In favor of Holism

I’m a licensed massage therapist and a board-certified structural integrator. I specialize in helping people feel more resilient and agile in their bodies. The “licensed” part means I can touch people for a living legally, but because of what is invoked when people hear the word “massage,” I rarely identify as an LMT. I’m also a practitioner of neurovascular release and visceral manipulation, and those descriptors best invoke the primary hands-on tools I use. Here’s the rub, so to speak: When I use any of the above titles, even those I currently employ most often—manual therapist and structural integrator—people have no idea what it is I actually do for a living. I will attempt to explain what I do towards the end of this essay. In the meantime I  invite you the reader into my telescoping awareness and observations on the often entangled and opposing relationships within the field of western medicine and alternative health care.

Something that the fields of massage therapy, structural integration, and chiropractic’s have in common is that they all live with the shadow of perceived quackery, and at different times have struggled to be recognized as legitimate and credible forms of healthcare in the eyes of what I will call the conventional corporate medicine complex, or collectively what we call the healthcare system (though it would be more apt to call it our disease-care system). Names are coined—like “complimentary care”—that minimize the substantive and profound capacity that we as non-conventional healthcare providers have to effect meaningful health changes. 

I imagine that anyone who tends to approach things from a holistic and plant-based healing point of view can relate to the following experience. I was recently in consultation with a Physician assistant at a gastroenterologist clinic because I’m contending with gastrointestinal-tract dysbiosis and I wanted to schedule a colonoscopy to gather more information. The PA asked me if I was treating the bacterial overgrowth, and I said yes, I was working with a naturopath and treating it with herbs. In an instant I saw a flicker across her face of disdain and dismissal. There might even have been an eye roll. “You know,” she said, “the standard way to eradicate this issue is to use antibiotics.” What she didn’t mention is that the health outcomes of using antibiotics for these issues are not great, and at times antibiotics can do more harm than good—whereas some studies have demonstrated that the use of herbs to treat SIBO (small intestine bacterial overgrowth) has comparable successful outcomes to antibiotics without the negative consequences. In fact, antibiotics can be part of the perfect storm that contributes to conditions such as gut dysbiosis in the first place. Other factors that come into play are diet, stress, hormonal imbalance, and a history of trauma. 

There are multiple reasons we alternative health care providers have struggled to be taken seriously, and most of us are well aware of them. To name a few, lack of evidence might be the most substantive, but then there is the fact the field has been inundated with it’s many charlatans and grifters riding the wave of new age consumerism. And besides the usual suspects like bureaucracy, limited capacity for research, and little interest in funding it, there is also the issue that some of the emergent research that has taken place in the past five to ten years has yet to find its way into teaching institutions, let alone into clinical practices. For example, the highly complex and multi-dimensional qualities of our fascial matrix as it makes up and relates to our whole body, as well as our understanding of polyvagal theory, and seminal research such as the ACE (adverse childhood experiences) studies—all have the potential to completely shift the modern medicine paradigm. The psychotherapy and somatic healing communities have embraced these insights because they affirm what we have believed to be true for a long time even before there was data present to support our views. People struggling with chronic conditions are left seeking, sifting through research themselves as they try to make sense of what is happening to their bodies, minds, and spirits. This dynamic often leads to patients being better informed about a particular subject than the specialists they’re consulting about the matter. 

All that said, it’s not just capitalism, bureaucracy, inertia  and quackery holding the alternative health care back; it’s also an arrogant western ideology that has seeped into both the lay person and providers' minds alike, and ultimately the populus as a whole. Western Ideology treats our bodies like objects. We think we can manipulate our bodies with inputs, bending them to our will to produce the desired outputs. We seek to colonize our bodies the way we have colonized and continue to colonize the land, laying waste to her fertile ground and perpetrating genocide on her indigenous populations and ecosystems. I’ve noticed plenty of providers in my field speak to the concept of holistic care but in practice are overly influenced by western thinking. 

