Responding to Madness With Loving Receptivity: a Practical Guide


In my last three blogs I posed the question- “If madness isn’t what psychiatry says it is, then what is it?” Now I’m asking- “If madness isn’t what psychiatry says it is, then how should we respond to madness?’

Here are some thoughts that I wanted to share with you about how to effectively serve your clients, friends and loved ones who are having an experience of madness. These ideas may also be of help in doing self-care if you are entering or traversing a madness process yourself.

They are followed by my quite personal and un-orthodox neo-Jungian formulation of madness.

That formulation and these practical suggestions are mainly gleaned from my own un-medicated, untreated experience of madness in my early twenties, and from working daily as a primary therapist for almost 30 years with actively mad clients using a Jungian/Transpersonal, Laingian approach.

During that time I worked for over 3 years at the  24/7, alternative, 20 bed, free standing, transpersonally oriented, acute care open door program called I-ward in Martinez California where no medications or leather restraints were used or diagnoses given to consumers who were acutely mad, which I describe in my last blog- “Remembering a Medication-Free Madness Sanctuary.”

I also helped develop a similar 5 bed program in Marin County, Passages In, that was short lived. I did several months of internship at St. George’s Homes in Berkeley where a similar Jungian/Transpersonal approach was used.

After that I worked for 25 years in public sector clinics and on a mobile crisis team as well as in private practice. Even in those settings, most of the mad clients I served were not on medication.

I also am drawing on my doctoral research follow-up study done on the San Francisco based, medication free Diabasis House sanctuary for clients in acute madness, and my 20 year relationship with its founder, Jungian psychiatrist John Weir Perry.

But my early experience of serving from age 18 as a medic in the Army and Air Force Reserve for 8 years and then as a State Hospital attendant with profoundly developmentally delayed men- and for 2 years as an orderly at a nursing home with brain damaged, demented and Alzheimer’s patients, also informs my advice on how to relate with love to people in physical and emotional pain and suffering.

So, here are two basic principles for helping someone or yourself in a madness process which are distilled from my own personal and work experience and  from the study of successful Bay Area alternative programs.

1. Keep suspending your disbelief

Every time you tell yourself or believe that the mad  person you are being with, or you yourself has a tragic, lifelong, and threatening illness that has no inherent meaning or purpose- such as a neuro-biological, genetically based diseased brain, an incurable thought disorder, or chemical  brain imbalance- try to suspend your disbelief that another explanation may be possible.

Instead, hold the belief that they or you are going through a necessary, meaningful, developmental, initiatory, trans-formative, transpersonal/archetypal, symbolic and/or purposive natural process – one that is neither pathological nor indicative of a genetically inherited, neuro-biological brain disorder.

Hold the belief that, as Dr. Karl Menninger famously said, it is possible to emerge from the madness process- “Weller than well!”

2. Be Receptive

Once you are able to stay open to the possibility that this process is an important, potentially transformative natural life event, draw on all your skills of receptivity and empathy. Begin by simply listening and receiving the person or your own experience with an open, compassionate heart. Let the gentle feelings of love that you would feel for a loved one who is frightened and suffering be present within you.

As this process unfolds, gently invite and encourage the expression of both the emotional and symbolic content. People in a madness process may need to use modalities such as drawing, painting, movement and evocative music to express themselves in addition to or instead of speech. Somatic modalities of touch and bodywork can be especially welcomed and grounding and soothing.

The common and overwhelming evidence from  the Agnews project, Diabasis House, I-Ward, Soteria House and other alternative programs from all over the world, confirms the basic need for a person in such a madness process to be believed in, listened to and lovingly received and responded to in this way.

Some years ago I co-led a workshop on madness with  Loren Mosher of Soteria and Mathew Morrisey of the medication free sanctuary Burch House. We all agreed that the necessary and sufficient condition for someone to traverse a madness process into wholeness, was the presence of heart centered people around them who received the person’s emotional and symbolic process with a certain level of compassion that I would call love.. Those loving people did not need to be professionally trained.

This view was also expressed by R.D. Laing when asked- “Dr. Laing, I still don’t understand the theoretical basis of your approach to schizophrenia. Could you please explain?”

“Certainly,” said Laing- “The basis is love. I don’t see how you or I can be of any help to our clients in a visionary state unless we are capable of experiencing a feeling of love for them. Therapy, as opposed to mere treatment requires that we have a capacity for loving kindness and compassion.”

The questioner was still perplexed and asked- “But Dr. Laing, what is your clinical methodology for developing this approach?’

A recent Facebook post from a psychiatic nurse shows how the very subtle, even non-verbal communication of the energy of love can dramatically effect someone who is mad-

“I remember once bathing a schizophrenic(that was her didgnosis)woman who had not responded or spoken for 20 years. I remember feeling some affection and sadness for her as I washed her gently in the tub. All of a sudden she started to respond and called me mommy and wole up from her catatonic state. The care, the loving touch got through to her.. I will never forget that.”

It is the same very familiar feeling tone of caring love that we often feel for our children or mates as we nurse them when they are ill, that can be evoked between us and someone in a madness process if we open our hearts beyond what professional mental health training teaches.

The nurse’s story makes me remember working with a man who was almost 80 years old who was diagnosed bi-polar and who had been in the hospital many times. Even though I was almost 30 years younger, because I sat with him with my heart very open and asked for his dreams, after some time he came with a hugley healing dream.

