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Voices Beyond the Threshold Isabel Clarke Consultant Clinical Psychologist.

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Voices Beyond the Threshold Isabel Clarke Consultant Clinical Psychologist
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Page 1: Voices Beyond the Threshold Isabel Clarke Consultant Clinical Psychologist.

Voices Beyond the Threshold

Isabel Clarke

Consultant Clinical Psychologist

Page 2: Voices Beyond the Threshold Isabel Clarke Consultant Clinical Psychologist.

The Talk

• What threshold – A psychological framework for understanding non ordinary experience

• Managing the threshold - Therapeutic approaches• Understanding the transpersonal aspect• The transformative dimension.

Page 3: Voices Beyond the Threshold Isabel Clarke Consultant Clinical Psychologist.

Different types of experience: psychosis and spirituality revisited.

What is the connection between the journey of life: the journey of therapy, and the spiritual journey?

• Why can some people manage to adust to difficult transitions

• Whereas other people find themselves in a different dimension?

• How is it that for some people this experience is creative and transformative?

• Whereas for others it is the opposite?• What can we learn about this other dimension – and

how can this help us to stand beside the journier?

Page 4: Voices Beyond the Threshold Isabel Clarke Consultant Clinical Psychologist.
Page 5: Voices Beyond the Threshold Isabel Clarke Consultant Clinical Psychologist.

O the mind, mind has mountains; cliffs of fall

Frightful, sheer, no-man-fathomed. Hold them cheap

May who ne’er hung there.

Gerald Manley Hopkins (from ‘No worst, there is none, pitched past pitch of grief’)

Page 6: Voices Beyond the Threshold Isabel Clarke Consultant Clinical Psychologist.

Travel into the strange places of the mind

Not mind safely locked inside the skull;

No!: mind that envelopes us;

Mind that is sea we swim in

Travel across the threshold – the Transliminal – but never to let go of Ariadne’s thread!

Page 7: Voices Beyond the Threshold Isabel Clarke Consultant Clinical Psychologist.

Characteristics of the other way of experiencing

• Metaphor come to life• Dissolution of boundaries

Page 8: Voices Beyond the Threshold Isabel Clarke Consultant Clinical Psychologist.
Page 9: Voices Beyond the Threshold Isabel Clarke Consultant Clinical Psychologist.

• Cosmic significance – terrible or wonderful• Confusion about the self

Page 10: Voices Beyond the Threshold Isabel Clarke Consultant Clinical Psychologist.
Page 11: Voices Beyond the Threshold Isabel Clarke Consultant Clinical Psychologist.

• Coincidence rules OK• Threat (cosmic)• Link with trauma

Page 12: Voices Beyond the Threshold Isabel Clarke Consultant Clinical Psychologist.
Page 13: Voices Beyond the Threshold Isabel Clarke Consultant Clinical Psychologist.

Two Views of the person

• people are rational beings, with, needs, plans and aspirations, who function more or less well, unless they turn out to have an 'illness'

– Static• people are perpetually seeking definition through dreams and

symbols, and deeply dependent on important relationships; easily knocked off course by loss of any of these props, and perpetually trying to balance the inner state.

– Dynamic and in flux.

Page 14: Voices Beyond the Threshold Isabel Clarke Consultant Clinical Psychologist.

Getting a scientific grip on the transliminal

The split between realities comes from the split in us!

• Interacting Cognitive Subsystems provides a way of making sense of this ‘crack’.(Teasdale & Barnard 1993).

– An information processing model of cognition– Developed through extensive research into memory and

limitations on processing.– A way into understanding the “Head/Heart split in people.

Page 15: Voices Beyond the Threshold Isabel Clarke Consultant Clinical Psychologist.

BodyState

subsystem

Auditoryss.

Visualss.

Interacting Cognitive Subsystems.

Relational subsystem

ImplicationalMemory

Propositional subsystem

PropositionalMemory

Verbalss.

Page 16: Voices Beyond the Threshold Isabel Clarke Consultant Clinical Psychologist.

Linehan’s STATES OF MIND (from Dialectical Behaviour Therapy) – Maps onto Interacting Cognitive Subsystems

EMOTION

MIND

(Implicational subsystem)

REASONABLE

MIND

(Propositional Subsystem)

WISE

MIND

IN THE PRESENTIN CONTROL

Page 17: Voices Beyond the Threshold Isabel Clarke Consultant Clinical Psychologist.

