The traditional definition of sanity and mental health involves as a fundamental postulate a perceptual, emotional, and cognitive congruence with the Newtonian-Cartesian image of the world, which is seen not only as an important pragmatic framework of reference, but also as the only accurate description of reality. More specifically, this means experiential identification with one’s physical body or the so-called body image, acceptance of three-dimensional space and irreversible linear time as objective and mandatory coordinates of existence, and the limitation of one’s sources of information to sensory channels and records in the material substrate of the central nervous system.
Another important criterion of the accuracy of all data about reality is the possibility of consensual validation by other persons who are mentally healthy or functioning normally by the above definition. Thus, if the data agreed upon by two or more individuals should represent a major departure from the conventional image of reality, the shared perception would still be described in pathological terms, such as folie à deux, folie à famille, superstition, mass suggestion, group delusion, or hallucination. Minor individual distortions of self-perception and the perception of other people in this sense would be referred to as neuroses, if they did not seriously challenge the essential Newtonian-Cartesian postulates. Substantial and critical deviations from the agreed-upon description of reality would be labeled psychoses.
Mental health is defined in terms of absence of psychopathology or psychiatric “disease”; it does not require active enjoyment or appreciation of existence and the life process. This can best be illustrated by Freud’s famous description of the goal of psychoanalytic therapy: to change the extreme neurotic suffering of the patient into the normal misery of everyday life. In this sense, an individual leading an alienated, unhappy, and driven existence, dominated by excessive power needs, competitive urge, and insatiable ambition could still fall within the broad definition of mental health, if he did not suffer from manifest clinical symptoms. In addition, in the general lack of clarity about the criteria of mental health, some authors would include such value-laden external indicators as fluctuation of income, changes of professional and social status, and “residential adjustment.”
Modern consciousness research has now generated abundant data indicating an urgent need for a revision of this approach. A new definition of healthy functioning would include as a critical factor the recognition and cultivation of the two complementary aspets of human nature—one’s existence as a separate material entity and as a potentially unlimited field of consciousness. I have already described the two corresponding experiential modes, the hylotropic and holotropic modes of consciousness (p. 345-6). According to this concept, a “mentally healthy” person functioning exclusively in the hylotropic mode, even though free from manifest clinical symptoms, is cut off from a vital aspect of his or her nature and does not function in a balanced and harmonious way. An individual with this orientation has a linear concept of existence dominated by survival programs and sees life in terms of exclusive priorities—myself, my children, my family, my company, my religion, my country, my race—unable to see and experience a unifying holistic context.
Such a person has a limited ability to draw satisfaction from the ordinary activities of everyday life and is obliged to resort to complicated schemes involving future plans. This results in an approach to life based on a sense of deficiency, an inability to enjoy fully what is available, and being painfully aware of what is missing. Such a general strategy of life is used in relation to concrete persons and circumstances of life, but in the last analysis represents a driving pattern devoid of specific content. Consequently, it can be practiced on extreme levels of wealth, power, and fame and continue changing its specific form as conditions change. For a person whose life is dominated by this mechanism, nothing is enough and no possessions and achievements bring genuine satisfaction.
Under these circumstances, if goals are not attained, the continuing dissatisfaction is rationalized as reflecting the failure to create a more desirable set of conditions. However, if a project succeeds, it typically does not bring the expected desirable emotional result. This is then attributed to wrong choice or the insufficient scope of the original goal, and the latter is replaced by a more ambitious one. This leads to what the subjects themselves refer to as a “rat race” or a “treadmill” existence: living emotionally in fantasies about the future and pursuing projected goals, although their achievement does not bring fulfillment. In the existentialist literature, this is called “auto-projecting.” The life of such an individual is infused with a sense of meaninglessness, futility, or even absurdity, which no amount of seeming success can dispel. It is not uncommon that under these circumstances a great success will trigger a profound depression—a direct opposite of what was expected. Joseph Campbell describes this situation as “reaching the top of the ladder and finding it was against the wrong wall.”
The existence of a person whose experiential world is limited to the hylotropic mode has, thus, a quality of inauthenticity. It is characterized by selective focus on, and pursuit of, goals and an inability to appreciate the process of life. Typical characteristics of this way of being in the world are a preoccupation with the past and future, a limited awareness of the present moment, and the exclusive emphasis on manipulation of the external world associated with critical alienation from the inner psychological process. A painful awareness of the limited life span available for all the projects that should be accomplished, an excessive need for control, an inability to tolerate impermanence and the process of aging, and a deep underlying fear of death are additional important attributes.
Projected on a social and global scale, this experiential mode focuses on external indexes and objective parameters as indicators of the standard of living and well-being. It tends to measure the quality of life by the quantity of material products and possessions, rather than by the nature of the life experience and a subjective sense of satisfaction. Moreover, it tends to consider this life philosophy and strategy as natural and logical. The characteristic features of this approach—short-sighted emphasis on unlimited growth, egotistical and competitive orientation, and disregard for cyclical patterns and holistic interdependencies in nature—reinforce and potentiate each other. Together, they create a fatal global trajectory with nuclear holocaust or total ecological disaster as the logical alternatives for the future of the planet.
