The field of psychiatry has exploded with exponentially growing knowledge of the neurophysiology of the brain and the associated organic pathology, which has revolutionized our understanding of the biology of many mental illnesses. Biological treatment modalities are expanding concomitantly. Amidst the excitement of these significant advances, it becomes easy to lose sight of the multidimensional facets of the human condition and of how many diverse factors contribute to psychiatric disorder and order.

The spiritual and transpersonal dimension of humanity has largely been avoided and neglected by the psychiatric community, partly due to a paucity of psychiatric literature addressing this important dimension. However, a distant voice can now be heard inquiring into the role of spirituality and trans-egoic experiences in our formulation of an individual's presenting story. That distant voice found its way into DSM-IV in 1994 with the addition of the V-code diagnosis of "religious or spiritual problem.” Filling part of the void in the psychiatric literature is the Textbook of Transpersonal Psychiatry and Psychology, the first comprehensive textbook that maps out this previously forbidden territory.

In 40 chapters, editors Scotton, Chinen, and Battista draw on the experience of 29 seasoned transpersonal clinicians, many who have made major contributions to the field of transpersonal studies. Guiding the reader through the diverse maze of transpersonal topics, the book begins by defining transpersonal psychiatry and psychology and explaining how it has developed as a respected field of study. Following is a historical review of the work of early clinicians who set the stage for transpersonal studies, namely William James, Sigmund Freud, Carl Jung, Abraham Maslow, and Roberto Assagioli.

Ken Wilber's work is referred to throughout the book, which is consistent with his role as one of the pioneers and major theoreticians in the transpersonal field. Wilber's "spectrum of consciousness"—the concept of consciousness as a spectrum of various divergent states, all valid when rightly viewed from their place on the larger spectrum—is a theme woven throughout the 40 chapters. Wilber describes this spectrum as consisting of three main developmental arenas: the prepersonal or pre-egoic, the personal or egoic, and the transpersonal or trans-egoic.

Western psychology, as it has developed over the past 150 years, has mainly focused on the prepersonal and personal states, mostly ignoring the spiritual dimension of the human psyche. Eastern philosophies and spiritual traditions, as they have developed over the past 4,000 years, mainly focus on transpersonal states. Wilber's spectrum integrates these divergent approaches to understanding the human psyche into an understandable model that reframes how Western and Eastern clinicians can approach their clients. The editors introduce the term “biopsychosocialspiritual continuum,”which expands on the traditional Western concept of the biopsychosocial continuum.

A section called Cross-Cultural Roots explores the transpersonal practices of diverse spiritual traditions, including Christian mysticism, Native American healing, Hinduism and yoga, Kabbalah, Shamanism, and Buddhism. A common theme is that as the spiritual aspirant opens to the deeper levels of the unconscious within, the qualities of compassion and altruism also ripen and replace the previous states of self-centeredness and closed-mindedness. The path that an individual travels—which can also include atheism and science—to facilitate that spiritual opening is not important, as all skillful paths lead to the top of the same mountain, where the mind opens to reality as it is, free of dogma and ritual. As Dwight Judy states in his chapter, "The client's worldview, whether religious or not, must be treated with the utmost respect.”

The ideal clinician's task is to accept each client's belief system as a truth for that person, and to then skillfully guide the client to healing and psychological freedom using whatever map of the territory of consciousness that individual is following—no small feat! This challenge highlights the importance of including transpersonal studies in all training programs for clinicians. Francis Lu presents such a training model in his chapter about training psychiatric residents.

Other chapters in the book explore topics that seem unrelated until the goal of mapping out the field of transpersonal psychology is kept in mind. Additional topics, in the sections on research on altered states of consciousness and on Western academic disciplines besides psychiatry and psychology that have contributed to the field, include meditation research, the use of psychedelics in consciousness research, parapsychology, contemporary physics, and anthropology.

The Clinical Practice section includes chapters on diagnosis, transpersonal psychotherapy, psychopharmacology, and various transpersonal techniques. Potential pitfalls are also brought to light. The clinician should be mindful of the "defensive misuse of spirituality and inflation of the ego.” For example, a client's suppression of strong feelings of anger, rage, depression, sadness, or hatred by a pseudospiritual presentation of forgiveness and love for all people should be gently confronted in case the client is using spirituality as a defense against emotions that feel too dangerous to allow into conscious awareness. The narcissist may use a spiritual practice to further delude a fragile ego into fantasies of increasing grandiosity.

The field of transpersonal psychology has grown rapidly. A large body of clinical, experiential, and experimental data has accumulated, but until recently it has existed in a fragmented state. The Textbook of Transpersonal Psychiatry and Psychology provides us with the first comprehensive, integrative, and at the same time provocative text of this important field of study. It will likely serve as the first authoritative text on transpersonal studies, and it is certain to become a classic.

Dr. Miller is with Harris Street Associates and North Essex Mental Health Centers in Newburyport, Massachusetts.