disorder or spiritual misery?
experienced extreme madness have later appreciated the spiritual
insights of their distress. We should do more to acknowledge this,
argue Phil Barker and Poppy Buchanan-Barker in their
edited book Spirituality and Mental Health.
ourselves to a life of suffering
It may be a truism to say that life is suffering: we are required
to undergo, experience or be subjected to various pains, losses,
defeats, grief and - in particular - change. However, humankind
still struggles to employ its ingenuity to clear the world of all
suffering. This struggle for emotional and psychological comfort
is set against the blackest backdrop, as many of the world's peoples
still struggle to gain daily access to clean water, and vast numbers
live on the edges of the precipices of war, famine and pestilence.
Even as Western scientists claim to have unravelled the mystery
of human life - to be on the brink of a 'theory of everything' -
those ancient bogeys, the Four Horsemen of the Apocalypse, still
ride roughshod over much of the earth.
we prepared the final draft of this book, the media was ablaze with
the story that the Raelian 'cult' had stolen a march on the world's
top scientists by cloning the first human child. It would have been
bad enough if the perpetrators of what many saw as the 'reckless
abandonment of the rigour of science' had been mere rogue biologists,
focused perhaps on making money from the emergent cloning technology.
The possibility, however, that science might have been overtaken
by someone in the pay of an 'extremist cult' caused much pompous
posturing about the near-sanctity of science, and the need for control
over the use of science's progeny, technology.
Perhaps this great brouhaha betrayed the deep nature of our shared
anxieties concerning fiddling with the life force. If the evidence
for cloning is examined carefully, the possibility of reproducing
exact replicas of any species, far less replicas of our dead pets
or children, is as far off as ever. The dream of pop genetics doesn't
quite match the reality.
effect, the Raelians trumped the excessive optimism of the whole
human genome mapping programme with their highly public, unsubstantiated
claims about cloning. They knew how to seduce a media hungry for
more evidence of humankind's capacity to match, if not triumph over,
the forces of nature. Indeed, our hunger for improving our lot,
or at least the lot of those with the money to pay, is one of the
hallmarks of the age. In the context of the spiritual life - whether
Taoist or Christian, Muslim or New Age - this hunger is insatiable.
The more we try to feed it, the hungrier it becomes.
the other great deception of our post-modern age is the much-vaunted
notion of self-help, which has much in common with the human building
and repairing programme dreamed of by the biotechnologists. When
the Scotsman Samuel Smiles first promoted the idea of self-improvement
more than a hundred years ago, he would never have dreamed that
it would grow into one of the juggernauts of the New Age. Ironically,
Smiles believed that:
wisdom is only to be learned in the school of experience. Precepts
and instruction are useful so far as they go, but, without the discipline
of real life, they remain of the nature of theory only.
the self-help book is the short cut to the search for fulfilment,
growth and personal development that was anathema to Smiles, who
saw, in all the 'great men' of his day, the virtuous evidence of
thrift, duty and character. Although Smiles did not suggest that
it was necessary to suffer to grow as a person, he recognized the
value of failure and hardship as setting conditions for negotiating
change. Today's self-help movement has other ideas.
his ironic novel, the Canadian writer Will Ferguson (2002) poked
fun at the self-help book and the publishing industry that feeds
from it. In Happiness, his fictional publisher launches the
self-help book to end all self-help books. When published, calamity
ensues because Happiness - unlike all other self-help books
- actually delivers on its promises. As readers lose weight, stop
smoking, enjoy otherworldly sex and discover True Happiness, chaos
overtakes America, which experiences an 'apocalyptic plague of happiness',
collapsing the economy in a benign pile of self-satisfaction. Only
a comic novel - or an allegory for the hunger pangs of the New Age
ambitions of medical technology and the fast-feeding side of the
self-help movement raise questions about the value of suffering.
The traditional belief that suffering might be beneficial, at least
in small doses, has largely been overtaken by the assumption that
pain of any kind is to be tranquillized, anaesthetized or avoided
altogether. The original Latin root suggests that suffering involves
the 'bearing' of something arduous. Not surprisingly, we talk of
people of upright or stoical bearing and, especially in the Christian
tradition, associate bearing with the cross: a symbol, perhaps,
for all humankind's suffering. These linguistic roots are also to
be found in the concept of the 'patient',1 who is required to tolerate,
endure or suffer, physically, mentally or both. However, with the
rise of various psychiatric 'survivor' and 'consumer' movements
around the world, people who have been required to endure 'mental
illness' and treatment for their 'illness', have distanced themselves
from the traditional labels of medicine. Consequently, the concept
of patient-hood has acquired pejorative associations. The possible
significance of psychic suffering has been obscured by a barrage
of alternative, often politically correct euphemisms.2
our vain ambitions to avoid suffering, or at least not to name it
as such, merely generate more suffering. Although we take no pleasure
in pain - whether physical or emotional - we recognize, at least
in the light of our own experience, that lessons can be learned.
