Somatic Psychotherapy and Integrative Medicine for Mental Health
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The Story of Woman by the Waters

9/22/2020

 
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​Once upon a time…
A young woman sat under an Oak Tree. She closed her eyes and was immersed in a rich array of color and passion. She danced under the Oak Tree with her eyes closed. She turned up the volume on all of the parts of her soul that were longing, that were crying, that were vibrant and alive. The music of Water sang within her. Quietly at first, whispering into her body, bringing her sensuality to life. The Water sang with a full voice and opened the young woman’s throat, healed her voice and poured through her out into the people.
When others in the village heard the Water song coming through her, they praised her and wondered at her talents. She knew deep inside that it was the Water flowing out, and it began to rise in her, it began to fill her and pour out of her and envelop her. She began to float on the Water that was pouring through and out of her.
The Water lifted her through a double helix into a vortex of passion again and again. Water flooded through her body until it settled in her Womb. There it pooled and simmered until she met the Lover that would instill the Water with Life. The passion for Life was so great that the Woman and her Lover lifted into a powerful spiral, the double helix became embodied in the form of a Boy.
Alas woman’s energy was sapped. The Water washed away in the afterbirth and she fell into a deep trance and was lost in the silence.
When the woman woke from the daze of spinning, she found herself deep in a Forest with the Lover at her side, the Boy tugging at her clothing and her mouth was dry. Her throat was dry, her lips were dry, her tongue was pasty and white. She was thirsty from all directions, in all her orifices, yet her hands and feet were swollen, retaining any moisture they could.
When she looked around at the trees in the forest, she was disoriented and lost. The trees were smooth, red barked Manzanitas and Madrones. They were gigantic Redwoods towering over. And the trees were all thirsty. Where was the Oak Tree she had been resting under as a young woman?
The only thing that helped her orient was the Path beneath her feet. It was dusty and tan, same as her skin.
Her urge to stay close to her family kept her alive, but now she was to claim her sovereignty and lead them home. Something in her knew that she could put one foot in front of the other.
The forest was dark and ominous - so she lit the light of her heart. The light shined the image of a White Winged Dove Woman ahead of them on the path. The man and the boy stepped into the figure of light and began to dance their way down the path. The woman’s heart leapt at the sight of her family filled with joy and she began to cartwheel ahead!
When they reached a clearing, the woman smelled the sweet citrus smell of Oranges that filled her tastebuds and quenched her thirst. The woman and the man built a cooking fire in the clearing and set up camp for the night. While the man was preparing their food, the woman took her Boy down to the river to bathe in the Water and remember where she had come from - and where she has always been.

Great Tool for Postpartum Self-Check

6/4/2019

 
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If Mamas' Self Care is Not Enough, What Is?

5/31/2019

 
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I read the Mother.ly article from April 19, 2019 titled 'Self-care' is not enough to fix how much moms are burnt out'and found it to add to the load that I experience as a mom. I know it has a lot of us raising our fists and going, "Yes, sister! I feel this!" But after reading the article and raising our fists what do we do with the built up tension stacked on the burnt out exhaustion?!

The article takes a few sentences at the end to suggest that vulnerability is the antidote to "mom burn out":

"But by being vulnerable—by putting it all out there, owning your story, and supporting other mothers as they claim their worthiness, we start to make it better. Being vulnerable is incredibly uncomfortable. The good news is that no one on this planet is braver than a mother."

I look at it differently: Self care and vulnerability are one in the same. Yes, mothers are burnt out but how does ranting about it serve us? Does this feel like an act of courage? Does this in some way feel vulnerable?

The article quotes Brene Brown and reminds us that she says that vulnerability is "showing up and being seen." But who the hell knows how to do that? Where do we learn this well-kept life secret?

Most people walk through their lives with a strong armor just like Brene talks about in her Special. She shares that she went through most of her life with her academic armor and that she was always afraid of experiencing shame and exposure. Right there was our little hint from the researcher/storyteller herself that points to an actual tool that guides us in how to “show up and be seen”. In order to start to show up and be seen in our true selves we need to recognize what armor we are dealing with. If we are not real even with ourselves and can't look ourselves in the mirror and recognize and name to ourselves what image we have knowingly or unknowingly been preserving...we haven’t begun the journey. This is the first step to accessing a raw state, our own vulnerability.  

