Calendar – Large Groups (20 +)

Calendar – Large Groups (20 +) 2014-09-01T16:12:55+00:00

Jan
27
Sat
2018
Exeter: Integrative Trauma Therapy – Weekend Workshop with Morit Heitzler @ The Wheelhouse
Jan 27 @ 10:00 – Jan 28 @ 17:00

An Embodied Integration of Trauma Therapy Approaches

If some of your trauma clients show resistance, manifest stuckness or get caught in hidden dissociation or re-traumatisation dynamics, or you encounter unexpected ruptures, impasses or enactments, these workshops are for you.

CPD Training Weekend with Morit Heitzler

This weekend is designed for practising counsellors and therapists who have some previous training and experience with trauma work. It is best described as an 'intermediate' workshop, for therapists who have completed basic training in one of the modern trauma therapies: Somatic Trauma Therapy (Babette Rothschild), Somatic Experiencing (Peter Levine), Sensorimotor Therapy (Pat Ogden), EMDR, EFT etc.

Is this workshop for me?

If you have trained and have been practising such trauma therapies for a while, you are likely to have encountered clients with varying degrees of receptivity, producing a mixture of results and creating a variety of problems. You may also have questions regarding the application of theory to practice.

Many of these problems and questions can usefully be addressed through an integration of trauma therapies, each of which have their special strengths and weaknesses.

The relational subtleties underpinning the working alliance

Although many of these modern therapies claim to be comprehensive, often presenting themselves as applicable to all kinds of trauma, this is not what we find in practice. Human beings present complexities that no protocol or manual can legislate for, especially when it comes to the – often unconscious - internal web of trauma reactions and associations in the psyche. It is in these very individual responses to the therapy and to the therapist that complications arise which are not catered for by theory and technique.

The client reads – or mis-reads – the therapist’s facial expressions, their speed, timing and intonation, their gestures and postures, and scans these for the warmth, professionalism, acceptance, knowledge or encouragement they might contain, or conversely for the coldness, lack of care, judgement, shame or impatience which the client may have come to expect from others.

It is the client’s subliminal reading of such cues and messages which infuses the therapeutic interaction with relational dimensions that can make or break the treatment, but that are not necessarily part of the manual. It is these all-too-human subtleties which either provide a foundation for a productive working alliance, or create doubt and ambivalence, or lead to outright ruptures, regardless of how competent the practitioner, or how appropriate the treatment procedure in and of itself.

Do you experience these obstacles with your clients?

If some of your trauma clients show resistance, manifest stuckness or get caught in hidden dissociation or re-traumatisation dynamics, or you encounter unexpected ruptures, impasses or enactments, these workshops are for you.

If some of your trauma clients do not respond well or only very slowly to the kind of approach that you know works well with other clients, what are the factors that can account for these differences?

If some of your trauma clients are having negative reactions against you or the treatment, or you detect that an atmosphere of mistrust, shame or scepticism interferes with the work, how can we tackle these obstacles?

Why do we need an integration of trauma therapies?

Trauma therapies tend to fall into a few recogniseable categories along a spectrum of the therapist’s relational position, in terms of they define themselves and their public presentation:

  • some of the new trauma therapies define themselves as treatments, with clear protocols and procedures, administered by a knowledgeable expert; here the therapist is understood - by both parties - as an authoritative and directive doctor figure, requiring cooperation;
  • in some other therapies the atmosphere is more oriented towards healing and recovery through the therapist’s nurturing presence; here the therapist is positioned in a more motherly role, still an expert or an authority, but with an emphasis on feeling and support.

Because trauma makes us feel helpless and regressed, the therapist taking a motherly or fatherly re-parenting role can be very helpful and often this is necessary to establish a working alliance at all. However, developmental trauma makes any kind of re-parenting task more complicated, as the psychoanalytic tradition teaches us. Even in single event trauma, the internalised drama triangle of victim, persecutor, rescuer can become constellated in the therapy, and complicates what might otherwise be a more straightforward helping or healing relationship.

We cannot take it for granted that the client will experience the therapist’s authority as benign. This has serious implications for the working alliance and for the success of the treatment. When the therapist’s authoritative interventions and directions are received by the client through the lens of transferential complications, the methods and techniques of the various trauma therapies cannot be expected to work in the same way that in principle we know they can. Then the same techniques that we can usually so powerfully rely on are not sufficient to overcome stuckness, resistance, dissociation and avoidance.

It is then that a relational integration of different therapeutic approaches and perspectives becomes increasingly necessary and helpful. The different traditions and perspectives, and their different relational underpinnings, complement and cross-fertilise each other in a way which gives us as therapists more flexibility, robustness and resilience. This can make a big difference to the effectiveness of our work.

Are the new somatic trauma and energy therapies suitable for complex and developmental trauma?

