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The Transpersonal Revolution: meditation, psychedelics, psychosis

One of the main insights of last year, for me, was that meditation and psychedelics are two useful spiritual practices that work well together. Meditation sharpens certain cognitive and emotional tools (concentration, acceptance, compassion) which help one ride the waves of psychedelic consciousness. It also helps you to integrate the insights you get from your psychedelic experiences, in the weeks and months afterwards, so as to turn altered states into altered traits.

At the ayahuasca retreat I went on in October, at a place called the Temple of the Way of Light near Iquitos, in Peru, we were encouraged to develop our meditation practice in the months leading up to the retreat, and if possible to do a Vipassana retreat. I went on a 10-day Vipassana retreat in 2016, and then a week-long Zen retreat in 2017, and they both really helped me to navigate the stormy seas of ayahuasca.

Even when I was buen mareado (which can be loosely translated as ‘properly mullahd’), I found I could still remember and practice certain spiritual attitudes: sit up straight, focus on your breath, practice self-compassion and acceptance.

At one particularly intense moment, I forgot who I was or where I was, and felt myself adrift in another dimension totally beyond my comprehension (this is quite common on ayahuasca). I had a deep sense of dread, a sense that I was way out of my head and would never come back. But even there, I could still remember to practice my tools. I had two cards I could play: firstly, accept what’s arising, and secondly, remind myself that everything passes. And it did. I came back into my body, remembered my name, remembered where I was and why I was there. 

Psychedelics and meditation are two of the most exciting fields in psychology and psychiatry. Mindfulness, as you know, has become a huge field of research and has transformed western mental health in the last decade. Psychedelic therapy has been tipped as the most promising new development in psychiatry by Tom Insell, the former head of the US National Institute of Mental Health.

Both psychedelics and meditation are rapidly spreading in our culture. Around 15% of Westerners practice some form of meditation, like yoga, mindfulness, Vipassana or Transcendental Meditation. The use of psychedelics is also on the rise – LSD use among young people grew by 175% among young people in England and Wales between 2013 and 2015.

We’re in the middle of not just a ‘mindfulness revolution’ or a ‘psychedelic renaissance’, but rather a transpersonal revolution. The ideas of transpersonal psychology, once considered marginal and kooky, are becoming mainstream, and transforming our ideas of the self, society and reality.

Transpersonal psychology can be roughly defined as the study of human development beyond the everyday ego (hence ‘transpersonal’), including a positive understanding of spiritual experiences (also called peak experiences, transcendent experiences, altered states of consciousness, flow states, self-transcendent experiences and so on). The field is more open to the possibilities of what one encounters beyond the self – the collective mind, spirits, God – and more open to the possibility of life after death.

It began with William James and Frederic Myers in the 1890s, developed with Carl Jung and Aldous Huxley in the 1930s-1950s, and flourished in the 1960s through figures like Abraham Maslow, Stanislaf Grof, Timothy Leary and Ram Dass.

It’s become much more mainstream in academic psychology today partly because neuroscience has given a new credibility to the study of consciousness and to fields like contemplative science and psychedelic science, and partly because baby-boomer hippies and 90s ex-ravers are now in positions of power in academia, and they’re much more open to a transpersonal perspective through their own spiritual practice. 

The transpersonal revolution is transforming our idea of the self. We’re discovering that the self is malleable, as Epictetus put it – we can rewire our habitual beliefs and behaviour through practices.   We’re discovering the importance of focus, attention and acceptance in dealing with thoughts and emotions moment to moment, and the possibility of training attention through meditation. We’re realizing William James was right – rational analytical consciousness is just one type of consciousness among many, and other types of consciousness also have their role and can be helpful in healing and bonding.

We’re recognizing the stable conscious ego is a construction, and that there is much bigger self – largely subconscious – which one discovers through dreams, contemplation and psychedelics. We’re realizing the importance of belief, faith and ritual in unlocking the placebo or ‘healing response’ in the subconscious. We’re realizing the importance of the body in processing, storing and releasing emotions and trauma – mainstream psychology ignored the body for a long time. Yes, the early psychoanalysts talked about hysterical symptoms in the body, but their cure was always talking, not yoga, healing touch, dancing or psychedelic puking. 

