A Service Evaluation of the U.K. Spiritual Crisis Network

Abstract

The Spiritual Crisis Network (SCN) provides support to people experiencing a spiritual crisis. Spiritual crisis can be defined as any self-identified spiritual experience that causes concern or distress for the person who experiences it or others around them. If responded to appropriately, it can often lead to personal growth or even profound psychospiritual transformation. Spiritual crisis sometimes overlaps with mental health issues and is part of the wider discourse about spiritual emergency in the literature of transpersonal psychology. Feedback was gathered from people who had contacted the SCN between 2011 and 2019 via an online questionnaire survey. Participants rated the SCN services and provided further qualitative data that were analyzed using Thematic Analysis. The majority of respondents (74%) who contacted the SCN found it to be helpful, while 63% were satisfied with the response they received. However, it was also clear that the SCN approach does not necessarily work for everyone. Seventy-four percent of respondents reported that their spiritual crisis caused them great distress, but 75% felt that they had now integrated their experience. The role of the SCN volunteers was highlighted as an important factor in helping people feel less alone and that their experiences had been validated and normalized.

A spiritual crisis can also be referred to as spiritual emergency (Bragdon, 1990), a Spiritually Transformative Experience (Brook, 2021; Kason, 1994), a Dark Night of the Soul (Robertson, 2018), or visionary spiritual experience (Lukoff, 2007). The concept originated with S. Grof and Grof (1989), C. Grof and Grof (1990), and Assagioli (1965) and also has connections with clinical parapsychology (Kramer, et al., 2012). However, in more recent years, some more mainstream clinical psychologists (I. Clarke, 2010; Cooke, 2014) and psychiatrists (Cook et al., 2016; Razzaque, 2014; Read & Evans, 2020) have taken an interest in the concept. In her BPS report on psychosis, Cooke stated, “There is growing interest in the idea that ‘psychotic’ crises can sometimes be part of, or related to spiritual crises, and many people feel that their crises have contributed to spiritual growth” (Cooke, 2014, p. 55). As such, spiritual crisis can be understood as an aspect of cultural diversity within modern healthcare practice.

The phenomenology of spiritual crisis is sometimes similar to what is experienced in psychosis or schizophrenia, and there is much debate about this relationship (Crowley, 2006; Lukoff, 1985; St. Arnaud & Cormier, 2017). Some researchers and clinicians attempt to make a differential diagnosis of spiritual crisis from psychosis, while others take a nondiagnostic approach (I. Clarke, 2010). Taking an inappropriate response may result in iatrogenic harm.

For this study, the researchers did not attempt to define “spiritual” or to differentiate spiritual experiences from psychiatric diagnoses. All participants were self-selecting; they themselves identified with the term “spiritual” or “spiritual crisis,” contacted the Spiritual Crisis Network (SCN), and opted into the research study. Another recent study attempted to reach a consensus definition of spiritual emergency by using a Delphi survey to explore the understanding of academics, clinicians, and experiencers. However, no consensus was reached owing to the ideological differences of the participants (Harris et al., 2020).

The question of the relationship between spirituality and psychiatry is large and complex. The majority of writers, who usually prefer the term “spiritual emergency,” advocate for differential diagnosis criteria to distinguish a spiritual emergency from psychosis. However, a minority view, mostly held within the SCN, is that it is difficult, if not impossible, to make this distinction in practice. This view has been supported most recently by Spittles (2022), who concludes by recommending a phenomenological approach to clinical support and research rather than differential diagnosis.

As such, this question was not a focus for this research study. Instead, the aim was to ascertain how people felt after contacting the SCN, regardless of whether they had received a diagnosis or whether they made a distinction between spiritual crisis and psychosis or not.

Many therapists and organizations provide support for people experiencing spiritual crisis, including: the Spiritual Emergence Network in the United States, founded by Christina Grof, the American Center for the Integration of Spiritually Transformative Experiences, Integrative Mental Health University founded by Emma Bragdon, Spiritual Awakenings International founded by Yvonne Kason, and the U.K. SCN.

The focus of this study was the SCN, which was founded in 2004 by Catharine Lucas, Isabel Clarke, Janice Hartley, and others, with the aim of supporting people affected by spiritual crisis (Hartley et al., 2011; Lucas, 2011; Rush, 2013). The SCN provides six main services: information via its website, support and information by email, peer support groups, volunteer training days, occasional academic conferences, and an online discussion forum.

