A HOLISTIC APPROACH – PHYCHE AND SOMA
Maintaining a holistic approach in this era of specialization is difficult, especially so in my field, psychotherapy and counseling. It is truly ironic that the explosion of research in overlapping fields such as brain function and biological psychiatry has generally had a splintering effect, rather than helping to provide an integrated view of the whole person. It is significant that the word "psychosomatic" includes "psyche" and "soma" (body); yet colloquially the term is usually used depreciatingly as "all in the mind." This attitude is reinforced by the medical profession, which, when unable to diagnose a problem, easily labels it as psychosomatic. In the face of constantly growing evidence that the interaction of all factors – psychological, biological, and environmental – plays a role in our functioning, there is a tremendous need for holistic education – of professionals, and, equally important, of the general public.
In this article, I focus on young adults, a group which includes college students and those in the early stages of career and autonomy. It appears that this segment of the population, among others, is manifesting a significant increase in severe psychological symptomatology. There are obvious major emotional stresses related to new developmental stages: separation from home and family, the establishing of a base for oneself at school or work, and the need for increased autonomy and independence. However, it is now known that inadequately handled emotional stress suppresses immune system functioning and thus leaves individuals generally more vulnerable. It is precisely because of this vulnerability that factors other than psychological, such as diet and lifestyle, also need to be considered when problems arise. These additional factors may be potentiating and escalating the stress and symptoms. I would like to share a brief clinical vignette as illustration.
I have been seeing a college student with a wide variety of problems: severe adjustment problems to school and separation from her family; depression and anxiety that intermittently were severe and immobilizing; headaches; and difficulty concentrating. As our work began to progress, I suggested that she keep an informal journal. The purpose, which is a major goal in psychotherapy, was to help her identify patterns in her life and develop greater self-awareness in order to modify maladaptive patterns. However, she was surprised when I asked her to keep track of not only behavioral and emotional data, but also diet, use of drugs, use of alcohol, etc. She was skeptical and resistant, but reluctantly complied.
Over a period of months, she was quite surprised that we found significant patterns beginning to emerge. Not only did she become depressed and anxious after a fight with her family or boyfriend, or after getting disapproval from a professor; also the incapacitating depression when she was unable to get out of bed in the morning and which she previously had thought "came out of the blue" seemed to follow binges of sweets, other carbohydrates, and fermented foods. Different symptoms followed excessive alcohol use. Occasionally she became completely "spaced out" after working with chemicals to restore some secondhand furniture for her new apartment. As we explored her history, we saw that all her symptoms seemed to have intensified after she began taking oral contraceptives. The clarification of these connections prompted her to make several significant changes in her diet and lifestyle.
As the related incapacitating symptoms gradually decreased, our work on psychological issues has become vastly more effective. She is still the "typical" student, and more frequently than I care to acknowledge, she still makes self-defeating choices. However, she now has considerably more awareness of both the psychological and lifestyle factors affecting her functioning. This awareness is a major tool in her development of better coping patterns, of greater initiative and autonomy versus feeling like a victim.
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Mind and body: we are beginning to view these as parameters of a single, complex entity – the functioning human being. As we struggle to learn and educate, to increasingly adopt a holistic approach, we may be able to offset some of the dis-ease of the twentieth century and instead progress toward healthy, vibrant functioning.Article from NOHA NEWS, Vol. XIII, No. 2, Spring 1988, pages 2,5.