Writings

Essay

Opening To Wisdom:

De-Mystifying Manic Depression

By Alice Holstein, Ed.D.

By the time I finally developed some coherent conclusions about manic depression, otherwise known as bi-polar mood disorder, I was so battered from dealing with it that I could hardly stand up again to tell the story. One day, in the midst of my shakiness, however, I realized that telling the story would help my healing. I will begin towards the end of that path that has been both tortuous as well as a route to authentic selfhood.

During my ninth year of psychoses, which followed nine years of undiagnosed mood swings and which now also mark more than two decades of mystical experiences, some understanding about this path came together as a whole. With it came a conviction that I would no longer need the suffering anymore.

There is no simple explanation and no single cause to explain the mood swings and their damage that characterize manic depression, which is evident from periods of depression alternated with periods of mania, or being out of control and therefore not dealing well with consensual reality. The Native Americans, however, have it right when they say that illness is a result of imbalance in the mental-emotional-physical-spiritual being. There is a branch of medicine called psychoneuroimmunology that would agree. (Hammerschlag, 1993) We are mind-body-spirit beings, all of which interact and have an effect on one another. Thus, to say that manic depression is a biochemical imbalance is insufficient and to treat it only with potent, often damaging psychotic medications is a practice that bears considerable re-examination.

Having worked hard, since 1998, to get well using a variety of approaches, I knew that recovery required work on the physical, emotional, mental and spiritual levels. It was not until 2003, however, while reading a book about diet, The PH Factor, by Young and Young, that I more fully understood my particular causes. The authors discussed the imbalance that can come from eating unhealthily, as is much of the standard American diet. My heart quickened when I found the paragraph about the imbalance in the emotional, spiritual, mental body that can affect the physical and vice-versa. My book on Nutritional Healing lay nearby, enabling me to look up additional information. Suddenly all the pieces came together. What did not come together at the time was the exact nature of a core wound I’ve carried, nor how to work more deeply with my wounds and lack of grounding. These factors would take another harmful episode to discover. One of the uncanny things about recent episodes is that each seemed to carry underlying beneficial purposes; each one pushed me deeper to the core of both my creativity and to understanding this illness in total. It was as though I was being moved along by chaos to get to the next person, insight and book that would create the whole picture. The fact that integration has occurred is part of a newfound conviction that I can now be well, but I am aware as well that only time will tell.

One of my most important healing clues came in 2002 when I dreamed that I had abandonment issues. I believe I had the dream in the first place because I had been working diligently for five years to do everything I could to counter the seeming death sentence that resulted from an incurable, highly debilitating condition. I say “seeming” because the doctors painted such a bleak prognosis. Starting with the mere pinprick of belief, however, I think my slow but steady fight for health strengthened my psyche enough to yield this gem of information. The dream also miraculously suggested that I needed cranial-sacral help, which I sought. This is a gentle form of bodywork that seeks to restore internal balance. Together the dream insight and some therapy helped set off a wave of what felt like healing connections in my brain. Although my psychosis and diagnosis emerged in 1993 and my determination to be as well as I could be in 1995, it was only from 2002 onwards, despite having more episodes, that I felt as though I was reclaiming my life in a positive sense. I experienced growing creativity, learning important life lessons as I hurtled along.

I trust my dream life when it reveals one of these “big dreams” that seem significant. The abandonment issues are likely a primary cause of my illness as it may be for many others, for there is research to show that loss of a parent is often a factor. (Torrey and Knable, 2002) But there are many ways to “lose” a parent, and the picture must include a set of multiple causes. Everyone undoubtedly has a different mix based on mental, physical, emotional and spiritual factors. Uncovering the emotional wounds, however, is difficult. Mere questionnaires won’t work. Besides that, once you uncover the wound you must find a way to work with it to heal.

