Does anyone here have any experience, personally or second hand, of significant psychological disturbances resulting from a 10 day vipassana retreat (or similar)? I ask as a family member of mine attended a retreat, was asked to leave after day 7 when her behavior became erratic and once out descended into mania and subsequently psychosis. She was hospitalized and put on strong anti-psychotics and was severely destabilized for months. I won’t go into the details of what she endured, but suffice to say it was shocking and deeply distressing for her and everyone who loves her. Even years later the event has a profound hold on her and her perspective of herself. She went from being ‘normal’ person, to experiencing her grasp on reality slip away and now has to live with the understanding that she is someone with the capacity to rapidly descend into madness. The stable reality in which we all live and exist and can assume to be consistent is no longer a guarantee for her – a terrifying realisation that follows her everywhere she goes.

I hope this won’t be a contentious topic as of course most people here will be big proponents of the practice. I myself know the value of both the daily practice and have completed four 10 day retreats (it was my idea that this family member attend a retreat in the first place). I personally meditate each day and have had life changingly positive experiences on retreat. I ask not to denigrate the practice but to find some sort context to help integrate and hopefully move past what happened to her. The response from anyone at the center where she essentially went insane has been shamefully inadequate – flippant and dismissive would be an understatement.

The internet is full of anecdotal stories of people experiencing similar issues, but details are scarce. The vipassana / Goenka organization also alludes to the practice being potentially dangerous in their entry form disclaimer that people with mental illness should not attend and that the center workers are not medical staff. That is fair, but what is not fair or ethical is to have knowledge that this practice can ruin lives and minds and not be forthright with the details upfront. Given the size of the organization and the number of people attending retreats the heads of the organization simply must have more information about this issue than they seem prepared to divulge.

Any related experience or thoughts would be gratefully received. I first posted this on reddit and was advised that people on this forum may have some knowledge to share on the topic.

What are you expecting from folks here? 

RE: Vipassana and Psychosis

After four ten-day retreats do you believe in a “stable reality in which we all live and exist and can assume to be consistent?”

maybe I’m nitpicking and you mean that on some relative kind of level; though I really wonder who in the world— if really pressed — would say they live in such a place. 

Ideally I'm hoping to hear from people who have either experienced or know someone who has experienced the same issue, with detail on what precipitated the issue, what they learned from it, how they integrated the experience into their life and what (if any) the long term impact of such an experience has been (etc).

Not an expectation per se, but more a hope that someone may have some information that my family member may find useful from the perspective of being 3 years out from the experience and still struggling somewhat to come to terms with what happened to her.

Hi - thanks for your reply. I understand what you are implying, that there is far more to 'reality' than our surface level day to day perception of the world. When I write about a stable reality I am referring to the workaday conciousness that we by default exist in. You or I can return in a practical sense to this state of perception regardless of whatever interesting and useful insights we have about the nature of reality. My relative lost this capacity due to her experience in a Vipassaba (thankfully tempororilty) and was unwillingly thrust into a terrifying world where she was convinced that her family were out to perform medical experiments on her, thought she was a spiritual healer who could communicate via telepathy, did not sleep for 5 days and needed to be forcably restrained and sedated as she was becoming a physical risk to herself and others etc etc. I'm just hoping to help her understand why it happened and what it may mean (though appreciate these are likely complex questions that may not have simple answers).

I don't wish to be antagonistic at all but I was hoping to hear from anyone who has experienced a similar psychological crisis after meditation rather than have a discussion on the nature of reality (unless doing so helps my family member integrate and move on from her experience). Hopefully people understand that when I refer to a stable reality in which we all live and exist I'm simply talking about a day to day experience of the world in which we are able have basic experiences such as interpersonal communicatuib, sleep, shopping, taking a bus etc without crisis or confusion.

RE: Vipassana and Psychosis

someone very close to me behaved like the woman you are describing. After a series of crises — divorce, death of her sister, and more — she had a manic episode that was very paranoid, wild and disturbing for all those close to her and she ended up being restrained and hospitalized. She’d go back to a kind of normal but any kind of high stress or life drama would bring on another manic episode until her medication was dialed in and she consistently used it. 

I wonder if a person with normal-seeming mental health  but with a potential for mania in times of crisis could be triggered into mania by the stress inherent in a ten-day vipassana retreat. 

