Chapter summary: an overview of concepts, methods, and outcomes in the context of treatment examples involving higher levels of emotional intensity, from earlier phases of development of the practice of embodying emotion.
To develop an understanding of emotional embodiment work, let’s begin with real-life examples. This chapter and the next will present clinical examples of emotional embodiment, touch upon some key concepts that underlie the approach, and give the reader a feel for how the work developed over time. I will not be discussing in depth the specific skills for embodying emotion in the chapters in this section. A detailed treatment of the skills involved can be found in part III.
I first noticed the effectiveness of emotional embodiment treatments when working with clients experiencing high levels of emotion, and these are the case studies presented in this chapter. In the next chapter, I present examples of treatments working with clients involving lower levels of emotion, through which I learned the breadth and versatility of the effectiveness of emotional embodiment. The names and locations of some individuals have been changed to honor their requests for anonymity.
Petra started having panic attacks at the age of seven. As she remembered it, she was playing in her room by herself when she heard a voice speak to her from her lower right abdomen: “Petra, it is time for you to die!” This was the start of fourteen years of suffering that involved panic attacks, depression, difficulty in school, and stress in low-paying jobs after high school. Petra went to work, came home, ate, and slept up to twelve hours a day. She did not want her parents to leave the house when she was at home because she did not feel safe. When I saw her for the first time, I was in the Netherlands facilitating a six-day training. At the end of the first day, her uncle, who was an assistant at the training, asked me to see Petra to determine if I could be of any help.
What I remember particularly about that first meeting was how dispirited her parents appeared to be. It made sense that they were not hopeful. Petra was their only child, and they had done everything they could think of to help her: medical doctors, psychiatrists, and psychoanalysts. At the age of twenty-one, Petra had already been through two psychoanalytic treatments and was on multiple medications. When I told her I could see her twice at the most during my short stay in her country and that she might have to do follow-up work with someone I referred her to, Petra was very clear with me that she did not want to do more psychotherapy. Instead of insisting that she should agree to see another therapist to ensure she was adequately cared for after the work we did together, I told her that she had a much better chance of improving if she did the things I taught her during our sessions.
The work I and others had done in Indian fishing villages among the survivors of the 2004 tsunami had taught me that clients could be active participants in their own healing.1 Over a period of two years after that devastating natural disaster, I led five international teams of therapists to the state of Tamil Nadu to offer treatments, education, and training for the survivors and those involved in their recovery. Follow-up surveys from one of our trips to India found that respondents who practiced skills they had learned during treatment sessions were much more likely to report a greater reduction in their symptoms.
Petra’s uncle had told me that she had had two surgeries soon after she was born in order to correct a life-threatening congenital defect in her large intestine—the same location where the voice announcing her time of death appeared to come from. I was curious about how that area might be involved in the formation of her panic attacks. I knew from my own experience and the experience of those I have treated that symptoms often involve dysfunctional patterns in parts of the body that have been most traumatized. An example from my own life: because I nearly died during my own birth because I was stuck for a long time in a birth canal too small for my head, whenever my degree of physical or emotional stress increases beyond a certain extent, the right side of my head has a tendency to become constricted and uncomfortable. This symptom is less evident now than it used to be, but it still makes its presence felt to this day.
I told Petra it was possible that unresolved traumatic patterns from her lifesaving surgeries might have something to do with her panic attacks. She was not surprised; one of her two psychoanalysts had made that connection already. I told her it is not unusual for energy to concentrate in an area of the body that has experienced trauma and to increase in intensity until it reaches an upper limit and triggers a symptom such as a panic attack, to reduce the intensity and bring about relief. The level of intensity at which the symptom forms is also referred to as the symptom threshold. I then suggested the following, both as a treatment and as a self-help protocol: whenever she felt stress in her life, no matter the cause, she should learn and practice ways to distribute the stress in her body so that it did not build and concentrate in the lower right abdominal area beyond the symptom threshold, which could trigger the voice and an ensuing panic attack.
