INCORPORATING SOMATIC OF SCIENCE ARTTHE AND PRAXIS INTERNATIONAL BODY PSYCHOTHERAPYINTERNATIONAL JOURNAL volume twelve

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INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL THE ART AND SCIENCE OF SOMATIC PRAXIS 2 INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL THE ART AND SCIENCE OF SOMATIC PRAXIS Australia; LisbethMarcher, Denmark; LindaMarks, Daniel USA; Mark Lewis, Ludwig, USA; Narelle McKenzie, Johnson, PhD, USA; Edmund Knighton,PhD, USA; Klisic, Ph.D., Serbia; René Kostka, Switzerland; Rae Inge Joachim, Germany; Rubens Kignel, Brazil; Ljiljana Regina Hochmair, Austria; Lawrence E.Hedges, USA; Heller, Switzerland; Sibylle Huerta Krefft, Germany; Grossmann, Germany; Claire Haiman, USA;Michel Grassmann, PhD, Germany; Elliot Greene, USA;Margit Glickman, USA;ChristianGottwald, Germany; Herbert USA; Ruella Frank, Giuffra, USA;Mary USA;Gary Duclos, USA; Werner Eberwein, USA;Nancy Eichhorn, Michael Changaris,USA; Will Davis, France/USA; Marcel USA; Fabio Carbonari,Italy; Fanny Chalfin,USA/France; Serbia; Stephen Buehler, USA;ChristineCaldwell, PhD, Barlow, Australia; Luisa Barbato, Italy; Sasa Bogdanovic, Peer Review Board: Young,Courtenay UK. Valstar, Netherlands; Halko Weiss, PhD, Germany; Stupiggia, Italy; Manfred Thielen, PhD, Germany; Joop Päd., Germany; Professor Frank Röhricht,UK;Maurizio Greece; LisbethMarcher, Denmark; Gustl Marlock, Dipl. EdD, USA;Peter Levine,PhD, USA;ClorindaLubrano, Stanley Keleman, USA;Rubens Kignel,Brazil; AliceLadas, Evertsen, Netherlands; Ulfried Geuter, PhD, Germany; Will Davis, France; George Downing, PhD, France; Lidy Malcolm Brown, PhD, Switzerland; Fabio Carbonari,Italy; Bauer, MD,Germany; Marianne Bentzen, Denmark; Netherlands; Jeff Barlow, BA,MEd, Australia; Prof. Joachim International AdvisoryBoard: Christina Bader-Johansson, Thomas Harms, German Editorialcommittee: Asaf Rolef Ben-Shahar, KatySwafford. Evertsen, Michel Heller, Elizabeth Marshall, Editorial committee: Design/Layout: Ronald Jeans Cover illustration: Cover Design: Joop Valstar, Chiel Veffer Production Team [email protected] German Editorial Board: [email protected] Managing Editor: [email protected] Editor:Associate [email protected] Editor inChief: and practicethrough ongoingdiscussion. exchangeinterdisciplinary withrelated fieldsofclinicaltheory field ofbodypsychotherapy as well astoencouragean the exchange ofideas, scholarshipandresearch withinthe The Journal’s promote andstimulate missionistosupport, which canbeordered through thewebsite www.usabp.org. a continuationoftheUSABPJournal thefirstten volumes of European Association forBodyPsychotherapy (EABP).It is States AssociationforBodyPsychotherapy (USABP)andthe spring andfall.It isacollaborative publicationoftheUnited a peer-reviewed, onlinejournal,publishedtwiceayear in The International BodyPsychotherapy Journal (IBPJ)is Volume 12·number 2·fall2013 International BodyPsychotherapyJournal (formerly US Association forBodyPsychotherapy(formerly USAssociation Journal) The ArtandScienceofSomaticPraxis Jacqueline A.Carleton,PhD Diane Cai Jill van derAa Panta Rei ChristinaBader, Switzerland; Jeff Nancy Eichhorn, Lidy Elizabeth Marshall, (Eugène Brands) Regina Axt,MD,

subscription: Members subscription: Members Printed singleissueMembers Print subscriptions: The IBPJ Editor: [email protected] Correspondence Addresses FORUM Representative: Stefan Bischof COUNCIL Representative: Elfriede Kastenberger, MD Zimmermann, Michael Heller, PhD Ethics CommitteeRepresentatives: Ilse Schmidt Science &Research Committee:Herbert Grassmann, PhD Kastenberger EAP Representatives: Thomas Riepenhausen,Elfriede Treasurer:Eva Wagner-Margetich General Secretary/Vice-President: Jill van derAa President: LidyEvertsen EABP BoardofDirectors Magazine Editor: Nancy Eichhorn, MA,MEd Journal Editor: Jacqueline A.Carleton,PhD Research: Jennifer Frank Tantia, PhD, BC-DMT Membership: Andrea Caplan,BA,LMT Treasurer: AlexDiaz, PhD Secretary: ChristineGindi, MDiv, MA,SEP Vice President: Dan Mingle, MBA President: Beth Haessig, PsyD USABP BoardofDirectors David Trotzig. Russian, Evgeniya Soboleva; Serbian, Sasa Bogdanovic; Spanish, Stavroulaki; Hebrew, RachelShalit; Italian, Fabio Carbonari; Marcel DuClos; German, Elizabeth Marshall; Greek, Eleni Abstract Translators: Young,Courtenay UK. USA; Joop Valstar, Netherlands; Halko Weiss, PhD, Germany; Stopforth, Canada;Maurizio Stupiggia, Italy; Jennifer Tantia, Kathrin Stauffer, PhD, UK;LauraSteckler, PhD, UK;Sharon Shahri, PhD, USA;AsafRolef Ben-Shahar, PhD, Israel; Professor Frank Röhricht,UK; Talia Shafir, USA; Homayoun Marc Rackelmann,Germany; Marjorie Rand,PhD, USA; USA; Elizabeth Marshall, Germany; Susan McConnell, USA; Publishers: retrieval system,without written permissionofthepublishers. photocopying, recording, orby anyinformationstorageand form orby anymeans,electronic ormechanical, including ofthisjournalmaybereproducedpart ortransmittedinany Copyright (c)2012USABP/EABP. No Allrightsreserved. ISSN 2169-4745Printing, ISSN2168-1279Online EABP ortheirrespective Boards ofDirectors. necessarily represent theofficial beliefsoftheUSABP, the NB The accuracyorpremises printeddoesnot ofarticles found intheoriginallanguage. mayalsobe accepted forpublicationinEnglish, thefullarticle originallywritteninanotherlanguagehasbeen If anarticle www.eabp.org/publications-journal.php Portuguese, Russian, Serbian andSpanish. website inAlbanian,French, German, Greek, Hebrew, Italian, language. Abstracts are ofarticles tobefoundontheEABP Translation Advertising: Changes ofaddress: through banktransfer, AmericanExpress orPayPal. isavailable free online. IBPJ www.ibpj.org EABP [email protected] www.eabp.org USABP [email protected] www.usabp.org TThe onlineJournalTThe ispublishedintheEnglish [email protected] [email protected] www.eabp.org/ibpj-subscribe.php   55.00, Non-members 30, Non-members Albanian,Enver Cesko;French,  17.50, Non-members 

35 Two-year  60. Payment  20 Yearly the principlethateverything moves,changesandtransforms allthetime(Heraclitus,Plato,Aristotle). The imageonthecover isanoilpaintingbyEugèneBrands, entitled‘EverythingStreams’.Itrefers to‘Panta rei’, PANTA REI TABLE CONTENTS OF volume twelve 63 50 39 88 BOOK REVIEW 9 ARTICLES 7 4 The EmergenceofSomaticPsychology andBodymindTherapy A Review ofBarnabyB.Barratt’s A waytoopenthedoorhappinessinpresent Filling theHoles-in-Roles ofthePast Diana HoughtonWhiting,MA Military CultureandBodyPsychotherapy:ACaseStudy Bernhard Schlage,MA Body ImageDisorders Michael C.Heller, PhD Idealism &TheGoalsofaPsychotherapeuticProcess Editorial With theRightPeople attheRightTime Christina Bader-Johansson, MSc Christina Bader-Johansson, Albert Pesso Stanley Keleman The Present asMorphogenesis Jacqueline A.Carleton,PhD

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3 INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL THE ART AND SCIENCE OF SOMATIC PRAXIS Editorial Michael Heller actively participates in many of the above-mentioned venues of communication amongst body psychotherapists. Best known at the moment as the author of volume 12 · number 2 · fall 2013 the magnum opus, Body Psychotherapy: History, Concepts and Methods, published by Norton in its English translation by Marcel Duclos in 2012, and reviewed in our last issue, Michael has Well, this is our second or twelfth year of publication, depending on whether or not you also been a guest in the SomaticPerspectives.com series and has hosted a discussion of the goals are counting the US Association for Body Psychotherapy Journal’s ten years as a precursor of the of psychotherapy in the Linked In group. Inspired by that experience, he delves further into International Body Psychotherapy Journal: The Art and Science of Somatic Praxis. In seeking to an aspect of the topic that particularly interests him in his article entitled, “Idealism & the fulfill our mission to reflect, define and validate body psychotherapy in the global community, we Goals of a Psychotherapeutic Process”. In this thoughtful essay, Michael explores several issues are moving in ever-widening circles of connection and diversification. Since the transition two in the formulation of aims for psychotherapeutic treatments, especially for those including the years ago, we have been committed to an open access, online publication with the alternative of body, clearly more interested in the questions and dilemmas than in any singular conclusions. print subscriptions for those who wish them. As I write this, our own website is in preparation He begins his discussion of this complex topic by pointing out that, “no one seems to know and will be up in the next month or so. Its address will be www.ibpj.org. That means that the how to differentiate a mental illness from spontaneous manifestations of the imperfection of IBPJ will be accessible from three sources: the EABP website, the USABP website and its own nature”, citing the presently controversial treatment of ADD in children. He then moves on website, in addition to being sent as an attachment to all members of both organizations. to the philosophical underpinnings of the discussion of aims of psychotherapy, contrasting the idealism of Plato with that of another Ionian philosopher, Heraclitus, in whose wake As a part of our goal to disseminate the practice of body psychotherapy as widely as possible, he places Spinoza, Darwin, and ultimately Wilhelm Reich. He poses the question whether THE ART AND SCIENCE OF SOMATIC PRAXIS THE ART AND SCIENCE OF SOMATIC PRAXIS we are committed to actively coordinating our other publications, events, and social media. psychotherapeutic treatment should take harmony and coherence as its goal, or whether it is We are planning to participate actively in the 2014 EABP Conference in Lisbon as well as the better to aim instead for an enlarged capacity to manage conflictual forces both within and USABP Conference in 2015. Nancy Eichhorn, the editor of Somatic Psychotherapy Today, and without of the organism. And, what of habitual responses of all kinds? I are in constant communication about the content and needs of both periodicals, and Nancy also serves on our editorial committee. The same is also true for Serge Prengel, who hosts an Can we embrace empirical idealism which assumes one form of adaptation is better than ongoing series of thought-provoking conversations with a broad range of practitioners and any other, or may we embrace the variety that otherwise ensues? Is our first concern building thinkers on SomaticPerspectives.com. Social media are also utilized, as by Serge whose Somatic an intimate relationship with a new patient or alleviating symptoms? And, what about the Perspectives group on LinkedIn, with 2,500 members to date, is a place for stimulating ethical considerations around who, therapist or patient, decides on those goals either overtly discussions on such topics as Embodiment or The Role of Touch in Psychotherapy (see linkedin. or covertly? And, is there a main or initial cause of present symptoms that we should seek SomaticPerspectives.com). to uncover? Questions such as these engender illuminating but ever-inconclusive treatment. He concludes that while there may not be major differences between practical aims of a In forthcoming issues, we will be presenting and encouraging dialogue among contributors psychotherapy process, each practitioner/school rationalizes them quite uniquely. The editors in two related forms. Editorial committee member Asaf Rolef Ben Shahar has invited Nick along with Michael invite you to submit your own questions and thoughts thereon for Totten to begin a series of dialogic articles on the concept of the self in body psychotherapy. publication in the next issue of the IBPJ. Upon receipt of Nick’s article, Asaf will invite comments from three colleagues, which will be published along with the original article and Nick’s closing reply to them. A similarly speculative point of view is taken by Bernhard Schlage in “Body Image Disorders” as he attempts to open inquiry into the realm of what he calls the “second body”. I have invited experienced clinicians to present case histories which will then be commented Taking a childhood experience of his own as a point of departure, he speculates on how this on by their colleagues. Colleagues will be asked to propose alternatives and then the original body might be linked to the physical body and the brain both in present and past cultures, writer will write a rejoinder, which will include further information on the treatment presented some of which were more comfortable with body image variations than the culture from which INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL PSYCHOTHERAPY BODY INTERNATIONAL along with comments on colleagues’ suggestions and ideas. We would like to experiment with he writes. He argues that body psychotherapy is in a unique position to work with both bodies JOURNAL PSYCHOTHERAPY BODY INTERNATIONAL this form both within and between modalities. We hope such dialogues will become regular and goes on to evaluate neuroscientific and neuroimmunological evidence for their usefulness features of the IBPJ. in such treatment. In conclusion, he invites feedback from readers who share his interest in this burgeoning field of inquiry and treatment. We would add that this discussion has a Honoring our subtitle, The Art and Science of Somatic Praxis, we begin this issue with a poem sociocultural relevance as well as we watch the globalization of serious, often life-threatening by Stanley Keleman. A pillar of body psychotherapy since the 1970’s, he allows us to publish body image disorders such as anorexia nervosa along with its more recent and equally serious “The Present as Morphogenesis”. Much of Stanley’s work in other genres is initially birthed by companion, obesity. him in poetic or sculptural form, so it pays to watch his subsequent work to see how it unfolds. At this point in time, he is just finishing a DVD of his seminal work,Emotional Anatomy. In “Military Culture and Body Psychotherapy: A Case Study” Diana Houghton Whiting It is a semi-animated version of the text with added material about the exercise protocol and the describes 10 weekly body psychotherapy sessions with a 65-year old male veteran of the dynamics of Formative Psychology. Vietnam war who has been in a variety of treatments for PTSD over the last 15 years. Diana

4 5 THE PRESENT AS MORPHOGENESIS was able in that brief time to help the client bring more awareness to his body, his emotions, and many habitual responses. She points out that attention to signals from the body is the exact obverse of military training to suppress bodily sensation in order to complete the assigned task. The Present as Morphogenesis She briefly describes the process by which a civilian becomes a member of the military, “a well- Stanley Keleman oiled machine”, and how that can make re-entry for some quite difficult, especially for those who carry trauma. Although neuroscientific research has made some inroads, the American June/2013, Berkeley Ca Veterans Administration only approves evidence-based therapy modalities for this enormous and underserved population. The need for research in the field of body psychotherapy is The body the serpent of animation clearly urgent. This article fulfills a requirement for the Master’s degree at Naropa University in Boulder, Colorado. We applaud the practicality of the necessity for each student to undertake a a ripening morphing from less to more, project that results in a publishable article rather than a “thesis” of some sort that might just sit on a shelf somewhere gathering dust. from a skin, into a cortex, Albert Pesso, along with Diane Boyden, founded the Pesso-Boyden Psychomotor System more than 40 years ago. As I mentioned in the last issue, I was privileged to be a member of the octopi of division and differentiation, one of their very early groups at the Charles Street Meeting House in Boston. “Filling the THE ART AND SCIENCE OF SOMATIC PRAXIS THE ART AND SCIENCE OF SOMATIC PRAXIS Holes-in-roles of the Past with the Right People at the Right Time” outlines and simultaneously that forms the pointillist illustrates how initial questions about how some performers are able to do some moves that living sky, a pointelle others cannot has become a very carefully worked-out and implemented modality of body psychotherapy. No stranger to their work, I found myself again and again confounded by the of throbbing delights, precision of the interventions described. What is particularly helpful are the minute dissections of each intervention with its theoretical and cultural bases explained. Questions seem to be a brightening the nights, theme of this issue, and Al poses many: What can make the present feel that awful? Does it ink, matter that interventions are in the here-and-now rather than the there-and-then when they were so urgently needed? What are the most basic drives/instincts in all living things? What with its tongues three motivators propel most human behavior (one of them may surprise you) and what are two underlying, genetically available primordial energy systems needed to successfully maintain life? desires, His answers to these questions provide the very specific bedrock of the work described. Concepts slithering from within and principles continue to come up and be discussed in the course of a single “structure”. His moment-by-moment tracking of therapist, client and participating group members provides a by the body and brain window into a concise and detailed set of interventions that lead to a not unforeseen conclusion. the twins Finally, we have a review of Barnaby Barratt’s important new work, The Emergence of Somatic grow starlight’s, Psychology and Bodymind Therapy. It is described and analyzed by Christina Bader-Johansson. flowers, within, I would like to take this opportunity to honor and thank our abstract translators: Albanian,

INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL PSYCHOTHERAPY BODY INTERNATIONAL Enver Cesko; French, Marcel DuClos; German, Elizabeth Marshall; Greek, Eleni Stavroulaki; the cosmic armature JOURNAL PSYCHOTHERAPY BODY INTERNATIONAL Hebrew, Rachel Shalit; Italian, Fabio Carbonari; Russian, Evgeniya Soboleva; Serbian, Sasa in intimacy, Bogdanovic; Spanish, David Trotzig.The abstract of each article in the issue is translated into these languages and posted on the websites so that people for whom reading in English is a of lying face to face, challenge can get an idea of whether they want to wade through a particular article. This is a very important service and other languages are welcome. Please volunteer! bending and blending

pulsing together, Jacqueline A. Carleton, PhD New York City in a gastrulating September, 2013 giving and receiving. appearing and disappearing 6 7 8 INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL THE ART AND SCIENCE OF SOMATIC PRAXIS Email: [email protected] Website: www.centerpress.com Living Your andMyth Dying, andtheBody, pioneering books lecturer attheSpectrum Schoolof Humanistic Psychology inLondon,England. He hasauthored the director ofresearch attheCenterofForm andDevelopment inZurich, Switzerland, andavisiting Saybrook Graduate Schoolin2007,heisalsothefounder anddeveloper ofFormative Psychology, the he teachestheFormative Approach tohumandevelopment. Awarded aPhD inHuman Lettersfrom Stanley Keleman PhD is the director of the Center for Energetic Studies in Berkeley California, where BIOGRAPHY STANLEY KELEMAN Emotional Anatomy, Embodying Experience, Your BodySpeaks itsMind, Insults toForm, embodied lifewe form. which isthelived for ourtime, we make, in thepresent to beapresence enough, there istime, announcements, echoes tothelips, and sends the face, that illumines, the molten,lava morphogenesis, of dynamicintimacies in thedeepsilence until death,tostay waiting, a hovering, wave, within theconceived world, in addition to numerous clinical books. inadditiontonumerous clinicalbooks. psychotherapy ismostlyusedinNorth America,whilebodypsychotherapy is mostlyusedinEurope. although Isuspect thatthedifference ofnamecovers differences thatwillbeclarifiedinthe future. Somatic 2 International BodyPsychotherapy Journal, forhelpingmewithmyEnglish andeditorialrequirements. 1 Twain, bed tohispresent positionwasprobably amatterofsurpriseandregret tothe Creator (Mark was mostlikelynoteven madeintentionally;andthat hisworking himselfupoutoftheoyster that hewasnotmadeforanyusefulpurpose,thereason thathehasn’t any;thathe served Natural History, p. 278;translatedby Michael C.Heller andMarcel Duclos). ofhim(Lamarck, 1815, part connections thatcontrol, outsideofhisperception, nearlyevery that activated themselves beyond thescopeofhisawareness. These grew intoahugemassof complex personalinterests. His inclinationssubdividedendlessly, needs andgeneratednew of relating tothesocietyin which helived, which,amongotherthings,generated increasingly needs increased andbecamemore andmore diversified. He developed increasingly varied ways in societywithfellow creatures, andfinallyprogressed andbecamecivilized. His delightsandhis © Author andUSABP/EABP. Reprints andpermissions [email protected] volume 12,number 2,fall2013 International BodyPsychotherapy Journal For themoment somaticandbodypsychotherapies designatethe sameschools.Itherefore use them assynonyms, I wouldliketothankJacqueline A.Carleton,Diane Cai and Jill van derAa,editorandassociateeditors of the In Iwillshow thefirstpart thatadiscussionontheaimsofpsychotherapy often presents aseriesofissuesonthesubjectasform“mind sharpeners” forcolleagues. a psychotherapeutic treatment thatcanbeacceptedby mostpsychotherapists. It explicitlistoftheaims This paperdealswiththedifficultyofproposing ashort efficiency, implicitandexplicitassumptions,idealism,coherence/incoherence ofhumannature. issuesthathauntmewhenIpracticepsychotherapy.will discussafew to improve ourunderstandingoftheaimspsychotherapeutic processes. Andfinally I philosophical idealism.Iwillthenspecifywhatwe wouldneedfrom scientific research raises implicitideologicalissuessuchasthosewhichare inspired by of various sorts Idealism andTheGoalsofaPsychotherapeuticProcess Concerning Man (…).Idesire tocontemplate himfrom –thispremise: thispointofview As manthrived indifferent regions oftheglobe,heincreased innumber, establishedhimself Key Autobiography Submitted 19March 2013;received inrevised form26June 2013;acceptedJuly 2013 words: psychotherapeutic cure, aimsofatreatment, bodyorsomaticpsychotherapy , 2012,p. 165). pp 9-38ISSN2169-4745Printing ISSN2168-1279Online Michael C.Heller, PhD The Art andScienceofSomaticPraxis Introduction Abstract IDEALISM ANDTHEGOALS

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9 INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL THE ART AND SCIENCE OF SOMATIC PRAXIS 10 INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL THE ART AND SCIENCE OF SOMATIC PRAXIS 3 that todayfundamental research inpsychology does notreceive funding enoughnonpartisan or evenweak with chronic working hyperactivity phases. One memory obvious explanation is disorder; andthetypeofsocialregulation systemsthatcancreatively integrate peoplewitha spent more timeanalyzing thespecificcreative giftsofpeoplewhosuffer from attentiondeficit which have allowed have not ofworking ustodescribe thevariety memory ofperformances people withweak attention from leadingcreative lives. Iamastonishedthatrecent studies of years. It ishighly probable that,insomesocieties atleast,socialpressure didnotprevent notion ofattentiondeficitis robust, thenthephenomenon hasbeenwidelyspread formillions the infinite variety thatcharacterizes all thefunctionsthatanimatehumanorganisms. If the considerablywithinthehumanspecies.Itthat vary isthenforsocietytofindways ofintegrating the deficitbutdoesnotcure thehypothesisthatattentionisoneofcharacteristics itsupports calledRitalin. an addictive drug factthatthistreatment reducesThe observable theintensityof as various formsofeugenics. being as symptoms is not a scientific endeavor when it isbased onideological ethical aims,such powerful medicalinstitutions. ofahuman The pushtoclassifyalltheindividualparticularities adeepinconvenience). Humanthe term(adiscomfort, variety isbeingfrontally attackedby Psychological difficultiesare oftenmostlyadiseaseifone refers totheoriginalmeaningof nearly of any the chronicself or others could be treated discomfort as a medical symptom. biological creativity. This inclusionisbecomingincreasingly It important. wouldseem that germs, etc.).Gradually dramaticmanifestationsofrandom medicinealsoincludedparticularly causedby accidents(breakingdiscomforts one’s leg,warwounds,infections,reactions to Long before of evolution, biologists createdthe notion of illnesses included painful the theory dynamics ofchanceandnecessity, how canitsmanifestationsbeanillness(Heller, 2006)? the creativity ofbiologicalevolution. If thisvariability isduetothespontaneousbiological sexual, emotional,etc.)?For (1859,chapter dimensionof variability isacrucial Darwin V), other, canwe notexpectanextreme inalldomains(intellectual, variability ofperformance that hashelpedmillionsofpeople.But ifoneacceptsthatallhumansare different from each onaperson’sdescribing theimpactofreduced memory short-term life,isausefuldelineation 2009). Noting thatsomepeoplehave amore thanothers,and restricted working memory recently created diagnosticdesignationssuchasattentiondeficitdisorder(Tuckman, (ADD) read themanual,soIwillnotcommentonitformoment,butknow abitmore about need to make love several times a week, shyness and the incapacity to shut up. I have not yet the listofpsychiatric symptoms notonlyhallucinations,depression, andanxiety, butthe (DSM-5) of thefuture Fifth Edition oftheDiagnostic andStatistical Manual ofMental Disorders ofnature.the imperfection Recently theissuehasbeenraised inthemedia,discussions one seemstoknow how todifferentiate amentalillnessfrom spontaneousmanifestationsof die aspainlesslypossible. remission. Inmomentary other cases the most humane solution is sometimes to help a patient autoimmune diseasestherapistscansometimescure; often theycanonlypropose awelcomed one canreduce thepainofmigraines,butonecannot alwayseliminatethem.Cancerand need ahierarchy ofaims.For example,onecancure monthsatthemost.Or acoldforfew therapeutic techniques cannot cure all the illnesses that haunt patients. Therapists therefore MICHAEL C.HELLER,PhD http://www.dsm5.org/Pages/Default.aspx. This issueisgermanetopsychotherapy, butitalsohasanadditionalproblem, inthatno A completecure isthemostobvious aimforallformsoftherapies.However, available Because attentiondeficitisclassifiedasanillness, millionsofchildren are forced toswallow 3 . Newspaper andtelevisionprograms predict articles thatthismanualincludesin

