Marrying the Clinical to the Contemplative

You only need to be open to the wisdom inside of you. You don’t need to believe in any theories or what I’m proposing, because the resources you need are all already within you. We mine for them together in a collaborative discovery process. I can help you practice mindfully observing, learning from, and listening to your own system with curiosity and without judgment. Hopefully, you can learn to trust that process of discovery as you see the results from nurturing that emerging relationship.

Somewhere along the way, we forget, get far away from who we are, and develop strategies grown in hostile environments that get neurologically wired, and that programming can overcome our will. But I have witnessed people slowing down, choosing to get off that runaway train, and writing a new story for themselves.

Soma simply means of the body. The way I use the term somatic therapies is methods that include the body, mind, and emotions in healing. Acknowledging that we are energy and matter, our systems learn, operate, break down, and heal on multiple simultaneous levels: physical, emotional, mental, and energetic. If we want to reclaim healthy homeostasis, we must regulate the nervous system and find the dysfunctional patterns that have wired our nervous system in suboptimal ways, albeit in an attempt to keep us safe when we were in compromised or traumatic states. Gradually, we can replace those patterns, practicing new ones, to rewire neural pathways and support healthier behaviors.

I draw from, modify, and integrate many somatic disciplines into a holistic methodology. First, we do a check-in, and I track what’s happening in the body and overall system as you describe what’s up for you and what you want to focus on.

Regulating the nervous system is an important key to all the work. I’m guided by what we’ve learned about our neurobiology, what your system is telling us, what our capacity is at the moment, what our common sense and inner wisdom reveal… In all therapeutic sessions, we cultivate a focused, calm state where what is usually not accessible, not conscious, and not able to be tolerated is now all available for safe observation and transformation. Some call this state ‘Witnessing Mindfulness.’ ** You can, simultaneously, experience, observe, and report body sensations, emotions, thoughts…that might come up, and we will let your body’s response guide the process moment to moment.

This helps us safely access areas of emotional and/or physical pain that would otherwise trigger fear or be too much to tolerate, such as when there’s trauma held in the system. It’s like time traveling, and your body is the portal.

I have many tools for work on and off the table from years of developing this work: movement and mind/body therapies, including structural yoga therapy, dance, imagery, Pilates, and Feldenkrais. I usually begin with internal focusing and/or guided relaxation/breathwork to cultivate a state where the nervous system can be more balanced and receptive, and I apply a lens of somatic psychotherapy, no matter what other tools I’m using. Though I don’t do much clinical orthopedic massage therapy anymore, I still occasionally employ some manual therapies like myofascial release, trigger point therapy, MET, neuromuscular re-education… if we choose to do bodywork that day.

All sessions are informed by, but some sessions are more focused on, Sensorimotor Psychotherapy, a somatic psychotherapeutic methodology by Pat Ogden. This bottom-up approach respects your body’s inner wisdom, is informed by the latest advances in neuroscience and trauma therapy, anchors the session in present moment awareness, and skillfully regulates the nervous system. We might learn more about your survival strategies, which have served to keep you functioning in the face of trauma but have become obstacles in your desire to make better choices for a more fulfilling life.

For times when the distressing experiences seem to be a response coming from a part of you that feels threatened, where your nervous system switches to survival mode and you’re too flooded to act as your wisest adult self, Janina Fisher’s TIST model is a cutting-edge, trauma-informed approach that respectfully, elegantly, and safely helps identify and welcome these adaptive strategies our brain uses to keep us safe but inevitably get in our way. Gradually, we work to integrate your internal family of parts into an integrated, better-functioning whole.

As needed, some sessions are devoted to life skills and holistic health coaching focused on improving diet, sleep, or developing healthier habits and lifestyle modifications. Often, there is a need for increasing somatic awareness or some postural retraining, reconstructing movement patterns, as in walking, or developing or refining a therapeutic or rehab exercise routine.

We expand or create support systems to help you succeed. I refer, build upon, consult with, and/or collaborate with other health professionals as required, so you have a team in your corner and resources within reach. What matters to me is that you are supported in the way that works for you, whether that’s me or someone else.

Though the methods are effective for many situations, there really isn’t a typical session. Each person’s needs and situation are a unique constellation of factors, even if they’ve received a similar diagnosis to someone else. Plus, what they require today may differ from what they required last week, and the way they respond to what we do will not be identical.

As the client, it’s your show, and you’re in charge of where we go, but we decide together what we are going to focus on that day. If it’s not apparent, we might start with an internal exploration to ask the body what requires addressing right now, what part of you is most in need. Keeping in mind your long-term goals but depending on your current emotional experience, acute symptoms, chronic pain patterns, and what themes, limiting beliefs, or behavioral patterns we’ve been working on, we pick a doorway and enter your fascinating inner world.

And again, the format intends to provide the proper pacing and enough time to address, process, and co-regulate as needed.

