How Mindful Body Awareness Heals with Cynthia Price (LBP 060)

yH5BAEAAAAALAAAAAABAAEAAAIBRAA7 cynthiaCynthia Price is an Associate Research Professor at the University of Washington in the Biobehavioral Nursing Department.  Her clinical and research expertise is in the development of body awareness, or interoception, to improve health and well-being. She is the creator of an approach towards educating people in body awareness called Mindful Awareness in Body-Oriented Therapy or MABT for short, and is the founder of the Center for Mindful Body Awareness.

Her research studies have focused on the use of MABT for multiple health conditions including Substance Dependency, PTSD, chronic pain, and HIV.  Interested in the processes involved in learning mindful body awareness, Cynthia studies qualitative aspects and underlying mechanisms of the MABT approach. She is an author of two scales to measure interoceptive awareness: the Scale of Body Connection (SBC) and the Multidimensional Assessment of Interoceptive Awareness (MAIA). Committed to increasing health care access to underserved populations, Cynthia works with local and international programs to provide and improve complementary and integrative health care through her research, teaching, and service.

Cynthia’s work is essentially getting at the heart of what I’m most excited about in approaches towards the body. Cynthia and I talk about what MABT’s components are and how it helps people with a diverse range of challenges in clinical settings, how and why she came to do this work, and, more broadly, why we disembody, how individual that is, and what we gain when we cultivate a relationship with our bodies.

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Conversation highlights

  • Cynthia describes herself as a bodywork researcher.
  • As a researcher she developed an approach that grew out of her clinical practice called Mindful Awareness in Body-Oriented Therapy, or MABT. She took the key elements that people needed to develop body awareness and connect with their bodies.
  • Research focuses on looking at how MABT helps people in their lives- people with trauma histories, substance abuse disorder recovery, veterans with chronic pain and PTSD,  as well as people living with chronic pain.
  • MABT involves developing interoceptive awareness.
  • Cynthia trained as a massage therapist in 1981, and was in private practice as a massage therapist for 20 years. Halfway through those 20 years she went back and did her degree in counseling/psychology. She didn’t want to do psychotherapy alone, but wanted to feel more confident bringing a psychotherapeutic focus to her practice.
  • Her practice became about body psychotherapy in approach, but really was about the development of body connection.
  • She worked a lot with people who were in recovery from interpersonal trauma, mostly childhood sexual abuse.
  • The key components of MABT- it is focused on teaching people the fundamental skills of connecting to their inner body sensations.
  • It happens in 3 phases: 1: Literacy. How do you help someone develop a language and identify and be aware of sensation? In this phase they are using massage and stopping and pausing in places and asking people what they are aware of. 2: Learning what mindfulness is and how to engage in that in a somatic way. There are a series of exercises in this phase 3: A guided process of expanding capacity to attend to internal experience mindfully. People tend not to be able to maintain awareness for very long, and this helps with developing the capacity to stay connected inside.
  • The incremental training orientation is enormously important for people who tend to avoid their bodies as a way of being in the world. What we find in our research is that people have gone to meditation classes and they are completely lost and this work helps them to know exactly how to meditate how to be in a mindful place.
  • Why do we disembody? There is not one answer to that question. In my [Cynthia] clinical experience it’s such an individual experience why someone is disconnected.
  • There is a cultural overlay but I think that individual reasons for why people get disconnected have to do with natural coping mechanisms that are really helpful for us for avoiding discomfort. Avoidance allows us to function in the face of things that are overwhelming.
  • There are common things but the individual stories are so individual. It’s part of the beauty of working individually.
  • MABT is differentiated by touch. Historically touch is not used as an emotion regulation tool.
  • The field of psychology has created this split between the body ad psychotherapeutic practices. It’s understandable in that there has been so much abuse of touch- sexual assault and inappropriateness which created those guidelines. That’s why I [Cynthia] wound up in school of nursing. They understood that touch is healing. Massage used to be something nurses did in their care of patients.
  • Psychologists will often wonder about this work- doesn’t touch create more trauma? Absolutely not. One needs to be sensitive in all sorts of ways, but touch allows people to ground their awareness in a way that provides an avenue for them to attend to their internal somatic experience. Touch is this centering focus for the mind.
  • We don’t have an understanding that body awareness is a therapeutic and useful treatment for trauma, addiction, for emotional regulation more broadly
  • That’s why it’s an exciting time. In mindfulness research there has been this focus on looking at mechanisms from a neurological and biological perspective. What has been written are theoretical models. What hasn’t happened so much is really having the clinical component of this. How do we teach this work? How do people learn it?
  • This work is ultimately about listening to their body to learn that they can trust their bodies. This sense that the body is against us can be something so pervasive- how do you soften into seeing it as something trustworthy?
  • We get quote after quote [from research participants] of people really describing this. Saying they had no idea how they felt, and no idea that there was a link between physical and emotional sensation.
  • A relationship with your body allows your life to unfold and most people don’t even know what that means unless they have experienced it. How do we talk about this? It’s such an internal process. It’s so experientially grounded.
  • The most surprising and most challenging work with MABT has been with people who have chronic pain. Their pain is so big that it is their primary experience very day.
  • Working with them to bring their attention into their bodies there can be a lot of resistance and fear. Someone who has lived with pain for 20 years and developed an array of coping mechanisms including medication- it’s a lot of them to shift and trust that they can go inside and be with this scary place. This is also true with people who are struggling with PTSD.
  • In working with people with chronic pain that’s been the most amazing thing to witness- how much they discover that their pain is just one piece rather than their whole world.
  • In MABT we’re helping people to take these baby steps. It’s an education process and a creative process.
  • Work with women with substance use disorders: Learning MABT had a significant effect in relapse reduction. They are close to end of a larger study that National Institute of Drug Abuse is funding.
  • The initial findings were quite positive. Not only did women with MABT have lower relapse rates and used less substances overall, they also had less depression, improved emotional regulation, reported less stress, less eating disorders which are often very high in women with substance abuse disorders.
  • That study had a follow up at 9 months and the strongest results were from women continuing the practice on a daily basis.
  • To date she has been training massage therapists in MABT. That’s shifting with growing interest from yoga therapists, psychotherapists, and more so they are starting to open up trainings to people across all these disciplines.
  • One of the things I’ve [Cynthia] started to do is to consider how do we make this work accessible to more people? This started The Center for Mindful Body Awareness for people across all these disciplines and to work with non and for profits who are providing clinical care to incorporate and integrate this work so that it can be more accessible to people who are low income.

Resources

Cynthia Price’s Center for Mindful Body Awareness

Upcoming training in MABT this November

Paper: Mindful awareness in body-oriented therapy as an adjunct to women’s substance use disorder treatment

All of Cynthia Price’s publications

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