Discussion Paper: Psychosis, Dreams, and Mysticism in the Clinical Domain, Tomas Agosin


I was assigned to discuss the essay of Tomas Agosin, or Dr. Robert Tomas Agosin’s Psychosis, Dreams, and Mysticism in the Clinical Domain. This is a very interesting topic because I am also inclined in doing a study on Islamic mysticisms in Maguindanao. When I was a child, I always see how my mom invited a pandita (male mystic religious leader) and a walian (a female counterpart of pandita) in doing ceremonies from a woman’s pregnancy, to delivering a child, a child’s entering early puberty, and until the death of a Maguindanaon Muslim. These practices is what we currently called us folk Islam.

Before I proceed further in discussing the paper assigned to me, let me give a brief discussion first about Tomas Agosin. A brief introduction about him may help us to put the writing into a larger perspective. Very interesting to note that he is a psychiatrist and a mystic man who lived in the modren world.

My initial research in the world wide web gave me this information:

“Tomas, always the ultimate clinician, combined a striking blend of love for people, openness to the experience of the sacred, critical thinking and awareness of the scholarly literature. A constant learner, he was a profound teacher because he always gave you the sense that he was learning along with you.

Tomas’s life was shaped by the above-knee amputation of his right leg as a child. He used an artificial leg and walked with crutches. Perhaps because his handicap was so obvious, he never really had to say much about it, but by the time he was an adult, he had overcome self-pity and used his experience of suffering as a means to connect with others, particularly those who were suffering. As a psychiatrist, he was not only supremely competent, but connected with patients as only a wounded healer can. He was able to forge strong relationships with even severely mentally ill patients who had trouble relating to anyone, let alone doctors. Tomas practiced “participation” as taught in his spiritual training and this led to a kind of existential sharing of the same space with his patients, something akin to empathy but not quite. Simply put, he was existentially with them, not above them. At least for me, as one who knew him, I find all of that in his writings, in between the lines.”


While he was well trained in medicine and psychiatry, he was equally well trained in the spiritual through commitment to the spiritual path of Cafh. He was one of the founders of Cafh in New York City. That training, and the experience that came through it, removes much of the idiosyncratic from his essays and puts his own personal experience within a universal perspective. 

“In retrospect, one realizes that Tomas’ life, spent so close to death, and his awareness that he would not likely live long, fueled a loving intensity that was given form by his family, his profession and his spiritual path. I believe these writings, fragmentary as they are, can continue to inspire and add to the many spiritual friends he made in life.”

The essay that he wrote for the book, The Fires of Desire, was in commemoration of Carl Jung’s 1912 lecture at Fordham. He presented his point of view as a clinician and as a spiritual seeking. In summary, his work tries to connect God, the Divine, the sacred, and clinical domain of psychology.


Jungs’ Model of the Psyche

According to Tomas Agosin, ” Jung was the first modern psychoanalytic thinker who integrated psyche and spirit”. Our mind and spirit are interconnected as it gives the importance of religion in man’s existence. He also made mentioned of the concept of the path of individuation. This concept refers to the process of becoming a  separate individual and at the same time a process of becoming more connected to the transpersonal, spiritual nature of being. In short, this is a process of our unconscious mind to become conscious.

In the whole process of individuation, Tomas made a conclusion which is the establishment of a “dialogue between man and his personal God, between the ego and the Self.”

Moreover, Jung had different view of libido as compared to Freud. According Tomas, “Freud saw it only as sexual in nature. Jung saw it as a much broader, psychic energy, the psychic force of the soul. It has a sexual component, but it has more than that.” For Jung, libido is the energy which manifests iteslf in the life-process and it is perceived subjectively as conotation and desire. Thus, Jung believes that libido is the energy which is able to communicate itself to any field of activity whatsoever, be it power, hunger, hatred, sexuality or religion.

Ego and Self Merged: Psychosis and Mysticism

Knowing the difference of ego from the self, Tomas stated further the difference of pscyhosis and mysticism. Both, start in the same place slowly developing a differentiated ego, but the ego in psychosis is weak. For Tomas, it is an ego that can ultimately get overwhelmed by the unconscious. Thus, it has trouble in dealing with conflict and anxiety, Therefore, for Tomas a person who ultimately becomes psychotic does not have a strong sense of self.

Tomas then discussed further the differences between the psychotic and the mystic. These are summarized as follows:

  1. Both developmental in terms of the ultimate consequence of the experience.
  2. Another difference has to do with relationship to the world. In mysticism there is also a gradual reduction of attachment to the world, but it is done for the sake of expansion. The detachment or gradual reduction of attachment to the world is not in the sense of being uninvolved, but in the sense of seeing things as transitory; seeing things as not ultimately that essential or important. There is something else that is deeper or more profound to which the mystic connects.
  3. In psychotic people, chronically psychotic people, there is actually profound attachment to whatever world is there for them, because they do not have sufficient ego to differentiate from it. Hence, they fuse with whatever is in front of them. There’s a fusion and a continuous shifting of the world, either positive or negative, depending on what’s going on inside of them at that moment. Because they don’t have a separate sense of self, they fuse with everything. And this weak ego has no place to stand on itself to be able to look at the experience. So they sort of attach and merge with everything.
  4. Another difference has to do with how the person relates to change. A mystic, or a spiritually-developed person welcomes change, out of their own sense of having grown or of having new growth opportunities. On the other hand, when you work with people who have a tendency toward psychosis, change is viewed as very, very threatening. In fact change is one of the biggest precipitants of another psychotic episode. Almost invariably the episode is precipitated by some kind of change, even in the smallest things.
  5. The mystic tends to take responsibility, not only for themselves, but also for all aspects of life around them. The psychotic does not take self-responsibility but rather projects out of themselves those things that seem especially negative.
  6. The mystic tends to reduce self-importance. They reduce themselves to a minimum, seeing themselves as a “nothingness” in the face of the immensity of the sacred. In contrast to that, the psychotic tends to have inflated self-importance. They see themselves as omnipotent, omniscient, feeling all-important and as “center of the world.”
  7. The mystic usually tends to have ever increasing serenity. This has to do with the detachment and recognition of the transient aspects of life. They are not going up and down so much with the emotions and the changes of life, but they are more involved with a deeper aspect of life that they connect with. In contrast, the psychotic tends to have very little serenity. The only peace they find is when their possibilities are very reduced; when they have a very, very small margin of thought, of feeling and of pre-occupation in life. Obviously, the increasing serenity of the mystic will lead him or her to be more open in life, more involved in life, and more loving towards all beings. The psychotic tends to be very closed, having difficulty relating with anybody, and clearly withdrawing from the world.

In his essay, he shared three cases that showed the negative and positive outcome of knowing one’s Self and the ego.  The light and the dark side of both can somehow dichotomize the psychotic and mystic.

In his final analysis, he showed the different relationships of ego and Self as they appear in the clinical domain using the concepts of Jung’s model of the psyche and Edinger’s “ego-Self axis” concept. In the process, he further stated that libido fuels and maintains that connection.




Tomas Agosin: Introduction to Psychotherapy & Spirituality at the Albert Einstein College of Medicine Cape Cod Institute, July 1990.

 Fredrica R. Halligan, Ph.D.: Psychotherapy & the Spirit:A Great Work of Love in the Writings of R. Tomas Agosin, M.D.


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