He had been depressed his whole life and said that his mother was always vey harsh with him and had never in his childhood told him that she loved him or touched him with love or hugged him..

He reported his healing dream with tears of gratitude and joy because in it he was a young boy again, held warmly and rocked for a very long time by his mother who repeated wonderful terms of endearment and told him over and over that she loved him..

He then said-‘And the strangest thing was Michael, she was bald just like you are.’

So,.in that spirit of risking to call what we may feel for ourselves or others in a madness process as being in fact love, here are observations I slowly learned for myself the past 30 years about how to more specifically make yourself available to anyone in a madness process. The list is only an attempt to begin a conversation and exploration of all the possible ways we can be of service.

  • To be most helpful try and feel like your inner subjective state is more emotional than mental.
  • Create a physical and emotional state of receptivity. Let warm feelings of caring be present in you.
  • With your feet flat on the floor, hold the awareness that there is now a solid base and foundation beneath you.
  • Remember to keep your anal sphincter relaxed.
  • Keep a focus of energy in the hara chakra below your navel.
  • With your stomach muscles relaxed, feel yourself do deep and slow belly breathing.
  • Drop down your shoulders.
  • Let your face become calm and relaxed–not becoming pensive or quizzical.
  • Let your voice come up from your hara in lower octaves, emerging with the energy of your heart chakra as you speak..
  • Let your kindly, gentle, even loving and tender feelings of empathy and compassion arise in your heart chakra for a fellow human being in distress and suffering who is sharing the room with you.
  • Allow silences.
  • Don’t seek direct eye contact if it seems to make the person uncomfortable.
  • The person may be in a very heightened state of awareness and is processing minute inflections in your voice and body language.
  • Their ability to see into you may surprise you as uncanny and psychic.
  • In this state they may directly or symbolically tell you secret things about yourself that are disquieting.
  • If the person is hostile increase your vigilance on your own physical and emotional markers of receptivity.
  • Because you may find that you may involuntarily be holding your breath.
  • You may notice your throat becomes constricted and your voice goes up in octaves.
  • You may notice you are opening your eyes very widely and blinking a lot.
  • You may feel the need to fold your arms across your chest or cross your legs.
  • To the degree that you can be aware of these shifts in you prompted by anxiety, you can refrain from them as much as possible and remain in the open, receptive, emotional and physical posture with a potentially physically or verbally assaultive person in a madness process.
  • The more you stay grounded and centered the more they will calm down, will not sense a fight or flight visceral response to them building in you.
  • Being with agitated people in a madness process is kind of like practicing an internal martial art at times- a form of Aikido.

Madness is an ancient form of uncivilized wildness. It also is a sacred mystery.

Emily Dickinson said it well-

“Much madness is divinest Sense–
To a discerning eye–
Much sense–the starkest Madness–
‘Tis the Majority In this, as All prevail–
Assent–and you are sane–
demur–and you are straightaway dangerous
and handled with a chain.”

If you are given the opportunity to serve those traversing the mysterious depths and heights of madness count yourself lucky, especially if they are not emotionally anesthetized by medication.

The efficacy results from the Northern California based Agnews Project, I-Ward, Diabasis, and Soteria House all clearly demonstrate that without medication, most first time, acute madness crises will in fact be the occasion for a life changing developmental and possibly even a spiritual transformation if a 24/7 alternative, non-medical model sanctuary is provided.

My experience and research into alternative approaches for serving those in an acute madness process has led me to believe that at least 75% of the consumers who become trapped in the mental health system could have avoided that fate if acute care, 24/7 Bay Area sanctuaries like Diabasis House, Soteria and I-Ward (where I worked )were available at first contact with the system.

They never would have gone on to be labeled Schizophrenic or Bi-Polar or Schizo-Affective.

But even for those not blessed to have a sanctuary to go to during their initial excursions into madness, hope is not to be lost.

John Perry acknowledged that my utilizing Jungian dream work with consumers who had been medicated for years such as the older man I told about above, extended his work on acute episode madness into another level. He had not worked with long term consumers.

After all the sanctuaries were forced to close in the Bay Area, I got to do therapy with long term people who were mad as well as acute phase consumers in clinic settings.

Against conventional wisdom and the wishes of my clinical supervisor at work, but with the tentative encouragement of doctoral program clinical supervisors John Perry, David Lukoff and Jungian, Tanya Wilkinson, I started asking consumers to share their dreams. For many, their psyches had just been waiting to be asked!

The buried, un-experienced, un-named, un-expressed affect/emotion that was the prime causal factor in their becoming mad in the first place was re-animated as archetypal dreams of emotional power and symbolic expression came pouring forth.

It took years for some people for their psyche to do it’s work of resurrection and to allow the person to have access to the full range of human emotions without becoming mad as before, whenever too strong and intense feelings would come alive.

One of the many contibutions that John Perry made to a Jungian approach to madness, was to wonderfully re-defined the meaning of ‘archetype’ to mean- ‘affect-image.’ He meant that affect and the image are co-equals of archetypal activation and experience.

I would take that further and say that affect, emotion is the source of all imagery, every word, thought, facial expression, auditory and visual hallucination, so-called delusion.

We are first and foremost emotional beings who from conception begin to rage, weep and laugh and hide in terror and dance for joy- and seek to receive and give the emotion of love.

