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Paradoxes of Madness and Philosophy

Have you ever met people who reported that “asking too many questions” was what seemed to have led them into madness?

Or maybe you noticed yourself that the more you looked into the deeper aspects of existence, the more paradoxical, and maddening, reality seemed to become?

If these sorts of issues interest you, and if you think understanding them may help us provide better help to people who are struggling, then you may want to view this recording of the webinar “How Can the Uncontainable Be Contained? Paradoxes of Madness & Philosophy:”

In this talk, Wouter explains a bit about himself, and how he came to write the book, and gives an overview of its main arguments and perspectives. He presents three text fragments, pertaining to both philosophy and madness, that address the themes of nothingness, infinity, and fragmentation, then shows a 13 minutes video, “Unravelling Reality,” that lets these themes come to life in a modern, metropolitan setting (that is, Brussels in Belgium), and also engages in dialogue and discussion with an audience.
About the presenter: Wouter Kusters (1966) obtained a Ph.D. in linguistics and earned an MA on the philosophy of psychosis. In the Netherlands, he is known for his books on the experience of psychosis and its relation to philosophy. For his Pure Madness (2004), and A Philosophy of Madness (2014), he won the Dutch Socrates Award for the best philosophy book of the year in Dutch. The latter has recently been translated into English (2020, MIT Press). Wouter Kusters works as an independent writer, researcher and teacher in the Netherlands, see: https://kusterstekst.nl/.

“…madness is less about living in another private bizarre reality and more about living in our ordinary reality but then stumbling on problems that are hidden in (or ‘under’ the pavement of) ‘realism,’ and being haunted by them, which grow the more attention you pay to them.”

“Now, an important difference for many ‘madmen’ is that they just find themselves in these abysses, without preparation, with no language or tools to navigate there, with no others, and without any sense of freedom within the fall. The seduction to reduce it to a psychological crisis, or even a neurobiological crisis is then overwhelming — and from a practical point of view it is quite prudent to do so. Nevertheless, many of the questions and problems that continue to haunt those deemed mad or psychotic have nothing to do with a personal or neurological problem, but all with the greater questions. Being in a condition of madness means you are trying to resolve the most fundamental questions of existence, but in an uncontrolled, wildly associative way. You want to know what it’s all about, what good and evil are, what is at the very heart of existence: you want to know the meaning of life and the cosmos. “

Those two quotes are from https://www.madinamerica.com/2021/04/wouter-kusters/

Robert Whitaker: The Rising Non-Pharmaceutical Paradigm for “Psychosis”

In a talk linked to below, award winning medical journalist Robert Whitaker reviews the science that indicates the need for a radical change in psychiatric care, and describes pilot projects that tell of a new way.

Starting in the 1980s, our society organized its thinking and systems of care around a “disease model” narrative that was promoted by the American Psychiatric Association and the pharmaceutical industry. That narrative has collapsed. The biology of mental disorders remains unknown; the diagnoses in the DSM have not been validated as discrete illnesses; the burden of “mental illness” in our society has risen; and there is an increasing body of evidence that tells of how psychiatric drugs, over the long-term, increase the chronicity of psychiatric disorders.

The collapse of that paradigm provides an opportunity for radical change. In Norway, the health ministry has ordered that “medication—free” treatment be made available to psychiatric patients in hospital settings. A private hospital in Norway has opened that seeks to help chronic patients taper from their psychiatric drugs, or to be treated without the use of such drugs. In Israel, a number of “Soteria” houses have sprung up, which provide residential treatment to psychotic patients and minimize the use of antipsychotics in such settings. Research into Hearing Voice Networks is providing evidence of their “efficacy” for helping people recover. Open Dialogue treatment, which was developed in northern Finland and involved minimizing use of antipsychotics, is being adopted in many settings in the United States and abroad.

About the presenter: Robert Whitaker has written three books on the history of psychiatry: Mad in America, Anatomy of an Epidemic, and Psychiatry Under the Influence (the latter book he co-authored with Lisa Cosgrove.) He is the president of Mad in America Foundation, which—through its webzine, radio podcasts, continuing education webinars, and town halls—promotes an exploration of these issues. He is also on the adjunct faculty at Temple Medical School, in the psychiatry department.

