A spiritual psychiatry: challenge or heresy?

We are convinced that we live in a world of causality, locked in endless cycles of cause and effect. Physical birth being the beginning of life and death its end.

But, all the sages, saints and mystics speak of another dimension of reality.

If we carefully examine our own experience, we will see that we have all known moments of perfect joy, that feeling of being fulfilled, happy, without needs or expectations. In these moments, there is no need to think of the future, no need to remember the past.

Time in such moments has lost its reality. A feeling of timelessness rules, in which the “I”, “my” age and “my ” story, become irrelevant.

In exploring our actions and behaviours, we are going to see that they impose themselves on us more than we impose ourselves on them. Actions occur, behaviours link up with each other, but we don’t really understand what drives them.

We can of course say that it is need and necessity that are the drivers, but these needs and necessities are not the same in each instance, or at every stage of our lives.

In taking a look at nature and the world, there appears to be intelligence behind the apparent chaos. Life seems intelligent. It makes the plants and trees grow in spaces best adapted to them. It connects human beings and separates them at the appropriate time.

The awareness of this intelligence, that governs the world and its creatures, is the basis of the actions of the one that is called a believer: the one who believes, who insists that birth and death are not the sole reality.

Spirituality is thus rooted in the experience of timelessness and the intelligence of the universe.

Cut an orange in two. See how the pulp of the fruit is drawn in an exquisite design. The harmony and symmetry leap out at one. See the union of an egg and a sperm cell. See the way the foetus takes shape, begins to move, and then becomes an infant that bursts out into life.

Religion has tried hard to put this spiritual experience into form, but trying to put the formless into form is a risky venture. Thus we have seen personal power try to appropriate impersonal intelligence for itself, and lead to violence and misunderstandings which are still legion in humanity today.

The human maturation process and its crises

Numerous crises mark out the course of human’s life. They are governed by attachment and detachment: the child’s attachment to its home environment, the adolescent‘s attachment to his social context, the adult’s attachment to his comfort and loved ones, the elderly person’s attachment to a past that he regrets. Each attachment will, sooner or later require the need for a letting go, which occurs more or less brutally and painfully depending on the people concerned and the time of life.

It is as if every grasping imposes, sooner or later, a letting go. Let us not forget the story of the monkey that grabs a banana by passing its hand through the fence, but can only bring its hand back by letting go of the banana, thus losing the object it desires.

In the end, we are hardly any different from this monkey. As soon as something pleases us, we try to catch it, to make it ours, but there comes a time when a letting go imposes itself, an essential step in finding a new level of freedom.

Thus we can see that a crisis can be seen as a painful letting go, during which the loved object must be given up. But there is not always a clear vision of what that letting-go points to. That giving up is then lived as a punishment, a suffering, and a fight develops to try to hold on to what has been acquired. It is only when the fighting is exhausted and dies in a painful resignation, that peace can begin to establish itself, only to be disturbed again by the emergence of desire to grasp at a new object.

Objects of attachment are not always socio-professional situations or loved ones. They can be subtler, and take the form of a certain image that I might have of myself, an image difficult to relinquish, because its abandonment would mean dropping an identity that one cherishes.

Beyond appearances

This question comes to mind, when we notice that successive experiences strangely resemble those of a fly caught in a glass, knocking endlessly against the invisible sides. A tiredness, a lassitude, an exhaustion, are often the opportunity to return to self. Finally behind all this circus, what am I looking for? What do I really want? This is not a question to which one can reply hastily. This question requires a patient approach, a sensitive interrogation on the motives that drive my actions. Is my altruism really worthy of respect or really a hidden need to feel loved? Are the presents I give really gifts, or are they really expectations that transform themselves into anger or resentment if they are not satisfied?

To observe what underlies actions and behaviours is a foundation of intelligence’s awakening.

Levels of reality

Thus we can see that there are several levels of reality.

At a first level, the world that we perceive appears to us perfectly real. It seems solid, dense and undeniable in the reality in which it is held.

Nevertheless, if we close our eyes and spend some time tasting the silence of our spirit and the peace of our hearts, or, instead, observe the agitation and emotion, we notice that during this time of interiorisation, the world that surrounds us no longer concerns us: those close by, and in the distance, the location and everything else are, as if, put in parentheses. When our eyes open again, and before we again take up our old habits, we can enjoy a moment in which the world is seen from a different point of view. Forms, colours and sounds seem to emerge in a more expanded and luminous space. They are still impregnated with the sense of peace experienced from the previous moment.

