When May-May Meijer (49) was admitted to a psychiatric clinic almost ten years ago, she spoke continuously with Christ. People thought that was strange, she says. “They said it was because of my psychosis. But when I went to a church after my admission, the priest said, “God is in us.” You see, I thought. I’m not crazy! When I told the others in church that I’m talking to God, they said, ‘How beautiful, so am I.’”
The psychosis is over, but God has remained. “I will not deny that I was sick. It felt like there were ghosts in my body, I felt them flowing like when you swallow hot tea. But it was also a spiritual transformation. I still talk to Christ. My environment had to get used to that. I used to work as a scientist, and now all of a sudden I go to church!”
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Let’s call psychoses ‘unusual experiences’, that’s a bit more neutral
Meijer’s trepidation does not come out of the blue, Samrad Ghane knows. As a medical anthropologist and psychologist, he has been treating refugees and migrants with psychological complaints for years. He knows that in mainstream psychiatry there is not always room for a spiritual view of psychoses. “Within Western psychiatry, there is a naturalistic view of the world. Physicians reject anything spiritual or supernatural.” Psychoses are seen as a disease in which the patient has lost contact with reality. The patient suffers from hallucinations and delusions. For example, they think there is a plot going on against them and don’t trust anyone anymore. They often become disrupted: they no longer eat or sleep, they are unable to go to work or other obligations.
“Let’s call psychoses ‘unusual experiences’ for convenience, that’s a bit more neutral,” says Ghane. “The diagnosis of ‘psychosis’ is only an interpretation. In some African cultures, people with such experiences are considered the chosen ones [zie kader]. Their ‘treatment’ consists of learning to tolerate and use those gifts. They can give advice to others by, for example, communicating with ancestors and thus become an important figure in their community. The same occurs in Indonesia, Mongolia and Mexico, for example, where shamanism is known.”
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Traditional healer
The University of Groningen and the mental health institution Parnassia investigated a rural community in the South African province of KwaZulu-Natal. People who suffer from what we in the West would call psychosis have a calling according to the community. When they get complaints, for example hearing voices, their loved ones regard them as mentally ill. But from a mentor they receive training as a traditional healer, the initiation. They learn how to channel the voices in their heads so that they don’t sow confusion but give advice. This is how they gain status within their community. According to the researchers, this approach contributes to recovery and reduces stigma.
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Spiritual or sick?
In the Netherlands, about one in a hundred people has to deal with what is called a psychosis in the West. It is unknown what portion of those considers such an experience to be a supernatural gift. In the transcultural outpatient clinic of the mental health institution Parnassia, where Ghane works, he rarely sees people who call their unusual experiences a gift. “Logical, because these people were looking for help. Why seek help if you don’t see your experience as a problem? I want to give patients space in their search: is it a disorder, a spiritual experience or a result of trauma?
It was precisely for this purpose that mental health care paid little attention, May-May Meijer found. “Most healthcare providers do not discuss the content of the psychosis. They see spiritual experiences as part of the disease. It’s about becoming ‘normal’, while many life questions arise during a psychosis. When psychiatrists show that they see my experience of God as a delusion, it feels like a value judgment about me.”
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Meijer now devotes herself to what Christ instructed her to do during her psychoses; she and others founded the international Peace SOS foundation, with which she organizes food aid campaigns and peace demonstrations. Christ also instructed her to be open about her susceptibility to psychosis. “At first I was ashamed. But through Christ I am open about it.”
Dawit* (33) also gained important insights during his psychosis. “When I was four I came to the Netherlands with my parents from Ethiopia. During my psychosis I heard a voice that reproached me that as a child I always wanted to play with the blond children. In my delusions I found myself a white supremacist, a kind of supreme Nazi. I was ashamed: my ‘true nature’ had been discovered. I saw only one way out: to end my existence.” His suicide attempt failed and he woke up in a psychiatric clinic.
