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Mental Illness as an Opportunity for Transformation: Applied Principles of Psychosynthesis with Schizophrenic Clients

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Message Blair Gelbond

The care and treatment of the severely and chronically mentally ill is the most common problem faced by the mental health profession despite the fact that to date the care of these individuals has probably had the lowest priority in the entire area of human services. In a recently published family manual, Torrey asserts that the magnitude of schizophrenia as a national calamity is exceeded only by the magnitude of our ignorance in dealing with it. In his words, "Schizophrenics are the lepers of the 20th century."

As the trend of "deinstitutionalizing" the severely mentally ill has followed that of warehousing them in state hospitals, it has become clear that, primarily due to lack of planning and funding for adequate community resources, many tend to function marginally in the community and that hospital readmissions have created a revolving door syndrome. The problems of getting schizophrenic persons adequate care in a state hospital setting are magnified exponentially by the difficult conditions awaiting patients after discharge.

The following article is a description of a unique treatment approach within an innovative community setting in the Boston, Massachusetts, area in which I participated a few decades ago. It has been written as a means of sharing a story of success in work with individuals designated as mentally ill in a period described by many as the national "debacle of deinstitutionalization."

A Unique Treatment Approach

When I joined the staff of this community aftercare program some years ago, I was intrigued by a sense of vitality, dynamic optimism, and clarity of purpose which appeared to bond colleagues together. Clients gathered daily to participate in milieu, group, and individual therapy, to spend time with one another, and to soak in a sense of belonging. Clients' family members eagerly participated in groups designed for support, education, and self-help. Frequently, they expressed their sincere gratitude to staff - strongly contrasting with numerous past instances of feeling accused or ignored in dealing with mental health professionals. Clearly, something was working.

In recent years, I had also made acquaintance of psychosynthesis, a therapeutic approach designed to facilitate the growth and integration of the human mind, heart, and spirit. As its founder Roberto Assagioli stated, the basic premise or hypothesis of psychosynthesis is that there exists, in addition to aspects of the unconscious revealed by psychoanalysis, "another vast realm of our inner being which has been for the most part neglected by the science of psychology, although its nature and its human value are of a superior nature."

As such, psychosynthesis represents a new branch of psychology which has been given the name "transpersonal" and which incorporates a "height" as well as "depth" dimension.

Seeking to understand and relate to the totality of the human psyche, it exists as a clear contrast and complement to the more reductionist approaches which tend to consider all human experience as either an adaptive or a defensive process. Psychosynthesis seeks to direct our vision toward potentials for growth and evolution latent within - toward, as Assagioli writes, "the grand promise of what each person could become."

In my work as an aftercare therapist within the clinic, I applied the principles of psychosynthesis. Most individuals, who had been discharged from a state hospital near Boston, carried a primary diagnosis of schizophrenia although diagnoses of borderline personality disorder and bipolar affective disorder (manic-depressive illness) were also common. For the sake of simplicity, I am limiting this discussion to work with individuals diagnosed as schizophrenic.

Due to the nature of the therapy team of which I was a part, and its place in the delivery system of mental health services, much work was involved with the family members of clients. I functioned as both family therapist and group leader in the network of support and education groups developed by the therapy team.

Extensive contact with other professionals was involved in both hospital and community settings. Such a setting has been ideal for the testing and integration of a psychosynthesis approach in a variety of situations. Application of concepts within a psychosynthetic framework could be compared with strategic and systemic modes of family treatment, as well as more psychoanalytic, medical, and psychosocial/educational rehabilitation models.

Because the psychoeducational, family-centered approach utilized by the aftercare therapy team was itself an innovative one and because our mandate was to provide a range of aftercare services to the most difficult clients in the region, other professionals (trained in more traditional approaches) tended to expect creative, occasionally surprising clinical plans from team members. This process was, of course, not without disagreements and conflicts, but these situations tended to throw into relief the various clinical assumptions of the care providers.

