Therapist, trainer, writer

 

 

 

 

 

 

 

 

Embodying the Sense of Self

 Extract from a chapter first published in New Dimensions in Body Psychotherapy, edited by Nick Totton. Open University Press, Maidenhead, England. 2005.

by Linda Hartley

The first movement of life is the rhythmical expanding and condensing of the fertilised cell as it absorbs energy and nourishment, and releases wastes. The rhythmical movement of expansion and condension, filling and emptying, underlies the basic pulse of life; the beating of the heart, the pumping of lungs, cycles of activity and rest in daily life, of giving and receiving in relationships, of bringing to birth and letting go in death, all reflect this fundamental pulsation between moving out and moving inwards, and health and sickness depend upon it. If we block the natural cycling of energy, trying to hold to one arc or the other, imbalance is created and somewhere in the bodymind the seeds of disease are planted.

In my practice of Authentic Movement, a discipline which has roots in dance movement therapy, Jungian psychology, and mystical practice, I found myself exploring over many months and years a gesture of opening reaching out. I discovered many aspects to this gesture; I could reach in longing or fear, reach to touch with tenderness, to hold onto in need; I could reach out to offer, to give; I could reach out to surrender and receive. The movement stories evolved over a long period of time until there was a moment when I simply stood, hand held out in front of me with upturned palm, simultaneously offering and receiving. How simple, yet how complex it actually is to allow ourselves to offer and receive freely. The web of conditioning, prohibition, rejection and punishment, which interweaves throughout our formative years, forms a veil obscuring this free exchange of energy.

Interruptions of our basic impulses to open out to the world and move back in towards ourselves will be reflected in the body as patterns of muscular or organic tension, weakness, or flaccidity; in cardiovascular, respiratory and digestive cycles, sexual function and the immune response; and in the quality of holding, permeability, rigidity and responsiveness at the cellular membranes. Physiologically this balance is regulated through the autonomic nervous system, with the parasympathetic branch stimulating internal processes of digestion, rest and recuperation, and the sympathetic branch enabling us to attend outwardly to challenges, goals and potential threats. Within the psyche an intrinsic need to periodically turn inwards for renewal and deepened connection to self, then outwards for self-expression and growth, also regulates cycles of inward and outward focus. Keleman writes: ‘If you want to know yourself, slow down. Stop what you are doing. But if you want to grow, if you want to form yourself, you must actively express yourself.’ (Keleman 1975: 124)

As the embryo and fetus develops, various functions evolve which mediate cycles of inward and outward flow. The nervous system begins to develop at an early age, but only as nerves myelinate (are covered in a fatty insulating sheath) can they function with precision and efficiency. Motor nerves, which travel from the inner core of brain and spinal cord to the body peripheries, myelinate before sensory nerves, which complete the cycle by returning from periphery to centre. First I move, I express myself, then I receive sensory information about that movement, and thus I come to know myself (Cohen 1993: 118). I also come to know the world as I touch, taste, bump into, fall against its surfaces: ‘We can never touch just one thing; we always touch two at the same instant, an object and ourselves, and it is in the simultaneous interplay between these two contiguities that the internal sense of self is encountered ..... By rubbing up against the world I define myself to myself.’ (Juhan 1987: 34) This is how the fetus and infant begins to learn about self, other, and the interplay between them. Through this play she lays a foundation for the way she will balance movements out into the world with returns to centre, to self and self-knowing.

A number of specific movement responses, primitive reflexes, are also developing; a specific stimulus will, if the infant is in a receptive mood, elicit a specific response. Primitive reflexes mediate movement towards or away from the stimulus; these movements underlie bonding and defence, both of which are essential for the infant’s survival and offer a neurophysiological basis for the way she will learn to negotiate her relationship to others and to life (Hartley 2004: 110).

Cohen describes movement as a sensation, and movement and touch as the first senses to develop (Cohen 1993: 114). They form the foundation for growth, learning and engagement with the world. From the earliest days of life in the womb experiences are imprinted within the fetus’ developing nervous system from self-generated movement, the sensations this creates, and information coming to the fetus from outside; this process continues throughout infancy and indeed throughout the whole of life. This information colours the sensory-motor patterning that is being laid down in the developing neuromuscular system, and will affect how the infant births herself, how she feeds, bonds, learns to crawl, to reach out, how she plays and socialises. It will be reflected in the movement patterns that emerge and the postural attitudes these patterns coalesce into. Layers of experience will accumulate upon early learning processes which begin in the womb, and all areas of development - emotional, social, intellectual and spiritual - will be supported or influenced by underlying cycles of sensory-perceptual-motor response, the inward and outward flow of energy, information and desire.

