| CARMEN: 00:03 | [music] Welcome to Recovery Out Loud, a Niznik Behavioral Health podcast where we discuss addiction, mental health, and recovery. We’ll explore the true nature of addiction with behavioral health experts and hear firsthand personal testimony about what the path to recovery really looks like. From Niznik Behavioral Health, I’m your host, Noelle Carmen. [music] |
| CARMEN: 00:56 | Hi, everyone, and welcome to our conversation today. I’m Noelle Carmen, and today we are talking about somatic therapy. Some quick housekeeping, for any participants needing CE documentation, you will receive this in an email tomorrow by end of business. As usual, I invite all of our participants to ask all the questions, and I will do my best to get to them as we move through the conversation. Now I would like to introduce our amazing, wonderful panel and jump right into this topic. So we have with us today Michele Rosenthal– Michele, I’m sorry. Michele Rosenthal, she is a trauma recovery specialist, author, speaker, and mental health advocate. Suzanne Gundersen, a somatic wellness practitioner. Mindi Fetterman, executive director and founder of the Inner Truth Project and a survivor advocate. And welcome, everybody, to the conversation. Thank you so much for being here. |
| FETTERMAN: 01:54 | Thank you. |
| ROSENTHAL: 01:55 | Thank you, Noelle. |
| CARMEN: 01:56 | Okay. So let’s just jump in and get on the same page in terms of trauma. So before we start talking about the somatic aspects of it, let’s just define trauma as we understand it. Suzanne, you want to jump in and start with that? |
| GUNDERSEN: 02:14 | Certainly. So trauma is such a big umbrella word that so many things could fall under. And for so long, it had so much taboo around it. People didn’t want to really associate with anything other than some big event that you might put into kind of a category of, “Oh, that must be something that’s trauma.” When really what we’re learning today is that trauma is as a chronic state of disconnectedness from ourselves when we are overwhelmed and overstressed, and everyone’s inner bounce-back ability is unique to us. And so we just can’t judge with life being so overwhelming, so stressful in the momentum in which we choose to live. Sometimes we have to live life that we can become very easily out of overwhelm and creating kind of states of dysregulation. And from there, we have a whole list of symptoms that we could experience that are kind of adaptive strategies that we develop to deal with that overwhelm. So it’s just really kind of a chronic state of disconnectedness and overwhelm that happens because of our ability or lack thereof of being able to stay present in the moment of our experience of stress. So it’s not so much always, oh, the gunshot wound or the rape or the car accident. It could be “I spilt the milk.” “I got yelled at work,” or, “I missed the exit,” or it’s some of these things that compound and compound and compound, whereas down that can be other little t traumas or Big T traumas. |
| CARMEN: 03:48 | Michele, would you like to add to that? Anything come to mind? |
| ROSENTHAL: 03:53 | Yeah. Oh, I think Suzanne just got us off on such a great start because that is all so true, and it’s so necessary for everyone to start understanding what is trauma in the most basic way. And I was just thinking too, Suzanne, Big T versus little t trauma. And I would add to that. A lot of times we think of Big T trauma are those life-altering events that change how you see yourself, others and the world. And little t trauma are those little daily stressors that do not necessarily change your life, but they are extremely difficult to deal with, and they challenge your coping mechanisms. And for a really long time, I had a podcast where I interviewed all of the leading trauma experts, the neuroscientists, the neuropsychologists. And one of the people that I interviewed on the show was Judy Crane. Some of you might know her. She’s the founder of The Refuge, A Healing Place, which is here near Suzanne and I in Florida. And I love the definition that she gave of trauma because it was so baseline – actually, she used that word, and it normalized trauma across the board. And it stuck with me for that reason because I think we need to normalize trauma as much as possible so that people feel more comfortable self-identifying with it. |
| ROSENTHAL: 05:16 | So Judy’s definition of trauma was any experience that feels less than good. And when you think of that, from the very first day we’re all on this planet, you could say we are all trauma survivors. And the reason that I like that is because since we get so disconnected after trauma from ourselves, others, and the world, it’s very easy to think that there’s something wrong with us. We blame ourselves. We shame ourselves. We feel guilty for who we are or what we did or what we didn’t do during that traumatic moment. And it makes us feel even more different, which only adds to our isolation and our withdrawal from the world, which we do emotionally, mentally, spiritually, physically. But when you start from that baseline definition of any experience that feels less than good, suddenly it’s very inclusive rather than exclusive. And I think that is a very important aspect of any trauma education or trauma informedness. |
| CARMEN: 06:24 | Mindi, what are your thoughts on this kind of disconnection? |
| FETTERMAN: 06:29 | Well, first of all, it’s going to be very hard to say anything different than these two brilliant women, but I will just put a little personal spin on it because Michele did say it becomes very inclusive. And so I will say trauma is personalized. And Suzanne said this as well, but my trauma can be very different than yours. And I often like to give people the example of– I’m in Florida too, ladies. I don’t know if you know that. But we have I-95. I think that’s all over the place. And I can drive down I-95 and see a car accident. And I’ll think to myself, “That was horrific,” and maybe say a prayer for the person and whatever. And then, unfortunately, because I have monkey brain, five minutes later, I’m thinking about what I have to do at home and dinner and whatnot. But I do know somebody who had seen an accident on I-95, and it was so debilitating for her that she was no longer able to drive. So it was extremely traumatic. |
| FETTERMAN: 07:34 | So it’s very personalized. Different events affect people differently. And I think that because trauma has become such a buzzword that people seem to become put off by it, and they categorize people: “They have trauma. I don’t.” But when you look at it as such an individualized event, then you realize, as Michele said, everybody has experienced some sort of trauma. Even looking at beauty magazines, for women, can be traumatic because you look through a magazine, and you’re being told you’re not skinny enough; your teeth aren’t white enough; you don’t have the right person. And that can be, without even realizing it breaking you down and be traumatic. So we’ve all experienced something. We just right now are kind of feeding into that. It has to be this horrific, horrible trauma thing, and it really isn’t that. |
