What is Integrative Psychiatry?
Authored by:
Anna Glezer, M.D.
The difference between integrative psychiatry and traditional psychiatry is sometimes described as the difference between focusing on wellness (integrative) versus illness (traditional).
Often, in more traditional psychiatry, the goal is to identify the illness and then treat that. This works for many patients. However, there are some patients who prefer a more holistic approach that looks at all the different components of health. This includes the physiologic, genetic and biological systems, psychological and the spiritual elements, and cultural and lifestyle components. And, of course, it integrates more conventional treatments as well.
When a patient comes to see an integrative psychiatrist such as myself, it is often because they may have tried more conventional approaches and are interested in the whole-person point of view. Our work starts with taking a full history. This includes asking about current symptoms, of course, but also about her lifestyle and functioning, her history, and having a frank conversation about the types of interventions that she would like to include in a comprehensive treatment plan.
This integrative mind-set stems from the evolving knowledge that a psychiatric issue is not just because of neurotransmitters gone awry. It includes:
The influence of the person's world around them - the stress of their job, the role of culture and identity, a history of trauma (either theirs or in the family given the transgenerational transmission of trauma)
The influence of the food they eat, the air they breathe and the environment around them.
Their belief systems, their relationships, and their sleep and exercise habits.
That means that the treatment needs to take into account all of these different components and address them. Treatment certainly can include more traditional prescription medications, but it should also include:
Optimizing biology through non-prescription means such as botanicals or nutrition
Optimizing the psyche through psychotherapy, good sleep hygiene, and a shoring up of healthy relationships
Focusing on building healthy habits related to physical activity, being out in nature, and eating food that is nourishing.
It also often includes treatments often described as complimentary, such as those taken from Eastern medicine.
I also believe that successful application of the integrative psychiatry approach requires a team, not just one clinician. This is because it's impossible to be an expert in all of the above mentioned treatment types, and working with a team will allow a patient to get the benefit of the expertise of many clinicians working together to improve her health. This is the main reason I use a team approach in my own private practice.
You may also get different answers when you ask the question, "What is Integrative Psychiatry?" because it is evolving and open to interpretation by those following its principles. As a patient-centered clinician, I like to ask my patients how they see the integration of traditional and complementary treatments and work together to achieve that.
