Archive for January, 2012

Attuned Touch

By Susan McConnell, MA, CHT, “The Internal Family Embodied” Topic Expert Contributor

Attuned touch lies at the top of the pyramid of Somatic IFS tools, resting on the solid foundation created by all the other tools. It occupies the least space. This is consistent with the space given it in actual practice with my clients. Attuned touch is a powerful tool, and a little can go a very long way.

Despite the vast amount of data on the importance of touch for human development and healing, the field of psychotherapy has generally taken a hands-off stance. Western culture in general has many taboos regarding touch. However, many methods of psychotherapy are recognizing that taboos against touch haven’t protected our clients, and that ethical, attentive, attuned touch has an important place along with verbal interventions (Ball, 2002).

My training and experience have spanned psychotherapy and bodywork, and I have always attempted to weave the two together. As a bodyworker, I worked at the interface of mind and body. Trained in psychotherapy, I developed a training for bodyworkers to work safely and ethically with the emotions that are embedded in the tissues and organs. Although now I do very little work with clients on the table, as an IFS therapist I recognize the value of touch in working with the internal system of parts. I value my training and experience as a bodyworker for what it has taught me about the therapeutic relationship and transformation.

Touch is our first language. It is the first sense to develop in the embryo (Montagu, 1971), and all other senses are derived from it. Shortly after conception, the skin cells are linked to the rudimentary brain. The skin can be thought of as the outer layer of the brain (Juhan). The tactile system remains a potent form of communication throughout our lives and holds immense potential for healing as well as harm.

The tools of Somatic IFS—awareness, breath, resonance, and movement—provide the foundation and container that can ensure that the powerful tool of attuned touch is used for healing. Since the Self of the client is the primary therapeutic vehicle, the client’s touch may be all that the part wants or needs. The therapist can guide the client to find the kind of touch the part wants. The client, in Self, connects with the part in the body through touch. If the client cannot be in Self (and the therapist can be), the part can be directly accessed through touch.

Accessing Parts Through Touch

Whether a part first emerges as a thought or a feeling, it generally can be accessed in the body as well, as a sensation or a movement. The part, as it shows up in the body, can be known in an intimate and full way through the touch of the client or the therapist.

As a bodyworker, I learned to ask my cognitive, diagnosing, fixing parts to step aside and be willing to receive information from the tissues of the body. I was often amazed at the information that came to me. Movement, stuckness, tightness, resistance, deadness, weakness, and fragility were some of the physical qualities I noticed. Images, emotions, impulses, sensations in my own body and even stories were there as well. My heart resonated and melted as I touched into the layers of the tissue and the painful history recorded there.

Although I don’t frequently employ touch in my work with clients, when I am asked by a client to make physical contact with a part in their body, I check with all their parts for permission. Throughout the touching, I use the Somatic IFS tools of awareness and resonance as I tune in to the place in my body that corresponds with the client’s.

Communicating Self Presence Through Touch

If the client is touching the part in their own body, I will direct the client to send the quality of Self energy that they identify when asked, “How do you feel toward the part?” through their hands and to the part. I may ask the client to touch into the warmth of their heart and allow that to flow through their arms and hands to the part in their body.

Touch can be used effectively in Direct Access if the client is not able to be in Self. If it is the therapist who is touching the client’s body, it is important that the touch be contracted for carefully. In the course of therapy, the therapist may ask the client if the part wants touch—their own and/or the therapist’s. The therapist will ask the client if there are any parts that have any concerns about the therapist making physical contact. Especially if there have been touch violations in the client’s history, it is crucial to only touch with permission from all the parts. The therapist cannot rely on verbal reporting for permission but must also rely on nonverbal signals from parts. With clients with extreme touch neglect, there will likely be parts polarized with the parts that long for touch. Clients who have experienced abusive touch may have parts that fear touch of any kind. Especially in the case of clients with a history of sexual abuse, it is important to let all the parts know that under no circumstances will the touch become sexual touch, and to find out how the parts respond to that statement.

Witnessing the Part Through Touch

With touch, the part knows we are literally “in touch” with it. This can facilitate the part’s willingness to share its story. Parts’ stories of wounding are encoded in the form of sensations and blocked or frozen movement impulses. They may not yet have words, but they still need to be heard. The parts may have experienced physical neglect or violations of touch. The touch from Self can be reparative. It may be the missing experience that parts have longed for for decades.

