Psychotherapy has many modalities and schools which emphasize different aspects of the human experience; emotions, cognition, behaviour, communications, insight, relationships, life cycle, family history, etc. Body-oriented psychotherapy focuses on the body. Somatic Experiencing (SE) involves that part of the body called sensations (or somatic experience). Its named as the “Somatic Experiencing ®” method by its founder by Peter Levine. It was introduced by him in his 1997 book, Waking the Tiger: Hearling Trauma. People who use this method are known as SEP (Somatic Experiencing Practitioners). They don’t claim to be psychotherapists. I had the honor of witnessing a live demonstration of this particular form of body / somatic work this year in Hong Kong.
Somatic Experiencing: My attempt to describe it
SE has an official institute (the Somatic Experiencing Trauma Institute) and a website (https://traumahealing.org.) According to Peter Levine, trauma is remembered in the body and in body sensations. The primitive animal system in our neural network retains its survival instinct of fight, freeze, or flight responses. Several neurological circuits are involved: the sympathetic and parasympathetic neural sub-networks and the vagus nerve. This neural network is autonomous, instantaneous, and even subconscious. Modern humans, culture and society have resulted in activation of this animal survival instinct beyond its basic function of survival. We experience “simple” traumas which might be short, intense and shocking, such as killing someone, witnessing killing or being involved in a fatal natural disaster. We experience “complex” traumas which might be lengthy, invasive, abhorrent and abusive, such as childhood emotional neglect or controlling manipulative parenting. These lived experiences traumatize us and activate our primitive neural network of survival. But the full expression of this survival is repressed, or not fully processed, or not returned to the default psycho-somatic mode. In other words, trauma sufferers are stuck in their survival instinct response and continue their lives with this “stuckness” or undischarged stress. This decreases their functioning in life and mental well-being. The SE practitioner works with the trauma by processing the somatic sensations in the here and now of the therapy session. Trauma could be traumatic events causing PTSD. It includes complex trauma from past relationship injuries accumulated over time.
Somatic Experiencing: A description by a SEP
“The body-oriented psychotherapy approach, Somatic Experiencing® (SE), developed by Dr. Peter A. Levine, teaches clients how to track sensation in the body through sensate focus to elicit the intrinsic healing capacity for self-regulation and healing that all humans share. Connecting the client to the experience of their innate healing wisdom supports mastery and restores self-confidence and the inner experience of core intactness regardless of previous experiences.” (Source: Dianne Poole-Heller MA, LPC, NCC, Ph.D, SE Practitioner. In www.seaustralia.com.au)
My Background: Limitations and Biases
Apart from superficial reading and brief conversations about SE, I have very limited knowledge of the SE concept, its theories, theoretical orientation, and methodology. I am interested in SE as a form of psychotherapy which might be integrated with my practice. I am a family therapist and family mediator with 3 years of post-FT master’s graduation practice experience in HK. If forced to apply a label to my theoretical orientation, I am a post-modernist with a post-positivist armor. My writing this article reflects my limited knowledge and experience; and at the same time, furthers my own family therapy practice and knowledge. I am writing from my handwritten notes taken during the session and from reflections of my notes and my memory of the event.
The Demonstration Background
This year, I had the opportunity to attend a live case demonstration by an acknowledged senior Somatic Experiencing Practitioner (SEP) from Brazil named Sonia Gomes, an extraordinary practitioner (at least to me). The demonstration took place during a beginner’s 5 days training module in HK for the 5th batch of students in what is a 2 or 3 year long training curriculum. It took place for about 1.5 hours in a morning training session. The Client is real; this was not a role play. For the writing of this reflection, I make random changes to the characteristics of the Client and the contents of his disclosures to ensure anonymity and confidentiality. His pseudonym is Starsley.
Starsley was chosen by Sonia, the SEP, amongst the many who submitted a request to be allowed to be a live demo test subject. A fellow audience member sitting close to me informed me that she too had volunteer and hoped to be chosen. If the intake protocol of SE is followed, then it is likely that this request contains the following information about Starsley: health history and expectations. This was the 1st of the live cases on that day. Starsley had several sessions from the referrer already. The referrer appears to be, but I am not sure, a student of SE or a SEP. The reason that Starsley volunteered was the reputation of Sonia as one of the best (so said Starsley at the beginning of the session). This would put Sonia in the position of a consultant and the session, a consultation session. Starsley is married with children at the early stages of marriage within the family life cycle. This is the 1st time that Starsley is interacting with Sonia. Starsley’s spouse and children did not participate; but they were present outside the small hall in which the session took place. They were in the hall at times; but my attention focus was in the SEP-Client interaction and I did not know how frequent or how long they stayed in the hall. The presenting trauma was written in Starsley’s request and not made know to the audience beforehand (and arose from the session itself).
