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

Edited by Fredrica R. Halligan, Ph.D.

Reviewed by Robert Magrisso, M.D.

In Psychotherapy & the Spirit: A Great Work of Love in the Writings of R. Tomas Agosin, M.D, Frederica Halligan has collected a number of the late Tomas Agosin's writings and presentations. In addition, she has added an introductory chapter and afterword about the life and teachings of Tomas as she experienced them. A brief introduction to each essay helps to put the writing into a larger perspective. The overall effect is that of introducing the reader to both the ideas and personality of a completely modern man sharing his experience with us as a psychiatrist and mystic.

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

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

While Tomas was well trained in medicine and psychiatry, he was equally well trained in the spiritual through commitment to the spiritual path of Cafh. He was one of the founders of Cafh in New York City. That training, and the experience that came through it, removes much of the idiosyncratic from his essays and puts his own personal experience within a universal perspective. For myself, I am pleasantly surprised how well these essays have held up over time. His paper distinguishing the mystical experience from the psychotic experience is widely referenced, but I don't think that producing “ground breaking” papers was ever Tomas' intent. That said, there is discussion in chapter 2 of the role of the Agosin Group as mental health professionals venturing out of “the closet” to discuss the importance of the spiritual in the life of patients rather than dismissing or reducing it to the psychological. This involved some risk since the professional world in which they were trained thought that most, if not all, of what might be termed “spiritual” was actually a form of regression. The chapter “Tomas Agosin: Introduction to Psychotherapy and Spirituality (Albert Einstein Summer Institutes, Cape Cod, 1990)” describes this tension very well. This talk was given the summer before his untimely death of a pulmonary embolism from the stump of his amputated leg.

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

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