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Secure Attachment in Therapeutic Relationships for Spiritual Emergencies: A Participatory Approach

    This was initially written for my master’s in consciousness, and was edited for this post.


    There is a need for more dialogue around how therapeutic contexts respond to non-
    ordinary experiences (Rominger, 2013). Non-ordinary experiences tend to be pathologized by mainstream western psychology as psychosis. On the other hand, transpersonal psychology views non-ordinary experiences (even extreme forms like spiritual emergencies) as transformational movements toward individuation and wholeness (e.g., Hartelius, 2016; Rominger, 2013; Maslow, 1965; Whitmore, 2001). It is also significant to note here that non-ordinary experiences do not always become a spiritual emergency, but spiritual emergency does notably involve non-ordinary experiences. Transpersonal psychologists have written that, “such
    transcendental states seem to be the seeds of spiritual life”
    (Goleman, 1988, as cited in Viggiano & Krippner, 2009, p. 117).

    The main focus of this essay is on non-ordinary experiences, which are categorized as spiritual emergence and/or spiritual emergency. The term, ‘spiritual emergency,’ was likely developed by Christina Grof in the late 1970s, and involves:

    episodes of unusual experiences that involve changes in consciousness and in perceptual, emotional, cognitive, and psychosomatic functioning, in which there is a significant transpersonal emphasis in the process, such as dramatic death and (re)birth sequences, mythological and archetypal phenomena, past incarnation memories, out-of-body experiences, incidence of synchronicities or extrasensory perception, intense energetic phenomena (Kundalini awakening), states of mystical
    union, identification with cosmic consciousness. (Grof & Grof, 2017)

    The term ‘spiritual emergence’ is used to signify a similar process, though one that is
    manageable for the individual and thus not an emergency. From hereon, the terms spiritual emergence and spiritual emergency are collectively referred to as spiritual emergence/y.

    Non-ordinary experiences are normalized when they are labeled ‘spiritual emergence/y,’ and pathologized when they are labeled ‘psychosis.’ Similarities between the two bring confusion in clinical settings (Goretzki et al., 2009). Various have already written on differentiating psychosis and spiritual emergence/y (Grof & Grof, 2017; Bragdon, 1988, 1990; Nelson, 1990; Sanella, 1992) This essay seeks to explicate that due to confusion with diagnoses (especially for clients without a mental health record) (Goretzki et al., 2009), it may be more useful for therapists to meet clients where they are. This means that therapists are invited to trust
    clients’ internal capacity for healing and wholeness and bring curiosity to the client’s
    experiences. This essay provides a therapeutic protocol for spiritual emergence/y, where therapists are invited to safely and empathically support clients to integrate experiences. In addition to the aforementioned, this essay argues for the importance of attachment in therapeutic relationships dealing with spiritual emergence/y because healing happens in safe and supportive contexts.

    Personal Experience of Spiritual Emergence/y

    Through the research for this paper, I have (again) faced my own experiences of spiritual emergence and psychological rebirth. A brief overview serves to bracket my experience. A stay in a yogic ashram brought three months in an embodied state of bliss and unity, which drastically shifted my worldview from atheism to spiritual interconnectedness. This experience unfolded over the course of a year into an activation of the central archetype which led to drastic changes in my work, home, hobbies, and interpersonal relationships (Perry, 2021; Grof & Grof, 2017). At first, this transformation brought ease and joy, then it brought fear and loneliness as my
    worldview shifted. After various therapeutic work to integrate, I arrived at a transformed and embodied sense of an interconnected self that is devoted to systemic transformational movements toward loving, healing, and regenerative spaces.

    The process for this essay has brought about shocks to my narrative when my experience was accurately described as psychosis by Perry (2021). Although I have interacted with fear for being thought ‘crazy’ before, I was surprised to find my experience as a recurrent pattern for others as well. I thus find myself grappling with my own narrative.