To start, we chose to practice how she could cope with her work situation, as her boss was often a source of stress. I asked her to imagine a difficult interaction with her boss and then to notice the buildup of constriction, arousal, stress, and discomfort in her lower right abdominal area. I guided her to work with the physiological defenses in her abdomen and legs to redistribute the unpleasant arousal, stress, and discomfort she felt in her abdomen to adjacent areas of the legs using simple tools of awareness, intention, movement, and self-touch. I invited her to notice how this helped ease the intensity of the unpleasantness in the abdominal area, and how that area eventually settled. All of this did not take very long. I asked her to practice what we had done during the session on a daily basis whenever she felt that she was getting stressed, regardless of the cause, and to come back in five days, on the last day of my training. During the treatment, I found Petra receptive enough to my suggestions; but I also found her somewhat skeptical, which was understandable, given how long she had suffered without relief.
When Petra came back five days later, I noticed a change in her. She appeared to be in a better mood. I asked her whether she had been able to practice what she had learned in the previous session, and what changes, if any, she had observed in herself since. She said she did “the exercise” regularly, and her mother had observed that her energy had somehow changed for the better. What she told me next, however, surprised me. Petra had suffered from severe constipation all her life and was able to eliminate only once or twice a week, with a great deal of difficulty. Since our session, however, she was greatly relieved to be able to have an easy and regular bowel movement every morning. The “exercise” seemed to have really worked, she said, adding that she did it as often as she could. She now really believed in “the method” and was looking forward to learning more about it.
The method I taught her, on the basis of what I had observed had worked well for her during the first session, was simply this: Whenever she felt stress building up in her abdomen, she should move her legs to relieve any constriction in them. Then she should place one hand on her abdomen and the other on first one leg and then the other, to draw the energy down and distribute it more evenly between her abdomen and her legs, and then observe the changes that occur in her body, especially for the better. For example, the high level of arousal might automatically come down, and the body might feel better overall.
Years later, such quick changes in long-term, persistent, and serious symptoms in some clients no longer surprise me as much as they did when I saw Petra, even for symptoms such as asthma, migraine, and chronic pain, when they are psychophysiological in origin. People can form serious psychophysiological symptoms, such as chronic fatigue, at low levels of emotional stress. Psychophysiological (formerly called “psychosomatic”) symptoms are physical symptoms that are caused or exacerbated by psychological conditions. (This book uses the term “psychophysiological symptoms” instead of “psychosomatic symptoms” because the latter has acquired a negative meaning of being only in one’s head.) Teaching people how to experience emotional stress in a more distributed and regulated way within the larger container or space of the body can achieve a number of beneficial outcomes:
Back then, knowing less than I do now, I could not rule out the possibility that Petra’s constipation cure was just a “transference cure”—a sudden cure that can happen because the client idealizes the therapist or the method—which does not always last. Putting those thoughts aside, during my second session with Petra I turned my focus to the work she and I could do before I left the country the following day. It seemed as though she had come prepared to jump in with both feet and do a lot, encouraged by what she had been able to achieve in just a week. As soon as we started to process a stressful situation in her life, she reported a more coherent emotion of fear emerging in the chest area. Emotions in the body often emerge first in the chest area. That she could sense it there right away was a good sign that she had developed a greater capacity to not shut her body down in the face of the difficult emotion of fear. It is not unusual for people to continue to heal on their own and develop greater capacity for emotions once they learn how to use more of the body to process them.
Emotion can be thought of as an assessment of how a situation affects or impacts the well-being of the whole body.2 This implies that the more the impact is distributed throughout the body, the easier it is to tolerate it subjectively. We have a tendency to use physical and energy defenses, such as constriction, to limit emotions to a few places in the body as a way of coping with them. All of us have a tendency to resort to this strategy for relief quite often, in a misguided attempt to reduce our necessary suffering. It is all too understandable, given our shared aversion to unpleasant experiences. Physical and energy defenses against emotions such as constriction, low arousal, or numbing can disrupt the various flows (blood, nervous system, lymphatic, interstitial or intercelluar fluid, and electromagnetic and quantum energy) that are vital for brain and body regulation and physical and psychological well-being. In this context, I use the phrase “expanding the body” to mean working to undo such physical and energy defenses to improve all of these vital flows from one part of the body to another, to help distribute the emotional experiences to more places in the body to make it more bearable, and to improve the level of regulation throughout the brain and the body to resolve psychophysiological symptoms.
