Radically Embodied Compassion Training: Cultivating Psychotherapist Courage, Distress Tolerance and Compassionate Responsiveness via Traditional Martial Arts
DOI:
https://doi.org/10.14738/assrj.112.16285Keywords:
Martial arts, compassion, radically embodied compassion, therapist courage, alliance rupture repair, therapeutic presenceAbstract
Psychotherapeutic encounters inevitably entail moments and episodes of disaffiliation, ruptures and conflict. These events can pose significant challenges and threats to both client and therapist. Resolving and repairing such ruptures requires therapists to tolerate not only their clients' but also their own distress, to better afford the courage and wisdom to respond compassionately. Whilst there is plenty of excellent research and guidance on how to respond to and repair alliance ruptures, few approaches explicitly focus on the development of the underlying (neuro)physiological capacities, embodied motivational switching abilities and somatic resources to be able to do so in situations of high relational threat. Traditional martial arts provide a powerful and fruitful means to entrain these competencies and processes, which can feasibly be transferred to psychotherapeutic encounters. This paper outlines the development of training workshops for therapists/clinicians based on traditional martial arts principles and practices, embodied neuroscience and interpersonal neurobiology. This overview will thus help illuminate how such training may afford therapists/clinicians greater distress tolerance and compassionate responsiveness, otherwise termed Radically Embodied Compassion (Clapton & Hiskey, 2020), in difficult therapeutic encounters such as alliance ruptures.
References
Gilbert, P. Compassion: From its evolution to a psychotherapy. Frontiers in psychology, 2020, 11, 3123.
Monticelli, F.; Liotti, M. (2021). Motivational monitoring: how to identify ruptures and impasses and enhance interpersonal attunement. Journal of Contemporary Psychotherapy, 2021, 51(2), 97-108.
Safran, J. D.; Kraus, J. Alliance ruptures, impasses, and enactments: A relational perspective. Psychotherapy, 2014, 51(3), 381-387.
Muran, J.C.; Eubanks, C.F. Therapist performance under pressure: Negotiating emotion, difference, and rupture. American Psychological Association, 2020.
Vivino, B.L.; Thompson, B.J.; Hill, C.E.; Ladany, N. Compassion in psychotherapy: The perspective of therapists nominated as compassionate. Psychotherapy Research, 2009, 19(2), 157-171.
Safran, J.D.; Muran, J.C.; Eubanks-Carter, C. Repairing alliance ruptures. Psychotherapy, 2011, 48(1), 80-87.
Muran, J.C.; Eubanks, C.F.; Samstag, L.W. One more time with less jargon: An introduction to “Rupture Repair in Practice”. Journal of Clinical Psychology, 2021, 77(2), 361-368.
Muntigl, P.; Horvath, A.O. The therapeutic relationship in action: How therapists and clients co-manage relational disaffiliation. Psychotherapy Research, 2014, 24(3), 327-345.
Liotti, G; Gilbert, P. Mentalizing, motivation, and social mentalities: Theoretical considerations and implications for psychotherapy. Psychology and Psychotherapy: Theory, research and practice, 2011, 84(1),
Eubanks, C.F.; Sergi, J.; Samstag, L.W.; Muran, J.C. Commentary: Rupture repair as a transtheoretical corrective experience. Journal of Clinical Psychology, 2021, 77(2), 457-466.
Flores, P.J.; Porges, S.W. Group psychotherapy as a neural exercise: Bridging polyvagal theory and attachment theory. International Journal of Group Psychotherapy, 2017, 67(2), 202-222.
Eubanks, C. F; Muran, J.C.; Safran, J.D. Alliance rupture repair: A meta-analysis. Psychotherapy, 2018, 55(4),
Hiskey, S.; & Clapton, N.E. The martial arts and embodied distress tolerance in psychological therapy. International Journal of Martial Arts, 2019, 5(4).
