To help shed light on the strange and mysterious space of the therapy room, I want to set out some of the key ingredients required for successful psychotherapy. I’m calling them the six Rs of authentic depth, mindfulness-based psychotherapy. They are: Regulation; Relationship; Roots; Resources; Responsibility and Radical Affirmation of Reality. It feels important to include in my description of mindfulness-based psychotherapy the word “depth” to flag up from the very beginning that embarking on a psychotherapeutic journey isn’t about quick fixes, or messing around in the shallows. It’s about descending – albeit with ease, safety and resources – into the depths of the psyche in order to enquire into the root causes of our suffering. Daunting maybe, but think of diving into the extraordinary world of a deep-sea kelp forest, with a competent swim buddy by your side, a good mask, a decent snorkel and a pair of extra-long flippers. A conscious and committed decent to fully experience and explore what’s down there – wreckage and treasure alike. The reward is the reclamation of your full life.

Regulation – calming the system and clearing trauma

We all carry some degree of stress and trauma in our body-mind-energy system and it can show up in a million different ways, impacting relationships, work, sleep, mental health and general health and wellbeing. Trauma compromises the ability of the nervous system to return to a balanced state. Trauma can result from any event or situation that threatens our life – an accident, war or abuse, for example. But it can also result from anything – and the important word here is anything – that seriously impacts our ability to be fully alive and present in our bodies on this earth. Seemingly innocuous or “minor” experiences that we brush away as insignificant can instil an overwhelming amount of fear into the system, stopping us from living to our full potential and effecting health and wellbeing on many levels.

The human nervous system is an incredibly sensitive piece of kit. From the very beginning of life it is receiving, interpreting and processing information – every interaction, every implicit and explicit message, every micro and macro experience is taken in by the body-mind. If the nervous system is balanced, and we have the support we need, even the most dreadful experiences can be processed or digested, allowing us to function and respond to life with resilience, ease and joy. Not so long ago, however, this wasn’t thought to be the case. Think of all the men and women – our grandparents or great grandparents – who returned from The First and Second World Wars suffering from the debilitating effects of trauma, and who were offered very little support or treatment. Thankfully, our understanding has changed and today there is a host of treatments, approaches and interventions that can help return our bodies and minds to a state of health and wholeness.

Whether people are seeking therapy specifically to resolve trauma or not, regulation of the nervous system is an essential component of successful psychotherapy. Good therapy needs to be able to offer safe and efficient ways to help bring a healthy balance between the fight-flight-freeze response of the sympathetic branch of the nervous system and the rest-and-digest function of the parasympathetic nervous system. When the whole system is balanced, we feel calm, stable, resilient, open and energised; we can think more clearly and are better at problem solving as well as engaging with others and the wider world. Basic mindfulness practice, using the senses to come back to the present moment, can help to calm the system. Other strategies might include gentle movement, trauma-informed yoga, breathing protocols, and combined somatic-cognitive interventions such as EFT (Emotional Freedom Technique), also known as tapping, and EMDR (Eye Movement Desensitisation Reprocessing).

Having said all that, it’s also important to point out that while resolving trauma is absolutely possible it isn’t necessarily easy. The very fear that has overwhelmed and traumatised the nervous system tends to keep us stuck in whatever, usually unconscious, holding pattern we’re in. If the nervous system has been constantly telling us that the world and other people are untrustworthy and dangerous, deciding to seek support can feel terrifying. The first step onto the path of therapeutic enquiry may be the biggest one of all. After that, it takes commitment, courage, practice and faith.

Relationship – coming back into connection

Another fundamental ingredient of depth psychotherapy is relationship. This may seem blindingly obvious, but it’s easy for the importance of this element to be overlooked. How many of us – myself included, way back when – have convinced ourselves that we can do all our inner healing work alone, perhaps with the aid of meditation or a self-help book or ten?

Relationship goes hand in hand with regulation – or co-regulation – of the nervous system. We do not exist in isolation, and as babies and small children we are totally dependent on our primary caregivers. We need them to help us regulate our developing nervous systems – we simply can’t do it on our own. We are social beings and as adults, too, we need others to help us manage our emotions through connection, understanding, non-judgemental listening, and talking through what needs to be digested, incorporated and more thoroughly understood. Psychotherapy offers a place where that can happen. Simply being with another person whose nervous system is calm and balanced will help to soothe and regulate a more activated nervous system. Although psychotherapy can offer useful strategies and practices, essentially it provides a spacious holding field where client and therapist can meet each other on a being-to-being level. It is heart-based place offering the safety needed to trust that authentic relationship is possible. Which opens up not only the possibility of reconnecting with other human beings but the possibility of meeting each moment of our lives more fully and deeply.

People sometimes wonder why psychotherapy is often such a long-term endeavour. We are complex creatures with intricate histories and it takes time for our sensitive nervous systems to really trust that it’s safe to fully meet the next moment; to simply be. And it takes time to trust that it’s safe enough for the wounded children we all carry within to be felt, seen, heard and recognised. Those vulnerable parts of the self tend to get pushed away into the depths of our unconscious – it can feel too painful, too dangerous to allow them to surface. We develop other, maybe more protective and sometime combative, parts of the self with which to meet the world. The psychotherapeutic relationship extends to those parts too. There are no parts of the self that are fundamentally bad or wrong, they simply need to be heard and understood. It can take a while, but when there are no longer any parts of the self that need to be firmly kept out of the room, we’re done – well, there’s always more to do, but essentially we no longer need to cover up, push away, pretend, feel bad, be good and generally use up all our energy in fortifying our ego.

Gradually and gently, within the safety of genuine, non-judgemental relationship, our nervous system discovers that regulation is possible, and we arrive at a place of freedom, wholeness and ease of being.

Next time: Roots and Resources, two more essential elements of successful mindfulness-based psychotherapy