by Carlos Gris, M.A.
In order to offer a model for regression research, the Journal is printing in full a proposal by Carlos Gris for exploring the potential of regression work with the homeless. His proposal has a theoretical grounding in the most innovative thinking of our time, out of which grow his hypotheses. A discussion of methods, measurement techniques, and population follows. The homeless are a difficult and sometimes almost intangible group, and many modifications may have to be made in the design, but it is a start. The findings may be negative—that is, psychodynamic techniques may work as well as regression therapy, or even better, but that, too, is a finding. Let us accompany Carlos sympathetically on his journey of exploration. It is certain that we will know more about regression research and also about the homeless when the investigation is complete.
This research is focused on outcome, as is the research study by Clara Riley which follows. An important and difficult consideration is how outcome is to be measured, and in an upcoming issue we expect to have an article discussing this and exploring possibilities. Meanwhile, Carlos and others are taking advantage of Nanette de Fuentes’ offer of free consultation, which is open to all members of APRT.
The present study intends to compare the differential effectiveness of insight psychotherapy and past-life therapy, as measured by the Semantic Differential technique and a tailored behavior rating scale with a group of sixty homeless people, within a major metropolitan area, who have been diagnosed as chronic mentally ill. The study tests the hypothesis that psychotherapeutic techniques based on and isomorphic with a transpersonal model of the self are more effective in supporting the restructuring of personality and changes in meaningful observable behavior than those which are based on an exclusively psychodynamic model. It attempts to identify and define the indications and contraindications for past-life therapy.
Macroframework
Recent developments in quantum-relativity physics, brain research, systems and information theory, parapsychology, study of dissipative structures, biology, holography, and holonomic thinking, among other sciences, have produced an avalanche of observations that cannot be accounted for within the traditional Newtonian-Cartesian paradigm They are leading the way to extraordinary changes in the basic philosophical and metaphysical foundations of Western science, while opening the door to the integration of fundamental principles and basic tenets of the more refined and sophisticated ancient disciplines of the East, such as the various forms of Yoga, Zen Buddhism, Vipassana, Vajrayana, Taoism, Sufism, and Kabala.
Some of this new information is of such far-reaching significance that it seems to call for a drastic revision of our current understanding of human nature, and even the nature of reality itself, and for a major overhaul of our methods and strategies.
Concurrently, in the jungle of conflicting and competing systems of Western psychotherapy, a new pattern of integration has been emerging in the inner circles within the last two decades. The new emphasis is on the recognition of spirituality and transcendental needs as intrinsic aspects of human nature and as valid, legitimate, and essential areas of self-exploration.
The major problem of Western psychotherapy has lain in the fact that individual researchers have focused their efforts primarily, if not exclusively, on a certain level of consciousness and have then generalized their findings to the human psyche as a whole. Similarly, rigid devotion to the Newtonian-Cartesian paradigm has resulted in the inappropriate application of the medical model to areas of psychotherapy.
There is currently a need for links and steppingstones that allow us to move gently into a new paradigm while integrating and enfolding what is useful in the old and supporting the discovery and understanding of the new. In a modest and limited way, the present study is an attempt to provide such a link between traditional insight psychotherapy and past-life therapy.
Microframework
Within the Newtonian-Cartesian paradigm, human beings are viewed as essentially separate and closed systems, complex machines operating under the laws of a mechanical, deterministic universe. Western psychotherapy typically narrows the level of analysis to the personal and biographical and seldom ventures into the interpersonal or social, let alone the spiritual and transpersonal.
The avalanche of new observations suggests that our experience is intimately connected with the structure and evolution of the larger cosmic context of which we are a part. Ilya Prigogine’s (1984) theory of dissipative structures states that we are one with the world. Holonomic theory (Pribram, 1971, 1976) suggests that we contain within ourselves the whole universe. Rupert Sheldrake’s (1981) hypothesis of formative causation proposes that the form, development, and behavior of living organisms are shaped and maintained by “morphogenetic fields,” which are in turn molded by the form and behavior of past organisms through direct connections across time and space. Quantum-relativistic physics (Bohr, 1934, 1958) advocates that isolated material particles are abstractions and that their properties are definable and observable only through their interaction with other systems. The flow of time is a psychological not a natural event, and therefore, the concept of and the length of a life is meaningless.
