Spirituality and Recovery from Mental Disorders

LESSON 4
The Spiritual Journey in Mental Disorder

Your life is a sacred journey. And it is about change, growth, discovery, movement, transformation, continuously expanding your vision of what is possible, stretching your soul, learning to see clearly and deeply, listening to your intuition, taking courageous challenges at every step along the way. You are on the path... exactly where you are meant to be right now.
Caroline Adams

Mental Disorder as a Spiritual Journey

Recovery from a mental disorder is experienced by many people as part of their spiritual journey. This was eloquently expressed by consumer advocate and Program Director of the Mental Health Division of Contra Costa County Jay Mahler. During a conversation with Dan Weisburd, editor of the CAMI Journal, Jay mentioned that he viewed his disorder as a spiritual journey. When Dan questioned how a devastating mental disorder could be a spiritual journey, Jay responded:

Case Examples

Sally Clay describes how her mental disorder was healed by her involvement with religious practices.

As another example, I will also use my own experience of a spiritual journey in recovery. Joseph Campbell once said if there was a sign in a hallway that said:
Lecture on God turn right. Meet God turn left
most people would go to the lecture. I was one of those who not only turned left to meet God but became God--or at least Buddha and Christ. This happened in 1971 when at the age of 23, I spent two months firmly convinced that I was a reincarnation of both Buddha and Christ. I spent many sleepless nights while holding conversations with the "spirits" of eminent thinkers in the social sciences and humanities. I had discussions with contemporary persons including R. D. Laing, Margaret Mead, and Bob Dylan, as well as individuals no longer living, such as Rousseau, Freud, and Jung. I also conversed with my past reincarnations as Buddha and Christ. Based on the wisdom they imparted to me, I compiled a collection of their teachings into a "Holy Book" that would unite all the peoples of the world. I began this sacred endeavor by making photocopies of the book and giving them to my family and friends.

For those two months, my episode met the diagnostic criteria for Acute Schizophrenic Reaction in the Diagnostic and Statistical Manual-II. In the current DSM-IV, that experience could be diagnosed as a Hallucinogen Induced Delusional Disorder or a Brief Psychotic Disorder. As has happened to others (Lukoff and Everest, 1985), I might have been diagnosed with some other psychotic disorder if I hadn't been supported by friends while going throught that episode. In 1974 in San Francisco, John Perry, MD, founded Diabysis treatment center that still serves as a model therapeutic environment for such crises. Diabysis created a homelike atmosphere where diagnostic labels were not used. Staff members were selected for their ability to be comfortable with the intensive inner processes of persons in psychotic states. In this healing environment, patients in such vulnerable states were able to follow their psyches while being protected from harm. Most episodes treated at Diabysis lasted 6-8 weeks.

I was fortunate during this period to be supported by friends who took me in for weeks at a time. They provided sanctuary for me and helped me to get grounded again in the everyday social world and consensual reality. Without their help, I might have been confined in a psychiatric hospital, diagnosed with a lifelong psychotic disorder, and "treated" with medication. Being supported by caring friends is one of the many experiences in my life for which I am deeply grateful.

However, for a long time after my delusional episode, I kept silent. No one had responded to me about my gift of the "Holy Book." I was intensely embarrassed about having believed myself to be such grandiose figures and distributing that book. For years I talked with absolutely no one about my experience--not my wife, my parents, nor even my therapist. Yet, like Jay Mahler, I also consider my psychotic episode to be the beginning of my spiritual journey.

Six years after this episode, I entered Jungian analysis and had a dream in which a large red book appeared. My analyst asked for my associations to the book. Memories of my "Holy Book" leaped into my consciousness. I had not discussed my episode with anyone in seven years, and my heart raced at the prospect of sharing my story with someone in my own profession. Recognizing therapy as a sacred place where one can safely tell secrets, I blurted out the details--about believing myself to be a reincarnation of Buddha and Christ whose mission was to save the world by writing the new "Bible." To show that I was now a sane member of the psychology profession, I described these as "grandiose delusions" and "visual hallucinations." At the end of my description, she said,

"Well, I don't think that's craziness. Sounds like something important was happening to you on a deep level."

She invited me to bring the book to the next session, and I got to tell my story for the first time.

At the time I assumed the identities of Buddha and Christ, I had very little knowledge about Buddhism or Christianity. In overcoming my own reluctance to discuss it, I discovered that the valid spiritual dimensions of my experience could be salvaged through psychotherapy. Jungian analyst John Perry, MD noted that,

I now view my own experience of having "been" Buddha and Christ as opening me to ideal models for my spiritual life. As James Hillman (1986) points out, "Recovery means recovering the divine from within the disorder, seeing that its contents are authentically religiou. (p. 10). I began my own process of "recovering the divine." I explored Buddhism, Christianity, and other forms of spirituality as I integrated this episode into my spiritual journey (see Lukoff, 1990 for a fuller account).

During the past 25 years in my clinical practice as a psychologist at UCLA-NPI, Camarillo State Hospital, and the San Francisco VA, I have often found myself face-to-face with individuals who have had delusions similar to mine. I believe that my ability to work effectively with those individuals has been aided by being given a rare opportunity to journey through the complete cycle and phenomenology of a naturally-resolving psychotic episode. Thus, beyond serving as a spiritual awakening, my journey held within it the archetypal gift of the Wounded Healer, providng me with the ability to connect more deeply with persons recovering from episodes of mental disorders.

