Integrative Psychology in the Service of Self
A Psychosomatic Paradigm
By Dr. Ursula Stehle
In Europe, psychosomatic means "originating in both psyche and body." In the United States, the same term generally implies that one's physical symptoms are generated in the mind and therefore not real. However, the term is undergoing redefinition. As therapists, physicians, and scientists re-evaluate the process of healing, they are finding physical evidence of a true psychosomatic connection.
Neurologists have discovered that body and mind are not separate entities but communicate through an elaborate chemical network. Pert et al. found that emotional experiences affect every organ and tissue in the body. They identified chemical messengers of emotion—neuropeptides— and have found receptors, or communication ports, for these emotional messengers on every human cell. Our proverbial "gut feeling" or "broken heart" are no longer metaphors alone but have physiological bases: Namely, that emotions manifest not only in our minds but in our organs, intestines, limbs, and skin. Thus science affirms what we have always intuitively known, that the human being is a totality of body and mind, with a complex interconnected communication system. This discovery forces us to bring mind back into the body and attribute substance to the mind. Chronic physical symptoms and illnesses always have deep roots in emotional experience, and psychological/psychiatric problems are not strictly the domain of the mind but always also manifest as bodily symptoms and are mediated by bodily changes and functions.
How do psychotherapy, art, movement, and meditation support mind/body integration? All of these therapeutic interventions encourage feelings and emotional expression to be valid and worthy of attention. In meditation, we observe feeling responses without changing, judging, or attaching to them; in movement therapy, we pay attention to movement and conscious gesture, expressing inner experience in time and space; and curative art directly works with our senses and feeling responses. Aside from its diagnostic function, curative arts are able to bring unconscious feelings to consciousness. Feelings that may have been locked into body without conscious voice become expressed through symptoms.
In psychotherapy, our feeling life takes center stage in that expression of feeling is both the medium and the object of the work. Metaphors, facial expressions, body language, and our tears give expression to feelings that we or others may deem unimportant or exaggerated. In psychotherapy, through genuine relationship and the metaphoric use of language, we again become aligned with the central organizing force within us, our Self or Ego. The capital letters here refer to an inner organizing principle that allows us to remain connected to our individual destinies, not to the short-term gratifications of selfishness. When we become aligned again with our Self/Ego, we free our feeling life from the blockage of judgement, and emotional expression again can function as a riverbed that connects and communicates between body and mind.
Mainstream psychiatric practice and to a lesser degree psychological therapies have increasingly embraced a "broken brain" paradigm, with the result that emotional problems have been primarily seen as chemical imbalances and brain dysfunctions. Our minds and souls have been reduced to bodily functions and have become mired in matter. Drugs such as Prozac, Lithium, Xanax, and others are given to fix these imbalances. However, not only is the response to these drugs limited, they carry risks that must be carefully weighed before a person embarks on interfering with the brain's and body's complex biochemistry.
In my psychological practice, therapists are generally committed to taking a path of least intrusion in their efforts to bring understanding and healing to the individual. The path of least intrusion suggests that we first approach a condition or problem by trying to understand what caused the symptomatic reaction. This approach also explores how symptoms can be understood in the context of a unique and important life that is striving toward becoming more healthy and whole. Understanding that symptoms may have informational and communicative value, a person is often given enough of a choice to change underlying conditions. In addition, psychotherapy honors, values, and holds feelings and emotions in the attentional space between therapist and patient. The therapeutic process of expansion—meaning active exploration and making conscious that which has lived deeply hidden within ourselves—is complemented by dynamic contraction, which includes holding, valuing, and observation of emotional content. The latter further allows both patient and therapist to experience and understand symptomatic expression.
Both movement and art deepen the processes initiated by the psychotherapist by making previously unconscious material accessible to our senses; making visible and bringing color, shape, and substance to experience and emotion we might have felt did not matter much. Through artistic expression we learn to connect again to our innate creative response: a knowing of our own inner truth, no matter how much it has been denied and covered up over the years. Just as we may have given up our own creative efforts in the face of the perfection that media images and movie stars project, so have we often given up our own individual and subjective experiences to culturally desirable ones. As we struggle to express ourselves through an artistic medium, we need to use our senses in a new and fresh way. The satisfaction of the art work lies not in the finished product but in the process of listening, trusting and manifesting our own experience. In this way we are all artists, men and women who risk sharing the pictures that live in their souls.
