Psychotherapy And The Spiritual Quest

EDUARDO PITCHON - London

In itself psycho-analysis is neither religious nor non-religious but an impartial tool which both priest and layman can use to the service of the sufferer.

Freud, 1909

The aim of this paper is to explore what psychotherapy has on offer for individuals who have spiritual concerns. It is beyond the scope of this work to prove the reality or otherwise of spirituality, God or the Soul. That is better left to theologians, spiritual teachers, philosophers and mystics. Our area of work is the inner world. Our field of exploration is the psychological dimension and all that is present there should be our concern. We are duty bound to explore that which is present with an open heart, a broad mind and as much common sense as we can muster.

It seems to me that the spiritual is not an area that most psychoanalytical therapists feel comfortable with. In my opinion this is a pity, because if we are not at ease it's very difficult to be broadminded and open hearted. Whether we like it or not our patients are going to know this. They will feel that the consulting room is not a safe place to bring their spiritual unease. When it comes to this particular area there is fear. The fear is that their spiritual concerns are going to be trivialised, by being analysed out of existence, or by being treated as hocus-pocus, or as pathological superstition.

What is it about this dimension that makes us become so cautious?

I don't think that the answer is that psychotherapists are spiritually insensitive or that they don't have spiritual needs. My findings over the years show me the opposite. There is a considerable proportion of us who are interested in exploring our own spirituality and many over the years have welcomed the opportunity of talking about these concerns in a friendly, unthreatening and undogmatic way.

However, there are real difficulties in the relation between psychoanalysis and spirituality. These difficulties, which cannot be ignored, occur on three levels: on a theoretical level, on an emotional level and in the area of concrete practice.

Psychoanalysis is a body of theories based on practical observations of psychic functioning. Since its inception our tradition was embedded in a strong materialistic outlook. The climate from which our profession emerged was that of Vienna at the turn of the century with its incipient anti-Semitism and proud new rationalist scientific views. In order for psychoanalysis to survive and grow in such a climate it needed to distance itself from the religious environment and establish its secular credentials. Three major works of Freud, Totem and Taboo, Moses and Monotheism and The Future of an Illusion are a testimony to our founder's efforts in that direction. The formative years of psychoanalysis were spent under a shadow of mistrust and scepticism about man's religious nature. Remnants of these shadows can still be found in the fact that our profession has not established a proper communication with the religious world. This is somewhat paradoxical given that psychology and spirituality share much of the same field. But the relation is overshadowed by mistrust. For a true dialogue to take place there has to be a change of climate from mutual prejudice to empathy. For this to happen we have to cross the chasm of ignorance that exists between us. 

I consider that the religious and the spiritual impulse are a normal part of our make-up as human beings. Like with any tendency we can either choose to embrace it or reject it.

I am not a religious expert., if anything I am a therapist with a religious and spiritual curiosity. After looking into this area for some years I have become aware of particular strengths in several religious traditions.

Buddhism's strength is the depth and subtlety of its psychological understanding. The strength of Judaism lies in its genius for law and structure. In my experience orthodox Jews make excellent practical psychologists, more compatible with behavioural psychology than with psychoanalysis. Christianity at its best has a lot to teach us about love, forgiveness and forbearance; whilst Hinduism, with its incredible breadth and colour has a great understanding of the feminine principle. This is something which western religions seem to have more difficulty accommodating.

A word about the much maligned New Age movement, which seems to have captured the imagination of so many people in the western world. This movement represents a contemporary attempt of sincere spiritual seekers to synthesise their own understanding of the search through diverse traditions and to present them in a way that is accessible, attractive and intelligible to the general public. The general idea is that there is a God, a Life Force, a Cosmic Light or Spirit that permeates the whole of creation. As our consciousness evolves, as it must, it will inevitably lead us to this realisation, which many call self realisation. The question that naturally arises from the above is, ˝is this really true or is it just wishful thinking ?ţ. 

Depending on what answer we give to this question, humanity divides into a spiritual or a materialistic viewpoint, with a central position held by agnosticism. It is interesting to note that in a recent survey of the British population, over 70% of people believed in God in some form or another. This gives us some idea of the importance of the issue.

