New research distinguishes between spiritual emergency and psychosis

Published 21 June 2019

New research by the University of New England is expected to improve diagnostic outcomes for individuals who present with symptoms of spiritual emergency (SEY).

SEY is a process of spiritual emergence (SE) or awakening that becomes traumatic, leading to a state of psychological crisis that, in some cases, mimic clinical psychosis.

Up until now research has been unable to differentiate between SEY and clinical psychosis, resulting in potentially poor diagnostic outcomes for individuals who present with SEY.

As part of her doctoral research in Psychology, Dr Kylie Harris explored, for the first time, the relationship between SEY and the symptoms of schizotypy - a personality trait that has been shown to have a relationship with, and predict the development of, clinical psychosis. Although, not all individuals with a schizotypal personality will necessarily ever develop clinical psychosis.

“Previous research studies have explored SEY in relation to psychosis but none specifically looked at SEY in relation to the positive and negative symptoms of psychosis and schizotypy,” Kylie said.

“The positive symptoms of psychosis and schizotypy refer to a distortion of normal functioning, e.g., delusions and hallucinations, while the negative symptoms refer to a loss of normal functioning, e.g., a lack of interest in social activities. Positive symptoms are more likely to be associated with good recovery and negative symptoms with a history of mental illness and poor long term outcomes.”

Kylie surveyed 250 participants anonymously online and found that SEY was associated with the positive symptoms of psychosis and schizotypy but showed only weak to no associations with the negative symptoms.

“These results suggest that it may be possible to identify whether an individual is experiencing SEY or another form of clinical psychosis,” Kylie said.

“That is, if a psychotic-like experience is characterised by positive symptoms, but not negative symptoms, it may potentially be SEY as opposed to a form of clinical psychosis that is more likely to lead to a poor outcome.”

Identifying a psychotic-like experience as SEY may offer hope to an individual who has previously been led to believe that they are sick with little hope of recovery.

“There are many individuals who have received mental illness diagnoses, but who feel that their experience is spiritual and holds personal meaning for them.”

“The current treatment for clinical psychosis often includes medication and, in severe cases, hospitalisation. While medication and hospitalisation may be helpful in some severe cases of SEY, it can also hinder an individual’s ability to process their experience as a personally meaningful, transformational journey. Conventional treatments may also promote a disease model of psychosis, and a pathological interpretation of some types of spiritual experiences.”

Kylie’s findings also have potential to lead to a revision of the diagnostic criteria for psychotic disorder as currently the diagnostic criteria specify that a diagnosis may be made based solely upon the existence of the positive symptoms.

The identification of measurable clinical and personality markers may further help to differentiate between SEY and cases of clinical psychosis that have a poor prognosis, as well as identify individuals who are at risk of experiencing the potentially debilitating effects of SEY.

Interested individuals can access the published research here.