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New Therapist
Indispensable survival guide for the thinking psychotherapist		   September/October 2012




                            The Body Edition




                                                                                   81
Features                     EDITOR
                                  John Söderlund

                                  MANAGING EDITORS
                                  Lee-ann Domoney
                                  Sue Spencer

6    Body of Evidence:
     The head-to-toe              CONTRIBUTING EDITORS
                                  Dylan Evans
     history of body use in       Graham Lindegger
                                  Jacqui de Mare
     psychotherapy                Julie Manegold
                                  Tim Barry
                                  Tom Strong
                                  Kelly Quayle
                                  Robert Langs
                                  Simone Descoins
14   Every body needs some
     body
                                  Robert Waska

                                  CONTRIBUTIONS
                                  Submissions for inclusion in New Therapist are welcomed.
     Jack Lee Rosenburg, Lisa     New Therapist reserves the right to edit or exclude any
                                  submission. Names and identifying information of all
     Loustaunau and Frederic      individuals mentioned in case material have been changed to
     Lowen on body-based          protect their identities. The views expressed herein do not
                                  necessarily represent those of New Therapist, its publishers or
     psychotherapy                distributors.

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26   Minding the body:            www.NewTherapist.com.

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3
                                  published by New Therapist Trust every second month and
     Drug watch                   distributed to psychotherapists around the world.

                                  Copyright © New Therapist 2012. All rights reserved. No part
4    Research                     of this publication may be reproduced or disseminated by any
                                  means whatsoever without the prior permission of the
                                  publishers.

32   From the therapist's chair   A publication of New Therapist Trust.
Drug watch

                                                               Creatine boosts effectiveness of
                                                               antidepressants for women


                                                               C
                                                                        linically depressed women appear to respond
                                                                        better to antidepressants when they are taken
                                                                        in conjunction with creatine, according to
                                                               researchers at the University of Utah. The findings
                                                               were published online in American Journal of
                                                               Psychiatry in July, 2012.
                                                                   The authors of the study note that creatine is a
                                                               naturally occurring amino acid typically associated
                                                               with providing fuel for intense bursts of energy
                                                               during high-intensity, short-duration exercises.
                                                                   The mechanism by which creatine works against
Negative suggestion can induce                                 depression is not precisely known, but the authors
symptoms of illness                                            of the study suggest that the pro-energetic effect of
                                                               creatine supplementation, including the making of


U
         ndesired effects of drugs can sometimes               more phosphocreatine, may contribute to the earlier
         be attributed to nocebo effects, according            and greater response to antidepressants.
         to researchers at the Technical University                The eight-week study comprised 52 South Korean
of Munich. The findings appeared in the journal                women with major depressive disorder between
Deutsches Ärzteblatt International in July, 2012.              the ages of 19 and 65. All the women took the
    Nocebo effects are the adverse events that occur           antidepressant Lexapro (escitalopram) during the
during sham treatment and/or as a result of negative           trial.
expectations.                                                      Twenty-five of the women received creatine with
    Nocebo responses can, for instance, be brought             the Lexapro and 27 were given a placebo. Neither
about by unintended negative suggestion on the                 the study participants nor the researchers knew who
part of doctors or nurses, e.g., when informing                received creatine or placebo.
the patient about the possible complications of a                  The study showed that depressed participants who
proposed treatment.                                            augmented their daily antidepressant with 5 grams
    The mechanisms behind this phenomenon                      of creatine responded twice as fast and experienced
are—as with placebo effects—learning by Pavlovian              remission of the illness at twice the rate of women
conditioning and reaction to induced expectations.             who took the antidepressant alone. There were
While the positive counterpart—the placebo                     no significant adverse side effects associated with
effect—has been intensively studied in recent years,           creatine.
the scientific literature contains few studies on                  The researchers hold that their findings are
nocebo phenomena, the researchers note.                        significant because antidepressants typically don’t
    The researchers say that the consequences                  start to work until four to six weeks. They also note
for clinical practice are that doctors may find                that creatine under a doctor’s supervision could
themselves in an ethical dilemma between their                 provide a relatively inexpensive way for women who
obligation to tell the patient about the possible side         haven’t responded well to SSRI (selective serotonin
effects of a treatment and their duty to minimize              reuptake inhibitor) antidepressants to improve their
the risk of a medical intervention and thus to avoid           treatment outcomes.
triggering nocebo effects.                                         “If we can get people to feel better more quickly,
    One possible strategy to solve this dilemma,               they’re more likely to stay with treatment and,
suggested by the authors, is to emphasize the                  ultimately, have better outcomes,” said senior author
tolerability of therapeutic measures. Another                  of the study Perry F. Renshaw.
option, with the patient's permission, would be to                 The researchers say that future research efforts
desist from discussing undesired effects during the            will test creatine supplements in men and women as
patient briefing.                                              well as individuals of different nationalities.




                              Indispensable survival guide for the thinking psychotherapist                         3
Research




Believing in a mind-body connection                          Sleep deprivation linked to hunger
linked to better health                                      and weight gain


T                                                            S
         he more individuals perceive their minds and               leep habits affect body weight by influencing
         bodies to be distinct entities, the less likely            an individual’s caloric intake and energy
         they will be to engage in behaviors that protect           expenditure, according to researchers at the
their bodies, according to researchers at the University     Society for the Study of Ingestive Behaviour. The
of Cologne, Germany. The findings appeared in                findings appeared in PsychCentral in July, 2012.
Psychological Science, a journal of the Association for          The authors of the study observed the effect of
Psychological Science in July, 2012.                         short-term sleep deprivation on hunger as well as on
   The researchers note that many people are                 physical activity and energy used by the body.
philosophical dualists—believing that the brain and              The researchers monitored the physical
the mind are two separate entities. Their findings           activity of participants by attaching acceleration
showed that people primed with dualist beliefs had           detection devices to each of their wrists. They also
more reckless attitudes toward health and exercise,          monitored participants’ energy levels using indirect
and also preferred (and ate) a less healthy diet than        calorimetry—a method that estimates how much heat
those who were primed with physicalist beliefs.              is produced by a person as they use oxygen.
   Furthermore, they found that the relationship                 The researchers found that participants who slept
also worked in the other direction. People who were          less had higher traces Ghrelin (or what they term the
primed with unhealthy behaviors—such as pictures of          “hunger hormone) in their blood. Those who slept for
unhealthy food—reported a stronger dualistic belief          shorter periods also moved around less.
than participants who were primed with healthy                   Results also showed that after staying awake for
behaviors.                                                   one complete night, the amount of energy used by the
   Specifically, these findings suggest that dualistic       body when resting was significantly reduced among
beliefs decrease the likelihood of engaging in healthy       participants.
behavior.                                                        The researchers say that their findings suggest
   Evidence of a bidirectional relationship further          that when individuals are sleep-deprived they are
suggests that metaphysical beliefs, such as beliefs in       likely to eat more calories because they are hungrier.
mind-body dualism, may serve as cognitive tools for          This alone might cause them to gain weight over
coping with threatening or harmful situations.               time. Sleep loss also means we burn off fewer
   The researchers say that the fact that the simple         calories, which adds to the risk of gaining weight and
priming procedures used in their studies had an              developing type-II diabetes.
immediate impact on health-related attitudes                     The researchers conclude by saying that although
and behavior suggests that these procedures may              much is still to be learned about the correct sleep dose
eventually have profound implications for real-life          for obesity and diabetes, the available research results
problems. Interventions that reduce dualistic beliefs        clearly supports the notion that sleep is involved
through priming could be one way to help promote             in the balance between the amount of calories we
healthier—or less self-damaging—behaviors in at-risk         eat and the amount we use up through activity and
populations.                                                 metabolism.


4                          		                New Therapist September/October 2012
Research

Fathers’ rejection can have particularly                       Snacking linked to brain activity and
adverse effects on children                                    self-control


A                                                              F
         study by researchers at the University of                     ood consumption and BMI (Body Mass Index)
         Connecticut shows that while mothers have                     are linked to both brain activity and self-control,
         unique social and emotional bonds with their                  according to researchers at the Universities of
children, a father’s love contributes as much—if not           Exeter, Cardiff, Bristol, and Bangor. The study appeared
more—to a child’s development. The findings appeared           in the journal NeuroImage in July, 2012.
in the journal Personality and Social Psychology Review in         The authors of the study found that individuals’ brain
June, 2012.                                                    'reward centre' responses to pictures of food predicted
    The researchers analysed the power of parental             how much they subsequently ate. This had a greater
rejection and acceptance in shaping our personalities as       effect on the amount they ate than their conscious
children and into adulthood.                                   feelings of hunger or how much they wanted the food.
    In a review of 36 international studies that involved          A strong brain response was also associated with
more than 10,000 participants, the researchers                 increased weight (BMI), but only in individuals
discovered that parental rejection causes children to feel     reporting low levels of self-control. For those reporting
more anxious and insecure, as well as more hostile and         high levels of self-control a stronger brain response to
aggressive toward others.                                      food was related to a lower BMI.
    “Children and adults everywhere—regardless                     The researchers note that their study adds to
of differences in race, culture, and gender—tend to            mounting evidence that overeating and increased weight
respond in exactly the same way when they perceived            are linked, in part, to a region of the brain associated
themselves to be rejected by their caregivers and other        with motivation and reward, called the nucleus
attachment figures,” said co-author of the study Ronald        accumbens.
Rohner.                                                            Responses in this brain region have been shown
    The authors of the study found that the pain of            to predict weight gain in healthy weight and obese
rejection—especially when it occurs over a long period         individuals. The current study adds to this by showing
of time in childhood—tends to linger into adulthood,           that this is independent of conscious feelings of hunger,
making it more difficult for adults who were rejected as       and that self-control also plays a key role.
children to form secure and trusting relationships with            The study comprised 25 young healthy females with
their intimate partners.                                       BMI’s ranging from 17-30. The researchers elected to
    Rohner notes that prior studies have shown that the        observe female participants as they typically exhibit
same parts of the brain are activated when people feel         stronger responses to food-related cues than men. This
rejected as are activated when they experience physical        is due to hormonal changes during the menstrual cycle.
pain.                                                          All participants were taking the monophasic combined
    “Unlike physical pain, however, people can                 oral contraceptive pill.
psychologically relive the emotional pain of rejection             Participants had not eaten for at least six hours. They
over and over for years,” Rohner said.                         were given a bowl containing 150 g of potato chips to eat
    The results showed that while children and adults          at the end of the study.
often experience more or less the same level of                    The researchers used MRI scanning to detect the
acceptance or rejection from each parent, the influence        participants' brain activity while they were shown
of one parent’s rejection—often the father’s—can be            images of household objects, and food that varied
much greater than the other’s.                                 in desirability and calorific content. After scanning,
    Researchers at the International Father Acceptance         participants rated the food images for desirability and
Rejection Project explain that children and young              rated their levels of hunger and food craving.
adults are likely to pay more attention to whichever               Lead author of the study Natalia Lawrence of the
parent they perceive to have higher interpersonal power        University of Exeter says, "Our research suggests why
or prestige.                                                   some individuals are more likely to overeat and put
    So if a child perceives her father as having higher        on weight than others when confronted with frequent
prestige, he may be more influential in her life than the      images of snacks and treats. Food images, such as those
child’s mother.                                                used in advertising, cause direct increases in activity
    Rohner notes that fatherly love is critical to a           in brain 'reward areas' in some individuals but not in
person’s development. The importance of a father’s             others. If those sensitive individuals also struggle with
love should help motivate many men to become more              self-control, which may be partly innate, they are more
involved in nurturing child care.                              likely to be overweight."



                                Indispensable survival guide for the thinking psychotherapist                           5
Features            Body of evidence




    Body of Evidence: An overview
     of body use in psychotherapy

                                         By Kelly Quayle



     M   uch as Descartes might have
         theorised that the mind and
         body are separate entities in his
         famous Cartesian dualism, it has
         long been understood that mind
                                             non for any interpretation offered
                                             by psychologists of the state of
                                             their clients. But many schools of
                                             thought in the psychology field have
                                             long considered the central role of
         and body are not neatly distinct    the body in not only expressing
         from one another. To a large        mental trauma or imbalance, but
         extent, the focus of traditional    also as a tool for therapeutic change
         psychotherapy is in working with    and for tracking the progress of
         one’s thoughts and beliefs. The     clients. This overview will cover the
         old adage of psychotherapy as the   work of some leading writers and
         ‘talking cure’ priveleges verbal    psychotherapists in this evolving
         communication to the sine qua       area of psychotherapy.

6   		       New Therapist September/October 2012
Features              Body of evidence

Understanding the body in mental                                  Clarifying ‘body in psychotherapy’
illness: From hysteria to conversion                              versus other disciplines
disorders                                                         Although, by definition, most psychotherapeutic
Hysteria is an obsolete medical term that is still                approaches involving the body have a holistic
used colloquially to refer to a state of extreme fear or          understanding and work towards some form of
emotion and the resultant irrational behaviour. The               body/mind integration, there are considerable
term was originally employed to describe women who                differences in terms of technique, therapeutic
acted irrationally due to a supposed disturbance of the           stance and the role of the therapeutic
uterus, and dates back as far back as Hippocrates.                relationship in the process. It is important to
    The notion of hysteria was revived through                    distinguish the various forms of body therapy
the influence of Freud’s theories about hysterical                from psychotherapy that integrates body
conversions, which no doubt influenced the current                work into its understanding and treatment
thinking, namely that people may have physical                    techniques. Body healers may, for instance, use
manifestations of psychological distress as an                    some form of massage or physical exercises,
unconscious way of repressing, expressing and coping              work simply to improve physical well-being and
with it.                                                          see inner balance and psychological benefits
    In modern psychological thought the term hysteria             as indirect results. Other approaches, such as
is no longer considered a diagnostic category, although           martial arts or cranio-sacral therapy, go further
physical manifestations of psychological conditions               and aim to involve the client more pro-actively
can be diagnosed as somatoform and dissociative                   in increasing inner awareness and healing the
disorders. A somatoform disorder is characterised by              body-mind split.
physical symptoms that have no identifiable physical                  But psychotherapy with a ‘body’ focus
causes. These symptoms usually mimic real diseases or             is distinct from the above in that it always
injuries. Such disorders include conversion disorder,             works from and within the client’s subjective
body dysmorphic disorder and somatization disorder.               reality, which includes an awareness of the
Dissociative disorders are psychological disorders                different levels of body, emotion and mind
that involve dissociation or interruption in aspects              that shape this reality. The understanding and
of consciousness, including identity and memory.                  use of the body in psychotherapy probably
These types of disorders include dissociative fugue,              stands in most stark contrast to other body
dissociative identity disorder and dissociative amnesia.          therapies in its conception of the therapeutic
    Routinely, the body is considered when diagnosing             relationship. Although a holistic model of the
mental imbalance and psychologists are trained to                 client is common to all approaches involving
assess a client’s vegetative functioning, take into               the body, most non-psychotherapeutic body
account their general physical functioning and observe            therapies tend to rely on a quasi-medical ‘expert’
non-verbal behaviours. But many psychotherapists and              relationship between patient and healer. Within
branches of psychotherapy are attempting to recognise             the psychotherapeutic realm, no one specific
the body not simply as a diagnostic agent, but as a               technique is considered therapeutic in itself,
living source of intelligence, information and change.            but only as an integral part of a therapeutic
                                                                  relationship.



