I am spending the summer here in Cambridge in the UK at the invitation of Dr Julieta Galante doing some research regarding the stages of insight and using the Dharma Overground as a truly massive and amazing public database on the various effects that meditation and other sorts of life experiences can create. What an incredible resource this community has created over its 11+ years of existence!

As I comb through the over 115,000 DhO posts we have created from the beginning to July 22, 2019, I am profoundly thankful to all who have authored parts of this evolving masterwork. There is true gold here. As I cruise back through the early posts, there  are a lot of memories that come back about this community and what we have gone through, both good and bad. It is also heartening to see so many people over the years expressing thanks for the resources and support this remarkable site has provided.

For those who like the details, to trim down the posts to a reasonable number for review, I am using a somewhat elaborate set of post-scoring systems I home-brewed using the 8-core MP version of Stata 16, then bringing selected posts that score high or in specific ways into Nvivo 12 for the Mac, which is a qualitative data coding package.

The plan is relatively simple, but there a lot of details worth knowing about. The first major thing I am working on is trying to figure out how to make awareness of the various wild experiences we here are used to reading about and experiencing ourselves into the mainstream medical literature, particularly the literature of emergency medicine and emergency psychiatry. I wish to help insure that when people having traditional meditation experiences run into healthcare systems that those systems have the advantage of the sorts of helpful, normalizing concepts, frameworks, and practice advice that literally thousands of posters have expressed gratitude for here so that outcomes are as optimal as they can be. There are diseases so rare that only a few people in the world have them that have gotten more scientific attention than the powerful, challenging, and transformative experiences thousands of us here have had, and I aim to change that.

This windmill has had some remarkable minds tilt with it before, including remarkable people such as, and in particular, the mighty Christina and Stanislav Grof, but their efforts have not reached as far into mainstream literature and medical and psychological consciousness as I would have hoped, so I find myself picking up the torch and will try to further this quixotic cause.

I also continue to be very appreciative of the works of the likes of Jack Kornfield with his paper in 1979 regarding meditaiton experiences on retreat, as well as the details he spells out in works such as A Path with Heart. He and Trudy Goodman have actually agreed to give a bit of help to the project, and I am grateful for their thoughts and mature wisdom.

My initial targets are the mainstream emergency medicine and psych journals, as well as having grander ambitions with targets such as the DSM-X and UpToDate (a resource used by medical clinicians to keep up to date on current medical conditions), as well as ICD-10 (list of medical billing codes). Those will take serious work, so this project will likely go on for many years, Norns permitting. That literature is free from most of the traditional concerns that make publishing on the topic of meditation stages somewhat difficult, such as ontology, impractical aspects of epistemology, neurotic concern with aspects of the traditional Pali and Sanskrit literature, and the like. Emergency medicine physicians are more likely to just need a good box to put something in that gets a patient off a bed in a good direction and as safely as they can be, and I think I can help provide that, as, being one, I know how they think and work.

I might write another book on the topic, something much more based on cases and supporting the phenomenology with real-world reports. I will probably attempt to publish some sub-topics, such as enhancing the literature on exploding head syndrome, in more topic-specific journals.

I have reviewed about 8 articles so far on the contemporary ethics of using online data and have come up with the following: anyone I wish to quote directly rather than in aggregate will be properly attributed as an author if they wish, as this website is public data and so different criteria apply from, say, anonymous patient data. No posts will be less anonymous than they appear here on the DhO, meaning no back-end data from the DhO that can't be seen on the web will be associated with them, and so the degree of anonymity that people have chosen as they post here will be preserved. I will try reach out to anyone whose direct quotes I wish to use to make sure they are ok with them being used in whatever I publish, though I can't be sure that the emails I have will all work still, as some quotes of possible value are up to 11 years old. If people want quotes rephrased or quoted more anonymously, I am happy to do that, as well as if people want a level of precise, name-using attribution for quotes that they authored more anonymously and are justly proud of, I am happy to go that way also, as people prefer. This ethics strategy will try to give as full control as possible to those who are the original post authors.

Currently, I am searching for some of the most classic 3C/A&P/DN/EQ descriptions, with an emphasis on topics relevant to emergency medicine and emergency psychiatry/psychology, meaning when things went too far off the rails and caused significant dysfunction. If you are aware of any particularly good threads or posts that further this goal, or just show the cycle in its more classic forms, please feel free to link them below.