For me, by definition, everyone who is mad is in an archetypal, transpersonal experience, just as everyone who isn’t mad is too.

The artificial distinctions that label some mad people chronic schizophrenics and others blessed to be in a spiritual emergency don’t exist for me. The mumbling, homeless mad person is just as deserving of our seeing that they are in a spiritual wasteland where the Gods of the wasteland rule as the person who is having amazing, visionary experiences that we are inspired and maybe dazzled by,- who brings Hermes or Persephone or Kwan Yin into the room with us as often happened on I-Ward.

The New Age and sometimes Transpersonal Psychology over emphasis on defining spirituality and spiritual emergency and spiritual emergence as being only enlightening and uplifting is an unfortunate mistake. The elevator goes down as well as up.

Spiritual experience means to me the contact with spiritual energy. From my own initiatory madness some of it is dark I know. Some of it is light I know. Darkness initiates just as much as light does. It turns out that both light, love emanating energy and rightly feared dark, dangerous spiritual energies are sometimes active in bringing balance through transformative madness as well as in- ‘normal’ life.

Based on my experiences on I-Ward which I describe in my last blog, I believe that if you spend much time with people in acute madness experiences who aren’t medicated you will encounter an uncanny presence of what can be viewed as spiritual light as well as darkness.

That is another reason madness has been feared as being demonic until science/medicine said it was all in people’s heads- and came up with perverse ways to silence it that at times would make an inquisitor smile.

Jung said that: “Psychiatry has turned the Gods into diseases.”

Unfortunately Jung and most Jungians have turned the Gods(and Goddesses) into archetypes: named and minutely described denizens of the collective unconscious that we can have an ‘as if’ relationship with at weekend workshops and schoomze with once and a while in our dreams. Unless we go mad and then we know them intimately.

Traditional Jungians have identified the forms, the affect and imagery tracings of the gods from dreams and visions, but rarely ask them into the consulting room for an embodied visit.

They haven’t turned the gods into diseases, but they have not honored them through the timeless practice of ritual where the gods were fervently called forth to have their way with the initiate. The 50 minute hour with some active imagination is about as wild as it gets!

Jung greatly feared going the route of Nietzsche who died raving mad. Perry extended Jung’s work on madness because he named it as purposive if welcomed with open arms.

Jung exhorted analysts to terminate an analysis if a single dream of a patient looked like a sign of an- ‘incipient psychosis.’


Please don’t make the mistake of too greatly fearing madness or underestimating the spiritual dimension of our human birthright as you may practice your own shamanic vocation or seek to understand the mysteries of others or your own madness.

One of my favorite Jung quotes points to that mystery-

“These inner motives spring from a deep source that is not made by consciousness and is not under it’s control. In the mythology of earlier times these forces were called mana, or spirits, demons or gods. They are as active today as they ever were…the one thing we refuse to admit is that we are dependent on ‘powers’ that are beyond our control.”

In my experience, behind every image, thought and word, there is an emotion first. Behind every emotion there is a universal so-called archetypal power and emotional energy that must come forth as imagery that expresses that deep emotion. Behind every archetype is a totally autonomous living force of deity that has no historical bounds, no time bound archetypal form.

These ancient and emerging deities, that use our lives and bodies as their playgrounds and every second hold us in sway as they incarnate themselves in us, ever emerging anew, arise out of a greater unifying mystery of benevolent silence.

Weep for the prophets and so-called psychotic visionaries who are robbed of their life giving gifts from the Gods by our culture of fear and human arrogance. And weep for us that we still treat the mad ones among us as lepers when they are, and always have been a divine source of the mana we need to survive on earth.

As a first ever, initial madness process begins, the psyche is faced with such overpowering unbridled emotion that the inner emotional charge grows to become profoundly existential in nature and magnitude.

As the person faces the initiatory challenge of young adulthood in such an all pervasive liminal depth, the ego, the frail manager of consensual reality, simply is engulfed.

The ego is swamped in the soul depth liminality of an emotional power that triggers all forms of desperate, seemingly delusional attempts to give some fragmented sense of meaning to the inner experience.

It is a visceral, first chakra existential experience that seizes the individual.  It is the emotional response to being lost. It may be experienced mainly as one feeling exalted and indestructible at first or feeling totally terrified, doomed and bewildered.


The experience may also fluctuate between being plunged into the underworld and being drawn up into heavenly realms with amazing rapidity.


In these dramatic ways the process mirrors shamanic initiatory ordeals described in every cultural lineage.

In any event, if not made numb by medication, the psyche creates a mythic story along predictable lines. The drama is played out on the stage of the central archetype, the Self, where every kind of polarity may be experienced and transmuted: good/evil, dark/light, male/female, life/death, terror/serenity, grief/joy, desolation/birth.

All  the emotion generated and image fueled polarities may be contained in the mandala crucible of the relationship that you, the loving caregiver, creates with the person who is mad. In that container with you, all the polarities can be balanced into a cohesive unity.

That loving feeling toned relationship with you is crucial, it is a prerequisite for transformation and healing to occur.. Without a loving ‘other’ to make the mandala crucible which gets forged by the connection of their two hearts and psyches, the mad person spins on out of control.

Acute madness is the ultimate identity crisis and is for some, a potentially shamanic initiation. Our feeble, arrogant egos usually assume we are master of knowing “Who am I?”

