Mainstream psychology lacks a paradigm for actually healing the mind. It needs one.
It’s easy for psychologists in Western civilization to assume that we understand more about human nature and how to improve mental health than pre-modern societies. Having the most sophisticated scientific methods providing a backbone of validity and credibility on matters of human nature gives us confidence in our paradigm of mental health, so much so that we scarcely consider its limitations. There’s a myopic arrogance in this perspective, and if Western psychology cares to be the preeminent authority on mental health in the eyes of the world, it’s time to recognize a new paradigm for healing the mind. Because presently, we don’t have any paradigm for healing the mind.
There is no doubt that psychology’s adoption of the medical model and scientific paradigm have served us well. Myth, superstition, pseudoscience, and plain quackery have all been superseded by certainties grounded in empirical research (it’s a wonder that spirituality and religion have not been likewise supplanted). With our evidence-based treatment models, we feel confident that we are providing the most effective interventions known to the modern world. So why is it, given our advanced levels of knowledge, that we have no paradigm for actually healing the mind? Have we determined that the mind is a construct amenable to cure, but incapable of being healed?
A search for the term healing psychology in the APA’s PsychNet database produces a solitary reference. Fortunately, that reference directly addresses the need for an alternative paradigm of mental health which includes healing. Indigenous Healing Psychology – Honoring the Wisdom of the First Peoples (2017), by Richard Katz, Ph.D., former professor of psychology at Harvard University, informs us that there is such a paradigm for understanding the mind, predating our own, that psychologists have neglected to give any serious consideration. Katz’s scholarly work provides an historic foundation and persuasive argument for Western psychology to examine ancient healing traditions, as well as a rationale for incorporating the practices of healing into our scope of expertise.
Central to Katz’s thesis is that the scientific paradigm lacks the ability to study the dynamics of healing in the first place because these dynamics can neither be directly measured or controlled. Turning a blind eye to alternative paradigms evinces the foolishness of looking for lost keys exclusively under a lampost because the lampost is the only tool known for discovering lost keys in the dark. It’s not rational to conclude that only those things we can master with the tools of science are real, all else being fiction. When the only things possible for a lampost to illuminate are treatments that cure, left out in the dark are equally valuable treatments that heal.
In Western medicine, a cure is defined as a means of improving health through the control or elimination of disease. In contrast, to heal means to improve health through a restoration of wholeness. It may be possible to cure an infection or cancer, but these are not conditions that are healed. Damaged organs or broken bones can be healed, but these are not diseases to be cured. This distinction between curing and healing is equally relevant to mental health, however our scientific paradigm has limited us to only identifying diseases (psychopathologies) that we have the tools to cure. Psychology has failed to recognize the ways in which a psyche can become broken and in need of restoration to wholeness, as well as the treatments capable of doing so.
Consider the following analogy. Imagine that health is measured by one’s ability to perform harmonious music. Improving health might include curing the conditions of tone deafness, impaired music reading skills, and broken instruments. So a community employs experts to cure these diseases, thereby improving the health of each member of the community. Still, their orchestra performs poorly as a group, so they next employ a conductor to teach the musicians to perform harmoniously as a unified whole. Their wise conductor knows that the greatest harmonies are achieved by fostering a spirit and synergy of oneness with a common value and identity. Now the relationships within the orchestra become harmonious as well. In this analogy, musical experts perform the curing, while the conductor performs the healing.
The difference between approaching health interventions through curing or healing reflects the difference between atomistic and holistic paradigms of reality. In the atomistic paradigm of Western science, the physical world is broken down into its individual components for empirical measurement and manipulation. In the holistic paradigm more common among non-Western cultures, reality consists of more than just the physical world. Its focus is on evaluating and treating the quality of relationships between individual parts and the greater whole to which they belong. Healing can only be understood through the lens of a holistic paradigm because the atomistic paradigm lacks the means to objectively measure or control the subjective nature of relationships. Within the holistic paradigm of healing, assessing relational dynamics is most important for understanding the conflicts of self, the healing of divisive conflicts, and how to increase the integration/wholeness/health of the collective.
A core tenet of the holistic paradigm is that all things share a common identity (the principle of wholeness/oneness/unity). Accordingly, health is conceptualized by how effectively individual parts are integrated, balanced, collaborative, and harmonious within the whole. By making the wellness of the whole the greater priority, individuals are treated by improving their relationships with the larger group. The school of Gestalt psychology sagely captured this concept with its assertion that the whole is greater than the sum of its parts.
To further illustrate the distinction between atomistic/curing and holistic/healing paradigms, consider how an individual can be healthy in relation to the whole and yet still be unhealthy as an individual. If one member of an orchestra is unable to play their instrument harmoniously, that member can be assigned a different role (e.g. stagehand) in support of the orchestra’s harmony. The individual and the group preserve their healthy harmony even while the individual remains uncured. Conversely, every musician could perform harmoniously as individuals, yet the orchestra could still fail to perform harmoniously as a whole.
