Acute Religious Experiences as a Way of Seeing Madness
Guest Post by Richard Saville-Smith, PhD
Richard Saville-Smith has a PhD in religious studies from the School of Divinity at the University of Edinburgh, UK, and he is an independent scholar who lives on the Isle of Skye at the edge of the world. Saville-Smith’s three careers began with and were punctuated by madness. After seeking out the low risk routines of business management in London, followed by the high risk atmosphere of a campaigning public relations firm for not-for-profits in Edinburgh, Richard found academia to be a goldilocks playground where ideas have consequences but the stress is less. Richard now seeks to persuade philosophers and scientists to engage more effectively with religious studies in a shared exploration of the role of madness throughout the human story. You can find him on twitter @DrAnamorphosis.
Saville-Smith is the author of Acute Religious Experiences: Madness, Psychosis and Religious Studies (2023, Bloomsbury; hardcover publication date is March 9, 2023; kindle is available for purchase). The book tackles the question of how we are to speak about experiences of the extraordinary/anomalous/extreme. Saville-Smith’s critical re-readings of seminal texts show how 20th-century theoreticians in the humanities ended up sanitizing madness in the study of religions while at the same time psychiatrists degraded religious experiences by reducing mad consciousness to psychosis or dissociation. Saville-Smith introduces explanatory pluralism as a way of recognizing these disciplinary biases and mad studies as a way of negotiating this understanding. By doing so, he seeks to recover the disproportionate significance of madness in shaping the fabric of the human story from both erasure and dismissal.
In this guest post, he introduces the book and the notion of acute religious experiences.
The story of an idea.
Nearly ten years ago I gave a paper to the British Psychological Society, two months prior to the publication of DSM-5. It was titled ‘Releasing the Spirits: The implication of cultural accommodation in DSM 5’ and contrasted the positions of psychiatry and the social sciences, which I understood in terms of power and disciplinary rivalry. In the social sciences, psychiatry is seen as a threat. This is exemplified by the anthropologist Morton Klass in his book Mind over Mind: The Anthropology and Psychology of Spirit Possession:
many anthropologists commonly refer to dissociation as the preferred ‘explanation’ for what the discipline (anthropology) has come to call altered states of consciousness. Unfortunately, this serves only to take us one essentially meaningless remove from “mental illness”, since in psychiatry, the discipline that introduced the term and studied its manifestations, dissociation is almost invariably joined with disorder – that is, mental illness. In other words, the anthropological usage to date of dissociation serves in the end, intentionally or not, merely as a euphemism for mental illness.” (Klass 2003: 116)
For Klass, psychiatric reductionism threatened not only the ancient practice of spirit possession within socialized (ritual) contexts, but the very language available to Western anthropologists. As long as the term dissociation is deployed in ethnographic accounts, the highly valued practitioners of spirit possession are transformed into the devalued victims of mental illness. The suggestion is that language as language has the power to morph a constructive cultural practice into a reductive medical condition.
For Klass the frustration is palpable, but a reading of the psychiatric literature reveals a radically different position. This is exemplified in “Dissociative Disorders in DSM-5” (Spiegel, et al. 2011), the output of the working party which informs the final 2013 text of the DSM-5. This paper makes two radical moves. The first is the validating incorporation of the ancient pre-psychiatric term ‘possession’ directly into the DSM-5 text. The second is the idea that a diagnosis of a mental disorder may not apply if the related behaviour is “a normal part of a broadly accepted cultural or religious practice” (APA 2013: 292). Spiegel et al. elevated this idea from an appendix in DSM-IV directly into the main criteria of dissociative identity disorder as a contra-indicator. There is plainly no reductionist intent. Instead, there is the genuine recognition of a need for judgement. As I see it, this introduces explanatory pluralism into the diagnostic process — and the concomitant need for psychiatrists to have resources for thinking about religious practices.
These contrasting positions, one defensive one apparently open minded, suggested a legitimate subject of study with constructive outcomes: If the language of dissociation is too prejudicial for the humanities and social sciences, there is clearly a need for better language; if a mental disorder can be mitigated by the socialization of cultural or religious practices, how might this challenge the focus on the individual in contemporary psychiatry?
If the language of dissociation is too prejudicial for the humanities and social sciences, there is clearly a need for better language; if a mental disorder can be mitigated by the socialization of cultural or religious practices, how might this challenge the focus on the individual in contemporary psychiatry?
I read a lot, including a ton of psychiatric papers on PubMed. I found that although the psychology of religion is an established sub-field, perhaps due to historical antagonisms there is no equivalent interdisciplinary psychiatry of religion. There has certainly been an explosion in the scientific study of spirituality and religion in recent years. But this scientific research has been largely undertaken without reference to the literature in the humanities and social sciences. This scientific insularity is an anomaly which remains to be addressed.
