Trauma, Post-Traumatic Stress Disorder (PTSD) & Treatment
I specialise in helping people with trauma and PTSD. My training and experience in leading edge approaches (Core Process Psychotherapy, EMDR and Sensorimotor Psychotherapy) put me in a strong position to help those who suffer in these ways. I had a 32 year career in the Army and I have a particular interest in helping military veterans.
I believe that to achieve deep and lasting change, we must work ‘from the inside out’. It is not merely a matter of changing outer circumstances or behaviour. Our belief systems learned in childhood, as well as traumas that occur at any point in life, live in the body, often below the level of conscious awareness. Unconscious beliefs and unprocessed trauma can show up as chronic tensions and stiffness, nervous system disorders, anxiety, depression, nightmares, chronic illness, low self-esteem and various inabilities to function at full capacity. Physical symptoms are often signals that something is wrong on a deeper level. Traditional “talk” therapies and medication are often either partially effective or only treat symptoms. The whole person and root causes are not addressed, and people do not fully heal as a result.
Trauma can result from “any perceived life-threatening experience.” What one person perceives as life-threatening may be different from another’s perceptions; the perception of threat often has its roots in childhood. The symptoms of trauma are often latent until months or years later, when there is a primary triggering event such as a car accident or the death of a loved one. Sometimes the symptoms start small, even undetected, and are “kindled” as a fire is kindled, until they have just enough fuel to become a raging blaze.
Incoming sensory information takes one of two primary pathways in the brain. One pathway leads to the neocortex, which is more of the “thinking brain” where we make sense of the world. The other pathway, which stimulates the “fight or flight” response, leads to the autonomic, or peripheral, nervous system, which enables us to defend ourselves or flee when we perceive threat. There are times, however, when we may be unable to fight or flee under perceived threat, in which case we freeze. If we are not able to “thaw out” from a frozen state, if our body is not able to complete the necessary response or movement to feel empowered and safe, and if we were not able to fully feel our emotional response at the time of the traumatic event, we risk developing trauma or, in more extreme cases, PTSD.
Classic symptoms of trauma include: anxiety, nervousness or hypervigilance, an inability to think clearly under stress, dissociation, nightmares, insomnia, heightened startle response, emotional paralysis, outbursts of anger or rage, and feelings of powerlessness.
The treatment methods I incorporate involve, first and foremost, developing a strong somatic, or bodily felt sense of “resources,” which were often missing at the time of the original trauma. While we cannot provide the resource that was missing at the time, we may be able to bring up the memory of supportive people or a safe place in our current life, and deepen into the “felt sense” of this in the present moment.
Many problems can be linked to early childhood traumas, which are "somatised" or held in the body. These can be difficult to access through talk alone, but for some people more easily reached when the body perspective is included. Communication also has a physical dimension, as bodies respond to things that are upsetting, frightening or pleasing (for example); think of butterflies in the stomach, excitement or breathlessness. A combination of bodywork and talk can have a deep effect. Body psychotherapists pay a lot of attention to the connections between the way clients think and their bodies feel, between physical sensations and emotions, and to what is experienced in the body in the course of conversation between therapist and client.
Our thoughts, based on past experience, can also trigger a trauma response. If we have had the experience of not feeling safe, whether a chronic state rooted in childhood or from an acute traumatic event later in life, we may have the experience of not feeling safe when presented with a similar situation in present time ie a “state-specific” emotional response. Our mind may begin to churn and ruminate, creating a cascade of thoughts, which can intensify our emotions. I encourage clients to develop the ability to watch their minds, thought processes (mindfulness), and breath, which in turn helps the body and emotions return to a more resourced state. My approach to resolving trauma is tailored to the client. The primary focus is on establishing an internal locus of control and sense of empowerment, along with helping the body and emotions complete or “sequence” through what they were not able to complete at the time. Please see Sensorimotor Psychotherapy: A Somatic Path to Trauma Treatment below for information on the trauma treatment approach that I use.
What is body psychotherapy?
Body psychotherapy is based on the view that body and mind are one thing, therefore emotional, mental health and relational problems are experienced in both. There is increasing research that supports this view and body psychotherapy is starting to move from being a small, niche practice to one that is more widely found.
