Bonnie Goldstein and Daniel J. Siegel
THE UNDERSTANDING OF mental health and wellness is evolving, like life itself, to embrace wider and more interdisciplinary perspectives. Through the lens of individual and group therapy we explore the nature of the human mind, the experience of consciousness, the impact of culture on mental health, how our social brains influence our connections with others and with ourselves, and how we provide the kinds of experiences that promote well-being, cultivate resilience, and foster integrative neurological growth.
One aspect of mental life is the process of being aware—that is, the ways in which we know, and have a sense of the known, within our subjective experience of being alive. When we combine a deep view of consciousness and information processing with emerging findings from the study of the social brain, we realize that harnessing the power of these states of consciousness is essential for relational health, equanimity, and contentment and for cultivating a healthy mind overall. The term and the process called mind includes consciousness, information processing, and a regulatory function called self-organization, which is an emergent process of the mind that is both embodied—it is within our bodies, including our brains—and in our relationships with others (described in detail in Siegel, 2012a, 2012b, 2016). This chapter explores in depth how consciousness itself may relate to this self-organizing function and offers clinically relevant information and practices to cultivate a healthy mind.
Cultivating awareness can be facilitated through the group experience, as we are socialized to come together to speak, share thoughts, exchange insights, and connect through words. In addition, the powerful experience of co-creating stillness, at moments, throughout the group experience can offer a powerful opportunity for individual members and for the group as a whole. T. S. Eliot’s line, “Not known, because not looked for. But heard, half-heard, in the stillness” (1968) illuminates the idea that the group psychotherapy format offers an experiential immersion that fosters awareness and exploration of the ways we know and have a sense of the known within our subjective experience of being alive. Applying the lens of interpersonal neurobiology to combine a deep view of consciousness with emerging findings from the study of the social brain, we will see that the goal of the group experience to promote mental health can be greatly enhanced with these new insights and practical applications.
Awareness is fundamental to human change processes. In this chapter we explore ways to cultivate the kinds of conscious experiences that promote change leading to well-being and relational health. In addition, using the lens of sensorimotor psychotherapy, we consider the somatic correlations to this sense of awareness, as well as explore the ways that consciousness itself may relate to this self-organizing function to cultivate health and well-being. This somatic focus is particularly significant because so many of us have been raised in a disembodied world—increasingly focused on technology, sitting endless hours at our desks predominantly emphasizing learning through our intellect, being “human doings” rather than “human beings.” The pace of life has become untenable for many of us. When asked, “How are you?” often the response is “Busy!” There is a complicated duality wherein, on the one hand, to be busy means that we are productive, important, needed, and wanted. Our societal “currency” of accomplishment with the accompanying multitasking may generate positive feelings based on achievement, recognition, and validation. Yet this societal norm comes at an expense: increased stress, anxiety, and depression; less time for taking care of ourselves; and a pressing need for affirmation and recognition from others to validate ourselves. Moreover, a prevalent cultural phenomenon is FoMO, or fear of missing out, which perhaps best captures, in four letters, the underbelly of our currency of accomplishment.
Jordana, a young adult who was the youngest of four girls, described growing up feeling left out throughout her childhood. As a teen she would dress up, preparing to look older, with the ever-present hope that at the last minute she might be told, “You can come too”—though she never was invited. She wore a mask of confidence, hoping to erase her self-doubt through actions of bold self-assertion, presenting the “false self” that the British analyst/therapist D. W. Winnicott (1965) proposed so eloquently in the last century. Jordana’s experiences with her peers perpetuated this sense of feeling left behind, this fear of missing out, and over time she seemed to feel alive only when things were in precarious balance, worried that if she didn’t jump over ascending hoops she would be left behind, miss out, and fail to live life. Lou Cozolino uses the term social status schema to explain the origins of the kind of experience Jordana described: “What is seldom directly addressed in psychotherapy (or the research) is the significance of social status schema, or the role played by early experience in the shaping of how we behave in social groups. Like an attachment schema, a social status schema is a form of implicit memory that shapes how we relate to others and the role we take on in groups” (2015).