Learning CBT for Psychosis in a Series of Live Online Seminars

The core idea of cognitive behavioral therapy, or CBT, is that therapists can help people learn to change what they think and do, and then by making these changes, psychological problems can shrink or be eliminated.

Over 50 randomized studies of CBT for psychosis (CBTp) have now been completed, and they show that people experiencing psychosis can learn to reduce distress and disability using these methods. And those who have made complete recoveries after being diagnosed with psychotic disorders like schizophrenia often credit learning to change thoughts and behaviors in the same ways that are promoted by CBTp.

One problem though has been that training in CBTp has often been difficult to obtain, at least in the US.This series of six live online seminars is designed to remedy that problem, by providing first an overview of CBTp, and then a practical understanding of its approach to the various problem areas associated with psychosis.

3.5 hours of Continuation Credit for many US professionals will be provided for each seminar: for information please see this link.

Schedule and Registration Options for the Seminars:

(Note that a detailed description of each seminar can be found at the following links, or also further below on this page.)

You can register for the five seminars individually, for $79.99 each, or you can register for all five at once for a discounted fee of only $299.99. To register for the series of five seminars at once, use this link.

April 30, 2021: Essential Elements of CBT for Psychosis: Engagement Style, Normalizing, & Developing a Formulation Cost: 79.99

May 28, 2021: Paranoia and Troublesome Beliefs: A CBT Approach Cost: 79.99

June 25, 2021: Voices, Visions, and Other Altered Perceptions: Changing Outcomes with CBT Cost: 79.99

July 23, 2021: Trauma, Dissociation, and Psychosis: CBT and Other Approaches to Understanding and Recovery Cost: 79.99

August 27, 2021: Addressing Spiritual and Cultural Issues Within Treatment for Psychosis Cost: 79.99

Each workshop will be from 9:00am-12:30pm Pacific Time / 12:00-3:30pm Eastern. There will be time for questions, discussion, and practice.

About the instructor: (Ron Unger LCSW): “I’m a therapist who has been practicing CBTp for almost two decades, and during that time I have led many seminars on CBTp at a variety of universities and agencies in the US and Canada. These seminars present CBTp as part of a deeply humanistic and open-minded approach to difficult experiences that can otherwise be too easily framed as “not understandable.” I am the author of 3 prerecorded “online courses” related to CBT for psychosis (these courses cover some of the same material that will be covered in these live seminars.) I am chair of the educational committee for the US Chapter of the International Society for Psychological and Social Approaches to Psychosis (ISPS-US) and am a blogger at https://recoveryfromschizophrenia.org/ and www.madinamerica.com.”

To make sure that everyone has a chance to ask questions and participate, class size will be limited to about 40. Register early to guarantee your spot!

Description of each seminar:

[continue reading…]

Exploring the Promise and the Pitfalls of “Mad Pride”

When people talk about finding something of value in “mad” or “psychotic” or “extreme” experiences, they are usually accused by those in mainstream psychiatry of “romanticizing an illness,” and overlooking how disruptive and distressing these states can be. But when only the negatives about mad experiences are noticed, the focus goes to attempts at suppression, despite increasing evidence that attempts at suppression can contributes to long term dysfunction.

In an ISPS-US webinar – Exploring the Promise and the Pitfalls of “Mad Pride” – I explored a middle ground approach, which balances an awareness of the hazards of mad experiences with a willingness to notice what might be positive about them. Starting with a more open mind, it becomes possible to help people to eventually understand their experiences in life promoting ways, rather than being stuck in either avoiding and suppressing them or being overwhelmingly immersed in them. Methods of applying this approach to improving interactions with “mad” people, and with the “mad” portions of our own minds, were discussed.

Check it out for yourself!

Psychedelic Drugs, Psychosis, and Spiritual Awakening

What are the relationships between the experiences caused by psychedelic drugs, and those we call “psychosis?” And what are the relationships between both those types of experiences, and experiences that seem to be a “spiritual awakening?”

