History as Therapy

The following essay was prepared by Eytan Gafni as part of a larger study on the applicability of Unique Self Theory to therapy. This study was based on a combination of academic and field work undertaken in 2016 by Eytan Gafni assisted organizationally by Yair Gafni.

Karl Popper says that we may become the makers of our fate,

when we have ceased to pose as its prophets.

I say that we may transcend post-traumatic acting out and attain therapeutic liberation,

when we accept history as a complex, non-binary reality;

when we are able to accept doubt as an integral part of human existence.

(eytan gafni-naky)

In this article, prepared as part of our larger work for the Center for Integral Wisdom, I will examine whether socio-historical narrative and its features may offer a therapeutic tool for the process of constructing personal narrative, that is the unique life story of each and every individual.

In doing so I intend to extend and deepen the vision of identity put forth in Unique Self theory.

By socio-historical narrative I mean history as it is written and told within the collective, and by features I mean that which is behind and guides the writing of history. I use the term therapeutic tool not in a clinical sense, as I am neither a physician nor a psychologist, but in relation to the basic psychotherapeutic idea of liberation from the past[1] and openness to the new possibilities offered by the present and, all the more so, by the future. I have therefore chosen to focus on the cognitive rather than the emotional aspects of the therapeutic process. The process of constructing personal narrative refers to the premise that the life story created by every individual is the result of daily efforts, conscious or unconscious, exerted to that end.

At the basis of this inquiry is the idea that history and psychoanalysis (a central method of psychotherapeutic treatment) share a common interest in the past and in the question of its influence on the present. Some might argue that the main difference between the two disciplines is that psychoanalysis deals with the unconscious past, while history deals with the past in general. It is precisely in this context, however, that I would like to explore whether history, as a discipline, also, naturally has an incomplete (unconscious) perspective of human reality, awareness (consciousness) of which would enable a renewed examination and reading not only of the past, but of the present and the future as well.

Further context for this paper can be found in Dominick LaCapra’s Writing History, Writing Trauma, which I believe offers fresh insight into the essence of historiography and the ways in which it is written. LaCapra seeks to provide a broad and profound perspective on the traumatic voice in historiographical space. According to LaCapra, the characteristics and symptoms of trauma pose a particular challenge for historical representation, due to the interpretive framework within which history is written and read. He therefore proposes the application of psychoanalytic concepts to the historical analysis of economic, social and political processes, thereby providing historiography with a new interpretive perspective. It is important to note that LaCapra does not refer to a psychoanalytic reading of historical events or figures, as in psycho-history, but to revealing the relation between the role of the historian and that of the critical intellectual; between deconstruction and psychoanalysis.

It is in the framework of these arguments that I will examine LaCapra’s stance, in order to determine whether it reinforces my thesis regarding historical perspective as a therapeutic tool in the process of constructing personal narrative. I will first provide a brief overview of LaCapra’s ideas as presented in the first chapter of Writing History, Writing Trauma, in which he lays the foundations for his position—in search of a connection, or the lack of one, between his views and the question I wish to examine here.

LaCapra first distinguishes between two historiographical approaches, as a backdrop for the exposition of his own view. He calls the first of these the documentary or self-sufficient model, which gathers evidence and makes referential statements in the form of truth claims. In this case, writing does not have a significant impact on content, but serves merely as medium by which to access the past. LaCapra then goes on to list various features of the documentary model, one of which strikes me as particularly pertinent to the “historical perspective” I would like to explore, and that is: “an exclusion or downplaying of a dialogic relation to the other recognized as having a voice or perspective that may question the observer or even place him or her in question by generating problems about his or her assumptions, affective investments, and values.”[2]

The second approach, which LaCapra terms radical constructivism, refers to factors not necessarily connected to the event itself, factors that construct the historical story. In this case, the referential statements draw their meaning and significance from those narrative structures. In its extreme form, however, constructivism presents the infinite projective factors that influence historiography, to the point that historical knowledge becomes amorphous, offering insight only into the historian’s own subjectivity.[3] Nevertheless, LaCapra shows that there are also less radical constructivist approaches. Thus, for example, it may be argued that fictional narratives may involve truth claims, as they provide insight into phenomena such as slavery or the Holocaust by giving a “plausible feel” for experiences or emotions, difficult to convey by means of restricted documentary methods. In brief, LaCapra argues that truth claims are a necessary but not sufficient condition for historiography and that we must understand the ways in which they interact with other factors and forces in historiography, including empathic and responsive understanding, as in the above example.

LaCapra presents both approaches—the self-sufficient documentary and the radical constructivist—as insufficient historiographical perspectives for a complete historical representation. Although each includes important and even essential components that must be taken into consideration in historical writing, each is lacking in some way. LaCapra then evokes the concept of the “middle voice”, as discussed by Hayden White and Roland Barthes, by means of which complete historical representation might be made. The middle voice, as LaCapra explains, is a voice that resists dichotomous binary opposites (such as active and passive, past and present, masculine and feminine) that repress an anxiety-ridden middle area of undecidability and absence of clear-cut positions.[4]

LaCapra also notes, rightly in my opinion, that the deconstruction of binary opposites does not necessarily entail the blurring of all distinctions [in a post-modernist sense of casting doubt on everything], but in fact distinguishes between the significance of binary opposites in empirical reality and the articulation of non-binary distinctions in areas that do not easily lend themselves to empirical scrutiny and the attribution of relative strength and weakness. By way of explanation, LaCapra suggests a correlation between deconstructive and psychoanalytical concepts. He thus shows how the deconstructive blurring of distinctions prevails in post-traumatic acting out:

[I]n post-traumatic acting out … one is haunted or possessed by the past and performatively caught up in the compulsive repetition of traumatic scenes—scenes in which the past returns and the future is blocked or fatalistically caught up in a melancholic feedback loop. In acting out, tenses implode, and it is as if one were back there in the past reliving the traumatic scene. Any duality (or double inscription) of time (past and present or future) is experientially collapsed or productive only of aporias and double binds.[5]

What LaCapra appears to be saying here is that the deconstruction of binary frameworks and their non-binary reconstruction may bring about the working through of trauma, distinguishing between past and present, recognising the difference between what happened then and reality in the here and now, as well as the possibilities held by the future. It must be noted here that the idea of a non-binary articulation of historical reality is no simple matter—and certainly not in a situation of post-traumatic acting out. LaCapra writes:

Those traumatized by extreme events … may resist working through because of what might almost be termed a fidelity to trauma, a feeling that one must somehow keep faith with it. Part of this feeling may be the melancholic sentiment that, in working through the past in a manner that enables survival or a reengagement in life, one is betraying those who were overwhelmed and consumed by that traumatic past. … [T]here has been an important tendency in modern culture and thought to convert trauma into the occasion for sublimity. … In the sublime, the excess of trauma becomes an uncanny source of elation or ecstasy. Even extremely destructive and disorienting events, such as the Holocaust or the dropping of atomic bombs on Hiroshima and Nagasaki, may become occasions of negative sublimity or displaced sacralisation.[6]

