Chapter Three
The observations from psychedelic research and other forms of experiential self-exploration have made it possible to bring an element of clarity and simplification into the hopeless labyrinth of conflicting and competing systems of psychotherapy.1 Even a cursory look at Western psychology reveals fundamental disagreements and controversies of enormous proportions concerning the basic dynamics of the human mind, the nature of emotional disorders, and techniques of psychotherapy. This is true not only for schools that are products of a priori incompatible philosophical approaches, such as behaviorism and psychoanalysis, but also for those orientations with founders who originally started from the same or very similar premises. This can be best illustrated by comparing the theories of classical psychoanalysis formulated by Sigmund Freud and the conceptual systems of Alfred Adler, Wilhelm Reich, Otto Rank, and Carl Gustav Jung, all of whom were initially his admirers and devoted disciples.
This situation gets even more complicated when we take into consideration the psychological systems developed by the major spiritual traditions in both East and West, such as various forms of yoga, Zen Buddhism, Vipassana, Vajrayana, Taoism, Sufism, alchemy, or Kabbalah. There is an abysmal gap between most Western schools of psychotherapy and these refined and sophisticated theories of the mind based on centuries of a deep study of consciousness.
Observations of systematic changes in the content of psychedelic experiences related to variations in dosage and to the increasing number of serial sessions have helped to resolve some of the most striking contradictions in a rather unexpected way. In psycholytic therapy, a typical patient would confront in the initial LSD sessions a variety of biographical issues. During this recollective-analytical work, much of the experiential material could be interpreted in terms of classical psychoanalysis. Occasionally, the nature of the biographical experiences was such that they rendered themselves equally well, or better, to interpretations in Adlerian terms. Certain aspects of the transference dynamics during psychedelic sessions, and particularly in the periods following drug experiences, have important interpersonal components that can be understood and approached through Sullivan’s principles.
However, once the subjects moved beyond this ‘Freudian” stage, the sessions focused on a profound experiential confrontation with death and on reliving biological birth. At this point, the Freudian system became useless for the understanding of the processes involved. Certain aspects of the death-rebirth process, particularly the significance of death and the crisis of meaning, allowed for interpretation in terms of existential philosophy and psychotherapy. Orgiastic discharges of energy and the resulting dissolution of the muscular “character-armor”—which, in a less dramatic form, occurs also during the biographical stage—reach extreme dimensions during the perinatal process. With some modifications, the theoretical concepts and therapeutic maneuvers developed by Wilhelm Reich can prove extremely useful for dealing with this aspect of the psychedelic experience.
The central element in the complex dynamics of the death-rebirth process seems to be reliving the biological birth trauma. Its significance for psychology and psychotherapy was discovered and discussed by Otto Rank in his pioneering book, The Trauma of Birth (1929). Although Rank’s understanding of the nature of this trauma does not exactly coincide with the observations from psychedelic work, many of his formulations and insights can be of great value when the process focuses on the perinatal level. Because of this, I sometimes refer to this stage of psychedelic therapy as “Rankian”; this does not accurately reflect clinical reality, since the death-rebirth process involves much more than just a reliving of biological birth.
Jungian psychology has been well aware of the importance of psychological death and rebirth and has studied carefully various cultural variations of this theme. It is extremely useful in approaching the specific content of many perinatal experiences, particularly the nature of mythological images and themes that frequently occur in this context. However, it seems to miss the relationship of this pattern to the biological birth of the individual and the important physiological dimensions of this phenomenon. The participation of archetypal elements in the death-rebirth process reflects the fact that deep experiential confrontation with the phenomena of death and birth typically results in a spiritual and mystical opening and mediates access to the transpersonal realms. This connection has its parallels in the spiritual and ritual life and practices of various cultures all through the ages, such as the shamanic initiations, rites of passage, meetings of ecstatic sects, or the ancient mysteries of death and rebirth. In some instances, one of the symbolic frameworks used by these systems can be more appropriate for the interpretation and understanding of a particular perinatal session than an eclectic combination of Rankian, Reichian, existentialist, and Jungian concepts.
Once the psychedelic sessions move into the transpersonal realms, beyond the gateway of birth and death, Jungian psychology and, to some extent, Assagioli’s psychosynthesis are the only schools of Western psychology that have genuine understanding of the processes involved. At this point, the LSD experiences have a philosophical, spiritual, mystical, and mythological emphasis. Coming from Western psychological and psychiatric tradition, I tend to refer to this stage of the psychedelic therapy as “Jungian,” although Jungian psychology does not cover many of the phenomena that occur in this context. Psychotherapy on this level is indistinguishable from the spiritual and philosophical quest for one’s cosmic identity. Various forms of perennial philosophy and the associated spiritual and psychological systems provide excellent guidance at this advanced stage, both for the client and the therapist, if those terms are still appropriate for two individuals who have now become fellow seekers and travelers.
So far I have focused on the changes in the content of the sessions with the increasing number of exposures to the drug; however, a similar progression can be demonstrated in regard to increasing dosage. Thus, smaller dosages tend to reach the biographical level, perhaps in combination with some abstract sensory experiences. A higher dose usually leads to a confrontation with the perinatal level and gives the individual a better chance to connect with the transpersonal realms. Here we can speak of levels of a psychedelic experience, rather than stages of the transformative process. These relations can be observed only in the initial psychedelic sessions; an individual who has thoroughly worked through the biographical material and integrated the perinatal contents will in subsequent sessions respond to even smaller dosages with transpersonal experiences. In this case the dosage will be related to the intensity of the experience and not its type.
