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The Dark Night of the Soul: Spiritual Distress and its Psychiatric Implications

Abstract

The Dark Night of the Soul is an expression describing phases in a person's spiritual life associated with a crisis of faith or spiritual concerns about the relationship with God, and which has intrinsic aspects of spiritual growth. This paper is concerned with the way in which those going through periods of angst and disillusionment do not see them as pathological phenomena. On the contrary, through a process of attribution of religious meaning they view them as opportunities for reflecting on their lives and as agents for beneficial change. Similarities and differences between the Dark Night and a depressive episode are discussed and illustrated using the accounts of five important religious figures. Their narratives have been constructed using original texts and their biographies. The Dark Night has clinical implications owing to the risk of its being pathologised, serving as a reminder of the importance of incorporating existential issues into clinical practice.
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The Dark Night of the Soul: spiritual distress and its psychiatric implications
G. Durà-Vilà
a
; S. Dein
b
a
Division of Neuroscience and Mental Health, Imperial College London, London, W2 1PG United Kingdom
b
Department of Mental Health Sciences, University College London, United Kingdom
First Published on: 08 May 2009
To cite this Article Durà-Vilà, G. and Dein, S.(2009)'The Dark Night of the Soul: spiritual distress and its psychiatric implications',Mental
Health, Religion & Culture,
To link to this Article: DOI: 10.1080/13674670902858800
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Mental Health, Religion & Culture
2009, 1–17, iFirst
The Dark Night of the Soul: spiritual distress
and its psychiatric implications
G. Dura
`
-Vila
`
a
*
and S. Dein
b
a
Division of Neuroscience and Mental Health, Imperial College London, St Mary’s Campus,
Norfolk Place, London, W2 1PG United Kingdom;
b
Department of Mental Health Sciences,
University College London, United Kingdom
(Received 15 December 2008; final version received 2 March 2009)
The Dark Night of the Soul is an expression describing phases in a person’s
spiritual life associated with a crisis of faith or spiritual concerns about the
relationship with God, and which has intrinsic aspects of spiritual growth. This
paper is concerned with the way in which those going through periods of angst
and disillusionment do not see them as pathological phenomena. On the contrary,
through a process of attribution of religious meaning they view them as
opportunities for reflecting on their lives and as agents for beneficial change.
Similarities and differences between the Dark Night and a depressive episode are
discussed and illustrated using the accounts of five important religious figures.
Their narratives have been constructed using original texts and their biographies.
The Dark Night has clinical implications owing to the risk of its being
pathologised, serving as a reminder of the importance of incorporating existential
issues into clinical practice.
Keywords: spiritual distress; Christian mysticism; coping; religion and psychiatry
Introduction
It is not uncommon to hear religious people say that they’re going through a Dark Night of
the Soul. It may be the case that some people know the title of the sixteenth-century
Spanish classic, Dark Night of the Soul (La Noche Oscura del Alma), a poem and its
theological commentary, written by the Carmelite priest Saint John of the Cross. In this
book, the Roman Catholic mystic described the arduous path, appropriately called
a ‘‘dark night,’’ which the soul travels to reach mystical love. The union with God is
described by the poet in passionate joyous verses such as the following:
‘‘I abandoned and forgot myself,
laying my face on my Beloved;
all things ceased; I went out from myself,
leaving my cares
forgotten among the lilies.’’
(translated by Kavanaugh & Rodrı
´
guez, 1991)
*Corresponding author. Email: duravila@doctors.org.uk
ISSN 1367–4676 print/ISSN 1469–9737 online
ß 2009 Taylor & Francis
DOI: 10.1080/13674670902858800
http://www.informaworld.com
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The Dark Night of the Soul has become an expression used to describe certain phases
in a person’s spiritual life that has transcended the Christian spiritual tradition in which
it was born. It is used as a metaphor to describe the experience of loneliness and desolation
in one’s life associated with a crisis of faith or with profound spiritual concerns about the
relationship with God. These painful periods of setback and disillusionment, of spiritual
torment and anguish have an inherent aspect of spiritual growth. Those experiencing
the Dark Night of the Soul go through a process of attributing meaning to this experience:
they consider it as a process of maturation of their spiritual life, as a natural not
pathological process in their spiritual development. Therefore, in spite of the emotional
distress experienced in this period of darkness, the Dark Night is perceived to be a divine
gift in disguise, whereby the individual can be transformed and purified, their faith
deepened and reinforced and the union with God brought closer. G.G. May (2004) argues
that, to the serious detriment of the individual’s spiritual life, this difficult side of it has
been often trivialized and neglected in favour of an easier and more superficial spirituality,
whereas the encounter with this Dark Night can be an enriching and healing experience
that could lead to true spiritual wholeness. Nevertheless, we have recently witnessed the
secular media’s reaction to the book Come, Be My Light that contains Mother Teresa
of Calcutta’s correspondence with her spiritual directors in which she described a 40-year
period of struggles with faith, doubts and a sense of abandonment by God. Following
its publication, Mother Teresa was called a ‘‘fake’’, a ‘‘pretender’’ or even a ‘‘liar’’ when
what she was experiencing as we will present below was what Catholic spirituality
describes as the Dark Night of the Soul, an experience shared by many saints such as Saint
John of the Cross and Saint Teresa of Jesus. This media reaction has been attributed to
a lack of knowledge of the mystics’ experiences and unfamiliarity with the language of the
spiritual life (Van Vurst, 2007).
Those who have undergone the Dark Night emphasise the important role of having an
accompanying personal relationship during this time of spiritual suffering. Spiritual
mentors and confessors can be inestimable companions to give assistance during the
Dark Night as they can provide the orientation and the perspective of someone
experienced and wise, and someone who is not immersed in this darkness. Belonging
to a religious community or prayer group has also been identified as a useful source
of companionship and as an instigator of the will to live (Font, 1999, p. 107).
This paper is concerned with the way in which those going through the Dark Night
do not see it as a pathological phenomenon but on the contrary, rather as an opportunity for
reflecting on their lives and as potential agents for beneficial change. They make sense of this
experience in the light of their religious beliefs and faith, and are able to transform the
psychological suffering attached to it into an active process of self-reflection, attribution of
meaning and spiritual growth. We first discuss the similarities and differences existing
between ‘‘salutary’’ religious depression the Dark Night of the Soul and ‘‘pathological’’
religious depression. In order to put these themes into context, five illustrative cases of
important religious figures who went through the Dark Night of the Soul follow with
a detailed description of their own experience (including those symptoms that differ from
a depressive episode as well as those that they share). Their accounts have been constructed
through the analysis of original texts (such as private letters, diaries and books that they left)
as well as biographies. The paper ends with a discussion of the Dark Night’s clinical
implications, focusing on the risk of its being pathologised when existential issues are not
incorporated into clinical practice.
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Religious psychopathology of depression: ‘‘salutory’’ and ‘‘pathological’’ religious
depression
J. Font (1999), a psychiatrist, a Jesuit and a theologian, establishes a distinction between
two different concepts: ‘‘salutary’’ religious depression (or the so-called ‘‘Dark Night
of the Soul, ’’ ‘‘griefs, ’’ ‘‘desolations’’) and ‘‘pathological’’ religious depression which is
the domain of psychiatry. This is one of his valuable contributions to the field of
religious psychopathology. Font’s ‘‘salutary’’ religious depression offers a theoretical
framework for depictions of the Dark Night, highlighting its significant differences from
a depressive episode. The experiences of spiritual darkness depicted by the saints and
mystics some of them many centuries ago that will be presented below bear a strong
resemblance with this concept of ‘‘salutary’’ religious depression. In this section, we will
proceed to offer a summary of the symptoms, psychodynamic aspects and religious
manifestations of the ‘‘salutary’’ religious depression, ending with a table presenting the
main similarities and differences between ‘‘salutary’’ and ‘‘pathological’’ religious
depression (Table 1).
Font’s justification for using the term ‘‘salutary,’’ while talking about depression,
comes from the ambiguous and polyvalent use of the term ‘‘depression’’ both popularly
and scientifically that may lead to confusion. This ‘‘salutary’’ depression may share
the symptoms of the ‘‘pathological’’ one, but the key difference is that the former can be
a maturing and healthy process of spiritual growth the depressive symptoms could be
the healthy expression of a maturation process in contrast with the melancholic
darkness of the pathological counterpart that could lead to mental illness. Also, from a
psychodynamic perspective, following Melanie Klein’s object relations terminology, the
‘‘depressive position’’ is a salutary state as it allows the transition to personal growth:
it is a phase in which, through the development of personal relations, the individual
reaches acceptance of the losses and sacrifices that bring relationships with others.
Although this process of renouncing may not come without depressive feelings, without
suffering and maybe even without feelings of guiltiness, it can bring a new and more
valuable reality than that which has been given up. This process starts with the conscious
search of the love object (God), a search that becomes a radical and progressive sacrifice
of all what is narcissistic in order to become united with God. During this state, there is
an elaboration of the losses and sacrifices and an acceptance of the reality of the other.