As I taught Petra how to “expand” her body in order to expand the emotion of fear, and to stay with it and tolerate the sensations in more places in her body, the level of fear as well as the psychophysiological arousal became extremely high—so high that I wondered if I had helped Petra to open up too much too fast. This made me very concerned that she might decompensate or fall apart during or after the session.
We hung in there—Petra and I and her uncle, who was observing the session—for a long period of time, as the fear turned into terror, a response clearly disproportionate to the situation we had started with. I got Petra to split her attention between what she was experiencing inside her body and what she was noticing in her surroundings, to reduce the subjective intensity of her suffering. I had her make statements such as “My body is afraid; I am not” to introduce mindfulness. I interpreted the fear for her as possibly the fear of dying after her birth from the congenital defect and from the surgeries, so as to provide a meaningful frame to contain the fear. This anchored the context that it was not a fear of an unknown in the present, which would be harder to contain, but a fear response to something in the past.
Most importantly, I remained focused on working with the physiological and psychological defenses against her terror so she could expand her body in as regulated a manner as possible, in order to distribute the emotion to as much of her body as possible (the rest of the chest, the abdomen, the arms, the legs, the head, the neck, the spine, the brain, the front, and the back). This was intended to manage but not eliminate the states of physiological stress and dysregulation that are inherent in the generation and experience of unpleasant emotions such as fear. The purpose of all this was to have Petra experience the emotion as being as regulated and tolerable as possible.
The notion that the body is involved in emotions might sound strange to those who have been taught that only the brain is involved in emotional experience. The idea that the entire body can be involved in an emotional experience might sound odd even to those who do not dispute the body’s role in emotion. As we will see later in this book, cutting-edge research on emotions has established that the experience of emotion depends not only on the brain but also on the entire body and its environment.3,4,5 Once we accept the idea that the entire body can be involved in the experience of an emotion, it is easy to imagine how using more of the body to process an emotion might be to one’s advantage, even though the scientific explanation might be indeed complex (as we will see in part II).
It was indeed a difficult and lengthy session for everyone involved, with a great deal of uncertainty about whether it would be helpful or harmful to Petra. I did not then have the confidence I have now that this method could or would work. In a way, I had no choice. The intense suffering was there all of a sudden, and I had to support her in managing it somehow to avoid another panic attack. Back then, I only had theoretical assurance: from neuroscience, that emotions could potentially involve the whole body; from intersubjective psychoanalysis, that healing involved greater affect tolerance; from cognitive behavioral therapy, that healing sometimes involved prolonged exposure to intense suffering; from Jungian psychology, that healing involved the development of a greater capacity to tolerate opposites; and from Eastern psychology, that the capacity to tolerate opposites in the body is a prerequisite for enlightenment, the highest possible spiritual achievement for the human psyche. Looking back, one could say I was being shown through treatments such as Petra’s that increasing the capacity for necessary suffering in a regulated manner, by using as much of the body container as possible, can help resolve psychophysiological symptoms in a surprisingly efficient manner.
The length of the cycle, with fear and then terror, was nearly forty minutes; but Petra eventually settled. Exhausted yet relieved, I educated Petra about the additional things we had done during the second session to manage her fear, stress, and dysregulation, and I encouraged her to continue to practice these techniques to manage stress or other feelings as they came up, as often as possible. I referred Petra to a local colleague just in case she needed help, and I also asked her to keep me informed of her progress through her uncle. Probably shaken by the session, Petra took the colleague’s contact information, although I learned later that she never used it. I left the country the following morning, and I might have said a prayer or two before leaving! Just in case you do not know this, there is evidence for the effectiveness of prayer, even in the treatment of cancer.6 Researchers have observed higher rates of remission among cancer patients who had others praying for them than among control group members who were not prayed for.
