Editor’s note: if you are withdrawing from psychiatric drugs there are times when in some cases hypersensitivities may prevent you from tolerating most herbs. Please proceed with caution.
By Jon Keyes
Recently a woman emailed me to interview me about my thoughts about working with herbs to help people who have been treated poorly in the mental health system or who have been experiencing psychosis. The term “survivor” is one that is sometimes used by people who have experienced trauma and ongoing emotional and physical suffering from hospitalization and psychiatric drugs. There is increasing discussion about how extreme states such as hearing voices, having odd perceptions and unusual thought patterns is extremely common and we jump far too quickly towards pathologizing these experiences.
Recently, the New York Times published a piece about a sea change that is going on in terms of perceiving psychosis, extreme states and “schizophrenia”. From the article
TWO months ago, the British Psychological Society released a remarkable document entitled “Understanding Psychosis and Schizophrenia.” Its authors say that hearing voices and feeling paranoid are common experiences, and are often a reaction to trauma, abuse or deprivation: “Calling them symptoms of mental illness, psychosis or schizophrenia is only one way of thinking about them, with advantages and disadvantages.”
The report says that there is no strict dividing line between psychosis and normal experience: “Some people find it useful to think of themselves as having an illness. Others prefer to think of their problems as, for example, an aspect of their personality which sometimes gets them into trouble but which they would not want to be without.”
The report adds that antipsychotic medications are sometimes helpful, but that “there is no evidence that it corrects an underlying biological abnormality.” It then warns about the risk of taking these drugs for years.”
The idea that extreme states are something that requires medical intervention is a relatively new one. Generally indigenous and folk cultures throughout the world have employed a wide variety of interventions that include spiritual, shamanic, herbal and dietary techniques for working with people in crisis and spiritual emergence. Within that context, I explored some of the ways that the practice of herbalism intersects with helping people in extreme states.
Q: Feelings of dissociation or disconnection in people going through extreme states, or particularly people who have been on psychiatric drugs, can potentially make it difficult to feel an emotional or spiritual connection with a medicinal herb – therefore hindering the healing process. Do you have any strategies or examples of ways to help encourage this connection?
Yes- so one of the key things to think about with herbs/plants is that they are not just something to ingest- as in a tea, tincture or capsule- but they have the potential to reach all of our senses in a variety of ways. For those in extreme states or for people who have been on psychiatric drugs and are deeply sensitive to whatever they ingest, I really emphasize the importance of working with the other senses (outside of taste/ingestion). That means that healing can happen via smell, sight, touch and hearing.
Smell is one of the most powerful ways to elicit an emotional response and many traditional cultures work with smudging and its associated odor for grounding, purifying and creating a sacred space for ritual and healing. The scent of white sage, cedar, tobacco and copal are all ways that indigenous cultures have helped people to heal and can be remarkably effective for helping create a tranquil space for people who are highly sensitive.
Other ways of accessing the sense of smell is via aromatherapy. This can be as simple as walking outside in a garden filled with daphne, rosemary, jasmine, roses and lilacs, or taking these fragrant flowers into the house as pot pourri. Diffusers and the use of essential oils are also a way of helping bring calm and relaxation. Rose, ylang ylang, lavender and neroli come to mind.
In terms of sight, I have worked in a number of contexts with people in extreme states and the change that happens when someone in psychosis experiences a beautiful garden is amazing. The connection to the colors, the play of light and shade, the energetics of the different plants elicit a sense of play, as if the person who may feel fearful and shut down comes to life. The eyes start to sparkle, start to come awake.
Touch can also be key- not just touching plants but also working with infused herb oils for self massage or massage from a close loved one. Rosemary, Saint John’s Wort and lavender oil can all be deeply helpful for grounding and centering someone who is experiencing an extreme state. Often in an extreme state, it is hard to connect to the body, hard to stay present. These are ways to honor a path back to the body via plants and nature.
Q: One of the most prevalent forms of trauma amongst psychiatric users and survivors seems to be the “loss of self” from involvement in the psychiatric system. Do you have any experiences with herbs which may help a person to release this type of trauma?
The experience of hospitalization, polypharmacy, the prescription of high doses of neuroleptics that can be heavily sedating with multifold adverse side effects, as well as a system that seems to disregard personal narrative in exchange for a one-size-fits-all pharmaceutical approach to emotional distress can be traumatizing for many people. In many ways you are right that some can feel a “loss of self” and a sense of violation with a lack of understanding of how to find true healing.
