Over the last few months we’ve had several clinical meetings at the London Art Therapy Centre exploring the ways emotional and psychological issues are expressed through the body. This included trauma, Somatic Experiencing and EMDR, as well as more recent discussions on sex and sexuality. This month, we invited Dr Brian Kaplan to give a presentation on Whole Person Medicine, an approach where health and ‘dis-ease’ are seen and dealt with in the context of the patient’s whole life.
Dr Brian Kaplan, a medical doctor by training, described his journey through medical school and the realisation that he was interested in a more holistic approach when working with his patients. He fondly talked of his old GP, who would genuinely listen to, and spend time with, his patients; with our current knowledge about loneliness being a health risk comparable to many diagnosable conditions, the isolated patient might require simple human contact and attention rather than a prescription. However, the competitive nature of the professions, practitioner stress and the pressure of ever-changing government targets have meant that very few doctors in the public sector are able to work in this way. With his interest in psychology, his work as a provocative therapist, further training as a homeopath and a regular meditation and yoga practice, Dr Kaplan eventually opened a clinic in Harley Street, offering his own take on holistic medicine – or, as he calls it, ‘Whole-Person Medicine’.
Using a chart, Dr Kaplan explained that the approach we often encounter in medical settings can also be conceptualised as a ‘Mechanistic Approach’. Similar to the way a mechanic might repair a car, the mechanistic approach looks at the body as a machine where something has malfunctioned. We might remove or replace the damaged part (e.g. surgery, transplants); prescribe drugs to improve functionality, replenish necessary components (by adding blood, hormones, vitamins etc.), consider prevention from an environmental health perspective and, when considering the mind, look for biological causes for mental health problems and treat with psychiatric drugs. Dr Kaplan explained that while this approach is vital and has saved millions of lives, it does not take into account something that mere machines are unable to do: it does not consider the body’s (and mind’s) ability to repair itself. Additionally, because it does not take into account more complex interactions involving patients’ social, relational, psychological and emotional circumstances it often fails to address conditions which are more complex to resolve and often improve with nutritional and psychological support – such as asthma, alopecia, IBS and eczema.
The next section on the chart was ‘Holistic Stimulus [patient passive]’. In this category, Dr Kaplan included many complimentary medicine approaches which, in a similar fashion to Western medicine, involve a largely passive client who is receiving an intervention to help alleviate difficulties. This includes several types of massage, acupuncture, homeopathy, reflexology and hypnosis. While many patients find these interventions helpful, the client is a recipient, rather than a partner in the implementation of treatment.
The final section was ‘Holistic Stimulus [patient active]’. Here, the patient is an active agent who is required to make actual changes and take actions in his/her everyday life in order to see an improvement. These interventions can involve an exercise programme, going on a remedial diet, undertaking yoga, meditation or breathing practice, Alexander technique or NLP. From a patient’s perspective, these interventions may involve hard work yet can be more empowering and provide a sense of agency and control over one’s life and health. The psychological benefits of being an active participant in one’s own recovery cannot be understated.
And where does art therapy fit into this chart? Dr Kaplan explained that when any therapeutic work takes place on a deep level and enables the client to make a change – especially with art-making being a clearly active part of the work – it would belong in between the ““holistic stimulus [patient active]” and the middle point. Removing the red cover, the middle point of the chart was a mirror. After all, providing our clients with mirroring might lead them to put together the reasons for their difficulties. In the safety of the therapeutic space, we can aim to work in a client-led and reflective way, enabling our clients to develop insight, self-knowledge and work towards self-healing. However, Dr Kaplan stressed, the mechanistic approach is vitally important and should never be side-lined, even if only to exclude other diagnoses; when a client is suffering with a acute appendicitis, there is no question over the choice of treatment. And when presented with clients who suffer unexplained symptoms we should always encourage them to seek medical attention.
Posted by Nili Sigal, art therapist &
clinical meetings coordinator