The Body is the Map of the Mind.
—J. D. Landis, Solitude
Physical sensations are the very foundation of human consciousness. As the biological creatures that we are, our bodies are designed to respond in an ever-changing, challenging and often dangerous world. A new baby must gradually learn to discern the meaning of the sensations that his or her body is experiencing. Babies learn about their body/mind self through action and interaction with their parents and with the environment that surrounds them. Infants live within a sea of sensations. Fortunately most parents catch on fairly quickly to their newborn’s code. They know when she is signaling the various and unmistakable sensations of hunger, pain, anger and tiredness because babies instinctively communicate those internal states, inducing their caregivers to provide relief. It is a matter of survival. Later, however, this evolutionary brilliance serves more than a life-or-death function. Sensations actually form the bedrock for a child’s gradual maturation toward authentic autonomy and independence.
As you grow, you are defined by how your body interacts with your environment. What you do physically—whether experiencing pleasure or pain, success or failure—is registered by your body and recorded in your mind. Your knowing about the world, as you interact with it, comes from the totality of your sensations, both external and internal. Sir Charles Sherrington, winner of the 1932 Nobel Prize in Physiology or Medicine, said that “the motor act is the cradle of the mind.” Fifty years later another such laureate, Roger Sperry, elaborated on Sherrington’s iconic premise:
In so far as an organism perceives a given object, it is prepared to respond with reference to it … The presence or absence of adaptive reaction potentialities, ready to discharge into motor patterns, makes the difference between perceiving and not perceiving.81
In a series of astonishing experiments stimulated by the “Sperry Principle,” Richard Held and Alan Hein had adult subjects wear special prism goggles that made everything appear to be upside down.82 After some time (usually a week or two), the brains of the subjects who were free to move about actively, touching and manipulating their environment, adapted so that they actually saw the environment as right side up again. The subjects who were not allowed to move around and explore, however, did not experience visual normalization. Held also carried out experiments that illustrate the developmental significance of motor responses.83 Newborn kittens were put on a movable apparatus and placed within a circular enclosure. One group of kittens walked and pulled the apparatus around the enclosure with them, while the other kittens were pulled along passively. Both groups had exactly the same visual experiences moving around the enclosure. The kittens that were moved around passively, not actively exploring their environment, were unable later to use sight to guide their movements. They could not place their paws properly or move away from a place where they could fall. This deficit was swiftly reversed when they could actively move around, exploring their environments.
Finally, in this parade of Nobel Prize recipients, Gerald Edelman, the American biologist who won the prize in 1972 for his work on immunology, has proposed a theory of what he calls Neural Darwinism.84 This complex theory recognizes the intrinsic relation of motor activity, from our past and present explorations of the environment, as the underpinning of experience and memory. Collectively, these Nobel recipients see “mindedness” (including our complex structure of meaning making) as deriving from the fine tuning and categorization of our actions, sensations, feelings and perceptions. Turning earlier theories on their heads, we are now aware that, rather than being the hierarchical, top-dog commander in chief, our thoughts are a complex elaboration of what we do and how we feel.
Thought can indeed be said to function as an “explanation” to ourselves: a reminder of what we are doing and feeling. Thinking and symbolizing help us to make categories of events, people or locations, such as “safe” and “dangerous.” The evolution of thoughts, symbols and verbal communication, derived from sensations, gave our earliest ancestors a crucial edge, allowing them to share successes and failures and to pass them on to others. As hunters and gatherers, survival meant being fully in our bodies just like the babies. Excessive mental rumination would have surely meant sudden death or slow starvation. However, over the millennia, the innate intelligence of the body was abandoned for the exclusivity of rationality, symbolization and language. Our bodies came to exist solely (as a character in a Jules Feiffer cartoon quipped) “to transport our heads from place to place … Otherwise we would have no need for them.” On the contrary, consciousness actually unfolds through the development of body awareness, of learning to understand the nuances and the meaning of our internal physical sensations, and of our emotional feelings as well.
Under ordinary circumstances, physical sensations are signals for action: to fight or flee when threatened, to chase down a wild turkey or open the fridge and make a sandwich when hungry, to go the bathroom when the urge presses, to make love when aroused by passion, to sleep when tired, to break into song when the mood strikes or to plant your feet and raise your voice in anger and assertiveness when your boundaries are violated. In all these instances, the body initiates and the mind follows.