So we see that the way we experience the world is a function of our inner state. When we are agitated and tense, we do not see the same scene as when we are relaxed and at ease.

Nocturnal dreams are also a rich source of information. The perceived world never appears as real or as substantial as when we are dreaming. The lion that enters the room is a lion, the fire that sweeps through the house is truly real and generates heat, the beloved or detested people that we meet, are just as attractive or repugnant as they are in daily life. And yet, on exiting the dream it is all erased. The people disappear, the fire is no longer there, and the lion is invisible!

We can note the same experience when we think back, with much emotion, to a painful or joyous past event that we live as a reality, when in fact it is not occurring in the present moment. And, the same applies, when we think with apprehension or anticipation of a future, imminent or distant, which has no reality in the moment outside of the thought that created it.

Illusions of the mind

So thought is the source of illusion. It tends to make us take the dream for reality. It is not so much thought in itself that is the cause, as the tendency to mistake the content of thought for the reality it points to, as the reflection of the moon on the water can be mistaken for the moon

When we bring our attention to the mental processes, we are going to see that a person named the self is always at the centre of our preoccupations. Is the person as real as he seems, or is it just another phantom created by the mind?

The root of delusion. Taking the false for the true

From this point of view, are we so different from the delusional person who is persuaded that he is at the centre of a conspiracy, who hears multiple voices that torment him, or who feels possessed by godly powers?

Can we really disassociate ourselves from the “madman”, all the while taking for real the thoughts of a past which no longer exists, or thoughts of a future that has yet to exist?

If we listen without any a priori judgments to the speech of the delusional person, we are going to see a flow, which has its own logic, its own coherence. And behind the stream of beliefs and opinions, we can feel the distress of a painful loneliness, the fear of abandonment and the terror of being nothing.

Deception, disillusion and depression

As soon as a desired object moves away, a feeling of painful resignation, of depression, arises. Depression is inseparable from the idea of loss. Only the one who is nothing has nothing left to lose. But as long as we are stuck to our points of view, opinions and habits, we are inevitably going to suffer from change and conflict.

From this point of view, depression is an initiation. It is an opportunity to become aware of the vanity of our projections and the habit to seek outside for what we can find inside. Hence it is an enforced meditation, imposing a change of rhythm to bring us to what we are seeking.

Fear and the ego

Fear is indeed in relationship with a self that is afraid: a self which seeks security and never finds it, a self which wants control and never achieves it, a self which wants what is far away without even knowing what is close.

Let us take the example of claustrophobia, this fear of being in an enclosed space, whatever its nature; the fear of being shut in, the sensation of restriction, of suffocation; the feeling of being unable to move, neither forwards nor backwards. Does that not remind one of the desperation of the fly in its glass? And if, instead of allowing ourselves to get agitated, we took the time to centre ourselves? Seeing that there is no way out at all, is it possible to sit down, physically or within ourselves, and to breath? We are then going to notice that our bodies are really tense, agitated, and contracted, that our breathing is shallow and rapid. If we take a moment to breath, to relax this frightened body, the feeling of suffocation leaves us. The self is like a contraction. The more it becomes agitated, the more it shrinks; the more it relaxes the more it dilates. When the inner silence has been touched, or rather it has touched us, the fear leaves us. It is the ignorance of inner silence that holds the fear and suffering in place.

Obsession and the pitfall of discipline

The obsessive does not escape from the quest for perfection that lies within us, the search for the right note, for the action that clarifies without dominating, which expresses itself without violence, and which transforms without expectation. The obsession with cleanliness is only the reflection of the awareness of impurity, projected guilt and misguided pride; the obsession with illness the consequence of the illusion of time. The obsession with loss, the reflection of the mirage of imperfection, making us think that we are not already fulfilled, and that what we seek must be acquired and seized to become ours.

Obsession is, in fact, a particular form that fear takes, when it passes through a personality that fixes and holds. It is a deviance of the disciplined mind, which attaches itself to a source of security with the desperation of the shipwrecked man hanging on to his raft. The security that is sought can be physical, emotional or mental, but in all cases leads to behaviour that is rigidified, ritualised and mechanised. The ritual becomes conditioning. It is cut off from the sensitivity and awareness that, in another context, would give it its value. Behind this sclerotic fear lies the impossibility to accept, to let go and surrender control. This endless search for security is a dead-end, since no safety can be found on the plane of manifestation. Paradoxically it is in the giving up of the search for security that it can be found, linked to an ability to face the unknown and all the things that life proposes. This sense of security is not of a material nature. It is rooted in the living free of expectations and in the experience of the very permanence of being.

