The
following article is based on a presentation made during the Second International
Conference on Integral Psychology, held at Pondicherry (India), 4-7 January
2001. The text has been published in:
Cornelissen, Matthijs (Ed.) (2001) Consciousness and Its Transformation,
Pondicherry: SAICE
Towards a spiritual psychology
Bridging psychodynamic psychotherapy with integral yoga
Michael Miovic
My friends, the whole
world is a lunatic asylum. Some are mad after worldly love, some after
name, some after fame, some after money, some after salvation and going
to heaven. In this big lunatic asylum I am also mad, I am mad after God.
If you are mad after money, I am mad after God. You are mad; so am I.
I think my madness is after all the best.”
Sri Ramakrishna1
“I cannot discover this
‘oceanic’ feeling in myself… But this gives me no right to deny that it
does in fact occur in other people. The only question is whether it is
being correctly interpreted and whether it ought to be regarded as the
fons et origo of the whole need of religion.”
Sigmund Freud2
Introduction
Is there a God? Is
there a non-material reality? Do we have souls that persist in an afterlife
(or next life or everlife if you prefer)? These sorts of basic existential
questions are rarely considered in the day to day practice of clinical
psychology and psychiatry, and yet they should be. If the answer to any
of them is Yes, then evidently our current theories of mental health need
to be enlarged in order to take account of these essential facts of existence
and to understand how they relate to the human psyche. For, in the most
pragmatic sense, how can we help people better “adjust” to life if we
misapprehend what the nature and aim of life is?
This paper will argue
that the fundamental questions of metaphysics are not trivial, because
the answers we select for them determine the framework of metapsychology,
and that in turn influences clinical practice. For example, consider the
following brief scenarios: 1) a Christian woman with a history of hypomania
in remission reveals that she feels God’s presence in her life and that
she is being guided by Him; 2) an avowed atheist struggling with grief
reveals that months prior to his sister’s sudden passing in a car accident,
he had a dream about the crash. How do we hear these reports as clinicians?
Do we increase the woman’s mood stabilizer, or support her religious faith
because it connects her to a community, or explore her beliefs because
they reveal the intrapsychic structure of her object relations, or learn
how God is in fact present in her life? Do we dismiss the man’s dream
as coincidence or a rationalization, hear it as a clue to unconscious
guilt vis a vis a conflict with the sister, or accept it as a precognitive
intuition? The answers to these questions depend largely upon what we
believe to be the ultimate nature of reality—a subject, unfortunately,
upon which there is no general consensus now, nor perhaps ever will be.
In his classic work
on religious experience, William James eloquently outlined the debate
between spiritualism and medical materialism, which views the cause of
spiritual experience as either neurosis or a neurophysiological event.3
Today, our knowledge of psychodynamics and neurobiology is much richer
than in James’s time, but the essential dilemma of how to understand spirituality
remains the same. This state of affairs is vividly illustrated by Newberg’s
recent use of SPECT scanning to show consistent patterns of prefrontal
activation with superio-parietal deactivation in Buddhist meditators and
Franciscan nuns absorbed in unitive states of awareness.4 Although
this emerging field of “neurotheology” is certainly fascinating, and does
demonstrate clearly that the brains of healthy mystics are not like those
of schizophrenics, it does not answer the conundrum of whether spiritual
experience is an illusion created by the brain, or the brain’s perception
of an actual reality. James presciently addressed this impasse one century
ago when he suggested that we take a phenomenological and pragmatic stance
towards spiritual experience, that is, that we explore its subjective
qualities and judge these by their fruits for life.
From the perspective
of psychotherapy, this means we need to build a conceptual bridge from
an empirically derived spiritual metapsychology, a la James, to modern psychodynamic and behavioural models of mind. That is,
we should form a working conception of the experiential (as opposed to dogmatic or scriptural) wisdom contained
within the world’s major religious/spiritual traditions, and then integrate
this with the wisdom of psychotherapy. The purpose in attempting this
is not to convert the reader to any particular theological orientation,
but simply to facilitate the transmission of insight among the various
and venerable traditions of psychological inquiry, secular, scientific,
and spiritual.
The aim of this study,
then, will be to tackle part of that task: to review the key insights
of Eastern spiritual psychology and synthesize these with the theoretical
foundations of Western psychotherapy. Particular emphasis will be placed
upon the yoga psychology of Sri Aurobindo (1872-1950), one of India’s
most respected philosophers and spiritual teachers of the 20th
century. This is not to deny the importance of Buddhism, other branches
of Hinduism, Christianity, Judaism, Islam, or any other religious tradition,
but to provide a focus given limitations of space. Both James and Sri
Aurobindo believed that the fundamental truths of spiritual experience,
when approached as psychological phenomena, are more similar across religious
traditions than dissimilar. To the extent they are right, this study will
have pluralistic relevance.
Sri Aurobindo’s interpretation
of ancient yoga psychology represents the most sophisticated expression
of the movement towards syncretism animating the teaching of his major
predecessors and contemporaries, Sri Ramakrishna, Swami Vivekananda, Ramana
Maharshi, and Paramahamsa Yogananda. These figures were central in modernizing
the timeless message of Indian spiritual philosophy and sending it westward.
