What Does a Somatic Psychotherapy Session Look and Feel Like?

 “At the center of your being you have the answer; you know who you are and you know what you want.” – Lao Tzu

I was recently given the honor of serving as the Topic Expert Contributor of Somatic Psychotherapy at GoodTherapy.org. Each month I’ll be contributing some new content on the subject and will share those articles here as well. Enjoy!!

What I find that many first time somatic therapy clients what to know is, what actually happens during a real session? How is Somatic Psychotherapy different from other forms of therapy? There is often a concern that because we include the body in our work, that somehow this will make things uncomfortable, or a little too out there. Therefore, I have included here a brief transcript from a recent session. I feel serves to provide a road map of sorts for a very typical somatic psychotherapy session. Keep in mind that for every somatic therapist out there, there is a unique way to do this work. No two sessions will be the same. But there are some key elements that I highlight in this session that are typical.

John is a 53 year old marketing executive. He originally came to me with complaints of depression, an increasing reliance on alcohol to feel “good,” and a life long sense of “not being good enough.” At the time of this session, John and I have been working together for about four months.

John enters the room and for the first five minutes or so we engage in chit chat, checking in with each other, exchanging pleasantries, that sort of stuff. John starts to talk about a situation at work that has left him feeling angry and nervous. He had given a presentation and felt he had done a pretty good job. In the break room just following the presentation, John’s boss approached him and asked if he was feeling alright today. A little confused, John indicated he was fine and asked why. His boss noted that John’s presentation seemed “off” and was “less polished” than usual.

While John is telling me this story, I’m both listening to the words, to the content, but I am also carefully listening to his body. I note that his breathing has increased and is coming more from his chest. His face is flushed, the muscles in his jaw are clenching, his right hand has formed a fist, and his feet are moving back and forth.

C: John, I’m curious as you tell me this story what you are noticing happening internally.

J: I’m pissed! I mean what kind of comment is that? What a jerk! (his fist comes down hard on the couch)

C: Yeah, you are pissed! Do you notice how your hand is now a fist?

J: Yeah! And my jaw is really tight.

C: Ah. Yes, it is tight. Just allow yourself to stay with all of that. Notice your breathing, allow your body to speak a little here.

This moment is an important one in any somatic session. We are moving out of talking about things, away from the content and from story telling, to mindfulness and present moment awareness. John has done this before with me, but for several sessions we worked together to help him develop this capacity to notice himself, without any judgment or need to change anything. John becomes curious about what his body is doing, and without losing the story, is able to gather important information about how the story is impacting him, not just in his thoughts, but physically and holistically as well.

J: Wow. I can’t believe how tight I am! My whole arm is tightening up.

C: Stay with that, notice what your arm wants to do.

J: It wants to pound on something! (he starts to make pounding movements with his arm. John pounds his fist a couple of times, then a long pause as he continues to be mindful.)

C: What’s happening now?

J: I feel sad too.

C: Ah, just stay with it and notice. (long pause). See if there is something familiar about this, or if there are any images, or memories.

J: (after a very long pause) Yeah. This is familiar. I’m having a memory of my dad. I’m like… seven or eight… and he is angry at me for something. Oh my God! I haven’t thought about this for years. He was angry that I didn’t catch the football. I was playing football and they passed the ball to me, and I dropped it. (John starts to cry, takes his time).

C: What is happening now in your body?

J: I’m sad, and angry. You know, that wasn’t fair! I was only a kid. (tears and anger) I didn’t do anything wrong! He had no right to be angry at me like that, did he?

C: No, he didn’t John. He really didn’t. That must have been very painful for you.

J: Yeah, it was, it is. (long pause)

C: What do you notice now?

J: My arm is relaxing. I’m thinking about Jim at the office and what he said to me. I think he was sort of like my dad in that moment.

C: Ah, yeah. Jim became your dad?

J: Yeah, and I just automatically reacted to it.

C: Makes sense. Your body wanted to protect you from that shame again, hunh?

J: Yeah. But Jim was actually being nice. He was more concerned about me than judging me. You know?

C: Yeah. Sounds like Jim really cares about you.

