Melanie Lee, 2025. The Integration Equation
Whilst I remain a big fan of the CAT model, I cannot deny that for many years now, I have felt frustrated in trying to meet my client’s psychological needs holistically with just CAT as my core therapeutic approach.
Given that many CAT Practitioners are also trained in other models – I myself have additional training in EMDR (Eye Movement Desensitisation and Reprocessing) as well as Internal Family Systems (IFS) therapy – the question arises of how to integrate these various approaches? This was an ongoing struggle for me that often felt clunky and inauthentic, until I discovered Somatic Integration and Processing (SIP) – a case conceptualisation model from the US (www.connectbeyondhealing.com).
After two years of formulating my clinical cases through an SIP lens, following SIP training in 2022, I was keen to share my experiences with colleagues. I was therefore delighted to be able to offer a workshop at the July 2024 CAT Conference in Swansea, entitled, “Here, take a SIP!: Integrating CAT with other relational therapies” (a collaboration between Trust Psychology, UK, and the Beyond Healing Center, USA).
Here, now, are my two key takeaways from that workshop and I’d very much welcome any feedback or comments from those keen to join me in further dialogue as we collectively work towards an ‘equation’ for therapy integration (contact details below)!
We can have it all – it is possible to bring together mind, body and spirit in therapy
When I reflected upon my own struggles in integrating CAT with EMDR and IFS (in the context of a Clinical Psychology training background which emphasised the cognitive traditions), I realised that I was searching for some overarching framework that would bring together an acknowledgement of the following clinical ‘truths’ that I felt within my clinical practice:
- the body is present in the room, holds wisdom and has an innate capacity to heal
- our past relational experiences profoundly influence our present relational experiences and our anticipation of our future ones
- the therapist is an also an embodied human being in the room
- it is possible to do ‘deep’, meaningful therapeutic work at the right time and pace without pressure
- clients know their own systems better than we therapists do and therefore we can trust them to do their own work (with our guidance)
Through their brilliant synthesis of the existing traumatology literature and evidence-base, our colleagues at the Beyond Healing Center (BHC) propose – through a series of symbolic diagrams - that if you place the three influential lenses of (1) attachment theory and neurodevelopment (2) somatic psychology and (3) adaptive information processing on a Venn Diagram, the point in which they overlap (the central SIP triangle) can be utilised as a framework for formulating cases.
I took this into my clinical practice to mean that in any one therapeutic session it is possible to hold in mind and utilise that (a) our early life relationships are relevant (b) our nervous system matters and (c) our trauma memories help us make sense of who we now are. There was no longer any need to have to ‘pick’ one of these to focus on in the room, as they can all hold simultaneous importance. Very reassuringly, the SIP diagrams held intuitively true when other key, respected psychological concepts were also ‘mapped’ on top of this central point of overlap meaning there is consistency and congruence with, for example, Maslow’s hierarchy of needs (safety and physiological needs are paramount), Compassion-Focused Therapy’s emphasis on the structure of the proposed ‘triune’ brain (reptilian, mammalian and rational) and what we know about the hemispheric (right and left) specialisation of the brain.
Safety in Connection is the crucial anchor to all therapeutic success
SIP therefore proposes that all these influential theories – at their core - converge on the same fundamental starting and ending point: we are always seeking safety in connection. As mammals, we are all hard-wired to connect with other humans and so are constantly responding and adapting to our environment.
At a personal level, this convergence offered me profound permission as a therapist each and every therapy session to prioritise relational safety above all else. Technique, protocol, psychoeducational teachings, strategy and skill development all became a secondary aim with the primary focus now being on attending to and offering a felt sense of embodied safety between two human beings sitting in a room together.
For the first time in my clinical career, the level of authenticity in the room felt unapologetically real and I felt able to trust my instincts to follow the client’s lead in determining what they needed - in that moment, on that day - to develop their trust in their own innate knowledge and capacity to heal.
SIP is not a model of therapy as such, but within the case conceptualisation framework, it offers a number of guiding principles – anchoring in safety, looping, left/right brain focus - to allow easy, organic movement between what therapist and client naturally attends to in each moment. This allows for a sequence in the therapeutic dialogue of activation, disconfirmation, integration and anchoring through recognising, understanding, attuning and co-regulating – all completely consistent with my CAT, EMDR and IFS training knowledge and experiences.
To offer some practical examples of this; when there is too much ‘in the head’ cognitive language in the therapy session, simply enquiring about where the experience is felt in the body can offer a small loop of re-focused attention. Similarly, if the therapist senses a discomfort in their own body, they can trust that naming this – with a light curiosity - will resonate at some level with the client’s felt experience and so build relational, embodied safety.
It’s wonderful to be authentically ourselves!
I recognise that my personal passion for what SIP has brought into my clinical practice is the deep permission-giving it has offered and the clinical results really do speak for themselves. We all have our gut instincts in our clinical work and I have found that if I am allowed to attend to these – in the knowledge that I am standing on ‘the shoulders of giants’ in all their combined and distilled wisdom of the last several decades of psychological theory, interpersonal neurobiology and trauma research – then therapy goes incredibly well! What a relief that we can be authentically ourselves in the room, trust our own systems and watch in awe as client’s start to believe, trust and heal in their own time and in their own way.
Join us
In order to spread the word about what SIP can offer, I have joined with some therapist colleagues; Dr Alan Bowman, Dr Nancy Bancroft, Rebecca O’Callaghan and James Lloyd, with the support of Bridger Falkenstien and colleagues at BHC, to start the SIP UK and Ireland Specialist Interest (SIPUKI) Group. Please do reach out to us if you are interested in hearing more.
Dr Melanie Lee
melanie.lee@trustpsychology.co.uk
This Article is a summary of a workshop presented at the ACAT Conference 2024 in Swansea by Dr Melanie Lee, Trust Psychology Ltd