International Journal of Transpersonal Studies 1

Integral Approach to Mental Sufering

Laura Boggio Gilot
Italian Association for Transpersonal Psychology
Rome, Italy
Tis article further develops one section by the same name in another article published in
the International Journal of Transpersonal Studies entitled Integral Approach in Transpersonal
Psychotherapy (Boggio Gilot, 2003) by proposing a model of mental sufering based on
uniting scientifc psychology with meditative wisdom (e.g., derived from Yoga Vedanta). Te
role of spiritual vision underlines a wider understanding of the origins of mental sufering,
including damage from ontological unawareness and egoism, non-ethical factors usually
ignored in psychology. Tese give rise to destructive poisons of the mind such as pride,
greed, fear, resentment, envy, and intolerance, which characterize egoic narcissism. Tis
comparative approach to psychology and meditative wisdom allows for an expansion of
developmental and psychotherapeutic theories.
W
ithin the perspective of Western psychology,
psychotherapy deals with a complex range
of sufering involving physical, emotional,
cognitive, and behavioral states, which afect persons
relation to life and produce an intimate and existential
sufering that undermines the achievement of personal
and interpersonal goals. In particular, it hurts the quality
of individual freedom and frequently its aims. Mental
sufering always involves drives, feelings, thoughts, and
behaviors, and manifests itself through the subjective
expression of painful emotions and distorted thoughts,
as well as through objective behaviors of a destructive
and irrational type.
Tese painful states of sentiment may produce
alterations in the sense of reality and antagonistic and
separative attitudes in the inner and outer world, thereby
hindering any harmonious integration in the intraper-
sonal and interpersonal relationships. To cure this inner
sufering, psychotherapy uses the therapeutic relation-
ship, but there is no univocal view of this clinical art.
Tere are various schools of psychotherapy, each based
on a set of notions on the nature of the human person
and of health and sufering, developed according to a
given cultural paradigm and the corresponding phi-
losophy and world vision, which is the context of the
science of psychotherapy. We thus see great diferences
in the so-called four forces of Western psychology:
psychoanalysis, behavioral and cognitive psychology,
humanistic psychology, and transpersonal psychology.
Te former two, psychoanalysis and cognitive-behav-
ioral psychology, are the product of the mechanistic
paradigm and the materialistic vision that restricts
reality to the physical universe. Humanistic psychology
includes existential philosophy and systemic science in
its embrace, as the human being is primary and central
to its vision. Transpersonal psychology, however, is
based on a vision of the human being and the world
that includes spiritual reality and considers its experi-
ence and expression as the utmost peak of psychological
growth.
Te study, interpretation, and vision of mental
sufering are strictly connected to the vision of the
world and the human person on which are based the
above psychological and psychotherapeutic theories. In
the conceptions born in the framework of mechanistic
and materialistic science, the reading of sufering takes
place in the context of personal biography and connects
to a disturbance of the instinctual-afective dimension
that is close to the biological life, in which context it is
studied and dealt with. When human existence is only
seen associated to bodily life, even the psychological
experience is seen as the result of the persons contact
with the surrounding physical and relational world, and
each reaction is attributed to positive or negative experi-
ences in the world. Tere being no possible assumption
that life may originate before birth and may be inde-
pendent of external experience, the causes of personal
sufering are all looked for in the context of personal
International Journal of Transpersonal Studies 2
biography and the relations with the environment,
parents, and society. Tus, in the psychoanalytic litera-
ture, the mental sufering, called psychodynamics, is
all in the incapability of adapting to reality, because of
impulses that cannot be regulated by reason or morals
often reduced to some maladjustment in the so-called
object relations, where object basically stands for the
parental fgures. Te psychoanalysis requires going back
to early history and the interiorized experience of object
relations. Te goal is a normal social adjustment, for
which what is needed is to restructure the malignant
internal objects and their structural by-products that in
turn cause the conficts, complexes, and inhibitions of
personality that make it difcult to establish satisfactory
social relations.
In behavioral and cognitive psychology, mental
sufering consists of a disturbance of the construc-
tion of thought due to a negative conditioning of the
environment. Terapy requires revising the texture of
thought and freeing it from the dysfunctional construc-
tions in order to reach a satisfactory adjustment to social
reality.
