Integrative Free Associative Dyadic Mapping: mindfulness-based graphic notation to promote clinician self-regulation

Introduction

The experience of torture, according to Jean Améry, moves a person beyond the borders of death to a place of Nothingness (1980). Améry’s observation appears to be consistent with the general clinical finding that dissociative symptomatology is a core feature of post-traumatic impairment as a consequence of torture (Başoğlu & Mineka, 1992; Saporta & van Der Kolk, 1992; Somnier et al., 1992; Ray et al., 2006; van der Kolk & McFarlane, 2006; Steele & van der Hart, 2009; Carlson et al., 2012; Dalenberg & Carlson, 2012; Courtois & Ford, 2013). If torture represents the phenomenological presence of the Cruel Other that leaves a survivor profoundly disconnected from the flow and rhythms of their own moment-to-moment experience, then perhaps the antidote to the dis-ease of torture may have something to do with the presence of a Loving Other – a presence that leaves a person more (and not less) connected to the flow and rhythms of their subjective phenomenological experience. Accordingly, if torture drives a person beyond the borders of ordinary death to a place of Nothingness, then perhaps “the rehabilitation of torture survivors” may have something to do with exploring what Abundance there exists beyond the borders of ordinary life. According to the Somatic Experiencing (SE) approach to trauma-therapy, this may represent the ideal meta-pendulation that heralds the resolution, integration, and re-calibration of the human nervous system in response to either extreme or normative traumas (Levine, 2010). In this regard, trauma therapists may need to become aware of and integrate, as needed, the clients unconsciously dissociated psychosomatic process, which can be readily transferred to the clinician in the course of their practice (McFarland, 2004; Diamond, 2020).

As a relatively inexperienced trauma-therapist, I wanted to write this paper to clarify an approach I have been finding helpful in my clinical practice at the Vancouver Association for Survivors of Torture (VAST). I have found this approach to be effective as a way to self-regulate and manage dissociation-related transference before, after, as well as between client sessions. Combining concepts and practices from sensorimotor 

Psychotherapy (SP) (Ogden et al., 2006), somatic experiencing (SE) (Levine, 2010), expressive arts therapy (EXA) (McNiff, 1992; Knill et al., 2010), Zen Buddhism (Suzuki, 1970), as well as reparenting skills (ACA WSO, 2021), I would like to describe an approach that I would call Integrative, Free-Associative, Dyadic Mapping (IFAD-Mapping). I wanted to share this approach because I thought other clinicians might find it helpful in their own clinical practice. IFAD-Mapping combines the following elements, with a special focus in this paper on the fourth and final element, mapping:

Integrative - IFAD-Mapping incorporates the mindful awareness of present-moment experience. The SE approach outlines five (5) aspects of phenomenological experience in its SIBAM model (i.e., sensation, imagery, behavior, affect, and meaning) (Levine, 2010). Similarly, the SP approach outlines five (5) core organizers of phenomenological experience (i.e., cognition, emotion, five (5) sense perception, movement, and bodily sensations (Ogden et al, 2006). For a complete description of the SIBAM model in SE please see Levine (2010). For a complete description of core organizers in the SP approach, please see Ogden et al., (2006).

Free-Associative - In IFAD-Mapping, the present-moment experience remains person-centered and is allowed to change and shift based entirely on the locus of attention of the person tracking and mapping their own phenomenological experience. There seems to be an interesting relationship between the stream of consciousness and the stream of phenomenological awareness. From my experience, I cannot deepen my phenomenological awareness of experience into every object of conscious awareness. Instead, I notice in myself a semi-intentional, semi-accidental process of selection and choice. One that is perhaps based on my convenience, comfort, familiarity, curiosity, the degree to which I want to challenge myself, as well as the ambiguous felt sense of “this feels right,” this feels right for me to notice right now, to become aware of this, and not something else. 

Dyadic - The experience of tracking and mapping in this method occurs in the felt presence of the Loving Other. When engaging in IFAD-Mapping “by oneself,” this is done in the imagined and/or evoked felt presence of the Loving Other (ACA WSO, 2021). When engaging in IFAD-Mapping in individual psychotherapy (a work in progress, I hope), the skilled helper or therapist can become the image of the Loving Other and so help elicit, if available, this foundational image in their clients.

