An Open Letter to the Spiritual Community About Psychiatry
There’s life with the experience of mental illness and then there’s life as a mental patient. I’ve been told that both entail a large serving of unfathomable suffering. Suffering that brings you to the brink of something you can’t imagine tolerating one more second of, and then it asks you how you’d like to stay there for infinity. The kind of existential fear that comes with not knowing what is real and what is illusion. A depth of pain that feels so endless it’s like a black hole inside your core. Others describe feeling on fire, electrified by worry. Or maybe you’ve just been told that your behavior is concerning, scary, or dangerous.
If you are reading this, it’s possible that you were brought to your edge, and like any one of us, you begged for mercy. It’s possible you tried alternative medicine, but ultimately surrendered to medication, battling a daily inner conflict as you opened that prescription bottle again and again. You had no choice, or at least it felt that way. When we get dragged by our hair through this human experience, we need to know that it’s going to be ok. And medication can offer us just that reassurance. But perhaps we are asking for help in the wrong places? In places designed to ensnare us, disempower us, and keep us arrested in our spiritual growth. Perhaps we need to come together around a new story for mental illness. But first we have to ask some important questions and open our minds to the possibility that there is meaning in struggle and there is meaning in how we respond to it.
If the goal of spirituality is integration – persistently examining where we are still asleep, where we are still defended, where we are still inauthentically manifested – then we must explore what the meaning of a pharmaceutical product is to us. To my mind, a pharmaceutical – whether it’s birth control pills, antibiotics, vaccines, acid blockers, or psychiatric meds – a pharmaceutical says, “No, you’re not enough. You’re not ok. What you’re feeling is a problem. It scares me, it bothers me, it’s unacceptable to friends, family, and society. This body, this felt experience needs management from more powerful agents.” When we say no to our felt experience, to our bodies, we are maintaining the tension of the war. It’s exhausting and at best results in a stalemate.
But are there really other options? How does a spiritually-oriented person relate to mental illness and needed treatment? I’d like to speak to that. But first, some context…
I am new to spirituality. As a conventionally trained physician and former science-worshiping atheist, the notion of spirituality was, for the better part of my adult life, something like a gold star board you might set up for a 6 year old – a cute strategy to encourage good behavior that quickly becomes irrelevant when there are pressing questions or real behavioral issues at hand. I used to think that spirituality was the land of rainbows and unicorns and sentimental tropes about gratitude. I used to think spirituality was a conveniently draped window dressing to the real stuff of life – science, and by extension medicine. I used to think spirituality was for the softies on the sidelines of the action.
Then I changed. I had a felt experience that turned the lights on and revealed to me that I was only in one room of a house that was in a neighborhood that was in a village that was in a region of a country on a planet in a solar system in a galaxy in the universe. I awoke. And as I spiraled outward, the whorls and patterns and beauty and designed chaos left me confused about what was true, what was real, and who I was. I would later learn that this confusion is the first sign of growth and change.
Metanoia
In Greek it means shift of the heart. That’s what happens to those who awaken to spirituality. Their heart undergoes a transformation. Because no one has ever touched their soul through their mind and because information has never by itself led anyone to their truth. Experience has. I know this but I have also come to know, on the level of an akashic remembrance, that I have an important message to deliver, and a good part of it is the experiences of those who have traveled beyond the pale and moved beyond their psychiatric labels. I have no intention of making anyone reading this feel that they have made a mistake, not tried hard enough, or that they have been duped. I believe passionately in the Maya Angelou principle of when you know better, do better. And I feel compelled beyond what I can contain to share some truths with the spiritual community in case it helps you to know better – or to confirm what you already know.
I have been saddened by the recent death of Michael Stone. A beloved teacher of Buddhist lineage, my office may seem a surprising place for his grief-stricken supporters to reach out to in the wake of his tragic death. While not intimately acquainted with his work, over the years I have received many a text message from my best friend sharing his wisdom. I witnessed the impact that his words had on her life, and know, through my own posthumous relationship with Zen philosopher Alan Watts that these words, disembodied as they might be, can feel like a rope ladder from the deepest, wettest, dankest well, out into the golden light of a meadow. They feel that way when they give voice to a truth that you already possess within. One that has become obscured.
And isn’t that what awakening is? A commitment to opening, to working with, to acceptance, to surrender, to peeling back the layers of gauze wrapped comfortably over our eyes?
Michael gave many souls a place to rest – created a container for them. But, as is the case with most teachers, myself perhaps included, there is the message and then there is the medium. And we are learning that Michael was wrestling with his own energies in a way that ultimately led him down a path many may be shocked to learn about.
When I read about his experience of surrender to conventional psychopharmacology, I felt a deep sense of heaviness – perhaps the weight of all that I want to share that perhaps can never be shared with this man.
