Understand the clinical process of Living Systems Medicine: So, what happens in an LSM consultation?
To understand the clinical process of Living Systems Medicine (LSM), it is helpful to break down a typical LSM consultation into 10 parts.
LSM is an exciting new frontier. One of the most frequent requests we receive is people seeking an understanding of what is “actually” done in a Living Systems Medicine clinical consultation.
Here the process is made clear in 10 simple steps
The exact content and length of a Living Systems Medicine consultation varies from clinic to clinic, as practitioners have different styles of practice, and implement LSM in different contexts. However, to help us understand the clinical process of LSM, we can say that a typical LSM consultation consists of the following 10 steps:
1. Preparation before the visit
First, the patient is usually asked to fill in a patient questionnaire beforehand, answering detailed questions about the health history, symptoms, lifestyle and toxicity exposures. Accompanying this, the patient is typically asked to also provide copies of past medical records, lab test results and any other relevant notes.
2. Patient interview, lab tests & case history
On arrival, the patient is first interviewed by the practitioner. Everything discussed in a consultation, and in all accompanying paperwork, is strictly confidential between the patient and the practitioner.
Questions are typically orientated towards symptoms, health history, toxicity exposures, lifestyle, diet, lab test results and previous therapies used. Questioning is also guided by several modes of analysis unique to LSM including The LSM 4 Pillar General Assessment and The LSM Key Case History Factors.
In follow-up consultations, this is repeated more briefly, with a focus on changes and updates.
3. Nonlinear systems analysis
During and after the interview, the LSM practitioner takes notes and applies what we call a “nonlinear systems analysis” to the case. This essentially means that tools from systems science are used to highlight potential “leverage points” in the system – areas of potential priority for maximising whole-system, lasting wellness benefits.
Among other things, this includes an emphasis on the core LSM concept of The 5 Key Organ Systems.
4. Preparing for LSM Resonance Testing
Next, the patient is introduced to the LSM Resonance Testing area. This may be done at the same consultation, or in some clinics at a second consultation. Shoes and all jewellery need to be removed, but otherwise the patient remains fully clothed, including with socks on. Rarely, there could be certain items that could affect the LSM Resonance Testing in certain cases such as particular types of synthetic fabrics or metal touching the skin, so patients might be discouraged from wearing these to consultations.
The patient lies down on the back, on a testing table (also known as a “plinth”), typically positioned with the feet and ankles hanging off the end, and holds a non-electrical metal testing bar in one hand. If in some clinics there are small variations in these or other details, that is no cause for concern – this is just a description of what may happen in a typical clinic. Finally, a blanket covering may be offered for comfort.
5. LSM Resonance Testing
The LSM practitioner sits at the foot of the patient, placing his or her hands gently onto the top of the ankles/feet area. The test is completely safe and non-invasive, and the patient is not required to do anything except lie there, so sometimes patients even have a bit of a snooze which is totally fine.
The LSM practitioner then proceeds to expose the patient’s body field to the information fields of an array of hundreds of small test vials, using a test plate connected via a cable which runs to the metal bar that the patient is holding.
As he or she does so, there will be gentle movements of the hands on top of the ankles/feet of the patient whilst checking the leg length in response to each new vial. In response to certain vials, the patient’s body will respond with an involuntary contraction of one side of the body relative to the other, leading to the length of one leg changing in relation to the other, which is professionally assessed via certain specific muscle groups in the ankle/feet area.
The technical name for the muscle testing method used is “non-force applied kinesiology”. Used with the test vials and LSM testing sequence, this whole procedure is referred to as LSM Resonance Testing.
6. LSM treatment plan
After the LSM Resonance Testing is over, several more things need to take place, although they may differ in their sequence, from clinic to clinic, depending for instance on whether or not there are any support staff to assist.
First a treatment plan is prepared based on the patient interview, lab tests, LSM Resonance Testing, systems analysis and any other methods of evaluation used. The full test results of the LSM Resonance Test are not normally written up as a separate test report, but instead the test procedure itself is designed to be a dynamic flow that leads directly into preparation of a treatment plan, and the treatment plan itself reflects key elements of the results of the test.
7. LSM wellness outputs & explanations
Once written up, the LSM treatment plan will be provided to the patient, with accompanying Wellness Outputs such as LSM Resonance Remedies, nutritional supplements and herbs.
This plan will need to be talked through, at least the first time, to check the patient understands the instructions, as well as to answer any questions about the test results and treatment plan. The practitioner may also bring up certain points of advice or recommendation in relation to the patient’s diet, lifestyle or environment, and may order or suggest certain lab tests for further evaluation of relevant areas.
8. Invoice for the consultation
The patient will normally then be invoiced for the cost of the Consultation, LSM Resonance Test, any Lab Tests ordered, and the various Wellness Outputs. Some of these costs may be bundled together, others may not be, depending on the invoicing model used at each clinic. Costs vary from clinic to clinic. In some clinics, the invoice may be payable in advance, or cancellation fees may apply.
9. Patient completes the LSM treatment plan later in sequence
Our journey to understand the clinical process of Living Systems Medicine is not complete yet. The treatment is not normally administered in the clinic, but prepared for the patient to take at a later time at home. This is done intentionally because results are more effective when the patient can first prepare the environment in which the treatment is done, rather than doing the treatment just before getting into a car to drive home.
