Posts Tagged ‘Christina and Stanislav Grof’

The world’s population currently consumes the equivalent of 1.6 planets a year, according to analysis by the Global Footprint Network. Photograph: NASA (For source see link)

We cannot segregate the human heart from the environment outside us and say that once one of these is reformed everything will be improved. Man is organic with the world. His inner life moulds the environment and is itself also deeply affected by it. The one acts upon the other and every abiding change in the life of man is the result of these mutual reactions.

(Shoghi Effendi, Letter to an individual Bahá’í, through his secretary, 17 February 1933.)

The previous post ended with the following point.

Most of us are trapped in our simulations, created by early experience and powerful influences in the present. Reflecting as an individual and consulting as a community are harder to do than we would like to think and need courage and perseverance in equal measure, courage to risk this shift in processing in the first place and perseverance if we are to learn how to master the skills in each case.

For the impact of destructive processes within the individual there is a wealth of evidence, both social and clinical, which I look at straightaway. I will look at the impact on groups and communities later using the work of Zimbardo as a powerful example.

Processes such as the ones I am about to outline are simply examples of the kind of invisible obstacles we might have to deal with when we are trying to shift our perspectives to integrate experiences and evidence against the grain of our programming. Breaking out of our individual or collective trance is not easy. When the evidence is complex, as with climate change, or collides head on with prevailing dogma, as with the reality of the soul, it’s particularly difficult.

Culture and the Individual

First, let’s take a look at some of the negative influences that operate under the surface within the individual. These do overlap with aspects of the wider culture but are worth considering here given their impact upon every single one of us as an individual.

As adults we may often find ourselves behaving in completely counterproductive or even destructive ways in our everyday lives and haven’t a clue why we do so, or even sometimes that we are doing so.

There are all sorts of ways that our culture subliminally shapes our reactions in ways that would shock our conscious mind. A recent study, for example, looked at the reactions of Americans from all parts of the racial spectrum. One of the experiments involved determining how quickly subjects would shoot at a target person in a risk situation. Pictures of different people were flashed up on the screen, some from a white European heritage, some from a black African heritage. It was no surprise that white subjects would take less time to shoot a black person than a white one. What was shocking was that the same was true for black subjects, so deeply had the toxin of racism infected them as well. What none of the subjects would have been aware of was that they were behaving in this way.

Even prominent people within a culture, those with access to the most information and with the most power to change things, succumb to the insidious influences of their society. Many of the founding figures of the United States were slave owners. Their personal investment in slavery conflicted with their avowed principles such as the equality of all men. John Fitzgerald Medina in his excellent book Faith, Physics & Psychology quotes the explanation given by historian Richard Thomas (iBook page 280):

Since America was not about to abandon slave labor or its policy of dispossessing the native peoples of their land, the only real and practical choice was to minimise the nature of its sins: blacks and native peoples (Indians) were not to be considered on the same level of humanity as whites; blacks were heathen and amoral, next to the apes in the scale of evolution. . . .

The technical term for this is resolving cognitive dissonance, and is a process that I was tempted to include in my earlier discussion of disowning, but wasn’t sure it applied directly to climate change. As Saul McLeod explains:

Leon Festinger (1957) proposed cognitive dissonance theory, which states that a powerful motive to maintain cognitive consistency can give rise to irrational and sometimes maladaptive behavior.

According to Festinger, we hold many cognitions about the world and ourselves; when they clash, a discrepancy is evoked, resulting in a state of tension known as cognitive dissonance. As the experience of dissonance is unpleasant, we are motivated to reduce or eliminate it, and achieve consonance (i.e. agreement).

This of course only works if we can successfully blind ourselves to the fact that we are doing it.

It’s obvious now to most people that the Americans and the British, in terms of race, hoodwinked themselves with this self-deceptive but profitable ploy. What we may not all fully appreciate is how far the toxic ideology of racism that thus developed spread its poison, for how long, and with how much resulting damage.

When John Fitzgerald Medina claimed in his book that Hitler was influenced by American eugenicists to develop aspects of his genocidal agenda, I had to check this idea out further.

I read Timothy Snyder’s Black Earth: the Holocaust as History and Warning in tandem with Ricard’s Altruism, quoted earlier in this sequence. He confirms the extent to which the Nazi vision of extermination to gain land was inspired by America (pages 15-16):

Racism was the idea that turned populated lands into potential colonies, and the source mythologies for racists arose from the recent colonisation of North America and Africa. . . .

In the late nineteenth century, Germans tended to see the fate of Native Americans as a natural precedent for the fate of native Africans under their control. . . . . For the German general who pursued these policies, the historical justice was self-evident. ‘The natives must give way,’ he said. ‘Look at America.’

. . . . When Hitler wrote in My Struggle that Germany’s only opportunity for colonisation was Europe, he discarded as impractical the possibility of a return to Africa. The search for racial inferiors to dominate required no long voyages by sea, since they were present in Eastern Europe as well.

Hitler saw the Soviet Union as a Jewish project and felt (page 20):

[a] second America could be created in Europe, after Germans learned to see other Europeans as they saw indigenous Americans or Africans, and learned to regard Europe’s largest state as a fragile Jewish colony.

It is deeply ironic therefore that the nation who saw themselves as liberators of Europe at the end of the Second World War should have been part of Hitler’s inspiration in the first place. So do destructive subliminal processes wreak havoc on a massive scale in our world, especially when potentiated by self-interest. Climate change denial should come as no surprise therefore, given the complexity of the issue and the power of the vested interests who would lose out if something really effective were ever done to address the problem.

It’s a moot point in both cases whether those pulling the levers of persuasion, the propagandists, are as unaware of their reality distortion as many of those who come to believe them.

There are many more examples of this kind to illustrate the way that culture warps and biases our perceptions to devastating effect and I won’t attempt to list them here. We’ll come back to the cultural scale later.

Trauma and the Individual

What is also true is that our personal history has a powerful subliminal effect on us as individuals and can wreck our lives and those of the people closest to us. Trauma is the easiest example to use to illustrate this.

We may be completely unaware of the still active impact of early trauma, to whose current significance we are almost completely blind even if we remember anything at all about it.

Many different models of therapy have developed way to explain how this works.

That there is such an effect and that it is relatively widespread can be demonstrated in many ways. In a study carried out in 2010 and quoted by Koenen et al in The Impact of Early Life Trauma on Health & Disease: the Hidden Epidemic (page 13-15), out of a sample of 5692 English speaking Americans 2190 (38.48%) reported some kind of traumatic experience prior to the age of 13.

A recent sequence of posts on this blog looked at the work of a Jungian therapist, Joy Schaverian, with people who had been traumatised by their experiences at Boarding School. She graphically explores through case histories the damage that has been done as well as the repressive mechanisms, with their consequences, that had been mobilised to cope.

To give a brief example, Schaverian explains, when she discusses one of her patient’s difficulties dealing with the time a teacher hit him in the face with a cricket bat, how hard it was for him to fully accept what he was saying (page 57):

Theo first told of this incident early in analysis. Then, a few months later, he retold it, this time with more depth of feeling. It was as though he was at first incredulous but then, as I took it seriously, he began to believe himself and to take seriously how abusive this had been. As Theo recounted it for the second time the feelings associated with the event became live in the session. Theo went white; he felt sick; he had trouble breathing and physically regressed.… The emotional impact of this was fully present in the room. Theo was overwhelmed and speechless.

