Episode 99 Using The Body In Therapy: Interview with Katelyn Jakobsen

Chris McDonald: This is Holistic Counseling, the podcast for mental health therapists who want to deepen their knowledge of holistic modalities and build their practice with confidence. I'm your host, Chris McDonald, licensed therapist. I am so glad you're here for the Journey.

Welcome. To the Holistic Counseling Podcast, I'm your host, Chris McDonald. If you're a new listener, I wanna say welcome as a listener, you have access to my free nine par email course, becoming a Holistic Counselor. In this course, you'll explore different holistic strategies, how to develop your skills as a holistic counselor, and how to manifest your holistic practice through journaling.

Go to www.holisticcounselingpodcast.com. Scroll down and enter your name and email address today. Have you been curious about integrating the body into therapy but are unsure how to do it? Or maybe you have used some somatic skills but wanna learn more? Today's guess is Caitlin Jacobson and she's going to share more about how she uses the body and therapy and uses sensory motorcycle therapy and therapy to treat chronic illness and self-esteem.

So welcome to the podcast,

Katelyn Jakobsen: Caitlin. Thank you so much. I'm listening to your voice and it's so nice to listen.

Chris McDonald: Wow. I'm so glad. Thank you, . Yeah. A lot of practice. Yeah, I bet. So can you tell my listeners a little bit more about yourself and your work?

Katelyn Jakobsen: Yeah, so I'm a clinical mental health counselor here in North Carolina.

I work at Agrippa Family Psychological and Wellness Services, and I really see kind of a wide variety of people, but I really specialize in treating individuals with chronic illness. And that struggle with like very active inner critics and self-esteem. I think with any, as like any other clinician, I use a variety of therapeutic interventions.

Yes. But I really love using the body and therapy.

Chris McDonald: Yeah, I hear that it's a game

Katelyn Jakobsen: changer, isn't it? It feels really critical to me in like incorporating the body. It feels like this really important piece of navigating therapy.

Chris McDonald: I think so too, cuz I think if you just stay in the cognitive realm that it's like there's something missing.

Katelyn Jakobsen: Yeah, absolutely. And I even feel that all the time. Like right now, you know, I can feel some tightness in my chest, like talking and being recorded. Of course. Um, right. So like, so I notice that sensation . Yeah, exactly. So it just, it feels like such a useful part to explore, like the role of the body for me.

Mm-hmm. .

Chris McDonald: And I think it brings things a little bit deeper.

Katelyn Jakobsen: Yeah, absolutely.

Chris McDonald: Yes. So what first interested you in using the body in therapy? For

Katelyn Jakobsen: me, it um, it kind of feels like a, like a story arc. I grew up playing a lot of different sports and dance, and it felt like this really kind of foundational part of.

Who I am today. But when I was younger, I feel like when it was like the biggest aspect of my identity, I started to get really sick and there were a lot of different unknowns around it. So both like the physical manifestations of being ill and like, you know, the mental implications of unknowns and.

Navigating kind of the medical industry really impacted me in going into college that felt , like something I really wanted to to focus on. It wasn't until I got to graduate school though, that I first heard about like the incorporation of. Body in therapy and for me, I was like instantly drawn to that. I think talk therapy has so much to value, but for me as an athlete, someone with a complicated relationship to my body and someone who ex.

Experiences, their emotions very physically the, the role of the body, like I was just immediately drawn to, and it felt really critical and important for both me as a person and as a counselor. So kind of right out the gates. Started to incorporate it and learn about it both personally and professionally.

Chris McDonald: So it sounds like you're somebody that's really in tune with bodily sensations and what's happening

Katelyn Jakobsen: inside. Yeah, absolutely. It feels so much, um, more apparent sometimes than, than like the cognitive and the emotional. The body I think is so intelligent, and I was actually listening to your podcast on body intelligence, but one of the things kinda that I really try and tell clients when learning about like the role of the body, cause they're like, why is that important?

Is that like if you were to fall down the stairs, that your body, your physical body, Seven times faster than your brain cognitively processes what's happening. So our body's always reacting to like both internal and external input and making sense of that even if we ourselves. Aren't aware of that. And that's something that I've come to learn.

