Saturday, August 7, 2010
Welcome to Ultima Thule, Helsinki, 2005
Recently, I found out that the priest who married us ten years ago is Finland's only officially certified exorcist. I thought that was kinda cool. Sort of like having a bit part in a movie. I have a hard time taking exorcists seriously, which is a mistake, because he does, and the people who come to him for what he does do too.
As miraculous as modern medicine is, it hasn't found a cure for madness. When somebody's suffering and delusions cross the lines of what's socially acceptable, we have pills and psychotherapy and, in extreme cases, confinement. They can help people get over psychotic episodes and manage them, stop people from physically harming themselves or each other, and even restore enough of a semblance of order to let the troubled individual function in society more or less normally. We know a good bit about brain chemistry, neurotransmitters, symptoms, and what have you. This is valuable and important.
However, I don't think anybody really knows what 'schizophrenia' or 'bipolar disorder' or 'schizoaffective disorder' really is; where it comes from, or what "curing" it would actually mean.
Yet society functions as if we do. If someone thinks they're Jesus Christ, or that the CIA is spying on them through implants in their teeth, or the Vatican is funneling gas into their house that's turning them gay, we treat that as a medical problem. To be sure, and to add to the tragedy, mental health issues carry a far heavier stigma than serious somatic conditions, but they're still treated as fundamentally the same. If you don't tell a schizophrenic to take his meds and go see his doctor, you're considered morally delinquent just like you had refused to take someone with a broken bone to the emergency ward.
Spiritual traditions see those diagnostic codes through a different lens. Christian churches have their demons and possession and exorcisms and prayers. In the Buddhist psychological model—like the one in Vasubandhu, whom I'm still working on—these diagnostic codes make no sense. There is no such thing as a stable personality; there are only consciousness-streams with afflicted consciousness-moments that produce a great deal of acute suffering. If somebody is seeing angels and demons, the question of whether they're 'real' is pointless; they're real to whomever sees them, which is what matters.
Vasubandhu would try to guide the sufferer to cultivate antidotes to those afflicted consciousness-moments, to let go of them and go beyond them.
I don't know if Vasubandhu's approach can 'cure' schizophrenia, in the simple sense of the word. I'm inclined to think not. Rather, I would expect that a schizophrenic following Vasubandhu's treatment would end up still with his 'hallucinations' and 'delusions,' but with a deep awareness of their impermanence and emptiness, and some ability to not grasp at them, cling to them, add to them, and get lost in them.
Such a one would probably still have a great deal of trouble functioning in what we think of as 'normal society,' what with all those angels and demons floating around, and the way 'normal society' reacts to people who talk to angels and demons. In a different setting, he might end up a respected monk and even Dharma teacher, if talking to angels and demons is accepted as just a point of view or a talent, no different from the ability to compose deeply moving poetry.
Perhaps it's our society that needs a cure, not the madmen.
This puts modern-day Western Dharma teachers in a difficult position. Being Dharma teachers, they would be inclined to see 'mental health issues' as 'spiritual issues,' and prescribe 'treatments' accordingly. These 'treatments' are strongly at odds with what society says should be done. What's more, they can be dangerous—as Daniel Ingram describes in his book, intensive meditation practice can produce effects that match diagnostic criteria for a variety of psychiatric conditions in otherwise perfectly 'normal' people. For someone who has some of those symptoms to start with, this could get a lot more intense. At worst, I've no doubt that these "side-effects" could break a person entirely.
Should that happen, the consequences would be terrible, not only for the sufferer, but also for the teacher and the entire community. He would be seen as a monstrous cult leader driving his students to insanity while preventing them from seeking the mental health care they so obviously need; the Dharma teacher's spiritual tradition would also get a black mark that's difficult to erase.
What's more, I think that spiritual communities get more than their share of people with serious issues. If you have your regulation house, regulation Volvo, regulation Labrador, regulation spouse, and regulation 2.1 children, you're a lot less likely to notice that you're suffering enough to go questing after the Great Matter than someone who's really, really, acutely hurting.
What, then, should teachers and communities do? Somehow, I think that requiring a doctor's certificate of mental health before letting them in the zendo isn't the right answer. Should they tell them "Well sure, you can sit quietly in the zendo as long as you don't make a fuss, but we won't let you participate in retreats or sesshins, 'cuz you might go nuts?" Should they require them to take their meds in order to do that more intensive practice, even if the meds cloud their minds to the point that meditation becomes nearly impossible? Should they accept them on retreats, but provide special, individual guidance and try to put on the brakes as soon as things start to get crazy? What if they sincerely believe that the way out of the crazy is through the crazy?
I don't think the healthcare view and the spiritual view of 'mental health issues' are necessarily and irreconcilably at odds. As Ingram drily notes elsewhere, one of his highly enlightened friends finds it useful to take meds for his bipolar disorder.
I like to think that each of us is responsible for our own decisions and actions: to seek medical treatment, or a spiritual practice, or neither, or both. This thought becomes problematic once we have someone who isn't capable of making such decisions—such people clearly exist, but how do we recognize them, and how much responsibility should we assume for them? Different people will have different answers, and will draw the line in different places.
I wish I could end these thoughts with a nice conclusion that ties it all up with a neat ribbon on top, but I'm afraid I can't. This spiritual stuff is powerful medicine, and scary and even bad things will happen around it. I don't think it's possible to set our tolerance of such stuff to zero without entirely neutering the practice, and I think that communities who attempt this—and there are many—risk losing their very reason for being. Yet I can't help feeling that even one individual who breaks in a way that can't be fixed because he got the wrong guidance is one too many. It's a dilemma. One of many we have to live with.
There be dragons. Let's be careful out there.