    There is trust in the larger cosmos, a felt sense of safety, and life is imbued with meaning when I view my experience through the lens of spiritual emergence/y. However, looking at an experience as psychosis brings shame, fear, and distrust in self.

    I am still grappling with wha thas been newly unearthed, and am grateful to have systems to support this continuing process. Therefore, my interest in this topic is both academic and personal.

    Academic Discussion

    Mainstream western psychology has traditionally pathologized experiences in non-
    ordinary states such as spiritual emergence/y, which is evidenced by the American Psychiatric Association’s only recent update to include ‘religious or spiritual problems’ as a category in the diagnostic manual. Mainstream psychology, with psychologists steeped in Western scientific rationalism, struggles with non-ordinary experiences (Viggiano & Krippner, 2009). However, there are indicators of a turning tide like the call for a post-materialist psychology by Beauregard, Trent, and Schwartz (2018). Multiple meta-analyses of psi phenomena create “holes” in the materialist paradigm, which demonstrate that more research is needed into the
    possibilities of mind (ibid.).

    That which has been traditionally pathologized may be challenging the mainstream western paradigm.

    However, participatory thought, a theory within transpersonal psychology embracing pluralistic perspectives, is appropriate for looking at non-ordinary experiences. Participatory thought, formulated by Jorge Ferrer (2011), explicates that there is no penultimate spiritual truth, but rather that experiences are co-created in relationship.

    … there is no penultimate spiritual truth, … experiences are co-created in relationship.

    Glenn Hartelius (2016) writes: “participatory thought invites transpersonal psychology to […] an approach to knowledge that holds inclusiveness and diversity not only as preferable and socially moral, but as imperative and indispensable for effective knowledge creation” (p.iv). I highlight this to include values of inclusivity and diversity for non-ordinary experiences. In other words, the knowing that can emerge from non-ordinary states is co-created as “actually-existing relational events;” — i.e., what is known emerges relationally (Hartelius, 2016, p. vi). There is an invitation here for therapists to not force their belief constructs on their clients. Therapists can respect their client’s narratives, and “trust in the client’s fundamental ‘allrightness’” (Whitmore, 2001, p. 7). In this way, therapists create a supportive environment with trust for the client’s unique path (Grof, 2012).

    Ken Wilber’s (1997) integral theory is contradictory to Ferrer’s participatory approach. Wilber argues for a hierarchical progression of consciousness from a Vedanta non-dualistic perspective. He specifies that it is only appropriate for those who have experienced certain states of consciousness to comment on particular experiences (Wilber, 1997). While there is some credibility to this, I would argue that respect for the client’s experience and worldview is more relevant in the therapeutic process. Nonetheless, some clients may wish to work with therapists that have experienced spiritual emergence/y so as to sense ‘sameness’ which may undo their
    ‘aloneness’ (the importance of ‘sameness’ for the client in the therapeutic relationship is discussed in a case study looking at race by Simpson, 2016).

    Transpersonal psychology offers various developmental theories concerned with spiritual growth (Daniels, 2005). One of these theories lies in the work of transpersonal psychologist Roberto Assagioli (1888-1974) and psychosynthesis. Assagioli, a contemporary of Sigmund Freud, included aspects of the unconscious in his theory alongside higher human functions such as the superconscious and transpersonal self, considered spiritual insight as valuable, and rejected pathologism (Crampton, 1977).

    Psychosynthesis also places significance on integration of non-ordinary experiences for coming into greater individuation.

