Diane Musho Hamilton is a gifted mediator, facilitator and teacher of Zen and Integral Spirituality. She is a co-director of the Integral Life Spiritual Center and has worked with Ken Wilber and Integral Institute since 2004. Diane is the Senior Teacher for Integral Recovery. She is the lead trainer on Integral Life Practice. She is also a core founder and faculty of iEvolve: Global Practice Community.

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Sofia Diaz is a gifted teacher of Hatha yoga, sacred movement, and feminine spiritual practice, deriving her form of teaching and body philosophy from the South Indian Temple Arts and their accompanying scriptures. She has apprenticed with dance and music masters of the Balasaraswati lineage of Devadasi Sadir. She is also a core founder and faculty of iEvolve: Global Practice Community.

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Marc Gafni, Sally Kempton, and Ken Wilber discuss the notion of the Unique Self, which represents the deepest possible expression of consciousness—a subject that can never be made object, the union of ever-present consciousness and individual perspective at a radically fundamental level.

The Unique Self is the substrate of our 1st-person experience, the subtlest patterns of perspective, flavors of love, and textures of spirit that make you exclusively you in this ecology of souls. With our deepest recognition of our Original and Unique Face, we begin to feel the evolutionary imperative surging though our veins—an insatiable drive to simply be ourselves, as freely and fully as we possibly can.

This is the first part of an ongoing dialogue series for the Integral Spiritual Experience community and event. Come alive to your unique service by finding stillness, breaking through resistance and fear, listening to your calling, and ultimately taking full responsibility for the deep dimensions of your being and becoming. For more information and to register for this amazing event, visit www.integralspiritualexperience.com.

LISTEN TO DIALOGUE HERE

Dr. Marc Gafni is a cutting edge evolutionary visionary, a gentle and provocative spiritual artist and teacher, academic, public intellectual, author, and social activist and lover of people. He holds a doctorate, written on Nondual Humanism in Kabbalah taken at Oxford University under the co-supervision of Prof. Moshe Idel. He serves as the founding co-director of Integral Life Spiritual Center, the founding co-director and teacher in residence of iEvolve Global Practice Community. He is also the founding co-publisher of Incorrect Inc, scholar in residence at Pacific Coast Church, and lead teacher at Shalom Mountain Retreat Center Wisdom School.

Sally Kempton, formerly known as Swami Durgananda, is recognized as a powerful meditation guide and as a spiritual teacher who integrates yogic philosophy with daily life. She is the author of The Heart of Meditation, and writes the popular Wisdom column for Yoga Journal. A teacher in the tantric tradition of Kashmir Shaivism Sally conducts conducts workshops and retreats on applied philosophy and meditation. She is co-director of Integral Life Spiritual Center and a core founder and faculty of iEvolve: Global Practice Community.

Ken Wilber is the most widely translated academic writer in America, with 25 books translated into some 30 foreign languages, and is the first philosopher-psychologist to have his Collected Works published while still alive. Wilber is an internationally acknowledged leader and the preeminent scholar of the Integral stage of human development, which continues to gather momentum around the world. His many books, all of which are still in print, can be found at Amazon.com. Some of his more popular books include Integral Spirituality; No Boundary; Grace and Grit; Sex, Ecology, Spirituality; and the “everything” books: A Brief History of Everything (one of his largest selling books) and A Theory of Everything (probably the shortest introduction to his work).  Ken Wilber is the founder of Integral Institute, Inc., the co-founder of Integral Life, Inc., and the Senior Fellow of Integral Life Spiritual Center.

Integral Spiritual Experience

Do you want to realize the unique purpose of your life? Do you want to share your unique gifts with the world? If you do, then please join us this December, over the New Year holiday, as we gather on the shore of the great Pacific Ocean to begin a historical five-year journey. This journey will help you realize that no one else alive can make the contribution to humanity that you can. The first year of Integral Spiritual Experience begins with you: The Personal Spiritual Journey, Your Unique Self.

Together, with an incredible list of teachers including Diane Musho Hamilton, Sally Kempton, Marc Gafni, Ken Wilber, and Jean Houston, we will take a personal, hands-on guided exploration and practice of your unique life and purpose as it manifests through your passion, talents and personal history. Come alive to your unique service by finding stillness, breaking through resistance and fear, listening to your calling, and ultimately taking full responsibility for the deep dimensions of your being and becoming. For more information and to register for this First Annual International Flagship Integral Event, visit www.integralspiritualexperience.com.

The Unique Self

Written by Corey W. deVos

What is the Unique Self?