Therefore, the psychological depressive process of the Dark Night has, par excellence, the
qualification of ‘‘salutary’’ (Font, 1999, pp. 100–106). ‘‘Salutary’’ is here translated from
the Spanish word ‘‘saludable,’’ which a third sense of its definition being ‘‘profitable
for a purpose, particularly for the good of the soul’’ (Real Academia de la Lengua,
1992, p. 1837).
This ‘‘salutary’’ religious depression can present with multiple symptoms. Firstly, an
unbearable vital deep sense of unease and a healthy guiltiness to be differentiated from
pathological guiltiness causes loving feelings to repair the evil caused. A negative self-
evaluation is dominant with a prominent feeling of uneasiness for the individual’s
limitations. Anxiety and suffering often accompany the depressive symptoms. In each
individual case, the anxious or the depressive feelings tend to predominate. It also
presents with loss of interests and satisfaction, sadness, disappointment, lack of volition,
feelings of emptiness, inhibition and anhedonia. A key difference with the ‘‘pathological’’
counterpart is that the individual has a clear wish to recover completely, to get out of it,
even if they feel lacking in the necessary strength. The somatic syndrome of depression
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is also present: loss of appetite (with possible loss of weight), tiredness, insomnia, waking
up at night and especially early morning wakening. Hypersomnia can also be present
along with tearfulness and crying. This depression can also manifest itself in vertigo,
headaches, migraines, dysmenorrhoea, dyspepsia, cardiac and vascular anxieties,
neurodermitis, etc. (Font, 1999, pp. 102–103).
Socially, the individual suffering from ‘‘salutary’’ depression is characterised by
passivity and slowness in action and speech. Everything is unachievable, even the most
ordinary daily activities. In contrast to the ‘‘pathological’’ depression, the individual
going through the Dark Night does not run away from social interaction. On the
contrary, although at times they may search for solitude or may look for frequent and
brief contacts, community life is well maintained in spite of the inner suffering. Even
more, as they advance in this process of spiritual maturation, their inter-personal
relationships and service attitude towards others increase and become more spontaneous
and sincere. The apostolic activity is not damaged either by this Dark Night. In some
cases, full activity ideological as well as external action is preserved. This is
exemplified by the testimonies presented in the following section. Nevertheless, praying
may become difficult, dry, desolate, restless, lazy or sad in a fight to abandon one’s own
egocentric interests for obtaining the love of the other. Praying can become an
experience of agony and darkness. In this situation, some of Font’s clients found
the repetition of a few words or verses from the Psalms a source of calm and relief
(p. 107).
Another essential difference with the pathological religious depression is that in the
Dark Night of the Soul the individual never ceases to feel hope from the love object
(God), and it does not lead to suicide. In the ‘‘pathological’’ depression in contrast
with the ‘‘salutary’’ one there is often a sense of hopelessness; using Font’s own
words regarding the experience of the Dark Night of the Soul: ‘‘even if the little light is
so tenuous that it seems completely off, in spite of all, you can see without seeing, it is
not longing for anything but longing for all.’’ The depressive tone of the Dark Night is
a salutary expression of the pain provoked by the radical search of God. The
experience of God could be felt estranged or absent; instead of a God of love, there is
darkness, a painful emptiness (p. 105). At times, a religious experience can also lead to
a ‘‘pathological’’ religious depression which fits the criteria for a depressive episode
(ICD-10, DSM-IV). Font identifies two possible causes for the development of mental
illness in the context of the religious experience: due to a previous existence of an
underlying psychopathologically depressive structure or due to the intensity of the
conflict and the fragility of the subject. Some characteristic symptoms of these
‘‘pathological’’ religious depressive phenomena, that he divided in three varieties, are:
(1) emotional instability dependent on external circumstances, irritability, attitudes of
provocation and to attract attention, pseudo-attempts of suicide and deliberate self-
harm (reactive histrionic type); (2) fatigue, exhaustion, impotence, incapacity to
work or study, dependence on others with frequent accusations of not being listened to
and being disappointed by them, incapacity to tolerate frustration (fluctuant
narcissist type); (3) deep sadness, total emptiness without any hope at all for the
future, persecutory guilt, rejection of any help, mental and physical passivity and the
risk of suicide (severe melancholic type) (pp. 109–111). A table presenting the main
similarities and differences between ‘‘salutary’’ and ‘‘pathological’’ religious depression
follows (Table 1).
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Christian mystics and the Dark Night of the Soul
Accounts of having struggled with the painful experience of the Dark Night of the Soul
are often given by priests, monks, nuns or other deeply religious people, followed by the
assertion of emerging from them transformed and invigorated by faith and certainty,
with their religious vocations confirmed. Mystics and revered religious figures were not
immune to the experience of the Dark Night and they were humble enough to record
some of them with admirable frankness evidence of their spiritual sufferings in their
writings and letters. Many saints and those seeking union with God, from Saint Francis
of Assisi (1182–1226) to Saint The
´
re
`
se of Lisieux (1873–1897), speak of similar
experiences of spiritual darkness and struggles. For some of them, they were not short-
term spiritual crises, but in some cases reached a more severe magnitude lasting
several decades and even led to devout believers feeling totally abandoned by God and
to questioning his existence. J. Van Vurst (2007) argued that Jesus during his own
passion and death was the most important sufferer of the Dark Night, experiencing
an abandonment by God: ‘‘why have you forsaken me?’’ (Matthew 27:46; Mark 15:34).
As these cases will show, during their spiritual anguish, an identification with
Christ’s Passion takes place, viewing it as an opportunity to be closer to Christ’s pain
on the cross.
In this section, five cases are presented in chronological order from the fourth to the
end of the twentieth century as illustrations of personal experiences of the Dark Night.
Their accounts display the features described by Font for ‘‘salutory’’ religious depression
as well as having the key features that set them aside from the ‘‘pathological’’ one. It is
interesting that, although these religious figures span many centuries, the narratives
of their spiritual darkness share many characteristics as well as bearing a great resemblance
in the language used, and in the way they were recorded and interpreted. An explanation
Table 1. Similarities and differences between ‘‘salutary’’ religious depression the Dark Night of the
Soul and ‘‘pathological’’ religious depression, based on Font (1999, pp. 100–108).
Similarities
Differences
(Characteristic of the
Dark Night of the Soul)
Passivity and slowness in action and speech Healthy guiltiness that causes loving feelings
to repair the evil caused
Negative self-evaluation Clear wish to recover completely
Low mood, suffering, loss of interests and
satisfaction, sadness, disappointment, lack
of volition, feelings of emptiness, inhibition,
anhedonia, tearfulness and crying
Does not run away from social interaction:
community life is well maintained and
inter-personal relationships and service
attitude towards others improve.
Apostolic activity is not damaged, full activity
sometimes is preserved
Somatic syndrome of depression: loss of
appetite with possible loss of weight,
insomnia or hypersomnia, tiredness, etc
Meaning: spiritual maturation as it is a process
of conscious search of the love object (God)
and of radical and progressive sacrifice of
all that is narcissistic in order to become
united with God
Anxiety can accompany Never ceases to feel hope
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that could be ventured for the similarity in their depictions of their period of spiritual
suffering is that some of the texts of the early mystics (such as Saint Teresa of Jesus’s
The Book of Her Life) have become classic texts that are read and taken as spiritual
guides by religious people, so they can identify their experiences with the ones of their
predecessors, attributing a religious meaning and consequently voicing them in similar
terms, creating a sort of religious script to refer to these dark times.
Saint Augustine
Saint Augustine (354–430 AD), by far the most important of the Fathers of the Western
or Latin Church and one of the most influential figures in Church history, recorded in his
Confessions (Confesiones) his personal Dark Night and this is the text used here to elicit
its particular characteristics. Augustine’s tormented spiritual search and heart-rending
grief is poured out in the pages of this book telling the reader how his heart was restless
until it could rest in God. His religious quest is to unreservedly commit himself to love
God with his whole heart, his whole soul and his whole mind (as Saint Augustine quoted
Matthew 3, 8), trusting him unconditionally and absolutely. His Confessions portrayed his
desperate craving and hunt for a trustworthy faith, the struggle to identify the fail-safe
God to trust (Dittes, 1986).
Saint Augustine experienced anhedonia, one of the similarities that the Dark Night
shares with a depressive disorder, as he complained about not finding calmness or
enjoyment in ‘‘the pleasant forests, nor in the games, nor in the songs, nor in the fragrant
gardens, nor in the splendid banquets, nor in the pleasures of the bedroom and bed,
not even in books or verses’’ and that ‘‘everything became repulsive, even light itself.
Anything that was not Him became for me tedious and overwhelming’’ (Saint Augustine,
400 AD, pp. 112–113). Tearfulness and crying were his frequent visitors, he seemed to have
been in a lachrymose state (‘‘...the inflexion of my voice was impregnated with
weeping ...’’) (p. 267), acknowledging how difficult he found it at times to hold his tears
back. Furthermore, he found considerable emotional relief in crying, these ‘‘painful and
bitter tears’’ seemed to have become his allies and he regarded them in a positive healing
light: ‘‘Only in them (tears) I feel a little relief. When the resource of these tears was
withdrawn from me, then I feel the tremendous oppression of my misery’’ (p. 113).
