7 ms·

Pivotal Mental States (2020)

80 points by luu 3y ago

BenFranklin100 3y ago
From the Center for Psychedelic Research of course.
pstuart 3y ago
An ELI5 for the peasants would be nice.
- rednerrus 3y ago
  > In the same way that traumatic experiences can trigger post-traumatic stress disorder (PTSD) or post-traumatic growth (Tedeschi, 1999), we hypothesize that intense periods of psychological crisis can serve to kindle conditions for major, potentially lasting, psychological change, pivotable either towards illness or wellness (Figure 1). They're saying that with the use of psychedelics you can create super states in your mind.
  - ryandv 3y ago
    Is that what it says? Emphasis mine, > _Inspired by_ research with serotonin 2A receptor agonist psychedelics, we highlight how activity at this particular receptor can robustly and reliably induce pivotal mental states, but we argue that _the capacity for pivotal mental states is an inherent property of the human brain itself._
  - pstuart 3y ago
    Illness seems obvious from PTSD, I'm curious about wellness -- as in, can this be used as a tool for healing in a straightforward manner. My experience with psychedelics in my youth was reckless recreation, and in my not-youth I'm fascinated by how it can be a tool to be a better me. I have a healthy enough respect for the medicine now to not just jump in willy nilly and it would be wonderful to learn if there are "new tricks" that the properly prepared psychonaut can put in play.
  - nonrandomstring 3y ago
    Be careful what you wish for with this sort of thing. The Matrix has obviously become a cliche, but it's modern telling of Plato's cave allegory is handy. Imagine if I could give you a "healing" pill. But I'll warn you, in my best Laurence Fishburne voice, that when you wake up you will see the world exactly as it really is, no more, no less. And even if you go back in the cave you won't be able to unsee it or relate to other cave-dwelling people. There's a reason 99 percent of us take that blue pill every day. We like to have friends, go to dinner parties, wear acceptable clothes and say acceptable things. Trauma sets you apart. That's the best way I can put it. PTG is a 20 or 30 year process of adapting to so-called "super powers". A movie they never made is "What ever happened to Will Hunting?" After Matt Damon hugged Robin Williams and drove off into the sunset... what came next? Drug abuse, alcoholism? A 20 year gambling spree in Las Vegas? Or just endless fun with Minnie Driver? I'm not against recreational psychedelics, indeed I take the Bill Hicks view that they should be mandatory for some :) But to use them as a "pivotal" therapeutic shortcut to "wellness" doesn't seem to add up in my view. You'll still have to do "the work", sooner or later.
    - fragmede 3y ago
      but it's a ladder where the first rung is too high up to reach without the help. you still gotta climb the ladder and do the work, but without the help, you can't even try to climb the ladder in the first place.
      - nonrandomstring 3y ago
        You make a good point. Yes, some people can really benefit from a helping hand onto the ladder. But I'd hate to encourage anyone to climb on, only to see them freeze in fear, and get stuck when the only way is up. I think there are three things one should always bring to psychedelics or potentially life changing traumatic experiences - some experience - a question - a friend
        fragmede 3y ago
        my opinion is that a qualified trained trip sitter is needed, not just a friend.
- readthenotes1 3y ago
  Hazing rituals and similar stresses have been used historically to bind people into a group. Pavlov's research with the salivating dog was part of an larger experiment to learn how to brainwash people. Not surprisingly, physical and psychological stress were found to put people into a highly receptive state where they could be taught new beliefs and behaviors. This paper claims that some psychedelics can mimic that stress to put people into a similarly receptive state. Further, it says that the same underlying brain chemistry comes into play. (At least that is how I understood it)
- ryandv 3y ago
  I will take a layman's crack at it. The paper discusses how crises and times of high stress and/or prolonged periods of social isolation, sleep deprivation, etc. can precipitate a psychological state (with accompanying neurochemical phenomena which I cannot speak to but appear to be centered around serotonin) that can foster rapid psychological transformation and re-arrangement of one's self-concept, their core beliefs about themselves and others, and their ultimate framing of and relationship to the world. A "resurrection." Under suboptimal conditions it can lead to a descent into psychosis. I am reminded of Jung's own brushes with such states as chronicled in the Red Book.
ryandv 3y ago
