{"id":18910,"date":"2020-10-16T15:46:23","date_gmt":"2020-10-16T20:46:23","guid":{"rendered":"http:\/\/thepapergown.zocdoc.com\/?p=18910"},"modified":"2023-03-06T09:45:46","modified_gmt":"2023-03-06T14:45:46","slug":"i-dont-do-therapy-to-explore-whats-on-my-mind","status":"publish","type":"post","link":"https:\/\/www.zocdoc.com\/blog\/patient-stories\/i-dont-do-therapy-to-explore-whats-on-my-mind\/","title":{"rendered":"I’m Not In Therapy to Explore What’s On My Mind"},"content":{"rendered":"

I stopped seeing my therapist two years ago, but not because I didn\u2019t like her. After several months of cognitive behavioral therapy, or CBT, I felt like I wasn\u2019t getting anywhere. In fact, my physical anxiety symptoms got worse every time I talked through my feelings on my therapist\u2019s loveseat. \u201cI don\u2019t know if this makes sense,\u201d I told a new therapist during a consultation call. \u201cBut my anxious feelings aren\u2019t really in my mind; they\u2019re in my body.\u201d<\/span><\/p>\n

Turns out, it did<\/i> make sense. The new therapist believed the constant heart-racing, muscle tension and stomach pain I\u2019d been experiencing were a result of childhood trauma. She recommended a therapeutic approach developed specifically for trauma survivors, and we began meeting weekly, just as I\u2019d done for years with other therapists. But our sessions were different in one major way: I wasn’t asked to explore my emotions or challenge my beliefs. In body-focused therapy, it was matter over mind.\u00a0<\/span><\/p>\n

The goal of all psychotherapy is to treat mental health issues, but treatment approaches differ. The right approach for a patient depends on the problem a patient is dealing with and how it’s affecting them. Cognitive behavioral therapy<\/a>, which helps people identify and change unhelpful emotions and behaviors, is commonly used to treat generalized anxiety and depression. To work through trauma, however, some therapists believe body-focused therapies, like somatic experiencing<\/a> and sensorimotor psychotherapy<\/a>, are more effective.<\/p>\n

\u201cThreats don\u2019t go through the thinking brain,\u201d says Pat Ogden, the psychologist who created <\/span>sensorimotor psychotherapy<\/span><\/a>, a body-focused and trauma-informed therapy approach. \u201cWhen you\u2019re threatened, your instincts take over, so to try to address it cognitively isn\u2019t efficient.\u201d<\/span><\/p>\n

A body-focused approach might be particularly helpful right now. According to Portland-based therapist Heather Fairlee Denbrough, COVID-19 and systemic racism are both enormous stressors that can elicit trauma-like responses.<\/p>\n

\n

Trauma survivors often develop overactive stress responses. Having a stress response is the same thing as going into fight, flight or freeze mode: The brain reacts to a perceived threat by telling the nervous system to release adrenaline into the bloodstream, prompting a series of physiological changes including an increased heart rate and sharpened senses.<\/p>\n

Those changes are immensely helpful if you’re trying to outrun a sabertooth tiger. But if you’re in therapy trying to sort through a painful memory, a pounding heart can be distracting or overwhelming.<\/p>\n

Stress also inhibits learning, an important part of CBT. Studies show<\/a> the thinking brain (the prefrontal cortex) goes \u201coffline” when people are exposed to stressors they feel they can’t control. Somatic therapists focus on calming down the body before<\/i> addressing thoughts and helping patients self-soothe, a method called \u201cbottom-up regulation.\u201d<\/p>\n

\u201cCBT is great when your \u2018top\u2019 is still on, but if you work from the bottom up \u2014 starting with a bodily sensation and working your way up to the brain \u2014 you can work through it, even in moments of stress,\u201d says <\/span>Ashley Eder<\/span><\/a>, a therapist in Folsom, California.<\/span><\/p>\n

\u201cBody-centered therapy can permanently shift the way we have automatic responses to stressors.”<\/span><\/p><\/blockquote>\n

