From Symptoms to Relationships: Practicing Integrative Relational Health with Lauren Barragan, LMSW
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About the Episode
In this episode of Etymologies of Care, Paul is joined by newly licensed social worker Lauren Barragan, who has been part of the integrative relational health (IRH) journey since its earliest days. Together, they explore how IRH departs from traditional therapy models by recognizing that what we call “symptoms” are often intelligent responses to relational ruptures—not evidence of something wrong within the individual. Paul and Lauren trace the origins of IRH, discuss the paradigm shift from individual pathology to relational fields, and reflect on what it means to embody these principles in real-world practice. From navigating supervision and treatment plans to holding space for clients’ lived experience, this conversation is both deeply theoretical and grounded in everyday care.
Listeners will come away with a clearer sense of what IRH is (and isn’t), how to recognize relational frameworks in therapy, and why the simple act of genuine presence can be transformative.
Topics Discussed:
The difference between technique-based therapy and relationship-based healing
How integrative and relational approaches often fall short when separated, and why IRH combines them into a true paradigm shift
The origins of IRH, from undergraduate research to developing a conceptual framework
Why “there is nothing wrong with you” is both radical and easily misunderstood
Navigating graduate training, supervision, and treatment planning while centering relational health
Real-world examples of shifting from applying techniques to cultivating authentic relational presence
The importance of trusting intuition when beginning therapy and recognizing if a therapist is working relationally
Suggested Practices:
Notice relational context, pay attention to the quality of connection itself, not just content being discussed
Practice authentic presence. In conversation, experiment with being genuinely present rather than trying to fix or solve something.
Episode Resources:
About Lauren:
Lauren Barragan is a Licensed Master Social Worker based in New York. She earned her Master of Social Work degree from the Silberman School of Social Work at Hunter College and holds a Bachelor’s degree in Psychology from Wesleyan University.
Lauren has experience working with adolescents, adults, and families in both school-based and community settings. During her time at Silberman, she interned with the Department of Education, where she supported teens through social-emotional learning and used genograms to strengthen connections to their families of origin. Most recently, she deepened her clinical skills at a Bronx community center, working with survivors of family violence and crime. In preparation for her clinical work, Lauren completed Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) training to support children who have experienced trauma.
In a previous role, Lauren worked closely with the founder of the Center for Integrative Relational Health, where she led an undergraduate internship program focused on digital engagement around relational health in everyday life. Through this work, she explored how cultural narratives, media, and community spaces can support deeper connection and healing—strengthening her commitment to making relational healing accessible, relevant, and grounded in lived experience.
Rooted in her lived experiences and African American and Afro-Latinx ancestry, Lauren brings a trauma-informed and generationally aware lens to her work. Her clinical and research interests include historical intergenerational trauma, ancestral storytelling, and the ways in which identity is shaped by the past. She is passionate about supporting individuals and families in their healing journeys. Through empathy, empowerment, and narrative exploration, Lauren works with clients to tap into the power of their stories as a tool for transformation and connection.
Connect with Lauren:
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Paul (00:10.892)
Hi everyone and welcome back to Etymologies of Care. This week I had an experience that perfectly illustrates what we're exploring today. The difference between technique-based therapy and relationship-based healing. I met with a therapist who was feeling stuck with a client. He said, I've tried cognitive behavioral techniques.
mindfulness interventions, even some somatic approaches, but nothing seems to be working. What technique should I try next? I found myself asking a different question. What's happening between you and your client? What does the relationship feel like in the room? As we talked, it became clear that he was understandably so focused on applying
the right intervention that he might have missed some deeper dynamics occurring in the relationship. The idea of stuck feels old and embedded in traditional models. The stuckness actually reveals something important. Both he and his client had been waiting for the right intervention to fix the problem, to reduce the symptoms. When the healing was actually asking,
Paul (04:09.196)
inviting them to attend what was happening between them. This is the heart of what we're exploring today. How relationship itself becomes the primary medium for transformation. Today I'm joined by my dear friend Lauren Baragan, a newly licensed social... Oh, I got stuck. Okay. Let's start again.
from the beginning. Today I'm joined by my dear friend Lauren Baragan, a newly licensed social worker currently practicing psychotherapy in Westchester County, New York. What makes Lauren's perspective unique is that she was instrumental in developing integrative relational health from its earliest stages along with Marissa Jackson and me, our core team. As an undergraduate researcher,
Lauren help uncover something crucial. Organizations claiming integrative care were often just adding complimentary services, yoga, energy, nutrition. While many were doing valuable work, adding complimentary services or emphasizing therapeutic relationships, we noticed a gap. We questioned in their languaging
whether combining these approaches occurred within a framework that understood distress as emerging from relational conditions rather than individual pathology. Do they still locate problems within isolated minds? To be clear, the intention and integrity of the relational connection was not in doubt. Our searching was deeper.
What our research revealed during that early period was that these organizations tended to use integrative or relational as marketing language without the paradigm shift that makes integrative relational health fundamentally different. IRH recognizes that distress itself emerges from relational conditions, that what we call symptoms
Paul (06:29.068)
are often intelligent responses to genuine disturbances in our connections with ourselves, others, and our environments, the most pronounced culture itself.
