How to Approach and Support Mental Health When You Aren’t a Therapist (Pt. 2)

Dr. Christopher Walling discusses mental health and the scope of practice for fitness, yoga and wellness teachers.

In the first installment of this three-part series interviewing Dr. Christopher Walling on the topic of mental health, we explored how the “mind” isn’t something we can so easily define. It’s a rather ephemeral concept.

Furthermore, the “brain” exists beyond just the confines of your skull. The brain branches itself throughout the entire body via the nervous system. So, if the question is, where is my mind? The answer Dr. Walling points to is that it’s everywhere. So how does this fit in with being a group fitness/wellness instructor who wants to support the mental health of their clientele?

Dr. Walling is a Somatic Psychologist and Body Psychotherapist and is president of the United States Association for Body Psychotherapy. This organization includes Somatic Experiencing® (SE) practitioners, Sensorimotor psychotherapists, Hakomi Psychotherapists, Bioenergetic psychotherapists, etc. There are dozens of somatic psychotherapy training programs that purposely integrate the “soma” (Greek for “body”) with the mind…and movement instructors can learn so much from the expertise of this group.

In this next installment of our interview, I started by asking Dr. Walling more about what it means to be a “somatic psychologist” which is a field that may seem to be on the fringe of mainstream psychotherapy… but isn’t actually as far-out as I had assumed.

We ultimately explore how yoga teachers and other wellness practitioners in body-based systems can support the mental health of clients, without stepping outside of their scope of practice.

The Emergence of “Body Psychotherapy”

Ariel Kiley [AK): So, if you’re looking at the big picture of where mental health practices and studies are going right now, it seems like there’s been a real blossoming of body-based psychotherapy happening. How do you see the emergence of body-based psychotherapy serving people here and now in our present-day times?

Dr. Christopher Walling (CW): The difficulty in answering that is that it’s really not that much of a shift; it’s more of an advance in technique. If we go way back to like, Papa Freud… Sigmund Freud always said that the ego is fundamentally a “body-based” ego. The mind is essentially situated within the context of the body.

So even Freud’s ideas were warehoused in this notion that he was searching for a scientific psychology and that scientific project of Freud’s initial work was the root that so many branches then dovetailed into. One of his students, Wilhelm Reich, who many regard as the papa of body psychotherapy–he was also onto Freud’s idea of the ego being fundamentally a body-based ego that he followed within the libido theory to interesting extremes. So, in some respects, what’s old is new again, as is the case with so many trends in our world.

But you are right in the sense that there is a bit of a paradigm shift that has occurred in the last decade or so. We can thank, largely, our advances in neuroscience, that have really in some ways reified and solidified these ideas that were largely held by both the psychoanalytic and the body psychotherapy community as intuitive faculties or intersubjective fields that were containing somatic and psychic transferences and counter-transferences and we’re now finally able to both image and measure those things.

We can now measure two brains that are engaging with each other in a dynamic social interaction. We’ve never been able to “prove it” until recently.

I think that because of advances in neuroscience, yes body psychotherapists are going to be like, “oh my gosh, neuroscience is totally proving that we were right all along!” But they’re not the only ones who are laying claim to that.

The mindfulness camp is [also] like “oh my gosh, neuroscience is proving that we were right all along!” So, really what we’re seeing is a further advance in our capacity to measure in vivo dyadic relationship and that is supporting a lot of our understanding of how to treat psychopathology and human suffering—through connection.

Now, to the interventional point that I’m making though, the fact was that for the first time ever in modern psychological history, one of my mentors Allan Schore, back in 2009, during his APA address to the American Psychological Association, basically said […] that this massive paradigm shift is occurring in which the relevance of developmental affective neuroscience, has essentially morphed us into understanding that the right brain–implicit, bodily-based, unconscious, emotional and relational functions–are the core of what really creates psychological change and fundamentally is at the heart of depth-oriented, growth-oriented, psychotherapy. All of them, trans-theoretically.

So what Allan was saying ten years ago is what you’re pointing to which is like “OMG there’s all this cultural representation now of the body in psychotherapeutic discussions.”

I think some of that has to do with accessibility, because bodily-based approaches can be in some ways partitioned off in various different scopes of practice that still give people access to lifestyle practices. They can essentially incorporate [these practices] into their day-to-day lives and they aren’t as expensive as say an elite Manhattan-based psychoanalyst.

So that scalability has improved people’s ability to incorporate some of the same fundamental insights that we gain from these advances in affective neuroscience.

