Somatic Psychotherapy

Therapeutic interventions for anxiety, depression, anger management, mood disorders and the whole gamut of DSM 5 disorders, in essence, should be  multifaceted.  Since the human being is a complex process, psychotherapy is enjoined upon a deep inquiry into our fight and flight responses, our childhood history, our subconscious minds, our lifestyles, our diets, our social relationships,  our dreams, our movement patterns  and our energy levels. In short, to work with anxiety and depression or any DSM 5 disorder effectively, the therapist should take a holistic approach  that engages the subtle and gross aspects of the self.  So where would one start in this jungle?

The body. The body is what  holds the various strands of our life experience together. Working any psychological issue demands a deep delving into the mystery of the body. Since the body is the subconscious and storehouse of repressed memories, thoughts, emotions and experiences. The body is pregnant with implicit meaning. Life literally inscribes and imprints  itself on our bodies through our posture, our gestures, the tone of our voice, the quality of our eye contact and the grip of our handshake.

The  body is the temple of our consciousness, the ground of our experience and the barometer of our felt sense. We know ourselves and the world through our bodies. We experience pleasure and pain through our bodies. Since its inception,  somatic psychotherapy has emphasised the import of the body mind connection. Today we are reaching even more subtler understandings of the interconnected nature of the psyche soma in the world of psychotherapy, where Cognitive Behaviour therapy and other talk therapies are acknowledged to not be as effective as body oriented modalities. Ground breaking discoveries in contemporary  medical research regarding the enteric nervous system, the gut -brain connection,  polyvagal theory and psychoneuroimmunology  have underscored that we have more information coming from the body to the brain then from the brain to the body. Bearing this in mind, any psychotherapeutic modality that does not take  the body into account is limited in its efficaciousness.

I teach all my clients how to settle, ground, feel and reconnect with their bodies and to bring psychological awareness to their muscles. Somatic awareness in combination with Dialectical Behaviour and Cognitive Behavioural techniques along with insights from Existential, Psychodynamic and Transpersonal psychology influence my therapeutic repertoire. Ultimately,  I believe that psychotherapy in itself is an art form  at the end of the day and  is not a one trick  pony phenomenon. Different individuals have different needs as one size does not fit all. Having said that,  I have found, in keeping with current understandings of the body-mind, that  for most clients, the first place to begin is by  engaging the physiology of our bodies so as to facilitate the unleashing of  the power of the unconscious. Working with the body is a powerful phenomenon that facilities the client in their own healing process. Ultimately, when  clients can begin to  feel their bodies more they  get more insight into their  histories and experiences and in turn improve their cognitive, behavioural and relational outcomes.

 


Managing Intense Emotions with DBT

Sometimes life feels very difficult, almost unbearable and we are left desolate and helpless. Dealing with the intensity of one’s emotions can be challenging and this might lead one to take extreme measures by over consuming alcohol and drugs, having a lot of sex, self harming, having suicidal ideation and loosing our boundaries with other people, to the point of one’s own self destruction. In such instances, we cannot handle the sensations and feeling that are coursing though the bodymind and we don’t want to feel them.  Our nervous system is fraught with arousal and we do not have the necessary psychological skills to self soothe and self regulate. We attempt to  drown out or change the feelings we experience be it anger, jealousy, sadness  or frustration, often with very unproductive and temporary methods.  Yet, while tragically these coping strategies bring us limited relief, the underlying problem continues to be with us, haunting us and goading us to continue in our self destruction.

Often cases of trauma constrain an individual’s  ability to tolerate distress and the  DSM V psychological disorders known as Borderline personality disorder, Bipolar disorder and other Mood disorders that show a constraint in managing  grief or rage effectively  have traumatic experiences underlying  them. In such instances, it is extremely important to get the right  psychotherapeutic support where the therapeutic work does not remain at the level of talk only. It is important to be able to tolerate emotions by feeling them in the body and being mindful of our experience where we can balance our emotions with our thoughts, our mind with our body, our internal world with the external world and ourselves in relation to others.  Dialectical Behaviour Therapy  (DBT) is a therapeutic modality to work with intense emotions and  low levels of affect tolerance to enhance mood management, prevent self harm and promote well being. DBT was founded by Marsha Linehan and is, at its a core, a set of self soothing and self regulating skills that help individuals gain their equilibrium in the most trying of circumstances. It is  noninvasive and medication free, premised on refining an individual’s self awareness, reframing thought processes and birthing new wholesome behaviours.

DBT is a progression from Cognitive Behaviour Therapy where the contemplative side of the individual is engaged through integrating a mindfulness practice along  with cognitive and behavioural therapeutic practices. In its essence,  DBT consists of 4 dominant skills- distress tolerance, mindfulness, emotional regulation and interpersonal effectiveness. It teaches one to live in the present moment while moving through very disturbing and difficult emotional states. DBT  primes individuals to draw on their higher minds and radically accept circumstances they cannot change while not feeling victimised by them. My clients who have persevered with DBT show remarkable progress in managing the stresses and contingencies of their life, it is not that they do not feel sad or angry or hurt anymore but they have the ability to make space for these emotions and utilise their energies in ways that are productive and beneficial as opposed to ways that are self destructive and malefic for themselves.


Working with Depression in the Body

Part of being human is to experience difficult emotions such as sadness, depression, anxiety, frustration, disappointment etc. Yet these emotions do not make us feel “good” and so we   have an unconscious tendency of not wanting to feel whatever we are feeling. We might brace, not breathe deeply and develop ways and means to numb ourselves and not feel. Commonly, this is what births addictions that range from food, alcohol, drugs, TV watching to excessive exercise, shopping, sex, and over working to name a few. However, these methods, at best, provide short-term relief, and at worst, create other issues for us, while lodging the disquieting feeling deeper into our psyche-soma, allowing it to eat away at our soul.

These obsessive self-numbing activities are called in psychological terms, “defenses.” In some cases, we are even lauded for being defended against our true experience, especially,  if we wear the mask of productivity as a   “workaholic” or have a great body because we are a “fitness freak.” Yet beneath that veneer, we chronically don’t feel so relaxed and much to our chagrin, nobody realizes our underlying state or empathizes with us.

Most mainstream psychological treatments for depression involve talk therapy, like psychoanalysis, which is known as the speaking cure or laced with some cognitive and behavioral interventions like CBT. While talk therapy, definitely has its relevance, sometimes, it maybe more palliative then corrective. The emotions will arise again and again and don’t really leave our system, unless they are fully felt, digested and processed through. Somatic therapy is a novel way to work towards a more permanent release of distressing emotions by increasing our capacity to really feel and tolerate troubled emotions in the body. In somatic therapy the understanding of what an emotion is expanded to psycho-motor holding patterns, like a permanent ache in the heart at the loss of a loved one or a knot in the throat due to not following one’s true calling, indicating a profound sadness that needs to be alleviated through the very physiology of the person.

These trying emotions are akin to muscular knots that need to be released. We are aware of the discomfort when we have a muscular knot in the neck; we often massage and stretch that part of the body to release the knot. Similarly, emotions metaphorically get knotted up and stuck in the body in half digested ways and need to be energetically discharged. Working with a somatic therapist allows one to truly embody, endure and expel difficult emotions in a self-regulating capacity. As the only way out of a distressing emotion is literally through it.