Transcript: Episode 84
84. Guest: Pat Ogden
Welcome to the System Speak podcast. If you would like to support our efforts at sharing our story, fighting stigma about Dissociative Identity Disorder, and educating the community and the world about trauma and dissociation, please go to our website at www.systemspeak.org, where there is a button for donations and you can offer a one time donation to support the podcast or become an ongoing subscriber. You can also support us on Patreon for early access to updates and what’s unfolding for us. Simply search for Emma Sunshaw on Patreon. We appreciate the support, the positive feedback, and you sharing our podcast with others. We are also super excited to announce the release of our new online community - a safe place for listeners to connect about the podcast. It feels like any other social media platform where you can share, respond, join groups, and even attend events with us, including the new monthly meetups that start this month. Go to our web page at www.systemspeak.org to join the community. We're excited to see you there.
[Short piano piece is played, lasting about 20 seconds]
Today we are 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 Sensorimotor 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 Sensorimotor Psychotherapy training of over 400 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. Dr. Ogden is the first author of two groundbreaking books in somatic psychology, Trauma and the Body: A Sensorimotor Approach to Psychotherapy and Sensorimotor Psychotherapy: Interventions for Trauma and Attachment - both published in the Interpersonal Neurobiology series of WW Norton. She is currently working on a third book, Sensorimotor Psychotherapy for Children, Adolescents, and Families with Dr. Bonnie Goldstein.
Her current interests include sensorimotor psychotherapy for groups, couples, children, adolescents, families, embedded relation mindfulness, culture and diversity, challenging clients, the relational nature of shame, presence, consciousness, and the philosophical spiritual principles that guide sensorimotor psychotherapy.
Welcome, Dr. Ogden.
***Interview Begins***
Interviewer: Bold Font
Interviewee: Standard Font
So, hello everybody. I’m Pat Ogden. I’m the founder of the Sensorimotor 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. 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 is 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 Besser van der Kolk to the discipline of rolfing, other dance movement therapies. But I would say my biggest teachers have been my clients. Those are the people I’ve learned the most from.
That’s beautiful. How did you begin applying what you learned about the body, even from dance and yoga, to trauma work specifically?
It’s been a long journey. I was teaching at a psychiatric hospital, yoga and dance, in the early 1970’s. And then I moved to Colorado, and about ‘77 or ‘78, I 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 70s was talking about trauma. In Charles Figley’s book on the trauma in war in Vietnam hadn’t come. 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, were defective with these clients. So, I remember thinking, I’m just going to try and keep them in their bodies. I’m just going to keep referencing the body and see if they can sense their 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 seemed 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.
How does trauma make someone dysregulated and out of touch with their body?
Because we are evolutionarily prepared to respond to threat with instinct and subcortical actions - fight, flight, cry for help, freeze, and playing dead are the five instincts, defensive responses to trauma. And those responses bypass our thinking brain, the subcortical then enables us to respond simultaneously 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 in feigning death response, which is like playing possum, where our arousal goes way down and we become immobilized.
After trauma, the arousal, which is risen to the extreme of hyperarousal, or drop to the extreme of hypoarousal, it doesn’t come back to -- often doesn’t come back to normal, within that window of tolerance. So those traumatized clients are triggered into hyper and hypoarousal.
How does reconnecting with your body help regulate that?
Because trauma first and foremost impacts the body - our physiology, our somatic muscular system. And so we want to work at that level to resolve the body. So, in sensorimotor 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. Grounding, stomping the feet, aligning the spine instead of collapsing… all of those are physical actions that can directly impact the impacts of trauma.
It’s 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.
Yes, I think for most of my traumatized clients, the body’s kind of in the battle ground. 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 want to help our clients re-enter the body in a safe and titrated way so that the body actually becomes an ally and a resource, instead of the enemy.
That’s a powerful thing, 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.
Mmhmm. Exactly. And has a very powerful effect. And we -- as long as we’re alive, we’re having a body. This is how we experience the world, is through our body, and if your body is the enemy, that can greatly diminish the quality of your life.
So, how did all of that unfold into becoming sensorimotor therapy?
1970’s…I met Ron Kurtz, and I moved to Boulder with him and studied with him. He’s 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. 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 Hakomi and call it Hakomi Bodywork. So, I did and I started designing my own trainings. And over the years, 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.
And I think it was in the mid 90s that I met Besser van der Kolk, and Vessel 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 psychiatry and psychology.
That’s an intense collaboration.
Yeah, it was. It was wonderful. We had a great influence on eachother. 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. [Laughs]
That’s a big shift, and it’s a powerful work in the literature - both for clinicians and for clients.
Absolutely.
So what do clinicians or clients themselves, if they’ve never heard of sensorimotor, how would you introduce it to them?
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, especially repeated trauma, it lives in our body. Our shoulders might hunch up. Our bodies might be tight. We might be ready to execute any one of those instinctive defensive responses. We might be ready to fight or to run away, to freeze, to cry for help, or to collapse into a feigned 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 posture of fear. And we’re going to have limited success resolving that fear, unless we also help the body learn how to relax the shoulders and that the eyes can drop back into the head.
