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What Does Body Psychotherapy Look Like? (Why Body Psychotherapy? - Part 5)


In the previous posts about body psychotherapy, I’ve provided an overview of why the body is important in psychotherapy, and I’ve also discussed three of the benefits:

However, these may not provide a very clear picture of what to expect in a session or over the course of therapy with me. Despite the fact that there is no ‘typical’ session, in this post, I will offer a case study that will at least give an idea of what a potential client might be able to expect.

For this case study, I will draw on my many experiences; “Paul” is not any particular individual.

Consultation

Work with Paul began with a phone consultation. He told me that he was having issues in his relationship and had a hard time communicating with his wife, Laura. While he loved his wife dearly, she complained that he lacked passion for her. Indeed, he described feeling distant from her, particularly recently. He was afraid that Laura was going to leave him, and he had begun to feel depressed and anxious. After discussing other stressors in his life, Paul asked a few questions about me and what I thought about his situation. I assured him that what he was experiencing was completely understandable and that I was optimistic that therapy could help. We decided on a fee and set our first appointment.

Beginning: life context and building resources

In the beginning, I invite Paul to share more about his life, both past and present, so that we have the full context with which to work. I listen attentively, reflect what I hear, and ask clarifying questions. I know that we are beginning to build trust when Paul confides to me that, as a very young child, he repeatedly witnessed his father beat his mother. I notice that Paul’s breath became short as he fights off the desire to cry.

“It’s safe to cry here,” I say. Paul gasps on an inhalation but continues to fight the tears.

I take a deep breath, which cues Paul’s body to also take a deeper breath. “That’s right,” I say. “Take a few more with me.” I count to five as we inhale, and then I count to five as we exhale. We repeat this four more times. Paul looks noticeably calmer.

“That was a lot for a you, just a little boy, to witness. No wonder you get so upset when talking about it. The way you fight back those tears, I wonder if you are ready to talk more about it?”

Paul confirms my suspicions when he tells me he is not.

The rest of the session, I lead Paul through several exercises, helping him regulate his nervous system. Paul imagines a huge vault with robust security where he can temporarily store the things that are bothering him, yet he is not ready to work through. He notices his body relax.Paul then imagines sitting on a deserted beach, the sun on his skin, a place where he feels safe. Paul remarks that he had not felt so calm in days, if not weeks.

At the beginning of therapy, I am curious to learn about Paul’s life, and we begin to build common understanding and trust. Often, dealing with difficult events from the past, or even those issues that brought a client in for counseling, are very emotionally activating. I spend time with Paul to create internal resources to help him return to a more positive state, a feeling of calm. This builds the safety and trust needed for him to take a closer look at the more difficult aspects of his life.

Increasing awareness

As he develops internal resources and is able to access feelings beyond his anxiety and depression, Paul tells me that he is beginning to feel better, more optimistic. Still, he expresses the need to create real change in the way he relates to his wife. I invite Paul to tell me specific examples of times that he wanted to be closer to his wife but found himself creating more distance.

He describes an incident earlier in the week. His wife had just gotten home from getting her hair cut, and she looked beautiful to him. His wife came to him immediately without even closing the door, greeted him with a smile, and told him he looked handsome. At that moment, he remembers wanting to grab her, pick her up and spin her around, and tell her how much he loves her. Instead, he deflected her compliment, noticed that the door was still open, and said something sarcastic about their energy bill. After he finishes telling the story, I ask Paul what he notices now, and he says he is mostly confused and angry with himself.

I request that Paul start the story again, creating an image in his mind of as many details as possible. We go through the story moment by moment. As Paul sees his wife walk through the door, I say, “Freeze the image right there. Right now, in this moment, what do you notice about yourself. What do you notice in your body?”

“It’s full of energy,” Paul says. “I feel light. Almost like butterflies in my stomach.” Almost immediately, his face turns down. His body is still, almost frozen.

“What’s happening now?” I ask.

“This voice…it’s my voice but I can’t quiet it. It’s saying, ‘No. You can’t feel this way.’ It’s ridiculous. She’s my wife! I’m not allowed to feel this way?” Paul’s body, temporarily animated, returns to stillness.

“Notice that, Paul. There’s a part of you that doesn’t want you to feel excitement, to feel butterflies, for your wife. I’m noticing your body has frozen, Paul. What would happen if you were to move, even just a little? See where in your body you might be willing to move.”

Paul remains still for a few moments. Then, he yawns and rolls his shoulders. “What do you notice now?”

“I’m a bit more relaxed. I can feel the butterflies again a little.”

“From this place, as you see your wife, what do you want to do?”

“I want to go to her and give her a big hug.”

“And how would that feel?”

“Part of me thinks it would feel so good to be close to her again.” I see his body begin to tighten and become still again. “Part of me just can’t.”

