Welcome to the MindBodyCouple podcast.

I'm Tanner Murtaugh and I'm Anne Hampson.

This podcast is dedicated to helping you unlearn chronic pain and symptoms.

If you need support with your healing, you can book in for a consultation with one of our therapists at painpsychotherapyca or purchase our online course at or purchase our online course at embodycommunitycom to access in-depth education, somatic practices, recovery tools and an interactive community focused on healing.

Links in the description of each episode.

Hi everyone, hi everybody, welcome, welcome, welcome.

So today's topic, somatic therapy, explained, feel away your symptoms.

Yeah, and I like this topic because I think there's more and more discussion about the importance in feeling versus thinking.

Not that thinking is wrong or bad, and we'll talk about that more.

Yeah, we're going to really break it down.

So well, thoughts and beliefs about the body matter.

We know this.

You can't think away your chronic pain, illness, dysregulation and trauma.

It's also necessary to build safety in the body, with sensations, with emotions and with your nervous system responses.

So I think today's episode is going to bring people a lot of value.

It's going to break this down because I can say definitively on my YouTube channel probably I get four or five comments a week being what the heck do you mean somatic or drop into your body?

And I get it Like it's confusing.

I think people gravitate towards the thoughts and beliefs because they're very, they feel more concrete.

Totally.

Yeah, where when we talk about like somatic, it feels really abstract.

Yeah, yeah, and it can feel very you're right abstract and hard to almost hard to reach or grasp.

So I agree, In today's episode we're going to break down the difference between top down therapy.

So I agree, in today's episode we're going to break down the difference between top-down therapy, so approaches like CBT, talk therapy and bottom-up therapy, and by the end of this episode, you're going to understand why, for chronic pain, trauma and nervous system dysregulation, focusing on the mind isn't enough.

Also, stick around till the end of this episode because I'm going to provide a free embodiment practice that you can start to use right away.

All right, so let's start then, Tanner, with talking about top-down therapy.

So, if we want to define it, it might look like approaches that focus on thoughts or cognition which influence our behaviors, emotions and physical sensations, and I totally read that.

But I wanted that piece in there because I think it really well describes that top-down approach.

Yeah, because a lot of people when they get into the self-help, the therapy world which is great, I think therapy can offer so much benefit for people, especially for people with chronic pain and illness.

But what you're going to see is most therapists are using a top-down approach.

The big one is cognitive behavioral therapy, or CBT.

It is the most well-researched therapy out there and it's been used for decades.

So most therapists when they're going through school, like when we were in our graduate degree, it focused a lot on CBT because it's kind of the gold standard that's being provided Now top-down approaches.

It could include narrative therapy or other traditional talk therapies.

So the goal here is to help clients change their thinking habits and shift their perspective to think in more helpful ways and do better.

Now the idea here why we call it top-down is you're changing your thoughts or cognition with the hopes that it's going to change your emotional state and your nervous system state Top-down.

And I very much support that approach.

I talk with clients about that a lot and so we want to kind of say in this podcast we're not against that approach.

We're just talking about how you need a bit more or both when it comes to chronic pain.

Yes.

Now bottom-up therapy how we would define this are approaches that explore sensations in the body or nervous system, noticing how these influence your thoughts and behaviors.

So examples might look like somatic experiencing mindfulness, polyvagal informed therapies, many forms of trauma therapy which encourage body connection and awareness.

Yeah, and in our approach, we definitely favor this side of things.

Our digital course is called the Somatic Safety Method.

Yes, it has some top-down within it.

That's vital, but we're really focusing on this bottom-up Because when I've worked with people and they really focus more in this area this bottom-up approach I see people getting more focused, more intense changes and more long-lasting changes, and so here, really, the goal is to help clients regulate the nervous system by reconnecting with the body, expressing emotions and restoring safety with all physical sensations.

Now, an effective therapeutic approach, in my opinion, includes both elements.

It includes the top down and includes the bottom up.

Well, I think a good question to ask yourself, if you're kind of involved in this work, is where do you fall?

Are you focusing just on top?

Are you looking at that bottom up approach, kind of where are you leaning?

And maybe there needs to be a shift to a more balanced approach.

Yeah, because you know there's therapy models that just focus on one or the other and again, I'm not knocking these I think they bring a lot of benefit.

Like CBT is really top-down.

Somatic experiencing would really be exclusively bottom-up.

But if you consider something like pain reprocessing therapy, which we really value in utilizing with clients, there are some helpful top-down actions, such as gathering evidence that your symptoms are neuroplastic, there's no physical or structural damage, you start to think differently about your health and your body.

You're gaining a sense of hope and confidence that you can heal and people ultimately just start to think differently about what activities and behaviors are safe versus dangerous.