| CARMEN: 08:31 | So we kind of talked about this before in terms of an emotional response, a mental response prior to the somatic response. So can you talk us through some of that? |
| GUNDERSEN: 08:47 | I would like to go– |
| CARMEN: 08:48 | Sorry, Suzanne. |
| GUNDERSEN: 08:48 | I always like to go back to the Doctor Dan Siegel version of the brain. And so I’m going to make this fist with my hand you may identify with, which kind of looks like the brain. This is our spinal cord where we have our vagus nerve that runs along it, connects with our brain stem that makes that autonomic decision: “Am I safe? Am I not safe?” Underneath here is our limbic system. We’ve got our glands called our amygdala, which is our emotional fire alarm, and our hippocampus, which stores our memory. And up here is our cortex layer of the brain where we have this rational thinking, this imaginative, creative thinking. And going back to what I’ve learned from Dr. Bessel van der Kolk and Dr. Stephen Porges, it’s always state of being before story. And so when we think about how the body– somatics means the body – right? – for those people who haven’t heard that word before. Really, it’s the body that senses and neuro-perceives what’s happening around us, relationally between us, inside of us, sending messages up to that brain stem: “Am I safe? Am I not safe?” And then that makes that executive decision. I have to go do something about it. I can either use my skills to regulate and stay present in the moment, or I need to go use ancient strategies like fight, flight, or freeze. |
| GUNDERSEN: 10:01 | From that point, if we are overwhelmed, overstressed, over, over, over, and we have a dysregulated body, well, then our limbic system starts to have wider emotional kind of bountiness, and we don’t have real kind of containment of our emotions. And then the stories start to surface. “Oh, this must be why I’m feeling this way and experiencing this in my body.” So it’s always kind of state– it’s state of being before story. It’s like imagine driving down the road. All of a sudden, you swerve. You go, “What was that?” And you go, “Oh my gosh, I didn’t even see that.” My body reacted that fast. The body is so much faster than how we can think. And yet, we put so much emphasis on story, story, story. Let’s reframe the story when really what we need to do is help the body calm down, send off the defenses of being in fight, flight, or freeze. When we have a regulated body, well, then we have more ability to contain our emotions and understand them and process them and then have an opportunity to even reframe the story that we may have been stuck on because of those emotions, because of that dysregulated state of being. Some people come to me chitter-chatty, overwhelmed emotionally. I say, “Hey, let’s help the body calm down. Let’s get this state of being calm down first.” |
| CARMEN: 11:16 | So it sounds like as clients come in and they’ve got their story as to explaining why they’re feeling this way, it sounds like part of your therapeutic approach is to go, “Okay. Let’s calm down about the story for just a minute and get to what is happening with your body.” Am I right? Am I wrong? |
| GUNDERSEN: 11:37 | Sometimes when they’re super chatty, there are beautiful techniques that you can do to help that mind calm down. If you can’t, just say, “Hey, let’s put the pause button on the story just for one second just to learn how to be in the body in the moment.” If this does some chitter-chatter and we keep floating up there, then we can do some things that will help to quiet that mind down. But ultimately, it’s let’s get into the body if we can. |
| CARMEN: 12:00 | I’d love to hear some actual anecdotes to really explain boots on the ground, Suzanne, kind of what it is you’re saying. Michele, Mindi, can you jump in with some anecdotes? |
| ROSENTHAL: 12:17 | Oh, yeah. |
| FETTERMAN: 12:17 | Yeah. Oh, go ahead, Michele. |
| ROSENTHAL: 12:19 | Go ahead, Mindi. Go ahead. |
| FETTERMAN: 12:22 | Well, one of the things that you just mentioned is it really is this psychological event that’s happening becoming physical, right? And so I work with survivors, specifically survivors of sexual trauma. And so I’ve seen so many people over the years that come in, and they have a chronic pain, and they have different types of illnesses and no idea where it comes from. And the perfect example I can give you is a girl who was 17, and every time she would start to speak, she would feel like her throat was closing up, and it was super dry. And she always felt like she had this knot in her throat, and her heart would start to race. And she just hated speaking in front of anybody. She was always anxious. And it was affecting, of course, every other function in her body. Well, when we were able to really get to the root of what was going on, we realized that she had been keeping the secret of her trauma, of her perpetrator, which was her father, for years. She was told she was not allowed to speak about what happened. |
| FETTERMAN: 13:32 | So it really was about allowing her to use her voice and letting her feel what it felt like to open her throat and letting her understand how that felt to take a breath and just swallow and be in that moment. And those are all the things I’m sure we’re going to get into. But once she understood that that was her right and her ability and that it didn’t have to be connected to the past, she was able to regain all of those senses and understand in this moment she was safe and that she could use her voice now. And then she was able to start working on having control of her faculties, and it was just a remarkable change somatically. And then as she was able to build up that energy, it changed the rest of her functions in her body too. So we have examples like that all the time. |
| CARMEN: 14:34 | So question, it sounds like once there’s some kind of physical, somatic understanding– this is the part that fascinates me, that it actually changes the narrative. Is that an accurate way to depict what it is we’re talking about Michele? |
| ROSENTHAL: 14:53 | I think it’s one of the accurate ways to depict what we’re talking about. And I’ll illustrate that with a story, actually, because I am a trauma survivor. I’m a medical trauma survivor. And I struggled with PTSD for almost 30 years before I made a full recovery, zero symptoms. And everyone was always asking me– I founded a very large survivor community, so I was always fielding the questions– I have a therapy dog in training, and he’s still learning, “I don’t need to know about every squirrel.” My apologies. |
| CARMEN: 15:32 | No worries. |
