138 154 1 pb

International Journal of Existential Psychology & Psychotherapy

Integrity: A Way In and Out of the Existential Abyss

Nedra R. Lander School of Psychology & Faculty of Medicine University of Ottawa, Ottawa, Ontario, Canada Danielle Nahon* Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada * Please address correspondence to: Dr. Danielle Nahon Suite 222 250B Greenbank Road Ottawa, Ontario Canada K2H 8X4

Abstract The Integrity model (Lander & Nahon, 1992, 2005; Mowrer, 1953, 1964a) focuses on the search for a meaningful life as based on honouring our values, and whether one is willing to pay the price for the rankings of one’s values. This theoretical and clinically-based paper offers an Integrity model perspective in addressing issues of meaningfulness and well-being in the arenas of (a) men’s workplace stress, (b) post-traumatic stress, and (c) dying well. The manner in which the Integrity model provides a vehicle for individuals to make their way in and out of the existential abyss by choosing to act in accordance with their values, www.ExistentialPsychology.org

Volume 3, Number 1 January, 2010

thereby finding ways to live with a sense of wholeness and joy that results from one’s earned Integrity and self-respect, will be explored.

Keywords: Integrity, Values, Death, Meaning, Ageing, Occupational stress, Human males, Posttraumatic stress, Death acceptance In our view, living with Integrity, which is operationally defined as honesty, responsibility, and emotional closure or community (Lander & Nahon, 1992, 2000a, 2005; Mowrer, 1953, 1964b), is a double-edged sword.

As we grow in our own level of Integrity, we grow into an ever-evolving pattern of angst which stems from the organismic awareness that our present level of Integrity is no longer good enough–necessitating a re-entry into the existential abyss.

This existential abyss is the crucible where the self is forged. ... In those dark hours before dawn, we face the decision: (a) to live a full and meaningful life; (b) to die–either by suicide or by a life unlived; or (c) to choose madness, thereby escaping the self by plunging into the abyss of the psychotic core. (Lander & Nahon, 2005, p. 52) From the Integrity model perspective, we are able to undergo profound changes in our character make-up and personality based on our choices, as we decide to face this existential abyss.

One stands, “naked and alone”, reflecting on life, its meaningfulness, one’s values, daring to encounter the self in all its fears, 1

International Journal of Existential Psychology & Psychotherapy

anxieties, aloneness, and to encounter a leap of faith into its potentials. This ability to look at the self with what Mowrer referred to as a radical honesty with the self, really seeing who one is with all one’s frailties, vulnerabilities, and unfulfilled potentialities, is the essence of Integrity. It means having the courage to assume the discipline of being responsible for the self to the self, to those significant others in one’s life, and to the world at large. If one chooses the affirmation of life and living, with all its terrors, one is able to close the space with self, and from that self-closure to venture forth, beginning to close the space with others.

(Lander & Nahon, 2005, p. 52)

We were very honoured that our three papers (Lander & Nahon 2008a, 2008b; Nahon & Lander, 2008a) were accepted for presentation at the 5th Biennial International Conference on Personal Meaning in Toronto, Ontario, hosted by the International Network on Personal Meaning (INPM). The goal of the INPM is that of “advancing health, spirituality, peace and human fulfilment through research, education and applied psychology with a focus on the universal human quest for meaning and purpose” (International Network on Personal Meaning, n.d.). Our three papers presented an Integrity model perspective in addressing the theme of a universal human quest for meaning and purpose in working with issues of (a) men’s workplace stress, (b) post-traumatic stress, and (c) a meaningful death. The Integrity model is based on the work of the psychologist O. Hobart Mowrer, beginning with his early seminal focus on values and on challenging the Freudian topology of development in the Zeitgeist of the 1940’s and early 1950’s.

www.ExistentialPsychology.org

Volume 3, Number 1 January, 2010

Mowrer’s work created what Corsini (2001) described as a “Copernican revolution” (p.

332) in understanding human nature and the plight of being human. The Integrity model focusses on the search for a meaningful life as based on honouring our values, and whether one is willing to pay the price for the way one ranks one’s values.

This theoretical and clinically-based paper offers an Integrity model perspective in addressing issues of meaningfulness and wellbeing. Using material drawn from clinical case studies, we will examine the applicability of the Integrity model in the arenas of (a) men’s workplace stress, (b) post-traumatic stress, and (c) a meaningful death. The overall theme of our discussion will be the unifying principle of living well and dying well with Integrity’s capacity to open the self up to the choice to experience awe and joy either in spite of or because of the context of our lives.

