Somatic psychology

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Somatic psychology or, more precisely, "somatic clinical psychotherapy" is a form of psychotherapy that focuses on somatic experience, including therapeutic and holistic approaches to the body. It seeks to explore and heal mental and physical injury and trauma through body awareness and movement. Wilhelm Reich was first to try to develop a clear psychodynamic approach that included the body. [1]

Contents

Several types of body-oriented psychotherapies trace their origins back to Reich, though there have been many subsequent developments and other influences on body psychotherapy, and somatic psychology is of particular interest in trauma work. Trauma describes a long-lasting distressing experience that can be subconsciously stored and bear upon bodily health. Somatic psychology seeks to describe, explain and understand the nature of embodied consciousness and bridge the Cartesian mind-body dichotomy. [2]

The term somatopsychic was introduced by the German psychiatrist Maximilian Jacobi (1775–1858). [3]

Origins

The body and the mind have always been seen either connected, one thing or two separate things. This has become one of the main problems in philosophy. Many philosophers can be cited writing about it, such as Descartes with his dualism. Freud, which is usually seen as one of the most influential figures preceding psychology, also saw the body as central within his theory. For him, the ego was first of all a “body ego”. [1]

Somatic psychology was first studied by Wilhelm Reich, an Austrian physician that initially was Freud’s student. His approach has been influenced by Salvador Ferenczi, a Hungarian neurologist who also studied with Freud and gave insight to Reich to write his book Character Analysis. [2] Reich was also interested in the origin of psychosomatic illness where George Groddeck, a friend of Ferenczi, influenced him a lot. He was the pioneer of somatic psychology from a medical point of view. Reich used vegetotherapy to name somatic psychology as it was touching upon the nervous system. [4] Reich's approach goes beyond traditional therapies, it emphasizes the significance of the body on therapeutic processes, by exploring the connections between the body, brain and mind to avoid certain tensions. His discovery continues to influence contemporary therapy processes and is still relevant in today’s practice. [5]

Trauma storing in the body

Since somatic clinical psychotherapy tries to heal mental and physical injury and trauma through body awareness, it is important to know what happens in the body when trauma is experienced to be able to help the patients. [1] Trauma can manifest in the body and lead to mental and physical health issues. Whenever someone experiences trauma, it can manifest in the body and lead to mental and physical health issues. The way trauma can lead to those health issues is closely connected to the effect it has on the hypothalamic-pituitary-adrenal (HPA) axis, since experiencing trauma leads to the HPA getting sensitized. The HPA describes the interaction between the hypothalamus, pituitary gland, and adrenal glands and is responsible for controlling body functions such as breathing, heartbeat and blood pressure as well as the endocrine stress response. [6]

In every person that feels distressed, the amygdala sends a distress signal to the hypothalamus which activates the sympathetic nervous system and the hormone epinephrine gets released which triggers the fight-or-flight response. As long as the brain perceives the situation as dangerous, the hypothalamus releases corticotropin-releasing hormone (CRH) which leads to the release of adrenocorticotropic hormone (ACTH) which then leads to the release of cortisol. In a healthy person the HPA axis ensures that if the threat passes, the cortisol release is stopped which dilutes the stress response. If a person experienced trauma, due to the HPA axis being sensitized the HPA axis stays activated and the stress response can become chronic. [7]

The constant release of the stress hormones can lead to physiological problems, like heart damage, diabetes and digestive issues through the excessive release of epinephrine and cortisol. Psychological effects such as anxiety, depression and disorders such as post-traumatic stress disorder (PTSD) can be triggered as well by the constant stress response of the body. To help patients with those mental and physical health issues there are different somatic therapy techniques. [3] [6]

Techniques

Somatic therapy techniques are commonly used to treat cases like Post-traumatic stress disorder (PTSD), and complex post-traumatic stress disorder. Failed prior therapy techniques enforced the need for more sophisticated ways of caring for the condition, through which Cognitive Behavioural Somatic Therapy was introduced. [8]

