Sensorimotor psychotherapy (SP) is a body-oriented psychotherapy which is aimed at resolving traumatic responses locked in the body and nervous system.
Pat Ogden, developer of SP and founder of the Sensorimotor Psychotherapy Institute, first began to develop her innovative treatment approach while working in a psychiatric clinic in California in the 1970s. As a dance and yoga teacher, Ogden observed that many of the patients in the clinic appeared to be deeply disconnected from their bodies, and this disconnection prevented resolution of their psychological issues. Missing from traditional talk therapies, Ogden noticed, was attention to the body.
The concept
The theory behind the approach is that traumatic threat stimulates the body’s emergency stress response. Release of adrenaline results in an increase in heart rate and breathing along with instinctive animal defense responses that compel us to automatically fight, freeze in terror, flee, or collapse in total submission (the ‘feigned death’ response seen in animals). To allow these instinctive responses to be successful, the prefrontal cortex or ‘thinking brain’ is inhibited. We sense what to do rather than decide what to do. But with an inhibited prefrontal cortex, we can’t put the experience into words.
Following the traumatic experience, the brain does not encode a chronological verbal memory of the event but instead stores the ‘memory’ of the trauma in the form of nonverbal physical and emotional memories. These implicit unresolved memories cannot be recalled, but they are continuously stimulated by even very subtle cues connected in some way to the event or events. These triggers evoke the same threat responses to danger, and our bodies respond as if we were.
Over time, the traumatic event does not resolve because it is activated over and over again by triggers. The traumatised individual still feels unsafe, frightened, and at risk or hopeless and numb. Bessel van der Kolk describes this phenomenon as “the body keeps the score.” The trauma cannot be resolved because the body responses keep re-activating it.
Healing the body
For a long time, talk therapies have been the go-to approach for treating traumatised clients. While they can be helpful in increasing insight and self-compassion, the physical effects of trauma go unchanged or can even be exacerbated by the telling and re-telling of the events.
With a traumatised nervous system unable to effectively regulate emotions and impulses and a body easily stimulated by triggers, the individual often remains on high alert, anticipating new dangers. The result is either emotional numbing (often labeled ‘depression’) or chronically high anxiety or impulsive and self-destructive.
A dysregulated nervous system affects all areas of life, from the ability to feel safe in the world to personal satisfaction and contentment, from the quality of our relationships to our ability to perform well at work or school. Nervous system dysregulation is also the underlying ingredient in anxiety disorders, mood disorders and personality disorders.
How it works
‘Traditional talking therapies (including psychodynamic psychotherapy, psychoanalytic methods, cognitive-behavioural treatment, and exposure techniques) can effectively address the emotional, relational, and cognitive symptoms of trauma-related disorders and/or manage the secondary symptoms to ensure patient safety, but traditional psychotherapy models generally lack techniques that directly treat the autonomic and somatic effects perpetuating the psychological symptoms.’[1] – Janina Fisher
Here is where sensorimotor psychotherapy aims to intervene. Sensorimotor psychotherapy uses a somatic (body-based) and mindfulness-oriented approach in which clients are asked to become aware of the physical sensations accompanying their painful thoughts and feelings.
Each traumatised individual uniquely encodes an event or events in the form of images, smells, sounds, autonomic responses, visceral and muscular sensations, movements and impulses, emotions, and cognitive and narrative components.[2]
By avoiding interpretation of the sensations or autonomic responses as danger signals and instead focusing on increasing the capacity to tolerate their feelings and physical reactions, most clients experience a calming effect. With practice and repetition, they begin to feel a greater sense of control over their overwhelming or numbing reactions.
In a sensorimotor psychotherapy session, the therapist focuses not on the events but on how the traumatic experiences are encoded in the client’s body. Mindful curiosity is encouraged, which itself helps with affective and autonomic regulation.
Sensorimotor Psychotherapy, Mindfulness and Dual Awareness
By cultivating their ability to be mindful, clients can foster a sense of dual awareness. They can feel the uncomfortable or distressing feelings in their bodies while also holding awareness of present time and safety: “I feel scared though I can see that I am here with you and not in danger.” Dual awareness keeps the prefrontal cortex or ‘thinking brain’ active, allowing individuals to distinguish a threat from a trigger. In addition, the brain’s threat center (the amygdala) decreases its activity when there is increased activity in the medial prefrontal cortex. With practice, aided by increased connection to clients’ innate strengths and inner resources, the nervous system becomes more regulated. The result is the acquisition of the ability to connect to themselves without becoming numb or overwhelmed.[3]
With a more regulated nervous system and more access to mindful curiosity, clients can then begin to transform the ways in which the trauma responses have become encoded in the body. The completion or transformation of old traumatic reactions occurs through the practice of physical interventions, such as a deep breath to expand the chest or a lengthening of the spine or the completion of defensive actions not available at the time. As traumatised individuals experience a physical sense of power, boundary, and mastery, their ability to tolerate their feelings and manage their impulses begins to grow, increasing the capacity for pleasure and connection in daily life.
In Conclusion
Sensorimotor psychotherapy addresses how traumatic memory is held in the body. Clients are supported and guided in becoming aware of how the body ‘remembers’ the trauma or communicates feelings and emotions. Focus is centred around befriending and managing trauma-related thoughts, feelings, and impulses so they are less disruptive to the client’s wellbeing.
Mindfulness and curiosity are combined with a cultivation of the client’s inner resources and strengths, along with psychoeducation, to help the client experience present moment safety, connection, and a bodily sense that ‘It’s over, and now I am safe.’
Get in touch
If you have a client, or know of someone who is struggling and could benefit from sensorimotor psychotherapy, reach out to us at Khiron Clinics. We believe that we can improve therapeutic outcomes and avoid misdiagnosis by providing an effective residential program and out-patient therapies addressing underlying psychological trauma. Allow us to help you find the path to realistic, long lasting recovery. For information, call us today. UK: 020 3811 2575 (24 hours). USA: (866) 801 6184 (24 hours).
Sources:
[1] Fisher, J., n.d. Sensorimotor Approaches To Trauma Treatment. [ebook] Available at: <https://janinafisher.com/pdfs/trauma.pdf> [Accessed 5 August 2020].
[2] Fisher, J., n.d. Sensorimotor Approaches To Trauma Treatment. [ebook] Available at: <https://janinafisher.com/pdfs/trauma.pdf> [Accessed 5 August 2020].
[3] Ogden P, Minton K, Pain C (2006) Trauma and the body: a sensorimotor approach to psychotherapy. W.W. Norton.
