‘How can we welcome that state of not knowing?’

What sets Sensorimotor Psychotherapy apart from other approaches?
People gravitate towards it. They see me work and they want to study this method – but they often don't know what they're getting into. They don't know that what they're actually picking up on is a context or a container – an atmosphere we want to create in therapy that allows people to go that next step in their healing.

How do you create that atmosphere?
Sensorimotor Psychotherapy has a set of guideposts or principles that guide our work. These six principles – Organicity, Non-violence, Unity, Mind-body-spirit holism, Mindfulness and Relational alchemy – are aspirational and emergent rather than steps to follow or concrete end points. They aren't formulas and so are not easy concepts to grasp… but they're vital to Sensorimotor Psychotherapists.

What does the principle of Organicity relate to?
Organicity is a term borrowed from Gregory Bateson that alludes to every living system having its own inner intelligence – its own growth path. It means resting in not knowing and helping the client go inside and find their own intelligence. All you're doing is helping the client take that next step in their own evolution.

Resting in not knowing – that's a difficult thing, isn't it?
Most of us aren't comfortable with not knowing – not knowing where we're going, not knowing what the outcome is going to be. I mean that's life anyway - you never know what's going to happen. We think we know but we don't. Who really knows the answers? And how can we welcome that state of not knowing? Because that's the only way we're going to be really open with the magic of possibilities, whether that's in your own life or in your clients' lives.

How do you guide therapists who struggle to let go of control?
I try to help people keep really open and expansive. So many people get tight around it – they want to know a formula. Students might ask 'Where are we going?' 'Where are we headed?' 'What's the goal?' My response is always the same – 'how can we cultivate comfort with not knowing?' If you really believe that people have their own answers inside – even your schizophrenic client who is cutting themselves, for instance – do you believe there's wisdom there? But there's no formula to do it, and that's what's challenging for most people in the western world.

Do you think as a society we're moving closer to that reality, in which we rest in the wisdom of the body more willingly? Or, in a global sense, are we moving further away? I suppose it's a difficult one to pin down.
I don't know. I think it depends on the culture, the person and their life path. I don't know in general. I know that the body itself has become much more prominent in psychotherapy, but there's also this tendency to dumb it down and to not honour the complexity of it. Just because the body is becoming more prevalent, it doesn't mean we honour the amazing intelligence it has that none of us even truly understand.

As I see it, we're oriented more toward resources than to the body itself. The paradigm seems to be 'when my bills are paid, I'll get back to the meditation, I'll get back to my body, I'll get back to me'. The body comes last.
Yeah. I get into that, too. Like, 'as soon as that curriculum revision is done, then I can be'. That's a trap.

It's tough when the reality is there are bills to pay.
Yeah. I feel very fortunate that I grew up in the 60's and 70's because it was easier to make a living – it was just a different time. My career built itself. I just did what I loved and it was fine and I made money and my work took off and there was never any worry, you know? It was very easy to be experimental and to explore and to try all kinds of things. I really feel for young people. I don't think your world is like that. It's so much harder for young people today.

I think in the western world there's a part of us that says 'I need to make this person better to achieve my goals' – being rather than doing can be quite uncomfortable 
I think you're absolutely right. I think in this culture we're not taught to be, we're taught to do and to accomplish stuff. But I don't think that's what really supports healing. For me, again, that is where the principles come in – like trusting the bigger intelligence and being receptive to that. Letting things come through you rather than trying to control it. That means being open and receptive rather than trying to make something happen. If you can stay open, magic happens because forces much bigger than you come into play. If you try to do it yourself, you're limited. You can't make something happen that's any bigger than it already is – so it stays small.

Coming back to the six principles - can you describe the others?
Non-violence is another of the principles within SP. If you really trust this idea that as living systems we're always growing, always evolving, then no pushing or force of any kind is required. We just encourage the evolution that is already happening.

Unity has to do with the interconnection within everything. There's a lot of othering going on but we really are interconnected. Can we embrace the parts of ourselves we want to push away because they don't feel good somehow? Can we extend to communicate with others? Unity is a real thing – it's always present but it is experienced more fully through communication.  

Mind-body-spirit holism?
That's about the unity of our mind, body and spirit. Mind is our thoughts, perceptions, imagination, memories, and can also include our emotions. Body is our physiology, our autonomic nervous system, our micromovements, gestures, expressions, and postures. There is amazing intelligence within our own physicality. Spirit relates to aspects of ourselves connected to the non-material – to something bigger than our own existence. It's often associated with a sense of reverence or awe, of a greater encompassing purpose, or of experiences that connect us to our spiritual nature.

And Mindfulness?
Mindfulness as a principle relates to a kind of dual consciousness in which there's the observer and that which is being observed. Mindfulness helps us to witness our internal world of sensations, movements, sensory perceptions, emotions and thoughts. Mindfulness helps us to notice when we're imposing patterns of the past on the present. When we're in autopilot, mindfulness can provide a bridge back to presence.

