Chapter summary: an overview of benefits of emotional embodiment that have been observed in different therapy modalities, and in different clinical contexts such as cognitive and behavioral therapies. The chapter also presents an overview of findings from both older and newer paradigms of research in neuroscience, cognitive psychology, body psychotherapy, and general psychology, which explain the observed range of benefits in diverse therapy settings.
Therapists trained in the emotional embodiment work of Integral Somatic Psychology (ISP) use it as a complementary modality to improve outcomes in whatever therapy modalities they happen to specialize in. Their professional backgrounds are diverse: they are psychoanalysts, psychiatrists, Jungian analysts, psychotherapists, social workers, cognitive behavioral therapists, counselors, body psychotherapists, psychologically oriented body workers, energy workers, educators, trainers, and teachers of meditation and spirituality. They work with different aspects of psychological experience as a means to help their clients.
In their work, some focus more on cognition, while others focus on factors such as emotion, behavior, brain, body, energy, and so on. Some work more with trauma, and others with ordinary but difficult life experiences and all kinds of symptoms. They are already trained in evidence-based therapies, do really good work, and help a lot of people. They are dedicated professionals continually training in new modalities to improve their practice. They recognize that the complex human psyche as it manifests in all individuals cannot be understood completely or treated effectively with one psychological theory or treatment approach. It is from such a diverse body of professionals that we continue to hear that integrating the emotional embodiment work of ISP into their practice as a complementary modality has helped them improve diverse outcomes and reduce treatment periods.
How does one explain the effectiveness of emotional embodiment work in improving outcomes across therapeutic modalities and in diverse domains such as cognition, emotion, behavior, body, energy, relationship, and spirituality? Let us look at how both older and newer findings in neuroscience, cognitive psychology, body psychotherapy, and general psychology could predict these outcomes, with examples from emotional embodiment work.
When emotions are more available to be experienced, we are able to appreciate more fully the significance of situations in our lives. When emotions become more bearable through their embodiment, we can imagine that we would live through and survive a difficult emotion, such as a broken heart, if it were to happen again. Then we do not have to shut the heart down, avoid relationships, or engage others halfheartedly. We can get to a place where we sense that our work with that emotion is resolved, to the extent that we can express it in statements such as “I am no longer as haunted by the loss.” When the emotion is experienced as just a difficult state within the body, it is possible to become truly mindful of the emotion without the development of secondary unhelpful reactions to the emotional experience. This includes unhelpful cognitive conclusions, such as “I am not worthy of love,” or self-destructive behavioral reactions, such as “I need to drink to get away from this pain.”
Mindfulness has been found to be a key factor in affect regulation.1 When one has a greater capacity for an emotion involved in a projection, such as when one believes that the distrust experienced in relation to the father is the distrust one is feeling toward the partner in the present, it becomes more possible to take back the projection. The following statement from a client demonstrates how this principle works: “Now that I can sense how deep the emotion of distrust is in my body, and that it is just an experience in my body, I can see that it is not my husband who is the cause of this distrust.”
When emotions become more tolerable through the body container, we can stay with them longer and more deeply in order to differentiate them, which gives our emotional experience the “granularity” that research in cognitive psychology has shown to be a key characteristic of psychological health.2 Emotional granularity refers to the ability to differentiate the emotional experiences of one’s body through language, especially metaphor, and in particular through body metaphor. Being able to describe the impact of a loss only as good or bad would indicate a low level of emotional granularity. Being able to describe the impact of the same loss in terms such as “It was a blow to my heart” or “It is as though all the energy drained from my body in an instant” would indicate a higher level of emotional granularity.
Emerging findings from the evidence-based paradigm of embodied cognition, emotion, and behavior in neuroscience inform us that cognition, emotion, and behavior are ultimately inseparable in the brain as well as in the body.3 Additionally, cognition, emotion, and behavior are a function of both the brain and the body, and of the environment.4 Therefore, when the brain and body shut down through physiological defenses to cope with intolerable emotions, the availability of the body and its connection to the environment are compromised, not only for the function of emotion but also for the functions of cognition and behavior. When our primary experiences of cognition, emotion, and behavior are compromised, so is every psychological experience, such as relationship or spirituality.
