Posts tagged ‘Integral Psychotherapy’
January 2, 2015
Mark Forman, PhD
First generation Integral applications are about the general application of quadrants, levels, lines, states, and types to a field – we might call this “big-picture” Integral application. Second generation Integral applications utilize this foundation and branch out to address more focused and granular application issues.
In the Certified Integral Therapist (CIT) Program, we work to ground our attendees in first generation Integral applications to psychotherapy and then augment them with second generation Integral applications. We believe we teach them in a unique, practical, and sophisticated way.
To provide a taste of the second-generation Integral concepts and applications in the CIT program, let’s address the idea of spiritual bypass: A now widely popular concept in the field of spiritual and transpersonal psychotherapy. In a recent interview, the creator of the concept, John Welwood, defined spiritual bypassing this way:
“[Spiritual bypassing is] a widespread tendency to use spiritual ideas and practices to sidestep or avoid facing unresolved emotional issues, psychological wounds, and unfinished developmental tasks.
When we are spiritually bypassing, we often use the goal of awakening or liberation to rationalize what I call premature transcendence: trying to rise above the raw and messy side of our humanness before we have fully faced and made peace with it. And then we tend to use absolute truth to disparage or dismiss relative human needs, feelings, psychological problems, relational difficulties, and developmental deficits.”
While this is a wonderful definition – and Welwood’s work is rich and ground-breaking – I would suggest that the concept of spiritual bypass can be made clearer for clinical work. One reason we need more clarity is that spiritual bypass appears to be so common; it doesn’t simply arise as a problematic situation in some. In fact, I have met very few people, let alone serious spiritual practitioners, who don’t demonstrate a version of this at one time or another.
Just think about this for a second. How often do we hear people say phrases like “God doesn’t give you anything you can’t handle” or “Money is just a form of energy” or “Everything happens for a reason” or “Sexuality is really just spiritual” or “Death is just a transition” – and yet are clearly using these ideas to avoid confronting difficult and uncomfortable areas of life? Using spiritual concepts we don’t fully understand but that we want or would wish to be true is as human as it comes.
In the CIT program, we begin to clarify this topic by applying Integral concepts including states, stages, and types. And when we do, we see that what looks and sounds like “spiritual bypass” is not simply one thing, but is actually several different things, each of which has a different psychology and requires a unique clinical response.
Here are four categories that we use in the CIT program to expand the clinical concept of spiritual bypass. Of course, any individual may have to deal with more than one of these categories of bypass at the same time:
Expectable Bypass: Built into every stage of development is some capacity to objectively confront reality as it is and another tendency to add subjective elements of fantasy to it – to project or imagine what we would like life to be like[[i]]. This tension might be irreducible, since I would argue that humans require some reality and some fantasy even through to the very highest stages of growth. Whatever the case, we can expect that people will bypass certain hard truths or difficult challenges as a regular matter of stage capacity and as a normal part of development. It is entirely expectable. Our position clinically should be that everyone will do this from time-to-time, and that our challenges to clients showing this tendency should be deliberate and focused, not automatic. Such bypassing might not be a problem at all, but just a natural psychological tendency at work.
States-Driven Bypass: When a person has a powerful spiritual opening, or takes up an intensive spiritual practice, they often engage in a different type of bypass. They are likely to experience deep altered states and be so compelled by the states themselves that they will minimize many important aspects of life (such as money, relationship, sexuality, and so forth) in order to pursue a maximal ability to experience further states. This might be best likened to a biological drive, like hunger or thirst, which can capture and significantly alter an individual’s life trajectory. This drive will likely run its course in months or years – depending on what depth of states and insights are eventually attained – but this path is not pathological in-and-of-itself. We have to understand this as a unique clinical situation when we see it and support the client appropriately. This category of bypass is most related to the states element of Integral Theory.
Problematic Bypass: This is perhaps the classic form of spiritual bypass, in that a person is clearly using spirituality to avoid very pressing needs or aspects of self when they could likely do otherwise[ii]. This problematic bypassing is most likely driven by current crisis, early trauma, or by long-standing mental health issues such as depression or addiction. The person needs to escape themselves because their everyday experience has become so painful. While this problematic tendency can run its course over time, clinical support, challenge, and intervention are very often needed. This category of spiritual bypass is related both to states (such as traumatic states or depressive states) as well as often stage elements of Integral Theory. That is, the tendency to problematically bypass is somewhat (though not entirely) more common at earlier stages.
