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Working with Depression in the Body & Somatic Psychotherapy

Part of being human is to experience difficult emotions such as sadness, depression, anxiety, frustration, disappointment etc. Yet these emotions do not make us feel “good” and so we   have an unconscious tendency of not wanting to feel whatever we are feeling. We might brace, not breathe deeply and develop ways and means to numb ourselves and not feel. Commonly, this is what births addictions that range from food, alcohol, drugs, TV watching to excessive exercise, shopping, sex, and over working to name a few. However, these methods, at best, provide short-term relief, and at worst, create other issues for us, while lodging the disquieting feeling deeper into our psyche-soma, allowing it to eat away at our soul.

These obsessive self-numbing activities are called in psychological terms, “defenses.” In some cases, we are even lauded for being defended against our true experience, especially,  if we wear the mask of productivity as a   “workaholic” or have a great body because we are a “fitness freak.” Yet beneath that veneer, we chronically don’t feel so relaxed and much to our chagrin, nobody realizes our underlying state or empathizes with us.

Most mainstream psychological treatments for depression involve talk therapy, like psychoanalysis, which is known as the speaking cure or laced with some cognitive and behavioral interventions like CBT. While talk therapy, definitely has its relevance, sometimes, it maybe more palliative then corrective. The emotions will arise again and again and don’t really leave our system, unless they are fully felt, digested and processed through. Somatic therapy is a novel way to work towards a more permanent release of distressing emotions by increasing our capacity to really feel and tolerate troubled emotions in the body. In somatic therapy the understanding of what an emotion is expanded to psycho-motor holding patterns, like a permanent ache in the heart at the loss of a loved one or a knot in the throat due to not following one’s true calling, indicating a profound sadness that needs to be alleviated through the very physiology of the person.

These trying emotions are akin to muscular knots that need to be released. We are aware of the discomfort when we have a muscular knot in the neck; we often massage and stretch that part of the body to release the knot. Similarly, emotions metaphorically get knotted up and stuck in the body in half digested ways and need to be energetically discharged. Working with a somatic therapist allows one to truly embody, endure and expel difficult emotions in a self-regulating capacity. As the only way out of a distressing emotion is literally through it.

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What Is Stress, Stress Reduction, Understanding Stress Services By Sonera

Understanding Stress

What is stress?

Stress is an ubiquitous and multilayered phenomenon that is an entrenched reality of our daily postmodern lives. In effect, the stress response has played a significant role in the evolution of our nervous system and was crucial for our survival on this planet. As hunter gathers we experienced acute stress when there were life-threatening perils from the environment confronting us for e.g. a wild animal that crossed the path of our foraging ancestors. In such instances, the human body would mobilize itself defensively and activate the autonomic nervous system to a fight, flight or freeze response to meet the demands of the situation.

When an organism is stressed and in either fight of flight mode, there are profound alterations due to the enervation of the sympathetic branch of the autonomic nervous system. Noticeable psychophysiological shifts take place such as an increase in the heart rate, blood pressure, respiration, muscle tension, sweat activity in conjunction with a cascade of neuro-endocrinological alterations. The adrenal-hypothalamus- pituitary axis gets activated and there are rapid secretions of the stress hormone cortisol along with blood moving from the periphery of the body i.e. the limbs to the core i.e. to the heart and lungs.

These psychosomatic shifts allow the organism to speed up the action that needed to be taken, which in most cases was either confrontation or agitated escape. However, in freeze mode, which occurs in profound experiences of trauma, the parasympathetic nervous, system dominates and the body drops in pressure, temperature, and mobility simulating a corpse. From an evolutionary perspective, the freeze mode was useful as on occasion predators may loose interest if the prey is already dead.

According to one of the pioneers in stress research Hans Seyle, upto a certain point stress is beneficial as it helps us take effective action when facing challenging conditions and this can be understood as “eu-stress.” As such, the stress response to a particular point helps us become focused and efficient and enables us to get things done while simultaneously it protects us from negative consequences that might pertain to our survival. Yet there is a certain threshold value to stress and beyond that stress starts becoming “di-stress” and it starts pathologically eroding and wearing and tearing down our cardiac-respiratory, immune, gastrointestinal and muscular-skeleton systems.

