0000-0999
Sites per thema:
psy0 algemeen
psy1 systemen
psy2 denken
psy3 brein
psy4 individu
psy50 diagnostiek
psy54 behandeling
psy6 optimaal
psy7 groepen
psy8 suboptimaal
psy9 optimaal

0105 Integration Method (E)

DEFINITION, METHOD AND APPLICATIONS
OF INTEGRATION

 

Dr Kris Roose

SEPI, Barcelona 2013 

Abstract

In this contribution, we explore the method of integration as an intellectual process, and suggest several fields where integration could be an essential tool. These fields include (1) the rapprochement between the different schools of psychotherapy, (2) integration as a tool for reliable scientific research in the absence of mathematical procedures and replicable experiments, (3) several therapeutical techniques useful for the client in communication, and some more. As examples of integrative scientific research in psychology, we propose some models with direct therapeutical use: (1) an integration of the different psychotherapeutical schools along their level of intervention, bringing the dream of psychotherapy integration very close to its realization; (2) an integrative model of depression, and (3) a proposal for an integrative psychopathology.

This contribution will be enriched with powerpoint illustrations and handouts, and is suitable for discussions in working groups and symposia. 

Introduction 

Scientific Societies like ours, are continuously thinking about, and working with integration. But, surprisingly, the integration process itself is seldom subject of any scientific research. Wikipedia speaks about social, racial, mathematical integration, and even about money laundering. But not about scientific or knowledge integration. We once tried to start a new Wikipedia article on that topic, but it was immediately deleted because we were not allowed to "promote our own theories or businesses". Isn't this unbelievable for such a fundamental concept in scientific, psychological en social sciences? It is the more unbelievable, because the wikipedia content collecting and transformational system seems to be the most appropriate and fertile system to produce such an integration. It is paradoxical that the controllers of wikipedia, who have the permission to delete any contribution they don't like, don't seem even to be conscious of the deeper and real values of their own system, and merely see it as a quick and cheap cumulative data collecting system. 

Our Academy for Integrative Psychology now exists since more than 35 years (1978), and very quickly we elaborated a vision on the integration process, and its numerous valuable applications. Here we present some of our results.

Definition 

We define intregration as an intellectual process of combining two or more (at first sight) uncombinable visions, theories, and actions based upon these concepts. The results of this procedure include: the creation of a new concept with the advantages and essential elements of each contribution, but without any of their negative aspects or limitations. This procedure -if duly and perseveringly applied- enables us to overcome any conflict, and any choice which should imply the loss of valuable alternatives. Furthermore, this procedure will reveal itself as a useful tool for scientific research, especially in those (mostly psychological and philosophical) fields where traditional scientific research is rather difficult or even impossible.

Description 

This unlikely process is made possible by the fact that each concept (and each action based on it) consists of two layers: the essential kernel or core, and the peripheral, practical and often useful, but not essential shell. The external appearance of an element is its expression. After an integration, a third layer is added: a creative synthesis of alle essential elements.

            Shell2   integration

            Shell1   partial projects / theories

            Core      essential elements

Applied to behavior, we can distinguish (1) needs, (2) conflicting behavior, (3) integrative behavior. Applied to action, we can discern (1) goals, (2) incongruent projects, (3) an integrative action. Applied to thinking, we can differentiate (1) observed facts, (2) partial theories, (3) an integrative theory.

Of course, the limit between kernel and shell largely depends on what the observer considers as interesting in a particular case.

Example. If you are only interested in the juice of the orange, for you the pulp forms a part of the shell, because it separes the essential kernel from the outside world. And it is thrown away. 

But generally, we consider the non-essential shell as an eduction of the essential constituents, the values, inside the core. It's an addition of non-essential ideas, most often a practical translation of the core values into a particular practical context. Thus an expression is an eduction of the values to be found inside the kernel.Example. A Buddhist monk is nearly always dressed with an orange cloth, one shoulder naked, bald, sandals without soks. One sees often Europeans, converted to Buddhism, starting to wear those same garments, apparently because an otherwise dressed Buddhist couldn't be a real one. The  garments and other external details are the eduction, the essentialcore being an aspiration for simplicity and a rejection of mundane pageant.