In comparison, the individual in the holotropic mode of consciousness is incapable of relating adequately to the material world as a mandatory and all-important frame of reference. The pragmatic reality of everyday life, the world of solid material objects and separate beings appears to be an illusion. The inability to identify with the body ego and experience oneself as a separate entity clearly distinguishable from the totality of the cosmic web leads to neglect of the basic rules that must be observed if the individual organism is to continue to exist. It can result in a disregard for personal safety, elementary hygiene, supply of food and water, or even oxygen. The loss of individual boundaries, temporal and spatial coordinates, and adequate reality testing represent a serious survival threat. The extreme forms of the holotropic mode, such as identification with the Universal Mind or the Supracosmic Void represent the exact opposite of matter-related ego-body consciousness. The underlying unity of all existence transcending time and space is the only reality. Everything appears to be perfect as it is, and there is nothing to do and nowhere to go. Needs of any kind are nonexistent or are totally satisfied; an individual immersed in the holotropic experiential mode has to be attended by other people who take care of his or her basic needs, as illustrated by many stories about disciples providing basic care for their masters during their samadhi or satori experience.
We can now return to the problem of mental health. In contrast to traditional psychiatry with its simple dichotomy of mental health-mental disease, we have several important criteria to consider. The first step should be to exclude organic diseases that might be the causes, contributing factors, or triggers of the emotional and behavioral disorder. If the examination detects a disease in the medical sense of the word, such as inflammation, tumor, or circulatory disturbance of the brain, uremia, severe hormonal imbalance, and the like, the patient should receive specific medical treatment.
After having considered the health-disease dimension, we are left with the problem of evaluating the two modes of consciousness described above and their combinations. Within the conceptual framework presented in this book, an individual functioning exclusively in the hylotropic mode would at best qualify for “lower sanity,” even if he or she manifested no psychopathological symptoms in the conventional sense. This mode of consciousness in its extreme form, associated with a materialistic and atheistic attitude toward existence, involves repression of vital and nourishing aspects of one’s being and is ultimately unfulfilling, destructive, and self-destructive.
The experience of holotropic consciousness should be treated as a manifestation of a potential intrinsic to human nature and does not in itself constitute psychopathology. When it occurs in a pure form and under the proper circumstances, it can be healing, evolutionary, and transformative. While it can be extremely valuable as a transitional state followed by good integration, it can not be reconciled with the demands of everyday reality. Its value depends critically on the situation, the style of the subject in approaching it, and his or her ability to integrate it in a constructive way.
The two modes can interact in ways that disrupt everyday existence or blend harmoniously to enhance the life experience. Neurotic and psychotic phenomena can be seen as resulting from an unresolved conflict between the two modes; they represent compromise formations and interface noise. Their various aspects—perceptual, emotional, ideational, and psychosomatic—which appear as incomprehensible distortions of the logical and appropriate way of reacting to current material circumstances, are perfectly understandable as integral parts of the holotropic gestalt that is trying to emerge.
This becomes clear to the subject as soon as the theme underlying the symptoms is fully experienced and integrated. Sometimes the intruding element is an experience from another temporal context, such as childhood, biological birth, intrauterine existence, ancestral or evolutionary history, or a previous incarnation. At other times it involves transcendence of the usual spatial barriers; it takes the form of conscious identification with other people, various animal forms, plant life, or inorganic materials and processes.
In some instances, the emerging theme has no connection with the phenomenal world and the usual temporal and geographical coordinates, but represents various transitional products characterizing levels of reality that lie between the undifferentiated cosmic consciousness and the separate existence of the individual material form. Vivid encounters or full identification with archetypal entities in the Jungian sense, or participation in dramatic mythological sequences would belong to this category.
The basic principle of symptom resolution is a full experiential shift into the corresponding holotropic theme; this requires a special context with unconditioned therapeutic support for as long as the unusual experience continues. When this process is completed, the subject returns automatically to everyday consciousness. A full experience of the holotropic mode will alleviate or eliminate the symptom, but as a result of it the philosophical commitment of the subject to the hylotropic mode will become looser and more tentative. When the underlying gestalt is a powerful perinatal or transpersonal experience, this typically leads to a process of spiritual opening.
This new approach to the problem of psychogenic emotional disorders, based on an expanded concept of the human personality, abandons the practice of using psychopathological labels for people on the basis of the content of their experience. This emerges from the observation that many of the experiences that used to be considered psychotic can be easily induced in a random sample of the population, not only by psychedelic drugs but by such simple methods as meditation practices and hyperventilation.
In addition, it has become quite clear that the spontaneous occurrence of these phenomena is far higher than has been suspected by mainstreaim psychiatry. The use of stigmatizing diagnoses, forced hospitalization in locked wards, and deterrent forms of therapy have discouraged large numbers of people from admitting even to their close friends and relatives that they have had perinatal or transpersonal experiences. Under these circumstances, psychiatry has obtained a distorted image of the nature of the human experience.