Curiously, the hardest part of this project may be figuring out what to call what we here call things such as the POI, as well as what we here would often call the 3C, A&P, DN, and EQ stages. I need a secular name for the whole thing and each of those parts that will accomplish the following goals:
1. Be acceptable to mainstream medical journals and textbooks.
2. Be acceptable on an ICD-10 code.
3. Be acceptable in the DSM-X.
4. Be non-limiting, meaning that it doesn’t artificially constrain what goes in that box.
5. Be non-tradition specific yet not be like Esperanto, a language that makes great linguistic sense but few speak. Said another way, I want this to be a term that doctors are comfortable using.

While I typically loathe eponymous medical terms (Alzheimer’s disease), curiously I am tempted to it in this case, as putting a name on it would avoid a lot of problems. As I am currently staying as a guest at Wolfson College, I  was thinking of calling the POI the Wolfson Cycle, as it is a neutral term that yet has some sense of respectability to it, and, as it is the name of a college rather than a person, it avoids the apparent narcissism that comes with people naming things after themselves. Any thoughts welcome. I have pondered calling the A&P the Ecstatic Phase and the Dark Night the Challenging Phase, but those are just sketches. I see that Vince Horn is trying to do something similar in his work.

There are also some plans for some neurophenomenology work using EEG and fMRI, with more details to come if and when those plans get more solidified and funded.

Any thoughts, ideas, insights, and dreams welcome. Wish those fine researchers I am collaborating with and me luck on this ambitious set of projects.

Daniel

This sounds like a huge undertaking and a very long journey - you have my best wishes on obtaining what you are seeking and success, Daniel.

Very glad to hear that Jack Kornfield and Trudy Goodman may contribute to your project.
A few months ago I heard Jack in one of his recent talks that he mentioned he is reading your book, and I wasn't very pleased by how he mentioned that (Although he didn't say anything negative about that), and now it's great to see that they are open to work with you on such projects.

I think you are on a very brave mission and I wish you and the other team members the best of luck. I look forward to seeing the fruits of this endeavor.

thumbs down to 'The Challenging Phase'!
Dark Night is perfect and packs a hefty memetic punch.  it would be PR suicide to drop it.

Daniel,

I have taken psychiatric meds during most of my tenure as a Dharma practitioner. The one systematic difference between how I was when I started taking medication and how I am now is anger reduction. The dark night is an anger reorganization protocol. No other emotions are determinably changed. You have given me a skillful outlet for sharing and learning about myself.

Dietrich

Edit. When I say "no other emotions are determinably changed," I mean that they have been channeled into my music. I play piano. Anger doesn't translate into music.

Edit 2x The mental health system is more geared towards visual artists rather than musicians, just a little fact I have come to recognize. A nice leap of faith for the medical sciences over, say, some other field to give credence.

Edit 3x. While on the subject of the Academy, I remember while in my University days there were some in my honors college circle who wished they could apply the fluid grading systems, open participation, and journal based reading assignments to a wider audience. I think that a Dharma reassessment campaign has a better shot than such a reorganization of our scholastic institution s.

Best of luck Daniel, this sounds like a greatly important project. It's tough to not draw parallels between the path of insight and reading people's accounts of challenging mental phenomena.

I would love to become involved in this sort of work, if there are any inroads available for others to pitch in (donations, volunteer work, data processing, institutions or people doing similar work) let it be known!

Dear rik,

Thanks for your kind offers. As to volunteering, that would depend on your specific skill sets, as might data processing, though data processing also depends, in this case, on two software packages that are unusually expensive (Nvivo cost $1400, Stata 16 MP 8-core cost about $3700, both paid out of my pocket). What skill sets do you bring to the table in these regards?

As to donations, there isn't yet an obvious structure or mechanism to take such things, and it also might depend on the scale of the donation. If, on the off chance that you are offering something substantial, like fund a position substantial, then definitely PM me and we can talk about how that might be utilized. As to smaller donations, probably should consider trying to set something up and have defined goals and the like in place to be sure that donations were supporting exactly what they were intended to support, and we aren't to that level yet, but perhaps we should be moving that way, so thanks for the encouragement.