Over recent years, the new somatic trauma therapies and the energy therapies have been extending their reach beyond clearly defined single-event trauma later in life to include early and developmental trauma. This extension has been driven forward on the assumption that the same principles apply to all trauma and to all trauma therapy. However, increasingly we find that this is a flawed assumption: it hinges on the question whether the client has a healthy, non-traumatised personality structure in the first place that will allow them to form a trusting attachment to a therapist. Without that bond, we cannot assume the client’s readiness and willingness to receive the therapist’s interventions, however competent and effective these are in principle.

In complex trauma, the issue of transference becomes unavoidable, as the client is likely to interact with the therapist via their traumatising early blueprint for relating. The client then perceives and experiences the therapist through the lens of that blueprint. This tends to complicate the working alliance and can undermine the therapeutic process in a way that is not sufficiently attended to in the recently developed trauma therapies. Therefore, early developmental trauma constitutes a qualitative difference to single-event trauma. Psychodynamic approaches have, of course, always appreciated the transference dimension, but have not worked sufficiently through the body.

Integrating somatic-embodied and psychodynamic perspectives

Therefore, an integration between somatic and embodied approaches on the one hand and psychodynamic perspectives on the other is becoming crucial in the field of trauma therapy. We increasingly understand how even clearly circumscribed single-event trauma can trigger early developmental trauma unconsciously and complicate and de-rail treatment, even when on the surface it appears fairly straightforward.

Psychodynamic and other ‘talking therapy’ practitioners can benefit from the somatic therapies in situations where clients’ reflective capacities are limited, as language and other cognitive functions are impaired by unconscious or unspoken trauma. The client’s mind is then not fully available for interpretation, collaborative exploration or associative play, as traumatic freezing and dissociation are dominant, and talking therapy doesn’t reach deeply enough into the client’s experience.

Treatment and the Relational Container

If as trauma therapists we can combine powerful methods and somatic techniques on the one hand and an awareness of the working alliance and the client’s reaction against therapeutic authority on the other, our capacity to co-create the kind of relational container necessary for the work takes a quantum leap. To some extent this also depends on the therapist’s awareness of their own body and embodiment, as the relational container depends strongly on ‘right-brain-to-right-brain’ attunement. This is only available to the therapist who is connected with her own subtle and subliminal physical and neurological responses.

In her practice Morit has found that the effectiveness of both EMDR and somatic trauma therapy interventions crucially depends on the timing of pre-reflexive communication, and the synchronisation between the client’s and therapist’s autonomous nervous systems. The difference between an intervention which elicits a relieving release of feeling on the one hand, or a suggestion which triggers in the client a re-traumatising implosion on the other may only be a couple of seconds. The therapist wants to be so attuned to the intensifying arousal in the client’s bodymind that they can offer an expressive and interactively regulating channel for it before it can tip into an internal roller coaster. Intervene too early, and the therapist is seen as anxious and over-controlling; on the other hand, intervene too late and the client’s autonomic process has – lemming-like – taken itself over a cliff into a traumatic pattern. This kind of attunement is only possible if the therapist is sufficiently attuned to her own neurophysiological and vegetative processes that she can micro-track her own arousal and shut-down.

However, many therapists – especially when their initial training was in one of the ‘talking therapies’ - are too habitually disembodied themselves and remain largely unaware of the client’s - and more so their own - subliminal and energetic processes to create that kind of moment-to-moment bond and responsiveness. As a result, treatments tend to lack spontaneity and significant moments are missed, giving the client a sense that they are indeed being ‘treated’, but in a somewhat formulaic fashion. Fortunately, in Morit’s experience, many therapists can learn quite quickly to extend their usual emotional sensitivities into the somatic and energetic realm.

The subjective and relational foundations of ‘treatment’

However appropriate the theoretical models and practical techniques are that we use in trauma work, these are only as effective as the pre- and non-verbal bonds, the reciprocal emotional attunement and the mutual intersubjective understanding which the two human bodyminds in the therapeutic relationship can co-create. It’s the meeting between these two idiosyncratic, unique subjectivities which – for better or for worse – provides the foundation for ‘treatment’. By ignoring – or attempting to remove - the unpredictable subjective human factor from treatment, we destroy the essence of what makes therapy work. Of course, the therapist’s identity is not free from its own wounds and traumas and shadow aspects – how can therapy be made to work when all we have at hand is the frail, imperfect instrument of the therapist’s human self?

The therapist cannot be – in fact, for attunement and mutual identification to work: must not be – invulnerable, ‘all sorted’, plain clinically effective, administering the same uniform treatment to each client, whatever the manual says. However, the therapist’s non-objective subjectivity does engender all kinds of relational vicissitudes which we need to find ways of apprehending: how do we monitor and bring awareness to the intersubjective mess co-created when the arrow of the client’s wounding seeks and finds and hits the therapist’s wounding?

