Banishing your demons
Laurence Pope delves into the world of schizophrenia and iPhone apps
Statistically, approximately one in every 100 of us will develop schizophrenia over the course of our lifetimes. Schizophrenia is one of the more commonly known mental disorders, but also one that remains somewhat of a mystery to non-sufferers. Whilst the Greek root of the word schizophrenia, literally ‘split mind’, implies a split personality the condition is much more than just having a second voice in your head.
“You don’t just have constant jabbering in your ears,” explains Harriet, who has lived with schizophrenia for over a decade. “The worst thing for me is my own jabbering. It can make people look at you funny. You say things that make no sense, and you don’t even realise. Stuff like ‘cooking on the washing sofa’ just comes out.Sometimes you even stop mid-sentence and can’t speak. Everything literally vanishes.”
The symptoms of schizophrenia can be broadly grouped into negative and positive categories. Negative symptoms are functions which are present in non-sufferers, but diminished in sufferers, such as apathy, social anxiety and reduced attention span. Positive symptoms are those not normally exhibited by non-sufferers, such as visual and auditory hallucinations and delusions. However, schizophrenics are not the only people who experience auditory hallucinations. They can even occur in mentally healthy individuals, and it’s these people who may hold the key to better schizophrenia management.
“In clinical hallucinations the voices themselves are very negative, entirely uncontrollable, and attributed to external causes. Thus, they create fear and are, quite simply, very annoying and cause suffering,” says Dr Kristiina Kompus, a psychology researcher at the University of Bergen. “When voices do not have negative content and are under control, then it already becomes quite a neutral, not negative, experience.” Dr Kompus is a member of the Bergen fMRI (functional Magnetic Resonance Imaging) group, headed by Prof. Kenneth Hugdahl. The group is dedicated to the study of a variety of cognitive functions.
Her recent research, published in Frontiers in Human Neuroscience, studied the differences between two types of hallucinators: those with clinical symptoms, and those without. During listening tests those without clinical symptoms were able to maintain regulation over brain areas dedicated to speech-processing, whilst those with clinical symptoms could not, suggesting, in principle, a reduced ability to direct attention outwards in clinical sufferers when auditory hallucinations occur.
Research by Dr Kompus and other members of the Bergen fMRI group aims to enhance understanding of auditory hallucinations, with the potential to develop a “cognitive training program aimed to relieve the feeling of helplessness when the negative voices start bothering you again,” says Dr Kompus. This is somewhat akin to the use of lucid dreaming, the ability to consciously control the actions in one’s dream, to combat persistent nightmares. Embracing the digital age, the research group has developed an iPhone app, iDichotic.
iDichotic is the brainchild of PhD student Josef Bless, also from the Bergen fMRI group. The app is named after the listening test it runs, the dichotic listening test. At a basic level the test assesses which hemisphere of the brain is most active during language processing. The information then feeds back to the research team, allowing them to further their work. A paper based off the initial results was published last February in Frontiers in Cognition, but according to Josef “there is a lot more to come.”
Though the public version of iDichotic currently only collects data another separate version has been developed to help schizophrenics manage their condition by improving their focus, allowing them to better identify when voices occur. It is pioneering work, and still requires modification, but Josef hopes to “provide a cognitive training tool for patients that can be used anytime, anywhere, without having stigmatizing features when used in public.”
If the iDichotic app performs well it may pave the way for future research and management of other mental disorders such as Alzheimer’s. Whilst Josef importantly notes that “it does take a strong investigative effort to provide psych apps with a real scientific basis,” he also notes that the “potential to use smartphone apps in research as well as in clinical contexts is huge,” potentially allowing research groups to both collect data and provide ways to help sufferers like Harriet manage their conditions through a widely available medium.
“I think I’ve mostly got it [schizophrenia] under some sort of control,” says Harriet. “But things can obviously get worse with age, so I’m prepping just in case things go downhill. Maybe a smartphone app can help. It’s an interesting idea, since everyone has one [a smartphone]. Support in whatever form is always appreciated.”
Find more about iDichotic at dichoticlistening.com