A helpful tool that enabled me to see the family dynamics surrounding the wounding was a Hellinger Family Constellation workshop, a unique form of psychotherapy that is well known in Europe. The workshop showed me that my mother was full of emotional losses that had never been grieved from her family background, thus weakening her and causing her to be unbalanced. They also meant that she was physically present for me but not emotionally. My father, who abandoned her by going off to World War II when he was old enough not to have to go, deepened the wounds to the extent that she rejected him when he returned. He, in turn, punished me unfairly, sort of like kicking the dog, instead of working out his anger with her. His disappointment in her later caused him to turn to me for companionship, although he turned out to be an absentee, workaholic father as well as an alcoholic. I adopted the hero role in response to all this, agreeing at a subconscious level to parent the parents and their unmet needs. This is an automatic setup for depression. Seeing these dynamics through the Hellinger workshop, plus experiencing the healing from having the broken love connections restored, constituted a quantum leap in my healing process.

Trying to parent both wounded parents is a devastating burden to carry. As a young adult, I became an addicted person, taking up smoking at age 20 and drinking too much by my late 20’s. Both of these addictions create a serious lack of balance in the physical body. Besides the abandonment wounds from both parents, I am ultra-sensitive in an emotional sense, am intelligent and creative and became a channel for the creative forces of the universe by undertaking the hard work of the inner journey. There is a saying among people pursuing higher consciousness work; the cleaner you get (from the collective wounds of childhood and socialization), the cleaner you must get in all respects. This is a countervailing notion to the one offered by traditional medicine that manic episodes become worse with age. They may, in fact, be merely signals that we simply must get balanced and healthy, and the closer you come to higher vibration levels, the more sensitive you are to disturbance. Sages and saints of the past have pointed out that one must be of extraordinary health in body and mind if we are to handle the input of spiritual energies.

During 2003, when I put together a wholistic picture of my illness, I realized that my addictions had contributed to the underlying emotional imbalance from my family life. It is a known fact that cigarette smoking creates physical imbalance, depleting us of essential vitamins. Alcohol is another cause of physical imbalance, also depleting our nutrients. While I never declared myself an alcoholic per se, I abused the stuff for about 20 years. The addictions, in combination with a relatively poor diet, set up a condition of hypoglycemia, meaning low blood sugar and fluctuations that create blood chemistry imbalance. Depression and mental disturbances are among the symptoms. Add to this the fact that during the 70s and 80s my diet was full of canned and frozen food versus the fresh things I eat today. Another factor is that the deadly combination of caffeine, alcohol, smoking and stress, such as from loneliness or family problems, can exhaust the adrenal glands. This element is never examined by traditional medicine. Dr. Norman Shealy, author of Sacred Healing quotes a grand master healer whose success has been documented, as suggesting that mental disease of a major brain dysfunction is impossible when the adrenal glands are functioning normally. (Shealy, 1999, p.70)

Beyond the physical aspects, when the mood swings began, I had no sense of belonging to family, place or steady socializing activities. I lived in a huge city. I was a single-minded career woman trying to make it in a man’s world and I had no children or family of my own. In short, I was a mentally ill person waiting to happen when my father and mother rejected me as an adult when I was 42. The reason was that I had talked back to my patriarchal, German father who could not listen during a sad replay of the original family dynamics triggered by my brother’s mismanagement of the family business. The parental rejection took the form of my father disinheriting me, a gesture that was reversed when he was diagnosed with cancer not too long afterwards. Then I returned to the family fold to play the hero role again. For some months, however, I was cast out of their life. That was quite an emotional blow given the fact that I had no family of my own nor a support system to cushion the effects.

I now see in retrospect that the mood swings date to this period. One doctor informed me that although most people become symptomatic in their late teens and early twenties, there is a secondary pattern of onset at midlife. During the initial years, however, the highs consisted of intense energy infusions of creativity, spiritual insights and envisioning sessions that went on for weeks. I am typical in that I went for at least nine years without a diagnosis while I dealt with puzzling symptoms that only later turned psychotic. That brings me to another important cause factor, which is that we are all creative, spiritual beings. Medicine, however, either does not acknowledge this or else does so only grudgingly without understanding the potential relationship of creativity and spirituality to manic depression. Actually the spiritual quadrant is supposed to begin opening in our teen years. Native Americans send young people out on vision quests to call in their spiritual life at age 15 and 16. And Elisabeth Kubler Ross, who found that dying people could find unexpected creativity and spiritual depth before death if they dealt with their emotional wounds, suggested that the spiritual quadrant would open in teen years if our cultural conditioning was not so thick. This can help explain why some people experience their first manic depression in these early years. The eruption comes as part of a spiritual opening amidst wounding in emotional and physical areas, but it is labeled only as madness.