The lesser figures of Krishnamurti, the Mahesh Yogi (founder of the transcendental
meditation movement) and Deepak Chopra—as well as even lesser vehicles
(the Hare Krishnas) and the lowest of all (Rajneesh)—are smaller characters
who have traversed a stage built by great architects. And among this high
circle of spiritual masters, Sri Aurobindo was the only one educated in
the West (England), and the only one to attempt a complete intellectual
synthesis of Eastern and Western worldviews. His yoga psychology is also
particularly relevant to psychotherapy because he emphasized that the
aim of spiritual practice is not to escape from the world or merely to
relieve “stress,” but to change the troublesome patterns in one’s character
structure and behavior. Indeed, many of his letters to students discuss
a variety of neurotic (and, at times, psychotic) symptoms that today fall
under the purview of general psychiatry.5 Interested readers
are referred to Dalal for detailed comparisons of Sri Aurobindo’s psychological
thought with that of the major figures and schools in Western psychology,
6 and to Basu for a variety of clinical observations and applications.7
For those who are unfamiliar
with the Indian notion of yoga, the term
refers not only to hatha yoga exercises—which have become a popular form
of physical fitness in the West—but to any devotional, contemplative,
philosophical, humanitarian, psychological, or artistic endeavour that
is pursued with the specific intention of becoming aware of the Divine
and cultivating that presence in oneself and others. The word “yoga” derives
from the root yug (to yoke), and the connotation
of “yoking” the human back to the Divine is quite similar to “religion,”
which derives from the Latin religere (to tie back). All religions find a relationship
between human life and the Divine will, however, in his major works on
yoga8 and social psychology,9 Sri Aurobindo further
argued that the aim of individual, social and biological
evolution is to manifest a higher spiritual consciousness on earth, under
the conditions of matter. This core idea, that the teleological goal of
matter is to manifest spirit in a progressive fashion, is the keystone
of Sri Aurobindo’s philosophy and is echoed from a Christian perspective
in the work of Teilhard de Chardin,10 to whom Sri Aurobindo
has been compared.
Historical background
Spirituality in psychology
is not new, but it is currently experiencing a wave of re-emergence that
is reflected in a range of disciplines and developments. The literature
in this area has grown so quickly in the last decade that it is not possible
to review it completely here. Following is a brief outline that highlights
several branches of development.
On the socio-historical
front, Taylor has documented the history of spiritual psychology in the
United States dating back to the 1600s. He argues that spirituality has
always played a role in the development of American culture, as evidenced
in the influence of the Shakers, Quakers, Transcendentalists, Christian
scientists, James, humanistic/transpersonal psychology, and now the “new
age”.11 The hold spiritual psychology continues to exert on
the popular mind was amply evident in a recent issue of Newsweek12 that reviewed the birth of “neurotheology.” In addition,
the establishment of Sir John Templeton’s “Prize for Progress in Religion”
in 1972, and later the Templeton Foundation, has greatly promoted (and
funded) the study of religion and spirituality. For instance, in 1996
the National Institute for Healthcare Research, with support from the
Templeton Foundation, developed a model curriculum13 for teaching
spiritual issues to psychiatric residents, which numerous programs in
the United States have since adopted, including at Harvard.14
Publications have also emerged that focus on interdisciplinary studies
in science and theology.15
In the psychology and
psychiatry literature, the latest edition of the DSM16 now
allows for a diagnosis of a “religious or spiritual problem” (V62.89),
and the journal Psychiatric
Annals has devoted an entire
issue to spirituality in clinical practice for two years running.17
Parsons has studied the original correspondence between Freud and Rolland
on the subject of the “oceanic feeling,” providing a scholarly study of
the relationship between psychoanalysis and mysticism.18 Karasu
has written cogently about core principles of spiritual psychotherapy
that can help both patient and therapist move towards soulfulness and
a turning to the spirit.19 There are now two textbooks on spirituality
and psychology, one by Richards and Bergin,20 who write from
a Christian (Mormon) perspective, the other edited by Shafranske.21
Boehnlein has also edited a compendium of reviews on the topic of psychiatry
and religion,22 while Sperry has described three levels of
incorporating spirituality into psychiatric practice, depending on the
clinician’s capacities and the patient’s needs.23
In medicine, these trends
are visible in the rise of “mind-body” and “complementary-alternative”
medicine (CAM). Benson’s pioneering work on the relaxation response24
has become so well established that his institute at Harvard has spun
off highly attended conferences on CAM and spirituality in healing for
mainstream medical professionals. A rigorous, peer-reviewed journal for
CAM research now exists,25 and there is a strong and growing
influence of Buddhist theory applied to problems of both physical and
mental health. For instance, Kabat-Zinn has used mind-body awareness training
to help both patients and healthcare professionals cope better with chronic
illness.26 Epstein has written about using Buddhist psychology
in his psychoanalytic practice.27 Linehan, who trained in Zen,
combined vipassana notions
of “mindfulness” with cognitive behavioral therapy (CBT) to craft DBT
(dialectical behavior therapy),28 the first therapy experimentally
proven to reduce self-destructive behavior in borderline personality disorder.29
Austin, a neurologist, has thoroughly reviewed the neurobiology of spiritual
awakening from the perspective of Zen philosophy,30 and institutes
are cropping up with distinguished faculty who are interested in exploring
the interface between meditation and psychotherapy.31
Lastly, in the arena
of parapsychology, there is a growing body of experimental evidence to
support the claim that consciousness has “non-local” dimensions. This
sort of research is naturally suspect to mainstream academic audiences,
because it treads the border of pseudo-science, but it merits mention
nonetheless because the quality of these investigations has increased
since the 19th century. Dossey, who coined the term “non-local
phenomenon,” has catalogued and summarized a large body of research in
this area in a series of books32 and essays.33 Byrd
reported positive effects for intercessory prayer conducted in a double-blind
fashion in a coronary care unit34, and his study—which was
criticized on methodological grounds—was recently replicated in a more
rigorously designed trial reported in the Archives of Internal
Medicine.35 Finally, Braud recently reviewed the literature on
direct mental influence (mind-over-matter effects), reporting a series
of well-designed experiments that demonstrated time-displaced retroactive
effects, i.e., that human intention can affect past probability fields.36
Although none of these studies proves conclusively the existence of a
non-material reality, they do, at the minimum, remind us that the fundamental
assumptions of scientific materialism remain open to question as we enter
the 21st century.