Before Fair Oaks Therapeuticum suggests a patient use powerful psychopharmacological agents, we investigate whether nutritional supplements, changes in diet, or the use of herbal or homeopathic remedies might be effective. Herbs and nutritional supplements have recently been the subject of much-needed scientific research, and outcome studies from Europe and the United States support their use for psychological treatment, often without unwanted side effects. Herbal and homeopathic preparations are especially helpful when symptoms are in the mild to moderate range and do not include life-threatening conditions. Natural remedies are frequently a first choice for children and teenagers because their brains and bodies are still developing. Research data on children and teenagers has not consistently demonstrated the benefits of psychopharmacological agents or herbs.
In summary, Integrative Psychological Treatment is based in the conception that many diseases and illnesses are an expression of a dynamic mind-body unity. Our internal healing system, which is guided by emotions and their biochemical messengers, preserves and protects the entire human organism with an intelligence and purpose that is conceptualized in the organizing principle of the Self/Ego. Integrative Psychological Treatment therefore is based on a psychology that attempts to connect a person with their innate capacity to heal and does not support a "broken brain" philosophy. Integrative Psychological Treatment embraces working directly with emotional expression through the spoken word; it supports our bodily functions through attention to diet and natural remedies; and it strengthens our own psychosensory perceptions through art and movement, which allow us to live more fully our own truth and destiny.
Where Mind & Body Meet
Recently there has been an outpouring of literature on the benefits of integrated medical treatment. And rightfully so: Compartmentalizing people, their pain, their symptoms, and their experience, has left the uniquely personal out of the equation for healing. Even though we have enjoyed an era of profound medical advances, limitations of the Western medical model have become evident in chronic and disabling conditions and those that do not respond to pharmacological interventions. Often these conditions are rooted more in the quality of inner experience than physical imbalance or injury.
This article illuminates the relationship of inner experience and its meaning in illness and healing. But what is our inner nature? Just as it is essential for trees to have a good location that will nourish and sustain them, so humans need good relationships that provide basic support for autonomy, connection and intimacy, and worthiness. Last not least, we need to be part of a human community that allows us to experience consistency, predictability, and security. When these needs are met we grow and develop and become the person we need to be, even in the face of adversity. When these needs cannot be met, over time, the life forces in human beings recede and illness and diseases take hold more readily.
When deepening inner experience, we receive ourselves in our incompleteness and woundedness—in all our humanity. |
When ill, we sometimes experience helplessness; sometimes gladly, sometimes fearfully, we give over control to professionals. In illness and disease, it seems difficult for most people to have a realistic experience of our human vulnerability. Questions arise as to whether we may have caused or brought on a particular illness, disorder, or disease? These questions may torment our thoughts and further contribute to a feeling of helplessness, frustration, and loss of control. We also know that "bad things happen to good people" and that illness, disorders, accidents and the like occur for a variety of reasons, many outside our control. More often than not, our careful plans for life did not turn out the way we intended. Nature, including human nature, ultimately cannot be controlled by rational processes; even though we mustn't stop trying. Ultimately, we may never know why we have a certain illness or disorder, but we can learn to understand our symptoms and our sufferings as messengers of an imbalance that we can strive to correct.
In approaching our symptoms this way, we start to relate to our symptoms as belonging to us, our selves, rather than seeing symptoms as intrusive foreign phenomena that must be eradicated. Taking one's symptoms seriously and listening to symptoms as messengers: Is this not wasting time in our already busy lives? But with symptoms it's the same as it is in other areas of our lives: that which we avoid we get more of. For most people, the automatic response toward experiencing symptoms is, 'What can I do about them? How can I get rid of them? I need to get through this day, and the next, and the next." This defensive approach colludes with a demand for perfection in which we always need to function well, always need to be on; down time is bad time. Symptoms do not just appear out of the blue—they are in response to something else. In taking our symptoms seriously we give these unwanted aspects of our being air time, and therefore recognition. This is the first step toward health. But this is also a step that does not come naturally.