Three months later, Petra’s uncle emailed me with very good news about her that he wanted to share with me over the phone. Extremely curious and much relieved, I called him as soon as I could. What he had to tell me was very good news indeed: Petra no longer had any panic attacks, a symptom that had persisted for fourteen years. She had been using the skills she learned during our sessions to prevent an attack from occurring if she sensed that she was on the verge of one. She was feeling much better and more positive about her life. She was no longer sleeping as much and had even started jogging with her father. I told him I was so glad we were able to help a young woman move forward in her life.
The next time I saw Petra for a session was six months later, when I was back in the Netherlands to teach the second and final part of the training. It was late November, and the spirit of Christmas was already palpable. I saw her only once during this trip. The session was mostly about catching up and reinforcing the skills she had learned during the earlier sessions. She had made significant changes in her life: she had quit her old job and had found a new one that she liked more, she still was no longer having panic attacks, and she was working with her psychiatrist to get off all her medications by the end of February. Her psychiatrist, intrigued by her progress, wanted to know what “exercises” I had taught her that worked so well. At the end of the session, Petra wanted me to tell her story to others—and even gave permission to use her name in the telling—so others could benefit from “the method” as well. I was very touched by the sincerity, gratitude, and generosity of this remarkable young woman.
The next and the last time I spoke with Petra was in the spring of the following year. She had reached out to me through her uncle because she was having a difficult time. Her grandfather had just died. I was in the United States, so we talked on the phone. By then, Petra was off all her medications and was still free of the panic attacks. She was in general feeling much better. What had been difficult for her was the loss of her grandfather, who had always been a special person in her life. I told her that such a loss is indeed a painful experience. It takes time to heal and come to terms with that kind of experience, and we need the support of others to get through it. However, she could use the skills she had learned to cope with fear to cope with her sadness as well. We then worked on how to undo the physiological defenses, such as constriction, that easily form against unpleasant emotions such as sadness. We also practiced ways to redistribute the sadness from her chest area to the rest of her body in a regulated manner, using again the simple tools of awareness, intention, movement, self-touch, and expression. This time, she learned more consciously how working to more fully embody an unpleasant emotion such as sadness in a regulated manner made it more bearable to be with it for a longer period of time. We sat with the shared sadness for a while.
I was about to end the session to prepare for my next appointment when Petra asked if I had the time to help her with another thing that had been of concern to her. She said she used to be depressed, but now she often had so much energy that she did not know what to do with it—a level of energy she had formerly only experienced during panic attacks. I explained to her that when the body is no longer symptomatic and shut down in defense against unbearable experiences such as emotions, its energy is free and available for constructive and life-enhancing purposes. I asked her if she could think of anything she could use her extra energy to accomplish in her life. Petra responded that it was interesting that I should ask her that, because she had been thinking about going back to the university to get a degree. I encouraged her to do it. I even pushed her a bit by sharing with her that old symptoms could come back if she did not use the newfound energy constructively.
That phone session was the last time Petra and I worked together. I write “Petra and I worked together” instead of “I worked with Petra” because I believe that much of her progress had to do with her willingness to learn and to use more of her body as a container to deal with overwhelming experiences of emotion, and the stress and dysregulation that accompanied them. Like a proud parent, I have been tracking the strides that she continues to make in her life, through my contact with her uncle: She has a boyfriend. She has graduated from college. She has a new job. She has an apartment of her own. She and her boyfriend are now living together. And the last thing I heard, years ago, was that Petra and her boyfriend were on a long motorcycle journey through an Asian country. I am curious if that country is India, where I am originally from. One of these days, I intend to find out.
Connie, a woman in her midforties, had suffered from migraines for as long as she could remember. They occurred once or even twice a week. When they did, they were sometimes so intense that she had to lie down in a dark room to lessen their severity. Connie was a psychotherapist and a participant in a training I taught in Denmark. I heard from the team of assistant trainers that Connie found it difficult to stop crying during practice sessions with other training participants, leaving those who were trying to help her feeling helpless and puzzled, or she would come down with a migraine after the practice session. I did not have much history about Connie on the voluntary information and consent form she had submitted to be considered for a demonstration, but what I heard about her made me wonder if I could help her in some way.
