An introduction to the somatic energetic

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  • 1. AN INTRODUCTION TO THE SOMATIC-ENERGETIC POINT OF VIEW IN THE THERAPY OF TRAUMAPhilip M Helfaer, Ph.D.PART I. DESCRIPTIONNoteThese brief notes introduce the somatic-energetic point of view in its application in the individualtherapy of trauma spectrum disorders. They are also an orientation to the rest of the papers in thisseries which continue the development of the somatic-energetic point of view and which describeother applications.[Societal Context][An indication of the significance of the field of trauma studies in the U.S.A. is that The Division ofTrauma Psychology is among the fastest growing field in the American Psychological Association.One of the stimulants for this growth in the U.S.A., as no doubt elsewhere, is not simply the largenumber of returning soldiers from the wars in Iraq and Afghanistan, but the increasingly alarmingawareness that a large proportion of them are seriously disturbed as a result of exposure totraumatic stress related to military service. This makes the study (and the conflicts surroundingsuch study) of P.T.S.D., its diagnosis and treatment, of pressing importance. However, there areother influences that elevate trauma in professional awareness. Catastrophes, both natural(Hurricane Katrina) and terroristic (the 9/11 attack on the New York Trade Center) sent thousandsinto shock and traumatic stress even as the events were being witnessed in the media. Like thereturning soldiers, these events and their effects could not be avoided. Prominent social influencesalso increase professional engagement with the effects of trauma: the various organizationsrelating to establishing safety and equality for women in society and the related movements forprotection of children of both sexes.]Personal context
  • 2. My own engagement with trauma studies and therapy came about in an entirely personal way. Ihad been aware of concepts of shock, dissociation, and trauma since early in my studies inpsychology and psychotherapy. However, when I experienced some aspects of the effects of myown developmental traumas, both emotionally and more exactly somatically, I gained a moreserious understanding of the significance of what “trauma” means as it effects the individual.The avenue by which I arrived at these insightful experiences was largely through my activeengagement with the discipline of bioenergetic analysis, which I designate here as a somatic-energetic approach to the study of the individual and to therapy. My professional engagementwith bioenergetic analysis resulted from personal experience of a serendipitous sort, certainly notfrom being exposed to it as a graduate student in psychology in the 1960’s. The serendipitousexperience occurred at the Esalen Institute in California, where I visited shortly after finishing myPh.D. There interesting people were teaching, experimenting with, and developing techniques forpersonal development that centered in inner experience and the body, rather than from acognitive or intellectual perspective. I found this very refreshing after so many years in academia.One day I had a very deep experience in which I found myself feeling very alive, at peace, joyful,and with a deep sense of connection with the natural world around me, which also felt alive. Tome, this was a highly desirable state. Could one live in such a state? Could it be the focus or goal ofa therapy? I set about exploring the possibilities, and in doing so embarked on what has turnedout to be quite a remarkable journey.Clinical Example and DescriptionsThe phrase somatic-energetic indicates that the therapy centrally involves perceptions andinterventions relating directly to the body, (as well as the mind), and aspects of the observed dataon which the therapy is based are energetic phenomena. An important example of an energeticphenomena is the manner in which the patient speaks.Mav, a gifted professional woman of sixty, shared her current status and life experiences in anintense, highly articulate, way that was charged with energy and a kind of inner pressure. As Ilistened to her profound, insightful, and thorough accounting, I respectfully asked several times tobe allowed to interrupt and invited her to pause, take a breath, and to feel her body and how shewas experiencing the pressured talk. At the end of each period of recounting, Mav experienced asense of what she described as a “collapse.”
