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In over 100 years of therapy, very little attention has been given to two elements of clinical practice: the body and positive emotions. Thankfully, somatic psychology and positive psychology have received increasing scientific recognition over the past two decades. This paper will explore ways in which somatics can contribute to the field of therapeutic healing, growth, and empowerment. As humans, we are complex systems, which means that our functioning is organized through multifaceted and interdependent relationships. Through evolution, simple life on Earth manifested with a basic physiological structure, affect followed and culminating with cognitive capabilities. This evolutionary process grew out of a need to complexify adaptive responses to augment chances of survival. While cognitive analysis can be of great support to heal and grow, both the weight of physiological processes such as the nervous system and the strength of emotions and moods to influence behaviour provide important therapeutic routes for resiliency and empowerment. Through its integrative approach to therapeutic conceptualization and practice, NeuroSystemics emphasize therapeutic interventions focusing on physiology, affect, cognition, and interpersonal dynamics. This paper will first briefly summarize the meta-developmental trajectory at the heart of NeuroSystemics’ conceptualization and range of therapeutic interventions. Second, a closer analysis of biological and affective dimensions of resiliency and empowerment will be described. A meta-therapeutic methodologyNeuroSystemics is a clinical practice that can be applied in four settings: (i) mental training, (ii) individual therapy, (iii) group therapy, and (iv) community processes. They each correspond to the concentric circles of (i) sense, (ii) self, (iii) social and (iv) societal, respectively, in the following diagram:  In whichever setting, we attempt to engage with all the parts of that system as well as the system as a whole. Biology and affect, as holonic fractals, can be both parts and wholes, depending on the breadth of attentional focus and practice setting. For example, in mindfulness practice, the emerging sensate networks of the in-out movement of the breath can be experienced as a dynamic wholeness with many interacting features. When attention is broadened, the spectrum of awareness may include. A sense of the whole body, in which the sensate rhythms of the breath would only be a part. The key here is to provide a firm foundation for understanding the interdependence of human experience, whereby any efforts towards differentiation necessarily imply consideration for integration and contextualization. Baring this fundamental principle of complex functioning in mind, it is of great benefit to explore mono-developmental trajectories, where a single dimension of human experience such as physiology, affect or cognition is cultivated. The next section describes the way NeuroSystemics understands resiliency and empowerment through a differentiated lens of biology and affect. Biological developmentWhen considering the possibilities of somatic cultivation, development, and training, it is helpful to refer back to our evolutionary process. Porges’ polyvagal theory describes a fairly linear direction in terms of physiological responses to stimuli from reflexes to social engagement. See this diagram of it.  Reflexes are the most primal physiological responses to the environment. They arise based on sensory contact of comfort and discomfort. Freeze, a shutting-down of major physiological systems, was already a more elaborate form of response to reflexes. It increased the probabilities of survival by “playing possum” and escaping one’s prey after they become disinterested. Fight-and-flight offers more opportunities for a differentiated response to threat and social engagement and is the culmination of a multi-million-year process of refinement. This last system arises out of feeling a sense of safety and promotes curiosity, playfulness, and enjoyment. A first important therapeutic goal, based on this evolutionary framework, NeuroSystemics uses elaborate maps, therapeutic conditions and interventions to support the emergence of social engagement. Porges’ neurophysiological findings have demonstrated that the freeze-flight-fight and social engagement systems are aroused in inverse proportions. One key practice to sustain a socially engaged nervous system state is to encourage the clients’ self-organizing impulses. These impulses, also known as Chanda in Buddhist meditative texts and Eros in Freudian meta-psychology, are generative organismic drives towards health, clarity and well-being. Supporting them implies sensing into the clients’ system as a whole, while simultaneously differentiating its parts to identify signs of arousal and deactivation: physiology (prosody, facial expressions, agitation, etc) and free-associative process, their affective variations, their bodily movements as well as their quality of presence in relation to the therapist (i.e. trust, vulnerability, appreciation).  Intensity spectrum of physiological deactivationWhen we work with the autonomic nervous system, we are walking a fine line between increasing the nervous system's backlog, or reducing it. Our aim in Neurosystemics (somatic-centered therapy) is to reduce it by reaching gentle and enjoyable thresholds (the edge of our client's window of tolerance) and then deactivating the system. You can assess the intensity of the threshold reach by identifying the symptoms of deactivation, which are on that spectrum above: the most subtle and easeful deactivation symptoms are spontaneous breaths and soft heat, and the most intense are involuntary movements and shaking. While some of the more extreme symptoms may sometimes be inevitable in our work, in NeuroSystemics we aim to have easeful and smooth deactivations so that our clients can stay oriented to the here-and-now and have better chances of integrating this somatic process easily in their daily life.
All these factors (and others) will provide valuable indicators to assess whether the physiological coherence and synchronicity are growing or diminishing. Therapists then adapt their interventions to provide more or less containment to shepherd a higher level of physiological resiliency. Complexity science has also provided a number of essential findings to support us in biological maturation. It explains that increasing levels of organization emerge from phase transitions which occur by reaching thresholds at far-from-equilibrium states. Human physiology has non-linear patterns whereby rhythmic oscillatory movements between equilibrium (homeostasis) and far-from-equilibrium states (morphogenesis) enable increasing levels of metastability. In terms of practice, this means that we will want to support our clients, in a gentle, progressive, and positively-valenced manner, to come into contact with physiological states which feel out of balance. By listening to the multi-faceted impulses (physiological, affective and cognitive), a cushion of resource and ease can help to soften, contain and eventually convert previously overwhelming sympathetic charge into regulating and organizing patterns of coherence and synchronicity. In summary, the two directions proposed by NeuroSystemics to encourage biological maturation is to conceive of skillful means to sustain our clients’ social engagement nervous system states, as well as to ground their physiology in gentle and progressively increasing rhythmic oscillatory movements between homeostatic and morphogenetic states. These will enable greater physiological resiliency, somatic embodiment as can be indicated by heart-rate variability.
