What is Somatic Psychotherapy?

In the Greek language Soma means body, which translates loosely to “the living body known to the self’.

Conventional forms of therapy or counselling are often focussed on the mind. We are encouraged to “talk about” or “think through” problems or issues, so that we can make sense of them or perhaps view them differently. This is a largely cognitive process.

However our emotions are a bodily process. All emotions originate in the body, directly experienced in the fascia, tissues, muscles and organs. Every emotion has a particular ‘somatic signature', a combination of sensation, movement, posture and neurochemistry, at a level of intensity that varies from person to person.  And the purpose of an emotion is to provide information, to others, and to ourselves.

Neuroscience, and in particular Poly Vagal Theory, has demonstrated that the mind and body are intricately interconnected. To simplify a complex process, we now understand that the brain (neocortex) receives information from our senses about our internal and external environment via a channel known as the Vagus Nerve. About 80% of the vagus nerve is ‘afferent’ meaning sensory. The brain then filters and evaluates this information and feeds it back to us as ‘thoughts’.

This means that the words we use to describe our feelings actually reflect the way in which the ‘mind’ has interpreted information from the body and nervous system. Over time we develop a narrative about what those signals mean. As Dr Stephen Porges - who developed Poly Vagal Theory - suggests, the ‘story follows state’.

This has a number of implications for therapy. Firstly, much of our experience as infants or children occurs before the brain has developed the capacity for verbal reasoning, or acquired language. The primary way that infants experience their bodies is nonverbal, and is stored in the ‘implicit’ memory system - as images, sounds, smells and bodily sensations. The mind will not be able to access this information through cognitive processes (no matter how much time we spend ‘thinking’).

Secondly, the emotional ‘pain’, and physiological responses that arise due to relational ruptures, stress or trauma can be quite overwhelming, preventing us from feeling at home in our body, and we may consciously or unconsciously ‘disconnect’ from (dissociate) or suppress bodily sensations.

Peter Levine, who developed Somatic Experiencing, notes that when we suppress our thoughts feelings and behaviours … suppressing tears, suppressing anger, suppressing fear, we interrupt the bodies spontaneous restorative process. The energetic charge (stress) of that experience remains in the body. This can result in physical symptoms of stress, such as migraine, chronic pain, or fibromyalgia.

We live in a culture where there are (often unspoken) messages for us to “manage” or suppress our emotions. A society in which we are frequently distracted with information, media, screens, or constant activity. In a literal sense, many of us have become disconnected from our ‘selves’, or from bodily information. Unknown to ourselves. If we cannot accurately discern our emotions and label them, the ‘mind’ may misinterpret what our body is telling us. We will respond very differently if we ‘think’ we are experiencing anger, when what may be occurring is sadness or anxiety.

In somatic approaches to therapy, the mind and the body are considered as two parts of the whole. Clients learn to befriend their body, and feel the sensations within it - a skill known as interoception - and to observe movement such as orientation, gesture or posture, a sense known as proprioception.  Our ability to notice sensations and movement within our body is known as somatic (body) awareness.

This skill helps us sense our internal state, and witness how our nervous system responds in different situations. We can then work directly with the body to bring our physiology back into balance. A somatic approach widens our ability to sit with and ‘listen’ to sensations (emotions) that may be frightening or uncomfortable, and which we may otherwise avoid, ignore, dismiss or distract from. Perhaps more importantly, it helps us to access nonverbal information that lies outside of our conscious awareness, in a way that does not overwhelm us. To more accurately discern what is occurring within.

How do thoughts, feelings, sensations, movements, images, memories interact with one another? How did the mind interpret certain sensations, and how might that influence behaviour? What processes are occurring when my nervous system is ‘activated’ in this way? How might the interaction of mental and somatic processes have shaped perception, and the way in which we relate to ourselves, others and the world?  

The somatic psychotherapies emphasise building trusting relationships in which co-regulation can occur, turning inward with compassion, and mindfully observing sensation.  This provides a container in which clients can develop insight into unconscious patterns, unwind trauma and restore wellbeing. 

Somatic Psychotherapy aims to:-

• Restore the body as a place of safety, and help to increase our capacity to process body memory (preverbal and nonverbal memory)

• Metabolize unprocessed emotion

• Complete interrupted (incomplete) stress responses

• Restore an optimal relationship to our self, and to the world around us.

Somatic Psychotherpies include Somatic Experiencing (Peter Levine), Hakomi Mindfulness-based Somatic Psychotherapy (Ron Kurtz), and Sensorimotor Psychotherapy (Pat Ogden). These approaches share a ‘focus’ on internal awareness with practices such as Yoga, Tai Chi and body oriented meditation, and also draw on knowledge from systems such as the Alexander Technique and Feldenkrais. 

Fiona Meredith is a Clinical Psychologist and Somatic Psychotherapist based in Adelaide, Australia.

Neuroplasticity: The science of change

Neuroplasticity is the brain's ability to reorganise itself by forming new neural connections throughout our lives. Scientists used to believe that the number of neurons in our brain was finite, and that the brain could only create new connections during childhood. But developmental neuroscience has shown that this is not the case, and that we continue to develop new neurons, and neuronal connections, until we die.  

