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About This Guide
This is not medical advice and I am not a mental health professional.
Spiritual psychosis is a matter that is very close to my heart. Psychosis in general is one of the most feared and misunderstood aspects of experience. It can be one of the darkest and most destructive things that can be experienced, and in its very nature, it is innately mysterious.
On the flip side of this, an aspect of spiritual development can include opening to something deeper or broader than your current paradigm. There can be a process of sense-making, where you have let go of your old way of looking, new information is coming into your being, and you are parsing worldviews and ideas in non-logical ways. This can include letting go of a more logical way of making sense of the world and embracing a more associative or diffused meaning-making structure.
Letting go of strict logic can be destructive, but when held well, it can lead to growth and development. A more diffuse sense-making process has the potential to heal deep trauma or open someone to deeper beauty, truth, and presence in life.
One of the things that supports positive outcomes is having a healthy model and practice for relating to the imaginal realm. This allows people to be in touch with deeper meaning and sense-making without getting lost in it or it becoming psychosis.
I am currently writing a book about the imaginal realm that will describe the benefits of being in touch with this aspect of experience and include the practicalities of how to do this safely.
In the meantime, I wanted to capture how to relate to these things when they have arisen more spontaneously or in an unsupported, unsafe, or chaotic container, leading to spiritual psychosis.
These experiences can be triggered by a wide range of things: large doses of psychedelics, intense meditation practice, high sensitivity and openness, severe stress, overwhelming trauma, or entirely spontaneously.
When I say spiritual psychosis, I am talking specifically about:
- being in unstable altered perceptual realities
- being lost or confused in different realms of experience, potentially including paranoia
- struggling to connect with a sense of shared reality with others
- experiencing a proliferation of ideas, information, energy or sense-making
- experiencing emotional or physical distress
- being in these states for extended periods of time while sober
This is opposed to:
- having one-off experiences that may challenge or change your existing paradigm
- experiencing altered states of consciousness during spiritual practices or while under the influence of substances
- being in a different paradigm to others around you that is stable and that you can function healthily from
Spiritual Psychosis vs. Psychosis
The line between a spiritual psychosis and a psychosis can be blurry. They can both manifest in many different ways, but in general, what I am calling a spiritual psychosis is coming from accessing more openness, depth, and meaning, whereas what I am calling a psychosis is coming from an explosion of things like disconnection, aggression, and paranoia. A lot of people who are going through psychosis will experience some aspects of both.
I believe that a lot of the difference in whether something manifests as a spiritual psychosis or a psychosis comes from the amount of trauma the person has and the opportunities they are given to engage with the material that is emerging.
For people who are willing and able to explore their consciousness in an open-hearted way, giving them safe spaces to connect to and engage with the contents of their experience can be very compassionate, meaningful, and effective.
On the other hand, in the case of an unhealthy or dangerous psychotic episode, medication and other practical support can be vital for people’s recovery. Sometimes even against the will of the person experiencing it.
Emergency services and mental health professionals are trained to medicalise psychotic experiences. This does hold value for keeping people safe – medication and a physically safe place can be the first step in someone’s recovery; however, pathologising people’s experiences typically does not lead to healing or integration in the medium or long term. Also, psychiatric wards are not places that are designed for recovery, healing, and integration.
I believe that a healthy, whole, and balanced approach to relating to the imaginal realm, spiritual psychosis, and psychosis creates the opportunity to potentially create better outcomes.
This guide introduces some of the key ways to relate to experience in this more whole way, whether you are supporting a loved one, working with people who suffer from psychosis, or are going through these experiences yourself.
It is written primarily with people who are experiencing spiritual psychosis in mind, but the information may be used to relate to psychosis.
Levels of Distress and Healing
I have defined some levels to help locate where the person who is experiencing the psychosis might be. This isn’t meant as a diagnostic tool or medical description of someone’s experience, but this will give you some understanding of:
- the spectrum of what is possible in psychosis experiences
- how severe the person’s experience is
- what sort of support or way of relating is most helpful at this point
I haven’t included anything about the content of what is emerging, as it can be an almost infinite range of things. I have focused on the state that a person is in and the behaviour that might accompany that.
