Hakomi Mindfulness-Centered Somatic Psychotherapy

by Halko Weiss

  Hakomi assumes both a psychodynamic and systems view of psychological processes. Internal dynamics are looked upon as parts that self-organize into a whole (see the unity principle in Chapter 5)—a whole that can have different grades of integration (Johanson, 2011c)—the quality of which is determined by the quality of communication among the parts of the whole (Bateson, 1979).

  Throughout the psychotherapeutic process, a Hakomi therapist contacts those parts of a person that get activated, but are just outside awareness, or deemed unacceptable by another part of the person. By employing mindfulness and exhibiting an accepting and empathic attitude toward all parts, the therapist models and helps strengthen the client’s capacity and willingness to explore, understand, and befriend internal parts that are not yet well integrated. She assists the client in finding a deeper and more complex flow of information among many elements of the overall organization—in line with Hakomi’s organicity principle (Chapter 5).

  Siegel and Solomon express these aspects of healing and transformation:

  [T]he mind is a self-organizing, emergent process that is both embodied and relational and that regulates as well as arises from, the flow of energy and information within us and between us. From an IPNB [interpersonal neurobiology] perspective, healing is the process of integration in which energy and information flow is cultivated, such that separate elements of a system are differentiated and then can become linked. Integration is the linkage of differentiated elements and allows the coordination and balance of a system to achieve harmony. (2013, p. 2)

  The idea is that communication among parts, and especially an awareness of each part’s important contribution to the whole, is essential to improve the quality of self-organization, or—according to Schwartz (1995), Siegel (2007), and others—support a well-integrated whole. Accordingly, a variety of Hakomi interventions are designed to depolarize and integrate parts and, in so doing, help end a history of dissociation. Good examples of this are sessions that unfold around the process of rapprochement between adult parts and child-type states, as the following example illustrates.

  Caroline, a 67-year-old former school teacher, comes to see her therapist because she has had a number of strange, self-induced accidents that she feels were caused by being in a constant state of irritation and confusion, and by having torn feelings. Her main complaint centers on a “hateful and envious” part that she absolutely detests and is embarrassed about (notice her identification with that antagonistic part of herself). She is in therapy for almost half a year before she finds the strength to deal with this central part of herself that she calls the Witch. At a crucial moment, the following occurs.

  In a mindful state, Caroline is aware of a compact and burning feeling around her diaphragm that she associates with the Witch. She has identified this part as a young state (in terms of age) that threatens to overpower her. The therapist invites her to try to find a way to speak to that young being from the internal observer. (Caroline understands that this is an impartial, interested, and accepting state, which she has already learned to find in herself.)

  CLIENT: I can’t stand that feeling, I want it to go away. [Client is identified.]

  THERAPIST: Can you find a place from where you could talk to it with compassion?

  CLIENT: Let’s see [almost half a minute goes by]. . . . I think . . . no, I just cannot find that place. . . . I am swamped by my resentment. . . . I just want it to go away . . . to die.

  The therapist continues to explore the part of the client that so despises the client’s witch-like child state. They find out that the rejecting part (she calls it her School Master) is worried that the Witch will dominate her existence and make her completely unlovable. Her therapist then asks the School Master whether it would be good for the therapist to talk to the child and try to make her feel better. After some hesitation, but with a glimmer of hope, the School Master gives way.

  Before the therapist starts talking directly to the Witch, she asks the School Master to observe closely and step in if the therapist does something that is not okay. She also invites the Observer to be present. The School Master is appeased. Now the therapist begins an intervention with the Witch by entering into a dialogue in which the Observer keeps reporting how the internal Witch-child [for a while the terms “Witch” and “Witch-child” are used interchangeably] is responding. After contacting and exploring the Witch-child’s experience for a while, the following exchange develops:

  THERAPIST: [to the child] I can see how furious you are. Can I come and sit with you? [To the observer] How does she respond?

  CLIENT: She looks up . . . somehow surprised. But also softening . . . kind of opening a little bit. . . . She nods.

  THERAPIST: Okay, so I will sit next to you on that log. How close should I sit? [To the observer] How does she respond?

  CLIENT: She wants you to sit right next to her . . . actually touching. . . . She feels you. There is a cautious smile. . . .

  As they go on, the therapist explores the world of the child more deeply and shows a lot of compassion and understanding. In their shared fantasy, they sit on a log in a hidden place in the child’s old backyard, as the visiting therapist has her imaginary arm around the child. It becomes clear that the Witch only protects an extremely rejected and marginalized even smaller child within Caroline whom she calls Beebee. The Observer is sometimes asked to share its observations and speak to the furious and aggressive Witch-child as well, which finally happens with ease and in a loving spirit. For example, at some point, from the Observer position, the client speaks to the Witch:

  CLIENT: Of course you hurt. . . . That is really bad. . . . I understand how they all hate you . . . and all your love . . . is stuffed down your throat. . . . Thank you for helping and protecting Beebee.

  THERAPIST: How does she react?

