The Body is Foundational for Somatic Psychotherapy
Psychotherapists are often curious about, how do I bring the body into my clinical practice? To be clear, we are always working with the body—whether we are adept at listening, deciphering, and utilizing the information is another story. As a therapist educator, the question then becomes, how do I assist clinicians to bring the body–theirs and clients—into practice. Conceptually, I speak about this in three key components: right brain to right brain, body to body therapeutic practice; embodied practice: and working with the modes of the right hemisphere.
Right Brain to Right Brain, Body to Body Therapeutic Practice
Bodies are always communicating under the, or embedded within, verbal dialogue. As clinicians, our capacity to regulate our autonomic nervous system (ANS) and offer dyadic regulation allows opportunities for dyadic regulation that over time increase the client’s capacity to regulate their own system—such regulation is at the core of both relational and incident trauma repair.
Therapists also need to be cognisant of the non-verbal communication that happens between bodies—the tone of voice, facial expression, and the way the body moves, or doesn’t, all transmit information beneath the dialogue to the other, as does each person’s current internal state. This transmission of information, either increases or decreases a client’s sense of safety (often unconscious), and its accurate interpretation or neuroception (Porges, 2011) is shaped by number of factors, including: their history; what is happening in the moment in the therapeutic dyad; the therapist’s ability to regulate; and the congruency of the therapist’s words and internal experience. This also can be true in reverse, where the attuned therapist registers discrepancies in congruence of the narration and physiology of the client—this can open a doorway for process. The therapist is also susceptible to their own history colouring their perception or neuroception of the therapeutic work, particularly when they are dysregulated. Given this, the capacity for the therapist to regulate their own ANS is integral to all somatic or body-centred practice, and I would propose, to good therapy in general.
Embodied psychotherapy for me, speaks to the valuing and use of the therapist’s body, and the client’s body, in clinical process and practice. By this, I mean a few different things that can be summed up as the therapist using their body to feel into and resonate with the client’s body as they bring content, both psychological and physiological, into the work. In using one’s body to feel into, regulate, and resonate, therapists are better able to: catch nuanced, or discrepant material that needs attending; track shifts in their ANS state and the client’s state in the moment; feel into the dissociated material that is out of the client’s awareness, and; track dyadic connection and disconnection. In using the body as a tuning fork, therapists are able attune, sophisticate, and nuance their clinical awareness, enhancing relational contact and collaboration in the clinical process, both moment to moment, and over time.
With embodied practice, therapists also lean into the conceptual framework of the window of tolerance (Siegal, 1999), utilizing their embodied awareness to track and then up or down regulate affect and content to help guide the processing of material. Further, use of Porges’ polyvagal theory (2011), in combination with the use of sensations and felt sense, is used to decipher what is happening in the ANS. In combination with this and other bodily based information, the therapist discerns in the moment whether to stay the course, or up or down regulate the system—this can happen in several different ways, ranging from increasing relational contact to making interventions to disrupt the ANS state. What I am meaning here, is that with embodied practice therapists tracks whether there is enough regulation and vitality in the client’s ANS state, or if more ventral vagal is needed to regulate and support the metabolizing of material—so, down regulating in the case of too much sympathetic arousal in the ANS, or upregulating when the ANS has too much dorsal vagal state dominance to metabolize material.
Right Hemisphere Processing in Psychotherapy
We understand that trauma is held in the body and right brain, and that left hemispheric work is refractory for trauma resolution. With this understanding, in addition to right brain to right brain, body to body process, and embodied practice, somatic psychotherapy utilizes processing through the different modes of the right hemisphere—sensations, sensory motor or gestures, emotion, images and the imaginal, including metaphors and analogies, and the symbolic or archetypal realms. In doing so, the psyche or bodyself brings into awareness unmetabolized and unintegrated material. In working in the right (rather than left brain processing) and processing through right hemispheric modes, traumatic material can begin the process of metabolizing through linking and differentiating elements of the experience, which supports regulation, organization and ultimately integration, all in service of change.
Admittedly, this blog just scratched the surface of how to bring the body into clinical practice. My hope is to alight more curiosity by opening your attention to these different but related elements of how the body can be utilized in somatic psychotherapy—right brain to right brain, body to body therapeutic practice; embodied practice: and working with the modes of the right hemisphere. As a therapist educator, I witness profound changes in therapist’s clinical practice, and their capacity and acumen, as they embrace and embody a somatic orientation in their work.
Porges, S. W. (2011). The polyvagal theory: Neurophysiological foundations of emotions, attachment, communication, self-regulation. New York, NY: Norton.
Siegel, D. J. (1999). The developing mind: Toward a neurobiology of interpersonal experience. Guilford Press.