Movement and Touch in Psychotherapy

Because the process of early learning and psychological development is so intrinsically embedded within somatic process, the use of touch and movement in psychotherapy can offer a potent entry into the realms of perinatal and preverbal experience; here the early roots of disturbances can be explored. I draw upon the theory and practice of Body-Mind Centering®, an approach to somatic movement therapy developed by Bonnie Bainbridge Cohen (Cohen 1993; Hartley 1995); and Authentic Movement, originated by Mary Starks Whitehouse and further developed by Janet Adler, Joan Chodorow and others (Pallaro 1999; Adler 2002; Chodorow 1991).

Both of these approaches invite dialogue between consciousness and the unconscious through movement, body awareness, touch and dialogue. Creative expression through dance, artwork, writing and voice may also be used to integrate into consciousness experiences accessed through the body. The process of giving language to somatic experience reflects the development of the sense of a verbal self. As the infant begins to master language, some areas of experience become difficult to communicate. They may be experienced as threatening or unacceptable, and become relegated to the shadows, forming the private or disavowed self (Stern 1985: 228). Through bringing into creative form and language the experiences encountered in movement and bodywork, we can begin to heal the rift created between ‘interpersonal experience as it is lived and as it is verbally represented’. (Stern 1985: 162) But first let us return to the beginning, to preverbal and perinatal processes, and to birth itself. 

Infant Movement Development

The process of infant movement development is a foundation of Body-Mind Centering® practice. During development the fetus and infant embodies a series of movement patterns inherent within the human nervous system; they reflect the evolution of sentient life from single-celled amoebae to humankind with our complex bipedal locomotion. Embodying and clarifying these movement patterns, with a therapist’s guidance and support, can help both child and adult to achieve greater strength, coordination and gracefulness in their movement, and posture can be improved; positive changes are also witnessed at other levels of functioning as neurological pathways are reorganised. Mills and Cohen describe developmental movement therapy with children whose emotional, social and mental skills improved as a result (Mills & Cohen 1979).

The movement patterns embody important developmental tasks with which the infant is engaged in the process of developing a sense of self, a healthy psychological core (Hartley 2004: 95-137). For example, in utero movement which is organised around the umbilical centre enables the fetus to begin to develop a sense of coherence, of being a whole with separate parts that are nevertheless connected. Self-coherence is one of the invariants needed for the development of a sense of core self (Stern 1985: 82-9). In utero, and during and after birth, touch to the skin is also crucial to the development of self-coherence, the sense of being a unified and boundaried whole.

Birth involves a monumental effort on the part of the infant and is a powerful act of agency, another of the invariants crucial to the development of a sense of core self (Stern 1985: 76-82). Then as the newborn begins to feed, she discriminates what is and is not desired, expressing her first ‘yes’ and ‘no’ as she turns towards or away from the breast in the rooting reflex.

Through yielding weight into earth or mother she bonds, then gradually finds the pathway to separate through pushing herself up out of this supporting ground; she is laying the foundation for developing independence and interdependence, the sense of being a separate yet related self. Soon she is reaching out in desire, curiosity, play, or fear, and drawing in to grasp, embrace, incorporate into herself; she is now fully engaged in the world of relationship. The experience of these movements will be coloured by the infant’s sensations, emotions, and the responses of others; these tones will become embedded into the movement experience, giving each person their own idiosyncratic movement signature. As a child or adult going back to embody these early movements, memories and feelings related to the original experience may be evoked, and insights can emerge from consciously reinhabiting the moving body and the memories held within it.

The process of movement development involves a powerful impulse outwards. From the confines of the womb there is a gradual emergence, unfolding, opening to ever wider and higher horizons, as first gravity, then space are mastered. There are many spiralling turns in and out, but the overall thrust is up and out. I am talking here about a healthy and unhindered development, and a birth that is natural, well-supported and free of unresolved trauma. When things go wrong we see the strong and passionate impulse of the infant and child to radiate and extend outwards become inhibited, restricted and fraught with fear or rage. This will manifest in blockages of energy within the body tissues and in restricted patterns of movement, perception and behaviour, as the natural cycle of sensory-perceptual-motor response is interrupted or inhibited in some way. As the child grows and other experiences become layered upon these powerful early imprints, they will be influenced by and may reinforce early patterns of disturbance that have not been resolved.

Birthing the Self

When a traumatic birth is not resolved the child (and often the mother too) is left in a state of shock which creates imbalance in the autonomic nervous system; the great challenge of birth stimulates sympathetic activity in the infant, which then needs to be modulated by quiet rest, nursing, and comforting contact to support parasympathetic activity, as well as bonding. When this does not occur the natural cycle of activity and rest - the movement outwards followed by the return inwards to centre - is disrupted, and various physiological and psychological problems could evolve.