In psychotherapy we step out of the hectic drivenness of everyday life and off the perfectionist treadmill and learn to listen to a slower, softer side that frequently gets run into the gutter by life's demands. So often, the drive for perfection attempts to outrun deep-seated feelings of helplessness, of being flawed, "found out" as a fake, or simply "not good enough." Often, these disavowed feelings block attempts to heal. No prescription, surgery, or health food can heal damage done by sabotaging or ignoring inner messages, mindsets, and deep-seated feelings. Frequently these messages and feelings are left over from earlier trauma including neglectful or abusive parenting and severe personal losses. However, by the time we reach adulthood these messages of inadequacy come not from other people, but live inside of us and can literally run our lives.
Psychotherapy in the service of inner experience can be a powerful tool in making conscious experiences that affect our vulnerability toward disease. With the professional and supportive guidance of a therapist we can learn that symptoms and other human shortcomings are gateways to who we are. In deepening inner experience we are able to receive ourselves and others in our incompleteness and woundedness: our humanity. Only then can we embrace health and illness, life and death, and continue to grow in both.
The Nature of Psychotherapy
Our inner/soul experience suffers when we cannot feel connected to ourselves and other people. As a result we feel depressed, anxious, or become symptomatic in other ways. For example, one might feel helpless and cut off from human contact; one may also feel disconnected from one's body or without a firm inner foundation to keep going.
How does the therapeutic process facilitate connectivity with oneself and others? In our efforts to connect with the world, raise a family, fulfill the demands of a job, and find our place in society, we frequently do not value or have no time to attend to inner experience. As a result, our inner life becomes secondary or it gets pushed into less conscious parts of our psyche. By the time we develop symptoms we are usually quite disconnected from our own inner life and need help to discover and value all that we have discounted or submerged.
We need a safe place to uncover the layers of pain and grief that we have suffered. It is the therapist's responsibility to create a safe place so that a patient can explore his or her symptoms and wounds. A safe place is created by professional training,personal expertise, a guarantee of confidentiality, and respecting boundaries that define the therapeutic relationship. The latter includes maintaining an inviting office and adhering to agreed-upon appoint times and financial arrangements and abstinence from physical intimacy and from any conflicting relationships. Above all, it is important for a therapist as well as the patient to feel an intuitive connection that allows the reclaiming of disavowed aspects of psyche and self. With the decision to seek guidance through psychotherapy, the patient also is asked to commit to certain responsibilities. Honoring time and financial arrangements mark the outer commitments. The most important contribution to psychotherapy is a patient's willingness to risk being seen in his/her woundedness by another.
With these foundations in place, we create a setting for therapy to occur and can embark on the journey of uncovering that which has been buried, cast aside, and deemed unworthy. If we are to reclaim all of who we are, we deserve to know and re-evaluate—choose or consciously let go—that which was unacceptable. Inner pain is often directly related to our efforts to gain love and acceptance from people close and important to us. Frequently we maintain those relationships at all costs, sacrificing our own self. The therapist now is being asked to hold such painful and difficult content, so that the patient may have the opportunity to learn to tolerate his/her own inner pain. It is through this process of unveiling and gradual acceptance that we grow compassion for our own wounded nature, our faults, and recognize them as gateways to our own development. Our pain is as unique as we are. Our unique circumstances—parents, genetic make-up, and all of our experiences— forge a particular response, particular personality, and particular destiny? We can choose how we approach our own limits and wounds: Ee can remain unsupported and continue being victimized by spiraling demands, symptoms, and increased helplessness. Or we can choose to reclaim exiled aspects of ourselves, to accept, tend and care for them with conscious compassion, to finally accept them so they no longer dominate our choices in life.
Symptoms, behaviors, or feelings that have seemed huge, ugly, and insurmountable gradually become more human and are tamed through compassion practiced in psychotherapy. Over time, as we reclaim all our experience, our defensive nature softens and we become more open and free in our perceptions and responses toward others. We are less dominated by the unknown or by our own darkness because it no longer threatens our capacity to be loved, successful, or just ordinary.
However, in this journey there are many pitfalls and challenges that can threaten the therapeutic relationship. We know that as humans we tend to recreate our deep wounding experiences in an effort to finally heal them. Especially in meaningful relationships where our hope for healing has been aroused, sooner or later our old patterns will surface and create trouble; this too happens in the therapeutic relationship. However, since the therapist consciously abstains from partaking in the external world of the patient, the interpersonal play of the therapeutic work is like a map of the dynamics within the patient.