Psychologists already have several treatment models that are compatible with the holistic paradigm of healing. Family Systems Therapy, Internal Family Systems (IFS), and Community Psychology all focus their interventions on improving relationships between parts and wholes. Each facilitates greater integration, collaboration, and harmony between self and others and, in so doing, both the individuals and the groups they belong to function in healthier ways.
Because the holistic paradigm places greater emphasis on the relationships between parts than the parts in isolation, models of healing require a greater understanding of relational dynamics. And beneath the umbrella of these relational dynamics, we need to identify which types can cause mental illness and which types can promote healing. Much is already known about interpersonal dynamics, but this knowledge needs to be clarified and woven into our treatment models in more coherent and systematic ways.
As a psychologist who has treated individuals, couples, and families for the past 30 years, I feel qualified to expound on some of the basic principles of relational dynamics, alternately causing pathology or healing within each of these treatment units. For instance, pathologies associated with unhealthy relationships share a set of common characteristics. They engender conflicts that play out in adversarial and divisive ways, thereby weakening the integrity of the family, couple, and/or individual. Similarly present in unhealthy conflict dynamics is the influence of condemning judgements. Condemning judgements are personal in nature, whether targeted toward an individual or certain aspects of an individual. These judgements are more damaging than the benign judgements that merely assess behavior rather than condemn people. A judgement that excessive video gaming is unhealthy for children and teenagers is not the same as saying these children and teens should be ashamed of themselves for their behavior.
Condemning judgements cause pathology because of the toxic emotions they provoke. Extreme levels of sadness, anxiety, guilt, depression, anger, hatred, and shame are all capable of causing mental illness. The combination of condemning judgements and the toxic emotions they create also lead to adversarial conflicts and broken relationships. This is a common way that unhealthy relational dynamics impair the health of both individuals and the larger system they belong to.
If this conceptualization of unhealthy relational dynamics adequately explains certain types of psychopathology, the next question becomes; What types of relational dynamics can heal these types of illness. Healing interventions might include goals such as; the elimination of condemning judgements, the purging of toxic emotions, converting adversarial conflict management patterns into collaborative ones, reconciling broken relationships, and fostering greater integration between individuals within the whole. The relational skills capable of achieving these goals represent the skills of healing. Therapists with these skills would use them in ways analogous to how an orchestra conductor would facilitate group integration and harmony.
The relational skills necessary for healing are not primarily procedural, cognitive, or behavioral in nature. Healing is induced more through interpersonal expressions of empathy, understanding, and compassion. Such expressions are effective because they are felt rather than applied or learned. What is felt from these expressions allows emotional defense mechanisms (that maintain separation) to be lowered, vulnerable wounds to be accessed, and toxic emotions to be released. These are all precursors to greater integration.
Other relational skills necessary for healing include expressions of respect, acceptance, reassurance, validation, affirmation, remorse, and forgiveness. Bear in mind that it is not always the therapist’s use of these skills that is most important for individuals and/or relationships to heal. Of greater importance is for these relational skills to be expressed directly between individuals in need of healing. We therapists do not actually have the power to heal others, but only to provide the relational influences necessary for them to heal themselves. That means that we not only need expertise in the use of relational skills, but also the ability to show others how to use them independently, both internally and with others. A good conductor will develop good relationships with every musician in the orchestra, but a great conductor will teach musicians how to have good relationships with one another that will transcend the performance domain. Likewise, therapists don’t want the couples and families they treat to only get along while in session. We want them to internalize relational skills that will serve them in their lives beyond therapy.
At this point in the discussion, readers might be thinking; Relational dynamics make sense in the context of healing interpersonal relationships, but how can they be applied to the healing of individuals? For this to make sense we need to recognize how there are multiple parts within an individual identity that interact in ways that parallel interpersonal relationships.
More than 140 years ago, Freud explained how the conflicts between the Superego and the Id would create neurotic symptoms unless or until the Ego figured out how to manage their conflicts. In the late 1950s, Berne’s Transactional Analysis theorized that intrapersonal and interpersonal interactions between Parent, Adult, and Child ego-states determined healthy or unhealthy functioning. One of the most well-known subpersonalities in the self-help culture is the Inner Child, comparable to Berne’s Child ego-state, both derivatives of Jung’s concept of the Divine Child. Today, Richard Schwartz’s IFS model offers a more fully developed model of relationships between intrapsychic subpersonalities. The implication for individual healing is that the same relational skills applied in family therapy need to be applied to the internal family of the individual psyche.
Regardless of the taxonomy of subpersonalities, it is the effective use of relational skills that is necessary to heal by mending the relationships that surround and serve the human heart. Although our convention is to regard ourselves as experts in treating sick minds, the heart is the core of where healing is needed.
Western psychologists can readily develop a model of relational dynamics and relational skills to suit the purpose of healing relational pathologies. Doing so will not supplant traditional interventions for curing psychopathology. Our challenge will be to embrace and integrate the holistic paradigm of healing to complement our atomistic paradigm of treatment. In order for troubled hearts, minds, and behaviors to perform music most harmoniously, psychologists need to be both expert instructors and talented conductors.
Michael R. Kandle, Psy.D.