Integrative Strategic Psychotherapy recognises that psychological change does not occur in a single dimension. Human experience is organised across different levels of the person and expressed through multiple psychological processes. Effective therapy therefore requires the ability to work both vertically (across levels) and horizontally (across axes of functioning).
This structure helps therapists move from understanding to precise and coherent intervention.
The Levels of the Person
Therapeutic work may focus on three interrelated levels:
1. Biological Level
This level includes:
- nervous system regulation
- stress responses
- bodily states and somatic memory
- sleep, energy, and physiological balance
Psychological difficulties often have a biological component, particularly in trauma, anxiety, depression, and chronic stress. Interventions at this level may support regulation, grounding, and body-based awareness.
2. Psychological Level
This is the level of inner experience and mental organisation. It includes:
- emotions and affective regulation
- beliefs, meanings, and self-concepts
- coping strategies and behavioural patterns
- internal conflicts and personal narratives
Much of psychotherapy operates here, helping clients understand, reorganise, and integrate their psychological processes.
3. Relational Level
Human beings develop and function within relationships. This level involves:
- attachment patterns
- interpersonal styles
- relational expectations and roles
- patterns of closeness, distance, and trust
Therapeutic change often emerges through the relational field of therapy itself, as well as through the client’s relationships outside therapy.
The Axes of Intervention
Across these levels, therapeutic work is organised along key clinical axes. These axes represent different pathways through which change can occur.
Emotional Axis
Focuses on:
- recognising and naming emotions
- processing affective experience
- increasing tolerance for emotional states
- transforming emotional responses linked to past experiences
Work along this axis helps clients move from emotional avoidance or overwhelm toward regulation and integration.
Cognitive Axis
Involves:
- identifying beliefs and schemas
- examining interpretations and assumptions
- developing alternative perspectives
- supporting flexible and realistic thinking
This axis addresses how meaning is constructed and how thinking patterns influence emotional and behavioural life.
Psychodynamic Axis
Engages with:
- unconscious relational patterns
- internalised early experiences
- defence mechanisms
- repetition of past dynamics in present relationships
Work here deepens understanding of the roots of patterns and supports structural change in the organisation of the self.
Working Across Levels and Axes
Therapy is not confined to one level or axis at a time. For example:
- Emotional work may require attention to biological regulation.
- Cognitive shifts may depend on relational safety.
- Psychodynamic exploration may lead to changes in behaviour and self-concept.
The therapist continuously assesses:
- Where is the difficulty organised?
- Which level needs attention?
- Which axis offers the most effective pathway for change at this moment?
This flexible but structured approach allows therapy to remain both responsive and coherent.
A Dynamic System
Levels and axes are not separate compartments. They form a dynamic system in which change in one dimension can influence others. Therapy supports gradual integration, helping individuals move toward greater regulation, self-understanding, relational capacity, and psychological flexibility.
This model offers therapists a clear map while preserving sensitivity to the complexity of each person’s experience.