Coming Alive: Embodied Psychodynamic Treatment of Racialized and Gendered Trauma

The embodied impact of trauma complicates the work of helping our patients access more enlivened states of being. Like all trauma, the intersecting traumas of racism, misogyny, and sexual violence can lead to chronic autonomic nervous system dysregulation that forecloses the capacities for fantasy, imagination, and insight so central to the psychoanalytic process. Somatic approaches can be enlisted to support the patient in developing an “embodied observing ego” that tracks present moment bodily experiences signaling the presence of anxiety, defense, core affect, and trauma survival responses. As self-regulatory capacity increases, the patient is helped to consciously execute trauma survival responses which had previously been inhibited or truncated. This approach, informed by the work of Pierre Janet (1919/1925) and contemporary neurobiology and traumatology (e.g., Levine, 1997; T. Ogden, 2019), and by sensorimotor psychotherapy in particular (T. Ogden, 2019), allows patients to experience a previously inaccessible stage of “triumph,” and unlocks their capacities for meaning making and integration. I outline this embodied psychodynamic approach through clinical illustrations from my work with an Indian American woman grappling with the effects of racialized and gendered trauma.