C

Sciency explanation

In the mid 1990s, C. had recurring "bouts of ringing after breathwork sessions" (MAS criterion B.3). On January 31 and March 2, 2008, respectively, he experienced 2 major attacks ("big K crises") presenting with recurring symptoms including cranial pain ("The top of my head suddenly felt as if someone had removed the entire top of the dome in a nice clean line and from the tips of my toes up above the top of my head was a rushing energy", "This area, the crown chakra, has been the most active and intensely felt chakra of all for me ever since the K started. Powerfuls flows pouring out of the top of my head was what started it all the day I went to the hospital"), vestibular sensations ("I was grabbing the sides of the couch cushions to try to have something to hold onto because I was fighting the uncomfortable sensation of flying down a hill and having no brakes", "I felt a bit shaky a lot of the time"), visual symptoms ("The room started fading to black on me"), decreased level of consciousness ("then began to lose consciousness"), "moments of confusion", depersonalization ("I was looking at my arm and it felt all swimmy and not solid in any way. I realized suddenly that my entire body felt like it was going to explode, scatter into a million pieces and be reduced to nothing", "I was way out of my body"), bilateral paraesthesias ("I had numbness down different places on my body", "all sorts of numbness all over my body"), a need to rest ("I just didn't feel good and needed to lay down"). The first major attack was accompanied by intense anxiety symptoms ("as if on the verge of a panic attack") including tachycardia ("heart was thudding like wild"), the fear of having a heart attack ("I became certain that I must be having a heart attack") or some "undiagnosed stroke or heart problem", culminating in "the certainty that I was going to die", and in the further course "many night were spent with loud thundering and rapid heartbeats pounding away... Usually the rapid heartbeat was most likely a function of the intense fear I was experiencing" (episodic paroxysmal anxiety). Following the first major attack, a diagnostic check-up "in the Emergency Department for maybe 10 hours" failed to identify any pathological medical findings: "They ran every test, gave me an MRI, CatScan and always had me on monitors. They never found a single thing wrong and instead commented upon how healthy I was." In the absence of being offered a medical explanation, he was provided with a non-medical explanation which proved to have a surprisingly well-fitting explanatory power: "After my first hospital visit, I ran into this woman through my LiveJournal blog. She told me that what I had experienced could have been a 'Kundalini Crisis'. I was like 'yeah, whatever.' But I did look at a site she recommended and in it there was a list of things to do if things got rough with the K symptoms." In retrospect, and taking into account the further course, with a history of 2 major attacks featuring - in addition to tinnitus (see below) - vertigo (vestibular sensations), visual symptoms (simultaneously in both temporal and nasal fields of both eyes?), decreased level of consciousness and (simultaneously?) bilateral paraesthesias, a diagnosis of basilar type migraine may be considered as a medical explanation. On March 3, 2008, he had attacks (MAS criterion B.4) of facial metamorphopsia ("When I would look at my friends I could see other faces on theirs. Their faces were morphing and shifting and swimming all over the place"), reminiscent of the visual illusions experienced during a single hallucinogen intoxication ("It reminded me exactly of what happened the one and only time in my life that I had partaken of hallucinogenic mushrooms. I was about 24 years old and watching faces shift in the mirror is pretty much standard fare during a mushroom trip").

Following the first major attack on January 31, 2008, C. noted "the gift of the ringing, or Nadi, going on constantly for me. What you all call tinnitus." This ringing - which was "similar" to the "bouts of ringing after breathwork sessions" in the mid 1990s except for its persistence (MAS criterion B.8) - wasn't apparent right away. "It took me about a month to recognize it was even there, but I am sure I started experiencing it in an uninterrupted fashion beginning with the first event." (MAS criterion B.8) About a week later, he had a transient attack of very intense tinnitus (MAS criterion B.4): "One night though I remember just hearing this loud waterfall sound way off in the woods. I was laying in bed with energy flying all over the place, feeling quite wonderful in fact. But I couldn't find the source of this loud rumble. Then I realized that underneath the rumble was something I first mistook as tinnitus. But I only heard it in my right ear and I immediately realized that the sound was very familiar and had been going on in the background for at least a week. I focussed on the sound and tried to find it's source or location." Following the second major attack on March 2, 2008, he experienced a significant increase of intensity of the persistent tinnitus (MAS criterion B.5). Furthermore, there was a history of recurring cranial pain described as "pushing sensations", "almost as if my skull was experiencing growing pains in specific spots, usually at the third eye area or the crown chakra" (MAS criterion B.2). "I also experienced transient pain, as if someone is inserting something sharp at the top of my crown chakra." (MAS criterion B.2)

The history summarized above fulfills the diagnostic criteria of ("definite", MAS score 7) persistent aura without infarction according to the current diagnostic criteria of the 2nd edition of the International Classification of Headache Disorders from 2004. With a history of a single hallucinogenic mushroom intake at the age of 24, a differential diagnosis of HPPD must be considered but can be excluded on the grounds that the symptoms are due to a medical condition, i.e. persistent aura without infarction, which is an exclusion criterion for the diagnosis of HPPD according to DSM-IV (see here). In this context, it may be emphasized that transient attacks of facial metamorphopsia have also been recorded as migraine aura symptom in the literature (cf. Podoll and Robinson, 2008). Though describing various types of migrainous cenesthetic pains sensations including sensations of movement ("pushing sensations") and circumscript or limited pain sensations (cf. Podoll and Robinson, 2009), C. stressed the conspicious absence of headache problems: "One clarifying point though... I don't have migraines or any headaches", which doesn't exclude, however, a diagnosis of persistent aura without infarction (see here). Similarly, in Peatfield et al.'s (2009) retrospective case series of 15 subjects with persistent aura without infarction, headache "was never a significant problem".

To C., who was left without medical explanation following his encounter with the medical system ("They never found a single thing wrong and instead commented upon how healthy I was"), the concept of Kundalini Awakening had provided a service the value of which cannot be overestimated. It represented a frame of reference that he could use to make sense of and thus cope with his experiences and that encouraged him to explore its creative and spiritual potentials. "If I had not had this, I am positive that I would have gone off the deep end, spent some time in a treatment facility and spent years on psychotropic mood disorder medications."

C.'s response

"Wow, that sure is 'sciency' and I mean that in the most friendly way. It was enjoyable to read it and I appreciate how committed you are to your work. I have to say that I am surprised that a physician such as yourself has room for science AND spirituality and that you are comfortable enough with not throwing out the import of a spiritual balance in the perspective. In America, I do not think there are many here who are open minded enough to do so. I was sure your explanation would denigrate any spiritual context and just say 'it's all chemicals and neurons, take a pill'... because that is so much what things are like here. [...]

I also would love to ask a few other questions in a bit."

(C., E-Mail to Klaus Podoll, November 16, 2009)

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