It's my view that it's this psychological transformation that is the end goal of many spiritual traditions; Jung's "process of individuation," various notions of "enlightenment," the alchemical "Great Work," the Greek notion of "anagoge," "union with the Higher Self/Genius/Logos," the Thelemic notion of "Knowledge & Conversation..." Unfortunately such flowery and offputtingly religious sounding language sounds quaint to our postmodern, secular ears. I think psychedelic, cogsci, and psychological research as explored in this paper offers fruitful avenues for recasting such religious or spiritual language in the vocabulary of science and empiricism.
- nonrandomstring 3y ago
  Dunno. As a scientist I say bring me flowery language and religiosity any day on this subject. Some things are improved by formalism, empiricism, and positivist reductionism. Some things are made worse by that kind of thinking. Science is not always a process of "removing confusion". A mature scientist who can question science itself stops seeing it as a hammer and everything else as a nail. Secular post-modernity is brilliant at giving us power plants, roads, and medicines. In other regards it's stunted our emotional and social development, bringing us to the brink of total war and social disintegration.
  - p-e-w 3y ago
    > Some things are improved by formalism, empiricism, and positivist reductionism. Some things are made worse by that kind of thinking. But that doesn't mean anything is made better by mysticism and appealing to some vague idea of transcendence. If nothing formal can be said about a topic, then perhaps nothing at all can be said about that topic. Which is perfectly fine. It seems to me that so much of the available literature concerning such things is driven by the desperate insistence that it must be possible to investigate it, and if it cannot be done scientifically, there must be some other way. "Whereof one cannot speak, thereof one must be silent." - Ludwig Wittgenstein
    - nonrandomstring 3y ago
      I'll respectfully disagree and explain why. > But that doesn't mean anything is made better by mysticism and appealing to some vague idea of transcendence. Actually it does. Let's talk about "better". Better for what, for who? Some of the most powerful forces for positive change are stories. Stories are made-up, vague, hand-waving. metaphorical and allegorical. They occupy a different, parallel communicative realm to science, maths and equations. But they are no less true, particularly with regard to their utility if you want to communicate important ideas to lots of people. Certainly, mysticism is not an analytical or investigative tool. But it is a powerful communicative, and - since you raise Wittgenstein - a powerful symbolic tool for word-concepts that "stand in for" formalisms. To be honest I think that the way the younger generations relate to smartphones, the Internet and AI is very much mysticism. The words have changed, but I don't see concepts like "The Cloud" having any more substance than "Ectoplasm" and "ethereal spirits". Again, that new generation mysticism isn't a bad thing, it's just a way of dealing with unfathomable complexity through stories that we can all share.
sidcool 3y ago
TLDR or ELI5 for the uninitiated?
- deleted 3y ago
  [deleted]
jdietrich 3y ago
Cautionary note: The same department recently completed a good-quality RCT comparing psilocybin and escitalopram (plausibly the most effective SSRI antidepressant) for the treatment of Major Depressive Disorder. While psilocybin was shown to be marginally more effective than escitalopram, the difference was not statistically significant. A subsequent Bayesian reanalysis did show a statistically significant advantage to psilocybin, but this difference was not clinically significant. Other RCTs investigating classical psychedelics have shown similar results. There's a lot of excitement about psychedelics, a lot of hype, a lot of people who dearly want them to be a breakthrough (and god knows, we need a breakthrough), but the data we have just doesn't justify that excitement. This article presents a compelling narrative explaining why classical psychedelics might be a radically effective psychiatric treatment, but that amounts to nothing if psychedelics are not in fact radically effective; although it is still far too early to make any firm conclusions, the evidence we do have suggests that psychedelics are, at best, only a modest improvement over the current state-of-the-art. This does not preclude the possibility that psychedelics could be the best available treatment for a subset of patients, nor does it invalidate the personal experiences of people who believe that they have experienced dramatic benefits from psychedelic therapy, but it is grounds for considerable caution. Pepole enduring the misery of mental illness deserve better than yet another cycle of hype and disappointment. https://pubmed.ncbi.nlm.nih.gov/33852780/ https://pubmed.ncbi.nlm.nih.gov/33852780/ https://pubmed.ncbi.nlm.nih.gov/37337526/ https://pubmed.ncbi.nlm.nih.gov/37337526/ https://pubmed.ncbi.nlm.nih.gov/36322843/ https://pubmed.ncbi.nlm.nih.gov/36322843/
- colordrops 3y ago
  Does it have to be better than escitalopram? Even if it were at the same level of effectiveness, the lack of side effects and additional insight psilocybin brings are great benefits.
- mtlmtlmtlmtl 3y ago
