Hakomi Mindfulness-Centered Somatic Psychotherapy
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Hakomi stands in this tradition. We believe that the early environment provides formative experiences that determine one’s understanding of the world and of oneself. A child starts to create implicit models of the world (beliefs) from the start—an inherent trait of all self-organizing living systems (Holland, 1998; Kauffman, 1995). These implicit beliefs and meanings help the growing individual anticipate external events and orient in the world, and make up the base of how experience and behavior are organized. Most of these beliefs are held outside consciousness in implicit memory, and—as body psychotherapists generally assume—as “affect-motoric schema” or “micropractices” (Downing, 1996, 2015), patterns of somatic and emotional processes that are used habitually.
Psychodynamic theories assume that a person is somehow structured intelligently by “forces,” “parts,” “voices,” “internal objects,” and so forth that have the capability to self-organize. For a Hakomi therapist, the central questions of psychotherapy are: How does the particular self-organization of my client work? Can we explore essential aspects of the client’s habitual information processing, even though these are mostly unconscious? Can we understand the meaning that the client has made of his experience? Therefore, as a core constituent trait of Hakomi therapy, the therapist consistently tracks for nonverbal signs of how self-organization seems to be engaged in a specific moment, rather than mainly listening to the content of what a client is saying. The unconscious self-organization of a client is the focus of attention and the object of research within the therapeutic session.
Many of the chapters in this book relate to these questions, and those of Section II (Theory) in particular, for instance, Chapters 4, 5, 7, and 8. In later sections, specific psychodynamic issues, like defenses (Chapter 17), regression (Chapter 18), working through (Chapter 19), transformation (Chapter 20), or transference (Chapters 22 and 23) are addressed.
The Experiential Perspective
Ron Kurtz, the founder of the Hakomi method, understands beliefs to be the key to therapeutic transformation. Transformation occurs when formative core beliefs, activated along with their deeply ingrained and complex, original experiential patterns, are expanded by new experiences. With reexamined and expanded beliefs and experiences, the world literally looks different and offers new options. This perspective on transformation is a foundational piece of the method.
Thus, the Hakomi method is designed to bring alive formative experiences and the beliefs held within them. Those experiences are coaxed forward, examined, and understood in a cooperative process between client and therapist. New, “corrective” (Alexander et al., 1946), or “missing” (Kurtz, 1990a) experiences are then conceived and introduced to the client. When taken in by the client as felt experience, they are thought to affect the related, highly habitual, activation patterns of self-organization and their representations in the neuronal architecture.
As an experiential therapy (a term defined by Greenberg, Watson, & Lietaer, 1998), Hakomi builds the psychotherapeutic process around the art of preparing for, evoking, and examining experiences that shed light on a person’s self-organization and its sources. Experiences always happen in the “here and now” (Perls, 1973). Clients are guided to become aware of a specific element of a meaningful experience, focus on it, and stay with it for extended periods of time. As a result, these sessions have the potential of becoming highly emotional, with an option toward carefully guided, regressive states. This is one of the reasons why the tool of mindfulness is essential for this kind of work.
The experiential aspect of the work is, therefore, one of the threads that the reader can follow throughout the book. Chapters 4, 7, 10, 11, and 16 through 20 shed light on different perspectives of this trait of the method.
The Perspective of Mindfulness
Ron Kurtz had long considered including the term “mindfulness” in the name of the method he created, because of the extraordinary meaning mindfulness has for the essence, feel, and process of Hakomi work. As early as the 1960s, Kurtz began to pioneer a way of working with this ancient Buddhist technology of consciousness in therapy (Johanson, 2006; Nyanaponika, 1972; Weiss, 2008). By the time the Hakomi Institute was formed in 1980, the use of mindfulness was already deeply integrated into a psychodynamic process and had shaped the character of the work. Certainly, this approach had its predecessors. Gestalt and other methods used special forms of awareness, rooted in Eastern practices, in their work. Kurtz, however, became quite specific about several characteristics of the traditional methodology. He created processes around
1. the conscious regulation of attention processes inward,
2. the conscious regulation of attention processes in relation to time,
3. the establishment of an internal observer with a number of critical characteristics,
4. a therapeutic approach that consequently would have to let go of goals and become experimental instead, and
5. a therapeutic relationship that would have to become nonviolent in order to not interfere with mindfulness and a naturally unfolding therapeutic process.
All of these characteristics are discussed in detail later in this book. Combined, they create the typical Hakomi flavor that distinguishes the work so clearly from other forms of psychotherapy.
Mindfulness serves several essential objectives of Hakomi work. Its use is primarily based on pragmatic considerations, rather than ideological or spiritual ones. The key advantages are the following:
1. For work with the body, a powerful tool for observing internal, somatic processes is needed, especially if that tool can deepen with practice. From within the traditions of spiritual practice, mindfulness constitutes a deeply tested and powerful method of self-study.
2. Mindfulness allows for comparatively easy, conscious regulation of attention processes that do not follow the automatic and habitual patterns of already established pathways of self-organization. Instead, it allows for the directed exploration of hitherto unconscious processes.
