Profitably Pathologizing Spiritual Experiences

A few days ago a scientific paper was published entitled “Psychotic Experiences in the General Population.” The authors used surveys of 32,161 respondents in which they were asked questions such as the questions below (my sources for these questions are here and here).

The first thing is seeing a vision – that is, seeing something that other people who were there could not see. Did you ever see a vision that other people could not see?

The second thing is hearing voices that other people could not hear. I don't mean having good hearing, but rather hearing things that other people said did not exist, like strange voices coming from inside your head talking to you or about you, or voices coming out of the air when there was no one around. Did you ever hear voices in this way?

The authors used positive answers to questions like these, and classified them all as “psychotic experiences.”  Although I have never had an experience of hearing a mysterious voice or seeing a vision, I regard such an approach as ludicrous. 

The approach is unwise because a significant fraction of people who have such experiences are probably not mentally sick in any way. Some of these experiences may be called paranormal experiences. Others may be called spiritual experiences. Others may be telepathic experiences. But according to the misguided approach of these authors, all such people are simply psychotics.

So imagine you, like countless other normal people in human history, happen to report seeing a ghost. According to these authors, you're simply a psychotic.

Or suppose you are tempted to do some very wicked thing, and when you are just about to do it, you suddenly hear a mysterious deep commanding voice saying: repent and follow the righteous path. According to these authors, you're simply a psycho.

Or imagine you see something strange in the sky, something that looks like a UFO, and you point it out to your friend, but before he can look at it, it's gone. According to these authors, you're simply a psycho.

Or imagine you leave your child in the bath to answer the phone, and then suddenly hear a voice from nowhere saying: go check your child right now! You check, and find your child had almost drowned. According to these authors, you're simply a psycho.

Or imagine you engage in mysticism, prayer or meditation, and after much practice you find yourself seeming to reach beyond your normal everyday reality and contact some numinous transcendent external intelligence who seems to say to you: yes, yes, I am here. According to these authors, you're simply a psycho.

"The Ecstasy of St. Theresa" by Gian Lorenzo Bernini

Or imagine you (like many other people) have some near-death experience in which you have a vision of some “being of light” or some vision of a deceased relative. According to these authors, you're simply a psycho.

There are a variety of different hypothetical reasons why a person might see something that other people don't see or hear something other people don't hear, including the following.

1. They might be hearing a voice from God.
2. They might be hearing a voice from some angel.
3. They might be hearing a voice from some deceased spirit.
4. They might be seeing some ghost or some vision of an angel or departed spirit.
5. They might be hearing some voice that originates from some other living human, through something like ESP or telepathy.
6. They might seem to hear some voice coming from some aspect of their own consciousness. Their own conscience might “send a message” in a way that resembles a voice.
7. They might be having some rare spiritual or psychic experience that awakens some rarely-waked part or functionality in their own mind.
8. They might be seeing something or hearing something because of a long-term mental disease.

Given all these possibilities, it makes no sense to classify any positive answer to the questions listed above as examples of “psychotic experiences,” as the authors of this paper have done. Indeed, the data they report conflicts with their assumption that most of the reported experiences really are psychotic experiences. This is because their study states the following (using PE to mean “psychotic experience”):

 Psychotic experiences were typically infrequent, with 32.2% of the respondents with lifetime PEs reporting only 1 episode... An additional 31.8% of respondents with lifetime PEs experienced only 2 to 5 PE episodes. Thus, for nearly two-thirds of respondents (64.0%) with lifetime PEs, these experiences occurred only 1 to 5 times in their lives.
 
 So a large fraction (32%) of those who reported hearing an unexplained voice or seeing some “vision” experienced such a thing only once in their life. That's not what happens when you have a real psychosis such as schizophrenia, which involves having hallucinations again and again. There is no known type of brain-disorder psychosis that causes a once-in-a-lifetime hallucination.

The paranormal literature contains countless examples of perfectly normal people who have one-shot experiences of hearing voices, often offering one-time messages of comfort or warning. There are many cases like one I recently read in a book by John Geiger. A boy found himself on the 16^th floor of a burning hotel, with his exit blocked. Suddenly he heard a voice telling him to stick his head out the window and look down. He did that, and saw that 2 floors down was a balcony he could jump to. There are also countless accounts of people who heard a voice or saw a vision of a deceased relative. Such experiences are the proper business of organizations like the Society for Psychical Research, not the American Psychiatric Association.

What we have in this study is an example of pathologizing the spiritual and pathologizing the paranormal. Things paranormal, inexplicable or deeply spiritual are treated as if they were a symptom of a psychiatric disorder. It's another blunder in a field that has been marred by many serious blunders (although it has no doubt done lots of good work).

For decades psychiatry was overshadowed by the dubious theories of Sigmund Freud. Countless patients shelled out fortunes to psychiatrists who engaged with them in long psychoanalysis treatments that might drag on for years. Such treatments were based on very shaky theories of repression and the subconscious. Later many psychiatrists got all enthusiatic about lobotomies as a treatment. Many patients had important parts of their brains severed in the belief that this would improve their well-being. For most of the 20^th century, psychiatric handbooks listed homosexuality as a mental disorder. Nowadays psychiatry seems to be doing better, although it still seems way too entangled with the pharmaceutical industry, as discussed here.

Why would psychiatrists want to list a wide variety of spiritual or paranormal experiences as “psychotic experiences”? Well, for one thing, such a confusion is highly profitable. The more human experiences are classified as psychotic, the more business for psychiatrists.

Rather than "jumping the gun" by using presumptuous and judgmental terms such as "hallucinations" and "psychotic experiences" to describe anomalous experiences, it would be better for psychiatrists to use neutral, objective terms such as "anomalous auditory experiences" or "anomalous visual experiences"  (except in the case of something that seems utterly preposterous and outside of any known belief system,  like a person reporting that his dog is talking to him).