To grasp the relationship of both spirituality and creativity to the overall psyche, envision a circle cut into four quadrants as the basis for a Jungian model of psychic development. Such examination shows us how significant creativity can be recaptured through inner work at mid-life. Starting at the top, right hand quadrant is the phase of infancy, or our physical self in rapid formation. During the first months and early years of life, our primal needs of hunger, food, warmth and love are dominant as we grow explosively into curious, mostly joyful children if we have not been too severely reprimanded or otherwise damaged due to poor parenting. The fact that some 98% of children ages four and five score very high on imagination, the key component of creativity, is cited by George Land, creativity expert. Five years later the same children were tested with the same instrument and only 30% of them remained imaginative. The story gets worse with age, for over a million adults have been tested at an average age of 31 and this time only 2% were imaginative. These are the dismaying effects of socialization. Children are naturally creative until social conditioning dampens if not forever blights the urge. Creativity studies suggest that most of us have an inner child that is wounded to a greater or lesser degree. Those with illness are the most vulnerable and are called to work through the wounds.

To return to our Jungian model, continuing counter-clockwise, the lower, right quadrant lies just below the infancy area on our imaginary circle reflects childhood, the time of extreme dependency on parents for physical and emotional nurturance. This is when the child’s mental and emotional nature is solidified along with significant physical growth. Moving along to the lower left quadrant, however, following childhood, is a time of intellectual development when the ego must gain control over emotions in order to develop our rational, thinking side. Adolescence is a time of turmoil and increasing bids for independence. In order to develop the faculties required for healthy ego strength, the child must throw off or say “no” to the feminine, the dependency needs, the emotional ties of childhood. This rejection of the feminine, in other words, is a natural part of growing up for both sexes.

As we continue moving around the circle to the upper left quadrant, we find the spiritual part of the Self, which is most often discovered during mid-life. As early as our late teens, however, there can be a quest for meaning and a search for answers about religion or spirituality. To fully open the spiritual quadrant, however, usually requires the age of 35-40 when Carl Jung suggested we undergo the “individuataion” process. This is an experience of unpeeling the egocentric roles and behaviors of early adulthood, going deeper within to find a heightened meaning for life and a sense of our own unique purpose. Depending upon a number of factors, including the degree of wounding, the consciousness level of one’s guide (i.e. a therapist), your level of sensitivity and the state of the culture, the work can be painful and arduous. What is required is the recovery of the emotional trauma of childhood so it can be healed and integrated at a new level. This healing process more fully opens the spiritual quadrant to its considerable creative, connecting powers. Not doing such work frequently results in illness, death or a life less than fulfilled. Some people may do this work unconsciously as a process of maturing and aging. Others might do it more consciously and painfully but end up fulfilled.

Despite all that has been written about “the inner journey” in the past 40-50 years, the fact that it is a part of maturation and can involve difficult, painful work is still not a part of everyday expectations. Instead, our consumer-based society paints a picture that only achievement and “success” of various kinds is the norm. And when pain or illness strikes to inform us of imbalance, Madison Avenue suggests that pills are the answer. Mainstream medicine then stamps a damaging label along with little hope for healing if you exhibit the mania side of manic depression. The alternative view, from the standpoint of whole person concepts, is to consider that spiritual energies are opening without the emotional and physical health to support this breakthrough to higher consciousness. Both mysticism and transpersonal psychology contain important clues that handling this level of mature human functioning requires extraordinary strength and balance. Present treatment methods, however, assure that you will become categorized, stigmatized and dehumanized in a way that further alienates you from a self that has already been fragmented and frightened by an experience of being a divided soul.

Research indicates that 25% of us recover completely, (Torrey & Knable), but doctors do not mention this and insist that only drugs can control the illness. Frequently, however, the drugs suppress thinking and functioning; they are often given in combination with others without knowing the side effects, which can mean serious harm. The magnitude of this approach to medicine includes the startling statistic that 157 million people take anti-depressants on a daily basis (Magney, 2004) much less the chemical stew of anti-psychotics and mood stabilizers that are given to those who suffer manic depression. Such massive ingestion is occurring without knowing the long-term effects.

