“The Awful Rowing toward God”: Interpretation of Religious Experiences by Individuals with Bipolar Disorder

Abstract

Limited research has been conducted on the religious experiences of people with bipolar disorder (BD). Qualitative research indicates that the disentanglement of pathology and genuine religiosity is an important issue for persons with BD and that some patients experience discrepancy between the explanatory models of mental health care professionals and religious leaders. The current study explores the ways patients with BD interpret religious experiences they have had during illness episodes, how this interpretation changes over an individual's lifetime, and the expectations of treatment that persons with BD have regarding these religious experiences. Semi-structured interviews with 34 stable BD patients were conducted by a hospital chaplain and a psychiatrist trainee. The method of analysis was interpretative phenomenological analysis. For many participants, a religious quest originated after a religious experience during mania, and then a variety of medical and religious sources supported the interpretation process. Most participants endorsed mixed medical and religious explanations for their experiences and tried to distinguish between spiritual and pathological features. The interpretation process changed over time, influenced by religious affiliation and views, mood swings and the course of BD, and communication with others about the experiences. Discourse about the experiences was often problematic within treatment; a majority expressed the need for recognition of the spiritual value of the experiences, together with a critical sounding board for reflecting on their meaning and the influence of BD. More attention could be paid to the subject in treatment, and the expertise of hospital chaplains could contribute to this.

Holy Apparition or Hyper-Religiosity: Prevalence of Explanatory Models for Religious and Spiritual Experiences in Patients with Bipolar Disorder and Their Associations with Religiousness

“…Of the total sample, 50% viewed religiosity in general as an important topic to address in treatment. In a qualitative study preceding the current one (Ouwehand et al 2019b), it was found that not all participants expected mental health care professionals to be equipped to address the issue. To find significance for their often impressive religious experiences, participants sought alternative (spiritual) therapy and training and literature on the Internet, along with standard treatment.…”

“…The high involvement in religiosity in the current study can be due to self-selection bias (more religiously interested participants applying than agnostics or atheists). Another explanation could be that high involvement in religiosity is a consequence of the experiences participants had had, especially during mania, which could lead to a religious quest for their significance (Ouwehand et al 2019b) and therefore to more religious involvement. Especially in forms of new spirituality, 'spiritual experiences' and 'spiritual growth' are important issues (De Hart 2011; Heelas et al 2005) and might provide explanatory models for the religious experiences related to BD.…”

“…In clinical practice, a clear demarcation line between genuine religiosity and pathology often cannot be drawn. Distinguishing between hyper-religiosity and genuine spirituality is a concern for patients (Michalak et al 2006;Ouwehand et al 2019b). They view hyperreligiosity as excessive religious practice during (hypo) mania, or as being deluded about the truth of their religious experiences during mania (Michalak et al 2006).…”

“…The qualitative study (Ouwehand et al 2019b) from which the types-of-explanation items in the current study were derived showed a variety of explanations and reactions to religious experiences related to illness episodes. A majority of the respondents endorsed mixed medical and religious explanatory models for their experiences.…”

“…A new questionnaire was constructed for the study because no questionnaire with explanatory models related to religious experiences in BD was available. The questionnaire was based on the results of a former qualitative study on religious or spiritual experiences in BD (Ouwehand et al 2018(Ouwehand et al , 2019b. Included were items on types of explanations of religious experiences related to illness episodes (see Table 3), items on communication and treatment expectations, socio-demographic items, and a range of items to assess religiosity.…”