Unpacking the Idea of “Resilience” as it Relates to “Mental Health”

AK: So cool! Okay, I want to pull back to something you were saying earlier about Freud’s reference to the ego being “body-based”. Would you draw a parallel between, let’s say, an exacerbated ego…or a troublesome ego… would you say that person potentially has a lower level of resilience in terms of what triggers them to more primitive survival responses such as going into the sympathetic nervous system when it wouldn’t be necessary? Would the ego in the body be analogous to how we’re just triggered for our “survival,” whether or not it’s necessary in certain environments?

CW: So that question has a lot loaded in its premise that I want to unpack. First, I want to highlight the intractability and the ubiquity of human misery and suffering–while we can normalize it in some sort of normative resilience model–I’m really, like so many of my colleagues, working hard to deliver this message:

In a world where ecological disaster is normalized and ignored and where we continually are starting to see the development of our human fate being galvanized to things outside of our control, we really have to start to understand that sometimes vigilance, and being under a threat response, is actually healthy… and normal.

It’s not healthy to be on the golf course if the mountain right behind you is on fire, and for you to be cool with that. It’s not healthy when people don’t have access to clean drinking water. It’s not healthy when there are children in prisons on the border of our country.

I know this might sound a bit political, but we also have to look at it just from kind of a flat level of human flourishing. And that really determining whether or not we can rely upon safety, and body quiescence [inactivity or dormancy] as normative or not.

So, in some ways, this particular metaphorical person might actually, in their vigilant state of not coding threat responses perhaps in the same way that a more “resilient” person might… they might actually be more ecologically in tune with where they are and the species.

Or they might even be a marginalized person–let’s say they’re a person of color in a very white privilege kind of society. Their vigilance might actually be adaptive and necessary. Does that make sense?

AK: Absolutely. And it reminds me a lot of the idea of bypassing. For me the big shift that taking Somatic Experiencing® training has created is that I’m not there to “make” people feel anything as a teacher. I’m there to offer techniques for them to deepen their own exploration and self-understanding and to also create a safe environment for them to do that in. That is my responsibility. But what they do with it is really not my business and it’s important for me to remove my agenda, for them even having a “happy life,” from my teaching.

CW: That’s right. Now I do want to get to the heart of what your question is driving at though… and the heart of what I think your question is driving at is a question that’s in some way similar to the causes of “psychopathology.” That’s a debate that is still not settled in the mental health space.

There are really two major camps in terms of the causes of psychological disorders:

[1] Is psychopathology the result of trauma? Healthy development thrown off course by destructive events and actual experiences?

[2] Or is it the result of misinterpretation of early experience due to the warping impact of early childhood fantasy and unmet needs?

So, this is kind of a reification of the nature vs. nurture debate that still plays out in modern mental health science.

That’s why it’s really difficult to say concretely if someone’s global high intense activation pattern is inherently indicative of their inability to regain a greater sense of resilience because it’s really so dependent on the individual’s nervous system and there are no two nervous systems that are the same.

So in some ways we have to recognize that resilience, much like the concept of “mental health,” is a great metaphor. But we really have to start using resilience as just a metaphor rather than, for like our hyper-performance-oriented, peak-performance types–as some goal that people are going to eventually obtain and be like oh, I’m so resilient now. Like, I don’t have to do anything more… I’ve reached Mount Resilience!

Mental health really has to be seen, at least I teach it this way, through the lens of a mental hygiene model. Just like you’d brush your teeth everyday, there’s a maintenance portion involved in how we remain resilient and how we maintain our mental health and that has a lot to do with understanding the nature of what it means to be a human being.

How to Approach Daily Mental Health Hygiene (Like the Celebs Do)  

AK: So for readers who are going to pick up on some of the ideas here and wonder “what can I do with all of this for myself today?” Regarding regular daily mental hygiene, what in-roads would you offer to people to help take care of that part of themselves?

CW: So, first and foremost, you have to get in therapy*. I say that in part because of the nature of what it really takes to be a resilient human being, and that you can’t do it alone. Human beings are mammals and mammals are designed to be interdependent creatures.

Our brains are created to need other brains. Because of that design, because we’re hardwired for connection–we cannot exist in isolation or we die–you must have someone to at least to touch base with even if you only see them every other week, or once a month. And friends are not therapists! A trained clinical presence is very different than a friendly dyad that has its own unconscious entanglements. So therapists serve as profound mental hygienists if nothing else.