With her particular social status schema dictating her behavior, slowing down was impossible for Jordana. She became a human doing, rather than a human being, as collaborative work by Goldstein and colleagues has recognized. When she was twenty-four years old, she developed an autoimmune illness. Her awareness of her body was only as “a machine,” running both literally (jogging 10Ks and mini-marathons) and figuratively (pushing her limits, saying, “I can do anything, go anywhere, face any challenge!”). Her body was merely the vehicle she needed to maintain to live in this way, yet she had little awareness of how she felt, at any present moment, nor was she fully engaged in living a life of embodied meaning that would include feeling authentic, connected, safe, and able to navigate the vicissitudes of life’s challenges.
As we worked together, Jordana developed a sense of safety over time that allowed her to add the concept of stillness to her life, while also cultivating a newfound body-based awareness that accompanied her new understanding of both the genetic markers of and the mind–body correlations contributing to her autoimmune illness. She became aware of the fallibility of her body and grew curious about her connection with it within the environments that she created for herself (e.g., How much did she listen to her body’s signals as she pushed herself through her work week? Was she aware of her body’s response—tension headaches, tightness in her back?) and within her community (e.g., Was she trying to use her body’s athletic accomplishments to gain status at any cost to her body?). Together we identified the need for a personal reframe of the societal “glorification of busy” as the foundation upon which our co-created safe space would increase her general well-being and aid her in managing her struggles. As we worked together, prioritizing consciousness as a collaborative goal included the following aspirations: enjoying times of play and calm, experiencing moments of insight, gaining validation from within rather than from achievement and recognition, and noticing and finding meaning within joyful moments. Thus began a journey to expand Jordana’s conscious awareness of her body’s intelligence—awareness of the ongoing communication the nervous system provides, of the moments of appreciation after movement/exercise as the exertion of muscles leads to chemical releases in the brain (oxytocin, endorphins). Such pleasure is self-reinforcing, leading her to seek out those same healthy sources of pleasure, such as the exquisite sensitivity of her skin as she immersed herself in baths, pools, even oceans.
Therapeutic orientations that include a central focus on the body have burgeoned over the past half-century and include Reichian therapy, bioenergetics, Rolfing, the Alexander technique, Hakomi, Sensorimotor Psychotherapy, and Somatic Experiencing. Sensorimotor Psychotherapy is the approach described below for clients such as Jordana because it prioritizes a body-oriented approach as an adjunct to traditional psychodynamic psychotherapy’s verbal narrative—the client’s story. Pat Ogden’s lifelong work integrates body-based therapeutic interventions with the concepts of embedded relational mindfulness and interpersonal neurology.
Ogden, Goldstein, and Fisher (2012) explain the value of including a somatic perspective:
Adding a body-oriented approach to traditional narrative therapies does not rely on language for its efficacy and can directly target the non-verbal legacy of childhood trauma. Underscoring the role of unresolved trauma on affect regulation, procedural learning, and sensory processing, this [technique] focuses on the centrality of these phenomena in the treatment of children and adolescents. Moreover, a bottom-up approach that targets the body, in addition to the verbal narrative when available, can produce changes that will influence resolution of symptoms and increase the capacity for relatedness and adaptive behavior (Bakal, 1999; Ogden & Minton 2000; Ogden, Minton, & Pain, 2006; Fisher et al., 1992). We will prioritize the non-verbal “somatic narrative” that is beyond words and cannot be articulated but continuously anticipates the future and powerfully determines behavior. (p. xxx)
Ogden and Fisher (2015) offer clinicians a deep understanding of Sensorimotor Psychotherapy with practical exercises that can help clients learn to notice their internal experience, heighten their consciousness, and develop awareness of their body sensations, movements, perceptions, and cognitions. In this way, by prioritizing present-moment experience rather than the past or future, Sensorimotor Psychotherapy capitalizes on the brain’s capacity for neuroplasticity by creating new experiences of awareness.