Having an intimate relationship with, and understanding of, your physical sensations is critical because they, in signaling action, guide you through the experiences and nuances of your life. If one has been traumatized, however, one’s sensations can become signals not for effective action but, rather, for fearful paralysis, helplessness or misdirected rage. When some of one’s bodily signals become harbingers of fear, helplessness, impotent rage and defeat, he or she is typically avoided like the plague at a dear cost mentally, emotionally and physically. While attempting to shut down distressing sensations, one pays the price of losing the capacity to appreciate the subtle physical shifts that denote comfort, satisfaction or warning of clear and present danger. Sadly, as a result, the capacity for feeling pleasure, garnering relevant meaning and accessing self-protective reflexes also shuts down. You can’t have it both ways; when feelings of dread are held at bay, so are the feelings of joy.
The good news is that human beings are generally flexible and resilient: we are ordinarily able to learn from and integrate a variety of life experiences. These experiences, whether uplifting or downbeat, flow easily through our body/mind stream of consciousness as long as we are not chronically over- or underaroused. The body/mind keeps flowing through new encounters with vitality, bouncing back into the stream of things unless there is a significant disruption. In this case, the person is knocked off that normal course—whether it is from a single episode, such as a disaster, an accident, surgery or rape, or from a chronic stressor, such as abuse or ongoing marital stress. When such disruptions fail to be fully integrated, the components of that experience become fragmented into isolated sensations, images and emotions. This kind of splitting apart occurs when the enormity, intensity, suddenness or duration of what happened cannot be defended against, coped with or digested. Personal vulnerability, such as age, genetics and gender also account for this psychic implosion. The result of this inability for the body/mind to integrate is trauma, or at the very minimum, disorientation, a loss of agency and/or a lack of direction.
Trapped between feeling too much (overwhelmed or flooded) or feeling too little (shut down and numb) and unable to trust their sensations, traumatized people can lose their way. They don’t “feel like themselves” anymore; loss of sensation equals a loss of a sense of self. As a substitute for genuine feelings, trauma sufferers may seek experiences that keep them out of touch—such as sexual titillation or succumbing to compulsions, addictions and miscellaneous distractions that prevent one from facing a now dark and threatening inner life. In this situation, one cannot discover the transitory nature of despair, terror, rage and helplessness and that the body is designed to cycle in and out of these extremes.*
Helping clients cultivate and regulate the capacity for tolerating extreme sensations, through reflective self-awareness, while supporting self-acceptance, allows them to modulate their uncomfortable sensations and feelings. They can now touch into intense sensations and emotions for longer periods of time as they learn how to control their arousal. Once a client has the experience of “going within and coming back out” without falling apart, his or her window of tolerance builds upon itself. This happens through achieving a subtle interplay between sensations, feelings, perceptions and thoughts. I believe that the people who are most resilient, and find the greatest peace in their lives, have learned to tolerate extreme sensations while gaining the capacity for reflective self-awareness. Although this capacity develops normally when we are very young, one can learn it at any time in life, thankfully.
Children gradually learn to interpret the messages their bodies give them. Indeed, it is by learning to coordinate movements (behaviors) and sensations into a coherent whole that a child learns who he or she is. By remembering actions that have proven to be effective, and discarding those that are not, children learn how to anticipate what the most appropriate response is and how to time its execution for maximum effect. In this way, they experience agency, satisfaction and pleasure. When a child is overwhelmed by trauma or thwarted by neglect, this developmental sequence is aborted or, if already developed, breaks down; and negative emotions come to dominate his or her existence.
After being traumatized, a child’s relationship with his or her body often becomes formless, chaotic and overwhelming; the child loses a sense of his internal structure and nuance. As the body freezes, the “shocked” mind and brain become stifled, disorganized and fragmented; they cannot take in the totality of experience and learn from it. These children, who have become “stuck” at some point along a once meaningful and purposeful course of action, engage in habitually ineffective and often compulsive patterns of behavior. These often play out in symptoms like those of attention deficit hyperactivity disorder or obsessive-compulsive disorder. The child’s uncoordinated fragmented efforts are not registered as normal, explicit, narrative memories but rather are encoded in the body as implicit, procedural memories including discomfort, constriction, distress, awkwardness, rigidity, flaccidity and lack of energy. Such memories are encoded not primarily in the neocortex but, instead, in the limbic system and brain stem. For this reason behaviors and memories cannot be changed by simply changing one’s thoughts. One must also work with sensation and feeling—really with the totality of experience.
