The Mind-Body Connection
"Somatic therapy is just about understanding the body, listening to the body and trying to express the charge that's contained in the nervous system."
What does anxiety or depression feel like? How can you calm your nervous system? Can you retrain your brain after experiencing trauma?
Blair O’Hara is an Australian psychotherapist with a wealth of experience in helping people heal from trauma. Through use of techniques like somatic therapy and cognitive behavioral therapy, Blair focuses on calming the nervous system and developing coping mechanisms to help the brain reframe thoughts associated with trauma.
In this episode, Blair explains how trauma and stress affect the brain, somatic and cognitive behavioral therapy models, and the importance of connecting the mind and body.
Read Blair's entire transcript below.
Blair O'Hara:
I'm a psychotherapist and I work mainly in anxiety, anger, family systems. And my primary modalities are somatic experiencing and CBT, which is cognitive behavioral therapy. So basically combining those two is working with the mind and the body. And I have a specialty in family systems, inherited trauma, developmental trauma, so how we kind of inherit the traits that we have, the patterns that we have, the emotional response that we have, whether they're kind of formed during our childhood, which is obviously quite common, but also whether they're generated through previous generations and their experiences. So quite a wide range of cases I take on, but yeah, I'm really positive about trying to help people live a happy life and with confidence that they can manage their emotions and their thoughts confidently.
Molly Casey:
Tell me about somatic therapy. It's fascinating to me and it's new as well to me. And I think it's something that a lot of people aren't fully aware of yet.
Blair O'Hara:
Yeah, it is an emerging therapy model. Somatic basically means body work. And so what we do when we're working in somatic therapy is trying to map out and understand the sensations that arise and subside when we're feeling certain things or when we're thinking certain things or when we're remembering certain things. Because the body, - I think we talked about the book, The Body Keeps the Score, quite a well-known book by Dr. Bessel van der Kerk. And the idea behind that is the body remembers traumatic incidents and events that happen to us. And even, I think it'll be relevant for our conversation today because it doesn't mean we even have to acknowledge what's going on consciously. The body is keeping track of all of the stimulus around us and it will kind of log it in the body. And so when we’re doing somatic therapy, we're trying to offer the body a chance to release things that it's never had a chance to release before because we have this tendency to suppress and bury certain emotions and certain thought patterns. So somatic therapy is just about understanding the body, listening to the body and trying to express the charge that's contained in the nervous system and helping facilitate a safe and as gentle as possible release of that energy so that person can kind of just regulate, it's all about regulating our nervous system okay so that we feel calmer more often we feel more comfortable more often we feel safer all as much of the time as possible so that's really what it's about in a nutshell.
Molly Casey:
How do you go about the process? Is it more mind-body connection? Is it through, I know CBT is the cognitive behavioral therapy, but is it all talk therapy? Kind of what goes into somatic therapy?
Blair O'Hara:
So somatic therapy is definitely an experience. Obviously we are having a conversation, we're talking through it, all the way through. But it's generally slower. So what we do when we do somatic work is we really try and slow down what we're paying attention to. And if there's a certain thought that's triggering distressing emotions, then we just pause and we go, okay, so you're having this thought, and what do you notice in your body when you're having this thought? Okay. And then all of a sudden people start paying attention to the little subtle tension points, the stress points, the heavy points that we all kind of get within our bodies, but we're not really slowing down enough to pay attention to it. And so when we do that, we get kind of a feedback from the body. And so for example, you might have a knot in the stomach when you think of a certain person or when you're remembering something, right? Or if, just give you an example, through like a painful breakup, right? Often, you know, it's in the chest that we feel a lot of tension, we feel heaviness, right? So it's like, okay, well, what's going on with this feeling in the - in the chest or in the stomach or wherever it might be. And then we - basically, what we're trying to do is just allow for the impulses that were that are being stored in there when we're feeling heavy or tight or stressed in certain parts, it means that the body’s holding kind of trapped energy, right? That really wants to get out and just release itself. So to give you an example of something that's really healthy and that we all would do. So let's just say you've heard something really funny, like you've heard a funny joke, right? So that's a trigger. So you're triggered by the joke. You laugh, you laugh, you laugh, you laugh. You can laugh for 10 seconds, you can laugh for five minutes. You know what I mean? Like you're just having that funny, great experience, right? And then, you know, it kind of subsides and you kind of slowly catch your breath again and come back to normal and then and then you're feeling just normal again. Right. So that from joke to feeling normal again is a cycle of an emotion, emotional flow. Right. But what happens when we feel something, when we're angered or when we're put in a stressful scenario, the emotion rises. You have the trigger, the emotion rises, but we put a break on it, it’s called a self protective response because we don’t want to risk us becoming overwhelmed right and so then this energy hasn't moved anywhere okay and so then it gets kind of stored in the body this is what it means and so what we try and facilitate with somatic therapy is the release of that energy just in the same way that the funny energy would move through without any resistance because there's nothing to block it this is what we’re trying to facilitate, things that have been stored up. So it doesn't matter how old it is, it could be 40, 50 years old, some trapped memory that hasn't had a chance to move. And so yeah, we're just trying to offer a safe and guided process to allow people to kind of let some of these emotions and energy go through.
Molly Casey:
Is there a specific emotion or experience, say PTSD or something of that nature, that does best with somatic treatment?
