THE ASELF@

IN

HOLISTIC APPROACH TO MENTAL HEALTH HEALING

By

William F. Cavitt Ed.D LMHC

This article is a continuation of AHolistic Healing: The Next Step in Mental Health,@

by Generoso P. Masangkay, M.D. and William F. Cavitt Ed.D, found on this Website.

Introduction. When I write or speak about the holistic approach to mental health healing, I realize that many of the readers may have more experience in this relatively new philosophy of healing than I. This situation reminds me of a story. President William Taft=s eleven year old great grand-daughter was accepting an award. She said Amy great grand-daddy was President, my grand-father was Secretary of State, and my daddy is a Senator, butY.. I=m a Brownie! That=s what I feel like when I address some of the experts in the holistic medicine field Y.. Aa brownie!@

I was asked to write my ideas about holistic, comparative, or integrative healthcare by some members of The society for the Advancement of Integrative Healthcare in Pensacola Florida. Rest assured, I am not an expert in this area, but I can share with you our beliefs and policies at the Center for Holistic Rational Living, 6150 West Fairfield Dr. Pensacola, Florida 32506 Telephone :(850) 457-4660.

The Center operates with the belief that healing is the function of the entire being: Mind, Body, and Spirit. Therefore, complete mental, physical, and spiritual aspects of a person are considered in developing a personal treatment plan. Our staff, which consist of a Psychiatrist, Testing Psychologist, and Mental Health Counselors, work closely with other holistic medical health givers, such as General Practitioners, Neurologists, Chiropractors, Acupuncturist, Clergy and other specialists to ensure complete health coverage. Each caregiver believes in both contemporary and traditional approaches to medicine and will work to provide the best healing services the patient needs. The Center provides only the mental health needs for healing and that will be the focus of this article.

Counseling. All holistic caregivers provide some form of counseling. The Chiropractors I have worked with oftentimes give just as sound mental health advise as a Psychotherapist would. However, the licensed mental health caregivers normally use a more structured approached to counseling. There are usually four distinct areas or stages of mental health counseling. These stages are Establishing Rapport, or Agetting to know you,@ which is most important in providing catharsis. Problem Identification is the second stage of counseling and sometimes the most difficult. More times than not what the client first says is only a symptom of a greater problem. Development and Implementation of a Formal Treatment Plan is the third stage of counseling. This stage also includes the assessment of treatment effectiveness. The treatment plan should contain the primary goals and interventions designed to help the client with their particular problem identified in the second stage of counseling. Termination is often the most critical stage of counseling. A sensitive counselor will terminate treatment without implying rejection of the client. Rejection may be a major activating event in the client=s life. Insensitive termination may add to their problems.

We at the Center use these stages during the Psychotherapy Treatment Process. However, there is a more extensive paradigm used in treating a client for mental, physical, and spiritual problems. This more extensive paradigm is the over-riding theme of holistic care giving. I believe that every therapist regardless if they or humanist, behaviorist, or a cognitive practitioner, should have a well developed paradigm of treatment for their clients. I am going to share mine. After all emergency issues are dealt with, the counselor and client must know who they are really dealing with. How does the client see themselves?

Measurement of Self-Concept. The first objective is to learn as much as possible about our client. There are various psychological tools we use to assess the personal self-concept. Because this self-concept, real or imagined, is what must be addressed, we at the Center use well known tools such as: Psych/Social Reports, MMPI-2, Beck=s Depression Survey, and Burn=s Felling Good Therapy Tools to determine the clients perception of self. We also use some more brief and specific tests, rating scales, and surveys. Samples of some of these devices are found in the book AMeasures for Clinical Practice,@ by Kevin Corcoran and Joel Fischer.

It is important to note that the primary purpose of assessment in therapy is to ascertain personal perceptions of some specific trait or condition of the client. Assessment tools should not be the final say in guiding your psychotherapy treatment plan, but merely a tool to point you in a specific direction. The therapy session itself is probably the most important tool.