Sam showed such an imbalance; he tended towards hyperactivity or emotional collapse, and could not relax into recuperative states of creative rest or quiet interaction. He showed high muscle and organ tone in the centre of his body, with limp, flaccid extremities which did not support his meeting and full engagement with the world; the strong outward thrust of birthing energy had been blocked and turned inwards, locked into his body tissues. Sam was five years old when he first came to therapy; his development was being seriously hindered by unresolved birth trauma and the bonding failure which ensued. Because therapy with a child has to occur through bodily expression, and because a young child is still close to and involved with their birth experience, Sam’s process vividly elucidates some of the ideas outlined above.

Sam’s mother, Lianne, described him as tense and hyperactive with low concentration and movement problems; he had not been ready to start school that year and was attending a nursery school with children much younger than himself. He was uncooperative and would sometimes attack other children or hide under a table. She was concerned he would not be able to attend school and would be diagnosed as having special needs; she feared he might be autistic, or would grow up to be a ‘delinquent’ adolescent. Her immediate goal was to get him accepted into school the following year. Their relationship was also difficult; Lianne found Sam’s states of high energy and high-pitched screaming intolerable, and tension would escalate between them until they got into a ‘vicious cycle’ which she could not find a way out of. This could be an expression of feeling trapped in the birth canal with ‘no way out’; Sam may have been trying to show his mother what it had been like for him, how intolerable his experience was.

When Sam arrived for our first meeting he burst into the large room where we were to work, racing around for some time wildly kicking the big green ball. I saw the limp hands and tense shoulders, the flailing arms, and the lack of clear organisation in his body. Sam’s spine was rounded over, as if he had not fully emerged from the enclosed space of the womb; his forehead jutted forward and his head was slightly turned and tilted to the right. He tended to run in curves rather than straight forward, following the angle of his head; again I was reminded of birth, as if his head were caught in the moment of spiralling through the birth canal, frozen in time, and the extension of his spine and the realigning of head with body had not been completed. I saw an interrupted birth process, and on asking Lianne about his birth she was clearly relieved that I would consider this relevant, affirmed and supported in her own feelings and concerns. This helped to build trust between Lianne and myself, so crucial if Sam’s therapy was to be successful.

Lianne’s father had died seven months into the pregnancy and a difficult relationship with her mother had added to Lianne’s emotional stress during this time. At birth Sam presented with his forehead instead of the crown of his head, which led to a long and difficult labour. Eventually forceps were used; because of his position there was a risk that his eye could have been damaged.

The birth was traumatic for both mother and child and Lianne described being unable to bond with Sam afterwards, suffering a long period of depression during which she stayed at home most of the time. Sam missed out on a lot of physical activity, play and social interaction that would have helped him develop physically and psychologically. Lianne felt guilty about what had happened and wanted deeply to help him; her commitment to this task did undoubtedly support Sam’s therapy, and she was very much part of the process. The healing of their relationship was an integral part of our work. In therapy with adults we work with the remembered and internalised parents of childhood. It was both fascinating and complex to work with Sam and his mother together, as we sought to repair the early trauma and bonding failure they had both suffered.

One aim was to restore balance within Sam’s autonomic nervous system, alternating periods of high activity which supported Sam to find channels to release the held energy in a creative and organised way, with periods of quiet rest and inwardly focused attention. In the beginning there was little respite from activity and Sam would quickly reach a threshold of tolerance beyond which over-excitement would lead to aggressive behaviour or distress. A first moment of contact was made when he finally lay over the big green ball and allowed me to gently touch his back and rock him, with a focus on supporting him to release weight and the tension in his organs; for a brief moment there was a qualitative change in energy and attention as he became still and quiet. He moved in a more measured way after this.

Over time Sam allowed more such moments of contact. On one occasion he was able to receive a very gentle contact to his forehead, the part that had led him into the desperate birth struggle. He settled into a quiet parasympathetic state, as if listening inwardly and recognising that something different was happening. After this he readily accepted and often sought contact and bodywork experiences, offering a foot to be held, or his head to be touched, or leaning into me for fuller body contact. Through touch and gently guided movements I could work to repattern the distribution of energy throughout his body and support the integration of his posture, movement patterns, and muscle and organ tone.