You, you said like yeah, you seem really in tune with your body. Um, sometimes maybe too in tune too, Chris. Yeah. . But um, I've learned for a lot of people that's not at all the case. I know. Case. So I think being able to like, describe the importance of it and reconnect to it feels. Yeah. This is why, this is why it's important.

Even if we don't notice what's happening, our body , our body says things are happening.

Chris McDonald: Yeah. And I wonder too, if, if you are that sensitive to your sensations, do you notice your body, like with clients in session, does that give you any clues of what's happening?

Katelyn Jakobsen: Absolutely. You know, I, when, when we first start learning about therapy, they talk about tracking our clients and noticing, you know, what's going on behaviorally.

But I feel like their bodies tell so much too. And you know, sometimes people will be like, it's like you're in my head because they might be saying something and then, you know, we might be talking about. Like the tightness in their jaw when they said that, or like the way they pulled back when we were talking about something.

And they might be like really surprised sometimes because they might be saying one thing, but their bodies are telling another story sometimes. Right. So yeah, for me, I try and be. So in tune with, with their bodies and try and like really feel what they're feeling while also noticing what they're doing.

So kind of both. Yeah,

Chris McDonald: absolutely. Yeah. That attunement I think is so important. Yeah.

Katelyn Jakobsen: I think, you know, to. To mirror it to them to question and bring attention to it. And then also for them to be able to start to notice those things themselves. Like, oh yeah, I did like my, like, sometimes it's even, um, you know, skin, like sometimes there's like visible changes around like the neck or chest with skin getting really red, which is also like really clear evidence of role of the body in your like thoughts and emotions.

Chris McDonald: True. Yeah. So even just tuning into that and Yeah, absolutely. So thinking about the sensory motor psychotherapy, how is that different than more traditional therapy?

Katelyn Jakobsen: Yeah, so talk therapy is kind of what we talk about being like top down therapy. So in talk therapy, The entry point to therapy is like our words, our thoughts, and our emotions.

While in like sensory motor therapy, it's that bottom up. Processing. So it's instead of kind of that cognitive restructuring and figuring out the way that our words, thoughts, and emotions shape our experiences past, present, and future, it's incorporating our physical bodies in that bottom up processing to make sense of our experiences and emotions both past, present, and future sensory.

Motor psychotherapy is created by Dr. Pat Ogden, who is, in my opinion, an incredible psychologist with a history in dance. So it incorporates the soma, the physical body and, and what we're experiencing on all of our sensations, but it also incorporates the, that motor. The movement, so you know, how, how we really move in this world.

You know, sometimes like I'll go on walks with clients or explore their posture or creating movements. A big kind of belief in sensory motorcycle therapy specific to trauma is that our bodies. You know, have these patterns of kind of movement for survival. And oftentimes in, in times of trauma, those patterns aren't completed.

So through, um, sensory motor therapy, you can kind of complete that cycle of movement that your body might have gotten stuck in or frozen in to help kind of repro. And navigate that trauma history.

Chris McDonald: That's so fascinating to think about reprocessing and through movement too, but how do you determine like if they're frozen with some kind of movement from a

Katelyn Jakobsen: trauma?

Yeah, so I, I would like to say that, you know, I first really just start out with clients by really connecting to their bodies and growing their window of tolerance. So maybe. that we just start to like contact wellness, right? Maybe it's just we start to, uh, talk about a pleasant time in their lives and we notice their bodies and the ways in which their bodies show up and hold that sensation and really embody that sensation.

And when I feel kind of confident in client's ability to increase their window of tolerance. And kind of regulate distress. Sensory motor psychotherapy uses dual awareness. So both being in the present moment, being embodied and feeling yourself safe in this moment while also, you know, accessing the past and just it's, it's less about like the client talking.

What happened, you know, describing the memories as much as it is them describing and noticing what's happening in their current bodies. So for example, you said, how do you notice, or how do you know if a client is frozen? And that would be from either, you know, tracking their movements. and or what they're describing as like, I felt really stuck.

Like I, like I couldn't move in that moment.

Chris McDonald: Cause is that, could that be like a freeze

Katelyn Jakobsen: response? Yeah, absolutely. So kind of going back to that bottom up. Processing. It kind of goes to when we think of like the triune brain that like three layers of our brain. The lizard brain is like the first to develop in our evolution and that's that really kind of instinctual, like that fight, flight or freeze.