When I ask myself this question I realize that in essence for me personally the choice to start a family has been shape shifting. The armor that I have carried all my life is the dream of being a successful musician and performer. The fantasy that I am going to be at the cutting edge of some artistic scene. My armor has been that I think I am special in some way. That I deserve fame and fortune without doing the work that it takes to reach very concrete goals. The illusion that my only obligation is to take care of my artistic expression and that it is the only thing guiding my life.

For me showing up as a mother has been the most vulnerable experience of my life.  Everything that I thought I was, has fallen away. All of my dreams have faded into the background. My sense of self has changed so drastically that I have had trouble recognizing myself. I had only ever felt that I truly knew myself when I was a raw and alone in the depths of my own soul searching. As a mother I am hardly ever alone nor do I have the time and space to be raw or soul search. (I am writing this article sitting in my car outside of my house on a Sunday evening. My husband thinks I am casing the place...) I trust that motherhood is the challenge I was meant for, that it is the most difficult thing I could do with my life, the only thing that would break down some of my ego and armor and act as the most vital reminder of my humanness. Most of all motherhood reminds me every minute of the day how vulnerable I truly am. How little control I have over my life or my children's lives. How human I truly am.

I believe that the burn out that mothers feel is precisely because of our holding on so tightly to our armoring. It takes up so much energy we aren’t even aware of. And in order to show up and be seen we need every ounce of strength and courage to be present. Moms burn out when we continue to hold on to the armor of past dreams, future desires, idealistic visions of perfect homes, work and partnership. The burnout is disconnection with our partners and our families and our communities. The burnout is disconnection with ourselves and a misunderstanding of what it is we are doing with our time and our lives.  For me the moments where I let go of the ideals and the dreams of who I thought I was going to be and who I think I should be, the moments when I actually breathe into the experience with my son and my family - these are the moments when everything becomes So. Much. Easier.

So yes, self care is not enough. It must start with self-awareness. With asking ourselves the hard questions: What are we holding on to? What do we need to let go of in order to show up? Being seen is the easy part once we have recognized our own armor and are willing to loosen it a little bit at a time.

For me this has become a lot simpler now that I have shifted gears. I have come to terms with the fact that it is time to dissolve the armor. It is not an easy thing to let go of my dreams, but ironically they are becoming more and more realized with less effort now that I am less attached. I am finally recognizing that my creative expression and music is a way that I feel connected to myself. It is not the way I am going to make a living or find fame and fortune. I know that taking space from my son and my family nourishes me so that I can come back and feel connected to them. I have joined a musical project where I am ‘just’ a singer and I don't do any songwriting or leading of the project. This is different than my artistic expression before where I would spend hours on end alone in my bedroom crafting songs and recording music. Now I get 4 hours a week to leave the house and sing for fun in a local band. Whether we become locally, regionally or nationally known is not of any concern. What is of concern to me is that I make time for this and I don't apologize for it. This has become a known routine to my husband and son and it is hopefully an inspiration to other mothers. It allows me to ask for help and have clearer boundaries because I am committed to other people in the band as well. I see many other mothers around me finding space for their passions within the context of their family role.

Focusing on ourselves, knowing ourselves and holding ourselves accountable to our own authenticity only gives us more strength. It only gives us more capacity to bear greater burdens. It only gives us the awareness to become better humans. It only gives us the courage to know ourselves well enough to make good choices, and to choose health and wellness for ourselves, our children, our families & our communities.

Mamas, have you faced yourself and recognized your own armor? Have you found an outlet for yourself that supports your sense of authenticity in a new light - without the armor? How has this affected your family life, motherhood and partnership?

I want to know that I'm not alone in shedding the armor and feeling good about it. Being raw and exposed on top of being a mom is exhausting and wonderful. I no longer have a sense of self, no longer know what my future holds, don’t know who is on my team or how I am going to pay the bills. Self care is my way of letting go of control, being open to the unknown, tolerating discomfort and being imperfect and human. Self care is my way of being vulnerable. I feel vulnerable every goddamn day and I'm gonna do as much self care as I can just to prove it.

Shall We Reap

8/31/2018

 
Not a simple time
But easy enough
To overwhelm with wishing
Wondering wistfully
Waiting, worried
For what we haven't got,
Never had,
And somehow lost

Our future swallowed and sown
By the innocence past,
Playful and incomplete.
With long drawn out moments
Pregnant with meaningless purpose
And now the seeds planted
Unknowingly and knowingly
Have come to ripen
​
What shall we reap?

