Due to length, this piece has been broken into a number of separate articles.
This article was originally published in its entirety on Reality Sandwich under the title:
Spiritual Emergencies: Understanding and Treatment of Psychospiritual Crises
One of the most important implications of the research of holotropic states is the realization that many of the conditions, which are currently diagnosed as psychotic and indiscriminately treated by suppressive medication, are actually difficult stages of a radical personality transformation and of spiritual opening. If they are correctly understood and supported, these psychospiritual crises can result in emotional and psychosomatic healing, remarkable psychological transformation, and consciousness evolution (Grof and Grof 1989, 1990).
Episodes of this nature can be found in the life stories of shamans, founders of the great religions of the world, famous spiritual teachers, mystics, and saints. Mystical literature of the world describes these crises as important signposts of the spiritual path and confirms their healing and transformative potential. Mainstream psychiatrists do not differentiate psychospiritual crises, or even episodes of uncomplicated mystical experiences, from serious mental diseases, because of their narrow conceptual framework.
Academic psychiatry, being a subdiscipline of medicine, has a
strong preference for biological interpretations, and uses a model of the psyche limited to postnatal biography and the Freudian individual unconscious. These are serious obstacles in understanding the nature and content of mystical states and the ability to distinguish them from manifestations of mental disease.
The term “spiritual emergency” (psychospiritual crisis), which my wife Christina and I coined for these states alludes to their positive potential. In English, this term is a play on words reflecting the similarity between the word “emergency” (a suddenly appearing acute crisis) and “emergence” (surfacing or rising). It thus suggests both a problem and opportunity to rise to a higher level of psychological functioning and spiritual awareness. We often refer in this context to the Chinese pictogram for crisis that illustrates the basic idea of spiritual emergency. This ideogram is composed of two images, one of which means danger and the other opportunity.
Among the benefits that can result from psychospiritual crises that receive expert support and are allowed to run their natural course are improved psychosomatic health, increased zest for life, a more rewarding life strategy, and an expanded worldview that includes the spiritual dimension. Successful completion and integration of such episodes also involves a substantial reduction of aggression, increase of racial, political, and religious tolerance, ecological awareness, and deep changes in the hierarchy of values and existential priorities. It is not an exaggeration to say that successful completion and integration of psychospiritual crisis can move the individual to a higher level of consciousness evolution.
In recent decades, we have seen rapidly growing interest in spiritual matters that leads to extensive experimentation with ancient, aboriginal, and modern “technologies of the sacred,” consciousness-expanding techniques that can mediate spiritual opening. Among them are various shamanic methods, Eastern meditative practices, use of psychedelic substances, effective experiential psychotherapies, and laboratory methods developed by experimental psychiatry. According to public polls, the number of Americans who have had spiritual experiences significantly increased in the second half of the twentieth century and continues to grow. It seems that this has been accompanied by a parallel increase of psychospiritual crises.
More and more people seem to realize that genuine spirituality based on profound personal experience is a vitally important dimension of life. In view of the escalating global crisis brought about by the materialistic orientation of Western technological civilization, it has become obvious that we are paying a great price for having rejected spirituality. We have banned from our life a force that nourishes, empowers, and gives meaning to human existence.
On the individual level, the toll for the loss of spirituality is an impoverished, alienated, and unfulfilling way of life and an increase of emotional and psychosomatic disorders. On the collective level, the absence of spiritual values leads to strategies of existence that threaten the survival of life on our planet, such as plundering of nonrenewable resources, polluting the natural environment, disturbing ecological balance, and using violence as a principal means of international problem-solving.
It is, therefore, in the interest of all of us to find ways of bringing spirituality back into our individual and collective life. This would have to include not only theoretical recognition of spirituality as a vital aspect of existence, but also encouragement and social sanctioning of activities that mediate experiential access to spiritual dimensions of reality. And an important part of this effort would have to be development of an appropriate support system for people undergoing crises of spiritual opening, which would make it possible to utilize the positive potential of these states.
