Welcome

and thank you

for your interest in
learning about how to
beMer support clients with
physical illness through a
DMT lens
To download PowerPoint
and References:
zinamercil.com

With Zina Mercil, MA, LPCC, R-DMT, RSMT, RYT

The Exclusive Addic?on Treatment Center, Hawaii

VitalHearts Resiliency Training Ini?a?ve, Denver

Project Athena Founda?on

Can listen to this session

from mul?ple perspec?ves:
Personal
Clinical
Not you, but us
approach illness is a
human life condi?on
Respect conden?ality
Listen non-judgmentally
Reference your own
experience
Take care of own comfort
Move and breathe!

What are you going to take away from this session?

Understand common themes and areas of curiosity

for clients dealing with medical and physical setbacks, in order to greater support clients with
normalization and integration of the medical
process
View the therapeutic process of support around
illness as one of grieving, meaning-making, and
potential posttraumatic growth
Embody the Five Fundamental Actions and
discuss how they specifically relate to the
regeneration and integration stages of illness and
recovery

Begin to view
illness as a potential initiation process a way for a
person to begin again.

 Personal and clinical

Mortality is our birthright, and physical
symptoms are oYen part of our journey
The process of suppor?ng being human
a normal part of the human process.

Many types of illness

Assessment
Diagnosis
Treatment
*Recovery/Integra?on
*PosMrauma?c Growth

Injury, medical trauma, autoimmune, cancer, cold, etc (full spectrum)

Life altering/Life limi?ng, chronic, single incident, terminal
Top 10 causes of death are, with the excep?on of #4 (accidents) and
#10 (suicide), all physically focused diseases; 1/4 all deaths due to
cancer (American Cancer Society, 2016)

Trauma and trauma
Is it held in our system and how? (Scaer, 2014)

Using physical symptoms/setbacks as a catalyst for inquiry and
curiosity around the possibility of psychological, emo?onal,
spiritual meaning
Crea?ng meaning
Why me, why this, why now?

He said the best way out is

always through.
And I can agree to that, or in
so far
As I can see no way out but
through
Leastaways for me

Trus?ng the road in.

(Frost, 1915)

An inroad to the therapeu?c

process and personal
transforma?on (growth, resiliency,
choice) through existen?al crisis,
and the body.

Rela?onship
Grieving
Meaning-Making
PosMrauma?c Growth

Much of this popula?ons experience is about

grieving physical and emo?onal losses, while
being in an aMuned rela?onship
To work with grief help clients to tolerate
sensa?on and awareness, and how that reects
emo?on and eects ac?on (boMom up). Titrate
the experience for the client, in this case, using
the Five Fundamental Ac?ons
Remembrance of our own existen?al crises as
clinicians choicefully work with
countertransference in our bodies

We are meaning making and meaning seeking

as humans
Meaning making aYer a loss or confronta?on
with death is par?cularly crucial, and minimizes
pain and distress (Yalom & Lieberman, 1991)
Slow down and aid client into crea?ng their own
meaning around their setback, using the
wisdom of the body, with the Five Fundamental
Ac?ons

No way out but through

Poten?al of posMrauma?c growth and resiliency

Tedeschi and Calhoun (1995) named the process of
people who have had transforma?ve development
cogni?vely, emo?onally, and behaviorally beyond
previous levels of func?oning prior to a trauma or
life-crisis as posMrauma?c growth (PTG), even if
distress s?ll exists.

An inroad to other life challenges, looking at

values, iden?ty, behavior, rela?onships, other
trauma, and existen?al themes.

The physical setback experience touches every area of a

persons life.
A lot of these areas are grievable, clients will desire to make meaning
about them, and some have the aspects of posMrauma?c growth

Iden?ty
New normal
Who am I now?
Roles
ShiY in family
Rela?onships
Body, interpersonal, spiritual, community
Priori?es/Values
Lifestyle, family, career, work/life balance
Making peace with treatment and side-eects

 Concepts of sickness/health
Working with labels and dx
Cultural expecta?ons
Being vs Doing
Mortality

Guide clients to:
Integrate a peak experience
state change -> stage change
Acquire acceptance of new normal
Look at iden8ty and beliefs

Why go towards the body, when our clients want to avoid the body?

