Holistic Care
During the COVID pandemic in 2020, a year many of us have tried to quickly forget, I rediscovered a love for jigsaw puzzles. As someone who often fidgets or repositions often during long meetings, I found that working on a jigsaw puzzle while participating in long virtual meetings allowed me to remain focused on conversation while also keeping my hands busy (if my former boss is reading this…I’m sorry!) There is something about jigsaw puzzles which appeals to both my problem solving skills as well as my curiosity. The former is obvious as finding the correct pieces to place in the correct order often requires problem solving via the investigation of color and form and matching said items together through trial and error. The latter, however, is something that I have come to appreciate about myself and about others. Curiosity, while often seen in childhood as problematic, is such a significant trait in and of itself. Curiosity leads us to ask questions, to investigate, to seek understanding and answers, and also to examine all possibilities as, well, possible. Perhaps that is why I found my way into the counseling room. People, as I quickly discovered, are not creatures which can easily or concisely fit into a box. That is to say, that while the medical model of care views diagnosis and treatment as systematic, the world of counseling and psychology has continually struggled to follow in its footsteps for this very reason. The medical model is systematic: examine the evidence of symptoms, tally the symptoms into one or more accurate diagnoses, and treat with regimented medication. The world of psychology attempted to follow in these footsteps by creating the Diagnostic and Statistical Manual of Mental Disorders or DSM. The design was similar to the medical model in that it attempts to understand a clients list of symptoms, align those symptoms with an accurate diagnosis or two, and then provide treatment which may or may not include medication. The problem with this system, yet again, is that people simply do not fit into a box. People, as I have learned, are far more like jigsaw puzzles.
I met a client a couple of years back who presented to counseling for anxiety. The young lady, a teenager, sat across from me with her mother and we went through the basic intake questions that I utilize to help myself get acquainted with my clients while also attempting to assess the situation from various perspectives. To the clients mother the situation was clear and obvious, the client was anxious and it would be better for her if she were not. The problem with this, however, is that it took the entire human existence and experience of a fifteen year old woman and attempted to fit it into a prepackaged and predetermined box we call anxiety. Maybe, I thought to myself, she is struggling with anxiety. But, I thought as I challenged my own thinking, even if that is accurate, where is her anxiety coming from? She is, afterall, a human being, complex in her thinking, emotions and behaviors, crafted and created by a loving God, and woven together with intricacy and purpose. To take all of that and place it in a box labeled “Anxiety” seems awful reductive. Could her anxiety be evidence of an anxiety disorder? Absolutely it could. But perhaps it stems from some past traumatic experience. If that was the case then her anxiety is really not the main issue even if it is the presenting problem. Or maybe her anxiety is really evidence of unproductive thinking, in which case learning some basics of cognitive behavioral therapy could be really helpful and productive. Maybe she is wrestling with her identity (a developmentally normal struggle) and her anxiety is actually evidence of her internal beliefs as they scrape against the reality of the world she faces everyday and the messages she hears about herself. The point that I hope this makes is that people are in fact like jigsaw puzzles. We are not so simple to label and diagnose; anxiety, AD/HD, depression and other mental health disorders do not capture the whole of the picture of our person-hood. Instead, when we accept that we are complex creatures crafted by a loving God, we can also accept that caring for ourselves and others requires a holistic approach.
I want to offer up some suggestions and thoughts as to what exactly holistic care means, and how you can practice it in a healthy and productive manner. When we say holistic, we mean that something (in this case you!) is not merely it’s symptoms or presenting issues, but rather a sum of all of the pieces. You as a human being have many facets to consider. There is, for starters, your physical body. Within that there may or may not be medical issues that you face and deal with, or physical limitations that play in. This is countered of course by whatever positive pieces of your physical health exist. There is your mental health, how you think and feel and manage those pieces. There is your narrative, the very story of you and what you have walked through and experienced. There is your family of origin and how those individuals have connected with you and played a role in your development. There is your belief system, what you have learned and chosen to believe about yourself, about others, and about the world around you. There is your social life, the friends and trusted confidants you lean on for support or enjoy the company of. There is your career, your passions and desires, your faith, your knowledge and wisdom, your personality, your dreams and hope, your attachment style, and on and on the list goes. You, my dear friend, are much like a jigsaw puzzle. You have many pieces, each individually carved out and shaped by a loving creator to fit intricately into its corresponding pieces. The sum of all of these pieces tells the story of you, a you that was loving made by a loving God. To care for you means to care for each of those pieces, and to recognize that each piece contributes to the overall picture and must be considered for its potential impact. That is holistic care.
Allow me to offer you with some reflective questions that might guide you into how you might care for yourself in a manner that is more holistic.
1. How am I sleeping lately? Sleep is one of the most commonly correlating pieces of the puzzle of you. Poor sleep can lead to anxiety, depression, social isolation and withdrawal, and decreased focus, motivation and physical health problems.
2. Who do I trust and lean on? We are ALL OF US created to be connected. There are no exceptions to this rule. Who we lean on and trust matters, and having at least that one person in that corner for us to rely on is crucial.
3. Where do I place my hope? Whatever your answer to that question is will tell a whole lot about your current emotional status. Whatever I place my hope in, I am asking that thing to be my savior, to provide meaning to my life, to provide guidance and fulfillment. Most things simply cannot give that to me, and therefore are not worthy of my hope. There is only one who can be that fulfillment, and his name is Jesus.
4. What do I believe about myself? About others? About the world around me? There is a deeper level at play here in these questions, for my beliefs directly contribute to my daily thinking, feeling and behaving. When we can examine these pieces of the puzzle more closely, we often find answers to the question of why we do what we do.
5. How do I care for my physical body? We only get one body, and it is our responsibility to care for it, nurture it, strengthen it, and provide for it. How we do those things matters and contributes greatly to the jigsaw puzzle of you.
So, about that client I mentioned earlier. While her mother saw a simple case of anxiety that needed to be eradicated, what I found was immense depth. Over months of working together I discovered an incredible young woman with loads of personality, charisma, joy and passion. I discovered a young woman with an incredible talent for art and an unmatched creative ability to convey deep and powerful emotion with paint and canvas. I discovered a young woman who was deeply affected by the family she was connected to, how they responded to her, and how she felt seen, heard, understood, and loved by them…or didn’t. I discovered a young woman who wrestled with many social pressures she faced day in and day out as a teenager in the 2020’s. I discovered a young woman who was not given proper guardrails in her life that might offer direction and hope, and instead went looking for belonging and acceptance wherever it might be given to her. I discovered a young woman with a bright future who simply did not believe the same about herself. I discovered, to be more concise, a human being. A human being which required love, care and compassion in each and every one of these areas of her life. You, dear reader, are also a human being; you are complex and created with such intention and purpose. To care for you requires a holistic approach that carefully examines each piece of the jigsaw puzzle that forms the complete picture of who God created you to be. That is my encouragement to you, that you would take the time to reflect on your own jigsaw puzzle and care for each piece as God designed it to be cared for.