Conceptualising the body in psychotherapy on a continuum
The therapeutic approaches that incorporate the body in psychotherapy may be depicted along a continuum. On
the one end, predominantly verbal therapies pay little or no attention to the body. On this extreme, the spoken
word dominates the therapeutic interaction and in the verbal interventions, there is little or no reference to body
aspects. However, even on this end of the continuum, nonverbal interactions have an important and unavoidable
impact on practice. Therapists and client are never just ‘talking’, they are always bodies interacting. Further
along the continuum, there are therapies that display increasing body-orientedness. There may still be a focus on
verbal interventions, but the body is recognised as an explicit source of information. And moving further along
the continuum, there are approaches that are sometimes called “body therapy”. Major methods here are working
with movement, nonverbal expressions and direct touch. These are the focus of this overview.


                             Indispensable survival guide for the thinking psychotherapist                             7
Features            Body of evidence


    History of the body in psychotherapy: From the 1900’s to the present
    A brief, incomplete history of the body therapies is       captures both the defensive and self-protective
    depicted below, followed by a fuller description of        aspects of ‘repression’ which have long been a
    some of the theorists that have contributed to the         cornerstone of analytic theory. Reich called his
    developments in this field.                                way of working with the body ‘vegetotherapy’,
                                                               which he considered ‘character-analysis in the
    zz Freud, early 1900’s: The grandfather of modern          realm of the body’. For Reich, the therapeutic
       psychotherapy was clear that the ego is first and       process is liable to remain bound by the linear
       foremost a ‘body-ego’ (certainly a statement            world of mental understanding and insight unless
       integrating body and mind) and, for a while,            the underlying ‘body armour’ is addressed—the
       assumed that some day psychoanalysis would be           body is just as effective and necessary an arena
       grounded in physiology and biology. His early           for change as is the mind.
       conceptualisation of libido within a framework
       of homeostasis is much more aligned with             zz Neo-reichian theories, originating from Reich’s
       biology and physics than with psychology, and           work, which focus on somatic healing and
       there was a strong subversive impetus to liberate       consider the mind-body interrelations and
       the body’s energies. From early on, Freud used a        connectivity in order to heal the whole person.
       wide variety of techniques, including massage.          Various techniques are utilized, including
       Later in his professional life he veered more           breath, physical touch and movement. Known
       towards seeing the body as representing the             generically as ‘body psychotherapy’, contributors
       dangerously dominant force of the instincts             to this line of work include Georg Groddeck and
       which had to be kept in check by an increasingly        Sandor Ferenczi, whilst Alfred Adler and C.J.
       conscious mind.                                         Jung and others contributed to its development
                                                               through their concern with the distribution
    zz Reich, from 1920: Reich was probably the                of psychic energy within the body and the
       first psychoanalyst to give significant impetus         relationship between body and mind. Specific
       to Freud’s early ideas about the body and               therapies that emerged from within these
       libido. He eventually became the pioneer of a           developments include (cited in Eiden, 1999):
       school of thought known generically as body             {{ Bioenergetic Analysis developed by Alexander
       psychotherapy, although he began with an                    Lowen, who emphasised the importance of
       approach he labelled ‘vegetotherapy’. Reich                 ‘grounding’—being in strong contact with the
       recognised that all neurotic symptoms also have             ground through feet and legs.
       a physiological and physical aspect and that            {{ Core energetics: Developed by John Pierrakos.
       the body is closely linked to the psychological             It emphasised the bridge between psychology
       process. His central understanding was that                 and spirituality.
       body and mind interact dynamically with,
       and mirror, each other. If the mind forms a             {{ 	 iodynamic psychology: Developed by Gerda
                                                                   B
       conclusion, the body has a reaction. Tension                Boyesen. She theorized that the dismantling
       in physical form is connected to a mental state             of psychological stress is also connected with
       and releasing it has a freeing effect on the mind.          the digestive system.
              Reich’s concept of ‘character armour’—           {{ 	 e Chiron approach was founded by Bernd
                                                                   Th
                    habitual and chronic fixed relational          Eiden and Jochen Lude in the early 1980s and
                                              positions—           emphasises an integral-relational approach to
                                                                   therapeutic healing.




8                         		
                          		                 New Therapist September/October 2012
                                             New Therapist September/October 2012
Features              Body of evidence

Other body-therapies:
zz Rolfing: Developed by Ida Rolf in the 1930’s. It is a mode of treatment which physically manipulates the
   body, creating a postural release which aims to loosen up and realign the body. It aims to release past
   trauma and built-up stress as a way of enhancing mind-body health.

zz Primal therapy: Developed by Arthur Janov in the 1970’s and based on the thinking that neurosis is caused
   by the repressed pain of childhood trauma, primal therapy is used to re-experience childhood pain as an
   attempt to resolve these feelings.




    Some more current mind-body psychotherapies:
  zz Pat Ogden’s sensorimotor approach to                    on traditional psychotherapeutic understandings,
     psychotherapy: For many years, the realm of             but includes the body as central in the therapeutic
     implicit nonverbal communications and bodily-           field of awareness and employs a set of
     based affective states was largely ignored by           observational skills, theories, and interventions not
     mainstream psychoanalysis. The result was a             usually practiced in psychodynamic psychotherapy.
     traditionally strong bias in favour of explicit,            Ogden argues that therapy is the context in
     verbal, cognitive mechanisms (Schore, 1994).            which we work with the wisdom of the body in an
         However, advances in our understanding              attempt to integrate sensations, images, feelings
     of the psychology and biology of bodily-based           and thoughts that constitute ongoing experience.
     emotional states and neuropsychoanalytic                The experience of trauma is recognised as being
     concepts that bypass the Cartesian error,               significantly body-based. Sensorimotor approaches
     along with the developmental psychoanalytic             recognises and use this to allow the therapist to
     discoveries of how affect regulating attachment         open up the client’s non-verbal world and make it
     experiences positively and negatively impact            available for integration and processing. By being
     evolving structure, are being incorporated              aware of how a client stands, sits, walks, talks
     into more complex clinical models of the                or gestures, the therapist can hypothesise about
     psychopathegenesis and treatment of brain/              these bodily gestures and client and therapist
     mind/body disorders.                                    can learn what these might be communicating.
         Until recently, body psychotherapy                  The therapist also attends to the way in which
     progressed independently, and somewhat                  bodily organisation reflects competence and well-
     apart from, contemporary psychoanalysis.                being. Techniques may include the inculcation of
     This field has focussed more intensely on the           deep and regular breathing, relaxation, physical
     somatic expressions of psychobiological trauma,         flexibility and physical alignment.
     especially trauma and affect dysregulation that             The sensorimotor therapist is concerned
     occur in the histories of severe self pathologies.      with “top-down” management skills, such as
     But the body psychotherapists appear                    clarifying meaning, formulating a new narrative,
     increasingly to be adopting an interdisciplinary        and working with emotional experience, as well
     perspective (Schore 2002).                              as with “bottom-up” interventions that address
         Pat Ogden and her colleagues are a                  the repetitive, unbidden, physical sensations,
     prominent source of neurobiologically,                  movement inhibitions, and somatosensory
     psychodynamically, and developmentally                  intrusions of unresolved trauma (Ogden, Pain
     informed clinical models in the expanding               & Fisher, 2006). Such an integrative approach
     world of somatically-focussed psychotherapy.            attempts to help clients experience a reorganised
     Dubbed the sensorimotor approach, it builds             sense of self.




                             Indispensable survival guide for the thinking psychotherapist                           9
Features           Body of evidence

 zz Mindfulness-based psychotherapies, eg.           zz Post-modern contributions (Tom Andersen and Jaakko
    the Hakomi Method: In the last decade               Seikkula):The late Tom Andersen, a well-respected
    mindfulness has become increasingly                 Norwegian therapist who co-developed a form of
    popular within many branches                        therapy known as ‘collaborative therapy’ and Jaakko
    of psychotherapy, based on the                      Seikkula, a renowned Finnish psychotherapist and
    growing recognition that the ancient                academic who borrowed from this approach and
    mindfulness teachings can reduce stress                        successfully developed social network based
    and contribute to the healing process                          practices in psychiatry, brought about an
    for a wide-range of difficulties (Kabat-                        increasing recognition of the dialogical and
    Zinn, 2005). Within mindfulness,                                ‘embodied’ nature of therapy.
    the somatic realm is not only deeply                           Andersen observed the work of
    tied into all our emotional and                               physiotherapists who worked intuitively with
    mental processes, but it reflects them                       a person’s body to effect change and he drew
    precisely, allowing the uncovering of                        forth many observations to apply to his therapy
    fundamental issues and memories that                         with clients. He stated that therapy must be
    give rise to them (Marlock & Weiss,                          like a ‘pain producing hand’ in the sense that
    2006, in Weiss, 2009)). Mindfulness                          a therapist’s words must be unusual enough to
    encourages ways of becoming more                             incite change in the client. He also observed
    ‘aware’ or more conscious of bodily                          that a good therapist is guided by his or her
    processes. Patients are usually                              client’s signs, which are often very subtle
    encouraged to sense, feel and observe                        ones, and from this his ‘slow’ way of working
    their bodies at great length.                                evolved. Tom Anderson’s approach to therapy
    Body psychotherapist Ron Kurtz                               highlighted the importance of a responsive and
    pioneered the integration of                                 embodied contact with an others expressions
    mindfulness into psychodynamic                                and following these moving’ expressions
    therapy in the 1970’s. In his approach,                        wherever they might lead (Shotter, 2007).
    The Hakomi Method, the therapist                               Jaako Seikkula developed Open Dialogue,
    constantly monitors and helps to                                a group therapy method in which ‘team
    regulate the state of consciousness                              members’ bring new words that offer an
    of the client. In the course of                                  alternative language to those of symptoms
    a successful Hakomi process,                                     and problem behaviours. Network members
    there is an expanding sense of                                   are encouraged to sustain intense painful
    mindfulness and the core of the                                 emotions of sadness, helplessness, and
    process usually takes place in                                 hopelessness as a multi-voiced picture of
    this state. As an experiential                                the event evolves. A dialogical process is a
    process, the therapist is                                     necessary condition for making this possible.
    radically nondirective in                                   To support diaological process, team members
    order not to interfere with                               attend to how feelings are expressed by the many
    mindfulness. This shifts                                 voices of the body: tears in the eye, constriction
    the focus of the therapist                              in the throat, changes in posture, and facial
    from a ‘thinking’                                      expression. Team members are sensitive to how the
    to an ‘observing’                                      body may be so emotionally strained while speaking
    mode. When                                             of extremely difficult issues as to inhibit speaking
    completely in tune                                    further, and they respond compassionately to draw
    with mindfulness, the                                 forth words at such moments. “The experiences that
    therapist will manifest a                             had been stored in the body’s memory as symptoms
    state of being that Kurtz calls                       are “vaporised” into words” (Seikkula & Trimble,
    ‘a loving presence’ (Martin,                          2005, p. 468). In this approach, dialogue is not just a
    2007). The mindful approach                           form of communication, but a way of engaging with
    requires a fundamental shift in                       others in a way that forms minds. ‘Mind’ is not seen
    attitude that is hard to fathom for                  as an independent element of human psychological
    those schooled in traditional ways of               structure, but an ongoing process from one second to
    Western psychotherapy (Weiss 2007).                 another between living (embodied) persons.



10                       		
                          		               New Therapist September/October 2012 2012
                                                New Therapist September/October
Features             Body of evidence

Towards an integration: Drawing from the                                        The body perceived from
concepts and practices of ‘body’ psychotherapies                                outside

It is clear that body psychotherapies do not emanate from a                     A person’s facial expressions, body
common theoretical base. Support for body work is found                         postures, gestures, breathing, even
in different theoretical models: psychodynamic theories,                        voice quality, sighing and laughing,
including Reichian and non-Reichian theories, humanistic and                    are commonly used by the
existential psychology, transpersonal psychology, and behaviour                 therapist to aid insight. People also
therapy. Despite the number of specific models and therapies                    have a natural tendency towards
that incorporate the body into psychotherapy, Leijjsen (2006)                   mimicking the posture, gestures,
suggests that a psychotherapist wanting to validate the body in                 facial expressions of the people
psychotherapy can work with one or a combination of these aspects               they are looking at, referred to as
of the body, which might include the body perceived from outside,               empathic attunement. Research
the body in action in movement and other nonverbal expressions,                 shows that mirroring of bodily
and the body in physical contact with another body, usually by                  positions and an unconscious
touch. These are outlined below, with practical illustrations of how            synchronisation of actions between
these techniques might be used in the therapy context.                          people helps to develop and
                                                                                maintain rapport and relatedness
                                                                                (Cooper, 2001 in Leijssen, 2006).
                                                                                    The nonverbal communication
The body sensed from inside                                                     may complement the client’s
                                                                                narrative or even reveal something
The body as sensed from inside, the experiencing body, relies on
                                                                                different from the spoken
the premises that what is most essential can be experienced in the
                                                                                narrative of which client may
body. This is a visceral process, rooted in emotional experience,
                                                                                not be conscious. An awareness
with cognitive activity as secondary. The inclusion of the simple
                                                                                and reflection on the non-verbal
invitation to pay attention to the body as sensed from inside can
                                                                                communication of the client can
enhance each method of therapy without changing it very much
                                                                                bring greater awareness and insight
(Gendlin, 2003 in Leijjsen, 2006). The therapist may ask: “Wait
                                                                                to the issue being discussed. For
a moment, can you check inside, in your body, what you are
                                                                                instance, a client may verbally
feeling there?” If this bodily source is not too alien for the client,
                                                                                express that they are no longer
the symbols arrived at from that place will deepen the therapy by
                                                                                affected by an experience from
accessing the emotional material on more than just the cognitive
                                                                                their past, but the therapist may
level.
                                                                                observe the client holding her
    In the interaction with the client, the therapist can also rely on
                                                                                hands across her abdomen and this
his or her body orienting sense, which some might call ‘somatic
                                                                                might cue the therapist to note
countertransference’. In their research on therapists’ experiences
                                                                                that she is trying to protect herself
of empathy, Greenberh and Rushanskiu-Rosenberg (2002)
                                                                                from something that she is not
investigated therapists’ internal process while being empathic.
                                                                                verbally expressing.
Therapists reported often using their own bodily responses as tools
                                                                                    However, sometimes clients
to finding the most accurate connection with the client’s experience
                                                                                may be confused when the
and as feedback for the accuracy of the interaction. A therapist
                                                                                therapist draws attention to
might notice that they have a physical sensation mirroring the
                                                                                physical components of their
client’s experience. This might be felt as a shiver down the spine or
                                                                                communication or feel intruded
a feeling of excitement; or as a body resonance that recognises the
                                                                                upon and thus therapists would
pain of the client. The therapist can even verbalise their own bodily
                                                                                ideally move the client along such
experience with comments, such as “I notice that my heart beats
                                                                                observations or interpretations only
faster when you talk about that.”
                                                                                at a pace that does not disrupt the
    There are also many benefits to experiencing the body from
                                                                                therapeutic process, particularly
the inside, such as increased self-awareness, a capacity for less
                                                                                when dealing with the results of
impulsive or automatic behavioural responses to feelings and
                                                                                trauma (Rothschild, 2002).
delaying automatic behaviour, and the attendant calming, relaxing
and grounding effects that follow from these.