  • 3. Comments on these observations and interventionsI describe Mav as she is sitting and talking. We had shared our mutual observation of the energeticqualities inherent in her self-expression. First, and very obvious, was the rapid, driven effort, as ifto discharge a disturbing energy. This energetic trait, the therapist will realize that it is of essentialsignificance to Mav’s functional situation. We will return to it. Second, we shared notice of thesense of collapse after the completion of each segment of her recounting. This sharing ofobservation, or tracking, of the energetic phenomena is an essential therapeutic process.‘Collapse’ is a word that invites exploration. Initially, the therapist really does not know what‘collapse’ means to the patient, what she is expressing when she uses the word, or what thepatient experiences that impels her to describe her experience with this word. The therapist can,however, sense that the patient is alluding to a body-state. The therapist can sense this from theuse of the word, the manner in which it is expressed, and the therapist’s own bodily reaction tothe word or phrase containing the word. Developing the capacity to sense the allusion to the bodystate is an aspect of learning the somatic-energetic point of view. This is how one learns the“language of the body.” This is not remarkably different from learning to listen for unconsciousmeanings in the psychoanalytic process.A body-state is a non-verbal bodily experience that has the significance of depth in terms of itsconnection to unintegrated traumatic material and the unconscious. Bringing attention to thatbodily state is the most direct route to these deeper aspects of the patient’s functioning. It is alsoa safe, controlled, and integrating route (Eckberg 2000, p.49).The therapist, upon sensing thebody-state reference, has options as to how and whether to initiate further somatic exploration.The patient may or may not be able or ready to follow such an invitation. The body-state maystimulate further disassociation at this point, and this may interfere with her ability to report on abodily state or bodily experience, and her mind will deflect her into associations, narrativememories, or another topic. In Mav’s case, her deep contact with herself allowed a therapeuticallysignificant exploration of the experience of collapse.Session continuedMav recounted that at the moments she “collapsed,” as for example, when she had completed aseries of historical associations, she felt on the verge of a kind of dissolution of her ego and afalling. These were not pleasant releases or relaxations. To her, they represented the possibility of
  • 4. insanity. Mav considers that both her parents were periodically psychotic during her growing upyears. Would she be like them? In her mode of adaptation, she believed that as long as she wasmoving and on the go, she would remain functional. She would also however, remain in a state ofdisassociation and tension, unable to relax, give in, be more comfortably in her body, and trust herinnate functional capacities, all of which contributed to her state of ongoing suffering and pain.Further commentsAll these explorations and elucidations evolved as Mav sat and described her current and ongoingexperience. A description of ongoing, daily experience will include accounts having to do withrelationships, work, love, and aspects of self-regulation such as eating, sleeping, and exercising. Itshould also include accounts of – as well as expressions of – the emotional aspects of affectregulation. These include moods, feelings, and hedonic tone. These are of the greatest significancefrom an energetic point of view. Feeling is life. The lack of feeling indicates a lower energetic lifestate, and this implies inhibited respiration. A depressive tone is a marker of the state of life in theorganism. Often it is associated with anhedonia, the lack of the capacity for pleasure, one of themost unfortunate states associated with trauma spectrum disorders and other types of problems.All these states and conditions need to be observed by the therapist, and the patient’s interest,involvement, and curiosity about them are to be mobilized. It is the therapist’s task to involve thepatient in somatic-energetic explorations and interventions that engage and energize these states,and lead to developmental explorations. This is a mutual enterprise. A significant form of learningand development for the patient is to arrive at a functional realization of the relationship betweenan inner experience and the somatic-energetic process which, in effect, mediates between theconscious experience and the body.I am elucidating and demonstrating that the therapeutic process follows and focuses on thesomatic-energetic process, from moment to moment in the ongoing session. Associations,narrative memories, and recountings of current experiences are a background interwoven withthe somatic-energetic process. This background is not ignored. The therapist tracks it. In doing so,the therapist has the opportunity to observe whether and how the various narrative, verbalthemes correlate with and further elucidate – or are disassociated – from the somatic-energeticprocess that is emerging. This process – tracking and correlating – is of the utmost importancetherapeutically. It allows the process of the therapeutic session to remain on a meaningful track. Ibelieve this aspect of the work, amongst others, is unique to a somatic-energetic approach.From sitting and talking, we moved to another phase of work together. At my suggestion andMav’s agreement that it felt like the right time, she moved to a standing position. Standing and
