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Content, Healing, and Integration

Epistemic status: opinionated, non-consensus, but mostly descriptive

I present here a somewhat opinionated cross-section of reports and models in this space.

I'll describe a critique of these perspectives in the next section, after that I'll contrast them with other perspectives. I'll also discuss models that I endorse more strongly later.

See also: Trauma, The Structure of Trauma, Trauma Smells, and Culture, Taboo, and Trauma.

I defined trauma earlier as something like "pathological changes in psychology as a result of adverse experiences." In this section I'll talk about broadly something to the effect of the ceasing of dysphoria and dysfunction, and centrally of the removal or resolution of their generators.

This of course already relies on some assumptions about a. the identification of some pattern as undesirable and usually pathological, and b. its etiology. There's nuance with each of these which I leave implicit here, I discuss some of this more later re "introspective epistemology."

Psychological content​

Most models here use some notion of generators (never by that name), namely usually of some disruption or intrusion which is regarded as causally upstream of some psychological changes. I'll refer to the generators involved in sustaining traumatic changes, at least in my own conception, as psychological content, sometimes material, and especially just content.

So, "content" here presumes a model, though thankfully it's wildly less laden than "trauma." The stereotyped story goes like this:

  • Alice has a traumatic experience, eg. has an abusive relationship.
  • She is disturbed in general for some time, and continues to feel fearful towards men indefinitely.
  • She "processes" these experiences, this is stereotypically cathartic and emotive, especially including revisiting specific memories and feelings associated with her disturbance.
  • Her previous disturbance has ended, and she is able to hold a more "mature" relationship to herself, male peers, and potential future partners.

In this kind of story, Alice's ongoing disturbance is due to some content which needs to be "processed," and the disturbance ceases once that content is "worked through."

The reports of the phenomenology associated with this kind of story align nicely with this notion of content. In particular, these reports often describe that some feeling, or bolus of feeling-and-belief, was lurking underneath the surface level traumatic responses, which can eventually be relatively cleanly excised, resolving the entire traumatic pattern. (See more below re metabolism and releases.)

To be clear, reports of this kind of "underlying clump of content" often don't mean that a person is continuously in distress, or that there's continuously available loud sensations in that clump. Often some cluster of feeling might only be available when elicited or triggered, or might be available to introspection usually only as a blockage. In any case, in these reports and models, there is a generator which persists, agnostic of the specific phenomenology, or how sensationally active the somatic correlates of the generator are.

Note that often the surface level presentation of some psychological content might be fairly subtle, and that the metabolism of content, while often intensely emotive, can also be progressive and relatively gentle.

This is not the only kind of story one encounters being called "healing," and many stories about trauma and healing will take features a la carte from various models in the broader culture. I'll discuss various different models in use and in the discourse throughout this section, and ones I'm less sympathetic to separately. Note also that these sorts of "models" are much more like intuition pumps for practitioners (and often for eg. therapists) rather than nice predictive causal models in the sense we would use ordinarily in "science."

Metabolism​

Most of these models refer implicitly or explicitly to a notion of psychological or emotional metabolism, also commonly eg. "processing emotions."

Indeed, let's say, one has a varied palette of emotions or moods, and correlated clusters of perception and behavior. And, distinctly, emotions pass! Emotions and "psychological states" clearly have something to do with external circumstances, but also with our relationship to them. In any case, most often, emotions arise in response to some circumstance, and then decay or are replaced, variously organically, smoothly, abruptly or chaotically.

This sort of process is stereotypically glaring when observing children, who can be inconsolable one minute, and peaceful or excited literally the next minute. Adults still have this basic pattern of arising-and-decay, and it's very difficult to imagine what a person would be like if they were missing either half of that cycle.

Besides someone being aroused more readily or more intensely, some people often hold on to emotions for longer than others. As well, some emotions are more intense or sustained, and decay with greater difficulty.

Many modern western theories of trauma and healing make claims along the lines that trauma is due to interruption in the natural process of emotional metabolism. The claim here often goes like: "when things are going well, disturbance, regardless of how intense, passes through the system with enough time. What distinguishes trauma is that for whatever reason this process fails or stops, and the disturbance forms a cyst of dysphoria which festers and inflames the rest of the body-mind."

