Spiritual
Interventions in Psychotherapy
Spiritual interventions can be essential to facilitating recovery
and change. At times these could include:
Educating
the patient about the spiritual emergence process
that is part of a spiritual journey with a potentially
positive outcome
Encouraging
the patient's involvement with a spiritual path or religious community
that is consistent with their experiences and values
Encouraging
the patient to seek support and guidance from a credible and appropriate
religious or spiritual leaders
Encouraging
the patient to engage in religious and spiritual practices consistent
with their beliefs (e.g., prayer, meditation, reading spiritual
books, acts of worship, ritual, forgiveness and service)
Modeling his/her
own spirituality (when appropriate), including a sense of spiritual
purpose and meaning, hope, and faith in something transcendent
Role
of Psychotherapy
Psychotherapy can help patients with religious and spiritual problemsto shape
their experience into a coherent narrative, to see the "message" contained
in their experiences, and to create a life-affirming personal mythology that
integrates their spiritual problem. These three phases of psychotherapy are
directed toward that integration are described below. In addition, spirituality
plays a special role in psychotherapy with such patients.
Phase
1: Telling the Story of the Experience
Psychotherapy can be seen as a process of helping clients construct a new narrative,
a fresh story of their lives. Psychotherapy does not consist in the cathartic
healing effect of releasing traumatic repressed events and their emotions,
but in reconstructing a person's authentic story (See What
is narrative therapy?). In making interpretations, the therapist retells
the patient's story, and these retellings progressively influence the what
and how the story told by patient. The end product of this interweaving of
texts is a radically new, jointly authored story. Or as Hillman [1]
explains it, the client comes to therapy to be "restoryed":
The patient is in search of a new story, or of
reconnecting with her old one...The story needed
to be doctored, not her. (pp. 17-18).
The specific therapeutic direction will depend on
the nature of the problem. A loss of religious faith
or conflict over spiritual values requires that the
person begin to explore a new spiritual direction
that is congruent with the person at this point in
his/her development. Often with spiritual emergencies,
the event itself has an inherently disjointed quality
that has led therapists, patients, and society to
devalue such experiences. Further exploration of
such anomalous experiences is believed by many mental
health professionals to be unnecessary and even to
run the risk of exacerbating symptoms.
People who have had spiritual emergencies often
do not receive validation for their experiences,
or even the opportunity to talk about them. In the
three case studies I have researched and published
(Case
Library), the hospital records did not mention
any of the spiritual content present in these patients'
episodes. The inpatient chart notes simply described
them as delusional, having religious hallucinations,
being preoccupied with space aliens, and making claims
of having special powers. That information alone
was sufficient to make the diagnosis of a psychotic
disorder. In the medical model, further exploration
of person's experiences would be unnecessary and
could even exacerbate symptoms by reinforcing his/her "delusional
system." Yet all three reported that working
with me to put their story into writing was very
helpful to them.
The conventional practice of discounting the meaning
of spiriutal emergencies is not therapeutically productive.
The spiritual emergency itself isolates the individual
from others. Then the subsequent devaluation and
condemnation of the experience as "only the
product of a diseased mind" results in further
isolation, just when the person needs to reconnect
to the social world. Thus, speaking one's story,
putting the experience into words, is usually the
first step in developing a life-affirming personal
mythology that integrates the spiritual dimensions
of the crisis.
At the turn of the century, Kurt Jaspers, MD, one
of the founders of the nomenclature and methods used
in understanding psychotic disorders, argued that
there was an "abyss of difference" between
psychosis and "normal" consciousness:
The profoundest difference in man's psychic life
seems to exist between that type of psychic life
which we can intuit and understand, and that type
which, in its own way, is not understandable and
which is truly distorted and schizophrenic...we
cannot empathize, we cannot make them immediately
understandable, although we try to grasp them somehow
from the outside (Jaspers [2]
p. 219).
Yet understandability is the result of a two-way
interaction. Laing [3]
has criticized the placing of responsibility totally
on the patients for making their realities understandable
to others.
"Both what you say and how I listen contribute
to how close or far apart we are" (p. 38).
Work with spiritual emergency patients requires
reaching across this abyss to connect with their
reality.
One of the first objectives in narrative therapy
is to find a mutually acceptable name for the problem.
