Spirituality & Mental Health
Understanding Extreme Spiritual States & How to Care for Them


Six Dynamics
— Presence & Energy
— Spirits
— The Path
— Meaning
— Belonging
— Identity
The Unconscious
Extreme Spiritual Behaviours
Emergence or Emergency?
Care & Intervention

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Reassurance and Safety

The purpose of this booklet is to help the reader better understand extreme spiritual states.  It is written for people experiencing those states and also for their companions and carers.  Our goal is to reassure, create safety and enable positive outcomes.

This booklet is published by the Spiritual Companions Trust. We are very familiar with extreme spiritual states and spiritual crises. This comes from supporting others and from navigating our own challenges. In the context of spiritual development we accept these extreme states as normal.

Although these states are normal, we know that they can also be distressing. They can be distressing for the individual experiencing them and for those around them. Our hope is that everyone will benefit from a better understanding.


This can also be a very sensitive topic. There is a history of spiritual states being misdiagnosed as mental illness. There are also cultural challenges. What is normal behaviour in one culture can be abnormal in another. Bliss, ecstasy, despair, shaking, quaking, visions, retreat, asceticism, talking with spirits, gift of tongues, hearing voices.  All these may be acceptable in someone’s home cultures, but frightening or risky in another.

This booklet asserts that to understand and interpret extreme or unusual spiritual states, it is necessary to be culturally inclusive. It is also necessary to appreciate both the psychological and the spiritual dynamics. If we look up a definition of  the word ‘psyche’ we will find: soul, mind, spirit. Both spirituality and psychology explore who we are.

This is a complex and tender subject. To be helpful and accessible we know that we have risked over-simplification. We apologise for that and hope that our approach is supportive and useful.