How Mental Health Practitoners Can Help More Clients with Somatic Practices

Ani
Hi, and welcome to the Somatic Coaching Academy podcast. Hey, Brian.

Brian
Hello, Ani.

Ani
Hi there. We're excited to bring you episode 66, where we'll be talking specifically about somatic practices and how they can be helpful for mental health professionals.

Brian
Yes, we're on Route 66.

Ani
Route 66. Right.

Brian
So, yeah. All right. I don't know this time. But, okay, we're moving. We're traveling. We're driving.

Ani
I'm actually really excited about this conversation. And, yes, we are driving professions forward, specifically for mental health professionals. There's a lot of mental health professionals who are finding out about somatic practices now. Actually, I don't remember if it was last week or the week before we were talking about how mental health professionals have actually started to incorporate somatic practices throughout the course of the past number of years and how fantastic that's been for the profession. And I think that the incorporation of body-centered practices is something that continues to not only drive professions forward, like with mental health professionals, but also with individual practitioners and the results that they get with their clients and the successes that they can see in their own private practices.

Brian
Yeah. You're right. It was a couple of weeks ago where we talked about the advent of psych professionals, health professionals, starting to use somatic practices somewhere around probably at the '60s and '70s and something like that. Typically in healthcare, in Western medicine, there's a pretty long delay between initiation of a new idea or a new practice, and then the adoption of that practice.

Ani
I would say that's true with a lot of things. I mean, I'm just thinking- We're really talking 50 years now. Yeah, especially with licensed professions, wouldn't you say, with licensed professions?

Brian
Well, I think that actually medicine and healthcare has even a longer trajectory around that. If you look at just the history of medicine, oftentimes just medicine, we're writing textbooks about it, and we're creating schools to teach on it and those types of things, and research being being driven around and funding your research. So typically, I think if you look out there and you talk to medical professionals who've purported new ideas, and you often see it's taken one or maybe even two generations of professionals before you actually see adoption of those changes.

Ani
So you think we're actually starting to see real adoption of these changes now? Is that what you're seeing?

Brian
I think we're seeing more broad adoption now of somatic practices in mental health professionals than obviously we did 50 years ago. Sure. I think, I even think more than 10 years ago. I think now we're actually starting to reach the cusp of more broader adoption with less resistance and less judgment of the practices. I think that's really the tipping point.

Ani
Judging of the practices is a big deal. And I would say coaching also into mental health professional practices, but that's not what we're specifically talking about today. We're talking about somatic practices. Can we talk about defining that for a second?

Brian
What are somatic practices, how a somatic practices are.

Ani
And how you might recognize one if you ran into one at the grocery store.

Brian
Yeah. So first, let's just back up for just a second to have that conversation. And let's just talk about how are we even defining mental health practitioners first, because that's where we're purporting that somatic practices can be so helpful for mental health practitioners. So of course, I just go and do some research. And when you go to the web, you can tell I'm a Gen Xer, right? You go to the web.

Ani
The website.

Brian
Websites and the WWWs. And you ask, well, how would you even consider themselves as the mental health practitioner? Well, we're talking about social workers. We're talking about counselors. We're talking about psychiatrists, psychotherapists, physicians assistants, nurses. Psychologists, did you say that? Yeah, psychologists. Those are the folks that we are talking about if we're going to create a grouping for mental health professionals with what we're talking about today. Then if you look at it and you ask yourself, Well, what do that group of professionals primarily help people with? Of course, I asked not only AI that, but I also did my- Did you? Yeah, I did. I did my own searching also. I don't go with ChatGPT. I don't trust them completely. I've got to get through my own research also to say where am I verifying that information. But I went and searched what are the most common things that people seek help with from a mental health professional, regardless of which one of the professionals we just talked about in that grouping. Well, it's things like improve coping mechanisms for life. How can I improve my coping mechanisms for the challenges that I have in life?

Brian
We're talking about boosting self-esteem, helping with depression, addiction, improving sleep, building healthy relationships, was a popular one. Creating healthy boundaries with relationships with other people, also with ourselves, our own decision making around boundaries, improving wellness self-care. Then, of course, the king of all of it, probably is stress management.

