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The Process of Therapy: Input, Integration, and Output
Blog post by Eric Moya Cst-D, Ms/Mfct
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Let’s talk about how a basic understanding of the function of the nervous system can be expanded to help your work with clients: body, mind, and spirit.
Functionally, the nervous system has three jobs. All three jobs are about navigating contact between us and the world around us. The first job of our nervous system is to collect input from the environment. This is done through our senses: sight, hearing, taste, touch, and smell. Some folks might argue that there are additional methods of perception than the above senses, but for the purposes of this article, it doesn’t really matter. The main point is that our nervous system collects input from the environment. The second job of our nervous system is to take all of that data and to make sense of it. This is done with the amazing processing ability of our brain and spinal cord. The third job of our nervous system is to then take that understanding of the sense data and respond to the environment. This overall process is repeated over and over our entire lives and is the foundation of any organism’s contact with the environment around it.
Input --> Integration --> Output
Each of these three elements get extremely complex, of course, but for the purpose of this article, it’s not actually necessary to delve too deeply into any one of the areas, but to understand that those three steps are the basis of how we interact and respond to the world. It is also the goal to describe why a misunderstanding of these steps can make it more difficult for therapists when interacting with clients.
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Let’s begin with a recent example:
I had a client contact me recently asking if I could help with vestibular dysfunction. The potential client would be traveling from out of town and was hoping for some reassurance that we would be able to help. It was a reasonable request considering that coming for therapy would entail a fair amount of money and time and potential vestibular discomfort in the travel process. This is a common situation for people in the helping professions: a client calls asking if we can help a particular diagnosis. In my response, I had to pause and pull from clinical experience and make an honest recommendation without promising any particular outcomes. In general, I explained that vestibular issues respond well to the type of work I do, but that there was no way of knowing whether or not she would respond well without trying the therapy.
Any seasoned therapist quickly learns that it is not possible to promise any particular outcome to a client. People and problems are just simply too complex, especially with complex presentations. It is possible to have 10 different people with the same diagnosis or even similar symptoms, and yet the therapeutic process for each of them would look very different. The more experienced a therapist is, the more likely it will be that he or she can make a prediction based on patterns of experience, but there still are no guarantees about how any one person is going to respond to any one therapy or therapist.
So, why is such a simple question, “will you be able to help me with ____ condition?” a developmental challenge for many practitioners? It’s a challenging question because it is a question that by it’s very nature confuses the three steps above of inputs, integration, and output.
Any symptoms a client may have are outputs of the dysfunctional system. Let’s say that a client has lower back pain. The client’s experience of that pain and discomfort is an output of the system after it has consulted and integrated various inputs of the body, including tight musculature, impinged nerves, osseous misalignments, fluid stagnation, emotional upset, or any other number of factors. Let’s say a different client is experiencing anxiety or depression. The symptoms of anxiety or depression might be a result of a complex mix of stressors including chemical imbalance, life events, past traumas, physical discomforts, social pressures, etc. The client’s own experience of anxiety or depression in this case is an output after the integration of the great mixture of inputs in that person’s life. The important thing for us all to remember as practitioners is that any experience a person has (which includes all symptoms) is a post-integration output of the bodymindspirit. Thus, anytime a client asks for help with a particular set of symptoms, they are asking for their system outputs to change.
And here’s the problem, therapy does not and can not directly work with outputs. It only works with inputs. A therapist can’t make a muscle relax, she can only help provide the type of stimulus which is likely to result in the muscle relaxing. A therapist can’t make someone feel less depression or anxiety, she can only work with the client to provide the typs of stimuli that are likely to result in better mood. A therapist can’t make someone sleep better, she can only help change the inputs which might result in better sleep overall.
Essentially, this means that all therapy is one or two steps removed from the reason why the client contacted us in the first place. Basically, we are limited to working with inputs in the hopes of creating different outputs. Even the most simple of client complaints can be a synthesis of what might be a great number of inputs. The more complex the client presentation is, the more complex the innumerable inputs and reactions creating the output are likely to be. And the more complex the client presentation, the longer the therapy is likely to take as a person changes the very patterns of his or her body, mind, and spirit.
For newer therapists who want predictability and reliability in the work they do, this is tough, particularly with the understandable desire to be effective and help their clientele. It is the impetus for learning new techniques and skills, and it is the promise of many modalities to be more effective than others. Additionally, for many therapists, receiving positive feedback and/or seeing transformation is one of the foundations of job satisfaction, and is one of the main forces propelling advertising, marketing, and client education information.
So, the difficult task for newer bodymindspirit therapists? To somehow embrace and work with the realization that any worthwhile therapeutic goal, particularly one that involves the complex interaction of the body, mind, and spirit is going to need a more nuanced understanding of the role the therapist plays in the client’s journey. An understanding that is based in complex interactions, the challenge we all have in changing in-grained patterns, and the limitations we have in affecting inputs, outputs, and integrations.
A good first step for a practitioner in developing that nuanced understanding is to begin identifying and witnessing the differences between input, integration, and output on a bodymindspirit level. Ultimately, that simple distinction becomes a way of building a critical bridge between diverse therapies. Even better, it is a distinction that doesn’t prioritize the body, the mind, or the spirit – one of the long standing challenges of integrating the bodymindspirit in the clinical setting.
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