Hakomi Mindfulness-Centered Somatic Psychotherapy

by Halko Weiss

  In Hakomi, Kurtz learned that second-order change could be brought about efficiently and effectively with a person’s consciousness intact the whole way. Nothing happens that the person is not aware of and does not approve of when he or she is invited to mindfully, curiously become aware of a repeating system through a technique he called “jumping out of the system” or “JOOTS.” This technique allows the person to get some distance on the system, but to stay with it and appreciate it, studying it for a while to understand how it has functioned and what it is good for. When it becomes clear how it also limits one’s options and how new possibilities previously organized out of the system can be mindfully explored, continuing in it unconsciously becomes difficult, and hope arises for the meaningful possibility of change.

  Family therapists, of course, have also explored couples and family systems for decades (Nichols & Schwartz, 1998). They have noticed that couples reinforce each other’s pathogenic beliefs and core injuries in very compelling ways. For instance, John may pull away from Mary, who then feels abandoned. She consequently pursues John more intensely, thereby provoking him to distance more intensely because he feels suffocated by her. He may have a history of interpersonal suffocation and intrusion dating back to his early years and primary relationships, whereas Mary may have a history of abandonment and neglect. Each of these wounds becomes revivified in the face of the partner’s unintended, unconscious, but nevertheless wounding actions (Fisher, 2002).

  Psychoanalysts have discussed these relational systems in terms of projective identification. In projective identification, the client enlists the therapist in enacting internal models of a relationship. For instance, my client Helen may have had an internal representation of others as undependable and unsupportive. Unconsciously believing that this is true about people, she will act toward me as if I were undependable and unsupportive. She will discount any information that calls into question her belief, and actively pursue and focus on evidence that supports it. Since she cannot rely on me, she has to do everything herself, including her own psychotherapy. As a direct result of her preempting me from saying anything or offering her any help, her prophecy about the relationship becomes true, and leaves me with a countertransferential experience of being a mere appendage to her monologue. Unconscious of what is happening here, I hopelessly settle back into my seat, convinced of my own ineptitude. I let her do the session entirely on her own and fail her basic test of me as a person and as a psychotherapist. Although the therapy in this example might be considered to be at a therapeutic impasse, it is actually a golden opportunity to explore and work through fundamental issues underlying the client’s presenting problem. We are at the core of her therapeutic work.

  Every person has a predisposition for entering into certain kind of systems. We do this by perceiving others through the filters of our own histories, treating people as if these perceptions are true and neglecting any evidence to the contrary, assimilating as opposed to accommodating in Piaget’s terms (Horner, 1974). Try as we might, none of us is immune to unconsciously entering into a system that is compelling to our clients. This inevitably wounds them in ways that evoke their own history. At first glance, this seems unfortunate. However, being able to notice, name, and intervene on this level brings to consciousness the client’s internal models of the world in an undeniable and visceral fashion (Aron & Anderson, 1998).

  Transference and Countertransference From a Systemic Perspective

  The Therapist’s Contribution to the Interpsychic Field

  Every therapist comes to the process of psychotherapy with her own characterological inclinations (Natterson, 1991). For instance, one therapist may be reluctant to become too intimate with his clients. It may be difficult for another to embody her own authority and set limits. Still another may need to dominate his client and give advice. Other therapists may worry about their own sense of neediness and may become dedicated to helping their clients eliminate their dependence on others. A therapist’s need for attention and understanding may interfere with the ability to focus on and enter into the client’s world. These examples represent just of few of the possibilities of how therapists may be internally organized as they work. Table 22.1 names the character strategies addressed in the Hakomi method (see Chapters 8 and 23) that many psychotherapists may unconsciously employ, and the type of limitation and strength each brings to the psychotherapeutic container.

  Psychotherapists tend to perpetuate their own systems by enlisting the psyche of their clients. For instance, a therapist may have a tendency toward moving quickly, performing and producing in a goal-oriented fashion. She will therefore tend to create a container in psychotherapy that silently and covertly pushes clients toward results and away from connection to their internal world. The therapist might have developed this disposition because she learned in her own family of origin that she would be loved and attended to only if she succeeded in performing at high levels. Being adaptable and creative, as human beings tend to be, she learned how to perform, produce, and achieve her goals. When she grows up and becomes a competent therapist, she will be likely to conduct therapy in the same goal-oriented fashion. If a client of hers happens to have a character strategy from which he resists others in order to maintain his sense of autonomy, he will begin to resist the therapist. At the end of the day, the therapist will go home and complain to her partner or colleague about the resistant client she saw during the day. The client will go home and complain about his pushy psychotherapist, if he is capable of noticing this. Still, the client’s characterological predispositions are interlocked with the therapist’s. Systems between two people are determined by the meeting place of their characterological strategies and the wounds that underlie them.

