Evidence from temporal lobe epilepsy

§ 1. TLE and orgasm

The associating of religious-mystical states with epilepsy has a long and venerable history. Jeffrey Saver and John Rabin point out that the early Greeks viewed epilepsy as a “sacred disease”, a visitation from the gods. In the Medieval and early Renaissance periods, wide currency was given the Biblical view that epileptic seizures are manifestations of demonic possession (Mark 9:14–29).⁴⁸ Interestingly enough (and turning a blind eye to the “demon inter-pretation”), a good case can be made that epilepsy, especially TLE, in addition to being a “sacred disease”, is also an “erotic disease”.

TLE is, according to Michael Persinger, a special form of epileptic disorder.

Unlike the more publicized types of epilepsy that involve either “petit mal” (the patient blacking out for a brief period) or “grand mal” seizures (the patient having a “fit”), TLE is not necessarily associated with convulsions.⁴⁹ And, im-portantly for the present discussion, epileptic activity in the temporo-limbic regions of the brain can elicit both intense sexual arousal and religious-spiritual states.

This said, a note of warning is in place. The below references to TLE are not to be read as saying that MSCs are something pathological. Rather, the cases in which epileptic (and other pathological) activity in the brain have produced religious-spiritual-mystical or erotic-orgasmic states provide ways (1) to localize the foci in the brain that may be involved in triggering sexual and

resulting sensory overload and flooding of the cortex. The result of such overload, these authors argue, would be cognitive fragmentation and ego-dissolution.

46 Austin 2006, 221.

47 Komisaruk et al. 2006, 211.

48 Saver & Rabin 1997, 499–500.

49 Persinger 2003b, 276.

mystical states and (2) to analyze the dynamics of the processes involved in generating both orgasm and MSCs. As Bianchi-Demicheli and Ortigue have aptly pointed out: much of current knowledge of the function of specific brain areas comes from the systematic study of patients with brain damage and/or neurological disorders. When it comes to the study of orgasm and MSCs, this is a highly valuable technique since both phenomena are difficult to test under laboratory conditions in healthy volunteers.⁵⁰

Taking up from Bianchi-Demicheli and Ortigue’s above point, Komisaruk and colleagues – in coming to discuss TLE and orgasm – note, “Much of what is known about how the brain produces orgasms is based on studies of epileptic seizures. There are numerous reports of men and women who describe orgasmic feelings just before the onset of an epileptic seizure. This experience has been termed an ‘orgasmic aura’.”⁵¹ It might be necessary to add to this that epileptic discharges can result in real, spontaneous orgasms as well.⁵²

As a rule, Komisaruk and colleagues note, orgasmic auras originate in the right temporal lobe, more precisely the hippocampus and the amygdala (the site of origin is usually ascertained by EEG). Orgasmic auras may have a sponta-neous onset. But they can also have specific triggers. For example, Komisaruk and colleagues point to Y.-C. Chuang and associates’ report of a woman in whom the aura was triggered by tooth-brushing.⁵³

Seizure-related orgasms are often unwelcome for their experiencers but, as Komisaruk and colleagues make quite clear, there are also several documented cases of patients refusing medical treatment for their epilepsy because they liked their orgasmic auras. While this is not entirely surprising, another obser-vation about orgasmic auras certainly is: according to Komisaruk and collea-gues, these auras (or actual, seizure-related orgasmic states) are not necessarily experienced as involving genital sensation.⁵⁴ This provides another interesting and informative clue as to how to conceptualize MSCs in their neurological relation to orgasm.

When it comes to defining the actual cerebral foci particularly associated with the generation of orgasmic auras, then, according to Komisaruk and colleagues, most often they are found in the deep structures of the temporal lobe. This becomes evident in the case of TLE patients who are described as hyposexual prior to treatment. According to Komisaruk and colleagues, after undergoing a type of temporal lobectomy for treatment of the seizures these patients have been observed to become hypersexual (the Klüver-Bucy syndrome alluded to above). What is important is that the surgery in question involves the removal of the anterior part of the temporal lobe on the side that generates the

50 Bianchi-Demicheli & Ortigue 2007, 2650.

51 Komisaruk et al. 2006, 214.

52 Bianchi-Demicheli & Ortigue 2007, 2650.

53 Komisaruk et al. 2006, 214 (with references to the following work: Chuang, Y.-C., Lin, T.-K., Lui, C.-C., Chen, S.-D., Chang, C.-S. Tooth-Brushing Epilepsy with Ictal Orgasms. – Seizure, Vol. 13, 2004, 179–182).