illness. Psychotherapists attempttoreframe psychophysiological habitual procedures insucha or generallyrobust that what patientssufferfrom therapeutictools,andwe is cannotbecertain frame to psychiatric illness is delicate because we do not have a really reliable diagnostic system profound ethicaldedicationtohelpingpeopleintrouble andalleviatingpain.Applying this two preceding factorsallow apractitionertohave. This movement hasbeenanimatedby a on adiagnosis(anillness),thetoolsonehastomasterthisillness,andwhatprognosis the mostly culturalandpedagogical. the notionofillnesscouldberelevant forattentiondeficitissues. In allothercasestheissueis industries whothrive onRitalin.My extreme positionisthatitonlyinparticularly casesthat with strictscientificethical requirements, while research onattentiondeficitiseasilyfunded by 4 because Iamsure sentenceswritten by thatthefew eachofusonthesubject wasbutthetipof vision oftheaimspsychotherapy. Iwillnotattempttosummarize their pointsofview, in thisconversation inJanuary 2013. Their commentsforced metoreconsider mysimplified discussions ontheaimsoftherapy. Several colleaguesin somaticpsychotherapies participated cure? Harmony and/orfriction? Which ofthetwois most plausibleaimforapsychotherapeutic I chose a theme that played a central role in my book on body psychotherapy (Heller, 2012): Prengel askedmetomoderateadebatefor the backofmymind.However Iwasforced toconsiderthissubjectinmore detailwhenSerge process are raisescomplexissues.Aswithmostofmycolleagues,theseissuestendtoremain in pedophiles (e.g.,parents andpriests)totraumatize somanychildren. context, ormaybeinourspecies.For example,asocietymaybeheldresponsible forallowing insurance thatattemptstorepair thedangerous behaviorsthatare inevitableinagiven cultural harassment, war, etc.), onecould imagine that such treatments could also be funded by a social blend ofgeneticfactorsandproblematic behaviorgenerated by socialdynamics(abuse,trauma, formany. formofintervention to beacrucial Asmanypsychological difficultiesare caused by a (Kelley, 1992).Even ifitdoesfitneatlyintoaclassicalmedicalframe,psychotherapy hasproven they andtheirpatientsdependonhealthcare institutionstofundthepsychotherapeutic process when appliedtothefieldofpsychotherapy. Some are afraidofgoing down this road, because facilities’ models.It ispossible thattermssuchastherapy, symptom,orillness,shouldberevised produced by psychotherapy schools oftenfollowed othertracks than thoseproduced inmedical As anincreasing numberofpsychologists joinedthepsychotherapeutic community, themodels adapt themedicalmodeltorequirements ofthedifficultiesexperienced by theirpatients. adopted amedicalwayofthinkingaboutmentalhealth. They laterrealized thattheyshould Psychotherapyappropriate formofsupport. therapeutictoolinsuchcases. isacrucial if these difficulties cannot always be addressed with current medical models, they badly need an healthy organism askilling a germthat enters anotherwise of intervention setofproceduresa destructive thatstructure aperson’s characterisnotexactlythe same type optimism orpessimism,etc.). These three factors,aswell asothers,oftenco-occur. Transforming that inciterejection by others,etc.),andwaysof thinking(e.g.,paranoia,ungrounded phasesof difficultydefendingoneself,and intrusiveness, unsatisfyingsexuality, andsocializationstyles affects(e.g.,anxiety,as destructive depression andstress), behaviors (uncontrollable violence way asto avoid strengthening spontaneous natural propensities and defense mechanisms such Even physicalillnesscanbemultifactorial anddifficulttoassess. The notionoftherapyismedicalinorigin. The aimsoftreatment are initiallybased I hopethathave saidenoughtoshow thatdecidingwhattheaims of thepsychotherapy Psychotherapy wascreated by medicaldoctors(Freud, Jung, Reich, etc.)whoatfirst Ithoughtthatthiscouldbean interesting way ofexploringtheissuessooftenraisedin Somatic Perspectives onPsychotherapy IDEALISM ANDTHEGOALS 4 . Nevertheless, even onLinkedIn. 11 INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL THE ART AND SCIENCE OF SOMATIC PRAXIS 12 INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL THE ART AND SCIENCE OF SOMATIC PRAXIS Platonic Idealism Psychotherapy andBody terms allow metodistinguish. for practitionerswhohave notalwaysread thephilosophers. Iwillnow summarize whatthese be simplisticforphilosophers,butIhave foundthem usefulindistinguishingtherapeuticaims know from mymore philosophicallymindedfriendsandcolleaguesthatthesedistinctionsmay trend, which is prevalent in psychiatry, which I will momentarily call “scientific idealism”. I I alsofinditusefultoopposetheperspectives inspired by Greek philosopherswithanother focus more onformsofcreativity associatedwith the grounded capacitytomasterfriction. approach, butsomedotendtofocusonasearch forharmonyandcoherence, whileothers 2005; Brown, 2001).Most somaticpsychotherapists seemtoincludebothmindsetsintheir psychotherapists asdeveloping the“warrior” inthepatient(e.g.,Heller, 2007;Audergeon, grounded pleasure inconflictsituations. Thesecondsolutionisoften referred to by somatic by Heraclites thatfinditmore productive tohelppatientsdevelop apleasurable,creative, and idealism that aim at rendering patients more coherently harmonious, and approaches inspired 3). In therealm ofsomaticpsychotherapies onecandistinguishapproaches inspired by Plato’s some fairlywidespread formulationsproposed by bodypsychotherapists (Heller, 2012,chapter during Greek antiquity, astheyseem to have hada more orlessdirect butstrong influence on philosophershadonthesubject Iwillfocusonsomeofthediscussionsthatcertain article implicit assumptionsanddiscussionsintomore explicitones. themes thathave beendeveloped by colleagues. The focusofmyargumentistotransformoften will insteadprovide ofliterature oneortwoexamplesofthesort Irefer towhenIdiscuss todiscussatlengththeimmenseliterature ontheaimsofpsychotherapy,not even try but clearly aspossible,withthehopethattheycanbeusefultosomereaders. Iwilltherefore than 38years ofexperienceinthatdomain.My principlegoalistoexpress mythoughtsas that are relevant particularly tobodyorsomaticpsychotherapies. considerations involve issuesthatexistinthe field ofpsychotherapy, Ihave focusedonthose be achieved whentheypropose apsychotherapeutic treatment. Althoughmostofthefollowing I canprovide ausefulmindsharpenerforpractitionerswhowanttospecifythegoalsthatcan have notfoundasetofcommonaimsthatare shared by alltheschoolsIknow. However, Ihope clinical andtechnical.Apart from I theobvious pointsmentionedinthefirstlinesofthisarticle, issues theyraiseare simultaneouslymetaphysical,spiritual, ethical,moral,ideological,scientific, training schools.It isforthemomentimpossibletosynthesize themodelstheypropose. The ethical committeesoftheEuropean AssociationforBodyPsychotherapy. discussions thatIhadontheaimsofpsychotherapy withfellow membersofthescientificand and hopethatourdiscussionshave alsobeenusefulforthem.Iwasinspired by themany the icebergs that roam in ourminds.Ithank them for their inspiringcomments and proposals, MICHAEL C.HELLER,PhD In I would like to share this article on the aims of psychotherapy, my views based on more The fieldofpsychotherapy isstructured by amultitude ofhighlydifferentiated andcompeting her opinion.Isay, then,thatto formanopinionistospeak,and opinionisaword spoken, gradually orby asuddenimpulse, and hasatlastagreed, and doesnotdoubt,thisiscalled and answering them,affirminganddenying.Andwhenshe hasarrived atadecision,either Discussions ofthemanagementharmonyanddisharmonyhave alonghistory. For this The soulwhenthinkingappears tomebejusttalking—askingquestionsofherself Philosophical Bases oftheDiscussion acquire andintegrateincreasingly intenseandrefined tastesoftheseideas. inhabited organismdies,thesoulwillriseagaintorealm ofideas.It willthusgradually organism, itstillcontainsreminiscences ithasvisited.Eachtimean oftheabsolutetruth beauty,of absolutetruth, harmony, coherence andjustice. When thesoulthenentersanew visits a realm ideas. In of perfect this world the soul can taste a form of bliss that is the juice philosopher andmathematicianPythagoras, isthatwhenanorganismdiesthesoulrisesand Does aHarmonious ConstitutionBreed Health? Alcibiades. See http://en.wikipedia.org/wiki/Know_thyself. 5 automatic andreasoned point.Current thinking continuestobeanimportant philosophical only inspiritualmovements thattheseparationbetween theemanationsof the soulandcurrent data andattemptstoorganize it,aformofthinking thatspontaneouslyemanatesfrom thesoul: soul formseparateentities.Plato seemstodistinguish aformofthinkingthatreacts tosensory is beyond thescopeofthisarticle. perceived theaimsofpsychotherapy seemssuperficial. Discussing thesephilosophical options Edmund Husserl’s phenomenology, buttheirimpactonhow thefirstbodypsychotherapists Empiricism ofJohn Locke,George Berkeley, David Hume andHermann von Helmholtz, or traditional philosophical alternatives toIdealism, such asEpicureanism, the philosophical impose onemeaningtosuchtermsas“bad” and“good”. There are ofcourseseveral important position when hestressed thatwords are by nature polysemous, and that only tyranny could coherent,what isbeautiful,just,true, andso on.Nietzsche (Rey, 1973)defendedadifferent aim isclosertothoseofmeditationratherthanpsychotherapy. thatarepropensity tocontactthedeeptruths tuckedawaysomewhere inourorganism. This how theirpersonaldevelopment structured whattheyhave become;itisthephilosopher’s to know oneself dynamics) andtheseabsolutetruths. This iswhyPlato’s Socrates insiststhatoneshouldlearn philosopher is someone who increases the contact between what he is aware of (his conscious similar experiences during meditation, breathing exercises, dance, trance or music. For Plato a and allow ustoexperienceblissfulenlightenment.Others mayhave becomeenthralledby he triedtoconvincethewholehumanspeciesthatonlyorgasmscanfree usfrom ourchains that Reich experienced intense emanations coming from hissoul during his orgasms,because by adream, anintuition,oreven atthemostblissfulmomentofanorgasm.One canimagine and enchants them. These delicious, enlightening vapors may be carried into our awareness emanatesfrom thesoul,flowsfleeting blissfulperfume through aforest ofconsciousthoughts Plato attributesthissentencetoSocrates insixdialogues: Charmides,Protagoras, Philebus, Phaedrus, Lawsand vol. II,p. 193). — Imeantooneselfandinsilence,notaloudoranother(Plato, 1937, Aristotle, whowasoneofPlato’s thisseparation. Henceforth pupils,didnotpreserve itis I have theimpression thatacentralimplicationofPlato’s metaphor isthatthemindand Platonic ideasare absolutetruths. This impliesthatthere isonly onepossibledefinitionof Plato’s mainmetaphorforidealism,whichisinspired by theIonian (ancient Turkey) The mind of the new organismisnotawareThe mindofthenew thatasoulisitsneighbor. But, sometimes,a but is aspiring after true being(Plato, 1937, but isaspiringaftertrue body, andhasaslittlepossibletodowithit,whenshenobodily senseordesire, her —neithersoundsnorsightspainpleasure, —whenshetakesleave ofthe Thought isbestwhenthemindgathered intoherselfandnoneofthesethingstrouble 5 . Knowing oneselfisnotthepsychotherapist’s urgetohelppeoplediscover Phaedo , 65,vol. I,p. 448f). IDEALISM ANDTHEGOALS Theatetus, 190, 13 INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL THE ART AND SCIENCE OF SOMATIC PRAXIS 14 INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL THE ART AND SCIENCE OF SOMATIC PRAXIS body andthemind. by Hegelian andMarxist dialecticallogic.It isonly attheendofhislifethathetalked afunctionalidentityofthe psychoanalytic period,Reich maintainedthattheinteraction between bodyandmind wasdialectic.He wasinspired coherence. Coherence emerges from thedialectics that organize the heterogeneous elements of a system.During his 6 idealism thatassumedtheuniverse isacreative, coherent andharmoniousentitywhich vision inwhichthesoulisdistinctfrom thebody: work with.Platocomfortably isprobably themostinfluential philosopherwhodeveloped a remain valid possibilities,psychotherapists tendtousewhatever philosophicalframetheycan that generatesanimmensevariety ofheterogeneous phenomena.Asallthesepointsofview laureate François Jacob (2000) wrote beautiful pages on the underlying unity of a universe onecanfindbothphilosophicalstances. in present dayDarwinism For examplethe Nobel introduced scienceofbiology. a similarargumentintothenew Charles Darwin However, of view, but didnotalwaysassumethatthere existedanunderlying coherence oftheuniverse. have quotesthatare usedasaphorisms(Heraclitus, Fragments, 2001): forces thatyou cancontacttheunderlyingunityofuniverse. His textsare lost,butwe still Heraclitus, itisonlyonceyou have learnedtomasterthefrictionsactivated by heterogeneous use theconflictingforces ofanorganismiswhatleadstohealthandcreativity. According to ofanotherIonianwith theviews philosopher, Heraclitus, whoassumedthatknowing how to synergic dialecticalcollaborationcalledlove among theseheterogeneous forces, whilehealthemergeswhentheseelementslearnaformof (water, fire, andair). earth He believes thatillnessisaformofchaosenhancestheconflict our organismsare structured by conflictingforces suchastheelementscontained inourbodies the soul,naturallawsorcosmicenergy. For inPlato’s thephysicianEryximachus Symposium, strongest argumentisthatevilproduced empathy, by alackofcontactwith eternaltruths, universe couldgeneratewars,torture, exploitationand illness(Ferry,The idealist’s 2012:16f). inpress;energy (Lewin, Pierrakos, 1990;Boadella1987;Boyesen, 1970). as avalidation oftheideathatsoulanditsmindare ofthedynamicscosmicorvital apart Balcetis andCole,2009;Marlock and Weiss, 2001); whileothersusethisetymologicalhistory use formulations such as “embodied” or “organismic” psychological dynamics (Heller, 2012; dynamics. Some use this argument to stress that the mind is a subsystem of the organism, and this linguisticroot designatespsychological procedures ascogwheelsimbeddedinorganismic as psychiatry, psychology and psychotherapy. Somatic psychotherapists repeatedly stress that life thatanimatesanorganism.It isthissemanticroot thatisusedfordenominationssuch became known asthepsyche. The Greek word “psyche” designatesthesoulandbreath of by inthe17thcentury. Descartes It isthisunifiedvisionofthesoulandmindthatgradually ofthesoul. idealism assumedthatthemindwaspart This wasforexampletheposition proposed MICHAEL C.HELLER,PhD It maybe relevant toremind thereader thatadialecticalinteraction isnotthesamethingassimpleharmonious The idealist view has an important flaw:ithasahard hasanimportant The idealistview time explaining how such aperfect In the 17th century theDutchIn philosopherSpinoza the17thcentury (1677)presented aform ofpantheist From Hobbes andHume onwards, British certain philosophersfollowed Heraclites’ point I, p. 450). pure knowledge ofanythingwe mustbequitofthebody(Plato, 1937,Phaedo, 66,vol. andallexperienceshowsand hindersusfrom seeingthe truth: thatifwe wouldhave The bodyintroduces aturmoilandconfusionfearintothecourse ofspeculation, The cosmosworks by harmonyoftensions,likethelyre andbow. (56) From thestrainofbindingoppositescomesharmony. (46) Harmony needslow andhigh,asprogeny needsmanandwoman.(43) 6 . Plato situateshimselfindialecticalopposition approach tobody-minddynamicswasinitiallyproposed by attheendofhislife. Descartes and coordinates (Misrahi, 1992),suchasjustthemindorbodyindividually. This new organism canmanageagreater numberofuniversal dynamicsthanthesubsystemsitcontains well aswisdom are not located in a dimension of theorganismbut in theircoordination. The vision themindisalsodistinctfrom matter, butthevisionisnow more systemic.Affectsas whilethelargerones(agalaxy)containagreaterrules, numberofuniversal dimensions.In this needs tofollow thesmallerphenomena(anatom)canonlyfollow theserules: someofthese these principles,disempowerment, willemerge.Every oftheuniverse illnessandmisery part on) conformtothelogicofnature theywillremain healthy, butassoontheydeviatefrom is noGod, astheuniverse created itself. If subsystems(asociety, anorganism,acell,andso theregenerates allofitscomponents (galaxies, planets and organisms).In thisatheisttheory believe thatReich’s orgonewasthe bestwayofdescribingcosmic forces. They were aware that may benoticed thatinthisgenerationofbody psychotherapists, colleagues didnotnecessarily could have facilitated theemergenceofcapitalism,slavery, racism,fascismandcommunism.It rigid cultural norms on the management of emotional interactions and the idea that certain was in line with the humanistic ideology that became fashionable view in the 1960s and 1970s, cultural environment thatwasrarely available inthesocietiesthatexisted1970s. This Reich onwards thatthesedeepemotionalstatescould onlybeexperiencedinasupportive which we hadtheimpression ofbeingadynamicglobal coherent entity. It wasevidentfrom ended, we experiencedincredibly powerful anddeeplyblissfulmomentsofharmony, during learned to express our negative and positive affects as fully as possible. Once the discharge had with theirsexualpartners. Those ofuswhofollowed oneofthesepost-Reichian approaches individuals becomehealthy, self-regulating, andcreative constructive personscapableoforgasm This modeofthinkingledtoavariety ofbodypsychotherapeutic approaches thataimtohelp of socialorganization,ontheotherhand,generateconflict, hate, illnessandsexualfrustration. dynamics from whichwe emergeinacoherent way. Chaoticforces engendered by current forms contained inourorganism,andallows oftheuniversal ustoexperiencetheblissofbeingapart this force activates adevelopmental process thatharmonizes thegreat diversity ofmechanisms close toPlato’s conception oflove asoneofitsmanifestationsisorgasticpotency. Contacting Wilhelm Reich. They learned that there exists a force that is of cosmic origin and that must be When I trained in psychotherapy in the 1970s, most body psychotherapists were influenced by (Selver and Brooks, 1980,p. 117),butthatthere ismore inthebodythan themind. truth that anincreased interactionbetween body and mindoftenbrings“greater innerrichness” his awareness hiddeninhisbody. ofthetruths What isidealized insuchformulationsisnot idealist body-minddisciplines,healthcanonlybeattainedifaperson’s mindlearnstoincrease the pulsationthatemergesfrom ourorganismwillgeneratepleasure, healthandwisdom.For Reichian somaticpsychotherapists isinourbody, tobelieve thattruth andthatlisteningto we are of. apart For him,hatingoneself isequivalent tohatingnature. This hasledmanyneo- capable ofexperiencingorgasticlove, fondnessforother creatures, andrespect forthenature to beincontactwiththedynamicsoforgoneifwe wanttobecomehealthyresponsible citizens and animatestheuniverse, whichhecalledtheorgone(Reich, 1951).He thatwe need asserted he claimed that we should all become aware of the logic of the cosmic energy that structures Soul, I.30). via themechanismsthatregulate “the assemblingoforgans” 1953, Passions (Descartes, ofthe ofways,heconcludedthatthesoulisprobably “jointly”sorts ofthebody linkedtoalltheparts After years ofenvisagingthemultipleandcomplexrelations between mindandbodyinall I situate Wilhelm Reich’s Orgonomy in this movement (Boadella, 2004). During the 1940s, IDEALISM ANDTHEGOALS 15 INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL THE ART AND SCIENCE OF SOMATIC PRAXIS 16 INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL THE ART AND SCIENCE OF SOMATIC PRAXIS 7 others. Ihave metbrilliant andefficientpsychotherapists whodefendeitherof these options. inclinations. Every thanwith typesofinterventions therapistismore withcertain comfortable These choicesare dependentonapsychotherapists’ partially individualcharacterandpersonal Maybe bothformulationscanbeblendedastwocomplementary, albeitirreconcilable, aims. These issuesare openquestions,becauseIdonotthinktheycanleadtoastraightanswer. capacity tomanagetheconflictualforces thatstructure hisorganismandenvironment? the psychotherapist promise more harmonyattheendofasuccessfultreatment, oragreater patients developed and referenced inmy book on body psychotherapy (Heller, 2012).Does others (Stern, 1985). probably innateaimscouldbestrong motivators toincrease thequalityofcommunication with can eventually beconsidered asymptomofpsychopathology whenitbecomesextreme. These of a form of wishful thinking that seems to be imbedded in the human condition, and that forinfants(Beebe, 2011). important This needappearstobeparticularly This isanexample ofthehumanmindneedtoexpectpredictabilityit ispossiblethatsomeparts andcoherence. Values. in the1993secondfull-lengthfilmon Addams Family: Sonnenfeld’sBarry brothers andsistersare agoodexampleofstate ofaffairsthathasbeenbrilliantlycaricatured Melanie Kleinposited thateven infantsare fulloflove andhate. The violentfightsbetween these disordered processes wasforhimtheessenceofbiologicalevolution. Psychoanalysts like and reproducing. Learningtolive findwaysofsurviving organisms whonevertheless within damage anelectricalinstallation. differentiation isrequired togenerateelectricitywithoutcreating circuit thatcould ashort differentiated polarities(+/-)tocreate andmanageastrong difference ofpotential.Anoptimal inelectricalengineering: other tolightfires.you need well- Asimilareffect canbeobserved that energyisoftenproduced twoflintstonesagainsteach through friction,aswhenrubbing ofeachelement.Paulproperties Boyesen, Gerda Boyesen’s sonandcolleague,reminded us one tochanneltheantagonisticenergiesofwaterandfire withoutdestroying theparticular activated by water and fire. Cooking and steam engines are well-known examples. Metal allows massage, taught us that metal is an element that can creatively regulate the conflictual forces perspective. Hiroshi Nozaki, withwhomIlearnedJapanese techniquesderived from Chinese the impossibilityofharmonizingwaterandfire. Even acupuncture thischangeof supported intelligence original formulations,andthemodularmodelsofartificial therefore psychotherapeutic) goal,andIbegantointegratetheprinciplesofHeraclitus, Darwin’s passion forPlato’s shapes individual organisms (Boadella, 1987). These theories resonated with my youthful nature animatesus.Some begantousetheterm“soul” withitsoriginalmeaning:thatwhich formulations developed by spiritualmovements fordeepeningtheirunderstandingofhow an incredibly powerful movement. Inspired by Jung, manypreferred torefer tomore refined Reich’s formulationsandtechniqueswere onlyarough initialsketchofwhatcouldbecome MICHAEL C.HELLER,PhD One oftheauthorswhointroduced modularmodelstoEuropean bodypsychotherapists wasFrancisco Varela (1979). In from harmonyandcoherence the1980s,mythinkingdeparted asamainhuman(and This is a summary of a long discussion on the aims proposed byThis is psychotherapistsa summary to their (1859,chapter waspuzzled by theincrediblyCharles Darwin V) messyarchitecture of Idonotthinkthatnature necessarilyfunctionsinacoherent andharmoniousway, but Dialogues . 7 . They allstressed Addams Family thoughts, behaviors,gestures, emotional reactions and musculartensions,) are necessarily Lowen and Fritz Perls) istheassumptionthatallformsof same thingasbecomingaware ofthesoulasdefined whenhewas50 by years old. Descartes I.30). In happensasifbecomingaware theseapproaches ofbodilysensationsisthe everything the mechanisms that regulate “the assembling of organs” 1953, (Descartes, theory, inwhichhewondersifthesoulisnot“jointly” ofthebodyvia linkedtoalltheparts thatdefendstheoptionsofidealisticsomaticpsychotherapies isDescartes’classical theory last for thosewhobelieve thatsoulandbodyare unconnecteddistinctentities.In facttheclosest ofmeknowWhich parts what? to admit that their clinical intuitions highlighted the fact that a highly visible habitual behavior if onecriticizes thewaypsychoanalysts ofthe1930stalked defensemechanisms,onehas and affectsinteractinawaythat reducesparticularities moods.Even the variability of certain a sign of anxiety or a way of producing anxiety, but one can show that in many cases postural with thefluidityoftheir regulation. It isimpossible toknow is whether sittinguncomfortably veins (Heller, 2012, chapter 12). Their interaction with affective dynamics may also interfere that somehabitualprofessional postures forspines,breathing canbedestructive patternsand they highlight how deeply imbedded in organismic dynamics such schemas can be. We know wasonlyadefensesystem. of the20thcentury psychologistsanalyst, butthatdoesnotmeantheintelligenceofone themostimportant (Ciffali, 1986).In thissituationPiaget’s intellectseemstohave managedtodisempower his according toher—Piaget onlyusedthesesessionstoexpress hiscritiqueofFreud’s approach a psychoanalytic thetreatment, process. Aftereightmonthsshedecidedtointerrupt because— intellectual integrityasadefense.In the1920s,Jean Piaget becameSabina Spielrein’s patientfor therapeutic goalthanremoving them.Awell-known exampleistheuseofintelligenceand not also have useful functions. In other words recalibrating automatic schemas is often a wiser several meanings.It is notbecause a skill is used as adefense against a treatment that it does But even whenitisso,aschemamayhave several functions,inthewaythataword mayhave are usedasadefenseormayhave anegative impactonotherorganismicregulation systems. children. In forspecific reasons, thatsome othercasesImayobserve, regulation procedures been usefulwithone’s parents, inthefamilyonehascreated butmaybedestructive forone’s been relevant, but does not fit with the present environment. For example sulking may have automatic waysofdoingthings.Inthatahabitualbehaviorhad somecasesImayobserve andcreative.destructive Itherefore tendtocallthesebehaviors“automatic regulators” or needed. They canbemore orlessuseful,more orlesscreative. They caneven besimultaneously Most habitualschemas are otherswere skillswe needto survive; usefulonce,butare nolonger varied, have infinitely varied needs, modes of functioning and ways of expressing emotions. way of imposing a so-called “humanistic” vision on patients. In humans are my view infinitely your emotions,andhow you hadlostyour authenticity. This strategywasaquasi-Pavlovian ordidnotyell whenyou wereyou didnotcry sadorangry, you were askedwhyyou blocked time andyelled, thetherapistwouldcongratulateyou forbeingsoauthentic;whileevery angry Reichian timeyou were therapiesandtraininggroups ofthe1970s,every sadandcriedor them awaysothattheorganismcanrepair itsspontaneousregulation systems.In mostneo- organism by socialrituals. destructive To rediscover whoonereally is,onemusttherefore throw chronicdestructive defensesthatshouldberemoved. They have beenintroduced intothe Another typicaltraitfoundamongthosewhowere influenced by Reich (e.g.,Alexander Idealistic bodypsychotherapists tendtoreject becauseforthem,heisanicon Descartes, For today’s psychologist, ofthesediscussionshabitualbehaviorsisthat theuseful part habitual IDEALISM ANDTHEGOALS organismicpractices(e.g., Passions of theSoul,

