Hakomi Mindfulness-Centered Somatic Psychotherapy

by Halko Weiss

  This procedure is how we assist clients to study themselves. The experiments we do are meant to evoke reactions that will lead to discoveries. The most important discoveries are those that tell a client about herself: who she has become; that much of her suffering is unnecessary; how her old habits and hidden beliefs are preventing positive emotions and nourishing relationships; that these habits and beliefs that shape her everyday experiences began in childhood; and that there is a path that leads out of that past into an easier, more fulfilling present. With good experiments and the right follow-through, all that becomes possible.

  A frequently used experiment is one in which the therapist offers a simple statement. The statement is designed to offer a nourishing idea that will be automatically rejected by the client. For example, with the indicator mentioned above, the head turned slightly away, the therapist might offer a statement like, “You can trust me” or “I won’t betray you.” In experiments like that, the first reaction might be a thought like, “I don’t believe it!” Often it will be followed by an emotion, such as anger or sadness.

  Experiments like this reveal the connections between beliefs, memories, and habitual behaviors. When clients experience such connections, accessing the unconscious material becomes possible. Mindful observation of triggers and reactions accesses memories of formative events, the experiences they created, and the habits that still manage those experiences.

  Supporting Spontaneous Emotional Management

  The Hakomi method is inspired by Buddhist principles. It is the principle of the primacy of consciousness that leads to the use of mindfulness. And it is the principle of nonviolence that leads to the particular way the method deals with emotions. When emotions are triggered by an experiment, clients very often react by containing them in a habitual way. They change posture, tense muscles, restrain breathing, and hold back expression. Some therapeutic methods think of such reactions as defensive—resisting the process as the therapist would like it to happen. Ideas like this are based on an adversarial attitude: the therapist versus the disease.

  We, on the other hand, see such reactions as habits intended to manage the intensity and expression of an emotional experience. Where some methods attempt to break down the “defenses” and overcome the “resistance,” we do the opposite: instead of pushing for a breakthrough, we offer and provide support for the reactions. For example, if a client has reacted by drawing her shoulders up and in—to contain her fear—we might help the client to maintain the tension by holding her shoulders up and in for her. In doing this, we are demonstrating understanding and compassion. In what may seem a paradox, this kind of support helps the client allow the emotional process to unfold. As we support the client and wait, the client very often relaxes voluntarily and allows the painful feeling and its expression. This supportive approach has been part of Hakomi since its inception. The techniques involved are referred to as “taking over” and they are the second major thing that is unique to Hakomi. (The first is the use of mindfulness in the evocation of experience.)

  Almost all management behavior involves muscle tension of some kind. It is often possible for the therapist to offer and, with permission, provide actual physical support for that tension. For example, when the emotion is intense, clients will spontaneously tighten their diaphragms, abdominals, and chest wall muscles. They may wrap their arms tightly around themselves. Holding the client tightly will provide support for this way of managing. What can happen then, and what often does happen, is that the emotion being contained is released. In the case of fear, it might be a scream. In the case of sadness, it would be sobbing. Taking-over techniques consistently lead to the voluntary release of emotion and they contribute a great deal to the effectiveness of the method.

  Providing Positive Missing Experiences

  The release of contained emotions is extremely satisfying and healing. But even more, it is the prelude to insight. Support for management leads to release and, when handled properly, release leads to insight and integration. The habits of containment, when relaxed, allow an alternative path to unfold—the path of expression and relief. Support for this path is the simplest of all. The first simple thing to do is to maintain contact by continuing to hold or touch the client, the touch that was already present in the taking over. Only at this point, when expression has subsided, should the pressure involved in taking over be relaxed. Contact is continued, perhaps by keeping a hand on the client’s back or by holding the client in one’s arms. This provides the kind of comforting that didn’t happen during the painful formative experience. This lack of comfort prompted containment rather than expression. This is a basic missing experience. Imagine a child playing and in his playing, he stumbles and falls, hurting himself. He cries and runs to his mother, who drops whatever she is doing and holds the child and dries his tears and whispers soft words of sympathy and reassurance. That’s the universal treatment for distress. In some way, all mammals do something similar (other species, too).