Somatic Experiencing (SE) is used as such a treatment for PTSD. It focuses on interoceptive, kinesthetic, and proprioceptive experiences, which can resolve symptoms of chronic and traumatic stress. [9] This bottom-up process focuses on the psycho-physiological consequences of the traumatic event and aims to recalibrate the dysregulation of the bodily responses in an indirect way. [10]

This technique aims to help regulate cognition and body, and is therefore powerful in addressing clinical dissociative disorders. Such sensorimotor techniques are often versatile and highly individual, created and adjusted for the patient, ranging in differing physical movements targeting the patient's weak point in an effort to build self-awareness and self-regulation. [11] Such bottom-up movements stimulate self-awareness and self-regulation [10] , like dance, breathing, and even a full-body workout depending on the individual's condition and need. [11]

Combining somatic psychology with group therapy can be effective for attachment disorders, transference impasse, and trauma. Incorporating somatic components through sensory awareness and movement of the body, is most effective for patients who experienced physiological trauma. [12] Teaching body awareness through monitoring physiological responses or behaviors, achieves or improves self-regulation, stabilization and a close connection to themselves or others. [13]

Efficiency/positivism

The effectiveness of somatic psychology and experiencing is still unclear. There are studies that show beneficial data points of somatic experiencing on PTSD-associated symptoms and depression. Somatic experiencing also showed positive impacts on affective and somatic symptoms, and general well-being outside of PTSD-treatment. [10] Different limitations are encountered within studies that show positive results, such as small samples and not following rigorous methodological criteria. Insufficient research has been done to evaluate and compare the differential impacts of various modalities, despite the results of those modalities being relatively similar. [14] The data is encouraging, but more objective studies are required to completely comprehend the efficacy of somatic psychology and experiencing, and improving the method-specific factors. [10]

Criticism

Few studies have shown the beneficial effects of implementing somatic psychology into PTSD treatment [10] [9] [8] , but the conclusion on the effectiveness of somatic therapy has yet to be established. Assessing the efficacy of that method, requires a broader examination of scientific research on body-oriented psychotherapy. [15] Another problem regarding the subject is an increased potential for re-traumatization of a patient. [16] While somatic experiencing can be healing, it is also accessing trauma stored deeply in the body. Being such a fickle matter, if treated by an inefficiently trained practitioner, may lead to resurgence of traumatic symptoms. [17] [16]

Related Research Articles

Post-traumatic stress disorder (PTSD) is a mental and behavioral disorder that develops from experiencing a traumatic event, such as sexual assault, warfare, traffic collisions, child abuse, domestic violence, or other threats on a person's life or well-being. Symptoms may include disturbing thoughts, feelings, or dreams related to the events, mental or physical distress to trauma-related cues, attempts to avoid trauma-related cues, alterations in the way a person thinks and feels, and an increase in the fight-or-flight response. These symptoms last for more than a month after the event. Young children are less likely to show distress, but instead may express their memories through play. A person with PTSD is at a higher risk of suicide and intentional self-harm.

<span class="mw-page-title-main">Hypothalamic–pituitary–adrenal axis</span> Set of physiological feedback interactions

The hypothalamic–pituitary–adrenal axis is a complex set of direct influences and feedback interactions among three components: the hypothalamus, the pituitary gland, and the adrenal glands. These organs and their interactions constitute the HPA axis.

<span class="mw-page-title-main">Dialectical behavior therapy</span> Psychotherapy for emotional dysregulation

Dialectical behavior therapy (DBT) is an evidence-based psychotherapy that began with efforts to treat personality disorders and interpersonal conflicts. Evidence suggests that DBT can be useful in treating mood disorders and suicidal ideation as well as for changing behavioral patterns such as self-harm and substance use. DBT evolved into a process in which the therapist and client work with acceptance and change-oriented strategies and ultimately balance and synthesize them—comparable to the philosophical dialectical process of thesis and antithesis, followed by synthesis.

Psychological trauma is an emotional response caused by severe distressing events that are outside the normal range of human experiences. It must be understood by the affected person as directly threatening the affected person or their loved ones with death, severe bodily injury, or sexual violence; indirect exposure, such as from watching television news, may be extremely distressing and can produce an involuntary and possibly overwhelming physiological stress response, but does not produce trauma per se. Examples include violence, rape, or a terrorist attack.

