An Integral Perspective On Depression

International Journal of Transpersonal Studies
Volume 22 Issue 1 Article 14
1-1-2003
An Integral Perspective on Depression

Dinu S. Teodorescu
Norwegian Transpersonal Association
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An Integral Perspective on Depression
Dinu Stefan Teodorescu
Norwegian Transpersonal Association
The integral approach to therapy proposes to accommodate all the etiological factors of
unipolar depression in its theory, as well as to make use of all existing therapies, both phar-
macological and psychological, in the treatment of unipolar depression. Integral Therapy is
compared to cognitive therapy to find evidence for its superiority over the cognitive
approach. It appears that the cognitive therapy is more cost-effective than Integral Therapy
as an individual approach in the treatment of depression, but that the integral perspective
accounts better for etiological factors.
Introduction are not really double-blind, since during the trials the
subjects come to realize whether they have placebo or
D
epression is the most widespread mental dis- not. Because of the pressure from medical insurance
order, and in 1999 as many as 1 in 20 companies, psychotherapies have been urged to devel-
Americans were severely depressed (Satcher, op short-duration therapies that can be quantified,
1999). Every year, about 6 million people suffer from and today the field has developed a new approach, the
depression in the U.S., with a cost of more than 16 bil- so-called evidence-validated therapies (EVT), propos-
lion dollars; 60% of suicides have their roots in major ing that only those therapies that have a research-based
depression, and 15% of patients admitted for depres- evidence should be considered. However, the benefits
sion to a psychiatric hospital kill themselves of EVT over the other therapies have been questioned
(Nierenberg, 2001). The recovery rate from major (Lampropoulos, 2000; Henry, 1998; Garfield, 1996).
depressive disorder (MDD) is as follows: 50% of those For the time being, there are only two therapies
who had a major depressive episode and recovered will that are recommended by the American Psychiatric
never experience a new episode; while 40% will have Association (APA) for the treatment of MDD based
MDD recurrence in the future, and 10% will never on research evidence: namely, cognitive therapy (CT)
recover and will experience a chronic depression and interpersonal therapy (IPT) (American Psychiatric
(Passer & Smith, 2001). Association, 1993). The question which remains is
Depression is perhaps the most researched mental what shall be the fate of the 200 or more existing psy-
disorder. Street et al. (1999) list more than 27 theories chotherapies (Bohart et al., 1998; Chambless et al.,
of depression and 99 factors that contribute to its 1998) that may work as well as CT and IPT, but for
onset and maintenance. Of the 27 theories, none is the time being don’t seem to have the “credentials”
able to accommodate all these factors. The classical from research. Some of them, such as psychoanalysis
ones have concentrated only on some of them, often and some humanistic psychotherapies, may prove
getting in conflict with other theories that emphasised impossible to quantify using a research setting, and in
other factors, and thus giving rise to an unfortunate the end they may prove “too long and expensive” for
competition for the “truth.” the health insurance companies.
Today we see in the U.S. a real battle between phar- Given this growing problem for today’s psy-
macotherapy and psychotherapy in claiming full rights chotherapies, it is indeed “unreasonable” to propose a
in the treatment of MDD. The psychotherapy quarter new therapy, which may prove even longer in achiev-
seems to be losing ground because of the problem of ing results and even more difficult to be tested in an
funding research, while the pharmacology quarter is experimental setting. And it is a problem for the pres-
obviously supported by large grants from the pharma- ent paper, meant to introduce a new form of therapy
ceutical industry. The double-blind pharmacology for MDD, Integral Therapy (IT).
studies on MDD have all been criticised, because they Psychotherapy integration has long been an ideal
100 The International Journal of Transpersonal Studies, 2003, Volume 22

for many psychotherapists dreaming of an overall and to propose a more parsimonious and more effica-
framework with a theory endorsing specific therapy cious therapy. The common factors present in all gen-
techniques. Efforts for an integration of different the- uine psychotherapies are: a positive therapeutic
ories were first made in 1936 by trying to combine alliance, a supportive relationship, genuine interest in
psychoanalytic and behavioral approaches, in order “to the client’s problem, authenticity, warmth, empathy,
combine the vitality of psychoanalysis, the rigor of the openness, unconditional love, arousing hope and pos-
natural science laboratory, and the facts of culture” itive expectations in the client, the client’s emotional
(Wachtel & Messer, 1998, p. 231). Surveys have found involvement in the therapy, encouraging new ways in
that between 30% and 65% of interviewed psy- the client to understand oneself and one’s problems,
chotherapists identified themselves as eclectic and generating new patterns of activity outside the
(Norcross & Goldfried, 1992). But there are big differ- therapy session (Norcross & Goldfried, 1992).
ences. Whereas the eclectic perspective is just borrow- A common-factors therapy for depression has been
ing freely from the classical schools and just chooses proposed by Arkowitz (1992), emphasising one basic
from the existing therapies, the integral perspective factor, lack of social support, as the main cause of
tries to create an umbrella that may accommodate all depression. He argues that there have been no signifi-
existing factors and therapies, as well as combine dif- cant differences between different treatments for
ferent therapies (Jensen et al., 1990). The integral depression (Robinson et al., 1990, Elkin et al., 1989),
approach tries to create something new, unifying the and that common factors are responsible for the out-
parts, while the eclectic approach is just applying the come of the treatment. Lambert et al. (1986) found
parts of what there is. that the common factors are responsible for some 40%
Today there are three popular pathways toward the of the therapy outcome, specific techniques for only
integration of psychotherapies: technical eclecticism, about 15%, expectancy (placebo effects) for another
theoretical integration, and common factors. The 15%, and extratherapeutic change for maybe 30%.
main aim is to increase therapeutic efficacy and effi- We also have an integrative therapy that combines
ciency by looking beyond the boundaries of single the- pharmacotherapy and psychotherapy (Beitman &
ories and restricted techniques. Klerman, 1991).
Technical eclecticism seeks to select the best treatment Finally, the last development on the integrative
for the person and the problem. It draws its techniques front is Integral Psychology (IP) as proposed by Ken
from a large number of different systems of psy- Wilber (2000a), which sets out a master template the-
chotherapy, which may be epistemologically or onto- ory that can accommodate 100 psychological models,
logically incompatible. using freely all possible therapeutic interventions and
Theoretical integration seeks to integrate two or weighing their strength according to the master tem-
more therapies, hoping that the resulting therapy may plate theory.
be better than each constituent therapy alone. The The aim of the present study is to compare the the-
emergent theory is more than the sum of its parts. oretical and therapeutic virtues of Integral Therapy
There are several examples of efforts meant to integrate (IT) and cognitive therapy (CT) (Beck et al., 1979).
two therapies: psychoanalysis and behavior therapy
(Wachtel, 1997), humanistic and behavioral therapies The Study’s Questions
(Wandersman et al., 1976), family/systems therapies,
biological and individual therapies (Pinsof, 1995),
incorporating interpersonal factors in cognitive therapy
(Safran & Segal, 1990), or integrating multiple thera-
I n this paper we shall look more closely at the virtues
of IT in the understanding and accommodation of
multifactorial causes for unipolar depression. Further,
pies such as the integrative psychodynamic therapy we shall look at the capacity of IT to use freely, in an
which combines psychodynamic, behavioral, and fam- integral perspective, from all existing therapies, either
ily systems theory (Wachtel & McKinney, 1992), and alone or in combination, to better serve the particular
the transtheoretical approach, which integrates the needs of the client in prevention and treatment, and
major therapy systems (Prochaska & DiClemente, 1992). against recurrence of major depressive episodes. IT will
The common-factors approach seeks to identify then be compared to an established, empirically vali-
similarities and core ingredients of different therapies, dated therapy, cognitive therapy (CT), in order to
Special Topic: Depression 101

identify its strengths and weaknesses. To this effect, we Etiology
have formulated two separate questions: (1) Does IT
provide a better understanding than CT of the multi-
factorial causes of unipolar depression, accommodat-
ing all the factors into a coherent theory of depression?
S everal causes have been proposed as the origin of
depression, such as: personality and intrapsychical
causes (Millon, 1996; Bowlby, 2000), personal vulner-
(2) Does IT provide a better therapeutic offer than CT ability (Vrasti & Eisemann, 1995), genetic causes
for preventing the first onset of the MDD, treating, (Barondes, 1999), sex differences (Nolen-Hoeksema,
and preventing recurrence? In order to answer these 1990), interpersonal causes (Joiner & Coyne, 1999;
questions a literature search has been undertaken. Brown & Harris, 1979; Hammen,1991), avoidant
coping strategies (Chan, 1995; DeLongis, 2000), culture
Nature of the Disorder (Manson, 1994; Culbertson, 1997), learned helplessness
(Seligman & Isaacowitz, 2000), and environmental
D epression is primarily a disorder of mood, charac-

terized by cognitive, motivational, and somatic
(physical) symptoms. Emotional symptoms include
causes (Nezlek et al., 2000; Tseng et al., 1990).
Different therapies have considered only some of
the possible etiologies, because of limitations of the
sadness, hopelessness, misery, loss of pleasure, dys- theory or out of ideological reasons, leaving unad-
phoric mood, affective emptiness, and depersonalisa- dressed all the rest. There are theories emphasising
tion. Cognitive symptoms can be briefly described as some factors while ignoring others: biological psychol-
negative cognitions about self, the world, and the ogy emphasises brain structures and chemical imbal-
future. More specifically, cognitive symptoms are the ances in the brain; behavioural theories emphasise
following: thoughts focused toward the past, followed inappropriate behaviours (Wolpe, 1982); cognitive
by intense regret; feelings of worthlessness; poor con- theories emphasise maladaptive cognitive processes
centration; intense rumination; diminished locus of (Kovaks & Beck, 1978); social psychology emphasises
control; magnification; minimisation; absolutistic the importance of relationships, life events and chronic
thinking; confirmatory biases; and the utilisation of stressors (Brown & Harris, 1979); self-psychology
the availability heuristic (Clark et al., 1999). Common emphasises personal needs and desires (Arieti &
motivational symptoms are loss of interest, loss of Bemporad, 1980); psychoanalysis believes in early neg-
interest in others and social relationships, lack of drive, ative experiences as the origin of maladaptive coping
and difficulty starting anything. Somatic symptoms mechanisms (early loss giving rise to anger directed
are loss of appetite, lack of energy, sleep difficulties, inward) (Freud, 1959); attachment theory emphasises
weight loss or gain, somatic preoccupation, and psy- early interpersonal conflicts (Bowlby, 1977); attribu-
chomotor retardation with fatigue. tional style theory emphasises the role of making
Unipolar depression is a kind of depression where wrong attributions about the outcome of events; and,
the individual experiences only the above symptoms, finally, the helplessness theory emphasises the role of
without mania, distinguishing it from bipolar depres- learning helplessness throughout one’s life (Alloy et al., 1988).
sion. To diagnose MDD, according to DSM-IV-TR, One of the best models to date proposes that per-
the subject must report five of the following nine sonal vulnerability to depression is determined by a
symptoms in the last two weeks: depressed mood and combination of biological, psychological, and social
feeling sad; markedly diminished interest or pleasure variables (Eisemann & Vrasti, 1995), but it fails to
in almost all activities; significant weight loss or weight include the developmental levels and lines of the
gain; insomnia or hypersomnia; psychomotor agita- patient (Wilber, 2000b).
tion or retardation; fatigue or loss of energy; feelings of Notable efforts have been made by Street et al.
worthlessness or excessive or inappropriate guilt; (1999), who tried to integrate 27 theories of depres-
diminished ability to think and concentrate, or indeci- sion. They found 99 psychological factors that can
siveness and recurrent thoughts of death or recurrent cause the onset of depression, leaving out other theo-
suicidal ideation (APA, 2000). retical approaches such as biological and sociopolitical
ones. They proposed that an individual vulnerable to
depression might interact with the environment in cer-
tain maladaptive ways, resulting in the formation of a

