Exploring spiritual crisis experiences in relation to mental illness

A systematic review of the literature explored similarities, differences and overlapping features between spiritual crisis experiences and mental health conditions, particularly psychosis. Three databases and three specific journals were searched for articles addressing the research question, and relevant papers identified. Quantitative papers and case studies have been briefly summarised. Eight qualitative papers were eligible and synthesised thematically. Three superordinate themes emerged: ‘Immense shift from normality’, ‘Entangled distress’ and ‘Distinctly meaningful’. Features of a spiritual crisis included experiencing oneself and the world in a different, extraordinary way. Distress was a key factor linking experiences to mental health conditions. Factors associated with distress included isolation, traumatic experiences, the experience of feeling out of control and not being able to integrate the experience. There were also positive experiences, with spiritual crisis associated with enriching and enhancing a person’s life, which may be distinct from a mental illness. Results identified the need for clinicians to recognise and understand features of spiritual crisis, to foster and support opportunities for growth.

The empirical study probed the relationship between spiritual crisis and mental illness using a qualitative methodology. Interviews explored the experiences of people who reported having a spiritual crisis within the past three years. Five participants had contact with mental health services, and three had not had involvement; similarities and differences were considered. Data was analysed using interpretive phenomenological analysis, finding three shared themes; ‘Navigating the immersive: emotional, physical and existential intensity of spiritual crisis’, ‘Building meaning through social stories, seeking knowledge, and coming to terms’ and ‘Seeking people who understand the inexplicable’. The subtheme ‘A foot between two worlds’ portrayed aspects of double bookkeeping and mysticism. Participants sought ways to make meaning of the experience and needed people who could understand spiritual crisis. Acknowledging alternative perspectives towards spiritual crisis alongside a medical model stance is addressed.