Weaving the Threads of Body and Mind: Combining CBT, DBT, IFS, EMDR, Somatic Experiencing, Sensorimotor Psychotherapy and Yoga for Embodied Recovery.

Klinger, Deborah

Saturday, March 24, 2018: 8:30 AM-10:00 AM

Congressional (Omni Championsgate)

Background: An eating disorder is a war within one's self, and the body is the battlefield. Recovery requires a shift from viewing the body as an object-- size, shape, weight to be controlled-- to becoming embodied: experiencing life through the five senses, and one's self via sensations as well as emotions and thoughts. Combining "Bottom Up" strategies with traditional "Top Down" approaches to therapy supports healing trauma, developmental wounding and other factors contributing to eating-disordered behaviors and attitudes, as well as changing distorted beliefs about food and body, and the body paradigm to a compassionate relationship with a wise partner.

Objectives: 1. ...the polyvagal theory of the autonomic nervous system, the concept of the Window of Tolerance, and mindfulness of internal experience. 2....the application of somatic principles and "bottom-up" strategies to traditional "top-down," cognitive and behavioral-focused approaches (e.g., including "Body Mind" in DBT), and other therapeutic modalities. 3....clinical interventions for teaching clients self-regulation skills and helping transform their relationships with their bodies-- moving from objectifying and seeking power over them to becoming embodied: experiencing themselves and life around them through their bodies, and practicing self-respect by listening and tending to their bodies.

I. “Psycho” means “mind.” Why the body in psycho-therapy?

A. The Autonomic Nervous System: Connector of Brain and Body

1. The Triune Brain

a. Brainstem (Reptilian brain)

b. Limbic System (Mammalian brain)

c. Neocortex

2. Steven Porges’ Polyvagal Theory

a. The Sympathetic Nervous System: fight, flight, freeze

b. The ventral vagal branch of the Parasympathetic Nervous System: social engagement

c. The dorsal vagal branch of the Parasympathetic Nervous System: submit, collapse, dissociate

3. Animal Defensive Systems and Early Childhood Attachment

a. Safety and danger

b. The Window of Tolerance

4. Experiential Exercise: Mindfulness of sensations and movement impulses

B. “Top-Down” v. “Bottom Up” Approaches to Treatment

1. Traditional Talk Therapies: Top-Down

2. Somatic-based Approaches: Bottom-up

3. In the middle: Emotions are called “feelings.” How do we know we’re feeling what we’re feeling?

4. And what’s yoga got to do with anything? An ancient practice that balances the nervous system

5. Experiential Exercise: changing experience with somatic resources

II. Weaving the Threads

A. CBT, ACT and DBT

1. Why do beliefs feel true? Why doesn’t logic change them?

2. Finding urges and values in the body

3. What about Body Mind?

B. Internal Family Systems and EMDR

1. Understanding ego states and finding parts in the body

2. Protective strategies

3. Working with the Window of Tolerance

C. Tracking ourselves when we sit with clients

D. Experiential exercise: noticing protection and vulnerability in the body

III. Eating Disorders and Body Image

A. Conceptualizing Eating Disorders from a Bottom-up Perspective

1. Being fed is probably the first thing that ever happens to us (that is, after we’re squeezed out into a strange, new world).

2. We start out embodied: we feel before we can think

3. Eating disorders as protective strategies: attempts at self-regulation

B. The Body as the Battlefield

1. How did we get from embodied to objectifying?

a. Pin the Tail on the Body: the body as symbol and container

2. Taking back what was once ours: becoming re-embodied

a. Making it safe to feel

b. Mindfulness of sensation

c. Treating yourself like you matter

IV. Discussion/Q & A

We humans are mammals. Our brains are connected to our bodies via the autonomic nervous system. As infants, we experience ourselves and the world around us through our nervous systems. We feel before we can think. Our nervous systems allow us to receive and relax into the safe, loving embrace of a caregiver. We automatically whimper and cry in response to the discomfort of hunger, alerting our caregivers to feed us. Secure early attachment gives us a big "window of tolerance": we can get startled and quickly calm down. As we grow, our emotional brain comes on line and we feel the light-heartedness of joy and the heavy-heartedness of sadness. But if circumstances are such that emotions become overwhelming, we find ways not to feel them. If this happens to someone who is vulnerable to developing an eating disorder, food becomes, rather than sustenance for their well-being, a means of altering feeling states and the body, an object that means something about their worth, to be molded into the right size and shape. Healing an eating disorder involves recovering that connection to the body and restoring wholeness. Traditional talk therapy focuses on thoughts, behaviors and emotions. It uses the executive function part of the thinking brain to generate insight and understanding and change damaging behavior. This is known as "top-down" processing: since the thinking brain is the last to develop, it's the "top," with emotions in the middle and sensations on the bottom. Working "bottom up" begins with using mindfulness to notice present-moment experience, including body sensations. This supports increasing non-judgment and the ability to tolerate discomfort, and shifts the relationship with body from object to home base-- becoming re-embodied. Somatically-informed interventions decrease distress and enable clients to safely feel the affect neccessary to resolve trauma and developmental issues underlying the disordered relationship with food and body. Therapists using other modalities can incorporate body-based principles into their existing approaches. In this workshop, I'll demonstrate how to weave concepts and techniques from Somatic Experiencing, Sensorimotor Psychotherapy and yoga together with other therapeutic models, including CBT, DBT, ACT, IFS and EMDR.

Primary Presenter:

Deborah Klinger, M.A., LMFT, CEDS-S

Deborah Klinger, M.A, LMFT, CEDS-S, is in private practice in Durham, NC. She is an AAMFT Supervisor Candidate, certified Phoenix Rising Yoga Therapy practitioner, graduate of the Trauma-Sensitive Yoga certificate training at the Trauma Center at JRI, and teaches yoga for trauma, and her own “Love Thy Body: Yoga for Eating and Body Concerns.” She is combines DBT, IFS, Somatic Experiencing, Sensorimotor Psychotherapy, and EMDR for a holistic, body-mind approach to healing. Deborah is a seasoned presenter, is published in “Eating Disorders: The Journal or Treatment and Prevention” and was the Eating and Food Issues Topic Expert for goodtherapy.org

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