What do you think of when you hear the words “Unique Self”? Childhood memories of gold stars and “I am special, look at me” nursery rhymes? Stacks of self-help books intended to help bolster and reinforce the ego? The latest New Age The Secret-type fads that place the self at the center of the universe, instead of the universe at the center of the self? A particular constellation of Jungian personality types, Enneagram typologies, astrological signs, and countless “Which Battlestar Galactica character are you” quizzes on Facebook?

As Marc mentions, the Unique Self is much more than a Myers-Brigges test with a spiritual overlay. It does not refer to any of these ornaments of the self—though it is immanent to the trials and tribulations of the ego, it utterly transcends the ego, remaining forever untouched by the appetites of identity. The Unique Self represents the deepest possible expression of consciousness, a subject that can never be made object, the union of ever-present consciousness and individual perspective at a radically fundamental level.

Imagine four people sitting in a room, each looking at each other. All four of these people are “fully” enlightened; that is, as enlightened as a person can be at this point in history. Gazing upon one another, they see the very same Oneness staring back at them, recognizing the effortless awareness behind each set of eyes. There is an immediate recognition of primordial consciousness, of the radical singularity of being—the singular to which there is no plural. In each other’s eyes, they see their own Original Face, echoes of ubiquity emanating from an unmentionable Source. They can all see the radical and universal sameness of reality, each understanding that there is only one single Witness behind every set of experiences. In each other’s eyes they see only themselves, recognizing the very same effortless awareness that looks out from behind their own.

Now let’s imagine that these four enlightened masters are sitting in a circle, each looking at a globe that sits on a table between them. Although they all share the same direct apprehension of Oneness, they each retain a particular perspective of the globe, and therefore each see the world in a completely different way. There is something markedly unique about each of their experiences, from their physical orientation in time/space to their individual experience of the universal. Within each of them lies a fundamental thread of perspective, stretching all the way to the darkest depths of the Mystery—a bottomless drop of the Heart that is unique to each and every one of us.

There is only one universal “I AMness” in existence, and as many unique experiences of “I AMness” as there are perspectives in the universe. If we allow ourselves to think of consciousness as “a sphere whose center is everywhere, and whose perimeter is nowhere,” we see that, although we all share the same existential center, my center is not your center—my “bottomless drop” is not your “bottomless drop,” even if they are laced together in the Heart of the world. There is a seamless union of the universal and the unique that is completely and inextricably your own. It is the very last inch of you—an inch that can never be duplicated, can never be imitated, and can never be taken away.

The End is the Beginning is the End

In a certain sense, the Unique Self represents an end to the spiritual journey, the final realization of enlightenment. Which raises the question: if Integral Spiritual Experience is to be a five-year journey, why start here? But here we begin chasing our own hermeneutic tails, words bouncing off the face of the Mystery like photons off a mirror. This nondual unification of self and no-self—”final” in it’s own right—is as unattainable as it is inescapable. It has no beginning and no end, as it never enters the stream of space/time to begin with; and yet it permeates all space and all time, never separate from the kaleidoscopic carnival of the manifest world.

The Unique Self is the substrate of our 1st-person experience, the subtlest patterns of perspective, flavors of love, and textures of spirit that make you exclusively you in this ecology of souls. With our deepest recognition of our Original and Unique Face, we begin to feel the evolutionary imperative surging though our veins—an insatiable drive to simply be ourselves, as freely and fully as we possibly can.

This is both the Alpha and the Omega of the Integral Spiritual Experience, the first and final step toward our own awakening, while guiding our hearts and minds at every point along the way.

“The Divine cries out to every individual human being: ‘I need you, I need your unique service.’ There’s something that you have that is so ultimately gorgeous and unique and is desperately needed by the universe for its own evolution, for the Divine’s own process of coming to know Him/Her/Itself.” – Marc Gafni

Returning to the Marketplace

Robb, Ken, Marc, and Sally discuss the plans for the final year of the Integral Spiritual Experience, which is designed to emphasize service and activism in the world, stemming from direct and immediate recognition of the Unique Self. In Zen Buddhism, this stage of realization is often represented by one of the “Ten Ox Herding Pictures,” a series of short poems and images intended to illustrate the various stages of enlightenment. The very last image of the series is often called the “Return to the Marketplace,” symbolizing the final stage of enlightened living, when the individual returns to society with open hands and an open heart. But how we return to the world and what form our expressions of love and service take depends entirely upon the particular textures and talents of our own Unique Self. Only finding our own voice, our own rhythm, and our own melody can we find our deepest contributions to the symphony of life,

“The Unique Self expresses itself uniquely at different life stages. So how my Unique Self and unique service expresses itself at age 20 is a very different set of questions than how it expresses itself at age 45 or age 60. And in a sense, the traditions that privilege emptiness and ask us to plunge deeply into the self as consciousness, free of its limiting prisms is not a young person’s natural path, because what a young person is doing in the world is to a large extent constructing a whole series of personae that are necessary to play in the world. It seems to me that what Integral is here to do is to bring this understanding of how you live in an egoless way without denying your worldly goals.” – Sally Kempton

Practicing Your Uniqueness

How do you practice that which you can never attain? Sally, Ken, and Marc each point a finger to the moon, recommending in turn a simple practice of ethics and self-inquiry, a brief taste of ever-present I AMness, and a quick 2nd-person exercise to help open our hearts to all the other Unique Selves we are surrounded by every day.