Stress becomes di-stress when the stress response is provoked chronically, which is, unfortunately the zeitgeist of our times. Today acute stress is replaced by chronic stress, where a biological threat is now a psychological one. We react to not finding a parking spot before an important meeting in the same way our ancestors reacted to encountering an avalanche near a mountain that might crush them. Our bodies have not caught up with the evolutionary shifts in our life style and so in a nutshell, our bodies are over reacting to the mundane pressures and irritants of every day living.

Due to a revolution in our material culture, life is now becoming faster and faster . . . we have faster computers, faster cars, faster communications and often our bodies lag behind and we have to whip ourselves to keep up our pace, to perform, to meet deadlines and to make money. As a result, our default existential state is that of an incessant low-grade activation of the autonomic nervous system, which keeps the bodymind latently stressed.

In busy urban areas, especially, we are almost all the time normalized to being unconsciously stressed to the point that we do not realize that we are stressed. This psychologically predisposes us to depression, irritation, frustration, mood swings, and angry outbursts, all of which underscore psychoemotional disturbances. Simultaneously we are prone to worsening any pre-existing medical disorder and susceptible to creating the causes and circumstances for diseases to take root in our bodyminds, highlighting psychosomatic over drive. Diabetes, hypertension, colitis, chronic fatigue syndrome, fibromyalgia, eczema and ulcers are a few stress related conditions.

How do we know we are stressed?

         Since stress is an integral part of our lives, learning how to identify when we are stressed and what to do about de-stressing ourselves becomes paramount for our psychophysiological health and well being. Stress is a polyvalent experience and has cognitive, emotional, physiological and behavioral ramifications.

Below is a brief exegesis of some of the symptoms that manifest in us in relation to each category within which our stress response can be observed. It is important to recognize if any of these are being embodied in our own experience in order to assess how stressed one is and moreover, the ways in which we create stress for ourselves through our perceptions. Regarding a demand from the environment as either a threat or a challenge depends very much on our sense of self esteem and feelings of being resourced and resilient.

Cognitive dimensions: ruminating repetitive thoughts that are automatic and pessimistic; negative interpretations of life events; and a predisposition to play the victim.

Emotional dimensions: feelings of anxiety, panic, irritability, agitation, frustration, jitteriness, anger, impatience, overwhelm, being out of control

Physical dimensions: changes in heart rate, blood pressure, respiration, muscle tension, sweat activity, body temperature, fatigue, migraines, stomach aches, palpitations

Behavioral dimensions: lack of exercise, eating excessively, indulging in unhealthy foods, smoking, drinking, abusing drugs, unnecessary shopping

Some useful guidelines to regulate stress

       While we cannot prevent stress in our lives, we can definitely shift our emotional reactions to stress. In order to modify how we are oriented to overwhelming life events it is quintessential to make life style changes that allow us to slow down and relax. Some suggestions to safe guard ourselves from being chronically stressed are the following:

1)     Mediation, yoga, tai chi, qui gong

2)     Physical exercise

3)     Spending time in nature

4)     Healthy nutrition

5)     Listening to music and appreciating the arts in general

6)     Meditation and yoga

7)     Enjoying conviviality with family and friends

8)     Going on holiday

9)     Sleeping a full eight hours

10)   Having a massage

11)   Adopting a pet such as dog, cat, hamster, even having an aquarium

12)   Working with a mental health professional to see your patterns of stress, how you perpetuate them and ultimately to dis-identify with them

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What is Psyche Therapy & Psychological Counseling Services

I am often asked why do I call my practice “Psyche-Therapy” as opposed to “Psychotherapy?” Psyche-Therapy is a particular orientation some practitioners of mental health have when they work with their clients, where attention is given to the whole person instead of being isolated or reduced to a DSM-V diagnosis.