My Only Regret

8/26/2018

 
I didn't know
who I would become
when my heart burst out of my chest with longing

I only knew the urgency
of clenching raw red
pumping from that organ
to extremities

sending signals
sensing sideways
in time

letting that storm settle
over the dry rocky landscape
of years
is my only regret

The Most Important Question You Can Ask Yourself

9/13/2017

 
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Take a moment to sit quietly and ask yourself: What is my heart's deepest need?
You will be surprised at the answer. And you will be surprised at how simple it is. You will be amazed at how easy it would be for you to give yourself a little bit of what you need - right now. It does not take much time or money to soothe an aching, yearning heart. But it does take intention. It takes waking up in the moment and being willing to be true to yourself. For only a moment be truly authentic with your heart and let it speak to you. It might be scary because you might worry that it will hurt to much to know how lonely or broken or tender your heart is. But that tender heart only needs a little of your attention to heal a little bit at a time.
Do this for a few moments in the safety of your home, bedroom or a place in nature where you feel grounded and supported.
Allow yourself a few moment or a few minutes to receive comfort from yourself.
This is the essence of all our healing work. We learn to give ourselves a little bit of what we are missing. A little bit at a time. And little by little, we find fullness and wholeness. 
It is not a miracle.
It is a practice. It is a process. It is a commitment to self forgiveness and growth.
And it is the path.

4 Months After

6/12/2017

 
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Picture taken & poem written in Sonoma County (on Monan's Rill) on June 12th, 2017

Tree with a thousand faces
Body of a woman
Broken and worn
Curved to perfection
Hollow and whole

Your green belongs to another
But you wear it so majestically
Your skin is smooth and so much more
Exposed, naked

I see your ravaged insides
I remember mine
Legs wide open
Turning myself inside out
The agony

Are you rotting there my lady?
Are you alive?

Now only my heart aches
At the distance between myself
And myself
The lost ideal of a beautiful birth:
Sliding my baby out of my slippery passage
Into peaceful waters
And warm awaiting arms

Ravaged instead
By the life struggling inside me

Nothing
                        Nothing
Coming to my aide

Where are my angels?
Where are my guides?
How does spirit deliver soul into body?

Cut open and pulled
Out of a woman-made hole

We surfaced under the fluorescent lights
Stunned by silence
For the first 9 minutes of your life
 I was numb for longer than that


Oh you long hollow bumpy stump of a tree
Bring me back to the mystery
Beneath your midsection something is hidden
I want you to hold me
Want to nuzzle up to your belly
And lose myself in your softness
Rest my head on your bosom
And hear your heartbeat
Ride on your hip and laugh wildly
(Just the way my baby uses my body)
And you can walk along with your curvy legs,
Sexy and lean
Like nothing ever happened
Like nothing ever died inside you
Like you are always the same as you were before
But I know you are more beautiful than ever
Radiant
Exhausted and aching

DBT - What is it really? (Sounds a lot like Buddhism!)

4/24/2017

 
Dialectical Behavioral Therapy (DBT) is a very fancy name for a skills based training program developed by a woman named Marsha Linnehan. Though the skills class is taught in as long as a 52 week model, I first learned the DBT approach as a 6 week class. The elements of the program are Mindfulness, Emotion Regulation, Interpersonal Relationships and Distress Tolerance. DBT is considered an evidence-based approach to help treat borderline personality disorder as well as others with tendencies toward suicidality and self harm.
When I learned the DBT material my first thought was, "this sounds like Buddhism!" Starting as a young adult, I have practiced meditation and mindfulness in the tradition of the Vipassana courses taught by SN Goenka and his assistant teachers.
The similarities between Buddhist practice and DBT is quite astounding...Except that it has worked for thousands of years to improve the lives of people all over the world so there is nothing surprising about using those same tools in the mental health field!
We start with mindfulness. Which means - paying attention in a non judgmental way to one thing at a time in the present moment. This itself is the core of much of what I teach clients to develop a stronger sense of internal witness. Strengthening the part of yourself that can observe what is happening inside of you is the single most valuable step toward healing. Only once you can be in the present moment and experience it as it is, can you begin to create a map you can follow toward changing old behaviors and mentality.
From here the DBT material, as well as the practice of Buddhism, takes you into more and more awareness of how you relate to life's stressors and relationships. DBT offers a very specific strategy for tracking yourself and staying committed to the work by being a part of a group where the material is being taught.
I use the DBT material with all of my clients. Sometimes it's more formal and sometimes it just seeps into the conversation. Recently I was sharing with a client about styles of communication (passive, passive aggressive, aggressive and assertive) and she looked up at me from the worksheets with wide eyes and said, "how come they don't teach this in school!?"
I agree. So many of us are left to our own devices when it comes to learning about relationships and how to deal with triggers and stress. We are so fortunate to have so much healing accessible to us as even folks one or 2 generations back did not.
The stigma of going to therapy is lifting and DBT has helped so much by being empirically studied and spreading throughout the mental health field as a highly desirable modality. Personally, I'd like to see Ms. Linnehan give Gotama the Buddha some credit... but he probably wouldn't mind since it was only ever his intention for people to find comfort and healing, regardless of who and how!!

