A somatic therapist’s view on healing

My services are typically sought out by people suffering from the effects of brain and muscle injuries or from persistent musculoskeletal pain of unidentified cause, who have already tried every means they knew of to tame their maladies, but to no avail. They learn about me from their friends or relatives whom I was able to help recover from similar conditions. Even so, I was often told that those friends and relatives had trouble describing just how their recovery came about. I therefore felt the need to spell out the key features of my approach to rehabilitation, lest it be viewed as some kind of magic.

Traditionally pain treatment has focused on managing the pain itself, and, in the case of an injury that also affected certain motor skills, on “retraining” these skills. It is not difficult to see why this approach is prevalent. When an illness or the effects of an injury start to interfere with our ability to carry out everyday tasks and even to enjoy life, the first thing we want to do is to get rid of these terrible “interferences” — that is, the symptoms. And this is what the pain treatment is typically aimed at. If we suffer from neck pain or frozen shoulder, we are advised to do exercises intended to “mobilize” the soft tissues around our neck and shoulder girdle; if we are troubled by headache, we take analgesics to keep it down; and if neither soft-tissue mobilization nor analgesics work, we may be prescribed injections of Botox into spastic muscles, which block the nerve impulses from the brain that tell these muscles to contract, and also suppress the transmission of pain signals from the body’s periphery to the brain. Inhibiting communication between the brain and the “problem” body areas renders the issues manifested in these areas imperceptible to our senses.

These courses of action may bring a much-needed respite from pain. As a rule, however, they do not lead to genuine recuperation or restoration of compromised functional abilities. Still less effective are they when our maladies do not manifest themselves in specific parts of the body — as is the case with “cloudy” thinking or with the sudden loss of both physical and mental energy. When faced with such non-localized symptoms, we are at a loss as to what specialist we need to consult, with the consequent feeling of helpless worry that can lead to a state of depression — and then we must wage a battle against this new and formidable foe!

But suppose that, instead of seeing symptoms merely as obstacles to well-being, we look upon them as integral characteristics of an organism whose current state is significantly different from its purportedly “healthy” state of days past?

The human brain possesses the remarkable capacity to reorganize itself throughout life by forming new neural connections (and, in some cases, even creating new neurons) in response to various sensory experiences. However, its unparalleled malleability is Janus-like: It’s a big asset which can also cause big trouble in our life! Often a state we call “pathological” is nothing else but a strategy our organism has actuated to survive in a situation it perceives as threatening. You may completely fail to notice when this strategy gets put into action: your brain deploys it automatically, without consulting your consciousness — nay, without even notifying it!

My hands-on work with clients starts with decoding the habitual strategies their organisms employ to respond to stressors, using their bodily expressions — especially the symptoms that interfere with their quality of life — as the Rosetta stone.

A person’s posture, gait, body shape, and patterns of muscle tension yield a rich and truthful picture of how he or she interacts with the world. My hands “read” the distribution of effort throughout a person’s body — they feel which groups of muscles are overused, which are unengaged, and which are unable to relax. This information enables me to identify the tasks (functions) to which the person’s organism, through its nervous system, preferentially allocates its available resources. It is important to keep in mind that resource allocation within the organism is ultimately mediated by the brain which can itself be damaged. Accordingly, if the neural pathways between the brain and certain parts of the body are disrupted, the brain can become “blind” to these parts (which accounts for multiple physical impairments often observed after a head trauma).

We delude ourselves if we think that, as members of the species whose scientific name means “wise man,” we are capable of exercising conscious control over how our body allocates its resources across biological functions. The functions that are directly responsible for our self-preservation occur without the participation of our consciousness (unless you are a yogi or yogini proficient in meditation techniques that can influence the autonomic nervous system). The term “self-preservation” is understood broadly here, involving both our immediate survival needs and the maintenance of our identity (sense of self) vis-à-vis various pressures from the outside world. For most of us, the inner priority-setting process, by which the psycho-physical energy coursing through our body is directed to specific purposes, occurs outside the scope of our awareness, let alone our control. When it comes to our self-preservation, our physical comfort may be one of the last things to be considered by our organism!

