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The Role of the Transpersonal Dimension in Life-Threatening Illness
listed in holistic psychotherapy, originally published in issue 117 - November 2005
For those who are not familiar with the term, Transpersonal Psychology is often described as the fourth force in psychology, following psychoanalysis, behaviourism and humanistic psychology. It is strongly based on the work of Carl Jung, Roberto Assagioli, Abraham Maslow and their successors; it combines Eastern and Western wisdom traditions and the essence of world religions with the insights of modern depth psychology, and puts great emphasis on the spiritual dimension – which has nothing to do with religion. Essentially, in this philosophy, life is seen as a journey of inner discovery and development, during which the ego and the Higher Self or soul must work together and move towards integration. Dreamwork, imagery, visualization, meditation, altered states of consciousness and the use of symbols are our tools on this journey; occasional peak experiences or mystical moments, which occur spontaneously, help us to realize the oneness of all life. At such moments time stands still, all barriers dissolve, and we understand once and for all that, despite appearances, everything is exactly as it should be within the cosmic order.
At the same time the Transpersonal approach is also highly practical. If we don't utilize its higher insights in everyday life, we have missed its essence. The downward journey, into the unconscious, towards the Shadow side of life, is considered just as important as the rare, precious moments of peak experiences; this is an approach that has to be lived in one's daily life, under all circumstances.
It is also an approach that has much to offer in therapeutic work with seriously ill patients. I have used it with cancer sufferers for the past 20 years, and had found it of great value before then, when I myself had been gravely ill with metastasized malignant melanoma. Let me try to explain how – and why – it works so well.
A life-threatening illness, such as cancer, pushes the patient into a narrow, grim, body-centred existence, where all interest and care are focused onto the endangered body and its symptoms. The diagnosis itself unleashes terror and a sense of helplessness. Having a tumour, within one's no longer reliable body, seems worse than having heart trouble or kidney disease which only involve problems with one's own organs. A tumour, however, is seen as an intruder, something alien and malevolent that will eventually destroy its host. That's how most patients see the situation; it doesn't occur to them that it is their own cells that have gone mad, that it is their own body that has produced the illness; and that much more than the body is involved. But since medicine today is still imprisoned in the Cartesian-Newtonian world view, that all-important extra, the psyche, is not taken into consideration; neither is the patient's shock and fear.
This is where the Transpersonal therapist can step in, providing an antidote to the purely disease-centred chaos the patient is trapped in. The perspective must be changed, widened and deepened. The meaning behind the event must be found. "Why me?" asks the patient, which is the wrong question. "What is life saying to me through this illness?" is the correct one. For it is the apparent meaninglessness of a life-threatening illness that is so hard to bear, the seeming injustice of being removed from one's normal existence for no obvious reason. To find meaning and reason is the first step towards healing.
The Meaning of Illness
Illness belongs to the great, simple polarities that define the human condition. Without it, health would lose much of its meaning. Illness is never accidental, invariably has meaning, and always springs – wholly or in part – from the psyche. Its meaning emerges, like a coded message, from the depths of the psyche to everyday consciousness, from the Higher Self to the ego. Understanding it is neither automatic nor free of charge. If we don't pay the price, which may be physical suffering or the dark night of the soul, or both, then, in TS Eliot's phrase: "We had the experience but missed the meaning". We have been ill and are now better. But if we experience the meaning, then we recover on more than just the physical plane. Our focus widens, our consciousness shifts to a higher level. Our values change. Everything that is inessential falls away. Other, normally ignored values emerge, perhaps from long ago, from our forgotten youth when we still remembered to look at the stars at night and didn't mistake the ceiling for the sky.
Why should the psyche play a part in making us ill? There are many possible reasons. We may need a drastic shock to realize that we are out of harmony with ourselves and with the universe; that we are marching to the wrong drumbeat and acting out the wrong scenario; that we are hungering and thirsting for something essential and can no longer manage without it.
There is a German phrase that expresses this brilliantly. The German equivalent of the English 'What's wrong with you?' is 'Was fehlt Ihnen?' Literally, what do you lack or miss, what is absent from your life? These are questions we would rather not answer, unless we are forced to – for instance by illness. Clearly, there is a block that must be removed. We have outgrown a stage – of life, of consciousness, of relating, but we dare not move on, because we prefer the devil we know to the potential angel we have not met yet.
