by Sally Clay

    Moses said to the Lord, "O Lord, I have never been eloquent, neither in the past nor since you have spoken to your servant. I am slow of speech and tongue." (Exodus 4:10)

Moses stuttered. His disability remained even after he had been to the mountain top and returned with the authority to lead his people. It is why his brother Aaron had to act as his spokesperson. Moses never recovered.

Recovery is the latest buzz word in the mental health field. For the last year or so, I have been labeled "recovered from mental illness." I acquired this label when the Office of Mental Health in New York State invited me to participate in their Recovery Dialogues. I was one of a select group of consumer/survivors chosen to discuss the concept of recovery with a group of psychiatrists. These dialogues are ongoing, and they have been very interesting. We have covered a wide range of topics, from complaints about mental health treatment more damaging than healing; to consumer participation in the education of psychiatrists; to personal descriptions of madness; to coping techniques and the management of symptoms.

What the discussions have failed to address, however, is the nature of mental illness itself. Several of us in the "recovered" category have described our extreme mental states in the hope that these might inspire examination of what really happens in the mind, as well as the body, of the person labeled mentally ill. If we are recovered, what is it that we have recovered from? If we are well now and were sick before, what is it that we have recovered to? For some reason this discussion never gets off the ground. The psychiatrists in our dialogue become visibly uneasy when the subject arises, and they divert the discussion to a less threatening line of thought. "Coping mechanisms" are just such a diversion, an attempt to regard the depth of madness as something that can be simply "coped" with.

It only makes sense that, if we are "ill," then this illness must have an objective marker. Diabetes, for example, is identified by a blood test that reveals a deficiency of insulin. AIDS is identified by a virus in the bloodstream. Cancer is identified by a tumorous growth visible in X-rays. But mental illness has as yet no objective marker. Although it is widely speculated that brain chemistry is the culprit, there is no laboratory test that will reveal the biochemical nature of our illness, or even whether or not we are ill at all. Genetic markers for manic depression have been announced, and then found to be mistaken. The truth is that the current state of the art for psychiatric diagnosis is based solely on the subjective observation of external behavior -- not a very objective marker for a process that is internal.

Those of us who have had the experience called "mental illness" know in our hearts that something profound is missing in these diagnoses. They do not take into account what we have actually endured. Even if the "bad" chemical or the "defective" gene is someday found, madness has its own reality that demands attention. There is something compelling about the experience of an altered state, something that Ed Podvoll calls "The Seduction of Madness" (Podvoll, 1990). What is compelling about madness is the tantalizing hint that it holds the secrets of consciousness, of healing, and of spiritual power. It is madness that brings the mind to our attention, that makes us remember that mind is inseparable from spirit, that it is consciousness that makes us human. A great Buddhist lama once wrote:>

    Spirituality, self-existing,
    In which there is no memory

    to upset you

    Cannot be called a thing.

    (Tilopa, 1963)

For me, becoming "mentally ill" was always a spiritual crisis, and finding a spiritual model of recovery was a question of life or death. My search began over 30 years ago, when I took time off from college studies to shut myself in my room alone to find God and the meaning of life. For a week or so, I listened to music, entertained myself with mental images, and had spiritual revelations. I experienced many unusual perceptions and bodily changes similar to ones that occur with drugs such as LSD. All of this climaxed with a vision of the oneness and interdependence of everything in the universe -- the sort of thing that sounds foolish when put into words, but is profoundly true for those who experience it.

But my extreme mental state did not wear off the way drugs eventually do. After a while my mood turned ugly and destructive -- like a "bad trip" that would not end. I struck the school nurse, breaking her arm, and I plunged into a hell of darkness and despair. When I did not eat or sleep or talk to my friends, the college called an ambulance to pick me up. The attendants gave me a shot of Thorazine, put me into a strait jacket, and carried me off. At the mental hospital I was diagnosed with schizophrenia, locked in seclusion for several weeks, and drugged with 1200 mg. a day of Thorazine. Later the doctor told me that my entire experience with spiritual ecstasy and darkness was sick and irrational, and had no meaning whatsoever. Shamed, I stayed in the hospital for five months, and by the time I got out I was a sadly different person from the one who had seen God just a few months before. I was defeated. I considered myself a complete and utter failure for the rest of my life. God was gone.