| ROSENTHAL: 15:33 | So in the survivor community, people were always asking me, “Don’t you worry that you’ll flip back to PTSD?” And I kept saying, “No. I don’t because I’ve really worked hard to get rid of my symptoms.” So fast-forward five or six years, and I had sepsis. So by the time my mother got me to the hospital, I was completely unconscious and woke up in the middle of a medical procedure that was extremely triggering and very reminiscent of my original trauma. So imagine my surprise to wake up, and my body is going berserk in a moment– they were just trying to get me into a CAT scan. I mean, it was not a big deal. But my body was so full of the memory of something similar, although not that, during my original trauma that it went nuts. And I remember thinking in my executive function, “This is crazy. I can’t control my body.” It was flailing around. I was screaming. But there was a part of me in my mind saying, “This doesn’t need to be happening. Something’s triggered me.” |
| ROSENTHAL: 16:44 | And because I had so deeply trained myself as a trauma recovery specialist and as a survivor, I said to all the orderlies, “Just take a step back. Don’t touch me. Give me two minutes and I can stop this.” And I did somatic work like that. And I started with breath work. But it was I needed to get back in control of my state and back in control of my body because my mind wasn’t what was making this happen. It was an unconscious programming that had gotten activated. And I think that’s a really important point to bring up here, and that’s the reason I told this story, is that the body has all kinds of wonderful neuroception, proprioception, all of the -ceptions that it does. And yet, at the same time, we do have unconscious programming that gets wired into that that the body can create a state that the mind does not understand or even participate in. And I think it’s an important point to make here that learning to control your state without having to think about the story is part of what’s so beautiful about somatic work because the story doesn’t always– I mean, it rarely ever serves us, but we always want to default to the mind. But the body is the faster way to reclaim control. |
| GUNDERSEN: 18:11 | And Michele, I love that you were able to tell them, “Just give me two minutes,” because in our modern western world, we always want to just immediately go into action to do something about it when the body has its own process it needs to take. And to your point, our neuropsychology can’t affect our neurophysiology as much as our calm neurophysiology can affect our neuropsychology. Try and tell somebody who’s overwhelmed, “Just calm down.” How well does that work for them? Not very much, right? But when you sit with them and say, “Let your body be and do its thing and process it,” then you are able to kind of give space and capacity and the presence that the body needed. And you had those empathetic witnesses around you, even though they probably weren’t at the time. You said, “Hold on a second.” |
| ROSENTHAL: 18:57 | Yeah. They were really annoyed, I think. But it didn’t matter because I just decided, “Look, I know what my body needs right now, and I know that if I have two minutes to do breath work, I can start reclaiming control here, and then we can take it from there.” And that’s what I think is so amazing about somatic work. And I know, Suzanne, you do so many different approaches to somatic work leading up to the big guns. But I think it’s that ability that we can teach people to do. And I love the science behind breath work. Two minutes of breath work or less can completely change your physiology. And I love telling people that little tidbit of science because you don’t have to trust your mind. You can just trust the physiology of the science of your body. |
| GUNDERSEN: 19:47 | And this is so great because there are so many somatic modalities. So if people are like, “Oh, but breath work, I tried it.” Don’t worry. There’s a lot more. Go out there and try them on for yourself and see what works for you and what resonates with you. |
| CARMEN: 20:02 | I love what you said. Well, obviously, there’s this whole notion that you’re talking about, this disconnection. We live very disconnected lives. That’s what we do. And it shows up, obviously, in these places where we don’t know what our body needs. How do you begin to train your clients to bring this connection into being? It sounds like there’s a lot of self-trust too that has to happen in terms of going, “Okay. I guess I do know what I– I do know what I need.” And this seems like a journey, a real process. Who wants to talk some about the whole process here from beginning to end? Mindi? |
| FETTERMAN: 20:47 | Yeah. I’ll jump in and just share. Again, I don’t know if I’m the only one that works specifically with survivors of sexual trauma. A lot of our survivors are also struggling– about 85% of them are also dealing with substance use issues and eating disorders, a whole host of different things. So they’re coming to us with this attack on their physical body. And so they don’t trust themselves. They don’t trust other people. And the whole journey of even just showing up is difficult, right? So when they come to us, the very first thing that we want to do is get them– as both the other ladies mentioned, it’s just let’s put the story aside for a moment because in this second, right now, it doesn’t matter. It does matter, but right now we just want you to know what it feels like to be safe. Let’s learn to take a breath and feel what it feels like in your body and feel safe. And let’s start from there. And that can take a week, a month, maybe longer. And then what we do is move from there to getting your body to move. So if you’re struggling with all these myriad of things, which a lot of us are, being able to go with a group of people and take a walk outside is a big deal, right? But then you start little by little trust your body. Your body is not the enemy, right? If you’re sitting with a group of people and you’re breathing together and you’re focusing on your breath, you realize you can do this. Your body is not the enemy. All the people around you are going to support you. |
| FETTERMAN: 22:34 | So it’s gradual. Nothing has to be on a timeline, at least not when we’re working with survivors, because nothing is linear, right? And there are some people who will do this work for a very limited time, and they’ll get to where they need to go. And for some people, trauma work, somatic work is a lifetime process. And it’s okay because all of this is very individualized. But the very first thing that we need them to do is recognize that this isn’t about trauma work. It’s about making peace with our bodies. And that is a change in the narrative because normally people come to us and they’re mad at their perpetrator; they’re mad at their moms. We’re all mad at our mom. They’re mad at somebody. And really, it’s bringing the focus back on it’s just us. It’s us and our bodies, and that’s where the work is going to be. And me myself as a survivor, I’ve had so many therapists over the years. The first thing they say to me is, “Okay. Where do you feel your pain?” I don’t know. From my neck down, I don’t feel anything. And so many people have been that way. So that’s where we need to start of reconnecting our body. |
