Dees Analysis Session 1


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This is a transcript of the first of 12 sessions that were part of the doctoral research of Amelia Kaplan in 2005. If you would like to see the session then contact Laurie at
Laurie does teach and facilitate supervision groups every month. She is on the faculty of the Hakomi Insitute and is also an individual and group supervisor for Somatic Experiencing.

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Dees Analysis Session 1

  1. 1. New York Center for Somatic Psychotherapy & Trauma Resolution 1 Lincoln Plaza Laurie F. Schwartz, L.M.H.C, M.S. Suite 21J New York, New York 10023 Analysis Subject 1 - Dee: Session 1Overview of Therapist’s Intention of the First Session In this session I am assessing whether Dee can be “resourced” - can she relax into her ownbody so that she can access self-soothing when she becomes anxious? Whether she can begrounded in her sensations is a precondition to working with her trauma. Thus, I am assessingwhether Dee can access mindfulness and is able to remain grounded before I ask Dee to open upher trauma narrative.Summary of the Process Dee began to speak but I directed her to look at what was happening in her body. This seta tone and intention for the style of working, which is much more present-oriented, body-focused, and less historical. Dee was able to follow my lead and she began to slow down, closeher eyes, and look inside for what was happening in her body. I also went into a lengthyexplanation of the way I work, which Dee seemed to resonate with in connecting mind and body.In fact, it was after this explanation that she associated to an early memory of painful eczema andas she reported this she made gestures with her hands. I followed the spontaneous gesture, (anHakomi “experiment in consciousness” following the spontaneous movement made by theclient), which led to further material from Dee’s trauma history. Dee began to give information,which she appears to have needed to tell. I listened until a point where she allowed for more 1
  2. 2. grounding work. This time, Dee spontaneously closed her eyes and went inside to mindfulness.This session was an example of how I move back and forth, stitching together both narrative andexperiential embodiment work in the session. Particularly for this first session much waseducative as well as experiential, since Dee is just beginning to learn the tools of going within to“listen” to her body’s sensation.Narrative of the Treatment Process (with themes elucidated) I described Dee with softness, yearning, longing, and melancholy in her appearance. I gota feeling of Dee seeming worn out. She also appeared, as many people with trauma do, to havesome trouble orienting. For this reason I made sure I was careful to help Dee feel safe in howshe got to the office and left. Hence how many details I attend to as I open the session:T: How’s the temperature for you? Is it okay? It’s not to warm?C: It’s warmer than I’m used to, but ah...[giggle]T: Yeah [throat clearing]C: [throat clearing]T: So, how was the trip coming here? Was it...?C: Oh, but I, um, Andrea mentioned a bus? A number 1-4T YeahC: Where does that leave?T: The 104 you can get that at Grand Central Station. When you come in.C: When you come in on 42 Street?T: Yeah.C: Um, okayT: And then it just drops you off right in front of this building.C: WowT: YeahC: And to get back, is it the same thing?T: YeahC: Right in front of this building?T: YeahC: OhT: Yeah and once you get on the 104, you can read a book or meditate or whatever you’re going todo...and then ...[long pause] I introduced meditation into this discussion of taking the bus - both orienting Dee andoffering her a suggestion that spiritually is welcomed in the therapy. Also, that taking time to 2
  3. 3. meditate is perhaps an important real world adjunct to this therapy. Then, I brought moreawareness to our relationship, affirming it as a “journey,” (again, connoting spiritual language),we have undertaken together.T: Well, so, we’re finally...C: Yes [laughter]T: So, what a journey, huh?.. To get to this moment of time...T/C: [Laughter]C: Yes, in more ways than one...T/C: [Laughter]T: Right, right.T: So ,yeah, how does it feel to be here?C: It feels very good; it feels very good. Um, I’m really welcome here...this, very much.T: Uh huhT: And when you say it feels good, do you have ah, a bodily experience right now, when your check-in...kind of curious? Without going to history I lead directly into the bodily focus of the session. I began rightaway by asking Dee what her bodily experience is. This is assessment and treatment - I amassessing Dee’s level of embodiment and at the same time I am educating and bringing Dee’sawareness