Sensorimotor Psychotherapy: Interventions for Trauma and Attachment (Norton Series on Interpersonal Neurobiology) by Pat Ogden & Janina Fisher

Author:Pat Ogden & Janina Fisher [Ogden, Pat]
Language: eng
Format: azw3, pdf
Publisher: W. W. Norton & Company
Published: 2015-04-26T16:00:00+00:00

Suggestions for Clinical Use

Because many therapy approaches emphasize the narrative memories of events and do not prioritize work with nonverbal implicit memories, you or your clients may equate memory work with detailed autobiographical recall. It is essential that you both understand the meaning of working with the effects of the memory as triggered in present time, rather than with the memory content. Even when clients do remember and describe a past event, it is the effect of talking about the memory—which stimulates mental, emotional, and physical states similar to those of the past—that becomes the focus of memory work. You might refer back to Chapter 5, “The Language of the Body: Procedural Learning,” to review how childhood experiences affect the body and to help clients understand that the effects of memories endure over time and can cause dissatisfaction, distress, or dysregulation. It will be helpful to emphasize that the past itself cannot be changed, but the effects of the past can be brought to awareness and changed.

Clients will need your support to identify physical reactions such as numbing, trembling, muscular tension, and autonomic dysregulation; physical patterns such as stiffening of the back, neck, or shoulders; pain; or the somatic components of a defensive subsystem (e.g., the constriction associated with freezing) as implicit, body-based memories. Intrusions such as panic, rage, images or sounds, nausea, and shivering can also represent implicit memories that disrupt the present moment and catapult clients out of the window of tolerance. Some will realize the presence of implicit memories as they find themselves repeating the same negative patterns in their relationships without knowing why.

You might explain to your clients that implicit memories are often “situationally accessible,” activated in present time by both internal and external stimuli reminiscent of the past (Brewin, 2001). Understanding the influence implicit memories of a past that they do not explicitly remember has on their present-day confusing and often distressing symptoms and patterns can be reassuring.

Making the connection between their day-to-day distress and implicit remembering will support clients’ motivation to identify the implicit memories that are most troublesome for them and then develop a resource repertoire to manage these implicit memories. To ensure that this goal is met, you can ask clients to refer to their homework sheets from the previous section and review together which resources are the easiest and the most helpful, as well as which resources are needed but still missing. Clients may need your help to identify the most effective resources to address implicit memories as they embark on Phase 2 work.

Keys to this chapter include your ability to track your clients’ here-and-now reactions indicating implicit memory, facilitate their mindful awareness of these reactions, and help them practice resources to create a different experience. In session, implicit elements of memories will emerge as clients begin to talk about the past, which usually stimulates the mental, emotional, and physical state that they had experienced during the event itself. At these moments, you might ask clients to mindfully notice the building

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