The psychotherapy of place

How we are in the world emerges from the matrix of mindbody and place. Although it seems very obvious that where I live or grew up will influence how I feel or even who I am, that reality is largely neglected by psychotherapy. The traditional Freudian model focuses on individuals caught in Oedipal family relationships and place is all but ignored. Psychotherapy in general seems to have forgotten embodiment, although there are notable exceptions like Focusing, body therapy and some Existential approaches. But even in the more embodied psychotherapies, place is rarely discussed. The term embodiment implies place – we are all embodied somewhere – but it often seems that those working with embodiment treat place as a mere background, an adjunct to the important business of having a body.

Merleau-Ponty suggests that we have “a knowledge of place which is reducible to a sort of co-existence with that place” (2002 [1962]). It’s not that I am sitting in my room – I am in a co-existence with that space. Gendlin is even more radical: the body “is an ongoing interaction with its environment” (Gendlin, 1992). To be clear, there isn’t a typo there: Gendlin isn’t saying that the body is in an interaction, but that the body actually is that interaction.

Ecopsychology engages with the wider world, and ecotherapists might well ask about a client’s relationship to nature. But how often do therapists consider the places that we live in more generally? We typically ask about siblings, parents, intimate partners and the like, but when do we wonder about the everyday landscape of our client’s lives? “How do you feel about your home? What’s your local area like? Do you drive to work, walk or take the bus? Where did you play as a child?” If ecotherapy is about the environment rather than just the ‘natural’ world, (whatever that means), these questions are vital.

Clients sometimes talk about the fields they played in as children, how they feel when they wake up in the familiar space of home or what the corridor outside their flat means for them. I’m increasingly curious about these things, perhaps because I’m aware of the importance of this dimension of our existence. Where do we go with this? Ecopsychology has opened new pathways and my Focusing practice is sensing into this edge. There are also clues in the work of Gaston Bachelard, who proposes a new strand of psychoanalysis he calls topoanalysis. Topoanalysis “would be the systematic psychological study of the sites of our intimate lives” (Bachelard, 1969 (1958]). I haven’t had time to study Bachelard yet, but watch this space.

Forests and minds

My work as a psychotherapist sometimes leads me to imagine the mind as like a dark forest. Such metaphors have a rich history, and Inger Birkeland comments that place in general “is a concept that mediates between body and mind, nature and culture” (Birkeland, 2012).

For some indigenous peoples – and in many myths – forests are liminal places that offer the potential for change. These ancient motifs are widespread in our culture: Shakespeare’s As You Like It it came to my mind today, and serves as a rich example. In the play the Forest of Arden becomes a mysterious place away from the civilized city where dramatic transformation take place. The play is a complex exploration of contrasts and conflicts; forest/city, nature/civilization, masculinity/femininity, child/parent, love/hate. Shakespeare doesn’t provide simple resolutions of these confrontations, but leaves us to make of it what we will – as you like it, indeed.

trees_damp_21_rt_blog

The dark forest can serve as a metaphor for the inner world that the psychotherapist and client explore together. In our wandering we must accept the reality of the unknown without fearing it. There may well be something frightening in the darkness, but finding it could be transformative. We need to feel our way through the trees, not blast at the darkness with the cold analytic beam of an electric torchlight. And as joint explorers of this forest, we must stay close.

This metaphor offers some valuable insights for psychotherapy. The therapist needs to feel safe with the unknown and not try to push it away prematurely with the intellectual light of theory. Instead, the therapist stays close to the experience of their client, helping them feel their way towards change.

CBT: The ‘gold standard’ for therapy?

Cognitive behavioural therapy (CBT) is like Marmite for many therapists. Some emphasize the research results which arguably show that it’s the “gold standard of the psychotherapy field” (David, Cristea and Hofmann, 2018). Others, like Richard House, see it as a “therapeutic technology” backed by a research regime that misses vital aspects of therapeutic practice; “subtlety, intuition, discernment and ‘the tacit’ in human relational experience” (2010).