54 Komisaruk et al. 2006, 214.

seizure, the removal of the limbic structures of the medial portion of the temporal lobe – the hippocampus and amygdala.⁵⁵

The issue of hypo- and hypersexuality in relation to hippocampal and amyg-dalar disorders is interesting, among other things, because it provides further insight into the peculiar dual involvement of the amygdala in reproductive responses noted in subchapter A. Not all patients with amygdalar-hippocampal disorders are hyposexual prior to treatment – some are hypersexual. In their treatment of the topic, Bianchi-Demicheli and Ortigue – confirming Komisaruk and colleagues’ associating of the medial temporal lobe (including the amyg-dala) with various aspects of sexuality – point out that the issue of whether epileptic activity in these areas results in hypersexuality or hyposexuality probably depends on whether the inhibitory or excitatory mechanisms are damaged.⁵⁶

In trying to estimate how strongly orgasmic auras and epileptic orgasms actually relate to the above mentioned brain areas, Bianchi-Demicheli and Ortigue have performed a meta-analysis of the data provided by studies that report patients having spontaneous orgasms and/or erotic feelings in relation to epileptic discharges.⁵⁷ They arrive at the following estimation: in 80 % of cases such patients had TLE (70 % focal and 11 % non-focal), in 16 % the epileptic focus involved the frontal lobe and in 21% there were parietal discharges.

Further, orgasmic auras usually originated in the right hemisphere (in 70 % of cases versus 21 %). 11 % of patients reporting orgasmic auras had epileptic discharges in both hemispheres. Hence a conclusion that, in the generation of an orgasm, the right temporal lobe plays a crucial role. However, some parietal and/or frontal activity is also implied.⁵⁸

In discussing these results, Bianchi-Demicheli and Ortigue conclude that although inter-individual differences for medical and epilepsy history have to be taken into account before making any binding statements about the hemispheric lateralization and localization of orgasmic states, it is likely that orgasmic sensations are the result of a spread of focal activity within the right hemisphere that might then be generalized to the whole brain. They contend that even though orgasm is not a pathological symptom, it can be assumed that epileptic orgasmic auras are caused by electric discharges at the same brain regions that produce the physiological orgasm in healthy subjects – a statement that deserves to be emphasized in relation to investigating MSCs, too (too often religious

55 Komisaruk et al. 2006, 214–215.

56 Bianchi-Demicheli & Ortigue 2007, 2650–2653.

57 For the bibliographical data on the reports included in the meta-analysis, see:

Bianchi-Demicheli & Ortigue 2007, 2650.

58 Bianchi-Demicheli & Ortigue 2007, 2650. Note that the references to the temporal lobe include limbic structures. Also note the references to parietal areas which are relevant in bringing the results to bear on Newberg and d’Aquili’s model of MSCs.

Again, note the right lateralization of the relevant epileptic activity – this confirms d’Aquili’s early view that MSCs are a right brain phenomenon if MSCs are related to orgasm.

people take such analyses to mean as if their religious experiences were labeled

“sick” somehow). However, Bianchi-Demicheli and Ortigue note, it must not be forgotten that the temporal lobe has myriads of other functions beside mediating orgasms. The medial temporal lobe is involved in cognitive functions such as autobiographical and semantic memory, perceptual and motivational func-tioning, facial recognition, emotion, the fight-or-flight response etc. Therefore, simple pointing at the right temporal lobe and the limbic system does not by itself explain much. Multiple other considerations have to be taken into account.⁵⁹

Among other things this well-balanced conclusion provides a good key as to the neural dynamics in generating an orgasm. Recall the note on the spreading of focal activity within the right hemisphere that might then be generalized to the whole brain. As it turns out, it is quite important – both in explaining the orgasmic process and in relating it to MSCs. Consider Komisaruk and collea-gues’ following analysis of the orgasm-epilepsy link (especially in how they connect the way epileptic seizures are generated to how orgasms are generated):

if one recalls the recruitment or “staircase” phenomenon discussed in the pre-vious chapter, it at once becomes clear how the same analogy also works to explain the generation of MSCs.

Here is what they say: the reports that epileptic seizures can generate orgasm-like feelings suggest a basic commonality between the two phenomena.

Epileptic seizures are characterized by abnormal, cyclical and synchronous activation and deactivation of large numbers of neurons. It is likely that the rhythmical and voluntary timing of genital stimulation (that ultimately leads to orgasm) also produces synchronous activation of large numbers of brain neurons. A consequence (and probably the function) of this regulated synchro-nous activity in orgasm is the activation of high-threshold systems (such as the one that controls ejaculation – see the section on the “staircase” phenomenon in chapter V).⁶⁰

Komisaruk and colleagues argue that the evidence of the ejaculatory mecha-nism being a high-threshold system comes from the fact that normally rhythmi-cal and timed stimulation is necessary to recruit neural elements to higher and higher states of excitation. In orgasm, genital stimulation is channeled into specific and coordinated systems. By contrast, in an epileptic seizure, the mass of synchronous neural activation becomes abnormally diffuse and “can “spill over” into motor systems that are not normally activated simultaneously.”⁶¹

These latter considerations – if viewed from the perspective of Newberg and d’Aquili’s analysis of MSCs – make it clear why there is more than enough reason to suspect that a similar link with epilepsy is also tracable in the case of MSCs.

