Insight Mind Body Talk

Ep 10: Bringing the Body into Therapy with Kate Lauth (Part II)

May 30, 2021 Jessica Warpula Schultz, LMFT Season 1 Episode 10
Insight Mind Body Talk
Ep 10: Bringing the Body into Therapy with Kate Lauth (Part II)
Show Notes Transcript

In a two part conversation, Jess and her guest, Kate Lauth, MSW, LCSW, talk about bringing the body into therapy. By using the body’s experience as the entry point to treatment, they bring insight and information about the sensorimotor processing system and trauma resolution. Listeners will learn about a body-centered model called sensorimotor psychotherapy and the key concepts SP uses to create holistic change.  Episodes 9 & 10 are a deep dive into the rich understanding offered to us through the wisdom of the body.  

   

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Produced by Jessica Warpula Schultz & Jeanne Kolker
Edited by Jessica Warpula Schultz

Music by Jason A. Schultz
Sound Clip Editing and Mixing provided by Jason A. Schultz
 

Bringing the Body into Therapy (Part II)

[00:00:00]

Welcome to Insight Mind Body Talk, a body-based mental health podcast. We're your hosts, Jessica Warpula Schultz and Jeanne Kolker Whether you've tried everything to feel better and something is still missing or you've already discovered the wisdom of the body.  This podcast will encourage and support you in healing old wounds, strengthening relationships, and developing your inner potential all by accessing the mind body connection.   Please know while we're excited to share and grow together. This podcast is not intended to be a substitute for mental health treatment. It doesn't replace the one-on-one relationship you have with a qualified healthcare professional and is not considered psychotherapy. 

Thanks Jess. And thank you for listening. Now, let's begin a conversation about what happens when we take an integrative approach to improving our wellbeing.

Welcome back. Thank you for joining us in part two of bringing the body into therapy last week, Kate, you and I  talked a lot about trauma, the different processing systems, emotional processing, cognitive processing, sensorimotor processing,  how trauma influences not only our thoughts and feelings, but our body and our present moment experience.

 today we're going to finish that conversation looking at what's called the window of tolerance. The five core organizers of experience, how our feelings and our thoughts, but also our internal sensations movement, our five senses, how they help bring meaning to what we're experiencing.

And  if you're interested in pursuing sensorimotor psychotherapy, we  want to help people have a little bit of that insider view so that you know what to expect when you start to work with your body in a therapy session.

 Welcome Kate. Thanks for being here again. Thanks Jess. It's going to be back. Uh Awesome. It's good to have you back. [00:02:00]  Let's begin. We're going to start by talking about the window of tolerance.  So I would explain the window of tolerance. Usually in sessions, if I'm explaining this to a client, I like draw a window with my fingers. So I'm doing that, right?

Yeah. Imagine a window. I have the vision. We'll have a window. So in a individual, there's a range of activation or arousal, but it's comfortable. It's containable. It's where normal information processing happens. So right now we're having a conversation we're both present or engaged. We're able to listen and respond.

We're both in our window of tolerance right now. The idea is  if there's a threat and our system gets activated into  response. There's too much arousal to integrate the information.  And the arousal feels overwhelming to a person. They can either go above or below the window of tolerance. when you say integrate information, it means information comes into our brain and body.

We're able to make a mindful choices, but we're not overwhelmed. We're not dissociated that we're not shut down. We're in that window of tolerating, what's happening to us a moment.  

And if there's too much arousal to integrate the information the prefrontal cortex like you were talking about is offline. It's going into that limbic. Sympathetic response. Hyper vigilance,  activated above a point of being able to respond and integrate information .    And if our arousal is too low, a person goes into hypo arousal, which is below the window of tolerance. that's where a person may be numb or depressed, or just really shut down, right? There's not enough activation. There's [00:04:00] not enough arousal present and to be integrating.

What I found interesting learning this in our training is that trauma comes into the body on the same pathway almost every time. So if you watch the trauma response, almost every, almost everyone, not everyone, but research shows most mammals first get hyper aroused. And then if hyper arousal does not help bring them into their window and regulate, cause this is all in a way, a response, right?

These survival responses again, are there to help us get back into the window. If that doesn't work. Or the threat is too large. We drop down and then we go low. 

