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Spiritual Emergency
or Psychosis?
Assessment:
Janet discusses her spiritual emergence, spiritual emergency, misdiagnosis, hospitalization, and recovery.
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Religious or Spiritual Problem, (V62.89), was added as a diagnostic modifier into the DSM-IV (American Psychiatric Association, 1994). The proposal for this diagnostic category was specifically aimed to increase the competence and sensitivity of mental health professional to spiritual issues, based on:
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The high prevalence of religious and spiritual problems reported by the public.
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The lack of training of clinicians in religious or spiritual issues.
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An ethical mandate for institutions to provide training in social and cultural factors that may affect assessment and treatment pertaining to these issues.
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This diagnostic modifier continues in the DSM-V.
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How to differentiate SE from Psychosis:
1) Rule out medical illness, including drug intoxication, that may impair psychological functioning (Lukoff, 2007).
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2) Assess for no serious psychiatric history, including no: disorganization, incoherence, loosening of associations, hostile delusions of persecution, or acoustic hallucinations of enemies with very unpleasant content (Grof and Grof, 1990).
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3)Look for an overlap of client's symptoms with previously stated categories of spiritual emergence.
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Katrina Michelle, PhD, LCSW, Director of The American Center for the Integration of Spiritually Transformative Experiences (ACISTE), discusses assessing for insight, when differentiating Spiritual Emergency from Psychosis.