This is a continuation of the work in the acute phase
to Normalize
the experience (see Lesson
5). The term spiritual emergency appropriately
describes and normalizes such crises. It provides
a non pathological explanation for patients, family
and friends to the rapidly developing literature
on these types of problems, and it can become the
basis for a new personal mythology.
It often helps to have the patient talk about and
write out a full account of all they experienced.
The word myth comes from the Greek mythos, meaning
speech. I have found that simply constructing a time
line marked with ages and key events serves a therapeutic
ordering function. Then the work of Phases 2 and
3 can move more easily toward integrating the experience.
Phase 2:
Tracing its Symbolic/Spiritual Heritage
People in such crises do want their spiritual backgrounds and values
to be taken into account. In my own spiritual emergency, I spent 2
months firmly convinced that I was a reincarnation of Buddha and Christ
and was on a mission to write a new "Holy Book" that would
unite all the peoples of the world. And I had been raised as a Jew!
So, once I was back with both feet on my ground, this gave me great
cause to explore these forms of spirituality with which I'd had minimal
contact. In retrospect, I consider this period to be my spiritual awakening.
But I could integrate it only after several years of therapy and work
with traditional healers (See Self-Case
Study Shamanic Crisis).
The treatment literature documents that there is
much therapeutic value in addressing a person's religious
delusions [4.
In cases where the person developed the grandiose
delusion that they were God or the messiah, these
stereotypical delusions of grandeur, inflation, and
possibly inappropriate or demanding behavior could
be embarrassing to the person. But the valid religious/spiritual
dimensions of the experience can be salvaged through
psychotherapy:
What remains . . . is an ideal model and a sense
of direction which one can use to complete the
transformation through his own purposeful methods
(Trials
of the Visionary Mind: Spiritual Emergency and
the Renewal Process, by John Perry, MD, p.
38).
I now view my own experience of having been Buddha
and Christ as the ideal models for my spiritual life,
and this has given me a sense of direction. My career
as a psychologist researching spiritual crises, and
my spiritual path derive from that event.
James Hillman, Ph.D., [5]
maintains that,
Recovery means recovering the divine from within
the disorder, seeing that its contents are authentically
religious (p. 10).
This recovery often involves helping patients reconcile
their idiosyncratic personal symbols with parallels
in symbolism and religious imagery. Eliade [6]
pointed out that the personal unconscious and "private
mythologies" (which are part of spiritual emergencies)
cannot awaken an individual. It requires:
The general and the universal symbols [to] awaken
individual experience and transmute it into a spiritual
act, into metaphysical comprehension of the world
(p. 213).
Much of my work in Jungian analysis consisted of
learning how to explore the meaning of my personal
symbols as they appeared in dreams and in my own
spiritual emergency. This search for meaning by exploring
parallels in traditional myths and religious texts
has also played a role in the integration of many
of the spiritual emergency patients with whom I have
worked. I have documented this process in the case
study Myths
in Mental Illness.
Phase
3: Creating a New Personal Mythology
People want more from therapy than a clear account and chronology (phase 1)
and symbolic analysis (phase 2). They want an expanded and deepened sense of
the meaning of their lives. Weaving the spiritual emergency into a life affirming
personal mythology is essential for positive transformation and integration
of the experience.
Personal Mythology (Definition)
Each of us has a personal mythology — beliefs about life that make up
our view of the world. Stanley Krippner, Ph.D., co-author of The
Mythic Path: Discovering the Guiding Stories of Your Past — Creating A
Vision for Your Future, defines a personal mythology as an individual's
system of complementary and contradictory personal myths. A personal myth is
a cognitive-affective structure consisting of strongly ingrained beliefs with
potent emotional components. Personal myths shape our expectations, and guide
our decisions. They influence the way we behave with other people. They address
life's most important concerns and questions, including
Identity--Who
am I? Why am I here?
Direction--Where
am I going? How do I get there?
Purpose--What
am I doing here? Why am I going there? What does
it all mean?
Personal Mythology in Psychotherapy
When people encounter religious and spiritual problems, they are usually dealing
with the existential issues delineated as part of personal mythology. So
they need to develop a more sustaining personal mythology for who they are
at that moment. Unfortunately, with spiritual emergencies, many of the personal
myths that people develop are "dysfunctional." They emphasize pathological
qualities and are not attuned to the person's actual needs, capacities, or
circumstances.