Many problems can be linked to early childhood traumas, which are "somatised" or held in the body. These can be difficult to access through talk alone, but for some people more easily reached when the body perspective is included. Communication also has a physical dimension, as bodies respond to things that are upsetting, frightening or pleasing (for example); think of butterflies in the stomach, excitement or breathlessness. A combination of bodywork and talk can have a deep effect. Body psychotherapists pay a lot of attention to the connections between the way clients think and their bodies feel, between physical sensations and emotions, and to what is experienced in the body in the course of conversation between therapist and client.
There are a range of body psychotherapy approaches with slightly different emphases, including dance and movement therapy. While not all body psychotherapy involves touch, a session with a body psychotherapist could include touch, movement, massage, art, dance, exercise or a mixture of all of these, along with talking therapy. It may take place seated in chairs, on cushions, lying on a massage table, or the floor. This will all be discussed with the client in advance.
Some body psychotherapists are traditionally trained therapists who have done extra training in somatic psychology or deep bodywork; body psychotherapy is part of their integrative practice. Others are body practitioners who have trained in therapeutic skills to help with the effects of their hands-on work. Some therapeutic approaches have an integrated body and mind perspective and practitioners are trained accordingly.
Who benefits from body psychotherapy?
Strategies that were developed to cope as children can be unhelpful as adults as can some relational habits. Anxiety, depression, relationship difficulties, low self-esteem can be the result. Problems in daily life may be what is experienced now, but the underlying cause may have been imprinted on body and mind at a much earlier time. If an adult client feels that they are held back or stuck but cannot articulate why, body psychotherapy may help release old fears or tensions from early childhood. If they are finding relationships difficult they can identify old patterns and explore new ways of relating
How body-focused psychotherapies can help patients with PTSD
‘In the largest published study of CBT for PTSD more than one third of the patients dropped out; the rest had a significant number of adverse reactions. Most of the women in the study still suffered from full-blown PTSD symptoms after three months in the study.’ B van der Kolk The Body Keeps the Score (2015).
Many leading psychologists now believe that the roots of PTSD lie in our bodies and that it is important to treat the physical as well as the psychological manifestations of trauma to provide integrated, effective therapy for PTSD sufferers. Dr Bessel van der Kolk, a leading authority on PTSD, explains how trauma affects the body physically as well as psychologically: “What most people do not realise is that trauma is not the story of something awful that happened in the past, but the residue of imprints left behind in people’s sensory and hormonal systems. Traumatised people often are terrified of the sensations in their own bodies. Most trauma-sensitive people need some form of body-oriented psychotherapy or bodywork to regain a sense of safety in their bodies.”*
For someone to heal from PTSD, Dr van der Kolk believes the patient needs to be attuned to their body’s habitual patterns. “PTSD causes memory to be stored at a sensory level in the body…Mindfulness, learning to become a careful observer of the ebb and flow of internal experience, and noticing whatever thoughts, feelings, body sensations and impulses emerge are important components in healing PTSD.”
Traumatic stress triggers physiological reactions throughout the body which can manifest themselves as physical ailments such as headaches, fatigue, insomnia and digestive problems. To ease the phsyical discomfort people may resort to drastic measures such as food, work, drugs or alcohol and the more this happens the harder it is for them to be present in the moment – they become dissociated from the present. Body-focused therapies aim to reconnect the sufferer.
I use a combination of body-focussed therapies such as Core Process psychotherapy, Sensorimotor psychotherapy, EMDR and Mindfulness to help trauma/PTSD sufferers.
Understanding Trauma and its Treatment
“Long-lasting responses to trauma result not simply from the experience of fear and helplessness but from how our bodies interpret those experiences.” Rachel Yehuda
We don’t survive trauma as a result of conscious decision-making. At the moment of life threat, humans automatically rely upon survival instincts. Our five senses pick up the signs of imminent danger, causing the brain to “turn on” the adrenaline stress response system. As we prepare to fight or flee, heart rate and respiration speed oxygen to muscle tissue, and the “thinking brain,” our frontal cortex, is inhibited to increase response time. We are in “survival mode,” in our “animal brains.” Later, we may pay a price for these instinctive responses: we have ‘made it’ without bearing witness to our own experience.
