Sensorimotor Psychotherapy

in Action
Harness the Wisdom of the Body to Treat
Trauma and Relational Wounds
Pat Ogden PhD
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SENSORIMOTOR PSYCHOTHERAPY
• Body-oriented, talking therapy developed in the 1980s by Pat
Ogden, Ph.D.
• Enriched by the contributions from the fields of somatic
disciplines, attachment, neuroscience, and dissociation
• Blends cognitive and emotional approaches, verbal dialogue,
and physical interventions that directly address the implicit
memories and neurobiological effects of trauma.
• Uses bodily experience as a primary entry point in therapy;
explores how the legacy of trauma, attachment and other
relationships affect the body. Ogden, 2002, Fisher, 2003

© Pat Ogden & Sensorim otor Psychotherapy® Institute 3

Advisory Board
Beatrice Beebe, PhD
Philip Bromberg, PhD
Emilie Conrad
Shelley P. Harrell, PhD
Ron Kurtz
Ruth Lanius, MD, PhD
Peter Melchior
Ellert R.S. Nijenhuis, PhD
Clare Pain, MD
Stephen Porges, PhD
Allan Schore, PhD
Daniel J. Siegel, MD

Marion Solomon, PhD

Martha Stark, MD
Kathy Steele, MN, CS
Ed Tronick, PhD
Bessel van der Kolk, MD

© Pat Ogden & Sensorim otor Psychotherapy® Institute 4

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 SPI Instructors
• Janina Fisher, PhD • Patrick Weeg, M SW, LCSW
• Kekuni M inton, PhD • Raphaël Gazon, M psych, LCP
• Lana Epstein, M A, LICSW • Raym ond Rodriguez, M A, LCSW, R
• Anne Westcott, M A, LICSW • Jennifer Gardner, M SW, LICSW
• Esther Perez, M A, LM FT • Laia Jorba, M A, LPC
• Rebeca Farca, PhDc, LM FT • Hanneke Kalisvaart, PhD
• Tony Buckley, BA Hons • M arie Dam gaard, M Ed (C.P.)
• Rochelle Sharpe Lohrasbe, PhD • Darlene Cohen, PhD
• Bonnie Goldstein, PhD • M ary Choi, LCSW
• Amy Gladstone, PhD, LCSW • Faan Yeen Sidor, Psy.D
• M ason A. Som m ers, PhD • Jacquie Com pton, RP, RCAT
• Kelley L. Callahan, PhD • Katrina Curry, LM FT
• M arko Punkanen, PhD • Lisa Stokkeland, Psych

© Pat Ogden & Sensorim otor Psychotherapy® Institute 5

We Adapt to Trauma, Attachment and

Relational Strife
We adapt automatically, without conscious intent, to traumatic events,
whether perpetrated by individuals, groups, or society as a whole.
We adapt to the mis-attunements of caregivers, significant other individuals or
groups of people to maximize available resources or at least minimize stress.

These adaptations accumulate to leave scars in the form of symptoms and

patterns of thinking, feeling and acting that correlate with each kind of injury.

The unique legacy of each category of adversity is revealed in patterns of

gesture, posture, movement, and physiology Ogden 2021

© Pat Ogden & Sensorim otor Psychotherapy® Institute 6

Habits of Posture, Expression,

Movement and Gesture
Physical habits reflect our personal and sociocultural history

Ogden et al 2006;
© Pat Ogden & Sensorim otor Psychotherapy® Institute Ogden, 2021
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 The Somatic Narrative
Ogden et al 2006; Ogden 2014, 2021

•continuously anticipates the future and

powerfully determines behavior

•reflects implicit relational knowing, trauma

history, attachment-related beliefs, sociocultural
elements, and affect regulation capacities

•communicates these implicitly to others

•influences our sense of self

© Pat Ogden & Sensorim otor Psychotherapy® Institute 8

Sensorimotor psychotherapy helps clients

discover and change their somatic narrative to
promote recovery from trauma and attachment
failure, as well as increase resilience in the face
of ongoing trauma and oppression.

We work with posture and with specific actions.

Ogden & Minton 2000, Ogden 2014

© Pat Ogden & Sensorim otor Psychotherapy® Institute 9

Proximity Seeking Actions

Proximity-seeking actions:
predictions of whether others
are accessible and how
probable it is that they will be
empathic & supportive if
needed. Ogden & Fisher 2015

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 Some Sources of Stress & Trauma
Ogden 2002/2020
Accidents Inside Threat Pre- Peri Natal
Asylum Seeking Loss/Death Racialized Trauma
Attack Medical/Surgical Religious Trauma
Captivity Moral Injury Ritual Abuse/Torture
Climate Change Neglect Sexual Abuse
Disaster Oppression Social Media
Domestic Violence Pandemic Terrorism
Historical Trauma Perpetration Transgenerational
Immigration Persecution
© Pat Ogden & Sensorim otor Psychotherapy® Institute
Vicarious Trauma 11

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Social Location
Socio-Economic Political
Status/Income Ethnicity Ideology Body/Appearance
Geographic
Location
Ability Sexual Orientation/
Religion Identity
Family Status
Neurodiversity
Race Education
Gender
Immigration Age
Status Religion
Thinking/Emotional Language
Style Communication
© Pat Ogden & Sensorim otor Psychotherapy® Institute
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The Brain under Stress and Trauma

The prefrontal cortex or ”thinking
brain” is underactive

The amygdala is overactive

The hippocampus is underactive

The survival instincts are active

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 We Remember Trauma with our Bodies
Non-verbal, bodily reactivation of memories of
traumatic events take many forms:
•dysregulated arousal,
•“vehement” emotions
•instinctive defensive responses
•mysterious physical symptoms with no
organic basis.
Reactivation is triggered by external and internal
reminders of the trauma.
The body does not feel safe. Ogden et al, 2006

