Sunday, March 3, 2013

Dis-Eased Minds, The Body & Mental Illness Pt 1

We look so different on the inside.
Do we shy away from internal awareness, falling prey to the body's instinctive nature, in our experience of mental illness?

This post seeks to further explore the latest neuroscience research from the perspective of "body psychotherapy," and its approach to resolving traumatic experience.Trauma induced behaviors, often described by medical doctors as symptoms of a mental illness.

Are we converging on a much needed multidisciplinary approach towards the experience of mental illness, which does not give precedence to the disease model of mental suffering, favored by our hierarchically structured, healing professions?
Body therapists have understood the body's role in mental suffering for many decades, yet their often "intuitive" knowledge has been dismissed as unreliable compared to laboratory study.

Despite the 100 years that has passed since we first began to suspect a brain disease process and classify discrete mental illnesses like schizophrenia and bipolar disorder, no empirical evidence of an actual disease has been discovered. Even the great advances in neuroscience research, enabled by a rise in technology have still not been able to confirm a brain disease process, yet they may be confirming body therapists “intuitive” knowledge by revealing the neurobiology of the nervous systems and bodily based feedback to the brain.

Below is excerpt from a paper by one of my favorite authors in the field of body psychotherapy, and a wonderful articulation of neuroscience and somatic psychotherapy. Please consider;


“The brain is a complex organ that constructs experience from many channels of sensory input, regulates our responses through thoughts and emotions, and controls our actions. Its raison d’ĂȘtre is to learn from experience so that we can adaptively meet the ever-changing challenges of our environments. In Part I we noted that we humans have a unique dual perspective on the brain; whereas neuroscientists grapple with the workings of the physical brain from an external viewpoint and examine its neural firings objectively with increasingly sophisticated instruments, psychologists study it subjectively from the position of what it feels like to be such a system.

This dual viewpoint applies equally to the body. Whereas traditional medicine evaluates and investigates the functions of the body objectively and treats them with increasingly sophisticated instruments, contemporary somatic psychotherapy studies the body subjectively, from the position of the experience of being one. Understanding the biological nature of perception, learning, memory, thought, feeling, and consciousness has emerged as the central challenge of the biological sciences.

The work of neuroscientist John Ratey suggests that, in order to approach psychotherapy more effectively, we need a new, multifaceted paradigm. Because the body’s neuronal memory is the ground within which our life experience is imprinted, Ratey proposes that psychological treatment begin with tracking experience. A clinician, in his opinion, should begin by investigating how a patient experiences the world, focusing the primary diagnostic inquiry not on “How do you feel?” but rather on “How do you perceive and comprehend the world?” He believes that because emotions are created by the physical firing of neurons, clinicians should delve below the emotional surface of feelings, first considering their biological cause and effect.

The approach Ratey recommends has been in development in our somatic practices since Wilhelm Reich who understood that the body’s communication goes beyond the symbolic representation of verbal expression. Reich and his followers taught us how beliefs are bound in posture and movement; inner realities emphasized, masked, or betrayed by facial expressions; and emotions revealed by the rate and pattern of breath. Thus, in somatic work, posture, movement, breath, facial expression, and vocal tone provide important clues about the congruence between embodied inner experience and its outer expression. This legacy finds itself renewed and refined in the new generation of neuroscientifically informed books that bring current findings to somatic clinical practice.

For somatic psychology, the body is not separate from the self. From a body-centered perspective, our innovative therapeutic objectives seek to elicit a sensory dialogue that sets up a meeting point and establishes a conscious unity between mind and bodily self. One of our principle goals is to help our patients develop the ability to observe the bodily activities that reside on the fringes of sensory awareness and that are difficult to put into words—that is, experiences such body heat, involuntary and voluntary muscular contractions, organ vibrations, and skin sensitivity.

Our body-centered approaches focus on felt sensory experiences as they rise, bottom up, from the implicit realms. Somatic methods use sensory tracking and the recognition of movement impulses to access the interactive links—or lack thereof—between sensation, behavior, affect, and cognition. Somatic work encompasses not only experiences processed in the neocortex, but reaches into experiences processed through the limbic, mid and lower brain centers. We could say that somatic work intends to harness the plasticity of the brain and nervous system, that it seeks to stimulate dendritic growth and neural connectivity by supporting the biological completion of developmental tasks and disruptive traumatic events.