Looking back over the progression of my illness, it is apparent that my spiritual quadrant began to open with a vengeance as I did the work of the inner journey without having healed the core wounds of childhood while I continued to smoke, drink and eat poorly. I also developed hypothyroidism at midlife, which is often an exacerbating factor in manic depression and is related to the imbalances of hypoglycemia as well. Add to this picture the shifting hormones of a mid-life female body and you have a recipe for disaster in my case.

One of the puzzling things about my mania during 2002-2004 was that there seemed an underlying purpose to the episodes. On the outside there were what people would call “horrible circumstances,” such as homelessness, hospitalization, disrupted work and financial resources I could ill afford to lose. In addition, I became intolerant to many medications, including lithium, depakote, naurontin, resperidal and zyprexa. Several of them gave me dreams about death, several felt like poison in my body and there were symptoms of malaise, abdominal pain, cramps and dizziness. Beyond the surface damage of the episodes, however, I could see some positive effects. The disruption of work as a consultant, for example, removed me from work that I had begun to realize was not where I belonged. The rejection from several people whom I thought were friends or colleagues initially hurt but then became apparent were not compatible relationships. Losing them meant also that I decided to validate myself by coming out of the closet at a mental illness hearing. Doing so undoubtedly cost me in terms of some people’s acceptance, but to become open in public about being mentally ill was a tremendously freeing thing. I no longer had to hide. I was also moved to plunge deeper into my own creative writing work.

Another example of the perverse nature of these episodes is that my 2003 hospital experience so angered me that I put together some 30 years of research about how to redesign complex systems, such as healthcare, partly based upon my 19 year evolution of an organization transformation methodology. This formed the basis for an article or thought paper. Finding out that I was not healed as I had hoped also pushed me deeper into manic depression research, especially the relationship to creativity and mysticism. Given the fact that there is so much mystification about the illness and such tragic consequences from the way it is currently treated, maybe it has been my role to be pushed to the extremes in order to forge some insights for consideration.

Since 2002, when I began to reclaim my life in a positive sense, I have found meaning in the possibility that my background in humanistic and transpersonal psychology plus my writing skills and extensive reading about mental illness will someday, after a period of health that establishes credibility, enable me to be spokesperson for more enlightened treatment. Being a single woman without children means that I have had to undergo the trauma essentially alone I thus claim my warrior badge freely and will admit that the process nearly killed me several times in several ways. But my singlehood and some financial resources, despite the drain of thousands, also means that I was fortunate to not end up on the streets. I had also had miraculous help along the way, from small and large acts of kindness to incidences such as that healing dream.

In 2004 the mania was accompanied towards the end with the feeling that I had finally hit the wall with this illness. I realized I simply had to find the last missing pieces to heal. Several things were different. One was that some further ideas about the whole puzzle came together. The catalyst was a Native American whom I experienced as grounding and balancing force while I was on a crazy winter journey in Minnesota. Conversation with this man brought me to some unusual insights, for I compared his life to that lived by many mystics in history. For example, he was a man of the earth, belonged to a tribe and had an extended family and children. This web of support makes a difference when you are manic! Many mystics live in religious orders that supported them financially, emotionally, mentally and spiritually. In contrast, I had none of these, yet I have been having mystical experiences since 1980. His situation convinced me that I had to build community and deeper roots in my life to stay grounded. The more I understand the culture we live in, however, the more I see how crazily imbalanced it is in the direction of achievement, independence, individualism and alienation without the balancing forces of community, cooperation, collaboration, rituals, ceremonies and collective meaning. No wonder it is so hard to get well and stay well. The illness alienates us from ourselves as well as others so that it can become extremely difficult to construct a meaningful life.

Thus, on one level I began to fully claim my own power as a creative, wise woman who had had mystical experiences, including the long, “dark night of the soul” that is characteristic, I also could see some kinship with the Shaman experience, for these are wounded healers who have danced with the forces of illness, including near-death, in order to bring back gifts that might help others. After the 2004 episode my desperation to heal led me to a breath work therapist who catalyzed a significant breakthrough. Thinking that I wanted to learn a meditative exercise that has grounding as well as purifying effects, I made an appointment. Instead, we began with a rebirthing session that unearthed an incest experience. This felt like a core wound that kept me prisoner to the illness. It helps explain the disassociation or soul flight during manic episodes, for such trauma amounts to stealing the soul of a child. The second breath work session was a profound release of the pain I carried in my body from both the incest wound as well as the manic episodes themselves. The session incorporated a way to release the underlying pattern.