Narcissistic Bypass: In this form of bypass, there is the melding within the person of strong narcissistic tendencies or narcissistic personality disorder with spiritual ideas, beliefs, or experiences. Here, significant narcissism can be understood as signaling an arrest at an early stage of development but also as being a “character style,” tendency, or type that one brings to each new stage. In this category, the person’s spirituality becomes a preferred vehicle for their narcissistic tendencies and allows them to avoid deep, underlying feelings of emptiness, shame, or unprocessed emotion. Lacking spirituality, it is likely that the person would find another outlet for their narcissism, so spirituality, while very significant in other forms of bypass, may not always be deeply felt by the person in this case. It may simply be his or her contextual or preferred mask. This is perhaps the most severe type of bypass and the most difficult to address clinically, since the person will often not see the existence of the problem or its negative life outcomes.
Hopefully readers will see the power of second generation Integral concepts and how these categories are directly applicable to working with spiritually interested clients. Each suggests a very different clinical response. This is something we see again and again: Utilizing the basic distinctions of Integral Theory, and bringing them to new areas of human psychology, opens up whole new vistas in our understanding of people. If you are interested in fully grasping this new way of seeing and being with others, please join us for the 2015 CIT Training!
[i] It is important and also possible to mesh the ideas of subjective and objective such that we see that they mutually influence and interpenetrate one another. So too do the concepts of fantasy and reality. Yet for many situations, and for much of our development, these concepts are useful to see in a polar way.
[ii] In the case of states-driven and problematic bypass, sometimes people are able to gain much greater equanimity and mindfulness during their time bypassing which they are then later able to apply to difficult life issues. In this sense, sometimes a bypass is a needed break from life issues in which the person is able to develop specific facets of the self. When bypassing is helpful and timely in this way versus when it has become a problem itself is a clinical, case-by-case judgment.
October 16, 2014
Mark Forman, PhD
The field of Integral Psychotherapy is young and in the process of defining itself. In that way, it is good to return to the question again and again: What is Integral Psychotherapy?
If we want to start with a theoretical definition that stays fully in line with the Integral model, we can begin with this:
Integral Psychotherapy is a psychotherapy that is AQAL. It attends to all-quadrants, all-levels, all-lines, all-states, and all-types as they show up in the client’s life as well as in the therapeutic space.
I believe that any therapy that attends to AQAL – in the very many ways that can be done – qualifies as an Integral Therapy. The only limitation with this definition is that to understand what this means in practice requires a solid background in Integral Theory and the ability to see how the five elements – quadrants, levels, lines, states, and types – show up in real persons, in real time. This is a very achievable goal, but it does take familiarity, study, and training (this is the training we provide in the CIT program).
Because of this, I don’t always use this definition of Integral Psychotherapy when there is not time to unpack it or when it is likely to come across as too abstract (it often will).
So the challenge has been to find a more grounded, accessible, and simpler definition. For this purpose, I have come up with the following. While it lacks the theoretical precision of the above, I think it gets at the essential heart of what we are trying to do.
Some problems were created in relationship and can only be healed in relationship.
Some problems are spiritual and can only be healed through spiritual means.
Some problems are caused by action and can only be healed through action.
Integral Psychotherapy attends to relationships, spirituality, and action – and will take you in whatever direction you need to go.
First, by relationship we mean the forces of family, romantic partners, and culture. Solving problems in relationships means that we help clients to more fully engage their interpersonal and relational worlds – by encouraging them to both grieve interpersonal hurts from the past and to proactively seek to love and connect with those who are willing and capable of loving them in the present. In addition, we recognize that many issues that are too painful to hold in daily life are best held in the healing relationship of therapy itself.
This tenet of Integral Psychotherapy recognizes the dimension of the other and our intrinsic connectedness to others.
Second, by spiritual we mean the deepest interiors of who we are, particularly our deepest existential issues and beliefs about ourselves and the world. At each phase of life, core feelings of longing, hope, and fear re-express themselves. In Integral Psychotherapy, we help clients to address these core existential issues in a way that matches their life stage and psychospiritual capacity. We help people learn to be at peace with themselves, within themselves.
This tenet of Integral Psychotherapy recognizes the dimension of the self and our innate individuality.
Finally, by action we mean the impact of the world and its forces upon us. The forces many be social, economic, related to the natural environment, or coming from our own biology. Whatever the genesis of these forces, there are times we have to act, to move, and to “do” in response to them. We cannot be passive bystanders or fear taking steps, but must discern the correct path and be willing to risk changing our behavior – and not just our thinking – if we want our lives to improve.
