Review: Mental Disorders and Spiritual Healing: Teachings from the Early Christian East by Jean-Claude Larchet
A Review by Jennifer Doane Upton
[This review appeared in Vol. 12, No. 1 of Sophia: A Journal of Traditional Studies]
Mental Disorders and Spiritual Healing presents the viewpoint on mental disorders held by the early Church Fathers, and in so doing provides a fresh “new” look at psychotherapy, as seen from the standpoint of a tradition which knows the human being as composed of body, soul and Spirit, and gives precedence to the Spirit. The author, Jean-Claude Larchet, is a practicing psychiatrist as well as an Eastern Orthodox Christian.
As moderns, we commonly hold to psychological assumptions based on the ideas of Freud, Jung, behaviorism etc., or on the belief that all consciousness is derived from physical processes within the human brain. This book cuts through many of these assumptions, which treat emotion and emotional energy as if they could be dealt with without reference to morality or the basic disposition of the will, and certainly without reference to the Spirit. For instance, Larchet posits the union of soul and body, but does so in a far different manner than many modern theorists. It is fashionable nowadays to say, in opposition to Cartesian dualism, that “soul and body are one,” but many of our contemporaries who assert this do not seem to have any clear idea that the soul exists in its own right. “By affirming that a human is at once soul and body,” the author says, “they [the Fathers] opposed every form of materialism and naturalism that denied the soul or reduced it to being an epiphenomenon of the body, or something derived from and determined by the body.”
According to Larchet, in the union of soul and body, the soul takes precedence over the body; it is active, the body passive. He quotes St. Makarios as saying, “The soul, which is a subtle body, has enveloped and clothed itself in the members of our visible body, which is gross in substance.”
Mental Disorders and Spiritual Healing maintains that mental illness is from three sources: the somatic (body), the psychic (soul), and the spiritual. The somatic level is related to our familiar idea of that mental illness is caused by imbalances in brain chemistry and physiology, if not by actual physical trauma. On the psychic level, mental illness is caused primarily by demonic influence, though it is pointed out that demons are attracted to pre-existing psychic dispositions. Mental illness resulting from the spiritual level is based on the perversion of human free will—sin, in other words—though the author makes it clear that the misuse of free will affects the other two levels as well, albeit not in as central a manner
This places mental illnesses of a physical origin in a much different perspective than that adopted by modern psychology. Larchet takes issue with our assumption that medieval monks and the early Fathers posited demonic activity only because they were ignorant of the physical causes of mental illness. He quotes Gregory of Nyssa as maintaining that “We are aware that mental aberrations do not arise from heaviness of head [drunkenness] alone, but skilled physicians declare that our intellect is also weakened by the membranes that underlie the sides affected by the disease, when they call the disease frenzy [phrenitis], since the name given to those membranes is phrenes.” However, Larchet points out that “In cases where an organic disorder is clear, the function of the physician is. . . limited to the physiological level alone. [To affirm] that in such cases the soul in its very nature is not harmed, and hence preserves its autonomy, hampers the claim of a certain kind of medicine or psychiatry to take charge of the human soul through the body and dictate to it its own ideas and values. In cases where the origin of the disease is physical, it is only the soul’s self-manifestation that is compromised; its essence is left intact.”
The author admits that it is often difficult to discern the true origin of mental illnesses, given that they can have three distinct etiologies, and a major element in this difficulty is the fact that appearances by their nature tend to lead us astray. This is certainly true when the illness is of demonic origin, particularly since our materialist assumptions do not even allow for this possibility. Larchet says:
If ‘profane’ or ‘rational’ medicine chooses to ignore such a demonic etiology, it is because it accepts phenomena as the only reality that can be objectively considered. . . True, it is especially difficult to determine the presence of demonic influence, to define its manner of acting or to gauge its importance. Such an understanding escapes the eyes of the profane. Only those who have obtained the charism of the discerning of spirits from God are capable of exercising this spiritual discrimination.
This limitation of diagnostic skill to one possessing certain spiritual gifts posits an authority higher than materiality and profane human knowledge. Clearly a postmodern mindset resists accepting such authority. Consequently, in talking about healing from the effects of demonic activity, Larchet is led into a discussion the charism (sacrament) of Baptism. He says:
. . .the Christian, by the grace received in Baptism, is freed from the tyranny of the enemy and always retains the power of opposing demonic activity. According to St. Symeon the New Theologian, Baptism gives us ‘freedom no longer to be held against our will in the devil’s tyranny,’ and ‘the enemy cannot take any action against us unless we of our own will obey him.’
