The idea of psychosis as potentially healing is not new, although it has been considered controversial — and reactively responded to with guffaws and dismissal. Since at least the time of Carl Jung, and perhaps more famously with R.D. Laing, clinicians and individuals with lived experience alike have been discussing the transformative power of psychosis.
What is new is that there appears to be an ever-increasing pool of evidence to support these assertions. So where is all this research? It’s actually coming from the very people who would cringe at the very idea of psychosis being described as adaptive or healing. It is being splashed across headlines and excitedly being promoted by pharmacologists, psychiatrists, and biological researchers as the latest great discovery: psychedelics as medicine.
Now, these researchers would argue vehemently that ‘mental illness’ and ‘schizophrenia’ are decidedly NOT the same things as taking a controlled substance under supervision, for a limited period of time, and for otherwise ‘healthy’ individuals. While the surface particulars are obviously true, the underlying presumption — that naturally-occurring psychosis in response to life-events is ‘sick’, while synthetically-produced psychosis is ‘medicine’ — may not be. In fact, these experiences may not be so different at all.
History of Psychedelics and Marijuana as Spiritual Substances
“When one person suffers from a delusion, it is called insanity. When many people suffer from a delusion it is called a religion.”
– Robert M. Pirsig in Lila (1991)
From the beginning of time, it appears as though humans have utilized imagination and the existence of supernatural beings to explain phenomena they otherwise could not. The need to explain chaos in the world led to many fanciful ideologies that are now looked upon as ‘myths.’ Such systems of belief serve to quell the unbearable anxiety associated with ambiguity, awareness of death, fear, and lack of meaning.
Several reports describe Siberian tribes, witch doctors and shamans using amanita muscaria, a hallucinogenic mushroom, in order to talk to gods. In Hinduism, considered to be one of the earliest religions, one way to be closer to the gods and find empowerment was through the use of a powerful hallucinogen, Soma.
In fact, many of the beliefs and teachings within the Hindu religion are thought to have grown directly from experiences had while under the influence of drink from this plant considered to be of the gods. In addition to Soma, Cannabis is said to have been given to humans by the god Shiva, who rested in its shadow.
Rastafarianism, while explicitly rejecting alcohol due to its inebriating effects, uses marijuana as a holy herb allowing individuals to expand their consciousness and experience freedom from oppression. It is used to increase feelings of connection to others and allow for religious vision. Similarly, Native Americans frequently used this ‘sacred herb’ in rituals of peace and prayer.
The chemically-induced experience of expanded consciousness, euphoria, hallucinations, contact with other-worldly beings, strange belief systems, ritualistic behaviors, and religious exceptionalism are all part of these spiritual traditions. Those who were able to have these experiences naturally, as in the case with Shamanism for instance, have long been considered to be potential leaders with the potential for great insight and healing power.
Modern research appears to support what humans have instinctually known since the beginning of time.
Psychedelics are substances that lead to profound alterations in perception, mood, and thought processes. Yet, it has now become accepted among many mainstream mental health professionals that psychedelic use can, for some people, result in permanent mental health benefits. For instance, research has demonstrated that psychedelics such as LSD and psilocybin can result in decreased anxiety in individuals with a life-threatening disease such as cancer. Further, psychedelics have also been shown to decrease suicidal thinking and attempts.
In fact, journals are highlighting the potential these substances have in treating myriad types of human suffering, including addiction and trauma. Individuals with lived experience have described how this alteration in consciousness resulted in healing long-term battles with the horrors of the world. The altered states may enhance the recall and ability to process traumatic memories while increasing insight by decreasing inhibition and psychological defenses.
Additionally, researchers have suggested that the psychedelic experience results in lasting improvements in a sense of inner peace, increased humor and playfulness, enhanced compassion and regard for others, decreased anger, and enduring personality change. Further, and in line with the history of psychedelic usage throughout time, these substances appear to boost spirituality.
In fact, participants in these studies have described the experience as the “most spiritually significant experience of their lives.” Interestingly, the experience itself is described as “mystical” and opening “a door to the mind.” The greater the dose, the more profound the transformation.
In one study conducted at John Hopkins, the mystical aspect of the experience was determined to be vital to lasting change. Griffiths, the lead author of this study, described “mysticism” as “a sense of interconnectedness with all people and things accompanied by a sense of sacredness and reverence.”
In addition to the mystical aspects of the experience, it is also important to note that these psychedelic trips were not necessarily pleasant! Many participants in these studies reported going through periods of extensive fear and anxiety. Some studies have found confusion and ‘thought disorder’ to be the most common effects. “Delusional paranoid thinking” has also been frequently noted.
Despite the fact that anxiety, fear, and thought distortions were the most extreme at the highest doses, the greatest healing effects and transformative results were gained at those very same dosages.