Would you say that? Yep. Yeah. And everyone's window of tolerance is shaped through past experiences through childhood, through past traumatic events. So someone might have a very narrow window of tolerance. Like it doesn't take much for a trigger to send them out of that window. And the window of tolerance is not fixed.

It's something that can grow and change through therapy through working with the edges of activation, right through bringing mindfulness to that moment of, okay, I'm starting to notice my heart rate increasing my palms are getting sweaty. My fists are, tightening. This is a moment where I'm coming to the edge of the window of tolerance.

And is there a way to intervene to bring myself back into the window to regulate instead of continuing to escalate and totally going out of the window dissociating or, then not having the choice of response different way. You're right. That edge is where a lot of sensorimotor work happens.

Healing happens is because we need [00:06:00] some activation to know what's going on, but when we bring that mindfulness to it, that's where we work with it before we completely leave the window. And so sometimes in session, it's just about resourcing and finding resources to practice getting back into the window, and that's it. And then sometimes as to working on that edge, when someone feels safe as well to to start to allow their brain and body to know that there's options and safety, even on that edge, and then in therapy, right? We work on making that window bigger so that the events that triggered hyper or hypo arousal a year ago, you don't leave the window because it's bigger. There's more space, right? Yeah. I think, a lot of self-care is working on expanding that window of tolerance. If we feel resourced in our life, like we're eating well, we're getting enough sleep where active, we're doing things to manage our stress.

We're going to feel like that window is bigger. Like we have more capacity to respond to triggers or to stressors without getting overwhelmed, such a good point. 

We're talking about  the window of tolerance,  what are the factors  that can shift us in and out of our window. 

Every moment of our lives is organized by our brain or nervous system in our body. We gather information through the five core organizers of experience.  thoughts, feelings, our five senses movement, and inner physical sensations

 We have information coming in at all times. And we don't just organize it and make meaning around it, through our thoughts and feelings we're forgetting about the body and how the body makes sense of what's happening. We forget about things like  movement any type of movement in the body, we forget how movement that [00:08:00] the body ranging from small to big, our posture, facial expressions, ours, others, gestures, all of those things give us information.

 We organize . And that influences where we are in our window of tolerance. Then we want to think about our five senses and not just their five senses. It's really our,  perception of our five senses. So our perception of smell, taste, touch, sight, hearing, all of that gives us information about the outer world.

And then  internally generated,  tastes and images like that. Blue, you were feeling the color blue earlier, you said, or in the last episode you said that influences where we're at in our window of tolerance. And then lastly, the inner body sensation. And I respond to this one so well, because a flutter in my stomach can pop me out of my window faster than I can think.

And all it is a flutter.  Even these internal sensations. So our heart rate, our breathing, if it's deep or shallow anyway, our body monitors what's happening, temperature, anything internal. That is another way our brain and our nervous system and our body decide where we're at in the window.

We have cognition and that refers to our mind. It includes our thoughts, the meaning we make of things, the way we interpret things, our beliefs about ourselves, our beliefs about the world. And it  ranges from small thoughts, to deep beliefs that  influenced the overall quality of our lives. Like I'm not good enough or I'm alone in the world. So our thoughts influences where we are in our window of tolerance, then there's emotion. So of course, feelings being [00:10:00] overwhelmed, bili, feeling joy, feeling sad, feelings of mistrust, or of confusion.

Those also. Shift our experience in  the window of tolerance, right?

So there's these five elements, thoughts, feelings, our five senses movement, and inner physical sensations that all times  they're all swirling together. And that's the way we organize every moment we're alive.

And if any, one of those things, any one of those core organizers reads a threat, we could pop out of our window and then imagine if two or three or four read threat or danger , imagine how much we could drop out of our window. So it's so important to observe. What's happening within our window of tolerance and with these five core organizers so that we can change things.

And that's where that understanding of how you're organizing can lead us to explore, be curious, maybe movement, maybe posture when your shoulders are slumped, maybe even experimenting and changing that posture changes your organization of experience. Maybe sitting up brings you back into your window because you feel confident and safe or for some people would have sitting up is too vulnerable and it pops them out of their window.

So really learning if curiosity and non-judgment how your body is organizing experience so that we can help increase your window of tolerance. 

And that leads to change .

And how each of those core organizers informs one another, right? With your example of screwing with your shoulders hunched, [00:12:00] that's a position of your body and the emotion that might come along with that is here. And there might be a belief that I can't take care of myself, or I can't protect myself, .

