I ended the previous post with a brief explanation of Myers’s concept of a threshold between conscious and unconscious aspects of the mind. How does this relate to psychosis?
A key passage to help us here in the context of psychosis is quoted from Thalbourne by Gordon Claridge (Psychosis and Spirituality: page 82):
As defined by Thalbourne, transliminality refers to individual differences in the extent to which ideas, affects and other mental contents cross the threshold between subliminal and supraliminal: in some people, he argues, the barrier is simply more permeable. Thalbourne paints across a broad canvas in outlining the consequences and correlates of transliminality. Quoting a range of psychometric, clinical and experimental evidence, he argues that a high degree of transliminality is associated with strong belief in and reporting of paranormal phenomena; enhanced creativity; a greater tendency to indulge in magical thinking; more frequent mystical experiences; and a susceptibility to psychotic and psychotic-like symptoms.
Isabelle Clarke’s book, published in 2010, relies exclusively for its explanation of transliminality upon Teasdale and Barnard’s 1993 interacting cognitive subsystems model, being presumably unaware at that point of McGilchrist’s 2009 hemispheric model brilliantly explored in The Master & his Emissary.
Chris Clarke, writing in 2012 (page 58-59 in Exploring the Frontiers of the Mind-Brain Relationship), regards these approaches as two ways of explaining basically the same phenomena:
It seems that, without too much over-simplification, the two models are different views of the same system of knowing, whose components I will refer to as rational (left-hemisphere based, propositional) and relational (right-hemisphere based, implicational).
For now that is all I need to explain before proceeding to draw on the transliminal model, in book Isabel Clarke edited, and its implications for the nature of psychosis.
She writes (page 108):
It’s a short step to recognise that, when the two central meaning making systems are not communicating or in asynchrony, to use Barnard’s term for this (Barnard 2003), and the precision afforded by the propositional is temporarily displaced, a different quality of experiencing becomes accessible. Hence, the everyday, scientific state is one where the propositional and implicational subsystems are working nicely together in balance, whereas the spiritual/psychotic state is one where the two are disjoint, and the system is essentially driven by the implicational subsystem.
The displacing of the left-hemisphere/propositional system and the unbalancing access to the right-hemisphere/implicational which then occurs is what Clarke terms transliminality.
She explains the consequence of this in a later chapter (pages 195-96):
By temporarily stepping out of their experience of a self bounded by individuality, a human being can experience a greatly expanded sense of reality. As well as frequently being an exhilarating experience, this could open the door to personal development, to new insights of wisdom and in some cases, the accessing of psychic powers… However, such a course is in no way guaranteed. This opening also puts the individual in touch with unresolved issues from their personal past. Where these concern problematic formative relationships and/or trauma this can be highly destabilising. Thus, for many, the journey into the transliminal loses its way; unable to conduct ordinary life with accustomed skill and unable to distinguish between threaten and no threat, between danger and safety, the person can flounder around, acting in ways that are causing concern to themselves or those around them. In our society, this tends to result in the involvement of the mental health system.
This concept of threshold, which I think is tenable regardless of whether we accept the particular details of the divided function models, clearly requires that we accept that ‘psychotic’ experiences are meaningful and that we need to distinguish between spiritual and trauma-related transliminal experiences.
This is for two main reasons.
If we can do it successfully, we will not be pathologising the spiritual and life-enhancing aspects of such experiences, and we will also be able to address the root causes of a ‘psychosis’ by recognising what it really means. Denying these experiences meaning, and labelling them as an illness, with all the stigma that entails, risks making them destructive by blocking their progress towards healing. Diagnosis thereby becomes a self-fulfilling prophecy further fuelling our misguided responses.
Writing of ‘visionary spiritual experiences’ Lukoff makes a statement that in my view applies strongly to both spiritual and trauma-based ‘psychotic’ experiences (Psychosis and Spirituality – page 209):
The clinician’s initial assessment can significantly influence whether the experience is integrated and used as a stimulus for personal growth, or repressed as a sign of mental disorder, thereby intensifying an individual’s sense of isolation and blocking his or her efforts to understand and assimilate the experience.
It is not just a clinician’s reaction that counts here. Mike Jackson’s excellent chapter in the same book shows how far the impact of other people’s reactions extends. Quoting Thornton’s research he writes (page 151):
Non-clinical voice hearers in her sample who had disclosed to others about their experiences, all had social contexts where their voices were accepted and where other people had similar experiences. By comparison, the patients who heard voices had not discussed them with others, and did not know others who had similar experiences. Interestingly, within this group there was a more pathologising view of other people who heard voices: “Yeah, I think it’s a mental health problem, yeah, I think they’re nuts . . .
If someone’s journey had led them into hospital, the prospects could be bleak (ibid.):
In the domain of acute and florid psychotic disorder then, there is often no context which allows the acceptance and integration of experience. Instead, psychosis is socially punished through diagnosis and the intrusive apparatus of the mental health system (hospitalisation, compulsory medication, community treatment orders). In terms of the PSP [paradigm shifting process] model, this level of invalidation would be expected to lead to repeated cycles of the process, by keeping emotional arousal high.
Social validation, as incorporated into Mike Jackson’s lucid diagram above, is usually critical to the achievement of a good outcome. (I will be returning to his model in a later sequence of posts.) Our culture, both within the psychiatric system and beyond, is changing but too slowly and too patchily. More needs to be done to speed up the spread of this kind of awareness. The price of our failure to do so is too high. I may be blogging about all this for some time yet!