Psychosis-like or manic symptoms

• International Early Psychosis Association: Global resources for family members and care givers.
• SAMSHA Early Serious Mental Illness Treatment Locator: USA early onset psychosis treatment locator (somewhat outdated, but better than nothing).
• US National Early Psychosis Directory: USA CHRP and first-episode psychosis treatment locator.
• SMI Advisor: free training and information for clinicians, individuals, and families.
• Screening for Psychosis: A toolkit for community providers.
• Sibling with Psychosis: Information, ideas, resources for siblings of someone with psychosis.
• Students with Psychosis: Services to help students adjust to mental health and academic expectations.

Spiritual emergencies 

For some people, their experience of psychosis or mania (psychedelic induced or otherwise) contains spiritual or ecstatic content which has a lot of meaning for them and which they might not want to dismiss as entirely pathological. Some prefer to refer to these crises as 'spiritual emergencies' (although others do not feel comfortable with this sort of spiritual labelling).

Breaking Open: Finding a Way Through Spiritual Emergency is a book CPEP director Jules Evans co-edited of 14 people’s stories of their experiences of mystical psychosis, spiritual mania and other extreme mental states, and how they navigated through them.

Common coping techniques used by the authors in the book include:

• finding a safe space (which could include being hospitalized)
• finding support from friends and loved ones
• sometimes seeking professional help
• cultivating an attitude of acceptance, patience and openness to what is arising
• trying to stay grounded in the body and present moment rather than dissociating out of the body
• reminding oneself 'this will pass'
• sometimes medication helps to stabilize the mind in such crises

This is a talk on 'mystical psychosis'.

This is a series of talks by people who went through what they called 'spiritual emergencies' sometimes involving manic or psychosis-like symptoms.

If in doubt do please seek professional assistance, it can help if the psychiatrist is familiar with psychedelics. In general, if one is in post-psychedelic psychosis or mania, it's not a good idea to do more drugs while already in a heightened state.

Thal's story 

Thal is a 42-year-old counsellor of Yemeni-Sudanese heritage; she was born in Abu Dhabi and moved with her parents to Canada when she was 17. She married a surgeon of Muslim heritage when she was 22 and they had two children, now teenagers.

Thal has had unusual experiences since she was a child.

Since childhood, I would see otherworldly entities that I now recognize as jinns. I remember one time we were in York, England, on a family vacation, and I woke up to see a big owl in the middle of the room. I had many experiences like that!

She was always quite sensitive to major global events like 9/11 and their ripples in the collective unconscious.

In the 1990s, when we lived in Abu Dhabi, and the war in Bosnia was happening, I would have archetypal dreams where I was in Bosnia in someone else’s body, experiencing the war.

Thal thinks these unusual experiences partly stem from childhood trauma, which has made her more ‘porous’ and prone to liminal states, and partly from her ancestry.

I was experiencing what my ancestors probably experienced in a more organized manner. I come from a lineage where, for example, my grandfather would heal people in the village by reading the Quran. And I feel like I inherited some of that—in Canada, once, during psychotherapy school, a colleague of mine was not feeling good, and I intuitively laid my hand on his head and read a few verses of the Quran. Then he started throwing up, and then he felt better.

She doesn’t just attribute her unusual experiences to her cultural background, however—she also thinks they are part of a genuine spiritual reality that people from different backgrounds experience: ‘We’re all going back to what the mystics have been saying.’

Despite her unusual experiences, Thal had a relatively settled life as a wife and mother. During her 20s, she felt more atheist or agnostic than Muslim. However, after her father died in 2010, when she was in her early 30s, she embarked on a period of psycho-spiritual searching and self-transformation. She began a PhD in Transpersonal Psychology at the California Institute of Integral Studies, although she opted out early to do a Master’s in East-West Psychology. She also began seeing a Jungian analyst in 2017.

Her Masters at CIIS brought her in touch with psychedelic culture and, in the summer of 2018, she travelled to the Amazon jungle to try ayahuasca at a retreat:

I saw the entire jungle, all the trees, bow down like in an Islamic prayer. I could hear the medicine tell me: ‘You thought you understood? You have no idea.’ And then, literally, my whole body went into prostration. Then I saw all the Yemeni women on my mother’s side wearing black face-covering (niqab); that’s how they tried to connect to the divine.’ I heard a voice say, ‘This is not the only way to connect to the Divine.’

In the summer of August 2019, Thal smoked 5-meo-DMT, with the intention to heal, and had a vision of childhood trauma. She was researching spiritual emergencies at the time, and recognized she was on the verge of one herself. She says:

I had to email my professor and ask, ‘Can I postpone my assignment? I’m going through a spiritual emergency myself.’ I now realize that is a rare thing since, usually, people on the verge of a psychotic break are the last to know that.

She describes this week-long ‘breaking-opening’ as follows:

I was very open, and the downloads were endless. I became very concerned with whether I would burn in hell for not being a good Muslim. I sought out help and met with a traditional Sufi healer from Sudan. He said, ‘You’re one of us; you must come to a khalwa here with us.’ That opened up another layer, where I was just shown everything—ancestors, entities, and other things beyond language.I felt like I was dying! While lying beside my husband to sleep one night, I spontaneously said, ‘Take care of the kids; I think I’m exiting my body.’ He told me later that my body was incredibly cold that night, and he genuinely thought I might be dying.