Mapping - More importantly, however, and perhaps in modest innovation of other mindfulness-based therapeutic approaches, such as SE and SP, is that IFAD-Mapping is a “graphic” approach. This means that the present-moment tracking of phenomenological experience is also graphically recorded, in real-time, using what I consider to be a relatively basic and evolving graphic notation. There are several good clinical reasons for adopting a graphic notion when tracking present-moment experience: Employing a “complex” language- and symbol-based notation in this way is likely to engage higher cortical functions alongside subcortical emotional and sensory-based neurophysiological information-processing (Halford et al., 2010; Steffan et al., 2022)

This notation is likely to be experienced as a novel. Because no one writes or thinks ordinarily in this way, this notation may generate novel neural connections and evolve extant neural networks across the adaptive/triune brain (Steffan et al., 2022).

Recording phenomenological experience in graphic notation requires a participant to resolve several choice points. Again, this is likely to engage higher cortical functions alongside subcortical emotional and sensory-based neurophysiological information-processing (Halford et al., 2010; Roy, 2017; Steffan et al., 2022), as well as potentially slow down the experience of experience.

Phenomenological experiences can sometimes feel ambiguous or “too close.” Engaging in a graphic notation can help resource these challenges by structuring and externalizing the perception of “internal experience.”  

This method produces a written artifact that can be assessed and analyzed in a variety of ways (e.g., in terms of recurring patterns, in terms of present or emergent resources, and so on.)

IFAD-Mapping Session and Notation

First, I will outline the basic steps to engage in an IFAD-Mapping session. Then I will explain the notation I’ve been using while doing my own IFAD-Mapping. To start, you will need a place where you feel comfortable. Dōgen (2013) suggests the following:

“…a quiet room is suitable. Eat and drink moderately. Cast aside all involvements and cease all affairs. Do not think good or bad. Do not administer pros and cons. Cease all the movements of the conscious mind, the gauging of all thought and views [the gauging of all internal sensations, complex imagery, movement, and emotion as well] …have no designs...” (p. 81) [Brackets my own].

 If you already have a meditation or mindfulness-based practice, you may choose to settle down as you would for your usual practice. Next, you will need some paper and some multi-colored pens. I like using 14” x 17” unlined sheets. But this kind of paper is not necessary. The ordinary paper will do. I also like using eight (8) or more different colored pens. But again, this is optional. Lastly, you will need anywhere from 2 to 60 minutes. For me, session length depends on several factors. How much time do I have between client sessions? How much time do I have before or after my clinical workday? Whatever the session length, as a general rule, if I am able to, I like to conclude a session at a place that “feels good” or “feels right” to my felt sense at a place where I feel stronger or calmer than before.  

As you will be doing your sessions “alone,” to begin the session, you will need to first elicit the presence of the Loving Other. This complex image (i.e., complex, because not necessarily visual, or not only visual) of the Loving other may be different for different people. And there are several ways to evoke or elicit this complex image. This may be accomplished with a short loving-kindness meditation, imagining the presence of an especially kind and loving person from any time in your life, or imagining a pet or a place in nature that helps you feel unconditionally welcome or secure (ACA WSO, 2021). For an example of loving-kindness meditation to elicit the presence of the Loving Other, please see ACO WSO (p. 36-37, 2021)

Once you have elicited the presence of the Loving Other, you can begin mapping your phenomenological experience when it feels right. To do this, you begin by asking yourself, what am I noticing right now? This will be your first and recurring choice point. And according to this notation, and in consonance with the SIBAM model of SE, there are five (5) possible responses:    

S – Internal physical sensations

I – Complex images, including five (5) sense perceptions

B – Behaviours, including movement impulses and actual movements

A – Affects, including emotions, mood, energy level, and the quality of orientation to time and space

M – Meanings, including cognitions, thoughts, and beliefs (Levine, 2010)