According to my experience, the above observations—although first made in the context of psychedelic therapy—are equally applicable to nondrug experiential approaches. Thus less powerful techniques will allow exploration of biographical realms, whereas more potent procedures can connect the individual to the perinatal process or mediate access to transpersonal realms. Similarly, systematic use of an effective experiential technique will typically result in a progression from biographical issues through the death-rebirth process to transpersonal self-exploration. It is not necessary to emphasize that this statement should be interpreted in statistical terms; in individual cases, this development is not necessarily linear, and it is also critically dependent on the specific characteristics of the techniques used, on the orientation of the therapist, the personality and attitude of the client, and the quality of the therapeutic relationship.
These observations indicate clearly that the confusing situation in Western psychology, with its almost inpenetrable jungle of rival schools, can be vastly simplified by the realization that they are not all talking about the same subject. As was brought out in connection with spectrum psychology, there are different realms in the psyche and different levels of consciousness, each of which has specific characteristics and laws. The phenomena of the psyche in its totality cannot therefore be reduced to simple common denominators of general validity and applicability, especially not to a few basic biological and physiological mechanisms. In addition, the world of consciousness has not only many levels, but many dimensions. For that reason, any theory that is limited to the Newtonian-Cartesian model of the world and to linear description is bound to be incomplete and fraught with inner inconsistencies. It is also likely to be in conflict with other theories that emphasize different fragmentary aspects of reality without explicitly knowing that they are doing so.
Thus, the major problem in Western psychotherapy seems to be that, for various reasons, individual researchers have focused their attention primarily on a certain level of consciousness and generalized their findings for the human psyche as a whole. For this reason, they are essentially incorrect, although they may give a useful and reasonably accurate description of the level they are describing, or one of its major aspects. Therefore, although many of the existing systems can be utilized during certain stages of the process of experiential self-exploration, none is sufficiently encompassing and complete to justify its use as an exclusive tool. Truly effective psychotherapy and self-exploration requires a broad theoretical framework based on recognition of the multilevel nature of consciousness that would transcend the sectarian chauvinism of the present approaches.
The following discussion will cover specific insights into the concepts of the major schools of psychotherapy, based on observations from deep experiential work both with and without psychedelic drugs. After a brief delineation of each of these systems, I will point out its major theoretical and practical problems, areas of disagreement with other schools, and the revisions or reformulations necessary for its integration into a comprehensive theory of psychotherapy.
The discovery of the basic principles of depth psychology was the remarkable achievement of one man, the Austrian psychiatrist Sigmund Freud. He invented the method of free association, demonstrated the existence of an unconscious mind and described its dynamics, formulated the basic mechanisms involved in the etiology of psychoneurosis and many other emotional disorders, discovered infantile sexuality, outlined the techniques of dream interpretation, described the phenomenon of transference, and developed the basic principles of psychotherapeutic intervention. Since Freud explored singlehandedly the territories of the mind previously unknown to Western science, it is understandable that his concepts kept changing as he confronted new problems.
However, one element that remained constant during all these changes was Freud’s deep need to establish psychology as a scientific discipline. He started his work with a firm belief that science will eventually introduce order and clear understanding into the apparent chaos of mental processes and explain them in terms of brain functions. Although he found the task of translating mental phenomena into physiological processes an insurmountable one and subsequently resorted to purely psychological techniques of exploration, he never lost the perspective of this ultimate goal. He was always open to the idea that psychoanalysis would have to adjust to new scientific discoveries, whether within psychology itself or in physics, biology, or physiology. It is, therefore, interesting to explore which of Freud’s ideas withstood the test of new discoveries and which of them require fundamental revision. Some of these revisions reflect the limitations inherent in the Newtonian-Cartesian paradigm and the drastic change that has taken place in basic philosopical and metaphysical foundations of science since Freud’s time. Others are due more specifically to his own personal limitations and cultural conditions.
It deserves special attention in this connection that Freud was deeply influenced by his teacher Ernst Bruecke, founder of the scientific movement known as the Helmholtz School of Medicine. According to his view, all biological organisms were complex systems of atoms governed by strict laws, particularly the principle of the conservation of energy. The only forces active in biological organisms were the physicochemical processes inherent in matter, which could ultimately be reduced to the force of attraction and repulsion. The explicit goal and ideal of the movement was to introduce the principles of Newton’s scientific thinking into other disciplines. It was in the spirit of the Helmholtz school that Freud modeled his description of psychological processes after Newton’s mechanics. The four basic principles of the psychoanalytic approach—dynamic, economic, topographical, and genetic—exactly parallel the basic concepts of Newtonian physics.
