Archive for July, 2010

Neurodiversity:an interview with Dr. Thomas Armstrong

Eight women representing prominent mental diag...
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I recently read Neurodiversity: discovering the extraordinary gifts of Autism, ADHD, Dyslexia and other brain differences(you can read a mini review here) by Dr. Thomas Armstrong and came away impressed. In the book Dr Armstrong makes a  strong case for viewing the traditional disabilities from a differences perspective and to focus on the different strengths and abilities of the neurodiverse people. A recurring theme of this blog has been that autism and schizophrenia/psychosis are opposites on a continuum model as proposed amongst others by Christopher Badcock and Beranard Crespi. Dr Armstrong touches on this model in his chapter on autism, though that not central to his theis .

Dr Armstrong, was kind enough to answer a few questions for the benefit of our readers and these are reproduced below:

[SG] You have written a wonderful book on neurodiversity. Could you explain in brief, for the benefit of our readers, why neurodiversity has become so important in today’s context and why the focus on neurodiversity now when the differences that underlie the neurodiverse spectrum themselves are age-old?

[TA] I think neurodiversity is, as I’ve suggested in my book, “a concept whose time has come” because of the disability culture we live in. Almost half of us will have mental disorders sometime during our lifetime according to the National Institute of Mental Health, and even more will have “shadow syndromes” or minor versions of those disorders. When we get to the point where virtually everyone is seen as having a mental disorder to one degree or another, I think it’s time that we shift paradigms and use a diversity model instead of a disability model to account for those differences.

[SG] How much does neurodiversity owe to the Autistic advocacy movement and whether those beginnings are productive or counterproductive when one wants to bring other differences like mood or anxiety differences in the fold and talk about them as well?

[TA] I believe that the autistic advocacy movement deserves a great deal of credit for coining and developing the idea of neurodiversity. It’s rather amazing that a group of people who are known for their non-social attributes have made this contribution to our social understanding of brain differences. My hope is that my book Neurodiversity will help to broaden the concept of neurodiversity to include a wider range of abilities/disabilities. As far as I can see from looking at many sites online, there is an openness in the autism community to expanding the definition of neurodiversity beyond simply autism and Asperger’s syndrome.

[SG] Positive Psychology shares some of the same concerns as that of the Neurodiverse movement- the focus on strengths and what works and skepticism about the disease and pathology model- yet why hasn’t, in your opinion neurodiversity become center stage like the positive psychology movement has? Is it because in neurodiversity we are swinging the pendulum too much to the other side and perhaps blinding ourselves to underlying pathologies by claiming everything as differences?

[TA] No, I think it has to do with the credibility of the leadership of the Positive Psychology movement – spearheaded by a former president of the American Psychological Association and other famous professors of psychology. It’s essentially a top-down movement, whereas neurodiversity seems to me to be a bottom-up or “grass roots” movement that is coming from the people who are actually themselves neurodiverse. I don’t think of the neurodiversity movement as saying “we’re all different so leave us alone” I believe that attention needs to be given to ameliorating the disability part of neurodiversity, even as we focus the spotlight on the abilities.

[SG] For the benefit of our readers, if you could highlight the differences between the dimensional and categorical model of pathologies/differences. I believe neurodviversity leans towards the dimensional (continuum ) model. What can DSM V learn form the findings you have discussed in the Neurodiversity book? is a dimensional model of pathology a better one as compared to the categorical one? a necessary evil? or can the DSM mentality be done away with altogether?

[TA] One of the eight principles that I discuss in my book Neurodiversity is that everyone exists along “continuums of competence” with respect to a range of human processes including sociability, literacy, intelligence(s), attention, mood, and so forth. This is very similar to the DSM-V’s embracing of a dimensional perspective, and to that extent, I think the DSM-V is moving in the right direction. The problem is that the DSM-V will be a high stakes publication, and if people are put on a continuum from normal to pathological, the fuzzy line where normal becomes pathological (and vice versa) becomes very important, and may determine whether a person will be labeled with a disorder, given a drug treatment, and perhaps even stigmatized as a result. There’s a danger that many so-called normal people will be added to the ranks of the mentally disordered. Also, what’s missing from the DSM (in all its versions) is any kind of discussion of the positive dimensions of each of the disability categories.

