A Transpersonal View of Human Development, Psychopathology and Psychotherapy John R.

Battista

A Transpersonal View of Human Development, Psychopathology and Psychotherapy

Abstract The authors information theory of consciousness is utilized to present a comprehensive transpersonal view of human development, psychopathology and psychotherapy in which the different forms of psychopathology are understood in relation to different developmental tasks requiring different types of psychotherapy. This view is compared to Wilbers transpersonal view of human development, psychopathology and psychotherapy. Keywords: Transpersonal, Development, Psychopathology, Hierarchy of ego functions, Wilber

Resumen La teora de la consciencia que se presenta a continuacin es utilizada para presentar una visin transpersonal del desarrollo humano, la psicopatologa y la psicoterapia, en la cual las diferentes formas de psicoterapia son entendidas en relacin a diferentes capacidades del desarrollo, que requieren diferentes tipos de psicoterapia. Esta visin es comparada con la visin de Wilber acerca del desarrollo humano, la psicopatologa y la psicoterapia. Palabras clave: Transpersonal, Desarrollo, Psicopatologa, Jerarqua de las funciones del ego, Wilber

Received: 14 October, 2011 Accepted: 4 April, 2012

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[The Journal of Transpersonal Research has decided to publish this article as it has been positively peer reviewed and because of its theoretical interest and its clarifying explanations. However, it is acknowledged and it is stressed that the references are very old and have not been updated].

Introduction Transpersonal psychiatry and psychology are often conceptualized as branches of psychiatry and psychology concerned with transpersonal states of consciousness. However, transpersonal psychiatry and psychology are not limited to the study of transpersonal states. They are encompassing approaches to psychiatry and psychology which are informed by transpersonal states and integrate them into a general psychological theory of normal, healthy and disturbed human development and experience. The encompassing nature of a transpersonal perspective is evident in Wilbers spectrum psychology, which provides an excellent example of a transpersonal approach to human development, psychopathology and psychotherapy. In The Spectrum of Consciousness Wilber (1977) contends that consciousness is best understood as a spectrum of types or forms of awareness. In The Atman Project, Wilber (1980) shows how these forms of consciousness are ordered structures of human development that evolve through prepersonal, personal and transpersonal stages. In Transformations of Consciousness, Wilber (1986) he argues that the disruption of these developmental stages result in identifiable psychopathologies. Finally, Wilber (1986) contends that particular types of psychotherapy are particularly appropriate for particular developmental psychopathologies. This paper provides another example of a transpersonal approach to psychology and psychiatry by extending the authors information theory of consciousness (Battista, 1978) into a somewhat different model of development, psychopathology and psychotherapy, which is compared to Wilbers. The Development of Human Consciousness The first step in developing a transpersonal theory of psychopathology and psychotherapy is to extend a general theory of consciousness into a theory of the development of consciousness. A previously published theory (Battista, 1978) of human consciousness involves six forms: perception, emotion, subjective awareness, ego awareness, self-awareness, and transpersonal consciousness. This section attempts to show how these forms of consciousness are manifestations of increasingly encompassing structures that can be understood in terms of the development of the self. Six different self structures are identified, and transitions from one to the next are discussed in terms of six orders of ego functions which resolve uncertainty associated with six developmental tasks. Table 1 shows the relationship among the six self-structures, six levels of consciousness, six developmental tasks, and six orders of ego functions (information processing functions) in comparison to Wilbers stages of development.

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Table 1 Self-Structures and the Development of Consciousness Developmental Operation Task (Information Processing Function) separation of nervous sytem consciousness development from unconsciousness separation of motor external and internal separation of interpersonal person from others separation of internalization identity from subjective sense of self separation of discrimination, authentic self acceptance and from identified integration self separation of disidentificatranspersonal tion self from authentic self Resulting Level Resulting Selfof Consciousstructure ness perceptual perceptual Wilber Equivalent Structure of Consciousness sensori-physical

emotional

emotional

phantasmicemotional rep-mind

subjective (representational) ego awareness

subjective

ego-identified

rule-role mind

self-awareness

existential

vision-logic

transpersonal

transpersonal (realized)

