Somatic therapy with Andrea Bell

Hello, I'm Julianne Good, and this is Psych One-on-One. And we're here to make psychology understandable, interesting, and enlightening. And we're here to give you tips to make your life better and the family of your friends and family also. So, happy belated Thanksgiving. I hope everybody enjoyed themselves and didn't stuff themselves too bad and was safe and had a happy journey for the day. So, today we are going to talk about mind-body connection. Mind-body connection, what's called somatic therapy with Andrea Bell, licensed clinical social worker. And I'd like to tell you a little bit about her background. Andrea has been employed in the helping profession since 1988 and a licensed psychotherapist since 2003. She has a bachelor's in psychology from UCLA and a master's in social work from California State University, Long Beach. She is also a certified substance abuse counselor and trauma therapist. The population she has worked with include developmentally disabled individuals, people with chronic severe mental illness, and children using play therapy. Currently, she's in private practice specializing in the treatment of developmental and shock trauma in adults and is a training coordinator for the Somatic Experiencing Trauma Institute in Los Angeles. Welcome, Andrea. Hi, am I on air? You are. Hi, how are you? I'm terrific. Thank you so much for inviting me to be a guest on your show this evening. Well, thank you. I mean, there's a lot that we don't know about mind-body connection and somatic therapy, so this will be really interesting. So, can you tell us what exactly somatic therapy is? I'm licensed as a psychotherapist and in 2009, I became involved in somatic experiencing and that nestled nicely with my existing practice because, in my view, somatic therapy is a very important part of life. I'm licensed as a psychotherapist and in 2009, I became involved in somatic experiencing and that nestled nicely with my existing practice because, in my view, somatic therapy is a very important part of life. somatic therapy and somatic experiencing, which is the type of somatic therapy that I practice, nestled really nicely with someone's existing clinical skills. Basically, somatic therapy adds the component of the clinician and the client watching to see what the person's body is doing. Specifically, the unconscious reactions that the body has and the autonomic nervous system, which I'm sure we'll be talking more about in just a few minutes. Okay. Okay. Okay. And when you mean the body is, you know, being brought into the therapy session, what do you mean by that? Because for a lot of people, that might sound a little odd. Yeah. Yeah. And a lot of things we do in a somatic therapy session might seem a little odd. Traditional psychotherapy uses primarily the client's thoughts and the client's emotions for a vehicle for change. Okay. Okay. Okay. Okay. Okay. Okay. Okay. Okay. Okay. Okay. Okay. Okay. Okay. Okay. Okay. Okay. Okay. Okay. Okay. Okay. Okay. Okay. Okay. Okay. Okay. Okay. Okay. Okay. Okay. Okay. Okay. Okay. Okay. Okay. Okay. Okay. Okay. Okay. Okay. Okay. Okay. Okay. Okay. Okay. Okay. Okay. Okay. Okay. Okay. Okay. Okay. Okay. Okay. Okay. Okay. Okay. Okay. Okay. Okay. Okay. Okay. Okay. Okay. Okay. Okay. Eugene Gendlin was a psychotherapist who coined the term the felt sense and what he meant by that was everything that you know in your body not in a knowledge sort of sense but things like sensation body temperature small micro movements of the body that sinking sensation in your stomach maybe your shoulders are creeping up around your ears or conversely if you're in a good spot you might be experiencing things like a general sense of expansiveness warmth opening inside your head might come up you might feel your face smiling these are difficult to put words to because they're a felt experience they're not a spoken experience and somatic experiencing and I believe other somatic therapies help the person tap into that to solve what's going on with them so in the case of somebody having chronic pain I would imagine that this would be really helpful to sit there and track exactly what their body is doing versus just giving in automatically to that pain sensation is that correct yeah it very much can be I'm not specifically trained to work with chronic pain but a lot of my colleagues are there's a somatic experiencing faculty member named Maggie Phillips I believe you can google her and she has a book out and she specializes in working with chronic pain syndrome so let's see if we can get her to introduce the speaker so if she wants to introduce the speaker she can go ahead if she wants to introduce the speaker she can go ahead if she wants to introduce the speaker she can go ahead if she wants to introduce the speaker she can go ahead if she wants to introduce the speaker she can go ahead if she wants to introduce the speaker she can go ahead if she wants to introduce the speaker she can go ahead if she wants to introduce the speaker she can go ahead if she wants to introduce the speaker she can go ahead if she wants to introduce the speaker she can go ahead if she wants to a bear comes in the door. Of course, you're going to feel lots of anxiety. Your body's going to rev up with that survival energy. You're going to feel some fear, right? That's appropriate to the current environment. But if you're having that feeling as you're going around doing your day and the internal environment inside of you is not matching what's going on outside, then we call that excessive. We call that an anxiety disorder. Well, somatic therapies work directly with that excess survival energy where it lives in the body. So that instead of trying to manage it via thinking about it or changing your thoughts, you're going directly into that sense of racing, the racing pulse, the extra energy in your body, the bracing, the tension, and you're learning how to work with that to get it to settle or move out of your body so that you can go on and do something else with your day. Would that also include