This often confronts us with the terrifying choice of whether or not to enter the existential abyss. In time, this journey becomes less terrifying and more of a dreaded annoyance as one becomes aware of the fact that an increased level of one’s Integrity ironically propels one towards the necessity to yet again leap into the crucible of the abyss.

The Integrity Model: Philosophical Underpinnings The Integrity model of psychotherapy is an existential, holistic, and value-based theory which offered the first non-pathologizing and wellness-based perspective towards psychotherapy and daily life. Based on the psychologist O. H. Mowrer’s Integrity (Therapy) Group approach which he spearheaded from

2

International Journal of Existential Psychology & Psychotherapy

the mid-1940’s until the mid-1980’s (e.g.

Mowrer, 1956, 1959, 1961; Mowrer & Vattano, 1976), the Integrity model views the human being as a valuing animal. Stress and distress arise from a failure to live up to one’s own values and value rankings. Integrity is defined as a three-legged stool of honesty, responsibility, and community (Mowrer, 1953, 1964a) or closure of the psychological space between self and others (Lander & Nahon, 1995, 2000a, 2000b). Anxiety arises not from the fear of catastrophic events, but rather from the fear of repercussions of one’s past fraudulent behaviours. Guilt arises from the violation of one’s values and the discrepancies between those values and one’s actual deeds done rather than feared. Self-esteem is earned for and by the self by living with Integrity and in accordance with one’s values. All relationships are guided by contracts, overt or covert; Integrity means honouring all of the contracts in our lives (Lander & Nahon, 2005).

Hunt (1984) described Mowrer as “one of the major figures in the self-help movement” (p.

913, p. 6). He suggested that Mowrer “played a pioneering role in the conceptualization and development of the key therapeutic concepts of therapist self-disclosure, therapist authenticity, and the role of morality in psychotherapy–his work preceding that of both Allport and Erikson” (Lander & Nahon, 2005, p. 6).

Mowrer (1964b) acknowledged that his work had been inspired by Sullivan’s emphasis on interpersonal relationships, and as such was developed in parallel with other frameworks, including Frankl’s “will to meaning” (Frankl, 1955). These as well as Adler’s (1964) concept of social interest and Jung’s (1933) emphasis on the “importance

www.ExistentialPsychology.org

Volume 3, Number 1 January, 2010

of ‘human decency’ and the pathogenic dangers inherent in deception” (p. 32) were all based on a breakaway from the traditional Freudian view, embracing instead the importance of interpersonal relationships and the positive aspects of morality (Mowrer, 1976). ... For Mowrer, therapy called for a return to community through improved communication with “significant others” (Mowrer, 1958; Sullivan, 1953) ... (Lander & Nahon, 2005, p. 6).

The Integrity Model and Working with Men Dealing with Workplace Stress In 1994, the World Health Organization identified workplace stress as a global epidemic (Lander & Nahon, 2005). In our view, stress in the workplace reflects an Integrity crisis stemming from a clash of values, often both internal and external. If such a clash remains unresolved, it will become manifest through symptoms of distress and/or dis-ease (O. H. Mowrer, personal communication, 1969) which might propel an individual to seek help. The severity of the clash will be relative to a given individual and to their value system, and to the magnitude of the difference between one’s values and one’s behaviours.

Working with individuals grappling with issues of workplace stress, we find that the perspective of understanding of stress and crises as reflecting a clash of values is helpful in assisting individuals to understand the self in relationship to the world and to the structures in the workplace which are creating some of the value clashes. Individuals quickly learn that they can take back their internal locusof-control (Rotter’s 1966 term) by increasing

3

International Journal of Existential Psychology & Psychotherapy

their level of Integrity and their fidelity to their value systems.

Men in the workplace are increasingly manifesting the distressing impact of stress on their increasingly poor physical and mental health (Lander & Nahon, 2008c). Because of space, we will focus on the latter with the acknowledgement that one sphere holistically impacts others. The literature on psychotherapy on men has portrayed men as being poor candidates for both engaging in and working well in therapy, due to what Nahon & Lander (1998, 2008b) have characterized as the “myth of the emotionally defective male”.