“Starting from the position of I AMness, and from the recognition that it is ever-present and the core of what you are, then you can start to understand and look for ways that this unique I AMness expresses itself in you. Because even though everybody is going to have the same I AMness experience, they are going to have a different perspective on the world through that I AMness. And that is the Unique Self. So resting in I AMness, start to ask yourself the fundamental questions—’What should I do? What are my gifts? What are my talents?—and start to see how I AMness is expressing itself uniquely through your body-mind.” -Ken Wilber

As Marc Gafni finished a Thirty Month retreat after an intense personal tragedy, he talked with Integral Rock Star Stuart Davis about the masculine, the feminine, love, compassion and enlightenment. Do not miss this beautiful, heart opening and mind expanding dialogue.

In this next clip we’ll explore a few practices to re-polarize your relationship and re-ignite that energetic spark .

Sofia Diaz, a gifted teacher of Hatha yoga, sacred movement, and feminine spiritual practice, offers insight into the nature of sexual polarity.  First, she’ll talk about how our relationships become de-polarized. Then, she’ll explain the benefits of healthy sexual polarity. And, finally, she’ll offer 4 simple practices for you so that you can strengthen your polarization or start to re-polarize all together.

LISTEN TO AUDIO INTERVIEW ON INTEGRAL LIFE

Conclusion
So an Integral approach to embodying sexuality is obviously very different—it doesn’t exclusively focus on your outer world (grooming practices, techniques, etc,), though it does see these as important. It also focuses in on your inner experiences: your primary energy, whether masculine or feminine, your thoughts, feelings, and responses to life. But the key to a hot and heavy sexual relationship is polarity and in this series we’ve offered you a number of practices to both understand and transform your inner relationship with sexuality. Thanks for joining me, and talk to you soon.

First, let’s define the two extremes of sexual polarity. Then, we’ll help you assess which pole you most resonate with in relationship. Finally, we’ll offer a series of practices that you can use to re-polarize your relationship. In the end, by purposefully cultivating an embodiment of your polarity, you and your lover can enjoy passion and intimacy like never before.

In this video, David Deida describes the qualities and energy of each pole. The masculine pole is purpose-driven, goal oriented, focused, and self-disciplined, just for starters. It identifies with the witness, the observer. The feminine energy or pole is open, flowing, wild, radiant, and spontaneous. It is the expression of form, the expression of motion. The masculine is the observer; the feminine is the observed. But let’s hear more about these polarities in this next video with David Deida. As you watch his presentation, consider which pole you resonate with most.

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Now that you’ve seen David  define the two poles of sexual polarity, which do you resonate with most? As you watched this video, did you notice whether you naturally identified with one pole more than the other? Do you identify more with the spacious witness of the masculine pole? Or do you feel more aligned with the feminine pole of form, energy, and feeling? Another way to sense your essence is to ask yourself…. “What do I do when I am upset or contracted?”

Do you tend to get angry, shut down, and want to leave the situation, both emotionally and physically? While this is certainly not the healthiest expression of the masculine, it may help you see yourself more clearly. If you insist on continually processing your emotions and feelings, demand that the other person listen to you until you feel resolved, or become afraid that the other person is going to leave you, you may be expressing your feminine essence, albeit not a very healthy one, but nonetheless it may give you some clues as where you reside along this polarity continuum.

If you still are unsure, don’t worry, just go with what feels most energetically true for you in this moment. If you feel resistant to the model or discussion, there’s nothing wrong with that, just notice it. Notice how you relate to your own resistance.

Now that you have considered which pole you embody, let’s take this one step further by exploring how the masculine and feminine extremes play out in relationship. In this next video, David Deida emphasizes the need to practice these extremes in order to manifest the spontaneous ecstasy of deep passion with one another.

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In your current relationship: Are you and your partner both embodying masculine energy? Do you both strive for autonomy or tend to feel suffocated in relationship? Do you prioritize your career over your relationship? Do you prefer stillness, silence, and stability over chaos and change? Or are you and your partner both playing the feminine role? Do you both prioritize your relationship over everything else? Are you more concerned with feelings and process over actions and tasks? Do you both privilege a flowing energetic that could be described as compassionate and caring?