[SG] Just like DSM, positive psychologists have come up with a list of character strengths and virtues as for ex can be seen on VIA signature strength website. Do you think those lists are sufficiently inclusive and give equal weighting to the special abilities found in neurodiverse individuals?

[TA] I think the VIA-IS (or Values in Action Inventory of Strengths) is a positive contribution to our understanding of human personality. It would be good to see someone take this inventory and map it onto the various pathologies taken up in the DSM-V. Wedding the two manuals would be a definite step in the right direction.

[SG] How much yours and your fathers experience of depression has been a driving force in your passion for psychology and especially instrumental in your focusing energies on the neurodiverse people.

[TA] I think it’s been very much a contributory factor. Seeing how my father’s depression affected our family’s functioning while growing up, and how my own depression has shaped my adult life, has been extremely influential in leading me to the field of psychology, and in trying to find the silver lining beyond the dark cloud.

[SG] People who are on extremes of the neurodiverse spectrum face immense stigma in our society. Your chapter on neurodiverstity in classroom talks about inclusive classrooms as you believe special classrooms for special ed programs end up labeling children. How practical you think is the concept of a neurodiverse classroom, esp in developing countries like India. Is a special ed class, even if it ends up labeling a child, better than no intervention at all and traditional classroom education only?

[TA] In a system based on traditional classroom learning, I believe that special education programs outside of the traditional classroom have a place, especially if they are using cutting-edge techniques for helping kids with special needs. But as an educational reformer, I am always pressing educators to expand beyond traditional learning environments for all kids, and when we utilize teaching methods that are good for all kids, we end up helping kids with special needs in the process.

[SG] Niche construction appears to be one of the special focus of your book. would you support or recommended special reservations in jobs/academics for neurodiverse people who may do especially well in those particular niches? For ex. would you favor a legislation that mandated for reservation for autistic people in computer testing industry. I’m thinking of cultural diversity guidelines in colleges, should we have similar neurodiversity guidelines too?

[TA] Are you talking about affirmative action for neurodiverse people? If so, then I believe there might be some merit in exploring how this might work. ([SG] note: yes, I was indeed talking about affirmative action; in India we typically refer to the issue as that of reservations!)

[SG] How did the writing of Neurodiversity enrich you as an individual. wWat can readers hope to take away from the book?

[TA] I wrote Neurodiversity while in the midst of a major depressive episode. At times I could hear myself saying “why are you looking at the strengths of these disorders, for God’s sake, when you know that they’re hell to deal with?” But there was another part of me, an intuitive part I believe, that instinctively believed it was important for me to bring strengths into the discourse about mental disabilities. I hope that readers will see this book as a supplementary guide to all the other books on disabilities that focus on the negatives. It’s important that we see both sides of the issue. We are, after all, whole human beings, with a great deal of complexity and richness. I hope that readers will take away a sense of this richness in the diversity of minds that make up humanity.

I would like to thank Dr Armstrong for taking some time off for the interview and would recommended the readers to read up some of his books, many of which focus on the special abilities and aptitudes of the neurodiverse people.

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Why is the world vivid in mania, but bleak in depression?

Down in a hole
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No, I am not speaking metaphorically. Quite literally,there has been accumulating evidence that sense are sharpened and have great acuity in mania while they are dulled in depression and the effects can be seen within the same individual over time as he/she suffers from manic/depressive episodes.

The latest study to add to this literature is by Bubl et al that found that depressive people’s brain registered lesser contrast than that registered by normal control brains when presented with same black and white images. They used pattern electroretinogram (PERG) to find whether the contrast gains registered by depressive retinas (those suffering from MDD) were different from those of controls and they found a strong and significant association with the severity of the depression.

I have covered earlier studies that found that sense of taste was compromised in depression (and enhanced in mania) and similarly that the sense of smell showed similar effects. Some snippets from the earlier posts:

What this means is that if you increase the amount of serotonin in the brain, then the capacity to detect sweet and bitter tastes is increased; if you increase noradrenaline levels those of detecting salty and bitter tastes is augmented; while a general increase in anxiety leads to better bitter taste detection. This also means that an anxiety state produces more bitter taste perception whereas a depressive state (characterized by low serotonin) is marked by bland sense of taste with marked inability to detect sweet and bitter tastes. A stressed state , marked by abundance of noradrenaline, would however lead to more salty and bitter taste perception.

and…

In one of my earlier post on depression, I had commented on the fact that those suffering from depression have less sensitivity to sweet and bitter tastes and as such may compensate by eating more sugar thus leading to the well documented diabetes – depression linkage.

