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Spiritual Emergency A Crisis of Pycho-‐Spiritual Transformation: What A Chaplain Needs to

Know. Part I of II

Shari Naismith

Upaya Zen Center

Prajna Mountain Order

Final Project

Upaya Chaplaincy Program

2010-‐2012

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Abstract

This paper is part one of a two part research project. The project explores the

subjective experience of an unexpected crisis called spiritual emergency. The purpose is to

provide a basic understanding of a spiritual emergency to chaplains and see the importance of

further education in this area. In its most general sense, spiritual emergency can be defined

as a temporary state of personal crisis during which the process of spiritual and psychological

growth and change become so chaotic and overwhelming that previously held daily activities

and functioning are severely interrupted. This paper, Part One of the project, will provide

enough information in and around the subject of spiritual emergency to see the need for

chaplaincy education. It will do so by blending a review of relevant literature. As spiritual

emergency is examined, key terms and definitions will be provided. One of the largest causes

of spiritual emergency is a spontaneous spiritual experience. Potential triggers for

spontaneous spiritual experiences are reviewed as well as key features of spiritual emergency.

The possible dangers and detours with spiritual emergency are discussed as well as an

introduction to the possible growth potential of spiritual emergence. Part Two will be

published in September 2012 as a final project of a residential Clinical Pastoral Education

(CPE) program. A preview of the content is provided at the end of this Part One paper.

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Spiritual Emergency A Crisis of Pycho-‐Spiritual Transformation

is liberated and compelled

suddenly to stand up and turn his neck around and walk

toward the light, he will suffer sharp pains; the glare will

distress him, and he will be able to see the realities of

which, in his former state, he had seen but the shadow

Plato

Purpose

The purpose of this research project in full is to review the phenomena of spiritual

emergency, investigate whether professional chaplains should be knowledgeable of it,

whether they should offer support to individuals experiencing it, and if so, how. Part One of

the project is meant to familiarize chaplains with spiritual emergency and other surrounding

concepts. Chaplains will gain a basic understanding of what can attribute to a spiritual

emergency, what happens during a spiritual emergency and with whom a spiritual emergency

can happen. Research shows that nearly half the individuals experiencing spiritual emergency

have no previous spiritual or religious path (Nightingale, 2007). This research project is

dedicated to that half of the population, as they are most vulnerable to encountering longer

lasting dangers along the way.

Professional interest seems to be growing in the areas of spiritual emergency. It was

reported in an article written in 2010 (Viggiano & Krippner), that the AltaVista advanced

search engine reported 120,000 articles and

books. The interesting fact was that 109,000 of those were from the previous year (2009)

alone. At the time of this paper, Google Scholar revealed 1221 different articles and books

referencing or spiritual emergencies. Close to half that number (533),

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are from the past five years alone (Google Scholar, 2011). The increase of books and articles

written on or referencing spiritual emergency, points to a growing interest in the subject.

Interestingly, out of all the articles and books written that referenced spiritual

emergency, or chaplaincy. However, on the

Association of Certified Pastoral Education (ACPE) Research Network website there was a

point in that direction. Chaplain John Ehman (2010), listed Religion, Spirituality, and Psychosis

(Menezes, Jr, & Moreira-‐Almeida, 2010), as the article of the month. Chaplain Ehman pointed

out that the article argues for the need of further research on the relationship between

spirituality and mental illness, and greater attention to the clinical differentiation between

spiritual experiences and psychosis. Even though th were not

mentioned, Chaplain Ehman comments that CPE students should consider how they

differentiate between extraordinary spiritual experiences and pathological issues needing full

psychiatric assessment. He also poses the question to all chaplains by asking if a valid spiritual

experience could involve experiences contrary to the notion of mental health and whether

such experiences and questions may have a theological answer in tension (personally or

professionally) with a medical one. Chaplain Ehman points to another article titled Religion,

Spirituality and Psychotic Disorders (Koenig, 2007), and comments that one-‐third of psychoses

have religious delusions but not all religious experiences are psychotic. The Koenig article

mentions that in many cases supporting the religious experiences can have positive effects.

As of the time of this writing, approximately twenty chaplains (candidates and existing

chaplains working in hospital settings) were informally asked about their knowledge of

spiritual emergency; no one was familiar. This paper, Part One, is intended to familiarize

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chaplains with the profound crisis of spiritual emergency and the spontaneous spiritual

experience that so often precedes it. Part Two will go further into the integration of these

experiences within Developmental Theories, the current treatments of spiritual emergency

and the possibility of a in the where this may be encountered,

what a chaplain can offer and how it can be done.

Format

This paper is written from an informal anecdotal perspective, involving literature

review and personal and clinical experience. It is written in a pluralistic tone for

easier reading by chaplains of all faiths.

The topic of spiritual emergency can be a complex subject involving many dimensions

in the spiritual, practical and medical domains. In an effort to reduce complexity and also

cover a lot of material, this author will simplify when possible with great care; yet not to over-‐

simplify and miss the mark. Please keep in mind this paper is considered a basic overview of

the subject.

In this paper, there are five sections. The first section provides the introduction to

spiritual emergency, the definitions of terms like spirituality, spiritual emergency,

spontaneous spiritual experience, and spiritual crisis; it also contains some known triggering

experiences that precede a spontaneous spiritual experience, along with features of a spiritual

emergency. Another topic covered in this first section concerns the similarities and

differences between spiritual emergency and psychosis. The second section of this paper is an

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example of a spontaneous spiritual experience and a spiritual emergency. The third section

describes the unfortunate detours and dangers a person can experience immediately after a

spontaneous spiritual experience and during the spiritual emergency process it may have

generated. The fourth section is an introduction to the possibilities of moving from spiritual

emergency to a healthy spiritual emergence, which will be discussed at great length in Part

Two. The fifth section of this paper summarizes the contributions and limitations of this paper

as well as some suggestions for further research on spontaneous spiritual experience and

spiritual emergency. The final section six, contains a brief review of subjects and research to

be covered in Part Two.

