One of the particularities of transpersonal psychotherapy is to accompany a person, patient or client, during existential crises or even spiritual emergencies. However, the symptoms presented by these states can lead the untrained psychotherapist to equate them with psychiatric pathologies. The diagnostic error can then have serious consequences for the patient or client. But while research has been conducted on spiritual emergencies, notably by Grof, little literature exists on therapeutic support during existential crises. Yet we all experience this type of crisis at some point in our lives.
In this article, we will explore the existential crisis and its specificities, which allow it not to be confused with a pathology. We will emphasize the importance of carrying out a global diagnosis, and not just a clinical one, of the person suffering, in order to apply the appropriate care or support protocol. Finally, we will study how transpersonal psychology can help the person overcome this crisis and how research in transpersonal psychology can help the practitioner make a diagnosis.
Introduction
Transpersonal psychology covers many fields, including psychotherapy, a sector in which it brings a new and holistic vision. The use of psychotherapy can be justified by several reasons, including the outbreak of an existential crisis. However, this crisis can present the same symptoms as a psychotic episode. However, few health professionals, whether psychologists or psychiatrists, have been trained to differentiate between these two states (Crowley, 2006; Boorstein, 2000). In addition, the fragmentation of psychological support for a person, patient or client as the case may be, between several professions, those of psychiatrist, psychologist or coach, does not facilitate a global approach to the individual's psyche. Some will look for an illness in the person's behavior, others for ways to adapt the person to their social environment, and the third for the possibility for the client to have a moment of respite and well-being.
Now, one of the characteristics of transpersonal psychology is to adopt a more holistic approach (Daniels, 2005) and to consider the individual in his environment and his genealogical lineage. In its diagnosis, it places the person in his space-time, starting from the principle that the person is interconnected and therefore influenced by his environment or what Rupert Sheldrake would call morphic fields (Sheldrake, 2011). Even if this theory is not scientifically proven, for the moment at least, no one can deny the influence of the environment on the psyche.
Transpersonal psychology is also interested in what constitutes or influences the psyche beyond the ego, notably the transcendent dimensions of the human being (Daniels, 2005). However, if this search for the transcendent is shared, the ways of experiencing it and/or conducting it vary from one individual to another. This is due to the personality of each individual, their essence or what makes each individual unique; which explains why in the same environment, behaviors are different.
These are all elements, environmental, genetic, age, medical history, etc., which should be taken into account when making a psychological or psychiatric diagnosis to differentiate between existential crisis and mental illness. However, this is rarely the case because a transpersonal model of the psyche is lacking (Crowley, 2006).
But first, let us study what an existential crisis is, what its characteristics and symptoms are, in order to (i) differentiate it from a spiritual emergency and (ii) compare its manifestations to those of a psychosis. I will then explain how transpersonal psychotherapy can help the client or patient overcome this crisis. I will conclude by giving some ideas for future research, particularly in the field of personality theories.
Difference between existential crisis and spiritual emergency
Although Grof's publications have raised awareness of spiritual urgency and the possibility of overcoming it through transpersonal psychotherapy (Grof, 1982, 1988), little research has been done on the application of transpersonal therapy to existential crisis. However, we all experience existential crises during our lives. For Hollis (2005), a major crisis would occur during the second half of life, but this is not the only time; adolescents also experience these passages to other levels of consciousness, called self-actualization by Assagioli (1989), during which questioning, doubts and sometimes despair are present.
These crises may be accompanied by psychotic episodes and, because these episodes are usually only transient, can be the subject of transpersonal therapy. But since the symptoms may be the same as those of psychosis, the danger for the patient is that they will be labeled as mentally ill by psychiatrists (Crowley, 2006; Lukoff, 1988), as I have often seen with adolescents, and then be put on neuroleptics, thus preventing the natural development of the individual's psyche. The adolescent thus treated will sometimes end up believing that he is ill, which at best can serve as an excuse for failure, or at worst, will allow him to avoid facing life and its challenges.