Blair O'Hara:
Yeah, so PTSD was one of the original cases that Peter Levine, kind of the developer, the founder of somatic experiencing model began with. He worked with veterans in war-based kind of traumatic scenarios and found that the approach, because it's the effectiveness of somatic therapy is that when we're avoiding overwhelm at all costs because what we don't wanna do is have anyone re-experience or become re-traumatized by remembering something painful from the past, right? And so PTSD has been, you know, one of the things that somatic therapy's found to be really useful for. It's a slow process because you have to be gentle and you have to honor what the person's gone through and just maintain their safety at all times. So that's another kind of pillar of the semantic model is rebuilding a sense of safety within someone's nervous system. And that can help offset the impact of PTSD where there's a constant feeling of threat. So the antidote to that is trying to rebuild a sense of safety. So semantic therapy is really all about bringing those foundational elements that make us feel okay again and that can dissolve a lot of the symptoms and yeah impact of PTSD.
Molly Casey:
When someone starts somatic therapy, do you have them talk through what the traumatic event was or is it just taking it bit by bit?
Blair O'Hara:
Yeah, great question. So the somatic approach is bit by bit. And often we work with things that are more of an incidental nature. You know, you're not going to go right into the core of the trauma from- in the first session, you might kind of broadly discuss it. So you've got a context of what's going on, but you don't have to. And what we're looking for is actually the thing that the person feels most comfortable exploring at that point in time. Okay, and the beauty of that model is that if you start to work with things that are more of a mild nature and you resolve them you have that energy kind of pass through the body then guess what the person actually built some capacity to deal with some more of the heavier work, So the bit-by-bit approach is part of the model that's proven to be quite effective in working with kind of severe trauma. So you never go into the trauma quickly and if you can avoid going into the deeper memories of that trauma then you would do that if you could. Sometimes it can't be helped like it's just present and the person will bring it up then you work with that but you just make sure and we're keeping track of the body the whole way through so if we get a sense - and there's things that happen our eyes dilate our body definitely starts to move if we get a sense that someone's going into an overwhelmed state, then we’ll try and resource them, bring them back out of that state. And again, just to feel comfortable, right? So we're working in comfort, we're building a baseline of comfort. And then what we're trying to do is get people to experience a bit of it, but not too much. And then we bring them back to comfort. And in that process, we call it pendulation, where you swing from comfort into exploration of the symptoms, that offers the release of whatever's being stored in the body. So yeah, the model's been fairly well defined and yeah if you follow it it's quite yeah it's really quite useful
Molly Casey:
And you also were talking about CBT, or cognitive behavioral therapy, and that's similar to somatic in some ways. Can you describe cognitive behavioral therapy?
Blair O'Hara:
Yeah, sure. So there is a lot of overlap, but the focus is more on how we manage our thoughts and how the impact of our thoughts have on the rest of the system. So when we're exploring CBT, cognitive behavioral therapy, we're looking at, well, what thoughts are you repeating in your mind and what kind of impact is that having on your emotional state, your somatic state, the way your body responds and also what you do actions and behaviors. Right. And usually what happens if there is a repetitive thought it will trigger quite a predictable emotion, a predictable set of behaviors and a predictable physiological response. Okay and what we do in CBT is and where it's effective is if you're feeling a certain way and you feel like you're stuck so you might have heard someone say I feel really stuck I'm just bogged down I can't get out of it. Well often what people are trying to do is get completely unstuck all at once and try to move this big boulder of distress all at once and that's hard to do. So the CBT model is “well, let's look at the different elements, our thoughts, our emotions, our behaviors and our physiology and what part do we have an ability to influence.” And so usually because the mind's so flexible we can come up with different thoughts and okay if we can come up with a different thought that's equally valid to the thought that you're having how might that affect your mood, how might that affect your emotion and behavior. And what we find is if we have a different set of thoughts, it will create again a new set of emotions, a new set of sensations, a new set of behaviors that are more beneficial to the person. So it's really about exploring the range of our experience and helping people feel that it's within their power to influence their cognitions, their thoughts, to create a different experience. Yeah, and so reframing thoughts is a big part of that model. And also, we often think irrationally. So if someone says hi you always do such and such like the always part that always word is not usually true like someone may do something but they don't do it all the time like like they definitely don't and we go to go through that. Well, like is that thought actually real? Is it true? It's partly true, but it's not all true. And so when we take the absoluteness out of our language and actually can soften the way we feel about it. So people say, I never and I always, and that's if we can get away from that type of thinking, it can actually help us be a little bit calmer about processing what we're thinking. Yeah, so it's really kind of looking at our thoughts more precisely and saying, what can we do with those thoughts to create a different experience?
Molly Casey:
So in a way, is it retraining the brain?
Blair O'Hara:
Yeah, it can be. Yeah, definitely. If you practice it enough and there's a lot of exercise you can do to kind of look at it as a skill, like being aware of what thoughts we're having and the ability to have some influence over them is a skill. And yeah, and you can develop a pattern of noticing what's going through your mind, readjusting, reframing. I have a lot of people do this. It doesn't take that long actually. And yeah all of a sudden they’ve gone from going down a slippery slope of you know not feeling great, thinking too much, getting them down, to okay I can reframe this and I can kind of reset and get on with my day just as I would like to. So, yeah so in some ways you could see it as retraining the brain and the brain adjusts quit e quickly once you kind of set it on the path that you'd like it to kind of follow so yeah it's kind of true.
Molly Casey:
Are there specific conditions that work best with CBT?
Blair O'Hara:
So CBT has had a lot of research done and a lot of studies. It's considered kind of the gold standard in psychotherapy purely because it's been around for a while and it's had the most efficacy tests done with that across different countries, different studies. And so it doesn't mean it's the best, but it's proven to be very reliable across a range of cases. But it's very useful for generalized conditions like anxiety. It's great for anxiety, great for depression, it’s great for kind of anger, it's great for kind of grief and loss. So a lot of the things that a typical experience have pro