minutes at a time. This is a quite normal d-state EEG on the screen. The only anomaly or peculiarity about it that you might be able to catch is an occasional high peaking right through the traces, a kind of brainstorm effect I've never seen in a d-state EEG before. Its pattern seems to resemble an effect that's been observed in electroencephalograms of men hard at work of a certain sort: creative or artistic work, painting, writing verse, even reading Shakespeare. What this brain is doing at those moments, I don't yet know. But the Augmentor gives me the opportunity to observe them systematically, and so eventually to analyze them out."
"There's no chance that the machine is causing this effect?"
"No." As a matter of fact, he had tried stimulating Orr's brain with a playback of one of these peak traces, but the dream resulting from that experiment had been incoherent, a mishmash of the previous dream, during which the Augmentor had recorded the peak, and the present one. No need to mention inconclusive experiments. "Now that he's well into this dream, in fact, I'll cut the Augmentor out. Watch, see if you can tell when I cut off the input." She couldn't "He may produce a brainstorm for us anyhow; keep an eye on those traces. You may catch it first in the theta rhythm, there, from the hippocampus. It occurs in other brains, undoubtedly. Nothing's new. If I can find out what other brains, in what state, I may be able to specify much more exactly what this subject's trouble is; there may be a psychological or neurophysiological type to which he belongs. You see the research possibilities of the Augmentor? No effect on the patient except that of temporarily putting his brain into whichever of its own normal states the physician wants to observe. Look there!" She missed the peak, of course; EEG-reading on a moving screen took practice. "Blew his fuse. Still in the dream now. . . . He'll tell us about it presently." He could not go on talking. His mouth had gone dry. He felt it: the shift, the arrival, the change.