The term 'integral' implies a holistic systems perspective, and in terms of the modern history of psychology and psychotherapy one of the most significant issues to be addressed by a holistic psychological approach is the relationship between body and mind and the potential wholeness of the bodymind as a complex system. The following text was adapted for the Body Psychotherapy strand of the 2006 BACP conference, and published on the delegates' conference CD. Please use this reference when you quote this piece.
Some preparatory thoughts on an embodied whole-person approach
THE BLIND MEN AND THE ELEPHANT It was six men of Indostan To learning much inclined, Who went to see the Elephant (Though all of them were blind), That each by observation Might satisfy his mind. The First approached the Elephant, And happening to fall Against his broad and sturdy side, At once began to bawl: "God bless me! but the Elephant Is very like a wall!" The Second, feeling of the tusk Cried, "Ho! what have we here, So very round and smooth and sharp? To me 'tis mighty clear This wonder of an Elephant Is very like a spear!" The Third approached the animal, And happening to take The squirming trunk within his hands, Thus boldly up and spake: "I see," quoth he, "the Elephant Is very like a snake!" The Fourth reached out an eager hand, And felt about the knee: "What most this wondrous beast is like Is mighty plain," quoth he; "'Tis clear enough the Elephant Is very like a tree!" The Fifth, who chanced to touch the ear, added: "E'en the blindest man can tell what this resembles most; Deny the fact who can, This marvel of an Elephant Is very like a fan!" The Sixth no sooner had begun About the beast to grope, Than, seizing on the swinging tail That fell within his scope. "I see," quoth he, "the Elephant Is very like a rope!" And so these men of Indostan Disputed loud and long, Each in his own opinion Exceeding stiff and strong, Though each was partly in the right, And all were in the wrong! John Godfrey Saxe (American Poet 1816-1887) |
1) Working with the whole spectrum of processes from unconscious to conscious, from spontaneous to reflective, from somatic to emotional, mental and psychological
If we want to work with the whole spectrum of body/mind processes (in both client and therapist), we might start with a simple list which might look like this: body - emotion - image - mind - intuition
(slighly different versions of this list exist:, e.g. sensation, affect, imagery, left & right brain, cognition; or Babette Rothschild's 'SIBAM': sensation, image, behaviour, affect, meaning).
| INTUITION - hunches, inklings, visions |
| MIND - thoughts, concepts, language, reflections |
| FANTASY - images, dreams, fantasies |
| EMOTION - ranging from raw and primal to complex and social feelings |
| BODY - physiology, sensations, gestures, movements |
The aim of such a list is to approximate some degree of comprehensiveness in terms of the various aspects or levels of the 'whole-person' experience. We could, therefore, say that the client's subjective sense of self is a stream which is fed by these tributaries.
Even with that simple differentiation it becomes apparent that if the client's whole body/mind is the proverbial elephant, then the various therapeutic approaches represented in the field each tend to favour certain parts of the elephant.
Of course, it is not as simple as that, but as a starting point we might say that, for example, the psychoanalysts and cognitive therapists in their very different ways favour the mind, the Jungians the realm of dream and image, the Body Psychotherapists sensation and emotion, and so on.
2) The field of psychotherapy mirrors the fragmentation of the client's body/mind
Each therapeutic approaches tends to favour and privilege certain processes over others, both in terms of their sensitivity to them and the importance they place on them as ingredients in therapy.
I will be working on the assumption that nobody can be entirely wrong all the time. Each approach has areas of ñ sometimes obsessive - expertise and sensitivity and competence, and also shadow aspects of obliviousness.
Comparative outcome research into the effects of psychotherapy has consistently failed to show significant differences between approaches. The famous Dodo bird verdict ('All of them are winners and all of them must have prizes') states that all kinds of therapy work at times, and that differences in theory and technique are not the main indicators of differential in outcome.
To stay with the metaphor of the proverbial elephant, if each approach concentrates on its own partial truth, the Dodo bird verdict is not entirely surprising: after all, the trunk can not be said to be more truthfully the elephant than the ears or the legs.
So - to illustrate this a little more explicitly - we can imagine a person having a significant life experience by having their repetitive, circular, blaming thinking challenged and correctly identifying cognitive insight into core schemata as a crucial ingredient in transformative change. Such a person can consequently formulate the tracking and interruption of negative thought patters as having a profoundly therapeutic effect - and they would be right. He or she may become a cognitive-behavioural therapist and henceforth develop special sensitivity to the damaging, self-perpetuating effects of irrational thought. The question then is to what extent they remain or become sensitive to other - just as necessary - ingredients in transformational processes.