And so Lauren brings this dual perspective. helped create the conceptual models of IRH and now she's discovering what it means to practice and embody these principles in the real world. Lauren, welcome and good morning. Let me get this prompt that got stuck again. Okay. Stay with me. Stay with me.
Lauren (07:15.885)
you.
Paul (07:17.1)
day.
Paul (07:22.54)
So Lauren brings this dual perspective. She helped create the conceptual models of IRH and now she's discovering what it means to practice and embody these principles in the real world. So Lauren, welcome and good morning. So what do you think about the title, etymologies of care?
Lauren (07:35.233)
That is okay.
Lauren (07:59.694)
Well, hi, Paul. Good morning. It's so great to be here. I think when I first heard etymologies of care, I thought it was brilliant, but also a little bit intimidating. Like, are we going to need Greek and Latin dictionaries? But I guess what I've come to understand is that it's really about
Paul (08:02.061)
You
Lauren (08:27.881)
excavating what's hidden in the language we use every day.
Paul (08:33.536)
Mmm.
Lauren (08:34.785)
When I was doing that undergraduate research, looking at how organizations used integrative and relational, I was essentially doing etymology without knowing it. was, right? I was tracing how these words had been emptied of their original meaning and turned into marketing buzzwords.
Paul (08:47.616)
Ha. Yeah.
Paul (08:59.53)
Mmm.
Lauren (09:01.153)
So for me, the title captures exactly what we're trying to do. Not just understand care intellectually, but trace it back to its roots. Care itself comes from the Old English karu, meaning sorrow or anxiety, which connects to being curious about suffering.
Paul (09:24.118)
Mmm.
Lauren (09:26.093)
It's not about applying techniques or managing symptoms. It's about the quality of genuine attention and concern.
And the plural of etymologies matters. This isn't just one story about how we came to understand care. Different cultures, different languages, different historical moments have created different frameworks. The work that we must do is learning to navigate between them without requiring them to collapse into one right way.
Paul (09:45.729)
Hmm.
Paul (09:56.588)
Hmm.
Lauren (10:07.31)
So the title tells you what the podcast is. It's not going to give you five techniques for better mental health. It's going to ask you to look at how the very language you're using might be shaping what you can see and what remains invisible.
Paul (10:10.062)
Hahaha.
Paul (10:14.476)
Mmm.
Paul (10:25.228)
Beautiful. Lauren, I want our listeners to understand your unique journey. You weren't just learning IRH, you were helping to build and actually embody it.
What we hope to make clear today is that the integrative approach recognizes that symptoms emerge from complex interdependent conditions operating across multiple functional levels and considers them all over time as you are building relationship.
IRH recognizes them as aspects of a single relational field, but changes at any level cascade through the entire system, right? So for example, a client comes into therapy seeking support for significant anxiety. The first thing we recognize is that the anxiety in some ways holds the body's wisdom.
Lauren (11:12.416)
Mm-hmm. Mm-hmm.
Paul (11:26.496)
We approach it not as a problem, but as adaptation, even self-protection. That's true, true shift right there. The pathways for connection and wholeness were perhaps in many ways blocked. There real challenges for the client, and symptom reduction is a part of a more complex healing process.
Lauren (11:26.55)
Yep.
Lauren (11:34.316)
Yep.
Paul (11:55.104)
Notice the language. Right?
Lauren (11:59.649)
Absolutely. I think when I hear you say that, especially the idea that anxiety being the symptom in some ways holds the body's wisdom, oftentimes we have to think about the symptoms that people around us experience, we ourselves experience, serve a specific function.
Paul (12:03.724)
Mm-hmm.
Lauren (12:28.44)
The symptom, be it anxiety, is something that we've learned along the way.
and was created, born from, usually, a relational rupture.
Paul (12:50.214)
Mm, yeah.
Beautiful.
So staying with our early research, right? When you notice the way organizations were using integrative or relational without the paradigm shift that makes them transformative together, can you explain what you discovered and even more importantly, what you felt? And I know it was very early back then before...
our conceptual frame was getting more and more coherent.
Paul (13:32.172)
So knowing what you now know, how is integrative relational health fundamentally different from either integrative approaches or relational approaches separately?
Lauren (13:46.895)
Great question. And I appreciate you calling back how early this was in our process working together, but also in my understanding and sort of entry into the clinical fields. This was kind of my access point into therapy, clinical psychology, and exactly what does that look like and how is language used.
Paul (14:06.624)
Yeah.
Paul (14:13.868)
And let's not forget you were an undergraduate. Let's be clear about in your own developmental process. So this is pretty magnificent, right?
Lauren (14:18.252)
Yeah.
Lauren (14:22.825)
Right, exactly.
Exactly. so seeing integrative everywhere and relational, I think the big thing, especially that you and I have talked about, is oftentimes seeing integrative standalone or relational standalone. And I remember there were times also where I would be digging, okay, well, what does integrative mean to this person and what does integrative mean to that person? And then
seeing that there were some similarities, but also that there were differences. And so ways that the same word can be taken and then also embodied differently and practiced differently in the field. And I think what is so significant with IRH is the descriptive
language that is used to fully make sense of both integrative and relational psychotherapy and health all in one. If you look at the website...