  • 5. feeling the feet on the ground is a simple, direct way to have an overall experience of one’s ownbody.The session continues to developShe stood, and I invited her to track and report body sensations. This proved to be difficult. It wasas if inner pressures and forces diverted her from attention to her body, and she quickly went intoassociations, memories, and descriptions each time she returned her attention to her body.Comments and a characterological formulationIn bioenergetic analysis, this standing position, with attention on the feet, is considered agrounding process, and it has energetic significance. The move from sitting to standing allows thepatient to experience her body in gravity and it reveals to the therapist how the patient holdsherself and how she connects to the floor through her feet. All this reflects her adaptation tostress, and often just how chronically stressed she may be, as well as the characteristic tensionsthat reflect the stress. These are observable, often characteristic, aspects of the individual’sfunctioning. Learning to look at the individual in this way is an aspect of learning the somatic-energetic point of view.As Mav is standing we gain further perspective on something we observed earlier as she wassitting and talking. There is a kind of inner charge or excitation which she is able to describe. Itspreads through her thorax from the diaphragm. It is a charge that seems to be seeking an avenuefor discharge, but does not have a natural channel available for discharge. In addition, we now canobserve a new aspect or impact of it. It has a distracting effect on Mav’s ability to consciouslyfocus on the experience of her body. We could even say the effect is fragmenting, or chaotic, inthat pieces, rather than a whole, emerge in Mav’s somatic reporting about herself in therelationship with the therapist.These observations add confirmation to an impression that began to emerge earlier. A degree andtype of fragmentation characterizes Mav’s sense of her own body. An inner force or energy is partof what drives that feeling, and in addition, there is a sense of dissolving and falling that canemerge when Mav’s talking quiets for a moment. These experiences are quite typical for traumaspectrum disturbances. We will learn more about it in the next phase of the session.
  • 6. A deepening phase and integrationEventually, after experiencing this kind of chaotic and pressured experience, I invited Mav to lie onthe mat, and focus on her breathing. At this point, she was certainly well aware of the innerpressure. As a result, after she lay down, she soon began to cry deeply. As Mav lay on themattress, her knees where up, so that she could press her feet into the mattress, to maintain asense of her feet. Soon, following her body, she allowed a strong rhythmic rocking motion todevelop from her pelvis. I said, “Good, an integrative movement.” Later, I learned that this and afew other simple words of encouragement were helpful and appreciated.Pain, body memory, insight, and further integrationAt the same time, something was occurring that, to me, was quite remarkable. This was thetransformation of a sense of pain into memory with insight. Mav began to speak of how much painshe was feeling and often felt. When I asked her where in her body the pain was experienced, shesaid it seemed to have no “where” to it. There were no specific body sensations. She then said thatit had to do with “enduring.” Day in and day out, she had to endure a horrible, torturousatmosphere in her childhood home in which she was constantly subjected to parental craziness.She was regularly related to with hate, emotional and physical sadism, and the parents’exploitation of her for their own narcissistic needs. We shared the belief that the pain she hadbeen experiencing was what we call a “body memory,” a direct reflection of what she hadexperienced and “endured” as a child and adolescent.Comments: body memory and character formulationA body memory is a memory that is remembered as a sensory experience, usually due to energeticor emotional arousal. The work of somatic-energetic therapy often awakens such memories.These memories are recorded in the usual neurological memory channels of the brain. They arenot “narrative,” or explicit memory. They are encoded as limbic, implicit, or procedural memory(Scaer 2001, 2005). This means they emerge as sensation or feeling, often without a picture orstory. The familiarity of the sensations may bring a story or picture to mind. As commonly noted,much of traumatic memory is of this sort.