So that is your first step: to attend and orient your attention to one object or atom of present-moment experience and decide if it is an S, I, B, A, or M. The second step, and second choice point, is to describe in a word or sentence, or brief illustration, the kind, category, or quality of the atom of experience you are attending to. For me, the notation is written in a column from left to right. And I find it helpful to have lists of words handy to describe common physical sensations and emotions. Here are some examples of the notation for each category of phenomenological experience:

S: tightness in my midback, around the spine

I: the sound of a songbird outside

B: the impulse to rub my eyes, and rubbing my eyes

A: panicky

M: I should take those plates to the kitchen

As a third step and fourth step, and as the third and fourth choice points, you can add a quality and/or quantity descriptor to the atom of experience you are attending to. For example, is the experience pleasant (P), unpleasant (UnP), or neutral (N). And on a scale of one to ten (1  10), is it a one (1), low intensity, or a ten (10), high intensity, or maybe somewhere in between? For example:

A: panicky (UnP) (4)

If you are practicing SE, when you have contacted an atom of phenomenological experience, and if it is pleasant, you are invited to stay with that experience and enjoy it. If it is unpleasant, you are invited to just notice it and see what happens next (Somatic Experiencing International). If this feels right to you, you can incorporate these elements of SE into your own mapping practice.

Sometimes, when mapping, I incorporate all and sometimes only some of the elements of the notation. It depends on the session, and every session is different. Don’t worry; there is no wrong way to do this. This particular notation is just an example. You may even find that adding to it or subtracting from it might be helpful to you. For example, sometimes I will include the following symbols of notation because I have found them helpful. They seem to jive well for me in terms of my own mindfulness-based practice, as well as where I am in my SE training:

Nm – met need

Nu – unmet need

Bi – behavioral or movement impulse

Bm – behavioral or movement action

∞ - horizontal pendulation

R – familiar resource

NR – new or emergent resource

The invitation is to work with the basic SIBAM notation organically, giving yourself the freedom to customize your notation in a way that feels right and makes the most sense. Additionally, I will use my different colored pens, and sometimes pastels, while mapping. Sometimes a shape, an image, or a diagram will spontaneously emerge for me, and I will take a few moments, or maybe a couple of minutes, to sketch the image. If the image feels especially resourceful or otherwise charged or interesting to me, I will continue to explore it once I have concluded the IFAD-Mapping session, using the expressive arts therapy approach (Mcniff, 1992; Knill el al. 2010). 

So, in summary, a single line of mapping may look something like this: 

S: Chilly Feet (N) (2)

I now want to briefly discuss a separate class of physiological phenomena that I also track and map during an IFAD-Mapping session. This class of neurophysiological phenomenon is important because they typically indicate either the discharge of sympathetic nervous system (SNS) activation or the activation of the parasympathetic nervous system (PNS). These neurophysiological phenomena include yawning, stomach gurgling, flatulence, goosebumps, trembling or shaking, burping, a spontaneous deep breath (i.e., the reptilian breath), waves of sensation along the limbs, giggling and laughter (Somatic Experiencing International). In my experience, this separate class of SIBAM phenomena frequently recurs even during a short IFAD-Mapping session. And so, for the sake of simplicity and flow, I note these phenomena and also their frequency in this way:

Yawning   I I I I

Stomach Gurgling  I I I

Goosebumps   I I

Trembling in abdomen   I I I I I 

So, for example, I haven’t yawned four times in a row, but I did notice yawning four times in the session. I noticed my stomach gurgling three times in the session, and so on.  For me, it feels good to observe and witness myself returning to these anchors of neurophysiological self-regulation throughout the session, as well as to track the dynamic balance between SNS and PNS activation. 

Sample IFAD-Mapping Session Map

Now, I will provide below a sample mapping of a ten-minute session. Because we are all different, a ten-minute session may look quite different for you than it does for me. This is because our nervous systems are different, and this difference will inform each of our unique capacities to experience and track and map our own experiences. There is no right or wrong; no need to worry. The idea is to be curious, to explore, and, if possible, to enjoy being open to your own experience.