  This data isn't terribly surprising to me in itself. The promise always seemed much greater for anxiety disorders than for depression, and I honestly believe we'll never find a pharmacological treatment that significantly outperforms SSRIs when depression is defined as broadly as it is in this trial. Depression is really a wide family of disorders that we don't have very good ways of telling apart yet, but likely work quite differently, along with a very fat tail of somatic conditions that are very commonly misdiagnosed as MDD or some other depression diagnosis. This seriously confuses any attempts at comparing efficacies like this. Anxiety disorders are much better understood and more clearly delineated. And what we see in anxiety land is huge strides being made even just in new forms of therapy. Metacognitive therapy is starting to show real improvement over CBT. Pilot studies with a new form of intensive exposure therapy have shown staggering remission rates of over 70% in severe anxiety disorders like panic disorder(look up the Bergen 4 day treatment). MDMA-assisted therapy for PTSD looks very promising as well. For depression, dissociatives have looked much more promising than psychedelics for a while now.
calibas 3y ago
>Psychological transformation (defined here as rapid, marked and enduring psychological change, where ‘psychological’ refers to perception, cognition and action or behaviour) has been the focus of previous psychological and philosophical texts (Miller and C’de Baca, 2001; Paul, 2014) as well as influential therapeutic programmes (Wilson and Cohen, 2015), but it has received surprisingly little formal scientific investigation and past definitions have been vague. I'd argue this is one of the very few fields where religion, specifically Buddhism, is more advanced than modern science. I'm not joking either, Buddhists have been concerned with this exact thing for over 2,000 years. When studied, I think scientists will find that certain mystical practices induce these pivotal mental states, at least in a percentage of the population.
- totetsu 3y ago
  you might find this podcast episode about neuroscientist Richard Davidson who also studied with meditators interesting https://hiddenbrain.org/podcast/seeking-serenity-part-1/ https://hiddenbrain.org/podcast/seeking-serenity-part-1/
- steve_adams_86 3y ago
  I've been thinking recently about how Buddhism and even some western philosophies are arguably sciences of the mind. You can't refute that ancient thinkers dedicated to contemplating reason, virtue, meditation, or otherwise were ahead of their time, so to speak. We are still proving out what they discovered, however subjectively they may have done it. It's sort of a marvel. I'm not sure people appreciate how incredible it is that thousands of years ago, with little more than paper and brains, these people recorded insights about psychological phenomena which we still struggle to understand. That's not to say people in the past have necessarily understood it. They experienced it and recorded it though, and the evidence of these collective experiences throughout time and space have turned out to be remarkably consistent. My favourite thread throughout eastern and western philosophies, as well as modern psychedelic research, is how crucial dissolution of the ego is to attain clear perception (at least what we consider to be clear) and ultimately, more virtuous action in the world. Buddhists did it, Taoism, Hinduism, Stoicism... I'm sure there are others, but I'm not that well-educated, just interested in this stuff. Many people will be strict about what qualifies as a science and exclude anything that appears to be religion or philosophy. I think it's worth taking seriously, though. I certainly wouldn't have 10 years ago.
tech-code-build 3y ago
[dead]
wolverine876 3y ago
(2020)
- dang 3y ago
  Added. Thanks!
SillyUsername 3y ago
This in part explains PTG (Post Traumatic Growth) after PTSD. As I started recovering I had a large ability to learn, I got 3 qualifications within a month, and won 2 workplace awards for innovation within ~6 months. I also excelled in the workplace in terms of workload and quality of work that it was noticed (and believe me sometimes you don't want that attention, it irritates the competitive types). Around 2 years later this level of attainment dropped, but it was great while it lasted.
- lioeters 3y ago
  I had never heard of Post Traumatic Growth until this week, when I noticed several people mention the phrase. A related concept I found fascinating is Positive Disintegration. > The theory views psychological tension and anxiety as necessary for personal growth. > These "disintegrative" processes are "positive", whereas people who fail to go through positive disintegration may stop at "primary integration", possessing individuality but nevertheless lacking an autonomous personality and remaining impressionable. > Entering into disintegration and subsequent higher processes of development occurs through developmental potential, including over-excitability and hypersensitivity. https://en.wikipedia.org/wiki/Positive_disintegration https://en.wikipedia.org/wiki/Positive_disintegration