He considered them a sacrifice acceptable to God and poetically described an occasion
when a ‘‘tremendous storm’’ that was taking place in his heart was resolved in an
‘‘abundant rain of tears’’ (p. 266).
His tortuous journey was filled with great suffering, as he himself vividly expressed:
‘‘What delivery pains my heart bore! What groans, my God!’’ (p. 213). His search for
God was described in violent terms: as an enraged quarrel with his soul, with his spirit
vibrating incensed with an anger like a true whirlwind because he ‘‘could not reach an
agreement with God’’ (p. 258). In his desperation, he resorted to release his rage hurting
himself physically (for example, pulling his hair and hitting his forehead). In his
Confessions, accounts of feeling his soul broken with pain and of being destroyed,
bewildered and blind were frequent. Saint Augustine was torn by doubts regarding
God’s mercy, by fear of death and of his judgement. Finding unbearable the misery of his
own soul and unable to run away from himself, he poured out how he felt trapped
and impotent. In spite of these moments filled with despair and agitation, called by him
‘‘salutary madness,’’ he seemed to have been able to keep a sense of control over his
situation as his suffering had a clear finality: ‘‘I was dying to live. I knew how unwell I was,
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but I knew how well I would be in a little while’’ (p. 258). His searching attitude was
a constant, feeling consecrated to the search for the truth. Saint Augustine was determined
to overcome his situation and to progress in a path of gradual purification and sacrifice of
pleasures that he considered necessary to be worthy of God. He exemplified the healthy
guiltiness explained above: he experienced a deep sense of shame due to his ‘‘past evilness’’
and ‘‘frivolities,’’ he felt that God was disappointed with him and he was furious with
himself for not putting an end to them and kept postponing indecisively their amendment
for ‘‘tomorrow, tomorrow’’ (p. 267).
At times, during his Dark Night, he was shaken by feelings of absurdity and fear, and
a negative evaluation of himself and the world tinted his perceptions. He confessed to have
even felt incapable of imagining virtue and beauty. His speech was also affected by his low
mood, finding the articulation of words and the meaningful expression of himself difficult.
During the worst moments of his Dark Night even thinking of God became agonizing:
God was not anymore ‘‘something solid and consistent’’ but ‘‘a futile ghost and my error
was my God’’ (p. 113). Anxiety accompanied his depressive symptoms becoming apparent
in the account of his tempestuous search for God.
Saint Augustine mentions reading the Bible as a valuable source of light that could
dissolve or alleviate spiritual darkness and pain; he described this curious anecdote: while
he was very distressed in the middle of a spiritual battle, crying, feeling that God was angry
with him, exasperated by his perceived weaknesses, he heard a child’s voice coming from
a neighbouring house who was singing repeating this chorus ‘‘Take and read!, take and
read!’’ He interpreted this as a command from God to open the codex of the Apostle Saint
Paul and read the first chapter that he found. As soon as he finished reading a few
sentences that his eyes fell on, he felt ‘‘how a light of security was poured in my heart,
frightening off all the darkness of my doubt’’ (pp. 267–268).
Keeping their suffering secret from their religious communities and only revealing
it to a superior or a spiritual director is a common feature in the cases presented here.
They strongly felt that, even if unknown by anyone else, God was fully aware of their
anguish. Despite Saint Augustine’s wretched situation he did not feel alone, as he recalled
the presence of God listening to him, as he proclaimed: ‘‘No man knew but You what
I endured. How little of it could I express in words to the ears of my dearest friends!
How could the whole tumult of my soul, for which neither time nor speech was sufficient,
come to them? Yet the whole of it went into Your ears, all of which I bellowed out in the
anguish of my heart’’ (pp. 213–214).
Saint Teresa of Jesus
Saint Teresa of Jesus (1515–1582) also called Saint Teresa of A
´
vila (her Spanish birth
town) was a sixteenth-century Carmelite nun, a mystic and a writer. She was a reformer
of the Carmelite Order and with Saint John of the Cross she founded the Discalced
Carmelites. She is one of the three women to be recognized as a Doctor of the Church and
is one of the most influential authors on mental prayer, didactically explained by Teresa
as ‘‘nothing else than a close sharing between friends; it means taking time frequently to be
alone with Him who we know loves us’’ (Estepa et al., 1992, p. 587). She also wrote
extensively about her mystical experience and was even popularly reported to have been
seen levitating during Mass in spite of her effort to resist especially when others were
present ‘‘the great forces’’ that ‘‘lifted me from under my feet,’’ having finally to accept
God’s will (Saint Teresa of Jesus, 1565, p. 230). Her writings (both in prose and poetry) are
filled with a great power of expression, of simplicity and tenderness, occupying a place
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of honour among the most remarkable in the mystical literature of the Roman Catholic
Church. One of her most quoted excerpts from her poems is the following:
‘‘Let nothing trouble you. Let nothing scare you.
All is fleeting. God alone is unchanging.
Patience everything obtains.
Who possess God nothing wants. God alone suffices.’’
(translated by Kavanaugh & Rodrı
´
guez, 1985)
In The Book of Her Life (Libro de la Vida) Saint Teresa left testimony of her Dark
Night explaining how her soul felt desperate, restless and uneasy as she felt surrounded by
darkness and affliction. She faced ‘‘doubts and suspicions’’ when her faith and virtues were
‘‘muffled and asleep’’ (Saint Teresa of Jesus, 1565, pp. 375–376) and had physical suffering
added to her spiritual pain. A process of mental filtering seemed to have taken place
during her Dark Night through which she selectively remembered her misfortunes and
‘‘all the favours that the Lord granted me were forgotten’’ (pp. 372–373). She evaluated
herself in a negative light: full of imperfections, evil, sin and possessing a false humility.
There are vivid memories of moments of indifference, insipidity, apathy and emotional
numbness when she felt nothing. Her thoughts were at times muddled up, her mental
blurring could last from one day to several weeks when her mind was unable to be the
master of herself to control the ‘‘stupid things’’ that were appearing in it. Her praying
became dry, fruitless and desolate, even a painful experience for her soul and body, calling
it an ‘‘anguish,’’ a ‘‘torment’’ and an ‘‘unbearable’’ activity. In contrast to the solace that
Saint Augustine found in reading, Saint Teresa referred to a time when immersed
in painful darkness she resorted to a book about the life of a saint (she did not state the
name) and she had to abandon it after persisting in reading ‘‘four or five times’’ some
sentences without understanding, resulting even in more confusion (pp. 374–376).
When distressed by the darkness, she complained repeatedly to God asking Him
how He allowed her to suffer so many ‘‘torments’’ but recognising how ‘‘well-paid’’ she
was afterwards as the torments were followed by ‘‘great abundance of favours’’ (p. 378).
Realising that her Dark Night was helping her to improve her spiritual life, the sorrow
intrinsic to it became a comfort and she became thankful to God for this opportunity.
Guiltiness for having offended God propelled her to confront her imperfections and to
progress in her faith. She used the metaphor of a crucible melting pot for the Dark Night,
stating that her soul came out from it like gold, sharper and clearer, to be able to see the
Lord in herself. Moments of peace and joy were intercalated between ‘‘the darkness of my
soul’’, dissolved by the ‘‘sun coming up.’’ These relieving experiences happened at times
‘‘...just after taking the communion ...I felt so good in soul and body’’ or at other times
hearing ‘‘the Lord just telling me: Dont dismay, dont be afraid ...I felt completely healed’’
(p. 378). Hope never abandoned her and this is one of the key distinctions with the
‘‘pathological’’ depression: not losing trust in God taking care of her and giving the
necessary strength to fight the darkness were common themes in the narratives of the Dark
Nights presented here.
Saint Paul of the Cross
Saint Paul of the Cross (1694–1775), founder of the Passionists (a Roman Catholic
religious order), is considered to be among the greatest Catholic mystics of the eighteenth
century but neither was his life free of spiritual turmoil as he underwent and overcome
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a very long Dark Night which lasted 50 years: ‘‘I cannot remember, for fifty years, to have
had a day free of suffering’’ (Lippi, 1994, p. 301). The length of his spiritual darkness and
some of his writings are impregnated with a deep sense of desolation to the extent to merit
being named by his biographers the ‘‘Prince of the Desolates.’’ In Lippi’s biography
(1994), Saint Paul is depicted as a very emotional and sensitive man; as well as being
extrovert, enterprising and full of initiative and imagination, he possessed an impetuous
and explosive temperament. As a writer he left numerous letters mostly to Passionist nuns
of whom he was the spiritual director. The Passion of Christ was central to Paul’s
spirituality and far from rejecting pain, he valued it positively, and consciously accepted
it as a source of spiritual learning. Furthermore, he regarded human suffering as a special
grace granted by God as provided the soul with the opportunity to participate in the
suffering of his ‘‘beloved Lord’’ through the contemplation of his Passion, as he himself
proclaimed: ‘‘I only wish to be crucified with Jesus’’ (Bialas, 1979, p. 34).
