We learned behavioral observation in our first year of graduate training. Crossed arms indicate defensiveness. Poor eye contact reveals shame or authority issues. Tapping foot? Anxiety! For most of us, that’s about as far as it goes.
But according to Pat Ogden, founder of the Sensorimotor Psychotherapy Institute and coauthor of Trauma and the Body: A Sensorimotor Approach to Psychotherapy, therapists are missing out on a wealth of valuable diagnostic and treatment information because of their failure to see what’s right in front of them in their consulting rooms every day. Citing research literature neurobiology, developmental psychology, trauma, and psychodynamic therapy, she insists that the body has been left out of the “talking cure,” and argues that integrating body-focused interventions into our work provides a more holistic–and effective–approach to the treatment of trauma, attachment, and relational issues.
RH: We all know that our early environment shapes our psychological makeup. How does it influence our physical posture?
OGDEN: It’s a similar feedback process. If you grow up in a family that doesn’t expect you to be strong, assertive, and powerful, but encourages you to be more quiet and withdrawn, your body will show it. A child growing up in that environment is likely to have a collapsed chest and a body that appears pulled in. In contrast, if you grew up in a family that expects you to be assertive, independent, and powerful, your body will tend to be more erect and even blown up a little bit. So people’s bodies are shaped by their family of origin, just as their psyches are. That impact is even more pronounced when children have been abused. Their postures and gestures often have a frozen quality because they can’t run away and can’t fight back. Those repeated iterations of freezing and collapsing leave their mark on the body.
RH: As a somatic therapist, how do you work with these repressive responses?
OGDEN: Imagine someone who has a habit of freezing somatically in the face of conflict because of a trauma history. At the same time, they still have the natural instincts to fight, to push away in defense of the self. As a sensori-motor psychotherapist, I want to help that person experience that dormant pushing response in his or her body. I might ask the person to remember a traumatic situation and then track in the body when that impulse starts to come up, paying very close attention to preparatory movements. I’d observe to see if the fingers might lift a little bit or the shoulders tense up. I’d direct the client to notice how the body is preparing, however subtly, to make an aggressive action. Then I’d work with the client to follow the body’s natural wisdom to execute that action.
I’d also pay attention to the belief system that goes along with what’s happening on the physical level. The person might have grown up believing that “I don’t have the right to set my own boundaries” or “I have to do what other people want me to do” or “It’s not OK to say ‘no’ to my family.” So we can work with challenging those beliefs by helping that person learn a movement that’s really unfamiliar, based on the old family dynamic and internalized beliefs. That interface of the physical and the cognitive is crucial.
If children grow up in a family where they’re encouraged to set their boundaries, say no, and not do anything they don’t want to do, they’re more likely to use those coping skills if somebody threatens them. But you grow up in the family where it’s not OK to protect or defend yourself or to say no, your body’s already started to develop movement patterns that take you into a compliant stance. Therapeutically, you want to expand clients’ movement vocabulary, behavioral repertoire, and beliefs, so that when a certain action is needed, it’s there. For example, in cases of trauma especially, but not exclusively, you want to help clients start to reach out again in a full way for connection or support. Of course, doing that can also bring up a lot of emotional pain and distress that’s implicitly emotionally connected. In workshops, I often show a video of a grown female patient who said that reaching out drops her right into her neediness: “This is what I want, but this is what I fear, too.” She didn’t have anyone to reach out to as a child.
RH: What is the therapeutic advantage of learning how to intervene at the level of the body?
OGDEN: What’s so exciting to me is that, to be helpful, somatic therapists don’t need explicitly to know clients’ beliefs, discuss their memories, or have them to report what happened. Since we’re always looking at how the body has shaped itself around past experiences, we can help clients with memories that are preverbal or forgotten. It reminds me of what Albert Einstein said: “The fish will be the last to discover water.” That’s just how most of us are–we don’t have any conscious memories that shaped our everyday movement patterns and body posture. But our past continues to live in the organization of our bodies.
RH: How can therapists not trained in somatic approaches become more aware of the body in therapy?
OGDEN: I always encourage people to become curious about how the movement, shape, gesture, and posture of the body reflect and sustain the presenting problem. Because it will–there’s just no way around it. If someone comes in saying “I can’t get any support, I feel like I don’t have any friends, I’m not in relationships,” look at how their body reflects that. Do they avoid eye contact? Do their arms hang limply by their side, so if they did reach out for support, it would be a very weak gesture? Is their chin up in the air in an arrogant position, so that nobody wants to relate to them? Look at how the body reflects and sustains the issue. It’ll be both. It’ll reflect the issue, but the movement and posture itself will sustain the issue as well.
It’s important to look at how the thinking and the emotions and the body all go together. Whenever clients feel sad or believe they’ll never get better, that’ll be reflected in how they hold their heads, or in their shoulders, or some other body pattern. It’s all right in front of us, if we’ll only teach ourselves to observe.