Anaesthesia psychica dolorosa

In order to complete my graduation research I interview and conduct psychological testing of depressive patients at the V. M. Bekhterev Psychoneurological Research Institute, which is situated in an industrial district of St. Petersburg, Russia, the city where I live. Some time later I want to tell here the story of Vladimir Bekhterev (1857—1927), the founder of this institute, who in the beginning of the 20th century embraced a truly integral framework, attempted to integrate individual and social psychology, neurology and behavioral studies, materialism and spirituality in a unified gesture of his works. Bekhterev was a person of profound spiritual insight, possibly having a stable access to witnessing consciousness; he is also known for his studies on the subjects of telepathy, clairvoyance, hypnosis, and  other altered states of consciousness. He was a founder of some of the major schools of the Soviet psychology. It is rumored that he was murdered by Joseph Stalin after assessing him as mentally ill. But all of this in a hopefully forthcoming post; right now I want to speak about something else.

With depressive patients I conduct a simple semi-structured interview that I designed based on The Integral Intake form created by Andre Marquis. Since I am doing an empirical research at this point and, therefore, am not working with the patients as a consultant or a therapist I significantly shortened the number of questions. In general, however, I am attempting to make a survey that touches some points that are essential to my research in all quadrants (psychological, behavioral, social, and cultural, including inquiries regarding patient's current state of consciousness, education, professional background, sleep behavior, destructive and self-destructive tendencies, sociocultural activities, religious attitudes, the meaning of life, and so on). (Initially, I wanted to do a different kind of research involving the state of consciousness assessment but it appeared that I didn't have enough time, tools, and support to complete such an investigation prior to graduation. As you may see, I still inserted some of the questions regarding the first-person experience into the qualitative part of my study.)

In the beginning of the week I interviewed a patient diagnosed with recurrent depressive disorder. A woman, 27 years old, has two kids. One of the striking features of her current state, based on her first-person account, was acute depersonalization, a condition that was historically called anaesthesia psychica dolorosa. This condition is characterized by painful mental insensibility, apathy, anhedonia, alienation from the self and others, lack of emotions, feelings, and concerns for oneself and relatives (in this case, including husband and children). She characterized her state as the state of "emptiness," "lack of feelings," "lack of love." This lack of feelings causes acute psychic pain, an overwhelming feeling of loss, of missing something important. This leads to intensifying questioning of the purpose and meaning of life and whether it is possible to continue living in such a disturbed state of consciousness.

During the clinical interview I asked a usual question in this case, which is about whether she currently experiences suicidal thoughts. She replied affirmatively and stated that in February (before being hospitalized) she actually made a suicidal attempt (took some pills) because she didn't want to live anymore, life was meaningless. After the interview, when I read her case file, I haven't found any mention of suicidal attempts or dangerous self-destructive tendencies, which was surprising because these are foundational data that must be gathered during the medical history examination by a psychiatrist (and, in the case, it is repeated over and over that there are no dangerous behavioral tendencies observed). I informed the local clinical psychologist, a graduate student with whom I collaborate on this research, and asked her to tell the doctor about these findings of mine, that this woman's behavior should probably be observed more closely. I also rated her very high on the clinical depersonalization scale (it was actually the first time I used that scale); and the tests results came also with very low scores in all essential indexes. All of it I sent by email right away. The response I got was that the doctor was aware of the suicidal attempt and "it was demonstrative" (no mention of it in the case file) and he was also aware of her suicidal thoughts (while the case file stated no dangerous behavioral tendencies). Today, I received an email from the clinical psychologist saying that in the morning the patient attempted a suicide by cutting her wrists (fortunately, unsuccessfully), so I was right when raising my concerns regarding her current psychoemotional condition. The patient is now under a special observation. 

Now I'm left with mixed feelings. It was the first patient whom I interviewed of whom I am aware that she attempted a suicide afterward. In fact, I read a case file of another patient whom I interviewed on the same day in which there was a doctor's note (dated the next day after my interview) that the patient feels better. Obviously, I don't think that the simple interview and attention of psychologist (i.e. me) was the crucial factor, but I think the change was at least in some ways supported by the interview because usually by the end of the interview patients leave seemingly in a better state than that which I observed in the beginning (as in that particular case). In the case of the suicidal patient she was very fixed on her depressed emotional state and showed little, if any, improvement by the end of the interview. (Pharmacotherapy, according to the patient's subjective account, didn't seem to help alleviating her interior pain either.)

