The DSM-IV definition notes that spiritual problems may be related to questioning of spiritual values. In the clinical literature, many cases which involve a questioning of spiritual values are triggered by an experience of loss of a sense of spiritual connection. Barra, Carlson and Maize (1993) conducted a survey study and also reviewed the anthropological, historical, and contemporary perspectives on loss as a grief-engendering phenomenon. They found that loss of religious or spiritual connectedness,
whether in relation to traditional religious affiliation or to a more personal search for spiritual identity, frequently resulted in individuals experiencing many of the feelings associated with more "normal" loss situations. Thus, feelings of anger and resentment, emptiness and despair, sadness and isolation, and even relief could be seen in individuals struggling with the loss of previously comforting religious [or spiritual] tenets and community identification. (p. 292)
Loss of faith is mentioned in the DSM-IV definition as a religious problem, but as Barra et al. (1993) note, the same sequalae can result from the loss of spiritual connection.
One case which involved questioning of spiritual values was described by Emma Bragdon (1994).
In 1971, Emma's mother, then 56 was living alone in a small town Vermont, and working as a visiting nurse. She was a Zen Buddhist practicing meditation 6-8 hours daily. Her friends noticed that she was spending more time alone and was becoming increasingly emotionally labile. They contacted Emma, but she did not sense a problem since she was having cheerful talks on the telephone with her mother about plans for her mother to visit during the birth of Emma's first child. However, before this happened, Emma's mother went into the woods alone, reading a passage from Zen Mind, Beginner's Min d where Suzuki Roshi compares enlightenment to physical death. When found dead, her finger was pointing to this passage. She had cut her wrists and throat.
In addition to the bereavement over her mother's suicide, this loss also triggered a spiritual problem for Emma who was herself a practicing Zen Buddhist. How could her spiritual path lead to her mother's suicide? Emma contacted Suzuki Roshi, who flew with her to Vermont where he conducted a traditional Buddhist funeral ceremony. During this time, Emma had a number of powerful spiritual experiences, including feeling herself engulfed in white light accompanied by ecstatic release. She sensed that her mother was fine, and that her passing had been a happy occasion for her. But afterwards, when back in California, she began to have doubts. How did she really know her mother was OK? As she became preoccupied with questioning the validity of her spiritual experiences and tenets, she also wondered if she was crazy. When it was 10 days past her due date, she went into her garden to pray, and made a commitment to stop questioning her spiritual beliefs until 2 months after giving birth. One hour later, she reports she went into labor. (adapted from pp. 171-177)
During this period, Emma was in turmoil as she questioned her spiritual beliefs and path. The guidance of a spiritual teacher, Suzuki Roshi, and spiritual practices, such as praying, played an important role in helping her to resolve these conflicts.