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Holistic Psychotherapy is Different in Diagnosis, Treatment, and Perception
REPRINTED BY PERMISSION from Natural Awakenings, pp. 14, 15, 19
A Holistic Problem Definition
She walked into my office, a picture of personal torment. Hounded by memories of unspeakable things, involved in one bad relationship after another, and hating herself more by the minute, she could easily have been labeled with a heavy-duty diagnosis right out of the Diagnostic and Statistical Manual of Mental Disorders. That's the bible that every therapist has to use in order to collect reimbursement from insurance companies. Except that holistic psychotherapists don't label people.
People deserve better than that.
Why should clinicians see the people-glass as half empty instead of half-full? A diagnosis is nothing more than an inventory of how a person is functioning. A "whole" picture should not emphasize the negative over the positive. If I were going to place labels on that lady, I would want to focus on the strength she showed in just making the call to see me, the courage it took for her to free herself from damaging relationships, the insight she showed in recognizing the role of her past, and the wisdom she showed in setting new goals.
But strength, courage, insight, and wisdom are not in that diagnostic bible. Too bad. If there were such a thing as a Diagnostic Manual for Capacity to Manage Under Tough Circumstances, those words would be in it because a holistic approach capitalizes on a person's resources- what the person does right, not what he or she does wrong.
Does a holistic problem definition ignore the problem?-No! A holistic psychotherapist is not a Polyanna pretending that everything is good when it is not. A holistic psychotherapist puts the good and bad into a realistic perspective. The lack of balance in the psychology world today is actually unrealistic because it's definitions of functioning are based on dysfunction.
As a society, we have been brainwashed to believe there is something inherently correct about this deficit model of human behavior. The historical root of this way of thinking is clear. Western medicine has been around longer than Western psychotherapy, and medical doctors are high status individuals. It is not hard to see how the medical model evolved as somehow representing "the" template for thinking about problems.
Furthermore, our society is fast-paced. We want quick fixes-and the pharmaceutical industry caters to this. Research and development money holds an antagonist treatment philosophy suited to the deficit problem definition model. This philosophy contends that the sick human being does not have the resources to overcome the problem and the extra help of medication and therapy are necessary to "fight" the disease process. When it comes to strep infections, this may very well be true, but in the world of mental and emotional issues, it actually slows down improvement. Evidence of this is the common term "resistence." The medical-model therapist, playing the expert, knows where the psychological deficit lies and wishes to attack and dismantle the resulting dysfunctional behavior.
This perception on the part of clinicians constructs barriers to improvement where there needn't be any at all. Instead of deciding on a preconceived "treatment plan"-to which there may be resistence-the holistic professional believes that people have the resources to overcome problems and illness and would rather work with those healing processes and enhance them. The course of healing always originates with the client, not the therapist. The art and skill of the therapist is to piece together, from the ordinary things the client says, what that client believes will be helpful to healing. Working from within the client's own values, opinions, and beliefs means that as the perceptive therapist notices and points out possible barriers to healing, clients will themselves want to knock them down or climb over them. There is no resistence because the entire process works respectfully from where the client is coming from.
From this perspective, when there is resistence, it is an indication that the therapist is on the wrong track, for resistence is the individual's identity asserting itself. It is the therapist's job to aid progress toward client goals without the authoritarian imposition of the therapist's worldview on the client.
Everything makes sense in context. The behavior of the lady whose story opened this article, we'll call her Angela, is an example. As a verbally browbeaten child, she naturally sought some grains of kindness where-ever she could find them. Doesn't that make sense? Notice, I didn't say it was good; it just makes sense-given what she went through. In fact, as human choices go, it could be that she has more going for her than the abused child who puts up a wall against love and human contact. Her desire to connect is what I would build on. Then again, just to play devil's advocate, the person who puts up that wall shows fortitute and survival skills and, as his or her therapist, I would want to capitalize on that strength. The point here is that it would not be possible to find those resources in these clients if the holistic therapist has no access to the contextual information surrounding these people's choices.
Not only is the context a form of past history, but it creates the present history. You know the story of the married couple who were arguing and came to the wise person for advice as to who is right and who, wrong. The wise person listened to the wife and said, "You are right." The husband hastened to tell his side and the wise person said, "You are right." The wife of the wise person heard this incredible impossiblity and said, "But they can't both be right!" and the wise person looked at his wife and said, "You're right, too!"
But they can. When each person's story is seen from his or her own perspective, it does make sense. And there is no need to win a point. The only need is to be heard and understood. As layer upon layer of understanding is placed on the story, the holistic psychotherapist can form a dynamic, three-dimensional picture of how everyone's reality interacts, not in the past, but in the present moment, to cause some part of the problem.
The Holistic Client
There is one final piece to explain how a holistic psychotherapist views people. Let me ask you this question, why did the term "emotional" change to "behavioral" as in behavioral healthcare? With the intention of trying to save money, insurance companies thought that if they could focus only on behavior-something measurable-then they would surely know whether a person's treatment was working and when it would be over. Based on the medical model, which purports to be scientific, this appears to be logical. Except that there is no research to back this up. And, no wonder. They have overlooked a logical fallacy in their thinking which is popping up in the most prestigious of medical journals-the important role of the spirit in distress and healing. Therapists who only work with behavior limit themselves, for problems could be emotional, cognitive or spiritual as well and it is a fallacy to assume that these other modalities always show up in behavior.
With a holistic psychotherapist, there are no artificially imposed limits on how deeply the client is perceived. The holistic psychotherapist is as comfortable focusing on the spirit as on behavior, thoughts, and feelings. A holistic psychotherapist also sees both problems and their potential solutions residing within the person; she or he sees treatment a matter of tapping into those answers rather than imposing resolutions from without; finally, the holistic psychotherapist views the client in context. These four aspects distinguish the holistic psychotherapist from conventional approaches.