One of the most damaging aspects of the mainstream understanding of “mental health” difficulties is that they are conceptualized as a problem separate from the bigger and deeper problem of how we make sense of our lives as a whole, and how we find meaning, or spiritual questions.
I was recently asked to address the intersection of spirituality and mental health in a talk at the Unitarian Church in Vancouver BC. What follows is roughly a transcript of that talk, in which I question that split and outline a very different, and integrated, approach to understanding. (Or if you want, you could also watch or listen to this video of me rehearsing the talk):
To start off, let’s consider a story of a man who isolates himself and then stops eating for over a month. He starts seeing and hearing things, and a demon suggests to him he should jump off a cliff and suggests that instead of dying, he would get special powers. He doesn’t jump though, and he does eventually come back around people. But sometime later he goes into a place of worship and starts yelling at people he thinks shouldn’t be there and he’s trying to throw them out.
Now if you know our mental health system, you know this guy’s experience and behavior are very likely going to get him diagnosed with a psychotic disorder.
But what I just described is also what we have been told was the experience and behavior of Jesus when he went into the desert, fasted, was tempted by Satan, and then later threw the money changers out of the temple. He definitely wasn’t behaving normally for a Jewish person of his time.
That’s just one example — there are lots of ways that mental health crisis and intense spiritual experiences can look very similar. So an important question is, what should we make of that resemblance?
I’ll briefly outline three approaches to answering that question that people sometimes try.
- One is to say that any resemblance is misleading, and that spirituality and mental problems are two very different things, and that we should turn to experts to help us tell them apart.
- A second approach is the one Richard Dawkins took in his book The God Delusion: just dismiss all of spirituality as mental dysfunction!
- A third approach is to see it as more complex or possibly mixed, with useful spiritual experiences often emerging at times of crisis and breakdown. From this perspective, we would expect to often see truly spiritual and helpful experiences coexisting with some degree of error and confusion.
Out of these three, the approach that is dominant in our culture is to believe that experts like psychiatrists can tell if something is really a spiritual experience or just “mental illness.” But if you check out how exactly they do that, you might see some problems with their method!
Essentially what they do is say that if a person’s experience is seriously disruptive, and if it is not normal in the person’s culture, then it is illness. But this implies that anyone who is experiencing something really new and disruptive to the culture, like Jesus or any kind of prophet, is at risk of being identified as ill. So there’s a danger that psychiatry will become a force used to suppress spiritual or cultural innovation.
A second problem is that psychiatry’s categorization of experience is very black and white. Once someone’s odd experience is categorized as being a result of mental illness, it’s then seen as worthless and meaningless, just something to be suppressed with drugs. But what about if someone’s experience is mixed, and they have some degree of spiritual revelation along with their mental and emotional troubles? In that case, what is the effect of refusing to see any possible value in what they are experiencing?
If you ask a lot of mental health professionals, they will say it’s a good thing to refuse to see anything positive in the experience of people who seem for example to be psychotic. They will say that it is “romanticizing psychosis” to see anything positive in psychosis. We are told to just see it as illness, having nothing to do with spirituality, even if the individual sees the experience as being all about spirituality.
I work with people who are experiencing what we call “psychosis” most every day. So I know how awful things can get. But while I do believe it is not a good idea to romanticize psychosis and to refuse to notice what’s bad about it, I would say it’s also not a good idea to refuse to notice what might be positive or spiritually important within people’s experience, and by doing so to “awfulize” psychotic experiences.
The method that I use most in my therapy practice is called CBT for psychosis. One of the most fundamental parts of this method is to aim at balanced thinking. Madness is typically about being unbalanced, so it definitely doesn’t help when professionals themselves have an unbalanced understanding of what is going on — as they do when they “awfulize” or “pathologize” confusing experiences.
One of the worst things that can happen when we awfulize experiences is we set off a vicious circle where people get more scared of their experiences, and then that fear and avoidance of their experience makes their mental disorder worse.
It’s interesting to reflect a bit on the way that trying to reject experiences we think we shouldn’t have, and being grasping of experiences we do want to have, affects mental health in general.
When we don’t want to have an experience, we often inadvertently make ourselves have more of it.
For example if we really don’t want to feel anxious, then if we do start to feel a little anxious anyway we are likely to also feel anxious about the fact that we are starting to feel anxious, and the anxiety will begin to snowball. Or if we really don’t want to feel depressed, then we are likely to get more depressed in response to noticing that we are having some depressed feelings, and that can also snowball.
