(Photo by Ursula Noboa. Manu National Park, Cusco, Perú)
Introduction
Lately, there has been a surging amount of interest in the topic of embodiment within the health sciences. What I find very interesting is that as humans it seems possible for us to actually live our lives in a “disembodied” way. To me, this would be a real possibility only if our sense of self is not fixed to a specific location of our physicality. Most mainstream sciences would have us think that the location of our identities resides in our heads, following the presupposition that we are nothing but the result of our brain’s neural activity, leaving our bodies as nothing more than machines we control from our heads. Another factor at play is the exaggerated importance and blind faith we have put on the human intellect to solve all of our problems. This way of understanding ourselves is also fueling the growing epidemic of disembodied human beings.
If we accept the idea that our sense of self is not just the result of brain functions, but an intentional force that enlivens, animates and organizes our entire physicality, then by relating to the “exterior” and “interior” worlds only from our heads, we would be greatly limiting our capacities of feeling knowing and being. By recognizing that our contextually constructed egos are just one part of our totality, we allow ourselves to step down from the “control room” of our ships and become the ship itself. This takes a great deal of humble trust in our body’s inherent intelligence and a letting go of the need to control all events in our inner and outer realities. As we allow ourselves to disidentify and gain distance from our mental-egoic representations and thoughts and allow ourselves to “drop down” and be from our whole bodies, we also open up to more authentic and present modes of relating with others. I will present theories that describe ways of being that honor all human dimensions while also considering the particular potentials of more embodied ways of being and how this would directly have a positive effect in the context of the therapeutic alliance.
Review of literature
This paper will be based on the Glenn Hartelius’s proposal of quantitative somatic phenomenology (QSP) as an epistemological framework in addition to his studies on body maps of attention (Hartelius, 2015) for describing the different somatically experienced locations of the self. Hartelius (2007) mentions that
“the stance of QSP is that, from the precisely defined and carefully regulated state-specific standpoint of phenomenology, not only the processes ascribed to the out there world by rational-empirical science, but also those assigned to the in here realm, can be described in terms of meaningful structure: size, shape, location and vector of movement relative to the body-as-experienced. It is in this way that QSP is ‘quantitative’, for there is an evaluation of dimensional structures within the phenomenological field of experience”. (p. 33)
QSP gives our experience as embodied beings and all ramifications that arise from that fact their deserved status as valid events worthy of study. This means that feelings, emotions, intuitions, and any other types of felt responses to stimuli that are not necessarily physical can be identified as coming from very specific locations in or around our bodies. Following Jorge Ferrer’s (2011) recently developed participatory philosophy, the separations of mind/body and subject/object are just illusions, understood as coconstructed rather than ontologically independent (Ferrer, 2002; Hartelius, 2006; Heron, 1996; Heron & Reason, 1997; Skolimowski, 1994; Tarnas, 1991). Marolt-Sender (2014) then talks about conscious experience as “not being relegated to a private interior domain” (p.18). Hartelius (2010) mentions that “there is no ‘inside’ or ‘outside’” (p.74).
If we really take these propositions seriously, then the boundaries that separate our physical bodies and the environment are also illusory. This idea could definitely lead to confusion in terms of understanding our sense of “locatedness”, for if we are not limited by our physicality, then fair questions would then be: are we then everything? have we not a realindividual substance that makes each of us unique? Spiritual traditions across the ages have relied on insights from mystics or “revealed” knowledge to answer these questions. My personal response would be that following Advaita Vedanta’s philosophy, we are everything (brahman), for our deepest sense of “Iness” points directly to an unchanging consciousness that is free from any qualities and is which shared by all that is. At the same time, we are also ourselves, for thanks to our “locatedness” we are immersed in the world in a very specific place and time, so that we take on a number of particular and unique qualities that respond to this context. It is then our sense of “I” that acts as a meeting point for the infinite, unchanging and sustaining consciousness, with its ever-transforming manifestation as the universe we know.
From this perspective, our bodies can be thought of as points of denser concentration of the intentionality of the universe for self-awareness. This implies a manifested reality where the interconnectedness of all beings and even non-living ‘things’ is one of its fundamental characteristics. Abrams (1996) mentions that
The “real world” in which we find ourselves . . . is rather an intertwined matrix of sensations and perceptions, a collective field of experience lived through from many different angles. The mutual inscription of others in my experience, and (as I must assume) of myself in their experiences, effects the interweaving of our individual phenomenal fields into a single, ever-shifting fabric, a single phenomenal world or “reality.” (p. 39)
Just as we are specifically located inside this universe, and our bodies play a key role in this phenomenon, our experience of “Iness” as subjects living from a body can also be understood as located and coming from a specific part of our bodies or primary energetic field. Hartelius (2015) mentions that “attention can be described not only in terms of its object but also in terms of whence it arises or originates within the lived experience of the body”. According to Hartelius (2007) we can equate attention with our located sense of Iness, the one which usually arises from in or around our heads, specially in the Western world.
