Latest / System Speak: Complex Trauma and Dissociation / Guest: Pat Ogden, PhD (Sensorimotor Psychotherapy)

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Guest: Pat Ogden, PhD (Sensorimotor Psychotherapy) · System Speak: Complex Trauma and Dissociation

• 0:08
  Speaker 1: Over:
• 0:11
  Speaker 2: Welcome to the System Speak Podcast, a podcast about Dissociative Identity Disorder. If you are new to the podcast, we recommend starting at the beginning episodes and listen in order to hear our story and what we have learned through this endeavor. Current episodes may be more applicable to longtime listeners and are likely to contain more advanced topics, emotional or other triggering content, and or reference earlier episodes that provide more context to what we are currently learning and experiencing. As always, please care for yourself during and after listening to the podcast. Thank you.
• 1:02
  Today, we're very excited to share with you an interview with Pat Ogden, PhD, a pioneer in somatic psychology. She is the founder and education director of the Sensory Motor Psychotherapy Institute, an internationally recognized school specializing in somatic cognitive approaches for the treatment of post traumatic stress and attachment disturbances. Her institute based in Colorado has 19 certified trainers who conduct sensory motor psychotherapy trainings of over four hundred hours for mental health professionals throughout The USA, Canada, Europe, and Australia. The institute has certified hundreds of psychotherapists throughout the world in this method. Doctor.
• 1:51
  Ogden is the first author of two groundbreaking books in somatic psychology, Trauma and the A Sensory Motor Approach to Psychotherapy and Sensory Interventions for Trauma and Attachment, both published in the interpersonal neurobiology series of W. W. Norton. She is currently working on a third book, Sensory Motor Psychotherapy for Children, Adolescents, Families with Doctor. Bonnie Goldstein.
• 2:20
  Her current interests include sensory motor psychotherapy for groups, couples, children, adolescents, families, embedded relational mindfulness, culture and diversity, challenging clients, the relational nature of shame, presence, consciousness, and the philosophical spiritual principles that guide sensory motor psychotherapy. Welcome Doctor. Ogden.
• 2:47
  Speaker 1: So hello everybody. I'm Pat Ogden. I'm the founder of the Sensory Motor Psychotherapy Institute. We teach internationally focusing on body centered psychotherapy, how to work with trauma and early attachment failures through the body. My background is varied.
• 3:13
  A big influence was dance, which I started when I was seven years old. And that really taught me a lot about being in my body and establishing integration through my posture. Later, I taught yoga and dance at a psychiatric hospital and then met Ron Kurtz who was my most influential mentor. He was the first person that I had met that integrated the posture and movement of the body with psychology. And then later I went on to meet various other influences from Russell Vanderkolk to the discipline of Rolfing, other dance movement therapies.
• 4:06
  And, but I would say my biggest teachers have been my clients. Those are the people I've learned the most from.
• 4:14
  Speaker 2: That's beautiful. How did you begin applying what you learned about the body even from dance and yoga to trauma work specifically?
• 4:25
  Speaker 1: It's been a long journey. I I was teaching at a psychiatric hospital, yoga dance in the early 1970s. And then I moved to Colorado and about 77 or '78, was asked to be an adjunct therapist for Wardenburg Psychological Services, which serves the University of Colorado students. The people that I was referred were women who were having difficulty with their sexuality. And nobody in the seventies was talking about trauma.
• 5:05
  Charles Spiegley's book on Vietnamese on the trauma of war in Vietnam hadn't hadn't come out. If it had come out, it wasn't popular. I hadn't read it yet anyway. And so my clients were all traumatized and I was trying to understand the difference between working with a non traumatized person and what was going on with my clients because they were very dysregulated and the interventions that I had learned both in social work school and in my alternative studies in psychotherapy weren't effective with these clients. So I remember thinking, I'm just gonna try to keep them in their bodies.
• 5:51
  I'm just gonna keep referencing the body and see if they can sense the body. And that was a big turning point for me because they actually started getting better. Whereas before working with childhood memories and strong emotions, they seem to be getting more dysregulated. So that taught me a lot about trauma. I would say that was my first really major teaching about how to work with trauma with these patients.
• 6:18
  Speaker 2: How does trauma make someone dysregulated and out of touch with their body?