Grasping at positive feelings can also cause problems. When we just want to feel good, we might start pushing away any feeling or thought related to self-criticism or a need to slow ourselves down. This can make us carried away with ourselves, and get impulsive or even manic, in a way that can also snowball.
Now I want to contrast the unbalanced states I have just described with the perspective of the 19th century Polish rabbi Simcha Bunem. His idea was that it is helpful to have something like two pockets.
- In one’s right-hand pocket can be a statement like “For my sake was this world created.” Or even as I heard it once, “I am one with the universe, I am the Divine, I am everything.” That’s pretty grandiose, but also carries a truth about our essential oneness.
- In one’s left-hand pocket can be a statement like “I am but a speck of dust, existing for but a moment in time.” That’s pretty humbling or even depressing, but also true in a sense.
The rabbi’s idea was that when feeling low or depressed, one might reach in the right-hand pocket and feel uplifted, while when feeling high and mighty and carried away with oneself, one might reach in the left-hand pocket and access some humility.
One thing I really like about that story is that it is about having access to, and finding spiritual value in, extreme states of consciousness. Because both those statements are extreme, but the rabbi is talking about accessing them both in a healthy and balanced and non-grasping way. We might say the rabbi is “bipolar” in a spiritually informed sense.
Tom Wootton is a modern guy who talks about the same kind of possibility, for example in his YouTube videos about what he calls being “bipolar in order.” Tom is a guy who was diagnosed with bipolar disorder, who then tried being a Buddhist monk for a while, and eventually learned to accept his extremes as being of spiritual value, as long as he kept them in perspective as just part of a bigger picture.
It’s actually not that uncommon that people will first experience extreme states of consciousness in an unbalanced way, and get lost and confused, and only later, if they are lucky and have help, learn to integrate those extremes in a balanced way like the rabbi did.
That’s my own experience. When I was a kid, I suffered lots of abuse, both at home and outside of home where I was severely bullied. Then, by the time I reached 17 years old, the abuse and bullying had ended. But inside I still felt crushed.
So, like many in my situation, I started experimenting with ways to make myself feel better. It started with using psychedelic drugs but quickly went beyond that, as I started thinking of myself as a completely new being with new ways of thinking and seeing. I would often see myself as God, able to recreate the world by seeing it differently. (Unlike some people who think they are God, I was open to the idea that other people were also really God. But since they weren’t aware of it like I was, they were more like insects or robots compared to me.)
During this time, I rejected the usual ways of making sense, so I often talked or even wrote letters in ways that made no or very little sense to others. Sometimes it was also very scary to me as I also struggled to make sense to myself.
One thing that helped, though, and that gave me some perspective on what I was going through, was reading the ideas of radical mental health writers like RD Laing, and mystical literature like the writings of William Blake and Alan Watts and books like The Cloud of Unknowing. And, over the course of a few years I also almost always had at least one person I could talk to who saw something meaningful in my experience.
A big fear I had at the time was that all important others would see me as just mentally ill, with my efforts to redefine myself seen as meaningless aspects of a disease rather than as the most precious aspects of my spiritual self, struggling to survive. Fortunately for me, that never happened.
Eventually I found more people who took an interest in my wild perspectives. And as they showed more interest in me I started showing more interest in making sense to them, and eventually I no longer came across as crazy. So I never did get forced into any psychiatric treatment. And now I can look back at that time as being when I made lots of spiritual discoveries that really set the foundation for my successful adult life.
But later several of my younger siblings started experiencing their own wild mental states. Unlike me they did get sent to mental hospitals and told their experiences were due to illness, and where no interest was shown in what might be positive in their experiences. It was seeing that mistreatment of family members and of some friends that got me interested in becoming a therapist and in trying to pioneer better ways of helping people with these kinds of challenges.
I believe that if we really want to get better at helping people, we need to do a couple things:
- One is to get better at wrapping our minds around all the research that is now showing that adverse experiences and trauma typically plays a crucial role in throwing people into the states we call mental illness.
- A second is noticing how trauma throws us into the zone where we face the big spiritual questions. This means recognizing that trauma and mental health and spirituality are all very related.
Most of us know the saying that it’s very difficult for a rich man to enter the kingdom of heaven. Often, we take that to be referring just to monetary riches. But being rich can also be seen as having a life free of trauma and serious losses. Because when things go well for us, we may just rely on those things, and relying on things gets in the way of spirit. Trauma on the other hand cracks open a hole in our lives and in our minds.
Psychiatrist Sandra Bloom is one who is good at describing how trauma disturbs our frame of reference, and brings into question our beliefs about self, world, causality and higher purpose.
