Hakomi Mindfulness-Centered Somatic Psychotherapy

by Halko Weiss

  T: I’ll help you explore these responses with as little effort as possible. This time I’ll say the same words to you again, and then I’ll step into your system and take over the job that these automatic responses are doing by doing those responses for you. You get just to watch where you go when I do the responses for you. Sound okay? [The therapist introduces concept of taking over in a simple way.]

  C: Yes.

  T: As part of this experiment, I’ll be touching your chest a little right in the center to mimic the tension. We’ve talked about this before, but I want to make sure that’s still okay with you. [The therapist engages in a collaborative way that asks for permission and underscores that the client is aware and in charge of the process at every step.]

  C: Yeah, thanks, it is. [The client is becoming more accustomed to the therapeutic setting. The proposal that includes touching is a physical variation on the verbal taking over of the voice in the head earlier on. It is clear that the touch is in the service of the client’s process. The therapist keeps tracking the client, of course, for any signs of overriding anxieties in the service of being cooperative. Though the process is okay, the client offers explicit thanks that the therapist carries concern for his safety.]

  T: So, watch what happens, especially what is evoked spontaneously, when you hear a voice that says, [pause] “I’ll support you—it’s your turn.” [The therapist simultaneously shifts to a position next to Mike, gently tightens the center of Mike’s chest with his hand, and then whispers “bull”—a taking-over experiment of both a physical tension and an automatic voice. Since such a procedure is sometimes strange to begin with, which means it introduces some noise of its own into the process, the therapist repeats the experiment of saying the probe and taking over the automatic response two more times while inviting the client to mindfully watch.]

  C: [Head dropping forward.] I feel really sad, and tired, man, really tired. [The taking over has been effective in that keeping the normal protection of the client’s defenses in place has allowed the client to drop down into the vulnerability protected against underneath.]

  T: Goes right to your core. It’s okay, man, just let it have you. [The therapist contacts the client’s deep experience and offers a reassuring accessing directive that it is okay to enter fully into the experience.]

  C: Oh God, man, I’m just so tired of doing everything alone. I just wish someone would help me, for Chrissakes. [Here the client crosses the nourishment barrier from defending against his own need for support to risking letting himself feel it. This is what was protected from consciousness by the automatic habitual chest tightening and the rebuttal voice.]

  T: I won’t leave you alone here, Mike. Just take your time and get used to feeling this need again. It’s been a long time. [The therapist demonstrates deep limbic resonance as he contacts the client’s present experience, supporting and stabilizing it.]

  C: I feel relieved and sad and good and scared all at the same time. [The client experiences, observes, and names his truth in a mindful way.]

  T: You can feel how big a thing this is even though it’s happening in a quiet way. It feels totally natural to me. [The therapist stays in supportive contact with the client’s unfolding in a way that normalizes it.]

  T: Just let your system get used to this, Mike. Don’t push through anything. Your whole system knows how to process this at its own rate. Just stay here with yourself and with me. [The therapist uses contact and gently offered support in the service of allowing the organic healing to continue and to stabilize.]

  C: I’m not going to go right out onto some street corner with a “help me” sign in the immediate future, but it feels really good right now here with you, like I’m not on my own. [The client begins to make some integrative connections between his historical truth that sometimes people did not support him, and his immediate truth that sometimes some people in some situations can support him.]

  T: There’s a natural pull to map this into the way you live outside of here, and, ultimately, that’s the point. We can talk about this in a little while if you like. Right now, to whatever degree it’s okay, just savor the relief you feel a little longer, the feeling of not being on your own and that there’s some help around. [The therapist is concerned that bridging into integrative analysis at this point might prematurely interfere with the client taking in the new experience and information at a felt-sense level. He guides the client back to accommodating the new possibility.]

  C: [Stays present to the felt sense of his new experience.]

  T: Kind of finishing in there, it looks like. [He tracks and contacts signs of client beginning to come back into ordinary consciousness.]

  C: Yeah, I’m starting to come back out.

  T: Tell you what—you just finish at your own pace and I’ll talk to you a little bit as you do. [The therapist actively seeks to integrate the client’s experience and hinted-at confusion, so that he can complete his process by not working too hard, and by learning to rest into the support of others, namely the therapist at this point. He invites the client into that in-between space of savoring new experience while also allowing the left brain to start weaving new meaning into its ongoing narrative.]

  T: I agree that this experience doesn’t cancel out all the experience and learning in your earlier life that led you to decide that there wasn’t much support available so you better learn to be on your own. The difference is that up till now, this whole level of little automatic habitual behaviors that run underneath the surface of your awareness has managed your conscious experience so that you no longer even sense your wish and need for support and to not be always on your own. At this moment, you’re off automatic, and you can actually feel and sense the way you also really want to be interconnected, giving and receiving support. In some way, this is the first chance in a long time you have to actually explore whether there’s more support available in the world you live in now than in the world you originally developed your beliefs in, because now you can again sense and feel that it’s important to you. Without sensing the need or desire, there’s no drive to explore or fill it. In a way, maybe it’s like now the world can possibly have another chance with you. [The therapist is cocreating a narrative that links experience, meaning, and body sense as an integrating tool. Neural networks are integrated—prefrontal, limbic, and posterior.]