17 INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL THE ART AND SCIENCE OF SOMATIC PRAXIS 18 INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL THE ART AND SCIENCE OF SOMATIC PRAXIS anatomy books. shape,allmusclesa These manuals assumethatallspinesshould have acertain humans functionwithalogical model. dynamics. It isinthiscontextthatSpinoza, inhisEthics (1677),attempted todescribehow thathappens,even psychologicalthat onedaywe could mathematicallydescribeeverything can beexpressed with logical, geometric and mathematical formulas. These scientists believed laws. non-contradictory The causal laws that animate the universe are so coherent that they single setofcoherent laws thatgovern phenomenonoftheuniverse, andmustrespect every presented themselves asscientists,suchGalileo andNewton. They believed thatthere isa “empirical scientific idealism”, whichappeared alongsidethefirst researchers whoexplicitly efficiency seldom overlap. Theyare therefore complementary. efficient thanthemore classicalformsofglobal-depthpsychotherapy. However, their realms of the momentresults provided by thistrend ofresearch are oftenhelpful,butnotreally more Papadopoulos, andPriebe, inpress; Savarese, 2013;Segal, Williams, and Teasdale, 2002).For symptomatologies, inthehopethatpsychotherapy wouldbecomemore efficient(Röhricht, could evaluate the relevance of specific modes of psychotherapeutic for specific intervention of psychotherapy isreal butlimited.Some ofthemmanagedtofinanceempiricalstudiesthat of psychotherapy processes, whichcanchangefrom oneformofpsychotherapy toanother. or omnipotent. This evolving contextledtoincreasingly lessambitiousandmore specificaims encompass alltheexistingpsychological dynamicswere considered old-fashioned,utopicand/ that focused on different aspects of their psychological dynamics. Approaches that claimed to andthatsomepeopleneededdifferenthad itsdomainofexpertise, formsofpsychotherapy 1970s manypsychotherapists choseamore modularapproach, which assumedthateachschool not require that a psychotherapy method solve all the psychological problems of a patient. In the need.quite alotofcases,even ifitdoesnotfitevery visionwhichdid Thisanalysisledtoanew changing oceans.Being ready therapeutic aim in toclimbontoashipagainisworthwhile enthusiasm. However, itisnotinsuchaharborthatwe candevelop theskillstofaceever- which inturnallows ustobecomeready toclimbonceagainontoourshipswithrenewed is akintoaharborforsailors.It containsamomentduringwhichwe canrest andbethankful, regulation, but not all. That is when I began to think that using methods based on harmony the 1970s,sheadvisedustoacceptthatherwork couldcure aspectsofouraffective certain discovered (Carleton, 2002). For example, at the end or our training with Gerda Boyesen in approaches, Jungian analysisor Transactional Analysistoconsciouslyintegratewhattheyhad psychotherapeutic process usingothertechniquessuchasGestalt therapy, psychodynamic that nootherknown approach couldintroduce usto. However, manythencontinuedtheir (Walt Whitman, Scientific Idealism Reck, andZiegenhain, 2008). psychotherapeutic strategy(Heller, 2012,chapter22;Downing, 1996;Downing, Bürgin, the aimofdiscovering how theycanbeleveraged toinfluencedeeperlayers, isalsoapossible social procedures. It naturally follows that initiating an analysis of habitual behaviors, with may bethetipofaniceberg,withaweb ofroots beneath,deeplyimbeddedinorganismic and MICHAEL C.HELLER,PhD In thebodypsychotherapy traininggroups ofthe1970s,we discovered innerworlds Do Icontradictmyself? Very well, thenIcontradictmyself, Iamlarge,containmultitudes In medicine thisformofempirical idealismexpresses itselfinaspectacular way with It whatIcall iswithinthesescientificand/or empiricaldiscussions thatoneoftenobserves Gradually, anincreasing numberofpsychotherapists acceptedtheideathatefficiency Song ofMyself , 1892 8 ). biological evolution andoftheorganismsthatemergefrom it.Empirical idealismassumesthat orforDarwin’sis notnecessarilycomfortable, thoughtsonthe spontaneous messinessof of idealism,becauseitleaves noroom forconsiderationsthatassumethehumancondition by themediawhencriticizingDSM-5.Ihave theimpression thatthistrend isanotherform is durablyembeddedinthedynamicsofanorganism.It isthisideologythatoftenhighlighted to considerpsychopathological anyformofpsychological assoonit orbehavioraldiscomfort is appliedtopsychiatric classificationsdeveloped from the1990sonwards. Thepresent trend is Any deviation from this reference model is considered pathological. The same type of reasoning that makesaminimaldemandonmusculartonewhileremaining inharmonywithitspurpose thermodynamics. It forexample,therequirement supports, thatacorrect movement istheone given tonus,andsoon. The argumentthatdefendsthisassumptionisbasedonmechanicsand He thenusesoptional strategiesthatoftenwork. where, mostlikely, hecanfindfish. heknows Nevertheless that hisintuitionisnotalwaysright. of ariver, oftenhasagoodideaofwhere to throw hisbait.His experienceallows himtoknow psychotherapist canusehisclinicalknowledge abitlikefishermanwho,sensing thecurrents awareness of how he functions in his a clientneedsor what hisgoals are, we know how to pay attention and help him sharpen his require different pedagogicalprocedures foreachperson.Even ifwe donotknow exactlywhat as well process, asemotions,oftenmay fosteraconstructive andthatthistypeofprocess can thatpayingattentiontothespecificsofexperiences associated withbodilysensations, observed be usefulforawiderangeofcases. Many aspectofourexpertise. ofushaveThis isanimportant psychotherapists do, we have can enough experience to know forms of intervention that certain andscienceofpsychotherapyis whysometalkoftheart diagnosticinterviews. explicit setofgoalsforapsychotherapeutic afterafew intervention That activated duringpsychotherapy sessions.It istherefore difficulttopropose a robust, reliable and practitioners inareliable way. We donothave awell-established mapofthedynamicsthatare haveand psychiatry not yet been able to provide robust models that can be used by most study ofhumanpsychological dynamicsisarelatively young discipline.Clinicalpsychology providing clearprinciplesthatdefinetheaimsofpsychotherapy treatment, isthatthescientific Combining Scientific, Empirical andClinical Observations to beless“perfect” fortheeye. prefer aworldinwhichapplescanofferwidevariety oftastesandtextures, even iftheyseem ecological nichesandhavevariety distinct properties. ofapplesthat fit particular Personally, I inallcontextsandfacilitateindustrialagriculture, whilenaturesurvive tendstoproduce awide companies thatproduce geneticallymodifiedorganismstendtolookforanidealapplethatcan there isoneformofadaptationthatbetterthanallotherformsadaptation.For instancethe ethically fair vocabulary wouldmakethetextmore difficult to ethically fairvocabulary read. render homagetobothsexes. Iwillusethetraditional masculineformwhenthesexisunspecified fortheseterms,asan 11 Praxis. See alsoSchore, 2012. 10 9 Some ofmyChinesetaichiteachersalsousedthisformulation. Patients and psychotherapists are either maleorfemale.Icanonlyregret thatthere existsnotermtoexplicitly For example the International Body Psychotherapy Journal has the following subtitle: and Science of SomaticThe Art Even if we assumethat we to understand what do notyet have an adequate theory One pointthatiswell known, hasastrong butnevertheless impact onthedifficultyof Research andClinicalExperience 11 cultural environment. For François (in press) Lewin a 10 . IDEALISM ANDTHEGOALS 9 . 19 INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL THE ART AND SCIENCE OF SOMATIC PRAXIS 20 INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL THE ART AND SCIENCE OF SOMATIC PRAXIS that theymanagemore dataandmore complexitythanan individual consciousnesscanapprehend. 12 of dataonintrospection, physiological phenomena,nonverbal interaction between patients Itconstructions. isthisadventure thatisslowly puttingitself together. It requires acombination of researchers that willstudythephenomenawithawidevariety ofmethodsandtheoretical a process, andthat are structured by it.Such aresearch project requires alargecommunity by psychotherapy. What we needtoanalyze are thenonconsciousprocedures thatstructure than onanunderstandingofthe procedures. Current empirical research doesnotsatisfy thisneed,asitfocusesonendsrather a scientificunderstandingofhow psychological dynamicscanbecalibrated by interpersonal Haynal-Reymond, andHeller, 2000;Frey, Jorns, andDaw, 1980),thatwillallow ustocreate psychotherapeutic interactions(forexample,Donnellan, Hill, andLeary, 2010;Archinard, of, andthenteachthetheoretical modelstheycouldimagine. their disposal,theycouldonlydescribehow theyexplainedforthemselves whattheywere aware (in Freud’s sense)andnonconscious conscious potentialtodescribephenomenathatregulate theindividualconscious,unconscious Stern, 1995;Haynal, 1993).One ofthedifficultiesisthatfirstpsychoanalysts usedtheir who are alsoinvolved inresearch (Roussillon, 2011;Beebe andLachmann,2002;Bucci, 1997; ways ofexplainingwhytheyare efficient. Thisimpression isshared by several psychoanalysts clinicians to revisit old strategies (Kramer, de Roten, Perry, and Despland, in press) and find new way ofunderstandingwhatpsychotherapistsand anew already do. These results mayalsohelp that willrequire formulations. new n modesofintervention This willinevitablyleadtonew phenomena that are activated during psychotherapy could lead us towards unexpected findings limited thescopeofthatgeneralization.It scientificexplorationofthe wouldseemthatatruly patients were necessarilyhealthier. This mayoftenbethecase,buthere we sawcasesthatclearly was counter-intuitive fornearlyallofmycolleagues,astheyassumedthatthemore expressive them were oftenmore expressive thanthosethatdidnotmakeanothersuicideattempt. This For thatpatientswhomadeanothersuicideattemptafterwe hadfilmed examplewe observed analyzed couldbeeasilyintegratedby arecognized formofpsychotherapeutic intervention. were not predicted by known psychotherapeutic theories, and that none of the phenomena we patients (Heller etal.,2001),Idiscovered thatmostoftheinteractive patternsourteamobserved rationalizations canbeusedasreliable explanations(Stern, 1995). psychodynamic psychotherapy works atleastsomeofthetime,butIdonotthinkthatthese psychotherapy process. For examplepsychoanalytic theoriesprovide rationalizationsforwhy actually allows onetodescribemore ofthephenomenathatare thanafew atwork duringa context ofpsychotherapy schools.However ofthematteristhatnonethesetheories thecrux be recognized by many but never by allrespected psychotherapists oftheethnographic is apart spontaneous creativity inarelatively efficientway. may Thefactthatapsychotherapeutic theory andchannelhisintuitions because hewasattractedby them,and/orbecausetheysupport so on)thatheappreciates because they were fashionableinhistrainingenvironments, and/or what I call “placebo theories” (psychodynamic, Gestalt, Reichian, cognitive, behaviorist, and (Snyder, A.;Bossomaier, T., andMitchell, D.J.,2004).Apsychotherapist willtendtouse 2010). This experienceiscalibratedby nonconsciousprocedures explicitguidelines andafew based onclinicalknow-how are oftenreliably efficient(Despland, Zimmermann, &de Roten, MICHAEL C.HELLER,PhD My (Heller, 2012) understandingofnonconsciousdynamics isthattheycannotbecomeconscious. One reason is In myscientificstudiesofnonverbal interactionsbetween psychotherapists andsuicidal Empirical researchers are gatheringdatathatindicatetheprocedures usedby psychotherapists What we donothave enoughofis procedures 12 . They didtheirbest,butgiven themeansthatwere at fundamental research (physiological andpsychological) thatare activated onthemechanismsthatstructure then show thatautisticchildren are capableofexperiencingaffective empathy, butnottheother entity, butratherthree dissociablesystems:sentiments,cognition,andexpression. partially They example RalphJ.Savarese (2013)reviews studieswhichclaimthatempathyisnotacoherent allow ustocombinehard datawithsubjective datainauniqueway. therapists tounderstandwhatisreally happeningduring theirtreatments. Such research would standard empiricalstrategiesthatare usedforevidenced-basedtreatments, butitmayalsohelp exploration cangathermomentum,itwillnotonlygive usmuchmore informationthan a steadilyincreasing body of evidenced-basedresearch ontheefficiency ofthestrategiesused by to internalandexternalevents. Today theawareness ofthepsychotherapist by isalsosupported (Kignel, 2010),understandthem, andproduce more refined modelsof how humans respond behavior andimpressions. Today thistrend stillexistsasawaytoresonate withpatients toforgetogetheranexplicitweb ofmeaningsthatcanbeassociatedwiththepatient’stry gestures andsoundsthat are explicitenoughtobegraspedby histherapist. They canthen behavior. while empathicallydigestingthrough hisown affects thegeneraltoneofpatient’s nonverbal this isoftenadifficultyoftheclient. Thetherapistmay thenfitshared meaningsinto models of thisstrategyistoexplore how apersoncoordinates hisinnerdynamicswiththatofothers,as an explicitwaythathecouldthenhelpthetherapisttounderstand him. The therapeuticgoal Contacting theDynamicsofIntimacy inand/orFocusing onAlleviatingSymptoms which were previously by cliniciansbutare considered infactcentral. secondary theyneed.Suchand thesupport studiesshow how experimentalresearch canilluminatepoints the know-how developed fordepththerapytoincrease ourunderstandingofautisticchildren information gathered by research inexperimentalpsychology, evidence-basedstrategies,and positively influencethiscorrelation forautistic children. Thiswillthenallow ustocombine between specificmotordeficitsandIQtesting, wecantestwhichformsofclinical treatment (Donnellan, Hill, andLeary, 2013).However, now thatwe know thatthere existsacorrelation autisticchildren), certain butitdoesnotvalidate aspecificformofsensorimotorintervention (e.g., themotorsystem)tore-educate psychological dynamics (e.g.,theintellectualcapacityof type of research on a variety of organismic confirms the need to intervene regulation systems body-mind therapistsandpsycho-motor therapiststofindwaysofexploitingthese results. This options, butnotconcrete practicalprocedures. It isforpeoplesuchassomaticpsychotherapists, demonstrating thetherapeuticsalienceofaspecificissue. cansuggestspecific Theseobservations is aconcrete exampleofresearch settingaspecificaimforpsychotherapeutic treatments by “addressing treatments” motordevelopment inearlyintervention withautisticchildren. This expression, or between thinking and doing. Once this has been shown, researchers recommend themselves (verbally andbodily),inhibitscurrent feedbacksystemsbetween sentimentsand on theircognitive performance. The motordisturbanceinfluencestheircapacitytoexpress two forms. They sufferfrom an“alteration ofmotorperformance” thathasanegative impact need toknow whathappenstoapatientandtherapistaftertreatment that structures thefieldofpsychotherapy. This research requires developmental data,as we and therapists, sentiments, impressions, thoughts, and an understanding of the cultural system 13 One oftenforgetsthatpsychotherapy mayalsoinfluence thewayapsychotherapist regulates. Scientific research willinevitablychallenge classical psychotherapeutic assumptions. For In somaticpsychotherapies the patientisencouragedtoexpress hisexperiencethrough Classical psychotherapy required thatatherapisthelppatientunderstand himselfinsuch IDEALISM ANDTHEGOALS 13 . If suchascientific 21 INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL THE ART AND SCIENCE OF SOMATIC PRAXIS 22 INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL THE ART AND SCIENCE OF SOMATIC PRAXIS discomfort, and that most of these sexual perturbations are andthatmost ofthesesexualperturbations manifestlygeneratedbydiscomfort, social integrate somatic activations andimpressions inducedby exercises, medication anddreams. a somaticperspective. Bodypsychotherapy isthetoolthatallows patientstoconstructively the efficiencyofpsychiatric demonstrates theneedtoapproach affective drugs dynamicsfrom one’s For deepestsentimentswitheducationaland medicatedformsofintervention. example in thisdiscussion,asitstheoretical stanceallows psychotherapists tocombineexplorationof strategiesdevelopedand thenew by psychotherapists. Somatic psychotherapy iswell placed Impact ontheAimsofPsychotherapy Ethical ConsiderationsRelated toanIndividual’s Social Support Systems That Have an approach tobody-mindconnections. initial proposal inthe1930s,mostneo-Reichian schoolshave proposed amore professional use theirknowledge tobecomefamiliarwithhisown sensorimotor dynamics.Since Reich’s use ofbodytechniques.He was surrounded inbody-mindapproaches, by butdid not experts for examplethecaseof Wilhelm Reich, whohadbeentrainedinpsychoanalysis butnotinthe that psychotherapists trainedinothermodalitiesmaynotnecessarilyhave acquired. This was using thesetechniques. These methodsrequire formofawareness, acertain respect andinsight trainingtoevaluateharmful ifthetherapisthasnotreceived theimplicationsof thenecessary context. For examplesomebodytechniques usedby asomaticpsychotherapy schoolmaybecome maynotbesufficientlycompensated by theothertechniquesusedinaneclectic of intervention moment, takingatechniqueoutofitscontextmaybeperilous,asthelimitsspecifictype theory, ethicsandphilosophicalintentionality. eachother. Alltheseelementssupport For the resolve isthateachclassicalapproach isamore orlesscoherent packageoftechniques,methods, influenced by thistrend. movements. Aspsychotherapy isonly120years old,mostpsychotherapists are stillstrongly of theplanet.Knowing eachotheraswe are isthusabasicdirective forearlypsychotherapeutic that haschangedtherelations between social procedures andindividualneedsinmostcultures that current chaoticaffective dynamicscoulddevelop inlesspainfulways.It isthisachievement ways ofimproving system(e.g.,psychotherapy system)so thesocialsupport isasocialsupport life. painsandaffectsastheyexistineveryday frustration, Their therapeuticaimwastofind the needsofspecificindividuals. Janet and Freud (Brown etal.,1996)wantedtounderstand existing human dynamics according to spiritual requirements developed independently of mental impressions, itwasoftenassociatedwithspiritualbeliefsthatsoughttotransform current intimatedynamics.Althoughmeditationisanincredibly powerful wayofexploring in theFar East,likemeditation,have notproduced suchaclinicalknowledge ofacitizen’s from Europe toAsiaandtheAmericas.Even therefined body-mindapproaches developed of humantherapeuticskills,whichjustifiedthefamefirstpsychotherapies inallcultures, locked intheirinternaldilemmas.It isthisbasicinitialaim,probably unheard ofinthehistory that offeringaframe in whichsucha dialogue could be established could helppeople who were psychotherapists totacklespecificpsychological, affective andbehavioralprocedures. MICHAEL C.HELLER,PhD The initialaimofpsychotherapists wasoneofunderstandingashared intimacy. They noticed The psychoanalytic modelassumed thatsexualmalfunctionactivates strong psychological I assumethatamnottheonlypsychotherapist whooftennavigatesbetween thetraditional One trend ofthedifficultiesthatnew ofempiricallybasedeclecticapproaches needsto Combining Ethical andClinicalPoints of View to Define theAimsof Psychotherapy They are thentakenover by medicalcare systems,whileemployers andsocialsupport feelfree professional environment untiltheyhave aburnout,becomedepressed, orcommitsuicide. familyplanning. support by socialinstitutions. needs besupported This ledtothecreation ofpowerful institutionsthat was stillapsychoanalyst. He created structured political movements todemandthat sexual (Geuter, Heller, & Weaver, 2010).It wasthendeveloped inamore systematicwaywhileReich was atfirstdeveloped by Freud andthe youth movements atthebeginningof20thcentury working conditionsthatgeneratestress, andsoon). This epidemiologicalapproach toneurosis make onefeelguiltyaboutexperiencingsexualpleasure or havingone’s own sexualstyle,poor dynamics suchasbeliefsthatgoagainstinescapableinstinctual needs (e.g.,religions that the social rituals that a person has practiced (sports, furniture,the socialritualsthat apersonhaspracticed(sports, eatinghabits,profession, etc.). 14 respectable, but some are more ideological than therapeutic. They can never be the only aims of 2001; Heller, 1993; Rosenberg, Rand, and Asay, 1985; Lowen, 1975). Most of these goals are to energeticallypulsate(expand andcontract)witheasepower inpress; (Lewin, Brown, orgastic potency, thespontaneouscapacityforself-regulation and self-respect, andtheability inner harmonyandcoherence, usingtoolssuchasthedissolutionofbodyarmor, developing explicitly includedintheirgoals thattheirtreatment shouldhelptheirpatientstofind a greater or ideologicalconsiderations.For example,colleaguesmanifestlyinfluenced by Reich’s proposals improve hiswayofdealingwiththecyclical aspectofthesyndrome. Teasdale, 2002). They therefore thepresent crisis,andb) seektohelpthepatienta)survive at helpingpatientstolive withrecurring cycles ofdepression oranxiety(Segal, Williams, and some casesthisdoeshappen,buttodaypsychotherapists know thatitismore realistic to aim ambition ofdefinitively curingsomeonefrom difficultiessuchasanxietyordepression. In decades offunctioninginagiven habitusorway ofliving of functioningfrom organismic regulation systemsthathave calibratedthemselves through modes ifoneassumesthatitisdifficulttocompletely disentangleasetofdestructive support, Therapeutic Ethical Considerations That Have anImpact ontheAimsofPsychotherapy and fightforabetterfuture are aimsofapsychotherapy alsoasetofcrucial treatment. and preventive measures. Thus, publications,publicpresentations andhelpingpatientstohope political campaigns that will fight for moreand then support social environments constructive cannot cure patientswhohave toalleviatetheirsymptoms suffered from abuse,buttheycantry such astherightsofwomen,defensechildren againstabuse,andAIDS.Psychotherapists were borninto. This multi-generationalstrategyhasalready proven itsusefulnessindomains patients becomeactive militantsthatdemandabetterworldfortheirchildren thantheonethey and thatoneoftheaimsapsychotherapy treatment istodiscover that whyitisimportant Reich wouldwarnhispatientsthattheycannotbecompletelycured inthepresent socialcontext, is notonlyanideologicalissue,butacentralethicalandtherapeuticconcernforalltherapists. media thatthisviciouscircle isspreading For asrapidly asthewarmingofEarth. me,this social dynamics that destroy individuals. However, theycan inform theauthorities and the learn how todefendtheirinterests more efficientlyinthefuture, buttheycannotmodifythe condition. Psychotherapists cancoachpatientsoutoftheir present crisescrisisandhelpthem employeesto usethesamestrategywithnew whoare —forthemomentstillinahealthy This termisusedinthiswayby sociologistslikePierre Bourdieu (1979), whostudiedhow anorganismisshapedby In thepresent economicandpoliticalcontext,peopleare oftenusedandabusedby their Ethical considerationsrecommend thattherapistsavoid usingsimplisticempiricalresearch Alleviation ratherthancure isajustifiedaimformanyadultswhoneedpsychotherapeutic 14 . Psychotherapists oncehadthe IDEALISM ANDTHEGOALS 23 INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL THE ART AND SCIENCE OF SOMATIC PRAXIS 24 INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL THE ART AND SCIENCE OF SOMATIC PRAXIS to hispresent stateasbeingofamedium intensity, whileapatientwhoisonly usedtolower I noticedthata psychiatric patient whoisusedtoextremely strong anxiety attacksmayrefer anxiety ofsuicidal psychiatric patients andthosewhocometosee meinmyprivate practice. (BDI) andtheHamilton Psychiatric RatingScaleforDepression (HRSD))to evaluate the person. Fora particular exampleIhave usedthe sametests(e.g.,theBeck Depression Inventory but theirvalue isbased onstatisticalnotionsthatdonotalwaysprovide areliable evaluation of themselves, even iftheysufferfrom current psychopathological ailments. competent judgesoftheirneeds;butmostthetimetheyare highlycompetentevaluators of really are. Isometimeshave theimpression thatwhentheyhave a deepcrisis,patientsare not together, whatthepatient’s through amutualco-construction, underlyingdynamicsandneeds by thejudicialsystem,recommended positionisthatpatientandtherapistneedto discover and psychotherapists hasalonghistory. Except dramaticcasesthatare inparticularly supervised scientific wayofdeterminingwhatthepatientneeds. Abuse ofpower by psychiatric institutions a diagnostic (e.g., Lowen, 1975),and clinical psychologists use teststhat may be presented as a Oedipus complexorcastration),Reichians analyze thebody structure ofapatientanddeliver unconscious issuesthepatientdoesnotperceive (e.g.,anabusive useofnotionssuchasthe about the authority of a specialist vs. the empowerment of patients. Psychoanalysts attribute affective, behavioralandsomaticdynamicsinamixer, whatemerges. toobserve abandon theneed to focuson specific psychological requirements, and seem toputpsychological, trends suchascognitive andbehaviortherapy and/orneuroscience. These approaches tendto also useacombinationofbodyandmentaltechniques. They are manifestlyinspired by recent that teachrequired skills,improve affect regulation, resilience, andsoon. These approaches can recent criteriasuchasthereduction ofsymptoms(PTSD, anxiety, depression, etc.)andstrategies takes togetwhere hewantstobe. a widerangeofissuesthatcanhelptherapiststonavigateandcontaintheprocess thattheclient that usethesenotions.It isalsopossiblethattheuseofsuchtermsasimplisticpolarization do notthinkofharmonyortheintegrationconflictsunlesstheyalready appreciate theories Fenichel, 1935). They justwantlesspainandguidance around future choices. Most ofthem Who Decides What theAimsof Treatment Are? against thetreatment. counter-productive, asthepsychotherapist maynotrealize thathisethicscreate thedefenses (weltanschauung).impose hisworldview In suchcasesthetherapeuticprocedures maybecome the anti-anxietyprocedures taughtby thetherapistbutdisliketherapist’s constantneedto that allowinsuchapsychotherapeutic himtosurvive context.He mayforexampleappreciate isavoided, thepatientmayneedtodevelopsuch anexplicitco-construction defensesystems may combinewhatatherapistcandowell withwhatthepatientneedstointegrate. When a psychotherapist shouldtry, asmuchpossible,toexplicitlydiscusswithapatienthow they suffered, nottoexchange intellectualideaswithme. The ethicsofpsychotherapy require that refined aimsthanhistherapist.Ihave hadpatientsIadmire. Theycametoseemebecausethey his psychotherapist. Bothmaybeequallyrespectable. Sometimes apatientmayhave more as orgastic potency. A patient’s belief system may be quite different from those defended by psychotherapy. Even forReich, developing one’s creative professional potentialwasasimportant MICHAEL C.HELLER,PhD Patients thatenterpsychotherapy seldomknow whattheyreally need(Reich, 1949; Current psychiatric testingtechniques developed by clinicalpsychologists are alsouseful, Balancing thevariables thatwilldeterminetheaimsofpsychotherapy alsoraisesethicalissues Other bodypsychotherapists usealanguagethatisclearlynotReichian. They prefer touse the basketofimplicit goalsthatanimatemany psychotherapists. Most people cannotafford to to thepatient’s limitationsandneedsiseven more important. This interest canalsobeputin motivator,in thedeeperstructures ofthemindisanimportant but learningtoremain close understand the deeperinner conflicts ofthe patient. Thepsychotherapist’s passionate interest has disappeared. Many psychotherapists findthatthisisapity, becausethey were beginningto patients comeforaspecificpsychological pain,and wanttostoptherapyassoonthispain anxiety maybestrong today, buthave hadadifferent pasthistory. but canassociatelaterforavariety ofreasons. Thus anassociationbetween abackpainand ease anxieties caused by a separate set of issues. Two symptoms may have independent causes, office, theymaybeawayofcontrolling anger, and/orabackpainmayactivate endorphinsthat withanxiolyticdrugs. has beenobserved a psychologically tensepersonneedsrelaxation isoftenavalid aim,butnotalways. The same from oneindividualtoanother,They vary oreven from onemomenttoanother. Deciding that increase thelevel ofanxiety. amongallthese dimensionscanbehighlyvaried. The interfaces he islessanxious,butrelaxing hismuscleswithmassageorrelaxation whenheisanxiousmay tensions inanotherway. In somecasesthechronic musculartensionsofapersonrelax when For example,musculartensionsinfluence moodsinoneway, andmoodsinfluencemuscular The modalities of these mutual impacts can behighly variable, and are often asymmetric. the organism (Heller & Westland, 2011) often — but not always — interact with each other. goals (e.g., since my difficult birth anxietytightensmybreathinggoals (e.g.,sincemydifficultbirth andthisgenerateseven more I needtofindafatherwhocanhelpmemanagemyfearofmothers)andnonconscious a psychotherapisthave becauseI increasingly anger),unconsciousgoals(e.g., violentfitsof of a person. A patient arrives at therapy with a conscious goal (e.g., my wife wants me to see interpersonal dynamic. The issuesIhave justmentionedcanbesituatedindifferent strata and Reich (Reich, 1940,p. 90;Breuer, toanalyze apsychotherapeutic &Freud 1895,p. 206ff), evenalways foundthemusefulandinstructive, ifImostlyusedeeppsychotherapy procedures. patients whocometoseemealready have apsychological evaluation basedontests,Ihave with psychiatric tests. Nevertheless testingtechniques have becomeincreasingly refined. When intensities may consider an equivalent intensity as extremely high. This is a current problem 15 closely related or lesstightlyrelated. Assumingthatalltheevents occurringinanorganismare necessarily of thepatient,aswell asproblems thatothersmayhave withhim. These factors canbemore In AllCases Psychotherapy CombinesMultiple Goals come. Sometimes itistheopposite. then itwillrequire anotheryear ortwotoclarifytheissuesthatreally motivated thepatientto “official” symptoms of a patient (e.g., panic andlow months, but in a few self-esteem) depart of theissuethatbrought thepatienttopsychotherapy. Often (butofcoursenotalways)the will becomeincreasingly clear, andthatwe cancreate amore explicitcommonrepresentation patient enters the room. It is only gradually that the implications of this dialogue of patterns timethis unconscious reactions tomenwhofearmothers,andfeelaknotinhisstomachevery anxiety). In thesameway, thetherapistmaywanttousestandard procedures foranxiety, have AswhenAlexander Lowen (1975)talksoffunctionalidentity between bodyandmind. There mayalsobeagapbetween theambitionsofatherapist andthoseofapatient.Some Back painmaybeduetobiomechanicalforces causedby the chairusedby thepatientinhis To dealwiththeseissuesIliketousethemetaphorof layers orstrata,asoftenusedby Freud It isalsousefulto distinguish aimsthatconcernthebody, affects,lifestyle,andcognition 15 is a belief that is not confirmed by my clinical observations. isabeliefthatnotconfirmed by myclinicalobservations. Dimensionsof IDEALISM ANDTHEGOALS 25 INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL THE ART AND SCIENCE OF SOMATIC PRAXIS 26 INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL THE ART AND SCIENCE OF SOMATIC PRAXIS can integrateatthatgiven moment. problems ofapersoninonetherapy, orifpsychotherapists shouldonlyaimforwhattheclient advantages: recently becomeincreasingly intense.Separating aprocess intodifferent “chapters” hasseveral difficulties withhermother.a few Five years latershecametowork withtheseissueswhichhad For exampleapatientmostlyworked onherfatherduringafirstsetofsessions,butmentioned again oftenbeganwithissuestheyhadraisedinthelastsessionsofprevious setofsessions. chapters I outlined for them. I was amazed to notice that those patients who came to see me throughout theirlives, orwholaterconsultedwithothercolleaguestodealthenext of psychotherapy years. sessionsinafew Ihave hadpatientscometoseemeseveral times what we have accomplished, and then mention other “chapters” that may require another set psychotherapyshortest possible; but attheendofa treatment Ihelpthe patient tounderstand spend hoursunderstandingtheirdeeperselves. My wayofdealingwiththisistoencouragethe MICHAEL C.HELLER,PhD This to case, solveas well all as the several others, raises the issue of whether one should try Autobiography, together thedetailsandthuslearn andknow thewhole extentoftheloss(Mark Twain, loss –thatisall.It months,and possiblyyears, togather willtakemindandmemory power torealize ismercifully wanting. theirfullimport The mindhasadumb senseof is stunnedby theshock andbutgropingly gathers themeaningofwords. The stroke likethatand live. There isbutonereasonable explanationof it. The intellect It isoneofthemysteriesournature thataman,allunprepared, canreceive athunder- that arose withtheinstitutioninwhichshewasworking. I have onlyseenherforthree sessions,duringwhichsheneededtodiscussadifficulty This timesheneededtowork onherproblematic relationship withasister. Since then job, butdidnothave enoughconfidencetomake relevant career. choicesforhernew depressionnew emergedwhenhergrownup children lefthome.She waslookingfora We thenworked onissueslinkedtohermother’s behavior. intrusive Ten years latera had married,experiencedsexualpleasure andbecomeagoodenoughmotherwife. because shebecamedepressed onceallherchildren were at school.In themeantime she mostly worked onhow sheperceived herfather. Ten years latershecametoseeme and theorgasticreflex asdefined by Reich. Becauseofthe dreams thatappeared, we exploration of movement, muscular tensions, breathing patterns, emotional expression mechanical sexological reasons. I mostly used deep vegetotherapy, which involved the patient cametoseemeafirsttimebecauseshecouldnothave sexual relations, for on themesthatare manifestlyproblematic inthepresent situationofthepatient.One 2. Psychotherapy, efficient whenthe sessionsfocus in my experience, is particularly prevent thismuchneededrecalibration inreal life. dealing withselfandothers.In somecasescontinuingthepsychotherapy mayeven need toseeatherapistwhilethisrecalibration process materializeswayof intoanew what we discovered duringasetofsessionsmaytakeyears. Apatientdoesnotalways 1. Apatient must digest the often complex matters that structure his life. Integrating Finding One’s Way inthe Vicissitudes That ConnectanIndividual Psyche 1896-2012,p. 165). to Other Dimensions ofInteracting Organisms one’s health,scientificknowledge, andsoon. individual organism(Rochat, inpress), asinlearningbreathing techniques,ritualsthatprotect like anInternet connection.It cancontactformsofknowledge thatare notcontainedinthe assume thattheorganismmanagesmore However information than itsparts. themindis also Warnecke, 2011). If we of the organism, one can consider that the mind is only a part often thebeliefthatbodyknows more thanthemind(well-discussed inHull, 1997;see Amongsomaticpsychotherapists thantheotherparts. thereit isatleastclosertothetruth is know. theimpression ofuscantruly supports thatapart If itdoesnotknow thewholetruth, Many Roads LeadtoRome, butSome Are More Convenient Sometimes 18 17 16 How Much Understanding isRequired? habitual waysofexperiencinghimselfandothers. psychiatriccertain drugs relevant. isparticularly aspects oftheirprocess forwhich myexpertise Imayalsorecommend body we donothave thetimetoexplore, theymayfollow myadvice.Icanthenfocusonthose ask themtojoinayoga group tolearnhow connectionsbetween towork mindand withcertain week, even iftheywould needtoseememore frequently andcaneasilyafford it continues hispsychotherapy withme. Today, mostpatientsrefuse todomore thanonesessiona sometimes refer himtoacolleague,oraskjoingroup inanotherapproach whilehe what anatmosphere conveys. Clinical knowledge andexperienceare calibratorofthewayIunderstand alsoanimportant me todiscover whatdimensionsandtechniquescouldhelp agiven patientatagiven moment. atmosphere. It isthisconstantdialoguebetween mycomplexityandthatofapatientallows As Ialwayswork inthesameroom, Icanbecomehighlysensitive tosmallvariations inthe a richsource ofinformationforsomeonewhowantstoexplore how ourintimaciesinteract. neutral summary, asit includes how myself into the present Iinsert situation impact onapsychotherapeutic dyadorgroup. Its sources are notexhaustive anditisnota for myconsciousthoughts. This impression isstructured by mostoftheevents thathave an ofwhatishappeningthatcreated by mynonconsciousproceduresme isthebriefsummary several times.Allthesefactorsstructure thegeneralatmosphere intheroom. An atmosphere for all thesedimensionsatonce,butduringayear ofsessionsIhave usuallyvisitedsomeofthem interaction withthepatienthasonalldimensionsofmyown organism.Icannotfollow what mypatientcommunicatesabouthimself. This impliesbecomingaware oftheimpactmy nonverbal communication, and attempt to reconstruct inmyself what itmustbetoexperience how hisbodymoves, thetexture ofhisskin,gaze, breathing movements, posturaldynamics, exercises andmodels(Reinecke &Ehrenreich, 2005). behavior therapistsmostlylook forawareness andtheinternalization(orlearning)of relevant aim foranincrease ofawareness (Perls, Hefferline, and Goodman, 1951),cognitive and 2011) and“making theunconscious conscious” (Fenichel, 1953b, p. 185),Gestalt therapists dealt withinaspecificpsychotherapeutic process. Psychoanalysts require insight(Ahumada, In Switzerland medicationcanonlybeprescribed by amedicaldoctor. Several hoursaweek wasstandard untilthe1980s. Nice examplescanbefoundin Prengel &Somerstein (eds),2013. When Iwanttounderstandwhere apatientneedstogo,Ilistenwhathehassay, observe As already mentioned, Wilhelm Reich’s idealism,aswell asthebeliefthatwe have asoul, When itseemsrelevant, Imaydiscusswiththepatientslimitsofmyknowledge andmay Another issueintheaimsofpsychotherapy istoevaluate how muchunderstandingcanbe 18 , andthenexplore onhis withthepatientimpactofthatdrug IDEALISM ANDTHEGOALS 16 17 . However it is . However, ifI 27 INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL THE ART AND SCIENCE OF SOMATIC PRAXIS 28 INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL THE ART AND SCIENCE OF SOMATIC PRAXIS and Reich. 21 Milne, J.L.,Ansari,D., Culham, J.C.,andGoodale, M.A.,2011. 20 19 psychotherapeutic processes thatadvance by chaptersexplored atdifferent momentsinone’s someofitsmembersmaybringforth. explosive truths That isanotherreason whyIprefer That iswhysciencecanonlyprogress asacommunitythatgraduallyintegrates thesometimes andinformation. is thatindividualconsciousnesscanonlymanagealimitedamount oftruth I cannotfully understand my patients andhow work. myinterventions ofthematter The crux course limited.Even scientistscannot understandhow humansfunction(Stoljar, 2005).Even a patientcanacquire duringapsychotherapy isoftenenlighteningandempowering, butof its patientsthattheybecomeilluminatedbeings(Freud 1933,p. 86). The self-understanding consciousmerely arelativelyeverything sideissue” unimportant (1945,p.15). unconscious is the ‘real that everything motor’unconscious ones; nor is it true of the mind, and not arealistic aimforpsychoanalysis: “Consciousphenomenaare notsimplystronger than Hefferline, &Goodman, 1951) ways, closer to what is discussed in non-psychodynamic models such as Gestalt therapy (Perls, that canchannelafluidcirculation ofinformation. Thismore complexformulationis,inmany to protect upon,buttheyshouldalsohave theconsciousnessfrom aflexibility beingintruded mechanisms todisappear. He wantedthemtolosetheirrigidity:theyshouldhave enoughtone forpastexperiences.Norwhile theunconsciousismore likealibrary didFreud wantdefense (Freud, 1923,p. 176). Consciousness adapts to what ishappening in the here andnow, subject toaprocess ofwearing-away, whilewhatwasunconsciousrelatively unchangeable” Furthermore eachsystemhasdifferent aims,tasksandfunctions:“Everything consciouswas of hisexplicitconsciousknowledge toschoolchildren, the expenditure isenormous. ofeffort is familiartoallschoolteachers.Even whenateachertriestotransfersmallandsimplepart p. 76)thatisenormous,forboththerapistandpatient. This enormous“expenditure ofeffort” unconscious contentintoconsciousthoughtrequires “an expenditure ofeffort” (Freud, 1933, an impossibilityifonehasacorrect understandingofhispsychological system. Transforming and thepreconscious (Freud 1938,p. 30f) has thecapacitytoperceive andintegratealltheinformationthatcirculates intheunconscious possible, butoneofthemain aims ofpsychoanalysis. Freud did not thinkthatconsciousness Fenichel (1940,p. 185)andReich (1949,p.11), suchahighwayisnotonly asifconstructing used toconvey thatlastmeaningby theyoung psychoanalytic traineesofthetime—including that isintheunconsciousintoconsciousdynamics. Yet thisformulawasnearlyimmediately that attheendofapsychoanalytic therapy, informationflows onahighwaythatcanbringall consciousness by a resistance that transferentialis active in a particular context. He is not saying which “hasastrong upwards drive” (1933,p. 75)tobecomeconscious,maintainedoutof about apsychoanalyst whohelpsapatienttobecomeaware ofspecificunconsciousmaterial patient whenwe attempttomakehisunconsciousconscioushim.”Freud isactuallywriting analysis is,asyou know, infactbuiltupontheperception oftheresistance offered tousby the New Introductory Lectures onPsycho-Analysis such asimplisticiconicsentence.Freud onlyusedthisformulaattheendofhislife,in1933 without anyreferencing, asifthemainaimofapsychoanalytical cure couldbesummarized by MICHAEL C.HELLER,PhD Laura and Fritz Perls psychoanalytical undertook training in the 1930s in Berlin, where they studied with Fenichel For arecent studyon thelimitsofconsciousexplicitattention seeGallivan, J.P., Chapman,C.S., Wood, D. K., IthankAndréHaynal forhishelpinfindingthisquote. It israrely referenced. The iconicexpression “making theunconsciousconscious” isoftenattributedtoFreud, I have detailedthisdebatetohighlighttheidea that psychotherapy doesnotrequire of 21 . Even Fenichel finallyagreed thatthefamousformulawas 20 , inchapter31 . Making theunconsciousconsciouswasforhim 19 : “The whole theory ofpsycho- wholetheory : “The

precocious experience of sexual relations with actual excitement of the genitals, resulting from cases ofhysteria thatwouldhave been healedafterbeingable to recover of“a the memory indeed presented by Freud in three published in 1896. He articles speaks of the first thirteen isnecessarily that ofasexualabuseoccurred intheir childhood. Suchmemory was aview ofanevent repressedthe memory intheirunconscious.Some even believe thatthisrepressed activated by meditation. We donotreally know how psychiatric alleviatedepressive drugs less impulsively towhathappensaround anddestructively him.Asimilar effect canalsobe When apatienttakesananti-depressant, itoftenhelpshimtothinkmore clearly, andto react that oftenallows himtodevelop inamore wayforhimselfandhisenvironment. constructive somehow activates a general reshuffling in the nonconscious dynamics of a patient’s organism psychotherapists hascreated inthepast130years. Psychotherapists have noticedthattheirwork skills,apersonmaybereadyand hasgeneratednew foranextmeal,ifhestillneedsit. for awhileisoftenuseful.Once ithasbeendigestedandintegratedby nonconscious procedures the amountofdatatheymanage.Lettingthis“bloomingconfusion” 1890,p. (James, 462)rest life. There alwayscomesamomentwhenthemindsofpatientsandtherapistsare saturatedby Is There aMain Cause? direction.constructive to whathappensinhisenvironment, thetherapistknows thatforthemomentheisgoingina detect and follow. If these adjustments only slightly increase a patient’s capacity to self-adapt mayhave compleximplicationsthatapsychotherapistand clearinterventions canlearnto such asbreathing, metabolicactivity, moodsandcognitive procedures. In otherwords simple coordinated. In othercasesthesemodulesmayhave animpactonmore generalprocedures, organism a setofindependent heterogeneous localprocedures (or modules) thatare not realignment. For exampletouchinganarmorspeakingofadream mayactivate inthepatient’s taking anti-depressants and/orgoingtoameditationgroup. nonconscious procedures canemergemonths afterapatienthasstoppedpsychotherapy and/or person (Krishnan,andNestler, reshuffling thatoftenaconstructive 2008).Ihave of observed symptoms, and we cannot always predict will effect haveon a particular which a drug particular I stillhave patientswho cometomethinkingthattheywillbecured assoon astheyrecover At itsbeginning,theaimsofpsychotherapy were oftwotypes: This doesnotprevent theknow-how mefrom trusting thatthecommunityof In simple explanations or actions can trigger such a some nonconscious cases a few psychotherapy I, chapterIII). 1890,part (Janet, of integratingsuchheterogeneous internalmodalitiesis,forJanet, oneofthegoals responses, even whentheycouldhave usedmore complexones.Learningtofindways different setsofprocedures andgoals. Traumatized personstendtorely onlower level organismic mentallevels functionrelatively independentlyfrom eachother, andfollow require alargedegree ofintegrative capacity”These (Ogden &Minton, 2001,p. 131ff). most primitive, tothecomplexandsophisticatedactionsthat reflexive, andelementary II) For Pierre Janet, ontheotherhand,“physical andmentalactionrangefrom the once apatientbecameexplicitlyaware ofthesecausestheneurosis wouldjustdisappear. I) Freud suggested that neurosis was caused by asingle traumatic event. He thought that The Feeling Child,p. 13). accumulation, theloadofonebadexperienceafteranotherthatdoesit(Janov, 1913, It isnottheisolated experiencesthatproduce neurosis, however. It isthe IDEALISM ANDTHEGOALS 29 INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL THE ART AND SCIENCE OF SOMATIC PRAXIS 30 INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL THE ART AND SCIENCE OF SOMATIC PRAXIS emotional dimensions ofatransferential dynamic. Freud, Ferenczi andBalint includedinthediscussion of thepsychoanalyst’s difficultiesincombining thecognitive and 22 became lesscentralbutnever disappeared. With vegetotherapy, Reich innovated: hedefined instinctual behaviorswere regularly habits. inhibitedby sociallyconstructed neuroses. For thesecasesFreud proposed amodelthatwasclosertoJanet’s, inwhichautomatic to avoid havingachild.It isthatrepeated that,according frustration toFreud, causedanxiety of contraceptionatthetime,ahusbandwouldwithdrawbefore ejaculatingwhenhemadelove repetitive ratherthanby asingleevent. frustrations For instance,asthere wasnoreliable form and anxiety). This typeofneurosis couldalsoahave asexualorigin,buttheywere causedby problems, bodilyshakingandtrembling, etc.)andmentalsymptoms (fear cravings,vertigo, (as does hysteria) physical symptoms (excessive cardiac and digestive palpitations, respiratory example, hadnoticedthatpatientswhosuffered from whathecalledanxietyneuroses blended years beforeclearly explainedwhyheabandonedthisgoalforty (Freud, 1895).He, for hope thatmakingtheunconsciousconsciouscouldcure all,Freud could claimthathehad psychotherapeutic process. events emotionallyaswell ascognitively wasastepintherightdirection, butnottheendofa event isnotenoughtorepair thedamagecreated by itinanorganism.Managing toexperience that itsapproach cannotsolve it.He realized thereal problem isthatremembering atraumatic p. cannotexplainthisproblem, 11)cametotheconclusionthatpsychoanalytical and theory conscious memory. tosolve thisproblem, Afterspendingseveral Reich years trying (1949,I.II, oftheemerging emotional dimensionsofatraumatizingsituationcouldbothbecomepart unconscious repressed memorieswouldonlyreach consciousnesswhenthecognitive and from theemotionalexperience. “technical”This raisedanew issue:how toensure thatthe unconscious. In otherwords, thedefensesystemhadmanagedtosplitcognitive content cognitive informationfrom theirmemory, butthattheemotional dimension remained inthe These psychoanalysts assumedthatthiswasduetothefactpatienthadretrieved some patientsbecameconsciousofaninitialtraumaticsituation,butthatdidnothelpthem. tosolve thefollowingthe 1920s,hewastrying preoccupation raisedby Freud andFerenczi less intense,we hadtheimpression nevertheless thatourmeetingshadbeenuseful. cause. Astherecurrent anxietycrisesthatbrought themtomypracticehadbecomerarer and setsofmarking events,important butintheendwe didnotfeelthatwe hadfoundabasic complex tobeapprehended by consciousprocedures. In mostcaseswe managedtountangle we triedtountangletogether. Their anxietywascausedby aGordian knotthat wasmuchtoo find acore causeoftheiranxieties. We oftenarrived atasystemofhighly varied events which some ofthem,whoare now lessanxiousthanwhenthey cametoseeme,butwe didnotalways notbeenabletofindduringtheirpsychoanalyticalhitherto processes. Ihave beenabletohelp psychotherapy wouldhelpthemfindtheultimatecauseoftheiranxieties,whichtheyhad articles. maturity” (Freud, 1896,p. 152).Somehow socialmythsare stuckonwhatFreud wrote inthese place istheearliestyears —theyears uptoeightorten,before thechildhasreached sexual sexual abusecommittedby anotherperson;andtheperiodoflifeinwhichthisfatalevent takes MICHAEL C.HELLER,PhD Amore psychoanalytical ofHaynal discussion ofthisthemecanbefoundinvarious (1987).It parts wouldseemthat When Reich (1940, V.1; 1949,I.I–III)beganhischaracteranalyticwork attheendof I have metwell-trained psychotherapists who cametosee me inthehope that body Among professional psychoanalysts the hopeoffindingtheinitialcauseaneurosis While, inthe1940s,someofFreud’s pupilsandtrainerswere withthe stillstruggling 22 : person isanaimthatrarely defendedtodayin thefieldofbodypsychotherapy. “accidents” were notfrequent, buttheyoccurred oftenenough.Eliminating thearmorofa in theGeneva psychiatric hospitalbecauseofprimalscream treatment (Janov, 1973). These Reichian whodestroyed patientsusingsuchadrasticaim could modifydeephumanstructures (Reich, 1952b).Gerda Boyesen wasnottheonlyneo- in1952,Reichimagined. In even became openly pessimistic that psychotherapy an interview systems andtheideathatarmorwasmore complexthantherigidsegmentationReich had by Fenichel’s critique(1935)ofReich’s vegetotherapy, inwhichhedefendedtheutilityofdefense where withadifferent hewassupported typeoftreatment. Gerda Boyesen wasalsoinfluenced eliminated thearmorofapatient.He becamepsychotic andwassent tothepsychiatric hospital that duringmytrainingwithGerda Boyesen, shewouldtellusthathadonce completely Reichian therapistsinthe1970s(Boadella,1987;Lowen, 1975;Boyesen, 1970). Iremember to finishacreative chapterofhispersonal development. Thisstancewasdeveloped by neo- understand andmodifybody-mindstructures, andthendecidewhatapatientneedstointegrate for vegetotherapy andorgonomicpsychiatry. world (Reich, 1953). This implies that even his patients could not achieve the goals he had set obviously canexpress theonethrough whomcosmictruth itselfandincarnateinthis by incompetentpersons(tooneurotic) tounderstand,ashedid,whatwasatstake.He is situation and to have been able to propose adequate solutions. He is desolate to be surrounded Clearly depressed, Reich (1952a)gives witnessthatheistheonly one tohave graspedtheactual vegetotherapist worked onthepelvistoadeeper—ormore fundamental — nature thanwhat were oftenequallydramatic the looseningofarmoractivated awidevariety ofrepressed emotions andmemoriesthat an infantilesexualtrauma(Reich, 1940).However, whathisclinicalcasesshow isthatlargely the process, andthathewouldinevitablyendupdiscovering thattheoriginofaneurosis was neurosis. Still aFreudian heassumedthatthepelvisshouldbedealtwithatendof atheart, that oncehehadloosenedallthemuscular armor hewould discover theinitialcause of a psychoanalyst toperceive thathismethodcouldbeusedinthislessbiasedway. He still hoped whatemerges.Reichdefense mechanismsandobserves himselfwastoomuchofaclassical character analysisisrelatively independentfrom content. The therapistsimplyloosensthe his treatment asasystematiclooseningofpsycho-vegetative defensesystems. This typeof example Ihave friendswhohave suffered from theirpsychoanalytic treatment. 25 24 (Heller, 1983). 23 3, 1952,afteraseriousaccidentcausedby hisexperimentsonorgoneandnuclearenergy of Reich’s idealismisrevealed tousinamoving recording thatheleftforposterityonApril orgastic potency, noarmorandadeepsensualcontactwithorgoneenergy. Astrikingexample according tohim,hehadprobably acquired by developing qualities hehadsincebirth: type as the search for illumination proposed by the meditation processes of yoga and Buddhism. cured (Reich, 1951). What is proposed here human beingsof is athesame search for perfect he claimedthatonlyanunarmored personcouldcontacthisinnerorgone pulsationandbe had beenpreviously worked on.Near theendofhislifehewent beyond therapeuticaimswhen It istobenotedthat disastrous effectsofpsychotherapies inallpsychotherapeutic have been observed schools. For Idiscovered thistape inBjornBlumenthal’s (Oslo). library thatworking ontherigidityof eye Ihave movements forexampleobserved couldactivate extreme affective discharges If we leave Reich’s whatemergeswhenonetriesto idealistideologyaside,we canobserve At theendofhislifeReich despaired thathistherapycouldtransmit thequalitiesthat, 23 . Only atheoretical biascouldattributewhat emergedwhenthe 25 . Ihave friendswhoalsoendedup IDEALISM ANDTHEGOALS 24 . 31 INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL THE ART AND SCIENCE OF SOMATIC PRAXIS 32 INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL THE ART AND SCIENCE OF SOMATIC PRAXIS 27 phenomena we cannotapprehend. 26 reality asitis the social sciences that we can seriously begin to doubt that idealistic presuppositions really describe and managetheuniverse withspectacularefficiency. It isonlywiththeappearanceofpsychology and Furthermore, scientificidealism hasshown thatits assumptionscancreate approaches thatdescribe are oftenseducedby theoriesthatassociatethisimpression withdeep, spiritual and/orcosmicforces. become impossible.Because this impression isarequirement ofexplicitconscious procedures, we have thesamedefinitionofwhatisgreen. Without thisassumption communicationwouldsoon When Ispeakwithsomeoneofgreen grass,myconsciousnessassumesthatthoseIspeakwith My senseisthattheidealismofPlato describestheimpression we needtohave tothinkefficiently. principles inourdiscourse.However onealsoneedstounderstandwhyidealismhasbeensoeffective. charge, ortoassociatethemselves withtrivialevents inwaysthatputthepersoncrisis. central issue. Traumatic memoriestendtopopupatdifferent moments,withfull-blown affective occurred afterthefirst years oflife. In thesecasesdealingwiththepowera ofmemoriesbecomes with patients who well remember their initial trauma. This is often the case when the trauma(s) coordinations repertoire thatemergewhenanew ofschemasmodifiestheold repertoire they cannotunderstandbecomesakeyfeature ofpsychotherapy. This impliesworking onthe complex cognitive procedures, working on how explicit conscious procedures integrate actions Assoonasautomaticsensorimotorreactionsparticularities. are differentiated from more requirements ofeachorganismicprocedure isformethesamethingasrespecting individual rather thanbelievingthattheyshouldallfunctioninacoherent way. Respecting thedifferent close toFreud’s aimoffluidifyingtheconnectionsbetween theprocedures oftheorganism, by procedures thatcomplexconsciousschemascannotapprehend inadirect way. They are also techniques. LikeJanet theytendtofocusonspecificsensorimotorpatternswhichare activated synthesis ofbodypsychotherapy cognitive andbehaviortherapymethodsrefined body most oftheseauthorshave beentrainedinneo-Reichian schools,theynow includeintheir and torevisit Janet’s aims(e.g.Ogden andMinton, 20012001;Downing, 1996).Although bodypsychotherapyless intrusive methods(Heller, 2012;MacNaughton, 2004;Levine 1997) Kernberg, 1975;Kohut, 1971). This changeinclienteleledbodypsychotherapists todevelop (Warneke, 2011;Marlock & Weiss, 2001;van derKolk, McFarlane, & Weisaeth, 1996; (narcissistic andborderlinevocabulary personalities,trauma,PTSD, authors etc.),andnew private practice. This required waysofpracticingpsychotherapy, new whichgeneratedanew 1970’s anincreasing numberofpatientswithinsufficientlystrong defensesystems were seenin armor. He then renounced formulations that implied that no armor is the road tohealth. In the Reich had already noticed (1949, that schizophrenicchapter XV) patients do not have enough However,Loosening theirarmorcantherefore beausefulaim(Heller 2012,p. by 1949, 507f). field ofbodypsychotherapy, itistraditionallyassumedthatneurotic patientsare over-armored. neurosis are now less frequently seen— perhaps because psychotherapy can be effective. In the character structures were rarer inaprivate practice.However, hysteriaandotherformsof MICHAEL C.HELLER,PhD Iamaware here, Iamtakingashortcut butalongermore subtleparagraphwouldarrive atthesameconclusion. Once againmeditationtechniquesare alsohelpful torefine theinteraction between ourawarnessandinner Before the Second World War psychotherapists mostly saw neurotic patients. Other In Ihave mostlyshown thisarticle whywe should becareful whenwe useimplicitidealistic This more recent formulation,inspired by Janet, wasproposed by psychotherapists working 27 . This explainswhyidealism isstillsopopular. Conclusion 26 . of life,ratherthanasaheapchaoticcontradictions. The patientsthatfindtransitionsdifficult appreciate transitionsthatinturnallow onetoappreciate ofthecreativity variety asbeingapart to experienceone’s capacitytoaddress conflictingaims. Thekeyformeistobecomeable an experienceduringwhichonehasfeltprotected andpeaceful,inwhichonehasbeenable repertoire ofskills,butpsychotherapy intheproper senseoftheterm.Psychotherapy shouldbe of skills that emerged. of psychotherapyThis is the part that is not just a recalibration of the developed in a counterproductive way. One thenneeds to analyze thecoordination systems is tocheckwhatskillsare available. Some required skillsmaybeabsent,poorlytrainedor person’s educationby helpinghisstrategiestobecomemore varied andflexible. Thefirststep back ofmymindfordecades,whichisthatabasicaimpsychotherapy istocompletea depressive patientsintheGeneva University Psychiatric Institutions. Asaclinician,he in theGeneva Psychology Faculty (FAPSE) and thenonverbal behavior ofsuicidaland As aresearcher, hehasprimarily studied theinfluenceofstatus onposturaldynamics who hasstudied,asaresearcher andaclinician,therelation between mindandbody. Michael C.Heller isaUSandSwiss citizen, borninParis (France). He isapsychologist BIOGRAPHY structure our field becomesalient. torationalizeprocess; theseaims,the differences butassoonwe inperspectives try that between psychotherapists when we psychotherapy discuss the practical aims of a particular heavilymedicated. of psychiatric services forpatientswho donotwanttospendtheirlifeinandout isoftencrucial type ofintervention of schizophrenia), becausethepsychotherapist’s mainaimisthenoftenclosetocoaching. This a stablestate(forexamplewithpersonswhosufferfrom manicdepression forms andcertain tokeep apersonin have alsoleftoutdiscussionsonpsychotherapeutic that try interventions tobedeveloped. I This isanexampleofalongdiscussionthatwouldneedanother article and transfer the patient to a colleague who may know better how to deal with such aperson. has theethicaldutytodiscontinuework withthispatient longbefore heispollutedby burnout, how relational toinduceconstructive dynamicswithothers.If itisnotthecase,therapist the long-term if processit induces a constructive for the therapist. The patient is there to learn patients also showswork that a psychotherapeutic with perverted treatment only functions in the firstethicalaimofpsychotherapy. ofpsychotherapists who On theotherhand,supervision a psychotherapeutic process. For exampleitisobvious thatcaringforwhatapatientneedsis interesting, psychotherapeutic butnotalwaysaconstructive process. therapies are more pedagogical.Some colleagueseven toldmethatpsychoanalysis isalways pedagogical aims.For example,psychoanalysis isanexplorative process, whilepsychodynamic we interact with others.In someschools, the explorative process isclearly differentiated from inspired by psychotherapy is to understand one’s drives and the way we integrate them when others, aconceptclosetowhatpsychoanalysts callinsight. The focusofaself-exploration strengthening one’s capacitytointegrateanincreasing numberof“truths” abouttheselfand exploration aftertheirpsychotherapy. Exploring oneselfthrough psychotherapy isawayof research tool,andsecondlybecausesomepatients mayfinditusefultolearncontinuethis are oftenthosethatsufferthemost. After having taken long detours, I nevertheless arriveAfter havingtakenlongdetours,Inevertheless ataconclusionthathasbeen the After 40years ofdiscussionswithcolleagues,Idonot thinkthatthere existmajordifferences I amaware thatIhave covered oftheissuesconcerningaims onlyasmallportion Psychotherapy explorative dimension,firstofall,becauseitis anessential alsohasanecessary IDEALISM ANDTHEGOALS 33 INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL THE ART AND SCIENCE OF SOMATIC PRAXIS 34 INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL THE ART AND SCIENCE OF SOMATIC PRAXIS Despland J.N.,Zimmermann, G., anddeRoten, Y. (2010).L’évaluation empirique des C.(1859). Darwin, Cifali, M.(1986).Sabina Spielrein inGenf. In S.Spielrein, Carleton, J.A.(2002).Body, selfandsoul: The evolution ofawholisticpsychotherapy. Bucci, W.(1997). Brown, P.; Macmillan, M.B.;Meares, R.& Van O.(1996).Janet derHart, andFreud: Revealing the Brown, M.(2001). 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Your andbalance bodyworks: Aguidetohealth,energy Movement andDance inPsychotherapy, overwhelming experienceonmind,body, andsociety. New York: Guilford Press. traumatic stress. (2nded.).New York: Guilford Press. Principles ofbiologicalautonomy. Autobiography ofMark Twain, Volume 1. Eye movement desensitizationandreprocessing: Basic principles,protocols and Ethics The motherhood constellation. The interpersonalworld oftheinfant. Harvard Review ofPsychiatry, More attention,lessdeficit: Success strategies foradultswithADHD The Science of the art ofpsychotherapy.The Scienceoftheart (E. Curley, Trans.). Penguin, Harmondsworth: 1996. 6(3),233–243. New York: Basic Books. 1(5),253-265. New York: Elsevier/North-Holland. Journal ofIntegrative Neuroscience, (pp. 117–125).Berkeley: And/Or Press and New York: Basic Books,Inc. New York: W.W.Norton. Mind &language, Retrieved from http://www. 20(5),469–494. . Plantation: Body, 3,1, sensations appear asinmychildhooddreams: themore restless thespiritmoves inthisstreet, Momo (1973)more thanten years later. There isa“street” where thesame in thisstory at thetime. some way lose control andsoIdid not dare confide theseunusualsensations toanybodyelse much tranquilityinthisrelaxed expansion.It wasstillaccompanied by thefearthatImightin hands, which seemed huge, and streaming sensations flickered through my body. There was so and larger. Somehow initslimitlessnessitwasalsosoothing.Almost by accidentInoticedmy increasing thetempoofexperience. There wasalsoafeeling ofspace,whichbecamewider My growing fearmadethesceneplayfaster, whichincreased myfearallthemore, thusfurther of whichwere increasingly dissolving,eventually consistingofnothingbutflowing colours. evolved intoscenariosincreasingly outofmycontrol. Iwaswalkingalongapath,the contours bodysensations.Myexperiencing strangeandnew innerimagesoflonelinessandemptiness my childhood. © Author andUSABP/EABP. Reprints andpermissions [email protected] volume 12,number 2,fall2013 International BodyPsychotherapy Journal to thephysicalbodyandhow thisbodyrelates ofthebrain.Drawing toparts on postulates theexistenceofaso-called‘second body’, abodydifferent from butlinked Coming outofachildhoodexperiencean‘expanded bodyimage’, thispaper the hope of coming to new modesofworkingthe hopeofcomingtonew withthesephenomena. practice, andinsteadfocusesondifferent definitionsandmodelsofunderstandingin and bodyneglectphenomena. seekstoavoid descriptionsofphenomenainThis article phenomena, suchasanorexia/bulimia, neuropathies, dream states, bodydissociations, us toward abetterunderstandingandtherapyofvarious bodyimagedisorders and historical andcross-cultural research, theauthorshows how this‘second body’ canhelp I wouldhave forgotten aboutallofitifIhadnotaccidentallyread Michael Ende’s book I wasnotyet five years oldwhenIwaslyingaloneinmybedonenightandstarted IwouldliketorelayAs apointofdeparture fortheideasinthisarticle, anexperiencefrom - Novalis Nothing isholierthanthishighform. and thisisthebodyofman. There isbutonetempleintheuniverse Key Received 12November 2012;received inrevised formJuly 2013;acceptedAugust 2013 words: body imagedisorders, neuroplasticity, peripersonalspace pp 39-49ISSN2169-4745Printing ISSN2168-1279Online A Unique Field Psychotherapy ofBody Bernhard Schlage,MA Body ImageDisorders The Art andScienceofSomaticPraxis Body ImageBody Disorders: Abstract BODY IMAGE DISORDERS