To think of our felt sense of Iness as fixed to a particular location in our bodies would definitely limit our potential as human beings only to our intellectual and mental capacities. Marolt-Sender (2014) conducted a study on attention posture during flow-like states, from which she concluded that
while in flow-like states, a majority of participants located their central attention primarily in the trunk of the body rather than in the head… This provides preliminary evidence that central attention has a considerable range of variation in terms of its somatic location and suggests that attention posture may be specific to particular states of consciousness. (Hartelius, 2015, p.6)
From here we can consider the idea that different attention postures offer different qualities to our experience of being. There are a variety of theories and systems that try to ascribe different qualities to particular areas along our spine to the top of our head. For our purposes we will pay specific attention to Albareda and Romero’s (1991) Holistic Transformation model for multiple ways of knowing, based on different energetic centers along the center of the body: body, vital, heart, mind and consciousness. Malkemus and Romero (2012) mention that the mind center
reveals the capacity of discernment and discrimination. It is the dominant form of knowing in Western culture. While it is essentially whole-bodied, it is most readily known in the upper shoulders, neck, and head. The mind center offers clarity and insight, allowing one to articulate the dynamic and vague flow of experience. (p.34)
The qualities of the mind under this model seem to imply that it is an essential center for us as human beings. Some of the most unique and differentiating traits of our species depend largely on this center, so my intention here is not to demonize any intellectual or cognitive faculties and go back to a pre-rational evolutionary state, but to make sure that our mental capacity is actually acknowledging, working with and integrating input that depends on other ways of knowing. Of particular interest for this paper is Malkemus and Marina’s (2012) description of the qualities of the heart center:
The center that we term heart reflects a distinctly human wisdom that thrives in relationship and is profoundly sensitive to the fragility of finitude. Its pulse fills all of one’s being, but it can be most directly felt in the thoracic cavity, arms, and hands, especially the center of the chest. The heart center is the essence of humanness and the source of trust and innocence. (p.34)
For Strupp and Henry (1994) therapeutic alliance is the interpersonal process in the patient-psychotherapist dyad. Studies show that “regardless of therapeutic modality or technique, the strength of the therapeutic alliance is the best predictor of therapeutic outcome” (Radandt, 2002, p.52). After reviewing many factors that would help create a positive therapeutic alliance, Radandt (2002) concludes that “it seems crucial for a psychotherapist to be able to cultivate genuine human warmth with the client, an ability to track moment-to-moment fluctuations in process, and a presence and spontaneity that transcend formulaic interventions” (p.53). I believe that these three factors mentioned by Radandt are negatively affected by the tendency of therapists to be in a therapeutical relationship from a mind-centered attention posture.
The mind center’s capacity for discernment and discrimination takes place in a mental reality that is parallel to the event taking place in the ever-changing present moment. Even if for brief periods of time, when as therapists we switch to attend the mind’s urges to organize and draw conclusions about what is going on during therapy, we forfeit the subjective experience of the client for our own inner world, and I honestly don’t think anybody can do both at the same time. Arvidson (2000) wrote that
if shifts of attention in consciousness are essentially typical and regulated transformations of presentation, and if the three-part pattern of theme, thematic-field, margin is stable and continuous throughout even the most seemingly discontinuous transformations, then with respect to attentional shifts, consciousness does not necessarily go on holiday. (p.8)
For attention to be a stable process, it must arise out of a stable self, and since our Iness can’t be divided into two, splitting attention to handle both ‘internal’ and ‘external’ events simultaneously wouldn’t be possible. Depending on the attention posture or bodily location of our Iness, it is more susceptible to very particular qualities of information incoming from the distinct bodily locations it can occupy. An attention posture that ‘sits’ along the core of our spine and integrates information from the body, vital and heart centers is more prone to elicit flow-like states because of its state of non-identification with mental events. Instead, such a way of being opens us up to spontaneous and pre-rational responses to the present moment as it presents itself.