The Dynamic Principle. In Newton’s mechanics, material particles and objects are moved around by forces that are different from matter: their collisions are governed by specific laws. Similarly, in psychoanalysis all mental processes are explained in terms of interaction and collisions of psychological forces. These can potentiate each other, inhibit each other, or be in conflict and create various compromise formations. They manifest definite directions, moving toward motor expression or away from it. The most important of the forces contributing to mental dynamics are instinctual drives. Newton’s principle of action and reaction was also adopted by Freud, and it deeply influenced his thinking concerning opposites. His tendency to describe various aspects of mental functioning as a series of contrasting phenomena has been seen by some psychoanalysts as a serious conceptual limitation.
The Economic Principle. The quantitative aspect of Newtonian mechanics became a major factor in its pragmatic success and scientific prestige. Masses, forces, distances, and velocities could be expressed in the form of measurable quantities and their interrelations and interactions represented by mathematical equations. Although Freud could not even remotely approach these rigid criteria of physics, he often emphasized the importance of the energetic economy in psychological processes. He attributed to the mental representations of instinctual drives, and to the forces opposing them, charges of definite quantities of energy, or cathexis. The distribution of energy between input, consumption, and output was of crucial significance. The function of the mental apparatus was to prevent a damming of these energies and to keep the total amount of excitation as low as possible. The quantity of excitation was seen as the driving force behind the pleasure-pain principle that played an important role in Freud’s thinking.
The Topographical or Structural Principle. Whereas in modern physics separate material entities of the phenomenal world appear as inseparably interconnected dynamic processes, Newtonian mechanics deals with individual material particles and objects that occupy Euclidean space and interact in it. Similarly, in Freud’s topographical descriptions, dynamic processes that are intimately interwoven appear as specific individual structures of the psychic apparatus that interact with each other in psychological space with Euclidean properties. Freud on occasion warned that such concepts as id, ego, and superego are just abstractions that should not be taken literally and referred to every attempt to relate them to specific cerebral structures and functions as “brain mythology” (Gehirnmythologie). However, in his writings they have all the characteristics of Newtonian material objects—extension, mass, position, and movement. They cannot occupy the same space and thus cannot move without displacing each other. They impose on each other and get involved in collisions; they can be suppressed, overwhelmed, and demolished. The extreme of this approach is the concept that the amount of libido and even love is limited. In classical analysis, object love and self-love are in conflict and compete with each other.
The Genetic or Historical Principle.2 One of the most characteristic features of Newtonian mechanics is its strict determinism; collisions between particles and objects occur in linear chains of cause and effect. The spatiotemporal description of events and their causal description are united and combined into a visualizable trajectory. The initial conditions of the system thus uniquely determine its state at all later times. In principle—if all variables were known— the complete knowledge of the present condition of the studied system should allow for its description at any point in the past and future.
The notion of strict determinism of mental processes was one of Freud’s major contributions. Every psychological event was seen as the result of and, at the same time, the cause of other events. The psychogenetic approach of psychoanalysis tries to explain the experiences and behavior of the individual in terms of previous ontogenetic stages and modes of adaptation. A complete understanding of present behavior requires exploration of its antecedents, particularly the psychosexual history of early childhood. The individual’s experiences in successive stages of libidinal development, solution of the childhood neurosis, and conflicts about infantile sexuality thus critically determine all subsequent life. Like Newtonian mechanics, classical psychoanalysis uses the concept of a visualizable trajectory in regard to instinctual drives involving source, impetus, aim, and object.
Another important characteristic that psychoanalysis shares with Newtonian-Cartesian science is the concept of the objective and independent observer. As in Newtonian physics, the observation of the patient can take place without any appreciable interference. Although this concept has been modified considerably in ego psychology, in classical psychonalysis the patient’s life continues to be determined during therapy quite uniquely by the initial historical-psychogenetic conditions.
Following this account of the general principles on which psychoanalysis is built, we can outline its most important specific contributions. They can be divided into three thematic categories: the theory of instincts, the model of the psychic apparatus, and the principles and techniques of psychoanalytic therapy. By and large, Freud believed that the psychological history of the individual begins after birth; he referred to the newborn as a tabula rasa (a “blank” or “erased tablet”). He occasionally mentioned the possibility of vague constitutional predispositions or even archaic memories of a phylogenetic nature. According to him, the little boy’s fantasy of castration might be a remnant from times when cutting off the penis was actually used as punishment, or certain totemistic elements in the psyche might reflect the historical reality of brutal patricide by a fraternal coalition. Similarly, certain aspects of dream symbolism cannot be explained from the individual’s life experience and seem to reflect an archaic language of the psyche. However, for all practical purposes, the mental dynamics can be understood in terms of biographical factors, beginning with the events from early childhood.
Freud ascribed a critical role in mental dynamics to instinctual drives that he saw as forces bridging between the psychic and somatic spheres. In the early years of psychoanalysis, Freud postulated a basic dualism involving the sexual drive, or libido, and the nonsexual ego instincts related to self-preservation. He believed that mental conflicts resulting from the clash between these instincts were responsible for psychoneuroses and a variety of other psychological phenomena. Of the two instincts, the libido attracted much more of Freud’s attention and received preferential treatment.