  After release and while comforting is available, clients will very often quiet down and look away. From their very slight head movements and facial expressions, one can tell that they are thinking, remembering, and making sense of what just happened. This is the integration phase. This is the reconciling of oneself to what was. This is the time of letting the past be past. This is how one moves on. It is how habits are changed and freedom of choice is gained. This is how painful experiences are resolved, how completion is accomplished. During this time of integration, the therapist continues to provide contact and, most important, the therapist remains silent—present and attentive, but without interfering with the client’s inner work of making sense of her experience and coming to completion. It may take five or even ten minutes.

  When the client is complete, she will open her eyes and look at the therapist. It is best to stay silent, even then. Best to just wait. She will slowly begin to talk about what she has discovered. That is also part of integration—telling your story to a concerned friend. Her understanding is shared and confirmed. She is now known to another as she has come to know herself. She feels relief and the warmth of being with a caring, helpful person. She feels a new sense of freedom and hope—the possibility of satisfactions previously missed. Such are the rewards for those with the courage to take the journey.

  The Shifting Vision

  My way of working was a fly-by-the-seat-of-your-pants affair back when I began. Over the years, it has evolved. It has clarified and changed through sessions, workshops, training, reading, and interacting with students and colleagues. The long process of learning my craft brought refinements. The biggest ones are these:

  1. When I started out, I was influenced mostly by the psychotherapy approaches that were academically based, like behavior modification and Rogerian therapy. But slowly, after several years and with the help of friends, I realized that the information I needed to move the process could not be obtained by conversational means. Discussion, stories, and questions actually interfered with the process I was developing. I learned to search for indicators and to do experiments. Friends versed in character theory and the body therapies provided the original inspiration for this shift.

  2. I learned to think of the work as assisted self-study. In this, I changed from being the doer, responsible for everything that happened, to the helper who only supported what the client did for himself. Elements of my support were necessary, but all of them together were not in any way sufficient. The client did the work.

  3. I learned to maintain a strong focus on present experience and to shy away from “taking a history.” Reich pointed out that a person’s history, at least what’s still significant about it, is present in everything about him. You only have to look.

  4. I learned, in one dramatic moment, to shift from breaking down defenses to offering support for management behavior. It was my personal experience with the kind of force used in some therapies and my devotion to the Buddhist principle of nonviolence that insp
ired this change. Since that moment, I have developed ways to move the process forward gently.

  5. I learned to place a strong emphasis on providing positive experiences and moved away from emphasizing the expression of painful emotions. When painful emotions arise spontaneously, I make an effort to help them complete in a natural way. The process became more and more a matter of following and supporting what wanted to happen and less and less of making it happen. As a result, the work became faster and easier.

  6. I learned to emphasize nourishment and comforting as ways to support the ongoing process. And I learned to be silent and to recognize when silence was called for. I realized that the most important work is what the client does.

  7. I shifted away from the Freudian image of repression and libidinal impulses. I learned to accept the unconscious as a potentially strong, positive player in the healing process. I learned to recognize the activity of the adaptive unconscious and, by honoring it, create a satisfying working relationship with it (Wilson, 2002; Gladwell, 2005).

  8. Again, in one dramatic moment, I learned about loving presence and the power it has to support healing. I learned to deliberately establish a felt state of compassion and to present myself as, first of all, just another human being (Gerhardt, 2004; Lewis et al., 2000).

  9. I learned that following is another way of leading, that supporting natural processes is more fruitful than trying to control them. The inspiration here is Taoism. This way of working grew more and more satisfying as my understanding and respect for the adaptive unconscious grew.

