Hakomi Mindfulness-Centered Somatic Psychotherapy

by Halko Weiss

  When a therapist is in a state of loving presence, he feels calm and open (Eisman, 2006). He can receive the client’s whole experience in an embodied way (Marlock & Weiss, 2001). This includes whatever the client is consciously presenting, as well as that which is present and unconscious or nonconscious. A limbic resonance (Lewis et al., 2000) develops between the two. This attitude on the part of the therapist is “crucial and is not easy. It requires a deep understanding of one’s self as well as the client. It must be part of the emotional makeup of the therapist, not something one simulates as part of one’s role” (Kurtz, 1990a, p. 60). The loving presence of the therapist also helps the client develop this inner attitude of warmth and friendliness through modeling (Rogers, 1961).

  The authentic curiosity of the therapist in this state prevents his own agendas or thought process from taking over the therapy. If the therapist engages in the intersubjective field from a more subjective orientation, then he risks allowing his own beliefs, interpretations, and needs (conscious and unconscious) to dominate in the exchange, thereby compromising the client’s process. The therapist can be aware of his needs (for example, to know, to understand, to be right, to be helpful, to be liked, to be with or avoid strong emotions, chaos, confusion, and so on) in a state of mindfulness, with a powerful internal observer present, and with loving presence. This way he can both manage them appropriately and gauge their impact on the client. The practice of loving presence creates space for the therapist to know his experience and draw from it by choice (Prenn, 2009).

  Empathy and Understanding

  Loving presence includes empathy and authenticity (Decety & Jackson, 2004; Paivio & Laurent, 2001). Authenticity reflects the therapist’s experience directly, including her countertransference and personal bias. In being empathic, the therapist leaves aside her own thoughts and feelings and joins with the client in his world. “Empathy enables the creation of ‘intersubjectivity’ and the increasingly social and shared nature of much of the content of human consciousness, in which individuals can have deeply shared emotional spaces, with this becoming a critical aspect of all long-term attachments” (Watt, 2005, p. 205). Along with resonance with another’s pain (perceived or inferred), empathy indicates an associated desire to mitigate his suffering. According to Watt (2005), empathy is possibly the most critical outcome variable from the therapist’s side in the therapeutic interaction.

  The selflessness of empathy and the reactivity of authenticity are both tempered by mindfulness and compassion (Davidson & Harrington, 2002; Fehr, Sprecher, & Underwood, 2009; Gilbert, 2005). Like two reins held together, the therapist can both locate in the client’s experience without losing herself, and she can observe her own experience while distinguishing between reaction and response. Loving presence takes the therapist out of the duality of empathy versus authenticity into a larger arena that includes both. In this way, loving presence creates safety by allowing the process to unfold in accordance with the client’s needs and integrity.

  Even when moments of empathic failure occur, the therapist can come back to loving presence and authentic truth sharing. Empathic failure can be useful in therapy. At those moments, the pain is present in the moment, as is the possibility of repair when the therapist is truthful about what has occurred and actively moves to mend the break (Meares, 2005). The failure affirms the distinction between the inner world and the outer. In such moments, the client comes to realize the therapist is human, not omniscient and omnipotent (Meares, 2005). Tronick (1998, 2007, 2009) considers the working-through process in therapy to be a dyadic venture of interactive repair. The therapist’s ability to navigate relationship repair depends very much on the therapist’s ability to recognize and regulate the negative affect within herself (Schore, 2003), transcending shame and pride in the service of connection.

  The process is fostered by the Hakomi attitude of proceeding experimentally, never being attached to a particular result, along with being prepared for the process to self-correct through the direction of the client’s organic wisdom. It is especially important for Hakomi therapists to monitor the parallel interpersonal process to the client’s intrapsychic one (Lamagna & Gleiser, 2007). For instance, if a therapist were not able to tolerate anger in the client’s relationship with her when the client is working on a new core organizing belief that anger is okay in relationships, the result would be a characterological disaster confirming the client’s worst fears, if the therapist were not to recognize it and make repair.