What specifically did you have in mind?

As to easier things, if there are particulary good posts that you know of that demonstrate well the phenomenology of the POI cycles we know here, as well as the value of normalization, as well as what happens when people run into the healthcare and mental health systems, please link to those below. My algorithms may find them also, but they are imperfect, and the amount of data to sort through is huge, weighing in at 63MB for the text file of the posts, which, at roughtly 500 pages per MB, means that I have about 31,500 pages of data to sort through.

I admire the ambitious goals. Good luck!

Some stuff isn't clear to me. Is this your ideal situation: for each stage of the POI you have a corpus of well-written, phenomenological posts describing it (from your POV). If so, where do you go from there? How do you get from there to in-the-DSM? There are obvious problems with DhO as a dataset: selection bias, scripting experiences, etc. Also you're obviously using your own interpretation of the POI to guide the research (confirmation bias).

Also from my POV these two are distinct:

• Good-enough quick-and-dirty categorization of the "POI" to help people in emergency situations. ASAP.
• Full scientific validation and/or explanation of the "POI"

It's not clear to me that there's much overlap. If your goal is 1, it seems to me that just the "Ecstatic" and "Challenging" phase are sufficient. Any more would be pushing people's credulity/patience. How clinically relevant are the rest?

Unfortunate you're working with such expensive closed-source software. A real tragedy for open science. I wonder how much of what you're doing can't be accomplished reasonably with R + RQDA + qdap + Python + etc for free. There's also Dedoose which is closed source but only $15/month. Can you go in a bit more detail about which features of NVivo/Stata you're using?

EDIT:

On the issue of rebranding, I brought this up to you years back about MCTB2. I asked whether using purely secular terminology was worthwhile. On specifically rebranding the POI, this thread might be interesting:
https://www.dharmaoverground.org/discussion/-/message_boards/message/5750948

Here is an infographic that I'd consider to start with. 
https://informationisbeautiful.net/visualizations/being-defensive/
But rework it into the dn expressions on one axis, then internal vs external projection on the other axis. This explains most of the problems of sensitivity to the different Nana's. It's not explaining all psychology problems but a whole heck of a lot of standard light weight ones.
Great luck to you capturing this stuff, I've read many years of posts in the entirety from the beginning of dho, signal to noise is extream, but do is planning for gold.
~D

DW, I remember years ago in a thread talking about an "ideal dharma book" you mentioned the importance of graphics... That's a great one, thanks for sharing!

My first thought with the "Ecstatic Phase" and "Challenging Phase" is that that is going to sound a lot like bipolar to most doctors.  I think a key element in creating a secular framing for the PoI is coming up with a framing for it that differentiates the diagnosis and treatment from standard bipolar treatment.  It might also be helpful to name it something like "meditation-induced variant bipolar".   This discussion also has me thinking of this old thread on bipolar: https://www.dharmaoverground.org/discussion/-/message_boards/message/105357 .

Hi,

First of all, very interesting project, and ambitious!

I'm a qualitative researcher (ph student), work in medical psychology and I'm very interested in details when it comes to strategy and methods. I have just submitted a paper (it's under review) with the aim of describing a phenomenon which is unknown in the literature, so the people who fit the description can receive adequate help from health care practitioners. 

Most medical journals mainly publish quantitative research, and then they don't really care about ontology and epistemological issues, but when you want to publish qualitative research it becomes important, becasue you have to prove that there is merit to your findings. Qualitative research is still not considered as real science by the mainstream medical audience.

Nvivo is a tool, not a method, but it is very useful for handling a lot of text and collaborations.

What is your ontological and epistemological approach? What method are you planning on using?

Best wishes for you and your fellow researchers!

/Mattias

Fantastic project.  Here are some more ideas to throw in for consideration.

1. Initial investigation
2. Experience of perceptual flux
3. Phase of emotional dissonance
4. Phase of clarity 
5. Crescendo of effort 
6. Weltanschauung reversal

*Edit:  And seeing you are looking at an Emergency Medicine context, maybe:
7: Risk of dissociation  (more about depersonalistion, derealisation, falling in to the pit of the void.)

