Problems Related to Spiritual Practices
In the DSM-IV, spiritual problems are defined as distressing experiences
that involve a person's relationship with a transcendent being or force,
but are not necessarily related to an organized church or religious institution.
Sometimes such experiences result from intensive involvement with spiritual
practices such as yoga. The impetus for proposing this new diagnostic
category came from transpersonal clinicians whose initial focus was on
crises triggered by meditation and other spiritual practices.
The connection between spiritual
practices and psychological problems was first
noted by Assagioli 
who described how persons may become inflated and
grandiose as a result of intense spiritual experiences:
Instances of such confusion are
not uncommon among people who become dazzled
by contact with truths too great or energies
too powerful for their mental capacities to grasp
and their personality to assimilate (p. 36).
Beginning in the 1960s, interest
in Asian spiritual practices such as meditation,
yoga, and tai chi, and experimentation with psychedelic
drugs led to an increase in the number of people
experiencing related spiritual problems and crises.
When novices who don't have the
proper education or guidance begin to naively
and carelessly engage mystical experiences, they
are playing with fire. Danger exists on the physical
and psychological levels, as well as on the level
of one's continued spiritual development. Whereas
spiritual masters have been warning their disciples
for thousands of years about the dangers of playing
with mystical states, the contemporary spiritual
scene is like a candy store where any casual
spiritual "tourist" can sample the "goodies" that
promise a variety of mystical highs. (Halfway
Up the Mountain: The Error of Premature Claims
to Enlightenment by Mariana Caplan)
Stuart Sovatsky, PhD, Director of
the Kundalini Clinic, notes that difficulties can
accompany valid spiritual experiences: "That
some problems arise as a result of the most auspicious
of spiritual experiences, long documented in diverse
religions, must, in such cases, also be considered.
from the Soul: Time,
East/West Spirituality, and Psychotherapeutic Narrative)
Stanislav and Christina Grof coined
the term "spiritual emergency" and founded
the Spiritual Emergency Network in 1980 to identify
individuals experiencing psychological difficulties
associated with spiritual practices and spontaneous
spiritual experiences. SEN also makes referrals
to therapists for such problems.
There exist spontaneous non-ordinary
states that would in the west be seen and treated
as psychosis, treated mostly by suppressive medication.
But if we use the observations from the study
of non-ordinary states, and also from other spiritual
traditions, they should really be treated as
crises of transformation, or crises of spiritual
opening. Something that should really be supported
rather than suppressed. If properly understood
and properly supported, they are actually conducive
to healing and transformation. (Interview
with Stanislav Grof
Intensive meditation practices can
involve spending many hours each day in meditation
for weeks or months meditating. Asian traditions
recognize a number of pitfalls associated with
intensive meditation practice, such as altered
perceptions that can be frightening, and "false
enlightenment," associated with delightful
or terrifying visions. Epstein
(1990) describes a "specific
mental disorder that the Tibetans call 'sokrlung':
a disorder of the 'life-bearing
wind that supports the mind' that can arise as
a consequence...of strain[ing] too tightly in
an obsessive way to achieve moment-to-moment
awareness. (p. 27)
When Asian meditative practices are
transplanted into Western contexts, the same problems
can occur. Anxiety, dissociation, depersonalization,
altered perceptions, agitation, and muscular tension
have been observed in western meditation practitioners
(Walsh R, Roche L. Precipitation
of acute psychotic episodes by intensive meditation
in individuals with a history of schizophrenia)..
Yet Walsh and Roche point out that "such changes
are not necessarily pathologic and may reflect
in part a heightened sensitivity" (p. 1086).
The DSM-IV emphasizes the need to distinguish between
psychopathology and meditation-related experiences:
Voluntarily induced experiences
of depersonalization or derealization form part
of meditative and trance practices that are prevalent
in many religions and cultures and should not
be confused with Depersonalization Disorder.
QUIZ EXERCISE 15:
Intensive meditation practices can lead to
a) feelings of depersonalization
d) all of the above
Record your answers for later insertion into the Quiz.
Yoga and Kundalini
In the Hindu tradition, kundalini is spiritual
energy presumed to reside at the base of the spine.