Experience - especially when facilitated by Mistress Unreason -
can be a harsh teacher.
fear, losing and loathing
Psychic suffering takes many forms, especially when we talk of psychological
problems, mental illness or plain old-fashioned madness. Threaded
through much human distress is the ancient and pervasive spectre
of fear. Meditating on the grief he felt after his wife's death
CS Lewis (1961) observed:
one ever told me that grief felt so like fear. I am not afraid,
but the sensation is like being afraid. The same fluttering in the
stomach, the same restlessness, the yawning. I keep on swallowing.
experience of loss reminds us that the final threat we face is our
ultimate aloneness. In The Rime of the Ancient Mariner, Coleridge
offered a metaphor for humankind's blind rejection of everything
that lies beyond our existing knowledge. Anything not already part
of our received wisdom is to be feared and, if possible, controlled.
By killing the albatross, the mariner was forced to face the emptiness
of his isolated existence:
alone, all, all alone,
Alone on a wide wide sea!
And never a saint took pity on
My soul in agony.
with time, and the wisdom of hindsight, does the now ancient mariner
come to understand the meaning of his once bloody act:
prayeth well, who loveth well
Both man and bird and beast.
He prayeth best, who loveth best
All things both great and small.
poetry and philosophical writing was shot through with self-doubt
and a metaphysical anxiety that anticipated modern existentialism.
Although hardly a spiritual text, Coleridge's poem carries some
important messages about experience, fear, responsibility and humankind's
almost insignificant scale on the wider canvas of existence.
what are we most afraid of knowing? Although we learn about death,
often from an early age, the experience of our own mortality can
be quite different. The recognition that, ultimately, we are insignificant,
at least in the wider sphere of things, if not in the cosmic sense,
is a terrifying insight. If we are only 'here' for such a short
time - cosmically speaking - what is the point? Indeed, physicists
often argue that because the universe is finite, and ultimately
will self-destruct, there is no point to our existence. Although
this is not going to happen tomorrow, even in cosmological terms,
such a scientific insight sends many people scurrying in search
of 'other worldly salvation', perhaps even like the Raelians, in
the prospect of rescuers from a parallel universe.
those of us who settle for life on earth, many spend our lives trying
to find ourselves in others, seeking shelter in their shade, only
- like Lewis - to risk losing that shelter, revealing, violently,
the scale of our aloneness. Although the pain of such suffering
is necessary, it may not be the endpoint of suffering. It may only
be a staging post. Our suffering - whether of the grief of melancholy
or the grief of loss - may only be signalling the way to an even
more significant destination. As the Buddha suggested (Goddard,
ye lamps unto yourselves.
Be your own reliance.
Hold to the truth within yourselves
As to the only lamp.
what is this 'truth' for which we search? And how do we know that
we are on the right path, however brightly lit? Why do we find the
experience of loss - whether of our kith and kin, or simply 'loss
of control' - so loathsome?
reader will not be surprised to hear that we believe this to be
a function of the spiritual vacuum of contemporary life. Once our
losses were borne (suffered/endured) with some serenity - whether
we were peasants or kings. This may not have helped to promote health,
since health is never a function of any one specific aspect of our
lives, but, for at least the past 20 years, we have recognized the
dangers of this 'spiritual vacuum' for healthcare. At the Assembly
of the World Health Organization in 1983, Al-Awadi (1983) appealed
for a wider appreciation of the role of the spiritual in the construction
of health: "material progress in the present world has reached
levels unprecedented in past history or civilisation. Yet we find
that what prevails in this world are anxiety and apprehension, so
much so that one could say that the distinguishing feature of this
age is a sense of loss and uncertainty. We have stripped man, over
the last decades, of his spiritual values, and materialism is now
in full control of all aspects of our life to the extent that man
feels lost and restless, desperately seeking tranquillity and peace
of mind ... I am quite certain that regardless of what we do to
provide health care for the body and the mind, man shall remain
lost and restless until we provide for the spiritual aspects of
the call to spiritual re-armament is no recent phenomenon.
and the soul
At least in principle, psychiatry sought to study the soul, although
many of those who cast themselves as 'psychiatric survivors' might
be forgiven for laughing aloud at this historical relic (Newnes
et al., 2000). The Hellenistic personification of the soul (psyche)
was sometimes represented visually as a butterfly, evoking its fragility,
beauty and movement; and most English dictionaries acknowledge that
psyche means soul and spirit first, with mind a latter day understanding.
This betrays the original Greek root psukhé, which meant
breath, life and soul. Regrettably, the soul has fallen through
the floor of mainstream psychiatry, although a tiny number of psychiatrists
are trying to reinstate this ancient focus (Culliford, 2002).
The psychotherapeutic arm of psychiatry has followed, perhaps unwittingly,
the path recommended by the Buddha and Socrates, who both suggested
the power of 'looking within', examining life as a way of finding
meaning. Indeed, understanding of life and our part of it, and in
it, may be both the beginning and end of the spiritual journey that
often begins in psychotherapy, but cannot be completed in such an
ultimately mundane activity.
the traditional therapeutic processes seem able only to offer transitory
relief from the emptiness and alienation felt by people caught up
in the spiritual crisis, which is embedded in certain forms of madness.
