Positive Health Online

Following on from my last article Trauma, Emotion and Energy, I want to explore how to assist a client to feel resourced in order to facilitate the emergence and re-integration of patterns of overwhelm, trauma and emotional holding. Trauma and bodywork, are increasingly being spoken about in the same sentence. This comes as no surprise, as the giants in the trauma resolution field point to the same truth – trauma alters body physiology and body function. Babette Rothschild tells us The Body Remembers, Besel van der Kolk tells us The Body Keeps the Score, Peter Levine tells us that trauma is treated in the body, not the mind.

The Body Keeps the Score

As hands on bodywork therapists with sophisticated touch skills, we are in the ideal position to help the emergence and re-integration of personal stories of overwhelm and disturbing tissue memories, to move towards healthy function of both body and mind. However we can only do this safely and effectively if we and our clients are well resourced.

I am going to explore in detail three different ways in which to establish a resource.

1. An embodied sense of resource;
2. A pet as a resource;
3. A positive memory as a resource. (It is best not to use a person for this – even our most beloved can be infuriating at times!)

These three exercises can be used by us the therapist, as well as taught to our clients. Finding and working with a resource is extremely useful in our everyday life, as well as in clinic. It is especially relevant when working with trauma clients for two reasons:

1. To ensure our client feels safe at all times and to safely facilitate effective, lasting change;
2. to assist in keeping us, the therapist present, self-aware and not drawn in.

The very nature of trauma draws us in to its story. Have you ever noticed that whilst working with trauma clients it can feel as though you are not only sucked in towards the physical body, but also into the story itself? We need to work at remaining present and grounded as well as calling on our own resources when needed. We also need to explore with clients a sense of resource that they can call upon and use at any time.

Finding a sense of resource needs to be set up before the hands-on part of treatment commences and can then be used throughout the session if required. If at any time a patient seems to be shutting down, showing physical signs of withdrawing, contracting or there are glimmers of overwhelm coming to the surface; we, the therapist, need to use verbal skills to gently draw clients back to the resource that has been established.  This will assist in keeping clients present during session work, it builds a sense of safety to facilitate profound change and enable the physical body to re-integrate patterns of trauma.

Assisting Clients with Feeling Resourced

We want to slowly explore with our clients the idea of a resource. Once discussed and established, the resource will give clients a tool to use if difficult physical sensations or (tissue) memories arise. There are many variations on this theme.  As mentioned above, I am going to explore three ways to do this. There is a subtlety to this work and patience is required.

1. Embodied sense of resource: As a therapist, think about your tone of voice, body language and your presence before commencing these exercises. With the client lying supine on the couch, covered and warm, you need to slowly ask some questions and really explore the answers, taking an active interest.

• “Just take a moment to settle onto the couch” pause…..wait and witness, is there a settling? Does the body soften, the breath slow or deepen?
• “Just allow yourself to feel into the support the couch provides” pause….. what changes? Does anything change?

To assist your client to settle more, OR if they have not managed to settle, take your time and explore this further. It is common for clients to not be able to feel or simply not to understand the directions.

• “Can you feel the contact your head makes with the couch?”…pause for an answer… “Can you feel the contact your shoulders make with the couch?”…..pause…. “Can you feel the contact your back makes?”. Slowly continue to mention all the body parts that make contact with the couch, pausing always to give them time to feel.

I like to ensure that my client is embodied and can feel all the way to their feet (as during times of activation it is common for clients’ attention and energy to be drawn either out of their body or up towards their head). If your client does not have an awareness of parts of their own body, it can help to ask permission to touch, and by simply placing your hands on the particular area of the body, this will assist in bringing their attention inwards. If they cannot find a sense of embodiment, you will need to use one of the other methods to help your client feel resourced. If, however, they are understanding this exercise; continue.

• “Now, I’d like you to slowly scan through your body…….. what do you notice right now”
• Mostly people will initially describe areas of ill ease, discomfort or pain, listen to what they describe and acknowledge this, then explore a little further……
• “So in the midst of all that, is there anything that lets you know you are ok? Anything at all that speaks to you of health, comfort, ease or wellness?” You will need to pause, as they explore this potentially new concept.

It may take a while for clients to explore the ever changing internal landscape of their bodies, this may be very unfamiliar territory to them. They may also find it challenging, but gentle encouragement and patience is rewarding. If clients are aware of areas of tension and discomfort in their bodies, get them to describe these to you; they may choose words like “tight, held, painful”. If they are able to feel and witness these, suggest that they must also have an awareness of what a “soft, relaxed or comfortable” area must feel like. This is an idea you can continue to explore with them.