As the price for survival, then, we are left with an inadequate record of what happened and how we endured it. If we have adequate support and safety afterward, we may be left shaken, but the events will feel “behind” us. If the events have been recurrent or we are young and vulnerable or have inadequate support, we can be left with a host of intense responses and symptoms that “tell the story” without words and without the knowledge that we are remembering events and feelings from long ago. Worse yet, the survival response system may become chronically activated, resulting in long-term feelings of alarm and danger, tendencies to flee or fight under stress, debilitating feelings of vulnerability and exhaustion, or an inability to assert and protect ourselves. To make the challenge even greater, therapeutic approaches that emphasize talking about the events often result in more, not less, activation of trauma responses and symptoms.
Since the 1980s and ‘90s, newer treatment paradigms have developed that more directly impact the somatic and emotional legacy of trauma. Sensorimotor Psychotherapy, developed by Pat Ogden, PhD, directly addresses the effects of trauma on the nervous system and body without the need to use touch. Easily integrated into traditional talk therapies, Sensorimotor utilizes mindfulness techniques to facilitate resolution of trauma-related body responses first before attempting to re-work emotional responses and meaning-making. Clients report an appreciation of its gentle and empowering interventions and find it equally or more effective than either narrative approaches or EMDR. Eye Movement Desensitization and Reprocessing (EMDR), developed in the 1980s by Francine Shapiro, is today one of the most popular and well-researched methods of trauma treatment. Like Sensorimotor Psychotherapy, EMDR does not focus on narrative recall but on reprocessing key elements of traumatic events, i.e, the legacy.
Sensorimotor Psychotherapy: A Somatic Path to Trauma Treatment
In the 1970s, Pat Ogden began paying attention to the connection between her clients’ dissociations from their bodies and their psychological concerns. With the development of sensorimotor psychotherapy, a client is able to examine how past traumatic experiences are affecting them somatically. This form of trauma treatment addresses physical symptoms, especially those of a dissociative nature such as bodily anesthesia or motor inhibitions, which can cause difficulties in emotion regulation, cognitions, and daily functioning.
Words are not enough to help a client heal, a somatic approach to trauma treatment can be effective. Traditional psychotherapy focuses on the cognitive or emotional aspects of the individual, but such an approach is limited. Sensorimotor psychotherapy joins cognitive and somatic techniques. This is important in treatment as trauma itself can have an overwhelming effect on the body and can manifest as somatic symptoms.
Q: What is sensorimotor psychotherapy?
A: Sensorimotor psychotherapy is body-based talk therapy, integrating current findings from neuroscience to transform traumatic memories into strengths and resources for the client. It works with developmental trauma, such as maternal lack of attunement, as well as acute or gross trauma like sexual abuse, violence, or verbal abuse. Sensorimotor therapists work on mindfulness and collaboration with the client, repeatedly asking permission to do each experiment or process along the way.
Q: What is involved in a typical therapy session?
A: Therapy sessions vary widely. They depend on the needs of the client and the capacity to process traumatic material as well as the level of training or skill the therapist has. If a client wants to speak about a traumatic incident, for example witnessing a fight between two older siblings, a therapist would ask the client to recall up to a few moments before the actual incident. The therapist would then help the client get into a mindful state by asking them to notice certain things: If they are upset, what is it in their body that tells them they are upset? Is it a tightening in the stomach? Or a dark feeling in the chest? Then the therapist asks the client to focus on those sensations, and by observing the client’s gestures and postures, find out what movement the client would have liked to have made, but couldn’t.
The therapist finds a way in the session for the client to complete the movement that was truncated, thus giving them an experience of triumph, which they can savour and integrate into their nervous system. The therapist might then complete the process by speaking to the younger self of the client, saying something like, “Look at your younger self in your mind’s eye, I’m going to say some words in a moment, and I want you to just notice how your younger self responds.” The therapist speaks slowly, saying, “I don’t know why your brother and sister were fighting, but I do know that all little children deserve to feel safe and secure in their home.”
Q: Which client populations would benefit from sensorimotor psychotherapy?
