A Response to Maggie Turp's Case Presentation from a Body Psychotherapy perspective

 by Michael Soth

This article was written for the for the European Journal for Counselling, Psychotherapy and Health, in response to a case presentation by Maggie Turp (who identifies as a post-modern psychodynamic practitioner in the tradition of Winnicott, paying particular attention to the 'indwelling of the psyche in the soma'). Michael's article is an in-depth critique of this analytic case presentation both from an analytic AND an holistic point of view, and it establishes quite clearly the differences and what 'working with the body' relationally might mean. For a copy of the original paper as presented to CONFER and then written up for the European Journal for Counselling, Psychotherapy and Health, click here.


Whilst appreciating the quality of containment in Turp's work as a learning point for the Body Psychotherapy tradition, the author argues that Turp does not represent a psychotherapeutic way of 'working with the body'. This would require a deconstruction of the body/mind dualism inherent in much psychotherapeutic (and psychodynamic) theory, so that the complexity of the spontaneous and reflective body/mind processes, especially in their polar extremes (body/mind dissociation - body/mind integration / 'psyche/soma unity'), can be contained. An holistic body/mind formulation of countertransference is approached by which - rather than being used as a gratifying or cathartic therapeutic shortcut which avoids the intensity of the transference - the body can be seen to constitute an avenue into the full experience of the transference/countertransference process and its relational sources in early development.



What comes through to me in Turp's case presentation is the therapist's capacity for containment, her patient, 'faith'-ful hanging-on-in-there and sticking to the principles and rationale of her approach. She makes it transparent that this is not at all a passive waiting: the power of containment requires constant processing of the therapist's countertransference reactions. This is a strength in Turp's work, approach and theoretical background which Body Psychotherapists can learn from enormously.

The value and the necessity of containment is an aspect of therapeutic work which Body Psychotherapy has traditionally undervalued and has had to work long and hard to appreciate and incorporate. As a tradition, Body Psychotherapy has been fairly ignorant of the significance of containment in the dynamics of transformation and real body/mind integration. An habitual, not to say 'blinkered', bias towards catharsis for the sake of counteracting repression which it perceived as all-pervasive and overpowering, has meant that powerful techniques and experiential depth were seen as more significant than relational depth. I have written elsewhere how it is perfectly possible for Body Psychotherapy to exacerbate the very body/mind split which the approach is designed to 'combat' and overcome (Soth, 1997).

Turp's work is characterised by an explicit focus on containment, comprising at least three parallel and interdependent elements:

a) the client's disowned emotions and primitive states are eventually being contained by reflection (the 'Id' by the 'Ego'),

b) the patient is eventually more contained by the analyst (along the lines of Winnicott),

c) the projectively identified material is increasingly contained by the therapist (along the lines of Bion).

Some therapeutic approaches would be sensitive to the inherent disadvantages of this containing therapeutic presence: from a Gestalt perspective, for example, we might find plenty of evidence in the case presentation that there is not much 'contact' and 'meeting' going on between these "two frightened people in the room" (Bion), but clearly contact occurs on some other, deeper level and undoubtedly some important transformations take place, in the client's inner world, in her psyche-soma experience, in her self-image and in her relationship with others. This is what matters, and I would think by anybody's standards, this work therefore comes across as 'good-enough'. Personally, I do not mind at all which method, technique, stance, style or meta-psychology a therapist relies on and feels herself contained by, and I don't suppose this particular client cares much about this, either.

In my own work, I share Turp's reliance on developmental psychology and the parallels between early relationships and the client-therapist relationship (including her reflections on the early Oedipal issues, her attention to projective identification and containment), on constant reflection on the transference/countertransference dynamic, and her appreciation of the interdependence of physical, emotional and mental/symbolic processes, in both client and therapist.

All of these strengths are sustained by an underlying openness, curiosity and commitment to the relationship, a willingness to be emotionally involved and affected, to risk and share. This is as much as we can expect from each other as colleagues.

