VariousPills“You’re taking a lot of garbage.” Those words, spoken to me by a psychiatrist newly evaluating my case, changed my life.

At the time I was on two antidepressants, two mood stabilizers, and an atypical antipsychotic. I had also been prescribed Oxycontin for the neck disease and chronic pain that had ended my surgical career. Between 2000 and 2006 I had deteriorated from fully functioning physician to obese, pre-diabetic, mentally dulled psychiatric patient and opiate addict.

And yet, when this good doctor stated the obvious, that this enormous load of medication was destroying me, my response was furious and immediate. How dare she question the drugs that were keeping me alive? I ran back to the psychiatrist who was prescribing most of that medication, and she comforted me. Of course I needed my pills, she crooned.

But the question had been raised. Were these drugs helping or harming me? In time, I came to admit they’d destroyed my health and undermined my capacity to engage life. My denial broke down. I returned to the new provider and worked with her over the next five years to taper off all the medications.

It wasn’t easy. At times, as moods roared and pain burned, I yearned for the soothing numbness of the pills. When that happened, I slowed the taper and sometimes reversed it. I also listened to my new psychiatrist, who told me she thought my only hope was some kind of spiritual solution. Since I knew her to be an addiction specialist, and given my long history in Alcoholics Anonymous, I understood what she was suggesting. Easier said than done, I thought.

After all, I’d experienced intense religious visions in 2000. Those so-called psychotic states had led to my second psychiatric hospitalization and, ultimately, to my brain’s marination in psychopharmaceuticals. Yet those visions hadn’t transformed me into a more accepting, tender-hearted person. If anything, they’d merely amplified my grandiosity and then, when I found myself reduced to a dull-witted mental case, fueled my shame.

But I trusted the doctor and did my best. I attended Buddhist meditation groups and embarked on long silent retreats. I renewed my commitment to Quakerism. Having been converted to Catholicism in the aftermath of my visions, I even went in for the occasional mass. I immersed myself in a strain of Hinduism offered at a meditation center a mile from my house. I studied Chinese medicine and learned to administer acupuncture, which I viewed as a powerful tool for recruiting the placebo effect; in other words, as a means of awakening the healing qualities we all harbor within. In time, I took up yoga and began teaching anatomy to aspiring yoga instructors, work that led me to find ways of merging Western science with Eastern non dual philosophies.

The accumulated effect of all this exploration has been profound. I find myself so deeply accepting of my sorrow, pain, and misfortune, that I actually believe they have served me. They have softened my heart and opened me to reality so thoroughly that I no longer make demands on the world. I don’t hope it will protect me or care for me in ordinary terms, but I am convinced it participates with me in extraordinary ones. (If you want a more detailed explanation of how I see this working, read this recent essay.)

What does all this mean for me as someone who blogs about mental illness? I no longer see myself as speaking to the mentally ill. Rather, I believe my audience–such as it is–to be suffering spiritual rather than neural malaise. I began exploring this idea some time ago, in a post that attracted more attention than most of my pieces. But my thinking has progressed since then.

It’s not that I don’t believe in psychiatric distress. Of course I do. It’s not even that I reject the use of medication. After a year or so off all the pills, I decided that life goes easier for me when buffered by low doses of mood stabilizers.

What I do question, strongly, is the possibility of true mental health without wholesale transformation of one’s relationship with the world. As long as we judge ourselves by conventional standards of success and failure, those of us who suffer with mood instability, anxiety, dissociation, and the like, will see ourselves as inferior to the seemingly strong folk who buckle down and muddle through.

But if we view¬†the past’s catastrophes as formative rather than merely ruinous, we can begin to reframe our understanding of life and of ourselves. We can find peace in the midst of chronic pain, persistent sorrow, and all the other aftereffects of trauma. And with that peace we become healed, even as we remain more sensitive and wounded than the larger world.

With that qualified form of recovery, healing with a small “h”, we recognize that what’s really sick isn’t the mind that admits pain; it’s the culture that insists on rejecting rather than learning from it.