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Are you a therapist in a setting working with underserved populations? Use this mindfulness exercise and contemplation for exploring marginalization and your and others' relationship to it. Part 1. For this exercise notice how you organize around the statements to be read. Notice that our responses may be different based on how culture has impacted us. Part 2. In this exercise, it can be helpful to explore the parts of ourselves that resonate with dominant culture and the parts of us that have been marginalized by the dominant culture. Post Exploration Discussion Questions: - Share (or journal) your experience of hearing the statements. - What do you imagine might be evoked from someone who is marginalized as they hear these statements? If you like this Demo please like it on YouTube and subscribe to our channel. Spread the healing. Share this demo with another using this link: https://youtu.be/svAi4MWdqhw There is a course we offer, in partnership with the Hakomi Institute, that further explores the topic of marginalization. It offers somatic activities to enhance your work with clients. For advanced students of Hakomi this webinar brings a fresh take on utilizing Hakomi with underserved populations. It is presented by Rebecca Lincoln, LPC-S, Certified Hakomi Teacher.
Earn 2 CE credits when you watch and take the course, Hakomi Mindful Somatic Psychology with Underserved Populations You can also watch it here free... but you need to be a member of the USABP. Learn more about the Hakomi Institute. Video Credits include - Presenter Bio Rebecca Lincoln, LPC-S, Certified Hakomi Teacher Rebecca is a Licensed Professional Counselor and board-approved supervisor in the state of Texas. She specializes in working with trauma, grief, anxiety, depression, and personal growth. She is a certified therapist in Hakomi Mindful Somatic Psychology and a certified Hakomi teacher. She has additional training in several modalities including EMDR, and spiritually integrated psychotherapy. When working with Ms. Lincoln, expect to consider the aspects of mind, body, and spirit in your healing process. Ms. Lincoln is open-minded, loves to laugh, and is interested in knowing who you are and what is important to you. She also loves mentoring interns. If you are an LPC intern looking for supervision for full licensure, send her a message to set-up a phone call to discuss details. Edited by Liam Blume, CPRA In this video presentation below, we are excited to introduce to you the possibilities, value, benefits of using virtual touch. We will provide simple step-by-step instructions on how to incorporate the beginning experience of touch into your sessions or with others you want to connect with. A significant portion of the presentation will be dedicated to a demo from which you can experience and learn from. Coming soon! Get the Full Home Study Training for Virtual Touch at our Somatic CE Center. 2 CE Credits will be available. The full method of Transformative Virtual Touch in Telehealth Care recording is free to USABP members and paid registrants. Expand your skills… Transform yourself. If you like this Demo please like us on YouTube and subscribe to our channel. Spread the healing. Share this demo with another, https://youtu.be/DAMc_VHBsEs Covid-19’s arrival has disrupted one of the ways that we touch our clients, that is, physically with our hands. This loss of physical contact creates tremendous anxiety because gentle, caring touch is the bedrock of safety. It allows for and promulgates the release of oxytocin which is a critical hormone that ameliorates sensations of feeling unsafe.
In response to this loss, we turned to the myriad of other ways we could still provide touch for our clients in order to bridge the isolation that sheltering at home was creating. We are now doing virtual sessions across the globe and have come to the recognition that virtual touch is an efficient and effective way to heal during Covid times and even when Covid becomes a distant memory. Possibilities abound! This post is a part of our "Insider Look" and "Somatic Self Care” Series. This episode has been brought to you in part by Joe Weldon and Noel Wight Co-Founders of the Somatic Therapy Center. The USABP has been integrating body and mind for effective psychotherapeutic health since 1996. Our USABP Somatic Continuing Education Center offers in-depth courses for health care providers. Enroll Now. It’s Free. There you can take the courses from many luminaries in the field of Somatic Psychology and Therapeutic Training such as from Noel Wight & Joe Weldon Ph.D. and more. Such as Stephen W. Porges Ph.D., Babette Rothschild, MSW, Dr. Alan Schore, Judith Blackstone, Noel Wight & Joe Weldon Ph.D. Learn more about the Somatic Therapy Center work at https://www.thesomatictherapycenter.com Become a member of the USABP (Association) first and pay just $15 per CEU. With membership, you'll get the next 12 webinar training programs FREE, access to our library of training programs, a subscription to our peer-reviewed somatic journal, and more. FREE Exercises, techniques, skills, case studies and more resources are available here on this site. Check out all our sections. Subscribe to our USABP Highlights and Viewpoints email sends. You'll be informed of our next posting, zoom webinars, book reviews, journal releases, research findings, case studies, and special VIP invites. Video Credits include - Presenter Bio Joe Weldon- Co-Director, Licensed Psychologist, Master Somatic Therapist Unable to walk until the age of five imbued in me a deep respect and regard for the traumatic experience of the loss of movement. In a Somatic Therapy session, I will help you differentiate your essence from the injuries that have happened to you. This will help you restore movements to your being that are necessary for you to live a life with ease, joy, and meaning. When full and free movement is restored then love becomes visible and viable. Come for a session and restore the lost, taken away, and forgotten movement that is your natural birthright. Thousands of clients seeking to restore movement to their bodies and transform their lives are now moving about more freely and easily because of the gentle transformative touch I have skillfully provided them. Hundreds more have learned the fine art and skill of Transformative Touch in our one-of-a-kind somatic therapy training. Produced, Edited and Hosted by Liam Blume, CPRA- Integrated BodyMind Therapist at https://www.Soulworkla.com - Director of Marketing and Content Curation for the USABP Insider Look: Watch Focusing-Oriented Therapist’s Approach to Deepening a Somatic Psychotherapy Session This 5-minute video was created by Jan Winhall and Serge Prengel. It is based on an actual session, but the client is not visible, just the therapist. It is meant to give you an experiential sense of what a Focusing-oriented therapist might do in a session. There are different perspectives, approaches, and styles in Focusing-Oriented Therapy (FOT). What would you do if your were a Focusing-Oriented Therapist?
