East Bay Therapist
CALIFORNIA ASSOCIATION OF MARRIAGE AND FAMILY THERAPISTS   –   EAST BAY CHAPTER
Including the Body in Couple's Therapy
A Preliminary Peek at a Large and Growing Methdology
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By Ruth Cohn
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by Ruth Cohn, MFT

(March/April 2005)

For those of us who work with couples, it is clear that the content of their difficulties is generally a small fraction of what is really at issue. What tends really to be at stake are dynamics between them, where each partners’ defenses and survival strategies originating in childhood, are evoking the defenses and strategies of the other. The circular patterns of conflict and pain may be frustratingly difficult to disarm and reroute. Often, especially in “high conflict” couples, the therapist may be hard pressed to figure out what is really going on.

In the past ten years or so, an endeavor abandoned early on by Freud, has been resuscitated. A courtship, moving toward marriage, between psychotherapy and neuroscience has been gently growing and advancing. Due to the advent of neuroimaging technology, the study of the living human brain has burgeoned. Many psychotherapists like myself, have become enamored, even obsessed with the study of the brain.

One of the significant byproducts of this advance is that brain research is now lending validity to the somatic therapies, which may have been rejected by many serious therapists as alternative and fringy; and helping them to evolve into increasingly sophisticated, powerful, effective and respected methods. Given that the human prefrontal cortex, the cognitive brain and the cognitive or “explicit” memory system is not fully developed until about the age of five, the phenomenal amount of experience and learning that takes place before that age is remembered “implicitly” or via the older brain systems: the limbic system and the brainstem. These experiences are retained in emotion and sensation, while remaining cognitively “unconscious.”

The field of trauma, which is so clearly a somatic affliction, recognized some time ago, that it is essential to include the body in our work. Too much of the trauma experience may simply not be “known” or accessed through cognitive or verbal approaches. I am increasingly discovering the depth and directness of somatic interventions for the full spectrum of problems I encounter in my office, particularly my work with couples.

Peggy and Joel (all names and identifying information have been changed) had a relentlessly recurrent argument. Peggy, a caring, empathic and attentive mother, was inclined to take special care and precautions, or remind her children of things they needed to do to be prepared or safe. When Joel observed this he routinely criticized her for being “overprotective and smothering.” Peggy, feeling criticized and judged would withdraw into feelings of hurt. She wanted a partner who would support her in her efforts at parenting, rather than constantly admonishing or pointing out her flaws. Joel would then feel shut out, frustrated and angry, disrespected and excluded from her world. The gulf of disconnection would widen between them and they would find themselves increasingly distanced from each other. By the time they brought this repetitive, patterned drone into their couple’s therapy, they each knew the other’s position verbatim, having heard it innumerable irritating times. Both felt the fatigue and erosion of connection and good will that comes of an endlessly cycling no win interaction.

Peggy and Joel are both bright, psychologically minded, experienced therapy clients. They are perhaps quick to interpret or analyze each other. In this case, each had the strong impulse to “explain” to the other what was “good parenting” and therefore best for Peggy’s adolescent kids; and what constituted a “good and supportive partner”. Neither was to be convinced, they could not agree, and they also could not seem to leave it alone. Peggy wanted Joel to simply stop criticizing and judging her, as they were in fact not his children but hers by a prior marriage. They both wanted me to help them be heard or understood in their most reasonable of feelings.

Peggy’s strong reaction was in keeping with her extreme general sensitivity to criticism, and we knew why. She had been mercilessly criticized and blamed as a child and longed for acceptance, and love that was “supportive.” I was curious, however, about why Joel responded so volcanically to these interactions between Peggy and her children. What was it that welled up in him each time he observed her carefully reviewing directions with her young teenager who was about to drive somewhere for the first time, or thoughtfully helped her daughter arrange all the things she would need for a school trip. What was the big charge that erupted inside of him? Joel’s response to my inquiries was to deflect them, to continue with his well reasoned argument about how Peggy’s “over protectiveness” was stifling to her children’s developing independence. Although he is generally fairly able to reflect and explore psychological and emotional questions, here he persisted matter of factly and self righteously in his rigidity.

Joel himself was a child of neglect. He grew up with parents who were involved in a secret life of illegal activities, and he was on his own. He raised himself and did very well at it. He was proud of his independence and his achievements. He had grown up to create a life of considerable success and professional accomplishment. He acknowledged that he was proud of how well he had done without the kind of doting attention that Peggy’s children got, but somehow that did not seem to account for his strong emotional reaction to it. He was not jealous of them, nor did he begrudge them Peggy’s care and attention. He himself was baffled as to why it was such a big deal to him.