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First Task: Help the Body Feel Safe

When the body does not feel safe we cannot fully
take in new information or engage adaptively
Activation is modulated;
Hyperarousal
the body feels safe

Window of
Tolerance*
Activation is extrem e. The
body feels unsafe and
engages survival strategies
Hypoarousal

Ogden 2008 © Pat Ogden & Sensorim otor Psychotherapy® Institute 15

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It Helps to Know Your Triggers

Social media, facebook, instagram, twitter
News media content, images, sounds
Reports of war, covid, climate change, etc
Triggered memories of past trauma
Ongoing oppression, racialized trauma, threats
Reminders of historical oppression Losses of all kinds
Worry/hopeless about the future
Anger, fear, despair, futility

Hyperarousal

Triggers Window of Tolerance

Hypoarousal
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 Stress and Trauma First and Foremost Affects the Body:
We are wired to increase activation to fuel action to protect ourselves,
and if action doesn’t work, to shut down
Ogden 1992; Ogden & M inton 2000; Ogden et al 2006; Ogden 2009/2011

A SNS Hyperarousal Zone Cry for Help, Fight/Flight, Freeze

R
O Social Engagement “Window of Tolerance”*
U Safety
S
A DVC Hypoarousal Zone: Feigned Death:
L
Ogden and Minton (2000)
*Term coined by Siegel, D. (1999)
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SP PEACE Resource Protocol

5 Steps to Modulate Activation and Build Resilience
•Pause what you are doing to briefly identify bodily signals of
unrest.
•Embody a somatic resource.
•Acknowledge the positive effects of the resource on your body.
•Concentrate your attention to savor the positive effects of the
resource for 15 seconds or more.
•Engage in your environment. Ogden 2022
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Step 1: Pause and Notice Body Signals

Ogden 1992; Ogden & M inton 2000; Ogden et al 2006; Ogden 2009/2013; Ogden & Fisher 2015

Hyperarousal Signals
FEEL IN DANGER: Accelerated heart rate, rapid breathing, hyperstartle response (jumpy),
trembling, hypervigilant, hyper-defensive, hyperactive, high intensity, circular thinking,

A
R
O
U
“Window of Tolerance” * FEEL SAFE
S
A
L
Hypoarousal Signals:
FEEL THREATENED: Feel numb, weak, low energy, low vitality, little facial expression, passive,
“spacey,” poor eye contact © Pat Ogden & Sensorim otor Psychotherapy® Institute
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 Top Down and Bottom Up Resources
Coping or safety plans or
Top Down Resources using cognition to remind
Frontal oneself that there is no
Cortex
current danger

Limbic
System

Physical actions and

Brainstem capacities that promote well
being and encourage
regulated arousal
Bottom Up Resources Ogden et al 2006; Ogden & Fisher 2015; Ogden
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Step 2. Embody a Somatic Resource: Take

your time to discover one that feels good in your body.
Ground Stand up Smile
Self Touch Orient to Surroundings Breathe
Lengthen the Spine Walk Hum
Stop Gesture Push Move Rhythmically
Embody your Culture Combine Resources
Hyperarousal
Use somatic resources to help the body feel
Identify safe, modulate activation, and build resilience.
Triggers
Hypoarousal

Ogden 2013/2022; Ogden et al 2006; Ogden & Fisher 2015

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Somatic Resources for Modulating Activation

and Building Resilience
1. Breathe: focus on breath, take a deep breath, sigh, long exhale
to down regulate activation, inhale to up regulate; bend over
slightly if diaphragm is tense, “box breath,” short breath holds on
exhale when over-breathing (common when stressed)
2. Ground: sense the support of the ground, the support of the
chair, feel the floor, push down against the floor with the feet
3. Orient to Surroundings: slowly look around the room and notice
colors, objects, lingering on the colors and objects you like
4. Lengthen the spine: gently sit upright or stand taller
Ogden et al 2006; Ogden 2021
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 Somatic Resources for Modulating Activation
and Building Resilience, 2
5. Walk: stand up, walk around, sense the legs and feet
in movement
6. Place Hands on heart, belly, place your hands on your
heart, rub your legs, hug yourself
7. Smile: find your own way to smile that fees best
8. Push palms of hands against each other, the wall, or
an object like a desk
Ogden et al 2006; Ogden 2021
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Somatic Resources for Modulating Activation

and Building Resilience, 3
9. Make a “stop” gesture, with palms open, facing
outward
10. Move Rhythmically: rock, sway, bounce, swing
11. Hum: find a low pitch you enjoy, sense the vibration
12. Embody your Culture: sense the support of your
ancestors, tune in to the traditions of your culture:
rituals, food, music, dance
Ogden 2022
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Step 3. Acknowledge the Positive Effects

of the Somatic Resource(s)
Ogden 2010
Hyperarousal

More relaxed, energy settles, heart rate

slows, breath deepens, eyes soften

More energized, able to move, take

action, can feel the body, feel less numb

Hypoarousal
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 Step 4. Concentrate Attention to
Savor the Positive Effects of the Resource.
Direct mindful awareness to concentrate on the positive effects of
the somatic resource for at least 15 seconds.
Capitalizes on neuroplasticity
Builds new neural networks
` Develops new habits and connections
Fortifies a balanced state

Directed mindfulness: paying attention to particular elements of internal

experience. Ogden et al 2006; Ogden 2022
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5. Engage in Your Environment

