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 20^th 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 Newsweek ¹² 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 19^th 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 21^st 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 naive 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, 10^th 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 Newswee k, 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 , 4^th 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 P sychotherapy, 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, 3^rd 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, 3^rd 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 10^th 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.