                             Indispensable survival guide for the thinking psychotherapist                         11
Features             Body of evidence

 The body perceived in action:                     The body in physical contact: Touch
 Movement
                                                   How touch is experienced is often subjective. The same
 In this step of validating the body,              sensory stimulus, like a tap on the shoulder, might be
 the therapist pays more explicit                  seen as an encouragement by one person and a reprimand
 attention to kinaesthetic, movement-              by another. Touch crosses a body border and there is,
 related experiences and also may also             inevitably, a correspondingly heightened sensitivity and
 experiment with guiding the client to             intimacy involved in the act of touch. For these reasons,
 new movements and body postures.                  it is hardly surprising that touch has been been considered
 The therapist might, for instance, ask            a controversial and usually undesirable practice in
 the client to exaggerate a movement               ethical codes that guide the practice of therapy. Where
 to increase its emotional salience and            it has been used in therapy, touch might extend from a
 to bring the client in contact with               handshake in almost exclusively verbal therapy to intensive
 something that is further away from               bodywork at the other end of the touch continuum.
 awareness. Or the therapist might                     While making physical contact with clients is indeed a
 introduce small steps of experiential             ‘touchy’ topic amongst therapists, a survey of members of
 learning and invite the client to                 the American Academy of Psychotherapists (Tirnauer et
 experiment with active behavioural                al, 1996 in Leijjsen, 2006), indicated that only 13% “never
 expression. For example, a client                 touch” their clients. Ethical fears of touch are typically
 reporting that he is “fed-up” with                centred around a fear that physical contact may lead to
 doing something and hunches his                   exploitative or sexual interactions. Therapeutically, there is
 shoulders as he says it might be invited          also a fear that touch may create transference issues and/
 to exaggerate the moment in his body              or retraumatisation when misuse of touch was part of the
 posture, or alternatively he might be             client’s original trauma. Leijssen (2006) suggests that
 encouraged to explore the opposite                acknowledging these concerns doesn’t imply that touch has
 body position.                                    to be problematic in therapy.
     The therapist may also modulate                   One way of framing touch in therapy is that, when
 body posture or movement that are                 used appropriately, it is a genuine expression of person-
 unusual for a client in order to help the         to-person relating, and a strategic means of providing
 client achieve a recognition of alternate         nurturance and support. Touch is clearly a more intrusive
 bodily experiences and explore new                technique, but Leijjsen (2006) argues that touch,
 possibilities. For instance, a dependent          used appropriately, can provide a physical holding or
 person who ‘holds on’ to others and               containment of the client in trouble. Take the example
 has difficulty standing on her own                of a trauma therapist, working with survivors of political
 legs might be encouraged to plant her             torture, who used kind and gentle touch to help them
 feet firmly on the ground. Movement               ‘come back into their bodies’ (Bingham Hull, 1997, p.6 in
 exercises and experiements can also               Leijjsen, 2006). Touch in these instances would appear to
 activate muscle functioning and                   assist the traumatised individual to move beyond a layer
 create bodily flexibility, creating the           of fear that ‘freezes’ their ability to benefit from other
 possibility of new awareness and new              interventions. As a guide, therapists are encouraged to ask
 experiences. However, Leijjsen (2006)             permission and state the intention behind touch before
 cautions against the pitfalls of working          making contact. Touch should also only be employed once
 with the body in action in the sense              the therapeutic relationship is well established and should
 that the therapist may take too much              always be congruent for the therapist and feel comfortable
 control, or see himself or herself as the         and appropriate to the client. Neither the therapist nor
 agent of change.                                  patient should experience the touch as a demand, nor as
                                                   an expression of intimacy beyond that felt on an emotional
                                                   level (Kertay & Reviere, 1993).




12                        		                 New Therapist September/October 2012
Features             Body of evidence
                                                                                 Women's Sexual Satisfaction. Baltimore:
                                                                                 The Johns Hopkins University Press.
                                                                                 ISBN 0-8018-6646-4.

                                                                                 Martin, D. (2007). Tracking and contact.
                                                                                 In H. Weiss, G. Johanson, & L. Monda
                                                                                 (Eds.), The Hakomi Method. Boulder,
                                                                                 CO: The Hakomi Institute.

                                                                                 McNeely, D.E. (1987). Touching. Body
                                                                                 therapy and depth psychology. Toronto:
                                                                                 Inner City Books.

                                                                                 Ogden, P., Pain, C. & Fisher, J.
                                                                                 (2006). A sensorimotor approach to the
                                                                                 treatment of trauma and dissociation.
                                                                                 Psychiatric Clinics of North America, 29:
                                                                                 263-279.

                                                                                 Rothschild, B. (2002). Body
                                                                                 psychotherapy without touch: applications
                                                                                 for trauma therapy. In T. Staunton (Ed.),
                                                                                 Body Psychotherapy (pp. 101-115). New
                                                                                 York: Brunner- Routledge.
The body in action:
                                     References
                                                                                 Seikkula, J (2008). Inner and outer
Nonverbal forms of self              Andersen, T. (1997) Researching client-     voices in the present moment of family
expression                           therapist relationships: a collaborative    and network therapy. Journal of Family
                                     study for informing therapy. Journal of     Therapy. 30: 478-491.
This way of validating               Systemic Therapies, 16(2), pp 125-133.
                                                                                 Seikkula, J. and Trimble, D. (2005).
the body is an extension             Eiden, B. 1999. The History of Body         Healing elements of therapeutic
of movements in more                 Psychotherapy—An Overview. This             conversation: Dialogue as an
nonverbal actions. The               article was written in January 1999         embodiment of love. Family Process. 44:
therapist may introduce              for 'Counselling news—the voice of          461-475.
expressive arts (dance,              counselling training'—a magazine
                                     published by CSCT.                          Schore, A.N. (2002). The right brain as
drawing, painting, sculpting,                                                    the neurobiological substratum of Freud's
music, sound) as an alternate        Greenberg, L.S., Rushanski-Rosenberg,       dynamic unconscious. In D. Scharff (Ed.),
path for exploration and             R. (2002). Therapist’s Experience           The psychoanalytic century: Freud’s legacy
communication. In the                of Empathy. In J.C. Watson, R.N.            for the future. (pp. 61- 88). New York:
                                     Goldman, & M.S. Warner (Eds.),              Other Press.
consulting rooms of Carl
                                     Client-Centered and Experiential
Jung for example, people             Psychotherapy in the 21st Century:          Shotter, J. (2007). Not to forget Tom
danced, sang, acted, mimed,          Advances in theory, research and practice   Andersen’s way of being Tom Anderson:
played musical instruments,          (pp. 168- 181). Ross-on Wye: PCCS           the importance of what ‘just happens’ to
painted, modelled with               Books.                                      us. Draft of paper delivered at The 12th
clay (McNeely, 1987, p.39).                                                      International Meeting on the Treatment of
                                     Kabat-Zinn, J. (2005). Coming to            Psychosis, Lithuania, September, 2007.
In this way of validating            our senses: Healing ourselves and the
the body, it is important            world through mindfulness. New York:        Weiss, J. (2009). The use of mindfulness
to remind the client that            Hyperion.                                   in psychodynamic and body oriented
performing visibly is not                                                        psychotherapy. Body, Movement and
                                     Kertay, L., & Reviere, S. L. (1993).        Dance in Psychotherapy, Vol. 4, No.
essential—these methods are
                                     The use of touch in psychotherapy:          1, April 2009, 5-16.
used to increase self-insight.       Theoretical and ethical considerations.
Nonverbal expressions can            Psychotherapy: Theory, Research, and
also replace or supplement           Practice, 30(1), 32-40.
words when talk fails to
produce results. What is
                                     Leijssen, M (2006). Validation of the       About the author
                                     Body in Psychotherapy. Journal of
creative is often therapeutic        Humanistic Psychology. 46, 2, 126-146.      Kelly Quayle is a psychologist in private
(Adzema, 1985; Kahn, 1985                                                        practice in Pietermaritzburg, South
in Leijssen, 2006).                  Maines, Rachel P. (1998). The Technology    Africa, and a contributing editor to New
                                     of Orgasm: "Hysteria", the Vibrator, and    Therapist.


                            Indispensable survival guide for the thinking psychotherapist                               13
Features        Every body needs some body




                                                    Every
                                                    body
                                                   needs
                                                    some
                                                    body
                          An interview featuring Jack
                                       Lee Rosenburg,
                                 Lisa Loustaunau and
                                       Frederic Lowen

14   		     New Therapist September/October 2012
Features        Every body needs some body

   “Everybody needs
   somebody to love”               Frederic Lowen
                                   Frederic Lowen, son of
  - Song by Bert Berns,            Alexander Lowen, M.D., is
   Solomon Burke and               Executive Director of The
                                   Alexander Lowen Foundation.
 Jerry Wexler, which first         With long term and extensive
     charted in 1964.              experience in Bioenergetics,
                                   Bioenergetic therapy, workshop




L
                                   and training attendance since
      et’s face it: Our            1966, Fred seeks to expand the
      most archetypal              visiblity, appreciation, and use
                                   of Bioenergetics.
      attachment scripts           Fred lives in Vermont, USA with
are predicated upon a              his wife and daughter.
fundamental urge to fulfil
the longing of every body
for some body to love.
   Our bodies are,                 Lisa Loustaunau
whether we like it or not,         Lisa Loustaunau, MFA, CCEP,
the vehicle of expression          OSC is Director of Education
for a great deal of what           and Assistant Director of the
                                   Institute of Core Energetics in
we feel, think and                 NY. Lisa teaches and supervises
confront in our daily              body psychotherapists around
                                   the world in the Core Energetics
psychic life. So maybe we          approach developed by the late
psychotherapists should            John Pierrakos MD, whom she
just get over ourselves            frequently assisted. Her private
                                   practice is in Norwalk, CT.
and our obsession with             www.LisaLoustaunau.com
the talking cure. Could
we contemplate that
the bodily cure might
be just as powerful and            Jack Lee Rosenberg
important a route to
                                   Dr. Jack Lee Rosenberg is
healing?                           internationally recognized
   We asked three                  as a pioneer for his
                                   innovative approach to
prominent body therapy             body psychotherapy, human
practitioners and writers          sexuality, and couples
to back us up on this              counseling. He is founder of the
                                   Integrative Body Psychotherapy
body check for overly              Institutes. He has conducted
talkative shrinks. This is         workshops at the Esalen
what Frederic Lowen, Lisa          Institute for more than twenty-
                                   eight years. The author of Total
Loustnaunau and Jack               Orgasm, Body, Self and Soul,
Lee Rosenberg had to say.          and The Intimate Couple, he is in
                                   private practice in Los Angeles.



                        Indispensable survival guide for the thinking psychotherapist   15
Features             Every body needs some body

     New Therapist: Mainstream psychology relies principally on verbal communication. In what
     ways does your working with the body supplement or extend this?



     Jack Lee Rosenburg:

 The body and the mind cannot be separated. They must be worked with simultaneously to help the client
 release somatic holding patterns, awaken, integrate and clarify the body and mind. In IBP (Integrative Body
 Psychotherapy) we use breath, movement and awareness work to open and release holding patterns that are both
 physical and psychological. We are psychotherapists working with the body with limited touch. Breath work
 can bring deep-rooted psychological material to the surface and intensifies it so that it is available to talk about.
 We work with the energy of the body to increase aliveness and release holding patterns to create flow.
     We use two intertwined approaches for working with the client. To begin with, we have the client sitting up
 while we take a history on a large white board. We use breath, movement, presence, contact, boundaries, and
 awareness of history, defensive styles and many tools to bring awareness of the source of holding patterns. We
 also look for thought, belief and behavior patterns that support unwanted results. At the same time we track
 somatic energy and provide experiences that lead to energetic release.
     Once trust has been established, we have the client lie down on a table. First, we track how they breathe. We
 want to know if they can breathe and stay present and be in contact. Can they tolerate the increased aliveness?
 Then, while they breathe fully to build a charge, we use several different weighted balls to help the movement of
 energy and for grounding.
     We usually have the client start lying on their back with their feet balanced on a 6-pound rubber ball. We
 have a number of varying weighted balls depending on the client’s size and strength that can be held between
 client’s knees to tire out the adductor muscles.
     This begins the process of tiring the muscles of the pelvis as a method to release fixed muscular holding
 patterns of the legs and pelvis. In this position the client must sustain core to balance and at the same time talk
 to the therapist and remain present.
     	 As the client fatigues from this position, we exchange holding the ball between their legs for a stretchable
 strap that fits around their legs. The client now is stretching against the strap held just above and around their
 knees. This tires the abductor muscles. The instruction is to push out against the strap. Remember the client is
 lying on their back still balancing their feet upon a ball.
     	 The final result is that this process releases specific muscles often held in the pelvis that are important for
 body psychotherapy and at the same time it opens and releases holding patterns of the body without touching
 the body, or going past the clients boundaries.
     	 The nice thing about this is that the process works very profoundly and effectively without the many
  problems that can arise when working with the pelvis.