Macdonald, J.; Muran, C.J. The reactive therapist: The problem of interpersonal reactivity in psychological therapy and the potential for a mindfulness-based program focused on “mindfulness-in-relationship” skills for therapists. Journal of Psychotherapy Integration, 2021, 31(4), 452.
Eubanks-Carter, C.; Muran, J.C.; Safran, J.D. Alliance-focused training. Psychotherapy, 2015, 52(2), 169-173.
Pope, K.S.; Tabachnick, B.G. Therapists' anger, hate, fear, and sexual feelings: National survey of therapist responses, client characteristics, critical events, formal complaints, and training. Professional Psychology: Research and Practice, 1993, 24(2), 142-152.
Binder, J.L.; Strupp, H.H. "Negative process": A recurrently discovered and underestimated facet of therapeutic process and outcome in the individual psychotherapy of adults. Clinical psychology: Science and practice, 1997, 4(2), 121-139.
Hill, C.E.; Kellems, I.S.; Kolchakian, M.R.; Wonnell, T.L.; Davis, T.L.; Nakayama, E.Y. The therapist experience of being the target of hostile versus suspected unasserted client anger: Factors associated with resolution. Psychotherapy Research, 2003, 13(4), 475-491. 81
Muran, J.C.; Safran, J.D.; Gorman, B.S.; Samstag, L.W., Eubanks-Carter, C.; Winston, A. The relationship of early alliance ruptures and their resolution to process and outcome in three time-limited psychotherapies for personality disorders. Psychotherapy: Theory, Research, Practice, Training, 2009, 46(2), 233-248.
Tishby, O.; Wiseman, H. Countertransference types and their relation to rupture and repair in the alliance. Psychotherapy Research, 2020, 1-16.
Geller, S.M. A practical guide to cultivating therapeutic presence. American Psychological Association, 2017.
Kramer, G. Insight dialogue: The interpersonal path to freedom. Shambhala Publications, 2007.
Geller, S.M. (2018). Therapeutic presence and polyvagal theory: Principles and practices for cultivating effective therapeutic relationships. In Clinical Applications of the polyvagal theory: The emergence of polyvagal informed therapies, Porges, S., Dana, D. (Eds.), Norton, 106-126.
Geller, S.M. Cultivating therapeutic presence: strengthening your clinical heart, mind, and practice. Transformance: The AEDP Journal, 2020, 10(1), 1-25.
Porges, S.W. The polyvagal theory: neurophysiological foundations of emotions, attachment, communication, and self-regulation (Norton Series on Interpersonal Neurobiology); WW Norton & Company, 2011.
Gilbert, P. The origins and nature of compassion focused therapy. British Journal of Clinical Psychology, 2014, 53(1), 6-41.
Porges, S.W. Reciprocal Influences between Body and Brain in the Perception and Expression of Affect: A Polyvagal Perspective. In The Healing Power of Emotion: Affective Neuroscience, Development & Clinical Practice, Fosha, D., Siegel, D.J., Solomon, M.F. (Eds.); 2009; 27–54.
Geller, S.M.; Porges, S.W. Therapeutic presence: neurophysiological mechanisms mediating feeling safe in therapeutic relationships. Journal of Psychotherapy Integration, 2014, 24(3), 178.
Ryland, S.; Johnson, L.N.; Bernards, J.C. Honoring Protective Responses: Reframing Resistance in Therapy Using Polyvagal Theory. Contemporary Family Therapy, 2021, 1-9.
Porges, S.W. Vagal pathways: portals to compassion. In The Oxford Handbook of Compassion Science, E.M. Seppala (Ed.); Oxford University Press, New York: NY, 2017, pp. 189-204.
Dana, D. The Polyvagal theory in therapy: engaging the rhythm of regulation (Norton series on interpersonal neurobiology). WW Norton & Company, 2018.
Oulanova, O. Healing through the martial way: Incorporating karate training into counselling and psychotherapy. Body, Movement and Dance in Psychotherapy, 2009, 4(1), 45-57.
Rosenberg, V.; Sapochnik, C. Martial arts – enactment of aggression or integrative space? Psychodynamic Practice, 2005, 11(4), 451-458.
