The Nature of Madness: Psychosis or Spiritual Awakening?
"The greatest blessing granted to mankind comes by way of madness, which is a divine gift."
- Socrates
INTRODUCTION
In this blog entry, I want to tackle the complex issue of madness. What does it mean to lose your mind? What does it mean to have your consciousness stretched and blasted open so that nothing makes sense anymore? Or, on the flip side, what does it mean when everything becomes overwhelmingly meaningful, especially after a life of apathy, so much so that it eradicates the intellect, challenges your inner belief system, and elicits a probable paradigm shift? Going "crazy," as defined by society, I argue, is an opportunity for growth and transformation.
It is a gift. It is a curse. It is a doorway to spiritual awakening.
I am not implying that this is an easy process. It is messy. It is gnarly. It is terrifying in every meaning of the word. There are a lot of people who do not make it to the other side. I have gone to the edge of my consciousness many times, and it was the scariest and most liberating experience. I can say this today as I reflect and write about the topic. There were times when I thought I would not emerge in one piece due to overwhelming psychological fragmentation. After months of trying different treatment modalities, I slowly started feeling like myself again.
Today my deep need to comprehend my experience drives my passion for psychotherapy and healing.
Mental illness, these days, runs the risk of being romanticized. Trust me. There is nothing romantic about losing your mind. I use the term 'mental illness' with trepidation because I am skeptical of the psychiatric model, even though I believe in it to a certain level. Still, I agree with Thomas Szasz, a psychiatrist who criticizes psychiatry in his well-known book The Myth of Mental Illness, whose famous statement declares, "Mental illness is a metaphor." A metaphor for what, you may ask. A symbol of an ailing soul? A sign of a sick mind? A reflection of distorted familial and societal systems?
Psychosis is an extreme state of mental health decline. The endpoint an individual may reach after severe mental and emotional pain. Metaphorically, it is a form of ego death and the breakdown of rigid defence mechanisms. Of course, one cannot hold and contemplate metaphor when one cannot get out of bed. When one is grappling with day-to-day functioning, psychiatry can help. Medications can save lives. It can also destroy lives. Therein lies the conundrum.
As modern humans, we have an incomplete understanding of mental health mainly because mainstream psychology stripped away words like 'Spirit' or 'soul' from the equation. In fact, the Greek term 'psyche' (psykhe) in 'psychology' means soul or the invisible animating entity that occupies the physical body. Ipso facto psychology is about the human soul - not just the brain. We are in dire need of a holistic approach to mental health that considers the soul.
Some psychologists have been addressing the gap between mental health and spirituality by studying the nature of consciousness, contributing to what is known as the fourth force of psychology. The first force is behavioural (B. F. Skinner), the second is psychoanalytic (Sigmund Freud), the third is humanistic (Carl Rogers), and the fourth force is transpersonal (Carl Jung). Some scholars find using the four forces as a classification obsolete. In contrast, others have added social justice, feminism, and multicultural perspectives to expand on the fourth force.
Currently, in the medical model, the two dominant paradigms are behavioural and psychoanalytic. Though primarily behavioural, with an emphasis on cognitive behavioural therapy (CBT). Behavioural psychology and psychoanalysis view psychosis as psychopathology, a problem that needs pills. While that may be true on some level, there is more to consider about non-ordinary states of consciousness. My area of specialty is transpersonal psychology. Transpersonal psychology invites the human imagination to contemplate something Higher than itself. On the other hand, the word 'transpersonal' means to transcend the personality beyond the ego. I will be speaking from that perspective.
This article is long, so I want to thank you for taking the time to read it. In fact, after writing this piece, I have decided to publish more material on psychosis, transpersonal psychology, and transpersonal psychotherapy, especially looking at more integrative treatment models. I also want to write about psychosis from the angle of mysticism and Divine madness and share more of my subjective experience. If you are interested, please email me at info@integrativepractice.ca, and I will add you to the mailing list.