Faith as a developmental
milestone
With that overview,
we now turn to the work of framing a spiritual psychology. The first and
most important step is to recognize that the consolidation of genuine
faith in the Divine is a major developmental achievement. In a recent
essay on the relationship between psychoanalysis and religion, Meissner
has summarized his own and others’ efforts to bridge the realms of psychoanalysis
and theology.37 He explains how Winnicott’s notions of transitional
objects and transitional phenomenon allowed for what Freud called the
“illusion” of religion to be reinterpreted as a developmentally necessary
need for humans to find meaning and creative connections in the world
around them.
Rizzuto advanced this
line of thinking by showing how the development of people’s intrapsychic
God-representation essentially parallels the development of other object
relations and may complete an integrated sense of self.38 The
limitation of her formulation, however, was that it stopped short of exploring
the relationship between the transitional phenomenon of the God-representation
and its supposed external referent, God. Meissner took the next step along
this trajectory by exploring how the psychology of a person’s faith can
be understood simultaneously both in psychodynamic terms and as referring
to a real Christ, a real God, and a real sacrament. Still, he remains
cautious about the following step in the sequence, Spero’s introduction
of an objectively real God as a factor both in the God-representation
and in the therapy process.39 Meissner wants to keep the dialogue
in the range of transitional understanding, because he argues that this
preserves the integrity of the two different realms of discourse, psychoanalysis
and theology. He seems to feel that to confuse these two realms would
be deleterious to both.
Although one can certainly
understand Meissner’s hesitation about the difficulties of apprehending
God’s presence in the patient’s psychological processes and the therapeutic
encounter, it is important here to separate for a moment the problems
of practice and the problems of theory. On the theoretical level, in the
end Meissner’s transitionalism cannot be right, for it suffers the same
fate as agnosticism: just because the human mind may never know whether
or not God exists in an absolutely final sense, does not alter the fact
that, in the end, it either does or does not. Atoms existed long before
humans knew them to be pervasive, and likewise God, if She does in fact
exist, does so independently of our current judgments—and is equally pervasive
as atoms. That is, She must be present in every aspect of the patient,
the therapist, and the therapeutic relationship, for there can be nothing
that exists outside of God. So, theoretically, Spero’s proposition, or
what Richards and Bergin refer to as their doctrine of “spiritual realism,”40
is more correct.
Admittedly, this poses
a huge practical problem for human consciousness, which is by definition
limited. The real value of Meissner’s approach, then, is that it does
not require clinicians to believe in the existence of a soul or God, nor,
if they do believe, to hold the same theological beliefs as their patients
do. Thus a therapist could be agnostic or even atheist, and still treat
his or her patient’s faith as a psychological reality worthy of the same
careful exploration given to the rest of a patient’s developmental history.
However, for those who do believe in the Divine, there is still a utility
to further articulating a doctrine of spiritual realism. For if there
truly is a spiritual reality, then the development of faith
must represent a major developmental milestone, because it signifies at
a minimum the crystallization of an intrapsychic capacity to have a conscious
relationship with that reality. To see it as anything less—or worse, as
a defence—would be a mistake.
Perhaps an analogy may
better illustrate this point: as Mahler showed, the development of object
permanence around months 18-24 of a child’s life is a major developmental
milestone that allows the infant to separate from its mother, because
it now has the capacity to maintain an internal image of her in her physical
absence. If the child did not develop this capacity, it could not individuate,
could not grow from a state of illusory symbiosis to having a real relationship
with a real mother who is in fact separate. It would be stuck in a Winnicottian
transitional limbo forever. If we fail to recognize this developmental
milestone—or worse, call object permanence a defence against separation
anxiety—then we fail to appreciate a critical step in normal psychological
growth.
The development of faith
is analogous, though not entirely the same because the separation-individuation
process that Mahler described is part of the solidification of the normal
ego, while the development of true faith is a spiritual process that leads
beyond the ego. While normal psychological growth proceeds from a pre-egoic,
illusory symbiosis with a human mother, to separation from her and the
establishment of an independent ego; supranormal growth proceeds from
illusory separation between the ego and God, to the real symbiosis of
supra- or trans-egoic unity between the soul and God.
This simple idea, the
foundation of transpersonal/spiritual psychology, has been stated and
restated by many authors, but one of the most vivid discussions of it
remains Watts’s easy yet insightful exploration of the interface between
Eastern religion and Western psychology (1961).41 Maslow catalyzed
the formation of transpersonal psychology with his study of “peak experiences”,
or ecstatic/unitive states of consciousness akin to mystical experiences,
which he found to characterize psychological health in “self-actualizers.”42
Subsequently, Wilber refuted yet again claims that such mystical/spiritual
experiences are due to fusion-fantasies of returning to the womb, as Freud
suggested when he deemed the “oceanic feeling” as deriving from the primary
narcissistic union between mother and infant. 43 Wilber attempted
to show that major differences exist between pathological states of ego
dissolution, which are regressive, and progressive, trans-egoic states
in which the individual can transcend the subject-object dichotomy while
remaining psychologically stable and aware of conventional reality.44
Scientifically, it would seem that the issue of regressive vs. progressive,
at least, could be answered definitively with future neuroimaging studies,
if indeed Newberg’s research cited previously has not already done so.
The dynamics of faith
But what exactly is
faith, and how is it psychologically active? Although beautiful things
are written about faith in every language, and every religious tradition
has its own insights to add to the multidimensional phenomenon of faith,
here we will focus on the Aurobindonian model of faith-practice, because
it is psychologically-minded. He sees the core of spiritual praxis as
a movement of three complementary and interdependent intrapsychic processes
which, together, both depend on faith and express it as a living relationship
with a living God. These he names aspiration, surrender, and rejection.