As time went on, I became aware of an interesting process. Many members of our agency's clinical staff appeared to be applying principles of psychosynthesis instinctively and intuitively despite having had extensive formal training in clinical approaches substantially different from psychosynthesis. Clients were held in a perspective of wellness as well as illness, and client disempowerment due to diagnostic labeling and self-fulfilling negative expectations was kept to a minimum. The atmosphere of the clinic was often joyful and sincerely caring, despite the severe dysfunction of many clients and the high case-load of staff members.

I began to notice that what was held by the staff as a group was an "attitude of synthesis." This attitude of synthesis had to do with an openness of mind in being willing to innovate in search of practical therapeutic results. It had to do with a faith in people's innate inner resources and an openness of heart which embraced clients and colleagues in an ongoing demonstration of the power of love and acceptance. It had to do with the reality that often it is only through the combined efforts of staff members that a client is able to take their next step in growth, or simply be kept from relapse and breakdown.

It was understood that to be effective, colleagues needed to intervene with clients at multiple levels, and to utilize data from many points of view. While such an attitude is difficult to express in words, it appears to be essential to the human growth process itself such that opposite qualities - work and play, feelings and mind, love and will, practical and ideal - can interweave and play upon one another toward ever higher levels of integration. As Ferrucci states, such syntheses release enormous amounts of psychological energy, leading to a positively spiraling growth process.

The following discussion is designed to be of interest to two audiences: those who are acquainted with psychosynthesis but have little knowledge of chronic mental illness and those who wish to provide comfort and therapeutic help to the mentally ill, but have little or no experience in the discipline of psychosynthesis. Herein, I seek to describe some hazards as well as advantages of a psychosynthesis approach.

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I work as a psychotherapist with an emphasis on transformational learning - a blend of psychoanalytic and transpersonal approaches, and am the author of Self Actualization and Unselfish Love and co-author of Families Helping Families: (more...)
 

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3 people are discussing this page, with 13 comments  Post Comment


Blair Gelbond

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While this article discusses mental illness from the perspective of pathology, this is not to say that this label has not be misused. We know, for example, that dissidents in the Soviet Union were frequently incarcerated in psychiatric hospitals when they espoused views that were in conflict with the Party Line.

Likewise, over the course of history many realized saints and sages were considered insane, because they viewed life outside of the "consensus reality," which the general population saw as "normal." An example is the perception that everything in the universe is a manifestation of the Infinite, or that - beyond dualism - at the deepest level there is no difference between the individual and God.

Submitted on Tuesday, Nov 16, 2021 at 1:37:10 PM

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Philip Pease

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Since you mentioned saints and sages and their perception of altered states of reality; there is also the idea of demonic possession. For a period of time my first wife was aware of an entity in our home (that I could not see) and I believed her because I saw a door open all by itself and heard noises coming from an empty room. During that period we went to a spiritualist church where the pastor would give messages that she was given to members of the congregation. My wife and this pastor functioned "normally" in daily life such that I at no time was concerned for their mental health. They seemed to be aware of and even communicate with this "other reality" as well as "consensus reality". It seems that they were able to integrate the "other reality" into their perception of reality.

In Schizophrenic clients have they lost connection with consensus reality (for periods of time) and/or do they identify the other reality as delusional (a mental illness that they are desperate to eliminate)?

For me the experience from using psychedelic drugs was interesting and I never had a "bad trip". I did have some experiences where I wanted the trip to end; but I was aware that it was a drug I took and that it would end when the drug effect diminished. As soon as I made the connection the scary feeling went away and I was no longer frightened by the experience, I was ok with my experience. I still had that connection to consensus reality (I knew the strange experiences was drug induced} so I was able to reason that I would return to consensus reality. In schizophrenia is it always a "bad trip" that one thinks will last forever or do some perceive as an interesting trip and are ok with their experience (but others are not ok with it).?

