Tough Grace

Posted on March 7, 2011 by

Author: Alice A. Holstein, Ed.D.
Published in Communities Magazine Issue #150

I was once a proud career woman with a doctorate and a privileged life. There were several prestigious clients in my consulting background and I lived in beautiful surroundings in Tucson, Arizona. But manic depression reduced me at times to being a genuine bag lady and I otherwise had continuous manic episodes that kept knocking me down for 12 years. Over the course of these horrific times, however, I gradually developed the conviction that mental illness can be a profound spiritual path. Getting there wasn’t easy. Sharing the background trauma sets the stage for defining the several reasons for calling it “tough grace” rather than only the “ain’t it awful” views we usually have of severe mental illness.

The hard times included 13-14 hospitalizations and probably 15 manic episodes over those 12 years. I can see, in retrospect, 20 years of manic depression symptoms, starting in the 1980s when I was in my middle 40s. My worst symptom was paranoia; I believed that there was a giant drug conspiracy operating everywhere so there was nowhere to go for help. I was argumentative and disruptive. The police picked me up a number of times. I bought three cars I didn’t need and was guilty of reckless driving. There were spending sprees that cost thousands and back-breaking medical bills. Fear drove me to travel far from home, to some 10 states. I created unbelievable messes, fouling my financial affairs, packing up my house, giving things away, leaving belongings in various places that then had to be retrieved over long distances. I intruded on people’s time and property.

I spent some six-eight months living on the streets in Arizona, California, Colorado, Minnesota, and Wisconsin, not because I didn’t have assets, but because I got separated from them or was too paranoid to tap them. Sometimes I walked all night just to keep warm. I went hungry for five days one time and eight days another. I slept in several homeless shelters, plus a soup kitchen where we were packed in like sardines, lying on thin pallets with one blanket each. Then there were the several battered women’s shelters, several cardboard boxes, the cement, and many open fields.

I had three or four Chapter 51’s (meaning when you are judged a danger to yourself or others, go to court, and then are sentenced to various treatment stipulations). I had grandiose beliefs about my abilities or powers plus delusions and impaired judgment. I experienced flashbacks and suffered from PTSD. I had several debilitating depressions where I felt hopeless and sad with barely the ability to function at all.

The hardest situation of all to deal with is what I call the “psychic split.” This is an invisible pain that is never treated. It means that there was the “crazy Alice” and the “normal” one that had to be integrated after a manic episode. This integration is so painful because what you have felt, thought, done, and seen is so mortifying and shame-filled that it is hard to put the pieces back together again. Sometimes this task took months. In an overall sense it has taken a very long time to heal. The shaming of society can be painful, but the self-shame is worse.

Other invisible things that were hard to bear were all of the losses I incurred. Hardly ever is the grief associated with them treated. For example, I lost possessions and personal keepsakes, a sense of safety, my health, my potential and identity, a career, and several jobs. I lost dignity, self-respect and self-esteem, thousands and thousands of dollars, friends and colleagues. I lost my youth, including what should have been some of the best years of my life. Many times I lost time and my mind. I lost my body image when I gained 50 pounds over my present weight from medication side-effects. I lost hope and structure in my life, plus physical strength and respect from others. I lost the will to live at times. I lost any semblance of a so-called “normal” life and was forced to the gutter to live as a homeless bag lady.

Recovery Beckoned

For four years, however, I have been in solid recovery and it is important to know why and how I healed. What transformed me? The process began with an intention in 1998. I got mad at the doctor’s bleak prognosis and decided that I would be as well as I could be. After that, despite periodically being very sick, I turned over every rock that seemed to offer help. I did some 50 things, such as energy healers, acupressure tapping techniques, Reiki, a variety of self-help methods, research, videos, spiritual direction, meditation, family constellation workshops, exercise, changes in my diet, support groups, and much more. Some of it cost money, some cost very little, and some cost nothing, but I lived an austere life to afford help. I am proud of the work I did to get well.

I also had a few people in my corner, such as my caseworker without whom I would be dead. I had some life skills, some previous success, age, and experience, and a good mind that stood me in good stead. I see now that I cobbled together my own recovery program without any particular design, but that I unconsciously pursued healing at all levels—physical, mental, emotional, spiritual, and social.

One of the most important aspects of my survival, however, is the fact that my life was saved hundreds of times by acts large and small. Some examples are telling: In a soup kitchen in Colorado Springs, where I had been sleeping on the floor for several nights, a woman worker came up to me one morning with a beaming smile, saying, “Here honey, maybe you could use these” as she offered a pair of thick-soled tennis shoes. Several churches gave me $20 to solve immediate crises.