Acute stress reaction and acute stress disorder (ASD) is a psychological response to a terrifying, traumatic or surprising experience. Combat stress reaction (CSR) is a similar response to the trauma of war. The reactions may include but are not limited to intrusive or dissociative symptoms, and reactivity symptoms such as avoidance or arousal. It may be exhibited for days or weeks after the traumatic event. If the condition is not correctly addressed, it may develop into post-traumatic stress disorder (PTSD).

Somatic Experiencing (SE) is a form of alternative therapy aimed at treating trauma and stress-related disorders, such as PTSD. The primary goal of SE is to modify the trauma-related stress response through bottom-up processing. The client's attention is directed toward internal sensations,, rather than to cognitive or emotional experiences. The method was developed by Peter A. Levine.

Complex post-traumatic stress disorder is a stress-related mental disorder generally occurring in response to complex traumas, i.e., commonly prolonged or repetitive exposures to a series of traumatic events, within which individuals perceive little or no chance to escape.

Gender is correlated with the prevalence of certain mental disorders, including depression, anxiety and somatic complaints. For example, women are more likely to be diagnosed with major depression, while men are more likely to be diagnosed with substance abuse and antisocial personality disorder. There are no marked gender differences in the diagnosis rates of disorders like schizophrenia and bipolar disorder. Men are at risk to suffer from post-traumatic stress disorder (PTSD) due to past violent experiences such as accidents, wars and witnessing death, and women are diagnosed with PTSD at higher rates due to experiences with sexual assault, rape and child sexual abuse. Nonbinary or genderqueer identification describes people who do not identify as either male or female. People who identify as nonbinary or gender queer show increased risk for depression, anxiety and post-traumatic stress disorder. People who identify as transgender demonstrate increased risk for depression, anxiety, and post-traumatic stress disorder.

Childhood trauma is often described as serious adverse childhood experiences (ACEs). Children may go through a range of experiences that classify as psychological trauma; these might include neglect, abandonment, sexual abuse, emotional abuse, and physical abuse, witnessing abuse of a sibling or parent, or having a mentally ill parent. These events have profound psychological, physiological, and sociological impacts and can have negative, lasting effects on health and well-being such as unsocial behaviors, attention deficit hyperactivity disorder (ADHD), and sleep disturbances. Similarly, children whose mothers have experienced traumatic or stressful events during pregnancy have an increased risk of mental health disorders and other neurodevelopmental disorders.

Prolonged exposure therapy (PE) is a form of behavior therapy and cognitive behavioral therapy designed to treat post-traumatic stress disorder. It is characterized by two main treatment procedures – imaginal and in vivo exposures. Imaginal exposure is repeated 'on-purpose' retelling of the trauma memory. In vivo exposure is gradually confronting situations, places, and things that are reminders of the trauma or feel dangerous. Additional procedures include processing of the trauma memory and breathing retraining.

Memory and trauma is the deleterious effects that physical or psychological trauma has on memory.

<span class="mw-page-title-main">Effects of stress on memory</span> Overview of the effects of stress on memory

The effects of stress on memory include interference with a person's capacity to encode memory and the ability to retrieve information. Stimuli, like stress, improved memory when it was related to learning the subject. During times of stress, the body reacts by secreting stress hormones into the bloodstream. Stress can cause acute and chronic changes in certain brain areas which can cause long-term damage. Over-secretion of stress hormones most frequently impairs long-term delayed recall memory, but can enhance short-term, immediate recall memory. This enhancement is particularly relative in emotional memory. In particular, the hippocampus, prefrontal cortex and the amygdala are affected. One class of stress hormone responsible for negatively affecting long-term, delayed recall memory is the glucocorticoids (GCs), the most notable of which is cortisol. Glucocorticoids facilitate and impair the actions of stress in the brain memory process. Cortisol is a known biomarker for stress. Under normal circumstances, the hippocampus regulates the production of cortisol through negative feedback because it has many receptors that are sensitive to these stress hormones. However, an excess of cortisol can impair the ability of the hippocampus to both encode and recall memories. These stress hormones are also hindering the hippocampus from receiving enough energy by diverting glucose levels to surrounding muscles.