Research has shown that the presence of emotion strengthens a person’s ability to generate relevant behavioral alternatives for a situation, as well as the person’s ability to choose the best course of action in a situation given a number of alternatives. Conversely, the same research has shown that the absence of emotion impairs these functions.5 Research has also shown that expanding emotions from the brain to the body improves cognition, both about the emotion and about its context.6 What this means for psychotherapy is that embodying emotion can help us learn about the emotions we have and what they mean, not only in relation to the present but also in relation to our past. These are connections almost all therapies try to make in order to help clients make sense of and heal their current emotional difficulties.
Even though cognition and behavior have long been known to be involved in generating and altering emotional experiences, emotion is now known to be the primary force driving cognition and behavior in every moment of our lives (when emotion is broadly defined to include the basic sensorimotor emotions of feeling good or bad, and cognition is broadly defined to include attention, focus, and perception).7 It is common for dysregulated emotions to lead to dysfunction in cognition and behavior. For example, I feel such unbearable worthlessness when she leaves me (emotion); I am so convinced that she is the cause of my worthlessness (cognition); I see no choice but to continue to beg her for her forgiveness (behavior).
When we can generate emotions and tolerate them for longer periods in the larger container of the body, we can regulate them better, giving our brains more time to process the cognitive and behavioral implications of the situation we find ourselves in so that our cognitive and behavioral responses to the situation are optimal. We can avoid blaming and acting out. For example, for someone who is in the habit of eating compulsively in the evenings to make themselves feel better, embodying the vague discomfort that triggers the compulsion would allow the person to develop a greater capacity to be with that feeling. The person might then be able to recognize the vague discomfort as loneliness, which might lead them to combat the loneliness by reaching out to a friend rather than to the food in the refrigerator. Also, when emotion is more available and embodied, we can offer the body adequate motivational emotional energy for carrying out the behavior necessary for dealing with the situation.
Discovering that a problem in the present has roots in the past, an act of cognition, is often therapeutic. Almost all psychotherapy modalities emphasize the importance of such insights in healing. At those points of healing, clients often say something like: “I knew that A was connected to B, but I did not know it as convincingly as I do now.” This often happens more expediently during emotional embodiment work, two instances of which are presented below.
I met Kim, a mental health professional in her midfifties who has never been married, at a training I taught in China. She asked for help to get over a depression she had suffered from for about six months, ever since a man had walked out on her. The man was her high school sweetheart, the love of her life. He had a pattern of coming back to her from time to time only to abandon her again, either to return to a former lover or to form a relationship with a new woman. Kim could not let go of this man or engage another person in a relationship, so she never formed as deep an attachment to anyone else. In our session we worked with embodying the sensorimotor emotion of how bad the most recent betrayal felt in her body, and then the primary emotion of how sad it made her feel. The sadness was hard to contact, but it eventually surfaced when I had Kim imagine her boyfriend walking away from her into the horizon.
As we tried to stay with the sadness, Kim suddenly reported that she was beginning to feel fear. Interpreting the fear as possibly the fear of permanent loss, I encouraged Kim to stay with it and expand it in her body. She became terrified. Her body started to contort, and her arms and legs became twisted. The more she got into that state, the more terrified she became. She wanted to open her eyes and get out of the state her body was in. When I asked her whether her body has ever gotten into that state during a session before, she said, “Never.”
As a body psychotherapist herself, Kim has had years of training and treatment in a trauma-focused body psychotherapy approach. Because certain emotional states can only be reached in certain body states, and regulating the body state toward normalcy could eliminate the emotional experience altogether, I encouraged Kim to stay with the terror—which appeared to be an affect state from early childhood, given the way her body was contorting—and expand the emotion to as much of the body as possible, especially by expressing emotion through vocalization. This technique can help expand the emotion in the body nonverbally, in addition to giving the client some relief. I told Kim it did not matter whether the terror was her terror of the contortions happening in the body or if it was an integral part of the emotional experience in the past situation.