39 INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL THE ART AND SCIENCE OF SOMATIC PRAXIS 40 INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL THE ART AND SCIENCE OF SOMATIC PRAXIS psychotherapists whichprobably involve bodyimagedisorders: tothepracticeofbody descriptionsofphenomenapertinent I willbeginwithshort beginning —before approaching amore detailedunderstandingoftheirexperiences. discourse. Our clients,too,usethesetermstodescribetheirexperience—intuitively inthe image, bodyschema,subtlebody, astralbody, dream body, andmuchelsewillbeusedinthe wide rangeofitemsthatwillbetoucheduponwhilelookingatthistheme. Terms suchasbody of thesephenomenaforbodypsychotherapeutic practice, soastogive anintroduction tothe to dealwiththeminamore consciousway. that thesesensations are rathercommon in thehumancontext of experienceandso I was able sensations were considered normalinsociety. Bothaforementioned textsmadeitobvious tome any clarifyingfeedbackfrom anyone foryears andthusalsotheunderstandingthatthese Although understandableinmyfamilycontext,thishabitofhidingprevented mefrom getting might bepathologicalandhencewent togreat lengthsnottoletanythinglikethatshow. a mentallyillmother, Ihadthetendencytoseeunusual physicalsensationsassomethingthat expression ofearlysexualsensations(Reich, 1987;Reich, 1942).Comingfrom ahomewith street seemstoemergeoutoftime,sospeak. the fasterMomo andassoonthere iscarriedby theturtle isacalmingdown inMomo the BERNHARD SCHLAGE, MA I would first like to stay with these rather diffuse terms and write about the importance I wouldfirstliketostaywiththeseratherdiffusetermsandwriteabouttheimportance I laterfoundtheexperienceofaugmentedhandsreferenced by Wilhelm Reich asan • • • • • • We willthenhave tonametheso-called ‘neglect’ disorders apparent instroke casesin In traumatherapy, there isaseriesofdiagnosticreferences related to‘dissociation’ from I amreminded ofthoseclientswhousuallydescribetheirbodyasstandinginfront of Secondly, there are allthosedisorders ofthebody imagethatresult from anervous First of all there are of course disorders involving body image and eating — namely, In someofourclientswe mayfindevidence ofafragmentedbodyimage. We usedto complete body image. in whomegodevelopment wasimpaired atanearly ageandsotootheconcept ofa as thoseclients withearlydevelopmental disorders, whomightalso betraumatised, call thesedisorders ‘schizoid charactertypes’ (Lowen, 1982). They are now classified do noteven belong to theirbodiesanymore (Sacks, 1985/Sacks, 1990). exist) (Sacks, 1984/Sacks, 1993).In extreme casespeoplebehave asifthesebodyparts ofthebody didnot which cognisanceofoneside thebodyismissing(asifthatpart delusional modificationsoftheirorganexperience). from schizophrenic psychoses mayalsoreport dissociative symptoms(coanesthesiaor of theirbody, eitherstandingnextto theirbodyorbehindit.Similarly, peoplesuffering one’s own body image. The people concerned find themselves, due to stress, feeling out confines oftheir own skin. body exercises. This means that theyare not able toperceive their body within the them or hovering above them while being asked about their physical state or during (Schlage, 2007). connectionswiththeclient’scommon becausethenerve consciousnessare damaged inwhichafailurelayer oftraditionalphysiotherapeutictreatment ofthenerves, is system disorder: forinstancesensorimotorneuropathy ordiseasesofthemyelinated reversely perceive theirbody asthinandpetite(Küpper, Müller&Unland, 2002). extremely fat(Keleman, 1992),aswell assomeadiposepatients(overweight) who cases ofanorexia andbulimiainwhichclientstypicallyperceive themselves tobe • • • •

When standingatthehelm on myfirstsailingtrip, Iexperiencedoncemore the We know from shamanic dream work thatthere are peoplewhoexperiencetheirown In hisbook,Quantenmensch (1996),Michael Murphy documentedexamplesof People withnear-deathexperiences alsofallintothiscategory, suchasPeter Nádaswho “feeling” fortheouter limits/movements of theircars,skipperslearnhow todevelop effectiveness of“modifications” tobody image: Just ascardrivers learntoget a in: Garfield, 1974/Garfield, 1983, p.166;Castaneda,2001, p.35and p.150). it isgenerallyunderstood:flying orbeingeaten by wildanimals withoutdying(examples body indreams, andthushave physicalexperiencesthatdo notseempossibleinreality as fever dreams and describedatthebeginningofthisarticle. space wasextendedintocosmicdimensions,similartowhat I have experiencedduring visualization exercises where arts, the perception or the martial of one’s own body in the outerappearanceofphysicalformwaschanged, among otherthings)by modifications tothebodyimagesofcompetitiveextraordinary athletes(whereby (Nádas, 2002). abouthislastyear oflifeandthechangesthathappenedto hisbodyimage wrote adiary Used withpermissionofCenterPress,Berkeley, CA Keleman, S.(1992).Verkörperte Gefühle,p.173. BODY IMAGE DISORDERS 41 INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL THE ART AND SCIENCE OF SOMATIC PRAXIS 42 INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL THE ART AND SCIENCE OF SOMATIC PRAXIS via thephysical body” (Steiner, p. 116-123). body appropriates imagesoflifein thedream whichitusually appropriates inthe outerreality outside, maystill abletodescribeitandeven move it:”…that the‘I’thatisoutofphysical that apersonwhoindream isoutsideofthephysicalbodyandcanperceive itfrom the remnants ofthephysicalbody except somehair andfingernails(Geshe Tenpa Choephel, 2007). about apersonwhohasexperienced therainbow bodyand,afterhisdeath,leaves noother able tovitalize thephysical body. There are alsostories,which mayseemstrangeto Westerners, Qi Gong, forexample,speaksaboutthedevelopment ofa‘rainbow body’, whichissaidtobe at theDresder Body Image Workshops (2009). Frankshall notelaterinthisarticle Röhricht’s definitions,which were developed inthenineties with theDream Body analyst, ArnoldMindell, follows thisquestionmostclearly, forexamplein hisbook, literatureI have theimpression theSwiss thatincontemporary physicistandJungian training that thefirstexpressions ofillnessorconvalescence maycoincidewithachangetobodyimage. which isonlyavailable toourown perception. it inamirror orby thetouchofother people, we possessasecond“inner” body, sotospeak, BERNHARD SCHLAGE, MA In In In other cultures, too, there are indications of the existence of body image variations: Tibetan Since Hippocrates’ ancientcasedescriptions(Lebensordnung, 1993),there are indicators The above examplesindicate that alongside the physical body, which we realize by observing (Ramachandran, 1998/Ramachandran,2002) random andunpredictable thesequenceoftouches,more astoundingtheillusion. of your bodyandthatyour nosehastransformedandisnow halfameterlong. The more secondsthatyou are orforty illusion afterthirty touchingyour nosesomewhere outside my noseandJulia’s incompletesynchronicity. With alittleluck,you willhave theeery with your lefthandinthesamerhythmandattimeintervals. You have totouch justlikeaMorserepeatedly toucheshernoseinrandomintervals, code. Touch mynose finger to Julia’s nose. Move sothatmyindexfinger myhandrhythmicallybackandforth, right sideandgive herthefollowing ‘Take instruction: myrighthandandbringindex turn towards you andtositdown inthechairfront ofyou. AskMina tostandatyour I willcallthemJulia andMina. Sit inachair, letyour eyes beblindfoldedandaskJulia to need twohelpersforthefirstillusion. your time you body image is and in what a areshort able to significantly change it. You practical reasons. Iknow thissoundsunbelievable, henceIwillprove toyou how malleable Your own temporarilysimplyfor bodyisaphantomwhichyour brainhasconstrued • • Anthroposophy,

As totheplasticityofoursensebodyimage,Iwillreport Vilaynur Ramachandran’s Facilitators ofcranio-sacralmovement therapyachieve bettertreatment successwhen ‘Pinocchio’s nose’ experiment: place inareas ofthetreatment where themotilityofbonesisbelow onemillimeter! they canimaginetheconnectionsofcranialbonesinamore detailedway. This takes size oftheship’s hull. that theymustexpandtheirsenseoftheoutlinebodydownwards untilitisthe cross thecrest of a wave, althoughthey still notice thebasicdeviations. This means Thus, theydonothave touseacompassbalanceeachcoursedeviationwhenthey a senseforthemovements ofthehullsothathelmcanbehandledmore easily. (1985)ormore recently in, Rudolf Steiner listspracticesforexperiencingtheastralbody. This means The Quantum Mind andHealing (2004). We Working activities: In summary, theexistenceofbodyimageenablesustoperform thefollowing everyday when we orsports. have tomasterspecialchallenges inthefieldsofarts dysfunctions, injuriesandaccidentstoourbodyimage. We alsohave toexpandourbodyimage established inourearlyrelationships. We becomeconsciousofits existence onlywhenthere are body imageinus,onethathasbeenpassedonphylogenetically, thatgets andanotherpart lives whenthisprocess isdisturbed.Iassumethatthere isaneurologically fixed ofthat part how vulnerablewe are whenwe establish it andhow significantly itcannegatively affectour phases. From attachmentresearch (Stern, 1985/Stern, 2007),we are abletounderstandtoday process ofbecominghumanbeings,we each mustlearnitindividuallyinthepre- andperinatal humanability.The physicalperception ofthe innerspacehastobeseenasarathernew In the for instance, talks of the change from the theocentric to the anthropocentric world image. perceptionpainting comeintoexistence,butalsoanew ofthehumanbody. Gebser (1970), It is my hypothesis that with the discoveries of the 15th century, not only did perspective in that, “ the foundationofessentialfunctionsconcerning our attitude and behaviour. He alsowrites system. He of our phylogenetic heritage and that it is, thinks as that such, body image is part of bodyimage.Bonnier(1905)assumesthatthere ispossiblyaplaceforitinthecentralnervous of theuniverse alsocorresponded totheexperientialreality ofpeopleinthosedays. inbeingtovarious degrees.participate from below inlayers, seenfrom itisformed theinsideitissotransparent thatithasallitscreatures manisamodelforthatcosmosplannedintransparentperfectissimum wayfrom above, of opening the human body. Through his anatomical studies, people in the West were, for the the perception ofspace. anatomist The important Vesalius eventually broke thechurch’s taboo areas well astheEarth, notdiscsbutballs.He thuscreated thepreconditions for achangein the geocentrictoheliocentricworldview. Galileo Galilei clarifiedthatthecelestialbodies, of the human body: Kepler’s discovery of the planets’ movements founded the transition of Thereafter, there were several scientificdiscoveries thatfundamentally changedtheperception (i.e. in the church’s15th century iconography, of weaving in carpets the and art in paintings). namely that the representation of the physical body stayed quite two-dimensional until the have tounderstanditasananthropologically newevolutionary acquisition? Have we alwayspossessedthis‘second body’ (Monroe, 1985/Monroe, 2000)ordowe further. Magnus “ Schipperges(2001)quotesAlbertus from the12thcentury: already athree-dimensional self-andbodyperception, althoughhedoesnotdiscussitany representationthe artistic of humanstook place in the formof reliefs at the time, there was about body image in ancient Egypt, Hans Georg Brecklinghaus (2002) writes, that, although first time,abletolearnabouttheinterioroftheirbodies(Gebser, 2007). work In hisimportant At theturnof20thcentury, we eventually findthefirsttextswithdetailed descriptions The observation ofthephilosopherJeanThe observation Gebser (2007)isremarkable tomeinthiscontext, • • we donotregister state but onlywhenthere manyfunctionsintheirnormal isadysfunction.

Orienting appropriately intimeandspace: To know up from down, rightfrom left. Noticing how are our body andits individual parts organized, how faritis extended Because we are abletosenseourselves now, we are alsoabletodetermine thepastand different way thanwe ballwithouthaving tothinkaboutit. handlearugby of ourmovements andtheirrelation objects:we touchaglassofwine ina to certain check them visually. Thus, we are able to estimate the power, extension and speed and ifthere are anydeviationsfrom commonphysical experienceswithouthavingto ” It isquestionableiftheperspective ofmedieval scholars BODY IMAGE DISORDERS As ananimal As ” 43 INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL THE ART AND SCIENCE OF SOMATIC PRAXIS 44 INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL THE ART AND SCIENCE OF SOMATIC PRAXIS How canwe theoretically explain ‘bodyimage’? needs tochangethe‘second body’, the‘peripersonal space’ orhowever you wouldnameit. to change ‘body image disorders’ while giving our clients the psychomotor-feedback the brain training andchangesinconsciousnessintofieldsthatcanseem mystical. ‘body image’ perhapsnaturallyinvolves plasticity, acertain sothatitdevelops dynamically by situations, andithasbeengiven different namesthroughout history. The originalmatrixofthe will becalled‘second body’ inourtangiblereality. This is revealed topeopleinvarious life of ourskin;whileBlakeslee &Blakeslee callit‘peripersonal space’ this (2007),inthisarticle something thatfeelslikeourbody, but isnotthesamethingthatwe senseinthesurrounding BERNHARD SCHLAGE, MA One of the phenomena described could be explained by changes in nervous conduction One ofthephenomenadescribed could beexplainedby changes innervous We are now goingtohave alookatdifferent theses,toexplainthesephenomena. is that only body psychotherapeuticThe central thesis of this article techniques are able In summary, itcanbesaidthatthere isawell-established assumptionoftheexistence • • • • • • Perceiving inmentalstatesandadaptingbehaviourappropriately before perturbations Adapting ourbehaviortovarious realities: lettingourbodyflyinadream, forexample; Reviewing/expanding ourskills insituationsthatare merely imagined(creative consciousorunconsciouspositions,learning Having ourbodiesassumecertain Intensifying experiences by increasing association with the body while experiencing Perceiving ourphysicalneedsinadifferentiated wayandgaugingtheirfulfillment healthy we canbehave inasuitableway.) a regulating/balancing effectonourphysicalbody. we sensewhatwouldbe (When the physicalbodyfallssick,or—whenwe are already sick—actinginawaythathas of hearinginaninnerdialogue. conversations withplantsinourimaginationandlearninghow tounderstandoursense being eatenby beings from our dreams and still knowing where we are; having phenotype. (Zane, 2008;Murphy, 1992/Murphy, 1996) visualizations havingatangibleinfluenceonourphysicalappearance,theso-called onavisuallevel.achievements Compellingly, insports there are examples ofthese to encompassthewholevehicle whileusingitatthesametime;anathleteanticipates act onit;forexample,askipperordriver expandsthephysicalsensationofbody imagination) oranticipatinganactioninourmindsooftenthatwe eventually dare to figuring outhow we can read withouttension.) automatedheadpositionwhenwe area certain reading, we willthenhave ahard time we have forgottenhow tochangeacompromising automatedbehavior. (Once we have (i.e. where doIwanttogoto,etc.).On theother handitnarrows ourbehaviorwhen one handthisgives usthefreedom tooccupy our mindwithotherthingswhileacting example, how we getup, how we sit,how we rideabikeandhow we walk).On the ofourautomaticrepertoire positionsthatwilllaterbecomepart ofbehaviors(for new pleasure, orweakening experienceby increasing dissociationwhiledealingwithpain. ofadiamond. being, thelongingtotouchananimalorfeelsurface perception ofcontactallows ustofeelourlongingfortouchfrom anotherhuman through ouractionsorcontactwithotherhumans,animals,flowers, stones. The which physicalrepresentation ofourbodieswe are occupyingduetopracticalreasons. future. With thehelpofourbodyimage,we are thusabletofindoutinfront ofamirror the previous section). example, withintheneglectsyndrome. (See theexamplein respective representations asisfound,for inthecortex, that impairtheafferent neurological pathways oroftheir Another aspectcaneasilybeexplainedthrough diseases their functionsinmovement, eatingorspeaking(Ludwig). and tongueare represented asmuchbigger, becauseof you mayseethathands inthemotor-cortex: body parts ‘somatosensory homunculus’ (Schlage,2008). or by changesoftherepresentation intheso-called from ourconsciousness’s capacityforcellchange thatitispossibletoseparate proprioceptive effects ofvisualizationexercises inoncological treatment andallergyresearch. Canwe infer assume tobethebasisofout-of-body experiences. of timeandwhosufferfrom exactlythesamelackofsensorimotorfeedback,which iswhatwe body imagedisorders withastronauts whowere inastateofweightlessness foralongerperiod of thesensegravityinaperson’s vestibular system?One optionwouldbeastudyonpotential to illness)we have toassumeadysfunction ofthesensorimotorfeedbackskinstimulior perception isdecreased inpatientswithdissociation(Anzieu,1991). have a sedating effect on the skin receptors. We also know that sensomotoric and kinesthetic in hisbook, Traumzeit, (1984)how suchphenomenaare madepossibleby substancesthat necessarily rest onthechangesofincomingsensualstimuli.Hans-Peter Dürrdescribes oftheseexperiences.Hence,an esotericview we postulatethatallexperiencesinthisregard But how canwe understandthe‘out-of-body’ aspectsofbodyimage? neurological resource ofbodyimagedisorders ofthebrain. islocatedintheparietalpart into account the research that has been done by Blakeslee & Blakeslee, we can assume that the thisexperiencecanbeneurologically enhancedatanearlyage. which interventions Taking and movementsensory experiences are needed to develop a complete body image and by the existenceofself-awareness. Furthermore, we know from infantresearch whichkindsof 255). He notonlyexplores thehumanbodyimage,butalsosearches foranexplanation (p. to existence“by iterationofcognitive operationsandreflexive applicationsononeself” brain dealswithitselfandhow “meta representations ofone’s own states” (p. 235)cancome researchers withindicationsastowhichbrain area istheoriginofbodyimagedisorders. in our life. Pinocchio’s dissociation or a trauma patient’s stress-related dissociations could provide body isdirectly connectedtowhatwe experienceonaphysicallevel andwhatwe have experienced with perceptual psychology. How detailed,how deeplyandhow consistentlywe experienceour those aspectsofthebodyimageexperiencethathave todo representation mightseemratherbizarre). This leadsusto (i.e. according tohabits,even iftheresult ofagiven that ourbrainorganizes realities according toprobabilities The illustrationshows thedifferent representation of Another placetoturnforpossible answers isthewell-documented neuro-immunological Does thismeanthatifsomebodyhasout-of-bodyexperiences(consciouslyinduced ordue In we firsthave theframework ofthisarticle, tofree ourselves from theimprecision of Singer (2004)explainsneurobiological connections,whichletusrecognize how the Ramachandran’s experiment,‘Pinocchio’s nose’, clarifies Open Resource Ludwig, Petra.www.Buecher4um.de, BODY IMAGE DISORDERS 45 INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL THE ART AND SCIENCE OF SOMATIC PRAXIS 46 INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL THE ART AND SCIENCE OF SOMATIC PRAXIS be mentioned in thiscontext,itstillclarifies injust how many professional fields specific are alsorelevant. up tothemethodsoftranspersonal psychology such asFelicitas Goodman’s trance techniques in theeducationalfieldoflearning, theuseofimaginative approaches in(competitive) sports breathing therapies,movement educationandtheapplicationofneurophysiological findings promotion ofdevelopment. Additionally, sensorimotorprocessing ofpost-traumaticdisorders, the “embodiment oftheunconscious”, pre- and perinatalpsychology andtheneurological suffering from eatingdisorders aswell asschizophrenia, analyticalmethodswhichwork with integration) andpsychosomatic therapy. We alsofindwork withbodyimagedisorders inclients therapy, therapymethods(suchasrolfing catathymicimageperception, andpostural structural Among themwe findneo-Reichian therapies,suchasorgonemedicine or vegetotherapy, dance another fieldofapplicationsbasedupontheinfluence‘body image’ inits various presentations. current standard work regarding thevariety ofmethods(Weiss &Marlock, 2006),we discover concerning thediagnosisofanexistingdisorder anditsdynamictherapeuticprocess. disorders. Some authors(Röhricht,Joraschky &Loew, 2009)alsoreport testprocedures are ofparamountpriorityinthetreatment ofatraumaandtheso-calledfunctional ‘body-self’ the therapy of body hallucinations which accompany a psychosis. Approaches referring to the are asfollows. Bodyimagedisorder treatments: disorders asthebasisfordevelopment ofdifferent have served therapeutic treatments, and (Dresden BodyImage Workshop, 2009). the basicdifferentiations developed by Frank Röhricht and the with bodyimagedisorders, we needtodifferentiate various notions.For that,Imainlyfollow strongly wishtobeamputatedinthefirstplace(Bayne &Levy, 2005). only have anormallifeaftersuccessfulamputation,butindeedthatsufferers ofBIIDwould side ofthings,itisamazingtobeholdthestrangeresearch thatconcludespeoplecannot experienced asstrangeandlifeless,mighthave comefrom a“former life”. On thepractitioner ‘body integrityidentitydisorder (BIID)syndrome’ sometimesfeelthatoneoftheirextremities, Hawking’s ‘wormhole theory’ (1988,p. 200)orBrian Green’s model‘teleportations’ (2004)? body phenomenaofthe Tibetans withthehelpofrecent space-time-models suchasStephen be creative imaginingsofourmind. Would itthenalsobepossibletoexplaintherainbow body imageakintothesensationofflying?Dysfunctionswouldthenonly them toanother(i.e.imaginedordreamt) reality perception andthusachieve of aparticular input,sotospeak,thentransfer and kinestheticsensualexperiencesfrom theirsensory BERNHARD SCHLAGE, MA If we now wanttodescribethevariety ofbodypsychotherapeutic approaches whendealing If we follow thesespeculative assumptions,we canunderstandwhypeoplewithaso-called Even though theabove isnot a complete enumeration of alltheprocedures thatcould If we take a lookat the range of body psychotherapeutic approaches as presented in the Thus theapproaches inherent inthepsychology ofperception are considered basicfor Röhricht, Joraschky, andLoew’s (2009)assumptionsabout thegamutofbodyimage • • • • deal with‘physical expression’ (facialexpression, gestures, posture andmovement are onthetopicofouremotionswhenwe deal withourbodyorsatisfaction tangible aim atbody knowledge and thefantasy about thebody, makingthe‘body-self’ aim attheestablishmentofa‘bodyschema’ (approaches ofperceptual psychology) patterns). dissatisfaction withitsexistence—theso-calledbody-cathexis differentiation between theouterandinnerperception as connectedwith,ordifferentiated from, outer relationships andwhichallow for Dresdner WerkstattKörperbild The bodynolongeristhe“basisofourperception” anymore asa (2003)anddoesnotserve consciences. In doing so, we have left the basic unity of body mind and soul. We are alienated. and roles, andthatnow we strive torecognize auniquenessthatconformswithour individual (2001) wouldprobably writethatwe have lefttheselfthatmerely conformswithregulations greater efficiencyoftheapproaches. acomprehensivemeaningful development ofspecifictherapeutictoolsmaycontributetoa body-image techniquesfindtheirimplicitoreven explicitapplication. It alsosuggestshow Email: [email protected] Website: www.bernhardschlage.de his work ontrainingthe next generation of healthcare practitioners and body psychotherapists. an ECP-holdersince2001.Specialised intreating psychosomatic disorders, heisnow focusing mental healthcenteruntil2008. He hasbeenatrainerforPostural Integration since1999and education centerforhealthcare Germany in1986andlater wasinchargeofa innorthern more aboutbodyimageandhaswrittenfourbooks.He than100articles co-foundedanadult international congresses inSan Francisco, Paris andSydney. Bernhard Schlageisauthorof 1980. He aprivate bodypsychotherapy hasrun practicesince1984andhasgiven lectures at Bernhard Schlagehasgiven workshops inmostEuropean countriesandhasbeenteachingsince BIOGRAPHY article! well-being ofpsychosocial development. The authorinvitesvaried andcreative feedbacktothis realm ofpsychotherapeutic approaches inthehealthsystem. be regarded asacentralendeavour totheprofessional relevance ofbodypsychotherapy inthe researchand further certainly inthisstill-young fieldofscientificandpracticalfindingscan other aspectsofourphenotype,i.e.physicalappearanceinareality ofconsensus.New as a correctiveis of practical importance at this level of experience. This seems to precede all role inthiscultureimportant inthefuture. The treatment ofdysfunctionsthe‘second body’ of coherent experiences in an individual, and in their varied forms of expression, will play an be cured by invisibleneuro-implants. genes isalready areality inoursociety. The lastremaining ordeveloping defectsmayeventually The search fortheideal,allergy-free, clonewithoutanycancer attractive, designedembryo methodsandtheyarein vitro fertilization examinedforgeneticdiseasesbefore theyare born. areof ageingnaturallyandissubjectedtoallkindsanti-ageingconcepts.Embryos bred using Reichart, 2004)andithastobealtered according toourpersonalidealimageofit.It isdeprived excessivethe caseinnew bodycultsaround bodybuilding,tattooingorpiercing (Hauner & (Baumgarten, 1983)andasGoethe appreciatedcentury it. “sensitive of our knowledge” instrument as it was postulated by the sensualists of the 17th The Fall of Man has taken place. We have eaten from the Tree of Knowledge. Ken Wilber A fastandresult-oriented involved collaborationofallparties is ofgreat forthe importance Body psychotherapeutic approaches withtheirpossibilitiesofworking toward therestoration The bodyhaslongbecomeanobjectofourvolition: itissubjecttoideasofbeauty, asis Conclusion BODY IMAGE DISORDERS 47 INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL THE ART AND SCIENCE OF SOMATIC PRAXIS 48 INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL THE ART AND SCIENCE OF SOMATIC PRAXIS Sacks, O.(1990).Casestudy:Der Mann, derausdemBett fiel. Sacks, O.(1993). Lebensordnung 4.Buch, Die Träume. In (1933).Hippokrates: Ramachandran, V.(2002). Küpper, Müller&Unland, (2002). Reich, W.(1987). Nádas, P. (2002). Murphy, M.(1996). Murphy, M.(1992). Garfield, P. (1983).Kreativ träumen. Interlaken. garfield, P.(1974). Murphy, M.(1996). Monroe, R.A.(2000). Mindell, A. (2004). Mindell, A.(1985). Merleau-Ponty, M.(2003). Ludwig, Petra. www.Buecher4um.de, Open Resource Lowen, A. (1982). Keleman, S.(1992). Hawking, S.(1988). Hauner, A.,&Reichart, E.(2004). Greene, B.(2004). Geshe Tenpa Choephel.(2007,December 11).[].,Retrieved from www.tibet.de Gebser, J.(2007). Ende, M.(1973). Duerr, H.P. (1984).On witchointments.In Castaneda, C.(2001). Schippberges, H.(2001). undheute. undMenschenbildKörperstruktur desaltenÄgypten Brecklinghaus, H.G.(2002). translation). Bonnier, P. (1905).Mémoires originaux:l’achematie. Blakeslee, S.,&Blakeslee, M.(2007). Bayne, T., &Levy, N.(2005).Bodyintegritydisorder. Baumgarten, A.G.(1983). Anzieu, D.(1991). REFERENCES BERNHARD SCHLAGE, MA dreaming. New York: Harper CollinsPublishers. a hat.New York: Simon &Schuster. einem Hut verwechselte stand on.London:Gerald Duckworth. V. (1998). discovery oftheorgonevolume 1 Simon &Schuster. et seq.). Wessobrunn. Murphy, M.(1992). T of thebody. Berkeley, CA Phantoms inthebrain Der eigene TodDer Der Tag, andemmeinBein fortging DieFunktion desOrgasmus Momo. Ursprung undGegenwart Der Verrat am Körper The Fabric oftheCosmos,Alfred KnopfNew York Das haut-ich The quantum mind and healing. Charlottesville: Working withthedream body ABriefof History Time, Bantam Books Verkörperte Gefühle Der Quantenmensch Der Quantenmensch The future ofthebody. Der zweite Körper. Die Kunst des Träumens. Frankfurt/M. (p. 130etseq.).Stuttgart. Leiblichkeit Die blinde Frau, die sehen kann (p. 85). Reinbek. Sacks, O. (1985). The manwhomistook his wife for Das Primat der Wahrnehmung Texte zurGrundlage derÄsthetik Die Menschen sind erwacht, du hast sie aufgerichtet – Die Menschen duhastsieaufgerichtet– sinderwacht, (p. 265).Göttingen. . Frankfurt/Main . Bodytalk. Identität undSelbstkonzept. Unpublished thesis. . New. York:Morrow. William (p. 49).Aachen. The bodyhasamindofitsown. (p. 173).Munich. Used withpermissionofCenterPress, (p. 27 et seq.). Reinbek. Lowen, A. (1967). The betrayal (pp. Chapter5.4.and19.1 -5,pg.115etseq.and439 (p. 540,ChapterGestaltwandlung’). Wessobrunn. Munich. Monroe, R.A.(1985). LosAngeles:Jeremy Tarcher. (Part 1ed.,p. 56).Schaffhausen. Traumzeit Munich: (p. 203etseq.).Cologne. Reich, W. (1942). he future ofthebody. . Boston:Routledge. (p. 66).Reinbek. Sacks, O.(1984). Alegto Revue Neurologique Journal ofappliedPhilosophy, (p. 17etseq.).Frankfurt/M. (p. 114 et seq.). Reinbek. Ramachandran, (p. 34).Frankfurt/M. (p. 200etseq.).Reinbek. (p. 21).Hamburg. Norderstedt. Castaneda,C.(1993). of The art Die Werke desHippokrates In Der Mann, derseineFrau mit (p. 494etseq.).Munich. Hamptons Roads Publishing. Creative dreaming. LosAngeles:Jeremy Tarcher. RandomHouse. , 12, (private , 12,(private Far journeys 22(1) 22(1) New York: . (Vol. 1). The The

