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.

The authenticity of religious and spiritual experiences during mania is an important subject for bipolar patients. The exploration of such experience in bipolar disorder is the central point of this qualitative study. A psychiatrist and a hospital chaplain conducted 35 semi-structured interviews with recovered participants, recruited from mental health care institutions in the Netherlands, the patients' association and via the internet, about their religious and spiritual experiences during illness episodes and in stable times. A variety in types (such as divine presence, unity, mission, meaningful synchronicity) during mania was reported, which were on a sliding scale with experiences/views in stable times in more than half of the interviews. During depression, absence of religious or spiritual experience was predominant. The reported experiences were viewed by most participants as both authentically religious or spiritual but also related to the disorder, requiring therefore language that transcended medical terminology. Also indicated is the relevance of the results for fundamental discussions about the nature or religious experience.

The aim of the current cross-sectional study was to estimate the prevalence of religious and spiritual (R/S) experiences and their perceived lasting influence in outpatients with bipolar disorder (BD; n = 196). A questionnaire with a range of R/S was constructed, building on the results of an earlier qualitative study. Experiences of horizontal transcendence (not necessarily referring to the divine) such as the experience of "intense happiness, love, peace, beauty, freedom" (77%) or "meaningful synchronicity" (66%) were the most prevalent. The experience of "divine presence" (vertical transcendence, referring to the divine) had a prevalence of 44%. Perceived lasting influence of the experiences was 20% to 67% of the total frequency, depending on the type. Most positive R/S experiences were significantly more related to BD I and mania, and on average, persons with BD I had more R/S experiences (mean = 4.5, SD = 2.6) than those with BD II (mean = 2.8, SD = 2.4, p = 0.000). Patient-reported R/S experiences in BD can have both R/S and pathological features.

One point that emerges from qualitative research on religion and bipolar disorder (BD) is the problem patients with BD experience in distinguishing between genuine religious experiences and hyper-religiosity. However, clinical practice does not obviously address communication about differences in explanatory models for illness experiences. The aim of the current study is first to estimate the frequencies of different types of explanations (medical versus religious) for experiences perceived as religious and related to BD, second to explore how these types relate to diagnosis and religiousness, and third to explore the frequency of expectation of treatment for religiosity. In total, 196 adult patients at a specialist outpatient center for BD in the Netherlands completed a questionnaire consisting of seven types of explanations for religious experiences and several items on religiousness. Of the participants who had had religious experiences (66%), 46% viewed the experiences as 'part of spiritual development' and 42% as 'both spiritual and pathological,' 31% reported 'keeping distance from such experiences,' and 15% viewed them as 'only pathological.' Measures of religiousness were positively associated with 'part of spiritual development' and negatively associated with 'keeping distance from the experiences' and 'only pathological.' Half of the sample viewed religiosity as an important topic in treatment. It can be hypothesized that strength of religiousness may help people to integrate destabilizing experiences related to BD into their spiritual development. However, the ambiguity of strong religious involvement in BD necessitates careful exploration of the subject in clinical practice.

Chaplain leadership may have played a pivotal role in shaping chaplains’ roles in health care amidst the COVID-19 pandemic. We convened an international expert panel to identify expert perception on key chaplain leadership factors. Six leadership themes of professional confidence, engaging and trust-building with executives, decision-making, innovation and creativity, building integrative and trusting connections with colleagues, and promoting cultural competencies emerged as central to determining chaplains’ integration, perceived value, and contributions during the pandemic.

In this article, a case study will be presented of a person with bipolar I disorder, who struggles to interpret his religious experiences and how they are related to the disorder. The analysis builds on a larger study into religious experiences within the context of bipolar disorder (BD). In this previous study, medical and religious explanatory models for religious experiences related to BD often appeared to go hand in hand in patients who have had such experiences. In this case study, the various ‘voices’ in the interpretation process over time will be examined from the perspective of the dialogical self theory of Hubert Hermans, in order to explore the psychological dimension of this process. The case study demonstrates that a ‘both religious and pathological’ explanatory model for religious experiences consists of a rich and changing variety of I-positions that fluctuate depending on mood episode. Structured reflection from a spiritual and from a medical perspective over the course of several years helped this person to allow space for different dialoguing ‘voices’, which—in this case—led to a more balanced attitude towards such experiences and less pathological derailment. The systematic reflection on religious experiences by the person in the case study was mainly conducted without help of mental health care professionals and was not derived from a DST perspective. It could be argued, however, that DST could be used as a helpful instrument for the exploration of both medical and spiritual ‘voices’ in the interpretation of religious experiences in both clinical practice by hospital chaplains and by other professionals.

No abstract

Attention for Meaning-Making Processes: Context and Practice of Spiritual Care in the Earthquake Area of GroningenIn the North of the Netherlands spiritual caregivers have been employed to respond to the social and personal needs resulting from human induced earthquakes. In the Netherlands knowledge on spiritual care in times of disasters is limited. Central to the present study are two questions: How is spiritual care being put into practice in Groningen? And how do the spiritual caregivers cooperate with others in psychosocial care and in the social domain? This article describes the context, the reasons spiritual care came to be provided and the primary activities of the spiritual caregivers during their initial year of practice.