From the Medical Model to Holistic Care

For several years I worked as a therapist at a community clinic in rural East Texas. This clinic provided affordable care options for individuals and families in an underserved area. These services were provided via the medical model, meaning that symptom reduction and stabilization were the top priorities.

Upon enrolling in services, the patient would be assessed and given a diagnosis. An appointment was then made to see a psychiatrist or physician assistant, who would prescribe medications. During this, if the patient met specific criteria, therapy services were offered.

As a therapist working within this model of care, my role was to provide short-term and solution-focused therapies. The aim was that through a combination of medication and short-term therapy, a patient would begin to stabilize and improve their functioning. It was evident that medications were helpful for some patients, namely those experiencing biochemical related mental illnesses (e.g., clinical depression, schizophrenia, bipolar disorder), and that short-term therapy was helpful for individuals wanting to try out a few alternatives for their current problem. However, it also became evident that there were a significant number of patients who found neither of these approaches useful. 

In response, I became more curious about the particular needs of these patients and started to discover they were dealing with a different kind of challenge. The further we explored their symptoms and distress, the more unconscious psychic conflicts arose from the depths of their psyche into awareness. These patients were getting in touch with unmet developmental needs, painful childhood experiences, sexual and gender identity challenges, and many other issues. For me, it became clear that these issues were not due to chemical imbalances in the brain, but due to the nature of repression and the unconscious.

Now in private practice, I have chosen to focus my work on individuals seeking to do depth-oriented work. Some of my patients experience chemical imbalances in addition to psychic conflicts and some are dealing only with psychic conflict. Either way, the individuals I treat have come to a place in their life where they determined that digging in, whether for personal growth or resolving past pain, is the type of work they are interested in.