is schizophrenia a pre-mystical state ?

Abstract

Schizophrenia is the last frontier of science. The etiology and treatment of schizophrenia is the holy grail of modern psychiatry. It calls for a comprehensive theory of man. The association between insanity and mystical states has a long history. The biographies of saints from different traditions indicate that they went through a phase of psychosis, from which they emerged more than "normal". Shamans in different cultures use hallucinogens in their training to become healers.

Psychedelics given to normal volunteers produced a brief mystical experience in which they experienced a loss of ego-boundaries without becoming psychotic. Schizophrenics come to the very edge, but are unable to transcend their ego. Their resistance to ego-disintegration may be the cause of their symptoms. It is empowering to conceptualize schizophrenia as a pre-mystical state(PMS). Entheogens may have therapeutic potential in schizophrenia if used under controlled settings.

Key Words: SCHIZOPHRENIA, SHAMANISM, ENTHEOGENS, MYSTICS, and PSYCHOSIS.

Introduction

The cause of schizophrenia is not known. In fact the etiology and treatment of schizophrenia is the holy grail of modern psychiatry. The onset of schizophrenia is often associated with profound alternations of subjective experience that may modify the patient"s world-view in the ontological sense and motivate a quest for metaphysical meaning that cannot be adequately addressed in the medical model terms(1). Guided by phenomenological considerations, it has been recently proposed that alterations of self-awareness constitute the phenotypic core of schizophrenia-spectrum disorders(2).

The modern concept of Schizophrenia is less than a century old (1911 – E.Bleuler)(3). The dopamine hypothesis of Schizophrenia, the current dominant paradigm, looks increasingly untenable. Currently available anti-psychotic drugs treat the positive symptoms of the disorder without much impact on the cognitive and negative symptoms, which are more enduring. Infact the cognitive deficits may be the core defect in Schizophrenia. Moreover the term Schizophrenia, with the associated stigma attached to it, has not furthered our understanding of the disorder. Currently available treatments have a high non-compliance rate, probably related to its lack of efficacy and poor side effect profile. It can be as high has 50%. It is interesting to note that substance abuse in Schizophrenia can be as high as 50% in some samples, with some schizophrenics reporting alleviation of symptoms.

The symptoms of Schizophrenia can be conceptualized psycho- dynamically as due to loss of ego-boundaries. Thus the patient is unable to distinguish between self and object, inside and outside and illusion and reality. Loss of ego or ego-death followed by rebirth is precisely what Mystics and Shamans describe in their writings. It seems there is a paradox here. Whereas Mystics and Shamans are able to transcend to a new level of integration, the schizophrenics are not able to. In Laing"s metaphor: whereas the mystics learn to swim, the schizophrenics drown. The variables here could be: careful preparation, the context and a highly supportive setting. The altered state of consciousness (ASC) induced by non-drug methods in mystics and by hallucinogens in shamans produces mystical states. The cognitive change (vision) due to the mystical state may be therapeutic in that it affords the psychotic a new grip on "reality" albeit at a higher level.

Shamanism

A shaman is a religious or ritual specialist, man or woman, believed capable of communicating directly with spirit powers, often while in ecstatic states. The name originated among tribal groups of Siberia, where a Shamanistic religion dominates, but Shamanic features are prevalent in so many geographically widespread pre-literate societies that,

for anthropologists, the term Shamanism has come to refer to a general religious phenomenon. A Shaman is sometimes called a medicine man among American Indian groups, a witch doctor among various African people and a Tantric or Mantravadi in India.

A Shaman is said to be chosen by the spirits selected from among persons of an introverted and intuitive nature, who are given to day-dreaming and visionary experiences. Sometimes a Shaman is marked for the vocation by repeated illnesses or mental disturbance – what a modern psychiatrist would label as a psychotic episode.

The person believed chosen for this calling must undergo an initiatory ordeal, which includes an ecstatic temporary loss of consciousness that symbolizes death and resurrection. He is taken away to a solitary place by elder Shamans and instructed in the myths, rituals and songs of the community. He is taught to identify and use herbs, which include hallucinogenic plants. As a person who has gone through an inner journey of transformation and came back to this world, he can guide patients struggling with a similar crisis.