    Another is the spiritual emergence/y model described above by Grof and Grof (2017).
    The Grofs’ model of spiritual emergence/y has been described as “ahead of its time,” because these experiences are still being wrongly categorized as psychiatric conditions (Viggiano & Krippner, 2009, p. 113). Additionally, “while therapeutically relevant and forward thinking, [it] may still be too controversial to readily integrate into the Western medical/medicinal mode” (Viggiano & Krippner, 2009, p. 114). Personally, perhaps because I am a student of transpersonal psychology, I do not view the model as ‘too controversial’ though perhaps it was ‘ahead of its time.’ It is about time that psychology embraces a wider spectrum of human experience. Nonetheless, the model can be improved. For example, it can incorporate the work of
    Jenny Wade on transcendent experiences during sexual activity (2000). It can additionally include work on “creative flooding” as an effect concomitant with spiritual emergence/y (Meek, 2005, as cited in Viggiano & Krippner, 2009). In conclusion, the Grofs’ model is a structured approach to look at non-ordinary experiences as another stage in personal growth.

    The Grofs’ model of spiritual emergence/y is a structured approach to look at non-ordinary experiences as another stage in personal growth.

    (See Daniels, 2005 for an overview of different spiritual growth theories on experiences of crises.


    Spiritual emergencies may feel very alone for some, especially if they are being pathologized instead of being looked at as having positive transformational potential.

    What may be needed is to come to loving care, which is why some therapists entered the healing profession in the first place. Spiritual emergencies may feel very alone for some, especially if they are being pathologized instead of being looked at as having positive transformational potential. Psychotherapists Carl Gustav Jung (1875-1961) and Assagioli have both argued from their work with clients to trust that all humans have an innate desire to move toward wholeness. In this context, “psychosis—so often dismissed as useless—might then be seen as the brain’s attempt to heal itself” (Goretzki et al., 2009, p.91). So, if the psyche is trying to heal itself, what role does the therapist have in supporting this innate process of healing?

    The following are protocols for therapists to consider when dealing with spiritual

    • An initial medical check is paramount to rule out other imbalances in the client’s health (Leach, 2006).
    • The client is educated about transpersonal views on spiritual emergence/y and offered various transpersonal developmental maps to normalize experiences (Crowley, 2006; Rominger, 2013; Vaughan, 2002).
    • Therapists self-assess their level of competence to support possible spiritual emergencies and reach out to peers, supervisors, or spiritual teachers for assistance (Bray, 2008; Rominger, 2013; Vieten et al., 2013).
    • The therapist checks the client’s support systems (family, community, etc.) (Bray, 2008; Crowley, 2006).
    • The therapist discerns the client’s level of functioning and ability to be with the
    • experience. Goretzki et al. (2009) call these “protective factors.” These are: “what Jung would call a ‘strong ego-complex,’ and […] innate and learned resilience factors, which may or may not include a capacity to draw symbolic insights” (Goretzki et al., 2009, p. 91).
    • A retreat setting may be ideal for the client (Crowley, 2006).
    • Two pathways emerge for therapeutic intervention:
    1. Speeding up the transformative process: The client is encouraged to engage in transformative practices in addition to talk therapy like dance, art, music, dreamwork, bodywork, movement practices, psychodrama enactments, or keeping a journal (Crowley, 2006; Rominger, 2013; Grof & Grof, 2017).
    2. Slowing down the transformative process: The client is encouraged to halt spiritual practices, engage in grounding practices, eat heavy foods, do physical tasks like house chores to connect to the physical environment, go out in nature, or create rituals (Bragdon, 1988; Crowley, 2006; Grof & Grof, 2017).
    • The therapist supports the client to integrate experience(s) (Crowley, 2006; Rominger, 2013) and/or create a cohesive self-narrative for the experience(s) (Vaughan, 2002).

    These protocols aim to support therapists working with clients experiencing spiritual
    emergence/y. Some argue that, “both a medical and a spiritual emergency approach may be indicated in certain cases” (Viggiano & Krippner, 2009, p. 119) with patient informed consent (Crowley, 2006). Grof and Grof (2017) argue that medicalization approaches are harmful because they halt the spiritual emergency process, instead of supporting integration and individuation. Perry (2021) agrees with this, and his work at Diabasis in California based on a medication-free model proved to be supportive for individuals with a psychosis diagnosis (though perhaps a spiritual emergency diagnosis would have been more appropriate). Medicalization may bring shame for some clients and make healing more complicated. For example, I believe that it would have been even more difficult to integrate my experiences if I
    had been given medication because of the additional layers of shame. However, some clients may wish to be medicated, if their experience is harmful or for other reasons. Although more research is needed on the benefit of medicalization for spiritual emergence/y, I tend to agree with Cornwall (2019), Grof and Grof (2017), Perry (2021) that a medication-free environment is more supportive. However, therapists must take these as suggestions and co-create a healing process with their client, trusting in the client’s innate drive toward healing in a spiritual emergence/y (Grof & Grof, 2017).