Awareness of this type of crisis, which is necessary because it evolves, began to emerge in the medical world thanks to the work of Grof, who introduced the concept of spiritual emergency in the 1970s based on the observation that many people were experiencing ruptures and evolutions during non-ordinary states of consciousness: shamanic journeys, parapsychological experiences, taking psychotropic drugs, etc.
But the Grofs' transpersonal approach can extend beyond the particular and exceptional situations they describe to any difficult situation of transition from one state of consciousness to another. We will then speak of an existential crisis rather than a spiritual emergency. The word 'emergency' refers in fact to a situation that must be resolved quickly. However, it is less a question of urgency in an existential crisis than of a passage or even a transitional state towards another level of consciousness. And the course of a life, whether animal or plant, passes through cycles or evolutionary stages; crises of transition from one state of consciousness to another are inevitable and salutary. These passages are marked by doubt and experimentation as shown in the literature on the subject:
Thus, for Campbell, there would be three fundamental stages during life, sometimes accompanied by neurotic disorders; Graves, whose theory was taken up by Beck and Cowan and then by Wilber, developed the concept of spiral dynamics to describe the evolution of the psyche and organizations; For Erikson, personality develops in a predetermined order through eight stages of psychosocial development, from early childhood to adulthood. During each stage, the person experiences a psychosocial crisis that can have a positive or negative result on the development of the personality.
These almost initiatory transitions from one stage to another can sometimes give rise to crises whose occurrence and extent depend on several factors: factors intrinsic to the person such as their personality or maturity or exogenous factors such as bereavement or separation, forcing the individual to question themselves in a brutal and unexpected way.
Furthermore, the essence of all life is to be evolutionary. Any resistance to this principle of permanent change causes an 'existential' crisis. So rather than talking about a spiritual emergency, I prefer to talk about an existential crisis. These two concepts share the same idea: Existential crisis or spiritual emergency can be described as a particular form of grief or loss, marked by a profound questioning or lack of meaning in life, in which an individual or even a community reaches a turning point, leading to a significant alteration in the way life is perceived.
But with spiritual emergency, the trigger is very specific because it is spiritual or parapsychological, whereas the existential crisis, the passage from one identity state to another, is part of the normal evolution of Man. No one escapes it. In both cases, the crisis can take on different degrees or aspects depending on the personality of the individual and where he is on his life path, what Jung calls the 'individuation process' or Assagioli 'self-realization'. The symptoms that accompany it can suggest a psychotic disorder (Crowley).
Existential Crisis and Transpersonal Psychotherapy
So we all go through phases of change and development that can be violent and the symptoms can be reminiscent of mental illness.
This comes down to questioning what is normal and what is pathological in our materialistic society where medical studies continue to ignore research on consciousness although positions are beginning to shift. For psychiatry, anything that deviates from a social norm established at a specific moment is considered pathological. For example, in the film "Girl, Interrupted" (Girl, Interrupted, James Mangold), we see how a gifted teenager living in the 1950s ends up being lobotomized due to a lack of understanding from those around her. The history of psychiatry is paved with acts of this kind where everything that is not normal must be normalized by all means.
The 'normal' and the pathological are also the subject of a dictionary, the DSM (Diagnostic and Statistical Manual of Mental Disorders) whose various rewrites since 1952 follow the evolution of social norms. Thus, the adolescent or child with his or her fanciful behavior can find himself or herself classified as a disorder of social norms and therefore be placed in a chemical straitjacket. Until the 80s, methylphenidate was given to all children with attention disorders, particularly at school, children who in other times were described as unruly and not mentally ill.
However, a diagnostic error can be fatal for the person's development.
But how then can we differentiate an existential crisis from a psychosis, since the symptoms are sometimes the same: delusions, disorganized speech, depression, mania, disorganized behavior, etc. Subjects with a brief psychotic disorder typically experience emotional upheaval or extreme confusion (Fochtmann et al. 2009). The same is true during an existential crisis.
