The body also plays an important role in psychosynthesis and in this article Assagioli reviews some of the different methods that Psychosynthesis uses, including body therapeutic methods.
By Roberto Assagioli, MD, translation Kirsten Hansen
For an assembly of highly qualified therapists, to whom I have the honor of speaking on this occasion, I need not elaborate on the principles and application of psychosomatic medicine. On the contrary, I am in the fortunate position of learning much from your contributions to the meetings during this “psychosomatic week”. I therefore allow myself to devote the short time at my disposal to an – by its very nature brief, and I would even say a “synthetic” – outline of the present and future contributions of bio-psychosynthesis to psychosomatic medicine.
The word “psychosynthesis” has been used by various authors, but they have not adopted it as a single concept or applied it as a specific therapeutic method. However, I must limit myself to describing the use of it, which will be my personal contribution here.
Psychosynthesis has developed naturally, and I would say spontaneously, from the field or mainstream of psychoanalysis as a psychotherapeutic method – or more precisely as a collection of techniques and methods, coordinated and directed towards achieving a complete and harmonious development of the human personality. Its principal objectives and tasks are:
1. Elimination of conflicts and obstacles, conscious or unconscious, that block this development
2. Using active techniques to stimulate the psychological functions that are still weak and immature.
The use of psychosynthesis, however, very quickly revealed the necessity of including the body, ie, of recognizing and utilizing the close ties between body and psyche, as well as the mutual actions and reactions. This is fully recognized both from a theoretical and practical point of view, and therefore the proper term for psychosynthesis is bio-psychosynthesis. (In practice, it is usually more appropriate to use the word “psychosynthesis,” but it must be understood that it always includes the body, bio, and it always stands for “bio-psychosynthesis.”)
The real nature and functioning of the psycho-physical interaction has been and still is, as is well known, the subject of lively discussion. Conflicting views and theories have been presented, but psychosynthesis, with its fundamentally pragmatic orientation, takes no position on this matter. It takes the reality of this interaction for granted (which forms the basis of all psychosomatic medicine) and uses its functioning for therapeutic purposes.
In order to make extensive use of an energy, it is not necessary in practice to have a thorough understanding of the nature of the energy or of what it really is. Just as knowledge of the law of gravity is not necessary to construct airplanes, or what electricity is to use it in countless ways; so the use of our body does not require knowledge of the nature of the relationship between body and psyche. We do not need to know how the will, an idea, or a mental image can cause muscles to move. If I want to lift an arm, the arm lifts itself without my knowing how. Boxers, acrobats, and pianists develop an astonishingly effective psycho-neuromuscular coordination, a real psycho-physical synthesis, without needing knowledge of even the most elementary anatomy—for example, of the location of the cerebral motor cells and the branching of nerves whose function is to stimulate muscular contractions.
This view is shared by Professor Atonielli, the able organizer of this comprehensive and versatile Psychosomatic Week. “In psychosomatic medicine,” he writes, “it is not so important, at least for the clinician, to know the psychosomatic structural process as to know its origin and how to diagnose it and what techniques can be used for its cure. This practical knowledge we have acquired.” (Practical Aspects of Psychosomatic Medicine, in “Medicina Psychosomatica,” Vol. 12, n. 2, p. 133)
One of the most important specific contributions of psychosynthesis, which distinguishes it from various other conceptions of the human psyche and from other psychotherapeutic methods (but at the same time does not contradict them), is the recognition of the higher functions of the psyche and the demonstration of their importance for the pathogenesis of many nervous and psychosomatic disorders.
The psychosynthesis view of the human psycho-physical structure is shown in the following diagram
The oval diagram used in psychosynthesis
The entire oval figure encompasses the bio-physical human being; the innermost circle represents the field of consciousness, and the dot in the center represents the personal self or “I.” The remainder of the oval shows the extended unconscious, which is divided into three zones:
1. The lower unconscious (the lowest zone) contains primarily the elementary but skillful psychic activities that govern organic life. Some biologists now speak of a bio-psyche and consider life and intelligence to be inseparable. This area is also the seat of instincts or fundamental drives such as sexuality, survival instinct, and aggression. Here are also found the highly emotional complexes that result from trauma and psychic conflicts.
2. In the middle zone are the psychic elements and activities that are similar to waking consciousness and are easily accessible. This is the pre-conscious; this experience is processed and future activities are prepared.
3. The upper zone contains the higher unconscious or superconscious. From here come intuitions and inspirations of a sublime, religious, artistic, philosophical or scientific nature, as well as the creation of unique ethical imperatives and the elicitation of altruistic action.