Clapton, N.E.; Hiskey, S. Radically Embodied Compassion: The Potential Role of Traditional Martial Arts in Compassion Cultivation. Frontiers in Psychology, 2020, 11.
Clapton, N.E.; Hiskey, S. The Way is in Training: Martial Arts-informed Compassionate Mind Training to enhance CFT Therapists’ Compassionate Competencies. OBM Integrative and Complementary Medicine, 2023, 8(1), 1-17.
Hackney, C.H. Martial virtues: lessons in wisdom, courage, and compassion from the world's greatest warriors. Tuttle Publishing, 2011. 82
Hackney, C.H. Martial arts as a pathway to flourishing. In Positive psychology: Advances in understanding adult motivation; Sinnott, J.D., (Ed.); Springer: New York, NY, 2013, pp. 145-158.
Kamen, R.K. Karate: Beneath the surface. Kamen Entertainment Group, 2017.
Ueshiba, M. The Art of Peace (translated and edited by John Stevens). Shambhala, Boston and London, 2007.
Westbrook, A.; Ratti, O. Aikido and the dynamic sphere: An illustrated introduction. Tuttle Publishing, 1970.
Lukoff, D.; Strozzi-Heckler, R. Aikido: A martial art with mindfulness, somatic, relational, and spiritual benefits for veterans. Spirituality in Clinical Practice, 2017, 4(2), 81-91.
Weis, G. Budotherapy: Embrace your Inner Peaceful Warrior whilst using Compassion Focused Therapy to cope with fear & pain. Independently published, 2020.
Cook, D. Taekwondo: Ancient wisdom for the modern warrior. YMAA Publication Center, 2001.
Cook, D. Traditional taekwondo: core techniques, history, and philosophy. YMAA Publication Center, 2006.
Ben Keren, G. Krav Maga Tactical Survival: Personal Safety in Action. Proven Solutions for Real Life Situations. Tuttle Publishing, 2017.
Morrison, L. The Complete Book of Urban Combatives. Paladin Press, 2015.
Faggianelli, P.; Lukoff, D. (2006). Aikido and psychotherapy: A study of psychotherapists who are Aikido practitioners. Journal of Transpersonal Psychology, 2006, 38(2), 159.
Foster, D. Fighters who don’t fight: The case of aikido and somatic metaphorism. Qualitative Sociology, 2015, 38(2), 165-183.
Twemlow, S. W. Training psychotherapists in attributes of “mind” from Zen and psychoanalytic perspectives, Part I: Core principles, emptiness, impermanence, and paradox. American Journal of
Twemlow, S.W. Training psychotherapists in attributes of “mind” from Zen and psychoanalytic perspectives, part II: attention, here and now, nonattachment, and compassion. American Journal of
Twemlow, S.W.; Sacco, F.C.; Fonagy, P. Embodying the mind: Movement as a container for destructive aggression. American Journal of Psychotherapy, 2008, 62(1), 1-33.
Soho, T. The unfettered mind: Writings from a Zen Master to a Master Swordsman. Shambhala Publications, 2012.
Fujiwara, H.; Ueno, T.; Yoshimura, S.; Kobayashi, K.; Miyagi, T.; Oishi, N.; Murai, T. Martial arts “Kendo” and the motivation network during attention processing: an fMRI study. Frontiers in human neuroscience, 2019, 13, 170.
Green, J. Embodied Compassionate Communication: Applied Aikido. In AiKiDô: The Trinity of Conflict Transformation, Wagner, W., Ed.; Wiesbaden: Springer Fachmedien Wiesbaden, 2015, pp. 181-190.
Linden, P. Embodied peacemaking: Body awareness, self-regulation and conflict resolution. CCMS Publications, 2007.
Black, A.E. (2017). On attacking and being attacked in group psychotherapy. International Journal of Group
Price, T.F.; Peterson, C.K.; Harmon-Jones, E. (2012). The emotive neuroscience of embodiment. Motivation and Emotion, 2012, 36(1), 27-37.