The SCN does not diagnose people or label their experiences; rather, people self-identify with the concept of spiritual crisis and contact the SCN. The approach taken by the SCN complements that taken by the traditional biomedical or psychiatric model. While the SCN does not adopt an anti-psychiatry or anti-medication stance, it does emphasize the importance of integrating one’s experiences using peer support in safe, nonjudgmental spaces.

Also, although the SCN does not promote any particular spiritual or religious perspective, it seeks to validate and normalize people’s experiences in order to help them find a meaningful narrative or framework that makes sense to them. The SCN also provides information about various practices that may help people during and after their crisis.

Aims of the Study

The SCN has been providing these services since it went online in 2011. However, it has never been evaluated to confirm whether its work is effective, and if so, why it is effective. To date, there has been relatively little empirical research into effective interventions for spiritual crisis. Researchers, therapists, and experiencers have been unanimous in their call for more research in this area (Agrimson & Taft, 2008; Collins, 2007, 2008; De Waard, 2010; Turner et al., 1995). Therefore, the aim of this study was to evaluate the SCN by gathering feedback from experiencer on the services it provides. The main research questions were:

1. Did people find contacting the SCN helpful or unhelpful?

2. What was helpful or unhelpful about contacting the SCN?

3. How did contacting the SCN compare to contacting mental health organizations?

Method

An evaluation research approach was taken (Ellis, 2008; Gray, 2004; Van der Eyken, 1993). Evaluation research can use various methods and is an iterative process with the aim of improving a product or service (A. Clarke & Dawson, 1999).

Feedback was sought from all 1,605 people who had previously contacted the SCN between 2011 and 2019 using an online questionnaire survey. To avoid selection bias, the entire population was invited to participate, rather than just a sample. The data collected by this survey comprised the first dataset. A second dataset was comprised of the original emails that participants had sent to the SCN (where consent was given to use their data).

Attitude ratings were collated measuring satisfaction with SCN services, or agreement with statements about the SCN, using 5-point bipolar Likert scales. A Thematic Analysis (TA; Braun & Clarke, 2006, 2012; V. Clarke et al., 2015) of the qualitative data obtained from the survey and emails was performed. TA was chosen because the qualitative data were not rich in content, often being comprised of just a few sentences. TA can be undertaken relatively quickly and utilized within any research epistemology. It also allows for two different approaches to the data: a deductive pass to identify relevant a priori categories, and an inductive pass to allow for any emergent themes to be identified, or preset and open-coding, respectively (Maguire & Delahunt, 2017). The preset codes included varieties of spiritual crises and categories of mental health diagnosis. These were needed in order to compare the experiences reported to the SCN with those reported in the literature, and to evidence the overlap between spiritual crisis and mental health. The qualitative data were then coded, and additional emergent themes were identified.

The TA undertaken here represents a small-q qualitative form of TA (Braun & Clarke, 2021). The overall aim was to evidence whether people found contacting the SCN helpful or not, and why that contact was helpful for them. It was anticipated that, if favorable, the results could be used to support applications by the SCN or similar organizations in applying for funds, charity status, or developing interventions and policies. This approach, then, reflects a realist/factist/positivist epistemology, rather than the Big-Q qualitative approach, which is based upon a more contextualist foundation, as described by Kidder and Fine (1987), who explain that:

Qualitative work with the small q consists of open-ended questions embedded within a survey or experiment that has a structure or design. . . Qualitative measurements (small q) embedded within structured research are usually selected to test a hypothesis stated at the outset. The hypothesis and questions do not change as the research progresses. The same questions are asked of everyone (p. 59)

The focus was on what participants reported, represented by their Likert scale ratings and comments, to gain a descriptive overview of the SCN services, rather than to explore the meaning of their lived experience within its social context. Participants’ comments were used to triangulate the numerical data from the Likert scales. However, a separate follow-up study utilized Interpretative Phenomenological Analysis (IPA) to explore participants’ experience and understanding in more depth.

This approach has similarities with Qualitative Content Analysis (QCA). However, a key difference is that QCA calculates code frequencies in order to develop themes within the data (Vaismoradi & Snelgrove, 2019), “The difference between QCA and TA . . . can be attributed to the emphasis in QCA of a more step-by-step method of data analysis on the background, context, and thick findings under the hue of frequency of codes as a complementary to theme development” (p. 8). This technique was not used in the present study.