As Karasu (1999) observed, they are so limited because, in general,
mainstream forms of psychotherapy (and psychiatric treatment) address
individual pathology rather than the wider aspects of human being.
person who is caught in the spiral of madness is trying, desperately,
to return to wholeness - feeling as if they are threatened with
complete disintegration. For many, this begins with self-realization
and the search for meaning, exploring as LeShan (1999) has observed,
the states of being that appear to use the most of themselves. Traditional
psychiatry and psychotherapy use, instead, a historical-pathological
approach, trying to establish how the person 'became' like this.
We should, perhaps, be exploring what this whole process of collapse
and disintegration might be about, and especially what might be
its hidden meanings, if not what the person might be trying to accomplish
within the spiritual crisis.
pursuit of such unashamedly 'spiritual' aims, therapists need to
move themselves from believing in 'fixing' psychopathology, towards
believing in the person's capacity for transformation. In Karasu's
view, the subject of therapy is not a patient or a client (far less
a 'user' or 'consumer') but 'an uninitiated human being' (Karasu,
1999). Rather than employing specific 'techniques' of therapy, therapists
must be open to whatever works, especially 'being with the other',
which targets the spiritual centre. Karasu is - arguably - the leading
voice for the spiritual transformation of psychotherapy to have
emerged from mainstream psychiatry.
By emphasizing his belief that what really matters is not the particular
school of psychotherapy, but the openness, humility and even ignorance
of the therapist, Karasu (2001) has challenged the traditional professional
empire of psychotherapy and psychiatry. In his most recent work,
Karasu (2003) has acknowledged that material possessions, success,
power and pleasure often fail to fill the void that lies at the
heart of our lives. Getting married and divorced, taking drugs and
engaging in other 'high-risk' activities may result in a temporary
abatement of our spiritual unease. For many, the life of a 'spiritual
tourist' (Brown, 1998) may offer some reassurance but, ultimately,
the hollow feeling that 'something is missing' returns. As far as
Karasu is concerned, we have no option but to begin to explore the
deepest yearnings of our heart. Especially in the West, our greatest
yearning may be for 'happiness' (Pepper, 1992; Whiteside, 2001),
but as Karasu notes, there is no end to the journey to 'real happiness'.
Indeed, there is not even a good place to start. Karasu urges us
to start here, where we are, to begin the journey NOW! This echoes
the traditional Tibetan Buddhist emphasis on embracing rather than
denying the painful aspects of our lives (Chödrön, 1994).
The fear of loss - especially of our 'sanity' and selfhood - may
lie at the very heart of the spiritual vacuum of our lives, and
may even deter us from taking that first, necessary step into the
and mental health
If we forget about the centuries-long association between madness
and demonic possession, spirituality and mental health have enjoyed
only brief flirtations. Only time will tell whether this will turn
into a meaningful relationship. The reference to demons reminds
us that religion represents a special class of spiritual experience.
Especially within the Christian tradition, evil spirits have been
represented as a virtual plague on the houses of people who came
to be classed as 'mentally ill'. Oftentimes the person so 'possessed'
was seen as deserving of such a hellish intrusion. Sinful ways and
a general wandering from the path of righteousness brought people
into contact with the demon, who clutched at their very soul. This
tradition offers, however, only a limited frame of reference for
what we understand as 'the spiritual'. Clearly, there is a difference
between religion and spirituality, if only because some practitioners
of religion, and the bureaucracy of the faith they profess, often
appear bereft of any spiritual quality. History suggests that religion
often becomes merely a crutch for living with worldly trials and
tribulations, or a lever for manipulating adherence to rules and
conventions, which are transparently social or cultural. The location
of the Godhead in our lives, and humankind's meaningful place in
the wider, cosmic reading of our relationship to the Spiritual Other,
are often religiously indistinct. More often it is obscured by the
internecine disputes that have ravaged most organized religions.
the world of spirituality fare any better? Does 'spirituality' offer
a clear, less ambiguous message as to what it might all be, ultimately,
about? To be concrete for a moment, all readers will be 'believers',
either in one religion or faith system or another (or perhaps several),
or they will be agnostics, atheists or 'rationalists' - their core
belief is in being an 'unbeliever'. However, they will all believe
in something, if only that the universe is ultimately meaningless
and that we are simply adding personal and social footnotes to Darwinian
evolution. The 'spiritually inclined' among us are drawn from both
of these faith camps. Some of the seekers, those who have tired
of traditional faith systems' inability to deliver whatever it is
they were looking for, may be drawn to the world of 'spirituality'.