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SECTION 1: SPIRITUAL EMERGENCY

1.1 Spiritual Emergency Introduction and Important Definitions

In its most general sense, spiritual emergency can be defined as a temporary state of

internal personal crisis during which the process of spiritual and psychological growth and

change become so chaotic and overwhelming that the previous held daily activities and

various functioning are severely impeded (Grof & Grof, 1989; Lukoff, Lu, & Turner, 1998).

Stanislav Grof, a transpersonal psychologist, and his wife Christina Grof, coined the term

play on words emergency (i.e.,

profound crisis) and the word emergence (i.e., arising), which works with the idea that both

processes typically are concurrent. They wanted to differentiate between the intensity and

duration of processes found within emergency and emergence.

In The Stormy Search for Self: a Guide to Personal Growth through Transformational

Crisis (Grof & Grof, 1990), critical and experientially difficult

s entire being. They take

the form of non-‐ordinary states of consciousness and involve intense emotions, visions, and

(p.

31). The authors also state: Individuals experiencing such episodes may feel that their sense

of identity is breaking down, that their old values no longer hold true, and that the very ground

beneath their personal realities is radically shifting. In many cases, new realms of mystical and

spiritual experiences enter their lives suddenly and dramatically, resulting in fear and

confusion. They may feel tremendous anxiety, have difficulty coping with their daily lives, jobs,

(back cover).

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Lukoff, Lu, and Turner (1998) a state of personal crises

during which the process of growth and change becomes so chaotic and overwhelming that

the previous held daily activities and various functioning are severely impeded They further

In spiritual emergence

emergency there is significant abrupt disruption in

psychological/social/occupational functioning

Cath an intensifying of the

process of spiritual awakening, a speeding up of the process that becomes unmanageable and

often terrifying. Both the spontaneous spiritual experience and a spiritual emergency can

happen to someone actively engaged on a spiritual path, but it can just as likely come

seemingly out of the blue to a person not consciously on a spiritual path. Both the

spontaneous spiritual experience and the spiritual emergency are a process of spiritual

awakening that has speeded up into an unimaginably intense state that is difficult to manage.

Whereas we might prefer our spiritual growth to be like a gentle paddle down the stream,

spiritual emergency is more like the rough ride of a speed boat (p.21).

Spiritual emergency involves a psychological transformation as well as spiritual

transformation. When a person begins to open up to the transcendental, any unresolved

aspects of personality can come to the surface. These can be referred to as repressed aspects

of ourselves, known as the shadow (Jung, 1958). As Joan Halifax points out in her article The

the Shadow tends to be denied or repressed, and when it erupts,

the effect on the individual, social, and environmental realms can be disastrous

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The ideas of such luminaries as William James in his Varieties of Religious Experience

(1902), Carl Jung (e.g., 1961), and Roberto Assagioli (e.g., 1965, 1991) seem to have paved the

way for the Gr

such as Laing (1960, 1983), Perry (1999), Lukoff (1988, 1991, 1998, 2007), Krippner (2002;

Krippner, Jaeger, & Faith, 2001), and Wilber (1993), Nightingale (2007). In Kaia Nighti

and she found 30%

reported having an established spiritual practice, whereas 43% reported not having a spiritual

ing attention to. It s this group that

will struggle longer in the spiritual emergency state and run the highest risk of dangers (see

section 3). Nightingale also found 44% needed many years to adjust and integrate the

spiritual experience. 70% were able to keep their current job but 30% had to adjust work

hours, quit or go on disability. However, 100% reported positive changes spiritual

understanding was developed. Some of the reported positive changes were: being freer and

more open to life, happier, more compassionate, more intuitive, and more aligned with inner

self and life as it flows.

How long a spiritual emergency can lasts varies enormously. The Spiritual Crisis

Network hears of both short-‐term and long-‐term spiritual emergencies; some will last days or

weeks, others months or years, in some cases many years.

Spirituality defined. Two definitions are provided here; one comes from the health

care field and the other from the psychiatric and therapeutic field. The former was created by

participants in a Consensus Conference held in California (Puchalski et al., 2009). They

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created a working definition of spirituality within the context of a health care environment:

eek and express

meaning and purpose, and the way they experience their connectedness to the moment, to

Pg 887.

The latter definition of spirituality is from the psychiatry and therapeutic environment

and is currently being re-‐evaluated with the advancement of the Diagnostic and Statistics

Manual (DSM) V. The DSM V Task Force, is considering culture and context in assessment,

diagnosis, and treatment planning in the area of Religion and Spiritual Issues (Peteet, Lu, &

Narrow, 2011). Bruce Scotton is a contributor to the current research agenda for DSM-‐V and is

recommending an addition to the current definition of spirituality found in the Textbook of

Transpersonal Psychiatry and Psychology Spiritual

refers to the realm of the human spirit, that part of humanity that is not limited to bodily

experience In the research for the proposed DSM-‐V (Peteet et al.), Scotton

recommends adding to the Spirituality involves the observing of both

oneself and things outside oneself Definitions in both these fields are relevant to

chaplaincy work, especially when dealing with spiritual emergency.

Spontaneous spiritual experience defined.