And, researchers don’t think that these are inherently just passing side-effects; researchers acknowledge that without a supportive environment conducive to healing, this anxiety and fear could potentially become harmful and ongoing. In fact, the environment, relationships, and expectations and beliefs regarding the mystical happenings are critical elements determining positive healing experiences. In other words, it is not one’s genes or the experience itself that determines outcomes but the subjective interpretation based on a supportive environment with helpful others.
The Transformative Power of Psychosis
So what about a naturally-occurring psychedelic trip? Is it really so different?
Much in the same way of the spiritual traditions, individuals, too, seek explanatory belief systems in response to terror and fear. Religious themes and one’s relationship with God is quite common in the belief systems of those labelled ‘schizophrenic’.
However, one could consider narratives of supernatural beings and other-worldly experiences as symbolic of an unbearable reality. The experience of an altered state may be the body’s natural attempt to process and heal from that reality while undergoing drastic change.
Qualitative research and analyses of first-person accounts have demonstrated how, for some, psychosis is described as a conduit for spiritual growth and transformation. The process itself is often one wherein the battle between good versus evil plays out. This mystical and spiritual theme is one that underlies a profound existential dilemma that, if worked through and supported, can result in spiritual enhancement.
Indeed, many have written about how recovery from psychosis can result in a greater connection with others, increased hopefulness, insight, improved psychological functioning and inner peace, and a sense of empowerment. It may also result in greater innovation and joy, as described by John Nash in a biographical essay. More specifically, the mystical aspects of their experience have been particularly important in helping individuals to change their lives for the better.
In fact, the only differences between what is more widely considered to be a ‘mystical experience’ versus ‘schizophrenia’ appears to be visual versus auditory extra-sensory perceptions and the precipitants (drug-taking versus life experience).
Similar to the psychedelic trip, environment, supportive relationships, and interpretation of experience appear key to whether the experience is transformative or destructive. For instance, one study’s findings suggest that mindfulness and encouragement of spiritual exploration may decrease overall distress and promote growth. First-person stories of interpreting ‘psychosis‘ or ‘mania‘ as a spiritual emergency have demonstrated the healing power of this subjective perspective and the promotion of recovery it may be associated with.
Alternatively, first-person accounts have also described the destructive nature of suppression and coercion versus that of a supportive and empowering relationship. Almost half a century ago, a Jungian psychiatrist name John Weir Perry wrote about how the traditional approach to working with these experiences is one that is based on silencing, disapproval, pathologizing, rejection, and oppression. He described this standard reaction as leading to the frustration of practitioners and the increased sense of isolation and madness for the very people they claim to help.
If, like with synthetic psychosis, the subjective interpretation of experience and the supportive nature of relationship are keys to determining outcome, does it not seem likely that this is also the case with natural psychosis?
A New Paradigm for Psychosis
Considering the now irrefutable link between developmental trauma and psychosis, the idea that psychotic phenomena develop as an adaptation and/or as a process of attempting to deal with unbearable experiences must be considered more widely.
While researchers continue to develop new models of experimentally understanding psychosis, often involving animals and manipulation of neurons and/or neurochemicals, it may behoove us all to consider that we already have experimental evidence at hand. Clinicians may benefit from adapting methods used in these studies to real-world interventions with individuals experiencing naturally-occurring psychosis.
While, again, many may repeat the oft-touted rhetoric that chemically-induced and naturally-occurring psychoses are completely different, what if the hypothesis that they are not is considered?
Imagine what might happen to the ‘healthy’ participants undergoing these chemically-induced altered states if their doctors were to tell them “you are insane,” “your experience is not real,” “your experience is not spiritual, it is a disease,” or if they were to suddenly be physically removed from their supportive and peaceful environment, stuck with a needle in their bum, and locked in a strange room. What if halfway through their trip they were given drugs that numb the mind and make it difficult to think or move clearly? What might their outcomes look like then?
On the flip-side, what if we took individuals who are experiencing emotional crises called ‘psychosis’ and offered them safe spaces of respite? Loren Mosher once asked this same question and had phenomenal outcomes as a result. What if, as in the psychedelic experiments, the therapist was more of a guide and support, allowing the person to go through their experience and helping them to make meaning of it in the process? What if interventions were based on respect for the psychotic experience and all it represents, and focused on ensuring that the person feels safe, supported, heard, and understood? What if people who had gone through the experience themselves were to teach others how to use this gift instead of being ridiculed as not educated enough?
Mad in America hosts blogs by a diverse group of writers. These posts are designed to serve as a public forum for a discussion—broadly speaking—of psychiatry and its treatments. The opinions expressed are the writers’ own.