So pain reprocessing therapy does have this top-down approach, but it also includes some very helpful bottom-up actions, such as engaging in somatic tracking to restore safety with physical sensations and exploring and expressing emotions.

Now, in our work at our clinic and in our online course, we go even further with the bottom-up practices.

We understood early on in doing this work with people that many of our clients experienced trauma, trauma and chronic pain and illness.

They're best friends.

Unfortunately, we know that even if you had a single traumatic event decades before your pain or symptoms ever came on, that you're more than twice as likely to develop chronic pain and symptoms in the future, so it's more than double.

And because of this we started to understand that this bottom-up approach was really valued, because we needed to help people recognize sensations of dysregulation, notice when they're having fight, fight, freeze, fawn energy and help them process past memories, recall past events and stay present in their body as they're doing this, so that they can lead their nervous system back to safety.

This desensitizes trauma and it's going to desensitize chronic pain and chronic symptoms.

And I think something we really focus on with people is recognizing and understanding their own unique safety signals.

Mm-hmm, I think this is so vital because it's something I cover with people early on.

Yeah, me too is so vital because it's something I cover with people early on yeah, me too, and in our course it's early on in the modules because the safety signals that work for me are different safety signals than work for Anne.

That's right, and we talk about like in the course as well.

But with people that we're working with we talk about both kind of cognitive safety signals and that somatic safety signal as well.

Yeah, so we can have this like safe self-talk, which is the more of this cognitive safety that we're giving.

But there's also more of this bottom-up kind of safety signals, which can include breath, work, visualization.

It could be savoring pleasant sensations, certain somatic movements, and we do some tapping and massage with people.

We also have these external safety signals that work for people.

Anne's number one external safety signal her horsey.

Oh my God, you don't say horsey, horsey.

Oh okay, stop it.

Yeah, Me and Anne have this ongoing joke.

Well, actually I have the ongoing joke.

Anne's just irritated with me, like right now, right now.

Anne's a little irritated with me right now.

We'll create some safety for you after this, don't worry Okay.

Whenever Anne starts to talk about a better horse, I just start to neigh, Neigh oh my God.

I can't believe you're doing this right now.

It's so good, anyways, but our point with bringing that up is that's an example of an external safety signal.

For me, yeah.

So when I am out with my horse, even talking about my horse, that creates a sense of safety, calm, comfort, all those pieces for me.

Yeah, and this is the idea that we really value is we're helping people attend to dysregulation inside, but we're also kind of creating safety as we go.

And so when we talk about a somatic approach, we've given you some highlights here already, but we just want to break this down because you're probably wondering what does this practically look like?

Yeah.

As we said, it's going to be really abstract and I think that's why people shy away.

And the reality, whether we like it or not and I had to learn to like it Therapy and somatic work is abstract.

I'm going to explain generally what this looks like, but what somatic work looks like for me is different than what somatic work looks like for Anne or for any of you listening.

So an effective bottom-up approach contains two key elements.

The first is exposure.

We need to drop in and describe the physical sensations within.

When we feel things that are unpleasant, we run for the hills, we want to get out of here.

That's just our normal human instinct.

A great example of this here's a you're going to appreciate this example Our daughter.

She's five.

A great example of this here's a you're going to appreciate this example oh my goodness our daughter mm-hmm she's five and she does this thing like probably like five times a day.

So you know, last night she's we.

The kids weren't listening to us.

Like often.

Like often, this is just our lives.

Yeah, and Anne was like okay, you both have to go upstairs now, like it's time for bed, and drew the line she was firm.

Kind but firm.

Yeah.

And our daughter started to cry and then what she does is she gets angry with her stomach.

Yeah, she's got good body awareness.

She starts to be like my stomach's making me cry and it's such a great example of.

She has two therapist parents so she's never going to get more support and emotional awareness in her life, but she still hates anything that feels unpleasant within yeah and gets angry with her stomach for making her feel anything interestingly, she also gets mad when our stomach makes her laugh yeah so she's noticing the mind body connection and maybe the discomfort of positive or like negative emotions, but the sensation in the belly Well, that's what it is.

I think when she lasts for too long, she starts to not like it.

But this is it.

It's this.

First element that you need to do is exposure, where you're dropping in, you're approaching and you're describing the sensations.

Right.

So we really want to recognize it and spend time with it, hang out with it.

And then you want to like deepen that connection, you want to get to know all the subtleties taking place.

I find with a lot of people, for example, when they feel anxiety, they focus on that one point.

That's so extreme, but there's all these more subtle sensations that are occurring around it.

Like often I'm asking people you know, where does the anxiety fade out in your body?

Where does the sensation start to fade out?