Stan and Christina Grof (1989) define spiritual experience An unsolicited and

sudden shift in perceptual and sensory experience that usually involves a profound and overall

sense of unity and interconnectedness to existence; coupled with piercing clarity far, far above

and beyond normal intellectual and emotional apprehension of reality .

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8). When the word spontaneous precedes

experience was completely unsolicited and unexpected.

Lukoff, Lu and Turner (1998) undertook the task of defining a spontaneous spiritual

experience in a way that is both congruent with the theoretical literature as well as holding

The experience is a sudden, transient, extraordinary experience marked by

feelings of unity, harmonious relationship to the divine and everything in existence, as well as

euphoria, sense of noesis (access to the hidden spiritual dimension of knowledge), loss of ego

functioning, alterations in time and space perception, and the sense of lacking control over the

event

themselves well to intellectual systematizing (Lukoff, 2007). David Lukoff, along with Stan

Grof, are considered experts in the field of spiritual emergency and will be cited often

throughout this paper.

There are other terms that are similar in definition to spontaneous spiritual experience

because they allow for non-‐ordinary elements within the experience, for example: benign

psychotic experience (Jackson & Fulford, 2002) which stems from the psychiatric field of

study, genuine spiritual experience (Marzanski and Bratton, 2002), which comes from the

Christian religion, visionary experience (Lukoff, 2007), which originated in the anthropology

field, and mystical experience (Nixon, 1990), which is derived from Eastern and Shamanistic

religions. Other descriptions are metanoiac voyages (Grof & Grof, 1990;

Laing, 1972; Lukoff, 1985).

here in the west (Goretzki, 2007).

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Spiritual experiences have been widely reported in the general population for decades

(Greenley & McCready, 1974; (Hay & Morisy, 1978). Per Lukoff (2007), polls conducted over

the past 35 years have shown a dramatic increase in the percentages of people who report

these types of spiritual experiences. Throughout history, cultures and religions have

considered inner transformation that comes from spiritual experiences as an integral part of

life (Grof 1991; Lukoff 2007; Lucas 2011). These spiritual experiences often revolve around

spiritual themes. Some of the common themes include sequences of psychological death and

rebirth, experiences that seem to be memories from previous life times, feelings of oneness

with the universe, encounters with various mythological beings, and informative insights that

provide knowledge in the understanding of life and/or death (Lukoff 2007).

Shamanism was hum -‐gatherer societies

(Winkelman 1992, 2000), in which they practiced sophisticated rituals and various practices

used to encourage spiritual experiences. It was believed that those spiritual experiences

would propel a person into inner transformation, known as spiritual emergence. Some of

these rituals and practices led to non-‐ordinary states of consciousness. Many would say both

the Buddha and Christ experienced non-‐ordinary states of consciousness previous to reaching

their highest realization. Buddha had his experiences under the bodhi tree and Christ had

forty days in the dessert. Both stories speak of non-‐ordinary states of consciousness and both

stories depict a significant transformation and wisdom following such experiences. Lucas

(2011) even goes so far as to call these times of the Buddha and Christ as spiritual

emergencies. Whatever the case, they led to profound spiritual emergence.

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Bragdon (2006) indicated three primary ways people respond to spiritual experiences:

(a) gracefully integrate them into their lives and further develop spiritually and psychologically

(spiritual emergence); (b) become temporarily overwhelmed and experience a spiritual and

psychological crisis (spiritual emergency), but eventually accept the experience as part of their

reality and move into spiritual emergence; or (c) fail to integrate the experience resulting in a

chronic state of fragmentation, either in a functioning capacity of fragmentation, or worst

case, be medicated and diagnosed by the mental health field (getting stuck). It is the hopes of

this author that by way of educating chaplains we can assist in helping some clients not fall

into the latter category, when ever possible.

Before a spiritual emergency happens to a non-‐practitioner (i.e. someone not

searching for a form of spirituality in their life), there is usually a significant and spontaneous

spiritual experience. It is most likely a profound one if it results in a spiritual emergency. The

spiritual emergency usually begins shortly following the spiritual experience, if not

immediately. It is also possible for a person to have a spontaneous spiritual experience and

not have a spiritual emergency at all and, instead enter a period of spiritual crisis (see

definition below)

spontaneous spiritual experience into their life without much internal conflict. However, if

the person has no spiritual practice or religious path prior to a significant spiritual experience,

the chances are greater that a spiritual emergency will occur.

Spiritual crisis defined. It helpful to differentiate between spiritual crisis and

spiritual emergency. A spiritual crisis is a deep and significant process but does not involve

the same features as a spiritual emergency. In general, a crisis occurs:

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an obstacle to important life goals and meaning that is, for a time, insurmountable through

the utilization of (their) customary methods of problem solving. A period of disorganization

ensues, a period of upset, during which many abortive attempts at solution are made (Young,

2010). Spiritual crisis is usually brought on by unexpected life events that usually do not

involve the elements of a spontaneous spiritual experience as described earlier. Examples of

major life events are: bereavement, divorce, loss of job, an accident, and experiences of war.

A person may withdraw from daily activities and go through a period of confusion. However,

the key difference between a spiritual emergency and a spiritual crisis is that in a crisis, a

reality stays grounded within the normal dualistic world, and rarely does the person

lose sense of their own individuation in the process (Young

, 2010).

intentionally set out to have the experience that brings them to this point, but nevertheless

they find themselves there. Spiritual crisis may occur more frequently for people than a

spiritual emergency does and therefore, deserves attention within the chaplaincy field also.

However, it will have to be a topic for another paper.