That\u2019s the goal of somatic therapy: To identify how the response affects you physically and try new strategies for managing it. For example, let\u2019s say you go to therapy feeling stressed over a recent breakup. In the safety of your therapist\u2019s office (or your own living room), you could pinpoint the accompanying physical sensation without being overwhelmed by it.\u00a0<\/span><\/p>\n

Once you figure out that stress made your chest feel tight, you can practice taking deep breaths until you feel calm again. \u201cWhen you understand what\u2019s going on in your body, you can try new ways of coping both in and out of therapy,\u201d says Denbrough.\u00a0<\/span><\/p>\n

All these things help turn off the stress response so that you can eventually process the thoughts you have in response to stress, on your own or alongside a therapist. \u201cBody-centered therapy can permanently shift the way we have automatic responses to stressors, not just the way we talk to ourselves,\u201d says Eder. \u201cWe can change the default as opposed to constantly having to talk ourselves out of the default.\u201d<\/span><\/p>\n

Focusing on your body while staring at a screen<\/h3>\n

If you\u2019re used to working through issues on your therapist\u2019s couch, telehealth might come with a learning curve. But Eder, who\u2019s been offering body-centered telehealth since 2015, says remote therapy can sometimes be better than in-office appointments for patients with trauma.\u00a0<\/span><\/p>\n

People are generally more relaxed in their own space, which often means more productive therapy. And it can be helpful to learn new coping skills in the place you\u2019ll actually be using them. Plus, having a glimpse of the home environment also gives therapists insight into patients\u2019 daily lives, potentially allowing for more specific treatment recommendations.<\/span><\/p>\n

Telehealth also encourages more direct eye contact, which Eder says can foster a connection between a therapist and patient. Staring directly at someone might feel weird when you\u2019re talking face to face, but it\u2019s normal when you\u2019re interacting through a screen. \u201cPeople who struggle with eye contact or feeling like they need a little space can relax and connect with the therapist more,\u201d she says. \u201cThere\u2019s a built-in distance, so you get to stare at them without breaking a social contract.\u201d<\/span><\/p>\n

“It\u2019s hard for me to imagine how just talking about something will effect lasting change.”<\/span><\/p><\/blockquote>\n

Virtual care doesn\u2019t always cut it; some health issues need to be addressed in person. But distance can actually benefit somatic therapy, Denbrough says. One goal of body-centered therapy is mindfulness, which patients learn by actively noticing and describing their physical sensations. In an in-person session, a therapist might play a supporting role in this exercise by making observations about, say, a patient\u2019s body posture. But in teletherapy, a therapist usually doesn\u2019t have a clear view of a patient\u2019s whole body, and thus can\u2019t make the same kind of observations. In the long term, patients can benefit from being forced to develop and hone bodily awareness without any assistance.\u00a0\u00a0\u00a0<\/span><\/p>\n

Ogden, who offered webinars for clinicians who want to offer body-oriented approaches through telehealth, says she hopes they become more prominent and available to the growing number of patients who need help managing trauma symptoms.\u00a0<\/span><\/p>\n

\u201cIt\u2019s hard for me to imagine how just talking about something will effect lasting change,\u201d she says. \u201cUnless physical patterns can shift alongside with cognitive and emotional patterns, I don\u2019t think someone\u2019s change will be as far-reaching as it could be.\u201d<\/span><\/p>\n

\n

Ready to book a therapy appointment? Visit Zocdoc.<\/span><\/a><\/span><\/h1>\n","protected":false},"excerpt":{"rendered":"

Body-focused therapy helps people manage physical anxiety, in person or through a screen. <\/p>\n","protected":false},"author":26,"featured_media":18778,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[231],"tags":[12,41,71],"class_list":["post-18910","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-patient-stories","tag-anxiety","tag-mental-health","tag-therapy","reviewer-dr-nassim-assefi"],"yoast_head":"\nI'm Not In Therapy to Explore What's On My Mind - Patient Stories<\/title>\n<meta name=\"description\" content=\"Body-focused therapy helps people manage physical anxiety, in person or through a screen.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.zocdoc.com\/blog\/patient-stories\/i-dont-do-therapy-to-explore-whats-on-my-mind\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"I'm Not In Therapy to Explore What's On My Mind - 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