SOMATIC THERAPIES and MILIEU THERAPY

Somatic therapy

• A holistic treatment approach that promotes healing by connecting the mind, spirit and emotions. It is grounded in the belief that the inner world (a person's attitudes, thoughts and feelings) impacts physical wellness and functioning.

• used to get the  ANS back into balance

• used to help people who have experienced trauma or abuse

• improve both depression and PTSD

• help you get in touch with, and address, physical symptoms you may or may not have noticed

• help you recognize physical discomfort and question which emotions give rise to this discomfort

Body psychotherapy

It achieves healing by helping the person modulate sensations, emotions, and reactions, thereby healing the whole person

• Post-traumatic stress disorder (PTSD) 

• Anxiety 

• Depression 

• Addiction 

• Insomnia 

• Chronic pain 

• Bipolar disorder 

• Sexual dysfunction 

• Grief and trauma 

• Abuse 

• Sleep disorders 

Somatic therapy is used for variety of health issues including:

Somatic therapy

the treatment of mental disorders by physical methods that directly influence the body, such as the administration of drugs (pharmacotherapy) or the application of a controlled, low-dose electric current (electroconvulsive therapy).

Mind-body Connection

This is what somatic therapy focuses as treatment for mental health issues.

Autonomic Nevcous System (ANS)

Therapists who use somatic therapy generally believe that emotional traumas of all kinds can cause instability in your

Body aches

Headaches

Nausea

Trauma symptoms that manifest

• Breathing exercises 

• Vocal work 

• Sensory awareness 

• Body-mind centering 

• Dance 

• Kinetic awareness 

• Martial arts 

• Ayurveda 

• Yoga 

• Massage 

• Postural integration 

• Reiki massage 

• Acupressure 

• Meditation 

Somatic therapy techniques

Getting in tune with the body

Understanding the Body’s Responses

Integration into Talk therapy

Benefits of Somatic therapy

Talk therapy

term that can encompass most therapy techniques

Somatic experiencing therapy

This type of therapy uses techniques such as massage, acupuncture, and yoga to alleviate physical issues. This technique promotes relaxation and stress relief and can alleviate physical symptoms resulting from pain, anxiety, depression, and chronic stress.  

Accelerated Experiencial Dynamic Psychotherapy (AEDP)

This therapy is based on the  belief that our core emotions–grief, anger, fear, joy, disgust, and excitement--are fundamentally healthy ones and naturally help guide us toward growth, transformation, and healing when fully processed.

Unbearable aloneness in the face of overwhelming emotion

The term that Diana Fosha used as a description to the attachment wound that AEDP heals

Sensimotor Psychotherapy

Another type of trauma therapy that guides the body through a trauma response. This treatment functions on the idea that the body’s trauma response was never fully completed, and this trauma response must be completed for healing to begin.

Stabilization and symptom reduction

Processing

Integration

Three steps of Sensimotor Psychtherapy

Stabilization and symptom reduction

the mental health professional will help one feel safe and relaxed before engaging in sensorimotor psychotherapy 

Processing

Therapist will guide an individual through their traumatic experience and help them notice and regulate both physical and emotional responses 

Integration

allows the individual to say or do things they wished they had done during the original trauma 

Hakomi method

It takes a mindfulness approach to somatic therapy. It believes everyone comprises core material or the thoughts, feelings, and beliefs that makeup one’s personality. This therapy technique allows people to recognize their core material and accept, challenge, or transform it through five core principles

Mindfulness

the process of living in the present moment and allowing oneself to observe, meditate, and reflect on their beliefs in a non-judgmental way 

Nonviolence

the support of a person’s defensive mechanisms to learn from them 

Mind-body integration

the belief that both the mind and body comprise a person’s core material 

Unity

the belief that individuals are interconnected systems that participate in larger interconnected systems 

Organicity

the belief that the self naturally gravitates toward healing, wisdom, and wholeness 

Gestalt

• a holistic approach that focuses on the present moment and supports clients to loosen the defensive patterns that inhibit someone's natural ability to access their vitality.

• embraces the ‘paradoxical theory of change’: that people transform when they deeply become aware of who they are, not by trying to become someone else

• embraces the ‘paradoxical theory of change’: that people transform when they deeply become aware of who they are, not by trying to become someone else

Eye Movement Desensitization and Reprocessing (EMDR)

a structured therapy that addresses specific traumatic memories and how they live in the brain. it directly targets a traumatic memory through “bilateral stimulation” to change the way this memory lives in the brain.  

