Visions and Psychosis

“In the last days, God says, I will pour out my Spirit on all people. Your sons and daughters will prophesy, your young men will see visions, your old men will dream dreams.”
(Acts 2:17)

Disclaimer: I have not experienced psychosis, or indeed heavenly visions. Please feel free to ignore what I write as the ramblings of the uninformed, if you wish!

Visions and voices that others cannot hear are fairly common in the Bible. Indeed, many non-Christians believe that the visionaries in the Bible were mentally ill, rather than inspired, and that what they wrote cannot be trusted. As Christians we face a difficulty when someone tells us they have seen a vision, or heard God’s voice – are they ill, or are they gifted by God? I have been reading some books on mental health and Christianity, and I have gathered together some wisdom on discerning the difference.

Firstly, I am not a charismatic, but many are, and there are many who believe God speaks to them in an audio-visual way. Certainly that sort of experience is attested in the Bible – for example the experience of the young Samuel in 1 Samuel 3 shows that he heard a very audible voice:

Then the LORD called Samuel. Samuel answered, “Here I am.”
And he ran to Eli and said, “Here I am; you called me.” But Eli said, “I did not call; go back and lie down.” So he went and lay down.
(1 Samuel 3:4-5)

Of course we know the story of Paul where in Acts 9 he heard a voice and saw a light, and was converted by Jesus. Many people today believe such things are as common now as they were in the Bible, although I would say that they were not that common in the Bible!

Like most Christians I do believe God speaks to me – I think that he speaks in his “still, small voice” through my thoughts. When I am contemplating something and a thought cuts across mine, directing me with good advice/Scripture/something contrary to what I was thinking (like for instance, I am thinking unpleasant thoughts about someone and a thought cuts in reminding me to love others) then I would say that is God. It is a very gentle thing, on the blurry edge of my thoughts/God’s voice, and would quite easily be dismissed as wishful thinking, if I were so inclined. I think many Christians have similar experiences.

But how do we tell the difference between a Samuel/Paul experience and a psychotic one? Marion Carson suggests that the vision/voice should be “culturally acceptable, legal and in line with [your] own values” (1) She also shares the story of a woman who had an experience where she heard a voice telling her that her pastor should not stay at his church, that his work was done there. The woman in question went to a spiritual director and a psychologist before going to the pastor, in order to check she had not become psychotic. This, Carson suggests, is a good plan – the fact that the woman had enough insight into her own mental state to notice something was very different and to wonder if it was mental illness, suggests that it was not. Another author suggests that psychosis entails a:

lack of insight into the fact that their symptoms are abnormal, unusual and not shared by others. Patients who assert that they are possessed by another human being, or that they are God and Napoleon, have a delusion of reference strikingly different from a Christian sense of the presence of God. (2)

Many of the people I have read suggest looking at the whole life of the person experiencing the vision. A writer, Evelyn Underhill, has something called a “fruits test” which is that an:

Ordered correspondence with each level of existence, physical and spiritual, successive and eternal – a practical realisation of the proportions of life – is the guarantee of the genuine character of that sublimation of consciousness which is called the mystic way; and this distinguishes it from the fantasies of psychic illness or the disguised self-indulgences of the dream world. (3)

I find that quote, while useful, a bit too high-flown. Carson, who I mentioned above (and whose book I would definitely recommend) states essentially that we can distinguish between illness-visions and divine by looking at what it does to the person, does it cause distress and harm day-to-day life?

The acid test here will be how this belief is affecting [the person’s] relationships with other people. Is it being expressed selfishly or constructively? Is the experience benefiting the community or damaging it? Are relationships being built up or destroyed? An increasingly disturbed and isolated lifestyle will point to psychosis and the need for help. (4)

The points I would bear in mind if someone talked to me about a vision they had are these:

  • Does it make sense? If I look at the Bible, do I see similar ideas/themes to the vision/voice? Does it contradict what I read in Scripture, does it express odd ideas about Jesus/God/heaven or whatever? Does it say only that the person with the vision is important – that they are the Messiah, a prophet reborn, etc? Does it claim knowledge which is not to be given – the Bible says that we will not know the day or hour Jesus will return (Matt 24:36), does the vision proclaim a day or hour? Is “God” in the vision saying things we know God would not say, is he telling them to harm themselves or others, that they are terribly sinful and cannot be forgiven?
  • What is the person like? Are they isolated from the community? Have their friendships and relationships started breaking down? Does their vision distress them? Are they looking after themselves physically? Eating? Drinking? Washing? Are they able to hold a conversation with another person?
  • Do they realise that their vision/voice is unusual, that other people do not experience these?

Essentially, a vision should build up (eventually, even if it is to say that we have a problem and God wants us to put it right – if you read the prophets, they were told that they were sinning and bad things would happen; they were also given hope in a God that loved them) rather than tear down. I would also add that it behoves us to foster an atmosphere where miraculous signs, visions and the like are not automatically taken as “gospel”, but which are weighed and measured against Scripture and other people.

I’ll finish off with a quote from someone who has experienced psychosis:

There are those who believe that they have a hotline to God or believe that they actually are God or Jesus, but these poor patients will have other abnormalities in their thought patterns as well which will be seen by the doctor. For instance they may believe that they can control the world or have outrageous supernatural powers. (5)

If anyone has personal experience of psychosis and would like to write about how they discern what God is saying to them, despite this, I would be interested in either quoting you or having you guest-post! Please get in touch at believersbrain(at)yahoo(dot)com.


(1) Carson, Marion L S, The Pastoral Care of People with Mental Health Problems (London: SPCK, 2008) p61
(2) Brown, L, “The Psychology of Religion: An Introduction” (London: SPCK, 1988) p89
(3) Underhill, E, “The Essentials of Mysticism and Other Essays” (Oxford: Oneworld, 1995) p34
(4) Carson, Marion LS, ibid. p62
(5) Wield, Cathy, “A Thorn in my Mind: Mental Illness, Stigma and the Church” (Watford: Instant Apostle, 2012) p136

Another book worth mentioning is “Ministry with Persons with Mental Illness and their Families” Albers, RH; Meller, WH & Thurber, SD (eds) Minneapolis: Fortress Press 2012.


  1. The Bible does distinguish between madness and the visions of prophets. There was an episode when king David pretended to be mad to confuse his enemies… also the famous passage where God says if the Israelites disobey him he will curse them with madness and blindness and faintness of heart…

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