Existential Concerns as Predictors of Spiritual Emergency and Psychosis

Abstract

The cause of psychosis remains uncertain, and the current biological model for treating psychosis is somewhat ineffective, with the efficacy of antipsychotic drugs to reduce psychotic symptoms and prevent relapse being 41%. As such, calls have been made for new hypotheses to be examined to aid in the understanding and treatment of psychosis. This study explored two complementary hypotheses: ‘Spiritual Emergency’ (SE), and ‘psychosis as a coping mechanism for existential distress’. SE is similar in presentation to psychosis, but evidence suggests that SE can be psychologically healing and can be differentiated from psychosis by its divergent relationship with alogia and depression. Existential psychologists have posited a relationship between psychosis and existential distress, but presently there has been no quantitative research conducted on the relationship between existential distress and SE/psychosis. This present study aimed to confirm alogia and depression as differentiating variables between psychosis and SE, in addition to exploring the relationship that the two constructs have with existential concerns (ECs). Results confirmed that alogia and depression predict psychosis only, and there was no overlap in the ECs that predicted each construct. Psychosis was predicted by increased death anxiety, existential loneliness, and identity distress, while increased meaning [search for and presence of], reactance, and decreased death anxiety predicted SE. The results indicate that SE may have a psychological healing effect through a reduction in existential distress, while psychosis can be predicted by increases in existential distress. The findings have implications for the diagnosis of and potential treatments for psychosis.