Integrating the Mind, Brain, Body, and Spirit

In contemporary psychiatry, the emphasis is usually on biological aspects of the illness. Psychiatrists study how the brain changes during an illness and what kinds of medicines are needed to normalize brain chemistry.

This has not always been the case – Sigmund Freud, the father of modern psychiatry was a neurologist by training, but he was more interested in the “mind” rather than the “brain” –  Freud’s unique (and, in his time, radical) contribution to the field was the idea that the unconscious mind affects us, and can lead to emotional problems.

But in the last many years the orientation of psychiatrists has become increasingly “biological” – which means that the emphasis is on the brain rather than on the mind.

Here I should differentiate between the brain and the mind. The brain is an organ – a collection of nerves, more than 100 billion of them – and psychiatrists who are biologically oriented believe that emotional problems arise due to malfunctions of the brain.

The “mind” is the stream of thoughts and feelings, both recognized and repressed, covert and overt, subtle and obvious.

It’s incorrect to assume that the mind is always at the mercy of the brain – that thoughts and feelings arise as a result of problems in the brain.

There is no doubt that brain malfunction can cause abnormalities of thoughts and feelings.

But – and this has been substantiated by countless research studies – thoughts and feelings also affect brain chemistry and function.

The brain and the mind share a bilateral dynamic relationship, each affecting the other.

With this perspective in mind, , let us consider the case of someone like Suresh (as always, names and details have been changed).

Suresh in his mid thirties says that he has been feeling anxious, sad and depressed for a long time.

A thorough evaluation has to include an understanding of Suresh on multiple levels, from multiple perspectives.
This is why it’s important to understand the role of a psychologist and a psychiatrist.

A psychologist will understand Suresh’s problem as being a product of the mind alone. For example, the psychologist might tell Suresh, “Your depression and anxiety is because you are in a bad relationship, because you have poor self-esteem, because you have negative thinking, because you have the tendency to catastrophise about the future.”

A psychiatrist who sees everything as a product of biology, would say to Suresh, “Your problems are because of chemical imbalances in the brain, and you need medicines.”

Both these approaches are only partly true.

In order for Suresh to achieve his authentic , peaceful, and joyful self,  an integrated approach is essential.

This would include attention to  the brain, the mind, the body, and the spirit.

What does this mean for Suresh?

That he would achieve his goals with a combination of supplements, proper diet, exercise, sunlight and lifestyle modifications, medications if necessary (depending on the assessment of how much brain dysfunction there might be),  psychotherapy and an exploration of meaning and purpose in his life.


A complete and integrated approach would include an exploration of the following: What is his current life situation? What is his current emotional state? How do his emotions and personality affect him and those around him?

What are the genetic and biological factors responsible for his current situation?

What is his lifestyle? How does he treat his body?

This includes understanding his family of origin, and his childhood.  For example, if Suresh’s mother was depressed and anxious, then she may have passed on these genes and hence the tendency to be depressed and anxious to Suresh.

We have to also understand how Suresh’s temperament interacted with his childhood situation to create his identity – if Suresh was a sensitive child and his mother was anxious and stressed, then this childhood environment may have created, in Suresh’s mind, the idea that the world is an uncertain and rejecting place.

We have to know: What is he repressing in his unconscious mind? What are his unexamined assumptions and presuppositions of life?

A thorough evaluation of the current situation has to also include questions that may be seen as being under the purview of philosophy or spirituality : What is Suresh’s understanding of existence? What is his current life purpose? What does he see as the meaning of life?

When all this comes together, then Suresh will not only leave behind his anxiety and depression, but he will also transform into the person that he is meant to be – peaceful, joyous, energetic, passionate, compassionate, and authentic.
That is why I believe – all emotional problems are a stepping stone to greater joy and clarity.

You Are Neo

“You take the blue pill. The story ends. You wake up in your bed and believe…whatever you want to believe.

“You take the red pill, and you will see how deep the rabbit hole goes. Remember. All I’m offering is the truth. Nothing more.”

– Paraphrased from the movie The Matrix

You’ve seen the now classic scene (and if you haven’t then you should watch it at least twice before returning to this article): Morpheus offers Neo a choice – either see the truth for all its discomfort, or continue to live in the constructed unreal dream world of the machines, where you are enslaved so much that you don’t even know it.

The fact is that many of us live life by taking the equivalent of the blue pill. We don’t want to see the truth, because the truth is not familiar.

And so we continue to live a life that is not really free, except we don’t even know it.

But we always know the truth in our hearts. We know the direction we should take. We know our potential. We may be too scared to break free, but deep down we always know.

Now, I am not suggesting that following your dreams always has to be an upheaval. The greatest revolutions are often the quietest. Some people say, “there are no good role models,” or “we really don’t have good teachers.

But in fact, any event in your life is a teaching. The more uncomfortable or troubled you are by the event, the bigger the lesson that life is trying to teach you.

So when you face a difficulty, remember this – you are in the classroom of life. When you learn that lesson, the discomfort will stop.

But the problem is that because of the discomfort involved, you may be tempted to ignore the issue. You may do one of many things to prevent the full realization of the issue. Some common ways people do this are by –

a) Completely ignoring the issue. “What, me worry?”

b) Playing the victim. “What to do, I am like this only.”

c) Becoming angry with someone else. “It’s all your/their/her/his fault!”

d) Becoming angry with life. “Life is horrible, it’s so unfair! There’s no point living!”