Human beings, in general, and therapists, in particular, make contact through a kind of “body resonance.” As described in Chapter 4, we humans are programmed to experience sensations similar to those of people with whom we are in close proximity.85 Imagine the scenario of being in a room filled with anxious conspiracy theorists as compared to one with blissful, meditating monks.
Resonance forms the basis for the empathic attunement needed to form intimate relationships.86 In treating traumatized individuals, a therapist first needs to cultivate a deep and enduring relationship with his or her own body. Only when a therapist’s embodiment skills are intact and engaged can he or she mentor and self-empower a client. Similarly, by refining their own capacity to observe the subtle behaviors of others, therapists can provide their clients feedback that helps them become aware of their sensations and feelings. Together, these two tools—somatic resonance and subtle observation—are of incalculable power and benefit. In the words of the analyst Leston Havens, “Perhaps the most striking evidence of successful empathy is the occurrence in our bodies of sensations that the patient has described in his or hers.”87
During the 1970s, I developed a model that allowed me to “track” the processes whereby my clients processed experiences. This model, which I call SIBAM, is based on the intimate relationship between our bodies and our minds. The model examines the following five channels, with the first letters of each element making up the acronym.
Sensation
Image
Behavior
Affect
Meaning
The SIBAM model stands in sharp contrast to the established hierarchical framework, codified as cogito ergo sum or “I think; therefore I am,” which has been the foundational premise of the standard, cognitive-behavioral therapies. In contrast, my five-element model is the essence of “bottom-up,” sensorimotor processing aimed at guiding the client through different “language” and brain systems, from the most primitive to the most complex; from physical sensations to feelings, perceptions and, finally, to thoughts. Sensation, Image, Affect and Meaning are tracked by the client, while Behavior is directly observed by the therapist. This approach allows for an intimate tracking of the multiple layers and textures of the totality of experience.
In this channel, I refer to physical sensations that arise from within the body, from receptors lying in the interior of our organisms. These sensations are also known in the literature as interoceptive. They ascend via nerve impulses from the interior of the body to the thalamus in the upper brain stem, where they are transferred to many, if not most, regions of the brain. Four subsystems, or categories, make up the sensation channel in order of increasing depth: the kinesthetic, the proprioceptive, the vestibular and the visceral receptors.
The first subsystem within the sensation channel is kinesthesia. The kinesthetic sense signals the state of tension of our muscles† and relays this information to the brain. When you feel “uptight,” it is because you are receiving excess nerve impulses coming from muscles in your shoulders and other areas—such as neck, jaw or pelvis—as well as from an overactive mind.
The second subsystem, called proprioception, gives us positional information about our joints. Together, kinesthesia and proprioception tell us where we are in space, as well as the velocity of any body part. One could, for example, conduct a symphony with one’s eyes closed and then at the end place a finger precisely on the tip of one’s nose without looking—an extraordinary but possible feat of sensation and coordination.
The vestibular subsystem derives from microscopic hairs embedded within the semicircular canals of the inner ear. There are two of these canals positioned at right angles to each other. When we move (accelerate and decelerate in any direction), fluid in these canals “sloshes” over the hairs, bending them. Each hair is connected to a receptor, and these receptors then send afferent impulses to the brain stem. Information from this sense lets us know our position with respect both to gravity and to any change in velocity (i.e., acceleration and deceleration).
The fourth subsystem, which provides the deepest level of interoception, derives from our viscera and blood vessels. In Chapter 6 I described the vagus nerve, which connects the brain stem to most of our internal organs. This massive nerve is second only to the spinal cord in total number of neurons. Over 90% of these nerve fibers are afferent: that is, the vagus nerve’s main function is to relay information from our guts upward to our brains. Thus, the colloquialisms “gut instinct,” “gut feelings” and even “gut wisdom” have a robust anatomical and physiological basis. Visceral sensations also originate from receptors in the blood vessels—as sufferers from migraines know all too well, the abrupt dilation of blood vessels (after strong constriction) causing their excruciating pain. However, we are also receiving all sorts of other ambient information from our blood vessels. We feel relaxed and open when our blood vessels and viscera gently pulse like jellyfish, causing sensations of warmth and goodness to surge through our bodies. When the vessels and viscera are constricted, we feel cold and anxious.