At some point during her experience of terror, Kim remarked that she was born prematurely and was incubated for about a month. She also said she had been separated from her parents from time to time and that for much of her childhood her grandparents had cared for her. I sensed that she was making deeper connections to her past as a result of embodying and tolerating her terror and other feelings in that unusual body state, which can often be seen in physically disabled children. I interpreted her terror as the terror of dying, which is common to experiences of premature birth, incubation, and separation from the mother at birth. This terror is likely to have been reinforced every time she was separated from her parents and her grandparents in childhood, and by the repeated separations from her lover in adulthood.
When I thought she had been with the terror long enough, I stopped supporting that emotion and asked her to do the same. I then asked her to orient to the present, and I had her body slowly recover to a normal state. Toward the end of the session, Kim became quiet and reflective. She shared with us that she had had no idea until then that her longstanding difficulty of not letting go of her high school sweetheart might have anything to do with the threats to her existence around birth. In the days that followed, Kim continued to work with her fear, sadness, and anger on a deeper level in her practice sessions and in private sessions she received from the assistants during the training.
On the last day of the six-day training, Kim told the class she had never been able to remember a dream before, but that day she was surprised by having remembered a short dream from the night before. She had dreamed that her boyfriend appeared, and he wanted to say just one thing to her: “Congratulations!” Kim reported waking up feeling good, with a certain emotional conviction that she was finally over him. Now she felt she could move on and engage someone else in a relationship in a way she had not felt before. A year later when I was back in Hong Kong, I talked with Kim, and she shared with me that she had indeed moved on. She no longer felt that her relationship with her ex-boyfriend was hanging around her neck like a millstone. It hardly crossed her mind, and it caused no anguish, she said.
Another example of deepening insight resulting from emotional embodiment involved a man named Peter, who could not bear to live in the same house with his girlfriend and their two children. Peter volunteered to work with me in front of a class I was teaching in Switzerland. In addition to the house he shared with his girlfriend and children, Peter also had an apartment across the street, to which he retreated from time to time. This was becoming a real problem, not only financially but also relationally between him and his partner. In the session, I had Peter close his eyes, imagine living in the same house with his girlfriend, and sense how unpleasant, bad, or uncomfortable it would feel if he did not have his apartment across the street. I had Peter continue to sense the close presence of his girlfriend as we explored and embodied the unpleasantness, lack of safety, and fear he felt.
After a while, Peter started to sense his body as extremely small and vulnerable in relation to the larger body of his girlfriend. As I encouraged and helped him to embody the vulnerability and stay with it, Peter arrived at a new and significant insight having to do with his twin brother. When the twins were born, Peter was very small compared to his brother because his brother had flourished in the womb, and Peter had not. Peter had always known this about himself, but he had not understood how this fact was playing such an important role in his current life and intimate relationship until he embodied and tolerated the difficulty affectively during the session. I do not know whether Peter was able to change his living arrangement after the session, but his ability to tolerate the vulnerability of being close to his partner and what it brought up, and to make the significant connection between his past and present in that deeper state, is the kind of development I have often seen lead to real change in behavior in people.
Gaining an important and transformative insight is an act of cognition. How can emotional embodiment facilitate such an act? As we saw earlier, the new paradigm of embodied cognition in neuroscience has accumulated evidence showing that cognition is a function not only of the brain but also of the body and the environment. When a body is shut down, with its connection to the brain and the environment broken, that person’s cognition is therefore compromised. Also, as we saw earlier, research on emotion has shown that embodying emotion improves cognition, and the lack of it compromises cognition.
Cognition can be defined narrowly or broadly. When defined broadly, acts of cognition involve awareness, attention, focus, perception, abstraction, association, evaluation, memory, imagination, and even language. Findings in embodied cognition research show that emotion affects every one of these cognitive processes, starting with the aspect of the environment one’s awareness is directed to before perception begins.8 Therefore, it makes scientific sense that Kim and Peter were able to arrive at important and potentially transformative “embodied” insights during their sessions of emotional embodiment work, when they had access to their emotions in a regulated manner and their body was more available for cognition because it was not shut down to avoid unbearable emotion. In both cases, the increased ability they showed to process difficult emotional experiences and resolve them shows the efficiency of emotional embodiment work not only in resolving emotional problems but also in arriving at significant therapeutic cognitive insights. That Kim had moved on from being stuck in an on-and-off relationship of many years shows the effectiveness of this work in changing a long-term behavior.