The importance of body-based forms of intelligence such as proprioception was first introduced to me (Goldstein) by Howard Gardner, one of my professors at the Graduate School of Education at Harvard University. Gardner has spent his entire academic career expanding the evaluation of frames of intelligence. Gardner (1983, 2004, 2011) proposes that we possess a range of capacities and intelligences extending beyond the traditional measurement tools, leading to expanded ways of identifying a fuller spectrum of intelligence. His concept of bodily kinesthetic intelligence, which stresses the powerful correlation between the body’s natural, deep wisdom and our ability to use this wisdom to positively influence ourselves and the world around us, impacted the way in which I viewed the younger clients that I worked with individually, as well through the group experience. Sharing Gardner’s concepts with group members—using everyday language to convey the scientific basis of the nonverbal somatic component of our work—had an impact that was amplified by the group context. A deep awareness is heightened collaboratively with the emergent experience of understanding and becoming connected to our bodies, and as appreciation for the body’s intelligence evolves for both members and leaders.
Similarly, adding neuroscience and somatic components to the traditional group therapy models that emphasize the cognitive-based verbal narrative can shift the emphasis from primarily dialogue and cognitive tasks by also inviting an exploration of present-moment awareness, practicing sensory intelligence, and welcoming experiences of consciousness into the group process. For example, as group members engage with one another in new ways, developing mindful awareness leads to powerful insights, practical skills, and expanded awareness of the body as a source of important insight and information. More significant, the group format offers an authentic experience in which members “feel felt.” Siegel describes this experience as “an eloquent way of expressing the connections we have with another person when we are felt, understood, and connected” (2016, p. 182). For example, just by holding someone’s hand, one can quiet anger, fury, or fear, all through soothing touch. Even more, one’s sense of the presence of another person whom one trusts can soothe distress in anticipated pain from a shock
Feeling felt can be viewed as the way in which two people become linked so that they resonate as they are influenced by the other but do not become the other, as in the symbiotic process. As we’ll see soon, this state has two fundamental elements: differentiation and then linkage. This is the state of integration in which the whole is greater than the sum of its parts. From the point of view of interpersonal neurobiology, integration is the basis of health. When integration is blocked, chaos and rigidity are more likely to arise. We think of integration as an active rather than static state—meaning that we are in a state of becoming, not a fixed accomplishment. And so we can see how any process of becoming can nurture differentiation and then the linkages of those unique individuals in a system that becomes a “we.” This is the underlying mechanism beneath the subjective sense of feeling felt.
An example of feeling felt in the group milieu comes from a case that addressed the social isolation of having your friends stop being your friends, feelings that are often buried—as was the case with Sophie, who was more successful in middle school than were her friends and was promoted to a private, high-achieving high school that launched a trajectory of success and left her friends behind.
Sophie, a group therapy member for the past six months, found that the gradual support of her peers in the group offered insight to the part of her that felt guilty for leaving her friends. Even more painful, she was then excluded by her former friends—they reportedly neglected her, not including her on weekends. She was fiercely determined to rekindle these friendships, with no success. Nor did she develop close friendships at her new school. Sophie buried her feelings so very deeply within that she couldn’t access them in individual therapy. Only through observing others share similar experiences in group sessions and realizing that she was not alone could Sophie reframe these social dynamics as inherent in peer relationships and feel a shift toward self-compassion and self-acceptance. Hence, through listening to her peers, Sophie had an experience of “feeling felt.” This means that she experienced being respected for her individual subjective world—she was able to differentiate, and then to link with respectful, accepting, compassionate peers. This is how an isolated “me” becomes an integral part of an interconnected “we.”