While image commonly refers to visual representation, I use it more generally to refer to all types of external sense impressions, which originally come from stimuli that arise from outside the body and that we have also incorporated into the brain as sense memory. These external (“special”) senses include sight, taste, smell, hearing and the tactile sense.‡ Counter to common parlance, I use the same word—Image—to categorize all of these external senses. Indeed, the I in the SIBAM model could refer, equally, to any of the externally generated Impressions (i.e., visual, auditory, tactile, olfactory, etc.). For example, if a person is physically touched by another person, he or she will experience both the external impression of being touched as well as the internal (interoceptive) sensation of his or her response to that touch. So if we have been touched inappropriately, it will be necessary to separate the actual tactile impression from our internal response to this stimulus in each new situation in order to free ourselves from reflexively reacting from past experience.
The visual impression, or Image, is the primary way modern humans access and store external sense information, unless they are visually impaired. The largest portion of our sensory brain is dedicated to vision. There are, however, other therapeutically oriented reasons for my including all of the external senses in the Image channel. At the moment a trauma takes place, all of a person’s senses automatically focus on the most salient aspect of the threat. This is usually a visual image, though it could also be sound, touch, taste or smell. Many times it is a combination of several or, even, all of the above sense impressions simultaneously. For example, a woman molested by an alcoholic uncle may panic on seeing a man who looks vaguely like him or whose breath smells of alcohol and who walks with a loud, lumbering gait. These fragmentary snapshots come to represent the trauma. They become, in other words, the intrusive image or Imprint. For me, the image of the shattered glass and the eyes of the teenage driver kept intruding on my consciousness and flooding me with fear and dread.
When reworking such embedded sensory images, a process of diffusing the adrenalin charge of the compressed “trauma snapshot” is necessary in order to uncouple associations that are symptomatic. An important therapeutic technique “expands and neutralizes” this fixation and helps the person recover the multisensory experience he or she may have had prior to the threat that caused the fragmentation. The following vignette illustrates this principle of expanding the “visual aperture.”
Imagine that early one summer morning, you are walking along a beautiful hillside. There is a babbling brook meandering beside the pathway. A gentle breeze makes the multicolored flowers look as if they are dancing on the meadow. You are touched by the sight of drops of morning dew sitting on a blade of grass. The sunshine warms your skin, and the scent of the flowers is nothing less than intoxicating. You are taking this all in. Then, unexpectedly, a large snake appears on the trail. You stop and hold your breath. All that you had perceived a moment ago is gone … or is it? Not really. What happens is that your perception has constricted to focus narrowly on the source of the threat. Most everything else retreats into the background, into the hidden crevices of your mind, so as not to distract you from what you must identify and do: to keep your attention solely focused on the snake and to slowly back away. After feeling safe again, you may return to the full sensory experience of the morning. When a traumatized individual is able to expand his or her sensorial impressions, associated hyperarousal begins to ease, allowing that widened perceptual field to return to its prethreat status, and thus enhances the capacity of self-regulation.
Before my accident, as detailed in Chapter 1, I was taking in the scene: the colors, sounds, scents and warmth of that perfect day. In the instant that I was struck, these pleasant images paled. Now my attention was riveted only on the image of the “predator”: the spiderweb cracks of the windshield, the beige grille of the car and the terrified face of the wide-eyed teenager. Luckily, in my self-administered first aid, I was able to return to the start of that perfect day, with the sensuous sights, sounds and smells of the precious moments before the impact.
Behavior is the only channel that the therapist is able to observe directly; all others are reported by the client. Although the therapist is able to surmise much about a client’s inner life from a resonance with her own sensations and feelings, such inferences cannot take the place of the client also accessing and communicating his own sensations, feelings and images to the therapist.§ The therapist can infer a client’s inner states from reading his body’s language, the unspoken language of his actions/inactions or tension patterns. For example, the therapist, in noting a particular body behavior, may direct the client to focus on what he may be experiencing in his body (Sensation). If, say, the therapist observes a slight rising of the client’s left shoulder (Behavior), she can bring the latter’s attention to this postural adjustment and allow the client to contact the sensations of the asymmetrical tension pattern. Similarly, the client may be encouraged to access the other channels of experiencing (Image, Affect or Meaning) during the execution of this postural behavior. This will be clarified by the case examples in the next chapter.
