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Philosophy, Psychiatry, & Psychology 9.4 (2002) 343-347
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Mysticism and Psychosis:
Descriptions and Distinctions
IT IS REFRESHING to read a paper that manages at once to be interdisciplinary and intercultural in its range of reference, and that also confronts a difficult and controversial question about how we are to assess the similarities and differences between psychotic and mystical experiences. Many psychiatrists have been skeptical about whether there are any genuine differences, and not, mostly, because they thought that psychotics were in reality mystics. But mystical is pretty vague, as is spiritual, and that does not bode well for the enterprise of making comparisons, unless we can tie these latter terms down with some precision. How vague psychosis is I must leave others to judge, but one of the conclusions I have drawn from reading this paper is that the crucial questions turn not on agreed definitions, but on agreed judgments about what are to count as the examples or cases that fall under the definitions. I have some doubts about Caroline Brett's approach to these questions, in the first half hesitant doubts, in the second part less so. Her leading claim appears first in the Introduction:
. . . spiritual or mystical experiences are those states in which the form of experience is altered from normal consciousness, resulting in a new understanding of the basic nature of reality, life, and the individual. Psychotic experiences are those states that also flow from alterations of the form of experience, but result in a pathological interaction between the individual and the world. Therefore, according to these definitions, phenomena occurring in a spiritual context may be identical to those traditionally viewed as symptoms of psychosis, but cannot be seen as psychotic in themselves. (Brett 2002, 322)
What I was struck by in reading this passage was not so much the claim that "phenomena occurring in a spiritual context may be identical to those traditionally viewed as symptoms of psychosis, but cannot be seen as psychotic in themselves." What struck me was its implication: that psychotic experiences cannot be seen as psychotic in themselves, either. In other words, the claim is that there is a neutral core of common experience shared by psychotic and mystic alike. I do not know how controversial this is in the psychiatric literature that deals with delusion and hallucination, but I should like to explore the claim a little in what follows. Brett expands on it near the end of her paper:
The pathology that differentiates the psychotic from the benign mystical state lies not in the content of beliefs, or even in the broad form of experience, but in a few interrelated commonsense factors. It consists of an inability to return to the ontological framework of consensus reality; in psychological isolation, and inability [End Page 343] to accommodate to the subjectivity of others; in a focus of interest in the mental realm and loss of practical concerns that leads to paucity of action and neglect of self-care. (Brett 2002, 336)
This pushes the pathology away from the experience that might have been thought to constitute the psychosis. I wonder whether there are problems with this. The fact, if it is one, that both mystic and psychotic alike undergo "an altered state" clearly does not imply that there is a (common) altered state that they both undergo, so what are the grounds for the claim that the core or central experience is the same? What kind of experiences are claimed to be common? How are we to conceive delusion on this scenario?
What makes psychotic experiences psychotic on the present pushed back view seems to be that they "result in a pathological interaction between individual and world" (my italics), which thus exonerates the experience itself of pathology, pushing it back to one possible set of consequences for someone who reacts badly to the experiential phenomena (e.g., their inability to return from it). It seems to suggest that someone can be comfortable or well adapted to their voices and visions (and surely there are such people around, for whom the boundaries...