1.2 Spontaneous Spiritual Experience Triggers

Catherine Lucas, in her book In Case of Spiritual Emergency (2011), differentiates

between two major groups of people who experience a spontaneous spiritual experience;

those who are actively engaged in spiritual development in some fashion (practitioners), and

those who are not (non-‐practitioners). With regards to practitioners, Emma Bragdon, in her

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book The Call of Spiritual Emergency (1990), writes that within the Western religious

traditions the psychological and physiological aspects of profound spiritual growth are not

widely known or discussed. In the Bible, it is not made clear that spiritual awakening involves

profound and sudden psychological and spiritual transformative experiences. Whilst in the

texts of Yoga, Hinduism, and Buddhism, it is clearer that there is a psychological result of

spiritual practices (Bragdon, 1990). Since most active spiritual or religious practitioners have a

teaching and community which they affiliate, it is less likely that a chaplain will find

themselves discovering a person in spiritual emergency whereby the person doesn t have

resources and a sense of understanding except maybe when the practitioner fears their

evil and will not seek guidance from their affiliation.

This section will focus primarily on the latter group, the people who seem to be

catapulted into a spontaneous spiritual experience with no spiritual path or spiritual

resources. So the question is-‐ what spontaneously catapults someone out of a seeming

normal moment in time, into a spontaneous and profound spiritual experience, that shatters

their known reality in a matter of seconds?

1. Extreme stress. This can result from a single event like a car accident or an operation, or

prolonged periods of stress like being at war. Kaia (2007) study found that

stress was a big contributor. Emma Bragdon (1990) points out that stress can include the

physical stress the body goes through at times, such as that experienced by athletes or

women during childbirth to include lack of sleep. he event itself that

leads to spontaneous spiritual experience or spiritual emergency, but it is the stress

experienced within the event that can lead to a spontaneous spiritual experience.

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3. Loss of any kind, whether through death and bereavement, divorce, loss of a job, home,

relationship, or even loss of faith. These can lead to a spiritual crisis or can generate a

spontaneous spiritual experience.

4. Experiencing a state of intensity such as falling in love, sex, drug use, or combat action can

also be a catalyst.

6. Being close to death. This can result in a spontaneous spiritual experience known as a

near-‐death experience.

5. There are life stages for people, right through to preparing for death, where psychological

work is intensified. Spontaneous spiritual experiences and spiritual emergencies are not

exclusive to adults; children and teenagers have been known to have them (Lucas, 2011). This

trigger is common in spiritual crisis as well.

There are a whole range of things that can act as catalyst for a spontaneous spiritual

experience, some not mentioned. It can be difficult to pinpoint the cause as there can be no

obvious or apparent trigger whatsoever, or a combination of several things. The area of cause

and effect deserves more research and is recommended at the end of this paper. However, it

should also be said that once in the spiritual emergency,

transformation is far more important than the external triggers (Grof, 1990).

1.3 Key Features of a Spiritual Emergency

A person experiencing a spiritual emergency may or may not be able to articulate what is

happening to them. However, there are certain frames of reference and behaviors that may

indicate a person is experiencing, or has experienced, a spiritual emergency. Here are key

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features that can be visible to those who are looking (Grof & Grof, 1990; Lucas, 2011;

Nightingale, 2007; Lukoff, 2007).

1. The intensity of the experience consumes the whole being. entire frame

of reference to life and their personal existence is affected. It involves the physical and

with new eyes.

2. Impossible to cope at an everyday level. Two categories of experience are possible

and a person can experience both at different times. First, the person can remain in the

heightened state brought about by the spiritual experience. This inhibits, or reduces, the

desire to do the things once done at an everyday level. Two, it becomes impossible for the

person to cope with everyday duties by the sheer fear, stress and confusion brought about by

the comparison of what was experienced and what life used to be seen as. The difference is

so drastic that it immediately creates the impossibility to cope with normal everyday duties.

3. The inner world takes over and blurs confusingly with the outer world. The qualities

of the spiritual experience usually remain strong after the experience. It can drive the primary

mode of thinking, processing and functioning. There is an apparent conflict between the

by the individual but almost always immediately seen by others.

4. Have unusual physical pains and/or sensations, finding it hard to sleep.

5. Experience a rollercoaster of powerful emotions. Feelings of unbound love,

sensitivity to the suffering of the world and of compassion are all common. Such strong

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feelings of love often go hand in hand with feelings of total calm and peace. Whilst these are

obviously positive, what can be difficult to cope with is flipping from such states into, for

example, strong feelings of fear. Fear is by far the most common emotion felt during spiritual

emergency. It can range from anxiety, dread or panic to abject terror. The fear is usually

entered because of the contradiction between the experience and the previous known reality.

When a person is catapulted into spiritual emergency it is as if they have no choice and no

preparation.

6. A sense of everything is falling away, including the sense of self in an ego-‐death.

Perhaps the most compelling themes in spiritual emergency are the universal theme of death

and rebirth. The process of psychological death and rebirth can be mirrored in fears as well as

peace and tranquility. There often is realization of no-‐self, (albeit usually temporary). This

can be a terrifying process for the ego. As Grof (1990)

that one is or was

naked, with nothing but the core of his or her being

who has no spiritual practice or religion in which to couch this experience.

7. There may be a new feeling of large identity; for example believing oneself as Christ

or any other figure or symbol of significant spiritual identity. A person can believe their

identity is so large as to believe they are everything. There can be a loss of sensing

boundaries, where one stops and another begins.

8. Thinking can become confused as the rational mind desperately tries to make sense

of what is going on. This is a fearful experience. The person will use past memory and

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current observation of how the world operates and yet the spiritual experience seems to

point elsewhere for truth of reality.