Before I delve further into the topic at hand, I want to highlight that I am speaking from a Western psychology point of view that is, in one way or another, informed by a Judeo-Christian worldview, even if it tries to be secular, objective, and scientific. A Judeo-Christian worldview falls under the 'Abrahamic' traditions, including Islam. Still, there are other ways to understand the human psyche from the perspective of Indigenous, Pagan, and Eastern traditions (Hindu, Buddhist, etc.) I refer to some non-Western concepts or practices through secondary sources, mainly Brant Cortright's book Psychotherapy and Spirit: Theory and Practice in Transpersonal Psychotherapy. Cortright is a clinical psychologist who combines neuroscience and depth therapy in his work. His book Psychotherapy and Spirit is one of few books that contribute to the emerging field of transpersonal psychotherapy.
Back to the title of this entry, what is psychosis? From a strictly psychiatric perspective, psychosis is to lose touch with consensus reality. A psychotic break happens due to several factors, including trauma and abuse, extreme stress, life transitions, psychoactive substances, genetics, and mental health conditions like schizophrenia or schizoaffective. People may hear or see things that may not be audible or visible to others. Common themes include feelings of paranoia or grandiose delusions with religious ingredients.
Looking closely at psychotic experiences, they make total sense to the individuals going through them. So, if we move further away from the ‘mental illness’ model and do not deem everything as hallucinations, there is an opportunity to engage with the symbolism and metaphor coming through. Through meaning-making, mental health professionals may be able to guide patients back to 'sanity,' a healing process that invites higher self-awareness and a shift in consciousness—a spiritual awakening. Instead of the ego wanting to fix the problem, the problem is outgrown or transcended by the soul filled with the power of the Spirit. Many anecdotal accounts of patients who have recovered from psychosis reveal that they are now more whole than their pre-psychotic state. Some profess to have a deeper insight into themselves and the human condition.
From a Jungian psychology perspective, the psyche, like the physical body, constantly seeks a state of homeostasis. In essence, psychosis is the psyche's way of healing itself. If someone is in extreme distress and depression, possibly suppressing a complex trauma and carrying rigid defence mechanisms, the possibility of psychosis becomes inevitable. It may be the only way to process the pain and resolve the conflictual tension. In such cases, mental health professionals can provide low-dose medications in tandem with depth therapy to produce lasting results. I do not think we can relinquish the psychiatric model entirely. Instead, offering patients a safe, loving space (the hospital is not that) is conducive to healing—a place where patients can see the process to its conclusion.
In Knot of the Soul: Madness, Psychoanalysis, Islam Pandolfo quotes a psychiatrist describing the psychotic experience as
"involuntary addresses, petrified fragments of social commentary, or a collective speech, delivering themselves as impersonal statements in the saying of psychotic patients. They can't possess their own history and yet that history tells itself to us, a history that eludes them and concerns us, that makes us reflect on the status of our own history. How are we to receive that saying?"
The psychiatrist here invites us to see psychosis as a mirror for society to reflect on its ills. Psychosis is not just about the patient. It is about the patient's family and friends, neighbourhood, city, country, and the world. It is like this; we may be moving closer to the Truth inside the walls of a psychiatric ward more than any other place, maybe jails too.
"It is no measure of health to be well adjusted to a profoundly sick society."
- Jiddu Krishnamurti
In the documentary Crazywise, Phil Borges refers to society as psychotic and says that we are all in a permanent state of psychosis. Because in Indigenous cultures, people who have access to altered states of consciousness are considered the shamans and medicine people of the village. In modern society, however, we place such individuals in psychiatric wards and heavily medicate them instead of asking why and exploring the stories behind these non-ordinary states of consciousness deemed as ‘madness’ because they may offer us healing tools that are far more impactful than drugs, and far beyond what the modern intellect can comprehend.
Stanislav Grof and Christina Grof coin the term 'spiritual emergence/emergency' to further explicate the depth of what psychiatry dismisses as psychosis. The Grofs highlight the connection between psychosis and mystical experiences. They argue,
"Although there are many individual exceptions, mainstream psychiatry and psychology in general makes no distinction between mysticism and mental illness. These fields do not officially recognize that the great spiritual traditions that have been involved in the systematic study of human consciousness for millennia have anything to offer. Thus the concepts and practices found in Buddhist, Hindu, Christian, Sufi, and other mystical traditions are ignored and dismissed indiscriminately."
