Reprinted
from The Journal of Critical Psychology, Counselling and Psychotherapy,
2, 261-266, 2002. (Special issue: "Taking Spirituality Seriously")
Guest Editor: Isabel Clark
The
introduction to this issue referred to the exclusion of certain ways
of knowing by the dominant, scientific, culture, and that spirituality
was among the topics regarded as beyond the pale. I am here going to
consider some of the arguments for and against exclusion, with special
reference to mental health. First of all, the vexed question of definition
needs consideration, and the very difficulty of definition takes us
to the heart of the debate about whether such an elusive concept has
any place in scientific discourse. The dictionary places the word in
varying contexts, such as the sacred, the religious, or "concerned
with spirits or supernatural beings." None of that is relevant
here. Religion would be a particular contextualisation of spirituality,
whereas we are here looking at a broader area of experience. The contributors
to this issue do not provide easy answers. Kate Maguire writes "to
define spirituality rationally for me is not possible......I know what
it is not, I do not know what it is; but I experience it when I encounter
it and experience it when it is not there." Nigel Mills profers
the following concise but elusive definition: "a full and direct
experience of the present moment". Other contributors develop further
the characteristics of that quality of experience noted by Maguire,
and fluidity of conceptualisation and interconnectedness recur as key
features. Jennifer Elam uses the term "transliminal" (Thalbourne
et al. 1997, quoted in Claridge 2001) to describe such experience, as
this avoids distinctions inherant in the labels "psychotic"
and "spiritual", and Peter Chadwick provides a powerful description
of the blurring of boundaries bewtween individuals characteristic only
of the more extreme manifestations of this state, as follows:
"[the borderline experience is] beneath mind-matter differentiation.
Hence the paranormal becomes normal, the uncanny becomes the rule. Clearly
the physics of consciousness is no trivial research field. Also in such
an, admittedly fragile, mental state it would be no surprise, at least
in principle, to find oneself sensitive to the preconscious and unconscious
of others".
What then are the arguments for taking this singularly ill-defined concept
of spirituality seriously, and according it consideration in the field
of mental health ? The issues to be considered are listed as follows.
- Can experience, and different qualities of experience, be a valid
field of enquiry for science?
- As spirituality is by definition at odds with conceptualisation, is
it possible to conceptualise it?,
- Conversely, should it be classified as a non concept? Nothing there?
Emperor’s new clothes?
- What can we learn from relating the current debate about the nature
of psychotic experience in CBT for psychosis to the overlapping experience
of psychosis and spirituality as represented by the papers in this issue.
The controversy over the admissability or otherwise of subjective experience
as scientific evidence has effectively been settled. Psychology has
always felt insecure about this, perhaps in reaction to the somewhat
fanciful conceptualisations of psychoanalysis, and has felt a need to
distance itself from that discipline in order to attain the sort of
scientific respectability accorded to, say, physics. Skinner and Eysenck
represent the high water mark of this distancing. However, within Eysenck’s
response, of establishing physical differences in arousability as a
substrate for individual differences in personality, lies one of the
foundations for the revision represented in this issue. Eysenck’s
line of enquiry leads to Gordon Claridge’s work on Schizotypy
(Claridge 1997). Researchers developing this concept have linked high
schizotypy to high creativity and openness to spiritual experience as
well as to proneness to psychotic breakdown (Jackson & Fulford 1997,
MacCreery 1997). Science might have a struggle defining spirituality,
but can provide data on its accessiblity.
More broadly, psychology has been in retreat over the inadmissability
of subjective experience as scientific data ever since the days of Skinner.
In my own field, cognitive psychology, and the growth of cognitive therapy
have made cognition and emotion respectable fields of study. Inevitably,
the contents of consciousness can only be ascertained by self report,
with all the disadvantages of lack of independent verification that
the behaviourists objected to. Such objections have been cast aside,
and the self report questionnaire and structured interview are the main
sources of data in most evaluative studies in this field.