A similar trek may be made out of the land of reason, by those who
- having rejected all religious thought - are still asking: 'Surely
there must be more to it than this?' Will these seekers find what
they are looking for? What exactly are they looking for? Eternal
life or salvation? Forgiveness for a misspent life or a return to
the comfort of the Father (or Mother) of all Creation?
yearning for a sense of the sacred, especially when pursued avidly
by affluent Westerners, can often appear foolhardy. Mick Brown (1998)
illustrated vividly how the spiritual quest had become a leitmotif
of 20th-century life. The 'road less travelled' by the spiritual
tourist encompasses the holy and the lost, the wise and the foolish,
all journeying inwards in search of illumination.
lemming-like rush for such illumination was captured by Rachel Storm
(1991) in her excellent exposé of the history and development
of the New Age. While much of the spiritual yearning that she uncovered
seemed pathetic, if not adolescent, she recognized that the wisdom
people sought might well be 'out there'. 'Where' they might find
it, was never clarified. She concluded with a pithy quotation from
a Rajneesh sannyasin: "The danger of the New Age is that amidst
all the spiritual slogans that sound like truth there are actually
a few pearls of wisdom. But for that one real mystic rose there
are ninety-nine plastic look-alikes that cost less, last longer
and promise instant enlightenment."
real pilgrimage to truth takes guts, integrity and putting your
whole life at stake - the New Age variety takes Visa, Mastercard
and putting aside three minutes a day chanting under a pyramid tepee
for lower interest rates. All in all ... people aren't actually
interested in the 'real' ...
Storm (1991: 207)
(2002: 251) cited research that suggested that a survey of 200 London
psychiatrists found that 90% viewed religious beliefs as relevant
to patient mental health 'to be considered during assessment and
also noted the 'official advice' of the Royal College of Psychiatrists
(2000: 41), that: "Good practice in general adult psychiatry
will include: taking a direct care role which involves assessment
of mental health problems ... and being cognisant of the spiritual
and cultural needs of patients and their carers ... understanding
and referring appropriately in respect of social, spiritual or cultural
leadership is obviously welcome, although many 'survivors' might
question how such cognisance of their spiritual needs is translated
into action. Many users of 'mental health' services have described
abysmal standards of care, especially in psychiatric units in London,
where even respect and dignity appeared to receive little attention,
far less the cognisance of, and response to, spiritual needs (e.g.
Rose, 2000). We would not expect established authorities like the
Royal College of Psychiatrists - or their international equivalents
- to deny the perceived importance of the spiritual impulse. Changing
the psychiatric method to express respect for its actual importance
may well be another thing. Perhaps, however, we need to clarify
what is meant by 'mental health' before we can explore how the spiritual
might be addressed.
health and meaning
In Australia, the Queensland Health Authority defined mental health
as: "A dynamic process in which a person's physical, cognitive,
affective, behavioural and social dimensions interact functionally
with one another and with the environment." In the USA the
Surgeon General (US Department of Health and Human Services, 1999)
defined it as referring to: "... the successful performance
of mental function, resulting in productive activities, fulfilling
relationships with other people, and the ability to adapt to change
and cope with adversity."
definitions betray an emphasis on function and efficacy, making
it clear that anyone who is not productively engaged, or who experiences
unfulfilling relationships or even the occasional flutter of disquiet
in the face of everyday challenges, is not mentally healthy. As
with all such bureaucratic definitions of health and wellbeing,
one is left wondering who does fit these stringent criteria.
thing is clear even if we found it difficult to classify a person
with a discrete mental illness, it would not be difficult to define
that individual as mentally unhealthy. The future of 'mental health
services' seems, therefore, to be safely assured, whatever they
actually do by way of promoting and enabling 'mental health' in
because of the problems of adequately defining mental health, the
past decade has witnessed a switch of emphasis to the facilitation
of recovery, which Anthony (1993) defined as: "... a deeply
personal, unique process of changing one's attitudes, values, feelings,
goals, skills and/or roles. It is a way of living a satisfying,
hopeful, and contributing life even with limitations caused by the
illness. Recovery involves the development of new meaning and purpose
in one's life as one grows beyond the catastrophic effects of mental
emphasis on growing through and beyond the experience of distress,
and especially the focus on meaning, seems to redefine the mental
health agenda, bringing it closer to a consideration of the 'point'
of a person's life. Such a point might involve not only questing
for meaning in life, but also - as Frankl (2000) has argued - begging
the 'question whether any such meaning exists at all'. Certainly,
this meaningful emphasis - from the writings of people like Patrica
Deegan (1996) in the USA, to Julie Leibrich in New Zealand - shifts
our focus beyond the internal functioning alluded to in most bureaucratic
definitions of mental health, to an appreciation of the almost ineffable,
emergent story of the person's life (Leibrich, 1999).
Leibrich, meaning is always there - in the story of our lives -
whether we are aware of it or not. The journey of recovery may be
no more than the long walk to recognition of that meaning. For us,
the journey is often taken on uncharted seas, invoking the dangers
of the deep as well as of distance (Barker, 2002). Leibrich (1999)
sees the story as a gift, even when it involves the pain of madness:
"The act of telling stories can restore people ('re-store').
