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Isabel Clarke on Psychosis and Spiritual Experiences

On the future of mental health

Eric Maisel
Source: Eric Maisel

The following interview is part of a “future of mental health” interview series that will be running for 100+ days. This series presents different points of view about what helps a person in distress. I’ve aimed to be ecumenical and included many points of view different from my own. I hope you enjoy it. As with every service and resource in the mental health field, please do your due diligence. If you’d like to learn more about these philosophies, services, and organizations mentioned, follow the links provided.


Interview with Isabel Clarke

What is “going on” inside a person who acts or appears “mad”? What sort of experience is a “psychotic experience”? Why do auditory and visual hallucinations arise in some people as part of the experience of “mental illness”? No one knows. Many hypotheses have been put forward, including the dominant one that these are “brain events” of some sort and akin to “faults in the machinery.” But other views have also been proposed, including the view that these are best thought of as “spiritual experiences.” Here is Isabel Clarke on the subject.

EM: You’ve written books with the titles Psychosis and Spirituality and Madness, Mystery and the Survival of God. Can you share some of your thoughts in this area?

IC: I have come to the conclusion (based on a lot of good research as well as personal and clinical experience) that both psychotic and spiritual experience come from the same potential of human experiencing which is accessible to all; the experience of being taken ‘out of oneself’ when looking at a glorious sunset, or when in love. At its extremes, it is characterized by anomalous experiencing. I argue that we can only grasp this topic by taking experience seriously as a way of knowing alongside exact, verbal, scientific knowledge: viewing it from the inside as well as the outside.

Words are not reliable guides here. In the scientific world, words pin things down; they help to distinguish “a” from “b.” In the realm I am interested in words are unreliable and tricksterish; they stick things together at the same time as appearing to distinguish them. As a time-limited experience this is recognized as desirable, life enhancing. However, it is not a place to hang around in long, as it is all too easy not to be able to find the way back across the threshold. Without boundaries, without groundedness in individuality, anything can invade the person’s innermost mind and fear takes over.

EM: You say that we are “partly individual” but also “embedded in a web of relationships.” To what extent would you say that our emotional and mental health difficulties are connected to that “web of relationships”?

IC: Mental health difficulties are associated with the web of relationships being fractured or distorted precisely because our connections are integral to who we are. We are all familiar with the distorting effect of abusive early relationships. What we sometimes fail to fully take account of is that breaking off any central relationship, however disastrous, leaves a hole in the fabric of ourselves. The wider relationships, as in social contexts, etc., are also significant in defining us.

The other ingredient in breakdown is the absence of time in emotional/experiential knowing which is in charge here. This has the effect of adding past trauma to current difficulties and transitions and it is often that which makes things truly unbearable.

EM: You are involved with the Alliance for Revisioning Mental Health. Who is that alliance and what are your goals?

IC: The Alliance came about when The Psychosis and Complex Mental Health Faculty (of which I was chair for a while) of the Division of Clinical Psychology of the British Psychological Society, Russel Razzaque who is spearheading Peer Supported Open Dialogue in this country, and the Spiritual Crisis Network all realized we were on the same page. Russell got it going. PCMH found a bit of money. Catherine Lucas, SCN founder is now heading it up. Here are its mission, vision, and values statements:

Mission statement

Our mission is to actively promote progressive, holistic mental health care by building an alliance of organizations and individuals who share our values and are committed to change.

Vision statement

Our vision is to offer such a compelling and appealing alternative to the purely biomedical model that the new paradigm replaces it within mainstream mental health.

Values statement

Our core beliefs include four guiding principles:

+ Listening more and labeling less

+ Collaborating more and imposing less

+ Connecting more and medicating less

+ Hoping more and fearing less

EM: What are your thoughts on the current, dominant paradigm of “diagnosing and treating mental disorders” and the use of so-called “psychiatric medication” to “treat mental disorders” in children, teens and adults?

IC: I think it is misguided. I see mental health difficulties arising out of people coping as best they can with an intolerable internal state. My answer to the second question gives a way into how internal states easily become intolerable. My understanding of the human being is that we are a wobbly balancing act between the two ways of knowing outlined in my answer to question 1. I base this on Teasdale and Barnard’s Interacting Cognitive Subsystem model of cognitive architecture, which states baldly ‘there is no boss.’ No wonder being human is difficult!

People cope with this intolerable state by doing things that make perfect sense in the short term (shutting down, drinking too much, clicking into another dimension, etc.) but build up vicious circles longer term. Not an illness, just coping gone wrong. Medication has its place to help people get by when it is truly intolerable, but there is plenty of evidence (e.g., Whittaker and Moncrieff) that it has been both oversold and miss-sold – and vested interests such as global capital are in there somewhere!

For young people, being labelled as somehow defective and dosed up so that they cannot so clearly work their way through all this is even more of a tragedy than for adults.

EM: If you had a loved one in emotional or mental distress, what would you suggest that he or she do or try?

IC: All of the following:

+ Talk about it and accept support and sympathy from those around.

+ Be kind to themselves – accept that they are going through a hard time and allow themselves space.

+ Get sleep, good food, good people around, time in the open air – take enough time off work to do all this. Be prepared to be open about problems.

+ If their journey takes them across the threshold, into the other reality, encourage them to ground themselves in the shared reality with grounding activity, plenty of sleep – all the good advice above.

+ At the same time, to honour what they learn from that journey – about themselves and the universe. Cultivate a foot in each.

+ For fuller understanding and good support for the journey – help them find good therapy.

+ If there is any question of risk – the mental health services are the only answer at present. Safety is a prime consideration.


Isabel Clarke is a consultant clinical psychologist with over 20 years experience working as a therapist in the NHS with people with complex problems. Her books Psychosis and Spirituality; Consolidating the new Paradigm (Wiley 2010) and Madness, Mystery and the Survival of God (2008, O-Books) explore the themes of spirituality, mental health and being human. See for more information on publications and activities.


Eric Maisel, Ph.D., is the author of 40+ books, among them The Future of Mental Health, Rethinking Depression, Mastering Creative Anxiety, Life Purpose Boot Camp and The Van Gogh Blues. Write Dr. Maisel at, visit him at, and learn more about the future of mental health movement at

To learn more about and/or to purchase The Future of Mental Health, visit here.

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