An Angle on Suffering (3/3): the nature of choice

Had the life and growth of the child in the womb been confined to that condition, then the existence of the child in the womb would have proved utterly abortive and unintelligible; as would the life of this world, were its deeds, actions and their results not to appear in the world to come.

(‘Abdu’l-Bahá in Bahá’í World Faith: page 393)

This is the last of three posts originally published in 2012, then again in 2014, 2015 and 2016. It seems appropriate to publish them yet again, because I have been pondering on the issue of theodicy in preparation from my talk in May at a humanist group. They will be interwoven another sequence over a three week period. 

In the previous two posts, I have been looking at Dabrowski’s Theory of Personal Disintegration (TPD) most particularly for what it has to say about suffering.

Both TPD and a rich and interesting approach to psychotherapy – Acceptance and Commitment Therapy (ACT) – owe much to existentialism. Mendaglio acknowledges his debt in the last chapter of the book he edited on this subject (page 251):

However, there is a great deal of similarity between existential psychology and the theory of positive disintegration. Both emphasise similar key concepts such as values, autonomy, authenticity, and existential emotions such as anxiety and depression. A more fundamental similarity is seen in the philosophical underpinnings of TPD, which is in large measure existentialism.

In spite of my own immense debt to existentialist thinking, only rivalled by my debts to Buddhism and to the Bahá’í Faith, I have certain reservations about Dabrowski’s take on the degree of choice we are able to exercise.

Crucial Caveats

His take on suffering is truly inspiring. Care needs to be taken though that we do not adopt this view in a way that assumes that those who are crushed by their sufferings are somehow to blame.

It is true that his model presupposes that each of us will probably meet a challenging choice point sometime in our lives, where we can either cling to the familiar comfortable half-truths that have failed us or strive to rise about them to higher levels of understanding. It is also true that he feels that many of us are capable of choosing the second option, if we only would.

However, not everyone is so lucky. I include here a brief summary of the life history of Ian – the man whose interview I have quoted extensively in the first three posts on An Approach to Psychosis.

His history shows very clearly that he could only make the second choice at times and then meet the pain and work through it to alleviate his tormenting voices. At other times the voices were preferable to experiencing the guilt and he chose what we might call madness rather than lucidity. Given the horrors he had faced it was clear that he should not be thought a failure. I would probably have done the same had I gone through what he had experienced in his life, from his earliest days.

Dabrowski seems to feel that our capacity to choose is genetically determined. Mendaglio explains (page 250):

Dabrowski . . . . postulated the existence of a third factor of development, representing a powerful autonomous inner force which is rooted in the biological endowment of individuals.

It seems to me that it would have taken a truly exceptional individual to make the choice to experience Ian’s level of pain in order to progress. If that does not seem quite convincing, there is another case history I would like to share very briefly.

Among the sequence of posts related to mental health there is a poem called ‘Voices.’ The woman upon whose experiences that poem is based, was brutally abused by her father, sexually, and by her mother, physically, from her earliest years through her mid-teens.

She came to us to work on her father’s abuse. We developed a safe way of working which involved starting with 15 minutes exploring how things had been since we last met. Then we moved on to 15-20 minutes of carefully calibrated work on the abuse. Then the last half hour of the session was spent helping her regain her ordinary state after mind after the work on her early experiences had intensified her hallucinations.

After almost a year of this work things seemed to be going well. Then came the unexpected. She found herself in a building that closely resembled the building strongly connected with the worst episode of abuse she had experienced at the hands of her father. Just being there was more than she could cope with. She became retraumatised in a way we none of us could have anticipated or prevented. The next time we met she could not stop sobbing.

We discussed what she might do. There were two main options.

She could, if she wished, continue on her current low levels of medication and move into a social services hostel where she would be well supported while we continued our work together, or she could be admitted onto the ward and given higher levels of medication in order to tranquillise her out of all awareness of her pain.

She chose the second option and I could not blame her in any way for doing so. It would be a betrayal of the word’s meaning to suppose she had any real choice at that point but to remain psychotic while the medication kicked in rather than deal with the toxic emotions in which she felt herself to be drowning.

It is when I consider these kinds of situation at my current level of understanding of his theory, that I feel it could leave the door open to destructive attitudes.

He believes, if I have understood him correctly, that some people’s genetic endowment is so robust they will ultimately choose the harder option regardless of the environment in which they grew up. Most of us are in the middle and with an environment that is not too extreme we will do quite well. The endowment of some is so poor, he seems to be saying, that it requires an optimal environment if they are to choose to grow even in a modest way.

