Al de Half’s Separate Reality
Last year I was studying for my psychiatric specialty board exams. I felt pretty nervous, so I began reading Freedman and Kaplan’s Comprehensive Textbook of Psychiatry (1989), the “bible” of information in the field. After reading one day on the psychoses, I dreamed the following dream: I am back at the Milwaukee County Mental Health Center, where I used to work. I call the medical director about an escaped chronic psychotic patient who is planning to murder me. They finally catch him and bring him to talk with me. He is a huge man, slumped over with arms that droop and hang down ape-like. He tells me his name is Al de Half (my other half). He looks absolutely enraged with me, saying that I read the wrong books. He pulls out a book and says “this is my Bible.” It is A Separate Reality (1971), Carlos Castaneda’s book about don Juan. I tell him I have read it, but he comments sarcastically, “Apparently not very well.” He is showing me a page from the book with eight principles on it when I awake.
There could be many layers of meaning to this dream. Typically, most dreams are interpreted according to the individual’s psychology, but I would like to view this dream through a cultural or “big dream” perspective, as Jung used to call it. One might say the psyche or soul represented as Al de Half tells us that extreme states form a “separate reality.” This seemingly strange reality has its own governing principles. To begin to understand and help people in these states of consciousness, we must learn to jump in and live these principles.
What are these eight principles? Are they methods and techniques for working with people in psychotic states? I do not believe Al de Half referred to techniques. Instead, I believe he meant the background attitudes or philosophies we bring to our work. Techniques and methods only become useful after the crucial background attitudes are brought to awareness. In this article, I will attempt to delineate eight of the principles I imagine Al de Half felt were crucial to help souls navigate the sometimes dark shores of his separate world.
1. Hercules’ sword be damned
In one of the many stories of Hercules’ adventures, he goes down into Hades. Dropping into the underworld, he finds it hazy and lit by moonlight, not the bright light of the sun. As he tries to accommodate his eyes to this new world two shades (ghosts of the dead) approach him. In a flash Hercules pulls his sword and beheads them.
Hercules responds exactly as he has been trained in the day world. “This is good, this is bad,” thinking the ego possesses the right to conquer and divide. Freud mirrors this attitude in his famous therapeutic goal: where the id is, there the ego shall be. But our heroic egos fail to see that the underworld is bathed in a different light, moonlight! We must get used to haziness and lack of clarity, unsureness and uncertainty. Good and bad are not so clearly divided here.
This principle helps us open to relationship, with “deep democracy” (Mindell 1992: 148). This is the realization that you are not the only ruler in your psychic house and that all inner parts deserve a voice.
2. Panic can be the deadliest enemy
We can see in the last story that panic leads to Hercules’ precipitous reaction against the shades. Panic is an extreme bodily reaction often brought on by an overwhelming fear of the unknown. But what if Hercules could have stood with someone who reacted with more understanding toward the contents arising from his unconscious? Jung points out this same thing beautifully in his introduction to John Perry’s book The Self in Psychotic Process (1987) when he says:
One should not underrate the disastrous shock which patients undergo when they find themselves assailed by the intrusion of strange contents which they are unable to integrate. The mere fact that they have such ideas isolates them from their fellow women and men, and exposes them to irresistible panic, which often marks the outbreak of manifest psychosis. If on the other hand, they meet with adequate understanding from their physician, they do not fall into panic because they are still understood by a human being and thus preserved from the disastrous shock of complete isolation. (Forward: v)
In R. D. Laing’s famous book the The Politics of Experience (1968) he wrote a chapter called “The Ten Day Voyage.” In it the client was asked what would have made a difference in his treatment, and he responded, “A sheet anchor, a feeling that someone understood” (163). These ideas of Jung’s and Laing’s were well tested in the late 1970s in facilities such as Diabasis and Soteria House, hospitalization alternative treatment facilities for people in psychotic states. When helpers met acute psychotic experiences (the shades of Hercules) with an attitude of openness and validation, they found that clients often came through these extreme states more rapidly than similar patients treated in less open facilities (Mosher 1975; Perry 1974).