hyperventilating? Yeah. Basically, there's two parts to your unconscious. I'm going to grossly simplify this just for the sake of ease of understanding. There's two basic parts to your autonomic nervous, your unconscious nervous system, which is the autonomic nervous system. There's the sympathetic and parasympathetic. The sympathetic is basically the gas pedal. And that's what comes on when you have all that survival energy going on, when your body's responding to a threat. And Yeah. In a lot of anxiety disorders, we're finding that your body's responding to a threat that's no longer present. That sympathetic charge that your body is mobilizing to deal with that threat isn't appropriate to your current environment. And then on the other hand, you have the parasympathetic nervous system, which acts as the body's brake. It slows you down, it regulates digestion, it regulates hormone production, growth, rest, and recharge. So in somatic therapies, we're working to balance those two. That must be a little bit tricky to sit there and exactly track which system is taking over, more or less. Yeah. You mentioned there's a specific set of indicators. You mentioned hyperventilation. Basically, when you've got too much, and this is where we differ, from traditional psychotherapies, we definitely work with the story that the client brings in. It's very important. People need to be listened to. We definitely work with people's thoughts and emotions, but we're also stopping them and saying, hey, what's happening in your body right now? I notice that your shoulders are kind of up and you're breathing kind of fast. And they might say, yeah, my stomach's really contracting and I feel uneasy in there. And those are signs of sympathetic arousal. Dry mouth, shaking, um, quick labored breathing, increased heart rate, um, changes in temperature, digestion shuts off. The legs or arms might be starting to move and little micro movements that can sometimes be the beginning of a survival movement. Those are all signs of a sympathetic arousal. And how often are your clients tapped into that? Their bodies are doing that. At least at the beginning, I would imagine that, you know, you go a few sessions, and to working with a client, they understand that you're going to be tracking them physically. But at the beginning, how, how aware are they that, that their bodies are actually doing something that's not normal or healthy? It really varies. I mean, I put it in all my intake paperwork. I say, hey, you know, I want to be respectful. Your story is genuinely very important here. And it's only the, the, the spoken story is only part of the story and the body, not telling the rest. So I will interrupt you, even though I want to be respectful. I also want to give us a chance to see what's going on in your body and what, what's happening right here. And can we work with that directly? And they say, yeah, yeah. Okay. And sometimes, especially if they've done a lot of body work before, um, massage, uh, Feldenkrais, moving out of pain, uh, rolfing, certain modalities like that, they might be more condemned to the body. They might say, yeah, my stomach's upset and I'm feeling a little bit sick. And they say, yeah, I'm feeling a little bit sick. And I don't know why other people have managed to cope with, uh, if they have an anxiety disorder or depressive disorder by just sort of cutting it off, not aware of what's going on down there. So they understand the words when I say, okay, we're going to be tracking what your body's doing, but the experience is a different thing. So it really varies. Um, I think in our culture, people, there's a movement towards mind body connection and honestly, in practicing this, practicing this sort of therapy, I feel like I'm on the, beginning of a benevolent wave that's starting to crest over not only psychotherapy, but other healing modalities. And it's a wonderful thing. It's not taking away from anything. It's just including a very powerful other dimension in how we help people heal. Yeah. And it's adding to and increasing your effectiveness and their awareness of what's going on with themselves. That's incredible. I love it. If the listeners would like to call in and ask questions, participate, the number is 800-893-9562. Again, it's 800-893-9562. So Andrea, what percentage of your clients would you say offhand, um, come in and they're in denial of what's going on with them with a, with a mind body connection? I don't know that I'd say denial. That's probably, um, a shorthand. Um, I would say that there's really varying degrees of connection with it. Sometimes people are really cut off because it's painful to access the body because when you start to feel around in there, it brings you some sort of either pain syndrome as in people with fibromyalgia or people have pain disorders or migraines sometimes, or I think it's, uh, I can't remember which famous trauma researcher says that the body, the fear of trauma, that's where it all plays out. So it's understandable that people don't necessarily want to poke around in there. So we have to find ways to help people access that, that are gentle, that are tolerable, a little bit at a time. Um, one of the strengths of the model that I practice somatic experiencing is that they really emphasize titration. And titration is just like it is, um, if you're, if you're, if you're, if you're, if you're, if you're, if you're, if you're, if you're, if you're, if you're, if you're, if you're, if you're, if you're, if you're, if you're, if you're, On a psychotropic med or any type of medicine, your doctor might try and introduce a little bit of it at a time until your tolerance goes up. And it's the same with learning to work with this activation. It's very powerful stuff because it's the body's survival energy. People, Dr. Levine, when he started to study the stress response in mammals, I'm talking about Dr. Peter Levine who founded this school of psychotherapy called Traumatic Experiencing. And he discovered or certainly noted that mammals across the spectrum tend to have very similar responses to threats. So in some