It is worth keeping an eye on how this develops, as psychotic episodes or spiritual experiences can change over time and often unfold in phases. It’s possible to move up and down the spectrum at different times and in different environments.
Red
The person is severely disregulated and a serious threat to other people or themselves. They are paranoid and acting out in ways that are harmful, which may include physical violence or being catatonic. They may be lost in their delusions completely or refusing to engage with any kind of help or support in a meaningful or productive way.
The person is a threat to themselves or others.
Amber
The person is in quite a lot of distress. They are disembodied and struggling to connect with any kind of shared or consensus reality. They may feel very confused. They may want the experience to stop, or they may be lost inside of it. It can be hard for them to establish a trustworthy or meaningful connection with others.
The person may be unable to function and incapable of looking after their own wellbeing or safety.
Yellow
The person is somewhat regulated, can take care of their physical needs, and is able to stay present in connection with other people, at least on a surface level. Their internal experience can be incredibly unstable and stressful for their body and mind. They may hide their experiences from others, only choosing to share specific aspects in safe connections, or they may feel attached to the experiences they are having and reify them into a worldview that they may try to impress on others. They may feel lonely, isolated, angry, or afraid underneath the surface. They may struggle to make sense of their experiences, or they may feel that what they are going through is meaningful or important but not know how to integrate it with consensus reality.
The person is able to keep themselves physically safe but may be struggling socially or psychologically.
Recovery
The proliferation of ideas, energy, or sense-making has slowed down significantly but still feels unstable. The person is engaging in meaningful and wholesome activities that are supporting their recovery. The person is in tune with their own needs and self-expression as well as able to attune to connections with others. The person may experience a lot of tiredness, stress, grief, anxiety, depression, or other challenging emotions.
The person is actively engaging with their recovery process. The person may need lots of time for this stage.
Healed
The person no longer experiences a proliferation of energy, ideas, or sense-making. They feel mostly healthy in body and mind and have a stable paradigm. They don’t feel an overtly oppressive sense of shame around their experiences or a strong attachment to them. They compartmentalise their experiences. They want to move on with their life, connect with people, be well, and do meaningful things.
The person has healed from the psychosis experience.
Integrated
The person can include different realms, ways of seeing, or aspects of experience in their worldview. Having accessed these things (either consciously through practice or from times of instability), they can take the knowledge or insights from their experiences, bring them back to shared reality, and integrate them into a healthy and whole understanding of the world. They have a stable and healthy paradigm. They are able to establish or maintain a personal connection to meaning that feels inspiring and creative. They will likely resist their ideas being wholly defined by rational worldviews, but they are able to engage with a scientific or logical approach as part of their capacity to connect to the world and others.
The person has integrated alternate realms of experience in a healthy way, and through doing this, they have increased their access to wisdom, wholeness, and creativity.
Support Check-List
Here is a check list of responses to psychosis, in rough order of priority.
Depending on which stage someone is in and a person’s history of behaviour, will depend how urgent any response needs to be.
It is better if any decisions or plans are created in collaboration with the person who is having the experience, if that is possible.
- Safety and physical needs: does this person have a safe place they can stay? Are they eating and sleeping? Can they do something that feels grounding, such as be in nature?
- Connection: does this person have someone they can trust who they can connect to? Ideally, this is someone they can share at least some of their experiences with and they trust to be able to support them in making good decisions.
- Medication: if the psychosis is acute, reoccurring, or creating dangerous behaviour, medication can help the person access and maintain a functioning and stable baseline. Where can this be accessed?
- Recovery plan: what does this person need to get back to a stable base? Do they feel like a recovery is possible and meaningful for themselves?
- Space for self-expression: does this person have somewhere where they can talk about and process their experiences in a free and helpful way? Examples might be art therapy or imaginal practices.
- Rest and nourishment: can this person take enough time to rest deeply? Do they have access to things that will nourish them in their recovery, for example, calm environments, body work, and access to nature?
- Therapy: does this person have access to therapy that feels meaningful to them? They may need to process any trauma that contributed to the psychosis emerging as well as any PTSD from the experiences themselves. This may be talk therapies, but alternative therapies, such as art therapy, may be more beneficial or used alongside more traditional modalities.