Hi LB,

Check out my memoir, Silicon Valley Monk, located here. Basically, something similar happened to me on a jhana retreat in 2011, except I never had to be physically restrained. As far as long term side effects, well, I was on about a half dose of an antipsychotic for about 6 months and seeing a therapist, then went off it. It had little impact on my daily life after that. W.r.t. the reaction of people at the retreat center, the center (well known in the vipassana community) I was at basically dumped me into the emergency room of the local hospital. Someone came to visit while I was in the emergency room, but I was still hallucinating at that point, and I think they called once after I was home.

I also contacted Willoughby Britton, a professor at Brown University, who has done research into people who have had psychotic episodes at meditation retreats (and lived to tell about them, some people don't), and particpated in one of her studies. I also talked with her about organizing a meeting to discuss the issue, but she advised waiting until her research was complete. I think last fall I saw where such a meeting was being held in LA.

The basic problem is that at the time the health and wellness literature was full of reports about how great meditation was for your mental health. Nobody said anything about the possiblity that you could develop psychosis. Since then, there have been a couple articles about the problem. I was pushing for having meditation teachers give a warning talk now and then, but nobody seems willing to do it.

Hope that helps.

Thank you for sharing Mike, the symptoms sound similar. She is now off medication and is more or less stable in her day to day life but the fear remains that she may experience some sort of trigger that sends her towards her mania or even psychosis.

Some have speculated that she may have some long suppressed childhood trauma (she strangely barely remembers her childhood) and that Vipassana somehow unlocked or enearthed these memories in a way that she was not able to process. We have since experimented with very moderate amounts of meditation (say, 10 or 15 minutes per day) but almost immediately she started having difficulty sleep so stopped.

Thanks for sharing svmonk. I will check out your memoir for sure.

Your situation sounds very similar to my relative's. She was kicked out of the course by staff who didn't know how to handle her and her condition deteriorated badly and within 48-72 hours she was restrained and being admitted to a psych ward for her own safety. I was with her the whole time and to be honest am somewhat traumatised myself by what I witnessed, and live with a degree of guilt as to whether any of my actions may have furthered the extent of her decline. Frankly I was emotionally under equipped to deal with her condition and did not respond as calmly as I should have done.

Anyway, she was on anti-psychotics for 9 or so months while she stabilised her life. She is in relatively good shape now and actively manages her mental state by a focus on regular sleep, exercise, nature, diet, no booze/drugs etc. She also had regular contact with Willoughby Britton who you reference and who was a real source of support and information.

As you say, the potential for meditation to cause psychological damage is either overlooked or ignored in the mainstream press (and often, sadly, even amongst experienced meditators). People new to the practice then charge headlong into very intensive retreats like those run by Goenka's organisation and unwittingly expose themselves to great harm. I suspect as proportion the numbers of people who have these experiences are very small, but given the large numbers of people who attend 10 day retreats then in absolute terms there must be a very significant number of negative outcomes. I just don't believe that the organisation aren't aware of this and as such their refusal to engage meaningfully with the risks (ie, proactively warn of the potential dangers, have staff trained in spotting students in difficulty and having a response beyond simply repeating the buddhist dogma espoused by Goenka) seems irresponsible and unethical.

Very sorry to hear about your friend.

I talk with an awful lot of people who have various bad side-effects of meditation, and in the last two months talked with three people who were hospitalized and put on meds after meditation retreats who had no previous psych history of consequence. One probably really just needed some good trip sitting and normalization. Two others were more severe, and so, while meds and a hospital helped, they also could have benefitted a lot from more, such as maps and normalization of what occurred.

Three in two months is a somewhat higher rate than is usual, but certainly not the worst month I have ever had in my 25 or so years of of helping people navigate in the wilder and often darker end of what can happen from intense (and sometimes not so intense) meditation and other varieties of spiritual openings.

If you don't know the book "The Stormy Search for the Self", by the Grofs, definitely check it out. While a bit heavily Freudian and a bit dated, it still has real value. If you haven't checked out www.mctb.org, its section on the Progress of Insight, Chapter 30, is recommended, particularly the section on the Dark Night. Also, A Path with Heart, the chapter on Expanding and Dissolving the Self, has some helpful advice, as does its section on Riding the Spiritual Roller Coaster.

Over the years, I have probably talked with a few hundred people who went on Goenka retreats, had some massive opening that was an odd mix of amazing and seriously destabilizing, and went on to damage or wreck their lives. I really shouldn't pick on Goenka in particular, as it can happen with any retreat and technique, except that I should. Those at the top of the organization know full well what can happen and still, despite over two decades of pressure, staunchly refuse to admit there is a problem, staunchly refuse to properly train their teachers, staunchly refuse to warn potential students of how bad it can be, staunchly refuse to provide adequate monitoring of people on the runway to crazyland so they can back them down if possible (not always possible), and blame the negative effects entirely on the meditator, failing utterly to admit that this stuff is simply not entirely safe even for the previously highly sane and stable and that they could in any way be a part of all that damage. I think that people should be given a truly fair warning of the risks, benefits, and alternatives in the beginning so they can make their own informed choices, and they should be given normalizing frameworks, maps, resources, follow up, support, grounding techniques, and advice for them and friends/family when things go wrong.