Hence the importance of broadening the anamnesis to include information other than that relating solely to the patient/client, of going beyond the medical aspect and integrating information on the sociological, cultural, spiritual and family conditions of the person. The doctor or psychologist himself must question what the person is telling him in terms of acceptance or rejection of values. An expanded anamnesis questionnaire integrating aspects specific to transpersonal psychology should be developed in this direction. Many authors have insisted on the importance of this diagnosis and the training of professionals to make such an 'expanded' diagnosis (Sinclair, 2016)
One of the contributions of transpersonal psychotherapy
But taking into account the multidimensional and interconnected aspects of the person is not the only contribution of transpersonal psychology (Jung, Grof, Assaggioli). It is also interested in what makes the individual unique. Now what explains this uniqueness is his personality. Indeed, faced with the same striking fact, the reactions of each person will be different according to their personality. To be effective, therapeutic approaches must take into account and adapt to each personality, the analysis of which is an essential element of psychological diagnosis.
It is also important to note that depending on the personality theory adopted, the explanation given to the disorders observed may be different: For a Freudian, the cause of the disorders would come from childhood, for a Jungian or an Eriksonian, it would be due to a lack of accomplishment, for an Alderian, an avoidance of challenges would be the cause. All implicitly call upon a theory of personality, defined as a set of coherent traits forming an organized system, structured around values and characterized by a certain type of behavior (Sollod & Monte, 2008).
While many personality theories exist, little research has been conducted to date with a transpersonal perspective. Yet, the transpersonal approach, drawing on traditions, would allow for a different conception of normality and mental disorder. An important and still unexplored area of research is therefore a transpersonal theory of personality inspired by ancient spiritual texts such as Kabbalah. This would allow us to accept that personality is multidimensional without being pathological.
This concept of co-personalities began to emerge around the 2000s and having multiple personalities began to no longer be considered a psychiatric disorder but as part of the essence of being human. Thus, for Rowan, each person is a group made up of at least half a dozen personalities and in this modern world, everyone needs to move flexibly between these own sub-personalities (Albery, 1986). Kabbalistic psychology also teaches us that there would be ten energy centers, in other words ten sub-personalities, each of which would have a specific function. These energy centers structure the universe but also the human psyche. As Drob (1997) indicated, “The ten dimensions of the Kabbalistic universe form a guide (…) on the psychological development of the human personality”.
Having multiple personalities would therefore no longer be pathological and recognizing their existence would allow the individual to be freer and more balanced (Stone & Stone, 1989). To quote Erikson (1980), “Each person is a unique individual. Therefore, psychotherapy should be designed to meet the uniqueness of the individual's needs, rather than trying to fit the person into the Procrustean framework of a hypothetical theory of human behavior.”
To quote Erickson (1980), “Each person is a unique individual. Therefore, psychotherapy should be formulated to meet the uniqueness of the individual's needs, rather than to fit the person into the Procrustean bed of some hypothetical theory of human behavior.”
This transpersonal recognition of multiple personalities or co-personalities would allow for a different perspective on the patient/client. And the identification of these sometimes conflicting co-personalities is certainly an element to take into account during anamnesis.
Conclusion
Existential crises are inherent in the destinies of individuals because all life is evolving. The transition from one state of consciousness to another can be painful depending on the individual and the context in which they live. Beyond only accompanying the spiritual emergency, transpersonal psychotherapy can help overcome these crises because its purpose is to focus on everything that is beyond the ego and the process of transformation of the individual throughout their life. It is also an integrative and holistic psychology (Hartelius,).
Transpersonal psychology allows us to take a different look at personality disorders and not consider the person experiencing an existential crisis as mentally ill. Diagnosis is important because it will determine the choice of treatment. Making a diagnosis requires the widest possible collection of information, not only medical but also sociological, spiritual, etc. A questionnaire should be developed for this purpose.
Although still in its infancy, research in transpersonal psychology challenges the "classical" approach to mental illness, particularly personality disorders, by drawing on ancient traditions such as Kabbalah. These research topics have yet to be explored, but the avenues exist and have been indicated by theorists such as Wilber, Grof, etc.
However, it is clear that few psychiatrists and health professionals are trained in transpersonal psychology, that is to say, a holistic, integrative psychology that supports the individual, considered as unique, during a difficult transition in a process of transformation. However, making a wrong diagnosis can have serious consequences for the individual and stop a process of natural evolution..
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