So, the movement and physiology of the body, the emotions, and our thoughts and belief systems, they all go hand in hand. So, we want to work bottom up…starting with the body, which can have a strong effect on emotions and thoughts as well as top down 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. There’s the cortex, the limbic system, and the reptilian or subcortical brain.
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 what to do about it.
Yes, and [unclear] Polyvagal Theory. C. Porges 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 we do that through the body. Polyvagal Theory 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 in the social engagement system, or the ventral vagal complex can come aboard.
So it includes even the piece about how our body -- how we connect with others as well through that?
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 making eye contact. We’re reaching out. We’re mirroring movements. We’re seeking proximity. We’re setting boundaries. And that’s all a somatic phenomenon.
I’m just trying to process, because I know these separate pieces, but when you describe them -- that’s really the most integrative experience when you’re saying it all fits together.
Absolutely.
How does a therapist or a clinician -- how do they learn more about sensorimotor or get trained for that?
They can go to our website. It’s sensorimotorpsychotherapy.org. We teach all over -- all over the world, and 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 advertised on our Facebook page. And they can google sensorimotor psychotherapy. There’s lots of articles.
We have two books out so far, and are working on books about sensorimotor psychotherapy for children, family, and adolescence, with couples, and so forth. So, it’s still growing… this work. And we have 25 trainers who are very active in teaching and writing, etc.
It’s really applying to all sorts of context, not just trauma.
Absolutely. And again, because we all have a body [laughing], so it’s relevant to everyone. And it’s -- our work is -- we have a different focus from talk therapy, because we’re working with [clears throat] how we organize experience internally. So, we’re not really working with specific events, or the effects of those events in our body mind. [Clears throat] So, this requires a mindful approach where our clients and our students learn to [clears throat] observe their sensations, their movements, the images that pop up through there, and their internal state - their emotions and their thoughts. And that’s the organization of experience. So, it’s not simply talking about. It’s working with how we organize the 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 talk about not getting support?” That’s the organization of experience. They’re likely to say, “Well, I feel I’m collapsing a little bit. I’m starting to pull in. My body’s kind of 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 another level of what drives the content of our lives, rather than just talking about specific content. Does that make sense?
It does. It does. I’m just realizing it seems like part -- and please correct me if I’m wrong. But just from listening to you, it feels 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.
That’s exactly right.
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.
That’s right. If that client loses her postural integrity when she thinks about not getting support, she starts to collapse in her posture. That is a pattern she has developed that crosses all kinds of situations. Once she discovers that pattern, she has a choice. We don’t have a choice unless you know what you’re doing. But once she discovers what she’s doing in her body, then she collapses in [phone ringing] the face of feeling like there’s a lack of support, which generates less support when you collapse, she can start to shift that.
So, it’s empowering in that way?
It’s empowering. Absolutely. Yeah.
So, what would a client -- if they were going to a session with a sensorimotor therapist, a trauma client specifically -- if they were going to a sensorimotor 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 you were saying?
At the beginning of a therapy session, there’s always talking. The client is talking about their issues, talking about what they want to work with, maybe talking about their goals. But then there comes a point in the conversation where it’s just from this talking about to a mindful state of consciousness. So, the therapist will say, “Alright, let’s -- maybe we should work with that memory that bothers you…of when your father started molesting you” for example.
Okay.
So, that’s what we call a frame. And the client says, “Yes. That’s what I want to work with.” So then the therapist will ask a mindfulness question. There are an infinite number of mindfulness questions. But questions like, “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, “Well, I’m tightening up. 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 the trauma sessions, we’re also trying to complete incomplete empowering actions.
Pierce Renee, who was a contemporary, 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 worked with a perpetrator who is bigger and stronger than you are.
But those impulses still live in the body. That’s one of the most empowering elements of this work, is that we can reestablish the ability of those empowering defensive responses. So, in this case, as the client feels the tension in her body, we might ask as she senses that tension in your arms, in your hands, and 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 micromovements that indicate the availability of a larger movement. So a client's finger might lift, or their fists might clench.
And then we just want to help the client reestablish that movement, often by pushing against a 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 your original trauma.
Acting out of some of the physical responses.
It is, but it’s not really an acting out. It is eliciting from the client’s mindful awareness of the body.
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.
Yeah.
And maybe an active process is more what I meant of responding and letting that be and being aware.
Yeah. The important thing is that it’s not an idea -- I think why I reacted to the word acting out, because you act out in a role play or in a psychodrama. You act something out. This is -- these defensive responses, they live in the body. So, they come -- they emerge spontaneously from the body. So, it’s a real authentic tracking and following what the body wants to do.
And what this does is it can redo that memory. We know that memory is reconstructive. And when you’re working with a memory, and you’re adding this action -- That memory, many clients have said that memory will never be the same, because now I’ve felt what my body what I 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. So that clients find that they have the availability of defensive responses that they had not had available before since sensorimotor psychotherapy. So, there’s more flexibility.
That’s so liberating.
They can say “no” or get away, etc.
