Hi listeners, welcome back to the Lessons from the Playroom podcast. I have an incredible individual with me and I’m so incredibly excited to be able to share her wisdom and knowledge with all of you. I am talking about Kim Barthel.
If you are not familiar with her, you are going to know her very well. By the end of this conversation, she is many, many things. I’m going to share a little bit about what she is doing in this world.
And then Kim, we will say a hello to you. And we were going to dive right into this conversation. She is an award winning occupational therapist.
She is a multidisciplinary teacher, bestselling author, who is active in supporting people in many contexts globally. One of my favorite things about Kim is Kim’s dedication to the human spirit and to helping people be their best selves. I know, Kim, you work a lot with kids, but also you work with adults too.
So it’s the full spectrum, helping us all be more of who we are meant to be. She’s very passionate about understanding complex behavior, neurobiology trauma, sensitive practice, attachment and mental health. Kim has been at this for 37 plus years, been in practice.
She also has a special interest in childhood developmental trauma. And what is so cool and what we’re going to touch into today is she has brilliantly merged the concepts of play, polyvagal theory and sensory processing and play therapist. Sensory processing is one of the pieces in our field that we are, in my opinion, really missing a deeper level of understanding on.
So Kim, I am so incredibly excited that you are here and that we get to have this conversation. Thank you for such an exciting welcome to the conversation and I am a very big fan of you and am deeply grateful for this opportunity to geek out together on something that we both love. Absolutely.
I was sharing everyone with Kim before we got going. That when I first heard Kim’s name and I heard what Kim was up to in this world. I took an afternoon off and I binge watched all her YouTube videos.
I couldn’t stop watching them and I just fell more and more in love with what you are saying and putting out into the world. So I’m really grateful that you’re here and we can have this conversation. So I know that you talk about so many different topics and you teach on such a range of different aspects of trauma and polyvocal theory and attachment and all of that.
And one of the things that I think would be lovely for us to go into is a deeper understanding of the body. As play therapists, we train so much kim in how to understand play and how to understand the development of the child. But we don’t spend enough time, in my opinion, talking about and understanding activation and what that looks like in the child and what that looks like for us and how do we read the body and how do we trust the body.
And I am hoping we can go into that as our talking points today. That’s a fascinating point of entry. And when I think about the things that you love to talk about, like regulation, and when you think about polyvagal theory and states of arousal, these behavioral things that we talk about, they exist as a manifestation of movement in the body.
They aren’t just in a vacuum, they live in people’s actions and that makes them observable. And we have this beautiful design to our motor system, the way that we use our muscles that allow us to be flexible, adaptable, socially connected, engaged and playful. And when we are in a state of equanimity, harmonious state of being, our muscle system has a beautiful balance of sympathetic and parasympathetic.
Those are autonomic nervous system terms of influence that allows you to have enough energy in your body to participate, to light yourself up, to direct your body in orientation to what you want to do and to be flexible and adaptable in your play. When you are not in that harmonious state, when you’re in active states of stress, when there is either a dominant fight or flight influence or a dominant collapse parasympathetic dorsal vagal influence, this also shows up in the body. And it can be a really powerful aspect of your clinical reasoning that informs you as to what direction the child that you’re with or the adult that you’re with, the parent that you’re with is moving within the momentum of your session or any intervention that you’re doing.
The body is another observable place that gives you those kinds of clues in your therapeutic input. Hey there. Need new tools for your playroom? Check out playtherapysupply.com.
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Visit Playtherapysupply.com to get all of your play therapy supplies today. One of the things that I have learned to appreciate about observing the body in the moment is it’s also giving me a lot of information about the child’s perception in the moment not only of what’s happening therapeutically but also what they’re working on.
Yes. So as they’re working through maybe a trauma component or they’re working through a felt sense stored in the body or they’re working through a memory or they’re working through a thought, I’ve come to really appreciate that the body is sharing with me how that is for them. Well, what you’re talking about that’s exciting to me is that there’s this sensory meeting of movement.
And when you think about interoception, which is the internal perceptions that you’re talking about how do I feel in my body? That meets all of the information sensorially that’s coming from the environment. And there’s a structure in the brain called the insula which is a beautiful home of the convergence of this data where I put together what’s going on inside with what’s going on outside. And that’s where triggers or when the dots line up and there’s integration.