psychic subtle causal

The first developmental step takes place in utero with the development of the nervous system. The peripheral nervous system has the capacity to transduce the physical environment into patterns of nervous system impulses transmitted to the central nervous system. The decoding of this sensory information by the central nervous system generates perceptions of the physical environment. Sensory information is the object of consciousness and perception is the subject of consciousness. This is the perceptual order of consciousness which comprises the first self-structure, the perceptual-self. The newborn infant is unable to regulate her own physiology. The resulting perceptual uncertainty is associated with distress (negative affect). The infant expresses this distress through instincts such as crying, rooting, and reaching out (Bowlby, 1982). These lead caretakers to respond to the infants needs, ideally resulting in emotional satisfaction and secure attachment (Karen, 1994). In addition, the infant perceives changes in the external environment (Stern, 1985) and is instinctually programmed to operate on the resulting perceptual uncertainty through motor actions (Karen, 1994). These motor operations allow the infant to organize percepts into physical objects. By between two and seven months, the infant can make a distinction between her physical body in an external world of objects and the emotions of an internal world that exist in relation to attachment figures (Stern, 1985). With this distinction of internal and external, the infant has
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achieved a second order of consciousness, emotional consciousness, which defines a second self-structure, the emotional self. With this achievement perceptions become the objects of consciousness organized into a physical world and emotion becomes the subject of consciousness, existing in relation to attachment figures. The infants organization of percepts into a physical world with attachment figures allows the infant to begin to interpersonally operate on her emotional attachments to form a subjective sense of self separate from emotion. This process is analogous to the preceding stage when the construction of sensations into perceptions allowed the infant to resolve perceptual uncertainty through action and attachment to form physical objects and experience emotion. Operating on emotional uncertainty with attachment figures takes place through interpersonal, dyadic games such as peek-a-boo and the modulation of interpersonal cues to elicit attention (Bowlby, 1982). These interpersonal operations, which resolve emotional uncertainty by allowing the child to influence and regulate her attachment figures, result in the emergence of a new order of consciousness, subjective awareness, which characterizes a third self-structure, the subjective-self. The child now experiences emotions objectively, as part of her intersubjectively conscious self (Bowlby, 1982). The attainment of this new self-structure is marked by the childs capacity to recognize herself in a mirror as me, something that normally occurs about age two. It is not until age five or so, when language and cognitive skills have developed enough for concrete operations to replace primary process operations, that the child begins a transition to a new self-structure--a transition that will normally not be completed until at least the time of puberty and early adolescence. This fourth developmental period is concerned with resolving uncertainty that develops from the childs being able to hold her subjective sense of self as an object. This objectification of the subjective sense of self is facilitated by people in the environment labeling her as a person with attributes--pretty, smart, athletic. Similarly, self descriptions also result from the internalization of emotions and feelings present in the environment, even if they are not verbalized. Rules and expectations about how one should behave and feel are also internalized. The child also internalizes strategies for coping with the world by observing the adults in her world. In all these cases, internalization is the information processing mechanism which the child utilizes to resolve uncertainty associated with objectifying her formerly subjective sense of self. Through internalization a child develops an identity; a concept of who she is that distinguishes her from others. In making this distinction between her identity and her conscious being, a fourth order of consciousness is attained, ego or conceptual consciousness. Attainment of this new order of consciousness and its associated self-structure, the egoidentified self, is marked by the childs ability to articulate her self attributes. In this self-structure ones being has become the object of consciousness while ones identity has emerged as the subject of consciousness, who one is. The development of formal operational thinking marks the beginning of the fifth developmental stage, one that will last many years. In the preceding stage the child is capable of taking her being as an object, but only through the use of concrete operations. Her identified-self is the result of being told how she is or experiencing herself in actual situations. However, with the development of operational thinking, the adolescent develops the capacity to imagine how she would like herself to be, and imagine how she might behave and feel in a variety of circumstances. Imagining how she would like her self and the world to be results in the formation of ideal self images with values and beliefs. This new developmental capacity allows a young adult to begin to distinguish how she would like to be from how she is. Such a conceptual differentiation of her identified self also allows her to differentiate how she acts from how she feels, and how she thinks of herself from how she is. These differentiations allow the emerging adult to begin to understand that identity is not unalterable, but something that can be chosen, developed, changed and transformed. Through these processes a personal, existential self is distinguished from a social, internalized self, and an ideal self is distinguished from a real self. Development in adulthood entails acting on the identity and beliefs we internalized and identified with
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in childhood. We begin to take responsibility for who we are. As a result it becomes possible for the person to speak of her own psychology; what her nature is, how she got to be the way she is, and what she would like to do about it. Possibility and uncertainty about identity are resolved through discriminating self-awareness which allows the construction of an existential self. With the acceptance of ones self and affirmation of ones values and beliefs, an authentic self can be constructed. With this construction a new level of co nsciousness, self-awareness, and a new self-structure, the existential-self, have been attained. Identity is now the object of consciousness while the sense of being ones own true self, is what one is subject to. The sixth stage of development involves operating on the existential-self and the discriminating, constructive nature of self-awareness characteristic of the preceding stage. For most people this is initiated by calling into question the purpose, meaning, or significance of the life, person, and work one has been constructing. Sometimes it is initiated by the realization that one is embodied and will die, a realization facilitated by the development of a physical illness or encounter with death. Sometimes it is initiated by the spontaneous experience of transpersonal states or a higher power. In any case, the constructive nature of discriminating self-awareness must be transcended. Many techniques for this purpose have been delineated in the contemplative traditions. In some techniques the person deconstructs self-awareness by witnessing it. In other techniques, self-awareness is transcended by concentrating on an object, sound, or image until all distinctions fall away. Techniques, such as koan, emphasize contemplation on questions and concepts that require the person to pass beyond constructive, rational consciousness to enlightenment. Similarly, devotion, prayer and service can lead beyond self-awareness to the transcendence of subject-object distinction. In all these approaches, disidentification with the existential-self who thinks, acts, discriminates, labels, evaluates, and constructs takes place. Through disidentification a new order of consciousness, transpersonal, and a new self-structure, the realized-self, comes into being. Here there is no subject or object of consciousness, only pure awareness. This model of development is summarized in Table 2. Table 2 The Development of the Self Development of the Self Developmental Task Period in which takes place Operations utilized First Task development of perception in utereo Second Task separation of inner and outer first year Third Task development of sense of self second Year Fourth Task development of identity 2-12 years Fifth Task development of authentic self adolescence and adulthood discrimination, acceptance and integration identity, beliefs, roles, Sixth Task development of a realized self maturity

