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Blending Disciplines
Using Exercise Science to Explain Somatic Psychology
Stacy Reuille-Dupont
ABSTRACT
Exercise has the potential to decrease negative side eff ects, lower societal medical costs, and increase qual-
ity of life. Exposure to physical exercise increased participation and led the way for a variety of pilot testing
movement-based interventions with a diverse, rural, clinical mental health patient population in treatment
for numerous clinical diagnoses. The original research (Reuille-Dupont, 2015) is briefl y outlined before a dis-
cussion of theory used to determine and perform movement-based interventions for psychological and phys-
ical health goal treatments. Throughout the paper, psychological and exercise science theory and research
are overlaid to explain the physical implications and psychological shifts of movement-based treatment. It is
important to understand common terminology to engage clients and other health care practitioners in move-
ment-based treatment for psychological and physical health. In addition, as specialists in understanding the
body’s role in experience, it is the somatic psychologist’s responsibility to promote and advocate for “exer-
cise as medicine” when possible. Included are visuals to help outline and overlap the disciplines for better
understanding, increased awareness, and expanding the language somatic psychologists need to engage in
multidisciplinary healthcare teams.
Keywords: physical movement treatment, movement for mental health, exercise science, somatic psychology
Submitted: 15.08.2019 WHY BLEND DISCIPLINES?
Revised: 29.02.2020
Accepted: 09.03.2020 Understanding Physical Exercise
International Body Psychotherapy Journal Participation in a Clinical Mental Health
The Art and Science of Somatic Praxis Population
Volume 19, Number 1,
Spring/Summer 2020, pp. 82-93 or many, it is common knowledge that mental health im-
ISSN 2169-4745 Printing, ISSN 2168-1279 Online pacts physical health, and vice versa. People may know
© Author and USABP/EABP. Reprints and the benefi ts of physical exercise, yet do not engage in
permissions: secretariat@eabp.org behavior to meet physical health goals (CDC, 2018). Re-
search shows that as little as two 30-minute sessions
per week can be as good as a selective serotonin reuptake
inhibitor for depression (Wipfl i, Landers, Nagoshi, & Ringenbach,
2011). Movement is what we do. It is experience. It does not have to
be large movement patterns. Make no mistake, all believed emotion
and thought are movements at the cellular level, and shape the hu-
man experience. This author and researcher posed the question in
a clinically diagnosed mental health population, “What keeps peo-
The exercise program training window ple from engaging in movement when they know the benefi ts?” (Re-
looks very similar uille-Dupont, 2015).
to the window of tolerance The specifi c question for this researcher began as “What is the per-
in many trauma treatment protocols. ception of barriers and benefi ts those with mental health challenges ex-
perience when trying to participate in physical exercise?” Based on this
“ author’s in-offi ce experience, psychological trauma seemed to be
a barrier; however, it did not return signifi cant results in the study
82 INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL Volume 19 Number 1 Spring/Summer 2020
(Reuille-Dupont, 2015). In a study with 149 participants cal health states. This information was used to create clin-
engaged in community mental health treatment, it was ical movement interventions in the author’s offi ce. Over
physical anxiety experiences, specifi cally panic, that were time, lessons learned from pilot groups, program devel-
the true barriers to participating in physical exercise at opment, grant opportunities, and individual work off ered
levels to impact metabolic change (Reuille-Dupont, 2015). refi nement and development of a structure to help bridge
Anxiety as the barrier to physical exercise participation the gap between physical and mental health treatment. In
is reasonable. The physical system (nervous system) is addition, feedback from study and intervention partici-
overwhelmed, and thus cannot participate in more over- pants off ered fertile ground to form questions that deep-
load (physical exercise). An interesting result showed sig- ened understanding of underlying physical structures and
nifi cance between those with increased co-morbid mental reasons for somatic distress (Reuille-Dupont, 2015).
health and substance abuse diagnoses (Reuille-Dupont, Psychology and exercise science disciplines are vast. The
2015). These participants described the least number of purpose of this article is to outline common categories and
barriers to participation in physical movement, and more themes of overlapping theory concepts. These were used
participation in physical exercise at levels that could in- to create successful exercise-based movement interven-
fl uence physical and metabolic change. tions with a clinical population in a rural psychology prac-
As this author and researcher studied those with fewer tice. This is a narrow focus of applied knowledge, leaving
barriers and more exercise participation, better under- much to be explored and expanded upon in future appli-
standing emerged around movement-based practices, cation and research. Below are outlines of several physical
specifi cally exposure to movement participation (Re- systemic operations, possible infl uences on psychology,
uille-Dupont, 2015). The next question became, “Can we and reviews of the overlap between exercise science and
manipulate the movement experience to promote engage- psychology theory. The article ends with implications and
ment in physical exercise at appropriate rates and intensity, to suggestions for using physical movement in treatment to
“dose” mental and physical health symptomatology?” Thus, reduce symptoms and/or build healthy coping skills.