I am currently traveling with my father in SE Asia where internet connections are not great (in Siem Reap, Cambodia at the moment), but, if you want, I would be happy to talk with your friend when time and internet connectoin permits, a service I offer freely and many take me up on. My email is d an i el _ i ng r am (at) int er acti ve bud dh a (dot) c om without the spaces, spelled out that way to avoid spam bots.

Very best wishes to all who do this,

Daniel

LB, you need to be kind to yourself. Are you seeing a therapist who can help you deal with the level of guilt you have? Having been involved in a situation like this with a close family member what I can offer to you is that the person who is suffering from the mental "collapse" is indeed the person to focus on, but to do that well and properly you need to first forgive yourself. You can't address their situation through a fog of your own guilt and other emotions. We always want to blame someone but that's not the way to healing and recovery.

Hi LB,

I've recently (~4 months ago) had a manic episode turned to psychosis, my second one to date. The last two posts made here in my personal log were right when the condition started. I was hospitalized for around a month afterwards. This didnt happen during retreat, but maybe my experience with it will be helpful in some way. I don't think you'll get a satisfying answer to your direct question, psychosis covering so many mindstates and meditation already being so subjective.
I really relate to your friend, having had childhood trauma and a lack of memories from that time in life as well.

Right after (~2 months) the first episode, which was 1.5 years ago, I went on a retreat. Generally this is probably not a good idea. At the time I figured whatever had happened was simply due to lifestyle choices, so I thought a retreat would help me clear out that stuff.
I noticed during day 6 or 7 that mild psychotic symptoms had returned. In fact, these seemed very similar to the symptoms during those days in previous retreats. I would wager that these symptoms were with me for a long time (since childhood). 
What helped me then, were clear instructions, a good foundation in the practice and advice from my teacher to keep everything simple and easy, not focussing on any aspect of imagination, view, what could be, might be, will be.
The symptoms didnt last, a few days later I ended the retreat like previous ones without incident.

What was hard to deal with following the second psychosis especially, was the feeling of anxiety, the feeling that at any point the rug might be pulled from underneath me. I feel lucky to have established a good practice before, so the anxiety and the practice itself were not actually that much intertwined. However, during psychosis, there was no way to do any kind of vipassana or samadhi meditation. It would either show me just how fking crazy I was (with no way out), or leave me sleepless for a long time. Cold showers, physical activity, none of the usual 'snap out of it' tactics would really do anything.
What's worse is the knowledge just how *close* that experience or view is to a more accepted view of reality. For me, this was driving the anxiety, the feeling that it might pop up any time. Whenever it comes up now, I'm able to see it as anxiety and it passes quickly. This wasn't easy at all, and I'm happy I was given the time to figure this stuff out in a closed off section of the hospital.

It's gotten into a bit of a personal story. I do hope it is helpful in some way.
I don't really know what else I could be offering you, so please feel free to ask anything and everything.
I have done a lot of reflection on this topic lately, but I fear it will be mostly unconstructive to go into any ideas I have about it. 

My experience is that vipassana experiences even on the dosage of a committed home practice can be (very) intense, and it doesn't seem surprising to me that retreat level doses can be seriously destabilizing for a small but significant fraction of people.  I don't think that means vipassana should be avoided, but it does mean that dosage and destabilizing effects should be monitored closely by the practioner, and when things start getting really weird it might not be best to muscle through.  One of the reasons I've avoided retreats is that I'm scared that by taking the control of dosage out of my own hands and into an institution's, I run the risk of getting into some dangerous territory that might be better off taken more gently.  Daniel's book does a really good job of discussing these topics.  Ben.

Hello LB,

I hope your sibling gets better with time

Daniel wrote : "Those at the top of the organization know full well what can happen and still, despite over two decades of pressure, staunchly refuse to admit there is a problem, staunchly refuse to properly train their teachers, staunchly refuse to warn potential students of how bad it can be, staunchly refuse to provide adequate monitoring of people on the runway to crazyland so they can back them down if possible (not always possible), and blame the negative effects entirely on the meditator, failing utterly to admit that this stuff is simply not entirely safe even for the previously highly sane and stable and that they could in any be a part of all that damage. I think that people should be given a truly fair warning of the risks, benefits, and alternatives in the beginning so they can make their own informed choices, and they should be given normalizing frameworks, maps, resources, follow up, support, grounding techniques, and advice for them and friends/family when things go wrong."