3. Random firing neurons do not exist
I took this comment from James Watson, winner of the Nobel Prize, who went into dream research after his DNA fame. He implied that dreams were random neuron firings with a purely biological purpose. This theory makes it very hard to validate a person’s experience as useful.
Armed with this attitude one would tend to compare the psychoses to chronic physical illnesses caused by biochemical abnormalities and genetic predispositions. Biologic theory has many merits. But I state unequivocally that no matter what a person’s genetic and medical history, they always have a psychology. Therefore they always have a communication system, albeit sometimes very difficult to understand. I believe in the irreducibility of a person’s psychology.
This belief allows us to continue to look for new ways to work and communicate no matter what the current prevailing theories. The idea that a client’s attitude can effect the outcome of their psychosis was shown very nicely by Sokis and Bowers’ (1969) research. They found that clients who were interested in how to make sense of their psychotic experiences had a much lower rate of recidivism than did the clients who considered the experiences as “nothing but” part of a biochemical illness.
4. Purpose and meaning exist even in the most obscure communications
This principle follows Jung’s famous ideas about finality, also known as the synthetic method or teleology. This is the idea that women and men are not created by past history alone, that is causa efficiens, or the reductive method.
They are also pulled toward the future by personality parts that wish to express themselves and to expand the person’s personality into its total creative potential.
The psychology of an individual can never be exhaustively explained from himself alone… No psychological fact can ever be explained in terms of causality alone; as a living phenomenon, it is always indissolu bly bound up with the continuity of the vital process, so that it is not only some thing evolved but also continually evolving and creative. Jung 1921: 430)
Jung’s finalistic ideas separated him from Freud, and Freud’s more causal emphasis, near the beginning of Jung’s career. Jung’s finalistic princi ples came to be widely held about neurosis. Jung also held the same ideas on psychosis in the last paper he delivered on the subject. He says:
it is now just about fifty years since I became convinced, through practical experience, that schizophrenic disturbances could be treated and cured by psychological means. I found that, with respect to the treatment, the schizophrenic patient behaves no differently from the neurotic… I have now, after long practical experience, come to hold the view that the psychogenic causation is more probable than the toxic causation. Jung 1958: 258; 263)
This attitude of belief in the purpose of the psychic contents of their clients helped distinguish the pioneering work of John Perry and Arnold Mindell. I feel this attitude is absolutely crucial in working with clients, regardless of how bizarre their statements seem.
I became even more convinced of the importance of this idea after recent work I did with a woman at a local mental health center. “Sandy,” a woman of about 25, had a long history of recurrent depression and psychosis. She came into my office in an extreme state, saying that she was one of the people who killed Christ. She also felt she had sinned against the ten commandments and felt quite paranoid about people at her workplace knowing her business. Sandy spoke in a crying voice, with huge gaps in content as if every time she had a thought an opposite one would come and attack her. This made verbal communication almost impossible. At one point she became quiet for a moment, then meekly said she felt like the holy spirit but was unworthy.
Her head then went down as if someone pushed her. I followed this signal by gently pushing her further down and telling her she was unworthy. I embodied the thing pushing her down as an intervention. She resisted slightly, then crumpled in a heap on the floor. We switched roles since she identified more with the pusher, or critic. She immediately demonstrated a lot of energy for this part, telling me I was unworthy. I countered by slowly resisting and turning to face her, telling her I was worthy. She escalated, pushing me and saying, “I hate you and I want you out of my life.” She suddenly stopped, gasped and began to weep uncontrollably. I asked her, “Who do you want out of your life?” She gasped, “The devil.” I encouraged her to tell me someone more personal and she gasped again, “My husband.” Sandy began to tell me the rage and despair she felt over an affair her husband was having that she could not confront. For the next 30 minutes, we spoke about her feelings with no further evidence of the thought disorder and psychotic thinking that had been present just a short time before.
