First and foremost, it is a commendable and courageous step to seek help from a mental health professional. Just the very fact that you have chosen to pursue assistance in this way indicates progress toward health. It is not an easy decision, and often one made with apprehension and fear. For that reason, it is essential that you feel comfortable and safe with your therapist. The information that follows should also assuage some of your concerns about entering into this unique relationship.
It is important that you find a therapist that you feel good about personally, someone you feel connected to, with whom you feel you can be open and honest. In therapy, you purposely make yourself vulnerable to another person, and this can be a very frightening endeavor. But don’t forget, it is through this trust and self-revelation that healing begins and wholeness can be experienced.
Initially, your therapist comes out to the waiting room, introduced him/herself and shows you into his/her office. If you are unsure of where to sit, you can ask and he/she will be glad to accommodate to make sure you are comfortable. When you are settled, the therapist may wait for you to begin, or may prompt you with a general question such as “What’s brought you here today?” You can describe whatever you think relevant at that time, or anything else that comes to mind. You aren’t expected to explain everything. The therapist should be able to guide you through this.
In this first session, you can expect your therapist to listen actively. He/She may not say anything at all until halfway through the hour, and then maybe ask for clarification. You should not feel judged or expect to receive advice. The therapists role is to listen carefully, evaluate your situation and decide on the best course of treatment.
Psychotherapy refers to a variety of techniques and methods used to help people of all ages who are experiencing difficulties with emotion and behavior. Although there are different types of psychotherapy, each relies on communication as the basic tool for bringing about change in a person’s feelings and behaviors. Psychotherapy may involve an individual person, group or family. With adults, it often important to talk about significant life experiences and learn new ways of interpreting and responding to ourselves and others. In children and adolescents, playing, drawing, building, and pretending, as well as talking, are important ways of sharing feelings and resolving problems.
Sometimes a doctor or psychiatrist will refer an individual or family to psychotherapy, other times a person or family will initiate the therapy without psychiatric intervention. The first meeting will be based upon such things as the person’s current problems, history, level of development, ability to cooperate in treatment, and what interventions are most likely to help with the presenting concerns. Psychotherapy is often used in combination with other treatments (medication, behavior management, stress management or work with the school in the case of children). The relationship that develops between the therapist and the patient is very important. One must feel comfortable, safe and understood. This type of trusting environment makes it much easier to express thoughts and feelings and to use the therapy in a useful way. The therapeutic relationship is considered confidential by state law and the exceptions to this law are specific to circumstances involving danger to self or others, or issues involving the courts.
Psychotherapy helps people in a variety of ways. They receive emotional support, resolve conflicts with people, understand feelings and problems, and try out new solutions to old problems. Goals for therapy may be specific (change in behavior, improved relations with friends), or more general (less anxiety, better self-esteem). The length of psychotherapy depends on the complexity and severity of problems.
It depends on the education and license of the professional. All Psychotherapists can provide counseling but not all counselors can offer psychotherapy. Only mental health professionals that have an active license with their state licensing board can provide psychotherapy.
The definition of counseling as found in the dictionary is as follows: “To exchange opinions and ideas; advice and guidance, especially when solicited from a knowledgeable person.”
To extend this definition even further, the following quote offers a comprehensive explanation of the experience of counseling:
“Counseling helps individuals understand their emotional responses to the ongoing crises of life. This leads to more effective methods of coping with these crises, and builds a more secure foundation for facing inevitable losses and changes… Often such care is sufficient, and spiritual and emotional growth is renewed.” –Gary Hellman
The word psychotherapist is an umbrella term that refers to any mental health professional licensed by the state and nation to provide psychotherapeutic services. This includes all the following professionals:
- Psychiatrist (M.D.)
- Psychologist (Ph.D. or Psy.D.)
- Licensed Clinical Social Worker (LCSW)
- Licensed Mental Health Counselor (LMHC)
All these professionals are licensed to provide psychotherapy and can call themselves psychotherapists. A psychiatrist is a medical doctor who specialized in psychiatry and has been certified by professional boards.
No, only a medical doctor can prescribe medication. The most important place to receive information about medication is directly from your prescribing psychiatrist or medical doctor. As an adjunct, you can look up information about a particular medication from your local library or on the web. One good reference book that is updated fairly regularly is The Pill Book published by Bantam Books and available at most book stores for about $9.
