“You needn’t be well to be wealthy
But you’ve got to be whole to be holy.”
Greg Lake (from Emerson, Lake and Palmer)
At its core, the holistic model poses a dilemma and/or a
challenge: How can you provide an overall model that effectively encompasses
and adjusts to individual differences and variations? For the scientific method,
one takes apart the whole in order to focus on and to better understand the individual parts, bolts,
After a careful study of them through trial and error and
experimental analysis, scientists would summarize the new findings and express
them in a general and often universally applicable theory or proposition. As a
rule, the medical field is founded and predominantly based on this approach as
it tends to split the body from the mind to be able to better treat the former
with the potential neglect of the latter.
On the other hand, the whole-person approach sees body and
mind as integral parts of the same system - the proverbial two sides of the
same coin - that can be stretched and expanded to include not only the personal
past but also the genetic and psychological heritage of the given individual.
At the same time, the holistic model will also consider and examine the
person’s current social, socio-economic, political situation and circumstances.
Put differently, instead of a focused view, we would zoom out and look at the
big picture and examine other parts and factors influencing the given individual
across space and time with the aim of better understanding the underlying medical issue or the problem at hand.
The dilemma or challenge exists in the objective to create a
universal theory by focusing on and taking into account the individual differences
and underpinnings. It does not help the matter that there is confusion both in
the perception of people as well as the practice of the holistic model as there
are notable fluctuations and inconsistencies across the same model, in addition
to misunderstandings and misperceptions by and of certain practitioners.
Yet for a better and clearer understanding of the whole-person approach, I decided to talk to Matt Erb, an integrative physical therapist whom
I happened to spot on a previous webinar. I found his ideas to be most
interesting and aligned with what I believe in and often write
about, so I invited him to speak on Arash’s World.
Most graciously, he
accepted, and we ended up covering a whole range of fascinating topics on
physical, mental, social, emotional, and spiritual health, philosophy, both
neuro-philosophy as well as the history of philosophy, and the strengths and
weaknesses of psychotherapy. It was a wonderful, insightful, and profound
discussion that you can find and access in its entirety at the bottom of this
Right from the get-go, Matt Erb stayed true to his
philosophy and model. On my question, what does a typical day of a physical (or
rather a physio) therapist look like, he acknowledged that every one of them
would experience their days differently as it would be difficult to resume, reduce,
or categorize the practices of this wide-ranging, expansive, and inclusive
In fact, his hope is that this method would not be regarded as
an outlier or an “alternative approach” but rather become more commonplace and
even embedded within the medical field, so much so, that the term integrative
would simply disappear; ideally, it would blend in, be fully absorbed, and
integrated with all the diverse health practices as well as theories and
The whole-person approach views the body-mind and environment
triad as interdependent and intricately and intimately connected, so that any proposed
remedy or treatment would vary as well as adapt and adjust itself to the
special and individual needs and circumstances of the given person. For
instance, the word physiotherapist as used in Canada and in Europe is more
encompassing than the more limiting, distinct, and designated use of “physical
therapist” in the US, one of the only countries in the world that insists on
this term. The former implies at least a certain connection to or affinity with
the physiological (and by extension mental, emotional, and spiritual) underpinnings
of the person, whereas the second one is more intent on showing the separation
and demarcating lines between the body and the mind in a purely Cartesian
More on Descartes a bit later, but, put differently,
mind-body integrated care is the driving force, motor, and underlying
inspiration behind the holistic model. This multidimensional approach looks simultaneously
at issues ranging from stress, trauma to somatic conditions like fatigue, headache,
and chronic pain. Moreover, it examines the relations, implications, influences
and repercussions of one of the dimensions on the other. Yet the current
medical standard has a more mechanical focus that limits itself by focusing
only on one aspect of health and disease without considering and looking at the
various other factors and components that equally shape and influence the lack
of well-being in the ailing patient.