Te humanistic-existential view largely refers to
a vision of the world extending from the mechanistic-
materialistic context to the recognition of the interde-
pendence of the various human, ecologic, and cosmic
systemseven the conception of sufering changes. Te
human being who recognises himself as part of a wider
universe than family and society is in search of a goal
and a task going beyond simple adjustment. Te reading
of symptoms, in this context, looks at not only the
damages of interpersonal and socio-cultural relations,
but also at the inhibition of a free relation with existence
due to the lack of meaning and the lack of free expres-
sion of ones creativity. Te humanistic-existential con-
ception underlines that the cause of sufering lies not
only in early life events, but in the repression of ones
emotions, talents, and most authentic valuesa crushing
of the truly original tendencies of the person which
hinders the natural track of self-realization and the
expression of higher fundamental needs. Healing here
requires the courage to exist with ones ideas and ones
values, as well as fnding an existential direction capable
for facing the great themes of lifethe result being
otherwise to fall into discouragement, boredom, insig-
nifcance, and eventually despair. Whereas the therapy
of psychodynamic sufering considers the dysfunctional
object relations and requires going back to the patients
past and transforming those elements that hinder the
adjustment to reality, existential therapy of sufering
requires going beyond adaptation and conformity and,
instead, living according to ones real nature, free from
the need of confrmation from others and conventional
safety.
Tis means that adaptation, which for ordinary
psychodynamic sufering is the goal of a much longed-
for normality, becomes an unbearable limit from the
perspective of existential sufering. As Jung himself had
to note on this issue, to be normal is a splendid ideal
for those who are a failure, for those who have not been
able to adapt. But for the ones who are more capable
than the average, for those who never fnd it difcult
to be successful and do their share in the world, to be
bound to normality is a Procrustean bed, un unbearable
bore, an awful sterility and desperation. It so happens
that many persons become neurotic because they are
just normal, whereas others become neurotic because
they are unable to become normal (Jung, 1939).
With transpersonal psychology, a sufering is
described that relates to the separation of the ego from
its spiritual essence: this involves not only the depri-
vation of the most profound values and the lack of
meaning in life with the associated feelings of alien-
ation, boredom and despair, but also the lack of con-
nection with the spiritual dimension toward which the
individuality naturally tends. Transpersonal psychology
underlines a sufering that is more specifcally related to
the removal of the sublime and the crises faced in the
phase of spiritual awakening, which generally occurs
around the middle of life.
Te various conceptions of sufering all share
a least common denominator: the recognition that
sufering manifests itself through a state of lack, which
refects the frustration of fundamental human needs.
Te psychodynamic conceptions, more related to early
biographic experiences, refer to the primary needs of
safety, love and esteem, whereas the humanistic-existen-
tial conceptions refer to the needs of growth, self-realisa-
tion, and meaning. Te transpersonal conception refers
to the lack in the needs of connection with the Sacred,
of knowledge, truth and self-transcendence. Here, going
back to a spiritual cultural context recognizing the unity
of life and its transcendent matrix, it appears that the
greatest source of sufering is the ontologic ignorance,
the deprivation of a contact of individual life with the
universal life, due to the identifcation with the histor-
ical ego, immersed in the outer fow and separated from
developmental and ideal values.
International Journal of Transpersonal Studies 3
In the spiritual vision, the lack of an encounter
with universal archetypes impoverishes individual life:
it is the lack of the feeling of belonging to the unity of
life that produces the anguish of life and death. Spiritual
poverty, due to the ignorance of ones essence, condemns
one to compensate through the importance of the sense
of the ego, confned to the body and its attachments
while unable to grant safety and continuously generating
conditions of separateness, fear, anxiety, and aggressive
defensiveness.