Early childhood is a critical period in a child's life that includes ages from conception to five years old. Psychological stress is an inevitable part of life. Human beings can experience stress from an early age. Although stress is a factor for the average human being, it can be a positive or negative molding aspect in a young child's life.

PTSD or post-traumatic stress disorder, is a psychiatric disorder characterised by intrusive thoughts and memories, dreams or flashbacks of the event; avoidance of people, places and activities that remind the individual of the event; ongoing negative beliefs about oneself or the world, mood changes and persistent feelings of anger, guilt or fear; alterations in arousal such as increased irritability, angry outbursts, being hypervigilant, or having difficulty with concentration and sleep.

<span class="mw-page-title-main">Post-traumatic stress disorder among athletes</span> Prevalence of PTSD among athletes

Posttraumatic stress disorder (PTSD) is a cognitive disorder, which may occur after a traumatic event. It is a psychiatric disorder, which may occur across athletes at all levels of sport participation.

The term functional somatic syndrome (FSS) refers to a group of chronic diagnoses with no identifiable organic cause. This term was coined by Hemanth Samkumar. It encompasses disorders such as fibromyalgia, chronic widespread pain, temporomandibular disorder, irritable bowel syndrome, lower back pain, tension headache, atypical face pain, non-cardiac chest pain, insomnia, palpitation, dyspepsia and dizziness. General overlap exists between this term, somatization and somatoform. The status of ME/CFS as a functional somatic syndrome is contested. Although the aetiology remains unclear, there are consistent findings of biological abnormalities, and major health bodies such as the NAM, WHO, and NIH, classify it as an organic disease.

Epigenetics of anxiety and stress–related disorders is the field studying the relationship between epigenetic modifications of genes and anxiety and stress-related disorders, including mental health disorders such as generalized anxiety disorder (GAD), post-traumatic stress disorder, obsessive-compulsive disorder (OCD), and more. These changes can lead to transgenerational stress inheritance.

Trauma-sensitive yoga is yoga as exercise, adapted from 2002 onwards for work with individuals affected by psychological trauma. Its goal is to help trauma survivors to develop a greater sense of mind-body connection, to ease their physiological experiences of trauma, to gain a greater sense of ownership over their bodies, and to augment their overall well-being. However, a 2019 systematic review found that the studies to date were not sufficiently robustly designed to provide strong evidence of yoga's effectiveness as a therapy; it called for further research.

<span class="mw-page-title-main">Post-traumatic stress disorder and substance use disorders</span> Association of PTSD and substance dependencies

Post-traumatic stress disorder (PTSD) can affect about 3.6% of the U.S. population each year, and 6.8% of the U.S. population over a lifetime. 8.4% of people in the U.S. are diagnosed with substance use disorders (SUD). Of those with a diagnosis of PTSD, a co-occurring, or comorbid diagnosis of a SUD is present in 20–35% of that clinical population.

In the context of the nature-nurture debate, interactionism is the view that all human behavioral traits develop from the interaction of both "nature" and "nurture", that is, from both genetic and environmental factors. This view further holds that genetic and environmental influences on organismal development are so closely interdependent that they are inseparable from one another. Historically, it has often been confused with the statistical concept of gene-environment interaction. Historically, interactionism has presented a limited view of the manner in which behavioral traits develop, and has simply demonstrated that "nature" and "nurture" are both necessary. Among the first biologists to propose an interactionist theory of development was Daniel Lehrman. Since then, numerous interactionist perspectives have been proposed, and the contradictions between many of these perspectives has led to much controversy in evolutionary psychology and behavioral genetics. Proponents of various forms of interactionist perspectives include Philip Kitcher, who refers to his view as "causal democracy", and Susan Oyama, who describes her perspective as "constructive interactionism". Critics of interactionism include major figures in behavioral genetics such as Arthur Jensen, Robert Plomin, and philosopher Neven Sesardic.