Several other things fell into place. I found a Deepak Chopra book that helped me begin a comprehensive program to shift consciousness about the way I approached all of life, from how I ate, to meditating, to being in the “now,” and getting connected to nature. In addition, I incorporated daily phone calls with a loving friend and began to build a life based on meaningful social involvement. My latest episode had moved me along, in desperation but nonetheless meaningful change, to a better place.

An Enlightened Theory Of Manic Depression Causes

The new ground where I stand includes renewed convictions about the possibility to heal, new daily healing habits such as meditation and ritual, a commitment to build community and the solidity of having formulated my ideas about manic depression causes and potential healing, which is different than “cures.”

My conclusions include:

1) Mystics show us the capacity of spiritual evolution in the species. I have done research over the years that shows some 28 different versions of how the psyche unfolds, coming from diverse fields and researchers. This collection of data indicates that a level of consciousness beyond what we normally understand as consensual, egocentric reality is possible and in fact, is being pursued by many people today. Underneath the different words that are used to describe this process and the variations in the stages themselves, there exists a similar pattern of unfolding to higher levels. This is the path of the mystic. It is also Joseph Campbell’s “hero’s journey” and the path of Shamanism. Buried in the compilation is the striking fact that the most wounded (i.e. the addicted and those suffering trauma) follow the same path as the saints!

2) The reason this capacity for higher consciousness does not open more than it does for the general population is the weight of cultural conditioning and wounding that exists as “normal” in society. The more dysfunctional the family, however, and the more sensitive and intelligent the child, the more possible that breakthrough to spiritual levels is registered as disruption that becomes labeled as mental illness. The culture as a whole is imbalanced, however, and has remained largely unconscious about its wounds until the baby boom generation seized the opportunity for higher consciousness.

3) Mysticism and creativity show similar characteristics. The relationship between creativity and manic depression is well documented, but only one pair of authors makes the leap about the relationship that mysticism might have to manic depression. (Hershman and Lieb) Studying mysticism as well as transpersonal psychology, however, suggests that extraordinary inner balance and health is required to handle higher consciousness levels, or what might be called strong psychic energy.

4) Many manic depressive sufferers are likely those who experience breakthroughs of the impulse toward both creativity and spirituality, but do not have the internal health (physically, emotionally, mentally, spiritually) to handle these incoming energies. Because emotions exist throughout the body (Pert, 1997) and influence everything else, triggering emotional wounds can create short circuits that travel to the brain and cause “irrational, abnormal” thought and behavior.

5) The traditional medical establishment, however, deals with “the problem” only in terms of consensual reality and only in terms of the biochemical imbalance, thereby assuming that a biochemical medication cure is “the” answer. A more enlightened view would be to consider that balance might be restored by treating the whole person in terms of mental, emotional, physical and spiritual aspects.

6) Some of the short circuits that occur for the manic sufferer can be understood as projections into the past or future in a leap of multiple realities that Native Americans understand as possible. The possibility of multiple realities also comes from a popular theory in physics known as “the string theory.” There is generally no attempt from the medical community to “be with” a patient suffering paranoia or delusions. The health care system in its present mode is simply not set up to allow such support even if the providers might be sympathetic, which they usually are not. Instead, such symptoms are sometimes met with professional attitudes that constitute toxic shaming.

7) Research shows that parental loss is a factor in much manic depression. Finding the trauma beneath the illness, however, such as my incest experience, may forever go untreated. Interviews alone will certainly not surface this material; the person may not allow the truth to be revealed until they are ready or have the right guide or helping professional. Maybe I was desperate enough in 2004 to finally be ready, or perhaps this was merely the right healing environment. Current treatment modes, however, relying so thoroughly on drugs, will mean that the truth remains forever submerged. Often these experiences reside in the subconscious where they cannot be either easily identified or else they never do surface because sufferers do not seek alternative healers who help uncover and heal such wounds.