Yes. It’s that intersection where I have found that this combination of therapies gives some hope of reclaiming one’s life from the thieves of not just the illness but our perception and judgment of ourselves and our limitations. My clients are usually highly functional but might feel tethered by a history of childhood trauma with unstable caregivers and compromised by anxiety disorders and invisible illnesses like fibromyalgia or chronic fatigue.

Some clients I’ve worked with have suffered from multiple injuries and neck pain, eating disorders and chronic PTSD or post-concussion syndrome with migraines and childhood sexual abuse or difficulty regulating emotions like anger and sadness, digestive disorders with repetitive strain injuries or multiple chemical sensitivities and boundary issues, and sciatica/low back pain.

People typically notice a shift in the first few sessions, and relief can come even after the first therapeutic session, but this is not a quick fix. It takes consistent effort to change sometimes longstanding patterns. This is a commitment you make to yourself, and the more you put into it, the more you’ll get out.

I always ask clients what their goals are so that is the foundation as we begin to assess their needs and develop a plan. The first phase might be pain relief if that’s an immediate concern. If sleep is disturbed, that would be a priority because healing can’t happen without your glial cells (the night janitors in your brain) having that time to put things back in order. Increasing somatic awareness and connection with the body, understanding the need for and incorporating self-care practices, reducing anxiety and interpersonal problems, having more agency to make the choices you really want to make, and being able to access more calm in the system to begin feeling the peace that is already inside you…

In our work, we’ll discover your resources to better navigate the triggers that happen in daily life, especially with family, to better manage chronic pain, illness, and anxiety, and to thrive and not just survive.

Maybe sometimes we need to let go of the old tricks. Being open to the fact that the ways you’ve done some things your whole life, the way you see yourself and the world, may not be serving you now, even though there’s good reason for those old tricks that were trying to keep you safe. Your body is telling you that, in sensation, not words, to get your attention. The function of pain is to tell you something is wrong, and it’s a great motivator. In acute pain, like after an injury, it’s simpler: first aid, rest, and repair. In chronic pain (physical and emotional), it may involve changing unconscious habits, including assumptions, addictions, posture, movement, counterproductive beliefs, discovering why you get triggered and respond in certain ways, and why you can’t give yourself what you need to be whole. So much of learning is unlearning.

I’m continuously fascinated by the connections and working at the intersections. In the interview “Connecting the Dots,” I explore this question further, but one example is with interoception, defined as the sense of the internal state of the body… Misrepresentations of internal states, or a disconnect between the body’s signals and the brain’s interpretation and prediction of those signals, have been suggested to underlie conditions such as anxiety disorders, PTSD, eating disorders, depression, OCD, ADHD, etc. This explanation is a modified excerpt from https://en.wikipedia.org/wiki/Interoception.

Working with connective tissue in bodywork and somatic therapies is a potential avenue to cultivate body awareness because there are even more receptors in connective tissue for interoception than for proprioception. Some have posited that piezoelectricity can partially explain the mechanisms by which myofascial release and trigger point pressure work to impact the system. https://www.explainthatstuff.com/piezoelectricity.html

We, like all life, are the union and relationship between energy and matter. There’s so much more to say about this exciting, inexhaustible topic.

It’s more like the effects of trauma are held in our nervous systems, limiting beliefs, posture, habits, and unresolved emotions, and expressed in behavior patterns. I think of trauma differently than I used to because we all have our share of imperfections, emotional wounding, and damage. I’m finally accepting that in myself. If we’re born of human parents and live in this world of noise and imperfection, we’ve likely been impacted by trauma, even if it's minor. Our systems can handle and overcome adversity, but many of us have suffered from complex, sustained trauma, neglect, and abuse, especially emotionally painful relationships with childhood caregivers. Not having our needs met in our early years and not having someone there to hold us through it negatively impacts neurological wiring, and resetting from that requires a trustworthy environment to change patterns and create new neural pathways and habits.

I actually don’t like that word so much and believe something was lost in translation. Being full of mind, to me, implies being stuck in thinking. I’d rather be heartfull. I sometimes do, though, use the word mindful in my work, since it’s code these days for present moment awareness, especially in somatic psychotherapy. I just defined my terms.

The British Buddhist scholar T. W. Rhys Davids coined the term at the beginning of the 20th century, attempting to translate sati, a word in the Pali language of ancient India, in which many original Buddhist texts were written. It roughly means awareness or remembrance. John Kabat-Zinn later picked it up as he developed his Mindfulness-Based Stress Reduction program, and it has stuck ever since in the jargon of our modern contemplative practices.

For me, I read ‘sati’ as remembering what we really are and maintaining an awareness of that inner reality. In my experience, this goes beyond what mindfulness practices embody.

** Ron Kurz (founder of Hakomi and mentor to Pat Ogden, founder of SP) explains the type and function of mindfulness in the Hakomi and SP method like this: “You can’t take the engine apart while it’s running”….“Witnessing mindfulness is very important when working with traumatic memory because the act of witnessing keeps the frontal lobes firing so that amygdala-driven fear responses don’t overwhelm the client. As long as the client can stay mindful of her experience and report her experience, she will not go out of the window of tolerance.“