3 Types of Listening and Insights on How To Use Them. You have seen the stages of a FOT session above. One key to what went in to the therapist's response above is her listening and empathy. In the audio below join Kathy McGuire and Serge Prengel as they explore deeply both listening and empathy. They look at 3 forms of listening. Serge, in connection with his exploration with Kathy, conveys in his blog the following: 1) Even simple listening, “passive listening” without interruptions, allow speakers to naturally begin entering into direct reference to felt experience and explication from there. 2) Active empathic listening takes this natural felt sensing a step further, as the speaker checks the listeners words against their felt reference and articulates anew. 3) When the speaker knows Focusing, then empathic listening helps the Focuser stay with, check, resonate and articulate their felt sense in the deepest way. In watching the audio below or the videos, Serge notes, "please pay attention to the central role of the pause: Notice how taking a pause opens up direct access to felt experience. In this context, felt sensing is the natural outcome of the pause. As is empathy." Serge goes on to note that in observing these recorded exercises you will get a sense of how deeper creativity and change can come through in relationship to another using these practices. He also goes on to say, "These skills can be also brought directly into interpersonal conflicts: Somebody who has seen our passive and active listening videos might jump in as a “third person listening facilitator.” Similarly, these skills can be used in group decision-making situations, as the Quakers do with “passive listening.” These two video posts come to you from our "Insider Look" and "Somatic Self Care” Series found on our USABP YouTube Channel. This episode has been brought to you in part by Judith Blackstone and the Realization Process. GROUNDING In this first video below, learn to Ground yourself so you can reduce anxiety, disentangle yourself from others, experience coherence, and connect better with others. This presentation teaches the Realization Process exercise: Foundational Grounding. Because anxiety is an upward movement in the body (“my heart was in my throat”), we can alleviate anxiety by settling into seven foundations in the body: the feet, pelvic floor, respiratory diaphragm, collar bone area, base of skull and jaw, eye sockets and top of head. These foundations allow our emotional life and our mental life to settle and rest. We do this exercise sitting and then remaining settled in the foundations while walking. CENTERING In the video below, learn to Center yourself so you can have a more present-day response in working with others, make deeper connections, and have the ability to stay open to more intense states of others. This presentation teaches the Realization Process exercise: the Core Breath. Helping you to live and breathe in the core of your being. It helps you find and breathe within the center of your head, chest, and pelvis. This can help you find a place of calm and stillness within yourself, no matter what is happening around you. The subtle vertical core of the body is experienced as your deepest connection with yourself, and your deepest perspective on the world around you. To live there feels disentangled from your surroundings and from other people, but not detached. You can still respond, even more deeply, but without getting entangled in habitual modes of reaction. We do this exercise sitting and then walking while remaining in the core points. Additional benefits of these two exercises include helping people (such as therapists, co-workers, family members, etc.) to have a more present-day response in working with others, deeper connections, and the ability to stay open to more intense states of others. By Sheila Rubin, LMFT, RDT/BCT
(Adapted from my chapter "Unpacking Shame and Healthy Shame: Therapy on the Phone or Internet" in the book Combining the Creative Therapies with Technology: Using Social Media and Online Counseling to Treat Clients by Stephanie L. Brooke, editor.) PART ONE I begin this article about the internet with the fact that my clients think I’m a Luddite. I grew up with a wall phone telephone that, by definition, was attached to the wall. At most we could stand a few feet from the wall, with a few inches of cord linking us to the phone. This was in a time even before answering machines. I came of age and went to study radio and television in college during the time of the black-and-white Porta Pak video machine that was heavy, where we actually spliced tape using our fingers—just before electronic newsgathering. Response time to a letter was a couple of days to a couple of weeks. I’m fully aware that the words I’m writing here will likely be outdated due to technology changes before this book is out in the world. I have accepted the use of a smartphone into my private practice, along with doing therapy over the phone or Skype or Zoom if I have met the client at least once in person. I have come a long way. Therapy on the Phone or Internet Therapy, on both phone and internet, is with individuals or couples. When I am not physically with a client, I find that I check more often for feelings that I might be able to sense when working face-to-face. I slow things down and tend to do more somatic work, asking clients to ground and to sense somatically for part of the session. I always ask at the end, “What are you taking from this session? What was helpful?” I also give homework after each session. For example: Make a list of the coping skills from the session and put them on your calendar day by day. Or: Take the powerful objects from this session and put them out in your room at home with a note by each to remind you what we did in the session today. If the session helped them find a vision to support the marriage, we have that symbol, like a strong tree holding both of them as they deal with difficulties during the week. Concerns about Technology What about when technology fails? When a person just revealed something they’ve been hiding and the screen suddenly freezes? A while ago, I was in the middle of a Skype session where a husband was telling his wife why he had trouble when she touched him. Suddenly the screen froze and this tender moment was interrupted with my frantically trying to call them on Skype, which would not reconnect. I had to call them on my cell phone, and by the time I reached them, the tender moment had passed and they were fighting again. I had to slow things down and gently find the words to tell them about the negative cycle their communication was in and how to do a repair to get out of it. As Kaufman says, shame is the rupture of the