116514881 the Journal of Transpersonal Psychology Vol 25-1-1993 PDF

Volume 25 Number 1, 1993

REVIEWThe transpersonal: Psychotherapy and counseling. Rowan

The art of transcendence: An introduction to common elements of transpersonal practices

Roger Walsh & Frances Vaughan

Transpersonal psychology research review:Psychospiritual dimensions of healing

David Lukoff, Robert Turner & Francis G. Lu

A

Reflections of shaktipat: Psychosis or the rise of kundalini? A case studyJon Ossoff

The physio-kundalini syndrome and mental illnessBruce Greyson

Death and near-death: A comparison of Tibetan and Euro-American experiencesChristopher Carr

1

11

29

43

59

NOTICE TO SUBSCRIBERS

NOTICE TO AUTHORS

BOOKS FOR REVIEW

The Journal of Transpersonal Psychology is published semi-annually beginning with Volume 1, No. 1,1969.

Current year subscriptionsVolume 25,1993.To individuals: $24.00 per year; $12.00 either issue.To libraries and all institutions: $32 per year or $16 either issue. Overseas airmail, add $11 per volume, $5.50 per issue.

Back volumes: Volume 24 (2 issues) $24, $12 per issue.Volumes 15-23 (2 issues per volume) $20 each, $10 per issue. Volumes 1-14 (2 issues per volume) $14 each, $7 per issue.All Journal issues are available. See back pages of this issue for previous contents.

Order from and make remittances payable to:The Journal of Transpersonal Psychology, P.O. Box 4437, Stanford, California 94309.

The Journal of Transpersonal Psychology is indexed in Psychological Abstracts and listed in Chicorel Health Science Indexes,International Bibliography of Periodical Literature,International Bibliography of Book Reviews,Mental Health Abstracts,Psychological Readers Guide, and beginning in 1982 Current Contents/Social & Behavioral Sciences Social Sciences Citation Index Contenta Religionum

Manuscript deadlines: Manuscripts may be submitted by any author at any time. Regular deadline dates are February 1 and July 1 for Summer and Winter issues, respectively.

All manuscripts, and an abstract of not more than 150 words, should be submitted in triplicate, double-spaced to the Editor,345 California Avenue, Suite No. 1, Palo Alto, California 94306 (with a postage-paid return envelope enclosed).

Send to Editor, 345 California Avenue,Suite No. 1, Palo Alto, California 94306.

The Journal of Transpersonal Psychology and the Association for Transpersonal Psychology are divisions of the Transpersonal Institute, a non-profit, tax-exempt organization. The views and opinions presented by authors and reviewers in the Journal do not necessarily represent those of the editors or the Transpersonal Institute.

Copyright 1993 Transpersonal Institute345 California Avenue, Suite No. 1, Palo Alto, California 94306

Scan & OCR by Shiva2012

EDITORIALSTAFF

FIELDEDITORS

BOARD OF EDITORS

Miles A Vich, editor

James Fadiman, Sonja Margulies,John Welwood, associate editors

Ken Wilber, consulting editor

Paul M. Clemens, technical editor

Michael S. Hutton, assistant editor

Francis G. Lu, David Lukoff, research review co-editors

Marcie Boucouvalas, Virginia Polytechnic Institute Jack Engler, Schiff Center, Cambridge, Massachusetts Jacques Maquet, University of California, Los Angeles

Medard Boss, University of Zurich, SwitzerlandJ .F. Bugental, Santa Rosa, CaliforniaJames Fadiman, Menlo Park, CaliforniaViktor Frankl, University of Vienna, AustriaDaniel Goleman, New York, New YorkAlyce M. Green, Menninger Foundation, Topeka, KansasElmer E. Green, Menninger Foundation, Topeka, KansasStanislav Grof, Esalen, Big Sur, CaliforniaHerbert V. Guenther, University of Saskatchewan, CanadaStanley Krippner, San Francisco, CaliforniaLawrence LeShan, New York, New YorkJohn Levy, San Francisco, CaliforniaSonja Margulies, Sunnyvale, CaliforniaMichael Murphy, San Rafael, CaliforniaHuston Smith, Syracuse University, New YorkCharles T. Tart, University of California, DavisFrances E. Vaughan, Tiburon, CaliforniaMiles A. Vich, Palo Alto, CaliforniaThomas N. Weide, Albuquerque, New Mexico

Roberto Assagioli (1888-1974) Hubert Bonner (1901-1970) Alister Brass (1937-1987) Charlotte Buhler (1893-1974) Robert Hartman (1910-1973) Sidney M. Jourard (1926-1974)

Arthur Koestler (1905-1983) Gabriel Margulies (1931-1981) Abraham H. Maslow (1908-1970) Walter N. Pahnke (1931-1971) Chogyam Trungpa (1939-1987) Alan Watts (1915-1973)

Anthony J. Sutich (1907-1976), founding editor, 1969-1976

VOLUME 25, NUMBER 1, 1993THE JOURNAL OF TRANSPERSONAL PSYCHOLOGY

Editors note

The art of transcendence: An introduction to common elements of transpersonal practices Roger Walsh & Frances Vaughan

Transpersonal psychology research review: Psychospiritual dimensions of healing David Lukoff, Robert Turner & Francis G. Lu

Reflections of shaktipat: Psychosis or the rise of kundalini? A case study Jon Ossoff

The physio-kundalini syndrome and mental illness Bruce Greyson

Death and near-death: A comparison of Tibetan and Euro-American experiences Christopher Carr

Book review

Books noted

Books our editors are reading

About the authors

Abstracts

Back issues

iv

1

11

29

43

59

111

113

114

116

117

119

TABLEOF CONTENTS

With this issue, the Journal begins its twenty-fifth year of continuous publication. For any periodical this would be a notable achievement, but perhaps of more significance for JTP is the degree to which the field of transpersonal psychology has developed since this Journal was first published in 1969.

Roger Walsh and Frances Vaughans opening article exemplifies this. They draw on both the oldest wisdom traditions and contemporary transpersonal explorations. Their presentation recognizes historical roots and an expanding body of new contributions to the art and technology of transcendence.

The growing range and depth of transpersonal topics is also evident in Lukoff, Turner and Lus Research Review of Psychospiritual Dimensions of Healing. They include an announcement of the recent acceptance of a new clinical category, Religious or Spiritual Problem, for problems not attributable to a mental disorderan indication of how much professional thinking is moving in these directions.

When JTP first appeared, the Western psychological and psychiatric literature was without any significant mention of kundalini, or near-death experiencesalthough these phenomena were recognized outside of psychology. Now, kundalini case material is accumulatingas Ossoff's dramatic and detailed report illustrates. Also, comparison-group research is refining similarities and differences, as shown by Greysons study of psychiatric patients, Near-Death Experiencers and control subjects.

About the time JTP first appeared, Tibetan Buddhists were beginning to teach in the West. Interest in the Tibetan books of the dead and meditation training drew increasingly serious attention. When, a decade later, Euro-American Near-Death Experience reports appeared in the research literature, some parallels were seen with the Tibetan materials. Work in these areas has now progressed such that anthropologist Christopher Carr believes a genuine comparison can be made. His careful study, drawing crossculturally from different psychologies and world views, could not have been done twenty-five years ago. Today, however, his research, and that of the many authors who have appeared in this Journal, is part of a wave of cultural change that has ever- increasing ramifications.

editors note

THE ART OF TRANSCENDENCE: AN INTRODUCTION TO COMMON ELEMENTS OF TRANSPERSONAL PRACTICES

Roger Walsh Irvine, California

Frances Vaughan Mill Valley, California

We must close our eyes and invoke a new manner of seeing . . . a wakefulness that is the birthright of us all, though few put it to use.

(Plotinus, 1964)

When historians look back at the twentieth century, they may conclude that two of the most important breakthroughs in Western psychology were not discoveries of new knowledge but recognitions of old wisdom.

First, psychological maturation can continue far beyond our arbitrary, culture-bound definitions of normality (Wilber, 1980; Wilber et al., 1986). There exist further developmental possibilities latent within us all. As William James put it, most people live, whether physically, intellectually or morally, in a very restricted circle of their potential being. They make use of a very small portion of their possible consciousness. . . . We all have reservoirs of life to draw upon, of which we do not dream.

Second, techniques exist for realizing these reservoirs of life or transpersonal potentials. These techniques are part of an art and technology that has been refined over thousands of years in hundreds of cultures and constitutes the contemplative core of the

The authors would like to thank all those who contributed to the writing of this article, especially Sonja Margulies, K.en Wilber and Bonnie LAllier.

Copyright 1993 Transpersonal Institute

furtherdevelopmentalpossibilities

The Journal of Transpersonal Psychology, 1993, Vol. 25, No. 1 1

trainingcatalyzes

transpersonalpotentials

worlds great religious traditions. This is the art of transcendence, designed to catalyze transpersonal development (Walsh, 1990; Walsh & Vaughan, 1993). As such it is based on two fundamental assumptions about the nature and potentials of the mind.