The benefits of revisiting traumatic events in this way , even when they have possibly been forgotten between sessions are priceless (page 118):

. . . if [traumatic events] can be told they are gradually detoxified, thus eventually accepted as part of the person’s personal history. It is then an accessible narrative and no longer unconsciously dominates their life. When there is no such witness the trauma may become embodied, leading to conversion symptoms such as digestive problems, migraines, chronic pain, poor energy and a large number of other physiological indicators. This may be because the event that caused it is remembered in an embodied sense, but not recalled cognitively and so it cannot be consigned to the past.

We’ll be coming back to the idea of embodied memories in a moment.

Other concepts from different traditions are scripts in Transactional Analysis, which I’ve explored elsewhere, archetypes from Jungian therapy, constructs from Personal Construct Therapy, schema etc. the formation and experience of all of which are shaped by early experience as well as culture.

The examples I want to focus on right now I’ve chosen both because they provide dramatic and detailed illustrations of the invisible impact of childhood trauma on adults and are part of my recent reading around trauma and psychosis.

A recent post includes a detailed example, from their 1991 book The Stormy Search for the Self, of what Christina and Stansislav Grof term a spiritual emergency. Those interested in knowing more detail should click the link above. Basically it explores how a traumatised person was helped through her crisis without standard psychiatric treatment and later in the book how what they call Holotropic Breathwork helps people gain access to embodied memories.

They feel that this approach unlocks blocks between our awareness and the contents of the unconscious (page 259):

. . . .  It seems that the nonordinary state of consciousness induced by holotropic breathing is associated with biochemical changes in the brain that make it possible for the contents of the unconscious to surface, to be consciously experienced, and – if necessary – to be physically expressed. In our bodies and in our psyches we carry imprints of various traumatic events that we have not fully digested and assimilated psychologically. Holographic breathing makes them available, so that we can fully experience them and release the emotions that are associated with them.

I want to focus on a couple of examples from their earlier work – Realms of the Human Unconscious: observations from LSD research. The use of LSD in this way has come to seem controversial, so much so it was made illegal 1981, six years after this book was published. Some researchers are recently beginning to think more positively about its potential benefits, but we are a long way from repealing the laws that ban it.

Why the Grofs’ research is worth drawing on in this context is for what it seems to reveal about the accuracy with which inaccessible traumatic memories are stored in the brain. LSD helps a person regain lucid and detailed memories, which can then be integrated.

More than that, the Grofs developed a strong sense of the sequence in which such memories can be retrieved and the way they group into a mutually reinforcing layered networks which they call (page 46) ‘systems of condensed experience,’ COEX systems for short.

Both the detail and the interconnectedness of the memories go a long way to explain their power to shape our experience and behaviour in the present in spite of our routine oblivion to their existence. That such interconnected detail coexists with such intransigent forgetfulness explains the power the past experiences have to impact upon us outside our awareness. The examples I’m giving go a long way towards proving how much changing this impact depends upon bringing the whole network of experiences into consciousness.

The work they report on in this book was done in Prague in the decade leading up to 1965.

The layering effect can be illustrated by Richard’s history (page 57-60). The first layer related to his expulsion from university because of his conflict with the communist orthodoxy of the time. A ‘deeper layer . . . . related to Richard’s experiences with his brutal, despotic, and autocratic father.’ Deeper still were earlier memories from childhood such as a strong electric shock at about age seven. A comically horrific encounter with a cow at about one year old was from the next level down. Finally (page 59), he encountered his birth trauma, which he concluded was ‘the fundamental prototype of all the situations in which he felt absolutely helpless and at the mercy of a destructive force.’

The Grofs later explain that, as a general rule, each more superficial level has to be explored before the deeper levels can be accessed (page 71):

The . . . . most important reason for thinking in terms of memory constellations rather than individual memories is based on the content analysis of consecutive sessions of a psycholytic series. Before the subject can approach and relive a traumatic memory from early childhood (core experience), he usually has to face and work through many situations in later life that have a similar theme and involve the same basic elements.

The final result of this LSD facilitated mental archaeology was positive in Richard’s case (page 60):

After the experiences of rebirth, positive ecstatic feelings of long duration occur in Richard’s sessions. They brought about a far-reaching improvement of the clinical condition. His depressions, anxieties, and psychosomatic symptoms completely disappeared and he felt full of activity and optimism.

The Grofs are keen to substantiate that most of these memories are rooted in reality. They quote case examples. For example, the mother of another patient, Dana, (pages 65-66) ‘was absolutely astonished by the accuracy of the account concerning the traumatic event as well as its physical setting. . . . . The description of the room was photographically accurate, even in the most minute detail, and its authenticity was unquestionable because of the very unusual character of some of the objects involved. . . In this case, there did not seem to exist a possibility that this information could have been transmitted by some other means. Before the patient was two years old, the family left this house; shortly afterward, it was condemned and torn down. . . . Dana’s mother gave away many of the things that formed the setting of the relived incident. There were no photographs of the room or of any of the described pieces, and the mother did not remember ever having mentioned any of the objects in front of the patient.’

So that’s what can happen to an individual.

Group Processes

It may seem a step too far to use examples of this kind, drawn from clinical work with individuals, and imply that group processes are similarly potentially pathological and operate all too often outside our awareness and conscious control.

One dramatic body of evidence will have to suffice for now to illustrate how this comparison might not be so far fetched. Philip Zimbardo provides the evidence in his brilliant analysis, The Lucifer Effect. His perspective is rooted in the study he initiated at Stanford University.

Student volunteers were divided randomly into two groups: prisoners and guards. It did not take long for the guards to descend into abusive behaviours that meant the study had to be halted before serious harm was done. From this, and after examining the behavior of American troops at Abu Ghraib, he came to disturbing conclusions about human behaviour in situations which steer us towards evil. He feels strongly that good people can do bad things not necessarily because they are bad apples who should bear full responsibility for their crimes, but because they are placed in a bad barrel that rots them. More than that, it is too simplistic to then blame the barrel for the whole problem. The barrel maker has to take his share of the responsibility. Corrupt systems can corrupt good people. Only the minority in his experience are able to resist.

Earlier work lends considerable weight to this latter point. For example, when I was studying psychology for the first time in the 1970s I came across the work of Thomas Pettigrew, which is still referred to even now.

To put one set of his findings very simply, whether you were a miner in segregated West Virginia or apartheid South Africa, the culture around you differed depending on whether you were above ground or below it. Below ground discrimination was potentially dangerous so the culture there frowned on it: above ground the culture was discriminatory. What was particularly interesting to me was that 20% of people discriminated all the time regardless of the culture and 20% refused to do so at all: 60% of people shifted from desegregation below ground to segregation above it (the percentages are approximate: the pattern is accurate).

What may seem baffling is how apparently decent people go along with toxic patterns of behavior. The forces that coerce conformity are astonishingly compelling. Haidt talks of the hive effect. In The Righteous Mind (page 247) he asks ‘Why do the students sing, chant, dance, sway, chop, and stomp so enthusiastically during the game?’ For him, ‘It flips the hive switch and makes people feel, for a few hours, that they are “simply a part of a whole.”’ Other experiments such as those by Solomon Asch, have shown how, when the majority in a group identify the wrong line as the matching one, the lone subject of the experiment tends to go long with the majority view at least some of the time: ‘To Asch’s surprise, 37 of the 50 subjects conformed themselves to the ‘obviously erroneous’ answers given by the other group members at least once, and 14 of them conformed on more than 6 of the ‘staged’ trials. When faced with a unanimous wrong answer by the other group members, the mean [ie average not stingy] subject conformed on 4 of the ‘staged’ trials.’

