Chapter summary: an overview of concepts, methods, and outcomes in the practice of embodying emotion, in the context of treatment examples involving individual, collective, and intergenerational traumas.
Emotional difficulties are universal and commonplace. So are low thresholds for suffering and the formation of psychophysiological symptoms—even serious ones—due to unprocessed emotions, even from ordinary life events. Traumas are generally understood as extraordinarily difficult life experiences with the potential to cause serious harm to the organism. In situations such as war or repeated physical abuse, the threat to the life of the organism is literal. The levels of stress and dysregulation endured are so high that, if left unresolved, they could be the basis of serious psychophysiological symptoms, including death. Those who are diagnosed with PTSD are understood to have suffered from such traumas and to have high levels of stress and dysregulation in their physiology.
It has also frequently been observed that there are many events, such as emotional neglect or emotional abuse, that are not physical threats to a person’s life but that can nevertheless stress and dysregulate the physiology to the same extent as severe life-threatening events. This fact has necessitated consideration of broadening the definition of trauma in the Diagnostic and Statistical Manual to include things such as emotional neglect and emotional abuse. Therefore, the extent of stress and dysregulation left in the person’s brain and body physiology after the experience can be used as a conceptual yardstick to assess how much the experience traumatized the person. The high level of stress and dysregulation in the physiology of traumatized people suggests that therapies that deal with trauma could be more effective if they also incorporated interventions for directly working with the physiology to manage the level of stress and dysregulation in it.1
Psychiatrist Bessel van der Kolk has been emphasizing the need to work with the body in any treatment of PTSD, and van der Kolk’s claims are backed by evidence. This is demonstrated by the effectiveness of the psychopharmacological approach of psychiatry, and in body-oriented trauma modalities such as Somatic Experiencing2 and mindfulness-based stress reduction.3 However, body-oriented trauma treatment methods that track body sensations share a weakness in that they can sometimes thwart emotion by tracking body sensation instead of emotion. This is especially a problem for clients who either do not have an adequate inner capacity for emotional experience or who have insufficient support from others for their emotional experiences.
If the body is regulated too much when working with unpleasant emotions, the emotions can disappear, as sometimes happens when a person is medicated excessively. The systematic expansion of the body and of emotion along optimal pathways in the body—as suggested by models of body and energy regulation and utilized in the emotional embodiment work in Integral Somatic Psychology (ISP)—ensures a balance between physiological regulation and emotional regulation. This ensures that excessive physiological regulation does not end up countering the meaningful emotional experiences involved. As opposed to approaches in which physiological regulation and emotional regulation are performed in alternating order, the possibility of tending to both simultaneously offers the advantage of providing the client with maximum emotional support, without the distraction of going away from it to tend to the physiology, which could compromise the emotional experience.
The ability to work with both physiological and emotional regulation at the same time during emotional embodiment work gives this approach the flexibility to work with emotion from traumas, which is characterized by high levels of physiological stress and dysregulation, and with emotions from ordinary but difficult life experiences, which are characterized by lower levels of physiological stress and dysregulation. In fact, we will see later in the chapters on the physiology of emotion and sensorimotor emotions that states of stress and dysregulation can themselves at times be thought of as sensorimotor emotions, because they make sense as meaningful reactions of the organism to the traumatic event. For example, the shock a mother experiences on losing a child is a proportionate and meaningful physiological reaction to the event. It therefore qualifies meaningfully as an emotion. However, a word of caution is in order. There are times when the level of stress and dysregulation is so high, as when a person is about to faint or is completely dissociated, that it makes sense to focus on the physiology and bring the stress and dysregulation down to a manageable level to make the psychological experiences, including emotions, coherent enough before proceeding with the difficult work of emotional embodiment.
That said, the guideline to regulate the physiology when it is extremely dysregulated before working psychologically or embodying emotion has its exceptions, as can be seen in the following case.