5. Don Juan’s ally or Jacob’s angel
If you begin with an attitude of purposefulness toward the psyche, then even frightening figures which appear, such as the “critic” in the example above, may become allies for you. I use ally in the dictionary sense as someone or something that may prove useful on your path. The ally usually arrives in even scarier disguises than above. An ally may come dressed in the paranoid fears of someone breaking into your house; you triple bolt the door in response. It may also appear as auditory hallucinations too bizarre to understand and too unbelievable to carry out, like the client who heard a voice which identified itself as his conscience and told him to have sex with his mother. The ally doesn’t just hand over helpful information “free of charge.” Jacob discovered with the angel God sent to wrestle him that the fight with the ally could be a fight to the death.
Don Juan says of the ally:
when a man is facing the ally, the giver of secrets, he has to muster up all his courage and grab it before it grabs him, or chase it before it chases him. The chase must be relentless and then comes the struggle. The man must wrestle the spirit to the ground and keep it there until it gives him power. (Mindell 1993: 114)
In psychological terms we might say the first step involves filling out the unconscious material, the hallucination, or overwhelming paranoid fear, into a figure with which we can relate. Then the key is the “Auseinandersetzung”, having it out and coming to terms with the figure. The ally must deliver its message to someone-the message must be heard. If you do not translate the message consciously, the ally controls you unconsciously, often acting out its message in literal forms in the day world.
6. An ear for the symbolic
It is one thing to believe in the purpose and meaning of the psyche when it shows you how you need to be more assertive in relationships. But what do you do when the message is not so understandable? Take for instance, these statements from clients I have seen: “You need to have sex with your mother.” “You know that you must stick the cross in the urine; it is finally the time.” “You must put the evil mind away in a coffin in the center of the ring of fire the temperature of the sun.”
The language of “the separate reality” is symbolic and we must practice developing an ear for it. People who fall unwillingly into psychosis often lose the ability to hear the metaphor in many of their allies’ messages. One of the first clients I saw as a resident was a young man living with his elderly parents. They brought him for hospitalization because he had become quite paranoid, barricading his door, staring out the window watching for intruders and hoarding knives under his bed. The court released him from the hospital after a two week stay because he failed to meet the criteria for long term commitment.
The client then refused all further treatment. A few months later he tragically came to my attention again when the police arrested him for murder. He had stabbed a five year-old boy to death because he thought the boy was an alien invader from outer space!
This topic has many unanswered questions in need of research. How do you take these symbolic statements and feed them back to clients so they can live them more usefully in the moment? How do you help connect the symbolism to the personal emotional core? The main principle to remember is that clients cannot hear the metaphor while in an extreme state of consciousness. The therapist must hold the awareness and be prepared to jump into the emotional caldron with them.
7. A nose and stomach for the putrefactio
Psychosis is the state of dissolution. The dissolving of the old personality is in the midst of occurring. When things dissolve and decay, they often smell: dirty clothing, caried teeth, malignant emotional disorganization, contorted postures and regressed behaviors, loose, tangential thoughts moving too quickly to catch. Speaking of this state, Bleuler said that we react to these experiences as something that threatens our very existence (1963). Harry Stack Sullivan noted that the normal have an aversion for the insane. How can we learn to stomach states like this long enough to work with them? An idea from Jung helps me. He said, “the establishment of order and the dissolution of what has been established are at bottom beyond human control. The secret is that only that which can destroy itself is truly alive” Jung 1944: 73).
John Perry realized this when he said that it is the order (the pre-morbid personality) that becomes the problem. The psychosis itself is the attempt by the psyche to destroy itself (the putrefactio) so that it can be reestablished in a new and revitalized form. He demonstrated this beautifully in his book The Far Side of Madness (1974).
Cross-culturally, this same pattern appears in Mircea Eliade’s writings on shamanism and anthropologist Victor Turner’s research showing that various tribes actually sought this dissolved state for long periods of time as a key to initiation rights (Turner 1987). Scholars call this state the “limen,” which means being in between doorways, or not yet one place or another. In some traditional cultures young boys and girls stayed in this state as long as a year, as a transition from childhood to adulthood. Turner delineated three stages of the process: separation or dissolution; liminality; aggregation.
