In the early years of the 20th century, a few pioneering Spiritualist psychiatrists attempted to cure acute mental illness via mediumship. Probably the most famous of these is Carl Wickland, whose 1924 book Thirty Years Among the Dead recounts his experiences in treating–and curing–a variety of psychoses in institutionalized patients. In these sessions, the obsessing or possessing spirit that was purportedly responsible for the patient's psychosis would communicate through Dr. Wickland's wife Anna while she was entranced. (A PDF of Wickland's book can be downloaded here.) Wickland would address the spirit as an equal, convincing the entity to accept the fact that he or she was dead and to move on to a higher plane.
Another Spiritualist psychiatrist of some note was Titus Bull, who employed somewhat similar techniques.
As the Spiritualist movement waned in the United States and Europe, such approaches to psychiatry, very rare to begin with, became all but extinct. Recently, however, I came across an article in the summer 2012 issue of The American Scholar which discusses a new trend in the treatment of schizophrenia, a disease characterized by hearing voices. The new approach, though it seems to owe nothing to Spiritualism, at least provides food for thought in considering the nature of these mysterious voices in people's heads. Perhaps it even suggests that these voices have more of an independent existence than conventional wisdom would have us believe.
The article, "Living With Voices," by T.M. Luhrmann, begins with this striking paragraph:
Hans used to be overwhelmed by the voices. He heard them for hours, yelling at him, cursing him, telling him he should be dragged off into the forest and tortured and left to die. The most difficult thing to grasp about the voices people with psychotic illness hear are how loud and insistent they are, and how hard it is to function in a world where no one else can hear them. It's not like wearing an iPod. It's like being surrounded by a gang of bullies. You feel horrible, crazy, because the voices are real to no one else, yet also strangely special, and they wrap you like a cocoon. Hans found it impossible to concentrate on everyday things. He sat in his room and hid. But then the voices went away for good.
How did the voices go away? Luhrmann reports that "recently a new grassroots movement has emerged. It argues that if patients learn to address their voices directly and appropriately, as if each voice had intention and agency, the voices will become less hostile and eventually go away. From the perspective of modern psychiatry, this assertion is radical, even dangerous. But it is being taken seriously by an increasing number of patients and psychiatrists."
This new grassroots movement is called Hearing Voices. Practitioners encourage patients to interact with the voices, treating them with respect and civility, as if they were real, independent entities. This approach, of course, stands in stark contrast to the conventional wisdom on the subject, which holds that the patient should not be encouraged in his belief that the voices are real. As Luhrmann observes, "In biomedical psychiatry, mental health professionals ask whether the patient hears voices, not what the voices say. The goal is to get rid of the voices, like getting rid of a fever, and the mind-numbing, sleep-inducing antipsychotics are prescribed toward that end."
But antipsychotics don't always work, and even when they do, their side effects–as Luhrmann indicates–can be almost as devastating as the disease itself. At the end of his rope, Hans tried the Hearing Voices approach:
Hans joined a group of people like him who met once a week. They talked about their voices, and they were encouraged to talk back to them. They were even encouraged to negotiate with their voices. One of Hans's voices thought he would be better off if he devoted his life to Buddhist prayer. Hans is not a Buddhist–like many Dutch, he grew up as a secular Protestant–and he did not want to follow the voice's command. The group persuaded him to cut a deal with his voices. He told his voices that he would read a book on Buddhism every day for one hour–but no more. He would say one Buddhist prayer every day–but no more. And if he did this, he told them, they had to leave him alone.
They did, more or less. He began to feel better. His psychiatrists began to lower his Clozaril from its high of 500 mg per day down eventually to a dose of 50 mg. He lost weight. He became more alert. He moved out of the hospital. The voices didn't disappear entirely, but they got nicer. When he was moving into an apartment by himself–and petrified by the prospect–he heard a voice say, “Buck up, we know you can do it.” By the time I met him in 2009, he hadn't heard a voice in more than a year.
Lurhmann emphasizes that treating the voices as real participants in the process is the cornerstone of the technique:
Staff members conduct “voice dialogues,” often working one on one with a client. The staff member asks to speak with the voice. The client will listen for what the voice says and then reported back, in a strangely ventriloquized process. Some staff members invite the voices to attend the group meeting.…
The group thought that one had to talk with respect even to the harshest voices–the ones that screamed and cursed and wanted you dead. It is not easy, Hans said slowly, to talk nicely to your most aggressive voices. But the group said that if you showed respect, they would calm down. And they did.
The paradoxical assumption here is that if the voice-hearer treats the voices as if they are real, as if they are like the independent, external people in the world they are perceptually experienced as being, the voices will become less real.
This respectful approach seems to bear fruit in many cases:
The people who were comfortable with hearing voices told the same story; their experience had a trajectory. Some voices had started out mean and difficult, and the hearers had first responded with startled fear, but once they had chosen to interact with them, the voices settled down and became more manageable, sometimes even useful. “They show me the things I do wrong,” one voice-hearer said, “and teach me how to do them otherwise. But they leave the choice to me if I really want to change it or rather leave it as it was."
Luhrmann includes the caveat that, "[a]lthough the Hearing Voices movement is one of the most innovative approaches in decades to the problem of hearing distressing voices, clinical research is still in the early stages, with, to my knowledge, no completed randomized, controlled trials." In other words, it's too soon to conclude that the approach will hold up under more rigorous scrutiny. Still, the anecdotal evidence is provocative, at the very least.
In light of this new methodology, we might say there are two possible ways of interpreting the success of Carl Wickland's methods. One possibility is that the mediumistic sessions encouraged the patients to think of the voices as real, independent entities, and this subjective belief then helped to effect a cure, just as it seems to have done in the case of Hans. The other possibility is that, in at least some cases, the voices actually do belong to obsessing or possessing spirits, just as Dr. Wickland believed, and the Hearing Voices movement, by establishing a respectful dialogue with these entities, is helping to moderate their behavior.
I suppose a third, more esoteric possibility is that both things are true–that the voices are purely functional constructs, as mainstream psychiatry would say, but also “spirits,” as Spiritualists would have it. This could be true if we view personality as such as a functional construct, somewhat in the way that Eckhart Tolle does.
In other words, if the ego-persona is itself a functional construct, then to all intents and purposes there is no difference between an artificially constructed voice in one's head and the artificially constructed façade of the self as we experience it in everyday life. What is real, then, would be only the higher self, the witness that watches all these ego-based dramas play out.
But I'd better stop now. Because if I carry this line of thought any further, I just might drive myself crazy ...