  • 7. Scaer’s (2005) concept of somatic dissociation suggests a possible neurological mechanism thatilluminates the body memory phenomena. Somatic dissociation is a function of changes in theautonomic innervation of specific end organs(muscle fibers, or etc.). When a muscle group thathas been dissociated is stimulated through somatic-energetic interventions, it may eventuallystimulate limbic memory channels through effecting autonomic innervation.The energetic impact of Mav’s parents’ psychotic way of relating to her is “stored” in Mav’sneurology, and it is experienced as a constant painful inner pressure, anxiety, or drive excitation.There is no normal avenue of release or discharge for it, just exactly as Mav could only endure andsuffer her early experience. A good-enough holding relationship allows the child’s emotionaltensions to be held and allowed to relax or release. The holding relationship is the child’sstructural requirement allowing for integration of emotional experience and the learning of self-regulation. To be under constant attacks of various kinds and to endure became the model, forMav, for what relationship is. The pressure was unrelenting and kept her on the edge of herbiological resources, always with the threat of fragmentation or of the ego being overwhelmedand dissolving. There remains aroused in her body a strong fragmenting energy which constantlydrives adaptive efforts in the hope of soothing connection and relief.There was one saving grace. Mother supported her intelligence and school work. Also, by takingon the role of caretaker of younger siblings, she developed other relational and adaptive skills.With these skills, she survived as an intact person, and was able to develop herself, but alwaysunder enduring traumatic stress.Eckberg (2000) also observed the transformation of an experience of pain into some other kind ofbody sensation and a memory.A client was experiencing body memories associated with a childhood memory of sadisticpunishment. She experienced the sensations as painful. After working through the memories anduncoupling the terror and immobility from the sensations (which took many sessions), she said,“Why, they are just sensations; they are not really painful.” (p.54)The relationship between various kinds of chronic pain syndromes and trauma has been exploredneuropsychologically by Robert Scaer (2001, 2005). The alleviation of some types of these painsyndromes through somatic-energetic therapy may be considered clinically demonstrated.
  • 8. Note on this sessionThe extensive depth and integrative potential of this session are made possible by threeconditions, (amongst other factors). We had created the opportunity to work for an extendedperiod of time, about three hours. Mav, herself, has had extensive therapy and has continued todo her own therapeutic work over many years. She was highly motivated and ready to makeimportant changes in her life. In an ordinary, ongoing therapy, this work would require weeks, ifnot months. As an extraordinary session, it provides a unique window into the process of somatic-energetic therapy.On somatic-energetic therapyI believe that a somatic-energetic therapeutic session of this sort reaches the limits of what istherapeutically possible in the most positive sense. In the bodily, emotional, and sensoryexperiences that emerge are seen the deepest sources of the ongoing traumatic stresses thatconstantly created pain, tension, and suffering in Mav’s life. Even more important, we are notsimply observers of the sources of suffering. The somatic-energetic experiences that emerge andthe way in which they emerge are the steps in releasing ancient painful reactions that have beenlocked into Mav’s neuropsychology since childhood and adolescence. These sensations emerge asreleases of tension within a holding relationship. Mav feels tangible relief at the end of thesession.Not only is tension released, there is integration of previously unintegrated traumatic material. Inthis session, integration occurred through bodily movement, and through the transformation of akind of body sensation into a conscious memory that connected with historical narrative. How canbodily movement foster or be an aspect of integration? This can be understood immediately if weremember the situation of a child in Mav’s position: movement, expression, appropriate use ofaggression, even free expression of feeling must be inhibited in the service of adaptation,maintenance of the semblance of attachment to the parents, and even survival of the integral self.Under these conditions, the autonomic nervous system, unable to mobilize either for fight or flightgoes into freeze. Somatic energetic work can release a freeze through breathing and movement,allowing a part of the early trauma reaction to be completed.
  • 9. One important physical sign of the relief Mav experienced deserves mention. This has to do withher breathing. Often after a session, there is an easier, deeper breathing, along with the feeling ofrelief. Mav’s breathing, she reported, for many years was what bioenergetic therapists refer to as“paradoxical breathing.” This is an uncomfortable breathing in which the lower abdomen, insteadof extending and
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