At times during his very long spiritual night, he felt immersed in a ‘‘very unhappy state,
almost as unhappy as that of the damned, because I truly feel a real abandonment from
God’’ as if his ‘‘whip’’ were beating him in an ‘‘inexplicable way’’ (Lippi 1994, p. 302).
His prolonged spiritual agony affected his physical health to the extent of making him
ill for several periods of time. Saint Paul frequently talked about his ‘‘naked suffering’’ as
a suffering deprived of any comfort; the cause of it coming especially from his relationship
with God that turned violent: like experiencing a ‘‘laceration of the conscience that at
times would like to be expressed with blasphemy’’ (Lippi, 1994, p. 303). A fragment
of a letter sent to a friend and priest (Father Juan Marı
´
a Cioni) confided his wretched
situation giving a glimpse of his desperate reality: ‘‘...believe me that I find myself
in a very lamentable state ...Especially, I struggle to bear myself and some days almost
all I do not know what to do to bear myself, nevertheless, I make an effort with great
fatigue to bear the others ...’’ (Lippi, 1994, p. 262). At the lowest point of his Dark Night,
he felt ‘‘buried by an abyss of miseries,’’ experiencing a generalised lack of meaning that
extinguished his will to live (Bialas, 1979, p. 61).
A negative evaluation of himself dominates his letters feeling overwhelmed by the
weight of his guilt: ‘‘I am the most miserable and abandoned of men.’’ He clearly tried
to liberate himself from this feeling of guilt fighting to redeem his limitations. At times,
his anguish took control of his thoughts and left him ‘‘unable to have one minimal positive
thought’’ (Lippi, 1994, p. 302). He also complained about feeling ‘‘melancholic,’’ not being
able to enjoy earthly joys and having a low threshold to tolerate people and noises:
‘‘I was bothered by seeing people, hearing them having a walk, noise, the bell ...’’ (Bialas,
1979, p. 51).
As sources of comfort he resorted to writing letters to intimate friends with whom he
could share his afflictions, mentioning with special gratitude the help received from the
Virgin Mary, whom he used to invoke when he was struck by ‘‘horrible temptations
of blaspheming against God’’ (Bialas, 1979, p. 74). He tried hard to keep his sufferings
away from his brothers, firmly believing that they were not aware of his sorrows; he only
wanted them to be known by God actively making an effort to externally appear happy.
His apostolic activity was not damaged by his Dark Night as he continued with his hectic
schedule of work: with his constant letters, travels, foundations, etc. On the contrary,
his suffering seemed to have propelled him to be more open to other people’s needs, being
‘‘full of attentions and charity’’ towards them. His letters ended almost always with
a ‘‘blessing full of faith, human warmth and sometimes poetry’’ (Lippi, 1994, pp. 263–264).
In spite of the darkness, his Night was full of light, of hope and of the presence of the
divine. He described passionately how he discovered his true self through an arduous
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search for the truth; from the ‘‘poverty and nudity of his spirit’’ he experienced God’s love
and learned many lessons. He called the Dark Night a ‘‘precious martyrdom of love’’ filled
with purpose: ‘‘such holy martyrdom produces in the soul two wonderful effects: one is to
purify it from any hint of imperfection ...; the other is to enrich the soul with virtues,
especially with patience, mildness, with high resignation to the divine will ...’’ (Lippi, 1994,
p. 303). He recalled how he was rewarded with the experience of union with God
‘‘a marvellous and highest wonder’’ when he ‘‘felt that he was dissolving in God.’’
It was accompanied by ‘‘abundant tears’’ and took place as Saint Teresa’s mystical
experience described above after taking the communion (Bialas, 1979, p. 89).
His desolation made praying a painful effort: he could not concentrate, he was
‘‘...arid, distracted, tempted: as if I was praying by force.’’ He gave the example of a time
when despite feeling hungry and cold and wanting to escape from his prayers, he resisted
‘‘with God’s grace’’ this urge to abandon his prayers. But his resistance provoked a painful
physical experience in which ‘‘my heart jumped, I shuddered from toes to head and every
bone of my back hurt, as well as my stomach.’’ Nevertheless, he believed that this kind
of painful prayer was a ‘‘great gift that God gives to the soul to transform it in an ermine
of purity, in a rock against pain’’ (Bialas, 1979, p. 70).
Saint Te
´
rese of Lisieux
Saint Te
´
rese of Lisieux (1873–1897) popularly known as The Little Flower of Jesus
and as Saint The
´
re
`
se of the Child Jesus a nineteenth-century Roman Catholic Carmelite
and a Doctor of the Church, underwent a desolate period of spiritual darkness.
Tuberculosis prevented her from becoming a missionary as she had deeply wanted. She
suffered greatly during the last 18 months of life when to her physical suffering, severe
spiritual trials were added, and she died in 1897 when she was only 24. There were
dramatic moments of spiritual conflict, especially during the final period of her illness,
which taxed to the utmost her faith and will, doubting whether anything awaited her after
death (Martin, 2007). At the request of her sister, who was also the prioress of her
monastery at the time, she wrote her autobiography Story of a Soul which is recognized
by the church as one of the most important works on spiritual life. She felt unable to
express her experience of darkness as it was necessary to ‘‘have gone through this dark
tunnel to be able to understand it’’ (Saint The
´
rese of Lisieux, 1897, p. 160). Nevertheless,
she poured out the desperation caused by the dense darkness that invaded her into this
book as will be shown here as well as leaving a record of her path to God and spiritual
growth.
An occassion was described when she was ‘‘exhausted by her surrounding darkness,’’
in which it appeared to her that the darkness borrowed the voice of the impious and made
fun of her dreams of a wonderful heavenly life, mockingly telling her: ‘‘Rejoice about
death as it will give you not what you expect but an even darker night, the night of
nothingness!’’ (p. 162). She also poured her anguish at doubting her faith into the letters
to her prioress telling her that she was ‘‘not exaggerating the night of my soul’’ as ‘‘the
veil of my faith is almost torn’’; later on she confessed that this veil had become a ‘‘wall’’
that reached up to heaven hiding the starry firmament (p. 163). She endured long agonised
nights at the infirmary being certain of her nearing end and fearing that heaven ‘‘was more
and more closed for me’’ (p. 241). The presence of the devil that she sensed tormented her,
making ‘‘thicker the darkness of my soul,’’ hearing an ‘‘accursed voice telling her: are you
sure that God loves you? Has He come to tell it to you?...’’ (p. 240). In this distressing
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wakefulness when although she could not see the devil, she could feel him around her,
she begged the nurse to sprinkle her bed with holy water. Although torn by doubts,
The
´
re
`
se made a conscious effort to maintain firmly her beliefs as she herself recognised:
‘‘If I proclaim the happiness of heaven, the eternal possession of God, it is not because
I felt any joy; I simply proclaimed what I want to believe’’ (p. 163). She exerted herself to
keep her inner turmoil secret; she reassured her prioress: ‘‘Oh Mother, our Sisters ignore
my suffering’’ (p. 241).
Font (1999, p. 107) pointed out that repeating a few words or sentences were a source
of calm for his clients undergoing the Dark Night; similarly The
´
re
`
se used to repeat a phrase
from a prayer which brought her relief during her darkness: ‘‘Liberate us from the
ghosts of the night!’’ (1897, p. 241). During the moments of loneliness she also recalled the
comforting certainty of knowing that Jesus was there with her, accompanying her in her
pain, but acknowledging that at times it was very difficult to ‘‘see the Beloved of my
heart’’ as she was ‘‘in the midst of the darkness of such a gloomy night’’ (p. 86). She had
a debt of gratitude towards her sister (also a Carmelite nun who became the prioress of the
monastery) whose patience with her she warmly praised and to whom she could pour out
her heart finding great relief: ‘‘Oh Mother, Your Reverence knows all the folds of my soul,
Your Reverence only!’’ (p. VI).
She expressed how much she longed to see God and how ‘‘incessantly’’ she aimed
for her ‘‘sweet homeland’’ (heaven): ‘‘I sensed another land, another lighter region which
will be my permanent home’’ (p. 162). She understood her Dark Night as part of her
spiritual journey, as a way to perfect herself to achieve these goals. Her suffering was not
fruitless or meaningless as she considered her spiritual night a ‘‘test’’ sent by God to
improve her. She embraced this pain as it had the purpose of leading her to what she most
wanted, stating that she suffered with joy as there could not be a better happiness than
to suffer for God’s love. The
´
re
`
se was determined to be victorious over this trial and used
words such as ‘‘combat’’ and ‘‘enemy’’ to express her will to defeat her doubts and
imperfections (‘‘I behave like the brave’’) (pp. 162–163). She also used her feelings of
abandonment as an opportunity to imitate the Passion of Christ. She called her Dark
Night a ‘‘heavy cross’’ strongly identifying with Jesus’s desolation in the Orchard of Olives
(‘‘the Orchard of Agony’’) (p. 86). Although she reportedly was in great pain until her
death (she was too unwell even to take the communion during her last two months), she
seemed to have been able to think of other suffering people, promising to help them from
heaven (many miracles were attributed to her after her death): ‘‘After death I will let fall
a shower of roses’’ (p. 247).