Ani
Sure. Of course, we're talking about people who may or may not have diagnosis when we're talking about these licensed professionals.

Brian
Exactly, yeah. A lot of people visit and work with mental health professionals without a diagnosis of their own. They're just really feeling overwhelmed by life. They're really feeling challenged. They're going through transitions, or they're anywhere on that list that we talked about.

Ani
Also, these professionals may be working in systems. They also may be self-employed. They might be employed, they might be self-employed.

Brian
Yeah, right. They could be working in the education systems, the prison systems, the organizational business and wellness systems.

Ani
They may be people who are directly providing the services and/or directing teams who are providing the services.

Brian
Yeah, so a lot of folks. Okay, so let's wrap back to that question that you were asking about in terms of defining somatic practices. A lot of mental health professionals may be already doing some somatic practices. Yeah, sure. In our core centering certification program, our Somatic Practice Essentials program, we really talk about somatic practices in four primary buckets, if you can think about it like that. Somatic practices are things that we are doing, acting on, that have an effect on our physiology in some way. The four basic buckets are, we have the self-massage bucket or the self-touch bucket, where we are using our own hands on our own physical structure, on our own body, and doing certain massage practices on different points on our bodies with acupressure or different muscles or those types of things to create a certain effect in our physiology. We're talking about mindful movement practices where we are moving our bodies in certain ways, and we are paying attention to certain signals that are coming from our bodies in a mindful way while we're moving. We're talking about breathwork, which is pretty common. A lot of mental health professionals that I've talked with, breathwork is their go-to.

Brian
They're like, Yeah, I do breathwork practices. That can show up in a breathwork practice. It can show up in a lot of ways in sessions, and we could talk about that a little bit more. Then meditation. Meditation is probably the most popular one I think that mental health professionals use. I've talked to a lot of those folks who use positive visioning, creative imaging, those sorts of things in the practices that they do. Those are the four primary buckets that we work with.

Ani
I was going to ask you, what do you think the most popular are? And I would agree with you that the number one is meditation, the number two is breathwork. And I think there's people who will do these somatic practices while they've got people in their room with them. But there's also the recommendation of somatic practices that happens after sessions, in between sessions that happens, too. Yes. Yeah, absolutely. Listen to this guided meditation, do this visualization or through this app. And I think there's an interesting distinction there that we may or may not talk about, because as we talk about the possibility of being a trauma-informed practitioner, it's interesting to think that we might be recommending that people do somatic practices while we aren't with them and don't even know what responses they're getting from that. So I just think that's interesting to note, because I remember for myself as a holistic manual therapist, there were times years ago that I would give somebody a home exercise program that I didn't necessarily do with them. And I don't know what happened when they left, and they might say things went fine or didn't. And then sometimes people don't report really accurately.

Ani
So anyway, as you're listening, you may be thinking to yourself, oh, yeah, I recommend these guided meditations. I didn't even realize they were somatic practices. I think a lot of times people say that. I didn't realize that I was talking about a somatic practice. But I would say anything that you're doing that affects changing somebody's nervous system state, you can pretty confidently say it's a somatic practice, and you just gave us four buckets.

Brian
Yeah. Actually, let's pick up on that a little bit, Ani. We listed off a whole bunch of reasons that people oftentimes seek out help from mental health professionals. We talked about coping mechanisms, self-esteem, depression. I'll just run through them quick again. Addiction, improving sleep, building healthy relationships, healthy boundaries, improving wellness, self-care, and stress management. And then my question would be, which one of those does not include a person's nervous system?

Ani
Yeah, that's such a good point because it's something that we oftentimes just don't think about, Brian.

Brian
Yeah, it's all of them, right? They all include a person's nervous system. So then the question is, if they all include a person's nervous system, then is it reasonable to think that if a person's nervous system was healthier, that all of those problems would probably get at least a little bit better? Yeah.

Ani
And if the person's nervous system was healthier, and also if a person understands that they may or may not be regulated and have that common language with themselves and with their practitioner about talking about it, for me as a person, that was a big thing to understand that all the different ways I could describe to you that I was having a problem in here, I could just talk about the fact that I'm dysregulated. And that common language between a practitioner and the client, I think it's just mind-blowing in terms of the effectiveness that we can have and making things really simple that could be highly... It feels highly complex.