If either of these situations rings a bell, you are most likely living a de-polarized sexual relationship. If you both embody the same pole on the spectrum of sexual polarity, passionate energy cannot flow. Rather, the energy becomes stagnant, stationed only at one pole, with nowhere to go. And, slowly, inevitably, your relationship will start to lose its charge all together.

Take a deep breath. You have the ability to change this situation. And solving this problem may be easier than performing Vogue’s number one kama sutra position for October. “ Uhhh, you want me to put my leg where?”

We recently began preparations for a new annual event called “Integral Spiritual Experience” in collaboration with integral spiritual leaders Swami Sally Kempton, Diane Musho Hamilton, Sensei and Dr. Marc Gafni. Ken Wilber and I both felt it was important to transparently investigate and address the current state of affairs as it relates to the alleged sexual misbehavior of Dr. Gafni from a few years ago. Indeed, in Ken’s letter to the community of a few years ago he made a commitment that any new information would be examined.

“The secret to great sex….” You’ve most likely seen this promise, or one like it, plastered on the cover of magazines since you were old enough to read. So, how is an Integral approach to embodying passion and great sex different from the approach of Cosmo, Vanity Fair, or Men’s Health magazine that claims to reinvent your sex life? Well, the Integral approach to great sex offers a number of additional insights that every other sexpert is missing.

For starters, the Integral approach to embodying passion doesn’t exclusively focus on your exterior or “techniques,” though there’s absolutely nothing wrong with good technique. An integral approach also includes your personal, subjective experience: what you think, what you feel (or don’t); what kind of energy you experience; and how you respond and react to life and other people. The integral approach knows that it’s just as important to understand your inner world as it is to understand your outer world. So observe and reflect on your inner reactions to this series. Whatever your response or reaction is, is just fine; I just invite you to be aware of it.

But more than that, the Integral approach offers a practice…. the practice of artful, sexual polarity. The subtle power of sexual polarity pervades each of our lives. It draws us towards our lover and  keeps our relationship lively.  So what is sexual polarity?

In the words of David Deida, sexual polarity is a dynamic, magnetizing energy, much like the magnetic, polarized energy between the North and South poles. For sexual energy to magnetize and flow you need two opposites that polarize one another. In terms of sexuality the two poles are Masculine and Feminine. Let’s be clear, we’re not talking about gender (male and female), but rather masculine and feminine energy. You could be a man with predominately feminine or masculine energy, or you could be a woman with predominately masculine or feminine energy.

Let’s make this concrete: when you orient two magnets so that their “like” poles come close to one another, they repel each other, but when you orient the same two magnets such that their opposite poles come close to one another, the magnets attract each other. Magnetic energy can either be attractive or repulsive, depending on which poles are brought together.

The same is true of sexual polarity. When one partner’s masculine energy is brought into proximity of the other partner’s feminine energy, polarity pulls them toward one another. But if both approach the situation with masculine energy, their attractive passion is neutralized or they may even feel repelled by one another, just like two similar poles of a magnet. Sexual polarity—the energetic pull or push between the Masculine and Feminine. Again, let’s not confuse masculine with male or feminine with female. You can have a dynamic sexual polarity between two men or two women, so this discussion applies to homosexual and heterosexual relationships alike.

For a moment, consider your relationship with your intimate partner. Do you feel more like friends than lovers? More like brother and sister than husband and wife? Do you wonder what happened to that passionate spark you once shared?  Are you no longer attracted to your partner, but you’re not sure why? If you answered yes to any of these questions, chances are your relationship lacks sexual polarity. Of course, your relationship doesn’t always have to be hot and heavy. All our relationships go through ebbs and flows, but you may agree that a little more “hot and heavy” couldn’t hurt. If things aren’t so hot and heavy in your relationship, don’t worry, you’re not doomed. The integral approach can help reinvigorate your sexual relationship.

Discussion

Now that we have seen the mental status exam applied to a client, let’s look at this evaluation in
terms of Integral Theory. In the Upper-Right quadrant I was able to access Matt’s dress, grooming, age, weight, posture, body movements, speech, eye contact, affect, eating, sleeping, memory, medication, and alcohol and drug use. In the Upper-Left quadrant I assessed Matt’s concentration, attention span, orientation, judgment, insight, perception, suicidal and homicidal impulses.

