V62.89 (Z65.8) Religious or Spiritual Problem
This category can be used when the focus of clinical attention is a religious or spiritual problem. Examples include distressing experiences that involve loss or questioning of faith, problems associated with conversion to a new faith, or questioning of spiritual values that may not necessarily be related to an organized church or religious institution.

Diagnostic and Statistical Manual of Mental Disorders -5 V62.89

Spiritual emergency, a little-recognized class of temporary impairments of conventional psychological and perceptual functions, resembles a form of psychosis on superficial examination, but upon deeper investigation bears earmarks of a different kind of psycho-spiritual event, with a different set of outcomes than psychosis and a positive prognosis for the future. These events, if handled appropriately, tend to resolve themselves in ways that result in better psychological health and a greater degree of wholeness after the event; they appear to be the psyche’s (or incarnated spirit’s) tumultuous way of breaking apart maladaptive psychological structures and re-patterning them to allow for growth, greater expansiveness and understanding. Spiritual emergency has only in recent decades begun to make it into psychology’s lexicon, beginning with the approval in 1994 of a new entry in the DSM for “Religious or Spiritual Problem,” a non-pathological category. This notion was due in no small part to the works of pioneering transpersonal and Jungian analysts, notably Stanislov Grof and John Weir Perry.

This page is intended to act as a resource and serve the function of dispatching to information, content, and contacts that can be helpful to an individual who finds themselves in the throes of a spiritual emergency.

What is a spiritual emergency? John Weir Perry

Reframing Non-Ordinary States of Consciousness as Spiritual Crisis: Stanislov Grof

A short video on the inner experience of schizophrenia. Another type of psycho-spiritual event, the so-called “visionary experience” (Perry), originates from a different source and leads to alternative outcomes, but curiously, it shares many of the same traits as classic schizophrenia. Visionary experience, along with kundalini arousals and other types of spiritually-originated states, are termed “spiritual emergencies.” It is important to distinguish between the visionary experience, with the prospect of a favorable and growth-enabling outcome, and a more pathological true schizophrenia. One should not mistake one of these for another, and a trained professional can conduct a differential diagnosis of the two. That said, the two do share remarkable similarities in content, of which this video masterfully illustrates. It is not my intention to minimize or discount the tragic toll of a schizophrenia that is pathological, and one should definitely seek appropriate mental health care if one’s diagnosis is schizophrenia.

Resources

• Spiritual Emergence Network: Referrals and Information
• IMHU: Spiritual Emergence Coach Directory
• Spiritual Competency Resource Center: Spiritual Emergence
• ACISTE: American Center for the Integration of Spiritually Transformative Experiences
• ACISTE: Psychic Opening, Spiritual Emergency, and the Pathology Paradigm
• International Spiritual Emergence Network
• Association for Transpersonal Psychology – Directory

What Worked? A Personal Perspective

What would I have to suggest to my fellow human beings who might be going through such an experience? In reflecting on my experience now more than 20 years ago, it requires a fair amount of distancing and objective consideration of the narrative that I was swallowed up in for 10 weeks; this has proven to be a valuable exercise, as it has required me to think critically about the event and to analyze and communicate, in the broadest sense, the elements of adaptation that were helpful to me personally during that time.

First, the standard disclaimer. I am not a doctor, nor a licensed counselor, psychologist, psychiatrist, social worker, or other mental health professional. Nothing I mention here should be construed as direct health care or mental health care advice to anyone needing or seeking such guidance. If you are looking for specific authorized recommendations, check out the referral links below and contact a professional who is well-educated in these types of treatments. I am merely offering observations based on my perspective and reporting as a layman who has gone through the experience myself.

With that out of the way, here is what I found particularly helpful in my event:

• A supportive friend and family network that could provide physical, environmental, and social care
• Rest and proper nutrition
• Non-pathologizing of the event
• The ability to withdraw or retreat gracefully from everyday activities – job, school, and normal social involvements – for the necessary period
• Prayer and meditation; spiritual application
• Active engagement in self-care, rather than submitting to passive victimhood
• A personal spiritual worldview that allowed for the possibility of transformation/metamorphosis and provided a framework for non-mainstream interpretations of the occurrence.
• Being outside in nature
• Bodywork

And here is what I didn’t have that would have been helpful to have:

• Access to transpersonal psychologists well-versed in spiritual emergencies who could provide ongoing in-person sympathetic counsel and contact
• Access to priests, pastors, or spiritual directors who understood the role of mysticism in their traditions and had first-hand dealings with individuals suddenly breaking into mystic capabilities.
• More social activities that could help move and discharge extreme levels of energy in creative efforts – whether singing, exercise/sport, dance, artistic endeavors, etc.
• Access to a model of care, if necessary, that could be considered partial-hospitalization and was based on transpersonal tenets

A brief discussion of each of these.

A supportive friend and family network that could provide physical, environmental, and social care
This one was the most important one, upon reflection. I was, and remain to this day, immensely grateful to my birth family and their network of family friends and social contacts, as well as my own friends, who assisted me during the time I was incapacitated. All of my needs were met in this time by those around me. This is no small thing, for to this day, I am not convinced that any of these blessed people understood what was happening to me; I barely apprehended the full context of it myself at the time. But that did not affect the care that I received from them; they understood that I was in deep distress and that I needed help in being looked after for a period. All that was necessary was provided – physical, environmental, and social. I recognize not all who go through such an experience will have these resources behind them. In those cases, it would seem necessary that the necessary support and shelter would need to be sought out from other sources. A close friend who can serve in a temporary assistance role can be invaluable for those without an extended network; better yet, two or three close friends checking in on a regular basis can provide some continuity of care, even if it is not around the clock.