CNS development

Objects of conscious experience

sensory input

motor operations on perceptions perceptual world

interpersonal communication emotional attachments, emotions

internalization

disidentification

personal self, impulses

personality, constructive consciousness universe and self

Context of conscious-ness

womb

physical world and

emotional attachments

family, school and

relations with society

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caretakers Consciousness subject to Uncertainty resolved Distinction made mothers physiology physical empathy of parents perceptual inner and outer recognizing objects, emotion emotional responsiveness of parents emotional self & other, person and thing sense of self

community reinforcers and values of society personal person and identity reflective selfawareness identified

and significant others own capacities personality identity and self selfexpression, selfacceptance existential

grace

existential self and noself (realized self) compassion, service and selflessness transpersonal enlightenment

consciousness, unconsciousness Conscious capacity perception that emerges

Self-structure that emerges Marker of attainment

perceptual responsive to input

subjective

What is integrated

Period in which self-structure operates Result

attachment (separation anxiety) perceptions into physical world later in utereo 7 months through 2 through 2 years years existence formed objects formed

recognize self can describe authenticity in mirror self attributes emotions into person qualities into identity needs, values and beliefs into dasein mid-late adulthood

self into universal

2 years through 11 years persons formed

adolescence through at least early adulthood identity formed

rest of life

personality realized

self realized

The Psychopathology of the Self This section addresses the signs and symptoms of difficulties in the developmental process discussed in the previous section. Levels of psychopathology are delineated that relate to the six developmental tasks. Ego functions which indicate these levels of psychopathology are identified and empirical studies in support of this approach are referred to. The first developmental task involves the construction of consciousness through in utero nervous system development. Difficulties with central nervous system development underlie many of the symptom pathologies of DSM-IV. However, this psychopathology frequently does not become manifest until later developmental periods. For this reason, psychopathology is understood in terms of later developmental tasks rather than in utero CNS development. Thus, the model of psychopathology utilized here is developmentally biopsychosocial rather than biological. The second developmental task involves the separation of inner and outer through motor operations on percepts and the regulation of emotion by attachment. Success with this task results in the establishment of a stable and coherent outer world that entails intact reality testing. Difficulty with this level of develop Journal of Transpersonal Research, 2011, Vol. 3, 85-96 ISSN: 1989-6077