The word Psyche-Therapy comes from two ancient Greek terms “Psyche” and “Therapeia”

Psyche: is an ancient Greek term which can be appreciated as soul, spirit, life force . . . or more expansively the animating principle of the kosmos. Psyche in modern psychology encompasses both the mind and the brain and the conscious and unconscious aspects of the Self.

The term Psyche has specific meaning in the Greek mythological and symbolic context where it is often synonym for the human soul. In the myth (see links below) Psyche is a human princess who falls in love with a divine God, Eros. The legend is about love, enchantment, betrayal, heartbreak, pain, reunion and everlasting happiness, pretty much the existential journey of life. Metaphorical it is about the soul’s love affair with the Divine and the hardship the soul goes through to realize that union.

http://www.greekmyths-greekmythology.com/psyche-and-eros-myth/

or

http://www.greeka.com/greece-myths/eros-psyche.htm

Therapeia: is another ancient Greek term that connotes healing, treatment, curing . . . Therapy, the modern English term is etymologically derived from Therapeia and encompasses vast fields such as pharmacological therapy to physiotherapy. Therapy then is a generic word that simply underscores a mode or method of working with a field to help catalyze results within the individual that are rejuvenating.

So Psyche + Therapy = Psyche-Therapy= a holistic therapeutic facilitation engaging the myriad conscious and unconscious layers of the Self.

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Mindfulness and Eating, Mindfulness & Conscious Eating

Conscious Eating: Re-evaluating our responses to food

The context of food in our lives

      As the festive season culminates in the onset of the New Year, we might invariably find ourselves ritualizing these transitions and celebrations with food and wine. Food is a necessity for our life and eating is a quintessentially primal activity whose roots lie deep in our evolutionary past. The ingestion and digestion of food is a nonnegotiable activity that is intimately weaved into the very rhythms of our daily lives and is an important arena of gratification where we relate and bond with others.

Food has been articulated as a life giving force in numerous traditions, from Ayurveda, Chinese Medicine to coeval nutritional science. Moreover, a significant number of the world’s cultures and religions have sacaralised the act of eating. From a biological perspective, our bodies need the right type of food to function properly as diseases and compromised health conditions have been scientifically linked with malnutrition.   Furthermore, individuals suffering from diabetes, cholesterol, heart disease, obesity, neuro-endocrinological disorders, digestive issues, cancer, kidney and liver disease all need regulated diets. In such circumstances, paying attention to the act of eating invariably starts taking on more importance than simply filling one’s stomach with tasty bites and is central to our health and well being.

Hunger: the drive to eat

Getting to know our subjective sense of hunger then becomes an important part in consciously eating. Understanding how we eat, when we eat and why we eat is necessary to correct our unstable relationship to food. Conventionally, hunger is understood as a physiological drive, which underscores an organic void or depletion within us signaled by a fall in blood sugar or a rumble in the stomach, indicating that the body is in need of nutrition. Yet, in a deeper sense hunger is an existential state that drives one consciously and unconsciously to want to eat food and functions on multiple levels from biological to emotional to spiritual.

Today, satisfying the polysemic phenomenon of hunger, in urban metropolitan areas has become increasingly easier due to the 24/7 accessibility we have to food. Over appreciating the value of the instant gratification good food provides us, our post-modern psyche has imbued food with a relevance that goes beyond physiological survival, making it food a principle source of pleasure and comfort We eat sugary, fatty, fried and salty foods not to fill our stomachs only but to help us deal with stress and assuage other disturbing emotions such as depression, loneliness, boredom, anxiety and anger.

Mindless Munching

The experience of stress and the need to de-stress is subliminally played out endlessly in multiple distress- gratifications cycles that seek to balance out an over-activated nervous system, but invariably ends up distorting the natural hunger of the body to a mechanical, unconscious and insatiable deprivation that hijacks the physical response to food. On a more rudimentary level, we “feel bad” so we eat food to “feel good.”

