Hi everyone,

I apologize if this is not the correct forum, but this is time sensitive "diagnosis" as my friend is currently suffering.

On Saturday (2 days ago), a close friend of mine was halfway through a 14 day Theravada-style retreat when he called me to be picked up. Apparently he was asked to leave because the facilitators were concerned for his well-being. He informed me that  in the past 24 hours he had a traumatizing experience in the forest where he felt "forest spirits" tricked him and injected something into his brain. He felt positive he was going to die imminently. He reported sleeping <3 hours per night during most of the retreat. Ultimately his parents picked him up instead of me, because it became clear this was a psychotic episode induced by his intensive meditation. According to his parents, the retreat facility offered no resources to help the situation (I will be investigating this further, as I find that shocking and disconcerting given the retreat center's otherwise positive reputation).

He was closely watched by his parents the first night, and after sleeping there was some improvement in his clarity of mind and reduced panic, but he still felt like he was being mind-controlled by the forest. On Sunday, I recalled the MCTB chapter "Crazy?" (which seems to directly reference the type of experience he is going through) and sent him the instructions in that chapter to cease all meditation and perform clearly-verbalized resolutions. He reported this helped, and he seemed to have a marked improvement over the course of Sunday.

However, this morning his condition had worsened. His parents brough him to the ER, but ultimately decided to not have him committed to a psychiatric ward. As you may expect, the psychiatrists had never heard of meditation inducing such a psychosis. The current plan is that if his condition stays the same or gets worse by Thursday, they will have him committed.

I am hoping you can help me to help my friend. I've directed his parents to Cheetah House, but apparently the resources they recommended have an 8 week waitlist. He told me he contacted Daniel Ingram, and while Daniel graciously agreed to meet with him, he's currently on vacation. What other lifelines might be available that I can explore to help stabilize my friend?

Potentially relevant details about my friend:

• Practicing meditation for 30-60 minutes 5-7 days a week for 3+ years, mostly via techniques from The Mind Illuminated (anapanasati) and MCTB (Mahasi noting)
  • To my knowledge, he has passed the A&P, has achieved jhana (1-3) a handful of times, but has not achieved stream entry, which was his main goal
• No other past psychotic episodes that resemble this

Thank you so much for any advice or resources you might have. I will answer follow up questions to the best of my ability.

TL;DR
Friend is suffering a traumatizing psychotic episode that was induced while on retreat. The retreat center had no advice. Cheetah House offerings have long wait lists. Daniel Ingram is unavailable for now. Who else can we reach out to that might have dual competency in meditation and psychiatry?

Update: This friend is now relatively stable, and we are in contact with Dan Gilner (https://thecaringspace.net). Things are trending in a positive direction. Also removed personally identifying information.

Is there a therapist or counselor he could speak with while waiting for other resources?

I imagine it would be helpful for him to have a safe environment to communicate what is going on. 

Has he had any episodes like this before?

And does he have a meditation teacher?
​​​​​​​

His family is getting in contact with his psychiatrist, but that psychiatrist is based in Alaska.

He does not have a formal teacher, but the teacher on his previous retreat (last year, not this recent one) was Greg Scharf. If anybody has Greg's contact information, I would appreciate it (feel free to message me directly with that information).

​​​​​​​As stated, he's had no past psychotic episodes that resemble this.

I would recommend they see someone, soon, that they can speak to about the issue. A therapist or a counselor. There's likely someone nearby they could speak with relatively quickly. I think finding them a safe space to communicate their experience ASAP would be helpful. 

Agreed -- I'm hoping to track down someone with meditation+psychiatry dual compentency for him while we wait for his psychiatrist in Alaska to respond.

Hello Matt

I am very sorry to hear about your friend's distressing experience. I hope from the bottom of my heart that he will find relief immediately and on a long term basis he will be able to bring his practice back on track. I want to offer the following to you - some thoughts regarding meditation practice and themechanics of why stuff go wrong. Some resources / advice for the long term -  this is not applicable immeditately, but maybe after this acute distress is taken care of.

