As a psychiatrist who has also studied so-called "mystical" experiences among the Jewish Sages [see: The Ethics of the Jewish Mystics], I am very much open to Dr. Saville-Smith's proposed category of "Acute Religious Experiences." There is clearly an important distinction to be made between religio-mystical experiences in otherwise fully-functioning, rational persons (yes, I know these terms cry out for explication); and, for example, persons afflicted by schizophrenia--an often devastating and incapacitating disease.

In my view, the proposed category of "Acute Religious Experiences" (ARE) can be accommodated reasonably well in the DSM-5's section on "Other Conditions that may be a focus of clinical attention" (p. 715 of the DSM-5). Importantly, these are not mental disorders. They include such conditions as, e.g., "parent-child relational problem" or "uncomplicated bereavement." I see no reason why Dr. Saville-Smith's proposed category could not be included in this section, though I suspect ARE would not be seen frequently in a typical psychiatric practice. But conceptually, there should be no barrier to its inclusion as a non-pathological entity, worthy of clinical attention and differential diagnosis.

Ronald W. Pies, MD

Professor Emeritus of Psychiatry

Author, The Ethics of the Jewish Mystics

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Thank you for posting this, it's excellent. For people interested in these topics, another book I recommend is Stefania Pandolfo's The Knot of the Soul. In it she lays out the Quranic treatments for what a Western doctor would call psychosis. Islam's understanding of psychotic conditions is that it is possession by a jinn. As you note this is a more productive and illuminating way of understanding the condition than anything that could be offered by the DSM. It is more true and also more helpful to the client. Like IFS, it creates a symbolic rubric or a narrative structure over the experience, so that the subject may navigate her own way out.

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