Sunday, June 24, 2012

Trance and Mental Health

Contemplative Neuroscience

Contemplative neuroscience research, collaborative research between meditative adepts and neuroscientists, has been ongoing at research centers such as: University of Wisconsin, Stanford University, Mind and Life Institute, and Emory University, Harvard, at universities in India and elsewhere, for over the past two decades. Left pre-frontal cortex brain activity is now known to be associated with feelings of happiness and well-being. A graph (below) showing results by Prof. Richard Davidson, at the University of Wisconsin, depicts left/right pre-frontal cortex activity for one meditation adept compared with 150 ordinary untrained people. The meditation adept lies 4.5 standard deviations outside the bell curve, for increased left pre-frontal cortical activity. This is an objective neurological measure of a subject's mental health status. 

Prof. Davidson & Mattheiu Ricard (L to R)
From "Habits of Happiness" by Matthieu Ricard, below:

Mind and Life introductory video on contemplative neuroscience:

Subtle Levels of Mind
Meditation adepts work with subtle levels of mind. What are subtle levels of mind? The grossest level of mind is our waking state. More subtle levels of mind are: the dream state, deep sleep, fainting, coma, and the subtlest level of mind is the mind at death. En route to 4.5 standard deviations from the bell curve, a yogi, a meditation adept, may experience trance states, alert mind states involving subtle levels of mind. 

Trance in Tibet
Trance states are well-documented in cultures around the world and are a recognized part of human experience. Trance in Tibet is a state institution. For centuries, three state oracles have entered trance states in order to advise the Tibetan government. This tradition continues today. A 17 min video depicts the Nechung oracle, Kuten La, in a trance state, and, later in the video, Khandro La Tseringma, also a Tibetan state oracle, being interviewed. The next video shows Kuten La, not in trance, speaking with Congressman Dennis Kucinich. 

Khandro La Tseringma (Tsering Chengma) in trance

The above photo depicts Khandro La Tseringma in a trance state. Hence, we can see two Tibetan state oracles in both waking or ordinary, and trance mental states. 

Nechung oracle in trance

Nechung oracle, Kuten La
Khandro La Tseringma

Tibetan oracles:

Nechung oracle talking with Congressman Dennis Kucinich:

Tibetan Medicine: Srok-rlung and rlung
Unlike the formal state institutions above, meditation practitioners may experience other kinds of trance states, known in Tibetan as rlung (say: loong) and srok-rlung (say: sok-loong). Rlung means 'wind' and srok-rlung means 'life wind,' which is a disturbance of the energy of the body's central channel. Tibetan medical doctors, called amji (say: umjee, also written: amchi), learn to differentially diagnose the different mental states collectively referred to as 'wind.' Characteristic symptoms of srok-rlung include forced control of mentation (thoughts), urine, voice, saliva, posture, defecation, etc. Srok-rlung is common in Tibet, especially in monasteries, is always treated properly and 'no one stays that way.' It is very important to treat srok-rlung properly. Treatment is mainly by gentle social interaction and play. 

When a monk develops srok-rlung, the other monks stop their meditation and study, and play sho,  a traditional dice game, together with the afflicted monk, until he gradual reconnects with gross consciousness and ordinary reality. The monks will play with him daily, every other day, every third day, until the condition is gradually resolved. Tibetan medical doctors also treat rlung disorders with herbs, massage, nutrition, mantras and medicinal incenses. Lamas, Tibetan spiritual teachers, may also perform purifying rituals for a person diagnosed with srok-rlung. Mental illness is rare in Tibet.

Tibetan medicine prescribed for srok-rlung

Regarding Tibetan medicine, His Holiness the Dalai Lama said, "Tibetan medicine is an integrated system of health care that has served the Tibetan people well for many centuries and which, I believe, can still provide much benefit to humanity at large. The difficulty we face in bringing this about is one of communication, for like other scientific systems, Tibetan medicine must be understood in its own terms, as well as in the context of objective investigation."

The Western Conundrum
Since trance is a part of human experience, many Westerners may also experience trance states. Some spiritual healers regularly go into and out of trance, such as psychic healer Dawn Clark. When trance states occur spontaneously, they are rarely, if ever, diagnosed as such in the West. Some trance states are self-limiting, while others may require short term acute medical attention. Such trance states are increasingly referred to as "spiritual emergence" and/or "spiritual emergencies." Western society, in general, tends to be intolerant of unordinary states of mind, and people reacting with panic and/or aggression around an individual in a trance state actually contribute to exacerbation, rather than alleviation, of the symptoms.