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ment is indicated by an inability to differentiate inner from outer. Ego functions which describe an inability to differentiate inner and outer, such as hallucinations, delusions, projection, and ideas of reference are markers of a problem with this level of the development of the self. This is the very severe or psychotic level of psychopathology. The third developmental task involves the separation of conscious being from emotion, and subjective self from other, through interpersonal operations on the emotional attachments formed in the preceding developmental stage. These interpersonal operations result in the ability to regulate emotion in relation to others. Failure to accomplish this developmental task is indicated by the failure to develop a coherent personal self, the inability to separate self and other, the inability to utilize another to regulate affect, the regulation of affect through pathological means (non-intrapsychic, non-interpersonal), or the continued reliance on immature attachments. The failure to develop a coherent personal self is indicated by dissociation, fragmentation, and splitting. The inability to utilize another to regulate affects is indicated by rage attacks, grandiosity, devaluation, or schizoid withdrawal. The inability to differentiate ones self from another is indicated by projective identification and projection. The control of emotion through pathological means is indicated by substance abuse, sexual perversions, sexual or physical abuse, rocking, head-banging, and self mutilation. The continued existence of immature attachments is indicated by idealization, abandonment depression and extreme dependency. All of these behaviors and ego functions are indicative of a severe or borderline level of psychopathology. The fourth developmental task involves the separation of identity from being through the internalization of attitudes and functions. These internalizations ideally result in the establishment of a positive, accurate, socially adaptive identity and the capacity to intrapsychically control emotions and impulses. Failure to successfully complete this developmental task results in a negative self image, or socially maladaptive means of relating to society. Socially maladaptive means of relating to society are manifest as a failure to modulate ones needs or impulses in relation to others, a tendency to blame others for conflicts, and a tendency to deny ones own role in generating conflict. Ego functions and behaviors which indicate this failure of adaptation are impulsivity, acting out, denial, lying, cheating, lack of concern for others, and displacement of responsibility. These behaviors and ego functions are indicative of a moderate or characterological level of ps ychopathology. The fifth task in the development of the self involves the differentiation of identity from self, and the reconciliation of ideal self images, real self images, and internalized beliefs into an authentic, existential self. A failure in this process is indicated by maintenance of an impersonal, non-intimate social self, or an inauthentic self-structure characterized by inaccurate self images or confusion about how to be in the world. An impersonal social self is indicated by the use of intellectualization, emotional distance, denial, or disavowal as a means of coping. Confusion is indicated by use of ambivalence, passive-aggressive behavior, reaction formation and doing-undoing as means of coping. These behaviors and ego functions refer to a mild or neurotic level of psychopathology. Successful resolution of this developmental stage is manifest by acceptance, humor, sublimation, and integration--ego functions characteristic of healthy adult functioning. The sixth task in the development of the self involves stilling the constructive nature of selfawareness and allowing the emergence of a realized self. Such a realized self is characterized by transpersonal states of consciousness, resolution of polarity, compassion, and altruism. Difficulties with this transition may result from the misuse of spiritual concepts to serve the defensive functions of earlier developmental stages or may emerge from the establishment of a new spiritual identity as a means of avoiding the difficulty of renouncing ones attachment to an ego identity. The misuse of spiritual concepts to serve defensive functions results in pseudospiritual or inauthentic spirituality characterized by inaccurate self-attributions of spiritual development to serve narcissistic and defensive functions (Battista, 1996a). Alternately, identification with the spiritual and difficulty disidentifying with ones identity results in inflation of the ego rather than its transcendence. The difficulties and problems of earlier ego identity formation become amplified in
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inflation. Inflation can appear psychotic-like and needs to be distinguished from psychotic states (Lukoff and Turner, 1996). Inflation can serve the process of spiritual development by presenting developmental problems to awareness to be worked through (Lukoff, 1996; Scotton and Hiatt, 1996; Grof and Grof, 1989). This developmental model of psychopathology defines a continuum of health and illness beginning with psychosis and progressing through borderline and characterological levels into neurotic, healthy and transpersonal psychological structures (Battista, 1981). This continuum defines a hierarchy of ego functions which is consistent with empirical findings (Battista, 1982). A factor analysis of global assessment scale ratings, as a measure of psychological health/disturbance, utilizing the levels of psychopathology defined above through an ego function inventory, was able to account for the variance in the global assessment scale ratings of a clinical population at the .001 level, providing good empirical support for this developmental continuum of ego functions (Battista, 1982 and Battista, unpublished). Table 3 presents an overview of the psychopathology of the self.