can we create a treatment model with “exercise as med-
icine” that impacts psychological functioning while ad- The Importance of Embodiment
dressing physical health markers? Many somatic psychologists intuitively know the internal
As noted above, the investment in physical exercise as landscape is refl ected in the external environment. Em-
a treatment for mental health symptoms is low; two bodiment is a way to return to health homeostasis in both
30-minute, moderate intensity aerobic sessions per week (Calsius, De Bie, Hertogen, & Meesen, 2016). Physical and
(Wipfl i, Landers, Nagoshi, & Ringenbach, 2011), and the mental health are inseparable (Kucyi, Alsuwaidan, Liaw, &
research shows similar benefi ts for anxiety, depression, McIntyre, 2010; Carless & Douglas, 2008; Wipfl i, Rethorst,
bipolar, schizophrenia, ADHD, substance abuse disor- & Landers, 2008; Ding et al., 2006; Droste et al., 2003;
ders, and trauma (Kucyi, Alsuwaidan, Liaw, & McIntyre, Dunn, Trivedi, & O’Neal, 2001; Doyne et al., 1987), and so-
2010; Carless & Douglas, 2008; Wipfl i, Rethorst, & Land- matic psychologists are in a unique position to communi-
ers, 2008; Ding, Vaynman, Akhavan, Ying, & Gomez-Pi- cate the underlying structural shifts (physical) in defi ned
nilla, 2006; Droste et al., 2003; Dunn, Trivedi, & O’Neal, personal experience (psychological/relational).
2001; Doyne et al., 1987). The research is also clear that People with mental health issues, on average, die younger,
a large percentage of those with mental health challeng- often have fi ve or more unrelated physical health symp-
es face more physical health problems, utilize approxi- tom presentations when seeking physical health care,
mately 25% more health care services (Spitzer, Kroenke, may have increased substance abuse or addiction behav-
& Williams, 1999), and die younger than those without a iors, decreased economic resources, and have dysregulat-
mental health diagnosis (Colton & Manderscheid, 2006). ed nervous system activation (Newcomer, Steiner, & Bay-
Yet many do not participate in or are guided to engage liss, 2011; Colton & Manderscheid, 2006; Kroenke, Spitzer,
in physical movement (Spencer, Adams, Malome, Roy, & & Williams, 2002). It is suggested that increased physical
Yost, 2006) as part of their mental health treatment (Re- health conditions are a result of the allostatic load of stress
uille-Dupont, 2015). on the body (McEwen, 2007). Medical healthcare staff of-
Despite the lack of exercise adherence, this author’s re- ten struggle to treat and accurately diagnose this popu-
search illuminated options of intervention promise. The lation (Ring, Dowrick, Humphris, & Salmon, 2004). This
complex diagnosis presentations showed that those with struggle can result in expensive testing and medical care,
necessity (lost driver’s license, jail time, poverty, limited increased pharmaceutical use, and increased invasive
transportation options, physical needs to move/walk) had treatments (Kroenke, Spitzer, & Williams, 2002). Thus,
to use physical exercise at moderate levels to get through these interventions could further exacerbate trauma in
typical daily life activities. As a result, they touted the ben- physical tissues, bodily structures, and may increase tax-
efi ts of physical movement in personal mental and physi- payer costs. Addressing both physical and mental health
Spring/Summer 2020 Number 1 Volume 19 INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL 83
Blending Disciplines
in psychological treatment offi ces has the potential to ment room or on the fi tness center fl oor. This results in a
lower medical costs and increase quality of life (Green et collective and holistic approach to health.
al., 2011; Hunter & Goddie, 2010).