8) There are several answers to the familiar argument that manic depression often has a genetic origin. One is that the tendency to alcoholism also shows a genetic relationship, but this does not mean that one is destined to become an alcoholic. In addition, we must look at the claim that dietary changes can affect genetics as well as the work of the neuroscience pioneer, Candace Pert, co-discoverer of endorphins, the brain’s natural opiates. Pert’s work provides growing evidence that consciousness inhabits the humblest quarters of our flesh. “A change in body is a change in mind; a change in mind is a change in body.” (Barasch, p. 46-48) In addition, the Hellinger work shows how emotional trauma from past generations, buried for years and unavailable to normal consciousness except through this approach, can be uncovered and healed. The trouble with the genetic linkage argument is that establishing its presence becomes permission to do little more than accept drugs as the sole response. Not so long ago we blamed parents of the mentally ill for their children’s illness, which was grossly unfair and misdirected. But we have swung to the other pole, blaming all mental illness on brain chemistry instead of examining all the factors that affect the brain. In terms of my own experience, alternative treatment methods and Hellinger family constellation work (which has been widely practiced in Europe for over 30 years) should be rigorously pursued. The trouble is that alternative methods cannot easily be studied using the scientific method. The exception to this is Emotional Freedom Technique (EFT) the acupressure tapping method that was developed in the 1990’s. While some still view this energy psychology with suspicion, EFT has actually met the criteria for evidence-based treatments set by the American Psychological Association for a number of conditions, including post-traumatic stress disorder. The Department of Veterans Affairs (the VA) utilizes this method with veterans, especially those suffering from PTSD. Using EFT broke a depression for me and later, helped me tap away PTSD symptoms from my many manic episodes. While I was not allowed to teach this technique in my VA practice as a Peer Support Specialist, I often referred patients to my supervisor, a psychologist, who regularly teaches her clients to use this with great success.

Changing Treatment

Seeing manic depression as an underlying urge toward wholeness could drastically change the way the illness is treated. The first step is to develop an enlarged framework for understanding the illness, based upon the idea that it is a condition of imbalance in the physical-emotional-mental-spiritual being. This is not a suggestion that means one should get off their medications. Instead, it is support for people to seek alternative health practitioners and assume more responsibility for their own recovery. The now well-known WRAP (Wellness Recovery Action Plan) helps people accept this responsibility. It contains a number of steps that encourage people to build a support system, conduct daily wellness regimes, identify persons and things that help them stay well, develop a crisis plan for when things have not gone well, etc. It is a powerful awareness tool as well as a regular guide to staying well, but often it is developed and then not used.

A treatment plan needs to address all four levels---the physical, the emotional, the mental and the spiritual, yet one cannot work on everything at once. Recovery is usually a step-by-step process. Nonetheless, if people were exposed to a new understanding of the illness and encouraged to pursue recovery rigorously, the outcomes might be far different than the estimated 45 billion or more that this illness costs us each year, plus the hundreds of suicides, the thousands of truncated lives and untold cost to family, friends, co-workers and employers. There are sometimes tragic consequences of the failure to treat this illness adequately, such as the young man in Santa Barbara who was diagnosed as bi-polar and had stopped taking his medication, as is common, when he drove down a street and killed four people.

The need to treat the biochemical imbalance with significant changes in diet and nutrition, plus a naturopathic blood analysis that is followed with food supplements, reminds me of the radical but common sense plan developed by Dr. Dean Ornish to treat heart disease with extreme dietary changes, exercise and group support. His approach has been shown to reverse the illness. Although the naturopath who helped me become more balanced through the use of supplements knew the value of nutrition, I did not fully appreciate the subject until I found The PH Factor book. Mainstream medicine, however, by and large still seems to ignore the idea that what we eat may be critical to restoring health. This may mean making a significant lifestyle change, which suggests that group support may be helpful if not necessary. Still, there is continued reliance on medications from psychiatrists who push pills to the virtual exclusion of all else.