In a laundry in Minneapolis, as I was sorting through discarded socks to use as mittens, a man folding his clothes gave me $20 without my asking for it. That bought me the ride to the next shelter. In Colorado Springs a woman and her family took me to a hospital; in California a couple took me in for a week. In La Crosse a nurse just held my hand and listened as I sobbed in despair over the threat of being institutionalized at the state mental hospital.

Whenever people just listened to me I felt strengthened to go on for the next few hours or days. I could bear the unbearable when I was merely validated by compassion, not advice or logic. I also had some other kinds of miracles. One time, while running down the road in a thin pair of shoes, I came across a pair of sturdy oxfords just my size lying alongside the road. Another time I found a pair of warm gloves on a park bench and not far away, a windbreaker wrapped around a tree. All of these and more helped me see that I had been protected and helped all along the way. From this I developed a rock-solid faith. It seemed as though “God,” however you understand that term, came often in the form of ordinary people whose acts of kindness kept me alive to tell this story. These things alone add up to my conclusion that mental illness can be a spiritual path.

Reframing Suffering

But there is more. One of the most important things I did to promote my healing was to reframe my experiences in a larger way. To reframe something means to shift perspective, to see something in an entirely new way. For me it meant making lemonade from lemons, seeing the glass half full, not half empty. This reframing helped heal my psychic brokenness.

One aspect of this reframing was to see suffering as a purifying experience. I found a tape by Carolyn Myss called “Spiritual Madness” that revolutionized my thinking. In it she said that spirituality is usually portrayed as sweet and easy, but that it is often filled instead with hardship, pain, and suffering. There we are tested and tried. There we are taught things such as humility, surrender, endurance, compassion, and facing all our fears. I listened and listened and listened and took notes from that tape, and healed several more notches because I identified so much.

A similar viewpoint comes from a Benedictine nun, Sister Joan Chittester, who wrote a book called Scarred by Struggle in which she writes about suffering. “I learned that struggle tempers the steel of the soul. It straightens the backbone and purifies the heart. It makes demands on us that change us forever and make us new. It shows us who we are. Then we make choices, maybe for the first time in life, that determine not only what we’ll do for the rest of our life, but what kind of person we’ll be for the rest of it.” (p. 85)

Another big aspect of my reframing was to find the “Hero’s Journey” and what it means. Its characteristics were highlighted in Joseph Campbell’s series of interviews with Bill Moyers on PBS some years ago, which produced the book The Power of Myth. Campbell studied myths all over the world and found their common denominators. His specific study of the hero’s journey gave me an enormously hopeful view about the trials of manic depression. His ideas are a major contribution to the reframing I did to recognize the underlying wholeness of mental illness.

But just what is this journey? It is a series of stages or experiences, steps on a universal spiritual path. They require suffering before you find a new sense of life and meaning. They apply to initiation rituals in tribal societies where there is psychological transformation; they apply to the mid-life crisis or to people who suffer serious illness or to their caregivers. The stages and process may apply to the families of the mentally ill, who are often required to deal with extreme hardship. Indeed, there are probably many readers who have been forced to the tasks of the hero’s journey in various ways.

Campbell’s stages are departure from all that is known or “normal,” then initiation and return. There are tests and trials all along the way. In psychological terms, we die to our egocentric self to find the deeper or inner self. In religious terms, we experience death and resurrection, and in our rebirth we are capable of manifesting our unique gifts.

The trouble with mental illness is that we enter the abyss of darkness and too often do not find a way back. We don’t make the return. We are seen as damaged goods, labeled negatively, which means rejection and dehumanization—rather than seen as people who are conducting heroic battles. Both the illness itself and these reactions cripple us rather than encouraging us to seek recovery and wholeness. I submit that this return is not achieved because we don’t reframe our experiences. We don’t know that brokenness can be healed and that the trials and tribulations of the severest kind can be survived.

We see the glass half empty rather than the life lessons these experiences teach us. We fail to see the compensations that illness offers as we concentrate on the lemons rather than the tough task of making lemonade. But what we believe matters a lot, and if we believed that this was a journey of hardship and suffering that was worthy of the highest esteem, then things could be radically different. This is a revolutionary viewpoint. It is a paradigm shift about how we see and treat mental illness.

Spiritual Lessons and Gifts

There is still more to my reframing and healing. There are some important spiritual lessons or gifts. Among the most important is a deepened compassion and empathy. Never again will I see a bag lady, a homeless person, a drunk, a mentally ill person, or anyone hurting, with the judgment I once possessed. I was one of them, and walking in their shoes opened my heart spiritually. Not being afraid of death is another gift. I faced it so often in various ways, including psychic, that I see it easily now as just another transition.