As the pre-madness/visionary ego floats in this ignorant vulnerability over an abyss of the unfathomable depth of the collective unconscious and spirit world of gods, demons and ghosts, the ego is always just a few nights without sleep away from psychosis, or a drop of LSD away from psychosis, or from a psychosis triggered by a kundalini eruption, or a loved ones sudden death.

The unprepared ego of an especially vulnerable young adult facing autonomous functioning separate from their family is at risk from drowning in the depth of the affect and images of the collective unconscious.

It is remarkable that the childhood tasks of such a vulnerable ego do not overwhelm it. However, in the late teens and young adulthood comes the awareness of mortality and the knowing that physical survival and social acceptance and success depend on functioning separately from parents.

The broad range of every possible human emotion I mentioned above that is our human birthright and imperative to experience and claim, makes up the magma of the madness eruption that is too strong for the young adult.

These emotions come boiling up to the surface because the young person has hit the developmental hurdle of young adulthood.. In their families, full emotional experience and expression was not allowed and made possible for them to sufficiently master.

Now the psyche will try and rectify that through transformative madness.

Because of the power of our toxic and soulless culture to create enormous deficits in our family systems, most notably an epidemic of the lack of a strong infant-parental love bond, when faced with the often cruelly threatening social Darwinism cultural gauntlet one must traverse into young adulthood, the pre-madness ego for some is simply not prepared to traverse the hero’s journey and initiation across so much underlying liminality.

We can’t underestimate the corrosive and pervasive effects on vulnerable children and young adults that our largely loveless and spiritually barren patriarchal culture inflicts through degradation ceremonies of endless winner-loser competitions where shame and guilt and fear of punishment break the spirits and hearts of so many.

For such vulnerable young persons, an affect of an unnamed existential terror, the dreadful sense of an abyss of yawning ontological insecurity seizes them. This overpowering challenge may then trigger an attempted visionary alternative restructuring of the ego through a radical immersion in a mythical inner struggle for adult independence.


This inner heroic struggle for ones future life is carried out at the archetypal center of the Self, if the young person’s process is not aborted, if they are given sanctuary and not medication.

I have seen them come out the other side with a new, heroic ego strength that grew out of their trial by fire.

As the great R.D. Laing said after witnessing and attending many on such a journey at the Kingsley Hall sanctuary he provided:

‘From the alienated starting point of our pseudo-sanity, everything is equivocal. Our sanity is not true ‘sanity.’ Their madness is not true ‘madness.’ The madness that we encounter in ‘patients’ is a gross travesty, a mockery, a grotesque caricature of what the natural healing of that estranged integration we call sanity might be. True sanity entails in one way or another the dissolution of the normal ego, that false self competently adjusted to our alienated social reality; the emergence of the ‘inner’ archetypal mediators of divine power, and through this death and rebirth, and the eventual re-establishment of a new kind of ego functioning, the ego now being the servant of the divine, no longer it’s betrayer.’


  1. You said: “The New Age and sometimes Transpersonal Psychology over emphasis on defining spirituality and spiritual emergency and spiritual emergence as being only enlightening and uplifting is an unfortunate mistake. The elevator goes down as well as up.”

    that is the truth! it strikes me that those who think spiritual things are all “positive” must have some scary shadows they’ve never looked at! And if they’re also therapists that is a dangerous person to be caring for those in challenging mental states. One must be comfortable with their own darkness to help others with theirs.

    thanks for your work.

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    • Thank you Gianna. I agree. Madness almost always involves going through an underworld passage where cthonic, soul level emotions and shadow energy reside, and need to be integrated. This can happen if the person is lovingly received and not medicated.

      If we are both emotional and rationl beings who also possess both a spirit as well as a soul, then it seems to me that integration of all levels of our being moves us towards wholeness.

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    • Yes Gianna, Michsael– but Stan Grof who think invented the term Spiritual emergence was certainly aware of that–in fact it’s frightening reading his stuffon birth process.But really what strikes me as more troubling on the part of many new agers is their ignorance or “denial” that ecocide, genocicde, omnicide is happening in the material world–not just as inner experience. WE are closer to destroying humanity thsan ever before.The political reality is that Obama and the Democrats are just as oblivious as Republicans to global warming, looming ecological catastrophe–in view of refusal of elites to do anything. THIS is the reality thsat many so called psychotics experienced asone side of their vision. And Perry said thsat we found that the msad were more concerned about ecological disasters than they ever had been before. I wish it wr just an inner archetpe. Michael I wasn’t aware that there was research done at Diabasis. Like Soteria research. I’d lie to see that published.Seth

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  2. Wow. How perfect is this blog for Valentines Day? I am reflecting on your two suggestions for how to support someone experiencing an extreme emotional state.

    1. Suspend your disbelief

    (or, its corollary, open to the belief that there is meaning in this madness)

    2. Be receptive…. Receive those in this process with grounded, unwavering love

    It strikes me that this is the way we should interact with life in general (extreme or otherwise). All the great wisdom traditions speak of the power of love. And in Eastern traditions, Mindfulness is more accurately translated as Heart-fullness (or present open acceptance of what is). Why, I wonder, does it continue to shock me that even the most challenging of relationships or circumstances respond to unconditional love?