During training, I usually do a demonstration of some aspect of the work with one of the participants in front of the class. I answer questions about what I did during the demonstration, and then I have the participants practice the demonstrated aspect in dyads or triads, under the supervision of an assistant trainer. I got the opportunity to work with Connie in a demonstration on the second or third day of the six-day training.
Even before we began, I knew that nothing would be accomplished if she just cried, and I made it clear to her and the class that this behavior had to be contained for any progress to be made. Although crying can often be therapeutic, it can also at times be a quick way to get relief or an indication of being stuck in a cycle of helplessness. It can rid the client of the suffering that is driving a symptom, but without providing the client or the therapist an opportunity to examine the suffering for the clues it might contain for the cure. In Connie’s case, helpless crying appeared to have become a habitual response in therapy whenever any suffering was touched upon. It turned out that Connie had also done some therapy in which she had been encouraged to express her emotions strongly.
Getting Connie to contain her crying was indeed challenging. I introduced interventions such as asking her to open her eyes and not keep them closed, and guiding her to pay more attention to what was happening outside around her than to what was happening inside her body, in order to reduce the intensity of her suffering. I also insisted that she verbalize her inner experience as often as possible to maintain her ability to think and speak, which can often be lost in states of extreme emotional overwhelm. These helped her manage her crying and emotional overwhelm to some extent.
Between bouts of crying, with much guidance and reassurance, she was able to identify, tolerate, and express the suffering in her body in terms of the most basic sensorimotor emotions, such as feeling too bad or awful or intolerable. This was as opposed to noticing one unpleasant body sensation or another and reacting to unpleasant sensations negatively and helplessly after unsuccessfully trying to change them through different strategies, such as looking for pleasant sensations to counter them. These ways of tracking and reacting to what is happening in the body can be counterproductive and can be common among those who experience hypochondria or who suffer from severe symptoms such as chronic pain, and even among people who have learned to track their body sensations in great detail to regulate themselves in therapeutic or meditative modalities.
Interoception—becoming aware of events in the body by tracking body sensations—is an effective evidence-based tool for regulating not only the brain and the body, but also all psychological experiences that form within them. The use of interoception in psychology as a way to bring the body into treatment is becoming widespread. This is a significant and welcome development for the field of psychology, much of which has remained disembodied for a long time. However, as mentioned above, it also carries the risk of being misused to eliminate and avoid uncomfortable but meaningful psychological experiences.7
Basic sensorimotor emotions, such as feeling good or bad or pleasant or unpleasant, are always there in every moment of our lives, either as emotional experiences in themselves or as foundational layers of more complex emotional experiences such as sadness or happiness. The general lack of understanding in therapy and in life that experiences such as feeling good and bad or pleasant and unpleasant qualify as emotions—because they are meaningful psychophysiological reactions to situations—is based on a narrow academic definition of emotion as consisting of a limited number of primary emotions, such as happiness, sadness, fear, anger, disgust, and surprise, and their combinations. According to this theory, all emotional experiences other than primary emotions are secondary or complex emotions that are combinations of these primary emotions, just as all colors in nature are understood to arise from combinations of a limited number of primary colors.
This conceptualization of emotional experience often leads to the erroneous conclusion that many people have no emotions when they do not express primary emotions or their combinations. This limits the understanding and recognition of emotions and the work done with emotions across therapeutic modalities. Broadening the understanding of emotions to include the basic sensorimotor emotions such feeling bad or good can help all therapeutic modalities (including those that are already body-oriented) to contact, validate, support, develop, and differentiate their clients’ emotional lives more effectively.
While working with the basic sensorimotor emotions, such as feeling bad, awful, or unpleasant, Connie was able to distribute her energy downward away from her head and toward her feet. The energy in her body had the habit of rushing towards her head and concentrating there, fueling her compulsion to cry for relief. When the brain is not able to cope with what is happening in the body, it too can become overwhelmed and symptomatic. Migraines, if they are psychophysiological in origin, often have such a pattern of top-heavy concentration of energy.
