Body Psychotherapy at Chiron from a Psycho-analytic Perspective

I have been practising psycho-analytic psychotherapy in the NHS for a number of years, having previously worked with physically ill patients, and I have always been interested in the various links between body and mind.  I was therefore attracted to a conference on attachment theory and the body in March 2003.  Although the speakers came from psycho-analytic or neuroscience backgrounds, a number of body psychotherapists were also present, and towards the end, one of them suggested that the psycho-analytic therapists were trying to re-invent the wheel, rather than looking at what they could learn from body psychotherapists.  This made me realise how clueless I was about what body psychotherapists actually did.  It seemed to me that the only way I would really understand what body therapy was about would be by having some, and, as it was some time since I had ended a long, intensive psycho-analytic psychotherapy, it seemed like an ideal time for me to do that.  I subsequently met one of the Chiron Directors for an initial consultation and was referred to a local therapist.  By the time I had seen her for 6 months, I was sufficiently excited and curious about her way of working to enrol on the Certificate Training at Chiron, and am now halfway through my third year.  I feel that I could easily fill a book with my experiences during the last three years, and so I am going to focus on what I consider to be some of the major splits and differences (or at least perceived differences) between psycho-analytic and body psychotherapy.

An obvious difference between body psychotherapists and psycho-analytic psychotherapists is in their attitudes towards touch.  I think that many psycho-analytic psychotherapists fear that touching clients will fuel erotic transferences that are likely to get out of hand, and so even discussing the possibility of touch has become taboo in the psycho-analytic world.  One problem with this is that if therapists feel unable to discuss their use of touch in therapy, there is a greater chance they will use touch in an ill considered fashion, and that things may get out of hand.  Body therapists, on the other hand, recognise that touch can be a powerful tool in therapy, and that therapists need to be trained to use it appropriately.  At Chiron, we do not start seeing clients, until we have completed at least three years of training, whilst, in my psycho-analytic training,  most trainees were allocated clients after only a year.  During my body therapy training, I have learnt about different ways of using touch, and have discovered that, although touch may evoke sexual feelings, it  may also be experienced in many other ways.  I have also been impressed with how comfortable the facilitators and my own therapist have been in working with sexual feelings, when they do arise in therapy.  Sexual feelings are welcomed and explored in a similar way to any other feelings, whilst it is made clear that the therapist will not engage in sexual intercourse or use the client for his or her own sexual gratification.

The most significant split that I have observed is actually a split between psycho-analytic psychotherapists and humanistic psychotherapists in general, around whether a client’s needs should be gratified.  Most psycho-analytic psychotherapists believe that it is not possible to make up for what a client has been deprived of in the past, and so it is not helpful to attempt to do this.  Instead, the therapist should help the client to get in touch with and think about the resulting frustration and anger.  They often see humanistic psychotherapy as attempting to gratify a client’s needs in a way that deprives the client of the opportunity to experience and express anger towards the therapist, particularly if it involves any form of touch. It seems to me that the reality is much more complicated; psycho-analytic psychotherapists may refrain from touching clients and frame their verbal responses to clients with a view to avoiding gratification,  but what about other forms of non-verbal communication?  Even if a psycho-analyst sits behind a client, such that they cannot be seen, the client may still be gratified by the tone of the analyst’s voice.  Is that so different from the gratification that a body therapist may sometimes provide through touch? 

No doubt there are a few humanistic psycho-therapists who use touch indiscriminately, and I have come across some psycho-analytic therapists who attempt to maintain a neutral tone of voice, and end up speaking in a boring monotone the whole time, including when they are speaking at conferences.  However, my experience has been that a more important difference between the two schools is that  body psychotherapists are trained to be finely attuned to all forms of non-verbal communication, including touch, and to consider when it is helpful to gratify and when it is not; on the other hand, psycho-analytic training advocates completely avoiding touch, whilst mostly turning a blind eye to other forms of non-verbal gratification.  Whilst many psycho-analytic therapists use non-verbal communication extremely sensitively and are no doubt aware of the gratification that they are providing, this is rarely acknowledged by psycho-analytic writers and it is hardly mentioned during psycho-analytic training, once basic counselling skills have been acquired. 

This brings me on to what I think is the most important difference between body psychotherapy and psycho-analytic psychotherapy, which is the form that the training takes.  My psycho-analytic training attempted to integrate theory and supervised work with clients, whilst requiring that I was in personal psychotherapy throughout.  If my countertransference response to clients seemed to partly reflect my own unresolved issues, I was encouraged by my superviser to take these back to my own therapy.  We did have to attend small “experiential groups” during the first year of the four-year training, but we were not generally encouraged to apply theory to ourselves during seminars.  When one of us did, it was tolerated, but there was often an unspoken message that what we had done was rather inappropriate and embarrassing for the facilitator. 

In contrast, it is recognised at Chiron that no amount of therapy will prevent our own wounds from entering our relationships with our clients, and so right from the start of the training, we are invited to bring ourselves as whole human beings and to reflect on our own processes.  When we begin to learn therapy techniques, we practise on each other, and subsequently reflect in the seminar groups on our experiences both as clients and as therapists.  It is made clear that we have to take some responsibility for ourselves as clients, for example, in how much we disclose or how vulnerable we allow ourselves to be, and that we are expected to take issues that arise back to our own therapy, if we need to do more work on them.  However, it is accepted that we may become very emotional or regress, whilst we are clients, and the trainers and assistants, who observe us working, are all well able to provide the necessary containment on the few occasions that fellow trainees are not.  In conjunction with my personal psychotherapy, my experience of being a client for fellow trainees to practice on or for demonstrations by trainers has been invaluable in my personal development during the training.  Although I have only been in twice weekly therapy, I seem to have changed much more in the last two and a half years than I did in the last six years of my four-times-a-week psycho-analytic psychotherapy.  

When I practise as a therapist with a fellow trainee, I can be helped to look at so much more than the verbal content of my exchanges with my client.  The observing trainer, assistant or fellow trainee can draw my attention to my posture, gestures, tone of voice and other non-verbal communication, based on both what they observe and also on their own internal experience.  It is essentially live supervision, but also supervision by somebody who has themself received live supervision during training and so is accustomed to tuning into non-verbal communication.  According to neuro-scientists, more than 90% of communication is  non-verbal, which perhaps explains why the training has been so  helpful in my work as a psycho-analytic psychotherapist.  I do not use touch in working with my NHS patients, but I have become much more aware of what they are doing with their bodies and of what is going on in my own body.  This has enabled me to draw patients’ attention to aspects of their own bodies, for example, particular postures, gestures or repeated movements that seems significant.  More importantly, it has helped me to recognise what might be going on for patients, when they are unable to express this verbally, as well giving me more information about what is going on between us at a non-verbal level.

The training at Chiron has been truly integrative in that, over the last twenty years or so, it has incorporated theory from many different schools, including psycho-analytic concepts such as transference and countertransference.  I wish that psycho-analytic training institutions could be as open to new ideas, and that there could be much more dialogue between psycho-analytic and body psychotherapists.  I have given examples of what psycho-analytic therapists can learn from body psychotherapy, but I also believe that psycho-analytic psychotherapists could help body therapists to become more aware of different forms of countertransference in practice.  I am still undecided as to whether I eventually want to practise as a body psychotherapist, but the training so far, in conjunction with my own therapy, has had positive effects on my work as a psycho-analytic therapist in the NHS, and has been transformative from a personal point of view. 

Third Year Trainee on Chiron Certificate Course