Often people come to physical and mental health care POSSIBLE TARGETS FOR BLENDING EXERCISE SCIENCE
disembodied, and look outside themselves for relief (Kir- WITH SOMATIC PSYCHOLOGY
mayer, Groleau, Looper, & Dao, 2004). This can lead to
addictive patterns and disconnected relationships. This Physical Structure Mental Health
lowers the protective factor of physical health as the body Endocrine and lymph systems
deals with diffi cult internal and external environments / Infl ammation and immune Stress response
(Kiecolt-Glaser, McGuire, Robles, & Glaser, 2002). As this responses / Chronic pain / of the hypothalamus-pituitary-
disconnection becomes more pervasive in the individu- Autoimmune disorders / adrenal axis (HPA-axis), trauma,
al, collective society at large may experience increases in Hippocampal damage emotional dysregulation
fear, violence, and disrespect as the internal becomes ex- Breath and heart: Respiratory
ternal (Fleckman, Drury, Taylor, & Theall, 2016; Tandon, sinus arrhythmia and heart rate Nervous system/
Dariotis, Tucker, & Sonenstein, 2012). One way to help in- variability Vagal nerve regulation
dividuals develop somatic embodiment is by helping them
return to physical activities. High blood pressure Emotional intelligence /
Alexithymia
Blending the Disciplines: Exercise Gastrointestinal issues / Clinical mental health
Science and Somatic Psychology Gut fl ora / Microbiome / and addiction diagnosis
Neuro-transmitter presentations / Emotional
Movement facilitates the physical wiring and structure of production regulation
being (Slepian, Weisbuch, Pauker, & Basian, 2014). Move- Infl ammation and immune Trauma and stress responses /
ment creates concrete manifestation of the abstract. The responses / Joint issues & range Chronic pain disorders / Digestive
embodied experience becomes tangible because thought of motion issues / Emotional regulation
and emotion are movement at the cellular level (Lipton, Electrical communication
2008). Somatic psychologists ask questions like: “What is in the body: heart, brain, Nervous system / Pressure &
the energy of the body telling me about this person’s beliefs fascia, neurons trigger points / Meridian lines
regarding self, others, the world? About the past? About the Brain / Limbic resonance /
future?” They explore the embodied state to shift aware- Mirror neurons / Co-regulation / Shared
ness, relationship, and self-narrative (Schore, 2018; Og- Right brain-to-right brain regulation / Mammalian
den, Pain, & Fisher, 2006, Aposhyan, 2004; Kurtz, 1990). relational connection interdependence
The somatic practitioner can use anatomy to look for psy- Stacy Reuille-Dupont, PhD, USABP Conference November 2018
chological blocks. For example, by looking at posture, the
clinician might ask, “What was this body built for? How is
the client holding themselves in the world? Who do they think Kinesiology, Physiology, Biomechanics,
they are?” Or, “Where does the movement in the body get and Somatic Psychology
‘stuck’ or transpose itself?” These questions give a pleth-
ora of information to use movement in mental health Kinesiology is the study of human movement from exer-
treatments. Exercise interventions use corrective move- cise science perspectives of anatomy and physiology: the
ment patterns from exercise science to identify and work study of the body at work and rest, and biomechanics: the
with postural deviations, physical health problems, and study of movement patterns and mechanics of human
movement misalignments (Calsius, De Bie, Hertogen, & movement (Wilmore & Costill, 1988). Through study of
Meesen, 2016), and can be expanded within the somatic these areas, many of the physical systems are explored in
psychology principles of relationship/connection, sense of relationship to movement patterns of the body. The en-
self, environment, and human attachment (Schore, 2018). docrine system functions as the “little nervous system,”
Many facets of human experience are impacted as a re- and helps dictate the role of chemicals throughout the
sult of blending disciplines. Systems impacted are those of body-neurotransmitters, neurotrophins, hormones (Yoke,
the physical structures: cardiovascular, musculoskeletal, 2010). Electrical and chemical systems of the body, such as
endocrine, and nervous systems (Walker, 2017; Martini, the heart, fascia, and brain, communicate using waves of
Ober, Garrison, Welch, & Hutchings, 1998). In addition, energy that infl uence cellular structures and impact cel-
when the intention of the movement is psychological, lular changes such as muscle contractions (Adstrum, Hed-
systems of attachment, social engagement, and corrective ley, Schleip, Stecco, & Yucesoy, 2017; Miura, Miki, & Yano,
experience become present (Schore 2018; Porges, 2011; 2010; Martini et al.,1998). Structures in the physical sys-
Ogden, Minton, & Pain, 2006; Kurtz, 1990) in the treat- tem communicate in vibrational patterns that are sensi-
84 INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL Volume 19 Number 1 Spring/Summer 2020
Stacy Reuille-Dupont
tive to other vibrational patterns (Walker, 2017; Ferrari, Stauff er, 2010; Martini et al., 1998). It also allows a tan-
Clemente, & Cipriani, 2018; Fuentes, Gomi, & Haggard, gible way to impact brain structures such as the parietal
2012; Ivanenko, Talis, & Kazennikov, 1999). Gross mo- lobe and motor cortex to increase the patient’s ability to
tor movements of the musculature and skeletal systems learn (Lojovich, 2010; Davis, 1977), thus helping them
allow organisms to manipulate environments and mani- implement the treatment exercises more eff ectively.
