This document discusses alternative perspectives on extreme mental states or "madness". It suggests that rather than always viewing such states as signs of illness or pathology, they could sometimes represent coping mechanisms or attempts at healing that backfire. The document outlines models for understanding voices and other psychotic experiences not just as threats but as signals related to stress. It argues for approaches that help people develop dialogue with disturbing experiences rather than just suppressing them, and sees potential for extreme states to contribute to personal and social transformation if negotiated successfully.

1. Presenter:
Ron Unger
4ronunger@gmail.com
1-541-513-1811

2.  A view associated with people like R.D. Laing &
John Weir Perry
 Criticized as “romanticizing madness”
 But if we leave this possibility out, might we be
“awfulizing madness”?
 A more complex view: madness as a possible
result of attempts to cope and to heal that may
backfire
 Better explains diverse antecedents and outcomes?
 Balances view of risks and opportunity?

3.  Often make it more scary
 by defining experiences as definitely part of a
terrible illness
 Puts emphasis on suppression of experience
 This may stimulate a “psychic civil war”
 Increase in helplessness
 “Passive victim of an active illness”
 Increase in stigma & isolation
 Over-emphasis on stability contributes to
rigidity in people and in culture

4. More
Stress
Increased
emotional arousal
hypervigilance,
listening harder
for more voices
Vicious
Circle
Hearing a voice
Interpret voice
itself as a threat

5. Less
Stress
Accept the voice
as a useful signal
of stress, take
action that reduces
the stress
Virtuous
Circle
Less trouble from
Hearing a voice
Interpret the
voice as an
effect of stress
or as a source of
information
about aspects of
self

9.  Traumatic situations require, or seem to require,
extreme reactions
 Extremes are achieved by excluding or pushing away
all other possibilities
 Black and White thinking,
 Dissociation from alternative ways of looking, thinking, and
acting that seem threatening
 At other times, the person may seem to require
exactly the extreme that was shut out previously
 “Black” and “White” may flip
 Instead of integration of opposites, there is
conflict

10.  The Apparently Normal Part, or ANP
 This part wants to move on with daily life, and avoid
traumatic memories and/or upsetting emotions
 The Emotional Part, or EP
 This part is preoccupied with the trauma and/or
possible recurrences of the trauma
 It is fixated on action systems that were activated at the time
of the trauma
 It is likely to have “vehement emotion” and emotional
reasoning that is not tolerated by the ANP

11. • I must go over events to
make sense of them
• It is important not to
have gaps in my
memory
• Thinking about threats in
the future will help me
cope
• Worry keeps me safe
• Paying attention to
danger will keep me safe
• I must stop thinking
about it
• It’s not normal to keep
thinking about the
trauma
• I must be weak to
respond like this
• I could lose my mind if I continue
to think this way
• My mind has been
damaged by what
happened
Taken from PowerPoint by Dr. Peter Scragg on Metacognitive Therapy

12.  In “Negative Dissociation” we identify with one
part of ourselves, the other part seems to be
missing
 In “Positive Dissociation” the other part is
present, but is seen as intrusive and as causing
a disturbance rather than as being a valued part
of self
 Flashbacks are a form of “positive dissociation”
 In more extreme states, intrusions may be seen as
completely alien, as a voice, demon, or CIA installed
implant

13. Map of Extreme States
Negative Symptoms
Positive Symptoms

14.  When people are trying to control something
 And there is no direct way to do it
 Then they become more likely to see unlikely
patterns
 Including
 seeing images in noise,
 perceiving conspiracies, and
 believing in superstitions
Whitson, J. A., & Galinsky, A. D. (2008). Lacking control increases illusory pattern
perception. Science, 322(5898), 115-117.

15.  1. Construct system breaks down
 Common cause of that: trying to solve a
problem not solvable within existing constructs
 2. Temporary suspension of constructs
 Encounter with the “transliminal”
 3. Construct restructuring
Success! If done under
low stress and/or with luck
etc., the process can result in
new vision that enriches the
person & possibly the culture.
If done under high stress
etc., errors are more likely,
leading to getting attached
to defective constructs,
and/or back into…..

16.  There are striking parallel
between a fully resolved
psychotic process and the
metamorphosis of a butterfly:
 They both entail an initial stage
of profound disintegration.
 They both entail eventual
reintegration into a form that is
much more resourced than the
original form.
Slide borrowed from Paris Williams, author of “Rethinking Madness”

17. People may “flip” between being lost in the transliminal & relying
on rigid & defective constructs
Rely on
defective,
dissociated,
and/or
dogmatic
constructs:
Attempts at
constructs
coexist with an
awareness of the
mystery that
surrounds them:
Mystery, or
awareness of
limits to the
constructs, is
denied.
Attachment to
constructs is
tentative, humble,
maintains a sense
of humor about
their limits. Lively.
Lost in the
mystery:
Since constructs
were not
adequate, all
attempts at
constructs are
abandoned.
But then there is
no way to
organize or
communicate.

18. Map of Extreme States
Negative Symptoms
Positive Symptoms

19.  All statements are true in
some sense, false in some sense,
meaningless in some sense,
 true and false in some sense, true and meaningless
in some sense, false and meaningless in some
sense, and true and false and meaningless in some
sense
 From THE PRINCIPIA DISCORDIA
 “Wherein Is Explained Absolutely Everything Worth Knowing
About Absolutely Anything”

20.  Where efforts to make things better are
inadvertently making them worse
 As things get worse, misguided efforts to make them
better often intensify
 Leading to an acceleration of difficulties
 Both efforts by individuals, and by “helpers” such as
the mental health system may be making things
worse
 Without insight into the vicious circle, it just
accelerates
 The whole pattern may then be labeled a very serious
“biologically based mental illness”

21. More
Vicious
Circle
Serious
problems,
depression
Bad results from
person’s own actions
& from mental
health intervention
leads to life going
further out of
control
Mental health
system intervenes
in way that is
traumatizing,
stigmatizing and/or
disabling
Goes into trance
and wild ideas to
escape problems
and depression
Acts on trance
or wild ideas
without using
adequate
discernment

22. Less
Serious
problems,
depression
Actions lead to
better results,
life makes more
sense
Any mental
health
intervention is
normalizing,
encourages
reflection &
discernment
Virtuous
Circle
Uses discretion,
though
sometimes still
goes into trance
and wild ideas to
escape problems
and depression
Acts on trance
or wild ideas
only after using
adequate
discernment

23.  If we recognize that all maps, concepts etc. are
only partially helpful & accurate
 Then we can listen to and respect those who see &
describe things differently than we do
 When we respect both our own views & that of
others
 We model for our clients how to do the same

24.  Dialogue involves cultivating multiple views
 And bringing them into relationship with each other
 There is need for dialogue at all levels




Within the person being helped
Between the helper and person
With family and friends
With the wider society or culture
 Mental health workers should be trained in how
to respectfully address issues framed as spiritual
within such dialogue

25. Shared and Non-shared Reality
reasonable mind
Ordinary thinking
Shared reality.
wise
Mind –
in touch
With both
in the present
in control
Slide by Isabel Clarke and Donna Rutherford
emotion mind
or open to other ways
of experiencing
Non-shared reality

26.  Mental health system role should be:
 To protect the person going through extreme states
 Help people develop a dialogue with that which
disturbs them
 Train people prone to extreme states
 in how to negotiate these states successfully
 And in how to draw on extreme states to support “creative
maladjustment” in interaction with social groups
 so the best aspects of “mad” or visionary experiences can play
a role in social transformation
 Our survival may depend on a better relationship
with the Visionary