All mental health professionals are bound by law to respect client/therapist communication. Though each state varies in its wording of this law, most are consistent is stating that everything a client says to his or her therapist must remain confidential. The only exceptions are if the client says something that would indicate harm to herself/himself or someone else, or if there were some form of danger or abuse to self or others involved, or if a judge ordered a therapist to disclose court-related information.
No! Life often presents stumbling blocks along the way. Sometimes we need help in moving these blocks out of the way. It can be difficult to rely solely on friends and family to help clear your path. Our society is very different from what it once was. We often no longer have extended family available to us geographically and sometimes even emotionally. This is a fast paced world that can leave you feeling isolated and disconnected. These are often normal responses to stressful circumstances. It is important to seek help when you are feeling out of balance. If your car were starting to rattle and lurch, indicating some malfunction, wouldn’t you take it to the shop to have it checked out? And would the mechanic think there was something wrong with you or your driving because your car was breaking down? Probably not. Remember, your value far exceeds an automobile, so be sure to treat yourself in the right order of importance.
Eye Movement Desensitization and Reprocessing is a powerful new method of doing psychotherapy. To date, EMDR has helped an estimated half million people of all ages relieve many types of psychological distress.
In 1987 psychologist Dr. Francine Shapiro made the chance observation that eye movements can reduce the intensity of disturbing thought under certain conditions. Dr. Shapiro studied this effect scientifically and, in 1989, she reported success in using EMDR to treat victims of trauma in the Journal of Traumatic Stress. Since then, EMDR has developed and evolved through the contributions of therapists and researchers all over the world. Today, EMDR is a set of protocols that incorporate elements from many different treatment approaches.
No one knows exactly how EMDR works. However, we do know that when a person is very upset, their brain cannot process information as it does ordinarily. One moment becomes “frozen in time” and, remembering a trauma may feel as bad as going through it the first time because the images, sounds, smells, an feelings haven’t changed. Such memories have a lasting effect on the way a person sees the world and relates to other people that interferes with his or her life.
EMDR seems to have a direct effect on the way that the brain functions. Normal information processing is resumed, so following a successful EMDR session, the images, sounds an feelings no longer are relived when the even it’s brought to mind. What happened is still remembered but it is less upsetting. Many types of therapy have similar goals. However, EMDR appears to be similar to what occurs naturally during dreaming or REM (rapid eye movement) sleep. Therefore, EMDR can be thought of a physiological based therapy that helps a person see disturbing material in a new and less distressing way.
During the EMDR, the therapist works with the client to identify a specific problem to be the focus of the treatment session. The client calls to mind the disturbing issue or event, what was seen, felt, heard, thought, etc. and what thoughts and beliefs currently are held about that event. The therapist facilitates by directional movement of the eyes or other bilateral stimulation of the brain (i.e. toning or tapping) while the client focuses on the disturbing material. The client just notices whatever comes to mind without making any effort to control direction or content. Each person will process information uniquely, based on personal experiences and values.
It is important to understand that there is no way to for the client to do the EMDR incorrectly! Sets of eye movements are continued until the memory becomes less disturbing and is associated with positive thought and beliefs about one’s self; for example “I did the best I could.” During the EMDR the clients may experience intense emotions, but by the end of the session, most people report a great reduction in the level of disturbance.
One or more sessions are required to understand the nature of the problem and to decide whether EMDR is an appropriate treatment. The therapist will also discuss EMDR more fully and provide an opportunity to answer any questions about the methods. Once therapist and client have agreed that EMDR is appropriate for a specific problem, the actual EMDR therapy may begin.
A typical EMDR session lasts from 50 to 90 minutes. The type of problem, life circumstances, and the amount of previous trauma will determine how many treatment sessions are necessary. A typical course of treatment is 3 to 10 sessions, preformed weekly, or every other week.
Scientific research has established EMDR as effective for posttraumatic stress. However, clinicians have reported success in the following treatment conditions:
- Panic attacks
- Disturbing Memories
- Performance Anxiety
- Stress Management
- Sexual or Physical Abuse
- An Adventure in Self-Discovery
- A Mind-Body Approach to the Relief of Stress and the Increase of Energy
- A Way of Enhancing Aliveness and Emotional Well-being
- An Approach to Resolving Emotional Pain and Creating Space for More Joy
- Do you feel like life is “Too Much” or feel Overwhelmed?
