a slightly deflated gym ball to lean on so that they can observe how the ball moves with each breath they take in, and give out. It is easier for a traumatized person to consciously recognize this external movement than their own internal body sensations. They become aware that the ball is moving and are able to consider that it is their own breathing (“agency”) that is moving the ball. This “mindfulness” of what is happening to the ball is a simple, but fundamental starting point for people who have lost their sense of autonomy. In later sessions, when clients are ready, they are taught breathing techniques. For example Bumble Bee Breathing is a technique which enables people who are anxious to stay calm when they are under pressure. It encourages longer exhalation, and therefore discourages gasping for breath (over breathing). Such techniques are adapted for clients in accordance with their physical needs, their psychological responses to trauma and in consideration of their cultural and language origins. Clients are monitored carefully by the therapist when they begin practice, to ensure that they don’t become dizzy, overwhelmed or suffer re-traumatization. As breathing is addressed, the impact of traumatic past experience on posture and movement can also be considered. For example, in the course of exploring a back injury or leg pain, clients’ breathing may be observed as they are guided to slowly change their physical position. “While we are focusing on subtle movements, I will make gentle statements about the client’s body responses. These do not demand an answer from the client but simply invite them to make their own observations if they choose to do so. “For example, I might say, ‘I’m curious about your breathing here....’ or ‘what is your experience of moving your leg here? This opens a flow of dialogue which accompanies the exploration of movement. “I will also talk to clients in a way which helps them to recognize and consider underlying thoughts and feelings that affect their breathing and movement: ‘If I say you can relax your arms now … how do you feel?’ Or ‘What happens when I say ‘you are safe now’. “These techniques gradually bring clients’ unconscious habits to the surface, helping them to observe their own reactions to traumatic memory so that they can be addressed.“ Carrie Tuke, HBF Body-Mind Therapist 106 Body-Mind work is always undertaken very slowly and carefully. Adjustments that are made to any one aspect of the body affect it overall, so the focus is always upon the whole person. It is crucial to maintain the client’s conscious recognition of this fact, and to “repeat, refresh and renew” their understanding until the client is able to assert themselves independently. Sustaining reassurance throughout therapy sessions is central to Body-Mind work. Sometimes clients who are undertaking Body-Mind therapy just need to be assured that they are fine as they are, to instil a self-belief and confidence in their body that is lacking and which they hope to regain. “Luana was trafficked from Albania for sexual exploitation and was held in a brothel for several years in the UK. She suffered many injuries while there, and when she came to her first Body-Mind therapy session she was also grieving for members of her family. “We considered her experience of walking towards me. She said she found it difficult to make eye contact with me, and she held her head tilted to one side. She identified ‘a dragging down-pull in the pit of her stomach’ which ached constantly. We explored various adjustments and she discovered that she could change her sense of physical support by shifting and distributing her weight in a different way through her legs and feet. This gave her a buoyant lift through her torso and relieved some of the pain and stress in her right hip and leg. She said that this adjustment made her feel ‘different inside’ and she felt more confident standing in front of me. “She then tried out different positions, noting how each made her feel. She thought about how other people might respond to her differently with her more confident attitude and re-vitalized posture. She realized that her habitual posture was associated with her previous traumatic experiences. This knowledge makes her aware of her body and how she moves. She can now influence the way she feels by shifting her posture.” HBF Body-Mind Therapist: notes on a victim of trafficking for sexual exploitation