Research Participants

Several ethical points were considered during this study. The SCN had not previously sought permission to use people’s data (emails sent to the SCN) for research purposes. Therefore, an SCN Privacy Policy was drafted, which was accepted by the SCN directors. All previous SCN contactees were then emailed to inform them of the policy and to request their permission: (a) to use their existing email data for research purposes, and (b) to be contacted about future research. Contactees during the last 12 months were excluded as they may still have been vulnerable due to their recent crisis.

Survey respondents were given the option to either remain anonymous or be named in the research report. This was in agreement with the argument of Kara (2018) that research participants should be given this choice, and also as some experiencers understand this process as a spiritual “coming-out” (Mottram & Gruel, 2019). All participants provided consent and were also provided with a participant information sheet that signposted them to additional support resources.

Ethical approval for this study was granted by the ERB at the Salomons Institute for Applied Psychology, Canterbury Christ Church University, UK.

Researcher Description

The lead researcher has been a volunteer with the SCN for about 10 years. He assists with responding to emails sent to the SCN, co-facilitates an SCN peer support group, and is one of the SCN Directors. He has not experienced a spiritual crisis himself. Therefore, he adopted the role of “scientist-practitioner” (Fillery-Travis & Lane, 2008), being both a consumer and producer of research, or an “insider-expert” (Sanjari et al., 2014). All volunteers and Directors are unpaid, and the SCN did not fund this research study.

Results

The key findings from this study are presented below. Out of 1,605 emails survey invitations sent, 125 emails bounced. Of the remaining 1,480, the overall response rate was 7.2% (107). Some questionnaires were not fully completed; however, these still provided useful data and were included in the analysis. As not all participants answered every question on the questionnaire survey, both percentages and numbers have been included for clarity. Where “participants” are mentioned below, this refers to everyone who took part in the survey. Where “respondents” are mentioned, this refers to those who answered a particular question. Participants have been quoted verbatim, with no spelling or grammatical corrections.

Demographics

Respondents were 61% (41) female, 36% (24) male, with 3% (2) preferring not to say. The age at which respondents experienced their first spiritual crisis ranged from under 18 to 64 years old. The majority of respondents experienced their spiritual crisis in young adulthood (18% were 18–24), approaching midlife (24% were 25–34), or during midlife (30% were 35–44). The majority of respondents identified themselves as White British 69% (46), and highly educated with 48% (32) educated to degree level, and 33% (22) educated to postgraduate level. Considering their religion, 39% (26) were not religious, 28% (19) were Christian, and 24% (16) indicated other, such as “spiritual but not religious” or pagan.

A future study is needed to explore how spiritual crisis is understood in other cultures and to compare the triggers, phenomenology, frameworks of understanding, and outcomes of analogous experiences. Work by researchers in India (Tobert, 2014), Brazil (Bragdon, 2012), and other non-Western cultures (Luhrmann & Marrow, 2016) has indicated that non-Western perspectives may be more beneficial for those undergoing such experiences. Furthermore, this analysis needs to be sensitive to the issues of cultural appropriation, psychologization (Cohen, 2022), and commodification (Carrette & King, 2005) of spiritual beliefs and practices, and must avoid perpetuating colonialist tendencies to export, or repackage and export, concepts to non-Western cultures. Finally, there is also the intriguing possibility that spiritual emergency can be understood as a socially constructed and specifically Western, educated, industrialized, rich, and democratic, or WEIRD (Henrich, 2021) phenomena, associated with the recent rise in the number of people who identify as spiritual but not religious (Parsons, 2018).

Varieties of Spiritual Crisis

The SCN is contacted by experiencers, carers, and others interested in spiritual crisis. Ninety-five percent of respondents (74) self-identified as having experienced, or come close to experiencing, a spiritual crisis themselves. Eighty-two percent of these respondents (61) identified their experience as a particular variety of spiritual crisis. Although mystical, unitive, and psychic opening were the most common categories, the full range of the varieties of spiritual emergencies listed by S. Grof and Grof (1989) and C. Grof and Grof (1990) was represented. The least common varieties were drug-induced experiences, Near-Death Experiences (NDEs), and close encounter experiences.