Zane, F. (2008, spring). Den Traumkörper entwickeln. Wilber, K.(2001). Weiss, H.,&Marlock, G.(2006). Röhricht, F., Joraschky, P., &Loew, T. (2009). Stern, D.(2007). Singer, W. undneurobiologische (2004).Selbsterfahrung Fremdbeschreibung. Schlage, B.(2008). Steiner, R.Ga 234(pp. 116-123). Schlage, B.(2007).Unfreiwillig geistigleben. interpersonal world oftheinfant. der deutschenGesellschaft Medizin. füralternative is enlightment, developing ofthedream body. Integrale Psychologie Die Lebenserfahrung desSäuglings Die Lebenserfahrung DieEntdeckung des(Un)Möglichen Handbuch derKörperpsychotherapie. New York: Basic Books. (p. 107etseq.).Freiamt. Arbor-Verlag Gesundheit kommtvon genießen, Verbandszeitschrift Körpererleben undKörperbild (p. 107).Stuttgart. Stern, D.(1985). Was ist Erleuchtung? (p. 68).Berlin. Stuttgart. BODY IMAGE DISORDERS Zane, F. (2008). (p. 34).Stuttgart. DZPhil , 235 - 255. , 235-255. What What The The 49 INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL THE ART AND SCIENCE OF SOMATIC PRAXIS 50 INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL THE ART AND SCIENCE OF SOMATIC PRAXIS and athome. reenter civilian life,theytendtousethis samemindsetintheirinteractions inlife,atwork of who they are; tois ingrained in recruits and becomes part when they leave the military given orders. Recruits are nolongerindividuals, butmembersofawell-oiled machine. This increasing physicalandmental toughnessandremoving egoandpridesothattheywillfollow else(Volkin,to everyone 2007). members byThe intentistoprepare service thesenew of theirbranchservice. The expectationisthatallpersonnelwillthink andactsimilarly member. The trainersbreak down theindividual andthenbuildhim/herupintheimage officer ranksas well asdifferences ofthecommonalities. ineachbranch,butthisisaportrayal personnel. There are differences intheenlistedranksversus intheculture forthosewhoserve depicted inthepagesbelow isabroad description oftheprinciplesandvalues taughttoall and disciplineoftherecruits’ actionsandwords (Halvorson, 2010). cultureThe military are alltaughtalongsidecontrol ofemotions,mind,body, oftheirbranchservice, history aswell values as and ethics, bearing,customsandcourtesies, candidate school.Military academy,potential officersinmilitary officertrainingcorps,and/or officer the reserve their firsttrainingsite. For theenlistedranksthishappensinbasicorbootcamp, andfor veterans canuseBPtohealfrom traumagiven theirenculturationwithinthemilitary. culture andbodypsychotherapy,case studyexaminestheintersectionofmilitary andhow healing by utilizingbothmindandbodytoexplore whatmemoriestheclientholds. This complete themission” isingrainedintheveterans. Bodypsychotherapy (BP)facilitates single culture with its own language and ethics. A cultural norm of “ignore the body to © Author andUSABP/EABP. Reprints andpermissions [email protected] volume 12,number 2,fall2013 International BodyPsychotherapy Journal DIANA HOUGHTONWHITING,MA population healfrom trauma. trauma, andhow bodypsychotherapy canbeusedinthecontextofthisculture tohelpthe trauma. culture,This casestudyexplores how theintersectionofmilitary veterans hold uncovering whatthebodyholdstohelpfacilitatehealinginthosethathave experienced in order tocompletethetaskathand. Therefore bodypsychotherapy (BP)ishelpfulfor first trainingsite. culture isto suppress Thenormwithinmilitary signalsfrom thebody hasitsown cultureThe military andteachesittoallrecruits assoontheystepontotheir Military CultureandBodyPsychotherapy:ACaseStudy The mission during training is to transform the recruit from a civilian to aservice The United States culture istaughttoall personnel theminutetheysteponto military personnel comefromMilitary diverse backgrounds andare brought togetherundera Key words: military culture, bodypsychotherapy,military evidence-basedpractices Diana HoughtonWhiting,MA pp 50-62ISSN2169-4745Printing ISSN2168-1279Online Received 16April 2013;acceptedJuly 2013 The Art andScienceofSomaticPraxis Introduction Abstract

disorder (PTSD) forthispopulation? body psychotherapy aviablemodalityoftreatment fortraumaandposttraumaticstress achieved. How doesthistrainingandculturalexpectationaffectthebodyofaveteran? Is silence thebodyifitisfatiguedorinpain,sothatjobcanbedoneandobjective body, and spirit. Part person is that they will of the training and expectations of the military andtheculture ofthemilitary,to theircountry whichbecomesthecore oftheirmind, andsomewere draftedintothearmedforces.for themilitary The commonthread isservice ethnicities, genders,ages,sexualorientations,educations,andabilities.Many volunteered routine with the perimeter extending further and further afielddepending ontheirexperience. andfurther routine withtheperimeterextending further to ensure the doorsare lockedandthat nooneisontheirproperty. This canbecomeanightly house. They can also feeltheneedtocheck perimeteroftheirhomemultiple timesanight they rely onthistrainingto feelsafesuchaskeepingaloadedweapon behindeachdooroftheir smell, orsound.Most have hadextensive trainingonweapons suchashandgunsandrifles, events, andmanyhavesporting memoriesthatcan be triggered flashbacks andintrusive by asight, withcrowdsreport being uncomfortable andstayingoutofcongestedplacessuchasstores or symptoms from clients, bothinindividualandgroup sessionsettings. The majorityofveterans distress (AmericanPsychiatric Association,2000). symptoms forlongerthanamonth,andmaybedealing with socialand/oroccupational for themselves. Finally, theDSMIVstatesthatpersonmusthave experiencedthese situations, whichcancausethemtotakeactionscreatehyperarousal duringcertain safety months and/oryears aftertheevent. Many and withPTSD may experiencehypervigilance nightmares, andflashbacksthatevoke emotionalandpsychological reactions perhaps intense fear, helplessness,and/orhorror. Later, thoughts, he/shemayexperienceintrusive natural disaster, orassault(Friedman, 2007).During the event, theindividualexperienced or injury, or threat to the physical integrity of self or others, and which can involve combat, person wasexposedtoatraumaticevent whichinvolved actualorperceived threatened death Institute ofMental Health [NIMH],n.d.). The criterionforadiagnosisofPTSD isthatthe and threat. Mental traumaincludesfrighteningthoughtsandpainfulfeelings” (National types: physicalandmental.“Physical traumaincludesthebody’s response toseriousinjury traumatic experiencesandrecover mind,body, andspirit. to uncover themessagestransmittedby thebody, helpingthepersonintegratetroubling or the soldierhasamind/bodythatremembers whathasbeenendured. Bodypsychotherapy tries kept ingoodphysicalcondition,makingitaseffective aspossible.Unlike avehicle orweapon, human mind(Totton, 2003). healing process. When thetherapistapproaches thehumanbody, he/shealsoapproaches the implicit memories (those stored in the body that are communicated through movement) in the uses theexplicitmemories(thoseheldinmindthatcanbeexaminedanddiscussed) soma withoutpsyche” (Totton, 2003,p.24). It isfrom thisperspective thatbodypsychotherapy unity thatexistsbetween themindandbody. isnolivinghumanwithoutmind— “There Veterans are adiverse population,presenting different socio-economicstatuses,races, As acounseloratthe Veterans Health Administration (VA), Iheard manyexamplesofthese According totheNational Institute ofMental Health, traumacanbecategorized intwo thebodyofanindividualasatool,likeweapon views oravehicle. ItThe military istobe that thereBody psychotherapy is a functional, nonhierarchical operates under the theory Body PsychotherapyBody Members withService MILITARY CULTURE ANDBODY PSYCHOTHERAPY 51 INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL THE ART AND SCIENCE OF SOMATIC PRAXIS 52 INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL THE ART AND SCIENCE OF SOMATIC PRAXIS to ignore 2011;Madert, the body(Lopez, 2007;Ogden, 2003;Samardzic, 2012). comparing this to the “top-down” approaches that VA offers, which work with the mind and tend idea ofa “bottom-up” approach to therapy, working withthebody as avehicle forhealing,and ofmemories, holdingtraumajustliketheminddoes. a repository investigate the These articles of the Western medicalmodel.Neuroscience isusedtoprovide evidencethatthebodycan be to be missing written about fromtrauma and the veteran the articles population in the system of bodypsychotherapy literature bringsneuroscience intothediscussion. This information seems have hadtoprovide theirown research toprove theeffectiveness oftheir therapies. The majority explored by thegovernment andtendstobeconsidered more unconventional. BPpractitioners categorized underthe Western medicalmodeloftreatment. Bodypsychotherapy hasnotreally been based practicesofCPTandcognitive behaviortherapy (CBT). symptoms (Gilman, Schumm,&Chard, 2012). This research iscorrelated withtheevidence- has increased over thecourseoftreatment fortheirdepression andPTSD show areduction in discusseshopeasachange mechanism,notingthatveteransOne whoreport article thathope been investigations of mindfulness practice, relaxation, and meditation (Perlman et al., 2010). and anxietywithPTSD. & Barber, 2011). The majority of the research also acknowledges the comorbidity of depression whichare namedmostoften(Karlinetal.,2010;ReadyTherapy (CPT), etal.,2012;Sharpless onexposurearticles therapies,specifically Prolonged Exposure (PE) andCognitive Processing different therapies(Gates etal.,2012;Hunt &Rosenheck, 2011). There seemtobemany (VA) veterans, whattypesoftherapiesare offered, military andrecommendations serves about 2011). The overarching themesoftheresearch are how the Veterans Health Administration 40% ofthemsufferingchronic PTSD symptomstenplusyears afteronset(Sharpless &Barber, veterans willdevelop PTSD, rangingfrom 12-24%(Gates etal.,2012;Ready etal.,2012),with 2011; Sherman, Zanotti, andJones, 2005).Studies onthestatisticsofhow vary manycombat 2012; Marshall &Dobson, 1995;Ready etal.,2012;Sautter, Armelie,Glynn, and Wieit, and potentialfordeveloping posttraumaticstress disorder (Dye &Roth, 1991;Gates etal., have nocontextforthepersonthatsoldierhasbecome. service trauma andthelanguageshiftseven more. thepersonpriortohis/hermilitary Those thatknew wayofspeakingandreactingnew inthemilitary, from civilians.Add basicallyalanguageapart its own communication barrier between the soldier and civilian society. The soldier learns a culturemake interactionsbetween selfandworldmore mayalsoplace difficult,butmilitary parents andotherfamilymembers. Trauma onitsown canshifttheindividual’s perspective and friendships, strainedornonexistentrelationships withtheirchildren, andestrangementfrom reactions andchildren. topartners Afairnumberreported multipledivorces, lossoflong-term The veterans that I worked withdiscussed questioning their sanity, and feeling guilty about these reactions cause distress tothetrauma survivor, and their friendsand family members. with strong emotionalandphysicalresponses tosituationsorinterpersonalcontact.Many of p. xxviii). Many report coping with disregulated trauma survivors body experiences, and dealing symptoms of traumatized individuals are somatically driven” (Ogden, Minton, and Pain, 2000, DIANA HOUGHTONWHITING,MA “We know systemandthatmany thattraumahasprofound effectsonthebodyandnervous The evidence-basedpracticesthatthe Veterans Health Administration hastooffercanbe In additiontotheevidence-basedpractices(EBP)that VA offerstoclients,there have There veterans, thestress isalargebodyofliterature ofcombat thatdiscussesmilitary Psychology Modalities and Trauma Price etal.,2007;Upledger etal.,2000). The majorityofthisliterature alsousesdiagnosticinstruments massage, craniosacraltherapy, andbiofeedbackasvehicles etal.,2012;Peniston, forhealing(Jain 1986; specifictypesoftreatments thatfallundertheBPumbrella.very Thesestudieslookat healing touch, government sanctionedstudies.Asis the trend withBPandtraumathere are studiesthatdiscuss discuss traumaatlengthandtheorize abouthow traumadevelops andhow totreat it. andExperiential Integration2012), andObserved (OEI)(Bradshaw etal.,2011). These treatments Bioenergetics (Helfaer, 2010),Spontaneous Healing Intrasystemic Process (SHIP)(Steenkamp etal., Sensorimotor Psychotherapy (SP)(Langmuiretal.,2012;Ogden, 2003;Ogden &Kekuni, 2000), show theefficacyofdifferent typesofBP.as Theseauthorsfocusonspecificcourses of treatment such into thepolicies, procedures, and approaches to healingthosetheyserve. The veterans are government-run agency, veterans. culture employing Military is strongly many military woven Cheyenne, Wyoming of the whichispart Veteran Health Administration (VA) systemandisa culture presentwith themilitary inthe VA? trend thatthe VA hasadopted?How canbodypsychotherapy useitsown culture andwork to proceed withtherapiesoffered totheveterans. How wouldBPnavigatethiscommunication modality atthe VA? The VA on what isthebestway tendstoproduce manualsandinstructions look like? How would it be structured, what are best practices related to using BP as a treatment culture, andEBPsmilitary provided by the VA. What would evidence-based body psychotherapy Totton, 2003).Is withtheveteran populationasitiswithcivilianpopulations? thisastrue than more traditionalcognitive therapies(Eckberg, 2000;Ogden, 2003;Ogden etal.,2000; canmeetatraumasurvivor’sThere isevidencethatBPinterventions presenting issuesbetter ofrepetition.missing thissort Just lookatthemeticulousframework the VA hassetupforEBP. its own research/evidence-based review foritsefficacy withtraumaingeneral,butappearstobe revisiting the evidence,and retesting the approach to verify its efficacy. Bodypsychotherapy has and all-purposeinformationaboutbodypsychotherapy’s veterans. usefulnesswithmilitary (Eichhorn, 2011;Hurley, 2011;Monell, 2011). seemedtobethemostcurrentThese articles mentalhealth,torecognizing body sensationswhiletreatingand military combatveterans ranged from therole ofearlychildhoodtraumaincombatpsychology, tosomaticexperiencing concentrating onhow veterans. returning different military aspectsofBPcouldserve The topics not apeer-reviewed establishedmagazinethatproduced journal,itisanewly anentire issue specifically magazine articles, Somatic Psychotherapy Today: TheUSABP Magazine. While al., 1999;Russell etal.,2007;Sharpless &Barber, 2011;Silver etal.,1995;Silver etal.,2008). as well asdepression, anxiety, anger, physicalpain,andothersomaticpresentations (Rogers et have been multiple studies conducted that prove its efficacy in reducing symptoms ofPTSD to fallundertheBPumbrella, andthatthe VA hasembracedasevidence-basedtherapy. There measures totracktheclient’s progress orlackofprogress toward relieving symptomsofPTSD. such astheBeck Depression Inventory(BDI-2),Beck AnxietyInventory(BAI),andotherPTSD There isasmallandgrowing bodyofwork thattalksaboutBPandveterans comingfrom U.S. Many writtenaboutbodypsychotherapy ofthearticles (BP)andtraumaare studiesattemptingto The settingforthiscasestudy was the Veteran Administration Medical Center(VAMC) in This hasleftmewithmanyquestionsinregard toBP, U.S.veteran population andU.S. The VA hasaculture ofusingtherapiesthathave beenstudiedandtestedthoroughly, described above,Along with the journal articles BP with veterans is being explored in Eye movement desensitizationandreprocessing (EMDR)isatherapythatsomeconsider Case Study MILITARY CULTURE ANDBODY PSYCHOTHERAPY 53 INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL THE ART AND SCIENCE OF SOMATIC PRAXIS 54 INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL THE ART AND SCIENCE OF SOMATIC PRAXIS the emotionshe wasworking through. the clientbring awareness tohisbodystates andnoticeifthere were sensationsassociatedwith psychotherapy interventions. The intent ofthesesessionswastoseeif BPcouldbeusedtohelp responses. My agreed toletme work withMr. supervisor Jforanumberofsessionsusingbody bodies. Mr. Jhasstrong cognitive tendenciesandcantendto ignore hisbodyandphysical session later, we talked about a feeling in the room that we described as being cut off from our EMDR sessionwithMr. andIdebriefedthe J duringthesummerof2012.Asmysupervisor facilitatean before facilitatingmyown. I starting by Iwatchedmysupervisor mysupervisor talked hiswayoutofthatsituationaswell. held atgunpointby asoldier who wasonguard duty. The soldier washighonLSDandMr. J was abletotalkthesoldierdown andgettheknifeawaysafely. On anotheroccasion,hewas soldiers. When hewasanofficer, heoncewokeupinhisbunkwithaknifetothroat, and during basictrainingwhenamesshallexplodedandhehad tohelprender aidtowounded to anaccidentthatlefthisbrother deadafterbeing shot inthehead.He wasalsoafirst responder addition to the emotionally abusive childhood with alcoholic parents, Mr. J was first responder training, hypnosis,and‘bodyemotiondesensitization’ tohelphimresolve presenting issues.In system intheearly2000’s andhistherapistshave utilized CBT, ACT, EMDR,meditation tends todealwithissuesthisday. engineering degree whichrequired acognitive approach tomostproblems. This ishow he in psychology andtheotherinelectricalengineering. The onethatheutilized mostwasthe that were setforhiminhisfamilyoforigin.Additionally Mr. Jhastwocollegedegrees, one extremely capable. reinforcedThe traininghereceived thesesamestandards inthemilitary his family, toMr. anditwasimportant Jthathebeperceived hardworking, assmart, and responses tosituationsandsuppress emotionalexpression. Intellect wasvalued highlyin rigid expectationsofhimandhissiblings. The familyculturalnormwastorely oncognitive when herequested andreceived atransfertotheinactive withtherankofCaptain. reserve overseas inacombatzone. He received hisbasictraininginthelate1960’s until1978 andserved is a Vietnam-era soldier, duringthe meaningthatheserved Vietnam conflictbutdidnotserve Hefew intheArmyenlistedranks,thenbecameanofficerayearslater. firstserved He evidence-based bodypsychotherapy veterans. asit relates totraumainmilitary effectiveness. In presenting about thiscasestudythehopeisthataconversation willbestarted out asquicklypossible. timetables forsuccess,inthehopethat VA canmotivate theproviders togetclientsinand approved approaches andtriesanotheronefrom thelist. These EBPoptionstendtoinclude one oftheprescribed therapiesisnotsuccessfulthenthe provider goesbacktothemenuof result therapeuticapproachIf isusedtheexpectationthatacertain acertain willhappen.If promotions andcommendationswillfollow. This formulaicapproach isseenatthe VA aswell. categorized aspatients,utilizingaclinical Western medicalmodelapproach tothispopulation. DIANA HOUGHTONWHITING,MA This case studycovers tenweekly sessions. The client,Mr. J, is a65-year-old, Caucasian male. The culture ofthe VA prefers therapieswithastrong setofevidencetobackuptheir In the military, expectations are outlined explicitly. tasks areIf certain completed then At the beginning of my internship at the Cheyenne VA I witnessed sessions facilitated Mr. J has been in one form of therapy or another for fifteen years. with theHe started VA Mr. Jdescribeshisupbringingasemotionallyabusive andhisparents ashavinghad Client History it wouldbeinteresting toseewhattheoutcomemightbe.It wasinthefall of2012thatMr. J scheduled a meeting with Mr. to discuss the possibility and we all agreed J and my supervisor not seen individual case studies in theliterature about veterans and body psychotherapy. I concentrated lookatoursessions,documentthem,andturnthemintoacasestudy, having EMDR sessionandseeifanythingshifteditdid,whatchangedforhim. for another sessions and then haveintent was to do this for a few him sit with my supervisor moved, redirecting his perspective away from cognitions and toward the body. My original awareness toasession.Iwascuriousseewhatwould happenwithMr. Jifhegotupand wastheonlypersonIhadwitnessedwhotriedtobringanybodysensationsor my supervisor about beinglonely andwantingcompanionship. He for manyyears; itis hashad thisstruggle that peopleare unsafeandthatinsome ways heissaferby himself. However, healsotalked came whenIremained incontactwithhim. From whathereported, hehadample reminders if theseemotionswere related that tohistendencyfeel saferby himselfandthediscomfort parents andthatatanearly agehelearnedtoquicklyhidehisinternalexperiences.Iwas curious fear response withtension andanxietygrowing whenImethispush. J reported that hefeltalesseningoftensioninhischestwhenpushedme awayandhehada We alternatedfrom himpushing me awaytomeetinghispushwithmyown pressure. Mr. I askedhimtoholdhishandsoutinfront ofhim, meetingmyhandsandpushingintome. moving.started The movements were directive smallandIwasvery aboutwhatheshoulddo. other discussingwhatwaspresent forhim.Halfway through thissessionwe stood upand togodeeperintoourwork. started reading relating tohimandthe casestudy. Ibelieve thatthishelpedtoputhimateaseaswe different movements. Part and papersIwas ofbeingopenwasgivingtheclientcopiesarticles thatIwasattemptingandwhysuggesting thatIwasexplicitwitheverything important him usedtotheideaoffeelingintohisbodybefore anymovements. we started back, andneckashewastalkingabouthisdifferent dilemmasandissues.My intent was toget body movements andIwouldalsoaskifhedescribesensations he noticedinhischest, titrating the idea of bodystates and sensations. I would notice handgestures andother small to session.Our normbefore wastositfacingeachotherandtalk.I thecasestudystarted that sitting and standing, video camera placement, and space to move differed from session smalltoroomy.uncomfortably With eachroom camedifferent furniture arrangementsso it was a room where groups metand at othertimes we were inoffices ranginginsize from we ended up in a different room or office around the mental health department. Sometimes tosendthem. their bodiestry of therapyforthosewhorely heavilyontheircognitionsandhabituallysuppress themessages mindset.Iwasnow culture curioustoseeifBPwasaviableform andthemilitary of military andtalkingwithdifferent veterans Ihad developedabout themilitary abetterunderstanding working withtheunderstandingthatworkand Istarted wasnow foracasestudy. In reading As we started to build a rapport and workto have together I saw a moreto build an a rapport opportunity As we started Given thecognitive orientationatthe VA, littlemovement there wasvery involved and Mr. Jhasstatedinthepast thatitwasdangerous forhimtohave emotionalcontactwithhis in theOur same manner as our previous first session started sessions, seated facing each Mr. easily. doesnotlikesurprises,andtrust Jtendstobehypervigilant, It was The setting for my sessions with Mr. J shifted over the course of the study. Each week The Sessions MILITARY CULTURE ANDBODY PSYCHOTHERAPY 55 INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL THE ART AND SCIENCE OF SOMATIC PRAXIS 56 INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL THE ART AND SCIENCE OF SOMATIC PRAXIS chest hadloosened andthathewasclaspinghis handstogetherwhenhewas goingthrough the of doingtheactions, whichhedidwithhisback andshoulders.He noticedthemusclesinhis his handsasintheprevious sessions.He wantedtoremember thembefore way hetriedthenew accomplish thetaskgiven tohim.He washesitantatfirstandhadto practicethemotionswith him thatIwouldnotshow himwhattodoand hewasgoingtohave tofigure outhow to to gothrough theactions withhisbackthistimeinsteadofhandsandarms. Ialsotold togethisbackcoveredamount oftensionandhisphysical response istotry asquicklypossible. the exits,andcanseeallofactiongoingoninspace.Having anyone athisbackcausesafair a wallinpublic.He stationshimselfinthecorner of arestaurant orothervenues, keepsaneye on his backexposedtoothers.Mr. J’s tendstomanifestwithhimkeepinghisback hypervigilance was behindhim.It wouldlingerthere forawhileeven whenIhadmoved tofacehimagain. him, hereported ashiver thatwent down his spineandstayed there fortheentire timethatI With eachsuggestedmovement walkingaround tohis backorstandingbehind onmypart, him. Asafinalexperiment Istoodwith my backtohisand we talkedalittleinthatposition. withstand witheachrotation. Toward theendIwasnottalkingasmuchand justmoved around telling himwhatIwasdoingtheentire timeIwaswalking. would belike.He saidhewantedtogothrough theactualmotions.Iwalkedaround his back, withtheexperimentorifhewouldratherwehe wantedtogoforward justtalkaboutwhatit idea atall.At thispointIfeltthatdidnotwanttocausehimmore distress andaskedhimif to hisback,hejumpedbackawayfrom meaboutsixinches,andsaidthathedidnotlikethe it hadhappened.AsIwasaskingwhatwouldbelikeifwere towalkaround himandgo He response. He it as an involuntary described it and I have observed did this, and then noticed talk aboutit,buteven thenitwasquickandheoffagainonanothertopic. discussing itandtalkedaboutgraspthemeaningofit.Ihadtobringupagainforhim to reach toward. He wasabletofind reach butwhen we talkedaboutitagain,heskipped over existent. Afterthree timesthrough theactions we talkedaboutitandIfoundaprop forhim work ourwaytoward nothavingtutorialsinfuture sessions. tohelpMr.teacher/student feeltothisbutIfeltitwasimportant Jsettleintotheexercise and to dostandingorsittingandwastheleastdangerous wayofmoving formyclient. There wasa arms andupperbody. Ichosethisexpression ofthef demonstrate the actions first before walking him through the exercise. Idid this with my hands, In ofmostpeopleandsituations,Isurmisedthatitwouldbebetterto working withhismistrust things intotheperson’s life. objects,people,andconcepts.Finally,making connectionswithnew thepullisbringingnew there isexplorationanddesire, acuriositytoseewhatisoutthere. When graspingwe thinkof Into theearth. thepush,apersoniscreating boundaries,learningtosay“no”. With thereach, associated withit. The yieldcanberelated tobecominggrounded andconnectingone’s feet yield, push,reach, grasp, andpull.Eachofthesemotionshasacorresponding meaning movement sequencewascreated by Susan Aposhyan (2004)andhasfive different motions: tenderforhim,andwasbrought upinmultiplesubsequentsessions. very DIANA HOUGHTONWHITING,MA From whatIhave seenin the past,Mr. J likes todothings correctly, asquickly as possible. The next three sessions worked with Mr. J’s back and the The fourth sessionputthe The fourth He related the two attacks he had managed to endure successfully to his sensitivity to having The exercise wasrepeated timesduringthesessionandhetoldmeitgoteasierto afew When thingswere botheringtheclienthisneck, shoulders,andbacktensedpretty visibly. As hewasgoingthrough thesequenceby himselfInoticedthatthereach wasalmostnon- five fundamentalactions ive fundamentalactions togetherwithhisback.Iasked Mr. J Five Fundamental Actions becauseitwaseasy . This to change subjects quickly when he started feeling emotional about a topic. Heto change subjects quickly when he started was discussing becoming curiousaboutthemashedidthem. noticing thingsthathehadnotnoticedinthepast.He naminghisown started movements and name some body states, and he seemed to be more in tune with what was going on and was There wasalotofverbal interactionandbringingitbacktobodysensation.He wasableto sessionsandpreparinglast few forthenextsetofsessionsandwhere we wouldgofrom there. self-regulating hisexperiencetobringitamore cognitive level. Ifeltthathewastitrating the tightening whenhewent topull. grasping motion.He reported atensioninhisbackashewasgraspingandstomachmuscles our work together, and how I might act and interact with him, as we deepened our therapeutic I couldaskorgetcuriousabout hisposture orgestures thatwere manifestingatthatmoment. As our sessions progressed over to notice what his body was doing before time, he would start help Mr. Jnoticehisbody more, andheisquickernow tonotice hissensationsandmotions. up astandingpositionintheroom ourwork. aswe Starting started inthispositionseemedto atthebeginningofeachsession hewouldtake Although neitherofusmadeit anexplicitrule, sessionstandingsoitbecame rare forustositatallduringanyofourtimetogether.every not allowing himselftotellanyone aboutwhathappenedduringthisothertrauma. about thisotherincident.Iamcuriousifthechokingsensation isaboutwhathedoesnotsay, he hasnever toldanyone about.He saidalotoftimesheusedtheknifeandgunevents totalk feeling in his throat and as we into thetopic wenthe mentioned there further was another event — butIwonderifthere wassomethingelsehewishedwouldhave donethathedidnotdo. about thesituations.He wasabletotalkhiswayoutofbothsituationsandwalkawayunhurt about theseevents: At firstIthoughthewaschokingdown angerathimselfandself-judgment make lightofthesituationandtellsthemina“funny” manner. Imaintaintwowaysofthinking and reports achokingfeelinginhisthroat whilehetalksaboutwhathadhappened.He triesto M-16 pointedathischestby asoldieronguard duty. Heofeachtheseevents tellsthestory to himinthemilitary. These were whenhewokeuptoaknifeathisthroat andwhenhehadan andvulnerabilityhewasexperiencing. discomfort talk abouthisfeelings.He wasabletousememotorthrough thetopicandstaywith as hetalked.Ifelttheclient’s tensionbetween wantingtochangethesubjectandhisneed with Mr. JandnotgetpushedawaysoIstoodmyground andletmyarmsfoldmore andmore but by theendofourdiscussionmyarmswere completelybent.Iwantedtostayincontact the subjectforlongerperiodsoftime.At thebeginningofexercise myarmswere straight the urgetochangesubject. This helpedkeephimontopicandwe were abletowork with going on. We went palmtoagainandIaskedhimpushonmyhandsanytimehefelt multiple timesinsession.Ilethimgowithitforawhileandthenaskedifhenoticedwhatwas past marriageandanotherrelationship thatwasunsatisfying,hechangedtopics. This happened his desire for a partner, of his life. As he was describingsomeone his to confide in and be a part The nextsetofsessionshitacoupletenderthemesfortheclient.Mr. J’s tendency was The fifth session was more verbal than the previous meetings. It was almost like Mr. J was One of the biggest themes that came up implicitly and explicitly was trust. Could he trust me, me, Couldhetrust One of thebiggestthemesthatcame upimplicitlyandexplicitlywas trust. At theendofourfirstsessionhehadnotedthat likedstandingandsincethen we started In thelasttwosessionswe hituponbothoftheseevents again. He mentionedthechoking During thisseriesofcasestudysessionswe touchedupontwoofthetraumasthathappened Evaluation oftheSessions MILITARY CULTURE ANDBODY PSYCHOTHERAPY 57 INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL THE ART AND SCIENCE OF SOMATIC PRAXIS 58 INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL THE ART AND SCIENCE OF SOMATIC PRAXIS out adesire togetoutmore. had avoided formanyyears. Mr. totest Jthentooktimetotravel ofthecountry around parts activities andthishelpedhimto stayactive. He alsotraveled backtohishometown, aplacehe golf, andpickedupplayingbasketballagain.He statedthathe feltbetterafterdoingthese the urgetoself-isolateagain,he wasgoingoutandattendinghisclasses,findingtimeto play and wasfeelingtheeffectsofthis. of ourwork. He hadtriedto wean himselfoffofantidepressants atthebeginningofstudy states. He reported thathefelthisdepression extentinthelastmonth comebacktoacertain can fallintodepression andself-isolateasawaytocopewithhislowered physicalandemotional years toquietthefeelingsandsensationsthathedid notwantto,orcoulddealwith.Mr. J awareness tohisbody, hisemotions,andmanyofthedifferent habitshehasacquired over the this issomethingthatcanbebrought upagainintherapy andworked with. realizes itisthere. There isstill atendencytochangethesubjectwhenheisfeelingemotionaland his back,shoulders,andneck.He hasalsodeveloped waystorelax andrelease thistensionafterhe and hecannameitafterhappens.He isconscious oftensioninhisbody, andhow heholdsitin body toquiethisemotionsandmove intocognition.Now there isawareness around thistendency in breath andoutbreath andhow theycorresponded tothedifferent movements. became aware ofbodysensationswhilepracticingtheseforms,describingdifferent feelingswithhis class. He attendedmultipleclassesandbrought themovements intothesessionswithme.He also moving in front of others,he was nottrainedor practiced in the activity before stepping into the at things. The taichiclasswas something thathehadnever donebefore. Not onlywouldhebe eachotherandhedidnot,sochosenottogoback. knew the participants about asenior’s golfclassthathehadsigned upforandgonetopreviously. He noticedthatalotof it. benefits ofthispractice. ifhewantedtotry Hetalked When we talked aboutit,hewasuncertain andadmires artist, hispractice,theformsthattheydoandhowthe martial hissontalksaboutthe balance andhealth)toseewhatitwaslikemove infront ofothers.Mr. Jisclosewithhiselderson, the shiver inhisbackandtheimpulsetogrow eyes inthebackofhishead. to watchhisbackashecompletedthisassignment.He reported thathewasabletodoitandnotice toarestauranttrusted and sit with hisbacktothecrowd. He blackbelt, arts chosehisson,amartial we were working with his back and the shiver response I asked if he could go with someone he therapyandhasbeenworking withtherapistseverfor hisdependencyhestarted since. his mindandbody when hisoldcoping strategies were not working well anymore. In seeking help decades. He dealtwithalcoholdependencyinthepastandIbelieve itwasatooltohelphimsuppress is inhisbrain.Intelligence, logic,andpersuasionwere toolsthathehadusedwithgreat successfor receive aprescribed movement thantoexecute aspontaneousmovement. before movement. There wasstillsomeshynessaboutmovement: itwaseasierforhimtoaskand into asessionwasslow andcareful process. First, we hadtowork withsensationanddescription For we him had to to trust build a strong relationship of give and take. Bringing body movement I also noticed that the more I disclosed about myself and my process, the was. stronger our rapport relationship? It wasaslow process withasmuchtransparency asIcouldprovide, toearnhistrust. DIANA HOUGHTONWHITING,MA There were times during the my work with him that I would assign homework to Mr. J. When Family culture taughtMr. oforigincoupledwithmilitary Jthatthesafestplacetobeinhisbody His doctor prescribed another anti-depressant. Mr. J has reported that even though he felt thatwereThe BPinterventions brought intotherapyhave seemedtohelptheclientbring Throughout ourtimetogetherIwatchedMr. J getclosetoatenderemotionandthenusehis In thetasksMr. helikestobeseenasminimallycompetent andprefers Jundertakes tobegood I alsoaskedhimtosignupforataichiclass(aslow meditative physicalexercise designedfor changing thetopic.It wastoughforhimtosaythetopictenderanditeasiershow an emotionaltopic,andhewaseventually abletotalkaboutwhatwasdistressing himwithout movements that he wasworking with. It became a toolto express a need while still discussing after Italkwithmostpeople? Why canthey set meoffwithalook? goamillionmilesanhourwhenIinteractwithotherpeople? does myheart Why amIangry is confusedby themessagesbodyisgiving. Why isthere ofthebody? paininthispart Why be brought intohis/hercivilianlife.It canleadtoproblems down theroad whentheindividual he cankeepgoing. responds waytosituations, andnotjustsomething thatneedstobeignored a certain sothats/ emotions. If approached properly the body’s messages can become insights into why a veteran traumas theyhave endured wayofthinkingaboutthebodyand andhelptoinstillanew demonstrates thatbodypsychotherapy maybeanother waytohelpveterans copewiththe ways oftreating PTSD andcorresponding symptomsuptoapoint. The work withMr. J working withtheevidence-based psychotherapy offered. These have beenshown tobeeffective emotions andfeelingsthathehadbeenunaware ofbefore. motions ashedidthem. These brought him informationandhewasabletorealize and name seen apersonwhohadpreviously beenunaware movement ofcertain tagsandhabitsnamethe ofoursessionstogether.he statedthatfeelsbetterandispleasedwiththetrajectory Ihave he reported thathehasnotgiven intotheurgehidehishouselikepast.Overall was toself-isolateduringdown timesandthoughhewasstillworking withthesymptoms, and itwaxed andwanedinourtimetogether. Before Mr. we started Jstatedthathistendency stress, andhow hisbodyheldtension.He hadbeendealingwithdepression offandonforyears, therapy. He hadcome to mewithsome awareness ofhis body sensations, where heheld his he suggestedthatbothwere probably true. in a position of authority or if it was where we needed to go. Ichecked this out with him and when Iwascuriouswhetherhedidwhataskedbecausebeingthegoodclientand I wouldgobacktodescriptionwhenhadthesefeelingsandwithwhatwasintheroom. these andmakesure thenextquestion camefrom aplaceofcuriosityinsteadinterpretation. would getannoyed withhimbecausehewouldremind meofthem.Iwouldhave tocheck There were timeswhenIwouldfeelliketotallyunderstoodwhere hewascomingfrom or There are traitsthathecarriesremind meof myfatherandhusband(bothengineers). being acognitive personmyselfIfound it easyandunderstandable when hewastelling a story. time sothathedidnotfeellikeIwasbulldozingover himinthesessions. comesslowlytrust andiseasilylost.Movement andsensationneededtobetitrated slowly over while not becoming overbearing with them. Mr. those he works J needs to trust with and this about bringinginbodypsychotherapy andutilizingthemattheappropriate time interventions people anditwaseasyformetoletthesessionbecomeabouttalking.Ihadbemindful it by pushingintomeandmonitoringtheneedtoexpress it. In oursessionstogetherMr. informationin the Jmadeconnectionsandfoundnew andcan cultureMilitary andtrainingcanstaywithapersoneven afterleavingtheservice Many oftheveterans whoseekhelpatthe Veterans Health Administration findthemselves waswithoneindividualwhohadalreadyThe studythatIundertook hadmanyyears of tobethe“good”I believe thathewastrying clientonmanyoccasions. There were times There wassomecountertransference thatIwasaware ofaswe worked together. Again, The challengesinoursessionstogetherwere thatboththeclientandItendtobecognitive Conclusion MILITARY CULTURE ANDBODY PSYCHOTHERAPY 59 INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL THE ART AND SCIENCE OF SOMATIC PRAXIS 60 INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL THE ART AND SCIENCE OF SOMATIC PRAXIS Hunt, M., & Rosenheck, R. (2011). Psychotherapy in mental health clinics of the department Helfaer, P. (2010).Positive disorders. development forpersonswithtraumatic spectrum Halvorson, A.(2010). Gilman, R.,Schumm,J.,&Chard, K.(2012).Hope asachangemechanisminthetreatment Gates, M.,Holowka, D., Vasterling, J.,Keane, T., Marx, B.,&Rosen, R.(2012). Friedman, M.J.(2007).PTSD with Eichhorn, mentalhealth:Aninterview N.(2011).Somatic experiencingandmilitary Eckberg, M.(2000). Dye, E.,&Roth, S.(1991).Psychotherapy with Vietnam veterans andrapeincest Bradshaw, R.,Cook,A.,&McDonald, &experientialintegration M.(2011).Observed Aposhyan, S.(2004). American Psychiatric Association.(2000). REFERENCES Christine Caldwell, Ph.D., LPC,BC-DMT(Naropa Professor andCaseStudy support) Nancy Eichhorn, MA,MEd, MA(CaseStudy andreader) support Dennis Sedlack, MA,LPC(CaseStudy Mentor) Heather Sutton, MA,R-DMT, LPC(Naropa Mentor) Lewis Waldron, MA,LAT (VA Supervisor andMentor) Acknowledgments: Email: [email protected] Association ofBodyPsychotherapy andAmericanCounselingAssociation. and specializes in trauma recovery and PTSD treatment. She is a member of the United States uses cognitive andbehavioraltherapiesinconjunction with body psychotherapy interventions training andwasavictim’s rightsadvocate ataNorthern Coloradoshelterforthree years. Diana the VA Medical CenterinCheyenne, Wyoming April 2013.Diana hasreceived EMDRlevel 2 Body Psychotherapy from Naropa University inMay 2013.She completedherinternshipat and combatveterans. She received herMaster’s inSomatic Counselingwithaspecializationin Diana Houghton ofdomesticviolence, sexual assault, Whiting hasworked withtraumasurvivors BIOGRAPHY: DIANA HOUGHTONWHITING,MA of veterans affairs. USA BodyPsychotherapy Journal, Retrieved from http://partnersforrecovery.samhsa.gov/docs/military_white_paper_final.pdf 270-277. doi:10.1037/a0024252 of posttraumaticstress disorder. and caserecognition. Posttraumatic stress disorder personnel:Epidemiology, inveterans andmilitary screening, va.gov/professional/pages/ptsd-overview.asp Peter Levine,PhD. docview/42420993?accountid=28179 of posttraumatic stress disorder survivors. Psychotherapy Integration, (OEI): Discovery anddevelopment setoftraumatherapytechniques. ofanew New York, NY: W.W. Norton &Company, Inc. (4th ed.,textrev.). Washington, DC:Author. Psychotherapy, Victims ofCruelty: somaticpsychotherapy inthetreatment Journal of ClinicalPsychology, Body-mind psychotherapy: Principles, techniques,andpractical applications. 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Asinglesession,group studyofexposure andeye movement desensitization a0021997 (1), 63-69.doi:10.1037/a0022323 International Journal ofStress Management, 14 Subtle Medicine, Energies andEnergy Professional Research Psychology: andPractice, (2), 202-213. BodyPsychotherapy: An introduction. (6), 626-633.doi:10.1037/0735-7028.36.6.626 The boot camp survival guide. The bootcampsurvival Journal ofAnxiety Disorders, Journal of Traumatic Stress, 8 Journal In ofClinicalPsychology: Session, 64 Professional Research Psychology: andPractice, Retrieved from http://images.military.com/ 13(1-2),119-130.doi:10.1016/S0887- 11(2),123-143. (2), 337-342.doi:10.1007/BF02109568 Philadelphia, PA: Open University 1,8-15.doi:10.1037/a0022351 (1), 61-71.doi:10.1037/1072- Professional Research Psychology: (1), 84-93.doi:10.1037/ South AfricaJournal of (2-B), 1265. (8), International BodyPsychotherapy Journal the present moment. we doubtwe willgetwhatwe longfor, nomatterhow muchpeoplegenuinelycare forus in give mewhatIdesperately neededbackthenanddespairinglyfeelIstillneednow?” Too often, search of a reassuring, “Yes!” to our unspoken question, “Are you that someone who will finally the metaphorical doors of all with whom we are in contact — friends, mates and teachers — in the experienceofhappiness. Without thatfoundationinplace,we mayceaselesslyknock on foundationfor asthenecessary self tocompleteandsatisfyourmaturationalneeds,whichserve unhappiness, we are underthenever-ending pressure from ourremembered, needy, inner-child- those deepestdesires andhopes?Not easily. very Though we mayhave endured alifetimeof and feelcheatedoutofafundamentalright.So dowe give upthatlongingforsatisfactionof why, whenlifefailstoprovide thatinnatelyanticipatedoutcome,we are deeplydisappointed satisfying life, fullofmeaning and a sense ofconnectedness to others (Bowlby, 1969). That is so muchofthetime? anticipate happiness. enjoy happiness. © Author andUSABP/EABP. Reprints andpermissions [email protected] volume 12,number 2,fall2013 First Iwillbriefly howreview we establishthefoundation forbuildingahappylife happened intheactualpast. ofthesatisfactionmaturationalneeds symbolic memory/experience using Pesso-Boyden System Psychomotor (PBSP)procedures thatprovide anew, receptivity tohappinessandthesweet satisfactions oflife. the hiddenneurological psychological doorsinourmindsandbodiesthatblock in-Roles inthepast,usingnew, powerful, PBSPconceptsandprocedures thatunlock We comeintothisworldasinfants,primed toexpectandexperienceapleasurable, If theexpectationofhappinessissonatural,thenwhydoeseludemanypeople My own reading andclinicalexperiencehasleadmetobelieve we are hard-wired to Aristotle, among other fundamental thinkers, believed that it is in our nature to seek and Key words: Received 19August 2012,received inrevised formJune 2013,acceptedJuly 2013 With theRightPeople attheRightTime PBSP, trauma,familynetwork Filling theHoles-in-Roles ofthePast A waytoopenthedoorhappinessinpresent pp 63-87ISSN2169-4745Printing ISSN2168-1279Online Then I’ll describehow we goaboutfillinginthe Holes- The Art andScienceofSomaticPraxis By AlbertPesso Abstract FILLING THEHOLES-IN-ROLES as ifthey had

