Hakomi Mindfulness-Centered Somatic Psychotherapy

by Halko Weiss

C: [Big tears.] It’s not fair. [With the support of the therapist—through both words and touch—Cheryl can be in contact with the previously unfelt aspects of her early emotional life.]

  T: It’s just unfair that they weren’t there for you. . . . You had to do it all yourself.

  C: Why weren’t they there?

  T: They weren’t there because they had their own stuff. And that’s not your fault.

  C: What’s happened to me?

  T: No one’s explaining anything to you. No one’s telling you what’s going on. [Children often conclude that they must be inherently flawed or others would take a greater interest in them. The therapist casts new light on the family situation by saying, “they had their own stuff” to help Cheryl understand why her parents were not there for her. This information is more likely to be integrated because the client is in the original experience.]

  C: It’s not fair.

  T: It’s not fair, I agree. Can you feel that, the part that says it’s not fair? Can we listen to that part?

  C: [Nods.]

  T: [The tension in the client’s neck is increasing, and she is holding a lot of tension across her whole back and shoulders. So the therapist makes an adjustment to the physical taking over.] Everything’s really tight, huh. I’m going to try something else. I’ve got a sarong. I’m going to put it around the back of you and hold really tight, okay? [The therapist slowly wraps the sarong around the back, enabling better taking over of the upper body tension by pulling on the sarong. As the client accesses the fullness of her grief, her internal protectors create more tension in her body to try to contain the feelings that are now coming into consciousness.]

  C: [Immediately the client cries. Something releases; tears start coming more freely now. Big sighs. Big tears. The containment provided by the sarong enables Cheryl to release the feelings that have been managed by the tension in her shoulder and neck.]

  T: [Therapist reaches across and gently caresses client’s head.] . . . I’m here for you now. I’m here for you—you don’t have to do it by yourself. [The client is having strong emotion and experiencing the support of the therapist at the same time. The therapist is using her words to show the client that she is not alone and that she doesn’t have to be strong. This is a powerful example of how Hakomi therapists use the therapy relationship to provide a missing experience for the client.]

  C: [More tears, starts to sob. When someone finally gets an experience they have waited a lifetime to have, it often elicits grief for having lived so long without it.]

  T: [Therapist reaches for a cushion and places it to support the client’s head, which is organically leaning over toward the side of the couch. Therapist caresses her head as she cries.] You don’t have to do it by yourself. [The statement “You don’t have to do it by yourself” is more likely to be integrated because it matches the experience that is happening here and now. The therapist’s loving presence, demonstrated through a combination of words and touch, enables Cheryl to actually receive the support she has hungered for both as a child and as an adult.]

  C: [She sobs and sobs. Tears coming freely now, with really big breaths. Real crying, not held back—riding the rapids. Having crossed the nourishment barrier, indicated by the client’s acceptance of the therapist’s support, the client can surrender to the cascade of feelings bound to her core material.]

  T: [Slowly, with a lot of long pauses] . . . You don’t have to do this by yourself. . . . It’s so sad. It’s so sad. . . . It’s not fair. . . . Yeah. . . . The sadness just keeps coming, huh? . . . You don’t have to do it all alone. [The therapist supports both the management of the feeling and its release, and continues to make contact to indicate she is really with the client.]

  C: [Big sigh.] So sad, no one’s there [childlike sobbing].

  T: I’m here with you. It’s okay to be sad. [The reminder that the client is not alone and that things are different now is what makes revisiting the client’s past healing rather than rewounding.]

  C: [Sobs change, childlike faster breathing; huh-huh-humm. Crying is moving through her body now. As the client gets more and more of what she has always longed for, she surrenders completely to her feelings of grief.]

  T: Yeah, it is so sad. So lonely.

  C: [Breathing continues as huh-huh-huh-huumm, then a big breath, and starts to become smoother. Therapist continues stroking her forehead. This continues for 3–4 minutes. Big gulp. Easier breathing, body begins to relax. The smooth breathing is an indicator that something is settling on the inside and that the process is nearing completion.]

  T: So sad. You’re not alone now. . . . I am here. . . .

  C: [Moving toward restful state, riding rapids slowing down.]

  T: [Continues stroking her head and just being with her for a few more minutes. Touch often communicates presence more powerfully than words, especially when someone is in the child state of consciousness.]

  C: I could go to sleep now. [When we have an experience of deep satisfaction, we are able to rest. Having unburdened her grief and surrendered her strategy of being strong, Cheryl now experiences her exhaustion.]

  T: Yeah, pretty tired, huh?

  C: [Sighs again.]

  T: Feeling your sadness when you’re not alone. It takes you to a very restful place. [The therapist is linking two formerly irreconcilable things together: having feelings and being supported. The therapist points out that, contrary to the client’s belief that she will be nothing if she isn’t strong, it is actually taking her to a restful place. If this experience is integrated, it can shift the neural pattern built around the original memory system.]

  C: Very restful.

  T: Mmm. It’s a good place, huh? It’s good to not be alone? [Just continuing to be with her, stroking her head, letting her take it in.]