And those are all blended together. And as soon as you start working with one, the other shift, so if there's a way to work with the body to find more openness, assertiveness strengthened stability in the body, then it's bringing awareness to, okay. How does that shift the emotion? Now I feel more.

Open and secure. And how does that shift the belief about yourself? So it's stitching all of those core organizers together and seeing how they work together to make up the whole experience. . Noticing how they're interrelated and how one leads to another is really essential , to bringing the body into the therapy room.

There's lots to be discovered when we do that. And I just want to take a moment ] there's so much there that we're not tapping into when we  stay in that front of that brain, or even in the limbic system where emotional processing. There's always an opportunity to notice what's happening in the body and how to bring in a resource to find more calm and ease groundedness in the body.

through that mindfulness, which is such a, we'll get to that in a second. Mindfulness is a key component in working with the body

 of this episode, we felt it was important to share with  listeners, what you might expect if you wanted to work with a sensorimotor psychotherapy list. Because even the idea of bringing the body into the therapy room  is  probably pretty overwhelming, I would say, and whatever we can do [00:14:00] to help normalize the process, or even just give a little bit of a bird's eye view.

And again, everyone's different. It doesn't always follow the specific pattern. Every therapist is different and yet knowing a little bit of what it would be like. I think it would be helpful. Don't you? Yeah, definitely. Okay, great. Great. So let's begin. When someone wants to work with their body, it's really important that we create a safe container.

That's always step one. And what do I mean by container? A container is really, this felt sense of safety that we know that, that session, that person, that time together is a place where the client feels or a person feels. Okay. With being in their body with working with their body and a strong container is really allowing

no, I'm just gonna okay. Create the container. Okay. So one we're creating a strong container. We usually check in and assess. We provide lots of education like we're doing here today. A lot of what we're talking about is something I would use. This is a containing session in a way it's building a container.

If this was a session where a lot of education comes in so that nobody is surprised, nobody feels out of the loop. And we explain how the brain works, explain how the body works, so that then we can begin to start observing. And in sensorimotor psychotherapy that observing how a person in the [00:16:00] present moment is organizing their experience, especially in the body is called tracking.

So it's our job to start tracking what's happening in the moment and just noticing any small changes like. Someone's eyes are dilating or their eyes are squinting. Maybe their cheeks are getting flushed or they're getting fidgety. Or like we said, a small postural change, their shoulders round forward, or they slump in their seat.

That's more of a bigger change, or hand gestures or even turning away. And, sometimes getting up, wanting to get up and leave the room. So just starting to track and what we do there is remembering that if a situation at one point was perceived as threatening to one safety and survival, those defense survival responses get triggered.

And then the inability to complete these actions, complete that survival response can get trapped in the body. And that's what we're looking for. Is, are there any survival responses that are still showing up right now as maybe someone explains or talks about what brought them to therapy or an issue or a struggle they're having when you say yeah, exactly.

It's noticing. Okay. As you're sharing about this family conflict, observing what's happening in the body, and noticing, does it seem like there's. The body's wanting to complete a movement here or complete some kind of action, whether it's, as you said, getting up to walk out of the room or having some kind of physical engagement to allow that that survival response to really process through, maybe it's leaning away or maybe it's reaching or leaning [00:18:00] forward.

And what we would do then to start to help build a movement vocabulary with the client, we would contact it's called contacting. And that's when you begin to name what or what you're tracking in the body, for example, when you talk about your son, your shoulders rise, huh. Or when we focus on this positive from memory seems like your breath slows and deepens and helping anyone start to begin to notice how their body is involved.

In their processing, as well as their thoughts and feelings. And we can't do that unless we, ourselves, as therapists, notice it, observe it, track it, and then make contact because often as humans, if our, if we're feeling disconnected from our body or we've experienced trauma on, and that disconnection happened, we aren't aware right.

Of what our body is doing. We aren't aware that we always crack our knuckles. When we talk about a specific person or that when I suggest,  what would it feel like to tell that person your thoughts and you lean away from me and your eyes get really big? I wonder if you notice that, huh? There is a response and that really helps someone begin to observe rather than just interpret, really work, to observe our present moment experience and not interpreting.