Table 3 The Psychopathology of the Self Developmental Task separation of inner and outer Level of psychopathology psychotic very severe Ego-functions that mark psychopathology hallucinations delusions ideas of reference projection dissociation, fragmentation, splitting, grandiosity, projective identification, emotional dyscontrol, idealization, abandonment depression impulsivity, acting out, denial, cheating, lying, displacement ambivalence, passive-aggression, reaction formation, doing-undoing, intellectualization, disavowal, aloofness psuedospirituality ego-inflation Ego-functions that mark success intact reality testing

formation of person and separation from other

borderline severe

capacity to regulate emotion internally and or interpersonally

formation of identity characterological moderate formation of authentic self neurotic mild

positive self concept social adaptation sublimation, humor, acceptance, humor, integration

realize self

spiritual problems

selflessness, humility, compassion, love

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The Psychotherapy of the Self Each level of psychopathology outlined in the previous section requires a different form of psychotherapeutic intervention. The healthiest transition is from an authentic personal self to a realized self through transcending the constructive nature of self awareness. This process is interior, but may benefit from a spiritual teacher, guide, or instructor. A therapist could serve as this guide, if properly trained and developed. Such a therapy would be truly transpersonal, and has been attempted in Jungian analysis and psychosynthesis in addition to the transpersonal psychotherapies which employ contemplative techniques. One essential aspect of therapy at this level is to open the person to the transpersonal. This can take place through the being of the therapist, or directing the person to practice techniques which lead to the transcendence of cognition. Once the person has moved along this path he or she is encouraged to continue to practice. I use a magic ring or mantra technique. In the magic ring technique, the client wears the magic ring (a remarkably gaudy, fake, red ruby ring) to remind themselves what they are doing and to get other people to ask them why they are wearing the ring. They then say the reason-- to be here now, to go slow, to allow. The mantra technique is similar and involves the development of a saying the person repeats over and over again to themselves (breathe, pay attention, allow) to remind them of their practice. Assagioli developed many interesting techniques to facilitate transpersonal development (Battista, 1996b). Most intensive psychotherapy occurs at the level below the transpersonal--the transition from a socialized, inauthentic self to an authentic, existential self. The initial step in this process is to help the client distinguish a real, embodied self from false or ideal self images. In the neurotic, embodied experience is often disavowed as needy, immature, or frightening, and replaced by strivings for perfection, or demands for higher levels of functioning. One role of the therapist is to encourage the person to claim, honor and integrate these split off dimensions of self as the foundations for authentic life. The therapist models authentic relationship in this process and offers an emotional engagement within the limits and boundaries of the therapeutic role. Particularly important in this process is the acknowledgment and reworking of yearnings to be cared for. Resistances to these yearnings must be addressed within a context of accepting, nurturing, but circumscribed, emotional availability. See the case of Alice (Battista, 1996a). This humanistic process of life transforming psychotherapy is particularly well facilitated by a therapist who has some familiarity with spiritual, transpersonal life. This allows the therapist to approach the individual seeking to claim her own life with compassion and empathy, not only of having been there, but of seeing the entire process in context. In this way, although existential-humanistic therapy may not be directly transpersonal, the transpersonal development of the therapist facilitates the authentic development of the client. Similarly, in dealing with more severely disturbed persons, the non-judgmental and compassionate nature of the transpersonally informed therapist will help the person to perceive and accept him or herself. The transition from an undersocialized individual to an independent, socialized individual who can exist in mutual relationship represents another type of transition that therapists are called upon to facilitate. Such characterologically disturbed individuals are commonly brought to the therapists office by their parents, spouse, or society rather than by their own motivation. The situation often represents a mixture of unresolved early childhood problems that relate to the preceding level of development, and the need to develop a coherent, authentic self that relates to the subsequent level of development. An example would be a youth who has been neglected or neglectfully indulged, so that she never learned to renounce her impulses or desires for the sake of the other, or long-term social success. Here the therapist is called upon to intervene in a different way from the neurotic level. At the neurotic level the therapist had to identify and support the disavowed real self to help the person construct a new and authentic way of being in the world. At the characterological level, the therapist must intervene to help the person transform her attachment to the gratification of her own needs and accept a social reality bigger than she is, in order to develop a positive, identified self.
