Maybe it's just me, but I think the tradition of Body Psychotherapy is coming of age (1). Having practised within this tradition, I don't think I am alone in having run into certain recurrent difficulties which made me look for help in other approaches and models. This also involved taking on board some of the common criticisms levelled against body psychotherapy, usually from analytical perspectives. Having taken in and learnt a lot, I feel ready now to respond to some of the common preconceptions about body psychotherapy and to give something back to the rest of the field.
I have come to the conclusion that body psychotherapy is criticised for some 'right' reasons based on 'wrong' assumptions, and it is defended for the 'wrong' reasons based on some 'right' assumptions. Let me explain ...
"You are your energy. Your body is your energy. ... The unfolding of your biological process is you ... as body. Your body is an energetic process, going by your name. It's a concept of rich promise. It delights me to say that I am my body, with deep understanding of what that means, as I experience my bio-electrical currents. It gives me identity with my aliveness, without any need to split myself, body and mind. I see all my process - thinking, feeling, acting, imaging - as part of my biological reality, rooted in the universe." (2)
Keleman's statement transcends one of the pillars of 2000 years of patriarchal fantasy: the 'body/mind split'. I can't imagine a Western person coming to therapy without this being at least a background issue. Whatever symptoms, conflicts, pain a client is struggling with, in our culture there is always a question to what extent a person's identity is suffering from a lack of rootedness in physical, bodily reality. Often the presenting problem is a very immediate opposition between their organismic, biological process and what the client considers to be their identity. That was Reich's intuition, and it has inspired several generations of body psychotherapists.
When people come to Chiron to train in this tradition, they typically have two ideas of what they want to learn. These reflect two stereotypical images for how the body can be used in therapy:
to provoke catharsis at a primal level by breaking through resistance ('armour')
to undercut the pseudo-autonomy of the social facade by nurturing the pre-verbal self
People are attracted to these ways of using the body because they bring an intuitive understanding of the 'body/mind split'. Let me admit that in oversimplified fashion this term can serve to cover a multitude of sins and is in need of clearer definition. But for now let me stick with the simple popular version: it's a condition in which I am sufficiently disconnected from my identity in the body that with Descartes I can say: "I think, therefore I am". This statement only makes sense if I have already lost Keleman's "identity with my aliveness" as a primary given of existence. I am then sufficiently identified against my body so that my disconnected mental identity can operate on my body as a separate object rather than as 'me'.
The 'body' is then treated like a car - it may still represent 'me' in terms of social prestige as a status symbol and it may get polished and maintained like a car for these same purposes. But that makes its status as an object all the more evident: it's precisely the body's symbolic significance in our culture which betrays our fundamental separateness from it.
So far, so good. Let's see what can happen when a therapist uses that understanding by applying one of the two stereotypical manoeuvres of body therapy.
Take a brief example from a session:
A client says: I felt really angry about how they treated me at work.
Th.: Well, you don't have to put up with that kind of treatment.
Cl.: (compliant gesture towards th.): Do you really think so ?
Th.: Well, you said you felt angry.
Cl.: I did. You have been telling me for a long time that I am angry but now I'm beginning to feel it. I did feel angry yesterday.
Th. (reassuringly): Just allow yourself to feel that.
Cl.: But I feel I could hurt somebody.
Th. (reassuringly): Don't worry - for once it is safe to be angry.
Cl.: It doesn't feel safe.
Th.: Nevermind - what do your hands want to do - yes, go with your hands!
Cl.: They are shaking. I don't want them to shake like that.
Th.: What would happen if you just let them ? Yes, now take a few deep breaths. Can you feel your anger now?
The client's body and mind are clearly in opposition. The therapist perceives the body/mind split, and has 'decided' that the client's anger is 'healthy' and needs to be expressed (and in principle I might well concur with her perception).
But the therapist's belief in the 'truth' of her agenda for the client outweighs awareness of the shadow aspects of her role: whilst working to liberate the client from her compliance at work, the therapist can paradoxically rely on it to back up her implicit authoritative stance, which is that of a well-meaning doctor/expert/parent figure ("I know what's best for you - in the interest of your growth and your therapeutic process I am telling you what to do: express your anger!"). From that position the therapist consistently overrides the client's reluctance - she keeps invalidating the client's hesitant ego-statements (in italics). At this stage of the process the client is sufficiently desperate to go along with the therapist's 'superior judgment'. Later on, however, the working alliance will increasingly become fraught as the therapist needs to raise the stakes to get the client to comply with her in siding with the body against her own ego. In this way it is perfectly possible for a strongly anti-authoritarian therapist to enact the disempowering aspects of the medical model whilst apparently fighting against disempowerment.