The first assumption is that our usual state of consciousness is suboptimal. In fact, it has been described in terms such as clouded, distorted, dreamlike, entranced and largely out of control. This has been recognized by psychologists and mystics of both East and West (Huxley, 1945; Mikulis, 1991; Tart, 1986). For Freud (1917) it was the culture-shaking recognition that man is not even master in his own house ... his own mind, that echoed the Bhagavad Gita's despairing cry two thousand years earlier:

Restless (the) mind is,So strongly shaken In the grip of the senses:Gross and grown hardWith stubborn desire.........Truly, I thinkThe wind is no wilder.

(Prabhavananda & Isherwood, 1944)

In the words of Ram Dass (1975), we are all prisoners of our own mind. This realization is the first step on the journey to freedom. Or as Pir Vilayat Khan put it even more succinctly, The bind is in the mind.

The second assumption is that although the untrained mind is clouded and out of control, it can be trained and clarified, and this training catalyzes transpersonal potentials. This is a central theme of the perennial philosophy. For Socrates:

In order that the mind should see light instead of darkness, so the entire soul must be turned away from this changing world, until its eye can bear to contemplate reality and that supreme splendor which we call the Good. Hence there may well be an art whose aim would be to affect this very thing (Plato, 1945).

Likewise, according to Ramana Maharshi (1955), All scriptures without any exception proclaim that for salvation mind should be subdued.

Although practices and techniques vary widely, there seem to be six common elements that constitute the heart of the art of transcendence: ethical training, concentration, emotional transformation, redirection of motivation, refinement of awareness, and the cultivation of wisdom. The purpose of this paper is to provide a synoptic introduction to the art of transcendence and its common elements in the hope of stimulating appreciation, research and practice of them.

The Journal of Transpersonal Psychology, 1993, Vol. 25, No. 12

SIX COMMON ELEMENTS

Ethics

Ethics is widely regarded as an essential foundation of transpersonal development. However, contemplative traditions view ethics, not in terms of conventional morality, but rather as an essential discipline for training the mind. Contemplative introspection renders it painfully apparent that unethical behavior both stems from and reinforces destructive mental factors such as greed and anger. Conversely, ethical behavior undermines these and cultivates mental factors such as kindness, compassion and calm. Ultimately, after transpersonal maturation occurs, ethical behavior is said to flow spontaneously as a natural expression of identification with all people and all life (Radhakrishnan, 1929). For a person at this stage, which corresponds to Lawrence Kohlbergs (1981) highest or seventh stage of moral developmenta stage that Kohlberg felt required transcendent experienceWhatever is . . . thought to be necessary for sentient beings happens all the time of its own accord (Gampopa, 1971).

Attentional Training

Attentional training and the cultivation of concentration are regarded as essential for overcoming the fickle wanderlust of the untrained mind (Goleman, 1988). As E.F. Schumacher (1973) observed of attention, No topic occupies a more central place in all traditional teaching; and no subject suffers more neglect, misunderstanding, and distortion in the thinking of the modem world.

Attentional training is certainly misunderstood by Western psychology, which has unquestioningly accepted William James century-old conclusion that Attention cannot be continuously sustained (James, 1899/1962). Yet James went further: The faculty of voluntarily bringing back a wandering attention over and over again is the very root of judgement, character and will. No one is compos sui if he have it not. An education which would improve this faculty would be the education par excellence. ... It is easier to define this ideal than to give practical direction for bringing it about (James, 1910/1950). Here, then, we have a stark contrast between traditional Western psychology, which says attention cannot be sustained, and the art of transcendence, which says that attention can and must be sustained, if we are to mature beyond conventional developmental limits.

Being able to direct attention at will is so important because the mind tends to take on qualities of the objects to which it attends (Goldstein, 1983). For example, thinking of an angry person tends

theficklewanderlustoftheuntrainedmind

The Art of Transcendence 3

to elicit anger while thinking of a loving person may elicit feelings of love. The person who can control attention can therefore control and cultivate specific emotions and motives.

Emotional Transformation

Ethical behavior and attentional stability facilitate the third element of the art of transcendence: emotional transformation. There appear to be three components to emotional transformation.

The first is the reduction of destructive emotions such as fear and anger, a process which is well known in mainstream Western therapy. Of course, what is implied here is not repression or suppression but rather clear awareness of such emotions and consciously relinquishing them where appropriate.

The second component is the cultivation of positive emotions such as love, joy and compassion. Whereas conventional Western therapies have many techniques for reducing negative emotions, they have virtually none for enhancing positive emotions such as these. In contrast, the art of transcendence contains a wealth of practices for cultivating these emotions to an intensity and extent undreamed of in Western psychology. Thus, for example, the Buddhists compassion, the Bhaktis love, and the Christians agape are said to reach their full flowering only when they unconditionally and unwaveringly encompass all creatures, without exception and without reserve (Kongtrul, 1987; Singer, 1987).

This intensity and scope of positive emotion is facilitated by a third component of emotional transformation: the cultivation of equanimity. This is an imperturbability that fosters mental equilibrium and as such it helps emotions such as love and compassion to remain unconditional and unwavering even under duress. This capacity is analogous to the Stoics apatheia, the Christian Fathers divine apatheia, the Buddhists equanimity, the contemporary philosopher Franklin Merrell-Wolffs high indifference, the Hindus samatva which leads to a vision of sameness, and the Taoist principle of the equality of things, which leads beyond the trouble of preferring one thing to another.

Motivation

Ethical behavior, attentional stability and emotional transformation all work together, along with practices such as meditation, to redirect motivation along healthier, more transpersonal directions.


thecultivation

ofpositive

emotions

4

The net effect is a change in the direction, variety and focus of motivation as well as a reduction in its compulsivity.

Traditionally it is said that motivation becomes less scattered and more focused; the things desired become more subtle and more internal. Desires gradually become less self-centered and more self-transcendent with less emphasis on getting and more on giving. Supportive findings from contemporary research suggest that psychological maturity is associated with a shift from egocentric to allocentric (concern for others) motivation (Heath, 1983).

Traditionally this motivational shift was seen as purification or as giving up attachment to the world. In contemporary terms it seems analogous to movement up Maslows (1971) hierarchy of needs, Arnold Toynbees process of etherealization, the means for, and result of, a life-style of voluntary simplicity (Elgin, 1981), and the means for reaching the philosopher Kierkegaards goal in which purity of heart is to will one thing.

In addition to redirecting motivation, the art of transcendence involves reducing its compulsive power. The result is said to be a serene disenchantment with the things of the world which no longer exert a blinding fascination or compulsive pull. This is the Buddhist nibbidda and the yogic viraga and is the basis of the Athenian philosopher Epicurus claim that the way to make people happy is not to add to their riches but to reduce their desires. This claim is explicitly formulated in the Buddhas Third Noble Truth which states that the end of craving leads to the end of suffering.

The reduction of compulsive craving is therefore said to result in a corresponding reduction in intrapsychic conflict, a claim now supported by studies of advanced meditators (Walsh, 1993; Wilber et al., 1986).

This is not to imply that redirecting motives and relinquishing craving is necessarily easy. In Aristotles estimate, I count him braver who overcomes his desires than him who conquers his enemies; for the hardest victory is the victory over self (Schindler & Lapid, 1989).

Refining A wareness

The great wisdom traditions agree that in our usual untrained state of mind, awarenessboth perceptual and intuitiveis insensitive and impaired: fragmented by attentional instability, colored by clouding emotions, and distorted by scattered desires. Accordingly

The Art of Transcendence

thereductionofcompulsivecraving

5

we are said to mistake shadows for reality (Plato) because we see through a glass darkly (St. Paul), a reducing value (Aldous Huxley), or narrow chinks (Blake).

The fifth element of the art of transcendence, therefore, aims to refine awareness. Perception is to be rendered more sensitive, more accurate, and more appreciative of the freshness and novelty of each moment of experience. Likewise, intuitive capacities, usually blunted or blinded, are to be cultivated (Vaughan, 1979). One of the primary tools for this is meditation.

Meditators notice that both internal and external perception becomes more sensitive, colors seem brighter, and the inner world becomes more available. These subjective experiences have recently found experimental support from research, which indicates that meditators perceptual processing can become more sensitive and rapid, and empathy more accurate (Murphy & Donovan, 1988; West, 1987; Shapiro & Walsh, 1984; Walsh & Vaughan, 1993).

As the psychiatric historian Henrie Ellenberger (1970) observed, The natural tendency of the mind is to roam through the past and the future; it requires a certain effort to keep ones attention in the present. Meditation is training in precisely that effort. The result is a present-centered freshness of perception variously described as mindfulness (Buddhism), anuragga (Hinduism), the sacrament of the present moment (Christianity), the draught of forgetfulness in which one forgets the past and comes anew into each present moment (Steiner), and characteristic of self-actualizers (Maslow, 1971). Refinement of outer perception is said to be accompanied by a refinement of inner intuitive capacities. Contemporary researchers report finding introspective sensitization (West, 1987) whereas ancient wisdom traditions speak metaphorically of the development of an inner perceptual organ or the opening of an inner eye: the eye of the soul (Plato), the eye of the heart (Sufism), the eye of the Tao (Taoism), the third eye (Tibetan), or the Western philosophers nous or intellectus. For an excellent review see Hustom Smith (1993).

When we see things clearly, accurately, sensitively and freshly, we can respond empathically and appropriately. Thus both ancient wisdom traditions and modem psychotherapies agree with Fritz Peris (1969), the founder of Gestalt therapy, that Awareness per seby and of itselfcan be curative.