interpersonal bridge (1974, 1992). Any disruption in connection with a significant other can disconnect the person from him- or herself, or the therapist, and activate the feeling of shame. And this couple was experiencing a disruption in connection. I was eventually able to use the symbol of disconnection because of the unpredictability of the internet as a way for each of them to have a role of explorer rather than blaming each other. What I realized was I have to let clients know ahead of time about the constraints and the benefits of using the phone or internet for therapy. It will save them time coming to my office when they are in a difficult place, but it may not be as contained as an in-person session. One couple was struggling with the husband having had an online affair and the wife needing to check his phone in order to be reassured that he wasn’t meeting the woman. I spoke slowly and carefully to them to get agreement before we began to talk: Because we are not face to face, I can’t just interrupt you if there is shouting. I am going to do the session slowly and have you repeat what you hear the other person saying, so that I can know you heard them and they can know that you heard them. We are going to take turns. Are you both in agreement? And because the phone is not a predictable medium, and each of us is on a cell phone, if one of us gets disconnected for any reason we need to have a plan. Are each of you near a home or office line? If someone’s line dies, we will momentarily stop the session and I will wait for the call of the person who was disconnected. Call me back on your phone and I will use my phone to accept both calls. Shame During the Session In my chapter in The Self in Performance, I write that “Shame can be right there in the shadows. It is easy for misunderstanding.” When I can’t see the emotion on clients’ faces, because we are on the phone or they are looking away from the screen, I don’t know what they are experiencing and truly expressing. In the book Shame and Pride, Nathanson (1992) explained that throughout life we are balancing between pride, when we are seen in a good light, and shame, when we make a mistake or are seen in a less than favorable light. Diana Fosha (1992) later wrote that we call this our “self at best” and our “self at worst.” We strive to be seen as smart or clever or helpful, but when a mistake is made and something is unclear, suddenly the person is risking being exposed and seen as self at worst. This concept is helpful to remember when a client is sharing vulnerable revelations. I know from my own vulnerability how scary it can be to be exposed at the wrong time or without kindness and support. Listen for Subtle Signs of Shame In the chapter “Treating Family Systems with Shame and Addiction Problems,” Ron Potter-Efron wrote that: Clients do not always directly communicate their experience of shame with their counselors. Rather, they may hint at their shame through relatively subtle cues, downcast eyes, sudden speech stoppages, avoidance of an apparently innocuous topic, unusual phrases, and so forth. They may also speak at length about other emotions regarding a particular experience without adding that they also or even primarily feel shame about it (p. 230). He suggests the importance of the interactive process between the therapist and client can even be more important than the client actually disclosing the feelings of shame because the client expects that the therapist will dismiss them. He explains, “Shamed clients have a specific hope, not necessarily stated, within the counseling relationship. They desire to reveal everything within them that feels dirty, disgusting, and defective. They seldom reveal all this material immediately and may never be able to share some of it” (p. 229). He explained how the therapist needs to gently layer by layer work carefully and not reject the client as they reveal more levels of shame during the sessions. Internet Therapy The good news is that the internet can serve as a bridge between family members who do not live within driving distance of one another. It can also get in the way of having the direct eye contact family members long for. It proved very therapeutic for an elder client to see her grandchild over Skype, even though she believed it would not “do the trick.” She had been hurting and reported being filled with rage because her son didn’t call her as often after his baby came, and because the other grandparent was being invited over and she was not. We role-played her talking to her son, but nothing shifted. She still felt left out, like something was wrong with her for not being chosen to spend time with the new family. We unpacked all the feelings of anger toward her son for not insisting that his wife invite her at the same time as the other grandparents, and under that was the feeling of shame. She felt ashamed to not be invited and fought with him on the phone when they did talk. I asked her to role-play talking to her son in a way that invited a solution instead of blaming him for her frustration. I invited her to role play the visit with the grandchild. She rocked back and forth. Finally, I suggested that she use Skype as a way to visit her grandchild. She told me that I didn’t understand. She wanted to pick her up and rock her in her lap in the rocking chair. I invited her to try just one phone visit on Skype with her son and grandbaby. She sat in the rocking chair at her home and rocked. She was delighted to see her grandchild recognize Grammy over Skype. This experience fulfilled her longing to visit with her grandchild. There were many Skype visits thereafter. Her feelings of shame about being left out decreased and invitations to visit increased. Containment Please note that I only do sessions remotely if I have met with the client in my office and we have developed a solid therapeutic container first. When the client is in my office, I can observe a range of nonverbal cues and get a sense of his or her energy. Over the phone, there are subtle cues I may miss. There are ways I work with the absence of the visual modality. Because I am not seeing them, there are things I need to do to contain the energy of the session and the pace of the session. Because the client isn’t seeing me, there are ways I want to structure things to help them feel me where they are sitting. Case Example of Phone Session This client was feeling dark. Her boyfriend was spending time with his ex-lover again instead of going on the date they had planned. Client: “He’s still in the role of letting his ex-wife rely on him. I couldn’t stop crying for hours. My emotions got all wacky or something. I see his side when he’s helping his kids. But every act of his kindness is an act of