I presented the following paper at the 20th international congress of International Society For Psychological And Social Approaches to Psychosis, in Liverpool , UK, on Sept. 2nd, 2017.
Good morning everyone! My name is Elahe Hessamfar.
In the paper I am presenting to you today, I will offer a fresh theological interpretation of the language of madness. My theology is centered on my Christian faith, and that is the worldview through which I’ve engaged in this research.
I will be telling you why I believe a psychotic experience is laden with theological content. Therefore, spiritual discernment and theological reflection are essential components for successfully interpreting the voice of madness and leading the person toward true recovery.
This is in line with the thinking and research of Nev Jones and her co-authors, who, in a recent paper, wrote about “a heightened recognition of the ongoing entanglement” or “cross-contamination” of “supernatural and scientific discourse.” They found in their research that it was common for participants to use a scientific theory to “legitimize religious interpretations of particular experiences” or vice versa. Like Jones, I believe that sooner or later we all encounter experiences that refuse to fit into secular and reductionist categories we impose on them.
I acknowledge that theories abound about the meaning of psychosis. But though I started my research and my journey as a marginal Christian, over time, I became convinced that Christian narrative is philosophically the most coherent worldview, to illuminate the experience of psychosis. Why? Because the Christian redemptive narrative is not only the one that is closest to my personal impulses but also, in my opinion, it explains the human condition better than all else. In line with Jones’ findings, a Christian narrative will allow me to “successfully translate otherwise liminal, and often pathologized experiences into events that [are] ‘consistent with what’s been going on in Christianity’ for millennia.” While psychosis often pulls the rug out from under us, throwing into question our silent assumptions about the nature of reality, theology has the ability to give us answers or at least suggestions for a path forward.
Understanding the language of madness requires radical hearing ability and capacity. I believe that faith and the indwelling of the Divine Spirit empowers that radical hearing. Madness speaks not only to the individual, but also to the community surrounding him; thus it offers a providential way for awakening.
I must note that my views are strongly influenced by my experience with my daughter, Helia, through her journey of madness for the past 17 years. I will not spend too much time here to discuss her case. I talked about the specifics of that experience in a panel discussion yesterday. I will briefly mention that the experience has been horrendous, yet rewarding and transformative in many ways.
Helia’s condition started in the year 2000, when she was diagnosed with “schizophrenia” at age 22. Her condition continued to worsen under medical care, and the downward spiral continued until she became catatonic. Her condition was deeper and darker than what medical science could explain. In the process the whole family was pulled into darkness with her. It was only when we started really listening to Helia’s silent communication that we decided to abandon our quest for medical answers and start exploring a different route.
Before all this, our family life was seemingly perfect. In many ways we were living the life that everyone else dreamt of. But we were blind to our own flaws. Like all other families, it took us a crisis and some sobering self-assessment to realize the dysfunctionality that had ruled us so pervasively. We were all living for ourselves, and could see no wrong with our life style—a life style that was ultimately turned upside down. We had not understood the truth laid out in Scripture that any house divided against itself shall not stand.
By caring for Helia and observing her behavior for many years, I became convinced that this was not merely a brain disease, and that there was a lot more to this phenomenon than anybody around me understood. You see, Helia would freeze in strange and twisted postures, at times for a few days, and then suddenly she would walk and go and get a cup of water, without talking or responding to us, and go back again to another frozen state. Shockingly, there was an order in her chaotic behavior. It appeared as if a narrative was at work. Her seeming random behavior seemed orchestrated.
Also I remembered that in the early years of her illness before her catatonic state, every word that came out of her mouth had religious content. As you know, one of the common symptoms of “schizophrenia” is what psychiatry labels as “religiosity,” meaning a preoccupation with God and the spiritual realm. Psychiatry dismisses this simply as crazy, without reflecting on what this might mean in the context of a particular individual life. Observing Helia day after day, I became convinced that God was doing something in her and through her.
So, what do I believe about the content of her psychosis and the language of her symptoms? There have been plenty of perspectives offered about madness through medical, psychological, or sociological lenses. I would like to offer a hypothesis through a theological lens.
I believe trauma, intensity of a supernatural experience, and cumulative effects of a life filled with disappointments and rejections can fracture a spirit. By “spirit,” I mean the basic self, inner-self, core being, and the seat of one’s consciousness. A fractured spirit will have fractured agency and becomes subject to all else that is happening around him in the spiritual realm.