This video below by Melanie Joy conveys an attempt to unpack some of the detail about how this might work at a cultural level in a context meat eaters may find bizarre. As a vegetarian the validity of her explanation of how collusion is induced is compelling. Meat eaters may have to temporarily suspend their disbelief and step back from their investment in carnism in order to see how her explanation could easily be mapped onto such social toxins as racism and sexism.

Hopefully this helicopter survey of a vast field has done enough to convey clearly my sense that as individuals and communities we are locked into unconsciously determined and potentially destructive patterns of thought, feeling and behaviour, until, in my view, we are either painfully jolted out of our trance by a spiritual emergency or we painstakingly discover for ourselves the keys of reflection for individuals and consultation for groups. Only then do we have an opportunity to see what is working on our minds and change it.

In a complex world it is easy to hide from the wider but more distant impact of our individual and collective actions. Because the damage is potentially so great, so much greater than it ever was is the need now for our awareness to widen and embrace not just the daunting complexity within us but also that which stands between and outside us.

I have been considering the implications of this in the context of climate change and the afterlife but it also applies to many other areas of human behavior such as deregulation which removes safeguards in the interests of profit, extractivism that aggressively exploits the earth’s resources without sufficient care for the consequences, and a global economic system that harms not just the environment but the workforce to whose country cheaper production has been exported.

Where we might go next is dealt with slightly more briefly in the final two posts.

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The previous post looked at the Grof’s account of Karen’s experience of a spiritual emergency and how it was dealt with. Now we need to look at some of the implications as well as other aspects of their approach.

The Context

I want to open this section with that part of Bahá’u’lláh’s Seven Valleys that has formed the focus of my morning meditations for the last few weeks. I have persisted so long in the hope that I will eventually understand it more fully. I believe that Shoghi Effendi, the great-grandson of Bahá’u’lláh and the one whom ‘Abdu’l-Bahá appointed as His successor, was of the opinion that one needed to read at least ten books by writers who were not Bahá’ís in order to have any hope of understanding a Bahá’í text fully. I may have conveniently chosen to believe that factoid in order to justify my own bookaholic tendencies.

Setting that aside for now, what matters at the moment are the resonances between the words of Bahá’u’lláh and the topic I am exploring more deeply here.

I have touched on how materialistic assumptions about reality will dismiss as rubbish or even pathologise phenomena their paradigm excludes from possibility.

Bahá’u’lláh directly addresses this point (page 33):

God, the Exalted, hath placed these signs in men, to the end that philosophers may not deny the mysteries of the life beyond nor belittle that which hath been promised them. For some hold to reason and deny whatever the reason comprehendeth not, and yet weak minds can never grasp the matters which we have related, but only the Supreme, Divine Intelligence can comprehend them:

How can feeble reason encompass the Qur’án,
Or the spider snare a phoenix in his web?

Our deification of reason has stripped the world we believe in of God and made it difficult, even impossible, in some cases for some people, to entertain the possibility that God in some form does exist, though that would not be as some white-bearded chariot-riding figure in the sky.

This is the Grofs take on this issue (page 247):

A system of thinking that deliberately discards everything that cannot be weighed and measured does not leave any opening for the recognition of creative cosmic intelligence, spiritual realities, or such entities as transpersonal experiences or the collective unconscious. . . . . . While they are clearly incompatible with traditional Newtonian-Cartesian thinking, they are actually in basic resonance with the revolutionary developments in various disciplines of modern science that are often referred to as the new paradigm.

This world-view seriously demeans us (page 248):

Human beings are described as material objects with Newtonian properties, more specifically as highly developed animals and thinking biological machines. . .

We have taken this model or simulation as the truth (ibid.):

In addition, the above description of the nature of reality and of human beings has in the past been generally seen not for what it is – a useful model organising the observations and knowledge available at a certain time in the history of science – but as a definitive and accurate description of reality itself. From a logical point of view, this would be considered a serious confusion of the ‘map’ with the ‘territory.’

This reductionist dogmatism has serious implications for psychosis (page 249):

Since the concept of objective reality and accurate reality testing are the key factors in determining whether the individual is mentally healthy, the scientific understanding of the nature of reality is absolutely critical in this regard. Therefore, any fundamental change in the scientific world-view has to have far-reaching consequences for the definition of psychosis.

A Holographic Approach

They contend that the paradigm is shifting (ibid.:)

. . . The physical universe has come to be viewed as a unified web of paradoxical, statistically determined events in which consciousness and creative intelligence play a critical role. . . This approach has become known as holographic because some of its remarkable features can be demonstrated with use of optical holograms as conceptual tools.

Their explanation of the holographic model is clear and straightforward (page 250):

The information in holographic systems is distributed in such a way that all of it is contained and available in each of its parts. . . .

It’s implications are profound:

If the individual and the brain are not isolated entities but integral parts of a universe with holographic properties – if they are in some way microcosms of a much larger system – then it is conceivable that they can have direct and immediate access to information outside themselves.

This resonates with what Bahá’u’lláh writes in the same section of the Seven Valleys:

Likewise, reflect upon the perfection of man’s creation, and that all these planes and states are folded up and hidden away within him.

Dost thou reckon thyself only a puny form
When within thee the universe is folded?

Then we must labor to destroy the animal condition, till the meaning of humanity shall come to light.

It is crucial for us all as well as for those labelled psychotic that we cease to reduce the mind to a machine. The Grofs spell out the implications for psychosis when we refuse to take the more transcendent perspective (page 252):

The discoveries of the last few decades strongly suggest that the psyche is not limited to postnatal biography and to the Freudian individual unconscious and confirm the perennial truth, found in many mystical traditions, that human beings might be commensurate with all there is. Transpersonal experiences and their extraordinary potential certainly attest to this fact.

. . . In traditional psychiatry, all holotropic experiences have been interpreted as pathological phenomena, in spite of the fact that the alleged disease process has never been identified; this reflects the fact that the old paradigm did not have an adequate explanation for these experiences and was not able to account for them in any other way.

Assuming that we do accept that possibility of a spiritual reality, what follows? They spell it out:

. . . . two important and frequently asked questions are how one can diagnose spiritual emergency and how it is possible to differentiate transformational crises from spiritual emergence and from mental illness.

This is only possible up to a point (page 253):

The psychological symptoms of… organic psychoses are clearly distinguishable from functional psychoses by means of psychiatric examination and psychological tests.

. . . . When the appropriate examinations and tests have excluded the possibility that the problem we are dealing with is organic in nature, the next task is to find out whether the client fits into the category of spiritual emergency – in other words, differentiate this state from functional psychoses. There is no way of establishing absolutely clear criteria for differentiation between spiritual emergency and psychosis or mental disease, since such terms themselves lack objective scientific validity. One should not confuse categories of this kind with such precisely defined disease entities as diabetes mellitus or pernicious anaemia. Functional psychoses are not diseases in a strictly medical sense and cannot be identified with the degree of accuracy that is required in medicine when establishing a differential diagnosis.

What they say next blends nicely with the points made in my recent posts about where the dubious basis of diagnosis takes us (page 256):

Since traditional psychiatry makes no distinction between psychotic reactions and mystical states, not the only crises of spiritual opening but also uncomplicated transpersonal experiences often receive a pathological label.

This has paved the way to dealing with their approach to intervention and their criteria for distinguishing spiritual emergencies that can be helped from other states.