And what do I mean by that? For example, as a personal trainer  maybe I'm working with someone new and they're doing a movement. And I ask a mindfulness question. What do you notice happening in your body right now? More often than not. I get an interpretation, not an observation.

I get I'm. So out of shape, it's been so long.   Okay. So we totally skipped observing there. And you interpreted soreness, fatigue,  [00:20:00] pain, hard to breathe. All of those sensations. quickly translated to an interpretation.

It must mean something. And this is what it means. And now I've even attached a narrative of shame to it, or it's self judgment. So we try to back it up and we  work to observe our experience rather than interpret it and build a movement vocabulary. Sometimes a therapist will ask mindfulness questions I've noticed for myself too, in the gym, if someone's getting overwhelmed and I want to help them get back into their window where they're mindful so that they maybe don't stumble or their form doesn't change and they get hurt.

I'll give mindfulness directives actually. I'll pick one core organizer to focus on to allow the body and the mind and the whole self-regulate come back into the window where they're mindful and safe. So I will say something such as point at every red thing in the room  to help them get back into that moment. 

And then maybe we start to hypothesize about why it's happening. So how do we set aside the narrative and observe  and be present with what's happening in the body and, allow for some exploration    

 When someone decides they want to explore something in their body, or maybe I noticed something for example , Oh, when you talked about your boss, you leaned back. Maybe that's something we should explore, you know really getting permission to explore anything could be an area of tension or a gesture, a physical sensation.

Change in prosody. Maybe they start speaking in a higher pitch and it gets really rapid or they start holding their breath deciding together. That's so important for safety and for the whole process is we collaborate and decide together what we want to work on and getting permission. [00:22:00] Right 

okay. So I'm noticing this, is this something that we can explore together?

because at the end of the day, again, it's not the therapist's agenda. They're not the expert. That's why we frame and collaborate. We always check in, is this where we should be going? How is this feeling? I may interpret, they want to talk about that lean, but maybe that's not important to them, or even that doesn't feel safe yet to talk about that body gesture.

So always checking in with each other and asking permission.  an opportunity then to honor a person's boundaries. If they say, no, I don't want to explore that or no, I don't feel ready. Then it's great for letting me know. And that's important to, to speak up for that. Oh, it's so his right.

No is such a resource. No. Is a resource I love when people tell me. No, I do too. Great. Yeah. So how do you know that? How is your body telling you that's a no

I could have a whole episode go with the resource. I'll stop myself there. That in the memory banks. Yeah. you're right. We're collaborating. We're  staying mindful, assessing what we should be working on. 

And that's where we also start experimenting a little bit and be curious, trying something new.  For that person who leaned back, maybe there's a movement that does feel safe.  That lean let's explore that maybe let's perhaps do an experiment. What if you not only leaned, but you like leaned further away, how does that feel?

What do you notice? Can we stay with that? Maybe that's telling me I should back up my chair. How does it feel to have even more space between us as we talk about this and  it's boundary setting and working with boundaries, working with the wisdom of the [00:24:00] body, perhaps there was a time someone wanted to lean or get away and they didn't feel like they were allowed to do that.

 Can we allow the body to follow through and do what it needs to do?    When our survival response is interrupted or incomplete, maybe we wanted to lean back or maybe get away. And we felt like we couldn't for whatever reason and the strategy we would have taken in that moment to protect ourselves is interrupted.   Isn't able to be followed through in a safe and mindful way or fully completed.

That's where in the therapy room we allow that response to be followed through with, and we've talked about it several times in this, in these episodes without saying it, but it's called an act of triumph.  I love the phrase act of triumph. When we have an act of triumph, that means a survival response is allowed to run its course.

And . Pat Ogden frames it as the possible future becomes explicit, conscious, and with choice. I love that.  The way I do trauma-informed personal training. There's so many moments for active triumph, right? It's are you ready to return to movement again? You don't have to say yes.

Just because it's been three minutes, or maybe someone comes back. Yeah, I am. And I can see their hesitancy. I may say, would you like more time? Would it feel good to walk and get some more water? Do you want to breathe? What does your body want to do right now? And more often than not, they're being polite and caring towards me.

So they feel as though they should get going. I've asked if there's been enough time, but instead we allow even this micro active triumph for, they slow down and say, Oh no, my body wants, I have this instinct. I want more time. Or I need to go get another [00:26:00] drink and just walk. Yeah, listen to that. Bodies.