Nahon & Lander (2008, in press) found that when group psychotherapeutic services were advertised in a manner that reached out to men in a respectful manner in keeping with the values of the Integrity model, men responded through help-seeking and viably utilizing therapeutic services. In almost four decades of working with men in individual, couple and group psychotherapy, we have found that men have responded in a profound and positive manner to the Integrity model perspective (Nahon & Lander, 1992, 2008b; Lander & Nahon, 2000a, 2008c). Contrary to the literature’s at times negative portrayal of men and masculinities, men do possess a deep sense of morality. We have found that their valuing of being honourable, which may make men vulnerable to being devalued by some for being “unmasculine” or even “a loser”, provides a profound therapeutic resource which, to paraphrase Robert Bly (1990), comprises the “key under the pillow”, in other words the process of reclaiming the self by finding the key under the pillow... . They come to understand that integrity, much as one’s

www.ExistentialPsychology.org

Volume 3, Number 1 January, 2010

personal power, cannot be given to them; it must be reclaimed from within and thus cannot be stolen either by or from someone else. One must openly pronounce to the self that one’s level of integrity and one’s personal power is exclusively one’s own.

(Lander & Nahon, 2000a, p. 139) Men have traditionally learned society’s value of the “strong, sturdy oak” paradigm for being male and masculine (Brannon, 1976). Consequently, they have learned to suffer in silence when undergoing emotional and relationship crises and dealing with difficult emotions.

This places them at high risk of missing the eleventh hour of seeking help. The twelfth hour comes quickly and without hope, with the dawning existential abyss of meaninglessness, and, sadly, with a successful track record of taking their own lives (Nahon & Lander, 1992, 1998, 2008b). In working with men in therapy in both in-patient, out-patient, and community settings, the Integrity model’s non-pathologizing view of their pain and angst is novel enough to pique their interest.

The model’s emphasis on encouraging men to value their personal values, and especially honour, allows men an immediate sense of a light at the end of the tunnel and a rekindling of hope in being able to work towards finding a solution. They readily become willing to own their fifty percent of the accountability for the problems and impasses in their lives, and that inherent in this lies the very solution to finding their way out of the existential abyss. They come to see that this embrace of honestly assuming responsibility in aggravating an aggravating situation is a reclaiming of their personal power to choose how to get out of an untenable situation and liking the self in the process.

4

International Journal of Existential Psychology & Psychotherapy

As they continue to work with the concept of the external value clashes in their lives, and their choices of addressing these as reflecting an internal clash of personal values, they come to understand that it was this clash that had rendered a bad situation meaningless in the past. Now that their sense of honour has become validated and restored as a highly ranked value for being-in-the-world, including the world of work, they come to understand that some of their behaviours have reflected personal violations that were even more profound than value clashes with others.

Our query is usually: “So, what are you going to do about it?” The only viable response becomes one of changing one’s behaviours in order to reflect one’s values. This is both simple and difficult, as human nature seems to prefer that others rather than the self adapt and change. However, the concept of price tags makes the suffering of these growing pains worthwhile when those are compared to the alternative prices that one would need to pay.

A case in point: Charlie Charlie was a mid-level public servant in his early forties, referred by his family physician for stress due to burn-out from high levels of incapacitating anxiety in the workplace. We were more credible to him since Charlie already knew of our work with the Men’s Clinic from 1984 to 1994 (Nahon & Lander, 1992, 1998, 2008b). He could acknowledge that he had bought into society’s pinning on of the badge of honour whereby as a man, he would just “suck it all up”. Charlie was asked to list his values, and to outline his past choices of behavioural responses. He was able to see that a number of those behaviours were clashing www.ExistentialPsychology.org

Volume 3, Number 1 January, 2010

with his values, especially that of being honourable.

By defining his current crisis as being one of Integrity, Charlie realized that he too had played a part in the situational and contextual dynamic of the perceived impasse. That knowledge provided the personal power for Charlie to choose to respond by acting differently. He discovered that freedom from despair would come as a result of the choice to be faithful to his own values, and thus living meaningfully and with a sense of wholeness and joy that results from one’s earned Integrity and self-respect.

The Integrity Model and Working PostTraumatic Stress The diagnosis of Post-traumatic Stress Disorder (PTSD) acknowledges the struggle of individuals to try to make sense of and to find a meaningful rationale for the personal traumatic impact of natural disasters (e.g. tsunamis, famine, infectious disease epidemics), human disasters (e.g. transportation accidents, genocide, or terrorist attacks), abusive relationships, poverty, environmental destruction, and the evil in every day life (Lander & Nahon, 2005). In our post 9/11 world, working with those grappling with PTSD has become an increasingly key issue for therapists working with individuals ranging from military personnel returning from conflicts overseas to victims of terrorism and of abuse.

