I HAD COME TO BELIEVE, SIMULTANEOUSLY AND SEQUENTIALLY, THAT I WAS: DEAD, ALIVE, OMNISCIENT, IMMORTAL, NON-EXISTENT, GAY, STRAIGHT, TELEPATHIC, A FLOWER, A PULSE OF PURE ENERGY AND A NUCLEAR BOMB. AND THAT WAS THE GOOD PART, RELATIVELY SPEAKING
Psychosis is, I suspect, a little like falling in or out of love: something on the cusp of the personal and the universal that each of us experiences differently. Between the ambulance ride and the oblivion of sedation, I was held in a room with two police officers at the local A&E. They looked on reasonably benignly as I did my best to convey what I was feeling which, among other stark hallucinations and a roiling, primal fear, was that I was dying and being reborn every 90 seconds or so. I can’t really describe what that is “like” since the one comparable event is largely unremembered and the other unknowable, but it felt real and it was gruelling, and, in the end, I was begging them to knock me out.
All this was much to reflect on as I recovered (to some extent) in a psychiatric hospital over the next 48 hours. How had I fallen so hard and wide of the mark of meditation, of something so seemingly benign? Others on the retreat had become emotional, openly weeping (as I had done) but no one else had begged to stop, only to refuse to leave and then been forcibly removed.
What I did know, was that I had been “here” before. And not in a past life. In the mid-Nineties, in my mid-twenties when I was working as a journalist in London, I took enough recreational drugs to keep me awake for nine days, at the end of which I was psychotic, sectioned, sedated and held in hospital for four months. That might sound dramatic, but I did it to myself and for all I know the treatment (including drugs since withdrawn from use) and the incarceration saved my life. Certainly, it shaped it.
The advantage of this, insofar as it had one, was that when my mind disintegrated for the second time, I had some sense of what I was in for, and I knew I could get back. Maybe. Even naked terror takes the occasional break, and the sense in those moments that there is a way out, is in some ways all you need to carry on.
This time I was in and out of hospital in one weekend. With a month’s worth of anti-psychotic medication, I had some decisions to make. It seemed clear to me that if I could reach such an altered state through intoxication and insomnia once, and then do it again 20 years later through silence and concentration, then that state was “real” and not a figment of my imagination or the symptom of an illness per se.
I didn’t want to stay medicated (my previous stint had lasted a decade), and I understood that the rules of the retreat meant that as I had left before the end, I could not go back. Vipassanā makes it clear in its literature regarding “serious mental disorders” that: “Our capacity as a non-professional volunteer organisation makes it impossible to properly care for people with these backgrounds.”
I had been screened out at the initial application because of my history and then, after going into detail, accepted, as my prior issues were so long ago. I was thrilled to be admitted and delusional when I left, but barring some emails and a follow-up phone call, early exits from Vipassanā are final. Tossed from what had seemed briefly to be heaven, I went back to my elderly folks, weaned myself off the meds, and got thoroughly depressed.
In the weeks that followed, I began to google “meditation”, “mental illness”, “mania” (as my ex-wife pointed out, I ought really to have done this beforehand). But it was then I found that far from being alone in this, I was one of many who had learned the hard way that at a certain level, for some practitioners, something like psychosis is part of the meditative programme. And that not everyone who goes through that survives.
Anna Bu Kliewer
Dr Daniel Ingram is a recently retired, frontline ER physician who worked in one of America’s largest trauma centres in Huntsville, Alabama. He left trauma medicine in his late forties, he says, since, “you see some extremely bad stuff in high quantities, it starts to take its toll… it is in some ways a younger person’s game.” Ingram is also the author of Mastering the Core Teachings of the Buddha, a seminal and substantial text which, alongside a busy online forum which he moderates, has become a resource for those for whom the vogue for meditation revealed the void. One of his contentions is that despite millennia of existing wisdom about what can and will happen when you close your eyes and follow your breath for long enough, modern versions of these practices are often mis-sold.
“This dream of peace and wellbeing, happiness and contentment, mental health and emotional clarity,” says Ingram, “[doesn’t recognise] that some reasonable proportion of people will also be catapulted into full-on, deep-end spiritual development by crossing what the Buddhist tradition I come from calls the ‘Arising and Passing Away’ stage. And then they’re off and running in this whole different end of development, which, as you now know, is quite a different thing than what most people signed up for.”
An irony of finding Ingram’s work was that my own “madness”, the singularity of which I was both scared and perversely proud of, was made familiar, if not quite mundane. In a broad sense, he has heard it all before.
“You crossed the ‘Arising and Passing’ and hit the standard ‘Dark Night’ stages, just as one would predict,” he explains. When I tell him about the birth-and-death cycling, which I had taken to be particularly troubling and profound, he just says, “Nice”. These challenging but navigable “stages of insight”, he explains, are as old as meditation itself. They have, however, been largely omitted from the modern conversation.
The Vipassanā retreat I visited is part of a global, free-to-attend franchise run on the guidelines established by Goenka. The regime there, says Ingram, is, “absolutely perfect for getting people across the ‘Arising and Passing Away’, [but] not normalising the next stages.” These stages are often traumatic, known colloquially and historically as the “Dark Night”, and bear little or no phenomenological difference to the medical classification of mental illnesses, particularly bipolar disorder. According to Ingram, with the right expectations and support, the stages are temporary. Without it, “people crash out into the world a total wreck. I’ve had a hundred of these calls, more, I couldn’t possibly count them,” he says. “If you go online, the number of reports of this happening is thousands. So many I’ve lost track of them all.”
Three months before I entered Vipassanā, Megan Vogt, a 25-year-old American woman left a near-identical centre in the US “incoherent, suicidal and in psychosis,” according to reports in the local news. Ten weeks after she left the retreat she took her own life. Unlike me, Vogt had no history of mental illness or drug use. She would not have presented any issue at the application stage or known what hit her on the retreat. Nor did her family, or, it seems, the medical professionals to whom she was referred.
A spokesman for the Vipassanā Trust, which manages the network of retreats in the Goenka tradition, acknowledged that Vogt’s case was “horrendous, tragic and traumatic” but that such outcomes were “exceptionally rare”. He told me 1.2m new students have used their retreats since 2001, and they have accepted more than 200,000 since 2016. He also said that this case, and any other “serious incident”, was subject to an “incident review”, and that the Vipassanā Trust’s objective in these matters was to “check ourselves that everything is being done, and if not then make some changes and tighten it up”. He added that any student, regardless of how they exit or whether they finish the programme, is welcome to contact them for support or even to reapply.