80 points by luu 3y ago

BenFranklin100 3y ago

From the Center for Psychedelic Research of course.

pstuart 3y ago

An ELI5 for the peasants would be nice.

rednerrus 3y ago
> In the same way that traumatic experiences can trigger post-traumatic stress disorder (PTSD) or post-traumatic growth (Tedeschi, 1999), we hypothesize that intense periods of psychological crisis can serve to kindle conditions for major, potentially lasting, psychological change, pivotable either towards illness or wellness (Figure 1). They're saying that with the use of psychedelics you can create super states in your mind.
- ryandv 3y ago
  Is that what it says? Emphasis mine, > _Inspired by_ research with serotonin 2A receptor agonist psychedelics, we highlight how activity at this particular receptor can robustly and reliably induce pivotal mental states, but we argue that _the capacity for pivotal mental states is an inherent property of the human brain itself._
- pstuart 3y ago
  Illness seems obvious from PTSD, I'm curious about wellness -- as in, can this be used as a tool for healing in a straightforward manner. My experience with psychedelics in my youth was reckless recreation, and in my not-youth I'm fascinated by how it can be a tool to be a better me. I have a healthy enough respect for the medicine now to not just jump in willy nilly and it would be wonderful to learn if there are "new tricks" that the properly prepared psychonaut can put in play.
- nonrandomstring 3y ago
  Be careful what you wish for with this sort of thing. The Matrix has obviously become a cliche, but it's modern telling of Plato's cave allegory is handy. Imagine if I could give you a "healing" pill. But I'll warn you, in my best Laurence Fishburne voice, that when you wake up you will see the world exactly as it really is, no more, no less. And even if you go back in the cave you won't be able to unsee it or relate to other cave-dwelling people. There's a reason 99 percent of us take that blue pill every day. We like to have friends, go to dinner parties, wear acceptable clothes and say acceptable things. Trauma sets you apart. That's the best way I can put it. PTG is a 20 or 30 year process of adapting to so-called "super powers". A movie they never made is "What ever happened to Will Hunting?" After Matt Damon hugged Robin Williams and drove off into the sunset... what came next? Drug abuse, alcoholism? A 20 year gambling spree in Las Vegas? Or just endless fun with Minnie Driver? I'm not against recreational psychedelics, indeed I take the Bill Hicks view that they should be mandatory for some :) But to use them as a "pivotal" therapeutic shortcut to "wellness" doesn't seem to add up in my view. You'll still have to do "the work", sooner or later.
  - fragmede 3y ago
    but it's a ladder where the first rung is too high up to reach without the help. you still gotta climb the ladder and do the work, but without the help, you can't even try to climb the ladder in the first place.
    - nonrandomstring 3y ago
      You make a good point. Yes, some people can really benefit from a helping hand onto the ladder. But I'd hate to encourage anyone to climb on, only to see them freeze in fear, and get stuck when the only way is up. I think there are three things one should always bring to psychedelics or potentially life changing traumatic experiences - some experience - a question - a friend
      - fragmede 3y ago
        my opinion is that a qualified trained trip sitter is needed, not just a friend.
readthenotes1 3y ago
Hazing rituals and similar stresses have been used historically to bind people into a group. Pavlov's research with the salivating dog was part of an larger experiment to learn how to brainwash people. Not surprisingly, physical and psychological stress were found to put people into a highly receptive state where they could be taught new beliefs and behaviors. This paper claims that some psychedelics can mimic that stress to put people into a similarly receptive state. Further, it says that the same underlying brain chemistry comes into play. (At least that is how I understood it)
ryandv 3y ago
I will take a layman's crack at it. The paper discusses how crises and times of high stress and/or prolonged periods of social isolation, sleep deprivation, etc. can precipitate a psychological state (with accompanying neurochemical phenomena which I cannot speak to but appear to be centered around serotonin) that can foster rapid psychological transformation and re-arrangement of one's self-concept, their core beliefs about themselves and others, and their ultimate framing of and relationship to the world. A "resurrection." Under suboptimal conditions it can lead to a descent into psychosis. I am reminded of Jung's own brushes with such states as chronicled in the Red Book.

