Hakomi Mindfulness-Centered Somatic Psychotherapy

by Halko Weiss

  Underlying these experiences is usually a core sense of loss and abandonment, with deep, insatiable feelings of emptiness and a primal rage at those who were somehow absent. The client will need to find, develop, and apply his own strengths, learn to take in and use nourishment, and decide to trust others in mature and reciprocal relationships.

  Therapist Adaptations

  Because the dependent/endearing client seeks to indulge dependency while actually needing to become self-sustaining, the attending practitioner needs to balance carefully the genuine need to be nurturing to the client with an unwavering commitment to pursue individuation. Actually being deprived, the client needs some caretaking from the therapist, but eventually must be weaned from such dependency to stand on her own. This requires the practitioner to access his own compassion and generosity while also keeping firm boundaries. It can be easy in this process either to be ensnared by the client’s endearing qualities and so become overly nurturing, or to feel drained by demands and so retreat from the client’s neediness, replicating the original abandonment events.

  The therapist does well to model trustworthiness and the certainty of abundance—demonstrating generosity and confidence in positive outcomes. It’s important to avoid rescuing the client and also to avoid abandoning the client in any way, though the client may typically seek to have more and more of the therapist’s time and attention. It is also important for therapists to avoid any expression of repulsion at the client’s neediness or childishness and, similarly, to resist the impulse to make the client responsible too soon.

  Therapeutic Strategies and Interventions

  Work with the dependent/endearing client often begins with a period in which the genuinely depleted client needs a certain amount of nurturing, comfort, and reassurance. The therapist must earn the client’s trust, demonstrating a heartfelt, no-strings-attached willingness to listen, validate, and respond. Ultimately, however, the therapy will be about not whether the therapist can nourish, but whether or not the client can accept and take in what is offered. The goal of therapy with dependent/endearing clients is to help them discriminate what is nurturing from what is not, and to actually experience the felt sense of being nourished and satisfied, thus creating a foundation for seeing and finding for themselves the abundance available in the world.

  Nurturing without rescuing, the therapist can contact lovingly the client’s feelings of sadness, loneliness, and helplessness, and have him study their origins, with experiments such as reaching out or placing a hand on the client’s heart. Experiment with the ways the client’s body surrenders to collapse, such as having him stand and study feeling unsupported, or taking over holding up his shoulders.

  Exploring and clarifying the barrier to actually taking in nourishment is central here. It is not enough to offer nourishment; it is also essential to explore the ways in which the client transforms potentially nurturing experiences into toxic or unsatisfying ones (for example, “It won’t last,” or “Yeah, but you get paid to be nice to me”). Probes that help the client explore this barrier include, “You can get what you need,” “I’m here for you now,” or “You can do it.” Because the dependent/endearing client clings to an empty past and so predicts a bleak future, it is essential to keep her in the present, noticing in the moment if things feel satisfying, and bite-sizing experiences into momentarily acceptable bits of nourishment. Often it will be valuable to provide something nurturing, such as compassionate touch, and then experiment with leaving and then, at the client’s request, coming back, so that she learns to trust both abundance and her own ability to obtain it.

  Usually there is great rage at the core, and the client’s ongoing whininess and complaining are pathways to accessing that deep hurt. Expressing the rage in a safe way (for example, a well-cushioned and supported temper tantrum while in the child state) allows not only catharsis but validation of the client’s entitlement to what he needs in life and empowerment for obtaining it. This paves the way for the development of a more firmly grounded adult self who can care for and protect the child, as well as seek and sustain mutual love and support with others.

  Integration for people with this pattern will include teaching discernment between situations where it is true that authentic support is not available, and other situations where it is appropriate to practice letting go of their anxiety of there not being enough, so they can take in the actual nourishment that is available. They need to learn the balance between starving in the midst of a banquet and opening themselves to neglectful or toxic relationships sure to confirm their worst fears.

  The Self-Reliant Pattern

  The self-reliant strategy has an etiology and underlying needs similar to the dependent/endearing pattern, with a different adaptation. Whereas the client with the dependent/endearing pattern responds to lack of support by caving in and imploring assistance, clients with the self-reliant pattern compensate for this lack of support by dismissing help from others and mobilizing against the possibility of collapse. Basic core beliefs of this strategy include: “Nobody is there for me,” “I don’t need anything,” and “I can do it myself.”

  As with the dependent/endearing strategy, we see the underlying collapse in the self-reliant character structure (sunken chest, locked knees, deep neediness), but with a prominent physical activation layered on top. Shaping the body around the need to handle any physical situation as a matter of survival, the self-reliant client exhibits a gunslinger pose, with elbows crooked and away from the sides, hands energized, and a wide stance. At rest, the energy may seem low or quiet, but with a sturdiness, sense of tension, and readiness to take action.