Although it was difficult to pull him away from his adamant case building on this theme, Joel was truly tired of the conflict it brought between Peggy and himself. Ultimately I was able to interest him in an “experiment.” I asked Joel to drop quietly inside of himself and enter a mindful state. Once there I asked him to revisit the most recent instance of an “overprotective” interaction between Peggy and her son. When he had had gotten back to it, I asked him to just focus on the sensations in his body as he observed the interaction unfolding in his mind, and see what he noticed when he let his intellect rest and attended to his physical experience.

Joel settled slowly into his bodily experience. Peggy quietly watched and listened with interest. Before long, he said he couldn’t breathe, he felt like he wasn’t getting enough air. “I feel,” he said,” as if I am suffocating under a blanket.” Resisting the urge to interpret, Peggy and I sat quietly with him. I encouraged him to stay with it and see what else he noticed, to just follow and allow whatever came to him on its own. A few moments passed.

After a little while, Joel’s face began to soften and his eyes fluttered as if tears were coming. From the experience of airlessness, Joel began to remember living in that desolate apartment with his parents. They were always busy and had no time for him. But the little boy Joel could not be with anyone else either. No friend or playmate could come over because of the shroud of secrecy surrounding his parents’ work life. “Protection” for the young Joel was lonely, boring and stifling. His life was airless, lifeless and desolate, and his frustration extreme. The slowly forming memory, first in his body and then in image, brought waves of tears. Peggy watched with great compassion as the reason emerged for Joel’s strong reaction to her protective stance with her children. It reminded him of his desolation, despair and later in adolescence, anger.

Had we relied on Joel’s prefrontal cortex, his rational mind, we could have readily taken another loop with the well worn argument about overprotective parenting. Even Joel’s psychological savvy and knowledge of his own story could not get us somewhere new, somewhere that would put us on a different path. What moved the work toward healing and resolution was visiting the experience of the body and being led by that. Refraining from interpreting the suffocation, led to his discovery on his own of the memories and feelings that fueled the strong emotional stance.

Of course the problem was not completely solved by this piece of work, but we were out of the rut and had the possibility of an empathic connection around the issue of protectiveness. Joel had a new awareness that would subsequently give way to a new “route” in future responses to the same sorts of events. We will similarly want to process Peggy’s strong reaction to criticism. But through this work with Joel’s body, the process of getting “unstuck” in this particular cycle, moved forward.

Increasingly I am utilizing the access route of sensation to short circuit looping interactions between partners. Many adults, whose childhoods were on the continuum of neglect or emotional deprivation, lack fluency around feelings and their expression. They may not know how to identify what they feel, or what the feelings associated with their experiences might be. Their partners may shame or criticize them for it. The experience of the body is for many of these people, a place to begin to know what they are feeling. As they begin to familiarize themselves with the pit in the stomach, the tightening in the throat, the pressure in the chest, the collapse of the spine, they begin to learn about emotion. They may find their tears or anger. They may begin to learn how to read their own and their partner’s emotions. Little by little they learn the language of feelings and how to communicate them, first to themselves, then to another. From there, contact and intimacy gradually deepen.

There are numerous ways to utilize the experience of the body in working with people and their relationships. The expressions of the face and the whole body’s configuration and movements, are the “music” that accompanies the words that they may or may not be expressing. Gaze and voice prosody or tone, are some of the earliest modes of communication we experience in our lives, and may contain more meaning than anything else. Touch is one of the most powerful forms of both stimulating and soothing intense emotions, and couples are unencumbered by professional ethics to utilize it consensually in therapy. All of these modes enhance and expand the potential for couples to more comprehensively and fully communicate and connect.

Since I have been increasingly incorporating the experience of the body in my work with couples, I have found the therapy to progress much more deeply and swiftly. I also increasingly find that health, both mental and physical, is profoundly “related.” That relationship is profoundly physical is obvious. It behoves us to attend to the whole person in our relationship therapy. In the words of Lewis, Amini and Lannon:** As the nervous system matures, a baby reclaims some regulatory processes and performs them autonomously. Even after peak parenting experience, children never transition to a fully self tuning physiology. Adults remain social animals: they continue to require a source of stabilization outside themselves. That open loop design means that in some important ways people cannot be stable on their own- not should or shouldn’t be but can’t be. This prospect is disconcerting to many, especially in a society that prizes individuality as ours does. Total self sufficiency turns out to be a daydream whose bubble is burst by the sharp edge of the limbic brain. Stability means finding people who regulate you well and staying near them.

**Thomas Lewis, Fari Amini, Richard Lannon, A General Theory of Love Random House. New York. 2000.

Ruth Cohn, MFT is in private practice in the Rockridge Area of Oakland. She specializes in individual and couple’s therapy with survivors of childhood trauma, their intimate partners and families. She is certified in EMDR and is a student of Sensorimotor Psychotherapy. She can be reached at (510) 653-6256.

Note: This article reflects the opinions of the author and not necessarily those of
East Bay CAMFT.

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