Holotropic Breathwork

Before we look briefly at their attempt to create criteria by which we might distinguish spiritual from purely functional phenomena I want to look at their recommended method for helping people work through inner crises. This method applies what the non-organic origin. This technique they call Holotropic Breathwork.

First they define what they mean by holotropic (page 258):

We use the term holotropic in two different ways – the therapeutic technique we have developed and for the mode of consciousness it induces. The use of the word holotropic in relation to therapy suggests that the goal is to overcome inner fragmentation as well as the sense of separation between the individual and the environment. The relationship between wholeness and healing is reflected in the English language, since both words have the same root.

They then look at its components and their effects (page 259):

The reaction to [a] combination of accelerated reading, music, and introspective focus of attention varies from person to person. After a period of about fifteen minutes to half an hour, most of the participants show strong active response. Some experience a buildup of intense emotions, such as sadness, joy, anger, fear, or sexual arousal.

They feel that this approach unlocks blocks between our awareness and the contents of the unconscious:

. . . .  It seems that the nonordinary state of consciousness induced by holotropic breathing is associated with biochemical changes in the brain that make it possible for the contents of the unconscious to surface, to be consciously experienced, and – if necessary – to be physically expressed. In our bodies and in our psyches we carry imprints of various traumatic events that we have not fully digested and assimilated psychologically. Holographic breathing makes them available, so that we can fully experience them and release the emotions that are associated with them.

As Fontana makes clear in his book Is there an Afterlife?, experience is the most compelling way to confirm the validity of a paradigm of reality, so my experience of continuous conscious breathing in the 70s and 80s gives me a strong sense that what the Grofs are saying about Holotropic Breathwork had validity. My experience in the mid-70s confirms the dramatic power of some of the possible effects: my experience in the mid-80s confirms their sense that the body stores memories to which breathwork can give access. I will not repeat these accounts in full as I have explored them elsewhere. I’ve consigned brief accounts to the footnotes.[1]

They go on to explain the possible advantages of Holotropic Breathwork over alternative therapies (pages 261-263):

The technique of Holotropic Breathwork is extremely simple in comparison with traditional forms of verbal psychotherapy, which emphasise the therapist’s understanding of the process, correct and properly timed interpretations, and work with transference . . . . It has a much less technical emphasis than many of the new experiential methods, such as Gestalt therapy, Rolfing, and bioenergetics. . . . . .

In the holotropic model, the client is seen as the real source of healing and is encouraged to realise that and to develop a sense of mastery and independence.

. . . . . In a certain sense, he or she is ultimately the only real expert because of his or her immediate access to the experiential process that provides all the clues.

Distinguishing Criteria

Below is the table they devised to differentiate between the two categories of spiritual emergence and what they term psychiatric disorder. They explain the purpose of the criteria (page 253):

The task of deciding whether we are dealing with a spiritual emergency in a particular case means in practical terms that we must assess whether the client could benefit from the strategies described in this book or should be treated in traditional ways. This is their table of criteria.

They are certainly not claiming that they have an unerring way of distinguishing between these states, nor that some of those who are placed in the ‘psychiatric’ have no aspects of spiritual emergency in the phenomena they are experiencing. Readers will also know by now that I am a strong advocate of more enlightened ways of managing any such problems than those which are implied in the term ‘traditional.’


This last post turned out to  be much longer than I planned. I hope it conveys my sense of the value of their approach and of the validity of their concept of a spiritual emergency.

My feeling that their approach is a good one derives largely from my own dramatic experience of what was an almost identical method involving breathwork. In a previous sequence I have dealt with the way the breakthrough I experienced in the 70s had lasting beneficial effects on my my life, first of all in terms of opening my mind so I was able to take advantage of other therapeutic interventions. Perhaps most importantly though in the first instance was the way that the first breakthrough loosened the grip of my previous pattern of anaesthetising myself against earlier grief and pain mostly by cigarettes, gambling and heavy social drinking, so that I could realise that I needed to undertake more mindwork.

I also find it reinforcing of my trust in the basic validity of their perspective that it has led them to draw much the same conclusions as I have about the dangers of materialism and its negative impact upon the way we deal with mental health problems

It doesn’t end my quest though for more evidence to support my sense that psychosis can and often does have a spiritual dimension. Hopefully you will be hearing more on this.


[1] Rebirthing provided the experience that gave me my last major break-through in self-understanding by means of some form of psychotherapy. I heard first about it from a talk I attended on the subject at an alternative therapies fair in Malvern in early 1985. I then bought a book on the subject. The key was breathing:

Jim Leonard saw what the key elements were and refined them into the five elements theory.

The five elements are (1) breathing mechanics, (2) awareness in detail, (3) intentional relaxation, (4) embracing whatever arises, and (5) trusting intuition.  These elements have been defined a little differently in several versions, but are similar in meaning.  Jim Leonard found that if a person persists in the breathing mechanics, then he or she eventually integrates the suppressed emotion.

It was as though what is known as body scanning were linked to a continuous conscious breathing form of meditation. All the subsequent steps (2-5) took place in the context of the breathing.

After three hours I was trembling all over. I was resisting letting go and ‘embracing’ the experience. When I eventually did the quaking literally dissolved in an instant into a dazzling warmth that pervaded my whole body. I knew that I was in the hospital as a child of four, my parents nowhere to be seen, being held down by several adults and chloroformed for the second time in my short life, unable to prevent it – terrified and furious at the same time. I had always known that something like it happened. What was new was that I had vividly re-experienced the critical moment itself, the few seconds before I went unconscious. I remembered also what I had never got close to before, my feelings at the time, and even more than that I knew exactly what I had thought at the time as well.

I knew instantly that I had lost my faith in Christ, and therefore God – where was He right then? Nowhere. And they’d told me He would always look after me. I lost my faith in my family, especially my parents. Where were they? Nowhere to be seen. I obviously couldn’t rely on them. Then like a blaze of light from behind a cloud came the idea: ‘You’ve only yourself to rely on.’

The earlier experience had been more confusing, with no specific experience to explain it by.

Saturday was the day I dynamited my way into my basement. Suddenly, without any warning that I can remember, I was catapulted from my cushioned platform of bored breathing into the underground river of my tears – tears that I had never known existed.

It was an Emily Dickinson moment:

And then a Plank in Reason, broke,
And I dropped down, and down –
And hit a World, at every plunge, . . .

I’m just not as capable of conveying my experience in words as vividly as she did hers.

Drowning is probably the best word to describe how it felt. Yes, of course I could breath, but every breath plunged me deeper into the pain. Somehow I felt safe enough in that room full of unorthodox fellow travellers, pillow pounders and stretched out deep breathers alike, to continue exploring this bizarre dam-breaking flood of feeling, searching for what it meant.

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So, as I asked at the end of the previous post, what chance do Christina and Stefan Grof stand in their efforts to prove the mystical component of psychosis?

I need to repeat the caveats I voiced at the start of this sequence about their book, The Stormy Search for the Self: understanding and living with spiritual emergency, so that I do not come across as easily taken in. It is not easy to tread the razor’s edge between the default positions of intransigent incredulity and irremediable gullibility, but here goes.

Their book has echoes for me of Hillman’s The Soul’s Code in that it combines deep insights with what read like wild flights of fancy and carefully substantiated accounts of concrete experience with vague waves at unspecified bodies of invisible evidence. Even so, so much of it is clearly derived from careful observation and direct experience, and goes a long way towards defining what look convincingly like spiritual manifestations which are currently dismissed as mere madness. It seemed important to flag the book up at this point.