I also believe that given a nurturing environment, madness opens a gateway to deep healing for the one who travels through its consuming depth; and given faith and spiritual discernment, it brings transformation to those who observe it and receive the voice of the illness.
John of the Cross, the famous Spanish mystic of the 16th century, explains in his masterpiece, Dark Night of the Soul, how the person has to lose the use of all faculties to be born in a new realm. All that the person depended on has to be dismantled, so that new spiritual faculties can be gained. This is a chance at transcendence! He explains, “When the soul is making most progress, it is travelling in darkness.” As the soul approaches the presence of God, “the blacker is the darkness,” and “the deeper is the obscurity” that is experienced because of its weakness. This is similar to a man who approaches the sun; the blinding light creates intense darkness, and the pain and affliction created is unbearable. He asserts that as long as the natural senses and faculties are engaged and active, they will lead the person to false light; it is only when the person is in darkness that the soul is well protected in the hand of God. The self has to go backward to be able to go forward. As Christ has said, one has to die in order truly to live (John 12:24–25).
The healing process is not painless and does not happen overnight. Most of us are content with superficial healing just to get on with life. But deep healing demands more of us! It forces us to become naked before God, and lay out all our inner pain, all our sublimated flaws and faults before His presence, so that the loving hands of the Great Physician can put us back together, to a state where there is no more fear; for perfect love casts out fear (1 John 4:18).
Please know that I am not talking about a religion built on a system of “must do’s and don’ts.” That is far more toxic than no religion. I am talking about a love affair with the Most High God who by His Spirit will penetrate into our inner fiber to regenerate it with new Life. And that requires hitting the bottom and being emptied of all that our families, our culture, and yes, even our churches have forced into us. That supreme and unconditional love of God that never perishes can only be discovered when we hit bottom, when all our idols have lost their significance. This love is the byproduct of an encounter and fellowship with a suffering God, who is no stranger to pain and betrayal, a God who in Christ, bore the scars of evil. It is when we hit bottom that our eyes are opened to the truth of the human condition. And that is when healing begins.
I believe psychosis, that distinctive human experience, is the greatest prophetic trumpet God uses to awaken humanity to their innate condition, enticing and calling them to an intimate loving relationship with Him. He opens our eyes and ears that we may see again and hear again, as all inner pain, all flaws and faults that have been pushed down come to the surface. We see the truth of humanity naked before our eyes.
I have also argued in my book why the journey is transformative for the faithful and discerning audience. The beginning of a psychotic episode is a warning sign, a cry for help and compassion. We rarely realize the extent of the vulnerability of a shattered spirit at that point, a spirit emptied of identity, at the mercy of greater forces in the surroundings. Thus how we treat them affects the progression of their illness. The emptied individual becomes seemingly like a sponge that elucidates the spiritual starvation and the illness of the community. “Schizophrenia,” manifests in what Steven Shawn Tuell calls, “sign acts,” or what psychiatry refers to as “symptoms,” which are prophetically speaking to the members of a community about the poverty of their souls. The prophetic books in the Bible are filled with “sign-acts,” which are symbolic behaviors, the embodied messages from God to the people in the immediate community to call them to action.
For example, many modern psychologists and psychiatrists have diagnosed Prophet Ezekiel to be “schizophrenic.” Edwin Broome, applying Freudian analysis, concluded that Ezekiel was “a true psychotic” characterized by “a narcissistic-masochistic conflict, with attendant phantasies of castration and unconscious sexual regression,” along with “schizophrenic withdrawal,” and “delusions of persecution and grandeur.” This cavalier assessment has been applied to Ezekiel more than any other prophet because God called him to be the most prominent example of a prophet who embodied his message in his actions. Ezekiel himself was to be the living symbol of the rebellious nation. According to Scripture, he was to act out all that was to befall Israel. Ezekiel was dumb and motionless for an extended period, and engaged in very bizarre conduct. Ezekiel did not necessarily understand all that was happening through him (Ezekiel 3:14, 24), neither do those who experience psychosis. As Karl Jaspers has noted:
We take it for granted that when we think, it is we who think… The thought phenomena of schizophrenics is something quite different in that they talk about “thoughts made by others” (passivity thinking) … The patient does not know why he has this thought nor did he intend to have it.