Bilateral stimulation

moving your body in a rhythmic way that activates both sides of the brain–such as rapidly moving your eyes from left to right or alternating tapping your left and right knee–while focusing on a specific memory

middle

Milieu in french word means

Surroundings or environment

Milieu in english means

Milieu therapy

• the treatment of mental disorder or maladjustment by making substantial changes in a patient's immediate life circumstances and environment in a way that will enhance the effectiveness of other forms of therapy.  

• A scientific structuring of the environment in order to effect behavioral changes and to improve the psychological health and functioning of the individual

manipulate the environment so that all aspects of the client’s hospital experience are considered therapeutic. 

Goal of the Milieu Therapy

Pinel

He coined the term moral treatment to describe his new approach to psychiatric care, which included removing chains, using attitudes, and setting examples of appropriate behavior and humanitarianism. 

Late 1700

Pinel (in France) coined the term “moral treatment” to describe his new approach to psychiatric care, which included removing chains, using attitudes, and setting examples of appropriate behavior and humanitarianism. 

Early 1800

Tuke (in England) established the York retreat based on atmosphere of kindness, meaningful employment of time, regular exercise, family environment, and the treatment of clients as guests. 

Late 1800

the service pattern in psychiatric institutions was the domestic service pattern in which care was custodial and the staff performed essentially house keeping tasks. 

York retreat

What dd Tuke established based on atmosphere of kindness, meaningful employment of time, regular exercise, family environment, and the treatment of clients as guests. 

Early 1900

attention to hospital atmosphere declined, resulting in the development of environments that were benignly custodial or more destructively controlling, much like a prison. 

1930

Sullivan began to experiment again with varying the treatment milieu by selecting the staff members who were sympathetic and interacted well with the patient. 

1939

Menninger and others developed prescribed attitudes based on psychoanalytical principles that determined staff interaction patterns. 

1940

the predominant service patterns was the medical intervention pattern in which staff, including nurses, served as the physicians agents in providing care. 

1946

Main ‘coined the term “therapeutic community” to describe the approach of resocialization of neurotic individuals through social interactions. 

Therapeutic community

term coined by main that describe the approach of resocialization of neurotic individuals through social interactions. 

1948

Bettleheim’ coined the term Milieu therapy to describe his use of the total environment for treatment of disturbed children.

Bettleheim

who coined the Milieu therapy

1953

Max Well Jones used the therapeutic community approach in two experimental units for the treatment of antisocial personality disorders in which the social environment was seen as the primary treatment modality. 

1990

the development of milieu therapy based on research to identify the milieu structure most effective for specific treatment groups. 

Future

Better integration of hospital and community psychiatry will provide for more efficient and   more effective care for the mentally ill in the community. 

• The health in each individual is to be realized and encouraged to grow: all individuals are considered to have strengths as well as limitations. These healthy aspects of the individual are identified and serve as a foundation for growth in the personality and in the ability to function more adaptively and productively in all aspects of life. 

• Every interaction is an opportunity for therapeutic intervention: within this structured setting, it is virtually impossible to avoid interpersonal interaction. The ideal situation exists for clients to improve communication and development relationship skills. Learning occurs from immediate feedback of personal perceptions. 

• The client owns his or her own environment: client makes decisions and solves problems related to government of the unit. In this way personal needs for autonomy as well as needs that pertains to the group as a whole are fulfilled. 

• Each client owns his or her behavior: Each individual within the therapeutic community is expected to take responsibility for his or her own behavior. 

• Peer pressure is a useful and a powerful tool: Behavioral group norms are established through peer pressure. Feedback is direct and frequent, so that behaving in a manner acceptable to the other members of the community becomes essential.

• Inappropriate behaviors are dealt with as they occur: Individuals examine the significance of their behavior, look at how it affects other people, and discuss more appropriate ways of behaving in certain situations. 

• Restrictions and punishment are to be avoided: Destructive behaviors can usually be controlled with group discussion. However, if an individual requires external controls, temporary isolation is preferred over lengthy restriction or other harsh punishment.  

Seven basic assumption on which a therapeutic community is based: