Why Sapolsky’s Take on Schizotypal Personality Disorder and Religion is Problematic

Dear CF,

BoingBoing posted one of Robert Sapolsky’s (Stanford neurobiologist and author of Monkeyluv, The Trouble with Testosterone and Why Zebras Don’t Get Ulcers) lectures on schizophrenia and schizotypal personality disorder today. It’s an hour long, but makes for pretty interesting listening if you have the time to give it. In this installment he starts off speculating about the possible selective evolutionary advantages of schizophrenia, which—unlike cystic fibrosis and sickle-cell anemia, which protect heterozygotes (carriers, usually with one good copy of the gene) from cholera and malaria, respectively—hasn’t been thought to confer any kind of selective advantage.

He suggests an advantage exists, and that it lies in schizotypal personality disorder—sufferers who display milder schizophrenic symptoms and are labeled “half-crazy.” A group of scientists studying adoptive and biological schizophrenics in Denmark discovered, after interviewing all the parties concerned over a period of (I think ten years) that many relatives of schizophrenics display this attenuated version of the disease, which he characterizes as “movie-projector syndrome.” These people tend toward the antisocial; they prefer isolated occupations and are guilty of “metamagical thinking,” a near-schizophrenic kind of mental process that protects the sufferer from ostracism by successfully channeling odd or schizophrenic qualities into their proper contexts.

I haven’t tracked down his lecture on schizophrenia itself yet and I’d like to, because that definition of schizotypal personality disorder is rhetorically a bit too pat and makes it easy for him to (for example) retroactively ascribe it to shamans, witch doctors, medicine-men and religious founders generally. Anyone who thought he heard a burning bush talk or believed he was talking to a man who’d risen from the dead (or indeed claimed to have risen from the dead himself) would, today, be diagnosed with schizotypal personality disorder.

This is clever, of course,  but it’s the argumentation I’m objecting to. I realize this is just a lecture, but it’s disappointingly poor logic from a defender of rationalism. To suggest that a newly developed (and rather hazy) diagnosis, rooted in a spectrum of sane vs. insane behaviors and defined only by a list of symptoms that have a priori been categorized as “schizotypal” or “insane,” can be applied to someone thousands of years ago who has precisely those milder “insane” symptoms is a textbook example of petitio principii, begging the question. I have developed this definition, it says, and look! someone a thousand years ago fits it!

(The difficulty lies, I think, in locating the definitional limits of schizotypal metamagical thinking. Is there any irrational or metamagical belief that wouldn’t be automatically classified as schizoid/schizotypal? Is it a matter of cumulative weight? Sapolsky mentions that 50% of Americans believe in UFOs, but wouldn’t (I assume) classify half the population as half-crazy. Is it then a matter of authorship—it’s one thing to hold an irrational belief that’s been culturally transmitted, another to create an entirely new one of your own? I think he’s getting at the latter, and suggesting that your evolutionary “fitness” depends on your ability to persuade other, more rational creatures of the truth of your idiosyncratic vision.)

Having established (which he hasn’t, at least not in this lecture) that important religious figures in different societies were schizotypal, he uses this to prove that in fact people who suffer from schizotypal personality disorder actually wield a hefty amount of power and had no trouble reproducing and passing on their genes. No data is cited to support this, and he dismisses the fact that many religious figures (both in shamanistic cultures and mainstream religions) were proscribed from marrying and asserts that indeed schizotypal personalities (unlike their schizophrenic counterparts) were and are reproductively quite successful.

I’m skeptical about both retrospective claims for a couple of reasons. One, I’d be interested to see hard statistics on the reproductive success of major religious founders. It seems to me that anecdotally, at least, they fall into two extremes: celibacy or some version of cult-leader polygamy. Two, the line he draws between schizotypal and schizophrenic is the second case where he uses the conclusion to prove the premise. His argument goes thusly:

  1. Schizophrenic people are not reproductively successful and can’t behave appropriately according to context.
  2. Schizophrenics are therefore ostracized from society.
  3. People with schizotypal personality disorder are milder cases that can channel their putative schizophrenic experience properly (for example, they’ll have an epiphany in church, not on a street corner).
  4. Schizotypals are not ostracized from society.
  5. Therefore, because religious founders who claimed to converse with bushes, etc., were not totally ostracized from society, they must be schizotypal personalities.

This is logical and historical nonsense. It’s proving a neurological diagnosis (schizophrenic or schizotypal?) by a social result. What’s more, he admits that one of the three modern charismatic schizotypal personalities he mentions, Charles Manson, was in fact diagnosed as schizophrenic. So phut! goes that theory.

(Unless, of course, he counts Manson’s eventual imprisonment as “ostracism,” but this is cheating—Manson was revered by his coterie. It was legal, not social pressure that removed him from society. This is a narrative roughly comparable to Christ’s, which would then—according to the “social result defines the disease” model—make Christ schizophrenic, not schizotypal, despite his obvious ability to muster a following. This, in turn, suggests schizophrenics either are not as socially inept as Sapolsky is suggesting, or that Christ doesn’t count because he didn’t reproduce. Again, Sapolsky’s definition of “fitness” along evolutionary lines seems inappropriate, since the success of many “schizotypal” religious founders was NOT reproductive but rather “narrative” propagation. There seems to be a different kind of fitness at work—not genetic but “mythic” robustness.)

The claim, though, which does make sense, is that schizotypal personalities are both compelling and necessary to a society, which prizes the metamagical thinking the schizotypal offers because it is performed in a contextually useful way. There is a space in the culture for schizotypals to exert their “trade,” which consists of attending to the irrational and ritualistic needs of a society.

Ritual, however, raises the specter of Obsessive-Compulsive Disorder, and Sapolsky develops a similar argument here: while people with full-fledged OCD have their lives destroyed by the tyranny of a series of unceasing demands oriented around hygiene and, well, compulsion, people with milder forms of OCD are very good at performing ritual. This is religiously quite useful, as religion exists largely to provide arbitrary structures and customs that order the entropy of everyday life.

Sapolsky attempts to apply this diagnosis of half-OCD to a historical figure to demonstrate how a pathological attachment to ritual translates to a pathological attachment to religion. He chooses(quite possibly the worst historical figure for his argument, a historical figure who was largely responsible for the movement toward eradicating ritual from religion. The man who said that “every good work designed to attract God’s favour is a sin.” The man who translated the Latin Mass to German. The man who married a nun, who defied a Church expressly dedicated to the preservation of liturgy, the man who said that “vows are an illegitimate and vain attempt to win salvation” and who claimed that to call the Catholic service a sacrifice was “idolatry.”

He chose Martin Luther. And—unless I heard him wrong, which is possible—claimed he lived several hundred years before he did.

The claim makes some sense, but might be a case of a little knowledge being a dangerous thing: Luther left extensive records of his monastic life, and Sapolsky talks, with understandable delight, about how Luther spent five hours a day confessing sins of omission, about how he made his first Mass last seven times longer than it should because he kept having to start over, so concerned was he that he hadn’t done everything exactly right.

Two problems here: 1) this extreme behavior would (I assume) be termed a case of full, not partial, OCD. Therefore, like Manson, it’s not a particularly useful example, especially since Luther was clearly “socially” successful and we’re still trying to prove that the evolutionary advantage of OCD derives from the heterozygote’s ability to integrate into society, not the fully expressed disease. 2) Sapolsky doesn’t address (or perhaps know?) the terrific about-face that resulted—that Luther’s rise to prominence was predicated exactly on an emancipation from those tyrannical rituals. This would seem to challenge the claim that he had OCD at all?

Lastly, Sapolsky proceeds—and this is the most interesting bit—to address temporal lobe epilepsy, which produces perhaps one seizure lasting 30 seconds or so every six months. It results in hypergraphia (excessive writing) and the development of a terrific interest in philosophical and religious matters, even in those who expressed no interest in those things before.

It doesn’t, he quickly points out, make people religious. But it focuses their attention and interest on the subject, even if only in a highly academic sense. (He talks about a young boy with temporal lobe seizures who claimed not to be religious but, when asked why, gave an hour-long disquisition on problems and inconsistencies in the Bible, Bertrand Russell, etc.

He hilariously accuses St. Paul of having this. All those letters to the Corinthians!

This is the most interesting and compelling example of a neurological basis, not for specifically religious or “metamagical” thinking, but for a particular philosophical bent that can be switched on (and can perhaps be switched off). I don’t know what to think about it. It’s really intriguing. And it doesn’t have the same set of logical problems that the rest of his discussion (which I quite enjoyed) does.

On a slightly more personal note, it gave me lots of food for thought re: the appeal the Firecrackers feel for the schizotypal, if not the downright schizophrenic.

Yours,

Millicent

11 Responses to Why Sapolsky’s Take on Schizotypal Personality Disorder and Religion is Problematic

  1. Carla Fran says:

    Hemmmm….I can see the attraction to schizonphrenia in pop culture, because if you have symptoms, then, it looks here as if you might be magic. But would every insistence on a non-physical world be attributed to this large schizotypal class? Could it have degrees of intensity? The amount of social behavior involved, as you note, and especially historically, is so vast.

    Randomish note: Apparently in Ireland, where there are the most records of visitations by Saints and Jesus, there are also the highest diagnoses of Schizophrenia. And, I am reading a book right now about a Victorian boy that can see auras.

    Randomish observation: Many schizophrenics, before their initial breaks, are the very center of society with humor, wit, and popularity. I don’t think that it comes from an idealization of what once was, once somebody has made the turn and struggles with the full presentation of symptoms–but there is often mentioned in narratives that specific mourning for the person that was so welcomed in society becoming a stranger in it.

    Final thought on science and odd clumps of information: they have also just linked the genes for sticky ear wax and smelly armpits to breast cancer.

  2. Jack hammer says:

    Hi,Very informative post.Having gone through very hard times fighting OCD, I can relate.Thanks,SandraPlease visit my blog at:http://ocdtreatments.info

  3. Joe says:

    Hi there,

    I came across your letter while trying to find the Sapolsky talk for a friend.

    I appreciate your thoughtful criticism, all these evo-neuro-bio just-so stories are easy to get carried away with. However, I think you’re being overly stuck on the definitions of schizotypal vs schizophrenic, which Sapolsky probably doesn’t care about at all because, as you’ve noticed, they basically boil down to social result.

    The actual DSM definitions of schizotypal vs schiophrenic are interesting in that it is the schizotypal, not the schizophrenic, which is defined in terms of social result. To wit: “pervasive pattern of social and interpersonal deficits marked by acute discomfort with, and reduced capacity for, close relationships as well as by cognitive or perceptual distortions and eccentricities of behavior, beginning by early adulthood and present in a variety of contexts…”

    And then you have Schizoid Personality Disorder which is even milder and (therefore?) even more defined by social context. As an aside, SPD is going away as a distinct diagnosis in the new DSM and, while someone who self-identifies as “somewhat Schizoid” I think this is a good thing because I think SPD lumps together people who have mild schizotypal-like cognitive issues with people who classic emotional/developmental “personality” issues.

    In any case, while I’m not aware of anyone in my own family having been diagnosed as schizophrenic, I can think of some good candidates and moreover there are clear schizotypal/schizoid traits on both sides. More interestingly, on both sides of the family there are many people who are deeply involved in religious life, but NOT in the same religion! Within just parents, aunts, uncles, and cousins, I’ve got: a Catholic monk, a Salvation Army family, a former presbytarian radio preacher, a converted Catholic AND devotee of Maharishi Mahesh Yogi (same person), a very eccentric Anglican-raised shut-in who converted to Orthodox Judaism and changed his name from Tim to Jacof (that one’s a cousin once-removed, I cheated), a converted conservative Baptist, and two women who, while not having any religion per se, read obsessively (and blindingly fast) — going through literally a stack of paperpack novels on a lazy summer afternoon.

    Not ONE of these people was raised in the religion which they’ve adopted, and which in every case became central to their lives and identity. Some were raised without religion, most were raised with nominal religion (mostly Anglicanism).

    And me? Well, I was doing okay on the outside (PhD candidate at a top school), but things have increasingly fallen apart over the last few years, and I’m barely keeping up the appearance of scraping by. My religion? None. I’m atheist to a fault, nihilistic even. And I think a result of this is that I don’t have a way to keep the hamster wheel from spinning, I can’t just shut off the ruminations, the worries, the doubts, the obsessions about how will I ever get through this, what is the right thing to do. I can literally feel the edges of the God-shaped hole that my thoughts are pouring out of.

