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DSM-IV Religious and Spiritual Problems |
Case Example: Brief Myths in Mental Illness Case |
Howard was a young man in his early 30s in 1982 when he telephoned me at UCLA. He had noticed an announcement for a workshop I was giving entitled "Psychosis: Mysticism, Shamanism, or Pathology?" He was unable to attend the workshop, but told me that he was sure I'd be interested in the story of his "Mental Odyssey." We arranged to meet for lunch where he began to tell me about the experiences surrounding his 2-month hospitalization 9 years earlier. I invited him to present at my UCLA Neuropsychiatric Institute seminar on "Hallucinations and Delusions" attended by psychiatry residents, psychology interns, and nursing staff. Several other ex-patients had already come and discussed their psychotic episodes, their treatment by the mental health system, and the difficulties they had encountered in readjusting to consensual reality and societal norms. Howard responded eagerly to my invitation to present, since he never before had an opportunity to tell the complete story of his Mental Odyssey. His talk was spellbinding. I was particularly intrigued with the profuse symbolic imagery that permeated his account of his psychotic experience. I conducted 15 interview sessions with him during the next 2 years to obtain the full account. Howard was right. He had been on an incredible Mental Odyssey, a journey through the mythological history of humanity. While in a psychotic state that lasted about 2 months, his everyday life was filled with images and themes from ancient myths. For example, he described experiencing a simple afternoon hike up a mountain as being a journey to heaven during which he encountered magical paths of entry, power spots, sacred mountains, guiding spirits, and powerful enemies. The content of his speech, which was the primary factor that led to his being hospitalized by his family, reflected his preoccupation with mythological imagery. He told his family that he had returned from hell, been reborn and had taken up his rightful place in the Kingdom of Heaven. He said to one friend: "I am the albatross; you are the dove." With his choice of the appellation, "Mental Odyssey," Howard showed his recognition of the mythic dimensions of his experience. Howard also drew elaborate "keys," as he called them, that were mandalas stocked with many well-known symbols and cultural motifs including the Islamic crescent and star, the yin yang symbol, the infinity sign, and pierced hands, eyes, and circles. Howard distinguished himself from the majority of psychotic patients with whom I have worked by delving on his own into the mythological, philosophical and artistic parallels to his own experiences. This became evident to me during the interviews when he discussed how these symbols still held great importance for him. I asked him to write an interpretation of the most elaborate symbolic "key" he had produced during the psychotic episode (Figure 1). First he re-sketched the "key" to make its features clearer (Figure 2). The 18 pages of interpretation he then wrote included extensive references to diverse religious and spiritual sources including alchemical and esoteric texts, Native American beliefs, and Jungian concepts. Despite their esoteric nature, such personal symbols as Howard's key are of great psychological significance. Jung (1960a) observed that, "the age-old function of the symbol is still present today, despite the fact that for many centuries, the trend of mental development has been toward the suppression of individual symbol-formation" (p. 49). Howard's key illustrates that the process of individual symbol-formation still occurs spontaneously in psychosis. Howard instinctively drew his symbol key in the form of a mandala, beginning with a prominent center and expanding along a vertical axis. Mandalas are found in many religions and are also produced by persons in states of psychological conflict (Jung, 1960a); they have been observed frequently in the drawings of psychotic patients (Baynes, 1949). Jung (1959) believed they have a therapeutic effect on their creators, including psychotic individuals, by helping them to compensate for the disorder and confusion of their psychic state. Yet, despite Howard's sophistication in comprehending the individual meanings of the symbols he encountered while psychotic, he had not organized the unfolding of these events into a coherent narrative. In fact, he reported that he had never before told anyone the whole story of this episode. As a result, it had remained unintegrated with the on-going process of his life. Verbalizing the entire Mental Odyssey to me and its subsequent publication as the story I entitled, "The Hero With 1000 Milligrams (Thorazine)," (Lukoff & Everest, 1985) helped Howard further integrate his psychotic episode into his personal mythology.
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