Brian
Yeah, totally. Let's just simplify this for a moment. I think the end game for anyone coming to work with a mental health professional, and I think most mental health professionals agree with this, is to help their client have some type of conscious behavior change. They either have to change their behavior to get a different result, or they have to be able to perceive their world differently in a certain way to get a different result. But there's got to be some type of eventual behavior change that occurs. I think we can also agree that behavior change, a lot of times, is driven from a conscious process. We have to consciously choose to change that behavior, which means that we have to consciously choose to do things different on a daily basis to create a different behavior.

Ani
Which means our conscious mind needs to be online.

Brian
Which means our conscious mind needs to be online to be able to do that, right? Yeah. We need to be able to have our intellectual cognitive capacities have to be functioning well in order to then have any behavior change. I think we can actually say that if someone had better cognitive functioning, would it be easier, probably, to create behavior change? I think we can agree that it probably is. If someone's cognitive capacities are diminished, is it likely more difficult to create behavior change? Agreeable? Yeah. Probably makes sense.

Ani
Things are making sense. Okay.

Brian
If someone's nervous system, below their cognitive processes because there's a lot more brain than just our cognitive brain. We have our limbic brain centers, we have our brain stem, if you just want to talk about Triune brain model.

Ani
That's just the brain brain. What about the gut brain and we're not exactly.

Brian
We're not even talking about vagus nerve, we're not talking about the enteric nervous system. We're not talking about the other type of plexes all throughout the body that bring information into those lower brain centers, primarily, which are all self-regulatory autonomic nervous system functions. But all of those, and I only call them lower brain centers because they are below the cortex. If you're standing up, cortex is on the top, and then you have the limbic, and then you have the brainstem. We're not making any judgment calls on them because the funny thing is those lower brain centers drive 95% of our decision making every day.

Ani
So they're important. Yeah.

Brian
So they're not really lower from a value standpoint. They're just positioned lower in a positional standpoint. This is where somatic practices come in because if you're a mental health professional that feels frustrated, that your clients are just... You're doing really good work with. You feel like you're doing really good work with them. You feel like you're showing up fully for them. You feel like you're really helping them. In session, they're like, Oh, my God, it seems like things are happening, and they just cannot seem to change their behavior. Their behavior seems to be stuck. You're like, I mean, we've talked about this a thousand times. They've told me that they know what they need to do, and it's just not happening. It's not getting done. They come back the next week, and we talk about all the other problems that they've had come up, those kinds of things. They're rather emotionally dysregulated or upset or having trouble cognitively being able to reframe what's going on in their life. Possibly, are a lot of those difficulties in cognitively reframing what's going on because of a chronic dysregulation of their nervous system.

Ani
It can also show up as the client who is in there and they just can't get on board with the change while you're in session, which would be so maddening. You feel like you're trying to intellectually Ninja them when in reality, if you could just help them change their state, they'd actually have a new experience with you right then and there. A big part of the reason that we started talking about the conscious mind being on board is that when the body is taken up with all of this dysregulation, just use that word, it actually brings the conscious mind offline. And so your client cannot get on board with you consciously to be able to enroll themselves into the change and to be able to move forward because they actually... To some degree, depending on how offline they are, they might actually think they're online, too. Yes. Yeah. Because there's a point at which with a conscious mind that we're online, and then there's a point with the conscious mind where we know we're not completely online. We know we're slipping off and we feel dysregulated. Then there's a point where we don't even know it.

Ani
And we would tell you, I am 100% with you here, but we're not. Our conscious mind is offline and we're functioning completely from subconscious. Yeah.

Brian
So hopefully, to this point in our conversation, I I think most people get this, that if a person's autonomic nervous system, their nervous system is dysregulated, then it's more difficult to function cognitively to be able to make choices and follow through on choices that would inherently change our behavior and then get different results. I think that's where we are right now. A lot of mental health professionals, really well-meaning, are like, Great, let's bring in meditation and let's bring in breathwork because those are things that can help. They're somatic practices. There's a lot of validity to that. But I also want to just bring up an interesting point that most people don't think about. That if someone is already challenged with their cognitive functioning, and then we ask them to do a meditation, what we're trying to do is have someone do a creative imaging on a cognitive function that's already dysregulated and upset. It's very difficult to focus our attention on any type of meditative process if our nervous system is dysregulated because our cognitive system is at the top member of that hierarchy, positional-wise, and everything that goes on below it informs the cognitive function, what I need to pay attention to.

