It’s been a while since I updated the Betwixt series. For those of you who are new to it, on selected Thursdays I shed light on lesser discussed aspects of the modern shamanic path, and in the vein of disclosure, hope to frame this path in a more realistic and accessible perspective. It’s one thing to be betwixt. Living it is an entirely other and more intentional choice.

I receive many inquiries from readers who experience spiritual crisis through psychotic episodes. I’ve touched on psychosis before in the Betwixt Series, but only from a general standpoint. I encounter so many romanticizations of mental illness regarding it being misdiagnosed intuitive brilliance that I want to be more specific about what’s going on in such circumstances.

I’m not a doctor, so everything I say is purely from an end user and spiritual caregiver perspective. And yes, I speak in generalities. I can only confirm my own experience with spiritual crisis and and psychosis, and have only witnessed that of others who are clients, mentors, or fellow seekers. I hope that by talking about these experiences in a wider context, how we see ourselves can expand, as well, and we can look to a new array of tools for self-support.

What’s the difference between spiritual emergence and psychosis? According to Dictionary.com, psychosis is defined as “a mental disorder characterized by symptoms, such as delusions or hallucinations, that indicate impaired contact with reality.” That sounds a lot like ecstatic experience, right? Sort of? No.

When I say “psychotic” I don’t mean ‘a little depressed,’ or ‘escapist’ in imagination. I’m talking schizophrenia, bipolar episodes. This diagnosis comes for someone who is experiencing a break from their norm so intense and disruptive that they cannot function in every day life the same.

Again, I have people say to that, “Isn’t that what fire in the head is? A state of awe so profound that one can’t return to regular life the same.” Yes, absolutely, yes. However, someone who is experiencing a psychotic disorder, in-and-of-self, can’t employ therapeutic tactics to bring this state under control. It often travels with debilitating depression or mania so exaggerated that basic tasks like personal hygiene such as cleaning your face (see brushes for your beard) or social interaction aren’t possible, let alone meditation, navel gazing, or guide work.

Spiritual crisis or emergence, as coined by Stanislov Graf, is a state in which the ego collapses. The ego protects the body. It creates a mental structure of reality that functions as a barrier to force self and the projections that self believes to come first, above all others. When we reach a point that our ego can no longer project who we are, as in spiritual emergence, we’re faced with truths about ourselves that we may not like. This extreme discomfort causes temporary episodes of anxiety, depression, PTSD–any range of behavioral or mental challenges.

Spiritual emergence can look a lot like psychosis, and frankly, they can travel together. That combination can be challenging to hold, and even more difficult to defend to a resistant traditional medical professional. A person having a spiritual crisis may not be comfortable getting through the day, but s/he can. There is no prolonged impairment of basic underlying ability to care for self, meet needs of self or dependent others, perform job duties, etc. During spiritual crisis, one may not feel like doing these rudimentary tasks to an acutely miserable degree, though when push comes to shove, they can be accomplished.

When I teach or mentor shamanic studies, the main things I drive home about intuition, spiritual emergence, and mental illness are:

We are all intuitive, regardless of life experience, religious path, gender, orientation, mental state, ethnicity, nationality, right-brained, left-brained–whatever. We all are. It’s not a special club only the elite gain access to.

What we do with that intuition is the significant and delineating factor.

We’re all called to something, sooner or later. Sorry, that’s not special, either.

We can choose how we progress through our gifts as well as our challenges.

When we can’t choose, we don’t have control. When we don’t have control over our ability to initiate ecstatic trance, what happens during ecstatic trance, and to stop ecstatic trance, it it not a process we are co-creating, but a state that is happening to us. This is neither desirable, nor healthy. Without this control we don’t possess the important mental functions to determine how we progress on our paths. This is the point that mental illness must be treated before or in conjunction with spiritual emergence.

Regardless of all of the above, spiritual emergence prolonged becomes PTSD, which is a mental health condition.

Not only are there misconceptions in the overlap of spiritual crisis and psychosis, there is also an assumption that soul healing can fully accommodate or heal psychological conditions. Examined in a case-by-case light, I have observed that this can be true. What I’ve observed most, however, is that an approach involving spiritual and psychological support is most effective longterm. Spiritual healing is not a substitution for psychological care, and assuming that they are synonymous is dangerous.

In my shamanic work, I do not treat mental illness. I know plenty of wonderfully credentialed people who do, and I work closely with them to support clients who recognize spiritual emergence amidst volatile mental states. My approach to facilitating these clients is to work with them between crises, so that they gain the skills in ecstatic control and gain allies to help them ground.

I’d love to say that once those skills are gained, spiritual crisis or emergence stops. It doesn’t. Life doesn’t stop, and neither does challenges to our growth. Even when one chooses the role of shaman, those initiations don’t stop; the crises that come with them don’t, either.

So, yes, we are all intuitive. There’s no reason to discount that people having psychotic breaks aren’t also having deeply profound and meaningful spiritual experiences. When they can’t control those experiences or the impact they have on their lives (or the lives around them), multiple avenues of treatment–including traditional mental health and alternative approaches–are needed.

If you are experiencing a pyschotic episode along with spiritual emergence, seek the help of the mental health community and a spiritual caregiver. There is value in both, in helping you ground the spiritual insights coming from the experience, and in being able to accomplish the things you need and want to in daily life. It doesn’t have to be a one-or-the-other situation. A team of well-informed doctors, therapists, and spiritual support can work together to facilitate wellbeing at the other end of mental and spiritual distress.

In the interim of spiritual crisis, stay in contact with healthcare providers, and begin working with your spiritual caregiver to integrate the wisdom of your crisis. This can be done through guide work, retrieving spirit allies, and in learning to manage and control the ecstatic experience.

In the west, mental health is stigmatized enough. Let’s not do it further injustice by calling it less severe than it is, not recognizing it for what it is, and by merely naming it “spiritual” implying that should be cure enough. Just because tribal cultures may manage these crises in a more well-rounded way without big pharma doesn’t mean that our culture by virtue of the New Age can do that well, or that bridging conventional western medicine and spiritual healing makes a mental break less “officially spiritual.”

Likewise, let’s recognize spiritual emergence for what it is–a step into personhood that deserves every modality of care it needs–including mental health–to bloom in wisdom and power.