I am going to focus on what I feel are their strongest points: concrete experiences that illustrate their perspective and their brave and, in my opinion, largely successful attempts to make a clear distinction between mystic and merely disturbed experiences, not that the latter are to be dismissed as meaningless. It’s just that their meaning is to be found in life events not in the transcendent.

First I’ll deal with their account of one person’s spiritual crisis. In the last post I’ll be looking at their scheme of diagnostic distinction.

Georgiana Houghton‘s ‘Glory Be to God’ (image scanned from ‘Spirit Drawings’ – the Courtauld Gallery)

A Concrete Example

What follows is a highly condensed summary of one person’s story. A key point to hold in mind is one the Grofs made earlier in the book (page 71):

Often, individuals benefit from their encounter with the divine but have problems with the environment. In some instances, people talk to those close to them about a powerful mystical state. If their family, friends, or therapists do not understand the healing potential of these dimensions, they may not treat them as valid or may automatically become concerned about the sanity of the loved one or client. If the person who has had the experience is at all hesitant about its validity or concerned about his or her state of mind, the concern of others may exaggerate these doubts, compromising, clouding, or obscuring the richness of the original feelings and sensations.

Karen’s Story

They begin by providing some background (pages 191-92):

[S]he had a difficult childhood; her mother committed suicide when she was three, and she grew up with an alcoholic father and his second wife. Leaving home in her late teens, she lived through periods of depression and struggled periodically with compulsive eating.

Assuming that her subsequent experiences were what they seem to be, and I do, then it is clear that just because there is trauma in someone’s background does mean that the unusual experiences they report are entirely reducible to some form of post-traumatic stress response any more than they can be explained satisfactorily simply in terms of brain malfunction. Whatever is going on in the brain is just a correlate but not a cause, and previous trauma may have rendered any filter susceptible to leaks from a transcendent reality. I am restraining myself from leaping too soon to that last and much desired conclusion.

Interestingly, it’s possible that there was an organic trigger to her spiritual crisis (page 192):

. . . [F]ive days before her episode, Karen had begun taking medication for an intestinal parasite, stopping as the daily experience started. . . . . It is difficult to accurately assess its role in the onset of this event. . . . Whatever the source, her crisis contained all the elements of a true spiritual emergency. It lasted three-and-a-half weeks and completely interrupted her ordinary functioning, necessitating twenty-four-hour attention.

Her friends asked the Grofs to become involved in her care so they were able to observe the whole situation as it unfolded.

That Karen was able to avoid being admitted to psychiatric hospital was down to the support of a wide circle of friends. That this meant that she did not have to take any medication is important, according to the Grofs and other sources. Anti-pychotic medication has the effect of blocking the very processes that a successful integration of the challenging experiences requires. They describe the lay nature of her support (pages 192-93):

[B]ecause of Karen’s obvious need and the reluctance of those around her to involve her in traditional psychiatric approaches, her care was largely improvised. Most of the people who became involved were not primarily dedicated to working with spiritual emergencies.

What were her experiences like during this period of what they call ‘spiritual emergency’?

Their description covers several pages (page 194-196). This is a very brief selection of some of the main aspects. To Karen her vision seemed clearer. She also ‘heard women’s voices telling her that she was entering a benign and important experience. . . .’ Observers noted that ‘heat radiated throughout Karen’s body and it was noted that ‘she saw visions of fire and fields of red, at times feeling herself consumed by flames. . . .’

What is also particularly interesting is her re-experience of previous life crises: ‘[S]he struggled through the physical and emotional pain of her own biological birth and repeatedly relived the delivery of her daughter,’ as well as confronting ‘death many times and in many forms, and her preoccupation with dying caused her sitters to become concerned about the possibility of a suicide attempt.’ She was too well protected for that to be a serious risk.

In the last post I will be linking a therapeutic technique the Grofs advocate, Holotropic Breathwork, with some of my own experiences. This makes their description of how this technique can uncover repressed memories of traumatic experiences all the more credible to me. More of that later. That Karen should have been triggered into such regressions is not therefore surprising to me.

By way of supporting her through this, ‘telling her that it was possible to experience death symbolically without actually dying physically, her sitters asked her to keep her eyes closed and encouraged her to fully experience the sequences of dying inwardly and to express the difficult emotions involved.’ It is significant for their model that encouragement and support in facing what we might otherwise be tempted to flee from helps. ‘She complied, and in a short time she moved past the intense confrontation with death to other experiences. . . .’

Given my interest in the relationship between apparently disturbed mental states and creativity, it was noteworthy that ‘[f]or several days, Karen tapped directly into a powerful stream of creativity, expressing many of her experiences in the form of songs. It was amazing to witness: after an inner theme would surface into awareness, she would either make up a song about it or recall one from memory, lustily singing herself through that phase of her process.’

They describe her during this period as ‘extremely psychic, highly sensitive, and acutely attuned to the world around her.’ For example she was ‘able to “see through” everyone around her, often anticipating their comments and actions.’

Georgiana Houghton‘s ‘The Glory of the Lord’ (image scanned from ‘Spirit Drawings’ – the Courtauld Gallery)


Things began to take a more positive turn (page 196):

After about two weeks, some of the difficult, painful states started to subside and Karen receive increasingly benevolent, light-filled experiences and felt more and more connected with a divine source.

Perhaps I need to clarify that I am not attempting to adduce this as evidence of the reality of the spiritual world. People like David Fontana and Leslie Kean have collated such evidence far better than I ever could, and sorted out the wheat from the chaff with honesty and discernment.

What I am hoping to do is use this as a demonstration that sometimes at least what could be written off as meaningless and irrational brain noise might not only be significantly related to early experiences in life, as the trauma work suggests, but also to a spiritual dimension whose reality our culture usually denies with the result that the experiences are pathologised. The outcome in this case strongly suggests that pathologising them needlessly prolongs them and blocks life-enhancing changes that would otherwise have resulted.

They go onto describe the end of the episode and its aftermath (ibid.):

. . . . As Karen began to come through her experience, she became less and less absorbed by her in the world and more interested in her daughter and the other people around her. She began to eat and sleep more regularly and was increasingly able to care for some of her daily needs. . . .

Rather as was the case with Fontana and his poltergeist investigation, as the vividness of the experiences receded, doubts beganset in (ibid.:)

As she became increasingly in touch with ordinary reality, Karen’s mind started to analyse her experiences, and she began to feel for the first time that she had been involved in a negative process. The only logical way of explaining these events to herself was that something had gone wrong, that perhaps she had truly lost her mind. Self-doubt is a common stage in spiritual emergencies, appearing when people begin to surface from the dramatic manifestations . . .

She was not blind to the positives in the end (page 197):

Two years later, when we discussed her experience with her, Karen said that she has mixed feelings about the episode. She is able to appreciate many aspects of what happened to her. She says that she has learnt a great deal of value about herself and her capacities, feeling that through her crisis she gained wisdom that she can tap any time. Karen has visited realms within herself that she previously had no idea were there, has felt enormous creativity flow through her, and has survived the previously frightening experiences of birth, death, and madness. Her depressions have disappeared, as well as her tendency toward compulsive overeating.

But her doubts persisted, and may have been to some extent fuelled by her family and friends’ reactions and the lack of informed support (page 198):

On the other hand, Karen also has some criticisms. Even though she could not have resisted the powerful states during her episode, she feels that she was unprepared for the hard, painful work involved. In spite of the fact that she received a great deal of assistance during the three weeks, she feels that she was not yet ready to venture forth into the daily world when she was required to do so by the exhaustion of the resources of those around her. Since that time, she has lacked contact with people with whom to further process her experiences. She considers herself somewhat “different” for having had the episode (an opinion also indirectly expressed by her family and some of her friends) and has tended to downgrade it by concentrating on its negative effects.