Fortunately as therapists we are not expected to be the arbiters of ultimate reality. Our task is to help our patients to overcome the delusional thinking that gets in the way and stops them reaching deeper areas in themselves. The foundation and central pillar of our work lies in Freud's dictum that ˝Psychoanalysis is about making conscious the unconsciousţ. Everything else stems from this. It is our raison d'Étre. The whole structure of theories and techniques which inform our practice are based on this axiom. 

How do we make conscious the unconscious? We do it by paying attention. By focusing our attention we become aware. We lighten up areas that had been in the dark before. Through awareness we bring light into darkness, we create new links between different parts of the psyche. This is how we and our patients grow.

The direction of the psychotherapeutic journey is one leading towards integration. This is just the psychological way of saying that we are growing, because psychic expansion, the growth of consciousness, is evolution. 

In our work we are guided by the Socratic dictum ˝Man, know thyselfţ. This brings to mind the best definition of our work I have ever come across. It comes from Dr Bion who stated that ˝The psychoanalytical procedure is an attempt to introduce the patient to who he is because, whether he likes it or not, this is a marriage that is going to last for as long as he lives.ţ. This introduction is a slow, gradual process which requires tact, skill, patience and courage from us and our patients.

I often think of the psychotherapeutic process as a journey of exploration, an adventure in which an intrepid explorer, the patient, searches for a guide, the therapist, to accompany him/her in the exploration of the jungle of their mind and heart. The journey is not an easy one, there are many ghosts, mythical monsters and shadows dwelling in the depths that need to discovered and recognised before they can be tamed, despooked and freed. The direction of the journey is one that goes from the periphery towards the centre of one's being. The centre of the heart, or the hidden heart. This is where the matter lies. 

We know from our experience how difficult the journey can be. There are moments in this voyage when the path seems bright and straightforward. The sun is shining, the weather is mild, the colours of nature are bright and the birds are singing. All of a sudden there can be a change of scenery. The sky becomes overcast and the temperature drops to freezing. What was a friendly country lane turns into a threatening and sinister obstacle course. Here is where the psychotherapist's experience becomes invaluable in encouraging the patient to continue pushing forward. This is not the end of the way, or of the world, even though it may look like it , but just another stage of the journey. For the journey to be able to proceed any further two ingredients are necessary; trust: and faith. The patient must have trust in the therapist. The therapist must have faith in the process. This faith is not blind faith but faith based on personal and clinical experience.

Trust is easier to speak of than to achieve. The growth of trust in a patient's heart is a process that takes time. The therapeutic relationship will have to face many trials and tests before trust can be established in a real way. It usually starts from a temporary suspension of disbelief, the therapist is given the benefit of the doubt. As the process unfolds the relation is tested in a thousand and one ways. The temporary suspension of disbelief slowly starts transforming itself into a whole-hearted trust. When this happens it is usually accompanied by an increase of love and concern.

What gets tested in the process? 

It is the therapist's faith in the psychotherapeutic process. As I have said, the therapist's faith is not just blind faith. That would be dangerous and irresponsible. It is founded on the therapist's beliefs and experience. When these are reflected upon they form the therapist's understanding which is the basis of the faith I am referring to. As the therapeutic treatment develops and, if the patient's trust in the therapist's understanding strengthens, so do the feelings of dependency. The need to be accepted, approved of and valued, temporarily increase. This is the shadow side. The explorer realises in the middle of the jungle his deep need of the guide, if he is going to reach his destination safely.

Psychotherapy is an artificial situation designed with the purpose of helping individuals to grow up. I define growing up as a replacement of habits , changing less efficient habits for others that are more efficient. By changing habits we transform the software of the psyche. Habits can be either habits of mind, of emotion or physical ones.

In connection to this, the image of Gulliver among the Lilliputians comes to mind. If you remember Gulliver was a giant who woke up from a dream. On awakening, he realised he was tied down to the earth by thousands and thousands of little threads knotted skilfully by tiny Lilliputians. These threads can be seen as our habits; our conditioning, that ties us down, imprisoning us and limiting our freedom. Each person is a Gulliver to some extent, but some Gullivers are freer than others. Psychotherapy is, in my estimation, a device to help the helpless giant become free.