Both in general and in working with PTSD, the Integrity model does not work within the DSM-IV (Diagnostic and Statistical Manual of Mental Disorders) (American Psychiatric Association, 1994) or ICD-9 (International

5

International Journal of Existential Psychology & Psychotherapy

Statistical Classification of Diseases and Related Health Problems) lexicon of labels as, for us, these look at the human being from the half-empty side of the glass (du Plock, Lander & Nahon, 2008). It does not emphasize the use of psychiatric labels nor jargon in discourse, inviting instead the use of one’s own words and one’s own voice. Consequently, it does not encourage the concepts of victim and survivor. Personal power is defined as “the willingness to own 100 percent of one’s own 50 percent in any given situation. One always has power; the challenge is how best to use it” (Lander & Nahon, 2005, p. 129).

We invite individuals to “look at how they have used their personal power and whether they have given it away or allowed someone else to take it. If this is the case, they must find ways to reclaim it” (Lander & Nahon, 2005, pp. 129-130).

The understanding of the self in dealing with trauma, which by our definition has a powerful valence of meaninglessness in such a chaotic and meaningless world, is a philosophical rather than a psychological enterprise. As we segue from the workplace to the concentration camp as one extreme example of a horrendously unfathomable traumatic context, the consideration of one’s Integrity might initially be perceived as entering the theatre of the macabre. Yet in this very arena of extremity and absurdity, the existential crisis of Integrity remains the same. Once again, one discovers the struggle to find meaning based on whether or not one is willing to pay the price for one’s value system. Through this struggle, one can find the willingness to pay this price, even with joy, as one quickly realizes that not to pay it would mean to pay another price which is too costly and involves www.ExistentialPsychology.org

Volume 3, Number 1 January, 2010

a personal violation by the self which is not worth it as it is meaningless.

Case Example: Ari Ari, a successful man in his mid-fifties, was a concentration camp survivor. He had become very depressed, and was referred to me after a second serious suicide attempt. He had spent several years seeing psychiatrists and other mental health professionals who had tried to help him resolve the horrors of his concentration camp experiences. These included having been scheduled for death; however, he had managed to slip out of line. When the day’s tally did not add up, there had been an attempt, to no avail, to find the missing person.

It was announced that if the missing person did not show up, 49 others would be taken in his place. Ari remained silent, and 49 others died.

After the war, Ari was busy building up a successful business. At the peak of his success, the memories and guilt of his war-time experiences returned. The therapists he saw had tried to absolve him of his guilt by contextualizing it in the horrors of the concentration camp experience. He was offered the explanation that individuals under stress can do things that they would otherwise never do.

Ari was initially skeptical about seeing me as not only was I not as well known as some of his former therapists, but I was still a student.

After describing his experiences to me, we sat in silence for a while. He broke the silence and asked me what I thought of him.

I took a deep breath, and told Ari that I thought he was as guilty as he thought him-

6

International Journal of Existential Psychology & Psychotherapy

self to be–if for no other reason that as a formerly observant Jew, he had committed the crime and sin of having bought his life with the lives of others. I suggested that taking his own life would not solve anything, and only create one more concentration camp fatality.

The only solution would be for him to make amends so that 49 others did not die in vain.

Ari smiled with tears in his eyes. He thanked me for affirming his guilt. He told me that like Cain, his punishment would be to live.

However, he would devote his time and money to helping children who had been victims of crimes, especially of war crimes. I only met with Ari once. Two months later, he called and told me that he had liquidated his assets and was moving overseas to work with children of war. (Lander & Nahon, 2005, pp.

133-134) Ari’s case offers a poignant example of one’s lack of Integrity as stemming from the violation of basic personal relational values structures, which can lead to suicide attempts. Ari was able to discover that it was the meaningful death of 49 others that would allow him to live a meaningful life. Taking his own life would have done nothing to affirm the loss of their lives as having been meaningful.

The topic of the Holocaust or other genocides is fraught with intense emotions and value challenges. However, if one reads Victor Frankl’s (1963) account of survival in the concentration camps, one hears the voice of a search for meaning amid meaningless. For us, it speaks of a quest for one’s self and one’s personhood midst the horror and madness. It is the choice of transcending the pull of becoming defined by the context, versus holding www.ExistentialPsychology.org

Volume 3, Number 1 January, 2010

true to one’s self and one’s values, in other words to walk the talk and pay the price, as, regardless of one’s choices, a price will need to be paid. Integrity never comes cheaply and may indeed cost one one’s very life which makes for a meaningful death amidst meaningless slaughter, versus paying the price for having walked another path that may not have been true to one’s values. Looking at Man’s Search for Meaning: An Introduction to Logotherapy (Frankl, 1963) from an Integrity model perspective, one can see that those whose lives were physically spared fell basically into two groups: those who kept their basic level of values and Integrity intact and those who did not. In general, our work with those with severe PTSD indicate that these individuals emerge from their experience deeply scarred. However, those whose struggled to maintain some behavioural and attitudinal fidelity to their sense of Integrity tend to bear less scar-tissue, thus facilitating the healing process. Although individuals in both cases experience PTSD, they require a different path of reclaiming their sense of self and of personal meaningfulness about their future.