The Adverse Impact of Childhood Experiences study documents a correlation between adverse childhood experiences and physical health throughout one’s life.9 There is a strong correlation between psychophysiological symptoms on the one hand and the combination of adverse childhood experiences and low capacity for emotional experiences on the other.10 A group of health care professionals in medicine and psychology founded an organization called the Psychophysiologic Disorder Association, which maintains an extensive bibliography of research articles on the relationship between adverse childhood experiences and physical symptoms such as chronic fatigue, fibromyalgia, and irritable bowel syndrome.11 Most studies show that as many as one out three symptoms for which people seek medical help may be psychophysiological in origin.12 Let us see how this might be happening to such a large extent, and how the work of emotional embodiment could be of help in alleviating it.
When the physiology of the brain and body shut down in defense to cope with painful or unacceptable emotional experiences, the physiology is often fragmented, and nervous system communication, blood circulation, lymphatic flows, interstitial (intercellular) flows, and electromagnetic and quantum energy flows between different parts of the physiology are compromised. The resulting decrease in the level of overall functioning and the increase in the level of stress and dysregulation throughout the organism constitute one possible basis of physical symptoms, ranging from minor symptoms such as headaches to major symptoms such as cardiovascular disease. Emotional embodiment work can reduce fragmentation and dysregulation of the body physiology and can efficiently contribute to the reduction of psychophysiological symptoms by increasing the body’s capacity to tolerate intense emotional experience, as we saw in the examples of treatment in chapters 1 and 2.
When we shut our bodies down as our emotional experience becomes unbearable, our ability to process difficult emotional experiences—something we need to do to remain open and connected in relationships—is compromised. In this state, we are more likely to find that others are responsible for the problems we have with them, increasing our distrust in them. Our ability to communicate, regulate, be regulated, and exchange vital energies in relationships is also impaired, further eroding the quality of our relationships. Our attachment patterns in childhood can become reactivated and reinforced. When we shut ourselves down in important relationships in our immediate environment, we also compromise our connection to the collective body and psyche and their resources. Because emotional embodiment work creates a greater capacity for the intense emotional experiences that often characterize relationships, it can help us remain open and connected to significant others, heal wounds from old relationships, and transform our earliest and most entrenched attachment patterns, which often take the form of implicit emotional memories in the brain and the body.
Attachment theory has found affect regulation to be crucial in repairing attachment wounds.13 Embodied attunement—the ability to sense emotional states in another’s body within our own body—is the key to affect regulation.14 When we are able to tolerate emotional states in ourselves, we can remain open to sensing, tolerating, and regulating others through interpersonal resonance. Interpersonal resonance refers to the ability our bodies and brains have to sense and regulate the emotional or physical state of another person by sharing information with each other through energies of the electromagnetic spectrum when we are near each other,15 and through quantum mechanical principles, such as quantum entanglement, even when we are at a great distance from each other.16 Developing the capacity to tolerate difficult emotions in the body through emotional embodiment work can therefore be of great help to both clients and therapists engaged in attachment work.
People often seek therapy because bad experiences in past relationships are causing them to have relationship problems, hardship in current relationships, or difficulty in forming new relationships. We saw that pattern in the cases of Kim and Peter. Let us now discuss another example of treatment in which emotional embodiment work was of great help in expanding relationship capacity.
When Sonia’s husband told her he had fallen in love with their secretary, she said she just accepted it and moved on. She was in another relationship when she attended a workshop I offered in Germany. The symptom she wanted help with was her inability to feel close to her new partner. No matter how hard she tried, she could not feel as loving toward him as she had felt toward her ex-husband. Sonia had worked on the end of her marriage in therapy, and she was therefore quite surprised how much energy, shock, and hurt there was behind her closed heart when we worked with it through awareness, intention, movement, self-touch, and expression.
In the session, we worked with the consequences of a broken heart—something to which we can all relate. When people have their hearts broken, the pain is so great that they sometimes end up in hospital emergency rooms, thinking they are having a heart attack. There is grief, hopelessness, despair, shame, guilt, and worthlessness. There is also the hurt, ache, and rawness of a wounded heart, and the stress, disorientation, and dysregulation that usually accompany loss of significant support in one’s life. No wonder people shut their hearts and bodies down to cope with such awful experiences, with cognitive, emotional, and behavioral problems as a consequence.