Submitted on Wednesday, Nov 17, 2021 at 11:25:14 AM

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Blair Gelbond

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Philip,

Thanks very much for your comment and questions.

Re- your 1st paragraph - due to my current understanding that there are more subtle levels of reality than the physical plane, I have no problem with the idea that negative subtle beings (and/or "demonic possession") can exist, although, of course, this idea can be misused according to various "religious" agendas. (Forms of hypnosis and group contagion can sometimes be used).

Re- your second paragraph - in my experience, some folks experience their delusions and/or hallucinations as "ego-syntonic" - that is, comfortable and just a part of themselves. I had a patient who had been hospitalized for many years, for whom I sensed that her hallucinations were a comfort re- her disappointment at not being able to function in the world, the loss of her great potential (when younger she had been the protege of a famous dance teacher). Her symptoms also, I believe made her feel special, given that other avenues were closed. She also stated that she was talking to "angels not in heaven, but not in hell." Who am I to say that these weren't real?

Others want their "dysfunctional" perceptions, experiences, and thoughts to go away.

Re- your third paragraph, I don't know. I do know that in our and other cultures both acute and chronic psychosis disorganize the logical consensus mind, language, and action. Many indigenous peoples have alternative ways of viewing this malady.

There is usually much distress connected with psychosis, yet I would think there are a few intrepid adventurers, who either "think of it as an interesting trip," and/or recognize that they are actually perceiving other levels of reality.

Paul Levy has an interesting, perceptive book entitled, Awakened by Darkness. R.D. Laing has done intriguing work with this population.

Submitted on Wednesday, Nov 17, 2021 at 1:56:37 PM

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Allan Wayne

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There is no such thing as a schizophrenic. It is a hateful word that stigmatizes people who are suffering from schizophrenia. In the same category as retard or spastic. One would think that people would know better by now, but apparently some are either ignorant or don't care.

Submitted on Wednesday, Nov 17, 2021 at 6:04:39 PM

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Blair Gelbond

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Allan,

Thanks for your comment.

I didn't quite understand it, since you use the term in your comment.

"There is no such thing as a schizophrenic. It is a hateful word that stigmatizes people who are suffering from schizophrenia. In the same category as retard or spastic. One would think that people would know better by now, but apparently some are either ignorant or don't care."

I know it as a diagnostic category similar to obsessive-compulsive or acute psychosis.

As I try to make clear in this and especially my next installment, none of us *are* categories. One can say, "I *have* an illness, but I am not my illness." We are always whole human beings.

Submitted on Wednesday, Nov 17, 2021 at 8:33:09 PM

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Allan,

In my opinion, your comment suggests that you either did not read or did not understand the article. Perhaps in the past, others put degrading labels on you. If so, I'm sorry to hear it.

Submitted on Thursday, Nov 18, 2021 at 1:13:38 PM

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Psychosis sometimes occurs when psychic material from what psychosynthesis calls the "superconscious" (or higher unconscious) descends into an ego that is not solid. Because the person's everyday identity has "cracks" and lacks a solid foundation, the power of higher energies disorganizes and can shatter the everyday ego.

The person experiences (and others perceive him- or herself as) being "crazy."

Psychiatry and much of psychology do not yet recognize the reality of superconscious levels of mind. Thus, there is a huge disconnect, where any appearance of psychosis is seen only as pathology.

Submitted on Thursday, Nov 18, 2021 at 1:10:35 PM

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Allan Wayne

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I know your article is important, but with obsessive-compulsive diagnosis, people are not called obsessive-compulsics, for example. People suffering from acute psychosis are called psychotics or schizophrenics, which is dehumanizing, instead of "People suffering from schizophrenia."

click here

Briefly, the article says:

"Referring to someone as, "a schizophrenic," instead of a person with schizophrenia, dehumanizes them. "An illness is a part of their life and experience and does not define who they are," Byrd said. Bruce Liese, a professor of family medicine and psychiatry and clinical director of the Cofrin Logan Center for Addiction Research and Treatment at the University of Kansas, said that people are too quick to use these kinds of linguistic shortcuts: "He or she is a drug addict. He or she is an alcoholic." But they are not, he added, they are people with these health issues; instead we should say, "He or she suffers from alcoholism."

