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A book for clinicians and clients to use together that explains key concepts of body psychotherapy. The body’s intelligence is largely an untapped resource in psychotherapy, yet the story told by the “somatic narrative”-- gesture, posture, prosody, facial expressions, eye gaze, and movement -- is arguably more significant than the story told by the words. The language of the body communicates implicit meanings and reveals the legacy of trauma and of early or forgotten dynamics with attachment figures. To omit the body as a target of therapeutic action is an unfortunate oversight that deprives clients of a vital avenue of self-knowledge and change. Written for therapists and clients to explore together in therapy, this book is a practical guide to the language of the body. It begins with a section that orients therapists and clients to the volume and how to use it, followed by an overview of the role of the brain and the use of mindfulness. The last three sections are organized according to a phase approach to therapy, focusing first on developing personal resources, particularly somatic ones; second on utilizing a bottom-up, somatic approach to memory; and third on exploring the impact of attachment on procedural learning, emotional biases, and cognitive distortions. Each chapter is accompanied by a guide to help therapists apply the chapter’s teachings in clinical practice and by worksheets to help clients integrate the material on a personal level. The concepts, interventions, and worksheets introduced in this book are designed as an adjunct to, and in support of, other methods of treatment rather than as a stand-alone treatment or manualized approach. By drawing on the therapeutic relationship and adjusting interventions to the particular needs of each client, thoughtful attention to what is being spoken beneath the words through the body can heighten the intimacy of the therapist/client journey and help change take place more easily in the hidden recesses of the self.
The body, for a host of reasons, has been left out of the "talking cure." Psychotherapists who have been trained in models of psychodynamic, psychoanalytic, or cognitive therapeutic approaches are skilled at listening to the language and affect of the client. They track the clients' associations, fantasies, and signs of psychic conflict, distress, and defenses. Yet while the majority of therapists are trained to notice the appearance and even the movements of the client's body, thoughtful engagement with the client's embodied experience has remained peripheral to traditional therapeutic interventions. Trauma and the Body is a detailed review of research in neuroscience, trauma, dissociation, and attachment theory that points to the need for an integrative mind-body approach to trauma. The premise of this book is that, by adding body-oriented interventions to their repertoire, traditionally trained therapists can increase the depth and efficacy of their clinical work. Sensorimotor psychotherapy is an approach that builds on traditional psychotherapeutic understanding but includes the body as central in the therapeutic field of awareness, using observational skills, theories, and interventions not usually practiced in psychodynamic psychotherapy. By synthesizing bottom-up and top down interventions, the authors combine the best of both worlds to help chronically traumatized clients find resolution and meaning in their lives and develop a new, somatically integrated sense of self. Topics addressed include: Cognitive, emotional, and sensorimotor dimensions of information processing • modulating arousal • dyadic regulation and the body • the orienting response • defensive subsystems • adaptation and action systems • treatment principles • skills for working with the body in present time • developing somatic resources for stabilization • processing
A guide to this groundbreaking somatic-cognitive approach to PTSD and attachment disturbances treatment. Pat Ogden presents Sensorimotor Psychotherapy with an updated vision for her work that advocates for an anti-racist, anti-oppression lens throughout the book. Working closely with four consultants, a mix of Sensorimotor Psychotherapy Institute graduates, trainers, consultants, and talented Sensorimotor Psychotherapists who have made social justice and sociocultural awareness the center of their work, this book expands the current conception of Sensorimotor Psychotherapy. Numerous composite cases with a variety of diverse clients bring the approach to life. This book will inspire practitioners to develop a deeper sensitivity to the issues and legacy of oppression and marginalization as they impact the field of psychology, as well as present topics of trauma and early attachment injuries, dissociation, dysregulation, and mindfulness through a Sensorimotor Psychotherapy lens.
Psychological trauma profoundly affects the body, often disrupting normal physical functioning when left unresolved. This work provides a review of research in neuroscience, trauma dissociation and attachment theory that points to the need for an integrative mind-body approach to trauma.
Winner of the 2017 International Society for the Study of Trauma and Dissociation (ISSTD) Pierre Janet Writing Award. Establishing safety and working with dissociative parts in complex trauma therapy. Therapists around the world ask similar questions and struggle with similar challenges treating highly dissociative patients. This book arose not only out of countless hours of treating patients with dissociative disorders, but also out of the crucible of supervision and consultation, where therapists bring their most urgent questions, needs, and vulnerabilities. The book offers an overview of the neuropsychology of dissociation as a disorder of non-realization, as well as chapters on assessment, prognosis, case formulation, treatment planning, and treatment phases and goals, based on best practices. The authors describe what to focus on first in a complex therapy, and how to do it; how to help patients establish both internal and external safety without rescuing; how to work systematically with dissociative parts of a patient in ways that facilitate integration rather than further dissociation; how to set and maintain helpful boundaries; specific ways to stay focused on process instead of content; how to deal compassionately and effectively with disorganized attachment and dependency on the therapist; how to help patients integrate traumatic memories; what to do when the patient is enraged, chronically ashamed, avoidant, or unable to trust the therapist; and how to compassionately understand and work with resistances as a co-creation of both patient and therapist. Relational ways of being with the patient are the backbone of treatment, and are themselves essential therapeutic interventions. As such, the book also focused not only on highly practical and theoretically sound interventions, not only on what to do and say, but places strong emphasis on how to be with patients, describing innovative, compassionately collaborative approaches based on the latest research on attachment and evolutionary psychology. Throughout the book, core concepts—fundamental ideas that are highlighted in the text in bold so they can be seen at a glance—are emphasized. These serve as guiding principles in treatment as well as a summing-up of many of the most important notions in each chapter. Each chapter concludes with a section for further examination. These sections include additional ideas and questions, exercises for practicing skills, and suggestions for peer discussions based on topics in a particular chapter, meant to inspire further curiosity, discovery, and growth.