Labels. In order to use the data obtained by any of the psychological devices, a firm conceptual understanding of the self-concept is required by both the counselor and the client. Both players must be sure they are using the same game plan and understand all the labels used. And, we must be careful when using these labels. This reminds me of a story, told by Father Anthony de Mello, that vividly illustrates how labels can get you into trouble. Patty was walking down the streets of Belfast, Ireland when he felt the barrel of a pistol at the back of his head. A voice asked, are you catholic or protestant? Patty, thinking fast, replied AI=m Jewish.@ The voice then said, AI must be the luckiest Arab in Ireland.@ Inappropriately used mental health labels can also be harmful to the client.

Reserved verses Projected Self. The reader will recognize that my concept of self has many aspects of humanism in it. It will become evident that my approach to mental health counseling even with its many eclectic aspects always returns to the basic foundation of Rational Emotive Behavioral Therapy (REBT).

The self is made up of two parts. The reserved and the projected. The projected self are those elements of the self that are readily observable, such as our body shape, how we act in public, and even some of our beliefs, hopes, and dreams. These are the things that can be changed in therapy or through some effort by the client. The reserved self is who we truly are. The reserved self is what absolutely is meaningful to becoming the person we know as Bill or Mary. It is the essences of our real being.

Self-Concept Reserved

Projected

WELL BEING

Physical Emotional Cognitive Social Moral

Sickness Depression Memory Marriage Values

Stress Anxiety Intelligence Friends Sin

Accidents Mental Illness Problem Solving Family Laws

Body Image Personality Street Smart Looking Glass Swinging

Figure (1) The Self-Concept and the Elements of Well Being

Elements of Self-Concept. As figure (1) illustrates there are various aspects that make up our self-concept. Figure (1) shows but a few of these aspects of the human complex self, each adding to our positive or negative self-esteem. For example, if you should have an ideal body image of Mr. or Miss America, but you perceive your body as short, fat, bald, wearing glasses, and having age spots, your self-esteem in the body image category of your self-concept will be fairly low . This is especially true if body image is an important aspect for your well being.

Ideal verses Perceived Self-Esteem. In actuality, most of us have a real body that is somewhere between our ideal body and how we perceive ourselves. However, it is not the Areal@ that establishes our self-esteem in a particular aspect of our self-concept, but our perception in relation to our ideal. This is what Carl Rogers called the incongruence or difference between the ideal and the perceived. This incongruence is what the client, with the help of the therapist, must attempt to reduce. The closer the perceived is to the ideal, usually the higher the client=s self-esteem will be concerning that particular aspect of their self-concept.

Reduction of Incongruence is the Goal of Therapy. The complex human being can have very low self-concept, meaning there are large incongruence in many aspect of their self-concept or they can have overall high self-concept if there are but a few differences between the ideals and the perceptions. The client and therapist have basically two missions concerning the Aself.@ If the incongruence cannot be reduced, then the client can be helped to accept the reality of a particular aspect of their self-concept. This acceptance comes through changing thoughts and feelings and is a primary theme of Rational Emotive Behavioral Therapy (REBT).

Our Self-Concept in Relation to Others. To complicate matters, our self-concept does not exist in a vacuum. Even though this is not shown in Figure (1), you can imagine an aspect of your significant other interfacing with its respective aspect of your self-concept. If there is a large incongruence, it will take more work to ensure harmony in the relationship. Now, consider all the possible aspects in your self-concept and all those in your partner=s self-concept. The effort required to maintain some form of smooth relationship becomes mind boggling. This is often the case in marriage counseling.

Summary. I have introduced the first consideration of holistic counseling. Before all the pieces that make up the mind, body, spirit connection of a client, can be put together both the counselor and client must understand the major elements that impact the dynamics of the client. What is important to the client? How do they see themselves in relation to what is importance to them. Once this is determined the client and therapist can enter into a dance that hopefully will improve the client=s well being. However, to do this our paradigm must include how the mind, body, and spirit influence the counseling process. This will be the topic of another article in this series.