Given that my original therapeutic training was with two of the most vehement critics of CBT – Richard House and Del Loewenthal – it seemed odd to some colleagues that I completed a Professional Certificate in CBT. One jokingly suggested that I’d “gone to the Dark side”!

At first CBT didn’t sit well with my existing approach, which is very much grounded in those qualities Richard extolled; subtlety, intuition and tacit embodied knowing. But I sensed that there was something of value here, notably because I’d unwittingly used CBT techniques to tackle my own anxiety in the past. Several years ago I started getting anxious about whether I’d locked the front door. I’d be about to cycle off to work when the thought would come: ‘Did I lock the door properly?’ My rational mind knew very well that I had: I’d  been successfully locking my front door every day for years! But the doubt nagged at me. The first couple of times I went back to check and it was, of course, fine. But I knew this wasn’t right because I was pandering to my irrational concerns. So I stopped checking. Sometimes it was quite hard. That voice in my head said: ‘It’ll only take a second to check, and then you won’t have to worry any more.’ I countered that with reason: ‘There’s no need to check. I already know it’s fine’. That’s a classic CBT approach and it worked very well: The worry went away instead of growing into full blown OCD!

But CBT doesn’t work for everyone. I’ve had several clients tell me that they tried CBT and it just didn’t work for them. Typically their CBT was provided on the NHS and the therapist didn’t know any other way of working. Why bother to learn anything else when CBT is the “gold standard”? This is part of the reason why CBT has such a bad name amongst some therapists: CBT is presented as the solution in a ‘one size fits all’ approach.

There’s some evidence that CBT is becoming less effective. A paper from 2015 looked at 70 CBT trials and found that the impact of the treatment for depression was falling (Johnsen and Friborg). The authors suggest several possible reasons for this decline, with the most likely being a reduction in therapist competence. What made CBT so attractive to the NHS was that it can be done by the book. In theory anyone who knows how to follow a step-by-step guide and can demonstrate the exercises to a client can be CBT therapist. But we know from extensive research that technique contributes no more than about 20% to the outcome of therapy. Those vital elements that Richard House highlighted above – subtlety, intuition, discernment and tacit knowing – are much more important.

I’m pleased I persevered with CBT. My trainer – a therapist with many years of experience – emphasized that CBT works best when it’s used creatively by an empathic, open minded therapist. It also opens the door to further training with the ‘third wave’ of CBT that integrates it with mindfulness.

CBT isn’t just one more technique in my ‘tool box’: It’s more like another pattern to weave into the rich tapestry of my therapeutic practice. As Richard House points out, the key to good therapy is how it’s practised, not which techniques are used (ibid.). To put it more crudely, it’s not what you do, it’s the way that you do it!

Focusing in Nature

Put simply, Focusing is a means of opening our awareness to the “bodily sensed knowledge” which Eugene Gendlin calls the “felt sense” (Gendlin, 1981). The term ‘felt sense’ describes those fuzzy feelings that we don’t usually pay much attention to – those vague ‘gut feelings’. As you become more aware of a felt sense it will often open like a bud, revealing an otherwise hidden embodied knowing. I discovered Focusing when I was doing my PhD research and it’s become central to my spiritual practice and personal wellbeing. It subsequently become the foundation for my psychotherapy when I trained as a Focusing Oriented Therapist.

Focusing is usually done indoors, but it occurred to me that it would be interesting to see what happened if I tried it in nature. It’s an obvious step and  it came as no surprise that other people were already doing it. What did surprise me was how powerful it could be. My first experiments were a revelation:  Focusing in nature quickly softened the perceived barrier between ‘me’ and ‘the world’, enabling a much more intimate relationship to place.

A boat sits on a still Loch at dawn

This was amazing! In minutes I could get a deep sense of connection to the natural world. Was it just me? I read about other peoples experiences and did some interviews. Although different people had different experiences, that sense of profound connection came up again and again.