This approach, if I have got it right, has two problems. The first, which is less central to the theme of this post, is that it is perhaps unduly deterministic because of the power that is given to inherited ‘endowment’ to determine the life course of any individual. The second problem is more relevant to current considerations in this post, though related to the first point. By placing such a determining role upon heredity, the force of the environment may be unduly discounted.

I am not claiming that he attaches no importance to environment. In fact, education for example is much emphasised in his work and he is clearly aware that limited societies will be limiting most people’s development – and he would include the greedy materialism of Western cultures in that equation. I’m not sure where he would place the impact of natural disasters in his scheme of things.

He may though be minimising the crushing impact of such experiences as the two people I worked with had undergone, in the second case throughout almost all her formative years. Could a strong genetic endowment have endured such hardship and come through significantly less damaged? If you feel so, you may end up not so much thinking ‘There, but for the grace of God, go I!’ but more ‘They broke because they were weak.’ Empathy, which Dobrawski values so much, would be impaired because we can start to define people as essentially different from us, not quite part of the same superior species.

More Complexities

This is a truly complex area to consider though, and I will have to restrict myself at this point to a very brief examination of one approach to it which does justice to that complexity.

‘Abdu’l-Bahá, in his description of the various components of our character, suggests that what we inherit is a source of either strength or weakness (Some Answered Questions: page 213):

The variety of inherited qualities comes from strength and weakness of constitution—that is to say, when the two parents are weak, the children will be weak; if they are strong, the children will be robust. . . . . . For example, you see that children born from a weak and feeble father and mother will naturally have a feeble constitution and weak nerves; they will be afflicted and will have neither patience, nor endurance, nor resolution, nor perseverance, and will be hasty; for the children inherit the weakness and debility of their parents.

However, this is not quite the end of the matter. He does not conclude from this that moral qualities, good or bad, stem directly from the inherited temperament of an individual (pages 214-215):

But this is not so, for capacity is of two kinds: natural capacity and acquired capacity. The first, which is the creation of God, is purely good—in the creation of God there is no evil; but the acquired capacity has become the cause of the appearance of evil. For example, God has created all men in such a manner and has given them such a constitution and such capacities that they are benefited by sugar and honey and harmed and destroyed by poison. This nature and constitution is innate, and God has given it equally to all mankind. But man begins little by little to accustom himself to poison by taking a small quantity each day, and gradually increasing it, until he reaches such a point that he cannot live without a gram of opium every day. The natural capacities are thus completely perverted. Observe how much the natural capacity and constitution can be changed, until by different habits and training they become entirely perverted. One does not criticize vicious people because of their innate capacities and nature, but rather for their acquired capacities and nature.

Our habits and choices have a crucial part to play. Due weight though has also to be given to the power of upbringing and the environment (Selections from the Writings of ‘Abdu’l-Bahá, Sec. 95, pp. 124–25):

It is not, however, permissible to strike a child, or vilify him, for the child’s character will be totally perverted if he be subjected to blows or verbal abuse.

This theme is taken up most powerfully by the central body of the Bahá’í Faith ((Universal House of Justice: April 2000):

In the current state of society, children face a cruel fate. Millions and millions in country after country are dislocated socially. Children find themselves alienated by parents and other adults whether they live in conditions of wealth or poverty. This alienation has its roots in a selfishness that is born of materialism that is at the core of the godlessness seizing the hearts of people everywhere. The social dislocation of children in our time is a sure mark of a society in decline; this condition is not, however, confined to any race, class, nation or economic condition–it cuts across them all. It grieves our hearts to realise that in so many parts of the world children are employed as soldiers, exploited as labourers, sold into virtual slavery, forced into prostitution, made the objects of pornography, abandoned by parents centred on their own desires, and subjected to other forms of victimisation too numerous to mention. Many such horrors are inflicted by the parents themselves upon their own children. The spiritual and psychological damage defies estimation.

This position allows for the fact that we need to take responsibility for our own development while at the same time acknowledging that we may be too damaged by the ‘slings and arrows of outrageous’ upbringing to do so to any great extent without a huge amount of help from other people. And most of us are the other people who need to exert ourselves to protect all children and nurture every damaged adult who crosses our path to the very best of our ability. Maybe Dabrowski is also saying this, but I haven’t read it yet. Even so his thought-provoking message is well worth studying.

In the end though, as the quote at the beginning of this post suggests, any consideration of suffering that fails to include a reality beyond the material leaves us appalled at what would seem the pointless horror of the pain humanity endures not only from nature but also from its own hands. I may have to come back to this topic yet again. (I did in fact return to a deeper consideration of Dabrowski’s model in a sequence of posts focused on Jenny Wade’s theory of human consciousness: see embedded links.)