Or we can imagine another person finding their experience transformed by entering and following in active imagination a dream image which eventually helps them embrace and surrender to a part of themselves which they have always been at war with. It is understandable that this person might extrapolate attention to the spontaneous productions of the autonomous psyche as an essential ingredient in any therapeutic change. And they would be right. Eventually he or she may stumble upon the theories of C.G. Jung and become a Jungian. Again, the question is to what extent they remain or become sensitive to other - just as necessary - ingredients in transformational processes.
Or we can imagine a person whose experience of life transforms following a breakthrough and catharsis of primitive feeling, and how they might generalise this into a form of therapy deemed to be applicable to all psychological issues. And they would be right in assuming that without embodied connection to deep, spontaneous feeling lasting transformative change is unlikely to occur.
Each person has got hold of an entirely valid and real part of the elephant. But the existing fragmentation of the psychotherapeutic field would be impossible without each approach absolutising one aspect of themselves and the patients/clients they work with. This tends to be a habitual position for the practitioner who takes - for their own reasons - refuge in a particular one-sided 'solution'. We need to recognise that what manifests as a meta-psychological and theoretical conflict and difference between the diverse approaches in our field also inheres in the psyche of the client. As a field, we parallel the splits and tensions in our clients' inner world. To the extent that we are giving some aspects 'preferential treatment', focussing on and identifying with these to the exclusion of others, we are unable to contain the splits and tensions within the client's psyche.
In the field of psychotherapy, the seven (or 400) wise men do not only have the problem that they are in touch with different parts of the elephant. We have the additional problem that they use different names and languages for the same parts. |
3) A partial single-focus perspective versus a 'whole-person' perspective
If different approaches champion different parts, we would expect the outcome to be partial and haphazard, just as the Dodo bird verdict confirms. After all, focussing on each part does not do justice to the whole elephant, nor to the relationship between the parts.
But that does not mean to my mind that this state of affairs is the best we can hope for in counselling and psychotherapy. A more comprehensive and integrative theory and practice is conceivable, once we have ñ as a field ñ gone through and survived a similar deconstruction of our 19th century heritage as neuroscience and genetics.
The integration of the - in many ways mutually exclusive - theories, practices and meta-psychologies of the psychotherapeutic field relies on the recognition that what each approach absolutises as the crucial factor in therapy is only a partial account; each approach privileges an entirely necessary, but not sufficient ingredient.
In privileging and absolutising a particular focus on a particular level of the client's body/mind, we sometimes find that we work with one level and the other levels come along effortlessly, and transform spontaneously alonside the aspect we are focussing on.
For example, you suggest a particular interpretation, and the insight is received by the client and moves them, and the process having started in the mind, the feeling comes along spontaneously. Or you follow a particular image or metaphor or fantasy, and the client suddenly has a relevant, previously inaccessible insight. Or the client is overwhelmed by a particular emotion which generates relevant memories which evolve into an understanding of a particular pattern both in its past and current manifestations.
A single focus can become an avenue into the transformation of the whole.
But sometimes we bang your head against one particular level and the others do not come along at all. Sometimes a particular single focus can abort engagement with the whole. What makes a particular approach work with one client at one time, and becomes a countertherapeutic disaster at another, may be more to do with the relationship between the different parts in the client than the validity of our approach to a particular level.
What I am working towards is the suggestion that ...therapeutic transformation does not depend on working out one (privileged) part/level, but it depends on all of them coming together and on the relationship between the parts/levels.
It is the whole body/mind matrix which shifts to generate a new sense of self. It is the whole body/mind matrix which holds a particular core schema, or constitutes identification with a pattern or releases identification from a script.
4) Rather than trying to resolve the contradictions between the approaches, recognise that the tensions between them mirror similar tensions in the client
The limitations of our notions of therapeutic change lie in the eye of the beholder - in the partial perceptions we inherit through our particular training and approach. We might, therefore, hypothesise that the outcome of therapy would be affected significantly if the practitioner could do justice to the conflicting therapeutic perspectives, theories and stances as they are constellated by and reflected by the respective tensions in the client's psyche and body/mind. In this perspective we are less compelled then to try to resolve the inherent contradictions between the theories, techniques and meta-psychologies of the different approaches. There are differences and paradigm clashes between the various branches of counselling and psychotherapy which may well be irreconcilable theoretically and philosophically. But in their functioning as collectively and historically constructed - mirrors of conflicting aspects of the client's psyche, we can enter and productively work with the inherent dichotomies as necessary paradoxes inherent in the therapeutic endeavour, if - that is - we can bear more than one 'truth'.