A harmonious blending of the two modes does not distort external reality, but gives it a mystical flavor. The person involved in such a process is capable of responding to the world as if it were made of solid discrete objects, but does not confuse this pragmatic notion with the ultimate truth about reality. He or she experiences many additional dimensions operating behind the scenes and is philosophically fully aware of various alternatives to ordinary reality. This situation seems to occur when the individual is in touch with the holonomic aspects of reality but no specific holotropic gestalts are competing for the experiential field.
The concept of “higher sanity,” or genuine mental health, should be reserved for individuals who have achieved a balanced interplay of both complementary modes of consciousness. They should feel comfortable and familiar with both modes, give them appropriate recognition, and be able to use them with flexibility and appropriate discrimination, depending on circumstances. For a full and healthy functioning in this sense, it is absolutely necessary to transcend philosophically dualisms, particularly the dualism between the part and the whole. The individual approaches everyday reality with utmost seriousness and full personal and social responsibility, while being simultaneously aware of the relative value of this perspective. The identification with the ego and body is playful and deliberate, rather than unconditional, absolute, and mandatory. It is not fraught with fear, need for control, and irrational survival programs; the acceptance of material reality and existence is pragmatic, not philosophical. There is deep awareness of the significance of the spiritual dimension in the universal scheme.
The individual who has experienced and integrated a considerable amount of holotropic material has an opportunity to see human life and existence from a perspective that exceeds that of an average Westerner who is “normal” by the standards of traditional psychiatry. Balanced integration of the two complemetary aspects of human experience tends to be associated with an affirmative attitude toward existence—not the status quo or any particular aspects of life, but the cosmic process in its totality, the general flow of life. An integral part of healthy functioning is the ability to enjoy simple and ordinary aspects of everyday life, such as elements of nature, people, and human relations or activities, as well as eating, sleeping, sex, and other physiological processes of one’s body. This capacity to appreciate life is elemental and organismic; it is essentially independent of the external conditions of life, with the exception of some drastic extremes. It can be almost reduced to the joy of existing or being conscious. If an individual is in this frame of mind, any additional assets of life—nourishing relationships, availability of money or material possessions, good working conditions, or opportunity to travel—will be experienced as extra luxuries. However, when this orientation toward life or this experiential tuning is missing, no amount of external success or material achievements can provide it.
A good integration of the hylotropic and holotropic modes makes it possible to be fully in touch with the events in the material world, but see them as processes to participate in rather than as means to achieve specific goals. The emphasis on the present moment outweighs the preoccupation with the past or concern about the future. The awareness of the goal is present in the fully experienced successive activities, but it does not become dominant until the task is completed. Then the celebration and enjoyment of the achievement constitutes the content of the present moment.
The generally affirmative attitude toward existence creates a metaframework that makes it possible to integrate in a positive way even the difficult aspects of life. In this connection, the attitude toward what conventional psychiatry considers symptoms of mental disease is more important than the presence or absence of these symptoms. A healthy attitude would view them as integral aspects of the cosmic process that can represent a great opportunity for personality growth and spiritual opening, provided they are properly approached, handled, and integrated. In a sense they indicate an opportunity to liberate oneself from the unfulfilling and crippling hegemony of the hylotropic mode of consciousness.
The occurrence of psychogenic forms of psychopathology can be considered an indication that the individual has reached a point where the continuation of a one-sided existence in the hylotropic mode has become untenable. They herald the emergence of specific holotropic elements and reflect resistance against them. Psychiatry oriented toward suppressing the symptoms and returning the individual to the straitjacket of inauthentic existence is thus essentially antitherapeutic. It interferes with a process that, supported and brought to completion, could lead to a fuller and more satisfying way of existing in the world.
The new definition of what is normal and what is pathological is not based on the content and the nature of the experience, but on the style of approaching it in the context of genuine support based on an understanding of the process; the most important criterion, then, would be the quality of the integration of the experience into the person’s life. Abraham Maslow’s great contribution to psychology was to demonstrate that certain mystical or “peak” experiences need not be considered pathological but can be approached positively (1964). This notion can now be extended to all perinatal and transpersonal phenomena.
However, it is absolutely essential to create for this purpose special circumstances and milieus for confronting such experiences, where the conditions and set of rules differ from those of everyday life. Full confrontation with the emerging material in a supportive framework, with the possible help of the facilitating techniques described above, will free the subject’s day-to-day existence from the agony of the interface turmoil between competing experiential modes. In the new approach, psychogenic disorders reflect the confusion between the hylotropic mode and the holotropic mode of consciousness, or the inability of the subject to confront the emerging holotropic material and integrate it into the everyday experience of the material world. The general strategy to be pursued is full experiential immersion in the surfacing theme and, after its completion, return to an uncomplicated and full experience of the present time and place. The systematic application of this principle in one’s life and openness to a dialectic and harmonious interplay between the two basic modes of consciousness seem to be necessary prerequisites to genuine sanity and mental health.