In 1980, Christina founded the Spiritual Emergency Network (SEN), an organization that connects individuals undergoing psychospiritual crises with professionals, who are able and willing to provide assistance based on the new understanding of these states. Filial branches of SEN now exist in many countries of the world.
Triggers of Spiritual Emergency
In many instances, it is possible to identify the situation that precipitated the psychospiritual crisis. It can be a primarily physical factor, such as a disease, accident, or operation. At other times, extreme physical exertion or prolonged lack of sleep may appear to be the most immediate trigger. In women, it can be childbirth, miscarriage, or abortion. We have also seen situations where the onset of the process coincided with an exceptionally powerful sexual experience.
In other cases, the psychospiritual crisis begins shortly after a traumatic emotional experience. This can be loss of an important relationship, such as death of a child or another close relative, divorce, or the end of a love affair. Similarly, a series of failures or loss of a job or property can immediatel precede the onset of spiritual emergency. In predisposed individuals, the “last straw” can be an experience with psychedelic substances or a session of experiential psychotherapy.
One of the most important catalysts of psychospiritual crisis seems to be deep involvement in various forms of meditation and spiritual practice. This should not come as a surprise, since these methods have been specifically designed to facilitate spiritual experiences. We have been repeatedly contacted by persons in whom extended periods of holotropic states were triggered by the practice of Zen, Vipassana, or Vajrayana Buddhist meditation, yogic practices, Sufi ceremonies, monastic contemplation, or Christian prayer.
The wide range of triggers of spiritual crises clearly suggests that the individual’s readiness for inner transformation plays far more important role than the external stimuli. When we look for a common denominator or final common pathway o the situations described above, we find that they all involve radical shift in the balance between the unconscious and conscious processes. Weakening of psychological defenses or, conversely, increase of the energetic charge of the unconscious dynamics, makes it possible for the unconsciou (and superconscious) material to emerge into consciousness.
It is well known that psychological defenses can be weakened by a variety of biological insults, such as physical trauma, exhaustion, sleep deprivation, or intoxication. Psychological traumas can mobilize the unconscious, particularly when they involve elements that are reminiscent of earlier traumas and are part of a significant COEX system The strong potential of childbirth as a trigger of psychospiritual crisis seems to reflect the fact that delivering a child combines biological weakening with specific reactivation of the mother’s own perinatal memories.
Failures and disappointments in professional and personal life can undermine and thwart the outward-oriented motivations and ambitions of the individual. This makes it more difficult to use external activities as anescape from emotional problems and leads to psychological withdrawal and turning of attention to the inner world. As a result, unconscious contents can emerge into consciousness and interfere with the individual’s everyday experience or even completely override it.
Diagnosis of Spiritual Emergency
When we emphasize the need to recognize the existence of psychospiritual crises, this does not mean indiscriminate rejection of the theories and practices of traditional psychiatry. Not all states that are currently diagnosed as psychotic are crises of psychospiritual transformation or hav a healing potential. Episodes of nonordinary states of consciousness cover a very broad spectrum from purely spiritual experiences to conditions that are clearly biological in nature and require medical treatment. While modern psychiatrists generally tend to pathologize mystical states, there also exists the opposite error of romanticizing and glorifying psychotic states or, even worse, overlooking a serious medical problem.
Many mental health professionals who encounter the concept of psychospiritual crisis want to know the exact criteria by which one can make the “differential diagnosis” between a crisis of this kind (“spiritual emergency”) and psychosis. Unfortunately, it is in principle impossible to make such differentiation according to the standards used in somatic medicine. Unlike diseases treated by somatic medicine, psychotic states that are not obviously organic in nature – “functional psychoses” or “endogenous” psychoses are not medically defined. The commonly used laboratory examinations of blood, urine, stool, and cerebrospinal fluid, as well as EEG, X-rays, and other similar methods do not yield any useful clues in this regard. It is actually highly questionable whether these conditions should be called diseases at all.