Paul (15:38.262)
Mm-hmm. Yeah.
Lauren (15:45.761)
Integrative relational health has such, there is such descriptive language about what that means in terms of culture, what that means in terms of the different relationships that we have throughout the span of a lifetime, and also what that means intergenerationally. And so there are all these aspects of IRH
Paul (15:57.397)
Mmm.
Paul (16:09.164)
Hmm.
Lauren (16:13.57)
that are embedded within the website that people then can pick and choose which aspects they identify with at the time. So I think that something really unique about IRH is bringing in the interconnected
Paul (16:22.284)
Mmm.
Lauren (16:36.172)
aspect of relationship and being very explicit about what that might look like to different people.
Paul (16:38.976)
Yeah.
Paul (16:43.606)
Yeah, there's that word explicit that we'll come back to because it's so, so crucial in communication and understanding. So this is so important for listeners to understand that most integrative approaches add complimentary services, but still locate the problem within the isolated individual, right? Most relational approaches emphasize connection.
but still treat symptoms as individual pathology. As you pointed out, IRH does something completely different. It recognizes that distress emerges from relational conditions and that what we call symptoms are often intelligent responses to genuine disturbances in the relational field, what you said ruptures.
And those coherent responses point to many relational contexts, really important here, many relational contexts across individual, relational, and cultural systems, right? That's a whole episode, that's a whole five episodes right there that we will get to.
Lauren (17:56.95)
Mm-hmm.
Yep.
Paul (18:00.781)
What was that realization like for you?
Lauren (18:09.059)
Yeah, that's a great question. It is a big question. It is a big question and it's funny because the question is large and it is vast and yet talking about this topic, although so, you know, it encompasses so much of who a person is, right? Having to think about
Paul (18:10.142)
That's a big, big question,
Paul (18:35.564)
you
Lauren (18:38.883)
your relationship to yourself, your relationship to your family members, your friends, and also your relationships and how they exist within cultural systems. And yet there is something so comforting about the fact that you asked.
Paul (18:51.498)
Mmm.
Lauren (19:02.627)
because it's something that isn't talked about enough. And I think the realization for me was, okay, whoa, this idea of relational health is massive and yet it's asking all the questions that I've been wanting somebody to ask, or it's asking all the questions that I've been thinking about, but that there's no space to engage.
Paul (19:07.136)
Yeah.
Paul (19:27.052)
you
Lauren (19:32.789)
in conversation around. And you're right, mean, it's all of these topics in and of themselves take time to fully get into and to fully develop. But there is something so it puts me at peace and it puts me at ease knowing that they're conversations that other people want to be having.
Paul (19:46.272)
Yeah.
Paul (19:57.931)
Yeah. And that is the source, right? Of IRH. We can call IRH a conversation itself, right? An opening to conversation. And it's a conversation that we all need to have. And not just that we need to have, but we desire, as you say, that we desire to have it.
Lauren (20:26.788)
Yeah.
Paul (20:28.458)
and the comfort it brings us and the connection it brings us, right?
Lauren (20:34.959)
Absolutely. And that in and of itself.
Paul (20:35.988)
Okay, so now, yeah, go ahead.
Lauren (20:40.175)
I just was saying and that in it of itself is healing
Paul (20:44.298)
Yeah. Yes. Absolutely. So simple and so complex. We honor both. Okay, so now you're implementing, if we can use that word, I'd like to use another word, but we're going to use that word for now. Now you're implementing what we developed together.
Lauren (20:47.471)
That's the...
Paul (21:09.344)
What surprises you about the translation from another great question. What surprises you about the translation from theory to practice? Like we spent years now, it's like four years now developing and concept development with Marissa. And we're now translating these concepts into programs. And now you're translating these concepts
Lauren (21:16.674)
I
Paul (21:39.724)
into your work as a psychotherapist.
Lauren (21:46.128)
Yeah, I think another big question. And I think we'll get to this also the more we continue to have this conversation. But I think what surprises me is how deeply aware I am of IRH.
Paul (21:58.412)
Mm-hmm.
Lauren (22:13.627)
And also how simultaneously when you're in a new environment or you're trying to develop a new skill, how easily our culture and our systems are set up in a way that makes it difficult, sometimes I'm finding, to recall.
Paul (22:28.043)
Mm-hmm.
Lauren (22:42.147)
that innate awareness and innate knowledge of IRI.
Paul (22:43.756)
Mm-hmm, mm-hmm, mm-hmm. Yeah. In a later episode, we're gonna talk about what blocks care. Right?
Lauren (22:55.705)
Yep. Absolutely.
Paul (23:00.082)
And what blocks care doesn't mean that it's a problem or there's something wrong with us in the blocking. This is a cultural phenomenon that we need to bring into conversation so that we can bring into awareness, right? As we shift this paradigm.
Lauren (23:10.731)
Exactly.