Illness is often an unconsciously chosen way out from what is known as a LIFE TRAP: a situation which has become unbearable, but appears to be unalterable. Impossible to stay in it, impossible to get out of it. Perhaps a marriage that has lost its raison d'etre but cannot be broken up, because of the children or for financial or social reasons. Perhaps the recognition, at mid-life, that one is in a wrong soul-destroying job, yet it's hard to find a better one past a certain age, and unemployment is not an option. Or simply a loss of meaning and purpose, a loss of faith, or the loss of a loved being. Any situation in which we feel stuck and paralysed, can result in the unconscious conviction that the only honourable way out is to fall seriously ill, or even die.
The Transpersonal Approach
In Transpersonal work the first task is to identify the life trap and show the patient that there is a way out of any situation, other than illness or death. Even if it means breaking up an established pattern or a long-standing relationship, it must be found. Many cancer patients are emotionally repressed and over-adapted, only caring for others and denying themselves. That kind of lifelong attitude builds up an enormous amount of resentment in the unconscious. Repressed and denied, it acts like a dangerous underground poison, waiting to erupt. My job as a therapist is to enable the patient to discover and acknowledge the denied negativity in his or her life. This is nothing less than meeting the Jungian SHADOW, that part of the psyche that one would rather not own; all one's so-called bad, unacceptable yet perfectly normal human qualities that have been repressed since childhood: anger, aggression, jealousy, greed, an appetite for power and control. And, possibly, many good character traits such as spontaneity, creativity, playfulness, warmth, which have also been banished by a repressive education.
For the first time ever, the patient is able to meet and befriend the Shadow. It is an immensely liberating experience to discover that it's not all black and evil, that there is nothing wrong with expressing anger or demanding one's fair share. In this work we strive for wholeness, not perfection, and wholeness includes our darkness, too. I know from my own experience how immensely liberating it was for me during my illness to release the anger that I had been repressing since the age of four, always remaining cool and civilized and ladylike. Little wonder my denied rage eventually turned against me: it had to go somewhere.
Was it my black anger that came out in the form of the dreaded black cancer, attacking the skin which is the boundary between us and the outside world? Did the symptom serve as the symbol of my inner conflict? 'Symptom as symbol' often seems to offer an accurate psychosomatic diagnosis. It cannot be proved medically, but then I am not just talking about the physical self. Body and psyche are two halves of one whole. They fall sick together and must be healed together. And each one has its own language. The body constantly sends messages. We don't normally listen to it, until its whispers become a loud roar – by which time we are in big trouble.
Some people need a serious illness to become fully grounded. They have never fully bonded with the body and have lived largely through the mind; they just used the body as a vehicle, a car made of flesh and bone, hoping that it would never break down. But now the car is in charge, not the driver: the body demands to be honoured as an equal partner. Others who normally over-identify with the body also need illness to realize that they are not identical with their physical self. The tight bond has to be loosened, the priority reversed. There is something else beyond the pain of the suffering body, something, or rather somebody who asks questions and tries to understand.
It is the search for that 'something else' that leads to the discovery of the spiritual dimension which until then has not played a role in the patient's life. Now it comes to the fore, since in a life-threatening illness we lose a great deal of our previous certainties. We have to confront our own mortality. At least for a while we lose our ability to work, our normal routine, we are no longer in control, our plans become meaningless, our very future seems uncertain. And our normal defences vanish. One loss after another.
But then comes the gain, the discovery of one's inner world where it is possible to get beyond mundane worries – at least for a while – and ask the ultimate questions of life: if our stay on Earth is limited, what went before, what comes after? What did I come into this world for, what is my true vocation, the task I have been called to fulfil? This is when the Transpersonal view of life as a journey becomes relevant, a journey that does not begin with birth and does not end with the death of the body. From that perspective it is possible to get an overview of the situation, and to discover unsuspected inner resources. According to a Sufi saying, "When the heart weeps for what it has lost, the spirit laughs for what it has found". What it has found is the numinous, a glimpse of the Eternal, and a sense of the unity of all life.
I don't want to give the impression that this way of working is a smooth, purely spiritual exercise. Far from it. In each case it is the patient's personality and needs that determine what approach I take. But, equally, in each case the Transpersonal dimension is present, like the deep sound of a remote gong, even if it is never mentioned. It is part of my daily life and daily work, and more often than not it becomes part of the patient's progress, too.
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