The danger is that the implicit splitting ("whilst obviously it's not safe to be angry at work, I am making it safe for you to be angry here!") - which the therapist sets up or at least plays along with - will lead the client to exchange one area of compliance (work) for another one (therapy), without the conflict between anger and compliance really being experienced, let alone resolved. On the contrary: the client's internal conflict (between her resistance and her compliance, on a deeper level between her anger and her fear) is now neatly distributed and being enacted between client and therapist. With the therapist making herself an ally to the unexpressed anger, she takes it over and carries it for the client, thereby actually relieving the client from internal pressure which might bring the conflict to crisis and possible transformation.
Far from healing the client's body/mind split, in this process it actually acquires a further contortion - the client's ego trying to comply with the therapist in performing an expression of anger which another part of her is still afraid of and trying to resist - all the while continuing to suffer from a backlog of 'real' unexpressed anger which continues to be turned against herself.
Whilst subjectively feeling truly supportive of the client, and personally and empathically involved, the therapist maintains her role throughout. In this rather mild example the therapist apparently is not affected by the client's anger, is not aware of her implicit contempt for the client's fear and 'resistance', never questions her agenda, does not attend to the here-and-now relationship, has no conception of transference or countertransference and follows rather blindly the precepts of an ideology. She's a body therapist, but the only things I am happy to go along with are some of her perceptions of the client and some of her theoretical values and assumptions.
I would like to extract from this example some general points:
In traditional body therapy the therapist takes the side of the body against the mind; this tends to be a 'habitual position' for the therapist, rooted in their own life story physically, emotionally and mentally (e.g. philosophically, politically, ...).
This habitual position implies a simplistic notion of the 'body/mind split': innocent, pure, 'noble savage' body = good versus civilised, contorted, life-denying mind = bad. Although 'true' in some ways, this clearly is a split way of thinking about the split: not surprising, but also not very useful.
The therapist here assumes that the neurotic rationalisations which the client's ego uses to minimise feelings, spontaneity and aliveness generally have outlived their usefulness and are basically excuses for hanging onto self-sabotaging patterns. These patterns may have served a protective purpose earlier on in life, but according to this therapist (and she is not alone) therapy requires the client to make existential choices to overcome the resistance and negativity. In particular, she assumes that surrender to feelings is the 'healthy' option.
These kinds of assumptions inform the therapist who sooner or later tends to become the enemy of the client's ego (and as the client's ego is involved in the working alliance, this is a losing battle and always puts the therapist into a fraught position - after all the working alliance significantly includes the little detail of paying for therapy). Incidentally, this is not at all reserved for body therapists. Yalom, for example (in "Love's Executioner"), evocatively describes the therapist's impotent and frantic attempts vis-a-vis a fiercely trapped ego. The client inevitably and quite accurately experiences this attack on the habitual ego-position as a threat to her/his known identity, as if the therapist wanted to strip the client of his/her only protection necessary for survival.
The therapist's bias towards the body, therefore, constellates regressive fears of the body. The fear is that without the willpower of the ego directing and managing life, I will lose control, the body will take over and leave me with chaos and disintegration. These regressive fears, in turn, constellate the wish for an omnipotent figure who is in control of the uncontrollable: a body expert, a magician-physician, an all-powerful doctor who can guide and direct the healing process with some measure of predictability - someone who can guarantee that the body won't become too painful or overwhelming. In psychotherapy the longing for the apparent certainty of the medical model is both an expression of and a defence against the wish for perfectly attuned mothering.
In order to reassure the client (and themselves) in these regressive fears, the body therapist paradoxically tends to take a therapeutic stance in line with the medical model (3). Whilst fighting against the dominance of the mind over the body the therapist takes refuge in a stance which enforces that dominance. By working against the body/mind split, the therapist ends up perpetuating it - this is the enactment of the split seen in body therapy's own terms.