I was not allowed to return to college, and most of the people who had been my friends would no longer talk to me. I felt so weak and degraded that I could not work, and I enrolled in secretarial school only because my mother insisted. After a year I was well enough to get married and find a job. I did well on the job, but after six months I suddenly cracked up again and wound up back in the hospital. Since then I have been hospitalized over 18 times, once for as long as two years.

I have been given just about every psychiatric drug in the med room -- major tranquilizers, minor tranquilizers, anti-depressants, mood elevators, sleeping pills, lithium, and Prozac. I have spent more days in seclusion rooms than I can count, and I have been tied down in five point restraints. I have received both insulin shock and electric shock. Few of these "treatments" helped me at all, and most of them damaged me badly. They left me debilitated and desperate. One might wonder why am I still standing at all. I certainly owe no thanks to the mental health system. The faith in my inner experience always returned to strengthen me, it is only this spiritual outlook that enabled me to go on.

As a child I had loved the silent time before the liturgy began at church. I would kneel on the prayer bench for a long time, absorbed in silence. In high school, without giving a name to what I did, I often sat alone in my room or outside in the mountains or woods, and I learned to trust the peace and confidence that this brought. Oddly enough, I did not realize how precious this was, for at the time it was simply a part of who I was and what I liked to do. Spirituality is like that -- it is so close to you that it may not seem very important. Because I had faith in my mind, and trusted it, I never lost touch with fundamental reality, even when later I became depressed or manic or fearful. Whether my thoughts became threatening or blissful, I knew that behind them all was spiritual stillness. I knew that although my emotions may arise from brain chemicals, or may themselves trigger chemical changes, the form my emotions take and the meaning I give them are my responsibility.

Even after the horrible treatment that I received in every single one of the mental hospitals, secretly I cherished the spiritual vision of my altered states. That could not be erased, because it was real. Even when depression and despair followed a manic episode, my vision of truth prevailed over the sorry platitudes and euphemisms offered as help by friends and therapists. Those lies were never real in the way that my vision was. Nevertheless, for fifteen years I lived a lie. I tried to regard my spiritual experiences as symptoms of illness, and dutifully kept my life safe and dull and meaningless. It never worked. Inevitably my mind would go its own way, and I would once again wind up in a mental institution.

My healing did not begin until 1978, fifteen years after my first hospitalization. I began to study and practice Buddhism, where I found a comprehensive psychology of the mind and specific methods to overcome confusion and suffering. I found descriptions of mental states identical to those I had experienced when "mentally ill." Most of all, I found psychology presented as part of a spiritual process, a psychology of the heart (Freemantle, 1975; Govinda, 1969; Trungpa, 1972). Finally I could admit openly that my experiences were, and always had been, a spiritual journey -- not sick, shameful, or evil. I was already a worthwhile person, right from the start, and there was a way to work with my own mind to transform fearful mental states to peaceful ones.

Of course nothing is as simple as that. I found at first that sitting on a meditation cushion in Buddhist fashion was very difficult to do when my mind was disturbed. I could not keep up with the people who meditated for hours at a time at the centers I attended. Finally I spoke about this to a Tibetan lama in Woodstock, New York, and I honestly admitted my diagnosis of mental illness. With trepidation, I confessed my conviction that I gained precious spiritual insights from my experiences. Unlike Western friends and therapists, he did not try to convince me that my spiritual concerns were trivial and just another symptom of mental illness. He took what I said seriously, and his advice was that I bring my understanding into the community, and use it to help others.

That is how I began working as a peer advocate and counselor. After my talk with the lama, I first volunteered for the Red Cross in Portland, Maine, and worked on their disaster team. Then I found a small group of psychiatric survivors and organized the Portland Coalition for the Psychiatrically Labeled. Little by little I learned how to give peer support to other people, and how to advocate for them within the mental health system. The more I did this work, the more confidence I gained in myself. For the first time since college, I started to feel like a real person, somebody worthy of respect. Not only that, I began to receive respect, not just from other ex-patients, but also from people in the community.