affection toward his ex-wife. One day it’s good between us, and the next day I feel ignored, neglected.” Therapist: “How about if you choose something in your room to represent your feeling neglected and ignored.” Client: “OK, this plant.” Therapist: “Can you move it near you and look closer at it? And as you are looking at it, what does it say to you? What does it symbolize?” Client: “You have to pay attention to a flower. You have to water it or it dies!” Therapist: “So that’s a very powerful symbol of needing to be tended and cared for.” I wanted to pause and have her reflect on the importance of her attachment needs. She really wanted to just rush past them in the session. Choosing an object helped me direct the session to make space for that subject. The act of choosing something took her into another part of her brain where creativity was more open to her. Having a symbol can be very powerful metaphor. Having it in front of her helped her to focus on it during the whole session. Client: “Yes! I want to be cared for. But when I feel this way, I don’t feel like myself. It feels like I don’t exist. It’s too painful when he says he’s coming over and then he cancels because he’s with his ex-lover. Why am I punishing myself? I could go out and be in another relationship!” Therapist: “So there’s another part of you that doesn’t want to be punished any more, that wants to find another relationship, one where the guy is choosing you instead of choosing his ex. Can you look around the room and find an object that represents this part of you?” This is another place I want to pause the session and give her time to feel the power of what she just said. I want a symbol for that part so we can talk to that part as well, maybe have a conversation with both of them. Client: “This candle!” Therapist: “Can you put the candle in front of you and look at it. What does it represent?” Client: (Surprised) “There’s a light in it! I can attract things… People! But I’m not ready to move on.” Therapist: “Can you give each a voice? What does the flower say and what does the candle say to you?” The candle told her that she is bright inside when she’s not so depressed, worrying what is going on with this guy she’s dating. It gives her inspiration to grow herself and step out of the relationship to a real relationship where someone could really be available for her. As she was expressing this, another feeling showed up. Client: “I feel deep anxiety.” Therapist: “Where is the anxiety in your body?” Client: “My diaphragm.” Therapist: “Can you put some space around it and take some slow deep breaths?” Client: “I’m not being logical. I should just leave him. But I don’t want to leave him. He says kind things to me, offers to work it out. I really care about him. He’s clear about his intention that he wants to be with me!” Therapist: “There are a lot of conflicting feelings.” Because we are on the phone, I want to keep the connection and let her know that I am here and that I hear her. Client: “I’m scared. Lonely.” Therapist: “Yes, there’s a part that’s scared and lonely.” I want to support this part. Client: “It’s like a pouting child!” And it feels like she is putting down that part. It is like some part of her is shaming that part of her for wanting what she is wanting. Therapist: “I wonder… I’m curious if there is some shame around that part?” Client: “Yes.” Therapist: “Can you look around and find an object to represent the part that comes out and shames you when you talk about your attachment needs?” Client: (Apparently looking around her room for a few moments) “A hat.” Therapist: “How does a hat represent shame?” Client: “I put it on myself!!! I have a hard time asking him to meet my needs and I’m scared that they won’t get met again. That he’ll cancel plans with me again!” Therapist: “Maybe the shame comes out to put you down for feeling what you’re feeling?” Client: “Yes. If I’d recognize those things, logically, I would leave.” Therapist: “That inner conflict is so painful. So one part of you shames you for having normal wants and needs from him, and when you think he lies again or cancels plans, then that part shames you again for not leaving.” Client: “He told me he couldn’t have me over because he didn’t want his neighbors to think I was a homewrecker because his ex just moved out. So now I feel shame for wanting to come to his house. It’s been over six months we’ve been dating. So when is he going to tell people?” Therapist: “How did you feel when he said that? Client: “Insecure! Nerves all over my body. On edge!” Therapist: “What did the nerves say?” Client: “Run!” Therapist: “And what did you do when you felt that strong urge to run?” Client: “I’m feeling shame about my feelings. He’s good with his words, but his actions don’t match. Then I feel shame for wanting to leave.” Therapist: “I wonder if this current feeling of shame reminds you of anything that happened before in your life.” Client: “I feel so much shame in this relationship. It reminds me of my last relationship.” Therapist: “The one where the guy was hiding his porn addiction and hiding his other lovers?” Client: “Yes. That was terrible. But I want to give this guy more opportunity, more time to show me that he can make the life for us he is always promising. I want to give him the benefit of my doubts. I want this relationship to work.” Therapist: “Of course you want this relationship to work. Can you turn to the plant that represents your needs? What does the plant say?” Client: “The plant says, ‘You’re making yourself suffer!’” Therapist: “What does the hat say?” Client: “It says that I’m ashamed of my feelings. I’m embarrassed that I want him to visit me instead of his kids. That’s terrible.” Therapist: “What does the candle say?” Client: “It says that I don’t need to shame myself for my feelings. I have light inside me. I need to remember.” I’m wanting her to stop here and reflect and to work to understand if maybe there is something here for her to be shameful for. That would be a form of healthy shame. Therapist: “Sometimes shame can pull a person out of her deep knowing by cutting off the life force or the light. Sometimes there is healthy shame that tells a person that there is something he or she is doing or another person is doing that is actually shameful, that should be shameful. And there might be helpful information here if this is healthy shame. Healthy shame can help a person make new decisions or understand things in a different way. Here is some homework to do before our next session. Get out your journal at the end of the session and ask yourself, ‘What did I get from this session?’ Please write it down. And please write down some of these questions. Please do some journal writing to answer these questions.”
