Spiritual/religious experience in atheists with bipolar disorder: A qualitative study of subjective interpretation, coping, and treatment experiences
Bibliographic record
Abstract
Spiritual/religious experiences (SREs) are a hallmark of bipolar disorder (BD), and their subjective influence often persists post-episode. However, difficulty disentangling SRE meaning from illness narratives is common in BD, which can negatively impact illness coping and treatment engagement. While individuals with pre-existing spiritual/religious beliefs may benefit from access to adaptive interpretive frameworks shared by supportive social contexts, such resources are less readily available to atheists, who may be especially vulnerable to maladaptive SRE coping and outcomes. The present study aimed to understand ways in which atheist adults with BD interpret their SREs, and which coping and treatment experiences are involved. Eleven medication-adherent Canadian and U.S. adults diagnosed with BD completed semi-structured interviews. A grounded theory analysis resulted in the following themes: SRE descriptions and mental health contexts; experiences influencing SRE interpretation; SRE explanations & related views; conflicting values and beliefs; helpful conceptual approaches; (predominantly negative) sharing and help-seeking experiences; spiritual/religious coping; relapse prevention; and personal growth and wellbeing. All participants endorsed agnostic and/or spiritual/religious worldviews after their SREs. Interpretation of the results employed a cognitive approach to belief formation. The resulting middle-range theory proposes that SRE interpretation in atheists with BD is significantly influenced by cognitive dissonance between the lasting meaning/value of the SRE, acceptance of illness, and pre-existing atheist values and beliefs. Explanatory efforts may involve online and offline research, community exploration, and counselling/psychotherapy, and may be influenced by social pressures (e.g., effects of stigma, marginalization); consequences for self-esteem (e.g., internalized stigma, self-enhancing beliefs); existential concerns (e.g., coping with mortality); and mood fluctuations. Hybrid biomedical–spiritual/religious explanatory models may be common in this group, serving to reconcile SRE meaning/value with illness acceptance and pre-existing atheist values. Residual uncertainty, which can be persistent and pervasive, may be managed using various cognitive and behavioural strategies. Clinical implications of the findings are examined and support a range of recommendations for clinical practice in assessment and treatment with this population. The study’s key contributions, limitations, and recommendations for future research are discussed, followed by some reflections from the researcher.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".