Osypiuk, K.; Thompson, E.; Wayne, P.M. Can Tai Chi and Qigong postures shape our mood? Toward an embodied cognition framework for mind-body research. Frontiers in Human Neuroscience, 2018, 12, 174.
Shih, E.W., Quiñones‐Camacho, L.E., Karan, A., Davis, E.L. Physiological contagion in parent–child dyads during an emotional challenge. Social Development, 2019, 28(3), 620-636.
Tschacher, W.; Meier, D. Physiological synchrony in psychotherapy sessions. Psychotherapy Research, 2020, 30(5), 558-573.
Mayo, O.; Gordon, I. In and out of synchrony—Behavioral and physiological dynamics of dyadic interpersonal coordination. Psychophysiology, 2020, 57(6), e13574.
Rassovsky, Y.; Harwood, A.; Zagoory-Sharon, O.; Feldman, R. Martial arts increase oxytocin production. Scientific reports, 2019, 9(1), 1-8.
Zilcha-Mano, S.; Shamay-Tsoory, S.; Dolev-Amit, T.; Zagoory-Sharon, O.; Feldman, R. Oxytocin as a biomarker of the formation of therapeutic alliance in psychotherapy and counseling psychology. Journal of Counseling Psychology, 2020, 67(4), 523-535.
Webb, C.E.; Franks, B.; Romero, T.; Higgins, E.T.; De Waal, F.B. Individual differences in chimpanzee reconciliation relate to social switching behaviour. Animal Behaviour, 2014, 90, 57-63.
Webb, C.E.; Coleman, P.T.; Rossignac-Milon, M.; Tomasulo, S.J.; Higgins, E.T. Moving on or digging deeper: Regulatory mode and interpersonal conflict resolution. Journal of personality and social psychology, 2017, 112(4), 621-641.
Gilbert, Paul (Ed.). Compassion: Concepts, research and applications. London, UK: Routledge, 2017.
Higgins, E.T. Beyond pleasure and pain: How motivation works. New York, NY: Brunner-Routledge, 2012.
Higgins, E.T.; Kruglanski, A.W.; Pierro, A. (2003). Regulatory mode: Locomotion and assessment as distinct orientations. In Advances in experimental social psychology, Zanna, M.P., Ed.; New York, NY: Academic Press, 2003, Volume 35, pp. 293– 344.
Kruglanski, A.W.; Thompson, E.P.; Higgins, E.T.; Atash, M.N.; Pierro, A.; Shah, J.Y.; Spiegel, S. To “do the right thing” or to “just do it”: Locomotion and assessment as distinct self-regulatory imperatives. Journal of Personality and Social Psychology, 2000, 79, 793– 815.
Webb, C.E.; Rossignac-Milon, M.; Higgins, E.T. Stepping forward together: Could walking facilitate interpersonal conflict resolution? American Psychologist, 2017, 72(4), 374-385.
Kimmel, M.; Rogler, C.R. The anatomy of antagonistic coregulation: Emergent coordination, path dependency, and the interplay of biomechanic parameters in Aikido. Human movement science, 2019, 63,
Friedman, H.L. Using Aikido and transpersonal psychology concepts as tools for reconciling conflict: focus on Aikido and related martial arts, such as Hapkido. NeuroQuantology, 2016, 14(2), 213-225.
Hiskey, S.; Clapton, N.E. Minding the gap: Compassionate maai, social relating and communicating within re-constructed space. Clinical Psychology Forum, 2020, 331, July, 37-41. 84
Sovereign, G.; Walker, B.R. Mind, body and wellbeing: Reinforcement sensitivity theory and self-cultivation systems as wellbeing influencers. Journal of Happiness Studies, 2021, 22(1), 1-20.
Kimmel, M.; Rogler, C.R. Affordances in interaction–the case of Aikido. Ecological Psychology, 2018, 30:3,
Gilbert, P. Explorations into the nature and function of compassion. Current Opinion in Psychology, 2019, 28, 108-114.