I said earlier that psychotherapy was a journey from the periphery to the centre of one's being. Of course it is not expected of any therapy to reach the dead centre. That is beyond the scope of any earthly therapy. It is an ideal. It's a magnetic centre towards which the needle of the therapeutic compass is always pointing. The overall direction of psychotherapy, like that of science, is from the particular to the general. Now, when we turn our attention to the spiritual we notice that the opposite holds true. It starts from the general and moves to the particular.

Whatever else spirituality is, it is a commentary about the centre of Man's being. This claim to knowledge about Man's essence is what lends credibility and authority to the spiritual dimension. Though the spiritual starts from a central vision it does not just remain there, it moves towards the periphery of life in an attempt to map out pathways through which Mankind can approach the Self. It is as if a man has climbed to the top of Mount Everest and having established camp there is describing what the vision is like from the summit. At the same time he is also mapping out the route, which the rest of us could take, if we intended reaching that same destination. This vision tells us that Man is trapped, caught up in a web of illusion and wrong thinking and that this confusion is the main obstacle to be overcome if we are to see clearly. It seemed as if it were all a matter of perspective, then.

The summit is not a physical place but something which arises within man when he becomes conscious and fully integrated. Some spiritual teachers have described this integration as consonance between thought, word and deed. Becoming conscious of the essence seems to give a sense of connectedness, first with all other human beings and by extension with all of creation. This sense of connectedness seems to alter aims and purposes by infusing identity with a different meaning. High ideals such as service and love come into play as well as the development of a sense of humility and gratitude and the need to live simply and truthfully. There is no difficulty in calling to mind historical figures who have striven to live their lives according to these ideals.

The world has a rich body of literature which encompasses diverse spiritual traditions; despite their diversity they share a belief in Man's common essence. Whether they posit a belief in many Gods, one God or no God, these traditions are important accounts of Man's striving for transcendence. 

There seems to be an impulse common to mankind which fosters the desire for the acquisition of wisdom, balance and a sense of unity. A search for enduring values. I call these efforts to transcend ˝the spiritual impulseţ. What is being transcended is essentially fear, some traditions call it ignorance. Fear is the root of violence which leads to destructive thoughts, tendencies, desires and indeed actions. Most spiritual traditions counter fear with the fostering and the development of love. 

Aside from countering fear with love, there are many other important ideas that illuminate the spiritual domain and which are broadly shared in many traditions. One of these ideas refers to the notion of time. The general idea is that although we have a past and possibly a future, the point of power is in the present. To become aware of the now means to become centred. The power to effect a change, to take a decision, to fix a new goal, is now. Our real world is in the present. The past is no more and the future is uncertain. Becoming aware of the present moment empowers - the idea is that man can transform himself.

This brings us to the idea of the honest witness. The central idea is that no man can effect a genuine transformation without becoming an honest witness of his thoughts, words and deeds. In the Jewish mystical tradition known as Kabbalah, when a man learns to become an honest witness he begins to function from that centre which is his true self. The virtue of detachment, which is strongly emphasised in Buddhism and other traditions, comes into play at this point. Detachment, however, does not mean a lack of concern. Rather it is only through the practice of detachment that true compassion arises as against sentimentality and selfish love.

Another important idea relates to the concept of consciousness or awareness. The practice of honesty of mind, sincerity of expression and detachment leads to awareness. The state of awareness, or full consciousness, is conceived of as a state in which man is freed from his conditioning. This is an ideal state, but it is also a goal to strive for. This ideal state in the Indian tradition is expressed as Sat Chit Ananda which means Truth, Consciousness and Bliss. While the concepts of Truth and Consciousness may be accessible, Bliss is more difficult. Nevertheless, it is possible to imagine that Bliss arises when a man loses his fear and emerges from his conditioning, which allows him to become who he truly is.

The search for authenticity is what connects the spiritual and psychological realms. The notion of what the self is may differ, but the search for the self and the value of the search are not in dispute. We have in psychoanalysis for example, the idea of the false self. This assumes that man has a real self. Perhaps an important difference between spirituality and psychotherapy as we know it, is the extent to which man can transform himself. What spirituality does is to extend the vision of what man is and what he can become. It is not only man's will or man's hope that is summoned here but also man's imagination and more. The spiritual vision is essentially dynamic. Most spiritual traditions seem to suggest that what man can become is greater than anything we can imagine. This vision is what leads man to expand his imagination, to extend his sense of identity and to strive for his transformation.