Aligning his head, spine and limbs and feeding gentle compression through the bones and joints helped Sam to begin to find the core of support which the skeleton provides. As his spine aligned more centrally Sam was beginning to develop his sense of core self, expressed in a growing confidence and boldness. The work through the bones also helped him to yield his weight into gravity and to push - first against my hands, then against the floor as he learned to integrate the early crawling patterns which he had not fully embodied. Learning to push through his hands and feet was essential for Sam to learn to make boundaries, to establish his sense of core self, and to be able to separate from his mother. Engaging with these movements Sam was also revisiting his first separation from mother, his birth experience, but in a playful way which allowed him to develop his power.

Through integration of his spine, pushing through his feet, and gentle work with his head, Sam was being ‘taught’ the movements of birthing. At this point in the therapy he began speaking about being in Mummy’s tummy, and often regressed into baby talk and play with Lianne. During one session he was leaning against me, his head in my hands and his feet placed against Lianne’s feet. He suddenly found the power to push her right away from him. He then turned around and did the same thing with his feet pushing against me - clearing space, pushing us away, he was making space for himself, preparing for birth.

The birth moment finally came gently and Sam discovered it all by himself. He began nuzzling his head into a soft ball which he liked to play with and rest on. He came onto his hands and knees and began purposefully rolling and pushing the ball across the floor with his head, flexing and extending his neck and spine to do this - the movement which initiates birthing. He travelled in a wide arc, deeply engrossed in the movement, then emerged and crawled onto Lianne’s belly where he lay for some time, resting. Lianne did not know what he was doing but felt it was important and told me afterwards she was moved to tears, just wanting to stroke and kiss him as he lay there. Sam had completed his birth process, even crawling up to his mother’s breast as a newborn will do if laid on her belly after birth, and this time she had been able to welcome him with love.

Soon after this Sam took some tests which would determine whether he would be selected for a place at school. He did very well and was offered the place. The doctor praised him and Lianne felt proud of her son; Sam’s progress had been generously affirmed. 

Embodying Relationship

The action of pushing allows the body to extend fully, and Sam had been finding the pathway to unfold out of his curved, fetal posture. Fully embodied pushing naturally leads into whole-hearted reaching out and into relationship. A game of pushing with his feet against my hands to roll over the green ball and reach with his outstretched hands towards Lianne, who sat in front of him, became a favourite; he was embodying the necessary task of separating from mother in order to come into relationship with her as a separate individual. Alternating with the pushing games there evolved lots of affectionate embraces and cuddles, their bodies learning to mould together, to bond. Cuddling had formerly involved Sam being very clingy or hurting Lianne, and Lianne drawing away; now they were finding a way to be together in intimacy. Sam was learning through his body to negotiate the complex relationship with his mother, and she was now able to respond. Stern claims that an infant must first develop a sense of core self in order to relate to and experience merging with another: ‘[T]he infant’s first order of business, in creating an interpersonal world, is to form the sense of a core self and core others ..... [T]he capacity to have merger- or fusion-like experiences ... is secondary to and dependent upon an already existing sense of self and other.’ (Stern 1985: 70) With a clearer sense of himself, Sam was now able to enter into intimate moments with his mother without the fear of being swallowed up.

The pushing games Sam now loved to play were usually high energy activities, and in time Sam came to know when he was tired and in need of rest; he was learning to self-regulate his levels of activity and rest as his nervous system came into better balance. He learnt to throw, catch and kick a ball, which he had been unable to do before. Ball games demand full externally focused attention, quickened reflexes, challenge eye-hand-foot coordination, and require alertness of the body extremities, all of which Sam needed. This could help him release held energy and the tension created by an overactive sympathetic nervous system, and support fuller engagement with his world.

After the birthing process Sam needed to create his own play, and invented games which helped him to deal with difficult feelings, acting out inner dramas and finding his own creative solutions. He evolved a game of ‘piggy and wolf’ where I was the bad wolf-mother and had to try to catch him, the baby-piggy; Sam was able to work out this transference in a safe and enjoyable way through the game. He created four ‘safe houses’ in the room where he could not be caught, and would spend a long time in one of his houses before tricking me to look away or running very fast to another place of safety. With slight variations, we played this game for many months as he learnt to deal, at another level, with his need to separate and protect himself from the devouring wolf-mother - first physically through the pushing games, and now symbolically through story. Eventually he learnt to symbolise the safety; now he could run freely about the room but if he was forming a letter T with his fingers, he was safe and could not be caught.

On one occasion Sam became very upset and left the room; I followed and sat with him until he could articulate his feelings. He was angry because Mummy had rescued a ball from under the cupboard when he had wanted to get it himself. Every child must go through this development, but it may have had special significance for Sam because of his forced delivery at birth. With support he was able to tell Lianne of his anger; he was learning to differentiate and express his chaotic feelings, and this incident led to them finding ways to negotiate boundaries together.