Using the larger body container and the support of the group, we helped Sonia to expand and process her overwhelming emotions from the experience of betrayal that had shut her heart down. When I heard from Sonia many months later, she said she was so happy about the session and its effect on her relationship that she summed it up in one sentence: “That session alone was worth the price of the workshop!”
At times, I hear from trainees and clients who tell me they’re noticing improvement in their spiritual practice or that their spiritual practice appears to be getting deeper from emotional embodiment work. It is hard to know what they mean specifically by “improvement in spiritual practice” because there are so many spiritual practices and there is so much variation among different spiritual paths. Still, let us explore how emotional embodiment work could improve outcomes in any spiritual practice.
Spiritual growth can be defined broadly as improvement in the relationship between the individual and a greater power, called “God” in some religions. Spiritual growth can also be conceptualized nonreligiously as improvement in the connection between the individual and the whole. Quantum physics tells us that the individual is ultimately inseparable from the whole at the subatomic level. The ability to tolerate emotion at the individual level by making the body more available for interactions with the environment can improve the individual’s connection to the collective level of our existence.
Jungian psychology—whose goal is individuation, or the development of a stable and healthy relationship between the individual ego and the collective self (which is defined as the totality of collective matter and psyche)—emphasizes that the basic requirement for individuation or personal growth is the ability to tolerate opposites at the level of the individual. Advaita Vedanta cites the same ability—the capacity to tolerate opposites in experience at the individual level—as a basic precondition or qualification for enlightenment, a state wherein the individual achieves a stable expanded awareness that the individual and the collective are one and the same. The Western alchemy tradition requires the ability to tolerate opposites as a basic prerequisite for transforming base metals (ordinary psychological experiences) into gold (extraordinary psychological transformation).
When we develop a greater capacity to tolerate opposites in emotional experience, such as hope and despair or love and hate, the individual body—and therefore the individual psyche—need not shut down in the face of seemingly unbearable or unacceptable emotional experiences. They can remain more open and connected to the collective body and psyche. Therefore, it makes sense that emotional embodiment work has been found to be helpful in improving outcomes in diverse spiritual practices that strive toward increasing the connection between the individual and the collective in whatever way it may be conceptualized. When awareness is not distracted by or concentrated in suffering at the individual level, it can soar to own the individual as well as the collective level as itself, which is another way of describing enlightenment.
In the examples of emotional embodiment work presented in chapters 1, 2, 3, and 4, we worked with experiences ranging from extraordinary traumas, such as electrocution and premature birth, to ordinary but difficult life experiences of separation and loss of adult relationships. The levels of stress and dysregulation and the levels of emotion and its intensity varied from low to high, and the traumas ranged from purely physical to purely psychological. They involved shock (posttraumatic stress) traumas, developmental traumas, and developmental shock traumas, where shock trauma has developmental implications or developmental traumas have led to shock. Almost all the cases presented in these chapters had prior psychotherapeutic or psychopharmacological treatment. Almost all the cases had prior body psychotherapeutic treatment as well. These cases, their outcomes, and reports of similar outcomes by therapists from multiple countries with different orientations to therapy who have integrated emotional embodiment into their work show the versatility of emotional embodiment work as a complementary tool for improving diverse outcomes across a range of therapeutic modalities, including those already oriented to the body.
No method works for everyone, and no method works for the same person at all times. That is why there are many psychological methods, to meet the differing needs of individuals as well as changing needs of the same individual over time. A meta-analysis of research studies on the effectiveness of different therapies shows that, across all therapy modalities, 50 percent of clients reported measurable improvement in eight sessions, and 80 percent of clients reported measurable improvement in six months.17 The ongoing viability of the various methods in the marketplace also indirectly attest to the efficacy of all therapy modalities. It appears that people stay with therapy modalities that work for them and leave those that do not, possibly explaining why studies among clients of different therapy modalities show that those modalities were more or less equally effective in meeting the needs of their clients.
