Short Manual on the Big Topics in Psychotherapy: The Brain, The Body, and Attachment

By Pamela Church

We are at a threshold. 

It is a time of much established good in the field of psychotherapy. This book, this Short Manual, is a call for a dynamic synthesis, a coming together of attending to the heart, to the body, and to brain states as an ongoing process that furthers the unified self. It is about estab

• Language: English
• Publisher: Pamela Church
• Release date: Jan 11, 2021
• ISBN: 9780578979137

Pamela Church

Pamela Church is the author of three books all speaking about the awakening of our good hearts joining the personal with the spirit of the time. Her work is informed by being a clinician in private practice for four decades as well as a long standing dedication to Buddhist practice. Her work is a call to a mystic revolution of compassion. Field Trust Project speaks to the cultural collective time and the need to train our minds and hearts in interconnectivity. And be playful.

Book preview

Chapter 1

ADDING TO THE LIGHT

I believe we are all wounded healers. We are called to help others because we need help. We carry old pain. We are defensive, scared, and angry. Sometimes we feel hopeless. Most likely, we also have a good life. Most likely, we are prosperous enough. Most likely, we take refuge in the decency of our intent. First and foremost, we are seekers seeking to understand the psyche and relieve suffering.

This therapeutic manual is distilled by decades of clinical experience (I have been in private practice since 1980), by my world view, and by my life experience. It may feel like a poetic voice rather than a theoretical voice in that terms will be used that require referencing other sources. There are many superb academic books available. This book is my expression of the ensemble that is whole-person intelligence. It may feel more spiral-like than linear. This is my way to kneel and kiss the earth. It is right-hemisphere dominant to be sure, but without the left hemisphere, there would be no language to convey what an astounding time we are in.

One way to experience this short manual is to approach it like an immersion course in a language. The immersion here is about the model of heart-mind-body and gestural protocols to support whole-person integration. In an immersion class, there is an implicit understanding that it is okay to not get everything. The brain is absorbing material while sailing through the river passage. I have included gestural protocols with the narrative of this book. It is all in the mix: new learning, text to accompany it, and a larger view.

Here is a call for integration. It is a call for aligning the body/ the belly, the heart, and the mind. It is a call for harmonious power. It is a call for restoring body coherence when there has been trauma. It is a call for deepening relationship. It is a call for bringing joy forward. It is a call for a unified self.

This is a book for clinicians, yet others may be interested also. The topics of the brain, the body, and attachment touch us all. The general guideline of take what is useful, assimilate what is of particular value, and leave the rest applies here. It is, I hope, a very practical manual that encourages exploration of protocols and visualization from the work I have developed: Harmonize Now: Tools for Integration. I am interested in regulating distress states and the felt synthesis of being in the body with resource and connection to others. I am interested in maps that show us the way home.

As a larger community, we evolve, we learn from Freud, and we move forward. If, as a metaphor, the profession of psychotherapist, our profession, is a tree of life, then it is large and healthy, with many branches reaching out. This tree is sturdy and provides good shade. It is a fertile time.

It is also a time of synthesis. A time to bring together what we know and what we don’t know into a larger whole. It doesn’t make any difference what our particular backgrounds are, whether they are supportive, short-term counseling done in a clinic or long-term psychodynamic work; it is about looking at the big field of our profession and taking note.

What I see is that the culture of psychotherapy has three components that are interacting with each other: focus on our connection to others, that is, attachment states; curiosity about the mind-body interface; and recognition that brain states influence our behavior. This short manual goes between those three points. It is not a text to historically understand the topics. It is a guide to connecting the dots. Everything in this short manual is about the interdependence of these topics. In the chapter on protocols, practical somatic tools are suggested as a way to facilitate parasympathetic ease and help generate insight. When I am referring to the brain, it is about the structural components of the brain, and when I am referring to the mind, I am speaking of an overarching consciousness.

I will be talking about the underpinnings of our work as psychotherapists and how to further a model of a unified self. This model of a unified self is about the collaboration of heart-mind-body and whole-person intelligence. With this model, we have an integrated map of the psyche.

One moment I am talking about body awareness, another moment about the resonance of the heart, and another the experiential quality of brain states. This is a weave that keeps weaving. It is all one piece. We need an entry point to talk about the separate dynamics. The working principle here is a systemic model of heart-mind-body. Know that if I am talking about one part of the system, the other parts are contiguous. This is about a focus on the heart, the mind, and the body as one self, a self that flourishes, a unified self in the world.