cases, we might be dealing with something like a car accident or an assault or having come back from war, and those are pretty much acknowledged across the board as being traumatic and overwhelming. Or we might be dealing with something else that society or the person's mind doesn't think is particularly traumatic, but the body... The body is reacting as though it is. It's a body's survival response. It might not always match our cognitive response. Going to the dentist, going to a doctor, those can be pretty intrusive and overwhelming, but they're normalized in our culture, so we don't necessarily think that they, quote-unquote, should be traumatic. Because certain experiences as a child, children are pretty easily overwhelmed. And moving, losing a friend, you know, by moving away, just a whole myriad. A tough fall on a bike, a whole myriad of child experiences can be pretty traumatic in terms of the body. If there's overwhelm in the body, then this survival response will come up, and it can stick around a while. Sometimes we have to work with those. Yeah, and then you have to also get to the point where both you and the client understand what their triggers are and then work with that. Right. And... Mm-hmm. Would that be one of the first steps of working with a client somatically? Understanding what the triggers are? Yes. Yeah. The way I practice, I really want people to be empowered. I want them to understand what we're doing and why, and I want them to understand, you know, everything that we do is a working hypothesis. I want them to know why their body's reacting. I want them to know why their body's reacting that way and how to work with it. So the first step is to learn how to track your sensations, your behaviors, your reactions, your emotions, all that. And there's a trend towards mindfulness and psychotherapy today, and that's a good thing because it's very useful, and that's what I'm talking about, a mindfulness or awareness of what's happening. And then if the client starts to incorporate that additional element into their experience, it becomes pretty apparent what the triggers are. The body will start reacting, and we can both see it, or one of us sees it at least, and then we can work with that. So when teaching mindfulness, do you also teach, like, breath techniques, meditation, that sort of thing? When you go inside and learn to track what your body's doing, okay? Sensations. They're the language of the nervous system. So you're hanging out with your sensations and really listening to what your inner nervous system has to say. If I say a name that has an association for you, you might feel a pleasant, warm feeling. If it was a good friend of yours and you had a wonderful relationship, or if it's somebody that you had a hard breakup with, there might be a thinking feeling. You learn to track those, and you really learn to be with those. That's a form of meditation, I think. It's not structured. In somatic experiencing, we always follow what the nervous system is doing. We have a profound belief in the body's ability to heal, and that the healing mechanisms are inside us. And so the goal of somatic therapies, I understand it, is to help restore that homeostasis, or help achieve it if it hasn't ever really been in place. And homeostasis being a biological balance, a state of ease. We'll know that. The person is pretty much done with therapy, or there's not much more to work on when they're feeling alert but relaxed, present, open, ready to respond to what's happening. You're not numb or shut down, but you're not on high alert when nothing's happening. Right. You're living in a state of be here now, right? Right. Yeah. Right, and that doesn't mean you can't think about the past or mull about it, but it doesn't have that same charge. Most of us have problems. We're hot buttons, or if you touch on it, you'll feel that charge in your body. And the idea is to help normalize that charge, and then the energy becomes available, like I said, to do other things with your day. Yeah, and that would be nice to get to that point if you are in an over-anxious state quite often, that you give yourself a break and just say, okay, today I don't have to... I don't have to be anxious about A, B, and C. I can just think about what's happening and maybe start rewriting it without all of the overcharged emotion that a lot of people get into, and they get used to it. It's almost like a constant companion for some people. Right, and that brings me to the difference between developmental trauma and shock trauma. In SED, which is somatic expansion, we define trauma as anything that provokes overwhelm in the body. Usually, if you're overwhelmed in your mind, you're probably overwhelmed in your body as well. But you can be overwhelmed in your body and be having a difficult reaction to something. Say you're going in for a simple surgery, right? Your mind is thinking, this is okay. I should be fine. Your body's going, whoa, I'm going to be put under, and somebody's going to do this, that, or other medical procedure. Your body can really be not okay with that. So in talking about the difference between developmental and shock trauma and talking about wanting to achieve, like you said, a state of just being present, relaxed during your regular day, how quickly that happens or how completely that happens really depends on what the person's background is, what's happened to them before whatever event that sends them into my office. So... So when we're talking about shock trauma, it's something that happens usually after the person's developmental period. It can happen prior to age 18 as well. And it's a single event. It's like a car accident or an assault or a natural disaster or surgery, something like that. It's an event that's not so personal. And when we're talking about developmental trauma, we're talking about actions. And it's a lot of actions between the child and their caregivers when their nervous system is forming and learning how to regulate itself. So if you have developmental trauma, it takes longer to really get back to a state