A turquoise meta-psychology is all about vitality, intimacy, and vibrant health

In Waking Up: psychotherapy as art, science, and spirituality, I say the purpose of psychotherapy is to remediate symptoms, enhance health, and support development.

20th century psychotherapies were largely based in remediating symptoms, though they increasingly emphasized enhancing health and supporting development as they matured. 21st century psychotherapies are largely based in health, vitality, and intimacy, but are still anchored in remediating symptoms (treating “mental illness”). Symptoms are anything disrupting health, vitality, and intimacy. Remediating symptoms leads to enhancing health, leads to supporting development, leads to new problems, leads to remediating symptoms, leads to more health, vitality, and intimacy, leads to…. ascending the developmental Spiral.

Early 20th systems dealt metaphorically with the unconscious and consciousness—we can now add neuroscience and social research.

Freud spent 20 years in the late 19th century studying the nervous systems of invertebrates like sea snails, looking to understand how brains function. With only a microscope—no fMRIs, no CT scans, no SPEC scans—this was profoundly frustrating. He finally gave up on empirical science and went into metaphor, self-identifying as a scientist. Through his metaphors of ego, id, superego, and all the rest he brought the subjective Upper Left Quadrant and the intersubjective Lower Left Quadrant roaring into the increasingly popular conversations about interiors in the expanding middle and upper classes of the world.

Freud’s passion to make interior psychic structures and childhood programming a psychological science was magnificent! His blind spot was that he was too inclusive about his own constructs—he never gave up anything—and too exclusive about his contemporaries and colleagues. The blossoming ideas of Jung, Adler, Bandura, William James, and countless others harmonize beautifully with the core truths of psychoanalysis, but Freud was too territorial to make the Integral move of harmonizing with other systems.

Freud postulated ego, id, super-ego, unconscious forces, repression, death instincts (Thanatos), sex instincts (Eros), introjects, cathecting energy flows, and counter-cathecting energy flows. These are all metaphors attempting to understand consciousness, development, and intimacy, and help people perceive and discuss drives and passions.

Carl Jung’s metaphors were deeply spiritual. His studies suggested universal forms, all connected to Spirit. Anima, animus, synex, shadow, puer, puella, and the Hero’s Journey arise in growth and integration, which Jung called the individuation process.

As the years progressed, practitioners kept discovering new perspectives/systems that helped them help their clients. Psychotherapy systems proliferated: somatic therapies, family therapies, cognitive, behavioral therapies, transpersonal therapies, catharsis therapies, sex therapies, and inner parts therapies all are still emerging. With the blossoming of practical interpersonal neurobiology, we’ve added therapies to rewire specific brain circuits with a variety of interventions like EMDR, Brainspotting, diet, meditation, exercise, and neurofeedback as well as all the talking therapies.

20th Century psychology began with the medical model

Psychotherapy emerged from 19th century doctors. The diagnose/treat/cure paradigm was strong. Early psychotherapy treated people suffering from frightening out-of-control psychological and relational symptoms they wanted cured. And psychoanalysis delivered to many people. Freud’s ideas of unconscious evolutionary drives, early wounds, internal conflicts, and unconscious conditioning guiding or tormenting us benefitted everyone. The world now had a Freudian mainstream window into the unconscious.

Psychology and psychotherapy captured the popular imagination. This led to rapid development of practitioners continuing to today.

Follow the money

In the 1950s psychiatrists and psychologists wanted to be paid by the same insurance/healthcare companies that reimbursed medical doctors. The concept of “mental illness deserves treatment” continues to be a main rational for charging insurance companies for psychotherapy. It also legitimatized a somewhat maligned, profession—psychoanalysis. Psychotherapists wanted the same respect and reimbursement that medical health professionals were receiving—a somewhat radical concept at the time.

The Diagnosis and Statistical Manuel (DSM) adopted by the American Psychological Association (first published in 1951) and the increasing medicalization of mental health created pushback in the psychotherapy world. This friction turbocharged the evolution of psychotherapy! Evolution requires friction between different forces to create new complexity, and there was a lot of friction in the middle parts of the century! As a student, practitioner, and educator in the 70s it became increasingly obvious to me that every therapist has their own Natural Healing Style with gifts for all of us. This has organized my training and supervision of therapists to this day.