Western conventional medicine reduces people to disparate parts and diagnoses, with little regard for the person’s wholeness or humanity. We have the digestive system, the endocrine system, the immune system, the musculoskeletal system, and so on. This reductionist point of view is alienating to many people, especially when they are in anguish from pain or illness and seeking care from a medical provider. The reality is, we are not a collection of separate systems, we are one system—a human being—with many interwoven and overlapping functions. Nuanced relationships and continuous highly sensitive communication happens inside us and between other people and our environment all the time. As the initiated shaman, healer, artist, and writer Martín Prechtel writes, “We are not separate from nature, we are nature.” Earth-based cultures, Eastern medicine, and Indigenous healing practitioners have known this to be true for thousands of years.

Now It’s important to note that I’m not here to lambast Western medicine, however myopic it has been in regards to chronic illness. Modern medicine has been remarkably wonderful in emergency settings, stitching people back together after the physical trauma of car accidents or other bodily injury. The advancement of imaging, and the ability to run different blood tests to rule in or out different possible ailments—these are hugely important tools. It’s more that I take issue with what is done with the information once it’s gathered. There has been a long-standing belief in Western medicine that if we don’t know what something does, or why something exists in our body, that it is most likely irrelevant (enter fascia, the interstitium, the greater omentum, and of course the appendix.) It has only been in relatively recent years that we have come to realize the value and importance of these tissues and structures as they make up and relate to our whole body and immune defenses. 

In the fields of massage therapy and structural integration, there is a hunger for credibility that is played out in a desire to be recognized as clinical and professional. The more clinical or scientific a practitioner is, the better. This leads to titles such as “medical massage therapist,” “neuromuscular therapist,” and, to speak personally, my habit of calling myself a manual therapist. The reasoning is that these words are evocative of clean, safe, effective, and objective health care. Yet even the idea that we can make objective assessments is flawed, because assessment is always filtered through our often biased and subjective experience as practitioners. And of course this is why, if we are worth our salt, we make differential assessments to gain a better understanding of what is happening with someone when they come to see us for help. Many alternative practitioners, including massage therapists, structural integrators, and chiropractors pay lip service to the idea of holism, and call themselves holistic health care providers, but in truth end up employing reductionist models of care, using a limited set of tools and skills as they try to tackle what is often a highly complex and monumental problem spanning somebody’s whole being and most likely their ancestors as well. So the question arises: Why are we looking to the medical establishment to set the standards of care for us when it is profoundly failing in so many ways?

Even as I write about my distaste for westernized medicine I find myself falling into an appeasing stance, a little fearful of angering the wrong people or being perceived as a New Age health nut, a distinction which in the eyes of the public diminishes my credibility. What I’d like to do is challenge the status quo without burning it all to the ground, but I’m not sure that it is  possible. I have a desire to be listened to and actually heard without being dismissed. (An important side note: I want to clarify that I value critical thinking and the scientific method. I trust that vaccinations are mostly safe, and I believe they are vital to keeping our global populations safe from diseases.)

I want to acknowledge that clinics and hospitals are filled with well-meaning, deeply compassionate nurses, doctors, and healthcare workers. They are working day in and day out and being pushed to the brink of their capacity, now more than ever as we contend with the global pandemic of Covid-19. The doctors and nurses I know personally are kind, generous people. But they have to work within the bureaucracy of our conventional Western system. So I ask, how can we emphasize bringing forth the warmth of humanity that is already present? How can we honor the years of ingenuity and scientific study and carry with us the meaningful learnings without being entrenched in antiquated ways of rigid, reductionist thinking? Can we start shifting the Western paradigm to include an understanding of true holistic health care? Can we teach the importance of relationality on a multidimensional level in medical schools?