The caveat to the above discussion, and perhaps to the discussion of trauma in any context, is the reminder that what is experienced as a trauma by someone is a function of an individual’s personal Integrity or value system. Consequently, we must become wary of thinking that something is not traumatic by our values when it is so for others, or vice versa. Since the Integrity model reflects Mowrer’s and our historical behavioural roots, we view feelings as responses and never stimuli (Lander & Nahon, 2005). Consequently, if a person feels guilty, they indeed are guilty 7

International Journal of Existential Psychology & Psychotherapy

by their own values. The challenge is to figure out what one is really guilty of. Ari had been unable to flee from his guilt despite his frenetic pursuit to achieve his current financial success. He saw that his past behavioural choices had cost 49 lives. He quickly realized that, ironically, his death would further the meaninglessness of theirs, and of the life he had bought at such a high price. These realizations of his guilt and the subsequent choice to live gave him an opportunity to give meaning to their deaths. While the choice of one’s life at the cost of 49 created such an untenable meaningless existence that the pursuit of amassing wealth could no longer be meaningfully sustainable, the solution for Ari was to value those 49 others and make sure that they did not die in vain for him by finding a meaningful way to continue to live his life until G-d chose otherwise. The choice to do good amidst the ravages of war in global outposts gave him the chance to make symbolic amends and to engage in meaningful, value-laden choices. With this decision he felt a return to a former sense of relationship with G-d from whom he had become estranged.

The Integrity Model, and How to Die Well and Meaningfully Death and its companion, ageing, are realities that require a great deal of time, energy, and often great financial expense and angst to deny. This denial can lead to all sorts of symptoms à la DSM-IV, including burn-out.

Similarly, while an unsolicited illness may threaten both quality and length of one’s life, there are still choices to be made about how one chooses to do it as well as whether or not one chooses to “go by the book”. www.ExistentialPsychology.org

Volume 3, Number 1 January, 2010

Like all choices, this leads to other decision points. Death and dying are always about choosing whether or not to allow this process to become meaningful. If one chooses to do so, then one must re-examine one’s values, and thus one must often dare re-enter the existential abyss in realizing that some values will not be actualized, but that this is now an opportunity for other values to be re-ranked in order for life to become more meaningful. For some, it is a chance to see the divine intervention inherent in valuing a value or values that one had previously ranked lower.

It becomes a second chance to get it right.

Being invited to share this sacred journey with another, as we do with those who choose to enter into the therapeutic encounter, is an entry into the awesome, terrifying, humbling and joyous dimensions of what Buber (1961, p. 244) referred to as the “between”. We believe that for us as therapists, entering into such a between with another is not a choice to be made with a faint heart, nor with the certainty of truly “knowing” the route, as the individuals we have sojourned with would truly qualify as statistical outliers in terms of their failure to live up to the limitations of medical expectations.

This is a veritable and venerable existential arena in which we feel there are no boundaries other than the self and the self ’s soul’s journey into and out of the existential abyss’s crucible for final transformation to ease the final leg of the journey here on earth. Our role is one of being a travelling companion who will not be able to join the other in their final destination. Sometimes we are able to articulate this, sometimes it is articulated by the other in order to be sure that we know

8

International Journal of Existential Psychology & Psychotherapy

what we are agreeing to, and sometimes it is just understood; to verbalize it would somehow devalue the sense of community and between that is inherent in the encounter.

Although meaningfulness, fidelity to one’s values and Integrity are critical in all contexts, they are particularly critical in this sandbox.

With the existential appreciation of each individual’s uniqueness, we discuss the diagnosis of death’s eminence as comprising an Integrity crisis with the concomitant need for a value clarification including the choice of defying (medical) authority versus “doing as told”. Often, individuals are referred to us as they are deemed to be non-compliant with treatment. When told to go home, put things in order as soon as possible, and die, they have a wonderful feistiness that is interpreted as having anger management issues. Feistiness, non-compliance and anger are highly valued character and personhood descriptors for us.