The Importance of Safety in Working through Childhood Trauma - A Case Study

4/8/2016

 
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The main therapeutic ingredient for someone who is grappling with childhood trauma, whether repressed or vivid memory, is SAFETY. The safety we refer to in psychotherapy is not only physical safety but emotional and psychological safety as well. People who have been abused or traumatized in childhood were helpless victims because they were young and did not have control over their environment or the relationship with the adults around them. In essence, their nervous systems were built around the trauma and this usually means that dissociation is a central defense mechanism the child used. For some people the dissociation was so strong (a great way to protect themselves!) that the memories of the trauma get lost in very depth of the mind.

Below I share a short case study of a woman who, over the course of psychotherapy, has started to uncover the lost memories and rebuild her life. The purpose here is to give clients insight into the importance of safety in treatment and some of the ways a client can work with a therapist to create a safe container.

CASE STUDY (This is a very condensed synopsis of work that took about a year)

'Freya' was referred to therapy by a local agency and complained that she feels "like something bad happened to me but I don't know what." I explained to Freya that whether or not we find out what happened to her or not, our intention in therapy is to help her deal with the impact of her traumatic past on her present-day life. The very first step in creating safety is stepping away from the trauma and focusing on creating a supportive therapeutic relationship.

After a number of sessions, Freya and I became more and more interested in what helped her feel safe in the therapy room. We discovered that it was helpful if she took 15 minutes before the session to prepare and ground herself in the waiting area and also 15 minutes after the session to reflect and transition back into her day. Extending the session time in this way on her own helped Freya to be ready to go deeper when she was with me.

In the beginning of each session I led a grounding exercise to help Freya connect with a feeling of safety and support. Her favorite one was mindfulness of her feet on the floor and back against the couch. We sat together for about 3 minutes focusing on these sensations and arriving into the session slowly.

We also found that Freya felt more comfortable in the therapy office when after the initial exercise, she lay down on the couch. Most of the time she did not make eye contact with me. Sometimes her eyes were closed when she spoke but other times they were not. She could speak more naturally and freely this way instead of sitting up across from me. Once she began laying down during the session, each session deepened in content.

One week Freya shared that she had been consumed all week with the feeling that there was a child screaming inside her. I interpreted this as the young child self that Freya had left behind. During this session I guided her to close her eyes and encounter the child. After she spent a few moments with the child, I asked her to see herself in a safe place. For Freya the safe place was at the ocean, listening to the ocean sounds and feeling the sun and sand. In our session she alternated between being with the screaming child and returning to the safe place. Eventually without my guidance, Freya felt the urge to return to be with the little girl. The child in her mind was upset and closed off. They did not speak very much since it was hard to communicate with such a child. I asked Freya what she might do to connect and comfort the child. She found herself sitting down next to the little girl and placing a hand on her shoulder. This was all the contact necessary. The two of them sat together in silence like this for a long time. 

A few weeks went by and Freya returned to session reporting that she was having memories of her childhood trauma come to the foreground in her memory. She told me this calmly, sitting up across from me as an adult. The memories she shared were very difficult and painful. I remarked to Freya how grounded she seemed to be as she spoke. She said that she herself was surprised by how well she has been doing even as the memories surfaced. She did not expect it to be like this. I explained to Freya that she had been doing a very good job creating safety for herself while connecting with the little traumatized girl inside of her. I reminded her that she is no longer that young girl. She is an adult who is no longer going through those experiences. Her ability to reflect and support herself is a real show of her strength and growing self-acceptance and self-love as an adult.

