Integral Approach in Transpersonal Psychotherapy

With these words, Ken Wilber outlines, inhis book Integral Psychology, the aims of hisintegral approach, which differs from thegeneral transpersonal movement in its spiritual anduniversal vision of consciousness and human growth,and in its general synthesis of the knowledge gatheredin psychotherapy with the knowledge stemming fromthe meditative approaches constituting the PerennialPhilosophy.

According to Perennial Philosophy, the Self, thetotality of the human being, is composed of severallevels hierarchically organised: body, mind, soul, andSpirit. At its core, the Self is seen as identical to, andindivisible from, the sacred essence of reality, whichthe various traditions have called Spirit, Absolute,Utmost Good, or pure Consciousness (nondual tradi-tion).

Whereas Spirit has no form or quality and repre-sents the ultimate and only permanent and indestruc-tible reality, the soul is the inner dimension that goesbeyond the limits of the body and the mind and is thedwelling of the higher qualities and potentialities ofTruth, Beauty, and Goodness. The temple of the soulis inhabited by the universal archetypes, and its core bythe divine image.

Two, it is told, are the wings of the soul: intuitiveintellect (buddhi in the Vedanta tradition), which hasaccess to the direct comprehension of transcendentreality; and love, which is the very essence of the souland by its nature is unconditional and eternally radi-ant. As Plato says, the soul contains an inborn imagethat he calls daimon and is the trustee of the individ-ual destiny, of the meaning and task of ones life. Thisinner image is that which drives to vocation and theexpression of ones talents and aspirations in life.

The aim of individual growth is Self-realisation,that is, the expression in consciousness and identity ofall bodily, mental, and spiritual qualities, until attain-ing the knowledge of the unity of the individual anduniversal Self, called Enlightenment and Liberationfrom ignorance or nondual consciousness (BoggioGilot, 1992).

In the integral approach, the separation of the egofrom the Self and the resulting ontologic unawarenessbrings the split of the individual from universal lifeand represents the greatest human suffering and theorigin of all the evil of life.

The suffering of the ego separated from the Self issymbolised in these words of Raphael (1986, p. 27),the Master of the Perennial Philosophy:

You are a flame of the one fire that all pervades,you live in solitude and conflictbecause you consider yourself a little flame,separate from the source.

In the integral approach, the scope of psychotherapyincludes, along with the clinical problems that are usu-ally dealt with in psychotherapy, also the narcissism ofnormality, that is, the state of the ego separated fromthe soua suffering that expresses itself in the materi-alistic identifications, in object-attachments, fear, ego-ism, and the lack of value and spiritual meaning of life(Boggio Gilot, 1997).

In the integral approach, the goals of therapyinclude, along with the usual ones related to theachievement of normal psychological functioning, alsothe development of awareness beyond egocentricboundaries and toward spiritual awakening. In thiscontext, the development of such qualities as intu-ition, love, and wisdom is favored.

Four levels of experience are recognized in integral

78 The International Journal of Transpersonal Studies, 2003, Volume 22

Integral Approach in Transpersonal Psychotherapy

Laura Boggio GilotItalian Association of Transpersonal Psychology

For an integral psychologya persons deepest drive is the actualization of the wholeness of body, mind and soul, so that one becomes, in full realization, a vehicle of Spirit shining radiantly into the world.

(Wilber, 2000, p. 190)

psychotherapeutic work: bodily, emotional, mental,and spiritual. Integral techniques associate psychother-apy to the ethical practices of awareness and transfor-mation derived from the meditative systems.

The awareness that the suffering of the ego is rootednot only in an individuals biographical history, butfundamentally in the separation from the universalunity to which the human being is related, is part ofthe context and the leading principle of integral psy-chotherapy (Boggio Gilot, 2001).

The integral perspective moves from the assump-tion that all those who suffer are imprisoned in a tem-poral ego separated from the unity of life: this causes afeeling of frailty and fear, naturally pushing to a searchfor egoistic compensations through objects that areunsatisfactory and void, thereby producing furtherseparation and suffering.

Suffering, of whatever type and degree, is adiminution of the human being, which derives from arupture of unity, a fragmentation of totality, startingwith the initial ontologic split between Self and ego,individuality and the sacred. So long as this primarygap is not filled, no real healing is possible.

So, the suffering of the ego separated from the Selfis the background and the soil of the symptomaticforms of mental suffering, and overcoming the latterrequires going back to the egocentric condition, andovercoming this, into an inclusive and spiritual con-sciousness. The spiritual demands of the Self are thedrives toward the expression of Truth, Beauty, andGoodness, and the alignment of individual will to uni-versal will.