    Food for thought.

  4. Millicent says:

    Joe,

    Food for thought indeed. Thanks for a thought-provoking response—that your family performs iterations of the same “metamagical” tendency, if in surprisingly different avenues, does seem to anecdotally support Sapolsky’s point. Interesting, too, that the impulse doesn’t lead to metaphysical consensus, and that in your case it leaves you with a God-shaped hole. (As a Ph.D student myself, I want to make a crack about hamster wheels and grad school, but I can’t—your hamster wheel is too vicious to trivialize.)

    Schizophrenia. Schizoid. Schizotypal. I’m troubled by the looseness with which these words get used, because the God-shaped hole is a hell of a problem and should, I think, be understood as the resultant of two vectors who really don’t share an epistemological dimension: neuroscience and religious/poetic temperament. It’s hard to treat a poetic black hole from which thoughts come. It may be easier to treat the black box the brain remains. But by transposing the former into the vocabulary of the latter and leaving it at that (which is more or less what Sapolsky does), we lose a lot in translation without gaining anything by way of understanding or (crucially) treatment.

    To offer a counter-narrative that seems a little more useful: my father yesterday was telling me about a program he remembered at UC Davis where—because they thought children with “schizoid” tendencies could be corrected early if they were kept away from marijuana and other substances, which seemed to trigger the condition—children with similar schizoid experiences were institutionalized together. One of the graduates of the program had stayed on as a lecturer, and spoke often about how much it meant to him, as a young adolescent, to be able to talk to other people about what he was feeling.

    This makes pretty good sense: if you can talk to a group of people who really know what it feels like to have the refrigerator tell you you’re scum, even if in their case it’s the ceiling fan, you can start to develop a language or a frame for understanding which parts of your experience are a function of the disease and which aren’t. (Many women experience a mild variant of this when talking about PMS—even as she’s weeping over a Hallmark card, she can know that it’s the hormones, and that the ad itself is kind of stupid. That kind of double-consciousness on your lived and biological selfhood is crazy-valuable. It can save many a sufferer from suicide or desperation because once you understand an experience, you can mitigate its horror slightly using a mode of rationalism that Sapolsky’s terms seem to make impossible—the schizophrenic will never know he is.)

    Community isn’t in itself a treatment, of course … but that kid’s testimony (which I’m going to try to track down) comes closer to the lived experience of schizophrenia than does the artificial distinction between thinking that’s “metamagical” vs. thinking that’s illogical. (Ironically, I think Sapolsky, whose work I often admire, falls victim to the second category. Again, I present the belief in UFOs as a problematic instance of metamagical thinking that half the population shares.)

    Full disclosure so that it’s clear where my thinking comes from: my sister is “schizophrenic” (I’ll explain the quotes in a minute) and my ex-husband was a “wannabe” schizophrenic—that is, NOT schizophrenic, but very much in love with “schizophrenia” as an artistic idea. I don’t know that I’d identify myself as a metamagical thinker exactly—I trained as a scientist before pursuing a Ph.D in English—but I certainly recognize myself in some of the criteria.

    Why Sapolsky’s model worries me: I suspect he doesn’t know any schizophrenics; otherwise he would know how incredibly grey those “social results” are.

    My sister, who has also been diagnosed as bipolar, narcoleptic, and a victim of temporal lobe seizures, has also and most persuasively been diagnosed as schizophrenic. Ironically, it’s precisely her control over the social context that makes treatment—or action of any kind—impossible. She’s a master at performing “normalcy.” She’ll have long and terrible bad spells, but she’s brilliant, as many “schizophrenics” are (and incredibly charming to boot). Whenever she does land in an institution that could help her, she can persuade any mental health professional that she’s “fine:” socially adept, “normal,” high-functioning, but the victim of a conspiracy.

    Nobody knows how to help her. One reason I’m interested in the schizotypal vs. schizophrenic distinction is that there seems to me to be (and I say this as someone whose degree in neuroscience is ten years old and therefore obsolete) to be a significant difference between my sister’s paranoia, delusions, and pain and the pain of a “schizophrenic” friend who, whenever he stops taking his meds, hears the air conditioner saying terrible things to him. He lives with his parents. There is no social context he can control. So according to Sapolsky’s model, which tries to make a neurological diagnosis based on social result, my sister and my friend don’t fit under the same rubric.