References

  1. 1 2 3 Krueger, D. W. (1989). Body self & psychological self: A developmental and clinical integration of disorders of the self. Brunner/Mazel.
  2. 1 2 "Somatic Psychology: Meaning and Origins". Meridian University. Retrieved 2024-05-15.
  3. 1 2 Functional Somatic Symptoms in Children and Adolescents. Palgrave Texts in Counselling and Psychotherapy. 2020. doi:10.1007/978-3-030-46184-3. ISBN   978-3-030-46183-6.
  4. ↑ Boadella, D. (1990). Somatic psychotherapy: Its roots and traditions. A personal perspective. Energy and Character, 21(1).
  5. ↑ Blackstock, Joel (2023-05-20). "The Curious Case of Wilhelm Reich". Taproot Therapy Collective. Retrieved 2024-05-15.
  6. 1 2 "How Trauma Affects the Body | Psychology Today". www.psychologytoday.com. Retrieved 2024-05-15.
  7. ↑ "Understanding the stress response". Harvard Health. 2011-06-15. Retrieved 2024-05-15.
  8. 1 2 Baranowsky, Anna B.; Gentry, J. Eric (2023). "Trauma practice: A Cognitive Behavioral Somatic Therapy". Hogrefe Publishing GMBH (4th ed.). ISBN   9781616765927.
  9. 1 2 Payne, Peter; Levine, Peter A.; Crane-Godreau, Mardi A. (2015-02-04). "Somatic experiencing: using interoception and proprioception as core elements of trauma therapy". Frontiers in Psychology. 6: 93. doi: 10.3389/fpsyg.2015.00093 . ISSN   1664-1078. PMC   4316402 . PMID   25699005.
  10. 1 2 3 4 5 Kuhfuß, Marie; Maldei, Tobias; Hetmanek, Andreas; Baumann, Nicola (January 2021). "Somatic experiencing – effectiveness and key factors of a body-oriented trauma therapy: a scoping literature review". European Journal of Psychotraumatology. 12 (1). doi:10.1080/20008198.2021.1929023. ISSN   2000-8066. PMID   34290845.
  11. 1 2 Reuille-Dupont, Stacy (2021-04-03). "Applications of somatic psychology: movement and body experience in the treatment of dissociative disorders". Body, Movement and Dance in Psychotherapy. 16 (2): 105–119. doi:10.1080/17432979.2020.1844295. ISSN   1743-2979.
  12. ↑ Payne, Peter; Levine, Peter A.; Crane-Godreau, Mardi A. (2015-02-04). "Somatic experiencing: using interoception and proprioception as core elements of trauma therapy". Frontiers in Psychology. 6: 93. doi: 10.3389/fpsyg.2015.00093 . ISSN   1664-1078. PMC   4316402 . PMID   25699005.
  13. ↑ Cohen (2011). The Application of Somatic Psychology to Group Psychotherapy. pp. 397–413.
  14. ↑ Brom, Danny; Stokar, Yaffa; Lawi, Cathy; Nuriel-Porat, Vered; Ziv, Yuval; Lerner, Karen; Ross, Gina (June 2017). "Somatic Experiencing for Posttraumatic Stress Disorder: A Randomized Controlled Outcome Study". Journal of Traumatic Stress. 30 (3): 304–312. doi:10.1002/jts.22189. ISSN   0894-9867. PMC   5518443 . PMID   28585761.
  15. ↑ Bloch-Atefi, Alexandra; Smith, Julie (2015-07-01). "The effectiveness of body-oriented psychotherapy: A review of the literature". Psychotherapy and Counselling Journal of Australia. 3 (1). doi:10.59158/001c.71153.
  16. 1 2 Levine, Peter A. (2010). In an unspoken voice: how the body releases trauma and restores goodness. Berkeley: North Atlantic Books. ISBN   978-1-55643-943-8. OCLC   496956960.
  17. ↑ Van der Kolk, B. A. (2014). The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma. Viking

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