When it is awakened by practices such as yoga,
it rises like a serpent up the spine, and opens
the chakras' psychic centers situated along the
spine from the tailbone to the top of the head.
As each chakra opens, new levels of
consciousness are revealed. Since the consciousness
of most people is fairly restricted, the opening
of the chakras is accompanied by consciousness
expansion and purification of the limitations
or impurities that correspond to each chakra.
(Brant Cortright, PhD, Psychotherapy
and Spirit, p. 161)
As kundalini rises, it is associated
with physical symptoms including:
laughing or crying
diarrhea or constipation
movements and sounds
Kundalini arousal most commonly occurs
as an unintentional side-effect of yoga, meditation,
qi gong. or other intensive spiritual practices.
Some theorists consider psychotherapy, giving birth,
unrequited love, celibacy, deep sorrow, high fever,
and drug intoxication to be triggers. Some believe
kundalini awakening can occur spontaneously without
Greenwell, Ph.D., is a transpersonal therapist
whose work focuses on kundalini awakening problems.
I concur with her view that the term kundalini
is most applicable to problems specifically associated
with spiritual practices. When Dr. Greenwell
was queried about a case which included symptoms
such as shaking at night, which can occur in
kundalini awakening, she responded,
If the person had presented me with
a description of an awakening experience, if
he did exercises such as meditation, yoga, or
a martial art regularly, or if he experienced
strong meditative states where he went beyond
concentration into stillness or a sense of unity,
then I would be more likely to consider it Kundalini. Kundalini
Derealization and depersonalization have been reported with intensive
meditation. Usually the symptoms cease if the practice is discontinued,
as in the case example in the Treatment section below. Meditation has
been reported to trigger psychotic episodes in schizophrenic patients
with active psychotic symptoms.
R, Roche L. Precipitation
of acute psychotic episodes by intensive meditation
in individuals with a history of schizophrenia.
Am J Psychiatry. 1979 Aug;136(8):1085-6
However this course author developed a multimodal
holistic health program for schizophrenic patients
at a state psychiatric hospital which incorporated
meditation without any adverse effects, and also
used meditation with patients at the San Francisco
VA for 14 years.
D, Wallace CJ, Liberman RP, Burke K. A
holistic program for chronic schizophrenic patients. Schizophr
Kundalini awakening can resemble many
disorders, medical as well as psychiatric. The symptoms
can mimic conversion disorder, epilepsy, lower back
problems, multiple sclerosis, heart attack or pelvic
inflammatory syndrome. The emotional reaction to
the awakening of kundalini can be confused with disorders
involving anxiety, depression, aggression, and organic
Bonnie Greenwell, Ph.D. did her dissertation
study on individuals who had a kundalini awakening.
She summarizes the clinical issues that she observed
in her book, Energies
of Transformation: A Guide to the Kundalini Process.
She describes a number of key features of kundalini
awakening which were experienced by people in her
Pranic movements or kriyas
Prana is the Hindu word for vital energy. As
intense energy moves through the body and clears
out physiological blocks, some people experience
intense involuntary, jerking movements of the body,
including shaking, vibrations, spasm and contraction.
Some people find themselves performing yogic
postures or hand mudra gestures which they have never
learned or could not do in a normal state of consciousness.
Unusual breathing patterns may appear with either
very rapid or slow, shallow breathing.
Kundalini awakening often generates unusual physiological
activity which can present as heart, spinal, gastrointestinal,
or neurological problems. Internal sensations of
burning, hypersensitivity to sensory input, hyperactivity
or lethargy, great variations in sexual desire, and
even spontaneous orgasm have been reported.
Emotions can swing from feelings of anxiety,
guilt, and depression (with bouts of uncontrollable
weeping) to compassion, love, and joy.
Some people experience visions of lights, symbols,
spiritual entities. Auditory sensations may include
hearing voices, music, inner sounds or mantras. There
may also be disruption of the proprioceptive system,
with loss of a sense of self as a body, or an out
of the body experience.
A person may experience precognition, telepathy,
psychokinesis, awareness of auras and healing abilities.