In fact, it turns out that our brain has an astonishing ability to make structural adjustments, and to grow, adapt and change its connections in response to new experience and learning. 

Norman Doidge wrote about this in his wonderful book "The Brain that Changes Itself" in 2010. Travelling the globe visiting scientists who pioneered the field of neuroplasticity, Doidge detailed fascinating examples how it was possible to transform physical and mental limitations, change lifelong character traits, recover from depression and anxiety, and to literally alter our brain anatomy. He has recently published "The Brain's Way of Healing", which continues with the theme of his earlier work, and uses cutting-edge science to show how we can use neuroplasticity to improve our brains performance. 

There is now an avalanche of evidence demonstrating the plasticity of the human brain. 

Our understanding of Neuroplasticity is exciting, as it shows us that it is never too late to change. With consistent effort, and by developing the flexibility of our mind, we can learn new skills, change the way we think, create new habits and improve the quality of our lives. Neuroplasticity gives us the opportunity to 'rewire' habits that may be harmful to us, or which have compromised our ability to develop our potential, form great relationships, or simply live healthy contented lives. 

"We are what we repeatedly do.  Excellence therefore is not an action, but a habit" Aristotle.

To create the optimum conditions for neuroplasticity, so that we can learn new ways of responding and change old patterns, here is what you can do:-  

Exercise: The best way to make new neurons is to exercise. In adults, neurogenesis (the ability to make new neurons) occurs in only two parts of the brain. One of these is called the Hippocampus, which is also responsible for learning and memory. Research has shown that people who exercise regularly and are physically fit have a larger hippocampus. In studies where adults participated in cardiovascular exercise and resistance training, the size of the hippocampus increased, and their performance on cognitive tests improved compared to people who did little exercise.  

Exercise also benefits us by increasing cerebral blood flow (which helps neurotransmitters circulate around the body and brain), and by its role in discharging cortisol from the body. Cortisol is a stress hormone (neurotransmitter) which helps us adapt to stressful situations. However, too much cortisol can interfere with our sleep, memory and ability to concentrate (and is implicated in weight gain and diabetes).  In very high amounts (which occurs when we have unrelenting stress or unresolved traumatic experiences) cortisol damages the hippocampus, causing it to shrink.  

Prioritise sleep: Adults require restorative sleep to clean our brain cells and consolidate memories (learning). Scientists have recently discovered that during our sleep our brain cells are flooded with cerebrospinal fluid. This allows toxic waste products that build up while we are awake to be flushed out of the system. At the same time our brain cells are fed with nutrients. Getting a good nights sleep allows new synaptic connections to develop, which in turn strengthens neuronal pathways. Specifically, the amount of plasticity in the brain seems to be associated with the amount of REM sleep (dreaming sleep) that we have each night. Loss of sleep can also lead to elevated cortisol levels and creates an unfortunate cycle of further sleep difficulties.

Sleep deprivation is strongly linked to depression, stress and other mood difficulties, and impacts the nervous system, taking it into states of hyper or hypo arousal. When the nervous system is outside of its ‘window of tolerance’ , our capacity to regulate our emotions, handle a relational ‘trigger’ - and respond well to one another in our families, work and communities - deteriorates. This can have profound implications for our relationships.

Eat well: Our diet provides the body with the nutrients it needs to make new neurons and neurotransmitters. Neurotransmitters are the chemicals in our brain that transmit messages from one nerone to the next. They are closely linked to our mood, motivation, cognitive abilities, and to the optimal functioning of our brain and nervous system. About 200 different neurotransmitters have now been identified, however some of the more commonly known ones include Serotonin, Dopamine, Oxytocin, Adrenalin and (as mentioned above) Cortisol. Neurotransmitters are created from the amino acids found in our food. They get circulated around the body and brain and become the building blocks of new neurons and neuronal connections. Higher amounts of certain fatty amino acts, such Omega-3, are associated with larger hippocampus size, better memory, and a much lower risk of developing problems such as Alzheimers disease. 

Serotonin, which is associated with feelings of contentment, and plays a role in sleep and learning, is largely created in the gut. Serotonin is targeted in a group of antidepressant medications known as SSRI's (Selective Serotonin Re-uptake Inhibitors). 

Meditate:  There is now a large body of research demonstrating the positive impact of meditation, which has been shown to reduce anxiety, depression, impulsivity and anger, reduce chronic pain, and slow down cellular ageing. Using state of the art technology, including brain scans and imaging, meditation has also been shown to increase grey matter in the brain, reverse degeneration of the hippocampus, and promote neural connectivity. 

Meditation involves observing our thoughts, the sensations in our body, our feelings, and also our impulses. It can be a vehicle that helps us notice the way our brain and nervous system is ‘organised’ , and develop compassion and insight.