Aspiration he defines an inner invocation of and yearning to
feel the presence of the Divine in one’s life. By surrender he means to open oneself entirely to that higher
power and to it alone, and to let oneself be a vehicle for its dictates.
And rejection he defines as to actively evaluate the quality, purity,
and source of one’s inner inspirations and to throw away all that is inferior,
egoistic, divisive, regressive, and false. A deficiency in any of these
psychological movements, or an imbalance among them, leads to an incomplete
or imperfect practice of faith.
The utility of Sri Aurobindo’s
formulation for our purposes is that it neither requires nor rejects adherence
to any particular religious theology, i.e., it is theology-neutral, like
the 12-step programs, which we shall discuss later. He is also careful
to approach faith not as a passive or naïve state, but as a wilful and
dynamic process that improves with practice. Note that dynamic in this context connotes “evolving” and is oriented
to the present and future, whereas in the term psychodynamic it refers to what one has learned, or failed to learn,
in the past. Psychodynamic theory has much to say about character pathology,
but little about how will and volition contribute to continuing psychological
growth across the life-span (for notable exceptions to this trend, see
Frankl’s compelling essays on meaning45 and Fromm’s work on
the art of loving46).
Sri Aurobindo’s model
of faith-practice of course depends upon the existence of a soul that
is conscious of God and engenders the psychological movements of aspiration,
surrender, and rejection. He calls this soul the “psychic being,” coining
his term from the Greek root psyche, and defines it as the
true and eternal entity within us that reincarnates from life to life
and thus develops an ever-increasing capacity to be conscious of and manifest
the Divine in life. Aurobindo takes for given the Hindu idea of reincarnation,
but places a new emphasis on the evolutionary aim of this process and
on the transformational goal in the Divine plan. That is, he argues that
the aim of spiritual praxis is not to transcend the cycle of karma and
rebirth, but to perfect life on earth. He accepts the classical Buddhist
notion of nirvana, and the Vedantic notion of the transcendent Self,
as real psychological experiences of major importance, only he views these
realizations not as the end of spiritual evolution, but rather as the
beginning of a radical transformational praxis.
Sri Aurobindo does concur
with the monotheistic traditions of Judaism, Christianity, and Islam that
the Divine is ultimately single and unitary, and that It represents itself
in humans as immortal souls. However, he prefers the Hindu metaphysic
of polymorphous monotheism, according to which the one God can differentiate
itself into in a plethora of attenuated forms, vehicles, creations, forces,
and beings. So, in summary, Sri Aurobindo believes that God made all,
all is God, God is in all and also beyond all, the All is all growing,
God is growing in all, and we are all growing into God.
The relevance of this
perspective to psychology is that it offers the largest possible rationale
for psychotherapy. In this view, since the entire aim of human life is
to become aware of the soul and use the consciousness thereof to transform the outer
being (i.e., personality
with its structure of cognition, affect, and behavior), then by definition
psychotherapy is annexed as a province of spiritual praxis. Furthermore,
this spiritual perspective holds true whether or not one accepts the Eastern
notion of reincarnation. As long as one –accepts that there is a soul
within human beings that is seeking to emerge, then the same argument
holds whether that soul has one life or many to manifest itself in thought,
feeling, and action.
This proposition—e.g.
that spirituality, health, and personal transformation are in some way
linked—is sensed but still imperfectly grasped in the burgeoning “mind-body”
literature. What is missing is a clearer focus on the role that affect
plays in the mind-body axis, as well as an articulation of the relationship
between the true soul (or inner being) and the outer triad of mind, emotion,
and body. This is where Sri Aurobindo’s metapsychology can help, because
he clearly distinguishes these four broad “parts” of the human being and
studies the influence each has on the full personality. These parts he
names the psychic (spiritual or soul) being, the mental (cognitive and ideational) being, the vital (emotional and desire) being, and the physical (biological) being. All coexist in the human being,
yet each has its own ontological and phenomenological reality; and the
relative balance of influence among these four parts determines the nature
and meaning of behavior.
Given this metapsychological
framework, our next task is to understand how these various aspects of
the human being relate to each other, and how psychodynamic and behavioral
models of mind relate to this framework. (For further reflections on the
neurobiology of spirituality, readers are referred to Austin and Newberg,
previously cited.)
Defence mechanisms vs.
transformational processes
A good place to start
is with the notion of defence mechanisms, one of the enduring pearls of
wisdom gleaned from psychoanalysis. Much credit for the articulation of
defence mechanisms goes not to Sigmund Freud, but to his daughter, Anna
Freud. It was her brilliant work with children that lead to the characterization
of many of the best known defence mechanisms (Table 1).47 More
recently, Vaillant, in his research following a cohort of Harvard graduates
over several decades, has shown as best as can be done from the data available,
that the basic defence mechanisms cluster into three groups: immature,
intermediate (neurotic), and mature.48 In general, people tend
to grow from using more immature clusters of defences towards more mature
clusters as they move across the life span, and those who stay stuck behind
are unhappy and fare poorly. Vaillant elegantly studies the interaction
between defensive styles and Eriksonian stages of adult development, and
the beauty of his research is that it captures in meaningful data a very
human process that clinicians viscerally “know” from sitting with people
over time.49
I.
Psychotic
Delusional projection
Denial
Distortion
II.
Immature
Projection
Fantasy
Hypochondriasis
Passive aggression
Acting out
Dissociation
III.
Intermediate (Neurotic)
Displacement
Isolation/Intellectualization
Repression
Reaction formation
IV.