In addition, there is usually a precise sequencing incorporated into the treatment (rather than taking everything at once!) – which brings much better results by building the treatment plan around the body’s own suitable pace.
10. Follow-up plan
Lastly, a follow-up plan is arranged, as typically LSM works best when the gaps between re-tests are planned in advance – decided based on a pace of organ support that is best suited to the individual patient’s body, and detox process.
In particular, gaps before re-tests should normally not be allowed to be too long – and especially in the beginning or whenever symptoms and/or toxicity status are bad – or otherwise a situation could develop of taking three steps forward and one or two steps back.
Think of this as a process of building up a momentum of periodic individualised organ support to help carry the system to an improved state of general wellness by raising the intelligence of the system over time.
Long-term LSM case management
No attempt to understand the clinical process of Living Systems Medicine would be complete without considering what happens after the first visit. This is because “LSM is a process, not an event” (to quote Dr Siegel).
For the LSM practitioner, a particular approach to long-term case management is used – which it is also helpful for the patient to understand in overview, as this provides a map of the journey ahead. Based on systems science, The 5 Phases of LSM are defined.
These are numbered from 1 to 5, although they may not always necessarily be met with in the same order. Overall, the first 3 represent a typical 1-2-3 sequence of chronic case management, whereas 4 and 5 represent phases that could arise at any time and therefore might need to be addressed either after or before any of the other phases.
The 5 Phases of LSM
- Nonlinear terrain rescue and key toxins
This is usually the initial phase, in which a focus is made on a few areas of top priority: the “tide that lifts all boats” within the body. This more often focuses on underlying “terrain” issues (such as resonances of key organs and key toxins) more than on chronic infections. Think of it as strengthening the bolts on your door (= building up terrain strength) before you kick out your unwanted guests (= confront chronic infections).
- Terrain, toxins and infections
Typically within 1 to 3 months, the process of Phase 1 continues but with the addition of a greater focus on chronic infections, at least in some parts of the treatment cycle going forward. This then becomes by far the longest phase. Its length depends on the case, and could range typically from a few months up to a year or even a few years, depending on how complex, serious, toxic and unwell the patient is.
This is the “plateau” phase that we all aim to reach and then maintain. This is when there are no chronic diseases, and the system just needs occasionally re-testing and re-tuning in order to keep it strong – as well as to stay vigilant to helping the system to “nip in the bud” any new toxins or anything else that arises which could potentially develop into something worse. As the saying goes, “a stitch in time saves nine”. During this phase, most patients do not need to schedule consultations very often – e.g. 2 to 3 times a year might be a typical pace that would be ideal.
- Constitutional and emotional
At some point in the case – either at the start or later on – there is often a need for treatment at a constitutional and/or emotional level. This could arise particularly when there is a loss of a sense of meaning in all or part of the patient’s life, or emotional traumas, or physical injuries, or simply a need for a general treatment at the level of the whole system, rather than at the level of any particular parts.
- Targeted, quick response
At any point, situations can arise where a new problem suddenly rears its head. We call these “acutes”. In LSM, we have specific tools to deal with these situations quickly, effectively and intelligently, in a highly targeted way.
LSM practitioner development through nonlinear study
Our aim to understand the clinical process of Living Systems Medicine should also take into account a key element from the practitioner’s side. The LSM follow-up process includes an emphasis on the need for the practitioner to pursue “Nonlinear, Multi-Disciplinary Practitioner Development”. This means that every LSM practitioner is continually growing professionally – through ongoing learning, study, experience and exploration.
Here, as in everything else in Living Systems Medicine, the highest value is placed on that which is nonlinear. Among other things, this means the deliberate study of subjects outside of your comfort zone – to prevent the widespread problems caused by over-specialization.
To understand the clinical process of Living Systems Medicine, let us also consider how long a consultation lasts.
The length of a typical LSM consultation (not counting the very first one) is typically about 1 hour, if there are support staff involved at the clinic to attend to some parts of the process like preparing the treatment plan, LSM Resonance Remedies and invoicing.
However, it may vary between, say, a typical length of anywhere between 45 minutes and 2 hours, depending on many factors including the practitioner style, the number of support staff at the clinic and the case’s complexity.
The length of a first consultation, though, can be longer, and could run typically from 30 minutes up to 4 hours, depending on the clinic, the practitioner and the case, but 2 hours is a typical length. This is why, in some clinics, the first consultation is split into two, as otherwise it can be quite an in-depth procedure to do all in one go, especially for complex cases – and this schedules in a natural break for a new patient starting out in LSM. So, because of the benefits of going into things in depth at a first consultation, as a highly useful focus at the start, some clinicians end the first consultation after Step 2 (the in-depth patient interview), then schedule a separate, second appointment – either later the same day or on another day – in which to proceed with Steps 3-10. This is a good approach, and also gives the patient time to reflect on what was discussed (which may often include useful pointers in relation to lifestyle, diet and environmental factors), and take a break, before proceeding with the next part of the process. The length of the interview part of each consultation (Step 2) could range from 10 minutes up to 2 hours, but is more likely to be longer at a first consultation (e.g. it could be 1 hour, whereas at a follow-up consultation it is more likely to be only 15-30 minutes).
The Four-Stage Clinical Process of LSM
We have also broken this whole process down, along with additional information that provides a nice overview, into a simple visual flow diagram showing what we call The Four-Stage Clinical Process of LSM: