11/27/2023 Video + Article: The Difference Between Sensorimotor Psychotherapy and Somatic ExperiencingRead NowAs the regional organizer for Sensorimotor Psychotherapy, I often get asked what is the difference between SP and SE. I did not create either of these resources but these are what I give to people who ask that question. I, unfortunately, do not have the name of the person who wrote the article but I do know that they were certified in both SE and SP.
Comparison Sensorimotor and Somatic Experiencing Somatic Experiencing and Sensorimotor Psychotherapy are two very distinct therapies with differing goals. Their founders had different objectives in mind; Peter Levine wanted to learn how to heal human trauma from observing animals in the wild, while Pat Ogden wanted to synthesize body and talk therapies to heal traumatic and developmental wounds. As a result, there are fundamental distinctions in their notion of therapeutic action; their understanding of the role of feelings, words, and thoughts in treatment; and their ideas about the therapy relationship. For example SP has developed specific techniques for emotional and cognitive processing, which plays a very important role in SP treatment. In comparison, because SE it is an approach based on animal behavior, it does not treat higher order functioning in the same systematic way that it treats autonomic nervous system imbalance for which it has a highly developed protocol. The distinction in goals and intention is clearly reflected in the overall structure and content of the training programs. While some of the techniques are similar because both incorporate a neurobiological model, they are elaborated in very different contexts. In SP the techniques are taught in relation to broad principles of practice, phases of treatment, and stages of the therapy process. Students are taught to apply SP techniques in accordance with certain criteria, i.e. whether the trauma is developmental or shock trauma, whether the phase of treatment is stabilization or memory processing. In SE on the other hand, the focus is not on the timing of the application of the technique but on the refinement and enhancement of the individual’s capacity to discharge arousal through such practices as titration, pendulation, resourcing and managing over-coupling between different elements of experience. After the first level of training, SP and SE completely diverge. The second level of SP deals with attachment patterns and character strategies and processing resulting emotions and limiting beliefs. In the second level there is an elaboration of the relational focus of the model with an emphasis on transference, countertransference and enactments. In contrast, the second level of SE applies the principal techniques of the first level to distinct kinds of categorical trauma like physical injury, horror, inescapable attack, emotional trauma and natural disasters. Training hours are spent on specific traumas within these categories such as drowning, electrocution, burns and car accidents. Which training should a practitioner choose? Pat Ogden’s broader project of combining talk and body therapies into a cohesive psychotherapy model to work with trauma and attachment is the mainstay of the SP training in the way that Peter Levine’s broader project of utilizing the technique of discharging excess arousal as a means of trauma resolution is the mainstay of the SE training. Which training a student would find more helpful is a matter of individual choice based on professional training and interest.
0 Comments
Relationship: We believe that relationships that are respectful, empathic, playful, open, honest, curious, and properly boundaried are healing in and of themselves. We believe that the rupture and repair cycle is foundational to connectedness and, therefore, celebrate difference and conflict. The relationship is the foundation of our work together as clinician and client and among clinicians and partners in the practice.
Somatic Therapy: We use talk, touch, and movement that lead to greater awareness of the body, mind (nervous system), and spirit to create a secure attachment relationship with the body and minimize the noise of trauma. (Sensorimotor Psychotherapy, Somatic Movement, and MFR). Parts Work: We believe in connecting subpersonalities (prosopon - the parts of the human that change) to the core Self (hypostasis - the aspect of the human that stays the same), promoting a secure attachment relationship of the parts to the Self Spirituality: We believe that the realm of the spirit operates on specific rules/laws that one must discover for oneself. That discovery process is healing in and of itself. Interdisciplinary: We honor the contributions from other medical, therapeutic, healing, and cultural lenses. We celebrate working in a multidisciplinary/multicultural manner. Intersectional: We recognize the harm caused by institutionalized racism, ableism, homophobia, etc. We encourage clinicians, and partners to consider how we can reduce the damage of prejudice in our groups and institutions while also working to support individuals in improving their own lives despite ongoing oppression. Healthy Lifestyle: We honor that research science has proven that a consistent whole-food diet, strong relationships, good sleep hygiene, and regular physical activity can improve and modulate mood, prevent and treat physical disease, and foster a sense of well-being. We encourage clients and clinicians to adopt a healthy lifestyle in a manner suitable for the individual. We acknowledge limitations due to accessibility and work to shed light on systems that create barriers (e.g. food deserts, predatory marketing, and poverty). Harm Reduction: When addiction to a practice that is harmful to the health is present, we use a harm reduction model over abstinence. The reason for this is if the wound or underlying trauma that causes the harmful behavior is addressed, the harmful behavior will stop because the person no longer needs it. Contrarily, if abstinence is encouraged, clinician and client are liable to experience an unhelpful entanglement with each other and each other's parts, preventing the client from spending time where it matters most: working with the underlying wounds. Harm reduction can also be applied to people living with chronic illnesses of all kinds. Though there may not be an addiction present, we aim to reduce the impact of symptoms rather than attempting a complete “cure.” Pursuing perfection, in this instance, can be more harmful than helpful because the client can feel pressured to “be perfect” before reengaging meaningful activities. We believe that one can have a full and meaningful life while experiencing symptoms. I am not formally trained in IFS but I am trained in parts work. I find the IFS way of explaining parts work to be be especially helpful. So, you have a mystery illness…