However, for the purposes of a deeper understanding and learning from each other (and possibly occasional integration between the various schools), some differentiating and even polarising comments may be useful. Each approach and school has its particular sensitivities and areas of expertise, and also its unused, neglected shadow territory of undifferentiated perception. My comments emerge from a particular brand of Integrative Body Psychotherapy, as developed over the last 15 years, which can not claim to be representative of this tradition, but it constitutes an influential part of it.

From this perspective, I am sensitive to some assumptions which Turp seems to make about Body Psychotherapy, about the body/mind relationship and about an holistic view of the therapeutic process, which I want to clarify and to some extent dispel. I perceive what appear to me as some disturbing inconsistencies, inherent contradictions and over-simplifications in her presentation, especially between her philosophical avowal of 'body/mind unity' and the apparent implications of her theory, technique and therapeutic stance.

Working with the body - what does that mean ?

Turp's opening statement evidences a profound misunderstanding of what modern Body Psychotherapy means by 'body/mind unity' and 'working with the body'. She says: "My own view is that it is impossible not to work with the body." As I will try to show later, from my perspective Turp does not - especially at crucial junctures in the relationship - work with the client's or her own body, but consistently against it.

The notion of 'working with the body' only makes sense in the context of a comprehensive and radical understanding of the extent to which many of us, clients and therapists, are trapped in a chronic habit of working against the body. Body Psychotherapy has called this, somewhat inaccurately, 'body/mind split', Ken Wilber (1992) talks about it as the 'European Split'. This is an epistemological minefield, but in simple terms, experientially, we are talking about body and mind being split and at war with each other through opposing and fragmented impulses, forces and feelings, manifesting in a spectrum of symptoms from dissociation through disconnection to repression.

Turp is well aware of this in her client, as several examples illustrate: "Although the words themselves are angry, I see that her eyes are full of tears." Clearly Turp has a notion of the body/mind experienced subjectively as a battlefield of dissociated fragments rather than a 'body/mind unity': "For Tracey, the physical sensation of sexual intercourse is entirely split off from her sense of herself as a person ...."

And the basic objective of her work is precisely in recognition of how split body and mind are in the subjective experience of her client in her most painful emotional spaces: "...the practitioner models thoughtfulness for the client in the face of experiences that are disconcerting, difficult or puzzling." "When little else seems possible, I endeavour to think about what is happening and to sustain and communicate the idea that thinking is possible, even in the most difficult of situations."

Turp apparently has an axiomatic and arguably dogmatic response to the intense disconnection in her client, nothing short of an educative paradigm. This flies in the face of her concluding statement, which I profoundly agree with: "There always exists, of course, a temptation to abandon a psychoanalytic stance and engage instead in an educational endeavour or some other plan of action. To the extent that we do so, we unwittingly collude with the client's re-staging of his or her early experience of a poor containment, with potentially catastrophic consequences." She then spells out her bottom line, her 'credo': "We need above all to hold on to our raison d'etre, which resides above all in our capacity for reflection, containment and continuing thoughtfulness (italics mine)."

This assumption is, indeed, taken-for-granted and never questioned. I have several responses to this 'credo':

a) for a start it is questionable in terms of socio-political issues of diversity, as it has a strong flavour of a possibly undigested middleclass bias by which educated and civilised psychotherapists educate the impulsive and primitive working classes about how to tame and socialise their raw and unrefined manners; I do not feel that this is really where Turp is coming from, but have some feeling about this, nevertheless, which inclines me towards mentioning it. But as I consider 'political correctness' one of the last things which is going to support the practice of psychotherapy, I am not going to 'make a meal' out of this.

b) for the purposes of this discussion, and in terms of Turp's own declared orientation it matters more that this 'credo' undermines fundamentally an holistic conception of 'body/mind unity' as I understand it, and in a later section on 'meta-psychological differences' I will try to expand on this.

c) but even more importantly (and well from within Turp's own paradigm), when I try to understand the relational function her 'credo' seems to acquire between her and her client ("when little else seems possible"), it appears to undermine the basic analytic principle of allowing herself to be constructed as a particular object by the client's unconscious. It rather functions as a habitual counterresistance (Strean, 1993) against really entering or working with the client's subjective reality in the 'here and now'. When it 'comes to the crunch', this credo serves - in spite of Turp's emotional involvement - to indeed keep her "above all".