And that's a lot of what we're kind of dealing with our bodies. Kinda instinctual reactions. In that fight, fight or freeze pattern when talking about these things. So absolutely a freeze

Chris McDonald: response. And how would you help a client that's in that freeze response?

Katelyn Jakobsen: Yeah. So while both, again, being in the present moment a little bit and and recognizing that we're safe, that's where that movement piece comes in.

So it could be a variety of things. It could be focusing on finding any part of our body that feels like it could move. It also might be asking questions. , you know, does your, does your body wanna do anything? And this is like such a far out question to clients who haven't yet gone through right this, like contacting wellness and stuff like that.

Like maybe you feel like you like need some, some pressure around yourself, or maybe you feel a lot of like energy in your legs or arms. So it's being able to both let the client like explore. And honor what their body wants to do, which again, is like the most far out question to people who haven't experienced this.

Yes. And also sometimes helping create sensations that feel really good. So maybe it's, you know, encouraging them to like create pressure against the floor or push their legs against a table. Again, because our bodies do have like this natural intelligence. And, uh, kind of really instinctual desires, allowing it to carry that out and just being, giving the client this space to be curious about their bodies.

And be patient really, you know, their bodies have answers like, ugh, I just, I, I need to create more pressure and, and push more against this. Or actually, I think I need to like kick my legs right now and we'll continue to kind of track that and check in. And maybe they need to add it or change to it in a way.

But really the level. Kind of resolve and regulation that they experience from that to me is, has been kind of profound to be able to witness.

Chris McDonald: Yeah, it sounds like it. That's really fascinating cuz that's something I've learned recently with yoga too. Cause I teach yoga in sessions and, and that's one question that I learned was, How does my body want to move right now?

Mm-hmm. is, is there a pose I want to do right now? and listening and I think you said the word trust, but trusting what comes up. Right. So maybe right now downward dog would feel really good for me and I get a, and for me, I try to use intuition to think what am, what is coming up? What do I see? I will see visual things, so I'll see like a pose.

And I feel like that's, my body wants me to do in the moment. So I don't know if that's like connecting with some of the sensory motor stuff, but, but I think that's very powerful for clients right. To, to really integrate that question and trusting what comes up. Cause I think I could see a lot of clients be like, what?

Yeah. Yes. My body wants me to kick and questioning and getting more cognitive with it.

Katelyn Jakobsen: Yeah, absolutely. There feels like a real kind of like psychoeducational piece and like warming up to the idea. And also I think trust in the relationship because I it too. Mm-hmm. , there's a real kind of vulnerability to being in session.

Holding your hands out because it, you know, to, I think a, a passer by, it's like, what's, what's going on in there, ? Um, right. So there's kinda like this real vulnerability to like this, this movement piece of recreating and changing postures and, and using props and so, so yes. I think you talked about that trust piece.

Something that. Often try and say is to approach it like an experiment. Yeah. There's, you know, in an experiment, like you can generate a hypothesis, but you, you know, in, in the true form of an experiment cannot for certain know what's gonna happen. Um, so really just trying to approach it from an exploratory and experimental point of view versus hoping that certain things happen or judging the experience,

Chris McDonald: so not expecting a certain

Katelyn Jakobsen: outcome.

Yeah, because like you said, so for example, you might do a downward dog and like actually it doesn't feel quite right. Yeah. Maybe you need to change it up. So being able to, yeah, be non-judgmental and explore. Does this feel right? , do I need to try something different can also be really useful.

Chris McDonald: Yeah, so that's a good question too.

Is there something different to try in the

Katelyn Jakobsen: moment? Yeah, absolutely. And, and so we might spend like a whole session trying to find what feels right and I feel like that language kind of can really parallel some of yoga. Like do what feels right. Yeah. ,

Chris McDonald: do what feels right for your body. Yeah. In this moment,

Right, exactly. Yeah, that's what I wondered. Is it invitational language like we use with trauma-informed yoga?

Katelyn Jakobsen: Um, in the sense of like asking if it feels okay? Yeah, yeah, yeah, yeah, yeah. Absolutely. I, I would never, you know, want someone to do something that feels like very dysregulating right. Or more of them they can handle.