That’s so -- it’s so liberating.
It can be. Mmhmm. Absolutely.
How does someone who is just starting, who is very, very dissociative -- How can they begin to get more in touch with their body’s? What are some of the things that they could do?
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 maybe even feel neutral, don’t feel bad. Start tracking that in your daily life. Simply… do you enjoy walking on a sunny day? That’s a physical activity that can be pleasurable to some people. Do you enjoy eating certain foods? Do you enjoy playing music? Do you enjoy taking a warm bath? Just start to just notice the physical things you do that you do enjoy, but to recognize that if you’re highly dissociative, they’re going to be Parts probably, that are really terrified of sensing your body.
I think it can certainly help to work with an experienced therapist. In our second book ‘Sensorimotor 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.
Oh.
So that could be helpful.
That’s a good resource. Thank you. How would someone find a sensorimotor therapist?
If they go to our website. It’s sensorimotorpsychotherapy.org. On the left hand side, there will be a tab that says, “Find a Sensorimotor Psychotherapist.” And if you click on that tab, then you will see a page come up that has countries, different countries, and if you click on that country -- like if you click on The United States, then you’ll see all of the states, and then you’ll click on that state, and find a therapist in your area.
In sensorimotor psychotherapy, is there some touching involved just with the client touching themself? Or like the example that you gave of the woman putting her hands on her torso? Or is there touch also with the therapist? Or does that depend on the therapist?
Well yeah, touch is never necessary in sensorimotor psychotherapy - touch from the therapist or self touch. Touch can be triggering for many traumatized patients, even self touch. So, it’s not a requirement. It depends on the needs of the client and what’s appropriate for that particular therapeutic dyad.
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?
Well Beatrice Beebe. was an infant researcher. She discovered that baby’s, who have mother’s with unresolved trauma, don’t touch themselves as much as babies who don’t have mother’s 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, but for a traumatized person, it can be triggering, but it also can be very healing to reinstate that capacity to nourish yourself with your own self touch.
Is it a kind of physical regulation, like there’s the emotional dysregulation and regulation? Is that a physical expression of it?
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 or rocking himself. Babies often just rock. Those movements and touch can definitely be soothing. We want to -- in sensorimotor psychotherapy, we want to help clients find what we call somatic resources, so they can soothe themselves and regulate themselves and nourish themselves through their bodies.
Empowering them to do it for themselves and then also it’s applied to other areas of their life.
Yes. So, if you’ve got the capacity to resource yourself through your body, that’s a capacity that extends across various contexts.
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.
Yeah. Right. Well, it helps with stabilization, which is the first phase of treatment, always to bring arousal within that window. So, yup, that’s true.
There’s hope in that it feels like…to increase someone's capacity to not just handle old things, but to handle things in the present differently.
Yeah, well I think that’s a big concept in sensorimotor psychotherapy. We’re not really working with past. We can’t change the past. We’re working with the effects of the past on the present moment. That’s what we can change.
That’s a powerful way of saying it.
Mmhmm.
Thank you for sharing that.
Yeah, you’re welcome.
Is there anything else about sensorimotor or trauma that you want to share?
Well, I like what you said about hope, because I think many people, who are traumatized, have kind of 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 offer a lot of hope by targeting directly where trauma makes its most powerful impact, which is the body.
It gives me a lot to process. And I know that the listeners, both the clinicians and survivors, will have so much to say about it, and I feel like it 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 -- just the bodies -- like what you said about the bodies being an ally -- is such a complete perspective shift than anything I’ve heard before on either side of things.
Well, that’s good. I’m glad that you really understand that, because I think it’s critical in healing, not just with trauma, but also with relational issues.
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?
Right. And not to think about our movement vocabulary - the way that we move, the movements that are familiar to us, the movements that we don’t make. So, it’s fascinating.
I grew up as a person who was just one of the smart kids, and just -- 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.
Oh. Lovely.
And it was the most healing and powerful thing.
Yeah.
And it was the first time I was able to just be with myself, without -- it wasn’t about being perfect. And it wasn’t about doing anything other than just being me and learning how to be -- I can’t even put words to it still. It was so freeing.
Mmhmm.
And the first time to connect with someone else and realize how much the way you interact with someone impacts everything.
Mmhmm. Mmhmm. 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 sensorimotor psychotherapy does, is we take those bottom up concepts of movement and alignment in the body and integrate them with psychotherapy.
Okay. I’m sorry. I’m just going to have to sit here a while or go for a walk, I guess, to be in tune with my body [laughs] and process some of what I learned today.
[Laughs] Okay. Well, thank you for the conversation, Emma. And it was wonderful talking with you.
Thank you so much for taking the time to speak with me. I really, really appreciate it.
Oh, you’re very welcome.
Thank you for listening. Your support really helps us feel less alone while we sort through all of this and learn together. Maybe it will help you in some ways too. You can connect with us on Patreon. And join us for free in our new online community by going to our website at www.systemspeak.org. If there's anything we've learned in the last four years of this podcast, it's that connection brings healing. We look forward to connecting with you.