LaCapra thus goes on to discuss the practical application of the “middle voice”: the “sacrifice” offered through writing. According to LaCapra, writing history closely involves an objective reconstruction of the past, as well as dialogic exchanges with that past and with others who inquire into it—in the course of which, knowledge involves processing not only information, but also “affect, empathy, and questions of value”. This brings LaCapra to the dimension of actual and subjective experience as important components in the construction of historiography. In this context, he claims:

Especially open to question is a strategy of objectification and sustained ironic distance allowing only for unargued subjective asides….  Such an objectifying strategy may well posit or assume a radical divide between objectivity and subjectivity (as well as between research and dialogic exchange) and lead to an either/or conception of the relation between empathy and critical analysis.[7]

LaCapra thus appears to combine the objective voice in historiography with the subjective voice or experience, which enables emotional respect for the other and recognition of the fact that the other’s  experience is not mine. This attitude to the voice of the other brings me back to LaCapra’s initial discussion of the documentary, self-sufficient research model, and one of its most conspicuous shortcomings: the exclusion of a dialogic relation to the other as one who has a voice or perspective that may question the observer or even place him or her in question by generating problems about his or her assumptions, affective investments, and values. Now, however, the opposite is true. Recognising the fact that the experience of the other is not ours calls upon us to recognise the other’s perspective, as a perspective that expands our own historical perspective and allows us to reconstruct binary opposites, thereby affording a more complete understanding of history. If so, LaCapra proposes a new approach to historiographical writing, which aims to present historical complexity—reality that can be apprehended within the framework of what he terms the “middle voice”, combined with dialogic exchanges involving empathy for the experience and perspective of the other.

LaCapra’s approach appears to entail a kind of contingent perspective when writing history, that differs somewhat from prevailing historical contingency. Contingency refers to the study of alternative possibilities—of events that might have happened but ultimately did not. (Contingency does imply casual or random development of history, but contends that events did not have to happen as they did.) In the case of post-traumatic acting out, however, the events presented have actually occurred and continue to do so, but are not narrated, as they stem from trauma that has remained unspoken because it is not a part of dichotomous, binary historiographical discourse. In other words, both post-traumatic acting out and historical contingency present un-narrated realities. The difference between them lies in the fact that contingency does not exist but is merely represented, while post-traumatic acting out exists and may exert a significant influence, but is not narrated and is thus excluded from binary history.

To return to the question I asked at the beginning of this article, regarding the connection between psychoanalysis and history, and whether history too has an incomplete perspective,[8] I would like to suggest that the incomplete perspective of human reality—awareness of which would enable a renewed examination and reading not only of the past, but of the present and the future as well—is the binary reality of writing history that excludes the full application of the perspective of the other. I believe the same approach may be applied to the idea of personal narrative, to which every individual contributes, consciously or unconsciously, on a daily basis, and which may also, at times, be incomplete. It has been suggested that an individual may afford meaning to her or his life and constitute his or her identity by means of a unique, personal story. Amos Goldberg, for example, writes:

The fundamental principle in life-story and autobiography studies is that only by means of language can people give meaning to the events of their lives and constitute their identities and subjectivity, that is by weaving those events into a narrative. In other words, there is a close affinity between the autobiographical text—as language, narrative, and narration—and the constitution and existence of a subject with a distinct identity.[9]

The question remains, what is the connection between an individual’s ability to afford meaning to her or his life by telling her or his personal story and the above assertions regarding the reconstruction of historiographical binary opposites, in order to attain a more complete understanding of history? The idea of constructing a personal narrative is not as obvious as it might seem. One of the main difficulties that people encounter when attempting to tell their life stories is the binary perspective from which they look at the series of events that make up the whole of their lives. They are unable to see their stories from a contingent perspective. My central claim is thus that the process of extrospection in history can help the process of introspection in personal narrative. In the words of Yemima Ben-Menahem:

[O]ne of the roles of history is to demythologize our current perception of the world. This role is analogous to the role of one’s personal history in the psychotherapeutic process, and the connection between confronting history and changing our beliefs and behaviors is similar in both cases. The analogy applies to two different aspects of this confrontation: the reinterpretation of the past which it entails, and the cognitive possibilities and new directions for action which are opened up for us as a result.[10]                                                  

According to Ben-Menahem, the way in which one may attain the liberating encounter with the past is by adopting a contingent rather than a necessary perspective. In other words, the past did not have to unfold in a particular direction; the events did not have to happen as they did; and the way in which they happened was only one possible outcome. So too, we choose the meaning that we give the event and thus, how we respond to it. Such meaning is only one of the many possible ways in which we could have responded.[11] Individual personal stories are not binary, just as history is not binary. Understanding different perspectives of history and the ways in which it is written may offer individuals a broader perspective of the historical narrative structures that have influenced the development of their personal narratives, as well as a mirror image of the various perspectives from which they may look at their own life stories.

In conclusion, I began this article by asking whether socio-historical narrative and its features may offer a therapeutic tool for the process of constructing personal narrative. I sought to examine whether, like psychoanalysis, history as a discipline naturally has an incomplete perspective of human reality, and whether awareness of this fact might enable a renewed examination and reading not only of the past, but of the present and the future as well. To that end, I presented the claim of Dominick LaCapra, in Writing History, Writing Trauma, that the deconstruction of binary frameworks and subsequent reconstruction can lead to the working through of trauma in particular, and to a more complete view of history in general. In this context, I created a kind of circumstantial chain, showing how historical complexity, according to LaCapra, offers a tool for the re-examination of personal narrative and hence the means to a therapeutic process and liberation from dependence on the past. The accompanying change in consciousness offers the individual the ability to harmonise narration and narrative, in a single unit.


Ben-Menahem, Yemima. “Michel Foucault: History as Therapy”. Psychoanalysis and Contemporary Thought 19, no. 4 (1996): 579-610.

Goldberg, Amos. Traumah be-guf rishon: Ketivat yomanim bi-tkufat ha-Shoah [Trauma in First Person: Diary Writing during the Holocaust]. Or Yehuda: Ben Gurion University press and Kinneret, Zmora-Bitan, Dvir, 2012.

LaCapra, Dominick. Writing History, Writing Trauma. Baltimore: Johns Hopkins University Press, 2001.

[1]  By liberation from the past I do not mean forgetting it, but being able to look at the past without being dependent on it or a prisoner to it.

[2] Dominick LaCapra, Writing History, Writing Trauma, p. 5.

[3] LaCapra, p. 8.

[4] LaCapra, p. 20.

[5] LaCapra, p. 21.

[6] LaCapra, pp. 22-23.

[7] LaCapra, p. 39.