Lauren (23:18.561)
Exactly.
Lauren (23:22.829)
Right. And I think as I hear you say that, I think maybe what surprises me more specifically is like the delicate balancing act. I feel like I'm doing sometimes to hold certain systems in place that are necessary in care and are part of the medical system while also delicately balancing the relationship.
Paul (23:45.6)
Yeah.
Lauren (23:55.04)
And I think maybe I didn't think it was going to require that much attention. Maybe I was hopeful. I'm young, remember. I was quite hopeful, but I'm realizing it's a lot of active, you know, it's a lot of active work to continue to center IRH in practice.
Paul (24:01.773)
Yeah.
That's awesome.
Paul (24:24.544)
Yeah, yeah. You know, what I'm feeling even in today's episode, which I feel all the time in all work, is this beautiful spiraling between the thinking and the theory and the practice. And so right now, I'm just, I wanna zoom out if we can for a moment.
Lauren (24:44.836)
Yeah.
Paul (24:52.244)
and take a look at the meta view. And the reason why I want to do that is because of this word paradigm, right? And so here's a nice historical and etymological moment. Folks often ask, Paul, what do you mean by paradigm shift?
Lauren (24:52.569)
Yeah.
Lauren (25:04.847)
Mm-hmm.
Paul (25:12.67)
It's such a beautiful question, historically, originally, paradigm meant a pattern or model to be copied. In the early 60s, the philosopher of science, Thomas Kuhn, transformed the construct of paradigm. In his 1962 work, The Structure of Scientific Revolutions, Kuhn used paradigm
to describe the entire constellation of beliefs, values, and techniques shared by members of a scientific community. Not just individual theories, but the underlying worldview that determines what questions can be asked and what counts as valid.
A paradigm shift is from understanding human beings as isolated individuals who relate to recognizing that we are fundamentally relational beings whose very identity, well-being, and distress emerge through the quality of our connections.
So this no doubt will sound obvious to many listeners and for a good reason. Your bodies already intuitively know this, primarily binary and analytic language models of our culture and systems of care, as you just pointed out, Lauren, often contradict that truth. And that contradiction has profound consequences, especially in the healing
Lauren (26:45.464)
Mm-hmm.
Paul (26:52.652)
process, creating this kind of split mind, this split consciousness between what we intuitively know and how we naturally function and the language of our culture. So this etymological shift is itself significant for our work.
Right? So, yeah.
Lauren (27:16.065)
Absolutely.
Paul (27:19.478)
So applying that to mental health, the shift from mental health to relational health represents what Kuhn called a paradigm shift. Not just adopting new techniques or theories, but transforming the fundamental assumptions about what human beings are and how healing occurs.
Lauren (27:43.767)
Okay.
Paul (27:45.259)
The traditional mental health paradigm makes certain things visible, individual pathology or expert intervention, while rendering other core elements of change invisible, like relational constitution and field dynamics. This new paradigm, what we are working with, reveals what was always present, but couldn't be seen through the previous
or the current, the traditional mental health framework. Why we say, for example, there is nothing wrong with you. What we mean by that is there is nothing inherently wrong with you.
Lauren (28:19.215)
Mm-hmm.
Lauren (28:25.071)
Yeah.
Lauren (28:30.511)
Yes.
Paul (28:31.894)
This connects our etymological methodology excavating as you said, how words carry hidden assumptions that shape reality, just as paradigms shape what can be thought and perceived. So now, in your graduate training, you were taught
to become ultimately an expert applying techniques. And we're simultaneously developing IRH's relational framework, integrative relational framework. Right? How do you navigate between these different understandings of what a therapist is? And by the way, I do recall that through your IRH work, you noticed in your graduate program,
Lauren (29:11.055)
you.
Paul (29:27.296)
the very paradigm shifts that we're describing. Remember that when you shared with me, like you've noticed like, you know, in my program, I'm seeing the changes. We're talking, we actually are talking about the changes. It's still not, it's still very underdeveloped or undeveloped, you will. I am noticing the changes and you were noticing the changes because you're, you were already
Lauren (29:37.761)
Yeah, absolutely.
Paul (29:56.544)
bringing into your own awareness what those changes are.
Lauren (30:02.191)
Absolutely. Absolutely. And I think the core of it, which I appreciate so much from my social work experience and my social work degree, is they were really honing in this idea that you talked about, that there is nothing inherently wrong with anyone.
Paul (30:23.5)
Mmm.
Lauren (30:26.531)
there isn't. And the things that we experience are all products of.
Lauren (30:36.271)
the symptoms that we experience are products of events that we've experienced, conversations that we've had, conversations that we weren't allowed to have, which all really at the center was the client or anyone is the expert of their own lived experience. And I think that having
Paul (30:40.374)
Mm-hmm.
Paul (30:49.835)
Hmm.
Lauren (31:04.855)
that message in school helped me to bridge these different ideas of what it means to be a therapist because they were already bridging. Okay, so you have techniques, you have things in your toolbox and also there's a way that you're gonna go about implementing these tools in your toolbox. There's also a way that we want you to understand that
Paul (31:16.598)
Yeah.