Of course, achieving flow-like states in the therapeutic setting is hardly realistic and probably not advisable. What is interesting about this, is that as Radandt (2002) concludes in his study, “more body awareness on the part of therapist tends to supports a stronger therapeutic alliance”, and also that “physical activity contributes to the therapeutic relationship” (p.56). Morrissey’s (2006) article on authentic movement talks how this technique can help us have a better embodied presence, bridging the gap between psyche and body. With this technique it becomes easier for the location of the self to move downwards from a head location to a body location while also facilitating the surfacing of unconscious material without the judging or organizing that the mind would normally undertake. This means that while physical activity does seem to play an important role in facilitating more embodied ways of being, the simple intention on the therapist’s side to be more aware of how the body reacts to certain elements of the therapeutic exchange seems to also be of high significance as far as allowing for positive results.
Bowes and Katz (2015) mention that “simulation-theory, on the other hand, argues that people do not go around with fairly sophisticated theories about the mind but rather use their own, sometimes fragmentary, bodily reactions to make inferences about others” (p.961-962). Radin and Schlitz (2005) concluded from their study on gut feelings, intuition and emotion, that “some somatic feelings may be associated with perceptions transcending ordinary sensory capabilities” (p.90), and that the “relationships commonly reported between gut feelings and intuitive hunches may share a common, poorly understood, perceptive origin” (p.85). This means that the levels in which our bodies actually act as sources of knowledge might be higher than we think. Whether we are conscious of this doesn’t seem to matter for I would say that even if our mind’s ability to override intuitive feeling is real, intuitive knowledge and automatic responses from our part seem to be evolutionary traits with thousands if not millions of years of practice. Now, intentionally considering our body’s inherent ‘intelligence’ and letting ourselves be guided by it certainly requires a great deal of humility on our parts. In animals this seems to be second nature, or more accurately, just nature. A trust in our own nature’s capacity to take care of ourselves better than all of our mind-ego’s continuous efforts to protect us from harm seems bold for sure, but for me, it seems to be the next step in our evolution as a species.
It would appear as if as human beings we are having to hit the ceiling of our glorification of our mental capacities in order to realize that we might actually need to ‘go back’ and reclaim a simpler way of being, where nature and her forces are revered and trusted. By this I don’t mean, like I said earlier, that it’s either an embodied way of living, or a mental-egoic one; it would be just as unfaithful to our nature and our potentials to neglect our mental capacities in favor of embodied knowledge. The integration of all human dimensions looks like the sensible way to proceed. For our purposes here, the integration of somatic input and our mental capacities would mean an intentional openness in our minds to the ever fresh and constant flow of data incoming and arising from in or around our bodies. As this happens, our mind’s tendency to judge all experience using pre-established rules and formulas is replaced by a moment-to-moment introduction to unique and unrepeatable events.
In the therapeutic context, Rand (2002) talks about how “somatic markers (Damasio, 1994, p.173) are defined as gut (visceral) feelings in the body of the therapist by which a particular response option is marked by a particular sensation” (p.30). Regarding how intense the therapist’s intentional effort to be present should be, it is important to first differentiate between awareness and concentration. Mikulas (2010) explains that there are three fundamental and omnipresent behaviors of the mind: clinging, concentration, and awareness. Clinging refers to the tendency of the mind to grasp for and cling to certain contents of the mind. Concentration refers to the focus of the mind. And awareness refers to one’s conscious experience of the contents, including properties of breadth and clarity (p.1).
He then continues to say that “although concentration and awareness are clearly different, they are very often confused and confounded. The main reason for this is that they are very intertwined. A change in one often produces a change in the other” (p.3). Taking this into consideration, clinging, as defined by Mikulas, would certainly be a quality to be avoided in the therapeutic container. As we mentioned before, clinging to certain mental events would prevent us from experiencing the unfolding of present moment. Concentration for me has to do with the intentionality of directing ones attention towards a particular ‘inner’ or ‘outer’ event, and for our intended purposes would serve as a prerequisite for awareness. Mikulas (2010) describes this process by saying that “quieting the mind with concentration makes it easier to be aware” (p.3).
It is with awareness then that our quality of presence in the therapeutic container can have its desired effects. For me, it is awareness which facilitates Carl Roger’s unconditional positive regard for the client and an “empathic understanding of the client’s internal frame of reference” (p.96). Finlay (2005) expands the Rogerian definition of empathy, mentioning that it is a relational process. Empathy here involves being a safe and steady human presence, being one who is willing to be with the client, whatever comes up. When clients go into therapy, usually they are able to articulate only a little of their troubles; much more is felt and sensed in what can be called an embodied and “more-than-verbal” way (Gendlin, 1981). (p.273)
This supports the claim that capacity to be authentically and empathically present with our clients is facilitated by our abilities to be in touch with our bodies responses. For this, an embodied attention posture from the core of the body seems to be the best option. When we are from our body’s core, we can, with practice, begin to seamlessly integrate all types of input coming from our different dimensions. Siegel (2013) wrote about the phenomenon of embodied resonance and described it as “when two or more come together, a sympathetic resonance develops that becomes interpersonal. There is a shared experience of the same emotional vibration that becomes intensified as they resonate together” (p.51).