Some connected thoughts regarding what could have gone wrong

1. The mind is a meaning making machine - but that meaning making isnt purely based on perception and cognition, it also has a major role for affect to play in the process of the meaning making itself. When we look at a rope and we perceive a snake our cognitive models come into play and trigger the affect function of our mind to generate negative affect. This negative affect gets intertwined in perception and cognition and constructs an entire story about doom that we then act on. The twist here is that our ability to perceive is itself shaped and directed by our affective state as a starting condition. When we are relaxed ropes usually look like ropes but when we are already agitated and feel threatened due to a prior story line then the chances of perceiving a rope to be a snake increases. In fact if there is persistent agitation in the heart without a clear connected story line that we can attribute it to then the mind goes out looking for snakes in order to attribute the agitation to and in that process tends to increasingly see snakes instead of ropes simply to have a neat logically consistent story to make the agitation 'fit'

2. In a retreat like situation where a yogi has the skills to get to the udaya abbbaya nana - but currently has no skill of getting the nana or the knowledge of dissolution, fear, misery, desperation - the yogi is likely to get the experience but not the knowledge. This creates a continuing ongoing experience of agitation in the heart. My theory is that retreats have noble silence in order to prevent people from ripping each other's throats out. I believe your friend experienced the Dukkha, did not get the nanas, continuously stayed in an agitated state for an extended period. His mind then constructed the story of forest spirits poisoning him in order to contextualize and explain away the near continuous agitation he was feeling. This is of course speculation on my part 

3. Is your friend undergoing clinical psychosis the way it is defined in the DSM 4 - I dont know. The clinicians that meet him will have to decide and their advice will have to be taken. But what I can understand is that your friend has the ability to get to the Dukkha Nanas - but is only getting  the experience of Dukkha and has no skill or appropriate guidance of how to get the nana. Your friend has an imbalance of skill. He is good at observation and not good at gaining knowledge and wisdom. I am speaking freely. I dont have any hostility towards your friend or his teachers / retreat guides. But I genuinely think that your friend should from this point onwards not join a 'Sotapanna Factory' like setting and should work with teachers one on one in an at-home atmosphere with his friends, family, parents accessible to him always. After addressing this acute highly elevated state of agitation and perverted dysfunctional perception/cognition, your friend should return to systematic structured practice


Some advice and resources:

1. Your friend should right now seek guidance from qualified clinicians - psychiatrists preferably, maybe therapists and strictly follow their treatment advice.

2. Once the acute maginified distress has significantly reduced, the feeling of 'I am in danger' has passed, your friend needs to educate himself on meditation and how it works

3. Patrick Kearney's talk on google podcasts app on Dukkha and the Dukkha nanas - https://podcasts.google.com/feed/aHR0cHM6Ly93d3cuZGhhcm1hc2VlZC5vcmcvZmVlZHMvdGVhY2hlci81MTYvP21heC1lbnRyaWVzPWFsbA/episode/MjAxNTA5MjItUGF0cmlja19LZWFybmV5LUJNSU1DLW9uX2R1a2toYV9kdWtraGFfbmFuYS0zMjMxOC5tcDM?ep=14

4. An article on when practice gets rough - https://www.reddit.com/r/Arhatship/comments/11z7cyn/when_practice_becomes_tough/?utm_source=share&utm_medium=web3x&utm_name=web3xcss&utm_term=1&utm_content=share_button

5. An article on how to get the nana in the dukkha nana - https://www.reddit.com/r/streamentry/comments/osqhcg/vipassana_the_progress_of_insight_part_3_dukkha/?utm_source=share&utm_medium=web3x&utm_name=web3xcss&utm_term=1&utm_content=share_button

6. A way of getting back to practice as and when your friend does get back to practice - while keeping his physicians in confidence - https://midlmeditation.com/meditation-for-anxiety

7. Teacher suggestion in case your friend would like to engage with them - Stephen Procter - midlmeditation.com, r/midlmeditation (reddit)


​​​​​​​I hope your friend finds relief. Best of luck to him and to you.