Wisdom

The sixth quality cultivated by the art of transcendence is wisdom. Traditionally, wisdom is regarded as something significantly more


tokeepone's

attentionin

thepresent

6

than knowledge. Whereas knowledge is something we have, wisdom is something we must be. Developing it requires self-transformation. This transformation is fostered by opening defenselessly to the reality of things as they are, including the enormous extent of suffering in the world. In the words of the Psalms, this is the recognition that our lives are only toil and trouble; they are soon gone, our years come to an end like a sigh (Psalm 90 HRS). Who can live and never see death? (Psalm 89 HRS).

In our own time it is existentialism that has emphasized this recognition most forcefully (Yalom, 1981). With its graphic description of the inevitable existential challenges of meaninglessness, freedom and death it has rediscovered aspects of the Buddhas First Noble Truth which holds that unsatisfactoriness (dukkha) is an inherent part of existence. Both existentialism and the wisdom traditions agree that, in the words of Thomas Hardy (1926), if a way to the Better there be, it exacts a full look at the Worst.

Whereas existentialism leaves us marooned in a no-exit situation of heightened awareness of existential limits and suffering, the art of transcendence offers a way out. For existentialism, wisdom consists of recognizing these painful facts of life and accepting them with authenticity, resoluteness (Heidegger), and courage (Tillich). However, for contemplative traditions this existential attitude is a preliminary rather than a final wisdom and is used to redirect motivation away from trivial, egocentric pursuits toward the contemplative practices that lead to deeper wisdom. Deeper wisdom recognizes that the sense of being marooned in a no-exit situation of limits and suffering can be transcended through transforming the self that seems to suffer (Vaughan, 1986). This transformation springs from the development of direct intuitive insightbeyond thoughts, concepts or images of any kindinto the nature of mind, self, consciousness and cosmos. This insight is the basis for the transrational liberating wisdom variously known in the East as jnana (Hinduism),prajna (Buddhism), or ma'rifah (Islam), and in the West as gnosis or scientia sacra. And with this liberation the goal of the art of transcendence is realized.

DISCUSSION

These, then, seem to be six essential, common elements, processes or qualities of mind that constitute the heart of the art and technology of transcendence. Of course different practices and traditions focus more on some processes than on others. For example, Indian philosophy divides practices into various yogas (Feuerstein, 1989). All of them acknowledge ethics as an essential foundation. Raja yoga emphasizes meditation and the training of attention and awareness; Bhakti yoga is more emotional and focuses on the


theartoftranscendence offers a way out

cultivation of love; Karma yoga uses work in the world to refine motivation, and Jnana yoga hones the intellect and wisdom.

However, the capacities of mind developed by the art of transcendence are highly interdependent and the development of one fosters the development of others. This interdependence has long been recognized by both Eastern and Western philosophers who held that every virtue requires other virtues to complete it (Murphy, 1992, p. 558). Therefore, to the extent a tradition is authenticthat is, capable of fostering transpersonal development and transcendence (Wilber, 1983)to that extent it may cultivate and balance these elements of the art of transcendence. Hopefully it will not be long before this art is better appreciated and its study and practice are widespread.

REFERENCES

Elgin, D. (1981). Voluntary simplicity. New York: William Morrow.Ellenberger, J. (1970). The discovery of the unconscious. New York:

Basic Books.Feuerstein, G. (1989). Yoga: The technology of ecstasy. Los Angeles: J.

Tarcher.Freud, S. (1917). A general introduction to psychoanalysis. Garden City,

New York: Garden City Publishers.Gampopa. (1971). The jewel ornament of liberation. (H. Guenther, transl.).

Boston: Shambhala, p. 271.Goldstein, J. (1983). The experience of insight. Boston: Shambhala.Goleman, D. (1988). The meditative mind. Los Angeles: J.P. Tarcher.Hardy, T. (1926). Collected poems of Thomas Hardy. New York:

MacMillan.Heath, D. (1983). The maturing person. In Walsh, R. & Shapiro, D. J.

(Eds.), Beyond health and normality: Explorations of exceptional psychological well-being (pp. 152-205). New York: Van Nostrand Reinhold.

Huxley, A. (1945). The perennial philosophy. New York: Harper & Row.James, W. (1899/1962). Talks to teachers on psychology and to students

on some of life's ideals. New York: Dover.James, W. (1910/1950). Principles of psychology. New York: Doublcday.Kohlberg, L. (1981). Essays on moral development. (Vol. I). The philoso

phy of moral development. New York: Harper & Row.Kongtrul, J. (1987). The great path of awakening. (K. McLeod, Transl.).

Boston: Shambhala.Maslow, A. (1971). The farther reaches of human nature. New York:

Viking.Mikulis, W. (1991). Eastern and Western psychology: Issues and domains

for integration. Journal of Integrative and Eclectic Psychotherapy 10: 229-40.

Murphy, M. (1992). The future of the body: Explorations into the further evolution of human nature. Los Angeles: J. Tarcher, p. 558.

Murphy, M. & Donovan, S. (1988). The physical and psychological effects of meditation. San Rafael, CA: Esalen Institute.


Perls, F. (1969). Gestalt therapy verbatim. Lafayette, CA: Real People Press.

Plato. (1945). The republic. (F. Cornford, Transl.). Oxford: Oxford University Press, p. 516.

Plotinus. (1964). The essential Plotinus. (E. OBrien, Transl.). Indianapolis: Hackett, p. 42.

Prabhavananda, S. & Isherwood, C. (Transl.) (1944). The Bhagavad Gita. New York: New American Library.

Radhakrishnan. (1929). Indian philosophy (Vol. 1, 2nd ed.). London: Alan & Unwin.

Ram Dass. (1975). Association for Transpersonal Psychology Newsletter, Winter, p. 9.

Ramana Maharshi. (1955). Who am I? (8th ed.) (T. Vcnkataran, Transl.). India.

Schindler, C. & Lapid, G. (1989). The great turning: Personal peace and global victory. Santa Fe: Bear & Co.

Schumacher, E. (1973). Small is beautiful: Economics as if people mattered. New York: Harper & Row.

Shapiro, D. & Walsh, R. (Eds.) (1984). Meditation: Classic and contemporary perspectives. New York: Aldine.

Singer, I. (1987). The nature of love (3 Vols.). Chicago: University of Chicago Press.

Smith, J. (1993). Educating the intellect: On opening the eye of the heart. In L. Rouner (Ed.), On Education. University of Notre Dame Press (inpress).

Tart, C. (1986). Waking up: Overcoming the obstacles to human potential. Boston: New Science Library/Shambhala.

Vaughan, F. (1979). Awakening intuition. New York: Doubleday.Vaughan, F. (1986). The inward arc: Healing and wholeness in psycho

therapy and spirituality. Boston: New Science Library/Shambhala.Walsh, R. (1990). The spirit of shamanism. Los Angeles: J.P. Tarcher.Walsh, R. (1993). Meditation research: The state of the art. In R. Walsh &

F. Vaughan (Eds.), Paths beyond ego: The transpersonal vision. Los Angeles: J.P. Tarcher, Inc.

Walsh R. & Vaughan, F. (Eds.) (1993). Paths beyond ego: The transpersonal vision. Los Angeles: J.P. Tarcher, Inc.

West, M. (Ed.) (1987). The psychology of meditation. Oxford: Clarenden Press.

Wilber, K. (1980). The Atman project. Wheaton, IL: Quest.Wilber, K. (1983). A sociable God. New York: McGraw-Hill.Wilber, K. Engler, J. & Brown, D. (Eds.) (1986). Transformations of

consciousness: Conventional and contemplative perspectives on development. Boston: New Science Library/Shambhala.

Yalom, I. (1981). Existential psychotherapy. New York: Basic Books.

Requests for reprints to: Roger Walsh, Psychiatry Department, University of Cali- fornia Medical School, Irvine, CA 92717.


TRANSPERSONAL PSYCHOLOGY RESEARCH REVIEW: PSYCHOSPIRITUAL DIMENSIONS OF HEALING

David LukoffSan Francisco, California

Robert TurnerSan Francisco, California

Francis G. LuSan Francisco, California

Since the last Research Review (Lukoff, Turner & Lu, 1992), which focused on the psychoreligious dimensions of healing, there have been significant developments on several fronts. In the diagnostic nomenclature, the medical and psychiatric establishments, and the media, spirituality has been acknowledged as an important aspect of a persons well-being. Most encouraging for trans- personally-oriented clinicians is the acceptance by the American Psychiatric Association (APA) Task Force on DSM-IV of the proposed new Z Code (formerly V Code) category entitled Religious or Spiritual Problem (Lukoff, Lu & Turner, 1992). Although revision of the definition and official acceptance by the APA Board of Trustees is still pending, it seems likely that, for the first time, this important diagnostic classification manual used in the United States, Canada, and abroad will acknowledge religious and spiritual problems that are not attributable to a mental disorder.