3. Mindfulness supports a nonjudgmental exploration of self. It creates a gentle and accepting relationship toward parts of a person that were previously seen negatively or have become dissociated.
4. Mindfulness strengthens reflexive ego functions or, in the terminology of Schwartz (1995), “Self”-states that serve progressive objectives and give protection from the dangers of regressive therapy processes.
5. Establishing a stronger and stronger internal observer over time is already a transformative element of therapy. The observer allows for a process of “disidentification” from the trancelike pull of limiting states of being, such as depressive states (Beck, Rush, Shaw, & Emery, 1979; Linehan, 1993; Segal, Williams, & Teasdale, 2002).
Of course, this list cannot yet reflect all the benefits that mindfulness practice offers for the therapist (Breslin, Zack, & Mcmain, 2002; Hick & Bien, 2008; Grepmair & Nickel, 2007; Grepmair et al., 2007). In Hakomi therapy, mindfulness becomes the very basis of what Kurtz calls “loving presence,” a being state that carries the fundamental qualities a Hakomi therapist can bring to the therapeutic relationship.
Cognitive-behavioral therapists in particular have recently begun to include mindfulness training in their therapeutic programs (Orsillo, Roemer, Block Learner, & Tull, 2004). In their methodology, mindfulness mainly serves the objective of disidentification, or helping clients to distance themselves from overwhelming and ingrained automatic patterns of experiencing. Clients learn to do mindfulness meditation, often in a parallel and separate process. In the Hakomi method, instead, mindfulness is deeply integrated into a moment-to-moment explorative and experiential psychodynamic process.
Consequently, a number of chapters in this book devote themselves to different perspectives on mindfulness: a more general and philosophical one (Chapter 6), one on the use of mindfulness in a psychodynamic context (Chapter 10), two on specific Hakomi interventions embedded in mindfulness (Chapters 16 and 23), along with chapters on some special benefits of working with mindfu
lness—regressive processes (Chapter 18) and transformation (Chapter 20).
The Perspective of the Body
Being aware of and using the body in psychotherapy is closely connected to the experiential aspect of Hakomi. The body is the place where emotions and feelings are experienced (Damasio, 1999), and where the unconscious often first shows us signs of emerging content on a sensing level (Gendlin, 1996). It is the place in the here and now, where self-organization manifests in ways that can be observed and directly experienced, rather than merely being talked about. Bodily experience is also deeply rooted in the precognitive, nonverbal, and implicit realms of memory, and sheds light on how we learned to respond to the world as we got to know it early in life (Downing, 1996; Roth, 2003).
There is no doubt that Freud was right in his assumption that those early years are most formative for the way a person experiences the world and relationships, even today. Moreover, it is implicit memory and the emotional-somatic levels of the self that hold the impressions and lessons from those times. Infant research has shown how strongly first relationships are encoded somatically and how their abstractions (called “representations of interactions generalized” or RIGs [Stern, 2002]) are reinforced through repetitive experiences that shape the neural architecture.
When in the business of reconnecting, uncovering, and understanding the deeply held models of reality that form in those years, it is the body that can most clearly and most quickly bring them into awareness, both emotionally and mentally. One just needs appropriate therapeutic relationship, technique, and process to bring them alive.
Staying in contact with how emotions are experienced in the body also allows those formative experiences to emerge in a live fashion. They become present, palpable, and evident. They can be studied for their exact makeup, for their consequences, and for what models of reality were established early on. Even if the connected memories have not been stored (infant amnesia, for example), have faded, or were repressed, their traces can be studied through the way the emotional body responds habitually. Understanding and meaning can be created by examining those traces.
Some authors (for instance, Becker, 2006) have called the body the “royal road” to the unconscious. For them, the future of psychotherapy is unimaginable without the inclusion of the body in the psychotherapeutic process. Hakomi, therefore, stands in the tradition of Reich, Lowen, Pierrakos, and others who, more than half a century ago, began to compose theories about how emotional, behavioral, mental, and somatic realities are interconnected and shape complex systems of self-organization in a human being (Marlock & Weiss, with Young & Soth, 2015). Today, even cognitive-behavioral therapists are thinking about the body in a new way, accepting the notion that there may be emotional and somatic schema in addition to cognitive ones (Sulz, 2015).
In this book, the body is addressed again and again: in the theory section (Chapter 4); in Chapter 23, on character-based interventions; and, of course, in many of the chapters in the technique section (Chapters 14, 16 through 19, and 24).
Therapeutic Attitude and Therapeutic Relationship
Before Kurtz simplified his concept of the therapeutic relationship to what he called loving presence, there was a thorough learning process about what works when using mindfulness and bodily experience as core ingredients in psychotherapy.
One aspect was clear early on: the use of mindfulness does not go along with a goal-directed approach. Mindfulness requires an accepting attitude on the part of the client and consequently on the part of the therapist. An emphasis on what needs to change destroys the quiet and curious observation of what is happening inside (Weiss, 2008).