  The Client’s Contribution

  Clients also enter the therapeutic relationship with a compelling predisposition to enact the relationship according to a blueprint determined by their own history. If a therapist attends not only to the content but also to the way in which the client engages in psychotherapy, he will discover important clues to how the client most likely engages in all intimate relationships.

  Table 22.1 Therapist Characterological Limitations and Strengths

  One way to begin attending to the therapeutic system is to notice one’s own countertransference. This will provide information not only about the therapist’s own psyche, but about the models of relationship, self, and other that the client brings to the therapeutic container. Once the therapist begins to sense the feelings, attitudes, and images that are rising internally, he can begin to assess what the client is doing to engender these specific experiences. For instance, one client with whom I worked in couples therapry would barely let a sentence go by without needing to reword what I said. I would say, “So, you’re feeling sad, huh?” He would respond, “It’s not exactly sad. It’s more like feeling depressed.” I’d say, “You have your right hand over your heart, huh?” He’d respond, “Well, it’s really on the center of my chest.” After a while I began to feel frustrated and started to doubt my ability to track what was going on with him. At that point in the session, his girlfriend was appealing to him to get married. He responded to her by saying, “Marriage is a form of slavery.” I realized that he was fighting for his freedom. He did not want to be categorized or penned in any way. This battle for autonomy with her was also occurring in the present between him and me.

  At this point, having understood the underlying wound, instead of feeling frustrated, I felt sympathetic toward his quest for independence. This was a just and noble cause that I could support. From this recalibrated internal place I said to him, “So this is about freedom, huh?” He looked up at me and said simply, “Yes.” I waited a moment and then, noticing that he was in a mindful state, offered a probe (Chapter 16). I slowly said, “What happens inside when you hear me say . . . ‘I will fight for your right to be free’?” During the rest of the session we worked with his core beliefs around his sense of being controlled by ot
hers.

  At the next couples therapy session he was grinning. He said, “Guess what happened between sessions? I asked her to marry me!” After several more sessions, we completed therapy. As we debriefed our series of sessions together, he remarked that the turning point for him was feeling like someone supported him in his quest for autonomy. This was an example of both noticing the system in place, intuiting what was driving it (Marks-Tarlow, 2012), and doing an intervention that jumped out of it.

  Transference and Countertransference as a System

  Each type of character strategy has its own set of transference and countertransference reactions. Table 22.2 is a very simplified chart that tries to convey some generalities about how two personal styles may become entangled. It names the character strategies commonly presented by clients and the typical countertransference reactions that a therapist might experience. It also details typical ways the client might act to engender these countertransference reactions. In real life, those entanglements are far more complex and varied, but the table may help to imagine certain general scenarios. Finally, drawing from control mastery theory (Weiss, 1995), the table names some possible ways the client may test the therapist to see if she will act to reinforce the client’s core beliefs. These tests are usually calibrated for failure, with the client looking for evidence to support his old beliefs and ignoring evidence to the contrary. Being able to notice one’s own countertransference reactions will provide a key to understanding and assessing the client’s characterological predispositions, core beliefs, and historical wounds. In addition, it will provide clues to the preferred types of intervention for each client (Feinstein, 1990).

  Table 22.2 Typical Transference and Countertransference Reactions

  Therapeutic Response to an Impasse

  Most everybody’s impulse when noticing being stuck in a system and feeling uncomfortable in it is to try to get out as soon as possible. Very often, the resulting attempts make the situation even worse. That is when the solution becomes part of the problem, as was so beautifully analyzed by Paul Watzlawick and his colleagues (1974). As an example: the client who is slow, helpless, and resistant may trigger a lot of good suggestions and proposals from the therapist. Since the underlying issue is about freedom, though, the client needs to unconsciously sabotage everything that tries to guide him from the outside. This creates an ever-escalating interactional loop with no exit door. The intuitive or even automatic attempt to find a solution for the client makes things worse—as it probably does in the world outside therapy.

  Therefore, the first order of business for the therapist is to stay in the system and to study it thoroughly. Trying to jump out too soon is often defeated, as safety and mindfulness need to be well established with the client before such a fine-tuned intervention can work. Tolerating the system, allowing it to show itself fully and deeply, can give both the therapist and the client the time to study and understand the unconscious rules of the game. Jumping out does not mean stopping it, but understanding it first. The jump is foremost a jump of consciousness.

  Once the therapist has a sense of the system in which he and the client are engaged, jumping out of the system with the client becomes possible. This kind of intervention contains the risk that the client can feel judged by the therapist’s stance of contacting the dynamic that is happening. For success at this juncture, it is critical that the therapist carefully guard against this possibility. Detailed below are a number of steps, both internal and external, that a therapist may go through to intervene on this level.