In the Lower-Right quadrant, I was able to investigate the systems in which Matt is embedded in his daily life. These include his social support network, legal issues, education, employment, military history, family, and previous treatment. It is interesting to note that Matt’s mother believes that her son’s issues are more related to anxiety than to schizophrenia. This is helpful in understanding why Matt decided not to take his medications. If his mother is having difficulty accepting that her son has been diagnosed with schizophrenia, it can be even more difficult for the client to accept as well; especially a client in their early 20’s. So in my treatment plan, since I want to shift the systems Matt is a part of, I will refer Matt’s mother to receive the support that is available to help her come to grips with her son’s illness, and hopefully positively influence her son’s environment and compliance.

In the Lower-Left quadrant, I inquired into Matt’s relationships a little more, meaning, and judgements. I was curious about his relationship with his parents. But with his mother in the room, it was difficult to get Matt to speak about it.

As the mental status exam covers a good deal of Matt’s world, it still leaves out the very real and important dimensions of Matt’s culture, morality, mutual understanding, communication, and values system. And these are important dimensions of Matt’s world, as they would help to inform me of his core beliefs. Understanding these components of Matt are very helpful in deciding which treatment and referral options would most serve Matt, but also a treatment plan that Matt would be able to comply with, as compliance is a major obstacle to most treatment plans. And this is where the importance of types fits into the assessment process. Matt is introverted and anxious. I do not think that group therapy will be the environment that he is most comfortable in, so I will refer him to individual psychotherapy.

During the mental status exam, I also assessed for stages, states, lines, and types. For stages, I assessed Matt at a personal level of development. I assessed Matt’s state by looking at his mood and the presence of psychotic thinking. The mental status exam also looks at a few lines of development. These include Matt’s abstract ability, calculation ability, and intelligence level. The evaluation provides the opportunity to access for one, specific type, which is the quality of Matt’s thought process.

As one can see, the mental status exam is best for assessing the clients Upper-Right and Upper- Left dimensions of experience. It does not assess much of the clients Lower-Right experience, nor does it take into account an in depth investigation of the clients state experiences, developmental stage, lines of development, or types. An Integrally informed therapist would use the mental status exam and supplement the evaluation with the investigation of the client’s stages, states, lines, and type.

Conclusion

Schizophrenia is a psychological disorder that has plagued society since the 1800’s. Even some 200 years later, the treatment for this disorder is still ineffective, as one cannot be “cured” fully from its effects. The medical model has tried to provide relief through medications and the biopsychosocial model has attempted to alleviate the suffering of those inflicted with schizophrenia by combining medications, psychotherapy, and social skills training. And still, neither one of these models is able to provide recovery for those diagnosed.

The integration of both these models as well as stages of development, states of consciousness, lines of development, and types, provides a more comprehensive, balanced, and inclusive view of the person’s experience living with schizophrenia. Although it will not cure schizophrenia, the Integral model promises an assessment and a treatment plan that honors the richness (both individually and collectively) of the interior and exterior dimensions of the client’s life. The Integral model allows the practitioner to gain a wider, deeper understanding of the client. And this more inclusive understanding then informs the therapist in the development of the most effective, ample, and manageable treatment plan for the client. The Integral model can help design a treatment plan as individual as the client it is serving. The Integral model brings one
much closer to the resolution of invasive symptoms that the client experiences on a daily basis. With a psychological disorder still as complex and mysterious some 200 years later, better treatment options are needed. And the Integral model can provide these options with skill, elegance, and brilliant sanity.

Case Presentation

I work at a community mental health center. The mental health center provides treatment for individuals who are indigent, on disability insurance, or are low-income. I am on the Emergency Psychiatric Services team at this mental health center. On this team, the client population consists of people with severe mental illness, such as psychotic depression, bipolar disorder, schizophrenia, etc. The population is also infused with clients with personality disorders who tend to experience suicidal ideations frequently and use this team as an added support system to their overall treatment at the mental health center.

The population served is adults, ages 18-Geriatric. When I see clients, it is usually in the context of a psychiatric evaluation. Clients either come to the mental health center for evaluations or I go to the hospitals in the local county area to see clients in the emergency room. I also see clients in the county jails. Clients are often brought in for evaluation by the local police department or come in voluntarily. Before I meet a client, I look up information in their chart so as to develop a sense of their situation. If I am seeing a client in the Emergency Room, I look at their medical chart and talk with the assigned nurse and doctor. Once the medical issues are addressed, I meet with the client, administer the mental status exam, and refer them for specific treatment, whether it is hospitalization, observation, or discharge with psychotherapy. The mental status exam is the main “tool” by which this process is guided. In order to come up with the most effective
treatment and referral plan for the client, I have re-organized the mental status exam into the four quadrants (see figure 4).

