Anguish, Illness as Psycho-Spiritual Crisis and Opportunity

storrier tim,

[An academic essay I wrote eighteen years ago for a graduate diploma of counselling. I was also in a midlife crisis at the time. The essay might also tie in with some of the mystical stuff I have been publishing here recently. Unfortunately I could not get the two summarising tables to format properly in WordPress, so please excuse that they are no longer in columns and thus a shambles. The painting is by Tim Storrier who lives in our southern highlands region.]

Anguish, Illness as Psycho-Spiritual Crisis and Opportunity

1. Introduction : The Notion of ‘Sacred Psychology’ and Psycho-spiritual Crisis

Jean Huston’s book The Search for the Beloved: A Journey in Sacred Psychology describes the beginning of what she calls ‘sacred psychology’ as being located in the psyche’s experience of “wounding (…) by the Larger story”. In this experience of “anguish” and suffering the psyche is “opened up”, its boundaries “cracked” or “violated” so that it becomes “vulnerable” to “larger forces” coming from “beyond our ordinary recognised boundaries”. Such a “time of pathos”, of feeling “abandoned, perhaps even annihilated”, may open up the sensibility to “a larger reality”, to “new questions” about true identity “in our depths” and to the “entry of the sacred, the possibility of redemption”. Thus, as in Greek tragedy, the wounding of the psyche may have “archetypal power” and may “contain the seeds of healing and transformation” by furthering his or her growth into a “larger sense of what life is all about”.

Huston’s description of the personal beginnings of ‘sacred psychology’ may be interpreted as a model of psycho-spiritual crisis and its inherent healing, or ‘growth’, potential: namely that

(a) some form of insight and meaning can be found in the process of crisis or ‘wounding’ itself
(b) that this meaning is of a ‘larger’, ‘sacred’ or transpersonal nature, and
(c) that this meaning is the healing or transformation itself.

This notion, perhaps describable as a kind of hermeneutics (the art and science of finding meaning: Solomon 1989, pp. 227ff) of suffering deriving from ancient spiritual traditions (cf. part 3 below), is implicitly ranged against the dominant scientific/medical model. The latter views pain and suffering almost exclusively as an external ‘objective’ state devoid of potential personal or transpersonal meaning, and which is to be prevented or ‘fixed’ by some form of technical/pharmaceutical intervention almost at all cost (cf. Griffin 1988, pp. 141ff).

This essay will seek to further build on Huston’s transpersonal perspective on crisis and healing by briefly looking at analogous processes seemingly relevant in four areas of human loss and healing: grief work, spiritual anguish and enlightenment, mental/physical illness and shamanism, perinatal experience. The essay will conclude with a tabular summary of these analogous ‘journeys’ and a critical or cautionary reflection on the problems and risks of all ‘theories of suffering’ in general.

2. Forms of Grief Work as Journeys through Psycho-spiritual Crisis

Huston’s description of the “time of pathos” experienced as the beginning of ‘sacred psychology’ is almost identical to many features of the grief process as described in the literature on grief, loss and bereavement (e.g. Parkes 1972, Bowlby 1998). Within this literature, the necessary mourning or ‘grief work’ (Freud’s Trauerarbeit) which a person carries out after experiencing significant loss is seen as often moving through, oscillating between or simultaneously incorporating several distinguishable phases of (1) numbness, (2) pining/searching /protesting and (3) despairing, before finally attaining the stage of recovery and re-organisation (Parkes 1972, p. 21, Worden 1995, p. 35). It would be in the middle two phases (2, 3) of this grieving process that Huston’s “time of pathos” would occur as painful ‘grief work’.

Of interest here is that Parkes’ identification of these four phases of the grief process is explicitly correlated with John Bowlby’s psychodynamic ‘attachment theory’. Thus it is posited that after the severing of personal bonds (as for example through death) a bereaved adult may display those patterns of early ‘attachment behaviour’ that an infant or a child characteristically displays when separated from its ‘attachment figure’, usually the mother (Parkes 1972, pp. 24-28).