As Deep Ecology has noted, that connection is fundamental to changing our environmental behavior. Herbert Schroeder, an environmental psychologist working for the U.S. Department of Agriculture Forest Service found that Focusing in nature “was a first step toward articulating the ineffable, experiential value that natural environments have for me” (Schroeder, 2012: 141).

There’s much more to be said and done. If you’d like to know more, see my article, Gendlin and ecopsychology: focusing in nature in the Person-Centered and Experiential Psychotherapies journal.

The Embodied Pathways of Connection in Therapy

My previous post introduced the EPOC, embodied practices that can reveal our radical interconnectedness. I initially came across the EPOC during my PhD research into spiritual eco-activism: The EPOC both inspired and supported the campaigners I worked with (Harris, 2008). Years later I noticed something curious; the EPOC I’d identified amongst road protesters seemed to underpin much of psychotherapy!

That may initially sound implausible, but the deeper I’ve looked into this apparent link, the more sense it makes. My research with activists identified seven EPOC; nature connection, meditation, Focusing, ritual, dance, trance and psychedelics. These seven all map to psychotherapeutic practices:

  • nature connection is the foundation of ecotherapy;
  • mindfulness meditation is at the heart of third wave CBT;
  • Focusing is a therapeutic practice;
  • psychedelic psychotherapy may be the next big mental health breakthrough;
  • dance therapy has been around since the mid-60s’;
  • ritual is widespread in psychotherapy, while
  • trance is an altered state of consciousness which is common in psychotherapy.

This is a big subject, but there’s two points I can make about how the EPOC function in psychotherapy. First, the EPOC facilitate access to embodied knowing and that process is fundamental to how psychotherapy heals. Second, they can dramatically widen our perspective: If you’re focusing too much on your own mental processes, mental distress is often the result.

John Kabat-Zinn launched the therapeutic mindfulness revolution that’s transformed the lives of millions. He believes that connection is fundamental: “the quality of the connections within us and between us and with the wider world determines our capacity for self-regulation and healing” (Kabat-Zinn, 2013).

Many Focusing Oriented Therapists speak of that connection too: “Focusing allows our consciousness to settle into that area in ourselves where there is physical in-binding with the rest of the cosmos” (Campbell and McMahon, 1997).

Research into how psychedelic psychotherapy works has come to the same conclusion: “a sense of connectedness is key” (Carhart-Harris, et al, 2017). The theme of connection also runs through dance therapy: Connecting the mind and body, the conscious with the unconscious, the self with the other (Halprin, 2002).

This leaves ritual and trance, which are both complex and multifaceted. I’d argue that ritual is fundamental to many psychotherapeutic approaches and my experience of psychoanalysis felt deeply ritualistic. But for the moment, I’ll be more specific and reference Family Constellation Therapy (FCT) which explicitly draws on African healing ritual. FCT is based on the notion of the ‘knowing field’ a web that “propagates information and affect through the family and ancestral network” (Adams, 2014). That sounds strange to Western ears, but accords very well with Eugene Gendlin’s claim that “Your physically felt body is in fact part of a gigantic system of here and other places, now and other times, you and other people. In fact, the whole universe” (1981).

Trance is much more common than many of us suppose: When you’re watching a film or reading a novel, you’re most likely in trance. Hypnotherapy is of course the most obvious use of trance in psychotherapy but it’s arguably more fundamental. Furthermore, nature connection, meditation, Focusing and psychedelics can all induce an altered state of consciousness which we might call trance. On that basis, trance can certainly facilitate a sense of deep connection. There’s also a powerful association between psychotherapy and shamanism which gives trance a central role (Thalhamer, 2015). Boundaries get very blurred at this point because Shamanism is intimately engaged with nature connection and can include aspects of meditation, Focusing, dance, ritual and psychedelics.