- Meaning-making: does this person have access to non-judgemental and open-minded spaces or information that supports them to integrate their experiences in a healthy, holistic, empowered, and humble way?
- Relationships: are the person’s support network able to be with their own experience in an honest and open way? This potentially creates more freedom and healing opportunities for the person who has gone through the experience.
Each of these check points has a whole world of information that could be included in it, but hopefully this gives a sensible place to start considering what is happening and what is needed in any given situation.
Context
Depending on what paradigm and social community you are in, it will depend on whether you and the people around you are more likely to relate to psychosis from a medical perspective or a spiritual perspective.
Both have benefits and downsides, and I have written a short list of these below.
Medicalisation
Benefits: Focused on the individual’s immediate safety, medication can support a fast and reliable return to a stable baseline and maintain mental health. This route can also offer access to more traditional therapies, such as psychotherapy
Downsides: Dismisses and pathologises the content of people’s experiences, misses important healing and integration opportunities, environments such as psychiatric wards can be damaging to people’s wellbeing and overall mental health
Shamanic or Spiritual
Benefits: Typically a more holistic and open-minded approach, it can support growth and healthy integration, offer a framework for alternate experiences and paradigms, and offer a broader range of therapeutic modalities, such as body work
Downsides: Can reify certain experiences or put them on a pedestal encouraging further delusions, is unregulated and risks taking people further away from recovery
Non-Adversarial Connection
If you want to be able to connect with someone who is still in a spiritual psychosis, one of the most important starting points is being able to offer them non-adversarial connection.
This gets more difficult if the person themselves is in an angry or agitated state and easier the more calm the situation is on the whole. The more you can be disentangled from the other person’s expression and needing it to be anything in particular, the easier it becomes to stay in your own centre.
In order to allow people who are suffering from psychosis to begin to heal properly, they need to be in a non-judgemental space.
This doesn’t mean that you need to agree with their reality, but it means that you aren’t punishing people for their feelings, thoughts and ideas.
The aim is to create freedom for all people to express themselves, without needing others to agree with their stories or ideas. To hold space and create connection on an emotional level. This is what allows healing to begin.
Here is an example of how this might look if you are interacting with someone who is experiencing delusions.
If they shared, “I can hear their voices in my head, and they are going to be here to get me any moment.”
You can meet the person with genuine compassion for the emotional experience that you feel or imagine they are in, without supporting their reality, for example, “That sounds really stressful.”
If you believe you can share it without escalating the situation, you could also share your perspective: “I don’t believe that anyone is coming to get you, but that sounds very stressful for you.”
This way of relating creates connection without supporting delusions and invites people down and in to their emotional and embodied experience.
External Resources
This is a list of resources that could be helpful in supporting people to get access to safety and recovery.
A comprehensive and user-friendly guide for people who are experiencing mania or people who are supporting someone who is experiencing mania. There is a lot of crossover between mania and psychosis, and the advice generally carries across very well.
Resources and support for adverse meditation experiences, including individual and group therapy.
MAPS is the Multidisciplinary Association for Psychedelic Studies. A collection of links and resources for people in crisis.
Information and referrals for people experiencing spiritual emergency
Medical Help
Depending on which country you are in will depend on what the process of getting medical help is. You may need to research what this process is in your location.
In the UK, there are Early Intervention Teams that support young people people with early symptoms of psychosis, crisis mental health teams who can come out to visit you, you can go to your GP, or you can call emergency services.
All of these will help you work through what options are available with things like being admitted to hospital or receiving medication.
If you’re in the US, here is a useful factsheet from the National Alliance on Mental Illness (NAMI), and here is a candid guide to navigating psychiatric inpatient care, written by a psychiatrist.
Suicide Hotlines
There are free suicide hotlines in most countries in the world.
Relating to Spiritual Psychosis Experiences with Practice
This part of the guide is about moving out of crisis management and towards compassionate holding, healing and integration of spiritual psychosis. This is relevant for people who are in recovery.
