Off-the-couch mental health therapies
New research brings new approaches. Here's a look at four fields: mindfulness practice, guided imagery, somatic experiencing and eye movement desensitization and reprocessing.
A free weekly mindfulness meditation convenes in the theater at the Hammer Museum, led by Diana Winston. (Katie Falkenberg, For the Los Angeles Times)
When you think of psychotherapy, the first image that comes to mind might be one of a distressed patient lying on a couch, talking, while a desk-bound therapist takes notes. But while traditional talk therapy can help people struggling with depression, anxiety and the stresses of daily life, the latest research on the brain and the mind-body connection has sparked a proliferation of approaches that may reach deeper levels of emotional healing than talking alone.
Talking takes place in the cognitive, or "thinking," part of the brain, and our thoughts are often the problem, adds Wolf Mehling, a physician at UCSF's Osher Center for Integrative Medicine. To help combat negative or obsessive thinking, many new therapeutic approaches focus on letting go of thoughts and becoming anchored into bodily sensations.
Though alternative treatments will probably never replace traditional talk therapy, new psychotherapeutic approaches can be used in conjunction with talk therapy to help people achieve optimal mental health, says Don Hanlon Johnson, professor of somatic psychology at the California Institute of Integral Studies in San Francisco.
Alternative treatments run the gamut from techniques that are championed by mainstream mental health professionals to practices that are more in the "fringe" realm of meridian-tapping and energy work. Here is a glimpse into four of the more widely accepted nontraditional approaches, each with an element of mind-body awareness:
What it is: Rooted in Buddhist meditation techniques, mindfulness practice has become accepted among many Western mental health professionals as a powerful psychological tool. The practice is usually taught in a group, in which people learn to focus on their breath and body sensations in moment-to-moment awareness.
How it can help: Studies have demonstrated that it can alleviate symptoms of depression and anxiety and that it may help prevent depression relapse. It's also been shown to reduce feelings of stress and loneliness, help manage chronic pain and increase success rates of addiction recovery.
This process can also help with impulse control, Johnson says. "Many problems are rooted in the fact that we're dissociated and unaware of our bodily response to things. People aren't aware of harmful impulses until they get out of hand. So mindfulness practice is about teaching people to slow down and notice when impulses arise."
What it is: Guided imagery is a mind-body technique that teaches people to use their imaginations to achieve a relaxed, focused state. Under the guidance of a therapist or CD, listeners use their senses to evoke positive, safe, relaxing images.
How it can help: The idea is that the body and mind will respond to images as if they are reality. If you imagine sucking on a lemon, chances are your mouth will water as if you are actually tasting a lemon. Much in the same way, people respond to comforting or relaxing images by experiencing feelings of increased well-being.
Research has shown that people who practice guided imagery have lower levels of the stress hormone cortisol and an overall decrease in depression, anxiety and fatigue. Guided imagery may also help motivate people to make positive life changes, such as losing weight or starting an exercise routine.
What it is: Somatic experiencing is a body-focused intervention used to discharge tension that is stored in the body following a traumatic event. The therapist directs the patient to revisit the event in small doses while focusing on body sensations, guiding the patient to shift focus back and forth between the traumatic memory and an image of comfort and safety. As fears dissipate throughout the patient's body, gentle touch or movement is used to help ground the person in the present moment.
How it can help: Somatic experiencing is believed to regulate the involuntary nervous system, the network that's responsible for the body's "fight or flight" and "rest" responses. There have been a handful of studies that show promising results. A 2009 study looking at social service workers involved in hurricanes Katrina and Rita showed that those who underwent somatic experiencing showed decreased symptoms of post-traumatic stress disorder (PTSD). Somatic experiencing has also been used successfully with victims of other natural disasters, automobile accidents and abuse.
Eye movement desensitization and reprocessing
What it is: In a typical session of eye movement desensitization and reprocessing (EMDR), a patient revisits traumatic memories while following a pendulating object (such as a therapist's waving finger) with the eyes. Originally developed to help veterans who suffered from PTSD, clinicians now use the therapy to treat such problems as anxiety and addiction. Frequently, the eye movements are replaced with audio tones alternating in each ear through headphones. The treatment also incorporates other mind-body approaches, such as focusing on body sensations and evoking images of positive resources that can help the patient work through disturbing events.
How it can help: The idea is that EMDR causes the brain to reprocess traumatic memories so they no longer function as emotional triggers. Though there is evidence that EMDR reduces symptoms of PTSD, the mechanism for how it works is still unknown. One prevailing theory is that focusing on two things at the same time taxes the brain's working memory, causing the disturbing image to become less vivid and less emotionally intense.
What the experts say: When a traumatic memory is incompletely processed, "it's like the train went off the neural track and is stuck," says Janis Clark, a Monterey-area psychotherapist specializing in EMDR. "Once the memory is completely processed, it's no longer stuck. The previously disturbing event moves from the emotional [region] of the brain to the long-term memory. You still remember the horrible event, but it doesn't disturb you anymore."