As I gained in confidence and in the practice of compassion, I found it easier to practice the mental disciplines I had been taught. I began doing meditation for 20 minutes a day, and I also went back to church and joined the choir, for I have always enjoyed singing. Still, I kept "going off the deep end" and had to be rehospitalized almost on a yearly basis. Weary of battling these psychotic episodes, and overstressed by my work, in 1988 I returned to Woodstock and took an apartment near the Tibetan monastery. I hoped that spiritual practice would help me clear away anger and fear, the emotions that caused my mental states to get out of control. My teacher, Khenpo Karthar Rinpoche, gave me individual instructions. I was assigned the practice of the Green Tara Sadhana, a chanting meditation in praise of Tara, a female deity of compassion and wisdom (Willson, 1986). For two years, I practiced intensively at KTD Monastery, and I heard oral teachings from many high Tibetan lamas. Hearing the teachings confirmed to me that my spiritual interpretation of manic experiences was valid, and my insights were genuine.

After this period, I again ventured out into the world. I volunteered at a local 24-hour community hotline, and joined peer support groups in two nearby towns. Within a couple of years I organized the support groups into a non-profit corporation called PEOPLe: Projects to Empower and Organize the Psychiatrically Labeled. Modeled after the Portland Coalition, PEOPLe became a force for advocacy and a resource for support throughout the Hudson Valley in New York.

It has now been eight years since I have been committed to a mental institution. Although I cannot claim stability in my life, much less enlightenment, my anger and fear are greatly reduced, and my impulses no longer drive me over the edge into madness. More than ever, I am convinced that this recovery, if you can call it that, is the result of my spiritual practice. The faith that I learned long ago from silent prayer made it easier for me to understand my mental states without fear. The Green Tara Sadhana, a kind of yoga, allowed me to stabilize my mental state by integrating mind and body. The help that I have given other people taught me compassion.

But I must also give a certain amount of credit to my madness itself. When I came to study at the monastery and listened to the high lamas, I compared what I heard to what I had experienced. It all fit together. Everything that the lamas taught about the nature of the mind coincided with what I had already learned within my altered states of consciousness. From the lamas I learned how very important it is that we respect our consciousness, in all its dimensions. It is a house of many mansions.

The questions remain. If mental illness is a disease of the mind, what is the nature of the mind? If altered states have value, what is there to recover from? What is our model of wellness? Is it true, as some say, that spiritual realization is the highest aspiration of the human race? If it is, should not that be our model of wellness? How do we recover to that state of wellness? Is recovery for a mental patient something different from the wellness of any other person?

Why do people in mania consistently experience an urgent call to save the world, and call themselves messiah or savior? Is this merely grandiose, or do such people truly hear a call to help others?

We know that people called schizophrenic hear voices. But why do they listen to them? Why in this culture are some forms of mental illness so excruciatingly painful and so interminable? Is illness the reason, or is there a tragic misunderstanding of global proportions? Who is ill -- is it the visionary or is it the society itself?

We now know that mental illness appears in a very high proportion of creative artists and world leaders. Some persons who achieved greatness in spite of -- or even because of -- mental affliction are the artist Vincent Van Gogh, poet Robert Lowell, and President Abraham Lincoln. Is this a fluke, or is there actually an indispensable link between madness and creativity?

For centuries, ever since human beings emerged distinct from apes in the chain of evolution, people have experienced extreme mental states. In most societies, altered states of mind have held a place of respect, and have served to give spiritual meaning to the culture. In indigenous cultures, for example, the shamanistic tradition involves an individual's journey through his or her own mind. This journey is typically painful and even turbulent, but because the people who experience it are guided through it by spiritual elders and the community itself, they emerge from their ordeal with newfound wisdom and the power to heal.

Eastern peoples believe that mental disturbance is a question of both body and soul. Although emotions come from the brain, the mind is located in the heart, not the head. Mind and heart are synonymous. Thus the brain is part of the body, but the mind is part of the spirit. In the ancient Hindu scripture, the Bhagavad-Gita, called the "Song of God", it says: "One must elevate oneself by one's own mind, not degrade oneself. The mind is the friend of the human soul, and its enemy as well" (Murray, 1980). In ancient Tibetan medicine, madness was considered the easiest of all maladies to cure, and it was treated with the use of herbs, diet, and spiritual practices (Clifford, 1984). Buddhism, like other contemplative traditions, uses the discipline of meditation to open up dimensions of extra-ordinary mental states that lead to spiritual wellness.