There may be a number of answers to those questions. Many different perspectives will be shared and discussed at an upcoming conference, titled Psychedelics, Madness, & Awakening: Harm Reduction and Future Visions. This conference will be starting on January 30th, 2021.

I will be one of the panelists, I will be talking about ‘Revolution Within the Mind: A Common Factor in Psychedelic Experience, Madness, and Spiritual Awakening.’

Anyway, if this topic interests you, please do check out the conference!

Making Peace with Voices

Voice hearer Dmitriy Gutkovich defines “a positive voice ecosystem” as a state of mind where voice-hearers talk to friendly voices, on enjoyable topics, and only when they are not busy. For those voice hearers who do not want to or can not get rid of their voices, creating such a state of mind is key to reducing distress and moving toward a desired lifestyle. After a decade of lived experience and community leadership roles, Dmitriy Gutkovich has completed a book to help voice hearers achieve harmony with hostile voices and to avoid confusing beliefs, all while maintaining physical community. The book’s title is Life with Voices: A Guide for Harmony.

He also offered a webinar on this topic, which you can find here:

Among the strategies presented in the webinar are understanding the motivations of distressing voices, defending against their attacks on attention and happiness, and navigating the relationships into harmony rather than hostility. Listeners also gain insights on how to explain the hearing voices experience, and how to recruit a physical community that helps voice hearers, rather than causing additional pain.

Whether you are a voice-hearer, a family member, a friend, an academic, or a provider, this webinar aims to deepen your understanding, and to teach you the core skills for navigating, a life with voices.

About the presenter:

Dmitriy’s journey to help the hearing voices community has earned him leadership roles in 4 nonprofits (Hearing Voices Network USA, ISPS-US, HVN-NYC, and NYC PWC), an advisory role for the Yale Cope Project, and to being a coach, facilitator, and advocate for the hearing voices community.

His main projects include celebrating the stories of those with lived experience, and creating a forum where those with lived experience can share their tools and strategies for improving quality-of-life.

Why Does Treatment for Psychosis Sometimes Hurt More Than It Helps?

While the experience of psychosis can be highly distressing, many who recover report that the treatment was often worse than the psychosis itself. What is it that goes so wrong with treatment, and what could we do to improve efforts aimed at helping?

In a webinar titled “What Hurts & What Helps in Treatment for Psychosis:  Insider Perspectives” (see below for the recording) two “experts by experience” reflected on their own experiences of treatment and on what eventually worked better. They also discuss attempts to get professionals to be more open to learning from the experience of those who have undergone treatment.

About the presenters:

Brenda Froyen is a motivated teacher/educator in language didactics and children’s literature. Besides her passion for education she is active in the field of mental health care, organizing conferences and giving lectures and workshops based on her own experience as a patient. Her writing skills have resulted in several books including Psychotic mum: an inside story, editorials in newspapers, and in the website www.psychosenet.be, one of the pioneer projects concerning E-health care in Belgium. For three years she was part of the Belgian Superior Health Council who formulated advice on the DSM5. Brenda is constantly looking for new ways and initiatives to improve the quality of mental health care and education: two fields that have a lot more in common than one might think.

Dmitriy Gutkovich is an activist for those with hearing voices lived experience. In addition to facilitating weekly groups for those with lived experience, Dmitriy sits on the boards of HVN NYCHVN USA, and the NYC Peer Workforce Coalition, and is chair of the ISPS-US Experts-by-Experience Committee. His main projects include celebrating the stories of those with lived experience, and creating a forum where those with lived experience can share their tools and strategies for improving quality-of-life. He is also a loving husband and hard-working professional.

Rethinking “Delusions”: Envisioning a Humanistic Approach to Troublesome Beliefs

When people are told they have “psychosis,” it’s usually because they are experiencing one or both of the following:

  • “hallucinations,” defined as sensations that don’t seem to have any physical cause, and
  • “delusions,” defined as beliefs that don’t agree with others in one’s culture and/or with physical reality.