The star at the top of the superconscious represents what modern psychology – and Jung in particular – calls the Self. The ego, the center of the personal self, is a reflection of this. Outside the oval is the boundless psychic world of the collective unconscious.
All the lines are dotted to indicate a constant exchange of elements and energies. One could say that there is a “psychic osmosis” between each area and all the other psychic areas.
A clarification of the higher unconscious is desirable. Its existence has been largely unexplored by modern psychology. Many researchers do not really believe that it can be investigated by scientific method. But this view stems from a limited and erroneous conception of such an approach, which is thereby restricted to the use of techniques used in the physical sciences. The scientific method, which is said to have originated in Francis Bacon’s Novum Organum, in reality consists mainly of the elimination of linguistic and judgmental errors. He called them “illusions,” and they have been even more skillfully exposed by modern semantics. It is essentially a question of common sense. Thus, everything can be a legitimate subject of scientific consideration; there is no reason why sexuality should be scientific but love should not. This view has recently been recognized by several avant-garde psychologists, such as Sorokin, Maslow, Frankl, and others, who have adopted this humanistic, existential, and anthropological position.
But psychosomatic medicine has not ignored these higher aspects of reality and psychic life. In fact, some of the most prominent exponents have persistently drawn attention to this. Here I would like to mention in particular the head of the Medical Clinic of Hamburg University, Prof. Jores, whom we have the honor of having among us. In his excellent book, Der Mensch und seine Krankheit (Stuttgart: Klein, 1956), he shows that many disorders are rooted in a frustration of a deep need to cultivate the performance and development of the personality. This need is not just a simple affirmation of the personality in front of other people. It is the urge to develop latent possibilities and to grow, which is often unrecognized or repressed. Just as a normal biological organism experiences an irresistible tendency to grow, there is a growth tendency in man which lasts throughout life; or at least much longer than the period of biological growth. When this growth is unrecognized or repressed, or frustrated by external obstacles, psychosomatic disorders arise.
Prof. Frankl, head of the Neurological Clinic of the University of Vienna, expresses himself in similar terms. With regard to existential growth and developmental crises, he states that they must not be considered mental illnesses and that the physician should not try to alleviate the existential despair with sedatives, but rather should guide the patient to overcome the crisis. (Man’s Search for Meaning, NY: Washington Square Press, 1963, p. 103.) According to Frankl, “the search for meaning is a primary force in man and not a secondary rationalization of instinctive impulses. The values that give meaning to life do not drive a man forward, but rather attract him.” (ibid. p. 157)
This fact is strongly supported by Abraham Maslow, professor of psychology at Brandeis University (USA) and current president of the American Psychological Association. “The full description of a person or of human nature must therefore include intrinsic values, as part of human nature,” he writes. “These intrinsic values are instinctive in nature; that is, they are necessary 1) to avoid illness and 2) to achieve the fullest humanity and growth. Illness resulting from deprivation of intrinsic values (meta-needs) we may call metapathologies. The highest values, the spiritual life, the highest aspirations of man are therefore appropriate subjects for scientific study and investigation. They are found in the natural world.” (A Theory of Metamotivation: The Biological Rooting of the Value-Life. Journal of Humanistic Psychology, Fall, 1967.)
The second contribution of psychosynthesis is that the importance and value of the will is re-emphasized, drawing attention to how the will has a special position, as it deviates from the other psychological functions. The will can be called the Cinderella of modern psychology. Since William James it has been almost completely ignored, not only by theoretical psychologists, but also by the leading exponents of dynamic psychology.
I cannot on this occasion discuss the reasons for this strange neglect. I will merely mention that the main reason is to be attributed to the pronounced materialistic and objective orientation which has until recently prevailed in psychology. In this connection I would suggest the following modification of the well-known statement about the sad fate of psychology: “First psychology lost its soul, then its will, and then its consciousness, and has nothing left but its behavior.” But it has been for some time in the process of rising from this collapse; it is regaining its consciousness, or rather self-consciousness, by recognizing the ego; and now it must find its will again.
There are visible positive signs of a development in this direction, and I am glad to say that one of the leading psychologists in Italy, Prof. Leonardo Ancona, who is the present moderator, recognizes the existence of the function of the will in psychic life. In his monograph on motivation, published in the book Questioni di Psicologia, edited by himself, he analyzes in detail the different types of motives and includes among them value motives as being specifically human. He expresses his opinion thus: “A human being intends to do something, rather than being forced or pressured or simply having the desire to do it. This fact is expressed by saying, ‘the individual wills’. At this level, motivation is not externalized as action, but as a cognitive representation, and identifies itself with the concept of will. Here it is a question of anticipated behavior, where the reality is ‘willed’ in the abstract before it is carried out on the concrete level.”