I am grateful for my training in craniosacral therapy, which was a strong foundation for my current work with Somatic IFS. I was taught to first ground and center before making physical contact with my client. Then as I tune into the rhythms and the pace and direction of the bones and underlying membranes, I simply follow the movement that is already happening. I form a “being with” relationship to what is happening as I physically support it, and even exaggerate the movement. The less-than-optimal patterns of movement in the body are witnessed, accepted, and supported rather than corrected. The movement pattern ceases as the system comes to a place of rest, called a “still point.” Then, out of this void, a fuller, stronger, healthier, more effective pattern emerges. The act of being present with and following the dysfunctional pattern in the body seems to be the support the body needs to be able to reinstate its inherent healthy, normal functioning. Practicing craniosacral therapy for years has taught me that a “being with” rather than a “doing to” attitude has a transformative effect on the symptoms.

When I have been in physical contact with an IFS client, I often tune into the craniosacral rhythms. I have noticed that this “still point” in the rhythm occurs when there is a transformation in the internal system—when the part is in relationship for the first time with the Self of the client, or when the part is being unburdened. The information I receive through touch validates the connection between mind and body.

I utilize the tool of Somatic Resonance when I touch. I tune into the corresponding places in my body when I touch my clients. I notice my muscle, my bone, my organ, my fluid system, or my digestive system. Most of the information I receive from the tissue and from my own body I store on a shelf. I stay accepting and curious about what is happening for the part that requested the touch, as well as the parts that gave permission. The part’s somatic story emerges through movement, sound, and continued sensation as well as images, feelings, and thoughts. I continue my Attuned Touch as the part is accessed, witnessed, and possibly unburdened, all the while being aware of parts that may want the touch to change or to cease.

The Therapeutic Relationship and Attuned Touch

Touch is a powerful vehicle for healing trauma and attachment wounds. Touch has the power to form a strong therapeutic bond with a part. Attuned touch communicates Self presence, triggering the release of oxytocin, the “bonding hormone.” It can greatly facilitate the part’s trust in the Selves of the client and the therapist.

Touch, when it comes from burdened parts instead of from the Embodied Self, also has enormous potential for harm. In our profession, there are numerous cases in which minor physical boundary violations have led to sexual misconduct on the part of the therapist. Therapists’ unburdened, blended parts may cause the therapist to engage in exploitative behaviors. Most professional organizations have ethical guidelines to protect clients from touch violations. For example, the ethical code of the United States Association of Body Psychotherapies begins with the following:

The use of touch has a legitimate and valuable role as a body-oriented mode of intervention when used skillfully and with clear boundaries, sensitive application and good clinical judgment. Because use of touch may make clients especially vulnerable, body-oriented therapists pay particular attention to the potential for dependent, infantile or erotic transference and seek healthy containment rather than therapeutically inappropriate accentuation of these states. Genital or other sexual touching by a therapist or client is always inappropriate, never appropriate.

Touching from the Embodied Self, with the permission of all the client’s parts, grounded in the other tools of Somatic IFS, can be a valuable and ethical therapeutic intervention.

More subtle hurts can occur when the touch is from parts. The therapist will be vigilant for parts that diagnose, judge, or attempt to correct or change, that try to get their own touch needs met, or that need to express protective, parental, or romantic feelings. The therapist may also have parts that fear the client’s parts’ attachment to them. All of these parts’ burdens can easily be communicated through touch. The therapist will notice those parts and will not engage with touch with that client until the parts are able to step aside and allow the Embodied Self of the therapist to make physical contact.

The topic of touch in psychotherapy deserves more attention. Perhaps it could be considered unethical to withhold touch when it can facilitate the healing process. Our cultural norms as well as our personal histories strongly influence our touching and our not touching. It can get confusing to know when it is Self energy that is agreeing to the touch and is doing the touching. For example, some therapists always hug their clients at the end of a session. Other therapists never make physical contact, even a handshake. It could be interesting to invite an attitude of curiosity to the touch norms in the therapeutic relationship. And of course, ethical and legal issues need to be considered in the decision to use touch as a therapist. I look forward to your comments on this topic.

 

References

Ball, A. (2002). Taboo or Not Taboo: Reflections on Physical Touch in Psychoanalysis & Somatic Psychotherapy. Australia: Psychoz Publications.

Caldwell, C. (1997). Getting in Touch: The Guide To New Body-Centered Therapies. Wheaton, IL: Quest Books.

Durana, C. (1998). “The use of touch in psychotherapy: Ethical and clinical guidelines.” Psychotherapy, 35/2, 269–280.

Epstein, R. S., & Simon, R. I. (1990). “The exploitation index: An early warning indicator of boundary violations in psychotherapy.” Bulletin of the Menninger Clinic, 54 (4), 45–465.