In a new study it has just been discovered that not only depressives have bland sense of taste, their sense of smell is also diminished and they may make compensations by using greater amounts of perfume. Overall it seems that those suffering from depression will have bland subjective experience of flavor(which is a combination of both smell and taste) and thus may even not really find what they eat to be tasty.

Further on, I speculate prophetically that blander vision will also be found:

To me, this is an important finding. To my knowledge no research has been done in other sense modalities (like vision), but there is every reason to think that we may discover a bland sense of vision in depression. Why do I surmise so? this is because there is extensive literature available regarding the manic state and how things seem ‘vivid’ during that state including visual vividness. If depression is the converse of Mania, it follows that a corresponding blandness of vision should also be observed in those who are clinically depressed.

We also know that in extreme or psychotic forms of Mania, auditory hallucinations may arise. I am not suggesting that hallucinations are equal to vividness, but I would definitely love to see studies determining whether the auditory sense is heightened in Mania (maybe more absolute pitch perception in Mania) and a corresponding loss of auditory absolute pitch perception in depression. If so found, it may happen that music literally becomes subdued for people with depression and they sort of do not hear the music present in everyday life!

Whether other sense like touch, vestibular/ kinesthetic , proprioception (a heightened sense of which may give rise to eerie out-pf-body experiences in Mania) are also diminished in depression is another area where research may be fruitful.

Of course I have also speculated about the others senses and would love to hear studies supporting/contradicting this thesis. But given that senses are attenuated in depression and exaggerated in mania the question remains why? Which brings me to the topic of this post- why is the world bleak /bland to a depressive and vivid for a manic?

This was also the question asked by Mark Changizi (@Mark_Changizi) on twitter with respect to this new study uncovered today and I replied that this may be due to broaden-and-build theory being applied to sensory domain or sensory gating phenomenon differentially acting in manic/ depressive states, while Mark was of the opinion that it might be the result of physiological arousal with arousal being the variable of interest controlling whether the sense remain acute or dull?

I do not see the two views necessarily contradictory and it may be that chronic affect per se activates arousal and that is the mediating variable involved in its effect on senses; and we can design experiments to resolve this by measuring the effect of state sadness/ happiness/arousal on visual acuity (if the effects of state manipulations are big enough); howsoever, I woudl like to elaborate on my broaden and build theory.

In the cognitive, psychological and psychosocial domains the broaden and build theory of positive affect is more or less clearly elaborated and delineated. I wish to extend this to the sensory domain. I propose that chronic positive affect signals to our bodies/brains that we can afford to make our attention more diffuse, let senses be perceived more vividly as we have more resources available to process incoming data; conversely in a chronic low affect state we might like to conserve resources by narrowing focus/ literally narrowing the range of sensory inputs/reducing the sensitivity of sense organs and pool those resources elsewhere.

I know this is just a hypothesis , but I am pretty convinced and would love to hear the results of experiments anyone conducts around this theory.
Bubl, E., Kern, E., Ebert, D., Bach, M., & Tebartz van Elst, L. (2010). Seeing Gray When Feeling Blue? Depression Can Be Measured in the Eye of the Diseased Biological Psychiatry, 68 (2), 205-208 DOI: 10.1016/j.biopsych.2010.02.009

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stroop

Cognitive control: when less is more!

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Yesterday I wrote a post about ADHD and creativity and how the frontal lobes hypo-function and dopamine may be the mediating factors involved.  Today I serendipitously came across this article by Thomson-Schill et al in which they posit that frontal cortex hypofunction during childhood is beneficial, on average, as it enables convention learning and thus linguistic acquisition.

What they basically mean is that frontal cortex has been found to be involved in cognitive control i.e. in higher cognitive functions like planning, flexible thinking etc ; and the frontal cortex does this by biasing the competitive responses elicited by a stimuli by goals /existing beliefs / other task related information that is maintained in the working memory. To take an example, cognitive control is often measured by tasks such as the stroop task. the strrop task measures how well you are able to suppress the prepotent response tendency of naming the color-term itself by the task-relevant constraint that you name the color of the term instead. when a color term like ‘green’ is presented in Red color, then the green as well as red linguistic response compete with each other. In the absence of frontal biasing in teh direction of color ie.e red, we are apt to name the color-term itself i.e green by default which is the habitual response. Children , who have less well-developed frontal cortices generally perform poorer at the stroop task than adults as their frontal cortex does not bias or tilt the scales in favor of the color used rather than the color-term presented.

