I see patients diagnosed with “mental illness” every day I work in the ER. Major depressive disorder. Schizophrenia. Bipolar disorder. And many more.
We have elaborate diagnostic criteria that must be met for patients to be diagnosed with these illnesses. The criteria for schizophrenia, for example, include:
“The presence of 2 (or more) of the following, each present for a significant portion of time during a 1-month period… with at least 1 of them being (1), (2), or (3):
(1) delusions, (2) hallucinations, (3) disorganized speech, (4) grossly disorganized or catatonic behavior, and (5) negative symptoms…
For a significant portion of the time since the onset of the disturbance, level of functioning in 1 or more major areas (eg, work, interpersonal relations, or self-care) is markedly below the level achieved before onset…
Continuous signs of the disturbance persist for a period of at least 6 months…” 1
When we read descriptions of enlightenment, we find that many of them could confirm “symptoms” that are consistent with these diagnostic criteria. We could easily imagine an elderly man clad in orange robes who might say that there are no physical things, only consciousness. Or who might say that he doesn’t exist as a separate individual. He may say so without any philosophical background or understanding of science, and without any desire to explain himself, content to live what he directly perceives. In the right setting, this would readily qualify such a person as delusional.
Next, he may have also opened up the faculties latent in every human being. Extra-sensory perception is a well-documented and frequent phenomenon in wisdom traditions around the world, and many if not most people today have experienced perceptual glimpses that seem to go beyond our everyday senses. If this person had opened up their faculties, he would glimpse and even live among perceptions that experts publicly say we are not allowed to have or are incapable of having. Our friend has just met another diagnostic criterion: having hallucinations.
Now consider that this becomes his baseline state over several months. His experience is so immersive that he is at a new “level of functioning” that is “markedly below” baseline, meaning he has dropped out of the busy 60-hour work week he was living. If he is in a society that values his new experience, he may be garlanded and provided meals to sustain him at this “higher” level of function. Instead, he is diagnosed with schizophrenia and medicated.
As an alternative, imagine that prior to this shift in his experience, he had earned a PhD in philosophy. Imagine further that he had been exposed to a tradition such as yoga that not only recognizes explicit stages of shifts in the mind, but also encourages them. And let’s suppose also that he lived with a person that recognized how this all unfolds. Instead of being overwhelmed by the experience, he communicates about it to those who have lived through it and adjusts to it over a period of years. His new insights propel him further as an insightful professor of philosophy and yoga practitioner.
The first person is painted as a “mentally ill” person who must be medicated for the safety of society. The second is painted as an enlightened sage who will lead society back from the brink. Which is he? What makes the two so different?
Surely, there is a range of experience that covers what we call spirituality and enlightenment, just as there is with schizophrenia, depression, and “mental illness” in general. But there is one thing all these have in common—medical science knows little about their inner workings.
In order to feel like we really understand ranges of the mind, we have to medicalize the mind, which is to say, we have to physicalize it. To study medicine and psychiatry today is to yield to the hypothesis that brain and body come first, and only then does mind appear, even though the evidence does not support this contention. Through this medicalization, we develop the rationale to deliver physical drugs to alter neurotransmitter concentrations and behavior.
What would we do if we had to not only consider, but accept the notion that the human being is not primarily a physical thing, but rather a mental phenomenon that can be explored and accessed in new ways? Physics is already approaching these frontiers, but its children—including chemistry, biology, and especially medical science—dare not step there yet, except through the backdoor of integrative or alternative medicine. Although these fields are promising, they cannot reach maturity until they move beyond a physicalist-based interpretation of the human being.
What all of this means is that we are due for a wholesale re-contexualization of medical science from a body-based model to a mind-based model. It doesn’t say what we know is wrong, but rather that what we know is much more incomplete than we imagined. If you know someone with “mental illness” today, you already know that’s the case.
Depending on where you live, the maturing mind just may be diagnosed as being “mentally ill.” That should be enough to wake us all up.
Anoop Kumar, MD, MM is board certified in Emergency Medicine and holds a Master’s degree in Management with a focus in Health Leadership. He practices in the Washington, DC metro area, where he also leads meditation gatherings for clinicians. He is the author of the upcoming book Is This a Dream? He tweets @DrAnoopKumar.