The principle of integration

To make an integration possible between two partial theories which are in fact an exaggeration of the value inside the kernel, we have to start with a retroduction of the element towards its kernel, its values. So we have to remove the shell, the eduction. At this moment, an integration is possible and easy:

 

Free the cores from the non-essential shell by a retroduction;simply combine the essential cores

and construct a new shell form the combined cores 

Integration distinguishes itself from the two other popular algorithms to resolve conceptual conflicts: choice and compomise.

The process of integration

Of course, in practice it's often less easy than we describe here, principally because:

(1) the boundary between essential values and non-essential eduction is not often clearcut, like the boundaries between cities and countries are not visible. Moreover, within a group of people, each can have his own preferences and interests. 

(2) as well in theories as in active projects ans decisions, the essential elements are not always conscious, which makes an integration process sometimes difficult, but approaching techniques (e.g. cyclically try and evaluate) can be used.

(3) at several moments in the process of integration, creativity is needed. But creativity can't be provoked on command, and is most often unpredictable. This means that the integrative method can offer neither a quasi-logic nor quasi-mathematical method, none exact paradigm, as traditional exact science seems to do. 

However this is a false impression of the so-called exact science. The first and most important stage in developing exact scientific theories, the formulation of a hypothesis to be tested, is mainly inductive, and to a certain degree intuitive and unconscious. Einstein didn't use any specific, exact paradigm to develop his hypotheses. But immediately afterwards, the deductions and practical applications can be tested on an experimental and mathematical way.

This makes the process of integration a little bit more complicated, but it remains essentially the same.

In practice, there are 2 possible kinds of application fields:

(1) conceptual integrations, e.g. an integration of behavioristic theories and psychoanalytical theories, making an integrative agreement with friends planning a vacation.

(2) factual  integrations: e.g. how to make an integration of a mobile phone, a camera, a music player, a portable computer and a portable torch. 

Methods and tools for integration

1. Direct method

This procedure is analytical. In some cases the core values are easy to discern. E.g. in a strategic plan, commercial, political or military, one knows which are the objectives. An integration of a (great) number or suggestions seems easy to realize, because the criteria (the objectives) are explicit.

Example: Induction of an hypothesis, an acceptable explanation for bad school results.

Example: Deduction of a common project e.g. vacation for the family: what are the underlying needs for each conflicting proposition

2. Indirect methods

Often, direct analysis is difficult. Then an indirect method of stimulating the inconscious integration process is used. These methods don't guarantee an easy integration, but accelerate the unconscious intuition. In fact, it is a rapid cycle of inspiration of elementary ideas, and attempts of integration. These attempts never succeed from the first time, but by the next cycles the intuition and inspiration generally are more successful.<i

a) schematizing: as many ideas, suggestions, proposals, as 

possible are collected, and one tries to schematize them into "logical" groups. After a certain time a possible underlying system becomes apparent, and each attempt is inspiring for the next cycle. After some cycles, the existence of new categories becomes apparent, even if no ideas are yet available to fit in these categories,

 

b )matrix method: if one doesn't have yet many ideas about detailed aspects of a system ons tries to develop, but rather variants, one could try to discern some major aspects (e.g. in music: rhythm and harmony), then classify the variants along the major aspects. The ideal form probably is a combination of the several dimensions, each in a maximal developed form. The attempt to classify the available variants along the original aspects probably will help to discover aspects that weren't yet conscious.Example: the "ideal" music, projected out of a classification of the different existent musical styles Example: an ideal school system, projected from several educational systems, as well schools as other systems e.g. youth movementc) corpus method: in this method a complete (as complete as possible...) theoretical logical scheme is developed, outside the traditional schemes of a theory. This implies e.g. that one stops to speak about integrative psychotherapy, but at least about integrative psychology.