The telling of our story to someone who is genuinely interested
and who relates to the telling through their own experiences is
a very precious thing (p. 5)."
a very real sense the story makes its own journey in search of greater
understanding, which can be found in the true listener. This explains
in some way why people 'talk to God' and often claim to have been
'heard' (O'Brien, 1964).
appreciation for the story-journey is illustrated by reference to
Janet Frame: "But if a story is told and not understood, then
a part of oneself has reached out into nothingness. They died because
the words they had spoken Returned always homeless to them3. Some
people even say when you lose your story, you lose yourself (p.
sense of communication is echoed in most commonly accepted definitions
of spirituality, which is often understood to involve some kind
of a partnership with one's Higher Power or Godhead, with Nature
or with the Absolute. As Culliford (2002) noted, spirituality can
provide hope and solace during the person's crisis or experience
of illness. Individually, this might take the form of a sense of
peace and, within group settings, a sense of understanding and social
often projected as being 'unworldly', the engagement with the spiritual
life is a highly practical and grounded activity. Evelyn Underhill
(1937) reminded us that: "Our favourite distinction between
the spiritual life and practical life is false. We cannot divide
them ... For a spiritual life is simply a life in which all that
we do comes from the centre, where we are anchored in God: a life
soaked through and through by a sense of His reality and claim,
and self-given to the great movement of His will."
that sense, spirituality is more of an essential than a luxury,
where people eventually realize that they have no choice but to
be on the spiritual path: "It was what people kept telling
me. I felt as I always did at such times, stranded between reason
and a craving for faith, uncomfortable in the knowledge that while
a spiritual belief may lead you to believe in anything, a materialist
outlook on life will lead you to believe nothing." (Brown,
The Celtic perspective
However, talking about spirituality, other than in vague terms,
is well nigh impossible. We fumble with metaphors, attempting to
evoke an appreciation of the experience, which lies beyond words.
As St Augustine said: 'If you don't ask me, I know; if you ask me,
I don't know!' (Montgomery, 1910). We all have a sense of what we
mean by the word but have a hard time clearly defining it. We attempt
to answer this question with our heads while spirituality is primarily
a matter of our hearts. For us, spirituality is a question without
an answer: something we look for but do not actually expect to find.
As we try to live our lives in pursuit of a higher understanding
of ourselves, God and the Universe, we examine all that we know
of what is inside and outside of ourselves.
In the Celtic tradition of spirituality, the journey we take towards
understanding always leads home. John O'Donohue (1997) reminds us
that, although we are often told that the spiritual journey involves
a sequence of stages, this is an illusion: "When time is reduced
to linear progress it is emptied of presence. Meister Eckhart ...
says that there is no such thing as a spiritual journey ... if there
were a spiritual journey, it would be only a quarter-inch long,
though many miles deep. It would be a swerve into rhythm with your
deeper nature and presence ... You do not need to go away outside
your self to come into real conversation with your soul and the
mysteries of your spiritual world. The eternal is at home - within
you" (p. 120, emphasis added).
being at the other side of the world, Julie Leibrich found a similar
understanding: "It is a kind of coming home. For me, the meaning
of spirituality is meaning itself (Leibrich, 2001)."
experience may well be signalling an important 'change of heart'
in the whole field of spirituality and mental health: "My definition
of mental health has a lot in common with the way I define spirituality.
Both concepts are concerned with the experience of self. One reaching
into dimensions of space to discover self, the other realising the
freedom that comes from accepting self. That is why spiritual experiences
and their interpretation can have such a profound influence on mental
appreciation that there might be something 'in' the space of her
Self that might ultimately be of great value echoes an ancient story
told by John O'Donohue (1997).
As a mark of respect, an old man brought melons every day to his
king who, not wanting to insult the man, accepted them graciously,
then tossed them into his back garden. One evening, just as the
old man was about to hand over the melon, a monkey jumped down and
knocked the melon from his hand, shattering it on the ground, sending
a shower of diamonds from its heart. When the king went into his
garden, he found that all the other melons had melted away, leaving
a hillock of precious jewels.
notes: "The moral of this story is that sometimes in awkward
situations, in problems or in difficulties, all that is awkward
is the disguise. Very often at the heart of the difficulty, there
is the light of a great jewel. It is wise to embrace with hospitality
that which is awkward and difficult." (p. 197).
people who have been in states of extreme madness have come to appreciate
the disguise of their distress and the great insights that lie nestled
in its heart (Barker et al., 1999).
Short or long, deep or shallow, the spiritual trek is taken alone.
Yet, the individual occupies a curious and critical place in the
whole process of being and becoming. Clearly, we all face suffering
alone, even when that is inflicted on the group, if not a whole
people, as in 'ethnic cleansing' (Frankl, 2000). All experience
is individual, but suffering often hammers home the isolated nature
of the endurance of reality. Perhaps because the success of society
is so dependent on aggregating human experience, normalizing it,
those who seek individual paths of self-discovery are destined to
come into conflict with 'social truths', which derive from statistical
representations of 'normality'.
and psychiatry represent grand narratives of what it means to be
human. These are expressed as various theories of the human condition.