Within the medical establishment, religious and spiritual forms of healing were also acknowledged in the prestigious New England Journal of Medicine. Eisenberg, Kessler, Foster, Norlock, Calkins and Delbanco (1993) documented that the frequency of use of

The authors wish to acknowledge the assistance of Lisa Dunkel, M.L.S., University of California, San Francisco, in conducting the computerized bibliographic searches used in the preparation of this article.


religiousandspiritualproblemsnotattributable to a mental disorder


increasingrecognition

inthe

scientificliterature

unconventional therapies in the United States is far higher than previously reported. One in three respondents (34%) reported using at least one unconventional therapy in the past year. In addition, Roughly 1 in 4 Americans who see their medical doctors for a serious health problem may be using unconventional therapy in addition to conventional medicine for that problem (p. 251). Several of the unconventional therapies were psychospiritual in nature (e.g., spiritual healing, prayer, homeopathy, energy healing, and imagery).

Similarly, an increasing number of presentations addressing religious or spiritual issues in clinical practice are being made at the American Psychiatric Association Annual Meetings. In 1993, there were at least a dozen workshops, courses and symposia in the scientific program. Topics included: Religious Issues in Residency Training, Transpersonal Psychiatry, Existential and Spiritual Issues in PTSD Treatment, and a Practicum on Spiritual Issues in Treatment.

In the scientific literature, there also seems to be increasing recognition of the relevance of religiosity and spirituality to mental health. Since the last Research Review on psychoreligious dimensions of healing, we became aware that Larson, Hohmann, Kessler, Meador, Boyd and McSherry (1988) published a study entitled The Couch and the Cloth: The Need for Linkage in a widely- distributed journal of the American Psychiatric Association. Larson, Sherrill, Lyons, Craigie, Thielman, Greenwold and Larson (1992) also published a report in the American Journal of Psychiatry showing the positive relationship between religious commitment and mental health. Mathews and Larson (1992) compiled an extensive bibliography of research on religious and spiritual subjects. In the clinical arena, there have also been publications addressing religious and spiritual issues in psychotherapy; for example, the book Sacred Landscapes (Randour, 1993) contains case studies and essays on this subject, and Spiritual Dimensions of Healing is a comprehensive cross-cultural examination of this topic.

Finally, the media has extended awareness of these issues to the population at large. In addition to the extensive coverage given to the New England Journal of Medicine article discussed above, the media also targeted religious and spiritual aspects of healing in television shows, magazine articles and newspaper articles. Bill Moyers five-part television series on Healing and the Mind brought these issues into the living rooms of millions. Newsweek (January 6, 1992) featured a cover article entitled Talking to God: An intimate look at the way we pray. The New York Times published a report on changes in how Therapists see religion as an aid, not illusion (Goleman, 1991).


This review article, the second of a three-part series, addresses the psychospiritual dimensions of healing. While there is no consensus as to the boundaries between religiosity and spirituality, we continue to adhere in this review to the distinction most frequently drawn between them in the literature. Religiosity refers to adherence to the beliefs and practices of an organized church or religious institution (Shafranske & Malony, 1990, p. 72). Spirituality describes the transcendental relationship between the person and a Higher Being, a quality that goes beyond a specific religious affiliation (Peterson & Nelson, 1987).

Considering that we recently reviewed research on mystical experiences in a previous Research Review (Lukoff & Lu, 1988), and that studies on meditation have been comprehensively reviewed by Murphy and Donovan (1988), we have focused on the topics of mystical experience and meditation in this review. Although they are clearly related to psychospiritual dimensions of healing, we chose to focus on less well-known aspects, including the spirituality of the general public and mental health professionals, phenomenology of psychospiritual life, assessment of spirituality, social dimensions of psychospiritual health, and treatment of psychospiritual problems. To obtain journal references, we conducted a computerized search of the literature contained in Medline, Psych- INFO, and the Religion Index. Books were located through a search of the reference lists in these articles, and through the authors acquaintance with them.

asearchofMedline, PsychlNFO, Religion Index andauthors sources

SPIRITUALITY OF THE GENERAL PUBLIC AND MENTAL HEALTH PROFESSIONALS

In the previous Research Review (Lukoff et al., 1992), we abstracted research documenting the existence of a religiosity gap between the general public and mental health professionals. Mental health professionals place far less importance on religion than do the general public and patient populations. Psychiatrists and psychologists are relatively uninvolved in religion, and 50-60% describe themselves as atheists or agnostics in contrast to 1 -5% of the population. However, the studies abstracted below indicate that there is not a comparable spirituality gap between the experiences, beliefs and practices of mental health professionals and those of the public.

Shafranske, E. P. & Gorsuch, R. L. (1984). Factors associated with the perception of spirituality in psychotherapy. Journal of Transpersonal Psychology, 16(2), 231-41.

Method: A survey was sent to 1400 members of the California State Psychological Association. The return rate was 29%. Findings: While only 23% of the sample reported themselves to be committed to a

Transpersonal Psychology Research Review: Psychospiritual Dimensions of Healing 13

traditional religious institution, 33% indicated that they were involved in an alternative spiritual path that was not part of a religious institution. The psychologists indicated a high level of agreement with the statement: Spirituality has direct relevance to my personal life. The authors concluded that while these psychologists were less religious in terms of affiliation and participation in traditional religious institutions than the general population, most perceived spirituality as important in their lives. However, the context in which this spirituality is experienced, i.e., the form of participation, and the belief orientation, is found primarily outside mainstream religion (p. 237).

Shafranske, E. P. & Malony, H. N. (1990). Clinical psychologists religious and spiritual orientations and their practice of psychotherapy. Psychotherapy, 27, 72-78.

Method: A sample of 1000 randomly selected psychologists from the APA Division of Clinical Psychology were sent a 65-item questionnaire. 409 were returned. Findings: While only 18% agreed that organized religion was the primary source of their spirituality, 51% characterized themselves as following an alternative spiritual path which is not a part of an organized religion. Spirituality was reported to be personally relevant by 65% of the psychologists. The authors concluded: The findings . . . and the limited training which clinicians report to receive, point to the need for the profession to reflect upon its fundamental attitudes towards religion and spirituality (p. 78).

In the Allman, de la Roche, Elkins and Weathers (1992) study abstracted below, 64% of the psychologists surveyed responded none when asked how many religious services they attended per month, but 66% rated spirituality as important or very important. This study also found that 50% of the psychologists reported personally having a mystical experience, which is significantly higher than the 30-40% incidence of mystical experiences in the general population (Lukoff & Lu, 1988).

Another survey (Bergin & Jensen, 1990) of psychiatrists, psychologists, social workers and marriage and family counselors found that 68% endorsed the item indicating that they: Seek a spiritual understanding of the universe and ones place in it. The authors concluded: There may be a reservoir of spiritual interests among therapists that is often unexpressed due to the secular framework of professional education and practice (p. 3). They named this phenomenon spiritual humanism and indicated that it could provide the basis for bridging the cultural gap between clinicians and the more religious public.

phenomenology of psychospiritual life

The long tradition of phenomenological exploration of religious and spiritual experience includes such turn-of-the-century classic


studies as Buckes (1961) Cosmic Consciousness and James (1961) The Varieties of Religious Experience. Ottos (1923) The Idea of the Holy is also a seminal study, and more recent works have been published by Jung, Maslow, Wilber, and Grof. Most of these were theoretical; only recently have empirical techniques been brought to bear on this subject. Below is one example of an empirical methodology applied to the phenomenology of psychospiritual lifein this case involving children.

Coles, R. (1990). The spiritual life of children. Boston: Houghton Mifflin.

Method: The author described his approach as contextual; it aims to learn from children as they go about their lives: in the home, the playground, the classroom, the Hebrew school or Sunday school (p. 342). He combined elements from several human science methodologies. For example, he engaged in participant-observation by conducting his study in both public and private places. For example, in his work with Hopi children, he began his study in a school, but even after 6 months, the children were taciturn, almost sullen in interactions with him. Finally a Hopi mother told him the children would always behave that way in the school; he needed to go to their homes: When I went to Hopi homes, there was no sudden miracle. But . . . within a month or two the children did seem altogether different. They smiled; they initiated conversations; they pointed out to me places that mattered to them . . . they gave me some memorable thoughts that crossed their minds (p. 25). He also incorporated in-depth, unstructured phenomenological interviewing, but often let the interviewee take the initiative: I let the children know as clearly as possible, and as often as necessary, what it is I am trying to learn, how they can help me (p. 27). In addition, he utilized content analysis to uncover themes that recur in the interviews. Finally, he also collected and analyzed 293 samples of artwork drawn in response to his request for children to draw a picture of God. His research is notably cross-cultural with Hopi, Chicano, Afro-American, Islamic, Jewish, and Christian (as well as other groups) represented. Findings: This book is rich with vignettes illustrating childrens views and experiences of God and spirituality and their ways of understanding the ultimate meaning of their lives. Individual chapters addressed the face of God, the voice of God, psychological themes, visionary moments, Christian, Jewish, Islamic, and secular soul-searching (by which he means outside of an organized churchwhat we are calling spiritual in this review). Coles seemed able to get at the heart of these childrens spiritual lives. A portion of a conversation with a 10-year-old Hopi girl he had known for almost two years nicely illustrates the nature of his approach:

The sky watches us and listens to us. It talks to us, and it hopes we are ready to talk back. The sky is where the God of the Anglos lives, a teacher told us. She asked where our God lives. I said, I dont know.I was telling the truth! Our God is the sky, and lives wherever the skyis . . .

Did she explain the above to the teacher?


No.

Why?