At this moment our Corpus of Integrative Psychology has this structure:

1. basic sciences: (a) general systems theory, (b) logics, (c) brain functioning
2. individual psychology: (a) general processes, (b) pathological (= sub-optimal) functioning, (c) optimal functioning
3. group psychology: (a) general processes, (b) pathological social functioning including history, (c) optimal functioning, ideal society The interaction between single theories and the general classification of the corpus is so inspiring and productive, that we decided at an early stage that no new theory or therapeutical method could be developed without situating it critically inside the corpus.

 

(1) First of all, it is usable for a rapprochement between differing theoretical orientationsThis is the most popular meaning of integration, for many the only meaning.

(2) Integration as a way of thinking, the “third way” after choice and compromise, which are the most frequently used. In this process we discern the stages of retroduction against eduction, synthesis of the kernels of the concept, and recombining. Some important conditions for this process are explained. Kant and Hegel already introduced this process in the 18th century, but its utility was largely disregarded.


(3) Integration as the essential tool in (good) communication processes, hence being the most useful tool to teach in couple, family and group therapy<

 

(4) Integration as the factor that makes one's life either healthy or pathological. Psychoses and neuroses (and psychopathy) could be explained as ways to avoid integration, and attempts to pursue conscious and unconscious choices.

(5) *Perhaps the most important:* Integration as a means for scientific research. It enables "plausible" scientific research in the field of the alpha and gamma sciences, while “exact” science never really succeeds in those fields.>

The “pre-scientific” thinkers, from the ancient Greek and Alexandrian to the Renaissance scientists onwards, intuitively used the integrative method, and consequently even discovered the "exact" scientific method. Modern concepts such as Evidence Based Practice and Qualitative Research are in fact intuitive attempts towards this integrative ideal. 

(6) The unconscious application of integration in creativity, and its importance for arts and research. (7) Integration as the way the brain functions, far away from the Cartesian and rational myths.

(8) Integration as the essential process used by cosmic evolution, of which nowadays 9 stages are known, the present psychosocial stage being the ninth. Both Pierre Teilhard de Chardin and Julian Huxley used the notion of "convergence”: their word for "integration". Teilhard's most loved motto was "What emerges merges" (Tout ce qui monte converge)

(9) Integration as the central process in the collaboration and synergy of "democratic" groups and societies, enabling peer to peer production and consensus governance. Is the art of integration the most important condition for politics after democracy? 

Integration as a scientific method

We discovered at an early stage that the method of integration is an excellent tool to enhance the quality of theories and therapies. We are confronted with the fact that the traditional scientific method, so successful in natural sciences, is practically of no use in psychological, social, political and philosophical domains. We were hoping during two centuries or more that  "our" psychology would become "scientific" one day, but we are still frustrated. Apart from "measuring" that patients feel better when exposed to certain therapeutical methods, and the "measuring" of symptoms including depression and anxiety, there isn't much available that is accepted by the majority of professionals. Even the results of comparison between different approaches is poor, and correlations are more present between result and personality traits of the therapist, than with aspects of the method. Moreover we will try to explain why most of those comparisons are senseless.

Of course, dualistic notions as exact/inexact, true/false, proof/falsification, very popular and apparently fundamental in traditional exact science, have to be replaced by more relative notions as more/less probable.

Let's refer here to the approach of Larry Laudan , who tried to solve the conflict of Kuhn's and Popper's approach to scientific method. Popper stated that the discovery one "counterexample" was enough to immediately reject a theory, KuhnLakatos and Laudan are more careful, and plead for nuance.