Before inviting the Starsley, who was sitting amongst the audience, to come forward, Sonia was telling the audience how each session was different. “I never know what will happen or come out in a session,” Sonia told the audience. She also mentioned how she will give the totality of her “mind, body, soul and self” in the interaction with Client. Then Client take his/her place in front of the audience.
The session set-up looks like a psychotherapy session with therapist and client sitting across each other slightly tiled to face the audience of 30-50 people. Even before Starsley sat down, Sonia was already describing Starsley using the hero metaphor to acknowledge his courage and resolve to come to this live case demonstration as a client. While the lapel microphones were being fixed, Sonia was continued to engage Starsley in conversation (social engagement conversational state of SE). She continued to radiate confidence and positivity in her appreciation of Starsley. “I am here for you” she said. “It is normal to feel nervous.” She was sitting close to Starsley and her left hand was on his right elbow. She was barefooted (I did not notice when she took her shoes off) and with one of her barefoot, she was stepping gently on the right shoes of Starsley as they talked.
I noted the respect shown by Sonia towards Starsley. She prefaced nearly each progressive step in the session by first asking for permission from Starsley to proceed to the next step; such sitting down, or lying down. Although Starsley had literally complied with each of her requests, it was clear to me that Starsley did not have agree to such request and it would have been alright for Sonia.
In a self-introduction at the start of the session, Starsley briefly mentioned a history of irritable bowel syndrome as an adolescent and one other mental or medical diagnosis of which I cannot remember. Sonia made explicit how she is communicating both to Starsley and to the audience in her conversation with Client.
By this time, I felt that Sonia has established a rapport with Client and the safe environment for Client. Then Sonia directed Starsley’s attention to body sensations. “Tinkling on the chest and then the top of the head”. Sonia proceeded slowly in a calm and confident voice to focus Starsley on body sensations and to describe them. Sonia referred briefly to Client’s pre-session request paper and made reference to a past stressful life event when Starsley was young. Starsley elaborated and I came to understand that it was about one of Starsley’s parents having dramatically failed in such a way that the family had to sell their home and live off the generosity of another family for several years. Starsley also mentioned that because of the parent’s failure, Starsley’s sibling ran away from home which appeared to also cause more stress. At this stage, Sonia go into any detail of this series of past events. Literally, the two above simple sentences on the two events were all that Sonia required.
The pacing of the session continued to be slow and calm with focus on the sort of body sensations. By this time, her barefoot was not longer resting on Client’s foot. My viewing position and angle in the audience was limited and I could not see when this occurred. The quality of her verbal and non-verbal communciations (her tone of voice, the tempo of speech, her mannerisms, her facial expressions and body posture) reminded me of the trance work and hypnotic suggestions of Erik Ericson and his followers.
In the middle of the session, with Client’s permission, Starsley lied down on a comfortable light bed which Sonia had requested assistants to take out and unfold. When Sonia decided to do this, she told the audience that she was demonstrating an advance technique beyond the beginning and intermediate course levels of SE training. I was given the impression that for Starsley, more advanced techniques were required. Starsley was not talkative and does not elaborate much … as if Starsley was waiting.
Sonia sat at the head end of the bed, touching Starsley’s head and making sure that Starsley’s clothing was loose enough as to be not constricting. A thin cloth blanketed Starsley. Again she asked what sensations were felt. Again Starsley’s response were sparse and simple ( I cannot remember exactly what they were). Sonia told the audience to notice that Starsley’s hands rested on the hips. She requested Starsley to lift his legs. Then she went to the feet end of the bed and assisted Starsley to try several postures with one or both of his legs lifted from the bed and Sonia using her palms to press on the bottom barefoot(feet) of Starsley seemingly to hold them in place. She requested Starsley to press the feet against her palms. After a few seconds she suddenly released her palms’ from pressing on Starsley’s barefeet; which resulted in Starsley’s legs collapsing back onto the bed in a measured way with a fall that lasted about 1 second.
It was sometime during bed part of the session that Sonia directed the conversation to the past event mentioned by Starsley at the beginning. The focus was on positive aspects of that series of events. My notes are not so detailed and my memory less detailed for me to recall more. My impression is that Sonia did not ask questions or talk about how traumatic it was, how negative the emotions were, how bad the situation was, who were involved or what effects the events had on Starsley. Sonia’s focus was more neutral and may have addressed the relationship that Starsley had with parents and siblings both within the context of the events and generally. On writing this, I wish that I had taken detailed notes on how she directed the conversation to see if I can detect whether I could see any similarity between what she said with what a strength based approach would do, or a solutions focused exceptions approach, or narrative style searching for stars in a field of crosses approach, or some other positive techniques. In any event Sonia still did not go into much details of the past events. It was clear to me that this was not “talk” therapy with detailing, interpretations or analysis.