Bccauseshe thinks God is a person. If Id told her, shed give us that smile . . . that says to us, You kids are cute, but youre dumb; youre differentand youre all wrong! (p. 25).

Other phenomenological studies of the manner in which children think of, artistically represent, and in their minds address God are Visions of Innocence (Hoffman, 1993), The Childrens God (Heller, 1986) and Picturing God (Belford, 1986).

ASSESSMENT OF SPIRITUALITY

Most of the instruments that purport to measure spirituality would be considered measures of religiosity by the definition used in this review. With the notable exception of the Spiritual Orientation Scale, the scales described below contain many items involving experiences with or beliefs about God. Scales were included in this review if they used the term God in a non-denominational way that is not oriented toward the beliefs of any particular sect. Of course, by virtue of the use of theistic terminology, the scales below would be most appropriate for members of Judaeo-Christian or Islamic faiths, but could also be used to assess the spirituality of nonmembers who had mono-theistic orientations. They would not be as sensitive to the spirituality of members of non-theistic paths (e.g., Buddhism) or of pagans who believe in multiple deities. Other scales were excluded from this review because they specifically address Christian religiosity (e.g., Mobergs [1984] Spiritual Well-being Questionnaire.) (See Butman [1990] for a review of instruments for assessing religious development.)

The first scale to be reviewed, the Spiritual Orientation Inventory (SOI), specifically attempted to be sensitive to the spirituality of those not affiliated with traditional religion.

Elkins, D., Hedstrom, L., Hughes, L., Leaf, J., & Saunders, C. (1988). Toward a humanistic-phenomenological spirituality. Journal of Humanistic Psychology, 28(4), 5-18.

Method: The authors began by interviewing five persons whom they considered to be highly spiritual. The interviewees gave support to a nine-dimension model of spirituality including: Transcendence, Meaning and Purpose in Life, Mission in Life, Sacredness of Life, Material Values, Altruism, Idealism, Awareness of the Tragic, and Fruits of Spirituality. The interviewees ratings of items led to a first draft of the scale that contained 157 Likert-like items evaluating the subjects relationship with a transcendent, spiritual dimension and about the experience of sacredness in their life. The term God was not used in


the items. A validity study in which the ratings of 24 adults nominated by a panel as highly spiritual were compared with scores of 96 graduate students in psychology led to the final version with 85 items. Reliability (alpha) was reported to range from .75-.94 on the nine scales. Findings: In the original study, the scores of the 24 highly spiritual persons were significantly higher than the scores of the 96 graduate students on 8 of the 9 scales (all but Idealism). (Copies of the SOI can be obtained by writing Sara Elkins, 33442 Cape Bay Place, Dana Point, CA 92629.)

This scale has also been used in some doctoral dissertations. Smith(1991) compared the scores of 172 polio survivors with 80 non-polio subjects. Her prediction that the polio survivors would have higher scores was confirmed. The full-scale score was significantly higher, as were scores on 8 of the 9 scales (again all but Idealism). Another study by Lee and Bainum (1991) compared 13 hospice workers with 23 hospital nurses. The prediction that the nurses dealing with death would score higher on the SOI was also confirmed.

The Mystical Experience Scale, which addresses a more specific aspect of psychospiritual life, was developed with considerable attention to psychometric principles. It has been used in numerous studies investigating both religiosity and spirituality (see Lukoff & Lu [1988] for a review).

Hood, R. (1975). The construction and preliminary validation of a measure of reported religious experience. Journal for the Scientific Study of Religion, 14, 29-41.

Method: Utilizing the conceptual categories for mysticism postulated by Stace (1960), the author developed 108 items divided into eight categories: ego quality, unifying quality, inner subjective quality, temporal/spatial quality, noetic quality, ineffability, positive affect, and religious quality. This pilot version was administered to several groups to refine the scale. The scale was reduced to 32 core statements, four for each category, based on item-to-whole consistency coefficients and other considerations. The scale was then administered to 300 college students. Findings: The results were subjected to a factor analysis which suggested two factor scales. Scale 1 (20 items) measured general mysticismnamely, an experience of unity, temporal and spatial changes, inner subjectivity and ineffability. This scale was not restricted to religion and thus referred to a broad type of mysticism. Scale 2 (12 items) measured the subjects tendency to view intense experiences within a religious framework.

The next scale to be reviewed, the Spiritual Well-Being Scale (SWBS) appeared in Ellison (1983) and Paloutzian and Ellison (1982). It has become the most widely used instrument for assessing spiritual well-being, second only to Allport and Rosss (1967) Intrinsic-Extrinsic Religious Orientation Scale in the number of research articles that it has generated. The SWBS consists of 20 Likert items, 10 of which address the religious dimension of ones


relationship to God, and 10 of which deal with a social/existential dimension of a persons adjustment to him/herself, their community, and their surroundings. Ellison and Smith (1991) published a review of research conducted with the SWBS from 1982-1990. Studies have examined its relationship to physical well-being, adjustment to physical illness, health care, psychological wellbeing, relational well-being, and several religious variables. The richness of these findings supported the validity of the SWBS as a measure of spiritual well-being. Kirschling and Pittman (1989) found high reliabilities of .95, .94, and .84 on the spiritual wellbeing (overall score), existential well-being, and religious wellbeing scales respectively. However, Ledbetter, Smith, Fischer, Vosler-Hunter and Chew (1991) reviewed 17 SWBS studies and found that with religious samples, the SWBS does have ceiling effects, and thus cannot differentiate amongst spiritually active individuals. In addition, Ledbeter et al. (1991) also questioned the two-factor conceptualization of the SWBS. They administered the scale to two religious samples and factor analyzed the results:

The fit was quite poor for both the one- and two-factor models. Although the two-factor model was superior to the one-factor model, neither model provided a good conceptualization of the factor structure of the SWBS in these samples. These results suggest that contrary to Ellisons two factor conceptualization, and a postulated general factor model, the SWBS may be factorily complex. This complexity makes interpretation of scores ambiguous (p. 94).

One noteworthy application of this scale focused on adults with life-threatening illness.

Kaczorowski, J. M. (1989). Spiritual well-being and anxiety in adults diagnosed with cancer. The Hospice Journal, 5(3-4), 105-14.

Method: The author wanted to compare the level of anxiety in highly spiritual persons and in less spiritual persons confronting life-threatening illness. In a correlational study, the SWBS and the State-Trait Anxiety Inventory (which differentiates between transitory and characteristic anxiety) were administered to 114 adults who had been diagnosed with cancer. Findings: A correlation of -.44 was obtained between the SWBS and the State-Trait Anxiety Inventory in the whole sample (p

mind, and spirit. Their awareness of the spiritual dimension in caring for patients was particularly apparent in the accepted nursing diagnostic classification system (Carpenito, 1983), which includes categories for spiritual concerns, spiritual distress, and spiritual despair. In addition to numerous articles addressing guidelines for spiritual assessment (Peterson & Nelson, 1987; Soeken & Carson, 1987; Stoll, 1979), there has even been research examining the extent to which nurses assess their patients spiritual needs.

Boutell, K. A. & Bozctt, F. W. (1990). Nurses assessment of patients spirituality: Continuing education implications. Journal of Continuing Education in Nursing, 21(4), 172-76.

Method: To determine the extent to which nurses assessed patients spiritual needs and the indicators of spirituality used in the assessment, the Boutclls Inventory for Identifying Nurses Assessment of Patients Spiritual Needs was developed. This is a 76-item survey divided into: (1) demographic data; and (2) five sections involving the methods of data gathering that nurses use to determine patients' spiritual needs, religious practices, and need for additional spiritual support. The Inventory was sent to 817 nurses eligible to practice nursing in Oklahoma, yielding 238 useable questionnaires. Findings: 34% of the nurses reported that they often or always assessed their patients spiritual needs, and 38% did so occasionally. The remainder (28%) seldom or almost never did. These findings indicate that the majority of nurses assessed their patients spiritual needs to a considerable extent. Two factors that were found to determine whether nurses carried out a spiritual assessment were patient acuity and setting. The components of spirituality most commonly assessed were fears of medical procedures, sources of inner strength, feelings of hope, and religious practices related to surgery and/or death. Least frequently assessed were integration (the unifying force in self) and transcendence (rising above worldly values). The authors concluded that in-service education and CE programs in the area of spirituality are needed, with older, more experienced nurses as well as psychiatric nurses playing a central role.

Below we describe five additional scales that have not received as extensive field testing as the ones above. Most have been developed for specific types of patients, including recovering alcoholics, hospitalized adolescents, terminally ill adults, and persons experiencing extraordinary events (e.g., near-death experiences and UFO encounters).

Brown, H. P. & Peterson, J. H. (1991). Assessing spirituality in addiction treatment and follow-up: Development of the Brown- Peterson Recovery Progress Inventory (B-PRPI). Alcoholism Treatment Quarterly, 8(2), 21 -50.

Method: The authors set out to design an instrument to assess spiritual practices associated with recovery and Alcoholics Anonymous (AA). Based on lengthy interviews with seven members of AA, they constructed a Likert scale questionnaire with 60 items covering behaviors, cognitions, attitudes, and chemical usage. It was administered to


36 AA members who rated the importance of each item to recovery and to 12-step spirituality. Based on these results, a final version of the B- PRPI with 53 items was created. Findings: The B-PRPI was administered to additional AA members, and scores were not found to be correlated with length of sobriety. However, it was significantly correlated with the Beck Depression Inventory, the Tennessee Self-Concept Scale, Scales K, D, Pt, Sc, A, and Es of the MMPI, and six scales of the Profile of Mood States. Pre/post scores of 15 patients in a treatment program showed significant change. In addition, the authors found a remarkable consistency in our subjects reported use of a broad range and large number of spiritual practices.

