Can people suffer from mental illness and also liberate themselves? Many would answer that question with a flat “no.” Their answer might seem to make sense, but my experience has been different.
Most likely you are one of the majority: you deal with ordinary neurosis, but you don’t have to deal with mental illness. If that is true, I’m glad for you. I will address the rest of this article to people like myself, those who live with serious mental illness (there are sixteen million of us in the U.S. alone), and who also live with a passion to be free. Maybe you know people like me and can pass this article along. The words that follow may also support you to be more compassionate and helpful to someone you know who struggles with mental illness. Perhaps, too, these words may be useful to you personally. After all, we all experience emotional distress, and some of the suggestions here can be universally applied.
I would like to offer hope to people who may at times give up on hope. I’d like to share my own experience of having mental illness and still tasting some of the fruits of the path. And finally I’d like to offer some practical guidelines for succeeding at a hard task.
One person’s journey
All my life I have had to dance with not just one but two serious emotional illnesses. Severe, prolonged traumas in infancy and childhood resulted in lifelong post-traumatic stress disorder (PTSD). The traumas also probably caused lifelong major depression. I cannot remember ever in my life living through a whole year without experiencing both PTSD and depression for part, or in some cases all, of that year.
Each of these two illnesses brings with it a load of mental anguish. Each can be a killer. Together they constitute a lethal mix. How, then, have I survived them to the age of 64? Barely, and with a lot of help. It has taken a village, and more than a village, to keep Eric going: a large network of loving, supportive friends; many psychiatrists and psychotherapists; many medications; psychiatric hospitalizations; electric shock treatments; and a great range of both mainstream and alternative modalities for healing. Without all of these supports, I would not be alive.
And surely without the Dharma I would not be alive. When I was young, with so much mental torment I was obsessed with two questions: Why is there suffering? What can I do about it? I read widely many of the best minds of Western civilization, but I could not find from them adequate answers. Then in college I discovered in the Buddha’s teaching clear, comprehensive, and accurate answers for both questions. That discovery was the first big turning point of my life.
Better than a cure
After that first intellectual encounter with the Buddha’s teachings, it took me a few years into my twenties to begin actual spiritual practice. My start was halting because I knew that I would need a certain level of mental stability in order to manage the rigors of serious practice. That stability was hard to come by.
Then eventually the practice took hold and became the major focus of my life. Through this ancient, sacred, transformative process, I have tasted more and more deeply suffering, the cause of suffering, the end of suffering, and the way to the end of suffering. For the past 25 years I have also taught to others the Buddha’s liberating teachings and practices.
As much as I’d like cures for these diseases, I haven’t yet found them. But in the seeking I’ve managed to find something better than a cure: a reality beyond any concern for sickness or health, life or death. “I” still suffer from PTSD and depression; I’m still crazy. And all the while the Natural Great Peace that we are lives on unharmed and unharmable. As awareness grounds itself more and more surely in that Natural Great Peace, the diseases appear more like mirages – though still nasty mirages, I’ll admit!
What about you?
What about you? Can you suffer with serious mental illness and still taste freedom? That depends, I think, on the answers to some questions. Can you emerge from the isolation that mental illness imposes in order to build deep support for your journey? Do you really, really want to be free, because it’s harder for us than it is for the others? Can you step away at times from the delusive thinking generated by your disease? Can you find the mental stability you will need in order to bear the rigors of deep spiritual practice? And can you pursue that deep spiritual practice at a pace that is appropriate for you?
We can’t do it alone
Mental illness isolates. Among the many ways it isolates, three come immediately to mind: When I’m sick my distressed words and actions can drive people away. I can tell myself that I’m only safe when I’m alone. When the
reality I see doesn’t mesh with the reality others see, it can feel easier to hole up in mine instead of engaging theirs.
Whatever our reasons for locking ourselves away in our illness, it seems to me critically important to make the effort to break out of the isolation and to connect with others. I carry in my head a short, irreducible list of three things to do when I’m depressed. The first item on that list: Reach out. It can be very hard. Once I sat for hours in the torment of acute depression with a phone on my lap. Again and again for hours I repeated like a mantra, “Call anybody. Call anybody! “ But the hand could not move. When I finally did succeed in moving that hand and punched some buttons on that phone, I saved my life.