Typically the therapist's medical model stance constitutes an avoidance of the client's inner reality of pain and conflict (where s/he doesn't feel there is choice, but feels at the mercy of apparently uncontainable distress). The therapist's avoidance inevitably resonates deeply with the client's history of early parenting, and tends to enact it. Working as a supervisor has led me to the general conclusion that it is impossible to pursue a 'therapeutic' agenda of breaking through or undercutting the ego's resistance without enacting in the transference the person whom the resistance first developed against - this is the enactment seen in psychodynamic and developmental terms. Because the therapist-client interaction repeats an early conflicted and unresolved experience, I am inclined to use the term '(re-)enactment'.
Earlier, I deliberately employed the phrase 'how the body can be used in therapy', because that's what we're accustomed to in the West: 'using' the body as an object. And that's where I see the downfall of body therapy: in its fight against the body/mind split, body therapy is liable to objectify the body every bit as strongly as it is objectified already. In simple terms: to counter the cultural objectification of the body as a 'bad object', I can objectify the body through imposing a fantasy of a 'good object' on it. Although it flies in the face of Keleman's statement, that's what I and a lot of body therapists in the past have been liable to do: 'using' the client's body to achieve our cherished pre-conceived 'therapeutic outcome'. The irony is that this is precisely what the client is probably already suffering from: a body which is not experienced as "I", but as "it".
In summary: if the essence of the body/mind split is objectification, and our therapeutic stance in relation to the split is based on fighting it in medical model fashion, we are caught in trying to counter objectification by more objectification (that's like putting out a fire by adding more fuel).
Having grown up in the Reichian tradition, I now see it as having spawned both an intuition of body/mind integration (as, for example, expressed in Keleman's quote) and some of the worst excesses of objectification within psychotherapy. For me, that's the beauty and the tragedy of Reich's contribution which I am hoping we may yet benefit from. As a person, therapist and teacher I am therefore struggling towards a way of being, working and thinking which addresses the split relationally, technically and theoretically.
As a therapist the split can manifest in my theory/philosophy, in my technique, in my therapeutic position - I take it as read that it is manifest in me. I also assume that in relating to my client's split, my own will become touched, constellated, involved. How I apprehend and respond to the split in me and the client, against the background of my habitual theoretical, technical and therapeutic position, will determine the extent to which the split can transform itself or will be perpetuated in therapy.
So far I have specifically focussed in a lot of detail on enactment of the split through body therapy. Let me now add some qualifications (see the longer version of this article for more on all of this):
- obviously it's not just body therapy which enacts the split - most other approaches are liable to do this implicitly, often without even noticing
- I have implied the 'body/mind split' as the crux of therapy - this is too simplistic unless we re-define the concept beyond how it is popularly used
- it is very difficult to engage with the split and think about it without taking sides, i.e. without splitting. Because we are all culturally steeped in the inescapable pain of it, if we engage with it at all, it is exceedingly difficult to maintain a real meta-position to the split.
Many people, including therapists, may try to ignore it, minimise it and accommodate themselves to the split. Body therapists tend to fall into the other extreme: the more I see it, experience it, face it, conceptualise it, the more I am liable to feel compelled to do something about it. But in that moment of compulsion I have already lost my therapeutic position and am caught in enactment. In the moment when a human response turns into a therapeutic agenda which I impose on the client, I'm no longer therapeutic, but am in the grip of the split.
This is the point in the training where students feel disappointed and hopeless, and want to give up. They want to give up being clients, and they don't even want to think about being therapists. Their fantasy of conquering what they have formulated as the root of the problem breaks down. Enactment reigns supreme and powerlessness in relation to it feels all-consuming. If I tangle with it at all, it'll possess me.
This is analogous to how Jungians think about the ego's relation to the unconscious: either the ego is in the grip of the unconscious or is rigidly defended against it, but rarely does the ego relate to it. It seems to me the same is true for the body. For many people the body is the road into the unconscious (usually it's more 'railroad' than 'royal' road because after body and unconscious have been ignored for a long time, the body usually drags us - kicking and screaming - into the unconscious through symptoms, pain and illness). Implicitly the body is either idealised or hated, but is not accorded a 'life of its own'. The frightening experience in both cases - psyche and body - is the recognition of the autonomy of what has been relegated to the shadow. The 'return of the repressed' threatens both the client's and the therapist's ego with its uncontrollable and transcendent quality.
This is a crunch point in the process, and to my mind it establishes the notion of (re-)enactment as a crucial one not only for body psychotherapy, but for both client and therapist in any approach. Although so far I have mainly used the notion of (re-)enactment in the context of the body/mind split, the concept itself has, of course, much wider relevance and could be applied within the terms, language and model of any approach.