The successful therapeutic process transforms both therapist and patient. |
In psychotherapy the therapist plays many roles. At times the patient unconsciously treats the therapist how she or he has been treated by his parents or other loved ones; sometimes the patient experiences the therapist as parental or as a depersonalizing authority; at other times, patients experiment with experiences of intimacy and new ways of being in relationship. In all these situations, feelings arise that frequently were unwanted in the original situation but now have a chance to surface, be seen, tended to, grieved, dissolved, or integrated. The force that prevents the repetition of old dynamics is rooted in the therapist's positive regard for his/her patient, the mutual respect and acceptance for the person of the client and therapist, and the safe setting of the process. It is in this context that a patient can experience compassion and love of self that has the power to transform symptoms and people. In the successful therapeutic process, both patient and therapist are transformed.
Finally, a word of warning: When insurance companies attempt to regulate, dominate, and prescribe this process and choices are no longer with the patient, then the above outlined process can be severely compromised. Love, compassion, and genuine relationship do not lend themselves to be managed by uninvolved others who impose their own agendas.
Reflections on Choosing a Therapist
1. For psychotherapy to bear fruit, trust is essential. Not only is trust based in competence and skill: It is also deeply rooted in respect, sensitivity, and compassion toward another. This is especially true for psychotherapy, where healing requires the patient to risk being seen as they truly are. Trusting in a capable therapist enables patients to re-envision and re-structure their relationship to themselves by incorporating respect, sensitivity, and compassion.
Symptoms need to be seen as doors to our own well-being and health. |
2. One may initially consider undergoing psychotherapy because of certain symptoms or illnesses, such as depression, anxiety, angina pains, or migraine. However, symptoms are always in response to something else, a response our body and psyche created in reaction to disharmonies, intrusions, genetic liabilities, or trauma. If we understand our symptoms, understand why our body or psyche needs them, we may be able to attend to our lives and experiences in a new way, a way that may not require a symptomatic expression. In this regard, symptoms need to be considered doors to our own well-being and health.
3. At the dawn of Western medicine, healing occurred in sacred places. Illness, wounding relationships, divorce, death, and other acute and chronic life stresses frequently challenge life's purpose and meaning. Psychotherapy requires a safe and reverent space that invites non-judgement and understanding so that body, soul, and spirit can become aligned again in the purpose of an individual's life journey and destiny.
4. Three qualities associated with healing are; passion and compassion, creativity, and a search for self-discovery. Regardless of diagnosis, pain, and suffering, passion connects us with our life force, to that which makes us truly human. To live passionately means to live deeply in our emotions, to draw fully from our intellect, and to embrace the gifts and challenges of life to the best of our abilities. Compassion is the ability to remain connected with our basic essential goodness, even in the face of adversity or trauma. The Old Testament Book of Ecclesiastes says, "To every thing there is a season ... a time to weep, and a time to laugh; a time to mourn, and a time to dance." When bad things happen to us, our capacity for passion and compassion is tested. We attempt to be in control of our lives, but it is often events outside our control that present our gravest challenges. Secondly, without the creative impulse within, life and change would not be possible. It is through passionate involvement in life and relationship that we connect with the creative impulse within, the creative life force. Symptoms frequently emerge when our creativity and passion have been dimmed in the course of our lives, when we feel compromised in our efforts to remain connected to the question "Who am I?" and we feel pulled from one demand to the next. Creativity is our innate human gift to feel our uniqueness and individuality. And third, to remain deeply rooted in a search for self-discovery throughout our lives we must balance outer demands with those of our inner being. The search for self-discovery is the ongoing, continuous attempt to live in a harmonious balance, between that which is required of us in the world (work, family, and friends) and our innermost being and reality (personality, temperament, and personal destiny issues).
Psychotherapy strives to engage all three qualities— passion and compassion, creativity, and search for self-discovery—to bring healing and integration to a patient's life. A successful psychotherapist must be engaged in the lifelong process of becoming more fully that which she or he is meant to be, just like everyone else. Only those who have survived their own dark night of the soul, those who are actively engaged in life and its rich challenges, in addition to years of training, can provide the ground for trust to take root and for a healing relationship to grow and mature.
Last modified on 01.13.10
© All contents Copyright 2004-2010, Fair Oaks Therapeuticum