to her body. I am offering a message that this session (and this work) is going to beworking in Dee’s present awareness, which is going to require a great deal from Dee.T: And when you say it feels good, do you have ah, a bodily experience right now, when you check-in...kind of curious?C: Um, well, outside, I was ah...watching the bubbles in the aquarium [giggle]. And..... I was...comingfrom uh, a very important lunch...and...I was, I can tell you about it another time, but, um, and so, I wasthinking about that and I feel, I did notice how warm it was, um, and it’s very soft. Uh, it feels good. With this question of bodily experience I also begin my formulation. Dee associates to thebubbles, which is a past memory, but it is a kinesthetic description. She appears to want to giveinformation, which I note. However I decided to work on embodiment and helping Dee resourcewith her own bodily awareness. In this way I bring Dee’s awareness and the focus of the sessionback to the bubbles, which were the client’s words previously spoken. 3
  4. 4. T: So, yeah, so, just take a moment now and just acknowledge the warmth and the softness, the softnessof the couch and the warmth, the memory of the bubblesC: Let them come next to the pearl...T: Just take a moment and just close your eyes and just allow yourself a little bit of time to rest in thatimage of the joy of the bubbles coming up, the feeling of the softness, the warmth, and just noticeanything you might experience as you allow yourself the time to savor the bubbles, the warmth, thesoftness...anything as all that you might notice... Where are your hands, huh? Is there an impulse in yourhands? Sense that movement. Let your hands do that movement. Just like that, exactly. What do younotice in your body? Using the imagery from the client’s description of warm and soft - that is how Deebecomes more grounded. Dee brought in this soothing kinesthetic experience, and I encourageher to explore accessing it in a more complete way. As Dee does so she makes a spontaneousgesture with her hands, which is then explored using somatic awareness. This is an example ofhow the client’s body leads the session, yet once brought into the room, I guide and direct theflow.C: Yeah, and I was noticing that I felt really completely relaxed, except for my hands.T: Ah.C: And it was as if the tension...and I don’t, I mean, sometimes my hands hurt, but, um, I don’t usually,it’s as if they were the only parts of me that were not relaxed.T: And everything was relaxed, but underneath your wrist.C: YeahT: The tension that was normally in your shoulders seemed to be in your hands?C: YesT: So you felt that impulse...So, could you do that movement slowly? Like a fish in water, or like anoctopus, just you notice what happens when you follow that impulse...and you senseyour body relax, relaxing. Take a breath. Yeah...just staying very curious, as you’re feeling you’refingers in your hands, sensing the quality of the your hands your wrists, and just noticeanything else you’re aware of in the rest of your your breathing or through your torso...that’sit...into your pelvis...that’s it...I just invite you to relax into the experience.C: I feel peaceful. Dee is able to access a peaceful feeling that happens when she slows down her movement.She is beginning to have a heightened awareness of the difference between rushing through hermovements and acting with awareness. I take a moment to educate:T: When we do body-centered work, we often slow time down. So, you will hear me at times just lettingyou slow down time, to stay with nourishment. And then we want to keep some sort of being sensitive to 4
  5. 5. what happens when you can just rest in the peacefulness.Dee takes this education a step further, and associates to the characterological piece, (i.e.developmental) that relates to her physical movement. This is in essence what Hakomi therapyexplained about character organization.C: You know, it’s interesting to hear you talk about slowing things down because, uh...I come form a longtradition of...I didn’t found the tradition but I inherited of, um, coping via acceleration. I have a soothing, calming voice that almost says slow down and be present just to listen toits tones and rhythm. On this discussion, Dee associates to my voice and engages with therelational piece of this work: how my embodiment through my voice tone and rhythm is alsocommunicating and modeling embodiment to Dee. I use my voice a lot in trauma work - boththe quality and pacing are important components of helping clients slow down. Often there is anactive choice point between getting a clients history and slowing the client down.C: Thats what struck me the first time I talked to you was...the quality of your