Frankly, the word "schizophrenic" is so widespread in the medical field that it seems ingrained. On Twitter or in politics, it is used to make fun of people or policies. Some things, it seems, never change.

I would be the last one to censure someone's language, but nevertheless, people have a choice in considering effect. Thanks for the article.


Submitted on Thursday, Nov 18, 2021 at 1:16:20 PM

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Blair Gelbond

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Allan,

I agree with you.

You might want to have a look at the discipline known as "General Semantics", founded by Alfred Korzybski - or Quantum Psychology by Robert Anton Wilson (which is a more humorous version of G.S).

G.S. clearly shows how we distort words, leading to negative events, and how we can fix this.

Submitted on Thursday, Nov 18, 2021 at 2:17:44 PM

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Allen,

Here is an article on G.S. It is rather intellectual.

GENERAL SEMANTICS

Toward a new general system of evaluation
and predictability in solving human problems

Alfred Korzybski
Author of Manhood of Humanity and Science and Sanity


Paper from Alfred Korzybski: Collected Writings 1920-1950
┬ę I.G.S. Englewood, New-Jersey

INSTITUTE OF GENERAL SEMANTICS

Englewood, New-Jersey, USA

gestalt.org/semantic.htm

***

I heartily recommend books by Robert Anton Wilson, who is trained in G.S., yet also has an insightful (and wonderful) sense of humor. They are highly intelligent, but not pedantic.

Submitted on Saturday, Nov 20, 2021 at 1:37:18 PM

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Psychosis or Spiritual Emergence? - Consideration of the Transpersonal Perspective within Psychiatry' Dr. Nicki Crowley

Spiritual Emergence and the Transpersonal Levels Spiritual emergence can be seen as a natural process of human development in which an individual moves beyond normal feelings and desires of the personal ego into the transpersonal realms of increasing relatedness to a Higher Power, or God. It is an acclimatisation to more subtle levels of consciousness.

In The Atman Project 7 Ken Wilber has described three levels of transpersonal experience, in ascending order: Subtle, Causal and Atman. At these levels people have access to a fluid creativity from a higher order of inspiration than that of the personality.

The Subtle level is that level of conscious awareness which includes extrasensory perceptions indigenous to the body, as well as those apparently separated from it such as out-of-body experiences and psychokinetic phenomena (objects moving without a physical catalyst.) The experience of this level is thought to be related to a system of energy centres in the body called chakras in Sanskrit, that are of a more subtle order than physiological organ systems, and subsequently activate a higher order of perception than that possible from our five physical senses. Experiencing awareness of dimensions beyond physical, objectified reality is often the basis for accessing a deeper, revitalised inner meaning of oneness in connection to others.

People have experienced Causal level consciousness as 'peak experiences' secondary to spiritual practice, inspired by music, taking mind-altering substances or following emotional trauma, childbirth or during intense sexual experiences. It is described as a state of perfect ecstasy, untainted by any distracting thoughts, desires or moods. The Causal level includes the awareness of Subtle and material dimensions, going beyond them to a fuller realisation of union with 'God', where there is said to be no sense of time, only eternity.

The Atman level is beyond the Causal, but including all dimensions below it. This dimension of consciousness is said to be so completely immersed in the Highest Power that nothing else exists in awareness. It is described as bringing perfect ecstasy beyond emotion. Indications of the Atman level exist in mystical religious texts where it is referred to as being beyond description.

Experience of these transpersonal realms does not necessarily precipitate a crisis. These intense intra-psychic experiences can phenomenologically appear similar to pathological psychotic states, but given the appropriate context, sensitive guidance, and opportunity to integrate the experience, individuals can reach higher levels of awareness and functioning following such an experience.