  Steps to Jumping Out of the System

  1. The therapist notices some internal discomfort, boredom, frustration, anger, repulsion, fear, feeling overwhelmed, or any other countertransferential experience. He may even feel critical or judgmental toward the client. This can be used as a signal that the therapist and client are caught in a dysfunctional system. At this point, the therapist must sort out what part of his experience is his own issue and what part is engendered by the client. For example, the session may jump from one content area to another, but whenever the therapist tries to focus the exploration, the client jumps to a new topic. The theme in general appears to be the client’s longing for understanding, but the session appears to be going nowhere. The therapist notices that he feels frustrated and overwhelmed. The therapist then notices that the client is changing subjects frequently and refusing to be corralled by his attempted interventions to deepen their exploration together.

  2. The therapist becomes aware of and takes responsibility for his part in the system. At first, this is an internal event. The therapist realizes that he is trying to control what the client is presenting, but the effort is futile.

  3. The therapist can then begin to assess what the client is actually doing to produce the countertransference reactions. So, for instance, if a therapist feels confused and overwhelmed by the intensity and complexity of his client’s expressiveness, and does not usually feel confused by clients, he would begin to look for how the client may be unconsciously attempting to confuse him. It could be a fast pace, sudden shifts, an intense focus on him, or any of a number of other subtle behavioral indicators that may be influencing the therapist.

  4. The challenge now is to name what the client is doing, feeling, or perceiving in a way that is nonjudgmental and invites the client’s curiosity and willingness to explore further. For example, the therapist says, “I notice that there seem to be so many important things going on at the same time that one chases the next and you hardly get to stay with one. Do you notice that?”

  5. The therapist connects the interpersonal issue with the client’s presenting problem or theme of the session. He might say, “There’s something in you which really needs my compassionate attention and understanding . . .[?]” In naming the system, in order to avoid sounding judgmental, the therapist must undertake both internal and external activities. Internally, he must find a way to celebrate this trait in the client as inherently creative, intelligent, and adaptive to a difficult situation in the past. In this example, being intense, expressive, and emotional may have been a very good and useful strategy in a family where nobody would pay attention to her if she did not crank up the volume.

  6. In order to speak about this, it is sometimes helpful to name the system metaphorically, or to initiate the conversation by saying something laudatory or celebratory about the client’s role in the system such as, “You’re like a butterfly that moves from flower to flower tasting the nectar of each, but never landing and resting” or, with another type of client, “You have a great analytic capacity that you easily lead with, and also something is turning you away from your feelings.”

  7. A very effective way to address the system while making it okay is to include something that the therapist has already understood about why that behavior makes sense. That can be helpful even if those reasons are as yet unsubstantiated guesses, such as, “When you move so quickly from one topic to the next, it seems like you really want to show me a lot of yourself in a short period of time[?]” or “When you speak about this event in such a factual and even tone, I get a sense that it might help you not to get into a mire of emotions[?]”

  8. Once the client’s curiosity is engaged (Johanson, 1988), therapist and client together can devise an experiment to be performed in mindfulness that will help bring consciousness to the system so that it no longer exerts an unconscious and covert influence on the client’s relationships and behavior. It is critical that experiments are performed with the client’s permission, that safety has been established, that there is a strong therapeutic alliance, and that mindfulness is invoked (Chapter 16). Experiments without prior invocation of mindfulness will be shallow and will yield information only from the neocortex rather than from the deeper structures within the brain in which these narrow patterns are buried. For example, the therapist says, “How about we explore this further? I can try to get you to focus on something in particular, and you can notice your impulse to swit
ch to another topic. As we do that, notice the feelings, thoughts, and sensations in your body, and any images and memories that might arise. Take time to bring your attention inside yourself before we do this, so you can really explore the subtleties of your experience.” Once engaged in such an experiment, therapist and client can proceed to explore the issue in their usual ways, using accessing techniques that contact and name the client’s present experience, immerse her in it, and get her to study it from the inside instead of discussing or speculating about it. It is critical to have the client immersed in her actual, live experience.

  9. Therapist and client can then construct a relationship that is not based on the limiting, old, characterologically driven models embedded in the client’s psyche. For example, in the case above where Helen, in her self-reliant way, does all the therapy herself, we eventually explored how to jointly lead and follow in the session. She experimented with allowing herself to notice that I was available to support her as well as with accepting that support. This new relational pattern could then be integrated (Chapter 20) and transferred to her life outside of the session.

  Conclusion

  While systems may appear to impede the progress of therapy, they are really the very heart of it. Transformation always happens at the barriers. The systems in which clients engage therapists provide keys to the core of their psychological organization. The impact of the aliveness of the moment, and the presence of immediate, direct experience provide an opening that can be deep and impactful. The mindful exploration of how clients engage in a system and how they enroll others in it can help them choose alternatives that are more nourishing in their lives. Working on this level of self-organization is very often the turning point toward success, as the client-therapist team steps out of the unconsciously established roles of interaction and self-management, and discovers a larger and unimagined realm of options.