There is a saying that there are some things you just can’t unsee. You can’t go back to totally mundane ways of seeing the world after very dark things happen. People have to access something spiritual, or something that could be called spiritual, in order to integrate the existence of darkness without being overwhelmed.
It’s also important to recognize that the effects of trauma are not all just at the time of trauma.
For example, my story is like that of a lot of traumatized young people. At the time when I was abused I just lived with a damaged sense of myself and the world. But when I got old enough to question my identity, I rejected most everything I learned about myself and the world and tried to reinvent it all. That could be described as a dangerous attempt to heal. I think of it as a process more like vomiting, expelling something that is messed up, or like a revolution, rather than as an illness.
What happened to me could be described as my mind having cracked open. Lots of bad things can happen, and bad ideas can get in, when things open up like that. But it’s also possible that the light, or something new and positive, can also get in at that time.
Joseph Campbell liked to say that the mystic swims in the same ocean in which the psychotic flounders. It’s in this floundering that people grasp onto fixed ideas to try to save themselves.
At times like this, people are sometimes grabbing very strongly onto really bad ideas. And then the mental health system comes along and says what they should really grab onto is the idea that they are just mentally ill. What might work better?
To stay with the Joseph Campbell metaphor, is it possible that we could assist people as they learn to swim instead of flounder? That is, can we help people move toward the kind of balance that the rabbi in the earlier example demonstrated?
I definitely think so.
To accomplish that, we who want to be helpers have to also work on being more balanced. We need to be less certain we know what’s going on or that our way is completely correct. That allows us to be curious about how there might be something positive or spiritual in someone else’s confusing experience. And when we model being less certain, we set an example for those whose task is to possibly find some value in their own experiences while also being curious about where they might be making mistakes that require correction.
I would propose that we do best when we are always searching for spiritual truth and sanity, but never too sure that we have it. In Taoism they say the way that can be spoken is not the true way. Just as in many spiritual traditions, any image of God or the Divine is understood to be not the true one.
We need rather a living interest in an ongoing process of discovery of the Way or of the Divine as we engage with each other. The terrible thing about modern psychiatric ideas about mental illness is that we are taught to lose interest in that kind of engagement. The diagnosed person’s views and experience are framed as just meaningless symptoms of an illness.
What I’m suggesting would work better is engagement and dialogue with those who seem crazy, and for each of us to engage and dialogue with the parts of ourselves that seem crazy. We can do this with the understanding that even though those people or those voices within us may be misguided in many ways, they may perhaps have a part of the truth that we don’t have, and if we talk together in an open-minded way we might all learn something.
Another way dialogue with apparently insane people or insane parts of ourselves can be helpful is a little paradoxical. When I was going through my wild experiences, I was very impressed by a William Blake quote: “The fool who persists in his folly will become wise.” Sometimes it’s our encounter with the opposite of the truth that becomes an enlightening experience.
For example I knew a guy who had the habit of just believing and acting on whatever a voice, that he believed to be a spiritual being, told him. Finally the voice stated, “I am just telling you all this so you will learn to be less gullible!” It was a backwards way of encouraging him to have critical thinking.
And often people can learn to find value in what initially seem to be very negative experiences. One guy was disturbed for years by voices who would make him feel vulnerable. And so he focused on fighting them, which really didn’t work. But later he realized he had spent years denying any feelings of vulnerability, and that he had the option instead of using the voices as a reminder that he did have vulnerability and that was part of life. So now the voices were something helpful instead of something he had to fight.
Now a lot of this stuff can get pretty tricky. But you don’t need to know all the tricks to be able to be helpful to people having the kind of experiences I’ve been talking about.
- One thing you can do is just be more open to talking to people about confusing or disturbing experiences, while keeping in mind that there may be some meaning in these experiences, and something of value mixed in with any confusion or errors.
- A second thing you can do is advocate for reshaping our mental health system so that it will support people in working through these experiences rather than just framing it all as pathology to be suppressed.
- A third thing you can do is support people having access to peer groups like hearing voices groups, where alternative views can be explored in an open-minded way.
At the end of my talk, I thanked those in the church for being willing to consider this point of view — there aren’t that many churches that are open to considering the possible intersection between mental health crisis and spiritual breakthroughs!
I might also have thanked Leonard Cohen for his recognition of the way the light comes through the cracks in everything:
Or earlier, Rumi: “The wound is the place where the Light enters you.” None of these ideas are entirely new, but we always need to introduce them again, because they are always being forgotten.
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.