When our safety is at stake, our muscular system can work well beyond its normal capacity, notwithstanding tiredness and pain. Significantly, the verdict on which situations are safe and which are not is typically not based on conscious deliberation: survival is a task of such importance and urgency that it is seldom, if at all, entrusted to the evolutionary youngest and slowest-operating part of our brain associated with reasoning. Most of the signals from the outside world that our sensory organs pick up do not even reach our prefrontal cortex, which presides over deliberate decisions. They are processed by the older brain structures that trigger physical responses to emotional experiences — particularly those that are essential for our survival, such as anger or fear. While being more rigid and compulsive than the prefrontal cortex, this primordial brain network (often referred to as the limbic system) is reliable and capable of producing near-instantaneous reactions — a feature that comes in very handy in situations that pose an imminent threat to our security, such as a sudden encounter with a large wild animal in the woods.

Although we rarely come face to face with free-roaming tigers anymore, there is certainly no shortage of things that can ignite our visceral sense of insecurity in today’s world. Common examples include physical traumas and unresolved conflicts.

However, these and other external events may not, by themselves, be sufficient to keep one’s body in a chronic state of dis-ease that can — and usually does — bring about a range of functional disorders. Typically, this only happens when external “ignitors” come into contact with one’s inner “combustible material” — a deeply held, and often unconscious, belief that the world is essentially an unsafe, unfriendly place.

For instance, in an auto accident, a person’s arm and upper body muscles are commanded to produce the maximum force of contraction in order to prevent the head from slamming into various parts of the car. Similar to many other processes essential to survival, this muscular defense is thrown into action before the person becomes aware of what is going on. And if the person happens to believe (without necessarily acknowledging it) that the world is unsafe, the car accident gives that belief a strong boost. As a consequence, the person’s organism may opt to stay in emergency mode in its aftermath — without “consulting” his or her consciousness.

I have met people whose arm and upper body muscles remained contracted — as though they kept clutching the steering wheel — for years after the accident! It is very plausible that these muscles never received an “all-clear” signal from the brain structures concerned with survival-related functions. Moreover, I have noticed that, as long as an “all-clear” signal has not been transmitted across one’s brain, its structures responsible for selecting which stimuli are deserving of our attention (known as the “salience network”) tend to focus on detecting further and further signs of danger in the surrounding world. There seems no need to explain why people who have experienced accidents causing chronic, painful contraction of certain muscles are little aided by the therapies that are aimed at “relaxing” these muscles.

If a car crash results in a concussion (which can occur without a direct blow to the head), some of the neural connections in the brain through which it interacts with the muscles, may be damaged. The brain that is unable to communicate effectively with certain body parts, can no longer rely on these parts and reassigns their functions to other parts of the body, thus making the latter work beyond their normal capacity, which inevitably causes discomfort and pain. In such circumstances, the ailing body part is hero and victim at once, forced to carry out a vital task at enormous expense to itself! A similar situation arises when the brain gets damaged as a result of a non-traumatic event such as a stroke.

Communication between different parts of the organism can be disrupted for a variety of reasons, in a variety of ways; but the body’s responses are never meaningless! In most cases, they represent the workings of an all-round “security system,” constructed by the brain. Once we begin to look at the human organism as an ingenious ensemble where all troubling symptoms make sense as manifestations of a certain life strategy, an opportunity opens for us to work with it, rather than against it!

I want to make it clear that the term “organism” as used here refers not only to our “purely physical” aspects. Rather, it denotes a psychosomatic whole, our complete individuality, with particular emphasis on our habitual beliefs and attitudes that heavily influence our daily actions toward the world (including ourselves). Our individual ways of dealing with the world are truthfully reflected in our bodies! Every emotion has its own “corporal signature” — it evokes a specific bodily response, which is essentially the same for different people. (This makes emotions “graspable.”)