Body-Mind Psychotherapy Principles, Techniques and Practical Applications

The basis for Body–Mind Psychotherapy lies in experiential anatomy, physiology, and early motor development. In her first book Natural Intelligence (1999), Aposhyan had introduced working with “a synergistic intelligence that combines all the creative resources of every tissue and fluid in the body down to the cellular level” (p. 34). Body–Mind Psychotherapy now looks at the relationship between psychological process and the tissues, fluids, and cells of the body. Body–Mind Psychotherapy continues to draw its foundational somatic principles in large part from the work of Bonnie Bainbridge Cohen (1993), founder of Body-Mind Centering (BMC), then greatly expands its reaches to incorporate the latest research in neuroscience.

Aposhyan, who is a certified practitioner of the School for Body–Mind Centering, also acknowledges the strong influence of her 30 years of contemplative meditative practice. In the book’s first of four parts, Aposhyan gives us a concise overview of the developmental lines of our field. She traces our somatic lineage back to the organic view that psychological forces use physical energy, first brought to the fore by French psychiatrist Pierre Janet. She connects our somatic origins to neurologist Sigmund Freud, whose early career was devoted to finding the neurophysiological basis of psychological disorders. Importantly, Aposhyan reviews the established principles of somatic psychology and positions her Body-Mind Psychotherapy within this framework:

• Body and mind function in mutual feedback loops. The state of the body reflects the mind, and the state of the mind reflects the body. This principle is the key to integrating cognitive and somatic processing in a therapeutic context. The recognition of mind–body mutuality is also the basis for processes of somatic self-discovery that emphasize an exploration of the relationship of sensation, posture, and movement to mental and emotional states. In BMP, this principle is articulated as the positional functioning theory. Following the Body–Mind Centering model, Aposhyan anchors this somatic portion of her theory in the stages of motor development. She writes: “By grounding diagnosis in early motor development, there is an indication of the direction of future development within the present structure” (p. 13).

• The link with early motor development leads to a second fundamental premise. Early development, which forms the template for later stages of development, is primarily nonverbal. Therefore, the body provides direct access to early developmental nonverbal and implicit behavioral issues. Aposhyan makes the point that as mammals, we all have the capacity to read the signals of each other’s physiology; however, the cultural overemphasis on the verbal has somewhat obscured the cultivation of this ability to translate nonverbal bodily states into verbal consciousness.

Whereas past somatic approaches have stressed the nonverbal, at times even to the exclusion of the verbal, BMP supports the maturing trend of integrating the body into mainstream psychology. Working through the body allows access to the physiological aspects of autonomic neurological regulation, so necessary in the treatment of posttraumatic stress, dissociative processes, depression, and anxiety. Thus, BMP stresses the skillful integration of verbal and nonverbal awareness, explicit and implicit memory, and cognitive and somatic processing. It also stresses the importance of training therapists in the subtleties of nonverbal as well as verbal attunement. Clinicians who want to practice integrative mind–body psychotherapy must include a focus on their own ongoing mindfulness and deepen their understanding of somatic states. To this end, BMP recommends and offers embodiment training for clinicians.

• Somatic approaches articulate concrete methods of cultivating and sharing positive affective states. Attention is given to help clients develop resources that enhance their level of vitality and well-being and their capacity for self-care and self-regulation.

• Somatic approaches provide concrete access to behavioral change. Simple changes such as how to stand or walk are expanded into more complex changes like how we reach towards others or pull away, and move on to greater interactive complexities such as sexuality.

As noted, Body–Mind Psychotherapy incorporates the principles of Bonnie Bainbridge Cohen’s Body-Mind Centering. Advocating self-knowledge through direct bodily experience, BMC supports the immersion in experiential physiology at the micro levels of cellular and molecular behavior, where body and mind are indistinguishable. Our conscious awareness tends to reside in the larger orders of affects, cognitions, and sensations, with little attention paid to the subtle dynamic processes out of which they arise. We now know that intelligence extends far beyond the human brain to every cell of the body.