Effects of Spiritual Crisis

Seventy-four percent (47) of respondents reported that their spiritual crisis caused great distress for them, and 72% (46) reported that their crisis caused great distress for others around them. However, it is important to note that 11% (7) of respondents indicated that they did not experience great distress, and 12% (8) indicated that their experience did not cause distress to those around them. Seventy-five percent (48) of respondents felt that they had now integrated their experience and that it had resulted in profound positive transformation, while 6% (4) felt that they had not yet integrated the experience, and 5% (3) had not experienced profound positive transformation.

Categories of Diagnosis

Seventy percent (45) of respondents said that they had contacted mental health services, and 82% (37) of these respondents reported that they had received a mental health diagnosis during their crisis. The most frequently reported diagnoses were depression and anxiety, followed by psychosis, bipolar disorder, various types of schizophrenia, and finally, stress.

Did People Find Contacting the SCN Helpful or Unhelpful?

Participants were asked to rate how helpful they thought the SCN had been; 65% of respondents (60) rated the SCN as very or moderately helpful, while 9% of respondents (9) rated the SCN as moderately or very unhelpful. Participants were also asked to rate their overall satisfaction with the support that they received from the SCN. Sixty-three percent of respondents (43) indicated that they were satisfied or very satisfied, while 13% of respondents (9) indicated that they were dissatisfied or very dissatisfied. In addition, 75% of respondents (51) said they were either likely or very likely to recommend the SCN to someone else, and 51% of respondents (25) indicated that they were interested in volunteering with the SCN.

What was Helpful or Unhelpful About Contacting the SCN?

The TA identified four emergent themes: (a) benefits of contacting the SCN, (b) a new perspective, (c) how people felt after contacting the SCN, and (d) volunteer qualities and behaviors. In the extracts below, quotations from participants are followed by the participant number in brackets. The “e” and “s” prefixes indicate the data source as either email or survey, respectively.

Benefits of Contacting the SCN

Participants reported that contacting the SCN provided a variety of benefits, such as reassurance, for example, one participant said, “It was affirmative and reassuring to learn about others’ experiences, that there is a network of people who have had similar experiences to mine, and that such experiences are becoming recognized and validated as profound and valuable” (s38), and Richard stated, “. . .I found it both beneficial and reassuring” (e106).

Other participants confirmed that their experiences had been normalized, “That I could hear and understand from other people that this is an experience that we can have as human beings” (s74), and, “They explained that how my problems was coming into play was not unnormal” (s15). Normalization is a way of depathologizing unusual experiences and thereby decreasing anxiety and stigma.

Participants also stated that the SCN provides, “. . .an excellent portal” (s101) to further helpful resources, such as, “Finding peers, local group, conferences and events, resources, vessel for activism” (s82), but also reading material, “Email support was helpful and a couple of books recommended helped a lot” (s50), online videos, “The online videos helped from SCN” (s49), self-care advice, “Good quality written response with follow on care and suggestions” (s21), and other information, “Thank you for your email, I really appreciate the support and advice that you have provided me with” (e21).

Some participants emphasized the importance of feeling validated, “I felt validated in my understanding of my difficulty and felt less alone” (s19), and, “They replied to my contact and provided me with an extremely validating and empowering message that helped support me during a spiritually challenging period in my life” (s9). Validation acknowledges that an experience can have meaning for the experiencer, rather than being a meaningless event.

Another benefit of contacting the SCN was the opportunity to access a safe space, “finding a safe space to express myself with like-minded people was amazingly helpful!” (s26), that enabled a sense of community and connection (s67), where people could share their experiences with others, “I was able to share my experiences with someone else who was used to hearing stories like mine” (s31). Finding such a safe space, where someone can have their experiences normalized and validated, is crucial to integrating their experience.

A New Perspective

The SCN provided some people with a “new way of looking” (s96), a “new path” (s99), or a “different mindset or frame” (s64), which enabled them to define their experiences differently (s83) or put them into a “another context” (s94), or even resulted in a “paradigm shift” (s25). One participant commented that the SCN helped by, “Validating the existence of my experience alongside the authority of the medical model” (s71), and another exclaimed, “It amazes me how I can now be at peace and see positives in something that was so so bad. Progress indeed!” (e50). Reframing such experiences in a more positive light can help to counter a pathologizing or stigmatizing diagnosis under the biomedical model.

