Abstract

Exceptional human experiences (EHE), used here interchangeably with anomalous experiences (Palmer and Hastings, 2013), for example near-death experiences, veridical psi, and other similar phenomena, are experienced throughout the population, yet research shows clients are reluctant to bring such experiences to psychotherapy for fear of pathologisation (Roxburgh and Evenden, 2016)."

These experiences challenge conventional accounts of reality which, for integrative psychotherapists, require consideration. In particular, how their chosen framework might facilitate or constrain working with phenomena sitting towards the edges of mainstream clinical certainty. This paper asks whether integrative psychotherapy's theoretical foundations enable practitioners to engage with such material in a coherent way.

From the many psychotherapeutic frameworks attempting to include the transpersonal domain in integrative psychotherapy, Gilbert and Orlans (2011) offer an influential framework which I examine here as a case study. I question their model's underpinning philosophical commitments both ontologically and epistemologically. I argue that theoretical integration based upon a relational, co-constructed ontology forecloses the very phenomena they seek to include when their framework is operationalised for the transpersonal domain. In part, this is due to the absence of any specified branch of the phenomenological tradition underpinning their approach. Despite this, the way they invoke Kant and Hegel, without specifying how either is being used, results in an essentially ego-bound operative position which cannot stretch beyond the personal. This represents a significant issue for the transpersonal domain. Particularly when considering phenomena where non-locality of consciousness is experienced and cannot be accounted for by merely interactive meaning-making.

Where Gilbert and Orlans do address the transpersonal directly, it is conceptualised through a lens of deficit and disconnection rather than as phenomena with independent epistemic standing. This paper argues that this can be seen as reflecting a structural, design limitation that may prove common to integrative models lacking a coherent approach to integrating the transpersonal. This demonstrates the aspirational nature of current integrative models in their attempt to provide a whole-person approach to psychotherapy. A point which Gilbert and Orlans themselves identify as a feature of meta-theoretical frames. This analysis forms the theoretical basis for a broader doctoral research question: how do integrative psychotherapists engage with exceptional human experiences in clinical practice, and what theoretical and philosophical resources enable or constrain that engagement?

Introduction

Some branches of Integrative Psychotherapy attempt a flexible, holistic approach to psychotherapy, designed to meet the full range of client needs by drawing on a broad range of schools and approaches within a coherent framework. Currently, there are several approaches widely adopted by clinicians including Theoretical, Common Factors, Assimilative and Technical Eclecticism.

In the U.K Gilbert & Orlans (2011) offer a prominent, foundational approach to integration within a relationally orientated, humanistic framework. This attempts a meta-theoretical framework that centralises the therapeutic relationship as a key component for integration, foregrounds the importance of clinical research to inform practice, and considers the role of client idiosyncrasy. The framework explicitly attempts to understand several domains of relationship relevant to the therapeutic encounter including the self as a spiritual entity (the transpersonal domain). Gilbert & Orlans’ approach remains committed to a social constructionist, relational, phenomenological position, preserving post-modern assumptions regarding the co-creation of relationship. They cite the works of Kant, Hegel and writers within the phenomenological and existentialist traditions as the basis of their underpinning philosophy.

Aims of this paper.

In this paper, I discuss the theoretical and philosophical tensions inherent in their model which I argue become prominent when attempting to use their framework to integrate transpersonal (psycho-spiritual) experiences. It’s possible such tensions influence the way integrative psychotherapists using this model conceptualise, think, view and act towards transpersonal encounters. It’s also possible that these tensions may be unhelpful and even harmful for clients when therapists attempt to operationalise their framework for transpersonal experiences. Integrative frameworks are designed to allow the practitioner to bring together several or more approaches, claiming this permits the therapist to meet the client where they are in the fullest sense. To do this coherently however becomes a more challenging task with the inclusion of the transpersonal. In part, this is because transpersonal experiences by their very nature challenge the theoretical and philosophical limits of what can be considered real and meaningful through the models dominant within mainstream western medicine.

