Religion and Spirituality in Psychiatry

318 Charles Knapphealthy way, with good relationships and meaningfulpursuits. The client may work, see friendsand family, and be part of the normal communityin which she or he lives. The schedule usuallyincludes meeting with a psychotherapist andwith a psychiatrist if medications are used. Thereis a system of meetings that all members of theteam, including the client and his or her family,participate in to keep the activity of the therapy,household, and treatment team coordinated andup-to-date. Most treatments last six months totwo years.2. HISTORICAL ROOTSThe Windhorse Project, as it was originally called,arose out of the powerful environment of theearly 1980s at Naropa University and the atmosphereand teachings of its Buddhist founder,Chogyam Trungpa. At that time, many outstandingand accomplished people had been drawn tohim, and his influence invariably had the effectof helping experts to see their respective disciplinesin a new light and larger context. Scholars,poets, dancers, musicians, and many involvedwith psychology found these experiences notjust enlivening, but revolutionary in the way theynow saw their activities. The late Dr. EdwardPodvoll, who had had a distinguished career asdirector of psychiatry at the inpatient psychiatrichospital Chestnut Lodge, was one of these people.Through years of inpatient psychiatric work,Podvoll knew about the benefits and deficits ofthe inpatient environment. That knowledge,coupled with his developing contemplative perspective,showed him that there were other waysone could work with people in extreme mentalstates. In 1981, with the help of Trungpa and agroup of committed students, Podvoll foundedthe Windhorse Project. (2)Windhorse Therapy was originally designedonly for individuals with acute mental disturbances,and many treatments are still conductedfor people with extreme and chronic major mentalhealth issues: schizophrenia, schizoaffectivedisorder, bipolar disorder, and major depression.Over time, we have also found WindhorseTherapy effective in treating milder forms ofmood disorders, substance abuse and addictions,eating disorders, autism, head injuries, and issuesof old age.Given the range of the types of treatmentswe conduct, there is a wide variation in size, andrelated to the size is cost. At the extremely structuredend of our care continuum, expenses canapproach those of inpatient services. At thelightly structured end, expenses resemble outpatientpsychotherapy. It is common that costs maybe high at the beginning of treatment, due to theneed for more contact and support at that transition.And, as recovery progresses, our teamsadjust the level of contact so that costs can fluidlyreduce.3. THERAPEUTIC FOUNDATIONSWindhorse Therapy is based on three healingprinciples. The first is that all human beings arefundamentally sane and healthy. As Trungpastates, “Mental confusion exists and functionsin a secondary position to one’s basic health.”( 3)This first principle is not about just adoptingan optimistic attitude toward human beings.Confidence in basic sanity is a direct experiencethat results from the clinicians’ exposure to contemplativediscipline, which we will discuss later.The second principle of the Windhorse Therapyprocess is, because human beings are inseparablefrom their environments,( 4) if a healthy environmentis created for the treatment, then clients willhave a greater probability of recovery. As statedby Trungpa, “The basic point is to evoke somegentleness, some kindness, some basic goodness,some contact. When we set-up an environmentfor people to be treated, it should be a wholesomeenvironmental situation. A very disturbedor withdrawn patient might not respond rightaway – it might take a long time. But if a generalsense of loving kindness is communicated, theneventually there can be a cracking of the cast-ironquality of neurosis: it can be worked with.”( 5) Aswe will see, creating tailored healing environmentsis the core therapeutic methodology of theWindhorse Therapy process.