Other symptoms from that turbulent week included paranoia, grandiosity, ecstatic downloads, ‘putting all the pieces together, understanding everything, telling everyone I’m going through a spiritual emergency and then going crazy the next minute…it was too much.’

Thal then slowed down on the psychedelic-healing experimentation for a while. She focused on building her private practice as a counsellor and integration coach. Then, in October 2021, she decided to try another guided psychedelic session with a high dose of psilocybin.

In my hubris, I thought I would heal myself and my family if I did one more ceremony. So, I took a heroic dose in a solid and safe container. I had very big mystical visions, like beyond… I can't, you know, I can’t even put some of it into language. My friend who was with me was also traumatized by how big it was. We haven't even talked about some of it until this day. We're still friends, but it's like it was traumatic…

I would spontaneously utter specific divine names, and then I would see the entire room explode with light. And it was this sort of majestic reverence feeling of unity, and everything is connected and meaningful, and the world is going to shit, kind of feeling at the same time. It was beyond anything personal, then slowly coming together at the end, being like, okay, all right, so this is clear. There's love, it's all one. Go back and figure out what you will do with your life now.

And then I come back to an agitated state at home. I started to leave my body. I wanted to be in that place where it was all love and light. I would dissociate and have visions. Anytime I heard the divine name in Arabic, I would see white lightning and lose consciousness. My husband (now separated) knew this was not good. Some things are meant to remain in the unseen.

She became paranoid at points:

The government is going to get me because they think I'm a terrorist…or the Muslim community is going to get me because I am a bad Muslim.

At times, she felt suicidal.

It felt like not wanting to be in your body, very contractive and just…I want to be in bed. Very intrusive suicidal thoughts.

She also felt isolated.

Some friends pulled back because it was way too much. Others were very supportive, but I was trying to contain it all and not share too much because I didn’t want to burden others with what was coming up. There were moments when I felt I was in conversation with the Divine on my own, laughing at the cosmic joke.

Finally, she was checked into an emergency psychiatric ward – four times between October 2021 and August 2022.

The last two times, my ego was back enough that I was like, You know what? Just surrender, stay in the hospital, be safe. My ex-husband and my kids said, “We love you, just get better.” I felt I had permission to fall apart. I went to a private site psychiatric center, and it was very expensive. The psychiatrists did not know what to do with me. At one point, I was like, bring the DSM, and I’ll explain every diagnosis from an archetypal perspective.

Thal was given various psychiatric medications throughout the recovery process,

I tried mixes of anti-psychotic medications. And I was desperate at the time. Okay, I will toss out whatever I learned and listen to you guys now. It was utterly not helpful. However, my outpatient psychiatrist, who I still meet with from time to time – I asked him recently about the schizoaffective diagnosis I was given. He said, ‘Knowing you for three years, clearly it was trauma-related.’ I have been trying to tell everyone about that. Some of my colleagues specializing in more transpersonally-oriented modalities respond with a look that screams, “No shit!”

And now?

Trying to be in this human experience is tricky. But what heals is good friendships, humour, talking to like-minded people, writing, and seeing clients.

She works as a counsellor and does psychedelic integration work, and is now writing a book about her healing journey.

I have a Master’s in English Literature. Literature saved my life when I was young; I read intensely. I think the humanities background helped me navigate the collective unconscious, symbolism, and different entities and archetypes. Some of the old Sufi texts saved my life, and I am currently reading Sha’ams Al Marif by Ahmad Al-Buni, a 13th-century text on astral magic and working with jinns. The main takeaway: stay away,

Finally, what advice would she give to anyone else, or their loved ones, going through a mystical and psychotic crisis?

First of all, make sure that you have a solid support system around you. For family members, just make sure they feel safe, know they’re loved, and know everything will be okay. Don’t treat them like they’re crazy. This is normal. People have been communing with the Divine since time immemorial. And if you need therapy or medications, that’s OK, too—I still take a very small dose in emergencies.

And she still has unusual experiences?

Oh sure. Just last night. I’m doing a spiritual cleansing of sorts at the moment, and just last night, my father’s spirit came in and helped me organize the room, and my mentor, who has also passed, was in the room as well.

That includes the occasional demonic encounter.

When I was in at an Islamic centre in Cambridge this summer, I saw a demonic face trying to attack me. At that time, I was in a retreat with other Muslim professionals in the mental health field, having these incredible conversations and feeling loved and in the community. My understanding now is that these dark or malefic entities try to cover up the truth and make you feel like you're severed from your heart or from the Divine and to keep you scared. If I don’t continue my inner work and upkeep my spiritual practice, I get lost in that darkness. In Jungian terms, it’s shadow work.

Thal concludes:

I’ve had a billion psychoses…what holds me together is that I have a solid framework to understand what happened to me because of holding both a Sufi cosmology that I’ve studied my whole life, and a Western-trained counsellor perspective.