This is compounded by many factors. Socio-economically, many of those who experience severe emotional distress are in poverty and with poor insurance with high deductibles and co-pays that essentially makes it impossible to access forms of care outside psychiatric based therapy. In terms of culture and heritage, we also neglect the wide diversity of healing tools and modalities found through the world such as diet, herbs, ritual, prayer, shamanic techniques and sacred movement or perceive them to be “un-scientific”, not “evidence based practice” and then repeat the age old trauma of colonizing peoples who have lost access to their cultural heritage. Native Americans, hispanics and african american cultures are often forced into a system of care that may not be culturally relevant.
Herbal medicine can be seen as part of a much wider story of multicultural connection to the natural world and plants as the prime source of healing. They have been used in ritual context, as entheogens, in teas, soup and diet as a way of accessing not just medicinal chemical constituents but the spiritual matrix that underlies their cosmology.
We live in a world that is disconnected from this way of looking at plants/herbs and see them as either fairly useless or often as a capsule to ingest to gain a desired effect. When I work with people who are recovering from trauma, I often do the simplest thing possible, I have a cup of tea with them. Just the act of siting down and sipping a gentle tea brings connection, warmth, a movement towards increased stillness and trust and away from the noise and the overstimulation of the modern world. I may also go for walks with them. I connect to their experience of the environment. I may point them to the beauty or fragrance of a particular plant. Later I may introduce them to one or two plants, say linden, holy basil, lavender or oatstraw, as a way of creating a direct relationship with single plants.Getting to know specific herbs as friends becomes a way of recreating trust, opening the door slightly to making a larger connection. Releasing trauma often involves embracing a new vision, a new way of life, creating beauty out of the ashes. Sometimes gardening can help create this new vision- simply digging hands in the earth, creating connection, reaching out to something whole, alive, real, instead of the shut doors, synthetics and florescent lights they have received. The advantage to these ways of healing is that they are simple, cheap and accessible to many.
Q: Herbs for various forms of “depression” (or sadness, melancholy, unhappiness, grief, stagnation, depletion) (I am thinking of borage, betony, or ashwagandha, but whichever you have used in your own practice) obviously play a very different role than pharmaceutical “antidepressants”, nor are they the “instant happiness” that pharmaceuticals want to be. Could you describe, or give an example of, the healing process with these herbs?
In my practice when I am working with plants for healing, I do indeed think of them in very different ways from antidepressants and psychiatric drugs in general. An antidepressant contains one chemical constituent that exerts a remarkable effect on the nervous system, globally changing neurochemcial pathways and leads to marked changes in the functioning of the nervous system where it become dependent on chemical intervention to produce mood augmentation.
In my practice I emphasize the role of nourishment with food and herbs in a way that strengthens the body’s own healing process. In this way I emphasize a nourishment model of healing from all states of emotional distress. Like plants, if people are given enough time, light, love, care and nourishment, they will begin to thrive and grow.
So when I work with herbs I like to offer gentle and nutritive herbs, often in a way that is most nourishing. That tends to mean encouraging herbs in the form of teas, syrups made with honey, elixirs that involve both water and alcohol based extracts, etc. I like to work with tonics such as the asian herbs reishi, ashwaghanda, astragalus, rhodiola, ginseng, american ginseng, mushrooms such as shitaki and chaga, western nutritive herbs such as nettles, raspberry and oat straw in a variety of forms. In general I offer these herbs depending on the “energetics of the person”. I may offer “blood nourishing tonics” to people who appear pale, deficient and worn out. I may offer soothing and cooling alterative and nervine teas such as lemon balm, skullcap and catnip to people who appear stressed out, hot and overexcited. I may offer a massage oil infused with an aromatic plant and recommend self massage as a way of reconnecting in a healthy way to the body. How I mix and match depends on the person’s appearance and the distress process.
Q: I really liked your article on “holistic approaches to psychosis” – a topic which herbalists all too often seem to avoid. Do you have a favorite herb to recommend in this context, or one that particularly comes to mind?
Psychosis can be really challenging to mediate and means a whole lot of different things so in some ways its a fairly poor shorthand for someone’s personal and very distinct narrative of an extreme state. I have worked with people who are operating on a very unusual level with deep and heightened perceptions of reality that can be piercing and powerful. I have worked with people who are so disorganized in their thinking patterns that they cannot communicate or express their thoughts coherently. Some people become agitated and violent. Most are trying to integrate complex thought patterns and somatic experiences into a language that expresses their process. Herbs are best suited to the individual, their particular temperament and their interest.