  To these ends, the therapist allows real intimacy in the relationship. That is, she allows herself to be fully touched by the client’s experience and she uses her own experience with the client as a basis for an authentic response (Natterson, 1991; Prenn, 2009; Rogers, 1951, 1961, 1980), as well as a means of gathering information about the client (objective countertransference) and what is happening in the moment. The therapist is a witnessing participant (Hirsch, 1987) and, in cultivating mindfulness with her client, encourages the client to also become a witnessing participant (Weiss, 2008).

  Such reception precedes any intervention so that the therapist’s responses and interventions are based on and embodied in the unique, authentic, dyadic relationship rather than cognitive processing. By being receptive to the client, the therapist can attune to the pace of the client and his unconscious needs, thereby increasing the general safety.

  Listening to the Storyteller

  The therapist demonstrates his understanding of the client not only by what he says but also by what he does and how he relates to the client. This understanding encompasses not only the “story” the client is telling, but also the storyteller. It is too easy to become lost in a client’s story and its thousand variations, and lose sight of the core narrative beliefs that generate the basic themes of the storyteller. In a state of loving presence, the therapist gathers the deepest levels of information from the nonverbal presence and expression of the client. The client’s use of language, her tone and rhythm of speech, and her gestures and overall body state are conveyed to the therapist, who listens for beliefs and assumptions, and connects present behaviors and beliefs with possible childhood situations or experiences (Fisher, 2011; Kurtz, 1990a).

  When the therapist cultivates a state of loving presence, he can bear witness to the experiences and parts of the self the client avoids or represses with the utmost warmth and friendliness. He can pay constant attention to what the client neither tells nor remembers, but what is enacted or communicated in the session in extraverbal forms—allowing the prosody to pierce his countertransferential skin more than the semantic content of the client’s narrative (Mancia, 2006).

  The therapist resolves to not lose himself in his role; he desires to remain relaxed and attentive to the client’s experiences without reacting to the storyteller’s story from a place of egoistic fear. Nothing is viewed as a problem or difficult. Everything is a reflection of how experience is managed. Loving presence allows for strengths and beauty to be experienced in the midst of pain, confusion, or strong emotion. Whatever emerges can be met with loving-kindness, thereby enhancing the safety in the relationship and the trust in the process. Loving presence anchors the process in the here and now and generates flexibility. It invites the guiding wisdom and signals of the unconscious to become more and more present, and assists the client in moving toward her innate sense of wholeness, through the possibility of organizing in elements of the core narrative (contact, support, intimacy, freedom, ease, and so on) that were previously organized out (Johanson, 2015). The practice of loving presence cultivates the optimal conditions for human growth and change (Bridges, 2006).

  Safety

  Each client experiences safety uniquely. A therapist has to tend to each client individually, addressing both conscious and unconscious needs for safety. Safety is always defined by the way a client perceives a situation, whether it is “objectively” safe or not. Porges (2011) notes that neuroception—a person constantly scanning for safety—is ever
present. If the therapeutic process slows or stops, it is inevitably a safety issue on some level. The attitude of loving presence, the therapist’s abilities for attunement, empathy, and understanding as well as her ability to actively demonstrate them, all add to the client’s felt sense of safety.

  Just as infant-caregiver relationships are recognized as unique dyads with an inherent rhythm of relationship, so each client-therapist pair engages in a rhythm all its own (Beebe & Lachmann, 1998, 2002). As adults, clients may have an aversion to care and compassion, so the therapist must be able to track and contact that aversion without taking it personally. The therapist who can be authentically and naturally present with the client in a way that joins a particular client’s need for closeness and/or distance has all of her resources available for the client’s safety.