• Look around and find any pleasant color, shapes or other
sights in your environment.
• Notice sounds or smells around you that are neutral or
pleasing to you
• Feel the air on your skin
• Connect with someone who can support you, or with a pet
• Drink water
• Slowly eat something you enjoy. Ogden 2022
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Systemic Oppression, Racialized Trauma

Trauma for marginalized people reflect not only personal trauma but also
systemic oppression, racialized trauma and historical trauma

Trauma is not “over” but occurring in present time:

•ongoing threat and economic struggle related to social location and
intersectionality
•ongoing microaggressions that are retraumatizing
•living in areas disproportionately affected by crime
•relocation, immigration, refugee status
•cumulative trauma across generations from mass group trauma
Ogden, Taylor, Jorba, Rodriguez & Choi, 2021
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Traumatic Memory and the Body

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SP Paradigm Shift: from “Talking About” to

Exploring “How” Experience is Organized
Less interested in conversation, more interested in exploring habits

Less curious about content and current events, more curious about automatic
reactions to content and events—the physical tendencies, related beliefs and
habitual emotions

Less focused on history (personal, collective, transgenerational), more

focused on the effects of history in the present moment

Less concerned with details, more concerned with patterns

Kurtz, 1990; Ogden, Minton & Pain 2006
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Ogden in press
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 Two Factors Determine How We
Organize Experience
1. What happens to us (the event)
2. Our reaction in the moment 5 Building Blocks of
Present Experience
• Cognition: thoughts,
Event meaning making
• Emotions
Event Our • Sensory Perception
Habits • Movement: gesture,
Event Event posture, facial
expression
• Sensation: ANS

© Pat Ogden & Sensorim otor Psychotherapy® Institute Kurtz, 1990; Ogden et al 2006
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Embedded Relational Mindfulness:

Rooted in Eastern practices & spiritual traditions
Has been widely appropriated by Western cultures
Serves a different purpose when applied to psychotherapy

•Prioritize mindfulness of organization Thoughts

& Beliefs
of experience instead of talking about, Emotion
conversation, interpretation or
Sensory
problem-solving Perception
Movement
• Track & help client become mindful
of how the organization of experience Sensation
(building blocks) changes in response
to stimuli © Pat Ogden & Sensorim otor Psychotherapy® Institute Ogden et al 2006; Ogden 2021 33

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Embedded Relational Mindfulness Skills to Study

the Organization of Experience
1. Track by observing the client’s present experience (building blocks)
2. Make contact statements that empathically name what you track
3. “Frame” by collaborating with the client to determine a focus for
mindful exploration
4. Ask mindfulness questions that clients can only answer from awareness
of internal present experience.
5. Create little “experiments” (verbal and somatic) to study the
organization of experience (“what happens when…?)
6. Obtain mindful report by asking that clients share their present
moment experience of the building blocks with the therapist.
Kurtz 1990 ; Ogden, M inton & Pain 2006;
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 Resourcing VS Processing
Ogden et al 2006
•Focus on resources that bring •Experientially access traumatic
arousal back into the window memories to catalyze the
of tolerance. effects of the memory.
•Develop a strength or •The dysregulated arousal and
competency to regulate truncated defensive responses
dysregulated arousal and provides the basis for
deactivate overactive animal processing memory.
defenses.
•Complete incomplete actions
•Practice somatic resources. voluntarily &/or use
sensorimotor sequencing.

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Memory: Individual & Collective, Explicit & Implicit

auto-biographical communicated
Explicit
individual Memory collective
Implicit
procedural
cultural
affective
transgenerational

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“ Trauma survivors have symptoms

instead of memories” Harvey 1990

LONG TERM Addiction, eating

Depression
disorders, substance
Em otional:
Insom nia abuse
Panic, fear, crying spells,
Sensorim otor disorientation, clinging or
HR, breath, distancing, worry, numb,
Panic temperature, flat, anger, helpless
Hopelessness,
Attacks tension, digestion, frustration, rage
sleep, numbness, Im m ediate Generalized
physical symptoms Sym ptom s Anxiety
(pain, itching, startle,
agitation, intrusions, Cognitive: Ruminating, hard Am nesia
Persistent nightmares
physical to concentrate, confusion,
impaired judgment, self- Self-hatred
sym ptom s/pain
judgment, minimizing

Apathy SYM PTOM S Attention

difficulties
Relationship Self-Destructive
Problem s Dissociative disorders Behavior
© Pat Ogden & Sensorim otor Psychotherapy® Institute Ogden 1992; Fisher 2012 37

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 A Sensorimotor Psychotherapy Approach
to Memory
Treatment of memory focuses primarily on:

•the effects of the memory as triggered in present

time, rather than on the event

•the nonverbal implicit memory, rather than on

explicit memory content.
Ogden et al 2006
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Neuroregulatory Intervention Skills

(Ogden et al 2006)

Teach clients the difference between body sensation and emotion.

Not doing so will result in escalating arousal
Use sensorimotor processing to interrupt cycle of escalating
arousal.
As attention is turned exclusively to sensation, emotion is disregarded until
arousal has subsided.
Limit the amount and intensity of information to be processed so
that it becomes more manageable

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Body Sensation Vocabulary

achy dry light shudder
airy dull moist spinning
bloated electric nauseous stinging
blocked energized numb suffocating
breathless faint paralyzed sweaty
bubbly flaccid pounding tense
burning flushed pressure throbbing
buzzy flutter prickly tight
chills frozen puffy tight skin
clammy fuzzy pulsing tingly
congested goose-bump quake tremble
cool heavy quivery tremulous
damp immobile radiating twitch
deadened itchy shaky vibrating
dense jerky sharp warm
dizzy jumpy shivery
© Pat Ogden & Sensorim otor Psychotherapy® Institute wobbly 40