Tuell contends that Ezekiel is taking upon himself “the sin of the house of Israel.” He is a “sign” to Israel so that they are prompted to change their ways. There is such power in existential embodiment of a message that word alone cannot accomplish. In many of these instances, the commands are manifesting in movements in the body. This seems similar to what Emil Kraepelin catalogued as “voices of organs,” or “voices which do not speak with words.”
This concept of integrating the spirit of your community with one’s stream of consciousness is not unique to the biblical text. I suggest that is exactly what is happening in the midst of psychosis. Who we are affects the content of psychosis of our loved ones, which is manifested through “symptoms.”
Studies that have investigated variations of the spread of “schizophrenia” in different cultures have produced some eye-opening results. The data indicates the nature of illness to be directly related to the community where it manifests itself, suggesting that it is anything but an abstract meaningless disease. The various expressions appear to have a voice demanding the attention of their immediate audience.
Will Hall, a psychiatric survivor and a community leader whose work is familiar to many of us says: “Change within me came when change came to the communities I live in.”
Let us see if science can offer some insight into this phenomenon.
Neuroimaging studies have found a unique characteristic of the Default Mode Network (DMN) in the brain of those engaged in psychosis. These neural characteristics fundamentally affect the person’s “stream of consciousness.”
The Default Mode Network of healthy people is turned “on” when one is at “rest” and is turned “off” when one is attending to activities with cognitive demands.
A study conducted by a group of scientists from some of the most prestigious academic institutions, showed that people diagnosed with “schizophrenia” take on the external stimuli from their environment, internalize it, and manifest it in the forms of “symptoms.” This is because the “default mode” of their brain is hyperactive and hyperconnected at all times. This means that they are always in a so-called “rest” mode. They are mostly devoid of active cognition, and cannot easily direct their attention to elements of choice, but instead, the stimuli from the environment—both good and bad—travel through them without their intentional engagement.
This “rest” mode, is the state that many people attempt to attain through meditative exercises, and it makes the person open to transcendence and spiritual influences. These influences from the environment, both in the physical and spiritual realm, reverberate back in the form of “symptoms,” and at times this can be overwhelming. The authors summarize this finding as follows:
Hyperactivation of the default network may blur the normal boundary between internal thoughts and external perceptions. Constant overengagement of the default network could lead to an… ambiguous integration between one’s own thoughts and feelings with events in the environment. Thus neutral events would seem to be imbued with exaggerated self-relevance, and the boundary between the internal world of reflection and feeling and the external world of perception and action would be weakened.
The very popular NPR podcast, Invisibilia, in one of their episodes looked at the problem of mental illness and communities that have been successful in caring for such individuals. Their researchers concluded:
Crazy as it sounds, [when dealing with people with mental illness] our private thoughts about a person—our disappoint[ment] in them, or even our wishes for them to get better—shoot out of us like lasers and can change their very inside.
Anyone who has had the opportunity to spend an extended time with an unmedicated person suffering from psychosis is bound to have encountered this phenomenon. It is an unescapable fact that in the midst of psychosis the person embodies representations of the consciousness in the environment. In other words, the person integrates the “spirits” of those in the surrounding and reverberates them back to them.
In the phenomenon of “schizophrenia” one loses all human filters. The person becomes a naked image of human condition, an intense picture of our true selves. This usually happens to the most vulnerable, most sensitive, and the most emotionally injured. They become empty vessels influenced by all that happens around them. This stream of consciousness ultimately becomes “superhuman and unescapable.” They become a mirror in which we are forced to gaze at our true selves.
Helia had become the manifestation of all that was wrong in our family. In her madness, a mirror was provided in which we could catch ourselves in the midst of our distractions and maybe “gaze long enough” to be shaken out of our comfort zones. And in doing so, our family encountered our own sickness in hers. In the midst of her psychosis, we had a grim portrait of one who is highly detached, inaccessible, and self-sufficient, but none of that sufficed to sustain her. Faced with the ineffability of the experience, she lacked articulation, but she was portraying the spirit of those who surrounded her. Her image expressed the self-encapsulation and anguish that is the outcome of failure to experience love. She was the image of human condition, without connection to the source of Life, and Light. The apparent self-idolatry that manifests as self-encapsulation, I suggest is to guard against an “overwhelming sense of worthlessness.” Scripture tells us that this is the human condition without the presence of God. For a society that does not want to face its personal flaws and relational dysfunction, madness is a call from God to force us to be awakened.