• If they are able to find an “OK” place in their bodies, encourage them to describe the physical sensations e.g. “my abdomen feels warm and safe” OR “my left leg feels strong and supported by the couch”;
• Notice what happens when they find this place of health and when they really begin to describe it and engage with it. Does it help them settle? Do you notice their voice change as they witness an area of ease? Is there a sense of relief that their body does have healthy, good qualities? Are they settling into a more parasympathetic state?
• Encourage your client to settle further into these sensations. Let your client know that they can come back to these sensations at any time. It is these sensations of health and wellness that you need to draw your client back to – perhaps several times in a session - as difficult sensations arise.;
• Try to remember the exact words they use to describe the sensations, and let them know that you will be asking them to bring their attention back to this area during the treatment, to help them settle.

This is a subtle dialogue that we need to have with our clients, throughout treatment. Be mindful that our body is an ever changing landscape of sensation, so if the positive sensations have changed, moved, or disappeared. Then we will need to re-establish a felt sense of health.

2. Pet as a resource: this is very useful when working with children or any animal lover.

If your client cannot access anywhere in their body that feels OK (which is common), ask them if they have a pet, ask them questions about their pet, really engage with the answers. What type of pet do you have? What is the pet’s name? The colour of their pet. Is their pet fluffy? Does it have any quirky features? Sticky up ears? As they talk about their pet, you might immediately notice changes, as your client settles. Actively take an interest in what they say.

This can be done before your client gets on the couch, explain it is a tool to help them settle before session work.

• Ask your client to visualize their pet on their lap, to imagine stroking their pet, to visualize playing with their pet, listening to the purr, smelling the fur, hearing the pit-pat of their feet etc. Try to really evoke a memory. I also create my own image of what they are describing, I feel this helps both me and my client;
• As they recall being with their pet, Notice what happens…. Do you notice their body physiology change? Do you notice a dropping down into a more parasympathetic state? Do you sense relaxation? Does their voice change?
• If you answer yes to any of the above, then they are feeling more resourced and this is the state you ideally want them to be in before you commence treatment, as well as during treatment;
• Point out to your client that you have noticed a change, ask them if they too feel more settled, comfortable, relaxed. Wait for a response.

During treatment, as any signs of activation occur, you will also be able to draw the client back to the memory of their pet, by remembering some details, the pet’s name, and some descriptors. This will facilitate a sense of safety and a return to a more parasympathetic state.

3. Positive memory as a resource: If your client cannot access anywhere in their body that feels ok, explore the idea of a good memory, a favourite place, a holiday, sitting in nature. Encourage them to take time with this. As they draw to mind a place, an event, ask them to describe it to you, try to get some sensory details. This might take a bit of exploring, clients can be very reluctant to engage with this at times. However even something simple like having a cuppa, at home, settling onto the sofa after a long day’s work, may evoke increased sensations of wellness. Once the client has come up with a memory for example “swimming in the river”, you might need to ask further questions, to gain some further sensory feedback, for example you may ask: what’s ahead of you, what can you hear, feel, and see? You might end up with a story something like this:

• “I am swimming in the river, I can feel the sun on my face, I feel my body supported by the water, there are trees to my right and I can hear kids playing further downstream”. “I am feeling happy and free”;
• As they describe this, what do you witness? Does their voice change? Do you notice they seem more settled? Does their body relax? Even a little? Encourage them to rest into this memory before you commence treatment;
• During treatment, if I sense any activation, I might say something like “take yourself back to the river, can you feel the support of the water?” Wait for a response. Then proceed with “can you feel the sun on your face?” again wait.;
• As you draw them back to the scene, do you witness a change in them?

The most important thing when finding a resource is not to rush, really take your time, and explore the ideas of a resourcing in detail. If you set it up well both you and your client will notice the benefits. Resources can be called on at all times to increase a sense of safety and therefore allow the emergence and re-integration of emotional holding and overwhelm.  Finding a sense of resource can be re-established and used in every session. If a client feels safe and resourced, they are in a much better position to allow and witness physiological change to take place, even if accompanied by challenging sensations. There is never a need to rush to “let go” or “release” that which no longer serves us, we simply want to facilitate change. If this is done safely the results are profound and lasting.