Ironically, therefore, I find frequent points in the case presentation where I do not consider Turp's reflections to be 'analytic enough': she is aware of - as well as clear and explicit about - the emotional aspect of her countertransference reactions ("I find being with Tracey an enormous strain"; "I frequently feel threatened, usually verbally but sometimes physically as well"; "being kept at bay and as weak and useless"), but never really questions whose is the swearing, the "grating coarseness", and the "seething fury, reluctantly held in check for fear of its potential consequences", nor what position in Tracey's early scenario is enacted by her own stance of maintaining 'thoughtfulness'. She never gets alerted to the possibility that the essence of what she considers to be therapeutic with this client (according to the 'credo') is in itself an instance of projective identification. This is where especially the somatic countertransference reactions she mentions might provide precious information about what early relationship dynamic is constellated, and which object she is being constructed as in her clinging onto 'thinking' for survival.

Although Turp announces "I believe it to be impossible to avoid being physically affected by the close presence of another human being for fifty minutes at a time, week upon week", which I wholeheartedly agree with, and then goes on to say "Since it is part of our work to reflect on what goes on in the consulting room, it is also impossible to imagine that we would not reflect on the physical aspects of our experience", in my view the spontaneous physical processes and symptoms which are all too present for the therapist's liking never get probed and reflected upon deeply enough to push through to their relational significance and their source in early object relations.

To illustrate, she says: "I suffer various kinds of physical malaise that thankfully disappear within an hour or so of Tracey's departure. These include vicious headaches and, strangely, attacks of 'pins and needles' in my arms and legs." She then continues: "my understanding of these physical states is that they are probably connected to how Tracey has herself felt in the past (italics mine)." The fact that Turp does not investigate these somatic symptoms more for their relational and developmental origins, but only vaguely and abstractly speculates about them, confirms my impression that she does not, as she declares, work with the body, hers or the client's. It is precisely her 'thoughtful' stance in opposition to the symptomatically raw expressions of the body which deprives her here of awareness and information about the early dynamic she is being drawn into via projective identification.

I will try to expand on this point in more general terms in a later section where I contrast the currently fashionable notion of 'somatic countertransference' with an holistic understanding of countertransference.

However, one theoretical implication of my responses outlined above may be worth noting at this stage: as arguably there are some dynamics in the relationship which are not being contained (including, significantly, the polarisation between raw affect and thoughtfulness), from an holistic perspective 'containment' needs to be a more complex and paradoxical process than Turp's formulation would suggest. To actually contain the 'whole' of the client's body/mind requires more than reflection, symbolisation and verbal translation of the all-too-obvious "raw and primitive emotions communicated primarily through non-verbal channels."

What do I mean by 'embodiment' and 'working with the body'?

I use the term 'embodiment' to refer to the subjective experience of the interdependent and mutually reciprocal relationship between physical and psychological processes which is at the root of the sense of self. It is a way of talking about the extent to which my subjective awareness of myself is rooted in the physical sensations, impulses, movements, processes which contribute towards generating my sense of identity in the first place.

This is similar to the Jungian conception of the relationship between conscious and unconscious along the ego-Self axis. To not imagine this relationship as mutual and reciprocal is seen - in Jungian terms - as a manifestation of pathology, i.e. for the ego not to acknowledge the autonomy of the psyche, but insist on a hierarchical, superior position is considered part of the problem which therapy needs to address. In a similar way, 'embodiment' and 'working with the body' become available only once we are not entirely trapped in dualistic, hierarchical fantasies of the body/mind relationship.