If you can't locate contact info for Greg Scharf try reaching out to the administration at Insight Meditation Society in Massachusetts they should be able to connect you (Greg's a layman who also spent some time as a Theravadan monk; he taught there at a retreat I attended).

Good luck getting your friend grounded.

Sounds like he is in good hands. Let the psychiatrist  deal with the acute phase. Let him get grounded.  . Sounds like he is somewhat of an advanced meditator.   He had a hard time crossing the abyss in the DN . Ego fought back.  He might have some issues he needs to deal with a therapist for a while than re implement  practice(gradually). I have a gut feeling he is on his we to stream entry 
​​​​​​​

 Hi,

Do you want me to share your post with the emergent phenomenology research consortium maillist? There are people in there who have skill in handling this sort of thing. There are also people he might be able to talk to about the experience, either now or when more stable, who will be able to relate, as this actually happens to many people.

For context, I know several pople (e.g. in the EPRC group), who have had seeming psychotic episodes during meditation retreats or outside of it, some of whom have been forced hospitalized for a bit, and though these were not easy experiences to integrate, have moved way past it without recurrance and are now doing fine or better than fine.

Also, if this is really an emergency, I can signal boost your message to Daniel Ingram, as I think he's probably as good as it gets for handling this kind of stuff. But busy indeed.

Let me know.

As an fyi, people like David Lukoff, who is one of the people responsible for the introduction of the V62.89 Religious or Spiritual problem into the DSM, list (1) acute onset of the episode, (2) good functioning previous to episode, and (3) an exploratory attitude towards the experiences, as good prognosis factors usually leading to good outcomes. At least (1) and (2) seem to be the case with your friend.

IMHO, just my 2 cts, a degree of insight, some ability to distance oneself from the experiences and to maintain some form of critical judgment around it, although it may still be really weird and disturbing, is an important factor as well.

Best,

​​​​​​​Olivier
 

@oliviers yes, I think sharing with the EPRC would be helpful (edit: my email is mattrslattery@gmail.com if anyone wants to contact me directly).

Regarding V62.89 Religious or Spiritual problem features, my hope is we can convert him to 3) as well. Thank you for that reference!

I'm going to reach out directly to Daniel now and try to fill in the gaps of where he's at and what his availability looks like.

Thank you everyone for the help so far. I'm super appreciative of the community coming together for this one.

Update: My friend is doing better today. Me and two other friends are visiting him tomorrow at his request. We're going to relax, play some games, get some good laughter in, and ground him down.

​​​​​​​Someone helped put me in contact with Dan Gilner who worked with Dr. Willoughby Britton to develop Cheetah House. Dan is going to meet with us Wednesday and Friday.

I think we're on the right course of action now. Thanks so much for all the advice and support. Will update again when there's more to say.

That's really good to hear. I'm glad that you're getting him the right help, he's lucky to have you. I hope he gets through this soon. 

Matt, out of caution and discomfort with the amount of information you have posted about a third party, does your friend know you're posting this here? Do they approve of this information being posted?

These boards are publicly available, and we need to be careful about posting personal or medical information that could be used to trace someone or use the information in unhealthy ways.

That said, it is impressive how the group here has jumped in to assist.

Chris M
DhO Moderator

Chris,

I have mentioned to him that I posted to online forums asking for assistance, to which he did not seem to care and was thankful. He has shared intimate details of his practice in other forums, but I appreciate your concern and will remove some of the identifying information, just to be extra cautious.

Thank you, Matt. 

Hey Matt,

I'll assume I can then hold off from reaching out to the group now that your friend has found support?

Please continue to update the final point.
No one ever gives the conclusion to these issues.
Thanks for the info.
​​​​​​​~D

Yes Olivier, you can hold off on sharing with the group. I believe my friend has what he needs for now. 

I'll do my best to close the loop on this, and share which resources were most helpful. 