Emotional wounding can be addressed at a variety of levels. The Hellinger Family Constellation workshop method is an extraordinarily helpful way to show us clearly what happened in our families of origin, including the dynamics from generations past that have been unconsciously transmitted to the present. Just seeing the truth can be healing, but the artful facilitator also excels at helping heal the broken love connections in the family. Mention this method to almost any psychiatrist and their eyes will cross, seeing it as some kind of witchcraft perhaps, but it is increasingly being used in therapy practices, particularly on the East and West coasts. Breath work, cranial-sacral therapy and other energy work may be other vital tools along with such things as Tai Chi and Yoga which help balance the physical body.

Working at the mental level includes doing everything possible to avoid the deadly effects of labeling. You cannot imagine the assault to one’s being when you are seen as damaged goods, faulty merchandise and terminally abnormal. Few of us are strong enough to endure such continual onslaught. There is first of all the assault of the illness itself, but it is the assault from medicine and society at large that makes it so hard to get up again. Amidst this prevailing atmosphere, however, working with forgiveness exercises might be a must. At one point I was so loaded with anger about the inhumane treatment I had encountered in a variety of health care systems that I designed a self-help method of writing out forgiveness exercises which I did every morning for six weeks. We must find ways to leave the anger and shame behind!

The question we need to ask about this illness is, not what is going wrong here but what is trying to happen beneath the surface? What urge toward wholeness is being expressed through disturbance and imbalance? The same question could be applied to many other illnesses if we understood that imbalance is a major cause and that healing often exists. Most cruel of all is to perpetuate the belief that recovery is impossible when doctors such as Herbert Benson, Bernie Siegel and Carol Simonton have proven that hope and belief play a strong fact in many cures. Dealing with the spiritual aspects of manic depression require acknowledging that soul and spirit do exist and play a vital role in healing. In fact, damage to these parts of the psyche may be one reason for the symptoms! Beneath the surface of puzzling surface symptoms is the creative force attempting to break through the wounds, creating imbalance that translates to craziness.

What does the spirit respond to? It responds to love. It responds to art as healing, whether that is writing, dance, painting, photography, gardening or journaling. It responds to nature. It responds to music. It responds to prayer and ritual. It responds to empathy and group support. It shrivels in the face of diagnosis, labeling and medications that are foreign to a natural life. It withers and dies in the face of ostracism, judgment and rejection.

We are particularly bereft of both group and individual rituals that might be healing in our culture. A whole book, Transpersonal Medicine (Lawliss, Shambala, 1996) has been written about this subject. An “art in healing group” might be beneficial because people can merely be present to one another as encouragement and soul witness. Art therapy is common in hospital settings, but that is different than a group where ordinary people can merely be present to and with one another in life affirming ways.

One of the most effective ways to nourish the wounded spirit of a mentally ill person is merely to listen to them in a compassionate way. Whenever this happened for me, I always had an easier time coming back to myself. Since I have been a teacher of communication skills as an organization consultant, I can verify that the majority of doctors and hospital staff need to be thoroughly trained, then retrained often, in the difficult act of active listening. This type of listening involves being able to see the world through the other persons’ skin and reflect back what they are saying at a word, feeling or meaning level. Not having this skill ingrained means that psych patients hear much judgmental communication that may include staff who try to talk us out of irrational behavior or thought, which only alienates us further. Sometimes we experience outright emotional abuse.

Being listened to can actually be life-saving. These are so-called “transpersonal moments.” One time, when I was in a near-death sequence, a Franciscan sister was simply there for me in loving presence. Without such total acceptance, I’m not sure I would have made it to the next step in my recovery from a traumatic episode and equally traumatic hospital stay. The psychiatrist, John Weir Perry, who became known more than 30 years ago for his avant-garde work with schizophrenia, had profound words to say about “being with” the person in their altered reality. His belief was that the Self was attempting underneath to heal and reorganize itself and that bearing witness to this process would help that happen. Unfortunately, I believe he had only one of several important pieces of a radical new approach to mental illness. Thus, his brave attempts at changing the way mental illness was treated were defeated, soon eclipsed by the pharmacological approach.

