It Takes a Village: Putting Theories Into Practice
From Individual to Dyad, to Group, to Community
All are Developmental Steps
By Anne Isaacs
Today, I plan to talk about the experiences that I believe have made me a better therapist, trainer, and person. The broad outline is that I have a ground for my theoretical understanding of human development in Bodynamic Analysis, a body of work developed by a group of ten people from Denmark, and led by Lisbeth Marcher. Their work incorporated the work of many others, whom they gratefully acknowledge. But as the whole is greater than the sum of its parts, their work is also.
I want to explain how I have continued in their tradition by studying with other brilliant people, and have taken what I consider to be the jewels of their work. I have adapted these jewels into my own work as a trainer, and therapist. When I originally submitted this proposal, I asked for a 2 hour slot. However, I only have one hour. So I plan to be very brief with the jewels from Schore and Siegel because I expect that most people are already familiar with them. At the time they were beginning to present their research, it was new, and had a profound impact on the therapeutic community.
Let me start by talking about emotional regulation. The consequences of emotional disregulation traditionally have been called defenses or dissociation. I believe a more compassionate understanding of this process is to recognize the co regulatory process of emotional and relational regulation. Our solutions to difficulties in emotional regulation we experienced when we were young were brilliant solutions for that time. They were based on limited understanding of our self and the others with whom we needed to maintain a connection. Because these strategies worked to some extent within the context in which we grew up, they often developed into a closed system of habits in our body and mind that became our implicit way of behaving in the world as adults. As an individual, or partner, or practitioner, we do not want to live in a closed system. These solutions become serious limitations if we cannot find a more flexible way to approach the problems we are trying to solve as an adult.
Today I want to share a particular period in my own childhood development that has both served me and limited me as an adult. And I want to identify the things that helped me to find more flexible solutions. This applies to my professional life as a therapist, and trainer of other therapists, and my personal experience as a parent, partner, and friend.
Throughout this presentation I will focus on the developmental time we call Autonomy, between ages 8 months to 2 ½ years, to illustrate the ruptures that occur and demonstrate that with experiential exercises. How I have incorporated the jewels from other theories into my practice will also be illustrated with exercises from this developmental period.
I will begin with my own personal journey of healing my own limited solutions to an early problem. I will then turn to the work of Ester Thelen and her understanding that somatic development is actually a problem solving activity. I will include my understanding from Allan Shore and Dan Siegel, and co-regulation, similar yet different from what the Bodynamic system calls mutual connection. I was also forever changed by Ed Tronick’s description of “moments of meeting”, and the impact of this on my work. I am also indebted to Diana Fosha and Ron Frederick for their their precise teaching on the HOW of emotional and relational repair, that can lead to “moments of transformation”. If there is time, I will then do a case presentation and explain how I have used Bodynamic therapy as the base and at the same time added the jewels.
A core principal of the Bodynamic theory of somatic relational psychological development is that we learn who we are in relationships. Bodynamic calls this “mutual connection.” This is the implicit problem the child is trying to solve as they are also developing somatically. This is a process of exploring: “Can I be all of me, and can you be all of you? Can we grasp and accept our differences and continue to grow in a close and caring relationship?“ How do our caretakers react to our new motor, mental, and psychological skills? For instance, when the child begins to crawl and then walk, how do the parents either support or restrain these expressions of impulse and individuation?
The new somatic skills reflect and support new psychological skills, and vice versa. If, in the relationship, there is a rupture, both the psychological and somatic development of the child is impacted and are linked together unconsciously. The child may either give up developing the skill, or they may hold it back for fear of rupture. The child’s response to the rupture actually occurs in the muscles, in the voluntary nervous system, not just in the belief system or behavior. Bodynamics calls this an “imprint” of the rupture into the child’s soma and psyche. Bodynamic theory understands the link in mutual connection between the psychological skills and the specific muscles from each developmental time that either support these skills or reflect the rupture. Bodynamics builds on this understanding by providing ways to work with the imprint – the history contained in the muscles – to build new psychological skills. And, we also work to provide the specific relational repair that was missing from the time of the original wound.
When we train people in this model, or when we do therapy, this is the ground from which we start. What skills are missing in their present day life, and how does the body reflect this? Therefore, what does the body need to learn to create a new competency that will support the healing of this psychological and somatic and relational disruption?
From this ground of theory and specific information, we also have to know our own undeveloped or more rigid adaptations. If these are not clear, this can impede our client’s finding new solutions to some of his or her own undeveloped parts.
