Somatic Attachment Therapy

As a therapist for many years, I yearned for a way to deepen clients’ self-understanding and capacity to change. I would sit with clients weekly and empathically offer the experience of attunement, comfort and consistency. Together, we figured out what had happened in their childhoods and sometimes in their overall life experiences that led to their interpersonal problems. Our analysis was good; we had a good therapeutic alliance that helped clients feel supported and cared about. Yet, so much of what clients wanted differently in their lives did not change. I often had a sense there was more information and another way to reach, to find, to work with the deeper experiences we weren’t touching.

Somatic Attachment Therapy came from an essential question: How do we work with those deeper layers of experience, in that place where beliefs about self and ways of being were formed? The relationship between therapist and client was so important; it just wasn’t enough.

The way of working I’ve come to call Somatic Attachment Therapy rests primarily on the principle that attachment security/insecurity has physiological as well as psychological manifestations. As these manifestations are primarily unconscious, using words or insight does not give us adequate access. We need to work at a level below language, essentially with a different part of the brain.

That part is the right brain where the limbic system holds visceral, emotional, and implicit memory. This is the part of the brain that recorded and stored experiences before we developed a full neocortex capable of language and analysis. And, it is the part of the brain that holds the fragmented selves associated with trauma.

It is there in the limbic right brain structures that our earliest sense of ourselves and in relation to others is formed. Those early experiences are not the only ones that matter but they are key. Without accessing them, we are working with only a linguistic representation, frequently distorted, of those formative experiences that unconsciously guide us through our relationship to ourselves and others.

Clients’ movements, energy, breath, relationship to us and sense of safety can be tracked on a moment to moment basis. In addition, our own reactions as therapists, our intuitions, hunches, feelings of meeting our client or failing, our sense of inadequacy and insecurity can all likewise be tracked. Specific skills in tracking, contacting and helping to deepen into a felt sense allows us to mindfully and slowly work with unconscious, unnamed core organizing beliefs.

Somatic Attachment Therapy intertwines an understanding of nervous system regulation and the somatic underpinnings of defenses that reflect attachment insecurity. By honoring defenses and seeking client permission at every juncture, we support the wisdom of the body as an illuminator of the path to healing. Within a defense is the seed for change. It points to the unconscious need to protect and keep the psyche intact.

For example, a client, in mindfulness, says, “I can’t let myself cry,” while tapping her chest. Her statement is a wise one. Somewhere along the way her “letting herself cry” was not a safe choice. In SAT, we support that wisdom without knowing the backstory – all we know is that in the moment, a protective urge has emerged and we share the clients’ sense that it is important and to be respected.  As SAT therapists, we can contact the gesture of her tapping her chest. Without having to know why, we understand the gesture is a reflection of a right-brain, limbic experience. It says more than: “When I was a little girl, my mother said, ‘I’ll give you something to cry about.’”  If we go with this explanation, we lose access to the deeper unconscious experience held in the gesture of tapping her chest.  As we begin to let that protective urge emerge, the full, implicitly-stored experience begins to come to conscious awareness – an image, a memory, an emotional sense, the presence of someone in the room, what we were doing, wearing, a hand raised to hit, an internal sinking feeling of shame, head bowed, shoulders collapsed.

We accompany the client through that somatic experience, both of us in mindfulness, the client simultaneously in present-consciousness of observation and an altered-consciousness experience of the memory.

In that space, words are fewer and visceral sensations, energy, movements, urges and images are more apparent. Words come out to communicate and describe states rather than to explain.

If we support the client to not let herself cry, e.g, “Really important not to cry. Let’s see how we can help you do that,” or we contact the gesture, “You’re tapping your chest. Can you let yourself do that,” she has the opportunity to observe her experience, feel in control of what happens, and feel supported and seen all at the same time. She knows we are okay with whatever happens, we will be present and accepting, that therapy isn’t designed to only go for the hard stuff but also to support the internal wisdom developed for survival purposes which later can alter to more creative, thriving resources. Over time, this relationship of respect and gentleness for the client’s process allows them to experience the seeds of an earned secure attachment as beliefs about themselves begin to shift.

Attachment work is the key to Somatic Attachment Therapy. We use somatic skills and important principles to support a growing sense of safety, trust, self-knowledge; ability to take risks, manage disappointments and rejections; and development of a deeply-held internal sense that a protecting, wise, and attuned someone lives inside of them, guiding them and keeping them safe while enhancing the capacity for joy.

In that regard, what happens for us as therapists, how regulated we are in session in regards to our own attachment beliefs plays a major role in our ability to help clients. If we are in session and a client’s tears or rage overwhelms us, and that overwhelm remains unchecked and unconscious, we may re-enact early attachment wounds for the client. Often, therapists may withdraw into their left brains, or pull back physically. Working with our own responses and the client’s in regulated mindfulness helps bring those early wounds to the forefront where change becomes possible.

Throughout Somatic Attachment Therapy is a constant theme of lovingkindness and, within that, love. It is our capacity to love from our own accessed secure attachment while in session with clients that creates the fertile soil for transformation, both of our clients and of ourselves.

Note: Somatic Attachment Work is a synthesis of my trainings, study and experiences. Key influences are Hakomi Mindfulness-Centered Somatic Psychotherapy; Sensorimotor Psychotherapy; EMDR; Neuro-Affective Relational Model; Internal Family Systems; and the work of Bonnie Badenoch and Julie Murphy.