A: I would say that anyone who is having difficulties in their life, such as with anxiety, depression, anger management, inability to sustain meaningful relationships, could benefit from sensorimotor psychotherapy. Clients who abuse alcohol or drugs could benefit from sensorimotor in tandem with addiction treatment.
Q: How would an individual who has experienced trauma benefit from sensorimotor psychotherapy?
A: Sensorimotor psychotherapy emphasizes helping clients develop resources within themselves to be able to self-regulate affect, or to move out of the fight/flight/freeze response, and into a higher-functioning mode where they can think clearly and feel appropriately. Clients can become less reactive and more proactive in their relationships, work, and families. They also benefit by developing the ability to regulate interactively with others.
A traumatic experience can damage implicit processes such as regulating emotions, being able to engage with others, and defence mechanisms against threat. After experiencing a traumatic event, an individual’s relationship to their body may be impacted. For example, the nervous system may not regulate emotions effectively causing feelings of vulnerability, being overwhelmed, or frightened.
Sensorimotor Psychotherapy Phases
There are three phases in sensorimotor psychotherapy: 1) stabilization and symptom reduction; 2) working with traumatic memory; and 3) re-integration. The body reading technique in Phase 1 allows the therapist to assess stable somatic abilities such as grounding in the legs or breathing fully. The therapist makes note of any abilities that are absent, which then will be taught to the client.
The body reading intervention is used again in Phase 2 to assess mobile defensive responses that were not carried out at the time of the trauma. The therapist helps the client to complete these defensive responses through awareness of the body. When the new reactions to the traumatic event are completed, these previously powerless responses elicit feelings of empowering triumph.
In Phase 3, body reading assesses any beliefs a client holds that interfere with daily functioning. In Pat Ogden’s Trauma and the Body, an example is provided where a client’s cognitive distortion “I’m worthless, I must hide” is reflected in bodily tension such as the pulling in of the shoulders or a spinal curve (p. 273).
Sensorimotor psychotherapy builds on traditional methods, allowing a trained psychotherapist to incorporate these somatic interventions into their therapeutic orientation of choice. It can then be integrated with a cognitive/emotional therapeutic treatment model in order to increase effectiveness in coping with traumatic experiences.
An integrative model can be significant in its focus on a client’s symptoms through cognitions, emotions, and the underlying bodily communication that exists without words.
I believe that to achieve deep and lasting change, we must work ‘from the inside out’. It is not merely a matter of changing outer circumstances or behaviour. Our belief systems learned in childhood, as well as traumas that occur at any point in life, live in the body, often below the level of conscious awareness. Unconscious beliefs and unprocessed trauma can show up as chronic tensions and stiffness, nervous system disorders, anxiety, depression, nightmares, chronic illness, low self-esteem and various inabilities to function at full capacity. Physical symptoms are often signals that something is wrong on a deeper level. Traditional “talk” therapies and medication are often either partially effective or only treat symptoms. The whole person and root causes are not addressed, and people do not fully heal as a result.
Trauma can result from “any perceived life-threatening experience.” What one person perceives as life-threatening may be different from another’s perceptions; the perception of threat often has its roots in childhood. The symptoms of trauma are often latent until months or years later, when there is a primary triggering event such as a car accident or the death of a loved one. Sometimes the symptoms start small, even undetected, and are “kindled” as a fire is kindled, until they have just enough fuel to become a raging blaze.
Incoming sensory information takes one of two primary pathways in the brain. One pathway leads to the neocortex, which is more of the “thinking brain” where we make sense of the world. The other pathway, which stimulates the “fight or flight” response, leads to the autonomic, or peripheral, nervous system, which enables us to defend ourselves or flee when we perceive threat. There are times, however, when we may be unable to fight or flee under perceived threat, in which case we freeze. If we are not able to “thaw out” from a frozen state, if our body is not able to complete the necessary response or movement to feel empowered and safe, and if we were not able to fully feel our emotional response at the time of the traumatic event, we risk developing trauma or, in more extreme cases, PTSD.
Classic symptoms of trauma include: anxiety, nervousness or hypervigilance, an inability to think clearly under stress, dissociation, nightmares, insomnia, heightened startle response, emotional paralysis, outbursts of anger or rage, and feelings of powerlessness.
