Psychotherapy and spirituality: the need for discrimination

Dr. Soumitra Basu

The introduction of meditative and yogic techniques in the psychotherapeutic armamentarium has raised a pertinent question: how far is it justified to use techniques intended for spiritual disciplines in psychotherapy and counselling? Way back in the fourteenth century, Gregory of Sinai had taught that the Jesus Prayer should be repeated quietly and in rhythm with the exhalation period of breathing. Modern practitioners of Transcendental meditation (TM) adopt a similar method which is also recommended in stress-reduction: two 20-minute sessions each day with eyes closed, silently repeating a selected mantra. More refined variations have been practised by spiritual seekers in India throughout the ages. D. Marcer, a contemporary Western researcher comments:

...”The last thing that concerned Gregory was to develop an alternative treatment for essential hypertension or migraine. In common with all meditation occurring within a religious context, be it Christianity, Shintoism or Taoism, his purpose was to achieve union with God, or some form of ‘ultimate reality’. While this metaphysical perspective poses no problems for some individuals, there will be many others... who find it inappropriate (1).”

Marcer thinks that in a climate of scientific objectivity, individual clients may find the use of meditative techniques unacceptable. But this is only a superficial view of the picture. What is more important is that techniques used for spiritual pursuits may prove to be harmful if used in clients suffering from psychological or psychosomatic problems. An exacerbation of chronic illness or even an appearance of a new illness in some cases may outweigh the benefits accrued in other cases. As this is an extremely important issue, it would be prudent to observe how spiritual influences in the form of techniques and concepts have entered the realm of psychotherapy.

The influence of techniques — the physiological perspective

Reports of spectacular physical feats like ‘voluntary stopping of the heartbeat’ or surviving for extended periods in ‘air-tight pits’ without food prompted Western interest in the physiological correlates of yogic and Zen practices. Extensive experiments by Herbert Benson and his colleagues on meditators confirmed the picture of a highly relaxed though wakeful condition. Benson’s research changed the connotation of the term ‘relaxation’. So long, ‘relaxation’ suggested states of passive enjoyment (viz. sitting in front of a fire, reading a book, enjoying a glass of sherry) or active hobbies (viz. golfing, rowing). But the relaxation gained from meditation was an ‘integrated hypothalamic response’ that ‘decreased sympathetic nervous system activity’ – a condition that reduced stress and was therefore of immense therapeutic value in a world of stress-linked diseases. To remove any inhibition in clients having aversion to the concepts of spirituality, Benson and his colleagues developed a simple, non-cultic variation of the meditative technique but retained the four elements identified as necessary to evoke the relaxation response: a quiet environment; decreased muscle tone; a repeated sound, word or phrase; and a passive attitude(2). Meditation itself came to be defined in a non-cultic way that would be more acceptable to modern psychotherapy:

“a family of techniques which have in common a conscious attempt to focus attention in a non-analytic way and an attempt not to dwell on ruminating discursive thought (3).”

The influence of yogic concepts: the psychological perspective

Along with the interest in the physiological correlates of yogic practices, there has been, of late, a serious attempt to appreciate the concepts of yogic psychology. True, Jung had evinced an interest in yoga, but he could not understand concepts like ‘egolessness’ or ‘the Self as a spiritual principle.’ It is only the latest transpersonal movement in psychology (also known as the fourth force in psychology) which is trying to build a superstructure on the foundations of yogic psychology. This school of psychology has attempted to study areas which had been taboo in academic circles: higher states of consciousness, ultimate values, highest meanings, self-transcendence, mystical experiences, etc. Dr. Dalal, in an overview of transpersonal research finds three important landmark developments:

(a) The redefining of psychology as a science of consciousness, the latter being considered as a pluri-dimensional reality in consonance with the Sri Aurobindonian perspective;

(b) The understanding of psychology in experiential terms as a ‘self-knowledge discipline’; and

Benefits and problems

Yogic techniques and concepts were motivated towards an ultimate aim of union with the Supreme and not meant to be palliatives for psychological and psychosomatic problems. Yet to a certain extent, the gains of such spiritual pursuits have been found useful in therapeutic considerations. Thus,

(a) at the physiological level, the relaxation response has an extremely beneficial effect in various types of stress-linked disorders and

(b) at the psychological level, learning to disidentify oneself from one’s ego and external self helps one to surmount many ‘complexes’ and promotes personal growth.

