David Lukoff, a licensed psychologist and a specialist in “spiritual emergency,” coauthored the new diagnostic category “Religious or Spiritual Problem” in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, a widely used psychiatric manual for diagnosis and treatment. He defines mystical experiences like kundalini this way: “The mystical experience is a transient, extraordinary experience marked by feelings of being in unity, harmonious relationship to the divine and everything in existence, as well as euphoric feelings, noesis, loss of ego functioning, alterations in time and space perception, and the sense of lacking control over the event.” In the following essay, he shares his own introduction to kundalini, as well as the most recent research on the phenomenon, which often becomes a spiritual emergency. He shares data from the Spiritual Emergency Network, and the Kundalini Research Network, common symptoms of kundalini experiences, and how kundalini functions in relation to Qigong, or chi kung, and other meditation practices. The research he presents brings this question to mind: Are the medical and kundalini support communities equipped to handle the increasing occurrences of spiritual awakenings?
To set a context for this essay, it is useful to know that I went through kundalini awakening myself. Back in 1971, I spent two months convinced that I was a reincarnation of Buddha and Christ, and wrote a forty-seven-page holy book to unite the world around a new universal religion that I would create. (Seemed like a good idea at the time.) Fortunately, I was not hospitalized or medicated. My friends provided food and shelter and spent time just talking to me.
I really feel quite grateful that I was allowed to go through the full experience. It was a touchstone experience in my life that set me on a spiritual journey. I needed to understand what had happened to me, and this has led me to the work I do today. It is baffling: how could this Jewish boy (I was twenty-three at the time) have believed himself to be Buddha and Christ, about whom he really knew very little? With this question in mind, I entered Jungian analysis, read Joseph Campbell, and went to many of Campbell’s workshops. I also worked with shamans and Native American medicine chiefs who helped me integrate this experience and taught me how to control entry and exit from such ecstatic states. I later became a psychologist, and I have worked to help other mental health professionals understand how to recognize and work with kundalini and other potentially transformative experiences that can be misdiagnosed as psychotic disorders.
Since the 1960s, there has been a significant increase in people adopting a wide array of spiritual practices, including yoga, meditation, Qigong, tai chi, chanting, and others. There has also been an explosion of interest in mystical, esoteric, shamanic, and pagan traditions that involve participation in sweat lodges, goddess circles, and “New Age” Groups.[1] These activities have triggered many mystical experiences and spiritual emergencies among people who were not prepared and were not working with knowledgeable teachers:
The connection between spiritual practices and psychological problems was first noted by Roberto Assagioli, who described how persons may become inflated and grandiose as a result of intense spiritual experiences: “Instances of such confusion are not uncommon among people who become dazzled by contact with truths too great or energies too powerful for their mental capacities to grasp and their personality to assimilate.”[3] Dr. Lee Sannella’s book Kundalini: Psychosis or Transcendence? published in 1976, was the first to link yoga with problematic kundalini awakening.[4]
Stanislav and Christina Grof coined the term spiritual emergency and founded the Spiritual Emergency Network (SEN, later the name was changed to the Spiritual Emergence Network) in 1980 to support individuals experiencing psychological difficulties associated with spiritual practices and spontaneous spiritual experiences. SEN provides information and makes referrals to therapists for such problems. When interviewed in 1995, Stanislav Grof noted this from his experience with SEN:
The term spiritual emergence is used to describe the whole range of phenomena associated with spiritual experiences and development, ranging from those that are not problematic, do not disrupt psychological/social/occupational functioning, and do not involve psychotherapy or any contact with the mental health system (probably the vast majority), to spiritual experiences that are full-blown crises requiring twenty-four-hour care. The Grofs note that “episodes of this kind have been described in sacred literature of all ages as a result of meditative practices and as signposts of the mystical path.”[6] Such literature has described the more common presentations as including: mystical experiences, kundalini awakening, shamanistic initiatory crisis (a rite of passage for shamans-to-be in indigenous cultures, commonly involving physical illness and/or psychological crisis),[7] possession states,[8] and psychic opening (the sudden occurrence of paranormal experiences). A distinguishing characteristic of spiritual emergencies is that despite the distress, they can have very beneficial transformative effects on the individuals who experience them.