59 Bianchi-Demicheli & Ortigue 2007, 2653.

60 Komisaruk et al. 2006, 216.

61 Komisaruk et al. 2006, 216.

§ 2. TLE and MSCs

Perhaps the best known present-day author to have developed on such an idea is Michael Persinger. He writes,

“The first time I recorded an inconspicuous electrical seizure from the temporal lobe of a meditator and heard the reports of cosmic bliss, I was impressed with the impact of this change on the person’s behavior. Here sat a person waiting with anticipation for the coming of a few short seconds of seizure. There were no convulsions or head movements of any kind, just a slight smile and the facial expressions of cosmic serenity.”⁶²

Leaving the ancient “sacred disease” doctrine aside, the possible link between epilepsy and religious-spiritual states first came under neuroscientific inquiry in the 19^th century. According to Saver and Rabin, back then the above average religiosity of epileptic patients was attributed to their disability, social isolation and need for consolation. By the beginning of the 20^th century the concept changed and the notion of ‘religious auras’ (compare to the orgasmic auras above) appeared, accompanied by a hypothesis that epileptics develop distinc-tive interictal character traits, one of which is religious fervor. Since then, based on these ideas, a substantial number of leading religious figures have been suggested to have suffered from epilepsy.⁶³

With the emergence of technologies such as EEG it has become possible to be more precise about the “epileptic character traits” and religious auras. It seems that – just as in the case of orgasmic auras and epileptic orgasms – both are most often present in the case of TLE (in comparison with other forms of epilepsy). As to the epileptic character traits, Andresen notes that TLE patients are prone to religiosity, hypergraphia, exotic philosophical and mystical ideas, pedantism and psychosis. Sexual dysfunction is quite common. The latter is not surprising, since, as Andresen notes, most often in such patients the

62 Persinger 2003b, 276. Michael Persinger is a controversial and much-criticized Canadian neuroscientist whose research has fueled animated debates in various scho-larly communities. He has been found guilty of several schoscho-larly “transgressions”, both on the experimental (his experimental designs are often methodologically deficient) and theoretical plane of his work (for a thoroughgoing analysis, see: Runehov 2007, 99–

135). However, when it comes to investigating the suspected links between TLE and MSCs, Persinger’s research still provides a wealth of clues. The fact that many of his ideas have been challenged cannot be taken to mean as if all of them were wrong.

Therefore, contrary to several other scholars I do not think one should avoid references to Persinger’s research. One simply has to maintain a critical eye towards his texts (which is something one should also do with any other researcher’s writings).

63 Saver & Rabin 1997, 500 (with references to the following works: Spratling, W.

P. Epilepsy and its Treatment. Philadelphia, W. B. Saunders, 1904; Turner, W. A.

Epilepsy. London, Macmillan, 1907).

amygdaloid-hippocampal complex is implied as the focus of epileptic dis-charges (see the notes on the Klüver-Bucy syndrome above).⁶⁴

The link between TLE and the interictal character trait of heightened religiosity becomes apparent from Vilayanur Ramachandran’s work. In reviewing the relevant results, Andresen explains that the team used skin conductance response to measure the strength of connections from the inferior temporal lobe to the amygdala. Using three populations, temporal lobe epileptics with religious preoccupations, normal “very religious” people and normal “non-religious” people, skin conductance response was measured to neutral stimuli, to be compared with responses to three types of emotional stimuli: religious, violent and sexual. In the latter two groups, the responses were maximal to sexual stimuli but rarely high to religious ones. Temporal lobe epileptics showed heightened responses to religious stimuli as compared to religious controls.⁶⁵ Hence, it seems that the TLE-related hyperreligiosity is linked to the TLE-related hyposexuality discussed above. If so, then there is a good reason to believe that religiosity and religious (including mystical) experiences are also neurologically linked in normal people.

However, the issue of TLE-specific character traits is very general and difficult to relate directly to research into MSCs. Things are both more clear and more interesting in the case of religious auras often associated with TLE. On these, Persinger significantly notes that they often involve an alteration of the subject’s sense of self. Typically, depersonalization is experienced. The person may feel as “not there”. The body may appear to be in one place while the mind is in another.⁶⁶ Considering that changes in one’s sense of self are one of the most important features of MSCs, there is every reason to relate the two phenomena – just as in the case of relating orgasm and orgasmic epileptic auras.