• 6:23
  Speaker 1: Because we are evolutionarily prepared to respond to threat with instinctive subcortical actions, fight, flight, cry for help, freeze and feign death are the five instincts, defensive responses to trauma. And those responses bypass our thinking brain, the subcortical, they enable us to respond instantaneously to threat with action rather than having to go through our thinking brain. And they elicit a lot of arousal. You can imagine if you're threatened and you're trying to run away or fight back, your body mobilizes a lot of physiological arousal to execute those actions. And on the other hand, if those actions are ineffective, we might instinctively engage a fame death response, which is like playing possum where our arousal goes way down and we become immobilized.
• 7:37
  After trauma, the arousal which has risen to the extreme of hyper arousal or dropped to the extreme of hypo arousal, it doesn't come back to often doesn't come back to normal to within that window of time. Most traumatized clients are easily triggered into hyper and hypo arousal.
• 7:58
  Speaker 2: How does reconnecting with your body help regulate that?
• 8:03
  Speaker 1: Because trauma first and foremost impacts the body. Our physiology, our somatic muscular system. And so we wanna work at that level to resolve the body. So in sensory motor psychotherapy, we have interventions that directly target the dysregulated nervous system that can help the nervous system stabilize. We work a lot with what we call somatic resources, which are physical actions and movements that help arousal calm down, such as one client's most powerful somatic resource was simply placing her hands on her torso and just feeling the touch of her own hands and that calmed her arousal down.
• 8:53
  Grounding, stomping the feet, aligning the spine instead of collapsing, All those are physical actions that can directly impact, the effects of trauma.
• 9:05
  Speaker 2: Is it generalized more than I mean, it can also be generalized besides just a specific trauma piece to being able to be more present with their body in general?
• 9:18
  Speaker 1: Yes, I think for most of my traumatized clients, the body's kind of been the battleground. And it hasn't been appealing to sense the body because when the traumatized client senses the body, often what they experience are disturbing sensations that have to do with that dysregulation. So we wanna help our clients reenter the body in a safe and titrated way so that the body actually becomes an ally and a resource instead of the enemy.
• 9:56
  Speaker 2: That's a powerful thing that what you just said about the body being an ally when we're working with trauma clients whose bodies have been violated or there's also the shame pieces in the relationship aspect. And so to think in either way of those, to think of that as an ally is a complete shift of perception.
• 10:22
  Speaker 1: Mhmm. Exactly. And it has a very powerful effect. And we as long as we're alive, we're we're in we're we're having a body. This is how we experience the world is through our body.
• 10:35
  And if your body is the enemy, that can greatly diminish the quality of your life.
• 10:41
  Speaker 2: So how did all of that unfold into becoming sensory motor therapy?
• 10:45
  Speaker 1: Nineteen seventies, I met Ron Kurtz and I moved to Boulder with him and studied with him. He is the brains behind the Hakomi method of body centered psychotherapy and I apprenticed with Ron. He and I and others founded the Hakomi Institute in 1980. And he and I taught the very first training in 1980 in Hakomi. And in 1981, I remember saying to Ron that I love Hakomi, but I was much more interested in the body and movement and posture.
• 11:22
  And also at that time, I was beginning to learn about trauma. So Ron said, why don't you start your own school, your own branch of a Comey and call it a Comey bodywork. So I did, and I started designing my own trainings. And over the years, it it just developed into my own method that draws heavily on Ron Kurtz's work, but also has other elements that aren't included in Hakomi. Primarily the work with trauma and the work we do with movement and resourcing through the body.
• 12:05
  And then I I think it was in the mid nineties that I met Bessel van der Kolk. And Bessel and I collaborated for years and years. We still do to some degree. And he was a major figure in helping me translate my work so that it would be accessible to mainstream mainstream psychiatry and psychology.
• 12:35
  Speaker 2: That's an intense collaboration.
• 12:37
  Speaker 1: Yeah. It was. It was wonderful. We we had a great influence on each other. He was not a body therapist, and now he is, as we know from his last book, The Body Keeps the Score, and I definitely take credit for that.
• 12:54
  Speaker 2: That's a big shift, and it was a powerful work in the literature, both for clinicians and for clients.
• 13:01
  Speaker 1: Absolutely.
• 13:02
  Speaker 2: So what do clinicians or clients themselves if they've never heard of sensory motor, how would you introduce it to them?