Juhan, Deane (1987). Job’s Body: A Handbook for Bodywork. Barrytown, NY: Station Hill Press.

Lawry, S., (1998). “Touch and clients who have been sexually abused.” In Hunter & Struve (Eds.,), The Ethical Use of Touch in Psychotherapy. New York: Guilford Press.

Montagu, A. (1971). Touching: The Human Significance of the Skin. New York: Columbia University Press.

Zur, O. (2004). “Ethical and Legal Aspects of Touch in Psychotherapy.” Online publication. Retrieved July 1, 2004 from: http://www.drzur.com/ethicsoftouch.html.

IFS with Eating Disorders and Addictions

By Mary Kruger, MS, LMFT, “IFS with Eating Disorders and Addictions” Topic Expert Contributor

Welcome to both the new year and the IFS column on eating disorders and addictions! My name is Mary Kruger. I’m an assistant trainer for the Center for Self Leadership as well as a certified IFS therapist. Working with eating disorders, addictions, and related issues has been my passion for more than twenty years. I am delighted to be able to share my enthusiasm, experiences, and ideas with my colleagues. I look forward to a rich, varied dialogue and exchange of ideas that piques curiosity and fosters creativity and connection.

During the first ten years of my career, I worked in a substance abuse treatment facility PHP (partial hospitalization program) and IOP (intensive outpatient program) as well as inpatient. I also worked in an outpatient setting where I helped to establish a substance abuse program and established an eating disorders group. During that time, I also founded my private practice, near New Haven, CT, which serves adults, adolescents, and children. My clients work with me in individual, family/relational, and group therapy modalities. I have been fortunate to be able to attend supervision, trainings, and workshops with a number of leaders in the field. In 1999, I was trained in the IFS Model of therapy, which has transformed both me and my work as a therapist.

IFS has been an easy paradigm shift for me in some ways. Prior to IFS, I had embraced the idea of not pathologizing clients, a perspective that is inherent in IFS. Being a systems thinker by nature and training, the concept of imbalances occurring within the inner system (family) was intriguing to me and made perfect sense.

My feminist parts resonated with the collaborative aspects of IFS. The parts of me that love the experiential were attracted to the body focus and right-brain aspects of IFS. And the psychospiritual aspect of IFS has made it easy to integrate with the Twelve Steps.

More difficult, and yet the most rewarding, has been the emphasis on working with our own therapist’s parts, which has made all the difference in my work with clients with eating disorders and addictions. Early on, it became apparent to me that the managerial energy inherent in some of the most popular therapies interfered with their effectiveness. IFS enables me to continue to work with any of my parts that may become polarized with my clients.

Another advantage is that IFS’s compassionate, Self-led approach makes the work safer and easier because clients and their parts feel trusted, honored, and held.

In my early years as a therapist, I often felt stuck as to where to go next with clients. We would create a role play of a client dialoguing with his or her addiction, involving only the client and that part. While it was great for the client to be able to differentiate from the part, it felt to me as though there was so much more to the work than just that. And there certainly were many more parts that weren’t known or acknowledged. IFS offered a way through that situation. Today it is possible to map, sculpt, and unblend from a part as well as the parts connected to it.

Another stuck point: What do we do with shame and other vulnerable feelings? How do we keep clients from being overwhelmed? One of my clients was unable to move past her eating disorder because despite her successful life, she still experienced herself as the ragged girl from Northern Ireland whose family had been burned out of their home. We came upon what I now recognize as a part, again and again. With IFS, it became possible to unburden this part without the client becoming overwhelmed. What an amazing discovery and contribution!

There is so much involved in working with eating disorders and addictions from the IFS perspective that it is best to break it down into smaller pieces. In each blogpost, I intend to share a small piece for discussion. While I have many of my own ideas, I am also very open to requests, comments, and questions. I look forward to some exciting and thought-provoking discussions!

Mindful Movement

By Susan McConnell, MA, CHT, “The Internal Family Embodied” Topic Expert Contributor

Movement is the unifying bond between the mind and the body, and sensations are the substance of that bond.   —Deane Juhan

The New Year is a time for setting intentions and goals. Many of our goals typically involve movement; more cardio, strength training, and agility training may be on our to-do list. One of my goals is to bring more embodied Self energy as a gift to myself, my clients, and other loved ones. As with the other tools of Somatic IFS, we begin with ourselves. Beginning a regular practice of mindful movement is a step on the path to Embodied Self.