This is the “grit” of Integrity: the struggle to define the self and live life (and death) on one’s own terms–i.e. in accordance with one’s values.

The clarification of honouring their fight to increase their longevity and their quality of life is contracted for. Individuals set the pace for this, and assume amazing responsibility for acting wisely to increase their life expectancy, and even, if possible, to live beyond the bounds of present-day knowledge. A colleague once described this a “conspiracy” against the medical system. This may be so; however, Integrity often asks us to be a marginal man/woman in order to be faithful to ourselves. www.ExistentialPsychology.org

Volume 3, Number 1 January, 2010

A case in point: Mike Mike, a brilliant professional in his midfifties with a new young family, was given an imminent death-date. Mike told me (Nedra) that he had no intention of dying, or at least dying before certain requirements, formulated in terms of his values, were met. We did visual imaging and briefly reviewed the Integrity model. When he was no longer able to come to the hospital to see me as an outpatient, I went to see Mike at home as I was fortunate to work with some wonderful psychiatrists who were willing to medically sanction this behaviour.

Mike would “report in” as to his value-fidelity between sessions. He reported minimal discomfort with chemotherapy and other major medical procedures, and required little or no pain medication. This got him a referral to see another psychiatrist to assess whether he really was psychotic and not aware of things. This made him furious, but he agreed that it would hopefully be a reality check for the referring doctor and his high value of “evidence-based knowledge” by providing him with some “new evidence”! Mike’s mental health was validated as he was diagnosed as being “remarkably sane”. He defied the experts and accomplished what he initially set out to do with me. He then “re-negotiated our contract” in that it was time for us to part and for him to journey this last leg with immediate family.

Mowrer’s (1960) notion of community is about relationships. He was one of the first to tackle the concepts of attachment and abandonment. From an Integrity model perspective, when attachments are secure, they are 9

International Journal of Existential Psychology & Psychotherapy

able to transcend time, space and physical presence. This results in an awareness that one is never alone in that relationship. When one loses a relationship–through death, although there is a deep sense of loss of the presence of the others, there is no experience of a gaping empty hole being left behind. Rather, there seems to be a fullness, and a gift of something precious having been shared and integrated.

This too often is a “secret” that is disclosed by the family, as though they are somehow guilty of not being pathologically devastated by the loss or sense of abandonment. Although they may be very sad and deeply miss the faceto-face presence of the other, they now have something else that is deeply palpable. It is a sense of awe, and of being left with a precious gift that makes their life richer and somehow more meaningful.

Discussion One needs a sense of Integrity in order to enter into the existential abyss. Integrity creates the crisis; one’s ever-evolving level of Integrity is the impetus to step into the abyss or crucible in order to grow in one’s meaningfulness. It is the willingness to enter into the existential abyss to meaningfully suffer in order to grow, that ironically becomes the conduit for finding one’s way out–whether the context is that of workplace stress, the horrors of the concentration camp, the last leg in the journey of life, or any other scenario. From the Integrity model perspective, the sense of meaninglessness, angst, anguish, despair, depression, anxiety, and paranoia that human being experience as so-called symptoms or inner voices are really reflecting crises of Integrity. The more severe the crisis, where www.ExistentialPsychology.org

Volume 3, Number 1 January, 2010

even escape via death is seen as viable, the greater the Integrity crisis.

The Integrity model invites individuals to look at whether their currently held values truly reflect something that they value or not, and whether it is a personally-held value or someone else’s. They also come to appreciate that their value system is at the very root of decision-making and of their choice of behaviours.

As individuals are invited at the very first session to list their values and to write them out, with a specific reference of their qualities of personhood, they almost universally find that this provides an accurate description of them, as they both are and would like to be. They usually tell us that although they initially would never have portrayed themselves in this manner, they like who they see on paper, and feel that it resonates deeply with who they really are. From this new point of reference, their sense of despair and their other symptomatology of meaninglessness begins to make a sense to them. They now see it as a function of the fact that they were not living in a manner that was true to this personal value system. Consequently the risks of making the necessary personal behavioural and environmental restructuring in order to become true to their values becomes scarily meaningful as they realize that if they do not make that choice, there will be nothing except for a sense of inner emptiness and meaninglessness to their existence.

In almost four decades of work with individuals across the DSM spectrum, we have found the Integrity model to be helpful across 10

International Journal of Existential Psychology & Psychotherapy

gender, situations, diagnoses, and other sociodemographic and cultural variables. We view Integrity as a path towards resiliency, recovery from all sorts of anguish and angst. It is a very personal roadmap or global positioning system (Lander & Nahon, 2008c) for doing life well, meaningfully, and in a manner that transcends even the most horrific of structures, in any environment, including relationships. Living with Integrity is not without cost, but one finds that the costs become meaningful and precious, as they reflect the honouring of one’s value hierarchies, and, ironically, validate the Integrity of one’s identity and self-hood that no one can tamper with as much as they may try to.