| GUNDERSEN: 23:46 | Yeah. When we’re infants, we don’t know how to self-soothe. We need someone to help us soothe and relax. And yet, we’re in these adult bodies, and still there’s part of us who are living with patterns of survival that have had us keeping a state of self-disconnection. And so going to therapy and being in treatment is so important to be able to have that safe environment to help us be lured out of those states of freeze or mobilization or fight or flight to learn how to be present with our body and learn through other people’s safe connection and safe offering to teach our body how to be okay. Like you said, Mindi, so beautifully, that It’s a lifetime of work. Once you kind of leave the state of disconnection, it’s a learning of how to be connected even deeper and deeper and deeper, physically, emotionally, and mentally, with ourselves, to be able to trust ourselves, lean on ourselves because as adults, we don’t have that caregiver anymore. We might not have a consistent presence in our life that keeps us regulated. We have to learn how to do those things for ourselves. And that’s why it’s so important to start off with a quality, therapeutic relationship with a provider to be that person to co-regulate and help you away from those states of disconnection, to turn to self-connection, and then start to have a lifetime of deepening that connection. |
| FETTERMAN: 25:16 | And I would add– oh, I’m sorry. |
| CARMEN: 25:18 | No. No. You go. I’ll ask in a second. |
| FETTERMAN: 25:22 | Well, this is a really important point because I know that a lot of the people that are participating today are working, of course, with people with addiction. And as somebody with long-term recovery, and we’re just as good as today, but I know the reason that I loved being high is because I didn’t have to feel my body. I didn’t have to feel anything. And so we’re working with people who are newly in recovery, or whatever their situation is. They’re feeling new things for the first time, and it’s scary. So on top of whatever else is going on, whether it is actual pain or emotional, they don’t want to feel. And who really wants to feel the bad stuff, right? We all want to feel good. So we have to be so highly intuitive about what is going on when we’re asking them to get in tune with what they’re feeling. And remember, they’re used to not feeling that, right? So it is very, very scary. When you ask somebody– I can say it right now, “Everybody who’s watching, take a breath.” And you realize you weren’t breathing. Most of the people watching right now weren’t even breathing, right? So you ask somebody who’s been used to numbing themselves out to feel those sensations in your body. It’s really scary for a lot of us for the first time. |
| CARMEN: 26:51 | So this begs the question then; when you have a client walk in your door, and they have a story, and they have the somatic stuff going on, historically – right? – clinically, we want to make someone feel validated. We want to make them feel heard. So do you find that sometimes you have a challenge in terms of saying, “I hear you. I hear your story. I hear your feelings. But let’s put that away because maybe you can’t trust that story.” Do you see what I’m saying? It’s like we as clinicians, we’re used to traditional modalities – right? – where it’s talk therapy. So give us some grounding for that in terms of, how do we validate for our clients what’s going on in their head, yet say, “Okay, but let’s take a look at what’s happening with the body”? |
| GUNDERSEN: 27:55 | Michele? That’s a big– |
| CARMEN: 27:56 | Michele. |
| GUNDERSEN: 27:56 | –question for you. |
| ROSENTHAL: 27:57 | Oh, I was going to let you take that, Suzanne, because you’re the somatic expert here. Okay. |
| CARMEN: 28:02 | You can all address it. |
| ROSENTHAL: 28:04 | I’ll start. Well, and I will clarify; I’m later in the process. When people get to me, they’ve gone everywhere else. So let me just say that. They’ve usually already done talk therapy. They’ve already done CBT. They’ve already done a slew of things. So by the time they get to me, I feel quite comfortable telling them, “I don’t want to hear your story. You’re going to have one shot, and it’s not going to be our first appointment.” |
| CARMEN: 28:34 | Ouch. |
| ROSENTHAL: 28:36 | Yeah. And that sounds harsh out of context, but I use a lot of humor in my work. So it doesn’t come across quite as abrasive as that may have sounded. But I’ve already spoken with them before they come into my office, and I tell them upfront, “You need to stop talking about the past, and you need to start healing the present. So this is not going to be talk therapy where we go over your story again. There’s a really great time for that, and there are really great people for that. That’s not the role that I play, and that’s not where I do my work.” So I’m very clear with them upfront; your story has got to end. And I explain to them that we need to respect and honor, acknowledge, and validate the story and the past. But from a neurological perspective, every time you tell that story, you are strengthening those neural pathways. You are lighting up those neural networks, and they are working faster and more efficiently every single time you do because that’s the way the brain is designed to work. So if you are going to come here and you tell me you want to feel better, we cannot keep telling your story and achieve that end result. Those two things don’t go together in my world. |
| ROSENTHAL: 29:53 | So I always like to say to them, “First day, we just get to know each other, and we do grounding work.” And I start teaching them how to use the energy of their body. In my own recovery, I found it very hard to sit still. My original trauma was very– I don’t want to get off on a tangent on that, but my original trauma had me trapped in a body that I would have done anything to be able to escape. It was so horrible what was happening. So I am very aware when I’m working with people that the body is not always a safe place to be. And so I like to teach them, “Let’s just work with the energy of your body,” because sometimes that can be a nice bridge to the body. It’s not asking them, “Just be in your body and feel how it feels.” It’s more like, “Let’s sense the energy.” Energy is always in motion. “What motion do you feel in your body? Which way is it going? Which way is it spinning? How big is it? How small is it? What’s the texture of it? What’s the color of it?” So I’m always thinking about, how do I create a bridge into their body where I’m not asking them just to plunk into their body? Because as Mindi and Suzanne have already said, that can be so uncomfortable. I know in my own process that was not a possibility for me. So that’s where I begin. Let’s hold the story for later and let’s just figure out how to be present with what is in your body without labeling it, without judging it, without having to change it right away. Let’s just figure out how to observe it. |