We cannot heal ourselves alone, and we cannot liberate ourselves alone. Both require a deep, active support network. Are we willing to swim against the stream of our illness in order to build that network? Are we willing to see the relationships in our lives that reinforce our distress, and then to let those unhealthy relationships go? Are we willing to see the relationships that reinforce healing and freedom, and then to strengthen and increase those healthy relationships?
For tens of centuries now, Buddhists have taken refuge in three precious things: Buddha, the awakened mind and our own innate capacity to awaken; Dharma, the way to awaken; and Sangha, the community of those supporting each other to awaken. Those three things constitute a safety net below which we cannot fall. For those of us with mental illness, Sangha becomes extra-precious: a reliable network of support that can shelter us through the storms of both emotional healing and spiritual awakening.
Having an internal network of support, in your own psyche, seems equally important as having an external one like Sangha. The most important internal support for me on this long journey has been to set and to hold in my heart a heroic purpose even greater than Dante needed as he walked through hell. This is an aspect of what Buddhists call Right Intention.
The Buddha said that freeing our hearts from suffering and the causes of suffering is the most difficult thing that any human can accomplish. Forgive me for being the bearer of hard tidings, but if you have serious mental illness, it’s going to be yet more difficult! That valiant, tenacious spirit Mary Lyon, the founder of our first women’s college Mount Holyoke, said, “It is one of the nicest of human activities to distinguish what is very difficult from what is utterly impossible.” Attaining liberation despite emotional illness may at times seem utterly impossible. It’s only very, very difficult.
You need to want to be free more than you want anything else. You need to be ready to sacrifice everything else, if necessary, in order to pursue this purpose.
A million lifetimes
Nearly 30 years ago I brought great mental and physical suffering into my first three-month-long meditation retreat. There would be many more three-monthers over the years, but for a while that fall it looked as if there would not even be one. Even though I had plenty of good external support at that retreat, I was suffering so much that I felt I would have to leave. That prospect brought desperation; I didn’t know where else to turn.
Then one afternoon, as I walked outdoors in solitary walking meditation trying to hold this desperation, a thought came seemingly from nowhere and struck deeper into my psyche than anything had ever done before: If it takes a million lifetimes, I will free this heart from its suffering! Almost 30 years later I remember precisely where I walked when this thought came. Because it set so deep, I knew immediately that the outcome would be inevitable: This heart will be free! There has never been a doubt about the matter since. An unshakable resolve had set itself, one that supported me to stay at that retreat, and also to face many more difficulties in practice and in the rest of my life.
Years later that purpose widened. I took the bodhisattva vows of Mahayana Buddhism, even though they were not part of my own Buddhist tradition. Since then I have tried to make my last thought before sleep, and my first thought after waking, these words: For as long as space and time endure, I will abide to relieve the suffering of living beings. For me the question of purpose has been settled forever. This, my only real purpose, is the true north star that guides everything in my life.
Do you sense the forceful strength of such purpose? It can support you through the challenges of spiritual practice. It can also support you through the grave challenges of mental illness, and indeed can change for the better your relationship with the illness. For example, unshakable purpose like this acts as a direct antidote to the futility, despair, and sense of meaninglessness that depression hawks as false truth. It also cuts through the solipsistic self-absorption that comes as baggage with all mental illnesses.
Recently, in the midst of a bad bout of PTSD, I watched a movie that depicted grievous human suffering. As the credits rolled, I thought, “My task is to relieve the suffering of living beings. So let’s get on with it!” Remembering and renewing my purpose propelled me out of self-absorbed PTSD pain into service again.
Clear mind, open heart
We set the intention to be free. That’s the what of our work. Then we refine Right Intention by determining to cultivate the how of the work: to deepen awareness and love. These two magical, transformative qualities both heal us psychologically and free us spiritually, making therapy and meditation two aspects of the same process.
I’m no psychologist, but my working definition for mental illness is “lost in delusion.” All mental illnesses seem to manifest distorted or delusive perceptions of reality. Each illness has its own flavor of delusion, but each has some crazy story we can lose ourselves in believing. Probably you don’t spend much time thinking that some of the pixels in your TV are cameras observing you, but someone afflicted by paranoia can spend a lot of time thinking about it.
Since freedom comes from seeing what is true, by definition mental illness can keep us from opening to the truth. It can be extraordinarily challenging for those of us who are mentally ill to step away at times from this tyrant distorter of reality into the clear space of the accurate witness. Good therapy and good meditation both support us to let the delusive stories go, and to observe experience without skewing it.