Prof. Jores speaks of the will in much the same terms: “The individual is endowed with intelligence,” he writes, “so that he is able to control his actions and judge their effects; on the basis of experience he can provide for the future. When one of these actions is guided by motivation, we speak of an act of the will. The individual’s sphere of action consists of a system of values. In this way one has become a moral being” (Der Mensch und seine Krankheit, p. 22.)
As I have mentioned, psychosynthesis has made the will the object of a special study; it has described the different stages of the will (goal, assessment, intention, deliberation, decision, planning, control of execution) and has specified its qualities (energy charge, ability to inhibit, readiness, endurance). Psychosynthesis has given the will the central position among the psychological functions, as shown in the following diagram:
The center of consciousness and the psychological functions
The recognition and use of will is of great importance in psychosomatic medicine, and the performance of many of the psychological and psycho-physical techniques requires the voluntary and active cooperation of the patient. This does not only involve the use of will, but requires a fundamental will to be cured. Where the will is deficient, blocked or overwhelmed by what has been called aversion (Gegenwille), the death instinct (Freud), the tendency to self-destruction (Menninger), it is important for the doctor to be very aware of the situation, and he must try to awaken or strengthen the will to be cured. If this is lacking, any therapeutic effort remains ineffective.
Turning now to the specific field of therapy, it is natural that the attitude of psychosynthesis must be “synthesis.” It values and weighs the merits of all therapies, all methods and techniques without preconceived notions. It makes use of all of them and selects, combines and alternates in various ways between the methods according to what each existential, clinical situation and symptom complex indicates. These combinations are not only different and even unique for each patient, but they vary continuously throughout the course of the illness and its treatment.
In accordance with the psychosynthesis’s recognition of the existence and significance of the superconscious, it takes special account of the patient’s existential reality and perception of life. Here one may object: “But these are concepts that belong to the realm of philosophy. How can they in any way provoke psychosomatic disturbances?” First of all, one must realize that everyone, every individual, from the simplest to the most cultivated, must of necessity have his own perception of life, however rudimentary and almost unconscious it may be.
This is easy to demonstrate from the fact that everyone “judges”; in fact, the more ignorant judge more frequently and more willingly than others. But “judging” presupposes “an assessment”; that is, judging on the basis of a system or a set of values, and these values presuppose a conception of the world, of life, and of humanity. Not only judgments, but also actions, depend on assessments and therefore also on these conceptions.
Like M. Jourdain in Moliere’s comedy, who wrote prose without knowing it, all men have their own “philosophy”, which is more or less simple and primitive, without calling it that; sometimes even without knowing what philosophy is! On the other hand, this philosophy, this conception of the world, is often not only rudimentary but also contradictory, as one would expect from the psychic complexity that we all have. Its characteristics change according to the moment, the individual state of mind or the sub-personality that is “on stage” in the theater of consciousness. André Maurois, who in his books shows a keen psychological intuition, although he is not a professional psychologist, has gone so far as to say that the normal man changes his philosophy ten times a day.
The individual’s conception of life should be taken into account, especially when he is ill. It is important to know what meaning he gives to life, or whether he believes that life has meaning. The psychological state of the person who believes that life has meaning and therefore value is very different from and more favorable than that of the individual who doubts or denies it. Frankl has proven this in his book From Death Camp to Existentialism (reprinted under the title Man’s Search for Meaning), in which he describes his own experiences and those of his companions during the months they spent in a concentration camp. He found that those who, like himself, were able and willing to give life a positive meaning survived, while the others did not.
The psychosomatic effect of how one perceives the world and life – in other words, the effect of the existential position or attitude with which one faces life – can be easily explained. This attitude is not just a mental conviction, but arouses emotions and feelings, often intense and sometimes even violent, as in the form of despair. Like other emotions and feelings, arising from any other cause, they provoke physical reactions, ie they cause psychosomatic disturbances.
I would like to make it clear, however, that psychosynthesis as a scientific concept and a biopsychotherapeutic technique does not take any metaphysical, and even less religious, stance. It attributes the highest value to these activities of the human spirit, but does not in any way attempt to invade their territory. It goes as far as the threshold of mystery and stops there. Therefore, everyone can approve and use it, regardless of faith and metaphysical stance.