BMC trains its practitioners in the direct conscious experience of the processes of cellular metabolism and energy production so that they can connect with the various systems of the body’s intelligence: cellular intelligence, chemical intelligence, vascular intelligence, neurological intelligence. I believe that this aspect of BMC, which brings us to experience ourselves on the microscopic level, is of the greatest consequence.

The genius of both Bonnie Bainbridge Cohen and Susan Aposhyan is that they guide us to experience ourselves at smaller orders of magnitude than we normally use in the conscious perception of our embodied experience. The belief is that with focused attention, microscopic processes can be brought within perception’s reach, no longer condemned to remain implicitly preconscious or unconscious. Bion, in his paper “Evidence”, wrote that:

 “we may be dealing with things which are so slight as to be virtually imperceptible, but which are so real that they could destroy us almost without our being aware of it.”

Body–Mind Psychotherapy reminds us that the focus on macro awarenesses may well curtail a rich web of accessible direct micro-feedback, if we center our attention on the subtler internal aspects of our experience.

As if this were not enough, Body-Mind Psychotherapy goes further in building its theoretical foundation. Aposhyan uses the wisdom of evolutionary psychology, highlighting the fact that the evolution of the nervous system is the result of the body’s need for a communication network that links all body systems together. Anchoring this aspect of her work in the affective neuroscience of Jaak Panksepp (reviewed in Part II) that shows how evolutionarily based emotional operating systems set up our fundamental brain–body states and movement behaviors, adding Damasio’s somatic marker theory, Hebb’s rule for neuronal connections and associations, and the fundamental work of Schacter and Singer on how implicit memory unconsciously dictates behavior, BMP offers a clinical approach that focuses on facilitating cooperation among all systems, thus supporting the integrative role of the nervous system.

From these principles, Aposhyan unfolds the work of integrating cognitive and somatic processing by using the brain as a modulator and coordinator, rather than controller, of the various body systems. She identifies self-talk and body sensations as distinct players in the mutual brain–body feedback loops and weaves them together to generate behavioral changes that in turn support brain changes. BMP is about balance; its intent is to optimize the brain–body partnership, to facilitate an internal cooperation that can shift the emotional set-points that affect brain states and baseline moods. For Aposhyan, somatic techniques are not tacked on to psychological practice. Following the conclusions of mother–infant attunement research which calls for the inclusion of the nonverbal in the playing field of treatment, Aposhyan’s sophisticated understanding of the realm of the body gives us a rich array of somatic resources from which to interface with psychological states.” _ALINE LAPIERRE, PSY.D.

* * *

“Body and mind function in mutual feedback loops. 
The state of the body reflects the mind, and the state of the mind reflects the body. “

In our “mainstream” understanding of mental illness, we assume that sufferers are affected by a disease of the brain, its common knowledge after all, affirming simple commonsense? Yet do we normally shy away from internal awareness, to the extent that we’re in denial about the body’s role in mental illness?

As many eminent authors point out, there are some interesting discoveries in neurobiological research, routinely ignored by a culture of “intellectualism” which is not yet ready to explore the foundational nature of our subjective experience, and the body’s role in the creation of the human mind. As my caption below the photo suggests, we are very different on the inside to our everyday sense of ourselves. As Aline LaPierre points out "the focus on macro awarenesses may well curtail a rich web of accessible direct micro-feedback, if we center our attention on the subtler internal aspects of our experience."

Before stumbling on Allan N Schore's book "Affect Dysregulation & Disorders of the Self," I was as unaware of the  micro-feedback levels of my body and its nervous systems, as the majority of people are. As I read Schore's book expecting to learn about my brain and how it was diseased, the constant references to the autonomic nervous system surprised me a lot. You might say that I began to wake-up. Wake-up in terms of a self-awareness I'd never known, and equally unaware of how birth-trauma had kept me stuck in my head, in self-reinforcing feedback loops from my body/brain/mind. Its a completely different experience to get to know oneself on the inside, leading not only to greater self-awareness but much better self-acceptance and understanding. So, how much do you know yourself on the inside, where all your mind's perceptions of experience are created?

Aline’s website has a host of information about the “somatic” approach to healing trauma and I personally believe body psychotherapy to be an invaluable resource, for helping manage the symptoms of our dis-eased mind experience, and discovering a fuller sense-of-self, acceptance and understanding. Please visit