They cancel out individual experience in favour of rules that appear
to apply to the majority. Ironically, these general theories apply
to no one in particular. As Jung (1961) observed: " Any theory
formulates an ideal average which abolishes all exceptions at either
end of the scale and replaces them by an abstract mean. This mean
is quite valid, though it need not necessarily occur in reality
... If I determine the weight of each stone in a bed of pebbles
and get an average weight of 145 grams, this tells me very little
about the real nature of pebbles ... This is particularly true of
theories which are based on statistics. The distinctive thing about
real facts, however, is their individuality. Not to put too fine
a point on it, one could say that the real picture consists of nothing
but exceptions to the rule, and that, in consequence, absolute reality
has predominantly the character of irregularity."
people are aware of their own uniqueness and 'irregularity', if
only intuitively, but are convinced, by the power of psychology
(and more recently the media), that their individuality is somehow
less real than some generalized theory about people and the human
condition. As these 'general rules' of humanity - derived from psychology,
sociology and psychiatry - have increasingly taken hold in the social
consciousness, the individual is, correspondingly, deprived of the
moral decision as to how he or she should live life (Szasz, 1996).
When 'the person' asks questions of 'the person' about the nature
of being that person, a personal theory of being and becoming emerges.
Alan Watts (1977) was aware of the paradoxes such self-inquiry involved:
"So long as I identify myself with my conscious intention,
and voluntary mind, I feel that I am in control of relatively few
events. But I realise that this identification is after all a matter
of opinion, of social convention, of an acquired way of describing
myself to myself. Both Buddhist and Hindu disciplines of spiritual
growth (i.e. meditation or yoga) consist primarily of exploring
the question 'what am I?' " (Watts, 1977: 117)
neuroscience is the latest 'grand theory' of the human condition
to emerge. It explains what it is to be and feel human, as a function
of neurochemical events in the brain. In psychology - and to some
extent psychotherapy - the superficial pragmatism of cognitive psychology
is in its ascendancy. Not all practitioners of the dominant mode
of therapy - cognitive behaviour therapy (CBT) - deny the possible
spiritual nature and meanings of extreme states, such as psychosis.
However, those who are more reductively inclined often try to guide
the person towards a 're-adjustment to the dominant paradigm (insight)
at the cost of the individual journey' (Clarke, 2002). This may
be socially helpful but spiritually disastrous.
great paradox of human experience is that, when restrained from
appreciating this individuality and uniqueness, the person can experience
a loss of a sense of 'self'. However, when life is devoted, wholly,
to the pursuit of 'selfhood' - as in hedonism - a similar loss of
selfhood can emerge. How people confront and explore their individuality,
and the purpose of such self-seeking, seems more important.
futility of explanation
Many of the grand psychological theories of the human condition
appear to diminish (or reduce to absurdity) the complex issues involved
in being and becoming human. Increasingly, we classify and categorize
all human functioning in the language of psychiatry. All distress
is a function of some dysfunction worthy of treatment. All evil
is a function of some personality disorder, even if impossible to
'treat'. In Jung's view humankind's trust in reason had produced
a fragmentation of our realities: especially the unreasonable splitting
of the world into 'good and evil', 'saints and sinners'. In Jung's
view, everyone carried the 'shadow' within their psyche, and merely
tried to project it into other groups (like communists) or individuals
(psychopaths). Regrettably, one outcome of this 'splitting' is that
we fail to acknowledge our inherent weaknesses, which are essential
aspects of who we are and what we might become.
risk reducing the experience of being human to truly absurd proportions,
by trying to explain all human experience in neurochemical terms.
Francis Crick, for example, recently claimed that ultimately we
would be able to demonstrate that: "You, your joys and your
sorrows, your memories and your ambitions, your sense of personal
identity and free will, are in fact no more than the behaviour of
a vast assembly of nerve cells and their associated molecules."
(Crick, 1995: 3)
believed that his approach to the mind reflected a new idea but,
as Szasz (1996) noted, this was because he was ignorant of the history
of the mind and especially of madness. Notably, Crick insisted that
his approach to the problem of the mind was scientific but this
was: "a claim he supports by denying agency to persons and
attributing agency to things. In Crick's world, neural networks
'learn' and free will (capitalized) is an attribute of the cerebral
cortex. He asks: 'Where might Free Will be located in the brain?'
and answers: 'Free Will is located in or near the anterior cingulated
sulcus'." (Szasz, 1996: 84)
would despair if such profound experiences as 'despair' were not
defined, largely, as epiphenomenal to the core brain function of
'us'. Thankfully, Szasz's gentle irony is a valuable antidepressant.