In Dancing with Fire, A Mindful Way of Loving Relationships (2013) John Amadeo writes “Stumbling into adolescence and adulthood we may continue to hear the message that we are too selfish, needy, or flawed to be loved. The resulting isolation generates emotional suffering that is often unbearable. This begins an epic journey of scrambling to figure out who we need to be in order to win love and connection” (p.23). He writes that we lose the thread of connection with ourselves. “Shame prompts us to seek affirmation and approval rather than connection and intimacy. We look outside ourselves to sense whether we’re emotionally safe” (p 111). Many people end up looking outside themselves to find out how they feel or even what they should be doing. See part 2 for the continuation of this article. PART TWO
Understanding Shame Shame is a primary emotion. The role of shame is to warn us and protect us. Our nervous system shuts down and we actually lose cognitive ability when we are feeling ashamed. Two indicators of shame are confusion and stuckness. Shame can freeze both mind and body. Shame is so difficult to see and cope with because it often hides behind other emotions. Shame is wired into our nervous system to protect us by lowering our emotional intensity and capacity to act. It is important to differentiate healthy shame, which can help us pause and rethink, from toxic shame, which can produce paralysis and leave a person so frozen that he or she is incapable of action and clear thinking. Healthy shame can lead a person to take responsibility for his or her actions, reassess, and make changes. Daniel Hughes, in Attachment Focused Family Therapy, writes that shame places a person in a fog that gets in the way of the intersubjective experience of being understood with empathy that can help a person gain understanding and acceptance. Also, shame itself can prevent a person from being able to reflect on their behavior or experience (p. 184). In the Eight Keys to Safe Trauma Recovery (2000), Babette Rothschild notes that “shame, quite simply, tells us that something is amiss” (p. 87) and that “Rather than discharge, as an example in yelling or crying, shame dissipates, when it is understood or acknowledged by a supportive other. More than any other feeling, I find that shame needs contact to diminish” (p. 92). Rothschild describes a process for deciding when to address shame, understanding the value of shame, apportioning shame fairly, and sharing shame (pp. 98–100). Shyness In the book The Authentic Heart, John Amadeo explains shyness can actually be a friend. “Shyness is an entrance into a tender fold within your authentic heart” (p. 110). But shame can cut both ways. “shame can be debilitating when you’re ashamed of your shame” (p.70). By replacing control with trust and by beginning to trust and express feelings, shyness can serve as a guide to use shame in a healthy way. One of my clients reported the comfort of shame like a blanket, like a burka, covering her grief after the sudden loss of her father and the shame of friends who expected her to just return to work after her three days of mourning period. Many clients let this feeling of extreme shyness, even social anxiety get in their way of making friends or living their life. Role Development In the chapter “Psychodrama” by Antonia Garcia and Dale Richard Buchanan in Current Approaches in Drama Therapy by David Read Johnson and Renée Emunah, editors (p. 396): “Moreno believed that the self emerges from the roles we play. He postulated that when people learn a new role, they follow a particular pattern of role development. The arc of the learning curve begins with role taking and proceeds to role playing and role creating.” The authors also say: “Dysfunction occurs when a person has a lack of either social roles or psychodramatic roles, and function is seen as having a balance of both.” First, a person can’t imagine a certain role, so I tell them a story about someone who had that experience. Then I may suggest a conversation that that person may have. Moreno wrote that “In order to develop functionally, each of us must first be doubled as newborns” (p. 43). So much of the work I do in the therapy session is about mirroring the client. This list is from my chapter “Almost Magic: Working with the Shame that Underlies Depression” in The Use of the Creative Therapies in Treating Depression, edited by Charles Meyers and Stephanie Brooke. I wrote a series of therapeutic processes to work with shame that can be used over the internet as well, as I describe in the case that follows (p. 236). Working with Shame
A teenaged client complained of feeling “a presence watching me sometimes.” As we worked, I wanted to understand about the presence she sometimes felt while undressing and also when she got home from school. I wondered if it was perhaps an externalized voice of her inner critic, so I asked general questions about how she felt at school, at home, and listened for something that said she might feel judged or criticized. I asked when she felt the presence most strongly. She said she felt it most strongly in school when, even though she knew the answer, she felt shy to raise her hand, worrying that the other person would be thinking that she would give the wrong answer and that maybe wasn’t smart. She had fears of letting herself down and letting down her family. Over time I normalized her concerns by telling her that some of the developmental jobs of this particular time in her life were about comparison and finding her way socially as well as academically. I shared briefly about my shyness in high school and ways that I overcame it. This helped to normalize what she was going through and model that it was possible to get through it. I helped her begin to feel inside her body by doing grounding exercises and stomping her feet. At some point she could feel inside her body and began to feel lighter and more hopeful. The next time she felt the presence was on a trip, and she was able to use coping skills to put her attention on other things. During one Skype session we used symbolic imagery to represent the part of her that was afraid that if she showed up as her real self in school, and people still didn’t like her, then she would feel destroyed. Describing the imagery helped her to develop empathy for the part of her that needed protection. In one session I asked her to imagine a movie or play with similar characters to the situation the client is coping with in her life, like a waitress and a customer. I said, “Let’s say the waitress made a mistake with the order. And in the first scene, let’s say the customer is a mom who used to work as a waitress. How would the girl who was a waitress feel? Terrible, just terrible. And if the customer left a big tip then the waitress would realize that she had gone through the whole dinner remembering her mistake and thinking about it.” I asked, “Would you have compassion for the young waitress? You know how hard a job that is and she is just learning.” My client replied, “Yes, but you know, if the woman gave her a big tip it is because she probably thought she was a loser.” “Wow,” I said, “That’s pretty critical. Let’s change the scene. Same kind of scene, but a different movie. Let’s say it’s the same waitress and the customer is someone her same age. Let’s say he’s a guy this time, a cute guy. So how would the waitress feel if she made a mistake at his table?” “Even worse,” she said. “So much worse, because he’s someone she wants to impress. That would be