voice and the pace of yourvoice... I then continue with education about the therapy. This educative piece helps orient theclient further. Note again, that it is before much history is taken. It is keeping the focus on theembodiment aspect of the work and not spending much on past in a cognitive fashionT: This form of therapy, um, we slow things down, and um, usually from week to week, Ill also have youcheck-in and see what your intention is - sometimes your intention will come from something thats goingon in your outside life, or a dream, or a situation with somebody. . . um, sometimes it might be that itcomes from your body, if you say youre not sure, we might just tune in to see the information that comesfrom your body. . . the context for the work is basically that all life happens in the body throughsensation. And that our thoughts, our feelings, our memories, our images, our beliefs.. .are all stored on acellular level in our organism. And what I do is I stay with people in the present moment and thentogether, we see what happens next. Sometimes Ill ask you a question or Ill slow things down or well tryan experiment. Um, so, interacting with you, and then Im sort of backing off. Sometimes we say, its likeum, Im the midwife that helps you make the discovery for yourself. And so, its kind of a whole creative 5
  6. 6. process.Dee immediately associates to a mind/body memory, and brings in the painful history of herearly childhood eczema.C: You know, its very interesting to me about that...I dont know why I never really thought about thisbefore, um, cause once I started thinking about it... urn, but it was partly about coming to see you andsomething else triggered it, I dont know what it was, but. When I, urn, there was a question there aboutthe earliest childhood memory...and, uh, Ive been thinking about how few childhood memories I can, youknow, dredge up and it suddenly hit me, that...Oh! I know what it was. I was at work and I was doing anarticle on eczema and um, they made a new discovery and they were talking about how debilitatingeczema was and that they found that it was this autoimmune disease and stuff. And I was born with reallyterrible eczema, I mean, I really terrible...uh...and my earliest memories are of having tar, you know, onmy arms and legs and ace-bandages and having my hands tied, so I couldnt scratch myself... From here, the session goes further into Dee reporting on this early trauma. I emphasizedthat the history taking often occurs spontaneously, as it does here. Dee talks a great deal aboutthis early traumatic memory of being held down, unable to scratch herself, believing that theeczema was her fault. I chose not to go further into the memory because it was so old and deep.In this first session, clients are building trust and alliance. In a later session, I might begin to askDee to go into her body as she talks about the eczema. However, in this session, I create areflective, empathic, mirroring space for Dee to tell her story, merely noting how Dee hasorganized to cope with this trauma. Here I am assessing that Dee, as a successful professionalwoman, has developed a certain coping style to self -regulate in response to trauma. I amexamining how Dee sequences - i.e., how she shifts from the story about eczema to her beliefthat "it wasnt my fault." She has adapted and is able to ground.C: And I just started thinking about all of the events that I probably went through and what I remembermost is somebody saying to me, "dont scratch"...[laugher], and one of the things that really helpedme because when I was growing up, anything like eczema or asthma or any of that was consideredpsychosomatic, so, you not only had the misery, but you had the feeling that there was something wrongin you that was causing that and was...a double whammy, really. And my nephew, um, God rest hissoul, was born, he was the only one in the family who had this skin condition I did. 6
  7. 7. T:MmmC: And obviously he was born quite a while after I was. [laugher...] And I remember seeing him as a babywith this horrible thing, and thinking, "my God, you know, it wasnt my fault!" Now, comes an interesting part of the session.T: So, lets check in, and see... what are you noticing?C: Im noticing, uh, a feeling like, my God, I have a very legitimate... Im very, very, aware of the surfaceof my body...T: Uh huhC: Very, very. Usually, if I have any awareness its, you know, whats tense in the muscles or but Im veryaware of my skin.T: Great! Yeah, so, just take this time and let yourself bring your awareness to your skin. Yeah. Becausewhen you were a little baby and were just born, your skin had some rashes on it...and just notice what itfeels like now...C: [Big sigh] Yes. As Dee sighs, she is