J: Yeah, he does. (starts to cry some)

This one short segment of John’s session outlines a very important and typical process in somatic work. We often start with whatever is happening for the person that day, something form work, from their family life, a dream, anything. We move from story telling into mindfulness and pay attention to the body, allowing it to unfold and move. From this place, new information becomes available to the client and they often make discoveries about how they function in the world. There is often a deep sense of appreciation and acceptance. As the body is allowed to move, energy that has been blocked or held for some reason, is able to move through, and we often experience relief and resolution.

This pattern can repeat several times during a session, and can include simple awareness of the body, movement, sound, reenactment, and touch.

So, in some ways, somatic work is very simple. We aren’t trying to figure out complex problems necessarily, or think our way through an issue. The problem is presented and then we create an environment in which the body can speak. All of the answers and resolutions to our problems are held within the body, we just have to be quiet enough to listen and follow.

James – “The Problem Child”

Every year around this time, as the days of summer come to a close, and school gets underway, I get a series of phone calls from concerned and panicked parents. Often they’ve received a phone call from a teacher or school counselor, or returned from a parent teacher conference, and have learned that their child is having trouble at school! It can be a painful moment. Filled with confusion and at times embarrassment, these parents reach out for help.

One such case sticks out in my mind as a clear example of how our system for helping kids is extremely misguided, and often does more harm than good. James was an 10-year-old boy whose parents called me one October day, expressing their frustration with him, with his school, and with themselves. Up until this point, James had been a star student, was well liked by his peers and teachers, and expressed joy and satisfaction with his own progress at school. However, as he entered the fifth grade, everything seemed to change.

One day, his parents received a phone call from his new teacher, informing them that James was disruptive in the classroom, was often out of his seat and seemed to be unable to pay attention. He was observed to stare off into space, and often didn’t respond to his teacher’s prompts. Additionally he often talked out of turn without raising his hand, and was a distraction to the other children. As a quick remedy, the teacher had moved James to a desk that was away from the other kids, in the back of the room. The teacher thought he might have Attention Deficit Disorder and suggested they have him evaluated by a doctor. Both parents reported that at home James was also showing some new behaviors. He didn’t want to go to bed at his bedtime, he was often short-tempered and clingy.

The parents called me for a consultation, not wanting to have their child placed on medication. I sat down with the two of them, gathered my usual background information, and provided an overview of child behavior to the parents. When a child’s behavior changes this is a sign for us as adults to pay close attention. Without the ability to communicate what is bothering them, a child will express his fears, or angers, by acting out. In this way, child behavior becomes a code of sorts that adults must learn to decipher. What is James trying to tell us by this behavior?

We reviewed the past several weeks and I learned that James had not had the usual restful summer that he was used to. Most parents often minimize the impact significant events will have on their children, and this was no exception. They both indicated that  the summer seemed to be a pretty good one.  Jim, the father, explained that his mother had been ill for many years, and finally passed away in August. The family traveled back to her home in Chicago, and attended the wake and funeral. They both indicated that James seemed fine, didn’t really cry, and was very polite and grown up. Susan, the mother, then explained that they returned to their La Canada, CA home just in time to witness the Station Fire burn over 160,000 acres! “It was amazing. We were fine, I mean, we had to be evacuated for about three days, but it was really OK. We got all the important stuff, our pets, papers, and all piled in the car and treated it like an unexpected bonus vacation. James seemed really excited and had a great time!” 

While James appeared to be “fine” and seemed to enjoy himself or not be too significantly impacted, he clearly was, and was now showing signs of traumatic impact. Many children who go through painful, even frightening experiences, will show little if any initial signs of suffering. Like James, it might be weeks later, when confronted with a stressful experience, that these emotions will surface as behavior. What’s more, children are significantly impacted by how their parents react to various situations, and while his grandmother’s death was a great relief to the family, it was also a significant event, and both Jim and Susan responded with the expected grief, sadness and even anger. While these emotions are understood as normal to an adult, to a child, who has never experienced death, they can be terrifying. Throw in the fire and the evacuation, and you have a clear case of a child who has been overwhelmed by fear, stress and trauma.

