Integration and the Healing Process

By Dennis Kirkman Ph.D.

When the expression of feelings or emotions is suppressed, a "split," disconnected human being is the result. Social and cultural values emphasize and encourage those modes that deal with accomplishment, competition, and capitalization of what is human.

In a family structure those values are absorbed and translated through emotional matrices and matriculated out the other end feeding back into society. By virtue of emphasizing a mode that supports (and is) a vast technology, the non linear intuitive, feeling mode is denied. What is lost is not just the so called receptive modality, but the integration of the two which forms the basis of our creativity, potentialities, and humanness.

When humans fail to live up to the standards imposed by this "split" reality, they are deemed and often consider themselves, maladaptive or pathological. What they are actually failing to adapt to is a cultural set that is dehumanizing and of itself maladaptive. Their defenses, in Freudian terms, are inadequate, and are failing to help them adjust to the rigors of day to day life.

These people are failing to live in a non-integral fashion; at the same time, they are caught somewhere between the values and expectations of family and culture, and the long denied and feared primal impulses and expressions they sense in their bodies. Not being able to go in either direction completely, they suffer "nervous breakdowns anxiety attacks" and are vulnerable to labels and diagnoses such as paranoid schizophrenic, manic-depressive, etc. - that are in reality all descriptions of symptoms of an organism's attempts to move toward integration, toward healing itself.

These people are in pain - psychologically and often physically, and worse they have had to deny the experience and its expression. While the organism may be attempting reintegration symptomatically and symbolically, those defenses the body has taken on, out of necessity and acculturalization, need to be addressed. "The spirit is willing, but the flesh is weak" is an aphorism that befits the difficulty often involved in unkinking those blocks to experience and expression that have accumulated over a lifetime. Typically, what has been denied, focuses on the more immediate developing environment: the family.

In sessions there is an emphasis on feelings never before felt, never before spoken - about things that hurt - words, looks, deeds. Memories are uncovered: neglect is re-experienced in a physical way. Need becomes not just a psychological concept but a gaping wound that has been covered up for survival's sake - a physiological deficit that has required a deviation around what was supposed to have been the potential development of the organism. These are factors in the organisms development, that, while they are disintegrating or traumatic in and of themselves, are compounded or "overlaid" by later events, usually again within the family. However at this point it is more an agent of the parents' psychological structures, their pain, and the directives of the cultural set. The disparity of connection within the organism is furthered when the attempts to "run off" the pain or attempts to reintegrate are blocked; what is natural expression to the person is denied.


An example of this dynamic is Carl, a 32 year old alcoholic who came into therapy. He started drinking when he was 19. Previous to that he had been diagnosed as a catatonic schizophrenic. For three years age 16-19, he had been unable to find the impetus to get out of a chair. Sitting, he would watch the hands of the clock spin, as time flew by. Although he came from an affluent and well educated family (his mother, a biology professor), Carl was unable to work for more than three months at a time, couldn't apply himself in any endeavor, and gravitated toward the lifestyle of an inner city hardcore wino. Carl came into therapy not because of difficulty in feeling, but because of a great excess of pain occuring beyond his ability to assimilate. He was unable to function and described feelings of imminent dying and blackness. His appearance was unkempt and disshevelled, and he vascillated between expressions of apathy and great fear.

Carl came to sessions initially for a period of three weeks, five days a week. He talked predominantly about his mother; particularly that she was constantly undermining and criticizing him, he felt.

Upon an occasion, he was describing a scene when he was 7 where his mother had made an especially cutting remark:

Dennis: What would you say to her when she'd hurt you like that, Carl?

Carl: Oh, I could never say anything. I'd just withdraw farther into myself.

Dennis: Tell her now. just look right at her and tell her how it feels.

Confronting the feeling so directly, Carl was rarely able to get out more than a few words before he would fall upon the floor, writhing and nearly convulsing. He would arch his back, with his head against the padded wall, and appear to have great difficulty in breathing. After going through this sequence many times and approaching it from different aspects of his life. (How he felt his father had died trying to save him from his mother, losing his ability to play basketball, circumstances around the beginning of his catatonia), he began to piece together what it seemed his body was attempting to resolve.