The physical sensations of a vice-president in a large corporation, who has just heard that its stock price took a hellish plunge, must closely resemble those of a Neanderthal caveman confronted by a bear at entrance to his dwelling, and their spontaneous muscular responses must likewise be very similar. In contrast to the caveman, however, the status of a big-time corporate VP in modern human society obligates its holder to “manage impulsive reactions.” In order to succeed in this, the vice-president’s organism has to use additional inner resources — typically in the form of muscular effort — that must be at least equivalent to the amount of effort it has already invested in its immediate response to the ominous news. Over time, this suppressive effort produces “muscular armour” whose maintenance requires enormous amounts of energy and ultimately engenders a constant state of weariness. However, the vice-president needs to pay this price in order to feel secure about his status in the eyes of society.

How, then, do I see my role as a somatic therapist in the rehabilitation of people whose nervous system has assumed a “security mode” as its baseline state, and holds on to this mode in spite of the pain, discomfort, and functional limitations it entails?

Rather than attempting to overpower the client’s “security system,” I seek to access it from within, as it were. This does not require any forceful interventions; through gentle touch — intended to communicate, not correct — the therapist’s hands can become “tactile witnesses” of the client’s sensations. A “witnessing touch” enables one to take a fresh look at the places of tension and holding in one’s body that have long become habitual. This often leads to surprising revelations. For example, a person can discover that she is incapable of lying down with her arms relaxed at her sides, and that her shoulders spontaneously jerk with every movement of her arms, even a very slight one.

Since tactile witnessing does not endeavour to fix anything in the client’s organism — whether it be to stretch chronically tight muscles, release tension knots, or “exercise” dormant areas, it does not trigger an alarm in his or her security system.

Besides revealing to the client her habitual neuromuscular patterns, the therapist’s non-corrective touch provides support to the most overloaded parts of her body — in a literal sense, by joining in their work and thereby taking some of the burden off them, even if only for a short time. This part of a somatic therapist’s work is an art, not merely a technique: every body presents a unique constellation of habitual tensions, rendering standardized procedures ineffective.

The support provided through this “going-with” touch engenders trust — the kind that is not so much a mental state as a bodily sensation, which resides at the deepest core of our being, where physical, emotional, and cognitive manifestations are inseparable. It feels like being filled with acceptance and security, and wondrously liberated from the need to prove our goodness to anyone. And with this feeling, a special space opens up within us, where change can occur.

Significantly, the message of support transmitted through non-corrective touch is assimilated by our nervous system directly, without being moulded into habitual patterns of thought and behaviour, which lie at the root of persistent tensions in our muscles.

The special kind of inner space one discovers through the therapist’s tactile support typically feels like a delightful breath of fresh air coming into one’s body. Empowered by it, one’s organism becomes more open to lifting the level of protection previously established by its security system. On the physical level, this opening is perceived as subsiding of habitual tensions, regaining the ability to move with ease, and rediscovering a sense of wholeness of oneself — as if the streams of vital nourishment have come to life in one’s body and soul. As these new self-perceptions are gaining ground, pain tends to lose its grip over one’s life.

However, one must keep in mind that that the change outlined above is stimulated externally, by the therapist. Accordingly, one’s organism is bound to revert again and again to the more habitual survival mode with the accompanying physical and mental suffering, unless one breaks out of old patterns. The dissolution of habitual perceptions of oneself and the world is the main factor that defines the state of one’s nervous system, and the most important process that needs to occur for healing, because it initiates change at all levels (physical, emotional, mental) from within.

Our body is our compass in this process, and my work necessarily involves helping people learn how to read their personal compasses properly. However, the actual use of these skills for the purpose of finding more effective ways of moving through life is something that each of us must do for him- or herself. It’s an inside job! It starts with a firm resolution to examine with the utmost honesty our habitual ways of being in the world. The awareness of how our habits of thinking, feeling, and acting contribute to our pain and physical limitations, which arises in the course of this examination, marks our transformation from passive sufferers to builders of our well-being. In my view, this transformation can be rightfully called spiritual, and signifies genuine healing.

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I want to express my immense gratitude to my dear partner in life, Anton Struchkov, for inspiring me to write this paper, and for his thorough editing and translation.

[*] Copyright © 2020 by Tatiana Reymarova.