Te application of the principles of transper-
sonal psychology is based of the following developments
of transpersonal psychotherapy. In the words of Walsh
and Vaughan (1993), transpersonal psychotherapy aims
at the integration of physical, emotional, mental, and
spiritual aspects of wellbeing. Its objectives include the
classical ones of a normal psychological functioning,
adding to these the fostering of human growth and
awareness beyond the notion of health as convention-
ally recognised. Te potential of healing implicit in the
modifcation of ordinary consciousness and the validity
of the transcendent experience is here strongly under-
lined. A transpersonal psychotherapist can utilise tra-
ditional techniques as well as methods derived from
spiritual disciplines, such as meditation and mental
training. According to Boornstein (1992), psycho-
therapy also deals with the psychological processes
related to the realization of the states of enlightenment,
bliss, transcendence, and mystic union, as well as of the
psychological conditions directly or indirectly under-
lying these events. According to Washburn (1994), a
fundamental objective of transpersonal psychotherapy
is the integration of the spiritual experience with a wider
understanding of human nature and the development of
sufering.

Ken Wilbers Integral Approach
O
ver the past 25 years, the historical development
of psychotherapy models has produced a progres-
sive tendency toward an integrative and intercultural
approach. Tis stemmed from the need to coordinate
the theoretical and epistemological body of knowledge
of the four fundamental schools of psychology and
psychotherapy (psychodynamic, cognitive-behavioral,
humanistic-existential, and transpersonalsee Table
1), along with psychologies coming from other contexts
than scientifc ones, such as the meditative traditions.
Te aim is to go beyond the atomistic and totalitarian
vision of the scientifc model that has ignored the dis-
coveries of others and the intercultural aspects.
Tis tendency has emerged in the International
Journal of Psychotherapy (2002), with special reference
to the distinction between the risk of a hybrid syn-
cretism, clearly to be avoided, and a pluralistic model
recognising the complementarity of the various concep-
tions with the aim of a unifed and wider vision of
psychological distress and the methods to heal it. Inte-
grative conceptions combining psychology and spiri-
tuality include the work of Naranjo (1989), the psy-
chology of Almaas (2004), and particularly the integral
approach of Ken Wilber (2000), already a leader of
transpersonal psychology who brilliantly combined the
theories and methods of Western psychology with the
wisdom of meditative traditions. According to Wilber,
human totality is composed of body, mind, soul, and
spirit. Development occurs through a process of inte-
gration of the potentialities of these levels in an arch
that goes from a prepersonal-prelogical-preegoic stage,
to a personal-logical-egoic, and then to a transpersonal-
translogical-transegoic one. At each stage, specifc dis-
turbances are possible and therefore specifc psychopa-
Conceptions of mental sufering
Psychoanalytic Incapability of adapting to reality, due to dysfunctional object relations
Cognitive Disturbance of the construction of thinking and of the systems of
diferentiation and correlation, due to a negative conditioning
Humanistic- Failure of self-realisation, due to frustration of the needs of growth and
existential lacking sense of existence
Transpersonal Removal of the sublime and conficts inherent to spiritual crises
Table 1.
International Journal of Transpersonal Studies 4
thologies, requiring an accurate diferential diagnosis
and diferential healing methods. With this complex
spectrum of psychopathological development, Wilber
coordinated the psychoanalytic, cognitive, human-
istic, and transpersonal conceptions and proposed a
new image of an integral therapist capable of working
with the diferent bands of the spectrum. Exploration
on meditative states sheds new light on the theories of
sufering and psychotherapy, both with respect to phe-
nomenological and prognostic aspects and with respect
to the signifcance of sufering and its developmental
value.
Spiritual Vision of Mental Sufering
I
n the scientifc approach, mental pathology is
signalled by a sufering exhibiting symptoms and is
faced according to a deterministic vision that attributes
its origins to a cause external to the patient (e.g., in early
traumas due to dysfunctional relations with the family
and the environment). In this deterministic frame of
reference, mental sufering derives from others: the
patient is a victim of external forces, family, or society,
making him or her the pathetic protagonist of a painful
condition not wanted and unable to be infuenced. Tis
strictly mechanistic vision showing us a human being
that is manipulated by and a victim of hostile external
forces, though partly valid in biographical terms, does
not fully account for the reasons of mental sufering nor
help the solution of human unhappiness, while on the
other hand easily stirring up destructive behaviors.