However, these beneficial effects cannot be generalised. Due to the lack of harmony between different parts of one’s being, a subject may not be able to tolerate the experience of relaxation or panic at the idea of delinking himself from his ego. This phenomenon itself can have a very disruptive effect leading to a sudden psychotic reaction or the appearance of a psychosomatic disorder.

Surpassing the dilemma

We are thus faced with a serious dilemma. On one hand, individuals not doing sadhana but interested in having a balanced life can draw some benefit from yogic endeavours which can help them in stress-reduction and personal growth. On the other hand, the risks inherent in using methods which were originally meant for a very different objective can disrupt the balance between the different parts of one’s being leading to serious disorders.

The only creative solution is to assign all such phenomena along a consciousness perspective where the characteristics, pathologies and remedial measures of different developmental stages are hierarchically arranged. Ken Wilber has drawn up such a developmental hierarchy based on what he considers as Sri Aurobindo’s full-spectrum model of development — a concept where the developmental stages (studied along psychodynamic object-relational and cognitive lines) described in conventional psychology and the ‘higher states of consciousness’ described in contemplative traditions like Yogic psychology find their distinctive places. He emphasises that the contemplative stages of development are not parallel (or alternative) to the typical, conventional stages of development but instead refer to different and higher stages of development altogether (although this by no means precludes complex interactions between the two). Nevertheless, a necessary corollary is that one cannot simplistically generalise the characteristics of one stage to other stages. Unfortunately, this is exactly what psychologists tend to do, creating what Wilber described as a ‘pre-trans’ fallacy — a confusion of pre-rational structures with trans-rational structures just because both are non-rational. Thus, on one hand we find pre-rational structures (phantasmic, magical, mythical) being raised to trans-rational status by Jung by equating them with mystic and spiritual experiences. On the other hand, trans-rational structures including higher mystic experiences were reduced to pre-rational infantilisms by Freud.

If a practice like meditation is to be used alone or as an adjunct in psychotherapy, one has to see where the psychopathology lies along the spectrum of consciousness:

(a) If the pathology lies in a position where the self-structure is not stable as in psychosis, narcissistic personality disorder or borderline personality disorder (the ‘pre-personal’ pathologies), then meditative experiences can be very disruptive and should not be advocated.

(b) Once the self-structure begins to stabilise, it can repress, dissociate, or alienate aspects of its own being. Neurotic subjects have such a self-structure and traditionally benefit from techniques like psychoanalysis, Gestalt therapy, etc. Wilber believes that they can get auxiliary benefit from meditative practices.

(c) Most conventional theorists trace the roots of psychological disturbances to the oedipal phase and its resolution (or lack thereof). It is here that pre-personal stages of development are replaced by the ‘personal’ stage where conflicts centering around role-taking, identity formation and existential problems occur. At the stage of role-taking, the self desires to fit in, to belong, to find its role among other roles, to understand rules with a correlative fear of losing face, losing role, breaking rules. At the stage of identity formation, the self can philosophise, i.e. can conceive possible futures with new goals, new possibilities and new fears (like death). Subjects who suffer due to pathologies arising from role-taking or identity formation can benefit from meditation. However, Wilber believes that they might become too much attached to ‘cults’ and ‘sects’ leading to therapeutic problems.

The self-structure at the existential level is concerned with meaning in life. The new-found potentials of autonomy and self-actualization have to be established against alienation, boredom, meaninglessness. The conflicts arising in such situations respond positively to meditation. However, many subjects at this level might not be motivated to practice techniques like meditation, mistaking them for a deceptive form of death denial.

Many psychologists have tried to view meditation as a form of narcissistic withdrawal. Wilber takes pains to show that meditation implies interiorisation which is actually the single strongest tool to decrease narcissism.(5)

Wilber’s model is still based on an intellectual approach to mystic thought. Supplemented by an experiential understanding, a richer insight can help us to intuitively discriminate between the psychotherapeutic and spiritual perspectives. This itself is an important area of research for future psychology.

References

1. Marcer D. Biofeedback and Meditation in Alternative Therapies, Edited by G.T.Lewith. London; William Heinemann, 1985.
2. Benson Het al. Historical and clinical considerations of the relaxation response. American scientist; 1977, [65]: 441-5.
3. Shapiro, D.H. Overview: clinical and physiological comparison of meditation with other self-control strategies. American journal of psychiatry; 1982, [139]: 3:267-74.
4. Dalal, A.S. Unpublished manuscript.
5. Wilber K., Engler J. and Brown, Daniel P. Transformations of Consciousness. Conventional and Contemplative Perspectives on Development. Boston; Shambala, 1986.

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