I was there!

The 60s and 70s were wild! I loved being in the middle of it—the different systems kept giving me integrative insights which I got to teach to other therapists. There was conflict between schools of psychology in those days. At the time, some behaviorist psychologists thought psychoanalysts was bogus (though behaviorists tended to choose psychoanalysis for therapists!). Humanistic people thought most behaviorists were idiots. Sex therapists thought the field was ignoring the elephant in the bedroom. Some family therapists were dismissive of individual therapy. Like I said, it was wild.

All this led me to have downloads and write books about the Integrated systems I was using in my individual, couples, family, and group work.

We start with symptoms and move towards unity

In my book, Sessions: all psychotherapy is relationships integrating towards Unity, I show different therapists enacting Integrally informed psychotherapies with a couple, their children, and the husband’s ex-lover over the course of a year. All the sessions start with the suffering, the symptoms, because we need to take pain seriously. As symptoms become resolved, therapists start leaning into enhancing health and supporting development. Generally, the farther reaches of enhanced health and upward development support more feelings of awe, love, joy, and connection. This tracks nicely with Dr. Lisa Miller’s findings of innate human hunger for spiritual connectedness and that certain spiritual practices leave us feeling known, loved, held, guided, and never alone.

Modern therapists generally include spirituality in their Natural Healing Styles.

Ask any experienced therapist about high functioning clients, and they’ll give you some version of, “We go straight towards Spirit in the 1st, 2nd, and 3rd person whenever we can.” Carl Jung, Alfred Adler, and humanistic psychologists knew this and focused increasingly on integration, growth, intimacy, agency, spirituality, and transformation as their careers progressed.

All therapists take symptoms seriously, but most of us also lean into improving relationships, supporting development, and radical wholeness.

This requires growth models, and all the modern psychotherapies are growth models. Family therapy, ego-psychology, humanistic psychology, positive psychology, sex therapy, and Integrally Informed psychotherapy have all emerged as systems explicitly privileging healthy living, loving, and growing.

As integrative models continue to proliferate, I believe modern therapists continue to see the benefits of traditional diagnosis and treatment models. Emergent health-oriented systems haven’t supplanted the old models but rather have included and expanded them.

Psychopathology has existence, but we have a flawed system

The DSM5 (Diagnostic and Statistical Manual of Mental Disorders) has been criticized as “The book of woe,” and a form of recolonization of native cultures. Both valid critiques, but let’s not throw the advancement-of-diagnosis-and-treatment baby out with the cultural-bias bathwater!

We need a DSM! Psychopathology has existence. Hundreds of thousands of hours have been invested in creating the DSM5 language to speak non-judgmentally about mental illness and psychopathology. The DSM5 (along with the ICD—International Catalogue of Diseases) are lingua franca for the world. I can talk to a trained clinician from any place on earth and have a common language of human suffering that allows us to connect and collaborate. This is especially important with the psychotic and neurobiological disorders which often require medications. In general, schizophrenics, bipolar sufferers, the hopelessly distracted, and panic disordered people often benefit from various medications in addition to all the lifestyle changes that support health, intimacy, focused attention, and vitality.

It has been curiously liberating for me as a therapist to recognize the value of the mental illness/treatment models. We need to take mental illness seriously, and sometimes medications are necessary! Mental illness is not merely a cultural construct or the pathologization of normal human experience. Mental illness has existence and wrecks millions of lives.

Part of the problem with treating mental illness is the same as problems with health care in general—a culture/lifestyle/extractive capitalism culture that makes us sick can’t be adequately addressed by treating symptoms. The U.S. high stress unhealthy lifestyles, toxic food, lurid media landscapes, and childhoods hijacked by smart phones generate predictable symptoms. Elementary and secondary education philosophies that cut physical education, the arts, and sports while increasing class time and teaching to tests create more distressed children and teenagers, who go on to become more distressed and fragile adults.