This is the part of the brain where that convergence of inner and outer perceptions meet. And you see it in the postural system where the body will line up a line, the child will sit up, their eyes will look different. There is so much power in the eyes to tell you where the mind is.
I always say the mind is behind the eyes. And when you’re in that present state of integration, it’s like everything clicks. And the body is here and you see it in the spine, you see it in the breath, you see it in the shoulders, you see it in the neck, you see it in the hands, you see it in the feet, and you see it in the face.
And it’s kind of like all of these integrating inner and outer confluence of information becomes reorganized. And to me, that’s the sweet spot of what you’re hoping for as a therapist is to know those moments in play or in psychotherapy where you see the AHA in that whole system. And that’s where true change transforms, I think like visibly seeing confirmation that something is integrated or visibly seeing confirmation that the client is having a moment of feeling empowered or feeling like themselves or feeling more deeply connected in the body.
And the body’s saying, look, I’m congruent one of the things that you said I’m going to maybe embarrass you here for a minute that absolutely landed in me like an arrow. And I heard you say this at the Gold symposium and you talked about how true regulation is not this persona of having it together. It’s being able to authentically land in the experience that you’re having so that the person you’re with can watch you process and reorganize and regulate.
It’s the process of change from the moment of consciousness of your emotion to being able to reorganize that within yourself. That is the value. And I want you to know how freeing that is because every therapist that I know, believes they need to have it all together before they step into that playroom.
And that this regulation is a behavior, not an honest, authentic connection to the self. And that’s a sensory experience being to that connection to the self. Connection is the word you use over and over again.
That connection is a sensory felt sense. And if you don’t have permission to do that in your life, then regulation isn’t actually possible because regulation happens in the body. It’s so true.
And thank you for naming that for our listeners, because I think that I don’t think there are enough times that we can hear it’s okay to be who you are at any given moment. And there’s wisdom to who you are at any given moment and there’s wisdom in your activation and there’s wisdom in your holding patterns and there’s wisdom in how you’re moving through the world and there’s wisdom. And we’re taught so much, I think, in our field that there’s good and there’s bad if you have certain behaviors or certain postures or certain whatever it is that somehow you’re a better person or more skilled.
More skilled, exactly. Versus really a deeper understanding and curiosity of I am moving through this word of the world this way in this moment because there’s perfection and meaning in it to me and who I am in my life. And I think that if we can hold that space for our child clients, to me, that opens up a whole new lens of understanding what behaviors are.
It takes away the labels on behaviors. It takes away this idea that there exists such a thing as a bad child or a bad behavior or a naughty behavior. And instead, it opens up the possibility of there’s a being in front of me.
There’s a being in front of me having an experience and moving at the world, learning and adapting and growing and attempting to integrate. And what role can I play in that? To me, that’s a heart opening space for me as a clinician to come from. And I think it’s a healing space to come from.
Yeah, and I know you come from a similar place, Kim. Well, and I think that the reason that those words are so powerful is because they are more than words. And just this morning, I was having a conversation with a clinician, and I was saying throughout time, in our experiences as clinicians, you evolve within these concepts that every single moment that we have with a client, not only are they evolving, we are evolving.
And it’s that connection to the self when you can actually connect to your own feelings while you are present to another person. That’s the juice, I think, that gives us that place to become better and better in our ability to connect with others. So I love that what you say is something that never ends.
I have a question for you. It’s a real practical question for you from your expertise. If a play therapist were to say, I struggle with sensing my body, I struggle with connecting to my body.
I don’t know how to be in my body, I don’t know how to read the activation in my body. Where do I start? How do I even begin that journey of recognition? What would you say from I think that’s a really cool question and I hope that the answer doesn’t sound too weird. When we look at typical motor development and we look at early sensory development in babies, it actually begins on the ground.
That gravity and what we call vestibular input, input that comes in through the balance center in your inner ear. This is our earliest developed sensory system. It actually is fully developed in utero and it gets hijacked by neurodiversity.