neuroscientific discourse is vital to our consideration of madness
and spirituality. People in the grip of madness are entrapped in
a consideration of self-hood that many of us avoid by throwing ourselves
into various 'normalizing' activities. Madness often involves the
perennial existential crisis: who am I and what, on earth, am I
doing here? This is not to say that other critical phenomena are
not involved in the construction of this human crisis - signposts,
en route to the ultimate concerns the person will express about
her or his 'selfhood'. However, the core crisis, if such a metaphor
is not inappropriate, involves the person's presumed relationship
with Self, albeit by dint of some troublesome relations with the
Frattaroli believes that contemporary psychiatry is in imminent
danger of losing its mind. Instead of treating patients as mere
chemical configurations, Frattaroli proposes that we should learn
to recognize and find compassion for the feelings that inform our
lives. Only by dealing with our selves and our souls can we ever
create true healing.
his evident feelings of unease with the medical model of psychiatry,
which holds that emotions stem from brain chemistry, which can readily
be altered through drugs, Frattaroli's argument could be read as
anti-psychiatric. It might be better to recognize his pro-human
emphasis. When we hypothesize that anxiety, shame and guilt, for
example, are meaningless neurological glitches, rather than urgent
calls to self-reflection, we promote the pharmacological quick fix,
at the expense of attending to the deeper, long-term needs of the
guru, no method, no teacher
So, how do we respond to extreme forms of human distress? It has
been estimated that there are, literally, several hundred forms
of 'therapy'. These variants of psychoanalysis, counselling and
behaviour therapy try to find simpler or more efficient ways to
'fix' various forms of human distress. When we consider what human
distress might 'mean' - in spiritual terms - the wisdom of 'fixing',
as opposed to developing understanding, might be questioned. Indeed,
many people make discoveries within psychotherapy, which appear
to have little to do with the therapeutic method, or even the therapist,
but may be a function of their own reflection: no more and no less
(Barker and Kerr, 2000; Karasu, 2001). In that sense, the therapist
- and the therapeutic method - may only be providing a context,
or setting, for the person to engage in a necessary act of reflecting
(Barker and Kerr, 2000).
this consumerist age, many therapists now sell their wares on television,
marketing themselves and their 'new' methods as the answer to all
manner of human ills. The influence of the grand theories of human
experience, which originally deprived people of their individuality
- and their individual morality - helps in this selling process,
whereby psyches are shaped and modified by presenters on daytime
television. The idea that these therapies (and their sophisticated
therapists) are unnecessary is a threatening concept. If the Emperor
really has no 'new clothes', then people must confront their own
individuality and make their own choices, if not their own 'clothes',
as they reflect on their own experience, coming to their own realization
of who they are and what is the ultimate meaning of their lives
The reflection, which is a necessary part of some forms of psychotherapy,
is akin to meditation. When people appreciate that reflection is
the beginning, middle and end of the therapeutic endeavour, then
therapy becomes a spiritual undertaking (Karasu, 1999). The reflection
process helps the person to appreciate that who he or she is, is
a function of how he or she lives. The understanding of living emerges
from the experience of doing. Reading spiritual works may make one
wiser, but meditation makes one better. Where the person allows
the 'silent conversation' its fullest rein, then it can become a
silent conversation with God (however defined), within which may
be revealed the meaning not just of distress but of life itself.
and doing: living as doing
The experience of reflecting - specifically - on life problems (the
common focus of therapy) is easily extended, through meditation,
to the reflection on the essence of life itself. Such reflection
need not be complex, and certainly does not require complex training
or sophisticated techniques. Indeed, there are as many 'meditation
merchants' as there are psychotherapy salespeople. Those who would
try to turn it into a 'product' often obscure the simplicity of
meditation and its many potential rewards. As Marcus Aurelius observed:
"Nowhere does a man retire with more quiet or freedom than
into his own soul."
inherent emptiness of meditation is often sufficient to allow us
to confront the futility of post-modern life, with all its striving
and struggling, helping us to appreciate more clearly the purpose
of life and one's ultimate destiny. Wallace (1989) believed that
even simple forms of meditation provide access to an intelligence
that transcends even the most sophisticated forms of education:
"It is quite possible that in all your years of education,
you have never been trained to cultivate the simple form of quiescent,
stable, lucid awareness. If so, you probably found that much of
that five minute period [in meditation] was spent in conceptual
distraction, and even when the attention was on the breath it lacked
clarity and continuity. Such an undisciplined mind is a poor instrument
for empirically investigating the nature of cognitive or physical
events. This unrefined state of consciousness also makes us prone
to unnecessary suffering when the mind is dominated by such emotions
as fear, resentment, guilt and aggression." (p. 168).
the most prevalent human problem of the day is 'low self-esteem'.