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My Parliament of Selves: Part 5/12 – The Séance in the Skull (a)

Image adapted from the Taschen edition of Renee Magritte

After my relatively recent preoccupation with dreams it seems appropriate to republish this sequence which is a fictional attempt to project my inscape into words. Dreams and day dreams feature quite a lot! 

After the milk van has gone, as I drift off again into sleep, I can feel a sense of their presence growing. As time passes it gets stronger and stronger, until I am back with them all once more, eager to implement our plan to hold a séance with Christopher Humfreeze, the seasoned meditator, under protest as our novice medium.

He’s looking very uneasy about the whole situation but knows it’s too late to back out now. Instead of sitting round the glass garden table, we have arranged ourselves on the garden chairs in a circle on the lawn.

Frederick Mires apparently lent Humfreeze a couple of books about mediumship, and he’s spent the nervous hours in-between thumbing through them hoping to prepare himself better for this moment.

‘I’m going to do it my own way,’ he blurts out before we even ask.

‘We never expected anything different, Chris,’ reassures William Wordless, in a rare moment of sympathy for him.

‘What do you need us to do, then?’ Mires enquires.

‘Join hands if you want and keep quiet,’ Humfreeze abruptly instructs.

We all know better than to argue at this point and do as he asks. The only break in the circle is where Humfreeze sits, hands resting in his lap and eyes closed.

It’s hard to judge what’s going on or what to do next. Emma Pancake catches Mires’s gaze and mouths, ‘Do we close our eyes or what?’

He shrugs in reply.

‘Let’s close our eyes for a few moments,’ I whisper, ‘and see what happens.’

After a minute or two, it becomes difficult to sit still and relaxed. I find myself constantly wondering whether to open my eyes or not, and, if I do, to work out what I should be looking for. The occasional nervous twitch in the hands I hold on either side suggests that I’m not the only one to feel this way.

Humfreeze says nothing and does even less, as far as we can tell.

After what felt like an eternity, Pancake cracks.

‘What’s happening? Anything?’

We all open our eyes. Humfreeze jerks out of his trance looking shocked and annoyed.

‘Don’t do that again!’ he barks. ‘We’ve wasted one attempt now. Only two more to go.’ You’d think he’d be pleased but he plainly isn’t.

‘Was anything happening?’ she probes, determined not to be put in the wrong.

‘I was pushing myself to go deeper but something kept holding me back. I’m not sure what.’

‘We need to try and work that out,’ Mires advises. ‘We need to know after each of these first two attempts what we think went wrong so we can do better next time. I’m wondering whether we were all fully behind this effort, or whether our doubts or impatience with the process were creating a block.’

‘Surely what we feel isn’t relevant. He can either do it or he can’t.’ There’s no sign of Pancake abandoning her defences just yet.

‘It’s not quite as simple as that, Emmie,’ Mires explains as patiently as he can.

‘How d’you mean, Fred?’ William Wordless asks. ‘I was really struggling there. For the first time in months I felt the words of a poem forming in my mind and tried to memorise them so I could write them down when we stopped. Could that have undermined what Chris was trying to do? Is that what you’re saying?’

‘Well, in a way, Bill, yes,’ Mires replies, aware that he is treading on potentially sensitive ground with all of us. ‘There’s a lot of evidence that this kind of process is very susceptible to subliminal influence.’ He sees that he had lost everyone but me, and starts again.

‘Basically, if we don’t focus, he can’t focus. Our energy helps him: our distraction distracts him. I could give you all the evidence but I don’t think you’ll want it!’

‘OK. We’ve got you. In the spirit of experimental enquiry – is that the right expression? – I’ll give it a go. It will be interesting to see if its works when we’re all pulling our weight, assuming we can that is.’ Behind the joking tone, we can all see that Pancake is deadly serious.

‘Are you all right to try again, Chris, or do you need a break?’ Mires asks.

‘No. I’m fine to give it another shot,’ Humfreeze replies, ‘but please, please keep focused. I can’t do this without you, and even then it’s doubtful.’ I wondered whether his doubt would also hold us back.

We all hold hands again except for Humfreeze, who closes his eyes and straightens his back, his hands folded on his lap.

After what seems another eternity his chair creaks. I open my eyes to see him leaning forward, staring into the middle distance.

‘Are you able to tell me what you see?’ I ask softly.

‘A young girl, little more than a child. She’s about ten years old, I guess.’

‘Can you ask her who she is?’

‘I’ll try.’ Raising his voice he asks, ‘Who are you?’

There follows a period of complete silence, an intent expression on his face, then Humfreeze sits back in his chair.

‘What did she say?’ I whisper. By this stage everyone’s eyes are open. You can hear a pin drop.

‘Quite a lot,’ our medium replies. ‘I can hear her speak, and she can read the questions in my head, so she answers them before I have to say a word out loud.’

I hear Pancake whisper, ‘Weird!’

‘She wanted to know how we knew she was here,’ Humfreeze continues, ‘I told her we didn’t – we just thought there might be someone. She wouldn’t tell me her name. I wondered why not and she replied that she doesn’t trust us. She doesn’t think we will understand. She was betrayed once and doesn’t want it to happen again. When I asked her what she meant by that, she went quiet and faded away.’

‘Betrayed! That’s a very strong word,’ exclaims Wordless, who should know as he’s a poet. ‘What on earth did she mean by that?’

‘That’s just a step too far, I think, for now. I don’t think we can even guess. We’ve made definite progress, though. That’s really encouraging.’ Myers sounds almost excited. ‘What we need to do now, if she’s vanished for the moment, is try to work out what this means and what we should do next.’

‘It’s got to have something to do with my history. Did she give any more clues? Was there anything in her appearance that might help?’ I search my memory for anything like such a significant betrayal.

‘That was all she said. I couldn’t see her completely clearly. She didn’t look like the photographs of your sister that you keep. She had dark hair and dark eyes. She was wearing a gown of some kind, but I couldn’t make it out properly.’

For some reason I couldn’t work out, the word ‘gown’ seemed to resonate.

‘Do you reckon we’ve gone as far as we can today?’ Wordless asks, clearly desperate to get the words of his poetic fragment down on paper.

‘I think we should blast on,’ Pancake urges.

‘I think that’s for Chris to decide,’ Mires temporised.

There was a short pause. Humfreeze seemed to be somewhere else.

‘I think she’s still here. I can sense her though I can’t see her anymore. I think we need to work out our next step and try again. She may not come back another time.’

‘I’ve been doing what I do with dreams and doing associations to the word gown,’ I chip in. ‘I may have a lead about what she meant. The first associations got me nowhere – it was all degrees and weddings – that kind of thing. Then a bizarre one came up: hospital.’

‘What have gowns got to do with hospitals?’ Wordless is as clueless on this front as he was about Ouija boards.

‘Surgeons wear them when operating. Patients under surgery wear special ones as well,’ Mires explained slightly wearily.

‘And that’s the connection with my past. When that association came up the light went on. You all must know about this. It’s been another blog theme. Before I was five in early 1948 I’d been operated on twice under chloroform.’

‘Yes, I remember, but you’ve worked that to death surely and come out the other side. How could that lead to a presence in your head when you’ve dealt with the left over emotional poison long ago?’ Mires was quite incredulous.

‘It’s not quite as simple as that,’ I sense a silent groan around me as I speak. ‘Just recently I was reading in my 1976 diary that, in my Transactional Analysis group at the time, I’d re-enacted the moment of my second surgery, when it took half-a-dozen ward staff to hold me down. I wrote that it left me sobbing in the absolute clarity of the insight. Even the words of the life-script I wrote in my diary the day before the re-enactment – ‘I’ve only myself to rely on’ –  are the very same ones that came like a bolt of light into my head in 1984 during the breathing meditation in Much Wenlock. OK, I can understand why I might not remember something that happened 40 years ago, even if it was important at the time. But to forget about something so significant in less than eight! Still, forget all about it was what I had done: I had no memory at all, not the faintest trace, that I’d used those words before. It came as a complete surprise.’

I knew I was labouring the point, but I could see the expression on their faces even before anyone else spoke.

(To be continued next Monday)

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Déjà Vu

In advance of my republishing My Parliament of Selves it seemed a good idea to do the same with this poem to help explain references to the hospital experience.

For source of image see link

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Making Sense of Mental Illness – a Bahá’í Perspective (1/3): Ian’s story

‘Reflection takes a collective form through consultation.’

(Paul Lample in Revelation and Social Reality – page 212)

One evening, towards the end of last month, I gave a talk at Birmingham University, concerning a Bahá’í perspective on making sense of mental illness as derived from my own clinical experience. Even though I had two hours at my disposal, I still had more planned than I had time to say. This was partly because some of the comments and questions sparked a lengthier diversion than I had intended. Anyway, I thought I’d publish everything I intended to say on this blog.

The quote at the top defines what processes this sequence of posts will be exploring in more depth in terms of their positive impact upon helping people find meaning in their experiences when they are struggling to cope with psychotic phenomena.

But before we home in on those we need a helicopter view of the overall context of the problems and processes we’ll be examining here.

Trauma, Transliminality and Psychosis

Previous posts on this blog have explored the possible relationship between the factors captured by this diagram. The focus though right now will be on trauma and psychosis.

