Special Section: Spirituality/Medicine Interface Project Visionary Spiritual Experiences

Even though psychotic disorders can have debilitating effects, many clinicians and researchers have observed that some psychotic episodes result in improvements in an individual’s functioning. Karl Menninger, often recognized as a founder of American psychiatry, noted: “Some patients have a mental illness and then get well and then they get weller! I mean they get better than they ever were. This is an extraordinary and little-realized truth.” Boisen, who was hospitalized for a psychotic episode and then became a minister who founded the field of pastoral counseling, maintained: “Many of the more serious psychoses are essentially problem solving experiences which are closely related to certain types of religious experiences.” Perry pointed out that below the surface level of specific identities and beliefs are thematic similarities in the accounts of patients whose psychotic episodes have good outcomes: “There appears to be one kind of episode which can be characterized by its content, by its imagery, enough to merit its recognition as a syndrome. In it there is a clustering of symbolic contents into a number of major themes strangely alike from one case to another.” Several diagnostic categories have been proposed for such psychotic-like episodes which have potential for positive outcomes: problem-solving schizophrenia; positive disintegration; creative illness; spiritual emergencies; mystical experience with psychotic features; metanoiac voyages; and visionary states. In this article, the term visionary spiritual experience (VSE) will be used to encompass such experiences. The term visionary is used in the anthropological and religious literature to refer to a mental condition that leads an individual to propose changes for the entire culture. Such visionary experiences are more likely to occur in societies undergoing rapid and devastating social change, such as with the Iroquois Indian leader Handsome Lake. In the late 1700s, he spent 6 months in a state of catatonia accompanied by visions. Following these experiences, he underwent a personal transformation, communicated his visions and new insights to others, and synthesized old and new beliefs into a new religion and way of living that revitalized the culture. However, in most cases, a VSE does not transform the culture, but adds a new dimension to the individual’s spiritual life. Spirituality is used to refer to an inner experience of connection to something greater than oneself, a personal sense of the sacred and meaningful. People in the midst of a VSE often traverse the range of the world’s religions and cultural history in the form of religious content and experiences that are similar to hallucinations and delusions (explored in more depth below). When they return, they often view the episode as a part of their spiritual awakening and an initiation for their spiritual journey. Jungian analyst John Perry noted that, after a VSE, “What remains . . . is an ideal model and a sense of direction which one can use to complete the transformation through his own purposeful methods.” To differentiate such episodes from psychotic disorders Stanislav Grof and Christina Grof coined the term spiritual emergency: “Critical and experientially difficult stages of a profound psychological transformation that involves one’s entire being. They take the form of nonordinary states of consciousness and involve intense emotions, visions and other sensory changes, and unusual thoughts, as well as various physical manifestations. These episodes often revolve around spiritual themes; they 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 other similar motifs.” But the symptoms will resolve spontaneously with appropriate support, and can lead to improvements in wellbeing, psychological health, and awareness of the spiritual dimension in life. There are scores of self-reports and case studies documenting such outcomes.