Carl's mother was advised to have a Caeserean section due to her extremely small pelvic opening. (She had had a previous "normal delivery" born dead, brain damage, also named Carl.) She refused. Consequently, he was born several weeks late, (with the aid of forceps), a long and hard birth, made all the more difficult from the size of his shoulders. Of the most painful realizations, or connections, was that his mother did not want him, and wanted him to die (however unconsciously). This was manifested, initially, in her denial of his most primal impulse - to be born as the organism is ready.

So, with Carl there were basic difficulties even at the beginning of his life. What would naturally happen would be for the child, as it grows, to develop behaviors that are symbolic expressions of any early trauma. For instance, Carl reported that he always as a child wanted to be active. . . . very active. He wanted, in fact never to sit still. This behavior represents a way for the organism to deal with the early pain it has incurred. It serves to "run off" the excess, to keep the channels to direct expression open. However, as so often happens, spontaneity, rambunctiousness, unorthodox behaviors are not suffered gladly in this culture, among children, as well as adults. Directives like "straighten up", "be still", "behave yourself", are familial and social demands to deny primal impulses, however symbolic, and to start jelling into the cultural mold. What opportunity the organism has for integration is thrown away by the imperative to deny, to adapt a primary left hemisphere view of self and the world. Those who can, are impoverished and are "normal". Those who cannot, suffer and are "mentally ill". Carl was "mentally ill." The care and environment he required as a child, particular to his in utero trauma, were not there. In fact, and is usually the case, the opposite was true.

Carl's mother could not see what he needed. Every movement or choice that Carl made, each expression, was responded to in such a manner that made him withdraw and as such he stayed in that parameter of experience that constituted his biological birth. This is a dynamic of compounding that frequently occurs. To move meant disaster, to be wedged still for eons while the source of life, the placenta withered, meant death.

To have such a basic neurological response denied and to have no way of expressing the pain and rage of it would mean disaster. Carl's "failure" to live, and self-hatred were a direct consequence of that rage turned inward, and the message to die. Something happened to his neuromotor apparatus and he simply withdrew from himself and the world. This constituted a basis for could be referred to as Carl's consciousness. His personal history remained with him in how he regarded himself and his relationship to others as assumptions, unconscious "understood", fears, as boundaries of experience to be responded to as if they were still real. He lived in a reality defined by prenatal experience and how that trauma was compounded.

The great tool of psychoanalysis is free association. This is a trend of thought or chain of ideas when restraint and censorship upon logical thinking are removed; the assumption being that when reporting verbally everything going through his mind, the individual will bring forward basic psychic material and thus making it available to analytical interpretation.

We assume that there are etiologic components to trends of thought; that language, how it is used and its content, is symbolic of experience. The experience is what we are after, since it is the neglect of it and its expression that is most often at the roots of disintegrity. What is attempted is to guide the client underneath the hubris of his or her own symbolization process to the "heart of the matter." This guiding ranges from merely providing safety - to the mechanics of the therapy - to intuitive grasps of what we call "openings." An opening is an opportunity whereby the person, either of his own accord, or with some help (as with Carl) will begin what looks like a neural sequence. In psychoanalysis, the client may go from thought to thought with occasional affect, in what I would consider a cortical meandering! The analyst is in the position of knowing what the patterns and content of those meanderings might mean (in conjunction with transference, resistance, dreams, etc.) But we believe when the client is given the safety to not have to symbolize, or verbally defend, his body will begin to experience, the meaning of which is his interpretation alone.

"Tracking" is another word used to describe what looks like an autonomous neural process. Steven Rose, a neurobiologist, in The Conscious Brain, describes a neuronal pathway model for memory, lear- ning, and information processing. . . . In transversing a particular sequence of memory traces, the brain proceeds from state to state along the different individual traces in an ordered manner. The phenomenon is analogous to synaptic conduction or axonal firing - all of these processes are unidirectional.

One state must "fire" another almost irreversibly. So the individual brain states associated with memories must presumably be linked by synaptic logic into a sequence in which one follows almost inevitably from another. It is as if the arrow of time is located at the synapse, at least so far as memories are concerned." Sequencing is an ideal of the healing process that is aimed for where the organism is healing and integrating itself in a way and at a pace that is intrinsic to it, rather than by taking on additional effluvia of a therapist. It can begin by the therapist picking up on an "opening", that is, where feelings may be ascending.

