SPIRITUAL SYMPTOMS : Does religion make you crazy?

the shades of Robert Lowell, Sylvia Plath, James Taylor, and Girl Interrupted hovered around the auditorium of McLean, the famed psychiatric hospital outside Boston--haven of celebrated patients. But I had been invited to speak to the staff association about spirituality--still a taboo subject in certain psychiatric circles. While nearly 90 percent of Americans report a belief in God, only 40 percent of psychologists do. A client might easily feel more free to mention intimate sexual matters than prayers or mystical experiences. In a secular milieu, religion can be the original "don't ask, don't tell" topic.

As both a defender of faith and a devout believer in psychology, I tried to provide my audience with a DSM I, or Diagnoses of Spiritual Movements. Recently, DSM IV, or the Diagnostic and Statistical Manual of mental disorders, the bible of the mental-health establishment, has been amended to include an entry for nonpathological symptoms of "religious crises" or "spiritual emergencies." Under this rubric, folks like Francis of Assisi, Ignatius Loyola, or Teresa of Avila might be able to escape hospitalization despite their strange mystical experiences.

But how can you tell pathological psychotic episodes from positive spiritual experiences? Today, differential diagnosis, or in religious language, discernment of spirits, will follow the traditional gospel criteria: By their fruits you shall know them. As William James pointed out long ago, if Saint Teresa had extremely abnormal mental states, no matter. Her visions, ecstasies, and levitations coexisted with whirlwind efficiency, lively charm, and astute charitable work.

If, however, mystical effusions produce grandiosity, arrogant hostility, and an inability to work or get along with people, watch out. Joan of Arc heard voices but she was a fount of common sense and courageous leadership. I keep her words on my desk: "Today rather than tomorrow, tomorrow rather than the next day--the Holy Spirit has no love for the lazy."

But in a discussion of spirituality you don't have to start at the top, with the Holy Spirit, identified as one divine person of the triune God. Better to begin with a bottom-up analysis of the slippery word "spirit." The human spirit with a small s can refer to personal consciousness and moments of awareness which are heightened by an investment of emotion and aesthetic response. A "secular spirituality" can consist of ad hoc heightened responses to the world, without any recognition of a transcendent reality beyond the powers of the human organism. Secular spiritualities can emerge in art, music, nature, exercise, sex, diet, crystal gazing, dreams, creative work, martial arts, or fly-fishing. Many practices that give pleasure and heightened cognitive awareness are meaningful to persons without being attributed to divine reality.

When people tell you, "I'm spiritual but not religious," they can be referring to their meaningful moments of secular spirituality. Or they may be referring to forms of "stripped-down spirituality," which go beyond the natural and seek transcendent meaning. Here the spiritual person tries to get in touch with, or become attuned to, some larger reality of Spirit, with a capital S--a Great Spirit, World Spirit, or Higher Power. Persons pursue the Spirit through meditation, prayer, worship, vision quests, or a disciplined practice. "Peak experiences," or epiphanies, can ensue and induce a belief in a benevolent ordered reality. When the Good is identified with the Spirit, then a demand for right action becomes necessary. Seekers must embrace the ethical requirements of truth and compassion, whether in an eightfold way or a twelve-step program. The numinous and the ethical become fused. Many eclectic forms of stripped-down spirituality exist in America and attract seekers who have an allergy to doctrine and religious institutions.

By contrast there is nothing stripped-down about the high traditional monotheistic religions in which the Spirit is a personal, transcendent wholly Other, Holy One. The children of Abraham--following Judaism, Christianity, and Islam, as peoples of the book--worship a God who is a self-revealing creator and who exists as both transcendent and immanent. Traditional worldwide high religions have prophets and scriptures, and they give birth to historical communities of continuity and reforming sects. They provide well-winnowed guidance for the spiritual seeker.

In Christianity the Holy Spirit is worshiped as working in the world to inspire, heal, console, empower, and sanctify human hearts, the church community, and the whole of creation. I think a Christian could be justified in claiming that the aspirations of the human spirit in secular spiritualities and in stripped-down spiritualities are manifestations of the Holy Spirit. Once, however, you assert that the creation is not God but God's good work, doctrines of pantheism will not apply. With the Christian doctrine of Incarnation firmly in place, embodied humans keep their unique identities for eternity. The resurrection of the body ensures that devotees do not melt away into some form of Nirvana.

Once a seeker gets caught up in a "nonstripped-down" "nonsecular" spirituality of a traditional high religion, the way to holiness requires blood, sweat, and tears. The arduous path of discipline leads away from egotism, illusion, and self-deception--as well as toward joyful celebration, thank God.

More to the point, a full-strength, high-test spirituality propels a seeker toward sanity and wisdom. You may not end up wealthy or healthy, or die safely in bed, but the Holy Spirit does not lead to mental pathology. Therapists should not be afraid or censor explorations of spirituality. Why not take a spiritual history on intake? Spiritual autobiographies are enlightening, especially for atheists and agnostics.

For years, McLean Hospital's chapel has gone unused, with no chaplain or pastoral counseling program any longer in place. That's a shame, for both the staff and the patients.