  CLIENT: She relaxes. . . . She looks at me. . . . There is warmth . . .

  THERAPIST: What does the warmth do?

  CLIENT: I can feel it fill my belly. . . . It spreads. . . . It is not hot anymore—it is pleasantly warm. . . . I am so glad she protected Beebee. . . .

  During the ongoing internal dialogue between the Observer and the Witch, the School Master does not intervene at all. Then, when the therapist wraps up this session’s visit with the Witch, she explores with the Observer how the Witch is doing and what she needs.

  CLIENT: She wants me to not leave her again. She wants me to not push her away . . . to stay connected.

  THERAPIST: Is that something you can do?

  CLIENT: Yes. I want to.

  A little later the therapist contacts the School Master:

  THERAPIST: Was this okay? Did we do the right thing?

  CLIENT: [from the Observer] She has become so soft as well. She sat down. She is nodding.

  THERAPIST: Can I talk to the School Master directly? [Client nods.] How is that for you?

  CLIENT: [talking from the position of the School Master] I am relieved. She is not alone anymore. I can breathe. . . . We need to make sure we stay connected.

  While such therapeutic processes can be quite complex, with different parts being triggered and needing attention, this example shows how the relationship between parts can depolarize by opening and deepening channels of information between parts, encouraged by the compassion of the observer self-state. Processes like this are well described by Richard Schwartz (1995, 2001).

  When parts are no longer adversaries but instead learn how to understand each other, and know what kind of support is needed, transformation occurs naturally. In the example of Caroline above, both the Observer and the School Master find ways of integrating the Witch and learn to deal with her compassionately. This part of the client no longer holds an exiled—or rejected—position, but is more deeply integrated into the overall self-organizing system. In later sessions, some deep work with Beebee opened the way for even bigger changes in Caroline.

  Experiential Learning

  For Ron Kurtz, providing missing f
ormative experiences in a psychotherapeutic process is the core mechanism of personal transformation of the client. As he saw it, unconscious beliefs (Chapter 7) are revised through powerful emotional learning when old formative memories are evoked. Insight is never enough. The tenet is: It takes experiences to counteract learnings from previous experiences.

  This approach also has important predecessors: Franz Alexander, in particular, put forward his idea of “corrective emotional experiences” in the early days of psychoanalysis (Alexander et al., 1946). More recently, similar concepts have flourished. Neurobiologists Nadel (1994), Roth (2003), and many others have shown how important strong emotional experiences are for learning—and that psychotherapeutic transformative learning may be state dependent.

  A regressive state, like an internal child, needs to be activated to be accessible for rewiring of the neural architecture (memory reconsolidation; Nader, 2003) by offering a healing experience, as kind of an antidote (Ecker, Ticic, & Hulley, 2012; Pesso, 1973). For many psychodynamic schools—such as Kohutian self-psychology (Kohut, 1984) or the intersubjective approach (Stolorow et al., 1987), and humanistic psychology schools, such as Rogerian client-centered therapy (Rogers, 1951) or dialogical Gestalt therapy (Hycner, 1991)—the therapeutic relationship in itself may already be a corrective emotional experience when it counteracts habitual core organizing expectations. Hakomi would add that it is best when the client is intrapsychically mindful of the corrective interpersonal experience, and how it challenges previous beliefs.

  The Hakomi method emphasizes that by activating problematic formative experiences in a mindful process of deepening and differentiation (Chapter 19), particularly powerful core situations may arise in therapy. The client may regress back into such formative experiences that express some lack of specific and badly needed input: a positive relationship of some sort, a sense of safety, important knowledge, and other key experiences a growing child must have in order to complete essential developmental phases to establish a good place in the world (Chapter 8). Because these potentially nourishing experiences did not occur when they were needed, the person was forced to put appropriate protective mechanisms in place that later limited his range of experience, behavior, and satisfaction.

  When such damaging formative situations arise in a live manner in a session and are explored in detail, client and therapist may experiment with what was missing in the past. When mindfulness is in place and the nature of the situation is clear, they can jointly create a new situation in the present moment that allows the client to experience the unknown, unexpected, and deeply missed experience. The assumption is that this novel experience becomes encoded in the neural architecture, especially when it is emotionally charged, and can be repeated and deepened (Cozolino, 2006). The learning arising from such an approach would then expand the client’s unconscious beliefs about the world and himself. The example above, of Caroline and her Witch part, can serve to elucidate this kind of therapeutic process.

  A session with Walter demonstrates a less complex way of working, where parts are not as directly expressed, but where it is obvious that transformative experiences have to be designed very carefully.

  Walter was a 32-year-old “perpetual student” who had explored a lack of support in his life during the course of many therapy sessions. He had repeatedly been in depressive and collapsed states that were connected with the memory of losing his mother in a car accident when he was six years old. These memories had merged with even older memories that were similarly characterized by feelings of loneliness and abandonment.

  The therapist spent a great deal of time exploring the corresponding somatic-affective states and supporting the development of the connected narrative. It eventually became clear why Walter had never succeeded in becoming involved in a warm, supportive relationship. At one session, Walter repeatedly alluded to how he would like to get to know such a supportive “world” (as he called it) at least once in his life.