One important aspect is to make sure everyone is physically safe. When everyone can trust that their physical bodies are safe and taken care of, everything else can flow a lot more easily.
My own experiences have led me to create practices and ways of relating that allow healthy, supportive and safe connections to be made:
- between people who are in different realities or paradigms
- between different aspects of a person’s experience, such as the physical and the spiritual
I wanted to share some of the core principles here that will allow people to start building connection and meaning.
Helpful Practices
These practices invite people into the aspects of experience that will help them process experiences from a more whole and meaningful place.
As a friend, relative, or support figure, you can also use these practice principles to help you orient towards coming from a place of compassion and curiosity, which will create the possibility for connection and openness, rather than fear, judgement, or dominance.
If you have experienced any spiritual psychosis, these practice principles may help you relate to your experiences in a whole and healthy way.
Heart Practice
Start by finding a heart practice that works reliably for you. This should be something that connects you to feelings of softness, kindness, care, openness, resilience and receptivity.
It can be a more formal practice, like Buddhist metta meditation, but it also doesn’t have to be serious. An example could be watching cute cat videos and then staying with the feelings that are evoked by this.
From here direct this sense of love towards yourself and others – wishing wellbeing, freedom and care.
Mindfulness & Emptiness
One way of relating to experience is to stop wrestling with experience and give it some space to breathe.
You want to try and release the controlling mind a little bit, to create more space for experience to flow freely through you.
When relating to anything imaginal, associative or immaterial, it can help to recognise the metaphorical nature of what you are experiencing. A solid base of mindfulness practice will help with this, starting from a place of being able to see thoughts as thoughts.
From here you want to recognise that the subjective experiences you are having are more like a poem than being representative of a literal reality or truth. Experience is presenting itself to you in an imaginal and creative way, rather than a logical way.
For example, if someone has a high openness to transcendental experience, they may be trying to parse ineffable and incomprehensible aspects of experience but getting lost in stories.
A simple practice for this would be to meditate and imagine that everything that you think, feel, and experience during the meditation time is the Universe reading you a poem.
Another practice is to doodle, or make art about what your inner experience feels like.
You can release a level of self-consciousness and self-judgement by creating space for ideas and thoughts to be moving through you in a more creative way. Once the ideas and thoughts have flowed out more freely, the logical mind can come back online to help sort through it, make sense of what is true, what problems need to be solved and how to handle the situation. This practice releases the double binds that can be at the root of a lot of psychosis experiences.
Embodiment
Once you can see the metaphorical nature of the subjective aspect of experience, you can notice how you are always just a human being hanging out in the present moment.
You can become aware of how even when you are connecting to visions, ideas, energies, or anything else that is emerging in your experience, you are still physically in your body and mind in this moment in time. You can still breathe and ground, staying connected to the body and how it feels.
It’s worth saying that there is a risk that connecting to the body can make someone feel worse if the levels and types of information they are parsing through their body are too much for the body to handle or if there is a lot of trauma in the body. They may be dissociated from the body for good reason.
The body also picks up on the subconscious and implicit energies that are present so it’s not good to force the body to be present if it feels unsafe in the container that it is currently in.
The aim is to respect the embodied aspect of experience and make space to find a healthy, supportive connection to this over time.
This could include receiving loving touch or body work, doing therapies that don’t introduce more implicit expectations and double binds, or doing simple practices of relaxing the body in a safe space and holding space for what emerges when you do that.
Imaginal Practice
Imaginal practice creates the opportunity to combine all of these things – heartfulness, emptiness and embodiment – into a healthy way of relating to and processing experience in the present moment.
If you can stay open, curious and present, you could engage with the content of intense spiritual experience in this way.
An example would be to loosely define a spiritual experience that is happening in your experience, for example:
- ‘Everything is one’
- ‘The eyes of God’
- ‘Infinite awareness’
Take this concept and drop it into your experience. Ask yourself questions about the experience and allow the creative aspect of experience to respond. For examples:
- Where do you feel that resonating in your body?
- What emotions are present?
- Can you describe an image of what you are experiencing?
- What does it mean to you personally?
You can do this with literally any idea or concept, and it brings things back to a more grounded, connected, embodied place.