Psychiatric medications may be very rapid and effective for resolving trance states. 1-4 days of medication1 may be sufficient for a person to return to the ordinary gross waking state and to ordinary functioning. At that point, medication should probably best be discontinued. Individuals with srok-rlung are especially sensitive; excessive use of psychiatric medications, both dosage and duration, may lead to disturbances of the neurological and circulatory systems. When psychiatric treatment is not coercive, the person experiencing the trance state may have control and say over when to discontinue the treatment, based on his or her own experience and judgement. 

This 45 minute film by Melissa Gunasena, "Evolving Minds: Psychosis and Spirituality," presents natural treatment of trance states, referred to here as 'psychosis,' mainly from a Western perspective. The film also presents the conflict that may arise for spiritual practitioners when dealing with Western psychiatry. 

The producer's site for the film has many useful links as well:
Here is an 9 minute interview with Melissa Gunasena and a link to a 2 minute trailer:

In Closing
Maybe it's time for us to begin applying objective scientific measures and understanding of mental health from contemplative neuroscientific research to the 'mentally ill' and to all the rest of us. We may also consider consulting Tibetan medical doctors regarding compassionate and effective treatment of unusual mind states. His Holiness the Dalai Lama has already extended an invitation to consult Tibetan medical doctors for situations where Western medicine does not provide relief.

1Based on 7 spontaneous trance (acute transient psychotic) episodes, of these: 2 resolved with 3 days of medication, 2 resolved with 4 days of medication, 2 resolved with a single dosage of medication and 1 resolved with 1 to 5 days of medication (not known precisely).

(A video appeared here by Tsem Tulku, who is not a reliable expert on Tibetan Buddhism. He is affiliated with the disreputable Dolgyal Shugden cult.
For more information on Shugden see I apologize for the error.)

Relevant Literature

Adams, T. Spiritual emergency or emergence.  Psychology Dept, University of CT. 1990.

Agosin, T. Mysticism and psychosis. Seeds of Unfolding, Vol. VI, No. 4, Fall 1989.

Alei, Ariole K.
 - How to recognize trance states?
 - What is trance?
 - Trance - The inherent wealth of 'altered states of consciousness'

Crowley, N. Psychosis or spiritual emergence? - consideration of the transpersonal perspective within psychiatry. Royal College of Psychiatrists, UK. 2006.

Kuijpers, HJH, van der Heijden, FMMA, Tuinier, S., Verhoeven WMA. Meditation induced psychosis. Psychopathology 40:461-464. 2007.

Lukoff, D. From spiritual emergency to spiritual problem: the transpersonal roots of the new DSM-IV category.  Journal of Humanistic Psychology 38:21-50. 1998.

Mind Freedom International
Psych Rights
Psych Integrity
Hearing Voices Network
Successful Schizophrenia
Foundation for Mental Health Excellence   
Isabel Clarke
Chris Clarke 
Free e-books from Emma Bragdon 
Spiritual Alliances - Emma Bragdon
UK psychologist thrives after diagnosis of paranoid schizophrenia
Integrative residential mental health centers in the USA: ARTA
Men-Tsee-Khang Tibetan Medical and Astrological Institute, Dharamsala, India   

Psychiatric Critique
Robert Whitaker "Anatomy of an Epidemic"
John Rengen Virapen "Side Effects: Death" and other books, and on Youtube
Gwen Olsen "Confessions of an Rx Drug Pusher"

My teachers: His Holiness the Dalai Lama, Khensur Jhado Tulku Rinpoche, Khensur Denma Locho Rinpoche, Kirti Tsenshab Rinpoche, Khenchen Thrangu Rinpoche, Geshe Pema Dorjee, Khenpo Kelsang Nyima, Geshe Jampa Gyatso, Ani Rita Riniker, Gen Gyatso, Gen Damcho Gyaltsen, Geshe Lhakdor, Jetsunma Tenzin Palmo, Ven. Sean Price, Ven. Antonio Satta, Ven. Sangye Khadro, Ven. Robina Courtin and more. Anyone not listed is not for lack of respect!
Dr. Lobsang Dhondup, Cynthia Husted, Amji Orni Sachs, Geshe Pema Dorjee and other Tibetan doctors and monks.

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