Or cPTSD, dissociation, an autoimmune diagnosis, mold illness, MAST syndrome, POTS, etc. You've had symptoms for a long time. You have seen many doctors and specialists. Nobody has any answers for you. Now, you're in therapy because you are beginning to feel despair. You don't know what's going on. You feel some relief because you found a therapist who works with this situation, but part of you is already out of hope. Your back is against the wall. I am so familiar with this situation. In my early days as a bodyworker, many clients came to me in this condition. My own story has similar elements. Here is how I have seen this situation play out in therapy. Beginning Therapy First, we have to establish a connection between you and me. I am just another provider. You have no reason to trust me. You are probably feeling isolated, confused, misunderstood, and dismissed. My job, first and foremost, is to help you feel connected, understood, and validated. I wish I could help you with the confusion, but a lot of this is confusing to me, too. We will have to work together, possibly with other providers, to get to the bottom of this. People can find answers, and a lot of people do get better. When people don’t get better symptom-wise, they can often find a way to come to terms with their situation and live a fulfilling life anyway. Second, I support you in continuing to look for medical professionals, including functional medical practitioners, who can help you with your symptoms. It is not a foregone conclusion that you will need a medical professional, but you have symptoms, and it would be unethical for me to suggest that you should stop that search. Just because you have something that is hard for the medical field to recognize doesn't mean you don't have something that the medical field can help you with. Third, I begin to provide integrative somatic trauma therapy. That means I support you with somatic interventions and parts work. I encourage you to add movement and nutrition that works for you. We can add movement and nutrition professionals to your team if necessary and accessible. If you have a diagnosis that needs support from medical professionals, adding trauma and somatic therapy can only help. If you don't have a diagnosis and your symptoms are solely from your traumatized nervous system, then we will have already begun interventions that will help with your symptoms. Diagnostic Considerations When clients hear they may not have a diagnosis, they can feel dismissed, or they can feel relieved. If you feel dismissed, I want to assure you that just because someone doesn't have a diagnosis does not mean that what is happening isn’t real. What you are feeling is real; it may not be something that traditional medicine and therapy can help you with. You may have something that is not a classic medical diagnosis and would be better supported by a functional medicine doctor and modern somatic trauma therapy. If you need support from a functional medicine doctor, I will help you get that kind of treatment. I have supported many of my clients' engagement in functional medicine. The first time you begin functional medicine, it can be really confusing. It is often helpful to have somebody who has witnessed a lot of functional medicine cases help you navigate the immense amount of decisions that you're going to have to make on functional medicine route. Sometimes, clients start receiving functional medicine and ask me, “Do I really have to do all this? Can we just treat my nervous system and skip the medical aspect? Won’t my symptoms go away if I just have a balanced nervous system?” In my experience, the answer might be yes. However, the clients I have seen that heal the fastest follow some kind of health support along with somatic therapy. If you are symptomatic, that means your nervous system has been dysregulated for a long time, long before your symptoms emerged. Functional medicine, traditional medicine, nutrition, and movement interventions help alleviate and reverse some of the damage that has been done while we rewire your nervous system pathways. A multipronged integrative approach accelerates your healing. I will support you in making decisions about what protocols to follow and how much or little you want to do. Often, less is more (to a point). If you feel relieved that you may not have a diagnosis, that's great. The course of treatment on my end as your trauma therapist is the same whether you have a diagnosis or not. Whether you have a diagnosis or not, you will have experienced stress and maybe even a traumatized nervous system just from going through this mystery-illness-situation. If you do have a diagnosis, I will tailor what we are doing for that diagnosis. Furthermore, I will always tailor what we are doing to your unique situation, diagnosis or not. Phases of the Process People who come to me for treatment for a mystery illness, dissociation, or complex trauma tend to follow a similar trajectory that takes about two years. The following are the phases of the process. Slowing the chaos train takes about six months. This is where you and I are establishing rapport. I'm wrapping my head around the situation that you're in, and we are looking for ways to simplify your life without completely derailing you. I introduce you to parts work and we begin mapping your inner world. This period can feel like it gets worse before it gets better. Even though it feels like it's getting worse, I promise you it's starting to get better. Knowledge is power, self-knowledge even more so. “Mere” understanding can provide a lot of relief. Here is a caveat about the chaos train. Indeed, many can slow its roll in about six months but there are some exceptions. Sometimes a part of you is not done trying to do life "it's way." That's ok, it just means phase one takes longer. You know its over when you feel a clear feeling inside that says "I'm ready." Once you're ready, the rest tends to happen relatively quickly. You can still get a lot of preliminary work done before you're REALLY ready. Finding practices that genuinely work for you comprises the second six months. This is a period of experimentation and trial and error. We have an opportunity to learn even more about you and start