  10. I also gained, as we all have these last 10 years, a greater understanding of the neurological bases of all behavior, and especially of emotions and beliefs (Calvin, 1997; Goleman, 2004; Damasio, 2003; Hobson, 1996; Llinás, 2001; Panksepp, 1998; Pinker, 2002; Rossi, 1996; Schore, 1994; Schwartz & Begley, 2002; Shlain, 2003; Siegel, 1999, 2009; van der Kolk, McFarlane, & Weisaeth, 1996).

  Appreciation

  So many people, so many open, loving hearts have shared themselves with me. I have witnessed tears shed and joy given and felt. I cannot imagine a more rewarding journey. For every inspiring book and every conversation, for all my students and colleagues, more than I can list, I offer thanks. I have built a life around this work. My sincere hope is that what I have contributed will help all those who wish to begin or to continue on this journey.

  Section II

  Theory

  CHAPTER 4

  The Central Role of the Body in Hakomi Psychotherapy

  Marilyn Morgan

  Andrew sits back in the chair, his legs crossed, his arms behind his head. He oozes confidence. “I know I deserve the promotion,” he says, “and I just can’t understand why I haven’t asked for it.” His brow crinkles as he tries to work it out. I suggest that Andrew imagine asking for his promotion, and turn his attention mindfully to his inner responses as he does so. He takes a few moments, and then reports a tight, heavy sensation in his solar plexus. I say to him, “You deserve the promotion.” Andrew notices the sensation intensifying. He stays with the experience in his body, and fierce words come to him: “No you don’t! You are not worthy!” Tears sting at his eyes and he feels small and shamed. Focusing his attention on his body sensation has rapidly taken Andrew to a deeper awareness of parts of himself that hours of thinking and talking did not.

  WE HAVE BECOME accustomed to dissociation from the body (Leder, 1990). Damasio calls it “the abyssal separation between body and mind” (1994, p. 249). This split was articulated clearly by the French philosopher René Descartes in 1637, and has since profoundly influenced Western thought, including Christian doctrine, psychoanalysis, science, and medicine. Cognitive functioning has been accorded a status separate from other dimensions of our being—those very dimensions that give our lives significance, pleasure, and passion. The pulse, movement, and wildness tend to be stiffly constrained, and our bodies become foreign, even an embarrassment, a nuisance—alien objects to be tolerated at best, or abused and controlled at worst. This is like the Freudian concept of the rational ego trying to dominate the unruly id. So much in modern life supports this separation from embodiment—frantic busyness, the television and computer, emphasis on appearance, efficiency, and the intellect. Discomfort and dis-ease bring people to consult a therapist.

  Hakomi is a body-inclusive therapy, giving a central place to somatic experience (Kurtz, 1990a, 2004; Kurtz & Minton, 1997). This position has been supported by clinical observations during therapy sessions, and is grounded in a lineage dating back to Reich, and influenced by Feldenkrais, Lowen (1958), Pierrakos (1990), and others (Boadella, 1987; Crisp, 1987; Greenberg & Rhonda, 1988). The role of the body in self-awareness, relationship, life satisfaction, and therapeutic change is now supported by a growing body of writing and research in neuroscience and attachment (Caldwell, 2011; Cozolino, 2006; Lewis et al., 2000; Porges, 2006; Rossi, 1986; Schore, 2003; Siegel, 1999, 2003). Trauma therapists affirm the importance of body experience in trauma recovery (Ogden, 1997; Rothschild, 2000; Scaer, 2001; Siegel, 1999, 2003; van der Kolk, 1994), and this perspective continues to scientifically inform and enrich Hakomi practice.