Mature
Altruism
Sublimation
Suppression
Anticipation
Humour
Table 1. Style of Defence
Now it is here that
we may begin to build the backbone of a spiritual psychology, grafting
larger ideas onto the existing latticework. Vaillant has essentially demonstrated,
on a limited scale, what could be called an evolution of consciousness,
a growth out of the darkness and turbulence of the inchoate ego, to the
relative stability and self-mastery of the well formed ego. In the terminology
of yoga philosophy, this represents growth from a tamasic character
structure (primitive/immature), through rajasic (immature/intermediate), to a sattwic (mature) personality, from chaos and inertia to a
state of some organization and light. People who know only how to deny
and project live in raw misery, while those who can sublimate and deploy
humour are much freer to find passion, meaning, and spots of joy in life—or
as Freud said succinctly, “to work and to love” despite the burden of
normal human suffering. Mature defences may not be sufficient to catch
happiness, but they are definitely needed to pursue it. It is impossible
to imagine an inveterate somatizer or paranoid psychotic achieving the
fullness of his or her inner potential.
But how does one grow
from personal to spiritual/transpersonal consciousness? This is the crux
of the matter. If you grant that there is a soul and a spiritual reality,
then it follows that above and beyond defence mechanisms, there must be
transformational processes. That is, there must be intrapsychic (and interpersonal
and social) processes that make it possible to grow from a mode of consciousness
in which the individual is defending against painful experience (anger,
sadness, fear, envy, sexual arousal, etc.), to a true living in the genuine
qualities of the soul (sincerity, honesty, compassion, purity, peace,
joy, love, harmony, forgiveness, goodwill, patience, endurance, integrity,
and so on). The latter cannot be simply defended derivatives of the former,
for then transformation is really an illusion. The soul must generate
its own primary affects, too, which either transform or replace the former.
Once we grasp this,
then suddenly the wisdom of spiritual practice emerges. Take for example
the teaching of the current Dalai Lama, a Nobel laureate. In a recent
work on ancient Buddhist teachings,50 the Dalai Lama begins
by saying that “the whole point of transforming our heart and mind is
to find happiness.” He then highlights that negative thoughts and emotions
make people feel unhappy, and finally suggests that the antidote is to
consciously develop positive thoughts and feelings of love and compassion
because “the nature of human thoughts and emotion is such that the more
you engage them, and the more you develop them, the more powerful they
become.”51 On that basis, he proceeds to expound a series of
meditations and psychological exercises to increase feelings of love,
compassion, and altruism, and to decrease envy, greed, and anger. Without
recounting the details here, let us simply note that his basic prescription—to
reduce negative thoughts and feelings by practising positive ones—is a
cognitive-behavioral approach to changing affect. Christ recommended the
same two millennia ago, and today CBT specialists have elaborated the
method in a secular –fashion. This is not rocket science, and yet it seems
like a space shot to psychodynamic theory. E.g., how often do analysts
tell depressed people to go feed the homeless or forgive their mean parents?
The problem lies in
a dispute between two equally valid yet separate models of mind, and the
solution therefore lies in a synthesis. To use a prosaic metaphor, when
it comes to driving the car of human happiness, spiritual traditions have
emphasized the need to step on the gas (practice positive thoughts and
feelings), while psychoanalysis has highlighted the need to step off the
brakes (by analyzing away neurotic conflicts and deficits). May we therefore
deduce that the way to advance most rapidly in our Jeffersonian “pursuit
of happiness,” is both to step off the brakes and to step on the gas? Are we finally ready to declare
an interdependence of East and West, of spirituality and science, and
on that basis draft a new constitution for mental health? In practice,
many seasoned therapists already call themselves “eclectic,” by which
they mean they use elements of both CBT and psychodynamics in their work,
as needed. Theoretically, sophisticated treatment regimens have been described
in family work in which CBT methods are used to modify dynamically imbued
behavior to stimulate both insight and behavior modification simultaneously52.
Thus the mortar has already been mixed. A spiritual psychology provides
the foundation and framework in which to apply it.
We can begin by simply
naming some transformational processes. Now as with defence mechanisms,
in describing these one could go to exhaustive detail in cataloging minute
inflections and shades of meaning. For the sake of practicality, I will
use only a few straightforward terms and arbitrarily group them into two
large categories (Table 2).
First and most obviously,
come four widely used processes that are so common they are taken for
granted, and thus not recognized: witnessing, listening, going into, and
understanding. To “go into” a difficult affect or painful experience means
to allow oneself to feel it as much as is consciously possible. It is
the whole aim of psychodynamic therapy to do this, and to progressively
roll back the curtain of unconsciousness so as to make more and deeper
pains conscious, and to bear them.
Transitional
Witnessing
Listening
Going into
Understanding (Mindfulness)
Spiritual
Aspiration (or Invocation or Remembering)
Surrender (or Offering or Sacrifice)
Rejection (or Purification or Discrimination)
Transcendent
Detachment (from the ego)
Identification (with the Divine)
Table 2. Transformational Processes
Witnessing, on the
other hand, means to detach, stand back, observe the flow of thoughts
and feelings without interfering, containing, controlling, altering them.
Witnessing is taught formally in Zen, vipassana, and
other meditation techniques, and is used extensively in CBT to monitor
one’s flow of thoughts and identify negative automatic thoughts and cascades
of catastrophic thinking. Ironically, witnessing was also sought by Freud
in his method of free-association, in which he enjoined the patient to
“say whatever comes to mind, without holding anything back.” The point
where the flow of thought blocks, where the patient is no longer able
to witness with detachment, marks the fall from transformative potential
to defence. In Buddhist terms, this is where the samskaras, or
conditioned patterns, of the mind emerge.