Therapists also work with change. An old teacher of mine, Dr Pichon Riviere, often said that psychotherapists were the ˝mid-wives of changeţ. Perhaps our aims are more modest, but it is a fact that we sometimes witness profound changes in our patients. It is in any case a fact that some acquaintance with spiritual ideas may enable a therapist to provide a facilitating environment for the patient to extend his field of exploration. When it comes to this subject there are three possibilities; either the patient is spiritually sceptic, or his spiritual needs are latent, and begin to awake at some point, or he is already alive to some spiritual enquiry. In the case of spiritual scepticism, if a person comes from a strong secular background no particular issues may arise in the first place. In other cases he may have come from a religious background and encountered disappointments or traumas along the way which make him turn against it. Here it seems to me that exploring such issues is worthwhile. A patient can be helped to rescue whatever is valuable from his past and use it in a creative way. In my consulting room I have encountered these three types. I will give an illustration of each.

One example of spiritual scepticism. A Catholic woman whose father had as a spiritual confessor a priest. As a child this woman was often left alone with this priest. He abused her sexually and she was severely traumatised. When she came to see me she was in her late thirties and had never had a relationship with a man. She was highly strung, attractive and intelligent. In the course of her analysis we discovered that she could not bear anything associated with Catholicism. It was all contaminated by her early childhood experiences, her sense of betrayal was deep. But, deeper still, underneath her anger, she still had un-met spiritual needs. In the course of the analysis she discovered Buddhism and subsequently became a Buddhist. Through this process she made peace with her own tradition. Further, we discovered that the archetype of the Holy Mother, in the form of the Virgin Mary, was present in her as an internal object which embodied aspects of her own sexuality and feminine identity. She was at war with these aspects of herself. This area provided a rich and fruitful vein of therapeutic exploration. During this time she developed her first sexual relationship with a man. She was by then forty years old. Perhaps both Buddhism and psychotherapy provided a safe vantage point from which she could make peace with her traumatic Catholic past. The experience of exploring her spirituality within Buddhism was congenial to her because she felt there was no coercion and less dogma. Buddhism came to represent an experience of freedom including a freely chosen future.

The second type of person, is one I would describe as spiritually latent. A patient comes to mind who was simply indifferent. She had lived for ten years with a man who was violent to her. She was in a state of existential despair and life was meaningless. She had bulimia and would go on dangerously long fasts. All her sexual experiences involved abuse or rape. She had never had a caring and close relationship with any man. She took this as the norm and, not surprisingly, had a low self esteem. Despite this she was a gifted and successful artist. During the course of her therapy she developed breast cancer and at last came close to death after flirting with it for so long. Her illness came as a shock. She had been very estranged from her body, and this experience forced her to begin to communicate with herself in a different way. She survived the illness and began to value life. In this way her life started to acquire meaning and she began a spiritual search. This eventually led her to a teacher in India. In the course of the analysis she visited India several times. As a sensitive artist she fell in love with the colour and richness of the country and its imagery. This spoke to her aesthetic heart rather than to her head. Through her appreciation of beauty her fiercely guarded heart began to melt. She no longer had abusive relationships with men and her bulimic tendencies came under control. Around the area of her spiritual interests she had developed many contacts with like minded people. She engaged in various service activities, including working with dying people in hospices. Her spiritual life and her therapeutic process developed in harmony with each other. The spiritual enquiry was brought into the therapeutic environment, which was perceived as a safe place to examine difficulties, doubts and problems that arose along the way.

The third kind of person I have encountered is one who was already alive to the spiritual enquiry. If a person is firmly encased within a spiritual tradition, the issue is often one of fear that the therapy will destroy or invalidate a person's beliefs. This is a difficult and delicate area. If a person's identity is closely bound up with their religious belief any attempt at exploration could be perceived as a serious threat. What a therapist can explore with a patient is the issue of integrity. This is a legitimate and necessary area of exploration. For even if a person holds a set of beliefs: does he actually live by them and, if he doesn't, what are the consequences ? In this context it is useful to remember the importance of consonance between thought, word and deed as a measure of integrity.

As an illustration of this kind of situation, I have selected a Jewish woman who came to see me. I call her a Jewish woman and not a woman who is Jewish because this was how she presented. She chose to come to see me because she was aware that I had worked in the Jewish Community and therefore she believed I could understand it. By extension she hoped I would be able to understand her.