Often in these sorts of models, emotional metabolism is believed to require some appropriate social-emotional context; stereotypically this is described from the perspective of a child, and so the corresponding "healthy" context is connection with a warm and compassionate caregiver.

(See also briefly re some empirical critiques of this sort of perspective.)

Also common here then are claims that this context can be reenacted (in some sense) with a therapist performing some narrow subset of the role of a caregiver, or of a person being able to "reparent themselves," simulating this kind of social-energetic quality "internally." Similarly there are reports from eg. fairly traditional religious adherents of getting this quality1 from eg. worship of Mary2, or Guan Yin.

A common claimed causal history for these interruptions is parental absence, or weak or absent parental attunement, but interruptions to emotional metabolism are meant to be possible under a variety of other circumstances. Commonly reported here are:

  • Cases where emotional expression is restricted or punished in a household or broader culture
  • Cases of social rejection more broadly, especially when not "offset" by an open and welcoming social context for that person elsewhere
  • Cases where a trauma is unspeakable or is refused by a person's family or local community, eg. very often in cases of rape
  • Acute trauma otherwise, especially under chaotic circumstances where there is no stable safety to be found for some time

Furthermore, a very popular claim in some pop-therapy circles, as well as western meditators and broadly "spiritual" types is that modern western culture is ~uniquely bad with respect to affording metabolism. First off, this smells more like an instance of the "Garden of Eden," (see an appendix) rather than a plausible empirical claim about the distribution of emotional health and robustness in historical or "traditional" cultures. Still, this touches on a central theme of this whole book, about the relationship between culture, "health," and spirituality. I'll discuss later some specific aspects of this question.

Some common reports of the phenomenology of emotional metabolism:

  • Nebulously felt relief
  • Energy (in sense #2 linked) moving
    • Sometimes reported as moving through specific or predictable contours of sensation
  • Sometimes, releases or movement of qi (see link above)
  • "Catharsis"
    • This is the term I'm using for the standard stereotyped loudly emotive, often vulnerable kind of metabolism.
    • Sometimes reported as moving through a specific sequence of emotions or views, at least when metabolizing whatever specific emotion etc.
  • Nebulously felt or perceived reorientation of meaning and social-energetic posture (see below)
    • Often this is present as a feature, but by itself I wouldn't quite call this metabolism.
  • Specific images or memories being elicited, and arousing strong emotions associated with them
  • Bigger or more intense releases (see below)

"Catharsis" stereotypically is not just about vulnerable and loud emoting, but usually distinctly about emoting which results in relief and satsifaction. Sometimes "healing" gets used to mean this sort of catharsis without respect to any model of the ceasing of generators of dysphoria, or else with a very weak sense of such a model. Broadly I think this is basically not an appropriate use of the word 'healing.'

Often in this context people will talk about "processing emotions," I'll say this is used to mean at least half a dozen different things, some of which I wouldn't call metabolism at all, and in any case usually used without any clarity as to the phenomenology it's supposed to refer to. In any case, often it means some combination of the above. Also, often "processing emotions" means something more focused or deliberate, rather than passive or ambient.

It's also not clear to me what the relationship is between catharsis in this sense and metabolism more broadly. I've occasionally encountered claims that metabolism requires loud catharsis, though my sense is that this isn't even clearly true for small children, let alone for adults—though this might be directionally true, or helpful as a prescription relative to the ordinary performance of adult emotional regulation.

Releases and openings​

See also Somatic Phenomenology, especially the sections on dissocation and blockages and releases.

Release and opening have somewhat overlapping usage; the former broadly speaking refers to somatic releases, whereas the latter can refer to the same but more centrally refers to shifts in behavior and felt affordances or optionality in behavior, life choices, etc.