It is our hypothesis that if a greater number of divergent theories and visions are integrated, the probability of the integrative theory based upon them, is higher. Therefore, we looked for safeguards that would secure the integration process. Five factors seemed essential;
            1) All available partial theories, or at least as many as possibe, have to be intregrated into the integrative approach. Of course, each partial theory itself has to be maximally secured, where possible with traditional "exact" scientific methods, if applicable.
            2) Deductions have to be made with fundamental sciences including General Systems Theory, Logics and Brainscience, including the Psychopharmacological theories.                                                              
            3) Even hypotheses out from non-scientific approaches of human sciences, e.g. literature, popular wisdom, can be taken into account 
            4) Every theory and technioque has to be situated within de Corpus of Integrative Psychology. During this operation, as well the theory and its components, as the corpus itself will probably be adapted and refined.
            5) Every theory that was utilized to develop the integrative theory, has to be reconstructed by reduction from the integrative theory, the reduction consisting in dropping or limiting the value of factors that are not relevant in certain cases. The mnemonic word alfunocore can be used for easily remembering those 5 conditions.

In our case, the integrative corpus, still in development, is published since many years (in Dutch) on psy.cc/0000.html

An integrative theory is acceptable and highly probable, if these five conditions are met.

Scientific publications are to be built on the same conditions. A traditional publication with a few pages and some statistically proved graphs and a lot of references to authors that say the same, is not sufficient. In fact, an integrative scientific publication has always to be situated within a corpus of integrated theories. It gets its justification from that corpus, and renders this integrative corpus more probable, the links with reality being the results of each practical theory and treatment. All traditional references concerning experimental applications and referral to other publications are present, but much more is needed to be a true integrative scientific publication. Sticking to the level of traditional academic science could hamper us to  develop an integrative psychotherapy and resolve the fragmentation of psychotherapy schools.

Due to the same reason short communications on scientific meetings are rather difficult, at least if one wants to use the integrative scientific method.

A comparison with the traditional "exact" scientific method

In fact each theory is developed through 3 stages: (1) collecting related data, (2) generating one of more hypotheses to explain the observations, and (3) proving or rejecting these hyptheses by testing their applications against experiences and experiments.<

By using the "exact", mainly mathematical tool, traditional science was able to reduce its attention to the third stage. The most important stage, the generation of hypotheses, could be left to the genius of some "discoverers" and "scientists", to the point that this moment even didn't seem to exist. All scientific exercices begin with the sentence "given a=b+c, how can we prove or refute it", as if all hypotheses could be chosen from a wide collection of available theories. Also the first stage, the collection of data, could be highly selective: just picking the data that are useful for the theory. In scientific research e.g. the publication of failures, that could contradict popular theories, is very rare.

As in psychology and psychiatry the possibilities for exact measuring the emotional and mental processes we are describing is very limited, if any, our general deceiving feeling that our knowledge is not very scientific, and that we have to wait till other sciences, perhaps neurology, will fill the scientific gap, is not justified. The integrative approach can strengthen the first two stages of the scientific process, most often neglected by traditional science: collecting the data by including all fragmented theories into the integration, and consciously elaborating integrative hypotheses. These two stages are so important that a weeker application of the third stage, is acceptable because it largely compensates. And don't forget that all traditional scientific data are always included in the integrative hypotheses. Integrative science doesn't replace exact science, it completes it. From a historical point of view, it is interesting to remember that the pre-renaissancistic science worked exactly the same way as we describe here, because they generally lacked the measuring tools we have. And nevertheless, they did a great job! They even invented exact science...

Some successful achievements of integrative research

1. Integrative classification of therapeutical schools by intervention level
2. An integrative concept of depression
3. An integrative approach to psychopathologies

1. An integrative classification of psychotherapeutical schools by level of intervention

Several methods were already used to realize an integration between the dozens of psychotherapeutical schools and approaches available nowadays: the research on non-specific, general and common factors, the translation of the concepts of one school into the wordings of the other school(s), etc.

