The definitions of mystical experience used by researchers and clinicians vary considerably, ranging from Neumann's (1964) "upheaval of the total personality" to Greeley's (1974) "spiritual force that seems to lift you out of yourself" to Scharfstein's (1973) "everyday mysticism." A definition of mystical experience both congruent with the major theoretical literature and clinically applicable is as follows: the mystical experience is a transient, extraordinary experience marked by feelings of unity, harmonious relationship to the divine and everything in existence, as well as euphoria, sense of noesis (access to the hidden spiritual dimension), loss of ego functioning, alterations in time and space perception, and the sense of lacking control over the event (Allman, De La Roche, Elkins & Weathers, 1992; Hood, 1974; Lukoff & Lu, 1988).
Numerous surveys assessing the incidence of mystical experience (Allman et al., 1992; Back & Bourque, 1970; Gallup, 1987; Hood, 1974; Spilka, Hood & Gorsuch, 1985; Thomas & Cooper, 1980) indicate that 30-40% of the population have had mystical experiences, suggesting that they are normal rather than pathological phenomena. While mystical experiences are associated with lower scores on psychopathology scales and higher psychological well-being than controls (Greeley, 1974), case studies document instances where mystical experiences are disruptive and distressing. This is one type of spiritual problem that psychologists see regularly. In a survey, psychologists reported that 4.5% of their clients over the past 12 months brought a mystical experience into therapy (Allman et al., 1992) . In the first case below, the mystical experience led to a spiritual problem, but not a spiritual emergency.
A woman in her early thirties sought out therapy to deal with unresolved parental struggles and guilt over a younger brother's psychosis. Approximately two years into her therapy, she underwent a typical mystical experience, including a state of ecstasy, a sense of union with the universe, a heightened awareness transcending space and time, and a greater sense of meaning and purpose to her life. For ten days, she remained in an ecstatic state. She felt that everything in her life had led up to this momentous experience and that all her knowledge had become reorganized during its course. Due to the rapid alteration in her mood and her unusual ideation, her therapist considered diagnoses of mania, schizophrenia, and hysteria. But he rejected these because many aspects of her functioning were either unchanged or improved, and overall her experience seemed to be "more integrating than disintegrating...While a psychiatric diagnosis cannot be dismissed, her experience was certainly akin to those described by great religious mystics who have found a new life through them" (p. 806).
This experience increasingly became the focus of her continued treatment, as she worked to integrate the insights and attitudinal changes that followed. The therapist reported that the most important gain from it was a conviction that she was a worthwhile person with worthwhile ideas, not the intrinsically evil person, 'rotten to the core', that her mother had convinced her she was. Her subsequent treatment focused on expanding the insights she had gained and on helping her to integrate the mystical experience. (adapted from Group for the Advancement of Psychiatry, 1976)
The second case (Lukoff & Everest, 1985) fits the spiritual emergency model in that the mystical experience led to a crisis, which resulted in hospitalization and medication that probably were not necessary.
At age 19, after returning home from hitchhiking in Mexico, Howard became convinced that he was on a "Mental Odyssey." To his family and friends, he began speaking in a highly metaphorical language. For example, after returning from a simple afternoon hike up a mountain, he announced to his parents that "I have been through the bowels of Hell, climbed up and out, and wandered full circles in the wilderness. I have ascended through the Portals of Heaven where I established my rebirth in the earth itself, and now have taken my rightful place in the Kingdom of Heaven." To one friend, he stated: "I am the albatross; you are the dove." The unusual actions and content of his speech led his family to commit him to a psychiatric ward where he was diagnosed with acute schizophrenia.
Once admitted to the hospital, Howard asked to see a Jungian therapist, but this request was ignored and he was given thorazine. While in the hospital, he continued his self-proclaimed odyssey by drawing elaborate "keys" that were mandalas stocked with many well-known symbols and cultural motifs, including the Islamic crescent and star, the yin yang symbol, the infinity sign, and pierced hands, eyes, and circles. In the hospital, he also conducted elaborate self-designed "power" rituals and rituals to the four directions, despite being on high doses of medication.
After two months in the psychiatric hospital, his psychiatrist wanted to transfer him to a long-term facility for further treatment, but he refused to go and was discharged. He left feeling totally exhausted, physically and emotionally, but he continued exploring the mythological, philosophical and artistic parallels to his "Mental Odyssey." He read works by Joseph Campbell and C. G. Jung and joined a "New Age" religious group where he encountered many similar motifs.
In the subsequent 24 years, he has not been hospitalized or on medication, has held positions as an operator of high tech video editing equipment, and completed a college degree. When interviewed 11 years after the episode for a case study, he maintained that, "I have gained much from this experience. I am sorry for the worry and hurt that it may have caused my family and friends. These wounds have been slow to heal. I am deeply grateful for the great victory of my odyssey. From a state of existential nausea, my soul now knows itself as part of the cosmos. Each year brings an ever increasing sense of contentment." (adapted from Lukoff and Everest, 1985, pp. 127-143)
The mystical nature of his experience is evidenced by his euphoria, intense sense of noesis, and feeling of direct connection to transcendent forces. He also had the several of the prognostic signs indicating that a positive outcome would be likely: acute onset, good pre-episode functioning, and exploratory attitude (Lukoff, 1985). Thus he serves as an example of how a spiritual emergency client, who in all likelihood could have been treated on outpatient basis without medication, was unnecessarily and inappropriately hospitalized.