    Which has implications for their treatment.

    I’m curious to see how the discourse on insanity as a series of behaviors and the neuroscience of schizophrenia will continue to intersect. I agree with your sense that dispensing with SPD is useful; I’ve posted elsewhere on how problematically devastating a diagnosis of schizophrenia has become, since it manages to be both maddeningly imprecise and bereft of anything approaching a medical “cure.” Treatments are poorly understood, and vary from the sort that turn patients into near-robots with stiff limbs to others that sedate them and make them feel unlike themselves. “Schizophrenia” is to some extent a disease of the personality—it’s a disease of the self, and to medicate that self can be tantamount to annihilating it.

    The term, which literally means “split-brain,” was something of a misnomer at the outset. It would better describe epileptics whose corpus callosa have been cut, were it not so heavily burdened with the social and poetic stigma that seems to plague our mythology of madness.

    Getting rid of SPD is a step in the right direction. The word has lost its relevance and become all stigma and despair.

    Speaking of which, having a God-shaped hole must be a source of perennial despair. As interesting as it is to think of God or the religious impulse as something certain brains need—that God is something like a gene, like hard or soft earwax—it’s a little inhuman not to think about what that feels like. And to assume, in the way of eugenicists in the first half of the twentieth century, who thought evolution was a line rather than a tree, with humans at the apex, that there is a *right* gene and a *wrong* one. If faith and schizophrenia are indeed genetic, they (or it, if on the same genetic unit of transmission) must be acknowledged as just another allele. It may be dominant, it may be recessive, but our ability to judge it ends there. To call it a mutation seems a bit much: whatever God is, Drosophila’s white eyes it ain’t.

    M

  5. Millicent,

    You conveniently glossed over the cumulative traits of SPD. Simply, questioning the cumulative then moving along to make your point is intellectually dishonest. You should know better.

    Simply dismissing the cumulative traits does not make them go away but does make you argument little more than a strawman and wholly illogical.

    What is your real motivation?

    • Lili L says:

      Hi SG–just noticed this post stuck in moderation purgatory. I’m not sure I understand your objection. Could you elaborate? My motivation was to challenge Sapolsky’s glib, if entertaining, attempts to retroactively diagnose historical figures with a neurological disease–especially from a historical point of view.

  6. ambiguous says:

    People are so obsessed with scrutinizing, and bullying schizophrenia, and the other diseases in its spectrum. I have to advise you something: What about scrutinizing “normality”? Here all you do is not help, or advocate schizophrenics, all you do is bully these poor, miserable sick people hurting noone. When it comes to normality, you can see wars, destruction, inequality. The normals do nothing but gossip, bully miserable people, be egocentric, selfish, manipulate events and people, use each person around in favor of his/her benefits, maybe you’d have some “scientific/evolutional reasons” for this as well? The normality is, in fact, the mild form of psychopathy, and instead of bullying miserable schizophrenics, the normals themselves must be treated, or bullied first. Shame on normals, that is, latent-psychopaths!

  7. I just want to say thank you because I thought that I was the only one who saw that all of the holes in this theory and I thought that Robert was too intelligent for this, which he is. What I think it is, is that he knows that no one will challenge him and sense he can’t prove that God doesn’t exist, he can do the next best thing to silence the opposition by simply using his scientific background to present his beliefs as fact. Basically by attempting to call your opposition crazy, knowing that most Christians do not study neuroscience, you can shut them down, easily without worrying about anyone that can stand up to him coming along and exposing the OBVIOUS issues that this deduction is infected with. Anyway, thanks.

    • Lili Loofbourow says:

      I owe you a very belated thank you in return–yes, questions are being begged here, and I’m so pleased I’m not the only one who think so.

  8. nitram says:

    I think that you missed out two things. Ritualizing against rituals is still ritualizing which still means “OCD”. Maybe Luther tried to “cure” his own “OCD” by a counterproductive measure.

    The second thing is that he was refering to Gescwind Syndrome which might implicate temporal lobe “differences”. I might reread your thoughts again and see if I can find anything. It was a interesting read though. Til then have at you!

  9. Buddy Hampton says:

    Did you ever happen to find any literature or websites about the program at UC Davis?

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