Many of my clients ask questions during the first session like “Why is my body so tight?” or “Why can’t I sleep at night?” People want to know why their bodies react to psychological stressors such as frustration, trauma, rejection, fear, and anxiety — why all of our bodies seem programmed to respond to these as well as environmental cues, facial expressions, attitudes, and other stimuli.
Pat Ogden, founder and director of the Sensorimotor Psychotherapy Institute, and Janina Fisher, a clinical psychologist specializing in trauma, synthesize psychological and medical models to explain why we physically respond to stimuli the way we do.
Their new book, Sensorimotor Psychotherapy: Interventions for Trauma and Attachment, is great for therapists who want to learn more about how the brain-body connection influences the lives of clients — their emotions, cognitions, and physiological responses. And it is especially helpful for clients who have traumatic histories or who have never experienced an appropriate interpersonal attachment.
Until around the 19th century, most people believed that emotions were the only explanation for disease, stress, and other somatic complaints. Now, most scientists, psychiatrists, and mental health professionals believe that disorders have a biological foundation — that they are triggered or influenced by biology. For example, autism spectrum disorders, ADHD, depression, anxiety, bipolar disorder, and even schizophrenia are all said to have a biological basis.
But unfortunately, psychotherapy often fails to incorporate the science of the body and mind into the analysis of psychological, physiological, and relational challenges. Rarely do we ask clients “What does your body feel like in this session?” or “What are you experiencing in your body as we talk about your abuse history?” Therapists notoriously focus on what happens in the mind, psychologically, and what happens to the emotions. Here, Ogden and Fisher attempt to reorient therapists and other mental health professionals by highlighting the importance of the mind-body connection.
For instance, when a family comes to therapy to discuss negative interactions between members, most therapists strive to understand how each family member interacts on a daily basis, why certain interpersonal relationships are strained, and how to fix the issue. But therapists who are tuned in to the intelligence of the mind-body connection might explore the “orientating reflex” (the positions of certain family members’ bodies during the session), body language (facial expressions, body posture, eye contact, and so on), somatic responses to stress, mindfulness, and core alignment, and how these influence mood and perceptions, memory, sensorimotor sequencing, boundaries, body sensation (feeling muscle tension, etc.), and neuroception (how the brain decides whether people or situations are safe or dangerous).
While this book requires some knowledge of the brain and body, Ogden and Fisher make it very simple for both therapists and clients to understand. The overview they provide for each chapter is specifically addressed to either the client or the therapist, and worksheets help with further exploration.
For clients, reading the materials their therapist reads can be truly intimidating, sometimes impossible. Science manuals, professional journals and articles, and sophisticated books with swelling terminology can cause clients to rely entirely on their therapist for knowledge on trauma and attachment. But Ogden and Fisher do make the book understandable, easy to read, and enjoyable. It can be read during a therapy session, prior to a session, or after a session in preparation for the next one.
Clients working with therapists can read about tools and techniques to identify their strengths, develop inner resources, ground themselves, align their core, and pay attention to somatic or physical boundaries. There are also sections related to memory, and ones that try to help the client move toward the future more comfortably.
When I meet with clients who are diagnosed with behavioral disorders for the first time, I use many of our sessions to provide psychoeducation on a disorder’s genetic or biological foundation. When parents bring in their kids for help, they feel relieved to know that there is a biological foundation underneath their child’s behavioral disorder. Once they understand this, they often feel optimistic that the medical model of treatment may provide some relief.
Ogden and Fisher make it easy to integrate the book’s exercises into therapy sessions, and to use the text directly with clients. In turn, clients who recognize that their traumatic experiences affect both the mind and the body may finally find some healing.
Sensorimotor Psychotherapy: Interventions for Trauma and Attachment
W. W. Norton & Company, April 2015
Hardcover, 832 pages