A G O’Malley
Background: This article describes an integrated form of dynamic psychotherapy, BART, which has components of both top-down reprocessing from EMDR and trauma-focused CBT combined with bottom-up approaches such as somatic experiencing and sensorimotor psychotherapy. The unique components of BART are described, with particular emphasis on the interaction between gut instinct, heartfelt sensation and head thoughts. BART is described in terms of what the individual letters stand for. Information processing at the levels of the gut, the heart and the brain are illustrated anatomically with diagrams of the heart-brain and the gut-brain with the brainstem. The anatomical structure of the gut mesentery is discussed along with the implications for information reprocessing in BART psychotherapy. The path of the vagus nerve is illustrated along with the endocrine system. BART psychotherapists can use knowledge of these structures to lessen the impact of trauma on physical and mental ill health. Compositions of neuroreceptors in the heart-brain or cardiac neural plexus are described. The role of the gastrointestinal tract in processing food and how it deals with emotional reactions are discussed. A link to the insular cortex in each cerebral hemisphere or head-brain is hypothesised as the mechanism of communication between the gut and brain. The influence of the heart’s magnetic field is discussed in relation to BART.
Results: A case example of a 17-year-old girl who has experienced physical and psychological abuse is described. Over three sessions and six hours of BART psychotherapy her symptoms of moderate PTSD are reduced from scores of 53/88 to a normal 21/88 on the revised impact of events scale.
Conclusion: Areas for future development of the theory and practice of BART psychotherapy are discussed.
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