This massive amount of observations and new information is consistent with phenomena of deep self-exploration in Jungian analysis; the psycho-synthesis approach of Roberto Assagioli (1976, 1977); the holotropic breath-work of Stan Grof (1985); clinical research with psychedelics, particularly LSD (Grof, 1976); Rankian, Reikian, and other relatively recent experiential and transpersonal systems of Western psychotherapy; Christian mysticism and the disciplines of more esoteric and refined Eastern systems.
Present Study
Formidable methodological and control problems, lack of a feasible model, and other complexities have plagued outcome research in psychotherapy.
The present study attempts to make a contribution to building bridges between shifting paradigms by utilizing a phenomenological conceptual framework and classical research strategies to compare traditional insight psychotherapy and past-life therapy and to identify and define indications and contraindications for the use of the latter with chronic mentally ill, homeless adults.
A phenomenological and behavioral approach: Rationale
The subject matter and focus of any system of psychotherapy are phenomena, as consciously apprehended and/or observable behavior. The current study measures both.
Phenomena, internal reality, or subjective experience are representational mediators between the self and that with which it is in relation: they provide the self with the meaning of its experience. The principal changes that occur in psychotherapy appear to be changes in this internal reality. As Osgood (et. al. 1957) has stated:
…the significance of meaning as a critical variable in personality is most apparent perhaps in the process of therapy itself, where the principal changes that occur appear to be changes in the significance or meaning that various persons, events, and situations have for the patient, and changes in the interrelationships between these significances (p. 273).
In summarizing the claims of various psychotherapy researchers, Endler (1961) states that:
Snygg and Combs (1949) claim that one of the criteria of effective psychotherapy is a change in the client’s meanings, especially with respect to the phenomenal self. Other theorists (Freyd, 1933; Mowrer, 1953; Sullivan, 1953) add the importance of changes in the meaning of the mother and father figures that occur during therapy. Previous studies (Rogers, 1954; Dymond, 1953; Scheerer, 1949; Ewing, 1954; and others) of perceptual change or changes in meaning during therapy, utilized unidimensional measuring instruments which were susceptible to bias, and which measured constructs that were not clearly defined (p. 107).
Concurrently, Zax and Klein (1960) pointed out that the least used and most promising method for measuring change would appear to be the use of external, objective criteria. For control purposes, behavioral tests for selected target behaviors are the most desirable because they remove the possibility of faking and bias.
Research Hypotheses
- Past-life therapy is more effective than traditional insight psychotherapy for effecting changes in the internal reality/meaning that basic concepts such as “self,” “mother,” “father,” etc. have for chronic mentally ill adults.
- Past-life therapy is more effective than traditional insight psychotherapy for effecting changes in observable, relevant behaviors.
- There are no significant differences in the changes in the observable behavior of or in the internal reality/meaning that basic concepts such as “self,” “mother,” “father,” etc. have for:
- Men and women
- Caucasian and black people
Research Design Structure
A classical three-group research design will be utilized, including two experimental comparison groups and one control group. The former two will be made up of subjects whose treatment required insight psychotherapy (Experimental group 1) or past-life therapy (Experimental group 2).
All subjects will be pre- and post-tested by a research assistant neutral to the outcome and blind to the method, using (1) an adapted form of the Semantic Differential technique designed and developed by Charles Osgood (et. al., 1957) at the Communications Research Center of the University of Illinois and (2) an observable/meaningful behavior rating scale.
Subjects will be randomly assigned to treatment groups.
Method
The Semantic Differential
The present study uses Osgood (et. al., 1952) Semantic Differential technique as one index of changes during psychotherapy.
The Semantic Differential is an objective, reliable, valid, and generalizable technique for measuring the connotative meaning of concepts which must be adapted to the requirements of each research problem to which it is applied. It consists of:
- A set of concepts or “stimulus” to which the subject’s checking operation is a terminal “response.” The concepts judged against a Semantic Differential may be as varied in nature as may be the modes of signs and the type selected depends chiefly upon the interest of the investigator. It is the nature of the problem then that chiefly defines the class and form of concept to be selected.
