BODY EXPERIENCES OF WOMEN SURVIVORS OF CHILD SEXUAL ABUSE:

IMPLICATIONS FOR THERAPEUTIC INTERVENTION

Margit E. Asselstine

A niesis submitted in confonnity with the requirements for the Degree of Doctor of Education. Graduate Department of Adult Education, Cornmunity Development, and Counselling Psychology University of Toronto

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by Margit Asselstine

A thesis submitted in conformity with the requirements for the degree of Doctor of Education, Graduate Department of Adult Education, Cornmunity Development, and Counselling Psychology, University of Toronto, 1997.

ABSTRACT

Previous research identifies the impact of child sexual abuse on a child's cognitive and

emotional orientation to the world but has neglected to include its impact on the child's physical orientation to the wodd. Conventional psychotherapeutic practice has few if any

techniques for including the physical dimension within verbal exploration and integration.

Research, however, continues to show the necessity for a non-intellectual approach for

accessing state-bound information for the purpose of traumatic mernory retrieval and

integration. The intention of this study was to explore the body experiences of women survivors within a verbal body-focused intervention that did not involve touch or movement therapy. This study demonstrates that the body is closely and inexûicably involved when trauma is experienced, particularly in childhood sema1 abuse.

Five women survivors of child sexual abuse, al1 of whom were currently in psychotherapy, participated in one body-focused verbal experiential session. The session was followed by two interviews one week and one year Iater to discuss and evaluate their body- oriented experience and its relationship to their healing process. An interna1 focus on their body experience created a non-ordinary state in which the body could speak from its own perspective without the filter of the intellect. Following the sensation of a memory led the participants either to a memory of the abuse itself or to an unresolved related issue. The iii results ïndicate that a variety of kinaesthetic experiences are part of the memory of trauma. including the trauma of immobilization and the feeling of being physically trapped in terror, body disruptions that involve the rnind "splittïng" from the body, and the "splitting" of body areas that represent separated parts of self with diffe~gperspectives on the trauma.

Following the sensation of a memory and incorporating psyche-soma linking led the participants to a changed and more integrated relationship with their body. Body-oriented memory retrieval and integration, and the intemalization of the process of dialogue with their body 1ed these women to new opportunities for healing that would not have been available otherwise. TABLE OF CONTENTS

Abs tract List of Figures List of Appendices Acknowledgements

1. INTRODUCTION

1.1 . Overview ...... 1

1.2. Locating Myself as a Researcher ...... 2

1.2.1. My Personal Evolution ...... 2

1.2.2. Evolving a Research Topic ...... 6

1.2.3. Rationale for the Study ...... 8

2 . LITERATURE REVIEW

2.1. Theories Relating Psyche and Soma ...... 13

2.2. The Effects of Child Sexual Abuse ...... 17

2.3. Trauma and Memory ...... 24

2.3.1. How Children Remernber ...... 24

2.3 .2. Myths and Misconceptions about Reality Versus Fantasy ...... 26

2.3.3 . Accessibility of Traumatic Memories ...... 27

2.3.4 . Trauma and the Body Experience ...... 30

2.3.5. The Relevance of State Dependency ...... 34

2.3.6. Intervention ...... 39 V

3 . RESEARCH OBJECTIVES AND METHOD

3.1. Research Objectives and Research Questions ...... 47

3.2. The Development of a Body-Focused Psychotherapeutic Intervention Technique . 48

3.2.2. Finding a Conceptual Framework ...... 49

3 .2.3. Finding a Body Base ...... 51

3.2.4. Acknowledging the Therapy Relationship ...... 52

3 .2.5. Understanding the Experiential Session ...... 55

3.2.6. Continuous Body-Refocusing Facilitates Psyche-Soma Linking ...... 59

3.2 .7 . Approaches to the Inclusion of the Body in Related Therapy ...... 60

4 . METHODOLOGY

4.1. Adopting a Heuristic Approach ...... 63

4.2. Women's Personal Experience of Their Body: A Case Study ...... 65

4.3. TheShxdy ...... 68

4.3.1. Women Survivors of Child Sexual Abuse: The Research Participants ... 68

4.3.2 . The Role of the ResearchedFacilitator: Engaging in the ...... 69 Therapeutic Process

4.3.3. Four Data Collection Phases ...... 71

4.3.4. Qualitative Data Analysis : Creating Stories ...... 75

4.3.5. Beuig Informed by the Pilot Smdy ...... 76 CASE STUDIES OF FIVE WOMEN'S EXPERIENTIAL SESSIONS: FESEARCH FINDINGS

Organization of the Findings ...... 79

Mary's Session ...... 80

Gwen's Session ...... 94

Willo 's Session ...... 108

Trudi's Session ...... 122

Laura's Session ...... 137

THOUGHTS. REFLECTIONS AND INSIGHTS RELATED TO THE EXPERIENTIAL SESSIONS: RESEARCH FINDINGS

The Healhg Process ...... 149

6.1.1. Individual Modalities for Entry to the Body Expenence ...... 150

6.1.2. The Head-Body Split and Betrayal by the Body ...... 153

6.1.3. Body Parts in Dialogue. Psyche-Soma Linking. Iritegrating ...... 159 the Hurt Child. and Creating Healing hagery

6.1.4. New Self-Care Strategies and Tools ...... 171

Participants' Evaluations ...... 184

6.2.1. A Process Not Dorninated by the Intellect Facilitates Integration ...... 185

6.2.2. The Session Facilitates Memory Recall and Retrieval of Images ...... 187 that Would Not Have Happened Otherwise

6.2.3. A Flexible Physical Environment Provides Opportunities to ...... 190 Explore Body Processes

6.2.4. A Therapeutic Relationship of Trust. Safety. and Gentleness and the .... 191 htemalization of the Therapist's Trust in the Process 1s Helpful vii

6.2.5. A Self-Directed Pace Ailows Full Processing of the Material as It ..... 193 Ernerges and Avoids " Flooding " and Dissociation

6.2.6. The Use of a Body-Focused Approach Without Physical Touch ....194 b y the Therapist Facilitates Integration

6.2.7. Drawing a Picture at the End of the Experiential Session ...... 198 Contributes an Additional Elernent to the Healing Process

7. DISCUSSION

7.1. Body Experiences of Women Survivors of Child Sexual Abuse: ...... 201 Refiections on the Findings

7.2. Implications for Therapeutic Intervention ...... 219

7 .3. Implications for Future Research ...... 222

7.4. Limitations of the Study ...... 225

7 .5 . Conclusion ...... 227

References ...... 228 viii

LET OF FTGURES

Mary's Drawing ...... 93

Gwen's Drawing ...... 107

Willo's Drawing ...... 121

Trudi's Drawing ...... 136

Laura's Drawing ...... 147

LIST OF APPENDICES

Appendix A Letter of Informed Choice ...... 233

Appendix B Background Information Sheet ...... 235

Appendix C Interview Schedule The Experiential Session ...... 238

Appendix D Interview Schedule Follow-Up Interview One Week Later ...... 242

Appendix E Interview Schedule Follow-Up Interview One Year Later ...... 243 ACKNOWLEDGEMENTS

To begin I would like to acknowledge the women survivors who so wiliingly gave their rime

to this project. Their sharing of experiences and insights so that others may lem from them

is greatly appreciated.

A special thank you to Dr. Niva Piran for her encouragement to pursue this topic and

her guidance during the course of its development into a thesis. 1 also owe thanks to my

other dissertation cornmittee members, Dr. Lana Stermac and Dr. Bill Alexander, for their

assistance.

The results of what seerned to be an impossible task at the outset has been made to

look easy because of the invaluable help from friends and editors Ellen Shearer and Joanne

Close. 1 thank Ellen Shearer for her enthusiastic perseverance during the wnting of this

project. Her supportive presence and skill motivated me to further explore and elucidate the

matenal. 1thank Joanne Close who copy edited this manuscript with exquisite attention to detai1.

Finally, 1 thank my many other friends and colleagues who encouraged and supponed me throughout this process. CHAITER 1

WRODUCTION

1.1. OVERWW

This smdy intended to investigate the experience of the body from a perspective that is largely unstudied within the field of psychological research. People who have experienced sexual abuse at a pre-verbal age and/or while dissociated from their body may be unable to process their past trauma in a verbal-oriented psychotherapy . Consequenîiy , this research is potentially relevant for the understanding and treatrnent of survivors of child sexual abuse.

Specifically, the purpose was to explore the body experiences of adult fernale survivors of child sexual abuse during a body-focused, verbal psychotherapeutic session. 1 explored how the participants verbalized rnemories from the orientation of their body experience and bow their remembered body experiences might be linked to and integrated in the healing or psychotherapeutic process of recovery.

Since researchers have stated that most women experience an unwanted invasive sexual experience before the age of eighteen years (Butler, 1978; Courtois, 1988), this area of study is relevant for a large segment of the general population. The development of approaches for examining and including the experience of the body within a psychotherapeutic frarnework may therefore contribute to the field of clinical psychology. 1.2. LOCATING MYSELF AS A RESEARClAER

1.2.1. Mv Persona1 Evoiution

As the researcher in this study, 1 need to explain how my interests and inclinations led me to this project.

1 studied dance throughout my childhood and adolescence at various schools in

Winnipeg, including the Royal Winnipeg and Lhotka's. 1 was also interested in drama and

studied at the Manitoba Theatre Centre between the ages of eight and thirteen. These classes represented my life blood; 1 believe 1 mainly relied on non-verbal communication until 1 reached my twenties.

At the age of eighteen, after a serious dance injury that 1 believed would elirninate any chance of a career in dance, 1decided to pursue my interest in child psychology and acquired a university degree in that field. When 1 was nearing completion of the degree, a fortuitous coincidence intemened: I found a Dance Therapy journal in the university Iibrary.

1 irnmediately understood that this field would connect the two disciplines where I had training. 1 also knew intuitively that this combination would sustain my interest and that it was a worthwhile field. My injury was now healed, and after three years in a mainly intellectual pursuit 1 was eager to return to dance and movement.

1 promptly applied to York University, where 1 completed an honours degree in dance and dancelmovement therapy. A substantial part of this degree involved intensive training in Laban Movement Analysis. At the sarne the, 1 was introduced to another system of body and movement analysis when 1 attended a workshop in experiential anatomy about leg alignment. This triggered my understanding of the relevance of anatomy and body alignment and tumed out to be a pivotal influence because in retrospect 1 realize that it led me toward the field of movement repatteming. I began to study body alignment privately and was drawn to other approaches, including the Alexander Technique and the

Feldenkrais Method, among others, which 1 studied for many years.

For ten years, 1 worked in the medium of movement and the body as therapist. educator, and consultant in a vai-iery of settings with leaming-disabled children, dual- diagnosed children and young adults, stroke survivors, accident victims, and chronic pain sufferers. During this the, 1cornpleted a posr-graduate Diploma in Gerontology and worked with elderly people in the entire continuum of settings, from chronic care to independent residences. 1 also worked part-tirne for six years at George Brown College, designing and teaching a course in therapeutic prograrnming for institutionalized elderly with a focus on expressive arts therapies. For two of these years, 1 also taught an introductory course in psychology.

During this ten-year period, 1continued to train in the areas of dance, yoga, and t'ai chi. In an effort to develop my voice 1 studied the Linklater Method, which resonated with my previous body-oriented work because of its focus on breath and the natural voice. 1 also spent six years in personal psychotherapy with a therapist using Gestalt, existentialist, and cognitive perspectives. 1 continued to sGdy the emerging field of what is now called somatic movement therapy and education. Although 1 also continued to study extensively in

Feldenkrais and AIexander, as well as Bartenieff Fundamentais, 1 decided to become certified in Bonnie Bainbridge Cohen's Body-Mind Centering approach because its inclusiveness suited my eclectic way of working. After six years of training, 1 completed the certification in Body-Mind Centering at the School in Amherst, Massachusetts, in 1989.

This certification was intensive, involving experiential anatomy, hands-on manipulation and 3 re-patterning, and developmental movement patterns. Cohen defmes her work as transformation through the union of movement, touch, sound, and mind. My training in these areas culminated in a registration with the newly created umbrella organization that represents this profession of somatic therapy. The International Somatic Movement Therapy and Education Association (ISMETA) .

During this ten-year period, 1 also continued to explore approaches in dance/rnovement therapy toward a registration in this area. To fulfil the requirements, in addition to my accumulated training and my work as a movernent therapisr with supervision,

1 studied dancelmovement therapy at the Naropa Instinite in Boulder, Colorado and in New

York City with Judith Kestenberg (Kestenberg Movement Profile) and Martha Davis (Action

Profiling). 1 eventually becarne registered with the Arnerican Dance Therapy Association

(ADTA), receiving my advanced regis tration (ADTR) in 1990.

Throughout my years in body-oriented therapy and education, it becarne clear that 1 needed advanced verbal skills that could enable me to facilitate more effectively the emotional and verbal component of the movement experience. For this reason, 1 decided to enter a master program in counselling psychology. While completing the master degree 1 realized that 1 wanted to become a practising psychologist and eventually to write about my work, so 1 entered the doctoral degree program. This degree program began a seven-year period of further study, involving extensive course work as well as practicums in adult psychotherapy at the Counselling and Development Centre, York University; psychological and neurological assessments at the Clarke Institute of Psychiatry; and family therapy at

Whitby Psychiatrie Hospital. During these years, I also worked part-tirne as a graduate assistant, researching in the area of children's leaniing and perforrning leaming disabilities assessments with children and adults at the Psychoeducational Chic at the Ontario Institure

for Studies in Education. Other part-time work included employment at the Addiction

Research Foundation and at a Native residential alcohol and drug treatment prograrn.

Mile fulfilling the requirements for the degree 1 becarne interested in developing rny

skills in touch therapy, which 1 had started at the School for Body-Mind Centering. To this

end, 1 studied craniosacral therapy, visceral manipulation, zero balancing, process

acupressure, and esoteric hea1i.g, among O then.

1undestand now that my development is a progression I followed inmitively so that

1 could offer clients an approach to transformation, healing, and embodiment that is holistic and can encompass verbal, touch, movement, and somatic therapies. 1 have finally reached a place in my own joumey where 1 feel capable of providing clients with the bridges between body, intellect, emotions, and spirit -- healing that includes al1 aspects of a person.

My work is a refiection of my own efforts to becorne what 1 feel is centred and complete. Movement therapy, bodywork, and body-oriented psychotherapy have connected me with my own body experience and I am able to offer this work to others. Body-oriented work can be taught successfully only from experience, not from a purely cognitive perspective. I believe an experiential base in leaming is the essential ground work for the newly emergent healing professions of our the. Therefore 1 feel that my intense involvement in varied approaches to bodywork has enriched and informed the development of an approach for focusing on the body in verbal psychotherapy. 6 1.2.2. Evdving a Research To~ic

I have a strong desire to bndge the two worlds of bodywork and psychology. At this time,

1 feel 1 am somewhat awkwardly straddling these two worlds and am often struck by their

unnecessary artifcial isolation. My hope would be that my dissertation topic might

contribute towards creating links between these two worlds for me. The observed

dichotomy may be a reflection of a separation between body and the mind in the larger

culture. 1 am fomnate to possess equally thorough training in both worlds and 1 have

found through experience that they do combine well and have the potential to enhance and

even transforrn each other.

Over the years 1 have become aware of the lack of published knowledge on the experience of the body and its place within the process of psychotherapy. The more I

studied verbal approaches to change or transformation, the more 1 came to realize that the overall process is similar to what occurs in body-oriented transformation.

The way to integration is through differentiation, whether we work in a psyche- or a soma-oriented methodology. An approach that serves to differentiate the parts of the personality or psyche is similar to an approach that differentiates actual body systems and tissues. When I speak about transformation through body knowledge, 1 speak of a process that goes beyond simple awareness to reach a profound knowledge of self that incorporates body experiences. Greater persona1 awareness and the ability to make choices about living one's life can be achieved through either a psyche- or a soma-oriented approach, or a combination of both. When each domain, body and mind, is fully understood in its own tems, psyche-soma links can be formed. Because 1 have completed extensive persona1 and professionai study in both psyche- and soma-orientations to persona1 change, I have 7 accumulated an active awareness of the constant nature of the link and an embodied

consciousness of their inseparability.

The open, non-judgemental, and compassionate approach 1 learned in touch and

rnovement therapy is similar to the therapeutic approach 1 use in verbal therapy. Gentleness

and joining the client's process or experience are characteristic of both verbal and body-

onented approaches. The process and the goal are much the same in each modality .

whether it be felt through the integration of body partslpsyche parts moving toward a whole

body experience, or through a psychological integration. Thus, both approaches use a

sequence of differentiating, dialoguing, interacting, and integrating parts of the psyche or

body to promote therapeutic change toward integration and wholeness.

Despite my skills in touch and movement therapy, 1 have chosen not to use these

rnodalities in this study. 1 made this decision in order to make the results more applicable

to verbal psychotherapists. Since 1 have never experienced bodywork without touch or

rnovement and I was curious to study the potential of this body-focused verbal approach. 1

wanted to determine whether the "voice" of the body would emerge, on its own tenns, in

the context of a verbal/intellectual modality. In effect, my work is a search for the psyche-

soma link between the cultures of bodywork and psychotherapy.

My intention is to explore one approach verbal therapists may employ to incorporate the body expenence in therapy. Ideally, psychotherapists would be at home in their own body, with personal experience of body-oriented change, before engaging in the attempt to resonate with another person and guide him or her through the realrn of the body.

However, verbal therapists can begin by tuning into the words clients choose, borh literal and rnetaphorical, for their body expenence, and by observing body shape and qualities of 8 movement and expression. Including these elements can be a way of opening to the

orientation of the client's body experience.

1 am aware that touch and movement therapy involve far more than sirnply putting

one's hands on someone or watching someone dance or move. My thesis is that the body

experience. on its own, can elicit a healing process and that for holistic healing to occur.

particularly for survivors of child sexual abuse, the issues relating to the body experience

and bodily expression need to be included.

1.2.3. Rationale for the Studv

In her book, Trauma and Recovery, Hemian (1992) suggests that people who have been

chronically traumatized will suffer physiological changes and that survivors "may need ro

devote separate attention to their physiological symptoms " (p. 187). Ho wever, in

conventional verbal psychotherapy, the experience of the body is often not explored or

validated. If addressed, the body's experience is explored from an inrellectual perspective.

Moreover, the body is not valued as a vehicle of intentionality and expressiveness for the personality .

Leder (1984) argues for a new paradigm in medical practice that will allow a conceptualization of unity between body and mind, or psyche and soma. He calls this the

"lived-body"and compares his concept to the medical mode1 of disease:

the paradigrn of the Iived-body, wherein subjectivity is always corporeally expressed .. . may be better able to address the role of psychological factors in the etiology of physical disease. When disease is understood as arising out of bodily intentionality it cm no longer be seen as a merely mechanistic event (P. 39).

Leder (1984) describes "talk therapy" as the "penultirnate" mental construction. He states:

.. . if many diseases arise from an intermediate bodily intentionality these separated physicalistic and mentalistic approaches may not always best serve. Medications and surgery, while crucial modalities of treatrnent, often do not address the intentionality behind disease . Conversely, as primarily actual ized in a pre-linguistic bodily expressiveness, the intentionality of illness may not always be transformable through lmguage and introspection (p. 41).

Leder's (1984) view of the inadequacy of treatment for child sexual abuse survivors

that is based solely on language and introspection, or a mental construction, has been widely

validated in recent years by clinical researchers (Goodwin, 1990; Putnam, 1990; Briere, 1992:

Whitfield, 1995; van der Kollc, 1995). Research findings that substantiate Our need for

investigating new approaches include: traumatic amnesia and dissociation are common

outcomes of child sexual abuse (Herman, 1987: Braun, 1989); early traumatic memories are

encoded and therefore retrieved from a child's perspective that requires developmental considerations (Freud, 1938; Fraiberg ,1982); trauma mernories tend to be encapsulated

experiences that are inflexible and invariable (van der Kolk & van der Hart. 1991) and are

therefore less accessible in ordinary states (Rossi, 1993); and traumatic rnemory is initially organized on a non-verbal level and remembered and retrieved as sensory fragments that have no linguistic components (Terr, 1991; van der Kolk, 1996). Thus research that establishes the characteristics of trauma teaches us about the limitations of conventional verbal therapy for effective treatment and illustrates the need for new, effective therapies.

Leder's (1984) perception of the new or non-conventional therapies is that they foster health by directly realigning the intentions and processes of the active body:

Posture, muscle tension, hormonal and immune functioning are regarded not just as machine processes but as intentional structures which can be volitionally realigned. Techniques such as biofeedback and visualization are used to aansform the preconceptual expressiveness of bodily functioning. This bodily functioning, not that of a disembodied consciousness. is regarded as the crucial locus of self-development, and of emotional as well as physical healing. The lived-body is incorporated directIy into treatment (p. 4 1).

Schwartz-Salant (1982) agrees: "One cm do very well with a psychic, more mental, comection, whether one works as a Jungian, Freudian, Reichian. Gestaltist. or out of any other school of thought. And it is so much 'cleaner'. Unfortunately, it misses a good deal"

(p. 126). He cornments: "The reality is that analytic work from the vantage point of the psychic unconscious is very poor at integrating those aspects of the psyche that are split off and hidden by the narcissistic smcturing of the personality " (p. 126). Schwartz-Salant

(1982) advocates "worlcing through the somatic unconscious .. . [towara a vision, an emergence of the life of imaginal sight which can see the split-off Self" (p.122). He says this "is a lunar rather than solar vision, a sight based upon imagination that is real in the sense of being nearly corporeal, and experienced in a very close relationship to one's body"

(p. 122). I believe Schwartz-Salant makes a strong argument for a form of psychotherapy that includes the experience of the body and the embodied self as a witness who can see.

Specifically, he appears to address the treatrnent of trauma, such as child sexual abuse, that can result in a tendency toward dissociation when one is not grounded in one's body experience .

Although the experience of the body at this point lacks language and empirical investigation, limitations of " talk therapy " to incorporate bodily experience are apparent.

The present need is to begin researching areas of the body experience, or the "lived-body," and develop holistic therapeutic approaches that encompass it.

Both verbal and body therapists are Iirnited in their ability to connect the psyche and the soma. Verbal therapists are competent with the psyche white body therapists are 11 competent with the soma. Very few psychotherapists, however. have training and expertise in both areas. Verbal therapists are not trained to notice and involve the client in dialogue oriented ro the experience of the body. In addition, they may require special training chat will facilitate awareness of their own body. Sirnilarly, many body-oriented therapiscs are not knowledgeable and trained in verbal psychological integration or verbal dialogue psychotherapy. The purpose of this study, then, is to show how a bridge rnay be formed between a verbal psychotherapy orientation and a non-touching body orientation. The provision of such a bridge rnay facilitate clients' experience of healing in that her body is evident in the dialogue.

The method 1 have chosen involves a self-generated body-focused integrative imager). process that locates and follows a body-oriented mernory. 1 am consciously choosing a methodology that does not involve specific [ouch or movement therapy techniques. Rather, 1 include the experience of the body by focusing attention and intention on it. This non-touch approach may be particularly relevant for survivors of child sexual abuse since touch could be experienced as a violation of boundaries and cause intense anxiety and associated symptoms. Broader goals of the study involve understanding the role of the body in the coding and remembering of traumatic events.

The area of body and body movement has always been preciominaritiy occupied by fernales. 1 think that in this society the intellect is held in far higher esteem than the body and emotions, and that this preference has originated from a predominantly masculine perspective. 1 believe the body has been discrirninated against largely because of the difficuities involved in studying it meaningfully within a quantitative methodology or positivistic paradigrn. 1 hope this research will contribute to the exploration and validation 12 of women's experiences, and the intuitive "knowing" that is grounded in the experience of

the body.

Sexual abuse is a violation of the body -- abuse that is extemally derived and directed toward the body. 1 believe these facts speak to the necessity of including the body processes in recovery from child sexuai abuse. In addition, memories arising from the body, or recorded by the body, will substantiate against clairns that the mernories are fantasies or part of what has become popularly known as "false memory syndrome."

Lastly, child sexual abuse is predominantly a women's issue and I want to support women's developrnent , particularly in the reclairning of their sexuality and the sacredness of their body. CHAP'IER 2

LïIBRATURlE REVIEW

A number of areas in the literature are potentially relevant to the topic of exploring the body

experiences of women survivors of child sexual abuse. The following is a discussion of

three of these areas: theories relating psyche and soma, the effects of child sexual abuse,

and trauma and mernory .

2.1. THEORES RELATING PSYCHE AND SOMA

The importance of analyzing the experience of the body or including the knowledge of the body in psychotherapy is not a new idea. In 1895, the father of modem psychology,

Sigmund Freud (in Sulloway , l979), diagramrned a schematic picture of sexuality that

"provided two logical sources of potentially neurotic disturbance within the organism: soma and psyche" (p.105). Sulloway (1979) describes a four-pan analysis of Freud's design of the relationship between soma and psyche:

1) Somatic neurosis. Somatic sexual excitation may poison the soma, Freud thought, without ever ente~gthe psyche; 2) Soma to psyche. Altematively. Freud reasoned that somatic sexual excitation may gain successful access to the psyche but, upon failing to €id adequate discharge, may encounter psychical defense against prolonged, undischarged sexual tension. The consequence of such psychical defense against libido would be the development of purely psychopathological symptorns -- for example, obsessions and phobias; 3) The psyche and intemal psychical haemorrhaging. Looking at the whole matter from the psyche's point of view, the psychical sexual group can become the victirn of an insufficient linkage with its terminal organ -- and therefore be forced to replenish its continually low level of psychical sexual excitation by drawing upon closely associated nonsexual neurones .. .; 4) Psyche to soma -- the theory of conversion. Finally, in the neurosis of hysteria, Freud assumed that the accumulation of a traumatic and unabreacted quota of affect within the psyche induced defence (repression) and caused a somatic conversion of emotion -- that is, a transfokation of this trauma into bodily symptoms following psychically analyzable paths of 14 discharge (p. 105-106).

Sulloway (1979) cornrnents that in Freud's early writings he was consumed with the need to explain the neurophysiological basis of psychoanalytic ideas. He describes Freud's

"Project for a Scientific Psychology" (1895) on the topic as follows:

[Tt is] neither a purely neurological document nor a projection of wholly psychological insights onto imagined neuroanatomical structures; rather, it combines clinical insights and data, Freud's rnost hndamental psychophysicalist assumptions , certain undeniabiy mechanical and neuroanatomical constmcts, and a number of organismic, evolutionary, and biological ideas -- al1 into one remarkably well-integrated psychobiological system (p. 123).

Sulloway (1979) explains that Freud abandoned "The Project" because his attenpting to solve the entire problern of psychology was ovenvhelming, involving much more than simply explaining the defence of repression. However, we can assume that together with

Freud's theones regardhg conversion, the roots of Freudian psychology came from a strong realization of the connection between psyche and soma.

Car1 Jung (in Swartz-Salant, 1982), a contemporary of Freud, explained the difference between the somatic unconscious and the psyche unconscious. Jung stated:

We have a conscious-unconscious connection that leads on one side to the purely spiritual or psychic realm, and on the other into the body and matter. As we go toward the domain of the spirit, the unconscious becomes the psychic unconscious, and as we go toward body and matter, it becomes the somatic unconscious (p. 120).

According to Jung (in Schwartz-Salant, 1982) "body and psyche are two aspects of the same reality." "Self is both body and psyche, [and] the sou1 is the life of the body"

(p. 120). The subtie body, or somatic unconscious, represents the unconscious as perceived by the body. Jung argued that since the unconscious is in the body, the only way it can uuly be experienced is through the body. He believed that "the Self wants to live its 15 experiment in life, and if it is not willingly embodied it will manifest negatively in somatic

symptoms and phobias" (p.120). His description has direct relevance for sexual abuse

survivors who may present with somatic symptoms and frequently report a feeling of

separation or dissociation frorn their body or body parts.

Grof (in Capra, 1988), a contemporary of Jung, corroborates Jung's point:

Exnotional or psychosomatic symptoms are condensed experiences. Behind the symptom is an experience which is trying to complete itself. This is called an incomplete gestalt in gestalt therapy. By energizing the organism you unblock this process. The person will then have experiences, which you support whether or not they fit your theoretical frarnework (p.296).

The experience of the body and the practice of body-oriented approaches that may or

rnay not include memory retrieval has largely been excluded from psychotherapy. Grof (in

Capra, 1988) explains:

The old psychotherapies were based, by and large, on the Freudian model, which held that everything that was happening in the psyche was biographically determined . There was tremendous emphasis on verbal exchange, and therapists operated just with psychological factors and left out body processes (Capra, 1988, p. 2%).

Terr (1991), a well-known researcher in the area of childhood trauma and rnemory, describes childhood trauma "as the mental result of one sudden, external blow or a series of blows, rendering the young person temporarily helpless and breaking pasr ordinary coping

and defensive operations " (p. 11). Terr believes trauma originates from the outside and never solely in the chiid's mind. Although she does not use the terms psyche and soma to describe her theories, she believes the experience of childhood trauma cm affect biological changes: " Childhood trauma may be accompanied by as yet unknown biological changes that are stirnulated by the exteml events " (p. 11). Terr (199 1) goes on to explain that although the biological changes may begin as a result of outside influences, they effect 16 interna1 changes that persist. Terr's (1991) comment is reinforced by Hagglund et al.

(1980) who explain that "throughout life the ego structure and identity of an individual are founded to a significant degree on the sensations and awareness of the body" (p.256). In addition, these authors view each of the erogenous zones with its own "inner space which is integrated into the body image and the body self as the child grows" (p.256).

Pert (1986), a neuroscientist, believes "neuropeptides and their receptors are a key to understanding how mind and body are interconnected and how emotions can be manifested throughout the body" (p. 9). She descnbes an " integrated system" she calls " bodymind, " in which the brain, the glands, and the immune system are "joined together in a bi-directional network of communication and that the information 'carriers' are the neuropeptides" (p. 14).

Pert (1986) hypothesizes that "perhaps mind is the information flowing among al1 of these bodily parts .. . maybe mind is what holds the network together" (p. 14). She explains that emotions are in the body as well as the brain, and that she "no longer can make a distinction between the brain and the body" (p. 12). Woodman (1996) views the

"comector" between the body and the mind as metaphor. She states: "Metaphor is the language of the sou1.... Metaphor is a physical picture of a spiritual condition" (p.33).

Leder (1984), in an article entitied "Medicine and Paradigms of Embodiment, " states his belief that it is a lack of language that prevents us from creating a paradigm that speaks to a me integration of the body, mind, emotions, and spirit. He states:

Those recognizing the need for preserving reference to the intentionality of behaviour frequently employ a covertly dualistic or multicausal mode1 of disease. One must look at a human not just as body but as body and mind, or perhaps as a complex interdependency of body, mind, emotions. and spirit. This paradigm attempts to assert the unity of al1 such levels, but fails to mly address the perennial problem of how physical and mental factors intercomect. The proponents of this holistic approach thus often find themselves leaping from one level of discourse to another, describing the cortical norepinephrine pathways at one moment, the next the beneficial effects of spiritual belief. While such phenomena are interconnected, the languages used to describe them are not, for they are derived from the two sides of the Cartesian dichotomy and thus have no linking terms. If purely physicalistic description looses the subjectivity of the individual, this multicausal approach has trouble expressing a unity (p. 39).

Leder (1984) outlines clearly the deficiencies that have become inherent in our

language to link the Cartesian dichotomy. Perhaps. at the same the, he also explains why

Freud was overwhelmed in his attempt to cornplete "The Project" and explain the entire

neurophysiological basis of psychoanalytic ideas.

2.2. THE EFFECTS OF CHfLD SEXUAL ABUSE

Finkelhor and Browne (1985) identiQ four core traumagenic dynamics or psychological

injuries inflicted by abuse: (1) traumatic sexualization. (2) beuayal, (3) powerlessness. and

(4) stigmatization. The authors suggest: "These dynamics alter children's cognitive and emotional orientation to the world, and create trauma by distorting children's self-concept,

world view, and affective capacities" (p.531). Finkelhor and Browne (1985) have neglected

to recognize that the core dynamics of abuse that they describe alter not only children's cognitive and emotional orientation to the world but also their physical orientation to the world. That said, however, the authors describe one instance in which the experience of the child's physical reality plays a role in the "dynamics" of sexual abuse; they "theorize that a basic kind of powerlessness occurs in sexual abuse when a child's territory and body space are repeatedly invaded against the child's will" (p. 532).

Browne and Finkelhor (1986), in an article entitled "Impact of Child Sexual Abuse:

A Review of the Literature" compared twenty-six studies on the topic, dividing the literature 18 according to initial effects, long-term effects. and effects by type of abuse. Within each of these areas, they discussed three topics: (1) the children's emotional reactions and self- perceptions; (2) their physical cornplaints and somatic complaints; and (3) effects on their sexudity. In the author's review, they stressed the importance of investigating the initial as well as the long-term effects of chiid sexual abuse. Browne and Finkeihor (1986) "prefer the term initial effects .. . because 'short-temTimplies that the reactions do not persist -- an assumption that has yet to be substantiated" (p.66).

They went on to state that the initial effects of child sexual abuse present in some portion of the victim population are reactions of fear, anxiety, depression, anger, hostility, and inappropriate sexual behaviour. However, the authors concluded that empirical literanire on the initial effects is sketchy (Browne & Finkelhor, 1986).

Regarding the long-term effects of child sexual abuse the pair limited their descriptive summary to adult wornen, the population most studied:

Adult women victimized as children are more likely to manifest depression. self-destructive behaviour, anxiety, feelings of isolation and stigma, poor self- esteem, a tendency toward revictimization, and substance abuse. Dificulty trusting others and sexual maladjustment in such areas as sexual dysphona. sexual dysfunction, irnpaired sexual self-esteem, and avoidance of or abstention from sexual activity (1986, p.72).

However, Browne and Finkelhor (1986) state that many of the studies on the initial and long-term effects of chiid sexual abuse are speculations by clinicians rather than studies with large samples and rigorous methodology:

Such speculations offer fruitful directions for research. Unfortunately .. . only a few studies on the effects of semal abuse have had enough cases and been sophisticated enough methodologically to look at these questions empirically. Furthemore, the studies addressing these issues have reached little consensus in their fmdings (p.72). 19 Despite their criticisms, Browne and Finkelhor (1986) conclude that child sexual abuse has serious negative effects on the victirns. In the authors' words, the literature

investigating the effects of child sexuai abuse "conveys a strong suggestion that sema1 abuse

is a serious mental health problem, consistently associated with very disturbing subsequent problems in some important portion of its victirns" (p.72).

Terr (1991) discusses trauma-stress conditions of childhood in two categories: type 1 and type 11 trauma. Type 1 trauma is characterized by one sudden-blow trauma; type 11 trauma is the result of long-standing or repeated ordeals. She proposes that children will differ according to the type of trauma they have experienced; some children will experience a blend of the two.

In type 1 trauma, or trauma as a result of a single, shocking, intense terror, Terr

(1991) found: (1) full, detailed memories, (2) the presence of "omens" or retrospective reworkings, cognitive reappraisals, reasons, and turning points, (3) misperceptions and mis timings.

In type 11 trauma, or trauma as a result of long-standing or repeated exposure, Terr observed profound character changes:

The fust such event, of course, creates surprise. But the subsequent unfolding of horrors creates a sense of anticipation. Massive attempts to protect the psyche and to preserve the self are put into gear. The defenses and coping operations used in the type II disorders of childhood -- massive denial, repression, dissociation, self-anaesthesia, self-hypnosis, identification with the aggressor, and aggression tumed against the self -- often lead to profound character changes in the youngster (p. 14).

Terr (1991) describes the emotions stirred by type II traumas as an absence of feeling, intense rage, and unremitting sadness. She explains that in the case of type II trauma, children have been known to attack their own bodies: Self-mutilations or physically damaging suicide attempts occur. The feste~g anger of the repeatedly abused child is probably as damaging a part of the condition as is the chronic numbing. Both of these, in fact, the numbing and rage, probably figure later in the antisocial, borderline, narcissistic, and multiple personality diagnoses that are so ofien part of the picture of the type II traumatized child grown up (p. 17).

Terr (1991) cornments further that four charactenstics are comrnon to al1 people subjected to extreme terrors in childhood: (1) repeated visualizations or other returning perceptions, (2) repeated behaviours and bodily responses, (3) trauma-specific fears, and (4) revised ideas about people, life, and the funire. Oddly , Terr does not include "bodily responses" in her summary of the four characteristics in her initial abstract or in the body of the paper; the inclusion is only made in her conclusion (p. 19).

In a later article, Terr (1993) found children have "pessirnism about the future"

(p.1543) which confims Briere's (1988) conclusion that for the adult women in his snidy. childhood sexual victimization led to "negative cognitions and perceptions regarding self, others, and the future" (p. 376). In addition, Briere (1988) concluded that sexual victimization led to "classically conditioned emotional responses that generalize and elaborate over time . .. and archaic coping behaviors that cease to be adaptive in the postabuse environment" (p.376). Browne and Finkelhor (1986) compared the findings of studies concerning the effects of various kinds of abuse. The areas they analyzed to assess for effects were: duration and frequency of abuse; relationship to the offender; type of sexual act; force and aggression; age at omet; sex of offender; adolescent and adult perpetrators; telling or not telling; parental reaction; and institutional response. Although one might assume that the severity of the impact -- for exarnple, of longer duration, greater frequency, parental figure perpetrator, the use of force or aggression, younger age at onset, 21

experiences involving genital contact, lack of support for disclosing -- would result in

greater trauma, Browne and Finkelhor (1986) cautioned that the research presented

contradictory results and "it would appear that there is no contributing factor that al1 smdies

agree on as being corsistently associated with a worse prognosis" (p.75).

Herman et al. (1986) studied the long-term effects of incestuous abuse in the

childhood of women and found that the severity of the incest correlated to the occurrence of

long-term effects. The authors cornpared a non-clinical sample and an outpatient sarnple of

adult women and found that the majority of women in the community had been upset by

their incest experiences, but believed they had recovered well. "Most women who had

suffered forceful, prolonged, or highly intrusive sexual abuse, or who had been abused by

their father or stepfather, reported long-lasting negative effects. The patients ' sample

reported histories comparable to the most severe traumatic histories in the community sample" (p.1293). The authors concluded that it is beyond the adaptive capacities of al1 but the most exceptional children to cope:

Although we have no way of howing what proportion of sexually abused women eventually seek psychiatrie treatment, it is clear from these findings that victims who become patients usually are those who have suffered the rnost severe early traumas. These results suggest that violent, prolonged, or intrusive abuse and abuse by a primary caretaker represents stressors that are beyond the adaptive capacities of al1 but the most exceptional children and that will regularly pruduce a long-lasting traumatic syndrome (p. 1296).

Briere and Runtz (1987) studied a clinical sample of 152 women and found child sexual abuse histories in approximately 44 percent of the cases. The history of child sexual abuse was associated with increased dissociation, sleep disturbance, tension, sexual problems, anger, suicide attempts, substance addiction. and revictirnization. A recent study by DeGroot et al. (1992) found that in a population of 184 female outpatients diagnosed for anorexia nervosa, bulimia nervosa, or anorexia nervosa with bulimia, approximately 25 % reported previous sexual abuse.

The Physical Effects of Trauma

In an article titled "Medical Consequences of Sexual and Physical Abuse in Women,"

Leserman et al. (1995) conclude that a "growing number of studies provide strong evidence of a link between the history of sexual and physical abuse in women and hnctional disorders such as imtable bowel syndrome and pelvic pain" (p.23). The authors suggesc that although many other medical conditions, including headaches, may be associated with an earlier experience of abuse, further research is needed to establish these relationships.

In her book, Trauma and Recoveq, Herman (1992) suggests that people who have been chronically traumatized will suffer physiological changes:

The physiological changes suffered by chronically traumatized people are often extensive. People who have been subjected to repeated abuse in childhood may be prevented from developing normal sleep, eating, or endocrine cycles and may develop extensive somatic symptoms and abnormal pain perception. It is likely, therefore, that some chronically abused people will continue to suffer a degree of physiological disturbance even afier full reconstruction of the trauma narrative (p. 187).

As well, Herman (1992) suggests that survivors "may need to devote separate attention to their physiological symptoms. Systematic reconditioning or long-term use of medication may sornetirnes be necessary" (p.187). While this may be the case, including the body in the process of reconstruction might enable sexual abuse survivors to integrate in such a manner that their physicai ailrnents or manifestations cm be incorporated and positively affected. The methodology presented in this study is one arnong what could be many approaches connecting the experience of the psyche and soma dunng the 23 reconstruction of mernones. This rnay result in the functional integration of physiological changes caused by the trauma of sexual abuse.

Perhaps Terr (1991) sums up the possible effects of child sexual abuse when she compares the experience of trauma to having rheumatic fever:

Like rheumatic fever, childhood trauma creates changes that may eventually lead to a nurnber of different diagnoses. But also like rheumatic fever, childhood trauma must aiways be kept in mind as a possible underlying mechanism when (these) various conditions appear (p. 19).

Terr makes two points in this statement. First, that like rheumatic fever the initial and long-term effects of child sexual abuse do not follow a set direction; that is, each individual's experiences will Vary. Second, sexual abuse in childhood should not be mled out as a possible underlying mechanism. or pathological source, for a vanety of conditions.