Mystical States of Consciousness
A person may shift into altered states of consciousness
where they directly perceive the unity underlying
the world of separation and experience a deep peace
and serenity. (see Karin Hannigan, PhD for additional
The sudden onset of these experiences
led many in Greenwell's study to become confused
and disoriented. Kundalini awakening is probably
the most common type of spiritual emergency. The
Spiritual Emergence Network Newsletter reported that
24% of their hotline calls concerned kundalini awakening
The DSM-IV, in Appendix I: Culture
Bound Syndromes, includes "qi-gong psychotic
reaction," which is similar to kundalini awakening.
chi kung is an ancient Chinese moving meditation
Unlike those suffering from psychosis,
individuals experiencing kundalini,
Treatment involves discontinuation of the spiritual practice, at least temporarily,
and engaging in alternative "grounding" activities. Kornfield (1993),
a psychologist and experienced meditation teacher, described what he termed
a spiritual emergency that took place at an intensive meditation retreat
he was leading.
An "overzealous young karate student" decided
to meditate and not move for a full day and night.
When he got up, he was filled with explosive energy.
He strode into the middle of the dining hall filled
with 100 silent retreatants and began to yell and
practice his karate maneuvers at triple speed.
Then he screamed, "When I look at each of
you, I see behind you a whole trail of bodies showing
your past lives." As an experienced meditation
teacher, Kornfield recognized that the symptoms
were related to the meditation practice rather
than signs of a manic episode (for which they also
meet all the diagnostic criteria except duration).
The meditation community handled the situation
by stopping his meditation practice and starting
him jogging, ten miles in the morning and afternoon.
His diet was changed to include red meat, which
is thought to have a grounding effect. They got
him to take frequent hot baths and showers, and
to dig in the garden. One person was with him all
the time. After three days, he was able to sleep
again and was allowed to started meditating again,
slowly and carefully.
(adapted from A
Path With Heart : A Guide Through the Perils and Promises of Spiritual Life by
Jack Kornfield pp. 131-132)
While in some cases, the psychological
upheaval is so acute that it resembles a psychotic
episodes, medication can further complicate the process
Dr. Greenwell suggests that it would be therapeutic
for the individual to study some of the Eastern theories
and descriptions of kundalini. Her other recommendations
follow the basic treatment guidelines for all spiritual
emergence processes (see Lesson
6.1 Spiritual Crises),
Look for ways to discharge this energy
by running, exercising, gardening, or working with
something solid, like wood or clay. I would suggest
doing a regular meditation practice, and letting
the process develop and teach him. . .The best
support is a balanced lifestyle and a commitment
to live one's life in alignment with the vision
it brings that is, if you have a heart-opening
or a visionary experience, instead of being attached
to holding onto it, ask yourself what you can bring
into the world as service to it. . .Think of it
as if the amps have been raised in your electrical
system. This is why balance, taking care of ourselves,
being in nature, and regular physical exercise
all help. We may have to change old patterns to
meet the invitation to a new kind of energy flow
and engagement with spirit in our lives. (Nighttime
She also suggests creative activities
such as art, music, or writing for expressing it.
Since this type of spiritual problem
is related to a type of practice, consultation with
a teacher of the practice who also has mental health
training would be advisable. Dr. Greenwall indicates
that learning some basic yogic breathing practices,
under the supervision of a knowledgeable yoga teacher,
can help guide this energy.
QUIZ EXERCISE 16:
A person experiencing symptoms related to a spiritual practice should be told to continue their practice until the symptoms subside.
Record your answers for later insertion into the Quiz.
by Jack Kornfield,PhD
on Religion and Spirituality
LIBRARY on Religion and Spirituality contains articles on meditation and
kundalini and guides to online resources on meditation..
in Mental Health -an Spiritual Competency Resource
which goes into more depth about the effects of
meditation and its clinical applications.
1 Assagioli, R.
(1989). Self-realization and psychological disturbances.
In S. Grof & C. Grof (Eds.), Spiritual emergency:
When personal transformation becomes a crisis,
Los Angeles: Tarcher.
2 Epstein, S. (1979). Natural healing
processes of the mind: I. Acute schizophrenic disorganization. Schizophrenia
Bulletin, 5(2), 313-321.
3 Lukoff, D. The SEN Hotline: Results
from a telephone survey. SEN Newsletter, March 1988.