Client’s utterances during session were not much. Near the end of the session as we approach 1.5 hours from the commencement of the demonstration, Starsley was able to voice out Client utterances at the end. “I love my spouse, my children, my parents.” Client utterance to children, “I love you” At the suggestion of the therapist:
How I experienced the Demonstration
I am sure that other audience members when accessing their memories and notes would have a different experience witnessing the demonstration and their own interpretation and analysis. This is just mine. If any of the facts in my narration is different, I will be interested to know; in order for me to see whether it affects my experience and interpretation.
If you were a grounded theory researcher coding my above narrative of the session, you would already sense from my languaging how I would code my experience as observer of the SE method in action and the behaviour of the SEP. Or if you were using narrative or linguistic analysis, you would already have an idea of how I storied my experience.
Rather than any lengthy discussion or analysis, I offer below in point form a summary of my experience and my thoughts of Sonia as SEP and the SE session as co-created between Sonia, Starsley and the audience. I am languaging from a psychotherapy perspective.
The SEP or Sonia’s attitude
- Non-expert attitude. Using the label “Practitioner”; not therapist, or expert or counsellor.
- Not knowing: “I never know what will happen or come out in a session”. Respect for and appreciation of clients. Client centered with unconditional positive regard and empathy. But using expert knowledge in the focusing on the somatic experience of client.
- Complete use of the self of the therapist in the session. “I give all of mind, body, soul and self”
- Respect and Value for Client. Sonia valued and respected Starsley. At no moment in time during the demonstration, did I experience any disrespect or pathologizing towards Starsely. Instead I felt a genuine valuing of Starsley as a fellow human being by Sonia.
The therapeutic relationship or the interpersonal interaction between Sonia and Starsley
- Physical touching not avoided. Touching by hand and foot of Sonia on the arms, foot, chest around the neck, hips and feet of Starsley. Neither frequent nor constant. Sparingly would be the word.
- Mental bonding between therapist and client. Sonia created a friendly environment which facilitated a psychologically safe place for Starsley. I think that she did it in the following ways. She paced her speech and used a calm and confident voice. Her speech was short and succinct. She did not go into long explanations or ask numerous detailing questions. She acknowledged and validated client. She was explicit to client in what she was doing or will be doing.
- Working with body somatic sensations and postures as indicators of trauma/ stress and as the pathway to release from trauma/stress in somatic based therapies
- The therapeutic relationship or alliance in various forms of Common Factors Theory.
- Unconditional positive regard, and congruence of Carl Rogers. I hesitate to add empathetic understanding, which must be present, because there was so little verbal exchange between Sonia and Starsley upon which I would rely before I can say with confidence that this 3rd Rogerian necessary condition for psychotherapy was present.
- Trance-like similar to Ericsonian hypnotherapy.
- The Self of the Therapist as written by Virginia Satir, later life Salvador Minuchen, Harry Aponte, and Carl Whitaker.
What was the trauma that was processed? The dramatic failure of the parent? The lost of the family home? The reliance of the family on others? The running away of the sibling? We don’t know. None of these questions were asked nor arose from in-session conversation.
It reminded me of how it was possible for a therapist to just lead client into a certain talk topic and then not probe into details and just let client self-reflect with no verbalization. Client chooses whether to verbalize and how much to verbalize. EMDR employs the same reasoning. The client of a EMDR practitioner does not insist on detailed verbalization.
The SE method does not require insight. It does not address behaviour. It does not require verbalization of cognitions or re-cognitions. It does not directly address emotions. There is no interpretation or analysis in the session conversation. It relies on sensations. As a SEP, Sonia is congruent to and has adhere closely with her chosen methodology of SE.
A Last Question and An Answer
The SEP did not ask for client’s feedback of the session. Nor do I find this in their methodology. What changes did client feel or perceive? In what way did client change? If any change, how long did the changes last? Ultimately what matters is whether client felt that the SE method or the SEP was effective for him. My pragmatic and utilitarian selves are fixated on this last question of effectiveness.
But I know that psychotherapists hardly have the pleasure of knowing whether what he/she did in therapy was useful or helpful to client and client families in all his/her cases. Even client tell you, you do not know if it is actually so. And change may have been induced in client which are not in client’s awareness or within client’s willingness to acknowledge that the change was due to the therapist, especially if the therapist works to strengthen client’s self-agency and cause of change has been internalized as the client’s own.
If SE is a portal that transforms certain individuals to lead better lives, mental well-being and social functioning, then it is a welcoming addition of other effective models or techniques. The SE Method website claims to have trained 12,000+ healing professionals. Trainees told me that as part of their training, they have to experience SE themselves as clients. The amount of interest in SE and the number of students who are willing to complete their 3 year training course to become SEP can be said to be a testimony of its effectiveness. For them SE is effective.