Mindful movement brings Self awareness to spontaneous gestures and movement styles to witness, access, and unburden parts. This fourth tool of Somatic IFS also includes re-embodying early developmental movement patterns associated with trauma and faulty attachment, and encouraging movement practices that foster and stabilize Self energy.

Although I am not trained in Dance Movement Therapy, I have been privileged to study with several people from whom I have learned about movement—Susan Aposhyan, Susan Harper, Bonnie Bainbridge Cohen, Amina Knowlen, and Pat Ogden, as well as IFS therapists Barb Cargill, Gina Demos, and Francine Passias. My experiences with these teachers, my academic study, and my clients have shown me that movement—moving with mindfulness—is an essential component of Somatic IFS.

My eight-month-old granddaughter, Sadie, is my most recent movement teacher. Applying my knowledge to my observation of her motor development has been fascinating. I was present at her birth and was awed by the power of her spinal push—head to tail and tail to head—as she worked with and pushed against the uterine contractions to birth herself.

Her original grounding was through her navel—her point of connection to Life itself and her sole source of nourishment. The sense of core Self is experienced by the infant at this early stage of life. Cohen believes that this development begins in utero and is supported initially by the motility of the cells through the process of cellular breathing, and also by the organization of fetal movement around the umbilical centre in the navel radiation pattern. The infant experiences, through movement, a basic sense of being a unified whole, with separate parts that are both differentiated and connected.

Sadie’s first task was to learn to breathe and to suck and swallow. The first motor nerves to myelanate are the sucking nerves. She practiced these movements in utero. At first, her body movements seemed mostly random, radiating from her core. She gradually gained increasing control and coordination over the gross movements of her trunk, legs, and arms. I noticed the various movement patterns of her limbs as they developed from homologous to homolateral and then to contralateral movements. I observed the infant movement patterns that Cohen describes—yielding, pushing, reaching, grasping, and pulling—which she says underlie the secure passage through the stages of psychological development and the emergence of the sense of self. Daniel Stern also describes how the sense of an “emergent, core, subjective and verbal” self develops out of the intimate reality of bodily sensation and expression—which is movement.

As Sadie learned to sit up, the sitz bones of her pelvis became an additional source of grounding (assisted by a fluffy diaper). Over the next few months, she learned to support this newly integrated spinal core upon all fours. Cohen says that the crawling patterns, which are initiated by yielding weight into and pushing out of the ground, facilitate ego development by embodying and strengthening muscles. Crawling creates a boundaried sense of self as the infant engages with weight, earth, and gravity. All of these movements that Sadie approaches with the same urgency as her birthing are developing her perceptual relationships, including spatial orientation and body image, and the basic elements of learning and communication.

With clients who have experienced trauma and attachment wounds in utero or during infancy, working with the internal family in an embodied way offers an opportunity to directly enter the preverbal matrix of the parts’ experience. IFS recognizes that certain qualities are “lost” when a part absorbs burdens. These qualities in very young parts are imbedded in the body’s systems. As the early movement patterns are reenacted, the associated memories and emotions may be accessed, allowing for witnessing and unburdening of the parts. In Somatic IFS workshops, I have led participants in reembodying the basic developmental movement patterns to access the burdens and restore the underlying sense of unity of Self. We begin on the floor as infants and experience both ontogenetic and phylogenetic movement development. We play frog and lizard, we roll and crawl, and happily suck our thumbs.

Mindful Movement can be employed at every stage of the IFS process. Movement can access the part, help the part unblend, enhance the relationship between Self and the part, witness the part’s story, unburden the part, and assist with the integration and completion phase of the IFS Model. The movements that can be addressed with Somatic IFS include spontaneous movement, habitual gestures, protective stances, and frozen/blocked impulses. These movements and gestures are generally outside of our awareness. We bring awareness, exploration, and mirroring to facilitate the IFS process. Specifically, we invite the client to notice the movement and any impulse to block or inhibit the movement. With permission from the part that is blocking, we encourage the movement to sequence through the body to completion. A movement may originate in the core of the body and sequence to an end point—the head, tail, or any of the four limbs.

Laura is a client who has benefitted from this embodied approach to her internal family. In the last year, she radically changed many of her addictive behaviors. She has lost a good deal of weight and is off some of her diabetes medications. In spite of these improvements (or because of them), in a recent session she reported feeling paralyzed—unable to continue on this course of behavior change. I invited her to experience the paralysis while she was sitting with me. She accessed a young part that felt scared, alone, and powerless. She heard another small voice that said it would be good to stand up and move around, but to move felt dangerously assertive and powerful for the first part. The first part eventually allowed her to stand up, and Laura began to move, quite stiff with fear. She cried and said this is how it feels every time she makes the choice to eat the right foods and not eat the wrong foods, as if she has to change a switch in her brain.