Gilbert, P. & Choden. Mindful compassion: Using the power of mindfulness and compassion to transform our lives. Hachette UK, 2013.
Ho, S.S.; Nakamura, Y.; Swain, J.E. Compassion as an intervention to attune to universal suffering of self and others in conflicts: A translational framework. Frontiers in Psychology, 2021, 11, 3825.
Kim, J.J.; Cunnington, R.; Kirby, J.N. The neurophysiological basis of compassion: An fMRI meta-analysis of compassion and its related neural processes. Neuroscience & Biobehavioral Reviews, 2020, 108, 112-123.
Weng, H.Y.; Lapate, R.C.; Stodola, D.E.; Rogers, G.M.; Davidson, R.J. Visual attention to suffering after compassion training is associated with decreased amygdala responses. Frontiers in psychology, 2018, 9,
Ashar, Y. K.; Andrews-Hanna, J.R.; Halifax, J.; Dimidjian, S.; Wager, T.D. Effects of compassion training on brain responses to suffering others. Social cognitive and affective neuroscience, 2021, 16(10), 1036-1047.
Kim, J.J.; Parker, S.L.; Doty, J.R.; Cunnington, R.; Gilbert, P.; Kirby, J.N. Neurophysiological and behavioural markers of compassion. Scientific reports, 2020, 10(1), 1-9.
Di Bello, M.; Ottaviani, C.; Petrocchi, N. Compassion is not a benzo: Distinctive associations of Heart Rate Variability with its empathic and action components. Frontiers in Neuroscience, 2021, 15, 223.
Klimecki, O.M. The role of empathy and compassion in conflict resolution. Emotion Review, 2019, 11(4),
Martin, P. Conflict resolution using transactional analysis and aikido. Transactional analysis journal, 2004, 34(3), 229-242.
Chen, R.; Atzil-Slonim, D.; Bar-Kalifa, E.; Hasson-Ohayon, I; Refaeli, E. Therapists’ recognition of alliance ruptures as a moderator of change in alliance and symptoms. Psychotherapy Research, 2018, 28(4), 560-
Rowland, D.L.; Van Lankveld, J.J. Anxiety and performance in sex, sport, and stage: identifying common ground. Frontiers in psychology, 2019, 10, 1615.
Chin, M.S.; Kales, S.N. Understanding mind–body disciplines: A pilot study of paced breathing and dynamic muscle contraction on autonomic nervous system reactivity. Stress and Health, 2019, 35(4), 542-548.
Laborde, S.; Raab, M.; Kinrade, N.P. Is the ability to keep your mind sharp under pressure reflected in your heart? Evidence for the neurophysiological bases of decision reinvestment. Biological psychology, 2014, 100, 34-42.
Hiskey, S.; Clapton, N.E. The in-betweeners. Private Practice, June 2021, 8-11.
Dunn, R.; Callahan, J.L.; Swift, J.K.; Ivanovic, M. Effects of pre-session centering for therapists on session presence and effectiveness. Psychotherapy Research, 2013, 23(1), 78-85. 85
Laborde, S.; Mosley, E.; Mertgen, A. Vagal tank theory: the three rs of cardiac vagal control functioning–resting, reactivity, and recovery. Frontiers in neuroscience, 2018, 12, 458.
Ceccarelli, L.A.; Giuliano, R.J.; Glazebrook, C.M.; Strachan, S.M. Self-compassion and psycho-physiological recovery from recalled sport failure. Frontiers in psychology, 2019, 10, 1564.
Chan, A.S.; Cheung, M.C; Sze, S.L.; Leung, Winnie W.M; Shi, D. Shaolin dan tian breathing fosters relaxed and attentive mind: a randomized controlled neuroelectrophysiological study. Evidence-Based Complementary and Alternative Medicine, 2010, 2011, 1-11.