Hi Matt,

Sorry for the late response, it sounds like you and your friend have the resources you need to resolve their problem.

Unfortunately, most meditation centers and teachers don't want to acknowledge that meditation induced psychosis exists. Having experienced this twice during and after intensive retreats, the measures I would recommend it seems your friend has been taking: stop meditating, get more sleep and undertake activities that ground your mind in your body. If your mind is still making things up, it might be worthwhile to see a psychiatrist and get a prescription to an anti-psychotic for a couple months, something like risperidone (Risperdal). These drugs all have side effects, but if you only take it for a couple months, long enough for the symptoms to subside (assuming you don't have a history of psychosis), then there should be no long term issues. Anti-psychotics helped a lot when I had an incident of meditation induced pychosis in 2011. Ultimately, your friend needs to decide whether their mind can handle the intensive altered states of conciousness associated with a long retreat and act accordingly. In my case, the answer was "no", so I don't do long term retreats anymore.

Best wishs and I hope your friend does better!

       svm

Matt, 

What is the name of the retreat center?
What kind of meditation were they teaching?
Who was leading the retreat?

Thanks,

Hi everyone,

I'm the friend in question who had a psychotic episode. I’m stable and doing well all things considered - actually, now that the dust has settled, I’m doing better than I was leading up to the retreat. Everything feels nice and flowy. Conversations with others are much more fruitful and a thick layer of anxiety has been removed. I did relieve a lot of trauma on this retreat, so it makes sense that I’m feeling good, despite having a bout of psychosis. There are some very minor symptoms still remaining, which I’ll get into. 

I want to start by saying THANK YOU. Going through all these posts on this platform brings a tear to my eye. It feels so comforting that random people on the internet who have no idea who I am are willing to take time out of their day to lend a helping hand to someone in need. This truly is such a wonderful and supportive community. Thank you.

Outside of doing recreational drugs or alcohol, this was the first time in waking reality that I felt out of control. There were lots of unknowing events that I’d like to diagnose, but not in this post. What I’ll do is give you background info about myself, a very very very brief description of the retreat, the trauma and its aftermath, what helped/didn’t help in my recovery, my current symptoms 2 weeks later, and a conclusion. I will probably post a separate thread with my phenomenological retreat experience and cross post it from this thread. 

Know that this is going to be a long response. While I’ve tried to be as brief as possible, I also wanted to give you the full picture. Most importantly, I’ve put in a lot of information that I wish I knew about before going on a retreat like this. A lot of these traumatic events could’ve been avoided. I put most of the blame on myself, but I also think the culture around retreat centers in the US is too lax. I was dismissed from a retreat and left to my own vices without any sort of support. They didn’t even give me a flyer with helpful websites or hospitals that I could go to. That seems crazy to me. I’m so lucky I have the support network of friends and family and like minded practitioners who were willing to talk me out of these delusional states, give me tools to prevent them from coming up, and made me hopeful for my future. 

​​​​​​​This post has been very difficult to construct. Knowing that I’m probably going to say something that future me will cringe at, produces a lot of anxiety. I’ve also made myself pretty vulnerable in hopes that someone who is on a similar path will read this, relate to it, and alter their trajectory. If I do a meditation faux paw or you think something should be omitted from this post, please let me know and I will edit it out. 

If you wanted to cut the amount of reading in half or are in dire need of a strategy to ground down, you could probably start the story at ‘symptoms days after the retreat’ and read from there.

I wanted to avoid posting an attachment pdf, but I'm having trouble with DhO formatting (IE: everything is bolded and I can't change it - haha). Anyways, here's the pdf. The intro is the same thing you just read, so you can just skip to 'relevant background information,' and read from there.