By slowing down Paul’s story, he is able to better access how he organizes that experience. He notices that if he makes a small change (rolling his shoulders), he is able to shift his awareness back to sensations connected to desire for his wife. This does not negate the “freeze” response he has, but it does allow him to begin to imagine alternative ways to act in common situations with her so that he can create outcomes that fit with what he truly wants for his relationship. As we work to build these alternatives, Paul progresses and begins to act from them, though he still has a part of him that creates fear and sadness every time he allows himself to feel and express his love for Laura.

Processing the past

Paul begins to report that, sometimes, he is able to catch himself when his body begins to freeze around Laura, and he’s found that he can put the feelings and thoughts associated with that freeze into his vault, and he is able to move again, and, at the very least, avoid begin sarcastic with her. He reports that he and his wife are feeling closer, yet he is still unable to express his love for his wife fully; he says that a part of him is holding him back. He says that sometimes he feels he is even more distancing than he was before.

I ask Paul if he is willing to bring curiosity to this part of himself that hold him back. He says he is hesitant, but he agrees to try.

Paul remembers a recent time when he is sarcastic with his wife. His body again freezes, but this time I ask him to simply notice the freeze. “Sit with this sensation in your body as if you would sit with a friend in need,” I instruct. “Be curious about it, and try not to assume. Your body holds information, and if we approach it patiently, sometime we gain new insights.”

Paul sits quietly for a few minutes. His face becomes softer, and his mouth turns down and trembles slightly.

“What do you notice, Paul?”

“I feel scared,” he says softly.

“Yes. It’s okay to feel scared. You’re safe here in this room, and it’s okay to feel what your feeling. Stay with it.”

I notice that Paul begins to tremble more.

“I am remembering,” he says slowly, in a quiet voice. “My mom bought a new dress and had it on when my dad got home from work. When he saw her, he grabbed her and kissed her and told her she looked great.” Paul paused and took a deep breath.

“Stay with it, Paul, you’re doing great. That’s it, take another deep breath.”

“But then…” he continued. “Then…he started to yell. ‘Is that new? How much did you spend?’ And…he hit her. She fell to the floor, crying. Things like this, they happened so many times.”

“Keep breathing, Paul. You’re safe here. What are you noticing as you remember this?”

“I’m scared. I don’t know what to do. My body is shaking.”

“That’s okay. Stay with your experience. I know it’s hard. It’s okay to feel scared, to not know what to do.”

After a few minutes, Paul’s face tightens. “My jaw is tight,” Paul says. I encourage him to notice that, to stay present with that sensation in his jaw. “I’m angry,” he says. “I’m so angry with my dad. I’ve never been able to feel angry with my dad.”

Paul and I continue to work with this memory and others like it, slowing the scenes down. It is difficult for Paul to feel the fear and the anger, but it begins to dissipate. He begins to have compassion for himself, just a little boy when all this happened. He knows he doesn’t need to feel helpless anymore.

As Paul brings more and more curiosity and attention to his current life experiences, he begins to see how his current behavior has been shaped by his past. By working with the past experience, he is able to feel the feelings that he couldn’t feel as a child. Often it is not safe to feel our feelings as children because we do not yet have the internal resources to handle them, the people around us model avoiding feelings, or we are simply told it is not okay to express our feelings.

Integrating the past

By feeling his feelings and working with the other organizers of his experience (thoughts, body sensations, his senses, and movement), Paul integrates his past experiences. Instead of creating strong emotions that leak out of Paul as sarcasm, these experiences lose some of their emotional charge. These memories also now become usable; Paul begins to make decisions in his daily life that are informed by his past rather than dictated by it. He realizes that he blocks feeling passion for his wife because his father’s passion for his mother so often turned into something much more destructive. Paul comes to learn that he can feel and express passion in his relationship without becoming abusive.

At this point in our work, Paul has identified other issues he would like to bring the same kind of awareness to, yet he is also making strides in creating a closer relationship with his wife. We make a mutual decision to close our work together for the time being until Paul is ready or finds need to address some of the other issues he discovered during our work together.

Final thoughts

Paul’s story is fictional, yet also very real. I have had many experiences of therapy that have followed a similar path’s to Paul’s, even if the reason for coming to therapy was very different. However, everyone’s experience is different. I offer this case study as a way for potential clients to begin to envision what therapy might look like with me at On Solid Ground. If you are interested in discussing your unique story and how we may work together to support your healing, please click here to contact me.

Illustrations by Samanth Land. For inquiries regarding her work, please complete the On Solid Ground Counseling Service's contact form.

#bodypsychotherapy #counseling #whattoexpect #casestudy #example #therapy #therapysession #relationshipissues

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Steven Moore, MA, LPC

Licensed Professional Counselor