negative view of the self, the environment and the therapy (ECT) (Rey & Walter, 1997; Petit et al.,
future, and in the occurrence of the depressive symp- 2001), vagus nerve stimulation, or with transcranial
tomatology. magnetic stimulation (TMS) (Boutros et al. 2001,
Four fundamental dimensions have been identi- Wassermann & Evans 2001). Treatment of depression
fied, each designated by a cluster of factors. either with drugs or with psychotherapy (DeRubeis et
The cognitive-bias dimension proposes that infor- al., 1999; Hollon, 1996) has been the subject of a hard
mation is processed selectively by the individual, thus dispute between the biological and the psychological
contributing to the creation of a negative view of self perspective. But now, any such ideologically motivated
and negative self-schemata. These two are involved in perspectives no longer have a place in choosing the
the etiology and maintenance of depression. right therapy for any given individual (Weismann,
The second dimension is the lack of positive rein- 2001).
forcement for the self, resulting from the individual’s What are the best therapies for MDD?
maladaptive social behaviours and pursuit of unrealis- Antidepressants are effective in approximately 70% of
tic social goals. cases with MDD and there are today more than two
Lack of social support and interaction is the third dozen drugs with seven distinct mechanisms of action
dimension, which has two aspects, a cognitive one and (Manning & Frances, 1990). Both pharmacotherapy
a behavioural one: for the cognitive one, the individu- and psychotherapy are available to treat MDD, and
als are unable to express their own thoughts and feel- often the treatment is a combination of the two (Blatt
ings and to monitor those of others; for the behavioural et al., 2000). In Norway, at a Consensus Conference in
one, individuals behaving in socially undesirable ways 1999, American publications on the effects of drugs
have deficits in social skills and lack social relationships were criticised as being biased by selective publishing
and/or a network of contacts and support. and by the economic interests of the big drug compa-
The fourth dimension proposes the importance of nies. The general consensus was that there appeared to
goal pursuit and achievement and indicates that a be very little effect from recommended drugs such as
failure to achieve goals affects self-esteem, which may TCA, SSRI, MAO and RIMA, and that psychothera-
give rise to depression. It is also stressed that inappro- pies like CT, cognitive-behavioral therapy (CTB), and
priate or unachievable goals may have the same impact interpersonal therapy (IPT) were recommended for
on self-esteem. Finally, four negative beliefs have been treating MDD.
found that contribute to the onset of depression: neg-
ative self-view, worthlessness, loneliness, and failure. Cognitive Therapy for Depression
In the effort better to serve the needs of those who
do not benefit from one therapy alone, an eclectic and
integral perspective has developed. IT has come into
being to address all the different factors of depression
T oday we have a couple of dozen cognitive thera-
pies, but in this paper we shall consider in depth
only Beck’s cognitive therapy (CT) (Beck, 1967),
and accommodate them in a comprehensive theory to while mentioning Ellis’s rational-emotive therapy
be used in the process of choosing a treatment. (Ellis & Dryden, 1987), covering the two most impor-
tant figures in cognitive therapy. Both Beck and Ellis
Prevention and Treatment consider the person as a biosocial organism and the
basic unit for analysis and therapeutic interventions.
U nfortunately, very little research in preventing the

onset of depression has been done, showing the
current widespread interest in treating rather than pre-
They believe in individual differences in biological
functioning, proposing that psychopathology is a
result of innate vulnerabilities or biological tendencies
venting (Munoz et al., 1996). One researcher found to either over- or under-react to environmental influ-
several measures that may prevent the onset of depres- ences. In their view, depression is seen as the result of
sion: prevention of childhood abuse and racism, relief predisposing factors, such as heredity and physical dis-
from economic hardships, early diagnosis, and safe, ease leading to neurochemical abnormalities, and of
effective treatment (Poslusny, 2000). precipitating factors, such as physical disease and
Treatment for MDD currently uses drugs, drugs in chronic or acute stress. Cognitive therapy emphasises
combination with psychotherapy, electroconvulsive psychological functioning as the main area of interest,

saying that human functioning is organised and regu- 5) If somebody disagrees with me, it means he or she
lated primarily by cognitive processes. Beck and Ellis doesn’t like me.
see healthy people as good scientists who gather 6) My value as a person depends on what others think
rational empirical data, formulate hypotheses, and test of me.
them. In contrast, malfunctioning people deviate from Depression is also seen as being caused by a depressive
these principles, are irrational, illogical, distorted, attributional style and learned helplessness (Seligman,
overgeneralised, and absolutistic, and display inade- 1975). Depressed people interpret success and positive
quate reality testing for their beliefs. events as due to external factors, while attributing fail-
Beck proposes that negative beliefs and dysfunc- ure and negative events to internal ones. Failing to take
tional, maladaptive processing of information are at credit for success and blaming themselves for failure
the origins of depression. The latter sets in when neg- and feeling guilty and worthless, they lower their self-
ative self-schemata are activated by current circum- esteem, thus maintaining their depression. Three
stances. Self-schemata are cognitive structures that can dimensions of causal attributions have been proposed:
be viewed as sets of rules, standard strategies that indi- internal-external, stable-unstable, and global-specific.
viduals use subconsciously to evaluate and control Depression is also seen as the result of making
their behaviours. Negative schemata are developed in internal, stable, and global attributions for negative
childhood due to repeated negative experiences of dep- events (Abramson et al., 1978). Learned helplessness
rivation, loss, or death of a loved one. Circumstances theory proposes that, due to earlier repeated experi-
analogous to those when the schema was created can ences involving bad events that one could do nothing
activate negative schemata, which are usually inactive. to prevent or escape, one learned that nothing can be
The activation of a negative schema causes dysfunc- done, and thus feels helpless, hopeless, and finally
tional, biased processing of information toward depressed (Seligman, 1975; Seligman & Isakowitz,
schema-consistent information and systematic cognitive 2000).
errors. Negative self-schemata manifest in conscious- The goal of cognitive therapy (CT) is to identify
ness as automatic thoughts, which can take the form of automatic thoughts and modify or restructure them in
the depressive cognitive triad: negative opinions about order to help the client to develop and use more func-
oneself, about the ongoing experience, and about the tional patterns of thought, emotion, and behaviour.
future. The therapist teaches clients to revise dysfunctional
Negative automatic thoughts result from processing schemata and faulty information-processing by reality
errors through which perceptions and interpretations testing of automatic thoughts, reattribution training,
are distorted. They include many errors in logic, such and changing depressogenic assumptions.
as overgeneralisation (making judgements based on a Reattribution training implies teaching the client to
single experience), selective abstraction (attending change the attribution for failure from internal, stable,
only negative aspects of the experience), dichotomous and global to external, unstable, and specific explana-
reasoning (thinking in extremes), personalisation (tak- tions (Ellis & Dryden, 1987).
ing personal responsibility for events), arbitrary infer- In CT, the therapist is seen as having much of a
ence (jumping to conclusions on the basis of inade- teacher role, teaching his or her client to identify, chal-
quate evidence), magnification (exaggerating personal lenge and test the automatic thoughts and depresso-
small faults), and minimisation (reducing the impor- genic assumptions. The therapist may use different
tance of personal successes). techniques, such as verbal challenging of the negative
In addition to errors in logic, depressed people also thoughts and dysfunctional assumptions, or assigning
make six depressogenic assumptions on which they behavioural experiments for a reality test of these
base their life: thoughts and beliefs. CT is a time-limited therapy,
1) In order to be happy, I must be successful in every- usually not extending beyond 20 sessions for treating
thing I do. MDD, and today there is a solid evidence for its effects
2) To be happy, I must be accepted by all people at all from a number of studies. Some 28 metaanalytic stud-
times. ies for unipolar depression showed CT to be better
3) If I make a mistake it means I am inept. than pharmacotherapy, behaviour therapy, and other
4) I can’t live without love. therapies, as well as the wait-list condition (Dobson,