Damasio's theories (1994) are now well-known for de-constructing the hierarchical bias inherent in the Western conception of mind over matter, by claiming - as Body Psychotherapy has assumed all along, starting with Reich - that cognition and reflection are rooted in the body: our sense of self is based upon our second-to-second sensing of our body-self (that is, I believe, what Freud referred to when he said: "the ego is first and foremost a body-ego"). Self-image and identity arise out of a complex monitoring and translating of our biological-physical-energetic-emotional state moment-to-moment.

It is only when we have begun to address and question the 'European Split' in all its pervasive manifestations, including in most psychotherapeutic theory and meta-psychology, that we can begin to work with the body, rather than against it, or at least become aware of how our practice tends to perpetuate and exacerbate the 'split' in ourselves and our clients.

What becomes available then - again similar to Jungian ideas: once the autonomy of the body is accepted - is a faith in the inherent wisdom of spontaneous processes, in what complexity theory calls the 'emergent process'. To balance Turp's one-sided 'credo', we would have to add that even in the most pathological body/mind situations (even with the body used, abused, repressed, split-off), physical processes - if only we can learn to trust and follow them - retain some inherent wisdom and functionality as part of the whole body/mind. Even the disowned, self-harming, un-reflected, raw and apparently 'blind' "primitive emotions communicated primarily through non-verbal channels" contain a self-organising impulse towards Turp's 'body/mind unity'. In order to meet the client where they are - one of the key principles of any approach that sees the dangers of an "educative endeavour" - we need to also meet the body as it is spontaneously experienced. If that happens to be the 'objectified' body, our faith in that self-organising principle is all the more important. This does not mean that we blindly follow or even impose a 'cathartic credo', as Body Psychotherapy traditionally has done, but that we work with the individual, subjective body/mind conflict by holding both the physical and 'mental' polarities of the client's experience, rather than constructing them as hierarchical and seeing the 'mind' as the 'solution'.

From this perspective I can not agree at all that "we are all embodied - practitioner and client alike," if by embodiment we refer to the subjective experience of the body as 'me' rather than the fact that I 'have' a body. This objectification of the body, and the sense of the body as an object which I 'have', which at best represents me, at worst I am trapped in, is part of the problem, as Turp is only too aware with her particular client. 'Embodiment' is not a useful term if we use it to refer to the mere fact of our physical, 'objective' existence. The way the term is used in the Reichian tradition implies the body experienced as subject, rather close in meaning to Winnicott's "indwelling of the psyche in the soma". (which Turp herself has so eloquently written about (2001).

It follows that we are all embodied to degrees, and that our sense of embodiment fluctuates, paralleling psychological process in its ebbs and tides. This is the aspect in which client and therapist are alike. Because of the parallel between physical and psychological processes, the fluctuating sense of embodiment carries relational significance. My own sense of embodiment in a session is a crucial aspect of my countertransference, and monitoring my body/mind and its moment-to-moment state of integration or dis-integration gives crucial clues about the emerging unconscious themes in the relationship.

In the abstract, Turp is well aware of this when she states: "the therapist's use of his or her body as a sensing device and a barometer of change has probably always been a part of psychotherapeutic practice." However, the only instance of this in her presentation which follows this statement is her relief when her own physical symptoms lessen. I find her reading of this as progress only partially acceptable: "I find it therapeutically significant therefore (as well as a personal relief) when my symptoms began to abate during the second year of our meetings."

Criticism of the work from a Body Psychotherapy perspective

Without the sense of these symptoms being entered, met, followed and then possibly transforming themselves, there can be no real understanding or containment of them.

It never occurs to Turp to meet the client where she is and to communicate back "primarily through non-verbal channels". Her own theoretical position implies, of course, that inevitably she is communicating back non-verbally, she is just not aware of how, as she focusses her self-awareness on the 'thoughtfulness' of her responses and interventions. There is no faith that the body's 'unthinking' spontaneous reality - if followed AND contained - can 'organically' develop into reflective capacity. Therefore the assumption is that reflective insight has to be provided externally, by the therapist.