  C: [She is integrating this. She moves a little, starts to sit up. Big sighs.] Thank you. So I can cry, but it feels different when I’m not alone with my sadness. [She puts her head back down on the cushion and flops into the side of the couch again. The client is assigning her own meaning to this new experience.]

  T: Uh-huh.

  C: Because every time I cry, I’m not crying like that. [This is the key missing experience for Cheryl. While she has cried many times in the past, she has never been able to fully release her grief in this way before.]

  T: It felt different, huh?

  C: [Big sigh, and she sits up.] Yes it does. I could just go to sleep.

  T: You may need to do that tonight. Go gently. Take care of yourself.

  C: Thank you. Hmm. So I make myself alone too. [Cheryl already recognizes that because she was alone in her sadness as a child, she recreates this aloneness as an adult by not expecting anyone to be there for her when she is sad.]

  T: You notice that, huh? . . . Just let yourself rest tonight, holding the good space, not feeling alone. [While it will eventually be important for Cheryl to see how she participates in creating her alone state by being strong, the therapist avoids engaging in a discussion about it at this juncture. Instead, she supports transformation and integration by encouraging Cheryl to savor the experience of being restful and sated. If the client integrates the good space, she will more likely notice future opportunities for support and connection, rather than defaulting to her compensatory strategy.]

  C: Okay. [Big sigh.] Yep.

  T: [Moving toward finishing up.]

  C: Thank you. [She sits up fully, looking brighter in her face. Even though this has been a taxing process, emotionally and physically, the client has integrated possibilities that are ultimately restorative rather than depleting. Her system has received the nourishment it has long been seeking through the therapist’s loving presence to her pain. This is exactly the kind of exchange that promotes the neural resculpting needed to experience life in a more accurate and affirming way.]

  Working With a Client New to Mindfulness

  Phil Del Prince

  The following session is offered not as an example o
f a perfect Hakomi session, but more as a real-world session with a client who has no experience of mindfulness. The client is part of a hard-driving, outer-oriented business world. Though he wants and needs help, he has a hard time joining in the classic Hakomi process. The therapist has to do a lot of work going back and forth between meeting him where he is and inviting him into what for him is a new and strange process.

  The client, Mike, is a 38-year-old single male. He works as an executive coach in the corporate world. He is medically healthy except for borderline high blood pressure and is physically active.

  His presenting issues involve concern over his inability to sustain intimate relationships over time, and an overreliance on physical exercise to gain an experience of satisfaction in his life.

  This is his third session in therapy. I have done some initial education with Mike about mindfulness, bodymind dynamics, and experiential exploration. I’ve been sensitive to the novelty of these concepts for Mike and have moved slowly in the first two sessions, from building relationship, rapport, and common understanding of Mike’s narrative to some initial movement into accessing the mindful state and experimenting with present experience.

  This third session marks a more focused exploration of some material possibly underlying Mark’s presenting issues. We pick up the session approximately 15 minutes in.

  T: I’m wondering how you are with support in your life.

  C: Why would you wonder that?

  T: Well, I notice that you don’t seem to ask very much of me during this session. You seem to work very hard to sense yourself, and then work to get insight from it, and then connect it to the rest of your life, and then plan out a course of action—all pretty much on your own[?] [Here the therapist assumes that there need be no secrets, that the client can better take adult responsibility for his process if an issue is clearly outlined, and that it will promote safety through fostering clear collaboration. The therapist is also naming the dynamics of what he has been tracking in the sessions to this point. It is an example of jumping out of the system in Hakomi, where the transference or organization of experience is now made the focus of mindful exploration. The (?) symbol represents a slight inflection in the therapist’s voice that indicates that he is not simply making a declarative statement or interpretation, but is contacting an experience with the implication that the client might want to be curious about it and take it under mindful consideration.]

  C: Huh, well, I haven’t really considered that before. Let’s see. I get a little nervous when you say this to me—I wonder if that means something. Yeah, I’ll bet that comes from my dad. He always said, “If you want the right answer, then ask the right person, and that’s usually yourself.” Maybe I ought to watch that more, or I guess I could have a talk with him about it. Yeah, thanks. [Here the client is partly in mindfulness, noticing his nervousness, but reverts to his default position of figuring things out by himself in ordinary consciousness.]

  T: So, right here, in this moment, I have the experience that you’re doing this[?] [The therapist maintains focus on the accessing route and contacts the expression of the issue in the present-moment context. By saying “I have the experience,” the therapist keeps his contact statement on the ground of his own truth, while promoting the safety inherent in the implication that the client should check it out in his experience.]

  C: Doing what? [The client is confused by this unusual intervention of calling attention to present-moment experience of a metalevel dynamic.]

  T: Kind of working on your own, while I’m present right here in front of you[?] [The therapist names the dynamic in a gentle, compassionate way without judgment that, again, seeks to evoke the client’s curiosity about his own process.]

  C: Huh, I’ve never caught that before. Do you really think that?