The term “biopsychosocial” comes to mind, meaning the biological, psychological, and social context we find ourselves in as humans all play a major role in determining our state of health. In other words, it’s helpful to apply an ecological point of view when we are discussing ourselves, our health, and our healing. “Ecology” comes from the Greek word for house or environment. It is essentially the study of organisms and their interactions with one another and the biophysical environment that makes up our ecosystem. This includes both living and non-living things such as animals, plants, minerals and water. An ecological understanding of something can be on a grand scale from microscopic to macroscopic. Ecology is, in short, the study of relationships. When we apply an ecological point of view to ourselves as human beings, we begin to see an unveiling of just how remarkably interdependent we are internally on the microscale, all the way to our macro existence, our interactions with other organisms, objects, and the world as a whole. I had an instructor once tell me symptoms aren't created in a vacuum, I fully agree and I would add to the sentiment that neither are solutions. Healing isn’t an individual endeavor, but something that takes the whole community, people coming together in practice, ritual and ceremony—in relationship—

In reality, allopathic medicine should be looking to holistic providers to shine a light forward. Skillful naturopathic and functional medicine doctors who aren't afraid to collaborate and use plant medicine are on the forefront of emerging/re-emerging medicine. I look forward to more propagation of relationships between manual therapists, acupuncturists, somatic counselors, NDs and MDs. The danger here is applying the same Western reductionist thinking and methods that have been employed in the rest of modern medicine. It feels important to acknowledge the nuance and complexity. How do we remember and rediscover old wisdom and knowledge without pilfering it from the historical and cultural contexts it’s originated within? Is that even possible to do in an ethical manner as a Westerner? Many of the New Age wellness and somatic practices are rife with appropriation or white-washing. In this day and age I’m increasingly aware of my own whiteness, maleness, and privilege; my own work is very much influenced by esoteric Daoist practices as well as modern interpretations of Buddhism. If I am to use these old teachings in my current work I feel it’s important not to decontextualize them from their origins or history. I rest in my understanding as I continue to inquire, listen, and learn. 

As a hands-on healer and holistic healthcare provider, I receive my clients as whole human beings when they walk through my door. I practice out of a studio in my home, and there is something special and intimate about welcoming somebody into my personal space in this way. A common refrain I hear from my clients is “Never in my life have I received care like this before.” The people I see are often the ones that have been failed by our conventional system of care and are fed up; they are looking for something else, something better. Often, they have received an amorphous diagnosis like chronic fatigue, lyme disease, or fibromyalgia. Or they have no diagnosis, and are struggling to find relief from some sort of chronic pain or other bodily dysfunction. Many also struggle with anxiety and panic attacks, or have histories of physical or emotional trauma that they may or may not be aware of before they start seeing me. I do not shy away from the multidual messiness that people bring to me. 

So what is it that I do? I joke that describing what I do is like trying to describe swimming in the ocean to someone who has never seen the sea. The root of my hands-on touch is based in osteopathy, although how I work has organically become unique to me, as it does for any practitioner who becomes immersed in the art and science of their practice. When I speak to new clients, I let them know their whole self is invited in, and everything is welcome. Then I listen, I observe, and I inquire. I listen and I continue listening throughout the session. Some of the listening happens verbally, but much of it is actually with my body, my heart, and my hands. I attune my awareness to my client and their needs without losing myself or overwhelming them. Their nonverbal communication and my assessment is what determines where and what I will treat within their system at any given moment. My care is guided by their body, not by my agenda. I use my hands to touch in various places using subtle, slow, and gentle force, inviting a shift in their tissue tone and span, and if change does not happen in that moment it will cue their system to keep working with that region even after we are done with the session. Often there is verbal guidance to inhabit different regions of their body so as to highlight their internal relationships. 

There is a fair amount of dialogue that takes place between me and my clients. I invite them into personal inquiry to peel back the layers of what is underneath the experience of their current symptoms so I can have a greater understanding of what their reality is. I’m curious to know and understand all the different aspects of their life that may be contributing to the issue they are seeking care for. In this way, we come to a shared understanding, and I can better support my client in finding resources for their healing. Inviting my clients to cultivate a more expansive relational experience internally can be a hugely grounding and supportive experience. It is paramount that somebody’s wholeness be accounted for when we are working with them. To dissect the process of deep listening and clinical assessment and create a reductionist duality of experience is a disservice to the work of inviting people into their own embodied sense of self, resilience, and agency.