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A holistic psychotherapy must incorporate the best elements from all the different approaches – existentialist, psychoanalytic and transpersonal psychotherapies. Roberto Assagioli provides an outline in this article.
By Roberto Assagioli MD, Translation Kirsten Hansen
Lecture given at the “Sixth International Congress of Psychotherapy, London, England, August 1964”.
At present, in psychotherapy one can observe many different methods which at first sight seem to be opposites. There is no need to list them; they are well known. I will only note that they can be roughly divided into two groups or classes, which represent two different conceptions and implementations.
Broadly speaking, one method can be described as existential psychotherapy , because it emphasizes the importance of the patient’s existential life problem or problems, and aims to help him first discover and then solve them. This group includes various forms of therapy that are based on depth psychology. In general, these therapies place great emphasis on the living relationship and interaction between therapist and patient (the “encounter”).
The second group includes a large number of specialized techniques, each of which aims to eliminate the patient’s symptoms or a specific problem.
Both types of psychotherapy have their respective usefulness and limitations. The value of the existential approach is that it goes deeper to the core of the patient’s problem, which is connected with his whole personality. It involves his attitude towards life, and aims to correct and change it in a constructive way. Mainly through the influence of the therapist himself. The limitation of this method is that it does not actively help the patient to use his newly gained insight, to change and reshape his life and his relationships with others in accordance with this insight. The patient may accept the new view of life, but find it difficult or be unable to practice it.
The opposite can be said of the specific techniques. They are valuable and effective in eliminating a number of symptoms. They can make the patient discover and use his own latent resources, but in general the techniques do not go deep enough. They do not remove the real cause or origin of the symptom, which is therefore liable to return. We refer to techniques such as suggestion and auto-suggestion, hypnosis, “autogenic training” in its more technical aspect, and other active training methods.
Different therapeutic approaches must be combined
Each group has its own particular advantages, and therefore they should be combined in a comprehensive psychotherapy. This combination, however, must take place and be applied individually in each individual case. Let us always recognize and bear in mind that patients are very different. The causes of their disturbances are therefore correspondingly different. Some cases can be called “Freudian” because the cause of the disturbances is in accordance with Freud’s interpretation; but many others do not fit into this pattern. Their problems, conflicts and resulting difficulties can be better understood in the light of the descriptions and interpretations given by Adler, Jung, Horney, Frankl etc. respectively. Of course, there are no fixed rules for a division, because a combination of different causes can often be seen to varying degrees. These individual differences require a differentiated treatment, which consists of a combination of different methods adapted to each individual case and the phase of each treatment.
In short, the various tasks and goals of a treatment where different methods merge into a higher unity are as follows: First, the direct causes of the problem must be found and eliminated, and then the symptoms are cured. Second, the physical, psychological and environmentally dependent conditions that may be the cause of a recurrence of the problems must be removed. Third, the consequences of the disease must be eliminated. Fourth, the patient must be helped to use his drives in a constructive way, so that new inner conflicts and/or antisocial behavior do not arise. Fifth, all latent abilities and possibilities must be awakened and utilized to the fullest, especially the higher abilities that are found latent in the superconscious.
The phases of psychotherapy
The following is the general course of a complete psychotherapeutic treatment. The first phase is a thorough assessment of the patient’s personality. It includes both an overview of all the conscious aspects and an examination of the different layers or levels of the unconscious. This assessment brings to light the patient’s central existential problem or problems; but the therapist must process, synthesize, and interpret the material in this light. This requires a knowledge of the patient’s general conception of life; his value norm or norms (we use the plural because he often has different and conflicting value norms); his main goals; frustrations, conflicts. This existential situation is different for each patient. Although many conditions and problems seem to be the same in many individuals and groups, the particular combination with different mutual proportions is unique.
After recognizing the existential problems, the therapist must find the most appropriate solutions. In many cases, they are not difficult to discover because they are indicated in the very nature of the problem. It is not easy – and sometimes very difficult – to effect the solution, that is, to make the patient arrive at it both internally and externally.