This shift in perception of self, through the interconnectedness of feeling felt, is described in Mind (Siegel, 2016), with the following excerpt:
So at the end of treatment I said to her that we would have an “exit interview” when we review what had been most helpful and what could be improved. “Great idea,” she said. So, I asked her, what was most helpful to you? “Oh, that’s obvious” she replied. Yes, I said, I know, but if you had to put words to it, what would you say? She paused for a moment, looking at me with moist eyes, and she said, “You know, I’ve never had this experience before. I’ve never had this experience of feeling felt by anyone. That’s what helped me get better.” (p. 182)
Feeling felt describes the connections we form with another person when our experiences and emotions are empathically received and understood. In individual therapy, this process occurs through the therapist’s focus on the client’s inner subjective experience of mind, wherein the therapist is attuned to the client’s inner world and offers a sense of trust in it, as in the following example from Mind (Siegel, 2016):
And with that trust, she and I could explore the inner world of her mind that was troubling her so deeply. The mind that emerged in her as we worked closely together, the resolution of her traumas from a painful past with her family, her feelings of helplessness in the present with the death of her colleague, her experience of hopelessness for the future that gave her a sense of despair, these were now resolved. Trust was the gateway to our journey to heal those wounds. What was the healing action? Feeling felt. I could be present for her, attuning to her inner life—her inner subjective reality—and then resonate with that reality. I might even attune to that inner world and connect with information processing that she was not in touch with herself, aspects of her non-conscious mind. And that, too, could shape my internal world even if it was not in her awareness. I was changed because of our connection too. This is the experience of resonance. (p. 183)
Sometimes that resonance can be consciously recognized and we are overtly aware of feeling felt, as we sense this way in which we have become connected as a “we.” I (Siegel) like to remember the importance of both differentiation as a “me” with the connection and membership of a “we” with the odd and funny neologism mwe. Mwe is how we can have both a “me” and a “we” in one integrated identity. With this term, too, we can recall that either one—me or we—by itself is missing the differentiation and linkage of an integrated life. Mwe is what mwe can feel in therapy when it goes well and our client feels felt by us, as his or her mind is experienced as existing within ours, and each of us is changed by the experience.
One way of considering the fundamental stance in therapy is the important PART—presence, attunement, resonance, and trust—we play in the growth of our clients, our patients, as well as our fellow travelers along this journey of life (Siegel, 2010). Presence is a state of receptive awareness the enables an openness to let into our consciousness anything that emerges in an experience with minimal filtering from expectation and judgment. Attunement is the focus of attention—that process that directs the flow of energy and information—on the internal world of self and of others. The term interpersonal attunement means that as therapists we focus beneath surface behaviors for the underlying mental experience driving those externally visible actions. With attunement, we focus on the inner experiences of feelings, thoughts, and memories. This is how we SIFT—sensations, images, feelings, and thoughts—the mind for its internal subjective contents.
Resonance is how we enable ourselves to be influenced by another, to be changed by the interaction without losing our identity. When we resonate with someone else and enable those changes to be revealed, the other person can feel felt by us. Trust is what develops with presence, attunement, and resonance, enabling what Stephen Porges’s (2011) polyvagal theory suggests is the turning on of a social engagement system. This is the receptive state that facilitates not only interpersonal connection but likely also internal attunement and growth (Siegel, 2007). Both conscious and nonconscious experiences of our connection with clients can create trust between us, and that trust facilitates learning as it harnesses neuroplasticity—the ways the brain changes in response to experience.