  T: It sounds surprising to you—like you don’t know what to make of it. [Therapist contacts the emotional content of surprise, all the while tracking the client to assess his nonverbal signs of congruence with the words spoken. The therapist does not accept the invitation of expanding on his thinking in ordinary consciousness.]

  C: [Nods slowly. The slow nod, as opposed to a quick verbal response, demonstrates that the client is increasingly orienting toward his present-moment experience in a more mindful manner.]

  T: It’s got you thinking now. [The therapist’s contact statement seeks to encourage and stabilize the client’s inner exploration.]

  C: Yeah, I’m thinking about my father.

  T: Tell me a little about your dad. Sounds like he depended on himself a lot. [The therapist makes a judgment that it is still a strange stretch for the client to enter deeply into inner experience. The question allows the client to continue longer in his comfort zone of ordinary analytic conversation and to make some intellectual connections that might help establish the logic for inviting deeper inner exploration later.]

  C: [Describes his dad’s career as a one-person entrepreneur, primarily a strong and silent type, and being the third child in a household where both Mom and Dad worked much of the time, beginning again to work on making sense of it.]

  T: It occurs to me that you kind of got lost in the shuffle somewhat, like it didn’t get to be your turn very often[?] [The therapist has an intuition of the emotional meaning of this report by the client, and offers a possible focus for accessing the underlying theme.]

  C: [Interrupts.] But they are very good people. They loved us and took care of us and worked really hard and did the best they could—wasn’t easy back then, you know. Took a lot to keep things going. [Here the client has a protective reaction and feels called to defend his parents.]

  T: It sounds like they really cared about you. And I can easily see how a child could start to feel like the best way to help is not to need very much, and not expect people to be there to help a lot. [The therapist demonstrates understanding of the client’s experience through contacting his protective concern with the first sentence. This promotes safety by removing any need for the client to defend his parents. The second sentence returns to the systemic level and adds the frame that the child might have made a choice to be self-reliant as a way to actually help these parents he loves.]

  C: Yeah, I guess—I’ll think about this.

  T: Tell you what—are you willing to do an experiment with this? [The therapist proposes a switch into a mindful state of consciousness that is characterized by an open, receptive, experimental attitude.]

  C: With what? [However, the client is still very new to this way of working and has a need to ask more orienting questions.]

  T: Well, instead of us just talking and guessing about how you’re set up around “your turn” and needs and support, let’s see if we can find some ways to know how all of the rest of you, like your feelings and body sense, can join your mind in talking to you about this. [The therapist takes the client’s question as a valid safety issue and addresses it directly while doing some brief teaching about the process. Once again, the therapist is collaborating with the client, telling him exactly what he is thinking and proposing.]

  C: I really don’t know how to go about that. [The client again reacts automatically out of his belief that he is the one who should know how to do everything by himself, but is offering some vulnerability in naming his concern.]

  T: Yeah, that’s okay. That can be my part of the job. I’ll help you into this state of mindfulness that we’ve been working with a little the last times you were here, where your only job is to watch yourself and notice anything that happens by itself inside you when we do an experiment in mindfulness right in the present moment. You good with that?

  The therapist is compassionate with the client’s worry, normalizes it, and refers back to previous elements in the therapy that evoke more familiarity and confidence in the client.

  By suggesting that he can help and have part of the job, the therapist is not only providing structure and safety, he is setting up an important parallel process between what is happenin
g intrapsychically and in the interpersonal field. The experiment in mindfulness that the therapist is suggesting is an attempt to invoke the reflective awareness or witness of the client and bring it to bear on his own internal process. Hopefully, this will help the client bring his own self-reliance under observation in a freeing and healing way. Since the client is actually allowing the therapist to help guide and support him in this endeavor, there is built in unspoken confirmation that he in truth does not always need to do everything himself. Thus, inner confirmation of new beliefs can be joined with outer confirmation in support of healing transformation. Were this parallel process not congruent, the client’s worst fears might end up being confirmed.

  C: Okay, I’m good with that.

  T: [Has Mike close his eyes and turn his awareness inward toward felt present experience.] Find a place where you can just quietly watch whatever happens on its own . . . not concerned with what’s true or what anything means . . . just noticing anything that happens inside you automatically, without any effort . . . when you hear a voice that says: [pause] “I’ll support you now—it’s your turn.”

  This is a classic Hakomi experiment, in this case a verbal probe. As with many such experiments in Hakomi, the words are put in a theoretically positive form, but are specifically designed to contradict the client’s core organizing beliefs. The possibility of support is precisely what has been organized out of this client’s experience. If the therapist’s hypothesis is correct, it is expected that the experiment will immediately elicit the person’s barriers to allowing in the possibility of support, which in turn can be mindfully explored for what the client needs in order to moderate and discriminate situations, or, as Freud put it, enable the person to see new situations as new.

  However, if the therapist simply said to the client in ordinary consciousness, “I’ll support you now—it’s your turn,” none of these hoped-for results would be likely since such consciousness is already organized, working unconsciously on automatic. It is only the explicit instructions that lead the client into a mindful state that slows down and suspends theories and judgments in favor of simply bringing bare attention to what is, that allows for distancing from what was subject and making it object.