Individuals are often amazed that they do not know why they have engaged in a particular behaviour or made a particular choice.

Once they discover the values that fuelled the choices and behaviours that they have engaged in, things have a way of falling into place. They come to realize that they are actually experiencing a sense of dis-ease, and that this dis-ease points to a clash of values. They come understand that they had learned and adopted values, or discovered that they had collected a series of values that were not really of their own choosing, and that other, more personal values were being violated by their current level of behaviour, resulting in a sense of disquietude.

As individuals look at the portrait revealed by their list of values, they find that this image resonate from deep within, and that a beginning sense of selfhood seems to well up from within. Some relate that they can actually hear a holistic singing as their values begin to harmonize mind, body and soul, and they like www.ExistentialPsychology.org

Volume 3, Number 1 January, 2010

what they see. They find that they can identify with this person on paper, and that although living with Integrity can be fraught with a fear of the unknown, there is a joyous sense of escape from the iron-bound chain of meaningless values which were not their own. They realize that this is their life, and that others’ social values had them trapped them from honouring and living this life.

This realization allow them to break through the iron-clad chrysalis of their former persona or pseudo-self, finding that it had a brittleness that could easily be shattered. While for some there is an initial fear of freedom, they discover that it is far less terrorizing than the fear of slipping back into the illusionary safety of their chrysalis. Individuals leave the first session saying often saying that, for the first time in their lives, they are experiencing a genuine sense of hope. It feels real, and it seems as though, even during that first session, something new and solid has become metabolized. They come to realize that they are no longer empty inside as a result of their previously meaningless value system, but rather that they are becoming filled with a wondrous sense of joy, worthwhileness, and increased self-esteem.

The Integrity model invites individuals to examine the concept of their responsibility in both getting themselves into and out of “messes”–or impasses in daily life, and for getting out of them. At times, like Ari, one finds oneself in a mess that is not of one’s own choosing. Nonetheless, one is responsible for what one does about it. This is why Integrity seems so simple, and yet is so very difficult to live daily until one appreciates the concept of prices to be paid no matter what the choice 11

International Journal of Existential Psychology & Psychotherapy

including the choice of not making a choice.

Individuals quickly come to understand this. By focussing on their values, their value ranking and price tags, they are able to avoid the trap of tackling the notion of unhelpful thought patterns and belief systems, which we view as the cognitive rationalizations of one’s values–thereby avoiding what Mowrer referred to“stinkin thinkin” (O. H. Mowrer, personal communication, 1970).

From the Integrity model perspective, life really is simple. One must do what one is destined to do. This often comes with price tags. If one is committed to this journey, one becomes willing to pay the piper with a sense

REFERENCES Adler, A. (1964). Social interest ( J. Linton & R. Vaugh, Trans). New York, NY: Capricorn Books.

Bly, R. (1990). Iron John: A book about men.

Reading, MA: Addison-Wesley.

Brannon, R. (1976). The male sex role: Our culture’s blueprint for manhood, what it’s done for us lately. In D. David & R. Brannon (Eds.), The forty-nine percent majority: The male sex role (pp. 1-48).

Reading, MA: Addison-Wesley.

Buber, M. (1961). Between man and man (R. G. Smith, Trans). London: Collins.

Corsini, R. (2001). Handbook of innovative therapy (2nd ed.). New York, NY: John Wiley & Sons.

www.ExistentialPsychology.org

Volume 3, Number 1 January, 2010

of joy, especially if one has finally broken through was a previously untenable position that could have led to more expensive price of premature ending of life by one’s own hand.

Suffering is a part of life, and so is the choice of making one’s suffering meaningful, independent of context, as the poet Lovelace (1618-1657) reminds us: “Stone walls do not a prison make/nor iron bars a cage”. We are always free to choose whether or not to be true to ourselves, and to choose our attitude towards life and its circumstances. Consequently, while the existential abyss is something that one dreads and experiences as a narcissistic injury, it need not be feared.

du Plock, S., Lander, N.R., & Nahon, D. (2008). The Integrity model: A trialogue. Existential Analysis, 19:1, 113128.

Frankl, V. (1955). The doctor and the soul. New York, NY: Knopf.

