Bodytherapy <=> Psychotherapy

Bodytherapy is Psychotherapy, and Psychotherapy is Bodytherapy. 

There, I said it. 

This reality is a huge taboo, and its taboo status has been gnawing at me.

Like many therapy professionals, my work is deeply connected to my personal journey. My life began with a foundation of confusion and fear, driving me to seek answers early on. At seven, I was fascinated by Maslow's hierarchy of needs, and by nine, I boldly declared that the cycle of my family's ancestral trauma would end with me. Despite having many friends and achievements, I always felt like an outsider, navigating life on shaky ground and unable to follow the "normal" path.

My first encounters with therapy came during my teenage years, and I saw several psychotherapists in college. However, my condition continued to decline until I met a psychologist and an osteopath who treated me like a person. This, I believe, is the essence of good psychotherapy: seeing the client as a whole person.

You might wonder, "If your other therapists weren't treating you like a person, what were they treating you like?" At times, I felt like I was merely a paycheck, a diagnosis, a problem, a juvenile delinquent, an ego booster, or a naïve teenager. I kept waiting for someone to ask, "And how does that feel in your body?" because I was experiencing so much physically, and I was surprised no one did.

Working with those two professionals evolved into a mentorship that shaped my approach today. One helped me understand transference, countertransference, and parts work, while the other introduced me to Osteopathic Manipulation and Katsugen Undo. Both taught me mindfulness and spirituality, leading me to leave the traditional career path and start a massage and yoga practice.

With their guidance, I moved away from medication, worked with a Functional Medicine doctor, and eventually stopped using FM protocols as well. By then, I had completed yoga teacher training, learned Myofascial Release, practiced energy work, and participated in extensive group therapy. I found freedom in using food, connection, and movement as my medicine, and for the first time in my life, I seldom felt fatigued because I was living in alignment with my values and regulating my nervous system.

My clientele began to evolve, attracting people who had experienced trauma and were dealing with its psychological and physical consequences. During bodywork sessions, clients would sometimes shift into sub-personalities, discharge their nervous systems, or recall memories spontaneously. When someone becomes a scared two-year-old on your table, you help them. You don't tell them to "cut that out" because this isn't psychotherapy. I did my best but knew I needed more training.

I attended the Interpersonal Neurobiology Conference and discovered Sensorimotor Psychotherapy. Shortly after, I woke up one morning and wept, realizing what I had to do. I shut down my thriving practice in Austin and moved to Boulder to study somatics. While in graduate school, I restarted my practice, earned my degree, and got certified in Sensorimotor Psychotherapy.

I had the serendipitous opportunity to work with a Functional Neurological Disorders expert, which brought all of my education together, enhancing my ability to help others on their healing journeys.

Learning to treat Functional Neurological Disorder (FND) was a pivotal moment for me, although I didn't realize it at the time. I hesitated to acknowledge it due to an unspoken taboo. Here's how this issue manifests:

• Bodyworkers with psychology degrees who wish to continue practicing bodywork are advised by lawyers to not only have separate onboarding and boundary practices (which I understand) but also to operate entirely separate businesses. While I see the protective reasoning here, I disagree with this approach as it stifles interdisciplinary innovation through fear and threat.

• In psychotherapy graduate programs, the use of touch is often discussed as if it is inherently harmful to clients. This leads to a rigid and narrow understanding of touch, implying it can only be sexual, which simply doesn't make sense.

• Body therapy programs often stress that body therapy is not psychotherapy, which reduces the chances for body therapists to learn about transference and countertransference dynamics.
  
  • As a result, when clients experience emotions or psychological symptoms during sessions, body therapists may freeze, dissociate, go silent, dismiss, give unhelpful advice, or try to fix the issue, instead of reflecting, affirming, validating, or facilitating the physical expression of emotion.
    
  • Effectively handling these situations requires personal growth work on the part of the therapist more than anything else. The actual techniques are simple, but the ability to use them well comes from the therapist's own development.

I respect the needs of large mental health institutions and workplaces that train new clinicians. While graduate programs do have rigorous evaluation practices, they often fall short in screening out clinicians who misuse touch or power. Understanding why touch is particularly taboo in these programs would require further research. Do we doubt new clinicians' ability to discern which clients would benefit from touch? Or are educators reluctant to learn about the appropriate use of touch themselves?

In residential programs, the taboo around touch is more understandable. During my time at inpatient treatment centers for people living with psychosis, it was evident that residents needed nurturing touch. However, allowing touch between patients posed risks, such as it turning into sexual contact or inappropriate boundary testing, which I witnessed frequently. While I believe we should strive to permit platonic touch despite these risks, I also understand why overworked and understaffed clinicians might avoid it. At a high-end facility for individuals with psychotic disorders, clients could leave the campus for massage therapy and physical therapy, among other complementary treatments. The disparity in care between those with and without financial resources is stark, and touch is one of the services these clients invest in.

Integrating touch in certain sectors of the mental health field is indeed a complex issue. However, there are many settings where it is both feasible and beneficial, such as private practices, group practices, and some community mental health clinics with relatively high-functioning clients.

I believe this enduring taboo around touch is more about habit than necessity, and it's time to reconsider these boundaries. We might need a separate field or license for those working with trauma from a nervous system perspective, or licensing boards could specify when and how such integrations are appropriate. Clinicians working in an integrated manner are generally not operating outside their license but are often fearful due to a lack of clarity. For now, I'll refer to this emerging field as Somatic Trauma and Attachment Therapy (STAT).

STATs use:

• Psychodynamic understanding of transference/countertransference
• Parts work
• Somatic Discharge practices (Somatic Experiencing, Sensorimotor, JFB Myofascial release, Katsugen Undo, TRE, etc)
• Somatic attachment practices (Sensorimotor, Hakomi, Dynamic Attachment Re-patterning experience (DARe), etc.)
• Any of the full range of somatic interventions (somatic movement repatterning, breath work, hands-on bodywork, martial arts perspectives, elements of yoga, certain aspects of physical, occupational, and massage therapy, dance, art, nature. Notice that parts of some fields are somatic and others are not. Too much to get into in this article)
• Spiritual and philosophical principles (no particular tradition)
• Awareness of the need for multicultural competence and ongoing humility regarding one's perceptions and prejudices in a multicultural or intersectional situation.

STATs Treat

• Nervous system dysregulation from a nervous system modulation perspective
• Habitual attachment, relationship, thoughts/beliefs,  movement, and postural patterns from past or ongoing trauma and developmental wounding

Somatic Trauma and Attachment Therapists (STATs) support individuals' personal growth and evolution while recognizing privilege and oppression dynamics and advocating for change in oppressive social systems.

STATs receive education, training, and supervision from experienced professionals within the field.

This outline represents the current boundaries of STAT practice based on extensive discussions with fellow STATs. I am passionate about continuing to explore and document the evolution of this field, as it is clearly developing its own unique path forward.