Lauren (31:34.09)
One tool is not going to work for everybody. And that each person that you see is a different person. And involving them also in choice around technique and choice around the tools that are used. A lot of transparency, a lot of teamwork, working together.
Paul (32:02.679)
collaboration.
Lauren (32:02.773)
really kill that. you. Collaboration, which is another pillar of IRH, right? and I think that.
Paul (32:06.496)
Mm-hmm. Yeah.
Yes, absolutely.
Lauren (32:16.611)
You know, inherently in the history of psychotherapy, that hasn't always been the case. And I think in this role, it's important to also understand that because that's the history of this role, it is often something that when we embody this role, we can revert to or take on. And it's important to be aware of that.
Paul (32:38.282)
Yeah.
Paul (32:43.478)
Mm-hmm.
Lauren (32:43.999)
and to continue to be as collaborative as possible.
Paul (32:49.28)
Yeah. I love what you're sharing because you're bringing into really sharp relief here, these two paradigms. One that is really focusing on symptom reduction, right? It's almost a kind of objectification of the human being against this paradigm of healing that could only occur
within the relationship, right? You could feel, you could just feel that difference. And so I'm wondering in your actual work, right? Can you share a specific moment when you shifted from trying to apply a technique, so to speak, to actually understanding someone's experience as relationally constituted?
Lauren (33:30.979)
Yeah.
Lauren (33:47.416)
Mmm.
Paul (33:48.298)
I'm sure there are many of those experiences. I'm just curious if you could perhaps share one.
Lauren (33:51.663)
Right.
Lauren (33:56.048)
Yeah. That is a great question. And I think something that comes to mind is an experience or two that I had in my previous, my second year internship. And in my second year internship, I was doing a lot of trauma work. And, you know,
Paul (34:13.525)
Mm-hmm.
Lauren (34:25.751)
I was taught different techniques. I went through specific training. You know, there was TFCBT training, implementing a lot of trauma informed care. And I think that there was a moment where I realized that this person who I was talking to every week was really...
Paul (34:39.317)
Yeah.
Lauren (34:54.953)
struggling within current relationships due to trauma from past relationships. And I think that's when I realized I could and I you know did utilize technique right but I think right but of course like what was most significant was
Paul (35:05.419)
Yeah.
Paul (35:16.608)
Yes, of course.
Lauren (35:24.715)
showing up. We had like the standing appointment, her knowing that she could count on me to be there, to talk about things that she had never been able to really talk about to someone about before.
Paul (35:34.54)
Mm-hmm.
Paul (35:43.67)
Bye.
Lauren (35:45.988)
building this trust, this vulnerability, this empathetic attunement to validate her experiences. And it's so interesting because at the end of our sessions together, when I was graduating, we...
You know, we went through assessments and she did not have a PTSD diagnosis anymore. And I kind of, you know, asked her to reflect a little bit about what, you know, how, how were things and, know, what, what do you feel like contributed to this real decrease in symptoms?
Paul (36:23.488)
Hmm.
Paul (36:36.682)
Beautiful question.
Lauren (36:39.277)
And she said, she said, honestly, I don't know what we did here.
Lauren (36:52.079)
And you know, I first I heard that I was like, oh, oh my gosh, well, she can't pinpoint what we did. But I think it spoke to this, this relation, this relational dynamic that sometimes we don't have words for like when something's
Paul (37:13.494)
Well, I can give you the words right now because it's so clear, especially knowing you, you cared so deeply for her. And that is what came through. No doubt. Right?
You
Lauren (37:33.434)
And so I think, you can use all the techniques, you can have them in your toolbox, you can work collaboratively, but just like how you and I know when we're talking to somebody and whether or not it seems like they care, everybody has that. Everybody knows what it feels like to feel like, know,
Paul (37:53.164)
Mm-hmm.
Lauren (38:02.735)
they're not really listening or they're not really understanding. like we can understand, we all as human beings understand the difference. And I think that being able to provide that care in a way that people that you're working with can really feel is the difference.
Paul (38:21.676)
Yeah. Yeah. Yeah. And I think there's another, as a matter of fact, I don't think, I know that there's another piece that came out in this example in terms of what you are conveying to clients and what you are conveying to clients is a core idea in IRH that there is nothing wrong with you. Right?
Lauren (38:49.814)
Nothing.
Paul (38:50.752)
And I wanna be clear about that statement because it could be reduced or simplified.
So I want to be clear about what this means, there is nothing wrong with you, because it's actually pretty easy to misunderstand. We're not saying that people don't need help or support. When someone is experiencing suicidal ideation, psychotic breaks, or crisis level distress, they absolutely need intervention and sometimes medication, sometimes hospitalization or intensive support.
Lauren (39:07.363)
Mmm.
Lauren (39:29.9)
Yeah.
Paul (39:30.4)
What we're simply saying here is that these responses, while they may require immediate care, often represent the psyche's intelligent attempt at coherence under impossible relational conditions.