Another simple example:

Bob: You know, I'm really scared right now. My arms and legs are tingly.

Dennis: What are you scared of?

Bob: Oh, I don't know. I guess that I'm not going to do this right, that you're not going to approve.

Dennis: Have you ever known this before?

Bob: Oh yeah, every time I get up to give a presentation at the office all I can think of is how the other architects are going to respond . . . you know, really negative. It nearly incapacitates me and my stomach goes into knots like this.

Dennis: Bob, as much as you can now, focus on those sensations and let your body express them in whatever way that matches the feeling.

Bob: (here Bob begins to tremble and sob for a few minutes.) Something just occurred to me about this. I remember being in a school play when I was five and my mother and uncle were in the audience. it seems like I fucked up what I was supposed to do and afterwards I was really ashamed and upset. When I saw my mother and uncle coming backstage I wanted to run to her and cry but I saw this look on her face. She and my uncle were laughing. She thought what happened was funny! She was laughing at me! (Here, begins to sob deeply) Don't laugh at me, goddamn it! Don't laugh at me! Mommie! Mommie! . . .

From here Bob reexperienced a time even younger when his mother misread or missed what he needed. When he was not appeased he would continue to fret and cry. Out of frustration, she would scold and punish him. What he learned was that his feelings and what he needed were not "right", something to be ashamed of. The summation of those hurts became symbolized at the time where he was in the play. In later situations, where he would be called on to perform, he would suffer debilitating anxiety because of what the situation provoked and meant to him; that he would not be seen and made to feel worthless for how he felt.

With the removal of societal inhibitions Bob was able to retrieve a part of himself he had had to disown. His body resolved it in an orderly sequential fashion. The same feeling was traced from a present situation to a previous sitaution, to a memory, to a prior memory until the initial causal matrix was discovered. Those memories had an emotional charge to them. Because he could not experience or express those early hurts, he was driven to symbolize and generalize in his attempt to integrate himself.

This can be seen in the diagram of an inverted triangle. The base at the top is the behavioral ramifications of single points of repressed, blocked experience at the bottom. As feelings continue to be blocked, the behavior generalizes further, until, at the top, the person suffers from vague, disconnected anxiety, and is compelled to act out and abstract what he cannot feel. The task is to guide the person back in the other direction to ever more specifics of what causes what feelings. Again, this is an ideal, whereby the client proceeds, as Bob did, in what looks and sounds like an autonomous neural sequencing. This is the organism healing itself.

There are times when not even one word is required. On the other hand, there are times when the pain is so great, psychological damage so extensive, defensive structures so tight or intricate that it is not initially possible for one's own natural healing processes to emerge. It is at times like these when it is up to the therapist to work at the level of the synapse; to become a catalyst, so to speak.

The model of neural pathways for brain processes related to learning and memory is an extremely helpful and powerful tool in this approach. Consciousness, as it has been described here, refers to parameters of experience that have emotional and psychodynamic determinants. Carl lived symbolically in the womb; in his experience to be himself (to move) meant to die, to not move meant to die. His response to everything was as it was then. . . to fearfully withdraw.

For Bob, in that particular situation, he behaved (and felt) as if he were going to be rejected. The particular "sets" are what are presented and addressed in sessions. They represent core, determinative experiences which form the prototype for a matrix pattern for the recording and perception of subsequent events. That is, outside cues are perceived in a particular fashion as determind by early experience. To help someone down that inverted triangle means for them to experience and integrate those early traumas. In that way, "disconnection" is ameliorated.

We believe connection is literal in these phenomena. Consciousness is changed, and expanded, as a result of a neural connectivity occurring that was not there before. By virtue, of neural connections, the person becomes able to step outside the dialectics of "neurosis" and to truly choose and act for the sake of self. "Oh, it was a feeling and I just didn't know it," is a statement that is heard in various forms many times. This is what we mean by a faulty consciousness: someone who lives within boundaries determined by feelings as if these were "reality."

In this respect, the process can be seen as involving neural processing and sequences, and inferring, however intuitively, what is happening and how to address it. The neuropsychologist works in a more tangible area. His task is to interview and then test the brain damaged patient in a variety of domains, specifying which skills have been spread, which impaired. From this is extrapolated what type of brain damage is incurred, based on previous case studies and where possible, medical exams.

