Bipolar Awakenings: The Quest to Heal Bipolar Disorder

BOOK REVIEW

Bipolar Awakenings: The Quest to Heal Bipolar Disorder

Sean Blackwell; Independently published, 2024

376 pages; $29.79 (hardcover), $19.79 (paperback), $9.79 (ebook)

Reviewed by John Calvin Chatlos, MD

Bipolar Awakenings: The Quest to Heal Bipolar Disorder by Sean Blackwell is a must read for any psychiatrist or psychologist engaged in a serious attempt to understand the often-confusing bipolar disorder diagnosis. As the author admits, he has no academic credentials in this area, but his years of work, meticulous pursuit of credible knowledge, his level of integration, and his personal and determined experiences deserve some academic institution granting him an honorary degree.

While Blackwell recognizes the necessity of psychiatric medications for many individuals with a bipolar diagnosis, he suggests that a significant number of them may be able to resolve their disorder using specific somatic practices which focus on “healing” (a word we almost never hear in psychiatric circles) life trauma, which he believes is the root cause of many disorders. With this claim, the challenge would be for him to work with an experienced psychiatrist to assess whether they think the disorder in specific patients is biological or psychological, which was not the case for Blackwell’s work. However, my addiction psychiatry practice affirms that about half of all clients that come to me with a bipolar disorder diagnosis are incorrectly diagnosed. His alternative explanation that many are trauma related and possibly spiritually related is fully consistent with my clinical experience and judgment. We have seen many of these clients have spiritual awakenings and begin “healing” with a new trauma-focused treatment being developed as cognitive behavior therapy self-transcendent experience.¹

Additionally, through his personal journey and vignettes of many clients diagnosed with bipolar disorder, his dedicated efforts carry the reader through his thought processes and conclusions. In some ways, his work affirms Loren Mosher, MD’s Soteria House² model of “being with” the individual with bipolar-related experiences and recognizing that there is an internal healing process that can be facilitated. He draws on work neglected by mainstream psychiatry of Stanislav Grof, MD,³ highlighting the relationship of psychosis symptoms with spiritual experiences that may intensify to spiritual emergency if poorly understood or poorly handled. Though Blackwell connects with current knowledge of the abuses of the mental health system with incorrect diagnoses, as recently exposed by such authors as Robert Wipond,⁴ he is not antipsychiatry. His critical message is that it is time for psychiatry and mental health to support the awareness of spiritual experience that was opened up with the exploration of the unconscious but missed by Sigmund Freud.¹ Assessment and understanding are presented within the psycho-spiritual developmental framework of Ken Wilber,⁵ that suffices but complicates some matters and requires further exploration. More simply stated, lower cognitive-psychological function and more severe trauma are related to schizophrenia spectrum problems, and higher cognitive-psychological development and less trauma are related to more spiritual emergency type problems. Bipolar disorder is often in between these extremes (Figure 1).

Figure 1. The Spectrum of “Psychosis/Spiritual Emergency” Experiences

His early chapters reveal an often painful but courageous maturation process in pursuing these ideas, moving from being a sharp critic of psychiatry to a seasoned therapist who comes to understand how his somatic practices are best used when working in harmony with wise psychiatric guidance regarding medications. His journey provides great teaching material for trainees in psychiatry, psychology, and mental health settings.

Blackwell’s greatest contributions to psychiatry and the mental health field are 3 revolutionary ideas and 3 revolutionary methods that must be taken seriously and merit psychiatry’s attention. Remember that these ideas and methods are for persons with these problems that are not the biogenetic/medical cases with proper diagnoses.

Revolutionary Idea #1

Spiritual experience and spiritual emergency must be included in mainstream psychiatry. Spiritual experience is real, common, important, and is often connected with mental disorder symptoms. Recent work with psychedelics has made this even more evident.⁶ Spiritual experiences can be intense, and when misunderstood or mishandled, progress to spiritual emergency which may have psychosis symptoms—but not be a mental disorder.

“Whether experienced as a blissful dream, a paranoid nightmare, or a mix of both, the source of what psychiatry labels an “acute psychosis” is (may be) our natural spiritual dimension. This dimension is possessed by every living being, regardless of their belief system.”(Italics added by reviewer)

Revolutionary Idea #2

Schizophrenia, bipolar disorder, and spiritual emergency are part of a spectrum of human experience (in many, but not all cases) that is directly related to severity of life traumas (Figure 2). His explanation and examples of this are detailed and credible, providing further support for revolutionary idea #1.

Figure 2. The Relationship Between Diagnosis, Consciousness, and Trauma

The axis of consciousness comes from Wilber’s theory as a model of cognitive-psycho-spiritual development.

Revolutionary Idea #3

An ever-present spiritual core is holotropic (drives to wholeness) and has natural healing abilities. Blackwell (as attributed originally to Stanislav Grof) calls it an “Inner Healer” that with processes described facilitate its coming forward from within the patient and provides emotional and sometimes physical symptom healing. My work has fully confirmed this idea^1,7 and is successfully being applied in a residential treatment setting.

Revolutionary Method #1

Holotropic Breathwork^TM (developed by Stanislav Grof) for psychosis and bipolar disorder is possible and can be very effective. Holotropic Breathwork is a way of being with a client, and through voluntary over-breathing in a safe setting, opens a trance-like state that facilitates awareness of life events, especially those that are trauma-related, that can then be processed therapeutically. Until now, Holotropic Breathwork has had bipolar disorder and psychosis as contraindications for its application. However, with a few security-related enhancements to the standard Holotropic Breathwork practice, Blackwell has described encouraging results when working with carefully screened clients in a private retreat setting. Psychotropic medication use can be included but must be assessed on each individual case related to severity of symptoms, timing of recent episodes, impact on cognition and emotional awareness, and current adverse effects.