Beyond that, we’re moving towards the idea that beneath our transient ego-beliefs there is a luminous open awareness, which we can move into and stay within. And this awareness can be a space of acceptance, equanimity, and love. People seem to reach this space through contemplation, through psychedelics, through near-death experiences. And this space – call it the heart-mind – seems connected to other beings or energies, in ways we don’t yet understand and that don’t fit into materialist psychology.

We’re also realizing that Jung was right – there’s a big Jung revival happening as a consequence of the transpersonal revolution. Jung (and other early pioneers, like Myers and Flournoy) understood how the subconscious speaks through myths, symbols and fairy-tales, which are sometimes shared. He (and others) also understood that not everything in the subconscious is flowers and bunny rabbits. Our constructed egos have a shadow – all the things we think we must hide or repress, all the things we push away and run from in fear and aversion. That shadow comes up in spiritual practices.

In contemplative science, for example, Brown University’s Varieties of Contemplative Experience project has explored the difficult experiences people often encounter in meditation, particularly the return of repressed thoughts and emotions. Psychedelic therapists also routinely draw on Jung’s idea of the return of the shadow.

In both contemplative science and psychedelic science, researchers are finding that Jung was right – the best way to deal with the shadow is through patience, acceptance and compassionate investigation. Rather than running away in terror, we can say: ‘welcome, come in, sit down, let me get to know you’. We remind ourselves of an acronym like RAIN: Recognize, Accept, Investigate, Nourish. Then, after a few minutes, years or decades, the unwanted, frightening and daemonic part of us becomes transformed into an ally and helper, just as the Buddha transformed the terrifying snake nagas into his allies and protectors (as in the statue above from Sala Keoku in Thailand). 

But the journey from awakening to integration and realization is no picnic. It’s no walk in the park. Well…it is, but only if we’re talking Central Park at night, filled with zombies and anacondas. The spiritual journey is a journey beyond the ego, a journey through the ego’s death. The shadow is a very good fence holding the ego up – on it is a big sign saying ‘do NOT go beyond here’, and scary monsters jump out at you if you do. Go beyond that fence and your ego screams ‘I’m going to die!’ Which it is, eventually.

The transpersonal revolution is leading to a rise in ‘spiritual crises’

Now here is the key point I want to emphasise. As more and more people meditate and take psychedelics, more and more people are also reporting spiritual or mystical experiences (see the results from Gallup on the right). And some of those experiences will be quasi-psychotic spiritual crises.

We think ‘oh, peak experiences, flow experiences, sure, great, I’ll upgrade myself and become a super-person. Bring it on.’ That’s how our culture thinks of flow states, because we’re so hung up on performance and productivity. And sometimes they’re lovely. But sometimes they’re deeply disorientating, and mess with our normal ego-functioning. And they should!

This much was noted by Ram Dass (or Richard Alpert as he was known at Harvard), who has been so helpful to me and our culture in navigating these waters. He noted, back in the mid-70s, that while more and more Americans responded in a survey that they’d had a mystical experience, the majority added they never wanted another one! ‘They upset the apple-cart of our ordered reality’, he says, in this excellent talk.

The area of spiritual crises was brilliantly explored in a collection of essays edited by Stanslaf and Christina Grof, called Spiritual Emergency: When Personal Transformation Becomes a Crisis, which they published in 1989. The Grofs write in the introduction: ‘As various Oriental and Western spiritual disciplines are rapidly gaining popularity, more and more people seem to be having transpersonal crises – yet another reason that the correct understanding and treatment of spiritual emergencies is an issue of ever-increasing importance.’

Spiritual awakenings can involve temporary psychotic phenomena like mania, ego-inflation, Messiah complexes, seeing patterns and significance in everything, intense energy and sleeplessness, physical anomalies like shaking or twitching, loss of critical thinking and a tendency to embrace one’s intuitions as the absolute truth, a flooding of dream-material from the subconscious, the return of repressed trauma, a merging of dream and reality, paranoia and persecutory complexes, and a general disordering of one’s usual reality and sense of the boundaries of the self.