Behavior occurs on different levels of awareness, ranging from the most conscious voluntary movements to the most unconscious involuntary patterns. These levels are similar to the gradations of consciousness I have examined in the sensation category. We will now briefly examine behaviors that occur in the following subsystems: gestures, emotion and posture, as well as autonomic, visceral and archetypal behaviors.
The most conscious behaviors are the voluntary ones: that is, the overt gestures that people generally make with their hands and arms when they are trying to communicate. These movements are the most superficial level of behavior. People frequently use voluntary gestures to convey “pseudo-feeling” states to others. We have all seen politicians deliberately exaggerate their gestures for emphasis and effect. If you know the real thing, you can readily discern the fundamental disconnect or incongruity between one’s attempt to convey what one is trained to express (e.g., opening one’s arms to the audience or holding a hand to one’s heart) and what one is really feeling. At the same time, even volitional gestures can convey feelings, both to others and to oneself.
For example, one can interpret the nonverbal communication of the clenched fist as either a threat enhancing aggression or as the setting of clear boundaries and quelling fear. Here are some common gestures to experiment with: Rub your forehead with your hand and notice how that feels. Now stroke the back of your neck. What do these two gestures convey to you? Do they make you feel more or less secure? How about when you are wringing your hands versus when they are steepled, fingertip to fingertip? What differences do you notice?
Facial expressions are at the next level of behavior and are generally considered to be largely involuntary. These micro-expressions are what the renowned Paul Ekman88 studied in his pioneering research spanning over four decades. With practice and patience, one can develop the skills necessary to observe these very brief changes of muscle tension (often in a fraction of a second) throughout parts of the face.‖ The specific patterns of these muscle contractions communicate the full range of emotional nuances to oneself and to others.a Giving clients feedback about their facial expressions can help them contact emotions of which they may be partially or fully unaware.
The third level of less conscious awareness in the behavior category is posture. Here I’m not referring to gross voluntary postural adjustments like those demanded by parents or teachers, such as “sit-up straight,” “don’t slump” or “shoulders back,” which refer to voluntary movements. These belong instead to the category of voluntary gestures. Sir Charles Sherrington, the grandfather of modern neurophysiology, alleges that “much of the reflex reaction expressed by the skeletal musculature is not motile, but postural, and has as its result not a movement but the steady maintenance of an attitude.”89 I would add that postures are the platforms from which intrinsic movement is initiated. In the words of A. E. Gisell, a student of Sherrington’s, “the requisite motor equipment for behavior is established well in advance of the behavior itself.” In underscoring how important posture is in the generation of new behaviors, sensations, feelings and meanings, Gisell added, “The embryogenesis of mind must be sought in the beginnings of postural behavior.”90
Although relatively few therapists have cultivated the precise reading of postures, they are still being impacted by them. We all subconsciously mirror the postures of others and register them as sensations in our own bodies. This occurs presumably through the operation of mirror neurons and postural resonance. Since spontaneous postural changes are generally subtle, it takes a lot of practice to observe them. Resonance is particularly compelling with survival-based postures such as the nuanced varieties associated with the premovements and movements of flight, fight, freeze/fright and collapse.
If a posture is rigid from bracing or is collapsed, we can assume that it was a preparation for some particular action, an action that was thwarted and that the muscles are still programmed to complete. If this dormant sensorimotor trajectory had not been impeded, it would most likely have had a more triumphant outcome—as it still can retroactively. In recounting my accident, I described what I was aware of in my body as I lay helpless in the ambulance. It was, first, from a subtle twisting sensation in my spine that I felt my arm initiate an upward move to protect my head from being smashed on the windshield and, consequently, on the road.
Observing spontaneous (intrinsic) postures gives the therapist a vital window into the state of a client’s nervous system and psyche. The body benevolently shows us when we are preparing to act and precisely what incipient premovement action is being prepared for. Most often, we as keen observers see before our very eyes a bodily orchestration unfolding that neither the therapist nor the client could ever have rationally predicted. The therapist begins by noticing postures that show rigidity, retraction, poised preparation for flight, twisting and collapse, as well as those of openness and expansion. I think of the unforgettable postural ease in someone like Nelson Mandela who, despite both the magnitude of his trauma and his advanced age, maintains a natural, graceful posture. And numerous people have described how they felt deeply relaxed and open in the presence of the Dalai Lama. The adroit therapist both sees and senses the opposite of such grace in a client whose spine becomes more rigid, braced against a perceived assault, or collapses (sometimes nearly imperceptibly) while experiencing difficult sensations and emotions. In the same manner therapists (and mothers, fathers and friends) are also able to observe and reflect momentary states of grace and goodness in others.