    Thank you for the reminder and your beautiful lived examples of love’s capacity to heal when it is offered in an open, nonjudgmental and safe space. Clearly, our most important work as human beings is in the heart, not the head.

    Happy heart day… Jen

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    • Thank you very much Louise. Your wonderful book-“Surviving Schizophrenia” should definitley be required reading for mental health professionals.

      There is hope for recovery as you have proven and hope is what a pathologizing diagnosis based on the medical model paradigm of human emotional suffering and madness can take away.

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  3. Michael,
    I appreciate so much your thoughts and experiences.

    I am in the process of ‘recovering’ from a bout of madness that landed me in the hospital with a first-time diagnosis of Bipolar I with psychosis (at age 45), just before Christmas. I began looking for alternative options to recovery besides medication and discovered that they are out there, but most are outside of the mental health systems in our society.

    I am currently in Portland, Oregon, and find that being in the urban environment is not as healing for me as being in a natural setting.

    I am a Retreat Center Director by trade and because of my experience in the past months, I have decided I would like to develop low-cost 1-12 week retreats for people like me who want to focus on holistic wellness of mind, body and soul. My hope is to get volunteer practitioners (massage, reiki, tai chi, accupuncture, non-violent communication, art/ recreation and/or various talk therapists, etc., etc.) who also would like a week or longer getaway at such a place in exchage for a couple hours a day sharing their expertise.

    I am in love with the concept of loving receptivity you have described in your blogs. Do you offer any training in such methods??

    I would love to get any suggestions from you or your readers about developing this retreat idea into reality. I am starting a website that I hope to have up and running in a week or so:

    I am currently in the information-gathering stage and also connecting with people who are interested in helping me plan these events. I have a location in southern Oregon near Ashland already lined up, the directors are excited to work with me on this project and the site is ideal. We are looking at a starting date of next January just to give the idea time to come together solidly, although a pilot project may very well be scheduled sooner.

    Please be in touch with me if you are interested.


    Miranda Joy Lovelong
    [email protected]

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  4. Thank you for your wonderful comment Miranda.

    It’s very synchronistic because just last night a dear friend was telling me she wished there was a holistic place available to go on retreat and do some over-due soul healing with all the healing modalities you describe in your planned retreat center!

    This isn’t the first time I have been asked if such a place is available that is off the mental health grid of traditional resources. Bless you for wanting to make it available.

    it’s amazing because I have been exploring opening a holistic storefront drop-in center in Berkeley with friends this year. Again, an all volunteer place with almost exactly the modalities you describe and with peer counseling and somatic awareness groups too.

    There is something in the air! It feels like a pent-up demand and recogniton of a huge unmet need for holistic centers of every kind, respite, drop-in, 24/7 madness sanctuaries etc.

    I’m co-leading a workshop this weekend on the heart centered approach described in this blog with friend David Lukoff(check out his site!) at the Assoc. for Transpersonal Psychology conference in Menlo Park. In April I’ll be at the CASRA conference in the SF Bay Area.

    Thank you for your contact info. I’ll get in touch and we can discuss holistic healing centers!

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    • Yes! Something IS in the air! Just went to a board meeting last night of the Portland-based group (their website led me to yours) and they were very excited about the idea too!

      Speaking of, they (I should now say “we” since I’m part of them now) are holding their 2nd Annual Rethinking Psychiatry Symposium May 11-12 here in Portland. We are calling for proposals for workshops and organizations that want a table at the event. It would be great if you or anyone else interested could be there.

      Looking forward to talking with you soon!

      -Miranda Joy

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  5. Rachelle, thank your for your comment.

    Ever since my own experience of madness(please see my blog here called-“Initatory Madness”) I have felt compassion for every family memeber I have encountered who had a child or loved one who has struggled with madness.

    I agree with the Open-Dialog program leaders who were cited in Bob Whitaker’s book- “Anatomy of an Epidemic” when they say-“Psychosis does not live in the head. It lives in the in-between of family members and the in-between of people. It is in the relationship, and the one who is psychotic makes the bad condition visible. He or she ‘wears the symptoms’ and has the burden to carry them.”

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    • Hi Michael-
      I have found your writings to be of great interest but I, too, have been troubled by your assertions that seem to blame all families. For instance,
      “On I-Ward I soon came up with my own litmus test that every family where a young adult becomes mad has sadly not passed- the apple of my eye test. Does at least one parent look at and express the feelings I have for my own daughter- that she is the apple of their eye?”
      Isn’t it possible that your are confusing the response to the crisis with lifelong patterns of interaction? Although there may be ways to help families to communicate effectively and promote recovery, I think it is unfair – and even cruel – to blame families. I have known many wonderful families over the years who are often the only ones who are able and willing to support their family member. I do not think any of us really understand what causes madness.
      Sandy Steingard

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  6. Thank you for your comment Sandy.
    Although I have been careful to say several times in my 4 blogs that I believe madness is a mystery, I have raised the question about what madness is, if it isn’t what Bio-psychiatry says it is.
    In attempting to answer that question, I have offered a description of madness as a multi-dimensional experience.
    The role of the modern family where fifty percent end up in divorce, and where child sexual, physical and emotional abuse are at record levels is but one factor in the genesis of madness.
    I am in agreement with the Open- Dialog program leaders I quote above,

    Now in my 66th year after my own madness 45 years ago, I am sad to say that after serving families for over thirty years, that a sufficiently strong love bond of emotional intensity has been conspicuously absent in every family where a young person has become mad.