We’re now close to the place to which these embodied pathways of connection all lead. For Glen Mazis this place is about ‘earthbodying’; Philip Shepherd names it “radical wholeness” (2017); David Abram might speak of participatory perception (2010), while Susan Greenwood writes of “a heightened awareness of an expanded connected wholeness” (Greenwood, 2005). For me this place is characterized by a particular kind of embodied knowing, the “wisdom of the body; that all things are ultimately one” (Harris, 1996).

The Embodied Pathways of Connection

What links mindfulness, psychedelics, nature connection, ritual and the therapeutic technique of Focusing? They can all help us access to our deepest embodied knowing and awaken us from the illusion of separation. For Thich Nhat Hanh, a Buddhist monk and lifelong peace activist, the purpose of our existence is “to awaken from our illusion of separateness.” But how?

Meditation is one path, and John Danvers wrote that mindfulness is a tool for coming to “fully realise that we are relational beings in a relational universe” (Danvers, 2016). John describes an experience where mindfulness allowed his fixed sense of self to dissolve:

“the egocentric, unitary, ‘I’, wasn’t there. Instead a different state of being was at work (or at play) – as if the edges of myself were dissolved into the surrounding space. It felt like there was no separation between me and the world” (2016).

Gail Bradbrook felt an inner stuckness for years. She was passionate about social change, but none of her campaigning efforts had really taken off. So Gail headed off to Costa Rica to experience the healing power of psychedelics – AKA enthogens – including Ayahuasca. She had heard reports of how “people on psychedelics report a deeply felt sense of peace, oneness and unity with the planet” (Bradbrook, 2019). The experience was transformational and on her return home Gail co-founded Extinction Rebellion.

Throughout the ‘60’s and ‘70’s Robert Greenway led groups on multi-day treks into the wilderness. He found that spending several days in wild nature could have a “profound impact on the psyche”. People typically had “feelings of expansion or reconnection” that he identified as spiritual (Greenway, 1995). I’ve written about this wilderness effect elsewhere, but it’s important to note that spending even a brief time in nature can open our awareness of deep connection. Claire Thompson describes her experience of watching a dramatically beautiful sunrise:

“I didn’t realise until afterwards, but my sense of self was absent. I was simply absorbed by the intrinsic wonder of the view and intimately involved in deep contemplation of the pure grace and delicate beauty of nature. I was an integral part of the scene” (2013).

Loch Voil

Ritual is one of the most ancient, powerful and widespread pathways to connection. In Sacred Ecology I wrote that being “part of a powerful ritual” can enable us to “come to the wisdom of the body; that all things are ultimately one”. A lot depends on the intention of the ritual and the integrity of those who facilitate it, but it’s no accident that members of my local Extinction Rebellion group will lead a Summer Solstice Ceremony this evening to support the movement.

I’ve often written about Focusing and Eugene Gendlin, the philosopher and psychotherapist who developed it. In essence, Focusing is a process of sensing into the body, curiously open to what meaningful sensations might be there. Many people have walked this pathway of connection and Herbert Schroeder is a good example. Herbert was working as an environmental psychologist for the US Department of Agriculture when he began experimenting with Focusing in natural spaces. He experienced “an inward, bodily sense of myself expanding out into space, as though the boundary separating myself from my environment had become relaxed and permeable” (2008).

How can practices as diverse as Focusing, ritual, meditation, taking psychedelics and walking in nature have such dramatic – and similar – effects? Gendlin gave us a key part of the answer when he wrote that the “physically felt body is in fact part of a gigantic system of here and other places, now and other times, you and other people – in fact, the whole universe” (1981). Gendlin, like many other thinkers, recognized that we are not the isolated individuals of our cultural myth.