An interesting study by Stone (2006) on embodied resonance in countertransference concluded that there are four factors that need to be met for the therapist to experience this:
- When working with borderline or psychotic patients.
- When the patient’s fear of strong emotion inhibits the possibility of the emotion or feelings being consciously and directly expressed in the analysis.
- When the analyst has a particular typology… The particular typology of superior introverted intuition, with auxiliary feeling or thinking, and inferior extraverted sensation… (p.118-122)
In answer to Stone’s question in his article to why not all therapists experienced embodied resonance, I agree with all three conditions proposed by him, but in the light of our study, it would be fair to suggest that the potential to experience this by any therapist depends greatly in his/her ability to conduct therapy from an embodied attention posture, and not from a mental-egoic one. Some concerns arise out of this. Is it desirable for therapists to want to deal with a number of physiological responses while also attending to the narrative material? and, how can one distinguish one’s own bodily cues from responses to external stimuli? These are questions that need to be considered. My personal view at this point is that from an embodied attention posture, the inclusion of physiological cues or somatic markers in the therapists’ awareness broaden his capacity to have a more accurate representation of the client’s subjective experience. Rothman’s (2011) article explores the dangers of not accounting for embodied resonance in countertransference and how this can negatively affect the therapeutic alliance:
Marty (2010) proposes that work with severely somatizing patients may provoke various difficulties in the analyst and may induce him to reject such patients. That is, a primitive narcissistic state may be evoked that can bring an actual experience of danger or self-destruction to the analyst. (p.27)
The idea that millions of therapists are not managing to be present with their clients because of not accounting for embodied resonance in countertransference is certainly worrying. This is of course something that might happen unconsciously and not something done on purpose, but more out of ignorance. Baer et. al. (2006) mention in their article that nonreactivity and compassion are actually “outcomes of mindfulness practice” (p.42), and not its components. For me, compassion and nonreactivity are necessary ingredients in the therapeutic container, so the degree to which any practice actually generates them on the side of the therapist is worth looking into. As it was mentioned before, the area around the heart center is especially “sensitive to fragility and finitude” (Malkemus & Romero, 2012, p.34), so conducting therapy from an attention posture around this center would make us more open to genuine compassion and care towards our clients.
Discussion
The evidence found in this article has pointed in the promising direction that, as the title proposes, the shift in the somatically experienced location of the self from a mental-egoic location to an embodied location may improve the therapeutic alliance. More research is definitely needed and encouraged on this topic. Training therapists to conduct therapy from more embodied attention postures would seem like a next logical step, in order to be able to gather large amounts of experiential data on this. A limitation that I see is that as our experience of identity becomes more embodied, we gradually become more permeable and open to the interconnective energetic matrix that unites us all.
This means that if we decide to call it like that, we would be coming closer to experiencing the divine in the here-and-now. So, rather than just assuming an embodied posture for the purpose of conducting therapy, my premise is that this should eventually conform our natural mode of being in the world. A relationship with reality that is open to the relative manifestations as well as to the divine within them can’t just be something one experiences for a little only to then go back about their business from a mental-egoic posture. Such a way of being requires practice and dedication, for relegating our egos to an equal rank as our other ways of knowing surely takes time and intentional effort. To this, Holloway (2003) mentions that
This spiritual practice of the everyday is fulfilled through a revaluation of the actuality, the moment-by-moment construction, of lived corporeal experience. As such, the everyday is (re)enchanted with a different mode of inhabitation or style of articulation that is felt, in its performance, to be sacred. (p.1972)
Conclusions
There is certainly a lot of work to be done around these constructs and ideas, but I think that we are living in an exciting era where our scientific methods are finally catching up and beginning to have glimpses of what most ancient spiritual traditions offer as their truths. The challenge for us is to devise ways of utilizing personal experiential insights from a few, and make them available to the masses, or at least to many trained therapists and people in the health sciences. This is of paramount importance, for like it has happened before when someone discovers something extraordinary, our tendency to want to impose such paradigms by force on others without having had the same experience is real. This is why we should focus on the creation of easily replicable ways of entering such embodied, and we also should able to describe the experience and categorize these experiences in quantitative and quantitative terms.
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