In my reading I discovered psychiatric research which showed around 25% of those currently detained in the acute psychiatric units of the West still articulate their experiences in religious terms. This real world data turned my exploration of a disciplinary power struggle within the academy into something much more tangible. Here, in the 21st century, in spite of modernity and the alleged demise of religion, mad Westerners are being locked up for their accounts of unmediated contact with the divine — including people with no religious background!
Of course, the fact I’m a mad person is somewhat relevant. Discovering the emerging approaches within ‘mad studies’ (see chapter 9 of the book), I turned my unconscious bias conscious — as a hermeneutical standpoint from which to advance critiques of both psychiatry and the social sciences. These disciplines are substantially products of 19th century colonial Europe, where the ‘Other’ as the mad/alien or savage/native was constructed as a deviation from the rich, white, educated concepts of ‘normal’; the biases which would lead to the theoretical heresies of degeneration theory and social Darwinism. Viewed from a mad studies perspective, there was no need to take sides between psychiatry and religious studies or anthropology — when their origins had so much in common.
Viewed from a mad studies perspective, there was no need to take sides between psychiatry and religious studies or anthropology — when their origins had so much in common.
I was a graduate student at The University of Edinburgh’ School of Divinity. It was a strategy of recovery from my latest detention in a psychiatric unit. Being a graduate student gave me an easy identity and an electronic card which opened doors to warm libraries filled with sparkling books. During my Masters, as a precursor to my PhD, my religious studies’ professor, Jim Cox, was an enthusiastic phenomenologist and I took a class with (the late) Mike Purcell, who introduced me to post-structuralist philosophers like Levinas, Lyotard, La Coste, Henry, Marion and Derrida. Although, on advice, I don’t explicitly engage in post-structuralist theory, I trust it subliminally runs through my book, surfacing only periodically in choice terms like ‘logocentric’. In that class I tested Moses’s (psychotic) encounter with a ‘fire which spoke’ against Jean Luc Marion’s ideas of saturation and excess. This use of ancient narratives to interrogate contemporary texts would turn out to be useful.
In religious studies PhD programs they like a bit of empirical research to reflect their social scientific aspirations. I proposed a study with people who articulated their experience in religious terms whilst they were actually detained in a psychiatric unit, one in which I’d previously been detained. I spent the next two years failing to persuade various ethics committee to approve ‘Listening to Psychosis’ and grant access. The response to my eventual complaint stated: ‘There was a risk that the researcher as a person with lived experience, might be seen to endorse behavior or ways of seeing that undermined professional therapeutic relationships.’ This contradicted the professionals who ran the locked ward and supported my research - a professor of psychiatry, three consultant psychiatrists and two senior registrars along with my supervisors. In the end I could boast the ‘most unfavored research in the United Kingdom.’ The process was not a waste of time as it gave me a glimpse the patronizing disability discrimination which underpins the status quo in medical ethics. And, surprisingly, I came to appreciate my ‘different ways of seeing’ as something of value.
With no access to contemporary data, I had to find a case study beyond the control of the ethics committee. I chose Jesus. Just as re-reading Moses against Marion had been a blast, I figured I could re-read Jesus through his two episodes of visions and voices, at the baptism and the transfiguration as the twin pivots in his life (see chapter 10). The snappy title of my PhD thesis became ‘Theorising disruption at the intersection of madness, mental disorder and acute religious experiences: a mad studies approach’. Access to this is locked away, for reasons too complicated to explain here, but the idea of Acute Religious Experiences blossomed as a non-pathological and less prejudicial way of talking about the constructive role of madness. It offered a solution to Morton Klass’s exasperation with the psychiatric overtones of the language of dissociation. And, it could provide a theoretical framework for identifying and naming some not-necessarily pathological states of consciousness, which might otherwise be reduced to mental disorders.
While the contra-indicator of ‘broadly accepted cultural or religious practice’ was written into the chapter on dissociation, it remains absent from the DSM-5 chapter on schizophrenia and its symptoms of visions and voices — symptoms which are common in accounts of religious experiences. This anomalous inconsistency has not been corrected in the text revision of DSM-5 and it perhaps reflects the chasm in how the individual chapters are constructed by the American Psychiatric Association (see chapter 8). Acute Religious Experiences offers a category which can accommodate the data of possession/dissociation and the data of visions and voices/psychosis, whilst understanding these as different cultural expressions of biologically grounded mental states. Acute Religious Experiences names not just the states of consciousness in spirit possession, but also the experiences in traditional categories of shamans, sufis, (some) sadhus, and mystics. It also names the acute experiences of individuals such as the prophets of the Abrahamic religions (Judaism, Christianity and Islam), the enlightenment of Buddha, or the visions of Arjuna in the Bhagavad Gita.
Acute Religious Experiences offers a category which can accommodate the data of possession/dissociation and the data of visions and voices/psychosis, whilst understanding these as different cultural expressions of biologically grounded mental states.
