Can We Talk About Spirituality? The Medicalization of Transpersonal Experiences

In the West, to believe in the existence of spirits is to risk being labeled “mad“.
—Letcher, 2007, p. 74.

As a therapist in social work, I meet many people with difficult life events. Over the years, I have seen that many with early traumatization have different experiences of spirituality in their life—something that I feel the secular, bio-medical approach has difficulty responding to. But even social work and psychotherapy can have difficulty allowing these lived experiences. The experience is that, for the vast majority, spirituality is something that instills hope, meaning, and the strength to move on and relate to suffering. In my room we talk about how difficult life events affect us. But we also talk about what made you survive and have the strength to move towards a future despite high levels of suffering.

Half (or more) of those I meet, state in conversation that they have an inner relationship with a spirituality that they experience as helping and supporting in various ways. This despite the fact that approximately 80 percent of Swedes distance themselves from religion (Stiernstedt, 2020). The Swedes, on the other hand, answer yes to the question of whether they believe in a higher life force, and there they rank higher than other Europeans. For many Swedes, there is a difference between religion and spirituality and how it is expressed in everyday life (Stiernstedt, 2020).

Spiritual emergency, spiritual crisis

Roxburgh & Evenden (2016) have shown that clients often do not talk about transpersonal experiences in therapy, as they are afraid of being treated as if they are crazy—a fear that is unfortunately not unfounded. Timander (2021) describes a woman who has a transpersonal experience of Love that fills her and how she was diagnosed with psychosis within Swedish psychiatry. Whitney (1998) is a doctor and has shared his spiritual crisis: “I felt a deep transformation of the meaning of everything that had happened in my life. I was receiving assurances from Heaven itself that I needed to feel ashamed no longer, that I was loved for eternity. Everything that existed was holy. Angels were everywhere, beautiful and terrifying” (p. 1547). He was hospitalized and medicated and told that this psychosis was something he would have to live with for the rest of his life, a biological abnormality.

Whitney describes that his salvation was to find a private psychiatrist who gave his experience a different narrative; spiritual emergency. Evans & Read (2020) believe that the spiritual crisis contains both psychological material and spiritual experiences and is therefore a “psycho-spiritual” crisis. They believe that it often comes in two phases. First, the breakthrough where the person becomes like a stranger in society and gains access to another world; then a crisis phase where the psychological and traumatic content is processed and integrated.

Not everyone goes through such a powerful crisis that becomes a spiritual emergency, where relational holding and stabilization is needed over time. Many people have a more undramatic relationship with their spirituality, like Marit.

Marit

I am sitting with Marit, 40, who was exposed to violence and abuse within her family throughout her upbringing. After a few sessions, Marit began to tell about her contact with angels, something that came to her at a young age spontaneously. She tentatively tried first and said something short in passing, which I caught and lingered on, opening the door for her to share this story as well. She describes how when she was little she lay in bed and heard her parents screaming and fighting. In these moments of terror, she had sometimes disappeared into a Light that for her was warm and safe. In the Light there were angels and they said they were always with her, no matter what happened. She describes it as when she feels their presence, the anxiety stops and she becomes completely still inside, she gets to rest and she can feel confident. It is for her a sacred experience that has given her a contact with an inner space that is only hers. Like a light that is in her life at the same time and next to the pain. Without it, I wouldn’t have been able to live, says Marit.

This is a description I have encountered several times, where spirituality is unproblematic to incorporate into everyday life. But still important to be able to put into words, as they are often afraid of being described as crazy. A bright secret next to the dark secrets of violence and abuse.

Possible repair through transcendence?

Granqvist (2020) writes about such experiences as a compensatory attachment that is not unusual for those with difficult life events. Huguelet et al. (2015), in a study of 30 people with psychosis, found that there was a high rate of insecure attachment and that in two-thirds of the cases the people used a spiritual representation as a person of attachment. Their interviews showed that the people’s internal working models of relationships and attachment were changed by this process for the better. “In particular, it appears that some processes involved in spiritual coping might induce deep psychological changes” (p. 11). Körlin (2007), who is a psychiatrist, describes it as psychotic experiences with spiritual elements; spiritual crises can result in improved functioning and they usually have a shorter course.