This tenet of Integral Psychotherapy recognizes the dimension of the world and the outer reality in which we live.
Addressing the client in their relationships, in their individuality, and in the world – while denigrating nothing and leaving nothing out. Integral Psychotherapy understands that each of these dimensions is essential and indispensible to us if we are going to live a full and satisfying life.
August 27, 2014
Mark Forman, PhD
There is no such thing as a perfect therapist. Even the best have strengths and weaknesses. Some excel at working with a client’s thoughts and cognitions, some with emotions, and some with gut-level feelings and intuitions. Some are wonderful at facilitating insight, others at encouraging emotional catharsis, and still others with catalyzing behavioral change. Of course, it is possible to become skilled at many of these dimensions of therapeutic practice – and perhaps to become outstanding at several – but the truth is that the human psyche (which includes the spiritual) is far too vast and multidimensional for any one person to master.
Recognizing this, Integral Psychotherapy encourages a strong attitude of appreciation towards the wide variety of ways in which therapists work with, relate to, and conceptualize growth and change. There is something of value in every perspective, from the most medicalized to the most spiritual. The world – and its seven billion individuals – require a growing and diverse meshwork of healers and helpers in order to bring it what it needs.
Encouraging appreciation not only makes for better interrelations between therapists of different orientations and a more positive collective atmosphere, but it also helps us grow individually as therapists. We should work hard to remain open to the idea that there is something to learn from every therapist and every particular school of therapy. For just as a client who is not open to change is likely to remain stuck, a therapist who is not open to different viewpoints and methods will remain with unfulfilled potential. Our attitudes and worldviews – the mindsets we carry with us – can leave us open and emerging or closed and stagnant.
Being appreciative, however, does not mean that we cannot be skeptical and discerning. This is a crucial point. We simply need to appreciate things consciously – with consideration and critical awareness.
Indeed, by keeping in mind that all therapists and therapies have strengths and weaknesses – and by using the Integral model as one helpful tool to help guide us – we can actually be more discerning and more skeptical than we would be otherwise. We can see that it is not “mean” or “oppressive” to think critically or to notice limitations in what other professionals do – an unfortunately common idea in much of our postmodern psychospiritual culture – but rather it is simply natural, honest, and sincere to try and distinguish what is helpful from what is not. We should also be honest about our own limitations and the areas in which we do not shine.
Of course, being appreciative is not always easy. In certain cases, it does not seem like the best (or the most immediately available) stance. There are two situations in particular where I think we need to approach appreciation that much more consciously.
The first is when a therapist or school of therapy claims that their way or method always works, is always better, or that they own the one-and-only truth of what creates mental health issues and what we need to do to address them. This happens, sometimes overtly, sometimes more subtly. It does not matter from what perspective, from what line of research, or from what cultural background such a claim arises: Absolutism is highly suspect. History shows us that all methods, insights, and paths are partial. When we hear these claims, we need to work harder to see what is of value to ourselves and others and what is simply being passed on as dogma.
The second challenging situation is when a therapeutic school is formulated in such a way as to be dehumanizing, or has moved in that direction over time. This also happens more than one would hope. Dehumanization occurs when an approach to therapy attempts to cut away, repress, and marginalize aspects of human experience that are part of the hearts, minds, lives, and shared cultures of humanity. We cannot cut away thoughts, feelings, dreams, intuitions, or fantasies. We cannot cut away the shamanistic, the humanistic, the hedonistic, the existential, the religious, the economic, or the scientific. Whatever it is that we don’t like or don’t favor – we cannot simply make it go away. We should realize first that these repressive impulses come from our own disconnection with aspects of self, and that they encourage divisions within others as well, pushing them to exclude and fragment rather than to embrace and integrate.
Of course, saying that we should not marginalize any aspect of our shared humanity does not mean that all ideas or aspects of self or culture are equally well-honed, equally important, equally moral, or equally timely. Many will be overturned or reformulated in the future. It only means that, in our current moment, all have their place. And that when we push anything away with the hopes it will never return it creates unnecessary darkness and shadow. What we should do instead is to try and find any approaches’ essential core and reform it in a more healthy fashion. This will certainly lead to debate, but it does not make one unappreciative. To be appreciative is to honor the complex diversity that surrounds us and that is within us and to work to include it. To be appreciative is to steer clear from creating unbridgeable divides.
