This page was created to offer a concise presentation for medical professionals dealing with ICU Psychosis.

The goal is to determine if a similar problem discovered in  the business office, late 1950's, is the same as ICU Psychosis.

This is not my pet theory or something I dreamed up. I learned of this phenomenon as an engineering student forty years ago. I heard it explained in a psychology lecture in about 1990. I have been stunned to learn this Design/Engineering  problem is unknown in medical or psychiatric fields.

I began to investigate the phenomenon after my wife had a psychotic break in the Payroll Office of the University of Alabama thirty days after the design of her office was changed. This site is now a five year project.

Page links are provided so that support material and Internet links placed on  related pages can be accessed without confusing the text here.

Executing harmless changes in individual ICU cubicles to block peripheral vision plus moving monitoring equipment to prevent subliminal detection of blinking lights are suggested to test this possible solution for ICU Psychosis.

Breaking the dissociation of daydreaming before approaching the patient would prevent the subliminal detection of staff approaching the bed as 'threat movement.'

This problem is caused by a 'conflict of physiology' related to the vision startle reflex.

 Have you ever encountered a blind victim of ICU Psychosis as defined below?

In this presentation ICU Delirium is distinguished from ICU Psychosis.

ICU Delirium is defined as those episodes of psychotic behavior, which have an explanation, based in treatment, injury, disease, or drug use.

ICU Psychosis is defined here as an unexplained period of psychotic behavior that may include hearing voices, which has a sudden onset with no reasonable explanation or cause.

History:

Fifty years ago engineers discovered the same sudden onset psychotic episodes in Knowledge workers. The engineers were designing the first close-spaced office workstations. Some of the workers using those workstations began having bizarre or psychotic episodes. When investigated the problem was Peripheral Vision Reflexes and the solution by the 1960's was the Cubicle.

The nature of the episode experienced in the business office is that it resolves with no treatment once the defective design is corrected and the source of repeating detectable movement blocked or the worker removed.

Why are all these places and events connected? In each case the "special circumstances" for Subliminal Distraction exposure were created by the activity engaged. Light dissociation is necessary to maintain a level of meditation or concentration to perform either Qi Gong or Kundalini Yoga. This eyes-open level of mental investment is the same as that required to perform knowledge work in business offices. Users can subliminally detect the movement of others near them in the exercise group. Landmark Education warns potential participants of the possibility of having a mental break although the participant is only sitting in the audience at the seminar. As they concentrate on the interrogation of a volunteer some participants begin to form mental images from the words of the lecturer. That level of mental investment allows subliminal detection of small movements near them.  Seng-Hui Cho used the suite common room to study while roommates walked by ignoring him.

The level of dissociation for these events is the same as that for ICU patients who think or daydream to pass time in the ICU. They can subliminally detect the approach of nurses and attendants every fifteen minutes around the clock as long as the patient was awake when approached.

Each of these subjects above has a separate page here on VisionAndPsychosis.Net. You must surf the site to read about them.

Emory Cubicle Bed

This PubMed article describes a bed designed to limit visual stimulation.   This modification of the Craig Bed used in Craig Hospital, Colorado may hold the solution to ICU Psychosis. .

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=2300695&dopt=Abstract

The problem may be solved with simpler approaches. Read further down page.

The Problem:

Humans developed as hunter gathers and over the millennia a detection system evolved to warn of movement approaching from behind. We call that system Peripheral Vision Reflexes. These reflexes are created at such a primitive level in the brain that they are said to be formed below thought, reason, or consciousness. When movement is detected that meets criterion a reflex happens.

It does not matter that the movement is benign, the reflex still happens. We evaluate the potential threat when we turn our head and look. Your brain does not attempt to identify the movement it just reacts. That's why it's a reflex

If you have ever been startled or caught something out of the corner of your eye, that was a peripheral vision reflex. Remember how fast that happened. There was no time for thought or consideration of the nature of the movement.