This search for perfection does not spare spiritual practice, which can also become an obsession, accompanied by a dependence on ritual and an intense fear of abandonment. In this case the obsession is not fixated on a material object, but on a spiritual end felt to be the ultimate goal to reach.

In all cases, obsession is fed by a belief that what I seek is outside of myself, an ideal towards which all the personality’s energies are orientated. When the awareness awakens to the reality that I am what I seek, all the efforts directed to some distant goal returns to the present moment, which now appears to hold the totality of the once desired objects. Peace can then establish itself, with no object being able to bring us what is already here.

Heal the other or heal oneself

So in all of this, where is psychiatry?

Psychiatry is supposed to study mental illness. But can one study mental illness, without first having studied one's own mind? Can one treat the other’s depression without first having faced our own grief, our sadness at not being able to keep what cannot be?

In their way, psychoanalysts had understood that it is useless to want to treat the other without first having started with ourselves. So they took the time to explore the self, but not reaching the core of this person, and answering what remains when the thought “I” disappears from the mind.

So psychotherapy comes to unravel the self’s tendencies, heir to the past, and help one to better live the present, after having made peace with the past.

It is a path towards acceptance.

Medication - a coat over distress

Medication is, one could say, an overcoat to cover distress. It camouflages the feeling of fear and suffering for some hours, and replaces it with the feeling of well-being and temporary relief.

When we hear of psychiatric services before the introduction of neuroleptics, in the Fifties, one can understand the passion for these treatments, which in a few minutes could calm a state of distress that before needed months of attention to abate, if it ever did.

For half a century we have witnessed a rush into neuro-chemistry with all the potentialities to adjust feelings, sensations and thoughts through the influence of diverse molecules. We have barely begun to emerge from this trend. Economic constraints, sometimes serious side effects, and the feeling of alienation from the cure all, are bringing some reflection on the moderate use of psychotropic medication, and a search for alternative non-drug treatments to alleviate human suffering.

Meditation, an alternative therapy or a new illusion?

The meditator who spends countless hours contemplating the silence has exhausted other solutions. He has already reached the dead-end of psychology and psychiatry, and no longer believes that the cure for suffering is in the past or in some redemptive pill. Through frustration or necessity, he comes to the conclusion that what he is looking for is in himself, and nothing external can come and assuage his hopes. He turns his gaze towards that which is closest, and abandons the belief that made him look in the distance for what is close-by, like that searcher who looks everywhere for the treasure only to realise that he has been sitting on it all the time.

But, equally, the meditator is not sheltered from the illusion of his own mind. He can become a slave to his practice if it becomes mechanised; thus losing its substance and the grace that inhabits him. His desire to reach what he seeks can therefore become an obstacle to living what he is.

Where psychiatry and wisdom unite

Can we therefore imagine a psychiatry that would make awakening to intelligence and love a priority? It is paradoxical that the words “love”, “joy”, “peace” and “freedom”, are absent from psychiatry textbooks that are teaching the next generation.

Are the “mentally ill” so different from us that they don’t need to learn how to love, and to taste the same peace that we ourselves seek?

In this chaotic quest for the reality that we are, of course it seems difficult to refuse a patient access to psychotropic medication that will temporarily ease his suffering, just as it would be difficult to refuse a “dying person” the use of painkillers to reduce his pain. But to ease suffering does not mean to render unconscious. Medication should be used with the sensitivity of a mother who feeds her child: too much makes one more ill, too little does not alleviate the feeling of lack.

It is in becoming fully sensitive that the psychiatrist will be able, most appropriately, to use the recommended treatments, all the while knowing that the real cure is not to be found in a pill, but in the one who takes it.

Thus the psychiatrist and his patient are not so very different from the student of wisdom who seeks fulfilment in an integrated life and in the awareness of joy without cause. They are two closely bound friends, who spend some time together and contribute to each other’s happiness: that of being heard for the patient in need of love, and that of being respected for the psychiatrist in need of recognition. When sensitivity and power unite, love becomes a force of conviction and transformation.

Let us hope for the advent of a psychiatry which places the psychic crisis in a wider context, that of man in search of himself, a potentiality inherent in all of life’s expressions. Psychiatry will then be able to fully inhabit its function, that of an awakener of consciousness and an artisan of peace.

“The twentieth-first century will be spiritual or will not be.”

André Malraux

Spiritual experience and the religious feeling