The support had to be reduced after the three-week peak period because the support network was burning out. The Grofs felt (ibid.:)

Many of these problems could have been avoided if Karen had had consistent and knowledgeable support immediately following her crisis, perhaps in a halfway house, and follow-up help – in the form of ongoing therapy, support groups, and spiritual practice – for a more extended period of time.

It is dangerous to extrapolate too wildly but I feel that in Karen’s story there are real grounds for hope. She recovered from an apparently devastating episode of mental disturbance without drugs. She demonstrated modest but lasting mental health gains in terms of no subsequent depression or compulsive eating. There is every reason to suppose given this experience and the evidence of Dr Sami Timimi’s study, adduced by James Davies in Cracked and described in the previous post, that an outcome like this could apply far more widely across the so-called psychotic spectrum. Yes, the intervention was time intensive, but it was brief and successful. This compares with long-term interventions involving medication resulting in symptoms that continue to simmer for years or even decades, blighting the whole life of the sufferer and the lives of close family.

The Grofs then explore models of help and aftercare, which I won’t go into now as the main focus I want to take is on their ideas of how to distinguish a spiritual emergency such as Karen’s from other forms of disturbance. This is clearly an important distinction to be able to make as the approaches taken when dealing with trauma-related disturbances and spiritual crises will be somewhat different, though Karen’s case implies there might well be an overlap.

However, all the evidence that has accumulated since they wrote suggests that all such so-called psychotic episodes are better dealt with in a non-diagnostic way, which is an issue that the Grofs do not fully address, probably because at the time of their writing placing spiritual emergency on the agenda seemed a more urgent issue, given that it was and still is doubly disparaged.

Now for the difficult distinction in the next post, along with a brief description of their recommended intervention.

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In the last post I ended up exploring James Davies’ perspective in his recent book Cracked. I was focusing upon his emphasis on relationships rather then medication as the more effective way to help those with psychotic experiences.


It’s where he goes next that I found most unexpected but most welcome to my heart. He leads into it with an interview with Thomas Sasz just before his death at the age of 92 (page 276). He asks Szasz, ‘why do we believe as a culture that suffering must be removed chemically rather than understood in many cases as a natural human phenomenon, and possibly something from which we can learn and grow if worked through productively?’

Szasz’s response is fascinating:

Our age has replaced a religious point of view with a pseudo-scientific point of view. . .   Now everything is explained in terms of molecules and atoms and brain scans. It is a reduction of the human being to a biological machine. We don’t have existential or religious or mental suffering any more. Instead we have brain disorders.

This resonates strongly with the Bahá’í position as expressed, for instance, in Century of Light (page 136):

What [Bahá’ís]  find themselves struggling against daily is the pressure of a dogmatic materialism, claiming to be the voice of “science“, that seeks systematically to exclude from intellectual life all impulses arising from the spiritual level of human consciousness.

Davies summarises Szasz’s position on psychiatry (page 277): ‘It had become deluded in its belief that its physical technologies, its ECT machines and laboratory-manufactured molecules, could solve the deeper dilemmas of the soul, society and self.’

He quotes Bracken’s view on how this brings in capitalism (page 278):

What complicates things more is that we also live in a capitalist society, where there is always going to be someone trying to sell you something… In fact, some people would argue that capitalism can only continue by constantly making us dissatisfied with our lives.… You know, if everybody said I am very happy with my television, my car and everything else I’ve got, and I’m perfectly content with my lifestyle, the whole economy would come shattering down around our ears.

He continues (page 279):

What we customarily call mental illness is not always illness in the medical sense. It’s often a natural outcome of struggling to make our way in a world where the traditional guides, props and understandings are rapidly disappearing… Not all mental strife is therefore due to an internal malfunction but often to the outcome of living in a malfunctioning world. The solution is not yet more medicalisation, but an overhaul of our cultural beliefs, a reinfusing of life with spiritual, religious or humanistic meaning with emphasis on the essential involvement of community, and with whatever helps bring us greater direction, understanding, courage and purpose.

Instinctive Incredulity

However, we are even further away from generally accepting that some experiences labelled psychotic may have spiritual dimensions.

Christina and Stefan Grof’s indictment of our civilisation in their book The Stormy Search for the Self: understanding and living with spiritual emergency sings from essentially the same hymn sheet as Davies (page 235):

Though the problems in the world have many different forms, they are nothing but symptoms of one underlying condition: the emotional, moral, and spiritual state of modern humanity. In the last analysis, they are the collective result of the present level of consciousness of individual human beings. The only effective and lasting solution to these problems would, therefore, be a radical inner transformation of humanity on a large scale and its consequent rise to a higher level of awareness and maturity.

David Fontana also writes from direct experience of this painful level of materialism and its default stance of resolute incredulity when faced with any evidence, no matter how compelling, in favour of a spiritual dimension to reality. He had to combat it at almost every turn of his investigations. He even bravely admits to being contaminated by it himself. In the in-depth survey of his book Is there an afterlife? he writes (page 335):

My difficulty in writing about Scole [a long and detailed exploration of psychic phenomena including material effects] is not because the experiences we had with a group have faded. They are as clear as if they happened only weeks ago. The difficulty is to make them sound believable. It is a strange fact of life that whereas most psychical researchers interested in fieldwork are able to accept – or at least greet with open minds – the events of many years ago connected with the mediumship of physical mediums such as Home, Palladino, and Florence Cook, a strain of scepticism fostered by scientific training makes it much harder for them to accept that similar events may happen today, and may even be witnessed by those of us fortunate enough to be there when they occur. I mentioned in my discussion of the Cardiff poltergeist case… the struggle I had with my own belief system after seeing the phenomena concerned. When in the room while they were taking place I had no doubt they were genuine, but as soon as I began to drive home I started to doubt. . . . . The whole thing seemed simply unbelievable.

He adds:

It took a lengthy investigation, including one occasion when I witnessed phenomena while I was on my own in one of the rooms where the disturbances took place and the owners were two hundred miles away on holiday, before I could fully accept that poltergeist phenomena can indeed be genuine, and provide evidence not only of paranormality but, at least in some cases, of survival.

The Grofs articulate the challenge exactly (page 236)

The task of creating an entirely different set of values and tendencies for humanity might appear to be too unrealistic and utopian to offer any hope. What would it take to transform contemporary mankind into a species of individuals capable of peaceful coexistence with their fellow men and women regardless of colour, language, or political conviction – much less with other species?

They list our current characteristics in detail including violence, greed, habitual dissatisfaction and a severe lack of awareness that we are connected with nature. They conclude, ‘In the last analysis, all these characteristics seem to be symptomatic of severe alienation from inner life and loss of spiritual values.’

To describe it as an uphill struggle would be an understatement. Climbing Everest alone and unequipped seems closer to the mark.

They see at least one window through which the light of hope shines (page 237)

[M]any researchers in the field of transpersonal psychology believe that the growing interest in spirituality and the increasing incidence of spontaneous mystical experiences represent an evolutionary trend toward an entirely new level of human consciousness.

As we will see in the final two posts, our medicalisation of schizophrenia and psychosis might well be slowing this process down. If so there is all the more reason to give the Grofs’ case a fair and careful hearing. This will not be easy for the reasons that Fontana has explained.