1989). Research has shown differential relapse follow- Integral Psychology
ing CT and pharmacotherapy for depression, with the
greater relapse being after pharmacotherapy (Evans et
al., 1992). The problem of matching patients to cog-
nitive and interpersonal therapies in research programs
I ntegral Psychology (IP) is a vigorous attempt to
change the memetic perspective (Price 1999) of cur-
rent psychology by proposing a new meme of looking
has been an important factor for the outcome of the at psychopathology and treatment. Integral psycholo-
therapy (Barber & Muenz, 1996). gy has risen to unify many of the existing psychologi-
The CT field is in continuous expansion and one cal, biological, social, and environmental theories,
of the latest developments is the cognitive-interpersonal from both East and West, into a master theoretical
approach (Safran & Segal, 1990), which criticizes template that may serve as a sound basis for research
Beck’s view as too reliant on an informational process- and treatment in the new millennium.
ing model. Safran and Segal stress the need to study The IP theory has been created by Ken Wilber, an
people from an ecological perspective, pointing out American seen by some as the Einstein of conscious-
that cognitive structures develop in relation to other ness (Ingram, 1987), because of his integration of
people. They propose interpersonal schemata to be more than 100 psychological models, East and West
added to self-schemata for a thorough understanding (Wilber, 2000a). Wilber is the only psychologist who
of the person. Interpersonal schemata are cognitive has his collected works published while alive.
representations of interpersonal events created by the Currently he is leading his private Integral Institute
person out of the need of relatedness to significant with more than 300 respected scientists working
others in order to maintain these relationships. The together in a new, integral way of doing research.
interpersonal schemata have a functional utility and Integral Therapy (IT) is both a perspective for
include cognitive, affective, and interpersonal compo- looking at causes and treatments of mental problems
nents. Some authors regard this new development as and a particular therapy, which tries to address “all
an integration of CT with interpersonal therapy quadrants, all levels, all lines” (4 dimensions of the
(Norcross & Goldfried, 1992). Kosmos, 10 levels of development, and 30 lines of
There have been some criticisms about Beck’s development) of the person. Today we know too much
description of schemata, because its vagueness and from so many sciences to ignore all the factors that
imprecision make it inadequate for testing and verifi- may contribute to the MDD, and it is IT that has the
cation (Mahoney, 1995). Cognitive theory says little capacity of integrating all of them into a master tem-
about developmental issues and the impact of environ- plate. IT is not an eclectic approach either in theory or
ment on individual development. Now some efforts in practice, but is in its own right both a theory and a
have been made to address the role of affect and inter- therapy that integrates all existing therapies, following
personal relations in the negative self-schema (Safran a careful logic based on the perspective of treating the
& Greenberg, 1991). whole person, “all quadrants, all levels, all lines.” IP
A new development in CT is its combination with can be seen as an ecological psychology, which takes
mindfulness, namely the Mindfulness-based Cognitive into consideration the person-in-context, as its pri-
therapy, that is used mostly as a cost-efficient group mary unit of analysis. This approach contrasts with
preventive program for major depressive disorders cognitive therapy, which concentrates mostly on the
(MDD) (Teasdale, 1999). psychological side of the person, while considering the
Overall, CT is very effective in treating depression importance of biological and social factors.
(Blackburn et al., 1986) and it is one of the two evi-
dence-validated therapies recommended by the The Four Dimensions of the Individual
American Psychiatric Association (1993) for the treat-
ment of MDD.
T he human being is seen in Integral Therapy as a
bio-psycho-social system that has an individual
existence; and also is part of a collective existence. Any
individual has two dimensions: an interior and an
exterior existence, or better said, a subjective life open
to introspection and phenomenological research, and

an objective life open to scientific investigation. The rants as important in understanding and treating
collective also has two dimensions: an interior domain depression; interpersonal theory stretches out to cover
created by the intersubjective contact between individ- also the third quadrant, stressing the importance of
uals, and an exterior domain that consists of the inter- relations between people, while integral theory covers
objective relations between the material entities. all the four quadrants.
Wilber (1999) has named these four dimensions that
define any person the four dimensions or quadrants of The Notion of Self in Integral Therapy
the Kosmos. Kosmos contains the physical and the
spiritual dimension of the universe.
The Kosmos is made by holons, which are organ-
ised in hierarchies, so that higher holons enfold and
T he self concept is a key one in Integral Psychology,
where it is not seen as a monolithic entity but
rather as a collection of lesser selves, composed by var-
include the previous ones. All holons have a quasi- ious subpersonalities and different modules of devel-
independent life, living their own life while at the opment—cognitive, emotional, social, spiritual,
same time being an integrated part of a higher holon. moral, and so forth (Rowan 1993). A subpersonality
Finally, every holon has its own four quadrants that may develop when, following a childhood trauma, a
evolve together with it. A short description of the four part of the existing self has defensively split off, with
quadrants follows. which consciousness remains identified. The subper-
The Upper Left Quadrant is the individual’s inte- sonality endures over time and maintains all the char-
rior dimension, involving the psychic dimension, soul acteristics of the personality at the moment the split
and Spirit. The right investigation method here is a occurred, usually characterized by specific age needs,
phenomenology that may describe qualitatively the desires and impulses. The subpersonality does not
subjective experiences of the person. develop further and lives its own life, at a conscious,
The Upper Right Quadrant is the individual’s subconscious, or unconscious level of awareness.
exterior dimension, composed by the body with its The feeling of a unique self is given by the integra-
brain. The right investigation method here is the sci- tive function of the overall self who tries to unite all
entific method, which may describe quantitatively the the subpersonalities and different cognitive modules in
physical changes of the body and brain. Between these a cohesive entity.
two dimensions there is a close relationship, so that The self is seen to also have several other functions,
any change in one dimension produces an effect on the such as cognition, will, caring for others, justice in
other, for example any thought involves an accompa- relationships with others, aesthetic apprehension,
nying emotion and a specific brain wave. metabolism (metabolizing the experience to build
The Lower Left Quadrant is the collective interi- structures), integration (integrating the function,
or dimension; it is characterized by intersubjective needs, states, waves and streams of consciousness)
relations between people and nations, and is the pub- (Wilber, 2000b).
lic domain of culture. The self also evolves through identification with
The Lower Right Quadrant is the collective exter- higher levels of the Kosmos, following a Piagetian
nal dimension; it is characterized by interobjective stage–like development of a constant process of
relations between physical objects, and is the home of embedding in the proximal level and then disembed-
nature and the environment, with its political struc- ding, and transcending that level for further develop-
tures. ment.
Any modification in any of the four quadrants The development of self can be stopped by child-
gives a reaction in the other three, so the causes of hood trauma, such as depression produced by the loss
pathology and the treatment of depression must con- of a loved one in the early stages of development, the
sider all the quadrants equally. Any change in any of preconventional stages, which may create a split in the
the individual, collective, biological, psychological, self. This creates a subpersonality that is characterized
social, or environmental dimensions has a direct influ- by preconventional impulses and needs, impulsivity,
ence on the other parts of the system, setting the cop- narcissism, egocentricity, moral stage one, and an
ing skills of the person to trial. archaic worldview. While the subpersonality stops its
Cognitive theory considers only the first two quad- development and endures over time as a distinct entity,

the main part of the self continues to develop. This psychosexuality, self-integration, religious faith,
split in development between the subpersonality and affects/emotions, needs, worldviews, gender identity,
the main self creates tensions in the integrative func- and defense mechanisms. Some of the Lower Left
tion of the overall self, which may result in psy- Quadrant–oriented developmental lines or streams,
chopathology. such as socioemotional capacity, communicative com-
The psychopathology of the self is then this inter- petence, interpersonal capacity, role taking, and empa-
nal conflict between the main part of the self-system thy, if they have an arrested development, may be
and the subpersonalities, which are at different levels responsible for vulnerability to depression. These
of development (each with its own needs, wishes, modules or streams tend to develop in a relatively
worldviews, morals, and so forth). The goal of therapy independent fashion and each needs a careful develop-
of the self-system is to end these internal conflicts and ment if the self is to function to its fullest capacity and
achieve a horizontal as well as vertical integration of to avoid the onset of depression.
the various self structures. IT acknowledges the exis- Different societies have emphasised different devel-
tence of defenses of the self, and for therapy it is opmental lines, and we may find a huge variation even
important to identify the level of defenses, so that if within the same society, so that we may not yet have a
these are not adequate for the present level of develop- clear consensus about which are the most important
ment, they may be changed, allowing the self to release and desirable lines of development. Howard Gardner
the internal tensions caused by the incompatibility of (1985) has demonstrated the existence of multiple
the level of defenses with the level of self-development intelligences, which has ended the monopoly of the IQ
(Wilber 2000a). as the only measure of human intelligence. For exam-
ple, a person may have a high IQ, but be underdevel-
Developmental Lines or oped emotionally, morally, spiritually, and interper-
Streams of the Self sonally.
None of these developmental streams can finally be
separated from the others, but each tends to be orient-
P sychological development is seen in IP as a parallel
development of several lines, which may develop
independently but nevertheless are held together by
ed toward a particular quadrant. Cognitive therapy is
concentrated mostly on the cognitive modules from
the integrative function of the self. Because of the the Upper Left and Upper Right Quadrant, giving lit-
quasi-independent characteristics of the developmen- tle importance to the affective, social relationship, and
tal streams, disjunctions and tensions occur, causing communication modules.
possible psychopathology. Wilber (2000d) identified
around 30 lines of human development, the most Developmental Levels or
important being sense-identity, defense mechanisms, Waves of the Self
interpersonal development, affects/emotions, needs,
morals, and worldviews.
Developmental lines included in the Upper Left
Quadrant (subjective components) are self-identity,
I ntegral Psychology is a whole-spectrum psychology,
which unites Freud’s depth psychology of the
unconscious with the height psychology of the super-
affects/emotions, needs (Maslow’s hierarchy of needs), conscious of Eastern psychologies (Wilber, 1977). It
and the like; those in the Lower Left Quadrant (inter- covers ten levels of development, from the most basic
subjective components) are worldviews, linguistics, material level to the highest spiritual level. Human
aesthetics; those of the Upper Right Quadrant (objec- development is seen as a rising of consciousness from
tive components) are exterior cognition and scientific the unconscious to conscious and further to the super-
cognition; and those of the Lower Right Quadrant conscious (Alexander & Langer, 1990). This develop-
(inter-objective components) are sociopolitical and ment may also be called the development of the self,
environmental structures. whose gravity centre rises its through ten fulcrums of
The most important lines or streams responsible development, trying to balance the different lines or
for vulnerability to depression may be the undevel- streams of development in each level or wave. Wilber
oped or arrested lines of development in the Upper follows the Piagetian scheme of cognitive develop-
Left Quadrant, such as cognition, morals, self-identity, ment, but identifies higher levels, such as post and

post-post formal levels of development, calling them moral stage 1, and animistic worldview, to the socio-
“second and third tier” (Wilber, 2000c). Self-development centric level, when it identifies with its family needs,
is seen more like a spiral than as neat levels on a lad- moral stages 2 to 3, and mythic worldview. Then the
der, but nevertheless, in order to move to one develop- self develops to the world-centric level, when it identi-
mental wave, the preceding level must have been con- fies with needs of the whole world, is at moral stages 4
quered. Wilber emphasises that no wave can be to 5, and holds a pluralistic postconventional world-
skipped in favour of a higher one, and every wave has view. Further, development can still proceed to the
an equal importance for the overall spiral. The main transpersonal level, when the ego is transcended and
point is that each wave is equally important and any what remains is a total identification with the Kosmos,
jump is dangerous and ultimately impossible, so that a post-post conventional worldview, or One Taste, and
the mission of the therapist is not to help people to a moral stage defined by Jesus by His commandment:
move to higher waves, but to help clients to accommo- “Love your neighbour like yourself!.” Table 1 shows a
date and integrate the waves where they are in the pres- graphical representation of all the levels of develop-
ent moment. ment correlated with memes, worldviews, psy-
The sense of self (“ego”) develops from the egocen- chopathologies and treatments (Wilber, 2000a).
tric level, when it is dominated by its narcissistic needs, Why is it important to know the levels of develop-
Table 1. Structures, levels, memes, worldviews, pathologies and therapies according to Wilber

