This column discusses the concepts of an integrated psychotherapeutic approach to patient care, and explores some of the underlying principles that make it beneficial.
For the past 20 years I have been developing a private practice that combines a number of complementary treatment modalities in an effort to support clients in all aspects of their being: body, mind, and spirit. This concept evolved from my philosophy that in order to be truly effective as a therapist, you need to listen on a deeper level, be present in the here and now, and use whatever approach is necessary to facilitate clients' healing.
The idea of an integrated approach to patient care that connects mind, body, and spirit is not new. It dates back to early times, and up until the 19th century, emotions and state of mind always were considered as components of physical illness. With the advent of our modern scientific approach we may have lost sight of the whole person for a while, but in the last few decades the integrated view has returned as practitioners attempt to enhance the healing process.
Psychotherapy, however, often still holds fast to the concept that the mind is the main and only focus of treatment, believing it to be the origin of emotions and feelings. Using "talking" as the primary modality of treatment and symptom reduction as the main focus for change, therapists today may approach the session in much the same way as their predecessors did, aligning themselves with only one aspect of the client--their mind.
Recent research by Dr. Candice Pert (1997), however, has shown that feelings and emotions are felt in many places of the body, not just the mind. When a client is depressed, chemicals released in many organs of the body mirror the same chemicals that are released in the brain. Mind and body are intimately connected chemically and share a vital energetic force that cannot be separated into parts. It is this energy, this circulation of emotional information throughout the body and mind, that supports health and well-being. Therefore, we are dealing with a system, not just a collection of parts, a system that continually strives to balance itself using symptoms as a way to self-heal.
Under this body-mind philosophy, each symptom is a communicator, not a dysfunctional piece that must be eradicated to attain good health. There is less of a sense that the symptom needs to be changed and more of a sense that it is an important part of the whole. The whole concept of illness changes as well. It takes on less of a negative role in the treatment process, becoming more of a necessary component to reach understanding and balance rather than something that simply brings pain and discomfort.
Applying this integrated body-mind approach to psychotherapy gives it a different look and focus from what we often see today. Since consciousness is not localized in the mind, the whole system becomes the treatment focus. Body and mind express the same issues, and both need to be strengthened. The goal shifts from trying to get clients to change and give up their symptomotology to providing an atmosphere of allowing people to be where they are right now, with the therapist honoring clients' experience and respecting their self-healing capabilities. Nothing needs to be removed or is alien to the process. All aspects are accepted and have equal value, providing important messages for both the client and therapist. It is in this atmosphere of acceptance that resistance is reduced and the client relaxes and feels involved, supported, and less fearful.
These concepts may not be new for nurses, since much of a nursing assessment requires looking at the whole; most of nursing education focuses on the interaction of all aspects of the person. As nurse psychotherapists, however, we may have been asked to abandon our holistic view in favor of the attitude that only the mind matters and the belief that to deal with the body and spirit is to create confusion in the client, who may have a poor body image to begin with. …