of self-regulation. I shouldn't say get back to, because you might not have ever been there in the first place. And it changes. Yeah. Yeah, most people who walk in my office, their caregivers and parents were very kind and good and well-meaning people. And they might... They might have been missing some pieces in their ability to give to their child what the child needed in order to form the ability to calm themselves down. So that's what developmental trauma entails. And again, a lot of it isn't commonly thought of as trauma, quote-unquote. But the child's body, their autonomic nervous system, internalized that as having been overwhelming, not getting what they needed. And so that will often create anxiety and depression conditions. And startle... Startle. And startle reactions also. Yeah, hypervigilance, all that. Right. And then some people have both, where they had a well-meaning or not-so-well-meaning, but less than ideal household. And so they go out into the world with most of the pieces that they need to be a reasonable, well-functioning adult. And then, bam, a shock trauma comes along, a car accident. They say, why am I reacting so strongly to this car accident? It shouldn't have been that big of a deal. But the shock of that event will bring up... Stuff that was never completed from their development. So people, sometimes when they come in, they say, how long is this going to take? I say, you know, I really don't know. We can kind of talk about some ballparks, but I don't know, because the nervous system takes as long as it takes. Whereas if you grow up without developmental trauma on board or without a significant amount and have a shock trauma, say it's a really ugly car accident, we can get through that a lot quicker, because you would have already done the work of having built a nice, resilient nervous system early on in life. So in other words, the shock trauma would be like in the category of just a one-time trauma. The developmental trauma, depending on how many traumatic events a person has undergone, can be complex trauma. Is that right? Exactly. Now, when we come back from commercial, Andrea, I would like to... I would like to maybe have you run through an example of what a possible first session might look like, okay? Sure. All right, great.! Thank you so much, so much, so much, so much, so much, Hi, welcome back to Psych One-on-One with Julianne Good and Andrea Bell. And we were talking about somatic therapy and the mind-body connection. So Andrea, what would an example be of a possible first session between you and a client? Example in terms of what happens during the session? Yes, just in general, just to let the listeners know what a possible session, what it might look like. Yeah, the first session is usually pretty different. I have an outline of what happens during the first session posted on my website, which is somaticwise.net. But since I'm a licensed health care professional, I do have to make sure and make a pretty thorough assessment about what's going on, what's working, what's not working, what have your symptoms been, have you had a history of mental health issues, what are the ramifications of the symptoms, how's that been, have you been in therapy before, have you been on meds, have you been hospitalized, etc. There's a lot of information that I have to collect in order to get a good picture as to what's going on. Now as a somatic therapist, there's a delicate balance there because I don't want to go into anything that's too activating. If you have a trigger, if you have a hot-button topic, something that stirs up your nervous system energy, and we start to talk about it, a lot of the times the activation will come up, and just hanging out there and talking about that is not, in Essie we found that that's not really helpful to the person. In fact, it can exacerbate the symptoms. So at the same time that we're doing this, we have to keep an eye on the activation. So I'm also teaching, starting to teach people and work with them to pay attention to what's happening in their bodies. What happened? It looks like your face is freezing up a little bit. You're getting really still on the couch. That could mean that they're going into a freeze state. And that's the part of the autonomic nervous system we haven't talked about. We've talked about being at ease. We've talked about fight and flight. We can talk about freeze in a minute if you'd like. Yeah, that'd be great. Yeah. Freeze state's an important thing to understand in somatic therapy. But anyway, we're tracking the person's behaviors. We're doing the assessment and what they're feeling inside, and to the extent that they can feel inside, because again, some people are pretty frozen out of their body because it's been too overwhelming to go in their bodies. We don't force them to try and go in their body. So there's a lot that we're balancing here. There's information I need to get without sending them into the pit, so to speak. Right? So if somebody starts to get too activated, I'll say, hang on, can we stop a minute? What feels good right now in your body? Or I could have them orient to the room around them. What's here and now? And then notice their body's starting to come down. And as we do that, you actually start to solve the problem because you're stopping, you're paying attention to the charge in the system and helping it come down. Yeah, that's a great technique. That's a great technique if somebody is feeling out of control at the moment. If they're in the middle of telling you their trauma story, sometimes they'll go on and on and on, and they'll just be escalating almost out of control because they're... And you can see in their eyes, they're almost back in that moment when they're telling you that story. Oh, they are. The autonomic nervous system doesn't really have a sense of time. So when you're telling that story, that part of your body is in the story. It could be 1978, even though it's late 2013 outside. And your body is still whatever year that trauma happened. And you go back there. And I think that's the main difference between typical therapy and somatically based therapy, is that by building that awareness, we really work hard to not inadvertently re-traumatize somebody during the information gathering process. I've had a lot of people say to me, gosh, that therapist was wonderful. They were very nice. They were very concerned about me. And I walked out of the office, and I felt like it's time's worth. That's because I didn't have this tool on board of attending to the client's nervous system and how it was dealing with what you're talking about. Yeah, and it's so intertwined. You have to take that into consideration, especially working with trauma clients. I think we've all got a little trauma on board. I mean, trauma is the typical word that we use to talk about it. Some people say trauma with a big T to delineate things like a car accident or an assault that are typically thought of as being traumatic. And trauma with a small T is cover all the rest, like a surgery. And some people say, oh, you only had your truncal belt. What's wrong with that? What's wrong with you? And your body's going, oh my God, I'm really not okay with this. So I think that we've all got a few glitches and a few areas of overwhelm on board unless we've done some work. Right, and Andrea, we have a caller. So, caller? Yes. Hi. Hi. What is your name? Larry. Hi, Larry, how are you? Very well, thank you. Great, and what is your question? I'd like to ask Andrea how somatic experiencing is used with relationship issues or in couples therapy. Used with relationship issues or in couples therapy? Andrea? Uh-huh. Hi. Did you hear the question? No, I couldn't hear the question at all. Okay. Larry was wondering, you know, if you're in a relationship, you're wondering how somatic therapy would work within relationship and couple issues. Well, when I work with a couple, what I usually try and do is help each individual and help them together realize what are their trigger points and how do you know when you're getting activated and how do you know when your partner's getting activated. I think that such a large percentage of disruptions between couples come from when somebody's activated. That is, all the surveillance, all the surveillance, all the survival energies running around their body because the body hasn't gone back to homeostatic balance, right? And so all the survival charges in the body, and it's not just affecting sensations, it's also affecting cognition. Everything's more of an emergency and much bigger and blown out of proportion when you're activated. Obviously, it's affecting your emotions, right? Yeah. So it's really hard to get things going in the right direction for a couple, until each member knows how to recognize their own activation and bring it down. And then you can get help from your partner in doing that. You can, you know, respectfully not, you're going off the deep end again, it's all your fault, not like that, but more like, hey, you know, I know we're talking about the fish that's really hard for you, how are you feeling right now? And being attentive and attuned to your partner. Yeah, and being caring and saying, hey, I realize this, I realize that I maybe push one of your hot buttons there and let's just discuss this. Right, right, exactly. Right, and Larry, sorry that we lost you there. For any of the other callers, if you call in, you're listening to this program, make sure that you turn the volume down, otherwise we get that feedback and we have a little bit of a difficult time understanding everything that's going on. So I thank you very much for that. And if anybody else wants to call in, anybody else wants to call up, the number is 800-893-9562. I would like to also discuss what do you do with children in anxiety with somatic therapy? Well, that's not really my forte. I did work with kids for years and we did a lot of play therapy, which is great because tools are the child's language because when the child, their nervous system is obviously still developing. We don't come out, unfortunately, prepared adults. Like if you were a lizard and you came out of the egg, you'd be pretty much ready to go. But mammals are more complex, right? So we're still developing. And so the kid might be able to speak, but that doesn't mean that the language centers are really connected to the emotional centers yet. So a child uses toys as their language. The play is the language and the toys are the words and the language. So I did a lot of that and unknowingly tapping into this play, I found that it was process. I mean, I knew it was process-based. I didn't know at that point how it involved the child's body. So I don't do somatic experiencing with kids. A lot of my colleagues do. There's a wonderful book out there. It's right here in my bookcase. It's called Trauma-Proofing Your Kids. It's by Dr. Peter Levine and my mentor, Maggie Klein. And it's the professional version. It's a much expanded version of that volume. It's called Trauma Through a Child's Eyes and it's written by two authors. They're both available on Amazon and it's about how to use this stuff with kids. The first one I mentioned, the smaller one, Trauma-Proofing Your Kids, is meant for parents. You can read the expanded version as well. But it talks a lot about how to incorporate these principles of each level of development. In short, you'd say that the younger the child, the less language they have and the less their language is going to be connected to their emotional processing center. So you would want to use more play-based therapy. Play is a lot less threatening to a kid than being sit down and talk to. Right, and that is their language. Yeah, but adolescents, you can... I've done SE with teenagers. They've loved it. They don't yet have all the inhibitions. They're more interested in what their kids and adults do about what's proper and our bodies and what have you. So they can sit there and talk about what their stomach's doing, what their shoulders are doing and how their legs want to run and they can really get into it. Yeah, and it's amazing too that... I've done play therapy with adults too, especially if they've had trauma in their childhood. And sometimes they just like to sit there in color and then they'll talk and they'll be in this relaxed state where they don't feel like they have to talk about the events or the bad things that have led them into going and getting counseling. So I find that that works with adults too. That's the other thing I find that is such a strength of the model that I practice is that we don't just sit there and go into the bad things. If you want a surefire recipe to put somebody, just kind of lock them up inside, that's the way to do it. So I talked about titration, which is just taking a teeny bit of a traumatic material at a time to process it. The accompanying word in SC to titration is pendulation. And that's where we kind of move into the trauma and then back into a resource, which is something that makes you feel good and relaxed. Like you might think of your favorite rose garden and the smell of the roses and the feeling of the cool, crisp air. I'm thinking of when I went to Back East. It was really pretty. Or the feel of your dog's fur underneath your fingers as you're scratching them on the head. Whatever works for you as a resource that's non-toxic, that's something that you can hang out with. And we move back and forth, and between that and things that are more traumatic. And then that way you don't have to just stay in the part that's so difficult for so long. Yeah, it's not overwhelming. It's not like you get done with the session, you walk out of the room, and then you're disoriented. And you're walking around, and you don't know left from right, and you get behind the wheel of a car in that state. That's really dangerous. So it's nice that you're working with incorporating that and being really mindful exactly where the client is at the moment and where they are before they leave your office. Exactly, exactly. And I've heard a lot of stories of very caring, well-meaning clients, competent professionals who just haven't had learning exposure to this piece to track and make sure that the client's not getting too overwhelmed in their body and if they are, helping them back down. And so people can leave these sessions just completely fried. And that's why, like I was saying before, the assessment piece is really a dance because I want somebody to feel comfortable in my office. I'm not going to sit there and do a whole bunch of techniques on them. But I want to help empower them to start to grapple with what brought them in. But I also have to collect a certain amount of information to make sure that I'm covering all the bases that need to be covered, to make sure that they're safe, to make sure that my treatment is competent. All right. And talking about techniques, how is somatic therapy different from eye movement desensitization and reprocessing or what's known as EMDR therapy? Well, I've never studied EMDR per se, but I know that it involves the movements of the eyes. And the reason that it's successful in a few terms is because a lot of activation is held in the eye. Again, activation being this highly charged survival energy that in humans tend to get stuck. It gets stuck because we have this big neocortex that gets in the way. It says, don't do this, don't do that. That's stuck. It's rude to do that. And we have social expectations, behavioral norms, and cultural expectations and all sorts of inhibitions on this more primitive part of us that is better at self-regulating. So anyway, that was a digression. EMDR uses movement to start to shake up the activation that's held in the eyes. And when you think about a mammalian threat response, if your body starts to detect a threat, what's it going to want to do? It's going to want to orient in the direction of that threat. So you might find yourself starting to look in one direction, like say it's a car crash and it's coming from kind of diagonally in front of you on the right. Your neck, your head, your eyes are going to go in that direction. Well, if somehow your response to the trauma is incomplete, let's say it hits you, the car hits you, or you can finish orienting and getting yourself out of the way, that survival energy will often bind up, say, in your eyes or your head and neck. And so my understanding is that EMDR uses movements to kind of stir that up and help move it out of the body. I could be incorrect about that. ESE works with the eyes. We do that. We track activation in the eyes and all over the entire body. So it's not just limited to the eyes. It's a response to the whole body. And in my understanding, some EMDR clinicians have a good understanding of titration and pendulation as taking only a little bit at a time and moving back into the face, good feeling part on a regular basis to prevent overwhelm. And I don't know that all EMDR clinicians have had the chance to be trained in that. And so sometimes you can leave an EMDR session pretty overwhelmed. If that titration and pendulation hasn't happened. Right. And again, I think that would be... That needs to be really looked at and make sure that the client feels grounded before he or she leaves the office. Right. And again, I've never studied EMDR or participated in it, and I'm not condemning it. I believe it's helped a lot of people. And that's anecdotal evidence that's come back to me from people who have participated in EMDR therapy before. Right. Yeah, I've known some people that have had tremendous results from EMDR. Especially from childhood trauma issues. So yeah, it's a very effective therapy also. It is. It is. And I think that the clinician has to be trained to hit that window, that threshold, that sweet spot. And what I mean by that is, if you don't work with the activation, if you don't stir up a little bit of it and deal with it and feel it and process it, you're not going to get anywhere. Your symptoms aren't going to go away. But if you do too much, you're going to get overwhelmed. So just a little at a time. What's that? Just a little at a time is the key, correct? Right. And as the client's capacity increases, you