Hearing voices and strange but strongly held beliefs are two key supposedly correlated signs we will be looking at today. Thought disorder and extreme withdrawal from contact with other people are also taken to be signs. I don’t propose to delve into the validity of the label all too frequently attached when more two or more of these come together in distressing form. For anyone interested, see Mary Boyle’s Schizophrenia: a scientific delusion for a clear exposition of the sceptical case against the idea these form a real syndrome.

For an understanding of the evidence for a relationship between psychotic phenomena and trauma see Longden and Read’s The Role of Social Adversity in the Etiology of Psychosis. They deal extensively with this problem (pages 7-8):

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.

Transliminality refers to the permeability of the filters surrounding our consciousness, whether that be from beneath (the brain’s subconscious) or above (some kind of transcendent level). Helpful analogies that illustrate the idea of such thresholds of access are our eye/brain system’s limited perception of light’s spectrum, a receiver such as a radio that only translates into intelligible sound the frequencies it is tuned into, or a transceiver such as a computer that can access and decode appropriate data stored in a cloud site as well on its own hard drive. Accessing outside those given ranges is taken to be impossible for the manmade devices. However whether the brain can access outside its normal range is a vex question. Good sources for evidence that this might be so can be found in Mario Beauregard’s The Spiritual Brain or in Irreducible Mind by the Kellys.

Ian’s Experiences of Psychosis

There are two people who were tormented by so-called psychotic phenomena from whom I learned a great deal more than they probably learned from me about what these are and how to deal with them. The lady in the poem above is one: Ian, whom I’ll consider in a moment, was another.

The lady had asked for help to deal with her childhood experiences of extreme abuse. Unlike with Ian, I do not have her permission to go into detail. However, what I can say to illustrate the depth of her problem is that the one-hour sessions dealing with her work on the abuse had to be divided into three roughly equal parts. The first part checked up on how things were going and that she wanted to continue the painful work. The second part looked at the abuse and her intensely painful memories of it, and the third part involved calming her down sufficiently after this to dispel the powerful and reactivated visual and auditory hallucinations of her father, the abuser.

I will look later in the sequence at one other indication of the painful and powerful hold the past abuse still had over her.

I can directly use Ian’s own words to convey the kinds of experiences he was grappling with. This is an extract from the transcript of a video interview which took place in late May 1993. Obviously P is me and I is Ian.

P. Could I ask you to describe at first how things were, say, a year ago before there was ever any question of our meeting and when things were not too good for you?

I.: Well, I’d got the voices nearly all the time. They used to wake me up at night, you know?

P.: Yeh. And can you say what kind of things they used to say, just as an example?

I.: `Get out of bed, you lazy bastard. Get up and wake up. Come flying with us. Go and jump in front of a train,’ you know?

P.: Right. And they were saying this to you constantly, were they?

I.: Constantly, yeh.

P.: Were they constant in the day?

I.: Yeh.

P.: Were they very loud?

I.: Yeh. They got loud when I was ill, you know, they got loud.

P.: Right. So, say last May, or last Spring, May, June, July, is this how it was with the voices . . .

I.: Yeh. They were pretty bad. They were loud, you know? They were right down in my ears. And – er – I was seeing things as well. I was seeing what I call the – the `Boss’, you know? He only come at night, yeh.

P.: Right. Where did you think these voices came from?

I.: The spirit world.

P.: So you thought they were ghosts of some kind, or . . .

I.: I thought they were spirits, come from the spirit world for me, you know? And that they wanted me to go with them. I didn’t think that I was going to hurt myself by killing myself, you see? But something inside me just wouldn’t let me do it, you know?

P.: Yeh. You held back?

I.: I think it was because I was afraid of hurting myself.

P.: Right. Because you did say at the time that unless you actually did it instantly it wouldn’t really count, would it?

I.: No.

P.: Right. So it was very important to you that you didn’t end up injured or in a worse state.

I.: Yeh. It was important not to get injured. It had to be a certain thing, you know? And the Express train looked the part.

P.: Right.

In an earlier exchange that month on audiotape, in response to my question as to whether his ‘experiences . . . were shutting [him] out from the world and shutting [him] out from the future,’ he replied, ‘Yeh. I was living in a dream world, you know.’ He also described it in the same interview as ‘brainwashing.’ He said:

They were so loud that I couldn’t hold a conversation, you know. And I couldn’t listen to the radio. They just blocked everything out. And I couldn’t think because they just sidetracked me, you know, saying the same thing over and over and over.

In an interview in September of the following year, he clarified further by saying that he no longer did what the voices told him to do, as he had in the beginning. He knew now they were not spirits but the products of his own head. Even so it was still hard work to keep them at bay.

