The importance of wonder

Wonder is a conscious state familiar to us all. The ‘wow’ moment, even when seen digitally as a 2-D face with open mouth and raised eyebrows, provides recognition of an unmistakable feeling. That feeling or emotion seems to be the trigger for action both to determine the cause of the wondrous event and to think about its nature and consequences. Plato said ‘This sense of wonder is the mark of the philosopher. Philosophy indeed has no other origin’.^{Reference Plato., Hamilton and Cairns7} Aristotle considered that the experience of wonder (ancient Greek, thaumazein) was the driving force behind scientific endeavour in order to produce an understanding of the ways in which nature worked.^{Reference Aristotle, Primavesi and Steel8} In more recent philosophy there has been a concern that an overemphasis on scientific explanations diminishes the degree of wonder experienced, because if the mechanisms are commonly known there is less reason to feel in awe of those particular phenomena. Our modern feelings about lightning strikes and eclipses are two classic examples: less awe and dread, more of a passing interest and recognition. Twentieth-century philosophers worried about this. Wittgenstein was especially critical about a culture that concerned itself with causes while downplaying meaning^{Reference Wittgenstein and von Wright9} and Howard Parsons talked of it extinguishing from awareness the qualitative uniqueness of things.^{Reference Parsons10} Lately, environmental concerns have raised awareness that for the sake of Nature itself there is indeed a cultural problem with reductive explanations.^{Reference Attfield11}

Psychiatrists are interested in how strange ideas arise, what meaning they carry for the patient and if they are likely to lead to behavioural abnormalities. A wonderful experience might remain in the memory as just that, but if it leads to unusual interpretations that become dangerous to the patient or others, psychiatrists are usually asked to supply a third-party understanding of why this has taken place. Organic brain disease is an obvious worry and cognitive tests are available to check (at the very least) orientation, ability to concentrate and aspects of the patient's memory. This is the biological approach to investigating ‘cognition’ in the sense of ability to think. In addition, a psychosocial approach might emphasise educational or cultural reasons for the patient's behaviour. Both those approaches are undoubtedly valid but there seems merit in trying to understand how the experience of a subjectively dramatic event (the ‘phenomenology’ in Edmund Husserl's sense of ‘going back to the things themselves’)^{Reference Gallagher and Zahavi12} can induce what appears to be (to the rest of us) a state of twisted logic, often accompanied by signs of heightened physiological arousal and declarations of fear, anger or distress.

Subjective significance

In the presence of something causing extreme astonishment, marvel, dread or awe, which historically constituted different variants of wonder,^{Reference Bynum13} one inescapably knows that something dramatic is taking place. In Wittgenstein's words, human beings can ordinarily see and hear and feel as a matter of general experience and ‘So they are their own witnesses that they have consciousness’ (his italics).^{Reference Wittgenstein, Hacker and Schulte14} With consciousness comes subjective significance and a ‘what it is like’ to have a specific awareness. An awareness of something seems to be an overall feeling as well as an intellectual appreciation, not simply the registration of a cognitive pattern. Yes, flashes of colour can be recognised and buttons pressed to determine P300 intervals (the neuropsychology of which is discussed by Polich^{Reference Polich, Luck and Kappenman15}) but what does that feel like – and why might it matter? Notions about inhibition of gated ion channels in neuronal circuits are not easily reconciled with wondering about significance and purpose.

Psychiatrists are familiar with the behavioural consequences of delusional ideas experienced by patients. Combatting a person's terror about what seems to be happening is of course a major concern but extreme fear is not the only emotion produced by delusional states. Puzzlement and consternation are often evident, particularly in both the early and the resolving stages. Trying to understand the mental mechanisms producing the strange beliefs is one thing but why there might be glimmerings of insight is another important therapeutic consideration. In the literature concerning the evaluation of insight there have been attempts to quantify its presence or absence with questionnaires such as the Beck Cognitive Insight Scale,^{Reference Beck, Baruch, Balter, Steer and Warman16} which pays particular attention to how well individuals view their ability to reflect on their judgements (self-reflectivity) and how certain they are about those decisions (self-certainty). Although developed for use with people with psychosis, some validity has been claimed for its use with non-psychotic people.^{Reference Martin, Warman and Lysaker17} The essential point about this endeavour is that it is a purely cognitive one (assessing the ability to think), with little regard paid to the importance of emotion or feeling. There is actually one question in the ‘self-certainty’ scale that asks for agreement or otherwise on the statement ‘If something feels right it means that it is right’. Intuitively, a psychiatrist would probably guess that someone experiencing psychosis is more likely than a non-psychotic person to agree with such a sentiment. Wittgenstein said that in questioning the truth of a situation one must remember: ‘from its seeming to me – or to everyone – to be so, it doesn't follow that it is so (his italics). What we can ask is whether it can make sense to doubt it’.^{Reference Wittgenstein, Anscombe and von Wright18} I think that the failure of the ability to doubt something which suddenly just feels right must be accounted a psychotic symptom and illustrates the importance of paying attention to how the patient experiences a significant event.