Visible autonomic behaviors include respiratory and cardiovascular signposts. Breathing that is rapid, shallow and/or high in the chest indicates sympathetic arousal. Breathing that is very shallow (almost imperceptible) frequently indicates immobility, shutdown and dissociation. Breathing that is full and free with a complete expiration, and a delicate pause before the next inhalation, indicates relaxation and settling into equilibrium. This type of spontaneous and restorative breath can be easily distinguished from a person who is “trying” to take a deep breath. Often, this kind of voluntary forced deep breath can actually increase imbalance in the nervous system and, at the very least, gives only temporary relief.91
Next are signs from the cardiovascular system, which include heart rate and the tone of the smooth muscles lining certain blood vessels. Heart rate can, as I have said, be monitored by observing the carotid pulse, which is visible as a pulsation in the neck. A therapist can, with a little practice, discern increases and decreases in rate, as well as estimate their magnitude. It is also possible to estimate changes in blood pressure from the strength or weakness of the pulse.
The therapist can identify the tonus of the blood vessels by noting alterations in skin color, although doing so requires a refined level of perception. In the case of a very high tone (vasoconstriction), a client’s cold fingers will have, for example, a whitish/bluish tint, reflecting—along with increased heart rate—sympathetic hyperarousal. On the other hand, when the blood vessels are relaxed and dilated, or open, the fingers are a lively pinkish hue. Yet another variation arises when the capillary vessels dilate abruptly, causing a red flush, noticeable particularly in the face and neck. In addition, the observer can sometimes actually feel a wave of heat emanating from the client’s body.b
The next observation point is pupil size. A very wide pupil is associated with high sympathetic arousal, while a very small pupil can be indicative of immobility and dissociation. “Pinhole”-sized pupils can also be an indicator of drug use—generally of opiates. Interestingly, these opiates are also released by the body’s own internal pain relief system92 and are an integral part of the immobility system and dissociation.93
Visceral behavior refers to the motility of the gastrointestinal tract, whose movements can actually be “observed” by the sounds that it makes. The wonderful onomatopoetic word for these intestinal rumblings and gurglings is borborygmus (plural: borborygmi). An entire system of body-therapy is based upon listening to a spectrum of these gut sounds with an electronic (fetal) stethoscope while different parts of the body are touched and gently manipulated.94
A therapist who is able to track all of the various behavior indicators discussed above has access to critical information that will help her to time various interventions efficaciously. She knows, for example, that cold hands generally indicate fear and stress; while warm ones signify relaxation. Flushed skin can reflect emotions like rage, shame and embarrassment. What is not widely known is that flushed skin can also be the sign of a strong release of energy and a movement toward greater aliveness. As with all such observations, sequence must be understood together with context: no single indicator stands alone. And, of course, the content that the client is currently processing must be considered in the mix. In this way, the therapist can artfully map an accurate topography relating what he is observing (Behavior) to what the client is experiencing (Sensation). In general, there is a correspondence between the level of Sensation and Behavior: that is, when the therapist gives the client feedback about a change in the latter’s autonomic nervous system, such as heart rate or skin color (Behavior), he or she will generally be drawn to exploring autonomic Sensations, such as the level of cardiopulmonary/sympathetic arousal.
Last, but not least, is the subsystem of archetypal behaviors coming from the deep “collective unconscious.” In tracking people’s postural shifts, I began to notice subtle hand and arm gestures that were clearly different from voluntary ones. These gestures often appeared at moments of significant therapeutic movement and frequently indicated pleasingly unforeseen resources and shifts toward flow and wholeness. Moreover, I became fascinated by the similarity of these involuntary gestures to those of the sacred dances that I had seen at various cultural performances presented at University of California–Berkeley’s Zellerbach Hall. These hand/finger/arm movements, called mudras, are all-embracing and inclusive, across the spectrum of the human experience and throughout the world. Particularly in Asia, the way one’s hands and fingers are poised communicates very deep and universal meanings, ones that are related more than just personally to dancer or audience member.c When the therapist observes such spontaneous mudras, then pauses, taking the time to bring them to the client’s attention, the client can then use that information to explore how his “outside” posture feels on the “inside.” It is not surprising, at this juncture, for the client to contact a treasure chest of powerful resources of connection, empowerment, flow, goodness and wholeness. I believe that these archetypal movements arise at unique moments when the instinctual is seamlessly wedded with one’s conscious awareness—when the primitive brain stem and the highest neocortical functions integrate.