Using ICS to understand the Transliminal

• Non-ordinary experience: when Emotion Mind/Implicational does not mesh properly with Reasonable Mind/Propositional

• This leads to a different quality of experience – fine in the short term – a problem when stuck

• Normalising the difference as well as the continuity – shared and unshared reality

• Sensitivity and openness to anomalous experience – continuum with normality

• Understanding the role of emotion – the feeling is real; the ‘story’ is improbable

Page 18: Voices Beyond the Threshold Isabel Clarke Consultant Clinical Psychologist.

Important Features of this model

• Our subjective experience is the result of two higher order processing systems interacting – neither is in overall control.

• Each has a different character, corresponding to “hot” and “cool” cognition.

• The Relational Subsystem manages emotion – and therefore relationship.

• The verbal, logical, propositional ss. gives us our sense of individual self.

This gives us the two ways of knowing:• The Everyday or Shared Reality (when Relational and Propositional

are in synchrony)• The Transliminal or Unshared Reality (when they are in

desynchrony).Both of these are available to all human beings.Both are incompleteThe transliminal has always both fascinated and spelt potential danger!

Page 19: Voices Beyond the Threshold Isabel Clarke Consultant Clinical Psychologist.

Evidence for a new normalisation• Schizotypy – a dimension of experience: Gordon

Claridge.• Mike Jackson’s research on the overlap between

psychotic and spiritual experience.• Emmanuelle Peter’s research on New Religious

Movements.• Caroline Brett’s research: having a context for

anomalous experiences makes the difference between– whether they result in diagnosable mental health

difficulties– whether the anomalies/symptoms are short lived or

persist. • Wider sources of evidence – e.g.Cross cultural

perspectives; anthropology. Richard Warner: Recovery from Schizophrenia.

Page 20: Voices Beyond the Threshold Isabel Clarke Consultant Clinical Psychologist.

Being Porous: therapeutic approach • Some people are more open to this type of experience

than others – cf. Schizotypy• Sensitivity and openness to anomolous experience – continuum

with normality• Positive side as well as vulnerability• Validating the experience • Normalising the difference in quality of experience as well as the

continuity – understanding the transliminal so that it can be recognized – give choice

• Motivation to engage with shared reality• Manage the threshold – mindfulness is key

Page 21: Voices Beyond the Threshold Isabel Clarke Consultant Clinical Psychologist.

Linehan’s STATES OF MIND (from Dialectical Behaviour Therapy) – Maps onto Interacting Cognitive Subsystems

EMOTION

MIND

(Implicational subsystem)

REASONABLE

MIND

(Propositional Subsystem)

WISE

MIND

IN THE PRESENTIN CONTROL

Page 22: Voices Beyond the Threshold Isabel Clarke Consultant Clinical Psychologist.

Managing the threshold

• Awareness of vulnerability – of openness to transliminal experience

• Grounding when the experience is overwhelming. Grounding activity. Grounding food.

• Mindfulness to manage the threshold• Challenge of facing unshared reality mindfully – both

pleasant and unpleasant• Transliminal state of mind = most accessible at high and

low arousal • Managing arousal – breathing control to reduce arousal;

mindful activity in the present to prevent it slipping.

Page 23: Voices Beyond the Threshold Isabel Clarke Consultant Clinical Psychologist.

Psychosis and the Transpersonal Dimension

• ICS offers a challenging model of the mind• The human being is a balancing act as the two

organising systems pass control back and forth: there is no boss.

• The mind is simultaneously individual, and reaches beyond the individual, when the implicational ss. is dominant.

• This constant switch between logic and emotion gives us human fallibility

• The self sufficient, billiard ball, mind is an illusion• In our implicational/relational mode we are a part of

the whole.

Page 24: Voices Beyond the Threshold Isabel Clarke Consultant Clinical Psychologist.

‘That’s How the Light gets in’ (and the dark)

• The Relational part of our mind is embedded in relationship; in the whole (the older part)

• The newer, self conscious, part holds our individuality• Temporary control passing backwards and forwards

between the two organising ss is experienced as normality

• When the ‘relational’ takes over for any length of time, the character of experience changes

• The person is no longer grounded in their individuality – boundaries dissolve – they are open to any influences – positive and negative.

