Making Sense of Spiritual, Metaphysical, and Eschatological Elements in Delusions: A Qualitative Study Using Interpretative Phenomenological Analysis.
Psychopathology – January 01, 2024
Source: PubMed
Summary
Spiritual, metaphysical, or eschatological elements in delusions (SMEDs) often mirror mystical experiences, impacting individuals profoundly. In a study with seven participants, alterations in perception of space, time, and unity were reported, alongside feelings of enlightenment that remained difficult to articulate. Participants interpreted SMEDs variably—as sources of insight or mental health issues—often struggling to reconcile their significance with dominant illness narratives. This highlights the complexity of integrating SMEDs into personal understanding, suggesting a philosophical approach could offer therapeutic benefits for those experiencing schizophrenia.
Abstract
Spiritual, metaphysical, or eschatological elements in delusions (SMEDs) are frequent and often subjectively regarded as profound transformational experiences, similar to mystical experiences. This study aimed (1) to explore how SMEDs are experienced and in which aspects they are similar to mystical experiences and (2) to investigate how individuals make sense of SMED. Seven participants were interviewed, and their expressions were analyzed using interpretative phenomenological analysis. We found that SMEDs were similar to mystical experiences with regard to alterations in perception of space, time, and unity. Furthermore, SMEDs were accompanied by a sense of enlightenment that however remained ineffable. SMEDs were interpreted from different viewpoints, i.e., as a source of ontological insight, as a mental health issue, as an inspiration for a new orientation in the world, and, for some participants, as an example of the limits of knowledge. Making sense of SMED appeared to follow a lively internal dialogue in which various, sometimes contradictory positions were reflected upon. Participants usually struggled to align the ostensible ontological significance of SMED to the dominating illness explanation. SMEDs have similarities to mystical experiences, but integrating SMED into one's own life is challenging. We propose a philosophical, non-pathological interpretation of SMED derived from a novel perspective on mystical experience which may also have some therapeutic utility.