Additionally, deep insights about the nature of change that Kurtz garnered from the Taoist traditions reinforced the understanding of the therapist as being in a midwifing role where existing forces are followed and used rather than confronted or challenged (Johanson & Kurtz, 1991).
Together with the conviction that a therapeutic path that is supposed to lead to the very foundations of self-organization needs to offer an absolutely safe environment (Porges, 2003), the pragmatic teachings of Buddhism (mindfulness) and Taoism (nondirectivity) have established a strong understanding of the therapist’s presence in the relationship: mindful and “contactful,” slow, accepting, compassionately curious, precise, nonviolent, observant, warm, and genuine (Hick & Bien, 2008). This list could be extended, but gives a first sense of what a therapist would have to find in herself when doing a Hakomi session. In many ways, Hakomi training can be looked upon as teaching the trainee a special state of being, designed to be supportive of a self-healing process. This state of being is understood to be more important than all the artful technique and specific therapeutic knowledge learned in the process as well. Chapters 5, 6, 9, 11 through 14, 17, 22, and 23 include a special eye on this aspect of the Hakomi method.
CHAPTER 3
The Essential Method
Ron Kurtz
I DO NOT, and cannot, speak for all Hakomi therapists. I am writing here about how I work now and how I now understand the method. I’m fairly sure that what I do is similar to what other Hakomi therapists do. Still, I began to develop and teach the work over 40 years ago. Some of my original students have themselves been teaching it for 35 years or more. Each of them has modified it in some ways. And I certainly have. However, the most essential elements of the Hakomi method have changed little. Those elements are what this chapter is about.
Though based on the best science available, the Hakomi method is not only science. The intimate and delicate exchanges the work gives rise to can be as beautiful as poetry or song. The skills needed are as much those of the heart as of the head. As theory, the method is reason, form, and tools; the use of them, however, is an art. As in any art, there is both freedom and constraint. And I am grateful for them both, for they have led me to whatever understanding I now enjoy. They have kept me interested and productive. They are a great blessing.
For me, the method is a living thing. For over 40 years, my vision of the work has continuously evolved, shifting, slowly, like a tectonic plate, under the whole endeavor. Occasionally, an earthquake of an idea has radically altered my understanding of the process. Three of these ideas are (1) the realization of the importance of the therapist’s state of mind; (2) an understanding of the method, not as working to cure disease, but as assisting another in his or her search for self-knowledge (the method can be described succinctly as assisted self-study); and (3) an understanding of the unconscious as adaptive (Wilson, 2002), that is, intelligent, aware, working to benefit the whole and, without our conscious knowledge, automatically handling most of our daily actions.
The adaptive unconscious operates on the basis of assumptions, expectations, habits, and implicit beliefs about ourselves, others, and the world of which we are part.
Whatever particular theory is subscribed to, all agree that expectations of other people and how they will behave are inscribed in the brain outside conscious awareness, in the period of infancy, and that they underpin our behavior in relationships through life. We are not aware of our own assumptions, but they are there, based on these earliest experiences. (Gerhardt, 2004, p. 24)
These assumptions were created by our earliest and strongest formative experiences. They are not available to consciousness through the usual processes that retrieve memories. They must be accessed using special techniques. The Hakomi method employs unique techniques, developed over many years, to accomplish just that.
In a very real sense, we start out ignorant of who we are. To gain understanding and control requires deliberate effort. Self-study is a powerful path to change and it is most powerful when we can discover our unconscious assumptions, when we can examine them with a more mature, experienced, and reasoning mind. The whole world is not the same as the limited one we spent our childhood learning to live in. To act as though it is usually results in suffering. The kinds of assumptions that cause such suffering are inaccurate, usually overgeneralized,
and emotionally charged. Because of this, the suffering they cause is, in principle, unnecessary. It can be lessened or even completely eliminated by changing the assumptions.
Not all formative experiences cause suffering. Positive experiences of love, protection, caring, and enjoyment can also be formative. And, of the negative ones, not all are inaccessible because they occurred too early in life. Some simply happened when the person was vulnerable. They overwhelmed the nervous system. The person simply lacked the inner resources and the external support needed to integrate them. The experiences were “encapsulated” and repressed:
During these periods of abaissement [a lowering of psychic energy], Janet found, our psyche seems to lose some of its capacity to synthesize reality into a meaningful whole. If we encounter a traumatic or strong emotional event during these periods, the mind lacks its usual ability to make sense of it and fit it properly into a meaningful, secure whole. . . . During abaissement, we tend to be emotionally vulnerable and easily overwhelmed; we can register the life experiences, but we cannot properly “digest” them. The emotional experience floats in our unconscious, unassimilated, in effect, jamming the gears of the mind. (Rossi, 1986, p. 125)
The Hakomi method is designed to access these “undigested” experiences and the habits that keep them outside of consciousness. We bring these experiences into consciousness and we find ways to integrate them. And, though the process is at times emotionally painful, it consistently accesses the adaptive unconscious. Doing so makes completion and transformation possible. And this reduces unnecessary suffering.