Isabel Clarke Consultant Clinical Psychologist

1. Bringing psychosis in from the cold. Seeing anomalous experiencing in the wider context of human cognition . Isabel Clarke Consultant Clinical Psychologist

3. What I propose to cover • Looking at psychosis and spirituality in the same frame, as one potential of human experience. • Research that supports this perspective. • A model of brain architecture to underpin this perspective. • Implications of looking at human beings in this way. • Implications for clinical practice will be the subject of my second talk.

4. Questions to ask of Psychology • Mental breakdown: what is going on? • How can people be better supported through it? • Where does spirituality fit within psychological science? • Psychotic experiences: what is going on here? • Euphoria followed by catastrophe ????

5. Making Connections • Early breakdown • Overwhelming sense of connection – spiritual literature • Followed by fear • Revolution and social movements • Euphoric, everything possible stage • Followed by terror, brutal dictatorship and repression • Stepping out of individuality – a sought after experience

6. Evidence for normalization of anomalous experiencing Mike Jackson’s research on the overlap between psychotic and spiritual experience. Emmanuelle Peter’s research on New Religious Movements. Schizotypy – a dimension of experience: Gordon Claridge. High Schizotypy = positives as well as negatives Wider sources of evidence – e.g.Cross-cultural perspectives; anthropology. Richard Warner: Recovery from Schizophrenia.

7. More recent research • Caroline Brett’s AANEX makes it possible to measure anomalous experiences phenomenologically – get away from symptom language • Research that demonstrates: having a context for anomalous experiences makes the difference between • whether they result in diagnosable mental health difficulties • whether the anomalies/symptoms are short lived or persist. • Caroline Brett, Heriot-Maitland and others.

8. What this points to • An area where experience becomes anomalous – spiritual/psychotic/ THE TRANSLIMINAL • This challenges the idea of psychosis as ‘just’ an illness and symptoms as things to be got rid of at all costs. • Powerful evidence: how the experience is made sense of impacts peoples’ lives • Health services do not come well out of this • Time for a new perspective!

9. Psychosis – Potential for Transformation Traditions such as Psychosynthesis and Spiritual Emergence/Emergency recognize the transformational potential of the transliminal. Jung: Meeting and integrating shadow - an aspect of transformation These traditions tend to distinguish between ‘psychosis’ and transformational crises More and more this is seen as a false dichotomy – Spiritual Crisis Network (.uk) Mike Jackson’s Problem Solving Model, encompassing potential and dangers. Role of stigma in trapping people.

10. The breeze at dawn has secrets to tell you. Don’t go back to sleep. You must ask for what you really want. Don’t go back to sleep. People are going back and forth across the doorsill Where the two worlds touch. The door is round and open. Don’t go back to sleep. Rumi, translated by John Moyne & Coleman Barks in ‘Open Secret’ (Threshold books). Two Ways of Knowing – Introducing the Transliminal

11. What is going on here? The levels of processing problem Being human is difficult because our brains have 2 main circuits – they work together most of the time, but not always. There is one direct, sensory driven type of processing and a more elaborate and conceptual one. The same distinction can be found in the memory. Direct processing is emotional and characterised by high arousal. The other one filters our view to make it more manageable The direct processing system is the default system – the one that dominates if the other gets disconnected – in which case we lose that filter – and land up ACROSS THE THRESHOLD –THE TRANSLIMINAL

12. Getting a scientific grip on the transliminal The split between realities comes from the split in us! Interacting Cognitive Subsystems provides a way of making sense of this ‘crack’.(Teasdale & Barnard 1993). An information processing model of cognition Developed through extensive research into memory and limitations on processing. A way into understanding the “Head/Heart split in people.

13. Different Circuits in the Brain (Adapted from DBT) EMOTION MIND REASONABLE MIND WISE MIND Reasonable Mind Memory Emotion Mind Memory IN THE PRESENT IN CONTROL

14. Interacting Cognitive Subsystems. Body State subsystem Implicational subsystem Auditory ss. Implicational Memory Visual ss. Propositional subsystem Verbal ss. Propositional Memory

15. Important Features of this model Our subjective experience is the result of two overall meaning making systems interacting – neither is in control. Each has a different character, corresponding to “head” and “heart”. The IMPLICATIONAL Subsystem manages emotion – and therefore relationship. The verbal, logical, PROPOSITIONAL ss. gives us our sense of individual self.