I won't mostly repeat descriptions of the phenomenology of somatic releases, see sections linked above. For "openings", reports that use this language often revolve around energetic, "psychological," and behavioral shifts downstream of a variety of kinds of "healing" (often also not using a "healing" frame, however.) Most often this involves specific ways of seeing and ways of being becoming available where they were previously flat, thin, aversive, or absent. Common features of reports of openings include, again overlapping with the reports of releases:

  • Discovering and disrupting somatic patterns, sometimes described as eg. "contraction" or "collapse," which block off the normal or desirable flow and expression of some energy, eg. confidence and verve, sexual desire, vulnerability, etc.
  • Some domain of meaning or swath of emotions which had been made under-salient or overly thin (something like, "phenomenally dereified"), newly becoming richly available
  • Changes in the weighting or salience of various domains or affordances in one's life and experience; very often softening some previously hyper-salient domain, eg. specific work relationships, expectations of achievement, or burdensome responsibility to family
  • Local or global relaxation of chronic somatic tension, both gross muscular tension and subtle energetic tension
  • Changes in affect and manner perceptible to ordinary friends and family, often described as eg. gentler, richer, more confident, or brighter

Behavioral changes associated with openings, in reports which use that language, are generally not associated with some discrete "decision" or verbal reflection, but are often indirect, unexpected, and progressive. While some of the most popularly advertised healing systems often claim clean and simple stories of metabolism and openings, many reports from practitioners who I take seriously are much more complicated, indirect, messy, and unpredictable. I'll discuss this in much more detail later.

Often both openings and releases come with a step down in dissociation, whether local or global; sometimes changes in dissociation can either precipitate openings or conversely can be caused by them. Changes in dissociation can be pleasant or painful, ranging from soft, gentle, lovely (if often still sad), to chaotic and violent, eg. reports fairly often describe screeching, blood curdling pain, or wracking sobs. Openings are also sometimes chaotic and pleasurable, and many other surprising variations.

Releases and openings are often reported to be disruptive to a person's relationships and general functioning, at least for periods of time. Where some pattern of restriction and dissociation was load-bearing, perhaps because it eg. held some intense negative emotions at bay, or because it allowed a person to remain amenable to people in their existing relationships, removing it can add chaos to that person's life or lead to the collapse of some relationships.

(This is a more common report than one would expect just based on the, uh, "marketing materials" for spiritual and transformative practice. I discuss this in more detail later.)

Even when not expected to be disruptive to this extent, many models which make reference to "openings" prescribe that a person has to capitalize on an opening, and something like actualize it in their relationships and agency in the world. Actualization can be more or less functional and healthy, but even healthy cases can still be disruptive, and healthy cases are broadly contiguous with those of major disruptive openings.

At least sometimes reported here are things getting very intense, and often very weird. Among these:

  • Revealing, at least to oneself, long-held snarls of motivation, or tucked away obsessions with some taboo
  • Bizarre and horrifying imagery of violence or body horror, eg. of violence done to oneself or others
  • What's sometimes called "shamanic sickness"—prolonged pseudo-physical illnesses caused or at least opened up by healing practices, rather than resolved by them
  • "Critters," energies or extra-personal psychologies found implanted or lodged in one's body-mind system
    • (Adjacent, also "entities," AFAICT this refers to what are reported as "external minds" found in a person's body-mind)

See more on this cluster specifically later.

While this domain seems like it must be "native" for humans, this whole broad flavor of report (openings in general, and maybe weird stuff especially) feels pretty modern, in my mind dating maybe to the 80's. Still I think it's right in broad strokes, and not a coincidental innovation of whatever recent culture. While conceived of very differently, IIRC I've found many of these contours reported, at least here and there, in traditional and historical sources cutting across traditions.

Energy work and "energy healing"​

Again, see also on energy.

Reports of releases are stereotypically intense, and indeed the easiest experiences to tell stories about are the intense ones, but many releases and movements of energy are subtle or even quite faint. Much of the work leading up to and surrounding big releases is described as more like subtle and intricate. As well, some people report that their practice is basically progressive and gentle with no major hiccups, or at least mostly so. See more later on gradualism and suddenism.

This sort of "intricate" healing practice is distinctive of what's most often known as energy work; also adjacent here is energy healing. Energy work generally includes practices, both "internal" (by one person on, or in themselves), and "external" (by a healing practitioner on a client or, ugh, patient or whatever), working with phenomena under both qi and subtle somatics (see link above for energy).

