Mania and psychosis as purposive

Below is an article that speaks to mania being a spiritual emergency. I’m convinced at this point in my life that what was stopped in me by powerful psychotropic drugs could have been a healing experience. Had I had the proper supports and a safe place to stay I would have emerged healed and healthier than I had ever been. Instead I have been oppressed by medication for 20 years and have suffered immensely as a result of not being able to see my healing process through. The below experience of Robert Whitney is very much like what I experienced except I had no one outside of the hospital to support me and tell me that my psychosis was purposive.

Psychosis as spiritual emergency can also be considered a “psychological emergency,” for what it is is the psyche calling out to be heard and processed. You need not be a new age believer to appreciate the validity of the psychotic process being one of the psyche demanding to be paid attention to and healed.

For more information on psychosis as spiritual emergency see the blog Spiritual Emergency. Also see my post with Sean’s youtube video which I recently posted.

Stanislov Grof has also written a book called Spiritual Emergency and countless others have remarked on this phenomena perhaps not always with the same vocabulary. People like Carl Jung and Joseph Campbell and John Wier Perry among many others.

Now the article:

Mania as Spiritual Emergency

Edward Whitney, M.D.

One night in May 1994 I was stopped by the police as I wanderedon the beach in my underwear and T-shirt, merging with the electronsin distant galaxies and looking for God. I was not sure whetherI was Hitler, Elijah the prophet, or King Lear gone mad. AllI knew for certain was that I had surrendered my customary framesof reference and had chosen to trust a process over which Ino longer had control.As the police asked me who I was and where I lived, I triedto come up with a story that they might accept. I told themthat I was a doctor who was deeply concerned about the Clintonhealth plan, that I lived four blocks away, and that I neededto go home. I was certain that they were angels sent by theLord to prevent me from disrupting the flow of energy in thegalaxies with which I was merging. If God had sent them, thenall was well; I could trust them.

Their police radio said something that included the words “sevenfour.” They were checking the seventy-fourth decimal place oftheir calculations; this was the precision they needed to besure that all the electrons in the universe were still in place.They were, therefore, connected to the mind of God.

Friends and housemates were becoming alarmed by my recent behavior.I, on the other hand, had never felt more sane. The processwas a healing one; all the shame I had felt for decades aboutbeing a disappointment to my father (an internist who had diedwhen I was 15) had fallen away in recent weeks. I felt a deeptransformation of the meaning of everything that had ever happenedin my life. I was receiving assurances from Heaven itself thatI needed to feel ashamed no longer, that I was loved for alleternity. Everything that existed was holy. Angels were everywhere,beautiful and terrifying.

I had always scoffed at those who said that we could do anythingwe put our minds to, and that our beliefs were what limitedus. We had to let go of our doubts, they said, and visualizewhat we wanted. Now I stopped scoffing; it was time to believein myself, just as they said we needed to. I knew what I wanted:years before, I had lusted after an exceptionally desirablewoman named Robin. My housemates and I had a cat named Bandit,and I reasoned that a bandit is a robber and robbers engagein robbin’; therefore Bandit could be transformed into Robinfor my carnal delight. I visualized the metamorphosis, liftedBandit to my face, and rubbed noses with him. He blinked atme and meowed.

Fantastic! Cats were cats, and women were women; reality hadlimits, and therefore my thoughts could not destroy the universe.Therefore, I was not God. I was relieved beyond measure. AsI digested this momentous discovery, my housemates and friendsbegan to make arrangements for finding me a safe place to be;three days later I was in the hospital on a 72-hour hold. Thismeant that I was Jonah the prophet, and that I had been runningfrom God my whole life, and was sent by Him to spend three nightsin the belly of the whale.

I told the psychiatrist about being overwhelmed by a sense ofangelic presences; he said that this idea was psychotic andthat he would put me on risperidone, a new antipsychotic drug.The healing intentions of hundreds of people who had developedand tested this drug were enfolded within this pill, I toldmyself, and it would reveal what I needed to do in order tofit into this world in which I had always felt like a stranger.

About 20 minutes after the initial dose, I had my very firstpsychedelic experience—brilliant rivers of intensely saturatedlight flowed before my eyes. Assuming that the vision of flowinglight was the intended therapeutic effect of the drug, I realizedthat disdain for psychedelics had been my basic problem; I hadplaced too much trust in reason and science. Risperidone wasa wonder drug! I was cured!