The lineage
Why would we want to encourage our clients to go towards the
body when they want to go away from it?
Suering = Pain + non-acceptance
Gesng curious about the wisdom and symptoms of the body
Systems approach the Iden?ed Pa?ent in the body
(ac?ng out the pain of the system)
Symptoms are asking for aMen?on and support: to be seen
Embodiment, or developing congruence between Inner
Connec?vity and Outer Expressivity (Hackney, 2002)
Rela?onship between Self and Environment
Physical template and new neural pathways for
psychological shiYs

Coming back to whats fundamental

It is valuable to return to the things that are
essen?al and founda?onal.
Seemingly simple and accessible, for clinician and
clients alike
Physically adaptable

Template to deepen into over ?me, realize new

subtle?es, and track the change process

Bonnie Bainbridge Cohen

Body Mind Centering

Create a neurological developmental model of
sequencing movement

Susan Aposhyan

Body Mind Psychotherapy

Is interested in the psychological implica?ons and
integra?ons of this and other movement sequences
Named this model

Five Fundamental Ac?ons

Developmental Rela?onship of Self/Environment

Sequen?al, developmental, each stage is supported
by the one that comes before: integra?ve
We are unique in our developmental edges and
?melines of change and growth, but there are also
paMerns

We are constantly giving and receiving through our

endpoints (Aposhyan, as a concept from Cohen)
Rela?onship between self and other, or Self and
Environment (Perls, working with a Gestalt)
Gesng needs met between self and environment

Res?ng into contact with the Environment

BMC- Five Fundamental Ac?ons/Sa?sfac?on

Cycle

Yield
Push
Reach
Grasp
Pull
(Yield)

Developmentally: merged with the mother

Res?ng into contact with environment; nding support within

release of weight; sense of ow
Being in contact, rather than doing
Basis of taking eec?ve ac?on in the world

Psychologically:

Yielding can bring up fear, to let down being hyper vigilant is it

safe to let down our guard?

Collapse: Succumbing to your Environment

Lesng go of the integrity and wisdom of your system

Yielding is more contacuul and aware than collapsing

The Illness Experience

Assessment: Yield into the unknown, into the discomfort
(physical and emo?onal) of not knowing, and into fear and
concern
Move closer to the unknown rather than push it away

Diagnosis: Yield into labels, into new iden?ty, into the story
of who you are
Treatment: Yield into the fear of change, again of the
unknown
Recovery: Yield into healing, and being okay again but as a
new version of yourself, new iden?ty, new normal
PosMrauma?c Growth: Yield into the meaning making of the
illness process, allow this to come with ?me and not rush it;
trust the process

Yielding into the support of the ground

Contrast with Collapse

You can yield into internal impulses rather than inhibi?ng

them (Aposhyan, 1999, p.65)

Dieren?a?ng Self from Environment

Developmentally: I am separate from my mother

Organizes movement coordinated at a specic goal

The Push can support and move the body
Contracts muscles in the pushing limb

Psychologically and emo?onally empowering during

illness
Allow your awareness to come into your body. See if you can
nd an area of some discomfort, and allow your awareness to
rest there. Can you move away from labeling your experience,
and just be with it? Now see if you can allow that area to Yield
into itself and rest into that which surrounds it, its own
environment.