Thanks to the revolutionary impact of the Hearing Voices Movement, many people around the world are now able to think of the experience of  the first phenomena, “hallucinations,” as something much broader than just as part of a “psychosis.”  In fact, even the term “hallucination” has been questioned, with less medicalized terms like “hearing voices” and “seeing visions” proposed instead.  And it has been asserted that hearing voices itself should never be defined as an illness.  Instead, hearing voices is conceptualized as a human variation, like being left handed or gay.  It is understood that people may have problems with the voices and may need help figuring out how to relate to them, but once the relationship has been improved, the experience may change to something that is overall benign or even beneficial to the person.

Unfortunately, less attention has been brought to that other key component of psychosis, the “delusions.”  And yet, the need for a revolution in how they are approached may be just as intense.

Sometimes, revolutions start with changes in understanding.  One area to begin with might be the notion of a firm distinction between hallucinations and delusions.  Hallucinations are understood as disorders of perception, while delusions are understood as disorders of conception: but in practice conception plays a big role in perception, and vice versa.  For example, consider the difference between thinking that an external force is controlling one’s thoughts (classified as a delusion) and “hearing” thoughts that seem to be coming from outside one’s mind (classified as a hallucination.)  Are these two really that different?  Or are they better thought of as on a continuum, with some experiences in the middle and not easily classified as one or the other?

The history of the distinction between hallucinations and delusions is explored in the article Voices, Visions and ‘Persons Under the Floor’: ‘Delusions’ and ‘Hallucinations’ in Nineteenth-Century Psychiatry.  It notes that the belief in a clear distinction between the two was not always present, and that our imagining that there is a clear distinction can make us insensitive to the lived reality of people’s experience.

In hearing voices groups, the lack of a clear distinction between perceiving a different reality, and conceptualizing or believing in a different reality, is often understood, and so alternative ways of relating to “unshared beliefs” have been developed alongside alternative ways of relating to voices.    But these alternative approaches to working with troublesome beliefs have not received as much publicity as have approaches to hearing voices.

One example of a person working to change that is Rufus May.  At age 18, Rufus became convinced that he was a spy and that a device had been planted in his chest.  His beliefs were treated in the conventional way by the mental health system:  he was diagnosed with “schizophrenia,” hospitalized, and drugged.  But Rufus decided not to believe in the diagnosis and the drugs, and he eventually found his own way to regain control of his life.  Then, using undercover skills which he had previously just fantasized, he infiltrated the mental health system, keeping his psychiatric history secret as he completed his training as a psychologist.

With his training complete, Rufus shifted to being open about his history, and became an effective advocate and educator for alternative approaches.  And while some of his efforts have been around alternative approaches to hearing voices, he has also written very coherently about alternative approaches to working with difficult beliefs. for example in his article Accepting Alternative Realities.  He also explored that topic in a recent webinar, Believe It or Not! Ways of Working with “Delusions” or “Unusual Beliefs”  (See the link at the end of this post.)

One reason I believe Rufus is a great teacher on this topic is due to the degree of flexibility, creativity, and respect for people that he brings to the work.

A key issue with “delusions” is that people are often holding beliefs in a rigid manner:  this tends to prompt those around the person to become unhelpfully rigid in return.  In conventional mental health treatment, this rigidity involves insisting that the person “get insight” into the “fact” that their belief is a delusion and is a sign of the presence of a “mental illness” like “schizophrenia.”  This rigidity is maintained despite evidence that many ideas about “schizophrenia” may be as untrue as any “delusion,” and despite extensive evidence that confronting any strongly held belief in a rigid way tends to make the person holding the belief dig in and defend it more.

I’ve been practicing CBT for psychosis for many years, and CBT does have some ways to approach “unshared beliefs” in a less rigid way.  But there is still a tendency in much CBT literature to emphasize attempting to change the belief seen as troublesome.  That is sometimes possible, and work around reconsidering beliefs can be important, but it is also sometimes not possible or not the most helpful approach.

In many cases, it can be more helpful to work on things like understanding the life experience that led to the belief, exploring the possibility of living successfully even while continuing to have the belief, and/or looking at the belief as a possibly metaphorical message about something that needs attention, and then shifting the focus to that area.

