Who Is David Lukoff, PhD

David Lukoff, PhD is a licensed psychologist and professor emeritus of psychology at Sofia University (formerly the Institute of Transpersonal Psychology) in Palo Alto, California, where he previously served on the faculties of Harvard University and UCLA. He is best known as the co-author, with Francis Lu, MD and Robert Turner, MD, of the proposal that resulted in the inclusion of "Religious or Spiritual Problem" (V62.89) as a diagnostic category in DSM-IV in 1994—a change that fundamentally altered the official relationship between American psychiatry and spiritual experience by creating diagnostic space for religious and spiritual difficulties not attributable to mental disorder.

What makes Lukoff's trajectory unusual—and clinically instructive—is that his path to this work began not in a library but in a crisis. In 1971, in his early twenties, he underwent a two-month episode that met all diagnostic criteria for psychosis: he believed himself to be a reincarnation of Buddha and Christ with a messianic mission to write a new holy book. The episode resolved without hospitalization or medication, and he came to understand it not only as a breakdown but as a genuine spiritual awakening—one that transformed him from an atheist with no interest in spirituality into a lifelong seeker, and ultimately into the clinician-researcher who would dedicate his career to ensuring that others with similar experiences would not be automatically pathologized. He received a special recognition from San Francisco Community Mental Health Services for his "pioneering and persistent efforts" leading to the inclusion of V62.89 in the DSM-IV, and later won the Exemplary Paper Award from the Templeton Foundation for his work in this area.

Core Concepts

1. Spiritual emergence vs. spiritual emergency: Drawing on the framework developed by Stanislav Grof and Christina Grof, Lukoff distinguishes between spiritual emergence—the gradual, broadly life-enhancing unfolding of expanded awareness—and spiritual emergency, in which that process becomes so intense or destabilizing that it disrupts daily functioning and may require clinical support. His contribution has been to develop diagnostic criteria that help clinicians distinguish a spiritual emergency from a straightforward psychiatric episode, and to recognize that these categories are not mutually exclusive. His own 1971 episode, he has argued, was simultaneously both.
2. Mystical experiences with psychotic features: Lukoff proposed a diagnostic category for experiences that overlap both mystical and psychotic phenomenology—episodes characterized by unusual perceptions, altered sense of reality, and visionary content, but also carrying markers historically associated with positive outcomes: good premorbid functioning, acute onset, a positive attitude toward the experience, and absence of conceptual disorganization. This diagnostic framework provides a practical clinical tool for the genuinely difficult borderland between psychosis and spiritual experience, and has influenced how researchers and clinicians think about these overlapping territories.
3. The DSM Religious or Spiritual Problem category: The V62.89 code (now a Z code in DSM-5-TR) that Lukoff helped introduce creates diagnostic space for distressing experiences related to loss or questioning of faith, conversion, leaving or joining a religious group, or the destabilizing quality of spiritually transformative experiences—without attributing these to mental disorder. Its clinical significance is partly what it does and partly what it prevents: by establishing a non-pathological category for these experiences, it reduces the likelihood that clinicians will reflexively apply a psychotic or dissociative diagnosis to phenomena that require a more nuanced response.
4. Spiritual competency as a core clinical skill: Lukoff has spent decades arguing that the ability to conduct a meaningful spiritual assessment, understand the major traditions and their relevance to mental health, and respond respectfully to clients' spiritual concerns is not an optional specialty—it is a core clinical competency on par with cultural sensitivity. Through the Spiritual Competency Academy, which offers CE-accredited online training for mental health professionals, he has worked to build this competency into the field at scale, producing over 80 articles and chapters on spirituality and mental health along the way.
5. Personal experience as a clinical resource: Lukoff is unusually transparent about his own history with psychosis and spiritual experience, and he models a stance that many clinicians find difficult: using one's history of vulnerability and transformation not as something to conceal but as a source of empathy, credibility, and insight. His willingness to speak openly about his 1971 episode has contributed to destigmatization both of mental illness and of spiritually transformative experiences, and has made him a trusted figure for clinicians and clients who occupy the difficult borderland between spiritual and psychiatric experience.

Essential Writings

• "The Diagnosis of Mystical Experiences with Psychotic Features" (1985, Journal of Transpersonal Psychology): The foundational paper proposing criteria for distinguishing mystical experiences that overlap with psychosis from straightforward psychotic episodes. Best use: the essential starting point for understanding Lukoff's clinical framework, and required reading for any clinician encountering clients who report visionary or mystical content during acute episodes.
• "Toward a More Culturally Sensitive DSM-IV: Psychoreligious and Psychospiritual Problems" (1992, with Francis Lu and Robert Turner, Journal of Nervous and Mental Disease): The paper that laid the scholarly groundwork for the DSM-IV Religious or Spiritual Problem category. Best use: to understand the clinical and epidemiological argument that succeeded in reshaping official American psychiatric nosology.
• Spiritual Competency Academy: Lukoff's ongoing educational project offering CE-accredited online courses for mental health professionals on spiritual competency, spiritual assessment, and clinical response to spiritually transformative experiences. Best use: the most practical resource currently available for clinicians who want to build concrete, evidence-grounded skills in this area.
• "From Spiritual Emergency to Spiritual Problem: The Transpersonal Roots of the New DSM-IV Category" (1998, with Francis Lu and Robert Turner, Journal of Humanistic Psychology): A retrospective account of the history and rationale behind the DSM-IV proposal, written after its acceptance. Best use: provides the full narrative arc from clinical observation to policy change, including the role of the Spiritual Emergence Network and transpersonal psychology in shaping the proposal.