Harnessing the Power of Stress in Therapy

Stress is often the black sheep of the mental health family. We’re told to de-stress, unwind, be calm, meditate, do anything but to become dysregulated or activated. Then we’re fed the data on how bad stress is. The cause of cancers, diabetes, strokes, heart attacks and every other disease in the ICD-11. In addition, stress plays a critical role in mental health and many of the diagnoses where gene-environment interactions are implicated. That’s pretty much the entire DSM!

And all this is true. Stress is a critical influencing factor in deteriorating physical and psychological health, and it should be tended to and reduced as a matter of priority. 

Stress can be defined as a subjective state of sensing potentially adverse changes in the environment that might move an individual’s state out of balance, away from emotional equilibrium and regulation. Some clients might describe this as being or feeling under too much mental and emotional pressure, or feeling overwhelmed, especially if the stress is prolonged and enduring.

However, in therapy, we can use this powerhouse of unprocessed, latent somatic arousal to help our clients heal from adversity and trauma.

First we need to understand the two categories of stressors and their impact on the body, which I will then illustrate through some case material.

Psychosocial stress

Psychosocial stress is associated with a potential threat on a social level. This might include bullying, public speaking and developmental wounding. This psychosocial stress activates the hypothalamus-pituitary-adrenal (HPA) axis, causing secretion of cortisol, which can induce metabolic effects, mobilisation of energy and increased production of catecholamines. These catecholamines, a group of hormones, are responsible for the body’s ‘fight-or-flight’ response. We can equate this type of stress with development or relational issues.

Physical stress

Physical stress is associated with a potential threat to physical or bodily integrity. For instance, this could take the form of physical and sexual abuse, accidents, or surgery. This type of stress activates the sympatho-adrenal-medullary (SAM) axis, also causing secretion of catecholamines, which can result in increased heart rate, blood pressure and respiration frequency. This is a fast response reaction in the body especially when physical trauma occurs.

Prickling arms and a heavy chest – harnessing psychosocial and physical stress in practice

Henry was a tall and slim 37-year-old man from a farming family. During our initial sessions he became curious about a feeling of high, prickly energy in both his arms. Furthermore, he didn’t like his height and would often round his shoulders so as to appear smaller when walking in public spaces.

We used one of the initial sessions to track and focus on the excess energy in his arms. As we explored the arousal, a forgotten image of his older brother came to mind. He remembered that he often felt stressed when around his brother and that he had felt powerless and frozen when challenged by him. As we tracked this further, an impulse arose to push away, something that he was not able to do previously when confronted by his older brother. When we tracked this impulse to completion, the activation and arousal in both his arms totally transformed into sensations of calm and relaxation.

Months later, after working somatically with activation in Henry’s body, we began to explore his hunched posture. This led him to notice a heavy feeling mixed with anxiety in his chest – a feeling that he wished wasn’t there and that his shoulders had tried to ‘hide’. As we explored it, he mentioned that it wasn’t safe to be himself in his family as he had been bullied by his older brother. He commented, “it’s safer not to exist”. As we worked with this core belief through the activation, and his right to take up space and feel safe in it, the heaviness and anxiety in hist chest disappeared. Months later, Henry remarked that he now enjoyed walking in public spaces and felt that that his relationship with his height had totally changed.

So whether you work with a client on a psychosocial or physical stress issue – or both, as I did with Henry – you can use this activation and arousal to help them heal. Unprocessed stress will surface in the form of implicit memory through their bodies in the form of tight breathing, increased heart rate, trembling, orienting or other somatic stress symptoms. And the good news is that there are a plethora psychotherapeutic modalities that can help you facilitate healing with your clients, from Dr Frank Corrigan’s Deep Brain Re-Orienting (DBR), Dr Kate Chard’s Cognitive Processing Therapy to Dr Pat Ogden’s Sensorimotor Psychotherapy or Dr Laurel Parnell’s Attachment Focused EMDR, to mention just a few.