The sensorimotor approach to storying trauma

Happy Endings. © 2014 Laura K Kerr, PhD. All rights reserved.

Far too often, getting on with ‘everyday life’ requires suppressing the impact of traumatic stress on body, mind, and spirit. This self-imposed desensitization to one’s own suffering also lessens how empathetic we are to others’ suffering, including to their stories of trauma. Much like the Twitter feeds, Facebook updates, and blog aggregates that keep us aware of current events without demanding much engagement, stories of trauma can suffer the same disconnection, if not compassion fatigue, in which only the most horrific and peculiar receive much of an emotional response. Hoping not to hurt, we can risk not feeling much at all.

The lack of emotional engagement with stories of trauma may have increased the last hundred years — an era overrun with world wars, genocides, community violence, poverty, natural disasters, and environmental devastation. What may distinguish this era from past periods of upheaval and destruction are not only the large number of people who have been impacted, but also how television, the Internet, and other communication technologies have led to a peculiar way of engaging with stories of trauma. Rather than listening to trauma stories with a group of people who share our concerns and our emotions, we often read about trauma when alone, such as in the privacy of our homes. Present communication technologies also primarily engage our thoughts, perceptions, and hearing, thus leaving our bodies largely inert as we passively watch stories unfold on screens or in print. In similar fashion, clients in psychotherapy traditionally have been expected to tell their stories of trauma with minimal or no awareness of their bodies.

This is actually a bit mind-boggling, since our bodies are the source of our emotions. Furthermore, recovering from trauma typically requires re-integrating split off emotions that threatened to overwhelm at the time of the traumatic event. Perhaps unwittingly (or in an unconsciously avoidant state of mind), we’ve sought communication technologies that allow us to connect to each other and be aware, but also to choose our level of emotional engagement — or disengagement, should that be preferred. (At the very least, this has been an unintentional consequence.)

At the beginning of the twentieth century Kafka wrote, “A literary work must be an ice axe to break the sea frozen inside us,” which speaks to the expectation that stories should somehow transform us by causing us to deeply feel our emotions. [1] More recently, American novelist Deb Olin Unferth stated, “Fiction is not natural. It imitates nothing but itself. More than resembling what we see, it expresses what is absent, what we dimly desire. Fiction is everything that life is not.” [2] Olin Unferth’s account of fiction reflects the sense of disengagement and muted emotions that seems more common today than when Kafka lived. When I read her words, I think of disillusionment, lack of hope, and disbelief that what we imagine is on some level also real — an attitude I do not contribute to Olin Unferth, but to the resistance to the power of story to transform that seems prevalent today.

And I believe this lack of faith in stories to transform is related to how we passively consume stories (both factual and fictional), including our own stories, especially stories of trauma. In particular, the lack of connection experienced between the body and the imaginal — that is, the images, fantasies, memories, and reveries that take up so much of our mental life — suppresses the impact of stories and the power of stories to transform.

This disconnect between the imaginal and the body also plagues the treatment of trauma and re-storying the past. It is difficult to heal from trauma, learn from it — grow in spite of it — without somehow bringing the body and the imaginal together. To overcome the dissociative splits between body, mind, and spirit caused by trauma, what we imagine, fantasize, and remember must be reconnected with the intense emotions that led to memories and images being split off in the first place. But this also means reconnecting with the body.

In what follows, I use sensorimotor psychotherapy — a mindfulness-based, somatic-focused form of psychotherapy developed for the treatment of trauma — as an example of how psychotherapy can support the kind of transformative experiences that emerge when the story of trauma is told through the body and the imaginal.

Basic goals and tenets of sensorimotor psychotherapy

When the body is the focus of treatment, the role of the trauma story changes. In fact, telling the trauma story can actually become an impediment. To resolve past traumas, we need to directly experience their effects on our body, mind, and spirit in the present moment, which allows us to address how they continue to impact us. And as Dan Siegel observed, “Without the balance of our non-linguistic world of images, feelings, and sensations, the seduction of words and ideas can keep us from direct experience” (Ogden, Minton and Pain, 2006, p. xiv).

Rather than focusing on retelling the story of past traumas, sensorimotor psychotherapy directs attention towards becoming mindfully aware of how experience is organized in the present moment. This involves tracking what are called core organizers of experience — the thoughts, emotions, five-sense perceptions, movements, and inner body sensations that co-occur with remembrances of past traumas. Thus, instead of mastering the trauma story — for example, remembering every detail as done with exposure therapy — clients become aware of how traumatic memories organize their felt-sense of selfhood. They pay attention to memories held in the body that speak not only of what happened, but also of what the body wanted to do — what Pierre Janet called acts of triumph — the scream that was suppressed, the shove or punch held back, the desire to run not acted upon. This mindful awareness of what did not transpire — what the body wanted to happen but could not do — becomes a central part of the new story about the trauma, regardless that this story exists only in body awareness and the imaginal.