| GUNDERSEN: 31:33 | I love that. And when clients come and they want to talk about their story, I always say, “Oh, let me just tell you about the worst thing I ever ate and how to make that recipe. And don’t you want to know about it? It was like the slimiest gumbo. And I love gumbo. But man, this one time the okra was–” do you really want to hear me talk about the worst of the worst of the worst? It’s like that’s the definition of insanity, when we do the same thing and expect a different result. So you’re here to do something different. So let’s just put a pause button on that story. And there are going to be some things I can do very quickly that are kind of– vagal toning, somatic experiencing, somatic orienting that are going to help them really physically feel grounded in their body to be able to continue to deepen and deepen and deepen that experience. Now, I get that they might oscillate back and forth between the story, but I want to bring them more safely in their body than the story. And the more that I’m there with them and as an empathetic witness to their– and being a safe co-regulatory presence with them, they will be able to regulate through my nervous system to calm down. So I do my own little mini-practice before clients to be able to be that dense presence for them to help them all that chatter calm in to the moment that way that they can do that body work with us. |
| CARMEN: 32:49 | Mindi, you wanted to say something. |
| FETTERMAN: 32:52 | I did. I did. For us, in our practice, we do validate people when they come in because most of the time with their stories, nobody has believed them; nobody has heard them. And so we allow them to share. We tell them that we hear them; they’re validated; we believe them. And then we ask them, “How is this still serving you?” Because it’s very much about being a victim versus being a survivor or whatever it is that you want to call it but no longer living in that victim mentality. And then explaining what those two things are and how both of them have been serving or can serve you. And so it’s taking your story as you know it, because it is a part of you. We cannot change what has happened to us. And I never want anyone to try to change their experience. It is your experience. But to change it and use it for power, right? So our program is pain to power. So how are you going to use that experience for your better good, right? Not to put it behind you, not to forget it. But this is a part of your experience. We don’t know why it happened. We can’t change it. But let’s move forward and make it part of your positivity. And that is a shift so that, yes, you are telling that story moving forward, but you’re using it in a different way. As Michele said, it’s no longer creating those neural pathways. It’s creating new ones. But it’s still part of your experience as you know it because every single thing that has happened to you has value and is important because it’s you. It’s part of your experience. And we want people to be able to own everything that has happened to their body and has been experienced in their life. So we encourage them to share that story but then to change how it is affecting them, impacting them, and how it’s serving them. So it’s a little bit different but similar. |
| CARMEN: 34:48 | Okay. So the more somatic work, the less effect the story has in an individual’s life. Do I have that part, right? So take us through then this process of getting rid of that story or coming into connection with our body from a clinical point of view. Suzanne, you want to start? |
| GUNDERSEN: 35:13 | Well, I’m just going to go back to that Dr. Dan Siegel version of the brain again, right? When this body is overwhelmed, the mind is going to say– the evolution of our thinking mind has taken us to unbelievable technological advances, like being on this Zoom webinar, right? And so the mind says, “I’ll figure it out.” Sure. We’ll get really busy up here, chitter-chatter, chitter-chatter. And we really can just kind of– the head can leave the body, go off into outer space thinking it can solve all world’s problems, when really we need to harmonize the two. We need to know that there are times when we need to say, “Hey, look, if I’m just so backed into a corner and I can’t think of the answer, it’s time for me to calm my body down. Even though I might be sitting down, I might have something going on internally process-wise that if I do some simple techniques, I can help myself being more of a deeper state of relaxation, which is going to then open up to a broader way of thinking about things,” right? When we calm the body, that emotional range starts to come inward, to be more peaceful, and then the thoughts have a chance to broaden and have more perspective. When we are stressed, not only squeezes the body in, but the limited flexibility of our emotional range and our mental capacity starts to shrink. And so when we start to calm the body, that thinking just wide open. Oh my gosh, now I can think about things differently. So it’s when you’re backed into that corner in your mind, “I only have three options. They’re all horrible.” Time to go into the body, do some somatic work, loosen the grip on it, right? The issues and the tissues start to soften and loosen up a little bit. Then I’ve got more flexibility, some elasticity, physically, emotionally, and mentally. And then there will come some more ideas of how we can think about things differently. We can’t always just one-track mind, single thinking that this was my trauma, and this is my story. We have to unravel it here and start to let it kind of– and then harmonize all of those pieces. |
| CARMEN: 37:07 | So it’s about recognizing that triggered thinking versus when the chemicals calm down, and then you can finally open up and think about things from different perspectives. Is that what you’re saying? |
| GUNDERSEN: 37:19 | Right. We know this, right? How many times you’re just so busy, and you go, “I’ve got to make a decision about something,” and just decide. And then an hour later, you’re like, “Shit. If I just had calmed down, I could have thought about that, and I would have made a different decision.” Well, trauma makes everything bigger in the brain, and so that makes those decisions even harder to fall from. And so when we start to really help the physiology begin to calm down, then there’s little peaks of new neural pathways that can get created. When we relax those stress neural pathways, we have opportunity for new ones to be created, and we just need to keep growing them and growing them and just exploring being more at awe and curiosity about what if this, what if that? Then going down and opening up to different ideas about what happened to us. |