How each individual develops through life is greatly influenced by personality and by genetic, social, and cultural factors, arnong others. Thus, where one person may somacize or create an eating disorder in response to the experience of child sexual abuse, another individual may becorne sexually dysfunctional or depressed. 2.3. TRAUMA AND MEMORY

2.3.1. How Children Remember

Understanding body-oriented memory processing in adults requires a knowledge of the way

a child's memory functions and what happens to children's rnemories between childhood and

adulthood.

According to MacFarIane et al. (1987) the thinking of preschooi children is very

concrete, with a non-logical organization and non-logical, non-linear understanding of space,

distance, and the. Children's ability to exhibit memory of past events is determined by a

nurnber of considerations, including age and type of memory , intelligence, suggestibility ,

and personal significance (Fundudis, 1989).

Citing Piaget, van der Kok and van der Han (1991) explain that modes of encoding

information reflect stages of the central nervous system development: maturing involves a

shift from prirnarily sensorimotor (motoric action), to perceptuai representations (iconic),

and later to symbolic and linguistic modes of organization of mental experience.

Fundudis (1989) explains that memory based on recognition is easier for children

than rnemory based on free-recall because children's recollections, although not less

accurate, will contain much less information. Benedek and Schetky (1987) also state the

mernories of children tend to be more fragrnented and less complete than those of adults,

and that it is difficult for children to relate one set of events to another and organize disparate elements into a cohesive whole because of the lack of prior knowledge (Benedek

& Schetlq, 1987).

Fundudis (1989) makes the distinction between episodic mernory or memory recall focusing on specific details about Urnes, dates and locations, and script memory or rnemory 25 recall of a pst event in a form that is a recounting of selected details that are personally relevant to the individual. Details about times, dates, and locations are not relevant to children unûl age seven; they will remember in a script memory fashion where they can spontaneously respond in their own way .

A child's cognitive understanding of an event and hislher memory representation of that event need to be disthguished (Fundudis, 1989). In the case of the experience of sexual abuse, a child is unlikely to have the cognitive understanding of the act. A child may, however, interpret the sexual events in relation to hislher own development. For exarnple, a young child may interpret sexual touch as a showing of affection, and lack the language development and sexual and emotional manirity to articulate the experience. Also, a child's memory representation may contain emotions helshe does not understand on a cognitive level. Fundudis (1989) confinns that the "effect of abuse is sufficiently significant for the event to be stored in the child's memory and for it to be capable of being retrieved at a subsequent date" (p.340).

Cognitive factors, sexual immaturity , memory , language, emotional factors, and the identity of the interviewer will also affect how a person remembers an experience of trauma from childhood (Benedek & Schetky, 1987). In agreement with Fundudis (1989), Benedek and Schetkey (1987) state children will interpret events according to where they are in their sexual development. As a result sexual abuse may not be interpreted as "sexual activity, per se, but rather as an aggressive attack and violation of his or her body or as a form of affection" (p.912).

The clinical evidence of Terr (1988) indicates that "the timing of a traumatic event in a child's life, the nurnber of events that happen, and the length of thne of the trauma have 26 sornething to do with how well an early trauma will be recalled" (p. 104). Nelson (1993) explains that children acquire narrative foms of rnemory recounting " through transactions with adults in activity contexts where those foms are employed." (p. 12) at the earliest in the rnid to late preschool years.

Van der Kolk and van der Hart (1991) substantiate Terr's findings. They expiain how modem research indicates that infantile amnesia is the result of a Iack of myelinization of the hippocampus:

Even afier the hippocampus is myelinized, die hippocampal localization system, which allows memories to be placed in their proper context in time and place, remains vulnerable to disruption. Severe or prolonged stress can suppress hippocarnpai functioning, creating context-free fearful associations which are hard to locate in space and time. This results in amnesia for the specifics of traumatic experiences, but not the feelings associated with them (P - 442) .

In summary, children's memories are typically fragmented, non-contextualized, and non-logical. In addition, details are selected for persona1 relevance. Children's memories of trauma are affected by the factors of age, number of events, and duration of the trauma.

Physiological evidence reinforces the non-contexkalized nature of children's memories and shows that stressful memories are likely to be lost although the feelings will persist. This evidence points toward the need for an approach to memory retrieval that does not rely on the intellect.

2.3.2. Mvths and Misconceotions about Realitv versus Fanta-

In Freud's early work, he cites the experience of traumatic sexual abuse in childhood as the factor responsible for the developrnent of later pathology in adult women patients. By early

1896, Freud had corne to the conclusion that the neuropsychoses of defence are caused by 27 childhood sexual traumas (seductions), perpetrated either by an adult or by a much older

child (Sulloway, 1984). Later Freud dismissed this idea, apparently due to social pressure,

and instead decided that women's recall of early traumatic sexual insult is fantasy and

shouid not be believed (Sulloway, 1979; Masson, 1984). Fundudis (1984) argues that

statistics confinn the high incidence of child sexual abuse in Our culture and that the

psychoanaiytic viewpoint that memones of childhood sexual abuse are fantasy is far too

exaggerated. He states that although studies documenting the incidence of child sema1

abuse are conducted retrospectively, they are sufficiently substantive to counter any

suggestion that child sexual abuse is an imagined rather than a real problem.

Johnson and Foley (1984) exarnined the question of whether children are worse than

adults in discriminating real from imagined events in memory. They concluded there is

iittle direct experirnental support for the pervasive belief that children have more difficulty

than adults in discriminating what they perceive from what they imagine.

2.3.3. Accessibilitv of Abuse Mernories

In the "Psychopathology of Everyday Life" (1901), Freud states that "today, forgetting has

perhaps become more of a puzzle than remembering, ever since we have learnt from the

study of dreams and pathological phenornena that even something we thought had been

forgotten long ago rnay suddeniy re-emerge in consciousness " (p. 134).

Incest and child sema1 abuse have been related to psychogenic amnesia and other dissociative symptoms by many researchers (Herman & Schatzow, 1987; Braun, 1989; van der Koik & van der Hart, 1991). Whitfield (1995), in reference to adults, states that when a person defends against a traumatic expenence, "these experiences may become so 28 separated, split off or dissociated fiom Our awareness that we end up with: (1) no conscious memory of the experience, (2) memory of only parts of it, or (3) a vacillating conhision about our experience" (p. 108-9).

In group therapy with women incest nirvivors, Herman and Schatzow (1987) found that three facrors influence the extent to which a memory of abuse is repressed -- age of onset, duration, and degree of violence:

Women who reported no memory deficits were generaily those whose abuse had begun or continued well into adolescence. Mild to moderate memory deficits were usually associated with abuse that began in latency and ended by early adolescence. Marked memory deficits were usuatly associated with abuse that began early in childhood, often in the preschool years, and ended before adolescence (p .4-5).

Hennan and Schatzow (1987) observed characteristic differences in the adaptive styles and symptoms between people with varying degrees of memory of their abuse. The authors found that people with full recall wish they could repress theu memories and depend on dissociation and isolation of affect to protect them from ovenvhelming feelings. Often this group of survivors will describe themselves as " nurnb, " " frozen, " "in a fog, " or

"behind a glass wall" (p.6). It is significant that these descriptions tend to relate to bodily sensations. Herman and Schatzow (1987) also found that when these women's resource of dissociation fails hem, they resort to maladaptive coping strategies including somatization

(conversion reactions, hypochondriasis), impulsive risk-taking, dmg abuse, and transient psychotic episodes.

Herman and Schatzow (1987) observe that people with mild to moderate memory deficits recover additional mernories in the context of group therapy and the stimulation of listening to others' stories. Individuals with severe memory deficits have complete amnesia 29 for childhood experiences with the exception of recurrent intrusive images that are associated with extreme anxiety. This group of women experience flashback images of the abuser and panic states when they attempt sexual intirnacy. In addition, they are preoccupied with obsessive doubt over whether their victimization is real or fantasized.

A second group of women in Herman and Schauow's (1987) study had "complete arnnesia until a recent experience triggered sudden, drarnatic recall of sexual trauma in childhood, at which point they developed acute symptoms of a full-blown posttraumatic stress disorder" (p.8). Repressed memories are experienced as extremeiy painful and dismptive to their established mode of functioning: reliving their childhood abuse experiences as though they are occurrhg in the present is a cornmon theme among this group of wornen.

Hedges (1994) states that there is "no existing theory of memory derived from a century of intense psychoanalytic observation that supports the layman's naive view of massive repression followed by full and reliable recall" (p.30). Clinically we have abundant evidence that factors ranging from age, duration. degree of violence, and adaptive style of the survivor affect the intensity and accessibility of memories of abuse. 2.3.4. Trauma and the Body Experience

Hartman and Burgess (1988) propose an Information Processing of Trauma Mode1 that

begins with a sensory level as the basic experience, a perceptuai level that begins

classification of sensory processing, and a cognitive level that organizes experience into

rneaning systems.

Traumatic memories are distinctive in at least two ways that are important for this

discussion: (1) they are extenially derived, and (2) they are not amenable to linguistic

organization. According to Benedek and Schetlq (1987), extemally denved memories, as compared to intemally derived psychic ones, are more likely to contain temporal and spatial

information than are drearns or fantasies. Detail and sensory information about taste, smell. and touch are more cornmon in externally derived mernories.

Johnson and Foley (1984) propose that intemally and externally derived memories differ along specific dimensions: externally derived memories are typically more detailed, more sensory in content, with more spatial and temporal information; internally derived memories are more schematic and include more information about the thought processes engaged in their creation.

Another important feanire of trauma memory is that it cannot be organized on a linguistic level. Reflecting Piaget's developmental stages of encoding information in the central nervous system, van der Kolk and van der Hart (1991) argue that "the experience [of trauma] cannot be organized on a linguistic level and this failure to arrange the memory in words and symbols leaves it to be organized on a somatosensory or iconic level: somatic sensations, behavioral reenactments, nightrnares , and flashbacks " (p.443). They maintain that "when people are exposed to trauma, that is, a frightening event outside of ordinary 31 human experience, they experience 'speechless terror"' (p.442). Van der Kolk (1996)

extends this observation, relating speechless terror to the deactivation of Broca's area in rhe

brain. which "is responsible for translating personal experiences into communicable

language " (p. 295). van der Kolk holds this phenornenon responsible for the way trauma

survivors with post-traumatic stress disorder (PTSD) have a tendency "to experience

emotions as physical states rather than as verbally encoded experiences. These findings

indicate that PTSD patients' difficulties puning feelings into words are reflected in actual

changes in the brain activity " (p.293).

A schematic understanding of trauma helps us to recognize ways in which the body

retains the trauma experience. Fine (1990) states that an abusive environment in childhood

will lead to cognitive schemas that reflect the abuse history. Such cognitive inflexibility

will impair adjustment to a non-abusive environment. She suggests clinical observation

indicates some schernas remain untouched by abuse whereas others may be "shactered or

larned" and that this "may explain the differential cognitive lacunae observed in abuse

survivors" (p. 173-4). Hedges (1994) presents a somatic version of the inflexible schemas described by Fine (1990): "The threshold to more flexible somatic experience is guarded by painful sensations (parallel with Freud's [1926] theory of 'signal anxiety') erected to prevent

hture venniring into places once experienced as painful by the infant or developing toddler"

(p.29-30). These observations coincide with earlier cited material on the physiological effects of semal abuse trauma (See Section 2.2.).

Fraiberg (1982) extends these findings, concluding that not oniy can trauma be

"obliterated, " it cm also be transformed from pain into pleasure. In her study of pathological defenses in infants between the ages of three and eighteen months who had 33 experienced danger and deprivation to some degree. she found thar early defenses of

" avoidance, freezing and fighting" appear from a biological repertoire on the mode1 of

"flight or fight" (p.612). Fraiberg (1982) makes it clear that she is not talking about

"defence mechanisms which can be assumed to function only when an ego, properly speaking, has emerged" (p.613). She finds that "before there is an ego. pain can be transfomed into pleasure or obliterated from consciousness while a symptom stands in place of the original conf?ictW(p.612). Fraiberg (1982) discusses her work with infants and how symptoms may stand in the place of the original conflict as follows:

The human infant, of course, does not have 'fighting' capability until motor advances and concomitant drive progression emerge at the close of the first year. The forms of avoidance .. . in these deprived infants employ a cutoff mechanism in perception which selectively edits the mother's face and voice and apparently serves to ward off painhl affects. 1 have suggested that this elementary form of defense against the perception of a painful stimulus may be related to forms of defense employed in later ego organization when repression and those cornpound defenses which make use of repression close off the perception of a painhl stimulus at the threshold of consciousness. The transformations of affect which 1 have described in infants in the first half of the second year tell us that long before there is an ego, pain can be uansformed into pleasure .. . , and pain can be obliterated from consciousness while a symptom, such as Cindy 's eye rubbing, stands in place of the original conflict. The deviant course of aggression in these deprived and imperiled infants is seen at the beginning of the second year of life when aggression is discharged in wild outbursts in one moment and tumed back upon the self in self-injury in another moment. And finally, Our attention is drawn to the picture of the infant when these defenses fail before the formidable task of defending without defenders. 1 have described disintegrative States in which the child flails and screams and is demonstrably out of touch with his surround (p -632-633).

Levine (1992) extends the fight, flight. freeze repertoire to include "collapse." He explains that when the "danger-orientation and preparedness to flee are not successful, when they are blocked or inhibited" there is "blockage which results in freezing and anxiety- 33 Fraiberg's (1982) statements are congruent with Freud's (1938) view of how

symptoms of trauma may manifest by association. He offers a perceptive comment about

the connection between the bodily experience of sexual abuse and the way other syscerns and

parts of the body cmbecome associated with that abuse: "rnysterious" disturbances of non-

sexual bodily functions become comprehensible when we understand that

semai disturbances encroach upon other functions of the body. .. . . For example, the lip zone, the comrnon possession of both functions, is responsible for the fact that sema1 gratification originates during the intake of nourishment; the sarne factor offers also an explanation for the disturbances in the taking of nourishment if the erogenous functions of the common zone are disturbed (p. 603).

Terr (1994) discusses her experience as an expert witness during the trial People us.

Franklin in which an adult woman testified against her father for the killing of her girlfriend

when they were children. Terr explains: "1 look for intemal confirmation -- clusters of

symptoms and signs of Eileen's trauma" (p.33). As it happened, Eileen pulled her hair out

in the same spot on her head where her father killed her young girlfriend with a rock before

raping her. Terr continues:

Since al1 the lobes of the cortex are involved in memory, a memory is not just the picture or the sound that person once perceived. The memory would encompass, for example, Eileen's bodily attitude at the the she witnessed Susan Nason's murder, her sense of the environment at the place she and her father stopped, her position above Susan, her father's presence, the condition of her intenial organs (a clutched stomach, perhaps), the words she thought -- in short, almost everything. When Eileen's rnernory came back, many sensory and thinking pathways, or circuits, that had been comected with her perceptions during the Nason murder reactivated, bringing her the sensation of a memory (p.44).

When T'en (1994) assists a client to remember trauma she asks questions about body position, clothing, and awareness of others being present. These questions could be viewed as body-oriented memory cues, and indicate that she is searching for the "sensation of a 34 memory ."

Freyd (1994) hypothesizes that "the degree to which a trauma involves a sense of

having been fundamentally cheated or betrayed by another person rnay significantly

influence the individual's (1) cognitive encoding of the experience of trauma. (2) the degree

to wkich the event is easily accessible to awareness, and (3) the psychological as well as the

behavioral responses" (p.308). It is possible to apply Freyd's (1994) " theory of trauma" not

ody to the "violation of the basic ethic or metaethic of human relationships" (p.308) but

also to a profound disturbance of the intrapsychic relationships between the body, intellect,

emotions. and spirit. This application makes it possible to acknowledge trauma survivors'

extreme sense of betrayal by their body. In their experience, the body, originally the reason

for the abuse, remains the source of the trauma.

2.3.5. The Relevance of State De~endencv

Rossi (1993) defmes state-dependent leaming and memory as a process in which "what is

learned and remembered is dependent on one's psychophysiological state at the tirne of the

experience" (p.47). Rossi (1993) States: "Since rnemory is dependent upon and limited to

the state in which it was acquired, we Say it is 'state-bound information"' (p.49). Rossi

(1993) explains that in "rnind-body information transduction and state-dependent memory,

leaming, and behaviour mediated by the limbic-hypothalarnic system, are the two

fundamental processes of mind-body communication and healing" (p.68). He views state-

dependent memory, leaming, and behaviour phenornena as the "'missing link' in all

previous theories of mind-body relationships " (p. 68). For exarnple, Rossi (1993) views psychosomatic symptorns as a mode of adaptation learned dunng a special (usually 35 traumatic) state-dependent psychophysiological condition. The psychosomatic mode of

adaptation "continues because it remains state-bound or locked into that special

psychophysiological condition even after the patient apparently returns to his normal mode of functioning" (p.81).

Current researchers attribute the earliest theories of dissociation and state-dependent

leamhg to the French neurologist Pierre Janet who pioneered the area of trauma and recovery in the late 1800s and early 1900s (van der Kolk et al., 199 1; Whidield, 1995).

Janet (in van der Kolk et al., 1991) also recognized that traumatic memory is state dependent or is evoked under particular conditions. "It occurs automatically in situations which are rerniniscent of the original traumatic situation. These situations trigger the traumatic memory. .. . When one element of a traumatic experience is evoked, al1 other eIements follow automatically. Ordinary memory is not characterized by restitutio and

integrum l1 (p .43 1).

Tulving (in van der Kolk & van der Hart, 1991) demonstrated that remembering events always depends on the interaction between encoding and retrieving conditions: "The more the contexnial stimuli resemble conditions prevailing at the time of the original storage, the more retrieval is likely. Thus, memories are reactivated when a person is exposed to a situation, or is in a somatic state, reminiscent of the one when the original memory was stored" (p 45). "Since traumatic rnemories are state dependent, Janet drew the conclusion that patients needed to be brought back to the state in which the memory was first laid down in order to create a condition in which the dissociated memory of the past could be integrated into current meaning schemes" (p -445-446).

a Janet (in van der Kolk & van der Hart, 1991) also believed that: "successfril action of the organism upon the environment is essential for the successful integration of mernories: 'the healthy response to stress is mobilization of adaptive action. He even viewed active memory itself as an action: 'memory is an action: essentially it is the action of telling a story. ' This notion keeps coming back in the works of modem neurobiolgists. For example, Edelmean (1991) States that 'action is fundamental to perception: both sensory and motor ensembles must operate together to produce perceptual categorization"' (p -446) -

When action is impossible, perception is irnpeded or distorted. Van der Kolk and

van der Hart (1991) explain: "It is likely that psychological and physical immobilization are

central features of the impairment of appropriate categorization of experience. and may be

fundamental to the development of hyperamnesia and dissociation" (p.446). They go on to explain that feelings of helplessness and physical or emotional paralysis are fundamental to

making an experience traumatic because the person was unable to take any action that could affect the outcome of events. van der Kolk and van der Hart (1991) do not speak directly to the effects on the body of this "helplessness" and resulting " immobilization. "

Terr's (1994) discovery of the key nature for memory retrieval of the "sensation of a memory " receives support from van der Kolk and Fisler (1995), who state:

Clinical experience and our reading of a century of observations by clinicians dealing with a variety of traumatized populations led us to postdate that 'mernories' of the trauma tend to, at least initially, be experienced prirnarily as fragments of the sensory components of the event: as visual images, olfactory, auditory, or kinaesthetic sensations, or intense waves of feelings (which patients usually claim to be representations of elements of the original traumatic event). What is intriguing is that patients consistently daim that their perceptions are exact representations of sensations at the time of the trauma (p.513).

Van der Kolk (1996) explains further that rnemory for traumatic events increases as more sensory modalities are activated. His findings are congruent with Terr's rationale for her reuieval technique, in which she questions clients about sensory material surrounding the trauma memory in order to retrieve more details. van der Kok (1996) states:

Ail these subjects, regardless of the age at which the trauma occurred, claimed that they initially 'remembered' the trauma in the form of somatosensory flashback experiences. These flashbacks occurred in a varîety of modalities: visual, olfactory , affective, auditory , and kinaesthetic, but initially these sensory modalities did not occur together. As the trauma came into consciousness with greater intensity, more sensory modalities were activated and the subjects' capacity to tell themselves and others what actually had happened emerged over time (p.289).

Van der Kolk (1996) explains that "the very nature of traumatic memory is to be dissociated, and to be stored initially as sensory fragments that have no linguistic components" (p.289). Waites (1993) explains how dissociation is a component of the state dependency :

Dissociation, like other symptomatic behaviour, can often be understood as a defense against unbearable anxiety. Traumatic expenence typically produces an overwhelming need to escape what is. in reality, inescapable. Dissociation is a psychobiological mechanism that allows the mind, in effect, to flee what the body is experiencing, thus maintaining a selective conscious awareness that has survival value. The shock of trauma produces states that are so different from ordinary waking life that they are not easily integrated with more normal experience. As a result of this discontinuity, the traumatic state may be lost to mernory or remembered as a drearn is sornetirnes remembered, as something vague and unreal (p. 14).

The body's evidence can provide a countenveight to this "unreal" quality of traumatic remembering. Because the body is concrete and contains unchanged confirmation of the experience, it can provide a continuing tangible reality.

Waites (1995) explains that dissociation can extend to the extreme of dissociative personality disorder (formerly called multiple personality disorder or MPD):

The sense of unreality, which results from physiological as well as psychological responses to trauma, is compounded by the wish that terrible events were not really occurring or had never happened. This wish, in conjunction with unusual sensations and perceptions, can lead to the conviction that 'This is not really happening to me; 1 am merely observing it. ' In such circumstances, a victirn may perceive her physical body as an alien entity from which her mind is detached. Having experienced such a dissociation she rnay elaborate on it when subsequentiy confronted by painful memories or by a repetition of trauma. She rnay even create an organized identity that is untouched by the trauma, or an identity that remembers the trauma but is discomected from her usual identity. In extreme cases, like MPD. a series of identity configurations are organized by particular sets of rnemones but remain isolated from one another (p. 14).

According to van der Kok (l994), traumatic memories may emerge from these dissociative states involuntarily when the person is in a non-ordinary state that resembles the original trauma or creates a vuherability. He explains:

Decreased inhibitory control may occur under a variety of circumstances: under the influence of dmgs and alcohol, during sleep (as in nightrnares), with aging, and after strong rerninders of the traumatic past. Conceivably, traumatic memones then could emerge, not in the distorted fashion of ordinary recall but as affect states, somatic sensations, or visual images (for example, nightmares or flashbacks) that are timeless and unrnodified by further experience (p. 26 1).

Anthony (196 l), in an article entitled "A Snidy of Screen Sensations, " comments that the "conditions" that trigger "screen sensations " involve foremost a state of " regression" that is part of the analytic process (p.238). He continues: "The depth to which regression attains has a close bearing on the reappearance of early sensations and is related in pan to the quality of the transference development and in part to certain inherent characteristics in the patients " (p. 23 8). 39 2.3.6. Intervention

Waites (1993) explains that a trauma survivor's "sense of reality is. of course. cornpticated

not only by familial beliefs but by developmental and traumatic factors in the encoding and

retrieval of memories " (p. 7 1). Some survivors expenence increased anxiety in the process

of recovering memones, but generally the new memories enable thern to form a more

realistic picture of their families and a Less cntical estimate of themselves (Herman &

Schatzow, 1987). Johnson and Foley (1984) comment that overall memory will improve

when the original physicai or cognitive context of the trauma is reinstated. van der Kolk

and Fisler (1995) point out that "people who have learned to cope with trauma by

dissociating are vulnerable to continue to do so in response to minor stresses. The

continued use of dissociation as a way of coping with stress interferes with the capacity to

fully attend to Me's ongoing challenges" (p.513). van der Kolk and van der Hart (1991)

state that "in the case of complete recovery, the person does not suffer any more from the

reappearance of traumatic memories in the form of flashbacks, behavioral re-enacunents,

etc. " (p.447).

Van der Kolk and van der Hart (199 1) explain that " traumatic memories are the

unassimilated scraps of overwhelming experiences, which need to be integrated with existing

mental schemes, and be transformed into narrative language. It appears that, in order for

this to occur successfully, the ûaurnatized person has to retum to the memory often in order

to complete it" (p 447). van der Koik and Fisler (1995) recognize that sirnply learning to

put traumatic experience into a personal narrative will not reliably abolish the occurrence of

flashbacks. Van der Kolk (1996) concludes that "because of the very nature of dissociative psychopathology, many such patients regularly enter States in which they partially or completely reexpenence the trauma, without any resolution whatsoever. Controlling

dissociation and integrating the traumatic experience must be the goal " (p. 3 10).

Herman and Schatzow (1987) raise the question of whether it is necessary to break

the barriers of repression to uncover traumatic memories when such breakthroughs are

marked by powerful affect and temporary ego disorganization. The authors respond to their

own question:

It is our impression .. . that the retrieval and validation of repressed memories has an important role in the recovery process. With the return of memory, the patient has an oppomnity as an adult to integrate an experience that was beyond her capacity to endure as a child. The purpose of reliving the experience with full affect is not simply one of catharsis, but of reintegration. Symptoms, feelings, and behaviours that previously seemed inexplicably bizarre, and ego-alien become comprehensible; the patient becomes more comprehensible to herself, and more able to construct meaning in her life history. In addition, the relief of particular posttraumatic symptoms following recovery of memory is often dramatic. This process has been well documented in the Iiterature on victims of many types of ovenvheiming trauma, ranging from child abuse to rape, torture, and combat (p. 12).

Briere (1992) suggests that going beyond the " verbal-analytic renditions " of the person's abuse to the "associated sensory components .. . the clinician may facilitate a more integrated (less dissociated) reexperiencing of abusive events, and thus potentially a more complete resolution of posttraumatic difficulties " (p. 133). Briere (1992) continues: " Some clinicians, in fact, encourage clients to draw, paint, or in some other nonverbal modality depict their abuse experiences in order to access the less linear, more sensory components of abuse-specific memory " (p. 133).

Briere (1992) suggests that the survivor's amnesia may be an unconscious decision

"to inhibit recall of events that would produce extreme distress if acknowledged." He recognizes that amnesia in this case is less a pathological process and more an adaptive 41 strategy. He cautions the therapist to "consider the vaiidity of methods that dramaticaliy

increase access to repressed memories. since the unconscious communication from the

survivor (by vheof the amnesia) is that he or she does not believe complete knowledge is

in his or her immediate best interests." Failure to act on the meaning of this "unconscious

communication" may result in exposing the survivor to information and experiences that

may exceed his or her capacity and result in a crisis (p. 134-135).

Briere (1992) acknowledges that there are instances when memory deficits are a

result of state-dependent leaming. With reference to van der Koik (1989), Briere suggests

that "the survivor whose abuse occurred under conditions of extreme fear or shock ... may

not have access to such memories when in a more 'normal'" (lower or different) arousal

state; for instance, during the typical psychotherapy session" (p. 134).

Briere (1992) advocates "gradually more detailed exploration of abuse memories

during regdar psychotherapy" (p.134). He explains "for exarnple, as the client recalls a

smaU fragment of a traumatic experience, associated thoughts , memories, feelings, and

transferential reactions are often evoked, thereby leading hirther into the memory. As a

result, the survivor is able slowly to re-create abuse-related affective and cognitive

experience, ofien allowing further access to state-dependent material" (p. 134-5). He

believes "this process has advantages over hypnosis in that it (a) arises smoothly and in an

integrated fashion from the process of treatment, rather than switching to a new therapeutic

modality, and @) unfolds more clearly under the client's control, at his or her own pace"

(p. 135). Bnere views the "safety, trust, and comectedness of the positive therapeutic

relationship" as involving a reciprocal process whereby the "therapeutic safety and support encourage memory recall, and growing recall reinforces the validity and importance of the 42 therapeutic relationship" (p. 135). Remarkably, Briere (1992) has neglected to recognize that the body is a potential resource for this gradua1 retneval of sensory material.

When body experiences are incorporated in a psychotherapeutic process. they are usualiy expected to result in a meaningless and repetitive cathartic expression. Hedges

(1994) describes how catharsis without resolution can become an ongoing mindless activity when he explains that "memones of primordial breakdowns are embedded in somatic symptoms and terror" (p.63). Hedges (1994) believes that in the case of intense trauma,

memory is guarded with intense physical pain attributable to the process of (quasi-neurological) primary repression. No one wants to go through the excruciating gross bodily pain and terror necessarily entailed in physically remembering the process of early psychic breakdown. A simplified recovery approach may foster repeated intense abreactions that bring the body to the pain threshold in an acting out that is then endlessly repeated in the name of recovery. But a cenairy of psychoanalytic research has repeatedly and unequivocally demonstrated the futility of this abreaction approach -- whether it be acted out in the form of screarning, kicking, accusing, confronting, switching personalities, generating yet more flashbacks, or whatever (p.64).

Hedges identifies the limitations of a simplistic approach to body experiences. His point of view demonstrates the necessity for a clear representation of what the body can offer as a resource in psychotherapy .

Waites (1993) States that "the dangers of emotional flooding" have been illustrated by the negative therapeutic reactions sometimes associated with abreactive techniques in which clients are "continualiy re-traumatized." Waites (1993) suggests that:

the key to the successful treamient of post-traumatic overstimulation lies in the careful integration of supportive and uncoverîng techniques in the treamient process. Many PTSD symptorns, including psychobiological ones, cannot be simply suppressed or avoided. They are the confiing data that convince many victims that repressed or dissociated abuse really occurred. Often, too, they are comected with important autobiographicai memories that the client needs to integrate into her view of herself and her history ... the goal of integrative therapy is to replace uncontrollable forgetting or remembering with controlled access to one's memories. In practice. this goal cm often be achieved through a controlled confrontation in a safe setting and a careful emphasis on integration in the wake of any traumatic reexperiencing. In this process, one role of the therapist is continually to monitor and guide the relationship benveen painful confrontation and mastery (P. 1w.

Waites (1993) states: "Helping a client overcome numbing and Bight from her body requires talking about bodily experiences and sensations " (p. 181). Waites's comrnents speak to the importance of not taking about the body from an intellectual perspective or simply as an access to ernotional content of experience, but rather allowing the body to have its own voice and to speak from the perspective of its expenence. Such experience offers the client an opportunity to differentiate her experience of her body in the present from that of the past. Waites (1993) states: "The transference features of the therapeutic relationship require continual acknowledgement and clarification in order to help the client differentiate the nonabusive relationship with the therapist in the present from abusive relationships in the past" (p. 181).

Putnam (1990) states: "The state-dependency of traumatic mernories and affects in sex abuse victirns makes this material and associated self-concepts relatively impervious to standard psychotherapy " (p. 126)- Putnam (1990) advocates treatment that addresses disturbances of self found in victims of childhood sexual abuse. He recognizes that "in many instances, adjunctive treatment modalities (e .g ., art therapy , rnovement therapy) may be more effective with certain disturbances of self (e.g., body-image distortions) than conventional psychotherapy " (p. 125). According to Putnam (1990)

the reconstitution of self through the recovery and chronologic sequencing of rnissing autobiographical memories cm play an important role in the therapeutic process. This reconstruction process is often accompanied by abreactions that activate latent self-images and liberated dissociated affects. The bringing of dissociated matenal into consciousness leads to greater self- awareness and decreased vulnerability to environmentai triggers (p. 125-6).

Goodwin (1990), in her discussion about what we have learned from victimized children, concludes that "especially with severely symptomatic adult victims, treatment may need to focus on 1) physical sensations and symptoms and the achievement of physical safety; .. . [and. (2)] the systematic identification of posttraumatic symptoms and the comection of these symptoms with specific traurnaric events in childhood" (p .70-71).

Hem(1992) explains: "For survivors of prolonged, repeated trauma, it is not practical to approach each memory as a separate entity. There are sirnp!y too many incidents, and often similar memories have blurred together. Usually, however, a few distinct and particularly meaningful incidents stand out. Reconstruction of the trauma narrative is ofien based heavily upon these paradigrnatic incidents, with the understanding that one episode stands for many" (p. 187).

Herman (1992) views helplessness and isolation as the core experiences of psychological trauma and ernpowerment and recomecting as the core experiences of recovery (p. 1997). According to Herman (1992) recovery from trauma unfolds in three stages: (1) the establishment of safety; (2) remembrance and mourning; and (3) recomection with ordinas, life. Hennan (1994) States: "The success of treatrnent does not depend on the retneval of memories the way the success of a fishing expedition depends on the catching of fish. One does not have to uncover a buried memory in order to feel better and perform better (p. 160). ... One way to determine whether sorneone's memory is false is to look for symptoms or signs that correspond to the remembrance. If a child is exposed to a shocking, frightening, painful, or overexciting event, he or she will exhibit psychological signs of having had the experience. The child will reenact aspects of the temble episode. and may complain of physical sensations similar to those originally felt. The child will fear a repetition of the episode, and will often feel generally and unduly pessimistic about the future" (p. 161). Whitfield (1995) states:

In ordinary memory, state-dependence is often an important factor, but in traumatic amnesia. state-dependence is usual. This is why in simple interviewing and regular 'talk therapy' the survivor and the perpetrator rnay not be able to remember their uaumatic experiences or the events of abuse. For the perpetrator the act of abusing another may be a reenanactment of earlier trauma, partly or totaily forgotten as soon as the state changes once again. Expenential therapies. which can assist a person to get into different states of consciousness, rnay be more helpful in the process of remembering and healing than talking alone. State-dependence also demonstrates why symptoms and mental disorders, which are often ernotional and somatic mernories of the original state, are indicative of abuse and often accompany the remembrance of trauma (p -45-46).

WhitfieId (1995) continues: "recovery cannot proceed successfuIly only in Our head.

It must also be experienced in our heart, guts and bones -- in the deepesr fibre of Our being"

In regard to ps ychotherapy that involves traumatic memory retrieval clinician authors offer the following guidelines. Whitfield (1995) cautions, "do not assume, lead or suggest anything about the content of past trauma" (p. 184). Briere (1992) suggests: "The process of memory recovery should be a gentle, nonintrusive one - a process that respects the survivors' unconscious choice not to remember certain things at certain times, sometimes despite his or her conscious statements" (p. 136). Van der Kolk (1989) stresses:

Failure to approach trauma-related material very gradually leads to intensification of the affects and physiologic states related to the trauma, leading to increased repetitive phenomena. It is important to keep in mind that the only reason to uncover the trauma is to gain conscious control over the unbidden re-expenences or re-enactments. .. . Once the traumatic experiences have been located in time and place, a person can stan makhg distinctions between current life stresses and past trauma and decrease the impact of the trauma on present experience. .. . Traumatized people need to learn to understand that acknowledging feelings related to the trauma does not bring back the trauma itself, and its accompanying violence and helplessness. There must be emphasis on finding replacement activities and experiences thar are more rewarding, successfil, and valuable in the long nin, although less exciting and powerfûi in the irnmediate present (p.403).

1 believe the accumulated evidence of these clinical studies creates a strong argument

for the inclusion of body experience and its sensory-perceptual rnodalities in the process of

rnemory retrieval, validation of childhood memories, and in any recovery process that has

its goal holistic healing from child sexuai abuse trauma. The body is an entity that can Pace

and measure memories, reclaim control and authority, and differentiate as well as bridge the

past, present, and future. One needs to have a body to own a body, and one needs to own a

body to recognize it as a part of oneself that needs to be nurtured and loved. The first step

in the path of healing is reclaiming ownership of one's body. Individuals who experiencrd early sexual abuse and as a consequence could not articulate what had occurred and/or those

who were traumatized in such a fashion that the memories becarne state bound because of extreme fear and shock require non-ordinary and non-intellectually dominated States for memory retrieval and reintegration. The research cited in this section has demonstrated that these state-bound, somatosensory traumatic memories from childhood do not become effectively integrated w ithin a conventional psycho therap y approach. CHAPTER 3

RESEARCH OBJECTIVES AND METHOD

3.1. RESEARCH OBJECTIVES AND RESEARCH QUESTIONS

The central objective in this research project is to investigate the experience of the body as elicited through a body -focused verbal dialogue and draw ing psyc hotherapeutic technique.

The intervention technique is intended to explore body-oriented memory reuieval and processing for the purpose of healing women who have identified themselves as survivors of childhood sexual abuse. A further objective is to investigate ways in which the inclusion of body experience may contribute to the process of healing.

The general research question is:

Does the body have a place in psychotherapy?

This research seeks to begin to answer that question by asking the following research-related questions:

What are the body experiences of women survivors of childhood sexual abuse?

Does the body-oriented mernory relate to the participants' experience of child sexual abuse?

Does working from the orientation of the body, through a body-focused verbal dialogue technique, facilitate rnemory recall that leads to healing or recovery?

How does the body experience link with psychological integration in the participants' process of healing?

1s it important to include the experience of the body in the process of healing from child sexual abuse? If so, can this research demonstrate ways in which this inclusion is important?

In the participants' view how dws working in this body-focused verbal dialogue technique compare to other approaches she may have experienced (e. g . touch, movement, and conventional verbal therapies)? 3.2, THE DEVELOPMENT OF A BODY-FOCUSED PSYCHOTHERAPEUTIC INTERVENTION TECHNIQUE

3.2.1. Where 1 Began

Five years ago 1 found myself in the midst of the debate about whether traumatic memories could be repressed and later rernernbered. In response 1 wanted to find a way to enable women survivors of sexual abuse to reclaim their bodies and through exploring their bodily experiences, "ground" in the "laiowing" of its experience. Since evidence suggests that memory is in the body (van der Kolk, 1994), body experiences may further validate the occurrence of trauma.

From my working experience in the area of body/movement therapy 1 knew that often, particularly in initial sessions, women survivors are not able to benefit €rom touch therapy because external physical contact easily triggen a return to traumatic body-oriented memories and dissociation. In addition, I have participated in a number of touch therapy sessions where the therapist employed in essence a primarily verbal approach while her hands did not relate to what 1 was experiencing. 1 understood that I needed to develop a technique in which the participant would feel in control and where she could continue to be grounded in her body throughout the experience. 1 spent wo decades teaching people to realign their body by focusing on my words as 1 instructed them with multiperceptual images and anatomy terrns to facilitate kinaesthetic learning and energy currenting. 1 decided to use the verbal modality as a means of offering women survivors a renewed relationship with their body and an opportunity to access its wisdom.

Among the factors that detemiined my choices were: 1) my training in Jungian psychology and in psychosynthesis (Assagioli, 19651, which offer psychological frameworks 49

for a conceptualized view of the self that includes the body; 2) my training and expenence

in touch and movement therapy; and 3) the need for the development of an appropriate

therapeutic relationship for sexual abuse swivors that reflects the intensity and distinctive

quality of their healing process.

To dari@ the unique qualities of my therapeutic intervention. I include references to

related literanire for cornparison and contrast. At the end. 1 present a description of what emerged as the intervention method for my research.

3.2.2. Finding a Conce~tualFramework

Twenty years ago, 1 snidied Jungian psychology intensively with Dr. Jakob Arnstutz. Car1

Jung gave me a language to articulate body-mind from a psychological perspective, and

from his work I have developed the term "psyche-soma link." Jung (1935) created terminology for inclusion of the body in the self, "the physiological unconscious, the so- called somatic unconscious which is the subtle body" (p.441). He explains:

Somewhere our unconscious becomes material, because the body is the living unit, and Our conscious and our unconscious are embedded in it: they contact the body. Somewhere there is a place where the two ends meet and become interlocked. And that is the place where one cannot say whether it is matter, or what one calls 'psyche' (p. 441).

The second major component in my conceptual framework is my training in psychosynthesis theory and its technique of guided imagery, which 1 studied with Dr. John

Weiser and Ann Weiser. Psychosynthesis offers a concepnial framework and a language for

speaking about psychological experience from a holistic perspective that has directly

influenced the development of my body-focused intervention technique. As a psychological 50 framework, psychosynthesis offers a conceptualization of self that includes the body. as well

as the higher self and transpersonal experience. The Italian psychiatrist, Roberto Assagioli.

founded psychosynthesis in the second decade of this century. Psychosynthesis may be

considered a holistic approach since it is concemed with a balanced development of the

various aspects of human experience -- physical, emotional. mental, and essential (related to

essence, identity. being, will) (Crampton, 1977). Psychosynthesis considers itself more

holistic than other current therapies, which tend to focus on the link between two of die

three personality vehicles . " Approaches like psychoanalysis , transactional analysis , and

Rogerian therapy emphasize the mental-emotional link; rnethods such as Gestalt.

bioenergetics, and prima1 therapy utilize primarily the link between body and the emotions;

and approaches like the martial arts, the Alexander technique, and the Feldenkrais method are based on the link between mind and body. Psychosynthesis recognizes al1 these links and uses whichever of them seem most appropriate to the situation" (Crampton. 1977. p.40).

Assagioli's perspective was one of growth; he viewed pathology not as a collection of symptoms that need to be cured but rather as an indication of an energy blockage that needs to be explored. Assagioli used the term "subpersonality map" to describe the "small

1's that speak for the part rather than for the whole person." His term, "personality vehicles map," refers to the body, the emotions. and the mind. "These three components, which make up the personali~,are like 'vehicles' for the Self because they are its media of manifestation on the material plane. It is important that each vehicle be adequately developed and coordinated with the others so that the personality expression is balanced and harmonious. Some people are so identified with one of the personality components that they 51 are cut off €rom other aspects. Such a split is most cornrnon between the mind and the

emotions" (Crampton, 1977, p. 11-12).