___________________________________________________________________________________________________________________________________________________________
Sources that helped when I was at my worst

Talking to someone:

• https://www.cheetahhouse.org/
• https://thecaringspace.net/ 

Valuable readings that gave me techniques and tools

• MCTB “crazy?” https://www.mctb.org/mctb2/table-of-contents/part-vi-my-spiritual-quest/61-crazy/ 
• MCTB “Those damn fairies” https://www.mctb.org/mctb2/table-of-contents/part-vi-my-spiritual-quest/62-those-damn-fairies/ 
• MCTB2 entire book https://www.mctb.org/wp-content/uploads/2021/09/MCTB2_Complete_PDF_Final.pdf 

Thanks for posting all of this.

For what it's worth, I was on a 16 day retreat where I kept getting more and more dialed in and continuously noting right at the point of arising, and I had a number of experiences that coorellate to yours --- but for better or worse, you win the extreme experience prize!   It was all very magical/energetic and it would lead to non-knowing events and I'm-going-to-die purification events, but it also was very very very draining/exhausting. (Which was the main clue that it wasn't  wisdom.) What I call it now, a decade-plus later, is a "A&P-Reobservation loop".

Basically, I was dialed in the A&P vibe, went through the nanas in a very 3rd jhana/manic way, and I would reach my limits in a kind of near-death purfication state that would break apart into an enlightenment experience. And this experience gave me EVEN MORE clarity and energy and kept me right at the cutting edge of experience in a very 3rd jhana/manic way, and I would reach my limits in a near-death purfication state and it would break apart into an enlightenment experience.... etc. etc.  But if you think about it, all of this was mostly the ten corruptions of insight: illumination, knowledge, rapturous happiness, tranquility, bliss, resolute confidence, exertion, assurance, equanimity, ... or maybe the 8 corruptions, because there wasn't true EQ nor true tranquility

I also thought I had SE and what I was going through "post SE cycling"... but actually, I knew in my heart that couldn't be it. The path wasn't this cruel, was it? What I was going through was too draining, too unhealthy, too extreme...  I stopped before I destroyed myself, but I was still weak for a month or two after the retreat and there was no way I could/should meditate (which is another clue that it wasn't wisdom/SE...)  

Well anyway, that's my story with nearly going off the rails on retreat.

For what it's worth, a "A&P-Reobservation loop" is where the meditator carries too much effort and doesn't gently surrender in Reobservation. If you meet reobservation with lots of energy, it doesn't send to you to SE, it sends you to the closest thing --- which is an A&P event. The A&P event seems like SE, but it isn't. An A&P event has that "data download" kind of feel and feels stunning in it's significance. It feels like being on the ragged edge of reality, etc. etc. 4. The Arising and Passing Away – MCTB.org

"When we do have a distinct A&P event, it can happen in three basic ways corresponding to some combination of the three characteristics, just as can happen at the entrance to insight stage fifteen, Fruition. The A&P and Fruition are easily confused for this and other reasons. There is great variation in the specifics of what we are seeing and feeling when we cross this profound and often intense event, but certain aspects of A&P events will be common to all practitioners. A&P events tend to manifest in a way that can mimic the three doors (described in a few chapters) at about the middle of the out-breath, leading to an “unknowing event”, which consists of moments about which we know little. During unknowing events, the sensory information available to us is very sparse or vague..."

Anyway, for me the end of this particular phase of practice was I licked my wounds for two months, then realized I wanted a teacher. I gave myself a month to find someone in-person, but when I couldn't I decided to work with Kenneth Folk over video-call. He normalized a lot of stuff for me and helped me deal with the raw FEAR I felt when I restarted meditation. He got be back to focusing on the basics, relax and note, relax and note. The 10 corruptions of insight arose, but they didn't corrupt because I relaxed and noted. I realized that mastery wasn't anything fancy, it was just getting good at relaxing and noting. And eventually I fell into SE at home in a very non-dramatic way. 

Now that I've actually had SE, it's clear that back then I didn't. SE is very simple, plain, complete, and healing. No mania, no egotism, no pride, no mega-wow factor. Just really simple. Like a candle being blown out. Like putting a spoon down after eating a bowl of soup. Simple. Nice. Good. Done.