Right? And so an integrative approach might address your whole person, body, mind, spirit, and still sees you, right? But I'm sorry, so let's just change that. But does not see you as broken or needing fixing. A relational approach might emphasize connection and still see your symptoms as
an individual who is experiencing this distress. IRH recognizes that distress itself again emerges from relational field conditions and that what's called symptoms are often the system itself doing exactly what it should do when relational conditions are compromised. So how does that distinction, how does that distinction land with you now?
that you're practicing? How do you hold both the intelligence of symptoms and the reality that people need support and relief? Right? That dialectic there is important. Because we're not saying either or. This is not a binary model of how are true. Okay.
Lauren (41:00.855)
Yeah, absolutely.
Lauren (41:07.055)
No, both are true. Both are true.
Both are absolutely true. And so I think...
Right.
People, you know, there are moments where people, and we've talked about this too, right? When talking about the sort of the cycle, the force of therapy and like how, and how it even begins. And oftentimes it begins with an individual's innate knowledge that something's not right. That that's, that's, that something that they want something to change.
Paul (41:27.776)
Mm-hmm.
Paul (41:43.265)
Yeah.
Lauren (41:50.692)
that they want to feel a different way, that they want to have a different way of being. That something that they're experiencing is not sitting well with them. And so I think this idea of people needing support and relief is absolutely present and not even something, I mean, yes, something that we as clinicians hold, but something that
many clients also hold. know, that is why, that's why they come in search of support and relief from certain feelings, certain feelings that maybe they've had in the past or haven't. And I think then what we must hold is that in this space of support and healing and relief is that these symptoms that we
Paul (42:26.464)
Yes.
Lauren (42:48.845)
want relief from. didn't. Oftentimes they don't come out of thin air. They are rooted in experiences that together we will get to the bottom of. We will talk about together. And in doing so, in talking about the symptoms as a product of an experience, of a relational rupture.
Paul (42:50.732)
love.
Lauren (43:19.715)
That provides the support and relief. I believe both our work is those two things coming together constantly.
Paul (43:24.939)
Yeah.
Paul (43:32.022)
want to ask you another interesting question as a new therapist coming out of internship and waiting, right? How do you talk about IRH and supervision when your supervisor, for example, might be more traditionally trained? I know we've discussed this in the past. I would like you to share that a little bit. This kind of navigation.
Lauren (43:59.524)
Yeah, I mean, I think that's a great, I think that's a great question. And I, know, over the time over, you know, master's program and being in a position now, I think every, every supervisor is different in the same way that every client is different.
Paul (44:28.441)
Right. And every therapist is different, right?
Lauren (44:29.999)
you and every therapist is different and every person that you have in your life is different. Right? So I think that especially like this this relationship between supervisor and supervisee is so important for learning and for professional
Paul (44:34.942)
It's different.
Lauren (44:58.137)
professional development, but also in terms of your own.
often times your own emotional growth in taking on this role. And so I think in talking about IRH with supervisors, I think it's important to...
Lauren (45:24.259)
Wait, sorry Paul, I feel like I have to start over.
Paul (45:26.912)
That's great. It's fine. It just happened to me before. Don't worry about it.
Lauren (45:32.207)
It's a good question, and I'm trying. It's a hard question.
Paul (45:34.476)
It's actually a hard question.
And it's also based on the same relational principles, right? Like what we want our clients to do with us, to share and be open with us. If they disagree with something that basically because maybe we share different points of view or frameworks, we still want them to share and empower themselves by sharing. So if you are in supervision, for example,
and you're noticing a traditional kind of trend with your supervisor, something you actually might not agree with, right? You're empowered. You are allowed to not be disrespectful, right? You're allowed to ask important questions.
Lauren (46:25.711)
No, of course.
Lauren (46:31.661)
Yeah. No, absolutely. Okay, I think I'm better understanding the question. Like, and how and how does the relate how did like the relational principles of IRH show up also in supervision? And I think that absolutely in so many ways, the supervisor and supervisee relationship is a mirror for
Paul (46:37.559)
Cool, cool. No, good, good. This is great.
Paul (46:45.869)
show off in supervision. Beautiful, beautiful.
Paul (47:00.553)
Yes, the same power dynamics, ostensibly, yes.
Lauren (47:01.411)
the therapist and client relationship.
Lauren (47:09.151)
Exactly. And so it's interesting as therapists, kind of, you kind of are holding both roles. And it's important to be able to, like you said, practice curiosity, practice curiosity that goes both ways, being curious with clients and their lived experience, but then also being curious about
Paul (47:18.007)
Mm-hmm. Mm-hmm.
Lauren (47:36.333)
your supervisor and their approaches and what leans them towards certain techniques or what leans them away from certain techniques.
Paul (47:43.714)
Yeah, yeah, yeah. It's not getting trapped in the binary that either they are correct and I am wrong or I, right? Okay, how do we integrate as a supervisee, how do I integrate these different frames of reference? What can I learn from a frame that I actually might not agree with?
Lauren (47:53.43)
Exactly.
Lauren (48:08.353)
Exactly. And keeping in this idea that it's not binary, especially because any therapist is going to have multiple supervisors in their life. And I think it's an important idea to be able to pull from each. Like your supervisors are pillars in your professional development as a therapist and they're all different and
Paul (48:15.021)
Mm-hmm.