These are all variants of the blue pill. Ignorance is not always bliss. Instead, be bold and chose self-awareness. Here’s how to do this. Say to yourself –

a) I am okay just the way I am. I am not perfect, but no human being is, and that’s okay.

b) Even though I am okay just the way I am, I can always learn and improve myself.

c) I can learn by deepening my understanding, of my motivations and feelings, and thoughts and others.

It’s a practice of course. It doesn’t happen as easily as Neo swallowing the red pill. But your awareness will grow until you are free, of all internal inhibitions and self-imposed external ones.
Your freedom will reflect in increased joy, energy, motivation, and happiness.


(From my Blog on

Lessons From Felix

“It’s kind of an awkward view because you’ve never seen a black sky. And at that moment, you realise you’ve accomplished something really big.” Felix Baumgartner

On October 14th, Felix Baumgartner, a 43 year old Austrian broke the sound barrier and the free-fall record by jumping from a balloon more than 39 kilometers in the sky.

The previous record was set by Joseph Kittinger in 1960, and many people died since, trying to beat that record.

Until now.

What a remarkable story.

It’s as big, if not bigger than the Neil Armstrong moment, or the 4 minute mile.

This is one of those achievements that causes an entire species to think of itself differently.


When we hear about this achievement we think of Baumgartner’s courage.

He must be really fearless, we think.

But let us examine the jump, and the psychology of it, a bit a more closely.

Baumgartner’s fearlessness is not his willingness to jump out of a moving plane. His fearlessness is of much deeper and more significant that that.

Many people jump off high buildings, or bridges when they are suicidal. But we would not call that courageous. (Neither would I call that cowardly, but more on that in a later post.)

Baumgartner is courageous because he committed himself to breaking the world record. He had the audacity to stand out of the herd, to chase a goal that had already killed so many.

He made it his mission and he had the courage to take his mission seriously.

His courage long preceded the jump. This was no foolhardy mission, fuelled by adrenaline and testosterone.


Felix planned meticulously. He assembled a team of engineers, physicists, doctors, scientists, more than 300 and planned the jump for over 5 years.

In the course of his preparation, he developed a deep friendship with Kittinger, drawing inspiration and courage from the man.


What I find most remarkable about the jump, is Baumgartner’s struggle with claustrophobia. Claustrophobia – the fear of closed spaces. Imagine how he felt in the tight pressure suit.

A person who feel claustrophobia will feel anxiety, fear, and terror in a situation like what Baumgartner put himself through.

Now imagine Felix’s will and determination to get to his goal.

He is courageous, precisely because he felt so much fear.

This is what we must admire – a man who transcends fear, not a man who doesn’t feel it at all.

A man who knows no fear at all is not courageous. He is abnormal.

As I said in my previous post, fear is a vital part of normalcy. It is not usual nor is it normal to be rid completely of fear. A person who is incapable of fear will not think about possible setbacks, and therefore would not plan adequately..

Baumgartner felt afraid, but he was so committed to his task, so intent on the mission, and so immersed in the steps of the jump that there was no question of going ahead – fear or no fear.

And that is the basis for courage: When you are committed to a mission, when you are passionate about a cause, that is somehow larger than yourself, you will transcend limiting fears.


So much more can be written about this jump, but for now let’s look at some life lessons from Felix Baumgartner:

1) Do what you love

2) Always seek to improve and be the best in it. Keep pushing yourself.

3) Compete only with yourself. Keep pushing yourself to do more and better

4) Prepare

5) Make friends and learn from them

6) Transcend fear by focusing on the goal, the purpose, and constantly improving your skills

7) Pursue your mission and purpose relentlessly

You Are a Flowing River

“Don’t push the river; it flows by itself” Fritz Perls

The self is fluid, and constantly changing, said learned Eastern philosophers of yore. Your thoughts come and go, emotions change, and although you think of yourself as the same person across time, actually you are never the same. In fact, in some ways, you have no self at all.

Now, this may sound nihilistic to many people. But, as it happens, embracing the fluidity of your identity is a direct path to bliss and happiness. And as a psychiatrist, I see these philosophical concepts being played out in numerous ways in many of my patients.

Consider Lalit, for instance. In his mid-40s, he has been contemplating resigning from his job and starting a business for a long while now. But he is scared and his fear paralyses him, stopping him from taking the decisive step. The risk of failure and the intense responsibility of the change is frightening because Lalit’s sense of self cannot shoulder such a responsibility or deal with so much risk.

He has become so used to living and working under the umbrella of an organisation that he cannot, emotionally, embrace the idea of himself as an entrepreneur striking out on his own. His real self is crying for freedom, but his current self-concept does not allow for so much autonomy. Consequently (and not surprisingly), this yearning is suppressed as Lalit continues to toil at a job, imprisoned by his current identity and the fear of losing it. But if Lalit were willing to experience his real self, which is unthreatened by more conventional definitions of failure and success, he would be free to pursue his destiny.

Remember, your authentic, deepest, abiding self does not disintegrate when circumstances change. Your real self is life-affirming, secure, resilient and flexible — it is an experience, not an intellectual construct.

When you find yourself, you will not find an object. You will not find something that you can point to and say, “This is who I am.” When you find yourself, you will find a flowing river.



From My Column in Outlook Business. All case histories are composites, and details changed.