Every time I meet patients for an interview it is always a challenge for me, because on the subtler level of communication I become increasingly aware of the qualia of the state of consciousness the patients are in; and I attempt to give full space to this state in my awareness. Most of the time after meeting especially strong cases I recognize shifts in my own mood and state of consciousness. I haven't learned yet how to minimize these effects; and I am not sure they must be minimized. As one my friend said, in the process of any kind of healing the most valuable gift is the pain one suffers. Pain is what is usually an authentic connection to experiencing reality; anything else may be more of an illusion.

Transformations of consciousness towards wisdom and compassion

Pain.

It is overwhelming.

We constantly live lives of others, holographically dreaming collective dreams, and sometimes attempting to make our dreams dominate over those of others or submitting ourselves to others' dreams. When a client visits a therapist or a healer or a shaman, two life stories meet, and these stories are shared both in gross and subtler dimensions of being-in-the-world; and the shaman's job is to emphatically embrace the totality of suffering in the other, virtually live it through in some translocal and transtemporal realm of one's own embodied universal consciousness as a sum of perspectives that are available so as to look and feel into the being of the individual, not get convinced in a false idea of the person that his or her life story story is absolute truth of what the world is (the myth of the given), offer in exchange one's own story of truth and liberation that at some point must be wide enough so as to embrace the entire Kosmos, and to be completely liberated from the story itself while fully embodying it as profoundly as one can. You need to be liberated in order to give space for the story's healthy development and evolution; and you need to be fully present as an embodiment of this story in order to support creation of the morphic field of such an altitude of consciousness (and actually have fun). And if you are good and honest with yourself, you can offer nothing nothing else than the story of integrally liberated universal being.

Even though I am in the initial phase of the practice in some ways, as I increasingly get in touch with subtle dynamics I start to feel the totality of blockages and pains and sufferings of sentient beings around. I feel how we virtually strangulate each other, inserting one another into one's own partial and limited life story of who we are as human beings and what life is about. All I can do is giving space to these sufferings in my own consciousness because there is ultimately no separation, we are all intertwined. And often it is overwhelming; and there is nowhere to hide from the fiery light of truthful seeing, hearing, feeling, and being.

I offer my Soul to the path of liberation of the Kosmos as a living total-unity; and I silently pray to the Divine for the grace and grit. I need to embody courage, strength and will as well as compassion and wisdom to manifest the deepest potentials of consciousness that offer treasures beyond any price.

I conclude with my favorite quotation from the splendid American Beauty movie that one is ought to watch at some point in life.

Ricky Fitts: It was one of those days when it's a minute away from snowing and there's this electricity in the air, you can almost hear it. And this bag was, like, dancing with me. Like a little kid begging me to play with it. For fifteen minutes. And that's the day I knew there was this entire life behind things, and... this incredibly benevolent force, that wanted me to know there was no reason to be afraid, ever. Video's a poor excuse, I know. But it helps me remember... and I need to remember... Sometimes there's so much beauty in the world I feel like I can't take it, like my heart's going to cave in.

The ground for conscious being

It is both fascinating and frightening how lost we can be in the world of apparitions due to subtle contractions and attachments of our psyche—the phenomena of which we tend to be unaware. We get used to a limited perspective on ourselves and on others; we develop some basic agreements with the world during the process of growth and interaction with the other, we co-create the worldspace where we live that includes our thoughts, things that we say, things how we say, our memories, visions, sensations, body movements, chronic energy fixations, and the totality of it all is our self which we present to the loved ones and the hated ones and the world at large.