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  7. Its a truly wonderful blog you are writing, Michael:))

    One of great integrity, honesty, courage and open hearted compassion for the vulnerability of the human soul, in all its guises. We strange creatures who fall victim of our own sensitivity, like no other?

    What a paradox of nature this energized mind sensation is, with its capacity to torture us with our own innate reactions to life? “Energized mind sensation,” sounds a bit odd in normal company, I know. Yet do we take for granted what our normal state of mind is, and how it is stimulated?

    Your introduction of the body and its chaotic discharge of nervous system energy, affecting an anguished sensation of mind, is a breath of fresh air within an overly cognitive debate on mental illness.

    Your advice on remaining grounded and self monitoring one’s own “autonomic state,” should be compulsory reading for mental health professionals drowning in conceptual theories, which have no self experiential awareness.

    Sadly people tend to prefer this distancing of detached concepts , to the counter intuitive task of monitoring unconscious reactions. Indeed the recommendations you offer should invite many people to think about their sense of self, and ponder that very popular blinding alley, “I think therefore I am?”

    After thirty two years of a manic depressive experience, my diagnosis of a disease like illness, requiring life long medication. Became a life long mindful meditation on the unconscious conditioning of a painful dis-ease.

    Learning to FEEL the energizing “buried, un-experienced, un-named, un-expressed affect/emotion that was the prime causal factor in their becoming mad in the first place,” became the challenge of a lifetime for me. Before I could go there though, I needed the guiding light of knowledge into my heart toned body/brain systems, to help me down those dark rickety stairs, towards my buried treasure of a meaningful life.

    Having been terrorized into a sense of life focused too much within my head, (dissociation) I needed to learn a method approach before sensing the cut-off energies of trauma, unconsciously buried and as such un-experienced and un-expressible, within any knowing sense of mind? I needed to re-learn a sense of being alive, which is as much about an immediate felt sense, as thought sense?

    There is an unconscious “cut-off” from my body sensations, inherent in traumatic affect/emotion, which energizes a flight into mental torment and or is projected as an avoidance of others, or external causation. Even during normal periods there was/is a cut-off from “here and now,” felt sensation disguised from my own and other peoples awareness by simulation, or mimicking of behavior in ritualized social interaction.

    Learning to bring such a highly emotive charge into conscious awareness, is a task that requires time and a gentle loving patience. How I wish I’d stumbled into a place like I-Ward 32 years ago and the wisdom of its wounded healers, with their experiential knowledge.

    People might do well to covet your advice;
    “Because you may find that you may involuntarily be holding your breath.
    You may notice your throat becomes constricted and your voice goes up in octaves.
    You may notice you are opening your eyes very widely and blinking a lot.
    You may feel the need to fold your arms across your chest or cross your legs.” and think twice about the deeper nature of their taken for granted sense of self, and just how much unconscious energies stimulate the mind? Walking the middle path of felt/thought sense has become a revelation to me, of torment anchored within the body as much as the brain?

    As a famous writer observes;
    “My belief is in the blood and flesh as being wiser than the intellect. The body-unconscious is where life bubbles up in us. It is how we know that we are alive, alive to the depths of our souls and in touch somewhere with the vivid reaches of the cosmos” _D. H. Lawrence.

    On behalf of so many voices buried beneath the public miss-perception of a disease process, thank you for being there and bringing a heart felt sanity back into view.

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  8. David thank you for commenting with such rare and hard won wisdom I have come to look forward to so much. I hope everyone clcks on your name to access the treasure trove of your writings. Your contribution to the understanding of the body, emotion, unconscious, soul and energy in all human experience is incredibly rare and valuable as witnessed in your comment above.
    You see so clearly the cost of our culture’s ‘I think therefore I am ‘ reification of cognitive experience that cuts us off from deeper truths of the emotional/ energetic/ soul levels of our human birthright. Thank you agiain!

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  9. Michael I have to agree with Sandy Steingard that laying the blame of mental distress at the feet of families is not helpful, just as the biomedical model isn’t the answer.

    Many of my family members have experienced mental distress due to a range of triggers and factors. Being sensitive and thinkers has a lot to do with it I think. When difficult things occur, outwith our control, then we are likely to retreat into a psychosis or hyperactivity. Other folk might develop physical complaints as a result of stress factors. The issue is the treatment of mental ill health compared to the treatment of physical ill health. The stigmatising and labelling. The drugging and controlling.

    To lay the blame on upbringing or family traits is just not fair. Have you read ‘History Beyond Trauma’ by Francoise Davoine and her husband Jean-Max Gaudilliere? Here is a link to the book which describes their work with ‘mad’ people in asylums and private practice in Paris. I heard them speak in London last year at their film premiere of Mere Folle.

    They talk about the ways in which transference and countertransference are affected by the experience of social catastrophe. I like this description of generational trauma which is less about family blame and more about the problems of living. Every family has its own history which is lived out in their lives. People do their best with the cards they have been dealt. It’s just not fair to castigate families and carers when they are often doing the best that they can.

    Regards, Chrys

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    • I think that the problem of laying the blame on families is better resolved by getting the blame out of the equation rather than getting families out of it. It’s not about who did what to whom; it’s about understanding that we become who we are within the relationships that are important to us, so understanding them is part of understanding who we are. I think it’s when we take those relationships out of the equation that people start to look broken or crazy or mean.
      So the first step is to get rid of blame. The next is to understand the significance of the relationships.

