Integral Medicine & Psychiatry – A Clinical Model

We are finally in a place to bring all of our cultural, historical, and theoretical mapping together into a coherent model of Integral Medicine. Traditional medicine developed along similar lines in all areas of the globe during the prehistoric or “matriarchal” era of humanity. This included first various aspects of “shamanism” in which the body was considered an extension of the larger mind of the spiritual archetypes or gods. Natural medicinals gathered from minerals, plants, and animals were used in these ceremonies for their holographic resonance with these various archetypes. The ceremonies were “psychotherapeutic” in that they were ritualistic and often involved psychoactive medicine for patient and/or doctor in order to reach a level of mind that would access curative properties and release them from the bonds of the material body. They were “psychedelic” in that they “revealed” the psyche, mind, or spirit which in itself was the most powerful healer. Matriarchal communities were guided by a maternal archetype in that they existed in a cyclical environment marked by the sustenance and seasons of mother earth and the mothering of child and home. As these communities came to be replaced by patriarchal societies, the father archetype became dominant, bringing in hierarchical government, written law, and linear history. Medicine too changed. Medicinals and other interventions became more theoretically codified and practice was based on the imbalances relating to the empirical substance of earth. While we find similarities in all the traditional medicines of East and West, it was in the development of Oriental medicine – most specifically Chinese medicine – that we find the most complex and articulated practice, scientifically evolving along a continuous line to the present. Like all traditional medicines, Oriental medicine is primarily focused on the naturopathic method of supporting the life principle or sustentive power – the tonification and harmonization of vital energy or qi – though in it we also find the roots of both allopathic and homeopathic methods.


The primary divide between Eastern and Western areas of the earth concerns what we call the Western turn of the analytic development. Beginning in the classical Greek era, the movement toward a splitting of right and left brain, an increasing development of rational thinking and argumentation lead to the creation of analytic philosophy and science seeking to separate and isolate parts of the world and to a democratic government seeking to recognize each individual man apart from the group. This movement continued to struggle over the following centuries with the group binding of religion and the church, but finally emerged during the enlightenment to fulfill its aim in the modern era. These changes led Western science and medicine into a parallel journey of divided legacy in which rationalism and empiricism struggled for domination, and during the middle ages they both had to struggle against the dogma of the church. The holistic science and medicine of the traditional era which persisted and evolved in the East went underground in the West and survived in various esoteric or occult traditions of alchemy and magic.


By the time of the enlightenment, medicine was but a chaotic array of brutal practices aimed at purging and cutting out the evil disease from patients’ bodies. The medical practices refined from the classics in Oriental medicine in order to support the vital healing of the body can be recognized at this time in the West in perverse form, where the severing of the material body from spirit was met with overwhelming assaults of opposition such as cutting, bleeding, purging, and burning in the desperate hopes of expelling the evil toxin – apparently based on the idea that more is better. Here we see the development of modern allopathy – the principle of treating with the opposite separated from that of treating with the same and intensified through a myopic focus on the gross material body. Science followed suit by increasing its efforts to control the material earth through biochemistry and microbiology, supplying more technology to refine the allopathic paradigm, which has made major strides in improving certain disease conditions, while remaining blind to the ultimate insufficiency of the paradigm itself. Meanwhile the marginalized lineage of traditional physicians surviving in the realm of alchemy influenced a return to the naturopathic and to the development of modern homeopathy. From this point on the modern era has been a struggle of the divided legacy of medicine in the West leading us to our current state of disarray.


From out of the depths of this materialist paradigm, the rediscovery of the mind in the West was a discovery of the small mind – the personal mind evolving out of each individual’s embodied experience of his life history stored and integrated through the brain. It is no coincidence that this “curious, extraneous, extraordinary” organ, as it is known in Oriental medicine, has risen to prominence through Western modernism. The evolving brain, with its neocortical mapping of the external environment and seat of the self in the frontal cortex, is the core of modern man’s individuating journey towards free choice and co-creation – his emergence from the domination of the collective mind of genetic organs and cultural laws – and for the introjection of this struggle into his own psyche he uses his new brain. This turn of events is also the occasion of the transformation of illness in modern man from environmental and epidemic disease of the group form to neurotic or biopathic diseases of modernity – personal diseases reflecting each man’s struggle with his divided subjectivity and the splitting of the bodymind. Psychoanalysis stumbled on to all of this from within clinical medicine and biological neuroscience and extended its findings and practices to include semiotics, philosophy, and cultural history in order to create an integral spiritual science of mind and innovative psychiatric practice which had been missing in the West for some time. Yet it still remains largely divorced from the practice of medicine and the body.


The problem with modern consciousness research is that it is trying to solve the problem of the splitting of mind/body, psychic/somatic, spiritual/material from within a dualistic approach. All of this has lead to the creation of a new integral paradigm in philosophy and science which is bringing traditional Eastern and modern Western thought together for the first time. It is time to bring this perspective to medicine and psychiatry as well. Achieving the integral without restoring the idea of the universal “One” or whole is quite a feat. It means preserving the complexity of difference and the uncertainty of becoming. It means following the flows of change, the emergence of innovation, the possibility of the new, the pulsation of expansion and contraction, differentiation and integration – all of which was always already there yet not perceived from our limited human perspective. But this human perspective is growing able to more truly grasp the essence of the universal as infinite and void, being and becoming, by virtue of its own experience of individuating into complexity and reconnecting transversally. The “big mind” of spiritual forms, ideas, elements, or archetypes contracts and involves itself in matter, manifests as material substance, in a body which expands and evolves itself outward again meanwhile developing its own “small mind” of the psyche by which it reflects the infinite multiverse of this big mind holographically – and even more it communicates, perceives, and invents with it in a continual co-creative process.