  C: My head’s back online, thinking about where I might check this out in my life, and how to go about it. I don’t want to lose it. [The client is completing and returning to an external-world focus, and he is expressing the value of the process and the desire to integrate it in his everyday life.]

  T: I really welcome your mind to chew on this and help check out what’s available now. We can do some more experiential exploration of this edge in you as we work together, and we can also look at ways to explore this in your family, work, and the rest of the world around you.

  C: Thanks, man.

  T: Yeah, me too. [The therapist is genuinely touched by engagement in the healing process of this other who is not completely other. The informal language and exchange supports the normalization of the therapy.]

  Working With a Veteran and His Family

  Greg Johanson

  The first two case verbatims here are individual sessions with a wife and husband who both participate in a veteran’s program offered by a church-related mental health center with state and county funding.1 The program offers therapy groups for veterans, support groups for spouse-partners, individual sessions for each, and couples sessions. In this example the vet, Ben, chooses to work on issues in individual sessions because he feels he would have to contain himself too much in a couples session with a nonvet, which is common. However, he is happy for his wife, Trish, to get individual support.

  Though both husband and wife are active people by nature, and have never been part of a contemplative tradition, they are relatively easy to work with since they are competent, aware, willing to look at themselves as opposed to bl
aming the outer world, dedicated to their family, and highly motivated by the effects of the PTSD they experience working on their life together.

  Wife, Trish

  C: So, I’m really struggling with Ben’s wanting to go with me and the kids, alone or separately, wherever we go. It felt, like, caring and protective when he first got home from the deployment. Now it’s starting to feel smothering or something. I can feel some angry part of me getting touched. But I don’t want to push him away and get him activated, and make him feel like we don’t want him. And he is also a bit angry and distant with Ed [four-year-old son]; kind of ordering him around instead of being warm in his communications. [The client is telling the story with appropriate affect in ordinary consciousness.]

  T: Okay. So I’d probably need to continue to deal with Ben directly about what’s up with Ed. On the smothering thing, it sounds reasonable to feel hemmed in when you are so used to being self-reliant with him away. But you are saying it feels like something in you is cranking up your reaction beyond what might be normal[?] [Sorting out issues in story, and working to collaborate on where the session might focus.]

  C: Yeah, it feels like some kind of fire that is ready to react to provocation, even before there is any. [Client is taking responsibility for her part in the couple’s interaction and expressing a willingness to explore it, knowing Ben is doing the same in his own therapy sessions.]

  T: So, exploring more deeply this part of you that is ready to feed the fire seems good, huh? [Proposing an agenda that seems to be where the client’s curiosity is. The “huh?” communicates that the therapist is not attached to the agenda and is willing to be corrected or have the proposal be fine-tuned.]

  C:Yeah. Let’s. I don’t want to get into something that ends up being more ugly than it needs to be. [Minicontract confirmed.]

  T: Good. Okay. There are a number of ways to get into this. How about you imagine the last time Ben came along that seemed a bit much, and we can slow down and study what that was like for you? [This is an invitation to switch states of consciousness into mindfulness that is fairly brief and straightforward since it is the fourth session and the client has already been exposed to the process.]

  C: [Trish closes her eyes, slows down, turns her awareness inward toward her felt present experience. Almost immediately her shoulders shake, and she shows emotion in face and voice.] Oh, it was yucky! But I didn’t let myself express it like here. [While the client is observing and reporting her experience, it seems she is fairly fused or blended with the yucky part and doesn’t have much distance.]

  T: So just remembering that last time is pretty activating, huh? [Tracks for nonverbal assent to contact statement.] How about we get a little more distance on the issue by just imagining you will be calling down the hall to let Ben know you are going out, anticipating he will say, “Oh, I’ll come too.” But before you actually call, stop and be a witness to whatever is evoked in you prior to calling. As you anticipate his response, notice what comes up for you spontaneously, without you forcing anything—any sensations, muscle tensions, feelings, attitudes, thoughts, memories . . . [?] [The therapist attempts to modulate the energy level by evoking enough of a signal to guide the process, but not so much that the person becomes the emotion as opposed to being present to it. More specific suggestions are offered to support a mindful state of consciousness. Notice the therapist does not limit the study of experience to affect alone, but broadens the range of possibilities.]

  C: The anticipation would be more like, “Don’t leave! I’ll be right there.” [It is a good sign for a client to fine-tune the words or process. It is an indication she is immersed in and listening closely to her experience.]

  T: Great. Anticipate the “Don’t leave!” and study closely what it evokes in you. [The word “study” supports mindfulness in that it invites Trish to be present to her concrete, felt experience, but also a step back where she can notice and be curious about it, as opposed to simply being swept along by it. It is a middle position between talking about her feelings or simply acting them out.]