It takes the charge out of whether something is literally real and allows things space to express the meaning, emotions and energies that they contain.
You can also use the imagination to access positive, healing and supportive states. One of the things that can be hard when you’re in severe distress is to imagine a way out into wellbeing.
An example exercise is imagining bringing in some ideal support:
- Can you imagine a very wise, caring guide who is there to take care of you through this process?
- An example of this could be a support figure, a spirit animal, a guardian angel or a future wise version of yourself.
- What advice would they give you?
- If they could give you a magical healing ceremony, what would they do? What impact would it have on you?
- Is there anything else you need or would like to ask them for?
The imaginal realm creates an opportunity to connect with the depths and mysteries of experience in a safe way. Amongst many other things, this can create freedom for people to feel their emotions and take the charge out of pent-up thoughts and ideas.
Once you have practiced with something in this way, there is more space for the idea to be integrated with a more logical or rational worldview or approach, also without expecting the rational view to become dominant.
Open Hand
The common thread amongst all these practices is that you are holding experience with an open hand.
Rather than trying to convince people of a story or be right about what experience exactly is, you are focusing on the felt senses and experiences that are here with you in the present moment and grounding them in an embodied, subjective place.
This creates more safety and groundedness. If someone is unable to relate to their experiences in this way, with some level of openness and flexibility, it can be a sign that they are in a spiritual psychosis.
Psychedelic Experience
Psychedelics can be a portal into imaginal and spiritual realms. They can also offer a window into the world of someone who is experiencing spiritual psychosis. It can be hard for other people to relate to someone who is in an altered state of consciousness. If you have taken psychedelics before, this gives you a reference point to imagine some of the aspects of what this person’s current experience might be like. Both the positive aspects and the downsides of it.
Integration
Ultimately, spiritual psychosis is often a sign of deep sensitivity in someone. They are picking up on aspects of experience that most people are closed to, and sometimes they do not have the capacity to hold this skilfully.
In many other cultures, these people would be identified as shamans early on and given the training to relate to these experiences in a healthy and meaningful way. While we do not have this kind of support in our modern culture, I hope that some of these ways of practicing give a sense of the potential for also relating to this capacity as a gift, rather than solely writing it off as a sickness.
Once someone has the capacity to hold their experiences, it becomes easier for them to connect to the important aspects and integrate this into a healthy paradigm and worldview.
Recovering from Psychosis
Any kind of psychosis takes a huge toll on your body, heart, mind, and soul. A person who is recovering will need lots of time to do this and may need to spend extended amounts of time resting or sleeping.
This is an emotional process, but it’s also the physiological process of the brain recovering. Rest, sleep, and dreams are vital to this recovery.
Here are some other things that can help support this recovery process.
A Healthy, Safe Life
Consider what the person needs to live a healthy and safe life. Things that this includes are a cosy place to live, nutritious food, enough time to rest, access to gentle exercise or nature, social connection, access to medication if they are taking it, and therapy or support.
Receiving body work or loving touch can be incredibly healing. Typically, when you have gone through challenging periods of disconnection and stress, the body will still be carrying this around with you. Having someone help the body come back to feeling safe in itself is very healing.
Finding Meaning
Having a means of creative expression can be helpful for someone making sense of their experiences. Also, when someone’s paradigm has been disrupted, finding gentle ways to ease back into a more consensus reality gives someone time to reintegrate into the world.
The person may want to compartmentalise their experiences, either temporarily or forever, in order to be able to function in consensus reality. Or they may feel that it’s important to find alternative paradigms that help them make sense of their experiences.
Healing vs. Integration
One of the core values of my approach to relating to spiritual experiences and spiritual psychosis is wellbeing.
For some people, when they go through a psychosis, their goal will be to heal and compartmentalise their experience. This can be incredibly healthy and help people move on with their lives and reconnect with what is most important in life.
For other people, they will feel that the thing they have touched or experienced is one of the things that is most important in life. I don’t believe that it is healthy or helpful to entirely dismiss this sense of meaningfulness.