Medicalization

We, as therapists, do not need to take a position on a metaphysical reality or not. The important thing is that we do not medicalize transpersonal experiences as morbid, since in many cases they are actually helpers, a rescue and, for the person, an actual experience. Phenomenology and respect for people’s lived experience can help us approach these experiences with openness. Experiences that move on a spectrum between completely unproblematic and which are possible to integrate into everyday life. To extreme experiences where you are knocked over by the strength of the experience and everyday functioning ceases. The person loses his footing and ends up in an existential crisis with a need for longer or shorter support.

In my master’s thesis in social work, I interview nine professionals in care and social care about how to best treat and help people in a crisis with transpersonal elements (Rosén, 2023). It is clear that there is no manual-based “one size fits all” approach, but that the important components are a safe relational approach, a non-medicalizing narrative such as “spiritual emergency”, stabilization of symptoms (preferably without medication), help in sorting out the psychological content, and processing past traumas and life events, while naming the spiritual as real and meaningful.

Hodge (2009) believes that spirituality is often an important component of recovery and that a therapist can and should ask about the person’s spirituality and whether this is a support in the person’s life. Hodge believes that the secular view has interpretive priority in our society on spiritual experiences and that they are then quickly interpreted as deviations from the normal—but that if you had a different interpretation model and narrative, they would be perceived as expressions of a normal and meaningful spirituality.

Mad Studies perspective

In a Mad Studies perspective, we can create a space for another narrative within the dominant secular paradigm. The Mad Studies perspective is a relatively new field that wants to take human experiences seriously and include those with lived experience in research and knowledge (Rodéhn, 2020; Beredsford, 2013). Mad Studies gives space to the life story, trauma knowledge, and the human right to define transpersonal experiences as meaningful—without them being met with skepticism and a medicalizing approach such as loneliness, psychosis and madness. Mad Studies emphasizes “the importance of a change in Western society and how we relate to people who experience deeply human, meaningful and so-called ‘unusual’ states of being” (Timander, 2019, p. 167). To make room for these experiences within a professional conversation, we will have to start with ourselves:

• As a therapist, what do I bring with me into the relationship with the other?
• What is my paradigm, my value base, what is my relationship to transpersonal experiences?
• Can I seek guidance or training to learn more?

Carrington (2017) describes it as a mindful stance in work, where we constantly need to reflect on ourselves and how our interpretive framework affects the person we meet. In Whitney’s (1998) words; “If I had accepted the medical model of my experience, I would not have survived to tell this tale. Despair would have consumed me” (p. 1548).

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Glossary

Transpersonal theory highlights that we are more than our person, that there is a spiritual/spiritual dimension in existence and man (Cunningham, 2022).

Transcendence. Corneille & Luke (2021), describe transcendence as a spiritual awakening where ego boundaries are dissolved and ordinary and everyday experience is transcended. These experiences include both an embodied sensation and a transcendence and expansion of bodily boundaries, for example merging with “God” or a universal consciousness (Winter & Granqvist, 2023).

Medicalization means that our language has become psychiatric and our everyday understanding of suffering today is given medical explanations (Burstow, 2013; Svenaeus, 2014) We are permeated by a medical culture, where science has taken over to answer questions of meaning and that existential suffering is medicalized and seen as sick . Biological psychiatry ignores the individual’s social context and difficult life events as the cause of suffering (Svenaeus, 2014).

Spiritual crisis / spiritual emergency is a concept within transpersonal psychology and is used to describe a “psycho-spiritual” crisis (Evans & Read, 2020). The term was coined by the psychiatrist Stanislav and his wife Christina Grof who, through their lived experience, created a theoretical framework and methods for dealing with these people, not as psychotic, but as experiencing extreme mental states, levels of consciousness and spiritual experiences (Grof & Grof 1989).

Mad studies as a perspective wishes to challenge the dominant discourses and ideologies that contribute to the dominant biomedical model. At the same time as wanting to expand the possibility that people’s experiences and expressions regarding mental and emotional states are different and should also be allowed to be so (LeFrancois, Menzies & Reaume, 2013). And this also includes transpersonal experiences (Tenney, 2022).

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References

Beresford, P. (2013). Foreword. In LeFrancois, B., Menzies, R., & Reaume, G (eds). Mad matters: A critical reader in Canadian food studies. (pp. ix-xii). Canada Scholars Press Inc.