In summary, Behavior is the only category that the therapist is directly aware of. As clients become aware—at first only marginally—of their own behaviors, they may incorporate these perceptions into an observer role where they are reminding themselves to note sensations associated with those behaviors. When linked with thoughts, this is a powerful tool to dissolve compulsions and addictions.
The two subtypes in the fourth channel are the categorical emotions and the felt sense, or contours of sensation-based feeling.
Emotions include the categorical ones described by Darwin and refined in extensive laboratory studies by Paul Ekman. These distinct emotions include fear, anger, sadness, joy and disgust. Again, these are feelings that the client is experiencing internally and that the therapist can deduce from the client’s face and posture even when the client is unaware of them.
Another level of affect—the registration of contours of feeling—is, perhaps, even more important to the quality and conduct of our lives than are the categorical emotions. Eugene Gendlin extensively studied and described these softer affects and coined the term felt sense.95 When you see dew on a blade of grass in the morning light or visit a museum and delight in a beautiful painting, you’re usually not experiencing a categorical emotion. Or when meeting a good friend you haven’t seen for months, you’re probably not feeling fear, sorrow, disgust or even joy. Contours are the sensation-based feelings of attraction and avoidance, of “goodness” and “badness.” You experience these nuances countless times throughout the day. While it’s easy to imagine a day without perceiving any of the categorical emotions, try for a moment to conjure up a day without any felt sense affects. On such a day you would be as lost as a ship at sea with no rudder or bearings. These contours guide us throughout the day, giving us orientation and direction in life.
Meanings are the labels we attach to the totality of experience—that is, to the combined elements of sensation, image, behavior and affect. Meanings are like descriptive markers that we use to get a quick handle on the whole spectrum of inner experience so that we can communicate these to others and to ourselves. We all have fixed beliefs, or meanings, that we take to be the unequivocal truth. When a person is traumatized, his or her beliefs become excessively narrow and restrictive. Examples of these crystallized mantras are: “You can’t trust people”; “The world is a dangerous place”; “I won’t ever make enough money to support myself”; or “I’m unlovable.” These beliefs are often connected to primal fears and are, by and large, negative and limiting.
As incredible as this might sound, we are likely to be programmed to have negative beliefs for survival purposes. For example, if you are walking in an area where you are confronted by a bear, you have likely gained the meaning that “this is a dangerous place” and “don’t go that way next time.” Unfortunately, when one has been traumatized or deeply conditioned through fear while young and impressionable, such meanings become pervasive and rigidly fixed. Later in life, rather than a client freely accessing the full spectrum of developing sensations and feelings, conclusions are drawn based on meanings born out of past trauma or early conditioning. I have called this kind of limiting prejudgment premature cognition.
Using the SIBAM model, the therapist can help the client work through the first four channels of awareness in order to reach new meanings. When cognition is suspended long enough, it is possible to move through and experience flow via these different channels (and subsystems) of Sensation, Image, Behavior and Affect. Then it is probable for fresh new Meanings to emerge out of this unfolding tapestry of body/mind consciousness. As an example, a client may start with specific fixed beliefs such as “my spouse is not behaving properly” or “I am unlovable.” The therapist, rather than trying to talk them out of the belief, may instead encourage the client to examine the physical loci of these thoughts, to notice which areas are tense, which are open and spacious, and to locate any feelings of collapse. More importantly, perhaps, clients are also asked to note a vacancy of feeling. A common example (especially in clients who have had sexual trauma) is the sense that one cannot feel one’s pelvis at all, or that it is disconnected from one’s torso or legs. A client asked to scan his body from head to toe might convey an uncanny absence of pelvic sensations. Of course, such an absence gives the therapist an idea of what the client is avoiding.
The SIBAM model includes the neurophysiologic, behavioral and somatic aspects of an individual’s experience, whether traumatic or triumphant. When there is a successful outcome, or a corrective experience occurs during therapy, the elements of SIBAM form a fluid, continuous and coherent response that is appropriate to the immediate situation. When individuals suffer from unresolved trauma, these various aspects of traumatic association and disassociation continue in fixed, now-maladaptive patterns that are distortions of current reality.