[8] Above, p.2.

[9] Amos Goldberg, Traumah be-guf rishon, p. 27.

[10] Ben-Menahem, p. 584.

[11] Ben-Menahem, pp. 585-586.

The Unique Self Education & Somatic Embodiment

A Somatic Perspective of the Unique Self Teaching

White Paper by Lawrence Gold, Hanna somatic educator


Too often, people get entangled or confused by the whirl of words and abstractions of spiritual teachings not familiarly connected to personal experience.  Zen Buddhist practitioners know this pitfall — confusing the “finger pointing at the moon” with “the moon”, itself.

The solution to this problem lies not in the mind, but in the body-sense, which includes feeling and movement, mind and intuition, and which is the living matrix of all expressions of consciousness available to humans.

This is not reductionism of everything to the body-sense; it’s recognition that “mind” IS the interiority of “body”, two perspectives of, “soma”.

This piece integrates the teachings of Unique Self and of Somatic Educationlinking the languages of spirituality, science and philosophy to immediately accessible and recognizable personal experiences.

Also watch and listen to this beautiful meditation by Lawrence Gold:

The Awareness of Totality is Here-ness

Unique Self in Integral Meta-Theory

In his Afterword to Your Unique Self, Ken Wilber calls the Unique Self teaching “a new chapter in Integral Theory.” He finishes with the words:

“And that’s an entirely new lineage—a trans-path path. This includes all of the good stuff of the previous paths, but adds this whole new level of emergence. And that is something that is extraordinary, and historic, and not to be denied.”

Ken Wilber is the foremost thinker defining Integral Meta-Theory as well as trans-lineage spirituality in our time.

His Fore– and Afterword to Your Unique Self establishes the book’s worthiness to be seen as a new spiritual classic.

From his Foreword:

“Dr. Marc Gafni’s integral unique self teaching is seminal. What you hold in your hands is a radically exciting and groundbreaking book that will change forever not only how you think about enlightenment, but how you understand, from a post-metaphysical perspective, the very nature of human life itself. The Unique Self work is magnificent, and it belongs among the “great books.” It offers what  may arguably be one of the most significant contemporary evolutions of enlightenment teaching. Unique Self brings together East and West in a higher integral embrace of stunning implications. Unique Self is a pivotal step toward an authentic Integral Enlightenment.”

Seminal Articles on Unique Self Theory in JITP 6:1

This special issue of the Journal of Integral Theory and Practice (JITP) is devoted to Integral Spirituality. The issue focuses on the conception of the Unique Self as developed by Dr. Marc Gafni. Unique Self represents a truly worldcentric and planetcentric mysticism that provides a powerful way of integrating the enlightenment traditions of the pre-modern East and the modern West.

Enjoy these two seminal articles on Unique Self theory, originally published in JITP 6:1.

Guest Editor’s Introduction–The Unique Self: A New Chapter in Integral Spirituality by Marc Gafni

The Evolutionary Emergent of Unique Self: A New Chapter in Integral Theory by Marc Gafni


This article outlines the basic teachings of a new chapter in Integral Theory: the post-metaphysical evolutionary emergence of Unique Self. The article begins by contextualizing theUnique Self conversation within a larger discussion on individuality and traces the emergence of theUnique Self teachings through the life and writings of the author. The core Western understandingof individuality and its affirmation of the dignity of the separate self is contrasted with the Easternteaching of dissolution of the small self, before both are integrated into a higher integral embrace through a new understanding of Unique Self. This article elucidates how the teachings of Unique Self fundamentally change the classical enlightenment paradigm through the assertion that enlightenment has a unique perspective, which might be termed the “personal face of essence.” Perspective taking, which emerges from enlightened consciousness, is rooted in the ontological pluralismthat lies at the core of the Hebrew textual tradition. The new enlightenment teaching of Unique Self therefore rests on a series of integral discernments between separateness and uniqueness, ego and Unique Self, and personal and impersonal man. The Unique Self teaching suggests a new understanding of enlightenment through intersubjective love; the Unique Self perception is then set within an evolutionary context of being and becoming, in which it is seen to express one’s response to the personal address of the evolutionary God impulse itself. In this sense, Unique Self is understood to be an essential chapter in the emergence of a truly evolutionary mysticism.

Unique Self Emergence Process with Barbara Alexander & Claire Molinard

USE Logo White Background Final LargeKen Wilber’s Integral Theory integrated with the Unique Self dharma as articulated by Dr. Marc Gafni is the basis for the Unique Self Emergence Process. Its articulation of the human journey through the necessary individuation we call the separate self to the realization that we are part of the “seamless coat of the universe” to the recognition that we are each a unique expression of the Ultimate Reality provides an elegant and practical framework for growth.

The Unique Self is not a concept but a quality of presence that is embodied as we awaken to our interconnectedness and grow beyond our sense of separation. We believe it is the purpose for existence because it is from here that we can most fully offer our gifts to the world.

Researchers have given us irrefutable evidence that humans continue to grow throughout our lifetime. Spiritual teachers ancient and modern echo that truth. As our world becomes increasingly complex, it is imperative that we grow into deeper and wider stages of development in order to navigate and assist our world’s evolution.

Our desire to assist in the transformation of the world has resulted in the Unique Self Emergence Process as a powerful change technology that taps into Creative Source to engage your unique potential and facilitate its emergence as your Unique Self. Because the process facilitates getting to the heart of whom you are and how the creative impulse of Ultimate Reality wants to express through you, it has many applications. Whether you are seeking spiritual connection and development, wanting to understand why your life is no longer fulfilling or exploring your life’s purpose, this process will help.

>>> Learn More about the Unique Self Emergence Process & Sign Up for Our Free Video Course <<<

About Barbara and Claire

Barbara and Claire are long time spiritual practitioners who believe spiritual development is the cornerstone of human transformation. Individually we were coaching clients using the Integral Coaching approach, with an emphasis on spiritual development using the Unique Self Teachings. These teachings, offered by Marc Gafni and which Ken Wilber has called “a new key chapter in Integral Theory,” are deeply rooted in the wisdom of the world’s spiritual traditions and informed by modern psychology.

When we met we embarked on a journey of developing and synthesizing our work and the Unique Self Emergence Process was born. We knew we would offer it to other professionals, who like us, believe true transformation integrates both psychology and spirituality.

>>> Learn More about the Unique Self Emergence Process & Sign Up for Our Free Video Course <<<

The Unique Self Emergence Facilitator Training

The Unique Self Emergence Facilitator Training is a nine month certificate program. It is designed to support change agents who wish to deepen their experience of their own Unique Self while learning a practical and elegant process rooted in the Unique Self Teachings. Upon completion of this program, participants are certified to facilitate the Unique Self Emergence Process with individuals and groups and join a collective of amazing people from diverse background – coaches, consultants, spiritual directors, therapists and body workers whose vision is to facilitate the emergence of Unique Self in men and women of all ages so they may live happier, more successful and purposeful lives in service to the world.