Bowlby’s two stages of attachment behaviour after separation or loss of a mother figure involve one of ‘protest’ (pining, searching, anger) followed by one of ‘despair’ (withdrawal, apathy, depression) before some form of adjustment or re-organisation is finally reached (Bowlby 1978, pp. 245ff). However, any blocking, avoiding or inhibiting of the searching or despairing behaviour of infantile or adult grieving can lead to various severe and prolonged disorders, either as ‘anxious attachment’, ‘detachment’ or ‘prolonged unconscious grieving’ in the case of early separations and losses (Bowlby 1978, Bowlby 1998) or as ‘complicated’, ‘pathological’, ‘chronic’, ‘inhibited’ or ‘masked’ grief reactions in the case of later ones (Worden 1995, pp. 65ff).

Where such disorders are present the painful journey through the psycho-spiritual crisis of loss and grief remains uncompleted and thus inner growth, healing and transformation suspended or impaired. The ‘four tasks of mourning’ as postulated in Worden’s grief counselling and therapy theory (Worden 1995, pp. 10ff) aim to facilitate the bereaved, or unconsciously grieving, person’s movement through this journey towards closure and renewed growth and maturation.

Similarly, Elizabeth Kuebler-Ross’ work with the terminally ill may also be seen as a form of grief counselling facilitating the dying person’s grief work with the process of their own imminent loss of life. Her well known five stage model (denial, anger, bargaining, despair, acceptance: Kuebler-Ross 1975, p. 161) seems quite similar to the phases of Parkes’ concept of the grieving process, with ‘denial’ correlating with ‘numbing’, ‘anger/bargaining’ with ‘anger/searching’ and ‘despair/depression’ being the penultimate stages before resolution in both cases. The corresponding correlations to the phases of Bowlby’s early attachment behaviour are thus also given, an interesting possible mirroring of a person’s earliest and last behaviours regarding two of the most significant losses: mother figure and life.

Joanna Macy’s ‘despair and empowerment’ work has developed another form of grief work for a larger ongoing process of loss: that of the planet and its threatened communities of human and non-human beings (Macy 1983). As in ‘sacred psychology’, this grief work also entails the full working through and eventual acceptance of the pain, anger, fear and sorrow involved in coming to terms with the many global threats to planetary existence and our children’s futures. In this working through the painful, healing and transformative ‘cracking of boundaries’ may also be experienced, and thus the world no longer felt as ‘outside’ but as ‘self’, one’s own true nature of interconnectedness experienced as in fact “already present in our pain for the world” itself (Macy 1991, p190). Personal psychology is painfully and joyfully opened up into its wider matrix, the ‘Larger Story’ of ‘ecopsychology’ (Roszak et al 1995).

Spiritual eco-psychologist Thomas Berry likens this collective process of painful opening to “initiation processes which have been known and practised from earliest times”, the planet now “mandating that the human community assume a responsibility never assigned to any previous generation” as it passes “from its stage of childhood into its adult stage of life” (Berry 1988, p. 47).

3. Spiritual Anguish and the Enlightenment Experience

Huston’s notion of ‘sacred psychology’ seems firmly embedded within an ancient spiritual tradition or ‘perennial philosophy’ (Huxley 1972) centred on the core experience of suffering (‘pathos’), existential anguish and eventual ‘transformation’ (‘enlightenment’, ‘redemption’). In contrast to the hierarchical model of organised religion as a secular institution cementing social order via the dispensation and administration of codified belief systems (Berger and Berger 1972, p. 379), this tradition is not grounded in ‘belief’ but in the individual’s personal and deep experience of spiritual crisis, ‘death’ and rebirth.

Often beginning as a ‘midlife crisis’ (Harding 1988, p. 66), the typical three-part trajectory of such a spiritual crisis is from an initial state of naïve, i.e. non-experiential, belief or non-belief through a usually protracted and painful period of inner struggle, loss of faith, anguish and despair eventually culminating in some form of death of one’s former identity and concomitant rebirth into a ‘larger’ new identity.