Thought and feeling in conflict

Rationality relies on intact cognitive capacities to reject outlandish ideas, so at some point in the formation of a delusion there must be a breakdown or an overwhelming of that function. Established delusions are by definition an intellectual fixture but in their development the patient often exhibits great puzzlement, or perhaps uncertainty, at contradictions that are still apparent in his or her thoughts. The same upset can accompany residual or returning insight. It seems to me that there is something akin to a debate going on in the patient's mind, a debate concerning the truth or falsehood of previous unquestioned assumptions versus a possible new understanding. The problem is that ‘emotion’ (etymologically, something out of which activity occurs) accompanying those ideas can drive matters on towards a frenzy.

The philosophical analysis of wonder, as an experiential state in non-psychotic people, links a definite happening in the outside world with an overwhelming feeling that forces complete attention on the remarkable situation.^{Reference Baldwin19} An emotion may be defined as ‘an occurrent conscious state, with a certain affect, and with a certain kind of intentional content’.^{Reference Scarantino and Nielson20} No emotion other than wonder has such a clear relationship with the outside world, being directly produced by the wondrous event. Something happens, triggering an emotion (Wow!), accompanied by a realisation that things do not quite fit together anymore, in that a previous belief about what was possible or true suddenly seems in doubt. This is intellectually astonishing and demands thought over time in the aftermath of the initial shock, producing ideas about what it is that has happened and what it might mean; and feelings about that meaning may seem to require action. This may be rational action in terms of a scientific endeavour to clarify the cause of the wonder, as in Aristotelian thaumazein (which would, strictly speaking, also ask questions about purpose), or perhaps lead to just talking loudly about it in an erratic fashion. Some might indulge in outright conspiracy theorising, depending on personality and their previous network of beliefs. Unfortunately, in the presence of severe mental illness actions felt to be subjectively necessary may turn out to be completely irrational and dangerous.

Descartes commented that emotions such as joy and love are different from wonder because they rely first on an internal decision by the intellect whereas wonder is a feeling triggered by something external.^{Reference Descartes and Wilson21,Reference Descartes and Moriarty22} Wonder at an internally generated idea, perhaps such as a mathematical formula, must be possible but using the terms ‘inner’ and ‘outer’ about the mind do represent an outdated Cartesian duality. As perceptively observed by Hao Tang: ‘Our sensations, insofar as we are rational animals, are already infused with conceptual content, already shaped by the hand of reason’.^{Reference Tang23} Stephen Mulhall goes further than just sensation with his take on being in the world: ‘we encounter the world as always already saturated with human meaning’ (my italics).^{Reference Mulhall24} So in the process of recognising wonder, the initial ‘jangling of brain cells’ is followed by mental turmoil trying to make sense of the astonishing event and fit it into some sort of consistency with the concepts about the world contained by an individual's network. No doubt there are several neural correlates underlying all this but at a metaphysically higher level (of consciousness) one can view an individual's sense of wonder as a cognitive recognition of the implication that relationships between concepts have been broken plus a radical astonishment that this could have happened. This recognition stimulates the feeling that may best be described simply as ‘Wow!’ or as something more lyrical, such as the poetic rendition of an epiphany (examples of such poetry are given by Chappell^{Reference Chappell25}).

Doubt overwhelmed by emotion

Autochthonous (primary) delusions, in which new meaning spontaneously arises about some previous understanding,^{Reference Casey, Kelly, Casey and Kelly26} seem to me to have the same trigger factor(s) as novel ideas. An observation invalidates a previous belief or hypothesis. Something apparently outlandish and incomprehensible has occurred. How can the implications be reconciled with the rest of the network? Remembering that Aristotle's appreciation of thaumazein contained a search for purpose as well as material cause, our modern intellectual approach looking for that cause may be missing an important interpretive angle. I suggest that although curiosity about truth is usually acceptable as a motive force, an emotional desire to find a particular interpretation that perhaps carries an ideological slant begins to look dubious. In terms of modern scientific endeavour, seeking after truth is generally considered as the paradigm of rationality – and being influenced by emotion is erratic. The switch to what we recognise as a psychotic state occurs at some point a little further along the scale of emotional balance. Then the normal cognitive correction (the ability to doubt) to emotional shock fails and the suddenly discovered meaning, however strange and dreadful, has to be seriously entertained by the individual under pressure from the tidal wave of the feeling that constitutes radical astonishment. The implications of any conclusions may themselves instigate further emotions, such as awe and dread (linguistic siblings of wonder) but more especially fear. In the presence of a developing psychosis an intellectual and emotional struggle has to take place, which all psychiatrists have observed, in what is usually described as a tortured mind.

How satisfactory or upsetting the patient finds the result of the battle is, I suggest, the key to an observer understanding the behavioural consequences of the illness. Will it settle into a set of understandings that are compatible with relatively normal social life, or will there be actively antisocial sequelae? Concentrating on possible neuropathology is vitally important because abnormalities clearly impinge on memory, beliefs, desires and intellectual abilities. Are neurological problems sufficient explanation for the radical misinterpretations (assuming they are indeed completely irrational) made by people with psychosis? It is possible to imagine minimal pathology and yet a sufficiently impaired overall awareness so that once a psychotic illness has taken hold the network is corrupted and all sorts of interrelationships between concepts are disrupted. The initial point of disruption is when the delusional idea is developing owing to the wondrous experience, which is not only puzzling and perhaps frightening but taken as increasingly convincing evidence that old ideas are unworkable. Similarly, on recovery, as the delusion begins to disintegrate and the previous network of beliefs looks more and more plausible again, there is often the rejection of any suggestion that the psychotic experience ever happened, which is a more welcome behavioural response.