During a training I was doing in India, Anita approached me for help with a symptom that caused problems for both her and her husband: she could not sleep at night without the lights being on all night long. She said she did not exactly know how her symptom came about, but she had had it for a long time. I assumed fear must be driving the symptom, so in a demonstration session I had Anita close her eyes and imagine trying to sleep without the lights off, to trigger the fear so we could work with it through embodiment. Specifically, I had her notice how scary or unsafe she felt and where in her body she felt that way. Anita started to dissociate as soon as she started sensing the fear. She said her body started to feel numb and she felt she could very well be outside her body.
Usually at that point I would have had a client in this situation open her eyes and reorient to the present, rather than tracking the overwhelming fear and the situation triggering it, to make her feel more present, stable, and safe before going back in for another cycle of embodying the fear. For some reason, with Anita I chose not to do that at that moment. Instead, I continued to keep the situation and the emotion alive and stay with that part of her that could still feel the fear somehow. I kept asking her where she could feel the fear in her body, despite the counteracting numbness, by trying to get her to ignore the numbness as much as possible. When she said she could faintly feel the fear somewhere, I quickly asked her where else she could feel it going, hoping we could encourage as much superficial and wide expansion of the fear in as much of the body as possible, to keep the experience tolerable. As for working with the fear despite the strong pull toward dissociation, we can think of it as working with the fearful self in the dueling presence of the dissociating self, I explained to her and the class.
In a way, this is what exposure therapists might do when they expose their clients to a fearful stimulus in a prolonged manner—but with one difference. Exposure therapy is a variant of cognitive behavioral therapy, which is based on classical conditioning principles, and that school of therapy typically pays no attention to experiences in the black box of the body. By contrast, in my work we pay a great deal of attention to the experience and regulation of the body while attending to the emotion and the situation at the same time. The balance between attention to the body and its regulation and attention to the emotion and the situation varies on a case-by-case and trial-and-error basis. This variation involves managing variables such as level of emotion, its intensity or subjective difficulty, width and depth of body expansion, and the length of each cycle of emotional processing. In Anita’s case, the balance was tilted so far in the direction of the emotion and the situation that at the end of the session she said she could hardly remember what she had experienced during the session, indicating the presence of a great deal of stress, dysregulation, and dissociation in the session.
I am sure you are as curious about the outcome as I was after the session ended, from which I emerged a bit numb and dissociated myself. Would she decompensate or fall apart later, especially that night? When she showed up for the following day of training, she said she had slept well the night before, although she did leave the lights on. She had traveled alone from the city where she lived to attend the training, and she was not ready to experiment with trying to sleep with the lights off without her husband sleeping next to her. At that point she shared with the group her idea that a sexual abuse trauma she had experienced repeatedly as a child might be related to her symptom—a significant cognitive insight. Anita used to be in the habit of getting up early in the morning, well before her parents, when it was still dark outside. The man who delivered milk to her house in the morning had repeatedly sexually abused her, and he threatened to harm her and her parents if she told anyone about the abuse. It made sense that such abuse could be related to her feeling unsafe in the darkness of the night. I thought at the time that if I had known she had suffered from such abuse as a child, I might not have been so brave as to work with her fear as much as I did, and to ignore the dissociation to the extent that I did.
I do not get to India often, once a year at the most. When I was in India a year later, I met Anita in another training, this time as an assistant. She said she was so impressed by the work we had done together in our session, and by how she felt afterward, that she continued to get more sessions of emotional embodiment from the local trainer. She became so interested in emotional embodiment work that she became an assistant in the next training so she could learn more about it. And she no longer needed to keep the lights on at night to be able to sleep! It took Anita only five or six sessions with the local trainer to rid herself of her nighttime symptom, demonstrating the potential of emotional embodiment work to hasten outcomes and shorten treatment times in all therapies and in daily life, even when severe trauma is involved.
When I wrote Anita to ask her permission to share her story in this book, she replied that in those five or six sessions she not only worked with her fear but also her shame in relation to the abuse, and she made deeper embodied connections between the abuse, her fear of darkness, and her symptoms. In conclusion, she wrote: “Today after seven years of my journey with Integral Somatic Psychology, I can say that not only did I overcome that symptom but also achieved many more milestones in my life. I have sweet harmony in my life, living successfully every day, and thanking you and the universe for allowing me to learn and practice ISP every day in my personal and professional life.”