9. Symbolism and mythological themes become very meaningful.

10. Meaningful coincidences, (synchronicity), become more apparent.

11. Visions or flashes in the minds eye. Visions and images can seem like scenes from a

film. They may relate to the current life of the person, a possible past life or even be images

ing through a

that is not their own.

12. Experience sudden strong energies in the body that last more than a few seconds.

life force energy spontaneously being released, a

powerful inrush of spiritual energies, or even just the overt sensation of the body as vibrating

energy.

1.4 Differentiation and Similarities of Spiritual Emergency & Psychosis

A frequently asked question is:

a (Lukoff,

2007). In the West, we live in such a materially and medically orientated culture that it is

sometimes very difficult to step outside of these paradigms and the parameters usually blind

us and bind us. When we do so, voluntarily or involuntarily, we have no positive images or

support to reinforce our journey, nor any routes or maps for our process. We thus resort to

of a person being seen as either sick, mentally ill, or just crazy.

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From that assessment it ere is a need to separate ourselves from such

people and/or exclude them. We may even feel the need to protect ourselves from them or

even protect them from themselves (Young, 2010).

People who have undergone spiritual experiences that involve visions and transcended

states of consciousness have, in ancient culture as well as still in parts of the eastern world,

been esteemed and enjoyed privileged status as shamans, prophets, or saints. However, in

contemporary Western society, experiences such as seeing visions, hearing voices, or

becoming one with all that is are viewed as delusions and hallucinations, symptoms of a

psychotic disorder (Lukoff, 2007). This is in part by lack of education and understanding of the

depth and width of spirituality in human nature. But it is also because the surface of spiritual

emergency can look very similar to psychosis.

If a professional feels it appropriate to differentiate, then it is best to become

educated in both areas of psychosis and spirituality. Another option is to create a team effort

between persons experienced and trained in psychosis and persons experienced and trained

in spirituality. Reading a book or two on a topic is not enough to appropriately discern human

behavior and experience in the other field. This can never be said enough chaplains are not

psycho-‐therapists. We need to stay focused and trained on the skills necessary to do

chaplaincy, and do it well and maybe visa versa for psychiatrists.

Some believe there should be an attempt to clearly define differences between

spiritual emergency and psychosis and others believe no line should be drawn. Can both be

This group tends to lean into the subject of spiritual

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emergency from the lens of the medical model. From that point of view, especially in the

West, it s probably a good thing to differentiate. Historically there has been a lack of

spirituality and spiritual experiences taken into account in medical diagnosis and therapeutic

interventions (Bragdon, 1990; Grof, 1990; Koenig, 2007; Lucas, 2007; Lukoff 1998 & 2007)

only been since the published work of Stan Grof that attention of spirituality was being drawn

into the psychiatric medical model. Those who are advocating for a differentiation from the

spiritual issue and psychosis believe that distinguishing between religious, spiritual or

transpersonal experiences and psychopathology requires a thorough understanding of what

characterizes spiritual emergence and spiritual emergencies (Bragdon, 1993; Grof & Grof,

1992; Lukoff, 1998).

The task of differentiation between symptoms of mental distress and those of spiritual

emergency is phenomenally complex. The reality is that very often psychotic-‐type elements

go hand in hand with the spiritual emergency and the experience is far more likely to be a

question of both for a period of time. For that reason, Lukoff et al. (1998) noted that

discernment is difficult but necessary by stating Making the differential diagnosis between

spiritual emergencies and psychopathology can be difficult because the unusual experiences,

behaviors and visual, auditory, olfactory or kinesthetic perceptions characteristic of spiritual

emergencies can appear as the symptoms of mental disorders: delusions, loosening of

associations, marking illogical thinking, or grossly disorganized behavior (p. 39). Actually

criteria for making the differential diagnosis between spiritual experiences and spiritual

emergencies and that of mental disorders have been proposed by (Agosin, 1992; Grof and

Grof 1989; & Lukoff, 1985). This information is highly valuable but will not be discussed

further in Part One of this project. Differentiation criteria will be in Part Two along with how a

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Spiritual Assessment can be used to differentiate and how that information can be shared

between professions.

Diagnostic and Statistical Manual (DSM)

The DSM-‐IV is authored by the American Psychiatric Association (1994) and is

considered the bible in the mental health field. It lists the characteristics and criteria in which

an individual can be diagnosed with a mental disorder. The DSM operates as a psychological

mirror of the society in which it develops.

Focus of Clinical Attention, include known characteristic and criteria that have been shown to

fall outside of a mental disorder and can be confused with actual mental diagnoses (APA,

1994). The V codes include behaviors and thoughts exhibited that are

when placed in context and not to be evaluated as pathology (Evrard & Le Malefan,

2010). As of 1994, one V code is Religious or Spiritual Problem (Code V62.89). It was created

by the pressed arguments of proponents of Transpersonal Psychology and has its roots in

concerns about the misdiagnosis and treatment of spiritual emergencies (Lukoff, Lu, & Turner,

1992; Lukoff et al. (1998).

David Lukoff, a psychotherapist, appears to have been the main torchbearer for

several aspects that contributed to the Religious or Spiritual Problem V code by highlighting

areas that begged attention at the time. These included gaps in training for a psycho-‐spiritual

assessment competency, a void in the medical literature regarding psycho-‐spiritual issues, and

the lack of initiative by mainstream psychology to fill such omissions. However, the American

Psychiatric Association didn t incorporate all that was proposed. The inclusion however small,

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marked the acknowledgment that distressing religious and spiritual experiences occur as non-‐

pathological problems (Lukoff, 2007).

What did get included are examples of distressing experiences that involve loss or

questioning of faith, problems associated with conversion to a new faith, or questioning of

other spiritual values which may not necessarily be related to an organized church or religious

institution (APA, 1994). This DSM Section V62.89 is used in the VA Hospital system when

logging chaplain patient visits. More and more, religious and spiritual issues are being

brought into view in health care systems as a whole.

At the beginning of this section, this author mentioned there are some folks who

believe no line should be drawn to differentiate between spiritual emergency and psychosis.

This group leans into the subject from a holistic premise of human experience; saying we are

better off viewing all psychosis as an attempt to progress through higher levels of

developmental stages. One primary reason for this point of view is the process of spiritual

emergency and spiritual emergence is neither linear, nor clear cut (Lucas, 2011). Not

everyone moves through to spiritual emergence in a certain period of time, or in a certain

sequence, nor do the all look the same. In Part Two of this project, this author will discuss the

probability of both views being beneficial. Keeping both views open for consideration on the

part of the Interdisciplinary Team will offer more opportunity for the patients well being.

Otherwise, one of two major diagnostic errors can be made. One is reductionism -‐ to fail to

recognize a spiritual emergency and reduce it to pure pathology. The other is elevationism -‐ to

overlook a pathological process such as schizophrenia and elevate it to a spiritual emergency.

The task can be complicated in which both mystical and pathological experiences coexist

(Lukoff, 1985).

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This section will end with a quote by Karl Menninger, often recognized as a founder of

American Psychiatry

truth that deserves attention

Spiritual Emergency 25 SECTION 2: UNFORTUNATE DETOURS

2.1 Dangers within the Spiritual Emergency

enal potential for psychological

and spiritual growth but also the potential dangers that should not to be underestimated. If we

realize for a moment, a spontaneous spiritual experience and a spiritual emergency can happen

to a person who has the average well together and structured life but with no existing spiritual

path or community in which to turn and receive some kind of positive support. This leaves a

person out in the community, most likely in an altered state and no resources for proper

assistance.

In Kaia Nighti

reported having a spiritual practice. When the key features in Chapter One are looked at

seriously, we can see the high risk of potential dangers. For example, when this author

attempted to drive a car, a previous every day event, there was such an overwhelming lack of

energetic boundaries that when the cars were moving fast, it felt as if they were moving

through this being instead of outside and nearby. It was so overwhelming and confusing that

the ability to discern what was important (like stop signs, stop lights and lane changing) was

blurred with the overwhelming rush of energies coming in all directions. This is an example of

number 1, 3, 8, and 12 in Section 1.3 Key Features of Spiritual Emergencies. Another example is

from Peter Chadwick (Clarke, 2010), a psychologist who had a spiritual emergency and found

himself lying on the ground in front of an oncoming bus. A person can become so out of touch

Spiritual Emergency 26

Catherine Lucas (2011) gives many examples of dangers, two involving unfortunate death.

One of her examples of unfortunate death involves a 17-‐year old who had been seen by

others in his life spontaneous spiritual experience and

entering spiritual emergency he himself phoned the police for help. He was handcuffed and

taken to a mental health hospital for evaluation and family was kept from him. After 2 days his

rights were read to him and told he still could

found in an open field were he had sustained fatal head wounds from bashing his head against

a discarded gas canister. This is not over dramatic. This author has clear memory of sitting in

Somehow, hoping that by shaking up the brain it would magically make the old familiar safe

reality come back. This is the sometimes fear based frantic state a person finds themselves in.

Another example of this involves a woman who couldn t understand her situation and

find help. She was at a loss with the immediate energetic and perceptual shift that

within a couple months of reporting the experience and losing her job she shot first her son and

then herself. The combination of lacking a fear of death and the fear of is a

dangerous combination.

Here are some less severe dangers, but dangers nonetheless. Not being able to function

at an everyday level when going through spiritual emergency has some very tangible

consequences. Someone may lose their job or even give it up. In Nighti

30% had to modify their work situation. This, for most people, has a financial component that

Spiritual Emergency 27 will affect many other aspects. This can happen because the crisis itself drags on over years or

because the struggle to integrate back into everyday reality is an arduous process. This author

found all of the above to be true.

Isolation is another danger. A person may become estranged from family and friends

who understand what going on. It can be all too easy in a spiritual emergency to feel very

alone with the experience, especially logical

level. Often it s only afterwards that people discover others have been through it too (Peteet et

al., 2011).

Being seen as mentally ill and a danger to themselves can be the beginning of a dangerous

treated with temporary small doses of medication but s also unfortunately common for

people going through spiritual emergency to end up on psychiatric wards under strong

psychotic medication (Lucas, 2011; Grof 1990; Lukoff 2007; Clark 2010). Even during the phase

to have the spiritual aspect of the experience

honored and not overshadowed by the interpretation given by the average western medical

model (Lucas 2011; Lukoff 2007; Grof 1990; Clark 2010; Peteet et al., 2011). Most everyone in a

spiritual emergency is in a sensitive state in many ways and a hospital psychiatric ward is not at

all the best place for them. It can even be dangerous, as seen in the example above. But

because a person ma of their display

of psychotic-‐type elements, being taken to a mental hospital may not be avoidable. Since

police officers

apons, taken for a ride in

Spiritual Emergency 28 the back of a police car, spend time at a police station, and then be transported to a mental

hospital for a 72-‐hour evaluation. Having made this type of arrest many times, and now having

had the spiritual emergency experience it is fare to say that it can be damaging in ways

unimaginable.

2.2 Getting Stuck

A person can get stuck in different phases of the process of a spiritual experience,

spiritual emergency and/or spiritual emergence

permitting the healthy spiritual growth to emerge. A conclusion is drawn by the

individual about the experience and f to transition into spiritual

emergence. Some come to this conclusion by themselves and others by being told then

believing it. In Part Two of this Research Paper, this author will investigate the notion as to

whether a chaplain being able to identify these areas could be helpful, and if so how and why.