I believe that it was Freya's willingness to let go of the expectation that the memories would come up that helped free them. She spent most of the first year of therapy focusing on resourcing herself in her day to day life by finding creative activities, support groups and a stable living environment. In therapy she focused on learning tools to use in times of high anxiety and depression. The repressed memories were not the focus of her attention yet when they began to surface, she had access to a whole new set of coping skills she had been building.

Building safety in and out of the therapy room is a very important process for clients dealing with childhood trauma. It can be a lifelong process. It is so valuable because healing can feel like a deep dive; you've gotta have that oxygen tank with you down there. But once you've been to the bottom of the ocean of your mind and come back to the surface, you can take a long walk on the beach.

Move your Body into Recovery from Disordered Eating

3/18/2016

 
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As I work to support women struggling with eating disorders, I am aware that the body can feel like their number one enemy. The images in the media and the cultural focus on size and shape prey on young women's vulnerable minds. They become victims trapped in a body that does not conform. Controlling their food and exercise seems like the best solution to find love and acceptance.

Overtime, once again they will learn that love and acceptance are not gained by body image. They are gained by an internal felt-sense of joy, ease and pleasure within the confines of the muscles, skin and bones - and even the fat. When this love and acceptance are for the Self - then the rest of the world will follow. They will find out the intrinsic value they have in being women. Beautiful from the inside out.

Getting from point A to point B seems like a million mile trek unless you find tools to help you traverse the long journey. One of the most profound, effective, and FUN tools is movement. You might call it dance but this can be limiting since many people have a pre-conceived notion of what dance is. The idea in using the word movement is that it is very open ended. It could be moving in any way at all. There is no right or wrong way to move.
For the purposes of healing and recovering the lost parts of yourself, it's important to begin to recover a deep attention to your inner urges. Moving to the rhythm of music while keeping focus on your internal impulses is an impactful way to cultivate that inner attention.

This week for our movement group at the IOP, I brought a play list of songs inspired by the 5rhythms practice developed by Gabrielle Roth. (The rhythms she proposes are Flowing, Staccato, Chaos, Lyrical, Stillness.)
I began by leading the women into their bodies methodically, beginning with the head - moving down to the toes. As we felt into the music, we each dove deeper into the interior of our bodies. Once we had opened up in this way, I let the songs play in order with sparse guidance amidst the music.

Some of the prompts I offered the moving women were:
  • Stay with the focus, with the attention inward. Don't use any words. Be with yourself.
  • You can close your eyes if you need to. Slow down whenever you start to lose track of yourself.
  • Keep coming back to your breath. Let your breath guide you into your body.
  • Is there a part of your body that wants some attention? Follow that. Find out more.
  • How else can you feel the rhythm of the music? Is there somewhere in between the beats that is calling to you?
  • This is time for you. Let yourself receive the movement as a gift to your body.
  • Find out all the dimensions you can be in here. From the ceiling to the floor.

At the end of the movement experience we took 5 minutes in complete silence and stillness, laying on our backs. I asked each woman to place a hand on her belly and hand on her heart at the completion and say thank-you to her body. In reflection some women shared the complexity of having had a good time moving but simultaneously knowing that they are not grateful for their bodies much of the time. Others shared that they recognize the abuse their bodies have been through and they can appreciate them for enduring it all. 

Once again, I am left with the important take-away that healing is a practice. Having used self-destructive coping tools to deal with the stressors of life for a long time, it's not easy to convince you that there are other options out there. You will need to find new, expressive and self-empowering tools to use - and just like with any craft, you will need to practice to master their art. But once mastered, these tools will be rewarding beyond your wildest imagination.

Moving toward recovery is a beautiful opportunity to get back in touch with lost parts of your embodied experience. Find music you like, that you resonate with, that shakes you up, that brings your to your knees. Music that makes you pray. You might find that you thank your body at the end. And surely your body will thank You.

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    Yonat Piva, MA, LMFT

    I write about navigating the challenges of prenatal, postpartum, parenting & relationships. I believe we can inhabit our bodies with a renewed sense of fulfillment in being a human woman.

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  • Home
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    • Yonat Piva, LMFT
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  • Services
    • Somatic Integrative Psychotherapy
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    • VoiceWork >
      • Past Students
  • Reflections
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