by Catherine Dowling and Brenda Doherty
Integrative psychotherapists have a vast array of methods and techniques at their disposal but two of the most powerful and effective tools in the therapist’s tool kit are the ones the client brings to the session themselves: their body and their breath.
Body and breath are elements of many therapeutic approaches. Gestalt and other therapies use body awareness, movement and posture as points of access to what is going on for the client, past and present. When the client moves their arm, for example, we may ask them to follow through with that movement but the movement is generally used as a signpost pointing to emotional or cognitive levels of experience. These are then processed through talking and catharsis. The body’s function is to kick-start the verbal processing of emotional and cognitive material.
The breath is used similarly. Unconscious sighing, shallow breaths, sudden deep, full breathing are all noticed as doorways to the emotions and thought patterns that go with them. Deep, diaphragmatic breathing is used to regulate emotional states. But the breath is rarely used as the means of exploration and processing. It’s as if the body and breath are servants to the emotional and cognitive processing that forms the bulk of most psychotherapy sessions.
Two modalities that put the body or the breath as an equal partner with the emotions and the mind are Sensorimotor Psychotherapy and Rebirthing Psychotherapy (breathwork). The basis of both modalities is holism: body, mind, emotions and spirit form an integrated whole that is embedded in and connected to the wider universe. Past experiences and core beliefs may be articulated by the mind but are stored throughout the body and are immediately accessible through body and breath. This article will give a brief introduction to both modalities and describe the role body and breath can play in the therapeutic process.
Sensorimotor Psychotherapy grew out of clinical practice with trauma victims, but the therapy is equally applicable to developmental and other issues. The foundation of Sensorimotor Psychotherapy is the body. Trauma can profoundly affect the body and produce a range of involuntary bodily reactions that often remain decades after the traumatic situation has passed. War veterans, for example, often startle and lash out when elements of the traumatic situation – a loud noise or unexpected movement – occur. Victims of rape can experience physical and emotional numbness in situations that, however innocently, trigger the original trauma. But all experiences, traumatic or otherwise, are carried in the body and have physiological as well as cognitive and emotional components.
Responses to events and patterns of relating are laid down in the neural pathways etched into the brain. They are also visible in what Wilhelm Reich (1980), one of the pioneers of breathwork, called “body armouring” (368): belief systems and experiences sculpt our posture, muscle tone and patterns of movement. In Sensorimotor theory, this sensory information can, and often does, over-ride the regulatory functions of the thinking mind. The body, therefore, is the starting point when working with clients. But the body is not just a gateway to the emotions and memories that are associated with a trauma or formative event. It has an intelligence of its own and is, therefore, a locus of healing in itself.
A Sensorimotor Psychotherapy session begins by bringing awareness to the body, to posture and sensation. The client is encouraged to be aware of all sensations and to let those sensations simply be. The body’s innate wisdom is then honoured with an invitation from the therapist to move in whatever manner it chooses. The word ‘invitation’ is the key to creating safety. The body is never directed, only invited to reveal its story. And it is never required to express itself under the cold light of clinical observation. The Sensorimotor psychotherapist tracks and accompanies the movements of the client’s body so that the body never feels scrutinised or alone. This creates what Pat Ogden, the founder of Sensorimotor Psychotherapy, calls the “window of tolerance.” (Ogden et al., 2006: 26-29). The window of tolerance is the safe zone where the client is neither over-stimulated at the top of the window, nor numbed out at the bottom. It’s the range of activation where effective therapy can take place.
Working at the body’s own pace, the client moves deeper into self-exploration through exploring the impulse to move. Where do the inner sensations and impulses want to go? Often they want to go to the place that was off-limits to the client during the original experience. A traumatised client might want to push against an abuser or attacker; something they were not able to do during the traumatic experience itself. A client who stoops under the weight of self-loathing might feel the impulse to stand tall. Someone who learned to hold in emotions such as anger may want to punch or shout. They are encouraged to follow that impulse and to reclaim the defensive actions that were not available to them in the past. Their story, the detail of past events, is less important therapeutically than the visceral, physical experience of reclaiming their own autonomy and personal power. Breaking through the body armouring in this way can lead organically to emotional release and to the awakening of memory, all within that window of tolerance. The client can then process the material cognitively, or what Ogden calls “make meaning” (Ogden et al., 2006: 269-271).