Similarly, David Lukoff, who talks about his spiritual emergency on YouTube, states that psychotic experiences and religious experiences have been associated since the earliest recorded history.
Cortright further elucidates the different features of spiritual emergence vs an emergency. In a spiritual emergence, he argues, the experience is positive, and the individual can go through it to its conclusion and, with the right support system, emerges into a healthier, more whole personality. In a spiritual emergency, the experience is overwhelming, the individual becomes fixated, the self is fragmented, and it becomes hard to integrate what has happened.
He classifies spiritual emergencies into two main categories: consciousness alterations and the opening of subtle realms. Consciousness alterations include the awakening of kundalini energy, near-death experiences, episodes of unitive consciousness, renewal through the return to the centre, and past-life experiences. Opening the subtle realms includes the crisis of psychic opening, shamanic crisis, channelling or communication with spirit guides, possession states, and UFO encounters.
CONSCIOUSNESS ALTERATIONS
The Awakening of Kundalini. Kundalini awakening is one of the most common experiences of spiritual awakening. According to the Hindu tradition, kundalini energy is located at the base of the spine. When that is opened, energy starts flowing through the chakras or energy centres, opening up and purifying consciousness. Some individuals may experience it as terrifying, while others may experience bliss. The body may react by shaking or any involuntary movement. One may emerge from this experience with a new perspective on life and its possibilities.
Near-Death Experiences (NDEs). NDEs are the most documented and studied forms of experiencing pure consciousness. People report seeing ancestors and light after a long dark tunnel. It is as though the soul leaves the body, accesses a higher-frequency consciousness then comes back with a renewed sense of self and an openness to life. Most of the time, individuals find that it is not their time to die and that they have a mission to complete after an NDE. After all, what is there to fear after almost dying?
Episodes of Unitive Consciousness. These are rarer forms of mystical experience. They can be one of the most destabilizing experiences for the ego. I have gone through them a few times. My ego shattered in ways I could not have possibly imagined. I was rendered immobile for months. I could not tell the boundaries between self and other, between self and the collective consciousness! Cortright declares, "The psychiatric establishment has usually diagnosed these as fusion states, loss of boundaries, fragmentation, or depersonalization." I have been through my fair share of hospitalizations and medications. People around me tried to offer support to the best of their ability; however, the experiences impaired my day-to-day functioning, and I needed more help than could be provided.
Unitive consciousness challenged my perception of reality, but due to my Sufi background, and exposure to hagiographies, I realized that what I was going through was a form of spiritual purification. My understanding of God changed immensely. It certainly does not mean that all is now purified. Being a spiritual seeker is a never-ending endeavour. The possibilities for growth are limitless. However, these experiences offered me a window into a higher state of consciousness that rendered my existential qualms minuscule. I now understand the concept of Divine union that the mystics talk about and the interconnected nature of existence, like Ibn Arabi's metaphysics of Unity of Being (Wahdat Al-Wujud) at an embodied level, not just cognitively.
Many saints or sages throughout history, who have become soaked in Divine Love, and Oneness, operate outside of societal conventions, which may confuse the uninitiated. In the Sufi tradition, an individual in that state is called a majzoob. The word majzoob comes from the root word jzb, which means attraction, almost magnetic. Therefore, the majzoob or the attracted, is the one who is annihilated in Allah, and Allah is the Jazib or the one who attracts. No wonder Sufi poetry is replete with the metaphor of the lover seeking their Beloved.
The majzoob exists in contrast to the salik. The salik is the wayfarer who intentionally practices a way of life that may be ascetic so that they may reach that state of Divine union. After arduous inner work, the salik may achieve the same state as the majzoob or even higher. Scholars usually prefer the latter since one can bring the benefits of a spiritual life into the day-to-day function of society.
Language is failing me tremendously. I shall defer to Maulana Jalaluldin:
Renewal Through Return to Center. The British psychiatrist R.D. Laing is one of the biggest proponents of this view. It means that psychosis is the psyche's attempt to heal itself. The idea is that individuals going through psychosis need a supportive environment where they can see the process through to its end. For that to happen, the patients' hallucinations need not be dismissed since they hold meaning for the patient and the collective.