Ten-Minute IFAD-Mapping Session – Session Map 

Yawn   I I I I I I I I I   R

Deep Breath   I I I

S: my feet are chilly (Un) (3)

S: watery eyes (N)

B: leaning back in my chair

S: spacious breathing

M: I wonder if I’ll finish this paper tonight

S: tightness, achiness in tops of shoulders (UnP) (2)

M: stay with the unpleasant sensation and see what happens

S: tension in mid-back

Stomach Gurgling,   I I

M: This article/paper does not have to be perfect, or completely consistent, or completely   R comprehensive

S: more warmth in feet (N 🡪 P)  ∞

B: pulled shoulders back

B: sat more upright and more aligned 

S: less tension in mid back   ∞

Burps I

That was about a ten-minute IFAD-Mapping session. Once I complete the session, if I have time, I just take a look at the session map and notice things that catch my eye. These may include shifts or pendulations in my moment-to-moment experience. These may also include any resourceful atoms of experience or recurring patterns that might indicate some under-resourcing. I often make some post-session notes for myself on the map, as I have already done in the above example. Doing so helps me orient to this post-mapping analysis. Also, the colors I chose throughout the session are chosen randomly. With that said, however, I usually note SNS and PNS activation in blue pen. Again, I don’t know why; it just happens that way.

Lastly, there are several Zen concepts, as presented by Suzuki (1970) in his popular work, Zen Mind, Beginner’s Mind, that I want to briefly touch upon here since they have contributed to my understanding of the IFAD-Mapping process:

Nyu nan shin – “a soft or flexible mind” (p. 110)

Nin – “constancy” – The unchanging, effortless ability to accept things as they are (p. 86)

No gaining idea – the attitude that this practice is not a means to something else (paradoxically, not even a means to self-regulation), but an end in itself. Or perhaps the means is the end. “When you do not try to attain anything, you have your own body and mind right here [!]” (p. 26-27) [brakets my own]

Everything is just a tentative form and color

Innumerable activities – IFAD-Mapping is a practice that “contains innumerable activities and includes the various activities of life. We study them….” (p. 125)

To see things as they are – “The true purpose is to see things as they are, to observe things as they are, and to let everything go as it goes” (p. 33)

Big mind – “Many sensations come, many thoughts or images arise, but they are just waves of your own mind. The activity of the big mind is to amplify itself through various experiences. With big minds, we accept each of our experiences as if recognizing the face, we see in a mirror as our own.” (p. 34-36)

One thing after the other – “Here there is no time or space. We do things one after the other. That is all.” (p. 30)

Conclusion

So that is a brief introduction to IFAD-Mapping. I look forward to continuing my SE certification and deepening my understanding of somatic psychotherapeutic work. I am eager and enthusiastic to further develop and evolve this method of practice and notation. 

By taking the time, effort, and awareness – before and after client sessions – to graphically record and map the discrete units of present-moment and moment-to-moment phenomenological experience, the intention is that unconscious dissociative coping mechanisms can be readily transferred to the clinician in the course of their practice (McFarland, 2004; Diamond, 2020), can be gradually and safety titrated back towards greater and more integrated neuro-physio-phenomenological awareness. In the presence of the Loving Other, the hope is that corrective experiences that re-integrate and re-connect the capacity to be “present for experience” can remedy the survival-based dissociation that often becomes entrenched in survivors and possibly transferred to their clinicians. Such that in the space beyond the borders of death and Nothingness and the Abundance beyond the borders of life, perhaps new or familiar tolerability, possibility, and hope can as yet co-emerge.   

References

Adult Children of Alcoholics/Dysfunctional Families World Service Organization (ACA WSO). (2021). The Loving Parent Guidebook.

Amery, J. (1980). At the mind’s limits: Contemplations by a              survivor of Auschwitz and its realities. Indiana University Press. 

Başoğlu, M., & Mineka, S. (1992). The role of uncontrollable and unpredictable stress in post-traumatic stress responses in torture survivors. In M. Başoğlu (Ed.), Torture and its consequences: current treatment approaches (pp.182-228). Cambridge University Press.

Carlson, E. B., Dalenberg, C., & McDade-Montez, E. (2012). Dissociation in posttraumatic stress disorder part I: Definitions and review of research. Psychological Trauma: Theory, Research, Practice, And Policy, 4(5), 479-489. doi:10.1037/a0027748

Courtois, C., & Ford, J.D. (Eds.) (2013). Treating complex traumatic stress disorders: Scientific Foundations and Therapeutic Models. Guilford. 