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 Neuroregulatory Intervention: Sensorimotor
Sequencing to Recalibrate the Nervous System
Use the memory narrative to stimulate dysregulated arousal
2. Sensorimotor sequencing: track and follow the sensations as they
sequence through the body

Window of
Tolerance
1. Patient experiences 3. Arousal returns to the
the sensation of hyper window of tolerance;
arousal body sensation calms
© Pat Ogden & Sensorim otor Psychotherapy® Institute 41
Ogden & M inton 2000; Ogden et al 2006

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The Modulation Model

Ogden 1992; Ogden & M inton 2000; Ogden et al 2006; Ogden 2009/2013

Freeze: Alert im m obility, Cry for Help (heightened eye

activity arrest , body is
contact, seeks proximity)
constricted, tense,
“paralyzed terror”
Fight/Flight (tension,
SNS Hyperarousal Zone: trembling in jaw, arms,
A Danger
hands or legs, feet)
R
O Social Engagement
Safety “Window of Tolerance”*
U
S
A DVC Hypoarousal Zone: Feigned Death:
L Life Threat Shut down, flat affect, decreased sensation, little
facial expression, unresponsive; slowed
Ogden and Minton (2000) movement, collapsed posture, flaccid muscles
*Term coined by Siegel, D. (1999)
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Regulate Overactive
Flight Instinctive Defense
Ogden 1992; Ogden & M inton 2000; Ogden et al 2006; Ogden 2009/2011
Dysregulated Flight Defense
Terror, impulses to twist away or to flee, actions of running away, moving, and getting away
to release tension in legs, feet

SNS Hyperarousal Zone:

A Danger
R
O
U VVC Social Engagement “Window of Tolerance”*
Safety
S
A
L DVC Hypoarousal Zone:
Life Threat
Ogden and Minton (2000)
*Term coined by Siegel, D. (1999)© Pat Ogden & Sensorim otor Psychotherapy® Institute
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© Sensorimotor Psychotherapy Institute 14

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 Regulate Overactive
Fight Instinctive Defense
Ogden 1992; Ogden & M inton 2000; Ogden et al 2006; Ogden 2009/2011

Overactive Fight Defense:

Rage, impulsive aggressive outbursts, destructive behavior, tense jaw, arms,
hands, disorganized movement
SNS Hyperarousal Zone:
A Danger
R
O
U VVC Social Engagement “Window of Tolerance”*
Safety
S
A
L DVC Hypoarousal Zone:
Life Threat
Ogden and Minton (2000)
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© Pat Ogden & Sensorim otor Psychotherapy® Institute
*Term coined by Siegel, D. (1999)

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Cry for Help Preparatory Movements

Tension in throat, a feeling of sound rising up,
impulse to yell
the “silent scream”
eyes fixed on you, the therapist
movement, tension, or sensation in hands,
arms, or the body that are related to
proximity seeking actions. Ogden 2021

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Immobilizing Defense: Freeze

Ogden 1992; Ogden & M inton 2000; Ogden et al 2006; Ogden 2009/2011

• Hyperarousal, hyper-alert • Frozen stare or hypervigilance

• Movement ceases (activity arrest) • May or may not have racing thoughts
• Body is constricted, tense, may be rigid • Usually coupled with high anxiety,
• Feeling of paralysis terror
SNS Hyperarousal Zone:
A Danger
R
O
U VVC Social Engagement “Window of Tolerance”*
Safety
S
A
L DVC Hypoarousal Zone:
Life Threat
© Pat Ogden & Sensorim otor Psychotherapy® Institute
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© Sensorimotor Psychotherapy Institute 15

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 Immobilizing Defense: Feign Death
Ogden 1992; Ogden & M inton 2000; Ogden et al 2006; Ogden 2009/2011

• Hypoarousal, shut down, flag • Collapsed posture, slowed movement

• (called “Freezing” by some authors) • Emotional and physical numbness
• Flaccid muscle tone, flat affect, little facial • Sometimes loss of consciousness or
expression, blank stare, decreased sensation awareness
SNS Hyperarousal Zone:
A Danger
R
O
U VVC Social Engagement “Window of Tolerance”*
Safety
S
A
L DVC Hypoarousal Zone:
Life Threat
© Pat Ogden & Sensorim otor Psychotherapy® Institute
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Track for Preparatory Movements and

Execute Empowering Actions
Fight: Movement, tension, or sensation in jaw, shoulders, arms, hands
that are related to fight or pushing actions (fingers start to clench, or
come up); impulse to bite or growl

Flight: Movement, tension or sensation in pelvis, legs, feet; leaning

backward, movements away; wanting to run

Cry for Help: Tension in throat, a feeling of sound rising up, impulse to
yell, the “silent scream,” eyes fixed on you, the therapist; movement,
tension, or sensation in hands, arms, body that are related to proximity
seeking actions.
© Pat Ogden & Sensorim otor Psychotherapy® Institute
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Recap: Processing Traumatic Memory

• Mindfulness: gently develop a capacity to witness negative internal
experience (sparts of the body, sensations, movements, sensory
perceptions, emotions or thoughts that feel activated, tense, anxious,
painful, overwhelming, frightening, etc.)
• Oscillation: shift attention between the positive effects of resource and
negative internal experience
• RAD (Reinstate Active Defense): regulate dysregulated defenses and/or
mindfully execute physical impulses to defend as they emerge (SP
technique).
• ROD (Regulate Overactive Defense): execute defensive action in slow
motion with mindful reporting of internal experience (SP technique)
• SMS (Sensorimotor Sequencing): allow body sensations of hyperarousal to
unfold or “sequence” through the body until they settle for metabolization
of the activation (SP technique)
© Pat Ogden & Sensorim otor Psychotherapy® Institute Farca & Ogden 2022 49

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 The Principles
Dissociation and the Body

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Organicity
Non-Violence

Principles to Guide Practice:

Presence &
Conditions for Optimal
Mindfulness
Growth and Evolution
Unity

Mind Body
Spirit Holism
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The Principles: A Map for Love

Vitalize a way of being in the world, with ourselves, with
each other that generates a context for evolution, a
container for healing.

