Creativity, Spirituality, and Mental Health

have functioned as competing belief systems for providing life meaning and purpose (Levin and Chatters, 1998; Rhi, 2001).

From Freud's work through the 1976 report on mysticism by the Group for the Advancement of Psychiatry (GAP), there has been a tendency to associate spiritual experiences with psychopathology. The report of GAP on "The Psychic Function of Religion in Mental Illness and Health" (1968) acknowledged that religious themes often surfaced during psychoanalysis and that religion could be used in both psychically healthy and unhealthy ways. Yet the residue of nineteenth-century interest in religious insanity could still be found in the glossary of the Third Edition of the DSM (Diagnostic Statistical Manual) and in the 1989 edition of the Oxford Textbook of Psychiatry (Foskett, 1996; Thielman, 1998; Larson, Milano, Weaver, and McCullough, 2000).

In order to redress lack of sensitivity to religious and spiritual dimensions of problems that may be the focus of psychiatric treatment, a new V-code category for DSM-IV was proposed, psychoreligious or psychospiritual problem. The impetus for the proposal of a new diagnostic category emerged from transpersonal clinicians and the work of the Spiritual Emergence Network. Their focus was on spiritual emergencies - forms of distress associated with spiritual practices and experiences. The proposal had the following goals: 1) to increase accuracy of diagnostic assessments when religious and spiritual issues were involved, 2) to reduce occurrence of medical harm from misdiagnosis of religious and spiritual problems, 3) to improve treatment of such problems by stimulating clinical research, and 4) to encourage clinical training centers to address the religious and spiritual dimensions of experience (Lukoff, Lu, and Turner, 1992).

The DSM-IV category was accepted under "Religious or Spiritual Problem" as follows: "This category can be used when the focus of clinical attention is a religious or spiritual problem. Examples include distressing experiences that involve loss or questioning of faith, problems associated with conversion to a new faith, or questioning of other spiritual values that may not necessarily be related to an organized church or religious institution" (АРА, 2000, p. 741). Frequently reported religious problems in the literature are a loss or questioning of faith, change in denominational membership or conversion to a new religion, intensification of adherence to the beliefs and practices of one's own faith, and joining, participating in, or leaving a new religious movement or cult. Spiritual problems cited in the literature involve conflicts concerning an individual's relationship to the transcendent and questioning of spiritual values. Moreover, questioning of spiritual values may be triggered by an experience of loss or a sense of spiritual connection. Spiritual problems also may arise from spiritual practices, e.g., someone who begins meditating as a spiritual practice and starts to experience perceptual changes. As well, mystical experiences and near-death experiences can lead to spiritual problems and were focus for concern by the Spiritual Emergence Network. It was argued that inappropriately diagnosing disruptive religious and spiritual experiences as mental disorders can negatively influence their outcome. For example, some clinical literature on mysticism has described