- Each concept is rated against the same set of bipolar scales chosen for their factorial (evaluation, potency, and activity) composition, their relevance to the concepts being judged, and their semantic stability for the concepts and subjects in the particular study. Scales should be linear between polar opposites and pass through the origin.
A test item is the pairing of a particular concept with a particular scale and each subject’s judgment of such an item provides a bit of information—in the phenomenological sense, not in the Information Theory sense.
The particular form of the Semantic Differential used in this study consists of 10 concepts (Table 1, page 8), rated on ten bipolar scales each. Concepts were selected according to the personal relevance or interior significance they are presumed to have for the population being investigated and (2) for their tested validity. Each has been factor analyzed and reported to have specific composite factor scores and standardized factor scores, as indicated (Snider & Osgood, 1969).
The factors and the scales are as follows:
- An evaluative factor represented by the following scales:
valuable-worthless
clean-dirty
tasty-distasteful - A potency factor represented by the following scales:
strong-weak
deep-shallow
large-small - An activity factor represented by the following scales:
active-passive
fast-slow
hot-cold - A neutral factor represented by the scale:
short-long
The Semantic Differential technique employs a multidimensional approach and is considered to be relatively free of response bias. Previous factor analytic studies of the Semantic Differential have yielded relatively pure factors of the construct of meaning (Osgood, et. al., 1957).
- Behavior measurement
The behavior rating scale was developed to include the most relevant observable behaviors for this population. It will be administered concurrently with the Semantic Differential by the research assistant at the beginning and conclusion of the project.
Α. Where is s/he currently living?
0 In the street
1 In a shelter
2 In a welfare hotel
3 In an independent living program
Β. Is s/he currently employed?
0 No
1 Yes
C. Regarding entitlements
0 S/he is unwilling to receive entitlements
1 S/he is willing to receive entitlements
2 S/he has made application for entitlements
D. His/her hygiene appears:
0 Poor
1 Fair
2 Good
3 Excellent
E. Does s/he report hearing upsetting or disturbing internal voices?
0 Yes
1 No
Administration
The same form of the Semantic Differential and Behavior Rating Scale will be used for the pre- and post-test and both will be administered by a research assistant, neutral to the outcome and blind to the method.
The pre-test will be administered at the beginning of the first therapy session, subsequent to the intake interview, during which a needs assessment will be taken and a preliminary diagnosis made by the experimenter. This diagnosis will be subsequently reviewed and corroborated or amended by the Board-certified psychiatric supervisor.
The post-test will be administered at the end of the last session of therapy with the subject. A session will be deemed to be the last session if (a) the patient states s/he feels that s/he has achieved the goals of therapy or will be moving out of the area or (b) the experimenter determines that (a) might occur without notice, as is often the case with this rather transient population.
Specific and standardized instructions for completing the Semantic Differential will first be read to each and all subjects by the research assistant, prior to having them read and complete it. The Behavior Rating Scale will be completed by the research assistant from subjects’ verbal report.
All subjects will complete the Semantic Differential in the presence of the assistant who will ensure that each and all items are completed. No other person will be allowed in the room during this time.
Subjects
Sixty homeless men and women selected from among clients that are referred to a local mental health agency in a major metropolitan area and who are diagnosed as suffering from some form of psychiatric disorder.
Context
Chronic mentally ill homeless people are among the most disenfranchised and neglected populations in the country. Their conditions span the range of diagnostic categories and cluster around the Borderline Personality Disorder and Schizophrenic Psychosis classifications with an increasing number of people that can be identified as “double diagnosis cases.” About twenty percent of the men in the target area are Vietnam combat vets.
These conditions are typically exacerbated or even triggered by chronic malnutrition, physical illnesses, lack of social, emotional, and financial supports, and homelessness. These people typically live in a culture that frequently invites substance abuse and prostitution and engenders physical, mental, and emotional violence. The limitations of traditional psychotherapy with this population are well documented in the literature (Kupers, 1981; Lamb, 1984), especially in light of what seems to be an increasing number of clients undergoing a transpersonal crisis (Grof, 1985; Bragdon, 1987).