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This often requires educating the client as to how the world works, persuading her to change her behaviors, and establishing social reinforcers for modifying her behavior, as well as working with her parents to have clear and consistent expectations for the child which acknowledge her own wishes, wants, needs and capacities without tyrannizing her or being tyrannized by her. The therapist acts as an agent in the socialization process with character disorders, whereas the therapist acts to undo the internalization of poor socialization with the neurotic in more traditional psychotherapy. Individuals with an undersocialized or impulsive self, have a self, but have not learned to regulate and coordinate that self in a mutual, interpersonal context. Similarly, neurotic individuals have a self, but this self, often disavowed, has been dominated and tyrannized by internalized social attitudes and constraints. When we go to the borderline level of psychopathology we enter a domain in which there is not a cohesive, differentiated self. The self exists in fusion, or intersubjective immersion in relation to another, although this may be defended against, as in individuals with a schizoid personality style. In individuals with dissociative disorders or borderline personality disorders, the self will be fragmented and disintegrated through splitting and compartmentalization. Individuals at the borderline level of development require a different type of therapy from that outlined for the neurotic or characterologically disturbed individual. They need outsight-- the capacity to see themselves from the outside, in order to be a functional, separate person in relation to others. The neurotic needs inner sight--to be aware of her true, embodied self and to have empathy for it. The borderline needs outer sight--to become aware of how she enacts her needs in an interpersonal context. She is fused in relationship, rather than having relationships. Although providing an emphatic, understanding and even gratifying relationship may be useful, necessary and important in the therapeutic process, the critical variable is the capacity of the therapist to understand and analyze the relationship and relationship demands that the patient creates, and not take them personally. These relations may be negative or positive, and not uncommonly, alternate between these poles. In the negative form, the therapist is commonly experienced as not understanding enough, not giving enough, or may be experienced as unavailable, or destructive. The client demands understanding and attention, blaming the therapist for causing them to be upset. She needs understanding, and deserves it, because she was deprived of it--mistreated. This is true, but the way she insists on this denies the existence of the therapist as an independent person, and interferes with obtaining the very thing she desires. Many times such an insistence contains a good deal of hostility and rage which is denied, projected onto, or provoked in, the therapist. This aggression must be acknowledged and dealt with before empathic understanding can take place. Alternately, the relationship may be idealistically positive. The client idealizes the therapist or is in love with the therapist, believing that the therapists full attention and nurturance would resolve her emotional problems. The therapist must be able to maintain her own boundaries and integrity, and separate the experiences of the client from her own self. Thus, the key to treating individuals at this level is the working through of the self-other confusion in which the person is embedded. This working through process involves empathic confrontation and understanding in the context of clear, consistent boundaries. See the case of Karen (Battista, 1996a). The final level of psychopathology is psychotic. Here the patient is unable to differentiate inner and outer. Again the therapist is called to relate to the client in a different way. The therapist must take care of the patient. On one hand she must give her medicines to help her clarify her perceptual and cognitive processes. On the other hand, the therapist must help her cope with the demands of life--must serve as a surrogate ego so she can function in society. This section has discussed five different developmental transitions on a continuum of health and illness: from personal to transpersonal, from inauthentic to authentic, from undersocialized to interpersonal, from intersubjective to personal, from dysfunctional to functional. Each of these transitions calls upon the therapist to focus in a different way: as guide; as engaged and authentic person; as social, interpersonal agent; as empathic analyst; and as caretaking organizer. Clients often embody all these transitions, thus demanding
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the therapist have familiarity and facility in going back and forth between each of these transitions with confidence and clarity.