Sessions such as Anita’s taught me that it is sometimes expedient to work with emotional embodiment when the body is in a state of extreme stress and dysregulation, even during dissociation, as long as there is enough of a witness in the person’s awareness and enough of the capacity to suffer without the development of a major symptom. We cannot always know in advance whether a person has such capacity, so we must sometimes resort to trial and error.
There is also a theoretical reason for why we have to sometimes work this way in situations characterized by extreme stress, dysregulation, and even dissociation, when it is usually contraindicated: the dependence of the emotion on such an extreme state. Emotion is an assessment of the impact of the situation on a person’s well-being. If the impact involves an extreme state of stress, dysregulation, and/or dissociation, then if we try to access the emotion when the body is regulated away from the underlying physiological and psychological states that generate the emotional experience, we run the risk of not being able to fully grasp the extent of the situation’s impact—i.e., “the emotion.”
As we have seen earlier, the level of stress and dysregulation involved in an emotional experience can be so great as to cause severe psychophysiological pathologies. Even in such instances, one can imagine that the extreme method employed in Anita’s session might apply. However, it is more likely that a more gradual approach might work better, with the capacity for difficult emotional experiences growing steadily, perhaps with shorter cycles and lower levels of emotion and intensity, and lower levels of stress and dysregulation in the body. In this way the client can move in small steps toward and beyond the level of stress and dysregulation at which symptoms form.
Such a gradual approach might be particularly suited to situations in which the level of stress and dysregulation in the person is so very high that no coherent psychological experience can be accessed, the person’s capacity for suffering is very low, and the psychophysiological symptom’s severity is extreme, such as migraine. The gradual approach might also be indicated when the person’s capacity for suffering is not adequate to maintain a steady witness in relation to the overwhelming experience. The more capacity one has for an experience, the more tolerable the experience is, and the easier it is to remain a witness to it in a steady manner. However, a word of caution is in order: there is no need to approach every person gingerly, because people vary widely in these capacities, even when they have extensive trauma histories.
Psychopharmacology tends to diagnose all psychological problems as having to do with excess stress and dysregulation, and to treat it with medication. There are times when this diagnosis is appropriate and medication is necessary to regulate the physiology away from serious, debilitating psychological and psychophysiological problems and into a realm of coherent physiological and psychological experiences. In these instances, medication acts as a regulating stabilizer allowing healing to take place on one’s own in one’s social networks, with professional help if necessary.
The tendency to approach all psychological and psychophysiological problems as being caused by stress and dysregulation, and to regard reduction in stress and dysregulation as the key to all symptom resolution, can also be seen in some bodywork and body psychotherapy approaches, especially the more recent ones. Again, it might well be true in some instances that such caution is warranted. However, it bears repeating that excess reliance on such a clinical strategy, with a bias toward downregulation of stress and dysregulation in the body, runs the risk of avoiding significant psychological experiences of suffering for which greater capacity needs to be built. Approaches that constantly seek to reduce stress and dysregulation may miss the opportunity to ensure that clients have physiological and psychological resilience in the face of those emotional experiences in diverse situations that might trigger them, and may fail to give them the resilience that would allow them not to form symptoms or to resolve symptoms quickly when such emotional experiences come up in the future.
It is well known that anxious parents tend to raise anxious children, and depressed parents, depressed children—even though some children might adopt the opposite position as a defense against the suffering caused by identifying with the parent.4 However, when parents have not worked through their own traumas, such as physical and sexual abuse or significant losses, their reactions to the present tend to be colored by their experiences and reactions related to their unresolved traumas. This can mold the child’s experiences and reactions throughout its development, going as far back as life in the womb.
This transfer of the effects of trauma from one generation to the next can happen in different ways. Our brains and bodies are known to communicate with and regulate each other by sharing internal states, experiences, and reactions (including physical and energetic defenses) with each other through measurable short-range energies of the electromagnetic spectrum.5 We are particularly capable of tuning into the internal states of our parents this way because of the implicit, and even instinctual, trust we have in our parents as the best custodians of our survival and interests. We can also see these mechanisms as a nonverbal means through which parents inculcate their children with their worldview so as to maximize their well-being, in light of the parents’ own experiences and expectations.
