The new spirit of psychiatry

People who believe they might be reaching their goal in the search for a deeper meaning and purpose to life, along with those who think the same thing may have been spontaneously thrust upon them, as in near-death-experiences, don’t always awaken to a new dawn of rapture. Instead, sometimes they spiral into what has variously been described as a spiritual emergency, religious crisis or, more metaphorically, as the “dark night of the soul” by the 16th century Spanish poet and mystic Saint John of the Cross.
It’s also been alluded to in spiritual traditions throughout the world and is seen as a profound test of faith, endurance, inner purification and surrender - a phase in a person’s spiritual life, marked by a sense of loneliness and desolation when the process of growth and change becomes chaotic and overwhelming. Also, being an awkward place of mind between the annihilation of a previous lifestyle and the beginning of a new one, it can bring on an internal crisis of identity, uncertainty, confusion and unspeakable despair as it makes its presence felt. Mother
Teresa, for instance, who famously endured it from 1948 until almost her death with only brief interludes of relief, may be one of the most extensive cases on record.
In Buddhist vipassana meditation, too, the practitioner is said to pass through the ‘Sixteen Stages of Insight’ towards Awakening of which steps five to 10 focus on the ‘Knowledge of Suffering’, including the Knowledge of Dissolution and Fearfulness and the Knowledge of Misery and Disgust. Novitiates are expressly cautioned that these steps are not to be taken lightly, especially if the meditation is being practised in isolation or without a guide.
Yet for many years, behavioural scientists regarded the phenomenon as a temporary aberration, self-induced delusion or even a put-on and, at worst, as a full-blown psychiatric affliction which required ‘medicalised treatment’. Madness sans divine. As a result, people undergoing a spiritual crisis but who were otherwise not cognitively impaired or abnormal were sometimes institutionalised for long periods and drugged - often against their wishes.
Fortunately in recent years, this has changed, as reflected in the Diagnostic and Statistical Manual published by the American Psychiatric Association. Its latest edition includes a new category called ‘Religious or Spiritual Problems’ where for the first time such distressing experiences are acknowledged as being non-pathological. According to the authors, the new diagnostic category helps to improve diagnostic assessments when religious and spiritual issues are involved; reduce harm from misdiagnosis of psycho-religious and psycho-spiritual problems; improve management of such problems by stimulating research; and encourage clinical training centres to address the religious and spiritual dimensions of human existence.
So what brought about this sudden paradigm shift away from received wisdom? The short answer is transpersonal psychology. Transpersonal psychology which has its roots in the works of William James and Carl Jung is considered by many to be the ‘fourth wave’ force - after psychoanalysis, behaviourism and humanistic psychology - that studies the transcendent or spiritual aspects of the human experience. Its practitioners are particularly interested in the many ways of expanding human consciousness and in the synthesis of Eastern and Western thought - a perspective based on the reality of a higher or deeper self within every individual that monitors our lives.
It was due to a proposal made by the Journal of Transpersonal Psychology to include a new diagnostic category entitled ‘Mystical Experience with Psychotic Features’ that the Manual finally agreed. The inclusion marks an increasing scientific acceptance of transpersonal questions, besides signifying a greater sensitivity towards spiritual issues and spiritually oriented narratives. There’s no doubt it will also contribute to a greater understanding between science and religion in the future.