Incidentally, after acknowledging that absolutely convincing proof of the paranormal seems permanently elusive, after all his years of meticulous investigation Fontana reaches a conclusion very close to that put forward by John Hick (op. cit.: page 327):

Professor William James may have been right when he lamented that it rather looks as if the Almighty has decreed that this area should forever retain its mystery. If this is indeed the case, then I assume it is because the Almighty has decreed that the personal search for meaning and purpose in life and in death are of more value than having meaning and purpose handed down as certainties from others.

In his book The Fifth Dimension, John Hick contends that experiencing the spiritual world in this material one would compel belief whereas God wants us to be free to choose whether to believe or not (pages 37-38):

In terms of the monotheistic traditions first, why should not the personal divine presence be unmistakably evident to us? The answer is that in order for us to exist as autonomous finite persons in God’s presence, God must not be compulsorily evident to us. To make space for human freedom, God must be deus absconditus, the hidden God – hidden and yet so readily found by those who are willing to exist in the divine presence, . . . . . This is why religious awareness does not share the compulsory character of sense awareness. Our physical environment must force itself upon our attention if we are to survive within it. But our supra-natural environment, the fifth dimension of the universe, must not be forced upon our attention if we are to exist within it as free spiritual beings. . . . To be a person is, amongst many other things, to be a (relatively) free agent in relation to those aspects of reality that place us under a moral or spiritual claim.

So what chance do Christina and Stefan Grof stand in their efforts to prove the mystical component of psychosis?

More of that next time.

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I am repeating my preamble to the first post to clarify the eventual focus of this sequence.

Readers of this blog will remember that I was struggling recently to find more detailed discussion of the possibility that some severe mental disturbances have spiritual aspects. Isabel Clarke’s Spirituality & Psychosis left me frustrated by its lack of such detail.

Recently I came across a second hand copy of Christina and Stanislav Grof’s The Stormy Search for the Self: understanding and living with spiritual emergency. It was published in 1991 at a less than universally receptive time so it is hard to determine from the book itself how far things might have moved on since. This is something I will have to investigate further.

It has echoes for me of Hillman’s The Soul’s Code in that it combines deep insights with what read like wild flights of fancy and carefully substantiated accounts of concrete experience with vague waves at unspecified bodies of invisible evidence. Even so, much of it is clearly derived from careful observation and direct experience, and goes a long way towards defining what look convincingly like spiritual manifestations within mental disturbances which are currently dismissed as mere madness. So, it seemed important to flag the book up at this point.

Before I go into more detail I need to place its thesis in perspective. We need to understand how much of an uphill battle it is going to be to get the spiritual dimensions of the experiences currently labelled psychosis accepted in mainstream psychiatry and psychology. I began by looking back at the history of the way the effects of trauma have been treated. I pick up the thread from there.

Meaning in Madness

Trauma and its effects took a long time to gain acceptance, as the last post explored.

It is taking much longer to acknowledge that extremes of mental disturbance may not be madness at all in many if not most cases.

It is thankfully being increasingly accepted that trauma leads to experiences that are then labelled psychotic which need to be managed and integrated not simply by drugs, which may sometimes be a temporary fix at best, but by therapeutic relationships within an accepting social context, something I have already explored at some length on this blog. I will briefly revisit the picture briefly here.

Richard Bentall’s examination of the issue in his 2003 edition of Madness Explained makes the problem clear. He writes (page 277):

In this discussion of environmental influences on psychosis, I have left the contribution of trauma until last because, for many psychologists and psychiatrists at least, even to raise this issue is to court to controversy.

Even so his conclusions on the basis of the best evidence at the time is (pages 478-79):

Despite difficulties, there is consistent evidence that a history of physical or sexual abuse is unusually common in psychotic women.

Comparable evidence of an association between trauma and psychosis has emerged from studies of men.

Even as late as 2010 there seemed to be persisting resistance to widespread acceptance of what should have by then have become obvious and widely accepted (The Impact of Early Life Traumapage 9):

Acceptance and acknowledgement of explanations more consistent with empirical findings need to overcome what societal attention to child abuse and neglect has always had to overcome: society’s desire for minimisation and denial. The existence and effect of child maltreatment is perpetually fighting for acceptance against powerful psychological and social processes set to deny, ignore or undermine it.

When we leap almost to the present day there is thankfully far less hesitation in many quarters. I’m not sure though that we have yet come to the end of the need to change the prevailing consensus.

Jamie Murphy, Mark Shevlin, James Edward Houston, and Gary Adamson uncover the true complexity of the problem (Modelling the co-occurrence of psychosis-like experiences and childhood sexual abuse –pages 1037-1043).

Evidence, in their view, has repeatedly shown that Childhood Sexual Abuse (CSA) is ‘significantly associated with psychosis at both clinical and sub-clinical levels (Psychotic-like Experiences – PLEs): the worse the CSA, the greater the risk, severity and duration of psychosis.’ They argue that the evidence from current psychological conceptualizations confirms that psychotic symptoms are closely related to a person’s psychological functioning and that they are therefore amenable to psychological intervention (quoting Yusupoff et al., 1996).

It is important that we make sure we are not being misled into attributing cause when we have only correlation. By this I mean that just because, when I am holding my key to either open or lock my front door, the light goes on, I should not jump to the conclusion that my door key is switching the light on. I need to understand that my mere presence with no key is enough to trigger the motion sensor. The key is a confounding variable that needs to be eliminated, for example by leaving the house without locking the door one night. I’d be wise not to go further than strictly necessary to prove the point though.

Longden and Read (The Role of Social Adversity in the Etiology of Psychosis – pages 7-8) deal extensively with this problem:

Large-scale population studies have shown that associations between adversity and psychotic experience remain significant when controlling for possible confounders, including: family history of psychosis and other mental health problems (which negates the notion that psychosis only occurs in those genetically predisposed), age, sex, ethnicity, marital status, exposure to discrimination, other psychiatric diagnoses, education level, neuroticism, and substance use. Furthermore, the association has repeatedly demonstrated a dose-response relationship; that is, the likelihood of psychosis increases relative to the extent of adversity exposure.

The full list is in the earlier sequence of posts.

It is some comfort that Bentall’s more recent book Doctoring the Mind brings the more grandiose pretentions of psychiatry back to the earth with a bump. Salley Vickers’ verdict in a review states:

Bentall’s thesis is that, for all the apparent advances in understanding psychiatric disorders, psychiatric treatment has done little to improve human welfare, because the scientific research which has led to the favouring of mind-altering drugs is, as he puts it, “fatally flawed”. He cites some startling evidence from the World Health Organisation that suggests patients suffering psychotic episodes in developing countries recover “better” than those from the industrialised world and the aim of the book is broadly to suggest why this might be so. . . .

My own view endorses Bentall’s rigorous analysis of the misleading inadequacy of psychiatry’s diagnostic system, its powerful and carefully argued exposure of the myths surrounding psychotropic medications and their supposed efficacy, and its moving description of the critical importance of positive relationships to recovery.

The Importance of Context

James Davies’ book Cracked also covers much of this same ground and is equally compelling. Both Bentall and Davies are very clear that there is still some considerable distance to travel.

What also needs to be acknowledged is that Davies also takes the argument to another level towards the end of his book.

Where he takes his case, in Chapter 10, I found both compelling and resonant. He is in tune with Bentall in seeing the importance of supportive relationships but, I think, explores that aspect somewhat more deeply.