    Therapists must take these as suggestions and co-create a healing process with their client, trusting in the client’s innate drive toward healing in a spiritual emergence/y.

    Looking at the Client in Relationship

    Protocols can be helpful, but it is imperative therapists create non-judgemental
    relationships with clients
    . Various therapies argue healing happens in relationship, especially humanistic psychologists à la Carl Rogers (1902-1987) (Watson, Greenberg, & Lietaer, 1998). Therapists become conduits for creating safe spaces where clients can foster their innate healing capacity. Let us, therapists, move toward “merciful love” and away from the “clinical gaze,” which therapist Michael Cornwall (2019) so beautifully writes about from his experience of spiritual emergency. So, there is a need for bringing attachment theory into therapeutic contexts with spiritual emergence/y. The days of the judgemental ‘clinical gaze’ can be over in services of
    modelling secure attachment in therapeutic relationships (Prenn, 2011). This is imperative in spiritual emergence/y cases because the client needs to feel safe in the therapeutic relationship to transform from and integrate phenomena (Siegel, 2001).

    In other words, secure attachment is necessary for the process of integration.

    The therapeutic intervention of Accelerated Experiential-Dynamic Psychotherapy
    (AEDP) by Diana Fosha brings attachment theory into therapeutic relationships. In AEDP, the therapist is invited to self-disclose, be visibly empathetic, and support the client to undo aloneness with a positive perspective on the individual’s capacity to heal (Prenn, 2011). The relationship between client and therapist is paramount in AEDP (Fosha, 2009). Moreover, AEDP brings in non-ordinary channels of experience, such as energetic modes of experience, which can be accepting and normalizing of spiritual emergence/y. To conclude here, the therapeutic model of AEDP may be beneficial for some experiencing spiritual emergence/y because of its foci on
    the relational, attunement, present-moment awareness, resourcing the body, and focus on metaprocess which further integrates the client’s healing process.

    Therapists can create a safe and supportive space for the client to feel seen, felt, and heard. It is unclear how helpful it is to assess clients as ‘psychotic,’ other than to place the client in a box filled with our potential assumptions and biases. It would be more helpful for the therapist to be open-minded and curious about the client’s experience (Crowley, 2006).

    This is exemplified by a case study of a therapeutic relationship between a counsellor and an adolescent client in New Zealand (Bray, 2008). The client presented to Bray (the author and counsellor) with psi phenomena — interactions with his dead brother and dead father and receiving information pre-cognitively. The client was surrounded by supportive systems, such as his Cook Island Māori community and grandfather, except for at school. The client’s grandfather was training him to step into a leadership role within his community, so his non-ordinary
    experiences were normalized and deemed to be a gift in this context. Bray (2008) describes his process of reaching out to supervisors and educating himself on transpersonal theories such as the Grofs’ model for spiritual emergencies when he started working with the client. However, Bray opposed the mainstream systems in New Zealand that wanted to give his client anti-psychotic drugs and take the adolescent out of his community and family system. The therapeutic relationship with Bray was helpful for the client to integrate his non-ordinary experiences. Unfortunately, the client’s school referred him to another organization, against
    Bray’s and the family’s recommendations, with a strict medication protocol. The therapeutic relationship with Bray came to an abrupt end when the client relocated to a different locality. To conclude, this case study exemplifies the positive growth and self-actualizing potential that is available when therapists meet their clients where they are and aim to “sympathetically support” them within their worldview context (Bray, 2008, p. 25). This case study also exemplified the positive transformation that can be made without medication, as discussed above. In Bray’s
    (2008) words, “the ways in which spirituality, spiritual emergence, and consciousness
    development are understood, assessed and managed have a significant bearing on our clients’ lives” (p.32). So, a participatory approach is paramount for the client’s process of healing in relationship, as well as creating a safe space for secure attachment to develop between client and therapist.