The central phase of such spiritual crisis, loss and struggle in the Western mystic tradition has been variously and metaphorically characterised as the “dark night of the soul” (the noche oscura of St John of the Cross, ed. Peers 1958, pp. 103ff), the “cloud of unknowing” (Johnston 1973), the “way of purgation” (Happold 1967, p. 58), the way through the “desert”, the “wilderness”, the “dead-end” (Merton 1961, p. 182), the “shaking of the foundations” (Tillich 1964). Within the Buddhist tradition, existence itself (samsara) is seen as suffering (dukkha), the latter consisting not only of everyday sufferings but of that found in the human existential experience of constant change, impermanence and contingency (anicca) including that found within the (illusionary) sense of ‘I’ or ego (Rahula 1959, pp. 16f).

At the same time however, as in Huston’s model, the very nature of this spiritual ‘dark night’ of anguish and suffering contains ‒ if ‘allowed’, ‘accepted’ or ‘surrendered to’‒ the seeds of its own overcoming, its ‘new dawn’ or ‘enlightenment experience’. It is within the very dark night of the soul that is the “renunciation of the empirical self, in the presence of death, and nothingness, in order to overcome the ignorance and error that spring from the fear of ‘being nothing’”, ‒ it is within the very “heart of anguish that are found the gifts of peace and understanding” (Merton 1966, pp. 17-18). Other words or dimensions found to characterise this mystical experience of ‘union’, ‘enlightenment’ or ‘redemption’ within the Western tradition are the basically ineffable “consciousness of the Oneness of everything”, a sense of “timelessness” and of one’s true self as the “divine Ground of Spirit” (Happold 1967, pp. 45ff).

4. Illness as Psycho-spiritual Crisis and Healing Journey

Like ‘sacred psychology’, current crisis counselling theory views the dual nature of human crises as ‘turning point’ events embracing both trauma, danger and the opportunity for further maturation and psychological growth (Hoff 1995, pp. 4-9). Coming from a psycho-socio-cultural perspective, however, this theory does not focus on the possible transpersonal or spiritual dimensions of the latter. In contrast, much theorising around the crisis of mental illness , in particular schizophrenia, undertaken by psychiatrists operating outside the dominant medical model has, like Huston, stressed the possible healing and spiritually transformative nature of psychotic suffering.

Huston’s debt to C. G. Jung seems fairly explicit both in her terms (psyche, archetypal power, mythical base, gods) and the whole notion of ‘sacred psychology’ as the possibility of being transformed by ‘larger forces’ both intra-psychic and transpersonal. Jung’s long years of therapeutic work with schizophrenic patients provided him with insights into the prevalence of not merely personal but collective, unconscious, mythological or ‘archetypal’ dream material within schizophrenic experience (Jung 1939, in S. de Laszlo 1959, pp. 388-391). Contemporary representatives of ‘transpersonal psychology’ (e.g. Grof and Bennett 1990, p. 12) have also acknowledged this debt to Jung for expanding the map of the human personality beyond Freudian and behaviourist biography and for introducing the transpersonal dimension into psychology.

From the transpersonal viewpoint of dissenting psychiatrists like Perry (1989), Grof (1989), Assagioli (1989), Dabrowski (1966) and Laing (1967), the painful process of psychotic break-down can sometimes also be break-through into some form of psycho-spiritual renewal (Laing 1967, p. 110). This ‘spiritual emergency’ can also become ‒ at least when suitably and empathically guided ‒ ‘spiritual emergence’ (Perry 1989).

(To avoid the obvious charge of minimising or romanticising real suffering ‒ cf. part 6 below ‒ Laing was at pains to point out that he was dealing with “the transcendental experiences that sometimes break through in psychosis” and with “this natural healing process that implicates some of the people whom we label schizophrenic”: Laing 1967, p. 108 and 105).

Thus, against the medical model, the suffering or ‘pathos’ of schizophrenia is here not seen as an alien entity called ‘illness’ to be externally ‘treated’ but as an internal healing ‘journey’ of “going further in” and “going back”, back possibly through one’s personal life and “through and beyond into the experience of all mankind (…) and perhaps even further into the being of animals, vegetables and minerals”, a quasi-archetypal journey fraught with the dangers of many terrors, spirits, demons, confusion, partial failure and even “final shipwreck” (Laing 1967, p. 104; cf. Siegler et al 1975 for a critique of Laing and a defence of the medical model). From this transpersonal perspective, premature intervention or ‘treatment’ (e.g. hospitalisation/ medication) may in fact often block, short-circuit or abort this self-healing process and thus in fact increase psycho-spiritually ‘unproductive’ disorders and suffering in the long run (Campbell 1972, p. 203).