Listening is a poise
half way between witnessing and going into. In pure witnessing, such as
is sought in meditation, one aims to detach from the stream of conscious
content until the mind (or conscious mind at least) falls silent—not blocked
or dull, but vast, open, calm, like a still sea. In listening, on the
other hand, the attention is turned towards what arises out of that stillness,
with an attitude of open-ended inquiry. There is no haste or pressure
to arrive at any fixed conclusion, and in that sense attention remains
detached from the contents of awareness, but there is a relationship akin
to “what can be learned from this?”
Witnessing, listening,
and going into interact with each other to yield understanding, the empathic
synthesis arrived at by thinking and feeling deeply about the content
and process of the former three. Understanding—or what the Buddhists call
“mindfulness”—is, of course, the very water in which successful psychotherapy
swims. Prototypically, brief flashes of witnessing allow painful content
to arise, which can then be listened to and finally gone into to activate
the process of working through. This cycle is repeated in miniature within
each therapeutic visit, and on a larger scale over time across visits.
Note, too, that it can occur both within an individual alone, or, in the
situation of therapy, some of these higher functions are initially delegated
to the therapist. Thus it becomes the therapist’s role to use witnessing
and listening to help the patient go into painful experiences from the
past and present, and gradually increase the patient’s intrinsic capacity
to witness and listen to himself. Traditional psychodynamic lore speaks
of how the therapist lends her ego-functions to help fortify the patient’s
“observing ego”. From a spiritual perspective, this process is seen as
larger and almost hyper-real: by tapping the contagious power of consciousness
to transmute consciousness, the therapist is drawing on the strength of
his or her own transformational processes to activate psychological evolution
in the patient. Thus, much psychotherapy already employs transformational
mechanisms, although this has not been sufficiently appreciated to date,
probably because our medical materialism has compressed our metapsychology
and thus led to misunderstanding.
Beyond the transitional
processes of transformation (Table 2), lie the truly spiritual and finally
transcendent operations. Aspiration, surrender, and rejection have already
been described, and of course can be practised using whatever nomenclature
is most suited to the individual (e.g., invocation, offering, and purification,
or any other comparable terms). Note that transformative faith-practice
is simultaneously dynamic and behavioral, because the aim is to consciously
apply the power of the soul—which greatly exceeds that of the mental/emotional
ego—to the hard labour of resolving the behavioral patterns and neurotic
conflicts and deficits that constrict the outer personality. Spiritual
praxis does not obviate or negate any of the problems studied in general
psychiatry, it simply offers the possibility of bringing a higher power
to bear on resolving these problems.
As for the transcendent operations, these consist of ascending cycles
of identification (with the Divine) and detachment (from the outer being)
through which the ego is progressively reconstituted as an increasingly
free and pure expression of a supra-personal spiritual consciousness.
These advanced dynamics pass beyond the realm of psychology into the province
of spiritual discipline proper.
Practical implications
Although there is
not space here for case material to illustrate the theoretical constructs
outlined above, a few general comments can be made regarding practical
implications.
The first concerns Alcoholics
Anonymous (AA) and other 12-step programs. Founded in 1935, the lay organization
of AA has become a worldwide movement and, despite all the efforts of
psychopharmacology and psychotherapy, 12-step programs remain probably
still the single most effective treatment for alcoholism and substance
abuse.53 Why? There are essentially only two possible explanations.
One is to postulate that the structure of 12-step programs fortuitously
hits upon an effective amalgam of therapeutic principles disguised in
spiritual language and embedded in a context of group dynamics, the other
is that God actually helps those who sincerely practice the 12 steps.
Vaillant has written
cogently about why AA should be called a spiritual organization, not a
church or a cult; and how altruistic and spiritual practices enhance maturity
by diminishing primary narcissism.54 Here we may briefly extend
this line of argument by noting that the 12 steps55 are a good
expression of Aurobindonian faith-practice: aspire to feel the Divine’s
presence in one’s life, surrender to that Higher Power for guidance and
healing, and reject all in oneself that is dishonest, weak, regressive,
and false. This simple schema is applied first intrapsychically, then
interpersonally, in a progressive fashion, and to the degree that it works,
it does so because a touch of genuine spirituality is turned to the task
of transforming thought, feeling, and behavior. AA is certainly no magic
bullet, and the method is difficult to practice sincerely and therefore
sometimes fails, but in the big picture it is still a small miracle. For,
in a world dominated by the economic motive, it has succeeded in propagating
itself widely and helping people as much or more than the so-called mental
health “experts,” and that without charging a penny.
A second key issue is
that of differential diagnosis. Clinically, the challenge is to distinguish
the relative influences of psychic (soul), mental, emotional, and physical/biological
processes, and to understand how these different parts of a person’s being
are interacting with each other both intrapsychically and interpersonally.
For instance, does the patient have real faith, or is her proclaimed faith
merely a mental-emotional construct that is being used defensively? Is
his illness undermining his faith, or is his faith preventing appropriate
treatment of his illness (perhaps with an antidepressant, antipsychotic,
or DBT)? Are her altruistic strivings motivated by guilt (reaction formation),
a true soul impulse, or a mix? Is he repressing an unwanted wish, having
trouble tolerating a semi-conscious affect, or is he fully conscious of
a defect in his character that his soul wishes to reject? In short, is
it transformation or defence, or complex mix of both? With spiritual assessment,
as in all branches of medicine, we should expect that sound clinical judgment
must be acquired through a combination of talent, training, practice,
and further research.