So, so that's part of those, you know, introductory and foundational pieces. Being able to inhabit your bodies, which I think, um, the idea sounds really pleasant, but for both people who struggle with chronic illness and self-esteem, the concept of like inhabiting your body. Doesn't necessarily feel safe. So it's being able to inhabit your body in a way that feels safe and being able to say no or to come away from it if it's not feeling okay.

So absolutely creating that invitation and permission

Chris McDonald: for them. I know you mentioned window of tolerance. Can you just share what that is real quick, just in case there's any listeners who aren't aware of.

Katelyn Jakobsen: Yeah, so I'm gonna just talk about it in the way that I always describe 'em. I'm, uh, I always have a drawing, but our window of tolerance is our ability to be embodied and present without leaving, like our distressed tolerance window of regulations.

So, um, leaving our window would look like hyper arousal. So that's that racing heart rate. Um, the quick breathing, those feelings of anxiety. Or conversely that hypo arousal, which is something that we see in that freeze response or catatonia when the clients kind of are absolutely stuck. Our window of tolerance is when we're able to, you know, not disassociate or be super dysregulated and stay in our bodies.

Does that mean it's without any unpleasant sensations? No. Um, because in order to. Expand. I think another word at least that I use kind of similarly is like, to expand our distress tolerance is to be kind of pushing right on the edges Absolutely. Of what you can tolerate, but like not overwhelming yourself.

And that can be a really fine line. Yeah.

Chris McDonald: That's tough. To, and, and with trauma-informed yoga, that's too is is pushing at the edge of the window . Right. We wanna open it more. Going into sympathetic

Katelyn Jakobsen: response. Yeah, absolutely. And so, so that's that constant kind of checking, well, I don't wanna say constant, but that's that frequent checking in of like, you know, how are we feeling?

Are we feeling okay? And, and kind of even sometimes for me, ranking how anxious we feel. And when you

Chris McDonald: say ranking, do you mean like scaling that

Katelyn Jakobsen: somehow or, yeah, sometimes it's like honestly using like some suds like subjective units of distress. So on a scale of one to 10, how anxious are you? Yeah, um, sometimes, you know, especially for clients who are, who are new to.

This experience of embodying, they, they might like check in with their bodies for really one to two seconds, and then you'll see them open their eyes right away. Because I often, uh, really encourage clients if it feels okay for them to either close their eyes or do a soft gaze so that they can feel really in the moment with their bodies.

And you'll kind of see for clients who feel overwhelmed, their eyes kind of open up right away. And that's definitely like, , that was too much for

Chris McDonald: us. That was too much . So I guess it is that clinical judgment piece of noticing and and being aware of yourself, of where they are.

Katelyn Jakobsen: Yeah, absolutely. And, and again, I think trust in each other so that, um, me checking in with them that they're gonna name what's going on and.

Them trusting in me that I'm gonna be alongside them and tracking and helping them to explore.

Chris McDonald: So it sounds like allotted too is just building that safety in the session. Yeah. Initially and yeah.

Katelyn Jakobsen: And we, we kind of do that in a variety of ways, like regarding our bodies. So one of the exercises that, some of the exercises, I would say three specifically that I really like as like orienting a client to this idea is contacting wellness.

Or pleasant moments, especially with chronic illness clients being able to like contact pleasant sensations in their body and hold onto it is one that I really like to get clients to orient this idea of using the body. I also go on walks with clients and explore like really the way in which they move and navigate the worlds physically and their posture.

Um, Effect of sensory motor psychotherapy is that like the way in which we carry ourselves physically continues to pattern our own beliefs about ourselves. So if we were to like think of some stranger behind the door that was really depressed, we might make, you know, judgments or expectations around the ways in which they would carry themselves, like maybe really slumped shoulders.

Or looking down or moving really slowly, and we would make those judgements because they're often kind of very similar, the ways in which we hold ourselves physically because our bodies are so smart and incorporated with our minds. Our mind is now interpreting kind of that sensory input, right? That internal and external sensory input and making stories out of it.

So it's continuing to pattern the ways in which we feel about ourselves.

Chris McDonald: Yeah. That's really fascinating and thinking about that and how the, how the way we move and the patterns that come up from that and, and really the making those connections. So I'm guessing that you'd probably have to work through that to make new connections.

Yeah.