16                         		                New Therapist September/October 2012
Features            Every body needs some body

Lisa Loustaunau:                                        Frederic Lowen:

Working with the body opens an entirely                The client’s conscious mind is an unreliable source of usable
new dimension in the treatment room,                   information. Irrational behaviors, emotions, thoughts,
providing a wealth of material that could              beliefs, and attitudes are justified, defended, rationalized,
take months or years to access through                 and/or denied by the conscious “rational” mind. So, the
verbal therapy alone. Words just as easily             value and usability of verbal communication is limited. A
hide or alter the truth as reveal it and, as we        client’s “truth” must be discerned from the motivations of a
know, most communication is non-verbal.                client’s words, not from the words themselves. Talk therapy
I am always struck by the depth of feelings            is like a mental chess game in which, too often, the patient
and experience that my work with the body              is better than the therapist. Driven by a desperate need to
elicits which the client could not verbally            maintain “control,” present an image, or to perpetuate a
or consciously communicate previously.                 relatively comfortable, seemingly safe homeostasis despite
This is much more than body language,                  the complaint/symptom, patients present all manner of
which reveals the truth of the moment.                 resistances; some hardened to the point that talk therapy is
The practice of body psychotherapy goes                virtually impotent.
far beyond body language in that the body                  In Bioenergetic Analysis, the body is the focus of the
communicates the story of a lifetime and               therapeutic work. Like the annual rings of a tree, the
offers a direct channel to experience past and         traumatic experiences of the individual are recorded in the
present.                                               body.
    When I look at a client's body I see                   Originating in psychoanalysis, and developed from
the story of a life journey. It is a moving            the work of Freud’s student Wilhelm Reich, Bioenergetic
and vulnerable experience to receive the               Analysis examines character and personality in terms
uniqueness of a human being in this way.               of the energetic processes of the body. An individual’s
The body speaks to me about their history,             energy is expressed psychologically in thoughts, beliefs,
their patterns of relating, their gifts and            and (motivations for) behavior, and physically and
strengths and innate potential, as well as             physiologically in form, structure, and movement. The self
of their primary defenses and repetitive               comprises both, as well as the psychological unconscious
limiting life-patterns, which will be                  and the autonomous physiology. Like two faces of a coin,
important to challenge in therapy. The body            each face may be radically different, and neither face is the
gives me the direction of the work. Working            whole coin.
physically opens deeply held or denied                     To an experienced Bioenergeticist, the body is
feelings which, when integrated, expand                an expression of a person’s self. Unlike the mind’s
the individuals awareness of who they really           rational verbal exchange, the body does not lie to the
are. The body tells the truth without all the          knowledgeable, aware therapist. All of us in the developed
embellishments and smoke screens that the              world, to varying degrees, have been restricted in fully
ego mind at times constructs.                          expressing our feelings and our selves. To a point, this is
    Body work offers me a way to open                  necessary for social cohesion. But when our feelings and
the door to new or different energetic and             the expression of those feelings are rejected, suppressed,
emotional experiences. They happen right               humiliated, threatened or denied, especially in childhood,
there in session. We aren’t figuring out what          the energy of those feelings becomes “frozen” into
they feel or what they should do about this            structure, subsequently restricting the motility of our
or that. The feelings emerge from within               bodies.
the body and are felt right there. It is very              This frozen structure and the quality of expression: the
immediate and very powerful when clients               inability to express, or inappropriateness of expression, are
experience themselves having feelings                  the elements used in Bioenergetic Analysis diagnostically
they didn’t know they had or were able to              and directly in treatment, hugely leveraging the value of
tolerate and having them freely and honestly.          verbal communications in uncovering and integrating
I engage the person physically to effect a             trauma, and relieving the conflict between conscious and
transformation that occurs on every level              unconscious energies.
of being—psychologically, energetically,                   In addition to improving integration of conscious and
emotionally, mentally and spiritually. It is a         unconscious, and mind and body, body work enhances
powerfully healing expansion.                          physical and physiological health.



                              Indispensable survival guide for the thinking psychotherapist                       17
Features             Every body needs some body

     NT: What, in your opinion, can we not access through verbal communication?



     Frederic Lowen:

 In Bioenergetic Analysis, or body-psychotherapy, direct body work improves the effectiveness of time in
 therapy. Theoretically, all traumatic material is available verbally. Practically, for reasons discussed above, direct
 body work is a reliable means to by-pass the “monkey mind” of consciousness, and access the unconscious and
 autonomic systems directly.
     Motivated by unconscious desires to maintain homeostasis, with effects of transference and counter-
 transference, willful verbal exchange often thwarts the therapeutic process. Even in seemingly successful cases,
 the patient’s conscious mind can feint progress, or offer false leads to protect the fearful self from painful
 realities and truths associated with the trauma the therapist is attempting to uncover or evoke. In contrast, the
 body does not lie.
     Bioenergetic Analysis normally begins with simple exercises and stress positions designed to increase a
 client’s energy level, and highlight the distortions and blockages of energy flow, evidenced by chronic tension
 and muscular tightness. Most usually, these tensions have been held so long, they are outside of conscious
 awareness; that is, they are unfelt.
     The exercise and stress positions make the areas of chronic tension apparent to both therapist and, more
 importantly, to the client. Restricted or disturbed breathing patterns, lack of alignment or balance, collapsed or
 inflated chests, weak legs and feet, poor ground contact, skin tone, muscle tonicity, facial masking, eye contact,
 voice expression, arms and hands, rigidity of pelvic movements, tightness of belly, are some of the common
 indicators of unresolved trauma, and the fears and constraints the individual lives with.
     Together with the verbal history and the client’s perceptions and awareness of his issues (to the extent he
 can articulate them), the body evaluation guides and confirms or refutes the therapist’s lines of inquiry. For the
 client, the bodywork enhances energy by improved breathing, and re-connecting to the natural energy flow in
 the body as tensions are perceived in a new way.
     Increasing energy to the client’s homeostatic state brings emotional material and related memories in the
 unconscious up towards, and into consciousness. For the therapist who is unaware of this dynamic, the client
 may engage in increased “acting-out,” or other patterned behavior with renewed energy and vigor. However,
 for a Bioenergetics therapist, it is an opportunity to focus the client’s higher energetic state on these issues, and
 accelerate the appearance of repressed or suppressed traumatic material.
     Upon release of the tension and trauma, integration is necessary. Verbally, and consciously, the client
 gains intellectual understanding of his story. The client’s ability to relate his traumatic experiences, feelings,
 and memories to how his body felt and responded to the trauma allows integration into the body and the
 unconscious, thereby eliminating the associated psychic conflict and enabling better alignment of 1) unconscious
 motivations with conscious desires; 2) the client’s self-image with the reality of his body/self.




18                        		                 New Therapist September/October 2012
Features             Every body needs some body

Jack Lee Rosenburg:                                   Lisa Loustaunau:

We cannot access the deeper holding                  We cannot access verbally what the unconscious intends to
patterns of the body/mind. IBP breath                disown.
work is used to change the balance                       In body psychotherapy we see the unconscious not as
between the sympathetic and the                      a vague psychological sphere but as located in areas of the
parasympathetic nervous systems,                     body where energy is being managed or blocked. In Core
allowing a sense of wellbeing to unfold              Energetics we see energy and consciousness as unified, so if
in the client's body/mind. There are                 you repress energy you repress consciousness.
certain emotions that cannot be known                    If you block pain, you block pleasure.
by the mind alone: such as love, trust,                  How this happens in the body is through the formation of
erotic sexuality.                                    what is known as armoring, set patterns of muscular holding.
    We cannot access holding patterns                A tight jaw prevents us from crying or expressing our anger,
stored in the body without some form                 vacant eyes caused by chronic tension in the intra-ocular
of manipulation of the body. Therefore               muscles protects us from the intimacy of contact. These are
we must use a number of techniques for               some examples of how our unique pattern of armor serves
working using minimal physical contact               to protect us from particular feelings or experience. Armor
and yet still opening or releasing fixed             (often called blocks) develops as a process over time as a
muscular patterns held throughout the                result of repetitive significant experiences during critical
clients’ body.                                       formational periods in early life that the psyche was not able
    Verbal communication alone does                  to handle. Better said, the armor in the body is the way the
not access early, emotional, relational              psyche handled the developmental frustrations.
limbic memory upon which our                             What is significant is that the same armoring which
foundation is built. And yet, it is vital to         originally served an adaptive purpose—protecting us from
get to the roots of holding patterns for             knowing and feeling what would have been too painful to
healing. Also, when the body is tight,               fully experience at the time—keeps us living and acting as
particularly in the chest, it shuts down             if those early realities continue, and thus we find ourselves
access to the energetic feeling of love,             repeating certain patterns over and over. These patterns
causing love to remain a less satisfying             contain what in Core Energetics we call an “image,” a fixed
mental construct or idea. This is a                  belief.
particular problem between parents and                   Let me give you an example of an “image.” Someone
their children.                                      who was deeply frustrated around needs may develop an
    Simply talking doesn’t reopen the                image that goes “if I allow myself to need then I will be
body to core self agency functions.                  disappointed, if I don’t need then I can’t be disappointed.”
Without this opening clients remain                  In this case closing off consciousness of real needs would
disassociated from core experience                   become the solution to the frustration. This may never have
and just learn more effective coping                 been formulated as a distinct thought, the wound having
strategies rather than accessing their               been experienced before this thinking was possible. It would
authenticity. Most profoundly, the                   however be revealed in the body. You can see it in a sunken
awakening of the body allows the                     chest that takes in little breath, (refusing the energy and
emotional heart to feel and connect with             sustenance), and in de-energized arms that have difficulty
others. It also allows access to deeper              reaching out toward what is wanted or needed. The body
wisdom. If we remain in our heads                    having formed itself in such a way as to literally close itself
talking, life remains flat. Awakening the            off from needing too much by a contraction of the receptive
energy of the body brings deeper, truer              centers in the front of the body.
emotions, essence of being and meaning.                  The experience of embodiment, the way a person feels
Emotions available without grounding                 and breathes and inhabits their body, needs to be changed
in the body are usually re-enactments                in order to really transform a life issue. It is impossible to
of old archaic emotional injuries and are            challenge the physical component of the defense with words
impervious to change.                                alone.




                              Indispensable survival guide for the thinking psychotherapist                        19
Features               Every body needs some body

     NT: To what extent to you use touch in your work with clients and how do you implement it?




     Frederic Lowen:

 Touch is not necessary for Bioenergetic work. However, the use of touch can improve effectiveness materially.
 In the Bioenergetic work I do, I use touch cautiously and with consent. I most commonly apply pressure on the
 client’s chest with my hands, while using the Bioenergetic Breathing Stool*. This helps a client deepen their
 breathing and experience a rigidity of the chest and constriction of their breathing they were not fully aware of.
     I will also manually adjust a person into specific exercises and stress positions. Occasionally, the application
 of pressure with hands or fingers to the musculature of the jaw or the neck, in conjunction with vocal
 expression, helps tire the muscles. It is necessary to stress and tire musculature to reduce it’s ability to retain its
 tension, thereby allowing the streaming flow of energy, which is evidenced by visible tremoring, or vibration.
     Many Bioenergetic therapists use these and other techniques of touch. Examples include deep tissue
 massage, Rolfing, or other massage; tender contact through a timely hug can be hugely effective; providing
 support through contact with the client’s back as he faces his issues (“got your back!”) can be a new experience
 for those who lacked that support; and the common issues people have with boundaries can be made real using
 their arms and hands to define their space and gently challenging them physically to both defend their space
 and to contain and maintain their own energy within their space.
     In group work, participants often pair up for various forms of physical interaction. One of the important
 aspects of such activity is to encourage people to explore and recall the childhood pleasure and fun of physical
 interactivity and games.

 * The Bioenergetic Breathing Stool is a 24” (60 cm) high kitchen stool, with a rolled up blanket, on which the client rests his back,
 keeping feet flat on the floor, allowing the stool to take the full weight of the person. This is simply a more extreme position that
  one takes when stretching across the back of a chair while sitting.




     Lisa Loustaunau:

 I use touch every day, though not with everyone and never gratuitously. There are of course many kinds and
 uses of touch. I might use touch to direct the breath, to bring awareness to a part of the body, or to support the
 release of energy and feelings from a tightly defended area. Touching generally “charges,” adds energy to, the
 area being touched. A client that has an area of the body that is energetically “undercharged,” lacking energy,
 indicates that feelings are being avoided there. Adding energy through touch will focus the clients awareness
 and make it more possible for them to make contact with feelings in that area.
     A different use of touch would be adding pressure to an area of the body that is “overcharged,” meaning too
 much energy is held and over-contained thereby creating a block which prevents the flow of energy into another
 part of the body. This condition distorts sensation and perception in the location of the block and prevents
 awareness of feelings in the area that the block is protecting. Using touch, such as squeezing or pressing, would
 increase charge in that part of the body to encourage a movement of energy into another area of the body that is
 being defended. In this way the client can become conscious of split-off feelings.
     Some clients who were not touched enough during early development have difficulty regulating their nervous
 system. Touch is very important for them until they are able to self-regulate and self-nurture. For others touch
 is difficult to tolerate, painful or invasive, so it is essential to explore touch as part of session work.Touch is our
 most primitive form of communication and how we receive it speaks volumes to our early holding environment.




20                            		                   New Therapist September/October 2012
Features            Every body needs some body

Jack Lee Rosenburg:                       NT: Do you think that the real value of body work is in
                                          diagnosis, in treatment, or in both?
We use limited touch.
The more the therapist
touches the client during
a body session, the
greater the possibility                    Lisa Loustaunau:
to set up a possible
problem, particularly                      The value is in both. We have already established that diagnostically the
a dysfunctional                            body imparts a wealth of information about our history, how primary
or misunderstood                           needs were handled during developmental stages, patterns of relating,
transference relationship                  challenges, as well as character strengths and gifts.This is all discernible
with the client. The                       by carefully observation or sensing of the body, not only its shape, but
client can begin to feel                   how it moves, how energy flows, posture, where energy is blocked etc.
dependent on the therapist                 All these blocks affect our vitality, our emotional and physical well-
for functions the client                   being and our ability to love.
needs to develop such as                       The same blocks that were created as an attempt to avoid pain also
wellbeing and problem                      diminish our pleasure and our life force. Every block is essentially a NO
solving. The client can feel               to life.
inundated and/or touched                       For me the goal of treatment is to support the client to reconnect
inappropriately, especially                with the fullness of their energy so they can walk in the world as they
if the client has been                     really are. Working through the blocks that keep us limited or stuck
abused.                                    requires energy—at least as much as it took to create them. I believe the
    Yet, touch is very                     best way to mobilize and harness energy for this transformative process
important for the                          is by working with the body. Clients that have done a lot of work on
wellbeing of human                         themselves are often struck by the power and directness of this work. It
beings. Sometimes we                       takes more than just thought, or observation, or mindfulness to change
hold a patient’s hand to                   the way we inhabit ourselves and walk in the world. Core Energetics
help the client not feel                   is a very powerful process, physically, emotionally and spiritually. Dr.
alone. If touch feels like                 John Pierrakos, founder of Core Energetics, who is now deceased,
too much for the client we                 always said that all our blocks and defenses were blocks to the heart.
may use a strap or rope                    For me the real value of body work is that it opens our hearts.
held both by the therapist
and client. This can also
be helpful to help a client
make contact and remain
present. We teach self-
release techniques rather                  Jack Lee Rosenburg:
than touch so clients will
feel self empowered.                      You must have an accurate diagnosis in order to have a competent
    We often hold the                     treatment plan. Both are needed.
clients wrist pulse. This                    When a clients sits and talks with us, they tend to talk about rather
is a very sensitive process.              superficial issues, such as “he said . . or she did . . .” And they have little
It places the therapist in                deep insight. If we awaken and open the body, whatever memories,
contact with the very soul                thoughts, sensations, emotions, images that are most relevant to work
of the client and the client              on inevitably come to the surface. The depth of insight that becomes
feels equally touched,                    available along with the corrective experience of the therapist/witness
known and connected.                      leads to both a more genuine diagnosis that can be understood and
                                          worked with. With this opened awakening the results of treatment
                                          become embodied more reliably than with talk therapy alone.




                               Indispensable survival guide for the thinking psychotherapist                           21
Features             Every body needs some body

     NT: Do you think that the real value of body work is in diagnosis, in treatment, or in both?