1 believe Assagioli offers a framework in which we can understand and comrnunicate

verbally about the parts of Our self and how the body, emotions, and mind porentially

represent aspects of each part. Psychosynthesis has greatly influenced me because it accepts

the relevance of the experience of the body and 1 have found validation through its existence

and language. Although Assagioli's intention was to offer the three "personality vehicles"

on an equal footing, 1 feel that this method lacks techniques for exploring the body and its

links with the other vehicles. A second limitation of this method, at least for my purposes,

is the pre-set agenda of the guided imagery.

3.2.3. Finding a Bodv Base

1 have also been influenced by my training with Bonnie Bainbridge Cohen. Through an

expenential process she calls "Body-Mind Centering," Cohen teaches that mind is everywhere in the body, and that mind refers to mind of being , not the intellect exclusively .

Cohen teaches that being present in one's body involves understanding how attention and

intention unite in an expression of embodiment through movement. IdentiQing and differentiating the rnind States of being present in various tissue or body systems ultimately

leads to an integration of the body experience. Focusing on the physical systems of the body in this way gives me a vocabulary to recognize, articulate, and cornrnunicate my physical experiences. The resultant body/movement knowledge, when combined with the mind's constant presence in the tissue, emotionally, intellectually, and spiritually leads, 1 suggest, to the experience of consciousness and soul. Embodiment refers to embodiment of 52

oneself rather than embodiment of intellect, embodirnent of emotions or embodiment of the

body, in their usual fragments. Self-knowledge of the body, of the intellect. and of the

emotions comes together through a profound persona1 joumey to acknowledge the whole

person. or a person in al1 of her aspects, leading to embodiment of self.

The body, when allowed, is a source of knowledge and healing and not simply a

means to an end. From this perspective, body parts or the body as a whole are perceived

with a new clarity and understood to possess information and awareness about the self.

3.2.4. Acknowledeing the Thera~vRelationshi~

Frorn existing clinical knowledge of therapy for sexual abuse survivors, a non-authontarian, non-judgemental, and cornpassionate therapy relatiomhip will best promote the establishment of trust (Herman, 1992). An unsmctured approach, which respects the client's boundaries, allows her to expenence control of the process. Marion Woodman

(1984) describes a process she calls the "feminine forward." waiting. respecting. and witnessing of the self that includes trust in the body experience as a source of knowledge.

It is expected that the most meaningful experience and what is most relevant to the clients' healing will surface at the appropriate tirnes.

In this study, 1 foliow a similar approach of supportive witnessing. 1respect each participant's process, allowing it to unfold, and offer both non-verbal and verbal support.

Often my words are an echo providing neither interpretation nor direction. Frequently al1 that a participant needs is the suggestion to stay with a feeling, or "hang out" with her body experience so she can let herself go deeper. Hendricks and Hendricks (1993) advocate what they cal1 the "presencing principle" in their method of body-centred psychotherapy. This 53 principle involves a similar type of being present and providing attention within the therapy relationship.

As a therapist, cornfortable with the body, 1 do not need to "know" anything except to trust and foilow the wisdom of its experience. Schwartz-Salant (1982) validates my perspective: "by not having to know we are much less involved in power-rnotivated countertransference reactions. By listening and organizing according to our body consciousness and physical babblings, a new order cm appear" (p. 125). He describes it as an "imagina1 seeing .. . based upon imagination that is real in the sense of being nearly corporeal, and experienced in a very clcse relationship to one's body" (p. 122). "In this state one is often discovering, along with the patient, their split-off parts that begin to feel seen" (p. 125-126). He describes "somatic empathy " as involving a "mutual discovery in imagination and embodied consciousness" and "enmeshed in the moment and the body"

(p. 127-128). Schwartz-Salant emphasizes the difference between the usual manner of

"extracthg data" through introspection and this "act of mutual, spontaneous discovery"

(127-128).

It is essential to create a therapy relationship that offers a "container" for the participant's experience and Our act of mutual, spontaneous discovery. In this case. the

"container" is my trust in the body's wisdom to "know" and guide the healing process. My source of dlls trust stems fiom the years I spent studying my own body experience.

Because 1 trust implicitly in my own body and in its availability as a source of knowledge and healing, 1 am able to offer myself as a "container" without speaking -- clients instinctively know that 1 am present in this role.

Since 1 have gone through multiple processes and experiences that have deepened my 54 comection to my body, I tend to resonate with others' experiences of their body and sustain an openness and ongoing receptivity . 1 believe Schwartz-Salant 's (1982) statement that counternansference issues are minimized when one is "in a very close relationship to one's body" (p. 125). I am familiar with intense sensation in my own body, and therefore I can witness participants as they pass through their own intense sensations without experiencing the need to interfere in their process. As a result participants have the option to sustain the intensity of their sensations as they experience related thoughts, feelings, images, memories, and whatever other material is necessary for healing. When working with sexual abuse survivors, it is particularly important to be cornfortable with one's own sexuality and recognize, moment-by-moment, how the sexuality of others may resonate with oneself in an understandable way.

Woodman (1984) comments: "1 approach body work with the same respect and attentiveness that 1 give to dreams. The body has a wisdom of its own. However slowly and circuitously that wisdom manifests, once it is experienced, it is a foundation, a basis of knowing that gives confidence and total support to the ego" (p.28). Certainly her statements confirrn the potential benefit of developing this type of knowing for women survivors of child semal abuse. 3.2.5 un der stand in^ the Emeriential Session

1 have chosen the term "self-generated, body-focused emergent .agery process " to describe

my method of focusing on the body experience employed in this research. This particular

process differs from other self-generated guided irnagery or guided visuo-kinaesthetic

imagery because at no time do 1 guide the participant to a place in her body that she has not

already mentioned .

Entering a Non-Ordinary State of Mind-Bodv

The technique of guided imagery used in psychosynthesis informed me of the power

available within an "altered state" for finding one's own questions and answers. The altered

state of consciousness during guided irnagery is not easily described, much less defined by

science. Grof (1996) recognizes the lack of appropriate words, describing the "non-

ordinary state" of his technique of "breathwork" as "holotropic," which means moving

toward wholeness -- from the Greek holus meaning whole and tropein meaning to move in

the direction of (Holotropics pamphlet). 1 envision my intervention technique as holotropic.

The content of traumatic memory . as explained in the "Trauma and Memory "

section, is likely to be organized on a somatosensory level, fragmented, associated with high

arousal, inaccessible to an inteIlectually dominated psychotherapy approach, and unchanged

and unintegrated over the, unlike ordinary memory (van der Kolk & van der Hart, 1991;

van der Koik, 1996). Thus memory retrieval and integration require a non-ordinary state.

A body-focused experience requires an intention to focus intemally and follow one's body experience. A suspension of the usually dominant role of the intellect is necessary since the

intellect often censors, edits, and judges emotions and body experiences: the participant 56 needs to be in a state of consciousness where it is possible to embrace material that emerges spontaneously. As a consequence, this non-ordinary state of consciousness allows the body to have equal importance with the emotions and the intellect. Some might view this state as deep relaxation, but it is much more than this, since intense contact with the self occurs on al1 levels of psyche and soma.

Non-Linear Bodv Experience tMy background and experience in body-oriented transformation led me to know that the body contains at any one moment past, present, and future experiences simultaneously. By bringing rhis awareness to the participant, 1 hope to provide ber with the tools for integration that wil! assist her with intrusive mernories.

A feature of the " non-ordinary state" is timelessness. Jung (1935) admits the diff~cultyof explaining this concept of the in relation to the body:

The subtle body is a transcendental concept which cannot be expressed in terms of our language or Our philosophical views, because they are inside the categories of time and space. So we cmonly talk primitive language as soon as we corne to the question of the subtle body, and that is everything else but scientific. It means speaking in images, Of course, we can talk such a language but whether it is comprehensible is an entirely different question (p.443 -444).

Gadow (1980) concurs that scientific language is inadequate for describing the

"subject body, " which she differentiates from the "object body, l1 because language is

"designed to express ody a finite reality and finite meanings. As self, however -- that which develops its own reality and meanings -- the body is infinite" (p.82).

Because of the elusive nature of the somatic experience and given the purposes of this study, I need to introduce the differentiation of past, present, and hture time frames. Reference to conventional time provides a framework for discussion of memory marerial.

By idenriQing the time factor we can compare and contrast different body expenences.

Furthemore. by inviting the participant to imagine her body in the funire, 1 hope to evoke an experience of how she might Like to imagine her body. ideally with the possibility of creating a bodily experience of-what healing might feel like. Also, expenencing in a bodily way whatever the future means might provide some felt sense of direction for her healing journey. Imaging healing while one is "down in the muck" is a psychosynrhesis method for giving vision, hope, andfor direction to one's healing process (Weiser. 1991).

Although 1 make use of the tems of conventional time, it is essential that 1 follow the choices of the participant, whose body guides the experiential session in a sequence that evolves naturally. For example, if someone resists making a transition in time either consciously or unconsciously, the session continues according to the participant's chosen direction.

The Sha~eof the Session

At the beginning of the session 1 invite the participant ro lie down. get cornfortable, focus toward her intemal experience of her bodylseif, and eventually contact a place in her body that draws her attention and involves a memory. If she identifies more than one place, 1 invite the participant to choose one to begin. Contrary to what one might expect, when the participant has a number of areas that seem important, any one place will lead an appropriate healing expenence. Choosing any area in the body that draws the individual's attention can begin the process and give sufficient direction to the session. The body naturally contains al1 the necessary materials in readiness for the process of healing and 58 integration.

1 suggest to the participan1 that she focus on her body and notice a sensation that relates to a memory; either sensation or memory may emerge first. The participant locates a clear body sensation and articulates the experience in a sensory-oriented fashion -- including size. colour. texture, temperature and more -- and, if possible. gives it an image with associated thoughts and feelings. What usually emerges could be called. using the terms of psychosynthesis, a " subpersonality" of the self. Thus each subpersonalicy exists within the body experience. If the body experience or tissue/body memory begins the session, what is relevant will surface if the person is invited to tell about what she is noticing in her body.

1 follow the pattern outlined in Appendix C, "The Experiential Session." The participant transitions from her memory into the present time, if possible. and relates this experience to the body perspective froin the past.

If a resistance, dficulty, or opposing perspective has not surfaced, it typically appears at this point. I encourage the participant to locate this experience in her body and also give it a sensory identification. In most instances at least two body parts will surface that express distinct perspectives, of which one may represent resistance in the form of

"protector" or "critic." The two body parts need to be given the opportunity to dialogue and share respective meanings so as to identiQ each subpersonality and develop relationships. Whenever the participant becomes mired in her intellect or confused in her emotions. I suggest she relate back to her body experience. 1 narne only areas or images that she has aiready clearly identified as part of her body experience.

We both follow the dialogue between the body parts or areas. I fmd that when we 59 follow the participant's experience, there is a naniral "resolution." An element of this resolution might be related to the future. 1 encourage the participant to imagine her body in this time frame, if she can, since this has the potential to offer a healing image. 1 suggest she €id an image that represents the (usually hoped for) future. At the end of the session. I invite the participant to draw a picture about the experience and discuss it with me.

3.2.6. Continuous Bodv-Refocusin~Facilitates Psvche-Soma Linking

This body-focused intervention technique involves a continuous process of refocusing on the body expenence. The body experiences of the participant lead the session and are continuously linked with the psyche, as completely as the participant is able. Each subpersonality speaks from the body perspective in a continuous cycle of psyche-soma linking, both within the individual subpersonality and while this individual psyche-soma linking occurs in relation to other subpersonalities. Thus, within the experiential session, the body consistently guides the healing process of the subpersonalities.

The types of questions that assist psyche-soma linking are similar to questions one would ask in a psychosynthesis session involving differentiating and getting co know subpersonalities. For exarnple, once the body area or body quality has been articulated, questions might be, "What is your purpose?" " What do you want?" " What do you need?"

In this case, however, it is the body area or body quality representing the subpersonality that speaks. Thus we discover the body perspective or consciousness of that part or the subpersonality of the self. Through dialoguing the various parts and connecting the related thoughts and feelings with the body experience, it is possible to integrate cut-off experiences. Pursuing the answers to these types of questions initiates an invitation to the 60

body to lead the individual through a series of psyche-soma linking in which one exploration

leads spontaneously to another.

initially this process is foreign to most people. As a result, it is necessary to guide

the individual back to her body experience in order to create the psyche-soma linlc. 1 cal1

this process a refocusing on the body experience. With experience the individual

intemalizes this way of relating skillfully with her body experience.

3.2.7. A~~roachesto the Inclusion of the Body in Related Therapv

Because of the pioneering nature of my work, it is impossible to be certain that there is, in

fact, no other person working in a similar fashion. However. a number of approaches to

the inclusion of the body in verbal therapy have corne to my attention. Most of these have

been cited in recent publications, appearing within the last three years. Since 1 have not

experienced these techniques, it is impossible to be certain that 1 have understood and

interpreted them properly. 1 apologize in acivance for any misunderstandings on my part.

Gendlin (1996) advocates that "a felt sense is most easily found in the middle of the

body. Therefore it helps to move a physical tension to the body's center" (p. 182). In my

technique, 1 do not instruct the participant to move sensations, but to follow her own body

experience. The dialogue is often with specific tissue or a whole-body quality and

represents a specific subpersonality. 1 will, on occasion, ask the participant to identify what

tissue she is feeling (e-g., heart, muscle).

Hendricks and Hendncks (1993) use a "breathing principle" to direct a client toward

the body experience of a feeling. In my approach, 1 may suggest to the participant that she breathe at certain times, for example at the beginning of a session in order to rest her body, 61 or if she appears to be cutting off her breath while crying. I fmd. however, that when a participant focuses on an area in their body, the breath moves nanirally into it. Again. I offer few suggestions to the participant that might influence her body. since my core objective is to follow her own body expenence as she explores it.

Rossi (1993) is interested in the state-dependent nature of trauma and uses techniques that he has evolved from hypnosis. He explains his approach to body-centred therapy as a

"self-generative process of 'autocaralytic healing'. The patient feels self-empowered because the approach usually completes itself in an insightful and therapeutic manner with very little interpretation needed from the therapist. Patient and therapist are both participant-observers in a genuine process of autocatalytic healing and discovery " (p. 129-

130). However, 1 find in Rossi's explanations of his techniques that he directs the experience rather than following the client's body as a guide. Some of his techniques of utilizing non-verbal movements of the body are similar to those utilized in dancelmovement therapy .

Kepner (1993) recognizes the relevance of the body within a Gestalt approach to psychotherapy. He States that the therapeutic "task is to help change frozen or automatic body structures to active organismic processes, and to facilitate the integration of the underlying split of the self" (p.52). Although Kepner uses the verbal modality , his techniques are fiequently movement-onented and sirnilar to dancelmovement therapy approaches. In Gestalt therapy, one may be asked to become a certain part of one's body.

In my method, one is aiready present with one's body and there is no need to be asked to become a certain part of one's body. One shply speaks from that place.

Woodman (1984) utilizes "deep relaxation" from which "a participant can find a 62 specific area of unconsciousness in the body, and then through concentration implant a

numinous symbol from a dream in that area. The symbol is recognized as an individual gift of healing that works on three levels: emotional, intellectual. and imaginative. appealing co body, mind, and spirit" (p.30). Woodrnan's (1984, 1996) method of dialoguing with rhe body is unclear from the descriptions of her approach, but 1 appreciate its intuitive and integrative quality .

My strongest point is that the body experience is not merely an access point for the emotions, left behind as if it were a mere means to an end. In order for the body expenence of each subpersonality to emerge, the body needs to be a consistent. equal aspect of the dialogue. 1 suggest that in order to integrate the body experience fully in the process of healing, we need to go beyond simple accessing of emotions through the body. We need to recognize the body as a visceral key to information about our self. CHAPTER 4

METHODOLOGY

4.1. ADOPTTNG A HEURISTIC APPROACH

In the course of this research, my relation to the topic of study has evolved in a persona1 fashion; that is, my developing awareness cannot be separated from the evolution and development of the data. For this reason, my research employs a qualitative case-study approach that is similar to the heuristic research design, methodology, and applications developed by C. Moustakas.

Moustakas (1990) explains that the "root meaning of heuristic cornes from the Greek word heuriskeh, rneaning to discover or to find" (p .9). According to Moustakas, heuristic

"refea to a process of intemal search through which one discovers the nature and meaning of experience and develops methods and procedures for further investigation and analysis"

(p. 9). Moustakas (1990) believes heuristic research acknowledges that the process begins with the researcher's self: "1 begin the heuristic investigation with my own self-awareness and explicate that awareness with reference to a question or problem until an essential insight is achieved, one that will throw a beginning light ont0 a critical human experience"

(p. 11). In this instance the "question or problem" is the involvement of the experience of the body in healing from childhood sexual abuse. My self-awareness as a touch and movement therapist allows me to bring needed skills to this problem, and perhaps reach an essential insight about the nature of the body's involvement. Because there is no precedent research investigating the perspective of a body orientation during a psychotherapeutic process, the heuristic approach is the only theoretical mode1 that will take me to the core body-oriented experiences of child sexual abuse survivors. Heurism provides a 64

psychological paradigm that frarnes my development of a potential mode1 to work with

sema1 abuse survivors.

My research is heuristic not in the sense mat 1 have a persona1 history of sexual

abuse. but rather that 1 have an intirnate, experiential knowledge of my body as a source of

wisdom and healing. Because of the work I have done in the area of body-oriented change,

1 know how to connect with my body experience in a way that serves my intention to

develop theory and techniques. I developed a healthy body awareness that includes a sense

of my body being conllnuously present in my experience as a constant source of information

and knowledge about myself, an inexhaustible fund of assistance with Me. Because this

research is part of my persona1 evolution in consciousness, the end result is that I have corne to embody the theory that has evolved. In fact, it is unlikely that any theory could evolve without sorne accompanying evolution of Our being. According to Moustakas

(1990): "The heuristic process is a way of being informed, a way of knowing. .. . In such a process not only is knowledge extended but the self of the researcher is illurninated" (p. 10-

11).

At some point I realized that my heuristic approach would determine rny intervention design for the experiential session, evolution which is congruent with the explanation of heuristic research provided by Moustakas (1990): "The self of the researcher is present throughout the process and, while understanding the phenornenon with increasing depth, the researcher also expenences growing self-awareness and self-knowledge. Heuristic processes incorporate creative self-processes and self-discoveries " (p -9).

1 approached the experiential session with some idea of how 1 needed to work with each participant. While working I would notice certain things and the participants told me 65 what was happening from their perspective. From this interaction, I gained reinforcement and clarification of the effective elements of my work. Thus, through this interaction. 1 also increased my self-awareness and self-knowledge. 1 found that with each additional experiential session that 1 facilitated, 1developed an increasing ability to know and trust the process of following the body. Beginnuig with the experience of the body and refocusing the participant on her body experience as it related to her thoughts and feelings led (the participant) to appropriate content, pacing, and amount of integration. My self-awareness and self-knowledge increased regarding how I functioned to provide 1) a technique in which each participant could creatively heal herself, and 2) a safe and available "container" that was intemalized as a healthy way of relating to the body.

4.2. WOMEN'S PERSONAL EXPERIENCE OF THEIR BODY: A CASE STUDY

It is necessary to conduct this research in such a way that whatever theories or techniques might emerge will relate directiy to the voices of the women participants. My decision to explore intirnately the individual voices necessitates a comparative case-study design. "A case snidy design can be used to test theory, but a qualirarive case study usually builds theory" (Merriam, 1988, p.57).

In the five-year evolution of this study, the experience of the body in the process of psychotherapy, and the relevance of including the body in the process, has continued to be largely unknown and unresearched. Thus my intention in cornparing and contrasting five case studies within a qualitative design is to evolve a theory about body experiences of women survivors. In regard to the development of theory within the case-study design,

Memam explains: "The place of theory in a case snidy depends to a large extent upon what 66 is known in the area of interest .. . Depending on the state of knowledge and amount of

theory, a case study might test theory, clai-iQ, refine, or extend theory. or, in qualitative

case studies, develop new theory ." (Merriam, 1988, p.57)

Memam (1988) explains that it is impossible to enter an investigation with "a blank

mind" because "every researcher holds assumptions. concepts, or theory" (p.59). For this

reason, I include a comprehensive account of my background, or in essence. where 1 corne

from as a researcher (Sections 1.2 and 3.2).

Glasser and Strauss (1967) suggest that "generating a theory involves a process of

research" (p.6), with the emphasis on process. They explain that "generating theory frorn

data means that most hypotheses and concepts not only corne from the data, but are

systematically worked out in relation to the data during the course of the research" (p.6). 1

believe the authors are addressing the relevance of the context in which data develops and

how sources other than the data could influence the development of theory.

In "Women's Perspectives: Research as Re-vision" Callaway (1982) asks: "How do

we Fmd the authentic forms of expression for female consciousness and experience?" (p.471)

I suggest that we can begin by returning to the experience of the body, the home of the

soul. Reinharz (1992) describes the case snidy as a "tool of feminist research . .. [that] defies the social science convention of seeking generalizations by looking instead for specificity , exceptions, and completeness " (p. 1%). She suggests that "social science's emphasis on generalizations has obscured phenornena important to .. . woment' and views case studies as "essential for putting women on the map of social life" (p. 174).

Thus it is my intention to view each participant in this study in ternis of her individual healing process to discover what occurs when she focuses on her body experience. Naturally, in this endeavour, 1 become limited by each participant's "abiliry ro articulate experience, cooperation, interest, willingness to rnake a cornmitment. enthusiasm. and degree of involvement" (Moustakas. 1990, p -46). In addition, within this case-study analysis. 1 cannot take the individual out of her healing context to uncover her body experience: 1 need to be specific to her process within this context and the context of her life and society. This specificity necessarily breeds the exception and, at the same time. underlines the complereness of each person's world.

Within the conventional domain of psychotherapy the systernatic exploration of the experience of the body is reIatively unexplored territory Therefore the research evolved during the process of this study. Kirby and McKema (1989) state that "research frorn the margins is by its very nature ernergent . .. a method in process; it is continually unfolding"

(p.32). The authors explain that "as people use it, what they discover in the process about the process contributes to what we know about research from the margins" (p.32). In this study, one important emergent approach to research is the need for flexibility while trusting the body experience to lead the participant to the place in her healing journey that is appropriate for her at the tirne and accepting with trust the significance of the outcome without imposing my values.

Olesen (1992) States that "fresh approaches are required .. . particularly if we are to interpret more fully the experiences of the lived body and the implications for the continually transforming self" (p.217). It is my hope that this research offers a "fresh approach" to the study of embodiment and encouragement and support for further research in this area. 4.3. THE STUDY

4.3.1. Women Survivors of Child SmaiAbuse: The Research Partici~ants

The participants in this study are five adult rniddle class women of Northem European

descent between the ages of twenty-eight and forty-four. who identified themselves as

survivors of childhood sexual abuse. Their education level varied between cornrnunity

college (Diplorna) and univers@ post-graduate (Masters degree). Al1 participants had

participated in some type of psychotherapy for at least several years. One participant was

hospitalized as a teenager for emotional difficulties and one participant is diagnosed with

Dissociative Identity Disorder. Participants are from the Toronto area and learned about

this research through therapist referrals and word-of-mouth. A written document of

informed choice for participation in the study invited women who (i) were currently in

psychotherapy (ii) had experienced sexual abuse in their childhood, and (iii) expressed a

willingness to share personai information. The written document of informed choice is

provided in Appendix A. Participants were informed that the study is a doctoral dissertation project researching body-oriented mernory and the experience of the body in the process of healing with chiidhood sexual abuse survivors. As well, participants were

informed that the process would facilitate mernory recall and might initiate emotionally charged experiences. Only participants who said they were willing to share their persona1 experiences were selected. An essential factor was the establishment of trust between the interviewer and the participant, with the understanding that confidentiality be respected and that any significant issues could be taken by the participant to her therapist.

Participants were informed that two interviews were involved, one experiential session and one follow-up interview, each no longer than two hours' duration. They were 69 informed (i) that the experiential session involved a body-focused psychotherapeutic experience including body-oriented memory and a drawing, followed by a discussion and

(ii) rhat in the serni-structured follow-up interview, approximately one week later, they would be asked to discuss their thoughts and feelings about what happened in. or as a result of. the expenential sessiodinterview, as well as their process of remembering childhood sexual abuse. Participants were also verbally asked if they would be availabie for further contact if the need should arÏse. AU participants agreed and in fact were asked to attend a follow-up semi-structured interview one year later.

Ensurine Safew .

A major ethical consideration was that the participants have a forum other than the interviews of the study to discuss personal material that may have arisen during the interviews in relation to their participation. For this reason, it was required that each participant currently attend psychotherapeutic counsell ing .

4.3.2. The Role of the Researcher/Facilitator: En~amngin the Therapeutic Process

As the researcher, 1 have taken the position of "facilitator-interviewer. " The pilot study, which included two participants informed me that the experiential session 1 was providing resembled psychotherapy more than the guided imagery experience 1 had initially conceptualized as the method design in this study. 1 came to this realization through the comments of one of the pilot-snidy participants, who told me she wished 1 had been more clear when we started about the depth of emotion her body-orîented memory experience would take her to, so that she could know what she was agreeing to and align her 70 expectations accordingly. Thus, as 1 had not done in the pilot snidy. 1 informed participants

that the sessions would resemble psychotherapy. Because the participants were involved in

psychotherapy apart from this study, each was aware of what that meant frorn previous experience.

Although the method of focusing on the body and following its experience through

the pax, present, and future time frame can be viewed as some type of guided irnagery, it differs in a nurnber of ways. Firstly, the imagery is self-generated, and I hold no preconceived notion or agenda regarding what the imagery will be. Thus 1 do not lead the person with a pre-determined agenda of imagery. Secondly, although 1 act as a guide, inviting movement from the past into the present and later future body experiences, 1 follow the participant's lead throughout the session. My therapeutic body-focused intervention diroughout the experiential session is intended to bring rhe participant to as complete an awareness as possible of the experience of her body, and to assist her exploration of how this relates to her thoughts and feelings.

The experiential session is sirnilar to verbal therapy in that 1 dialogue with the participant throughout the session. At no tirne during the experiential session do 1 touch or suggest movement beyond encouraging the person to get cornfortable lying down and to move in whatever way she wants during the session. Similar to the procedure in psychotherapy, 1 ahto create an environment that is a safe container in which the participant cm explore her process. mena participant is lying down with her eyes closed and focusing intemally, a non-ordinary state is created which is similar to that of a guided imagery session. My intention is to interact from a place of non-judgement and compassion, evident both in my presence and my speech tone and content. For example, I 71

do not sit in a chair while a participant lies down on the floor. but instead sit close by at the

same level. I am not necessarily recommending a particular seating arrangement; radier 1

point out the therapeutic tactic of creating psychological congruence and equality rhrough

observing the use of levels in space and their meaning.

Another important factor is that before the experiential session I did not know any

persona1 details regarding the participants' background beyorid their belief that they had

been sexually abused in childhood. Thus 1 had no knowledge of their family background or

sexual abuse history at the time of the experiential session. 1 decided to proceed without a

history-taking because I wanted to enter what 1 believed was an intuitive process, as free of bias as possible, for the purpose of this research.

4.3.3. Four Data Collection Phases

Data colIection involved four phases: 1) a pre-screen interview; 2) an experiential session;

3) a follow-up interview approximately one week later; and 4) a follow-up interview approximately one year later. With the exception of the initial screening interview, al1 interviews were tape recorded and transcribed.

1) Phase One, the pre-screen interview, was designed to introduce the project and determine if the person met al1 of the criteria for participation.

2) Phase Two, the experiential session, began with a brief discussion that involved the person signing a letter of informed choice and requesting that she complete a short written background information sheet to be returned at the follow-up interview. An outline of background information questions is in Appendix B. The interviews were approximately one and one-half hours in duration. 72 I invited the participant to lie down on a carpeted floor and get comfortable. then 1

oflered pillows and suggested andlor helped her adjust herself so that she was in a

cornfortable position of her choice. Each participant was then invited to move however she

wanted, stop whenever she wanted, ignore inappropriate questions, and advise me if my

questions or suggestions were unsuitable or unwelcome. I told each participant that 1 would

not touch her at any the or direct her to move her body during the session. I suggested the participant close her eyes as that would help her focus inside or onto her interna1 experience. Al1 participants closed their eyes for most or a11 of the session and took the initiative to change position or move their body as they wished.

Each participant was invited to dialogue her experience continuously throughout the session. At the completion of the experiential session, the participant was invited to draw whatever she wanted about her experience in the body-focused session. When the session and drawing were completed, the participant described her experience using the drawing as a way of organizing or focusing the discussion.

The session involved the retrieval of a memory from the orientation of the body that would begin a body-focused psychotherapeutic process. Once the participant was comfortable and focused internally, she was invited to scan her body and to notice an experience of her body from the past, using her body orientation to retrieve it. Although a participants may have had several mernories, she was asked to choose only one as a way to begin.

The intention was to break the experience into three parts and allow the participant to scan her body from the past, present, and future tirne perspectives. Thus the oniy frame

1 provide is one of time. (An outline of the content of the session sequence is provided in 73 Appendix C.) I expected that if 1 invited the participant to move into the present and later

the future from a body experience in her past, she would have the oppominiq to become

conscious of the transitions and contrats she was experiencing. The intention was to

provide the participant with an opportunity to ground her body experience in the present.

and to compare and contrast her body experience in the future.

This method of interweaving the body and psychological experience utilizing a

progressive time change evolved from a desire to document and validate the body

experiences of women survivors. As the imagery is entirely self-generated, I becarne more

clearly a witness to each participant's experience. Also 1 understood intuitively the benefit

of a body orientation to "ground in the present" and "heal toward a funire," so that these

eiements could be highlighted by me in a more natural and less abrupt sequence than the

rnethod I used in the pilot study. Following the person's body experience, as they wove

between thoughts, body sensations, and feelings within non-linear "body time " was the

priority .

Through the evolution of this work 1 came to understand that 1 needed to trust fully

in the process of allowing each individual to follow her body experience and leam whatever became apparent, knowing this was, in fact, the essential learnuig or shif-t in awarenesslconsciousness that needed to happen. This perspective was in fact more in congruence with my own nature and philosophy of body-oriented approaches to change.

Body-oriented processes are not always about memories, but in the event that the body reveals unfinished psychological issues, memories are often involved.

I decided that if theory were to evolve from this study, it would be important for me to follow and act upon my developing awareness and trust of the knowledge and wisdom of 74

the body experience to lead a person. Given this belief, it would be imperative that 1 not

direct or impose an extemal agenda. This is particularly important for sexual abuse

survivors, who have been invalidated or unempowered about the ownership, auchonty. and

trust in their own body and body experience. Even the time frame of past. present, and

funire is an arbitrary inclusion and although somewhat useful as a rnethod of analyzing body

experiences, it is unnecessary. Of course. this less prescriptive methodology makes it

difficult to compare and contrast expenences between participants in a linear fashion.

3) Phase Three, the initial follow-up interview, took place approximately one week after the experiential interview. The interview was intended to be semi-stnictured.

Participants were ïnvited to discuss their thoughts and feelings about the previous experiential session. The research objective was to discover if, and in what ways, the previous experience was important. Each participant was also asked to answer questions about 1) her process of remembering (or not) childhood sexual abuse; 2) the experience of her body as it related to her healing or psychotherapy process; and 3) how the experiential session was similar to or different from other approaches she may have experienced, including verbal psychotherapy, touch therapy, andlor rnovement therapy. The intention was to ascertain how the participant would describe and assess her experience when she reflected back on the session. Thus the focus of this interview was to explore the participant's understanding of her process.

4) Phase Four, the second follow-up interview, took place approximately one year after the first follow-up interview. The intention was to discover if the same elements were as important as they appeared to be at first or not, and if there was continuity in the participant's descriptions and assessments. Again the interview was semi-stnicnired and the 75 questions were similar to those in the first follow-up interview. Because the participant had one year to reflect on the experience and its impact on her healing process. the participant was asked to fucus on where she was in her healing process at present and if and how the previous sessions were part of her healing joumey. Thus the second research objective was to establish whether or not the participant felt she had been influenced by her experience in the experiential session and by the opportunity to articulate aspects of this experience in the first follow-up interview. The intention was not to look at ber experience in tems of an outcome but rather to explore her process and the developing integration of body consciousness .

4.3.4. Qualitative Data Anaivsis: Creatine Stories

The five case studies are included in Chapter 5, "Case Snidies of Five Wornen's

Experiential Sessions: Research Findings. " Transcripts of the five participants' experiential sessions are summarized individually to show the main developments in each session and how these occurred sequentially and in relation to one another. The summaries of the experiential sessions focus on each wornan's process of body memory retrieval and the psyche-soma integration that resulted from her orientation to the experience of her body.

Attention is given to dialogue between parts of the body or different qualities of the body and to integration of the psyche-soma through the use of emerging images and metaphors.

Material from the two follow-up interviews has been rearranged thematically to present collecfively the participants' perspectives on the experiential session. Their views on the experience as a whole, in relation to their persona1 healing process, are gathered in the section called "Participants' Evaluation. " 4.3.5. Bein~Informed bv the Pilot Studv

A pilot smdy was carried out prior to the writing of this thesis. Two women who had

experienced childhood sexual abuse participated. Each participant was screened for

suitability in an initial interview. The experiential session was of approximately one and

one-half houn duration; follow-up interviews were approximately one hour long. In a

similar fashion to the interview outlined previously. the initial interview focused on the

participant's past, present, and future experience of her body, followed by an invitation to

draw and discuss her experience. The follow-up interviews for this pilot study were

unstrucnired because 1 wanted to give the participants the opportunity to direct the content

of the conversation. In this way, I could discover what they wouId choose to discuss.

Frorn this study, I leamed that 1 needed ro have some prepared open-ended questions to jet the participants started. Full transcripts of the interviews were created and analyzed.

Individual profiles for each participant summarized in her own words the important elements and relationships in her body experience. The profiles were intended to gather the essence of the two participants' experience, that is, to summarize what 1 cal1 their "story."

The profiles surnmarized five question areas: 1) What was the memory? 2) How was this memory related to their body experience? 3) How does the body experience link with their psychological experience? 4) What are the images or metaphors for this htegration? and 5)

In the follow-up interview, what was most important for rhem in the past experiential interview? The profiles were compared for cornmon and divergent themes.

Discussion of Findings .

The results of the pilot study indicated that the methodology 1 chose was effective. Both 77 participants were able to retrieve a body-oriented memory and follow easily the progressive

the-change framework. The experiential session and drawings elicited rich data: the participants' descriptions and discussion were elaborate: each stated that the experience was personally meaningful for them. 1 learned that some people prefer to process verbally and to draw during the experience, radier than waiting until the end as 1 had initially conceptualized the session. 1 decided to retain the technique of dialogue throughout for the main study. I found the unstnicnired follow-up interviews required more direction on my part, each participant wanted some lead as to what 1 would be interested in hearing from them. For this reason, the main study follow-up interviews focused on what was important or mernorable about the experie-ntial interview and how they believed a body-oriented psychotherapeutic experience differed from a traditional verbal psychotherapeutic experience. The variable the-lag between the experiential session and the follow-up interview demonstrated that it was most ideal to do the follow-up interview not more than two weeks after the expenential session. In this interval, the participant was more likely to remember her experience clearly and, at the same time. she was given time and opportunity to reflect upon the experience.

Another important finding in the pilot study was the effectiveness and therapeutic value of the drawings. 1 believe the drawings served as a means of bndging the somatic with the psyche experience and aided greatly in allowing the unconscious to speak. For this reason, 1 included a picture analysis in the main study and therefore as part of the profile or case sumrnary.

The pilot-study research fmdings suggested that when a person has experienced sexual abuse as a child and when she is facilitated to recall body-oriented mernories, she 78 will recall the experience of abuse or some unresolved related issue. Based on findings of the pilot study, 1 developed the following postdates: 1) that through the process of integrating psyche and soma, traumatic body-oriented mernories become less heightened and more integrated; and 2) that as a resuIt of including the somatic experience in the psychological process of integration, physiological repercussions of the sexual abuse may be diminished (e.g., dissociation, panic attacks, physical ailments) more readily than if the somatic experiences were not consciously integrated . CASE STUDIES OF FIVE WOMEN'S EXPEWNTIAL SESSIONS: RESEARCH FINDINGS

5.1 ORGANIZATION OF THE FINDINGS

For the purpose of clarity 1 have organized the research fmdings in the following format.

First. in this chapter "Case Studies of Five Women's Experiential Sessions: Research

Findings" 1 present each participant's background information and a sumrnary of her experiential session. Next, in Chapter 6 "Thoughts, Reflections, and Insights related to the

Experiential Session: Research Findings, " 1 present the themes or progressive healing stages of each participant's experience, drawing on both her experiential session and the content of the two follow-up interviews. In the final section of this chapter, "Participants'

Evaluations," 1 include each participant's analysis of those elements in my approach she did or did not find effective, and the reason for this assessment. Where relevant discussions also include a cornparison with traditional verbal psychotherapy and therapy that involves touch. Cornparisons with movement therapy would have been useful, but none of the participants had experienced that modality .

Notation System

When referring to the case study transcnpts, the interviews are numbered after the preliminary screening interview: Le., the experiential session is 1, the follow-up interview one week later is 2, and the follow-up interview one year later is 3. Notation will aoDear: e.g., (19ofl) means page 19 of the experiential session or 1 ; (19of2) means page 19 of the follow-up interview one week later or 2; (19of3) means page 19 of the follow-up interview one year later or 3. 5.2 iMARY'S SESSION

Background Information.

Mary is a married, young professional woman of European descent with no children. She was referred to the study through a colleague of mine. and although she attended two

" treatments " of touch therapy , she considers herself inexperienced in body-oriented personal change prior to her first session with me. This was our first meeting.

Mary grew up with her parents, two brothers, and one sister, in what she calls an

"alcoholic home. " She describes her father as alcoholic, although she feels closest to him.

She is somewhat close to her older brother and sister and feels somewhat distant from her mother and younger brother .

Mary outlines her experiences of child sexual abuse in terms of three perpetrators.

1) An elderly uncle once put his hand on her leg while they were in the car. when she was between five and seven years old. 2) An adult male cousin abused her under the guise of punishment, when she was five or six years old. "He pulled down rny pants and spanked me on his lap when his penis was exposed and touched me. 1 had a great fear of being alone with him when he visited." The abuse was ongoing and she is "unsure how long it went on or how many times." 3) A teenage brother abused her on a daily/weekly basis involving pomography and oral sexual contact when she was between the ages of eight and thirteen years old. He was unsuccessful in his attempts at penetration. She States: "1 have always remembered these incidents. However, the [associated] fear with the adult cousin and many [additional] examples of abuse with my brother have surfaced since beginning psychotherapy. This additional information came to memory when 1 was writing about the abuse as part of psychotherapy." 8 1

Mary has been seeing a verbal-oriented psychotherapist bi-weekly dunng the rwo

years before her first session with me. She says it has only been in the lasr six to eight

months that she has "really started to deal with" the sexual abuse (6lofL). Mary describes

her healing process as foilows: "1 have read extensive literature. 1 am involved in a rwelve-

step program for adult children of alcoholics. I write in a journal and read a rneditation

booklet daily. 1 try to express my feelings dirough art." Mary started touch therapy at approximately the same tirne she began this study, and she comments thaf her healing

process has quickened as a result of participating in therapy that focuses on the body experience. She explains that she becarne open to the idea of healing through the body

when she read a book in which body massage was described as facilifating mernories of sexuai abuse and connecting with feelings. She States: "Right away when I read that. rny gut feeling was YEAH THAT works" (40of2). Thus, Mary has reached a place in her healing where she is intuitively drawn toward her body experience.

In regard to her physical health, in the follow-up interview one week later, Mary mentions that she suffers frorn "chronic headaches . " The Ex~erientiaiSession.

Memory and Bodv Ex~erience.

Mary begins the session by noticing her throat tightening. When she focuses on this experience, she notices it clenching and releasing and she feels a heaviness. 1 suggest to

her that she free-associate to a tirne in the past when she experienced similar sensations.

Mary's way of remembering is primarily visually. She comrnents: "1 picture myself: I grew

up in an alcoholic home and there was a lot of fighting and yelling, but 1 see myself as a child around six or seven, hiding, and being afraid, and that's the feeling, .. . 1 don? actually remember doing that" (60fl). Next. she notices a heaviness in her chest that feels like choking. The pressure in her chest travels down to her stomach. 1 suggest she imagine how this heaviness might appear and she describes it as "dark grey, shapeless, like a blob, something without definition" (80fl). She says the heaviness is stopping her breathing and it feels as though she is cutting off her breath by pulling down. Shonly , she associates this experience with fear of the unknown and notices that it imrnobilizes her. Then she remarks,

"1 get headaches often, it still feels like the pressure is giving me a headache" (120fl).