It is dramatic that our self, as it constantly grows towards more maturity and embrace and experience and becoming more aware of itself by including more and more entities into its space of being-in-the-world, at earlier stages can learn and adapt to the world, construct the basic sets of its elements in a way that in the future would become self-evident as self-contractions and subtle attachments that hinder liberation and hide essential qualities of one's own human being, of one's own profound truth under limited adaptive masks or personae of which we are not aware for initially and genealogically these masks were developed in order to comply with the requirements and agreements that the other and the environment told us, showed us in the days when we were just starting to make first steps towards self-consciousness and conscious liberation. And these masks of which we are not yet aware, the shadow patterns of our co-existence contaminate our whole life and communion with the ones we love and prevent us from being fully and self-recognizably who we are, radiant blissful fluctuations of the Spirit's meaningful, passionate, unlimited unfolding, the unfolding that is personally embodied in the Soul, the ego, and the bodymind.

The Spirit is always present in our life as the very fact that we are aware. In fact it is the space of awareness, of consciousness that is aware of us and all our life right now. In this space the wisdom and compassion grow and stabilize as structures, as fractals, as flowers. Giving space to yourself the way you fully and deeply are in your true embodied nature means grounding yourself in awareness and putting everything that exists in life into this ground, washing with its liberating rain the basics presets of your tetra-constructed¹ being and knowledge of the world and how to engage with it. In the space of awareness the spontaneity occurs that breaks ice of the old and allows novelty to emerge, and the novelty brings new excitements and flow of life and the conscious awareness always liberates them from attachment, for the attachment per se is something of which we can become conscious in the space of awareness.

The names of attachments, fixations and repressions are Legion. They hide everywhere in your private and public worldspace and they cause you to develop a false concept of the self, a false self. You get used to move in a certain way and not the other; and you unconsciously consider these movements to be the boundaries that divide the territory of your self from the foreign land of not-self, the unknowing land that brings anxiety by its very existence. Thus, you get a limited perspective of your self embodied in movements. You get used to have certain sensations and feelings in the body; and you may not even be aware of the fact that these are only sensations and feelings that emerged in the process of growth; and you just take them for granted. Thus, you get a limited perspective of your self embodied in how you feel your body. You get used to have certain thoughts and preconceived ideas in your mind; and these ideas are always more limited than the mystery of the world and your self. Thus, you get a limited perspective of your self embodied in how you think about yourself and existence.

You get used to hearing a limited spectrum of sounds, seeing limited things, enjoying limited moves, experiencing limited emotions, playing limited roles, having a limited diapason of dreams, and living a limited range of possibilities of life. And all of it in the totality of who you are you present as a total message of your existence to others. And others respond, both consciously and unconsciously, to this message as a whole with their being. Of course, you are responding to their message as well.

If I am so attached to these things that I don't even let them into my awareness so as to let go of them, how not to get lost in this vortex of apparitions and how to finally arise above the process of recreating the suffering, the suffering that is constantly shared with others? If there is nothing in my self that I can ground myself in, for it all is essentially a fleeting and constructed experience, what is the way to freedom? How can I free myself to being fully embodied and yet unattached? The ultimate way is to ground yourself in something that has no content and yet is always already present, in a presence that constitutes the basic undeniable dimension of the being-in-the-world that is closer to you than your self.

That which is always already present and yet has no content is the silent awareness, the very framework of attention, the very space of consciousness in which everything you are reading right now as you are sitting in a certain posture, feeling certain sensations and thinking ideas and making various micro- and macro-movements is arising moment to moment. This awareness is your best fucking friend forever. Ground yourself in awareness and allow yourself making new moves, approaching people in new ways, playing new roles, having a fresh taste of feelings in the body, no matter how silly you think those are, for these very thoughts of silliness are just temporary clouds in the sky of your awareness that come and go, come and go like flowing waves in the ocean cradled by the wind which is the Spirit whispering.

Ground yourself and help your beloved to ground themselves in awareness and then look into their eyes and make funny faces, scream and cry and move and liberate and dance together and give the full space to feelings in the body and suffering in the life for this is the path to healing and redemption and underneath suffering you can find profound happiness if you actually follow this advice, this practical injunction. Constantly remind yourself and others of this translucent awareness and the power of the present moment and the glory of all-pervading silence by being a living example.

The quietude is the Spirit smiling to you.

¹ Tetra-construction is the term that points to biological, psychological, cultural, and social factors of development and evolution. See, e.g., Wilber, Integral Spirituality, 2006.