The quotes above all speak of connection, relationship, expansion and the dissolution of boundaries. Although they’ve taken different pathways, they seems to be arriving at the same place; the wisdom of the body that revels what Thich Nhat Hanh calls the “illusion of separateness”. Mindfulness, psychedelics, nature connection, ritual and Focusing are all pathways that lead us to deeper connection. Crucially, they are all part of our embodied experience. These then are embodied pathways of connection (EPOC). There are other EPOC, some of which I’ve already identified; trance, dance, sex and sensual experience. Others are still to be recognized, so if you think there’s an EPOC I’m missing, I’d love to hear from you.

In my next post I’ll explore the role of the EPOC in therapy.

Eugene Gendlin

Writing a PhD thesis on embodied knowing was a tricky task and at times I doubted that I could research something so nebulous. My big breakthrough came when I read the work of contemporary philosopher and psychologist Eugene Gendlin.

Eugene Gendlin

Gendlin describes a “bodily sensed knowledge” which he calls a “felt sense” (Gendlin, 1981). I’d bet you’ve often had a felt sense: They’re those fuzzy feelings that we don’t usually pay much attention to – a vague ‘gut feeling’ about something or that odd sense of unease we’re feeling when we say ‘I just got out of the wrong side of bed this morning’.

You need an intuitive understanding of the felt sense to really understand Gendlin’s work, so I’ll give a few more examples. Imagine you are at a party and you spot someone that you have ‘a bit of a history’ with. How might that feel? Maybe some butterflies; maybe some vague memories – A mixture of things. That whole mixture is a felt sense. On a lighter note, imagine you’re taking a walk on a beautiful fresh morning, just after a rain storm. You crest the brow of a hill to see a perfect rainbow on the horizon. As you stand gazing at it, you might feel your chest fill with an expansive, flowing, warm feeling. That feeling is a felt sense. So it’s familiar and simple enough: A felt sense is a physical feeling that carries some meaning for you.

It’s not always easy to say what that meaning might be, but it’s worth trying to find out because the felt sense often carries deep embodied wisdom. As Gendlin says, “your body knows much that you don’t know” (Gendlin, 1981). Anyone can learn to access and verbalise the embodied knowing of the felt sense using a simple technique called Focusing (Gendlin, 1981).

In common with many others I’ve mentioned on this blog, Gendlin thinks that the body extends beyond the skin into “a vastly larger system” (Gendlin, 1997). In fact the body “is an ongoing interaction with its environment” which means that the felt sense can access “a vast amount of environmental information” (Gendlin, 1992). Gendlin’s ideas are fundamental to my cognitive iceberg model and help make sense of the work of philosophers like Andy Clark and David Abram. Given all that, perhaps it’s no surprise that I consider Gendlin to be the most significant thinker I’ve ever read.

Glen Mazis & David Abram discuss embodied ecology

Last year I was invited to host the ecology thread for the 2018 Embodiment Conference. Who would I recommend to speak on the subject of embodied ecology? Two thinkers immediately came to mind who have been a huge influence on my own work: Glen Mazis & David Abram. This podcast brings them together in a fascinating dialogue. After a brief introduction, I sit back to enjoy a journey through embodied ecology guided by these poetic philosophers. The core theme is, I think, participation. Glen points out that “The world is in your body and you’re feeling what it’s telling you”. David develops that idea with his suggestion that “to be a body is to be entangled, enfolded and infused with so many other bodies, most of which are not human”.

Both of them are fascinated with imagination and language. David points out that “our bodies are imagining the world constantly … Imagination is an act of the sensing body itself, all the time. We are creatively adding to to what is immediately given in the world”. Glen develops this idea when he speaks of how poetry is “a way of using language that tells you, no, you can’t stay just in the web of words, you’ve to go back to your fleshly experience”.

Glen and David explore many of the topics I’ve touched on in this blog – Merleau-Ponty, deep ecology, embodied knowing – and then follow the path into sensuality, language, climate change and eco-trauma. David beautifully expresses the pain: “To taste the world with our creaturely senses all open and awake is to feel a world that it is filled with wounds”. Glen identifies the danger here: “There’s the cycle of hurt and violation … that takes you further away from the resources you need”. But this source of pain is also the root of healing. For David “that edge of grief and pain is just a threshold, and if we step thorough that threshold without flinching from it we come into a world of wonders”.