The idea of such a capacious classification involves all sorts of initial obstacles. As Acute Religious Experiences can be defined as naming non-pathological instances of contra-indicated psychiatric conditions, there is the apparent oxymoron of ‘non-pathological psychiatric conditions’ along with the asymmetry of the approach in the different chapters of the DSM-5 just mentioned. It also presupposes a cultural plasticity which can sustain radically different expressions capable of persisting over time. I found support for this capacious approach in I.M. Lewis’s classic Ecstatic Religion which subsumes shamanism and spirit possession and concludes with a chapter on psychiatry.
Starting with William James’s The Varieties of Religious Experience, I went in search of a literature in the social sciences which addressed (what I was now calling) Acute Religious Experiences. I chose seven well known philosophical/ psychological/ humanities texts by William James, Rudolf Otto, T.K. Oesterreich, Mircea Eliade, Walter Stace, Walter Pahnke and Abraham Maslow. Each championed a particular term – the more, numinous, possession, shamanism, mysticism, the psychedelic experience and peak experiences. As I read I discovered a fractured discourse (each read some of their predecessors) with partial focus and no agreed terminology.
My proposal for Acute Religious Experiences can be understood within the argument in the study of mysticism between contextualists and perennialists who respectively create a dichotomy between the binary of culture and an essential common core of experience. My idea of Acute Religious Experiences offers both a route beyond the contested category of mysticism (chapter 5) and a route to reconciling the perennial with the contextual. Western psychiatry makes claims about the universality of its analysis considered in terms of biological capacity, rather than content. By analogy the capacity to have Acute Religious Experiences is perennial if read as a biological rather than theological capacity. But the content remains contextual with explanations involving supernatural gods or ancestor spirits reflecting prevailing contextual (meta)narratives. Similarly, the capacity for only some to experience Acute Religious Experiences is consistent with the psychiatric data on the (limited) prevalence of dissociation and psychosis (chapter 9).
And there it is: Acute Religious Experiences is a capacious category which can accommodate cultural diversity and provides an operational distinction within the generality of religious experiences: If such experiences aren’t extraordinary/ anomalous/ extreme enough to be of interest to a psychiatrist, they aren’t sufficiently acute. This co-option of psychiatric opinion is no more than the converse of the implied psychiatric co-option of religious and anthropological scholarship in determining what is a ‘normal part of a broadly accepted cultural or religious practice’!
If such experiences aren’t extraordinary/ anomalous/ extreme enough to be of interest to a psychiatrist, they aren’t sufficiently acute. This co-option of psychiatric opinion is no more than the converse of the implied psychiatric co-option of religious and anthropological scholarship in determining what is a ‘normal part of a broadly accepted cultural or religious practice’!
Acute Religious Experiences can name all of the proposals suggested in the fractured discourse I identified. But such experiences cannot be reduced to mental disorders because, even when they involved distress, they are/were understood and integrated as non-pathological by the communities in which they were recognized and understood as ‘broadly accepted cultural or religious practices’. Acute Religious Experiences is effectively a diagnostic label which affirms a non-pathological interpretation of the visions, voices and possessions which are described in both the DSM-5 and the literature in the humanities and social sciences — both ancient and modern. And with that distinction in place the data of human experience can be re-orientated to recognize the contribution of madness in human culture.
The first 35 pages of Acute Religious Experiences can be read here.
A 35% discount is available if you purchase the book through Bloomsbury.com. Discount codes:
USA: GLR CA4US
Canada: GLR CA4CA
Australia and New Zealand: GLR CA4AU
UK and other parts of the world: GLR CA4UK
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As a psychiatrist who has also studied so-called "mystical" experiences among the Jewish Sages [see: The Ethics of the Jewish Mystics], I am very much open to Dr. Saville-Smith's proposed category of "Acute Religious Experiences." There is clearly an important distinction to be made between religio-mystical experiences in otherwise fully-functioning, rational persons (yes, I know these terms cry out for explication); and, for example, persons afflicted by schizophrenia--an often devastating and incapacitating disease.
In my view, the proposed category of "Acute Religious Experiences" (ARE) can be accommodated reasonably well in the DSM-5's section on "Other Conditions that may be a focus of clinical attention" (p. 715 of the DSM-5). Importantly, these are not mental disorders. They include such conditions as, e.g., "parent-child relational problem" or "uncomplicated bereavement." I see no reason why Dr. Saville-Smith's proposed category could not be included in this section, though I suspect ARE would not be seen frequently in a typical psychiatric practice. But conceptually, there should be no barrier to its inclusion as a non-pathological entity, worthy of clinical attention and differential diagnosis.
Ronald W. Pies, MD
Professor Emeritus of Psychiatry
Author, The Ethics of the Jewish Mystics