Even with Dawit, the caregivers did not discuss the content of his psychosis. “It was only after two years that I dared to say that my delusions might have meaning. That contributed a lot to my recovery. Of course I wasn’t a white supremacist, but I had tried to be someone I wasn’t. Now I have more insight into my identity and more peace with myself.” Dawit is now psychosis-free and no longer on medication.
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What is psychosis and how do you treat it?
In psychosis, people see or hear things that are not there. The age group between 14 and 30 years is most often affected. The form, intensity and duration of psychosis varies from person to person. Risk factors include trauma and drug use. People who belong to a minority group are also more at risk, because they experience social exclusion more often. 8 percent of all adults have had ‘psychotic experiences’, such as hearing voices or feeling extreme suspicion. Treatment often consists of medication, so-called antipsychotics, which dampen hallucinations and intense feelings of anxiety. But the underlying causes – such as trauma – are not removed.
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Cultural context
Image by:
Petra Katanic
In transcultural psychiatry, the context is central, says professor of transcultural psychiatry Mario Braakman. “We don’t judge patients solely on the basis of symptoms, but also look at their environment.” Within the circles of transcultural psychiatrists, the story is told that even Jesus was psychotic, says Braakman. “He spoke to God, came to save the world. The fact that he did not end up as a psychotic in a clinic but founded a world religion is related to his environment. If you’re unlucky, you live in a rational culture that associates anything deviant with illness.”
Research shows that first- and second-generation migrants of non-Western origin in the Netherlands have a greater chance of being diagnosed with schizophrenia than Dutch people without a migration background. One explanation is that they are often misunderstood. “For example, some patients believe they have an evil eye; someone harmed them by looking at them with a jealous look,” says psychologist Ghane. “That may be a very common explanation in their cultural context.” Both Ghane and Braakman emphasize that even the DSM, the ‘psychiatry bible’ that prescribes the standard for diagnosis, states that a disorder is only a disorder if someone deviates within the cultural group to which he belongs.
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I now know that I am not possessed, I have a neurobiological problem
It usually takes longer for patients with a migration background to reach mental health care. “If the extraordinary experiences are not perceived as a problem, they do not seek help. In the long run, someone sometimes poses a risk to themselves or others. In that case, a forced admission is necessary, which could perhaps have been prevented.” Because often patients have already completed a treatment program with traditional healers.
The consequences of such treatment are not always beneficial, Hafiza William (52) experienced. “Around the age of 28 I became more and more confused, I lived in a dream world that I couldn’t get out of. My father sent me to an acquaintance. He called himself an Imam, but was not qualified. In Surinamese Islamic society they believe that you can get rid of your jinn – an evil spirit that has taken possession of you – if you talk to an imam. But that man said I was a bad Muslim, it was a punishment from God. Surinamese didn’t want to talk to me after that, I felt lonely and isolated. My mother remained loving and eventually advised me to see a doctor.”
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Hafiza William (52) on the beach near her house, where she can be herself without judgement.
Image by:
Petra Katanic
Good help
William ended up in the emergency room. “I got a good psychiatrist and meds. In the years that followed, I started to delve into neuropsychology and spirituality. I understand why people link psychosis to possession, but now I know I’m not possessed, I have a neurobiological problem. I have to watch out for my limits: don’t make too many appointments, sleep well, eat healthy.”
Whatever one’s take on the extraordinary experience, good help is basically the same, says psychologist Ghana. “The starting point is the patient’s own interpretation. Does someone come to me because of a ghost? Okay, then we’ll get started on that. How can we strengthen you so that you can better withstand the evil attacks of that spirit?” Braakman: “We psychiatrists often think that we know exactly what reality is. A little modesty would do us good.”
*Dawit’s name has been changed for privacy reasons.
A longer version of this article appeared in March 2022 in OneWorld Magazine.
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‘I wanted to connect with my African side’
Liesbeth Tjon-A-Meeuw moved ‘back’ to Ghana.
Liesbeth Tjon-A-Meeuw moved ‘back’ to Ghana.
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