The creation of two diagnostic categories in the 1994 DSM—'religious or spiritual problem' and 'dissociative trance disorder'—reflects ongoing debates among psychiatrists and psychologists about whether religious and spiritual experiences should be considered normal or pathological. Proponents of these categories draw on psychological and anthropological concepts, particularly from transpersonal psychology and studies on dissociation, to frame phenomena like religious trance, spiritual possession, and transcendental experience. Analysis of scientific articles, academic works, and interviews reveals how these professionals produce distinct psychological understandings that can either normalize or pathologize such experiences.
The diagnostic category 'Religious or Spiritual Problem,' introduced in 1994 in the DSM-IV, has followed a trajectory that reflects broader shifts in scholarly debates about spirituality, moving from New Age practices to institutionalized forms. Drawing on archival, bibliographical, and ethnographic research, the article shows that the category originated in transpersonal psychology, was debated during its inclusion in the DSM-IV, and is now mobilized in psychiatric research on spirituality in Brazil. Although psychiatry has historically pathologized religious or spiritual experience, the author argues that using this category actually legitimizes contemporary psychiatric research on spirituality.