In the Hindu tradition, kundalini is spiritual energy presumed to reside at the base of the spine. When it is awakened by practices such as yoga, it rises like a serpent up the spine and opens the chakras’ psychic centers, which are situated along the spine from the tailbone to the top of the head. Dr. Brant Cortright describes the kundalini awakening process as follows: “As each chakra opens, new levels of consciousness are revealed. Since the consciousness of most people is fairly restricted, the opening of the chakras is accompanied by consciousness expansion and purification of the limitations or impurities that correspond to each chakra.”[9]
As kundalini rises, it is associated with physical symptoms including:
Kundalini awakening is probably the most common type of spiritual emergency. The Spiritual Emergence Network Newsletter reported in 1988 that 24 percent of its hotline calls concerned kundalini awakening experiences. In kundalini awakening, there is typically a surge of energies along the spine and throughout the body that can overwhelm and incapacitate the ego and leave the person adrift in a sea of profound consciousness changes at every level—physical, emotional, and mental. Kundalini awakening most commonly occurs as an unintentional side effect of yoga, meditation, Qigong, or other intensive spiritual practices. Some also consider psychotherapy, giving birth, unrequited love, celibacy, deep sorrow, high fever, and drug intoxication to be triggers. Others believe kundalini awakening can occur spontaneously without apparent cause.
However, Bonnie Greenwell, PhD, a transpersonal therapist whose work focuses on kundalini awakening problems, believes that the term kundalini is most applicable to problems specifically associated with spiritual practices. When Dr. Greenwell was asked online about a case that included symptoms such as shaking at night, which can occur in kundalini awakening, she responded: “If the person had presented me with a description of an awakening experience, if he did exercises such as meditation, yoga, or a martial art regularly, or if he experienced strong meditative states where he went beyond concentration into stillness or a sense of unity, then I would be more likely to consider it Kundalini.”[10]
Greenwell did her dissertation study on individuals who had experienced a kundalini awakening, and she summarizes the clinical issues she observed in her book, Energies of Transformation: A Guide to the Kundalini Process.[11] In it she describes a number of key features of kundalini awakening that were experienced by people in her study:
Prana is the Hindu word for vital energy. As intense energy moves through the body and clears out physiological blocks, some people experience intense, involuntary, jerking movements of the body, including shaking, vibration, spasm, and contraction.
Some people find themselves performing yogic postures or hand mudra gestures they have never learned or could not do in a normal state of consciousness. Unusual breathing patterns may appear, with either very rapid or slow, shallow breathing.
Kundalini awakening often generates unusual physiological activity, which can present as heart, spinal, gastrointestinal, or neurological problems. Internal sensations of burning, hypersensitivity to sensory input, hyperactivity or lethargy, great variations in sexual desire, and even spontaneous orgasm have been reported.
Emotions can swing from feelings of anxiety, guilt, and depression (with bouts of uncontrollable weeping) to compassion, love, and joy.
Some people experience visions of lights, symbols, or spiritual entities. Auditory sensations may include hearing voices, music, inner sounds, or mantras. There may also be disruption of the proprioceptive system, with loss of a sense of self as a body, or an out-of-body experience.
A person may experience precognition, telepathy, psychokinesis, awareness of auras, and healing abilities.
Some people may shift into altered states of consciousness in which they directly perceive the unity underlying the world of separation and experience a deep peace and serenity.
The sudden onset of these experiences led many in Greenwell’s study to become confused and disoriented. Unlike those suffering from psychosis, individuals experiencing kundalini are typically much more objective about their condition, communicate and cooperate well, show interest in sharing their experiences with open-minded people, and seldom act out. An example of such a case follows.
Kundalini awakening can resemble many disorders, medical as well as psychiatric. The symptoms can mimic conversion disorder, epilepsy, lower back problems, multiple sclerosis, heart attack, or pelvic inflammatory syndrome. The emotional reaction to the awakening of kundalini can be confused with disorders involving anxiety, depression, aggression, and organic syndromes. While in some cases the psychological upheaval is so acute that it resembles a psychotic episode, medication can further complicate the process. Dr. Greenwell suggests that it would be therapeutic for the individual to study some of the Eastern theories and descriptions of kundalini. Her other recommendations include:
She also suggests creative activities such as art, music, or writing as ways to express the energy. Since this kind of spiritual problem is related to a type of practice, consultation with a teacher of the practice who also has mental health training would be advisable. Dr. Greenwell indicates that learning some basic yogic breathing practices, under the supervision of a knowledgeable yoga teacher, can help guide this energy as well.
The Diagnostic and Statistical Manual of Mental Disorders (DSM-IV)[14] includes in Appendix I: Culture Bound Syndromes “Qigong psychotic reaction,” which is similar to kundalini awakening. (Qigong, or chi kung, is an ancient Chinese moving-meditation practice.) DSM-IV describes this syndrome as “an acute, time-limited episode characterized by dissociative, paranoid, or other psychotic or non-psychotic symptoms” and says that “especially vulnerable are individuals who become overly involved” in Qigong. Researchers R. Lim and K. Lin reported in 1996 that the “Chinese psychiatric literature describes a syndrome called ‘Qigong Induced Psychosis’ characterized by the appearance of auditory hallucinations and delusions after the initiation of Qigong in a practitioner who has never experienced these symptoms before and in whom these symptoms remit soon after the cessation of Qigong practice.”[15] It seems, though, that this disorder is only caused by extreme types of Qigong, which place practitioners in a trance and have them attempt to communicate with other beings.
As with yoga, Qigong, especially when practiced alone and unsupervised and to extremes, can trigger a kundalini awakening crisis. And most of these crises resolve after the practice is terminated.
The DSM-IV emphasizes the need to distinguish between psychopathology and meditation-related experiences: “Voluntarily induced experiences of depersonalization or derealization form part of meditative and trance practices that are prevalent in many religions and cultures and should not be confused with Depersonalization Disorder.”[17]
Depersonalization disorder is a mental disorder, so it is important to distinguish such problems from episodes related to spiritual practice. Intensive meditation practices can involve spending many hours each day in meditation for weeks or months at a time. Asian traditions recognize a number of pitfalls associated with intensive meditation practice, such as altered perceptions that can be frightening, and “false enlightenment,” associated with delightful or terrifying visions. Mark Epstein describes a “specific mental disorder that the Tibetans call ‘sokrlung’” as “a disorder of the ‘life-bearing wind that supports the mind’ that can arise as a consequence ... of strain[ing] too tightly in an obsessive way to achieve moment-to-moment awareness.”[18]
When Asian meditative practices are transplanted into Western contexts, the same problems can occur. Anxiety, dissociation, depersonalization, altered perceptions, agitation, and muscular tension have been observed in Western meditation practitioners as in the case described below. Yet R. Walsh and L. Roche point out that “such changes are not necessarily pathologic and may reflect in part a heightened sensitivity.”[19]
Treatment involves discontinuation of the spiritual practice, at least temporarily, and engaging in alternative “grounding” activities. Jack Kornfield, a psychologist and experienced meditation teacher, described what he termed a spiritual emergency that took place at an intensive meditation retreat he was leading:
Meditation has been reported to trigger psychotic episodes in schizophrenic patients with active psychotic symptoms.[21] However, I developed a multimodal holistic health program for schizophrenic patients at a state psychiatric hospital that incorporated meditation, and none of the patients experienced adverse effects. Meditation was also used with schizophrenic patients at the San Francisco VA Day Treatment center for fourteen years.[22]
In the DSM-IV, spiritual problems are defined as distressing experiences that involve a person’s relationship with a transcendent being or force, but that are not necessarily related to an organized church or religious institution. Sometimes such experiences result from intensive involvement with spiritual practices such as yoga. The impetus for proposing this new diagnostic category came from transpersonal clinicians whose initial focus was on crises triggered by spiritual practices and psychedelic drugs, as well as spontaneous spiritual crises. In 1990, to redress the lack of sensitivity to religious and spiritual problems, the author, along with two psychiatrists on the faculty at University of California, San Francisco, Department of Psychiatry (Francis Lu, MD, and Robert Turner, MD), proposed a new diagnostic category for the fourth edition of the Diagnostic and Statistical Manual. We viewed such an addition to the DSM-IV nomenclature as the most effective way to increase the sensitivity of mental health professionals to spiritual crises and issues in therapy. The proposal involved a three-year process of working with various subcommittees (for a more detailed history of this diagnostic category, see the 1988 journal article, “From Spiritual Emergence to Spiritual Problem: The Transpersonal Roots of the New DSM-IV Category”),[23] and resulted in the acceptance of a new diagnosis entitled Religious or Spiritual Problem, defined as follows:
Articles on this new category have appeared in the New York Times, San Francisco Chronicle, Psychiatric News, and the APA Monitor where it was described as indicating an important shift in the mental health profession’s stance toward religion and spirituality. What did not receive attention in the media is that this new diagnostic category has its roots in the transpersonal movement’s attention to spiritual emergencies such as kundalini awakening.
The spiritual journey has risks and perils. The self can become disorganized and overwhelmed by an infusion of spiritual energies or by new realms of experience that it is not able to integrate. David Steindl-Rast, a Benedictine monk who teaches spiritual practices, has noted that spiritual emergence can be disruptive: “Spiritual emergence is a kind of birth pang in which you yourself go through to a fuller life, a deeper life, in which some areas in your life that were not yet encompassed by this fullness of life are now integrated.... Breakthroughs are often very painful, often acute and dramatic.”[25] Yet it seems that more and more people are exploring spiritual practices such as yoga and meditation, reading books on spiritual topics (many are bestsellers), and attending retreats, workshops, and conferences on spiritual topics. While this can certainly be seen as a hopeful sign for the survival of the planet, since spiritual traditions share many values such as peace and harmony, on the individual level there will likely be an increase in the number of people who experience kundalini awakening and other spiritual problems related to the spiritual practices and exploration they undertake on their journey.