In the integral approach, this frame of reference,open to the recognition of the spiritual presence inevery human being, represents the interpersonal spacebetween the therapist and the patient, and an openingof the heart on the side of the therapist, through whichpasses the intention to alleviate the suffering, but alsoto awaken the patient to the spiritual dimension andexperience. In other words, the integral psychothera-pist is focused on making the ego receptive to the souland on lining up the individual consciousness to theinterconnection with the universal will.

In order to do this, the therapist must practicemeditation and consciousness disciplines. The idealintegral psychotherapist is an advanced meditator, whoremains centered in the practice during all sessions.

The state of consciousness of the therapist, result-ing from a meditative path and as close as possible to

the liberation from ignorance, is a basic condition forthe patient to get free from the chains of incomplete-ness and discover yet unexplored potentialities.

Consistent with the position of Maslow (1962),one can only give what one is. The more the psychother-apist can witness, in his or her living in the world, theliberation from ignorance, the more he or she can be atrue healer, a vehicle for the liberation of the spiritualpowers hidden in the subjects unconscious.

This means that an integral psychotherapist shouldalways be in touch with the voice of the Self, which iswhat drives towards Truth, Beauty, and Goodness,obeying its influence and witnessing in his presenceand actions the path of a transforming spirituality.

On this basis, the scope of the integral approachtranscends the interest of the individual and promotesthe development of healthy and creative persons, ableto help others and contribute to the well-being of society.

As has been noted by Walsh and Vaughan (1993),there is a need for people of wisdom and maturitywork not only to release suffering but also to awakenthemselves and others. To become a person of wisdomand maturity is the goal of any serious researcher inthe field and of all those of us who passionately believethat the meaning of life is to donate oneself to an aimthat transcends ones own egocentric needs and reflectsa more universal way of living.

Psychopathology as a Developmental Disturbance

The integral model of psychotherapy realizes a syn-thesis of the psychoanalytic theories (especiallythose of ego psychology and of object-relations) alongwith the humanistic-existential approaches and themeditative wisdom (Boggio Gilot, 1993).

The entire spectrum of mental suffering include:(a) psychodynamic suffering, that is, the psychoses,

borderline disorders, and neuroses, described inpsychoanalysis;

(b) cognitive and existential suffering, described inhumanistic psycholog, and

(c) spiritual suffering, referred to the state of the egoseparated from the Self, described in the meditativetradition.

Special Topic: Depression 79

Psychodynamic Suffering

Psychodynamic suffering is outlined in psycho-analysis in the neurotic, borderline, and psychoticsyndromes, consisting of disturbances of the develop-mental arc that leads to the development of an egoadapted to society. Psychodynamic suffering is charac-terised by emotional states of anxiety, fear, anger, andconflicts centered on dependence on authority, and oncomplexes of abandonment, guilt, and inferiority.These disturbances of affection, instincts, and think-ing prevent the adaptation to reality, and thus preventthe personality of the child from growing and becom-ing integrated with society and its roles.

According to object-relations theory, the most seri-ous suffering (psychosis, borderline) originates in a dis-turbance of development in the pre-Oedipal stage,during the process of separation and individuationtaking place in the first three years of life, before thestructuring of the superego. A less serious suffering(neurosis) originates instead in a disturbance in thepost-Oedipal stage, when the process of separation andindividuation has been completed and the superego, asthe source of rules and ethical values, has been struc-tured, so that self-esteem can be regulated.

Neurosis indicates a conflict in the tripartite struc-ture (id, ego, superego), that in a more modern andrelational approach can be defined as a conflictbetween the subpersonality of an inner parent, repre-senting a dysfunctional superego, and the subpersonal-ity of an inner child, representing the sacrificedimpulses and affections, with the subpersonality of amediator who wrongly mediates, through defensemechanisms, the internal conflict and the adaptationto reality.

The superego is a fundamental element in differen-tiating milder from more serious pathology. A struc-tured superego implies the existence of a regulatingmoral structure capable of producing the feeling ofguilt, and therefore of removing undesired elementsinto the unconscious. In psychotherapy this allowswork on the removed unconscious and the use ofdestructuring techniques. The lack of a superego,along with the associated primary split and defenses,characterises the most serious pathology and requireswork on the construction of more mature structures,and particularly of a superego with realistic features.