The personal ego is a fiction, but it’s a fiction we’ve clung to all our lives, perhaps for thousands and thousands of lives. Waking up to the emptiness of the ego, the power of the Higher Self, and the interconnectedness of all things can be wildly euphoric, or utterly terrifying.

Contemplative science, which is about 20 years ahead of psychedelic science, is already grappling with this fact. Having gone through a decade of unremitting positivity and hype around meditation (it heals depression, it heals anxiety, it improves productivity etc etc etc), there is now more research pointing out that sometimes, people on retreats have very scary, difficult experiences, which can last weeks, months or years. Psychedelic research is still in the era of unremitting hype (psychedelics can cure depression, anxiety, addiction, improve productivity etc etc etc), and is still somewhat in denial about the dark side of psychedelics. But it’s there.

What I noticed in other participants and in myself, on the ayahuasca retreat, was a loss of the ability to critique or reflect on what the medicine / subconscious was telling us. People became much more prone to unusual beliefs and magical thinking. Our whole model of reality – based around the everyday ego – was dissolved. This was hugely healing, and opened up a joyful vision of interconnectedness, play and even immortality. But people could also believe some crazy stuff.

One of the shaman said to us at the beginning of the retreat: ‘The medicine is a poet, it speaks in metaphors’. But, like fundamentalists, we would sometimes seize on the metaphors presented to us as the actual literal truth. ‘I saw the future, I am the pilot of an interstellar spaceship’. ‘I realized my father isn’t actually my father’. ‘I need to build a giant pyramid in the jungle to communicate with aliens’ (this last one was a vision by an IT engineer called Julian Haynes – he built the pyramid, then it fell down. Classic Werner Herzog stuff. But still, quite a vision!)

These insights might be spiritual metaphors rather than the literal truth.

People often think they are about to die on ayahuasca. This is mistaking temporary ego dissolution for permanent actual death. Or we might even think the world is about to end – again, the psychic and spiritual death-and-rebirth is misinterpreted as a literal apocalypse.

As Chris Kilham, author of The Ayahuasa Test Pilot Handbook, puts it:

Ayahuasca and other psychedelics can deliver positive, transformative benefits. But they can also set the mind afire with lavish, nonsensical ideas. Most common is the notion of discovering that you, yes YOU! will save the planet. You wont. This is just the same old messy messianic thinking that has never worked and never will. For if there is to be a new, more free and conscious world, we will need not one, but several billon messiahs, each selflessly pulling together for the whole of humanity and planetary welfare.

In the meantime, we have only begun to see the Age Of The Kooks. As more people drink ayahuasca, there will be more visionary fallout. People will decide to undergo rapid and regrettable sex changes. They will ink themselves from head to toe, like Rod Steiger in The Illustrated Man. They will bellow revelations from building tops and get whisked away to secure cells. It is all going to happen. In the great and fabulous circus that is the explosion of ayahuasca into the public mind, every freaky, awkward, bizarre and outright nutso scenario that can play out, will.

In my own case, for three or four days after the retreat, when I was travelling on my own in Ecuador, I had the overwhelming sense that I was in a dream. I began to think the external world was being generated by my memory-imagination – the streets, the cars, the other people, the hotel, the sky, it was all my dream. My subconscious was constructing the people, the traffic, the planes, the sky. I didn’t know how to wake up, and how to return to the dimension where my loved ones were. So I travelled back from South America to the UK – a very strange few days in planes and airports. I was amazed at the ability of my subconscious to construct such a vivid reality – the 747 was so big, the KLM air-stewards were so Dutch!

Finally I got home, where my friends gave me a lot of hugs, and within a few days I decided this reality was real. I would still get moments of panic and ontological uncertainty, but I could practice my tools – slow breathing, acceptance, reminding myself that everything passes – and I would calm down and ride the waves. I realized the same spiritual tools worked – focus, acceptance, compassion – no matter how altered my mind or the reality I was in.