making contact with her skin in the present moment. She is workingthrough old trauma held in her skin. The feeling of being ugly, of being damaged, of havinguntouchable skin.T: Be aware of your skin.C: You can actually touch it.T: You dont have to scratch it... you can just touch it. What does it feel like?C: It feels really good.T: Yeah.C: You know, I often wondered why I have had such a feeling of ugliness my whole life and I, you know,I was ugly. You know, I mean...I was...T: The eczema...C: Yeah, yeah, it was really not a nice thing to look at.T: Was it on your face too?C: It was everyplace.T: So, you felt ugly, and you also felt like it was your fault, and you were also all tied up.. .and you werealso very young, and little, a time when babies like to move and stretch. . .C: [big sigh] Yeah.T: You are a very courageous soul to get through all that. . . to get where you are now.C: Thank you. Its amazing to me, that... connection. [tears up] Finally I contact the affect. This sadness Dee acknowledges is an important part of whathas brought her to therapy. She is making the somatic mind-body connection between her skin 7
  8. 8. and her sadness. Some might say that some sadness was trapped in the skin.C: I have had, um, Ive had a lot of sadness in me forever that I couldnt quite feel, I couldnt quite getto the bottom of it. Not, I couldnt quite, I couldnt [laughs] As I begin to work with Dee’s affect, she still uses very visible, concrete, embodiedimagery of a well. Dee connects this imagery to her own body, gesturing to a line from her headdown her esophagus to her belly as a "well of tears."T: Just notice everything that happens. Where in your body. . .C: You know it really does...its as if I can feel the shape of the well going right down there...T: Uh-huh. Great. Let yourself feel that.C: Its just thatT: So youre sensing the well, sensing the shape going down your throat, your chest, your diaphragm, intoyour belly. Just kind of stay with it ...feel that well...the boundaries, feel that shape...C: It does have a very specific shape...T: Right, yeah... A very specific shape. So, does it curve, does it go straight?C: It goes straight down...T: Straight down.C: Its about that wide.T: A few inches wide. And how deep does it go?C: It sort of goes from there, just straight... It doesnt hurt.T: It doesnt hurt, right. And is there a texture? Does it feel like it has a wall?C: Yes, yes, kind of like a... um, a a ceramic...T: Like a vase?C: Yeah [real upbeat]T: So just kind of touch into that ceramic shape. Sensing the sides, the boundaries. That well...acknowledging... your sadness. If you look in there, looking into the well and the water and the tears.And just notice if there is any thing that you see when you look into that well, any image or memory?There doesnt have to be... just asking...C: SniffC: I just saw two faces...uh...just for a in water...T: OkayC: Just for a second, just kind of very curious faces.T: Curious faces [smiles]C: And, one was mine, and, the other was Jacks and Jack is the man I just had lunch with ...and...its sucha huge, long story, but anyway. He was the first love of my life... All through this associating, from her past trauma, through contacting her skin, to her deepsadness and now to an important relationship (sensation connected to affect and image), is all 8
  9. 9. happening in an embodied way. Throughout this session, even while exploring painfulmemories and feelings, Dee remains, (with my encouragement), close to her body and herexperience of being in her own skin. So Dee begins to tell more of her storyC: [sighs]. Thats another thing. You know, what happened there was, ah, I, I had been in a very abusivefirst marriage. I mean, just [pah!]...and uh, I, I didnt know, I didnt know it was a sin...I was living inFrance, thought it was my fault, you know. But now everything I realize I was just a walking textbook,you know, of what happens in I couldnt get out of it and uh, and finally I did, not because Iwas brave enough to make a decision, but because it really was so bad...there wasnt much choice...andthen I married again and it was a very compatible, it was the antithesis of my first marriage and I thinkmy second husband and I, we both were really looking for safety...and we gave it to each other...and itwas...and then I, I went to a high school reunion and I saw Jack again and, um, we started correspondingand, know I guess I went through that whole getting bashed around, with a form ofamnesia almost... and I just blocked it out and went on and didnt think about it...and um, but I do really...Ijust sort of shut the whole door. But when I met Jack again and I would write something to him and hewould say something like, "you always used to say that" or "you never used to say that". .. and I had thisfeeling he remembered me better than I did, you know? And he did. I note how Jack became the mirroring object for Dee’s unmet early developmental needs.In her other relationships, she appeared to maintain the role as caretaker. However, despitehaving safety for the first time Dee ends up following Jack, who offers her a new developmentalbond of mirroring. She seems to have deep resonance with him, who also raised the awarenessof these unmet longings for receiving love. I am beginning to formulate all of this as I assessTerry in this early stage of therapy.C: [continues] And then my husband.. .you know...I started feeling that I was doing something that wasn’tmorally good, because I hadnt told my husband I was having this correspondence...I wasnt seeing him oranything, but it was very important to me. So, I talked to my brother, and he said, "Oh, I think you should 9
  10. 10. tell your husband, because hed want this for you"...and I was thinking I dont want to do something...itfelt weird to have this private in that way. So, I told him...and... I, you know, and hegave me all ultimatum, I had to stop writing to him or leave...and, uh, you know, it was the hardestdecision I ever made, um, because I, I was safe for first time and I hadnt spent a lot of time in safety, and,I, I remember thinking I must have a self-sabotage gene. I mean, here everything is okay, and what am Igoing to do, but blow it all up again? But I just felt as if, you know, I would be living some kind of a lie. Here I note that despite the "self-sabotage" of her actions, Dee acted from a deep integrity.I respectfully acknowledge how hard this woman has survived with such deep trauma of anunmet sense of security. I am beginning to formulate how Dee appears to have deep unmetdevelopmental needs which led her to give up safety for this relationship. What continues tostrike me is how important the truth was for Dee; she was uncompromising in making sure thather husband knew about her correspondence, even if it ultimately meant losing him.C: Yeah. And I seriously, to tell you what a mess I was, I was seriously considering lying to my husbandand telling him I wasnt writing him any more, so that I could stay, you know. . .T: And have bothC: And have both. We had just inherited his mothers house, so for the fIrst time we werent in financialwhatever... And we worked on the house for two years to clean it out...and I loved it, you know? And Iwas 55...and I thought I’m really ever too old to go camping...but, I just, I know I couldnt do it, but Iwent through a period of really feeling utterly desolate...I wish I’d known you back then...the day Imoved out of my house it was New Years Eve and I didnt know what town to go to, so I went to a townwhere I didnt know anyone, and I had caught the flu from my son, and I was sitting there with theseboxes and I had nothing to listen to music with. And I didnt know you needed cable TV to watch, youknow. And I was sitting there thinking that, you know, I had no idea where I was going to go from thereor how... I am gathering Dee’s clinical history in an "organic" way. I am not asking for linearquestions and responses, but listening as Dee desires to tell it. However, after gathering theinformation I return her attention back to the body.T: So, what happens, take a moment now, when you kind of sit with yourself, today, right now, right here,in the present time, just sensing the woman you are now...When you see that woman back then with thehouse and the boxes on New Years Eve... How do you feel towards her? What would you say to her?How would you contact her? 10
  11. 11. Again, I reframe Dee to bring her awareness toward her body, using imagery and as well ascognitive. Helping Dee focus on this somatic, cognitive, and affective integration is animportant component of my treatment.C: I would say, you know, my son used say to me... I have a wonderful son, who loves me, he really lovesme. He used to say, "Mom, youre a fucking lunatic!" [chuckles] But, I would say to her that, "Im reallyproud of her,” because she did something that made no sense to anyone, including herself, um,she...ah...had a very deep-seated need for approval...and her family pretty much freaked and thought shehad lost her mind... um, and she just had this feeling that, you know, if there was ever any hope of beingtrue to herself this was it, and then...You know those times in your life when theres really a fork in aroad, a real, real fork. I mean they happen all the days, all the time, and usually you look back and yousay "oh yeah"...or I did this one or I did this one..." That was really, Uh [groans], I remember just a reallyan overwhelming temptation...I... she was, she was