Mindfulness is different from presence though. Presence is a more unified state of consciousness, not a dual state. There is no observer. Presence is more about being engaged without awareness of time passing. With presence we are fully participating, not observing.

Both mindfulness and presence are important, but the challenge is that when we're too mindful our attention is constantly divided [between observer and that being observed]. If we're too divided, we risk hindering our participation and engagement with the present moment.

The distinction between mindfulness and presence is really helpful. Where does the principle of Relational alchemy fit in?
Relational alchemy has to do with the unique connection between people. It reflects the magic that happens in therapy when you're just synched up. It's as though something just blossoms and you're like 'woah, this is incredible'. But it also reflects the synchronicity of our histories interacting in ways that inherently lead to rupture in relationships – we can feel misunderstood, criticised or disregarded. The unique relationship brings forward aspects of both parties that need a voice, but we often don't realise the potential healing in such ruptures – working through them relationally can lead to healing and greater connection. If I trust relational alchemy as providing opportunities through the conflict or struggle for amazing personal growth in relationships – if I really trust that – I can become curious rather than judgemental about the strife. You can't fall back on technique in those situations. It just doesn't work. You need to fall back on connection, on working it through together.

What are Enactments as they relate to SP?
Enactments are when the implicit parts of the therapist and client collide and are interlocked like a hand in glove. Nobody consciously understands it or knows why. Both parties can be frustrated, but there's just as much wisdom and intelligence in that state of not knowing. This is also relational alchemy – the enactments reflect the unique alchemy of the particular relationship. My friend Phillip Bromberg, a relational psychoanalyst, said that if you can just stumble along and hang on in the relationship, you'll find your way through these relational enactments.

Perhaps an impossible question to answer, but how endemic do you think enactments are within the therapy setting?
Oh, I think they're constant. Philip used to say enactments are always happening. Always. We tend to work with the part of the person we want to work with, so we tend to draw out certain parts of the client and not others, and this can lead to enactments.

I think it's important that the therapist is being self-aware. Negotiating enactments requires ongoing self-examination by the therapist. But you're never going to get it perfectly right because, you know, it's not the nature of being in these bodies. You're always going to miss stuff, you're going to get into enactments, and you should get into enactments with your clients because that's where a lot of growth is for therapists and clients.

Staying open and aware seems to be the key.
Yes. And with enactments it's hard. You feel stuck, you may even feel angry with your client. Or that you don't want to be there. And so, to really look at yourself – at your part – and to open up rather than shutting down or trying make something happen, I think that takes real courage. It's much easier to try and make something happen or to shut yourself off from the client when you're in an enactment.

Courage – can you say more?
I think it takes a lot of courage to navigate enactments, but I would say the courage is more about vulnerability – about not pushing. It's about showing vulnerability and patience until the two of you can find relational meaning in the encounter. I think therapists get in trouble when they try and solve the enactment because they're blind to it – they're blind to their own part in it. It's about accepting that we all have bias and we can be unaware of our own implicit patterns. What becomes dangerous is when these go unexamined and we're just acting them out.

I imagine safety and trust would have to be prerequisites here.
Yes, but I think we have to look at where that safety comes from. What, or who, do we look to for safety? My therapist who I saw for a few years would say – and I really think he's right – that healing was having the trust in yourself that you could handle whatever comes. I think people are more inclined to look for safety outside of themselves. I want my clients to find that safety within themselves. And so if they don't feel safe in their family, or if they don't feel safe with a person, they can find the appropriate action – either they ask for what they need, or they leave, or they stop the relationship because they trust themselves. Everybody is messed up in their own way. I don't think we can count entirely on other people to make us feel safe, but we can find safety and trust in ourselves.

Perhaps more precisely then, creating a context of safety is what matters.
In therapy there has to be enough safety so that a client can take risks – so that you can grow. But I think safety can hold a different meaning for therapists. I don't think therapy is about being safe. I think therapy is about being challenged. So many people talk about safety as almost being the end point and I don't feel that way. I don't like always feeling safe, I like being challenged.

So these guideposts – these principles – they invite a level of conversation without pointing people to the solution.
Yes, the intention is to embody the principles and to implement interventions and techniques that are in alignment with those principles. I think that the most important part of therapy is not what you do, but paying attention to what's happening at the meta level. What is the big picture perspective you're conveying to the client? For example, if a client comes in complaining that they are obese, and if you agree with them that they're obese and should lose weight, for instance, what's really the message? The message is that they don't have inner wisdom, that they're messed up and unattractive – that there is something wrong that needs to be fixed. This happens all the time in modern psychology. People don't need to be fixed.