The Conflict of Physiology:

Briefly stated, the conflict is that we have the ability to ignore movement that is not a threat to us. But we cannot stop seeing anything in our vision field. We can attach selective levels of attention to objects or movement in conscious sight. The portion or your vision field that detects threat movement from behind operates subliminally. This means that once you ignore movement detected in that segment of your vision field the subliminal operation prevents re-acquiring the movement consciously. You could say it is lost to consciousness. The Demonstration page allows you to experience the habituation to extinction of that movement.

Once the process is complete you are not aware that you are still subliminally seeing threat movement and that your brain continues to attempt to break your concentration to warn you. Because there is no memory associated with the generation of these reflexes they will repeat as often as the movement is detected.

When you learn to ignore movement around you to be able to concentrate you do it every time you return to that job and location. In the ICU this would mean that the process continues every day the patient is there with their eyes open.

Supporting Information:

This problem is discussed and explained in first semester psychology lectures on Psychophysics, Physiology of Sight, Subliminal Sight, and Peripheral Vision Reflexes.

You can verify this much of the information by calling someone teaching one of the basic psychology courses and having them explain Subliminal Sight to you. I recommend against contacting a Ph.D. to inquire. My experience is that a Ph.D. will tell you they have never heard of the problem then offer you their opinion that it is not possible. When I found my instructor she remembered me but not the course material. She had changed fields and is now a Ph.D. in Child Development. Over the months I have yet to find a Ph.D. that does not argue that there must be a preexisting mental condition to have this happen even though the Ph.D. acknowledges ignorance of the phenomenon.

The second source of verification is an instructor in the design of Systems Furniture. Not every civil engineering school teaches this course. You should find the catalog on line, or phone near by schools. Have the instructor explain Cubicle Level Protection.

A third source of verification is a dealer for one of the major office furniture manufacturers. There are links to some of them on the Modern Cubicle page. If you use this method do not ask any one except the designer or engineer. This is not an ergonomics issue. Receptionists and the sales force will not be aware of this problem. In fact, you may have difficulty getting this information because of the perceived  threat of lawsuits. Engineers and designers do not want to be called as witnesses in such suits. They don’t want to be trapped and end up testifying against their employer. I called a dealer  for Steelcase in Birmingham Alabama.

This page has received a hit from Steelcase Research and Development. The only page hit was ICU Psychosis.

Suicide attributed  to ICU Psychosis

"The psychiatric experts hired by each side predictably disagreed whether the patient’s suicide was foreseeable. That being so, the trial judge, in the Appellate Court’s opinion, was in error on a technical point as to how he presented the foreseeability question to the jury. The verdict was thrown out and a new trial ordered. Hooper v. County of Cook, __ N.E. 2d __, 2006 WL 1319458 (Ill. App., May 15, 2006)."

Possible Solutions:

Using the design features of Cubicles to block side vision was the solution for the business office. That won't work in the ICU.   Patients are in bed so that the narrow plane or cone of peripheral vision is no longer vertically aligned.  A reclining person's peripheral vision sweeps the room.

The patient's full peripheral vision must be blocked to test this phenomenon as a cause of ICU Psychosis.

The need for sterile materials will limit the things that may be used.

If they were available, a sterile pair of safety glasses with the plastic protective lens removed would suffice. The opaque face mask portion that holds the lens would diffuse peripheral vision.

Putting pads over the closed eyes will do the same thing.

A simple first test might be:

Calling the patient by name and having them look directly at you as you approach will prevent one source of subliminal detection.

Has there ever been a blind victim of ICU Psychosis?

I am unable to find case histories  to investigate this.  Your hospital may have records that would indicate this.

Blinking Lights:

There is a problem with blinking lights that are near the frequency of brain waves causing seizures.

The brain system that creates vision reflexes works at such a primitive level in the brain that there is no difference in the neural impulses created by  reflected light from an approaching threat, and neural impulses from a blinking of a point source of light. At that level it is all electric pulses carried on  nerves and then transmitted across synapses between neurons.

Peripheral vision reflexes only happen when movement is detected approaching from behind. But that effect can be achieved through relative movement. This happens when the head is turned toward a stationary blinking light to acquire the stimulus. As the light enters Subliminal Peripheral Vision the path across the retina is the same when the head turns as when the head is stationary and the source of light moves.

