A few weeks ago I attended a two-day workshop on Personalised Integrative Therapy presented by Adrian Lopresti, PhD.
Current treatment modalities for depression and anxiety have some efficacy, but meta-analytic studies (a statistical analysis combining the findings of many studies) appears to suggest that efficacy varies between 38% and 87%. This means that the response to more traditional psychological therapies (CBT, other therapy and medication) sometimes meant that remission occurred, and at other times there was a relapse or no change. So sometimes people in the research reported that they felt better, sometimes they experienced no change in their depression or anxiety and sometimes they felt better, but then they felt worse again.
And there is a growing amount of research that seems to indicate that there are many variables that might contribute to mental wellbeing that are not covered in traditional psychological therapeutic modalities such as CBT. Some of these other variables are physical health, diet, connection to others, they way we live and our values.
Dr Lopresti developed Personalised Integrative Therapy (PI Therapy) as a way of putting these variables together into a coherent model that can then be put into practice in the therapy room. The PI Therapeutic approach suggests that depression and anxiety can be impacted by a variety of factors associated with the domains listed below.
The PI Therapy model takes a wholistic overview of each individual, exploring 5 domains in our life that can have an effect on our mental wellbeing:
- Psychology
- Lifestyle & Environment
- Diet & Nutrition
- Social & Spirituality
- Biological & Medical
There is an emphasis on the impact of psychological and lifestyle factors on various physiological process, as well as the interaction between these physiological processes. And dysfunction in one area can have an impact on functioning in other areas.
Dr Lopresti provides a great explanation for each of these domains on the PI Therapy website. But here’s a basic summary:
PSYCHOLOGY
This refers to our thoughts, beliefs and coping skills. This is how and why we think and behave in particular ways. This is the area within which psychologists generally work. We might look at the thoughts you have at a particular moment, the emotions that are elicited and then how you choose (sometimes without being aware it was a choice) to behave. We might then look at previous experiences and your beliefs about the event or yourself that might have had an impact on what you thought, felt and did.
DIET & NUTRITION
There is a growing body of research that indicates how and what we eat can have a significant impact on how we feel and even how we think. Research suggests that there are some foods that lift our mood (for example fruits & vegetables) and others that might contribute to a lower mood (for example foods with a high sugar content and highly processed foods).
LIFESTYLE & ENVIRONMENT
Within this domain we might talk about sleep, exercise, screen time, exposure to sunlight and nature and reducing alcohol and drug use, as well as limiting exposure to a variety of toxins. There has been research implicating each of these factors in improving or diminishing our mental wellbeing.
SOCIAL & SPIRITUAL
Social connections have a significant impact on how we feel about ourselves and therefore on our mental wellbeing. And when we experience significant social pressure this can be unhelpful for our wellbeing. The spiritual refers to having meaning in your life. For some this is connected to a religious or spiritual belief and for others it might be related to their personal values which guide their behaviour.
There is increasing evidence that having meaning, and maybe a spiritual practice, can contribute to greater mental wellbeing.
BIOLOGICAL & MEDICAL
There are a number of biological and medical factors that can influence mood and anxiety. Managing these factors effectively can improve out mental health. Some of these factors include digestion (there is increased understanding about the brain/gut link), sex hormone balance, thyroid function and of course our blood sugar. Medications can also have an impact on the way our body works which can in turn have an impact on our mental wellbeing.
So how might PI Therapy be applied at Enhance Life Psychology?
I’ve been working with people as a psychologist for over 10 years and I have always asked new clients I about their exercise level, about social connections, and sometimes about medical issues that might have been included on referral documentation. At times, I might have asked clients about their diet and nutrition. I often worked with clients on their values and meaning in life.
However, since completing this workshop I am more likely to ask about diet and nutrition, exercise, other lifestyle factors, medical issues, as well as the psychological factors that are standard inclusions in psychological therapy.
So despite the fact that I have often taken a wholistic approach to my clients’ wellbeing, I am now more likely to consider the influence of these factors on your wellbeing as we work together. I might also talk about prescribing exercise or other lifestyle changes that are likely to have a helpful or positive impact on you. At times I might even talk about supplements that could be helpful, and I might even write a prescription so you can get the best version of a particular supplement, but it is always your choice about following this course of action. I might sometimes suggest you have a chat to you GP about medical issues that you might present with, if this is not something your GP is aware of already. This is all within the context of psychological therapy in which we talk about how you think and feel, alternative perspectives you could take, alternative behaviours you could engage in that might be helpful, learning where your beliefs might have been learnt, developing a greater understanding of yourself, and learning strategies that might be helpful in living you most enhanced life.
As always, please feel free to share this post with anyone you think might find it helpful.
And if you’d like to talk a little bit more about how I might be able to help for you contact me.