Transpersonal psychology classifies such experiences as Exceptional Human Experiences (EHE) White (1993) that often occur spontaneously, and frequently during altered states of consciousness (ASC) Ludwig (1966). In such cases, the ASC may or may not have been induced deliberately. Here Parapsychology favours the term anomalous experiences (AE) to also describe the same phenomena although some within this field consider an AE a precursor to a full blown EHE, see White (1997, 1998a) and Brown (1998). Either way, both disciplines study these experiences:

particularly for their meanings and their transformational potentials in the lives of the experiencers. EHE typically consist of mystical experiences, psychic experiences, encounter experiences, unusual death-related experiences, exceptional human performances, healing experiences, desolation / nadir experiences, and dissociation experiences, Palmer & Hastings (2013).

Qualitatively, “transpersonal experiences may be defined as experiences in which the sense of identity or self extends beyond (trans) the individual or personal to encompass wider aspects of humankind, life, psyche or cosmos”, Walsh & Vaughan (1993).

Within integrative psychotherapy, how these types of experiences are understood and engaged with varies greatly amongst practitioners. This is influenced by the philosophical position adopted by the individual therapist and that which their chosen theoretical frame of reference infers and can facilitate. The aim of this paper is to help broaden the understanding of how integrative psychotherapeutic frameworks equip practitioners to work with experiences sitting towards the edges of what can be understood through current frameworks. This paper forms part of my developing research question and thinking towards a PhD proposal. Currently this is being explored around the following research question;
How do integrative psychotherapists engage with exceptional human experiences in clinical practice, and what theoretical and philosophical resources enable or constrain that engagement?

Why this research is important. A cultural and clinical contextualisation of EHE in Western society today.

We are arguably living through times where the culture has never been more complex and diverse. Carried by a global economy, the inevitable cross-pollination of knowledge and ideas shows no sign of slowing. The wide-spread adoption of digital technologies appearing to expedite this process may even increase the occurrence of EHE in today’s society. For e.g., over the past two decades there has been a significant resurgence of interest in contemplative practices and psychedelics across Western cultures. Both are increasingly recognised as methods for inducing altered states of consciousness (ASC) with potential therapeutic significance (Jiwani et al., 2025). Such practices as these are now widely adopted by many and have even become embedded within well-established subcultures as both emblem and method. A good example of this can be seen in the electronic music scene which in the U.K, arose circa 1989 / 1990 onwards. Drawing on my own long-standing interest in this movement, I have seen first-hand how people routinely engage life in ways which both encourage and enable ASC and EHE in a normalised, matter-of-fact way. Whatever view one might take on this from a legal, moral, ethical and regulatory perspective, whilst all important, what cannot be ignored is that this is happening. That these types of experiences occur, and that EHE are being brought into, and occur in psychotherapy, Blades (2023). This has consequences.

For practitioners, I argue this requires awareness of one’s own beliefs and philosophical commitments in regards to EHE phenomena including how one reconciles this clinically / theoretically. Research shows clients who engage therapy having had an EHE are often reluctant to disclose their experiences in therapy for fear of being pathologized or seen as “mad” by the therapist, Roxburgh, E. C. and Evenden, R. (2016). Furthermore, research conducted on the prevalence and phenomenology of EHE, found that “44% of a sample of 226 therapists had experienced EHE in the therapeutic setting, but that these experiences came as a shock to therapists and challenged their concept of reality”, Roxburgh, E. C. and Evenden, R. (2016). Dein (2012) also highlighted that according to Targ, Schlitz, and Irwin (2000):

in most countries where surveys have been conducted, psi (paranormal) related experiences have been reported by over half the population. A prevalence of over 50% has been found in surveys undertaken in North America, Great Britain, and other countries in Europe, especially Iceland, the Middle East, Brazil, South Africa, Asia, and Australasia, Cardeña, Lynn, & Krippner, (2000).

This is perhaps no surprise when we consider that some people routinely alter their states of consciousness via a variety of means, leading to experiences that are exceptional, unusual, and anomalous. The data shows, while these experiences may be considered 'non-ordinary’, they are by no means rare, and inevitably find their way into the therapy room. Consider this, a ‘normal’ Saturday night might, for some people, include a face-to-face encounter with an entity resulting from a DMT (dimethyltryptamine) experience, or shamanic journey. Another could experience an unusual dissociative or unitive state as a result of a meditation retreat. Further still, another could die on a hospital bed during routine surgery, only to watch themselves being resuscitated from an unusual vantage point within the same room.

