Depersonalization Disorder and Living Corpses: Psychiatry, Religion, and Alienation

milarepa emaciated

(The 11th century yogi Milarepa, in his retreat cave.  He appears here  in his iconic emaciated, green-tinged form that was brought about by subsisting on a diet of nettle soup)

I tend to read pop science pieces on neurological/psychiatric conditions with interest, as I’m sure most cultural and medical anthropologists do. I’m versed in neither neuro-anthropology nor neuro-theology but I do often find myself wondering about the broader social, historical, economic, and political landscapes through, in, and in spite of which specific bio-medical conditions emerge. It’s probably far too reductive and glib to characterize the cases below as merely examples of a contemporary willingness to ‘neurologize’ sicknesses of society. Still, while I’m not about to advocate for a hard-line social constructivist take on these kinds of ‘bizarre’ neurological conditions, I do think it can be interesting to reflect on contemporary psychiatric disorders and discourse in parallel to, and against religious vocabularies.

On September 4th, 2015, The Guardian put out a fascinating piece on De-Personalization Disorder (DPD), or depersonalization-derealization disorder, which got me thinking along these lines. Here’re some excerpts from the piece, called ‘Depersonalization disorder: the condition you’ve never heard of that affects millions’ by Howard Swains:

“People with depersonalisation disorder describe a sense of complete detachment, a life lived as an automaton or on autopilot, characterised by an absence of emotions, either good or bad. (You might think of Channel 4’s recent hit Humans, which featured an intelligence trapped, powerless, in the body of a robot.) They feel as though they are observing their life through a plate of glass or a dense fog, or as if it is appearing in a film. Their bodies and their beings have separated; their limbs are no longer their own.

…The earliest writing that attaches the label “depersonalisation” to an overwhelming, clinical sense of separation dates from the late 19th century, since when its symptoms have often been presented as contributory to better-recognised conditions, such as anxiety disorders and depression. However, DPD can also exist in isolation, and the general understanding is that the brain has triggered a natural defence mechanism against extreme anxiety; having reached an arbitrarily defined limit, it has entered a complete emotional shutdown, taking with it sensations of pleasure as well as pain; love as well as hate..

…An onset of DPD prompted by recreational drug use is not uncommon, and cases are known of regular users suddenly being incapable of snapping out of a high or a comedown. (Charlton had tried cannabis only once before.) But other principal triggers for DPD include a single traumatic event or sustained periods of physical or emotional abuse. Others experience the disorder without ever fully understanding its cause…

Moreover, people with DPD often do not appear at all unwell or different to even their closest acquaintances; despite experiencing a total lack of empathy, friends and family do not notice any marked change. The person with DPD is often able to sleepwalk through daily life, and even to maintain close relationships, but is robbed of the emotional peaks and troughs of normal human existence. It only enhances sensations of detachment…
“I was playing football at school,” Killick wrote in an email. “For some reason I looked down at my hands and my mind said, ‘They are not yours.’ I just started screaming and running in every direction in absolute horrendous fear.”

When he was only a few months old, Killick’s house was destroyed by a V2 rocket and he was rescued from beneath the rubble after being missing for two days. He subsequently endured a childhood of extreme physical and psychological abuse from both his parents and grandparents, precipitating (according to psychologists now) the disorder that still plays a large part in his life. Throughout the years, he has been institutionalised more than once and given ineffective medications that have inhibited all other functions. In the mid 1970s, he says he spent two years as a virtual hermit, confined to his bedroom. Killick has also, however, married and had children, and has held down a number of jobs, using advice from psychiatrists, psychologists and self-help books to make the most of periods between extreme DPD episodes.

Killick wrote: “I have had for the last 61 years a PERMANENT feeling that I do not exist. Nothing I do or think seems to be able to change that feeling. I just want to be me, whatever that me is. I long for that so much.”