63 INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL THE ART AND SCIENCE OF SOMATIC PRAXIS 64 INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL THE ART AND SCIENCE OF SOMATIC PRAXIS they have apparently neededandlonged for, simplycannotabsorb itortakein—much who, even consistingprecisely whenprovided of what memory withthepossibilityof new ridden andtraumatized clients,we have foundthatthere are asignificantnumberofpeople, best assistedby learning toimprove myhandling ofawheelchairorcrutches. has presented us.Had there hip, waytodevelop notbeenanew anartificial Iwouldthenbe seemingly be a reality-based solution, i.e. how best to cope with the exigencies with which life didn’t create new, available would memories,theonlyamelioratingeffort albeitartificial needs attheappropriate ageandwiththeanticipated andappropriate kinshipfigures. If we memory.successful artificial to learnhow hipandindeedsohasittakenalongtimetomake tomakeaworkable artificial and itworks then? more thanjustfine. memory Ittooksurgeonsalongtime Whynotartificial with farmore success, hopeandhappinessthanwasavailable before. negative, long-termmemoriesofthepast,clientscanexperienceandrespond tothepresent linkedwiththe positive memoriesfirmlyimplantedinbodyandmindmasterfully real, peoples’effectively run experienceofthepresent andfuture (Damasio, full ofpleasure, satisfaction,meaningandconnectedness.Just asreal memoriesinfluenceand interactions. developmentally necessary they been in the client’s actual life, would have been capable of providing him or her with those the additionalhelpofrole-played, “Ideal” humanfigures—parents, grandparents, etc.who,had events, asiftheyhadhappenedatearliertimesandinotherplaces. We accomplishthiswith andcontrol oftheclient—new,with thefullparticipation healing,alternative, need-satisfying simulated stagethatwe have evoked inthetherapyroom, we carefully andprecisely organize— being addressed andthoughtabout,moment-by-moment inthe“present”. On thesymbolic and events visually represented in the therapy room. This is done in tandem with what is and imagination play,the mind,uponwhichbothmemory andhave thoseimagesofpeople and consequentrelief. memories to offset the negative experiences of the past, endlessly waiting for their completion positive,client, assistedby maturational need-satisfyingvirtual thetherapist,canconstruct banksusingprecise micro-tracking techniquessothatthe access thosebrain-basedmemory PBSP, AlPesso andDiane Boyden, foundamuchsimplersolution. We have learned how to invent andclimbintoatimemachine? We, thefoundersofPesso-Boyden System Psychomotor our experienceofthepresent, whatifthere were awaytocreate abetterpastwithouthavingto life now inthepresent (Edelman, 2000). basic needsduringourdeveloping years, i.e.,thepast,fundamentallycolorsour experienceof ALBERT PESSO Following the micro-tracking process, we externalize that interior neurological stage in Sinceruining) itisourmemoriesofadeficit-riddenortraumaticpastthatarerunning (or It of isabiological/neurological aswell offrustration aspsychological factthatthememory Though this “new memory” been processa boon for a great has certainly many deficit- This isourrationale for whywe symbolicmemoriesofthesatisfaction of those makenew hipthatallowsI have anartificial meto overcomeruined hip the reality ofanarthritically memories. symbolic/artificial 1999; Edelman, 2003),sodothesenew With thesenew, In thisritualarena, clientscanemotionallyre-live past,onenow anew organized tobe What canmakethepresent feelthatawful? Does itmatterthatit’s artificial? sense thathumans of itsdimensions. To doso,we willhave toposesomefundamentalquestionssuchas: and effective solutiontotheproblem ofinabilitytoreceive whathasbeenmissing. simply describedasresistance. However, we have developed anotherfarmore usefulrationale maturational satisfaction exactly what they had endlessly longed for? This phenomenon is often unaccepting response appearsincredibly contradictory, forisn’t designed,interactive, thisnewly to their disappointment and their therapists’ surprise and astonishment. Of course, their we we toenhanceourresources time inthepresent.our learneddatabaseofvisualmemory Andevery Every timewe extremely rapidandtherefore forsurvival. notbrought toconsciousnessunlessitisnecessary tolive well basedonwhatwas is necessary we humansrespondCertainly topleasure asareinforcer ofpositive, satisfyingexistence. pioneering creatures thatwouldreinforce thecontinuationofexistence. behaviorthatsupported primitively similartopleasure mighthave beenregistered intheinteriorofthosesimple,life- with their material bodies in ways that would ensure their continued existence. Something very that suppliedinformationregarding whatwasaround themanddeveloped waysofresponding on beingalive inthatmaterialbodyworld. physical/material worldwithabodythatismadetowantpassionatelykeep stored inourgenes. Through evolution, we humanshave becomedesigned/adaptedtolive ina Why dowe have abodytoactwithinthefirstplace? appropriately towhatit“sees”! Further on,we willextrapolatefrom this whenexploringnormal system is still intact and therefore their body is prepared and dynamically organized to move condition.Butother unfortunate theneurological pathwayofvisual informationtotheirmotor “see” becausetheneurological pathwayofvisual informationhasbeensevered by a stroke or 1986). This phenomenonoccursinindividualswhoare blindandliterallycannot cortically the neurological condition known as“blindsight” asstudiedby Nicholas Humphrey (Humphrey, our mothersinmind’s eye andrecall/feel how torideabikeinourmind’s body. we setourmindtodoit(Erikson, 1964; Stern, 1986).For instance,most ofuscanrecall/see what we andcanactuallyfeelinour“real” have stored inourlearned,motormemory bodyif actually “see” interiorlyifwe setourmindtodoit.And,we usethetermmind’s bodytomean We usethetermmind’s eye tomeanwhatwe andcan have stored inourlearned,visualmemory inorder toenhancethesuccessinpresentmotor memory circumstance (Edelman, 1999). do • What moves peopletoact/behave astheydointhefirstplace? There are manytheoretical elementstoputinplace inorder tofullygraspthisprocess inall To address term, thisphenomenononthehumanlevel, Iusetheshorthand Over theeonsourancestors—one-celledcreatures equipment onup—developed sensory The answer tothiscanbefoundinthe“evolutionarily-remembered (recallable)” data To answer thisfirstquestionproperly we simplyhave togobackaneven earlierquestion: Our answers willprovide insightintothedilemmaofresistance andinabilitytoreceive. established? • What are thebasicconnectionsinlifethatneedtobeclearlydifferentiated andfirmly An interesting exampleof the unconsciousnessandautomaticity of this process isevidentin , we recall whatwe have see , we automaticallyrecall whatwe have seenbefore likethat,whichisstored in We callthatprocedure: Working withHoles-in-Roles. see (ortasteortouchsmellhear)asituation,andhumansdowhat done before likethat,whichisstored inourlearneddatabase of seen . This process isabsolutelyautomaticand FILLING THEHOLES-IN-ROLES see-do . In the 65 INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL THE ART AND SCIENCE OF SOMATIC PRAXIS 66 INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL THE ART AND SCIENCE OF SOMATIC PRAXIS the moment of the closure of the loop, we call that sweet, rewarding feeling a “pleasure-pop.” completed circle, ready foranother round. By theway, whenwe getthatsenseofsatisfactionat conclusion, therethe pleasure is a “click ofthesatisfactory ofclosure”, the senseofafully expectation, andthemotoraction inresponse combinetogive satisfaction.And,following countershape interchanging between objects, expectations, and actions. See-do, sensory flavors andtextures matchmysalivating expectation ofsatisfaction. perfectly Heaven onearth. juices cascades down my welcoming countershaping throat and gullet, and the rainbow of countershape. Andfurther, theexquisitely anticipatedshapeoftheflavor ofpeachpulpand with tongue, lips and teeth. Suchthe delectable fruit a lovely shape and such a satisfying the shape of the peach. I bend my arm and place the peach in my mouth, which countershapes look ofthatpeachintree matchesmyinteriorexpectation:delicious! perfectly countershape to thefeltlonging and feelingofhungerIhave experienced internally. Yes, the picture ofapeachIhave already conjured upinmymind’s eye, andquiteinterestingly, aperfect i.e. a delicious peach. Thus, the peach actually seen on the tree is a countershape to both the happens tobeinconjunctionwithaninteriorpicture ofaspecificsatisfactiontothathunger, Infruit. thisexample,theshapeismyinteriorfeelingofaspecific hunger. Thathungeralso elseaswell.principal ofshape/countershapeistobefoundeverywhere of sensorimotor would be thecountershape. would be theshape and themotor part The ofthetreewhatever parts myhandsandlegsclungonto. Thus, the“sensory” ofsensorimotor part clamberinguptheshapeoftree countershapetotheoutlineof parts would thenbeaperfect world ofpotentialbehaviorsregarding thatshapewouldbethejigsaw-puzzlecountershape. to thecountershape?In thisexample,theoutsideworldpresents theshapewhilemyinterior would becomeavailable aspotentialcountershapes.Do you begintoseethematching-quality appropriate behaviors that we have internally stored (genetically and personally) regarding trees could bethevisualoutlineofatree thatisimmediatelyrecognized asatree, andthenallthe is tothinkoftheactualshapeanexternalobjectthatperceived. Shape inthisexample what isseen,usingthenotionof are sorely atvariance withtheirpersonalhistories. have suffered somanydeficitsintheirmaturational process isthattheirinterior requirements needs (Bowlby, 1969). The source individualswho orroot ofdiscontentforthoseunfortunate satisfaction ofbasicneedsandthepossibilitypleasure asaresponse tothesatisfactionofthose source ofbehaviorinthepresent. Onesecondary mightsaythatourgenesanticipateanoptimum of life-needs storedof satisfactions or frustrations in each individual’s banks is the memory behaviorinthepresent. source And the of survival primary place?” automatically, withprofound effectandwithlittletonoconsciousawareness. images in the mind’s eye whichthenprovoke actionsin the mind’s body. Allthis happens to the dilemmas presented in those stories. Briefly stated, the words we hear in stories promote totally unconsciousresponses whichoftenincludemind’s bodyattemptsatsatisfyingsolutions mind’s eye (blind-sighttype)seeingoftheevents describedinthosestoriesandtheunwitting, human responses tofamily, culturalandmythicstorieswhichpromote internal,unconscious, ALBERT PESSO Let’s now between whatisseenanddoneornotabout examinetheinterface So toreturn tothequestion, Looked atinthisway, shape/countershapeisanendlesslycircular process, withshape/ Now comesthemomentofreaching forthepeach:My configure handsgraspandperfectly Now let’s sayIwashungry, andIwaslookingforaspecifictree bore thatIknew delectable Say My Iwantedtoclimbthattree togetabetterlookatthecountryside. bodyandits The answer issimple:thepast. The “What moves“What peopletoact/behave asthey dointhefirst shape/countershape evolutionary past, . The easiestwaytoconceive ofshape personal autobiographicalpast stored inourgenes,isthe

expectations ofshape/countershape,andpleasure. Instead ofthepeachandtree, hopelessness combinedwithaninclinationtoseekalternative arenas ofpleasurableexistence. Andiftheincompletion is postponedindefinitelythereand frustration. isdespairand completion isachieved there ispleasure. Conversely, whenitisnotachieved there isdispleasure But fornow let’s acknowledge thatthere isanexpectationofcycles ofcompletionandwhenany to lifeandisacentralprincipleinallofPBSPespeciallythework withHoles-in- Roles. throughout ourlives. pleasurable andsoappealingthatitistirelessly soughtafter inmanydifferent aspectsandlevels The clickofclosure signalsthesenseofa for satisfaction in life(Bowlby, 1969).So ifwe lookatthis kindofinteractionfrom theangleof other. This emotional states,andinthatcondition bedeeplyconnectedtoarichlysatisfyinginteractive really are, we firsthave tobeconscious of as well asdeeplyconnectedtoourinner, bodilyfelt, become more ofthemselves. in which they make “room” and a safe accepting atmosphere where it is possible for clients to sphere isthepsychological, emotionalcountershaping spacethatwe traintherapiststooffer, provide inPBSP sessions with the helpofwhat we call the“possibility sphere”. The possibility allow thepositive, loving selftoemergeintothelightofday. That isexactlywhatwe attempt to in dreams. tohave alifefilledwithpeopleandcircumstancesThat iswhyitsoimportant that as symptomsorbodilysensationsunconsciousimpulsesand ideasthatmightpossiblysurface which are notgiven thevalidating countershapeofourcaregivers gointohidingandshow up roil inyou tofindananswer tothatdilemma. going oninsideyou. You have tosearch for“feelings” perhapsinyour bodyorinemotionsthat accomplish, but it is not. Think of being in that kind of state where you don’t really know what’s ineffable, transcendentsource ofallthings). to theother, andconnectiontotheultimate answer tothisquestion. The answer Ihave inmindis: forthatinteractive notionisindeedincludedinthe countershape andinawaythatistrue, in order toexperienceasatisfying life? through significantothers,when we firstarrive onthisplanet. shape of our human internal hopes and expectations of what we should find and experience of figures we call Ideal humanfigures. They human,externalcountershapetothe are aperfect, It astheimpetusforourinvention ofthekinds isthisideaofshape/countershape thatserved replenishment. waiting cells in that child’s mouth, throat, and gullet, resonating in expectation of nurture and countershaping nipple and breast.the perfectly Then share a protoplasmic thrill with all the infant andyou are seeingshape/countersphape parexcellence asthebaby’s eagermouthfinds and imagination and “see”memory in your mind’s eye a lactating mother with her newborn sense ofitsflavor andtexture. Pan thecameraof your innereye on your own internal stageof withaninbuiltsenseofwhatshouldcomeintoitsmouthand think ofanewborn I will give onemore example that highlights how basic and fundamental are theinner It is clear that there is aninnate tropism and pressure for a complete gestalt that is central As for of the self that showThose parts up as a shape (desires or impulses from childhood) and Let’s withconnectiontotheself. start That wouldseemtobeanobvious easystepto Next, let’s consider: Obviously, shape/countershapehastodowithinteractions withpeopleaswell aswiththings. connection withtheother, other is necessary for the maximum development of one’s is necessary fullest self and capacity what are the basic connections that need to be accomplished this concernsthefactthatinorder tobecomewhowe At firstglance,thissoundslikeamatterofshape/ rightful (theseeminglyinbornneedfororsenseofthe , you couldeven say connection totheself, FILLING THEHOLES-IN-ROLES just endingthatisso 67 INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL THE ART AND SCIENCE OF SOMATIC PRAXIS 68 INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL THE ART AND SCIENCE OF SOMATIC PRAXIS outside ourselves, whichmeansthe otherpersonandobjects aswell. That means that the other? To accomplishinteractive closure there hastobegreat awareness ofwhatisperceived gets turnedonatsomepointwhen we stopthinkingaboutourselves tothinkabout and we start invested increating children whowillgothrough thesameprocess. So isthere a“switch” that capable andmore interested insatisfying the needs of theother. In ourmaturity, we become ofthespecies,i.e.we become most ofusbecometheagents forthesurvival/continuation ultimately preparing usto becomeproviders forothers.Aswe reach thatstageofgenerativity, skills we need — that which would give us a good foundation in our developmental process — that during our childhood we are mostly absorbed with accumulating all the information and ofthespeciesimpliesinterest-in-the-other.implies self-interest andsurvival Indeed, itisareality becoming autonomous. nurture, substitutedwithsymbolicnurture whenthechildisolderfrom theotherbefore God asprovider ofthatwhichshouldhave comefrom otherhumans.Achildneedsconcrete be accomplished“correctly”. Simply put,we shouldnotbecomeourown otherandnotturnto connections elaboratedissothatwe keepclearlyintheforeground thateachconnectionshould have to experience and grow had the good fortune up with. The point of having these three sense is good as long as we don’t turn to God as the replacement for the people that we should appropriate developmental age(Bowlby, 1969). satisfying dependencywiththegood,countershapingofappropriate is tobedesired, butitisbestifdeveloped following adevelopmental stageofbenignand for theneedsofself, isexperiencedwithouthope,color, oremotionalvalue. Autonomy deep feelingofconnection,love, andmeaning.In thatcase,the our own satisfiers with the result that we then look upon the presence of connections we have postulated,theanswer issimple. We canturntoourselves andbecome Who thenisgoingtocountershapeus,satisfyourneeds,andvalidate us? With thethree order forustoliterally, physically, emotionallymature andbecomehappygenerative adults? part. achieved throughout timeandeternity, duringwhich,in ourlifetime,we eachplayourhuman that there isjustice,order, andrightness—allwithasenseofcompletionwhatistobe state ofbeingproduces thatlonged-forexperienceofpleasure thatcomesfrom theexperience at largeandtherefore andparcel ofavibrant,cosmicnetwork part ofmeaningandorder. This deeply connectedtotheother, thenwe are more likelytofeeldeeplyconnectedtheuniverse with theshapeofour“felt” or“limbicselves”. the templateforourown internalcountershapingofourconsciouscognitive imageofourselves shape of the burgeoning, evolving self. This validating interpersonal interaction then becomes shape/countershape, thevalidating acceptanceofthesignificantotherisacountershapeto ALBERT PESSO What happens when we lose the connections that we so desperately need with the Lastly we have theconnectiontoultimate.If we are deeplyconnectedtoourselves and But let’s oftheself lookabitdeeper at twoseeminglyopposite inclinations, for survival We refer toDarwin’s tenetsofevolution: If theotherhasfailedus,whatcouldbeanextpossiblesolution?Having ahealthyspiritual • ofthespecies The survival • oftheself The survival What are twoofthemostbasicdrives/instincts inalllivingthings? other , seenasanon-provider others without that other other atthe in the placeofwork andlove inthislist. The see-doprocess isaboutwork. What we motivating power ofwork and love —butjustice? What Ihave already writtenclearlysupports fell swoop. to her. Shape/countershape, clickofclosure, doingjustice,andcaringfortheother, allinone children clambered over, andonereached down andpicked uptheclothespintohanditback “accidentally” dropped oneofthepinsasshewashanging apieceofthelaundry. Invariably the process of hanging some washed clothes on the line using clothespins. The tots watched as she full of18-month-oldtots.She hungaclotheslineintheroom andthenwent through the (Warneken & Tomasello, 2009).In thisprogram, aresearch assistantwassituatedinaroom regarding shape/countershape,theneedforclosure doingjustice,andinterest-in-the-other fundamentals ofinterest intheotherare operant. though we are essentiallyfocusedonself-interest inourchildhood,even the from thestart, them with what is necessary for their development and willhelpthembecomesuccessfully them withwhat isnecessary output are mature enoughto beinterested increating lifeforothers,we are more concernedwith and takeinthatwhichwillallow ustodevelop andbecomesuccessfullygenerative. When we process, we are mostlyconcerned with for theywillshedlightonthe topic ofresistance. While we are goingthrough thematuration children isinvested inhelpingthemlive good,justlives. consequence ofloving. Loving canproduce children, andthemature of us thatdesires part things have tofit,bebalanced, complete,andeven. asafollow-upJustice isimportant and Clearly, thesemattershave aflavor ofshape/countershapetothem. For there tobejustice, and wishtogive love. We must first be able to experience being loved and then to experience and express the impulse and thrive. to survive whatever else is necessary To love of the species. has to do with survival what we have to different behaviorsandtheinternalneedsstatestheybroadcast. toretrievemade noeffort it. They couldimmediatelyevaluate thedifference between thetwo the clickofclosure. Incidentally, iftheresearch assistantthrew down theclothespinkids I amsure thatboththetotandresearch assistanthadthefeelingofpleasure thatcomesfrom The first two are easily understandable and acceptable — Freud himself subscribed to the Recent research withhumaninfantsatage14-18monthshighlightsthepointsmade To dealwiththetopic ofjustice,we have toattendthenotionsof Justice of way. hastodowithfairness,makethingsrightorcompleteinagestaltsort I willnow address thenextquestionwhichisreally asubsetofthefirstquestion. Thank goodnessthatsuchisingrainedandsoearlyevidentabletobeevoked. —to give totheotherswe have created thosethings andbehaviorsthatwould provide • Justice • Love • Work What are thethree basicmotivators whichpropel mosthumanbehavior? somewouldsay, todoGod’s work. o Endeavor tomakethingsjustandrightinaworldfulloforder andmeaning.Or as o Endeavoroftheother todothatwhichleadssurvival o Endeavoroftheself todothatwhichleadsthesurvival do tomaintainexistenceandthatishunt,forage,plant, andtodo intake . During ourmaturationalperiod we busilyingest FILLING THEHOLES-IN-ROLES intake and see awakens output, 69 INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL THE ART AND SCIENCE OF SOMATIC PRAXIS 70 INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL THE ART AND SCIENCE OF SOMATIC PRAXIS complete gestalt afamilystructure shouldhave, justasthey know how tocompletethingsand ofthose that camebefore them. family backgrounds and thehistory They “know” whata histories. withaninnatehunger toknowThey seemto have cometoearth the shape oftheir a motherrespectively. Readers mayhave noticedhow curiouschildren are abouttheirfamily human lifebeginswiththeunion ofspermandeggisthuscontingentuponafather and anyway? Though themodern erahasshown usthatmanyalternatefamilystructures can work, closure andpleasure popare theresult whenthenetwork ismadewholeagain. in theviewer(see)andanimpulsetomakeitcomplete unifiedagain(do). Theclickof supposed tobeorganicallywhole,theperception of theholeproduces asenseofincompletion fabric ornetwork offamilyroles andrelationships. Whenever there isagapinsomething thatis bridling thebasenature oftheid. uncontrolled sexuality—ofthoseforces, though systemic,life-stiflingdefensesagainsttheunharnessed expression —murder and root forces,loosening oftheboundsandlimitsthosebrute, resulting inunconscious Holes-in-Roles? Because oneoftheunexpectedconsequencesfilling Holes-in-Roles is loose. experience heaven onearth. When thoseforces are notlimitedorboundproperly allhellbreaks with loving, justice-mindedparents andothercaregivers toresult intheincreasing capacityto years, thoseexplosive forces mustbeeffectively limited,defined,countershaped, andnuanced maintain life? systems whichare amongtheroot sources formanyoftheactionsneededtosuccessfully in otherwords, toallow to dowithintakeandoutputalong with thattheexplanationforinability to receive, or and theneedtodojustice,bothofwhichwe have shown are inextricablyentwined.It alsohas thatcomeoutofhave todowithboththeconceptofshape/countershape constructions in-Roles”, afeelingofincompletion. The Holes-in-Roles conceptandtheoretical/technical incapable ofreceiving whatwe need,i.e. generative. If we attendto ALBERT PESSO Lastly: A missingclickofclosure isreadily evidentinjustreading orhearingthewords “Holes- What is a whole family network and how do we know what a whole family network is What holesandwhatroles are we referring to?First ofall,by holeswe meangapsinthe Why dowe have tolookatthetopicsofaggression andsexualityinthisdiscussionabout These twopolar opposite drives underlie most essential actions. During the developing • Sexuality • Aggression o Ability tocreate o Ability todestroy What are twooftheunderlying, geneticallyavailable, primordial energy willcontinuetobealive afterone’s own death ofthoseotherswho communityandsocialprograms intheservice • people,art, continuedexistence. ofone’s• material(alsoideational)formsorlivingbeingsintheservice own intake output Finally, Holes-in-Roles intheflesh. . , i.e.doingjusticeforotherstooearlyinourlives, we become intake justasFreud hadpositedabout theego’s role in . the the littlegirl’s unconscious mind. “ . my father . . ” “Oh, my mommy had a father, just like I have a daddy”, might flash across Iwasfouryears old.”.Now“When lookwhatcomesnextashermother continuesspeaking, mind’s eye, sheis“automatically/unconsciously” looking at alittlegirlthatshehasnever seen ofherfuture ofthatimagewillbecomepart destiny(Damasio, 1999). the memory Moreand codingisconcerned,shehasabsolutelyirreversibly madeamemory! importantly, an internalimageofhermotheratagefour. Butsystemandneuronal firing asfarhernervous know thatsheisseeinganythingatallandhasnoconsciousknowledge thatshehas constructed anticipated futures. It’s abitstrange tocallthisa“memory” forthatchilddoesn’t consciously influence herexperienceoftheoutsideworldinnextmoments oftheimmediatepresent and seen”, moving, andtherefore acting-feelingfigures) ofherlong-termmemory willbecomepart has beguntomakea“movie” inhermind’s eye theatre. This “movie” (madeof“internally the ellipses here,instant the child notbecause the mommy paused, but because inthat very she listensintentlytowhathermotherissaying. the outsideworld.But more insidiously, theyare capableofspringingintoactioninthenon- stem-selves are justsittinginsidethedeveloping childwaitingfortheappropriate releasers into need forthoseroles. us, whichwillspringintoflowering in the response toouterandinnerevents thatcallforth and aunts and uncles, and grandmothers grandfathers. We have the seedof each role inside become adultmenorwomen.Andonedaymaybehusbandswives. Andmothersorfathers, familialrole. Afterall,onedaywehave willall withinusthecapacitytotakeoneachandevery structure, Ibelieve allchildren withroles, stem-selves. cometoearth By thatImeanwe all bring dropped clothespinstoadultsinneed. the mind’s eye andtoseesomething inreality istoactivate thesameoccipitallobeof brain. what hasbeenrecorded ashavinghappenedinthepast (Edelman, 2000). To “see” somethingin presentsshares uswithmind’s thesameneurological stageuponwhichmemory eye imagesof seen beside herpicture ofhermother asafour-year-old child,neitherofwhichshe hasever actually happened inside her ( “actions” inthechild’s mind’s bodywithoutthechildknowing thatanythingofthekindhas consciously knowing she is seeing anything at all ( Remember thatwords makeimagesorpictures inthemind’s eye thatthechild“sees” without heard about(butmaybe“smelled” or“gathered” or“intuited” insomenon-consciousway). mommy beginstotellhersomethingaboutown past,whichthechildhasnever seenor is dropping tears. wants todosomethingmakemommyfeelbetter. Mommy isnotdropping clothespins;she mommy’s facewithlittle-girlconcern andcompassion.See-do isalready operanthere. She todaysheisfouryearsShe old.But party; looksupather birthday hermommyiscrying. conscious, automaticbackground onthestageofmind’s eye and mind’s body. And you know what?Her automatic-unconscious — her mother at age four. That is an instantaneous reaction to what her mother just said, Let’s lookattheinsideofthatchild’s mindather“movie screen”. There, infront ofher The mommysays,“You’re suchaluckylittlegirl. When Iwasfouryears old.…”.Iput Kids play out these possibilities when they play house. By their play, it is clear that all those tothisimplicitknowledgeAs akindofcorollary familykinshiprelationships and “What’s thematter, Mommy?” shesays.Now here comestheinteresting because part Now here’s where storiescomein.Let’s imaginealittlegirlwhoisalldressed upforher before! thingtonotehereThe strange andimportant isthatthetheatre of do ). Let’s seewhathappens in thatchild’s mind’s eye andmind’s bodyas see-do see ). And that those pictures produce process flashesapicture ofadaddy FILLING THEHOLES-IN-ROLES imagination