Another way this can happen is when parents become the perpetrators themselves, subjecting their children to the same traumas they were subjected to. Even though not all parents who were physically abused as children physically abuse their children in turn, we run into those who do. We even encounter such intergenerational abuse in instances where the parent is determined not to visit their own suffering upon their children and to break the cycle of violence across generations. Although conventional wisdom has it that abused children who have not worked through their abuse tend to become abusers themselves, a large longitudinal study has found that people abused as children are no more likely to become abusers than those who were not abused as children, which perhaps is a testament to the resilience of the human spirit.6 Through observation and imitation of the parent, the child can also learn outmoded traumatized perceptions, such as the world appearing to be unsafe, and dysfunctional defenses such as fight or flight.
My father was easily slighted and reacted to perceived slights with anger. He projected his vulnerabilities, such as shame and hurt from his unresolved traumas, outward in order to rid himself of them. It is as though he used his anger as a missile to project his vulnerabilities onto the person he was angry at. I would, of course, have my own reactions of shame and hurt from being verbally, emotionally, and physically abused by my father. What I did not know then is that I was also taking in and identifying with my father’s disowned vulnerabilities, in addition to experiencing my own reactions to his abuse.
A theory from Kleinian psychoanalysis called “projective identification,” which is used to explain one method that parents use to regulate their children, can be helpful in understanding how children might end up absorbing their parents’ vulnerabilities during abuse.7 When a baby feels an anxiety that is too much to bear, it projects the anxiety onto the parent. The parent, who is uniquely equipped to regulate their child, “identifies” with the projection, making it their own. Then, in addition to soothing behaviors such as holding and rocking the child, the parent uses their more mature physiology to transform the projection of anxiety they have received. The parent then nonverbally projects the remaining traces of anxiety, along with calm, back to the child. The child identifies with such nonverbal help gratefully, just as a young bird would swallow the partially digested food that the mother bird places in its mouth. During abuse, the parents could project their vulnerabilities from being abused themselves into their children, who then identify with their parent’s disowned vulnerabilities to maintain their connection with them.
The scientific evidence for the possibility of such nonverbal information exchanges between people through short-range electromagnetic energies emanating from the body, such as the electromagnetic energy field emanating from the heart that has been observed to travel several feet beyond the skin, provided a solid basis for my understanding of the process of projective identification. In projective identification, there is a willingness on the part of the receiver of the projection. In violent experiences such as physical abuse, in addition to identifying with the parents’ projected vulnerabilities to maintain their connection with them, the child might simply be a victim of it, unable to prevent itself from taking in the strong energies directed at it.
My late father-in-law was all of five years old in World War II when the Germans and the Americans were fighting for territory in Belgium in what became known as the Battle of the Bulge. Caught between the two armies on a farm in Belgium, where his German father had sent his family to be safe from the intense Allied bombing unfolding toward the end of the war, he would hide under his bed, shaking in fear. As he grew up, he developed the habit of raging at whoever was around him when he became fearful. My wife internalized this pattern through observation and projective identification when she was a child. When she became an adult, if something on the road scared her while she was driving, she would sometimes curse and scream to get rid of her anxiety. Through my own reaction and projective identification, I would then experience a great deal of fear for a long time—the fear that a five-year old might have felt in the night under a bed on a Belgian farm some seventy years ago.
There are a number of ways to learn about our heritage of intergenerational traumas. One way, of course, is to get a detailed history of the traumas our family members went through. This might be easier said than done, as there can be a great deal of resistance to talking about one’s traumas or seeing them as such. This was particularly true of Germans who were traumatized by the war, for many reasons, including the guilt of belonging to the country that initiated the war. So indirect methods such as the ones presented later might help people understand their inheritance of trauma.