The therapist's task is to help such patients develop
a new personal mythology. This is a narrative approach
to psychotherapy focusing on the shared retelling
of the patient's story, reconstructing it for the
patient's benefit.
Personal myths are developed using
biological
sources--physical limitations, genetic endowments
cultural
sources--economic and political systems, books,
movies, folklore
personal history--family,
romantic relationships, friendships, work
Spiritual sources often play a significant role
in shaping personal mythologies. They can include
nonconsensual reality experiences such as visions,
past-life experiences, parapsychological experiences,
and also spiritual emergencies. Such spiritual sources
involve transcendence of ordinary life concerns and
an experienced contact with a "higher" or "deeper" reality.
Spiritual emergencies often involve experiences
of this type which can become the foundation for
a new personal mythology. The therapist can help
post spiritual emergency patients build a new personal
mythology with spiritual sources drawn from their
crisis.
For many people, recovery from a spiritual emergency
is experienced as a spiritual journey, a personal
myth. Sally
Clay, who spent two years hospitalized and now
works as a patient advocate, has written that,
For me, becoming "mentally ill" was
always a spiritual crisis, and finding a spiritual
model of recovery was a question of life or death
(Clay [7]).
Not only are people who have had such a crisis challenged
to compensate for weaknesses, but they are also invited
to integrate their unique set of concerns, interests,
temperament, and imagery, which may give clues to
future vocational and avocational choices, social
affiliations, and ideologies.
My own spiritual emergency set me on the path of
becoming a "healer," and provided me with
a vocational calling as a psychologist working with
serious mental illness and with spiritual emergence.
The Jungian analyst John Perry, MD, who developed
Diabysis, an innovative treatment center for persons
in an acute psychotic crisis, observed that,
It is also probable that those persons who come
through their journey enriched and gifted may turn
out to be the best source of congenial therapists,
who would be able to react with unusual understanding
to others going through their psychosis.
(The
Far Side of Madness, p. 158).
Jeanne Achterberg, Ph.D., [8]
also noticed the prevalence of "wounded healers" in
the health professions.
The books, The
Mythic Path: Discovering the Guiding Stories of
Your Past Creating-A Vision for Your Future by
David Feinstein, Ph.D. and Stanley Krippner, Ph.D.,
and Your
Mythic Journey: Finding Meaning in Your Life Through
Writing and Storytelling by Sam Keen, describe
a variety of methods that facilitate the deepening
of life-stories and the illumination of a person's
personal mythology. It isn't always necessary for
a person to work with a therapist to find the myth
at the center of his/her life story.
However, the symbols encountered in spiritual emergencies
are often idiosyncratic without a coherent cultural
context. Jung noted that fragments of mythic themes
and symbols occur frequently in the experiences of
psychotic persons, but,
the associations are unsystematic, abrupt, grotesque,
absurd and correspondingly difficult, if not impossible,
to understand. They are further distorted by their
chaotic randomness. (Psychogenesis
of Mental Disease, pp. 262-263)
Therefore therapists are often helpful
during the integration phase to help weave the images
and symbols into a coherent personal mythology.
References
1 Hillman, J. (1983). Healing
fiction. New York: Station Hill Press. 
2 Jaspers, K. (1963). General
psychopathology. Manchester: Manchester Univ.
Press.
3 Laing, R. D. (1982). The voice of experience. New
York: Pantheon.
4 Eisenbruch M. (1992) Commentary: Toward
a culturally sensitive DSM: Cultural bereavement in Cambodian refugees
and the traditional healer as taxonomist. J Nerv Ment Dis 180(1): 8-10.
5 Hillman, J. (1986). On culture and chronic
disorder. In R. Sardello and G. Thomas (Eds.), Stirrings of culture.
Dallas: The Dallas Institute Publications.
6 Eliade, M. (1960). Myths, dreams, and
mysteries. New York: Harper & Row.
7 Clay, S. (1987). Stigma and spirituality.
Journal of Contemplative Psychotherapy, 4, 87-94.
8 Achterberg, J. (1988). The Wounded Healer.
Shaman's Drum, 11, 18-22.
 REQUIRED
QUIZ ITEM: 31
Psychotherapy
People who have had a difficult period
of spiritual emergence should be encouraged
to
a) move on with their lives and leave
bizarre experiences behind b) explore the
spiritual dimensions of their experiences
c) join a religious group to provide an
appropriate container for their experiences.
Record your answer for later insertion
into the Quiz. |
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