71 INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL THE ART AND SCIENCE OF SOMATIC PRAXIS 72 INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL THE ART AND SCIENCE OF SOMATIC PRAXIS of herfatherbefore, butnow sheishearingmommy’s pain anddispleasure aboutit. whensheisinthis state!Of coursethelittlegirl hasseensomeofthatbehavior satisfying partner irritated andwalksaway.” Abigholeisbeginningtoyawnhere. Mommy hasno compatible, the playbutton,tohearmother goingontosay, helaughsorgets “.Because whenIcry compatibly partnered. image isregistered. Clearly adisturbanceinthegestaltpicture ofamother-daddy, wife-husband give hermore informationtowork withas she says,“.issucharat!” Wow, aratfather what picture to consolidate as her mother keeps talking. And sure enough her mother does a compositepicture ofherfatherinmanydifferent states—suspended, waitingtoseeexactly “But your father . . ”. Hit the pause button here. The little girl conjures up in her mind’s eye completed thegestaltofaneededfatherinfirstplace. But lookwhatthemother saysnext. that feelingofconsciouspleasure simplyreinforces theunconsciouspleasure popofhaving andsad.”Of coursethechild glowslisten tomewhenIamcrying withthiscompliment and interest.touched by herheart-felt So shegoesontosay, “You’re suchagoodlittlegirl. You resistance tohavingone’s own needsmetisbeingput intoplace. down oreven turnoffreceptivity to care comingtoward theselffrom others. The beginningof interest incaringfortheotherbefore theprefontal lobehassufficientlydeveloped beginstoturn provider, but that’s anotherstory. likely toremain unmet,asherown mommyhadnoteven, untilnow, becomeafullydeveloped long before herown developmental needshave beenfullymet.Alas,they would alsobemore a pleasure popofreinforcement thatisregistered somewhere inside. mind’s eye andmind’s bodyandnotconsciouslyregistered. Alsofeltisakindofbody-relief and insistence forjusticehasbeenaccomplished,even ifit’s onlycompletedintheinteriorof is created. That Hole-in-Role-fulfillment makesforthe clickofclosure. Theinternal, eternal to theimageofhermotheratagefour. Out ofherfather-stem-self, afather-for-her-mother and anima,etc(Pesso, 1997). thataddressesanother article theintegration ofmalenessandfemaleness,yinyang,animus mother stem-selves. Ihave goneintothetopicofintegrationandunificationpolaritiesin it into her mind’sthrusting body. (Yes, little girls have father stem-selves and little boys have selves isstored andplucksoutthatstem-self whichcouldhave becomeafathersomeday, for itwasnever consciousinthefirstplace) reaches insideherselfwhere herclusterofstem- Here isaclassicexampleofHoles-in-Roles. needs adaddyfor, inhavingoneherself, she canimaginehow baditwouldfeeltoloseone. about this loss to her dear mommy. What does she have available? She knows how a little girl to the person who needed it, just think of what a compassionate, albeit a bit older, tot will do daddy dropping dead!Andifatoddlerwillautomaticallystrive tobringthedropped pinback circle ofcompletion—ahugehole. This isnotaclothespindropping tothefloor. Thisisa complete Gestalt: hermommyatagefourwithadaddybesideher, suddenlyhasabreak inthe . . . ”. And now the next word is a killer, literally, for she says, “. . . died.” That picture of a pause buttonandpushtheplaytoseewhatmothersaysnextafter, “.myfather ALBERT PESSO Next, I think she automatically and totally unconsciously (not unconscious as in repressed, Now allthisisgoingoninsecondsandfractionsofseconds.Let’s takeourfingeroffthe But there’s more comingtobreak thatgestaltandpresent anotherHole inaRole. Now push The motherthenseesthelookofcompassionandconcern onthelittlegirl’s faceandis Let’s continuewith theshiftinenergiestonotethatthiskindof“switch” tothepremature So now thatchild,alltoosoon,hasenergiesinhersystemdirected tothecare oftheother, That stem-self goes right into action and, in her mind’s eye and body, that child extends present andanticipationsofthefuture. powerfully theorganizationofherdestiny—inotherwords, distorts herexperienceofthe powerful effectontheenergydispositionsinheractualbody. ofthosestories The memory produces aneurological process inhermind’s eye andmind’s body, whichhasanincredibly and complete,isincredibly powerful andbusilyatwork atthismoment.Further, thestory butthecompulsionfordoingjustice,makingthingsright allusiononmypart, a literary/verbal mother where a “husband” should “rightfully” be. This emphasis on rights may seem to be just spaceandbecomesthecountershape-husbandtofillemptybesideher into virtual into lifethehusband-stem-self. This pseudopod,powered by hermind’s body, extendsout keep thingsfrom gettingoutofhand.Some ofthoseare: that result insuchdisasters,provide to uswithanumberofdifferent, automaticinterventions 1910). So ourpsyches, intheirsystemicattemptstoholdoffemotionalandphysicalupheavals dangerous intheirunlimitedform,muchaswithFreud’s envisioningoftheunbridledid(Freud, consequenceoflooseningthecontrols overand startling thoseforces thatare frighteningand incest. Why bringthatupnow? Because whenwe fill Holes-in-Roles, ithastheunexpected form todestroy/kill/murder —andsexuality — initsunboundform to rape and commit arise regarding forces oflife,aggression —Xinitsunbound thehandlingoftwoprimary insufficient satisfactionofmaturationalneeds.I’m alsolistingsomeofthesystemicdefensesthat tasks,wonderingwhyshesooftenfeelsdepressed anddepletedofenergy.completing necessary fear inherstaff, muchtoherconsternation.It’s possibleshehasnotedthatsometimesputsoff nowshe hasanexplosive sidetoherpersonalitywhicherupts andthenthatproduces painand some conflictaboutusingherfullpower orperhapssomedifficultiesindelegation.Also,maybe herself. She perhaps.She isabitofmartyr mightalsohave become aleader, albeitonewhohas expectation orabilitytoreceive, thoughthere maybelotsofoffersfrom caringpeopleoutsideof care of others with little time and energy spent on her own emotional needs. She has too little She mayhave becomeaneffective, compassionateadultwhohasspentmuchofherlifetaking Let’s now andimaginetogetherwhatthislittlegirllookslikeasagrownup. jumpforward You cantellwhat’s comingnext. The littlegirlreaches insideherstore ofselves andplucks What Iamlistinghere are someoftheproblems thatmightshow upfrom herpastof • Retroflection • Avoidance ofCompletionsandClosures • Dissociation • Depression o Feeling pursuedby externaldark forces o Turn offthecapacity tocompleteeven closures simply ordinary stirring o Turn offtheconnection totheselfsoasnotbeintouchwithwhatisinteriorly o Turn thethermostat ofallenergyexpressions waydown • It’s not methat’s sodangerous, it’s what’s coming aftermethatissodangerous • Rigidanddesperatelyrepetitive control ofsimple behaviors • Obsessive-compulsive behavior completions • Some passive aggressive one’s behaviorsoffrustrating own andothers’ ofmurder andrape • If onecompletesthingsitmightopenthatPandora’s box ofungodlycompletions o Self-destructive tendencies • Don’t destroy theother, destroy theself FILLING THEHOLES-IN-ROLES 73 INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL THE ART AND SCIENCE OF SOMATIC PRAXIS 74 INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL THE ART AND SCIENCE OF SOMATIC PRAXIS wrongs thatchildren around theworldgrow uphearingabout. In ourmind’s body, eachofus dominations of one’s — all the historical stories of the horrors of slavery clan, tribe and country; totheearlyChristians;stories ofimperial bondage inEgypt; the agonyofChrist;andthecruelty that we allseeand hear about.Just thinkofallthecultural storiesofinjustice:Israelites in Role. But Oedipal completionsofmissing fathersare onlyasmallfractionoftheincompletions i.e. becomesthemanbesides the motherwhenfatherisnotthere, andfillsa Hole-in-a- imperial, omnipotentself. Regime change isoneofitsmajorstrategiesandinclinations. endlessly attackitinanattempttodethrone it.Any otherauthoritywouldbeanaffront toits internal “entity” bepresented withanyotherauthoritythanitself, itwouldimmediatelyand one.Shouldthe universe, cold,andheartless albeit,unlikemostimagesofGod, our acruel, wants tobethe“only” —God-like inthatrespect. It power wouldbetheonlyruling in conscious mindsandthatdrainenergyfrom ourmore consciousprocesses. That entityforce way are: of ourparents duringourmaturationprocess. beautifully intheirintegratedandunifiedform—theconsequenceofloving interactions the instinctualcapacitytokillandcreate. Those primordial alloflife forces run also include a yearning for satisfyinginteractions and justice.Indeed we takeinto consideration culture (Freud, 1910). In PBSP theory, we understand our quintessential emotional nature to the source ofinstinctualandraw-emotionalenergiesthatrequired theconstraintsofexternal forces andwhichFreud sawinhispracticeandlabeledtheid.He understoodtheidtobe eagertoexpressof thepersonalitythatissetlooseandperfectly unboundaggressive andsexual to introduce thenotionofwhatIcall“entity”. That isthenameIhave given thatfragment ALBERT PESSO The three categories of memory whichresultThe three inpeoplebehavingan“animal” categoriesofmemory andbrutal Before we address thetherapeuticprocedure we wouldgothrough withher, Iwouldlike The Oedipal theory addresses whathappenswhenOedipusThe Oedipal blindlymarrieshisown theory mother, We all have those demonic forces which lurk, grinning and deadly, out of sight of our • Memory offilling Holes-in-Roles • Memory oftrauma • Memory ofdeficits thestrategiesforsurvival rewards and pleasure to the attacker (including unbridled sexuality) as one of myths “one andonly” answer totheproblems we hearaboutinfamilystoriesandcultural o When we fill Holes-in-Roles, we automaticallyandunconsciouslybecomethe • Appease • Freeze • Flight • Fight —unbridled aggression o Traumatic events mechanismswhichinclude awakenuncontrollable survival right kinshiprelationship, especiallytheneed forlimits o When ourmaturationalneedshave notbeenmetattherightageandwith isnoother, i.e., nocountershaperwhocaninfluenceus • Whenever we are theonly, we becomeomnipotent andGod-like forthenthere • In appeasement there is a powerful but hidden, unconscious impulsetoprovide • Guilt o The powerful feelingofguiltholdsdown otherinternaldark energies

way andcausefrictioninherwork team.Besides that,sheischronically discontented withthe hercolleaguesthewrongshe ispresently ofherpersonalitythatrub concernedaboutthoseparts return toourlittlegirlwhohasnow becomeanadult. Though sheissuccessfulinherprofession, role neededtokeepthingsgoing. each ofthemtheblueprintforevery could bethefoundationforhumanre-population oftheplanetastheywouldhave within value because if only two this people planet. wereI guess that has evolutionary they left on earth collection ofselves isthebasisforauniversal messiahcomplexembeddedineachoneofuson in the past and that should have beenthere to make things right. You might say thatthe whole have heard about.Every familialfigure thathadbeenmissing oneofushasastem-selfforevery has pluggedintoallthegapsandbecomemessiahtodispossessedabandonedwe Because ofthesimpleaccuracy the rightword usedtodescribeherinterior, emotionalfelt- pop isregistered. Here, theemotionis shapeandtheaccurateword isthecountershape. countershape isexperiencedand thatresults inaclickofclosure anditsconcomitant pleasure actually experienced.But ifthetherapistwasindeed rightonthemark, thesatisfactionofshape/ to forge a neural link between the wordeyes, trying the therapist chose and the feeling she not have nodded at all but glanced first at the therapist’s face and then perhaps narrowed her chosen adifferent andperhaps lessaccurateword, forinstance,sadorbitter, theclient would her life this week,” moment. If as the contextfor her the therapist feelings had that particular chosen by thetherapistanduseofclient’s own words, “discontent withthequalityof motion is anindicator of herreceptivity to theaccuracy of theemotional word “resigned” a number of other things are beginning to happen. First, what makes her nod that way? That her headvigorously inassent.In thatmomenta number ofthingshave already happenedand context isonthemark andverbally accurate, theclientwillinstantlyandautomaticallynod recall how discontented you are aboutthequalityofyour life.’” moment tosay, “If awitnesswere here thewitnesswouldsay, ‘Iseehow resigned you feelasyou unconsciously, butinstantaneously and automatically, flashing by. Thetherapistcantakethat do) to what her mind’s eye is seeing because fleeting imagesof scenes ofprior similar states are body isintheroom withthetherapistandgroup, ofherisemotionallyreactive apart (see- registering, instantby instant,theimpactofherown words onherpsyche. Though heractual quality ofherlifethisweek, thetherapistcanseeexpressions shiftonherfacewhichare awaken thehistoricalevents associatedwiththosestatesofmindandfeelings. affect and thought, knowing that what is actively arising in the present moment will inevitably of threads ofmemory. The therapistthenmicro-tracks thosemoment-to-moment shiftsof experience of emotions and thoughts, knowing woven that present consciousness is a tapestry how thingsmightproceed, leadingtoward asatisfyingandlife-enhancingend. ahypotheticalsessiontodemonstrate with theessentialtheoriesandtechniques.Iwillconstruct in thehopeoffindingsomekind resolution. encouraged by hersuperiorstodosomethingaboutitandthengoesintotherapyorcoaching quality ofherpersonallife. Therefore, shefinallydecidestodosomethingaboutitorhasbeen Now isinplacetodescribehow everything PBSPtheoriesandtechniquesare used.So let’s If thetherapist’s choiceofwords describingtheimmediateemotionofclientplusits When theclientbeginstospeakaboutherpresent stateregarding herdiscontentwiththe The therapistsimplyandcalmlywaitstoseewhatorganicallyarisesinthiswoman’s present Let’s sayshehas now ofaPBSPgroup forsomesessionsandisacquainted beenaparticipant Back tothebeginning. FILLING THEHOLES-IN-ROLES 75 INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL THE ART AND SCIENCE OF SOMATIC PRAXIS 76 INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL THE ART AND SCIENCE OF SOMATIC PRAXIS the client’s databaseofmemories and recollections of specific illustrative events are now also coming from the Witness Figure andtheworld-describing words comingfrom the Voice Figure, controlling ideas governing her world. Now, with the consciousinclusionofinformation client hasassessedinnumerable situationsandbecomeconvincedthatthesewere thelawsand life. This cognitive evaluation has been developed and viewpoint and cultivated over time as the Figure, thetherapist hasexternalized theclient’s own cognitive of her viewpoint/description ofconsciousness thatwe parseinthe processother part ofmicro-tracking. Using the Voice Figure wouldsay, ‘That’s thewayworldis,andthere’s nothingyou candoabout it.’” from theoutside.For instance, the therapistcansay, “If there wasa Voice Figure here, the Voice client’s own words, butspokenintheimperative, asifthosewords were acommand coming prepares todeliver whatiscalleda Voice Figure whowillrepeat backtotheclient,using example ofavalue statementorinternalbeliefsystem. So thewell-trained PBSPtherapistthen is andthere’s nothingIcandoaboutit.” That isimmediatelyregistered by thetherapist asan merely thereporter/narrator/stage manager ofthisevent. hypothetical Witness Figure whoisproviding therightwords andcontext. The therapistis the therapistisseenasactualprovider ofwhathasbeenmissinginthepast.Here itisthe therapeutic alliance. This feelingofallianceisquiteotherthana“transferential feeling” whereby a feelingofgratitudeandappreciation andenhancesthe forthetherapist,whichsupports this moment. The client feels seen and assisted by the witnessing process and that produces PBSP system,healinghappensattheexclusion oftransference. feelings entirely, whichinunpredictable waysconstrictstheclient’s rangeofpossibilities.In the to includethetherapist’s feelingandrelationship toherselfandthatproduces anotherrangeof in innumerablesessions,assoonthewitnessistherapisthim/herself, theclientis forced Figure there isafeelingofpossibilityandsensespacetimeforself-review. AsIhave seen inclusion of the personality, history, and emotional state of the therapist. With the Witness own process —underthepermissionandquietoversight ofthe Witness Figure withoutthe client’s interior. When anexternal,benignwitnessispostulated,theclientfree toreview her the therapisthim/herselfwouldbeviewerandsomethingfardifferent wouldoccurinthe a difference itwouldmaketotheclientiftherapisthadonlysaid,“ therapist has simply described and is narrating what the witness is seeing and saying. What accurately inawaythatsheseesandknows herself. goodfeeling. That isavery of beinginresonance withanexternalfigure. She isnotaloneinherfeeling,shebeingseen other.” So theclientisnotonlyresonating withherselfbutisbeginningtofeelthecomfort internalized and used as a way to see one’s self, there is the feeling of being “connected to the decision, as well as sense-making. In addition, in that instance, before the witness statement is template forone’s ego,i.e.apre-frontal own lobefunctionofexecutive observing judgmentand and namingfigure —noqualitiesorfunctionsotherthan that. Thusthewitnessisaperfect has earlierbeendescribedtothegroup andpostulatedasabenign,non-judging,observing When sheregisters thatstatement,shefeelsisbeing seenby anotherfigure, awitness,that the clientregisters animageofsuchawitnesspresent bothintheroom andinhermind’s eye. connections: heremotional“self ”isnow abitbetterlinkedtohercognitive “self ”. state, the client is now in a condition of greater connection to herself. Recall the three basic ALBERT PESSO But where isthetherapistinthisconfiguration? Thetherapistisnotthewitness; Now, remember thetherapisthadsaid,“If awitnesswere here .”.Andinthatinstant, Here we are notfollowing theclient’s emotionalstatebutattendingtoherthoughts,the The clientmightthengoontosay, “Yes, Iamresigned, butthat’s justthe waytheworld However, doeshappenbetween theclientandtherapistat important somethingvery I see how .”. Then state, somewhat akintohypnosis;but,incontrast withhypnosis,inthisstructured procedure,state, somewhat real, negative memories. present;The clientisnolongerinthe ordinary sheisinanaltered charged ritualspacewhere positive new memoriescanbecraftedandlinkedwiththe original, and influenced by, shesees inthe room. everything In thisway, the room becomesahighly- in hermind’s body, herthoughts,emotions,and actual body feelings—willbelinkedto, or unconsciouslyinhermind’s eye —whichwill produce changesintheorganizationofaction mother in her mind’s eye; the two theaters are linked. Therefore she sees consciously everything behavioral theories—andisnow thoughttobebestavoided orminimized. client. Repetitionreinforces ofnegative thepower—atenetofcognitive memory ofthathistory satisfying alternative totheactualhistory. This isdoneasearlywouldbebelievable by the healing counter-experience.By antidotewe meanthestagingofwhatwouldhave beenamore hear andregister to feelandprocess whathadhappened inthepast.Nowadays, we are more inclinedtomostly the client. For thisreason, role-players we instruct never toinitiateanyactionorwords notsuppliedby going oninhermindthatmaydestroy theresonance andsynchronicity of thosetwotheaters. stand-in. It istherefore thatnothingbedoneintheroom thatiscountertowhat important with hermothercanbeplayed outintheroom withthisconsciouslyacknowledged projection/ the room. She aware isperfectly thatthisisarole-player; however, alltheassociationsshehas not hallucinatinghermother, nordoesshebelieve foramomentthatitisherreal motherin images andfeelingsthatsheisseeinginhermind’s eye andfeelinginhermind’s body. She is designated asthesymbolofhermother. She cannow project onthisrole-player thekindsof her “real” mother inhermind’s eye, allthewhilealsoseeingreal role-player intheroom becomes thematchingexternalizationoftheaterinmind’s eye. The clientisseeing figure inthe room where shecanproject thatimageofhermother. Thusthe space inthe room by saying, “I will role-play your image of your mother.” Then the client is asked to place that you withbothyour real eye andyour mind’s eye.” the group torepresent thatfigure inthe room, sothatthefigure canbesimultaneouslyseen by up inone’s mindthathasanemotionalimpactonclients,we askthemtochoosesomeonein afigure comes that witnessstatement;thetherapistmightsaysomethinglikethis,“Whenever witness statement.Butthatwouldfollow Iwanttohighlightanothertechnicalintervention is litupandregistering onthescreen ofhermind’s eye. Of course,thetherapistwilloffera helplessness, andyou canbesure thatthemoment shesaysmother, herown mother’s image anyone coulddotoever changeit.” might choosethatmomenttosay, “My little motherwasalwaysunhappyandthere wasvery arethe foundationforthatviewpoint abouttopopintoconsciousness.Andindeed,theclient the witnesswouldsay, ‘Iseehow acceptingyou are ofthatviewpoint.” a fact.” The therapistcanthenpostulatea Witness statement,saying,“If awitnesswere here, mind’s eye andmind’s body. produced are thatviewpoint hovering onthethreshold oftheinnerstagetheater ofthe resonating inpattern-recognition ofthatcombination of feeling and thinking. The events that The clientlooksattherole-player intheroom whileatthesame time“seeing” imagesof her In thepast,we “historicalscene” usedtodevelop ahighlyarticulated inorder fortheclient Now theclientchoosessomeoneingroup andthatsomeoneformallytakesontherole Here it comes. The client has now consciously mentioned her Of course,if“acceptance” istherightword, scenesthatare theclientnodsandvery Upon hearingthevoice statement,theclientmightreact by saying,“Yup, you saidit,that’s what had happened in the past and then to construct intheroom theantidote/ whathadhappenedinthepastandthentoconstruct FILLING THEHOLES-IN-ROLES mother in this context of 77 INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL THE ART AND SCIENCE OF SOMATIC PRAXIS 78 INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL THE ART AND SCIENCE OF SOMATIC PRAXIS mother who would be constant and supportive andnot leavemother whowould beconstantandsupportive herinchargeofsibling when didyou leave methat way?”Clearlyshewasindesperate needofa mother inthepast, “Why hold her. and feelingherselfasmiserably andterrifyinglyaloneasachildwithnoonepresent to hearor helping volunteer from thegroup enrolled asacontaining figure, andanotheris remembering with fear. Thus theclientisintwostates simultaneously. One isinthepresent room witha wrenching sobs,onecanhear thetonalityandrhythmofachild’s expression ofgriefcombined expressed have to do with the past. However, now with even as the client is crying more heart- outofcontrol. without constraintorfearofthemerupting container. In thatway, withthathelp, theturbulentemotionscannow beexpressed physically, like a membrane to a cell, which would keep the cell and self from spilling out of its bodily client thatthisfigure isnotthere toquellthefeelings buttogive an “envelope” ofcontainment, tosay,is instructed “Iwill helpyou handlehow muchyou feel.” This communicatestothe mentioned above allthesurfaces that supports thatare soagitatedandunderstress. That figure client doesso;arole-player toholdtheclientinaway isthenchosen, enrolled, andinstructed would helpthemhandlehow muchtheyfeel. Would you liketochoosesuch afigure?” The agitation andstrainthatyours isshowing now, we suggestthattheyenroll acontactfigure who muscles spasmundertheinfluenceofconflictinggoalsexpression andsuppression. tries to control andstifle thoseimpulses, herchest heaves, her shouldersshake, andher stomach sobs asshevividlyrecalls theterror shesuffered andperhapsdidn’t express atthosetimes.Asshe care ofherlittlebrother whileshewent outatnight. These memoriesproduce body-wrenching question. that wouldunderlinetheemotionclientwasexperiencingatmomentsheanswered the was whenIachild.” The therapist would continue to micro-track with a witnessstatement room inthepresent andsays,“Iwasremembering how unhappyandunavailable mymother presents. her memory rateandbloodpressureheart changesinsynchrony withtheemotionalqualityofscenes of herspeechandbreathing. If they would shewasconnected showto appropriate instruments, up as mercurial and rapid changes of expressions on her face and marked shifts in the rhythm will awakenamultitudeofsensations,emotions,andimpulsesinhermind’s body, whichshow andexperienceswithhermother.rapidly shiftingimagesofherhistory These internalimages processes likelypresenting are tohermind’s very unconscious memory eye fleeting,fragmented, as humansuperstructures uponwhichtheclientcansafelyproject herpowerful internalimages. They learntobethere figures, assupportive whoare willingtobepresent andofferthemselves state oftheclientby behaviorsthatthey (and sometimeshave tobereminded) the therapisthave tobehighlyprecise andcarefully chosen. The role-players mustbeinstructed term therapeuticgoalsandstrategiesoftheclient. given by andinstructions The interventions client moment-to-moment via themicro-tracking process andalsoacutelyaware ofthelong- her consciousnessofthereal settingandhercontrol over itisnever lost. ALBERT PESSO The clientsitsstaringatthefigure representing her motherinthe room, deepinthoughtwhile Therefore, thatthetherapistbeextremely itisimportant sensitive towhatisgoingoninthe The client,aftersomediminishment ofsobbing,shoutsoutatthefigure representing her This figure ispostulatedinthepresent, though theemotionsthatare beingfeltand withtheirfeelings,andbodiesshow peoplestruggle the The therapistsays,“When The clientthenrecounts innumerableoccasionsonwhichhermotherleftalonetotake “What’s going on inside?” the therapist asks. The client shifts her awareness back into the not think toidentifywiththerole orattempttoinfluencethe wouldbe“good” fortheclienttosee,hear, orfeel. disbelief atthetherapist,nochild-longinglookhere, andsayssarcastically, “Do you thinkI now, suddenly, herentire demeanorandgaze depictanotherkindoffigure. She looksupin through aremarkable transformation.Amomentago,shewasthepicture ofachildinneed; enabled hertobemore maternal. The client,insteadofbeingopentosuchanoffer, goes choosing someonetorole-play anIdeal Mother withthosecharacteristicswhichwouldhave match hersenseoflongingforwhatsheshouldhave received asachild. sibling. Here needfortheinternalizationofanexperienceto exampleofacrying isaperfect who wouldnothave leftheraloneatnightwiththeresponsibility oftakingcare ofheryounger unmet. Now ofwhatwe callan “Ideal memory wouldbethetimetoexperienceanew Mother”, she wassuchachildherself. Her andprotection wasclearly maturationalneedforsupport her motherinthe room. shoulders foralifetime. formanypeopleinthisstatefeelliketheyhave carriedtheworldontheir is oftenthetruth, too-soon interest-in-the-other? therapist mightsay, didyou takecare of?”In “Whom otherwords, whowastheobjectofher and teachthatthiscanbeseenasasignofhavingputouttoo muchtoosoon. This iswhenthe spoken about longing for. The therapist can underline the lack of receptivity at such moments occurs, it highlights the client’s unreadiness for precisely what was missing and shehasjust receive thenbecomesapossibility. automatically redistribute herlifeenergiesonown behalf. Self-interest andthecapacityto of interest-in-the-other energyviathepseudo-podsstem-selves whichthenallows theclientto appropriate filler ofthose roles otherthantheself. shuts down Thisintervention theoutflow missed. The way we have found to offset this seeming “reflex” is topresent imagesof amore care of the other, one effectively loses the capacity to receive what one has wanted and sorely child. fully mature andtherefore capable and desirous oftakingcare perfectly oftheother, i.e.her self thathaslackedsatisfyingmaturationalcare by theappropriate other, i.e.amotherwhowas self.The entityisnotthetrue However thatappearsnow thechildpart isaremnant ofthetrue authority figures asifthey ruling theuniverse.were enemiesoftheirimperialright mortal leftvacant, theydotendtoleer,unfortunately jeer, jibeat,andmercilessly attackallother whenever someonehastooearlyinlifetakenonthosejustice-fulfilling roles thathave been early inone’s life. That figure hassomeofthedemonic,satanicqualitiesIspokeearlier. For is produced whenonehasbeenthehealer, caretaker, messiah figure forone’s fore-bearers too call the“entity,” by whichwe meantheomnipotent,unboundedfragmentofpersonalitythat appearance/emergence ofherchildstatesandalsoforthewhatwe client’s mind.Now Iwouldliketousethe metaphor oftheclient’s bodybeinga stageforthe One istheritualstageinroom, andtheotherisinnertheaterofimaginationin would believe that? You have tobekiddingorjustnaïve.” The therapistoffersapicture ofaneed-gratifyingsceneby suggestingthattheclientconsider “What didyou do forher?”thetherapistasks. “What The clientanswers, “Well forinstance,mymother,” asshepointstothe figure representing The therapistcouldretort, “Pick outoneperson.” A frequent reaction to thisquestionisahumorous andironic, “Everyone!” Indeed, that Now at hand toreturn—when such a moment of sarcasm to the therapeutic intervention Here isthewaywe seetheequation: When onehasputouttoomuchearlytotake So inonemomentthechildisonstage,andnextentitystage. We have already spokenabout thetwodifferent stagesortheatersthatwe are dealingwith. FILLING THEHOLES-IN-ROLES 79 INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL THE ART AND SCIENCE OF SOMATIC PRAXIS 80 INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL THE ART AND SCIENCE OF SOMATIC PRAXIS reinforcing theclient’s role asthesavior andprovider ofjustice.Freud hasdescribedthisasthe it according tohow ithadbeenfulfilled intheunconsciousimagination, thusunwittingly if leftonhisorherown tostageaHoles-in-Roles situation,wouldimmediately re-construct body andmindasintraditional client-centered therapiesissuspendedtemporarily. The client, offollowingthe usualrule onlytheimpulses, emotions,andthoughtsthatariseintheclient’s is incontrastwiththetherapist’s styleupuntilnow. When makingHoles-in-Roles interventions, who infactdidnotfulfillthe genetically anticipated role offatheringforhermother. figureplaying contractsare new ispresented assumedsothatatruly andnottheoriginalfigure, there. In other words, we have learned to monitor and track clients’ internal images as the role- unconsciously awaken in their mind’s eye a picture of those who had actually been or not been father.” for we have important foundthatpeopleoften This clarificationanddistinctionis very to say, “Iamrole-playing your mother’s Ideal Father ofyour mother’s andamnopart real to role-play your mother’s Ideal Father.” The clientdoessoandtherole-player isinstructed “mother” tolookatand receive isinstructed from. satisfyingcontinuityofsupport — theexactoppositeofwhathadactuallyoccurred. It isthatIdeal Father figure whomthe of thatchild-imagehermotherinthepresence ofanidealfatherwhowouldnothave died The therapist’s task atthisjuncture istopresent theclientwithsatisfying“movie” or“scene” affix intheclient’s mindthatsheisoncemore theoneandonlyanswer tohermother’s needs. interpreted asarequest avoided asitwould forhelpandthatpossibilityhastobescrupulously giver andprovider forthoseinternallyimagined,needyfigures. Anymomentofeye contactis with theclientawakens an immediate, reflexive response toonceagain takeon the role ofthe the role-player doesnotlookattheclient.For we have foundthatanyinstantofeye contact by theclientwhere tostandorsit.It that even duringthisstage-managingmoment, iscrucial do not make eye contact with the client.” Then the role-player takes the role and is instructed four-year-old,” thetherapistsaystorole-player, “For therest ofthetimeyou are intherole, toofficiallytakethe role, saying,“Iwill instructed role-play your imageof your motherasa highlight acriticalissuethathastobeattendedatthismoment.Aftertherole-player is and pickssomeonefrom thegroup uponwhomtoproject thatimageofhermother. Letme represent theimageofyour mother as a four-year-old?” The client looks about theroom vacuum theycreate will“suck in” thecompassionate,justice-desiring“instinct” intheclient. where her mother’s husband should have been. Both holes have to be filled appropriately or the represented here. One istheholewhere hermother’s fathershouldhave been,andtheotheris in bothmindandbody. From whattheclienthasjustsaid,there are now twoHoles-in-Roles hastremendousand unconscious,itnevertheless consequencesforthedispositionofenergy justiceand countershape-completion towhatisseen. Though this process is totallyautomatic and pictures, inthemind’s eye, makemovements inthemind’s bodytoresolve andbring mind, thoughshehasnever “seen” itbutonly“heard” aboutit. To repeat, storiesmake pictures, mother takecare ofthehouse.”Asshedescribesthisscene itissurely beingplayed outinher to thoseimages( through hermind( those words thatimagesofhermother’s unhappinessare consciouslyandunconsciouslyflashing ALBERT PESSO The therapist suggests the following. “Why don’tThe therapistsuggeststhefollowing. “Why you picksomeoneorsomething to “Well, herfatherdiedwhenshewasonlyfouryears old,andshehadtopitchinhelpher wasshesounhappy?”thetherapistasks. “Why “She wasalwaysunhappy,” theclientanswers. You canbesure thatwhentheclientsays The reader mustsurely directive have notedthatthetherapistisbeingvery andactive, which So, aftertherole-player isappropriately placed, thetherapistsays,“Now picksomeone do see ). ). You canalsobesure thathermind’s bodyisautomaticallyresponding this symbolic,positive reconstruction ofthenegative pastitwillbehermother’s Ideal Father own emotions,feelings,andthoughtsasaguideforwhattheIdeal Father shoulddo. Now, in in thisarrangementtheclientcanbesafelylicensedtouseinformationarisingfrom her structure whentheclientisoncenter-stageandreceiver ofneeds. but is a viewer in the “audience”. Those procedures are in contrast to those moments in the representing hermother as a four-year-old. In thisevent, the clientdoes not have arole toplay in-Roles thetherapistasksclienttoplacehiminrelationship constructions), tothefigure why thetherapisttakesleadwhenever thisrepetition pitfallappearsabouttobeplayed out. “repetition compulsion” )Freud, 1975),andthisoutcomeshouldbestrongly avoided. That is of theprinciple ofanIdeal Mother, i.e. someonewhohadbeenraised tomaturityandwhowas emerging, maturationally evolved mother-imagecould alsobeunderstoodasanembodiment have beenabletobecome asanadulthadshebeenfathered likethisinher childhood. That feelings. is theappearanceofhopeonher faceandprobably anincreased sensationof hopeinherbody walls intheroom anddefinitelynotturnedinward. Thefuture hasopened upabit,andthere be lookingoutfrom intothespacearound eyes herandnotsolimited by focusedfurther the of thefuture beginstochange.At once,theclient’s gaze reflects thischange. She appearsto different.” Once again,thisphraseistypical.Changeone’s andthentheperception history privilege offeelingthealiveness thataccompaniesthisshiftofenergy. have immediately been made available to her own personal self. She now has the pleasure and that should have been available for her own life — has now been retracted and those energies fathertohermother alltheseyears —drainingenergyresourcesthat wasactingasavirtual In oftheclient comes withthissatisfyingintervention. myimagination, the pseudo-podpart It the changeingaze andposture isstunningtoseetheshiftinenergyandalertness, that like this.It isasifthere wasauniversal scriptandauniversal effectthat goesalongwithit. shoulders —Ifeellighter.” Ihave heard thoseexactwords hundreds oftimesinstructures a shiftoffeelinginherbackandshoulders.She says,“Ifeelasifaburden wasliftedoffmy your mother.’” the witnesswouldsay, ‘Iseehow touchedyou are asyou imaginehow thiswouldhave beenfor assent andglancesatthetherapist,tearsinhereyes. The therapistsays,“If awitnesswere here with you all the time as you grew up.” Hearing and seeing this, the client nods her head in your Ideal Father, Iwouldnothave diedwhenyou were fouryears old,Iwouldhave beenthere that itisright. the arrangement,stepsbacktolookatitandthennodsherheadtherapistindicating member representing theIdeal Father andtosmileathim. The client,havingchoreographed child. thatrole-playerThe therapistinstructs Ideal Mother tolookupatthefaceofgroup role-player andplacesthemaround theshouldersoffigure representing hermotherasa imagination. had endlessly/tirelessly triedtoprovide herwith,inunconscious,mind’s body, see-do outexactlywhatshewouldhave likedhermothertoreceive likely who willcarry —andvery The client,withthetherapist’s overview, proceeds todothis. The therapistknows that Once theIdeal Father isonthestageorestablishedinthis“movie” (whatwe calltheHoles- Accompanying theclient’s exclamation isanemergingpicture ofhow hermother would The clientsays,“If mymother hadbeenfathered likethat,mywholelifewouldhave been The clientnodsinagreement, thenheaves asigh ofrelief andmakesagesture thatindicates theIdealThe therapisttheninstructs Father figure tosaythechildfigure, “If Ihadbeen It ismoving andimpressive towatchthissequence.She takesthehandsandarmsof FILLING THEHOLES-IN-ROLES 81 INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL THE ART AND SCIENCE OF SOMATIC PRAXIS 82 INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL THE ART AND SCIENCE OF SOMATIC PRAXIS me getitstraight inmyheadnow.” She closeshereyes andassemblesadifferent picture inher of your realmother andnopart mother.” her role anditscorollary. The role-player thensays,“Iamrole-playing your real brother’s Ideal believable.” Then thetherapistasksgroup memberenrolled asthe Ideal Mother torestate client answers, “You’re right,I’m to imaginemyreal mothersayingthatanditisjustnot trying for him.” hold him,hereally ofmecanhardly neededme,andpart believe thatshewouldreally bethere looks backattherole-player representing herbrother andsays,“IfeellikeIshouldbethere to been there totakecare ofhimandputtobed. says thatshewouldnever have lefthimandhissisteraloneatnight,sheherselfwouldhave Ideal Mother onceagain.Asceneisplayed outwhere theIdeal Mother, attheclient’s request, to represent his Ideal Mother. The client choreographs the setting and settles back with her client choosingonepersontorepresent herbrother whenhewasalittleboy andanotherperson him hisown Ideal Mother. Which waywouldyou prefer togo?” him, andhewouldbewithyou andyour Ideal Mother, orwe canmakeanothermovie andgive is takingcare ofhim?” can continueforseveral minutes. insecurity ofthepastare literallyside-by-side inhermind.Relief andgriefcycles ofthiskind between theexperienceofsafetythathasbeensoendlesslylongedforandterror and at knowing how muchshehadmissedthisrelief. well upintheclient’s eyes, andshecriesonceagainbutthistimewithoutterror butwithgrief her faceandinthewayshereleases herbreath. This iswitnessedappropriately butthentears client reacts atoncetothatstatementandfeelstherelief ofthatresponsibility, whichshows on Mother, Iwouldnothave leftyou aloneatnighttobeinchargeofyour littlebrother.” The night tobeinchargeofherlittlebrother. The role-player thensays,“If Ihadbeenyour Ideal The client snuggles intothemotherandasksher to saythatshewould never leave her aloneat about whomtherest ofthecastwillassemble. is no longer making a movie that she will be the audience of, but she will be the central figure do you at this want point, to “Where place me?” Foras is customary at this juncture the client role-play your Ideal Mother ofyour real andnopart mother.” Then thegroup memberadds, dismissive attitudeandresponse tothesameofferjustsomeminutesago. idea.” The shifttoacceptanceissopronounced thatitcouldseemasifshenever hadherearlier similarly well raisedby herown Ideal Father?” can now say, do you think of enrolling an Ideal “What Mother for yourself now, who had been the possibilityofexperiencinganIdeal Mother forherself. The therapist,noticingthiseffect, mother beingsatisfied by alivingfather, theclientismoving closertobecoming receptive to now ableandready toraisethenextgenerationeffectively. With thatimageinmind,ofher ALBERT PESSO The clientarrangestherole-player inawaythatepitomizes achild-motherrelationship. She looksabouttheroom andchoosesoneofthefemalesingroup whothensays,“Iwill No rolling oftheeyes andcynicismnow from theclientwhosimplysays,“That’s agood “Yes,” theclientsays,“You’re topicture myreal right,Iwastrying motherdoingthat. Let are you seeing in yourThe therapist asks,“Who mind’s eye asyou look over there?” The Upon hearingthistheclientrelaxes intothearmsofherown further Ideal Mother, butthen “Let’s give him his own Ideal Mother,” the client decides. That scene is then set up with the wouldyou liketodohere?” thetherapistasks.“You“What canhave someonerole-play Then the client sits up and says, “I’ve had enough, now I’m worried about my brother, who This isatypicalpatternseeninmanysessions,theshiftfrom relief togriefasthecontrast “That wouldhave beenmyjob,“That notyours,” thenshereturns tobeinginthemovie by turning from the role-player representing her little brother and direct her gaze to the client and then say, But now theIdeal Mother role-player/actor onthescreen tolookaway outsideherisinstructed screens (theoneintheroom andtheonein her mind’s eye asshereconstructs itinteriorly). the membersofaudience.Remember, theclientissimplyaudiencewatchingdual automatically, and instantaneously fill the Hole in the for her mother.Role ofa partner Indeed, the clientwould immediatelyrespond to aseemingrequest forinteraction andunwittingly, or makeeye-contact withherfrom thatmoment on.For ifshedid,asIunderlined before, young woman”, andthen,onceagain,thisrole player istoldtonever lookdirectly attheclient make thecontractforrole, by saying,“I’m role-playing your imageofyour real motherasa counter-shape hermother’s asayoung woman. needforpartnering to be amovie partner beginningforhermotherasawifeandthistime withaperfect ofanew forhermother,create history anew priortotheremembered painful,actualhistory. This will mother’s withheractualfather, misery thisroute istaken.In thiscase,we are endeavoring to that much-laterscenariopossibilityandtooffsetthereproduction andrepresentation ofher her motherifhaddivorced herfatherandmarriedadifferent man.So, tooffset father. For indeed, it is possible and likely that she fantasized how things would have been for a picture ofwhathermotherwouldhave lookedlikefollowing thepossibledivorce ofher is madesothatthenextstepwillbeclearlyasceneoffirst marriageforthemotherandnot a young woman.” hermotherasayoung woman?” The reader mightask,“Why That choice deserved.” love herandgive herthetime,attention,love, andrespect you your alwaysknew mother and give heranIdeal Husband. Not asecondhusbandbutanidealfirstwhowould don’ttherapist says,“Why we bringinsomeonetorepresent your motherasayoung woman to mymothereither.” just meandmymother. He wasnever around enoughwhenIwaslittle,andhewasn’t kind very abouthavinganIdealsaying, “What Father aswell?” juncture, ismissing atthisparticular andthetherapistnotesthatby something ofsymmetry her breathing maychange;shetakealongbreath andexhaleitwithasenseofclosure. But that she is finished. She maycloseher eyes andnod herhead in reaction to herinner scenes; at that spot for she shows subtle changes in gaze, is over tone, and words that the story and viewer astheindicatorsofwholenessandcompletionbecomeevident. The clientseemstobe relishing even more theexperienceofbeingsimplyachildandnotsurrogate parent. her headtolookattherole-player representing theclient’s littlebrother. in WoodyAllen’s useful fortheclient to experience a cinematic illusion called “breaking the 4thwall” asseen night withhissisterandwouldhave beenthere totakecare ofhimandputtobedherself now.” The role-player repeats thesamesentencethatshewouldnever have lefthimaloneat mind’s eye and then opens her eyes and says to the role-player, “Say what you said to him again The clientsayswithrelief, Iwouldn’t “Then have hadtodoit.”At this pointitissometimes The clientpicksawomanfrom thegroup, thatrole-player andthetherapistinstructs to That sceneisthensetup. The therapistsays,“Pick someonetorole-play your motheras “Okay,” theclientsayswithrisinginterest, “Iwouldliketoseewhatthatlooklike.” andnotingtheclient’sBeing conservative resistance totakeinorreceive fathering,the wantshim here anyway,”“Who the client says cynically. “I’m with comfortable perfectly Structures follow anorganicprocess, andwhentheyare over itisevidenttotheoutside arelief,”“What theclientsaysandsnugglesdeeperintoarmsofherown Ideal Mother, Purple Rose ofCairo where theactorsleave thescreen andspeakdirectly to FILLING THEHOLES-IN-ROLES