James’ behaviors in the classroom were the gateway to understanding that he was having a hard time focusing on school because he was still trying to process the difficult experiences he had at the end of his summer. Once we figured that out, I worked with the parents to help them make room for James’s processing of his grief and fear. Art projects, games, looking at pictures of Grandma, talking about the fires, were all ways they helped James make sense of what had happened to him. I worked with James in therapy for several weeks, primarily using play therapy to help him process, express and understand his feelings. Additionally, the parents approached his teacher and explained what was going on. They asked him to be patient with James, and instead of isolating him in the back of the room, to consider moving his desk closer to him. What James needed was comfort and understanding, not punishment and shame.

This case illustrates how easy it is for teachers and parents to quickly make assumptions about a child’s behavior. If Jim and Susan had taken James to their doctor, a stimulant like Ritalin would most likely have been prescribed to help James focus in the classroom. And while that might have helped, the underlying issues of grief and trauma would have gone untreated. This is often the first step down a long road of medication adjustments, special education classrooms, Individualized Education Plans (IEP’s), non-public schools, and more.

The moral of the story? Listen to your child’s behavior, become a detective. Ask yourself what is he trying to communicate? What would make anybody act the way he is acting? Find the missing piece, figure out what the need is (ie to express underlying painful emotions), and then provide it. Once the missing experience is had, the child will begin to return to themselves, the behavior will begin to diminish and he will return to the confident, health and happy child he deserves to be.

Stress Reduction – Part Four

Will You Just Relax Already!

In this, the last of a four-part series on stress reduction, we will focus on reducing the harmful effects of stress by finding ways to relax! No matter how hard we work to change the way we react in stressful situations, inevitably we’ll get stressed out! We all do. That’s why it’s important to know some quick ways to relax.

Breathing exercises are considered one of the most powerful ways to reverse the stress response. By simply noticing your breath you start to relax. Try the following breathing exercise…

Slowly take in a deep breath through your nose and imagine the breath filling your tummy, actually see if you can make your abdomen get bigger as you inhale. Hold the breath for a few moments. Now exhale through your mouth. Hold again for few moments before repeating.

When we breathe in this way we trigger the relaxation response, the opposite of the stress response. Our heart and breathing rates slow, our blood pressure falls and we gain a sense of wellbeing and peacefulness. Try this the next time you’re stuck in traffic!

Another powerful tool in reducing the impact of stress is progressive relaxation. In this technique breath and awareness are combined in a process of deeply relaxing the whole body. There are tapes and CD’s available that walk you through this technique, which over time can become a powerful way to quickly and deeply relax. In a nutshell, you breathe into various areas of the body as you squeeze the muscles in that area. Hold the breath and the muscular tension for a few moments, then relax and exhale. Progressively move all the way through the body, from the feet, to the top of the head. If I can’t sleep at night, I’ll start this and usually by my tummy or lower chest, I’m out!! Give it a shot.

Some of the key components to a relaxed and healthy lifestyle include a nourishing, well-balanced diet, plenty of restful sleep, and regular physical activity. It’s also helpful to create a soothing and calm atmosphere in home. You can do this with fresh flowers, soothing music, and essential oil diffusers that give your home a relaxing aroma.

Finally, remember to take time for you. Be good to yourself! Treat yourself to a hot bath, indulge in a good book, go see a concert or art exhibit. Remember that the more you do to take care of yourself and relax, the better you will feel, and the healthier you will be!

Stress Reduction – Part Three

And breathe 2, 3, 4…

In this, the third of a four-part series on stress reduction, we will focus on treating the cause of stress.

 

Remember that stress is an automatic response to a perceived threat. This perception is based on our previous life experience. If we had an encounter with an aggressive dog as a child, for example, we might still be afraid of dogs as an adult.

 

 In order to reduce stress, therefore, we must find a way to change our perceptions. This requires mindfulness, the ability to be clear and present in a given moment, free from judgment, criticism or intense emotions. When we develop this ability, we find that we become intimately aware of our own perceptions and thoughts. For example, as an adult we can become aware that our fear of dogs is from our childhood, and certainly should not rule our lives as adults. Once we understand this, we can change our lives. Maybe we might discover we love dogs. Replace this dog example with any stressful situation in your life. You have the power to change the way you react. This power is mindfulness.

 

Mindfulness can be cultivated in many ways including meditation, yoga, exercise, and spiritual practice. Try the following brief introduction to meditation.