to help give you more marked relief than the first six months. You'll get some relief in the first six months, but it starts to become more tangible in the second six months. Then, you deepen into your practices. In the third six months, we know a lot more about how you operate based on your responses to our trial and error experimentation of the second six months. This is when people start to really get a sense of relief. This is when you are in the “gym,” so to speak, applying the workout regimen that allows us to shift how your nervous system processes function profoundly. You can think of your former habits and processes like a well-cut trail in the woods. Your brain has been following a path that has been walked for decades. No plants grow on it. It is a deep rut of dirt. Now, we are creating a new path through the woods, one that works better for you. We are starting to pound out the dirt on this new trail, but it is thin and shallow and has a tendency to get overgrown. You begin to trust the process, and you begin to trust yourself in the fourth six months because you've started to see how these practices specifically tailored to you improve many areas of your life. If you have a diagnosis, it may not take away the disease or the disease process. Still, you do notice that it lightens your load physically and helps you have a more helpful belief system about your disease process that lightens your load mentally. You may even experience a decrease in your symptoms, something I've seen many times, too many to count. If you don't have a diagnosis and your symptoms truly are from trauma, it is common to see an almost total elimination of symptoms. At this point, you may not be symptom-free, but the difference between when you started and where you are now is so significant that you feel like you have performed a miracle. At this point, you have an orientation towards life and a set of practices that you can continue to do. Even if you are not symptom-free right now, you may experience the elimination of symptoms someday if you continue to practice cutting new trials in your neurological forest. Upsides and Downsides This process is not for the faint of heart. There are times when people regret having, as one of my clients puts it, “ left the shore” and wish they were back in the harbor. You may feel angry that you started this journey and scared that you left the tools that were “working” for you. You'll have to remember over and over again that those tools were also part of what brought you to therapy in the first place. This process is only for people who have a basic support system, unfortunately, because it is a destabilizing process. You also need a reason for why you are doing this process, whether that is more quality time with loved ones, a better quality of life for you, or the ability to express the gifts and talents you have that these symptoms cover up. Only you can decide if you are eligible to embark on this recovery journey. If you do choose to walk this path, whether you work with me or not, I commend you. If you choose to stay in the harbor, I respect your decision. This path is one of the hardest things anybody can do in life. This will not be like a typical accomplishment with public celebrations and awards. Some people will get it, and some people won’t. But if you undertake this massive task, you won't care what other people think because you will finally have the peace of mind and freedom that is yours and yours alone. Here is an essay by Dick Schwartz about the Larger Self. I love how he and his Internal Family Systems model conceive of what has been called "the higher self" and so many other names throughout history (Prana, Kundalini, the Atman, Christ Consciousness, Buddha Nature, neti neti neti (not this, not this, not this)). Since the earliest days of my work as a swim coach, I have emphasized orienting clients and students to their higher selves because to enjoy doing or achieving anything in this life truly, even the backstroke, we must first know our true nature. This essay of his discusses that Self.
Techniques that provide memory reconsolidation are a foundational element of the Prosopon approach. Ch 1 of Bruce Ecker's book Unlocking the Emotional Brain offers background information about these techniques.
Tracking the dynamics in the Polyvagal system help us know where you're at in your process so that we can use appropriate interventions that support your recovery and evolution.
No Time For Trauma
You’re in pain and have no time for this. Life is happening, and you’re sick of this crap hurting you and slowing you down, taking all your joy away. If you’re beginning trauma therapy, you probably want this to be over yesterday. By this, I mean your body symptoms, bad thoughts, anxiety, self-hatred, or whatever else you experience. I want that for you, too. That means you need to stop everything right now. The fastest way to address your trauma is to SLOW DOWN. That’s it. There is no quick fix or cutting corners. Everyone comes to trauma therapy like college kids to a get-rich-quick scheme. You may get some temporary results, but cutting corners will not create lasting wealth (healing). Not being traumatized anymore is a learned skill. There is no magic wand that will make you a champion skier, nor is there one that works for trauma. "I've tried to slow down, and I can't." Totally, I get it. I've been there. The first scary steps of the process take about six months on average. These first six months are all about decelerating the chaos train. It feels scary. Part of you thinks going fast is what you need. "I've lost so much time! I can't afford more time lost." Then hurry up and stop. Your current mode of operating got you this far, but it won’t get you where you need to go. Stop everything. Eliminate as much complexity from your life as possible but, more importantly, learn to stop your inner processes. This is sometimes called "thought-stopping." Stop explaining, understanding, worrying, scheming, searching, complaining,... Just stop everything and hear the silence within. Trauma is essentially a habit (called procedural learning). You don’t intend to do the habit. The habit happens when you’re not paying attention. That is why your symptoms seem to happen out of nowhere and why they seem out of proportion to situations you find yourself in. If you can stop, you can begin to track your trauma habits. Learning to stop is not the “answer.” It is the beginning of a long, strange trip to freedom. |
Details
AuthorProsopon Therapy Archives
April 2024
Categories |