How People Felt After Contacting the SCN

One of the clearest themes was how contacting the SCN made people feel. The most commonly mentioned affect was no longer feeling alone, “It felt extremely personal, empathetic and helped me feel less alone, and more grounded” (s9). Another participant commented, “It has really helped me to realize that I’m not alone, ‘it’s not all in my head’” (s25), while Laura said, “Many thanks for taking the time to contact me; it has helped me to not feel as alone” (e11), which was echoed by Rina, “All the best to you and the team and please keep up the amazing work for people who are lost and alone” (e44).

Other feelings included relief, “I felt understood. Someone knew it was going to be ok, huge relief” (s34), a new sense of hopefulness, “It gave me hope that there were others out there who saw mental illness differently to mental health services” (s35), of being supported, “To feel supported and taken seriously was paramount importance to me” (s26), and comfort, “Just thing that somewhere are people who try to understand gave me undescribable feeling of comfort in this dark time” (s27). Therefore, it was the response by other people that made a positive difference to experiencers who feel confused and alone.

SCN Volunteer Qualities and Behaviors

Eighty-five percent of respondents (42) rated the SCN volunteers as polite and friendly, 81% of respondents (40) as supportive and empathic, 77% of respondents (38) as knowledgeable about spiritual crisis, and 68% of respondents (33) as responding quickly.

Helpful volunteer qualities and behaviors that were mentioned in particular included:

• welcoming newcomers, “Any topic around spiritual crisis and mental health was welcomed. Personal experiences were welcomed. The wisdom of the members was welcomed. It was a very welcoming environment” (s86),

• an attitude of understanding, “It’s very nice to know that there are people out there who understand these things, and even more, are willing to help. Thank you” (e52),

• empathy, “The relief of being around a group of understanding, empathic people was immense” (s86),

• being nonjudgmental, “They took my confused thoughts without judgment and gave them back to me in a way that made more sense” (s47),

• deep listening, “I was surprised someone had taken the time to really listen to me and provide some ‘holding’, demonstrate they heard and understood my pain and anguish, validated my feelings and even suggest some things which I could call on to help me at the time” (s62),

• and compassion, “Thank you so much for your reply. It was lovely to receive such compassion and support from a stranger. I’m glad to say I’m coping far, far better now!” (e7).

Sometimes experiencers had thanked individual volunteers for their responses, and sometimes the SCN as a whole, “Thank you so much [redacted], your thoughtful, considered and kind response is extremely appreciated, . . . I felt understood and listened too and in some ways quite astonished there are volunteers willing to listen directly and respond with expertise on what can be personal and difficult traumas/trials/challenges of which all can be seen associated in a spiritual light. . .” (e76: Andrew).

As the majority of participants reported that they found the SCN helpful, there were relatively fewer comments about what was unhelpful. However, four themes emerged: (a) accidental triggering, (b) sustained contact, (c) opportunities for connection, and (d) delayed responses.

Some participants reported that they found the online forum, email replies, and peer support groups triggering, “The stories I read were absolutely triggering. Instead of calling me and offering perspective, it made everything feel 100 times worse” (s52). This exacerbated their anxiety rather than alleviating it.

The need for ongoing contact with SCN volunteers or other experiencers was also mentioned, “One response doesn’t provide the sustained support I needed, . . . I feel that being able to have a continued email support, even once a week for a few weeks perhaps, would have helped to consolidate the information” (s19). This applies to email and peer support groups.

Related to this need for sustained contact was the desire for more opportunities for social connection, “Organizing events where people get to actually share and connect and not just listen to other speakers also would be helpful” (s84). Finally, three participants reported that they had received delayed replies to their initial emails when contacting the SCN.

However, even when critiquing the SCN, participants often acknowledged the difficulties and made suggestions such as: a directory of therapists with spiritual crisis knowledge, a telephone hotline, the need for more research, seeking funding, time-restricted sharing in peer support groups, and increasing awareness of, and accessibility to, the SCN.

How Did the SCN Compare with Contacting Mental Health Services?

In addition to contacting the SCN, 70% of respondents (45) said they had contacted mental health services during their crisis, with 47% (21) finding this helpful and 40% (18) finding it unhelpful. Thirty-seven participants indicated that they received a mental health diagnosis. 51% (23) found the diagnosis unhelpful, while only 17% (8) found it helpful.