ment of the client for the treatment of depression? It is so understanding the developmental nature of human
because IT assigns the adequate therapy for depression consciousness (e.g., its structures, waves, streams,
based on the persons’ current level of overall develop- dynamics) is indispensable to both diagnosis and treat-
ment, which may facilitate and accelerate the healing ment (Wilber et al., 1986). Wilber identifies a self-
process (Wilber, 2000a; Wilber et al., 1986). pathology originating in the personality organisation
Cognitive therapy is not concerned with the levels of and ego functioning, which may produce structural
development of the client, although it works faster deficits in the function of the whole self, object repre-
with clients who are verbally developed (Wachtel & sentations, and lack of a cohesive, integrated sense of
Messer, 1998). self (Wilber, 2000a).
Here are some examples of etiology as may appear
Causes of Depression in IT in the different quadrants. In the Upper Left
Quadrant, the etiology of MDD can be any failure in
T he person is seen in IT as a holon integrated into

higher holons, each characterised in a quadruple
perspective forming the four aspects or quadrants of
the capacity of differentiation and integration of the
self at each stage of development; in the Upper Right
Quadrant, it can be any imbalance of brain physiology,
the Kosmos. A person is seen as a physical entity with neurotransmitter imbalance, or poor diet; in the
a material brain in the Upper Right Quadrant, while Lower Left Quadrant, it can be any cultural patholo-
the person’s thoughts or psychological existence are gies, communication snarls, or double-meaning com-
seen in the Upper Left Quadrant, and interpersonal munication; and in the Lower Right Quadrant, it can
relations and their part in a social culture are seen in be any economic stress, environmental toxins, or social
the Lower Right Quadrant. All four quadrants define oppression that may put pressure on the person’s cop-
a person and his or her place in the Kosmos, and every ing mechanisms causing them to break down. The eti-
dimension of the Kosmos directly influences the per- ology of MDD from the Upper Left (self pathology
son, who must constantly adapt to its internal and factors) and the Upper Right Quadrant (brain pathol-
external changes. From this quadruple perspective, the ogy factors) must be integrated with the Lower Left
individual’s psychopathology is an all-quadrant affair, (cultural pathology factors) and the Lower Right
and respectively, recovery is also an all-quadrant Quadrant (social pathology factors), in order to have a
endeavor. In order to find out the causes of MDD, IT complete understanding of the causes of MDD.
proposes that all four dimensions of the person must We have now several studies that identify the caus-
be searched for etiology, first independently and then es of MDD in the Lower Left and Lower Right
together for a search for possible multiple causes. For Quadrant, such as levels of social support (La-Roche,
example, in the Upper Left Quadrant the etiology of 1999; Lin & Lai, 1999); adverse living environment
MDD may originate from the psychopathology of the (Cheung et al., 1998; Lizardi et al., 1995); environ-
self. The self is seen to develop through a series of mental stressors (Lin & Lai, 1995; Lin et al., 1999;
stages or waves, so any arrest or failure at a particular stage Pahkala et al,. 1991; Richter, 1995); poor social skills
would manifest as a particular type of psycho-pathology, (Gable & Shean, 2000); poor interpersonal relation-
ranging from psychoses, borderline disorders, and per- ships (Zlotnick et al., 2000); communication prob-
sonality disorders, to existential, psychic, subtle, and lems (Segrin, 1997); distressing interpersonal context
causal pathology. The type of psychopathology (Whifen & Aube, 1999); and other social factors
depends upon both the level of consciousness in the (Stroebe, 1997). We identified only some studies
fulcrum where it occurs and the phase within the ful- pointing to a combination of factors from two quad-
crum when the miscarriage occurs. Each fulcrum has rants, Upper Right + Lower Right, that is, genetic lia-
three basic subphases, namely: fusion, transcendence, bility to stressful environment (Kendler, 1998;
and integration. These give us a typology of 27 major Kendler et al., 1997), and only one study emphasising
self-pathologies, which range from psychotic through multiple causes from three quadrants, Upper Left +
borderline, neurotic, and existential, to transpersonal, Lower Left + Lower Right, namely, negative thinking
with depression being possible at any level, but of a patterns, social relationships, and social stresses (Barry
different kind, and requiring different treatment. et al., 2000).
MDD can appear at any wave of self-development, Cognitive therapy is mostly concerned with the

self-pathology from the first five fulcrums, in the personal, affective/emotional, spiritual) and
Upper Left Quadrant, while other factors from other levels/waves of development using individual tests.
quadrants are overlooked. From this point of view CT The test results may be shown on an Integral
is reductionistic in its etiological views, and only later Psychograph as the psychological profile of the client
new changes have occurred to include also factors from (Wilber, 2000a; 2000c). The Integral Psychograph
the Lower Left Quadrant, that is, interpersonal and shows levels of each developmental line, vertical and
affective factors. horizontal type of self development (ego development)
Integral Therapy is also concerned with higher (Descamps et al., 1990), level of basic pathology, pre-
developmental fulcrums, the transpersonal levels con- dominant needs (motivations), moral stage, spiritual
sisting in soul and Spirit. MDD can be caused by development, level of object relations, and so forth.
transpersonal causes, and it is important to mention This profile can be interpreted to prevent and discov-
here the Kundalini phenomena (Shannella, 1992; er psychopathology.
Greenwell, 1990; White, 1990; Krishna, 1989, 1993; In order to find the best therapy for MDD, the
Yang, 1992; Satyananda, 1993), the Dark Night of the integral therapist needs to identify its possible causes
Soul (St. John of the Cross, 1988; Tweedie, 1993; from each of the four quadrants using a battery of psy-
Roberts, 1993; Segal, 1996), and spiritual emergencies chological tests: Psychological Map, Form A, The
(Grof & Grof, 1990; Bragdon, 1990, 1993),which are Values Test (the first two tests have been developed by
the most common causes of psychopathology in the Spiral Dynamics), Dimensions of Self Concept,
higher fulcrums. Kundalini awakenings can cause Defense Mechanisms Inventory [Revised], Bessell
MDD and the integral therapist must consider this Measurement of Emotional Maturity Scales, Social
possibility. Adjustment Scale, Social-Emotional Dimension Scale,
Quality of Life Questionnaire, and Kundalini
Treatment of Depression in IT Experiences Inventory. Based on the Integral
Psychograph an IT should be suggested.
IT is not a particular psychotherapy in itself, but

rather a therapeutic approach, which makes use
of the existing therapies on the market in an integrated
Cognitive therapy rarely makes use of tests and
gives a standard treatment for any type of client, while
IT acknowledges the uniqueness of the individual
way, in order to cover all four domains that define a clients and their complexity and diversity, calling for a
client. Treatment of MDD in IT implies treating each tailor-made treatment for each individual. This char-
client as a unique individual, with a specific develop- acteristic also makes the randomisation of treatment,
mental history and particular bio-psycho-social com- as practised in other therapies, inappropriate. IT pro-
petencies. Even if the cause of MDD is the same in poses a detailed identification of the causes of MDD,
two individuals, the treatment of MD in each of them and based on this first assessment, there may be given
may be different, based on the personal developmental one or a combination of therapies for treating MDD,
history and the competencies in the four quadrants covering “all quadrants, all levels, all lines.” The quality
that have been assessed in the Integral Psychograph of IT is that it can integrate apparently different psy-
(Wilber, 2000c). Treatment can ideally be seen as an chotherapies, seen as complementary rather than
all-four-quadrants endeavour—“all quadrants, all lev- mutually exclusive.
els, all lines”—just as psychopathology can be seen as For interventions in the Upper Left Quadrant, the
caused by all four quadrants. integral therapist can choose from a number of self-
Prevention of depression is one of the main con- psychotherapies, such as psychodynamic, cognitive,
cerns of IT, and studies have shown that this effort humanistic, or transpersonal. In the Upper Right
must be both personal, by engaging in an integral Quadrant, he or she can choose between various drugs,
transformative practice (ITP), and political, in order to CTS, ECT, vagus nerve stimulation, or acupuncture
prevent rather than cure depression (Dadds, 2001). (Allen et al., 1998). In the Lower Left Quadrant, the
IT makes use of clinical interview, using the therapist may choose different therapies, such as trans-
ICD-10/DSM-IV-TR, in assessing the MDD togeth- actional analysis (Berne, 1975), relational therapy
er with a specific assessment of some of the major (Magnavita, 2000), and volunteer community work
lines/streams of development (cognitive, moral, inter- therapy. In the Lower Right Quadrant, he or she can