Swains’ piece provides useful person-centered, anecdotal material, and is certainly part of a now popular genre of scientific-medical journalism on ‘diseases you’ve never heard of, unusual human suffering and experience you know nothing about’. When I shared the piece on my Facebook page I reacted against this expose’ narrative by dismissively normalizing the condition, joking that “I thought this just used to be called ‘existential ennui’ and meant that you were sensitive to the nightmares of society, maybe wore a beret and probably read a lot of books.” Of course, I hardly think DPD sufferers are ‘making it up’ or that the condition has no connection to neurological, biological reality (after all, I’m not sure what does!). Still, reading the piece, and sufferers’ descriptions about their experiences of feeling alienatied from their sense of self, I couldn’t help but think of Buddhist ideas about personhood, reality, and religious practice.

In Buddhist contexts, one can find lasting happiness and freedom from suffering by alienating oneself from one’s habitual sense of self. The first step of escaping the relentless grind of Samsara is renunciation, or what is called in Tibetan ངེས་འབྱུང་ nges-‘byung, ‘ngay-joong’. The term implies a sort of disenchantment or detachment from the things that once felt real and gave one pleasure, a nausea for worldly life, a stepping forth from the palace, a leaving behind of the attitudes and activities that were once one’s ‘home’. And yet literally translated the word means ‘authentic becoming’, a ‘definite emergence’ from the routines that have guaranteed one’s suffering. As such, for Buddhists, feeling like you’re ‘losing your grip’ on reality and your once conventional, stable notion of self can mean progress, can carry an air of triumph. Buddhist tantra likewise offers a panoply of methods for deepening and stabilizing one’s sense of the overarching dream-like ’emptiness’ of life – the key difference though is that these are pitched as a path to increased presence, joy and clear awareness. To richer everyday experiences, to stronger feeling, greater vitality and fulfillment.

Again, I certainly don’t mean to dismiss or refute the reality of DPD sufferers’ pain or condition, but looking merely to that one joint at the party or to brain activity to understand the condition’s causes seems pretty parochial to me. This article points out that a large number of quite young people are diagnosed with DPD these days. This reminds me of the gendered and generational nature of Borderline Personality Syndrome diagnoses, where BPS starts sounding like a medical label for the particular kinds of damage done by hetero-capitalist patriarchy to certain demographics and generations of women. In much the same way, DP disorder sounds a lot like a symptom of well, living in today’s world and/or Samsara. I dunno. Is this still all a bit too glib though?

Swains’ piece on DPD reminds me of another interesting story about a teen in the US diagnosed with Cotard’s, or ‘Walking Dead’ Syndrome, a psychiatric disorder which causes the sufferer to believe that they/their body is dead. In this typically rather sensational  Dailymail.co.uk piece, the seventeen year old teen in question, Haley Smith, credits her recovery,  after some three years of affliction, to watching Disney movies, which “made her feel alive”. The article includes other choice lines:

“…Miss Smith began missing school, sleeping through the day and staying awake at night.
She said: ‘I’d fantasise about having picnics in graveyards and I’d spend a lot of time watching horror films because seeing the zombies made me feel relaxed, like I was with family.’
She added: ‘Being a corpse was the most bizarre experience, but I’m so glad I managed to get out alive.’”

In his songs of realization, the 11th century Tibetan tantric saint Milarepa declares: “The frightful corpse they talk about, is the very body you wear, meditator.” And “Rest without self-concerns like a human corpse.” Given these proclamations, I can’t help but wonder how Haley’s condition would be perceived by charnel ground frequenting Indian or Tibetan yogis.

These sorts of speculations are the bread-and-butter of cross-cultural psychiatry and medical anthropology. More specifically, they hinge around different ways of evaluating concepts like the self, alienation, and the body. Ideas of alienation and estrangement have been central to modern social science theory. The intellectual projects of Karl Marx, Max Weber and Emile Durkheim, distinct as they were, can be understood as a product of the three men’s shared anxiety about the future of social relations under modern industrialized capitalism, a future that each agreed in his own way could be characterized by increasing fragmentation, estrangement and disconnection. For Marx, Weber, and Durkheim respectively, the tutelary gods of capitalist modernity went by three names: alienation, bureaucratic rationalization and anomie. These three processes were the salient and insidious characteristics of a new age – together, they spoke of a disquieting rupture with pre-industrialized Europe’s past, one that cried out for professional analysis and comment.