And it might be the same answer, but if I could ask – what's the biggest opportunity SP has that maybe sets it apart from other modalities? Is it that?
I think it is. I think the biggest opportunity is to help people embody these principles. I think we often want to change our clients. It's really hard just to let people be, to let them be free to make their own choices. Can we give people that freedom? I think that's when change starts to happen – when the push goes away and you can trust an inner intelligence in your client. I mean, when a client complains of being obese there's intelligence and wisdom there. I'd want us to discover that intelligence for starters.

What are you most excited about in relation to SP?
I love to see the impact that this work is having on the world. I love that our students are finding value and the healing power in this work. The SP Institute is at a place where it's growing so much. We have trainings in 23 countries. I'm excited and a little daunted about what that means because I'm not that person who wanted to lead a big international company. I just love this work and wanted to help people heal. But we've got some really good people all over the world who are aligned with our principles and are wanting to support the Institute. What I'm excited about is how we can have this organisation and really work in an embodied way that feels in alignment with our principles – that we all feel we can trust and rest in. That's challenging, but a good endeavour.

You seem to be philosophical about the world as it is. What bothers you? What gets you riled?
I get into the same issues everyone else does – relational hassles. This and that. So and so didn't do the dishes. And I have concerns about the world at large – what is happening in terms of social justice, and so forth. I think we have to kind of live in two worlds. One is the spiritual world. And the other is this earthly plane. We have bodies and illness and war and relational hassles on the earth plane. But in a spiritual realm, I believe all is well.

Our foundational principles are aspirational and emergent. Aspiring to embody them doesn't mean I'm immune to difficulties or that I can live in accordance with the principles all of the time. That's the beauty of it, you know? We're human. We're limited by these bodies and these brains. We can't live these principles all the time. They're guideposts and call for us to be gentle with ourselves and with each other.

What is the most misunderstood aspect of SP?
People have in the past tended to weaponise the principles – they'll say, 'oh you're not being non-violent' or 'you're not trusting organicity'. But the principles are personal and subjective – what is violent to one person may not be to another. What is in organicity may not be for another.  

More generally, in terms of the field, I do feel as though psychotherapy is going in a direction that I'm not aligned with – the formulas and the methods that are technique oriented rather than person oriented. SP is not formulaic and one of its strengths is that it honours the individuality of each person, their own uniqueness. We are not technique oriented. Whatever technique we use emerges in the moment, and not from a protocol or formula. 

That resonates. People often take what's essential and turn it into a 'to do'.
I think you're right – they do. But you can't do that with these principles. It won't work because they're abstract and emergent. People in psychology and psychotherapy seem to be gravitating toward researching 'quick fixes' because that's where the money is – that's where you get funded. People want to see results that can be measured quantitively but there are wonderful ways of working with people out there that will never be evidence based because they don't have a formula you can test in the western scientific lab.

What advice would you give to aspiring psychologists?
That's a big question. I would say be interested – be curious. Use your own bodymind as your laboratory. Watch how you move and walk, how other people walk. Watch how people move and see how everyone moves so differently. Because those physical habits of movement reflect that which is implicit, and has meaning. Let yourself develop your ability to see, not just with your eyes but with your whole self. And keep that interest and curiosity alive because you're never going to have the answers. So, you should keep asking the questions – questions like, 'what is healing? What really promotes growth in a person? Where do I interfere in a client's growth by my own habits, or in my own way of being? Where am I impatient? Where am I wanting something from the client that they can't give? Why do I want that? Why can't I let that go? How can I give people freedom to be whoever they want to be, even when someone is doing things I think are inappropriate?' I think the questions are so much more important than the answers.

And a final question for you, Pat – do you ever intend to slow down?
I probably won't. I'm passionate about my work. I know for me this work is a mission. It's what I came here to do. It's not work, it's more of a calling.

• Pat Ogden, PhD is a pioneer in somatic psychology, the creator of the Sensorimotor Psychotherapy method, and founder of the Sensorimotor Psychotherapy Institute – which will be starting trainings in the UK in 2025. Dr Ogden is a clinician, consultant, international lecturer and the first author of two groundbreaking books in somatic psychology: Trauma and the Body: A Sensorimotor Approach to Psychotherapy and Sensorimotor Psychotherapy: Interventions for Trauma and Attachment (2015). The card deck, Body of Knowledge: Sensorimotor Practices for Awareness, Regulation and Expansion was published in 2022. Her third book, The Pocket Guide to Sensorimotor Psychotherapy in Context, advocates for an anti-racist perspective in psychotherapy practice. She is currently working on a fourth book Sensorimotor Psychotherapy for Children, Adolescents and Families with Dr. Bonnie Goldstein. Dr Ogden's current interests include couple therapy, child and family therapy, the relational nature of shame, social justice, and the philosophical/spiritual principles that underlie her work.
• Dr Kal Kseib is a Chartered Psychologist. Read more of his interviews.