Frankl, V. E. (1963). (I. Lasch, Trans.) Man’s Search for Meaning: An Introduction to Logotherapy. New York, NY: Washington Square Press.

Hunt, J. M. (1984). Obituary: Orval Hobart Mowrer (1907-1982). American Psychologist, 39(8), 912-914.

Jung, C. G. (1933). Modern man in search of his soul. New York, NY: Harcourt & Brace.

Lander, N. R., & Nahon, D. (1992). Betrayed within the therapeutic relationship: An Integrity Therapy perspective. The Psychotherapy Patient, 8(3-4), 113-126.

12

International Journal of Existential Psychology & Psychotherapy

Lander, N. R., & Nahon, D. (1995). Danger or opportunity: Countertransference in couples therapy from an Integrity therapy perspective. Journal of Couples Therapy, 5(3), 72-92.

Lander, N. R., & Nahon, D. (2000a). Working with men from a Mythopoetic perspective: An Integrity therapy framework. In E. R. Barton (Ed.), Mythopoetic perspectives of men’s healing work: An anthology for therapists and others (pp. 130-144). Westport, CT: Bergin & Garvey.

Lander, N. R., & Nahon, D. (2000b). Personhood of the therapist in couples therapy: An Integrity therapy perspective. Journal of Couples Therapy, 9(3/4), 29-42.

Lander, N. R., & Nahon, D. (2005). The Integrity model of existential psychotherapy in working with the ‘difficult patient’.

London, UK: Routledge.

Lander, N. R., & Nahon, D. (2008a). Meaning in everyday life and in death: An Integrity model perspective. Paper presented at the 5th Biennial International Conference on Personal Meaning, Toronto, ON. Lander, N. R., & Nahon, D. (2008b). An existential, Integrity model perspective in working with post-traumatic stress.

Paper presented at the 5th Biennial International Conference on Personal Meaning, Toronto, ON. Lander, N. R., & Nahon, D. (2008c). An Integrity model perspective on working with occupational stress in men. Journal of Men’s Health, 5(2), 141-147.

www.ExistentialPsychology.org

Volume 3, Number 1 January, 2010

Mowrer, O. H. (1953). Neurosis: A disorder of conditioning or problem solving?

Annals of the New York Academy of Sciences, 56, 273-288.

Mowrer, O. H. (1956). Neo-analytic theory.

Journal of Counseling Psychology, 3, 108111.

Mowrer, O. H. (1958). Relations between religion and mental health. American Psychologist, 13, 577-579.

Mowrer, O. H. (1959). Changing conceptions of the unconscious. Journal of Nervous and Mental Disease, 129, 222234.

Mowrer, O. H. (1960). Some constructive features of the concept of sin. Journal of Counselling Psychology, 7, 185-188.

Mowrer, O. H. (1961). The crisis in psychiatry and religion. Princeton, NJ: D. Van Nostrand.

Mowrer, O. H. (1964a). The new group therapy. Princeton, NJ: D. Van Nostrand.

Mowrer, O. H. (1964b). Science, sex and values. Personnel and Guidance Journal, 42, 746-753.

Mowrer, O. H., & Vattano, A. J. (1976).

Integrity groups: A context for growth in honesty, responsibility, and involvement. Journal of Applied Behavioral Sciences, 12, 419-431.

Nahon, D., & Lander, N. R. (1992). A clinic for men: Challenging individual and social myths. Journal of Mental Health Counseling, 14(3), 405-416.

Nahon, D., & Lander, N. R. (1998). Men’s health: Towards a healthier global society. Orgyn, IX(2), 12-16.

13

International Journal of Existential Psychology & Psychotherapy

Nahon, D., & Lander, N. R. (2008a, July).

Working with men & workplace stress: An existential, Integrity model perspective. Paper presented at the 5th Biennial International Conference on Personal Meaning, Toronto, ON. Nahon, D., & Lander, N. R. (2008b). Recruitment and engagement in men’s psychotherapy groups: An Integrity model, value-based perspective. The International Journal of Men’s Health, 7(3), 218-236.

www.ExistentialPsychology.org

Volume 3, Number 1 January, 2010

Nahon, D., & Lander, N. R. (in press). The effectiveness of gender role re-evaluation & non-gender focussed group psychotherapy in the treatment of recently separated men. The International Journal of Men’s Health.

Rotter, J. B. (1966). Generalized expectations for internal vs. external control of reinforcement. Psychological Monographs, 80(1), 1-28.

Sullivan, H. S. (1953). The interpersonal theory of psychiatry. New York, NY: Norton.

14