The next day, another doctor started me on lithium. Aha! Lithiumwas the lightest of the metallic elements, number three in theperiodic table. It was the ideal conduit by which cosmic energiescould be grounded. The stars were mostly hydrogen and helium;lithium was the vehicle through which their messages could cometo earth. How wise the psychiatrists were! They really knewwhat I needed!

Thus the mental health care system and I were at cross purposes;what I was experiencing as a wonderful healing process was construedby my doctors as a serious disease process. Neither of us hada clue about the other’s perspective. They knew nothing aboutmy issues with my father, the spiritual and religious interestsI had had since childhood, and my recent fascination with theLubavitcher Hasidim, who were saying publicly that their elderlyand ailing leader was the promised Messiah. If the Lubavitcherswere right, then the healing of the whole world was at hand,and we would have no more war. Fear and hatred would rule nolonger. God would no longer be a tool of oppression. With myentire being, I wanted this to be true. For their part, thedoctors knew messianic obsession as a symptom of illness, amedical disorder of the brain.

Mania, in my experience of it, is a process of giving birthto hope in the soul. It is opposed from within by an equallyintense nihilism and fear that the entire creation is nothingmore than a cesspool of doom. Inner conflict can make a personlabile. The cosmic grandiosity comes from trying to answer thequestion “Is the universe a friendly place or a hostile place?”This is ultimately a religious question, hence the preoccupationwith spiritual and religious issues.

The struggle between hope and utter despair can frighten onlookersas well as the person on the inside of the experience. Thereis a difference between the expression and the intention ofany problematic behavior; the expression of mania, intrusiveand melodramatic, gets the attention of onlookers. The constructiveintention, concealed inside a person and covered over by layersof wild behavior, must be looked for or it will be missed.

“If you don’t think of it, you will miss it,” every medicalstudent is told when learning the art of clinical diagnosis.My doctors did not think about the possibility that they wereseeing a person in the midst of a spiritual emergency; the conceptitself is not on their map of reality. It is not listed in thedifferential diagnosis of manic episode in DSM-IV. Psychiatristsdo not think about it, and they miss it. The patient, unfortunately,pays the price for the doctor’s impoverished frame of reference.

It is a very serious matter when a physician mistakes a healingprocess for a pathological one. The intention of the doctorswas positive, but their expression was most destructive. Thehead of psychiatry at the hospital told me that I was in denialif I insisted that I had been having a spiritual crisis. No,he said, this is a medical disorder like asthma or diabetes.When I finally understood that he meant what he said, I wasdevastated, and I was feeling suicidal within hours. I couldnot argue with his self-assured, expert manner.

Where, I wanted to ask, were the mast cells, the inflammatorymediators, the glycosylated proteins of this allegedly medicalcondition? But I was too demoralized to speak. I felt only likedying. The whole episode meant nothing; it was just a case ofbad DNA making defective protoplasm. If I had accepted the medicalmodel of my experience, I would not have survived to tell thistale. Despair would have consumed me.

I emerged from despair because other people interpreted thingsdifferently. One of my housemates said, “This happened for areason, Ed.” A psychiatrist who understands the concept of spiritualemergency accepted the legitimacy of the nonordinary statesof mind that I described to him, and he likened them to crisesthat many people had passed successfully through. Outside themedical profession, there were many people who easily understoodwhat I was saying, and they helped save my life.

Medical education does not prepare psychiatrists to deal withspirituality in human experience. In shaping human lives, spiritualityis at least as powerful (and as subject to compulsiveness) assexuality, and just as irresistible when intensely felt. Itis expected that psychiatrists will be able to take sexual historiescompetently, but spiritual histories seem to be another matter.It saddens me to report that physicians were the main obstaclethat I had to overcome on my quest for a hope-filled view ofthe world.

When confronted with manic patients, psychiatrists ought toask themselves, “Could this be a spiritual emergency?” Whenno medical illness or drug intoxication is found, this possibilityshould be carefully ruled out before a medical model is imposedon the situation. There are features in the territory of humanexperience that are deleted from the professional maps thatpsychiatrists use. Those maps must be revised. DSM-IV shouldinclude “religious or spiritual problem” in the differentialdiagnosis of manic episode. Physicians who do not think aboutit when appropriate may do their patients grave harm.