We bring to the office a loving presence. Most of us do that most of the time. How do we keep polishing that presence? Of course we have consultation, supervision, training, and our own therapy. We wouldn’t be here without these. This new phase shift allows us to benefit and learn along the way in a manner that may be surprising.

My experience is that intentional touch regulates the nervous system, hence the development of the gestural protocols in this book. An aroused sympathetic nervous system (SNS) state from trauma can become habituated. This is one path that directly addresses the chaos that can happen to the body from neglect, abuse, and trauma, and how to restore physical coherence. The design here is about self-regulating with self-touch.

Knowing how to recognize and negotiate brain states is a useful skill. This takes training, of course, and a willingness to learn a new language. In this short manual, I give my experiential knowledge of various parts of the brain. See if this has a correspondence to your theory and experience around brain states.

In a therapy session, I am listening to my body, sensing my brain state, and connected to my heart, in addition to listening and responding from my theoretical orientation. The voice of the body is about anxiety, symptoms, and hunches; really, it is about anything.

Bringing attention to the body in the psychotherapy office is about noticing the matrix that is the self. We live from the body, and we need to go to the body to find out what is what. Let us work from whole cloth. Whole cloth has the body woven in the design. Mostly, we just haven’t known how to include the body in the verbal exploration and understanding that has been the domain of therapy.

We work our study from many angles and benefit. For decades I have trained in psychoanalytical/ psychodynamic theory, trauma work, and somatic understanding of the body. I believe this age is asking for an inclusive, comprehensive frame. Whatever our specific training, let us meet and address the whole person. The medical equivalent of this can be found in functional medicine, with its focus on seeing the entire person and all of the interpenetrating forces at play.

In the mid-1990s, I began experimenting by bringing what I was learning about trauma and the brain into my office. It was the beginning of a new way to see the world. I was in a long-standing psychoanalytical consultation group that focused on trauma states. We all went to conferences like crazy and found a new vocabulary to bring to the office.

One of the wonderful benefits of those years was that we spent dedicated time applying what we were learning to ourselves by practicing with each other. One of us would be a client, the other a therapist, and then we would switch. It made me hungry for more and grateful for this rich time (which for me lasted about a decade).

We were learning new techniques for addressing the body to facilitate trauma release. Verbal processing now had to share the hour with techniques that interacted with the body. Over time, my particular focus became about opening the heart. Hence, the title of my first book, Gestures of the Heart. I began developing Harmonize Now Tools around 2002.

Ah, the heart. Isn’t ah the sound of the heart? Whether we have read John Bowlby’s work on attachment or state that cultivating healthy attachment is the frame of how we practice, we are all working it. People come to see us because their hearts hurt and they need help. People may be unhappy in their relationships or they may be unhappy in their work. How we function in the world, for one thing, is related to our beliefs about self, inculcated with years of others saying what a sweetheart or, conversely, what a jerk we are.

Of course, it is not about just two categories; it is about an intricate weave of all that has been said and all that has been unsaid; ways we have been touched and ways we have not been touched; ways we have had support and ways that we have not. It is this mystery that we get to respond to.

It is all about relationship. It is about the relationship a person had with the driver in front of them on the way to the office. It is about the relationship in the room. It is about the relationship to self and the sensations in the body. It is about relating to our partners, our kids, our dogs, our neighbors, and our colleagues. It is about feeling safe and dynamically alive. It is about the courage to negotiate intimacy, to be revealed and to see others truly. It is about vulnerability and beginning again with a beginner’s heart, full of life experience and available to marvel.

Helping others access self-wisdom and cultivating openness is one way to describe what we do in therapy. In a basic way, whatever our clinical orientations, it is about awareness and curiosity and deepening the capacity to love. The frame of the heart-mind-body interface gives us a supple, stable foundation from which to attend to our work.

A person comes in and has particularly harsh judgements towards self (and others) that are causing constriction and difficulty. We can ask the person to feel the body experience of the judgement and ask what is underneath that. The person identifies an experience, and we ask what is underneath that as we explore the rings of the tree—the life experience that has resulted in a core belief.