Corrington, J. E. (1989). Spirituality and recovery: Relationships between levels of spirituality, contentment and stress during recovery from alcoholism in A A. Alcoholism Treatment Quarterly, (5(3/4), 151- 65.

Method: This study explored the relationships between four variables: (I) time in AA; (2) level of spirituality; (3) level of contentment; and (4) stressors encountered in the past year. Three separate measurement instruments were administered to 30 volunteers from AA meetings in Columbia, Maryland. The Spirituality Self-Assessment Scale (SSAS), a 35-item questionnaire designed by Whitfield (1984, 1993), was used to measure an individuals level of spiritual experience and his/her level of spiritual awareness. Questions covered the physical, emotional, and mental aspects of spiritual experience, with an emphasis on the emotional. The Hudson Generalized Contentment Scale and the Life Events Scale were used to assess level of contentment and level of stressors encountered in the preceding year, respectively. Findings: Regression analysis revealed a direct relationship between the level of spirituality and the level of contentment with life, regardless of the amount of time in AA. This suggested that the amount of time in AA is not as important as what an individual does with that time in relation to spirituality during recovery. Additional findings suggested that continued attendance at AA meetings could provide an effective stress management program for recovering alcoholics. (The most current SSAS can be ordered by calling (800) 851-9100; ask for Whitfield, 1993.)

Silber, T. J. & Reilly, M. (1985). Spiritual and religious concerns of the hospitalized adolescent. Adolescence, 20(11), 217-23.

Method: The authors created a Spiritual and Religious Concerns Questionnaire (SRQ) with 17 items in order to study the concerns of medically hospitalized adolescents. It was not piloted or evaluated for reliability or validity. Findings: More seriously ill adolescents had higher scores than less ill subjects. Weekly administrations of the SRQ showed that almost 50% of the adolescents with severe, perhaps fatal, illness experienced marked intensification of their spiritual concerns.

Kass, J. D., Friedman, R., Leserman, J., Zuttermeister, P. C. & Benson, H. (1991). Health outcomes and a new Index of Spiritual Experience. Journal for the Scientific Study of Religion, 30(2), 203-11.


Method: To explore the relationship between spiritual experiences, life purpose and satisfaction, and improvement in physical health, the Index of Spiritual Experience (INSPIRIT) was developed. This scale measured two characteristic elements of core spiritual experiences (i.e., reported spiritual experiences described in more concrete terms than a belief in God). Those two elements are (1) a distinct event and a cognitive appraisal of that event which resulted in a personal conviction of Gods existence (or of some form of Higher Power as defined by the person), and (2) the perception of a highly internalized relationship between God and the person (i.e., that God dwells within combined with a feeling of closeness to God). The study sample consisted of 83 adult outpatients in a behavioral medicine program where patients were taught to elicit the relaxation response in a 10-week treatment program for the stress-related components of illness. In addition to the INSPIRIT scale, subjects were given the Medical Symptom Checklist, the Inventory of Positive Psychological Attitudes to Life, and the Religious Orientation Inventory. Findings: The INSPIRIT scale showed a strong degree of internal reliability and concurrent validity. Multiple regression analyses showed a relationship between core spiritual experiences and (1) an increase in life purpose and satisfaction, (2) an increase in a health-promoting attitude, and (3) a decrease in frequency of medical symptoms. In addition, data suggested that elicitation of the relaxation response may facilitate an increased occurrence of core spiritual experiences.

Reed, P. (1987). Spirituality and well-being in terminally ill hospitalized adults. Research in Nursing and Health, 10, 335-44.

Method: Using three groups of 100 adults matched on age, gender, education and religious background, two hypotheses were examined: (1) terminally ill hospitalized adults indicate a greater spiritual awareness than nonterminally ill hospitalized adults and healthy non- hospitalizcd adults; and (2) spiritual perspective is positively related to well-being among terminally ill hospitalized adults. All 300 participants completed the Spiritual Perspective Scale (SPS), Index of Well- Being, and other questions. The SPS is a 10-item Likert questionnaire assessing the extent to which spirituality permeates an individuals life and he/she engages in spiritually-related interactions (e.g, talking with family or friends about spiritual matters). Findings: The results from planned comparisons supported the first hypothesis, and a low but significant correlation lent support to the second hypothesis. In addition, differences among groups on recent change in spiritual views were examined. A significantly larger number of terminally ill adults indicated a change toward increased spirituality than did nonterminally ill or healthy adults.

Ring, K. (1992). The Omega Project: Near-Death Experiences, UFO Encounters, and Mind at Large. New York: William Morrow & Co.

Methods: Having established himself as one of the worlds foremost authorities on near-death experiences (Ring, 1984), Ring took his research a step further by exploring the surprising parallels between UFO encounters and near-death experiences (NDEs). He initially


focused on factors that predispose certain individuals to having extraordinary experiences like UFO encounters and NDEs. The first factor he examined, using his Psychophysical Change Inventory, was the psychophysical changes following an extraordinary encounter. Then he revised his Life Change Inventory (LCI) from Heading Toward Omega (1984) to explore belief and values shifts following extraordinary encounters. The LCI is a 50-item questionnaire that examines 9 principal value clusters: (1) appreciation for life; (2) selfacceptance; (3) concern for others; (4) concern for impressing others; (5) materialism; (6) concern with social/planetary issues; (7) quest for meaning; (8) spirituality; and (9) religiousness. Findings: Ring uncovered a similar psychological profile for individuals experiencing both UFO encounters and NDEs. He called this profile the encounter- prone personality, characterized by (1) a sensitivity to non-ordinary realities, (2) a history of childhood abuse and trauma, and (3) a dissociative tendency closely linked to psychological absorption. He then documented the startling similarities in the aftereffects produced by UFO encounters and NDEs: (1) a similar pattern of psychophysical transformation occurred in both UFO encounters and NDEs; (2) both UFO encounters and NDEs lead to a similar kind of spiritual transformation. The latter is characterized by greater altruism, social concern, appreciation for life, self-acceptance, concern for others, quest for meaning, and spirituality, and a decrease in materialism. Finally, he concluded his book with several chapters exploring the collective implications of extraordinary experiences, particularly with regard to global ecology and the evolution of consciousness.

SOCIAL DIMENSIONS OF PSYCHOSPIRITUAL HEALING

Some research has targeted the social dimensions of healing, focusing on spiritual support, healing groups, and the role of spirituality in family crisis resolution.

Maton, K.I. (1989). The stress-buffering role of spiritual support: Cross-sectional and prospective investigations. Journal for the Scientific Study of Religion, 28(3), 310-23.

Method: The relationship of spiritual support (perceived support from God) to well-being was examined in two high and low life-strcss samples: (1) in recently bereaved (high stress) and less recently bereaved (low stress) parents attending Compassionate Friends mutual help groups; and (2) in college freshman who had experienced three or more uncontrollable, stressful life events (high stress) and those who had experienced two or fewer such events (low stress) during the previous six months. A three-item spiritual support measure assessing emotional, intimacy and faith aspects of spiritual support was used in both studies. Social support variables were also assessed, allowing a comparison of the relative predictive utility of the two different domains of perceived support. Findings: With demographic variables controlled, regression analyses indicated that: (1) spiritual support was inversely related to depression and positively related to self-esteem for high life-stress (recently bereaved) parents; and (2) in a prospective,


longitudinal analysis controlling for pre-college depression, spiritual support was positively related to personal-emotional adjustment for first-semester college freshman in the high life-stress group. Spiritual support was not significantly related to well-being for low life-stress subsamples.

Glik, D. C. (1988). Symbolic, ritual and social dynamics of spiritual healing. Social Science and Medicine, 27(11), 1197-1206.

Method: The investigator spent two years conducting participant- observation research among members of 30 healing groups in the Baltimore metropolitan area. She attended group meetings and healing rituals, administered a questionnaire to members, and also conducted in-depth interviews with 23 leaders of these groups. Findings: Groups were categorized into two types: 1) Christian, Pentecostal, or charismatic healing groups (CHGs); and 2) New Age or metaphysical healing groups (MHGs). Both groups were small (6-15 members) and were informally rather than formally organized. Both had a family-like atmosphere. However, in the CHGs, the structure of the organization was more authoritarian and stratified, with the leader in control of events. In contrast, the MHGs were more democratic and spontaneous with members helping in the conduct of rituals and the healing of others. MHDs had more matriarchal leadership patterns (10 of 13 leaders were women), whereas all except one of the CHGs were led by men. The CHGs had ideologies based on Fundamentalist, Pentecostal or neo-Pentecostal movements. MHGs ideologies were more syncretic, having their origins in Spiritualist, New Age, New Thought, theosophical, occult or shamanistic traditions. Symbols and myths used in the healing rituals of the CHGs involved the death of Jesus and his subsequent resurrection. A variant of this myth appeared in the MHGs as the Souls journey toward enlightenment, a belief derived from Eastern traditions. Generally CHG rituals were noisy, dramatic, and expressive . . . including Bible reading, group prayer, hymn singing, and sermons lead by the healer. . . . Members of MHGs attempt to tune in to a transcendent reality, usually through meditation practice. . . . Other commonly used techniques in these groups were guided imagery or visualization, chanting, or therapeutic touch (pp. 1202-3).