By organizing the exam in this way, I am able to see both its strengths and limitations. The mental status exam is excellent for assessing the Upper-Right and Upper-Left quadrants. But it lacks the same excellence in assessing the Lower-Right and Lower-Left quadrants. If I only use the stagnant form of the mental status exam, the client is not receiving a comprehensive exam, which will result in a partial treatment plan. As many schizophrenics have severe difficulty in the Lower-Left quadrant (they have an extremely difficult time with building friendships and finding support to live with their illness); and with the Lower-Right quadrant (they need access to services and therapy and the means to secure it) it seems that this is a severe deficiency in the exam, which the Integral model brings to light.

I use this exam as a guiding principle and add my own assessment where the mental status exam falls short. I include issues of culture and religion, morality, mutual understanding, communication types and skills, and value systems (Lower Left). By including these aspects in the assessment process, I am better able to take the perspective of the client and his experience of being in the world and use that to inform my treatment plan and referrals, which places them within a larger support system (Lower Right).

Let’s look at the case of Matt. Matt is a 21 year old, single, Caucasian male who is currently living with his parents in town. He has been a client of the mental health center for the past few years. I first saw Matt when he voluntarily came to the ER with complaints of anxiety and a rapid heart beat. Matt was accompanied to the hospital by his mother. His mother was present for the psychiatric evaluation as she did not want to leave and Matt felt comfortable with her staying. I usually find it best to perform an evaluation with just the client first, and then speak to anyone else who may be able to supply additional, pertinent information.

Matt had been previously diagnosed, by his current/regular therapist, with schizophrenia, undifferentiated type. He had been taking Zyprexa 2.5mg everyday, but has not taken his medications for the past two weeks. Matt was causally dressed, well groomed, and slightly underweight. His posture was tense and rigid and his body movements were fidgety. Matt’s speech was pressured during this evaluation. He was cooperative, but was unable to make eye contact as he keep his eyes down cast. Matt presented as very anxious.

Matt reported that his appetite was normal and that he was sleeping 8-10 hours per night. When I asked Matt if he was able to concentrate he stated “Yes.” But I noticed that Matt had a difficult time elaborating on answers to questions. Matt was unable to perform the abstract calculation part of the mental status exam, even though his estimated intelligence level was above normal. Matt was oriented to person, place, and situation, but did not know the day or time.

Matt’s judgment was slightly impaired due to the difficulty he was having with anxiety. Matt used to take walks to help with the relief of anxiety, but was even too anxious to do that now. Matt also decided to stop taking his medication two weeks ago, which is contributing to his anxious affect. He demonstrated immediate recall abilities, but performed poorly on delayed recall. His remote memory was within normal limits. Matt demonstrated insight in that he knew he was anxious, but could not account for why he felt anxious. Matt denied auditory hallucinations and admitted to some visual hallucinations, but could not describe what these were. There was no evidence of psychotic thinking in this evaluation. He was somewhat shaky, but was able to follow and respond to questions, but not in any detail. His thought process was
logical and coherent.

Matt denied suicidal and homicidal impulses. He also denied alcohol and drug use. Matt stated that he stopped taking his medication because it made him feel tired and depressed. During the evaluation his mother stated that she spoke with Matt’s psychiatrist early in the day and he advised Matt to increase his medication to 5mg today to help with the anxiety. Matt took the 5mg, but did not experience any relief and felt that he needed to come to the hospital for help. Matt was given 1 mg of Ativan while he was in the hospital for anxiety relief and was given 2 more to take home for the night and the next day if needed.

Matt previously had been working everyday throughout the summer until a couple of weeks ago. He was scheduled to start school at a local community college, but the growing anxiety prevented him from continuing to work and start school. His mother feels that his condition is anxiety based, and does not fully believe that her son has schizophrenia. Matt has an appointment with his psychiatrist tomorrow afternoon and said he came to the hospital because he needed to rest and thought being hospitalized would help him to do that.

Per consultation with the Emergency Room Doctor and the on-call psychiatrist of the mental health center, Matt was deemed not to meet 27-10 criteria. Matt was not gravely disabled, nor a threat to himself or others. Matt was discharged with instructions to keep his appointment with his psychiatrist tomorrow and to discuss his complaints about his medication.