Also, just as in the case of the above TLE-specific character traits, religious auras seem to most often relate to epileptic discharges in the amygdala and hippocampus. This becomes evident from Saver and Rabin’s (among others) discussion of the topic as they argue – available evidence suggests that spontaneous discharges or electrical stimulations producing religious auras can be localized to the mesolimbic structures: the hippocampus and especially the amygdala. According to Saver and Rabin, it is these areas that are critically responsible for generating the feelings of unreality about the self or the environment.⁶⁷

Importantly (from the perspective of the question how can spontaneous epileptic-like discharges account for the MSC arrived at via centered effort –

64 Andresen 2001, 268–269.

65 Andresen 2001, 272.

66 Persinger 2003b, 276–277.

67 Saver & Rabin 1997, 500 (with references to the following works: Gloor, P. Expe-riential Phenomena of Temporal Lobe Epilepsy. – Brain, Vol. 113, 1990, 1673–1694;

Fish, D. R., Gloor, P., Quesney, F. L. et al. Clinical Responses to Electrical Brain Stimulation of the Temporal and Frontal Lobes in Patients with Epilepsy. – Brain, Vol.

116, 1993, 397–414).

such as meditation), as Persinger explains, when electrical criteria are con-sidered, the temporal lobe maintains a unique position among neural tissues.

Hippocampal cells, in particular, display more electrical instability than any other portion of the brain. Persinger notes that these cells are also prone to repeated firing long after the stimulation has been removed. This electrical

“lability” leads to unique properties. The amygdala and the hippocampus can learn specific electrical patterns. Like the total person learning to drive a car or to play tennis, specific kinds of electrical activity can be slowly acquired by these structures. This means that the experiences associated with those electrical patterns can come under the control of a place (e.g., a church), a behavioral pattern (e.g., meditation) etc. In other words, learned electrical changes within the brain are integrated within the intrinsic patterns of activity.⁶⁸

The way all of the above fits together is well summed up in Andresen’s overview of W. J. Wildman and L. A. Brothers’s model of religious-spiritual states. These authors argue that epileptic-like temporal lobe “transients” (or microseizures) spontaneously occur in the mesolimbic regions of all normal individuals. This (normal) epileptic-like activity may then spread from their original focus to adjacent structures (such as the hypothalamus), this resulting in intense religious experiences. The amygdala and hippocampus have the lowest threshold for seizure-like activity and the high degree of plasticity of these structures means that they are “trainable”. This fact may be relevant to initiation, training, or “practice” sequences in religious traditions cross-cultu-rally, which often are intended to induce religious experiences and MSCs.⁶⁹

In addition to providing a good general summary of the TLE-based approach to MSCs, the above also provides another key that is quite important in terms of understanding the neural dynamics involved in the generation of MSCs. Note the notion of epileptic-like activity spreading from its original focus to the adjoining areas and leading to what Saver and Rabin call hippocampal-septal hypersynchrony.⁷⁰ This is highly parallel to Komisaruk and colleagues’ above discussed TLE-based explanation of the neural dynamics behind orgasm that also involves synchronous temporo-limbic discharges arrived at via gradual

“recruitment” of neural elements.

Finally, as if these parallels between orgasmic and MSC-related processes were not enough, Bianchi-Demicheli and Ortigue’s above discussed conclusion that orgasmic auras most often occur in relation to right hemispheric TLE is also paralleled in the TLE-based studies of mystical states. In Persinger’s view, for example, MSCs represent the awareness of the right hemispheric equivalent

68 Persinger 2003b, 275.

69 Andresen 2001, 273 (with references to the following work: Wildman, W. J., Brothers, L. A. A Neuropsychological-Semiotic Model of Religious Experiences. – Neuroscience and the Person: Scientific Perspectives on Divine Action. Edited by R. J.

Russell et al. Vatican City State and Berkeley, Vatican Observatory Publications / Berkeley Center for Theology and the Natural Sciences, 1999. Pp. 347–416).

70 Saver & Rabin 1997, 503–504.

of the left hemispheric sense of self.⁷¹ He further argues that many of the qualities associated with MSCs clearly suggest right hemispheric origin. For example, MSCs are profoundly emotional, spatial, “beyond the self” and meaningful. According to Persinger, all of these qualities depend on the right rather than the left hemispere.⁷²

of the left hemispheric sense of self.⁷¹ He further argues that many of the qualities associated with MSCs clearly suggest right hemispheric origin. For example, MSCs are profoundly emotional, spatial, “beyond the self” and meaningful. According to Persinger, all of these qualities depend on the right rather than the left hemispere.⁷²

Im Dokument of Sexual Response? (Seite 113-121)