Hall, C. M. (1986). Crisis as opportunity for spiritual growth. Journal of Religion and Health, 25(1), 8-17.

Method: Longitudinal life history data from 200 crisis families and 200 non-crisis families were examined to specify the influence of crisis conditions on spiritual growth. Data were collected from in-depth interviews conducted over a several year period and covering three generations of family members. Findings: Results indicated that the most substantial impact of crisis intervention occurred in families where one or more family members reoriented their lives according to spiritual values. This reorientation process involved a shift in focus away from the familys previously-held perception that they were victims of social or emotional circumstances. A more universal view, which included transcendent realities, provided these people with a frame of reference that allowed them to cope with the objectively


difficult empirical conditions of their existence. This new-found emphasis on spiritual values appeared crucial in enabling these people to experience more productive and satisfying lives. These findings suggest that a crisis may produce constructive changes in life orientation and become an important catalyst in reordering personal values.

TREATMENT OK PSYCHOSPIRITUAL PROBLEMS

In this last area to be reviewed, we have chosen articles covering the treatment of mystical experiences, the similarities and differences between spiritual directors and psychotherapists, a psychotherapy case of spiritual emergency, the use of biofeedback with Navajo substance abusers, and the role of spirituality for professionals working with the terminally ill.

Allman, L. S., de la Roche, O., Elkins, D. N. & Weathers, R. S. (1992). Psychotherapists attitudes towards clients reporting mystical experiences. Psychotherapy, 29(4), 564-69.

Method: Questionnaires were sent to 650 members of the American Psychological Association to assess therapists attitudes toward clients who report mystical experiences. The return rate was 44%. In addition to demographic data, the survey included a Likert scale measuring attitudes toward mystical experience and a scale to assess the therapists diagnostic judgments of mystical experience on a continuum from possibly psychotic to probably not psychotic. Findings: The therapists reported that among the 20,670 clients seen in the preceding 12 months, 4.5% had reported a mystical experience during the previous year; 67% of the therapists had seen at least one such client during that period. On the diagnosis scale, humanistic/existential therapists were less likely than behavioral, cognitive and psychodynamic therapists to rate clients who had mystical experiences as psychotic. Furthermore, therapists who rated spirituality as important were less likely to view their clients mystical experiences as pathological.

Ganje-Fling, M. A. & McCarthy, P. R. (1991). A comparative analysis of spiritual direction and psychotherapy. Journal of Psychology and Theology, 19(I), 103-17.

Method: One hundred psychotherapists from a state psychological organization and 100 spiritual directors from retreat centers were sent surveys. Fifty psychotherapists and 68 spiritual directors responded. Findings: There was considerable overlap in the techniques, topics of discussion, and outcome evaluation methods employed by both the psychotherapists and spiritual directors. The goals seemed to be the most distinct; that is, the purpose of psychotherapy is psychological growth, and the purpose of spiritual direction is spiritual growth. There was no significant difference between the two groups in their reported use of self-disclosure, open and closed questions, advice, confrontation and interpretation. However, the spiritual directors reported using more meditation, prayer, and silence. Both groups deal with psychological issues, but spiritual directors more often address spiritual is


sues. There was no difference between the groups in receiving psychotherapy, but the spiritual directors had received spiritual direction significantly more often. While all of the psychotherapists had received degrees in psychology, only 3% of the spiritual directors had. Conversely, none of the psychotherapists had received training or formal education in spirituality or theology.

Hendlin, S. J. (1985). The spiritual emergency patient: Concept and example. In E. M. Stem (Eds.), Psychotherapy in the religiously committed patient, pp. 79-88. New York: Haworth Press.

Method: The author presents a case study including the history, symptoms, and treatment of a 32-year-old man in a spiritual emergency. Both severe depression and suicidality were present. Findings: The patient had been participating in a spiritual group that practiced intense meditation. His commitment to the group led to marital difficulties. Hendlins treatment addressed the clients problem as a depressive disorderbut within a spiritual framework. Treatment began with meetings 4 times a week and were gradually reduced to twice a week after 3 months. The therapy focused on aspects of his spiritual experiences, and his meditation practice was changed to one that was more grounding. Marital therapy was initiated after about 100 hours of individual therapy. The crisis was resolved without any acting out of the suicidal ideation and the patient reported less depression. He was able to resume his business and re-connect with family.

Other case studies illustrating the treatment of spiritual issues in clinical work include Grof and Grof (1989), Lukoff (1991), Lukoff and Everest (1986), Podvoll (1990), and Nelson (1990).

Kelley, M. (1991). Brainwave biofeedback for substance abuse: The development of a Navajo alcohol abstinence empowerment program. Sedona, AZ: Navajo Nation Department of Behavioral Health.

Method: Twenty Navajo patients on an in-patient substance abuse unit were given biofeedback training involving two 45-minute sessions per day, averaging a total of 35 training sessions. Theta and alpha brainwaves were monitored and the patients were given feedback tones through headphones. Previous research had shown that many alcoholic patients have low alpha and theta frequency brainwaves. Findings: The author reported that the Navajo patients found the biofeedback training to be compatible with their beliefs and practices, especially since techniques such as breath patterning and meditation were, or still are, important components of some Navajo medicine way techniques (p. 13). In addition, to increase the acceptance and effectiveness of the brainwave training, patients were encouraged to keep protection feathers on their laps, and the faint smell of blessing way sage smoke permeated the treatment room. During the follow-up period of 4 months, 15 of the 20 patients reported no alcohol usage. Four could not be located, and one relapsed. Eighty percent of the patients showed significant improvements of at least 15% increase in wave amplitude or synchrony over their baseline EEG measurements in either theta or alpha ranges. Scores on the Beck Depression Inven


tory also improved, but the absence of a comparison group does not allow this finding to be attributable to the biofeedback training. During the 8-month trial, more than 13 Navajo therapists expressed interest in learning these procedures. (Copies of the report are available from the author: P. O. Box 2163, Sedona, AZ, 86336.)

Millison, M. B. (1988, March/April). Spirituality and the caregiver: Developing an underutilized facet of care. American Journal of Hospice Care, 37-44.

Method: In order to examine the role that spirituality plays for the caregiver, open-ended interviews were conducted with eight caregivers (two physicians, two nurses, two social workers, and two clergy); all were experienced in working with the terminally ill. Each respondent was asked to discuss his/her own spirituality, describe how he/she thought that it might impact patients being treated, and to give examples where spirituality was a factor in treatment. Findings: All respondents acknowledged the heightened spirituality experienced . . . as a result of their work with the terminally ill, and the impact that it has upon the patient. . . . [They] felt they received more from their patients than they were able to give.

CONCLUSION

This Research Review completes the second part of our three-part series addressing various dimensions of healing. We have been impressed by the scope and accelerating interest in these topics by researchers. Although we have considered studies conducted since 1980, most of the articles abstracted are from the past five years. By focusing on methodologies and instruments appropriate for studying transpersonal experiences, we hope that these reviews will facilitate further exploration of these crucial domains of human existence.

In addition to the psychoreligious and psychospiritual dimensions, there is another dimension that falls outside of these two categories. Experiences such as UFO encounters, out-of-body experiences, and paranormal phenomena, which in many cases are associated with healing and/or transformation, have challenged us to consider a new category. In conformance with the most recent literature, we have settled on the term anomalous experience as the most inclusive, yet with the fewest theoretical assumptions and pejorative connotations. In our next Research Review, we will examine Anomalous Experiences and Healing.

REFERENCES

Allman, L. S., de la Roche, O., Elkins, D. N. & Weathers, R. S. (1992). Psychotherapists attitudes towards clients reporting mystical experiences. Psychotherapy, 29(4), 564-69.


Allport, G. W. & Ross, J. M. (1967). Personal religious orientation and prejudice. Journal of Personality and Social Psychology, 5, 432-43.

Belford, A. (1986). Picturing God. Cambridge: Cowley Press.Bergin, A. & Jensen, J. (1990). Religiosity of psychotherapists: A national

survey. Psychotherapy, 27, 3-7.Bucke, R. M. (1961). Cosmic consciousness: A study in the evolution of

the human mind. Secaucus, NJ: Citadel Press.Butman, R. E. (1990). The assessment of religious development: Some

possible options. Journal of Psychology and Christianity, 9(2), 14-26.Carpenito, L. (1983). Nursing diagnosis: Application to clinical practice.

New York: J. B. Lippincott.Eisenberg, D., Kessler, R., Foster, C., Norlock, F., Calkins, D., &

Delbanco, T. (1993). Unconventional medicine in the United States. The New England Journal of Medicine, 328, 246-52.

Ellison, C. W. (1983). Spiritual well-being: Conceptualization and measurement. Journal of Psychology and Theology, II, 330-40.

Ellison, C. W. & Smith, J. (1991). Toward an integrative measure of health and well-being. Journal of Psychology and Theology, 19(1), 35-48.