The authors claim that this inability to bias results on the basis of pre-existing knowledge/beliefs leads to a greater ability to learn. They posit that learning conditions (that maximize competition )  are different from performance conditions (where one response needs to be selected or competition minimized) and the child’s brain is optimized for learning by not having frontal inhibition and control. An example they give is filtering noise form signal which the child are able to do, but adults can’t. for eg. if a new language has a phrase ‘et tu brute’ and 75 % of times it is in this form and 25% of times it is of the form ‘et tu vous Brute’, then adults will tend to probability match and select the utterance/ utter themselves phrase ‘et tu brute’ 75% of times and ‘et tu vous Brute’ 25 % of times. This is because when they want to utter the phrase their existing knowledge that sometimes the other phrase is also used, makes them sensitive to variations. In child’s brain on the other hand a competition between the two phrases takes place and as there is no moderating influence involved, the outcome hundred percent of the time is ‘et tu brute’. Thus, they are able to learn conventional meaning of a phrase/word etc more easily than an adult who gets bogged down by variations. Thus sometimes, less is more!

However the reason I got hooked to this study is the implications they draw for ADHD/Autism and creativity. I’ll quote them verbatim on the issue:

Central to our proposal is the claim that the timing of PFC development has been the target of selection and, therefore, that variations in timing are functionally meaningful. Recent neuroimaging studies have revealed potentially important differences in the timing of PFC development across typical and atypical individuals. Variations in the trajectory of PFC maturation (based on repeated measures of cortical thickness) have been associated with cognitive measures in typically developing children (Shaw et al., 2006). Children with attention-deficit hyperactivity disorder (ADHD) exhibit a delay in cortical maturation that is most prominent in the PFC (Shaw et al., 2007). In contrast, children with autism spectrum disorders (ASD) undergo early maturation of the PFC (Carper, Moses, Tigue, & Courchesne, 2002). A better understanding of the implications of these timing changes for both learning and performance may illuminate some of the behavioral and cognitive patterns associated with these diagnoses (e.g., impaired acquisition of social conventions in ASD), as well as offer a fertile ground for testing the validity of our hypothesis that typical PFC development involves a trade-off in favor of learning to the detriment of performance in infancy and early childhood.

This gels quite nicely with what I have been speculating for some time, that ADHD and Autism are opposed and that ADHD is childhood equivalent of psychosis. ADHD kids are bound to be good learners, more divergent creative and have better social and linguistic skills. Autistic kids on the other hand would be better performers (say child prodigies in memory etc) , more convergent thinkers, and have less social and linguistic skills- one mechanism of which may be lesser ability to learn social and linguistic conventions- like the usage of metaphorical terms.

On creativity this is what the authors say:

Creativity—the ability to approach an object or a situation from an alternative perspective—may benefit from the unsupervised competition that occurs in the absence of prefrontal control. Consider one common assessment of creative thinking, the Alternative Uses Task: When attempting to think of ways to use an object in some atypical way, adults struggle. In this case, an active PFC might, paradoxically, hinder flexible thinking, because the representation of the object is sculpted by prior experience and expectations. Interestingly, young children are immune to this kind of functional fixedness (German&Defeyter, 2000). Successful performance in similar tasks of ideational fluency has been associated with EEG changes in prefrontal regions (e.g., Mo¨lle, Marshall, Wolf, Fehm, & Born, 1999). Furthermore, patients with PFC damage solve insight-problemsolving tasks better than do their healthy counterparts (Reverberi, Toraldo, D’Agostini, & Skrap, 2005). This apparent flexibility of behavior can be interpreted as a stimulus-driven response: A mind that is at the mercy of its environment is not shaped by expectations or beliefs. This interpretation highlights a parallel between functional fixedness and probability matching, in that both of these ‘‘adult’’ phenomena involve biasing stimulus–response associations based on expectations. This proposal suggests new avenues of investigation into the processes that support creative thought and into putative relations between creativity and psychological disorders associated with hypometabolic prefrontal function (i.e., a state of lower energy consumption in the PFC, as in bipolar disorder, for example).