can take bigger and bigger chunks at a time. That sounds good. Yes. Now, the other healthcare practitioners that you've trained and worked with, how do they use somatic therapy differently than yourself or incorporate it? Well, the great thing about SE, somatic experiencing, is that we train practitioners from all sorts of different modalities. Like, you know, I had plenty of training in cognitively-based trauma therapy and behavior therapy, cognitive types of therapy. And I added in the second one. And I think that's a really good extra component of directly tracking and working with the body. So that's within the context of a psychotherapy practice. But we also train teachers and doctors and nurses and physical therapists. We train different religious practitioners. I've worked with rabbis and shamans from indigenous cultures. We also train even teachers. And so, you know, it's a great way to get in touch with the public and to have a supportive role. Now, if you're a paramedic and you're trained in somatic experiencing, it's probably going to be more like trauma first aid. You're not going to be going into a relationship with your mom and how that affected you. But there are certain things that an emergency responder can do in the field that, in fact, if you read Peter Levine's latest book, it's called, In an Unspoken Voice, How the Body Releases Trauma and Restores Goodness. And it's available on Amazon.com. I think it's the forward or one of the first chapters. He talks about his own experience with just strolling along in a crosswalk and being suddenly hit by a car. And how fortunately, can you imagine running over one of the world's premier trauma therapists? That's got to be pretty traumatizing. But fortunately, because he was, he knew what to do. And so he talks about specific methods he used to kind of get himself back down and go. And he's going to talk about how he got himself back down and grounded and what some of the bystanders and professionals did to help prevent him from getting posttraumatic stress from that incident. Yeah, well, that's a good point too, Andrea, is that this sort of training would also help the practitioner to keep grounded. And also because of hearing so many negative stories from doing counseling work, the therapist also has to do techniques to keep his or her mental health intact and healthy. Oh, yeah, they teach us in the SE training how to maintain grounding. We're constantly self-regulating ourselves during sessions. So we're monitoring not only the client's activation, but our own and making sure that it isn't getting too high. Because an important component of therapy is the space between the practitioner and the therapist. And if the practitioner is agitated, even if they're covering it pretty well, you would think the client's body will often pick up on it. And then it's harder to release the anxiety and come back to a nice, calm state. Right. So yeah, self-regulation and making sure that you have good boundaries. Not just boundaries in the traditional clinical sense is absolutely that, but also boundaries of calmness. Yeah. And so if the practitioner is so stiff, if the practitioner is so stiff, if the practitioner is so stiff, if the practitioner is so stiff, And sometimes some of the women that we work with become highly agitated and they become aggressive and physical and they strike out or they throw furniture. So it can be a rather dangerous situation for the residents that we work with and also ourselves as staff. And so to have this kind of tool to be able to use for an effective way to de-escalate the situation yet take care of the self I think would be incredible to have. Yeah, I truly believe in it. It's really transformed the way that I practice and it's transformed the results that I get in my practice as well, much for the better. I imagine in a domestic violence... In a domestic violence shelter you would have just a lot of highly charged survival energy running around because if somebody is assaulting you, the natural response is to motivate that, mobilize that survival energy to protect yourself. And if the person was being prevented from protecting their self, like if the other person was bigger or overwhelming to them or etc., etc., there's lots of reasons. Then that energy is going to be rattling around in there until the person can... And the type of therapy I practice isn't about reliving, it's about renegotiation in a safe and contained manner. Right, that sounds like that would be some really good techniques to learn. So I'll definitely have to take your class. Yeah. Well, speaking of that, we do have a class coming up. There's classes all over the world. We're teaching, I believe, on every continent except Antarctica. If you go to traumahealing.com, there is a link for professional training and it lists all the different trainings. We have one coming up in Los Angeles in March and that training is listed on the website as well. Okay, and what could you recommend to our listeners as we're wrapping up here if they're interested in getting this type of therapy done, the somatic therapy? Also on the website, traumahealing.com, there's a little tab that says find a practitioner. That's where you can find a practitioner in your area if you're interested in somatic experiencing. I'm not as familiar with the other somatic therapies. There's a lot of crossover. I have a couple of modalities of trauma healing training and psychotherapy. Some of my colleagues have like a popular one is SE plus Feldenkrais, which is a slow movement to come out of pain. And bracing patterns in the physical body. So there's a lot of overlap with other modalities within SE. I don't know what, where to look for other modalities per se. You can certainly Google around. But for SE, just look on traumahealing.com under find a practitioner. But as in comparison with Feldenkrais, you do not touch the client, correct? No, I'm not currently trained in touch therapy. Okay. There is a form. There is a form of somatic experiencing touch therapy for psychotherapists. The attitude towards physical