In any case, these experiences all have an impact on the psyche. Where required, they need processing and integrating in a way that feels safe and meaningful to the experiencer, like all good therapy. When this does not happen, and depending on the psychological structure of the experiencer, the EHE may become a source of overwhelm leading to what is sometimes termed a spiritual crisis or spiritual emergency, Grof & Grof (1992). This term broadly describes a form of disruption in the psyche which may become mistaken for something unhealthy if not handled in a careful and informed manner. This is directly relevant for psychotherapy as:

pathological and spiritual experiences cannot be always distinguished from each other in form or content. Similarities exist between transpersonal and pathological experiences, but there are diagnostic features that necessitate different case conceptualisations and clinical interventions, Kaminker & Lukoff (2013).

Gilbert and Orlans as a suitable framework for working with EHE.

Gilbert & Orlans (2011) position their framework as a specialist training pathway for therapists rooted in several different traditions that came together in the nineteenth and twentieth centuries based on much earlier philosophical ideas. Referenced, is the humanistic challenge to positivistic psychology, and the philosophical developments from the likes of Kant, Hegel, and other unnamed writers within the phenomenological and existentialist traditions. Based on these foundations they propose an integrative framework that attempts to operationalise four domains of self, including the self as a spiritual entity, or the transpersonal domain.

While any genuine attempt towards holism must include the transpersonal, when we consider Gilbert and Orlans’ foundational commitments, their inclusion of the transpersonal appears more aspirational than an operational prospect tenable for working with transpersonal phenomena. Although Gilbert and Orlans do not explicitly share which branch of phenomenology they are using specifically to conceptualise the transpersonal (a problem in its own right), they use Kant and Hegel to move towards a social constructionist position, one they make explicitly ontological in their claim that no one ontological truth is possible (Gilbert & Orlans, 2011). If we are to only take Kant and Hegel as the primary examples on offer regarding the type of phenomenology being used, what is essentially revealed is an ego-based position which can only ever stretch as far as the self and other, or subject and object.

Of course, phenomenology of this nature is a central tenet of the humanistic project. This freed psychotherapy from reductionist / materialist views of self. When used for the transpersonal however, paradoxically, this confines the self to a one, two, or at best, group psychology. This simply cannot account for the transpersonal. That being, a sense of self and phenomena that exceed the bounds of the individual ego. Where Gilbert and Orlans more clearly state what forms the basis of their integrative stance they evoke the idea that all relationships are co-creations. They centralise this position in the idea of the inseparable nature of figure and ground. This again suggests a one, two, or group construction as their operative position. The objects arising from a subjective field of experience. Unless of course, their conceptualisation of ground is taken as a conceptual metaphor for something field based in the trans egoic sense. No indication is given that this is the case however so that would be a sizable assumption to make. In fact this seems more unlikely, given that they further claim relativism concerning the impossibility of any one ontological truth.

Gilbert & Orlans openly advocate for practitioners to continually develop their own meta-perspective. However if one takes their framework as the starting point, from what is disclosed philosophically / theoretically, it is not possible to do this coherently when it comes to the transpersonal domain. This is because the framework appears fundamentally predicated on an ego-based psychology and a relational, social constructionist position, with the transpersonal then presented as if it could be held within the same methodology. While therapists need frameworks that are flexible and free of the burden to conclusively resolve ontology, this cannot be at the expense of foreclosing ontological possibility and / or the epistemological means of engaging it. Particularly if part of the requirement is to provide an operative methodology inclusive of phenomena and experiences that lay beyond the skin incapsulated ego. It is reasonable to assume therefore that therapists at the very least need ways to conceptualise ontological possibility when faced with phenomena that can rock the very foundations of a person’s sense of reality. Surely, this cannot be at the expense of a client’s, or for that matter a therapist’s, sense of what is real and meaningful in the world.

