Being in spiritual life for decades, I have come to a stunning realization that in spiritual societies there are a disproportionate number of practitioners who have mental health issues. Surprisingly and unfortunately these issues go unnoticed and therefore untreated. One of the reasons for this is that people in the spiritual circles lack knowledge about mental health issues and the second is that these mental health issues are many times mistaken for spiritual achievement. One of the common mental health issues which I have personally witnessed in my own institute and ashram as well as in my Guru’s ashram is Delusional disorder. The tricky thing about delusional disorder is that people who have delusional disorder may be highly functional in all areas of life except in the area in which they have the delusion, so this can go unnoticed for years. Because tamas has some similarity with sattva, a highly dysfunctional tamasic person can be mistaken for a supreme transcendentalist called Avadhuta. I have seen examples of this in Vrindavan. Similarly, a highly delusional person may be mistaken for a great realized spiritualist. Therefore, I thought it will be helpful for the spiritual community to have knowledge about this fact so that the problem can be recognized and addressed. The following article is written in collaboration with Jessica Richmond (Joshika Devi Dasi), a Licensed Mental Health Counselor from America who has many years of experience in various mental health hospitals dealing with patients with a variety of mental disorders, including delusions. She now spends half of the year in Vrindavan at my ashram working with the local devotee community and devotees internationally. She is also teaching to psychotherapists how to apply Vedic Psychology to get to the root cause of mental health imbalances.

A CLINICAL EXAMPLE OF DELUSIONAL DISORDER

To give an idea about the mind of a person who has delusional disorder, here is a conversation from her practice: “I know my daughter is going to come back home for her 30th birthday. She wouldn’t be so cruel to leave me like that and not come back,” Rhonda said, her glassy pale blue eyes gazing past me into the distance, as if she was looking at her sweet daughter. “Where is your daughter now, Rhonda?” I said, trying to get her to admit to the reality, which is that her 29-year old most beloved daughter, Heidi, died tragically 6 months ago after years of a valiant battle with ovarian cancer. “She is in heaven,” Rhonda gazed at me and smiled confidently, then added, “But Heidi is a good girl and she will be back for her birthday this May. It is only 42 days away, and she will be here. I just know it.” I tried another angle to snap her out of it… “So, where is Heidi’s body right now, Rhonda?” She smiled pleasantly, “Heidi’s body is on my mantle at home in an urn.” “So you are saying that Heidi’s body is in ashes, is that correct?” “Yes,” Rhonda agreed, nodding her head assuredly, still smiling. Good, I thought to myself, at least she agrees that her daughter’s body is in ashes…now I have a foundation as a starting point to poke a hole into her delusion. “So, Rhonda, let me ask you one question, if I may?” “Sure, anything,” she calmly replied. “Okay, so if Heidi is in heaven, and her body is in ashes on your mantle, how is she going to come down from heaven and get back into that body, which has been burned into ashes? I don’t understand. Please explain how this will happen?” Rhonda maintained that same superficial look on her face – that plastic smile that was covering up her immense pain, and peacefully said, “My baby will be here. I’m throwing a big 30th birthday party for her. She will wear all pink to her party, her favorite color. She is such a kind person, with such a big heart. She will never let me, her best friend, down. She is very reliable, she will come. Just wait until May 21st. You will see what I mean.” “Rhonda, I still can’t imagine how Heidi could come to her birthday party. This isn’t making any sense. It sounds like you have thought about what will happen if Heidi comes, but what will happen if Heidi doesn’t come? Have you at least considered that option? Are you prepared to deal with the let down you will feel if Heidi does not show for this birthday party you are throwing for her?” Rhonda smiled the same smile as when she walked in the door, and repeated her mantra, unflustered, “Heidi will show. Of course she will show to her own birthday party.” It was at this point that I realized that no matter what I said, no matter what reasoning I used, Rhonda was completely fixed in her delusion. Her thoughts would not budge. These thoughts were protecting her from feeling the immense pain of the loss of her daughter – pain that was so overwhelming that her mind created some other reality. This may seem far out of the realm of many reader’s experiences, as most devotees don’t spend too much time working with clients at mental hospitals. But, delusion is a disorder among devotees – unfortunately, one that goes undiagnosed all too often. In the case of Rhonda, it turned out to be pretty clear-cut in getting her help. I phoned Rhonda’s friend, explained Rhonda’s problem and the friend brought her to the psychiatrist and got her on the proper medication. When Rhonda returned to see me next time, her daughter’s birthday had passed, she was properly medicated and she was out of the delusion. We spent a few months processing her deeply cutting and desperate pain of the loss of her darling daughter Heidi, and her thoughts eventually were normalized.

DEVOTEES IN DELUSION

Unfortunately, working with devotees afflicted with delusional disorder is not so easy. In fact, working with actively suicidal and homicidal devotees has proved to be easier than working with devotees in delusion. Delusion is difficult to break through. It is like an iron-clad wall of beliefs that a person has, that no psychotherapist, in fact, not even the Guru’s words nor direct orders can penetrate. You may laugh or scowl in disbelief, but we are only reporting what we are seeing. Until now, you may think someone around you who isn’t changing perhaps has just a big ego, or has made some offenses and that is the culprit for lack of progress, or maybe they are stubborn or narcissistic. But possibly there is more to their story. They may actually be in a delusional state of mind and not know it.