  Staying in Contact With the Body Is Staying in Contact With a Deeper Knowing

  It is not uncommon for people to believe that rationality and deciding what we want in any given moment are functions emanating from the head. However, our experience is located in the body, of which the head is only a part. As Kurtz says, “your mind is hooked up to your physiology” (2004, p. 78). Damasio describes how we use body sensations to assist us in decision making. In fact, he argues, reasoning and efficient decision making would otherwise be well-nigh impossible. Sensations generated by the emotional brain, based on prior experiences, give us immediate messages about the significance of options we are considering for the future. Damasio calls these sensations “somatic markers” (1994, p. 174). For example, when thinking of going to a social event, you might perceive a sinking in the stomach. It doesn’t feel right to accept the invitation, so you decline. It saves hours of weighing the pros and cons. The negative somatic marker has acted like an alarm bell, giving a warning. On another occasion, you think of going out with a friend and you feel a warm expansive feeling in the chest. After some thinking about practicalities, you decide to go. You have experienced a positive somatic marker, which acts as an incentive. Frequently, somatic markers influence our decisions, even when we are unconscious of their operation (Damasio, 1994).

  The Body as a Royal Road to the Core Unconscious

  To understand the role of somatic markers and the body in therapy, we need to know about memory. “The body is alive with meaning and memory” (Kurtz, 2004, p. 78). Important remembered experiences are embedded in emotion, and emotion arises in the body. Damasio differentiates between emotion as bodily response, and feeling as conscious perception of the emotion: “Emotions play out in the theatre of the body. Feelings play out in the theatre of the mind” (2003, p. 28). A person can have a disconnection between the conscious experience of feeling and emotion. This can occur after head injury and in avoidant attachment experiences such as occur in sensitive/withdrawn, tough/generous, and charming/seductive character styles (see Chapter 8). Due to this disconnection, conscious memory of important events may be sparse, and it is possible these events have not been encoded into autobiographical memory (for a good discussion on this topic, see Siegel, 1999, p. 94; Caldwell, 2011). Clinical experience and some research suggest that unrecognized emotions are still occurring on a bodily level and can be accessed somatically (Lambert & Kinsley, 2005).

  In Hakomi, the focus is on assisting the person to self-study and explore his own truth at all levels of organization. A person like Andrew, described earlier, can gain an understanding of himself that is not just conscious, intellectual knowledge, but is an awareness of the deeper, unconscious aspects of self. This includes core material, which is composed of beliefs, nervous system patterning, sensations, memories, images, emotions, and attit
udes about the self and the world. Core material shapes our patterns of behavior, our bodily structure, and our experiences—and is mainly unconscious. In fact, it may be in complete contradiction to our conscious beliefs and aspirations, but tends to “run the show” (Blakeslee & Blakeslee, 2007).

  Core material not only is about memory, behavior patterns, and beliefs, but also influences the ongoing experience and expression of self. Damasio says, “At each moment the state of self is constructed from the ground up” (1994, p. 240). Daniel Stern (1985) describes the core self, the foundation of which is formed in the first two years, as essentially somatic in nature. Kurtz comments, “[The] job of observing bodily expressions and inferring core beliefs from them is one of the more important tasks of the body psychotherapist” (2004, p. 62). He also says, “understanding the expressions of self through the body is one basic component of body psychotherapy” (Kurtz & Minton, 1997, p. 54).

  The Body May Remember What the Mind Cannot

  During infancy, and under conditions of threat, we may not make conscious memory, but experiences at these times can continue to influence us long after. The body and associated emotional circuits are imprinted. Implicit, intuitive knowledge is memory that is encoded functionally in the nerve circuits, and structurally in the brain and body. Implicit memory does not require attention for encoding and is not experienced as a remembering. Our unconscious can process information very rapidly, below the threshold of awareness, and this information is held in implicit memory. (For a discussion on rapid unconscious acquiring and utilizing of intuitive knowledge, read Malcolm Gladwell’s [2005] book, Blink.) The infant can make implicit procedural and emotional memories from birth. She can also start forming memories for features of things and snapshot images. The right hemisphere and amygdala, the brain areas most connected to implicit memory and the body, are “online” at birth. However, the hippocampus, which is necessary for encoding the sequence and context of explicit memory, is not developed until about three years of age, hence the commonly observed infantile amnesia. The left hemisphere, necessary for verbal encoding and developing conscious narratives, is not functioning until around the same time (Badenoch, 2008).