ryandv 3y ago

It's my view that it's this psychological transformation that is the end goal of many spiritual traditions; Jung's "process of individuation," various notions of "enlightenment," the alchemical "Great Work," the Greek notion of "anagoge," "union with the Higher Self/Genius/Logos," the Thelemic notion of "Knowledge & Conversation..." Unfortunately such flowery and offputtingly religious sounding language sounds quaint to our postmodern, secular ears. I think psychedelic, cogsci, and psychological research as explored in this paper offers fruitful avenues for recasting such religious or spiritual language in the vocabulary of science and empiricism.

nonrandomstring 3y ago
Dunno. As a scientist I say bring me flowery language and religiosity any day on this subject. Some things are improved by formalism, empiricism, and positivist reductionism. Some things are made worse by that kind of thinking. Science is not always a process of "removing confusion". A mature scientist who can question science itself stops seeing it as a hammer and everything else as a nail. Secular post-modernity is brilliant at giving us power plants, roads, and medicines. In other regards it's stunted our emotional and social development, bringing us to the brink of total war and social disintegration.
- p-e-w 3y ago
  > Some things are improved by formalism, empiricism, and positivist reductionism. Some things are made worse by that kind of thinking. But that doesn't mean anything is made better by mysticism and appealing to some vague idea of transcendence. If nothing formal can be said about a topic, then perhaps nothing at all can be said about that topic. Which is perfectly fine. It seems to me that so much of the available literature concerning such things is driven by the desperate insistence that it must be possible to investigate it, and if it cannot be done scientifically, there must be some other way. "Whereof one cannot speak, thereof one must be silent." - Ludwig Wittgenstein
  - nonrandomstring 3y ago
    I'll respectfully disagree and explain why. > But that doesn't mean anything is made better by mysticism and appealing to some vague idea of transcendence. Actually it does. Let's talk about "better". Better for what, for who? Some of the most powerful forces for positive change are stories. Stories are made-up, vague, hand-waving. metaphorical and allegorical. They occupy a different, parallel communicative realm to science, maths and equations. But they are no less true, particularly with regard to their utility if you want to communicate important ideas to lots of people. Certainly, mysticism is not an analytical or investigative tool. But it is a powerful communicative, and - since you raise Wittgenstein - a powerful symbolic tool for word-concepts that "stand in for" formalisms. To be honest I think that the way the younger generations relate to smartphones, the Internet and AI is very much mysticism. The words have changed, but I don't see concepts like "The Cloud" having any more substance than "Ectoplasm" and "ethereal spirits". Again, that new generation mysticism isn't a bad thing, it's just a way of dealing with unfathomable complexity through stories that we can all share.

sidcool 3y ago

TLDR or ELI5 for the uninitiated?

deleted 3y ago
[deleted]

jdietrich 3y ago

Cautionary note: The same department recently completed a good-quality RCT comparing psilocybin and escitalopram (plausibly the most effective SSRI antidepressant) for the treatment of Major Depressive Disorder. While psilocybin was shown to be marginally more effective than escitalopram, the difference was not statistically significant. A subsequent Bayesian reanalysis did show a statistically significant advantage to psilocybin, but this difference was not clinically significant. Other RCTs investigating classical psychedelics have shown similar results. There's a lot of excitement about psychedelics, a lot of hype, a lot of people who dearly want them to be a breakthrough (and god knows, we need a breakthrough), but the data we have just doesn't justify that excitement. This article presents a compelling narrative explaining why classical psychedelics might be a radically effective psychiatric treatment, but that amounts to nothing if psychedelics are not in fact radically effective; although it is still far too early to make any firm conclusions, the evidence we do have suggests that psychedelics are, at best, only a modest improvement over the current state-of-the-art. This does not preclude the possibility that psychedelics could be the best available treatment for a subset of patients, nor does it invalidate the personal experiences of people who believe that they have experienced dramatic benefits from psychedelic therapy, but it is grounds for considerable caution. Pepole enduring the misery of mental illness deserve better than yet another cycle of hype and disappointment. https://pubmed.ncbi.nlm.nih.gov/33852780/ https://pubmed.ncbi.nlm.nih.gov/33852780/ https://pubmed.ncbi.nlm.nih.gov/37337526/ https://pubmed.ncbi.nlm.nih.gov/37337526/ https://pubmed.ncbi.nlm.nih.gov/36322843/ https://pubmed.ncbi.nlm.nih.gov/36322843/