Study of the mystics as well as transpersonal psychology and higher consciousness tells us that handling strong spiritual energy requires extraordinary balance. We already know that there is a strong correlation between manic depression and creativity/genius. It is also known that 98% of children are creative while only 2% remain so in adulthood. What happens along the way? The answer is that the inner child becomes socialized and often wounded. Most of us function as adults with that wounded inner child that fills itself up with addictions of food or alcohol, drugs, relationships, sex, smoking, busyness, gambling, intellectualizing, work, sports, television, religion or modern technology. Over a decade ago John Bradshaw observed that there are 60 million sexual abuse victims, 75 million lives seriously affected by alcoholism and unknown numbers by hard drugs. Over 15 million families are violent and there are 13 million gambling addicts. We are a highly addicted society!

Illness, however, CAN be the route to authentic selfhood. For medicine to consider this possibility, however, would mean the need to reframe and expand the basis of provider training. Such expansion undoubtedly would appear to them as having been wrong about their approaches. But what really needs to happen is to admit that the knowledge we have is not so much wrong as incomplete. And we need not throw out the previous knowledge but rather, expand upon it. Certainly a new paradigm, however, would mean that doctors moderate their convenient reliance on pills, learn how to truly be “with” their patients and then be willing to design a different approach to treating manic depression and perhaps other mental illnesses.

One of the forms that a changed treatment picture might take is a drop-in center where a holistic approach is employed. Education would be paramount in various areas. Strong skills in active and empathic listening would be a staff prerequisite. Various modes of counseling and healing would be available at various times so that clients could be guided to next steps. The center would also be a place where groups could form, including art in healing, healing rituals, drumming, mindfulness practices, meditation and more. The center might be linked to other community resources, not set aside only for the mentally ill, for there is much commonality to healing strategies that affect other illnesses. All over the country if not the world we have cancer centers, heart centers and addiction treatment centers. Why not depression and mental health centers? We say that’s because that’s not where the money is, yet if we looked at the costs of depression in lost productivity and family pain, and at the costs of lost lives and productivity of other mental illnesses, we might quickly see that there is cost-benefit gain to funding and staffing such centers. We are being penny wise and pound foolish in our treatment of the mentally ill!

Meeting my Native American friend was helpful to me on multiple levels. I understood completely from my encounter with him that the plight of his people is to have undergone a process of psychological destruction. Bearing the burden of manic depression is similar, and seeing the comparison strengthened the vow to continue my own reconstruction. I take heart from much Native American wisdom, such as their belief that the mature person is someone who has been publicly embarrassed and survived, or that one needs to empty oneself of negative emotions in a safe environment, such as in a sweat lodge.

Besides creating healing centers, the whole culture needs to change in the direction of those millions who are already seeking higher consciousness. The rational, intellectual nature of this era in history, with its “death of God,” its separation from nature and each other, its analysis paralysis and its emphasis on technological progress, has finally exposed the limits of such a guiding path. To live with manic depression is certainly to live with a painful, costly illness, but part of getting well may be to recognize that we have been “the canaries in the mineshaft” suffering death before our time from what is also widespread societal illness. What is needed now is recovery of the feminine, the indigenous, the need for community and collaboration alongside independence. It is not a question of “either-or” but rather, “both-and.” We need lifestyles, organizations and communities that reflect this integration, this ability to become fully ourselves at the same time that we recognize our need for others, for belonging, for ritual and an emerging planetary myth that suggests that we are just now coming of age as a species.

John Weir Perry was a beacon of hope in an otherwise dreary wasteland when it comes to treating mental illness. He believed that psychosis should be dealt with as valid experience. It’s a type of experience and should be accepted as such rather than treated as abnormal or unacceptable. As Carl Hammerschlag, the psychiatrist who became humbled and changed as a healer through his exposure to Native Americans in New Mexico suggests, there is in each of us a mountain of garbage, wounding and dysfunction that we ought to treat gently with love. Underneath the garbage is also a magnificent being of untold creativity and joy. Manic depression sufferers may, in fact, be partial guides to the future. Currently they are seen as among the most damaged, but the possibility exists that we are the most sensitive of souls who point the way to true wholeness in the human race the same way that genius has done in the past. Perhaps we are missing much of the genius in the current population because it is being medicated to death! To live otherwise, without this philosophy of hope and healing, is to suffer the cruelest of tragedies. As William Styron, the writer who suffered a debilitating depression at age 60 suggests, “being vulnerable to illness is the opening to wisdom.”

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