Psychological Profile  

Paul's Psychological Profile

From  The Journal of Neuropsychiatry & Clinical Neurosciences

Paul (Saul of Tarsus)

Acknowledgments | References 

Paul lived during the first century CE. It has been speculated that his religious experiences resulted from temporal lobe epilepsy.43 We would argue that it is not necessary to invoke epilepsy as an explanation for these experiences. Paul’s mood in his letters ranged from ecstatic to tears of sorrow, suggesting marked mood swings.44,45 He endorsed an abundance of sublime auditory and visual perceptual experiences (2 Corinthians 12:2–9) that resemble grandiose hallucinations with delusional thought content. He manifested increased religiosity and fears of evil spirits, which resembles paranoia. These features may occur together, in association with primary and mood disorder-associated psychotic conditions.

In 2 Corinthians 12:7, Paul relates “a thorn was given me in the flesh, a messenger from Satan, to harass me, to keep me from being too elated.” This thorn has been speculated to be a reference to epilepsy.43 Other theories have proposed that the thorn was a physical infirmity, the opposition of his fellow Jews,46 or a harassing demon.47

We propose that he perceived an apparition or voice that he understood to be a harassing, demonic messenger from Satan. This perception might have afflicted him with some amount of negative commentary of the type characteristic for psychotic conditions, resulting in psychological distress.

The complexity of Paul’s interactions in his perceptual experiences weighs against a seizure ictus as a cause, as does the lack of evidence for more common epileptic accompaniments, such as repetitive stereotyped behavioral changes and cognitive symptoms, as previously discussed. Paul does, however, manifest a number of personality characteristics similar to the interictal personality traits described by Geshwind,48–50 such as deepened emotions; possibly circumstantial thought; increased concern with philosophical, moral and religious issues; increased writing, often on religious or philosophical themes; and, possibly, hyposexuality (1 Corinthians 7:8–9). These characteristics are controversial as to their specificity for epilepsy,51,52 with a preponderance of larger studies not confirming a specific personality type associated with seizure disorders.51–57 Similar features may also be present in bipolar disorder5,35,36 and schizophrenia.35,36 As previously mentioned, productive writing tends to be more strongly associated with mood disorders than psychosis or epilepsy. This is persuasive toward Paul having a mood disorder, rather than schizophrenia or epilepsy.

Paul’s religious conversion on the road to Damascus (Acts 9:1–19, 22:6–13, 26:9–16) is an event understood as marked by the acute onset of blindness. This blindness has been hypothesized to have been postictal in nature43 or psychogenic.58 There appears to be a lack of clarity as to whether this was literal visual blindness or metaphorical, since Paul refers to persons outside his immediate belief system as spiritually blind or having their eyes closed to spiritual truth (Acts 28:26; Romans 11:8, 11:10; 2 Corinthians 4: 3–5; Ephesians 1:1. Differences in the three most detailed conversion-experience accounts contribute to this ambiguity. Acts 26:12–18 relates his conversion, during which a vision of Jesus tasks him to spiritually open the eyes of the people to whom he will be sent (see Figure 4). In this account, there is no mention of acute-onset visual loss followed by its restoration. The application of the blindness metaphor in Acts 26:12–18 may suggest that Paul’s own loss of vision was equally metaphorical and served as a descriptor of his profound realization of feeling suddenly bereft of spiritual understanding; that is, realizing his eyes to be spiritually closed, before the completion of his conversion to the new religious sect. In such an emotional state, it is speculated that he might have required encouragement and emotional assistance to reach Damascus. Another possibility would be that of blindness due to conversion disorder. The absence of other episodes of visual loss (i.e., lack of event stereotypy), the absence of features often seen with postictal blindness (a generalized seizure, anosognosia for deficit, or a gradual return of vision),59 the presence of complex, mood-congruent auditory–visual experiences resembling hallucinations, and the possible sudden return of his eyesight with a compassionate touch does not fit well into a readily discernable neurological pattern of vision loss. His perceptual experiences, mood variability, grandiose-like symptoms, increased concerns about religious purity, and paranoia-like symptoms could be viewed as resembling psychotic spectrum illness (see Table 1). Psychiatric diagnoses that might encompass his constellation of experiences and manifestations could include paranoid schizophrenia, psychosis NOS, mood disorder-associated psychosis, or schizoaffective disorder. Paul’s preserved ability to write and organize his thoughts would favor a mood disorder-associated explanation for his religious experiences.

 D. Landsborough, "St. Paul and Temporal Lobe Epilepsy," J Neurol Neurosurg Psychiatry 1987; 50; 659–64: [1]

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