Dialogs at the Edge of Reason: Addressing Spiritual Issues Within Treatment for Psychosis

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Length: 57 minutes

Ron Unger, LCSW

Mental health professionals are trained to empathize with clients, and to use the client’s own language and metaphors where possible.  Yet these same professionals most frequently base their explanations on reason and on empirical knowledge of bio-psycho-social factors, while those diagnosed with psychosis often speak in ways that defy reason and empirical knowledge, and use spiritual concepts or metaphors instead.  Professionals are likely to view such spiritual talk as ”hyper-religiosity” or simply as part of the disorder, or at best as something they lack the expertise to discuss.  These differences create a barrier to an effective therapeutic relationship. 

There are ways, though, to overcome this divide.  Professionals can learn to humbly recognize the limits of their own reason and knowledge, and the potential validity, in some sense, of even odd spiritual perspectives.  At the same time, they can learn how spiritual language and metaphor can be seen as another way of discussing complex dynamic processes and emergent phenomena related to trauma, attachment, and identity, so that even atheistic professionals can perceive spiritual discussions as related to the core issues of psychosis.  Then, professionals can gently and non-dogmatically deepen spiritual dialogs by using methods similar to Jung’s “archetypal amplification,” helping clients identify possibly useful alternative spiritual perspectives while also preserving self esteem and positive aspects of otherworldly experiences.

When recovery does occur, people often report that spirituality played a key role.  By becoming willing and skillful participants in discussing spirituality within psychosis, professionals can make recovery from psychosis more likely.

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