External energy healing practices most often involve touch, sometimes massage, sometimes with application of a good deal of force, but most often with just very gentle and light touch. These are generally reported to be mostly about movement and interaction of energy in the healer's body-mind with the client's, and indeed some schools teach healing practices which involve no touch at all, and may be practiced anywhere from a distance of a few inches from the client's body, to across a continent.3

Internal practices are usually explained to work on similar principles, and often with similar or tightly aligned reports. Many schools teach some combination of both, usually with a healing practitioner being required to be adept in internal practices in order to practice on clients.

Most centrally, at least to my mind, both internal and external energy healing practices feature qualities phenomenologically of spacious attention and "coaxing." The former means something like "co-attention," or eg. there's commonly claims that the attention and energetic space of a healer affords a client's system to soften or move as needed.4 The latter means something like gently inclining the system to unravel or release—even when applying a fair amount of physical force via massage, my sense is there's generally here a quality of gentleness or "careful energetic attunement," eg. as opposed to "energetic contradiction" etc.

There are some claims here that the energetic system of a healing practitioner can convey some information to a client about what energetic/somatic affordances exist, or a way of being with energy already arisen, or to impart a specific energy which is absent or unavailable for the client. Any of these will sometimes get called "transmission," or "a transmission," which unfortunately means a few other things in other contexts as well.

Unfortunately, "energy work" also refers to healing practices with something of the opposite quality, namely purposefully, forcefully moving energy, or adding some energy to the system in an effort to budge the configuration this way or that. See also here briefly re energy practices, in that context moreso with respect to "meditation." The extreme end of this I would describe as trying to blast the system with energy, reports of these sorts of practices (eg. many kinds of "breathwork") describe being overwhelmed with energy, pushing out or rapidly clearing most other sensations or emotions present.

Adjacent to this category are also practices to the effect of purposefully putting the system under "energetic stress," so adding some energy that's intense or difficult to be with, or in physical postures which are energetically challenging, and working with those. There's a wide range here, most of which I'm not that familiar with.

Releases and verbalization, "nominal content"​

See also on introspection and verbalization.

Releases and openings often have a complicated relationship with nominal content, and especially verbal expression. Again, the stereotyped Hollywood image of cathartic healing involves some very straightforward correspondence between felt emotion, emotional expression, "underlying generators" (usually implicit), verbal introspection, and verbal expression. In practice, in the reports I take seriously, every linkage in this network can be distorted, opaque, inverted, or completely obfuscated, including to the person introspecting.

By my sense, often verbal expression is confabulated, larped, or improv'd in the moment, and some expression might be resonant partially, but still felt strongly. More generally, very very commonly in the therapy literature, and in reports from modern solo "healing" practitioners, the presenting symptoms and reports can have fairly little to do with the content of the underlying generators, as evaluated much further along in some healing journey. Correspondingly, the same is true for someone's apprehension of some disturbed or dysfunctional pattern, as well as both their private stories about it and their expressions about it, regardless of how emotive or strongly felt.

Separately, there's also often a feedback loop between openings and expressions: in many reports, openings will lead to shifts in self-understanding, which might precipitate some big verbal expression, and conversely there are surprising or momentous verbal expressions which precipitate big releases. (All of this is agnostic of the "accuracy" or truth value of any particular verbal expression.)

Integration​

Integration refers to processes oriented towards, and relative outcomes of, something like psychological robustness, maturity, and non-compartmentalization. I feel actually a bit unclear about this concept and more sparsely read here, but it's still pretty fundamental, and I have some useful to say.

Most often I see this term used to refer to what I might very loosely want to distinguish as four features:

  1. Somatic integration
  2. Mature relationship with traumatic experiences
  3. Mature and robust relationship with taboo subjects
  4. Lack of inner conflict

Related to all of these, 'to integrate' often gets used to mean, very generally, "to allow psychological/emotional learnings to percolate," or "to synthesize new perspectives and orientations from something one has learned."

Somatic integration​

Somatic integration broadly is used to mean a. somatic healing, mostly the same as the kinds of practices and experiences described above in releases and openings, and b. re-embodiment, most often in the context of a., with a priority on integrating somatic phenomena with the rest of attention and experience.

Sometimes this means a variety of different kinds of body practices, which might be explicit "bodywork" or energy work, or might mean explicit attentional + physical embodiment practices, eg. Tai chi etc. More broadly the notion here is usually about developing the relationship between attention, emotion, and somatics to be more "whole," more cooperative, fluent, etc.