The treatment methods I incorporate involve, first and foremost, developing a strong somatic, or bodily felt sense of “resources,” which were often missing at the time of the original trauma. While we cannot provide the resource that was missing at the time, we may be able to bring up the memory of supportive people or a safe place in our current life, and deepen into the “felt sense” of this in the present moment.
Many problems can be linked to early childhood traumas, which are "somatised" or held in the body. These can be difficult to access through talk alone, but for some people more easily reached when the body perspective is included. Communication also has a physical dimension, as bodies respond to things that are upsetting, frightening or pleasing (for example); think of butterflies in the stomach, excitement or breathlessness. A combination of bodywork and talk can have a deep effect. Body psychotherapists pay a lot of attention to the connections between the way clients think and their bodies feel, between physical sensations and emotions, and to what is experienced in the body in the course of conversation between therapist and client.
Our thoughts, based on past experience, can also trigger a trauma response. If we have had the experience of not feeling safe, whether a chronic state rooted in childhood or from an acute traumatic event later in life, we may have the experience of not feeling safe when presented with a similar situation in present time ie a “state-specific” emotional response. Our mind may begin to churn and ruminate, creating a cascade of thoughts, which can intensify our emotions. I encourage clients to develop the ability to watch their minds, thought processes (mindfulness), and breath, which in turn helps the body and emotions return to a more resourced state. My approach to resolving trauma is tailored to the client. The primary focus is on establishing an internal locus of control and sense of empowerment, along with helping the body and emotions complete or “sequence” through what they were not able to complete at the time. Please see Sensorimotor Psychotherapy: A Somatic Path to Trauma Treatment below for information on the trauma treatment approach that I use.
What is body psychotherapy?
Body psychotherapy is based on the view that body and mind are one thing, therefore emotional, mental health and relational problems are experienced in both. There is increasing research that supports this view and body psychotherapy is starting to move from being a small, niche practice to one that is more widely found.
Many problems can be linked to early childhood traumas, which are "somatised" or held in the body. These can be difficult to access through talk alone, but for some people more easily reached when the body perspective is included. Communication also has a physical dimension, as bodies respond to things that are upsetting, frightening or pleasing (for example); think of butterflies in the stomach, excitement or breathlessness. A combination of bodywork and talk can have a deep effect. Body psychotherapists pay a lot of attention to the connections between the way clients think and their bodies feel, between physical sensations and emotions, and to what is experienced in the body in the course of conversation between therapist and client.
There are a range of body psychotherapy approaches with slightly different emphases, including dance and movement therapy. While not all body psychotherapy involves touch, a session with a body psychotherapist could include touch, movement, massage, art, dance, exercise or a mixture of all of these, along with talking therapy. It may take place seated in chairs, on cushions, lying on a massage table, or the floor. This will all be discussed with the client in advance.
Some body psychotherapists are traditionally trained therapists who have done extra training in somatic psychology or deep bodywork; body psychotherapy is part of their integrative practice. Others are body practitioners who have trained in therapeutic skills to help with the effects of their hands-on work. Some therapeutic approaches have an integrated body and mind perspective and practitioners are trained accordingly.
Who benefits from body psychotherapy?
Strategies that were developed to cope as children can be unhelpful as adults as can some relational habits. Anxiety, depression, relationship difficulties, low self-esteem can be the result. Problems in daily life may be what is experienced now, but the underlying cause may have been imprinted on body and mind at a much earlier time. If an adult client feels that they are held back or stuck but cannot articulate why, body psychotherapy may help release old fears or tensions from early childhood. If they are finding relationships difficult they can identify old patterns and explore new ways of relating
How body-focused psychotherapies can help patients with PTSD
‘In the largest published study of CBT for PTSD more than one third of the patients dropped out; the rest had a significant number of adverse reactions. Most of the women in the study still suffered from full-blown PTSD symptoms after three months in the study.’ B van der Kolk The Body Keeps the Score (2015).