This transpersonal perspective affords us an opportunity to build a modern scientific theory of 'madness' around a radically expanded view of consciousness, and allows us to differentiate extraordinary states of consciousness that are more adaptive than the ordinary state, from alterations that restrict one's ability to function in the world.

Submitted on Friday, Nov 19, 2021 at 12:45:21 PM

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Psychosis or Spiritual Emergence? - Consideration of the Transpersonal Perspective within Psychiatry

Dr. Nicki Crowley

Spiritual emergency, consciousness and the transpersonal perspective

Observation from many disciplines, including clinical and experimental psychiatry, modern consciousness research, experiential psychotherapies, anthropological field studies, parapsychology, thanatology, comparative religions and mythology have contributed to the concept of 'spiritual emergency' a term that suggests both a crisis and an opportunity of rising to a new level of awareness or 'spiritual emergence.'

This term was first coined by Stan and Christina Grof who founded the Spiritual Emergency Network at the Esalen Institute in 1980. Its remit was to assist individuals and make referrals to therapists for people experiencing psychological difficulties associated with spiritual practices and spontaneous spiritual experiences.

Grof describes a spiritual emergency: 'There exist spontaneous non-ordinary states of consciousness, (NOSC) that would in the West be seen and treated as psychosis, and treated mostly by suppressive medication. But if we use the observations from the study of non-ordinary states, and also from other spiritual traditions, they should really be treated as crises of transformation, or crises of spiritual opening: something that should really be supported rather than suppressed. If properly understood and properly supported, they are actually conducive to healing and transformation'.

In order for psychiatry to appreciate the relevance of this perspective to the medical diagnosis and treatment of psychosis, it is necessary to move beyond our materialistic, biomechanical focus on brain function and start to expand on the concept of consciousness - that fundamental yet intangible core aspect of 'aliveness', within which is held our perceptual awareness of experience. Medicine, psychiatry and traditional psychotherapies hold the assumption that consciousness is a by-product (or epiphenomenon) of the brain and cannot persist independently of it (the productive theory of consciousness).

The transmissive theory of consciousness holds that consciousness is inherent in the cosmos and is independent of our physical senses, although is mediated by them in everyday life. So the brain and the psyche can be thought of acting as a lens through which consciousness is experienced in the body.

This forms the basis of the transpersonal perspective, which received its initial articulation by thinkers and scholars in the field of psychology, Carl Jung, Robert Assagioli, Ken Wilbur and Stanislav Grof amongst others. They recognized the limitations of the field of psychology and sought insights and teachings from the spiritual traditions and certain philosophical schools of the east.

The term 'transpersonal' is used here to refer to psychological categories that transcend the normal features of ordinary ego-functioning, that is, stages of psychological growth, or consciousness, that move beyond the rational and precede the mystical. At the root of the transpersonal perspective is the idea that there is a deep level of subjectivity or pure spirit that infuses all matter and every event. (con't)

Submitted on Friday, Nov 19, 2021 at 2:04:36 PM

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(con't)

A common metaphor throughout the spiritual wisdom traditions refers to this consciousness, or living spirit, (be it called Brahman, Buddha-Mind, Tao, or The Word) as having been breathed into all being at the moment of creation as a manifestation of divine nature.

It is necessary for sentient life, because experience and awareness are possible only through the activating power that flows from this Source. Transpersonal theory is a way of organizing our experience of 'reality'; it is not that reality itself.

It relies on the phenomenological observations of inner subjective experience and instead of merely pathologizing those which do not fit into expected socio-cultural models, attempts to set them in the context of the wisdom of the world's spiritual traditions (Hinduism, Buddhism, Taoism, Judaism, Christianity, Islam and the Primal Religions) with some of the philosophical (Plato, Aristotle, Augustine, Kant, Kierkegaard) and psychological (Jungian, Humanistic, Existential) schools of the West.

Submitted on Friday, Nov 19, 2021 at 2:06:24 PM

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