From the diagnosis proceeds the prognosis.

Howard Gardner, a neuropsychologist, in The Shattered Mind, says "The schizophrenic talks as he does (word salad) because presumably as a result of extreme interpersonal conflicts, he has undergone radical changes in personality. The Wernicke's aphasic, on the other hand, has suffered a lesion in a specific region of his brain. . ." To my thinking and experience, it is a fallacy to assume there is not a physiological correlate to the schizophrenic's "word salad".

Our tenet is that "interpersonal conflicts" are physical, and presumably neural and synaptic in nature as is the Wernicke's aphasic, but different in quality. [In fact, genetic susceptibility to schizophrenia may likely be traced to monoamine oxidase (MAO), an enzyme that breaks down the monoamine neurotransmitter substances (serotonin, dopamine, noradrenalin, etc.) subsequent to their release. Significantly less MAO is found in schizophrenics perhaps due to some inhibiting agent, which causes the systems by way of monoamine transmitters to become flooded with transmitter and go into spasm. . . sensory flooding and overload.] There is an internal logic, of course, of how one subject may be followed by another in free association, but what is missing is the vertical descent from ideas to the physicality that those ideas represent.

Our concern is by what means can those conflicts be resolved. It is the contention of this essay that the people we see, (and perhaps most of us), so called maladapts, suffer in varying degrees from brain distress possibly in the form of synaptic dysfunction, or poor integration of neural fields.

To say that an internal conflict has a basis in neural functioning does not mean a jot unless it can provide a basis for doing something.

For example, the clinical elaborations of Ronald Melzack's gate-control theory of pain and Paul MacLean's triune brain model by Arthur Janov and Michael Holden has provided insight and utility toward the development of a neuro-psychological paradigm of what it means to be in pain.

Carl came in a state of "overload." By way of how he looked, moved, what he said, and how he said it, it could be seen that his nervous system was having to process too much pain. He did not have the internal mechanisms to push the pain down, i.e., defend, "pull himself out of it." At the same time, his access to what all this meant was quite remote; he was disconnected and could not integrate the whole, great mass of feeling at once.

The task, then, was twofold:

  • First, was to help him lower the level of pain he was living in so that what was experienced could be integrated a tolerable bit at a time.

  • Second, was to help him develop access to the lower levels of his psyche/body in a sequential fashion.

Based on this, an opening was taken that represented at that level at which he could integrate; that is, experience a feeling, know it was a feeling, and understand where it came from and what it meant to his life. In this case, he could cry about a Joan Baez song he had heard that day. He was allowed and encouraged to cry as much as possible to drain some of the emotional load he carried. He talked about what she said, what it meant to him, and how it made him feel.

From there it went to how rock and roll had affected him as a teenager how it seemed that music was the one-thing he could allow in. He proceeded to go into what he would later describe as a birth sequence, which was described earlier. He almost immediately began to fragment. At this point I talked to him in such a way that addressed the base he had established for himself from when he was a teenager.

We talked more and I gradually moved the focus more toward the present, but always with the base he established as a reference point. This was to be the tenor of the rest of our meetings: building on what he was able to integrate, lowering the overall pain level, and allowing him to experience ever further the physical trauma he was born and lived in.

Neuropsychologists have maps, i.e., performances on perceptual and cognitive tests that correspond to lesions and affected areas of the brain and corresponding treatments modalities. As in the above example, likewise, in a counselling or therapeutic situation, it would be beneficial to delve into more detail into the processes and dynamics that may be involved in helping people like Carl who require a certain "carrying" or fine tuning before their healing processes can emerge.

I'm interested in how those processes might be more readily recognized, conceptualized and translated into effective action. I assume that with more knowledge, possibly at a neurological physical level, the approach to those faulty consciousnesses could be more exact and economical.

As with Carl, if it can be established that a particular dysfunction is occurring, it may provide a basis for approaching the "gaps" in that person's consciousness. This is not to say that all human feelings, motives, conflicts, aspirations can or should be reduced to neuropsychological, neurolinguistic, or physiological explanations.

The purpose of any model about humans should be to enrich or expand our knowledge of ourselves. No one level of explanation should ever be expected to provide the full meaning of our humanness.

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