If ones sufering is attributed to others, ill-
feelings and anger naturally develop, and particularly
when sufering is exclusively related to early emotional
traumas, hate against the parents can burst with unfore-
seeable outcomes. In a rigidly deterministic context,
psychotherapy, rather than being an instrument to
foster peace and unity in the family and society may
instead increase separation. In this perspective, other
negative consequences arise that are hardly coherent
with a positive model of mental health.
Seeing the sufering as originated by others, it is
only natural to consider that salvation should also come
from the outside. Te only way to be healed is therefore
seen in psychotherapy, and if will or means to access
it are lacking, then what is left in front of sufering
is to dull ones senses, having recourse to pleasure,
alcohol, drug, the alienating hedonistic distraction, and
afrming ones power, as means to compensate for the
wrongs one considers to be the victim of. When such is
the human condition, sufering is no longer an instru-
ment of contact with oneself, a means of knowledge and
growth, but rather becomes an instrument of alienation
and loss of a realistic and developmental relation with
life. Te scientifc and materialistic notion of mental
sufering lacks both a wise vision of life and ethical con-
siderations: it deprives the patient of a precise responsi-
bility towards his condition, underestimates the human
capacity to face sufering, fails to promote the devel-
opment of good forces, and rather fosters a basic nar-
cissism. To recover, frequently only means acquiring
aggressive forces to use in a more intelligent way (see
also Boggio Gilot, 1997).
Ancient wisdom, that which derives from the
great meditative traditions (especially Yoga Vedanta),
has a profoundly diferent vision of sufering, as well
as a diferent approach to recovery. It emphasises that,
although it is true that in ordinary life a great part of
human experience is related to sufering, it is also true
that only to a small extent does this sufering comes from
external causes. Mostly, it is instead self-produced and
depends on factors that are intrinsic to the self-centered
mental state, that is, on basic narcissistic afictions of
a mind that is unaware of its own potentialities and
spiritual nature. It is this ontologic unawareness that
causes the development of the non-ethical factors and
poisons that inhabit the mind and give rise to wrong
and separative behaviors.
In this context, because the origin of sufering
is in the human being, he is responsible for it, and can
overcome it by having recourse to his own inner poten-
tialities, that is, to the development of consciousness,
until reaching the spiritual experience that connects
individual to universal life (Boggio Gilot, 1993). Tese
goals require a profound knowledge and transformation
of oneself.
Te spiritual vision is profoundly diferent from
the scientifc one, in that it confers responsibility and
a central role to the patient, making him no longer an
unaware victim but rather the maker of his own destiny.
In looking broadly at the sense and nature of sufering,
the Eastern view adds a particularly enlightening per-
spective by emphasizing the central role of karma, that
is, the law of cause and efect, which attributes a determi-
nant value to human action with the consequent produc-
tion of corresponding efects. Te inevitable sufering,
such as for instance that related to an organic disease or
the daily problems of existence, that the Western view
attributes to a bizarre and obscure fate, is in the Eastern
International Journal of Transpersonal Studies 5
view the result of a negative behavior, possibly even
stemming from some previous existence, that created
negative efects precipitating in the present.
Te concept of karma recognises a relative
free-will, in the sense that fortune or misfortune is the
product of previous behaviors and choices. Te present,
however, is not only inevitably predetermined, but is also
the time when new free actions are promoted, thereby
strewing the negative or positive seeds that will sprout
in the future.
Close to the concept of karma is Platos notion
of daimon, reconsidered by Hillman (1997), according
to which the soul becomes incarnated even in choosing
his or her own parents and life events, in order to pass
through a developmental process and face the chal-
lenges needed to reach liberation. In this context, the
sufering that life brings along is in no way accidental,
but is rather a signifcant and liberating element meant
to foster the perfecting of the individual and elevation
toward the supreme goal of life.
In agreement with the Eastern tradition (e.g.,
Samkara), Plato outlined that not only sufering does
not derive from others, but also it is highly useful in
that it serves to lift up oneself: it has a cathartic value
and brings along the possibility to live it as an oppor-
tunity of growth and development. In this spiritual
perspective, sufering as such is dignifed as an oppor-
tunity of growth, and responsibility is underlined, in
that the individual is at least a co-creator of that which
he lives, and has a task. In short, there is a meaning in
what happens, and this must be understood in terms of
ones own development.