Alternatively, working with this process rather than against it would entail appropriate mind sets (e.g. ‘journey’ rather than ‘illness’), settings (safe, secure, non-clinical) and professional or lay ‘guides’ knowledgeable and experienced in dealing with the dynamics and patterns of non-ordinary, ‘initiatory’ or psychotic states and thus able to “help the process of disintegration and reintegration along” (Campbell 1972, p. 203). (Perry, Grof, Laing and the ‘anti-psychiatrists’ have in fact been involved in the running of many such non-clinical ‘spiritual emergency’ centres or hospices, cf. Grof and Grof 1989). High demands of experience, insight and maturity could be expected of such guides. Robert Hadfield has attempted to phenomenologically describe the reciprocal relationship of healing needed between such “wounded healers” aware of their own wounds or ‘inner patients’ and their clients/patients being helped to increasingly become aware of their own ‘inner healers’ and potentials (Hadfield 1997, p. 216).

From this kind of ‘hermeneutic’ or non-medical perspective shared by ‘sacred psychology’, a similar painful healing journey opening into insights into self and ‘a larger sense of what life is all about’ can be found in the process of more physical forms of illness as well.

Thus Kat Duff’s (1994) moving meditation on her own debilitating and protracted illness-healing process (chronic fatigue and immune dysfunction syndrome) charts the “great labour of illness”, a ‘labour’ like grief or childbirth. In a description remarkably applicable to the work of the ‘wounded’ and person-centered counsellor, Duff describes this ‘labour’ as being one of active listening and “careful attending to the particulars of one’s own experience (that muddle of odd sensations, startling dreams, and bizarre associations)” for the emerging truths about self and world (Duff 1994, p. 67). In her ‘initiatory’ or ‘alchemical’ experience of illness “lives condense, collapse, and recoalesce, requiring changes” and thus “we are not responsible for our illnesses, we are responsible to them, to what they offer and require of all of us, sick and well alike” (Duff 1994, p. 67). As in Huston’s model, illness and suffering are seen as important healing processes of opening up, or being opened up, to ‘larger forces’, larger truths about self and reality.

Such an ‘opening up’ on a voluntary basis and usually with healing intent is of course the vocational activity of that ‘wounded healer’ of tribal societies, the shaman (Eliade 1975, Halifax 1987, Kalweit 1989). Shamanism also understands “sickness and suffering as processes of physical and psychic transformation”, sickness, suffering and death not, like Western medicine, as “primarily evil and hostile” but as “manifestations of the body’s inherent wisdom, to which we only have to surrender to reach areas of perception capable of revealing the true basis of our earthly existence” (Kalweit 1989, p80).

The career of many shamans begins with a dramatic episode of illness or “altered state of consciousness that traditional Western psychiatry sees as a manifestation of serious mental illness” (Grof and Grof 1989, p. 78). These states often follow the characteristic three-stage sequence of initiation ceremonies or rites of passage: suffering, death and rebirth (Eliade 1975, p. 43, Halifax 1987, p. 93).

Thus Duff, for example, describes the ‘alchemy’ of her illness-healing process as a similar sequence of separation, submergence (suffering), metamorphosis (death) and re-emergence (rebirth: Duff 1994, pp. 93ff). Joseph Campbell has also noted the close similarities between the forms and stages of such initiatory rites of passage, mythological heroes’ quests, shamanist initiations or healing journeys and schizophrenic disintegration and reintegration: separation, initiation, return (Campbell 1972, p. 202). Transpersonal philosopher Ken Wilber sees a similar three-fold universal dynamic of identification, dis-identification and integration-on-a-higher-level (a dynamic modelled on the Hegelian dialectic of thesis/position, antithesis/negation, synthesis/integration) informing human psycho-spiritual development in general (Wilber 1985, pp. 79-81).