Ok, +1 on Daniel's comment... It seems I am one of the few "still committed" Goenka practitioners here, so... I am appalled by this kind of stories that comes back again and again, I would like to help change it, but... is it such an impossible task? In my experience, every assistant teacher (AT) will put any hardship encountered by a student on sankharas and/or on some fault by the student ("she stopped her meds without telling us", "did not tell us about his condition on the form", "was practicing another method" (big one, this one!)etc.). In the discourses, Goenka says that, as the technique is good, any problem must come from you.
I think it is in the guidelines of the ATs to bring any student with a problem back to anapanasati, but I have seen some concerned about food intake, sleep and rest for the student when some out of balance behavior was noticed... The other thing is that the three group meditations daily (and the discourses) are compulsory and not attending them is a reason to be asked to leave.
Like you and, I guess, most of the ATs, I never experienced real hardship on retreat myself (so far!), but I do not consider it a reliable indicator that it cannot happen to anybody!
I do not know what people at the top of the organization know "fully well"... I had the hope that they were truly blinded by their beliefs and were not choosing to hide some facts?
When faced with issues, their answer is that the waiting list is really long (so why bother). I guess if the general public really gets aware of the risks of intense practice, the waiting list would shrink a bit?
I would at least put something in the bunch of documents the student has to read before he applies... But... is not warning about the potential risks a way to script them in people's mind? Or so they might fear? And to have a kind of easy-to-access follow-up for students after the retreat (you can contact the center but the advise is, it seems, quite minimalist... and I suspect that many people who run into difficult territory do not even consider contacting the center)

Well, just a little bit of rambling, really

with metta
Smiling Stone

PS: I saw some truly offensive comments to your post on reddit (r vipassana) by some, showing a total lack of empathy... felt sad and a tad bit angry...

edited : a couple of missing words

To be fair, I recently applied for a Goenka retreat, and they did warn me that the worst mental health issue I had ever experienced was very likely to occur during the retreat. Nothing about it happening to people without prior issues, though, and nothing about making anything worse. 

Hi L B, I am a long-time meditator, and am also no-nonsense bi-polar, with multiple hospitalizations over a period of decades, the most recent being about five years ago. There is no way for most people to grasp the qualitative difference of the psyche going through the quantum jump into psychosis, as we all use our own experience as a baseline for our empathy, and if you haven't been there, you just haven't. That said, there really are a bunch of people working very hard to try to address experiences like your family member's. You say she has found a ,lot of help from Willoughby Britton, who is right there on the front line, and state of the art. Daniel Ingram, as you well know, is also putting a lot of attention into this stuff. So you've opened the right can of worms in the right place here, as far as that goes.

I gather from your posts that your family member's break was three years ago, and that she has found her way back to a fragile-feeling stability in day-to-day life. That is already a shining accomplishment, for those who have had a psychotic break. What's not clear to me is whether you bring the issue up at this point because she herself is experiencing some kind of (understandably gun-shy and mega-conflicted and scared-shitless of triggering-anew) pull toward meditation now or not. If not, God bless her, and may she continue on the humble path of someone who has gone through what she went through; one of the genuine benefits of a break like that is often a truly deepened compassion, and a much-broadened range of compassion. It is humbling, too, for a neurobiochemical mammal, and she is right to be hyper-aware of avoiding triggers. But three years of healing and re-grounding is marvelous, and you go, girl, keep up the good work.

So the real question is whether she has some variation of "insight disease", at this point, whether she is drawn again toward some kind of practice that deepens the investigation of the fundamentals of human reality, despite her history with the genuine dangers of those depths. What motivated her renewed efforts at meditation? How does she feel about the feedback (to use a ridiculously bland  term here, to bracket a host of side issues) that her biochemical reality seems so reactive to meditative techniques? Also: Why are you the one asking the question here, and not her? I do not mean that in a contentious way. Is she seeking some kind of baby-step path into practice, or what? Or is this post-thread simply a larger social discussion about what to put on the warning labels and the state of the art on triage among the casualties of the path?

Best wishes to your family member. I hope she is able to see what an extraordinary thing her recovery of equilibrium is, however flimsy it may feel, and however many fears for its stability may arise. It is precious, and she is uniquely positioned to realize at this point just how precious.

Dear LB and readers,

My name is Ben Meijer, and Ive been a alternative therapist using both ACT and EFT, and more. Ive spent years treating people with trauma, phobias, depression, and curing all of those in short order... and yes, I have run into my share of people with Bi-polar disorder, schizophrenia and psychosis. I have done exorcisms succesfully as well.
.
Ive also done lots of meditation types many years back. Since 2012 ive done 3 Goenkha 10 day-10 hours a day retreats. You can find my other posts on that.
Goenkha vipassana retreats are not for the faint hearted. Ive posted a few years back trying to figure out the utility and limitations of the Goenkha vipassana retreats.
What I also did, is see the enormous potential of these retreats to help people with emotional issues.
During my last retreat, I spent a few talks with the AT regarding the utility of vipassana for therapy clients, and their position regarding all manner of psychological issues, the counter-indications, the why behind their attitude regarding what to do when vipassana meets pschological issues, including Bipolar, psychosis, etc. 

A short summary is that they are not qualified as medical professionals, dont pretend to be, have very little usefull information about how to deal with the emotions, breakdowns, etc. There are all sorts of pitfalls to having partial knowledge/partial training about emotional issues, where this could lead to (These ATs) doing some form of treatment, which is NOT what they are about. There is no room or time to do any of this in the present structure. If there is any form of treatment from ATs, staff, meditators can/would then expect the next teacher to also do this and be just as good as the previous person.
Their approach/attitude is to try to exclude potentially people by asking about mental health history and medication history at the intake proces.  They look for typical buzz words which indicate risk factors, and then people are rejected. I have several acquantainces who have been rejected, also a close friend who got rejected.

I believe there is a historical reason vipassana teachers dont know much about therapy, and that is traditional SE Asia is NOT flower power therapy friendly 1970 and beyond WESTERN.

I believe there are lots of people who fib on their applications just to pass the entrence.


Heaven forbid you have repressed trauma, abuse, etc, dissociated experiences or major loss that you have not dealt with, but have lied to yourself about.
Why? The vipassana will bring up old emotions if you do it properly. PERIOD. 

The structure of the course/ATs, etc is NOT supportive in the sense that you get to talk about stuff. Some meditators will keep trying to repress the stuff comming up because it is their character to not talk about stuff.

Normally, the comming up of emotions is part of the proces that makes it so valuable, because it is cathartic in nature.

Do I think anything NEEDS to change in the Goenkha system? You cannot just change it. If you want to make vipassana embedded inside a therapeutic setting, with suports by therapist, and lots of time to talk, it would completely change the nature of the meditation retreat.
Expectations inside a therapeutic setting would completely flip to the opposite side, trying to make sure eveyone is OK would interfere with a serious meditation retreat. During My last retreat, my GF went as well. She is a psychic. They really dont know what to do with people like her either, and were quite cautious.

Now, if you or your loved one have stuff come up, it is very important that they do keep a normal sleeping rythm, none of this not sleeping. Also, excessive illogical anger is a red flag, as is paranoia and mania. (to just name a few).

Now if it went all wrong, and you have had psychosis occur because of the retreat, you need to do serious and high quality therapy. Most therapy is not all too effective to deal with this kind of serious stuff. More effective therapeutic techniques are dangerous by nature, it can destabilize as well as heal, and you need a good stable therapist to know the difference. The therapist needs to have courage/balls to dare to do what is necesary. He/she needs to have been around the block a number of times.
Daniel Mackler on Youtube talks sense regarding these types of serious psychiatric issues.

How often do people lose it and enter psychosis during vipassana retreats? I cannot say. When I was there 3 x, nobody lost it. The floor manager said in the last retreat one DID lose it, and was deposited at the local mental health clinic.
In my experience, I could NOT fault the Goenkha organisation.
I am not going to claim they were perfect either, but it is debatable what could and should be improved.
If you think things should be different of better, think about why you feel it MUST be different or better.
If you are a normal and reasonably stable human being, vipassana is a retreat that is worthwhile.

Now I have shared my experience and perspective, I hope I have helped to shed some light on these issues.


Warmest

I am sorry for your relatives suffering. I hope she feels better soon. 

I just want to share my experience as I am also a committed Goenka practionare - 

I have had major mental challenges in my early 20s, 

In my experience attending a Goenka retreat (over 8 retreats by now) has only helped me become more peaceful and happy and i heartfully recommend it to any one - I do not know how or why this has happened, however, I do hope she feels better soon.