Pathological possession experiences, defined as involuntary and unwanted alterations of consciousness attributed to spiritual forces, were subsumed under dissociative identity disorder (DID) in DSM-5, but this link is contested by researchers across countries. It remains unclear how pathological possession differs from possession delusions in psychosis or from cultural syndromes such as ataque de nervios, which some authors consider dissociative. Nonpathological dissociative experiences, including spiritual experiences during religious or ritualistic practices, are also poorly understood.
A scoping review and bibliometric analysis of 174 studies found that psychodynamic and transpersonal approaches dominate the clinical literature on non-ordinary experiences (NOEs), such as feelings of cosmic unity or sensing the deceased. Intervention techniques more frequently aimed to induce altered states (e.g., holotropic breathwork, meditation, psychedelic-assisted therapy) than to manage NOEs after they occurred. Bibliometric analysis revealed four research traditions: transpersonal/spiritual, psychiatric/psychopathological, psychedelic/meditative, and ethno-dissociative. The field relies heavily on case studies and qualitative reports, with limited experimental evidence, highlighting methodological and ethical challenges for future research.