| ROSENTHAL: 38:10 | If I may just jump in to piggyback on what you’re saying, Suzanne, because I think it’s also– I think educating our clients about what’s going on is so important. We all know from our studies and our certifications and our diplomas and everything– we know the science of everything. And I find it really useful to educate clients about the science of what’s happening. Like the Dan Siegel brain example is great. And I love Jill Bolte Taylor. For those of you who have seen her TED talk or read her book My Stroke of Insight, she talks about the 90 seconds where a thought creates a physical reaction. You have a thought. It’s an electrical impulse in the brain. It changes the neurotransmitters. That cascade of neurotransmitters goes down into the body. The body receives that cascade and has a response. And so when we talk about the mind-body connection, it goes both ways. And I think it’s really important often to help clients understand that you can start to change your physical experience just by changing the thought that you’re having and understanding that it’s only 90 seconds. That electrical impulse changes the neurotransmitter cascade just for 90 seconds. It spikes up and naturally comes down. That feeling will come down and go away if you stop thinking that thought, right? |
| ROSENTHAL: 39:41 | And so sometimes we don’t have control over what we’re thinking, but I have a lot of clients– they talk about it in terms of the 90-second rule. And then they all figure out what to do for 90 seconds or 180 seconds or 270 seconds or whatever it takes to distract the mind so that the body can reregulate itself. I mean, some of them count to 270. Some sing. Some dance. Some call a friend, whatever it is that they use the mind to help the body find homeostasis. Rather than separating the mind from the body in that moment, using the mind to help the body reregulate, which I think is– Suzanne, I think you said earlier; there are so many techniques. |
| GUNDERSEN: 40:35 | Yeah. I’m so glad you mentioned this too because the vagus nerve, which sends messages from the body to the brain about 80% of the time, 20% of the time, it does send messages from the brain to the body. So it’s not just all about– I mean, we’re finally talking about the body because for so long, we will never talk about the mind. So we’re here talking about like, “Let’s talk about the body. Let’s talk about somatics. What’s the value of that?” But still, 20% of the messages go from– our afferent messages, they go from our brain to our body. So if we can redirect thought, it can really change even the body chemistry too. We’re just here talking about the 80%, the messages that go from the body to the brain, but definitely they go both ways. |
| CARMEN: 41:22 | We talk about educating clients, but it also seems like, in the clinical world, now this shift, right–? Again, I know you all have been doing this for a very long time, but there’s a shift – right? – in therapy and an interest in this somatic way of looking at therapy. What kinds of ideas do you get from other clinicians or maybe misconceptions about what somatic therapy is? Because this would be the perfect place to address some of those things. Obviously, this is not the historical, traditional talk therapy we’ve done for a while. So what are some of those kinds of things that you would like to say? I’m not sure who to best answer that question first. |
| GUNDERSEN: 42:16 | I’ll just say quickly that trauma is not one size– trauma healing is not one size fits all – it’s not just one modality – and that it is unique to the individual. And if you’ve got somebody really stuck in their story, there may need to be some talk therapy that gets that started. But if people are really stunted in their progress of their own trauma healing, consider the option of getting into the body. Or if they just aren’t even broken open into the emotion of their trauma, then it’s time to get into the body. So think that there’s new value being considered about harmonizing the body alongside of traditional methods. And again, not one size fits all. |
| ROSENTHAL: 42:58 | I want to jump in and piggyback on that, Suzanne, because we’re talking about the clinical approach to somatics, right? I want to also just remind all of us that we can encourage our clients to do things outside of our office that are not necessarily clinical processes but are also somatic work. And Suzanne, you brought up Dr. van der Kolk who talks a lot about different ways to use the body, from kickboxing to tango dancing. And in my recovery, tango– wait, my recovery was back in like 2005, 2006. So before Dr. van der Kolk was talking about it, I started to dance because I was so disconnected. I could not get out of my head into my body. And I started to dance just because it forced my head to shut down, and it forced me to be present in my body. And partner dancing really forces you to be present in your body because you have to lead or follow, depending on what role you’re in. So I just want to throw into the mix here that we work with clients in our office an hour, an hour and a half. What do they do the rest of the time? |
| ROSENTHAL: 44:17 | They need to be practicing these things. And I think it’s good to encourage them to practice somatic work in their own way, in a way that’s fun, in a way that feels good. I mean, dance became everything to me. I did it seven days a week because I couldn’t believe what it felt like to be in my body when I did that, whereas I spent the rest of the day hating my body. So I think it’s good just to also think about when people are in distress, which is where they are when they come to us, how do we turn them toward joy? How do we turn them toward not just calm but a feeling of happiness? And encouraging them to find somatic things to do outside of their time that’s therapeutic, that allows them to take the work that we teach them and deepen it in their own individual way. And I find that in my practice really, really useful. |
| CARMEN: 45:21 | Mindi, thoughts? |