  Behaviorally, people with this pattern are self-attending, operating alone even if others are present. Independent activities like running, biking, mountain climbing, and such are not uncommon. While they can often offer willing, reliable help to others, when help is offered to them, it is turned down with some version of “It’s okay—I can do it.” With a determination to handle things on their own, these clients will take on challenges, like carrying heavy suitcases, fixing appliances, or taking on the care of others. At the same time, there may be an irritation or weariness about having to do so much—displaying the cost of having to survive without being able to count on anyone but themselves.

  In addition, matters of trust will be prominent. The self-reliant client will need not only to allow nourishment in (like the dependent/endearing client), but because he has abandoned the possibility of external support from others (unlike the dependent/endearing person who must rely on others for help), he must find a way to include the realistic support of others—to recognize and trust them as partners and not just parallel presences. In fact, this client may come to therapy at the urging of a partner who feels alone in the relationship, or because the circumstances of his life (illness or job loss, for example) are such that the self-reliant stance no longer works—receiving the support of others is crucial. At the deepest level, others seem moot to the self-reliant client, and the therapy must address this alienation and work to reestablish a trust in the value of genuine connection and support.

  Therapist Adaptations

  To establish the possibility of a true connection, and to appeal to the genuine need underlying the self-reliance, the therapist must explicitly model the values of trust, abundance, caring, and being loved. The therapist may assume that the client will tend not to allow in much nurturing—heading off instead to work by herself—and so must not succumb to frustration and impatience.

  In fact, this tendency for the client to work on herself by herself presents the greatest challenge in trying to proceed in a Hakomi-like manner. The practitioner needs to track carefully for when the client is engaged in therapeutic dialogue, and when she goes off on her own internally to self-process. The therapist must remain diligent in not assuming that he and the client are working together, and invite the client to bring the therapist along as the client works.

  Therapeutic Strategies a
nd Interventions

  As with the dependent/endearing pattern, the overall therapeutic strategy is to reclaim the ability to be nourished and to trust in the caring of others. In addition, the work must clarify the issues around help being available; uncover the alienated stance of the client and resentment toward others failing him; and develop a view of the world that expects supportive relationships and the ability to engage with others in mutually satisfying ways. In particular, it will be essential to demonstrate attention and consistency, and to continue to offer help, so the client does not have to work on himself alone.

  Experimenting with the barrier to taking in nourishment will be central, especially around the client recognizing that nourishment comes from other people. Probes like, “Let me help you,” “I will support you,” or “You have needs of your own” help the client explore this barrier. Whereas the dependent/endearing process needs to move from dependency to independence, the opposite is true here: the client must learn the value of being dependent—recovering that as a childhood missing experience and integrating it into an option in adult life where appropriate. There will also likely be the need to explore the core rage at this dependency having been unsupported.

  Experiments may include working with the posture of mobilization and readiness, studying its purpose, and then, through taking over the shoulders and weight, allowing the client to explore the feeling of being supported and cared for. Trust issues can be explored through falling backward and being caught, or by leading the client on a blind walk (she keeps her eyes closed while you lead her around).

  Mindful eye gazing may serve to reestablish connection and dissolve alienation. As you hold eye contact, have the client pay careful attention to when he wishes to look away, and investigate the nuances of what makes him want to leave and what it would require for him to return.

  Characterological dilemmas are often based on false choices. Here, it would be between being supported or being self-reliant. The experiment of taking over the weight will often lead to a good feeling of being supported, followed by an anxiety that says, “Okay, that’s enough for now,” because the person fears living in a perpetual state of needing support. Hakomi never seeks to take away any adaptive strategy from a person but only to integrate new, more encompassing options. The integrative position that transcends the false choice here is: It is okay to be self-reliant and go take care of business yourself when that is right, and it is okay to allow for and take in support when that is what is needed. When the client can embody both positions, he has developed the capacity to make realistic choices that are nourishing and satisfying.

  The Tough/Generous Pattern

  The tough/generous character strategy arises when the need to be authentic and autonomous in a context of shared intimacy is met with domination, exploitation, or humiliation. The child learns to hide his vulnerability—to toughen up and appear powerful at all costs. People with this strategy see the world as dangerous competition. Core beliefs include, “You can’t trust anyone,” “People will use you if you let them,” “You can’t hurt me,” “I am special—the rules don’t apply to me,” “I must get them before they get me.” This stance can lead as far as “I must lie, cheat, and use people to survive and succeed.”

  Feeling invulnerable and superior on the surface, people with this strategy often end up in therapy only at the insistence of others (including the law). Their bodies are bulky and powerful, with large, strong arms and shoulders, and an inflated, “puffed up” chest (as if holding a full inhale with no exhale). Their energy mobilizes upward, to appear larger and more dominating, leaving the lower half of the body thin and stiff by contrast. Their gaze is often direct and challenging.

