DSM-IV Religious and Spiritual Problems

Case Example: Jaqueline Chapman

A formerly hospitalized person who later became a licensed mental health professional has also described how pursuing the understanding of the content of her psychotic episode led to its transformation into a meaningful spiritual experience. As Jacqueline Chapman described to me in an interview for a case study (Chapman), she had been a teenage runaway in Connecticut. When she was 16, her father found her smoking marijuana in her room and kicked her out of the house. It was during the middle of winter.

She ended up in court, arrested for shoplifting and was to be tried as an adult. Her father told the judge that, like her mother, she was emotionally unstable and he intended to seek professional help for her. Because of this declaration, and the report of a psychologist who had seen her once, she avoided jail. However, she was committed to a psychiatric hospital on the grounds that she was suicidal. She declares that she,

was too terrified of death to entertain suicidal thoughts, but I was clinically depressed and somewhat dissociative.

"Life was hell in that private hospital," Chapman recalls.

They treated me with indignity. They watched me constantly, even while I was relieving myself and showering. I was permitted only to sit, smoke cigarettes, and play cards with other patients. By the time of my discharge weeks later, I had been stripped of my self-esteem. I had lost my confidence; I could not even perform a simple task like turning on a light switch.

One year later, she was able to start college, but she fell in with some students who took psychedelics and started taking them herself. Once, before going to a Halloween party, she reports that she took some LSD, unaware that there would also be LSD in the punch.

I got so high that I didn't come down for months. During that time I wasn't eating or sleeping much. I lost considerable weight and became physically exhausted, yet did not feel distressed or anxious. My thought processes became tangential and circular. One thought would trigger another which would trigger other thoughts and then lead back around to the first thought. I also began hearing voices. They told me I was to be visited by people from the planet Mars. The voices told me to go to a field where the Martians would land. In the middle of a cold November night, I went to that field and waited for hours for the spaceship to land. Finally, another transmission revealed that they weren't coming because it was too dangerous for them. During further transmissions from Mars, I learned that I had been called to be a "messenger." I was to tell everyone to get on boats and go out into the middle of the ocean in order to be saved. Messages were coming to me from the radio, television, telephone, and, of course, the voices. I would stop people who were in their cars or walking down the street to give them the instructions. I called radio stations to tell them to announce the instructions on the air.

Her roommate reacted to Chapman's condition by phoning her father and telling him that she wanted Chapman out of the apartment. He came immediately and took her to a psychiatric hospital in New York City. The copy of the admission note she received later showed a diagnosis of paranoid schizophrenia. She left the hospital two weeks later when she realized that she was a voluntary patient and was free to go. A few days later she ended up in Massachusetts at J. B. Thomas Hospital, which had just opened a new therapeutic day treatment program including a community group, a therapy group, and occupational therapy. She found this a very helpful environment.

At least the staff there approached me more as a human being. I wasn't seen as crazy, just a mixed-up kid. I was 19. That was my saving grace.

The day treatment staff helped her find a room near the hospital so she could participate in the program. In the early 1970s, when there were significant social safety nets, she qualified for general relief, Medicaid, and food stamps. She remembers that the doctors prescribed several medications for her, but she agreed to take only Librium to help her sleep. But in the next few months, she went from being ecstatic to being mildly depressed, and then into a deep depression. Chapman remembers,

I knew I had to get out of my depression. I began walking to the library where I spent hours reading science fiction. That sparked my mind and I started to think again. I went to vocational rehabilitation for a battery of tests. I became eligible for funding to go back to school, and I could get social service benefits as long as I maintained a B average.

When she was well enough to function again, a nearby drop-in center hired her to work with others who were abusing drugs. She went on to take a double major in psychology and human services administration in college. At the age of 22, she wrote a grant for a drug and alcohol program and it was funded. A few years later, she completed a masters degree in psychology, and took a staff therapist position at a county mental health department. She is now licensed in California as a Marriage and Family Therapist, and works primarily in private practice.

Reflecting on my interview with her about these events and experiences, Chapman reports,

I had tapped into a spiritual dimension, often described as a higher power. At the time, I didn't know how to make sense of such an intense experience. I used the only frame of reference that seemed logical — that the voices were transmissions from the planet Mars (probably related to my avid reading of science fiction literature during that period). Today, I view my "psychotic episode" as a transformative transpersonal experience that has enhanced my spiritual connection and values.

I have become the kind of therapist I myself needed 23 years ago. Now, faced with a client in the throes of a tumultuous episode with spiritual content, I know how to respond. I spend a lot of time listening without judgment to that person's story. I honor the experience and focus on its transformative potential as a vehicle of increased spiritual connection and values.

The full integration of Chapman's experience involved addressing the many nonordinary experiences encountered during her psychosis. She turned to the writings of transpersonal psychiatrists and psychologists, such as Roger Walsh, Stanislav Grof, and Francis Vaughan because "They highlighted the importance of spiritual values and experiences that can occur in nonordinary states of consciousness." She found many meaningful correspondences between the "content" of her experiences and spirituality. Podvoll observed that in psychosis, "religious truths are realized, the religious truths, the ones of the desert fathers and the great mystics" (p. 118). Such correspondences can be found when the world's great religious and spiritual myths are explored by persons who have had psychotic episodes.

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