The first step towards this realization is the patient’s recognition of the solution, his conviction that the elimination of his disturbances is found here. When the patient and the therapist have reached agreement on this point, the various steps, means and ways to achieve the imagined goal must be planned . At each stage the therapist must secure the patient’s understanding, acceptance and willing cooperation.
The elimination of obstacles, the dissolution of complexes, the removal of repressions is the first task of the active part of the treatment. It can be called the psychoanalytic phase in the strictest sense of the word or the cathartic phase. In many cases it is sufficient to give the patient a feeling of relief and to bring a number of symptoms to an end. But experience has repeatedly shown that this is not enough.
The next task is to control and use the drives, and especially the energies released by the elimination of complexes and blockages. It should be strongly emphasized that the control of the drives is not the same as their condemnation or repression. It is a matter of necessary regulation . The energies must be expressed in a harmless way or, if possible, used for constructive purposes by channeling, transforming and sublimating. This is especially necessary for the aggressive and sexual drives.
The development of the deficient functions is a different and in a sense opposite task, requiring the use of other techniques. The patient’s lack of balance is frequently part of the problem, i.e. a lack of proper development of certain basic human functions. In some cases, especially in men, it may be the emotional function; in other cases it may be the mental function. Often it is the regulation and synthesis of the will that is lacking (although this is rarely recognized). Here it is necessary to use active techniques and systematic training .
A task that is partly similar and partly different is the activation and use of latent energies and abilities . It is increasingly recognized that everyone has unused opportunities and talents, which often have great human and spiritual value. It has been found that a fundamental reason for the patient’s condition is that in many cases there is a feeling of having such opportunities without being able to bring them to light and realize them. This feeling gives a feeling of frustration and inferiority, which can lead to depression, rebellion and be the cause of several psychological and psychosomatic problems.
Sometimes these superconscious abilities and energies are awakened and their entry into consciousness occurs spontaneously in the form of artistic inspiration, religious experiences, etc. The problem is to help the individual assimilate and use these harmoniously and balancedly.
The goals of psychotherapy
The methods available to solve these different tasks are many and diverse, and they can be applied pragmatically, independently of the theories and systems with which they have been and continue to be associated.
The use of these techniques requires a certain amount of willpower from the patient; therefore, an important part of the treatment is to help the patient with appropriate methods (which are available) to awaken, develop, and use the will wisely . This is of great value to all people including therapists!
The above different goals should not be kept separate and pursued individually, so to speak. They should be coordinated so that they are united towards the achievement of the individual’s psychosynthesis , i.e. the building of an integrated, harmoniously functioning personality, in other words, complete self-actualization .
Such an individual psychosynthesis inevitably includes right and harmonious interpersonal and intergroup relations . No individual lives in isolation; there is constant interaction between him and other individuals and groups. Moreover, the rapid development of communication – both tangible and psychological – has extended this interaction to an ever-growing environment – in fact to all of humanity. Therefore, the therapist must help the patient to establish such right and harmonious relations. This is by no means an easy task, because these relations depend not only on the patient but also on the people and groups who influence and often exert undue pressure on him. In many cases, the therapist must directly or indirectly treat other members of the patient’s family.
Of course, the therapist cannot change groups and the generally disharmonious conditions characteristic of modern society; a society which can be considered pathological. But every therapist can make every effort to identify the psychological illnesses of modern society through personal influence, lectures, written works, etc., and to suggest solutions. Some therapists, such as Erich Fromm, do this consciously.
Psychotherapists must establish good collaborative relationships themselves
In any case, it would be good if psychotherapists would first establish a harmonious relationship and proper cooperation among themselves . This means, first of all, recognizing that every partial point of view must be taken into account; as Leibnitz said about the different philosophical schools – true in what they affirm and false in what they exclude and deny. It should be recognized that every school, movement, point of view and technique has both its value and its limitation; therefore, knowledge, recognition and use by all or most of them are required. This makes it possible for therapists to have a fruitful cooperation among themselves, and also between therapists and other humanitarian workers such as social workers and representatives of the different religions. This is already happening in various groups and societies; for example, the “Academy of Religion and Mental Health in America” was established for this purpose and is very active.
In short, this is the scope and goal of psychosynthesis in psychotherapy.
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Also read the article Psychosynthesis an integral psychology