On the face of it, it was strange for her to choose me as her therapist. At the time I was working among strictly orthodox sectors of the community. The patient on the other hand had chosen to identify herself with radical feminism and had been in a lesbian relationship for some time. She came from a provincial Jewish background with a strong sense of belonging. After a prolonged engagement to a man the relationship broke up. She was very hurt and let down by this. She had also had severe gynaecological problems that required extensive surgery. This increased her sense of vulnerability and sexual unsafeness. This whole situation influenced her to move away from the conventional Jewish life she had grown up in. She started exploring alternative Judaism. By the time she came to see me she was in her late twenties. She had been in a homosexual relationship that had lasted for some years. She professed to love her partner very much though the relationship hadn't been a good one for a long time. She was identified closely with radical feminist views. She felt that it was time to get even and correct the injustice of male predominance; preferably in society as a whole, but her main focus was the Jewish community. Her style was gladiatorial. She had enough of a revolutionary zeal inside her to make her quite powerful. She was a person with boundless energy, good organisational skills, a sharp mind, a keen sense of humour and was quite creative. On the other hand she was confused, hurt and felt that her life was in a mess. In addition to this she had a strong spiritual urge.

Most of this patient's therapy was spent in a lengthy exploration of her Jewish identity. Because she experienced her Jewishness so intensely it filled a great space of her being. It was therefore very important for her to have this part seen, understood and accepted. I think she had a secret hope that if this part of her could be held and pacified something new would emerge.

As we worked together the relationship was tried and tested severely. This joint overcoming of obstacles gave a measure of relief to her anxiety and also gave her the courage to start really trusting me - not a blind trust. She didn't think that I was always right. Indeed she knew I would get it wrong sometimes and she would let me know in no uncertain terms. The trust I am talking about is something different. She trusted that I had a spirit of good will towards her and that whatever I told her was in good faith even if I got it wrong. She valued authenticity very much.

During the time of her treatment she broke down, became very ill and was almost bed-ridden for an extended period. By this time the relationship with her partner had ended. She also felt a deep need to explore further into prayer and Jewish ritual. During the most acute period of her illness she used her prayers, her readings and her therapy as a lifeline that kept her connected to the world.

As her therapy progressed she continued moving towards Jewish orthodoxy. It was difficult for her, because on the one hand she knew she was always going to be a committed feminist and, on the other, she felt in her bones the deep spiritual pull of orthodox Judaism. She tested her real beliefs, her hopes, her fears and her superstitions in the laboratory of the consulting room.

Towards the end of her therapy she met and married an orthodox Jewish gentleman, of the stricter variety of observance, who seemed to give her the warmth, the affection and the spiritual vision that she needed so much.

The fact that patients have spiritual or religious interests does not of itself tell us much. The central question is how patients use this understanding. Here the psychological exploration has a legitimate place - for example in the first case discussed, that of the woman who rejected her Catholic upbringing and became a Buddhist. The central Buddhist idea that spoke to her was that of ˝skilful actionţ. The idea of skilful action in Buddhism has ethical connotations and is linked to the ideas of balance and measure. She used it as a criterion for self examination. This idea was a new lens which enabled her to clear up many issues that were greatly contributing to the confusions in her life.

By living life more skilfully as she would put it, she improved the quality of her life and her relationships. For her, having a more harmonious relationship with her family and ending the feud with her old religion were an outcome of the practical application of this idea of skilful action. As her therapist, I felt able to embrace wholeheartedly this idea and it became an important therapeutic tool. This alliance proved to be fruitful and enabled her to gain access to areas of herself which had previously been untouched because they were too emotionally charged and too raw. This enabled her to make big changes in her life. The idea of skilful action was firmly present in the transference. She would judge interpretations that she found helpful as 'skilful' and when she felt I was off the mark, she would let me know I was being 'unskilful'. Throughout the most stormy episodes of her therapy the idea of skilfulness was like a keel, it kept her life and her therapy on course.

Ideas are dynamic, they grow and mature. The more she used the concept of skilful action the more her understanding of it grew. She was able to extend it to more and more areas of her life. Skilful action in practice was the main idea that she used to shift from a confused and muddled view of the world to the establishment of a discriminating eye - this helped her to bring order into chaos. It brought to her life a new sense of proportion and it led her to heal many damaged relations. 