We propose a complimentary kind of approach. In the process of psychotherapy we could distinguish 4 well defined levels of psychic functioning: (1) observable symptoms, (2) interactive roles, (3) personality frames, and (4) the ability to autonomously influence/transform the functioning of one's personality, which we call the autonomy of the person. In this model, it appears that the several psychotherapeutic approaches just focus and target one level: level (1) behavior therapy, (2) system, communication therapy and family therapies, (3) psychoanalysis, CBT, TA, Rogerian Approach, focusing, and (4) personality training and "growing" groups. Also remarkable is that the "organic" treatments aim at the same levels: (1) tranquillizers and incisive neuroleptics, (2) -not yet available apart from drugs and alcohol-, (3) antidepressants and socializing antipsychotics, but also meditation and ECT, (4) some modern antidepressants including the revolutionary tianeptine, amineptine.<

It appears that the so-called fragmentation of psychotherapeutic schools is much less intriguing and confusing than generally accepted. With this scheme, the "mystery" of these conflicting ways of thinking largely disappears, and combinations -a step towards real integration, clinical as well as scientific- become obvious, taking also into account that each one-level therapy inevitably influences the processes on related lower and higher levels. It also shows that medication and other organic treatments, when properly handled, don't conflict at all with psychological therapies, but are rather synergistic ways for improving treatment. 

Moreover, this model suggests why comparison between the different psychotherapeutical models isn't very important, because they are working on different levels

This scheme is also a very practical guide for integrative psychtherapy as it is practiced at our centers: one starts at the symptom level if necessary, e.g. with symptom oriented behavior therapy, switching progessively from negative mental experiences (classical behavior therapy) to positive autosuggestions (in autogenous training style). Sometimes the client is already partially conscious of the nature of his problems, and the treatment can start at level 2 or 3. Progressively one  goes to a deeper level, as long as cooperation and motivation are adequate, ideally to conclude with personality training in group, where autonomy techniques are tought.

2. An integrative concept of depression

By bringing together a number of observations from different related psychological, neurological, psychopharmacological, genetic fields, we were able to develop a novel theory on the nature of depression, with useful implications for therapy.

Some of the observational data (this list isn't complete here):

- after more than two weeks of dream deprivation, e.g. by barbiturates, depressive symptoms appear. One of the two important functions of dreaming, apart from memory conservation, clearly seems to be the processing and recovery from frustrations

- there is still the mystery of the time lag in the effect of antidepressants: minimal 2 weeks. Sometimes biochemical explanations are proposed, but they aren't very convincing

- stopping antidepressant treatment too early provokes a depressive relapse after (more or less) 2 weeks

- even if the anidepressive effect of an antidepressant isn't observable in the first weeks of the treatment, the patient very often reports changes in his dreams from the first days on, as well as increased irritation and agressiveness

- the temperament circuits described by Cloninger are also operated by neurotransmitters, as by coincidence by the same as the famous three from the monoamine theories: DA, NA and Ser.

- the great majority of depressions are masked depressions, i.e. depression with week or without sadness. The percentage is still higher in endogenous depressions

- on psychological tests including the MMPI, a lowered energy level (9. Ma) is the most striking scale deviation, often more than depressiveness (2, D)

- in mammals, including rodents, there is no typical animal model for depression, which makes research on animals more difficult, in contrast with the studies on tranquillizers and neuroleptics, where it is easy to find animal analogies for human symptomatology. Only in the SDS-test (social defeat stress) we observe that after 2 weeks of different levels of anxiety, depression-like symptoms appear.

- when an animal. living in a herd, doesn't get enough reinforcement strokes from the group, after 2 weeks it switches to a low-profile behavior, to avoid being dumped by the group, which would make it too vulnerable to predators

- disorders as ADHD, ADD, ASS, Asperger, etc. react very well to antidepressants, often better than to amphetamines and (for ASS and Asp) to neuroleptics. This medication of course doesn't address the primary neurological cause, but apparently a secondary, masked depression has installed itself, and progressively becomes a more important cause for the primary disorder.

