top of page

Spiritual Emergency

or Psychosis?


Janet discusses her spiritual emergence, spiritual emergency, misdiagnosis, hospitalization, and recovery.


Full Video

Did you know?

Religious or Spiritual Problem, (V62.89), was added as a diagnostic modifier into the DSM-IV (American Psychiatric Association, 1994). The proposal for this diagnostic category was specifically aimed to increase the competence and sensitivity of mental health professional to spiritual issues, based on:


  • The high prevalence of religious and spiritual problems reported by the public.

  • The lack of training of clinicians in religious or spiritual issues.

  • An ethical mandate for institutions to provide training in social and cultural factors that may affect assessment and treatment pertaining to these issues.

This diagnostic modifier continues in the DSM-V.

How to differentiate SE from Psychosis:


1) Rule out medical illness, including drug intoxication, that may impair psychological functioning (Lukoff, 2007).

2) Assess for no serious psychiatric history, including no: disorganization, incoherence, loosening of associations, hostile delusions of persecution, or acoustic hallucinations of enemies with very unpleasant content (Grof and Grof, 1990).

3)Look for an overlap of client's symptoms with previously stated categories of spiritual emergence.

Karrina Jpeg.jpg

Katrina Michelle, PhD, LCSW, Director of The American Center for the Integration of Spiritually Transformative Experiences (ACISTE), discusses assessing for insight, when differentiating Spiritual Emergency from Psychosis.

00:00 / 01:11

Differentiating Spiritual Emergency from Psychosis

SE vs DSM Chart Daria New.png

Copyright © 2019 Janice Miner Holden, EdD, LPC-S, NCC, ACMHP

Spiritual Emergency or Psychosis Flow Chart

SE FlowChart.png

Copyright © 2019 Janice Miner Holden, EdD, LPC-S, NCC, ACMHP

Note: If a stressful precipitant, containing religious or spiritual themes, only affects mood and conduct, a diagnosis of Adjustment Disorder is valid. Spiritual Emergencies may include distressing symptoms, such as hallucinations (visions) or delusions of a spiritual nature, which does not meet criteria for adjustment disorder, and warrants a Religious or Spiritual Problem diagnosis.

bottom of page