• 13:09
  Speaker 1: I would help them understand that everything we experience, we experience through our bodies. And our body develops habits of response that reflect that experience. So if we have suffered trauma, repeated trauma, it lives in our body. Like our shoulders might hunch up, our bodies might be tight. We might be ready to execute any one of those instinctive defensive responses.
• 13:43
  We might be ready to fight or to run away, to freeze, to cry for help, or to collapse into a pain death response. And because the body develops these patterns, it reflects and sustains our history. So for example, if somebody who's traumatized and tells us they're living in fear, we're looking at how their body reflects that. And it's usually with hunched up shoulders and wide eyes like a a posture of fear. And we're gonna have limited success resolving that fear unless we also help the body learn how to relax the shoulders and let the eyes kinda drop back into the head.
• 14:32
  So the the movement and physiology of the body, the emotions, and our thoughts and belief systems, they all go hand in hand. So we wanna work bottom up, with the body, which can have a strong effect on emotions and thoughts, as well as top down with with our thoughts and beliefs and emotions. So we integrate those three levels of processing, body processing, emotional processing, and cognitive processing, which is also reflective of the three levels of the brain, the cortex, the limbic system, and the reptilian or subcortical brain.
• 15:12
  Speaker 2: When something like the polyvagal theory explains sort of this is how this piece of it works. You're looking at the full context of the brain and the whole system of it in the body and then what to do about it.
• 15:28
  Speaker 1: Yes. And but so does the polyvagal theory. Steve Borges and I are good friends and we've also collaborated for years. And his theory is extremely compatible with sensorimotor psychotherapy because according to the polyvagal theory, we need to quiet the defensive responses so that the social engagement system can be prominent. And it's the same, and we do that through the body.
• 15:55
  Polyvagal theory is is all about the body. So we also in sensorimotor psychotherapy, we need to quiet the defensive responses, which is why the woman who places her hands on her torso, that's a somatic technique that quiets the defensive responses and allows her arousal to be in the window of tolerance so she can be socially engaged. So a social engagement system with a ventral vagal complex can can come on board.
• 16:25
  Speaker 2: So it includes even the piece about how our bodies, how we connect with others as well through that?
• 16:31
  Speaker 1: Oh, absolutely. Absolutely, because our body again participates in everything that we do. So when we're connecting with others, we're connecting with others through our bodies. We're we're making eye contact, we're reaching out, we're mirroring movements, we're seeking proximity, we're setting boundaries, And they're all somatic, phenomenon.
• 16:53
  Speaker 2: I'm just trying to process because I know these separate pieces, but when you describe them, like, that's really the most integrative experience when you're saying it all fits together.
• 17:05
  Speaker 1: Absolutely.
• 17:06
  Speaker 2: How does a therapist or a clinician, how do they learn more about sensory motor or get trained for that?
• 17:14
  Speaker 1: They can go to our web site at sensorymotorpsychotherapy.org. We teach all over the world. We also offer workshops. They also can go to our Facebook page where we have little short talks by trainers and they can find webinars that are open to the public. They will be advertising on Facebook page.
• 17:42
  And they can Google sensory motor psychotherapy. There's lots of articles. We have two books out so far and are working on books about sensory motor psychotherapy with children, family and adolescents, with couples and so forth. So it's still growing, this work. And we have twenty twenty five trainers who are very active in teaching and writing and etcetera.
• 18:14
  Speaker 2: It's really applying to all sort of context, not just trauma.
• 18:18
  Speaker 1: Absolutely. And again, because we all have a body, so it's relevant to everyone. It's our work we have a different focus from talk therapy because we're working with how we organize experience internally. So we're not really working with specific events, we're working with the effects of those events in our body mind. So this requires a mindful approach where our clients and our students learn to observe their sensations, their movements, their the images that pop up from their from their internal state, their emotions and their thoughts, And that's the organization of experience.
• 19:15
  So it's not simply talking about, it's working with how we organize experience. So if somebody's talking about a relational issue, say where they're just not getting the support from their partner, we might ask, well, what happens now as you're talking about not getting support? And that's the organization of experience. And they're likely to say, well, I feel my my I'm collapsing a little bit. I'm starting to pull in.