83 INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL THE ART AND SCIENCE OF SOMATIC PRAXIS 84 INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL THE ART AND SCIENCE OF SOMATIC PRAXIS I hadbeenyour Ideal husband Iwouldhave toldyou how muchIlove you.” The client might Husband thenplaceshis armaround therole-player representing herreal mother andsays,“If shoulder andtellherhow muchheloves her.” The role-player representing hermother’s Ideal how itcouldhave beenforyour mothertohave aloving idealhusband.’” witness were present thewitnesswouldsay, ‘Iseehow muchpleasure you feelasyou imagine to thisimaginedsceneofcompatibility. That couldbewitnessedby thetherapistsaying,“If a a replay ofthepast. that the therapist monitor such moments that mightunintentionally representit is important their preoccupation withdoingagoodjoblookofgrimdeterminationontheirfaces.So case thatsomerole-players, intentondoing agoodjobfortheclient,unwittinglycommunicate young womansmilewithpleasure figure. asshelooksatherpartner In fact,ithasoftenbeenthe interaction withapartner. It thattherole-player isalsoimportant representing hermotherasa the clientfor she isseeingwhatcould be forthefirsttime hermotherengagedin apositive her mother’s Ideal Husband. Such and has an immediate effect on a moment is important the role-player representing her real mother to look into the eyes of the role-player representing the twofigures together, side-by-side. Thetherapistcanonceagainbedirective here andinstruct ofherreal nopart father’sambitions andthathewascarrying andqualities. history whowouldhave lovedpartner hermotherandbeenthere forherdreams asasupport and a choice,thetherapistshouldbebitdirective andremind theclientthatthiswasideal the emptyspaceoncemore asaHoles-in-Roles filler. In theevent thattheclientmakessuch asitwasandthusdrawtheclientinto wouldsimplyunderlineandreinforceapart thehistory as playersa realization far apart and representation of those actual memories. Seeing them far images ofdistancebetween hermotherandfather, andshewould most likelyplacetheserole- moment, fraughtwithpotentialpitfalls,forinalloftheclient’s ithasbeenreplete with history ofyour realno part father.” The therapist then says,“Now place him.” This is animportant toenroll byand heisinstructed saying,“Iamplayingyour real mother’s Ideal Husband and potentialities. In otherwords, justicewouldhave prevailed. own dreams aboutherfuture andnothave hindered herdevelopment ortherealization ofher therapist wouldaddthatthisIdeal Husband hermotherinfulfilling wouldhave supported would have allowed her mother to be fulfilled andstill be partnered. In this circumstance, the a happy, fulfillingmarriageforthemother—stillleavingopenthatnooneotherthanherself married atall.” This isokay, butinthismomenttheclientmaybeholdingoffpossibilityof young woman,withsomuchpromise andtalent.She wouldhave flowered ifshedidn’t get that shecouldbehappilymarriedinthefirstplace.” Husband.” The therapistmightadd,“Not hersecondhusband,butanidealfirstso be the appropriate place, and then the therapist says, “Now pick someone to role-play her Ideal where tostandandwhere toface. The clientplacestherole-player atwhatseemstotheclient watches therole-player tomakesure thatshedoesn’t lookattheclientinorder toascertain reinforced. she isreleased responsibility from partnering andburden, isnot andthusthatnegative history she hasmostlikelyunconsciouslyfulfilledthatfunctionherentire life. In this representation, ALBERT PESSO In passing,theclientmightnostalgicallyreminisce andsay, “My motherwassuchabeautiful The therapistsaystotheclient,“Place her.” The clientdoessoasthetherapistalertly “Yes,” the client might say and add, “Now I would like to see him put his arm around her If allgoeswell, thecontentedsmileonclient’s faceshows how positively sheisreacting Let’s imaginethat thosepitfallswere dealtwithappropriately, andtheclienthasnow placed Going on,theclientpickssomeonefrom thegroup torole-play hermother’s Ideal Husband, a different conclusiontowhatwasbefore anendlesssenseoflosswithnoexpectationrelief a hopelessgriefbutcoupledwithrelief atseeingamore justclosure. This sceneprovides results in clients wellingoften the pain of that up history with tears. But now, she is not feeling vividcontrasttowhatshehadactuallyseeninhermother’ssatisfaction presents avery lifeand which regularly occurs the moment a longed-for alternative isexperienced. image of This new her mother’s naturalcycle, lifewithherfatherhadactuallybeen.Once again,thisisavery being cared for, andinthenextinstantgriefthatisevoked by remembering justhow painful much, andIwouldnever walkawayfrom you whenyou were crying.” from herwhenshewascrying.” The role-player thensayssimplythosewords, “Ilove you very say, “Never mindthat.Just tellheryou love muchandthatyou wouldnever walkaway hervery have felttobeinyour ideal parents’ armswhenyou were ayoung child.’” present thewitnesswould say, ‘Iseehow contentedyou feelasyou experiencehow itwould bliss comingover herface. you were achild.’” The clientagrees, andtheydeliver thatmessage. Parents wouldsay, ‘If we had beenyour Ideal Parents, we wouldhave heldyou likethiswhen might say. reach above herandpullthearmsofrole-players around her. “Hold melikethis,”she been andcouldhave beenwithmypicture ofwhatIdeal Parents couldbelike.” shifting, shemightsay, “Yes, now Ihave itclearer inmymind;thisisthewayitshould have immediately becamelessbelievable.” andThen, aftersomemomentsofinternalsorting mind’s eye asyou lookupatyour Ideal Parents.” the therapistmightsay, “Make sure you are notseeingthefacesofyour real parents inyour feelingtolookupandseethetwoofthem togetherlikethat.” awonderful “What To besafe, indicating thefigures inthescenefront ofher. “Sit besideherandputyour armaround myIdeal Mother likehedidwithmyreal mother,” Father ofyour real andnopart father.” The client,stillinthearmsofIdeal Mother says, the room andchoosesoneofthemen.He tosay, isinstructed “Iamrole-playing your Ideal to receive forthemselves. when theweb offamilynetworks iscompleteare peoplefullyready, willing,andable previously offered possibilitywouldfeel.Andhere ofthisarticle. we cometothecrux Now, in marked contrast,sheisprimed,ready, andeagertoexplore andexperience how that resistant theclienthadbeentosuggestionofanIdeal Father before thisscenewasprovided? can experiencehow itwouldhave beentobethechildofasimilarlycontentedcouple.” for thetherapisttosay, “How aboutchoosingsomeonetorole-play your Ideal Father so you together likethat.If Ihad,mywholelifewouldhave beendifferent.” This wouldbethetime in thefuture. The client’s reaction here isinteresting. First shefeelstherelief ofimagininghermother “I couldstayhere forever,” theclientmightsay. The therapistcouldsay, “Would you like To underlineandanchor thismoment,thetherapistmightsay, “If there wasawitness theclient mightsay. iswonderful,” “This “Ifeelsosafeandcozynow,” alookofinnocent The therapistmightsay, inorder toplaceatimelineonthescene,“Perhaps theIdeal With relief andcontentmentshemightthensnuggle between thetwoofthemandthen “You’re right,”theclientmightsay. toimagineitwasthem,andthey “Iwastrying She looks up at the two of her own Ideal Parents with satisfaction and pleasure, and says, “Pick someonetorole-play your Ideal Father,” thetherapistsays. The clientlooksabout “Yes,” shesays,“Iwouldliketofeelhow thatcouldhave beenlike.”Remember how Following thosesequencestheclientmighteventually say, “Wow, Inever sawmyparents FILLING THEHOLES-IN-ROLES Only 85 INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL THE ART AND SCIENCE OF SOMATIC PRAXIS 86 INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL THE ART AND SCIENCE OF SOMATIC PRAXIS client mightsay, “No, I’m notlettinggoofthem.” The therapistmightthensay, “Do you therapist thensays, “Are you ready tode-role your Ideal Parents?” jest, the Often, inpartial client accompaniesby makingthesamewipingmove aswasdoneforthe Voice Figure. The role-player ineachsceneturnfollows thatprocedure. boy, I am”andthentheysaytheirown nametoendtheircontract asthatrole-player. Each appropriate de-roling statementssuchas,“Iamnolongerrole-playing your brother asalittle client says,“First mylittlebrother withhisIdeal Parents.” Those role-players thensaytheir Ideal parents. Usually theclientde-roles eachsceneinreverse order, soitislikelythatthe thatthelast figureswithout sayingthatitisimportant tobede-roled should betheclient’s Figure whatmovie shallwe hadbeenlocated.“Then de-role first?”thetherapistasks. It goes before.” The clientmakesa gesture ofwipingawaythatarea where thatimage ofthe Voice simply thegroup room the room cleared ofthepastinorder ofalltheartifacts forthearena to becomeoncemore therapist says,“It looks likeyou are finished,isthatright?” which willpowerfully influencehow shelives inthepresent andanticipatesthefuture. The and shehasputtheevent intothepast,andwe havememory, madeasatisfying,symbolic,new deeply connectedandresonating withmemoriesofherpast.But now the structure isover, throughout. She inanaltered wascertainly statebutfullyaware ofthepresent, whilealso among themtorole-play forhervarious figures. She hasbeenontwolevels simultaneously known allalongthatsheisinthetherapyroom withherfellow group members,choosing present withthepastnow more inthebackground. and sohastheclient,returned from animmersion inthedeepmemoriesofpastinto is anorganicprocess, withabeginning,middle,andanend.Andnow theendhasarrived on clients’ faceswhenastructure isover. This phenomenonindicatestomethatastructure at the therapist, now clearly as an adult in the present — for there is a totally different look breathing changesandafterasigh,ormarked exhalation,theclientopenshereyes, looks minutes assheanchorsthosememoriesandsensationsinhermindbody. Slowly her that age,arelaxed lookofpleasure andrelief glowing onherface. There issilenceforsome ofyourself —inyour mind’syour senseandmemory body—asachildofthree orfour.” faces, thefeelingsofcozycontentmentyou feelinside—allofthosefeelings,linkthemto their armsaround you, thefeelingsinyour backasyou snuggleintothem,thelookoftheir what you wouldhave feltasachild.So deliver allyour bodilysensations—thecontactof contentment andsnugglingthatyou are feelinginthepresent momentwouldbeprecisely emotionally false. to children, along,longtimeisforever, sothisstatementisanexaggeration,butitnot isinternalized itisindeedthere foreverthe memory tobetastedandre-tasted endlessly. Also, with us forever?’” This is not to say that this is a realistic wish but in fact to suggest that if the Ideal Parents tosay, ‘If we hadbeenyour Ideal Parents you couldhave stayed likethis ALBERT PESSO The clientcloses her eyes andsinksinto the sensationofhow itwouldhave beenat willsaythat,butbefore theydo,imagine thatthesefeelingsofThe therapistsays,“They The clientsays,“Yes, Iwouldliketohearthat.” Then the therapist says, “Let’s de-role the Witness Figure that was in the air,” which the The therapistsays,“First let’s takeoutoftheair Voice Figure thatwe hadposited “Yes,” saystheclient,“Iam.”Now theritualofenrollment is about tobereversed, and “Are you ready forthede-roling?” thetherapistasks. “Yes,” theclientsays,nodding. This is not to say that the client has been out of contact with the present, for she has Psychology, Warneken, F. & Tomasello, M.(2009). The roots ofhumanaltruism. those new memories firmlyinplace,theclientisableto those new return to her real lifewithmore hope filled by theappropriate persons,whichhadanimmediateeffectonherabilityto receive. With and moviesinterventions that were made gaveto see those network her the opportunity holes could have provided herwithwhatsheneeded.Her own capacityforreceiving wasblocked. The inthestructure.process astheywatchedorparticipated following astructure thatallows thegroup memberstoexpress whathappenedintheirown where theyhadbeenseatedintheroom before thestructure began. got itinsideofmenow.” The Ideal figures thenmakethede-roling statementsand return to morewant a few moments to anchor that feeling?” Or, the client might say, “No, I’ve really Stern, D.(1986). Pesso, A.(1997). Humphrey, N.(1986). Freud, S.(1975). Freud, S.(1910). The originanddevelopment ofpsychoanalysis. Erikson, E.(1964). Edelman, G.M.& Tononi, G.(2000). Damasio, A.(1999).Chapters2,9.In A.Damasio, Bowlby, J.(1969). REFERENCES Email: [email protected] Website: www.pbsp.com sees individualsinBoston,Massachusetts. continues his intensive training schedule in the US and Europe and also leads programs and a frequent lecturer atuniversities, hospitalsandclinicsintheUSEurope. At present, he Mind” distributedby Icarus Films. He onPBSP, istheauthorofmanybooksandarticles and in The Democratic Republic film,“State ofCongohave beenfeatured inadocumentary of in many countries in Europe. He and his work with PBSP for the German GTZ Mission VA Hospital. He hasconductedtrainingprograms inPBSPtheUS,Brazil, Israel, and at McLean Hospital inMassachusetts, andConsultantinPsychiatric Research attheBoston and Director oftheDance Division atEmerson College, Supervisor ofPsychomotor Therapy Psychomotor, andPresident ofthe Psychomotor Institute, Inc. wasformerlyAssociateProfessor Pesso,Albert co-founderwithhiswife,Diane Boyden-Pesso, ofPBSP, Pesso Boyden System BIOGRAPHY depression, dread, doom,ordisaster. Happiness isindeedanattainablepossibility. become reduced and bound, allowing her to feel strong emotions without the consequence of Shedeserve. isno longer the omnipotent healer of herfamily network. The entity energies have and optimism,aswell asareadiness toreceive therewards andlove herpersonalityandtalent So there itis.At thebeginningclientwas simplyunabletoimagineanyfigure who The therapistsays,“Let’s takesometimeforsharing.”Sharing istheusualprocedure touch: Aguidetobody-centered therapies. Norton &Company. Psychology NY. W. W. Norton &Co. emotion inthemakingofconsciousness. (100),450-471. , 21(2),196-218. Pbsp: Pesso Boyden systempsychomotor. Beyond thepleasure principle The interpersonalworld oftheinfant Attachment andloss. Childhood andsociety The innereye. Oxford, UK:Oxford University Press. A universe ofconsciousness. (2nd ed.).New York: Basic Books. . Homburger, 1964;reprinted 1993,New York, ). Orlando, FL:Harcourt Brace. Wheaton, IL: Theosophical Publishing House. . (Standard Edition). New York, NY: W. W. The feelingofwhathappens:Bodyand . New York, NY. Basic Books. In C.Caldwell (Ed.), FILLING THEHOLES-IN-ROLES New York, NY: Basic Books. American Journal of British Journal of Getting in 87 INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL THE ART AND SCIENCE OF SOMATIC PRAXIS 88 INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL THE ART AND SCIENCE OF SOMATIC PRAXIS programmes inclinicalandsomaticpsychology. andbehaviouralneurosciencefamily medicine,psychiatry at Wayne State University, hehasdirected several graduate 1 cannolongerbe seenastotallyseparate andtheobserver causality), where theobserved relativity oftime,particle-wave-duality, relation, theuncertainty correlations ratherthan tell aboutauniverse of entanglement, ofinterdependency (quantumphysics: theory capitalism andglobalization. things” (p. 25):civilized, indicative ofmodernvalues, andwell acceptedinthespheres of other tothemind. These polarizationshadprogressively beenseen asthe“natural order of people of the third world and people of color. Along these lines, the bodyisalsotreated as about manipulates theviews in which the male, Western, white, Christian, dominant power structure governs and the bodyandguidedby theknowledge andthe vision ofsomaticpsychology” (p.21). therapies experience asthefoundationandoriginationofallexperiential potential.”Asfor that focusesonourlivingexperienceofembodimentashuman beingsandthatrecognizes this psychotherapy bodymind therapy. no longercredible asascience,andthatpsychology willbecome predicts thatpsychoanalysis willnolongerbemuchinevidenceandcognitive behaviourism togetawayfrom representationsat thepresent, trying “inthehead” dichotomy between psyche andsoma.Barratt arguesthatthedisciplinesare atacrossroads philosophical, cultural and neurobiological evidence can bridge the reductionistic no longerpossibletomaintain. body. In that light, the values we hold today of high margins of profit and possessions are considering theimplicationsitcouldhave forreally working withspiritualhealingofthe what itmeanstobehumanandhealsuffering.His bookisalsopoliticalwhen and Easternattitudestoward therapy. Underlying considerations of itall,hepleadsfornew wide stanceonthethemeofpsyche andsoma,givinganexcellent ofboth overview Western energy medicinetograspabroad conclusionforsomaticpsychology. Barratt’s booktakesa body psychotherapists andunitesaspectsofhistory, philosophy, culture, neurobiology and disciplinehecalls“Somatic tothenew Psychology,”pertinent quotesmanywell-known the reader before agoodoverview delvingintothecontent.Barratt, collectingthemes withapresentationchapter starts ofthe themes discussedandtheoriespresented, giving Contemporary” (7chapters),and“Current Challenges:Possible Futures” (5chapters). Each three sections:“Introducing aNew Discipline” (5chapters),“Sources: Ancientand MSc CHRISTINA BADER-JOHANSSON, Barnaby Barratt isapsychoanalyst, sexualityeducator, sextherapist andsomaticpsychologist. Asaformerprofessor of Barnaby Barratt’s This hasgraduallychangedas advances inthephysicalsciences,awarded Nobel prizes, asthetimeHe oftheend ofthe19thand20thcentury gives anhistoricalsurvey Barratt defines More andmore disciplinesofpsychotherapy andpsychology are realizing that , heencapsulatesthemas:“the healingpracticethatisgrounded inthewisdomof The EmergenceofSomaticPsychologyand somatic psychology somatic psychology A Review ofBarnabyB. Barratt Christina Bader-Johansson, MSc Emergence and Bodymind of Somatic Psychology Therapy the other Bodymind Therapy as follows: “the psychology ofthebody, thediscipline , considered tobenature, aswell aswomen and 1 somatic psychology and somatic psychology ’s about thebody. He

contains bodymind the chapter on neuroscience Barratt briefly describes the polyvagal theory, mirror neurons, what isknown aboutthebrain’s functioninghasbeendiscovered inthepastdecade.In Barratt gives some vignettes of therapeuticinteractionto illustrate this.Ninety percent of in whichtheemergenceofsomaticpsychology andbodymindtherapiesistobearticulated. before themattercomesintoexistence.Intention comesbefore action. This isthecontext enableddialogueabout world whichhasfurther Western scienceandBuddhist thinking. Barratt also honors the Dalai Lama’s exile as a gift to the North American and European been confirmed by moderntheoriesofnonlineardynamicsystemsandcomplexitytheories. which there are nodichotomiesofsubject/object,man/nature, ormind/body, nondualityhas entities. Already foretold inthe Vedic, Buddhist, Taoist andmanyindigenousteachingsin - The movement ofbodyfluids isessentialtothemaintenance ofhealth. - mechanisms. The body possessesself-regulatory of subtleenergies. - The structure andfunctionofthebodyare reciprocally interrelated, aswell astheflow - The bodyandthemind interactinandasoneunit. widely applicabletomanymodalities ofbodywork. These principlesinclude: stimulate self-expression. He presents someprinciplesorempiricallawsthathefinds massage, dancetherapy, andfree-form expressionist dance,whichliberatethebodyand the liveliness oflifeitself! a procedure ofpoliticalorsocioculturaladaptation.Healing isinherently acelebrationof Healing isnottheavoidance ofpain.Healing isnottheavoidance ofdeath.Healing isnot touching inthesenseofethical,physicalpalpationandrespectful, emotionalengagement. moving withawareness, andc)theappreciative connectivityoftouchingwithawareness: individual andhisorherecology, b)mobilizingenergiesby intentionallybreathing and ofhonoring-by-listening toallaspectsofthefactors forhealing:a)theimportance spiritual process whichpresupposes safety, andintimacy. trust He describessomerequisite spiritual potentialofthebodymindcomponents.Healing thepsyche isanethical and shifttowardsan important abroader understanding sociology, andculturalstudiesdemonstratehow anincreasing interest inthebodyindicates the increasing interest inbodymindtherapies.Such diverse disciplinesasanthropology, philosophers likeHabermas, Husserl, Bergson andMerleau-Ponty andtheirinfluenceon and thatitacknowledges theprimacyofembodiedexperience.Barrett mentions intothepsyche subjectmatterofanyinquiry establishes, humanexperienceastheprimary in hisbook, context,asexemplifiedin amodern,criticalandconstructive by thethoughtsof Gallagher around thezeitgeist shared by Freud, Rank,Reich, Ferenczi, Balint andothers,putsit in itspotentialtoheal(p.45). In somechaptersheexhaustively continues thediscourse approach totreatment thatfocusessolelyon oneoftheaspectsisdoomedtobelimited conflicts asmuchitinvolves the verbalization ofmental representations. Therefore, an complex andgradualprocess —involves thesomaticexpression ofaperson’s internal machine (p. 123).He makesthepointthatcharacterchange—whichisinvariably a imageofacerebral inoffsettingtheCartesian mindthatgovernsdo theirpart thebodily cell,allofwhichcertainly thatisencodedinevery vascular communicationandmemory In thisnew-to-the-West lineofthinking,thequalityamaterialevent isdetermined Barratt describessome Western traditionsofbodywork, suchasosteopathy, chiropractic, Instead of manipulating the body from the outside, Barratt sees healing as an inherently The significanceoftheemergencesomaticpsychology isthatitestablishes,or re- How theBodyShapes theMind (2005). of thepsychology ofthebody. A REVIEWOFBARNABY B.BARRATT 89 INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL THE ART AND SCIENCE OF SOMATIC PRAXIS 90 INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL THE ART AND SCIENCE OF SOMATIC PRAXIS and practitioner of Tantric meditation. In additiontohis35-year career asa psychotherapist, practice, aswell asforhiswork as asexualityeducator, sex therapist,somaticpsychologist, internationally recognized forhiscontributionstopsychodynamic philosophy, and theory Barnaby B.Barratt PhD, DHSisapracticing psychoanalytic healerandteacher, BIOGRAPHIES person presenting thenext chapterandthegroup againreflecting. presenting onechapterandthegroup reflecting anddiscussingitindepth,thenanother go. My suggestion is to read it in the form of a Scandinavian study circle, with one person outstanding, but the dense 234 pages of content admittedly are not easy to digest in one world. Are we aware oftheimmenseimpact we couldhave? of liberation and thus contribute to radical political and economic transformation in the discipline ofsomaticpsychology couldhave avitalrole in theelaborationofpsychology is stillachallengetomainstream psychology andmedicine. The questionisinwhatwaythe global culturalchangeisrequired forhumanbeings toevolve onthis planet, heargues. This of identityinauniverse ofnon-lineardynamicinterdependence. Indeed, nothinglessthan social oppression. to spiritualawakeningwhichincludesaplayful,joyful experienceofsexualityfreed from Heof whichneedtobecriticallydiscussedanddeconstructed. champions abodilypath and optimized “products”: themediaideal,medicalandeconomicall experiences ofsexuality. He describesthe Western culture ofembodiment inthree alienated is mentionedinitsdeterioratedforms,suchasabuse,incestandothertraumatizing books onbodypsychotherapy forcompletelyavoiding thesubject.Instead, sexuality has beendonewithinthestudyofphenomenologicalsexualityandhecriticizes modern inherent Sexualityin thechapter“The ofBeing Human”. He little pointsoutthatvery (p. 107). an “astral body” orsubtleenergybodywhichyogic sciencehasknown aboutformillennia our embodimentisnotmerely physical.It alsohasa“supra-physical” doubleinthatthere is increased awareness. Currently, Western scienceisbeingchallengedtoacknowledge that being. ofourpersonalityareparts emotionally contactedandbrought backtotheembodied shamanic practicesandtranspersonalpsychologies. In shamanicsoul-travels, dissociated were influenced by Suzuki, Barratt informsus. He concludes withabriefdescriptionof his lectures atColumbiaUniversity. It iswell known thatJung, Fromm, Watts andMerton Tibetan the work tradition in the diaspora after 1949 and in byparticular D.T. Suzuki and of yoga, prana, chi, nadis, meridians, chakras and kundalini. He values the teachings of the towards relationship. more iterationsinacontemporary lessfearful constructive, Dance movement - therapyallows fortherecapitulation objectrelationships ofearlydestructive - Movement improvisation allows waysofbeing. thepatienttoexperimentwithnew - Movement reflects personality. MSc CHRISTINA BADER-JOHANSSON, The Easternreligions allincludeyoga teachings asapathwaytospiritualgrowth and Barratt then presents the influx of Asian healing disciplines with detailed descriptions I highlyrecommend thisbook! This bookisamustforallbodypsychotherapists. Reviews ofitsofarhave been In thechapter“Oppression andMomentum ofLiberation”, Barratt discussestheissue Barratt hasadeepknowledge ofhealthysexualityandsexualtherapy, whichhepresents Email: [email protected] available inSwedish. working onabookaboutthenature offreedom. seventy professional andbookchapters. andscientificarticles, reviews He iscurrently Somatic Psychology andBodymind Therapy (2010).Additionally, hehaspublishedover (2005), What is Tantric Practice? (2006),LiberatingEros (2009),and The Emergence of (2004), Sexual Health andErotic Freedom (2005), Ten Keys toSuccessful Sexual Partnering Psychoanalysis andthePostmodern Impulse (1993), The Way ofthe‘BodyPrayerPath’ Dr. Barratt is the author of eight books: Psychic Reality and Psychoanalytic Knowing (1984), and Professor ofPsychology atNorthcentral University. practicing inSouth Africa,Dr. Barratt wasmostrecently Provost (ChiefAcademic Officer) as Harvard University, theUniversity ofMichigan, and Wayne State University. Currently ofteachinginhighereducation,atsuchinstitutionshe hasadistinguishedhistory the authorof (EABP) andPresident oftheSwiss National Associationof theEABP(CH-EABP).She is Christina Bader-Johansson, MSc, is a psychotherapist (ASP),bodypsychotherapist Email: [email protected] Movement andInteraction (Studentlitteratur 2012) whichiscurrently only A REVIEWOFBARNABY B.BARRATT 91 INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL THE ART AND SCIENCE OF SOMATIC PRAXIS 92 INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL THE ART AND SCIENCE OF SOMATIC PRAXIS INTERNATIONAL BODYINTERNATIONAL PSYCHOTHERAPY JOURNAL (formerly US Association for Body Psychotherapy Journal) US Association for (formerly Two-year subscription: Members € Payment through bank transfer, American Express or PayPal. 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Please note, To ensure theconfidentiality of All articles are Allarticles peerreviewed by three It isaconditionofpublication 95 INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL THE ART AND SCIENCE OF SOMATIC PRAXIS INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL THE ART AND SCIENCE OF SOMATIC PRAXIS INCORPORATING US ASSOCIATION FOR BODY PSYCHOTHERAPY JOURNAL volume twelve ● number two ● fall 2013

TABLE OF CONTENTS

4 Editorial Jacqueline A. Carleton, PhD

7 The Present as Morphogenesis Stanley Keleman

ARTICLES

9 Idealism & The Goals of a Psychotherapeutic Process Michael C. Heller, PhD

39 Body Image Disorders Bernhard Schlage, MA

50 Military Culture and Body Psychotherapy: A Case Study Diana Houghton Whiting, MA

63 Filling the Holes-in-Roles of the Past With the Right People at the Right Time A way to open the door to happiness in the present Albert Pesso

BOOK REVIEW

88 A Review of Barnaby B. Barratt’s The Emergence of Somatic Psychology and Bodymind Therapy Christina Bader-Johansson, MSc

E UROPEAN A SSOCIATION FOR B ODY- P SYCHOTHERAPY EABP

Journal (ISSN 2169-4745)