What I think happened was I took a spiritual insight – this reality is a dream constructed by our egos – and interpreted it literally – this is all my dream, and no one else is real. I managed to walk through that experience and keep calm. But if I’d panicked, and not had any spiritual training or a community of loving friends to take care of me for a few days, there’s a chance I’d have been sectioned, and even diagnosed as suffering from a life-long biological condition requiring a life-time of medication.

This sort of weird experience provokes so much fear in ourselves and other people. We’ve managed to overcome some of the stigma around depression and anxiety. But psychosis? We still find it terrifying. It is the nightmare Other of our rationalist society. In other cultures, there is still a sense that psychosis can have a meaning and a message for mainstream society, and that it’s a temporary place one may sometimes go to beyond the ordinary ego, rather than a lifetime exile to the rubbish heap of society. In our culture, psychiatry usually denies it any meaning or message, beyond a permanent brain disorder.

We need to have compassion for ourselves and each other, and compassion for those having transpersonal experiences where the boundaries of their ego are temporarily disordered. Such people are unlikely to fit into civilized conventions for a while, and we may need to be patient with them – in my case, for a few days, I literally needed help crossing the road, because I wasn’t sure if the cars were real. Experienced guides can help to steer people through their experiences so that they’re positive. And the rest of us can see these experiences as potentially pointing to something incredibly valuable and true – the ego is a fiction, reality is a hallucination, we are God…or something different to what we think, anyway.

Dougie / Agent Cooper from Twin Peaks – people in transpersonal moments may have difficulty navigating ordinary reality

One of the most interesting people I met this year was someone called Anthony Fidler, who helped to run the Zen retreat I went on in India. I watched him occasionally during the silent retreat, and thought, ‘wow, what a calm, collected person, that’s exactly what I want to be like when I practice more diligently’.

After the retreat, I got talking to him, and heard his story. He’d gone to Cambridge, trained to be an accountant, then had a breakdown, leading to psychotic episodes in his 30s. Over the last decade, he has taught himself to manage his occasional moments of psychosis / unusual states of consciousness through spiritual practices, particularly breath-work, touch practices, and self-compassion. He’s also been helped by leaving the UK and travelling to cultures like India and China, where this sort of spiritual awakening is more accepted and less pathologized by the culture at large. 

Part of the transpersonal revolution needs to be an upgrading of our psychiatric healthcare system and our cultural attitudes so that we have better understanding and compassion for those going through temporary quasi-psychotic / spiritual awakenings, so we don’t immediately section them, pump them full of drugs, and label them as sufferers of life-long biological disorders called things like ‘bipolar’, ‘schizophrenia’ and so on.

Clearly there are some people who have mental disorders that require medication, and some people need to be institutionalized for a few weeks, months or even years for their safety and the safety of others. But psychiatrists have been far too quick to impose their own version of reality onto the most vulnerable people in our society, even though that version of reality is spiritually bereft.

Luckily we are already seeing changes in mental healthcare, driven by the transpersonal revolution. I wrote about some of these changes in The Art of Losing Control, in which I applauded the work of David Lukoff to get a new disorder in the Diagnostic and Statistical Manual called ‘religious or spiritual problem’ – ie a temporary spiritual stage rather than a lifelong biological condition. I applauded the work of the Hearing Voices Network, which supports people who might hear voices or see visions, including many people who are not hospitalized or on medication. I applauded the Spiritual Crisis Network, and the Spiritual Emergence Network, and I urge you all to read Spiritual Emergency by the Grofs.

Meditation, psychedelics, psychosis – the three are linked, all involving journeys beyond the fiction of the everyday ego. You see worried articles in the Daily Mail: can mindfulness lead to psychosis? Yes it can. Psychedelics can also lead to temporary psychosis, and in some sad cases it seems to trigger life-long psychosis in teenagers. However, with care and compassion and wisdom, the majority of these sorts of psychotic experiences can be temporary, and lead to positive outcomes.