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  10. Thank you for your comment Chrys. For more information on the role of the family in the genesis of madness I think the Open-Dialog quotes from Whtaker’s book I cite above, the work of RD Laing, in his book Sanity Madness and the Family, Gregory Bateson’s work on the double bind and my mentor John Perry’s work on pre-madness family conditions that contribute to madness being necessary for some young people- all point to an alternative to bio -psychiatry’s
    theory of why madness happens,

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  11. “Now in my 66th year after my own madness 45 years ago, I am sad to say that after serving families for over thirty years, that a sufficiently strong love bond of emotional intensity has been conspicuously absent in every family where a young person has become mad.” According to your judgment—
    Unfortunately, The strongest “love bond of emotional intensity” isn’t a magic wand. “Shit happens” and why some people become psychotic is a mystery.
    Your attitude of blaming the family is dangerous. You need to look into yourself and find out why you need to blame the family. How can you truly “serve” families if you believe they are to blame?

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    • Thank you for your comment Rachelle. In all 4 of my blogs I have tried to share, in an attempt to encourage a conversation among us about my question posed to readers- “if madness isn’t what bio-psychiatry says it is, then what is it?”- that based on my experience of madness and work and research, that madness is a multi-dimensional phenomenon that exists as a transpersonal, familial, cultural, interpersonal, mythical, spiritusl, cognitive, somatic, developmental, attachment and love bond influenced subjective experience.

      I believe that all of those elements are at play in the genesis and experience of madness.

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    • Rachelle, obviously you’re passionate about this issue of “blaming” and you have reasons for that. But since the author has admitted madness is a mystery several times and to the best of our knowlege involves multiple life experiences/events and some biological contributions surely you’re not ruling the possibility that family dynamics/interactions/experiences is potentially one source of “madness” Just like we wouldn’t rule out the myriad other potential sources. No one is “blaming” nature or “blaming” nurture as far as I can tell. I don’t know the Dr. so mabye what you say has some truth, it just doesn’t fit with everything he has said on this blog. By the way, what is necessary for someone to experience blame?

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  12. Michael-

    I am deeply moved by your work, consistent with my mad experiences their grave mistreatment by psychiatry. Thank you for being an unwitting support for me during my withdrawal from 15 years of psychiatric medications.

    I am struck by the word ‘blame’ which has come up in response to your essay. I don’t get the sense that you are in fact blaming families. However, to call into question the ways in which a family relates to one another can, understandably, feel like blame.

    I sympathize with this frustration. For many years, my parents felt blamed for my experience. For many years, I blamed them. It was nearly unavoidable, and in the end couldn’t hold as a kind of reconciliation. Blame denied me the opportunity to accept and love my family (and my extreme states of consciousness) as they are, as best I can.

    Removing blame, and accepting our collective humanity has been extrememly healing. It is a challenge! Sometimes our strengths are not in line with what the other needs. When I take responsibility for my relational wellness, I am accepting us in a moment as human, with needs, strengths and limitations of our own. This has often meant I had to find what my heart needs elsewhere. They, too, have found ways around the sometimes vast and painful gaps in connection with me.

    Additionally, if I accept madness as a sometimes torturous, sometimes beautiful, always meaningful experience, I am open to the possibilty that there is nothing for which we need to blame. To me, this is truth– the fruits of which are easily obscured. In some of my most trying moments I see no meaning. I am to give up, to remain passive and separate, and to blame. In these moments I have been helped by saying aloud, “thank you”.


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  13. Thank you for your comment Vanessa. I’m grateful that anything I have shared has been helpful to you, as I feel what you have just written is helpful to me and will be to others.

    The loving receptivity I point to in this blog as being a healing balm we all need in our own self- compassion and that we need from others when we are mad, rests on the belief that we all are deserving of love, are all doing our best, especially when we are in those trying moments when we feel the despair that there is no meaning to our madness and suffering and feel isolated from loved ones who also are doing their best.
    Thank you for showing that even in those dark night of the soul moments that redemptive gratitude and compassion can still be possible.

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  14. A few brief comments Michael. I believe there are multiple causes of psychosis: sleep deprivation, nutritional deficiencies, experimenting with recreational drugs, reactions to prescription drugs, meditation and contemplation, etc. There is also a well-recognized link between traumatic life events and psychosis, including trauma in childhood or adulthood.

    “40 studies that reveal childhood or adulthood sexual or physical abuse in the history of the majority of psychiatric patients (see, also, Read’s book, Models of Madness). A review of 13 studies of schizophrenics found rates varying from 51% at the lowest to 97% at the highest.”

    I can understand the sensitivity of families. After all, I have a child of my own who went through psychosis. I have also gone through psychosis. I would attribute my experience to trauma and multiple losses and theirs to cannabis, loss, and sleep deprivation.

    Meantime, any parent who is a good parent is usually capable of recognizing that not all parents are. Do some family situations/environments push their family members into psychosis? Yes, I believe they do — I’ve spoken with too many people who came from very unhealthy families to not recognize that. However, I’ve also spoken with many people who came from supportive and loving (albeit, not perfect) families.