White Paper on Unique Self & Education

From Deconstruction to Reconstruction: Marc Gafni and the ‘Unique Self’

by Kathy Brownback, Instructor in Religion and Philosophy, Phillips Exeter Academy January, 2014


As practices promoting mindfulness become more prevalent in contemporary society, a question naturally emerges:

What role should “mind-body” or contemplative practices play in education and academic life?

What do they have to do with the study of science, or the humanities and the arts?

What place do they have in the curriculum?

For much of the modern era, the answer to that question was none whatsoever. Any mind-body practice was understood to lie outside the objective goals of the academy, because such practice involved subjective internal states often linked to particular religious traditions. In fact, a good part of modern Western intellectual history has been a rebellion against, or at least a differentiation from, the dogmas of religion and coercive (yet unprovable) metaphysical claims. Every subject from science to art has had to disentangle itself from such claims, including the study of religion itself.

But the last 40 years or so have brought a new understanding of contemplative practice as a kind of embodied self-awareness. Such practices involve the movement of the mind and body in ways that are not primarily cognitive, and incorporate the use of the breath and the stilling of the “monkey mind.” Their primary goal is to draw the practitioner into direct awareness and experience of the present. They include meditation, yoga, chant, contemplation of nature, contemplative prayer, poetry, dance, or even methods for listening, playing an instrument, or shooting an arrow.

These are separate from dogma, even from the entire religious matrix itself. There is a growing body of practitioners who choose this direction not as an expression of loyalty to a particular tradition or to fulfill an external obligation. Rather, they practice to gain knowledge. They ask, “How can I live differently?” and “How can I know more deeply and fully?” They may think of themselves as religious or secular, or “spiritual but not religious,” or they may disavow labels altogether, but this is the direction of their quest.

These are also the very questions that many students ask. If you are a student, you know there is nothing abstract about these issues. These are questions of the heart—questions about human nature and direction. They are intellectual, emotional, and spiritual—and always personal. Most likely you’ve asked yourself some of the same questions I’ve been asked by other students:

  • “People keep telling me to be myself, but I don’t really know who that is. I feel pulled in so many directions.”
  • Do we have free will, at all? Or are we totally determined by our genes, and conditioned by our environment?”
  • “Why, in the midst of all they have, are so many people angry and dissatisfied? Can I hope to avoid this? Why is there so much addiction? Why depression, among people who have so much to offer?”
  • “I haven’t found any kind of God I can believe in, yet I somehow feel there is something more to life. Your thoughts?”
  • “Are science and religion looking at the same world? They seem so contradictory. Your husband is a physicist. Do you argue about this?”
  • “Is there such a thing as truth? Is there anything I can be certain of?”
  • “Do you think life has some kind of point, or meaning? Or is it, as Shakespeare said, ‘a tale told by an idiot’? It really feels that way. Then all of sudden, even though I have no real answers, the feeling goes away.”

These are more than a series of isolated questions. When you pose them, you are asking if there is some kind of map you can trust, one that might give you a reliable sense of direction.

The old maps that your parents and grandparents grew up with are not enough, and there don’t seem to be others around that really describe the territory. Your liberal arts education has taught you critical analysis and fluency in different ways of thinking, but hasn’t equipped you with a reliable “inner GPS” that can navigate contradictions and find its way. You might sense that such a thing is possible, but you observe that many in the world around you seem to lack both compass and map—and you do not want to be among them.

How can contemplative practice help you discern such a map?

First, there is the practical level. Contemplative practice can encourage the ability to focus and enter into a subject with minimal distraction and interruption. It can help a great deal with stress reduction. Moving more deeply, it can foster the capacity to hold apparent contradictions in tension with each other without immediate dismissal of one side. It can encourage you to listen to and help develop the ideas of others from a less egoic perspective—and to see connections between disciplines that infuse their understanding of each other. It helps provide the space for deeper creativity and inspiration. At its most profound level, contemplative practice has the potential to help you reconnect with a deeper sense of purpose, meaning, and value in your life.

This goal is at the heart of the work of philosopher Marc Gafni, director of the Center for Integral Wisdom, a think tank dedicated to evolving and articulating a shared global framework of meaning and responsibility. Gafni, who holds a Ph.D. from Oxford, is classically trained in the study of the Kabbalah, as well as in modern and postmodern schools of epistemology (the study of knowledge, or how we know what we know).

His work brings significant developmental insights of modern psychology and science together with spiritual practice and the study of world religions. Along with philosopher Ken Wilber and other scholars, Gafni is working on the articulation of an Integral world spirituality.

Its first principle is what Gafni has termed “Unique Self”—a theory of self and contemplative practice that he has likened to a puzzle piece. The unique self has all the idiosyncrasies—the many-formed edges—of an individual life, and yet it is also profoundly committed to the larger whole.

This article is an introduction to Gafni’s theory of the unique self, and to the making of maps and the solving of puzzles.

We’ll begin by exploring three meta-questions that underlie Gafni’s theory:

What do we know?

How do we know it?

And what does it mean to be a self?

Download the whole article here>>>


Unique Self Essentials

A Summary of the Unique Self Teaching by Marc Gafni from Your Unique Self

The Unique Self teaching evolves and qualifies the classic enlightenment teaching of many of the mystical traditions. The Unique Self-realization, which began to emerge with my Soul Print teaching (1986), has been a key lodestone in the dharma that I have tried to share in the world.

In the last years 2003-2012) an intense and delightful friendship and dharma dialogue with Ken Wilber further evolved and clarified the teaching within the context of Integral Theory.

In the last ten years (2002-2012) the Unique Self teaching, has challenged and evolved the way enlightenment has been understood and taught in many, if not most, contemporary Western con- texts.

Many realized teachers, passionately committed to evolving truth, have encountered the Unique Self teaching, recognized its insight, and audaciously incorporated it into their own dharma.

The enlightened state, in the classic Eastern enlightenment traditions, is your awakening to the one True Self. The total number of true selves in the world is one. True Self is the realization of reality—which exists unconsciously in every state and in every level of consciousness—that there is only one True Self and every being has that True Self as it own essence. Awaking is when your unconscious reality of True Self becomes our conscious identity.

You are enlightened when you have the shocking realization that your True Self is the True Self. You then further evolve to realize that the same is true for every other sentient being. You realize at the same time that your True Self is utterly one with everything that is, everything that ever was and everything that ever will be. The sensual knowing of this truth is what is usually referred to as enlightenment.

Enlightenment practices and processes teach you how to open the eye of the spirit and realize the truth that your essence is your True Self. You are aware of your body, your emotions, your thoughts, but you are not exclusively identified or defined by them. You are the consciousness that holds them and in which they arise. You are True Self. The more profound the enlightenment the more clear, powerful and stable the realization of True Self.

