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Case Study - Page 6

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“Yeah, let’s stay with this a while. Feel yourself holding that infant.” More gentle silence. “Now, see if you can feel yourself as the infant being held,” I prompted.

We’d dropped into what the Hakomi Method calls the “missing experience”: the key developmental need that didn’t get met sufficiently in childhood. A tiny part of the nervous system has frozen itself in time, still waiting to get the need met, and a larger part of the nervous system has constructed defenses, coping mechanisms, character strategies—what could be called “self-states”—to cope with this fundamental absence.

For Suzanne, the missing experience involved soothing by a caretaker in the face of a profound loss. No one had done that for her when she’d been an infant or a child. So she never internalized an ability to self-soothe. She constructed a self-state based on the inevitability of sudden loss and the impossibility of soothing. In this state, she could do nothing but collapse, and then judge herself deficient. Now, by reaccessing that “frozen” part of the nervous system that was still waiting to be soothed, we could finally attend to the underlying need, the missing experience she’d been waiting for all this time.

Suzanne started to open her eyes. “I feel so different,” she announced. Her eyes were wide open, taking in the room. Her breath was going more deeply into her body. Her head and neck were rocking ever so slightly.

“Yeah, take your time and really feel how this does feel different,” I said. We took plenty of time for Suzanne to orient herself to this new self-state—a state of being that allowed for the possibility that her deep places of distress could be soothed, and for other changes that could flow from this. Our task now was to support her as she experienced herself grounded in this new state.

I instructed Suzanne to now notice everything she could about her body—first, how she felt in her chest and legs. Her chest was no longer pounding, she said, and her legs felt energy moving through them. Then I invited her to notice her breath, her spine, her eyes, her jaws, her belly. I asked her to notice how she saw and heard the outside world from this place. I also asked her to notice how she experienced herself sitting across from me.

Finally, I asked Suzanne to imagine waiting for a call from Harvey from this new place.

“It’s so different. I’m OK in myself. I don’t need him to call for me to be OK,” she responded.

We continued to support the new self-state by discussing how she could apply it in relationship with others. Could Suzanne still be as present with herself while she was talking to me? Did she need to take a few moments to reconnect with herself from time to time? Could she imagine relating to others from this place?

Now that she’d experienced this new self-state and had an embodied template for it, she could use this as a reference marker in her life to remain conscious of whether she was in her usual self-state or in this different, calmer one. This is what I call “self-state awareness.”

I invited Suzanne to take some time later in the evening to reflect on our session, and to feel herself back in her body. Journaling, walking in nature, art—all these could be ways to reconnect with the new self-state. More homework was to become aware of when the habitual self-state reemerged through bodily cues, thought processes, and the other elements that made it so familiar.

Suzanne described her new ways of being in relationship as a “newly discovered continent.” Metaphors can be helpful for identifying self-states, and recently, I’ve been finding landscape metaphors particularly useful for enhancing mindfulness. Jagged cliffs of isolation, dry deserts of longing for intimacy, flowing rivers carrying new life to verdant plains of relational possibility, congested cities that simulate sexual arousal but feel emotionally vacant—these are examples of how metaphors can evoke greater internal awareness and contribute to a deepening mindfulness. In any good psychotherapy, we survey these internal landscapes. In mindfulness-based psychotherapy, we learn the features of these landscapes as signified by specific bodily experiences. Having journeyed to these different landscapes in the therapy room, our clients are able to notice which landscapes they inhabit at any given time.

Clients report that becoming physically aware of the current internal landscape, or self-state, empowers them, in the words of one client, to “transport out.” Being somatically aware of a self-state accompanying an experience allows us to witness the experience as an experience—not the totality of ourselves. This is the liberation of self-state awareness: we can witness habitual tendencies, but not be controlled by them.

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