• Emergent and Aspirational

• Complex and multifaceted
• Shape the atmosphere conducive to healing
• Define the therapeutic relationship
• Guide interventions

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 Complex Trauma
(1) are repetitive or prolonged,
(2) involve harm or abandonment by
caregivers or other adults
(3) occur at developmentally vulnerable
times, such as early childhood or
adolescence.
(4) Can also develop in adulthood
Ford & Courtois 2009
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Complex trauma can Lead to

Dissociative Parts of the Self that May
Have Different:
• Predictions and expectations
• Abilities for reflective functioning and mindful awareness
• Emotional biases and preferences
• Physical habits (postures, movements, gestures, facial
expressions)
• Meanings, beliefs, interpretations and ways of thinking
• Relationship styles & patterns with others

Ogden 2021
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Therapists often report:

•Clients with complex trauma are too dissociative to work
with the body
•They’re are not interested in somatic work
•I cannot use Sensorimotor Psychotherapy’s body-oriented
interventions because my clients with complex trauma are:
dysregulated low functioning
triggered anxious
not ready depressed
unaware body phobic
“in their head” [fill in the blank] Ogden in press
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A Few Reasons why a Somatic Approach may be
Challenging for Dissociative Clients
• Dissociative parts manifest somatically, so different postures and
movements represent different parts of the self
• Different parts have different goals, so they have different responses to
body-oriented interventions
• Movements and postures that are helpful to one part can dysregulate
another (problems with body-based homework)
• The body does not feel safe; clients are phobic of the body
• Many clients live with ongoing trauma and systemic oppression; the
trauma is not “over” Ogden 2014
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Structural Dissociation
cf., publications by Van der Hart, Nijenhuis, & Steele
Existence of at least two dissociative sub-systems of
personality, each with at least a rudimentary sense of self

Action Systems of Action Systems of Defense

Daily Life These part(s) live in
These part(s) avoid “trauma time” and are
traumatic memories rooted in instinctive
and reminders defenses

More severe, chronic trauma leads to more complex structural

dissociation of the personality, i.e., more parts fixated in trauma, and,
eventually, more parts living in trauma time
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Diagram of Structural Dissociation

Daily Life part(s), rooted in action
systems of daily life, avoid traumatic
reminders to engage in normal life
roles and tasks.
Parts in Trauma Time, rooted in action
systems of instinctive defense, engage
survival strategies and as such are
usually hyper- or hypo-aroused.
Partner Worker Caregiver

Fight Flight Freeze Feign Cry for

Death Help

Ogden, Adapted from van der Hart, Nijenhuis & Steele, 1999

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 Conflicting Goals of Parts
The goals of the defensive parts-- to defend and protect
-- that are stimulated by traumatic reminders conflict
with the goals of daily life parts -- to engage with other
people and the environment.
•Both daily life parts and instinctive defensive parts are
visible in the postures and movements of the body that
often conflict.
Ogden et al 2006; Ogden & Fisher 2015
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Structural Dissociation:
A good theory for body-oriented therapy
•Action systems readily clarify how dissociative parts manifest
somatically. Each part (associated with action system) has
corresponding movements, postures, gestures, expressions, etc.
•Both daily life parts and instinctive defensive parts are visible in
postures and movements of the body that perpetuate dissociation

•The body offers opportunities for addressing parts of the self gesture,
posture, tension, gait, movement, and body sensation become targets
for treatment interventions Ogden 2008
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Personal Trauma & Systemic Oppression

…a person or group of people can suffer real damage, real distortion, if
the people or society around them mirror back to them a confining or
demeaning or contemptible picture of themselves.(Taylor, p. 25)

“Double Consciousness (Du Bois 1903): the contradiction between

society’s perspective and one’s own perspective of oneself, can be
internalized as two differing views of oneself.

Double consciousness: a condition in which two distinct, unrelated

mental states coexist within the same person. This may occur, for
example, in an individual with dissociative identity disorder. (APA 2020)

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 Mapping Physical Correlates of Parts
Daily Life part in back and Shutdown, feigned
squared shoulders, death part in numbness
(present when caring for and a collapsed posture,
others, at job and other self-loathing and shame
“adult” roles)
Freeze part in overall
Fight part that turned constriction, high anxiety and
her anger toward darting eyes
herself in tension of jaw,
arms and hands Cry-for-Help part in a sensation
of panic in her chest when her
Flight part connected with
boyfriend is upset with her
addictions, precipitated by
a backward movement and
jittery feeling in legs Ogden 2004/ 2021
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Actions, like words, can be

viewed as threatening and
adversarial by other parts or
self states whose reality is
challenged by such actions.
Ogden 2014

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Parts have their own postures, movements,

perspectives, perceptions, memories, predictions,
emotions beliefs

Ogden 2004/2019
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 Collaboration among parts should include
finding how to change posture or make
actions in a way that includes various parts
of the self, rather than choosing between
one posture, or one action, and another.
Ogden 2012

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Use Directed Mindfulness as a Titration Strategy