Hokai Sobol of h~log has put Black Plum on his list of seven brilliant blogs. Many bows Hokai! I have to say I’m a bit shocked, as Black Plum was birthed a mere two weeks ago. I’m honored to be in the line-up with these other reputable blogs. And here is a list of the other nominees from h~log , in no particular order…

1. Joe Perez‘ integral blog
2. Vincent Horn’s numinous nonsense
3. Bruce Alderman’s blog
4. Robert Godwin’s one cosmos
5. Just Perception without a perceiver
6. William Harryman’s masculine heart
7. and more recently Kelly Sosan Bearer’s black plum

I’ve been asked to nominate my top 7 seven “brilliant blogs”. Stay tuned for those rankings coming soon…

- Kelly Sosan Bearer

Lines of Development

People have different lines of development: cognitive, emotional, moral, artistic, etc. Individuals tend to do really well in some areas of their life, such as musical and cognitive abilities, but perform poorly in other areas, like morality or interpersonal relationships. This is due to their varying lines of development. These lines “unfold in progressive ways.”38 All these lines have the capacity to grow through stages of development. The therapist is able to discern where the client excels and what aspects of the individual need more growth and development. As part of the assessment process, the therapist is able to tailor a treatment plan that uses both the client’s strengths (strengths based) and weaknesses (deficits based) to better serve the client. Most treatment plans tend to focus on either the clients strengths (biopsychosocial model) or the clients deficits (medical model). The Integral approach allows for the therapist to use both the client’s strengths and weaknesses, while developing the treatment plan.

Many clients with schizophrenia have difficulty with treatment compliance. By including both strengths and deficits in treatment, the client may have a greater chance of actually complying with the treatment plan. Clients are not compliant out of a deviant stance. Clients tend not to comply when they don’t possess the necessary skills to carry it out. The Integral model offers the therapist a tool to actually assess the clients various lines of development. Figure 3, Appendix C, represents the Integral “psychograph”.

The client’s level of development and the therapeutic relationship are also important for treatment compliance. The therapeutic alliance, or the “we” space between the client and the therapist can be a large factor in determining treatment compliance. The therapist needs to be able to resonate at the same developmental level as the client. The integrally informed therapist words language to meet the client where he is at, so as not to talk above or below the client’s level of understanding. Different levels of development provide different skills and abilities. A lot of treatment compliance is determined by the meaning and value the client sees in treatment. The integrally informed therapist discusses this with the client in value language that the individual will relate to and be motivated by.

The psychograph is an easy way to visually represent these multiple lines of development. Through the stages of development (prepersonal, personal, transpersonal) the lines of development unfold. In figure 3, we see someone who excels in artistic and cognitive intelligences, but who is less developed morally, kinesthetically and emotionally. Each client will invariably have a very different psychograph.

The psychograph helps to locate where the client’s deepest gifts are and where they need help in their overall development. It helps to spot ways in which the client is unevenly developed. For the client, this will mean that the treatment plan not only focuses on the client’s strengths and gifts, but also those specific lines that are weak and causing issues in their everyday life.

Types

The fifth element of Integral Theory is types. This paper focuses on types in the Upper-Left quadrant. Everyone has a personality style. Some of these different styles or types can be seen along a continuum of polarities. For instance, masculine/feminine, thinking/feeling, active/passive, judging/perceiving, sensing/intuiting, extrovert/introvert, etc. Types are most often assessed using a personality inventory such as the Myers-Briggs or the Enneagram.

For example, a person with schizophrenia who is also an introvert may not be able to discuss his internal phenomena as easily as one who is an extrovert. The client who is more masculine in type, may have a more difficult time seeking help, versus the more feminine client who may present as overly dependent. The feminine type client may have difficulty with a treatment plan that emphasizes autonomy as the feminine type is known to thrive in communion with others. This client will fare better in group therapy, whereas the client with a masculine type may be overwhelmed participating in a large group.

An integrally informed therapist might choose to include a types assessment in treatment. The therapist takes everything into account, but may not treat all of the elements in the AQAL matrix. The therapist may choose to treat only one or two quadrants, but taking all elements into account when deciding that.

- Kelly Sosan Bearer

I am including my endnotes and references per requests to have these available along side the article posts. I was going to post these at the end, but I see the value to having them upfront. I hope these are helpful…This article was originally written in 2005 and published in 2006.