     Frederic Lowen:

 In Bioenergetics, the value of body work is not only in diagnosis and treatment, but also as proof of therapeutic
 progress.
     In childhood, we are all subjected to the feelings, behaviors and words of our parents, both rational and
 irrational. As discussed above, when children’s feelings and expressions of feelings are suppressed, humiliated,
 threatened or denied, the energy of those feelings becomes “frozen” into the body structure in the form of
 contracted musculature. Just as an experienced woodsman can tell much of a tree’s history from the annual rings,
 an experienced Bioenergeticist can sense, see, hear, and feel a client’s energy “economy;” that is, their energy level
 and how they manage their energy: whether it is held, out-of control, totally controlled, split, or scattered.
     Additionally, the structure and form of the body is always telling. The alignment, posture and shape of one’s
 body speak volumes. A mis-alignment in legs, torso or neck and head, where one part of the body does not
 appear to match the rest of the body, may indicate a psychic conflict or a split in personality.
     The posture tells much of the quality of an individual’s contact with the ground, which mirrors one’s contact
 and connection with their environment, social and natural. It can also indicate the burden one carries, or the
 lack of maternal fulfillment, or the quality of one’s relationship with one’s father. In conjunction with the shape
 of the body, an attitude of superiority may be discerned, as the body exhibits a person who is “stuck” up, cutting
 themselves off from the fullness of life.
     Similarly, the facial mask many wear, a mask and pose adopted to protect the child from the anger or
 humiliation by a parent, becomes structured into the face as the automatic smile; or an irrational situation may
 create the knitted brow and angry countenance of a confused individual; or the jaw is thrust forward and rigidly
 held in defiance and determination; etc, etc, etc.
     Most basically, breathing is one of life’s most important functions. It is the autonomic function we have the
 most conscious control over, so it is a common starting point for both diagnosis and treatment. The fear and
 anger we have all experienced growing up, and the socialization of individuals within developed countries, has
 created widespread breathing disorders. Commonly these are not problematic, or even recognized until advanced
 age. However, they can be seen by a Bioenergeticist. Whether standing at ease, or in a Bioenergetic stress
 position, the quality and freedom of chest and abdominal movement in breathing tells us something of the fears,
 the energy, the spontaneity and the history of the person.
     Just as the inability to express feelings has been structured in the body, so too can those feelings be accessed
 by direct body work in treatment. Of course these feelings and memories need to be subsequently integrated
 into the personality. Body work focused on grounding, boundaries, and energy/feeling containment, enables
 deep integration in mind and body, thus completing the therapeutic process more effectively than verbal therapy
 alone.
     Finally, positive therapeutic progress can be visibly seen in a person’s body in changes in shape, form,
  demeanor, and enhanced aliveness.




22                        		                 New Therapist September/October 2012
Indespensible survival guide for Psychotherapy Treatment
Indespensible survival guide for Psychotherapy Treatment
Indespensible survival guide for Psychotherapy Treatment
Indespensible survival guide for Psychotherapy Treatment
Indespensible survival guide for Psychotherapy Treatment
Indespensible survival guide for Psychotherapy Treatment
Indespensible survival guide for Psychotherapy Treatment
Indespensible survival guide for Psychotherapy Treatment
Indespensible survival guide for Psychotherapy Treatment
Indespensible survival guide for Psychotherapy Treatment
Indespensible survival guide for Psychotherapy Treatment
Indespensible survival guide for Psychotherapy Treatment
Indespensible survival guide for Psychotherapy Treatment
Indespensible survival guide for Psychotherapy Treatment

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Indespensible survival guide for Psychotherapy Treatment