It all boils down to French philosopher and mathematician René Descartes as he ended up encouraging and
facilitating the separation of body and mind. This is mostly a staple of the
Western world, as the Eastern traditions, such as Buddhism, tend to see them as
an integrated unit where one aspect of one’s existence lives, thrives, and
feeds upon the other. Matt equally believes that the Western model of
healthcare is biomechanistic and while reductionism in the scientific
discipline may at times serve a useful purpose, it should not be the universal
approach to health and wellness as most of the health challenges people
experience is not that simple.
Matt gave the interesting analogy of having a rock in your
shoe and that its removal would alleviate the discomfort and dis-ease one would be feeling. Examples of this pertain mostly to acute care. However, the counterpoint
could be that alleviating the issue may not necessarily solve the problem as
more rocks and pebbles could appear at any time maybe due to the fit and structure of the shoe. To
stretch the shoe analogy even further for our purposes here, the traditional medical model does not look
at improving the fit and comfort of your shoes; its aim and purposes are not
necessarily to increase your comfort and ease.
To give a slightly clearer example, I used to suffer from
regular headaches. I would take painkillers on an almost weekly basis. The medication
would help deal with the (acute) pain, but it would not solve the problem or underlying
issues. The pain would be recurring on a regular basis until I managed to bring
about a seismic shift in my body system. The root problem or cause was my
troubled and troubling stress response not only to work but to events in general.
Once I effectively dealt with the underlying issues, headaches became a thing
of the past and I have not had one in more than three months - and counting!
The other problem with Cartesian dualism is how it has
shaped our way of thinking, observation, and interpretation of the world. It is
an either-or approach and allows little room for dynamic interactions,
complexity or integrative approaches and practices. It is better, healthier,
more beneficial, and more accurate to see and understand the world on a
spectrum and to accept, if not embrace, a non-linear quantum or spiritual view
and interpretation of oneself and the world in lieu of a limiting either-or,
one-or-the-other or P and not-P viewpoint. Ever since the days of Descartes,
consciousness (let alone the properties, dimensions, and influences of the
unconscious) is something that science continues to grapple with and it still has to come to grips with it, and it is certainly not a far stretch to assume that the
mind would play a significant role in one’s physical existence, and vice versa.
In my view, the Dao with its harmonious depiction of yin-and-yang
elements is the symbol par excellence for overcoming dualistic thinking and of not
seeing the world in simplistic dualistic terms; both aspects, alongside their
different shades and spectrums, are embodied beautifully in such a simple image, which is conveyed much better and more clearly than words could possibly explain them.
Moreover, it is the symbol of a circle, a nonlinear
depiction. In a similar vein, we often tend to split off and compartmentalize
our knowledge in different fields and disciplines, such as religion, sociology,
psychology, and the medical sciences. Although this is necessary due to the abundance of knowledge, and there are few veritable Renaissance men and
women out there, it becomes a vital issue and potential hindrance in treating
and dealing with ailments and diseases.
In terms of health and wellness, it would be even more
important to track and hunt down the root causes of one’s medical and
psychological issues, and often it is a complex combination of both, in most
cases, due to trauma or unconscious memories and experiences. Hence, this poses
a challenge in terms of education and training as the holistic health practitioner needs to have
a good grasp and understanding of various disciplines to be able to best help
However, culture is another important factor that is not
always considered, evaluated, or appreciated when it comes to medical treatments. For
instance, countries can be often divided by how much and to what degree they
identify with individualism versus collectivism. Although this is a spectrum,
many people adopt a particular individualistic or collectivistic lens, which
affects their thoughts, actions, and behaviors, both consciously as well as
Each approach has its share of benefits as well as failings
and shortcomings. Yet at the same time, neither could really exist without the
other. For instance, you can only be an individual in the context of society;
if you were stranded on an island your individuality would fade away as you
would not be able to compare or contrast yourself with anyone else. The best
way would be to find the middle ground and to meet halfway between the “me” and
“we” because when they are out of balance with each other, that is when, more
often, than not, problems do arise.