The second case I discussed was that of the patient who felt life was meaningless, who endured violent sexual encounters, who developed breast cancer and was later inspired by a teacher in India. Thinking back on her treatment I can detect two distinct phases; the time before the eruption of the cancer and what transpired subsequently. In the first phase, which lasted for about four years, I experienced her as extremely vulnerable, with very strong defences. She was co-operative and helpful enough on a superficial level, but on a deep level she was untouchable. It was not that she was unwilling, she was also out of touch with these levels of herself. Whenever I made any reference to this she would respond as if I was speaking an unknown and mysterious language. It was this lack of contact with deeper parts of herself which made her feel life was meaningless. Her experiences were felt to be thin and unsatisfactory. She was frightened, puzzled and confused. She was out of touch with her body and experienced it as something shameful, ugly. Something she hated and which deserved to be severely punished and even destroyed. I was feeling, on the other hand, as if I was constantly butting my head against a brick wall.

The discovery of her cancer dramatically changed all this. For the first time in her living memory she noticed that other people cared and valued this body of hers, which she had despised so much. Her body became a reality to her and not just a two-dimensional caricature. This new relation with her body allowed for a deepening of her feelings. The consequence of this was a deepening of the therapeutic situation. Life was no longer just something to be endured. I was not just a liferaft to which she was holding on by her fingertips. Her life now had acquired value.

The value of her life was not anymore something that I had to continue convincing her about. It was something that she experienced herself and was grateful for. This gratitude expressed itself in a dramatic extension of her interests, which took place in two main areas, namely her body and a deep curiosity about the meaning of life.

The concern for her body led her into the care of a homeopathic acupuncturist whose ideas of health and wholesomeness were quite compatible with her own. The curiosity about the meaning of her life led her to explore different spiritual traditions. She became deeply interested in the subject and was very surprised at the broadness of the field. When she discovered that she could be spiritual without having to go to church this was a great relief. This was an alternative lady; she wanted alternative medicine and alternative spirituality whenever possible. As I said before, her explorations led her to a well known and respected spiritual master from whose teachings she gained much solace and inspiration. This teacher had the breadth that she so desperately needed and also provided the depth of understanding of life that she was yearning for.

If I had to find one idea that was essential to the second part of her analysis it would undoubtedly be love and service. Love and service are not exclusive to the spiritual domain, but in her case they were brought to life by it. To be more precise I would say that it was her therapy together with the spiritual teachings which acted as catalysts for her growth. A bit like Snow White she was awaking after a long nightmarish dream. She was awake and alive, it was time to celebrate and celebration meant loving and serving.

˝If you want peace and if you want happiness you must live in love. Only through love will you find true happiness. Love flourishes through giving and forgiving. Selfishness grows by getting and forgetting. Develop your love, immerse yourself in love.ţ.

These words of her teacher spoke to her heart. They inspired her and fired her imagination. The problem which remained to be solved was; ˝What was love ?ţ. In her analysis she had to learn the surprising fact that one couldn't give what one didn't have. In order to be able to give love one has to have love. The paradox is that one can't have love unless one loves oneself. As the treatment progressed hand in hand with her spiritual quest, her love for herself and those around her strengthened. The attacks from her severe super-ego became less ferocious and she gradually developed a more tolerant and humorous relation with herself. She managed to make peace with her traumatic past and lost much of her fear of life.

The third case I discussed was that of the patient who started therapy as a radical lesbian feminist and by the end of it had transformed herself into an observant orthodox Jewish wife. Her therapy could well be described as a stormy search for herself. She was committed, at a very deep level, to finding a modality of expression in the world that was an accurate reflection of who she really was. The main difficulty with this aim was that before she could reflect better, she needed to know herself better. This then was the purpose of her coming to therapy, in the words of Dr Bion, she needed to be introduced to who she really was.

This journey of introduction ranged widely. There were many contradictions in her mind and many more between her mind and her heart. She needed to reorder these conflicting tendencies so that they could operate in a more harmonious way. To do this, she needed to have courage and to look seriously. The mess was big; nothing seemed to be in its place because she didn't feel in her place. The patient chose to use her therapy as the place to bring her conflicts, her doubts and her confusion. She also brought her passion, her strength, her sense of humour and many things more.