Katelyn Jakobsen: So we've, I, you know, I've kind of touched on. Creating safety and contacting, you know, pleasant sensations for clients with chronic illness, but posture, um, for everyone. But definitely clients with self-esteem is, is really interesting. You know, they often talk about maybe like feeling really small or something, something that feels kind of intertwined with the narratives about themselves and us working on identifying.

You know, moments if there are, or creating a moment of either strength or certainty or whatever the client feels drawn to and the way in which they carry themselves physically is really cool to witness. And then for them themselves to be able to like say like, ah, like, yeah, I don't feel as small or feel.

You know, like my heart rate, like softening a little bit and then having them continue practicing and recreating that posture to help develop new narratives and ways in which they commune with themselves.

Chris McDonald: Yeah, I can imagine that that's really fulfilling to, to see the success with that

Katelyn Jakobsen: too. Yeah, absolutely.

One thing that I, that I have to say about working with the body is it does. Sometimes feel like there's kind of immediate gratification both to the client and to the therapist because I do get to witness on occasion really kind of immediate physical and emotional reactions from the ways in which we incorporate our body, which is really incredible.

Yeah, that's. , definitely. Yeah. It's really awesome, um, to be able to see like some of those changes posturally in the way in which clients start to change, you know, how they really navigate the, the world. Yeah. I think even, even our eye line, you know, if we're always looking down, like not being able to see safety or connection, And by just being able to look up even a little bit more often and, you know, seek safety, see what's comfortable, and seek connection.

Like even our eyesight change or our eye line changing, you know, can have some of those effects.

Chris McDonald: Yeah. It's just those small things, but they make a big difference. And, and I'm sure a lot of this too is neurologically based, right? In our brains

Katelyn Jakobsen: and Yes, absolutely. Yeah. The, the theory is, is definitely, you know, integrated using some of the, like Dr.

Peter Levine somatic experiencing. I don't personally feel really qualified to speak on the Hakomi experience, um, but I know Dr. Pat Ogden really relied on the hakomi experience in incorporating some of that polyvagal theory into the theory as.

Chris McDonald: Yeah. Yeah. So I know you talked about working with people with chronic illness, so I wondered how else do you help them to develop a better relationship with their body?

Cause I know I'm someone with chronic pain and sometimes it's hard to have a positive relationship. When you know it, it's all going to hell and you're in a lot of pain. And I imagine with a illness too, that you're just not feeling well and that's gotta be

Katelyn Jakobsen: difficult. Yeah, absolutely. I. Use both the kind of body, so I use an incorporation of like sensory motor psychotherapy, acceptance and commitment therapy and, and pain and neuroscience education when helping clients navigate pain.

So being able to identify our bodies as not just unsafe and harmful and being able to feel the ways in. Serves you or notice the physical sensations and how they change without either hyper attuning to them or judgment attention. To our pain can either turn down or amplify that experienced pain signal.

So if I orient to, let's say, you know, my shoulder's hurting and if I orient to that pain signal, it helps to amplify that pain signal, especially if I'm showing up with a stress response or a response of being really overwhelmed. So that like reaction to the pain and orienting to the pain. Focusing on it all kind of continue to amplify that pain signal.

Again, some of that kind of experimental lens of just like noticing the sensation without judgment can be really useful as well as attuning to other senses. So it might be a sense in some other place of our body, it might be creating a. Of warmth or using our other senses to, you know, focus on maybe like some music or, um, like a nice warm cup of tea.

So really kind of sense faith with our attention. Sensory. Yeah. Yeah. And, and our response. To the

Chris McDonald: pain. No, that makes a lot of sense cuz I know when I have pain that acts up, it, it . It does just tune you into that. Right? That's, oh my gosh. Yeah. It's hard to focus on anything else when

Katelyn Jakobsen: it's real bad. Yeah.

And then it's like this, you know, it can be really all consuming. And, and for me, like self-reinforcing loop Yes. Of like, now I'm fixating on it and my stress and cortisol levels are Oh, yeah. Increasing. So now the inflammation is rising and my brain is interpreting that danger signal more and more. So yeah, it's, it's a potent relationship that can be hard to disentangle from.

Yeah,

Chris McDonald: for sure. It sounds like this approach has a lot of different parts to it that could help.