Dalenberg, C., & Carlson, E. B. (2012). Dissociation in posttraumatic stress disorder part II: How theoretical models fit the empirical evidence and recommend modifying the diagnostic criteria for PTSD. Psychological Trauma: Theory, Research, Practice, And Policy, 4(6), 551-559. doi:10.1037/a0027900

Diamond M. J. (2020). Return of the repressed: Revisiting dissociation and the psychoanalysis of the traumatized mind. Journal of the American Psychoanalytic Association, 68(5), 839–874. https://doi.org/10.1177/0003065120964929

Dōgen, E. (2013). The essential Dōgen: Writings of the great zen master (K. Tanahashi, P. Levitt, Eds.). Shambhala.  

Halford, G. S., Wilson, W. H., & Phillips, S. (2010). Relational knowledge: the foundation of higher cognition. Trends in cognitive sciences, 14(11), 497–505. https://doi.org/10.1016/j.tics.2010.08.005

Knill, P. J., Levine, E. G., & Levine, S. K. (2010). Principles and practice of expressive arts therapy: Toward a therapeutic aesthetics. Jessica Kingsley Publishers. 

Levine, P. A. (2010). In an unspoken voice: How the body releases trauma and restores goodness. North Atlantic Books. 

McFarland, S. H., (2004). Self-creation and the limitless void of dissociation: the 'as if' personality. The Journal of analytical psychology, 49(5), 635–656. https://doi.org/10.1111/j.0021-8774.2004.00493.x

Ogden, P., Minton, K., & Pain, C. (2006). Trauma and the body: A sensorimotor approach to psychotherapy. W.W. Norton. 

Ray, W. J., Odenwald, M., Neuner, F., Schauer, M., Ruf, M., Wienbruch, C., & ... Elbert, T. (2006). Decoupling neural networks from reality: Dissociative experiences in torture victims are reflected in abnormal brain waves in left frontal cortex. Psychological Science, 17(10), 825-829. doi:10.1111/j.1467-9280.2006.01788.x

Roy A. (2017). The theory of localist representation and of a purely abstract cognitive system: The evidence from cortical columns, category cells, and multisensory neurons. Frontiers in Psychology, 8, 186. https://doi.org/10.3389/fpsyg.2017.00186

Saporta, J.A., & van Der Kolk, B, A. (1992). Psychobiological consequences of severe trauma. In M. Başoğlu (Ed.), Torture and its consequences: current treatment approaches (pp. 151-181). Cambridge ; New York: Cambridge University Press.

Somatic Experiencing International (SEI). Beginning year: Module one.

Somnier, F., Vesti, P, Kastrup, M., & Genefke, I.K. (1992). Psychosocial consequences of torture: current knowledge and evidence. In M. Başoğlu (Ed.), Torture and its consequences: current treatment approaches (pp. 56-71). Cambridge ; New York: Cambridge University Press.

Steele, K., & van der Hart, O. (2009). Treating dissociation. In C. A. Courtois, J. D. Ford, C. A. Courtois, J. D. Ford (Eds.) , Treating complex traumatic stress disorders: An evidence-based guide (pp. 145-165). New York, NY, US: Guilford Press.

Steffen, P. R., Hedges, D., & Matheson, R. (2022). The Brain Is Adaptive Not Triune: How the Brain Responds to Threat, Challenge, and Change. Frontiers in psychiatry, 13, 802606. https://doi.org/10.3389/fpsyt.2022.802606

Suzuki, S. (1970). Zen mind, beginner’s mind. Weatherhill.   

van der Kolk, B. A., & McFarlane, A. C. (2006). Trauma and Memory. In B. A. van der Kolk, A. C. McFarlane, L. Weisaeth, B. A. van der Kolk, A. C. McFarlane, L. Weisaeth (Eds.), Traumatic stress: The effects of overwhelming experience on mind, body, and society (pp. 279-302). New York, NY, US: Guilford Press.