These facts inspired us, in the course of some years, to develop an integrative theory of depression:

As a mammal, humans also have the low profile instinct to protect themselves. This instinct is switched on, if a lack of strokes and social reinforcement occurs during more than two weeks. If partial redeeming is possible in the meanwhile, this frustration period can be extended, but two weeks is the minimum. When antidepressants are administered, the temperament is restored to its normal state and balance, and dreams in the subconscious restart to recover from this state, by processing the frustration e.g. with more aggressive dreams. After two weeks (at least), the low profile instinct can be switched off.

When the biological low profile state continues, a secondary neurotic reaction installs itself, comparable to learned helplessness (LH), strong in humans, but also present in other mammals.

At several points in therapy, these notions can help the therapist, not only for psycho-education, but also to use more frequently antidepressants, to tackle the resistance of many patients against "these artificial and chemical drugs", and to check the pharamceutical response long before depression disappears.

3. An integrative approach to psychopathologies

Far from the behavioristic maze of the DSM, and more in harmony with the intuitions of psychotherapists, we developed an integrative scheme for psychopathology.

Two major categories: 

1. Pure psychological pathology: with only psychological symptoms

2. Complex psychopathology: complicated by somatic symptoms and causes (but organic and biochemical factors are included in the "pure"). The pure psychological pathologies: acute: for some days or weeks, or 1-3 months.
chronic: generally lasting more than 3-6 months. Very often, but not always, a process of neurotization leads to chronification

Level 1 (fusional, psychotic, i.e. leaving reality): 

acute: psychosis, intoxication, decompensation of manic and depressive peaks, extreme agressiveness, murder, suicide including suicidal aggressiveness
chronic
: schizophrenia, paranoia, chronic delusional and hallucinatory psychoses, identity psychoses

Level 1/2: borderline psychotic decompensations

Level 2 (oral)

 

acute : anxiety and panic attacks, beginning (months) of depression

 

chronicdepressive neurosis, hysteria, phobia, anxiety neurosis, hypochondria

Level 2/3: Oedipal conflicts 

Level 3 (anal)

acute: agressiveness, decompensation of genital-hysterical neurosis

chronicobsessions, OCD

Level 3-4: psychopathy

Level 4 (narcissistic)

acute: hypomania

chronic: narcissistic and phallic personality disorders

Level 4/5: pseudogenital personality: fakes genital functioning with narcissistic drives

Level 5 (genital) -- no problems: hamonious relationships, happiness

The complex psychopathologies

Somatoform pathologies

- neurovegetative stress symptoms

- psychosomatic diseases

- body  function disorders: toxicomania, alcoholism, anorexia-obesity, sexual disorders

Mental disorders

- Minimal Brain Damage: ADHD, ADD, ASS, Asp

- Intelligence disorders

-- Congenital: oligophrenia, low IQ

--Acquired: posttraumatic, psycho-organic

- Dementias

The advantages of this classification are mainly for psychotherapeutic intervention at the personality level. It shows which are the different levels  that are to be transited, e.g. in a mourning process.

 

REFERENCES / LINKS

http://en.wikipedia.org/wiki/Temperament_and_Character_Inventory

http://en.wikipedia.org/wiki/Evidence-based_practice

http://en.wikipedia.org/wiki/Thomas_Kuhn

http://en.wikipedia.org/wiki/Imre_Lakatos

https://en.wikipedia.org/wiki/Larry_Laudan

http://en.wikipedia.org/wiki/Abraham_Maslow

http://en.wikipedia.org/wiki/Karl_Popper

http://en.wikipedia.org/wiki/Research_Quality_Framework

http://en.wikipedia.org/wiki/Social_defeat

http://en.wikipedia.org/wiki/Pierre_Teilhard_de_Chardin

http://en.wikipedia.org/wiki/Thesis,_antithesis,_synthesis

A corpus of integrative psychology, Kris Roose (in Dutch, since 1980) psy.cc

Kris Roose, psychiatrist, psychotherapist, ECP. kroose@gmail.com
Founder (1978) of the Academy for Integrative Psychology, Gent, Belgium.
President of the Belgian-Dutch Society for Integrative Psychology and Psychotherapy