Even the Judeo-Christian religions are founded upon the inner experience of the heart. When Moses went up to the mountain, he experienced an altered state of mind. He had a vision -- you might say hallucination -- of a burning bush, and a face to face encounter with something for which he had no name, and which terrified him.

There the angel of the Lord appeared to him in flames of fire from within a bush. Moses saw that though the bush was on fire it did not burn up. So Moses thought, I will go over and see this strange sight -- why the bush does not burn up." When the Lord saw that he had gone over to look, God called to him from within the bush, "Moses, Moses!" And Moses said, "Here I am."

[Yahweh told Moses that he was being sent to bring the Israelites out of Egypt.]

Moses said to Yahweh, "Suppose I go to the Israelites and say to them, 'The God of your fathers has sent me to you,' and they ask me, 'What is His name?' Than what shall I tell them?" God said to Moses, "I am that I am. This is what you are to say to the Israelites: I AM has sent me to you." (Exodus 3:2-14)

It was this experience that made Moses a prophet. Later, of course, he received the ten commandments and brought the stone tablets to his people. But that was later. The experience that enabled Moses to lead his people to the promised land was an altered state of consciousness. And many of us who have been labeled mentally ill know first hand what that altered state is like.

We know what the "I am" is. If we are Buddhists we know what "suchness" is. If we are shamans, we know who we are.

Until recent times, altered states of the kind I have described were an integral -- and integrated -- part of human experience. Among the ways they were incorporated into society were the shamanistic/healing way, the contemplative/teaching way, and the prophetic/leadership way. It is only recently that altered states have been medicalized and stigmatized. It is only recently that powerful drugs have been used to suppress the altered states that once produced our prophets and our saints.

Not surprisingly, it is also recently that society has fallen into a spiritual crisis of unprecedented proportions. In case you had not noticed, we no longer have any shamans or prophets. There may be those who go by those names, but somehow the mental experience that shapes such people is missing. This lack is sorely felt. We are lost now, lost on a global scale. Our world has lost its meaning, and our religions have lost their authority.

Not surprisingly, millions of people today are seeking to reach an altered state in the only way that they know how -- through the use of mind -- altering drugs. We may try with all our might to get rid of the drugs, but as long as we are human, we will not get rid of the need for altered states.

Buddhism identifies two components of spiritual realization -- wisdom and compassion. It prescribes meditation to attain mental clarity and good works to learn compassion. The intimate experience of mind through meditation opens the heart to compassion. Similarly, the good that we do for ourselves and others opens our minds to wisdom. The Bhagavad-Gita says, "One whose mind is controlled and who strives by right means is assured of success" (Murray, 1980). And Jesus was talking about the same two activities when he named the two great commandments (Matthew 22:37-39). The first is to "love the Lord your God with all your heart and with all your soul and with all your mind." This corresponds to wisdom. The second great commandment is to "love your neighbor as yourself" -- and this is the same as compassion.

For me, Dharma practice was healing, for I found that the two Buddhist aspects of enlightenment -- wisdom and compassion -- are prescriptions for mental wellness in general. By following them, I achieved what others have called "recovery." But clarity and love are not restricted to Eastern religions, and we need not turn to esoteric practices to find a cure for mental suffering. We do, however, need to reexamine mental health treatment from the perspective of mental states -- in other words consciousness. I believe that any meaningful treatment for mental illness must have a spiritual basis.

Any model of healing the mind must begin by acknowledging the spiritual properties inherent in altered states. It will include a human exchange between client and provider, one in which the client can share and even transmit what he or she has learned. People who have experienced madness have something to give back to the world. It is no coincidence that we are likely to be sensitive thinkers, talented in the arts, and understanding of others. Many of us have seen the "I am," have understood the "suchness" of phenomena, and want to help others.

Mental health professionals need to study the dimensions of consciousness, and to learn to practice compassion and wisdom themselves. These inner disciplines can and should be taught to anyone entering the field of mental health. Persons suffering from mental confusion may need medical technology, and even drugs, to help them "cope." But any good psychiatrist, psychologist, or mental health worker must first be a decent human being -- and certified as such!