          Eating, as the pursuit of comfort, in a fast paced, hyper stimulated and highly pressured epoch, becomes a coping mechanism to face the numerous demands made on us on a daily basis.  Behaviorally this is more common than not. Have you every sat in front the TV or in the cinema with a tub of popcorn or some other snack and have ploughed through the whole thing in the course of the film? Or been at a cocktail party sipping a drink and chatting with a friend while devouring bowls of nuts and chips? Or polished off a whole bar of chocolate while sitting front of your computer screen trying to make our work deadlines? In such instances we are not realizing how fast or how much we are eating. This is called mindless munching or the act of grinding down edibles with a mind contemplating everything but the food one is eating.

Conscious Eating

An antidote to this would be to mindfully observe and understand our experience of hunger and by that token our relationship to food. By being “mindful,” one pays nonjudgmental attention to the moments when and why one wants to eat, the food one eats and the act of one’s eating. By being focused on how we feed ourselves we can aid a more sophisticated self awareness of ourselves and our subliminal desires and drives that motivate us to eat as well enable a balanced relationship to food and body size. The reasons why we over eat, starve, grow fat, become skinny or on a more severe note become anorexic, bulimic or obese have a lot to do with how we are psycho-emotionally processing our sense of self and the stresses we encounter. Hence it is very imperative to pay attention to the emotional states behind one’s eating habits and working with them if they are disturbed.

For those of us seeking meaningful and healthy ways of being-in-the-world, our relationship to food, (equivalently) along with other quotients of well being, such as spiritual practice, psychological growth, exercise, time spent in nature, nurturing relationships, and aesthetic appreciation, to name a few, is of paramount importance. Below are some guidelines to help restore us to consciously eating:

1)      Before eating do a baseline self- check on your hunger level before eating. Ask yourself where do you feel the hunger? How hungry are you?

2)      Involve all your senses when you eat i.e. really see, smell, taste and feel the food you are eating

3)      Serve yourself moderate helpings of food

4)      Really chew your food and break it down

5)      Eat in a slow fashion to prevent over eating

6)      Don’t skip meals

7)      Avoid all distractions when you are eating

8)      Eat an organic plant based diet as much as possible for yours and the planet’s health

9)      Therapeutically work with yourself or with a mental health professional to reduce your stress, depression, anxiety, anger and boredom levels

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Making Friends With Our Emotional Distress & Mental Health Disorder

Most of us are pegged on the pleasure-pain continuum bobbing up and down the scale between hedonism and agony. We do not want to feel sadness, loneliness, and alienation; instead we want to feel happy, peaceful and content. Our instinct is to resist, get rid of, repress, dissociate or defensively do away with difficult emotions as they hurt. Yet these efforts to dispense with emotional distress are often clumsy and psychologically ineffective. As the pain we feel will return and and we can feel it deep in out bodyminds’ if we pay attention.

Another way, to deal with emotions, even disturbing ones might be to practice what the Sufi mystic Jalaluddin Rumi says to “welcome them all!” By allowing difficult emotions to arise and by simultaneously training our capacity to tolerate distress, we can become equanimous in the face of any mental storm.

http://persweb.wabash.edu/facstaff/hulenp/sperit/poetry/rumi/guesthou.html

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Mindfulness Treatment- Addictions, Anxiety and Panic Disorder

Mindfulness: more than just a buzzword

Mindfulness is an ancient Buddhist practice of paying attention to moment to moment experience in a nonjudgmental way.  Contemporarily, it has been highly regarded and recognized by western psychology, psychiatry, and cognitive neuroscience as having a deeply therapeutic value and literally transformative impact on the mind/brain. Mindfulness is about developing self-awareness and is the cornerstone of all psychological and spiritual work.

Before starting a session, I always begin with mindfulness meditation to help gather and center my client. This is because mindfulness allows one to get in touch with oneself as an observer behind the whirlpool of distracted thought, emotion, and sensation. It deeply anchors one in the present moment and allows us to really experience and study our selves.