Love this idea. I spit balled this idea with my partner. I thought it would be cool if, after full awakening, I did a thesis on the neurobiology of the POI. In any case, thanks for doing this. I know you probably aren’t doing it for the appreciation you’d get from us, but  The fact that you’re doing it rather than somebody else who is less detail-oriented makes me very excited. Good luck!

As far as donations go I'm nowhere near the realm of wealth required to fund work directly, I was moreso wondering about what sorts of one-off contributions I could make to this group (or others) as I do make enough money to live comfortably and would like to contribute to this sort of thing in some way/shape/form.

I'm currently a professional software developer although I don't deal directly with data analysis these days. I had a brief stint of that back in college to support the work of a lab on campus but my minimal knowledge pertains to open-source methods like R. I am pretty comfortable with picking up new skills in the tech world so if there is any need for additional man-power that can be our-sourced I would be willing to contribute.

In general though I would love if I could somehow move my career in a direction that would somehow assist in this field. Whether it be going back to school and studying medical psychology, or finding a job doing IT support for a group like the one that you are working with. It's tough for me to see the way forward to determine what first steps would lead me that way, and I understand that you and the other members on this board are not career counselors 

Yeah for this kind of thing to have wheels, it needs a foundation.

Based on my experience with such tendencies, I wouldn't do them unless they are my main/highest priority in life currently, otherwise it would probably lead to suffering and conflict of interests. I write this because I've done it before, and the result was unnecessary suffering, without any notable practical output.

Thanks! I appreciate the concern. Would you be comfortable sharing what you did and what went wrong?

Just to be clear, I'm not considering suddenly up and dropping my current life for one devoted to dharma or anything like that. I'm just interested in donating, volunteering, contributing, and if the opportunity presents itself shifting my focus in life in ways that can be beneficial to projects like this. Basically just checking to see if there's any ways in which I can be useful, and to be honest I don't expect there to be many options at this point in time.

Exactly one of the points is this: We don't expect there to be many options, so it doesn't seem to be any risk or conflict with our current responsibilities, so we say we are ready, then a big task comes that we weren't ready for it, that we had understimated it, and conflicts arise.

In my early 20s that I was religious, I volunteered to move to another country to help some people there, and they accepted, but then I realized how much conflict it would create with my studies, with my family and etc. It caused suffering for some weeks and paralyzed my life in that period. Thanks God they canceled the whole thing later.

And last year I volunteered to develop the android version of Brightmind app, Shinzen's app, I started the project and did some work on it, but later I realized it requires at least half of my time that I wasn't able to do by any means.

There were worst cases that don't need to be mentioned here.

It needs to be done very carefully.

@Mattias: regarding my approach, much of emergency medicine is pattern recognition, often of syndromes we don't entirely biochemically understand which can have widely variable presentations, e.g. Migraines or Kawasaki's Disease. So, I don't particularly care about epistemology or ontology in any profoundly deep sense in this context beyond superficial, practical concerns. There is definitely a place in the medical literature for case series that simply describe a pattern that has some clinical application, meaning it can inform management and predicts something about disposition (where the patient goes when they leave your ER bed), and outcome. Similarly, for most of the work here, which is normalizing and giving advice based on pattern recognition, we often are able to to good without any rigorous exploration of epistemology nor anything like a coherent medical (or philosophical) ontology.

The point of view of an ER doctor is radically different from a social scientist in this regard, and so I get that it is complicated to shift from one frame to the other. Consider a patient presenting to you in a clinical setting which you have 24 minutes total to help, including getting a history and physical done, documentation time, test ordering and interpretation, any treatments you perform filling out prescriptions, talking to consultants, explaining the results of your evaluation and the management plan to the patient and/or family, answering questions, and getting them off the bed better than they arrived, hopefully.

You have no time for questions of epistemology more grand or abstract than the physical constraints of that clinical setting and the limits of your history, physical, and radiological and laboratory tests, as well as the very algorithmic frameworks you carry with you for clinical  decision making, as those are how you know things in that setting. You have no philosophical concerns for the deeper ontology of any question beyond the very philosophically superficial frame of that clinical setting.

The person arrived with some problem, and they need to leave that bed within a few hours in the right direction with some diagnosis and treatment plan that hopefully helps more than harms. That pragmatic frame removes a ton of barriers that are otherwise faced by academics in more intellectually lofty disciplines uncerned with harsh clinical realities where you are forced to make rapid, imperfect decisions.