Freud (1953a) discovered that the origins of sexuality lie in early childhood and formulated a developmental theory of sex. According to him, the psychosexual activities start during nursing when the mouth of the infant functions as an erogenous zone (oral phase). During the period of toilet training the emphasis shifts, first, to sensations associated with defecation (anal phase) and, later, with urination (urethral phase). Finally, around the age of four, these pregenital partial drives become integrated under the domination of genital interest involving the penis or clitoris (phallic phase). This also coincides with the development of the Oedipus or Electra complex, a predominantly positive attitude toward the parent of the opposite sex and an aggressive stance toward that of the same sex. At this time, Freud attributes a crucial role to the overvaluation of the penis and the castration complex. The boy gives up his Oedipal tendencies because of castration fears. The girl moves from her primary attachment to her mother toward the father because she is disappointed by the “castrated” mother and hopes to achieve a penis or child from her father.
Overindulgence in erotic activities or, conversely, frustrations, conflicts, and traumas interfering with them, can cause fixation on different stages of libidinal development. Such fixation and a failure to resolve the Oedipal situation may result in psychoneuroses, sexual perversions, or other forms of psychopathology. Freud and his followers developed a detailed dynamic taxonomy linking different emotional and psychosomatic disorders to specific vicissitudes of libidinal development and of the maturation of the ego. Freud also traced difficulties in interpersonal relationships to factors interfering with the evolution from the stage of primary narcissism of the infant, characterized by self-love, toward differentiated object relations, where the libido is invested in other people.
During the early stages of his psychoanalytical explorations and speculations, Freud put great emphasis on the pleasure principle, or an inborn tendency to seek pleasure and avoid pain, as the main regulatory principle governing the psyche. He related pain and distress to an excess of neuronal stimuli and pleasure to the discharge of tension and reduction of excitation. The counterpart of the pleasure principle, then, was the reality principle, a learned function reflecting the demands of the external world and necessitating delay or postponement of immediate pleasure. In his later investigations, Freud found it increasingly difficult to reconcile clinical facts with the exclusive role of the pleasure principle in psychological processes.
Originally, he considered aggression largely in terms of sadism, believing that it manifests itself at every level of psychosexual development in the context of partial instincts. Since aggression had some clearly nonsexual aspects, he classified it for some time as an ego instinct. Later he distinguished nonsexual aggression and the hate that belonged to the ego instincts from the libidinal aspects of sadism that were clearly related to the sexual instinct. Sadism itself was then seen as a fusion of sex and aggression due primarily to frustration of desires.
However, Freud had to face an even more serious problem. He became aware of the fact that in many instances aggressive impulses were not serving the purpose of self-preservation and, therefore, should not be attributed to the ego instincts. This was quite obvious in the case of the self-destructive tendencies of depressed patients, including suicide, automutilations occurring in certain mental disorders, self-inflicted injuries among masochistic individuals, the inexplicable need to suffer manifested by the human psyche, the repetition compulsion involving self-damaging behavior or painful consequences, and wanton destructiveness normally occurring in small children.
Consequently, Freud decided to treat aggression as a separate instinct the source of which was in the skeletal muscles, and the aim, destruction. This gave the final touch to an essentially negative image of human nature depicted by psychoanalysis. According to this view, the psyche is not only driven by base instincts, but it contains destructiveness as its intrinsic and essential component. In Freud’s earlier writings, aggression was seen as a reaction to frustration and to thwarting of libidinal impulses.
In his late speculations, Freud postulated the existence of two categories of instincts—those that serve the goal of preserving life and those that counteract it and tend to return it to an inorganic condition. He saw a deep relationship between these two groups of instinctual forces and the two opposing trends in the physiological processes of the human organism—anabolism, and catabolism. Anabolic processes are those that contribute to growth, development, and storage of nutriments; catabolic processes are related to the burning of metabolic reserves and to expenditure of energy.
Freud also linked the activity of these drives to the destiny of two groups of cells in the human organism—germinal cells, which are potentially eternal, and regular somatic cells that are mortal. The death instinct operates in the organism from the very beginning, gradually converting it into an inorganic system. This destructive drive can and must be partially diverted from its primary self-destructive aim and be directed against other organisms. It seems to be irrelevant whether the death instinct is oriented toward objects in the external world or against the organism itself, as long as it can achieve its goal, which is to destroy.
Freud’s final formulations concerning the role of the death instinct appeared in his last major work, An Outline of Psychoanalysis (1064). There the basic dichotomy between two powerful forces, the love instinct (eros) and the death instinct (thanatos), became the cornerstone of his understanding of mental processes—a concept that dominated Freud’s thinking in the last years of his life. This major revision of psychonalytic theory generated little enthusiasm among Freud’s followers and has never been fully incorporated into mainstream psychoanalysis. Rudolf Brun (1953), who has conducted an extensive statistical review of papers concerned with Freud’s theory of the death instinct, found that most of them were clearly unfavorable to Freud’s concept. Many of the authors have considered Freud’s interest in death and the incorporation of thanatos into the theory of instincts as an alien enclave in the development of his psychological framework. There have also been inferences that intellectual decline in old age and personal factors were the basis for this unexpected dimension in Freud’s thinking. His later ideas have been interpreted by some as a result of his own pathological preoccupation with death, his reaction to the cancer that was afflicting him, and the demise of close family members. Brun, in the aforementioned critical study, suggested that Freud’s theory of the death instinct was also deeply influenced by his reaction to mass killing during the First World War.