Delusion is defined by The American Psychiatric Association DSM-5 as, “fixed beliefs that are not amenable to change in the light of conflicting evidence,” (APA, p.87). The beliefs are irrational. According to Bhagavad Gita, the root cause of delusion is the influence of rajas and tamas on buddhi. In the 18th chapter, Krishna describes three divisions of buddhi:

pravattia ca nivattia ca karyakarye bhayabhaye
bandham moksam ca ya vetti buddhih sa partha sattvika

O Arjuna, that intelligence which discriminates between the paths of action and renunciation, between what is to be done and what is to be avoided, between that which results in fear and that which causes fearlessness, and between bondage and liberation, is sattvika.

yaya dharmam adharmam ca karyam cakaryam eva ca
ayathavat prajanati buddhih sa partha rajasi

O Arjuna, that intelligence by which one comprehends inaccurately what is righteousness (dharma) and unrighteousness (adharma) and what ought to be done and what is forbidden, is rajasika.

[What it means is that buddhi is unable to discriminate between right and wrong and rather presents the truth in a distorted manner]

adharmam dharmam iti ya manyate tamasavrta
sarvarthan viparitams ca buddhih sa partha tamasi

That intelligence which, being covered by ignorance, conceives unrighteousness as righteousness and all things as contrary to their real nature, is tamasika, O Arjuna.

[In other words such an intelligence presents the reality just the opposite of what it is].

The person who is in delusion does not see things as they are because his or her intelligence is influenced by rajas or tamas or both, and it is the intelligence by which a person comprehends things around them. Depending on the intensity of the influence of rajas and tamas one has corresponding intensity of delusion. According to the intensity of the influence of rajas and tamas, the delusional disorder can be classified into three categories.

• Impenetrable and Completely Unaware. People in this category are unaware of their delusional disorder, which is so intense that it is impossible to make them aware of their problem. They may be highly functional in their life and charismatic and very convincing. For that reason, they can have followers because they have the power to convince others. Because they are highly convinced about their delusion they are also very devoted to their concepts. Their delusion is a result of predominant tamas complemented by rajas.
• Impenetrable but Aware. The intensity of delusion here is lesser than in the previous category, therefore it is possible for them to become aware of their delusions, yet it is difficult for them to get out of it even after knowing that they have delusion. This category of people will rationalize their delusions, taking support from the scriptures. Therefore, they will also be convincing to others. Their delusion is a result of predominant rajas complemented by tamas.
• Penetrable and Aware. The intensity of delusion here is less, therefore they are aware of their delusion and it is possible for them to accept that they have a delusion. For this category of people they are willing to accept help to come out of their delusion. Their delusion is a result of predominant rajas complemented by sattva.

If one’s intelligence is polluted, then it is almost impossible to break through and make the person understand what actually reality is. We perceive things with our senses which send information to the mind but it is the buddhi which makes us comprehend the perception. It is at this level of comprehension that delusion occurs. Every human being is prone to delusion because the buddhi of a common person is always under the influence of the gunas, which keep on changing. But a person who has a delusional disorder is different because he or she has a chronic and constant misconception that is impenetrable.

There are numerous types of delusions that one can have, and they must persist for at least one month in order for it to qualify as a delusional disorder. Detailed below are the six delusional disorders that we have either seen directly in devotees, or have heard stories about devotees in ashram life. A common characteristic of individuals with delusional disorder is the apparent normality of their behavior and appearance when their delusional ideas are not being discussed or acted upon (APA, p.93).

• Persecutory delusion – belief that an individual is being conspired against, cheated upon, spied on, followed, poisoned or drugged, harassed, or obstructed in pursuit of long-term goals. The affected individual may engage in repeated attempts to obtain satisfaction by legal action. Individuals with persecutory delusion are often resentful and may resort to violence against those they believe are hurting them.
• Referential delusion – belief that certain gestures, comments, environmental cues, and so forth are directed at oneself when they are not. Taking hint on the basis of these cues, they act with confidence that they have received a divine message.
• Grandiose delusion – when an individual believes that he or she has exceptional talent, or insight or of having made some important discovery, or of having some special relationship with a prominent individual, or that they themselves are a prominent person. Grandiose delusions may have a religious content and the person may believe himself or herself to be empowered as savior of humanity.
• Erotomanic delusion – when an individual falsely believes that another person, usually of higher status, is in love with him or her. They are obsessed with the person with whom they think is in love with them and they may stalk him or her.
• Somatic delusion – when an individual believes one or more things about his body parts: that he/she emits a foul odor, there is an infestation of insects on or in the skin, or an internal parasite, that certain parts of the body are misshapen or ugly, or that parts of the body are not functioning. Even a visit to the doctor will not dispel the belief.
• Jealous delusion – when an individual believes that her spouse or lover is unfaithful and clings to their delusion with a righteous unshakable zeal. The belief is arrived at without due cause and is based on incorrect inferences supported by small bits of evidence. The individual in delusion usually confronts the lover and attempts to intervene in the imagined infidelity.

(American Psychiatric Association DSM-5, p.90)

It is possible that a person has more than one of these types of delusions. The general understanding in the devotee community is that just by performing one’s sadhana, one will be cured from one’s disorders. There is some truth to it. One can find scriptural statements in support of it, since bhakti is the panacea for every problem. However, just as when we have some physical ailment, we are advised to take help of a qualified physician, similarly when one has a mental disorder, one should take psychiatric help. Indeed, taking psychiatric help is more necessary in the case of mental disorders because they are very subtle in comparison to physical problems.

In the follow-up articles we will analyze and give examples of the six types of delusion from the devotee community.