Sam developed a passion for drawing and this became an integral part of our work. In the drawings, too, he was expressing and resolving difficult feelings and dynamics within the family. His first drawings were of black monsters, robots and devils. One day he surprised us by producing a flower; I was touched to see this and, perhaps recognising that it was meaningful for me, he offered it to me at the end of the session. I later had an opportunity to compare it to a Little-Red-Riding-Hood doll that transforms into Grandmother-and-the-Wolf, which he had been fascinated by; I told him it reminded me of his drawings, the black monsters transforming into the beautiful red and yellow flower. He gave me a long and focused look which communicated to me that he felt seen. He was emerging from his dark inner world into a world of colour and light. After this, colourful and inventive stories began to evolve through Sam’s drawings, telling the story of his inner emotional life.

Sam was now seven years old, doing well at his new school, had made many friends, and was growing into more independence. A new level of separation was occurring as Sam looked towards a wider world of school and friends and activities that took him away from mother; he was also  ready to end therapy. His drawings showed he had internalised a good and nurturing mother and learnt to mediate through his creative play the difficult and frightening feelings that had once overwhelmed him.  

Working with the Child in the Adult

Working with early wounding and perinatal trauma in therapy with adults will of course look different from therapy with a child, but there are many similarities in the core issues and the process of therapy. In both adult and child the exuberant expansion of energy outwards has been inhibited, and bodily tensions and weaknesses reflect underlying psychological contractions or dissociation. Each has struggled in his or her own way to connect to and express from an authentic and vital sense of self, and been thwarted in this to some degree. There is an infant-self seeking to grow, expand, and engage fully with life, but fear and unresolved trauma inhibit this.

As for the child, bodywork and movement can help the adult client integrate a more fully embodied sense of core self, which is a foundation for development in the domains of relatedness and symbolisation through image and language. In working with early disruptions to the sense of self in adult psychotherapy, I might combine work on infant movement patterns with bodywork that seeks to free energy blocked in the tissues and integrate areas of the body that feel disconnected or dissociated. By bringing conscious awareness into specific tissues information can be accessed as to how energy is flowing or blocked within them, and the quality of responsiveness and integration between tissue layers and body areas may be sensed. Memory and feeling held in the tissues might be accessed and can be explored and integrated in various ways.

As described in Sam’s story, movements which support the ability to push can also help the creation of personal boundaries and empower the adult client to, literally as well as metaphorically, ‘stand on his own feet’; it is important that the client is helped not only to regress and resolve early issues, but that he is supported to continue the developmental journey up and out towards individuation and healthy functioning in the world. Themes of reaching out for contact and relationship, or towards goals, may also be addressed using movement as a support for exploration and integration of the complex themes that can be involved; embodying early movement patterns can facilitate access to unconscious memories and feelings related to these issues, uncovering the needs and longings, the fear and shame as well as the joy of reaching out for what we desire. 

Concluding Words

This article has explored the use of touch and movement in psychotherapy, relating Stern’s theory of the development of the senses of self to the therapeutic application of infant movement development from the perspective of Body-Mind Centering®. A description of therapy with a young child demonstrated how bodywork and movement repatterning facilitated the development of a sense of core self; this supported psychological and relational growth, helping to heal a disturbed attachment pattern between the child and his mother.

References 

Adler, Janet (2002) Offering from the Conscious Body. Inner Traditions. Rochester, Vermont 

Chodorow, Joan (1991) Dance Therapy and Depth Psychology - The Moving Imagination. Routledge, London and New York 

Cohen, Bonnie Bainbridge (1993) Sensing, Feeling and Action. Contact Editions. Northampton, MA 

Hartley, Linda (1995) Wisdom of the Body Moving - An Introduction to Body-Mind Centering. North Atlantic Books, Berkeley, CA 

_______ (2004) Somatic Psychology - Body, Mind and Meaning. Whurr Publishers Ltd. London 

Juhan, Deane (1987) Job's Body - A Handbook for Bodywork. Station Hill Press, Barrytown, New York

Keleman, Stanley (1975) Your Body Speaks Its Mind. Center Press, Berkeley, CA 

Mills, Marghe & Cohen, Bonnie Bainbridge (1979) Developmental Movement Therapy. School for Body-Mind Centering, Amherst, MA 

Pallaro, Patrizia, editor (1999) Authentic Movement. Jessica Kingsley Publishers, London & Philadelphia 

Rothschild, Babette (2000) The Body Remembers: The Psychophysiology of Trauma and Trauma Treatment. W.W. Norton & Co., New York & London 

Stern, Daniel N. (1985)The Interpersonal World of the Infant. Basic Books, Harper Collins