So we have to de-stigmatise this idea that you only go to a therapist when you have serious problems because that’s BS. Like, I don’t go to the dentist when I have a cavity only, I go to the dentist for maintenance. Right? It’s the same kind of idea.

Hopefully in the year 2019 there’s been enough opinion leaders and celebrity types who have disclosed that therapy is where it’s at. If you look in the news, Kerry Washington has disclosed that she goes for binge eating disorder, Gwyneth Paltrow for postpartum depression. Kourtney Kardashian has been in couples therapy. Lena Dunham does it for self-help. Halle Berry does it for stress management. The list goes on and on, but it’s hip to be in treatment.

I’m a Hollywood-based psychotherapist–half of my practice is entertainment people and celebrities (none of them I just talked about by the way). But the point that I’m making is that’s job one: find a therapist who you have good rapport with.  

There are what are called “common factors” across all psychotherapy techniques that no matter what kind of style that therapist has, are the common factors that actually determine treatment outcome. The number one thing that makes psychotherapy work is what’s called the therapeutic alliance, aka the quality of the relationship itself. So you’ve gotta have a therapist for whom you have that affinity… a solid, safe connection.

Scope of Practice for Group Fitness/Yoga/Wellness Teachers

AK: So for teachers or wellness practitioners who want to be a positive, conscious supporter of their students’ mental health, how do you suggest that they behave in the classroom?

CW: I think it goes back to the same way that they navigate ensuring that they aren’t prescribing the same pose… the same exercises to every client… that they understand that the unique complexity of each individual’s physiological and psychological makeup are so intricate that it’s impossible for them to ever, in a safe way give any opinion about the psychological benefit or disadvantages of an individual student’s choice.

So really, we’re talking here in the realm of what are trauma sensitive approaches to teaching yoga? Because that’s about giving choices; respecting agency, not being a proselytizer, and ensuring that you always encourage critical thinking and that you tell your students no matter what I say to you don’t believe a single damn thing that comes out of my mouth, go investigate it for yourself and with your trusted, licensed team of professionals.

All you can do is teach your class, have a really great network of professionals who are in your resource directory that you can refer people to that you know are solid and they can trust. That’s really how you maintain the… what were those little rubber things called when you would like, go to the bowling alley?

AK: The bumpers?

CW: Yes! Those are the bumpers.

AK The bumper lane.

CW: Yes, that’s your bumper lane as a yoga teacher.

Find the final installment of this conversation with Dr. Walling HERE.

*For people who cannot afford, or do not have insurance that covers mental health practitioners, Dr. Walling suggests either seeing an intern (working with an intern therapist might cost zero to $25/hour, and their work is monitored by a supervisor who you can speak with directly if you have any issues). Or another option is investigating if you qualify for free mental healthcare at the city or county level. They may limit the number of sessions to nine or ten, but this can help get you through a crisis.

This article is part of a larger discussion on Mental Health and Emotional Resiliency.

During the month of August we are sharing educational articles and interviews to help navigate the challenges and struggles brought forth from living amidst a pandemic.  Our intention for sharing this curated list is so that you may learn new skills (or revisit old ones) to take care of your nervous system and incorporate breath, movement and mindset practices to increase emotional resiliency.  We invite you to take what works, and allow the rest to fall away.

If you liked this article, we’ve curated a list of practical how-to’s, interviews, and more on mental health and emotional resiliency:

• How to Raise Self Awareness by Meredith Amann 
  “The unexamined life is not worth living” Socrates.   Many people agree awareness, like mindfulness, is a skill, but could it be our hidden super power?
• The Secret to the Change You Crave Beth Damm 
  Words are not just tools for communication. Words have the power to uplift, unite, bless and transform, as you will see in the examples in this post. They can change your mindset.
• Learning to Say NO as an Act of Self Care by Kate Hamm
  Just like yoga, saying No is a practice unto itself.
• Compassionate Insight: Shifting How We Define Resilience by Emily Pantolone
  Interested in building emotional resiliency?  Self-compassion may be the entry point to expanding your perspective.
• Why does it hurt? Demystifying pain. by Dinneen Viggiano 
  Do-at-home, no-equipment-needed, non-invasive therapeutic skills are indispensable for effectively managing stress, anxiety, exercise burnout, pain and more. Dinneen shares three self-care skills and accompanying practices to help you understand and transform your experience of pain.

Related Article: Where is My Mind? An Interview About Mental Health With Dr. Christopher Walling

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