Integration of Consciousness in Therapy

The most important thing is that we, as therapists, give ourselves is self-compassion! Learning new concepts takes effort, so let’s be gentle and kind to ourselves as we build our clinical skills and become rockstar therapists!

Applying relational neurosciences to clinical practice sounds daunting. I hope that this case example, primarily using the Integration of Consciousness from an interpersonal neurobiology (IPNB) lens makes the process seem more organic and attainable.

Client: early 30s Caucasian female, has a committed relationship with her boyfriend of almost 3 yrs. History of impulsive behaviors, FSLA (female sex and love addiction) stemming from childhood attachment patterns , but in the last 5 years, there has been a ton of growth and “earned security”. I’ve worked with her for about a year.

In session, client reported that she randomly ran into an ex-bf at the airport. It was a brief exchange but words like “I think of you often. I still miss you.” were said. This encountered moved the client from “the hub” of her Wheel of Awareness to “the rim”. She was not in a state of integration, and her field of consciousness had narrowed to her memories (the good ones with the ex), her emotions and questioning thoughts about her current relationship.

I’ve used the Wheel of Awareness before with this client, so we discussed how she had moved to the rim. Appropriate psychoeducation is an important part of using relational neurosciences in clinical work. Because she was in a dysregulated state (sympathetic nervous system activation aka “flight or fight”). I first chose to work with integrating her consciousness to help her return to a state of “social engagement”, regulation and felt safety. (Notice the polyvagal theory (PVT) terms and how PVT helped guide my assessment.)

I asked her to put one hand on her chest and one on her belly; I did the same, and we did 3 inhales with long exhalations. (Utilizing a little vertical integration aka brain/body connection). I validated how unsettling it can be to encounter someone from your past— especially when the relationship was tumultuous. I “offered” a seed of self-compassion— “What do you notice if you tell yourself, 'I did the best I could in a surprising situation?’” We stayed with that for a while, and explored her Core Organizers of Experience in the here and now… Remember 5MICE? (Here I also used a few different levels of integration, but it was all Phase 1 treatment to help her find stabilization.)

To activate the “watcher” part of her brain (the prefrontal cortex), I asked, “How do you feel towards the shocked and surprised part of yourself now?” (A little “parts work” thrown in with IPNB… see how all these approaches can combine to create a lovely therapeutic moment…?)

The client stated that, “Of course I’m going to be surprised to see my ex at DFW. Who wouldn’t be? It was a bit of an adrenalin rush when we chatted, so that will definitely make me feel confused and emotional. I don’t have to beat myself up for a situation that was outside my control. It feels good to just breathe now!”

She was able to witness her experience without judgement and utilize self-compassion to help calm her limbic system and survival brain!!

We stayed focused on her Core Organizers (5MICE), and I used more vertical integration and “embodied mindfulness” (where you work with what the client is experiencing right now vs at the time of the event.) This further enhanced the self-compassion, and I could see a softening in her physical body. I contacted this physical change, and allowed the client to mindfully sit with this “act of triumph” which had calmed her nervous system and helped her consciousness to integrate the experience.

See, it’s not so hard! It only took me ten years of practice to learn all this lol. I promise you’ll get there too. Slow and steady and a whole lot of self-compassion are what will lead you here.

I hope this is helpful!!