One possible mechanism in the brain that may mediate such experiences of feeling felt can be hypothesized as the following sequence. When we have the repeated experience of others in the PART of someone with whom we feel felt, an implicit engram may be laid down in our own brain—that is, a neural net profile of activation that would include a set of neural firings that, with repetition, would become structural changes in the brain itself. In this way, a certain experience fires a set of neurons, and, as Dan Siegel has paraphrased the physician and psychologist Donald Hebb, “Neurons that fire together, wire together.” Firing occurs in the moment of neural activation with feeling felt experiences; wiring is the synaptic, neuronal, and perhaps myelin growth associated with repeated experiences. This is how we learn. And what feeling felt may teach us is that we are not alone. How exactly that might influence brain anatomy, no one knows exactly, but it could involve any or all of a number of possibilities. One is that a client’s window of tolerance for experiencing interactions that could be interpreted as isolating or rejecting would be widened, so that he or she could maintain equilibrium even in the face of such nonsupportive experiences. Another possibility is that the limbic appraisal processes would downregulate the tendency to experience dependency on nonsignificant others’ actions as powerfully shaping a sense of self in the moment. Such a change might be enhanced by having a neural net profile of a sense of self that is more resilient, something that we might describe as “I am a loved and am a lovable person.” When interactions happen, such a feeling-felt mental model of the self would serve as a source of inner resilience. Yet another possibility is the implicit memory that “my self in connection with others in the group was deeply rewarding,” and with this implicit memory of a past actual experience, the prospective memory—the implicit memory of the future—would be shifted so a client could now imagine a future of connection as a realistic possibility, not just a fantasy, which would soothe current distress of isolation and support constructive behaviors to make such imagined future outcomes an actual reality.
The group experience offers the opportunity, cocreated by group members, for spontaneously arising moments of mindful awareness, thereby liberating expression through the emergent experience—both group experience and individual members’ experiences—without interfering with the integrity of their narrative processing and spontaneously emerging experiences. These ongoing experiences likely shape the neural firing, wiring, and architecture of each member’s brain—and these changes can positively reinforce the ongoing relational interactions that can then recursively support the continued experience of feeling felt in the group, infusing the group process with an atmosphere of enduring trust and exploration. Having an individual or a group experience wherein the focus is on attuning to a person’s story—attuning not just to the external events described but especially to his or her inner subjective experience, as well as to the intersubjective cocreated experience of the group—offers a powerful and unique opportunity for feeling felt. Such opportunities expand consciousness, harness attention, and amplify present-moment awareness of transformations large and small, as they emerge and are cocreated.
Part of the mindful awareness nurtured here is captured by the acronym COAL—curiosity, openness, acceptance, and love (Siegel, 2007)—that we bring to our awareness and our interactions. In this way, mindfulness is not only a state of being aware but also a way of being. In a group setting, it is a relational way of approaching others with these COAL qualities. Such a group experience then models how individuals can use that same kind regard toward their own inner experiences when away from the direct support of the here-and-now group. The group’s mindful awareness becomes an innate stance each individual carries with him or her both within the group experience and as each moves out into the world. As we noted previously, “Introducing mindfulness training in group therapy does not necessarily change the elements in the outside lives of group members, but it invariably changes the way they react to those elements. Because groups provide the opportunity to reexperience old patterns with new people, it is within such groups that members can repair old wounds and develop new ways in which to interact as they move more robustly into the overall growth process” (Mark-Goldstein & Siegel, 2013. p. 225).
Over the past three decades of working in the mental health field, we have explored mind–body processes through a multitude of perspectives, practices, and theories, including interpersonal neurobiology, mindfulness practices, Sensorimotor Psychotherapy, and other mind–body orientations toward healing. Each of these modalities has strengths and unique influences, depending on what clients need at a given point in their journeys. Harnessing movement and stillness, playful touch (as clinically appropriate), and awareness of sensations, breath, connection to self, and connection to other mental health practitioners provides a plethora of tools with which to engage clients in healing processes tailored to their particular circumstances.