Keep in mind that even though the spiritual emergency may have subsided, the person is stuck.

Here are three examples of how this can happen:

Being mentally diagnosed and believing it. In the west, the Mental Health System is a

strong structure that operates in the average American s mental continuum. The danger is,

however, many mental health processionals know about spiritual emergency nor have

received training in spirituality components of growth and crisis. Fukuyama and Sevig (1999)

Because psychologists are steeped in Western scientific rationalism, these experiences

are difficult to explain since they are outside the five senses and logic, and traditionally have

been relegated to the category of mental illness Because of the psychotic-‐type

elements, they will tend to pathologize the entire process as mental illness. Lukoff (2007)

Spiritual Emergency 29 states (p 24). Lucas (2011) states from her

experience The spiritual dimension gets completely overshadowed by the interpretation given

alternative framework with which to understand what is happening, they feel the only answer is

to buy in to the pathologizing perspective .

Podvoll, in his book The Seduction of Madness (Padvoll, 1990), speaks about the

and

discipline required to overcome these symptoms in order to recover fully. He believes the

triggers to that (psychotic) state must be reviewed as the subtle stirrings instead of diagnosing

based on symptoms alone. Failure to do so drives one deeper into madness.

Some of the Western mental health interpretations of spiritual emergency can be: (1)

. This is often considered to be a classic symptom of

psychosis (Bragdon, 1990; Clarke, 2010; Peteet et al., 2011). This may be the medical models

interpretation when a person has had (and/or may be continuing to have), an experience of

seeing or being God, Jesus, Mary, Buddha, the Pulse of Humanity, etc... (2) Spiritual visions are

(Lukoff, 2007). (3) Spiritual emergency can also look like

) Thinking can become confused as the rational

mind desperately tries to make sense of what is going on.

So the difficulty with some of the features of spiritual emergency is they can easily look

like psychosis. When it seen this way by a convincing doctor or a loved one, coupled with the

individual being so desperate for answers, the person may just believe it, and in turn, begin

Spiritual Emergency 30 living it as truth. Again, chaplains are not psychiatrist and cannot say whether a diagnosis is or

However, they can assist with the spiritual and religious expertise they have.

(2) Spiritual by-‐pass. When a person has experienced a significant spiritual experience

there can often be a temptation to try and move quickly from early levels or stages of

development and integration to more advanced ones (Whitfield, 2003). The reasoning egoic

mind begins rationalizing that because the experience may have provided deep insights into

creation and/or humanity, or provided an experience of God, or a sense/taste of clear vision,

. This is a trap for active spiritual

practitioners and non-‐practitioners alike. In the words of Ken Wilber (1998),

individual nonetheless begins life at the archaic, then the magic, then the mythic, before (and if)

There are important steps in spiritual development that no one gets

to bi-‐pass, regardless of a profound spiritual experience.

(3) Fear, Suppressing and Faking it. This section comes

experience and hopes that future research will be done in this area. The continual combined

state of trying to pretend nothing has happened, attempting to suppress the visible effects and

thoughts, and faking sanity in order to appear sane all coming from the edgy state of fear of

falling into the truth of being mentally ill -‐ keeps the state of spiritual emergency alive like a

ticking bomb. Living in this state for very long is dangerous to the individual s psychological and

physical well being. By not allowing the full process of the spiritual emergency an individual is

creating Post Traumatic Stress for themselves. Integration of the spontaneous spiritual

experience and allowing the spiritual emergency, no matter how scary it seems, is most

likely needed for a healthy functioning system to be restored.

Spiritual Emergency 31 eatures of the spontaneous spiritual experience will

continue to manifest in the psyche and will keep the feeling alive that a psychotic break is right

around the corner. This can create a problem with the central nervous system just as any high

level of continued stress. There is usually shame and guilt hidden behind the act of hiding.

This deep sense of hiding can create a

to people and events becomes deadened; yet simultaneously there is an increased internal

arousal that can create anxiety and/or panic attacks. The continuous effort to numb can

exacerbate any alcohol or drug tendencies.

Spiritual Emergency 32 SECTION 3: NOT ALWAYS EASY TO EMERGE -‐ BUT WORTH IT

3.1 Spiritual Emergence Introduction

If there via

spiritual emergence. But what about those who have a spontaneous spiritual experience with

no previous spiritual life and find themselves in a spiritual emergency? Spiritual emergence

then becomes the journey of healing. Stan and Cristina Grof (1991), define spiritual emergence

The gradual unfolding movement of an individual to a more expanded way of being that

involves enhanced emotional and psychosomatic health, greater freedom of personal choices,

and a sense of deeper connection with other people, nature, and the cosmos

As Lukoff, In spiritual emergence

emergency there

is significant abrupt disruption in psychological, social, and occupational functioning (p. 38).

Catherine Lucas (2011) states:

gradual, and even graceful. Whether it turns into a spiritual emergency depends on its

intensity p. 23).

For those entering the emergence process from a similar place as spiritual emergency

there have been names given positive d

(Dabrowski, 1964; Ellenberger, 1970; Flach, 1988; Pelleteir

&Garfield, 1976; Perry, 1986). Spiritual emergence can be seen as a normal maturational

process; and it happens to ordinary people all over the planet through normal processes like

falling in love, being hurt, having babies, working, burying parents, etc... Most often, when

Spiritual Emergency 33 s

recognized. However, a finger needs to point to this normal, healthy development so that

people who are going through some of the more extreme forms of it, can allow it to be put into

a normal context, and not be treated as aberrant or abnormal (Young, 2010).