July 9, 2014
Mark Forman, PhD
Before most of us have even sat with a client in psychotherapy, we have to begin to confront the question of diagnosis – whether or not the client can be said to have a specific, well-defined condition offered in the DSM-V or ICD-9/10.
Unfortunately, unlike our sister field of medicine, where much clearer tests can be created and employed, mental health diagnosis is a tricky proposition. If we pay attention to the ambiguities of the research, to critical voices in the field, as well as to our own experience working with clients, we start to see that diagnosis in psychotherapy is fraught with complexities. What are the clear lines that separate addiction from non-addiction, a depressed person from a non-depressed one, and an anxiety disorder from typical, normal anxiety? Often the answers are murky and – journalistic overstatements to the contrary – there is little on the horizon in neuroscience that is going to provide us definitive answers.
Going deeper, we may begin to see that diagnoses are created and employed within a cultural context and a certain set of conventional beliefs about the right way to live. These ideals change and morph with the times and along with our class, gender, ethnicity, age, and geography. For example, in our relatively recent history being gay or lesbian was considered a mental illness (and in some places in our culture it unfortunately still is). Or just recently some regions of our country are beginning to accept the idea that smoking marijuana does not make one socially deviant any more than having an occasional drink does. And then there is a condition like ADHD. How much of it is a true diagnostic category versus a behaviorally-defined byproduct of our constrained modern ways of living and schooling our children? What do we say to the fact that ADHD diagnoses among children are rising at rates that seem fully out-of-step with any identifiable cause? (Getahun et al., 2013)
The combined issues that relate to each diagnostic category can be dizzying. So how do we approach this? And further, what to make of it when you have an actual client sitting in front of you? As far as I can tell, to manage what might otherwise be overwhelming, many of us get stuck in an unresolvable tension. The tension is something along these lines:
- Diagnoses describe verifiable and well-defined conditions that ultimately have a biological basis, whatever the environmental contributions might be. Providing a client with a diagnosis is therefore part of being a professional and offering quality, responsible care. This view is typically much more supportive of the use of medication to treat mental health issues.
- Diagnosis is a way that cultural norms are enforced, often to control and limit the lives of individuals. Further, lacking any medical tests for mental health conditions, the idea itself of “mental illness” is really just a misguided, socially constructed metaphor. We should instead look to the subjective and spiritual lives of the individual to see what is really happening and not to any supposedly fixed diagnostic categories.
The truth, of course, is at neither of these two extremes. There is evidence and good will – as well as overstatements – on both sides. So in order to provide the best possible care, and get closer to the truth, we have to decide what is the right approach for a given client given the circumstances. We have to dance with diagnosis and all its complexities. This means that, depending on the exact issue the client is struggling with, how severe their suffering is, as well as their level of anxiety about their condition, sometimes a diagnosis is the most compassionate and effective thing to offer and sometimes it is just the opposite.
Let’s think more about this. On the positive side, a well-delivered and accurate diagnosis provides the client a container. It offers a sense of safety and structure whereas before there was bewilderment and confusion. Recognizing that they are are “depressed” can be a huge relief to people who didn’t know what they were struggling with. Or taking on the identity of an “addict” can help a lot of people get organized to begin to take steps to change whatever has reportedly become compulsive in their lives. A proper diagnosis suggests all sorts of direct pathways to change; pathways that may be harder to accept when the issues are fuzzy and undefined.
At other times, however, giving a client a diagnosis stunts the process of growth by making what is truly complex far too simple. To diagnose a person with a host of early childhood wounds, a loveless marriage, or deep existential or spiritual issues as simply “depressed” is to see the cover of the book and never to read the pages.
Knowing as a therapist how to make things simpler when the client needs that simplicity by offering a diagnosis and knowing how to stand back from labels and let things unfold in all their complexity – that is the dance of diagnosis and much of the art of being a psychotherapist.
In order to learn this, I believe we first have to know ourselves: We have to see the side of us that needs labels and finds comfort, order, and direction in them, even as they are imperfect. And we also need to see the side of us that wants freedom and needs room to self-define and not be boxed-in by our culture, age, behavior, or by other peoples’ way of judging us. When we see both sides in ourselves, then we will begin to see this same set of holistic needs in others. We will have “ears to hear.” This complex listening, seeing all sides, and then discerning the most helpful and accurate direction – that is the Integral way.