Hakomi Mindfulness-Centered Somatic Psychotherapy

by Halko Weiss

  CHAPTER 23

  Hakomi Character-Informed Interventions

  Lorena Monda and Jon Eisman

  AS CLIENTS EXPLORE their direct experience in mindfulness, core organizing behaviors and beliefs emerge. Some of the basic core patterns that Hakomi therapists assist their clients in uncovering are reviewed in Chapter 8 (cf. Kurtz, 1990a). The goal of Hakomi therapy is to help clients develop effective and satisfying choices beyond these limiting core patterns. The intent is never to take away any valuable lesson or defense clients have learned, but to expand their agency-in-communion (Wilber, 1995) by integrating newer, wider, and deeper connections and possibilities. Character theory is helpful for a clinician to learn because it reviews a number of basic developmental conflicts that everyone goes through, along with the typical ways a characterological issue presents itself (Lowen, 1975). It is a useful map for guiding clinical thinking and therapeutic interventions. It is essential when using this map that every person’s developmental uniqueness be kept in mind—as well as every person’s formation through multidetermined dispositions (Engler, 1991; Popper & Eccles, 1981) related to internal consciousness, behavioral and biochemical issues (Jean-Didier, 1990), cultural values, and social structures (Erikson, 1963; Paniagua & Yamada, 2013; Wilber, 1995), including pre- and perinatal issues (Grof, 1988; Pesso, 1990).

  It is important to remember that character behavior, no matter how dysfunctional, is ultimately meant to be protective—an adaptive defense system that originally arose as the best possible response to less than optimal situations, in a place and time where no better resources were available (Kagen, 1998; Kegan, 1982). The problem is that the client still behaves as if this world of long ago is the world he is living in now. People seek therapy when their internal or external world no longer works for them. Clients’ habitual and often unconscious impulses toward avoidance, collapse, protection, seduction, resistance, clinging, mobilization, and so forth feel like existential absolutes and mandates that describe the facts of their world and drive their experiences (Loevinger, 1976). It is the practitioner’s job to help the client understand these impulses—where they come from, what habituated and unresourced feelings, thoughts, beliefs, postures, and behaviors accompany them—and how to meet the underlying needs they represent in a more satisfying way.

  Unfortunately, the protective nature of character patterns, perceptions, and needs may often be at odds with or in explicit conflict with both the client’s desire for transformation and the therapist’s pursuit of this goal. The art of Hakomi lies in the therapist’s ability to respond successfully to each client’s automatic perceptual and behavioral nuances. Because character theory is a map of those nuances, it provides a secondary blueprint for approaching and working through the client’s core material. Understanding character theory allows us to respond more effectively to the client. By understanding the unmet needs, woundedness, and adaptations that may underlie habitual behaviors, and by entering a dialogue based on this understanding, modulating the degree or flavor of engagement, therapists can avoid the various projective traps that clients, in their characterological trances, automatically set (see Chapter 22).

  In addition to assisting the practitioner to engage successfully with the client, character theory also maps out the developmental needs and missing experiences that Hakomi therapy seeks to provide. Characterological orientation implies and reveals the missing developmental learning experiences (Missildine, 1963). By recognizing the developmental origins of character elements, the practitioner can be more efficient and direct in pursuing a client’s specific core needs.

  Looking more closely, we can see that a client’s character strategy actually creates four kinds of therapeutic avenues for the therapist to explore with the client: (1) the genuine developmental need of the client, often disowned or held in exile; (2) the sense of core hurt from not having the need met (both the internal depletion from the missing experience and the relational betrayal of it not having been provided by others); (3) an organic effort to enlist help, get the need met, and restore relationship; and (4) a protective function constantly seeking to avoid further injury or disappointment.

  It is often the case in therapy that as the client gets close to the missing experience or to getting his needs met, the protective strategy is activated, which prevents him from taking in the nourishing experience. In Hakomi we call this the nourishment barrier, a general term for the organizing out of potentially nourishing experience by the client—differentiated from the more specific nourishment barrier (the inability to feel nourished or satisfied) making up one of the four barriers within the sensitivity cycle (see Chapter 17). Studying and working at the client’s nourishment barrier is an essential part of Hakomi therapy (see Chapter 19), and each character style approaches this barrier from a unique perspective and with a different strategy. Thus, working with character patterns requires approaching our clients with patience and compassion, embracing whatever they present, and working skillfully to redirect limiting, habitual patterns toward something more nourishing and functional. To see our clients this way, to feel both their genuine humanness and how it is often moderated by learned, protective, and combative instincts, allows us to respond effectively and compassionately.

