Bringing the Body into the Therapy Room
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Integrating awareness of the body within a talking-therapy context can have a surprisingly powerful effect on changing our psychological patterns. In practice, it’s a bit like bringing mindfulness into dialogue with another person. But tuning into our bodies often begins with noticing unpleasant, unwanted sensations. This is exactly why I want to use an example from the therapy room, where my client, Rosie, managed to become relaxed and confident going into an operation that she’d been terrified of. Navigating through and beyond our physical experiences can enable us to shift the tracks of our nervous systems and transform experiences like anxiety.
Mind–body therapies have been gaining increasing attention in recent years (Scharff, 2017), with a growing awareness of how strongly linked our mental and physical well-being are. There are many studies on the effects of practicing mindfulness meditation (Sundquist, Palmer, Johansson, & Sundquist, 2017), acupuncture, doing yoga (Rankin-Box, 2015), and breathing techniques (Alderman, 2016), which show the links between these practices and reducing stress, anxiety, and depression. There has been a great deal of research into the brain–gut connection (Carabotti, Scirocco, Maselli, & Severi, 2015), revealing how much our guts influence our mental health (Rieder, Wisniewski, Alderman, & Campbell, 2017). Advances in the neuroscientific research on the brain and body in trauma also abound, an excellent starting point for which is Bessel van der Kolk’s book, The Body Keeps the Score (2014).
In any kind of body-based therapy, when the therapist talks with her clients, she is also listening to what their body is saying: the way they hold themselves, the places that seem tense, stuck, or absent, how they become animated or worked up, or collapse and shrink into the chair. At various points in my conversations with my clients, I slow things down and ask them to describe what they notice about their experience, gradually including the physical level as well as emotional and cognitive experience.
Bodies can be uncomfortable things. When we start tuning in to them, shoulders have a habit of feeling tense or weighed down, chests can feel tight or like an empty void, and bellies can seem to have minds of their own, becoming tensed and twisted, or like a heavy block. For some people, noticing their bodies means noticing a high level of activation that they have built strategies around shutting out. What’s worse, paying attention to those sensations can intensify them. For some people, starting to actually notice the tension in their belly or chest makes it feel as though that tension is rising up to strangle them in the throat.
Focusing on these experiences can make people feel uncomfortable and frustrated, and can bring a sense of shame or self-judgment. Stronger still, it can make us panicked and overwhelmed. But there is a lot to be gained from learning to dip into these uncomfortable sensations. Taking a slow, titrated approach, we can explore the sensations, learn about them and how they are connected to different thoughts, emotions, and ideas about ourselves, and learn how to move through them.
As a way to engage further with this physical level, I encourage my clients to describe what it feels like their body is trying to do at that moment. What does it feel like the tension is for? Some people feel like they’re ready to spring, while others feel a restless energy of needing to do something, but not knowing what, and are trying to hold themselves together. Others feel like they’re trying to defend themselves against something, or that they’re trying to hide or disappear. Still another pattern is to feel disconnected from their body, becoming numb and shut down. Getting to know these physical patterns can help us change our psychological states, since they are always linked.
Changing the Volume
Near the start of one of our sessions, Rosie* told me that she was feeling strongly disconnected from her entire body, with a sense that there were uncomfortable feelings in her belly that she didn’t want to feel. We had been talking about an upcoming operation, which was triggering a lot of anxiety for her; just thinking of the operation brought intense nausea, and then the feeling of becoming absent from her body. She was filled with dread.
After telling me this, Rosie immediately added that she has felt like this every time she’s been sick since a few years before, when she had passed out when sick. She seemed gripped by this memory, her eyes widening and shoulders stiffening and hunching inwards as she related it. The memory seemed so integral to her current experience that I stayed with it long enough to find out what had been so frightening. Rosie explained how she had been taken to hospital after falling unconscious, and how she remembered feeling completely powerless and weak there.
Just relating the story strengthened my sense of her being frozen in fear, and so I brought us back to the present moment, asking if there was anywhere in her body now that felt a little bit less disconnected, a little more accessible. I made sure she knew that I wasn’t ignoring her feeling of being absent and afraid, and that I was just curious to see if we could shift the focus. I also made sure that I stayed relaxed, with a lightness to my voice, and that I didn’t react to her fear. I’ve been with clients experiencing a lot of fear many times, and I’m usually confident we’ll find a way out.
Rosie realized after a few moments that her face and hands felt more accessible. They felt more in control. I asked her to focus there, suggesting that she even bring her hands to her face so that they were together. She placed her hands over her cheeks and eyes, and gradually they both began to feel warmer and more energized. Starting to smile, she said it felt calming.
A few minutes later, I asked Rosie to put her hands wherever else it might feel good. She placed them on her belly, which had felt so disturbing before. Slowly, the warmth of her own hands seemed to calm the uncomfortable feeling there, and she related feeling more attached to her body again. What could she sense when she was more attached, I wondered, and she replied: “Joy!” I gave Rosie time to explore this experience, which is usually quite unfamiliar to her, encouraging her to try to label the physical sensations that came along with the joy. Both of us found ourselves laughing as she described feeling light and physically able to act—the opposite of powerless!
Movement as Resource
Continuing to describe the sense of joy, Rosie mentioned that it felt like floating in water. Just saying this helped her relax even further. The anxious alarm bells were now definitely off, which was excellent, but I sensed that it would be useful for her to learn to shift again into a more active experience, since her original memory had focused on feeling helpless. Just as an experiment, I suggested that she imagine swimming in that water. I invited her to make micro-movements (tiny movements that are barely visible) of that action, but mostly just to imagine it.
A few minutes of this brought a sense of powerful joy and freedom in her entire body, and she seemed to visibly glow. She talked about having loved swimming as a teenager, and how it had made her feel free. Not only had we journeyed out of a disconnected fear state into a relaxed sense of power, but we had also broadened her self-image beyond identifying with that powerless moment, to remembering an earlier self who had felt free and confident.
After giving her some time to get used to that experience, I brought us back to paying attention to her belly and thinking about the operation, and then back again to the swimming sensations. We repeated this shift of focus between feeling powerful and free, and thinking and talking about the operation, and by the end of the session, the operation seemed something matter of fact to her. Instead of the looming event that brought a flood of anxiety, it had attained the character of one of those practical tasks you just have to get done. As I found out the next time we met, Rosie stayed calm right until the operation, and it went very smoothly.
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