The third comment regards
the relationship between counter-transference, projective identification,
and telepathy. Aurobindo’s unified field theory of consciousness would
suggest that these are not unrelated phenomenon, but in fact different
manifestations of a single, underlying process of communication that can
occur at varying levels of abstraction from observable behavior, and degrees
of therapist involvement. That is, counter-transference can be viewed
as emotional intuition that, at times, is so intuitive it becomes telepathic;
or, more commonly, is so unconscious that it is enacted in the dyadic
process of projective identification. Jung grasped some of this possibility
in his work with synchronicity and his concept of the “shadow,” which
is essentially the part of the patient that he or she unconsciously “disowns”
in projective identification.56 Along this line of thinking,
Wilson has explored synchronous dreams and events in the therapeutic dyad
57, and Mayer is bringing out a posthumous record of one psychoanalyst’s
telepathic experiences with patients that he never dared to publish during
his lifetime due to fear of professional ridicule.58 However,
Buddhist and Yoga psychologies have much to add to this picture in terms
of cultivating the varieties of intuitive experience.
That is a short overview
of a large territory. Other issues that deserve further exploration include
the use of prayer and meditation in psychotherapy; reincarnation, karma,
and near-death experiences; possession, hostile influence, black magic,
and evil; the spontaneous spirituality of children, and how and why they
lose it as they grow up; and EMDR, energy therapies and bodywork, to name
but a few.
Conclusion
This paper has attempted
to show how Eastern and Western psychologies can be integrated using a
spiritual metapsychology, and how this would affect the theoretical basis
of psychotherapy. Certainly, it is not the office of psychotherapy to
produce a swelling population of Mother Teresas, nor do therapists have
to become saints in order to be helpful to patients. But to the degree
that therapists of whatever persuasion can open themselves to spiritual
growth, to that degree they can draw upon transformational processes to
inform their clinical work. Yet whatever is done, it should be emphasized
that the aim is not to convert the patient to the therapist’s beliefs,
but to convert the patient more fully to his own higher Self, to help
her draw on the strength, wisdom, and beauty of God as
she understands Her. It is
a tall order—but it shrinks when we remember that we do not cure the patient,
the Divine does. Both client and clinician are souls in evolution seeking
to transform our humanity into something a little closer to God.
Notes
1 Swami Vivekananda,
The Complete Works of Swami Vivekananda, Calcutta, India: Advaita Ashram, 1970 Vol. 3, 10th
edition, pp. 99-100.
2 S. Freud,
Civilization and Its Discontents, trans. by James Strachey, New York: W.W. Norton & Co., 1961, pp. 11-12.
3 W. James,
The Varieties of Religious Experience, New York: Penguin Books, 1902, see especially pp. 1-25, and 78-125.
4 A. Newberg
and E. d’Aquili, Why God Won’t Go Away: Brain Science and the Biology of Belief,
New York, NY: Ballantine
Publishers, 2001.
5 A.S. Dalal,
Living Within, Pondicherry,
India: Sri Aurobindo Ashram Trust, 1987, pp. ix-xxxvii, and 30-85.
6 A.S. Dalal,
Psychology, Mental Health and Yoga. Pondicherry, India: Sri Aurobindo Ashram Trust, 1996.
7 S. Basu,
Integral
Health, Pondicherry, India:
Sri Aurobindo Ashram Trust, 2000.
8 Sri Aurobindo,
The Synthesis of Yoga, Pondicherry,
India: Sri Aurobindo Ashram Trust, 1992; The Life Divine, Pondicherry,
India: Sri Aurobindo Ashram Trust, 1992
9 Sri Aurobindo,
The Human Cycle, Pondicherry,
India: Sri Aurobindo Ashram Trust, 1992, The Ideal of Human Unity, Pondicherry, India: Sri Aurobindo Ashram Trust,
1992.
10 P. Teilhard
de Chardin, The Divine Milieu: An Essay on the Interior Life, New York, NY: Harper and Row, 1968; Christianity and Evolution,
New York, NY: Harcourt Brace Jovanovich, 1971; Human Energy,
New York, NY: Harcourt Brace Jovanovich, 1971; The Phenomenon of
Man (New York, NY: Harper
and Row, 1961; The Future Man, New York, NY:
Harper and Row, 1969.
11 E.I. Taylor,
Shadow Culture: Psychology and Spirituality in America, Washington, D.C.: Counterpoint, 1999).
12 S. Begley,
“Religion and the Brain,” in Newsweek, May
7, 2001, pp. 52-57.
13 D.B Larson,
F.G. Lu, and J.P Swyers, “Model Curriculum for Psychiatric Residency Training
Programs: Religion and Spirituality” in Clinical Practice:
Course Outline, Rockville,
MD: National Institute for Healthcare Research, 1996.
14 C.M. Puchalski,
D.B. Larson , and F.G. Lu, “Spirituality Courses in Psychiatry Residency
Programs,” Psychiatric Annals, 2000; 30(8):543-548.
15 “Research
News and Opportunities” in Science and Theology, Durham, NC: Research News and Opportunities in Science and Theology, Inc.
16 Diagnostic and Statistical
Manual of Mental Disorders, 4th edition, Washington, DC: American Psychiatric Association,
1994.
17 Psychiatric Annals, August 1999 and 2000.
18 W. Parsons,
The Enigma of the Oceanic Feeling, New York: Oxford University Press, 1999; see especially pp. 3-15.
19 T. Karasu,
“Spiritual Psychotherapy,” American Journal of Psychotherapy, 1999; 53:2, pp. 143-162.
20 P.S. Richards
and A.E. Bergin , A Spiritual Strategy for Counseling and Psychotherapy, Washington, DC: American Psychological
Association, 1997.
21 E.P. Shafranske,
Religion and the Clinical Practice of Psychology, Washington, DC: American Psychological Association,
1996.
22 J.K. Boehnlein,
ed, Psychiatry and Religion: the Convergence of Mind and Spirit,
Washington, DC: American Psychiatric Press, 2000.
23 L. Sperry,
“Spirituality and Psychiatry: Incorporating the Spiritual Dimension into
Clinical Practice,” Psychiatric Annals, 2000; 30(8): 518-523.