It is here that differentiated bodymind awareness takes us beyond mental speculation into a realm of embodied experience where we have a whole realm of otherwise ignored and neglected information that makes the complex task of tracking ‘right-brain-to-right-brain’ attunement less impossible.

Vicarious traumatisation and the therapist’s own bodymind

The recognition that trauma therapy is hazardous for the practitioner is now widely established, but it is much less clear what we can do about it. Unlike medical practitioners who tend to learn to dissociate from their patients and the pain they encounter, we do not want to lose our relational sensitivity. But unless we can learn to recognise the symptoms, effects and emotional load of the therapeutic position, we cannot effectively process and digest the bodymind impact we experience through exposure to our clients’ trauma. Understanding somatic resonance, projective identification and evacuation of dissociated trauma states helps us become aware of the consequences of unconscious processes in the therapeutic relationship, and the conflicts we are likely to absorb in our work.

Tracking and processing these unconscious dynamics, we gain precious insight into our client’s inner world and their internal relationships, which provide the background context in which recovery and healing occur. This allows us to understand more deeply how current and past trauma interlink and generate protective mechanisms which block and slow down treatment.

About the workshop facilitator:

Morit has been developing an integrative, embodied and relational approach to trauma therapy for the last 20 years. She began to encounter these issues in her practice long before they became widely apparent, and engaged with these dilemmas at the root of trauma therapy in a way which has helped her forge a robust integration. Over the years, she has given many presentations which address transference-countertransference dynamics in trauma work, and the dangers and transformative potential of destructive enactments. She is known for using her own body and embodiment as a resource in surviving such enactments and turning them into deeper understanding of her client’s inner world as well as the therapeutic process. This perspective now underpins her supervision of trauma therapists and sheds light on common ruptures, stuckness and failures of treatment, especially cases of inadvertent re-traumatisation.

Feb
24
Sat
2018
Brighton: The Body Speaks – 1-day Conference @ Brighthelm Centre
Feb 24 @ 10:00 – 17:00

A conference with presentations by Margaret Landale, Ewa Robertson & Michael Soth

Embodied Conversations in Psychotherapy

The rise of body-oriented approaches to psychotherapy has seen the discipline shift from being the kooky poor relation of psychoanalysis in the 1970s and 80s, to a vital component in the therapeutic understanding of all therapists over the course of the last 20 years or so.

An increased understanding and appreciation of neuroscience alongside the development of effective approaches to treating trauma have shown that being able to work effectively with embodied presentations and communications will increase our effectiveness as therapists and offer greater and safer choices for our clients and patients, particularly for those who are struggling with traumatic experiences or somatic symptoms.

In this one-day conference with three leading experts in the field of body-mind psychotherapy - Margaret Landale, Ewa Robertson, and Michael Soth - we will explore ways in which to attune to the embodied presence of both ourselves and our clients and how to facilitate body-mind communication and dialogue. There will be particular attention paid in our final presentation of the day to the skills required by non-body psychotherapists who might wish to respond to embodied moments that occur in the process of talking therapy. A Q&A Panel Discussion will round off the day.

 

Michael's presentation: Techniques for expanding talking therapy into bodymind process

Even the best therapeutic intervention can only be as good as the client's receptivity to it, and that is not mainly a left-brain issue. Whether a therapist's words 'land' in the client is not only a question of their content and meaning. Whether or not a therapist's response is being received gets determined, largely pre-reflexively, by the client's whole bodymind system, and that depends interpersonally on the 'felt sense' of the working alliance. Readiness for change (i.e. neuroplasticity) occurs at the edge of the window of tolerance (which Michael will introduce as having both intra-psychic and intersubjective dimensions). Practically, this often boils down to charged moments of heightened affect when the working alliance is in crisis and enactments are manifesting.

As a therapist, how do you 'catch' and make use of these moments that are characterised by spontaneous bodymind processes, which occur between client and therapist before, alongside and in spite of left-brain reflections and words?

In this presentation Michael will focus on the principles of embodied- relational practice, not so much in terms of body-oriented techniques that can be used to deliberately pursue heightened affect, but mostly in terms of embodied ways of being and working in those critical moments that arise spontaneously as part of the normal talking interaction between client and therapist. Rather than grafting new 'body techniques' onto their existing style and practice, the aim of this presentation is to help therapists to become more deeply embodied in moments of crisis and to craft spontaneously and creatively embodying interventions from within enactments.

Jun
17
Sun
2018
Bristol CPD Workshop: Relational dynamics in body-oriented psychotherapy @ Quaker Meeting House
Jun 17 @ 10:00 – 16:30

Organised by the Association for Core Process Psychotherapy:

This follow-up workshop is another ideal opportunity for an introduction to Michael’s work, and specifically how he approaches the integration of the paradigm clash between the humanistic and psychodynamic traditions. It is an affordable workshop on a crucial topic, as many integrative therapists struggle to integrate these paradigms rather than oscillate between them, both in their work and in supervision.