Therefore, I’d like to talk about how my own developmental disruptions impacted me as a therapist. When I was still in utero, my 5-½ year older brother developed a severe case of polio. He was still recovering throughout my early childhood. When I had already learned to walk, he was relearning how to walk. This particularly impacted me during the developmental time we call the autonomy stage, between ages 9 months to about 2 ½ years. My mother’s statement about me from that time was “ You were so good I could forget I had you”. In other words, it helped her that I was good at creating things for me to do by and for myself. Now for an energetic, impulsive child, there certainly were advantages to that. I was never bored. One time my mother came down from helping my brother with physical therapy. I was in the kitchen and had taken much of the grains from the pantry shelves and dumped them on the kitchen floor and was sliding around on them. I also loved being outside in our yard and inventing games and scenarios that I would enact. Neighborhood kids liked to come to our house because I was very inventive in creating games to play.
As an adult this was reflected in that I was really good at following my impulses, had great curiosity about many things, and was fully engaged in the moment, whatever that moment might be. However, the effect of the rupture was also that I ended up with the false, and implicitly unconscious belief that I was “independent” and did not need any help, and that even if I did, it was not there, so why bother asking. I also held another implicit understanding about the world: that it was good not to sense what I meant to others or what others meant to me. There was never any discussion about my brother’s illness or what that was like for him, or anyone else in the family. It was as if the profound effect polio had on every one in our family did not exist.
Assuming that there was no help to be had, and having little experience of what help from others could offer, I was not grounded in the current reality of what support was there for me, or how it might be useful. I also could not deeply take in what I meant to others and what others meant to me. This very meaningful experience could not be discussed. Both these beliefs were reflected in my body, not just my mind. I would impulsively charge into physical situations that could be difficult without being thoughtful about how or what to climb, for instance. I therefore got into some physically dangerous situations, and did not know how to get help once in them. When I was two, I actually fell off a second story roof I had climbed onto when I opened a screen. I had a lot of energy to engage in the world, yet I was not very grounded. I also did not know how to sense or show any vulnerability. After my mother checked me in to the hospital, she came into the childrens’ ward. I was in a crib that had a fishnet over the top of it and down the sides. Apparently I had climbed out of the crib and was found walking down the hall.
Of course, this early time impacted me as a therapist. For instance, years ago after working with a female client for some time, we came to a completion in our work. As a young therapist, I really had no idea how that would impact her, and what I meant to her. I was living in my world of “imagined independence of all”. So when I behaved in a casual way about our ending, she was really hurt. At the time, I honestly did not understand that, and only when I had worked on my own autonomy issues could I reflect on her response and feel my own shame and disappointment at my limitations. I also needed to work on both giving and receiving from my core, something children do spontaneously at the age in question. If I had been able to sense the depth of giving and receiving in my relationship with this client I would have known how significant I was to her and handled the ending of our relationship with more care. The somatic reflection of the skill in giving and receiving is using both the pronator and supinator, two muscles in the lower arm that are used for these purposes, especially at this age. I had been unconsciously protecting myself by not taking in what I meant to her. It turns out that the two muscles in my arm were fairly tense. (over-elastic?)
It was much later, after our daughter was born, that I deeply experienced my need for help. It happened one time when I was at home alone with Vida. She was in the high chair and I was feeding her. I was really tired, as we had not just had a new child, but were building a house at the same time. My husband Joel was also the contractor for that project. Vida seemed not to be hungry, and I did not want to spend the time it was taking to make sure she got enough to eat. I found myself getting really angry. Fortunately I knew she did not deserve any of that. So I went into the next room and called a friend to say I needed help to regulate myself (these are not the words I would have used then, as it was before I had studied Allan Schore’s and Dan Siegel’s work.) This was an enormous change for me. I recognized I was overwhelmed, that my anger was about me and not about anything Vida was doing, that I needed support, but most importantly: I asked for it. And the asking came from a deep place in me, as I knew I did not want to hurt Vida with my lack of self-regulation.
Exercise: One person is the child, the other the parent. The Child can pull herself up to stand, but stumbles as they take a step. They say to the parent “I need help”. The Parent watches and coaches them with the words “I’m so proud of you, you can do it”. The child takes a step and again stumbles and loses their balance.
Sense what happens inside when the parent keeps saying, “you can do it”, but offers no help.
Now try it again, but this time the parents asked the child what kind of help they would like. And the parent gives just that amount of help. Sense inside what happens with that response.
Ester Thalen was an American developmental psychologist, who researched infant development somatically as well as psychologically in the early 80”s until her death in 2003. Eventually she used chaos theory to explain how babies learn to walk, reach, etc., and also to relate to the complexity of the world around them. She said, “The mind simply does not exist as something decoupled from the body and experience.” Her theory says that motoric development is not initiated only by neuronal and cognitive development. She also saw that babies are not rigidly pre- programmed, but instead that they learn by trying to solve a problem. Their developing skills are not determined by one thing but the impact of multiple causes. As she studied motor development, she recognized it as a problem solving activity that their body movement tries to solve.
