Philosophy, Psychiatry, & Psychology

This is an ambiguous though clinically valuable paper. Jackson and Fulford suggest that the distinction between their two categories, spiritual experience and mental illness, is conventional, yet their emphasis on issues of correct practice from the medical perspective threatens to return both into distinct ontological categories, albeit with a shared phenomenology. I do not understand why any single instance must either be pathological or spiritual, except through clinical and clerical demands for clarity and order.

Mental illness and spirituality are not two distinct natural phenomena “out there,” existing independently of human volition. They are both social—cultural if one prefers—ascriptions. Neither has some substantive core whose elucidation through psychophysiological, phenomenological or ultrahuman procedures could enable us to define its essence and thus differentiate it from the other. Neither experience is a self-evident datum. Both are easily susceptible to critiques, either that they do not exist as natural categories, or else that they should more properly be described as something else—as the workings out of social exclusion in the case of mental illness, as cosmological understanding or mass hysteria in the case of spirituality. Neither, I would suggest, can be specified by physiology or ultrahuman interventions respectively, but rather through shared cultural meanings which in turn are experientially validated by the biosocial phenomena themselves. It is not that we need to exclude the possibility of concurrences in brain states, but rather that these cannot specify the meaning and experience of the phenomena.

Note that I emphasize “experienced through cultural meanings,” not “influenced by” culture: I do not accept that psychophysiology can have any existence independent of the social world through which it occurs. The psychiatrists’ form/content distinction, an optimistic proxy for nature/culture (Birnbaum 1923; Schneider 1928) may remain a convenient heuristic device, but it has a curious, perhaps doubtful, intellectual history (see the Endnote following).

Cross-cultural comparisons argue that local idioms which we might approximate to current Western notions of mental illness and religion are quite varied. And the validity of particular instances of both “spiritual experience” and “psychopathology” may be contested in any society. While the social consequences of a pattern may determine the approbation accorded to a pattern such that patterns recalling chronic schizophrenia [End Page 67] are regarded as a deficit (and here I agree with James [1902] and the two authors), they are not necessarily aligned to categories of physical illness, but may be seen as a spiritual failure or obstruction. Unsuccessful or inappropriate shamanic practice among Amerindian and circumpolar societies is the classic instance (Eliade 1964). Within Western societies, demonic possession may be read by doctors as mental illness. (It is just as much a “spiritual experience”: why introduce the religionist’s distinctions between different types of ultrahuman agency? Compare Maslow on “peak” experiences. The terms “spiritual” and “religious world view” are naturalized idioms of late Christianity rather than cross-culturally valid terms [Tambiah 1990].) But also the converse (Koch 1972). And this depends on our professional interests. Clearly, psychiatrists prefer to perceive the world in a psychopathological idiom, while religious enthusiasts and clergy may favor divine intercession or demonic possession; and a Christian psychiatry not surprisingly may claim to act as arbiter (Sims 1991). Any specific instance may be perceived differently by individuals in accordance with their interests and affiliations.

The paper’s terminology—“spiritual psychotic experience,” “genuine spiritual experience”—is confusing in that it does imply realist, not conventional claims (cf. Endnote 1, Jackson and Fulford). It is not necessary. A less laden idiom—such as “statistically or normatively unusual brain states and their experiential correlates” (Littlewood 1993, 257)—may be just too unwieldy for repetition, but I would propose that at this level of detail we need rather four categories depending or not on concordance with (i) something close to psychiatry’s recognition of a major mental illness, and (ii) something like an anthropological notion of religious or spiritual experience (cf. Littlewood 1991):

[Table 1]

So Jackson and Fulford’s three cases fall into group “A” if the PSE was scored...