Rest and proper nutrition
More sleep than one usually gets is necessary. Deep psychological and physiological healing is taking place, and the body and mind need to be energized adequately to meet the task. A nutritious diet is also essential, with grounding foods (root vegetables, lean protein, etc.) particularly helpful. Minimize sugar, junk snacks, and processed foods.

Non-pathologizing of the event
Mental health care may be called for, but the industry generally pathologizes any unusual state it encounters. This is not helpful. I found it helpful to minimize the exposure to being stigmatized, even while the event was ongoing.
Beyond the mental-health care industry, on a personal level, it is quite easy to fall into a self-pitying frame of mind, a sort of “Why me?” attitude. But at some level, I was fortified against that, partly by my prior knowledge of other possible interpretations of the event, and at various points along the way by the outside counsel and advice of others with transpersonal leanings. This counsel was important in helping me see the possible positive outcomes, and that it was possible to go through the experience while withholding one’s personal judgment about it or about oneself. The intellectual framing of the event is critically important in whether one considers themselves in a tumultuous, but possibly healing process in the long-term, or considering themselves as “losing their marbles” and on a downhill trajectory with little or no possibility of reversal. And that distinction makes a huge difference.

The ability to withdraw or retreat gracefully from everyday activities for the necessary period
Not everyone may have this luxury, but if it is available and needed, one’s focus can be entirely on dealing with the crisis. In superficial respects, it can be considered like an extended medical hospitalization. If one is able to take leave or an extended leave of absence, this possibility can be considered. With family obligations, cooperation with one’s spouse to shift, minimize, or defer the obligations of family life for a few weeks may be necessary. In cases of mild or moderate severity, one may be able to continue with ordinary obligations, or only curtail them minimally.

Prayer and meditation; spiritual application
Helpful internally, though one must take care not to exacerbate the existing crisis through excessive meditation. Also helps promote a non-victim and self-help attitude.

Active engagement in self-care, rather than submitting to passive victimhood
Dovetails nicely with the previous point.

A personal spiritual worldview that allows for the possibility of transformation/metamorphosis and provided a framework for non-mainstream interpretations of the occurrences.
As mentioned in the point previously, the mere knowledge that these experiences can sometimes happen to spiritual seekers is immensely helpful – it provides a stabilizing influence and allows one to draw inferences and conclusions for oneself independently of what mainstream medicine or religious input might seek to impose.

Being outside in nature
I’ve always been sensitive to and felt the healing balm of nature. That sensitivity was greatly magnified during the experience. For those who benefit similarly, take advantage of being in the great outdoors. It helps to settle and smooth the day-to-day distress.

Bodywork
Though I had only one instance of this during my event, it was immensely helpful and I wish that circumstances would have allowed for more of this. Grounding, soothing professional massage therapy with a trusted practitioner provides a lifeline of physical contact that can assist in keeping one helpfully tethered to the material dimension, allowing for a consistently-persisting base of reference in one’s body, even during the tumult of metamorphosing consciousness. This is a benefit over and above the simple emotional reassurance that comes from human touch in difficult times.

For items I wish I had access to:

Access to transpersonal psychologists well-versed in spiritual emergencies
Regular counseling by professionals who understood the larger context and could assist in moving the process to resolution would have been very helpful. Unfortunately, such counselors tend to be concentrated in major metropolitan areas along the coasts and are not widely accessible in other parts of the country. In this day and age, remote consultations may be a possibility.

Access to priests, pastors, or spiritual directors who understood the role of mysticism in their traditions
This was the most astonishing and head-scratching lack I encountered – an utter blindness to the transpersonal dimensions of their faith for the pastors I consulted with during and after the event. “Heaven” and our aspiration after it is not simply a different version of subject-object realm after life with static selfhoods; a spiritual leader who consciously or subconsciously subscribes to this view is teaching exclusively in the shallow end of the pool without a true ability to swim. That’s not helpful when one is floundering in the deep end. The complete ignorance of the mystic dimensions by these purported spiritual leaders, even within the contexts of their parent faiths, does not speak well of the understanding and comprehension of the essence of spirituality by these leaders of orthodox religious denominations.
If possible, for those in Christian or Jewish traditions, seek out pastors or rabbis who have some notion of the process of active spiritual development and how it can manifest in practice, even if you must search beyond your home faith to find it.

More social activities that could help move and discharge extreme levels of energy
There are two components to this which could be treated as separate needs. The first is social activities of any type, congruent with one’s ability to tolerate (which may be very limited), which can help remind the individual she is still a human being in a society among other human beings. Better if those one is interacting with have some general knowledge and understanding of one’s limitations at this time, and can tailor their interactions and be solicitous and kind to the needs of the person in spiritual crisis.
The second need is for some type of creative and physical endeavor, preferably active, that can help discharge or ground the overwhelming energy one in spiritual crisis is contending with. It is extremely difficult to begin such a practice when one is in the throes of spiritual crisis; that is one of the main reasons Via Perennis advocates establishing such a practice before a crisis occurs.

Access to a model of care, if necessary, that could be considered residential care or partial-hospitalization
Sputtering and abortive attempts to provide halfway-house types of environments for those undergoing transformative events have met with mixed success, but tend to run into funding and support problems. Perry started Diabasis, such an experimental treatment facility in San Francisco, in the 1970s that achieved better success than traditional medical approaches with a more humane model of care. In recent years, a handful of soteria houses have been established across the country and internationally serving a similar function. The name Soteria comes from the Greek Σωτηρία for “salvation” or “deliverance”. Unfortunately, while this model seems to have a good deal of promise, it is not widely known or available.