Kids with developmental disabilities almost always have difficulty with this system and in trauma. So anytime we are connected to the ground, sitting on the ground, rolling on the ground, lying on the ground, the gravitational pull is greater and it gives your brain more and more information about you. The sense of self begins through these sensory systems.
And so if you just even lie on the ground and in my experience, clinicians find this really hard because the act of being still in your body on the ground can be very activating because it’s not something that we do. We don’t just lie there on the ground and feel into our own body. And at first it can be very hard to do.
I’m reminded of in my yoga classes where they say the shavasana practice is actually the hardest pose because how do you lie still and alert in a way you’re sensing? I had an interesting experience today that will be very pragmatic right here. So I was explaining a concept to one of my colleagues and she likened it to she just used Buddha as an example. She said, you know, Budha has his left hand out in a receiving position and his right hand up in a stop sign.
So she said, I want you to try something. Start with both hands out in a receiving position and just feel what that’s like. And then what happened is she said, okay, now shift to put your right hand in to stop.
And what happened to me when I did that was my left foot came back like I needed to brace myself and I caught it that I was no longer that as soon as I was both in reception and boundary, I was no longer grounded. So when I put both feet flat on the ground in that position of receiving and boundary, I noticed then that I stopped breathing. That this was genuinely an example of how my body didn’t actually know how to do this.
This psychological emotional concept that I was bringing into a movement wasn’t easy. It was much easier to have both hands open in let me hold space for you position. And this balanced state was harder.
And so that was a very pragmatic experience for me just today of how the body really tells you how connected you are to what you say, what you think, and how you want to be in the world. My mind is going in so many different directions with what you’re talking about, of a starting point being on the ground and how activating that can be. It’s reminding me of in the play.
Why? As a clinician, if you are put in a hypoaroused position where, let’s say you were just pretend shot dead and you have to lie there, how vulnerable that is, or if you have to stay still in the playroom, like how vulnerable that is it’s also reminding me of why falling asleep can be such a big deal for so many. What a vulnerable place. And if we’re talking about those places being at the root of our sense of self, or our root, our ability to connect, how powerful of a place for us to spend time being curious in what happens for us.
So, Kim, practically speaking, is the invitation to spend time lying there and noticing what are some practical things? Well, when I think about what we were talking about, which is play, one of the things that play therapists and therapists need to do is play. And you can yourself, as a clinician, almost recapitulate is a word that comes to mind these experiences yourself. I never ask a kiddo to do something that I won’t do myself.
Right. So in occupational therapy, we often, in our play therapy context, use all kinds of very fun sensory environmental invitations, lycra swings and climbing structures and scooter boards, and we’re all about moving. And in those shifts in movement, it’s like I’m getting into the emotion through the movement systems instead of sometimes coming into the emotion through the play.
And then the movement system goes sideways, perhaps, and does something that you don’t expect. It’s deliberately thinking, well, what movement do I want to offer? And so for therapists, it’s like put it into context for yourself. If lying there on the ground, which I don’t think I do ever, but rolling, or when I’m with kids and I’m rolling through the tube, or if we dive into the ball pit, those movements, they are invitations to consciousness right there.
Yeah. I remember years ago, I wanted to explore my own experience of crawling. And I remember just crawling around my home and feeling confused in my body about it, noticing how some of my movements were not very in sync, and noticing what worked and what didn’t work, just as a curiosity for me of my own connection with my body.
I know we’re talking about offering or us embodying some of the things we have kids do in the playroom, but I’m even thinking of other ones. Like for me, I love to submerge myself in water to go underwater in the bathtub so that I can heighten my sensory experience in my body and feel and hear. I know for some people that can be very overwhelming and very triggering.
And I know for me, it’s an invitation into really hearing my heartbeat in a way that I can’t typically hear it. So what I’m hearing you say, Kim, is try on movements. Try on movements consciously.
Yes. Try anything consciously. Yeah.
Try eating consciously, standing in the shower whole. And you can approximate it because, as you asked the question in the beginning, sometimes we don’t even know where to start. Right.
Go for a walk consciously. These are all slow and titrated, gentle, easing into one’s own sense of self. Yeah, I know.