Goleman, D. (1991, September 10). Therapists see religion as an aid, not illusion. New York Times, p. Cl, 8.

Grof, S. & Grof, C. (Ed.). (1989). Spiritual emergency: When personal transformation becomes a crisis. Los Angeles: J. P. Tarcher.

Heller, D. (1986). The children's God. Chicago: Univ. of Chicago Press.James, W. (1961). The varieties of religious experience. New York:

Collier.Hoffman, E. (1993). Visions of innocence: Spiritual and inspirational

experiences of childhood. Boston: Shambhala Publications.Kirschling, J. M. & Pittman, J. F. (1989). Measurement of spiritual well

being: A hospice caregive sample. The Hospice Journal, 5(2), 1-11.Krippner, S. & Welch, P. (1992). Spiritual dimensions of healing. New

York: Irvington Press.Larson, D., Hohmann, A., Kessler, L., Meador, K, Bovd, J. &

McSherry, E. (1988). The couch and the cloth: The need for linkage. Hospital and Community Psychiatry, 39( 10), 1064.

Larson, D., Sherrill, K., Lyons, J., Cragie, F., Thielman, S., Greenold, M., & Larson, S. (1992). Associations between dimensions of religious commitment and mental health reported in the American Journal of Psychiatry and Archives of General Psychiatry: 1978-1989. American Journal of Psychiatry, 149(A), 557-59.

Ledbetter, M., Smith, L., Fischer, J., Vosler-Hunter, W., & Chew, G. (1991). An evaluation of the construct validity of the Spiritual Well- Being Scale: A confirmatory factor analytic approach. Journal of Psychology and Theology, 19(1), 94-102.

Lee, J. R. & Bainum, B. (1991). Spiritual orientation in hospital workers, crisis help workers, and college students. Unpublished study. Northern Pacific Union College.

Lukoff, D. (1991). Divine madness: Shamanistic initiatory crisis and psychosis. Shaman's drum, 22, 24-29.

Lukoff, D. & Everest, H. C. (1986). The myths in mental illness. The Journal of Transpersonal Psychology. 17(2), 123-53.

Lukoff, D. & Lu, F. (1988). Transpersonal psychology research review topic: Mystical experience. Journal of Transpersonal Psychology, 20, 161-84.

Lukoff, D., Lu, F. & Turner, R. (1992). Toward a more culturally


sensitive DSM-IV: Psychoreligious and psychospiritual problems. Journal of Nervous and Mental Disease, 180(11), 673-82.

Lukoff, D., Turner, R. & Lu, F. (1992). Transpersonal psychology research review: Psychoreligious dimensions of healing. Journal of Transpersonal Psychology, 24( 1), 41-60.

Mathews, D. A. & Larson, D. B. (1992). A bibliography of research by scientists on spiritual subjects. Arlington, VA: National Institute for Healthcare Research.

Moberg, D. O. (1984). Subjective measures of spiritual well-being. Review of Religious Research, 25(4), 351-59.

Murphy, M. & Donovan, S. (1988). The physical and psychological effects of meditation: A review of contemporary meditation research with a comprehensive bibliography 1931-1988. San Rafael, CA: Esalen Institute Study of Exceptional Functioning.

Nelson, J (1990). Healing the split, madness or transcendence?: A new understanding of the crisis and treatment of the mentally ill. Los Angeles, CA: Jeremy P. Tarcher.

Otto, R. (1923). The idea of the holy. London: Oxford University Press.Paloutzian, R. & Ellison, C. (1982). Loneliness, spiritual well-being, and

quality of life. In L. A. Peplau & D. Perlman (Eds.), Loneliness: A sourcebook of current theory, research and therapy. New York: W iley-Inter-Science.

Peterson, E. A. & Nelson, K.. (1987). How to meet your clients spiritual needs. Journal of Psychosocial Nursing, 25(5), 34-39.

Podvoll, E. M. (1990). The seduction of madness. New York: Harper.Randour, M. L. (Ed.). (1993). Exploring sacred landscapes religious and

spiritual dimensions in psychotherapy. New York: Columbia University Press.

Ring, K. (1984). Heading towards omega. New York: William Morrow.Shafranske, E. P. & Malony, H. N. (1990). Clinical psychologists

religious and spiritual orientations and their practice of psychotherapy. Psychotherapy, 27, 72-78.

Smith, D. W. (1991) A study of power and spirituality in polio survivors using the nursing model of Martha E. Rogers. Doctoral Dissertation, New York University.

Soekf.n, K. L. & Carson, V. J. (1987). Responding to the spiritual needs of the chronically ill. Nursing Clinics of North America, 22(3), 603-11.

Stace, W. T. (1960). Mysticism and philosophy. Philadelphia: J. B. Lippincott.

Stoll, R. I. (1979, Sept.). Guidelines for spiritual assessment. American Journal of Nursing, 1574-77.

Whitfield, C. L. (1984). Stress management and spirituality during recovery. Alcoholism Treatment Quarterly, /(l), 3-54.

Whitfield, C. L. (1993). My recovery plan for stage 3: Spirituality. Deerfield Beach FL: Health Communications.

Witer, R., Stock, W., Okun, M. & Haring, M. (1985). Religion and subjective well-being in adulthood: A quantitative synthesis. Review of Religious Research, 26, 332-42.

Requests for reprints to: David Lukoff, Ph.D., Saybrook Institute, 1550 Sutter Street, San Francisco, California 94109.


REFLECTIONS OF SHAKTIPAT: PSYCHOSIS OR THE RISE OF KUNDALINI? A CASE STUDY

Jon OssoffGlen Oaks, New York

None of us had ever seen anything like it. It seemed to go on and on. Bouncing, hopping, springing off her feet, she seemed motivated by some external force, driven. The breath rapid, drawn in and out in quick machine-gun bursts, her fingers clicking, snapping in stereotypic movements over and over again. The eyes rolled back and in, the whites showing, then the hopping would take over again.

Later we all tried to shrug it off as just another strange psychotic reaction. After all, it was Friday and a long Labor Day weekend was beginning. But by Tuesday, after returning to the hospital, my suspicions had turned to certainty. This woman was not psychotic, and what we had witnessed on Friday was not a psychotic episode, but was in fact, a Kundalini Awakening.

There was nothing extraordinary about her, nothing to suggest other than another patient brought to our admission unit due to an acute psychotic episode. They come in all the time: four, five, sometimes eight each weektheir stories thematically similar too much crack cocaine, refusing to take their anti-psychotic medication, picked up by the police on the streets, assaulted somebody. And so, initially, I assumed it was the same with her.

There were some differences. She (I will call her Rosita) was from Mexico, in her early thirties, pretty, slim, carelessly dressed, brought to the psychiatric center for bizarre behavior. It was reported she was running about a hotel without clothing, after having attended a conference in New York three days before. The report also stated she said people from other planets were after her. Rosita had no previous hospitalizations (very rare for the patients


justanotherstrangepsychoticreaction?


itseemed

she had

undergone a brief

reactive psychosis

we see). It was also reported she had not slept in three days and was confused. Selectively mute was also noted and with good reason. Rosita did not speak even in response to simple questions posed in Spanish and not even to her boyfriend who visited her that first day. She continually looked at him and at me but appeared so withdrawn, so lost as to be nearly catatonic.

Her boyfriend was naturally concerned. He spoke English haltingly, but well enough to address most questions. He stated she had never had a psychiatric problem such as this. Yes, she had been depressed on and off beginning ten years ago when her father died, but she had never needed or seen a therapist, had never even taken any medication, and had certainly never been so, so, well, look at hershe does not even know me!

Any drug, alcohol use?

No.

Anything stressful, frightening, traumatic recently?

Again he just shook his head and sighed. The psychiatrist told him we would try to stabilize her so that she could fly home to Mexico City as soon as possible, where she could then receive more psychiatric treatment if necessaryand at this time, it certainly appeared necessary. It seemed at the very least she had undergone a brief reactive psychosis in response to some stress or event or combination of events of which she (and apparently everyone else) was unaware.

Rosita seemed to look at me continually. Her mouth had a kind of rigidity to it, open yet frozen to one side, and on several occasions she made an effort to formulate words but could not.

Her psychiatrist had ordered anti-psychotic medication to help reduce the withdrawal, the possible hallucinations, and Rosita had received her first injection that morning. In fact, when her boyfriend had visited, he had expressed concern Rosita was becoming worse, stated she had been better the day before and wondered if she were overmedicated. He was reassured she had been exactly like this since admission, and, in any case, one dose would not cause such a change in behavior. At this point he thanked us, told Rosita he would call her later that day and departed.

Rosita looked at me, then went back into the larger patient area. She appeared no better and no worse than when she came into the unit some fifteen hours before. I left her, assumed other duties, then went to lunch.


When I came back onto the ward, I was greeted with loud noises, jostling, harried voices, nothing completely out of the ordinary for this unit, but worthy of investigation nonetheless. There in a hallway I observed Rosita hopping, bounding upright, springing into walls, with an attendant at her side, doing her best to intervene. Rosita did not appear to be trying to harm herself, but was seemingly unable to co

116514881 the Journal of Transpersonal Psychology Vol 25-1-1993 PDF

Documents

Transcript of 116514881 the Journal of Transpersonal Psychology Vol 25-1-1993 PDF