| FETTERMAN: 45:23 | Yes. So to your question, Noelle, about dispelling myths for clinicians, I heard over the years also, “You’re just providing massage.” “You’re doing those lights back and forth. What does this all mean?” So I think a lot of people who are doing traditional modality, they have a hard time wrapping their head around it. Also, I’ve lived in some parts of the country where people think, “Oh, this is all fluff,” right? And so I often remind people, for a million years, people always say, “I’m going to go for a run to clear my head.” Think about that for a moment. That’s exactly what we’re talking about. Nothing that is being said here today is new. Michele talked about dancing or the kickboxing. None of this is new. We’re bringing the science and the terminology. Just like we were talking earlier right at the beginning about trauma. The idea of trauma is not new. We’re bringing it to the forefront, right? So in my recovery, especially with my addiction, a lot of my time was spent outdoors. And I started mountain biking and I started hiking. Of course, that wasn’t in Florida because we have no mountains there. And just like both the ladies were saying, I didn’t want to die off the side of a mountain. So I was constantly thinking about like, “How do I keep the bike straight,” right? So for an hour or so, I’m in my body, and I’m thinking about the bike. And then before I know it, I also realized that my body is capable of more than being a sexual object for all of these perpetrators from my past. |
| FETTERMAN: 47:10 | So it starts to change the narrative. And I also start to understand what my body is capable of. And it also teaches me about how I can spend an hour without obsessing about all the bad things in my life. And all of us have clients that say, “Everything sucks. Everybody is horrible,” right? And then you ask, “Okay. Well, what’s the reality?” “Oh, yeah. I did have an hour where I was okay,” right? So just telling clinicians, getting your clients into an activity that they enjoy, bringing the joy, as Michele said, that in itself is somatic work. It doesn’t have to be this fluffy, rainbow, and hard thing. It really is about allowing people to use their body to build their strength and to use that time where they’re not in their head obsessing about what their trauma is. And in a way, that’s very sneaky, but it works. And there’s all this evidence of– really, they’re talking about the science that– I have thousands of people that we just get them outside, and it works. And that’s why you have treatment centers around the country that take young people out into the wilderness. That’s somatic work. They just don’t use those terminologies. |
| CARMEN: 48:32 | So we’re talking about dance. We’re talking about kickboxing, running, climbing mountains. Okay. So I get it. Take us into the office. Take us where– what you are doing with clients to get this started so that we kind of have a real boots-on-the-ground understanding of what that looks like. Suzanne? |
| GUNDERSEN: 48:56 | I’m going to just say that stress and overwhelm that sets into the nervous system, gets into the body is what we call trauma. And how we experience that somatically is that we literally curl in into the fetal position. Our diaphragm starts to squeeze. So I’m going to do everything that I can to help bring some rhythm and some openness to that diaphragm. Maybe I’ll do some leg marching just to start to open up, maybe some hip circles, right? Some hip circles, some tree bends, right? Just to get some simple body motion going to help loosen the contraction of that diaphragm. And we’re going to keep building on that and building on that as we build rapport with our own bodies, build rapport with our body to kind of learn and explore. This is my thumb. These are my hands. What’s the temperature of my hands? Just keep building on that and building on that. |
| GUNDERSEN: 49:49 | But really, to the point of being able to really have an ability to contract and release the whole body through the diaphragm, babies naturally cry to release the contraction of the stress in their diaphragm. So I really know in the work that I do that helping build rapport with the body one body part at a time, which could take days, weeks, however long, to feel safe and then allow that expression. Just like the body wants to breathe in and breathe out, it wants to contract, and it wants to release. And we often get that contraction really stuck in the diaphragm. When you think about it, even deeper levels in the body, what does that do? Clamps down onto our intestines. And why do you think we have so many–? That’s early developmental trauma right there because all our gut impulses that happen through our gut, through our intestines are just being squeezed. So it’s a lot of just starting with some simple things to open up the diaphragm and keep building rapport with the body and deepen that and deepen that and deepen that, offering co-regulation between therapist and client until they can begin to learn how to self-regulate using some of these things without any story, without any emotion. Those things might bubble up certainly, and there’s a time and place for those things, like Michele mentioned. But yeah. That’s how I would approach it. |
| CARMEN: 51:05 | Michele, what–? |
| FETTERMAN: 51:06 | I would– |
| CARMEN: 51:06 | Oh, go ahead, Mindi. My apologies. |
| FETTERMAN: 51:09 | No. It’s okay. I wanted to add, and I know Suzanne knows about this because I did a workshop with her, but you have to be willing to move with your client. And you’re going to look silly, and you’re going to have to go with it and literally go with the flow. When we do our groups and we do our one-on-one sessions or whenever I go into the treatment centers, before we start, because everybody is kind of curled up on a couch or with a pillow, we get everybody up and moving and let them get their heart rate up. And so they can physically feel that they’re here. You are here. Feel your heart, feel your breath, right? And that’s how we start. So that is a grounding technique, but it doesn’t have to be outside in the wilderness type of thing. You can do that right there in an office. We also have a trampoline. Make sure you have your insurance if you’re going to do that. But before you’re going to start talking in a group, people jump up and down on the trampoline, and it just gets everybody out of that place of everything’s miserable. It’s like you cannot be miserable when you’re jumping on a trampoline, right? And so there’s just little fun things that you can do just to start a session. |
| GUNDERSEN: 52:20 | Beautiful. |
| ROSENTHAL: 52:22 | It’s awesome. |
| CARMEN: 52:24 | Michele, also, wanting to hear about your work also in terms of what that looks like in your office. |
| ROSENTHAL: 52:33 | Right. So I work on an integrative team that is part of an addiction program. And so by the time they get into my office, they’re out of detox. Sometimes I go into detox, but mostly, they come to me after they’re out of detox. And the first thing that I like to do with everybody, and this is going to sound counterintuitive but just roll with me because it works. Because to me, survivors need two things as immediately as possible. And we all know this, but I’ll just start here. They need safety and they need control. And we can provide in our offices safety. And so the first thing I want to do– taking safety as a done deal, I want to start giving them control because to be in a body that feels as dysregulated as theirs does is frightening. It’s terrifying. It always feels like something’s out of control. And so the first thing I want to do is to teach them that they are more in control than they realize and that how their body feels is not necessarily reality because the body is running unconscious programs of the mind or it’s holding memories that have not been properly consolidated, and they’ve been triggered or activated. I mean, there are so many different ways to describe and explain it. So in addition to what I was saying earlier about teaching them about energy and how to understand their own energy, I will often ask them to take how their body feels. |