colordrops 3y ago
Does it have to be better than escitalopram? Even if it were at the same level of effectiveness, the lack of side effects and additional insight psilocybin brings are great benefits.
mtlmtlmtlmtl 3y ago
This data isn't terribly surprising to me in itself. The promise always seemed much greater for anxiety disorders than for depression, and I honestly believe we'll never find a pharmacological treatment that significantly outperforms SSRIs when depression is defined as broadly as it is in this trial. Depression is really a wide family of disorders that we don't have very good ways of telling apart yet, but likely work quite differently, along with a very fat tail of somatic conditions that are very commonly misdiagnosed as MDD or some other depression diagnosis. This seriously confuses any attempts at comparing efficacies like this. Anxiety disorders are much better understood and more clearly delineated. And what we see in anxiety land is huge strides being made even just in new forms of therapy. Metacognitive therapy is starting to show real improvement over CBT. Pilot studies with a new form of intensive exposure therapy have shown staggering remission rates of over 70% in severe anxiety disorders like panic disorder(look up the Bergen 4 day treatment). MDMA-assisted therapy for PTSD looks very promising as well. For depression, dissociatives have looked much more promising than psychedelics for a while now.

calibas 3y ago

>Psychological transformation (defined here as rapid, marked and enduring psychological change, where ‘psychological’ refers to perception, cognition and action or behaviour) has been the focus of previous psychological and philosophical texts (Miller and C’de Baca, 2001; Paul, 2014) as well as influential therapeutic programmes (Wilson and Cohen, 2015), but it has received surprisingly little formal scientific investigation and past definitions have been vague. I'd argue this is one of the very few fields where religion, specifically Buddhism, is more advanced than modern science. I'm not joking either, Buddhists have been concerned with this exact thing for over 2,000 years. When studied, I think scientists will find that certain mystical practices induce these pivotal mental states, at least in a percentage of the population.

totetsu 3y ago
you might find this podcast episode about neuroscientist Richard Davidson who also studied with meditators interesting https://hiddenbrain.org/podcast/seeking-serenity-part-1/ https://hiddenbrain.org/podcast/seeking-serenity-part-1/
steve_adams_86 3y ago
I've been thinking recently about how Buddhism and even some western philosophies are arguably sciences of the mind. You can't refute that ancient thinkers dedicated to contemplating reason, virtue, meditation, or otherwise were ahead of their time, so to speak. We are still proving out what they discovered, however subjectively they may have done it. It's sort of a marvel. I'm not sure people appreciate how incredible it is that thousands of years ago, with little more than paper and brains, these people recorded insights about psychological phenomena which we still struggle to understand. That's not to say people in the past have necessarily understood it. They experienced it and recorded it though, and the evidence of these collective experiences throughout time and space have turned out to be remarkably consistent. My favourite thread throughout eastern and western philosophies, as well as modern psychedelic research, is how crucial dissolution of the ego is to attain clear perception (at least what we consider to be clear) and ultimately, more virtuous action in the world. Buddhists did it, Taoism, Hinduism, Stoicism... I'm sure there are others, but I'm not that well-educated, just interested in this stuff. Many people will be strict about what qualifies as a science and exclude anything that appears to be religion or philosophy. I think it's worth taking seriously, though. I certainly wouldn't have 10 years ago.

tech-code-build 3y ago

[dead]

wolverine876 3y ago

(2020)

dang 3y ago
Added. Thanks!

SillyUsername 3y ago

This in part explains PTG (Post Traumatic Growth) after PTSD. As I started recovering I had a large ability to learn, I got 3 qualifications within a month, and won 2 workplace awards for innovation within ~6 months. I also excelled in the workplace in terms of workload and quality of work that it was noticed (and believe me sometimes you don't want that attention, it irritates the competitive types). Around 2 years later this level of attainment dropped, but it was great while it lasted.

lioeters 3y ago
I had never heard of Post Traumatic Growth until this week, when I noticed several people mention the phrase. A related concept I found fascinating is Positive Disintegration. > The theory views psychological tension and anxiety as necessary for personal growth. > These "disintegrative" processes are "positive", whereas people who fail to go through positive disintegration may stop at "primary integration", possessing individuality but nevertheless lacking an autonomous personality and remaining impressionable. > Entering into disintegration and subsequent higher processes of development occurs through developmental potential, including over-excitability and hypersensitivity. https://en.wikipedia.org/wiki/Positive_disintegration https://en.wikipedia.org/wiki/Positive_disintegration