As things slowed down and stabilized, and Connie was able to notice, expand, and tolerate the basic sensorimotor emotion of not feeling good in her body, it became more possible to work with the primary emotion of fear that was there right from the beginning of the session. I have often observed this in myself as well as my clients. When basic sensorimotor emotions such as feeling bad or awful in relation to a situation are experienced and tolerated, it becomes more possible to differentiate other higher-order sensorimotor emotions, such as the painful emptiness in the complex emotion of loneliness, as well as primary emotions such as fear.
As for Connie’s fear, it did not matter whether it was her fear of the suffering in her body or her fear of something outside. Because it was there, stronger and more differentiated than before, it made sense to expand the fear to as much of the body as possible. We will see later that there is neuroscientific evidence that expanding an emotion in the body can help improve the cognition of it.8 That is, expanding an emotion in the body can help us understand our emotions better—what they are and where they come from. Between bouts of crying that decreased in frequency as the session progressed, Connie was able to embody her deep fear of whatever it was she was afraid of.
When Connie was in a relatively settled state toward the end of the session, I remarked to her that it appeared she was trying to cope with whatever she was coping with all by herself. Usually, at the end of a session I would feel as a clinician that my body had participated and worked somehow, especially if the session had been difficult. However, as difficult as the session with Connie had been, I felt that my body had not been taxed by the work at all. I was curious enough about this observation that I shared it with Connie and the class. When she started to cry again upon hearing this, I started to criticize myself for having made a bad intervention when things were finally settling, and I set about correcting it. Connie reassured me that she was okay, and she shared with us more of her story that, if I had known it earlier, would have probably made me far more cautious in the work I did with her, especially because I was still learning and developing my methods through the challenges that cases like Connie’s presented.
When Connie was a year and a half old, a critical time for a child’s brain development and attachment learning, she put her fingers in an unprotected electrical outlet and was badly electrocuted. She spent months in the burn unit of a hospital recovering from her wounds. As advised by the hospital staff, her parents did not visit her often. When they did, they often only saw her from behind a one-way mirror. To hear that history helped to make sense of many things: the migraine, a symptom that often forms when the central nervous system is overwhelmed; the rush of energy toward the head; the overwhelming helplessness and crying; the lack of trust in any help from outside, especially during difficult times; and the repeated experience of people letting her down during practice sessions.
Studies from multiple disciplines show that our bodies are constantly communicating with each other, regulating or dysregulating each other, through the measurable frequencies of the electromagnetic spectrum.9 This process, which I call “interpersonal resonance” or simply resonance, is a valuable source of information about what is happening in others as well as a powerful tool for regulating others, despite the confounding complexities of possible transference and countertransference—the reactions of clients and therapists to each other that might have nothing to do with the other. Resonance is an ability we are born with, and it grows with the development of our physiology throughout our lives. Imagine Connie as a year-and-a-half-old child, with the medical staff peeling off her burnt skin or scabs, cleaning her wounds, and applying painful medications to help her heal in the absence of the reassuring presence of her parents, for months on end. One can appreciate why her body would shut down to interpersonal resonance and form an implicit distrust in its place. No wonder my body had felt barely used or taxed from the work I did with Connie.
In the days that followed, I heard that Connie was having a better time during practice sessions and was working with a great deal of sadness about her childhood, without crying as often, and allowing others to support her more than in the past. I thought these were good signs. From what I had already been observing in my clients and myself, when people are able to embody an emotion and tolerate it, they are often more able to work with other emotions in relation to the situation more fluidly. Their cognitions and behaviors often change for the better, not only in relation to the past, but also the present.
We will see later that there is growing evidence in neuroscience that it is emotion that drives cognition and behavior in every moment of our lives, as opposed to the conventional wisdom that cognition always precedes emotion, and emotion in turn drives behavior. Thus, it is common for dysregulation in emotion to lead to dysregulation or dysfunction in cognition and behavior. Therefore, tapping into the entire range of emotions, including the always present and often overlooked sensorimotor emotions, and regulating them by creating a greater capacity for experiencing and tolerating them, offers a better chance of improving not only emotions but also cognition and behavior—even among those who have poor access to primary emotions such as sadness and happiness.