Cortright also mentions John Perry, a Jungian analyst who brings,
"a transpersonal dimension to his work and sees the potentially healing process of psychosis as an attempt by the psyche to renew itself by activating the archetypal, spiritual energies of the Self."
Often, schizophrenic or schizoaffective patients are sensitive individuals who can see what's beyond the veil and have access to these energies, which, in some cases, psychoactive substances may trigger. On that note, what we deem as psychoactive substances in other traditions are considered sacred plant medicines used to commune with the unseen world and bring about healing. (Check out books like Entheogens and the Future of Religion by Robert Forte or The Immortality Key by Brian C. Muraresku - a topic deserving a separate blog entry!).
Cortright writes,
"In this process the common themes are that the person experiences a death, followed by a regression in time back to the beginning (his or her own beginnings - birth or inside the womb - or even the beginning of the world's creation). As this is reenacted, there is a clashing of cosmic forces - a battle between Good and Evil, or God and the Devil.
Eventually, as the process unfolds, the individual finds the middle place where the realization is that all of this happened inside rather than in outer reality as the individual's ordinary consciousness comes back. Arguably, this can be very hard and costly to explore in a traditional psychiatric ward!
Past-Life Experiences. Another form of consciousness alteration is having past-life experiences, in which an individual can access oneself in another time and culture. It is fully experienced by the individual via vivid memories and insights into previous relationships, behaviours, and feelings. The situation becomes a spiritual emergency when these experiences intrude upon one's day-to-day living in this lifetime. People surrounding the individual may view it as bizarre and nonsensical. The formal diagnosis is that these are mere delusions or hallucinations. In reality, many ancient spiritual traditions touch upon this and give it context and meaning.
OPENING TO SUBTLE OR PSYCHIC REALMS
The Crisis of Psychic Opening. Cortright explains,
"The opening of such psychic capacities as subtle vision, subtle hearing, telepathy, precognition, et cetera, can precipitate a spiritual crisis for the person who has no framework with which to deal with these new abilities."
I can speak to these experiences from a personal level. There were many instances where I could hear people's thoughts or what they were about to say before they said it, and, yes, it was scary to go through.
There were other times when I could visually see people around me shape-shift. I cannot forget the encounter with the nurse who appeared to me with a head that looked like an octopus during one of my hospitalizations. Opening my psyche had blurred the boundaries between myself and the other. My sense of self disintegrated, and it felt like I had no ego. It is challenging to capture the experience for the reader even right now as I write this. Words fail me, again. Precisely how William James puts it in The Varieties of Religious Experience, what happened to me "defies expression, that no adequate report of its contents can be given in words."
Looking closely, however, what does seeing a nurse with a head shaped like an octopus (tentacles and all) mean? Mere delusions? According to The Book of Symbols, "the image of the octopus symbolically depicts an encounter with the depth of the psyche, in all its ambivalence, suffering and seeming chaos," and chaotic is how I felt at that moment. I was being confronted with my madness, which is probably rooted in ancient preverbal trauma, and, at times, from an archetypal perspective, I was being confronted with the collective's madness.
Yet, the octopus is not all horror and monsters because, at the center of the chaos, this intelligent being carries a lot of creative energy. It changes colours based on its emotional state and is quite adaptable to its environment. The octopus, according to depth psychology, represents the Great Mother. My experience was probably a nod toward my negative mother complex—an invitation to face my worst fears and heal childhood wounds. The Book of Symbols adds, "the image of octopus brings together extremely negative and positive attributes," a paradox out of which order can be born—the result of holding the tension of opposites.
Shamanic Crisis. Anthropologists refer to this as ‘shamanic illness.’ Individuals find themselves in the Underworld, where they experience death, dismemberment, and rebirth. They also encounter ‘power animals’ and gain spiritual healing gifts. This type of state usually indicates that the individual is ready to begin studying and training as a shaman.
Channelling or Communication with Spirit Guides. Cortright says, "Channeling involves contact with a supraphysical entity by a medium or channeler, either telepathically or while in a trance...the information received is either spoken aloud or written down." However, Cortright warns that just because a ‘discarnate’ entity is a source of information does not mean that it is a being that is "enlightened, evolved, or even particularly knowledgeable."