horrible!!! She probably would just feel like she’s wrong for even thinking he was cute, if she made a mistake with his order.” “And what about the tip? What if he left a big tip?” “That would be the worst,” she said. “Why?” I asked. She sighed and said, “If it was someone her own age and she made a mistake, that would be horrible.” “Why?” I asked. “Because he would know how awful she really was.” As we discussed the imaginary scenes and went into detail exploring the different levels of imagining embarrassment, my listening to her rather than judging her allowed her to share the level of inner criticism she was coping with. “So is there something you could tell the waitress about each of those scenes?” I asked. “Given that it’s a new job with a high learning process, what would you tell the waitress, if you could, to reassure her?” I asked her to replay the scene one more time, then said, “If you could go back and change one thing after the mistake, what would it be?” For the first scene my client had the waitress tell the female customer how sorry she was, and that she was just learning this new waitress job. I asked her to imagine how the woman would respond. She said, “She might laugh in a kind way and say that she remembers what it’s like to learn something new.” I asked her how that felt. She paused and said, “Not so bad when we talk about it.” I had her go back into the second scene with the cute guy. She imagined telling him later that it was her first day, so of course the job was new. She imagined the waitress then joking with the guy and both of them laughing! I asked, “How does that feel?” “So much better,” she said. I asked, “So how does your body feel?” She replied, “Lighter… A little more space.” “Where is the space?” I asked. She pointed to her chest. We both breathe a sigh of relief together over Skype. As we unpacked the scene, she admitted surprise at how easy it was to imagine the waitress talking about her mistake and saying what was happening for her instead of keeping it all inside! I asked about the feelings of embarrassment. She said they were much less. And she couldn’t wait to practice this next week. I ask what she’s taking from the session, and she reports feeling lighter and less worried about the pressure she has been feeling. I explained that we were working on several levels. One level was giving her tools to cope with the experience of the presence and the shyness. On another level we were working with symbols to understand the role that the presence had for her and other ways to relate to it. On another level we were working developmentally about what it is to be female in high school and all the issues of dating, finding her place with the other kids socially and intellectually. She began to understand that the presence was something she could gain more control over, by shifting her focus away from it by talking to family, friends, and getting busy with schoolwork. Eventually she realized she had gained a different relationship to it and it bothered her less and less. As she became more comfortable with saying what was going on with her instead of hiding behind her shyness, friends started to reach out to her more and she didn’t feel as alone. The power of somatic imagery helped. Role plays that we did over Skype helped. The eye contact we had over Skype helped her feel normal and that this was part of her life journey. She reported learning to laugh at herself, something that had been very hard, in a way that was counter-shaming for herself and the other person. She reported that it took the pressure off of herself and the other person when in an uncomfortable moment. She said that sometimes she wasn’t worried what the other person was thinking. Along the way we found things she could say in her new role of power, taking her locus of control back: “I’m committed, I’m ready, I’m in control. In sessions she felt a calmness in her body and a relaxedness. That’s how I would track. I would track her aliveness returning in the sessions. She first felt like a cold fish. After each session she felt a little more hopeful and a little surer of herself. Her somatic awareness also increased. She became more hopeful and began taking a few risks by sharing more what was going on with her. We found a way for her to talk to herself in a kind counter-shaming voice inside. Imagination Activated via Drama Therapy and Expressive Arts Therapy From our workshops and from an unpublished paper on “Healing Shame in the Imaginal Realm,” Bret Lyon, Ph.D. and I present that: When a person gets stuck in shame, the most powerful way to get unstuck may be to activate his or her imagination. In the imaginal realm, logic and time are fluid and flexible. What actually happened can be explored and changed. What was stuck can be reexamined and shifted. Shaming situations from the past can be revisited, excavated through writing and expressive exercises, and thereby shifted. There are ways to give back the shame to where it belongs—through drawing, writing, and imagining past shaming experiences and saying now what you wish you had said then. Structured writing and expressive processes can symbolically give back the shame. This is where to find resilience. This work needs to be done with extra care when the session is over the internet, because the person can quietly slip into the shame vortex. I develop exercises to help them have something to hold on to during and after the session. Renée Emunah, in her book Acting For Real (1992), writes about “Drama Therapy as the intentional and systematic use of drama and theater processes to achieve psychological growth and change.” Psychodramatist and child psychiatrist Adam Blatner, expounded in “Foundations for Psychodrama” that psychodrama can offer a place for expressing unexpressed feelings and even replaying scenes of the past, expressing feelings now that have not been expressed, and for opening new possibilities for the future.” There is the idea of surplus reality in which a person can play with and change a conversation or an event that happened in the past where they felt shame and replay it to take a new role. The idea of act hunger that can be explored where unexpressed parts of a person can be invited into the psychodrama scene. Sometimes I use psychodrama just sitting with a client and ask them to imagine some things. Conclusion: Working with Counter-Shaming Metaphors There is much to be explored in this new world of online therapy. There is much to be explored. There is much to be created. I am excited about being able to reach people who don’t live near me and to do work online. I am excited about developing ways to work through shyness and awkwardness and shame using a combination of drama therapy, expressive arts and attachment work/psychotherapy. What I realize is that because they are home or at work when we do the session, they can actually have a power symbol or drawing or object on the shelf that we work with during the session and put on their desk or shelf behind them to help them keep ahold of the changes between sessions. References Amadeo, J. (2001). The Authentic Heart: An Eightfold Path to Midlife Love. New York, John Wiley and Sons. Amadeo. J. (2013). Dancing with Fire, A Mindful Way to Loving Relationships. Weaten, Il, Quest Books. Blatner, A. (1988). Foundations of Psychodrama: History, Theory, and Practice. New York, NY: Springer Publishing. Emunah, R. (1994). Acting for Real: Drama Therapy Process, Technique, and Performance. New York, NY: Brunner/Mazel. Fosha, D. (2000). The