In working with people experiencing psychotic phenomena, I found it important to distinguish the experience, with which I never sought to argue, from the explanation, which could be modified in helpful ways, for instance here in terms of the power of the voices. It is possible that this will lead, as in Ian’s case, to a recognition that the voices come from inside the person’s own head. This though is neither necessary nor inevitable. It is sufficient that a more benign explanation of the voices is arrived at that gives them far less power and, if possible, reduces any malignity.

Ian’s Life

For those interested in the full back ground to his psychotic experiences and how far back in his life traumatic events and situations began helping to shape his sensibility I have included at the end here a brief summary, which I helped him write, of his life up to the point I worked with him.  

By the time I was 14 months old my mother was dying of tuberculosis and I was failing to thrive. I was abandoned by my dad. My aunt rescued me and took me to live with her. She applied to the courts to adopt me. My dad, at the 11^th hour, began to contest this. The proceedings dragged on until I’d started school. My situation with my aunt was not secure until I was six years old.

When I was seven my grandfather died suddenly. I was extremely close to him.  The pain of that still haunts me.

When I was nine I was walking to school through a farmyard, when I saw the farmer hanging in his barn. Shortly after that, the voices started, but they were nice and friendly, and kept me company as I walked the hills near home.

I went down the mines as soon as I left school. I wasn’t happy with that and joined the army. Within the first couple of years a bullying sergeant major triggered a psychotic episode. The voices turned nasty. I heard the voice of the sergeant major mocking and insulting me all the time. I faked my way out the army hospital by denying I was hearing voices any longer.

The army didn’t know what to do with me. As they reckoned people with schizophrenia were antisocial, they decided a solitary job within the army would be the best thing for me. They came up with what they felt was the ideal solution: they’d train me to be a sniper. You spend long periods alone and when anyone comes along to disturb you, you kill them – a great idea in their view. There’d be none of that stressful social contact!

At least two incidents in which I was involved in the army left me with strong feelings of guilt. The pain of the deaths I caused, I know now,underlay the later experiences of psychosis.

I was discharged from the army after I was seriously injured walking towards a bomb. I did this deliberately. It was part of a pattern. From time to time I felt I didn’t deserve to live so I put myself in danger. If I lived I felt I was meant to live and maybe I deserved to do so. When the feeling built up again, as it kept on doing even in civvy street because the guilt about the deaths never left me, I’d play the same kind of Russian Roulette.

Once out of the army I used to do this by lying down on a railway line in the early hours of the morning. If no train came within a certain period of time, I reckoned I deserved to continue living.

After leaving the army my marriage broke up and I ended up living with someone with a serious drink problem. I held down three jobs, working all hours, in order to make ends meet and finance her habit. Eventually, I got completely exhausted and depressed. I couldn’t cope any longer and threw her out.

That didn’t finish it though. I was so convinced that she would die on the streets, I felt like I’d killed her. I became tortured by guilt. I shut himself away in my room with my dog. I survived on frozen chips for six weeks, until my boss became so concerned he got the police to break in. They found me completely psychotic, they say. I think I was determined to die this way. They sectioned me. That began an eight year history of sections, medications, with long and frequent admissions, until I felt that life had nothing to offer me.

At the end of this eight year period our work together began. At the end of the first phase, the May 1993 video interview took place.

We are now at a point to move onto examining how far we were able to help Ian make sense of his psychotic experiences in terms of his life history. More of that next time.

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Book Review: ‘Why We Sleep’ by Matthew Walker

I found myself staring outside my window earlier today, but not the same day that triggered my recent poem on the death of trees. I looked past the silver birch immediately outside, with most of its green or golden leaves in place, to the bare branches of the denuded sycamore, left with only a handful of its leaves on this cold but sunny November day. As I looked the words of the sonnet penned 400 years ago came floating into my mind:

That time of year thou mayst in me behold
When yellow leaves, or none, or few, do hang
Upon those boughs which shake against the cold,
Bare ruin’d choirs, where late the sweet birds sang.

Shakespeare, of course: sonnet 73.

That led me to Don Paterson’s reflections from his book on ‘Reading Shakespeare’s Sonnets: a new commentary.’ A later line of the sonnet reads: ‘Death’s second self, that seals up all in rest.’ Paterson observes (page 212) that ‘WS is referring to night, though Death’s brother has long been sleep, whom he’s also invoking indirectly.’ Inevitably, we go further yet. He adds, ‘Remember Macbeth’s Come seeling night,/Scarf up the tender eye of pitiful day.’ He reminds us that ‘seel’ is to ‘stitch the eyelids shut, as one would a hawk’s.’