- Are you having Difficulty in Relationships?
- Looking for Tools to Manage Stress?
- Are you in Physical Pain that has not responded to Traditional Medicine?
- Do you Struggle with Anxiety or Depression?
- Have you tried Talk Therapy but are looking for Something More?
- Are you carrying Emotional Pain from the Past that Holds you Back?
Bioenergetics was started in the 1950s by a Psychiatrist named Alexander Lowen. He found that we store emotions in the body when it’s not safe to express them and that over time this manifests as chronic patterns of muscular tension and psychological stagnation. This often shows up as physical pain, emotional emptiness, depression, anxiety, self-sabotaging behavior or relationship problems, personally and/or professionally.
Even later in life, when we are safe to express our feelings, our bodies inhibit this expression and our minds still don’t believe it is safe.
Lowen, now 92 years old and living and practicing in Connecticut, was a student and patient of Wilhelm Reich, who died in 1957. Reich was a patient and student of Sigmund Freud, the father of all psychotherapy. While Freud paid attention only to the verbal productions of his patients, Reich introduced to psychoanalysis the observation of the body, such as expressions of eyes and face, quality of voice and muscular tension patterns. What we today call body language was first described by him. Just as Freud noted a split between a conscious and unconscious memory, Reich noted a split in the expressions of the body. For example, a person may smile but be unaware that his face looks mournful. He may say kind words but not realize that his eyes look resentful, that his jaw is set in an expression of spitefulness.
As his patients improved through psychotherapy, Reich noted that muscular tensions also changed. The depressed person’s shoulders and arms became less tense, the jaw became relaxed, the teeth were no longer clenched. The reason he determined we restrain the impulse to reach out and instead repress the painful memories in the first place is to prevent being vulnerable. With the relaxing of the chronically tense muscles the patient therefore re-experiences the vulnerability. By his set jaw and clenched teeth he had adopted a bodily expression which spoke of never wanting to reach out and be hurt again.
Reich experimented with attempting to relax chronically tense muscles by pressing on them directly. He discovered that it worked. People would often experience strong emotions and recover long forgotten, painful memories. The unity of body and mind and emotions became clear.
He also noted that people started looking more alive, their skin pinker, their voice fuller and stronger, their movements more graceful and flowing, their eyes brighter. It was as if they had more energy.
Dr. Lowen broadened the scope of body work and introduced bioenergetic homework. Instead of only pressing on chronically tight muscles, he also made use of stress positions which cause chronically tense muscles to let go. Evidence of this relaxation could be seen in a trembling and fine vibration of the muscles.
Lowen could actually observe the blocks to energy flow caused by chronically tense muscles. For example, a chronically tight diaphragm interrupts the respiratory wave, causing shallow breathing. As a result the oxygen intake is reduced and the person’s energy level drops. Such shallow breathing is one way we keep our emotions controlled. To help people breathe more deeply, Dr. Lowen introduced the bioenergetic breathing stool.
This intricate combination of body work and psychotherapy work constitutes the essence of bioenergetics.
Dr. Lowen believed that to release the tension and know and express our true selves, we must access the original source feelings in conjunction with the release of the muscle contraction. How does this happen? Using a combination of self-expression, movement, breathing and body awareness techniques, which are explained in more detail below.
Bioenergetics provides a forum to express one’s thoughts and feelings in a safe, supportive environment. The use of sound and vocalization of feelings can be a powerful catalyst in building our sense of self and communicating with others with more confidence and clarity. In addition, Bioenergetics creates a space to explore the issues of boundaries and intimacy with self and others.
Dr. Lowen believed that we must move the body in order to release tension and access feeling. This can take many forms ranging from passive movements such as stretching to more active movements like kicking. The movement prescribed is based on the quality and location of blocks in the body. Some examples of this are explained below.
Blocks in the throat and jaw restrain our crying and screaming; they also inhibit our joyous shouting and singing. Blocks in the shoulders and arms restrain not only our drive to get what we want in life and to be able set boundaries with others, but also inhibit our desire to reach out to others with softness and trust in ourselves.