He repeats basic points, to begin with (page 266):

What the evidence shows… is that what matters most in mental health care is not diagnosing problems and prescribing medication, but developing meaningful relationships with sufferers with the aim of cultivating insight into their problems, so the right interventions can be individually tailored to their needs. Sometimes this means giving meds, but more often it does not.

He then quotes research done by a psychiatrist he interviewed (page 267). Using two existing MH teams, Dr Sami Timimi set up a study comparing the results from two groups, one diagnostic, the usual approach, and the other non-diagnostic, where medication was given only sparingly, diagnosis was hardly used at all, and individual treatment plans were tailored to the person’s unique needs.’

In the non-diagnostic group the psychiatrist spent far more time exploring with his clients the context of their problems.

The results were clear (page 269):

Only 9 per cent of patients treated by the non-diagnostic approach continued needing treatment after two years, compared with 34 per cent of patients who were being treated via the medical model. Furthermore, only one person from the non-diagnostic group ended up having to be hospitalised, whereas over 15 people in the medical-model team were referred for inpatient hospital treatment. Finally, the non-diagnostic approach led to more people being discharged more quickly, and to the lowest patient ‘no-show’ rate out of all the mental health teams in the county.

This middle is by no means the norm, unfortunately.

Davies also interviewed Dr Peter Breggin, a US psychiatrist who is critical of the medical model. Breggin explained his viewpoint (page 279):

Most problems are created by the contexts in which people live and therefore require contextual not chemical solutions. ‘People who are breaking down are often like canaries in a mineshafts,’ explained Breggin. ‘They are a signal of a severe family issue.’ .  . . . For Breggin, because the medical model fails to take context seriously – whether the family or the wider social context – it overlooks the importance of understanding and managing context to help the person in distress.

Davies quotes Dr Pat Bracken as singing from the same hymn sheet (page 273):

We should start turning the paradigm round, start seeing the non-medical approach as the real work of psychiatry, rather than as incidental to the main thrust of the job, which is about diagnosing people and then getting them on the right drugs.

Davies’s final points I’ll leave till next time as a useful link between this theme and the issue spirituality and its treatment in Christina and Stanislav Grof’s The Stormy Search for the Self: understanding and living with spiritual emergency.

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Readers of this blog will remember that I was struggling recently to find more detailed discussion of the possibility that some severe mental disturbances have spiritual aspects. Isabel Clarke’s Spirituality & Psychosis left me frustrated by its lack of such detail.

Recently I came across a second hand copy of Christina and Stanislav Grof’s The Stormy Search for the Self: understanding and living with spiritual emergency. It was published in 1991 at a less than universally receptive time so it is hard to determine from the book itself how far things might have moved on since. This is something I will have to investigate further.

It has echoes for me of Hillman’s The Soul’s Code in that it combines deep insights with what read like wild flights of fancy and carefully substantiated accounts of concrete experience with vague waves at unspecified bodies of invisible evidence. Even so, much of it is clearly derived from careful observation and direct experience, and goes a long way towards defining what look convincingly like spiritual manifestations within mental disturbances which are currently dismissed as mere madness. So, it seemed important to flag the book up at this point.

Before I go into more detail I think I need to place its thesis in perspective. We need to understand how much of an uphill battle it is going to be to get the spiritual dimensions of the experiences currently labelled psychosis accepted in mainstream psychiatry and psychology. To do so we need to look back at the history of the way the effects of trauma have been treated.

Attitudes to Trauma in the Past

It has taken a century or more for the work on trauma and its basic consequences to be properly understood.

This struggle involved swimming against the strong tide of dismissive opinion.

There are many places to look for evidence of the slow progress towards an acceptance and understanding of the role of trauma in mental disturbance. There are few better than Judith Herman’s book Trauma & Recovery. I have covered her account in more detail elsewhere on this blog so I’ll just summarise it here.

Herman rightly emphasises that only if the social context facilitates, can trauma and its impacts be studied (page 9):

The study war trauma becomes legitimate only in a context that challenges the sacrifice of young men in war. The study of trauma in sexual and domestic life becomes legitimate only in a context that challenges the subordination of women and children.

She lists, in her historical review, three forms of trauma (ibid.): hysteria, shell shock/combat neurosis and sexual and domestic violence. She looks at the work of Charcot, Janet, Freud and Breuer. The fruit of their extensive collaborative interactions with female patients was Freud’s The Aetiology of Hysteria, in which he wrote (page 13):

I therefore put forward the thesis that at the bottom of every case of hysteria there are one or more occurrences of premature sexual experience, occurrences which belong to the earliest years of childhood, but which can be reproduced through the work of psychoanalysis in spite of the intervening decades.

There was a massive backlash which caused a backtrack. Experiences were dismissed as fantasies or interpreted as subliminally desired. As Herman puts it (page 14): ‘The dominant psychological theory (psychoanalysis) of the next century was founded in the denial of women’s reality.’

Herman recognises how impossible it would have been for Freud to fight successfully to get his authentic theory recognised (page 18):

No matter how cogent his arguments or how valid his observations, Freud’s discovery could not gain acceptance in the absence of a political and social context that would support the investigation of hysteria, wherever it might lead.

Soldiers in the First World War triggered a similarly divisive debate. Lewis Yelland used shaming, threat and punishment as a ‘remedy’, for example treating the mutism that sometimes resulted from combat neurosis with electric shocks, in one case to the throat – it seemed the best was to get a traumatised soul quickly back to the trenches that had traumatised him in the first place.

The Second World War resurrected the issue with some progress. Even so (page 26), ‘systematic, large-scale investigation of the long-term psychological effects of combat was not undertaken until after the Vietnam War.’

This took an altogether different form from the expert-dominated approaches of the past (ibid.):

The antiwar veterans organised what they called “rap groups.” In these intimate meetings of their peers, Vietnam veterans retold and relived the traumatic experiences of war. They invited sympathetic psychiatrists to offer them professional assistance.

Their activism ultimately led to (op.cit. page 27):

. . . comprehensive studies tracing the impact of wartime experiences on the lives of returning veterans. A five-volume study on the legacies of Vietnam delineated the syndrome of post-traumatic stress disorder and demonstrated beyond any reasonable doubt its direct relationship to combat exposure.

Activism remained a vital element in the further development of a proper understanding of trauma and its true prevalence (page 28):

For most of the twentieth century it was the study of combat veterans that led to the development of a body of knowledge about traumatic disorder. Not until the women’s liberation movement of the 1970s was it recognised that the most common post traumatic disorders are not those of men in war but of women into civilian life.

The incidence figures were as staggering then as they had been when Freud decided they could not be credible and backed off. A rigorous study of 900 randomly selected women in the 1980s revealed that one in four women had been raped, and one in three had been sexually abused in childhood.

Herman describes the way that research into rape led investigators from the street more deeply into the family (page 31):

The initial focus on street rape, committed by strangers, led step by step to the exploration of acquaintance rape, date rape, and rape in marriage. The initial focus on rape as a form of violence against women lead to the exploration of domestic battery and other forms of private coercion. And the initial focus on the rape of adults led inevitably to a rediscovery of the sexual abuse of children.

Later in the book they explore in detail how accepting relationships are usually critical to the fully effective treatment of trauma. I may come back to that in more detail in later posts but for now it is important to signpost that point for future reference when we come to look at trauma and psychosis in the next post. Herman writes:

. . . . group treatment complements the intensive, individual exploration of the trauma story, but does not necessarily replace it. The social, relational dimensions of the traumatic syndrome are more fully addressed in a group than in an individual setting, while the physioneurosis of the former requires a highly specific, individualised focus on desensitising the traumatic memory.

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