Mother Teresa of Calcutta
The recently published book about Mother Teresa (1919–1997), Come Be My Light.
The Private Writings of the Saint of Calcutta (Kolodiejchuk, 2008), contains the agonized
testimony of a woman widely known in her lifetime as a ‘‘living saint’’ who confronted
a terrifying period of darkness that lasted for over four decades. Interestingly, her patron
saint was Saint The
´
re
`
se of Lisieux with whom as showed above she shared this
experience of darkness and of doubts about her faith (Martin, 2007). Monsignor Pe
´
rier,
archbishop of Calcutta, was instrumental in this book as he kept the many letters despite
Mother Teresa apparently having wished them to be destroyed in which she sought his
guidance and help for her very long Dark Night. Her private journals and correspondence
with her confessors and spiritual mentors vividly portrayed the Nobel Prize winner’s long
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inner turmoil: ‘‘In my soul I feel just that terrible pain of loss, of God not wanting me
of God not being God of God not existing’’ (Kolodiejchuk, 2008, p. 238).
Evidence of her Dark Night started to appear in her correspondence with her spiritual
directors when she was in her late thirties; in a letter to Monsignor Pe
´
rier she
approximately dated the beginning of ‘‘this terrible darkness inside of me, like if
everything was dead’’ to when she founded the Missionaries of Charity (Kolodiejchuk,
2008, p. 187). Since then she openly depicted her ongoing spiritual agony leaving
a valuable record of her Dark Night as well as how it evolved and coped with throughout
her long life (she died in 1997, when she was 87 years old). She was invaded by a ‘‘terrible
feeling of loss’’ (p. 15) and complained about darkness preventing her seeing with her mind
or with her heart and about loneliness. Her perceived source of suffering was her ‘‘constant
longing for God that is causing me this pain deep in my heart.’’ She felt that God’s place
in her soul was empty: ‘‘There is no God in me’’ (p. 15). Her prolonged spiritual darkness
had weakened the certainty of God’s love towards herself and the reality of a heaven
after death. But in spite of her doubts, she was reported to hold her faith firmly with all her
might and without any comfort to devote herself daily to serve the ‘‘poorest of the poor’’
(p. 211). Mother Teresa was admirably able to use this experience of loss, identifying
herself with the abandonment that the poor faced daily, to devote her life to serve the
neediest. She confessed that in the outcasts and the dying of the streets of Calcutta that
were rejected and abandoned to their pain, she saw reflected ‘‘the true image of my own
spiritual life’’ (pp. 285–286). Her Dark Night was a source of inspiration and strength for
her apostolic activity, it propelled her to help them as well as giving her the sensitivity
to understand the feelings of the poor. B. Kolodiejchuk a member of her priests’
community and her postulator (promoter) for canonization stated that Mother Teresa
achieved a total identification with ‘‘her people.’’ Despite feeling that she had lost her
faith, she continued living according to her initial vocation of service to the poor. Mother
Teresa wrote that when she was ‘‘out there’’ focused in her work she felt a strong presence
of ‘‘someone living very close to me, in me’’ (p. 260), adding that day by day the love she
felt for God was becoming more real. She intended to continue with her attitude of service
even after her death, as she herself wrote: ‘‘If I ever become a saint, I will surely be one of
darkness. I will continually be absent from heaven to light the light of those in darkness on
earth’’ (p. 282).
Mother Teresa left a clear record in her writings that she did not enjoy suffering: on the
contrary, she found it ‘‘almost unbearable’’ (p. 217). Nevertheless, as her predecessors
did, she appreciated her Dark Night as a privileged opportunity to be united to Jesus in his
Passion and to go deep in the ‘‘mystery of Christ’s cross’’ (p. 217). Throughout her
extremely long darkness, Mother Teresa herself as well as her spiritual mentors undertook
a process of attribution of meaning to her desolate experiences, understanding it within
a religious framework and regarding it with total certainty as a normal non-pathological
part of her particular path of spiritual maturation. Monsignor Pe
´
rier had a central role in
her Dark Night offering comfort and advice to her. In his letters, he tried to reassure her
in the following manner reminding her that her experience of darkness was a blessing:
‘‘in what you reveal, there is nothing unknown to mystical life. It is a grace granted by
God.’’ He carried on explaining that her source of suffering was her strong longing
for God: ‘‘to be all His without receiving anything in return ...to live for Him and in Him,
but this longing that comes from God can never be satisfied in this world, simply because
He is infinite and we are finite’’ (pp. 204–205). Monsignor Perier continued witnessing her
anguish and during another period of her life he provided another interpretation for
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her persisting darkness: as being a purification and a protection against pride following the
increasing fecundity of her work (p. 208).
Mother Teresa had a total trust in God’s ultimate loving plan for her, accepting fully
her suffering: ‘‘my soul remains in deep darkness and desolation. No, no, I do not
complain, let Him do with me whatever He wants’’ (p. 193). She struggled to remain
hopeful and she was committed to become an ‘‘Apostle of Joy’’ (p. 213). There is
a discrepancy between Mother Teresa’s inner pain and the joy that those around her
perceived. Those who spent time in her company talked about the serenity, happiness,
hope and enthusiasm that she exuded and inspired in those that work alongside her and
in particular to her Sisters (Missionaries of Charity) and to the poor that she served.
There are many testimonies along those lines, as the impressions of father Van der Peet
who knew well about her spiritual agony: ‘‘...I was often surprised at how someone
who lived face to face with people who suffered, and who was personally going through
such a dark night, could smile and made you feel so happy ...’’ (p. 327). On these lines,
B. Kolodiejchuk called her effort ‘‘heroic’’ as ‘‘in the midst of her darkness, she exuded
light’’ (p. 345).
Like her companions in the Dark Night she had difficulties in praying, nevertheless,
she commented that in spite of being at times incapable of saying a word of prayer she
could feel ‘‘in some place deep in her heart that her yearning for God was making way
through the darkness’’ (p. 260). As her predecessors she kept her doubts and suffering
hidden only revealing it to her spiritual directors in her own words: ‘‘I want to smile
even at Jesus and so hide if possible the pain and the darkness of my soul even from Him’’
(p. 187). She had to fight against the fear of deceiving everybody else but whenever she
wanted to disclose her apparent lack of faith she was incapable of doing so. Continuing
to live with faith even when at times she felt a total lack of it was a particularly
hard trial for her.
She resorted to spiritual books to alleviate her suffering and as a source for hope,
stating that these readings ‘‘lighted the hope that the darkness will come to an end ...and
that a time will come when God will fill what He emptied’’ (p. 224). Even through intense
sorrow, her sense of humour did not leave her as we can see in her warm description
in a letter to father Picachy of how she would follow Jesus in the darkness: she compared
herself to a ‘‘little dog’’ that tried to follow closely its master’s footprints, asking him to
pray for her to be a ‘‘happy little dog’’ (p. 289). She described moments of intense light
in her darkness (‘‘oasis in the desert’’) such as the one experienced while she was attending
a requiem mass for Pope Pius XII. During the mass she asked God for a sign that He was
pleased with her congregation and at that instant ‘‘the long darkness, the pain of loss,
of loneliness, the strange suffering of ten years’’ disappeared: ‘‘today my soul is full of love,
with an indescribable joy’’ (p. 219).
‘‘Good’’ and ‘‘Bad’’ madness? ‘‘Good’’ and ‘‘Bad’’ sadness?
In an attempt to throw light into the relationship between religious experience
and psychopathology, researchers at the Alister Hardy Centre in Lampeter (formerly in
Oxford) have looked into the idea of ‘‘good’’ madness and ‘‘bad’’ madness (Foskett, 1996).
We would like to extend this analogy to the Dark Night’s experience of emotional suffering
by calling it ‘‘good’’ sadness to differentiate it from ‘‘bad’’ sadness (that meets criteria for
a depressive episode according to the ICD-10/DSM-IV). Similarly, Jackson and Fulford
(1997, 2002) also talked about ‘‘psychosis good and bad,’’ claiming that the exclusively
descriptive criteria developed by psychiatry in the twentieth century lack face validity
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to the extent that they fail to distinguish pathological from non-pathological forms of
psychotic experience. There are many similarities between the ‘‘salutory’’ religious
depression described above and ‘‘spiritual’’ psychotic phenomena: they argued that in the
case of ‘‘pathological’’ psychotic phenomena there is a radical failure of action while in the
case of spiritual psychotic phenomena, action is radically enhanced. The latter can also be
a normal and adaptive psychological response to existential crises, and its psychotic
elements can promote a paradigm shift in the individual’s underlying assumptions, which
effectively resolves their impasse and allows them to move forward.