Recently, when I was doing an online introduction to my system of Integral Somatic Psychology, I shared the case of Connie as anonymously as possible to give the audience an idea of the possible outcomes of the approach. At that moment I received a text message: it was from Connie, saying “I am here.” Pleasantly surprised, I greeted her and asked how she was doing. Her response: “I am fine. And I am still without migraines. Thank you!”
Looking back, I realize that Petra and Connie were not the only ones who benefited from their treatments, because I gained a tremendous amount from working with them. Such cases were pivotal in reinforcing my emerging understanding that embodiment of emotions, especially unpleasant ones, in the larger container of the body in a regulated manner could be an efficient method not only for working with emotions and changing them, but also for working with and changing cognition and behavior in all therapeutic modalities. However, it has taken me some time to refine the method; test its effectiveness in diverse cases, clinical settings, and cultures; and accumulate the scientific reasons for the method’s effectiveness. In addition, one reason why it has taken me this long to write this book is because the scientific findings that validate emotional embodiment as a potentially effective therapeutic method are from emerging and rather exciting paradigms in neuroscience and body psychotherapy.
That is what this book is all about: presenting a method of embodying and regulating a broader range of emotions to create a greater capacity for them, so as to improve diverse outcomes and reduce treatment periods in all therapy modalities; and providing the scientific basis for the method in emerging paradigms in neuroscience and body psychotherapy.
The work with Petra and Connie involved high levels of emotions at high levels of intensity (or subjective difficulty) for long periods of time, as well as deep and wide expansion of emotion in the body. These sessions made me wonder whether intense, prolonged, deep, and extensive embodiment of high-level emotion was always necessary for an expedient cure. Research on exposure therapy in the cognitive behavioral therapy paradigm has shown that it works best to resolve symptoms when the experience is intense and the exposure to the disturbing stimulus is prolonged.10 Exposure therapy is an evidence-based therapy for posttraumatic stress disorder that research has found to be more effective than systematic desensitization, another evidence-based cognitive behavioral therapy modality for treating posttraumatic stress disorder. Systematic desensitization exposes clients to scenarios of increasing emotional level and intensity, and then it uses a relaxation protocol to calm clients after each encounter with the traumatic experience at increasing levels of intensity.
Exposure therapy suffers from a high dropout rate among clients and reluctance among therapists to practice it because they find its intensity too much for their clients or themselves. So I thought I had found a way to help therapists do exposure therapy with greater ease and regulation for both clients and therapists by using a larger and regulated body container to make the emotional intensity more manageable and tolerable to be with for a longer period of time.
However, as I continued to do emotional embodiment work with clients and teach it to therapists in different parts of the world, I discovered something else that made its applicability and usefulness more universal and versatile. Through my experiences with my clients and through the experiences of other therapists with theirs, I learned that emotional embodiment does not always have to involve high levels of emotion, be intense or prolonged, or have extremely wide or deep expansion in the body for it to be effective in improving outcomes in different therapy modalities. What appeared to matter more is a person’s capacity for emotional experience in the body. It appeared that people often form serious psychophysiological symptoms, such as cardiovascular and respiratory illness, even at low levels of capacity for emotion in the body.
All of this made me curious, so I went back to look for clues in the literature on emotions and their physiology, especially in new and emerging research paradigms such as embodied cognition and enactive emotion in neuroscience, which I refer to broadly as the science of embodied cognition, emotion, and behavior. I found a number of new findings that, in combination with older findings on cognition, emotion, and behavior in neuroscience and body psychotherapy, helped to explain why emotional embodiment as I had conceived and refined it would work even at lower levels of emotion and intensity, and when emotional embodiment is less deep, wide, or prolonged.
Before we look at the method and its basis in science in a systematic and detailed manner in part II, let us look at a few other examples of successful emotional embodiment treatment that vary in the level, intensity, and duration of the emotional experience, and in the depth and width of its expansion in the body. These examples will also introduce us to other concepts in emotional embodiment work.