The reference to Macbeth reminded me of the fascinating book that I had just finished reading: Why We Sleep by Matthew Walker.

He couldn’t resist wheeling out Macbeth either (page 108):

Ironically, most of the “new,” twenty-first-century discoveries regarding sleep were delightfully summarized in 1611 in Macbeth, act two, scene two, where Shakespeare prophetically states that sleep is “the chief nourisher in life’s feast.”

He argues that our industrialised society is chronically sleep deprived. And he harvests acres of evidence to prove (page 107) that sleep, amongst other things, ‘enhances memory,’ ‘makes [us] more creative,’ ‘protects from cancer and dementia,’ lowers our ‘risk of heart attacks and stroke,’ and leads to our feeling ‘happier, less depressed, and less anxious.’ We need to wake up to the danger we are in by not sleeping enough.

Three examples

Because I’m still a clinical psychologist at heart, to prove the value of the book I want to focus on his discussion of three problems: Autism, ‘Schizophrenia’ and Attention Deficit and Hyperactivity Disorder (ADHD). I have called them problems rather than illnesses or disorders because I am deeply sceptical, as I have explained elsewhere, about the value of such labeling.

But I can set aside such quibbling for now and focus on his demonstration of how much sleep can do to mitigate such problems and how much the lack of it makes them worse.

Autism

His link between autism and sleep abnormality is dramatically strong (page 82):

Autistic individuals show a 30 to 50 percent deficit in the amount of REM sleep they obtain relative to children without autism.

A word of explanation might be necessary here.

During waking hours, in terms of information, we are in reception mode, he argues. Non-rapid eye movement (NREM) sleep performs a kind of reflective function (page 52) and stores and strengthens the ‘raw ingredients of new facts and skills’ whereas rapid eye movement (REM) sleep (dreaming sleep) integrates the information, ‘interconnecting the raw ingredients with each other, with all past experiences, and, in doing so, building an ever more accurate model of how the world works.’

He accepts that this correlation does not prove that the sleep problem in humans is the cause of autism or vice versa. However, research using animals suggests that when infant rats are deprived of REM sleep ‘aberrant patterns of neural connectivity, or synaptogenesis’ occur in the brain, and the rats affected ‘go on to become socially withdrawn and isolated.’

He adds that, since ‘alcohol is one of the most powerful suppressors of REM sleep that we know of’ it can ‘inflict the same selective removal of REM sleep.’ ‘Vibrant electrical activity’ is the detectable sign of REM sleep. The infants (page 83) ‘of heavy-drinking mothers showed a 200 percent reduction in this measure of vibrant electrical activity relative to the infants born of non-alcohol-consuming mothers.’ However, even when pregnant mothers consumed only two glasses of wine (pages 83-84), it ‘significantly reduced the amount of time that the unborn babies spent in REM sleep, relative to the non-alcohol condition.’

While he acknowledges that for humans (page 85) ‘we do not yet fully understand what the long-term effects are of fetal or neonate REM sleep disruption, alcohol-triggered or otherwise,’ the abnormalities caused in adult animals is clear.

I also feel that the evidence adduced by Raine in his masterly book The Anatomy of Violence may be partly explicable in these terms, though Walker makes no reference to it. In this study of violent offenders, Raine finds that foetal alcohol exposure is very much a factor needing to be taken into account, and not just with violent offenders, the main focus of his book, as it has implications for cognitive functioning including memory as well as impulse control in general (pages 163-164):

Part of the reason for this is its effects upon the hippocampus. The hippocampus patrols the dangerous waters of emotion. It is critically important in associating a specific place with punishment – something that helps fear conditioning. Criminals have clear deficits in these areas. The hippocampus is also a key structure in the limbic circuit that regulates emotional behaviour . . .

This impairment then interacts with early experiences of attachment, and disruptions to attachment make the likelihood of later personality problems much higher. Sleep strongly impacts upon the functioning of the hippocampus as Walker explains (page 155):

The very latest work in this area has revealed that sleep deprivation even impacts the DNA and the learning-related genes in the brain cells of the hippocampus itself.

So, whatever the exact direction of causation, and regardless of what other factors may or may not be involved, REM sleep disruption and autism are undoubtedly linked.

‘Schizophrenia’:

Even though I worked in mental health over thirty years, until I read his book I never realised fully the important role of sleep in the problems I was looking at, even though I used to explain to lay audiences that psychosis, as it is termed, was a kind of waking dream, which, I used to say, meant that we all became psychotic at night, whether we remembered our dreams or not.

There is an additional twist to the role of NREM sleep here (page 89): ‘Of the many functions carried out by deep NREM sleep… it is that of synaptic pruning that features prominently during adolescence.’