The author speaks of the appropriate treatment for mental illnesses of a psychic nature as the product of a collaboration between the patient and the healer(s). Thus, in addition to a reorientation of the will through prayer and fasting, which the Fathers recommend, Larchet speaks of the spiritual intervention of the saints as a powerful form of treatment. It might be objected that, if psychic illnesses are partly based on the misuse of the will, and given that the will is free and that no-one can will for another, it is up to the patient to reorient his will to the Spirit and thus to heal himself. This would seem to deny any legitimate role to “outside” spiritual intervention, such as the prayer of a saint or of the patient’s friends and family. I would answer that in the case of possession, the door to the demonic may have been opened by a misuse of the will, but by the time the possession has really taken hold, the illness is beyond the control of the will. It is now the will of the demon that must be subdued, and this can only be accomplished by theurgic means, such as exorcism:
If the Fathers tried to have the possessed/insane participate as much as possible in their own deliverance, it is because the individual must, if he is to be delivered from demonic influence, turn his will from himself and orient it toward God. God, in effect, does not grant healing unless it is asked of him, for he has granted man free will and in all the cases respects his will and will not act against it. However, the will of the individual is not always fully at his disposal. . .Those who are disturbed in a significant way cannot even ask for their own healing or give evidence of their faith. . .And yet it is possible for such individuals to be delivered and healed thanks to the faith and the prayers of those around them or accompanying them, as well as to those of the saint to whom they are entrusted. But the power of the saint’s intercession is so much stronger when the faith of those asking for the deliverance of the possessed is more ardent and their prayers more fervent.
Spiritual illness has precisely to do with a perversion of the individual’s relationship to God. According to Eastern Orthodox tradition, the Fall affected both the Intellect and the will; consequently some spiritual illnesses (acedia in particular; see below) repeat and accentuate the darkening of the mind resulting from the Fall. According to the early Fathers, some (but not all) mental illnesses actually derive from the spiritual level, though their effects nonetheless appear on the level of the psyche per se:
Mental illnesses of spiritual origin should not be confused with the spiritual illnesses themselves. Spiritual illnesses are formed by a disorder or perversion of nature (more precisely of nature’s mode of existence) in the personal relationship of the individual to God. On the psychic plane, mental illnesses correspond to somatic disorders on the plane of the body; mental illness has to do with difficulties in the psyche considered in itself, with a dysfunction of the psyche’s nature considered within its natural order. . .From the point of view of Patristic anthropology, such a distinction can only have a relative value, for nature can never be considered in isolation and is fundamentally defined by its relationship to God.
This is clearly not how we view mental illness in today’s world; and equally foreign to the postmodern mindset is the idea expressed by the author that such things as fear and sadness are actually passions. We can easily understand anger and lust as passions, but it is harder for us to see fear and sadness as such, because they show the passions to be essentially “passive,” whereas we like to think of them as vital and dynamic. According to the Fathers, the passions take control of our will and force us to passively act according to their agendas instead of being true to ourselves. Thus the cure for them is action in its truest sense. Pure act is to center in God —who, according to Aquinas, is Himself “Pure Act.” The essence of pure action is prayer.
Not every passion gives even the appearance of an excess of vitality, such as anger or lust seem to do. Larchet deals at some length with the more negative passions of acedia and sadness. Sadness is a direct and conscious feeling of loss, while acedia is more like a general deadening of all life; one has “lost the taste for life.” (Since the author points out that some of the Fathers do not distinguish between acedia and sadness, I will use the term acedia alone from here on.)
Acedia is characterized by a deadness of the senses, and even more so by a deadness of the feelings. A person afflicted by acedia has great difficulty in finding any meaning in life. In a recent article entiled “A Requiem for Friendship” [Touchstone: A Journal of Mere Christianity; September, 2005) Anthony Esolen complains that the youth of today are no longer as alive and “youthful” as young people once were; this could certainly be classed as a form of acedia. Acedia is a passion that pervades the modern world. It lowers spiritual expectations and thus draws people into an acceptance of hopeless materialism. It pervades every aspect of life, and as such its origin is difficult to isolate. According to Larchet, it is in the very nature of acedia that its victim should be relatively unconscious of it, since it always produces a decrease in awareness, and even on occasion a physical sleepiness. It is clear that the term acedia covers much of what we would define today as depression.