There is also growing evidence that including the body in some way can improve the effectiveness of all therapies. That is probably why mental health professionals are repeatedly placing body-oriented courses and presentations at the top of their lists of things they would like to see more of in Psychotherapy Networker magazine (the magazine with the largest circulation among mental health professionals in the United States) and its conferences. That is also probably the reason for the steady increase in the offering of courses on body-oriented methods for continuing education of mental health professionals.
The aim of ISP is to increase the effectiveness of all therapy modalities, body-oriented or not, by involving the body in their work in a particular way. The primary clinical strategy used by ISP is emotional embodiment. This happens through the embodiment of a greater range of emotions, especially the often-overlooked but always present sensorimotor emotions, in as regulated a manner as possible, with simple tools that can be easily incorporated into the diverse therapy modalities out there. It is a complementary method for incorporation into all therapy modalities. It is best not to approach it as a therapy modality in itself, as that could severely limit its potential use and benefit when perceived as just one among many competing modalities. Because emotional embodiment work brings a broader understanding of emotions, and because it emphasizes educating clients about different kinds of emotions, it offers therapists a better chance of getting clients in all therapy modalities to sense and work with emotions in their body, to help resolve their symptoms efficiently.
All methods have limitations. So, despite the evidence that emotional embodiment is effective in improving outcomes in all kinds of therapies and all kinds of individuals in different clinical situations, an answer to the question of when it might be ineffective or contraindicated is very much in order. Emotional embodiment is unlikely to work when a person’s emotional development is so lacking that they are not able to access and stay with emotions. It is also not likely to work when a person cannot sense their body, at least at the level of emotion, because emotional embodiment work requires the ability to sense emotion in the body. It is also not likely to work with people who easily decompensate when body awareness is brought to bear in relation to emotions. Emotional embodiment is not likely to work with those who lack enough of an observing ego for their experiences, nor with those at the extremes of the clinical spectrum, such as schizophrenia. Other limitations of the work will surely emerge as it is incorporated and tested in different therapeutic modalities for different ends.
However, a person’s ability to sense one’s body and emotions depends very much on the therapist’s understanding of the different types of emotion and the role the body plays in emotional experience, and on the therapist’s ability to educate, guide, and support clients to sense different types of emotions in their body. I often hear therapists say their clients cannot sense their body or get in touch with their emotion. Based on my experience, I think this often occurs because the therapist is working with either too narrow a definition of emotion or is not giving their clients adequate education about emotion, sufficient emotional support, or enough motivation to work with emotion.
Clients come to therapy not because they are feeling good but because they are feeling bad enough to do something about it. They have to feel bad enough in the body for them to come into therapy and spend hard-earned money to find relief. Now, feeling bad is an emotion—a basic sensorimotor emotion, or an aspect of the experience of any unpleasant primary emotion, such as sadness or fear. Feeling bad is something they could easily and readily sense in their body if their therapist guided them there. In my experience, clients are able to arrive at more differentiated emotional states when they first work with the basic sensorimotor affects, such as feeling bad or awful in the body, which are almost always available. This technique is effective because it is the “feeling bad” aspect of an emotion that often makes it intolerable. Asking clients what they sense in the body or what they feel and where they sense it in the body in the abstract is unlikely to motivate them enough to get there.
Clients also need to be educated about why it is important to sense something unpleasant in the body, and why it is helpful to expand the unpleasant emotional experience in the body. Most people seek treatment to rid themselves of their suffering. They will not be motivated to suffer any more than they already are if they do not get some simple explanation from the therapist that explains how what they are being asked to do is connected to the healing of their symptoms. For example, a therapist could say: “Just as it is easier and faster to carry a load with two arms than with one, it is easier and faster to process an emotion that is causing a symptom with more parts of the body than with one.” Here is a more detailed example:
“When painful feelings become unbearable, we shut the body down to cope with it. Then, the body becomes more stressed and dysregulated, and its connections to the brain, other people, and the world at large are compromised. Psychophysiological symptoms form as a consequence. When we expand the body by working with defenses against emotions to expand the painful emotions in the body, it can help the body to get regulated and remain open and connected to the brain as well as to other people and the environment. In that way, our symptoms can resolve. And we might even find that the pain of the emotion is bearable.”