Page 25: Voices Beyond the Threshold Isabel Clarke Consultant Clinical Psychologist.

Web of Relationships

Self asexperienced

in relationshipwith primary

caregiver

Sense ofvalue comes

from rel. withthe spiritual

primarycare-giver

In Rel. with wider

group etc.

In Rel. withearth:

non humansetc.

Page 26: Voices Beyond the Threshold Isabel Clarke Consultant Clinical Psychologist.

What does this say about the possible transpersonal dimension of psychosis?

• Taking experience seriously – experience of possession

• Experience of cross generational healing• On the other hand – the transliminal is governed by a

logic of both – and……

Page 27: Voices Beyond the Threshold Isabel Clarke Consultant Clinical Psychologist.

Psychosis – Potential for Transformation

• Traditions such as Psychosynthesis and Spiritual Emergence/Emergency recognize the transformational potential of the transliminal.

• They tend to distinguish between ‘psychosis’ and transformational crises

• More and more this is seen as a false dichotomy – Spiritual Crisis Network (.org.uk)

• Mike Jackson’s Problem Solving – Paradigm Shifting model.• Click into another dimension for a wider perspective – with the

danger of a vicious circle getting set up – getting stuck• Role of stigma in trapping people.

Page 28: Voices Beyond the Threshold Isabel Clarke Consultant Clinical Psychologist.

The What is Real and What is Not Programme – designed to combat stigma

First : Form an Alliance. • Validate their reality • Introduce the idea that their reality is only one way of looking at it:• shared and unshared reality (negotiate the language).• The individual’s experience is taken seriously and valued – at the same

time as working on a better relationship to shared experience• It is possible to get away from illness language – and arguments about

diagnosis

Normalising openness to unshared reality – idea of the schizotypy spectrum

• Advantages and disadvantages of openness to unshared reality

• – e.g. of people who have used unshared reality positively.

Page 29: Voices Beyond the Threshold Isabel Clarke Consultant Clinical Psychologist.

Characteristics of unshared reality. • Idea of the line/ the threshold.• Importance of being able to manage the line• Motivational aspect – pros and cons.

Coping skills to manage the line• When is unshared reality most powerful; in charge?• Arousal as a means of being in control; • Stress management• Being alert and concentrated – watch out for drifting states• Grounding in the present• Wise mind and mindfulness• Focusing/mindfulness v. distraction

Page 30: Voices Beyond the Threshold Isabel Clarke Consultant Clinical Psychologist.

Session 2. The role of Arousal shaded area = anomalous experience/symptoms are more accessible.

Level of Arousal

Ordinary, alert, concentrated, state of arousal.

Low arousal: hypnagogic; attention drifting etc.

High Arousal - stress

Page 31: Voices Beyond the Threshold Isabel Clarke Consultant Clinical Psychologist.

Linehan’s STATES OF MIND applied to PSYCHOSIS

Ways of coping suggested by this approach – management of arousal and constructive activity.

Page 32: Voices Beyond the Threshold Isabel Clarke Consultant Clinical Psychologist.

Final Session:Making sense of the experience

Why do people click into/get lost in unshared reality/the transliminal?

Discussion of Different meanings for the experience• Meaning for the individual• Place in their life – what was happening in their life

when it all started?• Address and validate the emotion – that is reliable. • 'Problem Solving' idea – Mike Jackson’s research.

Page 33: Voices Beyond the Threshold Isabel Clarke Consultant Clinical Psychologist.

Contact details, References and Web addresses

[email protected]• AMH Woodhaven, Calmore, Totton SO40 2TA.

• Clarke, I. (Ed.) (2010 Forthcoming) Psychosis and Spirituality: consolidating the new paradigm. Chichester: Wiley

• Clarke, I. ( 2008) Madness, Mystery and the Survival of God. Winchester:'O'Books.

• Clarke, I. & Wilson, H.Eds. (2008) Cognitive Behaviour Therapy for Acute Inpatient Mental Health Units; working with clients, staff and the milieu. London: Routledge.

• www.SpiritualCrisisNetwork.org.uk• www.isabelclarke.org


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