touch is always evolving in our field. Traditionally, it's a no-no because of the fear that it will escalate into something improper. However, when you think about the relationship between the child and the caregiver, it inherently uses a lot of touch to help the little child learn how to downregulate, calm down, all that. Okay. So, what are some of the things that you can do to help the child learn how to do that? Well, there are some psychotherapists who do SE, do use touch in their practice. There's a very specific set of ethical guidelines. You can find them by going to zurinstitute, I think, .com. You can Google O for zur, O-S-E-R is the first name, D-U-R is the last name. And he has a zurinstitute, I think it's .com, for the website that lists concerns and how to make sure that if you do use touch in your psychotherapy practice, how to do it very ethically and effectively. And then there's a website that I think is called the Zer Institute. And it's a website that I think is called the Zer Institute. And it's a website that I think is called the Zer Institute. And if you find the tools, if you find the tools, if you find the tools, if you find the tools, if you find the tools, if you find the tools, if you find the tools, if you find the tools, if you find the tools, if you find the tools, if you find the tools, if you find the tools, if you find the tools, if you find the tools, if you find the tools, if you find the tools, if you find the tools, if you find the tools, if you find the tools, if you find the tools, if you find the tools, if you find the tools, if you find the tools, if you find the tools, if you find the tools, if you find the tools, if you find the tools, if you find it can be amazing, very transforming and helping people heal. Well, it sounds like your work is incredible. If listeners would like to contact you, how can they do so? Well, my website is, what is my website? It's somaticwise.net. And my email address is andreabandread.lcsw at gmail.com. And my phone number is 562-243-9963. Okay, that's great. Would you like to add anything else that you haven't mentioned yet about somatic therapy and your work? Well, as you can see, I'm a somatic therapist. As you can see by my frequent tansenses, it's a really big topic. You don't have to use any of the techniques with a client, but knowing how to look at what's going on in the physical body and respond to it is invaluable. Even if you've never, even if for whatever reason a client doesn't want to or can't track what's going on and say, oh, my stomach is clenching up and I'm shaking. If they don't want to go there and work in there, you can still use it as a lens. It's a lens how you can see how your client's responding both in your office and outside of your office. So it's really helpful in that regard. And it sounds like you're getting them to slow down and think a little differently about their lives. Yeah, yeah. And in so doing, I'm always kind of fighting against the general trend of the culture. Where we're always moving really fast and trying to cram in yet one more thing. And so coming in for regular SE sessions is, hey, at least you've got an hour carved out of your day. That is just for you to attend to your inner self and the needs of your body and your autonomic nervous system. And then hopefully from there you can slow out how to do it into the rest of your life as well. Even if it's only a moment here and a moment there. Right. And how powerful is it to have one hour a week, even if it's just one hour, to sit there and carve out for yourself, like you said, and be able to really understand how you work and restructure your life, no matter what you have been through prior to that one hour. The last thing I want to add is that before, you try practicing techniques. It's important to have the assistance of a trained professional, simply because the survival energies are the body's deepest energies. A mammal will call deeply, deeply upon their resources if the body thinks it's in danger. And so as in the case of your domestic violence shelter, this can be pretty explosive at times. So you have to know what you're doing or you can inadvertently worsen symptoms. Yeah, definitely. Like you said before, you need to take it incrementally. You need to take it in baby steps sometimes. Yeah, yeah. And again, we're always on this show. I'm just talking about the general case. None of this is intended as specific advice for anybody, but I'm hoping it can be a good jumping off point for people who might want to be more informed about. SE is not the only somatically informed body work or therapy work that's happening. There's a lot. Like I said, it's growing waves. It's growing in the field. And I think it's really, really powerful to incorporate, you know, what our body's doing, what our nervous system is doing. But you have to know what you're doing. So that's why there's professional training. And that's why there's a lot of certified practitioners around to assist you. Exactly. And thank you so much for educating us about somatic therapy. And Andrea, it was a wonderful program. You've taught us so much today. Thank you. So that was Andrea Bell. Licensed clinical social worker. And the topic again was somatic therapy. Thank you so much, Andrea. And I'd like to thank the listeners. If you would like to tap into prior Psych One-on-One programs, you can do so by going to skidrowstudios.com. There are about 30 to 35 programs that are archived right now. We are also in the iTunes store and Psych One-on-One PSY. I-C-H, the number one O-N and another number one. And reach me by Facebook. I would love to hear what you have to say about the program and any ideas you would like to pass on. And also, I have a practice in Newport Beach, California. If you would like to contact me for counseling, my number is 562-234-4650. And my email is jgoode8 at Verizon. Dot net. Thank you so much for joining me on Psych One-on-One. Take care of yourself and take care of each other. Bye now. Bye. Bye. Bye. Bye. Bye. Bye. Bye. Bye. Bye. Bye. Bye. Bye. Bye. Bye. Bye. Bye. Bye.