  Tracking the moment-to-moment relationship provides the therapist with invaluable data regarding the safety status of the client, what relaxes him, and what activates him. How relaxed the client is, how open and forthcoming, the amount and quality of eye contact, all give clues to the client’s safety in the relationship and with the psychological material emerging. The more the therapist stays in contact with the client, not caretaking, but providing authentic safety, the more the client is available for self-study. In this way, following the client’s lead and pace, staying on equal ground (not becoming the expert or in any way removed from the client), and allowing the client to follow his own insights and curiosity all add to the safety in the relationship.

  The therapist’s genuine warmth and caring are essential ingredients for the client to allow difficult unconscious material to emerge. Any harsh judgment, perceived by the client or not, will interfere with the therapeutic process. The skillfulness of the therapist, as well as her openness and confidence, add to the safety of the client. Porges’s (2009) polyvagal theory demonstrates that everyone scans for safety before being able to engage socially. Cozolino asserts that the warmth, enthusiasm, and encouragement of the therapist optimize the biochemical conditions for learning—the “enhanced production of dopamine, serotonin, norepinephrine and other endogenous endorphins . . . support neural growth and plasticity” (2002, p. 300). Engaging in the therapeutic relationship provides safety moment by moment as well as enhancing the overall safety and well-being of the client.

  Cooperation of the Unconscious

  The therapeutic relationship impacts the “cooperation of the unconscious” quite directly. Kurtz (1990a) used this term to describe the goal and primary outcome of a well-working therapeutic relationship. When the client feels safe, the process moves along, there is cooperation of the client’s unconscious, and previously repressed or dissociated material emerges. When resistance arises, it is because the dyad is misattuned or some need of the client has gone unattended. Perhaps the therapist misunderstood the client or shifted out of mindfulness and loving presence. Perhaps he sped up when the client needed to slow down. Resistance always has emotional intelligence at work—it has a good reason to be there. When even a slight resistance is tracked, contacted, and honored, the cooperation of the unconscious can be established or regained, and whatever interaction interfered with the client’s feeling of safety can be studied in mindfulness. It becomes a constructive moment of repair.

  Signs for the cooperation of the unconscious in the client include a focused attention to the moment-by-moment interaction; thoughtful consideration and responses to the therapist’s questions and suggestions; the inclusion of the therapist in the client’s interactions; and genuine participation (Kurtz, 1990a). A therapist needs to be able to read the signs of the unconscious and adjust to the client’s needs and interests in order to earn her cooperation. If the therapist fails to do this, the client will demonstrate signs of resistance: disregarding the therapist’s input, proceeding without connecting with the therapist, taking off in a different direction, not considering the therapist’s interventions or suggestions, and so forth. “When the unconscious cooperates, significant material emerges” (Kurtz, 1990a, p. 59).

  The safety of the relationship and the cooperation of the unconscious are not dependent on whether or not the therapist correctly interprets the information gathered from the client. Because insight is used to create little experiments in mindfulness rather than as interpretations in and of themselves (Feinstein, 1990), the client’s defenses are befriended rather than challenged. Because interpretation is not necessary to the implementation or success of the process, a Hakomi therapist has no investment in being an expert or being right. Consequently, little resistance to self-study is created. Whatever insight is required for change to occur arises primarily from the implicit experiences of the client. Together, therapist and client discover the meaning throughout the stages of the Hakomi process. It is this kind of continual involvement of cognitive and emotional processing that is essential for positive change (Cozolino, 2010).

  To be creative and intuitive, to participate fully in the healing relationship, the therapist must cultivate the cooperation of his own unconscious (Kurtz, 1990a). Thus, the therapist must be able to hold himself with the attitude of loving-kindness and be connected to his own experience (Cooper, 1999; Eisman, 2006). When everything is accepted, when nothing is a genuine problem, when all experience is welcome, the feel of the interaction is very open and even playful. Playful exploration of experiences, amplification of the client’s awareness, and the sense that the experiences are the client’s own reflect the proper role of the therapist (not demonstrating the therapist’s brilliance) (Meares, 2005). Both client and therapist feel the genuine goodness that accompanies self-discovery and loving presence.