To embrace the necessity of (re-)enacting as part of the process the very thing therapy is supposed to 'overcome' sounds manageable in the abstract, but is of course - over and over again - deeply painful for both client and therapist in the intricate emotional detail which is their particular relationship. For me, following Reich into attempting to conquer the root of neurosis in the body/mind split gives way to the generally useful recognition that as part of the therapeutic process the psychotherapist will fail.
For one I will certainly fail the client's initial construction of me as an omnipotent quasi-medical expert, but beyond that and worse: by empathising with the conflicted aspects of the client's psyche I will be drawn into taking sides, I will be split and experience my own splits by favouring certain aspects of the client's conflicted psyche over and against others which I will therefore fail.
Within a Western paradigm the client can't help but construct therapy as a heroic procedure towards overcoming, mastering, getting control of the uncontrollable: the unconscious, the body, nature, the past, the present, the future. But as our egos are at the mercy of the body and the inherited conflicts structured into it, the process itself will lead the ego ad absurdum, including the therapist's therapeutic ego. I therefore will have to fail the client's ego if I want to get anywhere near doing justice to the spontaneous wisdom of the client's body or the calling of their soul. My fantasy of therapy is no longer so much about healing as an active procedure - it's more about surviving the intensity of the splits (Hillman likes to use the word 'dismemberment') until spontaneous re-organisation and transformation occurs.
Gone is the cliche of the therapist's powerful role; the therapist is - and needs to be - 'contaminated' by the clients conflict / wound / problem. This catapults us out of the comfort of the medical model into a post-Newtonian participative universe where the observer is always already 'merged' with the observed, and especially with the pain, trappedness and conflict which the other cannot contain.
The conflicts between body and mind, spontaneous and reflective capacities, feminine and masculine, between mothering and fathering modes, between the medical model and a relational model, between colluding and objectifying are the foundation of therapy. For my ego to try and short-circuit these conflicts one way or the other destroys therapy. To nail therapy down to one or the other polarity kills it. This means as a therapist I will more or less continuously feel pulled between these polarities without being able to settle either way. The therapeutic position requires me to be in conflict.
The way I practice it, 'body psychotherapy' presents no gratifying shortcuts. It's not a tool or technique, although it may include these. For me, the main purpose of attending to the body in psychotherapy is to engage fully, with my and the client's whole being, in what the client brings from the beginning as an essentially painful and conflicted war zone. All the mental symptoms, all the addictions, compulsions, repetitive patterns and denials are rooted in conflict about spontaneous processes which the client's and the therapist's ego are essentially at the mercy of. It makes 'common sense' to 'fight' these symptoms, but that is perpetuating the war, precisely because by fighting and attempting to avoid the pain our egos exacerbate it.
This is no easy option for the therapist - it requires being able to 'sit in the soup' and being involved in suffering without either passively withdrawing or actively pushing and 'fixing'. The body with its physical, tangible sense of pain, discomfort, conflict, unbearableness can function as an anchor to hold us in the reality of the 'war' which the client so far always had to escape from. Spontaneous transformation (i.e. without the ego's defensive strategies, manoeuvres, behaviour modification and exhortation) is possible - it becomes more likely the more fully we can be in the 'war' and between us hold it in awareness as it gets enacted in the therapeutic relationship in all its very real agony and absurdity. To hold the war in awareness requires attention to its manifestation on the level of spontaneous processes, including vegetative functioning and the autonomic nervous system, in the here and now.
When we embrace a sense of pain and conflict for the therapist not as occasional 'leaks' of the client's material into the otherwise solid position of the therapist, but as the source and the foundation of the work, we are less attached to particular therapeutic models.
I am thinking of the various polarisations which the therapeutic endeavour is subject to whatever the approach, e.g. therapy as business versus therapy as love, the medical model treatment aspect versus the intersubjective relational aspect, archetypal mothering versus archetypal fathering, the debates regarding nature - nurture and interpersonal/social versus intrapsychic/individual. The history of psychotherapy is rife with the opposing claims of the various schools - claims which often are philosophically irreconcilable. These conflicts are, of course, the reflection on a theoretical level of precisely the same kind of internal conflict which brings our clients to us. To do this justice, I think we need to formulate psychotherapy, and especially attempts at integration, from a secure rootedness in conflict.
Without this, 'integration' easily becomes another attractive sound-bite covering an eclectic hodgepodge or a one-sided take-over bid by particular approaches. But that's another article.