    Significance of Trusting the Client’s Journey

    As already stated, we have not yet arrived at a definitive worldview on the reaches of human consciousness. Although there is a predominant materialist worldview, psi phenomenon and consciousness studies are evidence of holes in this paradigm (Beauregard et al., 2018; Butzer, 2021; Cardeña, 2018).

    I would argue that to behave like we understand penultimate reality is not only limiting, but dangerous in therapeutic settings.

    Therefore, therapists can come into relationship with clients who push the boundaries of their worldview instead of branding their perspective as psychotic. In other words, the therapist does not have the power to see what is real while the client is delusional. I would like to invite more nuance when therapists work with clients’ differing worldviews, and to not disregard experiences as delusional or wrong based on worldview. I would argue that it is unethical to do so for therapists. I invite therapists to take the whole person in front of them as one already intelligently and innately moving toward individuation and authenticity. Perhaps this requires a larger transpersonal view that there is something larger than ‘us,’ something sacred supporting us through life experiences. Or, perhaps, it simply requires respect for differing perspectives and experiences. This speaks for clients who are not deemed to be a danger to the safety of others, and such drastic possibilities need to be approached differently than I am suggesting here for individuals who are not a danger. Just as therapists are guided to be culturally, spiritually, and religiously sensitive, they are invited to be sensitive to worldview.

    I also wonder about what valuable human insights we might be dismembering from society because they come from pathologized non-ordinary experiences.

    Ultimately, western society might be missing the integration of the embodied and experiential wisdom from spiritual emergencies and other non-ordinary experiences (Maslow, 1965; Grof, 2012). I wonder what leaders we might be institutionalizing and pathologizing, as in the case study with the adolescent boy above who was being guided to be his community’s leader in New Zealand. I also wonder about what valuable human insights we might be dismembering from society because they come from pathologized non-ordinary experiences. Spiritual emergence/y may be “an initiation into a greater possibility for existence” (Rominger, 2013, p. 151). These can be pivotal experiences in life that drastically change the direction of life (Rominger, 2013; Taylor & Egeto-Szabo, 2017; Vaughan, 2002).

    I invite therapists to create secure attachment within therapeutic relationships to support clients to integrate spiritual emergence/y experiences. I invite therapists to undo their clients’ aloneness in spiritual emergence/y. I invite therapists to use the newest research on empathic resonance, such as AEDP does, in their therapy rooms. The days of the still-face therapist can be over as we bring relationality and secure attachment to our therapeutic relationships in service of healing.


    In summary, I hope this essay prioritizes attachment in the therapeutic relationship with spiritual emergence/y protocols. The participatory approach is beneficial for therapists as it posits that knowing is co-created relationally — and, in turn, healing is co-created relationally, too. Although certain protocols are suggested in this essay, it is meaningful to stress that therapists working with spiritual emergence/y trust their client’s innate healing capacity for individuation. This essay has hopefully invited therapists to create secure attachment within therapeutic relationships to support clients to integrate spiritual emergence/y experiences and to undo aloneness. The days of the ‘clinical gaze’ can be over as we bring empathic resonance into therapeutic relationships so that clients can feel supported, safely held, and trusted by their therapists. Spiritual emergence/y have positive transformation potential. Therefore, it is essential to support therapists in holding these non-ordinary experiences ethically and respectfully so that clients can nurse all the healing and transformational potential. And, hopefully, this healing can
    ripple out into our larger societies as well


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