Paradoxically, as people meditate on their own, essential, unimportance
- in the cosmic sense - their inherent value grows. Meditation allows
the person to develop a buffer against the tongues of both flatterers
and critics, eradicating the itch for praise, allowing our natural,
inherent light to illuminate us from within.
to the absolute
It is by no means necessary, or even desirable, to try to construe
therapy in spiritual terms. However, the threats present in an increasingly
material culture appear to be bringing more and more people, perhaps
unwittingly, to an appreciation of the emptiness of their lives,
and the need to see beyond themselves, into the infinite. As people
look into the reflection of themselves and the construction of their
own lives, they may gain a glimpse of the Absolute that serves as
the backdrop to their human struggles. As CS Lewis (1961) remarked:
"Of course it's easy enough to say that God seems absent at
our greatest need because He is absent - non-existent. But then
why does He seem so present when, to put it quite frankly, we don't
ask for Him?"
the realization of our own individual importance - and yet, at the
same time unimportance - may be an essential part of the continued
development of humanity. As Jung noted: "It is, unfortunately,
only too clear that if the individual is not truly regenerated,
society cannot be either. (Instead of roping the individual into
a social organisation, reducing him to a condition of diminished
responsibility, the Churches should) be raising him out of the torpid,
mindless mass and making it clear to him that he is the one important
factor and that the salvation of the world consists in the salvation
of the individual soul.
with the angel, on very thin ice
Although presently fashionable, the contemporary pairing of spirituality
and mental health may, in years to come, provoke much head scratching.
Certainly, the contemporary critic of such a development might well
argue that many (if not most) people in states of high anxiety,
deep despair or extreme alienation - whether from self or others
- are disturbed, and that this disturbance lies somewhere, or perhaps
in several places, within the physical body. In that sense, not
much has changed since Hippocrates' day. However, it could also
be said that any 'disturbing' experience shields the potential for
spiritual revelation. There is no logical reason why people described
as 'mentally ill' should be excluded from such revelations. As many
of the authors gathered together in this book show, education, socialization
and plain old-fashioned 'trying too hard' to gain enlightenment
may represent barriers to the experience of the spiritual.
What is the difference between the tortured soul of Coleridge's
Ancient Mariner and the tortured experiences of those who have encountered
what has been called madness and now, patronisingly, is referred
to as mental health problems? Political correctness demands that
any experience, which anyone wishes to call spiritual, must be accepted
as such. But this is the terrorism of acceptance, which can be just
as imposing as the terrorism of rejection.
We would urge caution against simply accepting, at face value, any
unusual experience as evidence of an encounter with the Absolute,
however we might wish to define this. Equally, we would urge caution
against the simplistic distinction between 'spiritual emergence'
and plain old-fashioned madness. When the New Zealand writer Janet
Frame was given a diagnosis of schizophrenia, this led to years
of futile and damaging psychiatric treatment. As her biographer
suggested, the writer, who had experienced a huge number of emotional
and spiritual upheavals in her early life, was 'wrestling with the
angel' (King, 2001). Arguably, she was in the eye of the storm of
spiritual emergence and should never have been diagnosed as mentally
ill, far less institutionalized. However, Sally Clay (1999) was,
by her own admission, possessed by madness, yet she too was like
Jacob, wrestling with the angel. And so she wrote: "Jacob named
the place of his struggle Peniel, which means 'face of God'. I too
have seen God face to face, and I want to remember my Peniel. I
really do not want to be called recovered. From the experience of
madness I received a wound that changed my life. It enabled me to
help others and to know myself. I am proud that I have struggled
with God and with the mental health system. I have not recovered.
I have overcome." (p. 15).
have spent a sum total of 60 years working with people in varying
states of madness, social estrangement and spiritual flux. We have
also encountered some of these states, face to face. Although we
can recognize when people are in a state of madness, or are estranged
from themselves or others, or are 'wrestling with the angel', we
are hesitant about providing any formula for discriminating such
states, for often they clearly overlap, if not - as in Sally Clay's
case - belong, each to the other.
this book is a journey taken across perilously thin ice and the
steps taken are tentative. If the reader hears the authors exclaim
'ah-ha', these are just as likely to arise from the experience of
slipping and floundering as from any genuine revelation. We can
live with such uncertainty. We hope that the reader will be similarly
1 (L) patiens, patientis: present participle of pati, to suffer.
2 Where people once were defined by professionals as 'schizophrenics'
or 'psychotic patients', many people now define themselves as 'people
with a serious or enduring mental illness', or more simply, 'users'
or 'consumers' (of mental health services). One way or another,
both kinds of descriptors suggest that the often short-term, and
certainly never constant, experience of psychic disturbance defines
the person. We would rather take the view that the subject in question
is a person, first and foremost, who sometimes is like this (e.g.
happy), and at other times is like that (e.g. sad). Unfortunately,
this implies that such persons are more like the rest of us than
different. Such egalitarianism appears to be too radical even for
the 21st century.
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Phil Barker is professor of health science at Trinity College in
Dublin, Ireland. He has worked in the mental health field for almost
Poppy Buchanan-Barker was a social worker for 26 years, working
with people with a range of disabilities, and their families.
Spirituality and Mental Health: Breakthrough is published by Whurr.
16, 2003: Pushing for compassionate and ethical psychiatric nursing
- Name an eminent thinker from 20th century psychiatry and mental
health, and a psychologist, psychiatrist or philosopher might spring
to mind. It's unlikely to be a psychiatric nurse. But if it was,
it might be Phil Barker.
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