In lieu of an abstract, here is a brief excerpt of the content:Commentary on “Spiritual Experience and Psychopathology”Anthony Storr (bio)Many psychiatrists, including myself, are deeply dissatisfied with current psychiatric taxonomy. Grossly abnormal people like multiple murderers are often deemed sane in law, because they do not happen to exhibit the symptoms of recognized mental illnesses like schizophrenia or manic-depressive psychosis. In contrast, some of those who do exhibit such symptoms, and who therefore risk being labeled psychotic, cannot be considered to (...) be “ill,” and are in fact mentally robust. There is considerable overlap between experiences which psychiatrists call psychotic, and experiences which are generally called spiritual by those who have them.In order to illustrate this overlap, the authors quote three cases of people describing a variety of delusions and hallucinations which would certainly prompt the diagnosis of psychosis—usually some variety of schizophrenia—were it not for the fact that all three claimed that their experiences had been of considerable benefit to them.It is noteworthy that, in each case, the psychotic/spiritual experiences followed a period of stress. The first subject was threatened by legal action; the second had surmounted an episode of depression, but was questioning whether she could continue her career in business; the third was unemployed, in debt, and suspected that he had multiple sclerosis. The first subject developed both grandiose and religious delusions; but the revelations which he claimed were a sign of God’s special grace toward him enabled him to win his law case and set up a charitable institution. The second heard the voice of Jesus summoning her to work for him. She became convinced that she was specially gifted in various parapsychological fields, and became a religious counselor. As the authors point out, “Her experiences, if delusional and hallucinatory, were overwhelmingly positive in their content and fruits.” The third subject also experienced hallucinatory voices which were intensely reassuring, gave him new insight into the nature of reality, and guided his further progress. As a result, he believed that he had such support that “nothing in this world can worry me.” In each case, the psychotic experience proved to be a solution to the subject’s problem, rather than a breakdown ending in admission to a mental hospital. This raises a variety of intellectual problems.The authors suggest that psychotic phenomena may be good or bad, and label the good phenomena “spiritual” and the bad phenomena “pathological.” According to this point of view, psychotic experience need not be considered pathological, especially if consideration is given to the structure of values and beliefs professed by the individual concerned. [End Page 83]I am not happy with this distinction. I entirely agree that psychotic experience may be a solution to a subject’s problems; but whether it is considered spiritual or pathological depends partly upon the nature of the experience, and even more upon the social setting in which it occurs. A grandiose delusion that one is especially selected and addressed by God may cure the depression of someone who has so far considered himself a nonentity if it is accepted by others. In my study of gurus, Feet of Clay (1996), I make the point that a guru seeks disciples because they reinforce his delusions and may, in some instances, keep him out of hospital. Of the three cases described in this paper, the first told “various friends and ministers about them.” The second confided in her priest and was told that her experiences were authentic within their shared Christian belief system. The third did not apparently share his hallucinatory experience with friends; but, when he responded to the invitation to write to the Alister Hardy Research Centre, wrote, “It is fascinating to find I’m not on my own in this. I have naturally queried my own sanity, and generally don’t discuss it....”Medical diagnosis and psychiatric diagnosis are not strictly comparable. If I as a doctor find that X is suffering from diabetes, I can treat X as an isolated entity displaying symptoms and signs of a well-known disease. I cannot do this when X is displaying “psychotic” symptoms; for whether or not those symptoms are regarded as pathological depends upon the social setting in which they... (shrink)

Anthony Storr offers a lucid and objective look at Freud's major theories, evaluating whether they have stood the test of time, and in the process examines Freud himself in light of his own ideas. 'a model exercise in synthesis, and the final essay on the 'appeal' of psychotherapy is especially neat.' -Independent.

Friedrich Wilhelm Nietzsche was born on 5 October 1844 and died on 25 August, 1900. From 1889 until his death eleven years later he was physically and mentally ill and incapable of work. It is almost certain that he died of the brain disease known as G.P.I., General Paralysis of the Insane, or general paresis. In the nineteenth century and well into our own era, this was a not uncommon tertiary manifestation of a syphilitic infection which might originally have been (...) contracted many years before. Because the initial stages of syphilis can now be treated with antibiotics, general paresis is rarely seen today. (shrink)