5. Crisis and Resolution in Perinatal Experience

Stanislav Grof’s transpersonal research with thousands of cases of ‘spiritual emergency’ and/or using LSD and ‘holotropic’ techniques with psychotherapy clients, has posited two additional and interconnected layers of human experience beyond the biographical: the ‘perinatal’ and the ‘transpersonal’ (Grof and Bennett 1992, p. 20). The former term encompasses all human experiences from conception through birth to the first post-birth events (Grof and Bennett 1992, p. 28). Within these perinatal phenomena Grof distinguishes four distinct experiential and sequential patterns or ‘basic perinatal matrices’ (BSMs) :

(1) the ‘amniotic universe’ (womb prior to contractions), (2) ‘cosmic engulfment and no exit’ (contractions before opening of cervix), (3) ‘death and rebirth struggle’ (moving through the birth canal), (4) ‘death and rebirth’ (entering the world), with each BSM having its “specific biological, psychological, archetypal and spiritual aspects (Grof and Bennett 1992, pp. 29-30).

According to Grof’s extensive research, such multi-layered birth matrices may be experienced in non-ordinary states of consciousness triggered by a wide variety of conditions such as “spontaneous psychospiritual crisis (spiritual emergency)”, a “session in experiential psychotherapy”, a “near-death experience”, “ingestion of a psychedelic substance”, “shamanic ritual”, “hypnotic regression” or the “practice of meditation” ‒ all of which represent “different gateways into deep territories of the human psyche” unchartered by traditional psychology (Grof and Bennett 1992, p. 14). The last three BSMs would seem to closely parallel the stages of suffering, initiation and renewal noted above for the human crises of grieving, spiritual anguish and transformation, mental and physical illness and shamanic calling or healing.

Figures 1 and 2 attempt to summarise these apparently universal or ‘archetypal’ dynamics of suffering and renewal (or ‘sacred psychology’) discussed in sections 2 to 5 above.

Figure 1: Three-Stage Archetypes of Suffering and Renewal

Perinatal Experience (Grof) Hero’s Quest (Campbell) Shaman’s Journey (Eliade) Grief Work (Gorer) Psychospiritual Development (Wilber) Historical/Ontological Dialectic (Hegel)

cosmic engulfment separation suffering shock identification thesis (position)
death-rebirth struggle initiation (The Ordeal) death intense grief work dis-identification antithesis (negation)
death and rebirth return rebirth/return re-establishment of balance integration on higher level synthesis (of thesis/antithesis

Figure 2 : Archetypes of Separation/Loss, Suffering and Re-organisation

Perinatal Experience (Grof) Journey of Illness (Duff) Hero’s/Schizophrenic Rite of Passage (Perry/Campbell) Stages of Mourning (Parkes) Stages of Child’s Response to Loss of Mother Figure (Bowlby) Stages of Terminal Patient (Kuebler- Ross)

cosmic engulfment, no exit (contractions separation Separation (a) break -off (b) inward/ backward retreat numbing (shock) protest (yearning, searching, anger) denial (shock)
death-rebirth struggle (birth canal) submergence (suffering) Initiation a) demons b) helpers yearning, searching, anger despair (depression, disorganisation) anger
death and rebirth (birth exit) metamorphosis (death) Rebirth, Return into life despair (depression, disorganisation) re-adjustment, re-organisation bargaining
rebirth, reorganisation re-adjustment, re-organisation acceptance

6. Conclusion: On the Necessity of Unknowing (a cautionary note on the legitimation of suffering)

Parkes’ study on adult bereavement notes how every change in human life “involves a loss and a gain” and that “the basis of grief” lies in the “resistance to change, the reluctance to give up possessions, people, status, expectations” (Parkes 1972, p. 25). Macy’s ‘despair and empowerment’ work posits that “processes of growth and transformation are never pain-free. They require a letting go of outmoded ways of being, of old assumptions and old defenses (and…) this letting go can be a passage through darkness” (Macy 1983, p. 28). In this view, living systems in general, as they develop and seek new connections, “seem then to demand a measure of dying” (Macy 1983, p. 29). Birth and death, death and life would then seem to be strangely intertwined, “as if these two aspects of the human experience were somehow one” (Grof and Bennett 1990, p. 28).