According to Cortright, some of the highest content that has been channelled include the Quran, the Book of Mormon, and a Course in Miracles. The material in each book has context and meaning of its own. It is interesting to elaborate here that Mohammed (peace be upon him) , the prophet of Islam, used to enter into an altered state before receiving revelation. Some of those states would render him unconscious, or he would sometimes hear an intense ringing in his ear. After such incidents, the words of the Quran would flow out of him. The people at the time were stunned by the intricate language of the Quran. Some of his opposers called him a mad poet and a sorcerer.
Empirical research in transpersonal psychology illustrates that individuals who become channellers in the village and participate in healing shamanic rituals (e.g., the Brazilian Candomblé) carry an extensive history of trauma. They are the wounded healers using their dissociative states to travel between the seen and unseen realms and, therefore, turning their suffering into something positive—an example of why dissociative identity disorder is not always a psychopathology.
Channelling was prominent in the '90s. Many other books have been channelled with various topics ranging from divinations to descriptions of other realms. These books are received from another source, not just inspired works. Conversely, not all channelled content is coherent or valuable.
Possession States. These are some of the scariest spiritual emergencies where the individual feels ‘taken over’ by another entity. The result may be bizarre behaviour and weird vocalization. Such states have been depicted in movies like The Exorcist. Many spiritual traditions speak about the dangers of possession, and different parts of the world have elaborate techniques to cast out demons from people's bodies. Jesus was known to do that, and it was proof of Christ's divinity, according to the Bible.
Discernment is crucial. Many people make a connection between psychosis or schizophrenia and possession. Others may go as far as claiming that mental affliction is a punishment from God. That is a very dangerous statement. Not only does it undermine the pain of individuals reckoning with severe mental health conditions, but it also anthropomorphizes God. We will never comprehend how the Divine Intellect works. Unfortunately, there are many stories of traumatizing exorcisms. Some healers say they can differentiate between a schizophrenic patient and a possessed individual. Lots of question marks surround this area of human knowledge.
Cortright explains that possession states have been recorded since the birth of modern psychology, but it was often diagnosed as multiple personality disorder. However, in transpersonal psychotherapy, the psychological and the spiritual are not separate; these states are viewed with more complexity and nuance.
UFO Encounters. These are one of the most documented forms of consciousness alterations. Individuals describe being taken by alien entities and board space crafts. These experiences cannot be literalized or concretized. In many cases, individuals are so traumatized by these encounters that they forget them, but memories can later be retrieved through hypnotherapy. There are many stories of jinn abductions and possession in the Islamic tradition (see possession states), and there may be some correlation here.
DIFFERENTIAL DIAGNOSIS
For clinicians to differentiate between spiritual emergence, spiritual emergency, and/or psychosis, Cortright writes, there are three criteria. The criteria for a spiritual emergence or emergency are that the client undergoing consciousness alteration can still form a functional therapeutic alliance, that there is a transpersonal emphasis, and that the client can see the process as psychological. The criteria for psychosis are when the client is incoherent, hallucinates, is delusional, and demonstrates grossly disorganized behaviour or catatonia. The requirements for a spiritual experience with psychotic features include an ecstatic mood, a sense of newly gained knowledge, and encounters with mythological themes.
"The psychotic drowns in the same waters in which the mystic swims with delight."
- Joseph Campbell
Whether the experience is psychotic or spiritual, or both, these experiences fall under the realm of the psycho-spiritual journey. We tend to associate peak experiences with the mystical and dismiss everything else. I would argue that even purely psychotic states can also be mystical. Yes, the psychotic may drown for a bit, as per Joseph Campbell's quote, but with proper support and therapy, the psychotic can arrive at the same destination as the mystic. Both the nadir experience and peak experience can produce the same results. The nadir, unlike the peak, is extremely uncomfortable and depicts states of overwhelm and disintegration. Yet, it is these states that offer the individual, through self-compassion, the means to heal and create a more meaningful and peaceful life.