Blocks in the waist restrict our crying and yelling as well as our breathing and sighing. Tight muscles in our legs and feet curb our rebelliousness, our ability to protest; they also decrease our capacity to stand our ground and be independent.
There are many muscles that connect the pelvic girdle with the trunk and the legs, such as the muscles of the lower back, the buttocks and the thighs. There are also muscles that form the pelvic floor. All these muscles are involved in controlling our sexual and excretory functions. Their chronic tension dulls our sexuality and often causes lower backaches and even frequent urination.
“When the breath is disturbed, the mind is disturbed. When the breath is calmed, the mind becomes steady.” –Hatha Yoga Pradipika
We can go without food and water for a long period of time, but only minutes without the breath. Therefore, it is amazing how little attention we pay in normal life to the importance of breathing correctly. As babies and young children, we breathed deeply with our entire body. But many people have forgotten how to breathe properly and our sedentary work environments and lifestyles, coupled with the stress of busy lives, have conditioned most of us to fast, shallow breathing. This type of breathing restricts the breath to our upper chest and can ultimately undermine our health, decrease our vitality and compromise our ability to appropriately cope with mental, physical and emotional stress.
Most of us breathe without involving our diaphragm at all and use only one-third of our lungs. This serves to limit oxygen in the body. When an insufficient amount of fresh air reaches your lungs, your blood is not properly purified or oxygenated. Lack of oxygen can result in a low level of vitality and resistance to disease. Poorly oxygenated blood also contributes to anxiety states, depression and fatigue and makes stressful situations harder to cope with. Stress is a powerful mind-body phenomenon; it initiates interactions between the brain, nervous system and endocrine system that initiates shallow breathing which restricts oxygen. When faced with stress, oxygen deprivation switches on the nervous system’s “fight or flight” mechanism, creating a physical sensation of nervous arousal, while triggering a feeling of fear, inhibiting concentration and sometimes creating a sense of unreality or detachment. Many people have a tendency to even hold their breath without being aware of it, especially those that suffer with anxiety, depression, panic attacks or other emotional disorders.
People with emotional disorders can benefit greatly by working on proper breathing. Dr. Ronald Ley, a professor of psychology and hyperventilation researcher at the State University of New York in Albany, speculates that oxygen shortages in the brain trigger a subconscious feeling of suffocation that leads to ‘irrational thoughts and feelings of imminent doom.’ Chronic breathing, also known as over-breathing can contribute to feelings of anxiety, panic and fear. A contributing factor often associated with over-breathing is chronic tension is the muscles of the chest, back, neck and shoulders. The tension interferes with the normal breathing action of the diaphragmatic muscle.
You may have noticed that when you are angry or scared, your breathing is shallow, rapid and irregular. When you are relaxed or deep in thought, your breathing becomes slow. You can test this by listening for a moment to the lowest sound in the room. In concentrating, you may notice that you unconsciously slowed your breathing. So if your state of mind is reflected in the way you breathe, then it makes sense that by controlling the breath you can control your state of mind.
Ultimately, full breathing creates space in our bodies for new sensation to emerge and literaaly provides the oxygen that we need to become more alive. It also establishes a container for feelings to be held and formed in. Breathing into a feeling helps us take responsibility for it as an experience that we ourselves are generating, not one that other people are pushing onto us.
As the mind-body expert Deepak Chopra has said, the first step to change is awareness. So it follows then that just the awareness of the breath can lead to a shift in unhealthy breathing patterns and bring about a greater sense of physical and emotional well-being.
Body Awareness/Body Work
Emotional stress from many areas – relationships, family crises, jobs, health, etc. produce tension in the body. Contractions in the muscular system are often the result of carrying unresolved emotional tension. These contractions can have a direct effect on our energy level, and on our capacity for spontaneous and creative self-expression, as well as feelings of well-being.
Body awareness interventions are designed to assist you in attending to your experience of your body. The focus is on areas of muscle tension, posture, breathing patterns, and the ways in which physical and emotional tensions are related.