Mature relationship with traumatic experiences​

This often means largely something like "healed," but with a specific priority on again something like robustness and maturity, often a gloss here might be "robustly and thoroughly healed." The claim here is often something like, "there exists incomplete healing which still has distinctive trauma smells, as distinct from a completed healing process (which we call 'integrated.')" Usually the trauma smells here would be a very exaggerated sensitivity to the possibility of harm in some domain, or a disgust or rejection of that domain in general, or a tendency to have one's hackles raised with respect to that domain or with respect to one's relationship with it. In contrast, an "integrated" relationship with some trauma is often depicted as "grounded" or "clean," even if there's a much deeper sensitivity and care for that specific kind of harm.

This is sort of presumptive of the answers to some spiritual questions, and often these claims are overstated as far as I'm concerned, but I think this is directionally right.

Robust relationship with taboo​

(Again see some context on taboo in general.)

The take here is usually something like, taboos in general create a kind of internal flinch or censorship, and that while relatively functional, especially for a society as a whole, this is still in a way "incomplete" or "brittle." Eg., taboos against feces often both track real concerns re disease risk, but also construct a reified cordoned-off domain of the world, at least for many people in many cultures. So then the claim is that this is psychologically distortive, and that even if one still practices hygiene re eg. disease transmission from feces, the structure of taboo around it "needs to" be integrated, in this sense.

And then, the claim here is broader, so feces is easier to explain because the taboo is relatively weaker and simpler, but I've seen many claims from practitioners about similar harmful knots psychologically/spiritually/somatically with respect to eg. a variety of kinds of taboos against sexuality, politicized taboos, etc.

More "dys-integrated" here would include reports, which are common from at least some kinds of practitioners, of exaggerated, contorted, or inverted relationships with taboos. The central example here (if contentious) would be at least some kinds of kink/BDSM, which I'll discuss later.

This kind of integration is also often connected to other kinds of internalized censorship (regardless of my using the word 'taboo' for this subsection.) Eg., many cultures strongly censure both gross physical violence but also overt aggressive verbal expression, and there are many reports of people needing to unravel and "integrate" trauma-smelly patterns around impulses to anger and violence. This type of practice, very broadly, is often known as "shadow work."

Inner conflict​

There are many reports of practitioners coming to intensive contemplative practice due to intense internal conflicts, or discovering these in the course of their practice. Reports here look like:

  • Being one's own slavedriver, especially to strenuous internal objection
  • Persistently punishing oneself for some undesired behavior
  • Struggling with some undesired behavior and constantly falling off the wagon
  • Feeling trapped in a relationship and wanting to express discomforts or objections, but always holding back
    • (This could be understood as more of an internalization of the punishments of an abuser or abusive dynamic, but is still relevant here.)

And then integration in this sense means the relative absence of this quality. Note while they're sort of contiguous, this kind of pattern is meaningfully separate from ordinary negotiation of competing goals and desires. Snarls involving internal conflict can get seemingly arbitrarily weird, see some context on partswork, and more later on weird patterns discovered in practice.

Footnotes​

  1. See also from Jake Orthwein on Twitter:

    My first experience of doing IPF directly gave rise to the intuition that attachment-related injuries are in fact basic injuries of existential meaning, experienced (in theistic terms) as alienation from god
    (I had some similar experiences spontaneously, while working with the image of a Bodhisattva.) ↩

  2. There's an amazing series on Youtube of interviews with a Coptic Christian monk, originally from Tasmania and now a hermit in the Sinai desert, Fr. Lazarus ElAnthony. He has some nice reports of his practices of Mariolatry, though he's perhaps not fully traditional as he wasn't raised in the church, but I've found similar reports from more traditional Orthodox Christian sources.

    (Unfortunately the playlist is a bit messed up, so this link starts at "season 1", but the sequence is sort of out of order.) ↩

  3. Just have to toss in here, the "across a continent" ones really do boggle the mind, and I'm basically just like nah bro about these claims. Also to clarify, this isn't even like "can be done over the phone," sometimes the claim is literally like, "I can tune in to their energy body from any distance and do work on them from where I am." ↩

  4. Sometimes I describe this as "letting the system do its business." ↩