Tag Archives: Integrative Psychology


Dr Shyam K Bhat MD is a
Psychiatrist and Integrative
Medicine specialist.

He is board certified in
Psychiatry, Internal
Medicine, and
Psychosomatic Medicine,
with additional certification
in clinical hypnosis

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Expansion


All of us have an “internal subjective space”, the world of our internal experiences – of thoughts, emotions, perceptions, and the interpretations of these perceptions.

Usually, people know where this internal space begins and where it ends – their “ego boundaries” are said to be intact. (I should emphasize that the word “ego” means very different things in western psychiatry and in yoga psychology. I will detail these differences in a later post.)

But profound alterations of this “inner subjective space” can occur, and ego boundaries can dissolve. From the perspective of contemporary western psychiatry, the dissolution of ego boundaries is a pathological or at least, an unnatural phenomenon, seen in drug induced states and psychosis, and occasionally in hysterical religious experiences. Even if it’s not seen as a pathology, these states are certainly not the goal of any western psychotherapeutic modality.

However, in Yoga, the dissolution of ego boundaries is the goal, the very purpose of the practice. A pure undifferentiated blissful state of being, where observer and observed are one – to the Yogi, this is the description of self-realization, to the psychiatrist, this is psychosis.

What is one to make of this seeming contradiction? That what seems to be psychotic or abnormal in one culture is the pinnacle of human psychological development in another?

I will return to the issue of ego boundaries in a later post. But for now, leaving aside the slightly troublesome issue of dissolving ego boundaries, let us consider the issue of the “inner subjective space”: In eastern as well as in western descriptions of mental states, we see that the “inner subjective space” constricts during times of anxiety and stress and expands during moments of peace and happiness.

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If thoughts and emotions are paint, then the internal subjective space is the canvas. Western psychotherapy focuses on the content of the subjective space – thoughts and emotions.

Yoga on the other hand, accentuates the space itself, the backdrop of thoughts and emotions. Therefore, even more than hypnosis or guided imagery, Yoga and meditation is an exploration and expansion of a person’s inner world.

When a person complains of anxiety or stress, feeling constricted, worried, fearful, the western trained psychotherapist explores thoughts, emotions, childhood issues, relationships and so on. But in psychotherapy based on the principles of Yoga, the person is guided so that they can reflect on their own internal state and then “expand” their internal subjective space.

The practice of Yoga involves a gradual experience and expansion of different “subjective spaces”: the limits of the body, the extent of the breath, the space inside the mind.

Worrisome thoughts – the source of the pain from the perspective of cognitive therapy – seem less relevant as the person experiences this expansion.

In this manner, a therapeutic method based on Yoga psychology decreases emotional distress by changing the context (space) of the mind, rather than the content (thoughts).

When the “inner subjective space” expands, troubling thoughts and painful emotions dissolve in an ocean of dynamism, equanimity, resilience, and peace.


Freud Meets Patanjali: Integrative Psychology Part 1


(Excerpted from my Medscape.com Blog for physicians)

In this series, I hope to demystify and destigmatize eastern approaches to psychological health.

To most western trained physicians, eastern conceptualizations of the body and the mind must seem like superstition or conjecture.

The recent wave of new age commercialization of these ancient concepts has not helped.

“Mind, Body and Spirit” is a cliche, meditation is often an affectation, and the words “Let me align your chakras” is the pickup line of choice at health food stores across the country.

This is unfortunate because in my experience as a physician and psychiatrist, I find that integration and reconciliation of western and eastern approaches to health are incredibly powerful, with the potential to help people transform into a higher state of psychological health.

Consider the case of Steve (name changed). He is in his mid -50’s, a career scientist, well respected in his field. He has published over a hundred papers in noted journals, and as the head of the department is well liked and respected by his peers. He has 2 children, both in college. He has been married for over 20 years, and has a relationship with his wife that is stable, if somewhat dull.

In the last few years, Steve has started to feel bored. He wakes up in the morning and often does not feel like going to work. He notes that his sex drive , never very strong to begin with, has all but disappeared.

He is eating well and sleeps well. He denies feeling anxious or depressed, however, as is often the case, his primary care physician starts Steve on an SSRI, after all investigations for a physical cause for his symptoms are ruled out. ( The primary care physician orders a TSH, BMP, CBC, and serum testosterone – all normal).

Now let us consider the psychological problems of Steve, through a western as well as eastern perspective.

From a western psychological perspective, some of the possible formulations are:

1. He has spent the last 20 years building a family and a career, and in doing so, has walled off some of his emotions and drives. He is suffering the effects of long term repression. He will be helped by insight oriented therapy or brief dynamic therapy

2. He has negative automatic thoughts , and his cognitive distortions about himself and the future, cause him distress. He will be helped by cognitive behavioural therapy.

3. He has poor interpersonal relationships because of sublimated narcissism. His career is a reflection of his drive for attention and control, and he is cerebral and intellectual at the expense of his own psychological well being. He will be helped by psychoanalysis.

None of these approaches are wrong, but they all are similar in one thing: They assume that Steve’s problems are a result of pathology: from a western perspective, negative emotions and thoughts are seen as a result of disease rather than health.

In the east, however, all of Steve’s symptoms are seen as normal, a by product of conventional, mundane, “Unaware” human existence.

According to the psychology of Yoga, Steve is suffering because his identity is tied up with situations and circumstances that are outside his control.

This feeling of separateness, according to Yoga psychology, is a delusion, and a universal one at that – we think we are individuals, when we are in fact, encapsulations of the cosmos.

Everything we see, indeed every aspect of our consciousness and being, is part of this cosmic energy. But as long as we live under the misconception that we are separate from the cosmos, we will continue to experience the neurosis of individual existence.

Although this concept seems to be metaphysical, and seems not to have any practical application, Yoga says that this is an experiential truth, that through the practice of Yoga and meditation, a person can transcend individual consciousness, and experience true psychological (and physical) well-being.

To be continued