Research states that mindfulness or rather the capacity of the mind to direct the brain, through trained attention and focus, can shift our neural architecture. Through mindfulness we can dis-identify with negative thoughts and behavior patterns and allow us to replace them with positive ways of being-in-the-world. It gives us choice and frees us from our habitual modes of reacting and judging. Today mindfulness has been used to treat many disorders from depression, anger management, addictions, anxiety and panic disorders, chronic pain and stress reduction to name a few areas.

https://www.youtube.com/watch?v=HmEo6RI4Wvs

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Meditation & Psychotherapy- Mental Health Counseling Services

Meditation and Psychotherapy

In today’s post-modern era, cutting edge understandings of mental health are emerging through an integration of both eastern spirituality and western psychology. Both traditions work with the mind, subjectivity and consciousness in different and complimentary ways. To do psychological work, one needs to be fully present in the moment and conversely, to do spiritual work, one needs to make peace with one’s personal wounds and traumas. Together like two wings of the same bird that move synchronically, they bring about self-knowledge and transformation. Combining meditation and psychotherapy will go beyond the individual limitations that shore up against each approach, namely, the shadow (i.e. disowned, split of aspects of one’s personality which are either positive or negative), which meditation does not integrate and conversely, the exaggeration of the wounded ego in conventional psychotherapy.

In my own therapeutic practice I have noticed that by both, supporting my clients in their mindfulness practice as well as facilitating psychological processing with some cognitive and behavioral shifts, has helped their capacity to self- regulate, become aware and integrate their rejected parts and most significantly, suffer less.

http://www.buddhanet.net/psymed1.ht

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Nature As My Co-Therapist & Mindfulness Therapy for Depression

NATURE AS MY CO-THERAPIST

I always encourage my clients to grant themselves solitary time in nature and moreover,  like to do retreats or therapeutic work in the wilderness with them. Consciously, spending time in the natural world is one of the most healing presents you could give yourself. Being-in-nature with a client serves as a holding environment, where a client can let go, relax and go deeper into their process. Since most of my work is in urban environments, occasionally, just doing a session in a park has a profound effect on the therapeutic exchange.

Scientifically, research has shown that time spent in the biosphere helps lift depression, brings down blood pressure, alleviates mental fatigue, relieves stress and stimulates the parasympathetic nervous system, to name a few benefits.  Although, there are definite psychophysiological shifts when immersed in nature, if we are busy with our smart phones, iPods, iPads or are engaged in compulsive thinking the positive effects of being in nature are reduced.

Our minds in their habitual thought patterns often veer us towards the future or the past, dissociating us from our environment and diminishing our capacity to stay with what IS.  In order to prevent ourselves from unconsciously hijacking our nature experiences with nonstop thinking, I recommend practicing mindfulness meditation when immersed in mother Earth. Please use this link to read about different nature meditations you can practice.

http://www.meditationoasis.com/how-to-meditate/simple-meditations/nature-meditations/

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Dream Remembrance,  Practice Of Dreamtime in Mumbai, India

Many indigenous societies, over space and time have given importance to dreams and have regarded them as messages from the Gods, oracles, spirit communications, a reservoir of important symbols, sources of deep wisdom and portals of spiritual experience. Different cultures, ranging from the Dream temples of the Hellenistic era to Tibetan dream yoga practices to the practice of Dreamtime, prevalent in many Australian aboriginal cultures, have given dreaming a central place in their religious and healing traditions.

Dreams represent the mytho-poetic and aesthetic processes of our psyches . . . Dreams are embodied images that reflect where we are in our lives, and what our most intimate and existential concerns, hopes, and fears are. Dreams don’t tell us what to do, but point us towards where we need to give attention to in our waking lives.

Bridging the dream life to the waking life, then, is an important kernel of psyche-therapeutic work as dreams are, as stated by Freud, “ the royal road to the unconscious.”

I always encourage my clients to remember and record their dreams in a dream journal and often facilitate them in processing their dreams in sessions so as to allow for a deeper, self-illuminating process.

Yet, often clients complain that they cannot remember their dreams, if this might be the case, please refer to the below link to allow for dream remembrance.

http://www.dreams.ca/recall.htm

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Health Psychology- Mind, Body, Stress & Anxiety Disorder

The term “health psychology” pertains to our emotional and psychophysiological responses to our personal conditions of health and illness as well as thoughts, emotions and  behaviours  that either contribute to or hinder our well-being.