This authoritative volume describes the state of the science of early intervention for trauma and traumatic loss across the lifespan and in a variety of contexts. While few would dispute the importance of helping people cope with severe life stressors, important questions remain about how to identify those at risk for chronic problems and which interventions actually facilitate recovery over time. Following a review of current knowledge on the predictors and course of acute stress disorder, PTSD, and traumatic grief, the volume presents a range of early intervention models designed for very young children, older children, and adults. Authors examine the empirical literature and recommend evidence-based clinical strategies whenever possible, while delineating an extensive agenda for future research. Also covered are the lessons learned from early intervention with specific populations: 9/11 survivors, combat veterans, emergency services personnel, survivors of sexual violence, and others.
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Neurobiological research helps explain the experience of motherhood. This book, the exciting collaboration of a developmental psychoanalyst at the forefront of functional magnetic resonance attachment research and a leading neurobiological researcher on mirror neurons, presents a fresh and innovative look at intersubjectivity from a neurobiological and developmental perspective. Grounding their analysis of intersubjectivity in the newest advances from developmental neuroscience, modern attachment theory, and relational psychoanalysis, Massimo Ammaniti and Vittorio Gallese illustrate how brain development changes simultaneously with relationally induced alterations in the subjectivities of both mother and infant. Ammaniti and Gallese combine extensive current interdisciplinary research with in-depth clinical interviews that highlight the expectant mother’s changing subjective states and the various typologies of maternal representations. Building on Gallese’s seminal work with mirror neurons and embodied simulation theory, the authors construct a model of intersubjectivity that stresses not symbolic representations but intercorporeality from a second-person perspective. Charting the prenatal and perinatal events that serve as the neurobiological foundation for postnatal reciprocal affective communications, they conclude with direct clinical applications of early assessments and interventions, including interventions with pregnant mothers. This volume is essential for clinicians specializing in attachment disorders and relational trauma, child psychotherapists, infant mental health workers, pediatricians, psychoanalysts, and developmental researchers. It combines fascinating new information and illustrative clinical experience to illustrate the early intersubjective origins of our own and our patients’ internal worlds.
The rich, complex theory of affect regulation boiled down into a clinically useful guide. Affect regulation theory—the science of how humans regulate their emotions—is at the root of all psychotherapies. Drawing on attachment, developmental trauma, implicit processes, and neurobiology, major theorists from Allan Schore to Daniel Stern have argued how and why regulated affect is key to our optimal functioning. This book translates the intricacies of the theory into a cogent clinical synthesis. With clarity and practicality, Hill decodes the massive body of contemporary research on affect regulation, offering a comprehensible and ready-to-implement model for conducting affect regulation therapy. The book is organized around the four domains of a clinical model: (1) a theory of bodymind; (2) a theory of optimal development of affect regulation in secure attachment relationships; (3) a theory of pathogenesis, in which disordered affect regulation originates in relational trauma and insecure attachment relationships; and (4) a theory of therapeutic actions targeted to repair the affect regulating systems. The key themes of Hill’s affect-focused approach include: how and why different patterns of affect regulation develop; how regulatory patterns are transmitted from caretakers to the infants; what adaptive and maladaptive regulatory patterns look like neurobiologically, psychologically, and relationally; how deficits in affect regulation manifest as psychiatric symptoms and personality disorders; and ultimately, the means by which regulatory deficits can be repaired. Specific chapters explore such subjects as self states, mentalization, classical and modern attachment theory, relational trauma (and its manifestations in chronic dissociation, personality disorders, and pervasive dissociated shame), supporting self-development in therapy, patient–therapist attunement, implicit and explicit therapeutic actions, and many more.
A practical guide to working with the principles of polyvagal theory beyond the therapy session. Deb Dana is the foremost translator of polyvagal theory into clinical practice. Here, in her third book on this groundbreaking theory, she provides therapists with a grab bag of polyvagal-informed exercises for their clients, to use both within and between sessions. These exercises offer readily understandable explanations of the ways the autonomic nervous system directs daily living. They use the principles of polyvagal theory to guide clients to safely connect to their autonomic responses and navigate daily experiences in new ways. The exercises are designed to be introduced over time in a variety of clinical sessions with accompanying exercises appropriate for use by clients between sessions to enhance the therapeutic change process. Essential reading for any therapist who wants to take their polyvagal knowledge to the next level and is looking for easy ways to deliver polyvagal solutions with their clients.