Here’s what I would have wanted to share, and what I will share with you in service of growth and expansion, alignment and perhaps confirmation of what you already know to be true:
1. Psychiatric medications are not what we are told they are. I used to be a card-carrying pharmaceutical dispenser. I thought that I was helping people when I wrote prescription after prescription throughout years of my medical training. It wasn’t until I had a lived experience of radical healing that flew in the face of all of the medicine I had been taught, that I went back to the books to see what other scientific narratives existed that I had not been exposed to. What I found out was shocking! I learned that in an effort to help, doctors prescribe medications that move symptoms around like a whack a mole game. Because when you suppress or distort a symptom, it doesn’t actually resolve, and that disturbed energy manifests elsewhere. So as our patients are falling off of cliffs, we are offering them knives to grab onto – we are offering them help that ends up making them sicker, or at best arresting an emergent and self-limiting process.
This is the perspective of several renegade psychiatrists and of Robert Whitaker, whistleblower and investigative journalist whose work led me to put down my prescription pad. For good. Through non-industry published literature, I learned that psychiatric medication can perpetuate the very disability that it purports to resolve. In other words, you are worse off taking it than not. Hard to believe, I know. Because we feel like we have to do something, and that medication is what we do in urgent and serious situations, right? Or what if your situation is neither urgent, nor serious, but is just really taking a toll? You’d be reckless or stupid not to avail yourself of the safe and effective tools Western medicine has to offer – perhaps even combine it with some Eastern methodologies for the best of both worlds?
That would have made sense to me too, before I spent a decade reviewing a very different tale – a much suppressed one – about these medications. If I had to use my credentialed expertise in analysis of primary literature to come to these inconvenient conclusions, then how could the non-clinician ever be expected to know?
Unfortunately, most of those who now know, know because of their experience being injured, harmed, or disabled by these medications. And what they would tell you corroborates what the science has to say, namely, that –
- Psychiatric medications result in worse long-term outcomes
- They are debilitatingly habit-forming
- They can unpredictably trigger impulsivity including suicide and violence
But for those costs, we would expect a sizeable benefit, of course. And these medications underwhelm at all objective analysis of their efficacy. In fact, they repeatedly perform only as well as placebo.
2. Belief is the key to healing, so know what you believe. We are in an interesting time, one in which research science is catching up with spirituality – namely in exploration of energetics, interconnectedness, complexity, and the power of faith. An area of exploding data is that of the placebo effect. Formerly dismissed like some fly-like nuisance, we are learning that belief is arguably the most powerful determinant of medical outcomes ranging from surgery, to bone healing, to even the effects of drugs like stimulants. Given this, it is a critical exercise to look at what your beliefs are around the body.
We are steeped in many centuries of conditioning, largely thanks to denominational religion, that has led us to separate the material and the sacred. There’s the spirit, the soul, and God, and then there’s the sins of the flesh that need to be managed and oppressed. Perhaps, for this reason, it is not common in spiritual circles to explore our relationships to our bodies and to the external authority that controls them – the medical system.
It may not be obvious that orthodox medicine is itself, a belief system. As my mentor, Dr. Nicholas Gonzalez told me – medicine is an unacknowledged religion complete with its own language, costumes, and places of worship. But through many interesting twists and turns in history including the Flexner report commission by Rockefeller that sought to single-handedly dismiss all and every non-pharmaceutical form of medicine, we have been told a story about the objective dominance of conventional medicine relative to all others. It’s important to know that it is a story so that you can be aware you are tethered to a religion, perhaps unwittingly. A religion that says – your body is broken and dangerous, that you cannot spontaneously heal, that you require the help of medications and surgeries to get by and survive, and that genes and bad luck are behind your health struggles. That this isn’t personal, it’s not meaningful, and you just need to manage the situation. Odds are, this is not what you believe. Odds are, if you’re reading this, you believe in the sacred design of your bodily vessel. You believe that everything has meaning. You believe that struggle and suffering lead to breakthroughs – that you must plumb the depths of your personal hell in order to transform it into heaven.
3. We need to make room for falling apart.With my patients and in my online community, there’s a lot of struggle. Suicidality, hopelessness, and distorted thinking. And it doesn’t scare me. That’s because I know that, if I can provide a solid container for it to all fall apart, then the alchemy of the wound takes place. And everything transforms. I never prescribe. EVER. And my patients know that I could prescribe…but I don’t. So they know that they have only one choice – let the energy move through and look for the teaching. No conditions, no negotiations. And it does transform, every time. But if you have never been told that this kind of struggle is ok – and you don’t recognize that you still believe in the religion of medicine – then how could you possibly move through this space? That’s like a woman in labor at home, wearing headphones that say “you can’t do this, you’re going to kill your baby, what are you doing, you reckless moron!”
We have to expose these influences, and also acknowledge that it is our responsibility as a community to begin to hold space for it to all fall apart. Hold space for non-functionality. Because one of the greatest ironies is that medication is often justified on the grounds that patients are “not able to function” otherwise. But what of the fact that medication is the ultimate cause of long-term disability? We, as a culture are terrified of grief, pain, suffering, and struggle. Tears, in fact, are a diagnosable symptom in the Diagnostic and Statistical Manual of Psychiatry. We must make room, real room for the ugly in order to allow these rites of initiation to take effect. It takes the tribe to hold space for that. One man cannot do it alone.