Be Mindful: The first step to changing anything is to become aware of it, and understand it. The practice of mindfulness encourages us to slow down and pay close attention to our own experience, with awareness, and without judgement. In doing so we are able to explore the connections that we have already have, the neuronal 'template' that guides our beliefs, feelings and actions. By shining a light on the stories we tell ourselves, and making us more aware of the patterns of thinking, feeling, and responding we have developed across a lifetime (and their origins) mindfulness offers a way to gently start to change them. 

Until we see how we are, we cannot take steps to become who we wish to be. 

Warmly, Fiona 

Fiona Meredith is a Clinical Psychologist & Somatic Psychotherapist based in Adelaide, Australia.   

Rewiring the brain - reshaping our lives

Our life experiences get 'wired in' to our brains in the form of an intricate network of about 100 billion neurons.

The human brain is one of the most incredibly vast structures on the planet. And the field of developmental neuroscience has greatly improved our knowledge of how it works. We now understand that the growing brain records what each individual is learning about the world into a complex system based on connections between neurons. 

The 'experiences', or circuits, that become wired together in our brains include thoughts, feelings, sensations, smells, sounds, emotions, impulses and urges, movements, actions, behaviours, images and memories. Neurons that 'fire' together - such as the thought "that puppy is soft" and the sensory, visceral and emotional experience of "delight'" - become 'wired' together due to the action of neurochemicals travelling between one neurone to the next. 

When the same experiences and connections occur over and over again, chains of neurons form tiny highways that transmit information around the body and brain. Eventually, like a trail that becomes more worn as it is repeatedly used, these neuronal pathways become stronger, and download information faster and faster. This is the neuronal basis of learning.  

Over time the links become more complex, forming what is known as 'neural networks'. These networks are continually firing without our conscious awareness. Like a broadband connection that instantly downloads what has previously been wired in (or learnt), our neuronal connections influence how we perceive and interpret what occurs within and around us, and how we feel and respond to those events. 

The human infant starts to connect patterns of visceral, visual, emotional and sensory information together long before they have acquired the ability to ‘think’. As the child starts to acquire language, they retrospectively begin to form ideas (or thoughts) about themselves and the world that make sense given their internal experience.

The implications of brain development for how we parent our children are sobering. And the implications of neuroplasticity for people wishing to create more balance and wellbeing in their lives, and undo patterns that were established long ago, is likewise remarkable.  

Neurons that fire together, wire together
and conversely
Neurons that fire apart, wire apart. 

When we slow down and pay careful attention to our experience, our bodies and minds can tell us a lot about themselves. If we do this mindfully, without judging our experiences or ourselves (like an objective and compassionate bystander) we develop the skills to rewire our brains. 

By noticing how we are 'wired', how the network of experience works for us, we can set an intention, should we choose to do so, to change how we respond to life. 

Science shows that when we intentionally and repeatedly practice new approaches, and pay attention to our overall health (diet, exercise and sleep are vital to support neuroplasticity), we can re-wire our brain. 

Old connections dissolve over time, and new, life affirming ways of being get wired in.  

To start, try this:

Get mindful:  Next time you notice yourself experiencing a strong emotion, a bodily sensation that seems quite intense, or responding in ways that you might like to alter, slow down and take time to reflect on your experience. 

Notice what is occurring:  Daniel Siegel uses the acronym of SIFTing your experience, which is a lovely reminder to explore the different elements of what is occurring.  See if you can notice the Sensations, Images, Feelings and Thoughts that came up for you at the time.  

I also like Tara Bennet Goleman's suggestions, which include asking yourself questions like "what was occurring at the time that prompted this", "what was going through my mind", "what story was I telling myself", "how did my body feel at the time", "what emotions were coming up", and "does this remind me of anything"? 

Is there anything about this experience that feels familiar, automatic or habitual? Was there a trigger?  

Write it down: It can help to write down what you are noticing, so you can refer to it later and build a map of what is occurring, and when.  Often this may help us become aware that we tend to have the same kinds of thoughts, feelings or urges in particular situations, or that similar themes re-occur.  With practice, we can start to notice these patterns earlier and earlier, and this creates a space for us to respond differently.  

Be compassionate to yourself: Remember that 'patterns' of thinking, feeling, and responding were soft wired into the brain long ago. They have been repeatedly occurring, sometimes without our awareness, over and over again.

Rather than telling ourselves harshly to "stop that", or beating ourselves up for thinking or responding in a certain way (letting our inner critic take over) set the intention to respond with kindness and compassion. "That makes sense, its an old habit I have, Ive been thinking in this way kind of automatically for a long time". Congratulate yourself for becoming conscious of an unconscious pattern. For is only when we notice what is occurring that we can start to alter it.

You might then like to work with a supportive therapist, coach or mentor to explore alternative ways of perceiving yourself, others, and events in the world around us, and to develop new ways of responding to life and its challenges. Over time, this creates a new neuronal pathway to replace the old.

It takes patience, kindness and perseverance to change our old patterns, and develop new, more supportive neuronal connections.  However neuroscience is demonstrating how possible it is to understand ourselves, and rewire our brains.

Fiona Meredith is a Clinical Psychologist and Somatic Psychotherapist based in Adelaide, Australia.