When comparing their experience of the SCN with mental health services, the majority of respondents, 80% (36), indicated that the SCN was more helpful. One participant commented, “It gave me hope that there were others out there who saw mental illness differently than mental health services” (s35), and another concluded, “Mainstream NHS services need to evolve dramatically. Work such as the SCN’s is really important in the sense that they are ‘ahead’ with understanding, knowledge-base, and also the compassionate approach” (s25).

Some participants found the mental health services helpful, “It’s a long-term diagnosis, a long-term situation. It’s made bearable by people being pleasant and humane. That includes NHS staff, community voluntary work providers, peer support groups, friends and family, etc.” (s86), although some were cautious, “I didn’t tell the doctor the whole story as I didn’t fancy being sectioned” (e31). However, many reported they found the mental health services unhelpful, “I felt that my GP did not understand what was happening to me” (s59), and that contact with mental health services, “. . .made the situation worse on many levels” (s23).

One issue raised with the mental health services was their lack of understanding about spiritual crisis, “They need to understand that sometimes it is a spiritual crisis as opposed to a mental illness. No nurses had much knowledge about spiritual aspects” (s10), and their resulting inability to help others understand their crisis, “Useful to contain people who are at risk to themselves or others. Not useful for me to understand the experience or personal development” (s101).

Another issue was that of coercion, particularly around taking medication, “It was forced on me so I could get signed off work and get benefits while I was ill” (s89), and, “I did not contact them voluntarily, it was forced on me via work and other ‘do gooders’ for my own and others safety, even tho I had caused no harm to another or myself” (s60), and, “It was originally completely by external force, my mum being my next of kin, insistent I ‘engage’ with services” (s25).

Finally, another issue was the relationship between spiritual crisis and mental health. The lack of clarity around this distinction caused confusion for experiencers, for example, “In the early throes of what was deemed a psychosis, I had no idea what was happening to me. I felt very much that what I was suffering was spiritual in nature but had no language to explain this” (51), and, “It was very isolating as most people just believed I had a psychotic episode but it was a spiritual awakening” (10). Whereas, after contacting the SCN, one experiencer commented, “Thanks for your advice and recommended reading. It has certainly helped with my recovery to hold on to my spiritual beliefs, and I think I’ll always see my experience as both spiritual and mental illness” (e50).

Some participants had mixed feelings about mental health services, which could be helpful at times and unhelpful at others, “I used the NHS extensively. Most of what they did helped, some of it was detrimental or neutral” (s79). Although, the mental health services could sometimes be helpful, this help was limited, “At first it was extremely counter-productive and dangerously unhelpful, but eventually I was referred to an NHS therapeutic community, which was excellent, and restored me to functionality. However, spirituality was not an ingredient of the care I was given or a consideration, and it was largely necessary for me to detach from my experiences in order to fit in at the TC” (s38).

Rather than an alternative to psychiatry, the approach of the SCN complements it. One experiencer thanked the SCN and commented, “You have been a great support to me mainly around my frustrations with psychiatry. I was allocated a new CPN recently whom I have seen once. She was more help to me in one meeting than anyone else has been in 5 years. She told me I knew best what happened to me and said that there is still lot they don’t know about mental illness” (e50). There is, therefore, a degree of ambivalence about mental health services when it comes to supporting those going through a spiritual crisis.

When asked about the five least helpful things that people tried during their crisis, the most common were the mental health services, medication, talking to the wrong people, and alcohol. This accords with Brook’s (2021) findings, where experiencers rated prescription medicine and psychiatric intervention as the least helpful practices.

Discussion

Regarding the variety of experiences reported, it may seem surprising that NDEs and drug-induced experiences were rare in this sample. Since Moody’s (1975) original book, NDEs have received much academic attention (Fox, 2003; Sartori, 2014). Entheogens have long been considered relevant to spiritual experience (Huxley, 1954; Smith, 2000), and there is currently a resurgence of interest in psychedelics for therapeutic use (Bourzat & Hunter, 2019). However, these figures do not represent the incidence of such experiences in wider society, only the incidence among people who contacted the SCN. It could be that people who have these types of experiences contacted other organizations, such as IANDS for NDEs or the Institute of Psychedelic Therapy for integrating psychedelic experiences. Alternatively, the low incidence of close encounter experiences could reflect a shift in cultural influences if such extraterrestrial encounter narratives are no longer in vogue. The influence of culture on the content of experiences is acknowledged (Appelle et al., 2000).