Next, she notices that "from my elbows down [a feel totally like they 're on a different body" (120fl). This is a physical manifestation of her experience of dissociation. She notices she feels as though she is fearful that something will happen. 1 ask her if she has any idea what this is about and she comrnents: "It's like a fear ... 1 know when I was a kid and 1used to be afraid, if my father was home and there was drinking I would hold my breath sometimes, kind of like waiting, and you just keep your breath as still as possible .. . maybe not to be noticed ... so as not to draw attention to rnyself" (14ofl). "1 would listen to hear what my dad was doing so 1 would know, I guess for self-preservation .. . when 83 you're not breathing because you're busy doing something else ... I know I used to kind of

take in a breath and wait, it's the same kind of sensation, and 1 still have that feeling of

hiding" (15ofl). Mary is describing a pathological defense "sumrnoned from a biological

repertoire on the mode1 'fight or flight' involving the early defenses of avoidance, freezing.

or fighting" (Fraiberg, 1982, p. 6 12).

At this point, Mary changes her body position from lying on her back to Iying on her front with her knees bent up under her. She continues to notice the sensation that nins

from her throat to her stomach and some resultant sensation of gagging and the urge to vomit. She notices she feels safer in the new body position. Again she pictures herself as a small child in the space between her bed and closet. At this point her memory fades and 1 invite her to transition into an experience of herself in the present the, noticing her bodily changes in this process.

Memorv and Psyche-Soma Links.

Mary easily transitions into a present here-and-now focus. She readily notes that the tension she has been feeling is gone and her breathing is "much more cornfortable. " She remarks that her breath feels " life giving. "

1 invite her to notice some of the body places she has focused on duruig the "past" experience. She notices some residual heaviness in the front of her neck and stomach. 1 ask her if she would like to work with one of these places. She quickly agrees and chooses to focus on her throat. I suggest three things: (1) to describe vividly the location of the place in her body; (2) to touch the place with her hand to heighten her awareness of the location and sensation. 1suggest this because Mary has been changing her body position 84 during the session and 1 thought she would be receptive to moving her hand to touch herselft and (3) to describe anything that cornes to her awareness as she focuses on the area.

She notices that something feels "stuck" in her throat and that it resembles a thick ball that seems immovabie, although she feels it has the potential to move. She names this ball

"Glob" and from this point refers to it interchangeably as the Glob or Blob. Next the Glob turns into a cartoon character with arms that push out.

At this point, I undentand that the image has formed enough to be capable of cornmunicating, but that a cartoon character might be less accessible than a human figure.

From her tone of voice, 1 have the impression that this character is sarcastic and 1 associate this attitude with the "cntic" part of her personality. 1 wonder if the Glob would be sornewhat resistant and therefore ask if it would be al1 right for her to ask the Glob questions. Mary responds in the aK~rmative.but says she does not know what to ask. 1 suggest she ask the Glob why it is stuck. 1 want to encourage her to understand the image and its meaning. While the cartoon character does not respond to the question her throat does: "My throat won? let me go by, my throat doesn't want me here. " I continue to suggest questions that might assist Mary to dialogue between the GIob and her throat so she cm discover the purpose of the Glob and what it needs, with the hope that it might become less stuck and thereby free her throat. Through this dialogue, she learns that the Glob is a he and that he is a jokester character with a big grin on his face. He does not take the issue seriously and is seerningly "emotionless." The throat tum out to be angry at the Glob because of its sarcastic and arrogant manner. Now Mary notices that the Glob is a round shape with "the head and the body al1 pushed together and it has arms and legs and a smile and two eyes" (29ofl). Noticeably missing in Mary's image of the Glob is the neck. 85 (Please see her drawing in Figure 1.) The missing body part of the Glob corresponds to die dissociated part of her body that is being closed off. It is very cornmon for people who have experienced oral-related trauma to have psyche-soma issues involving gagging and the throat area in general. 1 recognize the significance of not having a throat as a way of defendkg against the expenence of her body. She describes the throat as having "no human characteristics" and resembling a tube-Iike chamber that clenches and narrows where the

Glob is located.

1. realize she now has a clear picnire of the two parts of herself that are resisting each other; her understanding includes her body experience and also her associated feelings and thoughts about their relationship: a Glob that is in her throat, refusing to move or communkate and is emotionless, and a throat that feels restricted and wants to rid itself of the Glob by vomiting. 1 offer her a brief summary to dari@ the issues for both of us: "So here we have one part that is quite angry at this other part that gives the appearance that it could care Iess, and it's just going to stay there. I'm just wondering now what your thoughts and feelings are about this situation" (30ofl). By pointing out their relationship, I hope to encourage her to move beyond the descriptions of her conflicting parts and explore their meaning. Mary enters into a long discussion in which she attempts to figure out whether the Glob is part of her or outside of her. 1 continue to encourage dialogue between the two parts. The Glob however, continues to be resistant.

Because we seem to be at an impasse, 1 offer an observation that might create a shift. I suggest that the throat would not be asking the Glob what its purpose is if the throat already knows. 1 point out that, in fact, the Glob's rnockingly telling the throat "you should know" is "a bit of a put down," because the question would not be asked if the answer were 86 already bown (320fl). 1 intend to draw attention to the fact that offering a simple question is still a desire to relate and might deserve some compassion or consideration.

Mary begins to notice a recurrence of the feeling of fear that she has experienced previously in her past memory experience. She remarks that this fear is "that 1'11 find out something that 1 wasn't expecting or .. . that 1 wouldn't be able to cope with .. . that would be harmfül .. . more hurtful to me than the sniff 1 already know about. .. . It's exactly the same feeling I had [when] talking to my [therapist] about the incidents in my childhood. 1 was afraid to explore any further because 1didn't want to find out that someone more important to me had harmed me" (33ofl).

Evidently she has a clear idea of her fears surrounding her abuse memories. and she is able to associate these fears with her recall in psychotherapy of a similar experience of fearing such memories and wishing not to acknowledge the part of her that knows more.

Therefore 1 ask her if it would be a11 right for me to offer my impression and she agrees.

1 suggest that the grinning Glob might be indicating that he is protecting her from further pain by remaining quiet. Mary then articulates the insight that she might be hiding the awareness from herself: "Maybe I've already had not dues but inklings and I'm not letting myself go with those" (34ofl). 1 ask her: "Now you don't know if those inklings are actually true or not?" She replies: "Right, but I'm not letting myself explore them one way or another." A few moments later she says "the Glob is not smiling any more .. . 1 think the sarcasm is gone, like the grin was really a sarcarric GRIN."

Realizing that the change in the Glob's attitude is significant, 1 suggest that she ask the Glob what has changed, or perhaps she already kmws. Through indirect and reflective comments, 1 continue to invite her to investigate her experience of the Glob. She realizes 87

that when she verbalized having "an inkling ... it was like vaiidation" of the Glob.

Gradually she gains a sense of the Glob as " not so threatening .. . or so intrusive " (350f 1) .

Eventuaily, through a process of thinking aloud. she reaches a place where she feels

she is "getting used to the feeling being there, 1 wouldn't Say cornfortable ... but maybe

more accepting. .. . 1 think 1 like him better without the smile."

By now 1 realize that Mary has successful~ymade a connection between her body

expenence and its psychological meaning and thar it has resulted in a changed attitude

within her, enabling her to work through her resisrance and acknowledge or validate her

experience. 1 suggest that it sounds as though she and the Glob were taking "each other a

little more seriously," and she agrees.

Because of the current resolution, 1 want to make sure there is nothing more that

needs to be processed at this time. 1 ask her if she wants to ask the Glob anything more

about his purpose. Mary again experiences "that feeling of hesitancy, it's like a part of me

wants to ask him and a part .. . doesn't want me ro hear his answer" (360fl).

Hearing the division apparent within her again. 1 suggest she uy to tell the Glob

about her fears. She seems to have difficulty, so 1 suggest to her that the part of her that does not want to know, does know why the Glob is there. Because this part of her is

embodied and apparent to her, 1 realize 1 am at a point where 1 can demonstrate my trust in the wisdom of her body to lead her effectively. 1 direct her toward the awareness that she is now making a choice not to know, being carehl to qualiQ this suggestion by using an invitational marner and leaving it up to her. For example. "Check it out, you don? have to agree with me" (37ofl).

At this point she acknowledges that she is afraid of the "PAIN." Pain is a felt 88 experience and 1 want to begin by grounding this awareness once again in her body experience. I suggest she allow herself to imagine where in her body she is feeling the

PAIN. This is a clear example of my technique of moving within the sequence of soma. to psyche, and back to soma. et cetera. When she says she feels the pain in her head, I inquire where in her head because I want her to be more specific for her own self awareness and so that her body can relay its full message. She describes the sensation: "1 feel my eyes tighten, clenching, not clenching, squint together." Usually this kind of tightening results in a headache, so 1 ask her if she experiences headaches in that location. She replies that she has a history of headaches across both eyes. I notice her movement of squeezing her eyes together and 1 reflect it back to her by remarking about it. She says: "Yeah, and then 1 want to pull back from it again, I feel like it's going to be too painful" (38ofl). I suggest she attempt to spend some tirne widi this feeling to get in touch with the part of her that thinks and feels it is going to be too painful. At this point the soma experience transforms itself into an embodied experience of self. She says: "Oh, 1 don? feel like it's a part of my body, 1 feel like it's, I almost feel like it's this linle kid inside of me, but 1 don't know if it's me when 1 was little or if it's like a vulnerable part of me that 1 see as a little kid" (38ofl). 1 suggest that the pain might be both, meaning that it might be a child part and a childlike vulnerable part of an adult.

Mary begins to cry quietly and says "when 1 get upset and hurt .. . 1 feel like a little kid, I'rn not sure if 1 feel that as an adult 1 can't react to that pain" (390fl). She says she wants to cry when she thinks about the Glob and why the Glob is there. "The tears are about knowing, 1 think, " she says at last. She is aware that she is afraid of remembering more and feeling that she does not have enough suppoa in her life at this time to open 89 completely to her past.

From this point Mary taiks about how difficult it is for her to trust that important

people in her life will accept her if they know everything about her past. Next 1 ask her

how the little girl inside of her is doing. Mary responds that she needs "something to

hold." She States: "It's not a cartoon any more ... so it must be part of me. 1 don? know.

Maybe it's that little child, and maybe 1 don't want it to be there, rhe child. maybe 1 don't.

or maybe 1 don? want to give it a voice, I sense there's sornething there about the voice,

that the Glob -- 1 don't know if it doesn't want me to speak or 1 don? want the Glob to

speak, whatever goes on, it doesn't allow a voice to corne forth ... yeah, 1 think it's more

that I won't let the Glob speak, like my throat is cutting it off .. . . " (41ofl).

Mary, at this point, describes how she dissociates whenever she does not want to

feel something: "If I'm upset about something and I've said it's not the right tirne to be upset 1 just take a deep breath .. . 1 cut off my feelings and it's a physical feeling when 1 do that" (430fl). She recognizes that in order for her to give her throat a chance to express her feelings, she needs to feel safe. She reflects that as a child and adolescent she did not feel safe in her family environment and was discouraged from expressing her feelings.

During this process, 1 continue to encourage her to "check in" with her experience and give herself the to notice her feelings and be present with them. As a result, she gains the insight that she can deal with her fear of knowing and speaking by "testing things out slowly, and seeing if it's okay , .. . and maybe doing what 1 feel is cornfortable for me and 1 feel workr for me" (45ofl). She mentions that this includes being able to set boundaries as an adult who can "make her own choices. " Without my direct intervention, she has internalized this technique of giving herself permission and time to feel without pressure and 90 self-judgement.

1 lead her through many layers of resistance as she recalls holding her child eariier

in the session and feeling inadequate to care for her. For example, the child is too

"intense, " she does not "know enough" about taking care of her, the child is "needy. " the chiId will take too much tirne, and finally she feels guilty that she has not noticed the child before. She recognizes she is king "hard" on herself. By now 1 understand that she has a clear expenence of the three parts of herself involved in this dialogue of acknowledging the child -- the child, the adult critic, and the inadequate-feeling adult who is figunng out how to care for the child. Because this dialogue has formed, 1 suggest she transition from the present into the future, and explore how she would like to imagine her body in the funire.

Healing Image.

Mary easily transitions into the future, picturing herself stretching out, with "light everywhere." She also feels a "release" in her head that causes her body to feel lighter and her headache to "float out of the top of my head, kind of like taking the lid off a pressure cooker" (520fl). She has a sensation of "expanding from the inside ... feeling loose and free to move," and as if "things that need to happen jusr happen naturally .. . without me thinking .. . or focusing." This awareness indicates to me that she has successfully set aside her familiar mode of restricting herself to her intellect and has reached a place of trusting her whole body experience, without the filter of her intellect to stop or edit her emotions.

In the future, she has a sense of her body feeling light and energetic and breathing naturally . When 1 ask her to check in with the Glob, she says it is "NOT there" in the future. She realizes that in the absence of discornfort, "the little girl can play .. . like ifs 91 MY body, it's Iike this BIG body, but it's like the little girl skipping" (540fl). She notices

the child is "worry free" with "no duties," and associates back to her earlier memory: "it's

a big difference from the bedroom, if 1 compare it to that girl curled up in the bedroom,

and then 1 see this adult with the little-girl heart, out there skipping in the Sun, and full of

hope" (55ofl). She is crying softly as she speaks.

After she has spent some time on her own, meditating with her expenence of her child part, I suggest as a way to finish that she thank her throat for Ieading her where she

needed to go. Then 1 invite her to draw a picture about her experience.

Drawin~and Discussion.

After completing her drawing, Mary explains that her picture involves three "intercomected

... segments" relating past, present, and Iùture. (See Figure 1.) Her picture includes a heavy dark cloud of the past, the present Glob "smiling sarcastically," but with a "little ray of something beside it .. . somehow comected to the Sun but hidden. " Then, pointing to the rainbow and the Glob peaking out from the top of the Sun, she describes "the future . .. the brighmess, vividness, and freshness ... the rays of sun spilling everywhere and again the

Glob, just a piece of the Glob . .. the part of the Glob that wasn't a cartoon any more, it was just there" (57ofl). This ability to be "just there" indicates her emerging readiness ro be present with her body experience.

Mary describes how much she enjoyed doing the drawing, "feeling the bright Sun even while 1 was drawing the whole thing .. . 1 knew exactly that 1 wanted the pastels and what colours and then it just kind of came out" (59ofl). Mary contrasts lying on the floor with "sitting up straight in a chair," as she is accustomed to in her therapy. "1 found that 92

[lying down] really really helpful and 1 feel positive about it and 1 surprised myself ...

[with] the tears and sniff" (59ofl). She admits she is usually "more reserved than to cry the

Fust tirne" she meets a therapist, and feels that it has something to do with the difference between sitting in a chair and lying on the floor. % 93 Figure 1

Mary's Drawing

>- 5.3. GMN'S SESSION

Background information.

Gwen is a middle-aged woman of northern European descenr. married with no children.

She is completing post-secondary education in psychology and has worked professionally in

the area of women's treament for sexual abuse.

Gwen is the only child of a couple who divorced when she two years old. She felt closest to her father, whom she describes as having a "hurnourless, unemotional presentation

(that) hides his feelings of concern, ernpathy. and kindness." She was much less close to her "neurotic, very angry" mother, and she describes their relationship as difficult, "both enmeshed and distant." She has recently leamed from her father that after the divorce and before her mother irnmigrated to Canada when Gwen was five, she was largely in the care of her mother's father. Her mother had a hysterectomy at age thirty-five and died of cervical cancer at age forty.

Gwen describes her experience of sexual abuse as follows: "1 have no knowledge of the event or memories. My memories are emotional, body, and behavioural in type. 1 believe my perpetrator was my matemal grandfather for logical reasons -- my mother's behaviour, my inability to retrieve knowledge-type memories, et cetera -- and because it feels as though he was. If so, 1 was younger thari five years of age. 1have no idea of duration, frequency, or type of abuse, although rny body and feeling mernories suggest fondling and digital penetration (at best) and/or intercourse (at worst). The probability that

1 have been sexually abused as a child surfaced in therapy via a dream, as well as a panic reaction to someone's disclosure in a group 1 was in." Her panic reaction in the group therapy happened about fifteen years ago. Subsequently she had the dream: "The dream 95 was about an oider man, and my feeling about the abuse was that it was my grandfather.

because 1 had this incredible sense of betrayaI, that someone who really Iiked me, who I

really felt loved by, who spent a lot of time with me, who was good to me. had betrayed

me. .. . He looked like a horneless person, chasing me. 1 would have been about five in

the dream. 1 couldn't get away and he was mnning after me. At the end of the dream

before I woke up in a panic, he threw me down on the ground and threw himseif on top of

me and 1 can remember the sensation of him grinding his pelvis into mine. I woke up with

a start and ... my whole body was vibraring in fear but ânother part of me was really

triumphant because I'd had the dream .. . now it was over." Gwen wishes her therapisr had

pursued this drearn at the time but she did not. "1 think if she had kept coming back to it 1

would have been forced to deal with it, but both of us were under the impression that what

was unconscious was conscious, therefore it's over, and so then the whole thing went

underground" (2800). When Gwen visited her country of birth she had a "cognitive

memory," "this feeling that my mother was taking me and handing me over to my

grandfather, as a sexual THING, and abandoning me with him. " Again this was not

pursued in therapy "and so 1 forgot about it" (2900). At this the she developed fibroids in

her uterus; since then she has scheduled a complete hysterectomy to rake place shortly after

the experiential session.

Gwen describes several years of previous experience in psychodynamically oriented psychotherapy as well as participation in a bioenergetics group for women for two years.

She explains her healing or recovery process up to the present the as follows: "My

healing process began when I went into therapy to deal with the unresolved issues

surrounding my rnother's death. Bodywork [oriented to movement] helped me to release 96 the repressed feelings of anger and pain that I had had to numb myself to. Since I had no feelings when 1 began therapy, a major pan of my heaIing process has been the recovery of my feelings and the body they reside in. The process of healing continues with my work with survivors and also with the perpetrators of chïldhood sema1 abuse. Working with offenders has helped me to deal with my anger (not excuse) why some men sexually abuse children, and this has helped me to deal with rny anger. Since my own abuse occurred in

Europe, 1 will someday have to resolve what issues remain in the language 1 spoke then. So far 1 have not felt the need to do so since the abuse no longer interferes in my life."

On the other hand, Gwen articulates severe frustration about not remernbering in concrete terms an actual experience of sexual abuse when she was a child. Sometimes her frustration makes her feel "crazy": "1 never did get any flashback mernories of the event or events, .. . and 1 don't think 1ever will, which is really frustrating .. . so I had to go by what my body was telling me" (130fl). When Gwen is feeling oppressed by doubts, she says, "1often take refuge in [telling myselfl I'm crazy, there's just something wrong with me, I've made this up" (32of3).

Although she has "a good physical relationship" with her partner, she says: "1 still wonder how much of my abuse has affected who 1 could be sexually if 1 hadn't been

[abused] and that is frustrating" (36of3). The Ex~erientialSession.

Memorv and Body Exoerience.

When I invite Gwen to imagine her body in the past and notice any memones that come to her awareness, she imrnediately says, "1 sense my body at about age 12" (3ofl). She notices initially that it is "not a mernory, I just sort of see it. " Evidently Gwen is visually oriented and she senses her body when she looks at her interna1 picture of it. She says it

"feels very awkward, my arms and legs are too long. I shot up in height very quickly over a space of a year, and 1 keep sort of fading into things and not knowing where to put my mind, at the same time I feel like a stick figure, not fragile necessarily but very thin, that's what it feels like, sort of stick-like, stork-like" (3ofl).

It is clear to me that Gwen does not intend to develop the image further. Therefore

1 invite her to imagine herself as the twelve-year-old girl she is seeing. 1 ask her how her body feels as that girl. She responds: "What cornes to mind is strange, it feels foreign, it has feelings 1 don? understand" (4ofl). When 1 ask her to be more specific she States:

"Emotions, specifically sexual feelings that originate in my body and I don? understand them, they make me feel dirty and ashamed, you know, it feels like my body is out of control, and 1 don't know what to do with it. And it also feels like everybody can tell what

1 am feeling, 1 don't know how to explain it, but 1 feel quite exposed" (40f 1).

Memorv and Ps~che-SomaLinks.

Gwen follows her awareness with littie guidance from me. She recognizes that up until age twelve she had fought to ignore her body, but at puberty it was no longer possible: "It feels like 1 can't get away from it . .. 1 successfully managed to ignore my body for most of my 98 life and now it is suddeniy having al1 these sensations. both from the growth spun and from

.. . getting my period, and it is al1 very confusing and I'm fighting to ignore it again ... it

[rny body] carried my head around, and now 1 am having to pay attention to it and 1 don't like it much" (4-5ofl). Gwen describes clearly a very early split between her head and body

(psyche-soma) indicated by her awareness thaï to include her body changes would drastically alter something that was secure, an ingrained state of being, intellectually oriented and seemingly unconscious of having a body. Puberty was inflicting body consciousness: Gwen was aware of her body irnposing on her head, and she felt antagonistic toward her body.

She already had a sense at age twelve of her body taking her somewhere she did not want to go and apparently betraying her in this process.

When Gwen drifts back into an intellectual interpretation of her experience during the session, 1 continue to encourage her to notice her body and, to link soma with psyche. observe any messages. She States: "Well, my sexual feelings and messages are in my genitals .. . it feels good and at the same tiine it feels dirty and it feels exposed and vulnerable and 1 can feel the shame in my face .. . and my shoulder, front part of my chest. at the top of my chest, that's where the shame seems to be, 'cause it feels like just by looking at me, everyone can tell what's happening in my body" (6ofl). Although Gwen cannot remember being sexually abused, she came to this study believing strongly that she had been. Her experience of shame, humiliation. and dirtiness associated with her sexuality is cornmon to sema1 abuse trauma. I suggest that feeling guilty about what is happening to her body also raises questions about where that guilt could have originated at such a young age .

Next she notices a sensation of heat: "It feeis like heat .. . in my shoulders, back of 99 my neck. blowing on my face. the sort of heat that you get when you're embarrassed and

you blush" (6ofl). 1 suggest she focus on experiencing the sensation of heat and she says:

"The feeling is that I want to cry, my thoughts are confused, 1 don't know what is

happening to me, I can't talk to anyone about it. there isn't anybody there. it doesn't feel

safe enough to talk to anybody so 1 am snick uying to go through this myself .. . and 1 have

the strongest sensation .. . both a sensation and an image, of basically severing rny head

from my body, so that 1 can free the pressure in my throat, along with the sensation in my

body. Confusion seems to be everywhere in it" (7ofl).

Gwen's image of herself demonstrates that her self-awareness was cut off at the

intellect. This split enabled her to free the pressure in her throat and the sensation in her body; she had removed her head from her body. Without a prompt, Gwen has apprehended a body image with a metaphorical quality. but at the same time she is vividly experiencing it as a body sensation, "the strongest sensation .. . both a sensation and an image" (7ofl).

1 want her to be clear about what her intentions are in severing her head from her body and 1 ask her to explain. She replies: "If I cut my head from my body, if 1 can separate that, then it will go away . .. the feeling dirty and the feeling asharned will just al1 go away." (7ofl). I ask her if she still feels like crying and she responds, "no, because then I don? feel my body at all, and that's just fuie, [my body] just seems to be a source of pain" (70f 1).

1 ask her what she feels in her body as she speaks about this. She says, "1 feel agitated, pressure in my throat, my legs are stiff and tense, part of what I was aware of before when 1 was speaking from a twelve-year-old body is agitation in my legs, like wanting to run, like wanting to get away. and that's what I feel down in my legs, sort of 100 stiff and terne, tingling in my hands and arms .. . shoulders .. . and sadness, the sadness is in my chest, and my heart area" (8ofl). Wanting to escape and feeling immobilized is another hallmark of traumatic childhood memories. Anatomically our legs represent the ability to travel through space or take action in a "flight" response. Gwen pauses and cornrnents:

"My sense is that this is where it started, that's when (twelve years) 1 cut off my body, when it started giving me so much trouble . .. " (80f 1).

After a couple of long pauses, 1 ask if there is anything more she wants to Say about the memory. When she replies that there is not. I suggest she transition to the present time and notice her body. She says she feels "heavier, and more solid .. . grounded and centred" and that she is "more cornfortable in having my body and feeling like it's a part of me as opposed to being a vehicle to cart my head around" (9ofl). Her body feels less breakable and thin, her legs "solid" and capable of holding her up and comecting her to the earth.

When she looks back at the twelve-year-old girl, she uses the image of a milkweed pod to describe what that body experience felt like: "1 certainly wasn't connected through my body

... . The image I get is of those seeds that have the long filaments attached ro thern, those puffballs .. . constantly dancing across the earth as opposed tg getting comected to it, like I was always trying to get away from [the earth]. 1 can remember wondering, when 1 was twelve, what on earth I was doing here, in this life, on this planet, and my body reflected that concem" (10ofl). This changed body image is indicative of the progress she has achieved through her years of attention to healing.

She feels that in the present she is "comected"; her feet are now "planted on the ground" and her arms are "strong ... so 1 can hold and ... touch and .. . feel." She compares her present body to the body of her twelve-year-old self, "whose arms were too 101 long and awkward and dropped things that she held in her hands." As a twelve-year-old girl she knew her body was "the only way she could be comected to touch and yet [she] tried to cut off the awareness of the body and sensation in [her] hands," and as a result

"couldn't connect" (1lof 1).

To focus Gwen on her body experience again. I suggest she observe how her chesr is feeling because she mentioned it earlier. She States: "There is no sensation of [feeling] ashamed. .. . I always have a feeling of sadness in my chest .. . pressure, like a bubble almost." 1 want to encourage her to go further with her body experience and ask where in her chest she feels this. She says it is " inside .. . pretty deep .. . it feels like the heart tissue " (12of 1).

Recognizing that her heart was affected by her experiences when she was a twelve- year-old girl, and that loss is a heart issue, I remember that when she went through the physical changes of puberty no one was around. Therefore, 1 ask her about it. She says:

"My mother died when 1 was thifleen, so she was pretty sick through when I was twelve,

.. . 1 am an ody child without relatives in Canada." She mentions her father was availabIe ody "peripherally." Now that she has made a comection with her hem, she notices "it's the bewilderment thoughts as well, of 'what am 1 doing here?', whereas as me now, it's not the bewilderment any more, just sadness, and I cm feel now that my legs are relaxed .. . not stiff any more" (13ofl).

1 recall her unwelcome feelings of sexuality in her memory experience and ask her if her bewilderment and sadness have anything to do with that. She says that has changed too:

"It's become sexuality and sensuality, 1 feel now 1 have a whole body, and what 1 know about myself now after many years in therapy is that I can sense as opposed to .. . think. I 102

used to think 1 was a visual person ami I'm not. I need to touch, to feel things, and rny

body gives me a lot of messages and now 1 cmpay attention" (13ofl). I feel this is an

intellecnial awareness that she is articulating and to some extent a hopeful projection for the

funire. Ofien, before a person is able to make a shift, the cognitive understanding is

evident as a first stage.

After a pause, 1 suggest to Gwen that we continue into an experience of how she

would like to imagine her body in the future. She transitions into the future and notices

fear in her body and tension in her legs and shoulders. She explains her "feu around my

body in the future" is related to her memory of her mother's illness and prernature death,

and getting older has becorne "synonymous with illness [and] . .. my body failing. " She

recalls recently having the flu and wanting to "sever the comection between head and

body." She laughs about it because her head hurt too and she was not sure which end to

keep .

Wishing to guide her towards a psyche-soma link, 1 invite her to notice where her fearful thoughts are located in her body. She notices a feeling of sadness, but also a sense of making "connections" to the earth, to other people, and to her purpose on earth, and she wonders if having these connections might change the sadness.

1 ask her for an image of herself in the funire. She has an image of "moving, jumping for joy, wanting to do cartwheels .. . like wanting to be light and free. " Gwen says she remembers watching seals at the zoo, swïmming undenvater in their tank: "1 remember being quite envious [about] how at home and a part of their environment they were, at the same time they were moving within it." She imagines her body in the future might feel

"the sensation of lightness and wanting in some way to jump and not corne down to earth .. . 103 exhilaration" (16ufI). Gwen's image is a development from her earlier image of herself as a milkweed pod floating weightlessly through space without needing the earth. However. she has now included the more substantial element of water, and she has graduated to intentioned movement .

1 remember that she talked about her heart in connection with fier sadness, and wanting to direct her toward body awareness, 1 ask her if she notices the feeling of exhilaration there. She says: "It onginates from the heart, but it moves into my arms and legs as well. .. . . But my belly, that seems solid and heavy, it doesn't seem a part of it. .. .

In the future it feels like that part weighs me down" (16-7ofl).

1 recognize that she has developed two distinctive parts of herself, or opposing images in herself, formed with enough clarity so that a dialogue between them would be possible if she wants it. 1 suggest she attempt a dialogue between her heart and belly. She begins with her belly and discovers the image is of "solid cast iron pots .. . heavy and black." On the other hand, her images of her heart are "of the Sun, everything just seems to be light glowing, light in both senses of the word." She says the two parts "seem so opposite that it feels like there's no dialogue possible .. . like they speak different languages"

(180f 1).

Healing Image.

Realizing she is having diff~cultydialoguing, I know we need to go back and bring more awareness and understanding to the images. She describes the " heavy part" as "keeping me attached to earth. " At this point she is surprised to find herself in an altered state which she calls a "stream of consciousness." 1 would suggest that at this point she is able to leave her 104 intellect and be present with her body experience. She continues: "The function [of the heavy part] is protection, protection of the genitals, the vulnerable parts. the parts that were hurt" (18ofl). Next she notices that "the light part belongs to now and the future. the dark part belongs to the past. The light part "has a feeling of optimism and hope, hope for the future, and joy at being alive" (18ofl).

Without pausing she says "that's al1 I cm think of." Therefore 1 know that she is back in her intellect and the images will be lost if 1 do not make a suggestion. 1 tell her 1 am going to make a suggestion that she cm accept or ignore. 1 ask her what would happen if she let the sun image grow and be felt by the harder dark part of the past that "needs to protect." She admits that as she listened to me she thought it would make no difference. but as she allowed herself to follow the image of light, she feels "the rays streaming down my hands and torso into rny belly .. . and the heavy dark pan was becoming thimer, like when a pot starts to rust and star& to flake off and eventually get holes in it. and that's what the rays of the light part seem to be doing .. . sort of lacy, still dark and parts still heavy and thick but getting thinner and lighter [with a] see-througli iacy pattern. The dark part before wanted to protest and Say I have a function and 1 have to do this, but it also didn't object. Lights. rays, and warmth started to melt away" (19ofl). She seems to be aware that the dark part "is no longer functional any more and it must know this or it wouldn't have given up" (200fl). She continues: "1 can be centred without being weighed down" and notices she feels much lighter despite some residual heaviness. 1 suggest she ask the remaining heavy part what it needs. She States: "It needs me to pay attention to it, to acknowledge its existence, and it needs to be reassured that it truly isn't al1 the time ignored" (200fl). She agrees that diis will be possible, "now that I know of its existence." 105 Evidently Gwen has begun to integrate the separated parts.

Gwen notices, "It doesn't seem like a head thing, more a body comection of one

part of the body to the other part of the body, perhaps a reassurance frorn the Iight pan that

it can take over [the role of protection]" (21ofl).

To cornplete the session. Gwen chose to take a few minutes to be present with her experience, saying "1 think 1 would just like to enjoy this feeling. "

Drawing and Discussion.

Gwen draws a stick figure, a tree with roots and fruit, and a Sun representing the past. present, and future respectively . (See Figure 2 .) She explains that she has drawn the twelve-year-old girl in the past as a stick figure enclosed in a circle that she calls "a grey void . .. [with] no connection between her and the earth .. . floating around there, wondering what it is she is supposed to be doing and how to get through whatever this is" (22ofl).

She says the arms are protective and she feels "vulnerabIe." As she reflects on her drawing, it seems to her that she has drawn the stick figure with a "big head . . . because that was where I lived. 1 did a lot of ... compulsive reading so that 1 could get away frorn what was going on in my . . . body and my life. "

In the present, Gwen draws a tree that connects to the earth and the sky. She says she feels the tree is solid and the fruit represents her leaming and healing activities. She observes that the circles around the sun that concentncally reach out to other parts of the picture represent her hem. She says that she often draws circles and feels they represent her being self-contained. She says: "The light that 1 felt in my heart [is] . .. now encompassing al1 of it, the present and the past." She is surprised that her past image is as 106 old as twelve years, since "the more painful things actually happened a lot earlier than that. a lot of the tirne ... 1 have the rnost trouble with the six-year-old. and in fact 1 saw the twelve-year-old." Listening to her story 1 am not surprised because at puberty her body changes probably forced her to become aware of her physical being. I imagine that puberty, as a time of inevitable biological sexual development that cannot be controlled by the intellect, could elicit possible hidden sexual trauma from the past. 1 would also suggest this need to protect her genitals was atypical of the general population. Figure 2 s ,- - ' 4 .. Gwen's Drawing 1 5.4. WILLO'S SESSION

Background Information.

Willo is a middle-aged woman of European descent. married with two children. She has

completed the second year of a university degree program. She has three older sisters. who

are considerably older than herself, and one younger brother. Willo is not especially close

to any family members. She describes her rnother as "a perfectionist with a martyr complex and a resentful caregiver," and ber father as "unable to express emotion other than anger and unhappy with himself," compulsively eating in order to "fil1 the void."

Willo comrnents that she has seen numerous psychiatrists and ps ychologists be tween age eighteen and the present the, and until she began working with her current therapist. who she has been seeing for three years, sexual abuse was never discussed. Willo has no background in body-oriented psychotherapy or therapy that involves movement or touch.

Willo was sexually abused by her father between the ages of eight and fifteen. The sexual abuse involved fondling and intercourse, but no oral sex. Her father stopped sexually abusing her when he "picked up a girlfriend." Although still living at home at age fifieen, Willo started her "dmg career" (26of3) and entered a psychiatric institution for the first tirne. "1 told [my mother] about my father having a girlfnend .. . 1 told my father too, and they both told me 1 was crazy and I was seeing things that weren't real. That was their way of thinking it was okay, that they were protecting me, and 1 started to believe thern"

(2700). While Willo does not feel close to any family members, she does not feel totally distant either. In regard to her parents, she States that she has been able to "let go of a lot of things that happened between my father and 1, [but] I haven't done that with my mother"

(28of3). While the abuse was going on her mother always appeared not to notice. "I've 109 tried to protect my mother or myself from believing that my mother knew, but how could

she not know, what did she think was going on ... there were a lot of things that were pretty obvious" (30of3). Unlike her three sisters, Willo was bathing with her father when she was as oid as twelve years and was given gifts by her father. He also "left money on the counter, like [for] a hooker, and 1 remember my sisters openly going, why does Daddy give Willo that" (30oD). She describes the message she was getting from both parents:

"You are completely and totally responsible for who and what you are and if somebody does something wrong to you, well you deserved it" (31oB).

Willo began to recall the abuse when she recognized exaggerated, shameful rage toward her father at his funeral: "His eulogy was a pack of lies .. .. and 1 remember just feeling awful things. ... 1 remember crying my head off and it wasn't because I was so sad, it was because 1 was so ANGRY that they were only getting one side of him. But I didn't really have concrete memories either, and being completely ashamed .. . here he is dead and

I'm MAD" (2308). She continues: "It was only when my pregnancy [came] and [1 was] giving birth [that] really concrete rnemories came into place" (6-7of2). The physical activity in yoga classes caused her to cry although she was not making any connection between her bodily sensations and her thoughts or feelings. She believes this physical experience "started to open the unconscious and then 1 started to drearn, and from the dreams I started to have real live memories. that I couidn't just Say: 'Oh well, you know this was a really weird dream 1 had'. And actual daylight memories. And now it makes sense " (70f2).

When asked to descnbe her healing process to the present, Willo States: "One-on-one therapy [for] the past two years coupled by a persona1 willingness to cease or at least curb 110 self-destructive behaviour and become aware of the source of my actions. CI am] confionthg anxieties, talking with rny therapist and supportive friends. [I have] a detemination to not avoid or run away from rnemories past and present."

At age twenty-six, Willo was diagnosed with leukaemia, and for the next two years was involved with this disease, receiving chemotherapy and radiation for a six-month period. She decided on her own to stop al1 ueatment because she did not feel confident it was effective. At the time of this study , Willo was under observation for lupus. She States:

"My personal feeling is that the leukaemia was a result of lupus because at that point lupus was stiil not a widely recognized disease." Her mother has also been diagnosed with lupus.

My study was mentioned to Willo through a mutual friend. Previous to the study. 1 had been introduced to WilIo at a social gathering where we spoke briefly as acquaintances.

She was curious to experience a body-oriented approach to change and wanted to be supportive of my research. The Ex~erientialSession.

Memory and Body Experience.

In the session, Willo begins with a memory of herself as a school girl running. She

associates this with her experiences playing spons such as broomball. and she is particularly

conscious of the sensation in her chest area. "1 [remember] the sensation of breathing .. . 1

used to run a lot ... I feel that everything is revitalized because of the expansion and

compression of rny chest while I'rn mnning and breathing and feeling the sensation on my

face and my hair as I'm mnning and it's a cold arena and yet 1 feel so alive and warm and

strong and capable and 1 feel carefree too because we're playing a game" (5ofl). She

comments: "1 mirs those feelings .. . 1 miss the feeling of mnning on ice and feeling that 1

like my body and I'm appreciative of it, because 1 LOATHED it" (9ofl). She says that at this tirne she felt undeserving and unable tu do anything "nice" for herself. "1 couldn't take

a bath .. . put on nail polish .. . I had corne to the conclusion that this isn't me. 1 tried to tell myself that . .. 1 can't do anything for myself, to be nice" (9ofl). Later in the session she identifies herself as a twelve-year-old in this memory of running on the ice; however, the memory of ninning appears to represent a span of years between the ages of eight and fifteen when she played broombalI.

Memory and Psyche-Soma Links.

At this point, Willo begins to recall how it came about that she stopped participating in sports. "When 1 was about fifieen or sixteen I just cut it out. 1 just stopped. And I remember being in a süirting block .. . and tuming my head and looking at the bleachers and they were full of students basically . And I couldn't run. I just stopped. And that was my 112 last [expenence in sports]. .. . 1 didn't realize it at the the but it al1 fits in with .. . whenever the relationship between my father and 1 ended was when 1 was about 15. So I didn't tie anything together then. I guess I've always sort of known it since I've been in therapy but I've never really openiy talked about it. This is really the first tirne. You know it makes sense to me" (7ofl).

1 ask her to dari@ what makes sense. She replies: "1 think that was when I started to really hate my body and 1 don't know whether it was other people looking or me wanting to hide [pause] IT or I'm not sure. Whether it was in a sense my father son of rejecting me, which 1 know for a while I defuitely felt" (7-8ofl).

After allowing Willo to pursue her thoughts for a while. 1 encourage her to refocus on her body experience, suggesting she renim to the feeling in her chest area. She continues to sustain her attention by recalling the thoughts that occurred at the tirne of her memory. Playing broomball at age twelve was a liberating experience for her because she did not need an identity that relied on her gender or sexuality. She explains: "1 matured very Iate and 1 only started my period when 1 was 17, but al1 of these women that 1 was

[with] -- they were women, 1 was not. And this was again an area where we weren't women, we weren't men, .. . the usual things .. . couldn't apply, we were just playing a game and it was really liberating. 1 guess I never felt any different than any of the other girls" (140fl). She said that when she played school sports she could relate to her peers, but otherwise "feeling cornfortable with my school friends was oniy after having something, a joint or something to make everything relaxed" (14ofl).

Next, she free associates the pleasure of mnning to feeling criticized by her parents and says: "1 used to get attention from my father, sexually, and it was still attention, 1 never 113

got sort of positive attention, 1 got criticized" (l50fl).

She notices two contrasting feelings in her body: "One is 1 feel like I'm trying to

hold things in and 1 feel a rush of anger. and what I want to do is tighten my body and try

to hold it in, and the other is a fluid, it's almost like a dance. it's a natural rhythm for me.

exercising. and needing to breathe, it's smooth where the other is clenching" (16ofl).

Realizing that she has discovered a division in herself and has clarified it with

images that involved her feelings and thoughts. 1 suggest we move into the present the and

check in with her body experience now. She notices being aware of an insight: "1 think 1

always struggle with rny body. 1 don? think I've loved rny body since 1 was twelve, 1 was

a -- outside of my father -- 1 was a virgin until 1 was about twenty, aimost twenty-one"

(17ofl). She says sex "always made me feel very uneasy" (17ofl).

Next she recognizes the connection between her clenching in her body and her

addictions to substances: "My father, 1 couldn't even be around him from fifteen until I

finally left, but 1 would always clench, this clenching, and cigarettes really helped because it

was like a metaphor for keeping things in, and just. you know. SHUT UP and stick a cigarette in your mouth and PUFF really hard and just, HOLD it. And that way you didn't scream and yell at someone, you didn't hit ... it was a way of staying in control" (18ofl).

Earlier she mentions that by her eighteenth birthday she was "doing a lot of pot and acid and basically anything," (8ofl) and that she believed that to do anything numiring for herself, such as taking a bath or putting on nail polish, was something she could not relate to (9ofl).

