Embodied & Relational Ways of Working with Psychosomatic Illness & Dis-ease in Psychotherapy
CPD Zoom Weekend for Practising Therapists with Michael Soth
Sat & Sun, 13 & 14 April 2024, 15.00 – 21.00 EET
in English (with expert simultaneous Greek translation)
Organisation & Booking for therapists from Greece: Dimitris Tzachanis - info@gestaltsynthesis.gr
Booking & Payment for therapists from UK, US and elsewhere: Michael Soth - michael.soth@gmail.com
The therapist’s position: “I'm not a doctor.”
Even though counsellors and psychotherapists are traditionally expected to focus predominantly on emotional, mental and verbal communications, many clients invariably do bring their physical and psychosomatic symptoms into the therapeutic space.
After all, being ill and suffering symptoms and bodily pain very quickly goes beyond the physical and becomes an emotional issue, too. Illness makes us regress and we tend to feel helpless, scared or out of control, and most of us become more needy of emotional support. As therapists, we have, of course, no hesitation to offer that support, and that in itself is fairly straightforward.
When symptoms, illness and disease come into the therapy room
However, this workshop addresses those situations where the work goes beyond pure emotional support, and the therapist gets drawn into the tricky territory of the psycho-somatic and body-mind connection. Often, the recognition becomes unavoidable that the psychological and the somatic cannot remain neatly distinguished, but are in a constant mutually co-creative reciprocal feedback loop, in both illness and health. The psyche is embodied, and illness is a bodymind process: emotional conflict creates muscular tension and physiological stress; trauma creates intense neuro-biological activation affecting our hormonal and immune systems down into the microbiology of every cell. Our mental states are manifest and mapped into our bodies, and the state of our body in turn shapes and conditions our capacity for feeling and thought. It is now well established that developmental trauma early in life can create a life-long internal bodymind atmosphere that is detrimental to physical health and a predictor of chronic illness and psychosomatic symptoms later in life.
Because emotional and mental well-being are so interconnected with physical health, maybe the client has a point when they are bringing their illness, physical symptoms and bodily suffering to the therapist?
The minefield of the psychosomatic connection
So how can the field of therapy keep its task and focus only on the psychological processes as entirely separate from the body and its tendencies to manifest the emotional and mental subjective realities? How can the therapist turn a blind eye to the element of emotional suffering inherent in psychosomatic symptoms and illness?
As many practitioners know, this can become a minefield: on the one hand the client easily feels accused and shamed, as if the message is that they have created their own symptom and are responsible for it. In reaction against this common guilt and shame, many clients feel relieved by the idea that their illness is a purely organic, genetic, random physical affliction that can happen to anybody and has no emotional correspondence at all. The first category of clients feels totally responsible for their own symptom in an exaggerated irrational way, the second category refuses all connection and accountability in an exaggerated irrational way.
Getting involved with the body-mind problem in health and illness
As therapists we get caught and involved in these dualisms which are part and parcel of the client’s inner world. We cannot refuse to get entangled with these dichotomies, without the client feeling that we have removed ourselves to a comfortably safe, disengaged position, where we restrict ourselves to dealing with the psyche and leave the medical profession to deal with the body. The client will feel that this is an artificial distinction that fails to engage with the body-mind-psyche wholeness of their experience. They can only feel held by our care if we actively relate to the totality of their reality, and what matters to them. Physical pain and symptoms, psychosomatic disease and illness constitute a significant part of human suffering, and our clients need us to engage profoundly and competently.
The validity of the psychosomatic connection
With some illnesses - like hypertension, chest and heart problems, digestive illnesses, symptoms of the immune system - it is scientifically established that emotional stress contributes to their origin. With many other psychosomatic problems, like all kinds of pain, tinnitus, insomnia, chronic fatigue and many other unexplained symptoms, it is known that the intensity of the suffering can be ameliorated through psychological therapy that addresses the regulation and expression of emotion and de-stresses the mind.
Stress is the catchall phrase that supposedly explains the influence of our psychological body-emotion-mind state on illness. However, what is less well understood, is how our bodymind does not just respond to stresses in our current situation and lifestyle, but carries accumulated stress from the past, reaching all the way back to childhood. A holistic and bio-social-psychological understanding of stress needs to include lifelong patterns of the bodymind including developmental injury and trauma (what Wilhelm Reich originally called character structures).