What's behind that intense sensation, like if you get a little bit more deeper into your body, what does it feel like?

Another great question I ask is what's the shape, size, color, texture, like really being curious and interested of anything that feels unpleasant within Now?

A key to the exposure is what we call staying in the healing window.

Yeah, yes, we want people to approach unpleasantness, but at some point it's going to get too much.

And that'll look different for everybody.

Yeah, there's a window and Peter Levine, the creator of somatic experiencing, talks about this.

There's a window where there's the right level of sensation that you can tolerate sitting with, and so if your sensations are really high, it's not a good time to drop into your body.

You would want to wait to, for example, for using anxiety.

You want to wait till it's mild to moderate, and you could tolerate sitting with it for five to 10 minutes.

And lastly, repeated exposure reestablishes safety.

Yes, this is key.

Yeah, and this is the part no one likes.

Well, no one likes exposure.

To begin with, no, but usually after we have the exposure, talk with clients, we're like, oh, you have to do this consistently.

Yeah, it's not just an activity you do you know once or one time a day.

Yes, the second element of this bottom-up approach is safety.

And so we kind of chatted about safety signals earlier.

This is where we would bring it in.

Yeah, so you start to use those safety signals while attending to what's unpleasant, because we need the exposure, but we also need to teach our brain and nervous system the exposure to these unpleasant things are actually okay.

Yeah, so safety signals that we might use could be present moment sensing, breath, work, somatic movement, like we mentioned that self-talk, tapping or massage or visualization.

Yeah, and we go back to our daughter example here With our daughter, Anne got these neat things, these cool like rocky things.

They sit on them and they rock side to side.

Which I have to say, tanner is taking credit.

My son thinks Tanner like picked it out for him.

It's like this kind of like seesaw rocking chair type thing.

It's great.

I did it, all you know, of course, but I'm letting Tanner get some of the glory because my son seems so excited that.

Tanner supposedly chose this for him.

Well, you know, you showed me it and I was like, yeah, it's a good idea.

So I was involved.

Oh no, I was involved Anyways.

But yeah, what's good about that, tanner?

Yeah, so when our daughter's crying and upset with her stomach for making her cry, she'll sit on this or she'll sit on and often and just sway side to side.

So she's getting the exposure to crying.

We don't want her to run away from that, but she's also creating safety with this somatic movement yeah, and that's what we want you guys to play around with, and not exactly like sitting on something and rocking, but maybe maybe of like, okay, what feels good to my nervous system, what movement might feel good, for example, when I'm tending to this like difficult sensation?

Yeah, now, another key to creating safety within is what we call shifting.

So you're moving towards difficult sensations such as pain symptoms or dysregulation, towards difficult sensations such as pain symptoms or dysregulation, but then you're also moving back out, towards safety signals.

So there's this shifting back and forth that you can practice.

This idea of going in and out at your own pace that's comfortable to you.

And I want to just break this down because people get confused.

You're shifting your focus, for example, between what feels unpleasant within, such as a tense constructed chest, and then shifting towards what feels pleasant, like your feet on the ground them feeling relaxed and calm and you go back and forth between these two places.

It's a great way to give yourself more ability to get that exposure but also create safety.

Now I want to be really clear with these two elements, exposure and safety.

There needs to be a balance between the two.

I've seen this happen, where some people go intense into exposure.

They're like I'm going to face everything, I'm going to feel my anxiety fully, I'm going to feel my pain and symptoms, I'm going to dive into it, and the reality is is they get incredibly overwhelmed and dysregulated because they don't have enough safety on board.

Now, alternatively, if you're just doing safety and not exposure, like all you do throughout your day is just safety signals, but you're using it at that point as a way to just avoid exposure, right, and then it becomes avoidance.

so there needs to be a balance of like you're getting some exposure but you're creating safety as you do this I think that's a really good point yeah, so, as we promised, I'm going to put a link in the episode description for free embodiment practice for pain and symptoms that I created about a month ago.

This is going to do everything that we talked about today and it's going to make a whole lot more sense as you do it and you get the feel of this abstract, bottom-up approach and find what works for you, really explore it.

And you get the feel of this abstract, bottom-up approach and find what works for you, really explore it.

I find the clients that take off with this and see success in lowering their pain, symptoms and dysregulation.

They explore doing these embodiments practices and all sorts of different ways to find what's unique to them and what works.

So thanks everyone for listening.

Thanks for listening.

Anne's going to go see her horsey now.

Yeah, I am, it'll be nice.

There you go.

I like it, Anne.

We'll talk to you all soon.

Talk to you next week.

Thanks for listening.

For more free content, check out the links for our YouTube channel, instagram and Facebook accounts in the episode description.

We wish you all healing.