The general debate about subjective experience might have been settled,
but the spirituality debate has hardly begun. It seems to belong to
that category of subjects, such as parapsychological phenomena, that
gain wide acceptance and lively interest in the general population,
but are generally dismissed by science. Attempts to marry the two areas
of discourse in the case of parapsychology characteristically produce
hopeful results to start with, which lapse into insignificance on repetition
(see Pallikari-Viras 1997). On the strict criteria of controlled experiment
such phenomena remain largely unproven, or only marginally supported.
This does not lead to societal consensus that they are illusory. Similarly
with religion, science has replaced religion in providing explanatory
models of physical phenomena, and many scientists have therefore expected
religion to quietly pack up and leave. Nothing could be further from
the current situation. Some scientists continue to dismiss the area
as a superstitious survival; others argue that religion is to be taken
seriously, but in a separate, non overlapping area of discourse. Stephen
J. Gould is a prominent proponent of this point of view (e.g.Gould 1997).
However, within the scope of social science and transpersonal studies
there is a real attempt to expand the mode of enquiry within science
to embrace areas that appeared beyond its grasp. I am referring here
to the development of qualitative methods of enquiry. This "new
paradigm" is now well established (Reason and Rowan 1981), though
still fighting for equal recognition with the quantitive in some university
departments and on Clinincal Psychology Training Courses.
Study of spiritual experience remains more on the margin. John Heron,
in Sacred Science (Heron 1998) develops the qualitative approach to
method of enquiry for group investigation of spiritual life. He writes
"A sacred science, I believe, is grounded in this immediate present
experience of a world that is sacramental." - suggesting that it
is not so much what is studied, but the way in which it is encountered
and conceptualised that characterises the study of the spiritual. On
the one side, this will give fuel to the sceptic who cries "emperor’s
new clothes"; on the other, Heron proposes validity criteria for
the study of this area of experience. He suggests that by an iterative
process of cycles of hypothesis, data collection and reflection, it
is possible for a group of people to enquire objectively into this most
subjective of areas. He quotes several such studies in his book, and
co-operative enquiries, as he terms these investigations, continue throughout
the world.
Neuropsychology can shed some light on the central "Is there anything
there?" question about spiritual experience. The neurological aspect
of what is generally called spiritual experience has long been recognised
(Fenwick 1996) , and the occurenc of mystical experiences in conjunction
with temporal lobe epilepsy have been a particular field of study here.
For the reductionist, this appears to offer the perfect excuse to consign
the whole subject to quirks of brain chemistry. On the other hand, it
is not surprising that differing subjective states can be traced to
their physical substrate in the brain - we are after all physical organisms,
so that all types of experience have physical concomitants. The choice
is whether to leave it at that, or whether to take seriously the meaning
ascribed to the experience, with all the importance for the understanding
of the self and adaptation in life for the individual that that entails.
The question of meaning brings the argument back to spirituality and
mental health. Perhaps the concept cannot be dismissed as irrelevant
if it plays a central, and positive, part in people’s meaning
making. The biological substrate is key for psychiatry, and for the
medical model of mental health, whereas meaning, and individual meaning
making is central for therapy. The current issue of Clinical Psychology
(No.17, September 2002, edited by A.Vetere and D. Spellman) is a timely
reminder of this, devoted as it is to narrative approaches. The ability
to integrate discrepant experience into the narrative of one’s
life is central to adjustment, particularly in severe mental health
problems (e.g. Roberts 2000). In the papers in this issue there are
several accounts (e.g. J. Elam, R. Knight, S. Sharpe), where the concept
of spirituality provided a meaning context with space for growth and
validation, where medicalising meanings had the opposite effect.
Finding meanings that give people value and hope is central to the normalisation
movement within mental health. This has provided a major impetus to
the development of CBT for psychosis, but normalisation itself can be
interpreted in different ways. Specifically, there is one strand of
opinion within CBT for psychosis that minimises or denies the difference
in quality of experience between psychotic and ordinary experience,
and another that argues that recognition of that felt difference is
helpful to individuals to make sense of and normalise their experience.