What we have added with the Unique Self doctrine is that your awakened True Self is not the same as anyone else’s awakened True Self. This is a key truth that many of the great Eastern traditions, which have almost entirely dominated enlightenment teaching in the Western world, simply did not understand.

They thought that your True Self and my True Self are simply the same. They understood True Self (or its awakened creative state, which have been called Authentic Self or Evolutionary Self ) as fundamentally impersonal. My True Self and yours are therefore essentially interchangeable. Whatever uniqueness you might have is ultimately a function of your ego or your “cultural, social and psychological conditioning”.

What Unique Self realizes in its genuinely evolutionary unfolding of True Self, is that every True Self sees from a different perspective. Every True Self sees through a unique perspective. Once you understand that perspectives are foundational there is no way to escape this truth. Perspective is not less than but it is much more than merely your conditioning. Perspective is a property of your essence.

While the same True Self exists in every one of us, each of is awakened as True Self from a radically unique perspective. Each one of us has a personal perspective that is irreducible. Unique Self thus insists that enlightenment is ultimately not at all impersonal. Rather, Unique Self reveals the radically personal nature of enlightenment.

For the classical enlightenment traditions enlightenment was the realization of the emptiness that is empty of all personal dimensions. I call this the enlightenment of emptiness. The new enlightenment of Unique Self is the realization of the radically personal nature of your True Self, which is your Unique Self. For this reason I have called Unique Self enlightenment the Enlightenment of Fullness.

Your Unique Perspective forms your Unique Self. This is the unique expression not merely of your manifest self but also of your unmanifest self. This is what the Hebrew mystics called Ayin and the Buddhists called sunyatta or emptiness. (This is why we deployed the term Unique Self instead of soul. While some texts refer to soul as I am using Unique Self, see for example, some passages in Gafni, Soul Prints, 2001. Other classical mystical texts refer to soul as the spiritual substance of separate self. Soul is thought in this usage to be the unique expression of your manifest self.)

Unique Self, however, transcends and includes this understanding of Soul, for unique self is the infinite and irreducible uniqueness of both your manifest and un-manifest self. Your un-manifest essence, which was there before the big bang, is unique as it always looks out through a unique set of eyes.

Your enlightenment has perspective. Your perspective.

Your perspective is the source of the irreducible dignity of your individuality. Your perspective creates your unique insight. Your unique insight creates the unique gifts of being and becoming that you have to bring to the world. The radical and irreducible uniqueness of your gifts is precisely what creates your Unique Obligation to give those gifts. You have a unique responsibility to give those gifts because they are yours and yours alone. There is no one else in the world that ever was, is or will be that can give those gifts.

The failure to realize Unique Self undermines the recognition of the infinitely special nature of every human being. It is only such a recognition that prohibits you from using another human being as merely a means for your end.

To love a human being is therefore to recognize their Unique Self and support its emergence in the world. Unique Self like True Self always exists.

Unique Self only fully grows up into itself after awakening to some level of True Self and after evolving to higher levels of developmental consciousness.

After I unfolded the core of the Unique Self teaching I was exposed to a plethora of developmental models, which confirmed that it is at the more evolved levels of consciousness – beginning at about World Centric and progressively deepening – that Unique Self is naturally and spontaneously experienced.

At these higher levels of consciousness your True Self-consciousness awakens to its Unique Perspective of the world. So while Unique Self, like True Self, is present all the way up and all the way down in every stage and state of sentience, it comes online spontaneously as the natural property of the higher reaches of developmental consciousness.

Enlightenment then can be properly understood as having two distinct steps. The first step is waking up and the second step is growing up.

The first step is when the human being wakes up to their state of being fully identified with True Self. The realization that True Self—your awakened conscious knowing that the living essence of all that is, lives in you, as you and through you—is step one.

Step two is when True Self grows into the realization of its irreducible uniqueness. In growing up you realize that what you thought was your identity at the level of separate self-consciousness was an illusion. Your ego claimed that all sorts of expressions of self, which are illusory and fleeting, are your core identity. These might include your wealth, social status, physical prowess and the like.

When you liberate those illusions of self into the realization of True Self, you wake up. You grow up when you reclaim every part of you, including the unique properties of your separate self, as an expression of your unique perspective. The natural and spontaneous experience of your unique perspective comes on line at the higher levels of developmental consciousness.

Pause for a second to review how we are deploying some of these terms.

A state of consciousness, be it a mystical, orgiastic or drunken, is attained through free grace of practice. It is transitory and not stable. In a mystical state you feel in first person the true nature of your expanded identity.

A level is not an awakened state but a structure stage of developmental consciousness. The simplest example might be the movement of moral consciousness to expand your circle of love from your self, to your tribe, to the whole world, including all human beings, and then even beyond. These expanding circles of caring, concern and love are often labeled ego-centric, ethnocentric and World Centric.Each is a distinct structure of consciousness that once you realize you virtually never lose.

Unique Self-Realization becomes a natural, spontaneous and stable expression of self at the higher levels of developmental consciousness beginning around the World Centric stage.

Beyond the World Centric stage is where states and levels (sometimes called stages) arise together. This level of consciousness has been called Kosmoscentric. At this level one’s circle of love includes not only human beings but all sentient beings and not only in the present but also all past and future. In parallel, in Kosmoscentric consciousness at its more evolved stages, you awaken to your real identity as True Self. At Kosmoscentric consciousness the movement of waking up happens together with growing up as well.

Growing up at Kosmoscentric occurs when you make the ultimate shift in perspectives. You move, as it were, from the human to the divine perspective. You become God’s perspective.

But not in the sense of being absorbed in the undifferentiated source. You do not become indistinguishable oneness or divinity. Rather, you shift to God’s perspective through growing up fully into your Unique Self that is grounded in your unique perspective. When your unique perspective wakes up and grows up into itself, a new emergent quality of divinity that never was before comes into being and becoming.

God has evolved. God evolves as and through the awakening of your Unique Self. This particular quality of essence that awakens in you when you fully grow up is your unique perspective that births your Unique Self. This is the radically personal face of both enlightenment and evolution.

When you grow into Kosmoscentric consciousness you become fully aware of the larger evolutionary context of ever emerging source, which seeks to awaken in you as you and through you.

Your awakening as Evolutionary Unique Self is source’s evolutionary awakening to itself. Through you and only through you can a unique set of gifts be given to reality, gifts that are not extra or ornamental, but gifts which are desperately needed and passionately desired by all.

Paradoxically Unique Self also implies relationship. Irreducible uniqueness creates the face of the other that yearns to recognize and be recognized. Mutual recognition is realized in the face-to-face relationship.

For Unique Self the paradoxical encounter with the second person of God is not dogma, but realization. Sufi master Rumi and Hasidic master Levi Isaac of Berdichev do not “believe” in the personal god. Rather, they know and taste the personal face of essence.

