A Client (Child) Centered Approach to Somatic Expressions

“Client-centered psychotherapy, which is based on the notion that human nature is inherently good, offers an alternative to traditional therapies, allowing the client to guide therapy” (Erekson & Lambert, 2015 p.4). Carl Rogers, the theorist behind the Client-Centered Theory, believed that a therapist is deemed successful if they have created the optimal client-centred therapy environment. This includes the client taking an active role in their recovery, as well as them taking responsibility for discovery and decision making that will eventually lead to growth (Erekson & Lambert, 2015). From a client-centred perspective, the behaviour of humans is motivated by being able to reach their full potential. The collaboration between a client-centred, empathetically engaged therapist and a client-directed therapeutic process can affect the process of psychotherapy and change (Erekson & Lambert, 2015). Somatically, the Rogerian framework believed that individuals are often well aware of their conscious thoughts, but when it comes to their body, they are unfamiliar with the reactions. Within this theory, emotions and bodily reactions are formed by needs, values and goals. They can also be formed by the advancement or harming of a traumatic situation. This is where the foundation of the self and self-organization is constructed (Erekson & Lambert, 2015).

Trauma experienced on a somatic level in infancy and early childhood can be stored in episodic memory. These experiences can sit unprocessed and held within the body and acted out upon until addressed (Spiel, 2019). When a stressor in the body is intense, severe and prolonged, a person’s neurological makeup is affected. This can lead to low-stress tolerance or constant heightened stress. This is common in children, as they do not have a lengthened history of security or homeostasis (Norton, 2011). Because of past experiences, a child’s neocortex and the limbic system can be bypassed, and the stress can move directly into the brainstem, which responds to fight, flight, or freeze. There are negative effects on a child’s brain when they have experienced abuse and neglect (Norton, 2011).

“The pattern of defensive and protective movement at the time of the traumatic event is stored in procedural memory for the purpose of adaptation to the future related threat, and incorporated in regional neuromuscular detail into the kindled cycle of trauma” (Scaer, 2007, p. 23, as cited in Norton, 2011, p. 144).

Symptoms of trauma can often show a story and when a child is triggered by a traumatic event, energy can release and the child will re-enact the trauma (Norton, 2011). Re-enactment can be identified through children’s play and art. These can look like high-pitched noises, an increase in energy, an increase in anxiety or unprompted jerks and rapid movements. In particular, sensory re-enactment can often occur and can show in actions that reflect pain. This is when a child’s body starts to reexperience the sensations of a trauma (Norton, 2011). This can look like a child covering behind when walking, as they had previously been spanked unprovoked. Vocally, this can look like screaming, grunting, moaning, or pointing out where they have been injured by accidentally inflicting pain or metaphorically by motor re-enactment (Norton, 2011).

Motor re-enactment in trauma is a protective movement and submissive action. Protected movements can look like a child flinching when a person reaches for the shoulder or to wipe something off their face. During this time of reaction, the child’s brain is preparing for injury. This happens by blood moving away from the limbs, heart rate lowering for lower blood loss from wounds, and endogenous opioids are released for pain relief and production of calmness and dissociation (Norton, 2011). Dissociation can happen consistently throughout a child’s life. In therapy sessions, this can also look like derailment. When the trauma cycle is not completed, there is an inescapable stock that turns into helplessness, hypervigilance and eventually PTSD (Norton, 2011). During therapy, hypervigilance can often be seen as oversensitivity to noises not in view, questioning of safety and trust, and inability to participate in fantasy play. The inability to participate in fantasy play is because “to the traumatized child, fantasy play is disguised reality” (Norton, 2011, p. 9). This is often seen when children start to engage in play, as they begin to have sensory and emotional memories of their trauma. This then influences the child to move on to a different toy or play scene as it is deemed triggering. This type of derailment can happen repeatedly through a therapy session and can lead to avoidance (Norton, 2011). Dissociated play and art can have metaphoric themes of sleeping, being dead, playing the therapist in a victim role, or even killing off the therapist in the storyline. This can also turn into ghost or zombie play, as well as narrating roles for the child so they have complete control of the play scene. When children play out these themes, they are often re-enacting when they were disassociating during their traumatic event (Norton, 2011).

Identification and treatment of traumatic symptoms can be done through sensation, soma, surge, and soothe. These phases can help a child reconnect their responses to trauma through play and somatic reflection. Treatment needs to address regaining a sense of safety in their bodies, as well as completing the cycle of the unfinished past (Norton, 2011). A therapist’s main role is to assist the child in the process of releasing the defensive responses that occurred during the event. The therapist must be alert for them to see small expressions that relate to trauma in play. If a therapist can identify these somatic reactions expressed during therapy sessions, there is a possibility for prevention of somatically based childhood trauma from establishing as serious adult illnesses in the future (Norton, 2011).