Conclusion An information theory of consciousness was used to present a transpersonal theory of development which identified six self-structures (perceptual, emotional, subjective, identified, existential, and realized) which result from the resolution of six developmental tasks (central nervous system development, separation of inner and outer, separation of self and other, internalizing an identity, differentiating an authentic self from ones identity, transcending the constructive nature of self-awareness). This developmental theory was used to define an empirically supported continuum of health and illness (psychotic, borderline, characterological, neurotic, psuedospiritual) and discuss the different types of therapeutic interventions that therapists must make (caretaking organizer, empathic analyst, social agent, authentic other, guide) in order to facilitate the development of a particular individual at a particular point in time.

References

Battista, J. (1981). The Structure of Health and Illness: An ego functions approach. In W. Reckmeyer (Ed.) General Systems Research and Design: Precursors and Futures. Louisville, Kentucky: Society for General Systems Research. Revised edition reprinted in W. Gray, J. Fidler and J. Battista (Eds.) (1982). General Systems Theory and the Psychological Sciences. Oceanside, California: Intersystems Press. Battista, J. (1982). Empirical test of Vaillants hierarchy of ego functions. American Journal of Psychiatry, 139, 356-357. Battista, J. The continuum model of health and illness: an empirical investigation. Unpublished manuscript. Available upon request. Battista, J. The science of consciousness. (1978). In K. Pope & J. Singer (Eds.). The stream of consciousness, (pp55-87). New York: Plenum Press. Battista, J. (1996a). Consciousness, Offensive Spirituality and Spiritual Defenses. In B. Scotton, A. Chinen & J. Battista (Eds.). Textbook of Transpersonal Psychiatry and Psychology, (pp250-260). New York: Basic Books. Battista, J. (1996b). Abraham Maslow and Roberto Assagioli: Pioneers of Transpersonal Psychology. In B. Scotton, A. Chinen & J. Battista (Eds.). Textbook of Transpersonal Psychiatry and Psychology, (pp52-61). New York: Basic Books. Bowlby, J. (1982). Attachment. New York: Basic Books. Grof, S. and Grof, C. (Eds) (1989). Spiritual Emergency. New York: Putnam.
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Karen, R. (1994). Becoming Attached. New York: Warner Books. Lukoff, J., Lu, F. and Turner, R. (1996). Diagnosis: A Transpersonal Clinical Approach to Religious and Spiritual Problems. In B. Scotton, A. Chinen & J. Battista (Eds.). Textbook of Transpersonal Psychiatry and Psychology, (pp231-249). New York: Basic Books. Lukoff, D. (1996). Transpersonal Psychotherapy with Psychotic Disorder and Spiritual Emergencies with Psychotic Features. In B. Scotton, A. Chinen & J. Battista (Eds.) Textbook of Transpersonal Psychiatry and Psychology, (pp271-281). New York: Basic Books. Scotton, B. and Hiatt, F. (1996). The Contribution of Hinduism and Yoga to Transpersonal Psychiatry. In B. Scotton, A. Chinen & J. Battista (Eds.). Textbook of Transpersonal Psychiatry and Psychology, (pp 104113). New York: Basic Books. Stern, D. (1985). The Interpersonal World of the Infant. New York: Basic Books. Wilber, K. (1977). The Spectrum of Consciousness. Wheaton, Illinois: Theosophical Publishing. Wilber. K. (1980). The Atman Project. Wheaton, Illinois: Theosophical Publishing. Wilber, K., J. Engler and D. Brown (Eds.). (1986). Transformations of Consciousness. Boston: Shambala.

*John R. Battista, M.D., has assumed the practice of M. Scott Peck, M.D. 25 years ago and continues to practice psychiatry and psychotherapy in New Milford, Connecticut. He is also consult at Wellspring, a residential treatment center for young adults. He works at Staywell, a Federally Qualified Health Clinic, which serves the poor population of Waterbury, Connecticut. He is a member of the Specialized Research Faculty of the Institute of Transpersonal Psychology in Palo Alto, California where he supervises the research of doctoral candidates. He was formerly an Assistant Professor in the Psychiatry Department of the University of California, Davis where he taught personality theory, developmental psychopathology and existentialhumanistic psychotherapy in addition to being the Director of Residency Training. For a good number of years he also taught at the Temenos Institute in Westport, Connecticut a Jungian-Transpersonal- Humanistic training institute for psychotherapists. He has published twenty five articles and edited three books, including the Textbook of Transpersonal Psychology and Psychiatry. Address: Riverbend Psychiatric Associates, 88 Cherniske Road, New Milford, Connecticut 06776 Email: [email protected]

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