Track, contact, and direct mindful attention to internal
experiences:
•that are generally resourcing and empowering
•to actions that are acceptable to most parts, rather than override
•to experiences that approach the edge of the window (not too
triggering)
•to how parts might help one another through action or words
•to small communications between parts
•away from “becoming” a part, reliving trauma, or the strong
emotion association with one part (until client is capable of
integration) Ogden 2021
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Symptoms
´ Anxiety
´ Insomnia
´ Depression
´ Addiction (struggles primarily with alcohol)
´ Avoids relationships, especially sexual intimacy
´ Isolated, no “real” friends
´ Agoraphobic tendencies
´ Consumed with regret about her life, especially about not
having a family Ogden 2021
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 Risks of Executing a Defensive Action
The action can vitalize the part associated with the action

Client may lose ability to be mindful, and instead identify with a part

Clients may fear that the part associated with the action will take over (they
will become the part)

The action may feel threatening to other parts of the self who fear the
repercussions of executing that action

Finding words to go with the action may be dysregulating

The action can bring up images, emotions and memories that can be
dysregulating Ogden 2021

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Recognize that Each Part has its Own

Unique Purpose
•Recognize (out loud) the important purpose and functions of parts as they
emerge
•Ask (yourself and client) about the purpose and function of each part
•Reframe parts as “survival resources”
•Express appreciation of the parts and their purpose, and ask other parts of
client do the same when they are authentically able to
• Do not take sides and intervene if one part of the client blames another part
•Do not try to get rid of a part; reassure a part that you are not trying to get
rid of it if needed
•If necessary, ask a part if it would be willing to “step aside” or “dial down” for
a few moments, then come back to it Ogden 2021
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Goals and Purpose of Parts

Purpose and Goals of Daily Life Part(s) Purpose and Goals of Parts in Trauma Time
To engage with others and what I have To be alert to danger, protect me and keep
to do in my day-to-day life me safe

Partner: Worker: Caregiver: Fight Flight Freeze Shut Cry for

Down Help
Support my Get up Take care To fight To get To not
partner, and go to of my back away and move so To do To try to
have sex, work, do a kids, pay when run away no one what get help
talk, and good job, attention someone from notices they and not
work stay to their threaten danger, me so I want do it on
together for centered, needs, set me use don’t and not my own
the good of interact, limits, alcohol to get hurt be there all the
our take don’t hit do it so I time
marriage feedback don’t
feel
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 Use the Body to Facilitate Somatic
Communication between Parts
• Search for ways to draw on the body to facilitate awareness
between parts
• Clarify how each part “lives” in the body , and what actions go
along with each part
• Use actions as experiments (“what happens to that part…”
• Ask if other part(s) can sense the somatic communication
• Track and name changes in the body as parts communicate
• Discover what the parts might want to say to one another
through words
Ogden 2021
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Use of Self-Touch to Help Parts Communicate:

• Physical contact can help forms connection between parts, can
facilitate communication and integration
• Releases oxytocin, which aids emotional connection, increases well-
being, decreases anxiety and fear (but can be threatening to some
parts)
• Replicates feelings of comfort and safety that we receive when a
trusted loved one touches us (can be threatening)
• Can be empowering, an action taken to support one’s well-being
• May help reduce pain and tension
• Can improve mood, lowers cortisol (stress hormone)
• Increases dopamine and serotonin, neurotransmitters that help
relieve stress © Pat Ogden & Sensorim otor Psychotherapy® Institute
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Facilitate Communication between

Parts, cont.
• When child part emerges, stay focused on the here and
now rather than go into negative emotions of the child
part (unless and until client has developed sufficient
integrative capacity)
• Help client find the “just right” self-touch
• Name the communication between the parts
• Capitalize on appreciation when it happens

Ogden 2021
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 “Safe but not too safe”
(Phrase coined by Bromberg 2006)
Work “on the edge:” at the regulatory boundaries of the
Window of Tolerance.

Hyperarousal
Zone

Original Therapy that stays in the middle (“too Expanded

Window of safe”) will not access dysregulated Window of
Tolerance* arousal and subsequent regulation. Tolerance*

Hypoarousal
Zone
*Term coined by&Siegel
© Pat Ogden 1999
Sensorim otor ©Ogden and Minton (2000)
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A Sensorimotor Psychotherapy Parts Work

• Body-oriented interventions, such as tracking and contacting somatic indicators
of parts, and the actions that emerge when parts do, help clients unblend parts
• Mindfulness helps the client identify and become curious about parts (unblend)
rather than identify (blend) with them.
• Experiments to engage new physical actions related to parts facilitate completing
actions and communication between parts
• Combining sensorimotor “bottom up” interventions with cognitive and
emotional approaches promotes integration
• The therapist engages interactive psychobiological regulation as needed

Ogden & M inton 2000; Ogden 2009/2021

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Privilege/Oppression and the Body

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 Trauma is Reenacted through
Somatic Narratives and Body-Body
Interactions
The impact of nonverbal communication has been
shown to be four times stronger than that of verbal
language when both are used simultaneously (Argyle et
al., 1970).

In this sense, seemingly ordinary social gestures not only

replicate but also perpetuate relational patterns,
transgenerational trauma and histories of cultural
domination and subordination. Ogden et al 2021
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“asymmetrical interactions are a hallmark of the

nonverbal exchanges between individuals from
dominant/subordinate social groups” Johnson, 2015
Dominant Actions (subordinate are the opposite):
• Take up more space through expansive postures and movements (Gillespie &
Leffler, 1983)
• Claim territory: invading other person’s space
• Eye contact: prolonged, direct eye contact can be a signal of dominance (Ellyson &
Dovidio, 1985);
• Initiate touch (Henley & Freeman, 1995) (can indicate a sense of ownership)
• Touch other people’s possessions
• Ogden et al 2021
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Body to Body Communication

Bias, and
power/subjugation
dynamics, are reflected
and sustained through
body-body interactions,
and non-verbal
microaggressions