• 19:45
  My body's kinda going limp. That's the organization experience rather than just talking about a situation. So it's a different focus. By studying the organizational experience, we're getting kind of at the meta level of what drives the content of our lives rather than just talking about specific content. Does that make sense?
• 20:09
  Speaker 2: It does. It does. I'm just realizing, like, it seems like part and please correct me if I'm wrong, but just from listening to you, it seems like part of what makes it so effective is that it's not just helping with that one particular thing, but your patterns of interactions with yourself, so to speak.
• 20:29
  Speaker 1: That's exactly right.
• 20:31
  Speaker 2: And it increases your awareness of what's happening in your body, which is what would generalize it to other areas or other moments as you go about your life.
• 20:42
  Speaker 1: That's right. Gabe, if if if that client loses her her postural integrity when she thinks about not getting support, she starts to collapse in her posture. That is a pattern she's developed that crosses all kinds of situations. Once she discovers that pattern, she can she has a choice. You don't have a choice unless you know what you're doing.
• 21:10
  But once she discovers what she's doing in her body, that she collapses in the face of feeling like there's a lack of support, which generates less support when you collapse. She can start to shift that.
• 21:25
  Speaker 2: So it's empowering in that way?
• 21:28
  Speaker 1: It's empowering. Absolutely. Yeah.
• 21:30
  Speaker 2: So what would a client, if they were going to a session with a sensory motor therapist, a trauma client specifically, if they were going to a sensory motor therapist for the first time, what would that look like different? I mean, how would that feel different or look different or experience different besides just the talk therapy like you were saying?
• 21:55
  Speaker 1: At the beginning of a therapy session, there's always talking. The client is talking about their issues, talking about what they wanna work with, maybe talking about their goals. But then there comes a point in the conversation where it shifts from this talking about to a mindful state of consciousness. So the therapist will say, all right, maybe we should work with that memory that bothers you of when your father started molesting you, for example. Okay.
• 22:36
  So that's what we call a frame and the client says, yes, that's what I wanna work with. So then the therapist will ask a mindfulness question like that can There are infinite number of mindfulness questions, but questions like, okay, what so what happens right now when you think about your father? Or what do you notice in your body when you remember being molested? Those kinds of questions take us out of conversation into studying how we organize. So the client might say, I'm I'm I'm tightening up.
• 23:16
  My shoulders are tight. My arms are getting tight. And I'm starting to feel really scared, for example. So we're accessing how the body responds and maybe it's connections with emotions, with thoughts. But then with a trauma session, we're also trying to complete incomplete empowering actions.
• 23:42
  Pierget, who was a contemporary of Freud's called them acts of triumph. So for example, in this case, most victims of childhood abuse could not fight back, could not run away, but either froze or just collapsed in the face of the abuse. So with a client such as this, we might find out what that tension in her body wants to do because tension is a precursor to action. And she might discover those incipient active defensive responses that she abandoned fortuitously when she was a child because fighting back, pushing away wouldn't have wouldn't have worked with the perpetrator who was bigger and stronger than you are. But those impulses still live in the body.
• 24:34
  That's one of the most empowering elements of this work is that we can reestablish the availability of those empowering defensive responses. So in this case, as the client feels the tension in her body, we might ask, as you sense that tension in your arms, in your hands, in your shoulders, see what your body wants to do. But not from your thinking mind, from your body. See what your body wants to do. And we're tracking the body very carefully because the body will often reveal micro movements that indicate the availability of a larger movement.
• 25:16
  So a client's fingers might lift or the fist might clench. And then we wanna just help the client reestablish that movement often by pushing against the pillow or making some kind of aggressive action that comes from the body, not the mind. So that we're really working with body processing, helping the body discover and execute the empowering defensive actions that were ineffective at the time of the original trauma.
• 25:50
  Speaker 2: Acting out of some of the physical responses.
• 25:54
  Speaker 1: It is, but but not it's not really an acting out. It is it is eliciting from the client's mindful awareness of the body.
• 26:07
  Speaker 2: Right. I mean, as opposed to holding it in. I'm sorry. That was a poor choice of words. But as opposed to holding it in or dissociating from it.
• 26:16
  Yeah. And maybe an active process is more what I meant of responding and and letting that be and being aware of what it is.