Awareness frees us, but as splendid as it is, awareness isn’t enough. Carl Rogers famously said that healing in therapy comes from the “unconditional positive regard” that develops between therapist and client. That’s an eloquent synonym for love. Love, generous acceptance of experience, equally liberates in meditative work.
Clear mind, open heart: these are the means and the ends of both the therapeutic process and also the meditative process.
If you have mental illness I hope that you will not heed those in therapeutic communities who disparage meditative work, or those in meditative communities who disparage therapeutic work. For decades I personally have combined the two; I could not have cultivated health and freedom without both.
If you feel thrashed by the oppression of great emotional pain, this talk about clear mind and open heart may seem abstract and remote from your real predicament. Remember, we’re distinguishing here what’s very difficult from what’s utterly impossible. I don’t pretend it’s easy to heal serious emotional illness or to go the distance with meditation. Today we know that Dante made it out of hell. But when he was in there, he didn’t know that!
Notice that I use the word “heal” here, not the word “cure.” The mental disease may stay with you – my two have – but by treating it you may be able to reduce its impact on your mind and life. If your life now has a powerful and noble purpose, freedom for yourself and for others, then you have a compelling reason to treat your illness. A bit of progress either in therapy or in meditation will support progress in the other.
In my own life I have had to choose some progress in healing mental illness before I could tackle the more challenging aspects of meditation. Mental health resources have become immense. The field has been making great discoveries and changes in every aspect of mental health care. If you have not done it already, I suggest that you find out as much as you can about what is available for your illness, both in the mainstream and at the experimental fringes. Then make informed choices, find the money, free up the time, and go for healing with single-minded, unswerving purpose.
Stabilize, stabilize, stabilize
Both psychotherapy and Buddhist meditation – at least meditation in the tradition I know, Vipassana – offer us ways to stabilize our minds/hearts, and also ways to uncover information, hitherto hidden, that can help us to heal and to liberate ourselves. We stabilize before we uncover, because what we uncover can be painful. If we lack enough mental stability to handle the pain, it can overwhelm us and make us sicker.
We don’t want to tackle painful experience, either in therapy or in meditation, until we are stable enough to accommodate it. “There is pain that leads to more pain, and there is pain that leads to the end of pain,” the Buddha said. Uncovering pain before we have enough stability can lead to more pain; uncovering with enough stability can lead to insight and the end of pain. A good therapist and a good meditation teacher can discern when to encourage us to stabilize and when to uncover.
Stabilizing through psychotherapy
Unconditional positive regard can do a lot to stabilize us emotionally. Good therapists can give us the first reliable, wholesome, loving relationships, free from judgment, that some of us have ever known.
Developing what psychology calls “ego strength” also brings stability. “You have to be somebody before you can be nobody,” wrote the research psychologist and Vipassana teacher Jack Engler. Psychotherapy can help us to stabilize, among other ways, by giving those of us with mental illness a more stable sense of what Engler calls “a sense of continuity, identity, and ongoingness in existence” (17); “inner cohesiveness, unity” (18); “psychological structures that make it possible to think, to plan, to remember, to anticipate, to organize, to self-reflect, to distinguish reality from fantasy, to exercise voluntary control over impulses and behavior, to love.” (19)
Okay, enough psychobabble. You probably get the essential point: without a strong, cohesive, integrated sense of self, we can’t tolerate the uncovering work that frees us in both psychotherapy and meditation. Once we have it, we have the strength to go developmentally further in meditation by seeing that there is not, there never has been, and there never could be a separate self. If we see all this as a developmental progression, we can win free from the tiresome self/no-self debate that goes round and round between West and East.
Stabilizing through meditation
In Vipassana our main meditative tools for helping people to stabilize are the four Brahma Viharas, or “Heavenly Abodes,” and the concentration that comes with them. We call them heavenly dwelling places because when our hearts are saturated with these beautiful states of consciousness, they experience celestial purity and happiness. The four are loving-kindness, compassion, appreciative joy, and equanimity.
All of these four practices, when we do them formally, also develop concentration, the one-pointedness or stability of mind that allows our attention to stay with a meditative object without wandering so much. Deeper concentration brings with it calm, a sense of wholeness, rapture or joyous interest in our experience, and bliss, a quiet but profound happiness. All of these wonderful states purify, heal, and stabilize our hearts in several ways. Loving-kindness alone, the Buddha declared, is the greatest healing power in the universe. These four Brahma Vihara practices are good for all people at all times. You can’t go wrong with them.
“Right!” I can almost hear you saying. “My mind is tortured with mental illness, with anxiety and obsession, and you think I’m going to get to celestial happiness and bliss? In your dreams!” I can only say in response to skepticism that it’s harder for those of us with mental illnesses, but it’s not impossible. Please remember that I began Buddhist practice in extreme anguish, with two full-blown, serious mental illnesses. Nonetheless these Brahma Vihara practices have worked their liberating, stabilizing magic on me. With the right effort, and with skillful support from wise guides, I think that you might do it too.
Now the uncovering
We come now to the hardest part, the uncovering. Let’s say that you have done all of the things that I have suggested here. You have built a strong network of external support. You have built internal support by embracing an unshakable intention for freedom. You have pursued psychological healing with the same strong determination. You have stabilized your mind through psychotherapy, Brahma Vihara practice, and concentration. In my Vipassana tradition we add one more preparation: to practice generosity and ethical conduct. Though we call it in some ways a “preliminary” practice, the effort to help and not to harm through our speech and action is a deep, beautiful, lifelong undertaking, invaluable in and for itself.
Once we are stable enough, both in psychotherapy and in meditation, we use those two great healing powers awareness and love to uncover information – forgotten or repressed or denied – that helps us to insight, to understand better ourselves and our relationships. Often the information is painful. We gradually accommodate the pain and integrate both the pain and the learning.
For example, even in my sixties I am still learning how having been sexually abused as a child has affected my entire life, in both gross and subtle ways. I remember the events; I experience the pain; I understand more about myself and others; I forgive and accept; and I come away more whole.
In my tradition we use Vipassana meditation, mindfulness, as our uncovering tool. Earlier in the progress of Vipassana, people may remember personal experiences like sexual abuse, and they may process the information in ways that are similar to the methods of psychotherapy. This personal uncovering may continue at different times throughout someone’s meditation career.
The truth will piss you off
At some point, though, in the progress of practice meditators also begin to discover transpersonal information, universal truths about reality that are not limited to their personal lives. Then the process can get really interesting, and sometimes really tough.
I used to own a poster of a rag doll squished in the middle of an old fashioned clothes wringer. The caption read, “The truth will make you free, but first it will make you miserable!” Gloria Steinem was even blunter when she said, “The truth will set you free, but first it will probably piss you off.”
Why be miserable and pissed off with the truth? Because transpersonal truths first challenge and then destroy our deepest assumptions about who we are and what reality is. “The search for reality is the most dangerous undertaking because it destroys the world you know,” said the Advaita teacher Nisargadatta. Before a new, truer reality can arise, the old, false reality has to die; there’s no way around it.
The truths we learn through deeper and deeper insight are the three universal characteristics of all phenomena: everything is impermanent; everything is unreliable because it’s impermanent; and everything is not self. How do you think you would feel when you profoundly, intuitively, get the fact that you will lose everything: every possession, every relationship, your body, your life, everything? How do think you would feel when you profoundly get that nothing whatever in the world is ultimately stable or reliable or secure or satisfying? How do think you would feel when you profoundly get that there is no self to be found anywhere, that no one is experiencing your experience? For most of us, at first it sucks.
Beyond pain and sorrow
It’s an existential crisis, a dark night of the soul, which all spiritual practitioners must transit in order to free themselves. Most experience deep fear, especially a fear of annihilation.
Eventually we accommodate these pains too, and then integrate and accept these truths simply because they are true. That acceptance establishes the mind in extraordinarily stable equanimity. Out of that equanimity the mind opens to Nirvana: that which never disappears, is entirely reliable and secure, and is beyond all pain and sorrow.
Wisdom and madness
Once you know, thoroughly and for good, that there is no self, you are armed with the spiritual version of Flash Gordon’s ray gun. It will atomize for you, eventually, any suffering you turn it toward. The crazy stories? Empty. And that which thinks them? Also empty. The anxiety, the dread, the despair, the helplessness, the rage? Empty too. They are felt, but no one feels them.
“Empty phenomena rolling on,” Munindra, one of my teachers, would repeat again and again. Those four words have become an all-sufficient mantra for me. The suffering still comes, but when no one suffers, it has nowhere to lodge. It has no choice but to dissolve away. We find in wisdom our ultimate healing. Empty phenomena rolling on. Some day the suffering will no longer come.
Find your own pace, no matter what anyone tells you
Such blessings from the path seem undeniable. But if the destructive process of uncovering can challenge anyone, what about those of us who have mental illness, with our wobbly psyches and our tenuous hold on reality to begin with? It’s very challenging, and even dangerous. Still, I believe that many of us can do it because I have done it myself.
In order to do it, I have had to go slowly, much slower than others: touching painful truth, then backing away; touching again and backing away again. My Buddhist teachers, who did not know at the time about people with mental illness doing deep spiritual practice, pushed me to strive, to make quick progress. Eventually I had the wisdom to say to them, “Please back off. I must go at my own pace.” When I went at my own pace, I was able to go where I had to go.
People can and do have mental breakdowns when teachers push them too hard through the deeper, more challenging stages of meditation practice. As a dharma teacher I have too many times picked up the pieces of practitioners who fragmented when they had been pushed too hard by teachers ignorant about working with fragile psyches. Unfortunately too many Buddhist teachers are unskilled in assessing people’s limits. We could use CEUs for gurus.
Friend, if you have mental illness and you aspire to liberation enough to take your practice deep, please remember this one thing, even if you remember nothing else from this article: You must go at your own pace. Trust yourself to know. Do not allow anyone, even great spiritual authorities, to dictate your pace to you. Your mental health may depend on heeding this advice.
Even if you don’t have mental illness, we all have limits for stress. We all have to stay within a manageable level of challenge. And, if our guides cannot assess that level, then we have to assess it for ourselves and assert for ourselves what we feel safe doing and what we do not feel safe doing.
Despite all of my warnings and caveats, if you can do it I hope that you will go the distance. This suffering universe needs more liberated hearts. How good it would be to number you among them! Even with mental illness, with enough care and preparation you can break the bonds of ignorance and shine your light on the world.
Compassion and spiritual urgency: the bonus gifts of pain
We would never wish upon ourselves or upon anyone the great affliction of mental illness. But here we are with it. What should we do? Under the pain of such affliction, many choose to contract into fear, bitterness, and hostility. We understand this response; it would be an easy enough choice to make.
But there’s another choice. We who follow a path of transformation can choose to let the pain of madness break us open. The only truly open hearts are broken ones. You have to break, really, for compassion to flood in. We know what pain is. When we see pain in others, our hearts quiver with resonance, and we care. People with easier lives, whose hearts have never truly broken, cannot know that depth of resonance and care. The enduring pain of mental illness, a kind of awful darkness, can give us the splendid force of empathy and compassion. “It is here, in this bad,” Wallace Stevens says, “that we reach the last purity of the knowledge of good.”
That same darkness can awaken in us strong resolve. Sometimes I envy the healthy ones. Their lives, their relationships, seem so much easier. Oh for the ease of mental health! But when things go well, how can anyone avoid spiritual complacency? There’s nothing like mental torment to breed spiritual urgency. We don’t think of “freedom from suffering” as some abstract idea. We want that freedom as a drowning person wants air. We will do what it takes to be free.
Next time a mentally healthy person patronizes you because you are mentally sick, remember compassion and spiritual urgency, great vessels that they are less likely than you to ride to the other shore.
There is a way out of hell. The Buddha gave it to us, and it works. The journey is arduous, yes, but no one who has endured it and has won home has ever regretted the effort. If your faith wavers, use mine. If the path seems too steep or too obscure, or if your eyes are blurred with the pain, take the Buddha’s hand. See, here it is – he holds it towards you.
By taking me as a good friend, beings liable to birth are released from birth, beings liable to old age are released from old age, beings liable to death are released from death, beings liable to sorrow, lamentation, suffering, grief, and despair are released from these things.
So cut through
The strap and the thong and the rope.
Loosen the fastenings.
Unbolt the doors of sleep
 Jack Engler, “Therapeutic Aims in Psychotherapy and Meditation: Developmental Stages in the Representation of Self,” in Ken Wilber, Jack Engler and Daniel P. Brown, eds., Transformations of Consciousness, Shambhala 1986, p. 24. Additional page numbers for this article appear in parentheses in the text.
 Wallace Stevens, “No Possum, No Sop, No Taters,” The Collected Poems of Wallace Stevens, Alfred. A. Knopf 1954, pp. 293-94.