 

Sit comfortably, or lie down. Start to notice your breath. There is no need to do or change anything. Just keep your attention on your breath. Eventually, a thought will come. When you notice you are thinking, don’t judge it, don’t indulge it. Just note it, and gently return your awareness to your breath. Do this for several minutes.

 

Cultivating mindfulness is not relaxation! It requires energy and discipline. It takes courage and intention to be open to knowing ourselves on such an intimate level. Research shows that mindfulness reduces stress, increases compassion for self and others, and promotes feelings of peacefulness and improved self-esteem. All of this leads to a more relaxed way of life.

 

Chris Tickner, MA, MFT is a Licensed Marriage and Family Therapist with a private practice in Pasadena. He can be reached at 818-568-6982 or by visiting his website at www.bodymindpsych.com.

Stress Reduction – Part Two

What Gets Your Goat??

What stresses you out the most? The kids, traffic, work, money… everything? You’re not alone! We all experience stress to some degree. Have you felt more stressed over the past few months? Most of us have, with all the turmoil in the economy, the threat of global warming. In fact, research indicates that over the past several years, since the terrorist attacks of 2001, there has been a nation-wide increase in stress levels and related psychological disorders including Major Depressive Disorder, Generalized Anxiety Disorder, and increased rates of alcohol and drug abuse.

Remember that stress is our natural, automatic response to perceived danger. It can keep us alive! In our modern society however, our stress response is often continuous. Every day we see violent images on the news and are bombarded with stories of death and destruction. Many people walk around in a constant fear state, and are in general stressed-out much of the time!

Many illnesses have been linked to chronic stress including heart disease, high blood pressure, hypertension, high cholesterol, stroke, diabetes, skin irritations, weight gain, and migraine headaches. Stress can make your back, jaw and head ache, leave you with a lowered sex drive and disrupt your appetite and sleeping patterns. Our immune system suffers leaving us vulnerable to colds and flues, and slowing the healing process. Emotionally, stress can leave us feeling irritable, anxious, and depressed and leads to increased rates of homicide and suicide.

What symptoms of stress do you experience in your life? Take a few moments and write down your experience. And tune in next time when we start to explore ways you can immediately decrease stress in your life and in the lives of those you care about.

Stress Reduction – Part One (funny bunny video at bottom!)

Stress Reduction – Part One: Take A Chill Pill!!

We’ve all heard it before. Stress is bad! We need to fight it! But if you’re like most people, it’s not a priority, and you probably don’t know the whole story.

In this four-part series we will learn exactly what stress is, why it’s sometimes bad, and what we can do to protect ourselves from its damaging effects.

The stress response is a built-in, hard wired, survival mechanism that allows us to respond to perceived threats quickly and effectively. It’s the same mechanism that allows animals in nature to escape attack. When our brains perceive a threat, our body automatically responds. Ever pull your hand out of hot water and then feel the pain? It wasn’t the pain that made you pull it out. It was the stress response automatically protecting you.

When our brain senses danger, its starts a neurochemical chain reaction. Adrenaline and other chemicals course through our bodies. Systems that are unnecessary start to slow down, including digestion, reproduction and immune protection. Our heart and breathing rates increase. Our muscles become stronger and more effective. Our senses become more precise allowing us to be more alert. All this so we can either run away from or fight whatever is threatening us.  

In nature, once the animal has escaped, his systems return to normal. But for us, confronted daily with violent and disturbing images in the media, more and more traffic, and a polluted environment, we stay stressed. This is where things go wrong for us. A mechanism that is supposed to keep us alive ends up making us sick.

Take time now to notice the level of stress in your life. Write down at least three things that really make you feel stressed out!

Next time we’ll look more closely at how stress can negatively impact us.

How to Find a Therapist!

It’s becoming increasingly popular to look for a therapist on the Internet. But how can you tell if a therapist is any good by reading their bio or looking at their picture? What are important things to look for?

Here are some important tips to help you find the perfect therapist. Keep in mind that research tells us that it is a therapist’s ability to build a genuine, trusting and meaningful relationship that is most likely to lead to client satisfaction. It has less to do with their training, orientation, or degree level.

Easy Steps

1. Use the therapist finders on the left hand column to locate therapists in your area. Keep in mind that if you go weekly, you’ll want your therapist to be close to your home or work.

