2015 Déjà vécu: When déjà vu becomes your reality

One drab afternoon a few years ago something very unusual happened to me.

I was lounging under a tree in a packed east London park when I experienced a sudden feeling of vertigo, followed immediately by an overwhelming and intense sense of familiarity.

The people around me vanished and I found myself lying on a tartan picnic blanket amid a field of high golden wheat. The memory was rich and detailed. I could hear the sway of the wheat ears as a gentle breeze brushed through them. I felt warm sunlight on the back of my neck and watched as birds wheeled and floated above me.

It was a pleasant and extremely vivid recollection. The problem was that it never actually happened. What I was experiencing was an extreme form of a very common mental illusion: déjà vu.

Living with persistent déjà vu

For the past five years I have been suffering epileptic seizures resulting from the growth and eventual removal of a lemon-sized tumour from the right-hand side of my brain. Before my diagnosis I appeared fit and healthy: I was in my mid-30s and displayed absolutely no symptoms. Until, that is, the afternoon that I woke up on the kitchen floor with two black eyes after suffering my first recorded seizure.

No, you haven't read this déjà vu story before

Seizures, or fits, occur after an unanticipated electrical discharge in the brain. They are usually preceded by something called an 'aura', a sort of minor foreshock lasting anything up to a couple of minutes before the main event begins. The nature of this aura differs greatly from patient to patient. Some people experience synaesthesia, extreme euphoria and even orgasm at the onset of a seizure. My own aren't nearly as exciting-sounding, being distinguished by sudden shifts in perspective, a rapidly increased heart rate, anxiety, and the occasional auditory hallucination.

By far the most significant trait of my aura is the striking sense of having lived through that precise moment before at some point in the past -- even though I never have. During my most intense seizures, and for a week or so afterwards, this feeling of precognition becomes so pervasive that I routinely struggle to discern the difference between lived events and dreams, between memories, hallucinations and the products of my imagination.

I don't remember déjà vu happening with any kind of regularity before the onset of my epilepsy. Now it occurs with varying degrees of magnitude up to ten times a day, whether as part of a seizure or not. I can find no pattern to explain when or why these episodes manifest themselves, only that they usually last for the length of a pulse before vanishing.

Many of the estimated 50 million people in the world with epilepsy experience long-term memory decline and psychiatric problems. And it's hard for me not to worry whether the blurring of fact and fiction that I experience might one day engender a kind of mania.

Exploring the déjà experience

Taken from the French for 'already seen', déjà vu is one of a group of related quirks of memory. Research from 50 different surveys suggests that around two-thirds of healthy people have experienced déjà vu at one time or another. For the majority, it is dismissed as a curiosity or a mildly interesting cognitive illusion.

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While déjà vu is instantaneous and fleeting, déjà vécu (already lived) is far more troubling. Unlike déjà vu, déjà vécu involves the sensation that a whole sequence of events has been lived through before. What's more, it lacks both the startling aspect and instantly dismissible quality of déjà vu.

A defining feature of the normal déjà vu experience is the ability to discern that it isn't real. On encountering déjà vu, the brain runs a sort of sense check, searching for objective evidence of the prior experience and then disregarding it as the illusion that it is. People with déjà vécu have been known to lose this ability completely.

Professor Chris Moulin, one of the foremost experts on the déjà experience, describes a patient he encountered while working at a memory clinic at a hospital in Bath, England. In 2000, Moulin received a letter from a local GP referring an 80-year-old former engineer known as AKP. As a result of gradual brain-cell death caused by dementia, AKP was now suffering from chronic and perpetual déjà vu: déjà vécu.

AKP claimed that he had given up watching television or reading the newspaper because he knew what was about to happen. "His wife said that he was someone who felt as though everything in his life had happened before," says Moulin, now at the Laboratoire de Psychologie et NeuroCognition CNRS in Grenoble. AKP was resistant to the idea of visiting the clinic because he felt as though he'd already been there, despite the fact that he never had. On being introduced to Moulin for the first time, the man even claimed to be able to give specific details of occasions that they had met before.

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AKP did retain some self-awareness. "His wife would ask him how he could know what would happen in a television programme if he'd never seen it before," says Moulin, "to which he would respond, 'How would I know? I have a memory problem.'"

On that day in the park, my vision of the picnic blanket and the wheat field disappeared when a paramedic began to shake my shoulder. Despite the fact that my memories had been hallucinations, they still felt as valid as any truly autobiographical memory. Moulin classes this as a form of déjà experience in which an image is somehow imbued with a sense of reality.

"Our feeling is that déjà vu is caused by a sense of familiarity," he says. "Rather than just feeling like something has a feeling of 'pastness' about it, something comes to mind that has a phenomenological characteristic, so that it appears to be a real reminiscence."