  • 1. New Therapist Indispensable survival guide for the thinking psychotherapist September/October 2012 The Body Edition 81
  • 2. Features EDITOR John Söderlund MANAGING EDITORS Lee-ann Domoney Sue Spencer 6 Body of Evidence: The head-to-toe CONTRIBUTING EDITORS Dylan Evans history of body use in Graham Lindegger Jacqui de Mare psychotherapy Julie Manegold Tim Barry Tom Strong Kelly Quayle Robert Langs Simone Descoins 14 Every body needs some body Robert Waska CONTRIBUTIONS Submissions for inclusion in New Therapist are welcomed. Jack Lee Rosenburg, Lisa New Therapist reserves the right to edit or exclude any submission. Names and identifying information of all Loustaunau and Frederic individuals mentioned in case material have been changed to Lowen on body-based protect their identities. The views expressed herein do not necessarily represent those of New Therapist, its publishers or psychotherapy distributors. ADVERTISING Advertising deadlines for New Therapist are six weeks prior to the first Monday of the month of publication. Please call or email for a media pack and rate card, or visit our web site at 26 Minding the body: www.NewTherapist.com. SUBSCRIPTIONS Feeling and sensations— Subscription charges are $48 per year to all international what they offer us destinations (including postage). To South African destinations, subscription charges are R320 per year (including VAT and postage). If you would like New Therapist By Trish Bartley delivered to your door every second month, please send your payment (by Master or Visa card or cheque) and full postal address to New Therapist Subscriptions, 27 Kitchener Road, Clarendon, Pietermaritzburg, 3201, South Africa. For further information, call +27 (0)33 342 7644 or visit our website at www.NewTherapist.com to subscribe online. Please allow up to 10 weeks for first delivery. CONTACT NEW THERAPIST Tel/fax: +27 (0)33 342 7644 Regulars Email: datepalm@newtherapist.com Web: www.NewTherapist.com 27 Kitchener Road, Clarendon, Pietermaritzburg, 3201, South Africa New Therapist (ISSN 1605-4458) is a professional resource 3 published by New Therapist Trust every second month and Drug watch distributed to psychotherapists around the world. Copyright © New Therapist 2012. All rights reserved. No part 4 Research of this publication may be reproduced or disseminated by any means whatsoever without the prior permission of the publishers. 32 From the therapist's chair A publication of New Therapist Trust.
  • 3. Drug watch Creatine boosts effectiveness of antidepressants for women C linically depressed women appear to respond better to antidepressants when they are taken in conjunction with creatine, according to researchers at the University of Utah. The findings were published online in American Journal of Psychiatry in July, 2012. The authors of the study note that creatine is a naturally occurring amino acid typically associated with providing fuel for intense bursts of energy during high-intensity, short-duration exercises. The mechanism by which creatine works against Negative suggestion can induce depression is not precisely known, but the authors symptoms of illness of the study suggest that the pro-energetic effect of creatine supplementation, including the making of U ndesired effects of drugs can sometimes more phosphocreatine, may contribute to the earlier be attributed to nocebo effects, according and greater response to antidepressants. to researchers at the Technical University The eight-week study comprised 52 South Korean of Munich. The findings appeared in the journal women with major depressive disorder between Deutsches Ärzteblatt International in July, 2012. the ages of 19 and 65. All the women took the Nocebo effects are the adverse events that occur antidepressant Lexapro (escitalopram) during the during sham treatment and/or as a result of negative trial. expectations. Twenty-five of the women received creatine with Nocebo responses can, for instance, be brought the Lexapro and 27 were given a placebo. Neither about by unintended negative suggestion on the the study participants nor the researchers knew who part of doctors or nurses, e.g., when informing received creatine or placebo. the patient about the possible complications of a The study showed that depressed participants who proposed treatment. augmented their daily antidepressant with 5 grams The mechanisms behind this phenomenon of creatine responded twice as fast and experienced are—as with placebo effects—learning by Pavlovian remission of the illness at twice the rate of women conditioning and reaction to induced expectations. who took the antidepressant alone. There were While the positive counterpart—the placebo no significant adverse side effects associated with effect—has been intensively studied in recent years, creatine. the scientific literature contains few studies on The researchers hold that their findings are nocebo phenomena, the researchers note. significant because antidepressants typically don’t The researchers say that the consequences start to work until four to six weeks. They also note for clinical practice are that doctors may find that creatine under a doctor’s supervision could themselves in an ethical dilemma between their provide a relatively inexpensive way for women who obligation to tell the patient about the possible side haven’t responded well to SSRI (selective serotonin effects of a treatment and their duty to minimize reuptake inhibitor) antidepressants to improve their the risk of a medical intervention and thus to avoid treatment outcomes. triggering nocebo effects. “If we can get people to feel better more quickly, One possible strategy to solve this dilemma, they’re more likely to stay with treatment and, suggested by the authors, is to emphasize the ultimately, have better outcomes,” said senior author tolerability of therapeutic measures. Another of the study Perry F. Renshaw. option, with the patient's permission, would be to The researchers say that future research efforts desist from discussing undesired effects during the will test creatine supplements in men and women as patient briefing. well as individuals of different nationalities. Indispensable survival guide for the thinking psychotherapist 3
  • 4. Research Believing in a mind-body connection Sleep deprivation linked to hunger linked to better health and weight gain T S he more individuals perceive their minds and leep habits affect body weight by influencing bodies to be distinct entities, the less likely an individual’s caloric intake and energy they will be to engage in behaviors that protect expenditure, according to researchers at the their bodies, according to researchers at the University Society for the Study of Ingestive Behaviour. The of Cologne, Germany. The findings appeared in findings appeared in PsychCentral in July, 2012. Psychological Science, a journal of the Association for The authors of the study observed the effect of Psychological Science in July, 2012. short-term sleep deprivation on hunger as well as on The researchers note that many people are physical activity and energy used by the body. philosophical dualists—believing that the brain and The researchers monitored the physical the mind are two separate entities. Their findings activity of participants by attaching acceleration showed that people primed with dualist beliefs had detection devices to each of their wrists. They also more reckless attitudes toward health and exercise, monitored participants’ energy levels using indirect and also preferred (and ate) a less healthy diet than calorimetry—a method that estimates how much heat those who were primed with physicalist beliefs. is produced by a person as they use oxygen. Furthermore, they found that the relationship The researchers found that participants who slept also worked in the other direction. People who were less had higher traces Ghrelin (or what they term the primed with unhealthy behaviors—such as pictures of “hunger hormone) in their blood. Those who slept for unhealthy food—reported a stronger dualistic belief shorter periods also moved around less. than participants who were primed with healthy Results also showed that after staying awake for behaviors. one complete night, the amount of energy used by the Specifically, these findings suggest that dualistic body when resting was significantly reduced among beliefs decrease the likelihood of engaging in healthy participants. behavior. The researchers say that their findings suggest Evidence of a bidirectional relationship further that when individuals are sleep-deprived they are suggests that metaphysical beliefs, such as beliefs in likely to eat more calories because they are hungrier. mind-body dualism, may serve as cognitive tools for This alone might cause them to gain weight over coping with threatening or harmful situations. time. Sleep loss also means we burn off fewer The researchers say that the fact that the simple calories, which adds to the risk of gaining weight and priming procedures used in their studies had an developing type-II diabetes. immediate impact on health-related attitudes The researchers conclude by saying that although and behavior suggests that these procedures may much is still to be learned about the correct sleep dose eventually have profound implications for real-life for obesity and diabetes, the available research results problems. Interventions that reduce dualistic beliefs clearly supports the notion that sleep is involved through priming could be one way to help promote in the balance between the amount of calories we healthier—or less self-damaging—behaviors in at-risk eat and the amount we use up through activity and populations. metabolism. 4 New Therapist September/October 2012
  • 5. Research Fathers’ rejection can have particularly Snacking linked to brain activity and adverse effects on children self-control A F study by researchers at the University of ood consumption and BMI (Body Mass Index) Connecticut shows that while mothers have are linked to both brain activity and self-control, unique social and emotional bonds with their according to researchers at the Universities of children, a father’s love contributes as much—if not Exeter, Cardiff, Bristol, and Bangor. The study appeared more—to a child’s development. The findings appeared in the journal NeuroImage in July, 2012. in the journal Personality and Social Psychology Review in The authors of the study found that individuals’ brain June, 2012. 'reward centre' responses to pictures of food predicted The researchers analysed the power of parental how much they subsequently ate. This had a greater rejection and acceptance in shaping our personalities as effect on the amount they ate than their conscious children and into adulthood. feelings of hunger or how much they wanted the food. In a review of 36 international studies that involved A strong brain response was also associated with more than 10,000 participants, the researchers increased weight (BMI), but only in individuals discovered that parental rejection causes children to feel reporting low levels of self-control. For those reporting more anxious and insecure, as well as more hostile and high levels of self-control a stronger brain response to aggressive toward others. food was related to a lower BMI. “Children and adults everywhere—regardless The researchers note that their study adds to of differences in race, culture, and gender—tend to mounting evidence that overeating and increased weight respond in exactly the same way when they perceived are linked, in part, to a region of the brain associated themselves to be rejected by their caregivers and other with motivation and reward, called the nucleus attachment figures,” said co-author of the study Ronald accumbens. Rohner. Responses in this brain region have been shown The authors of the study found that the pain of to predict weight gain in healthy weight and obese rejection—especially when it occurs over a long period individuals. The current study adds to this by showing of time in childhood—tends to linger into adulthood, that this is independent of conscious feelings of hunger, making it more difficult for adults who were rejected as and that self-control also plays a key role. children to form secure and trusting relationships with The study comprised 25 young healthy females with their intimate partners. BMI’s ranging from 17-30. The researchers elected to Rohner notes that prior studies have shown that the observe female participants as they typically exhibit same parts of the brain are activated when people feel stronger responses to food-related cues than men. This rejected as are activated when they experience physical is due to hormonal changes during the menstrual cycle. pain. All participants were taking the monophasic combined “Unlike physical pain, however, people can oral contraceptive pill. psychologically relive the emotional pain of rejection Participants had not eaten for at least six hours. They over and over for years,” Rohner said. were given a bowl containing 150 g of potato chips to eat The results showed that while children and adults at the end of the study. often experience more or less the same level of The researchers used MRI scanning to detect the acceptance or rejection from each parent, the influence participants' brain activity while they were shown of one parent’s rejection—often the father’s—can be images of household objects, and food that varied much greater than the other’s. in desirability and calorific content. After scanning, Researchers at the International Father Acceptance participants rated the food images for desirability and Rejection Project explain that children and young rated their levels of hunger and food craving. adults are likely to pay more attention to whichever Lead author of the study Natalia Lawrence of the parent they perceive to have higher interpersonal power University of Exeter says, "Our research suggests why or prestige. some individuals are more likely to overeat and put So if a child perceives her father as having higher on weight than others when confronted with frequent prestige, he may be more influential in her life than the images of snacks and treats. Food images, such as those child’s mother. used in advertising, cause direct increases in activity Rohner notes that fatherly love is critical to a in brain 'reward areas' in some individuals but not in person’s development. The importance of a father’s others. If those sensitive individuals also struggle with love should help motivate many men to become more self-control, which may be partly innate, they are more involved in nurturing child care. likely to be overweight." Indispensable survival guide for the thinking psychotherapist 5
  • 6. Features Body of evidence Body of Evidence: An overview of body use in psychotherapy By Kelly Quayle M uch as Descartes might have theorised that the mind and body are separate entities in his famous Cartesian dualism, it has long been understood that mind non for any interpretation offered by psychologists of the state of their clients. But many schools of thought in the psychology field have long considered the central role of and body are not neatly distinct the body in not only expressing from one another. To a large mental trauma or imbalance, but extent, the focus of traditional also as a tool for therapeutic change psychotherapy is in working with and for tracking the progress of one’s thoughts and beliefs. The clients. This overview will cover the old adage of psychotherapy as the work of some leading writers and ‘talking cure’ priveleges verbal psychotherapists in this evolving communication to the sine qua area of psychotherapy. 6 New Therapist September/October 2012
  • 7. Features Body of evidence Understanding the body in mental Clarifying ‘body in psychotherapy’ illness: From hysteria to conversion versus other disciplines disorders Although, by definition, most psychotherapeutic Hysteria is an obsolete medical term that is still approaches involving the body have a holistic used colloquially to refer to a state of extreme fear or understanding and work towards some form of emotion and the resultant irrational behaviour. The body/mind integration, there are considerable term was originally employed to describe women who differences in terms of technique, therapeutic acted irrationally due to a supposed disturbance of the stance and the role of the therapeutic uterus, and dates back as far back as Hippocrates. relationship in the process. It is important to The notion of hysteria was revived through distinguish the various forms of body therapy the influence of Freud’s theories about hysterical from psychotherapy that integrates body conversions, which no doubt influenced the current work into its understanding and treatment thinking, namely that people may have physical techniques. Body healers may, for instance, use manifestations of psychological distress as an some form of massage or physical exercises, unconscious way of repressing, expressing and coping work simply to improve physical well-being and with it. see inner balance and psychological benefits In modern psychological thought the term hysteria as indirect results. Other approaches, such as is no longer considered a diagnostic category, although martial arts or cranio-sacral therapy, go further physical manifestations of psychological conditions and aim to involve the client more pro-actively can be diagnosed as somatoform and dissociative in increasing inner awareness and healing the disorders. A somatoform disorder is characterised by body-mind split. physical symptoms that have no identifiable physical But psychotherapy with a ‘body’ focus causes. These symptoms usually mimic real diseases or is distinct from the above in that it always injuries. Such disorders include conversion disorder, works from and within the client’s subjective body dysmorphic disorder and somatization disorder. reality, which includes an awareness of the Dissociative disorders are psychological disorders different levels of body, emotion and mind that involve dissociation or interruption in aspects that shape this reality. The understanding and of consciousness, including identity and memory. use of the body in psychotherapy probably These types of disorders include dissociative fugue, stands in most stark contrast to other body dissociative identity disorder and dissociative amnesia. therapies in its conception of the therapeutic Routinely, the body is considered when diagnosing relationship. Although a holistic model of the mental imbalance and psychologists are trained to client is common to all approaches involving assess a client’s vegetative functioning, take into the body, most non-psychotherapeutic body account their general physical functioning and observe therapies tend to rely on a quasi-medical ‘expert’ non-verbal behaviours. But many psychotherapists and relationship between patient and healer. Within branches of psychotherapy are attempting to recognise the psychotherapeutic realm, no one specific the body not simply as a diagnostic agent, but as a technique is considered therapeutic in itself, living source of intelligence, information and change. but only as an integral part of a therapeutic relationship. Conceptualising the body in psychotherapy on a continuum The therapeutic approaches that incorporate the body in psychotherapy may be depicted along a continuum. On the one end, predominantly verbal therapies pay little or no attention to the body. On this extreme, the spoken word dominates the therapeutic interaction and in the verbal interventions, there is little or no reference to body aspects. However, even on this end of the continuum, nonverbal interactions have an important and unavoidable impact on practice. Therapists and client are never just ‘talking’, they are always bodies interacting. Further along the continuum, there are therapies that display increasing body-orientedness. There may still be a focus on verbal interventions, but the body is recognised as an explicit source of information. And moving further along the continuum, there are approaches that are sometimes called “body therapy”. Major methods here are working with movement, nonverbal expressions and direct touch. These are the focus of this overview. Indispensable survival guide for the thinking psychotherapist 7
  • 8. Features Body of evidence History of the body in psychotherapy: From the 1900’s to the present A brief, incomplete history of the body therapies is captures both the defensive and self-protective depicted below, followed by a fuller description of aspects of ‘repression’ which have long been a some of the theorists that have contributed to the cornerstone of analytic theory. Reich called his developments in this field. way of working with the body ‘vegetotherapy’, which he considered ‘character-analysis in the zz Freud, early 1900’s: The grandfather of modern realm of the body’. For Reich, the therapeutic psychotherapy was clear that the ego is first and process is liable to remain bound by the linear foremost a ‘body-ego’ (certainly a statement world of mental understanding and insight unless integrating body and mind) and, for a while, the underlying ‘body armour’ is addressed—the assumed that some day psychoanalysis would be body is just as effective and necessary an arena grounded in physiology and biology. His early for change as is the mind. conceptualisation of libido within a framework of homeostasis is much more aligned with zz Neo-reichian theories, originating from Reich’s biology and physics than with psychology, and work, which focus on somatic healing and there was a strong subversive impetus to liberate consider the mind-body interrelations and the body’s energies. From early on, Freud used a connectivity in order to heal the whole person. wide variety of techniques, including massage. Various techniques are utilized, including Later in his professional life he veered more breath, physical touch and movement. Known towards seeing the body as representing the generically as ‘body psychotherapy’, contributors dangerously dominant force of the instincts to this line of work include Georg Groddeck and which had to be kept in check by an increasingly Sandor Ferenczi, whilst Alfred Adler and C.J. conscious mind. Jung and others contributed to its development through their concern with the distribution zz Reich, from 1920: Reich was probably the of psychic energy within the body and the first psychoanalyst to give significant impetus relationship between body and mind. Specific to Freud’s early ideas about the body and therapies that emerged from within these libido. He eventually became the pioneer of a developments include (cited in Eiden, 1999): school of thought known generically as body {{ Bioenergetic Analysis developed by Alexander psychotherapy, although he began with an Lowen, who emphasised the importance of approach he labelled ‘vegetotherapy’. Reich ‘grounding’—being in strong contact with the recognised that all neurotic symptoms also have ground through feet and legs. a physiological and physical aspect and that {{ Core energetics: Developed by John Pierrakos. the body is closely linked to the psychological It emphasised the bridge between psychology process. His central understanding was that and spirituality. body and mind interact dynamically with, and mirror, each other. If the mind forms a {{ iodynamic psychology: Developed by Gerda B conclusion, the body has a reaction. Tension Boyesen. She theorized that the dismantling in physical form is connected to a mental state of psychological stress is also connected with and releasing it has a freeing effect on the mind. the digestive system. Reich’s concept of ‘character armour’— {{ e Chiron approach was founded by Bernd Th habitual and chronic fixed relational Eiden and Jochen Lude in the early 1980s and positions— emphasises an integral-relational approach to therapeutic healing. 8 New Therapist September/October 2012 New Therapist September/October 2012