We all agree that nature connection, opening “to the more-than-human world is the path to healing”. This is a very familiar route for some of us, but as Glen points out, it can be a rough walk and many people will need support along the way. However, he adds, “As soon as they open themselves, it’ll be self-affirming because the world is a nourishing place”.

Related resources:

Psychedelic psychotherapy: The next big thing in psychiatry?

The UK Home Secretary has announced a review of cannabis for medicinal use. Does that bring psychedelic psychotherapy a step closer? When LSD was synthesized back in the 1950s psychiatrists were quick to see its potential. Research proliferated over the following decade, producing over 1,000 peer-reviewed clinical papers. The results were overwhelmingly positive and “psychedelic therapy was truly considered the next big thing in psychiatry” (Sessa, 2017).

So what went wrong? Several factors came together to stop what could have been a revolution in psychotherapy. Millions of people were taking LSD recreationally, and perhaps inevitably there were casualties. Psychedelics open us to experiences that the more reactionary elements of society find weird at best and even threatening, so it’s no wonder that the press leapt on any negative news. Psychedelics like LSD are the most powerful mind changing substances that exist and deserve to be treated with respect. There are a few basic principles to using psychedelics: Are you in the right mental state to take them? Is this the best place and time for the trip? Carefully considering these essentials – commonly known as set (mindset) and setting – will very much reduce the risk of a ‘bad trip’. In a psychotherapeutic context set and setting are carefully controlled and the whole process is facilitated by a trained professional.

A second factor was the rise of antipsychotic drugs which led to less emphasis on outpatient psychotherapy sessions. Someone with a more conspiratorial turn of mind might also point out that psychedelic psychotherapy promised a permanent cure for many mental health disorders. People who are cured don’t need a daily dose of expensive drugs to keep them feeling (kind of) OK.

The psilocybin molecule

The good news is that research into psychedelic psychotherapy is undergoing something of a renaissance. Clinical research using psilocybin (the active ingredient of ‘magic mushrooms’), MDMA (ecstasy), ketamine, ayahuasca and LSD is ongoing. Psilocybin looks especially promising. A recent review of seven clinical trials found “large effect sizes related to improved depression and anxiety symptoms” (Thomas et al.) The results overall are encouraging: Psychiatrist Dr. Ben Sessa concludes that psychedelic psychotherapy “is a cost effective way of treating otherwise unremitting mental illness” (Sessa, 2017).

Why is psychedelic psychotherapy so effective? According to one influential paper, one of the key processes is a shift from “disconnection (from self, others, and world) to connection” (Watts et al., 2017). I’m hugely excited by all this, not least because there are some parallels with my PhD research. My research suggests that what inspires and supports many environmental activists is a profound sense of connection. The experience of living close to nature and practices like mindfulness help facilitate this, as does the use of psychedelics like psilocybin. Could it be that a sense of connection – or reconnection – is the underlying mechanism behind our sense of wellbeing?

The power of place: Protest site pagans

Research has established that spending time in the wilderness can have profound effects on people. This “wilderness effect” (Greenway, 1995) usually occurs in truly wild places like the Grand Canyon, but my research shows that it can work its magic in more urban environments.

Home comforts

I describe this process in my article on ‘The power of place: Protest site pagans’, which has been published in the European Journal of Ecopsychology. The article expands on several themes I’ve explored here, notably Eco-Paganism, the spirit of place and the cognitive iceberg. It’s based on my research with protest camps activists and describes how spending extended periods of time in nature can catalyse profound personal change.

The article also explains the model of embodied situated cognition that I’ve described as ‘the cognitive iceberg’ in several posts. In the last section I use the cognitive iceberg model to provide a partial explanation for how the wilderness effect works. I think it works really well as a companion piece to my chapter in The Wanton Green, which was published in 2012.