    There is no need, in my estimation, to become defensive about the link between childhood trauma and psychosis. If you didn’t rape or beat or terrorize your children, let yourself off the hook. On the other hand, if you did… I think you should feel badly about that.

    See also: Presumed Causes of Schizophrenia and/or Psychosis:

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  15. That’s a really excellent short summary essay of your many years of practical experience and the wisdom it’s conferred !
    God–we need teachers like you spreading the word wherever and as often as possible. . . .
    But the hanging Damoclean nuclear bomb of profiteering dominates medical practices… it is the deciding majority vote all too commonly.
    (fingers crossed on MedicareForAll)

    I must confess that the only thing I still find troubling about the movement to exclude mental illness as a working diagnostic terminology for people experiencing energy at a different level of being . . . is the failure of many proponents to establish the primacy of medical testing to rule out organic or synthetic causative factors for those altered states of consciousness.

    Everyone back East here knows all too well …now….that the spirochete Borrelia can induce severe neurological distortions. Everyone understands heavy metal toxicity effect on CNS functioning…..that endocrine disruptors affect ideation and emotion…..that tumors and cysts and hypo/hyper growths and parasites and allergic reactivity can interfere with the standard patterns of functioning.

    What I really want to be hear is the assurance that all foreign-to-the-body factors have first been fully eliminated from consideration before moving on to treating people with engaged listening, deep communion self to self…and continue to be questioned as underlying possible factors, not to rule out that there also could be something testing missed, falsely negative.

    I’m sure you agree with this. Sane triage demands this.
    I’ve only read a few things you’ve posted here…and some of the things others have written—-I am sure that I will discover my above concerns have been addressed many times, in great detail.

    I think your admonitions to suspend disbelief and remain open are two of the best recommendations one can make . . .another way of saying “have no preconceptions, prejudices, or conclusions”— the deeper sense of self cannot be sustained when the mind is overridingly busy.

    I am new to this site….new to this conversation….a mutual friend of Jay’s and yours recommended I come here, and I can’t thank Lisa Eckhart enough for that. It has been a wonderfully comforting breeze of fresh air to hear people talking about Being With others—–as opposed to “dealing with/grappling with/putting up with” those who are in different perceptual & interpretive mode, those who are moving at a different spiritual speed than the world around them.

    Thanks for the insightful essay, Michael.
    Most helpful, indeed.

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    • Thank you for your important comment Robert. I totally agree that detecting any and all organic/toxic causes of madness or any emotional suffering must be a first priority. Sometimes those tests take time and a sanctuary or holistic clinic that doesn’t immediately start someone on psych meds would not impede tests for organic causation.

      Come to think of it, wouldn’t that be the legitimate use of the training of MD psychiatrists? I have worked both in a state and Army hospital and other settings where organic brain syndromes were diagnosed with physical tests and treated. They are real.

      It has been frustrating to me to see then, how non-organic and genetic causation has been claimed by bio-psychiatry where it clearly doesn’t exist. It’s great to hear that you know Lisa and Jay too!
      Please stay tuned for more on this site- your comments are appreciated. Best wishes, Michael

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  16. Excellent post. Just what I was searching to find.. (The complicity of Synchronicity, maybe.).

    I’m curious to know if you believe it is a necessity that this process be accompanied or supported by another person? As for myself, I have been struggling through a dark odyssey without the benefit of another who is receptive and empathic. Is it your opinion that the solo journey rarely bodes well for an individual?

    Thank you again for your wonderfully insightful writing.

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  17. Hi
    Can I respond after all this time?
    I have a question.
    Your advice is good,BUT most of us need to pay our bills,answer mail even when in deep crises.

    What is your solution ?
    Not all us can dropr everything and go to a sanctuary even if we already have time to so,because we live on disabiliy pension.

    Not everybody have friends or family to pay bill and open mail.

    Often the chaos economically and legally after periods of withdrawal create more problems than before the crises. It adds up. On crises after an other…..economically and otherwise.

    In Europe historically persons went on travel “to Italien” when in distress. It may have been good idea.

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  18. I wanted to share a few of stories. When I was in college, I took an internship at a VA and worked in a lab doing clinical trials on the cognitive affects of Risperidone. I was one of two employees running some of the computerized psychological tests. Before testing, I always asked the participants about themselves, their families, etc. A couple of weeks later I was removed from the tests because all of my results were coming in less disordered than that my coworker who didn’t build rapport.

    Later in life, just before graduating from grad school, I was on the subway. There was a woman with some kind of schizophrenia next to me, and across from us, two teenaged girls. The girls were laughing at the woman’s behavior, which was becoming more and more disorganized. I glared at the girls and said, “Shame on you for laughing at someone going through a pain you cannot even imagine.” I then took the woman’s hand and said, “I know it is hard when others laugh at you. It is so hurtful. Is there anything you need?” The change was instant. Her behavior stopped, she looked in my eyes, and cried. She expressed how difficult her life is, and was afraid she could not find the hospital to which she was traveling. I made sure she existed on the correct stop…by then I could not tell, aside from her appearance, that she was mentally ill.

    One last one: Again on the subway, a clearly psychotic man engaged me in conversation. He had written a detailed circuit diagram. Aspects of the circuit represented all types of government and power institutions. There were three primary batteries…The two main ones were pumping too much power, and the third was damaged. I asked if that was his family. He looked at me with glee and said, “Yes! You get it!” He was whistling when he existed the train.

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