I will alert the reader that there are elements of Holotropic Breathworkthat will be easy to dismiss, especially when it comes to a focus on birth-trauma. Grof’s birth-trauma theories are not accepted by mainstream psychiatry or psychology, but are widely acknowledged within transpersonal circles as one of his great discoveries. I would just urge readers to know that Holotropic Breathworkis a very effective treatment, so do not throw out the baby-trauma with the bathwater. I am presenting these ideas now as I think psychiatry and the American Psychiatric Association (APA) are at a turning point in accepting the power of spirituality.

Revolutionary Method #2

Surrogate breathwork (being done by a trained person such as a facilitator either with or separate from the patient) can be similarly effective.

Since this amounts to psychiatric heresy, I realize I am placing my reputation as an APA Distinguished Life Fellow in jeopardy with fear of ex-communication! Blackwell postulates a “Healing Field” that is beyond the Inner Healer of our spiritual core that can operate from a distance. To have you think that this is not so far into heresy, respected anthropologist Michael Harner, PhD’s⁸ contemporary core shamanism instructs students in ways of connecting with this nonordinary spirit experience for promoting healing in a partner.

Nevertheless, this is a hard one for me to get my mind around. Even with, as I have publicly presented, my own personal experiences of dealing with family members with medication-responsive bipolar disorder; my own medication responsive major depressive disorder; an episode of psychosis resolved in 1 session with a good psychoanalyst; and my multiple ecstatic reality challenging, non-drug related personal spiritual experiences, the presence of a “Healing Field” has escaped my experience. In defense of identifying this as a revolutionary method, after many hours of meeting and talking with Blackwell—who is one of the most science-grounded, rational, open-minded, and nondogmatic therapists I have met—his description of these experiences appears compelling enough for me to make this statement. You must read this book and judge for yourself.

Additionally, anyone that has not had their own personal nonordinary spiritual experience can easily dismiss this entire book as “quackery.” Similarly, anyone that has not had the experiences Blackwell describes about surrogate breathwork, distance healing, and shamanism will almost surely dismiss these ideas based on our materialist grounding. (I do wish he would change the term quantum shamanism to transcendent shamanism or something else. Quantum theory has nothing to do with these macro-level experiences.) Before dismissing these ideas, please read the final words of this review

Revolutionary Method #3

Conscious emotional clearing, the use of body sensations related to trauma-related emotions that when properly processed promote healing. Though this may not be as revolutionary as the other choices, and may be an extension of Bessel Van der Kolk, MD’s⁹ work, I include it here as this would be considered revolutionary if adopted by the mainstream psychiatric community.

In support of my conclusions, I will add that we now have a clear understanding of this spiritual core and how it is psychologically organized within human experience.¹ Clinically we have evidence of how being with the person can open this spiritual core to provide transformational growth with healing and often a new sense of meaning and purpose and faith in life.

Beyond these important psychiatric considerations, Blackwell’s journey is engagingly presented with authentic and self-exposing detail that will provide “grist for the mill” that hopefully will help the APA, psychiatry, and mental health be awakened to these truths. In a closing chapter, Blackwell presents a blueprint of how he imagines his somatic healing processes could possibly work in cooperation with mainstream psychiatry. He also opens a door for the fascinating exploration of his claims with potentially life-changing results. At the least, I hope that this book would lead to all future studies being done on bipolar disorder and schizophrenia including a full trauma assessment beyond excluding or assessing just for posttraumatic stress disorder.

These final words are to anyone that has had personal spiritual experiences and explored the absolutely real, irrational, archetypal, dream-like experiences, and healing powers of our spiritual core who may help psychiatry enter a new dimension of true healing of the psyche/soul. This book is an invitation to step forward and be heard. It is also an invitation to those who have not had spiritual experiences to not dismiss them, but to engage in processes of self-discovery for one of the greatest adventures of your personal and professional life. Open-mindedness, open-heartedness, and open-handedness are the source of our creative forces.

Dr Chatlos is medical director of the Avatar Residential Detox Center in NJ, and professor of psychiatry at the Rutgers-Robert Wood Johnson Medical School, Piscataway, NJ. He is an addiction, child and adolescent, and adult psychiatrist working with spiritual principles in his practice for over 30 years. He is the originator of a “Framework of Spirituality” that describes how spiritual experience is psychologically organized in human experience and has developed successful intervention techniques to address the “spirit/soul” experience. He is an APA Distinguished Life Fellow.

References

1. Chatlos JC. Did Freud miss the discovery of our spiritual core? Religions. 2023;14(2):282-306.

2. Mosher L. Hendrix V. Soteria: Through Madness to Deliverance. Xlibris Corp; 2004.

3. Grof S. Psychology for the future: lessons from modern consciousness research. Spirituality Studies. 2016;2(1):3-36.

4. Wipond R. Your Consent Is Not Required: The Rise in Psychiatric Detentions, Forced Treatment, and Abusive Guardianships. BenBella Books; 2023.

5. Wilber K. Integral Spirituality: A Startling New Role for Religion in the Modern and Postmodern World. Integral Books; 2006.

6. Green WM, Raut S, James FL, et al. MDMA assisted psychotherapy decreases PTSD symptoms, dissociation, functional disability, and depression: a systematic review and meta-analysis. medRxiv Preprint. 2023.

7. Chatlos JC. Is spirituality a master controller for human well-being? Arch Psychiatry. 2024;2(1):23-29.

8. Harner M. The Way of the Shaman. 3rd Ed. Harper Collins; 2011.

9. Van der Kolk B. The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma. Penguin Books; 2014.