Uniting psychology and the spiritual vision
into an integral conception (Boggio Gilot, 2005), it
is possible to outline two basic categories of human
sufering: (1) Tere is one type of sufering that has a
developmental signifcance: it is useful because it ofers
the possibility of a transformation of ones person-
ality and, through this, the opportunity to get rid of a
negative karma accumulated in the past. Tis sufering,
if well understood, helps liberation and salvation. (2)
Tere is another type of sufering that is useless and self-
produced, in the here and now, through the factors of
self-centered unawareness and the consequent poisons
Human sufering according to

...the scientifc view
of Western psychology
All human sufering comes from the outside:
the human being is a passive victim and is right to be
afraid and to defend himself from external threats.
Mental sufering is signalled by symptoms stem-
ming from troubled object relations or negative con-
ditionings. Te human being is right to be resentful,
because he is the victim of the violence of others.
Te healthy mind is identifed with the absence
of clinical symptoms and its sufering does not re-
quire to be cured.
Te unhealthy mind shows symptoms and must
be cured countering the symptoms, with no refer-
ence to the ethical and spiritual state.
...the meditative tradition
Part of the sufering is self-produced through
wrong doings of the past and the present: rather
than being afraid, the human being must take re-
sponsibility for his actions by doing right.
Mental sufering is either the result of a previ-
ous negative karma, or the result of the poisons of
the unaware and egocentric mind in the here and
now. Te human being has no reason to be resent-
ful: his task is to proceed towards the understanding
and transformation of himself.
Te absence of clinical symptoms does not
mean that one is healthy. Te healthy mind is the
one which is inhabited by ethical factors and quali-
ties that produce the right perception and is united
with life.
Te unhealthy mind is inhabited by factors of
egocentric unawareness and by poisons that are un-
ethical attributes of illusion and sufering. Te cure
implies spiritual development.
Table 2.
International Journal of Transpersonal Studies 6
of the mind. Tis sufering, caused by wrong doings of
the present, is soiled with non-ethical factors and brings
along destructiveness, as well as negative efects for the
future.
Te sufering that is not self-produced and is
ultimately useful includes both those disturbances of
development deriving from traumas sufered by the
child in the family and early environment, as well as the
sufering related to unavoidable life events.
Te sufering that is self-produced, instead,
stems from a thought lacking wisdom and from nar-
cissistic and non-ethical personal choices. Here lie the
roots of that negative assimilation of the frustrating
experiences of life and of those reactions of rejection
that frequently give rise to clinical symptoms and the
maladjusted behaviors of overt psychopathology.
Te integral approach is that which takes care of
the various forms of sufering with an accurate diagnosis
and using tools derived from Western psychotherapy and
Eastern meditative wisdom: particularly the practice of
ethics and the practice of awareness and transformation
of the Yoga Vedanta systems of meditation, considered
to be particularly useful for taking care of mental and
behavioral sufering (see Table 2 and Figure 1).
As has been pointed out, it is and will become
increasingly evident that the only psychology capable of
facing the despair, destructiveness, and bewilderment of
the modern world will be an integral psychology that
includes the wisdom of spiritual traditions. Only these,
in fact, possess the methods to foster the awareness of
the good forces that every human being carries as inner
nature, and only these can foster the trust and the hope
without which neither healing nor the peace of the heart
will ever be realised (Boggio Gilot, in press).
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Shambhala.
Human sufering
SUFFERING
MEANINGFUL MEANINGLESS
TRANSFORMATIVE DESTRUCTIVE
Disturbances of Diseases and Factors of Poisons
development due unavoidable egocentric of the
to traumatic life events unawareness unethical
factors mind
Figure 1.
International Journal of Transpersonal Studies 7
About the Author
Laura Boggio Gilot, PhD, is a psychotherapist and
author. She is founder and president of the Italian
Association for Transpersonal Psychology (AIPT), co-
founder and past president of the European Transper-
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