Brian
If the nervous system is dysregulated, then what is telling the cognitive mind needs to pay attention to is whatever the problems are in its current environment. What I've done and talked to a lot of people who have used meditation as the primary somatic practice that they do with their clients. What happens is people get frustrated, and they have a very difficult time shifting their ruminating thinking away from the problems to be able to focus on the meditation.

Ani
Well, and what they'll do because they're focused on the problems and it doesn't work for them, they'll then internalize that they're the problem. They'll think that I'm a problem, or I have a problem, and then you're still stuck in the same issues.

Brian
Meditation is an amazing tool. There's been so much research done on mindfulness and meditation in lots of different ways, lots of great benefits for it. At the same time, it can be really challenging for people who have a chronically dysregulated nervous system. Is it always the best tool to use right away? I'm not sure that it is. That just might be my opinion, and I'm happy to have a conversation with anybody about that. When I look at the research and I look at the case studies we've done with our own clients, that bears itself out in my experience, but that's just my experience.

Ani
Yeah, well, we have people tell us time and time again that once they do core centering, even if they have had success with meditation before, that the experience they're having is one that I wish I had been having before. I didn't even realize there was even I don't know what word to put. I don't want to say better, deeper, more meaningful, more quiescent experience that I could have been having. I didn't even know.

Brian
Yeah. I'm all on meditation. I love meditation. I think it's important to use meditation in its proper place and order when we talk about somatic practices. Then people will say, Well, breathwork. I do a lot of breathwork. Now, breathwork is really powerful, really potent. We've actually done past podcasts on breathwork, and should I become a breathwork facilitator? If you're just listening to this podcast and breathwork is like, Oh, that's something I'm interested about, go back and listen to our past podcast on that, too, because you'll pick up some more information. But this is the little sneaky thing I want to let people in on on breathwork, is that our breath, of course, one of the reasons it's so powerful is that it's both an autonomic function, but also a conscious function. If we're not thinking about breathing, we're going to just keep breathing. But we can also consciously choose how to breathe. We can hold our breath, we could breathe faster, we could breathe slower. We can consciously change our breath. So breathing is interesting because we can make a very powerful effect on our nervous system by changing how we breathe because there are direct linkages from our breathing pathways without getting too complicated about it directly into the hypothalamus, which is the part of the brain that runs our metabolism.

Brian
It's like the carburator of the brain. We could change our nervous system function pretty quickly by changing our breathing. But here's the thing - if we're not thinking about consciously breathing in a certain way, our breathing is always an expression of what our nervous system is already doing.

Ani
That's what you said with the last thing. Yeah.

Brian
It's the same thing.

Ani
Yeah. So you said with the last thing.

Brian
That's the way we're thinking.

Ani
If you do this somatic practice on top of a dysregulated system, you're actually just getting more of the problems that are-Correct.

Brian
Coming out. Yeah, exactly. If we have something going on in our body, let's just say. Let's just switch out nervous system for body for a moment. Because what's going on in the body? We're talking about the neuromuscular system at this point. Lots of times- Which is interesting because as soon as we shift that conversation, some people are like, wait a minute, that doesn't apply to me and might not be in my scope of practice.

Ani
I just want to say that, right? Yeah.

Brian
Here it is, though. Let's talk about chronic tension. Sure. That's a neuromuscular thing, right? When we have chronic tension in our bodies, chronic tension in our muscles, then that's a neuromuscular thing. When we have chronic tension from whatever reason, and I would also say, if you're a person who treats, let's see, anything that we've talked about, someone with poor coping mechanism, someone with poor self-esteem, someone with depression, someone experienced addiction, someone with sleep problems, insomnia issues, people with unhealthy relationship challenges, people have unhealthy boundaries that you're trying to work on, people who have difficulty with their own wellness self-care, people who are in extensive levels of stress, check their chronic muscle tension and tell me whether or not it's not healthy. Yes, really good point. You're going to see chronic muscle tension in every one of those conditions.