He found that in times of sociocultural transition the limen phase was induced in the tribal initiates by tribal leaders as a rite of passage.
The limen consists of an area symbolic of no past and no future, yet both. The candidates are stripped of all clothing, have no place to live except the wilderness, and are nameless. Every trace of graspable identity is removed. Turner found that “logically antithetical processes” symbolize this period (1987). For instance, the snake is chosen because it sheds and regrows its skin. The tunnel represents the womb and the tomb, the moon waxes and wanes. All symbolize the death and rebirth theme that occurs over and over again in work with extreme states clients.
8. What’s love got to do with it?
Everything! As therapists know, technical interventions do not equal cures. Interventions help in the moment, often getting crucial information to help with the integration of split off personality parts over time. But no technique will replace the traits of love, patience, and devotion. “The thing that really matters the most is personal commitment,” Jung said, noting that he had seen miraculous cures “…by nurses and lay people through their courage and steady devotion, to reestablish psychic rapport with their patients” (1958: 265). This was hammered home in the 1973 study of cross-cultural psychosis by the World Health Organization. They found that in nonwesternized, non-technical countries the cure rate and lack of recidivism far surpassed westernized, technologically developed countries even with so called modern treatment. The conclusion drawn was that the non-westernized countries keep individuals involved in the community, and therefore not isolated and ostracized (Sartorius, Jablensky and Shapiro 1978).
I want to reiterate that these eight principles are just beginning musings to fill out the pages of Al de Half’s bible. The ending is nowhere in sight. We need new ideas and insights from patients, their families, mental health professionals and ordinary citizens. Hopefully some day not too far in the future, we will be able to have an open discussion in collective mental health circles about the importance of psychotherapy in the treatment of psychoses.
- Bleuler, M. “Conceptions of Schizophrenia Within the Last Fifty Years and Today.” Proceedings of the Royal Society of Medicine, 56, 1963.
- Castanada, C. A Separate Reality. New York: Simon and Schuster, 1971.
- Jung, C.G. Psychological Types. Trans. R.F.C. Hull, Collected Works, Bollingen XX Princeton: Princeton Univ. Press, 1921.
- Jung. C.G. Psychology and Alchemy. Collected Works. Princeton: Princeton Univ. Press, 1944.
- Jung, C.G. The Psychogenesis of Mental Disease. Col lected Works. Princeton: Princeton Univ. Press, 1958.
- Jung, C.G. “Introduction to the Self in Psychotic Pro cess.” The Self in Psychotic Process. Perry, J. W. Dallas: Spring Publications, 1987.
- Kaplan, H., Sadock, The Comprehensive Textbook of Psychiatry, Vol. 2. Baltimore: Williams ;md Wilkins, 1989.
- Laing, R.D. The Politics of Experience. New York: Bal lantine Books, 1968.
- Mindell, Arnold. The Leader As Martial Artist. San Fran cisco: Harper San Francisco, 1992.
- Mindell, Arnold. The Shaman’s Body. San Francisco: Harper San Francisco, 1993.
- Mosher, L., Menn, A. “Soteria: Evaluation of a home based treatment for Schizophrenia.” American Jour nal o/ Orthopsychiatry 45. 455-467, 1975.
- Perry, The Far Side of Madness. New York: Prentice Hall, Inc. 1974.
- Sokis, D., Bowers, M. “The Schizophrenic Experience.” Thejournal of Nervous and Mental Disease, Vol. 149, No. 6, December, 1969.
- Sullivan, H.S. Schizophrenia as a Human Process. New York: Norton, 1962.
- Turner, V. “Betwixt and Between: the Liminal in Rites of Passage.” Betwixt and Between. Louise Carus Mahdi, (Ed.). Evanston, IL: Open Court, 1987.
- Sartorius, N. Jablensky, Schizophrenia Bulletin. Vol. 4. 102-113, 1978.
George Mecouch, D. O., is a psychiatrist in public and private practice in Portland, Oregon. He has maintained a special interest in treating clients in extreme states of consciousness with therapy. He has studied with A mold Min dell since 1982 and currently teaches at the Process Work Center of Portland.