He goes on to explain how important adequate sleep is for the adolescent brain, given that it is critically involved in determining what synapses (neuronal connections) are removed to mature the brain appropriately. Then he makes his key point early on in the book (page 92):

Individuals who developed schizophrenia had an abnormal pattern of brain maturation that was associated with synaptic pruning, especially in the frontal lobe regions where rational, logical thoughts are controlled – the inability to do so being a major symptom of schizophrenia. In a separate series of studies, we have also observed that in young individuals who are at a high risk of developing schizophrenia, and in teenagers and young adults with schizophrenia, there is a two- to three-fold reduction in deep NREM (non-rapid eye movement) sleep. . . . Faulty pruning of brain connections in schizophrenia caused by sleep abnormalities is now one of the most exciting areas of investigation in psychiatric illness.

He does not deal with this here except in terms of correlation. This therefore does not exclude the possibility that there are other causative elements at work.

Graph of the Model that states Psychosis is on a continuum with Normal Functioning (Source: The route to psychosis by Dr Emmanuelle Peters)

I am well aware, for example, of the strong evidence for the role of trauma in the development of so-called schizophrenia. His treatment of trauma is quite separate from his discussion of schizophrenia, as he is content to term it, and he relates the persistence of nightmares in the aftermath of trauma to the failure of the brain to suppress noradrenaline, a failure that keeps the terror alive. Normally the brain suppresses noradrenaline in sleep so that dream experiences do not create strong feelings of fear and the mind is desensitised to the terror by the calming dreams – a very different process from the NREM one he is describing here.

None the less, the correlation is significant and potentially valuable therapeutically. I would hope that future research is less diagnostically naïve and includes other potentially relevant factors in the mix.

Attention Deficit and Hyperactivity Disorder (ADHD)

His exposure of the way in which sleep deprivation is ignored as a fundamental factor in ADHD was music to my ears. He launches it by saying (page 314):

An added reason for making sleep a top priority in the education and lives of our children concerns the link between sleep deficiency and the epidemic of ADHD. … If you make a composite of the symptoms (unable to maintain focus and attention, deficient learning, behaviourally difficult, with mental health instability), and then strip away the label of ADHD, the symptoms are nearly identical to those caused by a lack of sleep.

The drugs we prescribe to treat it further prevent sleep.

He is not claiming there is no such thing as ADHD, simply that many people to whom the diagnosis has been attached are simply sleep deprived. The treatment makes it worse not better. He quotes the figures (page 316):

Based on recent surveys and clinical evaluations, we estimate that more than 50 percent of all children with an ADHD diagnosis actually have a sleep disorder, yet a small fraction know of their sleep condition and its ramifications.

And more than that. Because our society undervalues sleep (ibid.):

Well over 70 percent of parents [believe] their child gets enough sleep, when in reality, less than 25 percent of children aged 11 to 18 actually obtain the necessary amount.

He points to early starting times in schools as one of the culprits and late bedtimes as another. This blind spot in our culture is damaging lives, he argues. We have to change.

Dreams

I can’t resist a quick postscript on dreams. Oliver Burkeman, in a recent Guardian article, nails the difficulty I have with Walker’s reductionist approach, which he describes accurately: ‘recent work by researchers including Matthew Walker, author of the new book Why We Sleep, strongly suggests dreams are a kind of “overnight therapy”: in REM sleep, we get to reprocess emotionally trying experiences, but without the presence of the anxiety-inducing neurotransmitter noradrenaline. In experiments, people exposed to emotional images reacted much more calmly to seeing them again after a good night’s dreaming.

He rightly argues that Jung would not have agreed that this was all there was to it, and neither would I. He even provides a counteracting argument that retains the magic of dreams even while conceding they might be random:

So you wrote down a dream, then studied it, with or without a therapist, trying out different interpretations, and if one rang true – if it gave you goosebumps or triggered strong emotions – you pursued it further. What’s striking, you may have noticed, is that this approach would work even if Jung were wrong, and dreams were just random. If you treat them as potentially meaningful, retaining only those interpretations that really “click”, you’re going to end up with meaningful insights anyway. I’ve dabbled in this, and highly recommend it. To ask what your dreams might be trying to tell you is to ask deep and difficult questions you’d otherwise avoid – even if, in reality, they weren’t trying to tell you anything at all.

Walker’s disappointing take on dreams does not for me diminish one jot the fundamental importance of his book. Sleep really matters and he marshals convincing evidence to prove just how vital it is that we recognise this and act accordingly. It’s a compelling, accessible, credible and critically important read.

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Invisible Influences & Unintended Consequences (4/6): individuals and communities

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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Trauma, Psychosis and Transcendence (4/5): Karen’s Story

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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