This is highly relevant to spirituality and mental health, the subject
matter of this issue. The papers cover the overlap between spiritual
and psychotic experience, so that what is said about one applies equally
to the other. This debate represents the tension between recognition
and denial of difference in quality of experience, which I suggest,
applies equally to the question of spirituality.
The background to this debate is as follows. CBT has been successfully
applied to psychosis by concentrating on the overlap with non psychotic
mental health problems. Bentall’s suggested that studying "schizophrenia"
as a unified syndrome was leading nowhere, and that detailed attention
to individual symptom groups was the way forward. This opened the way
to a number of fruitful ideas, such as misattribution theories for hallucinations
(confusing internally and externally generated speech), and cognitive
bias in delusion formation. The assumption behind these approaches,
which was made very explicit, was a continuum between normal cognition
and the sort of distortions found in psychosis. Morrison, who has taken
these ideas forward with, for instance, work on the overlap between
intrusions and voices (Morrison et al. 1995), has argued at two recent
British Association for Behavioural & Cognitive Psychotherpies conferences
as follows:
"A normalising cognitive approach to the understanding of psychosis
will be outlined. This approach highlights several common cognitive
processes and structures that appear to be involved in the development
and maintenance of both psychosis and anxiety disorders.....This approach
suggests that it is the cultural acceptability of interpretations that
distinguishes psychotic disorders, and that basic cognitive dysfunction
or anomalous experiences are neither necessary nor sufficient ...."
(BABPC 2002 p.38. Morrison)
This was countered by David Fowler, as follows:
"....Psychosis is associated with episodes of altered cognitive
state and characteristic anomalies of experience. This altered cognitive
state and the anomalies associated with it are assumed to be continuous
with normality but form a dimension of psychological disorder specific
to psychosis" (BABPC 2002 p.38 Fowler) and Rufus May (who should
know, as he is a Clinical Psychologist who has been through the experience
himself), cautioned against "Catastrophising of the problems themselves,
heavy-handed medical interventions and a lack of enthusiasm for meaningful
understanding and creativity in generating solutions." (BABPC 2002
p.38 May)
I have quoted this debate at length because it mirrors exactly central
themes of this issue, but with no mention of the word spirituality -
only anomalous experiences. The fact that this debate is taking place
at the hard, scientific, edge of the therapy world, suggests that the
material presented here does need to be taken seriously. For the connection
between the anomalous experiences of psychosis and spirituality, I must
refer to the publication and debate which gave rise to this collection
of papers referred to in the introduction. My chapter on "Psychosis
and Spirituality: the discontinuity model" (Clarke 2001) presents
a psychological formulation for this very difference in quality of experience,
based both on Kelly’s construct theory, and on the cognitive science
based Interacting Cognitive Subsystems model (Teasdale and Barnard 1993).
This gives research based backing to the insights quoted at the beginning
of this article that suggests an incompatiblity between conceptualisation
and spirituality. This perspective is ably summed up by Dorothy Rowe,
(Rowe 2001) in an argument sceptical of spirituality, as follows:
"You just have to work at deconstructing your constructions in
order to get as close as you can to seeing the world as it actually
is, while all the time knowing that, constructed as we are physiologically,
we can never see reality directly."
I would only add, that, constructed as we are physiologically, when
we do manage to get beyond our constructions, and therefore our verbal,
new brain, take on the world, the experience is indeed qualitative different,
anomalous and mind blowing. The stories and articles in this issue bear
witness to that.
REFERENCES:
BABPC (2002). Abstracts for 30th Anniversary Annual Conference at Warwick.
Bentall, RP (Ed.) (1990) Reconstructing Schizophrenia.. London:Routledge.
Claridge, GA, (1997) Schizotypy: Implications for Illness and Health.
Oxford University Press: Oxford.
Claridge, G.S. (2001) Spiritual experience; healthy psychoticism? In
Clarke, (Ed.) (2001) Psychosis and Spirituality: exploring the new frontier.
London: Whurr Publishers Ltd.
Clarke, I. (2001). Psychosis and Spirituality; the discontinuity model.
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frontier. London: Whurr Publishers Ltd.
Fenwick, P, (1996) The neurophysiology of religious experience. In D.
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