Coming now to psychotherapeutic techniques, I would like to recall Freud’s clear expression of the difference between psychoanalysis and suggestion. The former, he emphasizes, is designed to remove blockages that exist in the unconscious; the latter is designed to introduce new psychic elements and content into the patient’s psyche.
Psychosynthesis fully recognizes the importance of both psychotherapeutic techniques and uses both to the maximum. However, due to its integrative and psychodynamic idea, it also uses many active techniques designed to:
1. Awaken latent energies, especially in the higher unconscious.
2. Develop the constitutionally weak psychological functions and those which have remained at an infantile stage.
3. Transform the overwhelming bio-psychic energies as well as those that cannot be released or expressed in a direct way.
4. Discipline and regulate (without suppressing or eliminating) the discharges of all psychic energies at every level, supporting their constructive and effective use and creative expression.
5. Harmonize the various functions and energies, thereby forming an integrated human personality.
6. Promote the individual’s functioning in society through harmonious interpersonal and group relationships.
This opportunity does not permit me to enumerate the many techniques used in psychosynthetic therapy to achieve these goals. There are more than forty. Some of them have been presented, and their indications and contraindications are discussed in my book, Psychosynthesis – A Manual of Principles and Techniques.
I will mention only one point that is of particular interest to psychosomatic medicine – the inclusion of the body in psychotherapy, or rather the integration of a strictly psychological method with the use of physiotherapeutic and physio-psychic techniques.
It can be said that there are two contradictory attitudes regarding the body. Many individuals identify themselves completely with the body and live a life largely consisting of various sensations, whereby the pleasures and pains of the body take on such an exaggerated importance for them that they become slaves to it. Their materialistic view leads to a tendency to attribute all their disorders to physical causes without recognizing the partial or total psychological background of many of them. And this is also true of many doctors!
There are, on the other hand, two categories of individuals in whom the opposite occurs. The first consists of those individuals who live almost exclusively in a world of emotions, feelings and imagination; the second group includes many students and cultured people – the “intellectuals”. None of these groups are interested in the body; they may ignore it and even often consider it a limitation, a burden. But this lack of attention and appreciation, this lack of “body awareness” and indifference to appropriate physical activity, leads to the weakening of the body and the emergence of various functional disorders.
All these cases indicate the use of psycho-physical techniques. The most effective exercises for achieving body awareness and gradual control are relaxation techniques and autogenic training – which receive appropriate attention during the “Psychosomatic Week”.
Furthermore, there are all the activities that are intended to develop psycho-neuromuscular coordination: gymnastics; harmonious rhythmic movements and classical dance (not modern); various kinds of sports such as golf, tennis, baseball and even to some extent football. All these techniques are used in bio-psychosynthetic therapy. They are selected in accordance with the specific requirements of the overall treatment program.
I would now like to draw attention to the last important point. Psychosynthetic therapy does not limit itself to the use of techniques, however numerous they may be. It fully recognizes the therapeutic importance (but also the danger of the illness being imaginary) of the doctor-patient relationship. The influence of the doctor’s personality is complex and difficult to define. A considerable number of doctors have drawn attention to it: let me point out Maeder, Tochtermann, and Tournier among many. Dr. Balint has recently dealt with the subject at length and will shortly tell us about it from his vast experience. In this case too, the effective use of this influence does not depend on a deep understanding of its nature.
Four main types of doctor-patient relationships can be distinguished in psychosynthesis. Each is used, controlled, and targeted according to the purpose of the treatment. (I have described these relationships in a lecture that was part of a course given at the Istituto di Psicosintesi in 1966 and later published in the monograph CG Jung and Psychosynthesis (New York: Psychosynthesis Research Foundation, 1967)).
In the few minutes I have left I can only mention two other important areas in which psychosynthesis can make important contributions. The first area is the therapeutic group. Its real usefulness, but also the not inconsiderable difficulties associated with it, have been demonstrated in an interesting experiment carried out at the Tavistock Clinic in London. Dr. Balint has given a detailed description of this in his valuable book The Doctor, His Patient and the Illness (London: Pitman Medical Publications Co., 1957). The second area, group therapy in its various forms, is now in a process of extensive development and has expanded to such an extent that it is now called socio-therapy.
Psychosynthesis, through its development in the interpersonal and social fields, has included and developed a variety of techniques, both to eliminate conflicts between individuals and groups, and between groups themselves. Instead, conflicts are to be replaced by harmonious and constructive relationships. The overall goal is to promote and achieve development and integration of all aspects of human life, resulting in ever-expanding and inclusive wholes.
It is this spirit that animates bio-psychosynthesis and its ideal goal.
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