When we talk about finding a "cure" for mental illness, it is important to expand the definition of sanity to include clarity and compassion that can co-exist within so-called "symptoms." Health, or sanity, can be achieved even within an affliction or disability. As examples, both Franklin Delano Roosevelt and Helen Keller were severely physically disabled, yet one became the leader and the other the teacher of millions of people. In my case, the healing process and my successful work as a peer advocate started while I was still suffering periodic breakdowns, and continued for some time while I was still going in and out of the hospital.

Few of us who have been psychiatrically labeled would claim to have recovered to the point where we no longer experience our manic energy, our depression, our voices, or even our confusion. It is embarrassing, but I must admit that for the last six months I have been quite depressed myself. I do not think I will ever again get so out of control that I will have to be hospitalized. But even if that should happen, I will not lose faith in my experience and my journey. I take comfort in another lesson that I learned from the Tibetan lamas. These holy people, and holy people I have met in other traditions, are remarkable for their very humanness. They have quirks and foibles and frailties, but these in no way contradict their spiritual realization.

Often ex-patients and patients within the community are expected to endure lives like those we see all around us. Everywhere these days we see people living lives of quiet desperation -- lives, as Kierkegaard noted, of "indifference, so remote from the good that they are almost too spiritless to be called sin, yes almost too spiritless to be called despair." (Kierkegaard, 1954). We who have experienced mental illness have all learned the same thing, whether our extreme mental states were inspiring or frightening. We know that we have reached the bare bones of spirit and of what it means to be human. Whatever our suffering, we know that we do not want to become automatons, or to wear the false facade that others adopt.

Whether we have had revelations or have hit rock bottom, most of us have also suffered from the ignorance of those who fear to look at what we have seen, who always try to change the subject. Although we have been broken, we have tasted the marrow of reality. There is something to be learned here about the mystery of living itself, something important both to those who have suffered and those who seek to help us. We must teach each other.

We must teach each other, knowing that it is often the wounded healer, or the wounded prophet, who is most able to help others. The stigma that we bear need not be a mark of shame. Instead, like Jacob after he wrestled with the angel, we can wear our disability as a badge of honor. In Jacob's first altered state, he received a wound that stayed with him for the rest of his life:

    That night, after Jacob had sent his family across the stream, he sent over all his possessions. So [he] was left alone, and a man wrestled with him until daybreak. When the man saw that he could not overpower him, he touched the socket of Jacob's hip so that his hip was wrenched as he wrestled with the man. Then the man said, "let me go, for it is daybreak." But Jacob replied, "I will not let you go unless you bless me." The man asked him, "What is your name?" "Jacob," he answered. Then the man said, "Your name will no longer be Jacob, but Israel, because you have struggled with God and with men and overcome." (Genesis 32:22-28)

Jacob named the place of his struggle Penial, which means "face of God." I, too, have seen God face to face, and I want to remember my Peniel. I really do not want to be called recovered. From the experience of madness I received a wound that changed my life. It enabled me to help others and to know myself. I am proud that I have struggled with God and with the mental health system.

I have not recovered. I have overcome.

  • Clifford, Terry (1984). Tibetan Buddhist Medicine and Psychiatry.
  • Freemantle, Francesca, and Chogyam Trungpa. (1975). The Tibetan Book of the Dead.
  • Govinda, Lama Anagarika (1969). Foundations of Tibetan Mysticism.
  • Holy Bible, New International Version.
  • Kierkegaard, Soren. (1954). Appendix to The Sickness Unto Death.
  • Miller, Judith S. (1990). "Mental Illness and Spiritual Crisis,' Psychosocial Rehabilitation Journal. (14:2).
  • Murray, Kim and Chris. (1980). Illuminations from the Bhagavad-Gita.
  • Podvoll, Edward M. (1990). The Seduction of Madness.
  • Tilopa (1963). "Song of Oral Instructions." The Life and Teaching of Naropa
  • Trungpa, Chogyam. (1972). Mudra.
  • Trungpa, Chogyam. (1984). Shambhala. The Sacred Path of the Warrior.
  • Willson, Martin. (1986). In Praise of Tara. Songs to the Saviouress.

*** Sharewrite 1994 Sally Clay ***
Permission is granted for personal distribution of this document
as long as it is unchanged in any way and this notice is included.
For permission to reprint it for general publication, contact me at

Back to Essays

Return to lesson 4

Historia zmian
1.0 – 05 września 2014: Wersja pierwsza na tej stronie.