Articles & Papers – INTEGRA CPD

Relational complications in current trauma therapy (Morit Heitzler & Michael Soth 2018)

Michael - Articles & Papers — Mon, 23 Jul 2018 14:31:18 +0000

Trauma therapy, aided by revolutionary neuroscientific understandings, has been very successful over the last 20 years or so, and has expanded enormously. New trauma therapies have proliferated, new tools, techniques and methodolgies have been developed, the reach and scope of treatable conditions has been extended and public and scientific acclaim (NICE guidelines) as well as financial success have followed (Ecker, 2012; Levine, 1997; Kalsched, 1996; Rothschild, 2000; Schore, 2003; van der Kolk, 1996).
Having extended their reach beyond the traditional focus on critical incident debriefing and single-event trauma, the modern trauma therapies, however, have reached a threshold. Increasingly, trauma therapists come into supervision distraught, frustrated and despirited because it is not working as it ‘should’.
Supervisees report that clients who initially present with circumscribed single-event trauma either cannot or do not respond well to standard trauma techniques like finding a safe place, body scans, mindfulness, or learning techniques for self-soothing. Many clients, although apparently desperate, fail to cooperate or exhibit active resistance. Some push and test the boundaries of therapy (e.g. demanding contact in between sessions), question or criticise the therapist, and generally create an atmosphere of suspicion and mistrust. Or they just fail to get better in terms of the reduction of trauma symptoms.
In response to these unexpected problems, therapists report confusion or incompetence, shock or frustration, or - when more intense - feeling powerless, used or worthless. Occasionally therapists make sense of their response in terms of vicarious traumatisation.

This paper is a collaboration between Morit Heitzler and Michael Soth from our shared vantage point as supervisors. Morit has been practising a variety of trauma therapies since the mid-1990s, integrating Babette Rothschild’s Somatic Trauma Therapy, E.M.D.R, Sensorimotor Therapy, Somatic Experiencing, Trauma Constellations and various other trauma therapies. Michael is known for integrating humanistic and psychoanalytic traditions to bring a more comprehensive embodied understanding to the relational vicissitudes of therapy (Soth 2005a).

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Book Review: “Somatic Experience in Psychoanalysis and Psychotherapy” by William F. Cornell (2015)

Michael - Articles & Papers — Wed, 23 Aug 2017 10:33:44 +0000

This book review was written for the journal Body, Movement and Dance in Psychotherapy, and you can find the 1500-word version there. But I got so engrossed with the book and the issues it raises, I wrote a whole discussion, plus I also included lengthy key paragraphs from the book. This piece here is therefore significantly longer than a book review, about 13000 words.

Abstract:
This is a long, long book review, which will probably become a separate article, as it goes way beyond commenting on the book itself. It became that long because I felt so inspired by the book that I seriously engaged with its substance. It is a book at the cutting edge of somatic psychology, and at the forefront of re-integrating the psychoanalytic and body psychotherapy traditions. Anybody interested in these topics needs to read this book.
For those of you interested in this integration, the book prompted me to engage with it for a whole week's worth of writing, i.e. expanding the book review that was required into a serious and comprehensive response (and I didn't, as Bill pointed out, even include commentary for what are arguably two of the most important chapters at the end of the book). For the first time in many years (since my chapter on embodied countertransference, really, 12 years ago), this book review therefore includes some ideas and notions which I have been teaching for quite a few years now, but have not set down in writing.
It addresses these ideas on a fairly abstract level, not readily applicable to the nitty-gritty of our practice, but it does address the question in some depth what might be required to get beyond switching and oscillating between the paradigms of the two traditions and get closer towards some integration.

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What Supports the Sustainability of our Practice as Therapists? – Part 2 (2015)

Michael - Articles & Papers — Fri, 16 Sep 2016 23:00:00 +0000

After some years of not writing very much, I have written a substantial article on this crucial topic: mainly based on years of supervision experience and seeing supervisees' practices struggle or flourish, I explore the key factors that influence how we process the 'emotional load' of our practice (which in turn affects its sustainability). The article includes some of the basic principles of an embodied-relational perspective, e.g. an awareness of relational stances as underpinning theories and techniques, the notion that the therapist will need to be drawn into the client's internal conflict (simplistically described as the client's 'habitual mode' versus 'emergency') and the therapist's habitual position. These ideas are foundational ingredients in the particular broad-spectrum integrative approach I teach, and thus a good introduction, as well as addressing the theme of the article. In its current form, the article is missing its conclusion - I will complete this during 2016, in preparation for publication in the BACP Journal 'Private Practice'. In the meantime, I welcome any feedback you may have, which may help me improve the final version and make it clearer and more accessible. The fourth and final part will be published later this year (2016).

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What Supports the Sustainability of our Practice as Therapists? – Part 3 (2015)

Michael - Articles & Papers — Thu, 15 Sep 2016 23:00:00 +0000

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Working with Sadism – an embodied relational approach (Morit Heitzler 2014)

Michael - Articles & Papers — Fri, 07 Feb 2014 00:00:00 +0000

Based on a presentation at CONFER in December 2014, this paper explores the complex identifications which occur in the therapist's countertransference when working with a horrifically traumatised client who had been on the receiving end of life-threatening sadism for a prolonged period in her teenage years. Morit questions her identification with the victim, and how she processes the trauma that she identified with as the therapist in and through her own body.