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 Transgenerational Trauma can be Transmitted
via Imitation
• Babies and children learn posture and movement
patterns through imitation

• Mirror Neurons (Gallese & Rizzoliati,1996) are premotor

neurons that are activated by the observation of an
action, internally activating the motor neurons as if
the action were being performed

• Posture and movement predisposes us to experience

particular emotions and thoughts
• Ogden et al 2006; Ogden 2021

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“Holly” Treatment
• Pattern of catering to her boyfriend
• Experiment with taking up space Exaggerate slightly how she physically
hides herself, pulls her body in, to not show her intelligence
• New positive childhood memory of reading a story in class
• Go back and forth between these two postures, noticing what happens
• Sadness when she make herself small and hides away and keeps herself
down
• Ask what the child part needs (“to know it’s ok to stand out, be smart”).
• Holly tells the child part it’s ok to stand out and be smart; her body gets
bigger, feels “here”
• Integrate by standing, taking up space (”I feel more alive, more free”)
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Historical Trauma Impacts Perpetrators or

Oppressors & Oppressed or Victimized
• Harrell (unpublished paper): legacy of relational adversity and trauma
“involves not just the target or “victim”, but also perpetrators and their
descendants”
• The targets of interpersonal violence often become the perpetrators
themselves (Friere, 2007; Kar, 2018).
• Being shunned or ostracized have been shown to predict later aggression
(Ren et al., 2018; Wesselmann et al., 2017).
• Both the oppressors and the oppressed can carry the effects of recent and
distant history in symptoms and behaviors.
Ogden et al 2021
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 A Shift is Required to Challenge the Cycle
of Trauma for Victims and Perpetrators
The dysregulation that perseveres after traumatic events can contribute to a
cycle of transgenerational trauma for both victims and perpetrators.
•Hyperarousal and anger can lead to violence as well as panic, anxiety and
other trauma symptoms
•Numbing and detachment can prevent empathy for the pain and suffering of
others as well as loss of engagement, immobility, and other trauma symptoms
“[P]erpetrator trauma demands to be recognized not only as real, but also as
profoundly affecting the future of societies riven by violence.” (Mohamed
(2015, p. 2006);
Ogden 2021
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Contextualize:
Challenge the Ahistorical Approach.
History does matter, the past does affect the present. The
privileged cannot understand the subjugated “out of context.”
K.V. Hardy

Keeping historical trauma in mind, and taking

opportunities to name, discuss, and explore it (while at the
same time assessing client receptivity as wall as our own
credibility and skill) can help place current symptoms and
experience in a broader context, provide opportunities to
express grief and to build resources. Ogden et al 2021
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Work with Perpetrator Parts

•Address the part that raped and somatic components (tension, a hardening
of his heart, and a narrowing of his eyes)
•Discover other parts ( a tender, hurt child part)
•Challenge the negative beliefs of the perpetrator part (that he had to assert
dominance to earn respect) and of the child part (that he was completely
worthless)
• Learn new actions to soothe the child part of him that felt “like scum” by
taking a breath and placing his hands over his heart.
•Process the remorse and shame he felt for his misguided violent actions
•Couple therapy using pulling motion
•Contextualize: acknowledge© Patsocialization, transgenerational
Ogden & Sensorim otor Psychotherapy® Institute elements 85

Ogden et al 2021
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 The way to right wrongs is to turn the light of
truth upon them. Ida B. Wells
Children keep the secret of trauma from shame, fear of retribution,
being judged and so forth, and lack of an attuned other.

Nations refuse to recognize violent histories of forces labour,

slavery, persecution, exterminations, and forced cultural
assimilation

Lack of acknowledgement of these truths perpetuates oppressive

policies Ogden 2021

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Trauma and Embodiment of Resilience

Recognize and inquire about the resources inherent in the client’s
culture: traditions, spiritual or religious elements, food, celebrations,
songs, art, and so on.

Inquire about your client’s caregivers, parents, grandparents, other

relatives and ancestors.

Encourage them to think back as far as they can, to reflect on

ancestors’ countries of origin, the challenges they faced, the talents,
strengths and personal gifts they possessed, their contributions to
their communities, their professions, the qualities they were known
for, that speak to the resilience they developed.

Encourage the ways your client embodies resilience

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Attachment, Relationships and the Body

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 Trauma & Relationship
•Trauma: overwhelming experiences (personal, racialized, systemic, etc)
that cannot be integrated and elicit subcortical instinctive defensives and
dysregulated arousal.
•Relational/Developmental/Societal Issues: experiences with early
childhood caregivers, other relationships or society as a whole that cause
emotional distress, but do not cause severe or prolonged dysregulation.

•Relational trauma: experiences with perpetrators; relational or

attachment conflicts (physical/emotional) are overwhelming or
experienced as dangerous, such that instinctive defenses are employed.
Ogden 1992; 2021
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Attachment and Relational Strife can be Non-

Traumatic or Traumatic (when extreme)
Core Self:
• “the self that is shaped by early attachment patterns—
is defined by who the parental object both perceive
him to be and deny him to be.” Bromberg 2006
Double Consciousness:
• …the contradiction between society’s perspective and
one’s own perspective of oneself. Du Bois 1903

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Social, Attachment- Trauma-

Related Defenses Related Defenses
• Defense against rejection, •Instinctive defenses against
abandonment, criticism, etc. danger and life threat
• Attempts to maximize what the
•Mobilizing Defenses:
relationship has to offer
Cry-for-Help
• Limit the negative impact of painful
Flight
emotions that evoked inadequate
understanding and empathy from Fight
others. •Immobilizing Defense
• Development of a social façade or Freeze
the “false self” Feigned death/Shut down
• Needed to some degree by
•Needed in the face of danger
everyone © Pat Ogden & Sensorim otor Psychotherapy® Institute Ogden 2020/2021 91