2. Limit the list to things that are must haves: gender, age, rate and availability, insurance coverage.

3. Make a short list of at least five therapists and call them. How do they sound on their outgoing message? Do they return your call promptly? Do you feel comfortable with them on the phone? Ask them questions about their practice, how long they’ve been practicing, do they specialize in anything? Give them an idea of what you would be coming for and ask for their input.

4. Set up introductory sessions with at least three therapists. During these sessions see how you feel. Are you comfortable, is this the kind of person you can see yourself spilling your guts with, do you feel respected and important? A good therapist will make you feel heard, understood and hopeful in that first session. If you aren’t feeling this right away, move on!

5. Sleep on it. We tend to make good, solid decisions after a good night’s sleep. Pick your therapist and make your first appointment!

And that’s it! While it’s not always necessary to be this exhaustive, this is a sure fire way to find the therapist that is most likely to meet your needs. Just keep in mind that the key ingredient is your comfort level. If you don’t feel safe right away, chances are you won’t, and looking for someone that does can save you a lot of time, and money!

Good luck, and feel free to call or email if you need help or referrals.

Chris Tickner, MFT is a licensed psychotherapist in private practice in Pasadena, CA. With over 12 years of experience, Chris approaches psychotherapy with an eclectic mix of cutting edge neuroscience, Eastern spiritual practice, somatic psychology, humor, wisdom, and plain old compassion and understanding.

Please visit his website or call him directly at 818-568-6982 to learn more about his practice and to set up an introductory session.

FDA Contemplating Use of Antipsychotics in Children

NPR’s Morning Edition focuses today on FDA actions that might approve Seroquel, Zyprexa, and Geodon for use in Children. I’ve worked with children who started taking these heavy medications as early as 5 years old, and can tell you that the side effects are devastating! I worked with one boy who started taking Zyprexa at the age of six and by nine had contracted diabetes and weighed 160 pounds. In all fairness, his auditory and visual hallucinations were reduced, but at a significant cost to his health and quality of life.  Read more…

Welcome!

Announcing Our New Blog!

Hello everyone! Welcome to our new blog! We’ve had lots of requests to provide our clients, colleagues and the general public with frequent updates on what is new in the world of holistic/somatic psychotherapy in and around Pasadena, CA. Well, we’ve gone a step further and hope to provide you with a comprehensive holistic resource guide. Stay tuned as we bring you articles, workshop and group listings, and referrals to local, holistically oriented businesses and practitioners. Welcome, and let us know what you think!

Chris Tickner, MFT is a licensed psychotherapist in private practice in Pasadena, CA. With over 12 years of experience, Chris approaches psychotherapy with an eclectic mix of cutting edge neuroscience, Eastern spiritual practice, somatic psychology, humor, wisdom, and plain old compassion and understanding.

Please visit his website or call him directly at 818-568-6982 to learn more about his practice and to set up an introductory session.

What is Somatic Psychotherapy?

Somatic Psychology (body mind psychotherapy, body-oriented psychotherapy, etc.) is a holistic form of therapy that respects and utilizes the powerful connection between body, mind and spirit. How we are in this world, how we relate to ourselves and others, is not just purely about the mind or our thoughts, but is also deeply rooted in our bodies and our spirits.

Somatic Psychology has a long and rich history and is primarily derived from the theories and practices of Wilhelm Reich, a psychoanalyst and student of Sigmund Freud. Since that time, it has been influenced by existential, humanistic and gestalt psychology, dance, movement and art therapy, family and systems theory, biology, neurology, and Far Eastern philosophy and spirituality.

Individuals seek this form of treatment for similar reasons they might look to more traditional talk therapy, to address stress, anxiety, depression, relationship and sexuality issues, grief and loss, addictions, trauma including abuse recovery, as well as more purely medical reasons including pain, headaches, and chronic fatigue syndrome.

Somatic Psychotherapy includes many different techniques that can be utilized depending on the specific needs of each client. Such interventions can include developing mindfulness and awareness of one’s physical presence using relaxation and meditative techniques; movement in order to promote a deeper physical awareness and to expand one’s capacity to feel and express emotions; breathing techniques to increase awareness of and improve functioning of the breath.

Check out this video of Wilhelm Reich’s life and work!