scared, broke, lonely, getting old...Um, I mean, it wasa disaster, and she made it through.In this first session, when I am primarily helping Dee resource and access this importantexperience of strength.T: And you are proud of her.C: I am very proud of her...T: Lets just take a moment and just feel. "I am proud of her,"C: I am proud of herT: Yeah. But she made it through.C: [Big sigh]T: Just kind of sit with that awareness. ..of following truth, true to thyself, to thy own self be true..." Youwere true to yourselfC: She was a strong lady... I. mean she was a f*ing lunatic, but she was a strong lady. ..T: I think so... Yeah.C: [Big sigh]T: Just take a moment in the present time to tune to kind of sense what it feels like in your heart and yoursoul and your body...C: It feels very full..T: ...just very ful...And when you feel the feeling of do you notice that as sensation?C: I have...ah...a feeling of, um, uh, how can I say...its not a pressure, but theres a sense of expansion...T: Expansion! So as we dance in this space of exploring Dee’s painful experiences and the ways shecoped with them, I am beginning to notice a trend in her behavior that leads her to hypothesizeabout what Hakomi refers to as the "organization of experience." 11
  12. 12. T: What is the universe telling you - in this place of expansion and this smile?C: Um [sighs]. I think Im not used to that feeling because I.... sort of have a sensation of, um, you know,once, that one time when I was really, really ill...T: [interrupts] Wait, go back...wait, go back....let s go youre not used to that feeling... C: So, Iwas going to say I have a feeling of, of observing myself... feeling...T: Great! So lets just hang on that part of you thats just observing yourself. Yeah, sometimes we needto have different qualities of connection, so observing yourself... feeling the expansion... feeling thesmile...and just kind of, feeling yourself as the observer. Yeah...And how is that? Just being in theobserving, out of the expansion.C: Yeah. You know, what I was starting to say...I know my mind thinks all the time Dee has some awareness of this aspect of herself. She may not know what it means, but onsome level she understands her lack of embodiment and her coping defense. Even though I amstill strongly in an assessment phase, I am beginning to get a picture of how this client isorganized. I can see that Dee is moving quickly from one topic to another, and I use thatinformation in my assessment of her unmet developmental needs.T: [interrupts] you know that about your mind...C: Oh my goodness, yes. My son, once we were having dinner with friends and he pulled out a napkin onit and went [drawing pictures] this is how my mothers mind works...[laughs]T: So, Im just getting to know you today and getting a little...C: [laughs] Of an experience!T: Yeah, and seeing how your mind sort of travels, right, you have, like, different associations, one thingto another...As usual, I bring her back to the body.T: Your mind jumped and what happens to your body when your mind jumps?C: Um, when my mind jumps I forget about my body...because I think...T: [interrupts] Oh, okay, so, when your mind jumps you forget about your body...C: Yes. [sighs]T: Yeah, so just kind of sitting there with that awareness...and if your body was going to speak to yourmind, while its watching your mind jumping, is there anything your body would say to your mind?C: “Wait for me...” [Laughter]T: "Wait for me...?"C: Yes! [laughs]T: "I want to go with you"C: Is there room on that horse for both of us?T: Right. Can we travel together?C: Yes, yes. Mmm. Mmm. 12
  13. 13. The therapeutic alliance is growing. I have spent a lot of the session tracking and mirroringDee’s experience.The End of the Session I am very careful about how I end sessions. It is difficult to do Body-centeredPsychotherapy, which involves slowing down to a very mindful level, in the middle of NewYork City. It is important that clients leave feeling grounded and contained, and thus they needtime to integrate what has occurred in the session . Often I will revisit the work we did together,reviewing and re-integrating it.T: So, we have a little bit more time and I’m still getting to know you today a little kind ofstarted with those feelings of warmth and bubbles and the fish tank....and that sense of kind of relaxation,and we noticed your hands... the movement of your hands...we talked a little bit about the grief and wekind of identified the well a little bit and some things...I now want to slow down to the end of the session.T: So, let’s take a moment...before we start to complete for today...and just see what it feels like rightnow...yeah...there’s a lot of richness you brought today...and we will be able to go back and