The image of a bewildered child comes to mind. She appears with a very big and messy toy box. The little girl looks insecure and frightened. She isn't sure of what is inside. But in spite of her fear she is determined to find out.. She comes with her box into the presence of a familiar and reassuring adult and proceeds to empty the box onto the floor. The child and the adult together proceed to sift through the toys, brick a brac and rubbish that lies in front of them. They reminisce and discuss what is of value. They decide together which toys are worth keeping and which can be given away. They throw all the rubbish away as well. As the confusion starts becoming ordered, the child's anxiety diminishes. The little girl becomes stronger, as her discrimination grows. The vision ends with the little girl taking charge of the ordering of her box under the benevolent gaze of the adult.

Coming back to the patient. In her therapy she placed her faith at the top of her value system. She had faith that she had a soul which was connected to a caring God. She wanted to move closer to God and this could only be done with integrity. The question of integrity was an important issue in the treatment. She had to go through the process without giving in to impatience and frustration and end up by smashing everything up. In her search for integrity she discovered the virtues of patience and self-control.

Another interesting strand of her analysis was gratitude. As a person she was generous with her gratitude. The problem was that it was directed to selected areas only - there were some glaring omissions. During the treatment, we were able to explore some of these black holes in her mind. By this her gratitude was able to expand, embracing areas that had been unrecognised and therefore untouched. She came to value her mother, her background and her past in its myriad forms. She started really valuing herself. Not just bits of herself. This self that she now valued was a more real, truer self. It had become wholesome through integrity and gratitude.

I will now turn to two aspects that these three cases have in common. The first aspect I would like to focus on is what I call the spiritual impulse. It seems to originate from a deep and mysterious place of the patient's being. It also appears to be a central aspect of the patient's consciousness. It is a dynamic energy and if it is allowed to flow it moves incrementally. This impulse was expressed in therapy by the patient's attitude of a responsible commitment to their self imposed quest.

People who express this type of impulse have the imagination to dream and the courage to follow their vision. The visions are not random but have a specific aim, they are visions of where the person wants to go and are, in a sense, more like aspirations. The form that the impulse adopts can vary, in the previous cases it took on the clothing of Buddhism, of Hinduism and of Judaism. The impulse was the same, the form was different. 

If we focus on the direction of the impulse, it seemed to point to an ever increasing expansion of consciousness. This process was accompanied by a strong desire for self realisation. Self realisation is an ambiguous idea. Self means different things to different people. Because it is so ambiguous, when it becomes an ideal, it will always require interpretation. As interpretations of the Self differ between individuals, so too do the paths to approach it. The spiritual impulse seems to be compatible with the idea that states; ˝Each one will come in his own way, at his own pace, according to his inner urge, along the path that the Self will reveal to him as his own.ţ.

The second characteristic that they shared was an underlying ideal of freedom. As human beings we live in a polarity range that extends from slavery to freedom. There are different degrees of freedom and different ways in which this freedom will express. Every being will experience its relative freedom in its own way. Absolute freedom is an abstraction but it is also an ideal that we all share, when we are awake to its value. Remember, Gulliver only realised he was in bondage when he woke up. The recognition of the value of freedom is a direct consequence of the growth of awareness. To be able to value freedom wholeheartedly we need to overcome our fear of freedom. Fear of freedom is closely associated with fear of death and the denial of our own mortality. Overcoming these fears is the road towards freedom. Fears are the blocks we place on our awareness. Growing means overcoming doubts, fears and negativity. A recognition that ˝Feelings are informative, they are not authoritative.ţ.

Real freedom is necessarily accompanied by responsibility. Being responsible means being aware and sensitive of the context. As human beings by virtue of our birth, we form part of a Universal Matrix of infinite interdependent connections. As we become aware of these connections, we ˝make conscious what was unconsciousţ. It is only when man is conscious that we can say he has free will. Slaves don't have free will, neither do the parts of a man that are enslaved in his unconscious mind. ˝Mind is the cause of both bondage and liberationţ as the Hindu tradition so rightly points out.

I will conclude by saying that this whole paper could well be summed up by the first line of the Argentine National Anthem:

Hear mortals the sacred cry; Freedom, Freedom, Freedom!

I dedicate this work with gratitude to all who taught me and all who learned from me.