Again 1 listen while she remuiisces about happy, satisfying tirnes when she first had her own apartment and about mistrating tirnes when she was in a hurtful relationship with 114 her employer. She also reminisces about recalling her sexual abuse experiences with her father and her anger at the time of his hineral. She notices: "I've always gravitated to son of abusive situations and drugs" (23ofl). She spoke at length about her fears of men and especially of men being around her small daughter. She believes her daughter naturally feels afraid of men.

During this time she shifts into an awareness of how her body is feeling at the present time: "My body is nght now defenceless, 1 feel very, very vulnerable .. . it feels softer, 1 feel bigger" (24ofl). She also says: "And 1 feel very lost ... I've been trying to do some physical [exercise] .. . and 1 haven't been able to get away .. .. If 1 could get back and get some of those feelings that 1 had when 1 was twelve and when I was exercising .. . I need to feel my body moving .. . I've always prided myself with my strength. .. . Like I've always felt that if 1 were attacked that 1 would be able to .. . I'd be physically strong enough to .. . like 1 don? walk in fear that someone might be able to overpower me. .. . . That's always been with me, that's part of my legs and amis" (25-6ofl). Willo is consciously aware that she is developing her body in order to have its physical strength, although she mentions she has "some girlfriends who are very rnuch concerned about that" (26ofl). It seems to me that her strong motivation to develop physical strength might be rooted in a defense against the fear of being overpowered by men; however, she does not articulate this. It makes sense on a body level that women would defend against their perpetrators by wanting to "work out" and build up muscular strength, sometimes to a point that is quite exaggerated, yet be unaware that îhis is a defensive behaviour. Others might seek a similar kind of protection by growing fat barriers between their body and other people's bodies.

Strategies of overbuilding the musculature or accumulating fat for insulation may serve 115 important purposes at certain times in a woman's healing process. On the other hand.

interna1 strength and the establishment of boundaries need to corne from an embodied experience of the self.

Willo rnakes a comection between her physically strong body and "the part of me that wants to be nice to me, the part of me that wants to stop being unhappy. to be really good to myself in ways that aren't destructive" (260f 1). She also connects this part of herself with her recent effort to quit smoking cigarettes: "1did it as an ACT for ME"

(27ofl). Willo expresses a desire to "get this BEHIND me so that 1 cm be whatever it is that I'm supposed to be .. . 1 feel 1 never have a chance to dream because I've been so busy trying to GET AWAY" (27ofl). She cries and speaks about how her tears are for "ME" and notices pain in ber chest.

Willo notices her breathing and then recalls the experience of attending a yoga class when she unexpectedly began crying spontaneously while perforrning the postures. She did not undentand what was happening, and experienced it as uncornfortable and overwhelming. She comrnents: "What was happening at yoga was, 1 was doing exercises in certain positions and then I'd suddenly start just bawling my head off ... but 1 wasn't sad and I wasn't thinking anything sad, 1 would just start crying. it was really WEIRD" (28ofl).

She says she never returned to yoga class because "1 guess 1 wasn't ready to deal with the emotion" (290f 1).

Recalling the yoga class experience bnngs Willo back to an awareness of her chest.

She mentions that a naturopath has told her that her chest is "where 1 hold everything in. "

She puts her hand on her chest as she speaks. Because her chest was the focus in her earlier memory, 1 suggest she focus again on the pain she was feeling in the area and where 116 her hand is now placed. After a few minutes. she describes the pain in her chest as a Rat, closed, dark area she eventually sees as a "big, dark, scary door with teeth" (3Oof 1). She

describes henelf as standing on the threshold: "1 hold the doorknob and I can't go back. but

1 can't bring myself to go in. 1 open the door a little bit and everything just cornes flooding

out. I just tum into this mess, 1can't function" (31ofl). Willo feels that she cannot go in the door because she would not be able to carry on her everyday activities, especially gening the kids to school, doing the laundry, et cetera. She says that the forty-five-minute time frame with her psychotherapist does not allow for this kind of exploration. It seems to me she is itemizing al1 of the reasons she has accumulated to help her avoid opening this door.

Willo recalls a day when she was ovenvhelmed with anger and trashed a bedroom:

"1just went crazy and 1 really scared myself' (33ofl). She speaks about being "terrified .. .

I'm trying to break it down so it's not this big overwhelming thing with teeth, and I'm trying to tackle one thing at a tirne. Like smoking, again, is part of that. 1 had never imagined, in my life, that 1 could not smoke. 1 needed my cigarettes, they were my friends, they have been there" (34ofl). She mentions that letting go of her addiction to cigarettes

"makes me get closer to the door," and she is "getting linle glimpses at what's behind there and taking out one at a tirne .. . but right now 1 have to keep holding it together" (34ofl).

It is clear to me that there is a division that she recognizes between the part of herself that wants to open the door and the part that was a mess behind the door and would feel overwhelmed if she does not continue to "hold on." 1 suggest she begin a dialogue between these parts.

She says "the mess" behind the door is trying to tell the person who is holding on, 117 "Look if you're not going to open this door, I'rn going to make you a mess anyway. and

I'm going to ERODE you to a point where you have no choice" (36ofl). She continues:

"The side of me that's behind the door needs to know that 1 can have some safe, quality

rime off so 1 don? have to worry about my children and stupid things, and get a CHUNK of

this pain out. ... And the side that wants to hold it together is finding it harder and harder

and harder" (36ofl). She also says a "physical outlet" would be helpful. She starts to cry

as she recalls her rnemory of nuining as a child and feeling "great" in her body and self.

She says the tears are sadness "because I was doing something great for the little kid and

I'rn not supposed to, 1 don? deserve" (37ofl).

She descnbes a child that she had met recently who reminded her of herself. wearing

glasses at four, "an awkward little kid." After crying at length she says, "I'm just

professional at putting unpleasant things out of my mind" (40ofl). Part of her coping

strategy has included the use of cigarettes and dmgs to du11 her mind and anaesthetize her

emotions: "1 dont even have to THINK about it, I just do -- anything unpleasant, it's gone.

And that's served me WELL sometimes." In this way she is successfully removin; her

head from her body. unlike others in this study who have chosen to remove their body from

their more cornfortable thinking head.

1 ask her where in her body she puts her "unpleasant things" when she wants them

out of her mind. She States she has "Mespaces in between organs ... little pockets .. . of

spirit or mind .. . I guess unconsciousness" (4O0f1). She continues: "1can just bury things.

It's almost reflexive because I've been doing it my whole Iife .. . like SECRETS .. . but I've perfected it too much" (41ofl).

Willo recalls that as a child she was an "adult from birth." She makes a link Il8 between herself and her mother. Apparently her mother told her that she. Willo, was the

reason her mother couldn't "take time for herself." "Many times [I have] had difficulty during therapy expressing anger and feelings because I've always chosen to be the ADULT

looking back .. . instead of the child and what the child felt. 1 couldn't connect with those feelings" (43). Connecting directly with her child part leads her to an appreciation of her potential for experiencing pleasure. She says: "1 woutd like to get to a point where at least

I'm doing things for myself that are nice. And give ME pleasure. And not necessarily have it amount to anything" (44ofl).

She talks about being impatient with her healing process: "I'm TIRED of feeling

SAD and just ALL of it. and 1 get really impatient" (48ofl). After this prolonged period of tirne with her intellect leading, 1 suggest she renirn to her image of the door with teeth and ask herself how it feels. She describes it as "not as black as it was, and the teeth are receding a bit, I even feel 1 could open it a bit and not burst into tears. it doesn't feel like there is so much from the outside PUSHING against the door, like the pressure is not as strong, as built up as it was before" (490fl). While she is talking she is touching her hean area and she says: "It's a real physical pain like an ache. and now 1 don? feel the build-up that's behind" (5Oofl). The release of pressure resembles the feeling she experiences after she has "dealt with something" with her therapist after postponing it, when she has "finally" processed it and as a result feels "relief" (5Oofl).

Healing Image.

I realize Willo has reached a point where she has attained clarity about the parts of herself that are in conflict and has located them in her body, successfully associating the emotional 119 content of her discovery. Therefore I invite her to transition into the fuhlre by irnagining how she might like to feel her body.

Wilio notices herself "floating in the ocean .. . [in] absolute bliss " (500f 1). She describes her experience of the ocean. recalling her visits to the ocean as a child: "It's an ease. a carefreeness. and €rom the ocean 1 get such strength, it's so suong. it's .. . powefil.

I've seen the ocean so many different ways .. . it's an instant calm for me to sit by the ocean

... it's very simiiar to ninning on the ice where you breathe deeply and your face feels the sensation of coolness and wind" (52ofl). She also enjoys the sensation of the hot sand, making a well for her body in which she can lie and feel "the heat moving through [my] whole body .... And 1 would like to enjoy my body like that" (55ofl). While recalling her childhood sumrners at the beach, she realizes her reluctance to return there is based on feeling certain that her sisters were also abused, but that no one is ready to discuss these fmily secrets. She also remarks on how critical her sisters are toward her and how she never confronted her father while he was alive.

To complete the session, 1 invite Willo to focus on the image of the ocean and whatever her experience of it is at this time. She tells me that the ocean and running over the ice rink both involve water and are "very similar" in their effects on her body.

Drawing and Discussion.

We end the session with a drawing and a discussion. (See Figure 3.) Willo draws an abstract shape that she says is herself behind the door: "It's ME. It's the centre of me which is red and hot and angry and sort of chaos. I'm coming out and I want to get to these cool blue shores. .. . I think [now] I'm in the yellow-green zone" (6Oofl). She 120 explains that she knows she is not going back to a tirne when the door is permanently and completely shut. "That [Le. the picture] is what is behind the door, and when 1 fmaily open the door and deal with what THIS [pointing to the centre] is, 1 will be able to have this

[pointing to the blue-green] ... and no other way .. . there's no short cut, there's no magic pill, no drugs, yeah ... letting THAT [pointing to the centre of the picture] out, and when 1 look at it in a picture, it's not that bad" (62ofl).

Willo is pleased that she has given the previously "overwhelming mess" a shape that is less terriQing. The drawing helps her to recognize her process of integration. She explains: "1think it is that I've given it a shape, and it's not a scary shape, there's roundness to it, but it's going OUT, it's not enclosed, the figure eight used to always be my favounte number and it was because of the shape, and it was very complete" (63ofl). She describes the open figure eight in her drawing as "like a flower, sort of like an atom exploding, in the centre you'll bum yourself, and at the edges it's whatever atoms ARE ar the end, energy, and Iife, that's what 1 want" (63ofl).

5.5. TRUDI'S SESSION

Background Information.

Trudi is a young adult, single woman of European descent from a Catholic family. Trudi grew up with two older brothers. two younger brothers, and a sister who is slightly older.

Trudi describes herself as extremely distant from both of her parents. She describes her father as treating her like an object (450f3) and the relationship as "psychologically incestuous" (4308). She is only sornewhat dose to the younger brother who is nearest in age to her.

Trudi believes her sexual abuse occurred when she was between the ages of seven and ten. The abusers were her two older brothers and another male "that lived in her house." She refrains from disclosing to me the details of the abuse. She ody had "a vague feeling that something happened" until three years ago when she started psychotherapy . She has been in analytically oriented therapy for the past three years. Recently she has had four and one-half months of touch therapy and has studied a body knowledge technique for the past twenty rnonths. However, she says that she has no previous experience in body- oriented persona1 change.

Trudi describes her healing process to date as taking her "a great distance .. . in tems of being able to ta& about the abuse. However, 1 cut myself off from my family and at times 1 feel I push my emotions down rather than experiencing them. 1 feel detached from rny story. At tîmes 1 feel myself splitting in two. At times 1 feel the same age as when the abuse occurred. My level of anxiety has decreased as I have learned to taik about the abuse." Trudi is very clear about the limitations of her process to this point. My experience in working with her evidenced her reluctance to deal directly with her body 123 experience. 1 believe her expectation is that I am to direct the experiential session. The

session is quite advanced when she realizes that she is "in conuol." In every interview she

tends to ask questions in order to ascertain my intentions. 1 am not entirely sure why she

does this; however. she may need reassurance that she is answering appropriately.

Evidently Trudi has expenenced betrayal by her body and by her farnily to an inhibiting

degree. Her family members al1 continue to be in denial regarding her abuse. and this

denial has created an ambivalence about the desirability of healing. As a result, she has

considerable diff~cultyreaching a healing image for herself. She admits, however, that she

has "never really told my story to anybody" (66ofl). It is unlikely that she will progress

further in her healing until she is able to reveal herseif more completely and tell her

"story. "

At age eleven years Trudi began a series of operations that involved inserting permanent metal "rods and pins" into her spine and hip joints. Before the surgery, attempts

were made to correct her hip problern with legs braces: "1 used to have to Wear braces on my legs to bed at night, from the the 1 was about seven [when] the problems started .. . until .. . about fourteen or fifteen" (l70f2). "Problems" here could mean a worsening of her hip condition and/or the beginning of her sexual abuse, since she refers to seven as the age when the abuse started (2108). Her curent physical problems are complicated by her compulsion to exercise strenuously, which in the tirne period of this smdy she has been seeking to moderate.

While Trudi did not remember her sexual abuse until she was an adult she says, "1 had funny sensations for a long tirne .. . a gut feeling that something went on and 1just pushed it down ... Before 1 started my analysis I remernber thinking I wonder if that will 124 corne up. .. . 1 went [to analysis] for different reasons" (6 1-2of2). In the interview one year

later, Tmdi has a different view of her body experience. She States: "1 don? get body

memories and stuff like that, 1 don? think I've had anything like that" (2500). This mm-

around is confusing for me and 1 assume that because she contradicts herself, it is confusing

for her too. It is likely that this confusion sustains her ambivalence about her healing

process.

After beginning nnaiysis, Trudi "started having tons of images and flashbacks"

(62of2). A year later she says she still doubts whedier she has a true memory of the sexual

abuse because she has not been able to receive any verification from family members.

Tmdi says: "1 hope 1 can trust that they are real [memories] without having to shock my

family about it because they don? really seem very approachable .. . I haven't seen my

family in nearly three years, there is this avoidance [and] fear. and I think as long as 1

[avoid them], it will always have power over me" (2608). As noted earlier, her farnily's

attitude plays a part in her ambivalence about comecting her physical ailments to her experience of child sexual abuse.

The follow-up interview one year later is also difficult for Tmdi because she has entered an academic prograrn and feels that focusing on her body experience and past sexual abuse will interfere with her cognitive abilities. She had also stopped therapy during this period, for the same reason. Because 1 understand the importance of her current academic work, 1 am very respectful of her resistance to a deep exploration. The Experiential Session.

Mernorv and Bodv Ex~erience.

Trudi's memory is of her first hip surgery at age "about eleven." She visualizes an X-ray of her hips and says. "1 aiways see this picnire .. . a lot" (7ofl). She continues: "It is up on the glass, and it always jumps out at me. that image, 1 can see it, ... it is just something 1 see a lot and I find it kind of embarrassing because everyone was always looking at it. 1 never see it alone, 1 always see it with a lot of people. It makes me fez1 very transparent.

I feel like they know, they cm see through it." She explains that her family and "a lot of doctors" were always present in the hospital while the X-rays were viewed. This visual picture makes her feel "horrible" but she does not know why; however, she says. "1 always felt that 1 was on display .. . the lights .. . I felt shame 1 guess" (9-10ofl).

Up to this tirne in the session, she is primarily focused in her intellect and not present in her body experience. Trudi continues throughout the session to speak in this tentative marner of maybes, sort ofs, and 1 guesses. In this transcription, 1 omit most of these qualifiers for the purpose of clarity; however, the reader needs to keep in mind that her hesitant, insecure verbalization is part of her expression at this tirne. At a particularly crucial point in the session, Trudi verbalizes her frustration at not being able to articulate her thoughts and emotions. At thes it is difficult for me to follow her explanations because it seems that she still has some need not to expose herself. For example, at this point when she mentions feeling shame, 1 invite her to notice where in her body she feels it.

She is unable to locate this feeling of shame in her body.

As a result, 1 follow her conversation and suggest she focus on her pelvis. She notices that she is feeling "numb" in her "hips and legs" (120fl). She is able to descnbe 126 the numb feeling as follows: "The image would be Iike a cross ... the colour would be black

.. . the texture would be something very horrible [such as] concrete" (l2ofl). She associates the concrete with "a feeling of powerlessness, no control" (Uofl).

At this time, she notices she was younger, "probably eight or nine" (Mofl). When I invite her to notice how her pelvis is feeling, she says: "Well I feel like 1 don't want to go there. " Shortiy afterwards she says: "My head is starting to hua a bit" (l50fl). She notices she is clenching her hands, holding her breathing, feeling anxious in her chest. She fdly says, "1 feel like I am totally locked in concrete" (160fl). She says this "stiff and rigid feeling" was not present when she fmt Iay down at the begiming of the session. At this point, Trudi sees her "brothers' faces" which makes her feel frightened. She feels as though someone has a "hold" on her body, which she associates with her "family" generally, and has an urge to "strangle" her brothers. As she follows the sensations in her body Trudi transitions to a memory of being tied down "on a striker bed .. . the bed 1 had to lie down on after I had the operation on my back" (210fl). Clearly the experiences of being sexually abused by her brothers and being restrained post-operatively have become enmeshed in her memory. Throughout the session she continues to want to talk about the two memory experiences as if they were joined. In the memory with her brothers' faces, she is eight or nine years old and in the mernory of the hospital bed she is thirteen years old.

Trudi continues to discuss the unpleasant forced passivity of her experience in the hospital: "They lift you up and tum you over . .. you don? ever get to Wear clothes, you just have a sheet covering you, that was really embarrassing" (23ofl). In a way that is similar to someone regaining consciousness in a recovery room after surgery, she notices a 127 sensation of feeling "really thirsty , really dehydrated, " and "complete numbness" and "a lot of pain" in her back (24ofl). She says: "1 can't take it any more .. . it is terrible, and they keep on doing more" (24ofl). She associates her family and the hospital non-specifically as she states: "1 feel like I'm going to explode .. . if people will not listen to me .. . but you can't do anything for yourself" (240fl).

Memorv and Psyche-Soma Links.

1 realize Tmdi has a clear memory, although it is a superimposition of two mernories.

Therefore I feel it might be appropriate to invite her to imagine her body in the present tirne. Once she is in the present, Trudi notices her head still hurts and she feels very stiff in her body and as if she is "not breathing. " She particularly notices "a really heavy weight" on her shoulders and feels that "this weight has something to do with my family"

(28ofl). She says that her shoulders feel "that they are not operating on their own" and that they are carrying her "family shit" (29ofl). At this point, Trudi makes a psyche-soma link and states: "1 just keep on carrying it around because it is mine .. . 1 just accepted it .. . just kept it in, and 1'11 keep the secrets buried ... so the load will keep on getting heavier because there are more people now involved, and more people can't know" (30ofl). Her shoulders feel "they can't take much more weight" (30ofl). Trudi starts to feei a headache and says: "1 think that is why there is so much pressure in rny head, because there is so much weight on my back" (3lofl). Tmdi is explaining how she creates headaches to aileviate her emotional stress. a fom of somatization. She senses disagreement between her head and her shoulders. Her head part wants to "give it [i .e., the weighthecrets] back, " but on the other hand, her shoulders feel "our secret is ... unbelievable, and they have known 128 and they keep it more secret" and therefore the shoulders "just can't do it" (3 lofl).

During the dialogue between her head and her shoulders, Tmdi notices her "stomach

feels .. . in knots and anxious" (33ofl). Her shoulders feel unable to "let go of the

responsibility " and as a result her head becomes "confused. l' She feels the family secrets

are going to make her head "snap off (34ofl). She notices her image of concrete has

changed into something less hard and "not like cernentr1(35ofl).

At this point Tmdi says she feels very confused and 1 offer back to her al1 of the

physical associations she has mentioned to this point. From the selection she chooses to

begin a dialogue between her head and her shoulders. She says: "1 wouldn't mind [my

head] being removed from my shoulders .. . 1 think I could look at things differently .. . be a

little more objective about my parents ... more aware of what I'm feeling and 1 wouldn't be

so critical of ... what my feelings are. just be able to Say it. and not be embarrassed by it"

(38ofl). She explains "it" is the abuse in her farnily .

Her head has a sensation of "chaos": "1 am not supposed to feel angry .. . it always

tells me not to feel" (38ofl). She immediately associates this command from her head to

deny her feelings with a sensation in her stomach: "1 always feel this very intensely in my

body and 1 feel the emotion right down to my stomach .. . but I can let it go if I wait long

enough .. . 1 can get rid of the feeling by just trying to numb it out" (39ofl). This numbing

tactic is Trudi's principal coping strategy, assisting her to avoid feelings and sensations.

I encourage her to continue following her body experience and she notices she feels as if she were "going to fall apart1' (40ofl). She says: "1 always had to be two different people, " one that keeps the emotions in check and one that "doesn't know how to deal with expressions but can feel it" (41ofl). She continues to illustrate how she experiences this 129 split in her body. For example she says, "1 often feel depressed ... but I'm not sure what it

relates to .. . just a very heavy feeling. " She describes her stomach as "splitting hard right

down the middle," with a thought that she "just can't take it any more."

She imagines herself in a hospital where "1 could just get sick and everybody eIse

would take care of me." She is using an "escape hatch" coping strategy resembling the one

she used in the past when her emotions became too conflicted. Now she is able to reflect

on this strategy. She says: "So it took away from whatever was going on ... and 1 did that

from about the age of seven years old .. . but 1 can't do that any more, I how that .. .

sometimes I wish 1 could go back" (43ofl). In her words, "When 1 get really desperate 1

feel that way .. . just go back into the hospital, the hospital only got me away from my bad

home situation" (44ofl). She realizes that her "bad home situation" no longer applies

because she no longer lives in that environment. but she still wants "someone else to take

care of me" (44ofl).

She notices her head wanting to "explode or spi11 out [like] a watermelon" (45ofl).

The image of her head as a watermelon leads her to this psyche-soma association: "1 just feel like .. . part of me has let out my secret but another part is just keeping it inside .. . and it is afraid of the consequences" (45ofl). Trudi has recognized two opposing parts of herself represented by her head and her hips. Focusing on the discornfort of her

"exploding" head leads her to notice pains in her hips and then she sees the "image of the

X-ray." At this point Trudi has an insight about the shame and embarrassrnent she remembers experiencing repeatedly when recalling the X-ray of her pelvis as a child:

"When I was a kid .. . 1 just had a lot of sharne around that [X-ray rnernory] .. . but I didn't tie it together with what happened to me" (46ofl). She says: "If 1 could go back, what ... 130 my head was trying to Say when 1 saw it [the X-rayJ was everybody knew Our secret. Our family secret. It was right there, it was right there every time they posted it. every time they put it under the bright Iights. They have to know. .. . Nobody said anything to me. they never said anything. 1 was just embarrassed, 1 hated them, 1 hated always being on display .. . they would never Say what it was, it was just an X-ray, just a specimen" (46ofl).

For the "past few years" in psychotherapy , Trudi explains. she has been " trying to figure out al1 the physical problems I had and how it [sexual abuse] is related, because nobody ever had an explanation for me .. . it just felt like when 1 was in the hospital, the way they treated me .. . 1 just felt like everybody knew .. . but nobody was saying anything

.. . they were abusing me again .. . it was al1 just continuous .. . the humiliation and the shame ... felt like it was al1 related to being abused again and again" (47-8ofl).

Trudi continues to draw parallels between her experience of sexual abuse and what she now regards as abuse by the hospital. When she is describing her hospital experience, it sounds like sexual abuse. Speaking from her hips, she says: "1 just have so much shame

.. . inside of me .. . at the hospital you are just open to anybody, they can do anything they want to .. . lift your sheets and they don? care .. . you are immobile and you .. . can't do anything" (490f 1). She recognizes that the hospital seemed "better than home" because her brothers "would not touch me any more" (@of 1). She believes the doctors treated her

"medically" and listened only to her parents. Apparently hospital staff never asked her persona1 questions. She recalls hating her body.

At this tirne, Trudi feels a pressure in her head that she is evidently reluctant to explore so she seeks direction. Since she has continued throughout the session to look to 131 me for confirmation and sometimes solutions (e.g., am 1 on the right track?). 1 now wish to bring to her attention my awareness that she probably has a part within herself that is capable of giving her guidance. Therefore 1 suggest she might fmd it helpful to get in touch with her "wise part," which she, coming from an analytic background. interprets as her

"higher self. "

Healing Image.

Trudi envisions "an older woman" who looks Iike a "wise man" wearing a black shawl and using a cane. Trudi says: "She is standing but she is not suaight, she is a little bit crooked"

(53ofl). This is particularly remarkable because Tmdi has a rod in her spine so that her back is entirely rigid and suaight. She notices the woman's eyes are blue and her hair is blonde and her name is Ida. Trudi notices the pressure in her head "spreading" down her back as she hears Ida telling her to "write from a perspective of a child," and to contact her family and express her anger toward them. Trudi realizes she is "too afraid of her farnily" to feel safe expressing her anger directly, although she articulates her goal is to stop

"tum[ing] it on myself .. . 1 find it easier just to blame myself" (56ofl). Trudi assumes that if she wntes from the perspective of her child part, the written account will necessarily reach her family. She says that in any case she is "always afraid to write" because "1 don? want to own the feelings" (58ofl).

Finally, Trudi suggests to me that neither of us knows the direction of her "journey."

She says: "Am 1 taking you on this journey but you didn't know where you are going at all?" 1 reply that 1 have no idea (59ofl). 1 am delighted and relieved to know that Trudi has understood at Iast that she is in control of this session and that 1 will not be able to 132 direct her because 1 am following her lead. I encourage her to be present with her "higher

self" and recognize her wisdom is available to her anytime.

1 ask Tmdi if she would be cornfortable making a transition to the future at this

tirne. and imagining what her body might be like. She realizes she wants to feel "much

more receptive. no boundaries .. . in control of my body, to like my body and not feel asharned of it .. . more open and not carry around al1 the pressure" 60- lof 1). She notices

she no longer has "the feeling of being ernbedded in concrete" and says, "1can move more

and 1 have more energy " (6104. Her stomach feels better but she still feels "a lot of weight on [her] head and shoulders." Significantly, she says: "1 can really feel the rod that is in my back .. . in the future 1 would like al1 the metal in rny body taken out of me .. . this rod, the pins in my hips .. . 1 would like to be totally free" (630fl).

Imagining the metal being removed from her body reminds her of being "opened up" and "exposed once again" in surgery. She says: "I'm just a pile of meat to hem" (63ofl).

However, she realizes that without the metal, "al1 the memories around them would be out too .. . [it would] take out al1 the bad times, al1 the things that led up to that point" (640f 1).

Referring to the metal and the memories, she says: "They are always associated .. . 1 look at my scars and 1 remember and it is always there, 1 look at the age 1 was then, what was going on for me ... it is a rerninder for me because they are still in me, I feel like that part of this unhappy childhood is sewed up inside of me" (64ofl).

Realizing that removal of the metal in her body is not an option for her healing, I suggest that she invite her "higher self" to assist her. She says: "She is still telling me to write .. . 1 could wnte about the experience of what it felt like to have them [Le., the metal pins and rods] put in, what it feels like now .. . because I never really told my story to 133 anybody .. . lots of things about the abuse .. . have to do with hospitalization .. . a lot of associations" (65-6ofl). She explains: "1keep on waitïng for people to take it away fiom me, to make it vanish. to make it go away. but it just keeps on coming back. like a stearn roller could run over me right now" (66-7ofl). She says her image is "of being tlattened out .. . into the ground .. . like if you break a watermelon open or you could just have a steam roller run over you" (67-8ofl).

She explores this idea, saying that she would rather "explode" than "irnplode" because that would make her "just get sick again" (69ofl). She explains that exploding the watermelon is important "because it is easy if you just imagine pieces everywhere and you could just see al1 the content, just everywhere. see al1 the liale parts of it" (69-70ofl).

Clearly she imagines the relief of being exposed completely by an extemal force that she cannot resist and for which she has no responsibility.

Trudi makes a vivid metaphorical association between her inability to tell her story and her longing for a thorough exposing of her entire being. The arnount of violent external force necessary for the exposure of her "content" is a representation of her extreme resistance and her expectation that she will need an external agent to open up. Her exposure evidently would result in annihilation; hence, the concrete.

Trudi reflects for a shoa tirne on the effects of change and her unreadiness to accept it. I invite her to find a way to complete the session and to draw a picture. 134 Drawing and Discussion.

Trudi describes her drawing as coming from her "unconscious. " She says: "1 can't put words to it .. . 1 don? really know what it is" (74ofl). (See Figure 4.) While describing her picture to me, Trudi continues to have difîiculty tallcing directly about the picture itself and instead makes parallels with more familiar images she has drawn in the past.

Viewing the completed picture, she has doubts about whether "there is any future" represented in it, but feels "there is this past, images in there" (pointing to her picture).

She explains the picture contains a "very sharp instrument cutting through something. " and although she is vague she says: "sometirnes images that 1 draw often resemble hip bones"

(76ofl). "1 often draw images that really have no limbs, no arrns, no legs. " She points out that the red and black colours and the crosses in her drawing are similar to the contents of other drawings she has made; however, she notices, "This is interesthg here, there is some green, 1 felt like I could introduce green" (75ofl). 1 would suggest that although Tmdi is not consciously aware of progress she may have made in the session, her ability to recognize her introduction of green as remarkable is probably indicative of some healing.

When 1 ask her about the green, she says it is "grounding" without being able to provide an explanation of what this means to her.

Another element in her drawing that strikes her as unusual is the appearmce of the red dots she has drawn inside one of the pelvic shapes. She comrnents: "1 often do little things like this, but it didn't corne out the normal way .. . [these look] like little creatures"

(75ofl). Apparently Trudi was expecting the dots to "look like Iittle demons," but as she looks at thern she fmds they "certainly don? look like that, they don't have that feel at al1 to me, and 1 wanted them to have that ... but they just did not come out that way" (75ofl). 135

She says she "wanted to spew out" these creatures, but this time they do not look "demony" enough (76ofl). Because the picture has elements that are new to her. 1 again feel it is likely that there has been some change. Tmdi, however, gives no signs of knowing what this means.

Tmdi describes the figure on the left in her picture as a "very sad figure .. . of a child" and "a cutting hamrner or .. . it could be part of an axe" (760f 1). At this point, she refers to a previous drawing of her death that she did not attempt to understand until her analyst " helped" her. "1 mean I just didn't thhk anything of it" (770fl). 1 realize that

Tmdi has difficulty integrating her intellect with her body experiences.

5.6. LAURA'S SESSION

Backerround Information.

Laura is a divorced, rniddle-aged, Caucasian woman with one adult child and a college-level

education. Laura grew up with her parents, two sisters, and one brother. Laura describes

her father as a binge drïnker. She does not feel close to any of her family rnembers at ihis

time. Laura describes her history of sexual abuse as follows: "The abuse began around four

months and continued throughout childhood with the last experience around age twelve. 1

had ten abusers -- father, uncle, three aunts, cousin, grandfather, old man neighbour, sister,

and mom. The abuse consisted of some isolated incidents, but most of the abuse was

perpeuated by my cousin who was twelve years older than me. He was very sadistic,

probably psychopathie, and was also physically and emotionally abusive toward me. Some

of the abuse was rinial -- cult-like in nature; this abuse stopped around age three years. My

father abused me from age four months to six years and then it stopped. My uncle abused me from when I was a baby until age three years. My grandfather abused me from age three to six years. "

Laura describes her healing process as "long, deep, and hard." She has been involved in various forms of psychotherapy since 1985. She has extensive experience in body-oriented approaches to healing that utilize touch. At the time of the experiential session, Laura says she has "stopped al1 the bodywork since 1 was being flooded" (80f2).

This body-oriented session with me represents a new experience for her because 1 do not touch her, although she is able to focus directly on the experience of her body.

In 1992, Laura found that she has a dissociative identity disorder formerly known as a multiple personality disorder (DSM-IV). I did not know this previous to the session. 138 However, during the session our focus becomes the body expenence of one of her alters.

The alter states that she is one of Laura's children. Apparently, Laura decided before the

session that if she dissociated, she would feel safe disclosing to me thac she was multiple.

Laura knew about this study through a mutual acquaintance. Her interest in participating

came largely frorn a desire to support research that would validate the experiences of

women who have experienced child semai abuse,

When her memories began, Laura believed she was crazy. She states: "We're glad

we never came across anything like false rnemory back then. we probably would have believed we were crazy .. . no one has ever Ied us to Our mernories" (19oQ). Laura's early memories ofien corne in dreams that she describes as nighmiares. Laura believes many

"bizarre thingsf' trigger memories for her, including "perfume and peppermints." Body pain has been a strong memory trigger and she now associates much of the pain in her neck and arms to the methods of being positioned during the abuse. She also explains that she has experienced many "medical diseases," including symptoms of multiple sclerosis that were never clearly diagnosed, and severe endometriosis. Initially she sought organic causes, but she now believes that these diseases were largely the manifestation of emotional stress and unresolved issues from the past. The Experiential Session.

Mernorv and Body Ex~erience.

In the session, Laura begins by focusing her attention on her lower back area. She remembers being very small and hating it. and a man picking her up off the floor. The sensation of weight in her lower back turns to numbness the moment he picks her up. The full memory that follows is a reconstruction of the experience of rape by this man, who was her uncle.

Memory and Psvche-Soma Links.

In the session, Laura describes the rape as "like being at the dentist -- they have frozen you, you know they are there and working, but you can't acnially feel anything" (5ofl). This is a startlingly accurate description of dissociation. She is able to describe a sensation of cold and pressure that she cannot identiv or conuol, which gives way to a du11 aching in her lower back that she says "feels sharp and intermittent" (5ofl). While she is relating this experience during the session, her body is in obvious rhythrnical contractions similar to an orgasm. She notices she is frightened and that what he is doing makes her cry. He calls her his princess and tells her that she should not try to stop herself but rather enjoy it. He tells her that she enjoys it because her body is hot. and although he calls her his princess he dso tells her that she is bad. Recognizing that her thoughts are clear, 1 invite her to tell me about the pain in her back. She says: "It feels like somebody has got a shovel and they are digging into my back with the pointy end .. . he is .. . digging in his fingers to hold me still"

(7ofl). He instructs her to hold still and she will get to the point where she likes it. Laura says, "1 donTtthink 1 have any choice, I can't get away from him, I can notice it's 130 throbbing, hands behind my back, there is a pulse there" (9ofl). He is hurting her and at the same the she is trying to stop the "feeling from happening because when 1 feel this way he says then 1 am enjoying it" (9ofl). Laura's experience of totai helplessness and inescapable abuse are hallmarks of trauma. Her abuser is definhg her experience by telling her that her body reaction means something different from the mental and emotional reality of knowing that he is hurting her and wanting him to stop. She is being betrayed by her natural bodily reaction to sexud stimulation.

At this point Laura starts to cry; her voice rises to a high pitch and she begins to whirnper. She says she is "bad because 1 enjoy it. .. . It feels like in my mind I didn't want it but rny body made me do it. 1 couldn't have helped it and I am angry that my body doesn't listen to my mind because he will keep hurting me as long as 1 seem to keep enjoying it .. . , 1 don't want him to do this and he just w& away when he finished, cleaned himself up, he has done this before" (IOofl). She is left feeling "sore with a bunch of guclq sniff." Laura is angry ar her body for not taking direction from her mind, thereby betraying her and making her into a "bad" person. Her body is to blame for her pain and her abuser's actions. Laura is describing an experience of a splitting between her body and her mind. Ultimately her mind could not control her body and she would split the two apart to protect herself from becorning wholly bad.

Laura continues in this regressed state and speaks in the tone, manner, and vocabulary of a very young child, probably age 2-3 years, she says. She notices her back hurts less now, although she is "stinging in a private place" (120fl). She moves to thoughts about telling people what happened to her. She recalls in the past she went to the doctor, but he told her she was cleaning herself excessively. Next, she recalls telling her mother 141 and aunt, who also did nothing. Thus, at that tirne, the people she perceived as abusers as

well as her caretalcers were sending her messages that she was deseming of the abuse and

helpless to stop it.

When 1 suggest to Laura that she refocus on the experience of her body, she notices

anger in her chest and is able to recognize it is because of the way the uncle abused her.

She notices a pain in her neck that tums into a pain in her head, and she becomes aware

that " when the headache cornes 1 don't feel so bad down below any more" (14ofl). This displacement is indicative of a somatization. At this point, Laura discloses to me that her name is SaUy and that "there are lots of us kids inside" (15ofl). Sally is an alter. Sally explains that she and the other children cm feel Laura "looking after us" (l60f 1). Safly says she feels safe. 1 recognize the safety arose out of her ability to displace her pelvic pain to her head. 1 redirect her to her body experience by asking how it feels in her body to feel safe like this. Sally responds, "Held, warm, .. . like something that 1 didn't like off my chest, [Laura] cares, helps when we feel bad, body feels better, feels no more bad. no more bad reaction, clears things, I'm not bad, [Laura] makes me feel good, aches go, fun things"

(16ofl).

Healing: Image.

At this point, 1 realize that Laura has reached a certain amount of self-knowledge, recognizing the pain in her body, where and how it came to be manifest, and understanding the source of her anger. Because her awareness is evident to me, I invite Laura to transition from the past into the present the. She easily does this. 1 ask how her body feels. She replies that she is breathing more deeply into her pelvis where she feels a 142

" healing bmise. " When I ask her to describe to me the " healing bruise" she responds. " this pink, sort of like a wann ooze. kind of sliding through al1 the areas that were hurt before"

(180fl). 1 recognize the pink ooze as a healing phenornenon and suggest to Laura thar she invite the pink ooze to offer her a message. Laura is silent for half a minute and then speaks: "It says 1 was created by you and my job is to love you and heal you .. . feeling a nice warm feeling in the pelvis .. . al1 that area that was tom before feels very warm and actually safe" (19ofl). Later, Laura draws the pink in her picnue at the end of the session.

1 direct Laura to notice how her lower back feels. She says she feels a du11 ache that is "trying to cry out, to be released" (200fl). She continues: "A lot of the ache cornes from there, from al1 of [the children alters]. .. it feels like they al1 want to tell their story and I need to send the area lots of loving and lots of reassurance that they will have a chance to tell their story ... the aching is subsiding because they were sent the message that they will all be helped also .. . my heart cries out too because it has contained this for so long"

(210fl). Evidently, Laura is now aware that parts of her personality from the past were in fact affecting her bodily through pain in her lower back. The children's pain was also affecting her heart. She can locate her "alters" in her body now and has developed a healing image that brings them relief.

In response to her saying that her "lieart cries out," 1 ask her if that is like wanting to cry. She says that she has "shed a Lot of tears" and that the children inside her have difficulty because while some are verbal others are not. "It's hard for them to tell their story because they can't talk, .. . sometimes they will draw pictures of their experience"

(220E1). She says that with reassurance and help from people, the "ache in my back will be gone" (220fl). Then she notices a lump in her lower back. 1 invite her to tell me 143 about the lump, and she explains the lump is a "block" that has a "gatekeeper" who makes

it "hard to taik. " She says, "Two things are happening .. . a road block between rny brain

and my mouth ... and 1 have just been punched in the gut. " Laura says she felt sirnilar

"body reactions" after she told this to her therapist. She describes her diaphragm as " tight"

and "really hurting." I suggest she continue to follow her body experience. to go "deeper"

and "see what is important there." At this point, Laura describes meeting an adult alter that

is concerned about safety and unable to speak because she feels betrayed. Laura seems

comfortable with her decision not ro pursue this part of herself at this time.

Next 1 invite Laura co imagine her body in the future. She says she would "Iike to

take flight" except that she is "pinned by strings to the ground .. . from my lower back and

my chest." When I suggest that she go further into the future, the strings disappear.

Initially she says it feels nice, but then she says she feels scared. "The kids are scared .. .

because 1 am in the .. . future and they haven't told their story yet, they are afraid that if 1 tell a nice story they won? get a chance .. . so 1 have to stay in the present" (280fl). She comments that her current psychotherapy is "al1 wrapped around my need to know of them and not leave them behind, so 1 have to stay here in the present" (29ofl).

I believe it is important for her that 1 validate her experience, especially since it was my idea to suggest imaging her body in the future. 1 tell her that 1 respect her process and believe the messages she is receiving are important. She says that the "intensity" in her lower back, where earlier in the session she located her children parts, has wamed her it is not right for her to imagine herself in the future. She describes her "short-lived experience" of the future as giving her "a sense of persona1 integrity [and] .. . self-love" (31ofl). She pictures herself as a "dormant Rower": "1 do things that reinstate that feeling [of integrity 144 and self-love] but it still has to stay dormant [because] 1 can't leave the head process"

(3 lofl).

Drawing and Discussion.