revisit someof these places in more depth, and take more time...and sensing where you are right now with where wetraveled to today...and see if there is anything you want or you need or you would like to kind of takewith you from our session...C: I feel as if you’ve already given it to me. [chokes up] You know, I tried therapy only once before...T: What is it that you feel that you want to take with you?C: The sense that I can go on this journey with you.T: Okay.C: And that I know I have had to be very self-reliant. A lot of people have relied on me. I feelas if for this, this I need to rely on somebody else because I...T: [interrupts] Some permission for you to go on your journey...and have me joining with you...C: and that...T: [keeps talking] You can rely on me...I stay firmly on the imagery, sewing the work we did together cognitively with a felt sense.Also, I continue to educate Dee about the process. 13
  14. 14. T: So, just take a moment and acknowledge that feeling of safety and the awareness of hope, hopefulnessand bringing your honesty and not having to be self-reliant...C: Sighs.T: and do it all alone, we can do it dont have to do this all by yourself... and youresafe...and how it feels...yeah, just sensing the beginning...just the beginning. Youve already brought a lotof your riches.C: a really good feeling.T: Is a really good feeling. So, whenever we get a great a feeling, what do we want to do? We want toslow time down and let the body absorb that on a cellular level. So just give yourself a little bit of time tofeel the safety...sense the movement of your breath...feeling your back against the pillow, sensing yourhands on your legs, your feet touching the earth...the feeling of containment...awareness of safety...andthe movement of your breath...and just notice as you acknowledge the safety...and acknowledge yourbody...your body telling your mind "Ill be with you." And just notice if there is any image that emergesout of this sense of safety in the present moment...a painting or a picture that was born out of the feelingin your body...a feeling of safe... C: It isnt visual, but its very...T: It could be kinesthetic...C: Yes, yes. Very much. ST: And whats the quality?C: Its a combination of buoyancy and being enveloped...T: So the feeling of being enveloped and surrounded and feeling buoyant.C: Right.T: Great...Mmm. Great...C: Thank you.T: Youre welcome[End of session]Initial Formulation I am now able to formulate some of Dee’s dilemma. Although my formulation of thisclient will adapt and change over time, the basic way I understand Dee is that she has mostlyworked hard to love others an is not very capable of loving herself. I hypothesize that Dee neverreally felt contacted, held, or joined with her mother. This type of developmental trauma is veryearly; some describe it at being at the level of existence: can I belong? Dee coped with thisanxiety by creating the belief: “My survival depended on loving other people. Giving love wasmy life.” To me this means that the treatment will probably be focused largely on working withDee to learn to receive love. She does not want to experience her feelings around a lack of love,because to do so would be to revisit the places in herself that are traumatized by lack of love and 14
  15. 15. nourishment. Her defense is to go into the story with out spending much time in her body.Initial Treatment Plan As explained in formulation, it appears that Dee will need to learn to be more resourced inher own body. She hopefully will learn more about “staying connected with nourishment.” I seemy work helping Dee to travel back and forth between being with joy and the deep grief of herunmet longings. Instead of following her as she moves away from her body sensations, I willwork to “slow time down” and help her become more mindful. As Dee learns to track her ownsensations, she will be able to pendulate between the extremes of joy and grief, and find morebalance so she can regulate her own affects. Over time I will help her discover how to livewithin her self so that she can access creative self-regulation as well as emotional resiliency.What we aim to help clients learn, discover and reestablish a place that feels safe and groundedwhere they can return home and feel alive, safe, whole and healthy.As Alice Miller has said: “Where there had only been fearful emptiness… there is now unfoldinga wealth of vitality. This is not a homecoming since this home had never before existed. It is thediscovery of home.”In listening to our bodies and also staying mindful and present to what is taking place frommoment to moment the opportunity to come home to one self is created, fostered andmaintained. 15
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