Cognitive-Existential Suffering

Disturbances in the development of a mature egoinclude the array of cognitive-existential suffer-ing outlined in humanistic psychology. This appears asa crisis of identity originated by the lack of develop-ment of freedom and creativity, as may happen whenones existence is excessively conditioned by family andsocial models and is thus poorly related to ones intrin-sic nature. This kind of suffering is due to alienationfrom oneself, when the ego is ready to grow beyondmere adaptation to reality, but gets entangled in theplot of conformism and fails to express its own aspira-tions and original talents which would be in conflictwith family and social models.

In existential suffering, the needs of safety over-come the needs of growth, and life is characterised byboredom and void, with a lack of meaning and value.The erosion of the feeling of freedom expresses itself ina lack of will in bringing forth what one loves. The tri-umph of the needs of safety over those of growth takesroot in the lack of the courage to exist, disconfirmingthe original aspirations and the authentic expression ofones potentialities. As noted by Maslow (1962), if youdo not aspire to make the most of yourself and yourlife, you will be unlikely to find true happiness. Thesuffocation of the expression of ones freedom for fearof losing ones safety goes side by side with a lack ofresponsibility toward ones own life, which flows fol-lowing the will and the principles of others.

The conditioning that constructs the ego leads tothe fear of living and loving. Lacking contact with itsprofound beliefs and aspirations, the personality fadesinto the void of an existence deprived of choice; thusarises that fear of death, so much described in existen-tial psychology, that is the emblem of a premature end,when the path of ones existence has not yet been com-pleted.

Spiritual Suffering

Spiritual suffering relates to the state of separationbetween the ego and the Self. 1. The suffering of the ego separated from the Self

originates in a conflict between ones egocentricattachments and the call of ones own destiny,which the ego can oppose through various types ofresistance. The suffering of the ego separated fromthe Self is symbolised by Patanjali (1992) in his


Yoga-sutras. The great Hindu sage states that thenature of suffering is related to the history of theego, which as such lives in the condition of avidya,or ignorance, separated from the real meaning andobject of existence. Patanjali says there are fiveafflictions of the ego separated from the Self:a) unawareness of spiritual reality;b) identification with the sense of the ego

encapsulated in the body;c) attachment to pleasure;d) repulsion against anything opposing it;e) fear of death.

2. A particular form of suffering of the ego separatedfrom the Self is outlined in the concept of spiritualemergency described by Grof and Grof (1990).These crises refer to the relationship of the ego withthe transpersonal energies, that is, with the arche-typical forms of the soul, at a time when the ego isimmature and still unable to integrate them.Spiritual emergency results from the impact uponthe ego of powerful energies that can disarrange theidentifications of personality. The archetypicallight that thus appears in ordinary consciousnesscan result in inflations, such as exaggerated eupho-ria or an illusory feeling of greatness, that are thebasis of real states of psychopathology.

3. A more advanced form of spiritual suffering is wit-nessed in religious traditions. Here, for example,we include such forms of suffering as the dark nightof the soul, and suffering due to the feeling of realguilt produced by the treason committed by thehuman being in her or his path toward God.

Integral Approach to Mental Suffering

What has been outlined so far is a hierarchy ofpsychological suffering, with or without clinicalsymptoms, arising at various points in the arc of devel-opment, from the preegoic to the transegoic stage.

Because, as Wilber (2000) notes, the developmen-tal lines of personality do not proceed in an orderlyway and immaturity of one line can be matched by agreater maturity of another line, it may so happen thatthe different levels of suffering, rather than being onesubsequent to the other, actually coexist. For instance,a person can experience a spiritual void, being unableto respond to the call of the Self, while at the sametime suffering from an inner conflict of a psychody-namic nature, stemming from a disturbance in the tri-

partite structure, problems with authority that stillneed to be overcome.

The integral model of psychotherapy teaches us todifferentiate the various qualities of suffering, andunderstand that, in order to heal mental suffering, weneed to start from the lower plane of personality struc-turing, that is, from the tripartite organisation into id,ego and superego.

Healing the tripartite structure is similar to repair-ing the foundations of a building. Just as in a buildingno construction is possible if the foundations are notsolid, in the construction of personality higher levels ofdevelopment and health cannot be realised if the lowerones are not well structured.

For example, an existential psychotherapy, such aslogotherapy, which focuses on recovering the meaningof life, fails if the person is conditioned by needs ofacceptance and dependence and still has disturbancesof the tripartite structure. Similarly, a psychoanalytictherapy, centered on problems of the tripartite struc-ture, fails with a patient who has an existential or spir-itual form of suffering and has already overcome thepsychodynamic conflicts.