Recovery has also brought an expanded sense of purpose. When I tell my story I hopefully speak for the voiceless ones. I have the skill to do that and I want to maximize the opportunity. In my work life as a peer support specialist at a mental health clinic, I speak with clients on a “been there, done that” basis. I am living a life of service.

Another lesson that serves as a constant reminder is to appreciate things large and small. During nightly gratitude exercises, I am thankful for a delicious salad or meal, for a phone call or human encounter, for my bed and clothes, for my peace of mind and happiness. I am thankful to be alive at all because of the despair and danger I faced.

The journey also taught me to adopt important life skills, such as eating healthily, getting regular exercise and sleep, developing community. I learned how to care for myself and I do that faithfully, which is as much a part of spiritual practice as anything else. I also learned about humility, surrender, endurance, and courage.

Finally, I tapped core self-knowledge that feels very deep and rooted. You find out who you are when your back is against the wall. I know my capacity for suffering. I know what I endured and that I am both fragile and very, very strong. I know the people and events that “saved” me countless times. I know how listening heals. I know what I claim as my own dogged work. I know how much of it was grace. I know the sources and depth of my faith. I see this illness has been a profound journey to the soul, a blessed path, and that I am just beginning to share my bounty. I know that this journey has been a bone-crushing path, but I choose to call it “tough grace” and that has made all the difference.

4 Replies to “Tough Grace”


Ms. Holstein,

I stumbled across your article while doing a google search on “spirituality and mental illness”. I have been in therapy now for 10 months, and am starting to make progress. over a period of four years my life has come completely untethered, and after a severe depressive episode last August, my intellect, which always seemed to serve me even in the most awful episodes, was rendered to sludge. My journey has not been as horrific as yours, but I find it difficult to wrestle the terror of sliding back into the abyss from my mind. I am actively working in a DBT program (my diagnosis is Borderline with an a la carte of comorbids)and in meaningful individual therapy. I too have been seeking definition, and like Dr. Gunnar Christiansen suggests, have discoved a difference between the terms “cure” and “healing”. I find I am no longer looking for a cure, but hoping for healing.

I struggle with community, with a sense of displacement that has woven throughout my life, leading me to consider my mental illness to be lifelong, with extended stays at circumstances that deepened the drift from recognizable “normalcy”. My 15 years as an inner urban teacher linked with single parenthood and a frantic drive to educate myself seemed to have snapped my moorings, and here I am, learning how to put thoughts into words again, bathe, make my bead, and pay a couple of modest bills to keep a roof over my head at a local hotel. These are all blessings indeed. How many times I have thanked God for a toilet and clean water, a place to sleep, etc. I have learned to live with less and be happy about it. Still, “bad” days abound, and Caroline Myss’ “Madness” is terrifying to me, as unto death, because I am afraid of going back to that dark place… each time it seems to be worse. Staying in therapy, on my meds, working daily to stay grounded, thankful, and not too pitiful is how I hug the side of the mountain even on days when it seems every sparrow that flies by will knock me from my ledge.

Thank you for your article. In writing you I am tentatively beginning to reach for some sort of community, solitude is my preference 90%, since it is only there that I experience something akin t relief. I hope you post more articles, I would be an avid follower. Your bounty gives me hope.


What a heartfelt narrative of profound recovery and growth! I found this post by searching on ‘Mental Health as Spiritual Path’ after blogging ( about my own struggle as a professional (former surgeon) who has worked long and hard to achieve peace and transcendence in light of emotional issues and bipolar mood swings. It’s good to read someone speaking with such clarity and sincerity about this path. Thank you.


After reading your article Alice you have served to convince me all the more of what i know, that spiritual emergence and mental illness are one in the same bag. It depends on the view of the individual concerned and their ‘ownership’ as in willingness to take responsibility that defines the outcome. It is a shame there are not more like us strong enough to stand out and say NO.

Your story is inspiring, having received an identical diagnosis back in 2009, my story mirrors your own in many aspects, only i was just 17 (in the late 1980s) when this all started to emerge, have since raised a family and live an independent life,with a greater sense of self than I would ever have had i not been exposed to and lived with ‘mental illness’ as an ongoing condition… I believe wholeheartedly in it being a transformational process, a path of initiation. In the western world there is much catching up, peer professionals can only be a positive step toward integration and further understanding.


Hi Alice!

Thanks for the great and inspiring article. I have a small but similar blog post on bipolar disorder being a blessing and the book I’m working on also uses Campbell’s Hero’s Journey as a template. I’d really love to speak with you sometime, see if there’s anything I can do to help you and perhaps get some guidance and mentorship as I embark on a path that you have experience with. My email is bretaw [AT] gmail. My blog and the post I mentioned can be found here:

Thanks again and Be Well,
Bret Warshawsky

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