Evidently, the client does not respond well to interpretations which are "wiped away". Turp assumes that this is a resistance to the particular content of the interpretation, rather than to the technique of interpretation altogether. She therefore never actually questions her technique (as I have suggested above: as an enactment), carries on regardless and is then reduced to empathic mirroring on top of quietly suffering the projective identification with the client's powerlessness. In the face of this dynamic continued attempts at reflective questions and interpretive suggestions then do tend to acquire a coaxing, educative quality.

There is clear evidence of some interpretations eventually 'getting through', and that Turp's surviving does indeed get received and taken in as containment. But even these transformations are not outside an overall educative dynamic through which client and therapist enact and actually perpetuate the client's body-mind disconnection.

Essentially, Turp is without an holistic theoretical frame which would help her grasp the body/mind complexity of the mixed messages which are part and parcel of the projective identification process. She describes how the client is split off from and therefore feels attacked by her own rage and sadness, including the projective mechanism by which these feelings are disowned and then inevitably return. She also describes the confusion which arises when "enormous amounts of anger" are both expressed and simultaneously split off, denied and projected. She does not really wonder how this key characteristic in her client's communication is possible, how Tracey manages to simultaneously express aggression forcefully and remain entirely unaware of it in herself and of its impact on the other. Nor does Turp fully appreciate the disturbing effect this must necessarily have on her (and her body) in the countertransference. She leaves this conundrum at a descriptive level, and has thus no way of conceptualising this repetitive and painful dynamic as the manifestation of an internalised object relation, in which both relational poles are anchored and expressed simultaneously through different "non-verbal channels". Nor can she then work with and contain the enactment of that particular object relationship in the transference/countertransference.

The same dynamic keeps recurring when she talks about "body-to-body matters, finding expression in sequences of harsh words followed by silences, in action and gesture and in my feelings of foreboding, exhaustion and physical tension." Again, two relational polarities (a harsh, aggressive, attacking one and an intimidated, contracted one trying to hold herself together and survive) are clearly described, but not followed.

Meta-psychological differences

In summary then, my critical suggestion on a meta-psychological level is that the very 'body/mind unity' (or integration of the psyche-soma) which Turp claims to pursue is undermined by her consistent bias towards 'mental' reflection, towards containment of the 'body' by the 'mind'.

As long as we favour insight, mental representation, symbolisation as the 'royal road' to an emotionally 'healthy' state of affairs, the conceptualisation of the body/mind psyche/soma relationship in psychotherapeutic meta-psychology will continue to be rife with non-sensical distinctions, such as the question, for example, whether self-harm should be included under the psychosomatic umbrella. Many implicitly holistic assumptions which Body Psychotherapy has worked with for decades are now being confirmed by modern neuroscience which is coming to similar conclusions: neuro-psychoanalyst Allan Schore, for example, insists that the attempt to differentiate between physical and psychosomatic illness is "meaningless and misleading."

Turp's confusion is largely a function of an attempt at reconciling the notion of "body/mind unity" with an underlying dualism which is never sufficiently acknowledged, attended to or addressed. The result is a haphazard oscillating between contradictory and un-integrated paradigms which is confusing and liable to perpetuate the client's internal and internalised dichotomies. This oscillating does not do justice either to the depth of body/mind dis-integration which the client is suffering from nor to the ever-present potential and impulse for spontaneous body/mind integration. Neither the profound pain nor the inherent paradox at the heart of the body/mind psyche/soma relationship are then contained. The extremes of the body/mind relationship - traumatised dissociation or explosive/implosive repression on the one hand and differentiated body/mind integration (including 'blissful' and 'healthy' embodiment) on the other - can only be contained if we see them as related poles of an underlying paradoxical process. This is impossible as long as we philosophically re-confirm dualistic assumptions in our meta-psychology and stipulate either extreme as ontologically given: e.g. that the 'Ego' is a civilised necessity over and against a polymorphous-perverse 'Id' versus Perls' "lose your head and come to your senses"; the assumption that psychological health is a function of the 'mind' containing the 'body' via symbolisation versus a humanistic idealisation of the unlimited potential for 'body/mind unity').