The core belief is noticed with an even attention—oh, what is this about? We burrow deep in order to find the light. The light of day comes when we can keep our core beliefs in awareness. At that point, they are mutable and subject to change. We awaken to new possibilities as we explore outdated paradigms.

Who doesn’t have limiting core beliefs? The restrictions of our minds and of our life experiences shape our brains. Whatever our particular training and clinical orientations, we want more well-being for our clients. Mindfulness helps that aim. Mindfulness, being more conscious and reflective, increases awareness of who we are and what it is like to be in our skin.

The more we have a relationship with mindfulness, the more we can occupy the space that is about compassion, love, and forgiveness. It is about noticing without judgement what is present while we identify core beliefs. Once the judgement is dropped, we have the opportunity to bring other things forward.

We are the model for our clients. Our clients may know very little personal information about us, yet they know very well our presence, how we show up. The goodness of this is that we get to evolve day to day to our best selves. The depth of our work with clients is equivalent to the depth of work with ourselves. I believe the reason most of us chose to be therapists was that our own healing was calling to us and we needed a way to understand it.

One thing I would like to bring forward is the word heartful. As I type it, spellcheck wants to correct me. In fact, heartful is not in modern dictionaries. Merriam-Webster has the word in its premium unabridged dictionary, saying it is from Middle English and means full of heartfelt emotion. Urban Dictionary has the word heartful and says it is to be honest, sincere and really mean it. Let us bring it back into common usage. Heartful: to be attuned to and aligned with the heart.

We all have a particular training around psychotherapy. We collect data points from our particular points of view and keep training. The individuality of that is about each therapist’s talent and inclination. A common ground for us all can be some of the language from neurobiology, such as resilience and coherence.

Resilience is the experience of being upset, changing, and returning to the situation renewed. In more technical terms, it is the ability to shorten the refractory period when we are upset so that we are upset for shorter and shorter periods of time. Resilience is a familiar word, and now we need to make it a familiar experience. We are upset, we work through it, and we are okay. Resilience actively builds coherence. Coherence means we have resource and awareness, and acknowledge our ability to change as needed.

Resonance is the hum that comes from time repeatedly spent with a feeling, an idea, a passionate pursuit, an addiction, a daydream. Our brains change with how we focus attention. If we are spending a lot of time on a pursuit, by virtue of the time spent, we develop myelination on the necessary neurons, which, to borrow a New England phrase, is like greasing the skids.

This resonance is increased with repetition and with those states we want to cultivate; resonance is also increased with gratitude. Gratitude, that sweet thanks of the heart, is a powerful experience for the mind and body. The metaphorical humming is the body tuning to a certain frequency and increasing its strength.

With this short manual, it is all about the song lines of the heart-mind-body. Song lines in the Aboriginal culture are about the lines of the land, which carry the history both of the people and of the land. They are the means of navigation. The song lines of heart-mind-body are about the amazing interconnectivity within complex, interpenetrating systems. If the pathways are open and flowing, we are likely to have resource, insight, and well-being.

We have studied family systems in graduate school and perhaps in post-graduate trainings as well. We know that parents fighting will affect their eight-year-old daughter. It could manifest academically or socially or with a weakened immune system. It is how things work. This is a systems understanding of family therapy.

The brain is a vivid example of an interconnected system. When I did groups in schools, I talked about the brain being a team player. What would it be like if the students’ soccer team had two people absent and they were playing with only nine players? In sports, we know that to be successful everyone needs to show up for a full team or else there is a huge disadvantage. Same with the brain.

We know and heal our psychological wounds, the splits in our psyches, just as we know and heal our brain systems. This is done by tracking our felt experiences, our understanding of how it feels if our prefrontal cortex isn’t on or if we can’t sense our body sensations. This is a call to have a curiosity for what different brain systems feel like in the body when we imagine they are on and when they are not. This will be a great help to our clients. Of course, it does take some study to recognize brain states, first academically and then translating them to body experience.

Our clinical perception is informed by our embodied presence. This is the good news—we get to be in relationship with our body states, our feeling states, and our brain states as a vehicle to bring our best selves to our clinical work. From this place, we support the aligned best self of the client. All of us are well-trained and dedicated. In addition, we bring our good hearts and good intentions to our work. I am proposing we, of course, bring all of that and something else as well: the awareness of our body sensations as a way to befriend ourselves and stay connected to the fundamental ground that is the body.

Abraham Lincoln said, "Give