I never once had a discussion with any patient regarding, say, the true nature of the soul, or the paradoxes of scientific materialism in a universe which also appears to contain consciousness. That just doesn't happen.

Never did any patient ask a question regarding epistemology beyond discussions of the known inaccuracies of histories, physicals, lab tests, and ragiological studies, as well as the clear and obvious limits of the conceptual boxes we have to diagnose patients who may present with clusters of signs and symptoms that don't fall into neat boxes.

However, if through this project I can add a few more neat boxes that help patient feel like they are not just crazy when they run into odd spiritual experiences, and help them attain to better dispositional and treatment plans than a diagnosis of "Psychosis NOS [not otherwise specified]", evaluation by a confused psychiatrist who is rapidly looking up Exploding Head Syndrome on Google and finding nothing useful, a possible hospital admission, and administration of antipsychotics or whatever when they really just needed some map-based normalization and some trip-sitting until they came down, for example, then I will feel that I have done some good and upgraded an clearly imperfect system just a touch.

@Mattias: Oh, yes. Regarding sorting through the data, all I need is enough cases that show the basic pattern, 3Cs, A&P, DN, possibly Equanimity, some cycling nature to it, and hopefully, for some here for whom we have enough longitidunal data, showing a radically different long-term clinical trajectory from bipolar (which tends to get much worse with time), whereas, for most, as we integrate the stages of insight and mature, we get much better, often better than when we started. So, I just need to find those cases, as I am not looking at incidence, prevalance, or any other syndrome, just that this pattern occurs and that it is diagnosable based on relatively predictable pattern  recognition, as we here do all the time to relatively good effect, mostly. That there are all sorts of other patterns of presentation is not that interesting, and hopefully can be sorted out at some point, but that this main pattern we who have been here a  long time know so well is describable and teachable is the key point.

Regarding those who wish to help: by far the most straightforward thing to do is, if you come across a thread or post that is discussing a really clear presentation of the A&P to DN cycle, link to it. I don't have time to read all the threads here, so I definitely have missed some great ones, I am sure. While I have some pretty sophisticated search methods, there  are over 115,000 posts here, and I will certainly miss some. If I come up with other obvious ways that those without access to expensive software packages can contribute, I will definitely let you all know. In terms of donations, again, I really need to be sure that I have a well-defined way to track money and be sure it is spent appropriately first, and we are not there yet.

I greatly appreciate this advice as I have a similar tendency to over-commit myself without realizing until it's too late.



Sounds good I'll keep this in mind!

Hi Daniel,

This all sounds exciting, and like a very logical new direction to be taking in your life...
Just a couple of things :

-Methodology wise, some work is starting to be done on the microphenomenology of meditation, such as this pilot study : https://hal.archives-ouvertes.fr/hal-01653495/document
This method is quite interesting in my opinion, and seems like it's really starting to get some recognition as a way to "get data" that is both "subjective" AND valid according to the epistemological values that most modern scientific minds share... Which is what you're after, if your goal is to be heard by the scientific community, correct ? 
So, perhaps conducting fresh new interviews according to this protocol would actually be more effective, convincing and to the point, than gathering massive amounts of  "data" which a trained scientist (not regular people of course !) would think have in themselves little "objective" value, i.e. poor neutrality, falsifiability and other popperian whatnot. In fact, I'm gonna go through training in microphenomenological interviewing in the coming year, so, perhaps that could be useful. 

-I'm sure you're aware of the institution called mind&life, and their new extension mind&life europe. I think it could be worth exploring that direction. They offer grants to fund research https://www.mindandlife.org/varela-grants/  https://www.mindandlife-europe.org/our-work/european-varela-awards/ (only for PhD or post doc students who have attended their summer school... But that could be me, or someone else, in the next few years.) Who knows what partnerships could be thought out ?

Cheers !

As methodological issues are discussed here I think I’ll crosspost what I wrote in another thread (about Michael Pollan), in case it is of any help. They adress comments that came up on that thread, so this is not a reply to Olivier’s comments. It is only vaguely connected.