The above analysis of creativity in terms of hypofunction of frontal cortex bodes well for my theories of creativity-ADHD relationships as well as creativity-psychosis (bipolar etc) relationship, both of which involve developmental or functional hypofucnction of frontal cortex.

Thompson-Schill, S., Ramscar, M., & Chrysikou, E. (2009). Cognition Without Control: When a Little Frontal Lobe Goes a Long Way Current Directions in Psychological Science, 18 (5), 259-263 DOI: 10.1111/j.1467-8721.2009.01648.x

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ADD

ADHD and creativity

ResearchBlogging.org

Brainscan of brains with and without ADHD
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ADHD has traditionally been conceptualized in terms of deficits- that of attention , impulse control or motor restraint; but the new neurodiversity paradigm forces us to take a more balanced look and acknowledge the strengths that the ADHD kid may have- divergent thinking, spontaneity and high energy and vitality.

That brings me to research by Cramform that shows that the symptoms that define ADHD/ADD- hyperactivity, impulsivity and distractability are just the negative connotation and spin put on some of the traits that define highly creative and gifted child-  the traits of Vitality, spontaneity and daydreaming/wandering phenotype.

But first things first. ADHD , as many of the readers will know , is defined by three primary symptoms- hyperactivity or the restlessness and fidgety or squirming behavior of the kid; impulsiveness or the inability to control impulses manifest in overt behavior like getting up in class and interrupting;  and distractibility where the kid ends up paying too much attention, even to stimuli that are extraneous and should be ignored, thus leading to fleeting attention! ADHD is a traditional classroom misfit and thus a traditional teachers nightmare. However, one should note that a traditional teacher is not too much impressed by the highly creative kid too, who proves to be a bit too much to placate and who doesn’t conform too easily.

But what could be the mechanism why ADD/ADHD must be so closely related to and resembling creativity traits as to be indistinguishable from it by behavioral symptoms alone? I believe dopamine and frontal cortex are the culprit. We have seen in the past that dopamine is related to creativity and we have seen that frontal cortex is related to creativity; and we have also seen that dopamine is related to ADHD. As a  matter of fact ADHD on a neurotransmitter level is characterized by dopamine’s quirky behavior , while on the neuroanotomic level is known by the late development of frontal cortex that is an inhibitor to other areas like motor areas and impulsive areas (basal ganglia and sub-cortical regions)  thus leading to symptoms of  impulsivity and hyperactivity. In creative people too, especially in divergent form of creativity, we see that creativity manifest itself when dopamine comes into play and when frontal regions give up their control of other regions of the brain thus making remote associations more likely.

Of course dopamine is not just involved in ADHD, but also in Psychosis and thus my theory of Autism and Psychosis as opposites would claim that ADHD is childhood form of psychosis and is opposed to Autism. There is already some support for that idea with autism and ADHD being discovered as opposites and with ADHD more common in bipolar probands.

The dual symptoms of ADHD as inattention and as hyperactivity/ implusivity are easy to conceptualize when one sees that one is trying to maximize predictive ability / minimize surprise and also maximize rewards by being flexible in one;s behavior and taking risks rather that persevering on the well trodden path. Both attention-allocation and action-selection are sensitive to dopamine and in one particular phenotype result in more leaning towards flexibility, distracatibility, hyper energy and arousal and more novelty and thrill seeking. The desire is to explore and not to exploit. The hunter rather than the farmer as per Hartman’s model. These same are characteristics of the creative phenotype- those touched with fire- and thus on the move literally or figuratively- always seeking new combination and ideas and exploring uncharted territory.

Perhaps its time we stopped negatively labellings the gifted, creative ADDers as difficult kids, but rather design and structure classrooms around them that bring their potential to the fullest and make them bloom fully. Lets not stifle the creativity. Lets not devalue the immense energy and joy these child exhibit and the creative potential they embody.

Cramond, B. (1995). The Coincidence of Attention Deficit Hyperactivity Disorder and Creativity University of Connecticut, The National Research Center on the Gifted and Talented. Other: ED388016

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Six world hypotheses or how we explain eyerything and anything

I recently came across this blog post by Christopher Peterson and was immediately drawn into the work of Stephen Pepper and using Google books access tried to read as much as I could of his print-on-demand book ‘World Hypotheses‘.

It is a philosophical work of how people reason about their world and ‘carve nature at the joints’ but despite being a philosophical work and thus being dense and obtuse to a degree, it is surprisingly lucidly written and in my opinion is an important work that needs to be highlighted.