If you are a clinician interested in exploring the differential diagnosis of spiritual emergence, spiritual emergency, and/or psychosis further, I highly recommend reading Cortright's book.
TREATMENT
The most powerful intervention in a spiritual emergency, Cortright suggests, is psychoeducation. Helping clients understand their experience can help them have a cognitive grasp of their condition and lessen the symptomatology. The second is to offer the client a solid, safe container. The idea is to minimize stimulation for the client since they are already very sensitive. Cathartic moments may manifest through vocalization, screaming, or crying.
The third form of treatment is the therapist's presence and energy, which allows the client to navigate the difficult places in their psyche. It teaches the client that it is okay to be open and vulnerable. The fourth mode of treatment is grounding which includes a specific diet, exercise and movement, walking, body work, medication, sleep, and possibly changing meditation. Finally, the most important mode of treatment is experiential therapy. Allowing the client to drop into their moment-to-moment experience can help the client process difficult material.
SPIRITUAL EMERGENCE: A CASE STUDY
In this section, I will demonstrate an example of spiritual emergence. I will write about a client that is an amalgamation of real-life clients I have worked with in the past. These clients gave me permission to publish. I will be changing some details for confidentiality.
A client came to see me because he kept hearing a female voice that would talk to him. He attributed that voice to a woman that was a student at the school he attended at the time. This voice, while sometimes loving, was abusive. My client developed a very intimate and meaningful connection with this voice.
Tortured by the voice, my client thought he should approach this woman and ask her if she also felt the otherworldy connection between them that he was feeling. He bravely did, but the woman gently declined. After this incident, the client contacted me, seeking transpersonal counselling. He was at his wit's end. He thought that he was going crazy. During the intake session, I ensured that he had a psychiatrist in case of an emergency. Together we identified his childhood traumas, abandonment wounds, and the tense relationship with his mother. We also explored what the voice may symbolize for him.
Could it be that his Higher self was trying to communicate with him? Could it be that the mysterious woman's soul (to whom the voice belongs) and his soul were only allowed to meet in the subtle realms but never in this realm? Was this an unfinished love story from a past life?
Eventually, and in one of our most significant sessions, my client shared a visionary experience that contained images from the Hindu tradition. He saw Krishna, the god of compassion, protection, and love, embrace him. Keep in mind my client grew up Christian, but, who knows, he may have Hindu ancestors in his lineage. He could have also been tapping into the collective unconscious. The point is our work together triggered an intense psychic opening.
His understanding of God and the nature of consciousness shifted and deepened after long periods of doubt. By offering my client a suitable container to engage with his psyche and the visions it produced, he was able to create meaning out of his suffering and integrate the experience into his new life. What's more, the voice no longer taunted him. It left. Did it go forever? I do not know.
In our closing session, my client expressed insights filled with wisdom and subtlety. His existential issues quelled down. When he allowed his ego to let go of the story of victimhood, he could finally connect with the depth of his soul and the strength of his Spirit. However, none of that would have happened without first acknowledging the pain and trauma of the past. Feeling it and then surpassing it. Ending therapy was a mutual decision, and my client left content with the work we did together.
IMPLICATIONS OF SPIRITUAL EMERGENCY
More recently, there has been rising interest in the transpersonal approach to mental health in contrast to the old mechanistic paradigm. We are beginning to understand that mental health is a holistic approach, not just about the brain or behavioural patterns. We are also starting to understand the role of intergenerational trauma and psychedelic medicine —all of which challenge scientism.
When we understand that some people in the psychiatric wards may be undergoing a mystical experience and need more than just medications, treatment will look different. The healing process is not only about the individual. It is about raising the collective consciousness as well. Cortright refers to Sri Aurobindo, the well-known yogi and Indian philosopher, who reminds us that it may seem like consciousness is in the body, but the truth is the body is in consciousness. Despite advances in modern psychiatry, people are still sick. Depression, anxiety, and suicide are on the rise. Why are there people choosing to exit this life? We must understand that mental health is a problem at a soul level and acknowledge our humanity along with its complexity.
Thank you for reading! If you have any comments or questions or would like to subscribe to the mailing list and receive announcements about similar content, please email: info@integrativepractice.ca.