16. Two Ways of Knowing Good everyday functioning = good communication between the main organizing systems At high and at low arousal, the implicational ss becomes dominant This gives us a different quality of experience – the transliminal More often, the two are working together, adding something to ordinary experience – e.g. where we get that sense of the sacred, the supernatural.

17. A Challenging Model of the Mind The human being is a balancing act as the two organising systems pass control back and forth: there is no boss. The mind is simultaneously individual, and reaches beyond the individual, when the implicational ss. is dominant. This constant switch between logic and emotion gives us human fallibility The self sufficient, billiard ball, mind is an illusion In our implicational/relational mode we are a part of the whole – and the nature of our experience changes.

18. Being Human is a Precarious State • Mental health breakdown is a common human experience • Comes from a combination of • Individual vulnerability/sensitivity • Life circumstances – losses, trauma etc. • Times of transition • Leading to unmanageable feelings • Important relationships are vital to hold us together – including the one with ourselves. • These can suffer in breakdown – or breakdown can occur because they have suffered • Therapy is about healing that crucial relationship between you and you!

19. We are not who we think we are!We constantly move between being self conscious individuals……and existing in a web of relationship

20. Web of Relationships In Rel. with earth: non humans etc. In Rel. with wider group etc. primary care-giver Self as experienced in relationship with primary caregiver Sense of value comes from rel. with the spiritual

21. Spirituality and Relationship As people, we make sense only within our context of relationship –we are held in a web of relationship Important others; our family; our social group; ethnic group etc. Spirituality is about relationship with that which is beyond; with the whole – the widest circle of the web At times of change, transition - and breakdown - that wider context becomes important

22. Beyond time and certainty • Emotional knowledge tells us about relationship – not reasoning – we can feel more than we can precisely know • Relationship operates across the boundaries of the self and across time – bereavement encounters. • Beyond certainty!

23. How do you cross the threshold? In a small way, in ‘spiritual’ etc. moments. Seriously across the threshold: • Times of transition • Trauma loosens the boundary, softens the walls • Illness and loss • Physical privation – lack of food, sleep, isolation • Mind altering substances All apply equally to spiritual practice, the saints, and vulnerability to psychosis!

24. Knowing which side you are onThe Everyday The Transliminal Ordinary Clear limits Access to full memory and learning Precise meanings available Separation between people Clear sense of self Emotions moderated and grounded A logic of ‘Either/Or Numinous Boundaries dissolve Access to propositional knowledge/memory is patchy Suffused with meaning or meaningless Self: lost in the whole or supremely important Emotions: swing between extremes or absent A logic of ‘Both/And’

25. Openness/Vulnerability - a spectrum • Times of transition and loss ‘wake up’ earlier trauma • People find ways to cope when things are unbearable – for some that coping is to cross the threshold – into another dimension. • This is easier for some people than for others – the ‘schizotypy’ spectrum - openness to anomalous experience – on a continuum with normality • People high on the schizotypy spectrum are more sensitive and “open”. • Leading to the need to regulate stimulation. • This can lead into an avoidance cycle; social isolation and withdrawal = the other ‘reality’ takes over – helped by stigma. • Positive side as well as vulnerability

26. Psychic phenomena and openness • Loss of boundaries = openness both to other parts within the self and perhaps to other minds • Loss of time dimension – pre-cognition • Interchangeability of psychic contents – past lives, telepathy etc. • Voices. Possession – invasion from within or without ? Distinctions lose their meaning

27. Part of a trend? • Richard Bentall, Mary Boyle and others: questioning the validity of the construct of Schizophrenia • Questioning of the biological illness idea – evidence for the role of trauma and past adversity • Read, Mosher etc. Stigma and an illness conceptualization • Whittaker and others: overselling of medication • Joanna Moncrieff: misselling of medication

28. Contact details, References and Web addresses • isabel@scispirit.com • Isabel.Clarke@nhs.net • Clarke, I. (Ed.) (2010) Psychosis and Spirituality: consolidating the new paradigm. Chichester: Wiley • Clarke, I. ( 2008) Madness, Mystery and the Survival of God. Winchester:'O'Books. • Clarke, I. & Wilson, H.Eds. (2008)Cognitive Behaviour Therapy for Acute Inpatient Mental Health Units; working with clients, staff and the milieu. London: Routledge. • www.isabelclarke.org • www.SpiritualCrisisNetwork.uk