As in Buddhism, the suffering would from this perspective then seem to lie in the holding on, the ‘craving’ (tanha) for a delusional stability, identity, permanence within a reality of flux and impermanence (anicca): suffering is not letting go, not ‘dying’ to the reality of the moment (Rahula 1959, pp. 29ff).

However, as in Huston’s ‘sacred psychology’, “it is in that darkness that birth takes place” (Macy 1983, p. 29), it is in the very suffering that the healing is enfolded and revealed, healing in its etymological sense of ‘making, renewing wholeness’. Suffering entered into, lived through and understood is, in this sense, an opening into total inter-connectedness, true self, ‘Buddha Nature’. In Mahayanna Buddhist terms: samsara (life-as-suffering) is nirvana (enlightenment, the extinction of ‘craving’, final liberation).

Having said that, the dialectical need for a certain balance arises: we must look at the dangers of any abstract theorising about pain and suffering. It would seem that any ‘theory’ or ‘philosophy’ of suffering risks violating its real process in real individuals. As light seeks to illuminate the dark it of course must destroy it. As ego-centred mentation (rational thought) attempts to think and ‘make sense’ of that which threatens to engulf it, it seeks to appropriate and control its own ‘other’, i.e. that deep process that is the very dissolution of egoic appropriation and control. ‘Thinking about’ seeks to mentally ‘hang on’ and create an illusion of stability (a belief, theory, faith, meaning) within the all-destroying, all-renewing maelstrom of constant change and transformation, death and rebirth.

The activity of assigning ‘meaning’ to pain and suffering (e.g. ‘the Larger Story’, ‘archetypal pattern’, ‘sacred psychology’, ‘necessary grief work’, ‘God’s will’, ‘karma’, ‘being-unto-death’, ‘existential anxiety’, ‘Buddha’s dharma’ etc) ‒ as in this essay ‒ may be an inevitable, cognitive part of the process of living and suffering, but it is not the suffering itself. Words are not the actual experience, the map is not the landscape, a theory of grief work is not the actual grief work (as Kuebler-Ross seems to have so tragically discovered in the process of her own dying: Stewart 1997, pp. 13f).

To theorise is always to safely stand outside some object, it must always be some form of ‘aboutism’. To think about or theorise is not to stand inside (or ‘under’, to under-stand) the experience, e.g. the experience of the ‘dark night of the soul’ in which all theories, all mentations, meanings and metaphors are consumed in the fires of suffering. (“With birth, old age, death, lamentation, misery, grief and despair are they on fire”: Buddha’s Fire Sermon: Solomon 1989, p. 349).

The transpersonal patterns and dynamics touched on in ‘sacred psychology’ and this essay share this inherent paradox of all thinking-about. They are, as it were, implicit ‘theodicees’, i.e. legitimations, justifications for suffering ‘within the greater scheme of things’ (whether ‘divine’ or not). Suffering is given ‘meaning’. In my view, however, any legitimation of suffering imposed from without runs the considerable risk of idealising and invalidating that suffering, whether social or personal, human or non-human. To invalidate, however subtly and well-intentioned, the experience of suffering is to add to it. The theories of suffering and renewal touched on in this essay do not intend to invalidate any real experience thereof.

This seems to be the point at which any representations, words and thought ‒ the creation of boundaries ‒ meet their own final boundary and stop. Perhaps the best that may be said of such theories is that they may be seen as “raids on the unspeakable” (Merton 1966), as temporary crutches or signposts, signposts to silence, insight, compassion, and their own dissolution.

Doubtless their ultimate fate is, like all else’s, to be swept away in the reality of dying and renewal that by its very nature is ungraspable, unspeakable, unthinkable, a deep ‘cloud of unknowing’… (And at this point we remember that Lao Tzu’s beginning to the Tao Te Ching says: “The Tao that can be spoken is not the ultimate Tao” ).

Reference List

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~ by Peter Lach-Newinsky on February 12, 2016.

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