• 26:26
  Speaker 1: The important thing is that it's not an idea, I I think why I reacted to the word acting out because you act out in a role play or in psychodrama, you know, you act something out. This is these defensive responses, they live in the body. So they come, they merge spontaneously from the body. So it's a real authentic tracking and following what the body wants to do. And what this does is that it can redo that memory.
• 27:01
  We know that memory is reconstructive. And when you're working with the memory and you're adding this action, that memory, many clients have said that memory will never be the same. Because now I felt what my body wanted to do and I executed that response. And you're doing it in the present moment, so it's changing the present. But it also opens up possibilities for the future.
• 27:24
  So that clients find that they have the availability of defensive responses that they had not had available before sensorimotor psychotherapy. So there's more flexibility. They can't say no or get away, etcetera.
• 27:41
  Speaker 2: That's so it's so liberating.
• 27:43
  Speaker 1: It can be. Mhmm. Absolutely.
• 27:46
  Speaker 2: How does someone who is just starting, who is very, very dissociative, how can they begin to get in more in touch with their bodies? What are some of the things that they could do?
• 28:00
  Speaker 1: I think the most important thing is to find ways in your life that feel good in your body, things that you do, things that you enjoy, or at least that maybe even feel neutral, don't feel bad. Like start to tracking that in your daily life. Simply, do enjoy walking on a sunny day. That's a physical activity that can be pleasurable to some people. You enjoy eating certain foods?
• 28:39
  Do you enjoy playing music? Do you enjoy taking a warm bath? To start to just notice the physical things that you do that you do enjoy. But to recognize that if you're highly dissociative, there are gonna be parts probably that are really terrified of sensing your body. I think it can certainly help to work with an experienced therapist.
• 29:09
  And our second book, Sensory Motor Psychotherapy, it's full of exercises that therapists and clients can do together. And there are sections in there that talk about working with applying this work to people with dissociative disorders. So that would be helpful.
• 29:32
  Speaker 2: That's a good resource. Thank you. How would someone find a sensory motor therapist?
• 29:41
  Speaker 1: If they go to our website at sensormotorpsychotherapy.org, on the left hand side, there will be a tab that says find a sensory motor psychotherapist. And if you click on that tab, then you will see a page come up that has countries, different countries and you can click on that country. Like if you click on The United States, you'll see then all the states and then you can click on that state and find a therapist in your area.
• 30:14
  Speaker 2: In sensory motor psychotherapy, is there some touching involved just with the client touching themself like the or the example you gave of the woman putting her hands on her torso, or is there touch also with the therapist or is that depend on the therapist?
• 30:34
  Speaker 1: Oh, yeah. Touch is never necessary in sensory motorcyclotherapy. Touch from the therapist or self touch. Self touch, touch can be triggering for many traumatized patients, even self touch. So it's not a requirement.
• 30:51
  That depends on the needs of the client and what's appropriate for that particular therapeutic dyad.
• 30:58
  Speaker 2: Why is it that that can be so healing? I mean, obviously, I'm talking about when it's done appropriately and safely and with permission and all of that. But why is it that kind of connection in a physical way can be so healing?
• 31:11
  Speaker 1: Well, Beatrice Bebe, who's an infant researcher, she discovered that babies who have mothers with unresolved trauma don't touch themselves as much as babies who don't have mothers with unresolved trauma. And I thought that was really powerful research because babies touch themselves all the time, children touch themselves. It's a natural way to nourish ourselves. We put our hands on our heart, we self touch, we might even twirl our hair or stroke our shoulders or legs. People do this automatically.
• 31:55
  But for a traumatized person that it can be triggering, but it also can be very healing to reinstate that capacity to nourish yourself with your own self touch.
• 32:11
  Speaker 2: Is it a kind of physical regulation? Like, there's the emotional dysregulation and regulation? That a physical expression of it?
• 32:20
  Speaker 1: Well, I think it's both. I think it's emotional and physical and physiological. Self touch can often calm ourselves down. Like think of a baby sucking his thumb rocking himself, babies often just rock. Those movements and touch can definitely be soothing.
• 32:49
  And we wanna in sensory motor psychotherapy, we wanna help clients find that what we call somatic resources so they can soothe themselves and regulate themselves and nourish themselves through their bodies.
• 33:01
  Speaker 2: Empowering them to do it for themselves and then also it's applied to other areas of their life.
