Saturday, August 7, 2010

Mental Health and Spiritual Practice

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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.

9 comments:

  1. Would you accept a man to enter monastic spiritual training, who is soon 30, has just abandoned his newborn baby, family, social network and wealthy career; who is obsessed by intense search for cure for suffering?

    Or would you tell him first to solve his personal problems?

    Maybe you just turned down Siddhartha Gautama.

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  2. According to the bible, angels and demons exist, and it would not be that abnormal to see them. all people hear from them, all the time, as thoughts in our heads. most people aren't aware of this, but this is scriptural. the book of James says there is wisdom from above and wisdom from below ch 3. nt. it is not hallucinating to think you hear voices, therefore, it is actually normal. psychiatry is an atheistic worldview that denies this spiritual reality, and calls hearing voices or seeing angels or demons hallucinations. this is their mistake. it is denial of truth, certainly of biblical truth. christian have been slandered as mentally ill, i.e. schizophrenic and schizoaffective, for 50 years, by psychiatry. the second question a shrink asks is "do you hear voices" a christian who confesses to hearing God talk to them when they pray, is labeled psychotic. the psych hospitals are filled with christians who are not at all mentally ill. 90 % of the doctors are atheists. their training is the problem. they are trained to call these people psychotic. I had a court shrink say I was mentally ill just cos I said I believe in the bible. he was obviously an atheist. psychiatry is atheism masquerading as science. they claim mental illness is caused by chemical imbalances, but this is theory, not truth, and it is a lie to sell drugs, make money for big pharma and all the doctors who get kickbacks from the drug co's for making up diseases so they can treat them. the drs who write the DSM, the manual for mental illnesses, all get money from big pharma. it is all fraud. God had me write a prophetic book to expose the atheism behind psychiatry. it is free on my website, at 1prophetspeaks.com. It is called Manual for Transformational Healing-God's answer to psychiatry. someone had prophesied over me, at a church, 2 years before I wrote it, "I'm gonna use you to write a manual". WHen I was in a hospital, God said to me "i've made you a witness to all this." One of the purposes of the book is to expose the fact that the mental health system is totally unconstitutional. Because they label christians and others with spiritual experiences as mentally ill, they violate the first amendment for religious freedom. THis needs to be addressed by the president thru executive order, or congress, or the supreme court. there are other constitutional violations as well; such as the anti-slavery amendment. patients are used as unwilling guinea pigs for drugs; this is involuntary servitude, which is slavery. the drugs are torture, which constitutes cruel and unusual punishment. the drugs are toxic and deadly. many people die from them. they cause, not cure, mental illness. all drugs, including psych meds, caffeine, nicotine, alcohol, pot etc are openings for demonic oppression. the bible's answer to mental illness is to pray in jesus' name to rebuke the demons. the same as exorcism. it is also called deliverance, and it works. the cure to mental illness is faith in christ and prayer. see my book. prophetess D

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  3. About your view on Vasubandhus way for "curing" schizophrenia.

    I too agree that it would be a waste of time for a psychotic person to try to silence the voices through means of meditation and get cured. Considering zazen this brings up the problem of wanting something else that is just now. I think in theory such a person could come in terms with the hallucionations as a product of ones imagination. In real life a psychotic person usually has a hard time eaven staying peacefully put. How then to observe your mental states, in at least, in the sitting form?

    There are few blogs (http://theicarusproject.net/spirit-mysticism/on-zen-practice-and-schizophrenia) by zennists/meditation practitioners who are affected by schizophrenia and schizhoaffective disorder. They all have sought out conventional cures first (medication/therapy) and through that obtained a certain kind of balance in their illness to be able to practise meditation. They also have accepted these hallucinations as a part of who they are and stopped fighting with them.

    There are also many, many zennist affected by clinical depression, actually me included. I feel that in an acute case of clinicial depression it is not wise to practice zazen so much. Too much practise can aggrivate the condition more(see: http://www.pbs.org/thebuddha/blog/2010/jun/3/suffering-zen-susan-moon/).
    I have treated my illness through conventional means (mediacation/therapy)and sought out the balance to do zazen and go to long sesshins, actually with less problems (so far) than I hear people usually might have. But I'm also aware that intensive meditation could make me feel worse and I can not know what might happen in a sesshin. I consciously take this risk every time I go to a sesshin. To me zazen shows have I managed keeping myself "walking the line" so to speak. I love doing zazen and I know if I don't keep my shit together there is not much practise. So actually my practise motivates me to live a balanced life listening to myself and my inner intuition of what is good for me and what is not. Zazen has helped mee to see my affectieve problems as just a fleeting interpretation of the reality. Though at the same time I ask myself what is going on in my life that might cause this? If I figure it out I'll get to business trying to develop a more balanced situation in life. I didn't develop all this doing just zazen. It took time, courage, therapy, pharmacology and knowledge of psychology to do so. Through zazen I accepted that a depressive person is affected by his sickness and suffers, this is totally natural and ok, but still a sick person tries to get better. That's the common sence wisdom.

