The Ground Beneath - How I work step-by-step
This article explains the practical structure of care, from first contact to long-term planning.
The aim is not to describe a protocol, but to make the container visible. In complex work, outcomes are shaped as much by structure as by any specific intervention. Safety, continuity, and clarity are not supportive extras. They are the conditions that allow deeper layers of physiology and behaviour to reorganise without overwhelming the system.
Many people arrive having already tried multiple diets, supplement regimes, or short bursts of treatment. What is often missing is not effort or information, but a steady framework that can hold change long enough for it to stabilise. This structure is designed to provide that.
Step 1: Free clarity call (30 minutes)
The process begins with a short call to understand symptoms, relevant history, what has already been tried, and what the person is hoping to change.
This stage is about orientation rather than commitment. It allows space to explore whether the nature of the symptoms, the depth of work required, and the pace of the process are a realistic match. It also gives an early sense of whether the nervous system is already under significant strain, or whether capacity for change is reasonably available.
From a clinical perspective, this step often reveals more than symptom lists alone. How someone speaks about their body, their expectations, and their level of urgency offers important information about how the work may need to be paced.
Step 2: Initial consultation (60 to 75 minutes)
The first session explores digestion alongside stress patterns, daily load, food habits, sleep, energy, emotional history, and relevant medical context.
The intention is to understand how the gut symptoms sit within the wider system, rather than treating them as an isolated malfunction. Digestive function is rarely independent of lifestyle pressure, long-term coping strategies, or the ways in which responsibility and emotional regulation have been managed over time.
This session usually provides the first coherent map of what may be driving the condition. It often becomes clear that symptoms are not random, but consistent with the way the system has adapted to its environment.
For many people, this is the first time their experience has been viewed as patterned rather than chaotic.
Step 3: Personalised plan
Each plan integrates nutrition, lifestyle support, and nervous system regulation. Supplement support and functional testing, including stool, SIBO, blood, or hormonal testing, are used when helpful rather than automatically.
Plans are not fixed. They evolve as physiology, tolerance, and life circumstances change. In practice, this means that the same intervention may be appropriate at one stage and counterproductive at another.
Early plans often prioritise stabilisation rather than optimisation. When a system is already under pressure, adding complexity can increase reactivity. As capacity grows, nutritional work and testing can become more targeted and effective.
This staged approach reduces the risk of cycles of short-term improvement followed by relapse.
Step 4: Ongoing support and review
Sessions are held weekly at first, then move to fortnightly as stability increases.
This phase is used to review responses, adjust interventions, interpret symptoms, and work with stress patterns as they emerge in real time. It is where most of the learning happens, both for the body and for the person inhabiting it.
Patterns that were previously invisible often become clear only through repetition. How symptoms change during busy periods, relational strain, travel, or attempts to rest provides information that no test result can fully capture.
Ongoing support also changes the internal experience of healing. Instead of feeling like a private struggle that must be managed alone, the process becomes shared, contained, and easier to sustain.
Step 5: Integration and long-term strategy
The final phase focuses on consolidation. This includes recognising early signs of imbalance, building routines that are genuinely sustainable, and reducing reliance on external structures.
At this stage, attention often shifts away from symptom monitoring and toward the broader shape of daily life. Sleep, work rhythms, boundaries, and expectations frequently become as relevant as food choices.
The goal is not symptom management, but internal coherence. When physiology, behaviour, and emotional load are no longer working against each other, the digestive system usually requires far less active control.
Typical timeframes
Most clients work within one of three structures:
three months for foundations
four months for integration
six months for deeper resilience
Longer support allows different layers of the system to be addressed. It does not reflect a higher standard of care, but a wider field of change.
Some bodies settle quickly but need time to learn how to remain settled. Others require more gradual reorganisation before stability appears. The structure exists to accommodate both without forcing progress or artificially slowing it.