assess the socioeconomic and environmental factors Quadrant, a double combination of IPT with pharma-
that may be a pathogenic source. The remedies here cotherapy (Klerman & Weissman, 1993; Weissman et
may be political, economic, and environmental sup- al., 2000; Frank et. al., 2000; Reynolds et al., 1992,
port, education, and skills training (Nezu et al., 2000). 1999) may be given. Unfortunately we don’t have
For multiple-etiology MDD, a more complete IT today any research on a treatment for MD that covers
may be given, working on several quadrants either three or four quadrants together—maybe with a few
sequentially or in parallel. For a double-cause MDD, exceptions (Pinsof, 1995; Lazarus, 1995).
say intrapsychical and interpsychical problems, Upper The main point of IT is that it is an “all-quadrant,
Left Quadrant + Lower Left Quadrant, CT may be all-level, all-lines” therapy, engaging the intentional
given for correcting negative thoughts, or helplessness, (Upper Left), behavioural (Upper Right), cultural
and afterwards or in parallel one may also give IPT for (Lower Left) and social (Lower Right) in all relevant
correcting interpersonal relationship skills. For a dimensions. The weakness of cognitive therapy as well
triple-cause MDD, say intrapsychical, interpsychical as other therapies is that they don’t recognise that the
and interobjective problems (economic problems), various levels of interior consciousness have correlates
Upper Left + Lower Left + Lower Right Quadrant, one in the other quadrants. Wilber says, “Human beings
may prescribe CT, IPT, and a social skill training. have different levels: body, mind, soul and spirit, and
IT for MDD is concerned with a quick reduction each of these levels has four aspects: intentional,
of symptoms and recovery without relapse. In order to behavioural, cultural and social.”
prevent relapse, a maintenance therapy may be given, So far we have discussed treatment of MDD at the
either individually or in group. The integral therapist first five fulcrums, but there are also higher levels of
may give the client an integral transformative practice consciousness development, and now we shall intro-
(ITP) that is expected to be carried out for the whole duce therapies that are concerned with these higher
life, as a means of preventing the recurrence, enhancing fulcrums. These are the transpersonal therapies, and
the quality of life, and raising the level of conscious- address the levels of soul and Spirit. IT acknowledges
ness for the benefit of the individual as well as society. all transpersonal therapies, adding the “all-quadrants,
Today a few studies on MDD treatment acknowl- all-levels, all-streams” healing perspective that may be
edge the efficacy of addressing multiple quadrants in pursued by the transpersonal therapist. Until the pub-
combination: Upper Left (psychotherapy) + Upper lication of Wilber’s book “Sex, Ecology and
Right Quadrant (pharmacotherapy) is more efficient Spirituality,” transpersonal therapists were not consid-
than one form alone (Nierenberg, 2001; Beitan & ering the integral perspective, being mostly concerned
Klerman, 1991; Thase et al., 1997). The decision to with only one or two quadrants. The four quadrants
use combined medication and psychotherapy in the are present until the last fulcrum, when the Kosmos
treatment of MDD (Petit et al., 2001) must be based becomes “One Taste” and division loses all meaning,
on severity of symptoms, quality of depression, dura- but until the last fulcrum it is important to practice
tion of disability, and response to previous treatments, transpersonal therapy from an integral perspective.
and not on ideological views favoring one treatment Today, there are very few evaluated transpersonal ther-
over the other. Some researchers have found that med- apies, so there must be caution in recommending and
ication does not interfere with the patient’s capacity to using such approaches. Many Western transpersonal
participate in psychotherapy, and because of the reduc- theorists have proposed different therapies for differ-
tion of the symptoms, the patient’s capacity to make ent fulcrums, based on their private experience with
use of social learning is increased (Klerman & clients, but there is no agreement among them, and
Weissman, 1993). their proposals are of an exploratory nature (Boorstein,
Based on existing research, IT may propose, for the 1991, 1997; Scotton et al., 1996; Rowan, 1993;
treatment of MDD caused by factors from the Upper Boggio Gilot, 1995, 1996; Weil, 1988; Wilber et al.,
Left + Upper Right Quadrant a double intervention, a 1987; Descamps et al., 1990; Leloup & de Smedt,
combination of CT with pharmacotherapy (Rush & 1986; Claxton, 1996).
Hollon, 1991; Blackburn et al., 1986; Kupfer & Therapies that can successfully address a sixth ful-
Frank, 2001; Savard et al., 1998). crum MDD may be mentioned: Jungian therapy
For an etiology of the Upper Right + Lower Left (Jung, 1957; Singer, 1995), psychosynthesis (Assagioli,

1993; Ferrucci, 1995), Gestalt therapy (Perls, 1994), zen meditation for several years, but suffers life-
and logotherapy (Frankl, 1985; Fabry, 1981). goal apathy and depression, deadening of affect,
The traditional transpersonal therapies that can postconventional morality, postformal cognition,
successfully address MDD generated by a transpersonal self-transcendence needs, and psychic self-sense,
cause at the seventh fulcrum are mainly from the East might be given: uncovering therapy, combination
and include Kundalini yoga (Swami Satyananda, weight training and jogging, tantric deity yoga
1993a, 1993b; Swami Sivananda, 1985), Yoga (Swami (visualization meditation), tonglen (compassion
Rama, Ballentine & Swami Ajaya, 1993), and Chi training), and community service. (Wilber, 1998, p. 252).
Kung (Chia & Chia, 1993; Yang, 1992; Lu, 1991). Finally, IT is an “all-quadrant, all-levels, all-lines” ther-
The few Western transpersonal therapies that address apy, which addresses equally the intrapsychic (Upper
this level are: Hara therapy (Dürckheim, 1988), bio- Left Quadrant), behavioural (Upper Right), cultural
genetics (Katchmer, 1993), neo-Reichian therapy (Lower Left) and social (Lower Right) in all their
(Reich, 1993) and the holotropic breathwork of dimensions.
Stanislav Grof (Grof, 1985; Grof & Bennett, 1993).
The eighth-fulcrum therapies that can address an Discussion
eighth-fulcrum MDD are mostly found in the tradi-
tional mystical traditions of both East and West, such
as Christianity (St. Nikodimos & St. Makarios, 1981;
St. Teresa of Avila, 1988), Theravada Buddhism
T he most comprehensive view for studying humans
is from an “all-quadrant, all-level, all-lines” per-
spective. The multiple factors of the etiology of depres-
(Buddhaghosa, 1975; Narada, 1975; Surangama sion are better integrated by integral theory than cog-
Sutra, 1978), and Tibetan Buddhism (Cozort, 1986). nitive theory, or any other theory for that matter. CT
The last fulcrum that may cause MDD is the has searched for MDD etiology only in the Upper
ninth, which is the domain of Spirit and causal reality. Left, and lately also in the Lower Left, while IT has
At this level there are few traditional therapies: taken into account all quadrants, and all the interac-
Mahamudra (Namgyal, 1986), Dzogchen (Clemente, tions between them. IT proposes that the causes for
1996), Advaita Vedanta (Godman, 1985), and Zen MDD can be multiple and their accumulative effect
(Buswell, 1992; Kapleau, 1989; Hirai, 1989). account for the intensity of the symptoms. There are
Recently, a new generation of enlightened Westerners today some efforts toward psychotherapy integration
has arisen who may have something of value to offer (Glass et al., 1998), but though valuable, this is still far
(Tolle, 1999; Kornfield, 1993; Segal, 1996; Packer, from a comprehensive research on “all quadrants, all
1999; Ardaugh, 1999; Parsons, 2000; Lumiere & levels, all lines.” The answer to the first question of this
Lumiere-Wins, 2000; Parker, 2000). Reaching the end study is clear: integral theory is more accommodating
of human development, the fear of death or annihila- for the etiology of MDD than cognitive theory.
tion may give rise to MDD, and here some bibliother- Integral Therapy can be more efficient in the treat-
apy may ease the anguish (Sogyal Rimpoche, 1992; Da ment of depression than other therapies, if the synergy
Avabhasa, 1991; Blackman, 1997). ensured from the combination of multiple therapies
Finally, there are yet untested integral approaches makes a difference, but today we have no studies to
to treat MDD from this perspective, but the best we support this. Further, the public seems not to be real-
can offer is Ken Wilber’s recommendations for treat- ly open to a combination of treatments (e.g., combin-
ment in a case with existential depression and in one ing psychotherapy and pharmacotherapy), and the
with a life-goal apathy and depression: first choice is psychotherapy alone (Hall & Robertson,
A client with existential depression, postconven- 1998). CT has a very good record of efficiency and as
tional morality, suppression and sublimation a single therapy it may be the therapy of choice even
defence mechanisms, self-actualization needs and a from an integral perspective. The answer to our second
centauric self-sense, might be given: existential question is that CT is better than IT in treating
analysis, dream therapy, a team sport (e.g., volley- episodes of MDD, but has no clear advantages for pre-
ball, basketball), bibliotherapy, t’ai chi chuan (or venting recurrence.
prana circulating therapy), community service and Finding empirical support for IT is difficult today,
kundalini yoga....A client who has been practicing because the existing meme in psychological research

on MDD tends to acknowledge only one, two, or sky, feelings floating by in the body, thoughts float-
three quadrants, mostly independently rather than ing by in the mind. There is a consciousness that is
together. Further, today’s research effort on MDD is already noticing all that, and is spontaneously and
much dictated by funding provided by the drug com- effortlessly present. All of those things—clouds,
panies which are mainly interested in research on the feelings, thoughts—all drift by in your own vast
Upper Right Quadrant, so as to sell more drugs and consciousness, right here, right now. But what
make more profit. This is a serious problem, and IT about that consciousness itself? what color is that?
research using a quadruple perspective may prove too where is it located? where is your mind right now?
expensive and wide to be funded; this may change if does it have a shape or size or color? In fact, your
we make the case for IT well known. own consciousness right now is without shape or
The weakness of IT is that it is highly specialised, form, but it beholds all the shapes and forms float-
that it requires therapists qualified in more than one ing by. Your own consciousness right now is without
therapy, as well as higher levels of personal develop- color, yet it beholds all the glorious colors passing
ment, at the second tier and beyond. The assessment by. It is without taste, yet can taste all the flavors
process in IT may take too long but the costs may that arise moment to moment. Your own conscious-
prove little in the long run, both for the individual and ness, in other words, is without taste or color or
society. The Integral Transformative Practice that may shape or form. Your own consciousness—right now
be given to a client in order to prevent future MDD at this very moment, and just as it already is—is in
episodes may prove difficult, needing to cover 31 fact the great formless Unborn. Even your own
streams of consciousness at 17 levels in 4 quadrants, body and feelings and thoughts and mind arise in
hence 2108 consciousness variables to develop (de the vast openness of your own ever-present aware-
Quincey, 2000). IT has already got critics who com- ness, and that present awareness is none other than
plain about Wilber’s limited description of Upper Spirit itself. In short, you are aware of yourself exist-
Right (Combs, 2001) or Lower Left Quadrant ing now. That of which you are aware is your indi-
(de Quincey, 2000), but even critics acknowledge the vidual self; that which is aware of your individual
importance of IT in opening a new perspective in self, right now, is God.
treatment. Anecdotal criticism has been raised on the And you, as pure witness, are that God, that
length of training: if an integral therapist should qual- Goddess. You, as pure witness, are the Divine itself,
ify as a Ph.D. in each of the four quadrants, education right here and right now; whereas you, as an object
would take some 7x4=28 years! Clearly, IT needs highly of that Self, are the mortal, finite, limited thing you
qualified therapists who are familiar with both phe- are used to calling yourself (“dinu” or “tom” or
nomenological approaches and quantitative research “ken” or “amy”). It is not impossible, or even hard,
methods. But the most important qualification must to rest as the great empty Witness, the great
be Spiritual Awakening, if the integral therapist is to Unborn, and simultaneously exercise any object
counsel clients on transpersonal levels. Enlightenment that arises in this great open awareness—such as
must come first in any IT curriculum, and only then your body, your ego, your psyche, or anything else
can the development of the streams and waves be that arises.
engaged in a gradual manner, from an awakened per- The integral view, then, embraces both absolute
spective on the Kosmos, following the recommenda- (Unborn and empty Consciousness) and relative
tions of Zen Master Chinul (Buswell, 1992). Once, (any and all Forms that arise in that vast infinite
the author of this paper asked Ken Wilber (2000e) space that you are). May this infinite great Unborn,
how can the self be developed after enlightenment. It which you always already are, tacitly announce itself
is believed that after enlightenment there is nobody to you when you aren’t looking, and slowly begin to
left to identify with the body, and no self to do any reorganize your entire being along lines that can
integral practice. Here is Wilber’s answer: never be whispered. (Wilber, 2000e)
How to function with the Unborn is indeed the We need a new therapy for the new millennium, and
question. Yet how simple that ultimately is, for the IT may prove to be the quantum leap therapy,
notice: Right now, you are spontaneously and helping the field to make the shift, from the present-
effortlessly aware of the clouds floating by in the day meme (Wilber, 2002) to the second tier.