Based on what I learned from my own psychotic episode, and through my work with other individuals who had similar episodes, integrating such experiences into a personal spiritual journey. It involves three phases:

Phase 1: Telling one's Story
Phase 2: Tracing its Symbolic/Spiritual Heritage
Phase 3: Creating a New Personal Mythology

Telling One's Story

This is one of the key steps in integrating an episode of mental disorder into a spiritual journey. I have published several case studies and found that people in recovery from mental disorders are not asked to recount or reflect on their experiences. Yet based on my case studies and contact with people in recovery, telling one's story is the important first step in the three stages of integrating a mental disorder. It often helps to talk about and write out a full account of all one has experienced. I did this with patients at Camarillo State Hospital, UCLA, and the San Francisco VA, and found that even constructing a simple time line marked with ages and key events serves a therapeutic ordering function. Then the work of phases 2 and 3 can move toward integrating the experience.

Phase 2: Tracing its Symbolic/Spiritual Heritage

At least of half of people with diagnoses ofdisorders such as bipolar and schizophrenia have religious delusions and hallucinations.1 In the medical model, further exploration of such experiences would be unnecessary and could even exacerbate symptoms by reinforcing his/her "delusional system."

At the age of 23, I spent 2 months firmly convinced that I was a reincarnation of Buddha and Christ and was on a mission to write a new "Holy Book" that would unite all the peoples of the world. And I had been raised as a Jew! Jungian analyst John Beebe (1982) has noted that,

Minimally, the experience of psychotic illness is a call to the Symbolic Quest. Psychotic illness introduces the individual to themes, conflicts, and resolutions that may be pursued through the entire religious, spiritual, philosophical and artistic history of humanity. This is perhaps enough for an event to achieve. (p. 252)

After 7 years, when I did begin to reflect on my experiences, I approached them as symbolic experiences, I first asked: who were Buddha and Christ? I really had little knowledge of Christianity or Buddhism at the time I assumed their identity. Like others whom I have talked with who developed the grandiose delusion that they were god or the messiah, these stereotypical delusions of grandeur, inflation, and possibly inappropriate behavior were embarrassing to me later. Yet the treatment literature documents that there is much therapeutic value in addressing a person's religious delusions [6]. The valid religious/spiritual dimensions of the experience can be salvaged through psychotherapy. James Hillman (1986) maintains that,

Recovery means recovering the divine from within the disorder, seeing that its contents are authentically religious. (p. 10)

Once I was back with both feet on the ground, these experiences gave me great cause to explore Christianity, Buddhism, and other forms of spirituality. In retrospect, I consider this period to be my spiritual awakening. In Seduction of Madness, Ed Podvoll, MD, observed that,

Many who have come through psychotic episodes describe them as the most fantastic time of their lives.

Much of my work in Jungian analysis consisted of learning how to explore the meaning of my personal symbols as they appeared in dreams and in my own episode. This search for meaning by exploring parallels in traditional myths and religious texts has also played a role in the integration of many of the ex- patients whom I have written about

Myths in Mental Illness Case

Phase 3: Creating a New Personal Mythology

Stanley Krippner, PhD, co-author of The Mythic Path : Discovering the Guiding Stories of Your Past Creating-A Vision for Your Future defines a personal mythology as

an individual's system of complementary and contradictory personal myths which shape our expectations, and guide our decisions.

Each of us has a personal mythology--beliefs about life that make up our view of the world, shape our expectations, and guide our decisions.

Personal myths address life's most important concerns and questions, including

1. Identity (Who am I? Why am I here?)
2. Direction (Where am I going? How do I get there?)
3. Purpose (What am I doing here? Why am I going there? What does it all mean?)

Weaving a mental disorder into a life-affirming personal mythology is essential for recovery. Unfortunately, many beliefs that people develop around an episode of mental disorder are dysfunctional myths that emphasize pathological qualities. Since these are not attuned to the person's actual needs, capacities, or circumstances, such myths do not serves as constructive guides during recovery.

Experiences of nonconsensual reality, such as dreams and parapsychological events, as well as the non-ordinary experiences from mental disorders can play a significant role in shaping positive personal mythologies. All of these involve transcendence of ordinary life concerns and an experience with a "higher" or "deeper" reality. Awareness of being on a spiritual journey often becomes the foundation for a new personal mythology that is growth-enhancing and spiritually supportive.

My personal mythology evolved after discovering the works of Joseph Campbell a few years after my episode. Campbell identified three stages in the Hero’s Journey. First the Call, then Initiation, and finally the Return stage, which

During psychosis, the mind is driven to reveal its deepest, most intimate workings, images, and structures. Whereas the myths are metaphors for journeys into the psyche, psychosis is a journey into the psyche. Stories of successful inner voyages of persons in recovery are boons that communicate the workings of the psyche at the most direct level. This is why madness is such an important theme in the arts. We have much to learn from such accounts. I have published several case studies illustrating the powerful dimensions for both the person on the inner journey and the reader.

My personal boon has involved publications and presentations targeted to increasing the awareness of mental health professionals about the important role of spirituality in recovery and in mental health in general. This work contributed to the addition of a new category to the DSM-IV entitled Religious or Spiritual Problem (V62.89) which I co-authored with Francis Lu,MD and Robert Turner,MD.

Some clinicians have expressed the concern that having patients discuss their delusional experiences could exacerbate their symptoms by reinforcing them. I was involved in a study of a holistic health program conducted at state psychiatric hospital in which participants were encouraged to actively explore their psychotic symptoms. They participated in in groups such as "Schizophrenia and Growth" which encouraged them to compare their experiences to those of mystics, Native Amerian vision quests. and shamanic initiatory crises. Telling their stories did not result in exacerbation of symptoms (Lukoff et al., 1986).

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