One of the things that comes up when I teach and I have this conversation with my students is that sometimes there can be a fear of going into the body because there was a reason why we left the body in the first place. And I think it’s important just to name for anyone that’s listening, it’s a process, and it’s a process of honoring. And I don’t know if you’d agree with this or not, Kim, but my experience has been is it’s one of titration? It’s one of leaning in and noticing and then noticing.
Okay, that’s my window of tolerance. And then giving myself permission to move away and then leaning in and then moving away. For me, anyway, that’s been very much my dance.
Would you speak to that a little bit? Oh, I would love to. This concept of being disconnected from the body is never really completely, fully the case because then you would be dead. Right.
What a great point, Kim, I think, about some of the most incredible human suffering. There are still points in the continuum of living where that person is in their body. And when we talk about bringing people into consciousness, you are definitely in sync with my thinking about titration.
But it’s important to remember that the person is still in their vessel no matter what. And one of the things that is so tricky in our clinical work that I think occupational therapists have a bit of an advantage is the use of touch and how, even if I’m not going to touch a child or a person, that they can do that for themselves. And we come into our body sensorially from the top down, from the head to the feet.
The feet are last, really, because you stand up last in your trajectory of development as a small child. And so the head is where most of us live. And I mean that literally and figuratively.
We live in it in our mental capacity, but we also feel it easiest. And so if you’re going even to think about activities yeah, putting your hands on your head, putting a hat on your head, playing in games with kids where they put on hats, or if you just think about what can I offer that might both be part of my assessment or my titration of intervention? And I think this way it allows me to tune into how can I make this as easy for this child to be safely in this vessel as possible. I’m going to actually repeat what you just said, because that last sentence was really powerful.
So as play therapists, how can we help a child safely be in their vessel? And what a beautiful goal. Or? Yeah, I guess. Goal.
If we looked at that, what if that’s what we were up to? What if that was the big thing? How do we create an experience where they can safely be in their vessel? I would then add so they can integrate and move towards those things that have been so challenging. And that is, of course, the ultimate goal. Right.
But I think I don’t know what you think, but I think many of our clients learn to do that integration aspect somewhat conceptually, but not necessarily always in an embodied way. I completely agree. I think for me, that’s why that understanding of regulation is so important too.
Because I think that without an understanding that what we’re looking for is a relationship with our bodies and a relationship with ourselves and moments of connection, I think that there can be an urge to bypass that and to try to present behaviorally a particular way which to me skips where the power is or where the juice is. I don’t know where the magic is. Yeah.
And I think that’s true of us as well, right? As us, as clinicians. It’s the same deal, is that it is in that action that I described this morning about my hands, I could have got that conceptually long time ago, but I felt it. And in the feeling of it, it will be more accessible to my memory in my body and will have a greater potential to alter my behavior, my actions, and my interactions with people.
Such a great plug for embodied therapy and embodied work. It gets stored in a completely different way. Kim, I have another question for you.
It goes back to our understanding of activation in the body. And I just want to hear your opinion about this, because there’s so many different opinions about it right now in the field, and I’m referring to the freeze response. So I was aware that when you first said sympathetic and parasympathetic that you said collapse as parasympathetic.
And there is there seems to be a lot of discussion right now about where does this freeze response live? What is it? Is it sympathetic? Is it parasympathetic? Is it both? Would you speak to that as an OT? I can try. And I don’t know if I’m speaking to it as an OT or as in the world according to Kim. Okay.
With a neuroscience skew on it. First of all, let me say that I do not see these states as a stepladder or as boxes, that I think that we have combinations of all of these networks. And by the way, arousal is more than just the autonomic nervous system.
So this is only one view of states of engagement. The autonomic lens is to me one view. But when I look at a magnifying glass of that one part of us, it’s not cut and dry.
So, for example, I can be in dorsal vagal. I just did a chuck chuck. And we’re on a podcast.
That doesn’t help the dorsal vagal. Quotation marks. Quotation marks, right.
So the dorsal vagal state often brings to mind a picture for folks of a frozen way of being. But I can be in a dorsal vagal yummy state, snuggled up on the couch with my favorite people and my dog. And there’s aspects of dorsal combined with beautiful integrated ventral, right? It’s not black and white in that way.