According to the founder of sensorimotor psychotherapy, Pat Ogden, the first goal in the treatment of trauma is “to restore the clients’ capacity to tolerate and integrate their own thoughts, feelings, and bodily sensations, to bear witness to their own experience, to be able to process significant life events — past and present, painful and pleasurable, ordinary and traumatic — within a window of tolerance” (Ogden et al, p. 40). This “window of tolerance” is gauged in part by how well a person maintains social engagement without activating the body’s defense responses, such as fight, flight, or freeze states. Within the window of tolerance, we are able to be mindfully aware of our thoughts, feelings, and body sensations while also engaging with awareness of others and their experiences. In sensorimotor psychotherapy, tracking the body and other core organizers of experience is key to understanding the extent to which someone is within the window of tolerance, or has moved either into a state of hyper- or hypoarousal, thus lessening their ability for present-focused, socially engaged thoughts and actions.

People who habitually activate traumatic defenses often become avoidant of traumatic memories, or alternatively, preoccupied by them. Consequently, opportunities for an ‘everyday life’ of relationships, work, and play are superseded by an often unconscious need to defend against the possibility of retraumatization. Sensorimotor psychotherapy attempts to disrupt the activations of traumatic defenses by challenging the often strict division that gets constructed between needing to protect oneself and being able to relax into activities of daily life. Play becomes imperative, including in the relationship between therapist and client. Ogden and colleagues wrote, “In the context of curious, nonjudgmental exploration, significant moments of playfulness between therapist and client often unfold spontaneously. The goal in treatment is to improve upon the adaptive functioning of all action systems and to mitigate the unfettered arousal of the defensive system so that it is activated only when needed, no longer disrupting the functioning of other systems” (2006, p. 138). When a person no longer has to live from the defended sense of self, he can begin to develop other aspects of who he might become as well as form and maintain supportive, safe relationships.

The sensorimotor approach and outcome

How does sensorimotor psychotherapy work? Well, it’s taken me several years of training, assisting trainings, and working with clients to understand the process, and yet so much still feels ineffable — and extraordinary — about the approach. Perhaps this is because sensorimotor psychotherapy is specifically directed towards transformation. The body often implicitly guides the process. Furthermore, event-bound conceptions of time, space, and memory often lose their veracity during moments of transformation.

An example comes from my own experience of practicing sensorimotor techniques with one of my peers. During our practice session, I recalled a pivotal moment in my childhood when awareness of my mother’s deepening depression was particularly acute and joined with an awareness of loss of her protection. Rather than focusing on the details of my memory — the story of that day when my mother and I were picking out wallpaper for my bedroom — my peer partner instead tracked my body, paying attention to the sense of heaviness in my shoulders as I recounted snippets of memory. We also explored the tingling in my feet, which I came to perceive as my previously unconscious (and unexpressed) desire to run. My partner also explored with me what I needed to believe was true in order to regain a sense of safety.

With my peer partner’s support, and through the integration of memories, images, and body sensations (all part of a sequenced protocol taught in the trainings), I told a new and transformative story of that time with my mother, one that took into account the narratives of both my body and the imaginal aspects of my psyche. This story was less organized around fear, and hence the need for defense, and more organized around a sense of wholeness and safety. No longer do I only have the unconscious, organizing belief that loss of a safe attachment necessitates a threat to safety. Sometimes I am just sad or afraid. And when I am in a mindful state, I try to stay with what I am feeling, watching how it shows up in my body and naturally dissipates, without getting caught in old stories and defenses.

Through the therapeutic process of sensorimotor psychotherapy, triggers that the body once unconsciously reacted to are less likely to be activated. There is a new way to respond to memories and events that once might have led to feeling defended. And by changing how the past is remembered through present-centered awareness of the body and the imaginal, there is also the possibility of emerging in an unanticipated sense of self and the future.

Sometimes for transformation to occur, we must be willing to let go of the quest to find the truths of our pasts, and instead trust the wisdom of the body and our capacity to imagine a different outcome from what originally occurred. This isn’t wish fulfillment, but rather an acknowledgement of unmet needs and letting go of defenses that no longer serve who we are becoming. There is often grief at such moments of transformation, which sensorimotor psychotherapy identifies as the “grief of relief.” But this grief is well worth the sadness, since it also signals the release of attachment to past circumstances that no longer contribute to growth.

When no longer driven by the need to defend against unconscious reminders of danger or threat, ‘everyday life’ can occur within the window of tolerance such that present-focused awareness of self and others is possible. Within this range of experience we feel the transformative effects of both life and story without the need to suppress their potential impact on us.

Endnotes

[1] From a letter to Oskar Pollak dated January 27, 1904.

[2] From “Don’t Tell It Like It Is,” in Rules of Thumb, Michael Martone and Susan Neville, Eds. Writers Digest Books, 2006.

Reference

Ogden, P., Minton, K., & Pain, C. (2006). Trauma and the body: A sensorimotor approach to psychotherapy. New York: W. W. Norton & Co.

© 2014 Laura K Kerr, PhD. All rights reserved (applies to writing and photography).