(Yes, perhaps people get SE like Daniel, like being a race car out of control... so I might be wrong, who knows? I don't know everything for everybody. I could be wrong... But 99% of people who truly get SE have long periods of EQ that preceeds it. If there aren't days/hours of simple, plain, spaceous, calm sitting... non "energetic", non "mystical", non "magical" sitting... then 99% chance that the person is probably in an A&P-Reobs loop.)


Glad you're doing better and hope you find a gentle and healthy and healing path forward. Best wishes for your future practice (when the time is right to practice again.) 

Be gentle and kind to your self! Thanks for the report and may all beings benefit from this conversation!!

Thank you Shargol. This is the third time you've given me really on point advice and I really appreciate you taking the time to both read my 16 page essay and write out these heartfelt responses.

Man, hearing all these adverse psychosis experiences amongst high level practitioners makes me think that everyone has gone through a bout of psychosis in their practice (though maybe that's just comfirmation bias since that's been my general vibe as of late). It's good to hear (but also a little scary) that this is a normal occurence.

I agree that there was probably a lot of fake equanimity in there, but I do think there was some of the real stuff too. Days 4 - 6 were incredibly tranquil and clear headed. Days 5 and 6 in particular was when I really felt like I nailed down samadhi. Everything became so clear and content. In fact, day 6 felt so freaking normal that I quickly got bored with anything meditation related, so I opted to just go on walks through the forest instead of sitting. Now that I write that out, that restlessness and aversion to practice kind of sounds like reobservation minus the consistent buzzing thought cycle. hmmm.

Looking back at the words I used in the post, "punching through reobservation" was hardly what happened and the word 'punching' was probably the worst verb I could've chose. In fact, it was the opposite of that. In reality, I just surrendered everything and welcomed all emotions: whether it was meta, karuna, anger, sadness, restlessness, equanimity, or what have you. And the surrendering was legit, I had already learned about faking it days prior. Unfortunately I couldn't talk much about the lead up to anything, because the post was already so long, and I mostly just wanted to talk about the traumatic event itself so other people knew to avoid the super super common trap of accidentally plugging themselves into a tree.

On the other side of the coin, I now recognize what my mind is capable of, and having intensely studied the PoI no doubt puts me at risk for scripting. Not to mention, not having a teacher to call me on my shit probably makes it even more of an issue. I try to hold true to the line "be honest with yourself," but I'm sure there are more pieces to the scripting puzzle.

FWIW, I don't think any of the things that happened the day of the traumatic event were insightful in terms of the 3Cs. Maybe I learned a thing or two about how to give up control in a non striving, fake, sort of way. I certainly learned a lot about my own psyche and the dangers of meditation, but as to gaining insight into the 3C's, I agree with you, they were very superficial and didn't have a lasting imprint. In fact, that whole day seemed superficial.

Before your post, I was on the fence about having attained SE. On one hand, i was almost certain that a lot of the events perfectly matched both yours and daniels cessation definition (some of the events at least). At the same time, my timeline and sensitivity to energy and rapture is indicative of someone who crossed the A&P, not attaining SE.

TBH, I dont really care about diagnosing SE at this point. What I do care about is cycling and if my own diagnosis of how I cycled matches others based on my phenomological description. If there was anything to diagnose, I'd really wondered if that was truly the realm of maleability, or if it was just classic AnP event stuffs (I'm guessing the latter). Feeling like you can do anything - powerful resolutions - gaining insight or jhanas that you thought were unobtainable, seems to fit in both the Anp-unknowing event category AND malleability-conformity knowledge category. So confusing.

I'd still like to give a bit more info about the lead up to some more profound unknowing events, both to understand cycling better and to learn more about these unknowing events so I can decipher them myself in the future. However, if you don't think that would be helpful to me or this community, please just say so and I won't write it out. I promise I won't be offended.

Anyways, thank you again for sharing your story and for the valuable insight into the situation. I always get excited when I see your name in the comments of the SE subreddit and DhO.

Take care.