I received a digital review copy of The Spiritual Gift of Madness: The Failure of Psychiatry and the Rise of the Mad Pride Movement recently and I must say: I have rarely read a book in which I highlighted so much…
However, instead of doing a proper review I will try and tackle the main issue this book raises. It is really several books in one and I don’t quite know what to make of it. I feel very unqualified to review this book, but then again – I don’t know who IS qualified. Who knows enough of human psychology, religion, spiritual transformation and medicine to tackle the basic questions in this arena?
Let’s start with my questions. Farber, the author, of course is very convinced he has the answers, which is one of the issues I have with the book.
- Is there a sharp divide between the mad and the sane, or is there a continuum?
- Does everyone who has a psychotic episode have to be on meds for the rest of their lives?
- Are psychiatrists, who only prescribe medicines, really giving the best possible treatment of people in psychological trouble?
- Is the spirituality of mad people a symptom or a potential source of inspiration? Or both?
- If spirituality can help people deal with life changing processes, does that mean that every one of them can manage in our world without medicine?
By the way I put it, I think you can probably see where I stand in all of this.
I do think there is a continuum between the ‘mad’ and the ‘sane’. After all, most people aren’t able to manage their lives with a bit of self-medication either. I’m talking about coffee, alcohol, smoking etc. Life is simply hard for most of us and humans have resorted to mind-altering substances to take the edge off since the beginning of time.
When I talked the issue over with my mother (*), she noted that it’s very hard to make a reliable diagnosis of psychiatric illness and that psychiatrists too are human. This is an important point: it means that while individual psychiatrists may simply be wrong in individual cases, that doesn’t mean the entire paradigm is in trouble.
She doesn’t think the labels are meaningless. Farber does. He thinks all DSM labels can be summed up as people having issues with living. Which is part of the human condition.
Sure, having issues with living is part of the human condition. However, some people have more issues with living than others. Some people just can’t manage in our complex society without help.
I would be the last person to suggest that this help should all be medical. I’m all for more human ways of solving things and helping people cope, like psychotherapy, group therapy and (the least expensive version of that) self help groups. And yes, the spiritual dimension of the person in trouble should definitely be dealt with as well. And of course that spiritual dimension can become a source of inspiration and strength even if it’s also a symptom.
However, that doesn’t quite mean that every mad person is a potential prophet. Just like not every autistic kid is a genius: in fact, most will never function in a productive way in society. Let’s not be too romantic about prophets. Most of them never make it big time. Most of them don’t leave writings behind like Ezekiel. The alternative to medication is often living on the streets. Are we really going to abandon mad people like that?
Similarly, while madness is definitely one of the temporary side effects of a spiritual process of change (see: I’m You’re Not Going Crazy…You’re Just Waking Up! Michael Mirdad for instance) that doesn’t mean it’s also the other way around: that every mad person has enough internal resources to come out of a psychotic episode and recover a manageable place in society again. Note that the person who is sane enough to say ‘am I going crazy?’ is very different from the madman who tries to kill himself.
Farber talks about ‘creative maladjustment’, noting that we live in a mad society and that therefor, to be sane and to be well integrated in society might not mash. Or in other words: it takes a bit of denial to become really successful in this world. For most people. He also notes that mad people have a few healthy values in common: worry about the environment, distaste of the financial system and most are also spiritual. Is this a sign of their madness or of being attuned to a deeper truth about our world?
Creative maladjustment – Martin Luther King, Nelson Mandela, Gandhi etc. However, there’s a very big difference between taking an unusual path in life – an activist path – and losing your way so much that you end up walking by a railway talking to aliens, for instance.
My mom stressed that there is real suffering going on with these people. She felt that people who say that these things can be dealt with without medication don’t know what they’re talking about. I didn’t mention the Dark Night of the Soul to her. The question is – can every depressed person (aka mystic) find a way through their dark night of the soul or do some or even most need medical help?
Sure, trauma needs to be addressed as such. However, even though there is no clear area of the brain scientists can point to for bipolar disorder, but it does have a clear genetic component. Most bipolars simply can’t manage without medication. She also clearly contradicted the claim made by Farber that the incidence of suicide has gone UP with the rise of medication on this particular illness.
If Vincent van Gogh lived today he might have lived a bit longer because of medication.
Yes, studies of shamanism show that controlled madness (because that is what shamanism is: it’s about controlling alternate states of consciousness) can be beneficial and produce leaders (Lewis 1971). However, I don’t think those anthropologists checked whether there wasn’t also the equivalent of the village idiot around somewhere. In other words: just because the experiences described fit those of mad people in our society, that doesn’t mean that those people would have had those experiences in an uncontrolled way in our society.
The issue with madness is precisely that it takes people outside the realms of realism. That is: they’re no longer able to function in our complex society. This isn’t so strange, our society lacks a lot of the social support and structure that older social forms had. We’re biologically programmed for villages and tribes, not cities and apartment buildings where you don’t know your neighbor.
What’s more: in previous societies it was a lot easier to isolate yourself in a hut or a cave without really isolating yourself. That is: it’s hard to live in our society and manage a low level of sensory input.
Schizophrenics benefit from the hut in the wilderness approach. But who will check on them weekly? And how will they make a living?
Our society just isn’t good at dealing with people outside the social norms. I read Max Weber, a famous sociologist, a few years ago and he noted that we’re becoming slaves to our work. He saw the process happening, I think for most of us it’s a reality.
The question is: what happens to those who just can’t… Should they just be medicated into submission? Well, no. Preferably not, obviously.
It’s a bit like ADHD – we bombard kids with sensory input, feed them unhealthy foods, avoid letting them play outside and then medicate them to keep them quiet.
However, since we can’t change society to fit the mad person, the mad person may have to medicate themselves to fit society. At least a bit.
In a European context I think the best approach is simply in trying to find the right therapist, keep control over your own illness and take as little medicine as you can while learning to function again.
In a US context I do feel it’s likely that the pharmaceutical companies cause over-medication on a grand scale. I like what the Icarus project (found through Farber’s book) does with this: it has a guide on how to reduce your dependence on meds or even get off them.
My conclusion about the book is that while Seth Farber finds a lot of interesting people to quote and makes some good points, he doesn’t quite convince me that in every schizophrenic there is a prophet and the world would be better off listening than medicating him or her.
There is a lot of room in between… each individual case should be dealt with on it’s own merits. Some people can manage without drugs, others can’t. Some people really just need a good therapist and support network and can transform themselves. Others just don’t have the resilience to do without medication. Even if therapy does help and even if they do learn to use their spiritual perspective in a way that helps them.
Life isn’t always pretty.
In writing this post I researched the topic of madness and spirituality online and found an article on integrating the spirit within psychosis. It sums up the literature on the topic quite well I think, though of course ignoring most of the anthropological material on shamanism. The classic on that topic, which we studied at Leiden University, is I.M. Lewis, Ecstatic Religion: A Study of Shamanism and Spirit Possession.
(*) Marijke Baljon, a licenced humanist (Rogerian) psychotherapist who has worked with traumatized people, has published in professional journals and teaches at post-doc level. This post was NOT read by her before publication. The content is purely my responsibility.