• 33:08
  Speaker 1: Yes. Well, if you if you get the capacity to resource yourself through your body, that's that's a capacity that extends across various contexts.
• 33:21
  Speaker 2: If I'm understanding what you're saying, it sounds like it's something that would help someone feel better in many different ways even while they're still working on other things as part of the process of working through things in therapy.
• 33:36
  Speaker 1: Yeah. Right. Well, it helps with with stabilization, which is the first phase of treatment always to bring arousal within that window. So, yep, that's true.
• 33:48
  Speaker 2: There's hope in that, it feels like, that
• 33:51
  Speaker 1: Yeah.
• 33:51
  Speaker 2: To increase someone's capacity to not just handle old things, but to handle things in the present differently.
• 34:00
  Speaker 1: Yeah. Well, I I think that's a big concept in Sensor Motorcycle Therapy. We're not really working with the past. We can't change the past. We're working with the effects of the past on the present moment.
• 34:13
  That's what we can change.
• 34:15
  Speaker 2: That's a powerful way of saying it. Mhmm. Thank you for sharing that.
• 34:21
  Speaker 1: Yeah. You're welcome.
• 34:22
  Speaker 2: Is there anything else about sensory motor or trauma that you want to share?
• 34:27
  Speaker 1: Well, I like what you said about hope because I think many people who are traumatized have kinda lost hope. And I think a big reason for that is that traditionally, we haven't addressed trauma at the level of impact, which is the body, physiology, and the somatic systems. So I think sensorimotor can can offer a lot of hope by targeting directly where trauma makes its most powerful impact, which is the body.
• 35:06
  Speaker 2: It gives me a lot to process. And I know that the listeners, the the clinicians and survivors will have so much to say about it. And it, I feel like opens up a whole different angle of not just treatment, but a whole different perspective on how to be in tune with ourselves, whether we have trauma or not, and to help each other be in tune with, like, just the bodies and what you said about the body being an ally is such a complete perspective shift than anything I've heard before on either side of things.
• 35:45
  Speaker 1: Well, that's good. I'm glad that I'm glad that you really understand that because I think it's really it's critical in in healing, not just with trauma, but also with relational issues.
• 35:59
  Speaker 2: Right. I feel like it's a really huge piece, and it's in a way not embarrassing. That's not quite the right word, but it seems silly that, like, we live in our body. Why would we have dismissed it so much to not even think of it as part of the equation?
• 36:17
  Speaker 1: Right. And not to think about our movement vocabulary, the the way that we move, the movements that are familiar to us, the movements that we don't make. So it's it's fascinating.
• 36:31
  Speaker 2: I grew up as a person who was just one of the smart kids and just like, school was the only thing that I really did well, and I was not an athletic kid. I did not come from an athletic family. But one of the best periods of my life developmentally was when I, through a series of circumstances, got involved in ballroom dance of all things. And it was the most healing and powerful thing.
• 37:04
  Speaker 1: Yeah.
• 37:06
  Speaker 2: And it was the first time I was able to just be with myself without like, wasn't about being perfect and it wasn't about doing anything other than just being me and learning how to be like, I can't even put words to it still. It was so freeing. Mhmm. And the first time to connect with someone else and realize how much the way you interact with someone impacts everything. Mhmm.
• 37:36
  Mhmm.
• 37:36
  Speaker 1: Yeah, that's beautiful. I think physical disciplines like dance or yoga or martial arts can be very healing in and of themselves. And what sensor motor psychotherapy does, we take those bottom up concepts of movement and alignment in the body and integrate them with psychotherapy.
• 38:01
  Speaker 2: Hey, I'm sorry. I'm just gonna have to sit here a while or go for a walk, I guess, to be in tune with my body and process some of what I learned today.
• 38:11
  Speaker 1: Okay. Well, you for the conversation, Emma, and it was wonderful talking with you.
• 38:18
  Speaker 2: Thank you so much for taking the time to speak with me. I really, really appreciate it.
• 38:23
  Speaker 1: Oh, you're very welcome.
• 38:34
  Speaker 2: Thank you for listening. Your support of the podcast, the workbooks, and the community means so much to us as we try to create something together that's never been done before, not like this. Connection brings healing, and you can join us on the community at www.systemsspeakcommunity.com. We'll see you there.