In this spirit we can usefully extend the initial simple differentiation of body/mind totality (into body-emotion-image-mind-intuition), and make our list more detailed and specific.
So what are the parts that make up the whole elephant?
What are the body/mind processes which constitute the client's sense of self and also both the structure and content of our awareness and understanding ?
What categories can we phenomenologically distinguish when we attend to the full spectrum of body/mind processes in the client and in ourselves ?
5) Levels of body/mind process
| self-reflexive thought / meta-level thinking |
| mental: formal-operational thoughts (including internal dialogue) |
| mental: concrete-operational thoughts (language) |
| images, fantasies, dreams |
| complex feelings |
| breath |
| raw emotion |
| spontaneous gestures / outer movements |
| impulses (manifesting instincts/drives or object-seeking needs) |
| inner movements, excitation, trembling etc. |
| sensations, proprioceptions |
| vitality affect / 'felt sense' |
| autonomous nervous system (sympathetic & parasympathetic) |
| energetic perception |
| physiological and biochemical processes throughout body and brain* |
For a more academic and scholarly treatment of this more differentiated list see Ken Wilber's writings. We can, of course, discuss endlessly what each of these terms mean, how we define them and what distinguishes them, whether the list is comprehensive enough or too detailed to be useful. We could investigate which of these notions are supported by scientific evidence and, for example, by neuroscientific research. We could also consider which of these processes are directly observable by sense perception and which can only be inferred. And we can, of course, question through which lens we are interpreting our perceptions. But the main purpose, for me, is to use some list like this to practice 'whole-person' perception because communication occurs on all these levels simultaneously (most of it non-verbal), constituting a wealth of information every second.
Generally speaking, we can say that whole-hearted spontaneous transformation cannot happen if any one of these ingredients / levels is systematically excluded or missing. What we cannot afford to say is ìthis is the one ingredient which all depends onî without losing the inherent plurality and diversity, the relational complexity between the levels and therefore the potential wholeness of transformation. Having distinguished these various levels of body/mind experience, we can pay attention to the relationship between them.
Conclusions - what we notice
1) Notice that all of these different aspects, processes or levels of experience can ...
... work together (congruent, integrated),
... work against each other (conflicted, opposed) or ...
... work in parallel, but dissociated (unconnected)
We all have an immediate intuition about a person's spontaneously given 'body/mind matrix', i.e. how these different processes work in harmony or may be at odds with each other. This we might call the degree of body/mind integration or dis-integration. In practice, we can attend to that ever fluctuating degree of body/mind integration or dis-integration in ourselves and in the client in response to and as a function of relational processes, integrating a body/mind holistic perspective (as developed in 80 years of Body Psychotherapy tradition) with a relational perspective (as developed in the psychoanalytic tradition, i.e. relational psychoanalysis and intersubjectivity).
Out of this we can develop a holistic phenomenology of the relationship, with re-enactment and parallel process as central notions (see my "Embodied Countertransference" in Totton, N. (2005) New Dimensions in Body Psychotherapy. Maidenhead: OUP).
2) Notice that all of these different aspects or levels ......
... can carry memory of past states, including past trauma
... are mapped onto the brain, holographically reflected in the brain (in a mutual, reciprocal rather than top-down brain/body relationship)
... can subjectively be experienced as sources of a sense of self i.e. subjectivity.
... can subjectively also be experienced as enemies of self, identity, subjectivity.
... apply to both the client's and the therapist's body/mind.
Out of this we can develop a holistic phenomenology of the relationship, with re-enactment and parallel process as central notions (see "Embodied Countertransference" in Totton, N. (2005) New Dimensions in Body Psychotherapy. Maidenhead: OUP).
3) Notice that all of these different aspects or levels ......
... can be approached in a 'first-and-second-person stance' or in a 'third-person stance' (they can be addressed intersubjectively as manifestations of subjectivity or treated as the phenomena of a 'case', i.e. quasi-objectively)
... can be approached by the therapist in an intersubjective fashion or in an objectifying fashion, dialogical or monological, depending on whether the therapist is connected to their own equivalent level of experience.
... can be worked with or without any reference to the client-therapist relationship in the room
This point is relevant for an exploration of the conflict between the 'medical model' and the relational perspective inherent in counselling and psychotherapy, (see my "What therapeutic hope for a subjective mind in an objectified body?" in "About A Body", edited by Corrigall, Payne and Wilkinson; Routledge, 2006 - the proceedings of the 2004 UKCP conference.
For a discussion of these processes in terms of what Body Psychotherapy calls the 'body/mind split' and a re-working of that notion into the dialectic of spontaneous processes versus reflective processes, see my "Re-defining the body/mind split".