Abstract
Many aspects of spiritual experience are similar in form and content to symptoms of psychosis. Both spiritually advanced people and patients suffering from psychopathology experience alterations in their sense of ‘self.’ Psychotic experiences originate from derangement of the personality, whereas spiritual experiences involve systematic thinning out of the selfish ego, allowing individual consciousness to merge into universal consciousness. Documented instances and case studies suggest possible confusion between the spiritually advanced and schizophrenia patients. Clinical practice contains no clear guidelines on how to distinguish them. Here we use a case presentation to help tabulate clinically useful points distinguishing spiritually advanced persons from schizophrenia patients. A 34-year-old unmarried male reported to our clinic with four main complaints: lack of sense of self since childhood; repeated thoughts questioning whether he existed or not; social withdrawal; and inability to continue in any occupation. Qualitative case analysis and discussions using descriptions from ancient texts and modern psychology led to the diagnosis of schizophrenia rather than spiritual advancement.
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References
Aguilera, A., López, S. R., Breitborde, N. J., Kopelowicz, A., & Zarate, R. (2010). Expressed emotion and sociocultural moderation in the course of schizophrenia. Journal of Abnormal Psychology, 119(4), 875.
Akroyd, M. J. (2013). You can’t spell schizophrenia without an ‘I’: How does the early intervention in psychosis approach relate to the concept of schizophrenia as an ipseity disturbance? Early Intervention in Psychiatry, 7(3), 238–246.
Baker, H. S., & Baker, M. N. (1987). Heinz Kohut’s self psychology: An overview. American Journal of Psychiatry, 144(1), 1–9.
Ballentine, R., & Ajaya, S. (1976). Yoga and psychotherapy: The evolution of consciousness. Honesdale: Himalayan Institute Press.
Basu, S. (1995). How the spiritual dimension of health was acknowledged by the world health assembly—A report. New Approaches Medicinal Health, 3, 47–51.
Boulanger, M., Dethier, M., Gendre, F., & Blairy, S. (2013). Identity in schizophrenia: A study of trait self-knowledge. Psychiatry Research, 209(3), 367–374.
Bronfenbrenner, U. (1979). The ecology of human development, experiments by nature and design. Cambridge: Harvard University Press.
de Vries, R., Heering, H. D., Postmes, L., Goedhart, S., Sno, H. N., & de Haan, L. (2013). Self-disturbance in schizophrenia: A phenomenological approach to better understand our patients. The Primary Care Companion for CNS Disorders. doi:10.4088/PCC.12m01382.
Deshmukh, V. D. (2008). The multistream self: Biophysical, mental, social, and existential. The Scientific World Journal, 8, 331–341.
Egan, H. D. (1998). Christian mysticism: The future of a tradition. Eugene: Wipf and Stock Publishers.
Grof, C., & Grof, S. (1986). Spiritual emergency: The understanding and treatment of transpersonal crises. Revision, 8(2), 7–20.
Grof, S., & Grof, C. (1989). Spiritual emergency: When personal transformation becomes a crisis. Los Angeles: Tarcher press.
Hansen, G. (1995). Schizophrenia or spiritual crisis? On” raising the kundalini” and its diagnostic classification. Ugeskrift for Laeger, 157(31), 4360–4362.
Hecht, D. (2010). Schizophrenia, the sense of ‘self’ and the right cerebral hemisphere. Medical Hypotheses, 74(1), 186–188.
Heinisch, C., Wiens, S., Gründl, M., Juckel, G., & Brüne, M. (2013). Self-face recognition in schizophrenia is related to insight. European Archives of Psychiatry and Clinical Neuroscience, 263(8), 655–662.
Kleinhaus, K., Harlap, S., Perrin, M. C., Manor, O., Weiser, M., Harkavy-Friedman, J. M., & Malaspina, D. (2012). Catatonic schizophrenia: A cohort prospective study. Schizophrenia Bulletin, 38(2), 331–337.
Kohut, H., & Wolf, E. S. (1978). The disorders of the self and their treatment: An outline. International Journal of Psychoanalysis, 59, 413–425.
Lam, D., Wright, K. I. M., & Sham, P. A. K. (2005). Sense of hyper-positive self and response to cognitive therapy in bipolar disorder. Psychological Medicine, 35(01), 69–77.
Lodge, D. J., & Grace, A. A. (2011). Developmental pathology, dopamine, stress and schizophrenia. International Journal of Developmental Neuroscience, 29(3), 207–213.
Lukoff, D. (2005). Spiritual and transpersonal approaches to psychotic disorders. In S. G. Mijares & G. S. Khalsa (Eds.), The psychospiritual clinician’s handbook: Alternative methods for understanding and treating mental disorders (pp. 233–257). New York: Haworth Reference Press.
Madhavananda, S. (2009). The Brhadaranyaka Upanishad. Kolkata: Advaita Ashrama Publication Department.