Sometimes clients bring psychosomatic illness as a presenting issue to the therapy, sometimes these symptoms actually evolve in direct response to the unfolding therapeutic process, and the therapist gets implicated in them, e.g. “After last session I had a headache for three days!”
Direct links to body sensations and symptoms as well as body image come up as part of our work in sessions every day, in so many ways: tangible pains, tensions, trembling and shaking, breathing difficulties (hyperventilation, asthma), the physical side of unbearable feelings like panic, rage, dread or terror. There are obvious somatic aspects to presenting issues such as eating disorders or addictions. And then there are the psychological implications of actual, sometimes terminal, illnesses and psychosomatic symptoms and dis-ease.
The integration of embodied and relational ways of working
How do we work with these issues and symptoms in psychotherapy? What experiential ways of working are available to us, to include the client’s ‘felt sense’, their embodied self states, their body awareness and sensations, their physiological experience in our interaction with them?
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Through including body-oriented ways of working into the talking therapies, we can learn to work with many of these symptoms more directly, more deeply and more effectively (as well as learning to recognise situations where the hope of ‘curing’ illness through psychology is an unreasonable idealisation).
This CPD workshop is designed to expand your understanding of the bodymind connection as well as offering a wide range of creative and body-oriented techniques to include in your practice.
It will give you a framework for thinking about the role of the body as it is relevant in your own style of therapeutic work, based upon the different ways in which clients as well as therapists relate to ‘the symptom’. Throughout the workshop, we will use roleplay of actual issues and dilemmas brought up by your clients. We will also identify and practice ways in which you can explore the emotional function and 'meaning' of your client's physical symptom or illness.
The 10 ways of relating to the (psychosomatic) symptom
Michael has been working with the psychological and bodymind connection of illness and psychosomatic symptoms for many years. In the 1990s he initiated a project called 'Soul in Illness', offering an integrative psychotherapeutic perspective, drawing on the wisdom which the different therapeutic approaches have accumulated regarding illness, both in terms of theoretical understanding and practical ways of working. He has run CPD workshops for therapists on ‘Working with Illness’ many times, and has developed a relational and embodied way of engaging with the client’s bodymind.
In 2005 he presented for the first time his model of ‘10 ways of relating to the symptom’, which addresses the client’s own relationship to their symptom, as well as giving an overview of the different stances taken by therapists in the various therapeutic approaches that correspond to each of the ways of relating to the symptom. These ten ways of relating to the symptom, including the corresponding theoretical understandings as well as methods and techniques for intervention, will form the underlying framework for this workshop.
This framework is now almost 30 years old, and has stood the test of time. It is based on the principle that all ten different ways of relating to the symptom are therapeutically valid, but all of them are also limited and partial, and they all can be used defensively and therefore become misleading and dangerous in degrees. It is only their comprehensive integration which brings out their full potential, in concert with all the other - very different, sometimes contradictory but equally valid - ways of relating to the symptom. Over the weekend, we will clarify what these ten different relationships are, how to be sensitive to all of them as well as moving fluidly between them.
This requires an appreciation of all the different techniques and ideas which different psychotherapeutic approaches have developed over the last 100 years in relation to illness. Drawing on a wide range of humanistic and psychoanalytic approaches (including Body Psychotherapy, Process-oriented Psychology, various schools of psychoanalysis and Jungian perspectives) as well as the holistic paradigm underpinning most complementary therapies, we will weave together an interdisciplinary bodymind approach which is applicable within the therapeutic relationship as we know it in counselling and psychotherapy.
Format, learning environment and scope of the weekend
This will be an online Zoom weekend, organised in Greece for Greek therapists, but taking place in English with simultaneous Greek translation, therefore all English-speaking therapists from across the planet are invited. Michael's work and workshops are integrative, therefore suitable and of interest for therapists from across the diverse therapeutic approaches and traditions. It will be most likely the participants will bring very different levels of experience to the workshop - we will try to do justice to this and attempt to try and turn that problem into a productive feature of our work together.
