I’m here joined by Kate Lauth. She is a sensorimotor psychotherapist at Insight Counseling & Wellness. We’re excited to bring some sensorimotor information to our listeners. 

For those who don’t know, sensorimotor psychotherapy is a body oriented talking therapy. It was developed by Dr. Pat Ogden and is a blend of thought-based approaches with physical interventions.  

I was a personal trainer and in grad school and noticed that as much as I was healing my psyche, there were aspects of my whole self that weren’t being addressed. I thought that exercise and personal training would address those concerns and in some ways they did. Weightlifting and cardiovascular work has changed my system’s ability to respond to stress, tolerate distress, and become stronger, but it was sensorimotor that completed the picture. 

I worked with a lot of people who weren’t feeling safe in their bodies. Sensorimotor gives that foundation to help someone first know that they have a body and then learn from their body. We use movement and nervous system regulation and nutrition and things like that to really treat the whole person.  

After grad school, I did level one training because it was just such a powerful modality of healing.  It felt like magic as a client, especially when sensorimotor was combined with inner child work. 

Sensorimotor therapy started in the seventies by Dr. Pat Ogden who noticed that many patients were reliving the past and that the past was alive in their bodies. Treatment methods only seemed to trigger those reminders. She began forming the principles of sensorimotor psychotherapy by joining somatic therapy, which means body, and psychotherapy, into this method for healing the disconnection between mind and body. 

After working with the Hakomi Institute with Dr. Ron Kurtz, she founded the Sensorimotor Psychotherapy Institute where therapists are trained on reintegrating the mind and body. We were once whole, it’s through life events that there’s a disconnection. 

A little bit about the foundational principles of sensorimotor.  

There are four guiding values of sensorimotor psychotherapy; organicity, unity, nonviolence, and mind body spirit holism.  

Organicity is honoring the intelligence and the wisdom of the body. Creating a condition for clients to trust and heal from within.  

Unity Acknowledges that we’re all interconnected and we’re all interdependent. There’s no hierarchy there where we’re humans that are relating.  

Nonviolence. Broadly means the therapist has an attitude of non-judgment. There’s no criticizing or pathologizing or giving advice. 

Holism means acknowledging that mind, body and spirit are constantly interacting, and they all make up our experience as humans. All significant mental, emotional, and spiritual experiences are registered in the body 

Does sensorimotor psychotherapy treat trauma, or does it treat attachment issues?  

First, a few key words.  

Attachment begins with a child using their primary caregiver as a secure base to explore the world. With a strong attachment, the child has a safe haven. When they feel ready, they go out into the world. 

Next, hyper arousal and hypo arousal. Hyper arousal means our bodies are in high alert, even if the danger is not present. Hyper arousal can look more like anxiety, worry, flee, fight. Hypo arousal is an under response, our system starts to immobilize, freeze, or shut down. Depression, feeling numb, and dissociated are hypo aroused states.  

Finally, trauma. Trauma is an event or a series of perceived threats that are overwhelming to your system, your body, your mind. Janina Fisher says, traumas imprint is both psychological and somatic. Long after the events are over the body continues to respond as if danger were present. This can look like changes in your heart rate, breathing, digestion, chronic pain, tension, or numbness. These responses are because our body and our nervous system perceive threats before we can cognitively process them. 

Next, let’s touch on the triune brain, a model based on the division of the brain into three distinct regions.  

The frontal cortex: the part of our brain that’s in charge of logic, reasoning, and language. 

The midbrain, where the limbic system, our threat response system, is located. Emotions and attachment also lie here. We refer to this as the mammalian brain, because all mammals have this area of the brain.  

Lastly, the oldest and most ancient area of our brain, called the reptilian brain. This is where automatic instinctive responses, freeze, shut down, or dissociate, come from. 

When we experience a threat, our midbrain sends a signal to our thalamus, which oversees sensory information. Our thalamus then sends a signal to our amygdala, which is the fire alarm for danger. The Amygdala then tells our nervous system to respond. This all happens in milliseconds. 

When we’re in the front of our brain, we make explicit memories, ones we remember. When we’re living in the middle or back of our brains, the prefrontal cortex shuts down, holding memories implicitly in the body. Oftentimes, people who experience trauma might not have an explicit memory of the event. 