Ani
Why do we know that? Because we're from a body-based background.

Brian
Exactly. If someone has chronic muscle tension in their bodies, what's happening at a level of the muscles is you are getting a lot of what we call anaerobic respiration at the level of the muscles because the muscles are being squeezed. When they're being squeezed, chronic tension, they're getting less blood flow. They're creating higher levels of blood lactate, which have been associated with anxiety, by the way. There's been some research to show that, that higher levels of blood lactate create higher levels of anxiety. So chronic muscle tension will perpetuate that, make that more difficult. Yeah.

Ani
You just said keep an eye on the levels of chronic muscle tension, but how might a practitioner actually go about practically doing that?

Brian
Well, you would just ask your person, are you experiencing any pain today? Most people will say, Oh, Oh, my God, I got a headache. I have neck pain. I have back pain. And you can say, can you point to that area of your body? It'll point to the area of the body. And you can say, well, does that feel tight? Now, if you have a license to actually put your hands on people, then you could go ahead and palpate tissues.

Ani
Okay, so just stop right there because some mental health practitioners actually go get a license to touch so they can affect the tissue, and you don't have to do that. But that's where the brain goes is I see people coming in with chronic muscle tension. If I get a license to touch or I'm a yoga therapist or something like that, which, by the way, the yoga therapy is also somatic practices, but it's yoga, and not everybody wants to do it. That's where the brain goes, is I got to go do that. I just think I'm listening to you talk about this. If I was a mental health practitioner, one of the things I would do when my people come in for every session, perhaps as a coach, I have things I ask people for every session to this, that, the other thing, one of the questions I would ask to my intake for each session is, are you having any chronic tension today?

Brian
Yeah. Any chronic pain today?

Ani
You just got a whole bunch of It's important data.

Brian
Exactly. Yeah, exactly. Why is that so important? Why is it so important to recognize that people have chronic tension? Well, for some of the reasons we've already talked about. Because when we have chronic tension, it creates metabolic changes in the body. Chronic tension, metabolic changes. And those metabolic changes will be expressed in someone's breathing because the nervous system is always trying to find balance. It's always trying to find homeostasis. If there are imbalances in our neurohormone profiles in our body because of chronic tension, then our body will try to use the breath in order to make up for those changes. Oftentimes, you'll see people with shorter and more rapid breathing to try to actually create... It's just a compensatory breathing model. People have a hard time slowing down their breath because of just the metabolic imbalances that are in their body. When we do breath work with folks, what you can see is that you will get oftentimes a short term change in the system and to help someone be able to process through something, maybe in session or something like that. But we're not really changing fundamentally what's going on in the body in the levels of chronic tension sustainably.

Brian
And then the problem just basically comes back again because the chronic nervous system imbalance is being held in the muscle tissue itself.

Ani
Well, I can't speak for anybody else's program, but with the somatic practices taught in Somatic Coaching Academy, you can actually learn how to affect that chronic tissue tension without going and getting a hands-on degree.

Brian
Exactly. It brings us to our point where we are right now.

Ani
Can I say one more thing about that? One of the things that I'm pretty passionate about why that matters is when you go get a hands-on degree, you're still putting yourself in the position as a practitioner, as the person needs to do something to someone. But when you understand how to help somebody to help somebody with them affect their muscle tissue tension, then you're teaching somebody skills so that they can do it. And that's where the empowerment is.

Brian
Correct. Exactly. Where we bring in this idea of... To make a really profound impact, a persistent impact, to really be able to drive sustainable behavior change for yourself and where the clients you're working with is to actually start at the body level. Most people don't do that. Most people don't know how to do that. They don't know how to actually start in the tissue itself, as you said, without going back to getting a degree where I'm putting my hands on you to try to create change in those tissues. Instead, we learn ways to be able to empower and do it along with our clients to be able to manage and change their own body tissue, which then gives them a tool to start using between sessions, as you pointed out. Then we build from there up because once we make a change in the levels of chronic body tension, then breathwork becomes more sustainable and more reliably changeable. And then once you get better changes in the breath structure, now meditation gets even easier. So we come back to the idea is, how do we make meditation easy? We don't make meditation easy by forcing ourselves to sit in a chair with illuminating thoughts and all kinds of dysregulation, and we're angry, and we're upset, and we're sad, and then try to sit down and focus on it.

