06 December 2022
In this brief Q&A, Ernst Meyer discusses his plans for supporting and growing the role of psychotherapy in PACFA and in the general population. He defines somatic psychotherapy and offers up a helpful metaphor to explain what a psychotherapist does.
Can you tell us something of your journey to becoming a psychotherapist?
Up until 2007, I never had any exposure to, and understanding of, psychotherapy. It was around that time that I participated in quite cathartic body-oriented personal development programs. This experience captured my interest and motivated me to enter a training program in somatic psychotherapy — from a personal development perspective, or so I thought.
After I finished my training at diploma level in 2012, I was accepted into a Master’s Degree in Psychotherapy and Counselling, and I decided to continue my studies. It was then that someone wanted to see me in my capacity as a somatic psychotherapist, and so I hastily joined a professional association, took out insurance, and rented a practice room. I then advertised my practice, more people came, and before I really knew it, I had become a practising somatic psychotherapist. And here I am, ten years later.
How do you explain to strangers who are unfamiliar with the field what you do?
In my experience, the differences between psychiatry, psychology, and psychotherapy are not clear even to those who are in treatment with a practitioner.
My understanding: in general, psychiatry perceives people as medically/mentally/biologically ill, while psychology concerns itself with changing thoughts and behaviour. Perhaps in contrast, the people who I see professionally are experiencing a crisis in their life, and together with them I attend to that crisis.
To explain the differences in treatment approaches to people, I often use this metaphor:
While travelling on the Sydney Harbour ferry, a passenger goes overboard. As they are wearing a life vest they are not going to drown. To me that’s the equivalent of psychiatry, supporting and stabilising someone with medication. However, that person is still in the water, and something else needs to happen to get them out of the water.
Along comes a psychologist in a small boat. After assessing the situation, the psychologist gives the person tools and strategies: they need to change their thinking about the situation, need to move their legs so they don’t die of hypothermia, focus on their breathing, and do mindfulness exercises.
However, the person is still in the water.
Then a psychotherapist like me arrives, and I will say to them ‘I can see you are in the water, and we need to get you of it ASAP.’ I push a wooden plank towards them, ask them to hold on to it, and rest. Then we have a look together where the shoreline is, and what movement we must perform to get the person out of the water. And then we start moving; and if I have to jump into the water with them, then I will.
Once that person is back on dry land, they might want to take the life vest off. We might ponder how they ended up in the water in the first place, and what needs to change so that it does not happen again.
Although this metaphor is very simplistic, arguably offensive to psychiatry and psychology (and I do apologise to practitioners who indeed feel offended), people can relate to it and sadly, often enough, it reflects their experience.
You were elected Convenor of the College of Psychotherapy in October 2022. Briefly, what’s on your agenda as Convenor of this College?
Being elected took me by surprise, and I freely admit that I am still finding my feet in this role. I am still in the process of making time and space for the new responsibilities, so I can give them the attention and care they require, demand and deserve.
It’s my conviction that the field of psychotherapy in Australia is in an existential crisis. My concern is that without public recognition there will be little incentive for training providers to offer relevant training in psychotherapy. This would translate into dwindling number of psychotherapists, and if that happens for long enough, the P in PACFA will become irrelevant, or even obsolete.
My agenda, then, is to prevent this, and the action points which need to flow from there, in my view, are:
a) Invite psychotherapists who meet the requirements into the psychotherapy college.
b) Provide a path for those who are not yet meeting the requirements, so they can enter the psychotherapy college.
c) Define psychotherapy competencies so training providers are guided in what it actually is they need to deliver in psychotherapy training programs, which will enable them create the next generation of psychotherapists.
d) Find ways to communicate effectively what psychotherapy is all about, and what makes it a valid clinical alternative to psychiatry and psychology.
e) Work together with PACFA and support them in their efforts to promote psychotherapy in their dialogue with stakeholders.
f) Last but not least: expand the psychotherapy leadership group that works together on the above.
You’re a somatic psychotherapist and co-founded the Institute of Somatic Psychotherapy – can you say more about this modality and how it differs from other modes of psychotherapy?
Now there’s a question without an easy answer.
One could argue that the ‘talk therapies’ including psychotherapy, in general, privilege mind (thinking) and language (narrative) over embodiment. The focus of psychotherapy, then, tends to be a verbal exploration of cognitive, imaginative, emotional and relational processes.
In Somatic Psychotherapy, we believe that human beings are deeply embodied, and that our experiences are laid down in our nervous system. In clinical practice, we work like other psychotherapists, yet we include an awareness of (and work with) bodily sensations, motor impulses, and movement. In other words, we pay close attention to a person’s embodied aspects, as well as our own embodiment.
Saying that, one could argue that Somatic Psychotherapy, as an entity or modality, does actually not exist. Considering the large number of different and differing schools and approaches (some of which have a long history in Australia), it probably makes more sense to think about the ‘field of somatic psychotherapy’ or ‘Somatic Psychotherapies.’
Yet despite the differences, a number of premises can be seen as the common foundations of somatic psychotherapies:
a) We believe that body, mind, psyche (and perhaps the soul) are an inseparable functional unit, or an interconnected dynamic system.
b) Formative experiences in human development have lasting structural effects on both psychic and levels and dimension of being. In other words, they are embodied.
c) The psychic dimension of a human being can be accessed, touched, and affected via the bodily dimension, and vice versa.
d) We trust that people have the inherent potential for self regulation, self organisation, and for maturational growth and development.
From a somatic perspective, it does not make sense to exclude embodiment from treatment, and non-somatic approaches might want to reflect on why embodiment is missing from their training programs and clinical practice.
You specialise in supporting people who have PTSD, including first responders like police and ambulance officers. How do you use somatic psychotherapy in working with complex trauma?
It is quite revealing how we use language: someone ‘having’ PTSD (which is a medical term) would suggest that there is something wrong with them and that they might need to be ‘fixed.’
Instead, in psychotherapy, we don’t follow medical diagnostic notions. Rather than someone ‘having PTSD,’ we attend to the person who feels traumatised, is in crisis, and explore ‘what happened to you?’ with them.
As a somatic psychotherapist, I will add to that the notion that traumatic experiences are embodied, and felt in the body. As Babette Rothschild states: ‘The body remembers’ (2000), and we work with that implicit memory, how it is remembered in the embodied person, how it can be made sense of and how it can be re-integrated into a person’s life story.
Importantly, this applies to both single traumatic events, and complex trauma presentations resulting from chronic stress.
What do you do to maintain your own wellness for this work?
That is another good question.
For starters, I don’t consider what I do as ‘work’ or as ‘laborious’ (even though it can feel that way at times). Instead, I am in clinical practice, and I enjoy what I am doing. That helps.
When it comes to self-care: I make sure that I take breaks in between sessions, and I avoid back-to-back meetings if at all possible. I don’t allow myself to be rushed, and I go about my life at my own pace whenever possible. It allows me to stay in a comfortable rhythm.
We all need people, and I maintain meaningful connections within the psychotherapeutic community and – perhaps more important when it comes to ‘wellness’ – outside of the community.
Ongoing clinical work can be draining, and I make a point of breaking that flow up by going on holidays, to conferences and social gatherings like football games or concerts.
And finally, I attend to things that I actually enjoy doing: connecting with nature, reading material that interests me, listening to prog rock music and watching slow-paced movies.