To integrate this shift, I reminded Laura of a session the year before when she made the decision to choose Life. There were more tears. I suggested she find something in the room that represented Life, and mindfully move toward that. She moved toward the object and held it tenderly in her arms for several silent minutes. She reported that her fear was calmer. It felt different from when the fearful, paralyzed part is pushed away by parts that are choosing new behaviors. She invited her guides to be with her. She realized that when she takes the initial extremely hard step to get off the couch, she inherently chooses Life, and she can trust her body to lead the way. She could imagine that her brain was being rewired. Since that session, it has been easier for her to turn on the switch, and it stays on for longer periods of time.

A session with my client Anne is another example of working with parts through mindful movement. Anne is an accomplished, successful corporate executive, wife, and mother with a complex and difficult early history. An exile was expressing itself in her body as a collapse—being pulled down from her solar plexus, while a manager was resisting that impulse and taking a strong, independent stance that pushes through, accomplishes, and achieves. We oscillated between the impulse to collapse and the opposing upright posture. As she inhaled, she extended the front of her body, and as she exhaled, she moved into the collapse and flexed the front of her body. Both parts of the polarization felt understood by Anne through witnessing the movement. We appreciated the upright protector that has served her so well, and learned that it is very, very tired and can’t keep up the resistance. The exile’s collapse was taking over in her body and in her system. Anne allowed that movement to sequence to its endpoint as it curled up in fetal position. She stayed in this position as she accessed a part that knew she was not wanted as a baby and that blames herself for her neglect and abuse. This exile wanted her to curl up and die. The part felt Anne’s compassionate presence toward her and knew that she was wanted by Anne. Eventually the pressure to curl up released. Anne uncurled and no longer felt the pressure in her solar plexus to collapse. She felt ease and calm in her body. Her life is moving toward more balance as her protector no longer needs to battle against the desire to give up and die.

With both Anne and Laura, the parts were telling their stories through movement, and these stories were witnessed mindfully. Movement may be the only way the part can tell its story. A part’s movement story may have been blocked and frozen in the body’s structure—impulses to run, to hit, to kick, to bite, to reach out, to suck, to hide, to cry, to cringe, to speak, to look. With permission from a polarized part, we bring intentional, deliberate movement to the block to free up these frozen impulses, completing the sequence, allowing for a physiological unburdening and restoring the original qualities of Embodied Self.

We ask the meaning-making and story-telling parts to wait until the movement has been able to be fully expressed and witnessed, and has come to completion. Often the meaning, the emotions, and the story associated with the relevant phase of development emerge during the mindful exploration of movement. Spontaneous unburdenings are frequent as we bring mindfulness to the movement. The movement pattern is embodied more fully, and the sensorimotor pathways are restored. Expression of unburdened parts that have restored qualities of freedom and joy anchors the transformation. Simply inviting our clients to move through space with these new qualities of body and mind integrates the shift into daily life.

A regular practice of mindful movement can increase capacity for Embodied Self energy. Martial Arts, Yoga, Alexander Technique, Pilates, and Feldenkrais are some structured mindful movement approaches. Yet we may not need to join another class. We may just need to commit the time to noticing mindfully the movement already happening in our bodies. Our bodies, even in relative stillness, are always moving. The fluids of our bodies each have their own rhythm and are pulsing with various frequencies and paces. Every organ is pulsating with its own energy. Every sensation we feel is a movement waiting and wanting to happen. We can start with our grounding—our navels, our pelvic floors, and our feet. We let go of the tension in our mouths and ask the cortical parts if they are willing to relax a bit. We notice the sensations and invite them to move, breathe, rest, and sound. We notice impulses throughout our bodies to reach, push, pull, yield, and grasp. A regular embodiment practice of attending to sensations and allowing them to move and sequence through to a completion is a beautiful practice for enhancing Embodied Self energy and is a gift we can bring our clients for the new year.

Resources:

Cohen, Bonnie Bainbridge. Sensing, Feeling and Action. Contact Editions, Northampton, MA, 1993.

Juhan, Deane. Job’s Body – A Handbook for Bodywork. Station Hill Press, Barrytown, New York, 1987.

Stern, Daniel N. The Interpersonal World of the Infant. Basic Books, Harper Collins, 1985.

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