When we’re in utero, our nervous system and body are forming and organizing around the energy of our mothers and their nervous systems, shaping the adult we’re going to be because the body remembers implicitly. If you experienced a trauma when you were five and it feels like you’re reliving something in the present moment, you are. You’re body doesn’t know you’re not five anymore. It is activated now.  

How do we ground ourselves back to the present, to bring the prefrontal cortex back online, to assess if I’m safe right now?  

Mindfulness.  

Awareness of my racing heart or tension in my body. Listen to your body. That’s a moment where you can follow through on that survival response. Often trauma gets truncated in the system when those survival responses are not allowed to be followed through on. It can get stuck. 

Let’s go into hijacking a bit. 

Being hijacked means the reptilian brain took over really fast and flooded someone either with an emotion or thoughts or a body sensation. 

We have what’s called top-down processing. Top-down processing means you’re working first with the front of your frontal cortex, then some midbrain emotion and then processing the body’s response. Cognitive Behavioral Therapy is a very popular and well-respected, top-down processing technique where if a thought is not helpful, you look at what triggers the thought, and you look to challenge the thought and reframe it hoping that this helps the psyche feel safe.  

The thought ‘I’m all alone in the world.’ Top-down processing would start with looking at that thought. Is that logical? Are you really alone in the world? What triggered that thought?  Can we reframe? Can we practice saying I’m not alone in the world? I know my partner loves me, but they just don’t have time to take on that task.  

That’s helpful to work on, but what it doesn’t do is acknowledge the body’s response. A lot of traditional talk therapy uses top-down processing only. The way we bring the body into the room is through bottom-up processing.  

Bottom-up processing is reptilian brain up through the limbic system and the emotional processing system to the front of our brain. This approach acknowledges that the body responds first to everything, way faster than our thoughts. Using this approach, we can start to see how our physical behaviors and actions create the foundation of our mental actions. Our body’s experiences are shaping our emotions and thoughts.  

If a client comes in and they feel overwhelmed and alone, how would you approach that from a bottom-up perspective?  

As the client, I would close my eyes to see what my body would feel like in that moment. Perhaps my heart is racing and there’s tension in my body, but I’m feeling stuck. I would just create awareness.  

Was I mindful in that moment or was I already overwhelmed? If I’m not mindful, that means I’m not in the front of my brain and I’m not going to remember the event as well. So maybe when my partner says, I’m really busy too. I wasn’t able to read the sincerity in their voice. I couldn’t look them in the eye and see that they care about me. I would explore how my system reads their responses. Maybe they crinkled the brow the same way a parent did or maybe they looked away and my system shifted based on their response. Be curious what was being informed? How did I feel? What sensations were present?  

We would look at it through the five minutes leading up to an event and as much as we can remember during. Then, how I felt afterwards. How did my body organize that experience afterwards? How did my body influence my emotions? How did my emotions influence my narrative and my story? Did I feel more shut down? Where did I have a fight response and say you never helped me. Maybe my system responded with, I really am all alone in the world, there’s proof. Then it shuts down further and disconnects  

I really work to observe rather than interpret what is happening, just be curious. Yes, a good sensorimotor therapist would say, how does your body feel right now? We work with what’s happening right now. Even if the event is in the past, because it lives in the body right now. Maybe, I don’t recall what happened but I’m living with these symptoms of hyper arousal or hypo arousal of anxiety or depression, and they come out of nowhere or it’s chronic.  

You don’t have to know why, let’s just work with what is here. We don’t have to rehash the past.  We don’t need to be scared or avoidant of what’s going on. We can allow it to happen and give ourselves the space to be present with that experience. Often then, it moves through us. When you allow that emotion to be processed and you feel those feelings, then you move on.  

When we’re truly hijacked or triggered the front of our brain gets shut down to preserve energy for survival. That’s why people say, I know I’m supposed to breathe deep, but I don’t remember to do it when I’m overwhelmed.  You don’t have access to your front of your brain at that moment. So how can we connect to the body?  

Just observe with curiosity. A lot of the work I do in sensorimotor psychotherapy with my clients is building resources so that we can get to the front of our brain where cognitive interventions work. The goal is to help the body, heart, and soul figure out a new way of being. 

Kate and I are going to pause here. We’re thankful to be sharing this information with our listeners and we’re excited to have you join us again next week, where we continue our conversation about bringing the body into therapy.