That's such a success. Yes. I love that. So the idea of. Knowing you're doing it, being conscious of it. And doing that action with choice is so healing. It creates a sense of empowerment too, for a person to feel like, okay, I can notice my needs. I can listen to them and act on them and do the thing I need to do to take care of myself right now.

And taking it a little further. Sometimes in the therapy room, using sensorimotor processing, we work to help when the body has shut down or immobilized to help it mobilize. And that's an act of triumph, or if someone is mobilizing, but they're dysregulated, right?

Maybe they've mobilized, but it's very overwhelming or panicky or their heart's racing. Maybe that's when we bring some regulation to that strategy for a great one is you want to push let's just not push anything. Let's be purposeful about this. 

Maybe it's a protective response, survival response that's coming out and you want to push. I just don't want you to push anything. Let's ground, maybe place our hands on the wall and feel the wall and mindfully push and see if that discharges anything. If that helps regulate  that survival response.

And often that can help something through the body as well.

What's your experience of how clients feel after an experience like that? Hear the word relief. A lot. I hear the word relief and I can see, and usually the client can feel [00:28:00] with practice, practice observing and noticing it doesn't happen right away. But with practice,  the person can feel the shift.

And for everyone, they describe it differently,  I think sometimes there can be grief that comes with that of realizing how that had been impacting them in ways that maybe they didn't realize until they felt the relief.

Yeah. And of course, there's also the possibility that they shift into another survival response. Almost like they're stacked. That's a  common reaction that when one survival response is allowed to move through, they'll shift into another one. It may not be that relief or that emotion.

There's no perfect path to this. Our job is to  be present and create safety.  Yeah, yeah. A compassionate witness to that. And with that compassionate witnessing,  being mindful with the client, helping them if they need to shift and work on something differently and choosing a new frame,  or learning more about their body and  refine that frame focus more specifically on something.

 We  process with mindfulness.  Asking questions about the present moment,  bringing mindful awareness to the internal organization, focusing on our present pink, curious, and allowing,

sorry, one to find opportunity for shifts in the body, right? So whether it's using somatic resources or embodying a non somatic resource, helping complete actions and creating shifts in the system, which leads us to transformation.

What is the point of all of this? The point, the reason why we do all of this hard work of observing and [00:30:00] noticing and processing and being mindful is So that we find those places of transformation. And when we find those acts of  triumph or we feel something shifting in the system, we return to the window of tolerance, we name it and we frame it. We want to help integrate this new resource. We want to spend time with this act of triumph. We want empowerment, really integrated helping that transformation connect to all of the five core organizers, not just maybe the one that it showed up in  and spending time with it, building that movement vocabulary, integrating it through our emotions and our cognitions.

What do we think about it? How do we feel about it and figuring out how to continue working on that on our own outside of session.

How to bring that into our lives. Those tools for accessing resources and feeling grounded and empowered and self-compassion And that's the goal for everyone. Anytime we do that kind of work from small moments, small events in our lives to  traumatic experiences or chronic or complex trauma. That's the goal is to help the body, heart, soul figure out a new way of being.

Thank you, Kate, for your wisdom for your time for sharing with us, how sensorimotor has not only impacted you as a professional, but as a person I'm really grateful for having you with us in these two episodes.

Thank you, Jess. I'm really grateful to be able to talk with you and learn from you as always. Thank you. Thank you. And thank you listeners for being with us. As we talked about bring the body into our therapy sessions 

and [00:32:00] next week's episode, my guest Annie Forest, and I talk movement, Annie is the owner of Forest Coaching and Studios.

She is a 200 hour registered yoga teacher, a strong first level, two kettlebell instructor and a certified TRX instructor. And by the way, a really amazing human being,   we'll dive deeply into the ideas of mind, brain and fitness, Annie'll share new ways to experience exercise.

She'll give tips on freeing up your brain to allow your body to move well.  And how we can show up for our whole self in and outside of the gym.   Thank you again for joining us on Insight Mind Body Talk, a body-centered mental health podcast. We hope today's episode was empowering and supported you in strengthening your mind-body connection.

We're your hosts, Jeanne and Jess. Please join us again next week as we continue to explore integrative approaches to wellbeing. Until then, take care.