Over the years, there has been an emphasis on identifying with schools of therapy, an emphasis on lineage—who has studied with whom, which therapeutic orientation is best. One benefit of the integrative model of interpersonal neurobiology is that it offers a scientifically grounded approach that prioritizes the relationship between therapist and client and incorporates awareness of somatic (embodied), intuitive, and emotional explorations of our life stories. Hence, the experience of sharing one’s story ultimately takes place in those precious and deeply personal moments of connection that occur when we feel safe enough to share ourselves and listen to others. Inviting curiosity allows us to look for relational connections in which feeling felt can bring our consciousness toward cocreated safety. Through this safety, we can combat our anxiety about the novel experiences, particularly when relationships feel frightening. It is these new experiences that engage our minds actively, thereby expanding our brains. This attitude of wonder, interest, and investigation can facilitate the novelty of change that emerges when members feel safe to share.
Large and small group experiences offer opportunities for members to gather lots of useful information—about themselves, other people, the world—simply by their participation. Part of the challenge in group therapy (and in any context intended to facilitate change) is the inevitable uncertainty that arises with the new experience. The brain is often said to be an “anticipation machine,” meaning that it filters experience through the lens of prior events embedded within memory. This is how “top-down” processing—what we have learned in the past—shapes our “bottom-up” experience of the sensory-rich present moment. Indeed, this top-down facility is one of the challenges of expertise, in that the more we know, the less we perceive. We have a propensity to view what is occurring in the present moment through the lens of what we are certain about, what we know, what we are an expert in. And one area we may even have a nonconscious expertise in is who we are—“I know myself.” What this means, then, is that anything that invites me—or challenges me—to consider becoming different challenges my self-expertise. Moreover, nonconscious expertise is likely to block experiences of feeling felt because the expertise is not a present-moment expression but, rather, a fixed belief structure. Whether in verbal form or behavioral enacted form, our lived narrative reveals that model of self in need of change.
Becoming comfortable with uncertainty is a component of the journey of psychotherapy. Learning to thrive with uncertainty is part of the mastery of therapeutic change. We are all lifelong learners, and when we embrace the reality that the brain changes throughout the lifespan, we can go for the ride of our lives, open to the excitement of this unfolding change, this continual emergence of uncertainty to disrupt the complacency of a seeming expertise of who we thought we were.
In reality, the self is both a constructor and a conduit of experience (Siegel, 2016). In this way, our narratives arise as we construct a self; being open and learning to thrive with uncertainty is embracing the equally important but distinct role of conduit in our experience of self in the world. Being with others—with a therapist and other group members—is a way of embracing the conduit function of our self as it emerges, moment by moment.
Participants also begin to see the larger context and thus become less affected by any single thing in itself: not so driven to get more of what they like, and not so stressed and unsettled by what they don’t like. Developing curiosity about others helps group members understand the inner workings of their own psyches. Curiosity is a great asset for healing, growth, and awakening, while also fostering awareness and engagement with the world and others. This is how the group process supports the ongoing development of a COAL state of mind, within the individual and relationally among the members. Such a process likely reinforces the neuroplastic changes in the brains of the members, which in turn support a mindful way of being with self and with others.
In working with trauma through the group experience, soothing and calming the nervous system of each member are paramount. We cannot explore and dare to take risks when our nervous systems are in a state of fearful physiological reactivity. The perception of being unsafe can be as covert as perceiving other members casting sidelong glances that are vague but slightly threatening. The cocreated safety in the therapeutic milieu helps offset discomfort by offering opportunities for mindful awareness of the present-moment experience, both implicit and explicit. Use of yoga-type breath work, mindfulness-based stress reduction techniques, and/or other somatic interventions are taught to aid members in calming their own nervous systems and increasing their social engagement systems; they are especially useful in this format, as group experiences are often novel and therefore anxiety provoking. This is how the therapeutic process can move members from the reactive state to the receptive state in which each member’s social engagement system is activated.
Feeling unsafe can lead to deactivation of the autonomic nervous system, identified by avoidant behavior, numbness, deadness, and disconnection, or to overactivation of the nervous system, experienced as hyperarousal, impulsive movement, incessant talking, and intrusive interactions that are not mindful. Therefore, providing a sense of safety as fundamental to our clients’ experiences is a foundational therapeutic goal that can be fostered through collaboration and the coconstruction of embodied relational safety—mwe emerges with a sense of trust. Porges (2011) proposes that only when we experience safety can we forge ahead in the environment. Safety is the prerequisite for activating the social engagement system, which is a key agent in healing. Ogden et al. (2012) write about strengthening the social engagement system as well as prosocial behaviors through the group therapy experience:
Group provides an opportunity to revisit early attachment issues, and group members often take on a particular role in the simulated group “family.” These roles, visible in the procedural tendencies of the body, are strongly influenced by early attachment relationships and the family milieu, which shapes posture, gestures, and movements in ways designed to adapt to the particular family environment.
The microcosm of the world that group therapy creates makes it a profound therapeutic setting in which to observe and amend relational problems, examining interpersonal experience as lived in the present moment, as it unfolds, including the physical elements that both reflect and sustain relational dynamics. The group creates a natural, authentic, organic opportunity for members’ issues and their physical manifestations to arise in real time: their own life experience recreated on the landscape of a group. The sensations, gestures, tensions, movement patterns, that go along with emotions, thoughts, and perceptions are happening live. The sensorimotor psychotherapist uses “bottom-up” approaches and interventions, teaching group members to observe, follow, and work through issues and relational dynamics starting with the physical experience. Sensorimotor psychotherapy also integrates bottom-up approaches that directly address the effects of trauma and relational issues on the body and on emotions with “top-down” approaches that focus on insight and understanding. Bodily experience becomes a primary entry point for intervention, while meaning-making arises out of the subsequent somatic reorganization of habitual responses. (pp. 124–125)
The conduit function of the mind (Siegel, 2016) is how we get as close to something as it is sensorily possible. Pre-sense, a way of thinking about presence, is limited by the fact that we live in a body. But once sensory inputs arise in our embodied realities, we then move to the level of perception. Perception often involves cognitive processes of input from sensory systems, with top-down memory filtering those bottom-up inputs. Porges (2004, 2011) describes a perceptual system, neuroception, designed to scan for danger and alert us when a threat is present. This neural process of neuroception is outside the realm of awareness but can influence our conscious experience. Neurobiological mechanisms allow us to neurocept features in the environment that indicate degrees of safety, danger, and threat. These features include behavioral and nonverbal cues from others that incline us to move toward, away from, or ignore the source. Ogden et al. describe a child’s ability to appraise the safety or threat of an environment through neuroception: “The nervous system evaluates risk in the environment and regulates the expression of adaptive behavior to match the neuroception” (2012, p. 17)
Overall, group and individual therapy aim to bring into awareness these many layers of often nonconscious neural, subjective, and relational processes. The chaos or rigidity that often characterizes the distress of individuals coming to therapy for relief of their suffering can be seen as the product of obstructed self-organizational flow, which innately tends to move us toward integration. In this way, a therapist detects chaos or rigidity as a sign of a blockage to health, a blockage to integration. Then the areas of a person’s life that are not differentiated and/or linked are determined, and the facilitation of those areas is the focus of therapy (Siegel, 2010b). What we have described here is the powerful ways in which the relational integration of feeling felt can be seen as a crucial domain in the therapeutic journey. Other domains of integration—such as those of consciousness, verticality, bilaterality, memory, narrative, state, temporality, and identity—all interface with this important domain of interpersonal integration. With the creation of safety within the therapeutic setting, we come to the experience as therapists with our presence, attunement, resonance, and the facilitation of trust. Knowing these components of the PART we serve in helping others to experience feeling felt, which is at the heart of interpersonal integration, can guide us in establishing the important foundations of change across many modalities of psychotherapy. Together, mwe in the field of mental health can work to use these interdisciplinary ideas to find powerful and effective ways of helping others create more integration in their lives. With the ever-increasing pressures facing each of us in this deeply challenged world, the field of mental health is in an important position to play a key PART in cultivating resilience and supporting the growth of well-being for all we care for so deeply.
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