Many leading psychologists now believe that the roots of PTSD lie in our bodies and that it is important to treat the physical as well as the psychological manifestations of trauma to provide integrated, effective therapy for PTSD sufferers. Dr Bessel van der Kolk, a leading authority on PTSD, explains how trauma affects the body physically as well as psychologically: “What most people do not realise is that trauma is not the story of something awful that happened in the past, but the residue of imprints left behind in people’s sensory and hormonal systems. Traumatised people often are terrified of the sensations in their own bodies. Most trauma-sensitive people need some form of body-oriented psychotherapy or bodywork to regain a sense of safety in their bodies.”*
For someone to heal from PTSD, Dr van der Kolk believes the patient needs to be attuned to their body’s habitual patterns. “PTSD causes memory to be stored at a sensory level in the body…Mindfulness, learning to become a careful observer of the ebb and flow of internal experience, and noticing whatever thoughts, feelings, body sensations and impulses emerge are important components in healing PTSD.”
Traumatic stress triggers physiological reactions throughout the body which can manifest themselves as physical ailments such as headaches, fatigue, insomnia and digestive problems. To ease the phsyical discomfort people may resort to drastic measures such as food, work, drugs or alcohol and the more this happens the harder it is for them to be present in the moment – they become dissociated from the present. Body-focused therapies aim to reconnect the sufferer.
I use a combination of body-focussed therapies such as Core Process psychotherapy, Sensorimotor psychotherapy, EMDR and Mindfulness to help trauma/PTSD sufferers.
Understanding Trauma and its Treatment
“Long-lasting responses to trauma result not simply from the experience of fear and helplessness but from how our bodies interpret those experiences.” Rachel Yehuda
We don’t survive trauma as a result of conscious decision-making. At the moment of life threat, humans automatically rely upon survival instincts. Our five senses pick up the signs of imminent danger, causing the brain to “turn on” the adrenaline stress response system. As we prepare to fight or flee, heart rate and respiration speed oxygen to muscle tissue, and the “thinking brain,” our frontal cortex, is inhibited to increase response time. We are in “survival mode,” in our “animal brains.” Later, we may pay a price for these instinctive responses: we have ‘made it’ without bearing witness to our own experience.
As the price for survival, then, we are left with an inadequate record of what happened and how we endured it. If we have adequate support and safety afterward, we may be left shaken, but the events will feel “behind” us. If the events have been recurrent or we are young and vulnerable or have inadequate support, we can be left with a host of intense responses and symptoms that “tell the story” without words and without the knowledge that we are remembering events and feelings from long ago. Worse yet, the survival response system may become chronically activated, resulting in long-term feelings of alarm and danger, tendencies to flee or fight under stress, debilitating feelings of vulnerability and exhaustion, or an inability to assert and protect ourselves. To make the challenge even greater, therapeutic approaches that emphasize talking about the events often result in more, not less, activation of trauma responses and symptoms.
Since the 1980s and ‘90s, newer treatment paradigms have developed that more directly impact the somatic and emotional legacy of trauma. Sensorimotor Psychotherapy, developed by Pat Ogden, PhD, directly addresses the effects of trauma on the nervous system and body without the need to use touch. Easily integrated into traditional talk therapies, Sensorimotor utilizes mindfulness techniques to facilitate resolution of trauma-related body responses first before attempting to re-work emotional responses and meaning-making. Clients report an appreciation of its gentle and empowering interventions and find it equally or more effective than either narrative approaches or EMDR. Eye Movement Desensitization and Reprocessing (EMDR), developed in the 1980s by Francine Shapiro, is today one of the most popular and well-researched methods of trauma treatment. Like Sensorimotor Psychotherapy, EMDR does not focus on narrative recall but on reprocessing key elements of traumatic events, i.e, the legacy.
Sensorimotor Psychotherapy: A Somatic Path to Trauma Treatment
In the 1970s, Pat Ogden began paying attention to the connection between her clients’ dissociations from their bodies and their psychological concerns. With the development of sensorimotor psychotherapy, a client is able to examine how past traumatic experiences are affecting them somatically. This form of trauma treatment addresses physical symptoms, especially those of a dissociative nature such as bodily anesthesia or motor inhibitions, which can cause difficulties in emotion regulation, cognitions, and daily functioning.