Freud’s early topographical theory of the mind, outlined at the beginning of this century in his Interpretation of Dreams (1953b), was derived from analysis of dreams, of the dynamics of psycho-neurotic symptoms, and of the psychopathology of everyday life. It distinguishes three regions of the psyche that are characterized by their relationship to consciousness—the unconscious, the pre-conscious, and the conscious. The unconscious contains elements that are essentially inaccessible to consciousness and can become conscious only through the preconscious which controls them by means of psychological censorship. It contains mental representations of instinctual drives that had once been conscious, but were unacceptable and therefore banned from consciousness and repressed. All the activity of the unconscious is to pursue the pleasure principle—to seek discharge and wish fulfillment. For this purpose it uses the primary-process thinking that disregards logical connections, has no conception of time, knows no negatives, and readily permits contradictions to coexist. It attempts to reach its goals by means of such mechanisms as condensation, displacement, and symbolization.
The preconscious contains those elements that, under certain circumstances, are capable of surfacing into consciousness. It is not present at birth, but develops in childhood in connection with the evolution of the ego. It is aimed at avoiding unpleasantness and delaying instinctual discharge; for this purpose, it uses the secondary-process thinking governed by logical analysis and reflecting the reality principle. One of its important functions is to execute consorship and to repress instinctual desires. The system—conscious then, is related to the organs of perception, to controlled motor activity, and to the regulation of a qualitative distribution of psychic energy.
This topographical theory encountered serious problems. It became obvious that the defense mechanisms warding off pain or unpleasantness were themselves initially not accessible to consciousness; hence the agency of repression could not be identical with the preconscious. Similarly, the existence of unconscious needs for punishment contradicted the concept that the moral agency responsible for repression was allied with preconscious forces. In addition, the unconscious clearly contained some archaic elements that had never been conscious, such as primordial fantasies of a phylogenetic nature and certain symbols that could not possibly have been generated by personal experience.
Eventually, Freud replaced the concept of system-conscious and system-unconscious by his famous model of the mental apparatus, which postulated dynamic interplay of three separate structural components of the psyche—id, ego, and superego. Here the id represents a primordial reservoir of instinctual energies that are ego-alien and governed by the primary process. The ego retains its original close connection to consciousness and external reality, yet it performs a variety of unconscious functions, warding off id impulses by specific mechanisms of defense.3 In addition, it also controls the apparatus of perception and motility. The superego is the youngest of the structural components of the mind; it comes fully into being with the resolution of the Oedipus complex. One of its aspects represents the ego ideal, reflecting the attempt to recover a hypothetical state of narcissistic perfection that existed in early childhood and positive elements of identification with the parents. The other aspect reflects the introjected prohibitions of the parents backed by the castration complex; this is conscience or the “demon.” Characteristically, the striving toward masculinity in the boy and femininity in the girl leads to a stronger identification with the superego of the parent of the same sex.
The operations of the superego are mainly unconscious; in addition, Freud noticed that a certain aspect of the superego is savage and cruel, betraying its unmistakable origins in the id. He made it responsible for extreme self-punishment tendencies and self-destructive tendencies observed in certain psychiatric patients. More recent contributions to Freudian theory have emphasized the role in the development of the superego of the drives and object attachments formed in the pre-oedipal period. These pregenital precursors of the superego reflect projections of the child’s own sadistic drives and a primitive concept of justice based on retaliation.
Freud’s revised model of the mind was associated with a new theory of anxiety, the symptom that represents the fundamental problem of dynamic psychiatry. His first theory of anxiety emphasized its biological basis in the sexual instinct. In the so-called actual neuroses—neurasthenia, hypochondriasis and anxiety neurosis— anxiety was attributed to inadequate discharge of libidinal energies as a result of abnormal sexual practices (abstinence or coitus interruptus ) and the consequent lack of appropriate psychic elaboration of sexual tensions.
In psychoneuroses, the interference with normal sexual functioning was due to psychological factors. In this context, anxiety was seen as a product of repressed libido. This theory did not take into consideration the objective anxiety that arises in response to realistic danger. It also involved a disquieting vicious circle in logical reasoning. Anxiety was explained in terms of repression of libidinal impulses; in turn, repression itself was caused by unbearable emotions, which certainly included anxiety.
Freud’s new theory of anxiety distinguished real from neurotic anxiety, both of them occurring as a response to danger to the organism. In real anxiety, the danger has a concrete, external source; in neurotic anxiety, the source is not known. In infancy and childhood, anxiety occurs as a result of excessive instinctual stimulation; later it arises in anticipation of danger, rather than as a reaction to it. This signal anxiety mobilizes protective measures— avoidance mechanisms to escape real or imagined danger from without, or psychological defenses to cope with the excess of instinctual excitation. Neuroses then result from partial failure of the defense system; a more complete breakdown of the defenses leads to disorders of psychotic proportions that involve greater distortions of the ego and of the perception of reality.
The psychoanalytical concept of the treatment situation, and of the actual therapeutic technique, shows equally strong influences of the Newtonian-Cartesian mechanistic science as Freudian theory. The basic therapeutic arrangement, with the patient lying on the couch and the invisible, detached therapist sitting behind his or her head, embodies the ideal of the “objective observer.” It reflects the deep-seated belief of mechanistic science that one can make scientific observations without interfering with the studied object or process.