Part Two of this research project will dive fully into the aspects of spiritual emergence

and the distinctions between spiritual emergency and spiritual emergence (Grof, 1990). This

introduction to spiritual emergence is provided in order to point in the direction the research

project will move.

Spiritual Emergency 34 SECTION 4: CONCLUSIONS ON PART ONE

4.1 Part One Final Comments & Contributions

and lots of work to unwrap and unpack the existing literature in and

around spiritual emergency. Many days were spent absorbed in one book after another. This

paper was initially meant to contain all elements of Part One and Part Two. However, once

certain information was discovered, or not discovered, it became clear this endeavor deserved

more time and careful research. This paper appears to be the first contribution to professional

chaplaincy regarding spiritual emergency. It s the hopes of this author that it not only stirs

chaplaincy interest in spiritual emergency but also affords the field to look deeper into

education on spiritual development and to be more familiar with theories as well as the varies

spiritual and religious teachings that speak to the path of spiritual development. As chaplains

serve more and more in pluralistic settings can it be serving to be familiar with many paths and

understandings of spiritual development? Since critical stages and phases of spiritual

emergence come to those not previously on a spiritual path, is it helpful for professional

chaplains to be able to identify and recognize signs and symptoms of various stages? Not to

diagnose folks or to get caught in the categorization of spirituality, but to be knowledgeable.

4.2 Limitations and Suggestions

Limitation #1: s some empirical data on spontaneous spiritual experience and

spiritual emergency there is little qualitative and quantitative research. The following

suggestions are made with these fields in mind: neuroscience, consciousness studies, spiritual

& religious studies, psychology & developmental studies.


Suggestion 1: Further research into what causes someone to catapult into a

spontaneous spiritual experience out of the blue. Research shows this is happening

more frequently.

Suggestion 2: Further research into why profound stress and trauma can result in a

spontaneous spiritual experience. Neuroscience research in this field would be

welcomed.

Suggestion 3: Research on similarities between Post Traumatic Stress (PTSD), and

effects of long periods of spiritual emergency. Is it possible that some folks diagnosed

with significant PTSD, especially in the military during war times, have experienced a

spontaneous spiritual experience and spiritual emergency?

Suggestion 4: Correlation research between resiliency and spiritual emergence post

spiritual emergency. Are there personal characteristics that have some emerge and

others get stuck.

Suggestion 5: Survey experienced professionals in the field of spiritual emergency to

gain insight into professional chaplaincy assistance.

Suggestion 6: Part Two of this research project (see Section Six below).

Limitation #2: There is little differentiation literature on spiritual crisis and spiritual

emergency.

Suggestion 1: There is a distinction between these two experiences how they come

about, what they look like and how assistance is provided. A good paper showing this

could be helpful for those working with populations that experience such.


SECTION 5: INTRODUCTION TO PART TWO

5.1 Purpose

The purpose of Part Two of this research project is to continue looking through the eyes of

professional chaplains with regards to the subject of spiritual emergency. Attention is turned to

a process of spiritual development and the best ways of assisting the process.

5.2 Review of Subjects

Part Two shifts the focus to possible positive outcomes of spiritual emergency, reframing the

experiencing into growth potential, and discovering whether there a role for chaplains in

identifying and assisting. Existing Personal Development and Spiritual Development Theories

will be reviewed that make room for spontaneous spiritual experiences and spiritual

emergencies as advancement to personal and spiritual growth. This will be done by reviewing

the works of James Fowler, William James, Carl Jung, Kazimierz Dabrowski, Ken Wilber and Stan

& Cristina Grof. Religious and spiritual teaching texts of Christianity, Buddhism, Judaism,

Hinduism, and Shamanism will be reviewed for insights.

Many items will be taken into account when considering the role of the chaplain. First,

there will be a review of current application treatments being used in situations of spiritual

emergency as well proposed treatments. Questions of effectiveness and appropriateness for

professional chaplaincy will be discussed. Second, the role, duties, and expectations of a

chaplain will be reviewed. Since this appears to be the first time this information has been

brought to chaplaincy, there will be a research component so chaplains, chaplain candidates,

CPE supervisors, directors and chaplaincy program administrators can provide feedback in

interview and survey format. The thrust of the research component will afford the questions:


(1) Should chaplains be educated in the areas of (a) spontaneous spiritual experiences (b)

spiritual emergency (c) the spiritual emergence process and developmental theories that

and religious community resources for the individual.

Other hopeful items to be covered are: (1) Any found research in relation to stress and

trauma as related to spontaneous spiritual experiences; and (2) A comparison of current Post

Traumatic Stress symptoms to those who experienced

emergency described in Part One.

It is the hopes of this author that by bringing this information to chaplaincy awareness

something good comes to the service of chaplaincy. It is unknown as to what part or parts will

take seed, but that a contribution is made and the populations served will benefit.


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References


RESOURCES:

1. In Case of Spiritual Emergency: Moving Successfully Through Your Awakening. Author:

Catherine Lucas, Published: 2011.

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2010. http://www.courtenayyoung.co.uk/courtenay/books/HANDBOOK_First_Contacts.pdf

3. Documentary Film: Spiritual Emergency, by Kaia Nightingale.

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4. Spiritual Competency Online resources by David Lukoff: www.spiritualcompetency.com

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http://www.courtenayyoung.co.uk/courtenay/books/HANDBOOK_First_Contacts.pdf

http://www.cultureunplugged.com/documentary/watch-online/play/8002/Spiritual-Emergency

http://www.spiritualcrisisnetwork.org.uk/

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