Paul (48:33.293)
Yeah.
Lauren (48:36.943)
pulling from each of them in order to sort of integrate your own approach and your own understanding, I think is also important.
Paul (48:47.853)
What's so cool about this here, we have roles, right? And we're talking about IRH principles, organizing principles that begin before we have identity and roles. These are organizing principles of relationship, right? And relational literacy and qualities of relating that apply even before we become
supervisee, even before we become a therapist. This is a real, this is a core part of our work. And so this is actually a perfect example that, okay, so I'm in a different role now. I'm a supervisee and I have a supervisor, but I'm still applying the same principle.
Lauren (49:35.669)
Absolutely.
Paul (49:36.941)
So that's really cool.
Lauren (49:39.312)
It really is cool. And I think that's also why, I mean, we've spent so much time also working on developing the, you know, guidelines or sort of ways of being that are so important within the supervisee and supervisor relationship, because oftentimes it does not get nearly as much attention as client and therapist.
Paul (49:50.157)
Mm-hmm.
Paul (50:05.579)
Yes.
Paul (50:09.441)
For sure, for sure. And getting a little deeper into the weeds, the very practical aspects, concrete aspects. What's it like to write treatment plans when you're focused, when you're focusing on relational health rather than symptom reduction? Like for those listeners who are therapists,
Lauren (50:10.973)
and
Lauren (50:23.823)
Yes.
Paul (50:36.737)
This actually often comes up, it certainly comes up in supervision and group supervision. know, it's like, you know, Paul, there's a lot of emotional labor in these details and it does take away from what I would love to be part of. And this is also this administrative part of my life, takes up a lot of time and energy.
Lauren (51:06.37)
Yeah.
Paul (51:06.987)
Right? So it's a really important question, certainly for listeners out there who are therapists.
Lauren (51:13.251)
No, absolutely. it's, you know, the treatment plan is fully necessary. I haven't had any experience where, you know, I haven't written a treatment plan. The treatment plan is part of, you know, the process of having therapy, implementing these goals, these objectives, the interventions. It's
part of the medical system, it's part of what the focus of progress notes is. Because oftentimes the progress notes are rooted towards how is the progress with the goals. And I think what I am finding personally, and I'd also love to hear what you think, but I am finding that the treatment plan,
Paul (51:59.243)
Right.
Paul (52:08.301)
you
Lauren (52:10.401)
and these smart goals and these objectives, can be part of treatment, they can be part of therapy, and it can be part of what we talk about in a session. But if I have a session that's 40, 45 minutes long, I think it's important as the therapist.
to build in times dedicated to relationship. Like, and while that might not be a smart goal.
Paul (52:39.371)
Yeah.
Lauren (52:47.041)
it's inherently part of how we can even begin to achieve the goals if that's really what we wanna do. And so I think...
Writing the treatment plan is also coupled with this idea of integrating techniques and relational.
and relational healing. And again, I think it's a, that gets back to what I was saying before. It's a delicate balance. It's a delicate balance to be able to hold these goals, to be able to continue to check in on their progress while also being relational.
Paul (53:15.957)
Yeah.
Paul (53:33.377)
Yeah, yeah, I love what you're sharing here. And what comes to my mind when we think about treatment goals, because we all have really strong and often negative, if we're honest, negative feelings about it. I think what's most important is not the treatment goals themselves, but our relationship to the treatment goals as therapists. In other words, how can I use
Lauren (53:59.183)
and exactly.
Paul (54:02.766)
this obligation, this necessary part of my job, my work, how can I use this creatively? How can I use this to help me continue to organize my care, organize my care for this client? In the same way when we do a group supervision, for example, and we do presentations, we've rewritten the whole way we do presentations to make it more of a creative process.
Lauren (54:09.263)
Right.
Lauren (54:16.825)
Yeah.
Paul (54:32.203)
And so treatment goals aren't going anywhere and they are necessary as part of this system. What we need to do is not be resistant to them and feel inadequate and objectified. We need to explore our relationship to these treatment plans and make them more, as you would say, curious and creative.
Lauren (54:36.543)
No, they're not.
Lauren (54:42.328)
Yeah.
Paul (55:00.289)
That would be my first response.
Lauren (55:04.047)
Yeah, no, I love that. I love that we have to explore our relationship to the treatment plan. And I think it's interesting because any, I think a different therapist at different stages of their career are gonna think differently about it. I think as somebody who's new, I kind of have a good relationship with the treatment plan. I like having something that helps me organize care. I like having specific.
Paul (55:25.633)
Yeah.
Lauren (55:32.738)
specific objectives that are, you know, proven objectives that are beneficial in treatment. And then I think also though,
Paul (55:42.785)
Mm-hmm. Yeah.
Lauren (55:48.412)
in that being my relationship to treatment goals, also leaving myself the room to be creative, to explore, and to center these relational ideas that I do hold so dearly.