Small lights at relatively large distances are probably not detectable. But to eliminate them as a source of stimulation in Subliminal Peripheral Vision, they should be moved or masked so that the patient cannot possibly see them from the bed.

Other cautions, possible screening:

 The possibility of  previous exposure would make certain people more susceptible to ICU Psychosis.

Exposure is cumulative so that college students and people who use Qi Gong and Yoga, particularly Kundalini Yoga , would be at high risk. Workers using computers in small business offices are another possible high risk group. No one hires an engineer to design office space for small businesses.

When either Qi Gong or Yoga  is performed in groups each person can subliminally detect movement from others around them. Concentration in the form of eyes-open meditation requires ignoring reflexes created from that threat movement detection.

Evidence of this is the altered mental states of long term users of these exercises. For 3000 and more years the onset of hearing voices, and  acquiring of the beliefs that you can communicate and direct the actions of others through mental telepathy, or that you possess of superhuman powers has been explained as the Awakening of Kundalini. It is viewed as a religious experience and proof that you have reached a higher plane of existence.

Some who attempt the path to enlightenment have serious psychotic episodes. They are told that this is caused by poor instruction or attempting short cuts through too many exercise sessions.  (Kundalini Yoga )

Qi Gong presents another interesting feature. Case histories from China state that victims cannot stop gathering others to exercise with them. This hints that there is an addictive quality to stimulation in Subliminal Peripheral Vision. (Qi Gong )

This addictive feature would also be present any place the conditions exist to cause repeating stimulation in Subliminal Peripheral Vision. Computer addiction, Internet addiction, MMORPG addiction such as Everquest Addiction can be explained when the computer workstation used is revealed to have the engineering design problem. The design problem does not cause the problem it allows exposure if repeating detectable movement is present near the computer. . The solution is simple and FREE read …Prevention … at the bottom of this and other site pages.

 Knowledge workers in small business offices should be included in this group. Engineers do not design office space for small businesses.

College students are at high risk. They have the same behaviors as Knowledge workers. Two person dorm rooms with study tables must provide Cubicle Level Protection for those study areas. A corner desk or side vision-blocking feature will do that. In Cubicles the converging corner walls are used for that purpose. Missing Students - College Suicides - Mysterious Disappearances site pages.

The current push to place children's computers in a family room to monitor Internet use is ill conceived if there will be repeating detectable movement around the computer. Any adult users of such computers will experience exposure if the computer is used while other family members move about in the room.

No one is screening for this problem because there are no medical professionals aware the problem exists.

There has previously been an awareness in the medical field of this problem from the business office. Several years ago the phenomenon was featured on a magazine type TV program. I saw just enough of the last seconds to understand what the subject had been. I found two people who watched it together. They were only able to remember three things. The problem had a name but they could not remember what the Doctor being interviewed said it was. The method of diagnosis was the speed of onset. The treatment was to do nothing because the episode would resolve spontaneously. My informants thought the program was 20/20 but the segment titles from transcript outlines does not have it listed. 

US Patent Office filing

Cubicle Bed

When a Stay in Intensive Care Unhinges the Mind By Sandeep Jauhar, M.D.
 

This article has several cases and contains the present understanding of ICU Psychosis.

http://www.nytimes.com/library/national/science/120898sci-icu-psychosis.html

Prevention:  This  section is now repeated at the bottom of most pages.

The rare occurrence of the injury establishes that is difficult to create enough exposure to cause an injury. But when it does happen the consequences are serious, possibly fatal.

The brain’s detection system only evaluates movement. There is little recognition of the nature of the object in peripheral vision. If you have several hours exposure from human traffic at the library, while reading at an open table or seated in a reading room chair, followed by long hours watching TV with a critically misplaced ceiling fan sweeping detectable shadows around the room, the combination of those two behaviors might cause the problem. The suggestion is that either activity alone would not consume enough exposure time even if the critical movement is present.

Copyright 2003