  • 9. Features Body of evidence Other body-therapies: zz Rolfing: Developed by Ida Rolf in the 1930’s. It is a mode of treatment which physically manipulates the body, creating a postural release which aims to loosen up and realign the body. It aims to release past trauma and built-up stress as a way of enhancing mind-body health. zz Primal therapy: Developed by Arthur Janov in the 1970’s and based on the thinking that neurosis is caused by the repressed pain of childhood trauma, primal therapy is used to re-experience childhood pain as an attempt to resolve these feelings. Some more current mind-body psychotherapies: zz Pat Ogden’s sensorimotor approach to on traditional psychotherapeutic understandings, psychotherapy: For many years, the realm of but includes the body as central in the therapeutic implicit nonverbal communications and bodily- field of awareness and employs a set of based affective states was largely ignored by observational skills, theories, and interventions not mainstream psychoanalysis. The result was a usually practiced in psychodynamic psychotherapy. traditionally strong bias in favour of explicit, Ogden argues that therapy is the context in verbal, cognitive mechanisms (Schore, 1994). which we work with the wisdom of the body in an However, advances in our understanding attempt to integrate sensations, images, feelings of the psychology and biology of bodily-based and thoughts that constitute ongoing experience. emotional states and neuropsychoanalytic The experience of trauma is recognised as being concepts that bypass the Cartesian error, significantly body-based. Sensorimotor approaches along with the developmental psychoanalytic recognises and use this to allow the therapist to discoveries of how affect regulating attachment open up the client’s non-verbal world and make it experiences positively and negatively impact available for integration and processing. By being evolving structure, are being incorporated aware of how a client stands, sits, walks, talks into more complex clinical models of the or gestures, the therapist can hypothesise about psychopathegenesis and treatment of brain/ these bodily gestures and client and therapist mind/body disorders. can learn what these might be communicating. Until recently, body psychotherapy The therapist also attends to the way in which progressed independently, and somewhat bodily organisation reflects competence and well- apart from, contemporary psychoanalysis. being. Techniques may include the inculcation of This field has focussed more intensely on the deep and regular breathing, relaxation, physical somatic expressions of psychobiological trauma, flexibility and physical alignment. especially trauma and affect dysregulation that The sensorimotor therapist is concerned occur in the histories of severe self pathologies. with “top-down” management skills, such as But the body psychotherapists appear clarifying meaning, formulating a new narrative, increasingly to be adopting an interdisciplinary and working with emotional experience, as well perspective (Schore 2002). as with “bottom-up” interventions that address Pat Ogden and her colleagues are a the repetitive, unbidden, physical sensations, prominent source of neurobiologically, movement inhibitions, and somatosensory psychodynamically, and developmentally intrusions of unresolved trauma (Ogden, Pain informed clinical models in the expanding & Fisher, 2006). Such an integrative approach world of somatically-focussed psychotherapy. attempts to help clients experience a reorganised Dubbed the sensorimotor approach, it builds sense of self. Indispensable survival guide for the thinking psychotherapist 9
  • 10. Features Body of evidence zz Mindfulness-based psychotherapies, eg. zz Post-modern contributions (Tom Andersen and Jaakko the Hakomi Method: In the last decade Seikkula):The late Tom Andersen, a well-respected mindfulness has become increasingly Norwegian therapist who co-developed a form of popular within many branches therapy known as ‘collaborative therapy’ and Jaakko of psychotherapy, based on the Seikkula, a renowned Finnish psychotherapist and growing recognition that the ancient academic who borrowed from this approach and mindfulness teachings can reduce stress successfully developed social network based and contribute to the healing process practices in psychiatry, brought about an for a wide-range of difficulties (Kabat- increasing recognition of the dialogical and Zinn, 2005). Within mindfulness, ‘embodied’ nature of therapy. the somatic realm is not only deeply Andersen observed the work of tied into all our emotional and physiotherapists who worked intuitively with mental processes, but it reflects them a person’s body to effect change and he drew precisely, allowing the uncovering of forth many observations to apply to his therapy fundamental issues and memories that with clients. He stated that therapy must be give rise to them (Marlock & Weiss, like a ‘pain producing hand’ in the sense that 2006, in Weiss, 2009)). Mindfulness a therapist’s words must be unusual enough to encourages ways of becoming more incite change in the client. He also observed ‘aware’ or more conscious of bodily that a good therapist is guided by his or her processes. Patients are usually client’s signs, which are often very subtle encouraged to sense, feel and observe ones, and from this his ‘slow’ way of working their bodies at great length. evolved. Tom Anderson’s approach to therapy Body psychotherapist Ron Kurtz highlighted the importance of a responsive and pioneered the integration of embodied contact with an others expressions mindfulness into psychodynamic and following these moving’ expressions therapy in the 1970’s. In his approach, wherever they might lead (Shotter, 2007). The Hakomi Method, the therapist Jaako Seikkula developed Open Dialogue, constantly monitors and helps to a group therapy method in which ‘team regulate the state of consciousness members’ bring new words that offer an of the client. In the course of alternative language to those of symptoms a successful Hakomi process, and problem behaviours. Network members there is an expanding sense of are encouraged to sustain intense painful mindfulness and the core of the emotions of sadness, helplessness, and process usually takes place in hopelessness as a multi-voiced picture of this state. As an experiential the event evolves. A dialogical process is a process, the therapist is necessary condition for making this possible. radically nondirective in To support diaological process, team members order not to interfere with attend to how feelings are expressed by the many mindfulness. This shifts voices of the body: tears in the eye, constriction the focus of the therapist in the throat, changes in posture, and facial from a ‘thinking’ expression. Team members are sensitive to how the to an ‘observing’ body may be so emotionally strained while speaking mode. When of extremely difficult issues as to inhibit speaking completely in tune further, and they respond compassionately to draw with mindfulness, the forth words at such moments. “The experiences that therapist will manifest a had been stored in the body’s memory as symptoms state of being that Kurtz calls are “vaporised” into words” (Seikkula & Trimble, ‘a loving presence’ (Martin, 2005, p. 468). In this approach, dialogue is not just a 2007). The mindful approach form of communication, but a way of engaging with requires a fundamental shift in others in a way that forms minds. ‘Mind’ is not seen attitude that is hard to fathom for as an independent element of human psychological those schooled in traditional ways of structure, but an ongoing process from one second to Western psychotherapy (Weiss 2007). another between living (embodied) persons. 10 New Therapist September/October 2012 2012 New Therapist September/October
  • 11. Features Body of evidence Towards an integration: Drawing from the The body perceived from concepts and practices of ‘body’ psychotherapies outside It is clear that body psychotherapies do not emanate from a A person’s facial expressions, body common theoretical base. Support for body work is found postures, gestures, breathing, even in different theoretical models: psychodynamic theories, voice quality, sighing and laughing, including Reichian and non-Reichian theories, humanistic and are commonly used by the existential psychology, transpersonal psychology, and behaviour therapist to aid insight. People also therapy. Despite the number of specific models and therapies have a natural tendency towards that incorporate the body into psychotherapy, Leijjsen (2006) mimicking the posture, gestures, suggests that a psychotherapist wanting to validate the body in facial expressions of the people psychotherapy can work with one or a combination of these aspects they are looking at, referred to as of the body, which might include the body perceived from outside, empathic attunement. Research the body in action in movement and other nonverbal expressions, shows that mirroring of bodily and the body in physical contact with another body, usually by positions and an unconscious touch. These are outlined below, with practical illustrations of how synchronisation of actions between these techniques might be used in the therapy context. people helps to develop and maintain rapport and relatedness (Cooper, 2001 in Leijssen, 2006). The nonverbal communication The body sensed from inside may complement the client’s narrative or even reveal something The body as sensed from inside, the experiencing body, relies on different from the spoken the premises that what is most essential can be experienced in the narrative of which client may body. This is a visceral process, rooted in emotional experience, not be conscious. An awareness with cognitive activity as secondary. The inclusion of the simple and reflection on the non-verbal invitation to pay attention to the body as sensed from inside can communication of the client can enhance each method of therapy without changing it very much bring greater awareness and insight (Gendlin, 2003 in Leijjsen, 2006). The therapist may ask: “Wait to the issue being discussed. For a moment, can you check inside, in your body, what you are instance, a client may verbally feeling there?” If this bodily source is not too alien for the client, express that they are no longer the symbols arrived at from that place will deepen the therapy by affected by an experience from accessing the emotional material on more than just the cognitive their past, but the therapist may level. observe the client holding her In the interaction with the client, the therapist can also rely on hands across her abdomen and this his or her body orienting sense, which some might call ‘somatic might cue the therapist to note countertransference’. In their research on therapists’ experiences that she is trying to protect herself of empathy, Greenberh and Rushanskiu-Rosenberg (2002) from something that she is not investigated therapists’ internal process while being empathic. verbally expressing. Therapists reported often using their own bodily responses as tools However, sometimes clients to finding the most accurate connection with the client’s experience may be confused when the and as feedback for the accuracy of the interaction. A therapist therapist draws attention to might notice that they have a physical sensation mirroring the physical components of their client’s experience. This might be felt as a shiver down the spine or communication or feel intruded a feeling of excitement; or as a body resonance that recognises the upon and thus therapists would pain of the client. The therapist can even verbalise their own bodily ideally move the client along such experience with comments, such as “I notice that my heart beats observations or interpretations only faster when you talk about that.” at a pace that does not disrupt the There are also many benefits to experiencing the body from therapeutic process, particularly the inside, such as increased self-awareness, a capacity for less when dealing with the results of impulsive or automatic behavioural responses to feelings and trauma (Rothschild, 2002). delaying automatic behaviour, and the attendant calming, relaxing and grounding effects that follow from these. Indispensable survival guide for the thinking psychotherapist 11
  • 12. Features Body of evidence The body perceived in action: The body in physical contact: Touch Movement How touch is experienced is often subjective. The same In this step of validating the body, sensory stimulus, like a tap on the shoulder, might be the therapist pays more explicit seen as an encouragement by one person and a reprimand attention to kinaesthetic, movement- by another. Touch crosses a body border and there is, related experiences and also may also inevitably, a correspondingly heightened sensitivity and experiment with guiding the client to intimacy involved in the act of touch. For these reasons, new movements and body postures. it is hardly surprising that touch has been been considered The therapist might, for instance, ask a controversial and usually undesirable practice in the client to exaggerate a movement ethical codes that guide the practice of therapy. Where to increase its emotional salience and it has been used in therapy, touch might extend from a to bring the client in contact with handshake in almost exclusively verbal therapy to intensive something that is further away from bodywork at the other end of the touch continuum. awareness. Or the therapist might While making physical contact with clients is indeed a introduce small steps of experiential ‘touchy’ topic amongst therapists, a survey of members of learning and invite the client to the American Academy of Psychotherapists (Tirnauer et experiment with active behavioural al, 1996 in Leijjsen, 2006), indicated that only 13% “never expression. For example, a client touch” their clients. Ethical fears of touch are typically reporting that he is “fed-up” with centred around a fear that physical contact may lead to doing something and hunches his exploitative or sexual interactions. Therapeutically, there is shoulders as he says it might be invited also a fear that touch may create transference issues and/ to exaggerate the moment in his body or retraumatisation when misuse of touch was part of the posture, or alternatively he might be client’s original trauma. Leijssen (2006) suggests that encouraged to explore the opposite acknowledging these concerns doesn’t imply that touch has body position. to be problematic in therapy. The therapist may also modulate One way of framing touch in therapy is that, when body posture or movement that are used appropriately, it is a genuine expression of person- unusual for a client in order to help the to-person relating, and a strategic means of providing client achieve a recognition of alternate nurturance and support. Touch is clearly a more intrusive bodily experiences and explore new technique, but Leijjsen (2006) argues that touch, possibilities. For instance, a dependent used appropriately, can provide a physical holding or person who ‘holds on’ to others and containment of the client in trouble. Take the example has difficulty standing on her own of a trauma therapist, working with survivors of political legs might be encouraged to plant her torture, who used kind and gentle touch to help them feet firmly on the ground. Movement ‘come back into their bodies’ (Bingham Hull, 1997, p.6 in exercises and experiements can also Leijjsen, 2006). Touch in these instances would appear to activate muscle functioning and assist the traumatised individual to move beyond a layer create bodily flexibility, creating the of fear that ‘freezes’ their ability to benefit from other possibility of new awareness and new interventions. As a guide, therapists are encouraged to ask experiences. However, Leijjsen (2006) permission and state the intention behind touch before cautions against the pitfalls of working making contact. Touch should also only be employed once with the body in action in the sense the therapeutic relationship is well established and should that the therapist may take too much always be congruent for the therapist and feel comfortable control, or see himself or herself as the and appropriate to the client. Neither the therapist nor agent of change. patient should experience the touch as a demand, nor as an expression of intimacy beyond that felt on an emotional level (Kertay & Reviere, 1993). 12 New Therapist September/October 2012
  • 13. Features Body of evidence Women's Sexual Satisfaction. Baltimore: The Johns Hopkins University Press. ISBN 0-8018-6646-4. Martin, D. (2007). Tracking and contact. In H. Weiss, G. Johanson, & L. Monda (Eds.), The Hakomi Method. Boulder, CO: The Hakomi Institute. McNeely, D.E. (1987). Touching. Body therapy and depth psychology. Toronto: Inner City Books. Ogden, P., Pain, C. & Fisher, J. (2006). A sensorimotor approach to the treatment of trauma and dissociation. Psychiatric Clinics of North America, 29: 263-279. Rothschild, B. (2002). Body psychotherapy without touch: applications for trauma therapy. In T. Staunton (Ed.), Body Psychotherapy (pp. 101-115). New York: Brunner- Routledge. The body in action: References Seikkula, J (2008). Inner and outer Nonverbal forms of self Andersen, T. (1997) Researching client- voices in the present moment of family expression therapist relationships: a collaborative and network therapy. Journal of Family study for informing therapy. Journal of Therapy. 30: 478-491. This way of validating Systemic Therapies, 16(2), pp 125-133. Seikkula, J. and Trimble, D. (2005). the body is an extension Eiden, B. 1999. The History of Body Healing elements of therapeutic of movements in more Psychotherapy—An Overview. This conversation: Dialogue as an nonverbal actions. The article was written in January 1999 embodiment of love. Family Process. 44: therapist may introduce for 'Counselling news—the voice of 461-475. expressive arts (dance, counselling training'—a magazine published by CSCT. Schore, A.N. (2002). The right brain as drawing, painting, sculpting, the neurobiological substratum of Freud's music, sound) as an alternate Greenberg, L.S., Rushanski-Rosenberg, dynamic unconscious. In D. Scharff (Ed.), path for exploration and R. (2002). Therapist’s Experience The psychoanalytic century: Freud’s legacy communication. In the of Empathy. In J.C. Watson, R.N. for the future. (pp. 61- 88). New York: Goldman, & M.S. Warner (Eds.), Other Press. consulting rooms of Carl Client-Centered and Experiential Jung for example, people Psychotherapy in the 21st Century: Shotter, J. (2007). Not to forget Tom danced, sang, acted, mimed, Advances in theory, research and practice Andersen’s way of being Tom Anderson: played musical instruments, (pp. 168- 181). Ross-on Wye: PCCS the importance of what ‘just happens’ to painted, modelled with Books. us. Draft of paper delivered at The 12th clay (McNeely, 1987, p.39). International Meeting on the Treatment of Kabat-Zinn, J. (2005). Coming to Psychosis, Lithuania, September, 2007. In this way of validating our senses: Healing ourselves and the the body, it is important world through mindfulness. New York: Weiss, J. (2009). The use of mindfulness to remind the client that Hyperion. in psychodynamic and body oriented performing visibly is not psychotherapy. Body, Movement and Kertay, L., & Reviere, S. L. (1993). Dance in Psychotherapy, Vol. 4, No. essential—these methods are The use of touch in psychotherapy: 1, April 2009, 5-16. used to increase self-insight. Theoretical and ethical considerations. Nonverbal expressions can Psychotherapy: Theory, Research, and also replace or supplement Practice, 30(1), 32-40. words when talk fails to produce results. What is Leijssen, M (2006). Validation of the About the author Body in Psychotherapy. Journal of creative is often therapeutic Humanistic Psychology. 46, 2, 126-146. Kelly Quayle is a psychologist in private (Adzema, 1985; Kahn, 1985 practice in Pietermaritzburg, South in Leijssen, 2006). Maines, Rachel P. (1998). The Technology Africa, and a contributing editor to New of Orgasm: "Hysteria", the Vibrator, and Therapist. Indispensable survival guide for the thinking psychotherapist 13
  • 14. Features Every body needs some body Every body needs some body An interview featuring Jack Lee Rosenburg, Lisa Loustaunau and Frederic Lowen 14 New Therapist September/October 2012
  • 15. Features Every body needs some body “Everybody needs somebody to love” Frederic Lowen Frederic Lowen, son of - Song by Bert Berns, Alexander Lowen, M.D., is Solomon Burke and Executive Director of The Alexander Lowen Foundation. Jerry Wexler, which first With long term and extensive charted in 1964. experience in Bioenergetics, Bioenergetic therapy, workshop L and training attendance since et’s face it: Our 1966, Fred seeks to expand the most archetypal visiblity, appreciation, and use of Bioenergetics. attachment scripts Fred lives in Vermont, USA with are predicated upon a his wife and daughter. fundamental urge to fulfil the longing of every body for some body to love. Our bodies are, Lisa Loustaunau whether we like it or not, Lisa Loustaunau, MFA, CCEP, the vehicle of expression OSC is Director of Education for a great deal of what and Assistant Director of the Institute of Core Energetics in we feel, think and NY. Lisa teaches and supervises confront in our daily body psychotherapists around the world in the Core Energetics psychic life. So maybe we approach developed by the late psychotherapists should John Pierrakos MD, whom she just get over ourselves frequently assisted. Her private practice is in Norwalk, CT. and our obsession with www.LisaLoustaunau.com the talking cure. Could we contemplate that the bodily cure might be just as powerful and Jack Lee Rosenberg important a route to Dr. Jack Lee Rosenberg is healing? internationally recognized We asked three as a pioneer for his innovative approach to prominent body therapy body psychotherapy, human practitioners and writers sexuality, and couples to back us up on this counseling. He is founder of the Integrative Body Psychotherapy body check for overly Institutes. He has conducted talkative shrinks. This is workshops at the Esalen what Frederic Lowen, Lisa Institute for more than twenty- eight years. The author of Total Loustnaunau and Jack Orgasm, Body, Self and Soul, Lee Rosenberg had to say. and The Intimate Couple, he is in private practice in Los Angeles. Indispensable survival guide for the thinking psychotherapist 15
  • 16. Features Every body needs some body New Therapist: Mainstream psychology relies principally on verbal communication. In what ways does your working with the body supplement or extend this? Jack Lee Rosenburg: The body and the mind cannot be separated. They must be worked with simultaneously to help the client release somatic holding patterns, awaken, integrate and clarify the body and mind. In IBP (Integrative Body Psychotherapy) we use breath, movement and awareness work to open and release holding patterns that are both physical and psychological. We are psychotherapists working with the body with limited touch. Breath work can bring deep-rooted psychological material to the surface and intensifies it so that it is available to talk about. We work with the energy of the body to increase aliveness and release holding patterns to create flow. We use two intertwined approaches for working with the client. To begin with, we have the client sitting up while we take a history on a large white board. We use breath, movement, presence, contact, boundaries, and awareness of history, defensive styles and many tools to bring awareness of the source of holding patterns. We also look for thought, belief and behavior patterns that support unwanted results. At the same time we track somatic energy and provide experiences that lead to energetic release. Once trust has been established, we have the client lie down on a table. First, we track how they breathe. We want to know if they can breathe and stay present and be in contact. Can they tolerate the increased aliveness? Then, while they breathe fully to build a charge, we use several different weighted balls to help the movement of energy and for grounding. We usually have the client start lying on their back with their feet balanced on a 6-pound rubber ball. We have a number of varying weighted balls depending on the client’s size and strength that can be held between client’s knees to tire out the adductor muscles. This begins the process of tiring the muscles of the pelvis as a method to release fixed muscular holding patterns of the legs and pelvis. In this position the client must sustain core to balance and at the same time talk to the therapist and remain present. As the client fatigues from this position, we exchange holding the ball between their legs for a stretchable strap that fits around their legs. The client now is stretching against the strap held just above and around their knees. This tires the abductor muscles. The instruction is to push out against the strap. Remember the client is lying on their back still balancing their feet upon a ball. The final result is that this process releases specific muscles often held in the pelvis that are important for body psychotherapy and at the same time it opens and releases holding patterns of the body without touching the body, or going past the clients boundaries. The nice thing about this is that the process works very profoundly and effectively without the many problems that can arise when working with the pelvis. 16 New Therapist September/October 2012