We end the session with a drawing and a discussion. (See Figure 5.) Laura draws her

"healing image" from the session and describes it as looking like a potato with eyes. She says it is "this core of me. al1 that I am as present." Within the present she experiences

"sadness and fear with these different faces." She explains that she has drawn a similar image in the past that was floating without eyes. The eyes represent to her the unheard children inside her. She surrounds them with a "blanket of love" that is pink: "1 see it as being the blanket of love 1 really try to give the parts of me that have been created to Save my Iife and ailow me to survive" (32ofl). Surrounding the pink blanket is "the future. what

I see the most .. . a very pastel healing layer" (32ofl). She describes the centre of the potato as "hot" and the area outside of it as "much cooler" because "there is a blending in the purple of the passion and the anger in the red and the calm sense of blue and outside of it al1 is a very peaceful place which is a soa of bluey green colour which tends to be very healing." She envisions that the "area of fear and anger and feeling udoved .. . will be gradually eliminated. "

At this point, 1 mention the similarïty in the blue colour of the "kids" inside the potato and the outermost healing layer. She responds by saying that she did not intend this but "this is the key to this, big time!" This association leads her directly to analyze the deeper meaning of the session, which 1 encourage non-verbally. She draws associations with her current process in psychotherapy, saying that when she began the drawing she 145 thought she would need to "force out what they need to Say." but she discovered that there

was "a sense of stillness, a sense of knowing thac there is no need to fight, no need for

anybody hide to fight to be heard, they really trust that they are going to be heard. so they

have calrned down,"

1 realize during this process that the challenge 1 unknowingly gave her in asking her

to imagine herself in the future was ultimately a catalyst, helping her to recognize that her children were "scared" and that she could hear thern when they were clear about their needs. Their message has helped her understand that her process of integration does not

include a future at this tirne: "1can't think about the future because 1 have to take them dong every tirne and see how things begin to work" (35ofl).

She explains that in therapy she has been working on "slowing things down" because she has had difficulty in the past with "flooding." She recognizes the session is

"augmenting" her current psychotherapy and relates that she has not identified Sally with this incident previously, although she knew about Sally. "Now 1 know it's Sally, so 1 know

[it's] a matching up of the rnemories with the child who experienced thern and then they can tell their story of how they felt and express themselves and be validated, so it's been a different avenue of treatment than many multiples have had, but it's been the safest course for me" (37ofl).

Because she moved a lot during the session, and because she has a background with both touch and rnovement therapy, 1 ask her how this body-orïented session differs. She

States it is different because feeling hands on her body brought her to recail her past and caused her to "flip out." Describing her experience in the session, she says: "Keeping focused on the area [of my body] was very beneficial because whatever area came into 146 importance at the the, staying focused in that area helped me to stay with whatever was

happening." She experiences her "tendency to flip out" as her "natural body defense" and

believes that the verbal focusing prevented this avoidance from occurring.

She completes the interview by explaining why it was difficult for her to "stay

present" in her body. Apparently when her alters "felt they were experiencing things that

were just too much for them ... they just cut right off of the body." Laura believes Sally's

behaviour in staying present with her body experience was atypical. Laura says: "1 knew

inniitively this would be okay and be safe so 1 let Sally tell you what she needed to Say ...

They are individuals and not just little Lauras .. . but it was hard for her, and for me

through her, to stay present [in] .. . the body." Laura is surprised that she did not "take a flight. " -C.. - . 148 Summary

The experiences of the participants indicate that this body-focused therapeutic intervention

was effective in eliciting memories from a body-oriented perspective. The research findings

suggest that when a child sexual abuse survivor is facilitated to recali body-oriented

. memories, she will recall the experience of abuse or some unresolved, related issue. Each participant generated new experiences from her unique perspective and became quite involved in her process.

Flexibility on my part was required to foliow appropriately each participant's process. The experiential sessions revealed that while each woman's process was unique, comrnon themes emerged. In each case. the dialogue between body parts or areas led to the identification of body disruptions and psyche-soma linking wherein the body experience could becorne integrated with thoughts and feelings. Each participant's body-oriented process led to one or more contacts with a hurt psyche-soma child pan that represented a previously repressed subpersonality and provided new perspectives on key areas of the participant's life. The next chapter presents additional fidings from the follow-up interviews, including the participants' comments about their experience and the cornrnon themes that emerged. THOUGHTS, REFLECTIONS AND INSIGHTS RELA'M3D TO THE EXPERIENTIAL SESSION: RESEARCH FINDINGS

6.1. THE HEALING PROCESS

This section of the research findings discusses the self-generated body-focused emergent imagery process of each participant, drawing on both the experiential session and the content of two follow-up interviews. Results from the three interviews are presented together rather than in isolation for three principal reasons: (1) participants' descriptions and assessrnent of the experience were consistent among al1 of the interviews; (2) the format better reflected the continuous nature of the quaiities and types of processes involved in healing; and (3) the format supported the intention of this study which was to detail and describe the body mind processes that were generated by the experiential session, their relatedness within each participant's healing process, and the themes that were shared among them. The notation system will inform the reader which interview is the source of a given quotation.

Each section is a theme that represents a progression in the participants' healing process. Thus 1 begin by descnbing the individual sensory-perceptual modalities for entry to the body experience and the recalling of past trauma. Secondly, 1 describe the various body disruptions of the participants, including their perceptions and comments as they were offered to me. Thirdly, for the end or resolution stage, 1 describe how each prnicipant was able to contact a psyche-soma child part that led her toward integration. Fourthly, I include the "tools" and other "take-home" matenal that the parficipants outlined. 1 conclude with the participants' reflections on the approach taken in this research study. Because there is 150 variety in their backgrounds and in their session experiences, and because the follow-up interviews were unstnictured, participants responded selectively to the evaluation topics.

6.1.1. Individuai Modalities for Entrv to the Bodv Experience

An important fmding in this study was that each of the five participants made her initial enuy into her body-oriented memory through a specific sensory-perceptual modality reflecting her individual orientation. This choice led directly to her experience of sexual abuse or a closely related psychological issue. As each participant explored her memory further. she employed other sensory-percepnial modalities, in part because 1 encouraged comprehensive exploration.

In the following presentation of the results, 1 will show each participant's entry point to her memory through her body. In addition 1 will show how this memory led to a recalling of her expenence of sema1 abuse, or to the elaboration of an unresolved, related issue. Common themes will emerge, including the disruptive force of puberty for abuse survivors. Periods of major biological change, including birth. puberty, pregnancy, menopause, and biological ageing, can be sources of upheaval. Puberty, in particular, can open the floodgates of sexuality, threatening the bamers surrounding earlier suppressed sexuai mernories. At the same the, as this study demonstrates, feelings of exposure, shame, humiliation, and hatred of the body emerge.

Mary's memory began kinaesthetically. The entry point of her memory was a body sensation of her throat tightening or "clenching." Asked to locate this sensation in her past, she immediately "pictured" herself as a child of six or seven, "hiding and being afraid" in her bedroom (6ofl). She proceeded to develop this body memory from a predominantly 151 kinaesthetic perspective, describing " heaviness, " "choking, " and " immobilizing" (7- 10of 1).

Her memory evolved into a recollection of hiding in dread from her alcoholic father (13-

Sofl), and a recognition that her choking sensation represented her present fear of unearthing mernories of other abusers: "1 how of two incidents where 1 was sexually molested, and I'm afraid someone more important to me than those two people could have moiested me" (33ofl). The session continued as an exploration of this unresolved fear of knowing more about her child sexual abuse.

Gwen's memory is a combination of visual and kinaesthetic. She entered her memory through a visual image of herself at puberty, "like a stick figure" with "awkward" arms and legs that felt "too long" (3ofl) unable to cope with her body changes especially in relation to her developing sexuality. She pursued diis image in a more kinaesthetic manner, for example, feeling "heat" and unwelcome " sexual feelings and messages .. . in my genitals" (6ofl). She identified the sensation of sharne in the front part of her chesr: "It feels like just by looking at me, everyone can tell what is happening in my body" (6ofl).

Because Gwen lacked any concrete mernory of actual abuse, her memory of the profound sexual turbulence surrounding puberty forced her to explore body disruptions that probably occurred earlier and that remained incomprehensible to her. For example, she explored her fit awareness of "hating"her body, not wishing to have a body, and attempting to "sever" her head from it.

Wilio's memory was strongly kinaesthetic. She entered her body memory through sensations in her chest that led her to the joyfui memory of running as a teenager, "the expansion and compression of my chest when I'm running and breathing and feeling .. . my face and my hair" (5ofl). She said this rnemory stemmed from the years when she was a 152 member of a girls' broomball team, between the ages of eight and fifteen. She linked the end of this penod with the end of her years of sexual abuse by her father, who replaced her with a "new girlfiend" when Willo was fifteen. She had the insight that this event coincided with the abrupt end of her sports participation. her new "drug career," and her frst awareness of feeling "exposed" and hating her body (8ofl). This was the fint tirne

Willo made this association; in the past, memories of her years between fifteen and seventeen had "been piecemeal. "

Tmdi's memory was mainly visual. She entered her body memory through a vision of an X-ray of her hips, locating the image in the hospital during her fust operation at age eleven, with her brothers, the rest of her family, and the doctors looking at the X-ray. She felt "very transparent": "1 never see it alone. 1 always see it with a lot of people .. . 1 feel like they know, they can see through it" (8ofl). In the session Trudi continued to draw paraliels between her experience of sexual abuse and what she now regarded as abuse by the hospital. Trudi reached a new insight when she realized that her childhood perception of the hospitd as a safe haven was, in fact, illusory. There was an unmistakable relationship between the humiliation she spoke about in reference to the hospital and the unspoken content of her sexual abuse experiences. What spoke most strongly was her image of ultimately being "just a piece of rneat" (24of2). Trudi recognized that the shame and embarrassrnent she felt in the hospital was intense because she was entering puberty at the tirne. In association with the hospital memory, she recalled that she " hated" her body " from a very young age" (5Oofl).

Laura's memory was kinaesthetic. She entered her body mernory through a sensation of "weight" and "numbness" in her lower back that took her to a memory of being 153 picked up off the floor as a young child by someone with whom she was uncornfortable.

The hi1 memory that followed was a recalling of rape by this man, who was her uncle.

This reconstruction led to an insight about an alter named Saily whom Laura previously had

not "taken seriously." By recognizing Saily's sexual pleasure within the abuse by her uncle.

which Laura had until now denied. she was able ro merge the two child alters. In the

follow-up interviews Laura spoke about being "self-destructive" toward her body in the past

(18of2) and mentioned her new "desire to be comfortable with [her] body" (18ofl). A year

later she had learned how to touch herself in a "loving" way (2908).

6.1.2. The Head-Bodv Split and Betraval bv the Bodv

During the experiential session, al1 the participants identified either direct betrayal by their

body or fear that their body experience would reveal information they were not ready to

accept, which would amount to betrayal. In the past, they had responded, by creating

various body disruptions to cope with their profound distrust of their body and its

unacceptable feelings. In this study, the disruption took the form of some variety of "split"

between head and body. The reason for this split appears to be related to the survivors'

feelings of physical immobilization within the trauma experience, it is as though the trauma

event is still present in the body. Feeling such entrapment and immobilization is a hallmark

of trauma, related to the condition of total helplessness. Trauma survivors will present this

entrapment in what could be called a "lived metaphor" that expresses the physical intensity of wanting to take action to escape. Participants in this study employed such a lived

metaphor, often refemng to their legs' urge to run. The body could not leave the situation,

so the mind had to leave the body. The participants referred to this phenornenon when they 154 spoke about severing their head from their body or vice versa. In fact, a11 remaining parts of the self were compelled to desert the body, which stored the experience. While there were varying degrees of dissociation its essence involved the flight of the mind from the body, which remained physically present in its trapped state. The body retained its sensations and urges, but dissociated from cognitive or emotional understanding of their meaning. Later these sensations returned and the urges were acted upon mindlessly. It was remarkable that the participants' "head" articulated this split. With the integration of their body experience, the participants came to understand how and why the split was helpful in their past as they attempted to move beyond it in their healing. With therapeutic intervention the memory of the trauma experience can reintegrate the body and its accompanying terror, resulting in a recovery of the original pleasure inherent in physical activity .

Often a participant's attention was drawn to her throat area. a significant body part that needs to be recognized as the gateway between the head and the rest of the body. In order to incorporate the experience of the body in the process of psychotherapy, we need to be alea to words people choose to describe their experiences and be prepared to understand and pursue, in both literal and symbolic terms, the meanings and implications of these words .

During the experiential session, Mary described a "sense of cutting off" that she associated with "not being able to speak" (5ofl). She explained: "If I'm feeling something strongly and 1 don't want to, my physical reuction is to cut it off at my throat" (50fl). She

rernembered "hiding and being afraid" (60f 1) and reported it as l' immobilizing" (1Oofl) .

MW described a headache when the pressure in her throat area became too intense, saying: 155 "The pressure is giving me a headache ... from my elbows down 1 feel totally like they are on a different body" (120fl). Mary also reponed that she stopped breathing when she felt fearful (14ofl), anticipating that "someone more important" may have abused her. Mary was describing a way of coping with diffi~cultfeelings by creating changes in her body.

Looking back on her experiential session, Mary identified her coping strategy: "For me maybe it's the intellect that cuts off the emotion" (330f2).

Gwen experienced a similar split. but with an additional element: when she felt at a loss and the head-body separation was not sufficient to help her cope, she sensed an urge to physically nui to escape the impossible situation. During the experiential session, in the context of experiencing feelings of extreme humiliation and shame and wanting to cry,

Gwen had a distinct sensation and image of "severing my head from my body ... I can feel the pressure in my throat .. . . If I can cut my head from my body, if 1 can separate that, then it will go away " (7ofl). She explained that "it" meant "the confusion, the feeling dm, and the feeling ashamed will just a11 go away." She said that she no longer felt like crying because "then I don? feel my body at all, and that's just fine, it just feels like a source of pain" (7ofl). At this moment she experienced "agitation in my legs, like wanting to mn, like wanting to get away " (8ofl). Gwen stated that the time of her memory, when she was beginning puberty, was the period "when 1 cut off my body, when it started giving me so much trouble" (8ofl). Her drawing at the end of the session showed a stick figure with a "big head .. . because that was where 1 lived, 1 did a lot of .. . compulsive reading so that 1 could get away from what was going on in my ... body and my iife" (220fl). In the follow-up session Gwen said, "1knew about the split because 1 knew I had ignored it and my body for most of my life . .. 1 didn't know about the difference between the top half of 156 me and the bottom half of me" (lof2).

Willo explained that "being physical is very important to me. 1 NEED it. 1 need to

feel my body moving" (26ofl). She also needed to feel that it was strong: "that's aIways

been with me, that's part of my legs and my ms"(26ofl). She tafked about her desire to

"get away " : "1 feel 1 never have a chance to dream 'cause I've been so busy trying to GET

AWAY" (27ofl). Her memory of running joyfblly as a child, combined with these

statements, suggests that ninning is a lived metaphor for escape or "getting away." A week

later Willo articulated her lived metaphor and explained further: "I'm starting to understand

where a lot of this '1-can't-explain-why-1' m-doing-this ' behaviour is corning from. And the

running. That was rny role [in the family] .. . 1 was the ninner" (24-5of2). A year after the

session she had resumed several physical activities that gave her "enormous pleasure" (19-

210f3).

She acknowledged during the experiential session that she was "so good at putting stuff out of rny head or burying it away ... 1 wouldn't allow myself to think about it, so 1 wouldn't feel this way ... 1 do that a lot. I'm just professional at putting unpleasant things out of rny mind" (39-40ofl). When 1 asked her where she put these unpleasant things she replied, "my head" (40ofl). Willo understood that her ability to "bury things .. . is almost reflexive because I've been doing it my whole life ... like secrets ... that's served me well sometimes" (Uof 1). Evidently Willo knew how effective this coping strategy had been for her past survival, but she had been "trying to leam how NOT to do this" (41ofl). In the follow-up session, Willo said she "noticed how out of touch 1 can be with my body from

[the head] down." She was able to make "sense" of her crying episode in yoga class because she now understood that focusing on her body "was opening this pan of me up and 157 even though my brain didn't know what was going on. my body did. and so .. . things make

sense" (4ofL). One year later Willo was able to look at herself in retrospect and recognize

that before this therapeutic experience she was "walking around as a head with nothing

below my neck" (20f3).

Trudi found in the experiential session that it would be helpful for her to "remove"

her head because "sometimes when 1 get headaches 1 fiel like removing my head, setting it

aside" (70ofl). She said she felt "lighter" when her head was "removed. " In the follow-up

interview one year later, Trudi explained that she had been a "compulsive" runner and had

pursued this activity excessively until her body was in chronic pain. In the period between

the interviews, she consulted with an orthopaedic specialist who was coaching her with a modified, gentler exercise program. "The interesting thing was I needed someone to give me permission or to tell me to do it right. ... 1 tried going back to it [Le., running] again but the pain came back, so 1 stayed off it another week and 1 changed my habits. .. . 1 started talking about it to my therapist. ... why 1 was mnning. what 1 was running away from, and lit] probably had a lot to do with the abuse" (18of3). She continued: "1 started doing some different activities that 1 really enjoyed like cycling. It still hurts my back but it was much more a liberating feeling, and 1 started walking more .. . 1 becarne .. . more aware" (18-9of3). She found her new regime difficult because "anytime 1 feel any kind of emotion it's like 'gotta run"' (19of3). Trudi demonsrrates the polarities of the trap of abuse, embodied in her imrnobilization in leg braces or concrete, and the unlimited mobility and emotional freedom of running mindlessly. Through her increased body awareness,

Trudi gained insight into the way her mnning helped her escape her feelings. Unfortunately her body could no longer tolerate the degree of abuse to which she had been subjecting it 158 and she was therefore forced to look deeper into herself.

Although Tmdi's head-body split was not explored directly in the session or follow-

up interviews, she had a clearer understanding of it one year later. Discussing the use of

touch therapy she said: "1 think it's easy if you haven't been touched. for me anyway. to

crawl back up into my head, find some kind of coping mechanism" (390f3).

Laura's initial memory of being raped as a srnaIl child by her uncle included

feelings of numbness and absolute helplessness. She said: "As soon as he picked me up,

actually 1can't feel a lot .. . . it's like being at the dentist and they have frozen you but you

still know they are there and they are working but you can't actually feel anything while

they are doing it ... 1 can't do anything about it" (4-5ofl). Her description dernonstrates

how a split was created between her head and body: she remembered the unacceptable

- feelings and sensations in her body, saying she was "bad because 1 enjoy it. ... It feels like

in rny mind 1 didn't want it but rny body made me do it. I couldn't have helped it and I am

angry that my body doesn't listen to my mind because he will keep huaing me as long as I

seem to keep enjoying it" (10ofl). Laura offers a strong example of betrayal by her body

and the necessity of splitting her head and body to protect herself from becoming wholly

"bad." (Perhaps her memory of the helplessness contributed to the way she remembers "1

hate being srnall" (400) and consequently as an adult, instead of running, she chose to

protect herself with food.) In Laura's case the need for the "split" between head and body

was so extreme that it required the creation of multiple personalities. The experiential

session involved the merging of the two personalities that represented her head and body

split -- one who physically enjoyed the sexual abuse and one who rejected or denied the

pleasure. Laura's need not only to "split," but also to isolate the parts to the extent that 159 they were unaware of one another indicates the extreme unacceptability of Laura's bodily

pleasure because she could not reconcile it with her abuser's definition of her as "bad."

Without includhg her body experience in her healing process. Laura would not have had

the opportunity to merge this "personality part" who appreciated the body's pleasure with

the other child pans who were abused. 1 would suggest that this particular kind of end

result cm only occur within a therapeutic context in which the body experience is fully

explored.

6.1.3. Bodv Parts in Dialogue. Pmche-Soma Linkin~,Intenatinp the Hurt Child, and

For al1 the sîudy participants, integration was achieved when they contacted one core child

experience that provided a psyche-soma link joining the intellect and feelings to the body

experience of trauma. An aspect of the psyche-soma linking is a preliminary identification

of significant areas or kinaesthetic qualities of the body, usually Ieading to dialogue between

them. Specific parts of the body, such as the heart and the belly, are involved. The

integration of the child or psyche aspect unfolds within the process of psyche-soma linking.

(For further details of this process, please see Chapter 3.) The core child experience has a

special relation to the body that may or may not be shared by other "child parts."

Communication with the psyche-soma child part usually evolves into the discovery of a

healing image or symbol. In the case where this evolution is incomplete or the achievement

of a healing resolution is not yet possible, the healing process has progressed to a point . where the validity of the participant's defenses cm be acknowledged and it is clear that she has made the most meaningful choice possible for her 160 For Mary the rnost powefil aspect of the session was her ability to access her

"inner child" for the first thne. This awareness of her child part occurred afier she allowed herself to focus and stay present with the sensations in her body. She noticed a heaviness in her chest that felt Iike choking and identified it as a "Glob," that was "snick" in her throat.

Her experience moved into a dialogue between her throat and the obstruction she felt there

(the Glob). Her throat said it did not want the Glob to pass through and that it was "angry at something outside of me" (3 lofl). The Glob, which appeared to be a sarcastic griming cartoon character. would not interact in the dialogue with her throat. although in the process of witnessing the throat's comments, its sarcasm diminished and it stopped grinning. Mary was feamil that if the Glob were to speak, she would experience pain. When she followed this pain, she found a headache that tumed into a recognition of a "little kid inside of me"

(38ofl) and so was able to meet her fear that "it's going to be too painful" (38ofl) and progress beyond this defensive reaction. By contacting the related thoughts and feelings, she was also able to explore and then articulate the part of her that was fearlkl, the "hurt" child.

Mary's body served as a vehicle for shifts in awareness that led to the discovery and integration of separated parts of herself. Mary believed she shifted from an intellectual awareness of an inner child to a "physical experience" and a lasting, "very visual" memory of herself holding this linle child (4 1,46-7ofl).

In the follow-up interview one week later, Mary was able to describe her process of integration: "1 think fist I was feeling things physically, and it was hard for me to know what was behind that feeling. 1 remember feeling a sauggle trying to, when we were talking about the Glob in my throat. It was pretty easy to Say 1 felt something right here 161 [painting to her chest]. pushing down on me. It was more difficult to [feel] below that and where thar was coming frorn" (350f2). This integration came about because Mary was abIe to understand that when she cut off her body experience she cut off her emotions. and that al1 this was organized by her intellect. Initially, Mary found it difficult ro dialogue with the

Glob; however, this focusing on the physical feeling evenntally brought her to her emotions

"in a very smooth, non-intrusive way " (320fZ). She explained: " 1 was thinking of my bodily reaction, my physical reaction of cutting off my emotions, but maybe that's rny intellect telling me to cut it off, 1 don? know, there was more of a flow through my body 1 think, more of an openness to feel, 1 guess because 1 was focusing, 1 took the the to focus on what my body was feeling" (350f2).

One year later, Mary had internalized the dialogue process with her body: "1 believe that my body will let me know and I believe that's been significant in helping rny healing. because instead of .. . always thinking well who was it, who was it, 1 HAVE to find out,

I've just allowed whatever needs to happen to happen, instead of whatever 1 rhink should happen .. . 1 used to think there was a PATH of healing, like this is what you do and then you'll be better, and I've certainly changed that view" (2008).

During the experiential session, Mary made her way through many layers of resistance before reaching her healing image of integrating with her child part, which she finally identified as a "picture" of herself holding the little girl. Her resistance involved contacting 1) the "adult critic," who told her she did not "know enough" about taking care of a child, that the child was "needy," that she was guilty because she had not noticed the child before; and 2) the "inadequate adult" who felt vulnerable and incapable or not ready to take care of the child. Picturing herself in the future, Mary had a sense of her body feeling 162 Iight and energetic and breathing naturally. She felt as if her child part had joined with her

adult self: "like it's MY body, it's Like this BIG body, but it's like the little girl skipping"

(%of 1).

One week after the experiential session, she said: "1 think that picture of me holding

that little child, 1 think that would be the key symbol ... what the whole thing was about

was that little child and .. . the relationship between the liale child and the adult. 1 would

definitely see that as a symbol" (17of2).

Gwen contacted her twelve-year-old child part, who was troubled by her emerging

sexuality and unable to trust or enjoy her body. Within the session she recognized two

disparate parts of herself: a light "heart pan" in her chest area that feIt exhilaration and

warmth like the Sun and represented both the present and her "optimistic" hope for the

future, and a "heavy dark part" like a "cast iron pot" in her belly, protecting her genital

area, "the vulnerable parts, the parts that were hurt, l1 representing her past (16-8ofl). In

the midst of dialoguing her two body parts, she interrupted herself and said, "This is really

a Stream of consciousnessl' (18ofl). She recognized that her head was not directing the

successful dialogue between her two separated parts. This was exceptional for Gwen

because it was so unlike her usual intellectual mode of processing experience.

Gwen's symbol unfolded as she irnagined "the rays [of the light part] strearning down rny hands and my torso into my belly. .. . The image that 1 saw was the heavy dark part becoming thinner, like when a pot starts to rust and flake off, and eventually get holes

in it .. . getting thinner and lighter and [getting a] see-through lacy pattern" (19ofl). Gwen noticed the "dark part" no longer objected, and she believed this pan of her "knew" it was no longer functional or necessary. Gwen also noticed that she "can be centred without 163 being weighed down" by this dark part. The remaining fragment of the dark part told her that it "needs me to pay attention to it, to acknowledge its existence, and it needs to be reassured that it truly isn't ignored al1 the time" (200fl). Clearly this fragment represented the child part of Gwen that was expressing what she needed in order to heal. Shortly after understanding this Gwen said: "It doesn't seem like a head thing, more like a body comection of one pan of the body to the other part of the body" (21ofl). With rny encouragement to refocus on her body awareness, Gwen successfully made use of her body experience to create bridges between her intellect and emotions. In the interview one year later, Gwen reflected that the images she was able to discover through focusing on her body experience enabled her to move beyond a "conceptualized" understanding of her body

"split." She articulated embodiment of self through images that integrated her body and psyche.

For some people like Gwen, the lack of concrete. tangible mernories of child sexual abuse creates an obstacle to their integration because they have difficulty validating their intuitive knowledge. Although Gwen had no "concrete mernories of .. . darnage, " a week later she said that the knowledge of the separation she experienced between her heart and belly "validated for me the darnage that was done" (20f2). In this follow-up interview, she also discussed at length several possible sources for validation of her perception that she was abused induding: 1) her father's confirmation that before age five she was placed in the care of her grandfather who she believed abused her; 2) her gynaecological problems that were shared by her mother; 3) her continuing problems with sexual arousal even though she was in a stable relationship with a caring man; 4) her automatic tendency to be afraid of men; 5) her continuing tendency to employ words as a way of avoiding her physicality; 6) 164 her drearns of abuse by an old man; 7) her recurring visualization of a knife whenever she

tried to meditate; 8) her tendency to "want to run" when she was "upset"; 9) her "chronic

low-grade depression" that recentiy diminished (27.30.33-908). Gwen appeared to have

made some connections that contribute to the validation of a stronger likelihood of very

early and forgotten childhood trauma. 1 noticed that Gwen was now better able to see her

difficulties in perspective, to validate herself, and to find strength by believing in her own

reasoning .

In the context of discussing her upcoming hysterectomy, Gwen said her discovery of the image of blackness in her abdomen "made me wonder again about the long-term consequences of my abuse" (4ofL). Once again Gwen was finding validation for her difficulties. Gwen and 1 did not discuss directly the similarity between her image of her

"belly " as a " heavy . black, solid cast iron pot" (18ofl) and the large round benign tumour in her uterus.

Previously Gwen relied on her intellect almost excIusively for information and understanding. This reliance has made it frustrating for her to comprehend psyche-soma disturbances because she had never had "knowledge-type mernories." In the interview one year later, Gwen articulated a readiness to respond to messages from her body, "whether it's feeling sensations or having images corne up from nowhere," and she was now "paying attention to those images radier than ignoring them, knowing that there are other ways of knowing that are not cognitive" (17of3). When Gwen paid attention to these images and sensations, she felt "more present [but] it's still a struggle" (18of3).

WUo's chiid part was predorninant in her memory and in her integration process.

Her initial memory as a child running exuberantly was similar to her final healing image, 165 floating in the ocean. In the future she imagined herself "floating in the ocean .. . [in] absolute bliss .. . . It's very similar to running on the ice where you breathe deeply and your face feels the sensation of coolness and wind" (50-2ofl). She explained that the ocean and the ice rink both involve water and their effects on her body were "very sirni1a.r."

Willo was able to discover this conjunction because previously she had recognized a division in herself based on her identification of two contrasting feelings in her body: "One is I feeI Iike I'm trying to hold things in and I feel a rush of anger and what 1 want to do is tighten my body and tq to hold it [Le., the anger] in. and the other is fluid, it's almost like a dance, it's a natural rhythm for me, exercising, and needing to breathe, it's smooth where the other is clenching" (l60fl). Evidently she had a sense of the " fluid" part of her as essential ("a natural rhythm for me"), and appeared to know she needed to engage in the process of releasing or freeing this part. Her choice of words in descnbing the "fluid," dance-like part indicated its clear relation both to her freely ruming child part and to her future self floating in the ocean. She located the clenching and compression in her chest area "where 1 hold everything in" (30ofl), describing the pain in her chest as a flat, closed. dark area that she eventually saw as a "big, dark, scary door with teeth" (30ofl). She visualized herself standing on the threshold: "1 hold the doorknob and I can't go back, but I can't bring myself to go in. I open the door a linle bit and everything just cornes flooding out. 1 just tum into this mess, I can't function" (3 lofl). She explained the "mess" behind the door was threatening the person who was holding on, saying she had no choice and that she needed "to know that I can have some safe quality time off .. . and get a CHUNK of this pain out" (36ofl). Immediately making a natural association between the needy "mess" and her child part, she started to cry as she recalled her memory of running as a child and 166 feeling "great" in her body and self. She said the tears were sadness "because 1 was doing

something great for the littie kid and I'm not supposed to, 1 don? deserve" (37ofl).

One year later Willo realized "I've let my body have an opportunity to make itseif

known. and there's no going backwards. and that's the biggest impact [of the session].

when] 1 came to talk to you, the door was opened and 1 can't shut it ... and it's been

really Iike the metamorphosis has occurred" (90ç3). A week after the session Willo

understood how openhg the door and letting out the "mess"khild part has been Iike a

"birth." She said it " was very awakening .. . an explosion .. . like a birth" (470E). She

continued: "More than three quarters of me that 1 have been ignoring [is] mine again. . ..

That's what exploded [and] that's what is going to get me to the end. It's not just what 1

remember. It's not just what 1 talk about. It's how if 1 allow my body to help my mind.

... And the two together are going to heal much faster. .. . And then the spirirual side is

going to be able to have a chance. Because until 1 get the head and the body together. my

spirit which 1 remember talking to you about, how 1 felt Iike it was sort of in al1 these little

pockets al1 over me - where I put things and store things. And 1 think that when 1 make the

connection, the parts of my spirit, al1 these Little pockers where things have been stored are

going to come together" (48ofî). Willo spoke about spiriniality as the direction for her

heaiing. She said: "1 feel that that will be rny next phase, because 1 continue to deal with

my head and emotions and the body is now part of it as well, and to me the next stage is

my soul, my spirit" (120f3).

Willo associated her new ability to listen to her body with her previous'capacity to cope with her father's sexual abuse. and understood how this harrnful coping strategy had generalized to influence her life negatively. "My whole experience with my father has 167 always been about rny mind being able to convol what happened to my body, and [control] the mernories and the thoughts .. . 1 can never go back to that, and 1 donTtwant to, either"

(90f3).

Willo made a comection between her "explosion" or "birth" and the image that emerged when she drew her picnire at the end of the session. She said when she drew the picture she "really didn't think about what 1 was going to do .. . 1 just DID it" (470fL). She was particularly surprised at the way the colours were "graduated .. . like an explosion out"

(470fZ). She recalled explainhg to me that the picture was "ME, " and she reinforced that the "awakening .. . explosion . .. birth" depicted in her picture was a me capturing of what

"this has been like .. . this body experience" (470fL). Willo visibly enjoyed looking at the picture and remembering her experience.

Willo's favourite metaphor for the session was the "open eight" in her drawing. She explained: "My favourite number used to be eight, and in this drawing, coming out from the red were al1 these sort-of open-ended eights. .. . 1 definitely did it in a graded basis .. . and the opening is to me .. . real physical, because 1 think my mind has been opened"

(S30f2).

Trudi articulated clearly her ambivalence about her healing process. She said: "It is almost like 1 want to go there but 1 don't want to go there when I'm there" (30fZ). She admitted "there is a real resistance with me .. . not really wanting to do any work .. . letting the other person take it away" (400). She said part of her wanted her pain ro go away, but only if someone else would "take it away" for her. Although her ambivalence prevented her from reaching a full integration of her "hurt" child part, she was able to gain insights.

Most important, her "higher self" was clear about the need to write her story from the perspective of herself as a child.

Trudi's memory was of herself as a child looking at an X-ray of her pelvis in a hospital. Throughout the session she remained comected to this child part. For exarnple. when she looked at the drawing she made at the end of the session she said: "My eyes are drawn to this little character, it is very pathetic looking ... What is important for me ... [is that] some of the images that came up around some of the physical things that happened to me [Le., the operations] .. . made me start thinking about what happened at that time and how 1 dismissed it" (15of2).

Tmdi gained some insights into the parallels between the sexual and emotional abuse she expenenced in her home and what she recognized as abuse in the hospital environment.

"It was very humiliating in the hospital, it wasn't a positive experience to choose that over going home" (l50fZ). She said, for exarnple: "You are on this striker bed with this sheet over you .. . and the doctor cornes in and lifts it up, and you are just a piece of meat, that is al1 you are" (24of2).

One of the images that promoted her awareness of this parallel was of herself

"totally locked in concrete" (16ofl) while someone had "a hold" on her body at the same tirne that she had an urge to "strangle" her brothers. Her avoidance made it necessary for her to transition this kinaesthetic body memory to a picture of herself on the striker bed.

This " flipping" from the kinaesthetic quality of immobilization in concrete to the real mernories of feeling invisible and objectified in the hospital initiated a dialogue between differing body experiences. This dialogue suggested her profound ability to defend against the associated thoughts and feelings of her experiences of sexual abuse by her brothers.

Another image that developed near the end of the experiential session and evolved only to a 169 certain point was that of her head as an exploding watermelon run over by a "stearn roller"

(66-7of1). "It is easy if you just imagine pieces everywhere and you could just see al1 the content, just everywhere, see al1 the little parts of it" (69-70ofl). This image as a final symbol suggested an association between her inability to tell her story and her longing for a thorough exposing of her entire being. The arnount of violent external force necessary for the exposure of her "contents" was likely a representation of her extreme resistance and her expectation that she would need an external agent in order to open further. Her exposure evidently would result in annihilation; hence, the concrete.

Tmdi recognized the inhibiting degree of fear she had toward her family, but was able to contact a wise part of herself that would provide her with some positive, helpful suggestions, including writing her story from a child's perspective. She cornrnented: "1 could write about the experience of what it felt like to have them [Le.. the metal pins and rods] put in, what it feels like now .. . because I never really told my story to anybody" (65-

6ofl). This image of what she called her "higher self" provided Tmdi with one potential approach to integration.

Because Laura had experienced touch and body therapy extensively, she was receptive to focusing on her body experience. Within the session she readily identified several significant body areas and was able to sequence arnong them easily, moving from one to the other and dialoguing arnong them. Her memory began in her lower back and proceeded eventually to a dialogue between her lower back and a lump in her lower back that she called the "gatekeeper." She came to this central dialogue after a preliminary process of dialoguing among her back. chest, neck, and head. Following her body sensations thcough these various areas she was able to map her pain until she recognized 170 that when she had a " headache" the pain in her lower back disappeared and she felt safe.

Communication with one of her alters narned Sally became possible at this point because

Sally felt safe and noticed that her body "feels becter. feels no more bad . .. aches go"

(16ofl).

Her memory of herself as a young child being raped by her uncle led her toward

integration with this isolated psyche-soma child part named Sally, who enjoyed the pleasure

aspect of her sexual abuse. Through the process of this therapeutic dialogue Laura "brought

Sally [Le., alter] to a different level .. . . We had always been holding inside .. . the feelings

we had around feeling good .. . as far as anytiing pleasurable to do with the sex act. there

was something wrong with us .. . . It was good that the child part brought that out .. . and things happened quite profoundly because of that. in that Sally became an integrated part or a merged part with another three-year-old child and several other children have joined, they are merged now under a child named Enid" (40f3).

A year later she explained that her body memory helped her to contact the emotional and intellecnial parts surrounding her sexual abuse experience: "It's less of a reconstructing of the memory and more of a getting in touch with thoughts and feelings that were greatly attached, creating the dynamic inside" (4900). She said that in the past she would have

"dissociated" but in this session, she said, "we didn't dissociate, like you kept us present and 'sou1 light' [the name she gives her higher wisdom] was holding SaIly's hand, sort of in an interna1 way, so Sally knew she was being supported" (5308).

Laura's healing image was "this pi*, sort of like a warm ooze, kind of sliding through all the areas that were hurt before" (18ofl). The message from the pink ooze was:

"1 was created by you and my job is to love you and heal you .. . feeling a nice warm 171 feeling in the pelvis al1 that area that was tom before feels very warm and actually safe"

(19of1). Later, Lam drew the pink as a blanket sumounding her "children. " She

described the pink as "the blanket of love 1 really try to give the parts of me that have been

created to Save my life and allow me to survive" (32ofl). Surrounding the pink blanket is

"the future ... a very pastel healing layer." She used blue for the children. later realizing

that this colour corresponded to the blue "very peaceful place" on the outside which was

"very healing " and in the future (320fl).

6.1.4. New Self-Care StratePies and Tools

Without exception al1 of the participants found new self-care strategies and tools that

enhanced the quality of their day-to-day life. The shift in consciousness that resulted from

integration with their body experience affected many aspects of their life. Through this

greater understanding and awareness they were able to manage such events as flashbacks

and sexual relations.

Mary had learned that my technique of inviting the body to dialogue with other parts

of herself could be helpful when she was on her own, particularly when she was

expenencing flashbacks. In a sense the technique of dialoguing and staying present with her

body experience gave her a way of taking care of her scared little girl part and moving

beyond her fear. "1 think most of it was just realizing that 1 can be safe for myself and I can direct, because 1 remember you saying things like -- well ask your body what it's

feeling, or, if you're afraid. why are you afraid -- and I've done that since then. In non-

therapy situations I've had flashbacks and I've said to myself, well it's okay because this

isn't then, this is now and what can 1 learn from it .. . . So 1just use those techniques to calrn myself and Say well I'm not a child right now, I'm an adult, it's 1994. I'rn in my house, I'm in my bedroom, and then ask myself those questions, which is something that 1 would never have thought of douig before .. . 1 think the session prompted that. just because it was something 1 hadn't experienced. and then to have you suggesr that and then to use it later on has been helpful .. . and to realize that 1 can be in control of what is happening" f 8-

90f3).

What was important is that Mary leamed access to a method that allowed her to feel that she could be in control of her Me. Rather than experiencing external control (e-g., sexual abuse), Mary internalized the locus of control. We can regard this as the achievement of therapeutic goal.

Mary also learned that she could control what happened to her when she remembered past trauma. In the discussion one year later, Mary remarked that she realized she could now be "more in control of what is happening" when feelings or mernories came up (900) in part because she could ask herseif some of the types of questions 1 asked her during the experiential session. Apparently, inviting herself to dialogue with her experience gave

Mary the oppominity to explore her feelings rather than being stuck in the traumatic memory.

In the interview one week later, Mary reflected that during the experiential session she took "the time to focus on what my body was feeling." She continued: "In day-to-day life .. . 1 don? do it, 1 go through the day and do everything I'm supposed to do and then fa11 into bed at night and think oh my goodness my shoulders are so tight or whatever ..."

(33-35of2). 1 believe Mary, in this instance, was describing her process of becoming conscious of how to listen to her body. In the interview one year later, Mary codirmed 173 this new -ability. She said that as a result of the experiential session. she was more aware of her body in day-to-day living. "1 don? know why, specifically what triggered it, but I've been more aware of what is going on in my body, and 1 guess just questioning .. . consciously thinking about it [as in asking] am 1 feeling tired? or are my shoulders tensed right now? I'm not sure exactly why it came out of this session, but that's what I connecr it to. Again it could be the sarne things, just you asking me, well what is your body saying?"

(100i3).

In the interview one year later, it was evident that Mary had reached a place in her healing process where she intuitively trusted herseif. She realigned her expectations of herself based on the new awareness that her "body will let me know " (2Oof3).

Gwen felt her body informed her about her "need for protection" (5of2). In the first of two interviews, she explained that past attempts at healing meditations were not successful, her body would "react" with "terror" to the images of penetration by snakes that came up. She explained her head told her body to "relax, it's not happening now, breathe in, you'll be okay," but her body was "reacting to these images and it left me feeling out of control" (7of2). The experiential session provided her with a method of including her body experience in a safe way: "The experience here was like my body almost saying 'we don't want to go through that again, so this is what you need to protect yourself" (70f2). Gwen knew she felt safe in the session because, as she stated, when she does not feei safe

"nothing will happen because] I learned very early, obviously, how to protect myself .. . to deny or dissociate" (70fl).

One year later, Gwen's experience of dissociation became better defined and understood through her body knowledge. Gwen was more consciously using information 174 from her body to stay in the present and take care of herself in response to social situations.