As the above case studies exemplify, when the Dark Night of the Soul descends upon
religious people, a sense of emptiness and angst possesses them as would occur in
a depressive episode. But similarly to the ‘‘good psychosis,’’ in the Dark Night the religious
attribution and interpretative framework take over those unpleasant feelings opening
a door that could transform their lives for the better. This experience that comes from
an outside agent (God, Jesus, etc.) may finally lead them to an existence that is perceived
as more fulfilled and complete by them, as well as having a positive effect on those
surrounding them. On these lines, Saint Augustine in his Confessions referred to his most
desperate moments of despair as a ‘‘salutary madness.’’ In spite of the enduring agony,
his Dark Night had a finality that was worthwhile for him as it was ultimately going
to benefit and improve him.
Clinical implications
The term ‘‘depression’’ itself is a cultural conception, but a Western one, in which
a constellation of symptoms is defined as illness. Although depression in its Western sense
is a universally present disease, what is labelled as such in the West is given a radically
different form of cultural canalization and expression across non-Western societies,
where the group of symptoms regarded as depression in Western society is an existential
issue, a natural product of life (Kleinman & Good, 1985; Obeyesekere, 1985).
Greater psychiatric familiarity with the former British colonies has put forward the
idea that depression could be a variant of dysphoric mood which in Western moral
psychology assumes an autonomous self. A more common experience of everyday
distress than depression emerges, one that interestingly also incorporates the word
‘‘soul’’ in its name, known in various Latin American idioms as ‘‘soul loss’’ referring to
the loss of something essential which has been taken out of the self (Littlewood, 2002,
pp. 11–12).
Although depression involves the whole person and cannot be split off like a broken
arm, the psychiatric conception of depression as due to a chemical disturbance of the brain
relieves the patient of personal responsibility, and deprives the individual experience of any
meaningful significance, possibly leading to greater isolation (Littlewood & Lipsedge,
2004, p. 77). But once the feelings of sadness and dissatisfaction are defined in existential
terms as is the case for people undergoing the Dark Night it can cease to be
pathological and it may even be resolved through the attribution of meaning, allowing the
individual to reflect on the negative aspects of their life. This can then become an adaptive
reaction that instigates transformation of those aspects, thus making positive changes in
one’s life. A spiritual experience can be a problem-solving process triggered by existential
crises involving both emotional and cognitive tension, ending with a reduction of the level
of tension (Batson & Ventis, 1982). Those going through the Dark Night of the Soul do not
consider it as a disease but, on the contrary, view it as a natural stage of their spiritual
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development and as an invitation for spiritual maturation and for becoming closer to God.
By giving a diagnosis of a depressive episode to the Dark Night of the Soul psychiatrists
may hold up or even prevent the attribution of meaning to take place. This attribution
of meaning to the experience of psychological suffering is the crucial element acting
as a cathartic agent. Therefore, the resolution of their suffering through its transformation
into the Dark Night of the Soul, an active process of self-reflection and spiritual
growth, may be hindered. We would like to attempt to simplify this through an equation
(Table 2).
It is interesting that, after the controversy caused by the publication of Mother Teresa
of Calcutta’s private letters (when some religious and non-religious people were horrified),
many testimonies have appeared in the media of people who were experiencing
inner anguish and sadness expressing how much reading about Teresa’s experiences
helped them to cope and to put their suffering into a spiritual light. As an illustration
of this phenomenon Borchard (2007) called Mother Teresa ‘‘my saint of darkness
and hope’’ and wrote about how she assisted her in her ‘‘spiritual journey to mental
health,’’ teaching her about how to live with inner anguish and giving a purpose to her
suffering.
In spite of the shared phenomenology between the ‘‘salutary’’ religious depression
(Dark Night of the Soul) and its ‘‘pathological’’ counterpart (which needs psychiatric
attention), we have presented in this paper the key differences existing between them, such
as in the former, a clear wish to recover completely, functioning being maintained, hope
being preserved and not leading to suicide, among others (see Table 1). In order to avoid
people undergoing the Dark Night being persuaded that they are suffering from
a depressive episode, having had their religious interpretations dismissed by mental
health professionals, psychiatric trainees should, in our opinion, receive training in
religious issues, as an understanding of religion is necessary both in terms of differential
diagnosis and patient management. Religious patients may perceive doctors as failing
to understand their religious beliefs, and may even feel that they are being ridiculed
and judged (Dein, 2004). It is imperative that health professionals ensure that people who
experience an eruption of the supernatural in their life are not treated for a biogenetic
brain disease rather than a spiritual ‘‘illness’’ (Castillo, 2003).
The views of psychological suffering held by people immersed in the Dark Night
involve a connection to the divine. Healing (especially emotional/spiritual healing)
involves putting suffering in a wider context than that offered by psychiatry and medicine
in general. They struggle to make sense of these experiences in the light of their beliefs and
religious vocation, considering their suffering as a chance for achieving greater spiritual
depth. In such a situation, it would be meaningless to consider their period of emotional
distress as disease: telling them that their experience of the Dark Night is abnormal
or pathological and offering a chemical disturbance in the brain as an aetiological factor
Table 2. Resolution of the ‘‘illness’’ through the process of attribution of meaning in the Dark Night of the
Soul in contrast with the functional impairment that may follow the psychiatric diagnosis of depression.
Illness (feeling of sadness) þ psychiatric diagnosis of depression ¼ Disease and functional impairment
Illness (feeling of sadness) þ MEANING (Dark Night of the Soul) ¼ Spiritual experience and normal functioning
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so antidepressant medication may be taken may deprive these religious people of the
opportunity to give meaning to their experience. In times where modern medicine
encourages us to regard emotional difficulties as illnesses rather than as spiritual questions
(Littlewood & Lipsedge, 2004, p. 21), where psychiatrists have a tendency to convert
patients’ emotional difficulties into diseases rather than opportunities for reflecting on
their lives and as potential agents for beneficial change, the Dark Night of the Soul reminds
mental health professionals of the importance of incorporating existential issues into their
clinical practice.
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... Reflections on the relationship between depression and mysticism invariably invoke the concept of the Dark Night of the Soul (DNS; Durà-Vilà & Dein, 2009;Durà-Vilà et al., 2010;Goretzki, 2007;Kinnier et al., 2009). DNS has often been equated with depression due to the sense of hopelessness, loneliness, desolation, existential struggle, feelings of abandonment (by God/Goddess or Spirit), crisis of faith, and empathic feelings of the suffering of others (Durà-Vilà & Dein, 2009;Durà-Vilà et al., 2010;Kinnier et al., 2009;Meadow, 1984). ...
... Reflections on the relationship between depression and mysticism invariably invoke the concept of the Dark Night of the Soul (DNS; Durà-Vilà & Dein, 2009;Durà-Vilà et al., 2010;Goretzki, 2007;Kinnier et al., 2009). DNS has often been equated with depression due to the sense of hopelessness, loneliness, desolation, existential struggle, feelings of abandonment (by God/Goddess or Spirit), crisis of faith, and empathic feelings of the suffering of others (Durà-Vilà & Dein, 2009;Durà-Vilà et al., 2010;Kinnier et al., 2009;Meadow, 1984). However, most authors working within the fields of spirituality and psychology, or transpersonal psychology, have clearly differentiated the two. ...
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The principal aim of this article is to explore the relationship between depression and mystical experiences. The paper begins with a discussion of definitional issues, inquiring into the meaning and interrelationship of terms such as peak experience, mystical experience, awakening experience, satori, and so forth. The case of a 68-year-old woman who underwent a profound and transformative experience while being treated for depression in the first author’s psychiatric clinic is then presented as a basis for an interdisciplinary discussion and literature review pertaining to the relationship between depression and mystical experiences. After a discussion/exposition of therapeutic approaches, the paper closes with a discussion of possible future research directions.
... Stanislav Grof, MD, and his wife Christina Grof coined the term spiritual emergence, representing the healing and transformative potential for crises on the spiritual path, resulting in a higher level of psychological functioning and spiritual awareness (Grof, 2019, p. 314). Spiritual traditions worldwide document these Dark Nights of the Soul, expect them, and offer guidance on navigating their often challenging and life-altering waters (Durà-Vilà and Dein, 2009). The Grof 's developed Holotropic Breathwork at the Esalen Institute in Big Sur, California, in the mid-1970s after studying the use of non-ordinary states of consciousness in various cultures and settings. ...
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Noetic comes from the Greek word noēsis, meaning inner wisdom or direct knowing. Noetic experiences often transcend the perception of our five senses and are ubiquitous worldwide, although no instrument exists to evaluate noetic characteristics both within and between individuals. We developed the Noetic Signature Inventory (NSI) through an iterative qualitative and statistical process as a tool to subjectively assess noetic characteristics. Study 1 developed and evaluated a 175-item NSI using 521 self-selected research participants, resulting in a 46-item NSI with an 11-factor model solution. Study 2 examined the 11-factor solution, construct validity, and test–retest reliability, resulting in a 44-item NSI with a 12-factor model solution. Study 3 confirmed the final 44-item NSI in a diverse population. The 12-factors were: (1) Inner Knowing, (2) Embodied Sensations, (3) Visualizing to Access or Affect, (4) Inner Knowing Through Touch, (5) Healing, (6) Knowing the Future, (7) Physical Sensations from Other People, (8) Knowing Yourself, (9) Knowing Other’s Minds, (10) Apparent Communication with Non-physical Beings, (11) Knowing Through Dreams, and (12) Inner Voice. The NSI demonstrated internal consistency, convergent and divergent content validity, and test–retest reliability. The NSI can be used for the future studies to evaluate intra- and inter-individual variation of noetic experiences.
