Why Include The Body In Psychotherapy?

First and foremost, body psychotherapy is simply very good psychotherapy. If it were less awkward, I would want to call the field “Body Included Psychotherapy” because I view the body and the psyche as all of a piece. I think that many of us, and many more traditionally trained psychotherapists and psychoanalysts, are realizing that the body has been - peculiarly - segregated and marginalized. For cultural and intellectual historical reasons, many forms of physical touch in psychotherapy became taboo in Western European and American culture. As a result, body or somatic psychotherapists split off from psychoanalysis and become “alternative.” In doing so, many professionals who work with the energy of the body and with the body itself have not availed themselves of the contributions of psychoanalytic psychotherapy.

As a rapprochement has begun, applied neuroscience along with attachment theory and its attendant research have contributed enormously toward bridging that gap. Both speak to the importance of relational bodily experience as formative from the beginning of life. And, perhaps equally important, both delineate how and why relational bodily experience facilitates changes and heals in the therapy relationship. So psychoanalysts can no longer ignore the body, and body psychotherapists can no longer ignore object relations and relational psychoanalysis.

The trauma response is a specific defensive bodily reaction that has become trapped. People initially mobilize this response in order to protect themselves from a source of perceived threat. They then use it to “protect” themselves against felling the totality of their horror, helplessness or pain. In the long range, these defenses keep people frozen and stuck in the past, cut off from the here and now. Trapped in the (incomplete) defensive trauma response, the shame, defeat and humiliation associated with the original event replays itself over and over again. It is through the living, knowing body that trauma can be accessed and healed.

- Peter Levine

Somatic Experiencing® was developed by Dr. Peter Levine as a somatic-based therapeutic treatment for victims of trauma. His inspiration for SE was largely based on his observations of animals and their ability to quickly recover after a traumatizing event, such as a near-death experience with a predator. Curious as to how animals are better able than humans to escape traumatization after such an event, he carefully observed their behavior directly after a potentially traumatizing experience. He consistently observed that animals exhibit a physical shaking, shuddering and release of energy followed by a calm, and quite normal return to their usual activities (Levine, 1997, 2010). Further investigation and research showed that animals that are restrained and unable to dispel this post-trauma energy were far more likely to show human-like symptoms of Post-Traumatic Stress Disorder (PTSD). Trauma, he concluded, is thus body-based, and frequently can get “stuck” when the energy during the event is not released; it is this that causes trauma-related pathology (Levine, 1997, 2010).

While many treatments for PTSD include only top-down cognitive processing, Dr. Levine stresses the importance of accessing traumatic events also through the physical body where they are stored (Levine, 1997; 2010). Because trauma is stored, or rather trapped, in the physical body, therapeutic approaches that neglect to include the body will be limited; it is essential to first and foremost address a patient’s “bodyspeak.” The talking cure for trauma survivors must give way to the “unspoken voice of bodily expressions as they surface on behalf of the wisdom of the deeper self” (Levine, 2010, p 45). By working through the body, trauma victims will be able to dispel the trapped energy and return to a state of calm with a healthy, regulated nervous system.

Through accessing the physical sensations of the body in small, titrated amounts, and tapping into the patient’s bodily instincts, SE directly addresses many of the symptoms of PTSD without overwhelming the patient with a flood of images and memories from the event (like, for example, Prolonged Exposure Therapy). Trauma, Levine believes (1997; 2010), “is in the body and not in the event.” Because of this, by tracking physical sensations and bringing the patient out of dissociation and back into their bodies, the patient will be able to dispel the energy that has been trapped in the nervous system, and will return to a relaxed state. The goals of therapy are to access physical sensation, slow down the nervous system, broaden awareness of bodily experience, and to bring awareness to the extremities to help clients notice the discharge of intense activation in the body (SE Manual, 2009). Through body tracking, titration and “pendulation” of the parasympathetic and sympathetic branches of the autonomic nervous system, patients are able to slowly increase their tolerance of sensation and return to a state of peace and calm.

In Somatic Experiencing treatment, there is a gradual resurfacing of disowned sensations of paralysis, helplessness, and rage into consciousness, as survivors shift between resistance and acceptance, fear and exploration of sensations. In the next stage of treatment, pendulation is utilized to shift body awareness from regions of relative ease to those of discomfort and distress, based on innate rhythms of contraction and expansion. Titration is also used, to prevent retraumatization by carefully activating small increments of survival-based arousal and other distressing sensations. In this way, unpleasant, distressing sensations are followed by comfortable, relaxing sensations.

Survivors are empowered by restoring a biologically active defense system in which the triumph of self-protection and resilience is experienced. They are encouraged to complete fight-flight responses in the form of minute movements of the arms or legs, to engage self-protective reflexes. As the brain registers this new experience, equilibrium is restored in the nervous system; natural resilience is activated, which heals trauma. Survivors are able to reorient to the here and now and this facilitates social engagement. The social engagement branch of the mylenated vagus system is linked to cardio-protective, immuno-protective, and enhanced cognitive function. Social engagement promotes a sense of belonging and safety by generating satisfying relationships (Levine, 2010).

Core Energetics is a therapeutic process originated by Dr. John Pierrakos, MD, in the 1960‘s. Dr. Pierrakos sought to integrate the mind, body, emotions, will and spirit in the service of the love and pleasure that are the essence of life. Core Energetic psychotherapy is based on the concept that when negative energy in the form of fear, anger, hatred, etc, is stored in the body’s tissues, physical and mental health may be threatened. Working with the body facilitates the release of emotional blocks, defensive postures, and destructive belief systems, so that the energies of the body can flow more freely, creating greater life fulfillment for the individual. Core Energetic helps individuals and groups to transform the obstacles which block contact with one’s inner core which is the source of all healing, wisdom, joy and creativity.

The Core Energetic therapist provides a supportive environment in which the client can access deep inner processes and release energy that is blocked in the body. The therapist is aware of the client’s character defenses, acting out behaviors, and destructive life patterns, but focuses attention on the core of the person: his/her spiritual capacity, ability to love, and life task.

The therapeutic process is based on the following principles based on the work of Wilhelm Reich:
•We are a psychosomatic unity which has within it the capacity to love and heal, and we have an inner impetus toward creative evolution.
•In order to evolve, we must deeply transform the negative aspects of our personality, releasing their energy into a creative whole.
•The creative potential of our life force is tremendous - virtually unlimited.
•The physical body is the vehicle through which we express our emotions, thoughts and spiritual selves. By working with the body to help confront the defensive reactions of our emotions, we open up the way to our healing and our evolution.

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