Psychosis and Spirituality: Inextricably Connected?

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During my time as an undergraduate at Stanford, I took an anthropology class called Culture and Madness. This course investigated how conceptions of mental illness change over time and across cultures. One of the learning units focused on psychosis, a collection of syndromes that result in a break with reality. Major symptoms of psychosis include hallucinations and delusions.

In thinking about the relationship between psychosis and culture, I came to an interesting realization: people regarded as religious prophets in the past could be considered mildly psychotic today, at least in Western society . Keep in mind that psychosis is not the same as schizophrenia–schizophrenia involves elements of psychosis, but includes other symptoms as well. Most importantly, schizophrenia involves cognitive decline while psychosis doesn’t necessarily include this symptom.

Examples from History

To illustrate the connection between psychosis and spirituality, I will describe a class exercise I participated in for Culture and Madness. In this exercise, students were presented with cases documenting the abnormal behavior of 3 individuals. We then had to review each person’s symptoms and diagnose them based on our knowledge of mental disorders from lecture. One individual’s symptoms included frequent delusions and hallucinations, most notably multiple visits from an angel. Our class speculated that he may be schizophrenic. However, it was later revealed that this man was Joseph Smith, founder of Mormonism. Smith eventually gained a wide following and came to be revered as an American prophet. Yet, if someone reported such hallucinations today, I believe they would be promptly delivered into psychiatric care and diagnosed with a form of psychosis.

We can also consider the case of Julian of Norwich. A mystic who lived during the middle ages, Julian experienced hallucinations of a spiritual nature. She claimed to be shown the teachings of the Lord through three hallucinations, one of which involved experiencing “red blood tricking down from under the crown of thorns, all hot, freshly, plentifully and vividly”. However, instead of being hospitalized for her visions, she was established as a spiritual authority in her community. She is venerated by the Lutheran and Anglican Churches. Her behavior was not seen as a sign of illness, as I believe it would be today.

“Shamanism” is another interesting course concept that highlights the fine line between the normal and the abnormal, as well as the the spiritual versus psychotic. This is a topic we discussed in much depth during Culture and Madness. A shaman is a person regarded as having access to the world of gods or spirits, often going into a trance-like dissociative state to communicate with these otherworldly beings. Shamans often report hearing voices from spirits daily. They act as both healers and religious leaders within the communities they serve. Indigenous populations, such as Australian Aborgines, American Indians, and certain African groups practice shamanism today. If someone was experiencing hallucinations or delusions, a shamanic community would embrace those symptoms as a source of wisdom and healing power rather than view them as abnormal. Indeed, shamans and other figures deeply connected to religion often display symptoms that could classify them as psychotic in Western society.

What to make of this?

It seems to me that spirituality often blurs the lines between normalcy and insanity. Conceptions of abnormal behavior, specifically psychotic behavior, vary across societies and time periods. Defining behavior as abnormal is especially controversial when the behavior in question is intertwined with religion or spirituality. Behaviors exhibited by religious prophets could be considered symptoms of psychosis in modern society.

This is not to discredit these spiritual leaders’ teachings and divine inspiration — it is definitely a possibility that God was speaking to them directly through their visions. However, it is worth noting that the cultural norms of the time likely influenced the interpretations of such phenomenological experiences. The prophets of the past may be the mildly psychotic of today.


“Joseph Smith.” PBS. Public Broadcasting Service, n.d. Web. 16 Mar. 2017.

Luhrmann, Tanya. “Psychosis and Culture.” Anthropology 186. Lane Hall, Stanford. 8 Feb. 2017. Lecture.

“Shamanism.” Encyclopædia Britannica. Encyclopædia Britannica, Inc., 19 Oct. 2016. Web. 16 Mar. 2017.

Documenting insights about humanity, culture, and design. // Self-experimenter, UX Designer @ Google.

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