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Clients With Serious Mental Health Issues

There are wide differences of opinion within the transpersonal community as to the appropriateness of doing transpersonal work with seriously mentally ill or psychotic individuals (Kasprow & Scotton, 1999). Jung (1960), Wilber (1984a), and Grot and Grot (1989) argued that transpersonal counseling is not appropriate for seriously mentally ill or psychotic individuals, whereas Lukoff (1996) suggested that transpersonal psychotherapy may be particularly appropriate for psychotic disorders, even serious ones. This issue is compounded by the resemblance of some altered states of consciousness (transpersonal experiences) to psychotic states such as in schizophrenia. Differentiation between altered states of consciousness and true psychotic states is of extreme importance to optimize counseling and prevent unnecessary or harmful treatment (Kasprow & Scotton, 1999). Several theorists (Agosin, 1992; Grof & Grof, 1989; Lukoff, 1985) have suggested guidelines for determining the difference. Lukoff (1985) suggested the following four criteria to establish the difference between altered states of consciousness and psychosis: Transpersonal experiences are more likely in clients with (a) good premorbid (pretranspersonal experience) functioning, (b) an acute onset of symptoms within a period of 3 months, (c) the presence of a stressful precursor that could account for the acute symptoms, and (d) a positive and exploratory attitude toward the experience. Building upon this, Bimbaum et al. (2008) urged counselors to proceed with caution when choosing a transpersonal approach with clients exhibiting serious mental health issues. Naturally, when the question arises as to whether the client is exhibiting psychotic symptoms or transpersonal experiences, the ethical counselor will always seek supervision or clinical consultation.

Another mental health issue transpersonal counselors must be aware of is that of spiritual emergencies. Spiritual emergencies, first documented by Grof and Grof (1989), are emergent trans-egoic experiences, or experiences, ideation, and behavior that appear to be pathological but are in fact part of the transpersonal developmental process that can occur as an individual crosses into a new stage of development (Cortright, 2000). As has been previously mentioned in this chapter, as an individual accesses a new line or stage of development, greater awareness and connectedness can occur, but so can the potential for greater pathologies. Spiritual emergency occurs when the crossing to another developmental line results in a negative experience or behavior. For example, a healthy or prepared individual who experiences Wilber's (1997) psychic level, which mediates a sense of connection to something outside the ego boundary, may experience feelings of universal love and em- pathic understanding, whereas an individual unprepared for this loss of ego boundary may experience paranoid ideation and separation (Kasprow & Scotton, 1999). Transpersonal theorists believe that these spiritual emergencies can have powerfully transformative effects on a person's life when supported by the counselor and allowed to run their course to completion (Bimbaum et al., 2008; Grof & Grof, 1989; Lukoff, Lu, & Turner, 1998; Perry, 1976).

Overall, the onus is on the transpersonal counselor to be aware of his or her own limits of practice as well as the limitations of transpersonal interventions with seriously mentally ill individuals. When faced with difficulties that may be beyond the scope of transpersonal interventions, it is the ethical responsibility of the counselor to either use a proven counseling method or refer the client to another mental health professional. Transpersonal counselors must also be prepared to deal with spiritual emergencies and the sometimes powerful aspects of clients experiencing new altered states of consciousness and deepening feelings of connectedness.

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