The illusion of the isolated symptom
We continue to act as if the body were a fragmented machine. A pain here. A disorder there. An isolated symptom that could be corrected locally, almost as if replacing a faulty part. However, in clinical practice, the experience is constant: nothing is truly isolated.
Chronic fatigue, persistent pain, and digestive or hormonal imbalances don't reside in a single organ. They emerge from a living, interconnected, adaptive, and intelligent system. George Engel, a psychiatrist and professor at the University of Rochester, argued this point in 1977 in the journal Science: the biomedical model is insufficient because it ignores the psychological and social dimensions of illness. His proposal for a biopsychosocial model, a term he coined, remains, almost fifty years later, more necessary than implemented.
The body as an integrated system
The body functions as a whole. The nervous system is in constant communication with the immune system. Hormones modulate metabolism. Emotions modify physiology. Beliefs guide behavior. And consciousness influences our decisions and, therefore, our internal states.
Stephen Porges, a neuroscientist, documented this from a neurophysiological perspective: the autonomic nervous system doesn't just regulate bodily functions. It regulates the perception of safety, the capacity for social connection, and the readiness for biological repair. Bruce McEwen, a neuroendocrinologist, added the dimension of cumulative cost: allostatic load shows how chronic stress reconfigures neuroendocrine and immune function systemically.
To imagine that a complex imbalance can be corrected by a single, specific, and localized action is a seductive oversimplification. It is reassuring. It is comfortable. But it is incomplete. And, therefore, inevitably insufficient.
The logic of a holistic response
A holistic problem requires a holistic response. Not because of ideology, but because of logic. When imbalance involves multiple systems, intervening in only one variable is tantamount to ignoring the forces that maintain the initial state.
Focusing solely on the body can mean overlooking the mental, emotional, and environmental stressors that underpin the physiological burden. Focusing only on the mental aspect is to forget that biology has its own laws, rhythms, and structural needs. Focusing only on symptoms is to confuse adaptation with healing.
Bessel van der Kolk, a psychiatrist and professor of psychiatry at Boston University School of Medicine, stated it clearly: trauma is not resolved with words alone, nor with the body alone. It requires the integration of both dimensions. The same principle applies to any chronic imbalance.
The symptom as a strategy of the organism
A symptom is often a strategy of the organism, an attempt at regulation, a coherent response to an internal or external context that has become incoherent. Suppressing a symptom without understanding its function is like silencing a signal without addressing the cause that made it necessary.
We can correct a biological parameter and leave untouched the mental terrain that caused the imbalance. We can alleviate pain and maintain the postural, emotional, or behavioral patterns that make it indispensable. We can alleviate without transforming.
Respect the logic of life
A holistic approach doesn't mean doing everything. That would be unrealistic. It means respecting the logic of life. Observing interactions. Identifying the loops that perpetuate the problem. Understanding that movement influences neuroplasticity, that nutrition modulates inflammation and cellular energy, that sleep regulates the hormonal axis, and that stress reconfigures the autonomic nervous system.
But it's also important to recognize that beliefs, conditioning, and how a person tells their own story shape their everyday behaviors and, therefore, their biological makeup. Allan Schore, a researcher in developmental neurobiology and clinical professor in the Department of Psychiatry at the UCLA David Geffen School of Medicine, documented this: affective regulation is constructed in relation to others and is inscribed in biology. The psychological is not a layer floating on top of the body. It is part of the body.
Part of the imbalance lies in what we believe, in what we repeat, in what we never question. The body often runs implicit programs, invisible loyalties, old adaptations that have become inadequate. Ignoring this dimension leaves part of the problem untouched.
Life doesn't demand a spectacular solution. It demands coherence. Alignment between the different levels of functioning. As long as changes remain partial, so will the results. As long as one dimension is excluded—physical, psychological, or conscious—the work will remain incomplete.
Holistic problem. Holistic treatment. Not as a slogan. As a requirement for rigor in the face of the complexity of life.
Sources and references
Engel, GL (1977). The Need for a New Medical Model: A Challenge for Biomedicine. Science, 196(4286), 129-136. MD psychiatrist, professor at the University of Rochester.
McEwen, B.S. (1998). Protective and Damaging Effects of Stress Mediators. New England Journal of Medicine. Neuroendocrinologist, Rockefeller University.
Porges, S. W. (2011). The Polyvagal Theory. W. W. Norton. PhD, neuroscientist, Indiana University.
Schore, AN (2003). Affect Regulation and the Repair of the Self. WW Norton. PhD, Clinical Professor in the Department of Psychiatry, UCLA.
Van der Kolk, B. (2014). The Body Keeps the Score. Viking. MD psychiatrist, professor of psychiatry, Boston University.