Medication or Mysticism? Why We Need to Recognize ‘Spiritual Emergencies’
In mainstream psychotherapy, clients experiencing intense spiritual crises are often met with a prescription pad. Their symptoms are viewed strictly as pathology: anxiety, mania, or psychosis, and they are often discouraged from engaging in conversations about mysticism because it is deemed "out of scope."
But as I delve deeper into transpersonal psychology, I’ve learned that we often do a disservice to clients when we pathologize their awakening. We need to be able to identify a "Spiritual Emergency" —-a crisis that is not a breakdown, but a breakthrough.
A Personal Reflection: The Client I Couldn't Help
When I first started out doing therapy as an Intern, I remember a teenage client I worked with years ago who was diagnosed with Major Depressive Disorder. They grew up in a strict Christian home but were struggling with deep religious trauma and a loss of faith. They felt lied to, distrustful, and developed a sense of mild paranoia.
At the time, I honestly had no idea how to help. I was trained to avoid religious conversations because they were "outside my scope of practice." My supervisors encouraged me to focus solely on the behaviors and symptoms. So, we focused on medication and coping skills.
Looking back, I realize I missed the mark. I didn't provide the support they needed because I lacked the competency to navigate a spiritual crisis.
What I Would Do Differently Today
Today, I know that avoiding the topic of spirituality only isolates the client further. If I were working with that teenager now, I would handle it very differently:
Normalize the Experience: I would validate their questioning not as a symptom of depression, but as a natural, albeit painful, stage of spiritual development.
Involve the System: In family sessions, I would encourage parents to share their own struggles with faith, reducing the client's sense of alienation.
Integration: Instead of trying to "fix" the crisis, I would support the client in integrating this new worldview into their daily life.
To be truly helpful, clinicians must be brave enough to step into the spiritual deep end with their clients, offering language to describe the experience rather than just medication to suppress it.