As expected, the majority of experiencers reported that their spiritual crisis has caused distress for themselves or others. However, a few participants reported that their spiritual crises did not cause any concern. This requires that the definition of spiritual crisis take this aspect into account, and further research could explore why these people did not experience a crisis. S. Grof and Grof (1989), C. Grof and Grof (1990) original definition of spiritual emergency includes the aspects of both crisis and emergence. The latter is a more gradual and gentle process of spiritual growth, which could be relevant here. Likewise, this understanding of spiritual crisis as a process may help explain why a few participants reported not having experienced transformation. Perhaps, they are still integrating their experience, or perhaps there really is a difference between spiritual crisis and other phenomenologically similar mental health conditions. This parallels the phenomenon of posttraumatic growth (Tedeschi, et al., 2018) as many people experience growth following a trauma, but not all. Therefore, it should not be assumed that a spiritual crisis necessarily indicates a mental health issue. However, it can be seen that diagnoses are sometimes given to those who experience a spiritual crisis, or that spiritual crises and mental health conditions can co-occur.

Respondents confirmed the numerous ways they benefited from contacting SCN, including reassurance, signposting to resources, normalization and validation of their experiences, and providing a safe space within which to connect with others. All of these are what the SCN aims to provide via email and its website, and ongoing contact in its peer support groups.

It is significant that some respondents mentioned the SCN gave them a new perspective on their experiences. This relates to previous findings (I. Clarke et al., 2016; Remy-Fischler, 2021) that providing experiencers with a more positive and empowering framework can lead to more positive outcomes. This is akin to the technique of reframing in psychotherapeutic practice (Griffin & Tyrrell, 2003; Heap & Aravind, 1989). Also, such narratives may or may not be understood by experiencers, volunteers, or therapists as making ontological claims. Rather, the emphasis is on the therapeutic function or effect of such frameworks.

The emphasis that participants placed on how they felt after contacting the SCN suggests that it was not simply signposting to resources or the self-care practices that were suggested that helped. It was also the quality of the social contact by which the information was imparted. This relates to studies that have shown that positive appraisal of experiences by self and others has a positive impact on the clinical outcome (Brett et al., 2007, 2009, 2014; Hartley & Daniels, 2008; Heriot-Maitland, et al., 2012). The qualities and behaviors of the SCN volunteers, many of whom have experienced a spiritual crisis themselves, are therefore important in understanding how the SCN is effective. This echoes the opinion of Mosher and her colleagues that it was the qualities and behaviors of the Soteria volunteers in a process of “being with” not “doing to” the residents that was therapeutic (Mosher et al., 1973, 2004). Soteria was an alternative approach to schizophrenic patients that utilized a nonmedical residential setting. They reported that Soteria volunteers scored highly on cognitive and attitudinal flexibility, introversion, independence, and intuition (Mosher et al., 2004). They also demonstrated good ego strength and were comfortable with altered states of consciousness, both their own and those of others (Mosher et al., 1973). This also concurs with research into the different modes of psychotherapy that has found the most effective component to be the quality of the relationship between the therapist and client (Priebe & McCabe, 2008). Indeed, while the SCN does not provide formal therapy as such, its work could be described as therapeutic in effect or as one participant put it, “The SCN helps to support people, so they don’t feel/get ‘dehumanized’, and in fact, this is a very THERAPEUTIC manner/approach toward such crises/emergences” (s25). This more communal and egalitarian approach is also taken by peer-supported open dialogue (Razzaque & Stockmann, 2016; Seikkula, et al., 2011).

Of the four themes that participants reported as unhelpful, three relate to the limited resources within which the SCN operates. The SCN is staffed by a small group of unpaid, part-time volunteers. These volunteers endeavor to respond quickly to emails and to organize peer support groups and events to provide opportunities for social connection, but are currently unable to sustain long-term contact with individuals. With additional volunteers and funding, the SCN could potentially do more.

However, SCN volunteers need to be aware of the potential to accidentally trigger people by email or at peer support groups. Some additional training may achieve this, but it may not be realistic to expect that experiencers will never feel triggered. It may be more important to ensure volunteers know how to deal with these situations as well as avoid them.

