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Although the importance of spirituality and culture is becoming more widely acknowledged in mental health care, the concept and phenomena of spiritual crisis is still not widely known or accepted in mainstream mental health services.

"Spiritual crisis is a natural process that can result in personal growth or
profound positive transformation."

I define Spiritual Crisis as: any self-identified spiritual or anomalous experience that affects the experiencer's identity and that causes concern or distress for the person who experiences it, or for those around them.

In many ways, every spiritual crisis is as unique as the individual who experiences it. This is likely a result of both individual and cultural differences (see below). Therefore, “spirituality” is an umbrella term that can mean different things to different people. I do not seek to categorise anyone, or their experiences, and allow individuals to self-identify with the concept of spiritual crisis in whatever way makes sense to them. However, it is possible to recognise different varieties of spiritual crisis and themes that are common across many of them. This can help to normalise people’s anomalous experiences.

Spiritual crisis is also known as a: spiritual emergency, Spiritually Transformative Experience (STE), psycho-spiritual crisis, kundalini awakening, or simply as a transformative crisis. Italian psychiatrist Roberto Assagioli, founder of Psychosynthesis, described four stages to spiritual crises: crises preceding the spiritual awakening, crises caused by spiritual awakening, reactions to spiritual awakening, and phases of the process of transmutation. Stanislav and Christina Grof identified ten varieties of spiritual emergency:

  • Episodes of Unitive Consciousness or Peak Experiences.

  • Kundalini Awakening.

  • Near-Death Experiences.

  • Shamanic Crisis or Journey.

  • Psychological Renewal through Return to the Centre or Activation of the Central Archetype.

  • Awakening of Extrasensory Perception or Psychic Opening.

  • Emergence of Past-Life Memories or a Karmic Pattern.

  • Communication with Spirit Guides and Channelling.

  • Experiences of Close Encounters with UFOs.

  • Possession States.

Other common types of experience are sleep paralysis and the Dark Night of the Soul. Spiritual crisis can also be triggered by religious doubts, conversion, spiritual abuse, bereavement, or other life crises. It is also important to note that spirituality can have negative aspects which need to be avoided, such as spiritual bypassing, spiritual narcissism, spiritual materialism, or spiritual abuse.

A common feature of a spiritual crisis is that it can, if managed well, offer the opportunity for personal growth or profound spiritual transformation. The experience is more like a natural process, such as childbirth or adolescence, rather than a disease or pathological condition. Many people who go through a spiritual crisis recover to normal or even better than they were before.

Also, many people now think of spirituality and religion as different things. Spirituality is often said to be about finding meaning and purpose in life, whilst religion consists of institutions, beliefs, and rituals. So, many people now consider themselves to be spiritual but not religious.

"Anomalous" means unusual or non-ordinary. This term is often used in parapsychology, which studies psychic and paranormal phenomena. Altered states of consciousness (ASCs) are common elements of these kinds of experiences. The branch of parapsychology concerned with the impact of paranormal experiences on people's wellbeing is called clinical parapsychology.

The majority of spiritual or anomalous experiences are benign, even positive, for the person who has them. Unfortunately, a minority can cause anything from mild concern to acute distress, or even an overwhelming crisis. This can include mental, emotional, and physical phenomena, such as seeing visions, hearing voices, or feeling energies. Therefore, spiritual crisis is often mistakenly diagnosed as a mental health issue, such as psychosis, schizophrenia, depression, or Bi-Polar Disorder.

Many writers on spiritual emergency advocate for the differential diagnosis of spiritual emergency/spiritual crisis and psychosis. In the U.S. the inclusion in the DSM-5 of the non-pathological v-code of “Religious or Spiritual Problem” provides for this (Lukoff, 1998). The rationale for this approach is to avoid iatrogenic harm caused by responding with an inappropriate intervention, usually medication, which is understood to suppress a natural process of psychological growth.


Whilst acknowledging that medication can be helpful in managing the acute stage of crisis, I avoid the debate about differential diagnosis as this perpetuates the biomedical psychiatric model, and adopt a more holistic and humanistic approach focusing on what helps a given individual in their specific circumstances. This approach avoids coercion and is akin to that of formulation taken by some psychologists, whereby the meaning of someone's problem is understood by a two-way discussion.


Sometimes the person who has the experience is not concerned or distressed by it at all, but friends, family, or others around them may be. These experiences can result in profound changes in someone's behaviour, attitudes, and beliefs. However, reacting in a negative way towards the experience can often make it worse.


The interesting question of cultural perspectives is an under-researched area, and a systematic study of the meaning of spiritual crisis across cultures and religions remains to be undertaken. It seems that the majority of people who self-identify with the term spiritual crisis are white, Western, highly educated people. Some categories of spiritual emergency are based on concepts from other cultures, such as kundalini awakening from Hindu yoga or shamanic crises. However, it is not clear whether these are different types of experience or different cultural interpretations of a common underlying process. We also need to be wary of cultural appropriation, the psychologization of spiritual practices, romanticization of different cultures, and subtle forms of Western cultural imperialism.


In addition, some anthropologists have noted the positive role taken by religion and spirituality for psychiatric care in non-Western cultures (Tobert, 2014; Luhrmann & Marrow, 2016). Certainly, cultural sensitivity and cultural humility have been proposed as important aspects of clinician training and awareness, which fits well with an informed approach to equality and diversity in clinical practice.


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