Therefore, I argue this is not enough. This is again particularly pertinent to psychotherapy when one considers the range and nature of EHE. Consider such examples as near-death experiences and evidence from veridical psi (scientific parapsychology) research. In these cases awareness, or the consciousness of the experiencer, are not bound by locality (time and space) in the same way a socially constructed, co-created ontology would require. Such phenomena can therefore only be received as narratives of meaning, rather than as possible disclosures of something real, and their independent epistemic standing is foreclosed. Is it not reasonable therefore to consider how design issues such as these influence a therapist’s beliefs about what is real and meaningful, and in turn, how they then respond when faced with phenomena that may not only oppose their own worldview, but also their clinical frame of reference? We might also consider here for a moment the ethical dilemma this creates for therapists. Even with the best intentions to, amongst many others matters, do no harm, they now become faced with doing the very thing they wish not do by virtue of their training and the framework used. This does of course assume some degree of awareness of such matter on behalf of the therapist. We therefore may also reasonably ask, how much more important this then becomes where the therapist has not arrived at an operative position regarding the transpersonal.

Most significantly, where Gilbert & Orlans, (2011) directly engage the transpersonal domain and relationship from an operative perspective, they determine in both cases that these fundamentally represent a form of disconnection in the client. I argue this illustrates the limits of their conceptualisation and underpinning philosophy. Clients are described as generally coming with some form of fragmentation between body, mind, and spirit which means that they “should rightfully include some concern for the spiritual domain of experience”. Here the transpersonal arrives from a pathologizing position. Hycner (1993) is used to substantiate this position and their stance towards both the transpersonal domain and relationship starts from a position of lack, and as they state, separation, void, anxiety and emptiness. Viewed as driven by a spiritually repressed anxious society with anxious individuals, the disconnection they warrant is said to be restored most often by pseudo substitutes. Coming from, and as referenced by them, the likes of “money, drugs, sex, and television”.

Particularly revealing here is the case referenced by Gilbert & Orlans (2011) from Maguire (2001) to illustrate the transpersonal “most directly and poignantly”. This comes from work with torture victims and survivors of extreme situations. Maguire (2001) is directly quoted describing how trauma of such inhumane proportion can take its victims to “another realm of existence”. I do not disagree that this can be the case. However, their reliance on this single case example is illustrative of a deeper limitation I believe. This example falls within the dissociative category of EHE. The reliance here on a singular EHE category leaves the fuller range of transpersonal phenomena conspicuously unaddressed. I suggest that in the case of Gilbert and Orlans this indicates the limits of what a socially constructionist ontology can accommodate when meeting phenomena pushing against its boundaries. The transpersonal is being essentially conceptualised through the lens of deficit and reparation rather than treated as phenomenon with independent epistemic value.

Conclusion.

Gilbert & Orlans’ framework is to be commended in its aspiration to integrate the transpersonal into the therapeutic relationship. They make interesting and valid points around the contribution this brings to those clients for whom the search for meaning may be considered transpersonal. And this may well be the limitation of their framework. The transpersonal here is limited and constrained by existentialism, and relational phenomenology. EHE require a broader, more inclusive epistemology that leaves the door open on ontological certainty. This permits not only the scope of transpersonal phenomena but also the range of the philosophical commitments of practitioners. When frameworks foreclose possibilities for experiences that are happening, yet remain outside the scope of what a framework can contain, this leads to conceptual confusion. This tracks my own experience of interviewing practitioners regarding EHE which indicated a need for practitioners to import unexamined philosophical commitments and theories to help conceptualise their clients experience. If this is more widely found to be the case, it may be in-part responsible for producing a type of inconsistent, belief-dependent quality of care that Roxburgh’s data also points to. To qualify the potential of this gap further, a wider literature review is required across other key models of integration to identify repeating patterns. If this is demonstrated it would warrant the need for further study. The major deliverable of such a project would be to create a report derived from a broader sample of the actual experiences of integrative psychotherapists in regards to this matter. This would evidence how they engage with exceptional human experiences in clinical practice, and what theoretical and philosophical resources enable or constrain that engagement. This could generate the required data to support further downstream projects to help design integrative frameworks in a way that coherently includes the scope of transpersonal experiences.

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