One powerful way to get at the unresolved traumas our ancestors might have passed on to us is to imagine them in their habitual postures or reactions and try to use our own bodies to get a sense of what they might have been feeling inside of their bodies. Another way is to do a “family constellation” in therapy. Family constellation therapy was developed by Bert Hellinger in Germany to unearth and resolve intergenerational traumas that clients might be suffering from without knowing about them—traumas that their ancestors might have taken to their graves with them. In this modality, other people stand in for their ancestors in a family constellation and trust that the world-soul will guide the souls of the ancestors into the bodies of their stand-ins, to bring up and resolve the intergenerational traumas that continue to unconsciously affect the lives of the clients and their families. If you are skeptical of his method, which is quite popular in Germany, try doing a family constellation of your own with a therapist competent in this modality.
Working in Europe, especially in countries like Germany, one runs quickly into the ghosts of World War II. Intergenerational collective traumas—the effects that major collective traumas experienced by one generation have upon subsequent generations—continue to shape the emotional reactions of postwar generations. In the United States, we can see the effects of the intergenerational collective trauma of slavery in the African American population and the effects of the genocide of Native American populations in their descendants to this day. These inherited patterns, when unresolved, add to a person’s reaction to current traumas and make it difficult to process the current traumas. The following treatment examples from Israel and Germany provide an idea of the efficacy of emotional embodiment work in cases where the weight of intergenerational collective traumas bears heavily on current traumas and symptoms.
Claudia’s father was the mayor of a small town in Germany during the Third Reich. He and his family felt constantly endangered during the war due to his resistance to the Nazis. Claudia, born well after the war, inherited her father’s social conscience and willingness to buck the system. Today she is passionately involved in efforts to protect the environment. She does whatever she can, personally and as a therapist, to help Jewish Israelis as well as Germans work through their intergenerational collective traumas from the war. She has been to Israel many times over the years as an assistant trainer in a trauma training program to help Israelis learn how to work with all kinds of traumas. I met her during one of the training sessions I taught there.
Claudia asked me for help with her symptoms of arrhythmia—sudden, scary irregularities in the heartbeat—and high blood pressure. The symptoms were sufficiently stressful that she was on beta blockers, a medication that can regulate both heartbeat and blood pressure. We did two sessions focused on her anxiety about things large and small in her life, to create greater capacity to embody and regulate the anxiety in the larger physical container of her body in order to help her resolve severe psychophysiological symptoms. The work was not easy, because of Claudia’s tendency to regress to child states and cry helplessly. We had to constantly orient to the present to work as much as possible in her adult ego state.
As she developed her capacity to tolerate her anxiety—which clarified itself as the fear of dying, or worse, as the terror of being killed or annihilated by the world—Claudia told me how, for as far back as she could remember, her life had been ruled by a general sense of dread, anxiety, fear, and terror that something suddenly could happen to end her life. From time to time, depending on what was happening in her life, she would diagnose the fear as having to do with this or that in the world and try to deal with it in one way or the other, only for it to rear its ugly head again. Since she was a child, she had had a lot of psychotherapy in her life, which helped to manage this fear but not to resolve it to any degree of satisfaction.
The fear of being killed and the terror of being annihilated by the world are common themes we run into in the processing of life-threatening prenatal or perinatal trauma. Claudia once interviewed her mother to learn if she had had any significant prenatal or perinatal trauma, and it turned out that she had not. Still, I explained to her that babies could be traumatized even in the womb by the mother’s unresolved traumas. Her parents, who went through the collective trauma of World War II while resisting the Nazis, could reasonably be expected to have unresolved activation, especially because postwar Germany had neither the time nor the resources to tend to its healing during the reconstruction of a country that had undergone incredible destruction.
It also made sense to Claudia that the collective war trauma carried by almost everyone around her might have continued to affect her as she was growing up in a number of ways. One of these avenues could be interpersonal resonance, the ability our brains and bodies have going back to the womb to exchange information with other brains and bodies nonverbally through the energies of the electromagnetic spectrum, such as electromagnetic energies emanating from the heart.8 Another avenue of influence could be the ability we have to communicate with each other rapidly at the level of subatomic particles.9
When overwhelming emotional reactions and the defenses against them from inherited collective traumas such as war have not been worked through, it is harder to work with emotional reactions to current life difficulties and resolve symptoms that form from them. Exposure to intergenerational collective traumas such as World War II and the Holocaust can happen from childhood onward in all the ways such exposure can take place through the family as well as the community. These inherited collective traumas can make processing of emotional reactions to current traumas more difficult, because accessing difficult emotional reactions to current situations can quickly trigger the larger and more overwhelming emotional reactions to the intergenerational collective traumas, bringing them to the surface. It is as though the larger reactions to past events are just beneath the skin, and even a small scratch can trigger them, making healing the present as well as the past a tricky and difficult proposition. This is something I have observed not only in Israel and Europe in relation to World War II and the Holocaust, but also in Sri Lanka among the survivors of a thirty-year civil war, and in the United States in the African American population.