- Kelly Sosan Bearer

Endnotes

1 Torrey, Bowler, Taylor & Gottesman, Schizophrenia and manic depressive disorder, 1994
2 Bebbington, “The predictive utility of expressed emotion in schizophrenia: An aggregate analysis,” 1994
3 Bebbington, “The predictive utility of expressed emotion in schizophrenia: An aggregate analysis,” 1994
4  Durand & Barlow, Essentials of abnormal psychology, 2003
5 Potkin et al., “Aripiprazole, an antipsychotic with a novel mechanism of action, and risperidone vs placebo in patients with  schizophrenia and schizoaffective disorder,” 1993
6 Durand & Barlow, Essentials of abnormal psychology, 2003
7 Durand & Barlow, Essentials of abnormal psychology, 2003
8 Karon & VandenBos, Psychotherapy of schizophrenia: The  treatment of choice, 1981
9 Sperry, “Biopsychosocial therapy: An integrative approach for tailoring treatment,” 1988
10 Sperry, “Biopsychosocial issues,” 1999
11 Sperry, “Biopsychosocial issues,” 1999
12 Sperry, “Biopsychosocial issues,” 1999
13 Sperry, “Biopsychosocial issues,” 1999
14 Nagel, The concept of schizophrenia: Historical perspectives, 1991
15 Durand & Barlow, Essentials of abnormal psychology, 2003
16 Durand & Barlow, Essentials of abnormal psychology, 2003
17 Durand & Barlow, Essentials of abnormal psychology, 2003
18 Smith, Bellack & Liberman, “Social skills training for schizophrenia: Review and future directions,” 1996
19 May, Treatment of schizophrenia: A comparative study of five treatment methods, 1968
20 Durand & Barlow, Essentials of abnormal psychology, 2003
21 Durand & Barlow, Essentials of abnormal psychology, 2003
22 Gournay, “New facts on schizophrenia,” 1995
23 Rogers, Pilgrim & Lacey, Experiencing psychiatry: Users’ views of services, 1993
24 Cobb, Safe and effective? MIND’s views on psychiatric drugs, ECT and psychosurgery, 1993
25 Parlee, “Integral psychotherapy: An introduction,” 2006, p. 2
26 Parlee, “Integral psychotherapy: An introduction,” 2006
27 Parlee, “Integral psychotherapy: An introduction,” 2006
28 Wilber, Integral psychology: Consciousness, spirit, psychology, therapy, 2000
29 Wilber, Integral psychology: Consciousness, spirit, psychology, therapy, 2000
30 Wilber, A brief history of everything, 1996
31 Wilber, “Foreword to Integral medicine: A noetic reader,” 2003, p. 1
32 Wilber, Integral psychology: Consciousness, spirit, psychology, therapy, 2000
33 Wilber, Integral psychology: Consciousness, spirit, psychology, therapy, 2000
34 Wilber, Integral psychology: Consciousness, spirit, psychology, therapy, 2000
35 Wilber, Integral psychology: Consciousness, spirit, psychology, therapy, 2000
36 Wilber, “Foreword to Integral medicine: A noetic reader,” 2003
37 Wilber, “Foreword to Integral medicine: A noetic reader,” 2003
38 Wilber, Integral psychology: Consciousness, spirit, psychology, therapy, 2000

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Engel, G.L. (1977). The Need for a new medical model: A challenge to biomedical medicine. Science, 196, 129-136.

Gournay, K. (1995). New facts on schizophrenia. Nursing Times, 91 (25), 32-33. Karon, B. P., & VandenBos, G. R. (1981). Psychotherapy of schizophrenia: The  treatment of choice. Northvale, NJ: Jason Aronson.

May, P. R. A. (1968). Treatment of schizophrenia: A comparative study of five treatment methods. New York: Science House.

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Potkin, S.G., Saha, A.R., Kujawa, M.J., Carson, W.H., Ali, M., Stock, E., Stringfellow, J., Ingenito, G., Marder, S.R. (2003). Aripiprazole, an Antipsychotic With a Novel Mechanism of Action, and Risperidone vs Placebo in Patients With  Schizophrenia and Schizoaffective Disorder. Archives of General Psychiatry, 60 (7), 681–90. Retrieved November 3, 2004, from http://www.ncbi.gov

Provost, G. (2002) On the Treatment of Schizophrenia and Other Psychotic Disorders: A Progressive View. Retrieved November 3, 2004, from http://akmchweb.org/ncarticles Rogers, A.,  Pilgrim, D., & Lacey, R (1993). Experiencing Psychiatry: Users’ Views of Services. London, MacMillan.

Smith, T.E., Bellack, A.S., & Liberman, R.P. (1996). Social skills training for schizophrenia: Review and future directions. Clinical Psychology Review, 16, 599-617.

Sperry, L (1988). Biopsychosocial Therapy: An Integrative Approach for Tailoring Treatment. Individual Psychology, 44, 225-235.

Sperry, L (1999). Biopsychosocial Issues. The Journal of Individual Psychology, 55, (2), Summer, 232-248.

Torrey, E. F.; Bowler, A. E.; Taylor, E. H. & Gottesman, I. I. (1994). Schizophrenia and  manic depressive disorder. New York: Basic books.

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Wilber, K. (2003). Foreword to Integral medicine: A noetic readerPosted on 5/16/03. http://wilber.shambhala.com/