Helia was manifesting right before our eyes our own deformities, which were covered under our masks of civility. She had taken on all our sins and was acting them out in physical forms. The pain of our depravity had transcended the theoretical realm and stared us in the face with vivid clarity; no longer could help be found in our “sense of genius,” or “flair,” or “riches,” or “loftiness” to rescue us from despair. Her illness was foreshadowing our destiny as Ezekiel’s did for the house of Israel. Encountering her illness, I was forced to look at my own insanity; I was forced into naked existence; all the covers were pulled back. Through her I saw who I was and I did not like the picture.
It was only after my husband and I began to change wholeheartedly that Helia began to come back after years of catatonia. My research affirms the need for the participation of the family and the immediate community in the milieu of illness and their willingness to receive its prophetic message. This participation will open the gates of healing and begin the process of transformation for all involved. It is, indeed, far easier for a society to depend on medication as the treatment of choice. It requires much less of us as a community. Unfortunately, this will certainly distort the voice of illness, if not completely silence it.
I finish by reminding us a truth that I learned the hard way:
Judging others makes us blind, whereas love is illuminating. [For] by judging others we blind ourselves to our own evil.
 Nev Jones and Timothy Kelly and Mona Shattel, “God in the brain: Experiencing psychosis in the postsecular
United States,” Transcultural Psychiatry (2016): 1-18,accessed August, 6, 2016, DOI: 10.1177/1363461516660902. Jones, a researcher and a community psychologist, is the Director of Research and Evaluation at Felton Institute in San Francisco.
 Ibid, 11
 Ibid, 15
 John of the Cross, Dark Night of the Soul (Mineola, NY: Dover, 2003), 84-85.
 Elahe Hessamfar, In the Fellowship of His Suffering, A Theological Interpretation of Mental Illness—A Focus on “Schizophrenia”
 Dillard and Longman, An Introduction to the Old Testament, 319.
 Edwin C. Broome Jr., “Ezekiel’s Abnormal Personality,” Journal of Biblical Literature 65:3 (1946), 291–92.
 Karl Jaspers, (1962) General Psychopathology (Manchester: Manchester University Press, 1962), 122 cited in
Andrea Raballo, 141n1.
 Ibid., 297, 300 n. 48.
 Andrea Raballo, “The Stream of Hallucinatory Consciousness: When Thoughts Become Like Voices,” Journal of Consciousness Studies, 23, No. 7–8, 2016, pp. 132–43
 Bustamante, “The Importance of Cultural factors in Mental Hygiene,” 254-55. See also
- M. Luhrmann, “The Violence in Our Heads,” The New York Times (September 19, 2013), http://www.nytimes.com/2013/09/20/opinion/luhrmann-the-violence-in-our-heads.html?_r=0.
 Will Hall, “INTAR India 2016: Community Development and Human Liberation,” https://www.madinamerica.com/2016/12/intar-india-2016-community-development-human-liberation/; Also see; Christopher Mackenna, “Exorcism: Some Theological, psychoanalytic and Cultural Reflections on the Practice of Christian Deliverance Ministry in the Light of Clinical and Pastoral Experience,” in Spirituality, Theology & Mental Health (London: SCM Press, 2013), p 80: Experiences of Projective Identification in Jung’s thought—“A complex belonging to one person’s mind can be projected into another’s, where it may function in a harmful or disabling way… difficult for us to know where our thoughts and feelings come from.”
 Susan Whitfield-Gabrieli and Judith M. Ford, “Default Mode Network Activity and Connectivity in Psychopathology,” Annual Review of Clinical Psychology, online: clinpsy.annualreviews.org, doi: 10.1146/annurev-clinpsy-032511-143049.
 Georg Northoff, “Resting State Activity and the “Stream of Consciousness” in Schizophrenia—
Neurophenomenal Hypotheses,” Schizophrenia Bulletin, doi:10.1093/schbul/sbu116.
 Whitfield-Gabrieli et al., “Hyperactivity and Hyperconnectivity of the Default Network in Schizophrenia and in First-Degree Relatives of Persons with Schizophrenia,” Proceedings of the National Academy of Sciences 106:4 (January 27, 2009) 1280.
 Invisibilia, “The Problem with the Solution,” Season 2, Episode 3
 Shirley, Sugerman, Sin and Madness: Studies in Narcissism, 2nd ed. (San Rafael, CA: Barfield, 2008), 26-27.
 Dietrich Bonhoeffer, The Cost of Discipleship, (New York: A Touchstone Book, 1995), 185