  C: I notice some sense of resentment with my cheeks and arms warmed up, almost hot, but I’m clamped down and feel tension in my face and arm muscles. [Good witnessing by the client, who is both present to her experience and able to comment on it from the position of an observer.]

  T: Uh huh. Maybe if you just hang out with the resentment, and be curious about it, you will sense more about it, or it will tell you more about itself[?] [Now that Trish has been invited into a mindful space, the therapist encourages staying in the state longer and deepening into present experience with trust in the organic impulse to unfold toward greater wholeness or complexity.]

  C: It seems to be muttering something about “unfair” between clenched teeth, but afraid to really be heard. [More threads or context gather magnetically around the original report of anger as the experiential spaciousness of the mindful process allows the unconscious to lead more deeply into unhealed constraints.]

  T: Like really in a bind[?] [A simple contact statement addressed to the present experience facilitates the deepening of the process.]

  C: [More emotional, with a younger quality to her voice.] Yeah, like her father loves her but won’t let her go play with the other bigger kids, and she is really mad, but can’t say so because he is really strict and will punish her right there in front of the other kids, and she would really be embarrassed! [Process spontaneously deepens into a memory.]

  T: Oh, a memory comes up. How old does she seem to be? [Contacting details like age helps stabilize the memory, and referring to “she” as opposed to “you” helps maintain the witnessing position. At this point the process has gone from becoming mindful of some aspect of creation—the anger—and has descended close to the level of creation, the memory that informs a core belief about not being able to be liberated to explore in freedom or express displeasure about not being able.]

  C: Four, maybe five. [More processing, deepening and stabilizing the memory.]

  T: As you simply view the four- or five-year-old from your position of compassionate awareness, what do you sense that she most needs that she is not getting in her situation[?] [Therapist invites both witnessing and compassionate aspects of the client’s larger self-state.]

  C: She needs to know that it is unfair for her dad to limit her and overprotect her, and then scare her into not even being able to express her feelings about it. And . . . she needs to know, to know, uh . . . it won’t be this way forever . . . that sometimes people in power do try to hold you back, . . . that’s true, . . . but . . . that there will be times when she finds the freedom to use all her strengths and energies without being held back. [Here the empty, nonagenda space of compassionate awareness releases itself to the situation of the inner child and receives some relevant psychological-emotional information. The slowness and space between realizations is an indicator of a mindful process.]

  T: Yes. So go ahead and communicate that to her in any verbal and nonverbal ways that seem right, perhaps having her look in your eyes so she really gets your presence, and check whether she is taking it in or not. [A therapeutic directive that invites her to take the awareness and loving presence of her essential self-state and apply it interpersonally to this inner child, thus, as Daniel Siegel puts it, helping her mindfully become a friend to herself.]

  C: Yes, she is getting it. But it is a new thought to get used to, kind of fragile. [Acknowledging both the transformation of organizing in new information previously organized out, as well as the fragility of the process that will need more integration.]

  T: That’s really important to follow up and keep integrating to foster this new neural network. In particular, ask her if she is willing to have a conversation with you when you go home, directly or through journaling, about how to have a talk with Ben that acknowledges both your knowledge of his care and your need for freedom to use your own strengths. [A directive to help foster this intrapsychic relationship, so the interna
lized object of the inner child and her larger self-state can dyadically regulate the affect that gets stirred up in these situations with the husband, as well as other situations.]

  C: Yes, she wants that . . . and needs that . . . to keep from going into that suppressed rage, and to know more about what is really possible. [Relationship is reinforced, which is an element of integration.]

  T: You can really help her grow into a new future by experimenting with this new possibility of freedom in relation to real situations. And do you feel you will be able to have a little distance on the anger when it arises in situations like with Ben, so that it doesn’t completely take over and blend and fuse with you? [Reinforcing compassionate intrapsychic relationship and checking for distancing or decentering aspect of mindfulness.]

  C: Yes, I think I’m much clearer now about what the anger and fear and holding are about, and if it comes up too hard, too fast, like with Ben, I’ll be able to ask for a time-out before we talk more, so I can sit, check with the young one, and get more distance and centeredness before sorting things out with him. I’m not quite clear about what is going on with Ben, but I have a more relaxed sense of compassion for what is going on with me. [Starting to complete and move back into ordinary consciousness.]

  T: Awareness and compassion are an ongoing practice we keep learning from. Good luck with this one.

  Reflection

  Internalized objects such as “self-narratives using stories about experienced events” (Bons-Storm, 1996, p. 437) or inner children frozen in time are ultimately illusion, basically a way of organizing energy and information (Eisman, 1989). To simply allow their manifestations to come into awareness and pass by like clouds in the sky, as in classic meditation practice, is a fine project that enhances spaciousness (Roberts, 2009) and does not give them undue importance and reality. However, when their clouds come continuously into the sky over time and affect the organization of one’s experience in the world in unconscious ways, perhaps a little compassion can be helpful in the overall quest to not be at the mercy of unconscious core organizers.