I also, when I’m playing am in a ventral vagal, socially engaged state. You listen to the excitement in my voice and there’s some sympathetic juice in there, right? That adds to the mix that goes up and down in variation. So these states are fluid and not hierarchical in nature and very contextual and very variable from one individual to another.
What do you think about what I just said about that? I would even add even moment to moment. Yeah, I know. In my own nervous system, 1 minute I can experience a more dorsal quality and 2 minutes later I can feel a surge of sympathetic and then maybe the next moment it’s really dorsal and ventral has gone missing.
And to me it’s all over. And sometimes it even feels like there’s two. Sometimes if I’m really attuned to myself, I get a sense that there’s a bit of sympathetic and a bit of dorsal even going on that I can have both happening concurrently, which a lot of people don’t talk about, that it’s not a one or the other.
Well, I know that in this conversation right now, I’m in ventral and sympathetic arousal with a lot of excitement. And I think when you talk about freeze, to me that part of that is hard to reconcile. And the analogy that I like to give for people to feel is it’s kind of like being stuck in your driveway in your car with 1ft on the gas revving at full throttle and the other foot on the brake so that your energy is so high and you’re completely immobilized.
And this to me is like a dial on the speedometer where you’re moving into states of arousal that become increasingly fragmented. And I really want to give adrenaline the credit for that because I think it also comes in the United States, you often call it norepinephrine, but that really high level of adrenaline. Its purpose is to save your life.
Its purpose is not to muse and reflect and consider, and it has a very predominant intention to it. So I don’t think this is a one thing. What do you think? Well, I agree.
I was going to say and so that clears it up. Play therapists. Don’t we think that there’s a play therapist? We all want that one answer, right? And I agree with you, Kim.
Play therapists, it’s complex. The brain is complex. The body’s complex.
Things don’t exist in a 12345 kind of fashion. To me, things are more swirly. We’re more swirly.
We’re more cyclical. We’re more things happening concurrently. There’s so much and our left brain doesn’t like that.
No. And I think the wonder of that complexity is what makes the human so adaptable, right? And why I’m just in the middle of writing this paper on post traumatic growth and why some people experience some of the most horrific things and emerge in a place of renewed sense of being beyond where they began. To me, this all ties back to where we started the conversation of I think the more that we can learn about the different variations of what this can look like and we can feel it in our own bodies.
And we can recognize it in our own systems. And we can begin to recognize what it looks like in other people and in our clients. To me, it’s just a whole other level of insight that helps us help each other, that helps us do relationship at a different level, helps us connect with each other at deeper degrees because we’re able to attune more accurately and more effectively.
So to me, play therapist, this is like a huge shout out plug for study the body, study the nervous system, spend time in your body. I don’t know if you want to add to that, Kim. I actually think that’s a beautiful place to pause and take it in, agree fully, and thanks for that.
Well, how about I invite all of us to take a breath? Well, Kim, this has just been extraordinary. I am again so incredibly grateful that you joined me for this conversation. I personally look forward to many more conversations with you, so many more things I’d love to pick your brain on and ask you about.
And my guess is that there are many listeners that would like to learn more about you as well. You have courses? You teach classes as I already shared. You can binge tube her YouTube videos or binge watch her YouTube videos if you’d like.
Would you share with everyone what your website is? And I know that there’s a particular course that might be helpful to play therapists if you want to share that as oh, thanks, Lisa. So our website is Kimbarthel CA, and the name of our company is Relationship Matters. And the course that I think might really sit with people in a place of assistance is called Trauma Sensitive Practice.
And it really. Brings together in its series. It’s a seven part series multiple facets of neurobiology.
Neurobiology is what I love to think about the most. Neurobiology attachment regulation, self regulation, co regulation. And there are many Lisa Dion quotes within.
Oh, Kim, thank you. And they can find that on your website as well. Yes, they can.
That is wonderful. Okay, listeners, thank you for again joining both Kim and I for this conversation. Wherever you are in the world, take care of yourselves.
Gentleness towards yourself and your own processes as we were sharing. You are wise, you are brilliant. Who you are in the world is meaningful.
It’s purposeful. There’s perfection to who you are, to what you do, to your behaviors and a real deep invitation into your body to discover that more deeply for yourself. So you are the most important toy in that playroom.
Be well and I can’t wait for our next time together.
