This article reviavs the professional literature on spiritual emergency, including history of the concept; etiology, features, and course of the phenomenon; differential diagnosis between spiritual mergency and pathological conditions; and professional response to clients in spiritual emergency. A verbatim transcript of a client describing a spiritual emergency illustrates aspects of the phenomenon and evaluates counselor responses. The article concludes with a discussion of the importance of counselor competence ~egarding the phenomenon of spiritual emergency.
The easiest way to be labeled schizophrenic in our society is to let it be known that you feel that in the deepest part of your being you (and all sentient beings) are one with the infinite Spirit, one with the universe, one with the All-an insight that every wisdom culture the world over has held to be not the depths of mental illness but the pinnacle of human understanding. (Ken WiIber as cited in Nelson, 1994, p. viii)
As we prepare for the changes and challenges of the twenty-hrst century, it is now more critical than ever for mental health professionals to possess an awareness of and sensitivity to the diverse spectrum of religous and spiritual issues that may arise in c h c a l settings. With the advent of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV; American Psychatric Association, 1994) category V62.89: Religous and Spiritual Problem, chents' religious and spiritual concerns have been further legtimized as foci of secular counsehg. These concerns may take a variety of forms, including manifestations as well as reports of altered states of consciousness (ASCs; Tart, 1990). ASCs include regressive psychoses for which hospitahation and medication may be appropriate. Another category of ASCs exists, however, that closely resembles the degenerative psychoses but possesses a qualitatively different, progressive nature, as documented by the