Functional psychoses certainly are not diseases in the same sense as diabetes, typhoid fever, or pernicious anemia. They do not yield any specific clinical or laboratory findings that would support the diagnosis and justify the assumption that they are of biological origin. The diagnosis of these states is based entirely on the observation of unusual experiences and behaviors for which contemporary psychiatry lacks adequate explanation.
The meaningless attribute “endogenous” (literally “generated from within”) used for these conditions is tantamount to admission of this ignorance. At present, there is no reason to refer to these conditions as “mental diseases” and assume that the experiences involved are products of a pathological process in the brain yet to be discovered by future research. If we give it some thought, we realize it is highly unlikely that a pathological process afflicting the brain could, in and of itself, generate the incredibly rich experiential spectrum of the states currently diagnosed as psychotic. How could possibly abnormal processes in the brain generate such experiences as culturally specific sequences of psychospiritual death and rebirth, convincing identification with Christ on the cross or with the dancing Shiva, an episode involving death on the barricades in Paris during the French revolution, or complex scenes of alien abduction?
When similar experiences manifest under circumstances in which the biological changes are accurately defined, such as dministration of specific dosages of chemically pure LSD-25 the nature and origin of their content remain a deep mystery. The spectrum of possible reactions to LSD is very broad an includes reliving of various biographical events, experiences of psychospiritual death and rebirth, episodes of mystical rapture, feelings of cosmic unity, sense of oneness with God, and past-life memories, as well as paranoid states, manic episodes, apocalyptic visions, exclusively psychosomatic responses, and many others. The same dosage given to different individuals or repeatedly to the same person can induce very different experiences.
Chemical changes in the organism obviously catalyze the
experience, but are not, in and of themselves, capable of creating the intricate imagery and the rich philosophical and spiritual insights, let alone mediating access to accurate new information about various aspects of the universe. The administration of LSD and other similar substances can account for the emergence of deep unconscious material into consciousness, but cannot explain its nature and content.
Understanding the phenomenology of psychedelic states necessitates a much more sophisticated approach than a simple reference to abnormal biochemical or biological processes in the body. It requires a comprehensive procedure that has to include transpersonal psychology, mythology, philosophy, and comparative religion. The same is true in regard to psychospiritual crises.
The experiences that constitute psychospiritual crises clearly are not artificial products of aberrant pathophysiological processes in the brain, but manifestations of the deeper levels of the psyche. Naturally, to be able to see it this way, we have to transcend the narrow understanding of the psyche offered by mainstream psychiatry and use a vastly expanded conceptual framework. Examples of such enlarged models of the psyche are the cartography described in my own books and papers (Grof 1975, 2000, 2007a), Ken Wilber’s spectrum psychology (Wilber 1977), Roberto Assagioli’s psychosynthesis (Assagioli 1976), and C. G. Jung’s concept of the psyche as identical with the world soul (anima mundi) that includes the historical and archetypal collective unconscious (Jung 1959). Such large and comprehensive understanding of the psyche is also characteristic of the great Eastern philosophies and the mystical traditions of the world.
Since functional psychoses are not defined medically but psychologically, it is impossible to provide a rigorous differential diagnosis between psychospiritual crisis (“spiritual emergency”) and psychosis in the way it is done in medical practice in relation to different forms of encephalitis, brain tumors, or dementias. Considering this fact, is it possible to make any diagnostic conclusions at all? How can we approach this problem and what can we offer in lieu of a clear and unambiguous differential diagnosis between psychospiritual crisis and mental disease?
A viable alternative is to define the criteria that would make it possible to determine which individual, experiencing an intense spontaneous holotropic state of consciousness, is likely to be a good candidate for a therapeutic strategy that validates and supports the process. And, conversely, we can attempt to determine under what circumstances using an alternative approach would not be appropriate and when the current practice of routine psychopharmacological suppression of symptoms would be preferable.