References Beitman, B. D., & Klerman, G. L. (1991). Integrating
pharmacotherapy and psychotherapy. Washington:
Abramson, L., Seligman, M., & Teasdale J. (1978). American Psychiatric Press.
Learned helplessness in humans: Critique and refor- Berne, E. (1975). Transactional analysis in psychotherapy.
mulation. Journal of Abnormal Psychology, 87, 49–74. New York: Ballantine Books.
Alexander, C., & Langer, E. (Eds). (1990). Higher stages Blackburn, M., Eunson, K. M., & Bishop, S. (1986). A
of human development: Perspectives on adult growth. two-year naturalistic follow-up of depressed patients
New York: Oxford University Press. treated with cognitive therapy, pharmacotherapy and
Allen, J. J. B., Schnyder, R. N., & Hitt S.K. (1998). The a combination of both. Journal of Affective Disorders,
efficacy of acupuncture in the treatment of major 10, 67–75.
depression in women. Psychological Science 9(5), Blackman, S. (1997). Graceful exits: How great beings die.
397–401. New York: Weatherhill.
Alloy, B., Abramson, L., Metalsky, G., & Hartledge, S. Blatt, S. J., Zuroff, D. C., Bondi, C. M., & Sanislow, III
(1988). The hopelessness theory of depression: The C.A. (2000). Short- and long-term effects of medica-
role of goals and the self–evaluation process. tion and psychotherapy in the brief treatment of
Cognitive Therapy and Research, 11, 665–680. depression: Further analyses of data from the NMH
American Psychiatric Association, (1993). Practice guide- TDCRP. Psychotherapy Research, 10(2), 215–234.
lines for major depressive disorders in adults. Boggio Gilot, L. (1995). Principi di psicologia transper-
American Journal of Psychiatry, 150 (suppl.4), 1–26. sonale: Le frontiere del potenziale umano oltre l’io e la
American Psychiatric Association. (2000). Diagnostic normalità. Roma: Associazione Italiana di Psicologia
and statistical manual (4th ed.), text revision. Transpersonale.
Washington. Boggio Gilot, L. (1996). Il cammino della coscienza oltre
Ardagh, A. N. (1999). Relaxing into clear seeing: l’io: Principi e metodi di psicologia transpersonale.
Interactive tools in the service of self-awakening. Nevada Assisi: Cittadella Editrice.
City, CA: Self Press. Bohart, A. C., O’Hara, M., & Leitner, L. M. (1998).
Arkowitz, H. (1992). Common factors therapy for Empirically violated treatments: Disenfranchisement
depression. In J.C. Norcross & M.R. Goldfried of humanistic and other psychotherapies.
(Eds.), Handbook of psychotherapy integration (pp. Psychotherapy Research, 8, 141–157.
402–433). New York: Basic Books. Boorstein, S. (Ed.). (1991). Transpersonal psychotherapy.
Arieti, S., & Bemporad, J. (1980). The psychological Stanford: JTP Books.
organisation of depression. American Journal of Boorstein, S. (1997). Clinical studies in transpersonal psy-
Psychology, 137, 1360–1365. chotherapy. New York: SUNY Press.
Assagioli, R. (1993). Psychosynthesis: A manual of princi- Bowlby, J. (1977). The making and breaking of affectional
ples and techniques. Glasgow: Harper Collins. bonds: Aetiology and psychopathology in the light of
Barber, J. P., & Muenz, L. R. (1996). The role of avoid- attachment theory. British Journal of Psychiatry, 130,
ance and obssesiveness in matching patients to cogni- 201–210.
tive and interpersonal psychotherapy: Empirical find- Bowlby J. (2000). Loss: Sadness and depression. New York:
ings from the treatment for depression collaborative Basic Books.
research program. Journal of Consulting and Clinical Boutros N.N., Miano A.P., Hoffman R.E., & Berman
Psychology, 64, 951–958. R.M. (2001). EEG monitoring in depressed patients
Barry, M. M., Doherty, A., Hope, A., Sixsmith, J., & undergoing repetitive transcranial magnetic stimula-
Kelleher, C. C. (2000). A community needs assess- tion. Journal of Neuropsychiatry and Clinical
ment for rural mental health promotion. Health Neurosciences 13(2): 197–205.
Education Research 15(3), 293–304. Bragdon, E. (1990). The call of spiritual emergency: From
Barondes, S. H. (1999). Mood genes: Hunting for origins personal crisis to personal transformation. San
of mania and depression. New York: Oxford University Press. Francisco: Harper & Row.
Beck, A. T. (1967). Depression: Clinical, experimental and Bragdon, E. (1993). Helping people with spiritual prob-
theoretical aspects. New York: Harper & Row. lems. California: Lightening Up Press.
Beck, A. T., Bush, A. J., Shaw, H. F., & Emery, G. Brown, G. W., & Harris, T. (1979). Social origins of
(1979). Cognitive therapy for depression: A treatment depression: A study of psychiatric disorders in women.
manual. New York: Guilford Press. New York: Macmillan.

Buddhaghosa, B. (1975). The path of purification: DeRubeis, R. J., Gelfand, L. A., Tang, T. Z., & Simons,
Visuddhimarga. Kandy, Sri Lanka: Buddhist A. D. (1999). Medications versus cognitive behavior
Publication Society. therapy for severely depressed outpatients: Mega-
Buswell, R.E., Jr. (1992). Tracing back the Radiance: analysis of four randomised comparisons. American
Chinul’s Korean way of Zen. Honolulu: University of Journal of Psychiatry, 156, 1007–1013.
Hawaii Press. Descamps, M. A., Cazenare, M., & Filliozat, A. M.
Chambless, D. L., Baker, M. J., Baucom, D. H., Beutler, (1990). Les psychothérapies transpersonnelles. Lavour,
L. E., Calhoun, K. S., Crits-Christoph, P., Daiuto, A., France: Editions Trimégiste.
DeRubeis, R., Detweiler, J., Haaga, D.A.F., Bennett Dobson, K. S. (1989). A meta-analysis of the efficacy of
Johnson, S., McCurry, S., Mueser, K.T., Pope, K. S., cognitive therapy for depression. Journal of
Sanderson, W.C., Shoham, V., Stickle, T., Williams, Consulting and Clinical Psychology, 57, 414–419.
D. A., & Woody, S.R. (1998). Update on empirically Dürckheim, K. G. (1988). Hara: The vital centre in man.
validated therapies, II. Clinical Psychologist, 51, 3–16. London: Mandala.
Chan, D. W. (1995). Depressive symptoms and coping Eisemann, M., & Vrasti, R. (1995). Modelele vulnerabil-
strategies among Chinese adolescents in Hong Kong. itatii in psihopathologie. In R. Vrasti & M. Eisemann
Journal of Youth and Adolescence, 24(3), 267–279. (Eds), Depresii—noi perspective (pp.1–7). Bucuresti:
Cheung, C. K., Leung, K. K., Chan, W. T., & Ma, K. Editura All.
(1998). Depression, loneliness and health in an Elkin, I., Shea, T., Watkins, J. T., Imber, S. D., Sotsky, S.
adverse living environment: A study of bedspace resi- M., Collins, J. F., Glass, D. R., Pilkonis, P. A., Leber,
dents in Hong Kong. Social Behaviour and Personality, W. R., Docherty, J. P., Fiester, S. J., & Parloff, M. B.
26(2), 151–170. (1989). NIMH Treatment of Depression Collaborative
Chia, M., & Chia, M. (1993). Awaken healing light of the Research Program: General effectiveness of treatments.
Tao. Huntington, New York: Healing Tao Books. Archives of General Psychiatry, 46, 971–982.
Clark, D. A., Beck, A. T., & Alford, B.A. (1999). Ellis, A., & Dryden, W. (1987). The practice of rational
Scientific foundations of cognitive theory and therapy of emotive therapy. New York: Springer.
depression. New York: Wiley. Evans, M. D., Hollon, S. D., DeRubeis, R. J., Piasecki,
Claxton, G. (Ed). (1996). Beyond therapy: The impact of J. M., Grove, W. M., Garvey, M.J., & Tuason, V. B.
eastern religions on psychological theory and practice. (1992). Differential relapse following cognitive therapy
Woollahra, Australia: Unity Press. and pharmacotherapy for depression. Archives of
Clemente, A., (Ed). (1996). Dzogchen: The self-perfected General Psychiatry, 49, 802–808.
state—Chögyal Namkhai Norbu. Ithaca, NY: Snow Fabry, J. B. (1981). The will to meaning: Foundations and
Lion Publications. applications of Logotherapy. New York: New American
Combs, A. (2001). All-levels, all quadrants: A review of Library.
Ken Wilber’s “A theory of everything.” Journal of Fenner, P., & Fenner, P. (2001). Essential wisdom teach-
Consciousness Studies, 8(11), 74–82. ings. York Beach, Maine: Nicolas-Hays, Inc.
Cozort, D. (1986). Highest yoga tantra: An introduction to Ferrucci, P. (1995). What we may be: The vision and tech-
the esoteric Buddhism of Tibet. Ithaca, NY: Snow Lion niques of psychosynthesis. London: Thorsons.
Publications. Frankl, V. (1985). Man’s search for meaning. New York:
Culbertson, F. M. (1997). Depression and gender: An Washington Square Press.
international review. American Psychologist, 52, Freud, S. (1959). Mourning and melancholia. In J.
25–31. Strachey (Ed. & Trans.), The standard edition of the
Da Avabhasa (1991). Easy death: Spiritual discourses and complete psychological works of Sigmund Freud (Vol.14,
essays on the inherent and ultimate transcendence of pp. 237–260). London: Hogarth Press. (Original
death and everything else. Clearlake, CA: The Dawn work published 1914).
Horse Press. Frank, E., Grochocinski, V. J., Spanier, C. A., Buysse, D.
Dadds, M. R. (2001). Fads, politics and research: J., Cherry, C. R., Houck, P. R., Stapf, D. M., &
Keeping prevention on the mental health agenda. Kupfer, D. J. (2000). Interpersonal psychotherapy
Prevention and Treatment, 4. and antidepressant medication: Evaluation of a
DeLongis, A. (2000). Coping skills. In G. Fink (Ed.), sequential treatment strategy in women with recur-
Encyclopedia of stress. San Diego: Academic Press. rent major depression. Journal of Clinical Psychiatry,
61(1), 51–57.

