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Preface

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This sourcebook was written for professionals and paraprofessionals in the field of human services as a guide for helping someone with spiritual problems. Spiritual Problems is a new diagnostic category in the Diagnostic and Statistical Manual (DSM-IV) arising out of the profound disorientation and instability that sometimes accompany spiritual experience. In its most intense manifestation, lasting between minutes and weeks, spiritual problems can create a crisis. In this case, spiritual emergency, it appears similar to an acute psychotic episode excepting that the episode eventually has a positive transformative outcome (Dabrowski, 1964; Grof, 1985; Lukoff, 1986). People with spiritual problems or in spiritual emergency have needs for care usually unavailable from therapists, doctors, or in hospitals dealing with more well-known mental disorders.

Although this sourcebook is written for medical practitioners, healers, professional therapists, pastoral counselors, paraprofessional people working in crisis situations, and students in training for these positions, it will also be useful to leaders and teachers in spiritual and religious communities who are faced with the care of people with spiritual problems catalyzed, in part, by their spiritual practice. The sourcebook is written from a "transpersonal" orientation - it assumes that beyond our normal ego functioning there are dimensions of superior perception and function. [See Appendix E for a glossary of terms]. When we enter the transpersonal domain we can access intuitive wisdom, creativity, brilliance, compassion as well as extraordinary energy, peace of mind and healing abilities. People have generally labeled these as "expanded states of consciousness" or "altered states of consciousness."

Since the publication of the first edition of this book in 1988 there has been an upsurge of interest in spiritual emergency. Where the term, "spiritual emergency," was hardly recognized 5 years ago, it is now more commonly heard. This is due, in part, to the publication of several books and lead articles on the topic, as well as new programs designed specifically to attend those in spiritual emergency [See Appendix D for referrals and references].

In mid-1993, the editors of the Diagnostic and Statistical Manual, (DSM), decided to include a diagnostic category for "spiritual and religious problems" in the up-coming edition of the DSM-IV due to be circulated in 1994. Since the DSM is used by physicians, psychiatrists, psychologists, clinicians, hospital administrators and insurance agencies to categorize and communicate about mental disorders, inclusion of a category regarding spiritual problems is formal recognition that spiritual experiences interact in a meaningful way with emotional well-being and may initiate periods of emotional distress. Prior to the designation of this new category in the DSM, health care providers relying on the DSM and conventional education were led to assume that phenomena associated with spiritual experiences were symptomatic of deep pathology because the phenomena could so easily be confused with indicators of psychosis, mania, depression, schizophrenia or borderline personality disorder. The new diagnostic label, spiritual problem, gives health providers a way to speak about spiritual experiences, including mystical states of unity, without having to regard the symptoms automatically as pathological.

This new edition of the Sourcebook for Helping People with Spiritual Problems can be used as a study guide and reference manual to learn about the phenomena of spiritual problems, how these problems can be differentiated from mental disorders, and appropriate care for those in spiritual emergency. This sourcebook includes updated references to books, articles, audio-tapes and movies which illustrate the dynamics of spiritual development and spiritual emergency. Readers will come to recognize how widespread these phenomena are. It also includes information regarding new treatment modalities which are appropriate for people wanting to accelerate spiritual emergence, growth into transpersonal realms or treat spiritual emergency. Resources for 24-hour care have also been updated. These include a range of licensed psychiatric units, residential treatment centers and spiritual retreat centers. Information about institutes which train people to work with spiritual emergency is also updated.

In this current edition I have attempted to simplify the definition of the spiritual emergence process so it can readily be identified as a natural part of human development. I have also significantly added to the definition of spiritual emergency by including more information on mystical states, possession, and UFO abduction (Chapter One). Chapter Five, "Ongoing Support" now includes a more thorough discussion of treatment modalities. I have not substantially changed the chapters which define when spiritual experiences happen (Chapter Two), Diagnosis (Chapter Three), Initial Interaction: Client and Helper (Chapter Four), the Role of the Helper (Chapter Six), or Case Study (Chapter Seven). Table Two, "Psychiatrists and Psychologists who Recognize Spiritual Emergency," in Chapter Three has been expanded. I have made some additions to "Global Trends Catalyzing Spiritual Emergence" (Chapter 8). I have dropped the chapter on suggestions for the future of the Spiritual Emergence Network as this organization is currently in the process of manifesting many of the ideas which were formulated in the 1980's. Appendices A and B still include "Identifying Community Resources," "Evaluating Your Knowledge of Spiritual Emergency/ Emergence" in order to help you or your group identify your particular skills and the resources of your community in attending someone in spiritual emergency. Appendix C, "Articles of Interest," now includes "Toward a More Culturally Sensitive DSM-IV: Psychoreligious and Psychospiritual Problems" by David Lukoff, Ph.D., Francis Lu, MD and Robert Turner, MD., published first in the November, 1992, issue of the Journal of Nervous and Mental Disease proposing the new diagnostic category to be included in the DSM-IV. I hope this inclusion will stimulate more discussion about training programs for psychiatrists, psychologists, and counselors.

Again, I have attempted to write this book in a language which is accessible to laypeople as well as professionals. In the past 6 years I have received many letters from laypeople in the USA and in Europe who have said that the Sourcebook helped save their lives. I want to continue to reach out to help those people who are looking for a conceptual framework to understand their spiritual crisis and a path to appropriate help, as well as address the health care providers who are trying to work effectively with this realm of human experience. There is still a scarcity of written material on the subject and I recognize that this book attends to the needs of a wide audience.

However, this manual is not a substitute for professional help and I advise anyone in crisis to seek appropriate counsel. If you need a referral in your area, a supportive friend who has had a spiritual emergency and/or a professional who can give you guidance, please call the Center for Psychological and Spiritual Health, (415) 575-6299. This international referral service can give you names and telephone numbers of people who may be able to address your needs relating to spiritual emergence phenomena. This network has several satellite offices throughout the world that offer support services as well as referrals. You can search the WWW for "SEN", and find independent offices in many areas.

Finally, it is my pleasure and honor to transmit the following information to those interested in spiritual emergence and spiritual emergency. I applaud the leaders in the field of Spiritual Emergency who attended the SEN conferences in 1985 (listed in Appendix D). Their pioneering contributions formed the initial seed of this sourcebook. I also applaud the people who have taken professional and personal risks to explore and become skillful in helping others in spiritual emergency when this field is only beginning to have credibility in conventional psychology. I am personally grateful for the opportunity to contribute to the expansion of knowledge about facilitating spiritual growth and providing safety and guidance for those in the process of personal transformation. The people who are called to integrate the brilliance which is our human potential are those who can lead us to a brilliant future. My writing and teaching is my contribution to personal, interpersonal and world peace. May it serve as a stepping stone to help all beings realize the wisdom and compassion which unites us all so we can live cooperatively in harmony. It is time.

Emma Bragdon, Ph.D.

Winter, 1993

A Sourcebook for Helping People With Spiritual Problems

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