Gwen said she knew when she dissociated because "it's a feeling that my body is wooden. it's wallcing and taiking and moving and I'rn sure I'm being appropriate ... but I'm not there

... I'm back here somewhere, and there's a heaviness to it, 1 guess that's the sensation. there is a .. . doom-like feeling" (19of3). "1 leamed to dissociate when 1 was very young and 1think it had to do with protection. ... I now know that 1 dissociate when 1 am feeling unsafe" (l90f3).

Gwen's had an increased awareness of her body. "1 don? focus on my body very often, even now, so that was instructive in itself. ... When 1 do relaxation at home 1 am always surprised at how tense 1 am because 1don? feel [that way] when 1 am ruming through my day. So that was important" (20tZ). Gwen admitted she was "more cornfortable with the imagery than ... with the body part because the imagery is in my head and it's still a problem to be in my body and in touch with it." Gwen's body awareness rerninded her that her healing was incomplete; however, this awareness was valuable in itself, "yet .. . it's hard for me to stay in my body" (30fZ).

Gwen found that her body was now able to help her expenence "feelings that are chronically there. " She continued: "1 think I mentioned .. . the feeling of sadness [during the session]. .. . Since then 1 think about that sadness and 1 focus on it and 1 can feel it. .. .

And 1 want to know why it's there and what 1 can do about it. That seems so counterproductive because 1 think that's the whole issue around rny body once again, some of this stuff just has to be, it's not controllable, and 1feel like 1 can control what 1do in my head so that's part of it as well, not knowing what 1 should do with this ùiformation"

(308). For Gwen it was easier to be in her head because her head could control her feelings and body. When she focused on her body. she felt sad and had difficulty

understanding her feelings.

Gwen explained that having no body was "a way of Iife" : "Numbness to me means

that there is some consciousness of the numbness. [In my experience] it's not numbness in

that sense, it's that the body isn't there, the body is not experîenced except as an entity that

carries the head around" (200fS). She continued: "Since my defense when 1 was a kid was

to be unconscious sornatically, it's a pattern, a way of life that's hard to work through, hard

to stop doing" (200f2). Gwen's consciousness shified dramatically from when she began

therapy: "When 1 came into therapy I had no body and I had no feelings, I only had rny

intellect" (80f2).

A year later, Gwen was better able to separate her past from her present and to

experience bodily pleasure. She repeated that the body-oriented session has helped her to

"separate . .. what belongs to the present and what belongs to the past. .. . . 1 am listening

much more to my body, and then being able to introspect about what this means and then

the up side of that is being much more present and much more able to take in bodily

pleasure, .. . not necessarily sexual" (160D).

Gwen was more cornfortable with her sexuality and less afraid of men. In the past, she explained she habitually associated sex with shame and pain, and "hated sema1 feelings, feeling my body again out of control and 1 couldn't do anything about that." She continued:

"Sex is always going to be a problem, not in the way that it was in the past because it's not like that any more, thank God, but it's still a problem .. . . The getting started .. . still seems to be associated with shame. Once that's past, then everything else is okay and 1 don't feel asharned any more afterwards, so actually it feels quite wonderful. When I'm having sex 1 176

feel like I'm in my body, whereas 1 didn't used to feel that. 1 used to feel Iike 1 was trying

my best to get out of my body as fast as possible. So that part has changed tremendously.

.. . . 1 think I'm more cornfortable with myself as a sexual being than 1 used to be and I'rn

not afraid of men to the extent that 1 used to be" (350f3).

Gwen also leanied to recognize the difference benveen physical and sexual touch and

articulated her need for non-sexual touch: "I'm really recognizing how much 1 need that and

recognizing there is a difference between physical and sexual touch, which is really good"

(90f3). Gwen was also "so much more comfonable around women .. . that's really a big

change for me" (1 lof3). However, she was aware that "men sexualize things, and so I'm

still very careful around men" (1 lof3).

In the follow-up interview to the experiential session Willo stated that she realized

that Listening to her body was "like a new tool. It's Like something that is going to help me,

and yet I OWN it too. It's like somebody can't take it from me . .. it's very liberating"

(5Sof2).

It surprised her to discover that "feeling stronger and ernpowered and more in touch

with [her] body" encouraged her to recognize the potential she gained to "get inside" and

"discover" the meaning of her bodily sensations. She called her new comection with her body "a powerfkl tool" (310fZ).

One year later, Willo was "a little concemed" that she might lose her newly found psyche-soma comection. She explained: "1 still separate, [my body] is distinct, it was a nothing and now it's an it, and one day it will be a we" (6ofi). She realized the importance of continuing to trust ber body experience as a major contributor to her healing process.

Willo believed this new comection was responsible for the changes that she was now 177 able to make. In the experiential session she articulated her goal of changing her "self-

destructive" activities. In the intervening year she found she had "altered a lot of things" in

her life that she did not anticipate being able co change. Her new sensitivity to smell gave

her messages about taking care of herself and lirniting harmful lifestyle choices. Lisrening

to her body and making healthy choices represented the achievement of an important

personal and therapeutic goal for Willo.

As well, Willo became more aware of her body in day-to-day life and was no Longer

able to ignore her body experience. "The most startling part for me .. . [is that] it sneaks up

on me ... the part of my body going ahah you don't think I'm here, let me show you

something . .. There won't be an event. there won't be a crisis, it'll be rny body going PAY

ATTENTION" (40f3).

In the same interview, Willo reflected on her dmg addictions, observing that in the

past she could be under the influence of dmgs but "never lost control of my body ... 1 was

always able to talk my body into behaving, 1 can't do that now, 1 have to listen to my body,

my body is [saying] , you can't eat that, you can't smoke that" (80fl).

Willo had also discovered that it was possible to take pleasure in her body and in sexual activity. One week after the session. Willo made a comection between allowing herself "to ENJOY the feelings of my body" and the "prornishg" possibility that she might enjoy sexual activity. "If 1 can allow myself lhis khd of pleasure why not other kinds of pleasure" (310f2). One year later, Willo said she was "allowing myself to feel pleasure in my body, like taking a compliment and not apologizing .. . or qualifying everything " (18-

90f3). She resumed a number of physical activities including cross-country skiing, dancing and other activities from her past "that gave me enormous pleasure" (19-21of3). She 178

remarked that this resurgence came about since the session and it's " al1 new since drawing

that picnire" (2lofi). She described dancing with her husband as "just wonderful. just

moving ... and L'm dancing with Andrew the way 1 would dance when I'rn by myself"

(21oD). Willo said that in the past there "was never any pleasure or any feeling" in sexual

activity for her. "Pleasure had nothing to do with it .. . it was always am done on me. or

me perfonning" (3200). In the interview one year later, she said she was now able to tel1

her partner when she was "uncornfortable." She felt that she used to be the one in control

during sex. "I'rn only beginning to learn not to have control and to trust a person enough

to allow that and to trust rnyself enough to allow that" (3300).

Willo had mentioned in the earlier follow-up interview that she had not "had sex straight in year and years Decause] the only way that 1 have been able to enjoy feeling and touching in the sexual context has been when I'm out of it." At the time of the one-week

interview, however, she was imagining that it would be "liberating" to be sober while having sex. She said: "1 still have a strong association with BAD and pleasure ... so 1 have to be out of it to enjoy it" (27ofZ). One year later she had continued to work with the experience of shame in her body and believed that she was "learning" not to "feel dirty if 1 touch myself in a way that is pleasurable. I still do feel that yilt. if it feels GOOD it's

BAD" (330f3).

Willo learned to Pace herself and have faith in herself and her healing process, stating that she "had the door shut for so long and now 1 feel like I'm SHINING, like 1 really do feel .. . like 1 know I need to corne more to a centre and a balance, and 1 will, 1 can't push it and rush it" (130fJ). Later in the interview she continued: "1 cry .. . but it's al1 worth it, there have been so many times I've wanted to wak away from it ... just 179 because it's too overwhelming or it's too scary or 1 donTtknow if 1 can handle this or I'rn

alienating myself from people, and 1 have for short periods. But if 1 get through it, if 1 can

walk through it, I'm alwuys better for it .. . . It's [faith] and faith is something 1 realize now

1 never had .. . not in myself and .. . not really in anybody" (15of3).

Willo was clearer about the direction of her healing process. The "metamorphosis"

she experienced in the experiential session one year earlier encouraged her to "stay open

and not close the door." She said: "1 can be scared or 1can go and bawl my head off and that's okay, but 1 know the direction I'm heading in" (90B). Looking at her drawing of this "birth" Willo said: "This body experience .. . is what's going to get me to the end. It's not just what I remernber. it's not just what I taik about. It's how if 1 allow my body to help my mind. And as 1 become physical and get in touch with my body, it's going to bring other things to my mind. .. . And the two together are going to HEAL that much faster. .. . And then the spiritual side is going to have a chance. .. . This is what I feel has been so important, is that my whole body has been given back to me" (48of2).

Willo gained insight and confidence in her ability to raise children, stating that initially she sought psychotherapy because she wanted to heIp them. She said: "1 knew 1 had to do something about the thoughts and the fears because 1 didn't want to transfer this to my daughter" (24oû). She stated: "Knowledge is so powerful .. . and my understanding

.. . will directly hit my children, and their children's children, without my even saying anything about [the abuse]" (llof3). She continued: "1 think that as 1 get better, they get better and it is a domino kind of thing" (120f3).

Trudi realized the experiential session helped her to notice how much she resisted letting her feelings surface. She reported that she thought about the session when she was 180 at home and recognized to what extent she was able to diminish and rationalize her feelings.

As a result of the session, Trudi was more aware of "sad" feelings when they came up for her, but she said, "it is easy for me to just put it away and focus on someone else. " She rationalized this because "1 wouIdnYthave my job if 1 couldn't do that" (5-6of2).

Tmdi was interested in bowing more about her physical ailments because she had a clearer understanding of their multidimensional nature. One week after the experiential session, she went to the hospital to retrieve some of her medical records "because no one really told me what was going on, they just operated" (2108). As a result of the session, she felt "really drawn" «, geaing her hospital records, but in the same breath said she had not been sure what that would -accomplish. Apparently she also obtained her psychiatric records from the past.

In the one-year interview Trudi told me she showed the X-rays to her psychotherapist, as well as "some friends. " She comrnented on the "strange" quality of this experience, feeling "exposed" but realizing that "other people don? see it that way " (608).

We can interpret this activity as demonstrating a new ability to be more in control of her X- ray image, and metaphorically, of her body. In addition Trudi felt confident enough to

"expose" henelf to trusted others.

She aIso found a new family doctor who was trying to help her explore the cause of her joint problems and their possible relationship to trauma. The doctor told her other kinds of trauma may have caused her physical probiems, but not sexual abuse. Trudi reported that she ended the discussion after she answered "Yes" to his question about whether she had been abused because she "felt realIy embarrassed" (80f3). She was pointedly asking for validation from an outside "authority" while at the same time resisting the potential evidence 181

of her body. On the other hand, some degree of progress was demonstrated by her ability

to explore her physical ailrnents in relation to other dimensions, although she was unlikely

to fmd the "scientific proof" she sought.

In the one-year interview, Trudi explained that she was more aware of her body: "1

am more aware of my body, at least more aware of when it hurts, ... I couId easily just

keep on going [Le., runniRgJ with the pain and ignoring it, and now 1 think I'm much more

sensitive to the pain" (17of3). Her increased body awareness gave her a sense of "getting

[her] power back" (36of3).

Laura leamed that she can stay present in her body without a therapist'ô touch to

focus her. Previously, touch therapy was the only body-fccused therapy she had

experienced, and she appreciated my ability to keep the focus on areas of pain and

discomfort without touching her body. "It was done very gently and without touch, that

was significant for me because 1 realized 1 could stay focused without somebody's physical

connection" (40f2). Thus Laura was aware that focusing on her body in this marner

allowed her to stay in the present and prevented her from dissociating. At die same the

she gained a new tool and accomplished a centrai therapeutic goal because she was able to

make a choice: she could choose to use this way of relating to herself and could integrate

her body experience independently, without an outsider's touch.

Laura was enabled to understand that she now had the tools to help herself without

the assistance of a touch therapist. Her self-maintenance ability could be interpreted as an additional advantage to the use of an alternative to touch therapy as a method of

incorporating the body experience in the process of psychotherapy. Laura's experience underlines the importance of offering clients a variety of options. 182 During the next year, Laura was able to use this body-focused method as a tool for

her own healing. She stated in the final interview: "The information that came forward

during that session was really important. It gave us a way of getting to things on Our own

without somebody facilitating. ... It gave us a sort of a language to talk to the area, and I've

used it in a lot in different ways" (20f3). Evidently Laura has adopted rny method,

cornmunicating with her body by focusing on it and dialoguing. She stated: "It [i.e., my

method] certainly got it far enough dong that we could quite comfonably complete it on Our

own, and thar's the difference between this kind of body-oriented psychotherapy and the

kind of bodywork we've done [previously] " (5 1oD).

Laura leamed to look deeper into parts of herself. Before the session she was aware

of Sally. A year later, Laura explained that at the tirne of the session, she experienced and

judged Sally as a frivolous part of herself. Laura stated: "Sally had always prior to that

presented as sornewhat superficial or cute. reminds me of a butterfly child. ... We never

really thought of Sally as expenencing much or having a Lot of deep feelings about some of

the things that happened .. . so when we accessed her going into this deep space, it let us see

that you need to look for much deeper aspects to many of Our parts, it gave us a different

view of her" (12of3).

Laura experienced a changed body awareness. Parts of herself were triggered to

speak up about their criticisms or negative feelings toward her body resulting from the sexual abuse. Laura was more aware of the "container" of other parts that needed to speak to their healing at a deeper level. She stated: "There was a real awareness that there was quite a container of other parts and that actually she [Sally], Our session with you really tiggered forth a lot of other parts that had things to Say, so it wasn't a bad triggering, but 183 what it did do was open a lot and make space for healing at a much deeper level" @OB).

"It allowed the children, some of the other children inside, to speak up about how they felt about their bodies or how they felt about a lot of things, and it opened up to a deeper layer of individuals who felt really badly about their body, who were made to feel badly during the abuse, not for enjoying and not for being pleasure or pleasurable but .. . lacking in a lot of ways, or a lot of messages came forward that we're still working on" (608). Laura expressed concern that she avoid abusing power within the hierarchy she experiences within herself. She tallced about the parts or personalities within herself as residing in a type of

"invented democracy." She described having "an aerial view" that "doesn't feel like it's an individual, it feels like it's a higher wisdom" (470f3). This new body awareness created a changed relationship with Laura's self and her body. She stated that her ability to love and care for her body increased as a result of the session. In the past year, she said, "we've been a Memore loving without pain than we had been, I guess knowing or having an awareness, we never thought about where Our parts of Our body, our children parts, were in

Our body, but in accessing that area and knowing they were contained there, and there's some contained parts here [points to shoulder], so now what we do is we touch, we touch

[shows me how] the body with a Iittle more love, like when it hurts a lot" (29of3).

Laura developed a new relationship to the pain she felt in her body. During the one- year follow-up interview, she stated: "The pain is not my enemy any more ... my body is not forsaking me, in that respect. I don? know how much that has to do with this, or just a new realization that we have to Pace ourselves, nurture ourselves, and part of that nurturing is the acceptance that the pain we're experiencing is messages that we're receiving, and that

Our body is the holder of messages, the station, and we can tune in when we need to.. ." 184 (590f3). and " .. . we listen differently to our body, if we' re tired we rest. we didn' t always

do that.. ." (63of3). She qualified these statements, however, when she stated that there

were still times when she dissociated from the pain. She felt this was a healthy dissociation

because if she picked up on everything that triggered her she would be in "massively bad

shape" (64uf3) -- "so we have to pick and choose what, and if it's something that's really

significant we'll get re-triggered until it cornes to the surface" (64of3).

"Body feelings were classed as bad right off the bat .. . if we ever displayed any

enjoyment in any way, and this came through a number of different ages of children, with

different abusers, then we were really made to feel like we were bad somehow" (330f3).

6.2. PARTICIPANTS' EVALUATIONS

Frorn the comments of the participants, the most effective qualities of my approach emerge.

In the two follow-up interviews, the participants self-selected aspects of their experience

with me that proved beneficial for them. providing reasons whenever possible. These

features are as follows: 1) A process not dominated by the intellect facilitates integration; 2)

The session facilitates rnemory recall and retrieval of images that would not have happened

othenvise; 3) A flexible physical environment provides opportunities to explore body

processes; 4) A therapeutic relationship of trust, safety, and gentleness and the

intemalization of the therapist's trust in the process is helpful; 5) A self-directed Pace allows

full processing of the material as it emerges and avoids "flooding" and dissociation; 6) The

use of a body-focused approach without physical touch by the therapist facilitates

integration; 7) Drawing a picture at the end of the experiential session contributes an additional element to the healing process. 185 The participants compared and contrasted my approach with two other qpes of therapy. From their descriptions we can construct general terminology to demonstrate meaning in their own words. We can apply "taik therapy" to any purely verbal approach and "hands-on" or "touch therapy" to an approach that involves the use of physical touch by the therapist as the primary intervention. The participants' discussion underlines the usefulness of my choice of terms in the phrases " self-generated" and " body-focused, " as well as "emergent irnagery," to describe the approach ernployed in this snidy.

6.2.1. A Process Not Dominated bv the Intellect Faciiitates Inteeration

Mary reported: "My thought process was not directing my body movement. it was avare of my body movement, and it was like this little commentary on it, but 1 didn't think first and then react. I reacted or remembered and then 1 thought about what was happening and that's a big difference with the verbal therapy, 1 was more thinking, thinking first and then well there was no body movement" (530f3). She also said: "1 would Say the session here was the most complete of al1 the things that I've tried before" (5400). She explained: "1 would see them [verbal therapists] as more intrusive even, somehow, 1 don? know why, and that might just be a persona1 [thing]. The similanty between [hands-on] therapy and the work that you did was that it was NOT an intellectual experience, whereas 1 found the verbal work very much an intellectual experience and my responses and reactions were very much on an intellectual basis, so as far as getting at that imer child and that experience that

1 went through, 1 found that there was a big barrier with the verbal work because it didn't get past my head, like it didn't get to my body at all, and the sirnilarity between the [hands- on] and what you did was that they both dealt with my body. Now the bands-on therapy] deals less with the mind 1 guess" (50of3).

Gwen said she was "surpnsed" at how much the images she discovered have helped her move beyond the "conceptualized" understanding she previously had of her body "split"

(lof3). During the session, in the midst of a dialogue between two areas of her body,

Gwen said, "Ifs Iike they speak different Ianguages " (Bof1). She recognized this dialogue as "really a Stream of consciousness" rather than an intellectual exchange (18ofl).

Reflecting on her process during this dialogue Gwen said later: "It doesn't seem like a head thing, more a body comection of one part of the body to the other part of the body"

(210fl). Previously she relied on her intellect almost exclusively for information and understanding. This reliance has made it frustrating for her to comprehend her psyche-soma disturbances because she never had "knowledge-type mernories" (17of3). In the interview one year later, Gwen articulated a readiness to respond to messages from her body,

"whether it's feeling sensations or having images corne up from nowhere," and was now

"paying attention to those images rather than ignoring them, knowing that there are other ways of knowing that are not cognitive" (liof3). When Gwen paid attention to these images and sensations, she felt "more present [but] it's still a struggle" (18ofl).

Wiiio reflected that although she can "conjure up in my head" a certain arnount of material, she found that by following my suggestions to focus on her body experience she was able to "remember thgs that I couldn't remember just by my head alone" (40f2). She also said: "It makes sense that there should be a body component because 1 have in many ways separated my body, and especially the mernories that occurred in my body when 1 was younger and 1 actually carry that [separation] from the head down" (30f2). She concluded that "this is a method to explore that" (3of2) and elaborated: "This [pointing to her body] 187 was peneuated, not just my mind, and not just my person, but my body was too" (4of2).

Willo believed that her "mind has been opened" by the session because she was

"getting a linle frustrated with [talk] therapy ... going around and around the same sniff"

(5308). She says: "1 seern STUCK and 1 haven't been able to get anywhere past it. ... I don? really want to go back and remember intirnate details of what happened and where 1 was touched. ... This is a completely different approach. By using my body, my mind is actually cut off, which is great because it's certainly long overdue. 1 think I've been using my head far too much -- and it's not always a good thing. ... Mymind] is not gone completely, but it's not the one who is directing ... it's taking its cues from rny body"

(Mof2).

Trudi found that focusing on the experience of her body allowed her to "go back and experience [the abuse] on some level .. . you know three years of talking .. . 1 just find the experience that 1 had through my body incredible ... if 1 go with what the body is giving me then 1 don't go in my head as much, where at times 1 fuid with my therapist talking,

[I'm] talking about what I really don't want to be tamg about" (30-lof2).

6.2.2. The Session Facilitates Memory Recall and Retrieval of Imams that Wouid Not Have Ha~uenedOtherwise

Mary commented that her memory retrieval was a physical re-experiencing of herself as a child: "1picture myself as a linle child .. . crouched down and covenng my head and rhar was like I was there, it wasn't like a memory. 1 think the difference probably is the clarity of it. When I remember things, like if 1 remember when 1 was a kid or whatever, a lot of it's fuzzy. 1 may remember things like 1 was playing on a swing and 1 was wearing a dress L88 or something, but especially the part that 1 remember where 1 was picturing myself as a

Little child crouched down ... if you had asked me, like 1 saw the details, I saw it was three-

dimensional ... it was like I was in that situation experiencing it, even probably some of the

other stuff that was more vague. like 1 remember feeling the weight on my chest, and my

throat tightening, and al1 of that was more like 1 was physically experiencing it. 1 would

Say for mosr as far as 1 can remember, the things that went on in the session were more,

more real than what 1 think of as a memory" (3600).

She added: "That's the difference between the bodywork that I've done and the

traditionai therapy sitting, 'cause when 1 was thinking back with my mind [about] what it

was like, and [this] was experiencing what it was actually like to me" (390fi).

Gwen said she was "surprised" she discovered the images and how much they have

helped her to move beyond the "conceptualized" understanding she had previously of her

body "split" (loO). She explained the image of the black pot in her pelvic area: "The

blackness and the heaviness of cast iron which I suppose could represent safety but it also

seems very cold, hard, maybe a lot of protection -- thor was something that surprised me"

(ion). This image gave her for the first tirne, a sense of her extraordinary need for

protection in what she identified during the session as her genital area. Gwen said she felt

safe in the session "or none of that would have corne up" (7of2), and believed that the

imagery she developed assisted her greatly in connecting with ber body in a non-threatening

way .

WiUo said that she "expected to go over things that I already had gone through in my verbal therapy. 1 think that was the biggest surprise". (20tZ). She described her body as a " key " to remernbering an experience that she would not have recalled othenvise. "And as 189 well, locating the spot in me where 1 keep a lot of things and how it feels to let go of it .. . I havent corne anywhere with that in terrns of my regular therapy ... that was so wonderfuI"

(20fZ). A year later Willo realized the session was "pivotal" for her development (13ofi).

Trudi said the experiential session "was a whole new experience for me" (40f2).

She recognized that her discovery of the X-ray image and its connection to the abuse would not have occurred without her focus on her body experience. "1 couldn't go in and see my psychotherapist .. . 1 don't think 1 would have those images corne up .. . 1 don't think I would spontaneously just start talking about that" (30of2).

In the follow-up interviews, Laura said the experiential session was significant for her and "different from anything [she] had experienced as far as body-oriented psychotherapy goes" (lof3). At least two aspects of Laura's experience were new for her:

1) Her memory retrieval involved what she called "completion" (5 1of3), and 2) She did not dissociate during her body-oriented experience. Laura was quite insistent that the part of herself named Sally who came fonvard in the session was not experiencing a memory retrieval: in her interpretation, if the experience were only a relived memory, there would be no resolution. She States: "Your having us stay with the experience was asking us to stay with the feeling and Sally's thoughts about how she was feeling .. . this kept us focused

.. . and didn't allow us to leave it before it came to some sort of a sense of completion"

(5 1of3).

Laura explained how important it was du~gthe session to have her higher wisdom part present. She told me that in the past she would dissociate, but in this session, she said,

"we didn't dissociate, like you kept us present and 'sou1 light' was holding Sally's hand sort of in an intenial way so Sally knew she was being supported" (530f3). This support was essential for her merging or integration.

6.2.3. A Flexible Phvsical Environment Provides O~portunitiesto Explore Bodv Processes

Mary believed this fom of psychotherapeutic process allowed her opportunities to "let my barriers down" when these have been impenetrable in other rypes of therapy. One aspect that promoted this freedom to explore was che chance to lie down on the floor and close her eyes. As a result she did not talk about her expenence, but was instead involved in

"experiencing." She felt that because she was on the fioor and was free to assume body positions she remembered from her childhood, she was better able to "refeel" and visualize.

She cornmented: "It was really rd,it wasn't just theory, it's fine to talk about something, but if you don't acnially erperience it. .. . Floor work .. . gives you more expression, to be able to use your whole body. It wasn't so safe as sitting in a chair, that was okay . when you're sitting in a chair you're holding yourself in a certain way, and 1 don? think your body cm possibly experience or remember in the same way, because you're stuck in one position, whereas on the fioor 1 was able to work through a lot of stuff by rnoving. 1 mean from moving fiom my back ... to being hunched over on my stomach, that was a real physical acknowledgement of what 1 was visualking inside, and refeeling that, feeling that over again, and then again turning on rny side, 1 just think there's a Lot more room for expression, for 1 don? know, just feeling what is going on .. ." (4of2). At the one-year interview, Mary said: "My healing has really been nine-tenths through my body responses and not through my memory .. . the work I did in therapy where the therapist was asking me questions .. . was more intellectual really and 1 wasn't getting anywhere . .. what 1 remember 191 I already remember and you know for me sitting there thinking what else or what about this, it's just like futile" (1300). For Mary. the formality and physical restriction of the tak therapy session became Iimiting. Mary was the only participant who emphasized the importance of moving freely . Whiie other participants also took advantage of this opportunity they did not comment on it.

In a sirnilar way Willo reflected one year later: "1 have just been at therapy and ifs in an office or clinical setting. 1 probably said more to you then 1 would Say in 1 don't know how many sessions in therapy" (3508).

6.2.4. A Thera~euticRelationshi~ of Trust, Safetv, and Gentieness and the Internalization of the Thera~ist'sTrust in the Process 1s Heï~ful

Mary said she "felt at ease very quickly" in the experiential session and believed this helped her to be "open to acknowledging what was happening." She believed that my questions and comments helped her "go further in the experience. That was important. and helped me to trust that whatever 1 was experiencing would be accepted" (27of2).

Mary felt that my trust in the process, allowing the session "to go where it needed to go," enabled her to let her barriers down. She explained: "1 really felt like you were confident, and you were kind of Ieading it but letting it go where it needed to go, and lookuig back 1 think that was really significant in allowing me to let my barriers down"

(30fl).

For Gwen, feeling safe was essential for the emergence of new matenal. She did not feel that there was more 1 could have done to assist her. She commented that 1 "have a very nice voice" that helped her to focus "on what was happening" (8of2). Gwen found the follow-up interviews "really helphl, because in having to uy to explain" her body expenences that occurred during the session, she was able to "understand them better"

(320f2).

In regard to safety , Willo said she felt "absolutely" safe: "1 didn't feel in any way pushed or intimidated to respond or to feel anything, not at all, 1 felt extremely cornfortable.

You have a very gende manner and voice" (62of2).

For Trudi, despite her difficulties surrounding her fear of exposure and her defense of "numbing out" her feelings and body sensations, the session " was a fine experience, 1 didn't feel threatened, 1didn't go away feeling exposed" (4of2).

Laura cornmented: "1 think what was so significant in this [session] was [that] it was done very gently " (3of2). "1 think the session with you was part of what was play ing towards gening or coming about to a sense of self-love in a different way. We've often thought we would have liked to have expenenced this kind of psychotherapy because it was very gently done, and there was a real sense of freeing up that happened as a result of it.

Whether it was a sense of there being an okayness around the feelings that Sally had or whether it was giving us a different aspect of how to look afier ourselves, 1 don? know exactly , but 1 do know it was significant .. . " (320fi).

Laura was surprised that this work went so deep for her and that so much occurred without touch. She comrnented: "1 think 'sou1 light' probably guided what happened, and letting you know that we were multiple at the onset allowed for the freedom of the child to corne fonvard, you were totally non-judgmental and there was no shock visible to us, your sensitivity was incredible .. . it was the acceptance that created space for what happened to happen" (56of3). 6.2.5. A Self-Directed Pace Allows Full roc es sin^ of the Material as It Emer~esand Avoids "Floodinp" and Dissociation

Mary said: "1 felt like you were allowing me to have happen whatever happened ...

Sometimes I feel guided by people. like they're expecting a certain answer. I didn't feel

that, I didn't feel like you were expecting it to go a certain way. 1 felt like you really were

... more following my lead, 1 really felt that" (27ofZ). She stated that the session "felt right and it felt like 1 worked through what was meant to be worked through during that the"

(530f2).

Mary thought that the lack of a pre-set agenda was one of the factors that helped her contact her inner child during the experiential session. She also said that the time factor was important for her, reporting that in a one-hour touch therapy session. her body may

"not be ready to corne back to the surface" (56of3). Nor being limited to the "therapy hour" also helped Mary to feel safe, knowing she would not be stopped if she opened herself to some deeper aspect that might take a long time to explore. Our session had no tirne limit although al1 of the sessions Iasted between one and two hours.

WiUo said: "1never felt that you pushed me in terms of the door, opening the door

.. . and that's something that 1 did . .. and what I felt that you did more for me was -- it was like you held my hand" (200fï).

Laura said that she felt she had reached "saturation" with touch therapy because of the "flooding" of emotions she experienced. She stated in the interview one week later: "1 liked the fact that without touching my body at all, you kept focus on the areas of pain and discornfort .. . you kept my focus on the areas in my body wherever there was pain and sensation and kept me focused" (2of2). Clearly Laura was empowered because she was 194 able to keep her focus in a place of her choice and not according to some agenda on my

part. based on words or the placement of my hands on her body.

6.2.6. The Use of a Body-Focused Avaroach Without Phvsical Touch bv the Therapist Facilitates Intemation

Around the time Mary became invoked in this research. she also becarne involved in a

fonn of touch therapy. She described a sense of stmggle between the sessions with her talk

therapist and those with her body therapist, where one thing happened here and another

there and the two felt "disjointed." in Mary's words. " it's hard to integrate the two when

they are not being integrated at the same moment" (53of2). When asked if the session with

me felt this way, she said no. Mary explained: "1 felt it came together there, and I think

that's why it was so intense and it was almost invigoraling, even though it was draining, but

1 felt really good wlîen 1 left here . .. 1 think it felt right and it felt like 1 worked through

what was meant to be worked through during the tirne, 1 didn't feel like 1 had been pushed

too far or anything like that, 1 was kind of tired, but 1 felt really 'up' about the session, and

saw it as a really positive thing. But maybe that's why, because 1 was feeling the

integration of the two [body and intellect] " (530f2).

Mary said she "had more control with no touch." She suggested that my role of

"facilitation" involves less "intrusion" than touch: "like you were there and yet you weren't part of the experience, so you were an outside influence in the session, but you weren't a

part of the actual experience that !was going through, and 1 think maybe that's the

difference with [touch therapy] , because the therapist is a part of the experience" (480D).

She also said: "Placing the hands on me makes my body move and then my body 195 gives me the memories. Here it was through your voice that you brought those same

memories in rny body, and then in the verbal therapy situation I didn' t get any of those

memories in rny body " (5 1of3). Leaving 1 felt a sense, I don? know . 1 guess 1 felt a sense

of 1 experienced it, and 1 felt some of ihat in the [touch therapy] but 1 certainiy haven't felt

the sarne to the saine extent" (540f3).

Mary also commented that in touch therapy "you have control over saying yes or no

to what they do, but you don? know especially where they're going to touch you next. .. . 1

think you're more vulnerable in that situation, it's harder to build up that trust" (4708).

She made another interesting comment regarding how she felt about the difference

between touch body-oriented psychotherapy and verbal body-oriented psychotherapy. She

explained: "1 think things go a lot faster for me in [touch therapy] and sometirnes it's just

too fast, like I've gone on to the next thing, whereas here you were constantly asking, what

is your body saying now or what is it doing now or what do you think that means. and so 1

was processing it as 1 was going, and I think a lot of times in [touch therapy] 1 process it

after 1 corne out, like rny body goes through a lot and then 1 have to sit there and go WOW

and I usually write things down, like whatever 1 was feeling or that kind of thing, but often

it goes a lot faster than what happened here. even though this went deeper" (550B). Mary articulated an important distinction between a fom of touch therapy and the body-focused technique she experienced with me: with her hands-on therapy, she went faster or perhaps covered more material because of the directive external infiuence of someone's hands, but she still needed to integrate her body experience later rather than during the session, as she did wiîh me. 1 believe that when she described Our session as going "deeper," she was referring to the full integration of her body experience at the time it was happening. 196

Mary's experience also confirmed that with touch therapy she was less clear about

what happened after a session was over. Refemng to the experiential session with me she stated: "Coming out of it, 1km what 1 had experienced ... 1 donPtthink 1 went home in a

fog and ofien 1 go home in a fog from [touch therapy]" (56of3).

She also added that it would take longer for her to develop uust with someone who was touching her because of her experiences of sexual abuse. In the session with me, she thought that trust happened more quickly because I did not touch her. (58of3) She stated:

"When that's what your abuse was, then that's a significant factor" (58of3).

In regard to touch, Tmdi stated: "My boundaries were crossed very early in life, and I've just never been very cornfortable with [touch]" (33ufl). She explained that compared to other forms of therapy, touch therapy and having her "feelings corne up through touch is more powerful or more overwhelming for me" (3508). Touch has connected her more strongly to her feelings and at times this has been powerful, yet it can also be overwhelming. Trudi associated touch with her "contarninating" of others and the surrounding "environment" (330f3).

Trudi reflected that hitting is "the only kind of touch 1 remember from my mom .. . she could do loving acts but she could never touch, ever, other than to hit you" (3708). In reference to our session, she said it was "good" that 1 did not touch her because she "didn't really know" me. This was Trudi's first experience of focusing on her body without a therapist touching her. She commented: "1 think it's easy if you haven't been touched, for me anyway, to crawl back up into my head, find some kind of coping mechanism, but I think once I'm touched it becomes unbearabie, ... Iike it's [Le., her abuse has] become confirmed" (390f3). 197 At the the of the experiential session, Laura was interested in "a compleie break from bodywork ... ro see if there are other avenues of keeping focused on the body withour touch" (8of2). She found touch therapy useful because she said she "needed to rernember or be given the memories, then match it up with the children" (1 lof2), but reported

"flooding" as a result. In both the second and diird interview, she commented on the effectiveness of rny rnethod for entering a more internai place that did not flood her. In the second interview she stated: "It was very effective. It wasn't the same level of flooding. ...

1 was given very gentle messages .. . it is very gentle what happened when Sally came through without the same floodgates of emotion opening .. . but also it feels like it was very powerful" (90f2). Laura learned that she could experience a powemil emotional comection in the present and not be overwhelrned by it. She found that touch therapy can sometimes be more numiring, but that she felt more in control of the process when there was no extemal touch. She qualified this statement by explaining that "there is a need for the

[touch] at times. Sometimes ifs a tremendous ernotional block and the hands-on ailows the added energy to facilitate a breakthrough. .. . It feels like this [my method] was very gentle.

1 don? know if 1 could do my whole therapy this way. .. . 1 couldn't really start to integrate until a lot of it [Le., memories] had corne fonvard" (1OofZ).

A year later, when Laura reflected on the method she experienced with me, she explained that it helped her to contact the emotional and intellectual parts surrounding her memories. She said: "What often happens with the other kind of bodywork, with the hands- on, is it reconstructs the memory [only]... and we're liking to do more of getting in touch with the feelings and thoughts [surrounding the memory]" (4800). When I asked Laura how she would describe her experience in the session, she stated: "It's less of a 198 reconstmcting of the memory and more of a getting in touch with thoughts and feelings that were greatly attached, creating the dynamic inside" (490f3). 1 believe Laura articulated the difference between simply experiencing a traumatic memory and experiencing what is in fact a reconstruction of a traumatic memory , which leads to transformation based on the inclusion and integration of related thoughts and feelings. This was established because

Lam recognized that "a sense of completion" was achieved by her as she sustained her attention on Sally's "thoughts about how she was feeling" (5 lof)).

6.2.7 Drawinp a Picture at the End of the Emeriential Session Contributes an Additional Element to the Healin~Process

The participants' cornments reveal that drawing their experïence at the end of the experiential session lent another dimension to their understanding of their healing process.

(In this case some cornments are drawn from both the follow-up interviews and the experientid session.)

Mary said her drawing was helpful: "1 found it really good to draw the picture afierwards, [it was] like an outlet almost, .. . a release of what 1 expenenced." She also felt it was "like a wrapping-up at the end, kind of pulling things together. " Initially, she was unsure "what was gohg to corne out on the paper" but she felt no hesitation. After she drew the picture, 1 observed that the ray of sunsbe touched the Glob. She said it was important that 1 had mentioned this relationship because she had not been "mentally aware" of it and felt that her unconscious choices were "verified" (14-6ofl).

Gwen felt her drawing inspired her to understand that her difficulties were not as bleak as she imagined and that she was making progress in her healing process. "1 199 remember being quite happy about the image that 1 came up with in that picture because 1

felt Iike that sort of black, cold, hard image was a very srnail part of the whole picnire.

which was kind of nice. ... The picnire generally seemed a lot more positive and grounded

and cheerful than I expected. .. . I've made some progress" (2oB).

Irnrnediately after completing her drawing, Wiiio said that when she looked at it in her picnire, the "mess" she found behind the door in her imagery experience seemed "not that bad" (610fl). One week later she said: "1 really didn't think about what 1 was going to do. It was the coloun -- and 1just did it" (4700). Willo expressed surprise about the

"graduated" colours that were "like an explosion out." She felt that the picture represented an "awakening .. . a birth. And that's what this has been like. This body experience. Ir's like three-quarters of me that 1 have been ignoring is now mine again .. . THAT'S what exploded" (470f2).

Two elements in her drawing surprised Trudi: 1) Although she usually uses only red and black when she draws, this time she " felt like 1could introduce green" (750f 1); and 2)

Red dots that she expected to look like "demons" came out looking like "littie creanires" instead (75-6ofl). Both observations indicate a degree of change in what could be perceived as a positive direction, although Trudi was unable to articulate the significance of these developrnents .

Looking at her picture one week later, Laura noticed "it feels exactly as it was supposed to be" (70fZ). She also thought that her picture syrnbolized progress in her healing: "It feels like there is not a lot of light in my life, it feels like there is an awful lot of heaviness, but when 1 look at the picnire, 1 realize that there is more light, 1 don? mean by the yellow streaks, 1 mean there is a lightness to the picture .. . so it [i-e., my life] doesn't feel Like it's al1 as dark as it feels sometimes" (7of2).

Summary

In every case, the expenential session generated new experiences and mernories that were significant for the participant. Although each participant's experience was unique comrnon themes emerged. Participants varied in the degree to which they could sustain their body focus, the extent to which they were able to aniculate their body disruptions, the ease and depth with which they were able to make psyche-soma links, and the way they were able to intemalize the method of dialogue with their bodylself for self-care. Because the follow-up interviews were semi-strucnired and open-ended, the majority of the evaluation topics were selected by the individual participants according to their assessrnent of what was important.

Thus these results reflect key areas of importance for the individuals. CHAPTER 7

DISCUSSION

7.1. BODY EXPERIENCES OF WOMEN SURVIVORS OF CHlLD SEXUAL ABUSE: REFLECTIONS ON THE FINDINGS

This method of body-focused intervention enabled the five participants to retrieve and

integrate mernories of their childhood sexual abuse or some unresolved related issue. In

each case, focusing on the body elicited a memory and led to an exploration of a body

disturbance that was either directly or indirectly linked to abuse. Furthemore. this

intervention helped the participants create psyche-soma links and integrate their body

experience with thoughts and feelings at a safe and appropnate pace. In each case contact

was made with a hurt child pan that required a body focus for retrieval because the somatic component was central to the experience of the child part. For this reason 1 have evolved the term psyche-soma child as a general term for this type of a hurt child part.

A basic difference besween my results and previous research fidings is the central aspect of the body within the discussion of trauma. The experiences of the five participants indicate that the body, as the site of the abuse, continues to harbour unresolved and distorted experiences and requires healing as much as the psyche. Finkiehor and Brown

(1985) present four traumagenic dynamics -- traumatic sexualization, betrayal, powerlessness, and stigmatization -- that account for the main sources of trauma in child sexud abuse. The authors believe these dynarnics alter a child's "cognitive and emotional orientation to the world" (p.53 1). This study, however, adds a new dimension to their perspective in that the body experiences of the five participants clearly showed that the four dynamics also markedly affect a child's physical orientation to the world. The participants' 202 experiences demonstrated that after childhood sexual abuse, the body remains a disempowered container of the abuse experience, mute and sexualized. As the site of the abuse, the body becarne a source of betrayal; it continues to be a source of stigmatization and is experienced by the survivor as cause for sharne. This sharne is embodied as a continuous sense of exposure as if the body, in its visibility, constantly reveals to others the secrets or stigmatization of abuse. Each woman was powerless to convol the abuse except to keep the "secrets" contained in her body, which resulted in a variety of body disruptions or "split off body parts. These body disruptions clearly represented physical manifestations of the changed "orientation to the world" described by Finklehor and Browne (1985).