    It takes all this to practise with depression, which is not nearly as bad as psychosis, so can you imagine what it takes to practise with psychosis?

    If one want's to combine mental illness and zazen you need to know alot from different fields of expertiece. Zen communities can not offer such a know how and they don't have the recources to handle practitioners with mental illnesess just by them selves. In my time when I started showing signs of sickness during zazen the symptoms were recognized and I was encouraged to seek cure trough therapy and such. It takes a lot of interdisclipinary knowledge for a Zen teacher eaven to do that.

    I feel zazen can offer a way for a person to see to the absoulute reality, nothing much else.

    I also feel that many people confuse the ego delusion a buddhist tries to get rid of with the ego personality which everybody has as long as we are human beings. Many practitioners struggle to kill of their own pesonality which they feel is some how wrong and dirty (might a shrink have a field trip with such a person!). Zen theory's language should get rid of the term ego delusion and start using a term like dualism delusion. Who eaven coined the english term ego delusion?

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  4. I would like to ask Zeniainen: A person want's to become a Zen teachers student really badly but the teacher rejects him. The wannabe student goes and cuts off his hand and offers it to the teacher. Would you see this as a sign of true zeal and aspiration for the Way, or would you say :"Hey man, this is not cool"?

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  5. @Teemu: I think what you say about consciously taking risks is a key point.

    If I decide to take up scuba diving or downhill skiing, I can find out pretty easily what the risks are – how many people have accidents requiring hospitalization, how many permanent injuries, how many deaths. I haven't found this type of information about intensive meditation practices. Instead, the discussion revolves around individual stories of either success (usually) or failure (sometimes), or theoretical discussions about what, or who, it's good for, or not. This makes informed decisions about the risks rather more complicated.

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  6. There is a thesis on extreme mental states among western buddhist students and teachers. I'll post it to you if I find it. I had it on my hard drive but I can't find it just now.

    There are also case studies on meditation induced psychosis. I'd think that it was ca. 90% of cases that had a prior history of mental illness of some sort who went and had a mental breakedown during intence meditation.

    But getting this info is up to one self. It is not given when one starts meditating. I don't think a scuba diver is given exact statistics of casualities when he/she partakes a diving course(which is usually mandatory).

    People are usually quite upset after finding out about this side of meditation. It shatters the illusion on meditations cure-it-all-we're-only-happy-and-getting-happier-and-more-balanced-the-more-we-do-it public image.

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  7. No, I don't think beginning scuba divers do get that kind of information handed out to them—although the cost of the insurance they'll (probably) have to take out is a bit of a clue.

    Then again, scuba diving and downhill skiing are activities that we're more or less familiar with; we understand that there's a risk of drowning or breaking your neck. We're less familiar with intensive meditation, and it probably doesn't even occur to most people that there is a real, if (I believe) relatively small risk of it messing you up.

    All the rainbows-and-unicorns-and-cotton-candy New Age fluff we get from the media isn't exactly helping, either.

    I dunno. Since I've never been on a sesshin, I don't know what the process is to get accepted on one. Perhaps making sure that you have *some* idea of what you're getting into should be a part of that process… or, perhaps, by the time you get to that point, you'll already have absorbed some of that knowledge on your own anyway.

    And thanks, if you can find that thesis, I'd appreciate it.

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  8. Here it is: Buddhist teachers' experience with extreme mental states in western meditators by Dr. Lois VenderKooi, PsyD. http://www.drloisvanderkooi.com/article

    Worthy reading for those interested in such things.

    Teachers she interviewed told that psychosis occurs in less than 1% of meditators. About other conditions which are more prevalent in general population I don't know. What I know of about 3% of the general population in Finland has psychosis in some part of their life. Depression varies from 5-20% of the population (5-8% are diagnozed, 20 is an estimate of the true extent).

    All responsible meditation schools have an applicaton form one has to fill in order to enter a retreat of a sort which usually asks questions about one's mental health in order to assess risks included.

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  9. Much appreciated. Those numbers are lower than I would have expected. A lot depends on the definitions, of course. Thanks!

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