  At this point the therapist offered to sit next to Walter on the floor and to allow Walter to lean against him. The therapist had never touched him, so this intervention was talked over and prepared in great detail. When they tried it out, with much awareness and a slow pace, Walter couldn’t feel anything other than tension and fear. These experiences were explored and processed.

  After more sessions on the floor, Walter—without anything unusual happening directly beforehand, but in a state that was characterized by deepening mindfulness—suddenly yielded and was able to lean easily and without resistance into the therapist. Then an avalanche of intense emotions erupted from within: sadness, relief, joy, and pain. During later sessions, the ability to receive “backing” (as Walter called it) finally became increasingly easy and natural. Mindful observation helped to create a sense of understanding and meaning. Mindfulness also made sure that Walter did not stay identified with this internal child, and that opening into the experience did not turn into “malign regression”—a state that many psychoanalysts warn about as characterized by intense identification.

  Transformation occurs when clients are able to accommodate into their structure those kinds of experiences that they had previously not been able to take in (Johanson, 2015). Here the client was able to experience something new and—certainly, for his unconscious mind—unexpected, as his body took in the information of how it feels to receive support. The underlying assumption is that only something that has been experienced as real by the emotional and implicit memory system will find its abiding representation in the neural architecture.

  From the point of view of a Hakomi therapist, the form of experiential learning illustrated in Walter’s case is possibly the most powerful way to reshape specific habitual, protective, and limiting patterns, which once were a healthy response to the absence of required existential experiences for the young, growing organism. As new experiences and meanings are encoded, they shift the beliefs derived from the original formative material. While these experiences are uniquely connected to the specifics of a person’s life, they also address basic existential needs that every human has, and can therefore be empathically detected and pursued by the therapist.

  Furthermore, it is necessary to direct the client’s attentional processes to the corrective experience for transformational learning to fully take root. If the client is not mindful, or if attention is directed elsewhere, the corrective experience will not be integrated (Begley, 2007). Directing awareness to the felt sense of having a long-awaited need finally met creates the requisite conditions for moderation of the original emotional learning (Ecker et al., 2012). This, in turn, changes all the experiences that are being shaped and colored by that particular memory system.

  Integration Revisited: Solidifying the New

  In terms of current models of transformation (Castonguay & Hill, 2012), Hakomi’s approach of transforming core beliefs based on early formative experiences—which in turn influence the person’s worldview or filters that affect perception and response—is closest to Constantino and Westra’s (2012) expectancy-based approach. Since there is a revision of the client’s working model of the world, the way the client expects things to be or organizes her experience is altered in a manner that affects virtually everything: cognition, emotions, interpersonal relationships, posture, breathing, movement, gestures, and more. Since the old expectancies or core organizing beliefs are deeply embedded in established neural networks, there is a necessary integration phase for the new way of being to take root.

  One metaphor for understanding the integration process of solidifying the new growth is to think of new corrective experiences and memories as being like a real but fragile flower beginning to grow in the garden of one’s bodymind. There is still the firmly established old growth in the garden along with the new bloom. But if attention, water, protection, sun, and fertilizer are given to the new growth, it will continue to grow bigger and stronger. Some of the old growth will wither from lack of attention, except for the growth that is
affirmed to have a valuable, though not exclusive, place in the garden. Some of the integrative growth and strengthening can happen within the therapy sessions or in agreed-upon homework. As with Walter, verbal or nonverbal corrective experiences can be repeated and reinforced. The new experience should be mindfully savored. The person can also voluntarily and with awareness “rock” back and forth from the bodily manifestations of the old belief system to those of the new. He can take time to reimagine going through his life developmentally while embodying the new expectations. Anticipated stressful situations at home, work, school, or wherever can be rehearsed, slowed down, and resourced through embodying the new working model of the world. The therapist can have clients check in and notice what other parts of their inner ecology support or might be nervous about the new developments. If the therapy context is a group, the corrective experience can be offered by a number of people in a mindful progression. The client can experiment in the group setting with new ways of sharing, reaching out, reacting to certain situations, or whatever is needed, again in a way that the therapist ensures is mindful as opposed to rote movements.

  In Caroline’s case above, she could agree to check in with her vulnerable part, Beebee, at certain times or before and after stressful situations, also checking for any dissident parts that might attempt to sabotage the progress. Every time clients check in and observe an internal part from a mindful place of awareness and compassion, they are also deepening the neural net that helps them reside in their more expansive self-state beyond the drama of ego states. Perhaps journaling about the new experience or debriefing how it played out in situations throughout the week could be helpful. Sometimes the therapist might volunteer a story that metaphorically incorporates the therapeutic journey (Weiss, 1987). For some people, developing movements, composing music, or creating art that corresponds with the new worldview can be integrative. There are endless possibilities that can be collaboratively agreed upon and supported. Stosny (2014) outlines many ways of strengthening new habit patterns.