An example of this fixity follows: A woman loves nature, parks, meadows and grassy knolls; however, every time she smells new-mown grass she feels nauseated, anxious and dizzy. Her belief (M) is that grass is something to be avoided. The olfactory and visual image (I) is associated with, or coupled to, the sensations of nausea and dizziness (S) coming from her visceral and vestibular systems. This positive feedback loop, with negative consequences, is an enigma. Part of the event is disassociated from her awareness: she has no idea why this happens; she just knows that she has a strong dislike (M) of grass. As this woman explores her sensations and images, seeing and smelling cut grass in her mind’s eye, she takes time to explore her bodily sensations in detail. As she does, she has a new sensation of being spun in the air and held at the wrists and legs. Next she gets a tactile image of her bullying brother giving her an airplane spin on the front lawn of her childhood house when she was four or five years old.
She feels scared (old A), but as she trembles and breathes, she realizes that she is no longer in danger. She now orients (B) by looking around at the peaceful office and then turning her head toward the open face of her therapist. Feeling intact with this newfound safety, she settles a bit. She experiences a spontaneous breath (new B), feeling secure in her belly (new S) now. Then she notices some tightness around her wrists (old S) and the impulse to pry her wrists loose (new S). Now, she feels a wave of anger (new A) building up inside as she yells “Stop!” using the motor muscles of her vocal cords (new B). She settles again and feels (new I) the tactile pleasure of lying on the soft new-mown grass in the warmth of the springtime sunshine. Fresh grass is no longer associated with unpleasant sensations (old M); green, freshly groomed grass is good, parks are wonderful places and “all is well” (new M). She no longer feels nauseated or anxious again in that situation.
The simple example above shows us how the elements of this biological model fit together to create a web of either fixity or flow. In nature, when one feels an internal sensation, frequently an image appears simultaneously or shortly afterward. If a client is bothered by an image, a sensation may accompany it that he is not aware of. When, with the therapist’s guidance, the client becomes conscious of both elements, a behavior, affect or new meaning generally follows.
Once we understand the process and do not interfere with it, biology works to move it along. The sensation-based brain stem has the job of bringing homeostasis and, thus, goodness back to the body. Therefore, it naturally follows that when the client’s body’s behavior becomes conscious in the safety of the present moment, the thwarted movements come to an intrinsic resolution or a corrective experience—as happened with me, Nancy and the woman in the example above. This resolution leads to a discharge of energy, resulting in a fresh, new affect (A) that brings with it brand-new options or meanings. If the client is unaware of behavior or sensation, the fixed image generally leads to fixed affects and/or thoughts that were troubling the client to begin with. When a fixed behavior does not complete in a new way, the result is a habitual, or (over) coupled, affect. Because behavior reflects preparatory, protective and defensive orienting responses, assisting clients to follow their sensorimotor impulses to completion, as they come out of freeze, is a key to unlocking the constrictive and limiting prison of posttraumatic stress disorder.
The therapist’s task as healer is to notice which SIBAM elements a client presents with are old, conditioned, ineffectual patterns and which are missing completely because they are unconsciously hidden. When we can read this map, we can provide the somatic tools to free the client from being tangled up in these habituated physiological associations from the past. In this way people are, thankfully, restored to a healthy, flexible and dynamic way of relating to all of the new experiences life brings.
* Recall Step 3 (pendulation and containment) from Chapter 5.
† It does this specifically from what are called “stretch receptors”—specialized fibers in the muscle called intrafusal fibers.
‡ The senses of sound and touch are actually similar. In the inner ear there is a membrane called the basilar. Sound waves make this membrane vibrate, stimulating hair receptors to send impulses to the brain. The hairs on our skin function in a similar way. Indeed, deaf individuals have some sense of hearing through the skin.
§ It takes a good deal of experience for therapists to be able to distinguish between their “own” sensations and those that they are “picking up” from their clients. Analysts sometimes call this projective identification.
‖ Another way to learn is by watching the TV series Lie to Me.
a This is the basis for the method of acting taught by Konstantin Stanislavsky.
b I am not sure how much is due to the actual radiation of heat and how much is the result of somatic resonance.
c The legendary actor of the Peking Opera, Mei Lanfang, used hundreds of specific hand gestures to communicate several unspoken or subtextual emotional aspects of whichever character he was performing.