For example, “how do I get from here to there?” In the attempt to figure this out, the child discovers their own somatic path – the action that will get them there. This involves so much complexity. At a preverbal time, the child is negotiating their body movement and all the environmental factors, such as the surface they are on, the placement of other objects, the movement of other people and animals, etc. Simultaneously, the toddler is also paying attention to the responses of their caretakers. Although Thalen did not spend as much time on the relational component and its impact on somatic development, Bodynamic does. “Do they support me and give me the help I need, or do they seem anxious about my getting hurt, or do they expect me not to need help?” The amount of input the toddler is trying to manage is amazingly complex. The response is also imprinted into the specific muscles.
Thalen’s research put into words the complexity of the experiences I was having in my Bodynamic work. For me, I was an adult learning to integrate cognitively and physically the psychological, emotional and physical interweaving of development. While I was having a more sophisticated understanding of that complexity, it became clear to me that the infant was managing all this complexity also. I began to have a more profound appreciation of how much an infant is capable of learning, and how deep the imprint is that unifies the body and mind.
The process still amazes me and in some way I think infants are still not recognized for how complex they are. As the infant and toddler solve these problems somatically, they are also developing new psychological skills. Bodynamic theory is particularly good at illustrating this process. In my own personal therapy and with clients, I was seeing that when a new physical resource is developed, there is a ripple effect throughout the person’s sense of self and in their relationships. It was as if this process reflected Thalen’s research on infants. I was also seeing how change can occur across the emotional and relational experiences when one intervention, i.e. resourcing specific muscles, is learned. That, along with the relational support, ripples through many parts and the integration then occurs at the cognitive level. When you metaprocess these changes, the implicit understanding of the world explicitly can change.
Exercise: While standing, lean forward but do not use your toes to stop yourself. Notice how easy it is to fall forward once you transfer the weight of your body forward. Now try it by just using your big toe. Put a bit of pressure on your big toe and see how that impacts your stability. Once a child learns to use this small muscle, the flexor hallucis brevis, they can stop themself from falling. It’s as if they have both brakes and balance. This is an important muscle for grounding for the autonomy child and adult. While Thalen was not looking at the specific muscles that allow the child not to fall, she was looking at the process of somatic development and how the child finds its own way not to fall. The big toe is the easiest way to do that, and if you do not use your big toe, you will need to contract other muscles in the feet and legs.
ED TRONICK, ALLAN SCHORE, DAN SIEGEL
These three researchers and professors provided the research to back up what happens in both child development and the therapeutic process.
Ed Tronick was a member of the Process for Change Study Group. In his research he noticed there was a time he called the “ moment of meeting”. He developed the “ still face experiment”. His research recorded how the infant spontaneously initiates social engagement with their parent as a way to try to regulate their parent’s still- face affect and withdrawal of attention the parent assumed for this experiment. While his research was with infants and parents, it also applies to the therapeutic relationship. Both parent-child and therapist-client are dyads that mutually regulate each other. The moment of meeting is a clear example of this dyadic expansion of consciousness. (Tronick later developed his mutual regulation model, MRM, from this idea). This is a time when in the dyad, an unpremeditated moment arises, or a rupture in disconnection occurs.
Now, the infant is probably the best example of rapid change. They are so present, so open. In therapy, we are seeing the results of ruptures that had no repair, and became solidified, unconscious. They developed into the implicit understanding of how the world is. But when the moment of meeting occurs, what happens is that there is a moment when something not known is possible. Both persons in the dyad sense it, and do not know what to do. Both need to dig into the self to authentically find this emergent possibility. And this needs to occur mutually. As a result, the new experience allows each person to be altered and to grow. The dyad as well as the individual become more complex. If the moment is not seized, and is not brought up later, the result can reaffirm the old patterns that the client has already developed.
The work of Allan Shore, on the co- regulatory relationship between parent and child deepened my understanding of the complexity of affect regulation and the neurological imprint in the brain. His brain research documents how the biological formation and growth of the brain mirrors the psychological experience of the parent child relationship. And the regulation that occurs for the infant happens between the mother’s and child’s faces and bodies, as the time is preverbal. In the same way, the therapist and client are a co regulatory team. This is both an opportunity for change to occur, or for the old patterns to assert themselves.
Dan Siegel’s work on neuro- plasticity.
Dan Siegel starts with the knowledge that interpersonal relationships shape our brains in our childhood, but adds that this continues goes on throughout our lifetime. He is especially brilliant at translating complex scientific concepts into usable practices. He emphasizes that through neuroplasticity, the brain can continue to change, as we can.