As per Pepper, we have four valid and mature world hypothesis that are adequate in scope (explain everything) and precision (explain uniquely and not vaguely) and two immature world hypothesis that fail the test of scope/precision in their adequacy. I do not make that distinction and will be treating all six world hypothesis on equal footing. For the record, the inadequate world hypothesis are animism and spiritualism.

A world hypothesis is a way to explain everything in the world and relies on root metaphors to explain thus. Each hypothesis has a pet root metaphor which is sued to illustrate and explain phenomenon or categories, and their relationships.

To met the six world hypothesis follow a stage pattern and it would be my contention that as one matures one may discard one world hypothesis lower down the ladder in favor of the other more developed and mature.

With that let us introduce the world hypothesis. Also taking the lead from Peterson, I’ll be taking an example of my neighbor playing loud music at 2:00 in the night to illustrate different ways of explaining the same event according to the different hypothesis and different root metaphors (and will be lifting from the Peterson article the examples he gave there).

The first hypothesis is that of Formism (realism/ platonic Idealism) i.e. everything is explainable because they belong to a particular category/ form and have characteristic qualities. The root metaphor is that of analogy or similarity. Formism explains in terms of placing whatever we are trying to explain into a category (form). Why did my neighbor play his music loudly at 2:00 AM? Because he is an a**hole!
This theory belongs to the first stage where one is more concerned with Describing things and concerned with traits.

The second hypothesis is that of Animism i.e. everything (even inanimate things like weather) has an underlying spirit that explains the way it behaves. The root metaphor is that of spirit and agency. Animism explains by associating everything we are trying to explain with an underlying spirit that has agency . Why did my neighbor play his music loudly at 2:00 AM? Because he was suddenly possessed by the Michael Jackson spirit!
This theory belongs to the second stage trying to Explain the phenomenon and concerned with impulses and agency.

The third hypothesis is that of Mechanism (most common amongst reductionist scientists) i.e. everything is a machine following laws of cause and effect. If something happens, it happens because of a well defined and unavoidable cause. The root metaphor is that of machine. Mechanism explains in terms of causes: events that regularly precede whatever we are trying to explain. Why did my neighbor play his music loudly at 2:00 AM? Because he passed all of his final exams and that is what people do when they pass exams!

This theory belongs to the third stage that tries to predict and is centered around observable behavior and causal chains.

The fourth hypothesis is that of Contextualism (pragmatism) i.e. everything can be explained in terms of the context or surround in which the figure/event takes place. this is most popular with historians who are used to see events as uniquely determined by the historical and cultural milieu. The root metaphor is that of a historic event. Contextualism explains in terms of the interplay between whatever we are trying to explain and its larger context. Why did my neighbor play his music loudly at 2:00 AM? Because it was Saturday night, and this is a college town!
This theory is properly of the fourth stage focused on how society / larger context can influence and control the phenomenon and is most concerned with social influences.

The fifth hypothesis is that of Organicism (absolute Idealism)i.e. everything is an organic complex whole. The theory is still determinate but as compared to Mechanism is ‘life’ oriented. The root metaphor is that of coherence. Facts are sparse at present and as they emerge and become more complex one reaches in the limits the absolute truth. Organicism explains in terms of the unfolding of the inherent nature of whatever we are trying to explain. Why did my neighbor play his music loudly at 2:00 AM? Because he is a young man who just moved into his own apartment!
the fifth theory is at the fifth stage concerned with integration/ individuation etc and is concerned with emergent properties.

The sixth hypothesis is that if Spiritualism i.e everything is not what it seems and can only be really grasped through the spiritual experience. The root metaphor is that of the spritual experience. All said and done, there is no substitute for experience. the metaphor is also that of Love and can be only felt inter-personally. Only Love is Real. Why did my neighbor play his music loudly at 2:00 AM? Because he loves music and felt at oneness with the world and forgot about time as he got absorbed in the music.
This is clearly a jump from previous stages and belongs to stage 6 dealing with transecdence and interpersonal concerns.

Of course there are bound to be higher (7 & 8) stage theories equally and perhaps better explain the world, and I woudl be glad if readers can point me to those world hypothesis, no matter how inadequate/mystic they may appear at first appearance.

I’m hooked to Pepper, what about you?

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