The paradox is that as long as we fight and counteract the 'split', we perpetuate it. If, however, we can enter the 'European Split' fully, i.e. become aware of the conflictedness and fragmentation of our body/mind, it spontaneously re-organises itself into a more integrated shape. To work with an holistic understanding of body and mind, psychotherapists need to take a quantum leap similar to the physicists who - after decades of struggling to decide whether light was a wave or a particle - eventually managed to embrace the paradox of it being both. Similarly in regard to body and mind: they are fundamentally split and they are inexorably linked and reflecting each other; they are not one and they are not two (see the opening quote in Staunton's new book on Body Psychotherapy, 2002).

Somatic Countertransference

Turp's paradigm confusion does not just apply to our understanding of the client's body/mind functioning. Just as significantly, the equivalent confusion in our understanding of the therapist's body/mind process manifests around the notion of 'somatic countertransference'.

This notion says more about psychotherapists' traditional bias in their self-awareness and self-perception than about the interaction between client and therapist. If I am mainly focussed on processing my moment-to-moment responses to the client cognitively, through mental reflection and/or strategising, I will experience strong somatic reactions as disturbing invasions of my otherwise composed therapeutic equilibrium. The intensity of the therapist's experience of invasion may well carry information about the degree to which a significant body/mind process in the client is split off, but the therapist is unlikely to be able to access this fully unless they are rooted in a continuous awareness of their own somatic reality in the first place.

Turp quotes Nathan Field's paper on 'Listening with the Body' which I heard him present at a AGIP conference on 'Somatic Countertransference' in the mid-nineties. At the same conference, we heard a fascinating presentation (unfortunately I have not been able to remember or establish the presenter's name) on the high statistical incidence of psychosomatic symptoms in the psychoanalytic profession. The presenter's argument was that psychoanalysts on the one hand are trained to take a therapeutic stance which is designed to give space to or even attract projective identification. But because their training conditions them to disregard their body, disidentify from their somatic experience whilst working and identify with their capacity for mental reflection, they are not supported in sufficiently processing the somatic aspects of projective identification which they receive, take in and carry unconsciously, somatically. The analyst thus takes away in their own body uncontained material which does not re-enter the relationship, but - after having been dismissed as temporary symptoms for too long - accumulates to a point where it manifests as psychosomatic illness.


To me, the notion of 'somatic countertransference' is like talking about a 'swimming fish'. There are indeed fluctuations in the charge of my somatic responses as a therapist, and I have no doubt that one of the variables in these fluctuations is the 'primitiveness' of the relational dynamics constellated (i.e. the urgency with which the client's body/mind seeks to evacuate them because they are experienced as uncontainable - the more unconscious and split-off the material, the bigger the 'swimming fish'). However, when I am rooted in the continuity of my somatic responses (rather than just noticing the disturbing 'peaks'), it becomes apparent that there are other significant variables: the opportunity for transformative crisis also announces itself through strong somatic responses in the therapist, so does the emergence of intimacy or hostility. Nathan Schwartz-Salant writes evocatively about his work with his energetic responses and awareness of subtle energy:

I have not come across, as yet, a coherent holistic formulation of the therapist's internal process and processing, a comprehensive grasp of the body/mind complexity of the countertransference. This is something we are still developing, and which Integrative Body Psychotherapy can make an important contribution towards.

Working with the psyche/soma in an holistic way

"Our concern, whatever our therapeutic approach, is with emotions and emotional conflicts and, as bodywork practitioner Stanley Keleman wrote in 1985 'the body is the somatic architecture of feelings'. This statement as relevant to the 'talking cure' psychotherapies as to those where the body is directly moved or touched."