4. There is a way to work with the energy, from a more solid foundation.While I have come to believe that all illness involves a personal teaching and a psychospiritual origin, co-created by the patient, I believe in multiple narratives, and that the body has its own story to tell. Those who struggle with their mental well-being, also struggle with their physical well-being, whether they know it or not. Even the literature suggests that they are not discrete in the way that we have been led to believe – that in fact 5 million people with Bipolar Disorder may actually have physical imbalances at the root of their uncontrolled experiences – and I don’t mean chemical imbalances in their brains. They are the canaries in the coalmine whose bodily mechanisms are sensitive to toxicant exposure, processed foods, and otherwise industrial lifestyles as much as they are sensitive to the many layers of wrongness unfolding on our planet today.
I have found that physical healing – remember that body we were told to transcend? – must be the foundation of a powerful spiritual process. That’s why I lead with (controversial) dietary self-exploration (and believe that nutrition dogma can be a tremendous handicap), and I recommend daily detox methodologies in addition to community and meditation. Because it may be that your body says no to an exposure through so-called mania, psychosis, or suicidal depression. Here’s a 37 year old woman whose delusional psychosis resolved after she eliminated wheat, another whose thyroid imbalance lead to suicidality, and another whose hormonal imbalance bought her a pile of dangerous and ineffective meds. Heal naturally first, then the real work can begin. You wouldn’t embark on an Everest hike after an all-nighter, with a couple of Snickers bars, so understand that honoring your vessel is saying yes to your process, and it will unfold all the more gently.
5. In order to choose, you have to know what’s possible. Perhaps the most important truth I am here to share is predicated on the one of the principal tenets of ethical medicine – informed consent. Informed consent implies the exploration and confirmed awareness of all known risks, benefits, and alternatives. In addition to peeking behind the curtain of medication efficacy and safety to see the small man pulling the strings, you need to know what is really possible in order to make a choice that feels empowering to you. Did you know that you could put schizophrenia, Bipolar Disorder, OCD, panic attacks, chronic fatigue, ADHD, Major Depression with suicidality, eating disorders, and generalized anxiety into total remission without medication, and even in spite of it? Watch what these people have to say about their experience doing just that. Did you know that you could shed these labels and walk into the wilderness of your life only to encounter the real you? I’ve come to believe, from the hundreds of patients and online participants who tell me the same thing after they come off of medication – that they finally feel like themselves – that psychiatric medication makes the deepest spiritual work largely impossible. It’s almost like cutting the chrysalis to free the struggling caterpillar before it has metamorphosed into a winged creature ready to set aloft.
But if you didn’t know what awaited you on the other end of your dance with psychiatry, you might imagine that euthanasia or suicide is the only option, as one mother of a schizophrenic son disabled by medication thought one month before completing a program of comprehensive healing that gave her son’s life back and then some. My mission is to make sure that as many people on this planet know that the presumed ‘incurability’ of chronic disease is a myth and that healing is eminently possible, because only then can you truly make an informed choice.
Perhaps this is triggering and you feel anger (maybe towards me!), indignation, or a sense of defeat. The reason I want to bring this message to you and your tribe is because I know you aren’t daunted by uncertainty and confusion. I know that you can sit with this reaction and let it transform. I know you are fundamentally curious. I know that you say yes to what life sets before you in so many arenas. But I also know that no one should be walking this path alone.
It may be our job, as a community to begin, one by one, to say yes to ourselves, fully, in all ways. Yes to a high level of self-care, to devotion, to the messages our body is attempting to send, to our felt wrongness, to our wild energies, to our very souls slamming the walls of the small boxes we have stuffed them into. But we have to do this together. We have to lock eyes and say – if you do it, I’ll do it.
Please help me to divine the means and method of re-looming the frayed fabric of a tribe that already knows the beauty of this life and that has the power to hold space for radical transformational healing from the messiness, bigness, and scariness of illness. We already know that the universe moves through us, each of us, and all of us with as fierce a grace as it knows we can handle.
For more information and data (if you love science that confirms spiritual tenets!), I’ve collected my findings/beliefs in my book, A Mind of Your Own.
© Kelly Brogan MD. This work is reproduced and distributed with the permission of Kelly Brogan MD. For more articles, sign up for the newsletter at kellybroganmd.com
Kelly Brogan, M.D. is a Manhattan-based holistic women’s health psychiatrist, author of the New York Times bestselling book, A Mind of Your Own, and co-editor of the landmark textbook, Integrative Therapies for Depression. She completed her psychiatric training and fellowship at NYU Medical Center after graduating from Cornell University Medical College, and has a B.S. from MIT in Systems Neuroscience. View full bio. Want to share this article on your own blog? View our reposting guidelines.
Note to Reader from IMHU:
If you see the wisdom in Dr. Brogan’s article, we encourage you to explore effective alternatives to medication in presentations at IMHU.org/courses. These include practical ways to overcome symptoms of depression, anxiety, bipolar conditions, psychosis, ADHD, and Autism. IMHU also shares information about new ways of perceiving extreme states of consciousness–to include spiritual growth and spiritual emergency.