A necessary prerequisite for such an evaluation is a good medical examination that eliminates conditions, which are organic in nature and require biological treatment. Once this is accomplished, the next important guideline is the phenomenology of holotropic state of consciousness in
Psychospiritual crises involve a combination of biographical, perinatal, and transpersonal experiences that were described in another context, in the discussion of the extended cartography of the psyche (Grof 1975, 2000, 2007 a). Experiences of this kind can be induced in a group of randomly selected “normal” people not only by psychedelic substances, but also by such simple means as meditation, shamanic drumming, faster breathing, evocative music, bodywork, and variety of other nondrug techniques.
Those of us who work with holotropic breathwork see such
experiences daily in our workshops and seminars and have the opportunity to appreciate their healing and transformative potential. In view of this fact, it is difficult to attribute similar experiences to some exotic and yet unknown pathology when they occur spontaneously in the middle of everyday life. It makes eminent sense to approach these experiences in the same way they are approached in holotropic and psychedelic sessions to encourage people to surrender to the process and to support the emergence and full expression of the unconscious material that becomes available.
Another important indicator is the person’s attitude to the process and his or her experiential style. It is generally very encouraging when people who have holotropic experiences recognize that what is happening to them is an inner process, are open to experiential work, and interested to try it.
Transpersonal strategies are not appropriate for individuals who lack this elementary recognition, use predominantly the mechanism of projection, or suffer from persecutory delusions. The capacity to form a good working relationship with an adequate amount of trust is an absolutely essential prerequisite for psychotherapeutic work with people in spiritual crisis.
It is also very important to pay attention to the way clients talk about their experiences. The communication style, in and of itself, often distinguishes promising candidates from inappropriate or questionable ones. It is a very good prognostic indicator if the person describes the experiences in a coherent and articulate way, however extraordinary and strange their content might be. In a sense, this would be similar to hearing an account of a person who has just had a psychedelic session and intelligently describes what to an uninformed person might appear to be strange and extravagant experiences.
Varieties of Spiritual Crises
A question that is closely related to the problem of differential diagnosis of psychospiritual crises is their classification. Is it possible to distinguish and define among them certain specific types or categories in the way it is attempted in the Diagnostic and Statistical Manual of Mental Disorders (DSM IV-revised) and its predecessors used by traditional psychiatrists? Before we address this question, it is necessary to emphasize that the attempts to classify psychiatric disorders, with the exception of those that are clearly organic in nature, have been generally unsuccessful.
There is general disagreement about diagnostic categories among individual psychiatrists and also among psychiatric societies of different countries. Although DSM has been revised and changed a number of times, clinicians complain that they have difficulties matching the symptoms of their clients with the official diagnostic categories. Spiritual crises are no exception; if anything, assigning people suffering fro these conditions to well-defined diagnostic categories is particularly problematic because of the fact that their phenomenology is unusually rich and can have its source on all various levels of the psyche.
The symptoms of psychospiritual crises represent a manifestation and exteriorization of the deep dynamics of th human psyche. The individual human psyche is a multidimensional and multilevel system with no internal divisions and boundaries. The elements from postnatal biography and from the Freudian individual unconscious form a continuum with the dynamics of the perinatal level and the transpersonal domain. We cannot, therefore, expect to find clearly defined and demarcated types of spiritual emergency. And yet, our work with individuals in psychospiritual crises, exchanges with colleagues doing similar work, and study of pertinent literature have convinced us that it is possible and useful to outline certain major forms of psychospiritual crises, which have sufficiently characteristic features to be differentiated from others.
Naturally, their boundaries are not clear and, in practice, there are some significant overlaps among them. I will first present a list of the most important varieties of psychospiritual crises as Christina and I have identified them and then briefly discuss each of them. [Click each item in the list fo the deeper definition]
1. Shamanic crisis
2. Awakening of Kundalini
3. Episodes of unitive consciousness (Maslow’s “peak experiences”)
4. Psychological renewal through return to the center (John Perry)
5. Crisis of psychic opening
6. Past-life experiences
7. Communication with spirit guides and “channeling”
8. Near-death experiences (NDEs)
9. Close encounters with UFOs and alien abduction experiences
10. Possession states
11. Alcoholism and drug addiction
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