Sensorimotor Psychotherapy

How did I learn to use my body as well as my mind in psychotherapy? These are the lessons taught by Sensorimotor Psychotherapy, a body-centered talk-therapy approach, developed by Pat Ogden for the treatment of attachment failure and trauma-related disorders. Although its techniques are drawn from the body-psychotherapy world, its theoretical foundation lies in neuroscience and attachment research. What first attracted me to it after 20 years of traditional psychodynamic practice was the opportunity to work with the somatic legacy of trauma and neglect without any requirement to use touch. Now, I value even more how it's added years to my "tread life" as a psychotherapist. Studying (and later, teaching) a method that capitalizes on an understanding of the body and nervous system has decreased the stress of psychotherapy practice while increasing its pleasures for me. It allows me to navigate tumultuous transferential relationships and therapeutic impasses in creative, satisfying, and often moving ways, as it has with Bob and Kathleen and their family.

A Sensorimotor Psychotherapy visit begins just like any other talk-therapy session: with the client's "story." It might be a story about last night's dream, a childhood memory, or the description of a problem, disappointment, or hurt in the client's current life. However, the therapist listens not just to the narrative and emotions, but also to the body, observing carefully the somatic language accompanying the language of words. Changes in posture, gesture, breathing, face color, stillness vs. agitation, stiffness vs. floppiness or heaviness—all these changes tell us about the client and the story.

At her first visit, Andrea describes her need to put others' wishes ahead of her own and her fear of displeasing people—a circumstance that's brought her to psychotherapy. As she tells the story of her attempts to create a more self-directed, meaningful life for herself and the obstacles that defeat her time after time, I'm tracking her body and my own. I observe the details of her physical and verbal presentation, looking for recurring patterns. I notice that her body is stiff and still. Her hands are folded in her lap, and her arms are held close to her torso. The only movement she makes is a sweeping gesture with her left arm each time she talks about a freer, more independent future. As she describes "folding" whenever her desires get blocked by some obstacle, her arm comes in, and her hand makes a pushing-down gesture.

As I see those movements, I notice a feeling of excitement in my own body. I lean forward, wanting to interrupt a monologue that drains her energy and mine. But she doesn't pause for breath. As I try and fail to create dialogue, I begin to feel a resignation in my body, like a balloon deflating. My body is giving up in the face of the "wall of words" she's creating. Finally, she pauses long enough for my energy to come back, though in a more thoughtful way. I find myself speaking to her in a slow, soft tone, as if talking to a frightened animal.

"Andrea, I want to share something wonderful that I saw as you were telling me about these frustrating experiences," I tell her. "I notice that each time you talk about what you want to do, your arm makes this movement, and every time you talk about what you have to do, your body becomes very still." She looks at her left arm for a moment, as if discovering it for the first time, and then says, "Yes, when I think about everything I want to do, I get excited." And, suddenly, she smiles broadly, leans forward, and opens up both arms wide as if reaching out. Her face lights up, her spine lengthens, and she begins to sway as if to music. I mirror her movements so we are facing each other, swaying, with our arms outstretched. We're smiling and laughing. I say, "Yes, I can see your excitement! You come alive, don't you?" Her monologue is now a dialogue, but a somatic one. As sessions proceed, I notice a consistent pattern: verbal dialogue is cut off by the "wall of words," but somatic dialogue brings Andrea alive and into relationship.

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johnskaggs5  - John Skaggs, PhD   |Registered |2010-10-26 08:08:00 Wonderful inspiring article, one that I more fully appreciate having done a three day workshop with Janina Fisher last year. This morning I had a parallel experience with one of our thoroughbred horses, standing at his head while my wife put his saddle and bridle on. I practiced being soft and receptive with him, looking for the right combination of body language and posture until his head dropped and his lower lip quivered, showing how relaxed he was. Then my wife took him out into the outdoor arena, with strong winds blowing and a thunderstorm threatening, conditions that normally will cause a thoroughbred horse to spook and run. Instead he was calm and steady, listening and cnnnected to all the cues my wife was giving as his rider. The instructor even noted how soft his eyes were, commenting on how much the lorse loved my wife. The point here is that what Janina Fisher is writing about works with horses as well as ...

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