The spiritual journey is not entirely safe. It’s not a linear journey into greater and greater serenity and happiness – this is one of the mistakes the West has made by reinterpreting spiritual practices like meditation in terms of this-world happiness. They weren’t designed to make the ego happy. They were designed to transcend the ego. And the ego does not want to be transcended. There’s an enormous amount of fear, clinging, pride and suffering that arises on the spiritual journey. That doesn’t mean we should be put off. If we don’t go on the journey, we’ll still suffer, but we”ll suffer in a circle, pointlessly, rather than suffering while advancing towards liberation. Go forward with boldness and hope, with kindness and humble curiosity. 

Translating therapy

Depression is the leading cause of ill-health worldwide, but therapy is little known or practiced outside the West. If psychotherapy is going to become more popular in the non-western world, it needs to build bridges and find cultural parallels in local spiritual traditions. This is totally doable. 

The UK has had a good last decade when it comes to mental health awareness. The Brits don’t talk about our emotions? We never shut up about them these days! Not a week goes by without some official or celebrity – Theresa May, Prince Harry, Rio Ferdinand – saying we need to talk more about mental health. That’s a good thing. It’s good to talk, though it’s even better when that talk is backed up by increases in government spending on mental health services.

The situation is a lot worse elsewhere. As the World Health Organization highlights this Friday in its World Health Day campaign, depression is now the leading cause of ill health and disability worldwide, affecting more than 300 million people. While only around 50% of people with depression get therapy or medication in high income countries, in middle and low income countries, the percentage is closer to zero.

In half the countries in the world, there’s only one psychiatrist per 100,000 people. In India, where I spent the last three months, the country spends 1% of its GDP on health (the OECD average is 9%), and 0.1% of that on mental health services – one of the lowest figures in the world. There’s one psychiatrist for every 300,000 Indians, though in fact most psychiatrists are based in the big cities. In poorer rural regions, there might be one psychiatrist for every million people.

There’s a lot of stigma around mental illness around the world, and little awareness of psychotherapy. And there’s a cultural and language problem for both psychiatry and psychotherapy. Sadia Saeed Raval, who runs the Inner Space therapy centre in Mumbai, says: ‘Therapy in India is mainly Anglophone. The training is in English, the terminology is English, and the therapy techniques tend to be developed in the West.’ 

At a recent event I attended on mental health in India, the discussions were almost all in English, and even when a psychiatrist spoke in Hindi, he still used English words like ‘stigma’ and ‘depression’. The WHO’s own campaign posters, ‘Let’s Talk’, are also all in English. Imagine if we in the UK only had Indian words for depression, anxiety or other internal states.

This Anglicisation of therapy has limited its cultural dispersal in low and middle income countries to affluent, westernized elites. So how does everyone else cope with mental illness? In large part, by turning to religious or spiritual healing. This might sometimes work – it can help provide meaning, community support, meditation, and the powerful placebo of hope. But it doesn’t always work, and in some cases can be harmful.

What to do? Obviously, the best thing would be for countries to increase their spending on mental health services. I imagine the WHO is trying to get its member states to do that. But we shouldn’t assume that western psychiatry has all the answers to the meaning of life (look at suicide rates, where some Western countries do worse than many non-Western countries).

We can also try to help bridge the cultural gap between western psychiatry and psychotherapy, and non-western cultures. And here the medical humanities can help.

In the UK, the most popular and evidence-based therapy for depression and anxiety is Cognitive Behavioural Therapy (CBT). As I and others have researched, CBT has its roots in the ‘healing wisdom’ of Stoicism and, to a lesser extent, Buddhism.

That means that it is easily translatable into other cultural contexts, because the idea of ‘healing wisdom’ appears not just in Greek philosophy but also in Christianity, Islam, Judaism, Hinduism, Jainism and many other religious and spiritual traditions. Indeed, Stoicism was a big influence on therapeutic wisdom books in Christianity (Boethius’ Consolations of Philosophy, for example) and Islam (eg Al-Kindi’s On Dispelling Sadness).

There is also a great deal of similarity between Stoic-CBT therapeutic ideas and those found in the wisdom texts of Hinduism and Buddhism. For instance, Stoicism / CBT is based on Epictetus’ idea that ‘it’s not events, but our opinion about events, that cause us suffering’. Likewise, the Buddha taught: ‘We are what we think. All that we are arises with our thoughts. With our thoughts we make the world’.

Many different wisdom traditions recommend learning detachment, both from one’s own thoughts and desires, and from the ups and downs of fortune, and learning to accept the limit of one’s control over the world – both of which are central concepts in CBT and Positive Psychology. Many also recommend some form of mindfulness and techniques for improving it – Stoicism-CBT recommends keeping track of your thoughts and behaviour in a journal, Jesuits practice ‘recollection’ at the end of the day, Orthodox Christians practice ‘nepsis‘ or watchfulness, and so on. 

Many wisdom traditions also emphasize that changing the self takes repetition and practice (askesis in ancient Greek), as CBT does. Proverbs, in the Bible, talks about seeking wisdom, and inscribing wisdom on the ‘tablet of your heart’ through memory and practice. The Bhagavad Gita says: ‘It is difficult to curb the restless mind, but it is possible by constant practice and by detachment’.

There is some evidence that CBT works better when its basic ideas and techniques are connected and translated into local language and local culture. Here, for example, is a paper on Islamically modified CBT. Others have developed Christian CBT, and of course mindfulness-CBT now has a strong evidence base, although ironically it is barely known or practiced in India, the home of Buddhism.

Medical humanities scholars can help explore the cultural connections between western psychotherapy and various wisdom traditions around the world, and help to discover the local vernacular for local emotional states.This will help people overcome their suspicion of therapy. Speaking personally, for example, I’ve done workshops on healing wisdom for evangelical Christians, where you can describe the basic ideas of CBT purely using quotes from the Bible and Christian wisdom literature. That is helpful for an audience which has traditionally been wary of psychiatry and psychology, partly because of psychiatry’s long history of hostility towards religion.

At the same time, we should remind ourselves that cultures aren’t static and monolithic. There is no such thing as ‘Indian culture’, for example, there are many Indian cultures, all in flux. A 2013 article in the Indian Journal of Psychiatry calls for the ‘Indianization of psychiatry’ to take account of cultural differences such as the greater emphasis on traditional family structures. Fine – but Indian therapists also tell me of the stress and suffering caused to some Indian women by the traditional understanding that their role is entirely to support their husband and his family. Therapy can help people not just adjust to traditional roles, but also help them evolve into new roles, new identities, a new place in society.

Working with local spiritual healers

A second way that medical humanities researchers can help to bridge the cultural gap between non-western cultures and western psychiatry / psychotherapy is by working with local religious and spiritual leaders, facilitating dialogues of mutual respect to work together.

Aaron Beck, one of the inventors of CBT, with the Dalai Lama, who has spoken about the close similarity between CBT and Buddhism’s theories of the emotions

At my university, Queen Mary University of London, a team of psychiatrists are working with local Muslim spiritual healers, to try and improve relationships with a community that has traditionally been very wary of psychiatry. The latest issue of the WHO’s Panorama magazine has an article on psychiatrists working with Kyrgyz spiritual healers. In India, I think it would help to work with local spiritual leaders like Sadhguru, the best-selling yogi who regularly speaks on yoga as a means to mental health. We already know how fruitful the dialogue has been between western psychiatrists and psychologists and the Dalai Lama – it has helped western psychotherapy advance. 

Finally, I think technology has a role to play in improving global mental health. Governments are spending far too little on mental health services, and should be encouraged to spend more. But could the WHO or other organizations like the Wellcome Trust help to develop apps, websites and online courses, in local languages and local cultural terms, to disseminate basic therapeutic ideas and techniques? It would not be enough, but it would be something. And it would be cheap. 

I’m working with the WHO on a project called the Cultural Contexts of Health. Find out more about it here.