For a psychotherapist, to be integral means to beable to differentiate among the various forms of mentalsuffering, and, understanding the personality structure,to start working on the lower planes, without forget-ting the higher ones and being ready to address thesewhen the time comes.

The integral approach applies differential methodsand techniques as needed for the different forms ofsuffering, making use also of meditative wisdom andof the ethical practices of awareness and transforma-tion contained in the various doctrines.

Clinical Depression in the Integral View

From Kraepelin to the DSM, the nosography ofdepression has not yet captured the true nature ofthis condition. The criteria adopted to classify depres-sive states have mainly been the following:1. The criterion that has focused on dichotomies (such

as endogenous vs. psychogenous, autonomous vs.reactive, or psychotic vs. neurotic);

2. The criterion that has focused on distinctions (bipo-lar vs. unipolar, primary vs. secondary);

3. The unitary criterion of the DSM that has focusedon depression in the continuum from mild tosevere.


As outlined by Pancheri (1982), a foremost Italianresearcher on depression, the condition can be seen asa normal reaction and adaptation to stressing situationsof loss and bereavement, that takes on psychopatho-logical features under extreme conditions. In this con-text, depression is a behavioral manifestation of a stressresponse originated by attachment-loss, in turn char-acterised by specific psychoneuroendocrine reactions.

The constant presence of some degree of depres-sion in most human situations suggests that, like painand anxiety, this condition may be part of an impor-tant adaptive and defense system meant to increasesurvival capabilities in the individual.

Under normal conditions, depression frequentlyfollows events or situations characterised by loss, andappears as a message of isolation and withdrawal fromsocial relations, and more generally as a request for helpspecifically directed to the surrounding social context.According to Pancheri (1982), this modality is usefuland adaptive, in that it allows better survival in theface of external threats. The depressive reaction wouldthen represent a stress reaction aimed at its resolution.

In the various schools of psychotherapy theapproach to the treatment of depression has followeddifferent perspectives.1. In the psychoanalytic perspective (e.g., Freud,

Abraham, Jacobson, Kohut), depression is a mentalstate in which the system of the self is damaged asa result of early experiences of frustration with ref-erence persons. The psychodynamic approachfocuses on the narcissistic components of depres-sion, such as low self-esteem, resulting from nega-tive object relations and omnipotent defensescountering the feelings of lack and impotence.Consequently, the therapy is aimed at modifyingthe stress situation through the understanding ofthe early conflicts and the transformation of inter-nal objects, that is, of the aggressive and loss-relatedmental images, into realistic and supportive ones.Of fundamental relevance, in this context, is theresearche of the object relations theorists, particu-larly Kernberg (1965), which emphasizes the roleof mental structuring in the diagnosis and therapyof depression. The analytic introspection is aimedat understanding the defense mechanisms and thestate of the superego, so as to find out if depressionis a symptom that expresses itself within a pre-Oedipalborderline structure with no superego and withprimitive defenses, or rather is a post-Oedipal neu-

rotic structure, with secondary defenses and asuperego. In the psychoanalytic context, the solu-tion of depression, in the continuum from mild toserious, requires working on transference: the ther-apist is here a mirror, which reflects and proposesinterpretations.

2. The cognitive approach to depression (e.g., Adler,Beck) stresses the presence of distortions of think-ing and of negative mental images as a cause of thedepressed mood. The depressed personality has aselective attention to the negative aspects of cir-cumstances and makes irrational and pessimisticdeductions concerning their outcome. The cogni-tive therapy concentrates on the transformation ofthe negative images of self and the world associatedwith the distorted thinking. Transforming negativeinto positive thinking is absolutely fundamental forrecovery. Especially relevant is the recognition ofself-destructive cognitive aspects, made possible bydeveloping control of thinking schemes. Ratherthan transference, the background of the work hereis a good therapeutic and collaborative relationship.

3. The interpersonal approach (e.g., Sullivan) consid-ers altered interpersonal relations and lacking orunsatisfactory social bonds. The depressive reactionis here seen as rooted in stress in the family and atwork as a result of dysfunctional relations. To easethe depression, one needs to reduce the stress infamily and working contexts, and to solve theinterpersonal problems. Recognizing the dysfunc-tional aspects, and training the patient to have bet-ter communication, is a task of the interpersonalapproach, realised through an active role of thetherapist, who influences the patient and providessupport, proposing alternative solutions. The widerattention paid to subjective needs appears to befundamental to overcoming depression. In theinterpersonal approach, the therapy profits fromthe relations established with family members, sothat they collaborate to modify the patients nega-tive relations.