To feel strength of dieren?a?on: whats in here vs whats

out there
Push away what we dont want
Saying no- to say yes to something else
Begin to move towards ac?on

The Illness Experience

Assessment: Organize your body around nding strength despite
uncertainty
Diagnosis: Begin to Push towards diagnosis with acceptance and
responsibility, claim the knowledge, move from unknown to known
Treatment: Dieren?ate self from treatment (this is me, this
integra?ng as part of me, this is not me)
Recovery: Dieren?ate Self from diagnosis, labels, and begin inquiry
around meaning

Moving from Self towards the Environment

Begin to look at beliefs, and move towards new iden?ty, re-storying

Resilience/PTG: Claim what is known, what is self, and begin to move

with this (not from it)
*Avoid the disembodied Push - Push with no Yield
Experien?al: Push from discomfort vs Yield with Push (Treatment)

Again, see if there is some place in your body that you can nd a small
sense of discomfort. First accept and Yield, be with and move towards
this discomfort. Then, with this embodied, begin to organize the
surrounding areas to move with but from this area. This is very rened.
Youre not leaving it behind, but you are saying I am dierent from fully
being this discomfort. It is a paradox. It is both me and not me.

The Illness Experience

Assessment: Reach towards discomfort as well as desire to know
Diagnosis: Reach towards facts, labels, iden?ty; towards mobilizing
energy
Treatment: Be ac?ve in co-crea?ng healing, towards allowing the
treatment integra?on
Recovery: Reach towards making meaning in ?me
Resilience/PTG: There is strength and support to sustainably reach out

Developmentally: I can move towards what I want to get

a need met
Lengthens muscles in the reaching limb
Push proceeds Reach; Support proceeds Movement
Psychologically: Envision a goal and reach towards it

Can bring up feelings of groundlessness, vulnerability, and

risk
Without Yield it feels like there is no support, falling
forward, need external support (because there is no
internal support)
When supported it can be an exci?ng connec?on of inner
and outer worlds

Contact with Environment, and bringing Self to Environment

Reaching takes energy, so it is par?cularly important to precede

Reach with the support of Yield and Push, so as to not Reach out of
oneself into the environment (for answers, solu?ons, ways to x)

Developmentally: I can have full vibrant contact

with the environment and experience the body
sa?sfac?on of that contact
Psychologically feeling Sa?sed with
accomplishment of crea?ng and receiving contact

It can bring up fear, and challenges of deserving the

Sa?sfac?on (upper limit), par?cularly if pain s?ll exists
Can I feel sa?sed in this new normal?

We can overly pull away from the world

and into ourselves

Experien?al: Reach maintaining Yield and Push (Treatment)

Allow your object to represent the goal of a cure, treatment, health.

Reconnect with that area of discomfort in yourself. No?ce your possible
tendency to reach towards this goal and want to leave the discomfort
behind.

The Illness Experience

Assessment: Grasp/Pull into being, into breath, into not
knowing, into pain/physical symptoms
Diagnosis: Grasp/Pull the diagnosis close, become friends
with it so that you can move forward with it
Treatment: Grasp/Pull co-crea?ng treatment, and of ac?ve
acceptance/responsibility in integra?ng treatment
Recovery: Grasp/Pull acceptance of redening health, of
deserving it, and living in the present moment
Resilience/PTG: Grasp/Pull into meaning-making, into
crea?ng new iden?ty, living life fully with illness

Death is completely
connected with life, and if
we look closely at how
we die, we will be
challenged as to how we
live.

Experien?al: Allowing yourself to sa?sfac?on of living,

redening health, and new iden?ty

Allow your object to become your redeni?on of health. Allow

yourself to hug this close, who you are now, and who you are
becoming in health.

(Donnelly, Michael, & Donnelly, 2006)

The paradox and power of this work is

that at the same ?me the challenges
of illness are happening the joy,
empowerment, resilience, and growth
is being created not despite illness,
but through it.

 What do you think about the idea of

PosMrauma?c Growth through illness and
How might the Five Fundamental Ac?ons
promote possibili?es of posMrauma?c growth?

How might you (or have you) used this with a
client?
What stood out to you from this presenta?on as
far as a hope or fear in working with people
dealing with life altering medical setbacks?

Chronic Illness Blog and

Website:
www.zinamercil.com

www.projectathena.org

The Exclusive Addic8on
Treatment Center
303-736-9807 Phone
www.TheExclusiveHawaii.com