Nevertheless, it cannot be denied nor overlooked that politics
and culture affect, color, and intersect with our paradigm and lifestyle. In an
individualistic society, success becomes more important as you can more easily
distinguish yourself from others, hence highlighting, contrasting, and
accentuating your individuality. As such, achieving success, which is often
measured by monetary wealth, becomes more important than bettering one’s
personal characteristics, such as increasing one’s levels of compassion, care,
and love for and cooperation with others. A betterment that is less focused on the
self but more on others becomes more important in a society that values harmonious
relationships between the different parts of one’s society, whether in terms of
family, neighbors, work, and teammates or one’s fellow citizens.
As we live in a competitive society that values and equates
money and wealth with personal worth, it is no wonder that many people are so high-strung and are always busy and on the go. That often leads to the experience of
chronic and toxic stress that then spills over in other areas of one’s life,
most importantly our physical and emotional health and wellbeing.
Moreover, stress dynamics affect our food choice and
consumption. We want to imbibe food fast and do so in a rush, and most often,
we opt for ultra-processed food items as we do not take the time - or tell
ourselves that we do not have time - for home-cooked meals with family and
loved ones. There can also be economic factors at stake as many people with
less economic means will not be able to afford organic and healthy food, or it
could be that healthy food options may not be available for them. In various
ways, this unhealthy situation feeds the rising epidemic of obesity and many
conditions associated with it, including but not limited to cardiovascular
diseases, diabetes, and certain forms of cancer.
As the stress becomes overwhelming, the body will adopt
various maladaptive coping mechanisms, which can range from overeating to
substance abuse or addiction in any of its forms and manifestations, be it promiscuity, drowning
oneself in one’s work or any other obsessive-compulsive behavior that does significant
harm to our body and mind.
Yet to deal with that, we cannot prescribe pills, and it is
not enough to tell people to relax, take time off, or to take it easy, the same
way, you cannot simply tell an insomniac to fall asleep or a depressive person
to stop worrying and be happy. This is also one of the main reasons why
education or simple forms of raising awareness is often insufficient and does
not help the affected individuals much.
The root causes would often entail looking at a person’s
past and is often related and associated with childhood trauma in all its
different shapes and forms. Exposure to childhood trauma, a point in your life
where one is at one’s most impressionable and vulnerable, often leads to
wide-ranging issues and complications ranging from chronic conditions to mental
There are three main routes that influence people’s health
at a later stage of their lives. First off, traumatic stress alters the stress
response system, that is, it changes how your nervous system regulates and
processes stress. As a result, one may become more defensive and feel less
secure; one perceives or decodes the environment as generally threatening or
Secondly, we would adopt or get stuck on coping strategies
to avoid or try to control the rise of uncomfortable feelings from the past
trauma. Hence, we attempt to create our own comfort zone that shuns those
supposed negative feelings. More about negative emotions in a moment. Yet there
is this unconscious drive to “medicate” those feelings of anxiety and suffering
and many choose to self-medicate by dealing with it in any way they see fit,
such as engaging in substance abuse and other addictive behaviors, including
overeating, gambling, or promiscuity.
Finally, the third route is centered on the field of
epigenetics. This is how genes express themselves and change when exposed to
traumatic experiences or prolonged stress. Our personal experiences and
environments may trigger or turn on certain genes by inhibiting or turning off
others. In that sense, there are a variety of genetic possibilities that are
determined by one’s personal make-up in addition to one’s personal experience
and interpretations of events, hence adding that extra touch and layer of
individuality; this is also why identical twins are more different than we
generally assume, apart from the effects of random variation and mutations.
But, in my view, it is trauma that often stems from family
dynamics, which has the strongest effect on our future health and well-being. In
fact, our own exasperated and often relentless drive for success may be
remnants and echoes of parental voices in the past that told us to work hard
and to be someone of substance and importance in the world. Many parents in
conjunction with standards promoted and encouraged by their society do not
insist on further developing our unique passions, talents, and personality; instead of wanting
us to focus on our interpersonal skills or emotional intelligence (except for
the vague notion that we always need to be ourselves), essentially, parents want us to pursue
well-paying and respected professions.
As explored by trauma-informed physician and psychologist Gabor Maté, who
was mentioned not once but twice in our conversation, there are four common
tendencies that emerge from adaptive patterns in children later affecting
people in adulthood. The first one is caring more for the emotional needs of others than
one’s own, hence prioritizing the other over oneself. The second one is having
an excessive role of duty and responsibility, which would then cause oneself to
lose connection with one’s authentic self.