Paul (56:04.673)
And I would probably argue that the reason why you have a good relationship to treatment plans is because you're coming at therapy, not from symptom reduction model, but you're coming at it from a relational model. So everything is infused with that principle or those principles, right? And so you're bringing relationality into your treatment plans.
Lauren (56:29.219)
Yeah.
Paul (56:34.411)
which make it more in sync or aligned with who you are and how you function as a human being.
Lauren (56:43.489)
Yeah, yes, absolutely, absolutely. Because, right, the way they're written is not relational, but the way that they're practiced absolutely is. It takes... You have to take what's on paper and do a little bit of... a little bit of work.
Paul (56:52.321)
Yeah.
Paul (57:00.129)
Yeah. Yeah. So let's circle back to people seeking therapy for a moment. How can they recognize if their therapist is working from a relational framework versus just applying techniques? I know it might sound like kind of obvious to us, but it's not necessarily obvious to someone new to therapy.
Lauren (57:17.446)
and
Lauren (57:26.125)
Right? It's not. And it's interesting too because...
Paul (57:27.917)
So that's why IRH work is not, we're not here just for therapists. You know what saying? We're here for the general public, if you will, and for everyone in culture, inside of culture. Right?
Lauren (57:46.05)
Absolutely. think far too often, especially the power, like we reference the power dynamic that exists in therapy. And I think that sometimes people new to therapy don't maybe don't trust their intuition in that space. mean, there are times, I mean, it can be therapy.
Paul (57:47.181)
and
Paul (57:54.605)
Yeah.
Lauren (58:06.467)
you know, has a lot, has a medical model and it can feel like similarly, I mean, I have times where I go to the doctor and I feel extremely intimidated and I'm kind of feeling like I can't trust the way that I'm feeling because the person that I'm seeing is an expert. Quote on quote, right? And so, and, and, and right, they are, but also I really want to encourage people like
Paul (58:24.68)
Mmm. Exactly.
Lauren (58:34.191)
if this is your 10th time in therapy, if this is your first time in therapy, you are you are not only the expert of your lived experience, but you are like you have an innate intuition that tells you whether or not you
I want to phrase this delicately, but I want to encourage people to listen to their intuition when they meet with somebody and listen to not only like how you're feeling during the session. Are you feeling heard? Or does this relationship bring up something in the past that really doesn't feel good? And afterwards also, does this
Paul (59:13.004)
Mm-hmm.
Lauren (59:26.807)
I want to encourage people to check in with themselves and how it felt to be in the space with that person.
Paul (59:37.9)
Yeah. You know, what you're sharing is inspiring me to do a whole episode on beginning therapy, actually, when one begins. That's something we should really explore because you're really making it so clear to me how important that is, you know?
Lauren (59:49.004)
Yeah
Lauren (59:53.967)
think so.
Lauren (01:00:01.452)
Absolutely. And it's funny because there are people like, there are times where it takes people multiple therapists to say, I've had bad experiences in therapy, feels like my therapist is just clocking in and clocking out is not really paying attention. Like, listen to those things. If that is what it feels like in session.
Paul (01:00:25.239)
Yeah.
Lauren (01:00:27.001)
then that relational approach isn't being used in the way that it can be, which again is not a direct criticism of certain of therapists, speaks to the systemic burnout that is present.
Paul (01:00:40.077)
And by the way, we've all experienced that just so everyone knows. You know what saying?
Lauren (01:00:46.56)
Exactly.
Paul (01:00:48.533)
Okay, so in the service of this episode and much like a therapy session, we're coming down to the end. And I wanna thank you. I wanna thank you for so much for everything. For everything from the very beginning of our relationship four years out. I can't believe it, Lauren.
Lauren (01:01:06.913)
I want to thank you.
Paul (01:01:14.817)
And I want to thank you for sharing both your intellectual journey and your vulnerability as always about the learning process. Before we close, I want to emphasize something crucial for our listeners. Integrative relational health isn't just being nice to clients while offering multiple services. It's not adding yoga to therapy or emphasizing warm therapeutic alliance. It's recognizing that human beings
Lauren (01:01:15.011)
I know.
Paul (01:01:44.653)
fundamentally relational. That our well-being and our distress emerge from the quality of our connections across multiple levels simultaneously. This changes everything about how we understand.
Paul (01:02:03.918)
It's got stuck again. Okay, let's try it again. This changes everything about how we understand healing.
It means recognizing that what we call symptoms often represent intelligent responses to relational health conditions. And it means that healing happens through participating in the transformation of those conditions. Cellular, psychological, social, cultural, trusting that the organism will naturally reorganize when the field shifts. But, and this is essential.
Recognizing the intelligence of symptoms doesn't mean people should suffer without support. Crisis intervention, medication, hospitalization when needed, when appropriate. These create the relational conditions that allow for deeper transformation. We honor both the wisdom of distress and the necessity of care.
Paul (01:03:12.021)
And for the listeners, these are your action steps this week. Notice relational context. Pay attention to the quality of connection itself, not just content being discussed. Practice authentic presence. In one conversation, experiment.
with being genuinely present rather than trying to fix or solve something. And subscribe and share. If this resonates, subscribe to Etymologies of Care and share with someone who might benefit.