Although we will be online, communicating via computer screens, Michael's teaching and workshops aim to be as experiential as possible within these limitations. Over the course of the weekend, Michael will invite participants to volunteer examples from their work for supervision demonstrations in the middle of the group. Some of the work will take place in small groups. Experiential work and theoretical input and discussions as well as group process and skills practice will interweave in response to the emerging needs and priorities of the group and its participants. We want to be especially mindful of confidentiality, and commit to a shared undertaking that nothing from the workshop will be indiscreetly shared with others, other than your very own personal-professional responses to the workshop. Based on that understanding, we are proposing to record the workshop, so the recording can be shared amongst participants for future reference.
Some of the possible learning objectives:
Michael Soth - biography and background
Michael Soth is an integral-relational Body Psychotherapist, trainer and supervisor, who studied, lived and worked in the UK between 1982 and 2021. During those four decades, he taught on a variety of counselling and therapy training courses, alongside working as Training Director at the Chiron Centre for Body Psychotherapy.
Inheriting concepts, values and ways of working from both psychoanalytic and humanistic traditions, he is interested in the therapeutic relationship as a bodymind process between two people who are both wounded and whole.
In his work and teaching, he integrates an unusually wide range of psychotherapeutic approaches, working towards full-spectrum integration of all therapeutic modalities and approaches, each with their gifts, wisdoms and expertise as well as their shadow aspects, fallacies and areas of obliviousness.
His original training at Chiron in the early 1980’s was based on body-oriented holistic psychotherapy, strongly rooted in the Reichian and post-Reichian tradition (including Alexander Lowen's Bioenergetics, David Boadella's Biosynthesis and Gerda Boyesen's Biodynamic Psychology). These approaches gave him a strong grounding in bottom-up, energetic, bodymind ways of thinking and working, which were supplemented by Gestalt, Process-oriented Psychology and a variety of complementary holistic bodywork therapies. Towards the end of the 1980s - through his practice and his own process - he began developing psychoanalytic understandings across a variety of psychodynamic orientations, including Jungian analytic psychology and Hillman's archetypal psychology. During the 1990s, he became one of the early pioneers of psychotherapy integration in the UK, reaching further into other traditions and approaches like existential, systemic and family constellations. In the mid-1990s he initiated the holistic health consultancy, a project exploring soul in illness, offering a unique integrative holistic approach to psychosomatic symptoms, dis-ease and chronic illness. Based on his experiences and work with clients who came to him through this avenue, he began distinguishing the 10 different relationships to the symptom, which form the foundation for this workshop which was previously entitled "Working with Illness in Psychotherapy". For many years he used to run this workshop annually, for counsellors and psychotherapists from across the various approaches, supporting their attempts to integrate bodymind perspectives and bottom-up ways of working into the talking therapies. Over the last 25 years, the somatic trauma therapies have made these perspectives and ways of working much more accessible and widespread; however, they often do not include psychoanalytic, systemic and relational considerations in their work with the body's spontaneous processes. Therefore, in many regards, this weekend offers an original and still rare opportunity to transcend the limitations of the fragmented traditions as we find them in the field of psychotherapy, as well as the dualistic assumptions and paradigms inherent in the talking therapies.
In 2021 Michael left the UK, and is now living near the rainforest in Central America, where he continues to work online as well as building a sustainable regenerative retreat and refuge, which will host workshops and trainings in the future.
He has written numerous articles and book chapters, and is a frequent presenter at conferences. He is co-editor of the Handbook of Body Psychotherapy and Somatic Psychology, published in 2015. Extracts from his published writing as well as hand-outs, blogs and summaries of presentations are available through his website for INTEGRA CPD: www.integra-cpd.co.uk.
Consultant Plastic, Reconstructive, Aesthetic & BURN Surgeon . at Ziauddin University Hospital.
11moMichael, Looking forward to your workshop here as well. Best Wishes.
C.E.O. at Naos Institute, Consultant Psychotherapist, Course Director London Diploma Psychosexual and Relationship Therapy, Consultant Trainer
11mosounds a good one, Michael, I might join. How to ? and how to distribute this to colleagues ?