A Spiritual Model of Healing and Wellness

Depression and Spiritual Growth

B. A Spiritual Model of Healing and Wellness

Major depression and bipolar disorder are among the most searing experiences of life. I have known people who have had an episode of major depression, and also have had a serious heart attack. When asked which they would choose if they had to go through one or the other again, most of them said they would choose the heart attack! It is therefore wise to try to obtain some kind of framework and perspective in which to view the illness and the progression back to wellness.

The initial phases of the model offered here resembles somewhat the model of dying developed by Dr. Elizabeth Kubler-Ross in her famous book "On Death and Dying". But I want to point out right away an essential difference: in Kubler-Ross's model the end state is that you die; in this model the end state is that you get to live, perhaps for the first time ever.

When one comes to the full realization that he/she has a chronic mental illness, the most common natural reaction is denial: the insistence that "there must be a mistake; this can't be true!" The trouble with denial is that it doesn't accomplish anything. It neither retards the course of the illness, nor facilitates its cure (quite the contrary, it typically delays meaningful treatment). How long this state lasts depends on how severe the illness is: if it's mild, denial can be sustained for a long time; but once grinding, crushing, mind-breaking major depression sets in, the luxury of denial falls by the way, and survival becomes the issue of the day.

In the Kubler-Ross model of dying, the next stage is often anger: "Why me?!". In contrast, strong anger is not typically a part of the progression of events in severe depression. Some psychiatric theories attribute special significance to its absence, and go so far as to say that depression is actually caused by ``suppressed anger''. From my own experience and contacts with many severely depressed people, I dismiss those ideas. The fact is that the scientific evidence shows severe chronic depression is biochemical, and requires treatment with medication. Also, it is unreasonable to expect depressed people show anger because they are in misery; rather than angry, they are passive. Furthermore, they often feel guilty about everything in their lives, and even believe, in some tortured sense, that they ``deserve'' their illness.

Manic people tend to become controlling rather than angry. They will often be very arrogant, and openly manipulative of the people around them. If the manic state is severe enough, they may even resort to violence to retain this ``control''.

As one comes finally to acknowledge the indisputable presence of the illness, one feels a sense of loss, grief, and mourning. One senses that life may never be the same (aside: it may actually become better, but one usually can't believe that at this stage). That some of the opportunities we thought we had may not be there any more; that we may not have, or do, all the things we had hoped to, and believed we would -- this is loss. As the loss sinks in, we feel grief: grief for that part of our own life that seems likely to be dead now; grief for the loss of ourselves as terrible as the grief we experience for the loss of others. And then we mourn. This can be a painful, tearful time, in which there is no consolation.

But the human spirit is amazing; it can survive, singing, under the most adverse circumstances. And the will to survive leads us to a new position: acceptance. This is the most important step in the process of healing! It is literally impossible to overemphasize how important acceptance is: it can be the choice between life and death. To illustrate, suppose some terrible disaster befalls you: your beloved spouse dies, or your child dies, or you are permanently injured and scarred in an accident. These are events that you really don't like; but you don't control them, and therefore cannot change them; nor are they going to change by themselves or by someone else's intervention. So you have a choice: you can forevermore be caught up in your loss, grief, and mourning, or you can say (out loud if it helps!) "I don't like this situation one little bit! I never will; but I can't change it, so I must accept it so that I can get on with living."

Once we can do that, once we can simply acknowledge what is, even if we don't like it, a wonderful thing happens. We begin to experience release. That is, the loss is still there, and we still don't like it; we acknowledge and accept its existence; but now we refuse to have it dominate every waking moment of our lives. In effect we say "Yes, you are there. And I have dealt with your presence as well I can. But I have other things to do now.'' This cuts the string that otherwise would have you jumping like a puppet for the rest of your life, and allows you to move forward again.

Once you are released, healing can begin. You gain the insight and courage to carry out your decision to continue living. You grow stronger. The ugly scars are still there; but they aren't painful any more when you press on them, even hard.

I remember, as a kid in junior high-school, seeing a friend naked in the shower after gym class who had a gigantic keloid scar reaching from the top of his left shoulder down past his left breast. It looked horrible. Not being a diplomat, I ingenuously said to him ``That looks really terrible. What happened?" He replied ``I was once burned severely in a fire." Still practicing my "diplomac"' I said "Wow, that must have really hurt!" And he returned "Yes it did. It was extremely painful." Then he did something remarkable, which I still remember 50 years later: he clenched his right fist, and he hit himself in the middle of the scar as hard as he could, saying "It hurt terribly then, but it is healed now, so it doesn't hurt any more".

I have thought about that ever since. It is true for a person with CMI as well; once we heal, very ugly ``scars'' may be there, but they won't hurt any more!

You will be different then. Healing has changed your environment and changed you. There is no going back to what was before.

You might conclude that the process I have described leads only to a state in which there is permanent loss, or some aspect of your life is permanently degraded. But here the analogy with a friend dying or a permanent physical injury breaks down. In those cases, your friend will remain dead; the limb you lost is gone. Whether your life is degraded or not depends on how you deal with these losses. But in the case of mental illness radically different outcomes are possible. For example, if one experiences a strong remission, then one can look back at the period of severe illness with an awareness of the loss of some things, which, with the help of successful psychotherapy we can replace with other things (habits, beliefs, insights, stance towards life, and so on) which we like better. My own experience, and that of other people with CMI who I have known, is that the trip through the "fire'' of depression or mania can be purifying, burning away the worst of us, creating new openings through which we can proceed into the future. I recall someone once saying to me "It is when your iron is thrust into the white-hot flame, and hammered, hammered, and hammered, that it becomes steel."

It is at the end of such a journey that one can begin to understand fully the meaning of the following quote, which once appeared on the cover of the Friends Journal:

The crucible is for silver.
But the fire is for gold.
And so God tries the hearts of men.

Those who have felt this Fire, and realize how it authenticates the depth and reality of their experience, and their experiential knowledge of God, are on the road which leads beyond healing to Grace, a subject to which we shall return.

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