Thoughts on Body-Centered Therapy
In the West, we traditionally think of healing as a "top down" process. This means that if I can change my thoughts or ideas about my situation, my body/feelings will follow and improve. For example, the thinking is that if I tell myself that I'm okay and safe, then my body will relax and I will settle. This can happen, for sure. But sometimes it's simply not enough, especially if the source of our pain is touching on very old wounds and/or we don't have already have a felt sense of safety or love, etc. The words don't have anything to activate because the neural network isn't fully there.
The idea of top-down healing (which is the basis of Cognitive Behavioral Therapy) assumes that there is a delineation between the mind and body, and the mind is the supreme part of that duo. This is of course a Western idea. But what if it's just an idea we have accepted, due to many historical factors that are reflected in our religions, systems of governance, medical models, and cosmologies etc.? Well, then they're based on culture, not on some universal fact.
I like to refer to older cultures for wisdom on these things: and older cultures seem to often treat the body and nervous system directly through different modalities. For example, what happens to a person's nervous system when they accept/know that their ancestors are actually in the room working to help them when they're suffering? That's not a top-down approach to healing. It's a felt sense in the body of connection and security.
Current psychology seems to be coming around to this bottom-up approach, thankfully. Now there are many bottom-up modalities for healing mental health symptoms. All the best trauma treatment modalities that I know of incorporate some form of bottom-up (body first) processing. And yet, it's also kind of like turning the Titanic because our background culture privileges the thinking mind over the feeling body.
In my own observation, deep trauma wounds do not permanently respond to top-down approaches of healing. That's because in order to do top-down processing, you have to have access to the prefrontal cortex "reasoning" part of your brain. And if you're in a state of total dysregulation, like what happens in PTSD symptomology, clinical depression or panic disorders, that's not possible. If you're having a panic attack, you can't reach your reasoning brain. Everything you learned in your CBT therapy session is lost to you in that moment.
So, what to do. This is where bottom-up processing and healing comes in. It's using a model of treating your body as the most important container for your healing. To heal anxiety, for example, we don't just talk about what your triggers are and make a cognitive plan for what you'll say to yourself or how you'll frame it in your mind when you're panicking. We do something very important in addition to any of that. We begin to train your body to know what safety feels like in small, titrated doses. We build a bodily felt sense of safety and secure love that you could have gotten as a baby and child, but maybe didn't.
When I do this with clients in session, we usually first talk about the most recent and important things that are going on in their lives. For example, someone might tell me about an argument they had with a loved one, and how they felt so upset afterward and couldn't sleep. As I am watching them in session I can see that it's bringing back the disturbing feelings. After their story, I will bring them back to what their body is experiencing right now. We get curious about what's happening physically: a feeling of tightness in their stomach, an increase in heart rate and breathing.
This is the moment of opportunity, Now they can learn to experience something new and maybe somewhat foreign: how to move from an upset feeling state to a resourced one through their body. We are teaching their body that they can recover and build a resilient feeling that eventually will automatically be there. Then in a stressful situation the mind/thoughts don't need to try and lead the process; the body does it automatically because the neural network is already wired in for safety, love, belonging, etc.
As children, we all need to learn and know a felt sense of safety, love, nurturance, belonging, etc. as we grow and develop our nervous systems. But of course that's not always possible. Sometimes there just isn't a holding environment for that. Instead, the young nervous system gets trained to simply survive, and that might mean being hypervigilant to others' moods, or learning to live with the anxiety of not having the care they need. A healthy nervous system development can be hampered in many, many different ways. It can also be disrupted by adult traumas.
Getting back to the healing in a therapy session: once the client is activated and curious about what they're experiencing, we are at an opportunity for teaching the body something new. I might have them physically push on something firm like a table or desk with their hands and the floor with their feet, in order to activate their large muscle groups. This is a good way to get back into the body and become more present. We also welcome whatever emotions are arising. We do body-centered resourcing so they can come into a regulated neural network inside their nervous systems. This can all take some time. But once the client is in a calm and secure feeling inside themselves, we take more time to let their body really take that in--this is what it feels like to be not-alone (I'm there with them) and safe and secure and calm. They have recovered from a dysregulated nervous system state by moving into a regulated one. And very little of this has involved thoughts or beliefs or mental ideas. It has been almost entirely body-centered.
Between sessions, their therapy continues. Ideally, they will practice coming into feelings of safety at home and take them in. Just like one might go to the gym to build muscle strength, the client has to build and practice these felt body states of safety, love, nurturance, attunement. One hour a week of therapy is great, but it will significantly increase their speed of healing by doing these things at home. Essentially, the client is rewiring their relationship with themselves and the world. When that happens, a new reality opens up. Oh, this is what it feels like to feel secure. This is what it feels like to feel stable and confident and recover more easily. It's a process to get there for some, but it's very possible and the body is the vehicle for that change.