Brian
That doesn't make it easier.

Ani
Yeah, you actually work with the physiology. And one of the things I really like about... We teach all these things in the Somatic Practice Essentials program, by the way. You become a core centering practitioner, and you can do these things with people in individual sessions, and you can do these things with groups. One of the reasons I bring it up is because one of the things I really like from a standpoint of, it doesn't matter whether you're an employee or you work for yourself, diversifying the way in which you can bring these services to people, because it's really powerful when you do them in private sessions, and it's really powerful when you do it in group. And when people have the opportunity to do both of those things, and they can do them privately one-on-one, and then do them with a community of people who are also doing these things, wow, that is so powerful for people. It just lights a fire under the possible transformation that they can receive because they're getting it in different modalities, and they're also getting it with community. Doing these things with community also feeds the nervous system in really powerful ways to help us change and transform.

Ani
Yeah.

Brian
It's really always wonderful. We've had several mental health professionals go through our somatic practice essentials and core centering certification training. It's always wonderful to get feedback from them about how transformational it was to learn how to help someone apply somatic practices in their own lives for all the reasons that you just mentioned, both in-session and out-session. I'm sorry. In individual sessions and with groups, and the impact that it's made in not only the lives of their patients, but in their personal lives as well.

Ani
Absolutely. That's so important because of all the reasons that so many mental health practitioners are stressed out. It feeds us as practitioners while we're helping the clients. That's win-win. It becomes a win also for everybody else who your client interacts with on a daily basis, and you interact with it on a daily basis, too. Your family and your colleagues and their families and communities. 

Brian
Yeah, because oftentimes mental health professionals feel like they're carrying the load for their patients. They feel like they're carrying the emotional load for their patients because- You can feel depleted. Yeah, very depleting when we're counseling and we're giving advice and we're trying to help people reframe. We really just want them to be able to pick up a little bit on their own and follow through and empower. When we have those somatic practices for ourselves, and there's things we can do along along with our clients, both in session and in classes, it just comes back and feeds and nourishes us as well, and it helps us live a more powerful and empowered life on our own terms.

Ani
Yeah, and in trauma informed ways because we have mental health practitioners tell us all the time that they feel a little out of integrity because they're not necessarily trauma-informed. That's not a you thing. That's not a problem. That's a problem with the curriculums, I think. But just to your point at the beginning, we're just not there yet with the way that we educate professionals in a lot of different professions, that that's something that we teach in the curriculum. We have to go about doing that ourselves and making it a priority for ourselves as practitioners for our own personal and professional development to learn trauma-informed strategies.

Brian
Yeah. Really, what we've seen is that in order to really drive sustainable behavior change, it doesn't have to be that. It's not really that difficult to do that if we are working with people who have regulated nervous systems. That's the foundation of everything that we do in terms of creating behavior change. If we're trying to carry behavior change on nervous systems that are dysregulated, it's almost impossible to help that become sustainable. Let's just go back to foundational basics and use somatic practices to help people regulate sustainably. Then the change processes from those points are actually really enjoyable when you're working from that foundation.

Ani
If you're listening and you're interested in checking out the program we're talking about, go to the website, somaticcoachingacademy.com. You're going to want to look at the Level 1 program, and that'll give you the information that you need. Also, our team is so excited to talk to you any day of the week if you want to talk to us about it. We hope this has been really informative, but I take away golden nuggets every time. I've got one for myself today. We hope you do, too. We'd love to know if you have a great takeaway from today, what it is. You can always email us at [email protected]. Depending on where you're listening to this, you can leave a comment or a review or something like that. Thanks, Brian. This is a powerful episode. Yeah.

Brian
Thanks so much, everybody.

Ani
Look forward to seeing you next time. Bye-bye. Bye-bye. Thank you for listening to this episode.