Integration, From 'A Course In Happiness'

This post is a summary of my YouTube post on the concept of Integration from Dr. Mardi Horowitz’s book “A Course In Happiness.” Here is the link to the video: https://youtu.be/vryPtI8w3D0

Dr. Horowitz’s book is an action-packed thriller! He works his way through 3 “levels of self-understanding”: Integration, Intimacy, and Integrity.

Integrity is the foundation of the recipe for happiness. Self-esteem, coping skills and your ability to pursue happiness all depend on integration. Integration takes into account the best and worst parts of you, your rational and irrational thoughts, your self-defeating behaviors and over-reactions. It depends on your ability to examine regrettable actions and missed opportunities from the past, and your ability to plan for a long-range future. It demands a review of your goals to see if they are mutually exclusive, and a capacity to prioritize your dreams. You need to avoid ending reflections with potential catastrophic outcomes. Accept compromise and remember that achievements don’t always turn out as expected. Finally, the process is ongoing.

Dr. Horowitz focuses on four skill sets to build Integration: Introspection, Focused Thinking, Mastering Stress, and Decentering.

Dr. Horowitz’s approach is based on the importance of a “configurational formulation.” He believes that an individual’s psyche is complex, and a continuous reduction of the ambiguity of this complexity is necessary. Each of the steps of the analysis of this formulation will be done multiple times. You will need to reflect on your symptoms, states of mind, obstacles, relationships (including with yourself), and refine your planning and self-treatment.

In my practice, Integration is a nearly universal starting point. At the initial meeting, I encourage a person to tell me about the different parts of themselves, their “inner lives” as the analyst Salman Akhtar would say. Some people have trouble accepting that parts of their minds are irrational, and even worse, that at times those parts are running the show! Some are too ashamed to confront the darkest parts of themselves and need to find courage and get support to do so. It can take a while before some realize that a “fact” of their lives is, actually, an over-reaction. Therefore, Integration requires frequent revisiting over the course of a therapeutic relationship.

Of the four skills that Dr. Horowitz’s mentions, Introspection is the skill that seems to require the most coaching. People mostly grasp the parts of themselves – you could probably pause this video right now and make a list of what you have, what you do, and what your “soul” or “spirit” is. But the PROCESS of Introspection takes some practice. He describes 4 elements: 1. Prep work must be done, including a clear and fresh mind, all thoughts and feelings being welcome without ruminating on self-criticism, prepare for short and long term thinking and resist insisting on solutions. 2. Next, be specific about a topic, and develop a list of pros, cons, and what ifs. 3. Have perspective – observe your physical and mental states and your self concepts. 4. Then, learn when to stop the process.

In my experience, people need to be reminded most of three elements of successful introspection. First, their mind’s environment needs to be fresh. They need to avoid self criticism during reflection. Second, They need to pick a specific topic to generate thoughts about. Thoughts need to be more pros/cons and what ifs than solutions. Finally, this work is not easy! A person needs to know when to stop. I suggest a start time of 10 minutes.

Thank you to Dr. Horowitz for allowing me to review and teach from two of his books. You can find a written review of his book “Formulation as a Basis for Planning Psychotherapy Treatment” on July 8, 2019 on my blog.