  Kurtz drew from his doctoral studies in experimental psychology to help understand the deep intransigence of characterological dispositions and the deep compassion necessary to work them. He often cited the work of Solomon and Wynne (1953) with their “traumatic avoidance learning” experiments with dogs. They would place a dog in one half of a box, called a “shuttle box,” that had a tall divider down the middle that the dog could jump over to shuttle to the other side. Then they would give a signal, followed 10 seconds later by a noxious shock through the floor that would be painful to the dog and would motivate it to jump over the divider to escape. They then studied how many trials were necessary for the dog to learn that the signal indicated an impending shock, which meant the dog should immediately shuttle to the other side of the box to avoid it. They reported that the dogs received only 7 or 8 shocks before reaching the criterion of 10 consecutive avoidance responses. This result was unremarkable.

  The truly insidious nature of the experiment was revealed when they turned off the shock and studied how many trials it would take the dog to learn that the signal no longer meant that they would receive a shock. The answer was never. One dog jumped over the barrier 490 times before the experiment was discontinued. Every time the dog’s physiological panic reaction at the signal motivated it to shuttle to the other side and find relief, it theoretically thought to itself, “Saved myself again.” The tragedy, of course, was that it saved itself from an illusion, since there was no shock. But after hundreds of trials, it was one powerful illusion reinforced by a powerful neural net (Badenoch, 2008; Cozolino, 2010; Porges, 2011).

  While it is a theoretical, philosophical jump from animal studies to human studies (Murphy & Brown, 2007), Kurtz could easily imagine instances—appropriate to particular stages of development—such as some kind of need for support from a caretaker being the signal, lack of support serving as a painful experience, and the unconscious decision to be self-reliant a way of shuttling away from the pain of not having one’s need met. Then, after years of doing everything oneself to avoid the pain of disappointment, it was easy to imagine that subsequent instances of people actually willing and able to offer support would understandably be met with deep anxiety and distrust.

  The following sections provide details about how the character material may be applied to accommodate the client’s presentation and to facilitate the therapist’s approach—always informed with a compassion and understanding of the client’s predicament illustrated by the shuttle box experiment. Of course, space here does not permit a full elaboration of how the information can be used strategically, but the reader should be able to glean a general sense of direction in how to proceed. For each disposition (Popper & Eccles, 1981), we discuss briefly how to
recognize the pattern, what issues may need attention, attitudinal and behavioral adaptations the practitioner may need to make, and specific interventions that may be useful for the client. It is essential to remember not only that all of us have combinations of character habits, rendering any merely linear approach ineffective, but also that our clients are whole people, of whom character is one habituated aspect.

  In addition, since underlying characterological issues are existential and touch on basic human needs (Maslow, 1943), it could be argued that these issues are alive in us at any time, whether strong at the moment and in the foreground, or sleeping in the background. Marlock and Weiss (2015) proposed understanding character for each individual person as a combination of five great character themes. In this model, every theme is thought to form a polarity of varying degrees of severity. As an example, the theme of safety would form a polarity, with safe/secure/belonging on one end and unsafe/threatened/isolated on the other. The assumption is that a person would have an assigned value for each polarity at any moment. Character would express itself by certain positions a person would inhabit habitually along those polarities, like, in the above example, finding oneself on the unsafe/threatened/isolated end of it a lot of the time. One advantage of looking at character this way is that typecasting can be avoided, and more flexibility and complexity of understanding is offered.

  Reading the descriptions of patterns below, the reader may notice the implicit invitation to assign certain patterns to people in their lives. In the Hakomi method, we discourage this tendency and encourage students to use character descriptions to understand the universal psychological needs that lie hidden beneath the surface of complex behavioral patterns. Character descriptions are meant to help us hypothesize and then explore what might actually be the case in a particular person. In truth, if we stay open and curious, we will usually find something unique and unexpected.

  The Sensitive/Withdrawn Pattern

  The sensitive/withdrawn pattern arises from the developmental need to safely be and belong in the world. Because this need was met with some kind of harshness at a time when the infant had only limited resources for dealing with the world, the child learned to withdraw internally from felt experience and externally from active engagement with life. Life is experienced as overwhelming and potentially annihilating.

  We can often recognize the presence of this pattern by structures and behaviors that involve connection and engagement. There is often something noticeable about the eyes: They may appear frozen, startled, intense, or especially wide open. Physically, we may see a sense of contraction toward the core, with the arms pulled in and the chest seeming to constrict in toward the center. The body will have core tension and often elements of asymmetry. There may be an overall sense of delicacy or fragility.

  Some of the basic core beliefs of this strategy include: “There’s something wrong with me,” “The world is harsh and dangerous,” “I am not wanted.” Behaviorally, the client may seem to be in his own world or, on a deep level, not to connect (inwardly or outwardly). Behavior may seem baffling or incongruent. Strong fear or anxiety is often present. The client may speak in images and metaphors, or in complex, jargony, or abstract terms. Emotions named may not be congruent with their presentation. The client may present as spiritual, creative, or nonconformist, with high integrity and an insistence on honesty.

