![\"Brighid](\"https:\/\/wp-media.patheos.com\/blogs\/sites\/243\/2018\/11\/Brighid-obscured-by-smoke.jpg\" "\\"Brighid")
<\/a><\/p>\nA Pagan who is bipolar and has mystical experiences<\/h1>\n
\u201cPsychotic disorder?\u201d<\/p>\n
\u201cYep,\u201d I said, looking out my psychiatric nurse practitioner\u2019s window and nodding. My last psychiatrist had recently sent me a letter for my disability records at work stating my initial diagnosis from over a decade ago. There was a secondary diagnosis on that page, though, that I hadn\u2019t been expecting. \u201cType 2 bipolar\u2026 and psychotic disorder.\u201d<\/p>\n
I saw his hands in his lap twitch thoughtfully.<\/p>\n
\u201cYou were diagnosed, when?\u201d<\/p>\n
\u201cI was 13.\u201d<\/p>\n
His eyebrows shot up. \u201cOh, my. That\u2019s very young.\u201d He gave me a keen look and softened his voice a bit. \u201cDo those diagnoses\u2026 seem right to you?\u201d<\/p>\n
\u201cI know that\u2019s a tricky age for diagnosis, but the bipolar, I think is probably true. When I miss my meds on accident I still have symptoms, and they\u2019re pretty by the book.\u201d I gave him a quick laundry list. He agreed that they sounded about right.\u00a0 \u201cBut the psychotic disorder diagnosis\u2026 I am\u2026 doubtful. And I am also here to ask you about that.\u201d<\/p>\n
He nodded. \u201cPlease go ahead.\u201d<\/p>\n
I took a breath, and let it out.<\/p>\n
\u201cI told my psychiatrist when I was younger that sometimes at night in my room I felt I could\u2026 sense presences, sort of. Beings. Nothing auditory or visual, or with any words, just like\u2026 there were entities there. Like I wasn\u2019t alone. I also told her that I felt vibes coming off people sometimes almost like they were touchable waves of energy. I was deeply, deeply religiously Pagan at the time, and spent time with other Pagans. Both these experiences are normal within the context of Pagan culture. And yet\u2026\u201d<\/p>\n
I felt a surge of disappointment in my chest remembering the conversations.<\/p>\n
\u201cWhen I told her those first two things, she told me they sounded like delusion to her, and she would lean toward classifying them as psychosis.\u201d<\/p>\n
I saw my new practitioner start to nod, then stop himself as if unsure.<\/p>\n
I shook my head. \u201cHere\u2019s the catch. Paganism is not a small group of eccentrics. It\u2019s an actual large-scale faith. The US Armed Forces even recognizes it \u2013 a fallen Marine can get a pentacle on their tombstone. The idea of sensing entities to a Pagan is no different than a Christian in church saying they can feel the Holy Spirit in the room. Or that they are aware of the presence of angels. And I don\u2019t find the claim of being able to feel energy coming off people much more far-out than the claim that a blessed wafer turns to human flesh in one\u2019s mouth.<\/p>\n
\u201cI\u2019ve also never actually shown other signs of psychosis, even though I still have bipolar symptoms sometimes. Now I reach out to my doctor to ask for a letter, and I see this diagnosis on my medical record.<\/p>\n
\u201cSo I guess my question is\u2026 what does the DSM say about this? How does science actually define delusion?\u201d<\/p>\n
I had been on a roll, and not paying attention to his expressions. As I gave him a moment to respond, I examined the psych nurse\u2019s face and immediately realized two things with a pang of guilt: he is Christian, and he is experiencing doubt.<\/p>\n
He cleared his throat. \u201cWell,\u201d he began. He adjusted in his chair, picked up a pen off the desk beside him, tapped the pen four times on the desk, and put it back down. He licked his lips. \u201cAccording to the DSM, delusion is not actually defined by\u2026what\u2019s objectively true or not true. But rather\u2026\u201d His eyes darted out the window. \u201cBut rather\u2026 how many people\u2026 also believe it.\u201d<\/p>\n
I let my face say: You\u2019re kidding me.<\/p>\n
I repeated back, \u201cSo it\u2019s about shared reality. Not provable reality. The more people who hold the belief, the more credible it is.\u201d<\/p>\n
He nodded. \u201cThat\u2019s mostly right, yes.\u201d<\/p>\n
\u201cWow.\u201d<\/p>\n
I leaned back in the chair and stared at the floor, taken by a flush of hot anger for myself and others like me. But I wasn\u2019t going to punish him for delivering information, nor ask him to be my witness in this. I took a moment to let the information soak in.<\/p>\n
\u201cThank you for answering my question,\u201d I said finally, with as much sincerity as I could muster.<\/p>\n
He said some \u201cNo problem\u201d kind of words, but his face had the look of someone who is very much struggling with a problem.<\/p>\n
I\u2019m a Druid who makes his living as an engineer. I\u2019m not a psychologist or a psychiatrist. I occasionally do pastoral counseling and spiritual guidance comparable to what a Catholic priest or a Protestant minister would do. But I know the limits of my expertise, and when someone\u2019s needs exceed my skills I refer them to a mental health professional.<\/p>\n This is one of those times. I asked two mental health professionals for their take on this \u2013 not for advice for this person, but rather general commentary on standard practices and recommendations for how to find a friendly therapist.<\/p>\n Cindy Jacobson (MEd, LPC) is a Licensed Professional Counselor in Denton, Texas and a fellow Unitarian Universalist. I\u2019ve referred Pagans and other non-Christians to Cindy, because I trust her to treat everyone with dignity and respect.<\/p>\n \u201cI just read this document and sadly was not surprised by it but definitely saddened by it. This is a problem in our profession and clients should be highly encouraged to carefully screen the clinician before seeing them, especially if they may be discussing things that they think may be unfamiliar or \u201cout of the range of normal\u201d for the clinician.<\/p>\n There are many clinicians who clearly profess to be Christian counselors. To me that is against our ethics as we are supposed to meet clients where they are and not let our biases interfere with the treatment of our clients. If we meet a client and learn that we have personal biases that may interfere with treatment, we are supposed to refer them out.<\/p>\n This individual being diagnosed at the age of 13 with a psychotic disorder based on what was mentioned here makes no sense to me. I think the psych nurse also knew this by their response but then was conflicted, maybe because of their own beliefs interfering. This is when it would be great for them to have resources where they could say to the client \u201cit might be helpful for you to talk to this person as I think they may have more experience in this area than I have.\u201d<\/p>\n It is sad but it is really necessary for a client to prescreen the therapist by asking questions prior to or at least in the initial session if they think they may be uncomfortable. I always ask a client at the end of the intake session if they are comfortable working with me and encourage them to let me know if they ever feel as if we are not a good fit. I think that it\u00a0 is crucial for a client to feel heard and accepted as they are and want them to know I will help them find someone else if I am not the best fit for them.<\/p>\n I do apologize for our profession when we fail clients and are not our best selves. Some people are not clearly in touch with their own biases and can at times do unnecessary harm to clients.\u201d<\/p>\n Many of us in the Pagan community know Anthony Rella (MA, LMHC). He\u2019s one of us, and also a licensed counselor in Seattle. His response was longer and I\u2019m reluctant to cut any of it, so here it is in its entirety.<\/p>\n \u201cMy observation is that many folks these days feel it has to be either\/or with psychosis and spirituality, but in my work with psychotic people it really seems to be more both\/and. A person could be having very valid spiritual experiences and also be experiencing psychotic symptoms that make it difficult for them to safely process and integrate their spiritual work. Often people with distressing psychotic symptoms experienced early violations of their autonomy and boundaries that make it difficult for them to have personal and spiritual boundaries, hence being flooded by psychic information along with the detritus of their unconscious.<\/p>\n I agree with the nurse practitioner that we can only measure delusions by how much they match shared consensus reality within the person\u2019s culture. I would also note that a delusion is also evaluated by its relative inflexibility\u2014a person who is truly delusional would be incapable of questioning their belief about their experience or entertaining alternative interpretations of what is happening.<\/p>\n In the past few decades the trend in psychology has been to emphasize examining a person\u2019s experience within their cultural context. The whole problem of \u201cabnormal psychology\u201d is that, very simply, it is any kind of mental or emotional presentation that is not normal for that person\u2019s community. But abnormal for your community is not necessarily abnormal in my community.<\/p>\n Any therapist who is seeing a client who has a religious, cultural, or ethnic culture that is completely foreign to the therapist should be doing their research into that culture. One of the things I strongly encourage Pagan and polytheist clients to do is to find a coreligionist in their community, ideally one with some authority, who is willing to do a consult with the therapeutic practitioner. This has a number of benefits. One is that it takes the pressure off the client (who is in a very vulnerable situation) to have to educate or worry about their therapist. Another is that it helps the therapist ask questions that would be awkward or problematic to discuss with their client.<\/p>\n I can\u2019t stress enough how helpful this is. I had a client who presented as highly psychotic with religious delusions in a Christian context, engaging in behaviors that were very dangerous to themself. I was able to speak with their pastor to get clarity about what beliefs and practices were normative and which ones the pastor themself thought were counter to their religious teachings and practices.<\/p>\n<\/a><\/p>\nI\u2019m an engineer, not a psychologist<\/h1>\n
Cindy Jacobson, Licensed Professional Counselor and Unitarian Universalist<\/h1>\n
<\/a><\/p>\nAnthony Rella, Licensed Mental Health Counselor and Pagan<\/h1>\n