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An Integrative Approach To Transformative Madness
by Michael Cornwall, Ph.D.
Here are some thoughts that I wanted to share with you about how to best serve your clients, friends and loved ones who are experiencing a psychotic/visionary experience. These thoughts will also be of help in doing self-care if you are entering or traversing a madness process.
These suggestions are mainly gleaned from my own un-medicated, untreated experience of madness in my early twenties, and from working daily as a primary therapist for almost 30 years with actively psychotic clients using a Jungian/Transpersonal, Laingian approach.
During that time I worked for over 3 years at a 24/7, alternative, 20 bed, free standing, transpersonally oriented, acute care open door program called I-ward in Martinez California where no medications or leather restraints were used or diagnoses given to consumers who were acutely psychotic.
I also helped develop a similar 5 bed program in Marin County, Passages In, that was short lived. I did several months of internship at St. George’s Homes in Berkeley where a similar Jungian/Transpersonal approach was used.
After that I worked for 25 years in public sector clinics and on a mobile crisis team as well as in private practice. Even in those settings, most of the psychotic clients I served were not on medication.
I also am drawing on my doctoral research follow-up study done on the San Francisco based, medication free Diabasis House for clients in acute psychosis and my 25 year relationship with its founder, Jungian psychiatrist John Weir Perry.
But my early experience of serving from age 18 as a medic in the Army Reserve for six years and then as a State Hospital attendant with profoundly retarded men and for 2 years as an orderly at a nursing home with brain damaged, demented and Alzheimer’s patients also informs my advice on how to relate to people in pain and suffering.
So, here are two basic principles for helping someone or yourself in a psychotic/transpersonal process which are distilled from my own experience and the study of successful Bay Area alternative programs.
1. Keep suspending your disbelief
Every time you tell yourself (believe that) the psychotic person you are being with has a tragic, lifelong, and threatening physical illness that has no inherent meaning or purpose – such as an injured brain, a genetically based diseased brain, an incurable thought disorder, or chemical imbalance – suspend your disbelief that another explanation may be possible.
Instead, hold the belief that they are going through a necessary, meaningful, developmental, initiatory, trans-formative, transpersonal/archetypal, symbolic and/or purposive natural process – one that is neither pathological nor indicative of a bio-medical brain disorder.
Hold the belief that, as Dr. Karl Menninger said, they might even come through the process “Weller than well!”
2. Be Receptive
Once you are able to stay open to the possibility that this person’s process is an important, potentially transformative natural life event, draw on all your skills of receptivity and empathy in order to be with them. Begin by simply listening and receiving the person with an open, compassionate heart. Let the gentle feelings of love that you would feel for a loved one who is frightened and suffering be present within you.
As their process unfolds, gently invite and encourage the person to express both the emotional and symbolic content of their process. People in a psychotic process may need to use modalities such as drawing, painting, movement and evocative music to express themselves in addition to or instead of speech. Somatic modalities of touch and bodywork can be especially welcomed and grounding and soothing.
The common and overwhelming evidence from Diabasis, I-Ward, Soteria and every other alternative program from all over the world confirms the basic need for a person in such a psychotic/ transpersonal process to be believed in, listened to and lovingly received and responded to in this way.
Today I also wanted to share some observations I slowly learned for myself the past 30 years about how to more specifically make yourself available to the person in the room with you who is in a psychotic/transpersonal process.
To be most helpful try and feel like your inner subjective state is more emotional than mental.
Create a physical and emotional state of receptivity. Let warm feelings of caring be present in you.
With your feet flat on the floor, hold the awareness that there is now a solid base and foundation beneath you.
Remember to keep your anal sphincter relaxed.
Keep a focus of energy in the hara chakra below your navel.
With your stomach muscles relaxed, feel yourself do deep and slow belly breathing.
Drop down your shoulders.
Let your face become calm and relaxed–not becoming pensive or quizzical.
Let your voice come up from your hara in lower octaves, emerging with the energy of your heart chakra as you speak.
Let your kindly, gentle, even loving and tender feelings of empathy and compassion arise in your heart chakra for a fellow human being in distress and suffering who is sharing the room with you.
Allow silences.
Don’t seek direct eye contact if it seems to make the person uncomfortable.
The person may be in a very heightened state of awareness and is processing minute inflections in your voice and body language.
Their ability to see into you may surprise you as uncanny and psychic.
In this state they may directly or symbolically tell you secret things about yourself that are disquieting.
If the person is hostile increase your vigilance on your own physical and emotional markers of receptivity.
Because you may find that you may involuntarily be holding your breath.
You may notice your throat becomes constricted and your voice goes up in octaves.
You may notice you are opening your eyes very widely and blinking a lot.
You may feel the need to fold your arms across your chest or cross your legs.
To the degree that you can be aware of these shifts in you prompted by anxiety, you can refrain from them as much as possible and remain in the open, receptive, emotional and physical posture with a potentially physically or verbally assaultive person in a psychotic process.
The more you stay grounded and centered the more they will calm down, will not sense a fight or flight visceral response to them building in you.
Being with agitated clients in a psychotic process is kind of like practicing an internal martial art at times – a form of Aikido.
To give yourself the best chance of staying open and receptive be realistic about real danger to yourself.
Have another person keep an ear open and check at your door if you are meeting with a hostile person.
Position your chair by the door if with an agitated person to allow quick exit if you are attacked.
Give yourself the intentional permission that if necessary to survive a physical attack you will struggle to defend yourself in a way that would cause the least amount of injury to your self and to the other person until help arrives to contain the situation.
Madness is an ancient form of uncivilized wildness.
If you are given the opportunity to serve those traversing it’s mysterious depths and heights count yourself lucky, especially if they are not emotionally anesthetized by medication.
