What is Integrative Counseling?
I don’t know of anyone else who is doing exactly what I do, but I can’t claim that integrative counseling is entirely new.
Integrative psychotherapy has been around as long as I’ve been alive, and it involves both integrating the self by “taking disowned, unaware, or unresolved aspects of the self and making them part of a cohesive personality,” and “bringing together of the affective, cognitive, behavioral, and physiological systems within a person, with an awareness of the social and transpersonal aspects of the systems surrounding the person.” (resource)
There’s also integrative medicine, which involves using traditional western medicine while acknowledging or encouraging some level of simultaneous use of what conventional medicine calls “alternative” or “complementary” therapies – anything from meditation and yoga, to acupuncture and different massage therapies, to the use of aromatherapy, and yes, mental health therapy.
My approach of integrative counseling is a bit different and even broader than that.
I’ve been a counselor in a medical clinic and on an integrative behavioral therapy team, where doctors and nurses would refer a patient to me when they felt anxiety, depression, trauma, or chronic pain was an issue and there wasn’t enough benefit from medical intervention alone. I’ve also worked with professionals in a day treatment program for eating disorders, where it was important to coordinate treatment with medical supervision, nutrition therapy and supervised eating, art and relaxation, yoga, and group and individual mental health therapy.
Yet integrative counseling is also more than this.
What I’ve found is missing with all of these practices is a sense of purposeful and even universal context. Some might call it the spiritual, while others would not. The word spiritual has a lot of baggage with it, so I'll explain further without exclusively using that word. Integrative counseling is not just using a person-centered, eclectic approach to tailor therapy to an individual – for example, I’m not only using cognitive behavioral, dialectic behavioral, or acceptance and commitment therapy (CBT, DBT, and ACT), EMDR (eye movement desensitization and reprocessing), prolonged exposure therapy, or whatever “best practice” is indicated for the diagnosis. I am trained in all of these therapies, however, and do use them or parts of them whenever appropriate.
Let me clarify first that I am not in the business of spiritual direction or guidance. I have a master of arts in psychological counseling, not in divinity. I always ask people about their spiritual or religious affiliation and/or beliefs, but I do not ask anyone to follow a specific spiritual or religious path. I do ask people to consider that their issues or problems are happening in a larger context, larger even than their family, society, culture, nation, and planet. I ask them to consider the idea that their issue has to do with a separation or a denial of some parts of themselves or their history, and the spiritual is one part of that.
What are all the parts?
Generally speaking and as a good place to begin, there are the related parts of what you think, what you feel, and what you do. This is the CBT Triangle. CBT is a very common type of therapy and probably the most used or referenced in the genre of “self-help” books, so it is something with which most people will be somewhat familiar.
It is fairly easy to see that thoughts affect feelings, which in turn influence behaviors, and that this continues in a cycle. For example, let’s say I have the thought, “I’m not good at art,” and I am in an art class feeling stress and low self-esteem among other students who I perceive as “good at art.” My attitude might lead me to avoid participating in the class or doing the art project, or to take my project and hide it or throw it away. Later on, when someone asks me about art or wants me to go to a painting or creative event with them, I might simply decline to participate, which could lead to feelings of disappointment, missing out, or isolation. That feeling, in turn, can affect my self-esteem and stress. The circle can go on and on, and this is just one example of countless types.
CBT involves learning about tools to help you examine your thoughts, look at some common distortions in thinking patterns, and practice more realistic and better-feeling thoughts. This in turn has the effect of improving feelings and behaviors, since they are all in some way connected. Integrative counseling, however, goes beyond the CBT triangle of thoughts, feelings, and behaviors. It includes the greater context of life itself.
With an integrative approach, I ask you not only to consider what you’re thinking and feeling and doing, but in what context? What is life really all about for you? What do you value most – your time, social connections, social status, material goods, love, peace, health, safety, purpose, altruism, spirituality, truth? If you’re unhappy or unsatisfied with your life or yourself, how do you know, and how long have you felt this way? What experiences in your life may have led to this moment and this particular problem?
Integrative counseling may mean looking at the timeline of your life, at a history of events, especially traumatic events, and even understanding what defines trauma itself. Trauma is vitally important to consider in an integrative approach. It requires a different treatment than more traditional “talk therapy.” It’s not just an event or series or events that happened, but moreso it is something that lives in the mind-body.
"A purely disembodied human emotion is a nonentity." - William James
Integrative counseling, like integrative psychotherapy, includes the physiological, or physical. We discuss the mind-body, not simply as an idea that the mind and the body are in some ways connected, but that there is no line between them. If you think that there is, where is it? How do you point to the separation between your thoughts, experiences, memories, pain, illness and disease? The old idea is that thoughts and memories are located in the brain, and that pain and disease are located wherever it is felt or shown in an image or biological to reside in the body.
More and more research has been done to reach the tipping point where now, in order to effectively treat and heal both trauma and many physical ailments, we need to acknowledge that the human being stores memories and psychological information throughout the physical body. Neurons, which were formerly thought of as brain cells, also exist, for example, in the heart and throughout the digestive system. Dr Bessel van der Kolk’s book The Body Keeps the Score delves in depth into this (see this excellent summary).
I am the child of a scientific researcher, but not a researcher myself. Knowledge is power, and I recognize the power of this type of information to help others study and integrate concepts for their own use. I do have a number of inspirations. In my next article, I will continue the introduction of the mind-body and how it is used in my integrative counseling approach by naming my top influences, who have provided extensive, research-backed contributions to the mind-body concept and how it can and must be used for healing and personal evolution.
And so, to be continued…