The Cartesian dichotomy between mind and body finds its expression in psychoanalytic practice in its exclusive focus on mental processes. The physical manifestations are discussed during the psychoanalytic process as reflections of psychological events or, conversely, as triggers of psychological reactions. However, the technique itself involves no direct physical interventions. There is actually a strong taboo against any physical contact with the patient. Some psychoanalysts have even advised strongly against shaking hands with patients as a potential hazard from the point of view of the transference-countertransference process.
The mind-body split of Freudian psychoanalysis is complemented by a rigorous isolation of the problem from its broader interpersonal, social, and cosmic context. Psychoanalysts typically refuse to interact with, or otherwise include, spouses and other family members and disregard most of the social factors of their cases; further, they are closed to any genuine acknowledgment of transpersonal and spiritual factors in the dynamics of emotional disorders. The dynamic foundations of the observable external phenomena are the instinctual impulses striving for discharge and the various counterforces that inhibit them. The therapeutic efforts of the analyst are focused on eliminating the obstacles that prevent a more direct expression of these forces. In this analysis of resistance, he or she has to rely entirely on verbal tools.
The therapist has the task of reconstructing—from certain given manifestations—the constellation of forces that produced symptoms, allowing these forces to be reenacted in the therapeutic relationship and, by transference analysis, freeing the originally repressed infantile sexual strivings, turning them into adult sexuality and enabling them to participate in the development of the personality.
In a psychoanalytic session, the patient is in a passive, submissive, and highly disadvantageous situation. He or she lies on the couch, does not see the analyst, and is expected to free-associate and not to ask questions. The analyst has total control of the situation, seldom answers questions, chooses to be silent or interpret, and tends to refer to any disagreement as resistance on the part of the patient.4 The analyst’s interpretations, based on Freudian theory, explicitly or implicitly guide the process, keep it within the narrow limits of its conceptual framework, and leave no space for excursions into new territories. The therapist is expected to be uninvolved, objective, impersonal, and unresponsive and to control any indications of “counter-transference.”
The patient contributes free associations, but it is the therapist and his or her interpretations that are considered to be instrumental in therapeutic change. The therapist is seen as a mature and healthy individual possessing the necessary knowledge and therapeutic technique. The influence of the medical model in the psychoanalytic situation is thus very strong and clearly discernible in spite of the fact that psychoanalysis represents a psychological, not a medical approach to emotional disorders.
The primary focus of analysis is on the reconstruction of the traumatic past and its repetition in the present transference dynamics; it is thus based on a strictly deterministic, historical model. Freud’s understanding of improvement is quite mechanistic—it emphasizes freeing of pent-up energies and their use for constructive purposes (sublimation). The goal of therapy as explicitly described by Freud is indeed modest, particularly in view of the extraordinary investment of time, money, and energy: to “change the extreme suffering of the neurotic into the normal misery of everyday life.”
This outline of the basic concepts of classical psychoanalysis and its theoretical and practical vicissitudes provides a basis for considering Freud’s contributions in the light of the observations from deep experiential psychotherapy, particularly LSD research. In general, it is possible to say that psychoanalysis appears to be an almost ideal conceptual framework, so long as the sessions focus on the biographical level of the unconscious. If recollective-ana-lytical experiences were the only type of phenomena observed in this context, LSD psychotherapy could be considered to be almost a laboratory proof of the basic psychoanalytic premises.
The psychosexual dynamics and the fundamental conflicts of the human psyche as described by Freud are manifested with unusual clarity and vividness even in sessions of naive subjects who have never been analyzed, have not read psychoanalytic books, and have not been exposed to any other forms of explicit or implicit indoctrination. Under the influence of LSD, such subjects experience regression to childhood and even early infancy, relive various psychosexual traumas and complex sensations related to infantile sexuality, and are confronted with conflicts involving activities in various libidinal zones. They have to face and work through the basic psychological problems described by psychoanalysis, such as the Oedipus or Electra complex, the trauma of weaning, castration anxiety, penis envy, and conflicts around toilet training. The LSD work also confirms the Freudian dynamic cartography of psycho-neuroses and psychosomatic disorders and their specific connections with various libidinal zones and stages of ego development.
However, two major revisions must be introduced into the Freudian conceptual framework to account for certain important and common experiences from the biographical level of the unconscious. The first of these is the concept of dynamic governing systems, organizing emotionally relevant memories, for which I have coined the term COEX systems. (They have been briefly described in chapter 2; a more detailed discussion can be found in my book Realms of the Human Unconscious [1975].) The second revision involves the paramount significance of physical traumas, such as operations, diseases, or injuries, which Freudian psychology has not recognized. Such memories play an important role in the genesis of various emotional and psychosomatic symptoms in their own right, as well as by providing an experiential bridge to corresponding elements of the perinatal level.
However, these are minor problems that could be easily corrected. The fundamental fallacy of psychoanalysis is its exclusive emphasis on biographical events and on the individual unconscious. It tries to generalize its findings, which are highly relevant for one superficial and narrow band of consciousness, to other levels and to the totality of the human psyche. Thus, its major shortcoming is that it has no genuine recognition of the perinatal and transpersonal levels of the unconscious. According to Freud, the etiology and dynamics of emotional disorders is almost entirely explainable from the sequences of postnatal events.