Gable, S. L., & Shean, G. D. (2000). Perceived social Jung, C. G. (1957). Psychiatric studies. In Collected
competence and depression. Journal of Social and works, Vol. 1. Princeton: Princeton University Press.
Personal Relationships, 17(1), 139–150. Kapleau Roshi, P. (1989). The three pillars of Zen. New
Garfield, S. L. (1996). Some problems associated with York: Anchor Books.
”validated” forms of psychotherapy. Clinical Katchmer, G. A. (1993). The Tao of bioenergetics: East
Psychology: Science and Practice, 3, 218–229. and West. Jamaica Plain, MA: YMAA Publication
Gardner, H. (1985). Multiple intelligences. New York: Centre.
Basic Books. Kendler, K. S. (1998). Major depression and the environ-
Glass, C. R., Arnkoff, D. B., & Rodriquez, B. F. (1998). ment: A psychiatric genetic perspective.
An overview of directions in psychotherapy integra- Pharmacopsychiatry, 31(1), 5–9.
tion research. Journal of Psychotherapy Integration, Kendler, K. S., & Karkowski-Shuman, L. (1997).
8(4), 187–209. Stressful life events and genetic liability to major
Godman, D. (Ed). (1985). Be as you are: The teachings of depression: Genetic control of exposure to the envi-
Sri Ramana Maharshi. London: Arkana. ronment? Psychological Medicine, 27(3), 539–547.
Greenwell, B. (1990). Energies of transformation: A guide Klerman, G. L., & Weissman, M. M. (Eds). (1993). New
to the Kundalini process. Cupertino, CA.: Shakti River applications of interpersonal psychotherapy.
Press. Washington, DC: American Psychiatric Press.
Grof, S. (1985). Beyond the brain: Birth, death and tran- Kornfield, J. (1993). A path with heart: A guide through
scendence in psychotherapy. Albany, NY: SUNY Press. the perils and promises of spiritual life. New York:
Grof, S., & Bennett, H. Z. (1993). The holotropic mind: Bantam Books.
The three levels of human consciousness and how they Kovaks, M., & Beck, A.T. (1978). Maladaptive cognitive
shape our lives. San Francisco: Harper. structures in depression. American Journal of
Grof, S., & Grof, C. (Eds). (1989). Spiritual emergency: Psychiatry, 135, 525–533.
When personal transformation becomes a crisis. Los Krishna, G. (1989). The awakening of Kundalini.
Angeles: Jeremy P. Tarcher/Perigee. Ontario: FIND Research Trust and Kundalini
Hall, L. H., & Robertson, M. H. (1998). Undergraduate Research Foundation.
ratings of the acceptability of single and combined Krishna, G. (1993). Living with Kundalini: The autobiog-
treatments for depression: A comparative study. raphy of Gopi Krishna. Boston & London:
Professional Psychology: Research and Practice, 29(3), Shambhala.
269–272. Kupfer, D. J., & Frank, E. (2001). The interaction of
Hammen, C. (1991). Depression runs in families: The drug and psychotherapy in the long-term treatment
social context of risk and resilience in children of of depression. Journal of Affective Disorders, 62(1–2),
depressed mothers. New York: Springer-Verlag. 131–137.
Henry, W. P. (1998). Science, politics, and the politics of Lambert, M. J., Shapiro, D. A., & Bergin, A. E. (1986).
science: The use and misuse of empirically validated The effectiveness of psychotherapy. In S. L. Garfield
treatments research. Psychotherapy Research, 8, 126–140. & A. E. Bergin (Eds), Handbook of psychotherapy and
Hirai, T. (1989). Zen meditation and psychotherapy. behaviour change (3rd ed.), pp.157–212. New York: Wiley.
Tokyo: Japan Publications. Lampropoulos, G. K. (2000). A reexamination of the
Hollon, S. D. (1996). The efficacy and effectiveness of empirically supported treatments critiques.
psychotherapy relative to medications. American Psychotherapy Research, 10(4), 474–487.
Psychologist, 51, 1025–1030. La-Roche, M. J. (1999). The association of social rela-
Ingram, C. (1987). Ken Wilber: The pundit of transper- tions and depression levels among Dominicans in the
sonal psychology. Yoga Journal, September/October, United States. Hispanic Journal of Behavioral Sciences,
38–49. 21(4), 420–430.
Jensen, J. P., Bergin, A. E., & Greaves, D. W. (1990). The Lazarus, A. A. (1995). Multimodal therapy. In R. J.
meaning of eclecticism: New survey and analysis of Corsini & D. Wedding (Eds), Current psychotherapies.
components. Professional Psychology: Research and Itaska, IL: Peacock.
Practice, 21, 124–130. Lin, N., & Lai, G. (1995). Urban stress in China. Social
Joiner, T. E., & Coyne, J. C. (Eds). (1999). The interac- Science and Medicine, 41(8), 1131–1145.
tional nature of depression: Advances in interpersonal Leloup, J.-Y., & de Smedt, M. (Eds.) (1986). Médecines
approaches. Washington, DC: American Psychological nouvelles & psychologies transpersonnelles. Paris:
Association. Question de.

Lin, N., Ye, X., & Ensel W.M. (1999). Social support Nolen-Hoeksema, S. (1990). Sex differences in depression.
and depressed mood: A structural analysis. Journal of Stanford, CA: Stanford University Press.
Health and Social Behaviour, 40(4), 344–359. Norcross, J.C., & Goldfried, M.R. (Eds.). (1992).
Lizardi, H., Klein, D. N., Quinette P. C., et. al. (1995). Handbook of psychotherapy integration. New York:
Reports of the childhood home environment in early- Basic Books.
onset dysthymia and episodic major depression. Norges, forskningsråd. (1999). Behandling av depresjon i
Journal of Abnormal Psychology, 104(1), 132–139. allmennpraksis-konsensuskonferanse 9–10 Nov. 1999,
Lu, K. Y. (1991). The secrets of Chinese meditation. York Rapport nr. 14. Oslo.
Beach, ME: Samuel Weiser. Quincey de, C. (2000). The promise of integralism: A
Lumiere, L. M., & Lumiere-Wins, J. (Eds.). (2000). The critical appreciation of Ken Wilber’s integral psychol-
awakening west: Evidence of a spreading enlightenment. ogy. Journal of Consciousness Studies, 7(11–12),
Oakland, CA: Clear Visions Publications. 177–208.
Magnavita, J. J. (2000). Introduction: the growth of rela- Packer, T. (1999). The light of discovery. Boston: Charles
tional therapy. In Session: Psychotherapy in Practice, E. Tuttle.
56(8), 999–1004. Pahkala, K., Kivelae, S. L., & Laippala, P. (1991).
Mahoney M. J. (Ed.). (1995). Cognitive and constructive Relationships between social and health factors and
psychotherapies: Theory, research, and practice. New major depression in old age in a multivariate analysis.
York: Springer. Nordisk Psykiatrisk Tidsskrift, 45(4), 299–307.
Manning, D. W., & Frances A.J. (1990). Combined Parker, J. W. (2000). Dialogues with emerging spiritual
therapy for depression: A critical review of the litera- teachers. Fort Collins, CO: Sagewood Press.
ture. In D.W. Manning & A.J. Frances (Eds.), Parsons, T. (2000). As it is: The open secret to living an
Combined pharmacotherapy and psychotherapy for awakened life. Carlsbad, CA: Innerdirections
depression (pp. 1–34). Washington, DC: American Publishing.
Psychiatric Press. Passer, M. W., & Smith, R. E. (2001). Psychology:
Manson, S. M. (1994). Culture and depression: Frontiers and Applications. Boston: McGraw Hill.
Discovering variations in the experience of illness. In Perls, F. (1994). Gestalt therapy: Excitement and growth in
W. J. Looner & R. S. Malpass (Eds.), Psychology and the human personality. Guernsey, Channel Islands:
culture. Boston: Allyn & Bacon. Souvenir Press.
Millon, T. (1996). Personality and psychopathology. New Petit, J. W., Voelz, Z.R., & Joiner, T. E. (2001).
York: Wiley. Combined treatments for depression. In M.T.
Munoz, R. F., Mrazek, P. J., & Haggerty, R.J. (1996). Sammons & N. B. Schmidt (Eds.), Combined treat-
Institute of Medicine Report on Prevention of Mental ment for mental disorders: A guide to psychological and
Disorders: Summary and commentary. American pharmacological interventions. Washington, DC:
Psychologist, 51, 1116–1122. American Psychological Association.
Namgyal, T. T. (1986). Mahamudra: The quintessence of Pinsof, W. M. (1995). Integrative problem centered therapy:
mind and meditation. Boston & London: Shambhala. A synthesis of family, individual and biological therapies.
Narada, M. T. (1975). A manual of Abhidhamma: New York: Basic Books.
Being Abhidhammatha Sangaha of Bhadanta Poslusny, S. M. (2000). Street music or the blues? The
Anuruddhacarya. Kandy, Sri Lanka: Buddhist lived experience and social environment of depres-
Publication Society. sion. Public Health Nursing, 17(4), 292–299.
Nezlek, J. B., Hampton, C. P., & Shean, C. (2000). Price, I. (1999). Steps toward the memetic self. Journal of
Clinical depression and day-to-day social interaction Memetics—Evolutionary Models of Information
in a community sample. Journal of Abnormal Transmission, 3, 1–6.
Psychology, 109, 11–19. Prochaska, J. O., & DiClemente, C. C. (1992). The
Nezu, A. M., Nezu, C.M., & D’Zurilla. (2000). transtheoretical approach. In J.C. Norcross & M.R.
Problem-solving skills training. In G. Fink (Ed.), Goldfried (Eds.), Handbook of psychotherapy integra-
Encyclopedia of stress. San Diego, CA: Academic Press. tion, (pp. 300–334). New York: Basic Books.
Nierenberg, A. A.(2001). Current perspectives on the Rama, S., Ballentine, R., & Swami Ajaya (1993). Yoga
diagnosis and treatment of major depressive disor- and psychotherapy: The evolution of consciousness.
ders. American Journal of Management Care, 7(11), Honesdale, PA: Himalayan Institute.
353–366. Reich, W. (1993).The function of orgasm. Guernsey,
Channel Islands: Souvenir Press.