  Summary and Conclusion

  The therapeutic relationship is the container in which all healing takes place in psychotherapy. It is crucial not only to the success of the therapy, but also to the overall positive experience of the client. This relationship works on many levels, both conscious and unconscious. It requires great attention on the part of the therapist and wholehearted effort to cultivate the attitudes that promote healing: loving presence, warmth, empathy, authenticity within intersubjectivity, openness, clarity, self-awareness, acceptance, discernment, and trust in the client’s unfolding process. Such ongoing practice not only benefits clients but also deepens the therapist’s inner experience and wholeness. As the therapeutic relationship creates safety for the client, it promotes full cooperation of the unconscious, which in turn provides the organic impulses and signals toward the healing needed. This kind of exchange occurs in an intersubjective field of real contact between two human beings. The resonance between therapist and client works both inside and outside of consciousness. The path of self-discovery and healing is not traversed alone. The love and connection inherent in this human bond become part of the reorganization of the client on every level.

  CHAPTER 10

  Mindfulness as a Psychotherapeutic Tool

  John Perrin

  It is your mind that creates the world.

  The Dhammapada

  Cognition is not a representation of an independently existing world, but rather a continuing bringing forth of a world through the process of living.

  FRANCISCO VARELA AND HUMBERTO MATURANA, The Tree of Knowledge, 1992

  Mindfulness is the aware, balanced acceptance of the present experience. It isn’t more complicated than that. It is opening to or receiving the present moment, pleasant or unpleasant, just as it is, without either clinging to it or rejecting it.

  SYLVIA BOORSTEIN, It’s Easier Than You Think, 1997

  THE VALUE OF mindfulness is finding widespread acceptance within mainstream psychology, four decades since Hakomi founder Ron Kurtz pioneered its use in psychodynamic therapy—and over 2,500 years since its healing properties were first recognized and its practice codified by Eastern wisdom teachers. Today, a strong movement is developing toward the use of mindfulness in both the psychodynamic traditions (Germer et al., 2005) and the cognitive-behavioral traditions (Hayes et al.,
2004; Johanson 2006; Mace, 2008; Segal et al., 2002), while Zen Buddhist training has influenced Jon Kabat-Zinn’s mindfulness-based stress reduction programs and Marsha Linehan’s dialectical behavior therapy.

  The Act of Just Noticing

  Mindfulness can be understood as a special state of consciousness, characterized by “receiving the present moment, pleasant or unpleasant, just as it is, without either clinging to it nor rejecting it” (Boorstein, 1997, p. 60). Typically, attention is focused on internal experiences, either on the inner world in general or on specific features of this landscape. The attitude is open, receptive, and curious—without acting on any impulse to change, judge, or prove a theory about what is being observed. It brings bare attention in a being, noneffortful mode. The pace is slower than ordinary consciousness, and one can lose a sense of time and space, like a child lost in play. This is in contrast to ordinary consciousness that is often in an active, fast-paced, goal-directed, habitual, unreflective doing mode that is effortful, with a narrow focus and external orientation toward dealing with some kind of problem to be solved. Mindfulness is also known as witnessing, open attention, or open awareness.

  Although mindfulness is a natural state of consciousness, it typically has to be learned and cultivated in an ongoing process of deepening skill—and isn’t always easy (Faucheaux & Weiss, 1995). Traditionally, mindfulness has been achieved by dedicated practices such as daily sitting or walking meditation, yoga, tai chi, and so forth. The cultivation of mindfulness is a form of meditation, but the two terms are not strictly interchangeable. Meditation practices pursue a variety of goals, such as calming the mind, increasing concentration, expanding awareness, and promoting equanimity and compassion, which might or might not be in line with the immediate unfolding needs of psychotherapy.