Psychosis and dissociation

Abstract

This chapter examines psychosis—particularly schizophrenia—from both mainstream psychiatric and transpersonal perspectives. It begins by noting that deep psychological awakenings can take different paths: in some cases leading to psychosis, in others to a “spiritual emergency” with better outcomes, or, more rarely, to complete and positive awakenings. Mainstream psychiatry classifies psychotic disorders along a severity gradient, from milder, brief episodes to severe, chronic conditions such as schizophrenia. Schizophrenia is now categorized in DSM-5 without subtypes, due to their limited reliability and prognostic value. Diagnosis requires persistent symptoms for at least six months, which may include delusions, hallucinations, disorganized thinking, and negative symptoms. Examples range from hearing accusatory voices to sensing tastes others do not perceive. Globally, schizophrenia affects about 1% of the population, with onset usually in young adulthood. Its course is often chronic or recurrent, though sudden or single episodes do occur. Psychodynamic theories view psychosis as a regression to early developmental stages, often triggered by trauma, with defenses such as splitting or projective identification. The transpersonal approach extends traditional interventions, aiming not only to prevent or manage ego collapse, but also to guide the reconstruction of identity on new, non-egoic foundations.