In this case, once people are safe and on the road to recovery, I would encourage people towards a healthy integration where they can connect to both the meaningfulness of the experiences they are having and a rational understanding of the world and the realities of others.
Recommended Resources
These resources give a range of perspectives that all come from a radically understanding and integrated place with regards to spiritual psychosis and the imaginal and spiritual realms.
Psychosis or Spiritual Awakening: Phil Borges at TEDxUMKC
Phil Borges has been documenting indigenous and tribal cultures for over 25 years. He describes what can be learned from individuals who have turned their psychological crisis into a positive transformative experience.
Healing the Split: Integrating Spirit Into Our Understanding of the Mentally Ill by John E. Nelson
This book cuts through both the medicalisation of psychosis and the pedestalisation of transpersonal or spiritual states and describes how they can be understood as different manifestations of the human experience.
John Nelson creates a framework for how and why different spiritual and psychotic experiences emerge in people, weaving together both mind and spirit.
Mastering the Core Teachings of the Buddha: An Unusually Hardcore Dharma Book by Daniel M. Ingram
Amongst other things, this book documents and normalises a wide range of spiritual experiences that can emerge on the spiritual path.
It has a Buddhist lens on experience and includes some frameworks and concepts for relating to these experiences, such as the stages of insight and the dark night of the soul.
Daniel and I also recorded a podcast about altered states of consciousness, which you can listen to here
Jung: A Very Short Introduction by Anthony Stevens
Jung was a prolific writer about the imagination and its healing power. He advocated for recognising the fundamental sanity in people, even those suffering from psychosis, and consciously went through his own seven-year psychosis as part of his spiritual journey and growth.
This short introduction shares his life story and introduces the basic concepts of Jungian psychology: the collective unconscious, complexes, archetypes, shadows, the persona, the anima and animus, and the individuation of the self.
The film depicts the true story of Nise da Silveira, a Brazilian psychiatrist who, inspired by Jung, created a psychiatric ward that used art therapy as one of its main forms of treatment. Many of her patients became celebrated artists.
‘God told me I should take more LSD’: Sari Soininen on her acid-induced photographs
An interview with Sari in the Guardian about her experiences of psychosis and the photography book she has made inspired by the experiences.
Down Below by Leonora Carrington
Leonora Carrington is a surrealist painter and novelist. This short memoir tells the story of her descent into psychosis and subsequent recovery. It is a powerful first-person account of madness.
An American journalist shares the story of his personal exploration with psychedelics and shamanic rituals to open to a more interconnected way of being.
Unpacking the Mystery of Ramanujan’s Dreams by Kristen Posehn
An article that describes some of the potential power of the imaginal realm, Kristen gives a really beautiful example of how dreamwork, prayer, and connecting with the creative aspect of being can contribute to the mystery of genius.
Imagination: A New Foundation for the Science of Mind
This paper by Stephen T. Asma describes the science behind how imagination is actually the foundation of human experience, rather than logical or rational thought.
“Imagination is not just a peripheral feature of cognition or a domain for aesthetic research. It is instead the core operating system or cognitive capacity for humans and has epistemic and therapeutic functions that ground all our sense-making activities.”
Podcast – Iain McGilchrist on the Divided Brain
In this podcast, Iain McGilchrist lays out the key points from his book, “The Master and His Emissary: The Divided Brain and the Making of the Western World”.
He describes how the left hemisphere way of thinking – logical, rational, oriented towards problem-solving – is incredibly dominant in our current paradigm and how this actively oppresses the right hemisphere qualities – creativity, openness, associative thinking, oriented towards interconnection.
One of the quotes from the podcast is, “The left brain is sure that it knows more, but it actually knows a lot less than the right brain.”
Somatic Resonance Course by River Kenna
This paid online course takes you through the practices you need to come into your body. Being present in the body is the opposite of an unhealthy and disconnected proliferation of mind that manifests both in psychosis and in most modern people’s way of experiencing the world.
It takes time, practice, and discernment to be able to come out of the left brain’s idea of the body and actually land in the true felt experience of being embodied. It also involves including the imaginal and emotional aspects of yourself in what you experience as the body.
This course takes you through this process of embodiment in a very rich and comprehensive way.