The third tendency, and in my view, the most
important one, is the suppression of “negative emotions” and hence holding and
bottling it all in, which ends up causing significant harm. It is like a
pressure cooker that keeps building internal pressure and if not released or
dealt with in one form or another, may turn into outbursts, which can be
reckless and irresponsible behavior and forms of aggression, panic attacks, or other
physical and emotional ailments and diseases. In fact, the best avenues of
self-expression would be to fully feel and experience one's emotions, to express them and
then to move through them without getting stuck or mired in those forceful feelings,
or as Matt puts it succinctly, “look back, but don’t stare.” In that sense, one
can, as Erich Fromm put it, make the unconscious conscious as one explores the
past to better understand the present.
There are various studies of adverse childhood experiences by
Vincent Felitti that show and demonstrate the therapeutic effects of validation;
naming, expressing, and acknowledging trauma is correlated with better health
outcomes in later life. This is not different from the beneficial effects of witnessing grief, a form of processing and dealing with our pain when faced
with the loss of a loved one.
The third common tendency or fallacy, as demonstrated by
Gabor, is believing that you are responsible for how other people feel and that
you must never disappoint anybody. When you become stuck in that state, you do
yourself harm since you would never say or dare to say “no” to other people at
the expense of your own health.
These are some of the main roots of chronic illness and
disease, but they do not operate on their own. They often combine and interact
with nutrition, unhealthy food choices, lifestyle, and the long-lasting toxic
effects of prolonged chronic stress.
How can we overcome trauma and the maladaptive stress
response? Some may opt for psychotherapy, but that is easier said than done.
First off, there is the stigma of mental health that unfortunately haunts us
across many cultures and traditions. The second one, somewhat tied with that
stigma, is that being vulnerable is a weakness and that seeking help is a sign
of a lack of personal competence or independence, which is also not true. The
third point, which Matt insisted upon, and which he is correct about, is the
fluctuation and inconsistency that comes within the field of psychotherapy.
Psychotherapy contains a wide range of fields and disciplines and some of them are beneficial and helpful, while others do not
address the issues, do not effectively alleviate the physical and emotional pain
and suffering, or the therapists are simply not good at their jobs. In the same
way, there are good and bad teachers, students, politicians as well as doctors
out there, some therapists are less competent than others.
In the field of my interest, psychoanalysis, it is of vital
importance that the analysts get themselves analyzed at different time
intervals to ensure that they are capable of providing the necessary help
without muddling their therapeutic work due to their own unconscious issues or
At the same time, as there are a variety of approaches and
disciplines within the mental health field, a lot of them are not
phenomenological and tend to distort issues and problems; in some cases, they
may make things worse. For instance, positive psychology may work for some
patients, but its insistence by some practitioners of constantly seeing the
positive side of things could potentially lead to what is now denoted as “toxic
positivity,” which is another type of evading the root problems, that is facing
one’s inner demons.
It is my opinion that we would all benefit from the insights
of psychoanalysis. Regardless of whether we have or believe we do not have any
emotional issues, it is of importance to ensure that we are as healthy and as happy
as we can be. When we feel well – and not just delude ourselves or tell
ourselves that we are well - then we are wealthy; once we feel whole, we are
also holy, which is why you will find many mental health professionals, the
better ones out there who are worth their salt, that do not object to nor
resist notions of spirituality and religion.
We may not have rocks and pebbles in our shoes, but we need
to make sure that the shoes are a perfect fit. With comfortable shoes and our
affairs all in order, we can walk the path of life with confidence and relish
and enjoy every moment that comes our way and, in the meantime and all along,
take in the good with the bad in our joy-filled stride.
For the full-length
interview on my YouTube channel, please click: here
If you prefer to listen to the interview, here is the link to my podcast: Arash's World Podcast
For further information on Matt Erb, please visit the
Matt Erb, PT: Integral Physical Therapist, Embody Your Mind