Following on from a first workshop on the topic in June 2017, the Association for Core Process Psychotherapy is organising a second workshop, to continue and deepen the theme. It will be possible for you to join this day without having attended the first workshop - in preparation you will have access to the teaching materials from the June workshop. Most participants will be a Core Process therapists, which will give the day an emphasis on the body-mind and psychosomatic connection, and how attention to the two bodies in the therapeutic relationship (or better: the two ‘bodyminds’) can provide the experiential foundation for the integration of paradigms.

Exploring the tension between ‘authentic’ and ‘transference’ relating

In the lineage of Body Psychotherapy, we come across a set of diverse and to some extent confusing and contradictory assumptions as to what we mean by therapeutic relating and the therapeutic relationship. On the whole, the whole range of body-oriented work as practiced today clearly belongs to the humanistic tradition, with its emphasis on authentic/dialogical and empathic/reparative relating. This sits alongside influences from the psychoanalytic tradition, notably the work of Reich and his ideas about working with transference, as well as his quasi-medical and scientific attitude to treatment (which he shared with Freud). These different paradigms of relating are quite difficult to integrate and bring together, as they are based on polarised attitudes and stances in terms of one-person and two-person psychologies.

That raises the question as to what we mean by being ‘relational', especially in recent years, when that notion has become increasingly fashionable, and is in danger of becoming diluted. As psychotherapists working in the body-oriented traditions, we have the potential to bring a more substantial, embodied and complex notion of relating to the talking therapies.

This workshop is an opportunity to explore your own experience of the tensions between the polarised humanistic and psychoanalytic traditions, and how you integrate them. This tension hinges around the essential conflict between ‘authentic relating’ and 'working with the transference' - two principles which many of us find equally valid and want to equally do justice to in our work.

It has been understood and acknowledged for decades that any direct and directive work with the body, especially if it includes touch, intensifies the transference. However, psychoanalysts have contested that by using directive body-oriented interventions, body-oriented therapists are minimising and sidestepping the transference. In fact, all therapies that are relying exclusively on an empathic, attuned, heartfelt connection are open to that psychoanalytic challenge (keeping things too cosy, encouraging regression or over-dependency, avoiding the negative transference) and the question of whether this is in the client's best interests.

When our intention is to work with the client’s ‘character’, i.e. with all the embodied levels of developmental injury, across the whole bodymind, how do these different traditions and paradigms of relating get in each other's way or complement each other and how might they create an integrative synergy?

Recommended preparatory reading:

Relating To and With the Objectified Body: This was my first public attempt at spelling out some of the difficulties and pitfalls of Body Psychotherapy, as I had increasingly become aware of them in the late 1980's and the early 1990's. From being securely ensconced in the body-oriented subculture, it took years to recognise and formulate the hidden 'medical model' assumptions, the implicit idealisation of the body, the simple reversal of mind-over-body into body-over-mind and how I was in the habit of turning my therapeutic position into an "enemy of the client's ego". Here I state for the first time how it is perfectly possible for Body Psychotherapy to exacerbate the body/mind split whilst intending to 'heal' it.

Humanistic or psychodynamic - what is the difference and do we have to make a choice ? by Lavinia Gomez: This brilliant and helpfully clarifying article by Lavinia Gomez tackles the difficult theme 'humanistic or psychodynamic' in a non-dogmatic and fairly comprehensive fashion. Lavinia poses some challenging questions, especially for integrative therapists: how free and fluid can we allow ourselves to be in terms of combining, mixing and matching different therapeutic traditions, and what are the possible negative effects of switching approaches, especially in terms of the client's sense of containment? - This paper is essential reading for this workshop, as is my response at the time:

Is it Possible to Integrate Humanistic Techniques into a Transference-Countertransference Perspective? (2004): Whilst agreeing with Lavinia's challenges to the integrative project and the mixing of humanistic and psychodynamic paradigms, 
I argue against one of Lavinia's central conclusions, based on a different interpretation of what we might mean by 'containment' and 'enactment'.

What therapeutic hope for a subjective mind in an objectified body? This is my first attempt at formulating the 'relational turn' in Body Psychotherapy, and taking the integration of humanistic and psychodynamic paradigms further. This is the abstract: Our modern attempt to re-include the body in psychotherapy – as necessary and promising as it is – brings with it the inevitable danger that we import the culturally dominant objectifying construction of the body into a field which may represent one of the last bastions of subjectivity, authenticity and intimacy in an increasingly virtual world. Edited from my presentation to the UKCP conference 'About A Body’, this paper addresses the question how embodied subjectivity – Winnicott’s “indwelling of the psyche in the soma” - can be found within a relational matrix pervaded by disembodiment and self-objectification.