Larchet maintains that acedia especially attacks hermits—those attempting to do spiritual struggle in solitude—though he makes clear that those living the active life are not exempt from it. If, as I believe, acedia is a particularly modern malaise, it may because we moderns are emotionally isolated by our conditions, whether or not we are spiritually struggling in a conscious way. Spiritual struggle, according to Larchet, is the key to the healing of this condition, not really its cause. The great temptation when confronting acedia is to distract oneself by seeking novelty. Restlessness is a major symptom of it—and who could be more restless than modern man? A special case of this restlessness is dissatisfaction with the place where one lives, which of course makes it difficult to establish domestic roots and thereby overcome social isolation. Jungian psychologist Marion Woodman, in a lecture given in the early 80’s, commented on the tendency among many of her clients to spend their spare time in restaurants, bars, coffee shops—anywhere but at home. Part of the reason for this behavior is that such people are trying to heal their acedia through contact with others. Larchet, however, maintains that this condition can only be healed through solitary struggle. One must directly resist the tendency to sleepiness, lack of awareness and loss of energy, not simply run from it.
Another result of acedia is our inability to value our homes, our habit of considering them merely as places to “crash.” Many of our contemporaries who groom themselves impeccably for the workplace allow their places of residence to fall into disarray and even squalor. If we could live content within our homes, we would be far less tempted to turn our houses into mere economic commodities.
Mental Disorders and Spiritual Healing concludes with a chapter on simulated mental illness: the tradition of the “Fool for Christ.” The Fool for Christ is one who consciously takes folly upon himself for spiritual purposes. This phenomenon seems to have largely disappeared from the Christian tradition in our time, but it was of great importance in the early church, and this importance certainly continued, in Russia, at least up to the time of the revolution (if not later).
Anyone can be a saint, and this includes the illiterate, the simple and the innocent—none of whom Larchet considers as Fools for Christ in the precise sense of this term. The simplicity of such people is related to a poverty of experience imposed by conditions. For example, the author does not consider Dostoevsky’s character Prince Myshkin from The Idiot as a true Fool for Christ, since Myshkin’s innocence is congenital, not adopted. The folly of the true Fool for Christ, on the other hand, is consciously simulated:
He pretends to be a fool, has chosen to appear the fool, and does everything he can to seem to be so in the eyes of others, so that he is really believed to be a fool. He controls every act and word, precisely calculating their effect. For certain individuals who have discovered his secret or he himself has chosen, he lays aside this mask of foolishness, just as he does whenever he is alone, and reveals himself to be perfectly sound of mind.
The Fool for Christ deals with the realm of appearance as precisely that: appearance. Christians often squirm at what they consider to be the “Eastern idea” that this world is in some respects illusory. But the Fool for Christ acts within the world as if it were in fact an illusion—and how can any Christian claim to believe that this world is real in the same sense that God is real, given the otherworldliness of Christ Himself, whose “kingdom is not of this world”? When Satan, “the Prince of This World,” is called “the father of lies,” this is a way of indicating that the fallen world in which we live is not entirely what it seems—or at least what it seems to us in our fallen condition. Eve, who precipitated the fall of Mankind, brought about a darkening of the human intellect, while the Theotokos, through her receptivity to the Holy Spirit, brought salvation to mankind in the Incarnation of Jesus Christ —and this salvation entails a metanoia, a renewing of the mind. But if our minds are to be renewed, we must confront the illusions that dominate us, not run from them.
If, according to the Patristic dictum, “God became man that man might become God,” we might say that the Fool for Christ becomes an illusion so that those in a state of illusion might come to Reality. Clearly this is a vocation that one must be called to, and one that should not be attempted without great spiritual maturity. Larchet recounts an instance of spiritually advanced monk who was considering taking on the responsibilities of a Fool for Christ, but was cautioned against this by his spiritual director. After all, the world of illusion is by its very nature tricky and deceitful, and to enter into this world is necessarily to take on some of this quality of trickery, either consciously or unconsciously. There have been those who have attempted to mimic insanity, who in so doing have lost their grip on reality, and slipped into insanity itself.
Mental Disorders and Spiritual Healing clearly reveals dimensions of patristic psychology that are not what most of us would have expected. It is a book that should be of interest to people in many fields, laymen as well as professionals. Its unique insights will be of benefit to anyone sincerely seeking a greater self-knowledge—the sort of knowledge that is based on the true, but now largely forgotten, stature of humanity.