When Spiritual Crises Show Up in the Mental Health System

Co-authored with Lotus Huyen Vu and Robert T. Muller, Ph.D.

The biggest regret I had was talking to my family and top doctors who were not informed about my experiences.

This is what Anna (name changed) had to say in an interview about her experience going through a spiritual “emergency” and how her situation was mishandled by the psychiatric establishment. Despite being included in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) under “Religious and Spiritual Problems”, few psychiatrists or psychologists are properly trained to diagnose and treat this condition.

Source: Mohamed Nohassi/Unsplash, Creative Commons

As defined by Stanislav Grof in 1989, a spiritual emergency is a process that involves experiences of Extrasensory perception, disorganized behavior, and unusual or illogical thoughts and beliefs that contain strong spiritual content. These troubling presentations can occur when spiritual experiences are not well integrated or progress too quickly, resulting in psychological difficulties.

The vast majority of spiritual experiences are not problematic. Practices like meditation, yoga, tai chi, chi gong, and the use of psychedelic drugs have long been a part of spiritual and mystical practices in Asian and indigenous cultures. These techniques are intended to induce spiritual awakening and an expansion of consciousness called spiritual emergence: a life-enhancing aspect of human development through which we seek meaning and connection beyond our personal identities.

Risks with the spiritual emergency

People are increasingly using these traditional spiritual practices to stress relief or exercise; however, the average person who engages in these practices may not be aware of the risks involved. When a spiritual emergence occurs, it can cause distress, or even a spiritual emergency, due to the confusion that arises from the lack of context for these practices.

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Many mental health professionals may identify as atheists or agnostics with no religious or spiritual background and have little or no formal training in treating this condition. However, 89 percent of the general US public reported holding some type of religious or spiritual belief. When spirituality intersects with modern models of mental health, clients may be left with inadequate support or negatively affected by the treatment experience. Anna describes her experience of feeling rejected by her spiritual beliefs:

I was full of anxiety for most of my life. I learned meditation and it helped me. I had extensive experiences of bliss, peace and contentment. With the experience of unity, I also felt that the flowers, the trees, the objects were alive and spoke to me. Although I had problems slept, I felt happy, with a new sense of purpose. When I told my family about my experiences, they hospitalized me, drugged me, and diagnosed me with maniac psychotic episode.

Kylie Harris, an independent psychology researcher and writer, shares her insights on mental health and spirituality:

When people go through these experiences, they can seem chaotic, even though the situation has symbolic meaning for them. People in spiritual emergencies need the space to explore the meaning of their experiences without judgment or being told that they need to be institutionalized and medicated. This is very different from typical psychosis in which a positive exploratory attitude, an understanding of one’s own experience and meaningful meaning to one’s life is not normally seen. Interpretations by psychiatric professionals or spiritual leaders may lead to a psychiatric diagnosis or, conversely, to a desire to explore the hidden meanings of life.

In some traditional communities, people experiencing spiritual emergencies are brought to a shaman or priest who contextualizes their experiences and helps integrate them. They are often set apart from others for a period of time and then return when they have fully integrated these experiences. Harris explains:

Indigenous cultures treat these experiences as a call for people to become healers or shamans. In traditional indigenous cultures, these individuals are revered rather than pathologized, as is the norm in Western culture.

Cultural, spiritual and religious competence

Spiritual emergencies can happen to theists, atheists, and agnostics alike. Many occur spontaneously through the natural course of life. There is a need for cultural, spiritual, and religious competence in mental health professionals, including the ability to treat clients in light of their beliefs and the meaning they derive from them, all of which can benefit therapeutic outcomes.

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David Lukoff, professor, researcher, clinical psychologist and co-author of the DSMThe “Religious and Spiritual Problems” section has worked for 30 years to raise awareness of these conditions. In an interview, he shares:

In traditional societies, people who have had these experiences of spiritual emergence do much better with the support of the community in spiritual and religious contexts that better understand and support these experiences. Mental health professionals need to know the role religious and spiritual beliefs and practices play in their clients’ lives, and how to identify and help their clients manage these challenging experiences.

Lukoff is currently participating as part of the Task Force to Educate and Promote the Spiritual, Religious, and Cultural Competence of Psychologists and Psychiatrists. Experiences like Anna’s should not be a common occurrence in spiritual emergency mental health treatment, but rather the exception.

Copyright Robert T Muller

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