Muktibodhananda, S. (1998). Hatha yoga pradipika. Munger, Bihar: Yoga Publication Trust.
Nelson, B., Thompson, A., & Yung, A. R. (2012). Basic self-disturbance predicts psychosis onset in the ultra high risk for psychosis “prodromal” population. Schizophrenia Bulletin, 38(6), 1277–1287.
Nelson, B., Thompson, A., & Yung, A. R. (2013). Not all first-episode psychosis is the same: Preliminary evidence of greater basic self-disturbance in schizophrenia spectrum cases. Early Intervention in Psychiatry, 7(2), 200–204.
Nicholson, A. R. (2007). The mystics of Islam. California: Murine Press.
Nikhilananda, S. (1980). The Gospel of Sri Ramakrishna. Chennai: Sri Ramakrishna Math Publication.
Oxman, T. E., Rosenberg, S. D., Schnurr, P. P., Tucker, G. J., & Gala, G. (1988). The language of altered states. The Journal of Nervous and Mental Disease, 176, 401–408.
Pierre, J. M. (2001). Faith or delusion? At the crossroads of religion and psychosis. Journal of Psychiatric Practice, 7(3), 163–172.
Raballo, A. (2012). Self-disorders and the experiential core of schizophrenia spectrum vulnerability. Psychiatria Danubina, 24(3), 303–310.
Rama, S. (1999). Living with the Himalayan masters. Honesdale: Himalayan Institute Press.
Rowland, J. E., Hamilton, M. K., Vella, N., Lino, B. J., Mitchell, P. B., & Green, M. J. (2012). Adaptive associations between social cognition and emotion regulation are absent in schizophrenia and bipolar disorder. Frontiers in Psychology. doi:10.3389/fpsyg.2012.00607.
Salvatore, G., Lysaker, P. H., Gumley, A., Popolo, R., Mari, J., & Dimaggio, G. (2012). Out of illness experience: Metacognition-oriented therapy for promoting self-awareness in individuals with psychosis. American Journal of Psychotherapy, 66(1), 85–106.
Sanella, L. (1978). Kundalini: Psychosis or transcendence. San Francisco: H. R. Dakin.
Saraswati, S. S. (2002). Four chapters on freedom: Commentary on the yoga sutras of Patanjali. Munger: Yoga Publications Trust.
Shad, M. U., Keshavan, M. S., Steinberg, J. L., Mihalakos, P., Thomas, B. P., Motes, M. A., et al. (2012). Neurobiology of self-awareness in schizophrenia: An fMRI study. Schizophrenia Research, 138(2), 113–119.
Sharma, P., Charak, R., & Sharma, V. (2009). Contemporary perspectives on spirituality and mental health. Indian Journal of Psychological Medicine, 31(1), 16.
Strober, M. (1991). Disorders of the self in anorexia nervosa: An organismic-developmental paradigm. New York City: Guilford Press.
Tandon, R., Keshavan, M. S., & Nasrallah, H. A. (2008). Schizophrenia, “just the facts” what we know in 2008. 2. Epidemiology and etiology. Schizophrenia Research, 102(1), 1–18.
Tapasyananda, S. (2005). Srimad Bhagavad Gita: The scripture of mankind. Chennai: Sri Ramakrishna Math Publication.
Turner, R. P., Lukoff, D., Barnhouse, R. T., & Lu, F. G. (1995). A culturally sensitive diagnostic category in the DSM-IV. The Journal of Nervous and Mental Disease, 183(7), 435–444.
Van, O. J., & Kapur, S. (2009). Schizophrenia. Lancet, 374(9690), 635–645.
Vander, G. R. (2007). Dictionary of psychology. Washington DC: American Psychological Association.
Vimuktananda, S. (1938). Aparokshanubhuti or self-realization of Sri Shankaracharya. Holistic health and medicine (8th ed.). Calcutta: Advaita Ashram.
Vitaliano, P. P., & Katon, W. J. (2006). Effects of stress on family caregivers: Recognition and management. Psychiatric Times, 13(7), 24–28.
Wilber, K. (1980). The atman project. Wheaton, IL: Theosophical Pub. House.
Yogananda, P. (2009). Autobiography of a Yogi. Kolkata: Yogoda Satsang Matha.
Zhao, Y., Zhang, D., Tan, S., Song, C., Cui, J., Fan, F., et al. (2014). Neural correlates of the abolished self-referential memory effect in schizophrenia. Psychological Medicine, 44(03), 477–487.
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Bhargav, H., Jagannathan, A., Raghuram, N. et al. Schizophrenia Patient or Spiritually Advanced Personality? A Qualitative Case Analysis. J Relig Health 54, 1901–1918 (2015). https://doi.org/10.1007/s10943-014-9994-0
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DOI: https://doi.org/10.1007/s10943-014-9994-0