Income inequality also determines treatment. Right now, if you become psychotic or have a personality disorder in this country, it’s a deadly gamble as to whether you’ll get adequate community support that best practices say will help you thrive. Much suffering comes from life conditions, and life conditions determine worldviews—healthy and unhealthy. It’s expensive to provide different life conditions for severely disturbed people needing supportive environments and external structures. Such resources are free in Finland, and cost up to $200 thousand a year in the United States, only available to the wealthiest Americans.

21st Century psychology is all about vibrant health.

We have innate drives to self-transcend, cooperate, love, thrive, and contribute. Once symptoms no longer dominate a client’s life, modern change workers focus on growing, loving, and thriving. Healthy people cost fewer health care dollars and naturally contribute to society. Modern psychotherapy is mostly organized around growing, loving, and thriving.

Types have existence

In the last thirty years, genetic research has revealed that we are born with much of our personality in place. Personality disorders are 80% heritable. Divorce is 30% heritable, and most temperamental traits are 40% to 60% heritable. Neurodiversity exists with all of us having strengths, weaknesses, and special needs. One in 34 children born today have some form of autism spectrum disorder. Typology systems like the enneagram normalize how we are different types and need to be healthy versions of our own type rather than try to force our square selves into the round holes of other types.

There are better ways to be—we are not born equal

21st century psychotherapy is not afraid to talk about another elephant in the room—we are not born equal, and all approaches are not equally valid. Diversity and acceptance require facing the fact that some ways of being are preferable. Examples? Assertion is better than codependence. Sobriety is better than addiction. High emotional intelligence is better than low emotional intelligence. Integrity is better than betraying your principles. Kindness is better than selfishness.

There are better ways to relate

I’ve written a lot about relating and handling. Mutually nourishing intersubjectivity is usually relating—self-regulating, honest, caring, and engaged. Draining or alarming intersubjectivity calls upon us to handle ourselves and others more gracefully, not fully open with the other, and tolerating more disconnection.

Remediating symptoms is central and important

I always start each therapy session exploring distress and yearning. “What do you want to focus on today?” is a common first question. In early sessions we tend to emphasize solving problems—like distress, symptoms, dysfunctional relationships, unhealthy habits, and distressing moods of anxiety and depression.

As the work unfolds over time and people feel better and more in control of their lives, I increasingly want to foster their faith they can love better and thrive if they continue to use their human superpowers of focused intent and action, in service of principle, driven by resolve. Such faith heals their distress. Faith in effort and progress makes the inevitable suffering of existence more acceptable and enormously less frightening.

Also, for every symptom that’s addressed and soothed, new possibilities of enhancing health and supporting development emerge in the session. This is joyful work.

Eventually, when symptoms intrude (as they always do), they become new focus points to enhance health and support development. This is like Buddhist Anapaya practice, there are no distractions because each new distraction becomes the focus of the meditation.

Love and work

Freud famously said health was the ability to love and work. I’m encouraged how many modern businesses are recognizing that there are superior corporate cultures and thriving workers, and that 21st psychology can help create and maintain such cultures and workers.

Lots of corporations are realizing that transformational culture increases profits, supports the environment, and helps workers thrive. Many therapists and consultants I know are committed to supporting corporations as health and profit generators for workers, managers, clients, and the environment. The B-corp movement is a good example of this on a social level.

I’ve been so impressed with all the business consultants I’ve met over the years! They all are emissaries for virtuous success—generative capitalism is the future of this planet. Humans need to have pyramids to climb and hierarchies to fit into, and generative capitalism has all the opportunities that extractive capitalism does, but with commitment to human thriving, supporting the collective, and healing the biosphere.

A turquoise meta-psychology is a mode of discourse

Every system I’ve mentioned has importance, power, and relevance. There is clearly no single approach that captures the vast array of human suffering, healing, and thriving. We only determine how to help people through complex algorithms of training, experience, openness, and engagement. How do we address this complexity in the 21st century?

A 21st meta-psychology is a mode of discourse. Informed practitioners stable at multiperspectival teal engaged in a dialectic to enhance and clarify the human experience is a turquoise psychology. Bringing the turquoise dialectic to bear in a community of the adequate self-organizes multiple approaches in an Integral embrace.