24 H. Benson,
The Relaxation Response, New
York: Avon Books, 2000, revised edition; see especially the new forward.
25 Alternative Therapies
in Health and Medicine, Aliso
Viejo, CA: InnoVision Communications.
26 J. Kabat-Zinn,
Wherever You Go, There You Are, New York: St. Martin’s Press, 1994.
27 M. Epstein,
Thoughts Without a Thinker: Psychotherapy from a Buddhist Perspective, New York: Basic Books, 1995.
28 M.M. Linehan, Cognitive Behavioural Treatment of Borderline Personality Disorder, New York: Guilford Press, 1993a; and Skills Training Manual
for Treating Borderline Personality Disorder, New York: Guilford Press, 1993b.
29 M.M. Linehan,,
H.E. Armstrong , A. Suarez , D. Allmon, and H.L. Heard, “Cognitive-behavioural
treatment of chronically parasuicidal borderline patients,” Archives of General Psychiatry, 48 (1991): 1060-1064; and Linehan M.M., Heard H.L., and Armstrong HE,
“Naturalistic follow-up of a behavioral treatment for chronically parasuicidal
borderline patients,” Archives of General Psychiatry, 50 (1993): 971-974.
30 J.H. Austin,
Zen and the Brain: Toward an Understanding of Meditation and Consciousness,
Cambridge, MA: MIT Press,
1998.
31 The Institute
for Meditation and Psychotherapy, Lincoln, MA, tel. (781) 259-7119; and
the California Institute of Integral Studies (CIIS), San Francisco, CA.
32 L. Dossey,
Healing Words (San Francisco,
CA: Harper San Francisco, 1993); and Reinventing Medicine,
San Francisco, CA: Harper
San Francisco, 1999.
33 L. Dossey, “Creativity: On Intelligence, Insight, and the Cosmic Soup,”
Alternative Therapies,
2000: 6(1): pp.12-17,108-117; and “Hypnosis: A window into the soul of
healing,” Alternative Therapies
2000:6(2), pp.12-17,102-111; and “Dreams and Healing: Reclaiming a Lost
Tradition,” Alternative Therapies,
1999:5(6):12-17,111-117.
34 R.C. Byrd,
“Positive therapeutic effects of intercessory prayer in a coronary care
unit population,” South Med J.
1988; 81(7)826-829.
35 W.S. Harris,
M. Gowda, J.W. Kolb, et al. “A randomized, controlled trial of the effects
of remote, intercessory prayer on outcomes in patients admitted to the
coronary care unit,” Archives of Internal Medicine, 1999;24(1):79-88.
36 W. Braud,
“Wellness implications of retroactive intentional influence: exploring
an outrageous hypothesis,” Alternative Therapies, 2000; 6(1)37-48.
37 WW Meissner,
“Psychoanalysis and Religion: Current Perspectives,” pp. 53-70, in Psychiatry and Religion,
op cit.
38 AM Rizzuto,
The Birth of the Living God, Chicago,
IL: University of Chicago Press, 1979.
39 M.H. Spero,
Religious Objects as Psychological Structures: a Critical Integration of
Object Relations Theory, Psychotherapy, and Judaism, Chicago, IL: University of Chicago Press, 1992.
40 Richards
and Bergin, op cit.
41 A. Watts,
Psychotherapy
East and West, New York,
NY: Pantheon Books, 1961.
42 A Maslow,
Toward
a Psychology of Being, Princeton,
NJ: Van Nostrand, 1968.
43 S. Freud, op cit., pp. 10-21.
44 K. Wilber,
The Spectrum of Consciousness,
Wheaton, IL: Quest, 1977; and The Atman Project: A Transpersonal View of Human Development, Wheaton, IL: Quest, 1980.
45 V. Frankl,
Man’s Search for Meaning: an Introduction to Logotherapy, New York, NY: Simon & Schuster, 3rd
edition, 1984.
46 E. Fromm,
The
Art of Loving, London, UK:
George Allen & Unwin Ltd., 1957.
47 A. Freud,
The
Ego and the Mechanisms of Defence,
translated by C. Baines, London, UK: Hogarth Press and the Institute of
Psychoanalysis, 1937.
48 G.E .Vaillant,
The Wisdom of the Ego, Cambridge,
MA: Harvard University Press, 1993, pp. 36-37.
49 Ibid., pp.
118-174.
50 Dalai Lama
XIV, The Dalai Lama’s Book of Transformation, London: Thorsons, 2000.
51 Ibid., pp
3-11.
52 L. Birk,
“Cognititive Behavior Therapy and Systemic Behavioral Therapy,” in The Harvard Guide
to Psychiatry, Cambridge,
MA: Harvard University Press, 1999, pp. 516-520.
53 G.E. Vaillant,
“Alcoholics Anonymous: Cult or Cure?” AMERSA Keynote Address, November
4, 1999; address correspondence to George E. Vaillant, M.D., Brigham and
Women’s Hospital, 75 Francis St., Boston, MA 02115.
54 Ibid.
55 Alcoholics Anonymous,
New York: Alcoholics Anonymous World Services, Inc, 1976, 3rd
ed., pp. 58-60.
56 P. Young-Eisendrath
and T. Dawson, editors, The Cambridge Companion to Jung, Cambridge, UK: Cambridge University Press, 1997,
pp. 52-70, 119-164.
57 Wilson,
T, Synchronous
dreaming in dyadic relationships,
paper presented at 10th Conference of the Association for the
Study of Dreams, Santa Fe, NM, June 1-5, 1993.
58 Mayer, E.L.,
“Telepathic dreams?: a posthumous contribution from Robert Stoller,” Journal of the American
Psychoanalytic Association,
in press.