When you lose your body, you lose your self

Chapter 6 in the book, The Body Keeps the Score by Bessel van der Kolk is called: Losing Your Body, Losing Your Self. The excerpt below is from this chapter and illustrates the importance of our interoceptive sense and befriending our body.

"What is your brain doing when you have nothing on in particular on your mind? It turns out that you pay attention to yourself. The default state activates the brain areas that work together to create your sense of "self".

When Ruth [Lanius] looked at the scans of her normal subjects, she found activation of default state network (DSN) regions that previous researchers had described. I like to call this the Mohawk of self-awareness, the midline structures of the brain, starting out right above our eyes, running through the center of the brain all the way to the back. All these midline structures are involved in our sense of self. The largest bright region at the back of the brain is the posterior cingulate, which gives us a physical sense of where we are—our internal GPS. It is strongly connected to the medial prefrontal cortex (MPFC), the watchtower. It is also connected with brain areas that register sensations coming from the rest of the body: the insula, which relays messages from the viscera to the emotional centers; the parietal lobes, which integrate sensory information; and the anterior cingulate, which coordinates emotions and thinking. All of these areas contribute to consciousness.

The contrast with the scans of the eighteen chronic PTSD patients with severe early-life trauma was startling. There was almost no activation of any of the self-sensing areas of the brain … There could be only one explanation for such results. In response to the trauma itself, and in coping with the dread that persisted long afterward, these patients had learned to shut down the brain areas that transmit the visceral feelings and emotions that accompany and define terror. Yet in everyday life, those same brain areas are responsible for registering the entire range of emotions and sensations that form the foundation of our self-awareness, our sense of who we are. What we witnessed here was a tragic adaptation: In an effort to shut off terrifying sensations, they also deadened their capacity to feel fully alive".

How do I create safety?

I was asked the other day how I create safety in a session. And it was hard to answer off the cuff but it's a crucially important question and it got me thinking. Some of the obvious answers are being present, attuned, active listening and taking someone's experiences seriously. You would think that these therapeutic ingredients would be a given, but they are not.  As a client I have had many experiences with therapists/practitioners who didn't listen, were anything but attuned and even gave me a different treatment than what I had asked for and then acted like I shouldn't have complained! Needless to say, the foundations are essential.

But there are some intangibles to creating safety and feeling safe that I think are ineffable. Safety is felt, it isn't explained, we can't talk someone into feeling safe, we create the right conditions and ingredients and it is a continuous process. It's like a good parent, they use actions as well as soft soothing words to meet the needs of their baby and the baby then learns they can trust them and as a result they feel safe. They have 'evidence' for knowing they can feel safe and a client needs evidence too. You'll know whether you feel safe or not (or the possibility of growing safer), it is a case of trusting the answers your body gives you.

I think using intuition can create quantum leaps in therapeutic work, which again is about trust; this can also create more safety, as a client can feel more heard when you intuit what's going on or how they're feeling. The best container that I know of is an attuned relationship, and healthy containment helps us feel safe. I am not a fan of container exercises as the bodymind will do what it does and get triggered etc. between sessions. It can't "obey" instructions to keep difficult stuff in, that stuff wants to be heard and seen. Learning to be the container for difficult emotions and sensations, rather than looking outside for containers, that often don't work in my experience and can make someone feel inadequate or that they're doing it wrong, is much more empowering.