I would also take into account the personal experience of those going though “psychosis.” If they are trapped in a cycle of poverty and homelessness, taking a regular course of herbs is not the best answer. Leading them to a place where they can receive shelter and wholesome food is the best. Most are looking for a direct connection, a relationship of some sort that is non-judgmental and authentic, a genuine expression of care and willingness to try and help.
We in the West work with psychosis in really poor ways. We either try to hospitalize or medicate the person which almost always means offering strong neuroleptics. We rarely take the time to listen to the process of psychosis, which is often rooted in trauma, broken connections at some point, abuse, neglect, a deep division where the intact filtered ego cannot hold and the flood gates of a wider unfiltered reality comes rushing in. Instead of processing this suffering, we try to close up the doors as quickly as possible, create a synthetic filter and sedate a person so heavily that they are no longer hearing the voices, or imagining bizarre realities. But the sedation comes at a price, physically and spiritually. The person is not allowed to naturally go through the process and then find a way home. The journey is stopped cold. In many indigenous traditions, psychosis is shorthand for a spiritual experience in which a trusted spiritual advisor or shaman acts as a midwife in helping the person transform and release deep suffering and come through as a wise man or woman, a healer.
So you ask which plant I would use. I start with the connection. Building rapport. Trust. A cup of tea- perhaps linden, mint, oat straw, rose, chrysanthemum…something gentle and calming. Then I try to listen and connect to hearing the person’s experience without judgment or agenda. I try to listen to the person’s song and rhythm. Are they hurting, confused, empty, wounded, hot and inflamed, angry, disconnected, confused? The person’s story and words are part of a larger narrative that is written in the person’s face, their eyes, their posture and their breath. But is what is most important is to truly listen and to try and understand the whole picture of what is happening. The plant can act as a bridge, via tea, through- scent, aroma and taste- a doorway to connecting more simply and directly with a person. The plant also becomes an extension of offering, a gift to reconnect the person to place, to ground and root the person in the here and now.
Q: Much of my research has dealt with herbs to heal the neurological or endocrine effects of psychiatric medication use (dementia, diabetes, etc.), but there is a very limited amount of information on this topic either in herbal or medical literature. Do you have any specific experiences with herbs for this purpose?
I’m not sure if I understand the question correctly but if you are talking about the positive or negative effects of herbs on endocrine or neurological systems, there are a number of avenues to explore. There are plenty of herbs that have nootropic effects such as bacopa, gingko and rosemary. They actually stimulate neurological functioning for greater alertness, memory and cognitive enhancement. In terms of endocrine systems, the adaptogens are best suited for strengthening the endocrine/immunological/nervous system over time. Herbs like eleuthero, schizandra, chaga, reishi, ashwaghanda and devil’s club all have marked effects on nourishing these systems and modulating them in a way that is salutary and strengthening.
In terms of specific experiences, I see people get better when they take tonics. Their mood improves. The light in their eyes improves. Things become less hard, less burdensome, less challenging. This doesn’t happen without modulating the diet as well and we haven’t talked too much about that but it is essential that ingesting healing herbs is paired with a diet that is based in whole foods. I am not too particular about what kind of whole foods diet someone chooses to take on (vegan, vegetarian, paleo, omnivore, etc) as long as it is based in avoiding processed foods and is high in plants. Because plants, at core, are what we are talking about. Essentially when we connect to plants in a respectful manner- allying with them, growing, gathering and consuming them mindfully, we create a way for our entire culture to repair the deepest trauma that exists, our disconnection from the Earth itself. Repairing that underlying fragmentation is ultimately the deep work that is going on here and the excessive intervention of psychiatry is really just a symptom of that underlying malady.
Editors note: Please do not attempt to discontinue psych drugs without first very carefully educating yourself on the risks involved so that you might minimize the chances of developing grave iatrogenic illness if you decide to withdraw. Doctors are not always trained to recognize such issues. Sometimes they do not realize their own ignorance. If you know what to look for you can help both yourself and your doctor learn the new terrain: Psychiatric drug withdrawal and protracted withdrawal syndrome round-up
Jon Keyes is a licensed professional counselor working in private practice at Hearthside Healing in Portland Oregon. Jon also has worked part-time in an inpatient psychiatric setting. Jon is interested in exploring alternative and holistic ways of helping people in emotional distress and crisis.
More by Jon Keyes on Beyond Meds here