Prajna and Psychosis

Note: The following letter was to a student who has strong mental health support systems and finds meditation practice grounding rather than destabilizing. Please know that for some, at times, the experiences of both opening up and intensity that come with practice—and particularly the more rigorous practice of retreats—can open doors to fears, confusion, depression, heightened anxiety, or loss of touch with reality. Should you experience these, please seek professional guidance, back off on the intensity of your practice and find safe spaces. Cheetah House (cheetahhouse.org) is an organization that is familiar with these phenomena and can provide guidance and counseling on a sliding scale. Thanks to senior dharma teacher Mark Brenner for helping edit this article. 

Thanks for your question about prajna and psychosis. I’ve always admired how your intellect supports your practice, so here’s another opportunity.

            One way to see prajna is as clear discernment. One way to see psychosis is as distorted discernment. If you think of dharma as transformation, then we’re looking at transforming distortion into clarity. This is the same process for any deluded view, so why not psychiatric conditions? One element of prajna here is seeing clearly that something is being distorted, what the distortion is, what conditions support that, and what conditions heal it. Then, even your question about prajna and psychosis is a first step toward seeing that something is off-base and creating distress. 

            If there is enough distance to see this, it's worth noting what kind of distress is happening, how it appears, what it affects, and what soothes it in a healing—rather than purely distracting—way. Certainly, in the midst of distress like psychosis, there's a feeling of being overwhelmed, which is natural, given its intensity. Looking solely for methods to address the most intense and frightening moments misses opportunities to practice prajna in the quieter moments and gain strength there. This, of course, gives anchors for when things get bad as well as calming the waves, so that they don't get so bad. 

            Here are two points to consider:

            First, know that isolation is one part of psychosis—not knowing what or who to connect to or trust. It's therefore important to have people and things to connect with who appreciate your needs and who you know are reliable—both the people and the things. I just saw an article online today about “glimmers”—the counterweight to triggers. These are small things or occurrences that brighten your life: a flower, the breeze, a bird, a sound, a thought, a memory, and so on. These glimmers are unique and individual to each person. Noticing and appreciating them as they appear can help to create a flow of connection and healing.

            Second is to have a sense of what grounds you and what makes things off balance. It's not unusual that prolonged periods of silent or intensely focused practice can be destabilizing. There are several reasons for this. One is that the quiet can be “too loud,” which means that the scary things have more room to be seen. Another reason is that practices that create energy will give energy to everything, so that distortions can also become stronger. 

            Because of these things that throw you off balance, it's good to have shorter and softer periods of practice, such as a minute of quiet breathing, or just counting your breaths to ten and then resuming your activity, or a minute of mantra practice, or quietly chanting one chant, then moving on. It may help to do this periodically and regularly during the day, to create a series of anchor points. But again, this is individual to each person, and it’s best to do this in consultation with a trusted guide. It may also be that methods that are useful will change over time, and it's good to be sensitive to reading your own flow well. 

            It's worth reflecting that change or progress is likely to be gradual and not all at once. Seeing this has some benefits. One is to have reasonable expectations. Another is to know how to experience progress with a micrometer and not a yardstick. A little better than before is still better.

            It's important to recognize that meditation in and of itself is unlikely to be sufficient to address all of this. Having supportive connections and activities, professional mental health guidance, a safe place to be, safe things to do, knowing how and when to rest—all of these are also vital. 

            If you are able to reflect on your own experience constructively through diaries, drawing, conversation, therapy, and so on, that may also help you have something reliable to hold on to, like a guide-rope in a maze. 

            I hope these thoughts are useful for you. They're certainly not comprehensive, but a place to start a conversation.

    Take care,

    Ken