Body work is simply the inclusion of your body in the therapy session. This takes many different forms. At times, body work directs you to become aware of and stay in connection with how your body is responding in the moment. What parts of your body are you most aware of? What sensations are occurring in these parts of your body? What parts of your body are you least aware of? How might you describe the sensations in these, less felt parts of your body?
Body work is used to bring increased awareness of your bodily sensations, and to connect these sensations to your feelings and to historical events.
As you become more in touch with your body, the Bioenergetic psychotherapist works with the basic concepts of breathing more deeply, grounding yourself more in your body (becoming more conscious of what it really feels like to live in your body; allowing yourself to notice when you feeling nothing, go numb, get anxious, afraid; feel needy, desperate, hopeless – all on a body level), and helps you release a wide range of feelings that have been held back as a means of coping and surviving. This increased contact with your self and your feelings develops in the safety of a solid, trusting relationship with your Bioenergetic psychotherapist.
In Bioenergetic therapy, the therapist sometimes uses therapeutic touch, usually the palpation of muscles, to facilitate the therapeutic process. Certified Bioenergetic psychotherapists have been fully trained to appropriately use touch in the therapeutic setting. Because most of us were wounded either by the misuse of touch or by the lack of touch in our early years, therapeutic touch helps to contact, understand and release contractions in our body. The therapeutic use of touch also helps deepen your feeling of and connection with your own body and your feelings. It is important to know that the therapeutic use of touch is never sexually intrusive or exploitive.
You learn that to deny your body is also to reject your deep longing for love, contact and affection, in order to avoid your fear of being hurt, rejected and disappointed.
As therapy progresses, you’ll realize that the constrictions in your body are really a defense against feeling and releasing a variety of different feelings. The immobility of your body stems from deep-seated fear of such expression. Given the opportunity to express your feelings by pounding or kicking and given the chance to voice your negativity, within the framework of a safe, therapeutic relationship, you discover that you will not be abandoned or destroyed for expressing your feelings. Since the body is such an important part of who we are, any increase in contact with and acceptance of your body will produce a significant improvement in your self image, interpersonal relationships, in the quality of your thinking and feeling and in your enjoyment of life.
This work is based on the belief that emotional pain and protection is anchored in the body. Over time, this creates muscular and psychological patterns that result in inhibiting our capacity for joy, spontaneity and creativity in our lives. These patterns can be identified, understood and shifted by exploring one’s posture, movement, breathing patterns, and capacity for self-expression in a confidential, safe and supportive environment.
Physical expressions or exercises are introduced to help experience these patterns of tension in the body and recover repressed feelings that are keeping us stuck. There is an emphasis on understanding how and why they developed. For example, how the very defenses that may be causing physical or emotional pain originated as an effective emotional survival strategy.
- Bioenergetics is for people who are looking for personal growth as well and those who are in emotional and/or physical pain.
- It can benefit those looking to resolve a specific issue as well as those wanting to create a positive change in their lives as a whole.
- Sometimes Bioenergetics is used as a primary treatment and other times it is more appropriate to seek treatment as a support for other healing methods.
- This type of therapy can also be an effective alternative for those who have pursued other forms of therapy that have not had the desired effect.
- For people who suffer with physical pain that has not been relieved through other more traditional means.
There are many mind-body treatments offered in today’s market. What separates Bioenergetics from the others is threefold:
- Bioenergetics was developed by Alexander Lowen, M.D. in the 1950s. Unlike many current trendy techniques, Bioenergetics has been refined, researched and written about for over fifty years. Its history, practice and development has evolved into a time-tested comprehensive form of treatment. For a comparable fee, you receive quality service based on years of training and professional expertise compared to other body-based treatments.
- Only Licensed Mental Health Professionals can practice Bioenergetic Psychotherapy. This involves a graduate degree, two years of postgraduate supervision, and passing of the National Clinical Exam and State Laws Exam.
- The certification program for Bioenergetics involves four years of direct training, 50 hours of Supervised Clinical Work, and 150 hours of Personal Bioenergetic Therapy.
This is determined on an individual basis and is negotiated each step along the way. I respect my clients decision regarding length of treatment.
Julie M. Simons is a Licensed Clinical Social Worker who provides psychotherapy utilizing approaches such as Bioenergetics, Hypnotherapy, EMDR, and other alternative modalities. Please visit About Me to find out more about Julie personally and professionally.