Transforming Power of Affect: A Model for Accelerated Change. New York, NY: Basic Books. Graham, Linda. (2013). Bouncing Back: Rewiring Your Brain for Maximum Resilience and Well-being. Novato, Ca.: New World Library. Lyon, B. and Rubin, S “Through the Looking Glass, Using Imaginal Resources to Heal Shame; A Workshop for Therapists,” an unpublished paper, Berkeley, CA Hughes, D. A. (2007). Attachment-Focused Family Therapy. New York, NY: Norton & Company. Potter-Efron, R. (2011) “Therapy with Shame Prone Alcoholic and Drug Dependent Clients.” In Shame in the Therapy Hour by Dearing and Tangney, APP Johnson, S. (2005). Emotionally Focused Couple Therapy with Trauma Survivors: Strengthening Attachment Bonds, NY, NY. The Guilford Press. Kaufman, G. (1974). “On Shame, Identity and the Dynamic of Change.” Paper presented at the annual meeting of the American Psychological Association, New Orleans, LA. Retrieved from http://files.eric.ed.gov/fulltext/ED097605.pdf Kaufman, G. (1992). Shame: The Power of Caring (3rd ed.). Rochester, NY: Schenkman Books. Nathanson, D. L. (1992). Shame and Pride: Affect, Sex, and the Birth of the Self. New York, NY: W. W. Norton & Company. Rubin, S. ((2015) “Almost Magic, Working with the Shame That Underlies Depression; Using Drama Therapy in the Imaginal Realm,” in The Use of the Creative Therapies in Treating Depression, eds. Brooke S. and Meyers, Springfield Illinois, C. Charles Thomas. Rubin, S. (2007) “Self-Revelatory Performance” in Intercalative and Improvisational Drama: Varieties of Applied Theatre and Performance, ed. Blatner, A. Universe. Rubin, S. (2017). “Unpacking Shame and Healthy Shame: Therapy on the Phone or Internet.” In S. L. Brooke (Ed.), Combining the Creative Therapies with Technology: Using Social Media and Online Counseling to Treat Clients (pp.187-198). Springfield, IL: Charles C. Thomas. Schore, A. Affect Regulation and the Origin of the Self: the Neurobiology of Emotional Development. 1994 New Jersey, Lawrence Erlbaum Assoc. Publishers. USABP in partnership with the Dillon Fund has awarded $290,000 for trauma recovery research.8/12/2020 Kinsey Institute Receives $290,000 Gift to Further Trauma Research
The United States Association for Body Psychotherapy (USABP) in partnership with the Dillon Fund has awarded a $290,000 gift to the Kinsey Institute at Indiana University. The gift will provide funding for trauma recovery research being conducted at the Kinsey Institute Traumatic Stress Research Consortium (KI-TSRC). “We are excited about the promising research the KI-TSRC is producing in response to the COVID-19 pandemic, and are happy to continue our shared support of this valuable and unique mission,” said Dr. Christopher Walling, President, USABP. Led by Distinguished University Scientist Dr. Stephen Porges, the KI-TSRC’s mission is to explore the science of human connection and the role that stress and trauma experiences play in disrupting a person’s ability to feel safe and to socially engage. KI-TSRC research emphasizes that social engagement is essential to health and wellbeing across the lifespan. With the collaboration of over 700 therapists specializing in trauma, the KI-TSRC is collecting data on the therapeutic needs of trauma survivors and the clinical practices of their therapists in order to advance research, develop innovative tools and methodologies, and further clinical care. Dr. Jacek Kolacz of the KI-TSRC is currently leading a study that seeks to learn about coping behaviors and mental and physical health during the COVID-19 pandemic and how they are impacted by prior trauma history. “In times when funds are scarce, philanthropists can make a difference and partner in the healing process by funding KI-TSRC research to uncover the diverse needs of our fellow humans today and offer accurate, effective support for trauma recovery tomorrow,” said Katherine A. Wolovsky, MA, Co-Director, The Dillon Fund. In addition to this impactful gift of $290,000, the USABP and The Dillon Fund previously gave $260,000 in 2019 to support the KI-TSRC’s trauma research and archival preservation. “We are incredibly grateful for the ongoing support of the USABP and The Dillon Fund. The continued confidence and generosity of our donors and Advisory Council members allows our research faculty to stay at the forefront of important and timely scientific research, including the effect of the COVID-19 pandemic on health and wellbeing,” said Dr. Justin Garcia, Executive Director of the Kinsey Institute. ----------------------------------------- About the USABP The United States Association for Body Psychotherapy was founded in 1999 to help develop and advance the art, science, and practice of body psychotherapy and somatic psychology in a professional, ethical, and caring manner in order to support their members as they promote the health and welfare of their clients. About the Kinsey Institute For over 70 years, the Kinsey Institute at Indiana University has been the premier research institute on human sexuality and relationships and a trusted source for evidence-based information on critical issues in sexuality, gender, and reproduction. The Kinsey Institute's research program integrates scholarly fields including neuroscience, psychology, anthropology, history, and gender studies. The Kinsey Institute Library and Special Collections encompass over 500,000 items spanning 2,000 years of human sexual behavior and are a destination research collection for scholars and students. Kinsey Institute outreach includes traveling art exhibitions, public scholarship, research lectures, and a continuing education program. For more information about the work of KI-TSRCplease visit kinseyinstitute.org or contact [email protected] ----------------------------------------- To continue these types of impactful services we draw upon readers like you to help us out. Would you like to donate to our cause? The United States Association for Body Psychotherapy Board is pleased to announce it has granted its inaugural Scholarship in the amount of $7,500 to Mystique Hargrove from North Carolina for the 2020-2021 academic year! Mystique is a first year doctoral student at Capella University.  Mystique is currently working on her dissertation topic for approval in hopes to focus her research on race based trauma among Black LGBTQ+ individuals. Outside of her doctoral studies, Mystique is a single parent to a very energetic and loving 5 year old, who she homeschools as well. Mystique is also a community birth worker who is certified as a full spectrum doula as well as a community lactation professional who services Black bodies and other bodies of color in Greensboro, NC and surrounding areas. Mystique says she is working "to improve accessibility in offering more inclusive services and support for Black bodies and other bodies of color, especially in the LGBTQ+ community.” Her vision is to provide the needed research as well as mental health and wellness services centered around identifying, assessing and treating minority stress and race based trauma within these communities. On behalf of all of us at USABP, congratulations Mystique! We are pleased to announce that USABP Member Carl H. Shubs, Ph. D. is deeply honored and appreciative of having been given the Award for Outstanding Practice 2020 by The American Psychological Association (Division 56 – Trauma Psychology) “to celebrate you and your fantastic work for Trauma Psychology [and] your amazing contributions to the field.”
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