As diagnoses of the nature of self and society under industrialized, capitalist modernity, for Marx, Weber and Durkheim notions of alienation, estrangement and anomie circled around questions of social relations and the political and affective costs of particular arrangements of labor, resources and production. Together, these notions suggested the loss of some kind of original and potentially more sanguine state of conviviality, cohesion and community, and framed a critique of modernity that each of these luminaries operationalized in various ways. Ideas of alienation and estrangement have typically been treated as the inevitably dehumanizing consequence of industrialization and capitalist modernity, but it occurs to me that the contexts, scope and consequences of alienation are much broader than these classic treatments allow. In my own work I am very interested in ethnographic examples where alienation and estrangement appear as key components in spiritual disciplines and cultural practice. In the context of ascetic practice, for example, rather than being framed as ultimately regrettable and negative, strategies of alienation are often treated as ultimately valuable and empowering (beyond religious asceticism, scholars have also explored the empowering dimensions of bodily alienation, objectification and abjectification in the context of anorexia nervosa, women’s engagement with medical imagining technologies in infertility clinics, and gay men’s participation in circuit parties) .

A while back I had a fun time writing an essay on this idea, which I called “Approaching the Unthinkable through the Monstrous: Alienation and Fear in Tibetan chöd and Lovecraftian Magick”, and which, as should be obvious, made some preliminary comparisons between Tibetan gcod practices (see this, this, and this post for more on these practices) and Lovecraftian magic(k) (‘post-modern’ ritual practices inspired by the themes and extra-terrestrial mythology of cosmic horror writer H.P. Lovecraft’s fiction)  as a way of re-appraising alienation as a concept. What do you think? It strikes me that there’s a lot of rich food for thought here, but it’s material that demands significant nuance and very careful contextualization to avoid potentially hurtful reductionism. Things are naturally not as neat as ‘either religious/or psychiatric’. The lines between ‘religious experience’ and ‘psychosis’ might be in the eye of the beholder, but that hardly means that the relationship between mental health and religious experience is an easily summed up matter of sheer opinion either.

* Here’s an excerpt from the essay I mention above, in case anyone is interested:

Self and Society: Modes of Alienation

The term alienation, for all its connotations of newness and modernity, has a long history of use in the English language. Williams (1989: 33) lists four core meanings for the word. In its earliest sense, the term betokened estrangement from some kind of sustaining higher power: “It has been used in English from C14 to describe an action of estranging or state of estrangement: “normally in relation to a cutting-off or a being cut-off from God, or to a break-down of relations between a man or a group and some received political authority.” A slightly later second sense (from the 15th century, and one still retained for specialist use today) refers to the legal transfer of anything from one person to another, “especially the transfer of rights, estates or money.” By extension the third sense then refers to the resulting state of estrangement following such a transfer. The fourth meaning extends the third, to imply “loss, withdrawal or derangement of mental faculties, and thus insanity.” (1989: 33)

As noted, alienation has been routinely associated with narratives of modernity and modernization. Marx, alienation was rolled into the logic of capitalism. In a capitalist system, laborers (or at least the kind of landless factory workers Marx had in mind) experienced multiple levels of estrangement. Not owning the means of production and obliged to sell their sole asset of labor power to capitalists, workers were alienated from the products of their labor; they were alienated from the full process of production; they were alienated from each other; and they were alienated from their own ‘species-being’ since in Marx’s vision it was the basic nature of humans to create, Marx’s picture thus emphasized the damaging effects of isolation and separation of person from person and person from thing and the process of production. For Durkheim, the increasing fragmentation and diversification of social roles in industrialized society produced anomie, dangerous feelings of isolation and aimlessness that could give rise to despair and suicide. In a related vein, Weber worried that the ‘ethos of brotherliness’ that characterized the world’s ‘universal’ religions (Christianity, Islam and Buddhism) was incompatible with the ‘iron cage’ of rationalizing bureaucracy that typified modernity. Growing out of these representations has come a more general and pop psychological understanding of alienation, one that associates the term with broader feelings of disillusionment, rudderlessness and anxiety that are seen as side-effects of modern, urban living (Williams 1989).