After his first encounter with AKP, Moulin began to become interested in the causes of déjà vu and how subjective feelings can interfere with day-to-day memory processes. Discovering that there was very little credible literature describing the causes of déjà vu, Moulin and colleagues at the Language and Memory Lab at the Institute of Psychological Sciences, University of Leeds, began to study epileptics and other sufferers of profound memory defects in order to draw conclusions about déjà experiences in the healthy brain and explore what déjà vu means for the workings of consciousness generally.

They were faced with an immediate problem: déjà vu experiences can be so transitory and short-lived that they are almost impossible to recreate in clinical conditions. The job that they faced, then, was one of trying to catch lightning in a bottle.

The causes of déjà vu

In his book The Déjà Vu Experience, Professor Alan S Brown offers 30 different explanations for déjà vu. According to him, any one alone may be enough to trigger a déjà experience. As well as a biological dysfunction like epilepsy, Brown writes that stress or tiredness could cause déjà vu.

Brown is also a proponent of what is called the divided perception theory. First described in the 1930s by Dr Edward Bradford Titchener, divided perception refers to the times when the brain isn't quite paying enough attention to its surroundings. Titchener used the example of a person about to cross a busy street before being distracted by a shop window display. "As you cross," he wrote, "you think, 'Why, I crossed this street just now'; your nervous system has severed two phases of a single experience, and the latter appears as a repetition of the earlier."

For much of the last century this idea was accepted as a plausible trigger of déjà vu. Another common explanation was one offered by a doctor working at the Boston veterans' hospital. In 1963 Robert Efron suggested that déjà vu could be caused by a sort of processing error: he believed that brains were responsible for assimilating events through the temporal lobe before then adding a sort of timestamp to them to determine when they happened.

Efron saw déjà vu as resulting from the lag between seeing and adding that timestamp: if the process took too long, the brain would think that an event had already happened.

But Alan Brown and Chris Moulin both agree that the way that the hippocampus indexes memories by cross-referencing them according to familiarity is a more likely cause of déjà vu.

"My belief is that a per-seizure déjà vu experience is triggered by spontaneous activity in that area of the brain that handles familiarity evaluations," says Brown. Probably, he says, in the area surrounding the hippocampus, and most likely on the right side of the brain. The precise point at which I have a lemon-shaped hole.

Brown suggests that déjà vu happens to healthy people only a few times a year at most, but can be stimulated by environmental factors. "People experience it mainly when they are indoors," he says, "doing leisure activities or relaxing, and in the company of friends; fatigue or stress frequently accompany the illusion." He says that déjà vu is relatively brief (10 to 30 seconds), and is more frequent in the evening than in the morning, and on the weekend than on weekdays.

Some researchers claim a connection between the ability to remember dreams and the likelihood of experiencing déjà vu. In his work, Brown suggests that although déjà vu occurs equally in women and men, it is more common in younger people, those that are well-travelled, earn higher incomes and whose political and social outlooks are more aligned to the liberal.

"There are some plausible explanations for this," he tells me. "People who travel more have more opportunities to encounter a new setting that they may find strangely familiar. People with liberal beliefs may be more likely to admit to having unusual mental experiences and willing to figure them out. A conservative mindset would likely avoid admitting to having strange mental events, as they might be seen as a sign that they are unstable.

"The age issue is a puzzle because memory usually gets more quirky as we age, rather than the other way around. I would guess that young people are more open to experiences and more in touch with unusual mental happenings."

One of the first comprehensive studies of déjà vu was conducted in the 1940s by a New York undergraduate student called Morton Leeds. Leeds kept an extraordinarily detailed diary of his frequent déjà experiences, noting 144 episodes over the course of a year. One of these episodes, he wrote, was "so strong that it almost nauseated me".

Following my most recent seizures I've experienced something similar. The shock of repeated déjà vu isn't physical, necessarily, but instead causes a kind of psychic pain that can feel physically sickening. Dream images suddenly interrupt normal thoughts. Conversations seem to have already taken place. Even banal things like making a cup of tea or reading a particular newspaper headline seem familiar. It feels occasionally like I'm flicking through a photo album containing nothing but the same picture reproduced endlessly.

Some of these sensations are easier to dismiss than others. Coming closer to finding an answer to what causes déjà vu also means approaching a kind of resolution for my more persistent déjà episodes, the ones that are the hardest of all to live with.

The night before completing this piece I had another seizure. The deadline had clearly been on my mind, as I suddenly had an intense memory of sitting down to write these closing sentences. When I regained my composure enough to read the finished article the next day, there was nothing here but blank space. It was another illusion. Now I'm actually typing this conclusion. It is, to borrow a famous solecism, like déjà vu all over again.

This is an edited version of an article that was first published by Wellcome on Mosaic. It is republished here under a Creative Commons licence.

Copyright 2015 The Wellcome Trust. Some rights reserved.