I took an oath when I graduated as a naturopathic physician. Part of that oath was to a specific principle — one that has governed everything I’ve done professionally, across two very different kinds of work.
What I eventually noticed is that I’d been applying it outside the clinic, in work that looks nothing like clinical medicine on the surface. The principle hadn’t changed. What I was applying it to had.
Naturopathic medicine is built on a set of founding principles. The one that has always felt most true to me is this: the body has an innate capacity to heal itself.
The physician’s job is not to override that capacity or install a result. The job is to remove the obstacles that are preventing it from operating, and to establish the conditions in which it can function. Work upstream, and what’s downstream rights itself.
This is the vitalist principle — vis medicatrix naturae, the healing power of nature — and it is the animating foundation of what naturopathic medicine was built to be.
The pull in clinical practice usually tends toward the symptom. The symptom is visible and uncomfortable, the patient wants it addressed, and every other practitioner has addressed it. The most available question is: what do I give this person for what they’re experiencing?
Vitalism asks a different question: what does the body need in order to do what it already knows how to do?
Those are not the same question. And they don’t produce the same results.
Earlier in my career, I worked with patients dealing with autoimmune conditions and endometriosis. Many had tried every available treatment before they arrived. Most had gotten partial results and then hit a wall.
When they first started working with me, many were confused by my approach. I wasn’t addressing the symptoms directly, the way every other practitioner had.
I told them: the body knows how to heal. What it needs is for the obstacles to be removed and the right conditions to be established. Work upstream, and what’s downstream rights itself.
Within weeks, they were experiencing movement they hadn’t seen from direct intervention. Over months, improvement they hadn’t considered possible became their new baseline.
None of it came from targeting the symptoms. It came from removing what was obstructing the body and providing what it needed in order to right itself.
When I stepped out of clinical practice and into the work I do now, I was sitting with a different kind of client.
Experienced professionals. People in consulting, strategy, policy, advisory roles, specialist fields, practitioner-based work. People whose judgment, perception, and independent thinking are the primary instrument of their work.
People who are driven to grow and evolve, and who were sensing that the next level of what they were here to do was more significant than what they were currently doing — and who couldn’t get there, not for lack of capability or effort, but because the tools that had worked at every previous level weren’t moving this particular thing.
The presenting situations looked nothing like clinical work. Someone wanting clarity on where their work was heading next. Someone sensing a bigger contribution they were here to make, one that kept forming and then not quite materializing. Someone who knew what direction they needed to move in but kept pulling back from it when the people around them didn’t understand or pushed back, despite having already done years of inner work to address exactly that pattern.
The instinct is to go straight at the presenting situation. To work on the direction, the vision, the next step. To figure out the answer.
I didn’t do that.
I did what I had always done. I looked at what was in the way. I looked at what conditions were present and what conditions were absent. And I worked there first.
The people I work with are not, as a rule, missing information or skills. They are capable and experienced and already think at a high level. What’s in the way is usually not something they can see clearly from inside their own situation.
Beliefs formed earlier in life — in contexts that no longer apply — are still running as automatic responses. When there’s pressure, or a moment where something important is at stake, those old beliefs fire before any conscious thinking happens.
As a result, the person finds themselves holding back, over-explaining, or stalling — and often can’t explain why, given everything they know about themselves.
Most of the people I work with have already done significant inner work. They can name the pattern, they know where it came from, they understand the theory. But understanding a pattern and having it stop running are two different things. Insight doesn’t update what’s operating below the level of thought.
One of my clients had been sitting on an idea for over a decade. When she’d shared it early on, the people close to her had told her it wouldn’t work. She’d tried to explain herself, couldn’t get them to see it, and eventually set the idea aside.
By the time we worked together, she understood all of this. She knew their response hadn’t been an accurate read of what she was capable of. She’d done years of work to get to that understanding. And she still hadn’t moved.
Once the underlying pattern was updated at the level it was actually running, she did.
When pushback came, it registered differently. She could see that the people pushing back were responding to their own discomfort with uncertainty and risk — not making an accurate assessment of her direction or her capacity. That recognition didn’t require effort or reframing. It was just what she could see.
So she followed her own read of the situation, built the project, and launched it, without needing their agreement first.
That is what becomes available downstream of upstream work.
Removing obstacles is one half of the principle. The other half is establishing the right conditions.
For the people I work with, the most important condition is that they’re operating from a state where they have full access to what they already know. Consistently, not just when circumstances happen to support it.
This matters because of something the research on differential sensitivity and vantage sensitivity shows about how people built like my clients actually function.
People with high environmental sensitivity respond more strongly to conditions in both directions. When conditions work against how they’re built, they’re more affected than the general population. When conditions are right, they benefit more than the general population would from the same environment.
The same wiring that makes them more reactive in difficult conditions is what lets them flourish significantly more in supportive ones.
The people I work with fit this profile almost universally. The depth of perception, the cross-domain pattern recognition, the capacity to see what others haven’t yet seen — these are features of the same wiring. Features that make working against their design so costly, and working with it so generative.
Establishing the right conditions for someone built this way is not a modest intervention. It changes what they can access and what becomes available to them in their work. It produces disproportionately beneficial results, which is what the research predicts and what I’ve consistently observed.
Most people I work with already know that pushing for the answer makes it harder to see. They’ve watched it happen enough times to recognize the pattern. The problem is that knowing it doesn’t stop it from happening.
Underneath the pushing is usually an old reflex that fires automatically when the answer isn’t there yet. The not-knowing registers as something going wrong. There’s a tightening, an urgency, a sense that figuring it out quickly is necessary.
And the answers that come from that state tend to be technically reasonable and slightly off. Directions that look right on paper and don’t feel right in practice. They move forward, hit a wall at some point, and have to backtrack.
The answers that actually fit tend to come a different way. Something catches their attention unexpectedly — a conversation, an idea, a direction they hadn’t been looking for. They follow it before they can fully explain why. And it leads somewhere more right than most things they carefully planned.
Once the old reflex is no longer running the same way and the right conditions are in place, following what pulls their attention becomes the reliable path rather than the occasional lucky exception. The answer appears as they move rather than something that has to be forced into view before they can move.
One client spent a long time trying to identify where her work was heading next. We didn’t start by trying to figure that out directly. We did the upstream work.
When the question became relevant, she was in the middle of an ordinary afternoon — something completely outside her work had caught her attention, and she followed it — and in that moment she could see a direction for her work that hadn’t surfaced during any of the time she’d spent actively searching for it.
The reflex that would have pulled her back to the desk to keep planning wasn’t running. So she followed the pull, stayed with what was in front of her, and the direction became visible.
That is downstream of upstream work.
I no longer practice clinical medicine. That chapter is complete, and the work I do now looks nothing like it on the surface.
But the operating principle is the same one I was trained in, took an oath to, and have never had cause to abandon. Remove what’s in the way. Establish the right conditions. The body, the person, the work — each does what it’s already built to do.
The people I work with are already capable of what they’re reaching for. The work isn’t about installing something they don’t have. It’s about working at the level where the obstacles are and the level where the conditions need to be established.
What happens from there is theirs. I’m working upstream.