Unique Self is paradoxically the unique expression of God in the first-person, what the Upanishads called, Thou Art That, known in Buddhism as I Amness, as well as God in the second-person, the unique face-to-face encounter of other with Source.

At the same time Unique Self incarnates God in the third person, the conscious and unique expression of the evolutionary impulse, God having a You experience. Therefore, it would be most correct to say that in Unique Self-realization the three faces of God incarnate in paradoxical unity.

Unique Self, Levels of Self, and the Puzzle-Piece Dharma

Watch Marc’s video message and read the summary

According to the Unique Self teaching, there are six core levels of self. To understand this journey of self-hood is to realize the purpose of your life, to find joy, to participate in the evolutionary context of giving your gifts. Be aware of these levels in order to better understand Unique Self enlightenment.

1. Pre-personal self – This is the developmental level before self has actually been formed.

2. Personal self or personality or separate self or ego self – This is the puzzle piece which has an experience that there’s a puzzle, a larger context, but it can’t quite find the puzzle. You have boundaries (you are a “skin-encapsulated ego”). You have embraced your individuality as a separate self. At this level, yearning exists and there is no genuine intimacy.

3. False self — This is the separate self. It is a corruption of your separate self with false, limiting, distorted beliefs about who you are.

4. True Self — The separate self is transcended and you have realized your larger identity. It is the singular that has no plural. There is no puzzle piece at all, only a puzzle. If you think there are lines that seem to be separating the puzzle pieces, that’s an illusion. At this stage, separation and uniqueness are illusions that need to be dispelled.

5. Unique Self — The True Self sees through a unique set of eyes. The puzzle piece is now located in the larger puzzle. Your unique essence and the unique contours of your puzzle piece self connect you. It is not separate, but unique in the larger context. Uniqueness is discovered to be the currency of connection.

6. Evolutionary Unique Self — Unique Self is connected not only to pieces around it, but the entire puzzle.

These six levels underlie the teachings that you will find at the Unique Self portal.


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Unique Self & Education

Students of all ages are consumed by the burning question, “Who am I?” Conventional teaching methods are not well suited to address this existential concern. Unique Self is a non-dogmatic, humanistic, values-based tool with the potential to shape education for generations to come.

Q & A

The following is a transcript of an excerpt from a dialogue between Joe Perez and Marc Gafni in July 2012 (audio file available for download at the bottom of the page).

Marc: Education, which is such a critical topic, is more important than any other single dimension of society. Education is the linchpin upon which everything else depends. How we educate ourselves and how we educate the next generation changes the game all the time.

Let’s look at four dimensions of education. First let’s look at high school education. One of the key issues up is “Who am I?”

I just had the occasion to do some teaching to the humanities and religion faculty at what perhaps is the leading private high school in America. It’s about a thousand kids. It’s considered the Harvard of private schools. These kids are considered the best and brightest. The best is an inaccurate word because the best are everyplace. They’re certainly the brightest, and they’re good kids. The faculty was utterly at a loss because the kids are saying, “Who am I?”

Am I a combination of a particular combination of a particular configuration of genes that I inherited and I’m affected by the different structures of society, by all the different contexts that I live in?

If that’s true, if I’m predetermined by the contexts – historical contexts, psychological contexts, etc.–then there’s no self that ever chooses? There’s no self that I’m responsible for. I’m a side effect in my own life. It’s a shocking realization.

The teachers themselves, educated in a kind of postmodern liberalism, had no response to “Who are you?” Some tried the Buddhist approach – you’re not a self, you’re a no self, you’re part of the All. That doesn’t hold for the students because they have this intuitive sense of self. The Buddhist no-self teaching runs in the face of the profound Western sense of individuality, so the teachers were unable to locate and transmit to the students a sense of self within their own beings, because the teachers weren’t able to locate and transmit that sense of Self within their own beings. That’s where Unique Self enters the conversation.

I introduced the idea of Unique Self. Actually one of the lead teachers at that school taught Unique Self for three semesters in the classroom so we were able to talk about how Unique Self functioned in the classroom. It was wildly transformative and effective in a powerful way. It allowed, on the one hand, kids to say (1) I’m unique, (2) my uniqueness is not a function of psychological, social, cultural, or physical conditioning. It’s not genes or contexts. Uniqueness is an irreducible property of essence which I’m actually able to discern through the Eye of the Heart, the Eye of the spirit.

We talked about different faculties of knowing. That the Eye of the Spirit is an important faculty of perception just like the Eye of the Mind and the Eye of the Senses which discern empirical structures in the world. The Eye of the Spirit discerns the nature of essences, and one of the things it discerns is the unique quality of essence.

So we’re able to say, Wow. I’m not just genes, but an irreducibly unique configuration of genes, molecules, and cells, and the 50 trillion cells that live cooperatively in my body is an irreducibly unique expression of all that is. And all that exists on the physical level, an emotional level, and a spirit level, and suddenly we are able to access uniqueness not as a property of ego, but a property of essence and (2) uniqueness became not a source of alienation – not separate from – but uniqueness as the currency of connection.

Uniqueness is the puzzle piece dharma of enlightenment. Uniqueness means I’m a puzzle piece, and the contours connect me to the larger puzzle.

Now the school is working on implementing Unique Self in the curriculum with a number of teachers and hosting a national conference on bringing Unique Self into the educational system.

Here’s the simple metaphor we used. You take a puzzle piece. If you think a puzzle piece is not a puzzle piece, it just lives by itself. You say, This is not a puzzle piece, it’s a strange configuration of jagged edges that lives by itself. That’s what it means to have a consciousness of separate self. I’m a strange jagged configuration of influences. I don’t fit into anything larger. It’s a puzzle piece that doesn’t know it’s a puzzle. That’s the consciousness of separate self. One.

Two. The consciousness of True Self – which is what classical Enlightenment talks about – means I don’t know there’s a puzzle. I don’t realize there are all these different pieces. I think it’s all one. I don’t realize it’s a puzzle, I think it’s all one. That it’s not made up of different pieces, that’s consciousness of True Self.

Unique Self is actually the consciousness of being a puzzle piece that’s part of a puzzle. I have unique contours to who I am. My uniqueness is my identity. That’s the self-identity that the classroom needs to be able to access. And that puzzle piece nature of who I am is part of the currency of connection. It is precisely what lets me fit, precisely what makes me fit naturally and be held by all the puzzle pieces around me.
That’s Unique Self.

That structure, that vision, is essential to education. I’ve used my time to talk about high school, but you can also deploy this at elementary school, the higher education / college level, as well as continuing education. Adult development – many studies say, and our colleague Ken Wilber cities some of these studies — adult development stops at age 26. That’s shocking. Education just stops. Unique Self training is to be constantly defining the contours of my puzzle piece within the larger context of awareness that I’m part of a puzzle and that my uniqueness is the currency of connection. Bringing Unique Self into the classroom at all levels of education and viewing education as accentuating and sharpening the deepening the awareness of our puzzle piece nature changes the game in education.

Joe: We live in a liberal Western democracy in which there is a secularization, a separation of government and religion or education and spirituality. I wonder if you could briefly address how Unique Self is able to overcome that potential barrier.

Gafni: Unique Self is not a religious idea. There is a separation of church and state. Church, synagogue, mosque, Buddhist dogma – a particular religion’s dogma shouldn’t be superimposed on the classroom. That’s absolutely true. At the same time, what’s very clear is that all the different faculties of perception can play in the classroom.

For example, more and more, we’re understanding, as Fichte and Schelling did in the great universities of Germany, that actually we can access within liberal education not only the Eye of the Mind – the logical, inductive, mathematical structural perceptions; not only the Eye of the Senses – the empirical understandings; but the Eye of the Heart or Spirit – faculties of perception which are trans-religious, post-traditional, post-denominational, have a real place in the classroom. They are not based on a particular religion or dogma, but are based on the human being engaging and grappling with what Christian theologian Paul Tillich calls “ultimate issues.”

Education can’t be a place where we don’t engage ultimate issues which include values, meaning, all those things that matter most to us. It would be preposterous to reduce education to a kind of vocational training and the liberal arts. That would be a mistake, and it was never intended to be vocational. Liberal education needs to be trans-lineage, trans-dogmatic, but not devoid of engagement with ultimate issues, values, and meaning.

File: unique-self-dialogue-gafni-perez-on-education.mp3 (20.4 MB)

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Unique Self, Therapy & Psychology

The alleviation of personal suffering requires for greatest efficacy a therapy that works at the level of identity. What is the purpose of my life? How can I realize the values and direction that are uniquely my own? Unique Self is emerging as a revolutionary new technology for psychologists.

Q & A

The following is a transcript of an excerpt from a dialogue between Joe Perez and Marc Gafni in July 2012 (audio file available for download at the bottom of the page).

Joe: I’m here with Marc Gafni and this is another 10-minute dialogue on Unique Self. Our topic today is Unique Self and psychology. I understand that Unique Self may be a new chapter in thinking about self in psychology and has generated a lot of excitement. I’m hoping that you tell me more about that.

Marc: That’s fantastic, Joe. I would be delighted to. We’re working with a number of leaders in the field in addiction, eating disorders, trauma therapy, internal family systems, etc. – particularly Professor Richard Schwartz, founder of internal family systems, a member of the World Spirituality Council. We’re working together on a paper on internal family systems and Unique Self. And Lori Galperin, with her clinical co-director Mark Schwartz, who are leaders in the world who have built centers throughout the world for eating disorder, sexual addiction, trauma therapy, etc., are developing with a team of therapists at their center a full program for Unique Self therapy. Particularly, they are developing a set of Unique Self models with a team of therapists to actually use as part of the intensive therapeutic process that takes place at their treatment centers.

Let me share for a second, if this is helpful, how this came about and why it’s so absolutely critical. Classical therapy at its best, classical psychology at its best, creates equilibrium. You get some of the disturbing factors out of the way, you become aware of them, you bring them into consciousness, you create a relationship with the different parts of self, and you feel a less disturbed, more balanced – more homeostasis if you will – more integration in your core system, which is fantastic. For any of us who felt disturbance (and who hasn’t?), whether in the form of depression or any other significant psychological disorder – and I think all of us have some moment where we run into some deep sort of psychic pain – the possibility of alleviating that pain is a huge function of psychology.

The problem is that it is often not sustainable because it doesn’t answer the larger questions of: Then what? Why am I here? What’s the nature of my life? Does my life have purpose, meaning, direction? Without addressing what it means to live a purpose-driven life, or values-driven life, and how I can identify the purpose and values of my particular life, all the homeostasis and equilibrium ultimately collapses, from a Unique Self perspective, and doesn’t sustain.

What we’re saying is that Unique Self fills in a critical missing piece in the story of treatment, whether that’s chemical dependency, addiction issues, eating disorders. It invites a person to define themselves not as an addict – as the classical 12-step model suggests – but as a Unique Self who has a set of Unique Shadows which are distortions of one’s own primary Unique Self, and to reclaim that Unique Self – the dignity, purpose, meaning, the values that are implicit in that Unique Self. And we’ve found that by actually enacting one’s Unique Self and accessing a sense of being profoundly needed by the cosmos, having a unique gift to give, actually experiencing all of reality living in you and as you and through you uniquely, with a unique contribution, a unique set of abilities, a unique way of being in the world, unlike any other, one that never was, is, or will be again; that has enormous efficacy as a healing process, a healing modality, a transformative modality that creates a sustained locus in a human being that can hold the psychic pain of engaging in the world. We’ve found that without that Unique Self locus all the other psychological work, important and critical as it is, often lacks a home, a locus, a place where it can rest and be sustained.

We are now developing – and this is a multi-year process, will take at least a decade to fully offer it to the worldwide community – our goal is to develop sets of Unique Self modules, Unique Self therapeutic process (like an EMDR process, which is a trauma process) which therapists can be trained in in a year of supplemental training. Our hope is that five to seven years from now there will be 5,000 or 10,000 therapists in America actually deploying Unique Self therapy in a significant way. That’s where it’s going. We’ll be getting the first group of 10 or 20 thousand therapists to deploy this. It’s one of the key lines of development in society which Unique Self is now meeting and deploying in its own vital way.

Joe: That’s really exciting. When I think about what you just said, I wonder if you’re talking about creating a new school of psychology or if you’re talking about enhancing the schools of psychology that currently exist with something new.

Marc: That’s a great inquiry. The answer is: a little bit of both. We haven’t fully clarified it yet. It will definitely be an enhancement of existing schools of psychology; it will be a critical dimension they can all access. We don’t need to have an old fight like in the olden days. disproving the efficacy of all the schools of psychology. Actually they do have efficacy. One of the things that our friend and integral mentor Ken Wilber has pointed out brilliantly in a long essay in his book Transformations in Consciousness, is that each school of psychology at a particular fulcrum of development has important unique gifts to give. We want to honor the particular gifts of each type of psychology. There is particular type of trauma work, for example, that Unique Self doesn’t address.

I was talking recently to Besel Van der Cook, perhaps the leading trauma therapist in the world, some would say, a brilliant theoretician and researcher, and we were talking about Unique Self particularly, and we both kind of agreed after a significant conversation that when people walk into his office they first need to deal with the overwhelming psychic pain and rupture and disruption of essential personality features, period. There are methods that he and other trauma therapists have developed to do that. If you try to have a Unique Self conversation about identity at that stage, it’s a mistake. We want to receive that methodology, but then when that stage has passed, what I said to Besel is that that’s when we need to bring Unique Self to bear. That’s when issues of identity becomes critical, it becomes part of other schools of psychological work, and adds a critical component.

I think is also true as you suggest is that Unique Self needs to develop into its own school of psychology. We need people writing on this. Rob McNamara wrote an important essay posted on this website on Unique Self and transpersonal psychology. The essay that I’m writing with Professor Richard Schwartz will be completed in the next several months. And there needs to be a deepening of how to deploy Unique Self as a psychological model. Then there’s the empirical work we’re doing at the treatment centers, so I think it will be a both/and. I’m sure we’re making mistakes, but I’m sure we’re making really great mistakes in the right direction. Unique Self has the possibility like perhaps no other individual component has in the last 50 years to transform the therapeutic process and investing within it a dimension of identity and spirit which is actually post-dogmatic and post-metaphysical, which can really change the game.

File Size: unique-self-dialogue-gafni-perez-on-relationships-July2012 (18.6 MB)

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Unique Self Health & Medicine

Read this White Paper by Board Members Venodhar Rao Julapalli, M.D. and Vinay Rao Julapalli, M.D., F.A.C.C.

There is a dire need for the integration of the art, science, and morality of medicine. This paper explores the deep implications of the Unique Self in integrating medicine. Co-authors and physicians Venu and Vinay Julapalli call on their extensive understanding of the promises and pitfalls of modern health care to reconceive the practice of medicine. The paper provides the framework to evolve medicine through the emergent Unique Self insight. At stake is no less than the future of how we care for ourselves and each other.

Unique Self and the Future of Medicine


Medicine is at a critical crossroads in its evolution from antiquity to our modern age. This article aims to reconceive the future of medicine. Key to this conception is an understanding of the evolution of individual development. To this end, the discussion will first outline the stations of the selves, on the path to what has been termed the Unique Self by spiritual thinker Marc Gafni. Next, the discussion will distinguish between two poles of development and outlook, in order to understand how the insight of Unique Self integrates these dualities. It will then view the Unique Self from three perspectives, or four quadrants, of reality and also illustrate how Unique Self appreciates the balance between part and whole. The discussion will subsequently correlate the stations of the selves with the history of medicine and further examine dualities in medicine that parallel those of the self . It will then elucidate how an understanding of Unique Self fundamentally shifts our envisioning of the practice of medicine. This shift renews the unique calling that is the art and science of healing.


Universal to the human experience is care of our health. Medicine is defined as “the science and art dealing with the maintenance of health and the prevention, alleviation, or cure of disease.” The topic of medicine is therefore relevant to all of humanity.

In the United States, the practice of medicine has reached a critical crossroads. National spending on health care has been estimated to total $2.8 trillion in 2012, which is 18% of the gross domestic product (GDP). It is projected to increase to about 25% of GDP and 40% of total federal spending by 2037. Few dispute that this trajectory is unsustainable.

The dispute begins in how to alter this trajectory. The debate has raged on from multiple perspectives. Some have focused on the structures of payment for health care, while others have investigated the sources of health care pricing. Some have proposed the standardization of health care delivery with an emphasis on maximizing value through evidence-based medicine, while others have highlighted the role of the social determinants of health in influencing the rising costs of medical care. The Affordable Care Act, signed into law in March 2010, expanded health insurance coverage for Americans and introduced programs designed to slow spending on health care. However, there is no clear consensus on its ultimate effect in bending the health care cost curve down.

Most of the recent discussions on the practice of medicine have preferentially approached health care as an object. Evidence-based guidelines, quality measures, value-based metrics, and pay-for-performance programs presuppose an objective perspective on medicine. The increasingly acknowledged urgency of controlling spiraling health care costs has certainly advantaged this perspective, along with desires to improve patient safety and even out regional variations in health care delivery.

Somewhat drowned out in the recent movements in medicine is the voice of medical humanism. This voice presents medicine from a subjective perspective, as it highlights the individual values, goals, and preferences of a patient with respect to clinical decision making. From this perspective, paramount are factors such as honoring the dignity of patients and their families, acknowledging their cultural and ethical sensitivities, sharing clinical decision making between the patient and the physician, and upholding the autonomy of the patient in making medical decisions. Physicians voicing humanism in medicine feel that the subjective aspect is crucial in maintaining medical professionalism, demonstrating good clinical judgment, and caring for patients near the end of life. They question the effectiveness of health care based merely on utilitarian medical decision analyses, rather than nuanced conversations between the patient and physician on the patient’s perception of his/her illness and its treatment.

The two perspectives, medicine as an objective science and medicine as a subjective art, are often diametrically opposed to each other. Health care objectivists regret that “Our current health care system is essentially a cottage industry of noninteg rated, dedicated artisans who eschew standardization.” They criticize the current system as one that “overvalues local autonomy and undervalues disciplined science.” In subjective medicine, “‘Good doctors’ are celebrated for their unwavering dedication to doing whatever it takes to care for their individual patients.” In their view, this leads to excessive tests and procedures, a fragmentation of care, limited oversight of such care, and ultimately wasteful and unreliable medicine.

Health care subjectivists, on the other hand, lament that “Reducing medicine to economics makes a mockery of the bond between the healer and the sick.” They eschew the replacement of terms such as “doctors” and “nurses” with “providers,” and “patients” with “customers” or “consumers.” They feel these terms are “reductionist; they ignore the essential psychological, spiritual, and humanistic dimens ions of the relationship – the aspects that traditionally made medicine a ‘calling,’ in which altruism overshadowed personal gain.” In objective medicine, the “discourse shifts the focus from the good of the individual to the exigencies of the system and its costs.” In their view, this results in diminished independent and creative decision making, dehumanization of the patient and professional, destruction of the trust so crucial to the patient-doctor relationship, and ultimately a demeaning of medicine.

How best can we reconcile these two positions in a way that includes and transcends them both? Is there another perspective that honors medicine both as a science and as an art, without congealing the two sides into a muddled compromise that satisfies neither?

Acknowledging the instability of the current system, can we evolve medicine to a practice of greater value, efficiency, meaning, and purpose?

In the rest of this discussion, we aim to reconceive the future of medicine. Key to this conception is an understanding of the evolution of individual development. To this end, we will first outline the stations of the selves, on the path to what has been termed the Unique Self by spiritual thinker Marc Gafni. Next, we will distinguish between two poles of development and outlook, in order to understand how the insight of Unique Self integrates these dualities. We will then discuss the Unique Self from three perspectives, or four quadrants, of reality and also see how Unique Self appreciates the balance between part and whole. We will subsequently correlate the stations of the selves with the history of medicine and further examine dualities in medicine that parallel those of the self. We will finally outline how an understanding of Unique Self fundamentally shifts our envisioning of the practice of medicine. Our discussion will highlight the physician as the exemplar of the medical professional but can apply to any professional involved in caring for patients. All are included in the future of medicine.