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We Are All Relational, But Are Some More Relational Than Others? (2013)

Michael - Articles & Papers — Mon, 10 Jun 2013 23:00:00 +0000

Discussant Paper in response to Ray Little: "The New Emerges out of the Old - An Integrated Relational Perspective on Psychological Development, Psychopathology and Therapeutic Action”. Building on Ray Little's integration of humanistic TA with both traditional and relational psychoanalysis, this paper explores both shared ideas and assumptions as well as reflecting critically from the vantage point of a wider broad-spectrum integrative perspective, with an emphasis on TA's sister tradition of Body Psychotherapy. The problems, inconsistencies and contradictions within the integrative project are discussed, with particular reference to our humanistic origins during the 1960's and their “partially reactive - differentiation against psychoanalysis, which leaves us with unresolved legacies in the form of fixed assumptions regarding both theory and practice, and key concepts like 'ego' and 'working alliance'. Taking the key notion of the therapist's 'equidistant position' between the 'needed' and the 'repeated' relationship as its starting point, this paper works towards 'enactment' as the central notion of relationality. In the process, a multiplicity of diverse therapeutic kinds of relatedness is affirmed as valid, and different notions of the 'relational' and inconsistencies and ambivalences in our integrative formulations are addressed. The aim is a more solid and robust integration which is grounded in a bodymind understanding of enactment as the paradoxical essence of therapeutic action.

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Broken Boundaries, Invaded Territories (Morit Heitzler 2013)

Michael - Articles & Papers — Thu, 07 Feb 2013 00:00:00 +0000

One of the most excruciating aspects of trauma is the invasion or collapse of boundaries, not just in the moment of trauma, but as lasting damage. Traumatised clients usually bring to therapy an ongoing background feeling of threat: both to physical and emotional survival and to their sense of identity. Not knowing where 'I' end and the 'Other' begins, creates chaos and confusion in the client's inner world, which echoes strongly in the therapeutic relationship. Therefore, most methods of trauma therapy are highly concerned with re-building and establishing safe, containing boundaries as the foundation of any therapeutic work. However, is it really possible to by-pass the client’s embodied experience of shattered safety by introducing safe therapeutic boundaries? Can we, as therapists, contain the impact of trauma without engaging with chaos, confusion and vulnerability in the consulting room? This paper explores the paradoxical nature of boundaries and containment and their role in trauma therapy.

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The Relational Turn in Body Psychotherapy (2012)

Michael - Articles & Papers — Sun, 10 Jun 2012 23:00:00 +0000

Based on an interview with Nancy Eichhorn in preparation for the 2012 International Body Psychotherapy conference in Cambridge, UK - she wrote it up, included her own comments and perspective and I then helped with the editing to get it to this published version: “The term 'relational' has recently achieved buzz word status. Therapists are quick to claim they are 'relational' because they see themselves as relating well to their clients and because they consider - quite rightly - that the 'quality of relationship' with their client/patient is crucial to the work. Books are written, conferences are held, workshops are offered based upon the increasingly widespread conviction that healing takes place in the relationship - 'it's the relationship that matters'. And it is indeed a precious achievement that the profession is now placing such significance on the relationship, rather than primarily on the supposedly 'correct' therapeutic theory or technique, whatever that may be. But unfortunately the apparent consensus across the profession around the centrality of the relationship in therapy is only skin-deep; the closer we look, the more apparent it becomes that being relational means profoundly different things to therapists from different approaches, so the old 'modality wars' between the approaches are alive and well, except they are now hidden and subsumed under different meanings of the term 'relational'.”

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Using EMDR with Various Types of Developmental Trauma (Morit Heitzler 2011)

Michael - Articles & Papers — Mon, 07 Feb 2011 00:00:00 +0000

Complex trauma is based on underlying developmental trauma. However, developmental trauma is a very broad, non-specific category. There are several typologies and classification systems of developmental trauma available, with various degrees of usefulness to EMDR practitioners. Having researched and assessed these different theories, in this workshop I will offer an integrative synthesis relevant to EMDR practitioners. An understanding of the different types of developmental trauma can enhance our work both in terms of faster and more accurate diagnosis of developmental issues and also in eliciting relevant material and designing interventions. To establish key features of the client’s developmental issues, we can use a holistic spectrum of physical, affective and cognitive factors, including the client’s posture and body language, habitual cognitions and attitudes and modes of relating and expression. Most developmental theories share a common view of the key factors of developmental trauma: the child’s developmental stage, the intensity of the traumatising event, the available resources etc. But they vary greatly in terms of underlying meta-psychology and techniques and interventions.

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Book Review: “Explorations in Transactional Analysis – The Meech Lake Papers” by William F. Cornell (2011)

Michael - Articles & Papers — Thu, 27 Jan 2011 00:00:00 +0000

This book review was written for the International Journal of Transactional Analysis: “Since his original psychotherapeutic trainings many decades ago in Radix and Transactional Analysis, Bill Cornell (working in Pittsburgh, US) has been at the forefront of the creative endeavour to integrate these approaches, and to bring a relational perspective to them. Inspired by the ideas and practice of relational psychoanalysis, he has been writing for many years, and the book reviewed here is a collection of papers and articles published over the last 20 years or so. The book is mainly addressed to the community of Transactional Analysis practitioners, and mainly written in that professional language, but has trail-blazing relevance also for body-oriented and relational practitioners, and anybody ready to be inspired by a continuously growing, developing, questioning and inquisitive mind. Michael brings his own similar - and in some ways parallel - development into the review, raising many general questions about therapy and therapy training, its history and future.”

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