The combination of these three brilliant theorists gave me hope as a therapist. First, I had hope that my fantasy that the therapy was all on me was just that: a fantasy. We are in this together, just as the infant and parent are, and we either grow together and thrive, or do not. The second hope was that we are in a continuous process of co- regulation, even when we are not aware of it. The third hope was about the neuroplasticity of the brain, that an old dog can indeed learn new tricks. And the fourth hope was that just as in childhood, ruptures in therapy can be moments of growth, if they are repaired.
- The child expresses some emotion. The parent deliberately tries to distract the child from this emotion.
- The child tries to give the parent an object that has some significance to them. They hand it to the parent and say, “Look”, in an excited way. The parent, looking neither at the child or at the object, says “That’s nice, put it there” and point to an area that is at a distance
Notice how you feel, what is happening in your body.
Now do it again, and try to repair the misattunement. Notice what happens in your body
DIANA FOSHA and RON FREDERICK: AEDP (Accelerated Experiential Dynamic Psychotherapy)
It’s not just me, it’s not just you, we are in this together
I am deeply indebted to the trainings I have taken with Diana and Ron. My initial body psychotherapy was in Radix work, a neo-Reichian emotional release model. I grew very comfortable in allowing people to fully express deep emotions, and recognized how transformative that process was. When the trauma field began to develop, there was a turning away from such strong expression, as it was possible that this could lead to dissociation for some people. While this was true, it seemed to me the reaction was too far in the other direction. I continued to support strong emotional expression. When I began training in AEDP, both Diane and Ron work with a model of affect being held in the body. And that its expression needs to be experienced in the relationship between the therapist and client, bringing what was frozen in the past into the present.
Diana writes that psychopathology is a product of a compromised capacity to process affect. Of course I have always known presence is essential to attunement. But AEDP’s emphasis on the relational container was what was missing in the original Reichian model for me. But the AEDP model the HOW of emotional attunement occurs is profound. Up to that point I had a concept we used in Bodynamic called “good parent messages”. These were things a good parent or therapist could say to a client at a specific time to support their emerging capacities. After working with DIana and Ron, I recognized that these could be translated into what we now call affirmative relational messages. These are statements you authentically make at a moment when either you are moved, or that some emergent capacity has appeared. These statements both recognize something new in the client and/or are some way of joining in the emotional tone of what is happening. They implicitly say, “we are in this together”.
In the Bodynamic context we include the kinds of words that touch the person in the developmental time they are reorganizing. For instance, when working on a rupture from an early period I might say, “I love that you are learning to express your needs”. For an issue from the age 2-4 years I might say: “I am so moved that you are starting to take care of yourself”. And for an even later stage (5 to 9) I might say: “I am excited hearing how you think about things”. All are relevant for different times in development.
Diana and Ron also gave me more permission to bring my heart into therapy. We are in deep connection with the people we work with, and many moments are filled with love. It shows in the facial expression, and in the quality of the eye contact, and in the touch you might choose to give. It can also be directly expressed. I know this is a bold statement, and I think very important. It is not for everyone, just as touch is not. But when done appropriately, it supports connection and change in a very powerful way.
So how does all of this this look in a Bodynamic session? Ester Thalen says that development is a problem solving process. This is not just a good description of child development, but of the therapeutic process. The client describes a problem that comes up in their daily life. Much like the child, the question they cannot figure out is “how do I get from here to there?” As they talk about what they want to change, we can often identify the developmental period when the issue was likely to have originated. We pay attention to what they say, the words they use to describe the consequences of this dilemma, and what shape their body takes and what feelings are evoked. The body shows us how the issue is embodied in the muscle. This awareness is the structure that the Bodynamic training teaches us. By recognizing this structure we have a sense of the territory we are entering. The process of the session is finding the person’s individual path.
The rest of the session is seeing the effects of somatic and relational interventions that are woven through the session. Much of the time spent is waiting to see the ripple effect of these moments. What skills are missing? Do they need more internal or external support? Are they uncentered and do not know how they feel? Are they ungrounded and can not stand up for themselves or out of contact with the reality of the situation? Different muscles support these psychological skills. The session unfolds and we bring awareness and new possibility to the body as a change agent. At the same time we are joining with them relationally in this process of struggle or change. We share the moments by being moved, giving support, by teaching new skills and by demonstrating compassion for the effects of the old solutions to these early developmental disruptions. We also work on holding the container that keeps them focused on a specific issue so that it can complete.
What we have found over time is that our work often resolves issue quite rapidly and in a sustainable way.
Originally presented at the USABP Conference in a workshop Nov 2, 2018