| ROSENTHAL: 54:15 | And let me say the caveat to this first is I do this when I feel it’s appropriate and the client can handle it. And that’s different for different people. But what I love to do is ask them to notice how they’re feeling in their body and rate it on a scale of 0 to 10. And usually, it’s not at a 10. It’s like an 8 or 9. And I’ll ask them, “Well, let’s just see if you can get it to go one number higher.” And in doing that, what they notice is they can make it worse. And when I say to them, “Wasn’t that interesting that you could do that? Now bring it back down to the 9,” or the 8 or the 7. “Just do that.” And they will do it. And suddenly, we’re in a whole different place than we were two minutes earlier because they’re starting to realize, “Oh, wait a minute. I can make this worse, and I can make this better. I am a little more in control of my body than I thought. Maybe it’s a little safer in here than I originally expected.” And just that tiny shifts can help bring someone more into alignment in terms of partnering with their body instead of trying to exit their body. And I don’t mean that in a suicidal way. I just mean whatever addiction we’re talking about, whether it’s an eating disorder addiction or any substance abuse or alcoholism or anything, we’re all trying to escape, right? So when you start to feel a little more safe and a little more in control, the need to escape suddenly dials down. Even if it’s just a tiny bit, if you can move the needle, then you’re going in the right direction. And so that’s what I like to teach them right away, is, “Let’s see. Let’s see what’s really going on here because I think it’s a little different than you may have originally experienced.” |
| CARMEN: 56:09 | Anyone want to add to that? |
| FETTERMAN: 56:13 | I love it. |
| GUNDERSEN: 56:14 | Yeah. |
| CARMEN: 56:15 | Yeah. That idea of control and realizing you have control over your body, that’s the connection you’re talking about, right? That’s bringing connection where there was disconnection. That’s incredible to be able to teach your clients that. I want to end on a message of healing and wellness from all of you. Michele, would you start? |
| ROSENTHAL: 56:44 | Oh, I would love to. I would love to because here’s the message that I think is most important, and I know we all do this already, but I’ll just call it out, is to hold that space for clients. I always tell them, “You have enormous healing potential. The goal is learning to access it.” And that is the premise from which I start everything. Taking it for granted, assuming from the outset you can do this. You just haven’t learned how to access that healing potential that you have. And that’s my job, is to walk beside you while you learn how to do that and then use that capability to take yourself to the ultimate outcome that you have always wanted to reach. And so that’s the wellness message of hope that I always like to offer. You have enormous healing potential. The goal is learning to access it, and you can do this. |
| CARMEN: 57:48 | Mindi? |
| FETTERMAN: 57:50 | Oh, absolutely. So I tell all of our survivors, from an early age or whenever your situation happened, somebody used your body, took advantage of your body, and made it for their own. And your body is your God-given gift or the universe or whatever you believe. But it’s yours. And for the remainder of your time on this planet, you have the right to be in control of your body, to enjoy your body and all of the pleasure that it’s capable of and to live without being in constant fear of what can happen to your body and what can happen to your mind. And the only way that you’re going to enjoy that gift is if you decide that you’re ready for that gift. But you deserve it. And because somebody took that away from you does not mean that you’re not capable of having it back. And I’m living proof of that, and I have tons of people around me that are also living proof of that. So I love to share that message, and I love to show the example that we see every day. |
| CARMEN: 59:00 | Suzanne? |
| GUNDERSEN: 59:00 | Beautiful. Oh, very simply, we are genetically encoded to survive and that just like the flower leans toward the sun, every moment of every day, our body is searching for ways to survive and recover. So we’ve got that going for you. You wake up every day, and your body is like, “Let’s do this. Let’s do this.” Even though you may be living in patterns that you don’t like or that are uncomfortable or that you want to end, you’re here, and there is new opportunity every moment to learn how to strengthen that into new, better ways that are more aligned with how you want to experience life. |
| CARMEN: 59:43 | What an incredible, beautiful conversation. I want to thank each one of you for coming on and just sharing your expertise with us. I want to thank our audience. Thank you so much for joining in the conversation. We will send you all of the contact information for all of our panelists. Would you all like to just say how you can be reached? Michele? |
| ROSENTHAL: 01:00:07 | Sure. You can find me at mytraumacoach.com. And there is a complimentary brain training program on there that combines brain training with somatic work, so I’m happy to share that with anyone who finds it useful. |
| CARMEN: 01:00:24 | Suzanne? |
| GUNDERSEN: 01:00:26 | transformedconnections.com. I have a free consultation link for therapists, clinicians, or clients, if you choose to send them my way. Thank you. |
| CARMEN: 01:00:36 | Mindi? |
| FETTERMAN: 01:00:37 | innertruthproject.org. |
| CARMEN: 01:00:40 | Thank you, everyone. This was an amazing conversation. Also, for your CE information, please be looking in your email by end of business tomorrow. Everyone have a wonderful, wonderful day. Thank you so much. |
| ROSENTHAL: 01:00:53 | Thank you, Noelle, for being such a great moderator. |
| CARMEN: 01:00:56 | You guys are easy to moderate. Let’s just put it that way. Bye. |
| ROSENTHAL: 01:01:01 | Bye. |
| CARMEN: 01:01:06 | [music] This has been Recovery Out Loud. Don’t forget to subscribe and stay up to date with notifications for new episodes. But most importantly, if you’re struggling, don’t hesitate to reach out. Help and a new beginning are only a phone call away. |