Rey, J. M., & Walter, G. (1997). Half a century of ECT Segal, S. (1996). Collision with the Infinite: A life beyond
use in young people. American Journal of Psychiatry, the personal self. San Diego, CA: Blue Dove Press.
154, 595–602. Segrin, C. (1997). Interpersonal communication prob-
Reynolds, C. F., Frank, E., Perel, J. M., & Imber, S.D. lems associated with depression and loneliness. In P.
(1992). Combined pharmacotherapy and psy- Andersen & L. K. Guerrero (Eds.), Handbook of com-
chotherapy in the acute and continuation treatment munication and emotion: Research, theory, applications
of elderly patients with recurrent major depression: A and contexts. San Diego, CA: Academic Press.
preliminary report. American Journal of Psychiatry, Seligman, M. E. P. (1975). Helplessness: On depression,
149(12), 1687–1692. development and death. San Francisco: Freeman.
Reynolds, C. F. III., Frank, E., Perel, J. M., Imber, S. D., Seligman, M. E. P., & Isaacowitz, D.M. (2000). Learned
Cornes, C., Miller, M. D., Mazumdar, S., Houck, P. helplessness. In G. Fink (Ed.), Encyclopedia of stress.
R., Dew, M. A., Stack, J. A., Pollock, B. G., & San Diego, CA: Academic Press.
Kupfer, D.J. (1999). Nortriptuline and interpersonal Shannella, L. (1992). The Kundalini experience: Psychosis
therapy as maintenance therapies for recurrent major or transcendence? Lower Lake, CA: Integral Publishing.
depression: A randomized controlled trial in patients Singer, J. (1995). Boundaries of the soul: The practice of
older than 59 years. Journal of the American Medical Jung’s psychology. Woollahra, Australia: Unity Press.
Association, 28(1), 39–45. Sogyal Rimpoche. (1992). The Tibetan book of living and
Richter, G. (1995). Evenimentele stresante de viata si dying. London: Rider.
suportul social. Semnificatia lor pentru tulburarile St. Nikodimos of the Holy Mountain & St. Makarios of
depresive. In R. Vrasti & M. Eisemann (Eds.), Corinth (1981). The Philokalia. London: Faber &
Depresii: noi perspective, (pp. 94–107). Bucuresti: Faber.
Editura All. St. John of the Cross (1988). The dark night of the soul.
Roberts, B. (1993). The experience of no-self: A contempla- London: Hodder and Stoughton.
tive journey. New York: SUNY. St. Teresa of Avila (1988). The interior castle. London:
Robinson, L. A., Berman, J. S., & Neimeyer, R. A. Hodder and Stoughton.
(1990). Psychotherapy for the treatment of depres- Stoebe, W. (1997). Social psychology and health.
sion: A comprehensive review of controlled outcome Buckingham, UK: Open University Press.
research. Psychological Bulletin, 108, 30–49. Street, H., Sheeran, P, & Orbell, S. (1999).
Rowan, J. (1993a). Subpersonalities. London: Routledge. Conceptualizing depression: An integration of 27
Rowan, J. (1993b). The transpersonal: Psychotherapy and theories. Clinical Psychology and Psychotherapy, 6, 175–193.
counselling. London & New York: Routledge. Surangama Sutra (1978). Trans. Charles Luk. Bombay:
Rush, A. J., & Hollon S. D. (1991). Depression. In B. D. B.I. Publications.
Beitman & G. L. Klerman (Eds.), Integrating phar- Swami Satyananda S. (1993a). Yoganidra. Munger: Bihar
macotherapy and psychotherapy. Washington, DC: School of Yoga.
American Psychiatric Press. Swami Satyananda S. (1993b). Kundalini tantra.
Safran, J. D. & Greenberg, L. S. (1991). Emotion, psy- Munger: Bihar School of Yoga.
chotherapy and change. New York: Guilford. Swami Sivananda R. (1985). Kundalini yoga for the West.
Safran, J. D., & Segal, Z. V. (1990). Interpersonal process Boston & London: Shambhala.
in cognitive therapy. New York: Basic Books. Teasdale, J. D. (1999). Metacognition, mindfulness and
Satcher, D. (1999). Mental health: A report of the Surgeon the modification of mood disorders. Clinical
General. Washington, DC: U.S. Department of Psychology and Psychotherapy, 6, 146–155.
Health and Human Services. Thase, M. E., Greenhouse, J. B., Frank, E., Reynolds, C.
Savard, J., Laberge, B., Gauthier, J. G., Fournier, J-P., F. III, Pikonis, P. A., Hurley, K., Grochocinski, V., &
Bouchard, S., Baril, J-G., & Bergeron, M.G. (1998). Kupfer D.J. (1997). Treatment of major depression
Combination of fluoxetine and cognitive therapy for with psychotherapy and psychotherapy-pharma-
the treatment of major depression among people with cotherapy combination. Archives of General Psychiatry,
HIV infection: A time-series analysis investigation. 54(11), 1009–1015.
Cognitive Therapy and Research, 22(1), 21–46. Tolle, E. (1999). The power of now: A guide to spiritual
Scotton, B. W., Chinen, A. B., & Battista, J. R. (Eds.) enlightenment. Novato, CA: New World Library.
(1996). Textbook of transpersonal psychiatry and psy-
chology. New York: Basic Books.

Tseng, W. S., Asai, M., Liu, J., Pismai, W., et al. (1990). Wilber, K. (2000a). Integral psychology: Consciousness,
Multi-cultural study of minor psychiatric disorders spirit, psychology, therapy. Boston & London:
in Asia: Symptom manifestations. International Shambhala.
Journal of Social Psychiatry, 36, 252–264. Wilber, K. (2000b). The collected works of Ken Wilber,
Tweedie, I. (1993). The chasm of fire: A woman’s experi- Vol. 5–8. Boston & London: Shambhala.
ence of liberation through the teachings of a Sufi master. Wilber, K. (2000c). A theory of everything: An integral
Shaftesbury: Element Books. vision of business, politics, science and spirituality.
Vrasti, R., & Eisemann, M. (1995). Depresii: Noi perspec- Boston & London: Shambhala.
tive. Bucuresti: Editura All. Wilber, K. (2000d). Waves, streams, states and self:
Wachtel, P. L. (1997). Psychoanalysis, behaviour therapy Further considerations for an integral theory of con-
and the relational world. Washington, DC: American sciousness. Journal of Consciousness Studies, 7(11–12),
Psychological Association. 145–176.
Wachtel, P. L., & McKinney, M. (1992). Cyclical Wilber, K. (2000e). On-line conference with Ken Wilber
dynamics and integrative psychodynamic therapy. In on TOE from Shambhala Publications, post for Dinu
J. Norcross & M. R. Goldfried (Eds.), Handbook of Stefan Teodorescu.
integrative psychotherapy, (pp. 335–370). New York: Wilber, K. (2002). Boomeritis. Boston & London:
Basic Books. Shambhala.
Wachtel, P. L., & Messer, S. B. (Eds.). (1998). Theories of Wilber, K., Engler, J., & Brown, D. (1986).
psychotherapy—Origins and evolution. Washington: Transformations of consciousness. Boston & London:
American Psychological Association. Shambhala.
Wandersman, A., Poppen, P. J., & Ricks, D. F. (Eds.). Wolpe, J. (1982). The practice of behaviour therapy (3rd
(1976). Humanism and behaviourism: Dialogue and ed.). New York: Pergamon.
growth. Elmsford, NY: Pergamon. Yang, J.-M. (1992). The root of Chinese Chi Kung: The
Wassermann, E., & Evans D.L. (2001). Acute mood and secrets of Chi Kung training. Jamaica Plain, MA:
thyroid stimulation hormone effects of transcranial YMAA Publication Center.
magnetic stimulation in major depression. Biological Zlotnick, C., Kohn, R., Keitner, G., & Dell-Grotta, S. A.
Psychiatry, 50(1), 22–27. (2000). The relationship between quality of interper-
Weissman, M. M., Markowitz, J. C., & Klerman, G. L. sonal relationships and major depressive disorder:
(2000). Comprehensive guide to interpersonal therapy. Finding from the national comorbidity survey.
New York: Basic Books. Journal of Affective Disorders, 59(3), 205–215.
Weissman, M. M. (2001). Treatment of depression:
Bridging the 21st century. Washington, DC: American
Psychiatric Press.
Weil, P. (1988). L’homme sans frontières: Les états modifiés
de conscience. Paris: L’Espace Bleu.
Welwood, J. (2000). Toward a psychology of awakening:
Buddhism, psychotherapy, and the path of personal and
spiritual transformation. Boston & London:
Shambhala.
Whiffen, V. E., & Aube, J. A. (1999). Personality, inter-
personal context and depression in couples. Journal of
Social and Personal Relationships, 16(3), 369–383.
White, J. (1990). Kundalini, evolution and enlightenment.
New York: Paragon House.
Wilber, K. (1977). The spectrum of consciousness.
Wheaton, IL: Quest.
Wilber, K. (1998). The eye of the spirit: An integral vision
for a world gone slightly mad. Boston & London:
Shambhala.
Wilber, K. (1999). The collected works of Ken Wilber, Vol.
1–4. Boston & London: Shambhala.

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International Journal of Transpersonal Studies

Volume 22 Issue 1 Article 14

An Integral Perspective on Depression

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100 The International Journal of Transpersonal Studies, 2003, Volume 22

Special Topic: Depression 101

D epression is primarily a disorder of mood, charac-

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U nfortunately, very little research in preventing the

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108 The International Journal of Transpersonal Studies, 2003, Volume 22

T he person is seen in IT as a holon integrated into

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IT is not a particular psychotherapy in itself, but

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