Behrends, A.; Müller, S.; Dziobek, I. Moving in and out of synchrony: A concept for a new intervention fostering empathy through interactional movement and dance. The Arts in Psychotherapy, 2012, 39(2),
Masciotra, D.; Ackermann, E.; Roth, W.M. “Maai”: The art of distancing in karate-do mutual attunement in close encounters. Journal of Adult Development, 2001, 8(2), 119-132.
Blum, M.C. Embodied mirroring: A relational, body-to-body technique promoting movement in therapy. Journal of Psychotherapy Integration, 2015, 25(2), 115-127.
Samaritter, R.; Payne, H. Kinaesthetic intersubjectivity: A dance informed contribution to self-other relatedness and shared experience in non-verbal psychotherapy with an example from autism. The Arts in
Daly, K.D.; Mallinckrodt, B. Experienced therapists’ approach to psychotherapy for adults with attachment avoidance or attachment anxiety. Journal of Counseling Psychology, 2009, 56(4), 549-563.
Egozi, S.; Tishby, O.; Wiseman, H. Therapeutic distance in client-therapist narratives: client attachment, therapist attachment, and dyadic effects. Psychotherapy Research, 2021, 1-14.
Gilbert, P. Compassion Focused Therapy: Distinctive features. Routledge/Taylor & Francis Group, 2010.
Egozi, S.; Tishby, O.; Wiseman, H. Changes in clients and therapists’ experiences of therapeutic distance during psychodynamic therapy. Journal of Clinical Psychology, 2021, 77(4), 910-926.
Welch, A.S.; Tschampl, M. Something to shout about: a simple, quick performance enhancement technique improved strength in both experts and novices. Journal of Applied Sport Psychology, 2012, 24(4), 418-428.
Gilbert, P.; Mascaro, J. Compassion: Fears, blocks, and resistances: An evolutionary investigation. In The Oxford Handbook of Compassion Science, Seppala, E.M., Ed. NY, Oxford University Press: New York, 2017, pp. 399-420.
Cain, L.; Perkey, H.; Widner, S.; Johnson, J.A.; Hoffman, Z.; Slavin-Mulford, J. You really are too kind: implications regarding friendly submissiveness in trainee therapists. Research in Psychotherapy: Psychopathology, Process, and Outcome, 2018, 21(2), 72-82.
Catarino, F.; Gilbert, P.; McEwan, K.; Baião, R. Compassion motivations: Distinguishing submissive compassion from genuine compassion and its association with shame, submissive behavior, depression, anxiety and stress. Journal of Social and Clinical Psychology, 2014, 33(5), 399-412.
Voutilainen, L.; Henttonen, P.; Kahri, M.; Ravaja, N.; Sams, M.; Peräkylä, A. Empathy, challenge, and psychophysiological activation in therapist–client interaction. Frontiers in psychology, 2018, 9, 530.
Moeseneder, L.; Ribeiro, E.; Muran, J. C.; Caspar, F. Impact of confrontations by therapists on impairment and utilization of the therapeutic alliance. Psychotherapy Research, 2019, 29(3), 293-305. 86
Crocker, J.; Canevello, A. Creating and undermining social support in communal relationships: The role of compassionate and self-image goals. Journal of Personality and Social Psychology, 2008, 95(3), 555–575.
Hiskey, S.; Clapton, N.E. Distress Tolerance Imagery Training. Martial Arts Studies, 2021, 11, 47-56.
Holmes, P.S.; Collins, D.J. The PETTLEP approach to motor imagery: A functional equivalence model for sport psychologists. Journal of applied sport psychology, 2001, 13(1), 60-83.
Di Bello, M.; Carnevali, L.; Petrocchi, N.; Thayer, J.F.; Gilbert, P.; Ottaviani, C. The compassionate vagus: a meta-analysis on the connection between compassion and heart rate variability. Neuroscience & Biobehavioral Reviews, 2020, 116, 21-30.
Eubanks, C.F.; Lubitz, J.; Muran, J.C.; Safran, J.D. Rupture resolution rating system (3RS): Development and validation. Psychotherapy Research, 2019, 29(3), 306-319.
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