... However, growing empirical evidence through a developmental lens suggests that people's spiritual lives are complex and nuanced, frequently including dialectical tensions between spiritual seeking and spiritual dwelling, as well as coexistent strengths and struggles (Sandage et al., 2020). Periods of struggle described by some R/S traditions as a dark night of the soul may, over time, foster personal growth and catalyze spiritual and emotional well-being (Durà-Vilà & Dein, 2009). Thus, it is important to identify religious practices that buffer the psychological toll of struggles that may arise (Abu-Raiya et al., 2016). ...
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Physical and existential threats stemming from the coronavirus disease 2019 (COVID-19) pandemic may provoke religious/spiritual (R/S) struggles or exacerbate preexisting angst and questions. In the Global South, where pervasive social–structural disadvantages limit resource availability to mitigate psychosocial consequences, doubts about divine presence and purpose amidst suffering, loss, and uncertainty may be especially salient factors in spiritual and mental health. With two independent samples of Colombians and South Africans recruited during an early phase of lockdown in each country, the current set of studies (N Study 1 = 1,172; N Study 2 = 451) examined positive religious coping (Study 1) and state hope (Study 2) as potential resources that may support the mental health of people living in the Global South who experienced R/S struggles during the public health crisis. Results of hierarchical regression analyses across both studies revealed that R/S struggles were positively associated with depression. In Study 1, there was a two-way interaction between R/S struggles and positive religious coping, such that the relation between R/S struggles and depression was attenuated when positive religious coping was higher for both men and women. In Study 2, a three-way interaction emerged among R/S struggles, state hope, and gender; R/S struggles were associated with higher levels of depression when state hope was low in women and when state hope was high in men. We discuss the implications of these findings for promoting psychological and spiritual well-being in low- and middle-income countries during the COVID-19 pandemic.
... It is a painful period of set back, disillusionment, spiritual torment and anguish. Those experiencing the Dark Night of the Soul go through a process of attributing meaning to their experience: they consider it as a process of maturation of their spiritual life, as a natural-not pathological-process in their spiritual development [3]. ...
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Religious and spiritual experiences can appear in mental health practice as far as they often structure what aspects of psychopathological phenomena are present, sometimes making it difficult to determine whether some experiences should be classified as symptoms of a psychiatric disorder or crises within spiritual life. We present a clinical vignette of a 62-year-old sacristan who was admitted to the Psychiatric Emergency Room for suicidal thoughts in the context of physical sequelae of a cardiac episode. He confessed that, in the process of coping with his illness, he had a distressing experience of guilt and of losing his religious faith and shared the intention to take his own life by hanging himself. Themes that emerge in the discussion include issues related to the boundaries of psychiatric diagnosis, the spiritual dimension of mental health and the values that underlie clinical decision-making regarding a suicidal individual. Incorporating religious and spiritual perspectives in the clinical assessment of patients is essential to understand individual’s framework of cultural values and social attitudes on disease.
... Philosophers and religious scholars across history have explored the role of disillusionment and angst amidst suffering as central to believers' spiritual formation and growth through expanding doctrinal and experiential schemas of the divine as well as facilitating psychological and emotional growth. Saint John of the Cross, a Roman Catholic priest in the sixteenth century, described these 'dark nights of the soul' not as pathological phenomena, but rather as common religious experiences embedded within the journey of mourning and recovery (Durà-Vilà & Dein, 2009). Empirical evidence suggests that posttraumatic growth is indeed a frequent occurrence following disasters, such that some survivors not only regain normative functioning, but also report psychological, relational and spiritual growth (Spialek, Houston, & Worley, 2019;Xu & Liao 2011). ...
Chapter
Religious and spiritual experience unfolds in the ever-changing milieu of culture, institution, social environment and physical place. But what happens when mass tragedy strikes? How might congregants be uniquely impacted when a shooting desecrates their synagogue, mosque, temple or church? Or when a hurricane obliterates their home, which is imbued with sacred significance for them? What role might local faith communities play in facilitating healing and resilience? This chapter explores the embodied experience of faith in the context of mass trauma and disaster, drawing on attachment, object relations, affective neuroscience and ecological systems theories. Specifically, we propose the multidimensional framework of embodied spirituality to capture the dynamic interplay of cognitive, affective and social processes in experiencing and restoring a sense of the sacred in the aftermath of mass tragedy and loss.
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Chapter
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This practical theology dissertation is grounded in palliative care practice, comprising an introduction, six articles, and implications. The main research question is: What is the spiritual experience of dying? Each article integrates the contemplative theology/spirituality of the Dark Night of the Soul with clinical palliative care questions: What is spiritual suffering? How does it differ from depression? How can it be assessed? How may it be best managed? Article one commends the Dark Night as a single theoretical construct for suffering, identifying the signs of the Dark Night. Article two, examining differential diagnosis between the spiritual suffering of the Dark Night and depression, includes: a Dark Night Lexicon, a Clinician [Spiritual] Self-Assessment, similarities and differences between the Dark Night and primary depression, and a palliative patient narrative. Articles three, four, and five use a palliative case study to illustrate spiritual assessment. Article six on managing spiritual suffering, builds upon the CanMEDS framework, contributes contemplative spiritual care competencies for the medical profession, and demonstrates their application in a case study. Spiritual suffering may be understood as the process of the Dark Night, differing from depression as a transformative form of suffering and non-pathological. This research introduced a language for spirituality at end of life, and can advance clinical practice – through tools that aid clinician’s understanding, assessment, and intervention.
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The aim of the current investigation was to identify universal profiles of lived spirituality. A study on a large sample of participants (N = 5512) across three countries, India, China, and the United States, suggested there are at least five cross-cultural phenotypic dimensions of personal spiritual capacity—spiritual reflection and commitment; contemplative practice; perception of interconnectedness; perception of love; and practice of altruism—that are protective against pathology in a community sample and have been replicated in matched clinical and non-clinical samples. Based on the highest frequency combinations of these five capacities in the same sample, we explored potentially dynamic profiles of spiritual engagement. We inductively derived five profiles using Latent Profile Analysis (LPA): non-seeking; socially disconnected; spiritual emergence; virtuous humanist; and spiritually integrated. We also examined, in this cross-sectional data, covariates external to the LPA model which measure disposition towards meaning across two dimensions: seeking and fulfillment, of which the former necessarily precedes the latter. These meaning covariates, in conjunction with cross-profile age differences, suggest the profiles might represent sequential phases along an emergent path of spiritual development. Subsequent regression analyses conducted to predict depression, anxiety, substance-related disorders, and positive psychology based on spiritual engagement profiles revealed the spiritually integrated profile was most protected against psychopathology, while the spiritual emergence profile was at highest risk. While this developmental process may be riddled with struggle, as evidenced by elevated rates of psychopathology and substance use in the intermediate phases, this period is a transient one that necessarily precedes one of mental wellness and resilience—the spiritual development process is ultimately buoyant and protective.
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In addition to the biological body and psychological and social aspects, humans are spiritual beings. There is much in the world that we are yet unable to explain, but to what human experience reacts, either positively or negatively. This article treats the possible negative interpretations of spiritual experiences that manifest in different crises. Spirituality can be defined in various ways and it can, in turn, be divided into core categories that relate to human spiritual needs. In order to provide help that corresponds to the multidimensional human experience, it is important for health care to consider spiritual crises. Several of the spiritual crises entail good opportunities for personal development and therefore represent, in a hidden form, a potential for treatment and positive dynamics rather than psychopathology. Meanwhile, people outside the health care system would need to acknowledge the mental health problems that accompany spiritual experiences. There is a big risk of romanticizing several paranormal experiences or even mood shifts, which can result in the person not getting the needed help or treatment. Unfortunately, not even religious persons or those active in spiritual practices are immune to mental disorders. A growing interest in different New Age practices, which mix the search for fast spiritual experiences and solutions with several cultural and religious settings, quickly bring the downside of spirituality to the attention of mental health specialists. Spiritual needs are common to human experience and they often arise during illness and treatment. There are several methods for collecting information and spiritual history on the patient’s needs, and sometimes simple questions asked during obtaining the medical history are sufficient to provide the specialist with necessary information that can be considered in developing the treatment plan. Changing the perspective can lead to a completely different understanding of the cause of several illnesses or disorders. As an example, a patient suffering from alcoholism can be seen as a person searching for connection or wholeness with higher forces. Spiritual issues are clinically related to the pathological risk that reminds us of the importance of including mental and existential issues in clinical practice. The religious/spiritual gap may become an obstacle. There is a considerable literature examining whether patients would prefer their physicians to inquire about their religious or spiritual beliefs as part of the routine history taking. Physicians maintain that the foremost reason they cannot provide spiritual care to patients is that they do not have enough time during the medical encounter. The second most common reason given is that they do not have adequate training to provide spiritual care to patients and that such care is better provided by others. Thirdly, physicians express discomfort about engaging in discussions on spirituality and faith with patients. In regard to the psychopathology of mental disorders, there are two basic classifications: the first one was created by the American Psychiatric Association (Diagnostic and Statistical Manual of Mental Disorders – DSM) and the second one was published by the World Health Organisation – WHO (The International Statistical Classification of Diseases and Related Health Problems – ICD). The development of the DSM, in its fourth edition, brought a change into the approach to religion and spirituality in the context of clinical diagnosis. Introducing V-code 62.89 (religious or spiritual problem) has increased the possibility of differential diagnosis between religion/spirituality and health/psychopathology. Unfortunately, there are no such developments in ICD-10. It sets boundaries to dealing with the R/S issues in psychiatry.