Assessment and diagnosis will be available at the time of intake from the patient’s previous evaluations by other professionals or will be made at the time of intake by the experimenter and/or psychiatric supervisor of the agency, according to criteria set forth in the Diagnostic Statistical Manual of Mental Disorders III. Only patients, who have not used any mind altering substance, including alcohol, during the four weeks preceding the pre-test, will be accepted into the study. It is likely that all subjects are malnourished and smoke excessively.
Selection
Subjects will be selected from among those clients that (1) are referred to the mental health agency by other professionals, other agencies, shelter staff or other clients, or who refer themselves, (2) fit within the profile set forth above, and (3) do not refuse to participate in the study.
Assignment of Groups
Subjects referred for or requesting psychotherapy will be randomly assigned in equal numbers to two experimental groups. Subjects for the control group will be randomly selected from among those staying at the shelters who do not request any other services.
Group 1: Insight Psychotherapy
Twenty subjects will be randomly assigned to this treatment group. Treatment intervention will consist of facilitating awareness and analysis of the impact of significant biographical events, deductions and decisions, the influence of significant others, and the basic forces of attraction and repulsion in the development and dynamics of personality and their relationship to current symptoms as well as the release of repressed emotion. This will be achieved through verbal interaction between the experimenter and each subject and the analysis of dreams and fantasies.
Group 2: Past-Life Therapy
Twenty subjects will be randomly assigned to this treatment group. Through the induction of hypnotic trance and regression, subjects will retrieve and relive significant prenatal, perinatal, and other events of past lives and relationships, release their unexpressed emotions, re-experience past-life deaths, and retrieve and review the decisions and emotions carried over by their soul from past lives to the present and analyze the relationship of these events among one another and to current symptoms.
Group 3: Control Group
Twenty subjects matched as closely as possible in biographical and diagnostic characteristics to those of groups 1 and 2 and who receive no psychotherapy or other mental health services from the project, other professionals, or mental health agencies in the area.
References
Assagioli, R. Psychosynthesis. New York: Atheneum, 1976.
Bohr, N. Atomic Physics and the Description of Nature. Cambridge, England: Cambridge University Press, 1934.
Bohr, N. Atomic Physics and Human Knowledge. New York: John Wiley & Sons, 1958.
Bragdon. E. A Sourcebook for Helping People in Spiritual Emergency. Unpublished dissertation, Institute for Transpersonal Psychology, Menlo Park, CA, 1987.
Endler, N. S. “Changes in Meaning During Psychotherapy as Measured by the Semantic Differential Technique.” Journal of Counseling Psychology, 8, 1961.
Grof, S. Beyond the Brain: Birth, Death and Transcendence in Psychotherapy. Albany, NY: State University of New York Press, 1985.
Grof, S. Realms of the Human Unconscious: Observations from LSD Research. New York: E. P. Hutton, 1976.
Harman, W. Symposium on Consciousness. New York: Penguin, 1977.
Kuppers, T. A. Public Therapy: The Practice of Psychotherapy in the Public Mental Health Clinic. New York: The Free Press, 1981.
Lamb, R. H. The Homeless Mentally Ill. Washington, D.C.: American Psychiatric Association, 1984.
Osgood, C. E. “The Nature and Measurement of Meaning.” Psychological Bulletin, 49, pp. 197-237, 1952.
Osgood, C. E., Suci, G. J., & Tannenbaum, P. H. The Measurement of Meaning. Urbane, IL: University of Illinois Press, 1957.
Pribram, K. “Holonomy and Structure in the Organization of Perception.” Mimeographed, Department of Psychology, Stanford University, Stanford, CA, 1976.
Pribram, K. Languages of the Brain. Englewood Cliffs, N.J.: Prentice Hall, 1971.
Prigogine, I. Order out of Chaos: Man’s Dialogue with Nature. New York: Bantam Books, 1984.
Sheldrake, R. A New Science of Life: The Hypothesis of Formative Causation. Los Angeles: J.P. Tarcher, Inc., 1983.
Zax, M., & Klein, A. “Measurement of Personality and Behavior changes following Psychotherapy.” Psychol. Bull., 57, pp. 435-48, 1960.