A couple years ago I had a chance to hear Aaron Beck, a key founder of CBT, speak about his understanding of how to approach apparent “delusions.”  It may be common for older people to be rigid in their views, but I was pleased to find that Beck, then age 97, was advocating for a more creative direction.  He was asked for example how he might respond to a man who was claiming to have been roasted in an oven.  Beck said first he would acknowledge the man’s story, and be curious about what that experience was like, how it felt etc.  Then he would ask about other times in the man’s life when he may have felt that way, and then inquire about whether anything currently was making him feel something similar.  In other words, he was saying it might make more sense to follow the vein of emotional content to where it might connect with the man’s past or current issues and distress, which then could be addressed directly.  That could be way more effective than simply trying to change beliefs.

Too often in conventional mental health treatment, once people express a belief that seems “insane,” there is just an effort to suppress the belief, rather than to really understand where the person might be coming from, and what their most important concerns might be.

Another example Beck gave involved a man who told hospital staff that his psychiatrist was a threat, and revealed that he wanted to shoot the psychiatrist.  In a conventional setting, this would be seen as a sign of the worsening of a dangerous psychosis, and an increase in antipsychotic drugs, by force if necessary, would have been seen as the solution.  But in this case, the psychiatrist had been trained to proceed with more sensitivity and flexibility, so instead of treating it as a symptom, he asked the patient, “why do you want to shoot me?”  The patient responded, “because you are planning to shoot me!”  “But,” the doctor explained, “I don’t even own a gun!”  “Well,” said the patient, “you use your drugs like a gun.”  The doctor thought about it and said, “I wonder if you are feeling you have very little control?  That must be frustrating.  But I know you must have lots you want to do outside of here and I want to help you get out so you can do that!”  This made sense to the person and they started to work together.

In the hearing voices movement, it is often pointed out that the voices may be “poor communicators” and that working things out with them may require considering alternative interpretations of what they are saying, until a more constructive meaning emerges.  For example, a voice that tells someone “you need to die” may be better understood as a part of the person saying that “something is wrong, you need to change something” or “you need to let something about you die.”  Once the message is properly understood, it becomes something helpful rather than destructive.  The voice hearer can learn to be like the parent who hears the child say “I hate you” but is able to infer that the child needs some love and a nap, rather than taking the statement literally.

One interesting thing about “delusions” is that people can be disturbed by their own beliefs:  that is, they can find themselves falling into a belief, but sense there is something wrong with the it at the same time.  At that point, they are like the voice hearer who hears a message that seems disturbing, but which they are also starting to believe.

A key skill people need to learn is discernment:  sorting out what might be a valid message in the belief or in what the voice is saying, while dismissing what might be exaggeration or a too literal interpretation.  This allows them to resolve the situation by believing the helpful part of the message, while disregarding the rest.

At other times people are not at all disturbed by their belief, but their having the belief does become disturbing to others.  At that point, the person with the belief is, in relation to us, like the voice is in relation to the voice hearer.  The person is saying something, and we must decide how to respond to it.  Do we see them as the enemy, and someone whose views simply need to be suppressed?  Or do we consider the possibility that while the person may be a poor communicator, there may be some valid message in what they are trying to communicate, even if we can’t agree with all of it?

To develop an adequate approach to difficult beliefs, it is also important to think more broadly about the nature and function of beliefs in general, and to understand how all humans tend to “behave irrationally” around their beliefs when those beliefs become important to their world view and their identity.

Beliefs are often a tribal kind of thing:  people may believe something to fit in with others, not because of logic.  Having a tendency to do so may benefit individuals in an evolutionary sense, because it makes the individual more likely to get along with others in their social group.  (This works, of course, only when the belief is not so destructive as to lead to the extinction of the entire group:  it remains to be seen for example how the “tribal belief” in the non-existence of the climate crisis, popular in many quarters, will affect the evolutionary viability of humanity.)

Curiously, psychiatry identifies only untrue beliefs held by one or at most a few people who are at odds with their culture as having mental health problems, and doesn’t consider the possibility that beliefs held by larger groups or even entire cultures may be even more of a problem – even though the dangerousness of a belief tends to increase the more people endorse it!