Experiential therapies bring overwhelming evidence that childhood traumas do not represent the primary pathogenic causes, but create conditions for the manifestation of energies and contents from deeper levels of the psyche. The typical symptoms of emotional disorders have a complex multilevel and multidimensional dynamic structure. The biographical layers represent only one component of this complex network; important roots of the problems involved can almost always be found on the perinatal and transpersonal levels.
The incorporation of the perinatal level into the cartography of the unconscious has far-reaching consequences for psychoanalytic theory; it clarifies many of its problems and puts them in a very different perspective without invalidating the Freudian approach as a whole. The shift of emphasis from biographically determined sexual dynamics to the dynamics of the basic perinatal matrices (BPM) without rejecting most of the important findings of psychoanalysis is possible because of the deep experiential similarity between the pattern of biological birth, sexual orgasm, and the physiological activities in the individual erogenous zones (oral, anal, urethral, and phallic). The dynamic connections between these biological functions are graphically represented in table 1, page 103.
The awareness of perinatal dynamics and its incorporation into the cartography of the unconscious provide a simple, elegant, and powerful explanatory model for many phenomena that have represented a crux for the theoretical speculations of Freud and his followers. In the realm of psychopathology, psychoanalysis has failed to provide satisfactory explanations for the phenomena of sadomasochism, automutilation, sadistic murder, and suicide. It did not adequately tackle the puzzle of the savage part of the superego, which seems to be a derivative of the id. The concept of feminine sexuality, or femininity in general, as outlined by Freud represents without doubt the weakest aspect of psychoanalysis and borders on the bizarre and the ridiculous. It lacks any genuine understanding of the female psyche or the feminine principle and treats women essentially as castrated males. Further, psychoanalysis offers only superficial and unconvincing interpretations for an entire spectrum of phenomena occurring in psychiatric patients, a subject that will be taken up at length later.
In terms of a broader application of Freudian thinking to cultural phenomena, we can add its failure to provide a convincing explanation for a number of anthropological and historical observations, such as shamanism, rites of passage, visionary experiences, mystery religions, mystical traditions, wars, genocide, and bloody revolutions. None of these can be adequately understood without the concept of the perinatal (and transpersonal) level of the psyche. The general lack of efficacy of psychoanalysis as a therapeutic tool should also be mentioned as one of the serious shortcomings of this otherwise fascinating system of thought.
On a number of occasions, Freud’s genius came quite close to an awareness of the perinatal level of the unconscious. He discussed repeatedly some of its essential elements and many of his formulations dealt, although not explicitly, with problems intimately related to the death-rebirth process. He was the first one to express the idea that the vital anxiety associated with the trauma of birth might represent the deepest source and prototype for all future anxieties. However, he did not pursue this exciting idea any further, nor did he make an attempt to incorporate it into psychoanalysis.
Later, he opposed the speculations of his disciple, Otto Rank (1929), who published a drastic revision of psychoanalysis based on the paramount significance of this fundamental event of human life. In the writings of Freud and his followers, a surprisingly clear line is drawn between the interpretation and evaluation of prenatal, or perinatal, and postnatal events. The material in free associations or dreams that is related to birth or intrauterine existence is consistently called “fantasy” in contrast to material from postnatal time, which is usually seen as possibly reflecting memories of actual events. The exceptions to this rule are Otto Rank (1929), Nandor Fodor (1949), and Lietaert Peerbolte (1975), who have a genuine appreciation and understanding of perinatal and prenatal dynamics.
According to the literature of classic and mainstream psychoanalysis, death has no representation in the unconscious. Fear of death is interpreted alternately as fear of castration, fear of loss of control, fear of a powerful sexual orgasm, or death wishes toward another person, redirected by the relentless superego toward the subject (Fenichel 1945). Freud was never quite satisfied with his thesis that the unconscious or id does not know death, and he found it increasingly difficult to deny the relevance of death for psychology and psychopathology.
In his late formulations, he introduced the death instinct, or thanatos, into his theory as a counterpart at least equipotent to eros or libido. Freud’s approach to death does not accurately portray its role in the perinatal dynamics; he was rather far from the insight that, in the context of the death-rebirth process, birth, sex, and death form an inextricable triad and are intimately related to ego death. However, Freud’s recognition of the psychological significance of death was quite remarkable; here, as in many other areas, he was clearly far ahead of his followers.
The advantages of the model that includes perinatal dynamics are far-reaching. They not only offer a more adequate and comprehensive interpretation of many psychopathological phenomena and their dynamic interrelations, but they also bind these logically and naturally to anatomical, physiological, and biochemical aspects of the birth process. As I will discuss in detail later, the phenomenon of sadomasochism can be explained fairly easily from the phenomenology of BPM III, with its intimate connections among sex, pain, and aggression. The mixture of sexuality, aggression, anxiety, and scatology, which is another important characteristic of the third perinatal matrix, provides a natural context for the understanding of other sexual deviations and disturbances. On this level, sexuality and anxiety are two facets of the same process and neither can be explained from the other. This throws new light on Freud’s frustrating attempts to explain anxiety from repression of libidinal feelings and, in turn, repression from anxiety and other negative emotions.