Often in the  Cartesian world of conventional  bio-medicine, individuals are split up as bodies and minds, implicitly  implying that the mind and the body are separate entities and not connected. This is because whatever the ailment whether it is cancer, auto immune diseases, irritable bowl syndrome, obesity etc.  the physical body is always treated with surgery and pharmaceutical drugs but the mind or rather the psyche is often left out and rarely given therapeutic attention.

This is unfortunate on two accounts, firstly,  people have very strong emotional reactions to their illnesses and physical disabilities,  which need to be treated as individuals could spiral into clinical depression, severe anxiety, anger or frustration in relation to not “feeling well,” which could hamper their recovery.

Secondly, our bodymind is an integrated system whose reciprocity needs to be acknowledged. Today, illnesses  such as fibromyalgia as well many neuro-endocrinological disorders are all pointing towards psychogenic causes of these conditions, as is the whole field of psychoneuroimmunology which emphasises the inter-connections between the psyche, nervous system and immune system.

The role of stress and anxiety in the cause and proliferation of illness ranging from cancer to coronary disease to diabetes  is getting highlighted, as last year in the US alone more 300$ billion dollars were spent on stress-related medical ailments. It is interesting to note that in contrast to conventional western medicine,  nonwestern medical systems such as Ayurveda and Traditional Chinese medicine have always given importance to and have inquired into the subjective states of those who were sick and have underscored a deep connection between the mind and the body.

Drawing from Eastern philosophical  systems of understanding the psyche-sensorium, I often work with people who are suffering or surviving from cancer or have recently recovered from heart attacks or those who have had Bariatric surgery with mindfulness-based cognitive therapeutic interventions. Mindfulness-based cognitive therapy helps  facilitate my clients to regulate their disturbing emotions regarding their physical conditions and enables them to tolerate  distress with more ease. Accepting and working with our emotional reactions to dis-ease has a huge impact for our recovery and ongoing maintenance of health. While not a substitute for medical attention, health-oriented psychotherapeutic attention is a very important complement and adjunct.

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2 thoughts on “Health Psychology”

MauricioMARCH 22, 2015 AT 1:52 PM REPLY

I have a LOT of experience with “mindfulness.” Did it for 30 years. Taught for a while. But that’s not the imtnaprot point. The imtnaprot point is study design.Where are the controls? What’s the demonstration that the subjects were doing anything other than sitting around? How much of the time they were practicing were they actually being “mindful?” Did they receive any other training (often, mindfulness studies include various types of group teaching or therapy or other support)? Are there any counterfactual cohorts (e.g. people who get a massage, or take some drug, or watch a comedy on TV)?In other words, while I’m a fan of the practice, I’m NOT a fan of almost all of the studies that have been done.At a recent cognitive psych conference, the Dalai Lama was a special guest. Many of the researchers were ecstatic, because they’re true believers in meditation (and, often, Buddhism). Only a few of the attendees pointed out the bias of many of the researchers and asked why it was imtnaprot to have a Tibetan Buddhist at a cog-psy conference.

sonera jhaveri

I think your raising some very important points here. Yes, there is always a researcher bias – true objectivity remains a fantasy, but phenomenologically and qualitatively, individuals (including myself) have felt shifts in their attention, concentration, awareness of “when the mind is running off” etc and this has enabled people(my clients and myself) more choice and the ability to dis-identify with unwanted or unproductive thoughts and behaviours. There is a lot of work done by Dan Siegal and others where MRI’s and PET scans of advanced meditator’s brains have been undertaken which show enhanced activity in the pre-frontal orbital complex. While I can understand that you may not agree with the methodology of double blinded random trials, there is evidence that mindfulness facilitates new ways of knowing and garnering novel neural pathways. . . . of course, this is subjective to practice. Yes, subjects could be just “sitting around” but not those who really get and understand the value of watching their mind . . . I don’t see any harm about the Dalai Lama being a special guest as I appreciate inter-cultural dialogue.