fest action in personal situations. However, each of these Mindful neuromuscular junction work (attention to slow
systems operates in tandem to create a complete physical movement) allows for increased awareness of physicality
experience. and experiences (Ogden, Pain, & Fisher, 2006). This hy-
per-awareness of the movement pattern then allows the
In the words of Hanna, “the themes of somatic philosophy client to rewrite the narrative around the experience that
are, quite simply, perception and behavior” (Hanna, p. 214, created it, and off ers an opportunity to engage in con-
1970). Utilizing movement and applying exercise science scious self-development (Aposhyan, 2004; Hartley, 2004;
interventions to psychological treatment allows for work Caldwell, 1997; Knaster, 1996; Kurtz, 1990). The trained
with boundaries, trauma, attachment, power, confi dence, practitioner can see muscle imbalances and postural mis-
and relationship issues (Caldwell, 1997; Knaster, 1996) alignments, and program movement to help re-balance
while impacting physical health problems (Walker, 2017; the physical and psychological structure of being.
BIOMECHANICS AND SOMATIC PSYCHOLOGY
Common Muscle Possible Psychology Focus
Imbalance Areas
Stepping into life/goals/self. Mechanics of walking are impressive and offer conversation around “small structures mak-
ing big changes.” Work with the feet directly impacts the pelvic fl oor and hip structures, making them a good entry for
Feet & sexual dysfunction/trauma treatment. Also, working with low back and stability/safety issues as all movement comes
Lumbar Spine from the core. Reliance on the big toe to walk effectively can feel “dangerous”. 80% of people have low back pain due to
a variety of issues, and this area is critical in digestive and reproductive health, feeling strong, supple, and stable in all
movement patterns.
Hips are chronically tight in many, yet without appropriate fl exibility they cannot move freely. The hip joint is designed
Hips to move 360 degrees (one of only 3 joints in the body). With limited hip range of motion, many other movement chains
become dysfunctional. Flexibility and rotation are concepts around self-regulation and the ability to move with adaptation,
focus, purpose, and confi dence in the world.
This area is often overlooked for the more popular lower back. However, it is very important in somatic psychology be-
Thoracic Spine cause imbalance in this region leads to diffi culties in breathing, collapsing of the chest, and rounding of the shoulders.
Many people feel stress through this region, and tension pulls energy away from supple movement options. When the
above is disrupted, the nervous system is also disrupted.
This area includes the scapula and clavicle regions wrapping the top of the torso. Many people have elevated shoulder gir-
dles and feel stress, burdens, and crushing despair through this region of the body. The shoulder, like the hip, is designed to
Shoulder and move 360 degrees, yet many do not have that level of fl exibility. Internal rotation of the shoulder can lead to collapse of the
Shoulder Girdle chest cavity and strain on the neck, thoracic spine, and abdominal cavity organs. This adds stress to elimination (kidneys/
liver), digestive, and pulmonary systems. When these are impacted, infl ammation and stress rates rise in the body, and
breathing impacts heart rate and heart rate variability, thus directly infl uencing nervous system states.
Misalignments and imbalances throughout the head and neck create issues related to communicating clearly, speaking,
Neck, Throat seeing, hearing, and regulation both from physical and emotional perspectives. Many have neck/headache pain which
and Head may decrease ability to regulate during increased stress states, diffi culties in connection, learning, attention, and engage-
ment in the environment.
Stacy Reuille-Dupont, PhD, USABP Conference November 2018
Overlapping Psychological for addictive behavior (Reuille-Dupont, 2015). Howev-
and Physical Information Systems er, many participants in the study were not exercising at
levels needed to shift metabolic measures, such as blood
Based on this author’s research with a clinical mental pressure, body composition, or blood sugar levels. In ad-
health population, a number of concepts were illumi- dition, although they knew it would help their mental
nated. The data suggested that people understood that health, they were not physically moving enough to in-
physical movement could help mental health symptoms, fl uence mental health symptomatology. Thus, this au-
positively impact physical health, and decrease cravings thor questioned what was getting in the way of physical
Spring/Summer 2020 Number 1 Volume 19 INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL 85
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