4. The transpersonal approach to depression is basedon the humanistic conceptions underlying the stateof human diminution of the depressed subject,who experiences a void of meaning in life caused bya block in development and freedom, in that safe-ty needs overcome the needs of growth. Aspiration,the expression of talents, and creativity are theninhibited; the meaning of life is seriously damaged;


and life loses quality and purpose.The humanistic model emphasizes that the root ofdepression is the inhibition of individual potentialitiesand that recovery requires the development of autonomy,responsibility toward ones life, and the prevailing ofones growth needs over conformistic conditioning.

The humanistic conception is the platform for thedevelopment of the transpersonal approach to depres-sion, which is particularly focused on the fragility andinsignificance originated by the separation of the egofrom the Self as the inner spiritual center of individu-ality. To the person who identifies with the biographicego, life lacks contact with universal values and istherefore imprisoned in unawareness and lack of truth.Depression is then the natural response to the failureof the egocentric project and to the void of an exis-tence that is based on empty and impermanentobjects.

A contribution to the conception of depression asarising from the separation of the ego from the Selfcomes from the wisdom tradition. In the Yoga-Vedantatradition in particular, Patanjali (1992) recognises thatmental suffering (hence depression as well) is rooted inthe egoism that develops from the unawareness of spir-itual reality and of its connections to the universalbackground of existence. This unawareness leads us toget lost in ordinary life events and to develop a terrorof death.

Egoism stems from the sense of the ego encapsulatedin the body and totally separated from its own fragili-ty: it is characterized by a drive to possess, a tendencyto defend oneself, and behavior that is centered onattachment to pleasure and avoidance of pain, whichmakes one vulnerable to the inevitable trials of life. Inthis context, overcoming depression then requiresgoing beyond the narrow boundaries of egocentriclogic, which brings with it attachments, fear, and dis-couragement; it requires giving up the egos possessiveand defensive modalities, progressively developing anawareness of the Self and a sacred sense of life, as wellas an attitude toward values and meanings that makesroom for the cultivation of spiritual states and quali-ties. These include love and wisdom, expressed insocial action that is free of personal interest and offeredto life.

The integral approach to depression includes thedifferent views and acknowledges the complementarityand interrelatedness of the various perspectives. Theintegral vision of depression recognises that the differ-

ent approaches are like different refractions of a prismand relate to the difficulties of the existential path inits various phases.

In this context, the various theories and approachesto overcoming depression are all seen to be valid asrelated to the specific levels of the developmental spec-trum: preegoic, egoic, transegoic. Integral psychother-apy requires one to know the clinical and diagnosticapproach of object relations psychoanalysis along withhumanistic psychology and the wisdom tradition, andinvolves the use of comparative techniques integratingthe introspective elaboration of internal objects, psy-chocorporeal work for emotional catharsis, and themeditative practice of awareness and transformation.

References

Boggio Gilot, L. (1992). Il S transpersonal [Thetranspersonal self ]. Rome: Asram Vidya.

Boggio Gilot, L. (Ed.) (1993). Sufferenza e guarigione[Suffering and healing]. Assisi: Cittadella.

Boggio Gilot, L. (1997). Crescere oltre lio [Growingbeyond ego]. Assisi: Cittadella.

Boggio Gilot, L. (Ed.) (2001). Il tempo dellanima[Time of the soul]. Torino: Psiche.

Grof, C., & Grof, S. (1990). The stormy search for theSelf. New York: Tarcher-Perigee.

Kernberg, O. (1965). Borderline conditions and patho-logic narcissism. New York: Aronson.

Maslow, A. (1962). Toward a psychology of being.Princeton: Van Nostrand.

Pancheri, P. (Ed) (1982). La depressione. Rome: IlPensiero Scientifico.

Patanjali. (1992). Yoga-sutras, Italian translation andcommentary by Raphael. Rome: Asram Vidya.

Raphael. (1986). La triplice via del fuoco (The triplepath of fire). Rome: Asram Vidya.

Walsh, R., & Vaughan, F. (1993). Paths beyond ego. LosAngeles: Tarcher.

Wilber, K. (2000). Integral psychology. London:Shambhala.

Correspondence regarding this article should bedirected to the author at AIPT, Italian Association of Transpersonal Psychology,Via Corvisieri 46, 1-00162, Rome, Italy. Email: [email protected]


Documents

Integral Approach in Transpersonal Psychotherapy