Despite a few respondents reporting that the SCN was unhelpful, the majority rated the SCN as more helpful than the mental health services. This was because the former was open to spiritual understandings about what they had experienced, whereas the latter were not. It seems that the importance of spirituality for patients and the phenomenon of spiritual crisis are still not well known within mental health services. However, respondents reported that some individuals working within the mental health services were helpful. So, one’s experience depends greatly on whom one has the opportunity to speak with. While awareness of spirituality is increasing within clinical services, for example, the Royal College of Psychiatrists has a spirituality special interest group (Cook et al., 2009), there is still a long way to go before it becomes embedded in mainstream clinician training and practice.

The feedback from respondents also suggests that they would find it helpful to be able to clearly define and distinguish a spiritual crisis from a mental health condition. Clinicians would probably also find this helpful, but there is no yet any consensus on how to do this (Harris et al., 2020). Indeed, the main criterion seems to be a retrospective classification based on outcome, which clearly has no prognostic use. However, it is crucial to note that there is a difference between narratives that facilitate therapeutic outcomes and statements about etiology and ontology. In other words, a spiritual narrative can be helpful whether or not it reflects any objective reality.

Limitations of the Study

While the chosen methodology was fit for its intended purpose, it did have several weaknesses. The survey was longer than necessary and resulted in additional data for analysis that could not be included in this report. One or two participants complained about the length of the survey. This analysis may be published separately at a later date.

Although everyone who had contacted the SCN between 2011 and 2019 was invited to complete the survey, participants were all self-selected. Participants could have been biased in favor of the SCN. However, the survey allowed for a range of feedback, and the results indicate both positive and negative responses.

Participants self-rated their responses to the questions about how much distress their crisis had caused themselves and others, as well as whether they had now integrated their crisis. Again, this could introduce a positive bias as there was no independent way to confirm their self-assessment. However, this is not a major issue as the study was not testing the hypothesis that their sense of integration was as a result of their contact with the SCN.

Conclusion

The types of experiences reported to the SCN reflect the varieties of spiritual emergency originally outlined by S. Grof and Grof (1989) and C. Grof and Grof (1990). However, some of these participants also received a psychiatric diagnosis.

It is clear that the majority of participants found the SCN helpful to a greater or lesser degree in supporting them during their spiritual crisis. While the SCN does not set out to provide formal one-to-one or group therapy, its services can nevertheless be therapeutic in effect.

The SCN helped by reassuring people and helping them feel less alone during their crisis. It can also normalize, validate, and provide a complementary framework for understanding their experiences. Contact with the SCN clearly had a highly emotional positive impact on many of the participants.

However, it is also apparent that the SCN approach is not effective for everyone and a minority found contacting the SCN had a negative impact on them. This was mostly due to accidental triggering from email replies and in peer support groups.

Although interventions in the form of self-help practices, attitudes, and behaviors are important, this study highlights the significance of the qualities, attitudes, and behaviors of the SCN volunteers themselves, both in online and face-to-face interactions.

While the SCN provides a complementary approach to mainstream mental health services, there were mixed feelings about the latter. Many participants did not find their diagnosis or their contact with mainstream mental health services helpful. Participants clearly indicated their preference for the SCN approach over that of mainstream mental health services. Although the latter could be helpful at times, it was often unable to provide a spiritual understanding of participants’ experiences. In addition, some participants were subject to coercion during treatment, whereas the SCN offered choices about how to interpret, appraise, and respond to unusual experiences.

This is the first study to evaluate the approach of the SCN in supporting people who experience a spiritual crisis. It is hoped that this will encourage greater interest in the SCN approach, and the allied support organizations and therapists, who work with spiritual crisis.

Recommendations for Practice

The following recommendations apply to the SCN and similar organizations working with spiritual crisis.

• Therapists and clinicians would benefit from an increased awareness and understanding of spirituality in general and spiritual crisis in particular in order to fully respect their clients’ experiences and to avoid an inappropriate response and iatrogenic harm. Direct referrals could be made to the SCN.

• Feedback mechanisms and evaluation studies should be undertaken to understand and evidence the effects of service provision to those who identify as having experienced spiritual crises. Such evidence could then be used to apply for funding.

• Identify, train, and support volunteers in developing helpful qualities, attitudes, and behaviors, such as empathy, deep listening skills, and knowledge of spiritual crisis. Ensure they are aware of the risk of accidentally triggering experiencers, and that designated carers are provided at public events, such as training days and conferences, “incorporate all gently” (s41).

• Aim to establish additional peer support groups and organize more frequent face-to-face events, as these appear to be the most effective for people to share, normalize, accept, understand, and find meaning in their spiritual crises.