Yet as Williams (1989) makes clear, the idea of alienation need not be so specifically associated with modernity. As a uniquely human problem, alienation has sometimes been seen by theorists as the product of ‘civilization’ or some related descriptor more generally. Theological, philosophical and psychoanalytical readings of alienation have, accordingly, framed alienation as a general and fundamental consequence of what it is to live as a human being in society. The idea here is of some fundamental estrangement from our essential or original nature, a condition that is in many senses a virtually inevitable consequence or necessary price of ‘civilization’ or ‘human society’. Whether the libidinal energy in Freud or the ‘divine’ or ‘perfected nature’ of particular religious theologies, humans’ quest thus becomes the partial or complete recovery of their sexuality or original nature.

Alienation as poison and remedy: Estrangement in chöd and Lovecraftian Magick

Chöd emerges from a broadly Buddhist theological context where the root of suffering is understood as delusion. Through twin impulses of desire and aversion, discursive awareness emerges and in labeling perceptions and experiences, reifies and abstracts them and thereby alienates the individual from the innate nature of their own awareness. Cognitive grasping at the supposedly discrete objects of perception which are imagined as having their own intrinsic and unchanging identity gives rise to suffering when impermanent and interdependent reality fails to live up to the constructed, conceptual ideal of a world of enduring and independently-existent people and things. In this context, where it is the unenlightened mind’s propensity to fetishize mental appearances that is the root of all suffering, chod can be read as a strategic use of objectification, alienation and projection aimed at overcoming these very problems of consciousness.

Expanding on chod’s relationship to broader Buddhist principles, Jones (1998) notes that:

“…the purpose of Severance practice…is to overcome delusion (‘khrul pa) at its root. Delusion is an imaginative creation of desire (‘dod), craving (chags), grasping (‘dzin) and attachments (zhen). It manifests as both an attraction to things that are beautiful as well as repulsion by things that are disgusting or frightening…Practicing in wild places that humans ordinarily avoid at all costs such as cemeteries for leprous corpses and haunted places, the practitioners heaps ‘fear on top of fear’ and intensifies her sense of disgust and threat in order to focus, quicken and sustain practice. By practicing like this, she comes to understand all things that terrify or threaten, such as gods, ghosts and illness created when these beings are disturbed, as illusions with no substantial existence. She develops and understanding that whatever happens is not separate from her own mind. These intensified feelings of repulsion and terror animate and ultimately exhaust thought, sharpen, focus and deepen meditative concentration. This process of separating delusion and appearance is the essential meaning of Severance. Convinced that the root of all suffering is delusion, the Severance practitioner understands that having practiced successfully, the self-generated external appearances of the world will arise as helpful friends. What previously appeared as demons will not only become helpful to her understanding but she will also receive the miraculous signs of spiritual accomplishment (siddhis) from those very demons. Her ultimate response is deep gratitude towards those gods and ghosts for enhancing her practice and ultimate realization. Out of profound generosity and compassion cultivated by this Severance practice, she teaches these beings the way to liberation.” (9-10)

From a Buddhist perspective then, we can argue that alienation (from the true nature of mind/reality as ‘empty’ of intrinsic existence) comprises both the problem and the solution. While alienation from the nature of mind is what must be remedied, disillusionment with samsara – the suffering and monotony of endless death and rebirth caused by delusion – and alienation and detachment from habitual thought patterns serve as a crucial first step on the path towards liberation.”

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