(If psychiatry were more able to recognize the “pathology” of widely held beliefs, it might for example be more able to reflect on the damage done by beliefs it has itself promoted, such as the one about how “mental disorders” are caused by “biochemical imbalances.”)

But, one might ask, if people often hold beliefs just to fit in with their group or tribe, why do some individuals seem to go their own way and choose beliefs that put them at odds with their community?

One answer may be that when a person’s life does not seem to them to be working out, they may be motivated to try on different beliefs, sometimes desperately grabbing on to whatever seems to offer some chance at inner coherence amid chaos and disruption.  Once a belief that seem to help restore internal order is found, the person may be reluctant to let go of it, even when that puts them at odds with their culture and gets them labeled “psychotic.”

It is also true that evolution would never work if there were not genetic variations, and cultural beliefs can never evolve unless we have people trying on different perspectives.  Much variation in belief may be just a part of human diversity, and not a problem that needs to be solved.  A skilled approach to working with beliefs involves both toleration of differences in perspective, with an awareness of a variety of possible things that can be tried when a belief is causing problems that do not seem to be tolerable, either to the person or to others with whom they must interact.

There’s a lot more that could be said about this topic:  this post just scratches the surface.  To go a little deeper into it, consider viewing the “Believe It or Not” webinar:

Topics covered include

  • understanding the protective function of beliefs,
  • understanding how they may be linked to past life events,
  • ways to be with someone with different beliefs, and
  • if someone is motivated to hold their beliefs more lightly how we might help them with this.

It Should Not Be a Secret: The Connection Between Trauma and Psychosis

According to fact sheets published by the US National Institute of Mental Health (NIMH) psychosis is caused either by a “mental illness” or by the current impacts of drug use, sleep deprivation, or a medical condition.  If other factors are ruled out, then a mental illness like schizophrenia or bipolar disorder can be identified as the cause.

But there is something quite important hidden by the language used by the NIMH.  When people are told that their disturbance is caused by their “illness” they naturally think of the problem as something inside of themselves, some brain defect or chemical problem.  But what if the real cause was something that happened to them, and what if their current problems are an understandable reaction to that?  Something, for example, like child abuse?    

While the NIMH often declines to mention trauma as a possible cause of psychosis, and even funds programs that explicitly deny that people can play a role in causing psychosis in others, research increasingly shows that trauma, such as various forms of child abuse, can be a major factor in making psychosis more likely.  In fact, the connection between experiencing multiple forms of trauma and then psychosis appears comparable to the link between smoking and lung cancer.

And while people are told that the brain differences that are commonly (but not always) found in people diagnosed with schizophrenia is proof that schizophrenia is a “brain disease,” a nasty but lesser known fact is that the brains of those traumatized as children show the same brain differences.    

Here’s a video summary of the evidence that trauma can be a cause for psychosis:

It is true that not everyone who experiences psychosis has been a victim of major traumas or abuse.  But we might best think of psychosis as something like taking a “fall” from stability.  Not everyone who falls was pushed, some fall for other reasons.  But telling people they fell because they have a “falling illness,” and distracting attention away from the impact of the push, is not a helpful way to help people understand themselves or figure out how to do better in the future.

That is, when people are told that an “illness” is causing the psychosis, attention is turned away from what might have happened to the person, and from how the person’s current behavior might be an understandable reaction to those events, even if a severely troubled one.  This makes it harder for people to understand themselves, which in turn gets in the way of recovery.

It’s also true that when kids are abused, they tend to blame themselves for what happened.  When the long-term consequences of the abuse are defined by mental health professionals as being caused by a “mental illness” within the person, the result is that people once again are likely to blame their troubles exclusively on something being wrong inside themselves.  This tends to deepen a sense of personal inadequacy and self-blame; there is a kind of piling on to the damage and distortions created by the original abuse.

What would work better?  That’s a subject I explore in an online course, “Working with Trauma, Dissociation, and Psychosis, CBT and Other Approaches to Understanding and Recovery.”  This course offers 6 CE to most US mental health professionals. You can find out more about it, check out some free preview videos, and register, at this link.