Clearly Turp does work with a notion of different levels or channels ("Inherent in the idea of bodymind unity is the idea that an experience that is primarily physical, such as massage, can have a profound psychological effect. Similarly, an experience that is primarily psychological, such as a conversation between two people, can have a profound physical effect. Effectively, any aspect of a person's functioning can be reached through any channel"). But if we want to do justice to the interdependence of the various levels, it becomes paramount to recognise that there are not just conflicts on an emotional level; there are also conflicts between the physical and emotional, between the emotional and mental, and between the physical and mental level. All of these conflicts, on each level itself AND between the levels, are a source of pain and as such are instrumental in bringing people to therapy. There is a longing that the whole subjective complexity of the body/mind will be related to and addressed. In this complex matrix it is not only perfectly possible, but inevitable that the therapist will bring their own bias, their own favoured avenue for communication into the relationship, and mitigate against others.

The well-established basic distinction between - what I like to call - 'habitual' aspects of the countertransference (i.e. those themes which the practitioner brings into the consulting room irrespective of the client's issues) and situational aspects (i.e. those experiences which arise in relation with a particular client) can be grounded in holistic body/mind terms.

The Reichian tradition can give us tools to distinguish between chronic body/mind conflicts which habitually interfere with a sense of embodiment (i.e. the practitioner's 'habitual countertransference') and physical responses and symptoms which are to do with the 'here and now' of the client-therapist relationship and which are, therefore, part and parcel of projective identification processes. From an holistic perspective, 'habitual countertransference' includes all the 'levels', from the most basic physical through the emotional to the various mental and collective patterns, including our meta-psychological assumptions and our, partially unconscious, construction of the therapeutic role.

As all experienced practitioners will have experienced, eventually our clients' unconscious will tend to seek out those areas of our therapeutic presence where we will get trapped in our most cherished assumptions about therapy, what it is, how it works, and what we are 'supposed to be doing'. Working holistically with the psyche/soma helps us be available both for the process of being constructed as an object, but beyond that also the necessary de-construction and transformation of that object which inevitable involves (and threatens) our own identity and psyche/soma subjectivity as therapists. This is not the space to outline a more comprehensive formulation of working holistically with countertransference (which necessarily includes working with the therapist's body).

But let me say in summary that anybody who claims that they are working with the client's body would, in my book, at least need to do justice to all of the following:

Generally speaking, they attend to and work towards containing the 'whole' of the client's body/mind, especially the whole of the client's habitual body/mind conflict (i.e. the client's idiosyncratic and individual version of the 'European Split'). Practically, this involves at least three steps, continuously repeated moment-to-moment:

a) working with the emotional and relational significance of the client's sensations, symptoms, movements, impulses whether subjectively experienced within 'body/mind unity' or in the various degrees of body/mind split or fragmentation.

b) attending to, having faith in and following the spontaneous processes arising from this attention to the body. And then ...

c) working with the reactions to or against these spontaneous processes, whether these are allowing or reactive, surrendering or restrictive, expansive or contracting.

All of this is provoked and contained essentially in the relationship, and does not at all need to rely on clinical techniques, exercises or, as Turp warns, "plans of action."

This would constitute the beginnings of a frame in which the client's body - rather than being used as a gratifying or cathartic shortcut which avoids the intensity of the transference - can constitute an avenue into the full experience of the transference/countertransference process and its relational sources in early development.


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Damasio, Antonio (1994) Descartes' Error, Putnam.

Schwartz-Salant, Nathan (1982) Narcissism and Character Transformation, Toronto: Inner City Books.

Soth, Michael (1998) 'Relating to and with the Objectified Body', Self & Society, Volume 27, No 1

Staunton, Tree (2002) Body Psychotherapy, Hove: Brunner Rotledge.

Strean, Herbert S. (1993) Resolving Counterresistances in Psychotherapy, NY: Brunner Mazel.

Turp, Maggie (2001) Psychosomatic Health, Basingstoke: Palgrave.

Wilber, Ken (1996) Up from Eden, US: Theosophical Publ. House.