  Behaviorally, people with the tough/generous strategy are often charismatic and generous. They can show great tenderness and sympathy for the underdog and are frequently rescuers, creating dependency in others who are more helpless. They often come across as superior or self-important, needing respect and admiration. They react quickly and impulsively and have difficulty acknowledging their limits. When provoked, these clients can be rageful, blaming, and intimidating. During therapy, tough/generous clients may seem fast-talking, superficial, or glib. They may not take therapy seriously or may want to control the process. They may question the therapist’s expertise or try to win the therapist over with flattery or gifts. It is difficult for these clients to open up to the process or to their own feelings, especially those that make them feel vulnerable or out of control. It is common for them to lie to maintain their image.

  Underlying these behaviors are great vulnerability and great rage—an abused, fearful, and vengeful child. The missing experience of the tough/generous pattern is to be safely innocent and authentic, without exploitation; to have freedom of action, with realistic boundaries and limits.

  Therapist Adaptations

  Therapists working with the tough/generous character strategy have the daunting task of working with a client that often does not want to be in therapy, does not want to show or admit vulnerability, tends to blame others for his problems, and whose sense of survival depends on being in control. It is important for the therapist to model honesty and an authentic intimacy and connection not based on image, power, or manipulation. The therapist must avoid expressions of superiority, engaging in power struggles, or being taken in by the client’s flattery or generosity.

  Tough/generous clients benefit therapeutically from the practitioner’s ability to be respectfully direct, honest, consistent, and unintimidated while maintaining warmth, connection, and support. The therapist should be attentive to the client’s boundaries (as well as his own) and authentic needs, and make interventions without using coercion or manipulation.

  Therapeutic Strategies and Interventions

  The therapeutic goal in working with people with the tough/generous strategy is to help them to be vulnerable and honest, to find and express what is real for them—without fear of humiliation, hurt, or manipulation—and to slow down and modulate their impulsivity, so that their reactions can be more thoughtful, deliberate, and reflective of their authentic needs and wants.

  Therapists can gain the cooperation of the client’s unconscious by tracking boundaries and attending to the therapist’s own need to make the client be or act a particular way. Gently and respectfully, uncover the underlying hurts and help the client slow down to discover and study authentic feelings and needs, without the client feeling in a down position because of these disclosures. Some probes that elicit this core material include: “You are important,” “It’s okay to feel hurt,” “You don’t need to impress me,” “You can be real with me,” “I won’t take advantage of you.”

  Experiment at the response barrier, helping clients uncover and explore their impulses and quick reactions. Experiment with closeness, such as slowly walking toward them or placing your hand on their heart, to allow them to see the ways in which they automatically protect themselves. Take over this protection for them. Have them experiment with saying, “I need you” or “You affect me.” Allow them to stay with and study the nourishment barrier—what it feels like to be safe while being honest and authentic.

  The polarity or false choice for this pattern is being independent and invulnerable versus being close with weaknesses exposed. Since people disposed in this way believe life is all about power, they have chosen the invulnerable position. Much of the therapy work addresses barriers to going the other way: toward opening to vulnerability and intimacy. Though these clients have been deeply entrenched in invulnerability their whole lives before therapy, it is still important to assure them that the therapist has no intention or investment in taking away any of their self-protective strategies. The transparent goal—where there are no secrets—is to help them judge situations where it would also be safe and possible to have more enriching and fulfilling intimacies based on authentic feelings and needs.

  The Charming/Seductive Pattern

  The charming/seductive ch
aracter strategy develops in a way similar to the tough/generous pattern, around the same basic needs for autonomy, love, admiration, appreciation, and realistic boundaries and limits. If this is met with narcissism, manipulation, or being used or seduced, rather than becoming tough, dominant, and in control, people in this pattern learn to get what they want by being engaging, seductive, elusive, and “‘shape-changing’ to suit the other” (Morgan, 2004b). In relationships they are often more interested in the chase (seduction) than in actual, ongoing intimacy. Core beliefs include: “I cannot be open about my feelings or motives,” “I will be what others want me to be in order to maintain a feeling of power,” “I must make others feel okay, so I’m included where the action is.”

  Physically, persons with this strategy may appear sensual, with inviting, seductive eyes, and a lithe, hyperflexible body, whose musculature is more balanced than those with the tough/generous pattern. Alexander Lowen, the founder of bioenergetics, used to remark informally, “Show me the person’s body and I’ll tell you what image of power they are embodying.” There can be the biker image, the beauty queen, the Oxford don, and many other images that reflect the arena of power in which the person is operating.

  Behaviorally, charming/seductive clients may seem empathic, impulsive, charming, and elusive. They may be ready to please the therapist, to be what the therapist wants them to be, or they may divert the focus of the therapy to the therapist. (“Has this ever happened to you?” “What would you do in this situation?”) It is often difficult to pin them down when it comes to their own feelings and needs. As with the tough/generous pattern, they may be deceptive, may believe their own lies, or may have a foggy memory of what they actually did or said.