The experiences we call “psychosis” can be incredibly confusing, not just to the experiencer but to those who may be trying to help.  And trauma is only one possible cause of psychosis, so many other factors may also need to be addressed.  But at the very least, let’s quit telling people that their experiences are caused by some “mental illness” which is really just a label invented by a committee.  People who are suffering deserve at least our honest efforts to understand them, and that includes addressing the possible role of trauma in creating their current confusion.

“There’s Someone in My Head, and It’s Not Me” – Pink Floyd

Since the beginning of recorded history, humans have reported having experiences in their minds (not tied to sensory perception of what others see as physical reality) that seem to be coming from somewhere other than their own mind. 

How people conceptualize these experiences has varied over time.  Such “visitors” within one’s own mind or personal sense of reality might be understood as spirits, ancestors, gods, demons, or in more modern times, the government intruding via technology.

Psychiatrists of course are not fond of any of these explanations.  They insist that people interpret everything they experience in their mind that is not based on physical sensation as being their own mind, as being sourced in themselves.  When people report experiencing things otherwise, they are routinely diagnosed with a psychotic disorder.  As psychiatric critic Thomas Szaz pointed out, what is asserted by psychiatry seems to be that “If you talk to God, you are praying; If God talks to you, you have schizophrenia.”

I recently started reflecting more on this subject when I encountered a recent article by Eric Coates, The Day I Became Schizophrenic.  In the article, Eric explains that he understands the word “schizophrenia” to indicate that one has ”a mind that you share with some sort of outside presence.”  He relates many of his experiences he has with such presences, such as voices that dictate to him poems and a novel that, it seems to him, he has no role in composing.  He also reports finding a lot of value in this experience.

Anyway, that got me thinking. For example, I reflected that we tend to recognize what is our own mind or our “self” by noticing the familiar patterns of thinking and feeling that we identify as ourselves. 

But this creates an interesting situation.  If we do suddenly find a new way of thinking or feeling, some really new perspective, it is not going to feel like “us.”  In fact this new way of thinking or feeling may feel alien to us, or even, perhaps, actively opposed to the patterns that we have identified with. 

But any kind of creativity requires stretching in some sense beyond what we previously have known as our self – because what we previously thought of as our self hadn’t previously done or said what is now being created.

That’s why I think many writers find the process of writing is often more like being dictated to, by some kind of awareness or entity that is other than their self, at least at times. Eric’s process seems especially that way, but creativity in general seems to have this aspect.

My favorite songwriter, the late Leonard Cohen, has written about the sense of not being the writer of his own work, for example as in the following lyrics from “Going Home”:

“I love to speak with Leonard
He’s a sportsman and a shepherd
He’s a lazy bastard
Living in a suit

“But he does say what I tell him
Even though it isn’t welcome
He just doesn’t have the freedom
To refuse

“He will speak these words of wisdom
Like a sage, a man of vision
Though he knows he’s really nothing
But the brief elaboration of a tube”

We often think of creativity as a conscious achievement, but really much creativity comes from “somewhere else.”  For example, I know nothing about making music, yet in my dreams I have sometimes heard very impressive music that did not seem to be anything I have heard while awake.  Something or someone composed this music, but it certainly wasn’t anything in my mind of which I am consciously aware!

Getting back to Eric’s assertion that schizophrenia means having a mind that one shares with others:  I don’t quite agree.  Instead, I agree with psychiatrist Russel Razzique when he says the function of the mental health system should be to help people with any distress they may be having while also recognizing and helping them make use of anything that might be of spiritual or creative value in that experience.  If they find a way to do this, then it no longer makes sense to consider them as a person with a mental health problem.

That is, our job should be helping people navigate the rocky parts of experiences of outside presences in our mind, without framing everything about those experiences as pathology.

Last year I put together an online course “Addressing Spiritual Issues within Treatment for Psychosis and Bipolar” https://www.udemy.com/course/spiritual-issues-psychosis-and-bipolar/ which is my attempt to convey this kind of message to the mental health field….

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