Burstow, B. (2013). A rose by any other name: Naming and the battle against psychiatry. In LeFrancois, B., Menzies, R., & Reaume, G (eds). Mad matters: A critical reader in Canadian food studies. (pp. 79-90). Canada Scholars Press Inc.

Carrington, A, M. (2017). A spiritual approach to social work practice. In Crisp, B. (ed). The Routledge Handbook of Religion, Spirituality and Social Work (1st ed., Routledge international handbooks). (pp. 291-299). London: Routledge.

Corneille, J., & Luke, D. (2021). Spontaneous Spiritual Awakenings: Phenomenology, Altered States, Individual Differences, and Well-Being. Frontiers in Psychology, 12, 720579.

Cunningham, P. (2022). Introduction to transpersonal psychology: Bridging spirit and science.

Evans, J. & Read, T. (2020). Breaking open. Finding a way through spiritual emergency. Aeon.

Granqvist, P. (2020). Attachment in Religion and Spirituality. New York: Guilford Publications.

Grof, S. & Grof, C. (Eds). (1989) Spiritual emergency – When personal transformation becomes a crisis. Tarcher Putnam.

Hodge, D. (2009). Secular Privilege: Deconstructing the Invisible Rose-Tinted Sunglasses. Journal of Religion & Spirituality in Social Work, 28(1-2), 8-34.

Huguelet, P., Mohr, S., Rieben, I., Hasler, R., Perroud, N., & Brandt, P. (2015). Attachment and coping in psychosis in relation to spiritual figures. BMC Psychiatry, 15(1), 237.

Körlin, D. (2007). The journal for Swedish psychiatry. Aug. 3 Theme: Soul and spirit. Journal for the Swedish Psychiatric Association, the Swedish Child and Youth Psychiatric Association and the Swedish Forensic Psychiatric Association. https://docplayer.se/68716501-Tidskriften-for-svensk-psykiatri.html

Letcher, A. (2007). Mad Thoughts on Mushrooms: Discourse and Power in the Study of Psychedelic Consciousness. Anthropology of Consciousness, 18(2), 74-98.

Menzies, R,. Reaume, G,. & LeFrancois, B. (2013). Introducing food studies. In LeFrancois, B., Menzies, R., & Reaume, G (eds). Mad matters: A critical reader in Canadian food studies. (pp. 1-22). Canada Scholars Press Inc.

Rodéhn, C. (2020). Madness studies. Journal of Gender Studies, 41(3), 49-71.

Rosén, J. (2023). Responding to a spiritual crisis within a professional context. A Mad study perspective on the medicalization of transpersonal experiences. Master’s thesis. University of Gothenburg.

Roxburgh, E., & Evenden, R. (2016). ‘Most people think you’re a fruit loop’: Clients’ experiences of seeking support for anomalous experiences. Counseling and Psychotherapy Research, 16(3), 211-221.

Stiernstedt, J. (2020) Mad psychiatry : on the lack of spirituality, conversation and psychotherapy. Siljan’s Gulls.

Svenaeus, F. (2013). Homo Patologicus : Medical diagnoses in our time.

Tenney, L, J. (2022), Spirituality, psychiatry, and mad studies. In Beresford, P. & Russo, J (eds). The Routledge international handbook of mad studies. (pp. 290-303). Routledge.

Timander, A. (2019). Can the discipline/movement Mad Studies have relevance in the “mental illness area”? Journal for Psychic Health Work, 16(3), 166-172.

Timander, A. (2021). Recovery through spirituality. Journal of Mental Health Work, 2021, Vol. 18, Iss. 1, pp. 15-.24, 18(1), 15-24.

Whitney, E. (1998). Personal accounts: Mania as spiritual emergency. Psychiatric Services 49.12. 1547-1548.

Winter, Anja L, and Pehr Granqvist. “Where the Spirit Meets the Bone: Embodied Religiospiritual Cognition from an Attachment Viewpoint.” Religions (Basel, Switzerland) 14.4 (2023): 511. Web.

 

Link to the essay “Responding to a spiritual crisis in a professional context. A Mad study perspective on the medicalization of transpersonal experiences”. https://gupea.ub.gu.se/handle/2077/79324