Integrative Health aims to treat the whole person and to do so within the context of whole systems and practices. We raise questions as to what constitutes the whole person and what must be taken into account to support the creation of optimal well-being. We propose that in order to fully account for the whole person, the transcendent aspects of human awareness, the development of which is the goal of many meditative traditions, must be taken into account. “Nondual awareness” is a term increasingly used in the literature to describe a state of awareness that is characterized by the experience of nonseparation, compassion, and love. Well-being in this state does not depend on anything being experienced per se, but it is rather an innate attribute of living in nonduality. For these reasons, nondual awareness can be considered foundational to the realization of the whole person and achieving the state of optimal well-being.
The foundation of Integrative Health (IH) is to treat the whole person.1 Indeed, in its definition of IH, the Academic Consortium for Integrative Medicine & Health places its focus “on the whole person” in order to achieve optimal well-being (https://imconsortium.org/). We raise questions as to what fully constitutes the whole person, and what must be taken into account to support the creation of optimal well-being. These questions are consistent with other recent efforts to broaden our understanding of what constitutes the whole person and IH, in order to help facilitate the achievement of health and well-being.2,3 We seek to add to this conversation to propose that in order to fully account for the whole person and achieve optimal well-being, the transcendent aspects of human awareness must be taken into account.
During the latter part of his life, Abraham Maslow moved beyond his work on self-actualization, which refers to an individual having fulfilled their own potential, to focus on what he called “self-transcendence,” which refers to an individual experiencing the “most holistic levels of human consciousness.”4 Such efforts by Maslow, as well as others, were in recognition of the capacity of an individual to experience a life beyond identification with the egoic self and its associated social roles, to a recognition of our capacity to transcend such limitations and identify with a more universal nonpersonal awareness.5 In addition to the development of this awareness being the goal of many Asian and esoteric Western meditative traditions, Western disciplines such as Transpersonal Psychology have sought to optimally integrate the transcendent aspects of the human experience, in order to foster growth of the whole person.6
Maslow’s self-transcendence is akin to the concept of self-realization, often espoused by Asian traditions. Among the many characteristics of having achieved such transcendence, such realization, is the primary experience of oneness (a unitive state). Nondual awareness is that “part” of consciousness that realizes oneness or nonduality.
When an individual realizes nondual awareness, what was previously experienced as separation and dichotomy is found to no longer exist. There is no longer any experience of separation, yet one is not confused about one’s physical and psychological boundaries. Other descriptions of nondual awareness include “an open, awake cognizance that precedes conceptualization and intention and contextualizes and unifies both extrinsic task-positive and intrinsic self-referential mental processes, without fragmenting the field of experience into opposing dualities.”7,8
Many traditional whole person medical systems, which were the inspiration for what we now call the integrative medicine movement, have a deep understanding of the importance of developing such states of awareness. In the West, however, there is much work to be done to advance our understanding and to develop a needed evidence base to answer questions regarding nondual awareness and the human experience. Such efforts have begun, including neuroscience and meditation research.6,9,10
Neuroscience research on nondual awareness has been concerned with the neural signatures of nondual awareness itself, and the neural signatures of changes in perception, affect, and cognition that occur when nondual awareness is realized.11 Although nondual awareness can be differentiated from any experience, the 2—nondual awareness and experience—are present together as a unity or nonduality.11 Thus, distinguishing neural correlates of nondual awareness itself from correlates of changes in various aspects of experience due to the presence of nondual awareness is nontrivial. In addition to the usual challenges facing neuroscience research of human experience, and the research on meditation specifically,12 research into neural correlates of nondual awareness has its own unique challenges, including the frequent conflating of nondual awareness with methods for realizing it, a mere conceptual understanding of it, or with various states of reduced phenomenal content.11
Nondual awareness is both phenomenally and neurally different from attention, vigilance, and monitoring.9 It has been associated with several, potentially overlapping, neural signatures, including the central precuneus network,8 the fronto-parietal global workspace representing itself, and sustained prefrontal alpha coherence.13,14
When occurring during the waking state, nondual awareness is experienced as the unitary space-like context within which phenomenal contents unfold.15 Relaxation of different layers of conceptually constructed self, a common effect of many contemplative methods, occurs with nondual awareness as well. This attenuation of the usually excessive self-evaluative mentation is accompanied by a decrease in activation and connectivity of medial prefrontal and posterior cingulate cortex, though such decreases are often not as large as those seen with methods that rely on suppressing all self-related content.8,9 On the level of body-based self, the relaxation of rigid representations of body boundary can be seen in decreased activation and connectivity of right angular gyrus.8
Recent meditation research has seen calls to expand and deepen the science of meditation beyond the study of clinical benefits and biological mechanisms, to examine how such practices lead to extraordinary and transpersonal experiences, including nonduality.10 Included in this work are efforts to explain how mindfulness practices can promote self-transcendence and nondual states, and how such states can enhance the therapeutic efficacy of standard western interventions.16
Cultivating a perceptual shift away from a predominate ego self-identification to self-realization and nondual awareness is a goal of many meditative practices and philosophies. Common approaches to gaining insight into nondual awareness and spiritual awakening include self-inquiry, meditation practices, and psychedelics.8,19,20
Methods of nondual realization offered mainly in Asian spiritual teachings are numerous and include “pointing out” instructions by the teacher, cognitive processes of disidentification with less primary aspects of experience, contemplation of the question “who am I?”, sitting in open awareness without any specific object of focus, or isolating nondual awareness by minimizing phenomenal content via the use of mantra or focused attention. While mindfulness by itself is not nondual awareness, as noted earlier, it can be one of many paths used to approach it.