BPM III is also characterized by an excessive generation of various instinctual impulses with a simultaneous blockage of external motor expression of any kind in the context of an extremely brutal, life-threatening, and painful situation. This appears to be the natural basis for the deepest roots of the Freudian superego, which is cruel, savage, and primitive. Its connection to pain, masochism, self-mutilation, violence, and suicide (ego death) is easily comprehensible and constitutes no puzzle or mystery if seen as an introjection of the merciless impact of the birth canal.
In the context of perinatal dynamics, the concept of dentate vagina —female genitals that can kill or castrate—considered by Freud a product of primitive infantile fantasy, represents a realistic assessment based on a specific memory. In the course of delivery, innumerable children have been killed, almost killed, or severely damaged by this potentially murderous organ. The connection of the dentate vagina to castration fears becomes obvious when these can be traced back to their actual source—the memory of the cutting of the umbilical cord. This clarifies the paradox of the occurrence of castration fears in both sexes, as well as the fact that, in their free associations, subjects in psychoanalysis equate castration with death, separation, annihilation, and loss of breath. The image of the dentate vagina thus involves a generalization from an accurate perception. It is this generalization, not the perception itself, that is inappropriate.
The recognition of the perinatal level of the unconscious eliminates a serious logical gap in psychoanalytical thinking that is hard to explain in view of the intellectual acuity of its representatives. According to Freud, his followers, and many theoreticians inspired by him, very early events that occurred during the oral period of the infant’s life can have profound influence on later psychological development. This is generally accepted even for influences that are of a relatively subtle nature. Thus, Harry Stack Sullivan (1955) expected the nursing infant to distinguish experiential nuances in the oral erogenous zone, such as a “good,” “evil,” and “wrong nipple.”5 How, then, could the same organism that is a connoisseur of female nipples possibly have missed experiencing, a few days or weeks earlier, the extreme conditions of delivery—life-threatening anoxia, extreme mechanical pressures, agonizing pain, and a whole spectrum of other alarming signals of vital danger? According to the observations from psychedelic therapy, various biological and psychological subtleties of nursing are of great importance. However, as one could expect from the above, the relevance of the birth trauma is of a far higher order. A certainty about the supply of life-giving oxygen is necessary before one can feel hunger or cold, notice whether the mother is present or absent, or distinguish the nuances of the nursing experience.
Birth and death are events of fundamental relevance that occupy a metaposition in relation to all the other experiences of life. They are the alpha and omega of human existence; a psychological system that does not incorporate them is bound to remain superficial, incomplete, and of limited relevance. The lack of applicability of psychoanalysis to many aspects of psychotic experiences, to a number of anthropological observations, to parapsychological phenomena, and to serious social psychopathology (such as wars and revolutions, totalitarianism, and genocide) reflects the fact that these aspects are characterized by substantial participation of perinatal and transpersonal dynamics and thus are clearly beyond the reach of classical Freudian analysis.
This description of psychoanalysis may not satisfy its contemporary practitioners, since, being limited to classical Freudian concepts, it does not take into consideration important recent developments in the field. In view of this, it is appropriate to touch on the theory and practice of ego psychology. The origins of ego psychology can be found in the writings of Sigmund Freud and Anna Freud. Over the last four decades, its present form was developed by Heinz Hartmann, Ernst Kris, Rudolph Loewenstein, René Spitz, Margaret Mahler, Edith Jacobson, Otto Kernberg, Heinz Kohut, and others (Blanck and Blanck 1965). The basic theoretical modifications of classical psychoanalysis include a sophisticated development of the concept of object relations, an appreciation of their central role in the development of the personality, and a focus on the problems of human adaptation, inborn ego apparatus, conflict-free zones in the psyche, average expectable environment, narcissism, and many others. Ego psychology considerably expands the spectrum of psychoanalytic interests, including, on the one hand, normal human development and, on the other, severe psychopathologies. These theoretical changes have also found their reflection in the therapeutic techniques. Such technical innovations as ego building, drive attenuation, and correction of distortion and structure, made it possible to extend psychotherapeutic work to patients with precarious ego strength and borderline psychotic symptomatology.
As significant as these developments are for psychoanalysis, they share with classical Freudian thought the serious limitation of its narrow biographical orientation. Since they do not recognize the perinatal and transpersonal levels of the psyche, they cannot reach a true comprehension of psychopathology; instead, they spin out refinements of concepts related to a layer of the psyche that is not sufficient for its understanding. Many borderline and psychotic states have significant roots in the negative aspects of perinatal matrices, or in the transpersonal domain.
By the same token, ego psychology cannot conceive of and utilize powerful mechanisms of healing and personality transformation that are available through experiential access to transindividual realms of the psyche. In light of the therapeutic strategies presented in this book, the main problem is not to protect and build up the ego through sophisticated verbal maneuvers, but to create a supportive framework within which it can be experientially transcended. The experience of ego death and the ensuing unitive experiences, both of a symbiotic-biological and transcendental nature, then become the sources of new strength and personal identity. Understanding of concepts and mechanisms of this kind is as far beyond the reach of ego psychology as it was for classical Freudian analysis.