  Therapist Adaptations

  Recognizing the underlying fragility of the client, the therapist must proceed especially carefully, slowly, and gently—demonstrating that she is not part of a world that will be harsh, overwhelming, or destroying. The therapist must explicitly create safety, committing herself to respect the client’s boundaries, around both physical and psychic space. It is important for the therapist to be sincere, honest, and authentic, as the client will sense and react to any hypocrisy. Because these clients often feel like they were never given the handbook on how to be a person, it is helpful for the therapist to model the value of aliveness and relating, normalize what the client feels, and make clear that there is something inside the client worth gently pursuing.

  Equally important are things to avoid. Provocation does not work as an approach with these clients. It is important to avoid dehumanizing them in any way: taking them for granted, assuming or expressing how they are a certain kind of person, not listening to their exact meaning, and so forth. The therapist should not let the intensity of the client’s fear keep her from proceeding, but continuously track and gently contact what is happening (Chapter 14).

  A friend, Mitch, once spent three hours patiently traversing a small clearing across which a deer stood watching him. At the end of that time, he stood alongside the deer, petting it. Then the deer slowly wandered off into the woods. This is a model of the therapist working with the sensitive/withdrawn pattern (LaPierre & Heller, 2012).

  Therapeutic Strategies and Interventions

  The main strategy here is to encourage the client’s felt experience of her inner world, to help create the ability to engage fully and spontaneously in the outer world, and to develop a sense of the self as whole. Along the way, we may expect to teach the client about aliveness and boundaries, to create a safe container for her to experience her terror and rage, and to assist her to feel alive and welcome in the community of human beings.

  Because there are usually strong attachment issues involved, working with the sensitive/withdrawn pattern requires reestablishing limbic resonance and allowing the client’s nervous system to ease into dyadic contact while self-regulating. This allows the person to become comfortable in her own skin. Much work can be done around eye gazing and the possibility of, and perhaps eventual embracing of, physical contact. With this pattern, the relationship between the therapist and client is not just a tool for working, it is the work.

  In terms of interventions, the most important task is to stay in contact. Track carefully, and teach and encourage careful mindfulness in these clients. Track for signs of the client withdrawing from himself and his felt experience, and withdrawing from the therapist. Some probes that are salient to the sensitive/withdrawn strategy address safety, being welcome, and the naturalness of being alive, such as, “You are welcome/safe here,” “What you feel is natural,” or “There is nothing wrong with you.” Experiment with the eyes and vision: opening and closing them, looking at you and then looking away, and so forth, carefully studying the impact of these seemingly mundane but surprisingly powerful explorations. The same can be done for touch: offering your hand slowly, studying the client’s impulses to reach out and retreat. Have the client pay careful attention to the exact quality of experience in all these experiments, searching for the discovery of pleasure in simple engagements—the path from withdrawal to safety and connection.

  To help these clients recognize these events, it is often effective to describe their apparent experience as it happens, like a tender parent: “Yeah, you start to reach toward me . . . but now the fear comes up again. . . .” Acceptance is also important; let them know you value their way of operating: “It’s okay with me if you want to go a little bit away. . . .”

  When, after time, it becomes safe enough, it can be very powerful to take over the physical containment (tension, resistance to connection, and so on). Working with just a small piece (e.g., how the elbow presses against the ribs) or enfolding the client’s entire body brings dynamic awareness to the somatic strategy of holding in against feeling. Often such experiments—again, done slowly and carefully with the client in mindfulness—can lead to the client’s discovery of his full aliveness. Birth trauma may be revisited and resolved, and the natural desire to have and follow impulses may become available.

  Integration for this client comes when he can recognize that the world is sometimes safe and welcoming and sometimes not, and he knows that he has the ability to discern how he organizes himself in relation to what he is experiencing. If a situation is accessed as not welcoming or harsh, there is always the option of withdrawin
g and taking refuge in music, books, technology, and so forth. If there is a perception of safety where genuine contact and connection might be risked, then the client can consciously choose to experiment with new options.

  The Dependent/Endearing Pattern

  The dependent/endearing pattern develops when the need to be secure that one’s legitimate needs will be met is joined with caregivers that are unreliable, neglectful, not in tune, or distracted. Life is experienced as empty, with a feeling that there will never be enough.

  Feeling undernourished and deprived, clients with the dependent/endearing pattern exhibit a tendency to collapse while invoking caring behavior in others. The collapse usually includes a downward, loose posture, as if the puppet strings were slack, with a sunken chest, rounded shoulders, head thrust forward, knees held in a locked position, and overall low energy. Soliciting help, clients may look waiflike with big, soft, puppyish eyes and pouting lips, and an endearing, innocent expression.

  Some of the basic core beliefs in this pattern include “I can’t get support,” “There is nobody there for me,” “Everyone will leave me,” or “I can’t do it.” In his interactions, the client disposed toward the dependent/endearing pattern may seem depressed, sad, and/or needy. His participation in the session may be low key, reflecting his low energy. Often the client may want just to talk about himself, with a wistful, “poor me” tone, and will likely have trouble taking in the therapist’s offerings of ideas, insights, and experiments. There is a feeling of chronic dissatisfaction. When nourishment is offered, it is difficult for the client to accept it, or to let it be just right or enough.