Katelyn Jakobsen: For me personally, as a clinician, yeah. I really try and use a blend of different theories. I, I honestly, I think for me personally, the incorporation of. , like also some internal family systems like part space.

The theories, yes. In addition to the body, like the body feels like for me, kind of foundational to always be coming back to while also lending to some of those like top down processes of like, okay, let's, let's incorporate, and that's I think for me, previous to learning about the Incorporat incorporat.

Of the body. For me, that's what it was missing by just doing, you know, talk theory alone. The, the foundation of the body has felt really important for me to incorporate with all the other theories as well.

Chris McDonald: So it sounds like you use a blend of different things. Absolutely,

Katelyn Jakobsen: yes. I love to . Me too. .

Chris McDonald: Yeah. I really do.

It makes sense though. Yeah.

Katelyn Jakobsen: Mm-hmm. , there's, you know, they, so many different theories have so many different pieces of value that I feel drawn to, to offer and, and oftentimes I feel like they can be interwoven. Really well

Chris McDonald: together. I know you mentioned going for walks with clients and, but what about with telehealth?

Is, does this, the sensory motor does, is that something you can use like with telehealth with clients?

Katelyn Jakobsen: Yeah, so you definitely can, you know, I'll say it's not without complication. If, if, um, like if I can't see the client for example, or maybe I'm only seeing part of them. Yeah, that's what I wonder. . Yeah, so I really do, you know, prefer personally to see clients in person because I feel more intertwined with them.

We do have the ability to go for a walk and, and be connected with each other, but it's not accessible for everyone, especially those with, with chronic illnesses. So I do just try and part of like the educational piece of working together, have them kind of be away from the computer enough so that enough of their body for me to be able to see.

Is in frame, like that feels really important for me. And while, um, if we're online only, I might not be able to go for a walk with them. Um, we can still, you know, do different things posturally in different moments within their room. And then I might assign a request that they. Go for a walk and just explore and start to build some of that like body-based knowledge of like, okay, yeah, if I do, if I do focus, I can actually like feel my toes and my shoes and like my joints moving.

And that is really like the groundwork of starting to identify the sensations in your body to be able to do this work because there are sensations always happening. We're just not attuning to them.

Chris McDonald: Exactly. Yeah. So what's a takeaway you could share today that could help listeners that might be just starting to use the body in therapy?

Katelyn Jakobsen: I feel like starting to do some of that groundwork of coming from an experimental point of view, maybe going for some walks or practicing movement in really noticing all of your sensations and being able to identify those sensations as they take. Specifically without like judging or giving those sensations stories, just really noticing them as they, you know, arise feels like a really useful place to

start.

Chris McDonald: That sounds like that could be powerful too. Cause I think we're so used to giving judgment to things.

Katelyn Jakobsen: Absolutely. Especially when. Tied to pain signals like, this must be wrong, this must be bad. But we know with, with chronic pain that isn't structural, for example, not a broken bone, that it's where we assume kind of in, in pain that it's just kind of a broken pain signal response.

And in fact, if, if you do have non-structural chronic. There really might not be anything wrong. Yeah. Um, so to, so to label it as wrong or bad can kind of continue reinforcing and amplifying those signals and experiences that we're having. So

Chris McDonald: what's the best way for listeners to find you and learn

Katelyn Jakobsen: more about you?

Yeah, so I, like I said, I work at Agrippa family, um, psychological and wellness services, and our website is NC as in North Carolina. psychologist.com. Um, you can find me right on

Chris McDonald: that page. Well, thank you so much for coming on the podcast, Caitlyn. This was very informative. Yeah, thank you so much for having me.

And thank you listeners for tuning in today. Have you gotten my free nine part email course becoming a Holistic Counselor? Go to www.holisticcounselingpodcast.com today and sign up. And again, this is Chris McDonald's. Any each one of you much light. Until next time, take care. Thank you for listening and supporting the Holistic Counseling podcast.

Are you ready to take the next step to create a holistic practice? I invite you to sign up for my free nine part email course, becoming a Holistic Counselor. In this course, you'll explore different holistic strategies, how to develop your skills as a holistic counselor in how to manifest the holistic practice of your dreams through journaling.

Go to www do. Counseling podcast.com. Scroll down and enter your name and email address today.