”Formulating and testing a hypothesis isn’t suitable for all types of research aims. It requires more of an experimental design, and exactly how would one put together the test groups and control groups? Spiritual quests involve so many different variables, and human beings are complex creatures [...] An experimental design would lack ecological validity. As for Daniel’s project, there is a massive amount of naturalistic data (data that would have been produced even if there were no study in place) available. It would be a shame not to use it. I agree that a mere statistic analysis wouldn’t do it justice, but testing hypotheses isn’t a valid option. The strength of this data corpus apart from the quantity and variety is the contextualization that it enables, both with regard to developments over time and with regard to an interactive context. It is important to bear in mind that the posts here are not written in isolation, but in dialogue. If treated as isolated reports, that’s a methodological weakness. People here tend to learn certain forms of lingo. That’s a possible bias. If treated as the community-based interactive process that it is, that context is a huge advantage. People’s spiritual journeys are collective accomplishments (dualistically speaking). The interaction is essential both for how practices take shape and for how they are framed in reports (even if what happens as the path progresses is universal, which I guess is what the study is aiming at - certainly a valid aim but methodologically more tricky to access with this kind of data, or at least to prove it). I would apply a dialogical perspective to study the spiritual path in the context of the online sangha and let the universality be a hypothesis for future research to test. As a complement to the more statistic part of the analysis, I would make use of the interactive dimensions of the data to study in more detail some carefully chosen process trajectories and some forms of interactive patterns that the coding (if possible) has showed to be essential for the process. But then again, studying interactive processes as they unfold in naturalistic data is what I do for a living, so I totally understand if that’s not everyone’s cup of tea. Also, it would probably be very time consuming - but fascinating! I could point to a couple of dissertations on online communities, if that would be helpful for that part of the methodology.

Empirically driven aims are not tautologies. They are what makes it possible to see things in the data that one didn’t imagine beforehand, that is, thinking outside the box, or discovering that there was no box. However, it is essential to present the research process in a way that makes clear how the conclusions were made and account for all possible biases due to the study design. That’s where many researchers fail.”

@Daniel

I think I get your overall aim, to give a clear description of various mental states that patients present in the emergency ward, so HCPs can recognize them, avoid unnecessary pharmacological interventions and so on.

When I asked about your approach I meant in relation to the research project. To be clear: How is the world constituted and what can we find out about the world?

You use the word phenomenology, which happens to be my field so I thought it might be interesting to discuss approach and method. 

You have a lot of data. In order to turn it into something useful for the scientific and clinical setting it needs a lot of work. If you want to present it in a peer-reviewed journal you need to describe and justify your
There several methods you could consider:

Hermeneutics
Ethnography (similar to what Linda suggested)
Content/Thematic analysis (needs a theory)
Descriptive phenomenology
Hermeneutic phenomenology
Grounded theory
and others

Regardless, before you start doing the actual work you should have a clear  idea of what your research question/questions is/are and what method you’re going to use to answer them. If you don’t, you’re most probably going to wish you had. 

Also, informed consent is an issue I would look into from the start. Would an ethics board approve of publishing content from a forum? I don’t think any peer-reviewed journal would agree to giving forum posters author status. Check out ICMJEs authorship criteria. 

I’m hoping that my input will be helpful

@Mattias: Hey, lost the thread here, as my life went off in some other directions, but, if you are still interested in this project, PM me here, or email me, and we can talk. I am on Skype at d a n i e l m i n g r a m without the spaces. You clearly have good ideas about this, and I would be interested in hearing more about them.

@Everyone: if you come across great posts which you feel demonstrate good phenomenology from a case series point of view, particularly those who hadn't had exposure to the maps when their experiences happened to them, please link to those here, as I am still working on this in between lots of other related projects.

Thanks!

Daniel

Mattias & Daniel - If you're interested in grounded theory.. I use a methodology based in grounded theory in analyzing & synthesizing data at work. We do a mix of qualitative and quantitatve analysis. Our statistician does the quantitative analysis, which I don't have a hand in because that's not my area of expertise. The design researchers (me & some of my other co-workers) do the qualitative analysis. Much of the qualitative data comes from interviews we conduct one-on-one with individual stakeholders in our research process (using a design thinking framework). It is rich, narrative, descriptive data, and all self-reported - much like the data on DhO. By analyzing in this way, we discover patterns that are emergent from the source data itself and work from there to develop conclusions/findings, rather than starting with a hypothesis or research question and working from there.