  • 17. Features Every body needs some body Lisa Loustaunau: Frederic Lowen: Working with the body opens an entirely The client’s conscious mind is an unreliable source of usable new dimension in the treatment room, information. Irrational behaviors, emotions, thoughts, providing a wealth of material that could beliefs, and attitudes are justified, defended, rationalized, take months or years to access through and/or denied by the conscious “rational” mind. So, the verbal therapy alone. Words just as easily value and usability of verbal communication is limited. A hide or alter the truth as reveal it and, as we client’s “truth” must be discerned from the motivations of a know, most communication is non-verbal. client’s words, not from the words themselves. Talk therapy I am always struck by the depth of feelings is like a mental chess game in which, too often, the patient and experience that my work with the body is better than the therapist. Driven by a desperate need to elicits which the client could not verbally maintain “control,” present an image, or to perpetuate a or consciously communicate previously. relatively comfortable, seemingly safe homeostasis despite This is much more than body language, the complaint/symptom, patients present all manner of which reveals the truth of the moment. resistances; some hardened to the point that talk therapy is The practice of body psychotherapy goes virtually impotent. far beyond body language in that the body In Bioenergetic Analysis, the body is the focus of the communicates the story of a lifetime and therapeutic work. Like the annual rings of a tree, the offers a direct channel to experience past and traumatic experiences of the individual are recorded in the present. body. When I look at a client's body I see Originating in psychoanalysis, and developed from the story of a life journey. It is a moving the work of Freud’s student Wilhelm Reich, Bioenergetic and vulnerable experience to receive the Analysis examines character and personality in terms uniqueness of a human being in this way. of the energetic processes of the body. An individual’s The body speaks to me about their history, energy is expressed psychologically in thoughts, beliefs, their patterns of relating, their gifts and and (motivations for) behavior, and physically and strengths and innate potential, as well as physiologically in form, structure, and movement. The self of their primary defenses and repetitive comprises both, as well as the psychological unconscious limiting life-patterns, which will be and the autonomous physiology. Like two faces of a coin, important to challenge in therapy. The body each face may be radically different, and neither face is the gives me the direction of the work. Working whole coin. physically opens deeply held or denied To an experienced Bioenergeticist, the body is feelings which, when integrated, expand an expression of a person’s self. Unlike the mind’s the individuals awareness of who they really rational verbal exchange, the body does not lie to the are. The body tells the truth without all the knowledgeable, aware therapist. All of us in the developed embellishments and smoke screens that the world, to varying degrees, have been restricted in fully ego mind at times constructs. expressing our feelings and our selves. To a point, this is Body work offers me a way to open necessary for social cohesion. But when our feelings and the door to new or different energetic and the expression of those feelings are rejected, suppressed, emotional experiences. They happen right humiliated, threatened or denied, especially in childhood, there in session. We aren’t figuring out what the energy of those feelings becomes “frozen” into they feel or what they should do about this structure, subsequently restricting the motility of our or that. The feelings emerge from within bodies. the body and are felt right there. It is very This frozen structure and the quality of expression: the immediate and very powerful when clients inability to express, or inappropriateness of expression, are experience themselves having feelings the elements used in Bioenergetic Analysis diagnostically they didn’t know they had or were able to and directly in treatment, hugely leveraging the value of tolerate and having them freely and honestly. verbal communications in uncovering and integrating I engage the person physically to effect a trauma, and relieving the conflict between conscious and transformation that occurs on every level unconscious energies. of being—psychologically, energetically, In addition to improving integration of conscious and emotionally, mentally and spiritually. It is a unconscious, and mind and body, body work enhances powerfully healing expansion. physical and physiological health. Indispensable survival guide for the thinking psychotherapist 17
  • 18. Features Every body needs some body NT: What, in your opinion, can we not access through verbal communication? Frederic Lowen: In Bioenergetic Analysis, or body-psychotherapy, direct body work improves the effectiveness of time in therapy. Theoretically, all traumatic material is available verbally. Practically, for reasons discussed above, direct body work is a reliable means to by-pass the “monkey mind” of consciousness, and access the unconscious and autonomic systems directly. Motivated by unconscious desires to maintain homeostasis, with effects of transference and counter- transference, willful verbal exchange often thwarts the therapeutic process. Even in seemingly successful cases, the patient’s conscious mind can feint progress, or offer false leads to protect the fearful self from painful realities and truths associated with the trauma the therapist is attempting to uncover or evoke. In contrast, the body does not lie. Bioenergetic Analysis normally begins with simple exercises and stress positions designed to increase a client’s energy level, and highlight the distortions and blockages of energy flow, evidenced by chronic tension and muscular tightness. Most usually, these tensions have been held so long, they are outside of conscious awareness; that is, they are unfelt. The exercise and stress positions make the areas of chronic tension apparent to both therapist and, more importantly, to the client. Restricted or disturbed breathing patterns, lack of alignment or balance, collapsed or inflated chests, weak legs and feet, poor ground contact, skin tone, muscle tonicity, facial masking, eye contact, voice expression, arms and hands, rigidity of pelvic movements, tightness of belly, are some of the common indicators of unresolved trauma, and the fears and constraints the individual lives with. Together with the verbal history and the client’s perceptions and awareness of his issues (to the extent he can articulate them), the body evaluation guides and confirms or refutes the therapist’s lines of inquiry. For the client, the bodywork enhances energy by improved breathing, and re-connecting to the natural energy flow in the body as tensions are perceived in a new way. Increasing energy to the client’s homeostatic state brings emotional material and related memories in the unconscious up towards, and into consciousness. For the therapist who is unaware of this dynamic, the client may engage in increased “acting-out,” or other patterned behavior with renewed energy and vigor. However, for a Bioenergetics therapist, it is an opportunity to focus the client’s higher energetic state on these issues, and accelerate the appearance of repressed or suppressed traumatic material. Upon release of the tension and trauma, integration is necessary. Verbally, and consciously, the client gains intellectual understanding of his story. The client’s ability to relate his traumatic experiences, feelings, and memories to how his body felt and responded to the trauma allows integration into the body and the unconscious, thereby eliminating the associated psychic conflict and enabling better alignment of 1) unconscious motivations with conscious desires; 2) the client’s self-image with the reality of his body/self. 18 New Therapist September/October 2012
  • 19. Features Every body needs some body Jack Lee Rosenburg: Lisa Loustaunau: We cannot access the deeper holding We cannot access verbally what the unconscious intends to patterns of the body/mind. IBP breath disown. work is used to change the balance In body psychotherapy we see the unconscious not as between the sympathetic and the a vague psychological sphere but as located in areas of the parasympathetic nervous systems, body where energy is being managed or blocked. In Core allowing a sense of wellbeing to unfold Energetics we see energy and consciousness as unified, so if in the client's body/mind. There are you repress energy you repress consciousness. certain emotions that cannot be known If you block pain, you block pleasure. by the mind alone: such as love, trust, How this happens in the body is through the formation of erotic sexuality. what is known as armoring, set patterns of muscular holding. We cannot access holding patterns A tight jaw prevents us from crying or expressing our anger, stored in the body without some form vacant eyes caused by chronic tension in the intra-ocular of manipulation of the body. Therefore muscles protects us from the intimacy of contact. These are we must use a number of techniques for some examples of how our unique pattern of armor serves working using minimal physical contact to protect us from particular feelings or experience. Armor and yet still opening or releasing fixed (often called blocks) develops as a process over time as a muscular patterns held throughout the result of repetitive significant experiences during critical clients’ body. formational periods in early life that the psyche was not able Verbal communication alone does to handle. Better said, the armor in the body is the way the not access early, emotional, relational psyche handled the developmental frustrations. limbic memory upon which our What is significant is that the same armoring which foundation is built. And yet, it is vital to originally served an adaptive purpose—protecting us from get to the roots of holding patterns for knowing and feeling what would have been too painful to healing. Also, when the body is tight, fully experience at the time—keeps us living and acting as particularly in the chest, it shuts down if those early realities continue, and thus we find ourselves access to the energetic feeling of love, repeating certain patterns over and over. These patterns causing love to remain a less satisfying contain what in Core Energetics we call an “image,” a fixed mental construct or idea. This is a belief. particular problem between parents and Let me give you an example of an “image.” Someone their children. who was deeply frustrated around needs may develop an Simply talking doesn’t reopen the image that goes “if I allow myself to need then I will be body to core self agency functions. disappointed, if I don’t need then I can’t be disappointed.” Without this opening clients remain In this case closing off consciousness of real needs would disassociated from core experience become the solution to the frustration. This may never have and just learn more effective coping been formulated as a distinct thought, the wound having strategies rather than accessing their been experienced before this thinking was possible. It would authenticity. Most profoundly, the however be revealed in the body. You can see it in a sunken awakening of the body allows the chest that takes in little breath, (refusing the energy and emotional heart to feel and connect with sustenance), and in de-energized arms that have difficulty others. It also allows access to deeper reaching out toward what is wanted or needed. The body wisdom. If we remain in our heads having formed itself in such a way as to literally close itself talking, life remains flat. Awakening the off from needing too much by a contraction of the receptive energy of the body brings deeper, truer centers in the front of the body. emotions, essence of being and meaning. The experience of embodiment, the way a person feels Emotions available without grounding and breathes and inhabits their body, needs to be changed in the body are usually re-enactments in order to really transform a life issue. It is impossible to of old archaic emotional injuries and are challenge the physical component of the defense with words impervious to change. alone. Indispensable survival guide for the thinking psychotherapist 19
  • 20. Features Every body needs some body NT: To what extent to you use touch in your work with clients and how do you implement it? Frederic Lowen: Touch is not necessary for Bioenergetic work. However, the use of touch can improve effectiveness materially. In the Bioenergetic work I do, I use touch cautiously and with consent. I most commonly apply pressure on the client’s chest with my hands, while using the Bioenergetic Breathing Stool*. This helps a client deepen their breathing and experience a rigidity of the chest and constriction of their breathing they were not fully aware of. I will also manually adjust a person into specific exercises and stress positions. Occasionally, the application of pressure with hands or fingers to the musculature of the jaw or the neck, in conjunction with vocal expression, helps tire the muscles. It is necessary to stress and tire musculature to reduce it’s ability to retain its tension, thereby allowing the streaming flow of energy, which is evidenced by visible tremoring, or vibration. Many Bioenergetic therapists use these and other techniques of touch. Examples include deep tissue massage, Rolfing, or other massage; tender contact through a timely hug can be hugely effective; providing support through contact with the client’s back as he faces his issues (“got your back!”) can be a new experience for those who lacked that support; and the common issues people have with boundaries can be made real using their arms and hands to define their space and gently challenging them physically to both defend their space and to contain and maintain their own energy within their space. In group work, participants often pair up for various forms of physical interaction. One of the important aspects of such activity is to encourage people to explore and recall the childhood pleasure and fun of physical interactivity and games. * The Bioenergetic Breathing Stool is a 24” (60 cm) high kitchen stool, with a rolled up blanket, on which the client rests his back, keeping feet flat on the floor, allowing the stool to take the full weight of the person. This is simply a more extreme position that one takes when stretching across the back of a chair while sitting. Lisa Loustaunau: I use touch every day, though not with everyone and never gratuitously. There are of course many kinds and uses of touch. I might use touch to direct the breath, to bring awareness to a part of the body, or to support the release of energy and feelings from a tightly defended area. Touching generally “charges,” adds energy to, the area being touched. A client that has an area of the body that is energetically “undercharged,” lacking energy, indicates that feelings are being avoided there. Adding energy through touch will focus the clients awareness and make it more possible for them to make contact with feelings in that area. A different use of touch would be adding pressure to an area of the body that is “overcharged,” meaning too much energy is held and over-contained thereby creating a block which prevents the flow of energy into another part of the body. This condition distorts sensation and perception in the location of the block and prevents awareness of feelings in the area that the block is protecting. Using touch, such as squeezing or pressing, would increase charge in that part of the body to encourage a movement of energy into another area of the body that is being defended. In this way the client can become conscious of split-off feelings. Some clients who were not touched enough during early development have difficulty regulating their nervous system. Touch is very important for them until they are able to self-regulate and self-nurture. For others touch is difficult to tolerate, painful or invasive, so it is essential to explore touch as part of session work.Touch is our most primitive form of communication and how we receive it speaks volumes to our early holding environment. 20 New Therapist September/October 2012
  • 21. Features Every body needs some body Jack Lee Rosenburg: NT: Do you think that the real value of body work is in diagnosis, in treatment, or in both? We use limited touch. The more the therapist touches the client during a body session, the greater the possibility Lisa Loustaunau: to set up a possible problem, particularly The value is in both. We have already established that diagnostically the a dysfunctional body imparts a wealth of information about our history, how primary or misunderstood needs were handled during developmental stages, patterns of relating, transference relationship challenges, as well as character strengths and gifts.This is all discernible with the client. The by carefully observation or sensing of the body, not only its shape, but client can begin to feel how it moves, how energy flows, posture, where energy is blocked etc. dependent on the therapist All these blocks affect our vitality, our emotional and physical well- for functions the client being and our ability to love. needs to develop such as The same blocks that were created as an attempt to avoid pain also wellbeing and problem diminish our pleasure and our life force. Every block is essentially a NO solving. The client can feel to life. inundated and/or touched For me the goal of treatment is to support the client to reconnect inappropriately, especially with the fullness of their energy so they can walk in the world as they if the client has been really are. Working through the blocks that keep us limited or stuck abused. requires energy—at least as much as it took to create them. I believe the Yet, touch is very best way to mobilize and harness energy for this transformative process important for the is by working with the body. Clients that have done a lot of work on wellbeing of human themselves are often struck by the power and directness of this work. It beings. Sometimes we takes more than just thought, or observation, or mindfulness to change hold a patient’s hand to the way we inhabit ourselves and walk in the world. Core Energetics help the client not feel is a very powerful process, physically, emotionally and spiritually. Dr. alone. If touch feels like John Pierrakos, founder of Core Energetics, who is now deceased, too much for the client we always said that all our blocks and defenses were blocks to the heart. may use a strap or rope For me the real value of body work is that it opens our hearts. held both by the therapist and client. This can also be helpful to help a client make contact and remain present. We teach self- release techniques rather Jack Lee Rosenburg: than touch so clients will feel self empowered. You must have an accurate diagnosis in order to have a competent We often hold the treatment plan. Both are needed. clients wrist pulse. This When a clients sits and talks with us, they tend to talk about rather is a very sensitive process. superficial issues, such as “he said . . or she did . . .” And they have little It places the therapist in deep insight. If we awaken and open the body, whatever memories, contact with the very soul thoughts, sensations, emotions, images that are most relevant to work of the client and the client on inevitably come to the surface. The depth of insight that becomes feels equally touched, available along with the corrective experience of the therapist/witness known and connected. leads to both a more genuine diagnosis that can be understood and worked with. With this opened awakening the results of treatment become embodied more reliably than with talk therapy alone. Indispensable survival guide for the thinking psychotherapist 21
  • 22. Features Every body needs some body NT: Do you think that the real value of body work is in diagnosis, in treatment, or in both? Frederic Lowen: In Bioenergetics, the value of body work is not only in diagnosis and treatment, but also as proof of therapeutic progress. In childhood, we are all subjected to the feelings, behaviors and words of our parents, both rational and irrational. As discussed above, when children’s feelings and expressions of feelings are suppressed, humiliated, threatened or denied, the energy of those feelings becomes “frozen” into the body structure in the form of contracted musculature. Just as an experienced woodsman can tell much of a tree’s history from the annual rings, an experienced Bioenergeticist can sense, see, hear, and feel a client’s energy “economy;” that is, their energy level and how they manage their energy: whether it is held, out-of control, totally controlled, split, or scattered. Additionally, the structure and form of the body is always telling. The alignment, posture and shape of one’s body speak volumes. A mis-alignment in legs, torso or neck and head, where one part of the body does not appear to match the rest of the body, may indicate a psychic conflict or a split in personality. The posture tells much of the quality of an individual’s contact with the ground, which mirrors one’s contact and connection with their environment, social and natural. It can also indicate the burden one carries, or the lack of maternal fulfillment, or the quality of one’s relationship with one’s father. In conjunction with the shape of the body, an attitude of superiority may be discerned, as the body exhibits a person who is “stuck” up, cutting themselves off from the fullness of life. Similarly, the facial mask many wear, a mask and pose adopted to protect the child from the anger or humiliation by a parent, becomes structured into the face as the automatic smile; or an irrational situation may create the knitted brow and angry countenance of a confused individual; or the jaw is thrust forward and rigidly held in defiance and determination; etc, etc, etc. Most basically, breathing is one of life’s most important functions. It is the autonomic function we have the most conscious control over, so it is a common starting point for both diagnosis and treatment. The fear and anger we have all experienced growing up, and the socialization of individuals within developed countries, has created widespread breathing disorders. Commonly these are not problematic, or even recognized until advanced age. However, they can be seen by a Bioenergeticist. Whether standing at ease, or in a Bioenergetic stress position, the quality and freedom of chest and abdominal movement in breathing tells us something of the fears, the energy, the spontaneity and the history of the person. Just as the inability to express feelings has been structured in the body, so too can those feelings be accessed by direct body work in treatment. Of course these feelings and memories need to be subsequently integrated into the personality. Body work focused on grounding, boundaries, and energy/feeling containment, enables deep integration in mind and body, thus completing the therapeutic process more effectively than verbal therapy alone. Finally, positive therapeutic progress can be visibly seen in a person’s body in changes in shape, form, demeanor, and enhanced aliveness. 22 New Therapist September/October 2012