An essential skill of the Sensorimotor psychotherapist is to follow the body in present time. This constitutes a journey into the unknown. There is no way of predicting where a sensation, a movement or an invitation will lead. Both therapist and client must be guided, moment to moment, by the client’s body, always inviting, always accompanying. Over time this honouring of the body and its impulse to reclaim lost autonomy leads to further physiological change. New neural pathways form in the brain, thus laying down a physical foundation for behavioural change.
Rebirthing Psychotherapy has its starting point in the body too, but with emphasis on breathing. A rebirthing session can take from 20 minutes to an hour of a type of breathwork called conscious connected breathing or CCB. In CCB the inhale and exhale are connected seamlessly through eliminating any pauses in the breathing cycle. This is done mindfully or consciously with attention initially focused on the physical sensations of breathing, both subtle and gross. Attention then expands to awareness of all the other somatic sensations present in the body.
The client is instructed to observe these feelings as they arise. Mindful observation allows sensations to come to the fore, to be recognised and acknowledged instead of suppressed or dismissed. Life events imprint themselves on breathing patterns in a kind of ‘breath armouring’. For example, someone who has learned to fade into the background, or who has developed a pattern of fearful engagement with life, will breathe shallowly and most likely into their mid-chest. CCB begins to break down that breath armouring and, as with Sensorimotor Psychotherapy, somatic sensations turn into emotions and cognitions. In Rebirthing Psychotherapy, this process can be fast and it is not guided in detail by the therapist in the same way that the therapist moderates the progress of Sensorimotor therapy. Rebirthing, therefore, is less suited to trauma work and is most effective with developmental issues that do not involve severe trauma.
Rebirthing offers experiential access to somatic, emotional and cognitive material that is often less readily available through forms of talk therapy, even when that therapy includes attention to physical expressions of deeper issues. In rebirthing, the process of breathing takes the client to what is called “completion” (Dowling, 2000: 148-9). This means the emotional and physical arousal subsides and the client reaches a cognitive resolution – an understanding of what has occurred and its significance. This is similar to ‘making meaning’ in Sensorimotor therapy. The role of the therapist is not only to facilitate the breathwork with minimal intervention but to help the client consolidate that ‘meaning’ and achieve cognitive ‘completion’ after the breathwork has concluded.
One of the major differences between these two types of therapy is the phenomenon of expanded awareness or altered consciousness. In rebirthing, breathers often enter a mystical state of consciousness, beyond mindfulness. This state is usually suffused with a perception of love, of being cherished and cocooned by the universe. Whether the client experiences this as the presence of God or has a more secular interpretation depends on the client’s belief systems and past experience. Regardless of the interpretation, the experience of deep, all-embracing love and acceptance can be transformative and constitutes an additional, highly significant dimension to therapy.
Both Rebirthing and Sensorimotor Psychotherapy take a holistic approach – they engage the emotions, the mind and the body in a way that all three functions serve and support each other. Because of the altered consciousness aspect of rebirthing, it is more suited to work with developmental issues rather than severe trauma. It is, however, a seamless fit with Sensorimotor Psychotherapy for clients who have learned to work within the window of tolerance. Both modalities offer the invaluable dimensions of body and breath as tools for other forms of psychotherapy.
Catherine Dowling MA is the author of Radical awareness: Five practices for a fully engaged life and Rebirthing and breathwork: A powerful technique for personal transformation. She can be contacted at http://www. catherinedowling.com.
Brenda Doherty is a Breathwork Psychotherapist and Level Two Graduate with the Sensorimotor Psychotherapy Institute. She can be contacted at http://www.mindandbodyworks.com/therapists/brendadoherty.
Dowling, C. (2000). Rebirthing and breathwork: A powerful technique for personal transformation. London: Piatkus.
Dowling, C. (2014). Radical awareness: Five practices for a fully engaged life. Woodbury, MN: Llewellyn Worldwide.
Ogden, P., Minton, K. & Pain, C. (2006). Trauma and the body: A sensorimotor approach to psychotherapy. New York: Norton.
Reich, W. (1980). Character analysis. New York: Farrar, Straus & Giroux.