The goal of this research has been to document and compare aspects of body experience in the processes of retrieval, integration, and intemalization while working directly with the body in therapy .

Retrieval

An important finding in this study is that each of the five participants made her initial entry into her body-oriented memory through a particular sensory-perceptual modality reflecting her individual orientation. Other modalities were involved as the participant continued to explore her memory and gather more details. This finding lends support to van der Kolk's

(1994, 1995, 1996) recognition that a traumatic memory is stored in sensory fragments and that entry is made through a single modality and details are retrieved as more sensory modalities are activated. This finding held me for each participant in this study. The fmdings of this study, however, supply an additional level of detail by showing that each participant -- regardless of the initial preference in sensory modality -- developed 203 kinaesthetic associations that led to her memory development. Focusing on her body experience created a body-oriented memory retrieval experience that involved the kinaesthetic modality and prornoted the experiential development of the memory. Thus when the kinaesthetic sensory modality became involved, each participant was able revieve what is called state-bound information. Janet (in van der Kolk & van der Hart, 1991) recognized the state-dependent nature of traumatic mernories and the necessity of bringing patients back to the state in which the memory was first laid down in order to "create a condition in which the dissociated memory of the past could be integrated into current meaning SChemes " (p. 446).

The findings of this study are in agreement with Terr's (1994) understanding that survivors retain a "sensation of a mernory . " In addition, support is given to Ten's (1994) memory retrieval technique: instead of seeking a cognitive or linear account, she recomrnends asking questions related to sensory material surrounding the trauma memory to retrieve more details.

This study extends previous research (Terr, 1994; van der Kolk, 1996) by providing hrther descriptive detail of the processes involved in remembering trauma. For exarnple, in this smdy, Mary's throat-clenching sensation led directly to her memory of hiding in dread from her alcoholic father. Sirnilarly Laura's knife-like sensation in her lower back led her to remember being raped by her uncle as a small child. Trudi's picnire of an X-ray developed hto the sensations of being locked in concrete and strapped in a hospital striker bed.

Researchers (Benedek & SchetQ, 1987; Fundudis, 1989; van der Kolk & van der

Hart, 1991) have found that focusing on exact times, dates, and locations is not congruent 204 with the way an adult would have encoded a traumatic childhood experience. This study is in agreement with their fmdings and suggests that in order to assist memory retrieval and integration, it is not necessary to pursue specific factual information that does not surface spontaneously. As the participants were remembering childhood experiences. this approach to renieval is in agreement with Fundudis's (1989) explanation of the child's preference for recounting selected details that are personally relevant.

Van der Koik's study of the "speechless terror" response to trauma was illustrated by the htensity of Mary's fear and her sensation that her breath was cut off. This is a classic example of the tendency of PTSD suwivors "to experience emotions as physical states rather than as verbally encoded experiences" (van der Kolk, 1996, p.293). It is worth noting that Mary had a vivid sensation and the associated feeling of fear, but said she did not remember the actual experience in narrative terms. Al1 participants in this study demonstrated the tendency to experience emotions as physical states and memory retrieval as a non-narrative event.

Putnam (1990) and Whitfield (1995) stress that conventional verbal therapy is not likely to be effective as the only tool for recovery from child sexual abuse or trauma since traumatic memory is not accessible through an intellectual orientation. Clinical research

(Putnam, 1990; Janet, in van der Kolk & van der Hart, 1991; Whitfield, 1995; van der

Kolk, 1996) has shown that because traumatic memory is encapsulated in tirne, it requires a non-ordinary state for retrieval and integration. The intervention used in this study facilitated entry to a non-ordinary state involving an intemal focus on bodily responses.

This state was achieved by having the participant Lie on the floor with her eyes closed, free to move or change position. It was this intemal focus on the body experience that 205 ulthately created a non-ordinary state in which the participant was physically cornfortable. at ease and therefore able to focus kinaesthetically and to retrieve state-dependent information. This approach differs greatly from one in which the therapist directs the participant to visualize a particuiar elernent. The participant was encouraged to follow her body experience continuously in order to allow her body to "speak" its language from its perspective. This opportunity strengthens the body perspective so that it is not dominated by thoughts and feelings. but interacting on an equal basis. This study revealed the distinctive conditions for retrieval and underlines the importance of a body-oriented focus involving a non-ordinary state for somatosensory memory retrïeval.

Inteeration

One of the most instructive aspects of this research was an enrichment of Our understanding of dissociation as it relates to and manifests in the body experience. In essence dissociation involves the flight of the mind from the body, which remains physically trapped in the trauma as if it were forced to exist in the unchanged "present tirne" of that experience.

Each participant demonstrated some type of body disruption or "split," most often articulated as a split between her head and body. These body disruptions correspond with

Waites 's (1993) description of dissociation as a " psychobiological mechanism" that allows the mind to flee what the body is experiencing and maintain "a selective conscious awareness that has survival vaIue " (p. 14).

All participants illustrated the "survival value" of dissociation. Each wornan provided an example of how the "split" occurred at the body sensory Ievel. For example,

Tmdi's "split" was represented by two body sensations -- a feeling of being immobilized in 206 concrete, which represented her home life, where the abuse occurred, and a sense of

exposure on a striker bed while in hospital. Dunng the session, Trudi oscillated between

the two sensations. Gradually she recognized the illusory nature of her childhood belief that

the hospital was a safe haven and gained the insight that the humiliating objectification of

her body in the hospital ("like a piece of rneat") offered a close parallel to the abusive

situation at home. Trudi's need to avoid entering her body experience supports Waites's

(1995) view that the effects of trauma are "compounded by the wish that terrible events

were not really occurring or had never happened" (p. 14). For Trudi and the other

participants, the need for safety motivated dissociation to another part of the body. avoiding

the site of the trauma or associated area.

In dissociation, the body retains its sensations and urges, but these are dissociated

from any cognitive or emotional understanding of their meaning. Later these sensations

return and the urges are acted upon mindlessly. Trudi provides a clear example of this

mindless urge in her compulsive need to run, to the point of developing chronic pain as a

result. She described it: "Anytime 1 feel any kind of emotion it's like 'gotta nin'."

Compulsive running became an issue in Tmdi's therapy, where it was recognized as an

impediment to her progress. The need to "nin" illustrates, on a physical level, a visceral response to the powerlessness that results from the entrapment of abuse. Thus this smdy

illuminates both the somatic conscious and unconscious experience of trauma descnbed by

Waites (1993), who States that trauma produces an "overwheiming need to escape what is, in reality , inescapable" and this need results in dissociation (p. 14). Herman and Schatzow

(1987) state that "the purpose of reliving the experience with full affect is not simply one of catharsis, but of reintegration. .. . The patient becomes more comprehensible to herself, and 207 more able to construct meaning in her Me history" (p.13). Several of the participanrs were

able to construct meaning €rom their compulsive need to run and came to undentanci. on a

viscerai Ievel, its deeper meaning and its relationship to their pasc abuse history.

Another variation on this mindless quality of unaccountable body sensations and

urges involves the emo tions . For example, the participants described feelings of pro found

sadness that were unrelated to anything concrete, or uncontrollable crying with no related

thoughts and feelings. Focusing on the body in the experiential session enabled the

participants to create meaning out of these previously incomprehensible feelings. As an

example, at a crucial point during her memory retrieval, Gwen experienced an unexpected

urge to cry. By connecting with her body experience, she was able to associate the urge

with feelings of shame, exposure, and confision. Within each session, using body

sensations as a source of information, participants were able to create a more complete

narrative of their difficulties. Gwen said this process "validated for me the darnage that was

done". The participants' experiences of creating meaning from what were originally

unaccountable sensations and urges have shed light on the way body wisdom "slowly" and

"circuitously" manifests itself but then once experienced becomes a " foundation [or] a basis

of knowing that gives confidence and total support to the ego" (Woodman, 1984, p.28).

This study provides further descriptive detail regarding the purpose and process of

dissociative pain, showing that a comrnon physical manifestation of dissociation is displacement of pain from the area of trauma. The body area that was damaged retains the unacceptable feelings and converts hem into dissociated physical symptoms of pain or disease in this area, or dissociates them into other body areas, such as the head. For example, Mary recognized that ber "physical reaction" to fear was to "cut off" her 208 breathing at her throat, and when the "pressure" in her throat becâme too intense, she experienced a headache. In a similar way, Laura said "when the headache cornes 1 donTt feel so bad down below any more," referring co the pain in her pelvic area that she experienced while recalling being raped as a child. Gwen, a chronic migraine sufferer, displaced feelings of dirtiness and shame from her genitals into a headache. My appreciation of the displacement of pain is also in agreement with Hedges's (1994) explmation that "The threshold to more flexible somatic experience is guarded by painful sensations .. . erected to prevent venturing into places once experienced as painhl" (p .29-

30). As Waites (1993) explains, in dissociation the "mind flees the body"; however, the participants in this snidy begin to show us how the pain of emotional and physical trauma is retained viscerally and converted into dissociated physical pain and mindless emotions that serve a protective function.

The effects of child sexual abuse on the body are also reflected in recent medical findings that confm survivors of child sexual abuse have "more chronic pain, more medical symptoms, and undergo more surgical procedures chan those with no such history"

(Leserman et al., 1995, p.23). Al1 participants in this study had physical symptorns ranging from chronic depression to migraines and pelvic pain. The process of focusing on the body and psyche-soma linking led them to a greater understanding of their physical pain and a more compassionate relationship with their body.

There is a direct association between the severity of the abuse and the degree of dissociation maites, 1993). The results of this snidy demonstrate Waites's finding from a body perspective -- the more severe the abuse, the more pronounced the head-body split or the body disruption. Therefore integration can be understood as the integration of 309 dissociated physical experiences, which al1 of the participants in this study demonstrated.

Laura, who has a dissociative identity disorder, provided an extreme and therefore unusually clear example. Her experience during the session illustrated the merging of alters on a physical level. DispIacernent of pain played a major role. 1 attribute the emergence of the alter to the safety gained when Laura was able to displace her pelvic pain to her head and

help the alter to feel accepted and no tonger "bad, " enabling her to corne forward and eventually merge with several other chiidren. The most important feature of this achievement was Laura's perception of safery. Putnam (in Waites. 1993) explains that in

MPD, "different alter personalities rnay have experienced the 'same' trauma quite differently and each may need to abreact the event individually" (p.222). Laura was able to invite each alter to participate and give "special attention" to "sharing information and discrepant experiences" (p.222). The findings in this study present in detail the physical dimension of Putnam's mode1 by placing the alters in various tissue or areas of the body that need to share or make connections regarding abuse experiences. The findings here also describe and document the process of refocusing on the body experience that facilitates psyche-soma linking necessary for such merging to occur.

Van der Kolk (1996) and van der Kok et al. (1996) explain the importance in psychotherapy of providing opportunities to integrate the "sensory fragments" into a personal narrative for the purpose of integrating dissociated experiences from the past. A major fmding in this study is that for the participants the "sensory fragments" developed into subpersonalities, in other words the somatic aspect of cut-off or dissociated parts. This study demonstrates the importance and usefulness of identifiing and dialoguing various body parts that represent these subpersonalities. For example, in Laura's case, a preliminary 210 process of dialoguing among several body parts -- back, chest, neck, and head -- was

necessary before Laura could corne to her centraldialogue in which she merged psyche- soma chiid alters. It was important for Laura to follow her body sensations through the various areas, mapping her pain until she discovered that when she displaced her lower back pain to her head she felt safe and Sally could speak. She identified the ache or "lump" in her lower back as the "gatekeeper," the "road block between my brain and rny rnouth" who made it "hard to talk" (22ofl). A similar pattern occurred with Gwen and involved her chest area as a source of shame. By continuously refocusing or "checking in" with this area of her body throughout the session, Gwen was finally able to identiQ this area as heart tissue and dialogue it with her "heavy, dark" genital area. Because she was able to enter what she identified as a "stream of consciousness," the two areas were able to interact and a healing image ernerged directly from this interaction.

In this study an overall pattem of integration was revealed during the dialoguing of body parts: the f~stsensation of a memory led to a recognition of dissociated areas of the body that needed to find a way to interact. In the case of childhood trauma, it is common to have as the players a hurt child part and a protector part. The body-focused nature of this study allowed the participants to identiQ and locate these subpersonalities by following physical sensations, particularly those of pain. This study informs us that each subpersonality resides in a specific body part and therefore speaks from that part. From within the body experience, the participants came to a new awareness, understanding, and integration of the involved subpersonalities.

Creating psyche-soma Links led the participants to recognize the protective aspect of the body. Often a "gatekeeper" was protecting the hurt child part who needed to speak. At 21 1 a certain point, the participant had to face the pain and for this to occur. trust in the process of following the experience was essential. For example. this is the point where Willo and

Mary cried and where Trudi dissociated to another part of her body. If the participant sustained a focus on her body experience without dissociating to another pan of her body. the pain 1ed her to the cut-off hurt parts that contained the "secrets" of the abuse and that she usually recognized consciously as the hurt child. For example, Mary said that the pain was a little kid, and dialogue with this psyche-soma child part 1ed Mary to her healing image, a "picture" of herself holding the child. The process. as discovered initially in the pilot study (Asselstine, 1992) indicates that the hurt psyche-soma child part can be reached through a successhl dialogue between confiicting subpersonalities that are explored through the body without the filter of the intellect. As Wiilo remarked, at the the of the session her mind was "taking cues" from her body. These experiences of integration resemble

Briere's (1992) description of what can happen if one goes beyond the verbal "renditions" of the abuse to the associated sensory cornponents, facilitating a more integrated and therefore less dissociated re-experiencing of abusive events and thus "potentially a more complete resolution of posttraumatic difficulties " (p. 133).

The pain of the body is the source of information and the potential teacher for integrating mindless emotions and incomprehensible symptoms and sensations. The participants' experiences vividly demonstrate that the body, as the source of the trauma, is also the guide for healing . Each participant offers an example of the way dialoguing with the body leads to a changed and less dissociated relationship with their body. Waites (1993) has found that "taking about bodily experiences and sensations" helps overcome numbness and flight from the body and that "over the course of the, the symbolic significance of 212 images may become more and more relevant" (p.222). This research demonsuates what

type of "talking about" is effective -- allowing the body to have its own voice and speak

from the perspective of its experience. The importance of a non-intellectually dominated

rnethod that can contact state-bound information has been conf7rmed by clinical researchers.

including van der Kolk (1996). Participants in the snidy cornmented that during the experiential session, significant images arose that they felt would not have done so in their conventional psychotherapy sessions. The body expenence fends itself inherently to sensory-perceptual images.

Each participant in this study illustrates the process and the benefits described previously, showing the usefuiness of an experiential approach for rehtegrating dissociated expenences in healing trauma. For exarnple, Mary made a distinction between "thinking back" with her mind and the kind of remernbering that occurred during the session that she said was "more real," as if she were in that situation experiencing it. Mary's experience is in agreement with van der Kolk's (1996) statement that his patients claimed to remember actual sensory elements of the original traumatic event. Although other participants in the study did not articulate this as clearly, it is apparent that al1 participants recalled sensory fragments of their original trauma. Heman and Schatzow (1987) also emphasized the importance for reintegration of reliving the experience with full affect. Waites (1993) recommends "a careful emphasis on integration in the wake of any traumatic reexperiencing " (p. 104). The relevant finding in this study is that because the participants were following their body experiences they were able to create a safe place in which diey could integrate their sensory expenences as they arose through the process of psyche-soma linking. 1 believe this safew was achieved because the participants had full control of their body-focused therapeutic process .

For Laura, there was an additional dimension that she caIled "completion." explaining that if the experience were only a relived memory, there would be no resolution.

Laura emphasized that for resolution to occur she needed to feel safe enough not to dissociate. Her expenence illustrates the findings of van der Kolk and van der Hart (1991) and van der Kolk (1996) who speak about retuming to the memory in order to complete ir and srress that in order for "resolution" to occur it is necessary to conuol dissociation and integrate the traumatic experience.

The use of drawings in conjunction with the body experience is in line with the opinion of Briere (1992) who believes that it is worthwhile to "encourage clients to draw. paint, or in some other non-verbal modality depict their abuse experiences in order to access the Iess linear, more sensory components of abuse-specific mernory" (p.133). Far from being simply a tool to access traumatic memories, according to the results of this study, drawing cm contribure many dimensions to a survivor's understanding after she has experienced on a bodily basis the non-linear nature of ber trauma memory. Participants' drawings, completed at the end of the experiential session. gave them a tangible reference point for their experience that supported verbalization and the recognition of shifts in consciousness that had occurred. In every case, the drawing provided the participant with another dimension, sometimes offering surprising insights, and always resulted in a more positive outlook.

The conditions facilitating integration in this shidy were unique. The participants cited the enabling factors that they believed allowed them to access memones and images they felt would not have been retrieved otherwise. These included: (1) the therapist's trust 2 14 ui the process; (2) a feeling of trust and safety with the therapist; (3) Iying down and moving as desired; (4) a self-directed Pace that allowed full processing of the new material at the time it emerged; and (5) drawing a picture at the end of the session. Evidently I was able to project a profound sense of trust in the process of following the body experience, co~dentin the belief that the body-focused, self-directed pace would ensure safety.

Participants were able to absorb this trust and therefore were able to allow themselves to proceed at their own pace. My underlying intention was to give the participant full control of the Pace and establish a uust that her body would direct her to what needed to be discovered .

During this smdy it became evident that psyche-soma linking prevented dissociation frorn the body during the re-experiencing. The internai focus on the body, once established. led to a feeling that prompted the participant to enter the psyche in order to pursue the intellectual or emotiond aspect of what was happening. After pursuing the new material on this level, the participant needed to be encouraged to refocus on the body experience. This process of psyche-soma lùikmg is the foundation of the self-generated body-focused emergent irnagery process. The conditions that the participants identified as necessary for their healing are inherent within this intervention.

Internalization

According to the follow-up interviews, al1 participants experienced powerful shifts in consciousness as a result of integration with their body experience. The most significant of these involved the ability to manage flashbacks using an intemalized version of the method of dialoguing with the body. 215 Mary aniculated the process of internalizing my method of dialogue with the body. a process that was shared by al1 the participants to varying degrees. Mary was clear about remembering my voice and the way 1 asked questions. A year after the session, she said that when she had flashbacks in non-therapy situations, she was able to apply my method of questioning her body as a technique to calm herself and remind herself that she was not in the past as a child, but in the present as an adult. She stressed that she would never have thought of doing this before and that it was helpful to realize that she could be in controI of what was happening. Mary's achievement of internalizing the dialogue rnethod indicates that she benefited from my guidance during her memory experience. She learned how to sustain a focus on her body experience, which provided her with a safe pace and allowed her to control the amount of confrontation with her pain. This achievement supports the recomrnendations for controlled access to traumatic mernories for the purpose of integration by Janet (in van der Kolk, 1994), Herman and Schatzow (1987), and Waites (1993). For example, Waites emphasizes: "The goal of therapy is to replace uncontrollable forgetting or remembering with controlled access to one's mernories " (p. 104).

Laura's application of the process of intemalizarion was specific to her own needs.

During the year following the session, she was able to use this body-focused method for her own healing. She said the session gave her a way of contacting her body without facilitation. She called it a language to talk to the body area and said that it helped her look for deeper aspects to her alters and "make space for healing at a much deeper level."

Laura's changed relationship with her body allowed her to be "a Little more loving" toward her body, including touchùig it lovingly when it hurt.

Willo vividly exemplifies a changed relationship to her body as a result of 316 intenializing the new way of Iistening to her body, which she said was "like a new tool."

She was able to experience physical pleasure, including sexual activity. that previously was difficult for her without drugs. She felt encouraged to "get inside" and "discover" the meaning of her bodily sensations. Within a year of the expenential session, she had not oniy resumed a number of physical activities that gave her "enormous pleasure," but she had also gained an ability to trust herself enough to be vulnerable in sexual activity.

Pessimism about the future is a cormon result of child sexual abuse (Briere, 1988;

Herrnan, 1992; Terr, 1993). This outlook is related.to the survivor's feeling of extreme helplessness or powerlessness to stop the abuse and the resulting entrapment. Changing this pessimism would be a major therapeutic goal, enhancing the quaiity of life for survivors. In this study, three of the participants gained a vision of their future body experience that was directly related to the healing irnagery they discovered during the session. (The other two participants were at a different stage in their healing process.) Common elements for the three women included a vision of themselves as energetic, expansive, and free to move with a childlike joy. Mary articulated one of the physical aspects of intemalization when she described her sensation that the "little girl" was the spirit inside her larger adult body that wanted to skip for joy.

Gwen had a similar vision of herself in the future doing cartwheels, with a sensation of lightness and exhilaration. These aspects of her image represent a metamorphosis of her previous picture of herself as a hopeless and sad child, floating weightlessly through space like a millcweed pod; however, the image of herself in the future included a development toward substance, intention, and joy. Gwen's milkweed pod was an image of dissociation, which she said she learned "very early" so that it became "a way of life" (200f2). One year 2 17 Iater, discussing what she learned from the session, Gwen stressed that she gained a berter understanding of her dissociation through increased body awareness. She reported that the session helped her to separate what belonged to the present and what belonged to the past.

She articulated that she was able to internalize dialogue with her body, introspect about the rneaning of various sensations, and was much more able to take in bodily pleasure.

Willo's vision of the future involved herself floating in the ocean. She compared this image to her memory of running exuberantly on ice as a child. Willo articulated that feeling pleasure in her body was acceptable and no longer "bad, dirty or negative in any way." Like Gwen and Mary, Willo discovered and embodied a physical reality that was no longer heavy , trapped, weighted and imrnobilized, but free to move with lightness , power, and fluidity. In each case, the irnagex-y dernonstrated the inclusion of a transformed version of the hun child in a new lived metaphor. These experiences illustrate Woodman's (1996) view that the "connecter" between the body and the mind is metaphor: "Metaphor is the language of the soul. ... Metaphor is a physical picture of a spiritual condition" (p.33).

1 believe these three women were able to sustain and further develop their successful integration of their child part because they moved beyond a cognitive understanding of having a hua child part to an embodied experience of a lost childlike perspective. This transformation personified the reclairning of their body and indicated the potential for a renewed relationship with the bodylself that could include the joyful aspect of the child.

The child part that retained the injury within the somatic unconscious was now able to join the adult woman and contribute an aspect of physical joy and bodily pleasure that was missing. According to the participants' comments, it was clear that this changed relationship with their body transformed their lives in tangible ways. 218 In sumrnary , the participants experienced the bene fits of internaiizing rny acceptance and tmst that their body would lead them safely and naturally through their healing process.

These benefits included conuolled access to mernories. an ability to listen to their body in everyday life, an enhancement of quality of iife involving a more optimistic outlook, and an ability to distinguish between the past and the present. The body is a source of direct knowledge that enables a survivor to recognize distortions resuiting from trauma and to gain a perspective that places the trauma clearly in the past, lessening its negative influence on the present. Evidently the participants were able to adopt a compassionate, respectful, and non-judgernental attitude to their body experience and make it their O wn. IMPLICATIONS FOR TNERAPEUTIC INTERVENTION

Varied implications for intervention were presented by the experiences of the five participants. Their process of leaming about pain and healing within an experiential approach required a non-intellectual focus. Although the women in the study had different experiences of integration, without exception focusing on their body experience brought them to awareneçs and provided thern with tools for change and self care that otherwise wouid not have been possible. When we consider the effects of chiid sexual abuse, their voices teach us that one's physical reality cannot be separated frorn one's cognitive, emotional, or spirinial reality .

The case studies presented here inform us that focusing on the body experience and allowing it to guide or direct a session creates profound transformations. Therefore this research points toward the need to re-examine the limitations of conventional verbal psychotherapy and to explore non-ordinary States for accessing the body's perspective.

A major aspect of body-focused therapy is the therapist's personai state of knowledge of the body. A thorough sensitivity, ongoing awareness, and knowledge of the body on the part of the therapist is essential if he/she is going to be able to follow, value, and attend to the body experiences of survivors. An aiertness to continuity in ternis of locating and re-focusing the client's awareness is crucial because of the subtle nature of some of these explorations and the novelty of the experience for the client. Questions of pacing , trust, and boundaries are dependent upon the therapist 's knowledge of psyche-soma linking and respect for the distinctive nature of the body perspective. As Swartz-Salant

(1982) articulates: "The way one approaches the body is always the central issue, not the particular techniques employed" (p. 122). This is particularly relevant for body-focused work.

Because a non-ordinary state is necessary for sustaining a focus on the body

experience, dialoguing body parts and contacting the hua child require expertise in guiding

the survivor through psyche-soma linking and the exploration of imagery that reflects

psyche-soma realities. A farniliarity with the body experience on the pan of the therapist is

essential for somatic empathy .

Somatic empathy is an elusive quality that enables a therapist to resonate with the participants' experience as it happens and sense the appropriate time to move through the steps of psyche-soma linking. (See Appendix C.) Somatic empathy also enables the therapist to recognize the events that are occurring and understand their importance. This research has demonstrated that the rnost significant contribution of a body-focused approach to the healing process is an understanding of the physical manifestation of dissociation in the form of body disruptions or headhody "splits." The process of integrating these "splits" between body and mind requires that they be identified and worked through with the appropriate guidance.

Another aspect involves the physical environment and cornfort of the participant.

Because the interna1 focus on the body experience is essential to create a non-ordinary state and contact the body material, the conditions for retrieval and integration must be arranged according to the body's needs. My experience suggests that the power differential is lessened when 1 am at the same physical level as the participant. Therefore 1 sit on the floor if the participant is on the floor. That said, this method of focusing intemally on the body experience could be accomplished in other adapted forms, including sitting in a chair with the eyes closed. The results of this study show that it is helpful to have the participant 22 1 lie on the floor with her eyes closed and free to move as she wishes. This freedom is evidentiy essential to provide an opening to the kinaesthetic modality.

Inviting the participant to "get cornfortable" and assisting her with this process (e.g., providing pillows), creates an atmosphere in which the body knows it is considered important in the session. Another aid to focusing internally on the body experience is ro breathe and follow the breath through the body as a way of scanning. This scanning permits any areas in need of attention to emerge easily, gives the participant full control of the body-focused process, and reinforces the significance of the body perspective.

Once the participant has entered her body-focused memory, the therapist must be amined to subtle shifts in the body perspective. Picking up on the non-verbal cues in breathing, body position, movernent, tone of voice, timing of these elements. and rhythm of the interaction between therapist and participant are necessary skills. The intention in body- focused therapy is to incorporate unconscious body processes into a conscious expression that can be explored and integrated for the purpose of healing. Consciousness of body processes leads to the creation of body-oriented self-care tools that result from such integration. It is the role of the therapist to assist the participant in developing this consciousness; it is unlikely that this body material will become conscious spontaneously because it concems trauma that is state-bound and therefore strongly protected by the body and its pain. The therapist cannot communicate body consciousness if she is not conscious of her own and others' body processes. There is no formula for acquiring the skills for body-focused therapy. It is cmcial that the therapist project throughout the session an acceptance of not knowing what the direction or outcome of the exploration will be. In this way, the participant is encouraged to accept this state of not knowing as productive. 222 Consequently, she wilI allow herself to be open to the emergence of unpredictable body-

oriented material. This openness to the body experience teaches the participant that the

body knows and has a wisdom of its own.

A major fiinding in this study is that for these particular women, who were already in

healing when they came to the experiential session, there was no reason for me to fear that

the body experience would be ovenvhelming. A comrnon misconception is that the body

will become uncontrollable and the participant will be trapped in an emotional crisis. These

five participants formed a select group. For a therapist experienced in body-oriented change

working with such a group, it is unlikely that a crisis will occur. Recognizing the

knowledge of the body and trusting it to guide the therapy is, for the uninitiated, a leap of faith. Acknowledging one's fear about unknown body processes is the first step in

overcoming reluctance to accept the potential wisdom the body has to offer. Without exception, the participants recognized my confidence in Ietting their body exploration proceed in a self-directed way. My confidence or trust was signifcant in facilitating the participants to lower their barriers and recognize the protective nature of their body experience and the potential capacity of their body to offer safety within a healing process.

7.3. IMPLICATIONS FOR RESEARCH

Further research is needed to investigate the value of body-oriented traumatic memory retrieval. It is necessary to explore methods for retrieval that provide control and safety for the suwivor who is accessing body-oriented experiences. The qualitative case study methodology of this research bas contributed a deeper understanding of the body experiences of women survivors. This sîudy suggests that the therapeutic technique 223 employed can be beneficial and the role of this approach within an actual psychotherapy session would make a useful study.

The distinctive kind of body-focused memory retrieval involved in this smdy requires specific therapeutic conditions. More study is needed in this area to determine what factors are most important, why, and how to create them. For example, the relative usefulness of lying on the floor as opposed to being seated in a chair could be exarnined. A possible area of research might involve the body education and training of therapists. Another area of research might be the transference issues within a body focus and how they may or may not differ from those that appear within a conventional ps ychotherapy session.

For the purpose of understanding the matching of appropriate therapy with the individuals who are likely to benefit, it may be informative to compare women's experiences with a body-oriented verbal technique such as the one used in this study to other therapeutic modalities, including touch and movement therapy. In these comparative studies, attention could be given to participants' background, including culture, type of child sexual abuse, medical history, and previous experience with a range of body-oriented modalities. Any and al1 of these variables may lead to a greater understanding of the beneficial aspects of various approaches.

We also need a better understanding of how to incorporate the body perspective within or alongside ongoing psychotherapy. A dancelmovement or touch therapist who is also trained in verbal psychotherapy may neveaheless need additional guidance for finding the best ways to blend the modalities. Further research will benefit conventional verbal therapists who need to undentand in greater depth how to include the body perspective.

Arnong the areas that could be researched is the question of guidelines for helping clients 224 reach an interna1 body focus for memory retrieval. At present, we do know if it is possible to teach the ability to recognize shifts and body consciousness within the traditional schools of psychology. Perhaps investigating the benefit of expenential approaches to leaming these techniques would be valuable. For example, a therapist interested in incorporating this method could witness sessions with an experienced therapist.

Research concerning the use of words by women when talking about their body expenences, including their development of imagery and metaphor, will inforrn us about ways to notice, invite, and include the participation of a body perspective. It is common knowledge that the mind flees the body in dissociation. However, this research has demonstrated how dissociation actually manifests on a somatosensory level. Further research to explore ways of describing these body disruptions would be of value.

Understanding body dismptions more clearly will have implications for psychotherapy.

An additional perspective on this type of research could be gained by investigating the participant's own interpretation of her medical and emotional history, including the psychological and somatic challenges that she feels she has had to face over the years. A worthwhile emphasis would be on the participant's personal discussion of her history rather than on medical professionals' descriptions of her condition(s). It would be informative to link the specific symptoms with signifiant body areas and the psyche-soma issues surroundhg body-oriented mernories. This type of research would extend Our knowledge and understanding of body disruptions. A thorough inquiry into each participant's interpretation of her medical symptoms would be helpful.

As mentioned earlier, conventional verbal therapists are not trained to attempt touch or movement therapy. These therapies involve the development of a sensitivity to one's 225 body and an indepth experience of one's body processes. Learning about one's body is not purely an inrellectual process so research that addresses cnteria for expertise to include the body could be useful. in particular, it is crucial to understand possible risks when the modalities of touch and movement are used without expertise.

In this snidy. the women welcomed the opportuity to adopt the method of dialoguing that they had learned, intemalizing it as their own way of communicating with their body in everyday life. Research that explores the ways this dialogue is internalized would be extremely pertinent.

7.4. LIMITATIONS OF THE STUDY

The women in this study came from a relatively unified cultural background: white, middle class, urban, and educated. Cultural differences may relate to varied experiences of the body. In addition, membership in visible minoriv groups rnay alter the body experience due to the larger cultural psyche. Perhaps the most important limitation, however, is that al1 the women in this study were currently in ongoing psychotherapy and had made varying degrees of progress in their healing.

This study explored and documented the experiences of five women within a qualitative case study design. Naturally a greater number of participants could teach us more about the individual differences and similarities of their body-oriented experiences.

It is likely that some people will not benefit from an intemal focus on their body experience. For any number of reasons, the intemal focus might present problems for some people. In these cases special considerations or adaptations of the intervention could be made. Another limitation of this study concerns the fact that 1 have had particular training in areas that the typical process of becoming a therapist does not include- This training certainly affected the way I worked and î3erefore raises the question of transferability when practitioners' training backgrounds differ from mine. 227 7.5. CONCLUSION

This intervention technique is not a therapy in i~if.As Terr has explained. psychotherapy is not just about memory work. This technique. however, rnay be useful for certain people at certain times for certain reasons. As research. it has been helpful in answering the research questions and informing us about the non-linear quality of body experience and about the body's ability to give us knowledge about ourselves and our past expenence in such a way that Our emotions and intellect can becorne grounded in that knowledge. There is an extensive body of literature concerning the psychological effects of childhood sexual abuse trauma. This study has demonstrated that the body is closely and inextricably involved when trauma is experienced, particularly in childhood sexual abuse. A wide variety of related kinaesthetic experiences have been shown to be part of the memory of trauma, including the trauma of imrnobilization and the feeling of being trapped in terror, body disruptions that involve the mind "splitting' from the body, and the "splitting" of body areas that represent different subpersonalities and perspectives on the trauma. Following the sensation of a memory and incorporating psyche-soma linking led the five participants in this study to a changed and more integrated refationship with their body. Body-oriented memory reû-ieval and integration, and the internalization of the process of dialogue with their body led these women to new opportunities for heahg. REFERENCES

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Letter of Morrned Choice

Dear Research Participant:

1 am currently a doctoral student in the Department of Applied Psychology at the Ontario Institute for Studies in Education. The research 1 am conducting concerm the experience of the body in the psychotherapeue process of healing from the trauma of childhood sexual abuse. More specifical1y 1am interested in studying how the body remembers experiences and the role the body has played in the healing process. 1 would like to invite participation From individuals who have, in their opinion, experienced at any tirne some type of body-oriented therapy in kir recovery process, as well as some individuais who have not experienced body-oriented therapy .

For this research 1 would like to conduct experiential interviews that invite the participant to focus on the experience of the body during a guided irnagery experience including the use of drawings, and, to discuss this experience with me. Participation will involve two interviews approxirnately two hours long and two weeks apart. The interviews will be taped and transcribed.

Exploring the experience of the body is persona1 and participation in this study will resemble a psychotherapy session as much as an interview session. Because this study necessitates that the participant be open to the experience and expression of personal issues (if they should arise) 1 am requesting that each participant be currently in psychotherapy . In this way, 1 know you have a safe place to continue processing your experience if you need to .

To protect your prïvacy, your name and any other identiQing information will be disguised in al1 data, written material, or publications. You are free to withdraw ftom the study at any the.

In the pilot study participants stated they found the experience to be both positive and personally informative. If you chose to participate in this study, 1 believe you will also be making a valuable contribution toward understanding the importance of including the experience of the body in the healing process with survivors of childhood sexual abuse.

Thank you for considering this request.

Margit Asselstine, M. Ed., Registered Dance/Movement Therapist Margit Asselstine Department of Applied Psychology The Ontario Institute for Studies in Education 252 Bloor Street West Toronto, Ontario M5S 1V6 Home Phone: (416) 963-8325

Dear Margit:

I have read the attached letter describing the research project you plan to do and I agree to participate. It is clear to me that 1 am free to withdraw from the study at any tirne.

Date Background Inibnnation

Code Number: Dateî

Age:

Occupation (s) :

Referral Source:

Birthplace :

Language of Choice:

Marital Status:

Educational History:

highest grade completed:

if post-secondary field of study:

Family Background :

description of parents and siblings (age, educatiow occupation, brief character description)

relationship with parents and siblings (10 - very dose, O - very distant) Page 2 (Background Information conthued)

Code Nurnber:

Previous Experience in .Psychotiierapy:

Previous Experience in Bodywork: (type and duration)

Previous Experience in Body-OrÎented Persona1 Change: Page 3 (Background Information continu&.

Code Number:

Briefly describe your experience of sexual abuse as a child (perpeuator, relationship to perpetrator, age, duration, type of abuse). Please descnbe how you came to remember being sexually abused as a child.

Briefly describe your healing or recovery process up to the present tirne. Appendix C Interview Schedule

The Experiential Session

Interview 1 - Self-Generated Body-Focused Emergent Imagery Roeess

PAST MEMORY

lie down and get cornfortable

notice yourself

notice your body

follow the breath through your whole body

expand on the iddation

gentry shrink on the exhalation

check in to notice thoughts and feelings

although we are going to focus on the body every part of you is really involved

allow self to be present in al1 aspects although we are focusing on the body orientation

when ready

scan through yom body

notice a place in your body that draws your attention

allow younelf to associate this place with a memory in your body you might notice more than one place or memory drawing your attention choose one you would like to work with to begin

[through dialogue. encourage the choice of an importaru rnemory, knowiizg at the same rime that all the me-es are important or eise the participant would probably not remember them] let me know when you have chosen a place to begin now @ chosen focal area of body] what do you notice as you focus on that place in your body notice any thoughts, feelings, images, sounds. pictures, movements you may notice your attention shift - as you begin in one part of your body and move somewhere else -- trace ùiis rnovernent as it accurs allow your body to guide ffollow orientarion of the body and dialogue w&h whutever cornes up; bnng fucus back ro the body as appropnate or in a psyche-soma &king; suggest the nert transition when rhe participant hm clatified the rnemory for hersetf as much as possible and the related rhoughts and feelings are evidend

if it's okay now 1 would like to invite you to transition into the present time in your body take your tirne to notice the transition as you move from the past into the present describe what you are noticing notice any thoughts, feelings, images, sounds, pictures, rnovements again allow your body to guide you

[if appropriate] check in with the places [name these] in your body that were in your awareness during your previous mernory expetience] For the purpose of creating frtrther psyche-soma linking between past and present experience and grounding in the body uwareness if appropriate] how is the place(s) [name these] diflerent from the way if was when you were in the past memory experience [explore each phce in depth ifpossibZe] notice your breathing, how is it different now, if it is what are you noticing now ffollow her dialogue and at the appropnate moments re-focm on areas of the body that were mentioned, so as to facilitate the parricipant's discovery of any relarion these might have to the present] floilow orientarion of the body and dialogue with whatever cornes up; bring the focus back ro her body us appropriare or in a psyche-soma linking; suggesr rhe nat transition when she hus clanfed as much as possible for herself her body experience in rhe presenr, any relared thoughts and feelings, and links ro the pasr]

if it's okay now, 1 would like to invite you to transition into the funire time in your body. again noticing whatever cornes up for you or draws your attention during the transition from the present to the future

how would you like to expenence your body in the future

take your time to notice the transition as you move from the present into the future

notice any thoughts, feelings, images, sounds, pictures, movements

as you allow yourself to imagine your body in the future, what do you notice about how you are feeling in your body

describe what you are noticing

[when appropnate] check in with the places [name these] in your body that were in your awareness during your previous past and present experience ffor the pupose of creating furrher psyche-soma linking between pasî and present ro mure erpenence and grounding in fhe body awareness, ifappropBm how is the place(s) [name rhese] different from your previous experience [erplore each phce in depth if possible]

[if appropriate] notice your breathing, how is it different now, if it is

[when appropriareJ what are you noticing now, allow your body to guide you ffollow her dialogue and re-focus, at the appropriate moments. on areas of her body thar were mentioned so as tu facilirate discovery of any relation these rnight have tu the presenr]

~olloworientarion of the body and dialogue with whatever cornes up; bring the fucus back tu her body as appropriate or in a psyche-soma linking; suggest the next transition when she has clarijici us much as possible for herself the future, any reZated thoughîs and feelings, and links to the present &/or pd fmd a way to complete the session for yourself when you are ready, corne back to the room I would like to invite you to draw a pic- of whatever you wish about your experience

PXCTURE Discussion based on the drawkg as a focal point. Interview Schedule

Follow-up Interview One Week Later

interview 2 - Reflecting on the Experiential Session

a) What are your thoughts and feelings about your experience in the previous interview?

b) What was most important to you or most mernorable about what happened in the first inteN ie w?

c) Do you think that focusing on the experience of your body served to facilitate mernories of cbildhood trauma that you may not have rernembered otherwise or remembered differently? Please explain.

d) As a result of the previous interview, do you think your body pain or physical syrnproms make more sense? e) Do you think including your body expenence rnight be important for healing or psychological integration?

f) In your experience, how is focusing on your body to explore mernories different from a conventional (verbal) psychotherapy? g) Did you feel safe in the session? h) If you have a background in both verbal and body-orieoted psychotherapy, how would you describe the difference? Appendix E Interview Scheduie

Follow-up Interview One Year Later

Interview 3 - Reflecting on the Experiential Session a) Where are you currently in your healing process? b) What are your thoughts and feelings about your experience in the previous interview? c) What was most important to you or most mernorable about what happened in the first interview? d) As a result of the previous interview, do you think your body pain or physical symptorns make more sense? e) Do you think including your body experience might be important for healing or ps ychologica1 integration?

9 In your experience. how is focusing on your body to explore mernories different from a conventional (verbal) psychotherapy? g) Any other comments?