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Philosophy, Psychiatry, & Psychology 4.1 (1997) 41-65 This paper explores some of the conceptual and practical implications of the finding that phenomena which in a medical context would probably be diagnosed as psychotic symptoms, may occur in the context of non-pathological, and indeed essentially benign, spiritual experiences. The existence of non-pathological psychotic experiences of this kind (we will call them "psychotic phenomena" as distinct from "psychotic symptoms"--see also Endnote 1, terminology) was a key finding in a study carried out by one of us (MJ) at the Alister Hardy Research Centre (AHRC) in Oxford. Details are given elsewhere both of the overall empirical findings of the study, including the relationship between spiritual experience and personality variables, and of a hypothetical cognitive problem-solving model of these phenomena (Jackson 1991, and forthcoming a and b). In the present paper, 1) the background to the study is described briefly in relation to earlier work on the possible links between spiritual experience and psychopathology; 2) some of the psychotic phenomena identified are illustrated with three detailed case histories; 3) the significance of these phenomena is reviewed for our understanding respectively of psychopathology, of diagnostic syndromes, and of the concept of mental illness; and 4) some of the practical implications of the study for clinical work and research in psychiatry are indicated. It has long been recognized that there are similarities between spiritual and psychotic experiences. William James (1902), for example, argued that "in delusional insanity, paranoia as they sometimes call it, we may have a kind of diabolical mysticism, a sort of religious mysticism turned upside down" (426). Other commentators have noted a wide variety of phenomena, such as time distortion, synesthesias, loss of self-object boundaries and the transition from a state of conflict and anxiety to one of sudden "understanding," all of which are reported in both spiritual and psychotic experiences (Buckley 1981; Watson 1982; Wapnick 1969; and Wootton and Allen 1983). Yet the similarities notwithstanding, the distinction between these two kinds of experience can be crucially important. Spiritual experiences, whether welcome or unwelcome, and whether or not they are psychotic in form, have nothing (directly) to do with medicine (Fulford 1996a). It would be quite wrong, then, to "treat" spiritual psychotic experiences with neuroleptic drugs, just as it is quite wrong to "treat" political dissidents as though they were ill (Fulford, Smirnoff and Snow, 1993). Pathological psychotic experiences, on the other hand, or psychotic symptoms, are by definition a proper object of medical treatment, sometimes even against the wishes of the person concerned. Hence it would be both negligent and, as Wing (1978) put it, morally "repellent," to leave untreated someone who is genuinely ill (244). Given how much turns on the distinction between spiritual experience and psychopathology, it is perhaps not surprising that scholarly discussion of the relationship between them has at times been polarized and polemical. At one extreme...
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This paper discusses the hypothesis that the symptoms of functional psychoses can be caused by culturally structured spontaneous trances that may be reactions to environmental stress and psychological trauma. Findings are reviewed of anthropological studies of meditative trance experiences in Indian yogis characterized by divided consciousness (dissociation), religious auditory and visual hallucinations, and beliefs in their own spiritual powers. An explanation of the psychological mechanisms of meditative trance is also provided, highlighting trance-related alteration of consciousness within an Indian cultural context. It is suggested that the psychological mechanisms of meditative trance are similar in structure to spontaneous trances underlying the symptoms of some functional psychoses. Findings from cross-cultural studies are also reviewed, highlighting the effects of culture on the symptoms, indigenous diagnoses, treatments, and outcomes of functional psychoses. In non-Western cultures, transient functional psychoses with complete recovery are 10 times more common than in Western cultures. It is suggested that egocentrism and a loss of spiritual explanations for psychosis in Western cultures constructs a clinical situation in which persons with functional psychoses are treated for a biogenetic (incurable) brain disease rather than a curable spiritual illness. This difference in cultural belief systems leads to poorer outcomes for Western patients compared to non-Western patients. Recognizing cultural differences in symptoms, indigenous diagnoses, and treatment for functional psychoses can help explain the dramatic cross-cultural differences in outcome.
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Some of the most innovative and provocative work on the emotions and illness is occurring in cross-cultural research on depression. Culture and Depression presents the work of anthropologists, psychiatrists, and psychologists who examine the controversies, agreements, and conceptual and methodological problems that arise in the course of such research. A book of enormous depth and breadth of discussion, Culture and Depression enriches the cross-cultural study of emotions and mental illness and leads it in new directions. It commences with a historical study followed by a series of anthropological accounts that examine the problems that arise when depression is assessed in other cultures. This is a work of impressive scholarship which demonstrates that anthropological approaches to affect and illness raise central questions for psychiatry and psychology, and that cross-cultural studies of depression raise equally provocative questions for anthropology.
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Mental health professionals in Western societies are generally less religious than their patients and receive little training in religious issues. Using case studies, the author discusses issues involved in working with patients who hold religious beliefs: problems of engagement; countertransference; religious and spiritual issues not attributable to mental disorder; problems of differential diagnosis; religious delusions; religion and psychotherapy; psychosexual problems; and religiously oriented treatments. The article ends with a discussion of the various ways in which religious themes can be incorporated into mental health work, especially the need to involve religious professionals and develop collaborative patterns of working together with mental health professionals.
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Philosophy, Psychiatry, & Psychology 9.4 (2002) 387-394 IN TWO PAPERS in this issue of Philosophy, Psychiatry, and Psychology, Marek Marzanski and Mark Bratton (2002) and Caroline Brett (2002) develop important critiques, from the perspectives respectively of Christian theology and Eastern philosophy, of our 1997 analysis of the distinction between pathological and nonpathological forms of psychotic experience (Jackson and Fulford 1997). In this response, we briefly summarize the main points from our 1997 analysis; we consider, separately, the important although very different challenges to that analysis from the perspectives of our two critics; and we briefly indicate the main lines of recent developments in policy, practice, and research in mental health as they relate to this important area of human experience. In our 1997 paper, we presented three case studies from a larger series (Jackson 1991, 1997, 2001) selected with the express aim of bringing into focus the conceptual difficulties that arise at the borderline between psychotic illness and what we called benign spiritual experience. On the basis of these case studies we argued that We then proposed a cognitive problem-solving model of psychotic experiences. This model suggests that such experiences can be a normal and adaptive psychological response to existential crises, such as loss of meaning or purpose in life, coming to terms with death or bereavement, and so on (Batson and Ventis 1982; Jackson, 1991, 1997, 2001). The model is consistent with a subsequent position paper published by the British Psychological Society arguing the case for a psychological formulation of psychotic experiences and cognitive-behavioural methods in their management (2000). In the case of nonpathological psychotic experience, the psychotic elements of the experience promote a paradigm shift in the individual's underlying assumptions, which effectively resolves their impasse and allows them to move forward. This is normally a self-limiting process, in that when the individual is able to utilize their insight, it acts to resolve the stress which triggered it. In pathological psychosis, this process fails for various possible reasons, which were not explored in any depth in that paper (but see Jackson 2001 for a more detailed discussion). Marek Marzanski and Mark Bratton reexamine the questions raised by our cases from a Christian theological perspective (Marzanski and Bratton 2002). They suggest a theologically based definition of spiritual experience according to which the criteria for "genuine" experience concerns its context within the development of the individual's religious faith. In Bratton and Marzanski's account, these criteria are based on a Christian value system. They present three cases of their own, which, in contrast to the three cases in our 1997 paper, vividly illustrate how phenomena that may be valued negatively from a medical perspective (i.e., as defined by us in terms of their consequences for action), may, at one and the same time, be valued positively from a religious perspective (i.e., in terms of their consequences for the development of an individual's religious faith). In the same vein, they discuss the spiritual experiences of "the dark night of the soul" described by various mystics, and more everyday spirituality "such as loving God," which unquestionably have religious significance, but do not involve psychotic features, and may not include, in any materialist sense, action enhancement. Marzanski and Bratton conclude that "genuine spiritual...