In addition to a focus on the mind, there are practices to cultivate nondual awareness based on increasing contact with the internal space of the body.21 In this method, the openness of nondual realization is based on increasing contact with the internal space of the individual’s body. Through this inner contact, the individual can uncover unified awareness, which can be experienced pervading one’s body and environment at the same time. When it is experienced pervading the body and environment, nondual awareness deepens and refines one’s contact with one’s surroundings. In this way, nondual awareness is the basis or the ground of both individual wholeness and self-other oneness.22
Although nondual awareness is itself nonconceptual and knows both phenomena and itself in a direct way unmediated by mental representations, once it is stabilized it can contextualize all aspects of experience including conceptual cognitions. Thus, in principle, it is not necessary to eliminate any aspect of experience to remain in nondual awareness. Therefore, unlike spiritual approaches which depend on suppressing all self-related experience, and with it any chance of authentic subjectivity, the nondual approach enables the unfolding of constructed self-related and other-related contents until the fundamental unconstructed aspect of consciousness, the nondual awareness itself, is revealed as the context within which both the self, and another, can return to their authenticity.
Nondual realization has traditionally been viewed as a pinnacle of spiritual maturity, requiring years of preparatory practices for developing devotion and concentration. Contemporary nonduality teachers, however, especially those whose work includes methods of psychological inquiry, have found that many people are ready to open to this primary aspect of their being.23
There are many ways that nondual awareness can be understood to be supportive of optimal well-being. The effect of nondual awareness on affect is a release of habitual emotional responses that are anchored in excessive self-other fragmentation and the uncovering of love and compassion as one’s natural affective baseline.24 Thus, emotion regulation in the context of nondual awareness is predominantly a change in the bottom-up emotion processing, rather than an increase in the effortful top-down cognitive control.24
In addition, there is no longer any sense of separation from the world, indeed the world is experienced as self. This state of awareness is also typically characterized by a great sense of love for others and a sense of freedom of thought and feelings. Well-being in this state does not depend on anything being experienced per se, but rather is an innate attribute of living in nonduality. Knowing oneself as awareness enables the letting go of less authentic, ego-driven, protective organizations of identity. While the literature on nondual awareness is very limited, studies do indicate better well-being in individuals who experience transpersonal states.18,24,25 Equanimity is a deep and abiding experience in nondual awareness.
It needs to be noted that, depending on an individual’s background and familiarity with such concepts, the onset of the nondual experience can be a challenge.16 In addition, for individuals who have not previously developed a reasonable degree of self-identity and maturity, the movement into nondual awareness can be disquieting. In such cases, a therapist with knowledge and ideally experience of nondual awareness can help the individual navigate this terrain.
What we now call IH has its roots in the Whole Person Medicine movement that started in earnest in the late 1970s, and which took much of its inspiration from traditional whole medical systems.1,18,26 Many traditional systems of medicine have an understanding of the potential of developing human awareness and actively seek to support and cultivate it. IH will be more able to address the whole person to achieve optimal health and well-being if it includes the understanding and practice of methods to develop nondual awareness of self-realization.
The authors acknowledge the support of the University of California, San Diego Center of Excellence for Research and Training in Integrative Health.
PJM, TJB, JB, DC, and ZJ designed the initial draft, wrote the manuscript, and did the literature review. PJM and ZJ managed the final revisions.
The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: PJM is director of research for the Chopra Foundation. DC is the founder of the Chopra Foundation. JB is founder of the Realization Process.
The author(s) received no financial support for the research, authorship, and/or publication of this article.
Paul J Mills https://orcid.org/0000-0003-4263-7686