Therefore, when I saw Claudia on a subsequent trip to Israel, I was indeed surprised to hear that she no longer had any symptoms of arrhythmia and high blood pressure, and that her doctor was intrigued that her condition could change so much in such a short period, after just two sessions. I experienced a similar surprise when I worked with Silvia, an older German woman who was born closer to the war than Claudia and whose parents also experienced much hardship during World War II, including the trauma of displacement. After just a single session together, Silvia reported that she no longer had allergy symptoms, even though she continued to test positive for allergies.
In the session with Silvia, we focused on a great deal of fear she had in relation to a current situation in her life. Interestingly, when we spoke years later, she no longer remembered that we had worked with fear! What she remembered from the session were the significant and impressive changes in her energy during the session. This made sense. When the body has a greater capacity to be open and regulated during overwhelming experiences through emotional embodiment work, deeper healing energies often arise to resolve the symptoms. Paying attention to and supporting such energies are important parts of emotional embodiment work. Silvia, a psychologist by profession, had no doubt about how much her parents’ and grandparents’ traumatic experiences during the war and its aftermath continued to affect her.
For a therapeutic method to have validity, it has to be effective not only when its developer employs it, but also when those who have learned it have success in applying it. That is why I am always glad to hear of successful outcomes of treatments given by others. Short descriptions of two such treatments from Israel follow.
Sderot is an Israeli city close to the Gaza Strip. Rockets from the Gaza Strip fall regularly in the area. A man who lived in Sderot and who loved gardening could no longer spend time in his outdoor garden without having an anxiety attack. The panic attacks started happening after a rocket landed close to his house. I recommended to the therapist who was in one of my classes that she work with her client’s fear and anxiety using the emotional embodiment technique, which at times I call the expansion technique, in order to develop a greater capacity in him to tolerate these emotions. A few months later, the therapist reported on the man’s progress: “I worked with him only a few times. He is still afraid of the danger that rockets pose in the area, but he no longer has panic attacks when he goes out to enjoy working in his garden.”
Areas adjacent to the Gaza Strip have recently been under a new threat: fires started by small incendiary balloons filled with hydrogen or helium and sent toward Israel. I heard from another therapist that a family she has been treating in that area is suffering from a great deal of anxiety, and the relaxation and discharge protocols she had taught family members to cope with anxiety were no longer working. She wanted to know if she could work with them by having them embody their anxiety. I replied through email that it was worth giving it a shot. When I was in Tel Aviv a month later, I asked the therapist about the family. Her response: “I only worked with the mother to begin with, because I was not sure whether the children could handle the intensity of staying with an emotion such as fear. When I spoke to the mother recently and asked her how she was doing, she said she was doing just fine. Whatever I had done with her had worked. Her children were, however, still not okay, so she wanted me to start treating the children just as I had treated her so effectively.”
The outcomes for Claudia and Silvia from Germany, along with equally rapid and effective outcomes reported by Israeli practitioners, taught me that emotional embodiment work could be efficient in treating serious psychophysiological symptoms when the capacity to process emotion is quite limited by the baggage of intergenerational or contemporary collective trauma, which can make the symptom threshold for the suffering of new traumas low and the probability of regression, helplessness, and falling apart high. When major symptoms form at low levels of suffering, it is possible that increasing the capacity for suffering only a little bit could help resolve some symptoms quickly, even when intergenerational collective traumas are involved. This does not mean that all aspects of the trauma, past and present, have been worked through; but it does mean that people do not have to live with serious psychophysiological symptoms or work with all aspects of their traumas for long periods of time before getting relief from their symptoms. Thank God!