The efficacy results from the Agnews Project, I-Ward, Diabasis, and Soteria House all clearly demonstrate that without medication, most acute psychotic/visionary crises will in fact be the occasion for a life changing spiritual transformation if a 24/7 alternative, non-medical model sanctuary is provided.
My experience and research into alternative approaches for serving those in a psychotic/visionary process has led me to believe that that at least 50% of the consumers who become trapped in the mental health system could have avoided that fate if acute care, 24/7 Bay Area sanctuaries like Diabasis House, Soteria and I-Ward (where I worked )were available at first contact with the system.
They never would have gone on to be labeled Schizophrenic.
Jung said that: “Psychiatry has turned the Gods into diseases.”
Unfortunately Jung and most Jungians have turned the Gods(and Goddesses) into archetypes: named and minutely described denizens of the collective unconscious that we can have an ‘as if’ relationship with at weekend workshops and schoomze with once and a while in our dreams.
Please don’t make the mistake of underestimating the spiritual dimension of our human birthright as you enter your own shamanic vocation.
In my experience, behind every image, thought and word, there is an emotion first. Behind every emotion there is a universal archetypal power and emotional energy that must come forth as imagery that expresses that deep emotion. Behind every archetype is a totally autonomous living force of deity that has no historical bounds, no time bound form.
These ancient and emerging deities, that use our lives and bodies as their playgrounds and every second hold us in sway as they incarnate themselves in us, ever emerging anew, arise out of a greater unifying mystery of benevolent silence.
Weep for the prophets and so-called psychotic visionaries who are robbed of their life giving gifts from the Gods by our culture of fear and human arrogance. And weep for us that we still treat them as lepers when they are, and always have been a divine source of the mana we need to survive on earth.
As a psychotic process begins, the psyche is faced with such overpowering unbridled emotion that the inner emotional charge grows to become profoundly existential in nature and magnitude. As the person faces the initiatory challenge of young adulthood in such an all pervasive liminal depth, the ego, the frail manager of consensual reality, simply is engulfed by the soul depth liminality of an emotional power that triggers all forms of desperate, seemingly delusional attempts to give some fragmented sense of meaning to the inner experience.
It is a visceral, first chakra existential experience that seizes the individual. It is the emotional response to being lost. It may be experienced mainly as one feeling exalted and indestructible at first or feeling totally doomed and bewildered.
The experience may also fluctuate between being plunged into the underworld and being drawn up into heavenly realms with amazing rapidity.
In any case, if not made numb by medication, the psyche creates a mythic story along predictable lines. The drama is played out on the stage of the central archetype, the Self, where every kind of polarity may be experienced and transmuted: good/evil, dark/light, male/female, life/death, terror/serenity, grief/joy, desolation/birth. All the emotion generated and image fueled polarities may be contained in the mandala crucible of the relationship you create with the person who is mad. In that container with you, all the polarities can be balanced into a cohesive unity.
That relationship with you is crucial, is a prerequisite for transformation and healing to occur.. Without a loving other to make the mandala crucible forged of their two hearts and psyches, the mad person spins on out of control.
Psychosis is the ultimate identity crisis and is for some, a potentially shamanic initiation. Our feeble, arrogant egos usually assume we are master of knowing “Who am I?”
As the pre-psychotic/visionary ego floats in this ignorant vulnerability over an abyss of the unfathomable depth of the collective unconscious and spirit world of gods, demons and ghosts, the ego is always just a few nights without sleep away from psychosis, or a drop of LSD away from psychosis, or from a psychosis triggered by a kundalini eruption, or a loved ones sudden death.
The unprepared ego of an especially vulnerable young adult facing autonomous functioning separate from their family is at risk from drowning in the depth of the affect and images of the collective unconscious.
It is remarkable that the childhood tasks of such a vulnerable ego do not overwhelm it. However, in the late teens and young adulthood comes the awareness of mortality and the knowing that physical survival and social acceptance and success depend on functioning separately from parents.
Because of the power of our toxic and soulless culture to create enormous deficits in our family systems, most notably an epidemic of the lack of a strong infant-parental love bond, when faced with the often cruelly threatening social Darwinism cultural gauntlet one must traverse into young adulthood, the pre-psychotic ego for some is simply not prepared to traverse the hero’s journey and initiation across so much underlying liminality.
We can’t underestimate the corrosive and pervasive effects on vulnerable children and young adults that our largely loveless and spiritually barren corporate culture inflicts through degradation ceremonies of endless winner-loser competitions where shame and guilt and punishment break the spirits and hearts of so many.
For such vulnerable young persons, an affect of an unnamed existential terror, the dreadful sense of an abyss of yawning ontological insecurity seizes them. This overpowering challenge may then trigger an attempted visionary alternative restructuring of the ego through a radical immersion in a mythical inner struggle for adult independence.
This inner heroic struggle for ones future life is carried out at the archetypal center of the Self, if the young person’s process is not aborted, if they are given sanctuary and not medication.
I have seen them come out the other side with a new, heroic ego strength that grew out of their trial by fire.
As the great R.D. Laing said after witnessing and attending many on such a journey at the Kingsley Hall sanctuary he provided:
‘From the alienated starting point of our pseudo-sanity, everything is equivocal. Our sanity is not true ‘sanity.’ Their madness is not true ‘madness.’ The madness that we encounter in ‘patients’ is a gross travesty, a mockery, a grotesque caricature of what the natural healing of that estranged integration we call sanity might be. True sanity entails in one way or another the dissolution of the normal ego, that false self competently adjusted to our alienated social reality; the emergence of the ‘inner’ archetypal mediators of divine power, and through this death and rebirth, and the eventual re-establishment of a new kind of ego functioning, the ego now being the servant of the divine, no longer it’s betrayer.’