Words are not enough to help a client heal, a somatic approach to trauma treatment can be effective. Traditional psychotherapy focuses on the cognitive or emotional aspects of the individual, but such an approach is limited. Sensorimotor psychotherapy joins cognitive and somatic techniques. This is important in treatment as trauma itself can have an overwhelming effect on the body and can manifest as somatic symptoms.
Q: What is sensorimotor psychotherapy?
A: Sensorimotor psychotherapy is body-based talk therapy, integrating current findings from neuroscience to transform traumatic memories into strengths and resources for the client. It works with developmental trauma, such as maternal lack of attunement, as well as acute or gross trauma like sexual abuse, violence, or verbal abuse. Sensorimotor therapists work on mindfulness and collaboration with the client, repeatedly asking permission to do each experiment or process along the way.
Q: What is involved in a typical therapy session?
A: Therapy sessions vary widely. They depend on the needs of the client and the capacity to process traumatic material as well as the level of training or skill the therapist has. If a client wants to speak about a traumatic incident, for example witnessing a fight between two older siblings, a therapist would ask the client to recall up to a few moments before the actual incident. The therapist would then help the client get into a mindful state by asking them to notice certain things: If they are upset, what is it in their body that tells them they are upset? Is it a tightening in the stomach? Or a dark feeling in the chest? Then the therapist asks the client to focus on those sensations, and by observing the client’s gestures and postures, find out what movement the client would have liked to have made, but couldn’t.
The therapist finds a way in the session for the client to complete the movement that was truncated, thus giving them an experience of triumph, which they can savour and integrate into their nervous system. The therapist might then complete the process by speaking to the younger self of the client, saying something like, “Look at your younger self in your mind’s eye, I’m going to say some words in a moment, and I want you to just notice how your younger self responds.” The therapist speaks slowly, saying, “I don’t know why your brother and sister were fighting, but I do know that all little children deserve to feel safe and secure in their home.”
Q: Which client populations would benefit from sensorimotor psychotherapy?
A: I would say that anyone who is having difficulties in their life, such as with anxiety, depression, anger management, inability to sustain meaningful relationships, could benefit from sensorimotor psychotherapy. Clients who abuse alcohol or drugs could benefit from sensorimotor in tandem with addiction treatment.
Q: How would an individual who has experienced trauma benefit from sensorimotor psychotherapy?
A: Sensorimotor psychotherapy emphasizes helping clients develop resources within themselves to be able to self-regulate affect, or to move out of the fight/flight/freeze response, and into a higher-functioning mode where they can think clearly and feel appropriately. Clients can become less reactive and more proactive in their relationships, work, and families. They also benefit by developing the ability to regulate interactively with others.
A traumatic experience can damage implicit processes such as regulating emotions, being able to engage with others, and defence mechanisms against threat. After experiencing a traumatic event, an individual’s relationship to their body may be impacted. For example, the nervous system may not regulate emotions effectively causing feelings of vulnerability, being overwhelmed, or frightened.
Sensorimotor Psychotherapy Phases
There are three phases in sensorimotor psychotherapy: 1) stabilization and symptom reduction; 2) working with traumatic memory; and 3) re-integration. The body reading technique in Phase 1 allows the therapist to assess stable somatic abilities such as grounding in the legs or breathing fully. The therapist makes note of any abilities that are absent, which then will be taught to the client.
The body reading intervention is used again in Phase 2 to assess mobile defensive responses that were not carried out at the time of the trauma. The therapist helps the client to complete these defensive responses through awareness of the body. When the new reactions to the traumatic event are completed, these previously powerless responses elicit feelings of empowering triumph.
In Phase 3, body reading assesses any beliefs a client holds that interfere with daily functioning. In Pat Ogden’s Trauma and the Body, an example is provided where a client’s cognitive distortion “I’m worthless, I must hide” is reflected in bodily tension such as the pulling in of the shoulders or a spinal curve (p. 273).
Sensorimotor psychotherapy builds on traditional methods, allowing a trained psychotherapist to incorporate these somatic interventions into their therapeutic orientation of choice. It can then be integrated with a cognitive/emotional therapeutic treatment model in order to increase effectiveness in coping with traumatic experiences.
An integrative model can be significant in its focus on a client’s symptoms through cognitions, emotions, and the underlying bodily communication that exists without words.