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 Meaning from Relationships
Children acquire ‘implicit
relational knowing,’ in other
words ‘how to do things with
others Lyons-Ruth, 1998, p284.
Encoded in procedural memory,
the legacy of attachment, other
significant relationships and
culture influences the meaning
Ogden 2021
we make of each moment
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Physical Habits Reflect Meaning

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Interventions for Resourcing & Processing

Attachment Failures & Relational Strife
1. Resource: Discover how the body reflects relational injuries
and beliefs and find an action that is incompatible with this.
Find the meaning.
2. Deepen and Process: Work with strong emotions, beliefs and
the body. Address proximity seeking actions. Exaggerate the
pattern of how the body reflects relational issues . This can
take a client deeper into the experience of associated beliefs,
memories, and emotions Ogden et al 2006
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 Linking and Unlinking the Building Blocks
Trauma: Unlink the Building Blocks to focus on body sensation and
movement in order to facilitate facilitate bottom-up processing.
“Put the fear aside & stay with your body;”
“Drop the memory & just sense that impulse to push away.”
Attachment/Relational Issues: Link, or stitch together the Building
Blocks to deepen the experience of the attachment wound. Integrate
bottom-up processing with emotional & cognitive processing.

“When you say the words, ‘I’ll never get what I want,’ what
happens in your body? What emotions come up? Images?
Thoughts?”
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Attachment-Related Emotions
“Many of the most intense emotions arise during the formation,
the maintenance, the disruption, and the renewal of attachment
relationships.” J. Bowlby, 1979, p. 130

Stimulate intense If we stay in the middle, we will not

emotion -- “on access the emotional pain and Expanded
Window of
the edge” associated limiting beliefs related to Tolerance
attachment relationships.

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Proximity Seeking Actions

and Meaning
Reflects cultural norms and adaptations to past
experience (personal, sociocultural)

Reflects and sustains implicit meaning

Communicates meaning to self and others

Originally served to maintain or enhance

individual, caregiver, community, clan, or peer
group relationships © Pat Ogden & Sensorim otor Psychotherapy® Institute 97

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Sensorimotor Psychotherapy Integrates Top-Down & Bottom Up
Top Down Bottom Up
Addresses cognitive & emotional processing Addresses body processing
•uses cognition to regulate affect and •uses the body to regulate affect and
sensorimotor experience sensorimotor experience
•the entry point is the story •the entry point is the body
•identifies and changes cognitive distortions •identifies and changes physical patterns
•fosters linguistic sense of self •fosters somatic sense of self
•focus on understanding and meaning- •focus on how physical habits affect meaning-
making making
•formulation of a verbal narrative •fosters a new somatic narrative
Ogden, 2002/2023
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We are what we repeatedly do

Aristotle
• Every waking moment, we are practicing something—some action,
attitude, thought, emotion, or way of being.

• Actions that we repeatedly do (or do not do) affect our well-being

• We can become mindful of our habits and decide to make a different

choice
• Ogden 2020

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“Safe but not too safe”

(Phrase coined by Bromberg 2006)
To expand the window of tolerance, we must challenge its
regulatory boundaries.

A
R
O If arousal stays in the middle, clients will not be challenged to
U address uncomfortable or somewhat dysregulating material
S
A
L
Ogden & Minton 2020; Ogden 2021
© Pat ©
Ogden
Sensorim
& Sensorim
otor Psychotherapy®
otor Psychotherapy®
Institute
Institute 100

100

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 SPI TRAINING LOCATIONS

© Pat Ogden & Sensorim otor Psychotherapy® Institute 101

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Upcoming Training in Paris – IN FRENCH & IN PERSON

Level 1 – Sensorimotor Psychotherapy for Trauma
Starting september 26, 2024

With Raphaël Gazon,

French certified faculty of the SPI

Organized by PEPS-E Center,

Resonance Institute & Parole d'Enfants

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Open a new
dimension for
effective therapy.
Professional Training Program
for Mental Health Professionals

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 Sensorimotor Psychotherapy

Resource Protocol
5 Steps to Modulate Activation & Build Resilience

Pause what you are doing to briefly identify Somatic Resources:

bodily signals of unrest. Orient, look around, name
Maybe you feel muscle tension, weakness, shakiness, colors you see
numbness, shallow, rapid breathing, fast heart rate. Lengthen your spine
Ground, sense your feet
connect with the earth
Embody a somatic resource that feels Breathe slowly & lightly
through your nostrils, into
supportive in your body in this moment.
your belly.
Try combining them (e.g., Breathe & Lengthen spine; Place hands on heart or
Make a Stop gesture & Ground). belly, or hug yourself
Smile in a way that feels right
to you
Acknowledge the positive effects of the
Make a “Stop” gesture with
resource.
palms open, facing outward
Maybe you sense more relaxation, settled energy, slower
Stand up, feel your feet push
heart rate, deeper breath, softer eyes, less numbness, or
more energy and alertness. against the floor
Push palms of hands against
each other, the wall, or an
Concentrate your attention on the positive object
effects of the resource for 15 seconds or Hum with a low pitch and
more. sense the vibration
Focusing attention on internal signals of ease fortifies a Move rhythmically: rock,
resourced state & helps rewire your brain. sway, bounce, swing
Walk slowly, sensing your
legs moving
Engage with your environment.
Embody your culture, its
Look around, notice pleasant sights, sounds, & smells, traditions, and/or the
feel the air on your skin, connect with a person or a pet, support of your ancestors
drink water, taste something you enjoy.

Find more resources at

sensorimotorpsychotherapy.org
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