The ethical-aesthetic paradigm by which we can practice medicine within this integral perspective of co-creation is that of nourishing destiny – not predestination but the arc of time from the unconscious drive as causal factor to the assumption of responsibility for this creation in the subjective position of the I in the analytic act – the karmic action that alone is. Thus nourishing destiny fulfills the first great principle of medicine – the sustenance of the vital life of the container through containment itself. The second great principle of medicine is fulfilled by the intervention, the analytic cut, the encounter that releases the generative disease or unconscious symptom by means of a return to the unresolved trauma for the purposes of continuing our own destiny of intervention in the universe. The first principle was perfected in traditional medicine in the East – especially in TCM and acupuncture. The second principle was perfected in modern medicine in the West – especially in homeopathy and psychoanalysis. Yet only if we strip each of these great methods from their isolated dogma and bring them into an integral formation can we evolve a greater medicine and psychiatry of the future.


The first great principle of medicine focuses on the body – but most especially on the higher physical body – the etheric energy body as opposed to the dense biomechanical body. We can delineate an essential four elements of medicine as: elimination, detoxification, tonification, and actualization. Elimination begins by removing the cause of imbalance or illness – that which does not sustain the upbuilding life principle of the body. Detoxification is necessary as a further step when the life principle itself is not able to perform its function of assimilating, metabolizing or ejecting to maintain homeostasis and needs support for this purpose. Tonification can then be engaged in order to strengthen the upbuilding process and nourish energy and drive itself, for if one did this before the other steps it may only intensify the imbalance or illness. Finally, these steps unfold into actualization, the destiny of the embodied being itself. All of that which goes into medically treating the patient and healing the body must lead not to some pure homeostasis or ideological image of health but to an act of creation which becomes the signifier for this life. These four steps unfold in time and yet come to accompany one another in a truly integral medical practice, and it is into these four elements of medicine that we can fit all of the interventions and practices of other medical systems. In the end then the first great principle of medicine which treats the somatic body leads to the psyche itself and so too must any medicine unfold into a new psychiatry. This is how we treat the spirit through the body – not by coercing it with drugs by nourishing destiny and supporting actualization.


We can also treat the body through the spirit and this is the second great principle of medicine which focuses on the higher mind – the egoic or mental body of the subjective I rather than the astral emotional body. Most psychotherapy gets lost in provoking, evoking, explaining and maintaining the endless host of embodied emotions. The goal is to reach down and back further than the interpretation and signification of emotional memory toward an encounter with the causal and senseless drive itself in order to offer the possibility of a reassumption of one’s destiny in the form of an act – a great work or magnum opus as the alchemists called it. The second great principle of medicine is psychospiritual in that it releases disease by returning through anamnesis to each unfinished encounter with one’s life history. Each physical or psychic trauma has spiritual consequence for shutting down the path and drive to creation and the first great sustentive principle is not enough to power through all of these blocks. For these are the very symptoms that show the life path itself. This is what is meant by karma. The karmic act of existence runs up against its own meaning and shows itself in the very place where pathos occurs. Thus we must not suppress or deny our symptom – we must learn from it and refine it into its purified form of artistic invention. The vibrational resonance and signification of material substances and physical practices – images, words, and memories – are the very medicines which stimulate a return to the repressed scene of the crime – the unfinished encounter invested with so much pain, meaning and enjoyment that we have not assimilated it.


For the purpose of this metanoia or psychic transmutation, four elements of psychiatry – four elements of clinical practice itself – must embrace and envelope the four elements of medicine as well: containment, intervention, transference, and dialectic. Containment is the frame, the space-time, and most of all the heart and mind of the doctor himself who holds the space of the patient while he takes on this journey of regression in the service of transcendence – this journey of alethia over the river of forgetting back to the underworld of depth. That is why the sustentive practice of medicine to is necessary though not sufficient for this true healing. For in order to let go of the very symptoms that are holding the patient together in his current state of homeostatic dis-ease, he will have to enter into to chaos and disintegration and thus must temporarily borrow from the containment of the doctor and his practice. When this is in place the interventions, as subtle as a word, as dramatic as a psychoactive substance – must be measured and applied with an art of timing and an acute ability to respond, for the purpose of a re-encounter and a cut which frees the patient from the repetition compulsion. While these two steps must inevitably accompany any medical or psychiatric practice, it is only with the further two that true cure and transformation can take place. The transference is the reconnection – the re-cathexis – with the deepest level of the psyche as it is manifesting from the large mind of the infinite to the small mind of the life history – from the causal drive to the subject. For once the art of “tong shen ming” or spiritual contact has been attained with the patient there must be a way to lead him to his own empowered act through a special clinical relationship. The dialectic of the signifier liquidates all overdetermined signification and programming that has accumulated at the hands of the Other whether family or society. It engages the powerful relationship of somatic and psychic attachment and desire in order to lead it away from dependency, suggestion, submission, or rebellion toward a free choice of separation, mourning and individuation and an assumption of responsibility to act and create that which is.