Accessing Emotional Discomfort with Sensorimotor Psychotherapy

What Neuroscience and Attachment Teach Us About Healing Stress in the Body

Janina Fisher

As I'm trying to prepare dinner, my 6-year-old granddaughter, Ruby, is tormenting her little sister with pokes and pushes. Tired, too, I feel myself tighten up, ready to bark, "Ruby, leave your little sister alone!" But instead, I pause and relax my body. I can see that Ruby is wired after a long, adventurous day at the park. If I reprimand her, I know I'm just piling on stress and asking for trouble. So I take a breath and notice a different impulse about what to do.

Whispering her name with a big smile and secretive air, I motion for her to come over to me. "Ruby," I say in hushed tones, as if conveying a top-secret message, "in a few minutes, Nika is going to start crying," I say sadly, "and then I'll have to give her all my attention." My body takes on the language of disappointment, "And I don't want that: then I won't be able to give any attention to you." She gives me a knowing look, cocks her head, and smiles. Nothing more needs to be said.

So what does this grandmotherly anecdote have to do with brain science? For millions of years, parents of all mammalian species, particularly humans, have had to undergo a crash course in "interactive neurobiology" to nurture their young. Most parents soon learn which postures are soothing, which tones of voice, which kinds of rocking, how much movement. Why do we learn so quickly? Because we ourselves are biologically thrown off-kilter by an infant's cries. Alan Schore calls this trait "adaptive projective identification": an infant communicates distress directly to our bodies, and in offering comfort, we regulate our own discomfort. The sense of soothing and warmth we feel as the baby falls asleep in our arms reflects this phenomenon.

But what does "interactive regulation" have to do with psychotherapy? The more we learn about the brain, the more apparent it becomes that, if we're to guide people in the process of change, we need to pay at least as much attention to the body and nervous system---theirs and ours---as to words, emotions, and meaning-making---which, until recently, have been the major focus of therapy.

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.

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.

It's Over Now

How do we help our clients experience physical safety, both in therapy and in the wider world? Here, neuroscience comes to aid us once again. Brain-scan research on the effects of meditation has pinpointed a part of the brain that becomes active when we meditate or simply observe our experience, moment-by-moment, without reacting to it: the medial prefrontal cortex, located just behind the middle of your forehead, has direct connections to the amygdala, our emotional memory center. When that area becomes more active, the amygdala becomes less active. Translated into psychotherapy, mindful observation yields a state of dual awareness, by which observers can reach into their inner worlds without becoming overwhelmed by emotions and body responses.

Neurobiological regulation in psychotherapy requires right-brain-to-right-brain communication. It requires therapists to attend more closely to the impact of words and body language on clients' nervous systems and somatic experiences. My brilliant words will fail to be heard if I dysregulate the client as I utter them. Instead of overattending to clients' stories, I've learned that I must pay equal or greater attention to clients' nervous systems and bodily communications. This is an art that most of us instinctively express when we relate to babies and small children, as I did with Ruby, or when we play with a puppy or scratch a kitten's tummy. Without conscious thought, we experiment with the language and body language that engages small, sentient, sometimes furry, beings until they respond positively. Why not bring that intuitive ability into the office?

This blog is excerpted from "Brain to Brain: The Talking Cure Goes Beyond Words." Want to read more articles like this? Subscribe to Psychotherapy Networker Today!

Topic: Anxiety/Depression | Mind/Body

Tags: brain science | amygdala | body psychotherapy | Daniel Siegel | depression | fight or flight | Janina Fisher | psychotherapy | sensorimotor psychotherapy | therapist | stress | networker | intuition | nervous system | regulation | self-regulate | instinct | interactive regulation | Alan Schore | body language

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